Digital Commons Network^™

Experience With The Quantitative Lyta Gene Real-Time Polymerase Chain Reaction For The Detection Of Streptococcus Pneumoniae From Pediatric Whole Blood In Pakistan, Furqan Kabir, Sahrish Muneer, Adil Kalam, Ana Sami, Shahida Qureshi, Aneeta Hotwani, Atif Riaz, Syed Mohiuddin, Mohammad Tahir Yousafzai, Sara Hussain, Syed Asad Ali, Sadia Shakoor

Department of Paediatrics and Child Health

Background: We present our experience with optimization and diagnostic use of quantitative real-time polymerase chain reaction (PCR) targeting the lytA gene of Streptococcus pneumoniae for the detection of S. pneumoniae in whole blood of children ≥5 CFU/10 μl or 1 copy of DNA/2 μl of blood.
Methods: This assay was applied on 1912 whole blood specimens collected from children pneumonia, of which 35 specimens were lytA positive. The bacterial loads were determined through categorization of load into five different categories, i.e., very high load, high load, moderate load, low load, and very low load.
Results: Of the 35 lytA-positive …

Age And Sex Normalization Of Intestinal Permeability Measures For The Improved Assessment Of Enteropathy In Infancy And Early Childhood: Results From The Mal-Ed Study, Margaret N. Kosek, Gwenyth O. Lee, Richard L. Guerrant, Rashidul Haque, Gagandeep Kang, Tahmeed Ahmed, Pascal Bessong, Syed Asad Ali, Shahida Qureshi, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Objectives: The aim of the study was to describe changes in intestinal permeability in early childhood in diverse epidemiologic settings.
Methods: In a birth cohort study, the lactulose:mannitol (L:M) test was administered to 1980 children at 4 time points in the first 24 months of life in 8 countries. Data from the Brazil site with an incidence of diarrhea similar to that seen in the United States and no growth faltering was used as an internal study reference to derive age- and sex-specific z scores for mannitol and lactulose recoveries and the L:M ratio.
Results: A total of 6602 tests …

Physician Attitudes Toward The Ethics Of Pre-Exposure Prophylaxis (Prep): Cost, Safety, And Resource Allocation, Jessica Grippo, Stacy W. Smallwood, Katherine Pincura, Tamara Wright, William A. Mase

Journal of the Georgia Public Health Association

Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP.

Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for …

Helping Public Health Professionals Access Infectious Disease Trainings And Resources: The Region Iv Phtc Infectious Diseases Training Database, Laura M. Lloyd, Lisa Mccormick, Melissa Alperin, Michelle Carvalho, Cidney Wilson, Brita Bergland, Arti Patel, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The Region IV Public Health Training Center (R-IV PHTC), located at Emory University’s Rollins School of Public Health, has a mission that includes providing training and educational offerings to strengthen the competency of the current public health workforce in HHS Region IV (which includes GA). Additionally, the R-IV PHTC has been charged with serving as a national resource in the area of infectious disease. To fulfill this charge, the R-IV PHTC conducted an environmental scan to identify and increase access to existing infectious disease trainings and resources currently available to the public health workforce.

Methods: From June 2015 – …

Towards A New Profession: Counselor Professional Identity In Italy. A Delphi Study, Davide Mariotti

Counseling & Human Services Theses & Dissertations

Counseling is a young profession compared to other mental health professions in Italy. The lack of agreement about counselor professional identity appears to have a negative impact on counselors. This situation has also led potential clients to confuse counselors with other mental health professionals. Because of this, the future development of counseling in Italy appears closely linked to a stronger counselor professional identity. The purpose of this Delphi study is to establish a consensus list among expert counselors of the distinctive elements that characterize counselor professional identity in Italy

Coliphage As An Indicator Of The Quality Of Beach Water To Protect The Health Of Swimmers In Coastal Georgia, Javier Gallard-Gongora, Kathryn Munck, Jeff Jones, Asli Aslan

Journal of the Georgia Public Health Association

Background: Gastrointestinal disease affects millions of people in the United States and places a substantial economic burden upon healthcare systems. Recreational waters polluted with fecal material are a main source for transmission of gastrointestinal disease. Georgia beaches are monitored for the presence of fecal indicator bacteria, but these bacteria are not well associated with enteric viruses. The United States Environmental Protection Agency (US EPA) has recently proposed coliphage (a virus of Escherichia coli) as an alternative indicator of fecal contamination in recreational waters. The present study compares fecal indicator bacteria and coliphage concentrations at two Georgia beaches with adjacent creeks …

Screening For Syphilis In Cases Of Suspected Gonorrhea And Chlamydia Infections, Kumara Nibhanipudi, K Cody

NYMC Faculty Publications

Background. In all cases of suspected sexually transmitted infections (STIs), it has been routine practice to screen for syphilis with a blood sample. The incidence of syphilis seems to be lower than that of commonly screened STIs. Objective. The objective of our study was to determine whether it is cost-effective to screen for syphilis with serological testing in cases of suspected gonorrhea and chlamydia infections. Hypothesis. Our hypothesis is that it is not cost-effective to screen for syphilis in cases of presumed gonorrhea and chlamydia infections. Methods. Our study is a New York Medical College institutional …

C-Safe: A Computer-Delivered Sexual Health Promotion Program For Latinas, Charles H. Klein, Tamara Kuhn, Midori Altamirano, Carmela Lomonaco

Anthropology Faculty Publications and Presentations

This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days …

Biology, Saint Mary's College Of California

Academic Catalog

No abstract provided.

Parents’ Perspectives On Caring For Children After Solid Organ Transplant, Stacee M. Lerret, Norah L. Johnson, Kristin Haglund

College of Nursing Faculty Research and Publications

Purpose

To explore parents’ experiences of the transition from hospital to home and complex chronic illness management following their children's solid organ transplant (SOT).

Design and Methods

Qualitative component of a larger mixed methods longitudinal study. Parents of SOT recipients were interviewed three times following hospital discharge from five major pediatric transplant hospitals in the United States.

Results

Analysis of parent interviews (N = 48) resulted in three themes that characterized the phases of transition to home and complex chronic illness care. Three themes, corresponding to the three time periods of data collection, included “getting back to normal” at 3 …

Managing Risk During Care Transitions When Approaching End Of Life: A Qualitative Study Of Patients’ And Health Care Professionals’ Decision Making, Ma Coombs, R Parker, K De Vries

School of Nursing and Midwifery

Background: Increasing importance is being placed on the coordination of services at the end of life. Aim: To describe decision-making processes that influence transitions in care when approaching the end of life. Design: Qualitative study using field observations and longitudinal semi-structured interviews. Setting/participants: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand. The Supportive and Palliative Care Indicators Tool was used to identify participants with advanced and progressive illness. Patients and family members were interviewed on recruitment and 3–4 months later. Four weeks of fieldwork were …

Neuropsychiatric Aspects Of Infectious Diseases: An Update, Sahil Munjal, Stephen J. Ferrando, Zachary Freyberg

NYMC Faculty Publications

Among the critically ill, infectious diseases can play a significant role in the etiology of neuropsychiatric disturbances. All critical care physicians are familiar with delirium as a secondary complication of systemic infection. This article focuses on key infectious diseases that commonly and directly produce neuropsychiatric symptoms, including direct infection of the central nervous system, human immunodeficiency virus infection, and AIDS.

Reducing Antibiotic Use In Pediatric Upper Respiratory Infection: A Multifaceted Parent-Clinician Approach, Sydnee H. Lucas Dnp, Aprn, Sydney Thompson Dnp, Arnp, Fnp-Bc

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The goal of this QI initiative was to decrease inappropriate antibiotic for the treatment of pediatric upper respiratory infection (URI) in the retail clinic setting. The approach included the use of a protocol to treat viral upper respiratory illness, a visual aid decision-making tool for guideline adherence, prescription pad for nonprescription remedies, and shared decision-making techniques for providers to involve patients and parents in management plans regarding nonprescription remedies, supportive treatment, and signs and symptoms that would warrant a return visit. An improvement trend during the first 3 months of the initiative showed a shift in antibiotic avoidance from a …

Evaluation Of Multiple Interventions Using A Stepped Wedge Design, Vivian H. Lyons, Lingyu Li, James Hughes, Ali Rowhani-Rahbar

UW Biostatistics Working Paper Series

Background: Stepped wedge cluster randomized trials are a class of unidirectional crossover studies that have historically been limited to evaluating a single intervention. This design is especially suitable for pragmatic trials where the study feasibility can be improved with a phased introduction of the intervention. We examined variations of stepped wedge designs that would support evaluation of multiple interventions. Methods: We propose four different design variants for implementing a stepped wedge trial with two interventions: concurrent design, supplementation, replacement, and factorial designs. Analyses were conducted comparing the precision of the estimated intervention effects for the different designs. Results: Concurrent, …

The University Of San Francisco Fact Book And Almanac 2017 Mid-Year Edition, Alan Ziajka

USF Fact Book and Almanac

No abstract provided.

Clinical Characteristic And Prevalence Of Invasive Candidiasis Patient In Cipto Mangunkusumo Hospital, Kemal Fariz Kalista, Lie Khie Chen, Retno Wahyuningsih, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Incidence of invasive fungal infections (IFI) are reportedly increasing in many countries. Candida is the most common cause of IFI. This study was conducted to determine the prevalence, clinical characteristics, and etiologic pathogen in adult patients with invasive candidiasis (IC) at Cipto Mangunkusumo Hhospital. Methods. This was a cross sectional study with restropective data collection fromof septic patients that’ medical records hospitalized in January 2012 until June 2014. Subjects were selected based on EORTC/MSG 2008 diagnostic criteria for IC. Demographic data, clinical and supporting data, diagnosis, etiologic pathogens, antibiotics, antifungal, outcome, and length of stay were recorded. Results. The …

Healthy Immigrants? Exploring Country Of Origin, Pre-Immigration Experiences, And Acculturation In Relationship To U.S. Immigrants’ Health, Ynesse Abdul-Malak

Dissertations - ALL

Immigrants belonging to some racial/ethnic minority groups might not be benefitting from the healthy migrant effect. With data from the New Immigrant Survey (2003), which includes immigrants from Mexico, Haiti, Dominican Republic, Cuba, and Jamaica, I examine the odds of three health outcomes, chronic conditions, depressive symptoms, and fair or poor self-rated health using a series of logistic regression analyses. I draw on segmented assimilation and the cumulative inequality theories to understand and explicate the extent to which immigrants’ demographic characteristics, pre-immigration experiences, and acculturation in the U.S. might have an impact on immigrants’ health outcomes. Compared to Mexican immigrants, …

Analisis Pembiayaan Program Promotif Dan Preventif Pemberantasan Demam Berdarah Dengue (Dbd) Bersumber Pemerintah Di Kota Semarang Tahun 2013-2015, Nisa Kamila, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

In 2010–2014, Semarang was involved as the big three city with high incidence rate of dengue in Central Java province. This study aimed to analyze the financing by the local government for Dengue preventive program in 2013-2015, as well as the resources gap. The health account approach was used to analyze spending by source, function, and provider. Total local government spending for dengue in 2013 were IDR 4.018.927.020,- increased by 101% in 2014 and increased by 218% in 2015. The largest expenditure for Dengue Preventive program is epidemiological surveillance and infectious disease control. There was no gap between available resources …

Evaluation Of T-Spot Tb Test To Detection Tuberculosis In Al- Muthanna Province, Haider Hameed Mitab

Muthanna Medical Journal

Tuberculosis (TB) stands as a major public health problem worldwide. The rapid diagnosis of individuals with active TB and detection of individuals with latent TB and rapid introduction of effective treatment to prevent them from spreading of disease. The aim of study was to evaluation the IGRA in the diagnosis of TB in comparison to other tests (conventional and molecular tests) during the period from October/2015 to June/2016 in advisory clinic for respiratory diseases and thoracic in Al-Samawa city in Al- Muthanna province. Sixty sputum and blood specimens were taken in this study was conducted with randomly selected people for …

Macrolides Selectively Inhibit Mutant Kcnj5 Potassium Channels That Cause Aldosterone-Producing Adenoma, Ute Scholl, Laura Abriola, Chengbiao Zhang, Esther Reimer, Mark Plummer, Wenhui Wang, Richard Lifton

NYMC Faculty Publications

Aldosterone-producing adenomas (APAs) are benign tumors of the adrenal gland that constitutively produce the salt-retaining steroid hormone aldosterone and cause millions of cases of severe hypertension worldwide. Either of 2 somatic mutations in the potassium channel KCNJ5 (G151R and L168R, hereafter referred to as KCNJ5MUT) in adrenocortical cells account for half of APAs worldwide. These mutations alter channel selectivity to allow abnormal Na+ conductance, resulting in membrane depolarization, calcium influx, aldosterone production, and cell proliferation. Because APA diagnosis requires a difficult invasive procedure, patients often remain undiagnosed and inadequately treated. Inhibitors of KCNJ5MUT could allow noninvasive diagnosis and therapy of …

Predicting Death Over 8 Years In A Prospective Cohort Of Hiv-Infected Women: The Women's Interagency Hiv Study, Deborah Gustafson, Qiuhu Shi, Susan Holman, Howard Minkoff, Mardge Cohen, Michael Plankey, Donald Hoover

NYMC Faculty Publications

OBJECTIVES: Predicting mortality in middle-aged HIV-infected (HIV+) women on antiretroviral therapies (ART) is important for understanding the impact of HIV infection. Several health indices have been used to predict mortality in women with HIV infection. We evaluated: (1) an HIV biological index, Veterans Aging Cohort Study (VACS); (2) a physical index, Fried Frailty Index (FFI); and (3) a mental health index, Center for Epidemiologic Studies-Depression (CES-D). Proportional hazards regression analyses were used to predict death and included relevant covariates.

DESIGN: Prospective, observational cohort.

SETTING: Multicentre, across six sites in the USA.

PARTICIPANTS: 1385 multirace/ethnic ART-experienced HIV+ women in 2005.

PRIMARY …

Capacity Of Blood Plasma Is Higher In Birds Breeding In Radioactively Contaminated Areas, Magdalena Ruiz-Rodríguez, Anders P. Møller, Timothy Mousseau, Juan J. Soler

Faculty Publications

Background Environmental pollution in general, and radioactive contamination in particular, may deeply affect host-parasite relationships and their consequences for the evolution of organisms. The nuclear accident that occurred more than 30 years ago in Chernobyl resulted in significant changes in diversity and richness of microbial communities that could influence characteristics of animal-bacteria interactions, including host immune responses and competitive interference by bacteria. Given the high mortality rate of birds breeding in radioactively contaminated zones, those with stronger defences against infections should experience significant fitness advantages.

Methodology/Principal Findings Here we characterized antimicrobial capacity of barn swallows (Hirundo rustica) from different Ukrainian …

Barriers To Treatment With Buprenorphine For Opioid Addiction In New Mexico, Kanwal Qidwai

Biomedical Sciences ETDs

More persons died from drug overdoses in the United States since 2000 than during any past years on record. There were approximately one and a half times more drug overdose deaths in the United States than deaths from motor vehicle crashes in 2015. Opioids, primarily prescription pain relievers and heroin, are the main drugs associated with overdose deaths. The 2014 data demonstrates that the United States opioid overdose epidemic includes two distinct but interrelated trends: a 15-year increase in overdose deaths involving prescription opioid pain relievers along with a recent rise in illicit opioid overdose deaths, driven by heroin. Natural …

Nlrp9b Inflammasome Restricts Rotavirus Infection In Intestinal Epithelial Cells, Shu Zhu, Siyuan Ding, Penghua Wang, Zheng Wei, Wen Pan, Noah Palm, Richard Flavell

NYMC Faculty Publications

Rotavirus, a leading cause of severe gastroenteritis and diarrhoea in young children, accounts for around 215,000 deaths annually worldwide. Rotavirus specifically infects the intestinal epithelial cells in the host small intestine and has evolved strategies to antagonize interferon and NF-κB signalling, raising the question as to whether other host factors participate in antiviral responses in intestinal mucosa. The mechanism by which enteric viruses are sensed and restricted in vivo, especially by NOD-like receptor (NLR) inflammasomes, is largely unknown. Here we uncover and mechanistically characterize the NLR Nlrp9b that is specifically expressed in intestinal epithelial cells and restricts rotavirus infection. Our …

Taiwanese Perceptions Of Refugees: Results Of An Experimental Survey, Stella Treumann

Mahurin Honors College Capstone Experience/Thesis Projects

This research paper deals with perceptions of refugees, with the intent to demonstrate what factors influence perceptions of refugees in general, and specifically in the context of Taiwan. The paper is divided into two larger sections. The first section functions as a literature review with the aim of providing the reader with existing background information on the topic of perceptions of refugees. The second section contains an experimental study on perceptions of refugees in Taiwan. While the effects of individual-level factors on perceptions of refugees have been examined by many studies and in different countries, their effects have never been …

Finding A Link Between Circadian Rhythms And The Immune System Of Captive Zebra Finches (Taeniopygia Guttata), Amber Bishop

Mahurin Honors College Capstone Experience/Thesis Projects

Circadian rhythms are commonplace in organisms and are normally controlled by a master clock. More recent evidence suggests that autonomous clocks operate in various systems in the body, including the immune system. This study looks for such a connection between the circadian rhythm and the immune system. In this study, captive zebra finches (Taeniopygia guttata) were exposed to different light and dark cycles and blood samples were taken every six hours. Birds were exposed to 12 hours of light and then 12 hours of darkness (LD), 24 hours of darkness (DD), or 48 hours of DD. After collecting …

Numerically Solving A System Of Pdes Modeling Chronic Wounds Treated With Oxygen Therapy, Stefan Stryker

Mahurin Honors College Capstone Experience/Thesis Projects

Chronic wounds such as diabetic foot ulcers are the leading cause of non-traumatic amputations in developed countries. For researchers to better understand the physiology of these wounds, a mathematical model describing oxygen levels at the wound site can be used to help predict healing responses. The model utilizes equations that are modified from work by Guffey (2015) that consists of four variables – oxygen, bacteria, neutrophils, and chemoattractant within a system of partial differential equations. Our research focuses on numerically solving these partial differential equations using a finite volume approach. This numerical solver will be important for future research in …

Disseminated Nocardia Cyriacigeorgia Causing Pancreatitis In A Haploidentical Stem Cell Transplant Recipient., Jason Chen, Md, Jonathan Pan, Md, Joanne Filicko-O'Hara, Margaret Kasner, Phyllis Flomenberg

Department of Medicine Faculty Papers

We report the first published case of acute pancreatitis secondary to disseminated nocardiosis in a hematopoietic stem cell transplant (HSCT) recipient on chronic immunosuppression for graft-versus-host disease (GVHD). Nocardiosis in the HSCT population is relatively rare, and has not yet been described in haploidentical HSCT recipients. Our patient is a 28-year-old male with a history of haploidentical HSCT and GVHD of the skin and lung who was admitted to the hospital with acute pancreatitis. The workup for the etiology of his pancreatitis was initially unrevealing. He subsequently developed worsening sepsis and respiratory failure despite broad spectrum antimicrobials. After multiple bronchoscopies …

Point-Of-Care Testing For Toxoplasma Gondii Igg/Igm Using Toxoplasma Ict Igg-Igm Test With Sera From The United States And Implications For Developing Countries, Ian J. Begeman, Joseph Lykins, Ying Zhou, Bo Shiun Lai, Pauline Levinge, Kamal El Bissati, Kenneth Boyer, Shawn Withers, Fatima Clouser, A. Gwendolyn Noble, Peter Rabiah, Charles N. Swisher, Peter T. Heydemann, Depina G. Contopoulos-Ioannidis, Jose G. Montoya, Yvonne Maldonado, Raymund Ramirez, Cindy Press, Eileen Stillwaggon, François Peyron, Rima Mcleod

Economics Faculty Publications

Background

Congenital toxoplasmosis is a serious but preventable and treatable disease. Gestational screening facilitates early detection and treatment of primary acquisition. Thus, fetal infection can be promptly diagnosed and treated and outcomes can be improved.

Methods

We tested 180 sera with the Toxoplasma ICT IgG-IgM point-of-care (POC) test. Sera were from 116 chronically infected persons (48 serotype II; 14 serotype I-III; 25 serotype I-IIIa; 28 serotype Atypical, haplogroup 12; 1 not typed). These represent strains of parasites infecting mothers of congenitally infected children in the U.S. 51 seronegative samples and 13 samples from recently infected persons known to be IgG/IgM …

A Study Of Ticks And Tick-Borne Livestock Pathogens In Pakistan, Shahid Karim, Khemraj Budachetri, Nabanita Mukherjee, Jaclyn Williams, Asma Kausar, Muhammad Jawadul Hassan, Steven W. Adamson, Scot E. Dowd, Dmitry Apanskevich, Abdullah Arijo, Zia Uddin Sindhu, Muhammad Azam Kakar, Raja Muhammad Dilpazir Khan, Shafiq Ullah, Muhammad Sohail Sajid, Abid Ali, Zafar Iqbal

Faculty Publications

Background

As obligate blood-feeding arthropods, ticks transmit pathogens to humans and domestic animals more often than other arthropod vectors. Livestock farming plays a vital role in the rural economy of Pakistan, and tick infestation causes serious problems with it. However, research on tick species diversity and tick-borne pathogens has rarely been conducted in Pakistan. In this study, a systematic investigation of the tick species infesting livestock in different ecological regions of Pakistan was conducted to determine the microbiome and pathobiome diversity in the indigenous ticks.

Methodology/Principal findings A total of 3,866 tick specimens were morphologically identified as 19 different tick …