9 results
212 Community engaged telehealth care access for Latino farmworkers
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- Javier A Morla Estrada, Katherine Ferry, Karla Ornelas Hernandez, Andrea Nuñez, Sergio Aguilar-Gaxiola
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- Journal:
- Journal of Clinical and Translational Science / Volume 8 / Issue s1 / April 2024
- Published online by Cambridge University Press:
- 03 April 2024, pp. 64-65
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OBJECTIVES/GOALS: Historically, Latino farmworkers have lacked access to healthcare. 1 Telehealth promises to bridge this gap in hardly-reached populations. 2 We evaluated the impacts of ACTIVATE, a community-engaged project co-developed withcommunityp artnersAmplaHealth, and a local grower. METHODS/STUDY POPULATION: Mixed-methods outcome evaluation included attitudes survey, knowledge tests, attendance records, exit interviews, and participant observations. Attitudes survey, based on the Unified Theory of Acceptance and Use of Technology (UTAUT) model 3, measured Latino farmworkers’ telehealth acceptability. Pre/Post knowledge tests measured participant knowledge gained on telehealth and mental health services. Semi-structured exit interviewsidentifiedthe impacts of incentives, Promotora training, and health education curricula on participants and community partners. Structured participant observation as certained the level of participant engagement and Promotora facilitation skills. RESULTS/ANTICIPATED RESULTS: Results [https://drive.google.com/file/d/1jQpQdDM3dIR_PzMc1xXPh45Jvz8uBka6/view] On what aspects of the project worked well: “This project really helped us… to make it a priority, to do [health education] workshops. When I was hired, we went out to a few farms and shared information about our services, but it wasn’t anything hugely structured like what you proposed. We hadn’t done a whole lot of Promotora health education prior to this project.” -Ampla Health Administrator The most significant change observed: “Their attitudes… I feel that the very first session, I saw how they were more laid back, not really answering questions, just listening to us. And then the second one… they were more talkative and the very last one they were more comfortable sharing.” -Promotora DISCUSSION/SIGNIFICANCE: Attendence and participant engagement increased over time. Results from the evaluation point to greater telehealth acceptability among participants, increased health education capacity among Ampla Health, and farm worker cohesiveness at the workplace.
Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC
- Victor Daniel Rosenthal, Ruijie Yin, Eric Christopher Brown, Brandon Hochahn Lee, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Prasad Rajhans, Yatin Mehta, Subhash Kumar Todi, Sushmita Basu, Suneeta Sahu, Shakti Bedanta Mishra, Rajesh Chawla, Pravin K. Nair, Rajalakshmi Arjun, Deepak Singla, Kavita Sandhu, Vijayanand Palaniswamy, Arpita Bhakta, Mohd-Basri Mat Nor, Tai Chian-Wern, Ider Bat-Erdene, Subhash P. Acharya, Aamer Ikram, Nellie Tumu, Lili Tao, Gustavo Andres Alvarez, Sandra Liliana Valderrama-Beltran, Luisa Fernanda Jiménez-Alvarez, Claudia Milena Henao-Rodas, Katherine Gomez, Lina Alejandra Aguilar-Moreno, Yuliana Andrea Cano-Medina, Maria Adelia Zuniga-Chavarria, Guadalupe Aguirre-Avalos, Alejandro Sassoe-Gonzalez, Mary Cruz Aleman-Bocanegra, Blanca Estela Hernandez-Chena, Maria Isabel Villegas-Mota, Daisy Aguilar-de-Moros, Alex Castañeda-Sabogal, Eduardo Alexandrino Medeiros, Lourdes Dueñas, Nilton Yhuri Carreazo, Estuardo Salgado, Safaa Abdulaziz-Alkhawaja, Hala Mounir Agha, Amani Ali El-Kholy, Mohammad Abdellatif Daboor, Ertugrul Guclu, Oguz Dursun, Iftihar Koksal, Merve Havan, Suna Secil Ozturk-Deniz, Dincer Yildizdas, Emel Okulu, Abeer Aly Omar, Ziad A. Memish, Jarosław Janc, Sona Hlinkova, Wieslawa Duszynska, George Horhat-Florin, Lul Raka, Michael M. Petrov, Zhilin Jin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 5 / May 2024
- Published online by Cambridge University Press:
- 04 January 2024, pp. 567-575
- Print publication:
- May 2024
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Objective:
To identify urinary catheter (UC)–associated urinary tract infection (CAUTI) incidence and risk factors.
Design:A prospective cohort study.
Setting:The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.
Participants:The study included 169,036 patients, hospitalized for 1,166,593 patient days.
Methods:Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression.
Results:Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower–middle-income countries (3.05); and with patients in public hospitals (5.89).
The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P < .0001), female sex (aOR, 1.39; P < .0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P < .0001), UC DU ratio (aOR, 1.09; P < .0001), public facilities (aOR, 2.24; P < .0001), and neurologic ICUs (aOR, 11.49; P < .0001).
Conclusions:CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities.
Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.
73 Processing Speed in Migraine With and Without Aura: A Meta-Analysis
- Jasmin H Pizer, Stephen L Aita, Melissa A Myers, Nanako A Hawley, Vasilios C Ikonomou, Kyle M Brasil, Katherine A Hernandez, Erika C Pettway, Benjamin D Hill
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 67
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Objective:
Migraine refers to recurrent, unilateral headache attacks, lasting 4-72 hours, that have a pulsating quality and can occur with or without aura. Aura is a symptom, usually preceding the onset of a migraine, where there is an experience of gradually spreading focal neurological symptoms which typically last less than one hour. A meta-analysis was conducted which quantitatively synthesized literature documenting performance on clinical measures of processing speed (PS) in individuals with migraine with (MwA) and without aura (MwoA).
Participants and Methods:Data for this study came from a larger study that compared overall neuropsychological functioning in primary headache disorders (PHD) and healthy controls (HC). We searched OneSearch and PubMed using a uniform search-strategy to locate original research comparing cognition between PHD and HC. Analyses were modeled under random effects. Hedge’s g was used as a bias-corrected estimate of effect size. We assessed between-study heterogeneity using Cochran’s Q and I2. Egger’s regression test was used to assess publication bias (i.e., the association between standard error and effect size). High heterogeneity in effects was analyzed for possible moderating variables using metaregression and sub-group analyses.
Results:The initial search interval spanned inception-May 2021 and yielded 6692 results. Twelve studies met inclusion criteria, included clinical measures of PS, and included PHD subgroups with MwA and/or MwoA (MwA n = 279, MwoA n = 655, HC n = 2159). MwA demonstrated moderately worse performance in PS overall when compared to HC (k = 7, g = -0.41, p = 0.028). MwoA also demonstrated worse performance in PS overall when compared to HC but the effect size was small (k = 12, g = -0.21, p = 0.006). Heterogeneity of MwoA studies was low (Q = 15.12, I2 = 21.19) while heterogeneity of MwA studies was high (Q = 21.91, I2 = 72.61). Meta-regressions of MwA studies indicated clinical age and disease duration to be related to effect sizes such that studies with older clinical participants and longer disease durations yielded greater (negative) differences. Egger’s regression intercept noted a possible association effect size and standard error for MwA articles (t = 3.60, p = 0.02) and MwoA articles (t = 5.21, p < 0.005). Trim-and-fill procedure estimated 0 MwA studies to be missing due to publication bias (adjusted g = -0.41, p = 0.028) while 7 MwoA studies were estimated to be missing due to publication bias (adjusted g = -0.03, Q = 34.79).
Conclusions:Individuals with migraine demonstrated worse performances on tests of PS compared to controls. Effect sizes were generally moderate in strength for MwA while effect sizes were generally small in strength for MwoA. This quantitative summary confirmed that individuals with migraine experience slowed processing speed in general and this effect is magnified when aura is a presenting symptom.
75 Neuropsychological performance in vestibular migraine: Preliminary findings from a meta-analysis
- Nanako A Hawley, Jasmin H Pizer, Stephen L Aita, Melissa A Myers, Vasilios C Ikonomou, Kyle B Brasil, Katherine A Hernandez, Erika C Pettway, Benjamin D Hill
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 68-69
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Objective:
Primary headache disorder is characterized by recurrent headaches which lack underlying causative pathology or trauma. Primary headache disorder is common and encompasses several subtypes including migraine. Vestibular migraine (VM) is a subtype of migraine that causes vestibular symptoms such as vertigo, difficulties with balance, nausea, and vomiting. Literature indicates subjective and performance-based cognitive problems (executive dysfunction) among migraineurs. This study compared the magnitude of the total effect size across neuropsychological domains to determine if there is a reliable difference in effect sizes between individuals with VM and healthy controls (HC). An additional aim was to meta-analyze neuropsychological outcomes in migraine subtypes (other than VM) in reference to healthy controls.
Participants and Methods:This study was a part of a larger study examining neuropsychological functioning and impairment in individuals with primary headache disorder and HCs. Standardized search terms were applied in OneSearch and PubMed. The search interval covered articles published from 1986 to May 2021. Analyses were random-effects models. Hedge’s g was used as a bias-corrected estimate of effect size. Between-study heterogeneity was assessed using Cochran’s Q and I2. Publication bias was assessed with Duval and Tweedie’s Trim-and-Fill method to identify evidence of missing studies.
Results:The initial omnibus literature search yielded 6692 studies. Three studies (n=151 VM and 150 HC) met our inclusion criteria of having a VM group and reported neuropsychological performance. VM demonstrated significantly worse performance overall when compared to HCs (k=3, g=-0.99, p<0.001; Q=4.41, I2=54.66) with a large effect size. Within-domain effects of VM were: Executive Functioning=-0.99 (Q=0.62, I2=0), Screener=-1.15 (Q=3.29, I2=69.59), and Visuospatial/Construction=-1.47 (Q=0.001, I2=0.00). Compared to chronic migraine (k=3, g=-0.59, p<0.001; Q=0.68, I2=0.00) and migraine without aura (k=23, g=-0.39, p<0.001; Q=109.70, I2=79.95), VM was the only migraine subgroup to display a large effect size. Trim-and-fill procedure estimated zero VM studies to be missing due to publication bias (adjusted g=-0.99, Q=4.41).
Conclusions:This initial attempt at a meta-analysis of cognitive deficits in VM was hampered by a lack of studies in this area. Based on our initial findings, individuals with VM demonstrated overall worse performances on neuropsychological tests compared to HCs with the greatest level of impairment seen in visuospatial/construction. Additionally, VM resulted in a large effect size while other migraine subtypes yielded small to moderate effect sizes. Despite the small sample of studies, the overall effect across neuropsychological performance was generally stable (i.e., low between-study heterogeneity). Given than VM accounts for 7% of patients seen in vertigo clinics and 9% of all migraine patients, our results suggest that neuropsychological impairment in VM deserves significantly more study.
Trends and duration of antibacterial drug supply chain issues in the United States, January 2017–June 2022
- Katie Suda, Katherine Callaway Kim, Inma Hernandez, Mina Tadrous
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue S2 / June 2023
- Published online by Cambridge University Press:
- 29 September 2023, pp. s106-s107
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Background: Drug manufacturing and distribution is a complex, global process. The global drug supply chain is prone to disruptions associated with geopolitical issues, trade, civil unrest, severe weather, and pandemics, all of which have the potential to affect medication supply and result in drug shortages. To our knowledge, the extent to which the supply of antimicrobials is threated due to disruptions in the drug supply chain in the United States is unknown. We examined trends and duration of disruptions to the drug supply chain for antimicrobials. Methods: Manufacturer reports of supply disruptions were extracted from the Food and Drug Administration (FDA) and the American Society for Health-Systems Pharmacists (ASHP) websites and merged on the agent-formulation level. For each month of the study period, a drug was considered to have an active supply chain issue if an FDA or ASHP shortage or recall report overlapped with that month for ≥15 days, or if a discontinuation had occurred within the previous 3 months. Total months of supply chain issues were summed for antimicrobials overall, at the agent formulation , and class levels. A Mann-Kendall test was used to determine the significance of trends in supply-chain issues. Results: Of 105 antimicrobials purchased in the United States, 74 (70%) had a supply-chain issue for ≥1 month from January 15, 2017, to June 30, 2022. Combined, the 74 agents had 1,611 total months of supply-chain issues over the 66-month study period. Agents from the penicillin class were most frequently affected (ie, 80% of penicillins had supply-chain issues for 206 months), but cephalosporins had supply-chain issues for the longest duration (66% of cephalosporins for 653 months). From 2017–2021, supply-chain issues decreased significantly for penicillins and quinolones (tests of trend, P = .01 and .02, respectively). No trend was identified for the other classes or antimicrobials overall. Interestingly, supply-chain issues for most classes did not increase with seasonal increases in antimicrobial use. Also, supply-chain issues affected 33 antimicrobial agents for at least half of the study period, and supply-chain issues affected ampicillin-sulbactam, cefotaxime, ceftazidime, cefotetan, cefepime, clindamycin, vancomycin for 100% of the study period. Conclusions: Drug supply-chain issues commonly affect antimicrobials and are not improving for most classes. Drug supply-chain issues cause significant strain on healthcare, including drug procurement, access to optimal therapy, and poses challenges to prescribing and antimicrobial stewardship. To decrease the threat to the antibacterial drug supply, action should be taken to strengthen the drug supply chain to ensure access to these essential medicines.
Disclosures: None
Impact of Hurricane Harvey on the Growth of Low Income, Ethnic Minority Adolescents
- Katherine R. Arlinghaus, Stacey L. Gorniak, Daphne C. Hernandez, Craig A. Johnston
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- Journal:
- Disaster Medicine and Public Health Preparedness / Volume 17 / 2023
- Published online by Cambridge University Press:
- 09 November 2020, e9
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Objective:
This study examined the differential impact of Hurricane Harvey on adolescent standardized Body Mass Index (zBMI), physical activity, diet, and perceived stress.
Methods:Prior to Hurricane Harvey, 175 ethnic minority adolescents were recruited from an independent school district in Houston. Height and weight were directly measured. The School Physical Activity and Nutrition Questionnaire assessed diet and physical activity. Stress was assessed with the Perceived Stress Scale. High hurricane impact was classified as at least 1 affirmative response to house damage, rescue, displacement, or going without food, water, or medicine. Repeated measures such as ANCOVA models were developed to assess differences in zBMI, physical activity, diet, and stress between the hurricane impact groups. Regression models were used to assess stress as a mediator of the hurricane impact and zBMI change relationship.
Results:Students who were highly impacted by the hurricane had a greater decrease in zBMI than those less impacted from pre-hurricane to 15 weeks post-hurricane (95% CI 0.02 to 0.25, p<0.05). Physical activity and diet did not differ by impact. Perceived stress at 3 weeks post-hurricane mediated the impact and zBMI change relationship (β=-0.04 95% CI -0.12 to -0.002).
Conclusion:The decrease in zBMI among highly impacted students warrants further monitoring. Perceived stress, immediately following the hurricane, impacted student growth months later.
Contributors
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- By Jessica Almqvist, Grace Bolton, Martin Dawidowicz, Eric De Brabandere, Katherine Del Mar, Malgosia Fitzmaurice, Duncan French, Gleider I. Hernández, Jackson Nyamuya Maogoto, Tamar Megiddo, Zohar Nevo, Alexandros X. M. Ntovas, Jadranka Petrovic, Yaël Ronen, Katja L. H. Samuel, Mohammad Shahabuddin, Kelly Stathopoulou, Charlotte Steinorth, James Summers, Mai Taha, Jure Vidmar, Jacqui Zalcberg
- Edited by Duncan French, University of Lincoln
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- Statehood and Self-Determination
- Published online:
- 05 March 2013
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- 21 February 2013, pp viii-xiv
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Incidence of and Risk Factors for Surgical-Site Infections in a Peruvian Hospital
- Katherine Hernandez, Elizabeth Ramos, Carlos Seas, German Henostroza, Eduardo Gotuzzo
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 26 / Issue 5 / May 2005
- Published online by Cambridge University Press:
- 21 June 2016, pp. 473-477
- Print publication:
- May 2005
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Objective:
To determine the incidence of and risk factors for surgical-site infections (SSIs) after abdominal surgery.
Design:A cohort study was conducted from January to June 1998. CDC criteria for SSI and the NNIS System risk index were used.
Setting:A tertiary-care hospital in Peru.
Patients:Adult patients undergoing abdominal surgery who consented were enrolled and observed until 30 days after surgery. Patients who had undergone surgery at another hospital or who died or were transferred to another hospital within 24 hours after surgery were excluded.
Results:Four hundred sixty-eight patients were enrolled. Their mean age was 37.2 years. One hundred twenty-five patients developed SSIs, 18% of which were identified after discharge. The overall incidence rate (IR) was 26.7%. The IR was 13.9% for clean, 15.9% for clean-contaminated, 13.5% for contaminated, and 47.2% for dirty interventions. The IR was 3.6% for NNIS System risk index 0 and 60% for index 3. Risk factors for SSI on logistic regression analysis were dirty or infected wound (RR, 3.8; CI95, 1.7-8.4), drain use longer than 9 days (RR, 6.0; CI95, 2.5-12.5), and length of surgery greater than the 75th percentile (RR, 2.1; CI95, 1.0-4.4). Patients with SSI had a longer hospital stay than did non-infected patients (14.0 vs 6.1 days; P < .001).
Conclusions:SSI is a major problem in this hospital, which has a higher IR (especially for clean interventions) than those of developed countries. In developing countries, prevention of SSI should include active surveillance and interventions targeting modifiable risk factors.
Novel illudins from Coprinopsis episcopalis (syn. Coprinus episcopalis), and the distribution of illudin-like compounds among filamentous fungi
- Antonio GONZALEZ DEL VAL, Gonzalo PLATAS, Francisco ARENAL, Juan Carlos ORIHUELA, María GARCIA, Pilar HERNANDEZ, Inmaculada ROYO, Nuria DE PEDRO, Lynn L. SILVER, Katherine YOUNG, María Francisca VICENTE, Fernando PELAEZ
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- Journal:
- Mycological Research / Volume 107 / Issue 10 / October 2003
- Published online by Cambridge University Press:
- 16 October 2003, pp. 1201-1209
- Print publication:
- October 2003
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The illudins are a family of fungal sesquiterpenes that have been studied as anti-tumor agents, and they also have antibacterial activity. Over a four-year period, 25304 fungal isolates (approximately 97% ascomycetes and 3% basidiomycetes), were screened for antibacterial activity against methicillin-resistant Staphylococcus aureus. Illudin-like compounds with antibacterial and cytotoxic activity against tumor cell lines were observed in 10 basidiomycete strains. The isolates were recovered from different types of substrata using indirect methods and only formed sterile mycelia in pure culture. The isolates were genetically related but not identical, based on PCR-based fingerprinting techniques. DNA sequencing of the ITS1-5.8 S-ITS2 region of the strains revealed that nine had identical sequences, indicating that they were conspecific. The sequence of the remaining isolate was 96.34% similar, suggesting that it was a closely related species. The D1–D2 region of the 25 S rRNA gene of the two strain types was also sequenced. Both sequences were 99.39% similar, and Coprinopsis gonophylla (syn. Coprinus gonophyllus) was the closest match for both. Strains were grown in pure culture on a rice-based medium that allowed the development of basidiomata from one culture of the main strain type, which was identified as C. episcopalis, a close relative of C. gonophyllus. Both species (or strain types) produced different types of illudin-like compounds. Three novel illudins (I, I2 and J2) were found to be produced by the cultures identified as C. episcopalis, while only illudinic acid was produced by the other Coprinopsis sp. The taxonomical relationships of the Coprinopsis species identified in this study with other illudin producers previously reported in the literature are discussed.