Clinical Epidemiology Commons^™

Ebola Scare And Measles Resurgence: Mandatory Isolation/Quarantine And Vaccination, Mark C. Aita Md, Takeem T. Ragland Ma

Journal of Health Ethics

Public outcry for radical isolation and quarantine policies followed the first Ebola diagnosis in the United States when Eric Duncan, upon his return home Oct 2014 from West Africa, then in the midst of a catastrophic Ebola epidemic, tested positive for Ebola. Likewise, the Dec 2014 Disneyland measles outbreak unleashed an angry backlash against parents who refused to have their children vaccinated; and there was public momentum to repeal all legal exemptions to mandatory vaccination of school children. This paper presents an ethical and legal analysis to adjudicate the issue which is at stake in both controversies; namely the inherent …

Factors Associated With High Rates Of Antiretroviral Medication Adherence Among Youth Living With Perinatal Hiv In Thailand, Ezer Kang

Department of Psychology Faculty Publications

 Antiretroviral medication adherence behaviour among Thai youth with perinatal HIV in Thailand has received growingattention. However, few studies have examined individual predictors of antiretroviral adherence using multipleself-reports. A convenience sample of 89 Thai youth (interquartile range 14–16 years) with perinatal HIV at threepaediatric programmes in Chiang Mai completed a structured questionnaire and reported their antiretroviral adherencein the past one, seven and 30 days using count-based recall and a visual analog scale. Mean self-reported adherencerates ranged from 83.5% (past 30 days) to 99.8% (yesterday) of the time. One-inflated beta regression models were usedto examine the associations between antiretroviral adherence outcomes, treatment …

Increasing Compliance Of Personal Protective Equipment S Election And Use For Isolation Precautions Among Rns & Nas On A Med-Surg Unit, Megan R. Alsmeyer

Master's Projects and Capstones

Background: Due to the high potential of transferring infectious diseases and/or organisms among patients, themselves, and the community, healthcare workers (HCWs) must be knowledgeable and confident in selecting the appropriate type of personal protective equipment (PPE), and the use in technique when putting on (donning) and removing (doffing) PPE based on the level of isolation precautions required for the patient being cared for.

Project Purpose: The purpose of this project is to determine whether assessing the knowledge and actual practice with observing, and utilizing an innovative approach of video and educational tools to isolation precautions would improve the consistency of …

Social Determinants And The Classification Of Disease: Descriptive Epidemiology Of Selected Socially Mediated Disease Constellations, Robert S. Levine, Barbara A. Kilbourne, George S. Rust, Michael A. Langston, Baqar A. Husaini, Lisaann S. Gittner, Maureen Sanderson, Charles H. Hennekens

Sociology Faculty Research

Background

Most major diseases have important social determinants. In this context, classification of disease based on etiologic or anatomic criteria may be neither mutually exclusive nor optimal.

Methods and Findings

Using Graph Visualization To Look At The Trajectories Of Events That Lead To Readmission, Abbas Shojaee, Isuru Ranasinghe, Sudhakar Nuti, Shu-Xia Li, Harlan Krumholz

Yale Day of Data

Information on specific sequence of healthcare utilization events in heart failure patients may be useful for identifying distinct subpopulations of patients with HF. Knowledge of patient trajectories may help to improve prediction of future readmission which can be used to tailor management to the individual needs of the patient.

This research introduces a new approach to mining administrative and clinical datasets by incorporating graph networks to identify & visualize the trajectories of sequences of events.

Genetic Predictors Of Metabolic Side Effects Of Diuretic Therapy, Jorge L. Del Aguila

Dissertations and Theses (Open Access)

Thiazide diuretics are a recommended first-line monotherapy for hypertension (i.e.SBP>140 mmHg or DBP>90 mmHg). Even so, diuretics are associated with adverse metabolic side effects, such as hyperlipidemia, hyperglycemia and hypokalemia which increase the risk of developing type II diabetes. This thesis used three analytical strategies to identify and quantify genetic factors that contribute to the development of adverse metabolic effects due to thiazide diuretic treatment. I performed a genome-wide association study (GWAS) and meta-analysis of the change in fasting plasma glucose and triglycerides in response to HCTZ from two different clinical trials: the Pharmacogenomic Evaluation of Antihypertensive Responses …

Obesity Indicators And C - Reactive Protein In African And Haitian Americans With And Without Type 2 Diabetes, Fatma G. Huffman, Joan A. Vaccaro, T. M. Rowe, Gustavo G. Zarini, Shiryn D. Sukhram, Lemia H. Shaban, Susan Himburg

Publications and Research

Purpose: High sensitivity C-reactive protein (CRP) is a risk factor for cardiovascular disease based on finding in primarily non-Hispanic White populations. Obesity, another risk factor for cardiovascular disease, is higher in Blacks as compared to non-Hispanic Whites. The objective of this study was to assess the relationship between CRP, a marker of systemic inflammation, and obesity indicators by ethnicity, diabetes status and gender for two Black ethnicities.

Methods: Anthropometrics and venous blood were collected for African and Haitian Americans with and without type 2 diabetes in a cross-sectional study. A total of 434 participants; 190 African Americans, 244 Haitian Americans, …

Investigating The Viability Of Two Stenotrophomonas Maltophilia Isolates After Air-Drying, Samantha Lane, Joanna Brooke

DePaul Discoveries

Abstract

Stenotrophomonas maltophilia is a water-borne infectious bacterium that is found in both clinical (hospitals) and non-clinical environments. This human pathogen is commonly recovered from respiratory tract infections. A recent study at a hospital in Taiwan suggested that dry patient charts can serve as a vehicle of transmission of this bacterium⁷. As S. maltophilia is not commonly isolated from dry surfaces, this current study tested the hypothesis that this pathogen can remain viable for some time on a dry surface. This study was designed to determine how long S. maltophilia could remain viable after air-drying by observing …

"Nursing Contamination: Wearing Scrubs In Public", Kemble Green

Undergraduate Honors Theses

Nurses are frequently seen in public in their “scrubs,” which could mean that contaminated clothing is being brought into the community, thereby posing an infection risk. The purpose of this study is to investigate if and which contaminants are present on the fabrics and the actions nurses are taking to eliminate contamination risks.

Eleven scrub tops were worn on hospital units over one twelve-hour shift. The contaminated scrubs and three control tops were then swabbed and used to inoculate agar plates. After incubation, colonies were counted, streaked onto nutrient and Mannitol-salt agar for isolation, and incubated. Using API Staph strips …

Performance Of The Oraquick Hcv Rapid Antibody Test For Screening Exposed Patients In A Hepatitis C Outbreak Investigation, Fengxiang Gao, Elizabeth A. Talbot, Carol H. Loring, Jill J. Power, Jodie Dionne-Odom

Dartmouth Scholarship

During a nosocomial hepatitis C outbreak, emergency public clinics employed the OraQuick HCV rapid antibody test on site, and all results were verified by a standard enzyme immunoassay (EIA). Of 1,157 persons, 1,149 (99.3%) exhibited concordant results between the two tests (16 positive, 1,133 negative). The sensitivity, specificity, positive predictive value, and negative predictive value were 94.1%, 99.5%, 72.7%, and 99.9%, respectively. OraQuick performed well as a screening test during an outbreak investigation and could be integrated into future hepatitis C virus (HCV) outbreak testing algorithms.

Forecasting The Spread Of Raccoon Rabies Using A Purpose-Specific Group Decision-Making Process., Aaron M. Anderson, Stephanie A. Shwiff, Richard B. Chipman, Todd C. Atwood, Tyler Cozzens, Frank Fillo, Robert Hale, Brody Hatch, Joanne Maki, Olin E. Rhodes Jr., Erin E. Rees, Charles E. Rupprecht, Rowland Tinline, Kurt C. Vercauteren, Dennis Slate

United States Department of Agriculture Wildlife Services: Staff Publications

The Centers for Disease Control (CDC) and USDA Wildlife Services (WS) have been involved in an oral rabies vaccination (ORV) program for raccoons (Procyon lotor) that has slowed the westward spread of raccoon rabies. The objective of this study was to forecast the spread of the disease if an ORV zone was not maintained. A group decision-making process was designed to address the forecasting problem and was implemented using a group of 15 experts and 4 support personnel at a meeting at the USDA National Wildlife Research Center. Ten expansion regions were constructed that described the spread of …

Computational Model For Survey And Trend Analysis Of Patients With Endometriosis : A Decision Aid Tool For Ebm, Salvo Reina, Vito Reina, Franco Ameglio, Mauro Costa, Alessandro Fasciani

COBRA Preprint Series

Endometriosis is increasingly collecting worldwide attention due to its medical complexity and social impact. The European community has identified this as a “social disease”. A large amount of information comes from scientists, yet several aspects of this pathology and staging criteria need to be clearly defined on a suitable number of individuals. In fact, available studies on endometriosis are not easily comparable due to a lack of standardized criteria to collect patients’ informations and scarce definitions of symptoms. Currently, only retrospective surgical stadiation is used to measure pathology intensity, while the Evidence Based Medicine (EBM) requires shareable methods and correct …

Perceptions Of Neighborhood Safety And Asthma Among Children And Adolescents In Los Angeles: A Multilevel Analysis, M. Camacho-Rivera, I. Kawachi, G. G. Bennett, S. V. Subramanian

Journal Articles

Background: Research examining the impact of neighborhoods on asthma has shown an increased interest in the role of the psychosocial environment. We examined the associations between various measures of neighborhood safety, individual and family characteristics, and asthma outcomes among children in Los Angeles. Methods: Multilevel logistic regression models were used to analyze data on 3,114 children across 65 neighborhoods from Wave 1 of the Los Angeles Family and Neighborhood Survey (2000 to 2002). Primary caregivers reported asthma outcome and all individual covariates; home environmental characteristics were observed by the interviewer. Results: In fully adjusted models, parents who reported their neighborhood …

Associations Between Human Papillomavirus And History Of Cancer Among Us Adults In The National Health And Nutrition Examination Survey (2003-2010), B. Liu, E. Taioli

Journal Articles

Background: Human papillomavirus (HPV) is an infectious agent that has been associated with human cancer. We have updated the U.S. population sero-prevalence using a large National Health and Nutrition Examination Survey (NHANES) sample of adults from 2003 to 2010, and have analysed the associations between HPV seropositivity and self-reported history of cancer. Methods: Four cross-sectional cycles (2003-2004, 2005-2006, 2007-2008, and 2009-2010) were used, for a total of 12 759 participants who had both cancer history and HPV serum information. Results: The sero-prevalences of HPV types 6, 11, 16, and 18 were 15.0%, 4.8%, 11.5%, and 4.1%, respectively. Females had significantly …

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder Among Responders And Civilians: A Meta-Analysis, B. Liu, L. H. Tarigan, E. J. Bromet, H. Kim

Journal Articles

The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e. …

Revisiting The Hispanic Health Paradox: The Relative Contributions Of Nativity, Country Of Origin, And Race/Ethnicity To Childhood Asthma, M. Camacho-Rivera, I. Kawachi, G. G. Bennett, S. V. Subramanian

Journal Articles

This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9 % of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also …

Average Values And Racial Differences Of Neutrophil Lymphocyte Ratio Among A Nationally Representative Sample Of United States Subjects, B. Azab, M. Camacho-Rivera, E. Taioli

Journal Articles

Introduction: Several studies reported the negative impact of elevated neutrophil/lymphocyte ratio (NLR) on outcomes in many surgical and medical conditions. Previous studies used arbitrary NLR cut-off points according to the average of the populations under study. There is no data on the average NLR in the general population. The aim of this study is to explore the average values of NLR and according to race in adult non-institutional United States individuals by using national data. Methods: The National Health and Nutrition Examination Survey (NHANES) of aggregated cross-sectional data collected from 2007 to 2010 was analyzed; data extracted included markers of …

Distribution Of Human Papillomavirus Genotypes Among Hiv-Positive And Hiv-Negative Women In Cape Town, South Africa, A. C. Mcdonald, A. I. Tergas, L. Kuhn, L. Denny, T. C. Wright Jr.

Journal Articles

OBJECTIVE: HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). METHODS: We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid …

Association Between Systemic Inflammatory Markers And Serum Prostate-Specific Antigen In Men Without Prostatic Disease-The 2001-2008 National Health And Nutrition Examination Survey, A. C. Mcdonald, M. A. Vira, A. C. Vidal, W. Q. Gan, S. J. Freedland, E. Taioli

Journal Articles

No abstract provided.

Incidence Of Extended-Spectrum-Beta-Lactamase-Producing Escherichia Coli And Klebsiella Pneumoniae Isolates That Test Susceptible To Cephalosporins And Aztreonam By The Revised Clsi Breakpoints, C. S. Mcwilliams, S. Condon, R. M. Schwartz, C. C. Ginocchio

Journal Articles

The incidence of aztreonam and cephalosporin susceptibility, determined using the revised CLSI breakpoints, for extendedspectrum-beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates was evaluated. Our analysis showed that results for aztreonam and/or> 1 cephalosporin were reported as susceptible or intermediate for 89.2% of ESBLproducing E coli isolates (569/638 isolates) and 67.7% of ESBL-producing K. pneumoniae isolates (155/229 isolates).