Digital Commons Network^™

Rationale, Design And Respondent Characteristics Of The 2013–2014 New York City Health And Nutrition Examination Survey (Nyc Hanes 2013–2014), Lorna E. Thorpe, Carolyn Greene, Amy Freeman, Elisabeth Snell, Jesica S. Rodriguez-Lopez, Martin Frankel, Amado Punsalang Jr., Claudia Chernov, Elizabeth Lurie, Mark Friedman, Ram Koppaka, Sharon E. Perlman

Publications and Research

Purpose. Capacity to monitor non-communicable diseases (NCDs) at state or local levels is limited. Emerging approaches include using biomeasures and electronic health record (EHR) data. In 2004, New York City (NYC) performed a population-based health study on adult residents using biomeasures (NYC Health and Nutrition Examination Study, or NYC HANES), modeled after NHANES. A second NYC HANES was launched in 2013 to examine change over time, evaluate municipal policies, and validate a proposed EHR-based surveillance system. We describe the rationale and methods of NYC HANES 2013–2014.

Methods. NYC HANES was a population-based, cross-sectional survey of NYC adults using three-stage cluster …

Intermingled Klebsiella Pneumoniae Populations Between Retail Meats And Human Urinary Tract Infections, Gregg S. Davis, Kara Waits, Lora Nordstrom, Brett Weaver, Maliha Aziz, Lance B. Price, +8 Additional Authors

Environmental and Occupational Health Faculty Publications

Background. Klebsiella pneumoniae is a common colonizer of the gastrointestinal tract of humans, companion animals, and livestock. To better understand potential contributions of foodborne K. pneumoniae to human clinical infections, we compared K. pneumoniae isolates from retail meat products and human clinical specimens to assess their similarity based on antibiotic resistance, genetic relatedness, and virulence.

Methods. Klebsiella pneumoniae was isolated from retail meats from Flagstaff grocery stores in 2012 and from urine and blood specimens from Flagstaff Medical Center in 2011–2012. Isolates underwent antibiotic susceptibility testing and whole-genome sequencing. Genetic relatedness of the isolates was assessed using multilocus sequence typing …

Using Whole Genome Analysis To Examine Recombination Across Diverse Sequence Types Of Staphylococcus Aureus, Elizabeth M. Driebe, Jason W. Sahl, Chandler Roe, Jolene R. Bowers, James M. Schupp, Lance B. Price, +11 Additional Authors

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus is an important clinical pathogen worldwide and understanding this organism's phylogeny and, in particular, the role of recombination, is important both to understand the overall spread of virulent lineages and to characterize outbreaks. To further elucidate the phylogeny of S. aureus, 35 diverse strains were sequenced using whole genome sequencing. In addition, 29 publicly available whole genome sequences were included to create a single nucleotide polymorphism (SNP)-based phylogenetic tree encompassing 11 distinct lineages. All strains of a particular sequence type fell into the same clade with clear groupings of the major clonal complexes of CC8, CC5, …

The Role Of Community Pharmacy-Based Vaccination In The Usa: Current Practice And Future Directions, Albert Bach, Jeffery A. Goad

Pharmacy Faculty Articles and Research

Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number …

Airborne Infection In Healthcare Environments: Implications To Hospital Corridor Design, Ehsan Mousavi

Department of Construction Engineering and Management: Dissertations, Theses, and Student Research

Several studies have linked nosocomial transmission airborne diseases to airflow in healthcare settings. Quasi-experimental methods are developed to observe the aerodynamic transport behavior of synthetic respiratory particles in corridors of a hospital. Computational models, validated by experimental results, are then developed to explore the spatial relationships of supply-exhaust air ventilation in patient corridors. The aim of this study is to determine optimal HVAC design strategies to contain and remove airborne contaminants in healthcare environments.

In addition to occupant comfort, hospital HVAC systems are designed to provide ventilation and directional airflow to contain, dilute and remove contaminants including airborne disease. Of …

Child Marriage Legislation In The Asia-Pacific Region, Elisa Scolaro, Aleksandra Blagojevic, Brigitte Fillion, Venkatraman Chandra-Mouli, Lale Say, Joar Svanemyr, Marleen Temmerman

Obstetrics and Gynaecology, East Africa

Child marriage is a human rights violation that robs a girl of her childhood, puts her health, growth, and development at risk, disrupts her education, limits her opportunities for empowerment and social development, and increases her risk of exposure to violence and abuse (for a review of the evidence on the negative effects of child marriage on girls and their children, see Parsons et al. 2015, in this issue). While child marriage is not mentioned specifically in the 1989 Convention on the Rights of the Child (CRC), the Convention does contain a provision requiring governments to abolish “traditional practices prejudicial …

Noroviruses As A Cause Of Diarrhea In Immunocompromised Pediatric Hematopoietic Stem Cell And Solid Organ Transplant Recipients, X. Ye, J. N. Van, F. M. Munoz, P. A. Revell, Claudia A. Korinetz, R. A. Krance, R. L. Atmar, M. K. Estes, H. L. Koo

ETSU Faculty Works

Case reports describe significant norovirus gastroenteritis morbidity in immunocompromised patients. We evaluated norovirus pathogenesis in prospectively enrolled solid organ (SOT) and hematopoietic stem cell transplant (HSCT) patients with diarrhea who presented to Texas Children's Hospital and submitted stool for enteric testing. Noroviruses were detected by real-time reverse transcription polymerase chain reaction. Clinical outcomes of norovirus diarrhea and non-norovirus diarrhea patients, matched by transplanted organ type, were compared. Norovirus infection was identified in 25 (22%) of 116 patients, more frequently than other enteropathogens. Fifty percent of norovirus patients experienced diarrhea lasting ≥14 days, with median duration of 12.5 days (range 1–324 …

A Combination Sms And Transportation Reimbursement Intervention To Improve Hiv Care Following Abnormal Cd4 Test Results In Rural Uganda: A Prospective Observational Cohort Study, Mark J. Siedner, Data Santorino, Alexander J. Lankowski, Michael Kanyesigye, Mwebesa B. Bwana, Jessica E. Haberer, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Up to 50 % of HIV-infected persons in sub-Saharan Africa are lost from care between HIV diagnosis and antiretroviral therapy (ART) initiation. Structural barriers, including cost of transportation to clinic and poor communication systems, are major contributors.

Methods: We conducted a prospective, pragmatic, before-and-after clinical trial to evaluate a combination mobile health and transportation reimbursement intervention to improve care at a publicly operated HIV clinic in Uganda. Patients undergoing CD4 count testing were enrolled, and clinicians selected a result threshold that would prompt early return for ART initiation or further care. Participants enrolled in the pre-intervention period (January – …

A Study Of A Simulated Infectious Disease On Healthcare Workers' Reaction, Knowledge, Attitudes, And Performance Towards Hand Hygiene, Lydia Wigglesworth-Ballard

Health Services Research Dissertations

Problem Statement. The high rate of healthcare worker-patient contact provides many opportunities for exposure to pathogens, which creates challenges in assessing healthcare workers' success at preventing healthcare associated infections caused by these dangerous pathogens.

Methods. This study explored the effects of a simulated infectious disease on healthcare workers' hand hygiene knowledge, attitudes, performance, and reactions using Kirkpatrick's Four levels of Evaluation. The study utilized a mixed method pre-test – 2 post-test design. The dependent variables were hand hygiene knowledge, attitudes toward hand hygiene guidelines, hand hygiene performance, and reaction to the overall experience. Data was collected three times over a …

Familiarity With And Preferences For Oral And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis (Prep) In A National Sample Of Gay And Bisexual Men In The U.S., Jeffrey T. Parsons, H. Jonathan Rendina, Thomas H.F. Whitfield, Christian Grov

Publications and Research

Objectives: We sought to determine preferences for oral versus long-acting injectable (LAI) PrEP among gay and bisexual men (GBM).

Methods: We surveyed a national U.S. sample of 1,071 GBM about forms of PrEP.

Results: Overall, 46.0% preferred LAI, 14.3% oral, 21.7% whichever was most effective, 10.1% had no preference, and 7.8% would not take PrEP. There were no differences in PrEP preferences by race/ethnicity, income, region of residence, or relationship status. Those unwilling to take PrEP were significantly older than those who preferred LAI PrEP and those who would take either. Those who preferred the most effective …

Middle East Respiratory Syndrome: A Global Health Challenge, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

Beginning in May 2015, Middle-East respiratory syndrome (MERS) experienced its first publicly reported “super-spreading” event in South Korea. By mid-June, more than 120 cases and 11 deaths in South Korea had been linked to a businessman returning from travel to Bahrain, United Arab Emirates, the Kingdom of Saudi Arabia and Qatar. Globally more than 1200 had been infected of whom more than 450 died—a high fatality rate of 37%.

What are the most effective legal, social, and public health responses to MERS and other emerging diseases? First, the World Health Organization’s International Health Regulations (IHR) did not effectively guide the …

Penile Microbiota And Female Partner Bacterial Vaginosis In Rakai, Uganda, Cindy M. Liu, Bruce A. Hungate, Aaron A.R. Tobian, Jacques Ravel, Lance B. Price, +8 Additional Authors

Environmental and Occupational Health Faculty Publications

Bacterial vaginosis (BV) is a common vaginal bacterial imbalance associated with risk for HIV and poor gynecologic and obstetric outcomes. Male circumcision reduces BV-associated bacteria on the penis and decreases BV in female partners, but the link between penile microbiota and female partner BV is not well understood. We tested the hypothesis that having a female partner with BV increases BV-associated bacteria in uncircumcised men. We characterized penile microbiota composition and density (i.e., the quantity of bacteria per swab) by broad-coverage 16S rRNA gene-based sequencing and quantitative PCR (qPCR) in 165 uncircumcised men from Rakai, Uganda. Associations between penile community …

Cronobacter Sakazakii Bacteremia In A 76-Year-Old Woman: A Case Report, Amy Y. Kang, Nancy Garcia, Bhanu Sud, Lee Nguyen

Pharmacy Faculty Articles and Research

Cronobacter sakazakii, commonly found in contaminated infant formula and thereby causes infantile bacteremia, is rarely associated with adult bacteremia. We present the tenth case of C. sakazakii bacteremia in adults. The patient is a 76-year-old woman who resides in a skilled nursing facility and presents with risk factors including bullous pemphigoid, Type II diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, and anemia. The therapy was started with intravenous ciprofloxacin and vancomycinempirically. After consultation with an Infectious Diseases specialist, ciprofloxacin and vancomycin was replaced with meropenem based on the patient’s extensive bullous lesions, history of ESBL infections, and possible pneumonia. Later, …

The Biological Consequences Of Kaolin Geophagia, Deloris Alexander, Desire Richardson, Lakisha Odom, Kara Cromwell, Dejuana Grant, Micoya Myers, Eddy Cadet, Hamid Mahama, Vijaya Rangari, Ralphenia Pace, Ramble Ankumah, Kokoasse Kpomblekou-A, Curtis Fluker

Professional Agricultural Workers Journal

Abstract

Kaolin geophagia is associated with the relief of gastrointestinal distress, but it may also cause adverse health effects on the body. This study was designed to: assess kaolin composition; test if 129SvEv mice would consume kaolin and determine the consequences of consumption; and assess rotational stress modulation of consumption. Thirteen kaolin samples were purchased from Alabama and Georgia stores. Chemical and physical properties were characterized for each sample using a Munsell chart, pH meter, Energy Dispersive Spectroscopy, Transmission Electron Microscopy, Visible Near-InfraRed Spectra, and Inductively Coupled Plasma-Optical Emission Spectrometry. Kaolin was then given to mice as food supplements and …

Commencement Program 2015, Loma Linda University

Commencement Programs

CONTENTS

1 | Message from the President

3 | 2015 Events of Commencement

5 | The Academic Procession

7 | Significance of Academic Regalia

9 | The Good Samaritan

10 | University History Highlights

12 | Loma Linda University Song - "Healing Love"

13 | The Speakers

23 | The University Honorees

45 | The School Honorees

72 | The Programs

• School of Medicine, 73
• School of Pharmacy, 95
• School of Dentistry, 103
• School of Allied Health Professions, 122
• School of Allied Health Professions - Physical Therapy, 143
• School of Public Health, 154
• School of Behavioral Health and School of …

Public Health At Risk: The Conscious Choice To Refuse Vaccinations Threatens Public Health

DePaul Magazine

Public health officials declared that measles had been eliminated from the United States after only 15 measles cases were reported between 1998 and 2001 and 90 percent of schoolchildren had been inoculated against the disease. Yet, in 2014, there were more than 660 documented measles cases in the country, the most in 20 years. This uptick started in the late 1990s, when a growing number of parents began refusing to inoculate their children with some or all of the recommended vaccines. Various factors fed their decision: an increase in the number of vaccines given in the first year of life, …

World Sepsis Day In Pakistan, Madiha Hashmi

Department of Anaesthesia

Celebration of World Sepsis Day at a global level started just three years back, and the immense importance of this celebration was not lost to Pakistan Society of Anaesthesiologists (PSA) and Pakistan Society of Critical Care Medicine (PSCCM). Both these organizations were quick to grasp the opportunity to use it to achieve the common goal of enhancing the level of awareness about sepsis and prevention of sepsis among the healthcare professionals as well as higher authorities. The result was multiple international academic events being organized regularly across the country as well as the adoption of National Sepsis Guidelines. The struggle …

Stigma Masyarakat Terhadap Orang Dengan Hiv/Aids, Zahroh Shaluhiyah, Syamsulhuda Budi Musthofa, Bagoes Widjanarko

Kesmas

Kabupaten Grobogan merupakan kabupaten dengan peningkatan kasus HIV/AIDS cukup tajam dibandingkan kabupaten lain di Jawa Tengah. Penelitian ini bertujuan untuk mengidentifikasi stigma masyarakat terhadap orang dengan HIV/AIDS (ODHA) dan faktor yang memengaruhinya. Penelitian explanatory ini dilakukan melalui pendekatan studi potong lintang dengan sampel berjumlah 300 kepala keluarga yang dipilih menggunakan sampel acak proporsional pada tiga kelurahan dengan kasus HIV tertinggi selama Agustus - September 2014. Pengumpulan data dilakukan melalui wawancara tatap muka menggunakan kuesioner terstruktur. Sedangkan analisis data dilakukan secara univariat, bivariat menggunakan kai kuadrat, dan multivariat menggunakan regresi logistik. Sebagian besar responden adalah laki-laki dengan tingkat pendidikan terbanyak sekolah …

Akses Jaminan Kesehatan Nasional Pada Pekerja Seks Perempuan, Ni Made Sri Nopiyani, Putu Ayu Indrayathi, Rina Listyowati, I Ketut Suarjana, Pande Putu Januraga

Kesmas

Pekerja seks perempuan (PSP) merupakan kelompok yang termarginalkan secara sosial dan memiliki kerentanan yang tinggi terhadap masalah kesehatan. Upaya perluasan Jaminan Kesehatan Nasional (JKN) pada PSP masih terbatas sehingga penting dilakukan untuk mendukung pencapaian universal health coverage. Penelitian ini bertujuan untuk memperoleh gambaran mengenai akses JKN pada PSP di Denpasar. Penelitian ini merupakan studi kualitatif. Data dikumpulkan melalui wawancara mendalam terhadap 15 orang PSP dan empat orang mucikari di Denpasar pada Agustus hingga Oktober 2014. Hasil wawancara diolah dengan analisis tematik. Kerangka analisis yang digunakan adalah The Health Access Livelihood Framework. Kepemilikan JKN pada PSP di Denpasar masih rendah, meskipun …

Isolation Of Mycobacterium Avium From Potable Water In Homes And Institutions Of Patients With Hiv Infection In Finland And The United States, Matti Ristola, Robert D. Arbeit, C. Fordham Von Reyn, C. Robert Horsburgh

Dartmouth Scholarship

Symptomatic disease by nontuberculous mycobacteria has been linked to potable water from institutional and domestic potable water systems. Potable water samples were collected from homes and institutions of patients with AIDS. Colonization of potable water with nontuberculous mycobacteria was demonstrated in 230 (15%) of 1489 samples collected from domestic and institutional water systems of patients with HIV infection in the United States and Finland. Mycobacterium avium was the most common species and colonization was favored at temperatures of 40–50°C in recirculating hot water systems. Such systems are a plausible source of human infection and disease.

Prevalence Of School Nurses In Kentucky And Student Outcomes, Teena Darnell

Graduate Theses, Dissertations, and Capstones

Objective: The purpose of this study was to identify whether the presence of a nurse in the public high school setting was associated student outcomes. Data gleaned from the study will be used to enact a new legislative policy mandating the presence of a nurse in all public schools in the state of Kentucky.

Background: Nurses employed in the school setting support both the educational mission of the institution, as well as the health and well-being of students. Studies have explored the relationships between school nurse presence and student health. It has been suggested that when children experience poor …

Refugee Health And The Kentucky Global Health Center, Rahel Bosson, Ruth M. Carrico

Journal of Refugee & Global Health

In this University of Louisville Grand Rounds lecture, Drs. Rahel Bosson and Ruth Carrico give an overview of the real struggle of the refugee population and provide an update of the current state of refugee health in Kentucky.

They also provide an overview of the Global Health Initiative at University of Louisville, which includes the follow programs: HIV/AIDs, Refugee Health and Immunization, Vaccine and International Travel and Global Health Research Support.

The talk concludes looking to the future with a comprehensive Global Health Center composed of improving refugee orientation and EMR, healthcare worker education, developing guidelines, and bettering our surveillance …

Draft Genome Sequences Of Six Different Staphylococcus Epidermidis Clones, Isolated Individually From Preterm Neonates Presenting With Sepsis At Edinburgh's Royal Infirmary, Paul Walsh, M. Bekaert, J. Carroll, T. Manning, B. Kelly, A. O'Driscoll, X. Lu, C. Smith, P. Dickinson, K. Templeton, P. Ghazal, Roy D. Sleator

Department of Biological Sciences Publications

Herein, we report the draft genome sequences of six individual Staphylococcus epidermidis clones, cultivated from blood taken from different preterm neonatal sepsis patients at the Royal Infirmary, Edinburgh, Scotland, United Kingdom.

Emergence Of Multidrug Resistant Influenza A(H1n1)Pdm09 Virus Variants In An Immunocompromised Child Treated With Oseltamivir And Zanamivir., Daisuke Tamura, Roberta L. Debiasi, Margaret Okomo-Adhiambo, Vasiliy P. Mishin, Angela P. Campbell, Brett Loechelt, Bernhard L. Wiedermann, Alicia M. Fry, Larisa V. Gubareva

Pediatrics Faculty Publications

Prolonged treatment of an immunocompromised child with oseltamivir and zanamivir for A(H1N1)pdm09 virus infection led to the emergence of viruses carrying H275Y and/or E119G in the neuraminidase. When phenotypically evaluated by neuraminidase inhibition, the dual H275Y-E119G substitution caused highly reduced inhibition by four neuraminidase inhibitors including oseltamivir, zanamivir, peramivir and laninamivir.

Tonb Not Directly Related To Efflux Of Antibiotics In E. Coli, Amber Gombash

Honors Projects

Studies in Pseudomonas aeruginosa have suggested that the TonB energy transduction system directly contributes to efflux-mediated antibiotic resistance, ostensibly by energizing one or more efflux systems. We have found ∆tonB strains of Escherichia coli to similarly be more sensitive to certain antibiotics relative to wild-type strains. To test the hypothesis that this enhanced sensitivity involved the energization of efflux systems, sensitivity patterns for a variety of antibiotics were evaluated using a set of strains differentially lacking genes encoding the Acr efflux system, the universal outer membrane efflux portal TolC, and TonB. No correlation was evident between the resistance phenotypes of …

Swords Into Stethoscopes: How The U.S. Military Could Conduct Medical Diplomacy, Oliver Kendall

Political Science Honors Projects

Since the early 1960’s, Cuba and China have won international appreciation by sending doctors abroad to help where they are needed. While there was surprise in some quarters when U.S. military personnel were deployed to combat Ebola in the last months of 2014, the Department of Defense actually has a long history of medical activity. In its current form, DoD medical outreach cannot likely garner soft power in the way that the Chinese and Cuban programs can, but with a few modifications, the U.S. military could be a serious conductor of medical diplomacy that would save countless lives and benefit …

Implementation Of Break Time For Employee Nursing Mothers At The University Of Louisville : A Case Study., Robin Elise Weiss, 1971-

Electronic Theses and Dissertations

This dissertation is a mixed methods look at the barriers to successful implementation of the Break Time for Nursing Mothers provisions of the Affordable Care Act (ACA) at an upper southern-midwestern university. As public health and medical officials push the desire for an increase in breastfeeding initiation and duration, many mothers must overcome barriers within the employment arena. Previous work has failed to look at how the university setting presents unique challenges with a diverse workforce, varied jobs, and differing space availability. In other settings, barriers have been identified; the goal of this dissertation was to identify what the specific …

Rush To Judgment: The Sti-Treatment Trials And Hiv In Sub-Saharan Africa, Eileen Stillwaggon, Larry Sawers

Economics Faculty Publications

Introduction: The extraordinarily high incidence of HIV in sub-Saharan Africa led to the search for cofactor infections that could explain the high rates of transmission in the region. Genital inflammation and lesions caused by sexually transmitted infections (STIs) were a probable mechanism, and numerous observational studies indicated several STI cofactors. Nine out of the ten randomized controlled trials (RCTs), however, failed to demonstrate that treating STIs could lower HIV incidence. We evaluate all 10 trials to determine if their design permits the conclusion, widely believed, that STI treatment is ineffective in reducing HIV incidence.

Discussion: Examination of the …

Adolescent Girls, Human Rights And The Expanding Climate Emergency, Holly G. Atkinson, Judith Bruce

Publications and Research

Many adolescent girls—the poorest girls in the poorest communities—already live in an “emergency.” Humanitarian crises only amplify the call on their coping and caring capacities, while exacerbating their vulnerabilities. The frequency and intensity of emergencies, including natural disasters, conflicts, and infectious disease outbreaks such as Ebola, appear to be growing.¹ These emergencies threaten entire communities and whole countries, often with global implications. Many become virtually permanent. The authors urge key actors responding to both the threats and opportunities that climate change poses to understand adolescent girls as exceptionally at risk on the one hand, and as exceptionally resilient and …

The Paleoepidemiology Of Malaria In The Ancient Near East, Nicole Elizabeth Smith

Graduate Theses and Dissertations

The end of the Late Bronze Age in the Near East (1300 - 1200 BCE) saw the widespread collapse of several large cultural centers, the reasons for which are a subject of continued debate. Evidence from events leading up to this cultural collapse suggest epidemic disease may have factored into the eventual downfall of these early civilizations. Recent DNA analysis from Egyptian mummies who lived during the period leading up to the Late Bronze Age collapse identified malaria in several elite individuals, suggesting the widespread prevalence of this infectious disease in Egypt. However, the exact prevalence, antiquity, and dynamics of …