1
|
Kimaru LJ, Habila MA, Mantina NM, Madhivanan P, Connick E, Ernst K, Ehiri J. Neighborhood characteristics and HIV treatment outcomes: A scoping review. PLOS Glob Public Health 2024; 4:e0002870. [PMID: 38349915 PMCID: PMC10863897 DOI: 10.1371/journal.pgph.0002870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/21/2023] [Indexed: 02/15/2024]
Abstract
Recognizing challenges faced by people living with HIV is vital for improving their HIV treatment outcomes. While individual-level interventions play a crucial role, community factors can shape the impact of individual interventions on treatment outcomes. Understanding neighborhood characteristics' association with HIV treatment outcomes is crucial for optimizing effectiveness. This review aims to summarize the research scope on the association between neighborhood characteristics and HIV treatment outcomes. The databases PubMed, CINAHL (EBSCOhost), Embase (Elsevier), and PsychINFO (EBSCOhost) were searched from the start of each database to Nov 21, 2022. Screening was performed by three independent reviewers. Full-text publications of all study design meeting inclusion criteria were included in the review. There were no language or geographical limitations. Conference proceedings, abstract only, and opinion reports were excluded from the review. The search yielded 7,822 publications, 35 of which met the criteria for inclusion in the review. Studies assessed the relationship between neighborhood-level disadvantage (n = 24), composition and interaction (n = 17), social-economic status (n = 18), deprivation (n = 16), disorder (n = 8), and rural-urban status (n = 7) and HIV treatment outcomes. The relationship between all neighborhood characteristics and HIV treatment outcomes was not consistent across studies. Only 7 studies found deprivation had a negative association with HIV treatment outcomes; 6 found that areas with specific racial/ethnic densities were associated with poor HIV treatment outcomes, and 5 showed that disorder was associated with poor HIV treatment outcomes. Three studies showed that rural residence was associated with improved HIV treatment outcomes. There were inconsistent findings regarding the association between neighborhood characteristics and HIV treatment outcomes. While the impact of neighborhood characteristics on disease outcomes is highly recognized, there is a paucity of standardized definitions and metrics for community characteristics to support a robust assessment of this hypothesis. Comparative studies that define and assess how specific neighborhood indicators independently or jointly affect HIV treatment outcomes are highly needed.
Collapse
Affiliation(s)
- Linda Jepkoech Kimaru
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Magdiel A. Habila
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, United States of America
| | - Namoonga M. Mantina
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Purnima Madhivanan
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| | - Elizabeth Connick
- Department of Medicine, The University of Arizona, Tucson, Arizona, United States of America
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona, United States of America
| | - John Ehiri
- Department of Health Promotion Sciences, The University of Arizona, Tucson, Arizona, United States of America
| |
Collapse
|
2
|
Iyengar MS, Merchant N, Ernst K, Rains S, Arora M, Ngaybe MGB, Gonzalez M. Resilience Informatics for Public Health. Stud Health Technol Inform 2024; 310:1276-1280. [PMID: 38270020 DOI: 10.3233/shti231170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Resilience research is attracting increasing attention as stressors such as pandemics and climate change impact normal life worldwide. Informatics tools can play an important role in enhancing resilience of people, communities, and organizations. We present Resilience Informatics as a sub-discipline of resilience research and propose a conceptual framework for Resilience Informatics to aid in the development and effective deployment of informatics systems for resilience.
Collapse
Affiliation(s)
- M Sriram Iyengar
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, US
| | | | | | | | - Mona Arora
- University of Arizona, Tucson, Arizona, US
| | | | | |
Collapse
|
3
|
Newman EA, Feng X, Onland JD, Walker KR, Young S, Smith K, Townsend J, Damian D, Ernst K. Defining the roles of local precipitation and anthropogenic water sources in driving the abundance of Aedes aegypti, an emerging disease vector in urban, arid landscapes. Sci Rep 2024; 14:2058. [PMID: 38267474 PMCID: PMC10808563 DOI: 10.1038/s41598-023-50346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
Understanding drivers of disease vectors' population dynamics is a pressing challenge. For short-lived organisms like mosquitoes, landscape-scale models must account for their highly local and rapid life cycles. Aedes aegypti, a vector of multiple emerging diseases, has become abundant in desert population centers where water from precipitation could be a limiting factor. To explain this apparent paradox, we examined Ae. aegypti abundances at > 660 trapping locations per year for 3 years in the urbanized Maricopa County (metropolitan Phoenix), Arizona, USA. We created daily precipitation layers from weather station data using a kriging algorithm, and connected localized daily precipitation to numbers of mosquitoes trapped at each location on subsequent days. Precipitation events occurring in either of two critical developmental periods for mosquitoes were correlated to suppressed subsequent adult female presence and abundance. LASSO models supported these analyses for female presence but not abundance. Precipitation may explain 72% of Ae. aegypti presence and 90% of abundance, with anthropogenic water sources supporting mosquitoes during long, precipitation-free periods. The method of using kriging and weather station data may be generally applicable to the study of various ecological processes and patterns, and lead to insights into microclimates associated with a variety of organisms' life cycles.
Collapse
Affiliation(s)
- Erica A Newman
- Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, AZ, 85721, USA.
- Department of Integrative Biology, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Xiao Feng
- Department of Biology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | | | - Kathleen R Walker
- Department of Entomology, University of Arizona, 1140 E South Campus Drive, Forbes 410, Tucson, AZ, 85721, USA
| | - Steven Young
- Maricopa County Environmental Services Vector Control Division, 3220 W Gibson Ln, Phoenix, AZ, 85009, USA
| | - Kirk Smith
- Maricopa County Environmental Services Vector Control Division, 3220 W Gibson Ln, Phoenix, AZ, 85009, USA
| | - John Townsend
- Maricopa County Environmental Services Vector Control Division, 3220 W Gibson Ln, Phoenix, AZ, 85009, USA
| | - Dan Damian
- Maricopa County Office of Enterprise Technology, 301 S 4Th Ave #200, Phoenix, AZ, 85003, USA
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA
| |
Collapse
|
4
|
Chebet JJ, McMahon SA, Tarumbiswa T, Hlalele H, Maponga C, Mandara E, Ernst K, Alaofe H, Baernighausen T, Ehiri JE, Geldsetzer P, Nichter M. Motivations for pre-exposure prophylaxis uptake and decline in an HIV-hyperendemic setting: findings from a qualitative implementation study in Lesotho. AIDS Res Ther 2023; 20:43. [PMID: 37415180 PMCID: PMC10324220 DOI: 10.1186/s12981-023-00535-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Pre-Exposure Prophylaxis (PrEP) has demonstrated clinical efficacy in preventing HIV infection, yet its uptake remains low. This study, conducted in five PrEP implementing districts in Lesotho, examined factors motivating persons at risk of HIV infection to adopt or reject PrEP when offered freely. METHODS In-depth interviews were undertaken with stakeholders directly engaged with PrEP policy (n = 5), program implementation (n = 4), and use (current PrEP users = 55, former PrEP users = 36, and PrEP decliners (n = 6)). Focus group discussions (n = 11, 105 total participants) were conducted with health staff directly providing HIV and PrEP services. RESULTS Demand for PrEP was reported highest among those at greatest risk for HIV acquisition: those in serodiscordant relationships and/or engaged in sex work. Culturally sensitive PrEP counseling was described as an opportunity to transfer knowledge, build trust, and address user concerns. Conversely, top-down counseling resulted in PrEP distrust and confusion about HIV status. Key motivations for PrEP uptake revolved around sustaining core social relationships, desire for safer conception, and caring for ailing relatives. The decline of PrEP initiation was driven by a combination of individual-level factors (risk perception, perceived side effects, disbelief of the drug's efficacy and PrEP's daily pill regimen), societal factors (lack of social support and HIV-related stigma), and structural factors related to PrEP access. CONCLUSIONS Our findings suggest strategies for effective national PrEP rollout and implementation include: (1) demand creation campaigns which highlight positive aspects of PrEP, while simultaneously addressing apprehensions for uptake; (2) strengthening health provider counseling capacity; and (3) addressing societal and structural HIV-related stigma.
Collapse
Affiliation(s)
- Joy J. Chebet
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ USA
| | - Shannon A. McMahon
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Social and Behavioral Interventions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | | | | | | | | | - Kacey Ernst
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ USA
| | - Halimatou Alaofe
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ USA
| | - Till Baernighausen
- Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA USA
- Africa Health Research Institute (AHRI), Durban, South Africa
| | - John E. Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ USA
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA USA
- Chan Zuckerberg Biohub, San Francisco, CA USA
| | - Mark Nichter
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ USA
- School of Anthropology, University of Arizona, Tucson, AZ USA
| |
Collapse
|
5
|
Yeo S, Park Y, McClelland DJ, Ehiri J, Ernst K, Magrath P, Alaofè H. A scoping review of maternal health among resettled refugee women in the United States. Front Public Health 2023; 11:1157098. [PMID: 37250071 PMCID: PMC10214470 DOI: 10.3389/fpubh.2023.1157098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2023] [Indexed: 05/31/2023] Open
Abstract
Background Globally, refugee women continue to face higher maternity-related risks from preventable complications during pregnancy and childbirth, partly due to high health care costs, unfamiliarity with the healthcare system, language barriers, and discrimination. Nevertheless, there is still a paucity of literature that evaluates the available evidence in the US. This scoping review delineated the body of literature on maternal health among refugee women resettled in the US in order to identify knowledge gaps in the literature and highlight future research priorities and directions for maternal health promotion. Methods Electronic databases were searched in PubMed, CINAHL, PsycINFO, and EMBASE from inception through July 2021. We included all peer-reviewed study designs; qualitative, quantitative, and mixed method if they reported on refugee women's perinatal health experiences and outcomes in the US. Results A total of 2,288 records were identified, with 29 articles meeting the inclusion criteria. Refugee women tend to initiate prenatal care late and have fewer prenatal care visits compared to women born in the US. Some of them were reluctant to get obstetric interventions such as labor induction and cesarean delivery. Despite numerous risk factors, refugee women had generally better maternal health outcomes. Studies have also highlighted the importance of health care providers' cultural competency and sensitivity, as well as the potential role of community health workers as a bridge between refugee women and health care providers. Conclusions The scoping review emphasizes the need for early prenatal care initiation and more frequent prenatal care visits among refugee women. Furthermore, more needs to be done to mitigate resistance to obstetric interventions and mistrust. The mechanism by which healthy migrant effects occur could be better understood, allowing protective factors to be maintained throughout the resettlement and acculturation process. The scoping review identifies critical gaps in the literature, such as the underrepresentation of different ethnic groups of refugee women in refugee maternal studies in the US. Since this invisibility may indicate unspoken and unaddressed needs, more attention should be paid to underrepresented and understudied groups of refugee women in order to achieve health equity for all.
Collapse
Affiliation(s)
- Sarah Yeo
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Yuae Park
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | | | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Kacey Ernst
- Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Priscilla Magrath
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| |
Collapse
|
6
|
Langendijk P, Fleuren M, Venrooy K, Ernst K, Page G. Effect of low colostrum intake on gastrointestinal development and uterine and cervical morphometrical architecture in the neonatal gilt. Animal 2023; 17:100725. [PMID: 36812720 DOI: 10.1016/j.animal.2023.100725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
To assess the importance of natural variation in colostrum intake on piglet gastrointestinal and reproductive development, two equally sized female piglets from each of 27 litters were selected, one with low (average 226 g) and one with high (average 401 g) colostrum intake. At weaning (23 d of age), piglets were euthanised to perform macromorphological measurements on ileum, colon, cervix and uterus tissues, and to obtain tissue samples from the cervix and uterus for histology. Sections of uterine and cervical preparations were analysed using digital image analysis. Despite being selected for the same birth weight (average 1.1 kg, standard deviation 0.18 kg), piglets with low colostrum intake weighed 5.91 ± 0.17 kg and piglets with high colostrum intake weighed 6.96 ± 0.19 kg at weaning (P < 0.05). Most of the micro- and macroscopic measures such as length and weight of ileum and colon, cervix and uterus, luminal size of cervix and uterus, number of cervical crypts and uterine glands, were greater in gilts with high colostrum intake. The histological architecture of the uterus and cervix in gilts with high colostrum intake showed more complexity, reflecting more advanced development in these piglets. In conclusion, these data demonstrate that independent of birth weight, natural variation in colostrum intake is related to the overall development of neonatal piglets, affecting body growth, as well as growth and development of the gut and reproductive tract.
Collapse
Affiliation(s)
- P Langendijk
- Trouw Nutrition R&D, Stationsstraat 77, 3811 MH Amersfoort, The Netherlands.
| | - M Fleuren
- Trouw Nutrition R&D, Stationsstraat 77, 3811 MH Amersfoort, The Netherlands
| | - K Venrooy
- Trouw Nutrition R&D, Stationsstraat 77, 3811 MH Amersfoort, The Netherlands
| | - K Ernst
- Trouw Nutrition R&D, Stationsstraat 77, 3811 MH Amersfoort, The Netherlands
| | - G Page
- Trouw Nutrition R&D, Stationsstraat 77, 3811 MH Amersfoort, The Netherlands
| |
Collapse
|
7
|
Luzingu JK, Stroupe N, Alaofe H, Jacobs E, Ernst K. Risk factors associated with under-five stunting, wasting, and underweight in four provinces of the Democratic Republic of Congo: analysis of the ASSP project baseline data. BMC Public Health 2022; 22:2422. [PMID: 36564730 PMCID: PMC9783987 DOI: 10.1186/s12889-022-14842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/08/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Determining the magnitude and risk factors of undernutrition in a country that has one of the highest prevalence of undernutrition in the world is paramount for developing contextual interventions. METHODS This study used baseline data from the ASSP project to estimate prevalence of stunting, wasting, and underweight in four provinces of DRC. It involved 3911 children aged 0-59 months old and mother pairs. Height-for-age Z scores, Weight-for-height Z scores, and Weight-for-age Z scores were calculated and used to classify child stunting, wasting and underweight respectively, based on the 2006 World Health Organization (WHO) growth reference. Hierarchical logistic regressions were used to identify risk factors associated with stunting, wasting and underweight. All analyses were conducted using STATA 15.1, and statistical significance was set at p < 0.05. RESULTS The prevalence of stunting, underweight and wasting was 42.7%, 21.9% and 8.2% respectively. Increasing child's age was a risk factor associated with stunting and underweight, while sex was not associated with the 3 indicators of undernutrition. Low levels of mother's education, mothers working in the last 12 months prior to the survey, children living in the province of Kasai occidental, children born at a health facility, children perceived by their mothers to be born very small were associated with higher risks of stunting. Factors associated with underweight were children from the province of Kasai occidental, mothers who worked in the last 12 months prior to the survey, and children perceived to be born very small or small by their mothers. Children born to mothers aged 35-49 years and children breastfed in combination with drinking water were at higher risk of wasting. CONCLUSION Prevalence of undernutrition in DRC is high. This study has identified certain modifiable risk factors associated with stunting, wasting and underweight. To reduce the burden of undernutrition in DRC, authorities should target factors at individual and community levels by improving women's education, child feeding practices and promoting agriculture.
Collapse
Affiliation(s)
- Joy Kinko Luzingu
- grid.134563.60000 0001 2168 186XDepartment of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Nancy Stroupe
- IMA World Health, 1730 M Street, NW, Suite 1100, Washington, DC 20036 USA
| | - Halimatou Alaofe
- grid.134563.60000 0001 2168 186XDepartment of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Elizabeth Jacobs
- grid.134563.60000 0001 2168 186XDepartment of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Kacey Ernst
- grid.134563.60000 0001 2168 186XDepartment of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| |
Collapse
|
8
|
Hoffmann DC, Hai L, Wagener R, Mandelbaum H, Xie R, Hausmann D, Dominguez Azorín D, Weil S, Sievers P, Cebulla G, Ito J, Warnken U, Venkataramani V, Ernst K, Reibold D, Will R, Suvà ML, Herold-Mende C, Sahm F, Winkler F, Schlesner M, Wick W, Kessler T. JS08.6.A A connectivity signature for glioblastoma. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Tumor cell extensions called tumor microtubes (TMs) in glioma resemble neurites during neurodevelopment and connect glioma cells to a network that has considerable relevance for tumor progression and therapy resistance. The determination of interconnectivity in individual tumors has been challenging and the impact of tumor cell connectivity on patient survival remained unresolved so far.
Material and Methods
A connectivity signature was derived by single-cell RNA-sequencing (scRNA-Seq) of highly and lowly connected cells obtained from an SR101 dye transfer xenograft model of primary glioblastoma (GB). The signature was validated in different in vitro models of cell-to-cell connectivity and could be translated to GB clinical specimens.
Results
34 of 40 connectivity genes were related to neurogenesis, neural tube development or glioma progression, including the TM-network-relevant GAP43 gene. Astrocytic-like and mesenchymal-like GB cells had the highest connectivity signature scores in scRNA-Seq data of patient-derived xenografts and patient samples. In 230 human GBs, high connectivity correlated with the mesenchymal expression subtype, TP53 wildtype, and with dismal patient survival. CHI3L1 was identified and validated as a robust molecular marker of connectivity with a functional relevance.
Conclusion
The connectivity signature gives novel insights into brain tumor biology, provides a proof-of-principle that tumor cell connectivity is relevant for patients’ prognosis, and serves as a robust biomarker that can be used for future clinical trials
Collapse
Affiliation(s)
- D C Hoffmann
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
- Faculty of Biosciences, Heidelberg University , Heidelberg , Germany
| | - L Hai
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
- Bioinformatics and Omics Data Analytics, DKFZ , Heidelberg , Germany
| | - R Wagener
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - H Mandelbaum
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - R Xie
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - D Hausmann
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - D Dominguez Azorín
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - S Weil
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - P Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg , Heidelberg , Germany
- Clinical Cooperation Unit Neuropathology, DKTK, DKFZ , Heidelberg , Germany
| | - G Cebulla
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - J Ito
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - U Warnken
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - V Venkataramani
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
- Department of Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University , Heidelberg , Germany
| | - K Ernst
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, DKTK, DKFZ , Heidelberg , Germany
| | - D Reibold
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - R Will
- Genomics and Proteomics Core Facility, DKTK, DKFZ , Heidelberg , Germany
| | - M L Suvà
- Broad Institute of Harvard and MIT, Cambridge, MA, United States; Department of Pathology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School , Boston, MA , United States
| | - C Herold-Mende
- Department of Neurosurgery, Heidelberg University Hospital , Heidelberg , Germany
| | - F Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg , Heidelberg , Germany
- Clinical Cooperation Unit Neuropathology, DKTK, DKFZ , Heidelberg , Germany
| | - F Winkler
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - M Schlesner
- Bioinformatics and Omics Data Analytics, DKFZ , Heidelberg , Germany
- Biomedical Informatics, Data Mining and Data Analytics, Faculty of Applied Computer Science and Medical Faculty, University of Augsburg , Augsburg , Germany
| | - W Wick
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - T Kessler
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| |
Collapse
|
9
|
Liu I, Jiang L, Samuelsson E, Marco Salas S, Hack O, Jeong D, Shaw M, Englinger B, LaBelle J, Ernst K, Palova H, Pokorna P, Sterba J, Slaby O, Geyeregger R, Jones D, Koschmann C, Svedlund J, Resnick A, Diaz A, Haberler C, Czech T, Slavc I, Cotter J, Ligon K, Alexandrescu S, Yung W, Arrillaga-Romany I, Suva M, Beck A, Gojo J, Monje M, Nilsson M, Filbin M. JS04.6.A The landscape of tumor cell states and spatial organization in H3-K27M mutant diffuse midline glioma across age and location. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Histone 3 lysine27-to-methionine mutations (H3-K27M) frequently occur in childhood diffuse midline gliomas (DMGs) of the pons, thalamus and spinal cord, presumed to be driven by the specific spatiotemporal context of these midline locations during postnatal development. While most common in the pons and at mid-childhood ages, the same oncohistone mutation is recurrently detected in adult DMGs and throughout different midline regions. The potential heterogeneity of tumors at different ages and in different anatomical locations of the midline are vastly understudied.
Material and Methods
Through dissecting the transcriptomic, epigenomic and spatial architectures of a comprehensive cohort of patient H3-K27M DMGs - spanning the age range from 2-68 years and locations from spinal cord to thalamus - at single cell resolution, we delineate how age- and location-dependent contexts shape glioma cell-intrinsic and -extrinsic features in light of the shared driver mutation.
Results
We identify that oligodendrocyte precursor (OPC)-like cells constitute the stem-like compartment in H3-K27M DMGs across all clinico-anatomical groups, however, depending on location, display varying levels of maturity resembling less differentiated pre-OPCs or more mature OPCs further differentiated along the oligodendroglial lineage. We further demonstrate increased mesenchymal cell states in adult tumors, which we link to age-related differences in glioma-associated immune cell compartments. We for the first time resolve the spatial organization of H3-K27M DMG cell types in intact patient tissues, identifying a local niche of the oligodendroglial lineage.
Conclusion
Our study provides a powerful resource for rational modeling and therapeutic frameworks taking into account determinants of age and location in this lethal glioma group.
Collapse
Affiliation(s)
- I Liu
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - L Jiang
- Dana-Farber Cancer Institute , Boston, MA , United States
| | | | | | - O Hack
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - D Jeong
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - M Shaw
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - B Englinger
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - J LaBelle
- Dana-Farber Cancer Institute , Boston, MA , United States
| | | | - H Palova
- Masaryk University , Brno , Czech Republic
| | - P Pokorna
- Masaryk University , Brno , Czech Republic
| | - J Sterba
- Masaryk University , Brno , Czech Republic
| | - O Slaby
- Masaryk University , Brno , Czech Republic
| | | | | | - C Koschmann
- University of Michigan , Ann Arbor, MI , United States
| | - J Svedlund
- Stockholm University , Stockholm , Sweden
| | - A Resnick
- Children's Hospital of Philadelphia , Philadelphia, PA , United States
| | - A Diaz
- UCSF , San Francisco, CA , United States
| | - C Haberler
- Medical University of Vienna , Vienna , Austria
| | - T Czech
- Medical University of Vienna , Vienna , Austria
| | - I Slavc
- Medical University of Vienna , Vienna , Austria
| | - J Cotter
- University of Southern California , Los Angeles, CA , United States
| | - K Ligon
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - S Alexandrescu
- Dana-Farber Cancer Institute , Boston, MA , United States
| | - W Yung
- MD Anderson Cancer Center , Houston, TX , United States
| | | | - M Suva
- MGH , Boston, MA , United States
| | | | - J Gojo
- Medical University of Vienna , Vienna , Austria
| | - M Monje
- Stanford University , Stanford, CA , United States
| | - M Nilsson
- Stockholm University , Stockholm , Sweden
| | - M Filbin
- Dana-Farber Cancer Institute , Boston, MA , United States
| |
Collapse
|
10
|
Imran M, Uddin A, Ambade P, Khan S, Wahab A, Akbar H, Iqbal Z, Ernst K. SARS-CoV-2 RT-PCR positivity in relation to clinical and demographic characteristics in residents of border quarantine centres, Khyber Pakhtunkhwa, Pakistan: a prospective cohort study. Trans R Soc Trop Med Hyg 2022; 116:750-757. [PMID: 35724259 PMCID: PMC9278253 DOI: 10.1093/trstmh/trac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 03/24/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background As international travellers were the primary source of sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, border checkpoints became an important tool to isolate cases. We determined the period prevalence and SARS-CoV-2 reverse transcription polymerase chain reaction positivity in relation to clinical and demographic characteristics in healthy travellers quarantined at the Pakistan–Afghanistan border. Methods The study was conducted from 15 to 25 April 2020. Period prevalence was calculated and the association between positivity and individuals’ age, sex and occupation were assessed using χ2 and Mantel–Haenszel tests. Logistic regression was used to calculate adjusted odds ratios (ORs) for each age group. Time-to-event (TTE) analysis was conducted to check the difference in positivity among various groups. Results In a total of 708 individuals, 71 tested positive (10%). Compared with those ≤20 y of age, the sex- and occupation-adjusted odds of testing positive were less among the older age group (41–60 y; OR 0.26, p=0.008). Taxi drivers had higher odds of testing positive (OR 4.08, p<0.001). Kaplan–Meier curves and hazard ratios (0.32, p<0.01) showed that the positivity period differed significantly across the pre-symptomatic vs asymptomatic group (26 vs 14 d). Conclusions The cases who were likely to acquire infection through occupational exposure largely remained asymptomatic. For effective control of transmission and the emergence of new variants, testing capacities should be revamped with effective isolation measures.
Collapse
Affiliation(s)
- Muhammad Imran
- Department of Pulmonology, Lady Reading Hospital , Hospital Road, Peshawar, 25000, Pakistan
| | - Azhar Uddin
- Department of Pulmonology, Lady Reading Hospital , Hospital Road, Peshawar, 25000, Pakistan
| | - Preshit Ambade
- Ottawa Hospital Research Institute , 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - Sajjad Khan
- Department of Environmental and Occupational Health, School of Public Health, Indiana University , 1025 E. 7th St. Bloomington, IN 47405, USA
| | - Abdul Wahab
- Department of Pulmonology, Naseer Teaching Hospital , Nasar bagh road, Peshawar, 25000, Pakistan
| | - Hussain Akbar
- Saidu Teaching Hospital , Marghuzar road, Saidu Sharif, 19130, Swat, Pakistan
| | - Zafar Iqbal
- Department of Pulmonology, Lady Reading Hospital , Hospital Road, Peshawar, 25000, Pakistan
| | - Kacey Ernst
- Epidemiology and Biostatistics Department, Mel and Enid Zuckerman College of Public Health , 1295 N. Martin Drachman Hall A246, PO Box: 245211 Tucson, AZ 85724, USA
| |
Collapse
|
11
|
Joy T, Chen M, Arnbrister J, Williamson D, Li S, Nair S, Brophy M, Garcia VM, Walker K, Ernst K, Gouge DH, Carrière Y, Riehle MA. Assessing Near-Infrared Spectroscopy (NIRS) for Evaluation of Aedes aegypti Population Age Structure. Insects 2022; 13:insects13040360. [PMID: 35447802 PMCID: PMC9029691 DOI: 10.3390/insects13040360] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023]
Abstract
Given that older Aedes aegypti (L.) mosquitoes typically pose the greatest risk of pathogen transmission, the capacity to age grade wild Ae. aegypti mosquito populations would be a valuable tool in monitoring the potential risk of arboviral transmission. Here, we compared the effectiveness of near-infrared spectroscopy (NIRS) to age grade field-collected Ae. aegypti with two alternative techniques—parity analysis and transcript abundance of the age-associated gene SCP1. Using lab-reared mosquitoes of known ages from three distinct populations maintained as adults under laboratory or semi-field conditions, we developed and validated four NIRS models for predicting the age of field-collected Ae. aegypti. To assess the accuracy of these models, female Ae. aegypti mosquitoes were collected from Maricopa County, AZ, during the 2017 and 2018 monsoon season, and a subset were age graded using the three different age-grading techniques. For both years, each of the four NIRS models consistently graded parous mosquitoes as significantly older than nulliparous mosquitoes. Furthermore, a significant positive linear association occurred between SCP1 and NIRS age predictions in seven of the eight year/model combinations, although considerable variation in the predicted age of individual mosquitoes was observed. Our results suggest that although the NIRS models were not adequate in determining the age of individual field-collected mosquitoes, they have the potential to quickly and cost effectively track changes in the age structure of Ae. aegypti populations across locations and over time.
Collapse
Affiliation(s)
- Teresa Joy
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Minhao Chen
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Joshua Arnbrister
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Daniel Williamson
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Shujuan Li
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Shakunthala Nair
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Maureen Brophy
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Valerie Madera Garcia
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85724, USA; (V.M.G.); (K.E.)
| | - Kathleen Walker
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85724, USA; (V.M.G.); (K.E.)
| | - Dawn H. Gouge
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Yves Carrière
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
| | - Michael A. Riehle
- Department of Entomology, University of Arizona, Tucson, AZ 85721, USA; (T.J.); (M.C.); (J.A.); (D.W.); (S.L.); (S.N.); (M.B.); (K.W.); (D.H.G.); (Y.C.)
- Correspondence: ; Tel.: +1-520-626-8500
| |
Collapse
|
12
|
López-Gálvez N, Wagoner R, Canales RA, Ernst K, Burgess JL, de Zapien J, Rosales C, Beamer P. Longitudinal assessment of kidney function in migrant farm workers. Environ Res 2021; 202:111686. [PMID: 34273367 PMCID: PMC8578352 DOI: 10.1016/j.envres.2021.111686] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 05/30/2023]
Abstract
Chronic kidney disease of unknown etiology (CKDu) is an epidemic that affects young agricultural workers in several warm regions of the world. However, there is a lack of monitoring of kidney issues in regions with extremely warm environments such as the Northwest of Mexico, a semi-arid region with a growing agricultural industry, where migrant and seasonal farm workers (MSFWs) travel to work in the fields. The objective of this study was to longitudinally assess kidney functioning of MSFWs in relation to pesticide exposure, heat stress and dehydration in a large-scale farm in Mexico. We enrolled 101 MSFWs, of whom 50 were randomly selected to work in an organic certified area and 51 were randomly selected to work in a conventional area. We also enrolled 50 office workers within the same region as a reference group. We collected urine and blood samples from all workers in addition to demographic, behavioral, and occupational characteristics. The physiological strain index (PSI) was used to estimate workers' heat strain. Sampling was conducted at pre-harvest (March) and late in the harvest (July). Linear mixed models were built with the estimated glomerular filtration rate (eGFR) as the dependent variable. We found a significant decrease in kidney function in MSFWs compared to office workers. By the late harvest, one MSFW developed kidney disease, two MSFWs suffered a kidney injury, and 14 MSFWs were at risk of a kidney injury. We found that the eGFR in MSFWs decreased significantly from pre-harvest (125 ± 13.0 mL/min/1.73 m2) to late harvest (109 ± 13.6 mL/min/1.73 m2) (p < 0.001), while no significant change was observed in office workers. The eGFR was significantly lower in MSFWs who worked in the conventional field (101.2 ± 19.4 mL/min/1.73 m2) vs the organic field (110.9 ± 13.6 mL/min/1.73 m2) (p = 0.002). In our final model, we found that dehydration was associated with the decrease of eGFR. We also found an interaction between heat strain and job category, as a significant decline in eGFR by job category (conventional/organic MSFWs and office workers) was related to an increase in heat strain. This suggests that pesticide exposure needs to be considered in combination with heat stress and dehydration. This study provides valuable information on kidney function in MSFWs, and it shows the importance of early long-term monitoring in farm workers in other regions where CKDu has not been evaluated yet.
Collapse
Affiliation(s)
- Nicolás López-Gálvez
- San Diego State University Research Foundation, San Diego State University, 5250 Campanile Dr, San Diego, CA, 92182, USA; Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA.
| | - Rietta Wagoner
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Robert A Canales
- Interdisciplinary Program in Applied Mathematics, University of Arizona, 617 N. Santa Rita Ave, PO Box 210089, Tucson, AZ, 85721, USA
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Jill de Zapien
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Cecilia Rosales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| | - Paloma Beamer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, PO 245210, Tucson, AZ, 85724, USA
| |
Collapse
|
13
|
Anderson E, Koss M, Castro Luque AL, Garcia D, Lopez E, Ernst K. WhatsApp-Based Focus Groups Among Mexican-Origin Women in Zika Risk Area: Feasibility, Acceptability, and Data Quality. JMIR Form Res 2021; 5:e20970. [PMID: 34709185 PMCID: PMC8587330 DOI: 10.2196/20970] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 11/23/2020] [Accepted: 05/31/2021] [Indexed: 11/26/2022] Open
Abstract
Background Despite unprecedented advances in worldwide access to the internet via smartphones, barriers to engaging hard-to-reach populations remain in many methods of health research. A potential avenue for conducting qualitative research is via participatory web-based media, including the free, popular social platform WhatsApp. However, despite the clear advantages of engaging with participants over a well-established web-based platform, logistical challenges remain. Objective This study aims to report evidence on the feasibility and acceptability of WhatsApp as a method to conduct focus groups. Methods A pilot focus group was conducted with Spanish-speaking women near the US–Mexico border. The content focus was knowledge and perceived risks for exposure to the Zika virus during pregnancy. Results Evidence was obtained regarding WhatsApp as a low-cost, logistically feasible methodology that resulted in rich qualitative data from a population that is often reticent to engage in traditional research. A total of 5 participants participated in a focus group, of whom all 5 consistently contributed to the focus group chat in WhatsApp, which was conducted over 3 consecutive days. Conclusions The findings are noteworthy at a time when face-to-face focus groups, the gold standard, are risky or precluded by safe COVID-19 guidelines. Other implications include more applications and evaluations of WhatsApp for delivering one-on-one or group health education interventions on sensitive topics. This paper outlines the key steps and considerations for the replication or adaptation of methods.
Collapse
Affiliation(s)
- Elizabeth Anderson
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States.,International Center for Research on Women, Washington, DC, United States
| | - Mary Koss
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | | | - David Garcia
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | - Elise Lopez
- Department of Health Promotion Sciences, University of Arizona, Tucson, AZ, United States
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, United States
| |
Collapse
|
14
|
Anderson EJ, Krause KC, Meyer Krause C, Welter A, McClelland DJ, Garcia DO, Ernst K, Lopez EC, Koss MP. Web-Based and mHealth Interventions for Intimate Partner Violence Victimization Prevention: A Systematic Review. Trauma Violence Abuse 2021; 22:870-884. [PMID: 31742475 DOI: 10.1177/1524838019888889] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Mobile health (mHealth) technologies are increasingly used across health programming including intimate partner violence (IPV) prevention to optimize screening, educational outreach, and linkages to care via telehealth. We systematically evaluated current web-based and mHealth interventions, which include web- or mobile-based delivery methods for primary, secondary, and tertiary IPV victimization prevention. We searched MEDLINE/PubMed, Embase, CINAHL, PsycINFO, Open Grey, and Google Scholar for empirical studies published 1998-2019. Studies were included if they considered empirical data, participants in adult romantic relationships, IPV as a primary or secondary outcome, and an mHealth component. The Mixed Methods Appraisal Tool was used to record critical ratings of quality among studies selected for inclusion. We assessed variation in targeted populations, types of IPV addressed, and mHealth approaches used. Of 133 studies identified for full-text review, 31 were included. Computer-based screening with or without integrated education was the most common mHealth approach (n = 8, 26%), followed by safety decision aids (n = 7, 23%). Feasibility and acceptability were found to be generally high where assessed (23% of studies, n = 7). There was limited evidence around whether mHealth interventions better addressed population needs compared to conventional interventions. mHealth tools for IPV prevention are especially acceptable in health-care settings, on mobile phone platforms, or when connecting victims to health care. Despite enthusiasm in pilot projects, evidence for efficacy compared to conventional IPV prevention approaches is limited. A major strength of mHealth IPV prevention programming is the ability to tailor interventions to individual victim needs without extensive human resource expenditure by providers.
Collapse
Affiliation(s)
- Elizabeth J Anderson
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Keegan C Krause
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Caitlin Meyer Krause
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Abby Welter
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - D Jean McClelland
- Arizona Health Sciences Center, 8041University of Arizona, Tucson, Arizona, USA
| | - David O Garcia
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Kacey Ernst
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Elise C Lopez
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| | - Mary P Koss
- Mel & Enid Zuckerman College of Public Health, 8041University of Arizona, Tucson, AZ, USA
| |
Collapse
|
15
|
Anderson EJ, Ernst K, Garcia DO, Lopez E, Pogreba Brown K, Austhof E, Carr McCuin D, Hayden MH, Koss MP. Knowledge of Sexual Transmission of Zika Virus Among Women Who Are Pregnant or Intend to Become Pregnant, Arizona, 2017. Public Health Rep 2021; 137:488-497. [PMID: 33798396 PMCID: PMC9109529 DOI: 10.1177/00333549211006986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona. METHODS In 2017, we conducted an Arizona-statewide survey 15 months after the initial release of US guidelines on sexual transmission of Zika virus. We used Poisson regression, adjusting for demographic factors, to estimate the likelihood among women who were pregnant or intended to become pregnant of knowing that Zika virus is sexually transmitted relative to other women of childbearing age. We used multinomial logistic regression models to explore associations with most used health information sources, either in person (eg, medical providers) or online (eg, Facebook), categorized by extent of dependability. RESULTS Women who were pregnant or intended to become pregnant had similarly poor knowledge of the sexual transmission of Zika virus as compared with other women of childbearing age (adjusted prevalence ratio = 1.14 [95% CI, 0.83-1.55]). Only about one-third of all respondents reported knowledge of sexual transmission. Reliance on high- vs low-dependability information sources, whether in person or online, did not predict the extent of Zika virus knowledge among women who were pregnant or intended to become pregnant. CONCLUSION As late as the second year of local Zika virus transmission in the United States, in 2017, women in Arizona were not receiving sufficient information about sexual transmission, even though it was available. To prepare for possible future outbreaks, research should explore which aspects of Zika information campaigns were ineffective or inefficient.
Collapse
Affiliation(s)
- Elizabeth J Anderson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.,10969 International Center for Research on Women, Washington, DC, USA
| | - Kacey Ernst
- 10969 International Center for Research on Women, Washington, DC, USA
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Elise Lopez
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Kristen Pogreba Brown
- 8041 Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Erika Austhof
- College of Public Health, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Dametreea Carr McCuin
- 8041 Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mary H Hayden
- 14676 National Institute for Human Resilience, University of Colorado, Colorado Springs, CO, USA
| | - Mary P Koss
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
16
|
Möhlhenrich SC, Ernst K, Peters F, Kniha K, Chhatwani S, Prescher A, Danesh G, Hölzle F, Modabber A. Immediate dental and skeletal influence of distractor position on surgically assisted rapid palatal expansion with or without pterygomaxillary disjunction. Int J Oral Maxillofac Surg 2020; 50:649-656. [PMID: 33131988 DOI: 10.1016/j.ijom.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/18/2020] [Accepted: 10/08/2020] [Indexed: 10/23/2022]
Abstract
The outcome of surgically assisted rapid palatal expansion (SARPE) can be affected by pterygomaxillary disjunction (PMD) and the distractor position. In this study, SARPE was performed, with or without PMD, in 20 fresh cadaver heads. Transverse expansion was conducted twice using a bone-borne distractor in the anterior and posterior positions, resulting in four groups (n=10). Cone beam computed tomography scans were completed before and after SARPE to evaluate maxillary changes. A comparative anterior decrease and posterior increase in midpalatal opening resulted from SARPE with PMD combined with a posteriorly placed distractor. Significant differences in the internal transverse changes were found between the two SARPE techniques combined with an anterior distractor at the level of the premolars and molars for alveolar ridge width (P=0.040, P=0.024), and at the level of the molars for the dental crown width (P=0.017) and corresponding tooth cusp width (P=0.018). In contrast, using a posteriorly placed distractor led to a significant difference for tooth cusp width only (P=0.050). No statistically significant differences were found between external transverse changes or between distractor positions. PMD is more important in achieving a more uniform and parallel transverse expansion pattern than the distractor position. However, a posterior distractor seems to intensify the effects of PMD.
Collapse
Affiliation(s)
- S C Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany; Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Aachen, Germany.
| | - K Ernst
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Aachen, Germany
| | - F Peters
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Aachen, Germany
| | - K Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Aachen, Germany
| | - S Chhatwani
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - A Prescher
- Institute of Molecular and Cellular Anatomy, Medical Faculty of RWTH-Aachen, Aachen, Germany
| | - G Danesh
- Department of Orthodontics, University of Witten/Herdecke, Witten, Germany
| | - F Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Aachen, Germany
| | - A Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Aachen, Germany
| |
Collapse
|
17
|
Bauer E, Koretz K, Schochter F, deGregorio A, Ernst K, Widschwendter P, Janni W, deGregorio N. Adenomatoidtumoren des Uterus – eine seltene benigne Tumorentität prämenopausaler Frauen. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Bauer
- Universitätsklinikum Ulm, Frauenklinik
| | - K Koretz
- Universitätsklinikum Ulm, Institut für Pathologie
| | | | | | - K Ernst
- Universitätsklinikum Ulm, Frauenklinik
| | | | - W Janni
- Universitätsklinikum Ulm, Frauenklinik
| | | |
Collapse
|
18
|
Polasik A, Friedl T, Lato K, Ernst K, Paulus W, Janni W, Friebe-Hoffmann U. Zu viel Fruchtwasser? – Outcome von 72 Feten mit pränatal diagnostiziertem Polyhydramnion. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
19
|
Großmann L, de Gregorio N, Braun T, Ernst K, Janni W, de Gregorio A. Ambulantes Mamma-MRT: Einsatz und Erwartungen – erste Ergebnisse einer anonymen Befragung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
| | - N de Gregorio
- Universitätsklinikum Ulm, Klinik für Frauenheilkunde und Geburtshilfe
| | - T Braun
- Universitätsklinikum Ulm, Klinik für Frauenheilkunde und Geburtshilfe
| | - K Ernst
- Universitätsklinikum Ulm, Klinik für Frauenheilkunde und Geburtshilfe
| | - W Janni
- Universitätsklinikum Ulm, Klinik für Frauenheilkunde und Geburtshilfe
| | - A de Gregorio
- Universitätsklinikum Ulm, Klinik für Frauenheilkunde und Geburtshilfe
| |
Collapse
|
20
|
Bärtels C, de Gregorio A, Ernst K, Friedl T, Janni W, de Gregorio N. Portkatheterimplantation an der Universitätsfrauenklinik Ulm – Retrospektive Datenauswertung vier Jahre nach Einführung einer neuen Technik. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
21
|
Ernst K, deGregorio A, Bauer E, Polasik A, Janni W, Schochter F, Mian E, deGregorio N. Zervixkarzinom, Myom oder Sarkom? – Der seltene Fall eines rein zervikalen Leiomyosarkoms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Ernst
- Universitätsfrauenklinik Ulm
| | | | - E Bauer
- Universitätsfrauenklinik Ulm
| | | | - W Janni
- Universitätsfrauenklinik Ulm
| | | | - E Mian
- Universitätsfrauenklinik Ulm
| | | |
Collapse
|
22
|
Comeau G, Zinna RA, Scott T, Ernst K, Walker K, Carrière Y, Riehle MA. Vertical Transmission of Zika Virus in Aedes aegypti Produces Potentially Infectious Progeny. Am J Trop Med Hyg 2020; 103:876-883. [PMID: 32524954 PMCID: PMC7410478 DOI: 10.4269/ajtmh.19-0698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 05/04/2020] [Indexed: 09/02/2023] Open
Abstract
Vertical transmission, or pathogen transfer from female to offspring, can facilitate the persistence of emerging arboviruses, such as Zika virus (ZIKV), through periods of low horizontal transmission or adverse environmental conditions. We aimed at determining the rate of vertical transmission for ZIKV in its principal vector, Aedes aegypti, and the vector competence of vertically infected progeny. Aedes aegypti females that consumed a blood meal provisioned with ZIKV were maintained under three temperature conditions (27°C, 30°C, and 33°C) following the infectious blood meal and allowed to complete three reproductive cycles. The overall vertical transmission rate was 6.5% (95% CI = 3.9-9.9). Vertical transmission of ZIKV was observed across all temperature conditions and virus detected in adult progeny up to 2 weeks postemergence. In total, 3.4% (95% CI = 1.6-6.2) of adult progeny produced saliva with ZIKV, indicating their vector competence. These results suggest the virus may be maintained in Ae. aegypti populations without a vertebrate host for short periods.
Collapse
Affiliation(s)
- Genevieve Comeau
- Department of Entomology, University of Arizona, Tucson, Arizona
| | - Robert A. Zinna
- Department of Biology, Mars Hill University, Mars Hill, North Carolina
| | - Taylor Scott
- Department of Entomology, University of Arizona, Tucson, Arizona
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kathleen Walker
- Department of Entomology, University of Arizona, Tucson, Arizona
| | - Yves Carrière
- Department of Entomology, University of Arizona, Tucson, Arizona
| | | |
Collapse
|
23
|
Ernst K, deGregorio N, Bärtels C, Janni W, Friedel TW, deGregorio A. Portkatheterimplantation an der Universitätsfrauenklinik Ulm – Retrospektive Datenauswertung vier Jahre nach Einführung einer neuen Technik. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Ernst
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - N deGregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - C Bärtels
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - T W Friedel
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - A deGregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| |
Collapse
|
24
|
Ernst K, DeGregorio A, Fink V, Janni W, Braun T, Bekes I. Gigantische Raumforderung der Brust - Der seltene Fall eines malignen Phylloidestumors. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Affiliation(s)
- K Ernst
- Universitätsfrauenklinik Ulm
| | | | - V Fink
- Universitätsfrauenklinik Ulm
| | - W Janni
- Universitätsfrauenklinik Ulm
| | - T Braun
- Universitätsfrauenklinik Ulm
| | - I Bekes
- Universitätsfrauenklinik Ulm
| |
Collapse
|
25
|
Lott BE, Trejo MJ, Baum C, McClelland DJ, Adsul P, Madhivanan P, Carvajal S, Ernst K, Ehiri J. Interventions to increase uptake of cervical screening in sub-Saharan Africa: a scoping review using the integrated behavioral model. BMC Public Health 2020; 20:654. [PMID: 32393218 PMCID: PMC7216595 DOI: 10.1186/s12889-020-08777-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/24/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) experiences disproportionate burden of cervical cancer incidence and mortality due in part to low uptake of cervical screening, a strategy for prevention and down-staging of cervical cancer. This scoping review identifies studies of interventions to increase uptake of cervical screening among women in the region and uses the Integrated Behavioral Model (IBM) to describe how interventions might work. METHODS A systematic search of literature was conducted in PubMed, Web of Science, Embase, and CINAHL databases through May 2019. Screening and data charting were performed by two independent reviewers. Intervention studies measuring changes to uptake in screening among women in SSA were included, with no restriction to intervention type, study setting or date, or participant characteristics. Intervention type and implementation strategies were described using behavioral constructs from the IBM. RESULTS Of the 3704 citations the search produced, 19 studies were selected for inclusion. Most studies were published between 2014 and 2019 (78.9%) and were set in Nigeria (47.4%) and South Africa (26.3%). Studies most often assessed screening with Pap smears (31.6%) and measured uptake as ever screened (42.1%) or screened during the study period (36.8%). Education-based interventions were most common (57.9%) and the IBM construct of knowledge/skills to perform screening was targeted most frequently (68.4%). Willingness to screen was high, before and after intervention. Screening coverage ranged from 1.7 to 99.2% post-intervention, with six studies (31.6%) reporting a significant improvement in screening that achieved ≥60% coverage. CONCLUSIONS Educational interventions were largely ineffective, except those that utilized peer or community health educators and mHealth implementation strategies. Two economic incentivization interventions were moderately effective, by acting on participants' instrumental attitudes, but resulted in screening coverage less than 20%. Innovative service delivery, including community-based self-sampling, acted on environmental constraints, striving to make services more available, accessible, and appropriate to women, and were the most effective. This review demonstrates that intent to perform screening may not be the major determinant of screening behavior, suggesting other theoretical frameworks may be needed to more fully understand uptake of cervical screening in sub-Saharan Africa, particularly for health systems change interventions.
Collapse
Affiliation(s)
- Breanne E Lott
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA.
| | - Mario J Trejo
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA
| | - Christina Baum
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA
| | - D Jean McClelland
- Health Sciences Library, University of Arizona, 1501 N Campbell Ave Ward 6, Tucson, AZ, 85724, USA
| | - Prajakta Adsul
- School of Medicine and Cancer Center, University of New Mexico, MSC08 4720, 1 University of New Mexico, Albuquerque, NM, 87131-0001, USA
| | - Purnima Madhivanan
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA.,College of Medicine, University of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA.,Public Health Research Institute of India, 89/B, 2nd Cross, 2nd Main, Yadavgiri, Mysore, 560021, India
| | - Scott Carvajal
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA
| | - Kacey Ernst
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA
| | - John Ehiri
- Mel & Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ, 85724, USA
| |
Collapse
|
26
|
Pogreba-Brown K, Austhof E, Okello A, Weiss J, Lira R, Ernst K. Public perceptions of non-pharmaceutical interventions for influenza and mosquito-borne illnesses - a statewide survey in Arizona. Perspect Public Health 2019; 140:214-221. [PMID: 31755813 DOI: 10.1177/1757913919886605] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS We conducted a statewide online survey to understand public knowledge, attitudes, and practices (KAP) related to non-pharmaceutical interventions (NPIs) for mosquito-borne diseases and influenza in Arizona. METHODS The survey included knowledge of diseases, major health concerns, and sources of health information and KAP of NPIs for influenza and mosquito-borne diseases. Our team worked with Qualtrics®, an online survey company, to recruit a representative sample of 1500 adults in Arizona. RESULTS Of the 1531 respondents who completed the survey, most indicated that chronic conditions were their primary health concern (48%), with the other half split between infectious diseases (25%) and health effects of environmental conditions (26%). The majority (88%) of respondents indicated that they use the Internet to get their health information. Approximately one in eight people reported not emptying standing water and reducing potential mosquito habitats, despite respondents citing them as being the most effective factors in reducing mosquitoes. Regarding specific diseases, about half of the respondents were concerned about West Nile virus and/or Zika virus. Most (85%) people knew the signs and symptoms of influenza and 63% of people reported being likely to get the influenza shot. Those who did not vaccinate (n = 285) reported concerns that the vaccine would make them sick (41%), was ineffective (37%), or others indicated, 'I don't want to' (37%). CONCLUSIONS Overall, respondents were most concerned with chronic conditions and received their information from the Internet. Knowledge about mosquito-borne diseases was low. There were high levels of acceptance and self-reported uptake of the influenza vaccine.
Collapse
Affiliation(s)
- K Pogreba-Brown
- Epidemiology and Biostatistics, Mel & Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave., A220, P.O. Box 245211, Tucson, AZ 85724, USA
| | - E Austhof
- Epidemiology and Biostatistics, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| | - A Okello
- Ohio Colleges of Medicine Government Resource Center, Columbus, OH, USA
| | - J Weiss
- Arizona Department of Health Services, Phoenix, AZ, USA
| | - R Lira
- Arizona Department of Health Services, Phoenix, AZ, USA
| | - K Ernst
- Epidemiology and Biostatistics, Mel & Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA
| |
Collapse
|
27
|
Asaolu I, Nuño VL, Ernst K, Taren D, Ehiri J. Healthcare system indicators associated with modern contraceptive use in Ghana, Kenya, and Nigeria: evidence from the Performance Monitoring and Accountability 2020 data. Reprod Health 2019; 16:152. [PMID: 31655615 PMCID: PMC6814992 DOI: 10.1186/s12978-019-0816-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 09/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background Public health literature is replete with evidence on individual and interpersonal indicators of modern contraceptive use. There is, however, limited knowledge regarding healthcare system indicators of modern contraceptive use. This study assessed how the healthcare system influences use of modern contraceptive among women in Ghana, Kenya, and two large population states in Nigeria. Methods This study used data from Phase 1 of the Performance Monitoring and Accountability 2020. The analytical sample was limited to women with a need for contraception, defined as women of reproductive age (15 to 49 years) who wish to delay or limit childbirth. Therefore, this analysis consisted of 1066, 1285, and 1955 women from Nigeria, Ghana, and Kenya respectively. Indicators of healthcare assessed include user-fees, visit by health worker, type of health facility, multiple perinatal services, adolescent reproductive healthcare, density of healthcare workers, and regularity of contraceptive services. All analyses were conducted with SAS (9.4), with statistical significance set at p < 5%. Results The prevalence of modern contraceptive was 22.7, 33.2, and 68.9% in Nigeria, Ghana, and Kenya respectively. The odds of modern contraceptive use were higher among Nigerian women who lived within areas that provide adolescent reproductive healthcare (OR = 2.05; 95% C.I. = 1.05—3.99) and Kenyan women residing in locales with polyclinic or hospitals (OR = 1.91; 1.27—2.88). Also, the odds of contraceptive use were higher among Kenyan women who lived in areas with user-fee for contraceptive services (OR = 1.40; 1.07–1.85), but lower among Ghanaian women residing in such areas (OR = 0.46; 0.23—0.92). Lastly, the odds of modern contraceptive use were higher among women visited by a health-worker visit among women in Ghana (OR = 1.63; 1.11—2.42) and Nigeria (OR = 2.97; 1.56—5.67) than those without a visit. Conclusion This study found an association between country-specific indicators of healthcare and modern contraceptive use. Evidence from this study can inform policy makers, health workers, and healthcare organizations on specific healthcare factors to target in meeting the need for contraception in Ghana, Kenya, and Nigeria.
Collapse
Affiliation(s)
- Ibitola Asaolu
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA.
| | - Velia Leybas Nuño
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Douglas Taren
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| |
Collapse
|
28
|
de Gregorio A, Otto S, Steinacker MJ, Ernst K, de Gregorio N, Janni W, Ebner F. Durchführbarkeit einer Expertenbefragung zum Thema „Sportempfehlung nach Brustaufbau“ – erste Ergebnisse einer Online-Befragung. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
| | - S Otto
- Sektion Sport- und Rehabilitationsmedizin, Universitätsklinikum Ulm
| | - MJ Steinacker
- Sektion Sport- und Rehabilitationsmedizin, Universitätsklinikum Ulm
| | - K Ernst
- Universitätsfrauenklinik Ulm
| | | | - W Janni
- Universitätsfrauenklinik Ulm
| | - F Ebner
- Klinik für Frauenheilkunde HELIOS Amper Klinik Dachau
| |
Collapse
|
29
|
de Gregorio A, Hering E, Friedl TWP, Ernst K, Schochter F, Koretz K, Janni W, Huober J. Der Proliferationsmarker Ki67 bei Patientinnen mit frühem Brustkrebs – eine deskriptive Single-Center Analyse. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- A de Gregorio
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - E Hering
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - TWP Friedl
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - K Ernst
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - F Schochter
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - K Koretz
- Department of Pathology, University Hospital Ulm, Ulm, Germany
| | - W Janni
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - J Huober
- Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| |
Collapse
|
30
|
Jerg-Bretzke L, Karremann M, Steffen W, de Gregorio N, Ernst K, Janni W, Ebner F, de Gregorio A. Arbeitszufriedenheit und psychische Gesundheit von medizinischem Personal einer Universitätsfrauenklinik. Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1693887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- L Jerg-Bretzke
- Sektion Medizinische Psychologie, Universitätsklinikum Ulm
| | - M Karremann
- Sektion Medizinische Psychologie, Universitätsklinikum Ulm
| | - W Steffen
- Sektion Medizinische Psychologie, Universitätsklinikum Ulm
| | - N de Gregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - K Ernst
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - F Ebner
- Klinik für Frauenheilkunde und Geburtshilfe, Amperklinikum Dachau
| | - A de Gregorio
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| |
Collapse
|
31
|
Ruberto I, Yaglom H, Erhart LM, Plante L, Weiss J, Golenko C, Casal M, McCotter O, Adams L, Ernst K, Komatsu K. Dengue Knowledge, Attitudes, and Practices Among Arizona Health Care Providers, 2014-2015. Vector Borne Zoonotic Dis 2019; 19:434-440. [PMID: 30802177 DOI: 10.1089/vbz.2018.2370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Detection of local dengue transmission requires an aware and engaged medical community, as health care providers are the front line of public health surveillance. To assess the knowledge, attitude, and practice about dengue, an online survey was distributed among Arizona health care providers during 2014 and 2015. Materials and Methods: The survey consisted of a total of 10 knowledge, attitude, and practice questions divided as follows: 5 knowledge questions, 2 attitude questions, and 3 practice questions. The link to the Qualtrics survey was distributed through the Arizona Health Alert Network to a total of 4582 e-mail addresses, of which 335 participants opened the survey, and 196 completed and submitted their responses. Results: Less than half the respondents reported choosing the right dengue diagnostic test (40.4%) or understanding the epidemiology of dengue in Arizona (40.9%). Slightly more than half the respondents reported frequently asking for travel history (59%), and three-fourth of them would notify the local health department on suspicion of a dengue patient (76.1%). Survey score was associated with providers specialized in infectious diseases (1.88, 95% CI: 0.42-3.33, p = 0.01), medical doctors or doctors of osteopathic medicine (1.82, 95% CI: 0.98-2.65, p < 0.0001), and respondents who reported to have heard about the increase in dengue cases in Sonora (Mexico) in fall 2014 (1.51, 95% CI: 0.67-2.34, p = 0.0005), indicating better survey performance. Conclusions: These results indicate that education for health care providers on dengue should be improved particularly among general practice noninfectious disease providers who might be the first point of care for dengue patients. Findings suggest that additional training on clinical management, asking travel history, and notifying the local health department on suspicion of a dengue patient are needed.
Collapse
Affiliation(s)
- Irene Ruberto
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Hayley Yaglom
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Laura M Erhart
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Lydia Plante
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Joli Weiss
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Catherine Golenko
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Mariana Casal
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| | - Orion McCotter
- 2 Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Laura Adams
- 2 Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kacey Ernst
- 3 Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Ken Komatsu
- 1 Office of Infectious Disease Services, Arizona Department of Health Services, Phoenix, Arizona
| |
Collapse
|
32
|
Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. Abstract OT1-11-01: The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot1-11-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
Further progress in the treatment of breast cancer will likely come from contributions of molecular biology and immunologic approaches. The search for druggable molecular aberrations may enable treatment based on the molecular profile. A better identification of patients with a high risk of relapse facilitates the selection of these pts for clinical trials investigating early therapeutic molecular-based interventions.
Trial Design:
The BRandO BiO Registry is a multi-center regional registry to record clinical, epidemiological, and biological data from patients with newly diagnosed breast and ovarian cancer at the University of Ulm, Dept. of Gynecology and 19 affiliated network hospitals and practices in the Alb-Allgäu Bodensee region (outreach area of the Comprehensive Cancer Center Ulm). Longitudinal biobanking is included with collection of paraffin-embedded samples of the primary tumor as well as blood samples at first diagnosis, after 6 and 12 months and at first relapse to isolate and investigate cell-free and germline DNA. Epidemiological, life style and quality of life (QOL) questionnaires are collected at first diagnosis, after 12, 36 and 60 months. The follow up is planned for 10 years.
Eligibility criteria:
Patients with primary newly diagnosed untreated breast or ovarian cancer of ≥ 18 years are eligible; primary metastatic untreated disease is allowed. Exclusion criteria comprise severe neurological or psychiatric disorders interfering with the ability to give an informed consent, no consent for registration, storage and processing of the individual disease characteristics and bio samples, and any malignant tumor in the last 3 years (except in situ disease).
Specific aims:
To register the majority of patients with newly diagnosed breast or ovarian cancer in all BRandO-BiO participating centers of a well-defined geographical area. To assess clinical characteristics and outcome data (event-free survival, overall survival) of these patients. To evaluate the primary tumor of all patients for mutational (druggable) aberrations. Further to assess cell-free DNA in the serial blood samples at baseline, 6 and 12 months and correlate these results with clinical outcome data as well as tumor and patient characteristics to look for early markers predicting relapse. To perform a longitudinal assessment of the patients' sociodemographic factors, comorbidities, lifestyle and QOL factors by analyzing serial questionnaires collected at recruitment and at 12, 36 and 60 months.
Present accrual and target accrual:
The BRandO BiO Registry started January 2016 in the Dept. of Gynecology, University of Ulm and February 2017 at the network hospitals and practices. Until June 2018, 1180 patients with primary breast or ovarian cancer have been enrolled. The current adherence to serial blood testing and serial questionnaires is good with a return rate of 90%. A sample size of 3000 patients is planned.
Contact information:
Jens Huober, University of Ulm, Dept of Gynecology, Breast Center, jens.huober@uniklinik-ulm.de
Amelie de Gregorio, University of Ulm, Dept of Gynecology, Breast Center, Amelie.de Gregorio@uniklinik-ulm.de
Citation Format: Huober J, Nagel G, Rempen A, Schlicht E, Flock F, Fritz S, Thiel F, Wiesmüller L, Felderbaum R, Heilmann V, Bekes I, Fink V, Albrecht S, De Gregorio N, Tzschaschel M, Ernst K, Wolf C, Kuhn P, Friedl T, Janni W, De Gregorio A. The BRandO BiO registry – A multicenter regional registry for patients with primary breast and ovarian cancer with longitudinal biobanking and evaluation of epidemiological, life style and quality of life factors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT1-11-01.
Collapse
Affiliation(s)
- J Huober
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - G Nagel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - A Rempen
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - E Schlicht
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - F Flock
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - S Fritz
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - F Thiel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - L Wiesmüller
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - R Felderbaum
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - V Heilmann
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - I Bekes
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - V Fink
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - S Albrecht
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - N De Gregorio
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - M Tzschaschel
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - K Ernst
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - C Wolf
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - P Kuhn
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - T Friedl
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - W Janni
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| | - A De Gregorio
- University Hospital Ulm, Ulm, Germany; Diakonie-Hospital, Schwäbisch Hall, Schwäbisch-Hall, Germany; Staufer-Hospital, Schwäbisch Gmünd, Schwäbisch-Gmünd, Germany; Hospital Memmingen, Memmingen, Germany; Sana Clinics, Biberach, Biberach, Germany; Hospital Kempten-Oberallgäu GmbH, Kempten, Kempten, Germany; Private Practice Dr. Volkmar Heilmann, Günzburg, Günzburg, Germany; Medical Center-Dr. C. Wolf, Ulm, Ulm, Germany; Institute of Epidemiology, University Ulm, Ulm, Germany; Clinical Cancer Register, University Hospital of Ulm, Ulm, Germany; Hospital Alb-Fils, Clinic am Eichert, Alb-Fils, Göppingen, Germany
| |
Collapse
|
33
|
Tzschaschel M, Schemm M, Polasik A, Schochter F, Ernst K, Redelstein H, Kautenburger J, Huesmann S, De Gregorio A, Friedl TW, Janni W, Huober J. Prosperus Trial – Prospektive Studie zur Evaluation des Ernährungsstatus von Patientinnen mit Mammakarzinom oder Ovarialkarzinom, die eine Chemotherapie erhalten. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - M Schemm
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - A Polasik
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Schochter
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - K Ernst
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | | | - S Huesmann
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - TW Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| |
Collapse
|
34
|
de Gregorio A, de Gregorio N, Babiak A, Ernst K, Uhde M, Reister F, Janni W, Gethöffer K, Ebner F. Pemphigoid gestationis – Ungewöhnlicher Krankheitsverlauf einer 29-jährigen G2/P1 mit begleitendem akuten Nierenversagen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | | | - A Babiak
- Klinik für Innere Medizin III, Universitätsklinik Ulm, Ulm, Deutschland
| | - K Ernst
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - M Uhde
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Reister
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - K Gethöffer
- Klinik für Dermatologie und Allergologie Universitätsklinik Ulm, Ulm, Deutschland
| | - F Ebner
- Klinik für Frauenheilkunde HELIOS Amper Klinik Dachau, Dachau, Deutschland
| |
Collapse
|
35
|
Amos L, Ernst K. Metastatic Breast Care E-Learning Modules. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.49900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and context: The McGrath Foundation has created an e-Learning course to upskill breast care nurses in current metastatic breast cancer practice. The e-Learning course has supported better specialist knowledge and helped close the gap in metastatic cancer support services across Australia. Aim: The project aimed to deliver specialist training to breast care nurses on current trends in care and treatment of individuals with metastatic breast cancer, via an e-Learning platform to enable a cost effective delivery across Australia to 119 nurses. Strategy/Tactics: Key learning outcomes were developed to ensure specific information could be delivered via an online platform. Industry experts, clinicians and experienced breast care nurses/nurse practitioners were consulted to develop the content and an outline of what would be delivered. An experienced online content development company was also engaged to ensure that the content would be presented in an engaging way. Program/Policy process: The metastatic e-Learning course was available for McGrath Breast Care Nurses in June 2017 and accredited for professional development hours by the Australian College of Nursing to contribute to registration under the Nursing and Midwifery Board of Australia. Certificates of completion are given to all participants who successfully complete the course once they achieve competency in all areas of assessment. Outcomes: The e-Learning course has had reach across all areas of the country and allowed easy dissemination of information on current trends in metastatic breast cancer to nurses. This is seen to have great reach with almost all McGrath Breast Care Nurses also caring for a proportion of patients with metastatic disease. Additional qualitative and quantitative analysis will be available during the presentation after analysis is completed. What was learned: Some key learnings from this project have been the scalability of e-Learning as a technology enabled professional development solution. The need for good design to enable engagement with content was consistent theme during feedback sessions. As well as using competency based testing to enable participants to gain professional development in a technology enabled platform has reduced nurse down time.
Collapse
Affiliation(s)
- L. Amos
- McGrath Foundation, St. Leonards, Australia
| | - K. Ernst
- McGrath Foundation, St. Leonards, Australia
| |
Collapse
|
36
|
de Gregorio A, Rempen A, Schlicht E, Fritz S, Flock F, Kühn T, Thiel F, Felberbaum R, Kuhn P, Rothenbacher D, Albrecht S, Ernst K, Schochter F, Tzschaschel M, Friedl TWP, Möller P, Janni W, Huober J, Nagel G. Erste epidemiologische Daten zum Patientenkollektiv des BRandO Biology and Outcome (BiO)-Projekts (BReast and Ovarian Cancer). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | - A Rempen
- Klinik für Frauenheilkunde und Geburtshilfe, Diakonieklinikum, Schwäbisch-Hall, Schwäbisch-Hall, Deutschland
| | - E Schlicht
- Klinik für Frauenheilkunde und Geburtshilfe, Kliniken Ostalb, Mutlangen, Deutschland
| | - S Fritz
- Klinik für Frauenheilkunde und Geburtshilfe, Sanaklinikum, Biberach, Deutschland
| | - F Flock
- Klinik für Frauenheilkunde und Geburtshilfe Memmingen, Memmingen, Deutschland
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Deutschland
| | - F Thiel
- Klinik am Eichert, Frauenklinik, Göppingen, Göppingen, Deutschland
| | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Kempten, Deutschland
| | - P Kuhn
- Comprehensive Cancer Center Ulm, Universitätsklinik Ulm, Ulm, Deutschland
| | - D Rothenbacher
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| | - S Albrecht
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - K Ernst
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Schochter
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - TWP Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinik Ulm, Ulm, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - J Huober
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - G Nagel
- Institut für Epidemiologie und Medizinische Biometrie, Universität Ulm, Ulm, Deutschland
| |
Collapse
|
37
|
Coalson J, Richard D, Damian D, Townsend J, Smith K, Ernst K. Human-environment interactions impact Aedes aegypti abundance in an urban desert setting. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
38
|
Abstract
Anthropometric measurements, including height and length, are routinely needed for health research worldwide. Measurement boards are the current gold standard for obtaining the height and length of children. In community-based research, however, the size and weight of the measurement boards make them difficult and cumbersome to carry in the field. In addition, children and infants may express an unwillingness to be placed onto the measurement board. Electronic measuring tools commonly used in industry and contracting work are precise and portable. This study piloted a protocol to use an adapted laser measurement tool, the anthropometric measurement assist (AMA), to obtain height and recumbent length in children in Western Kenya. Intra- and inter-observer variability were determined and compared with measurement board measurements. Results of this initial pilot indicated that the AMA may be a viable alternative to measurement boards. The AMA can measure height/length accurately and reliably, is portable and is equivalent in price to measuring boards, making it a viable option for fieldwork in low-resourced countries.
Collapse
Affiliation(s)
- Ashley Bauman
- Department of Health Promotion Sciences, Mel and Enid Zuckerman School of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman School of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Mary Hayden
- National Center for Atmospheric Research, Boulder, CO 80301, USA
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman School of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Rachel Murray
- Department of Health Promotion Sciences, Mel and Enid Zuckerman School of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| | - Maurice Agawo
- Kenyan Medical Research Institute, Centre for Global Health Research, Kisumu 40100, Kenya
| | - Stephen Munga
- Kenyan Medical Research Institute, Centre for Global Health Research, Kisumu 40100, Kenya
| | - Erik Schmahl
- College of Architecture and Landscape Architecture, The University of Arizona, Tucson, AZ 85719, USA
| | - Douglas Taren
- Department of Health Promotion Sciences, Mel and Enid Zuckerman School of Public Health, The University of Arizona, Tucson, AZ 85724, USA
| |
Collapse
|
39
|
Alvarez-Hernandez G, Ernst K, Acuña-Melendrez NH, Vargas-Ortega AP, Candia-Plata MDC. Medical knowledge related to Rocky Mountain spotted fever in Sonora, Mexico. Trans R Soc Trop Med Hyg 2018; 112:109-114. [PMID: 29617892 DOI: 10.1093/trstmh/try030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/09/2018] [Indexed: 11/14/2022] Open
Abstract
Background Rocky Mountain spotted fever (RMSF) is a tick-borne disease with a high case-fatality rate unless diagnosed promptly and treated timely with doxycycline. Physician knowledge about presentation and treatment can improve outcomes of RMSF in endemic regions, such as Sonora in northern Mexico, where RMSF has caused 1348 non-fatal cases and 247 deaths from 2003 to 2016. Methods A cross-sectional study was conducted with 343 physicians working in medical facilities in Sonora, Mexico. A 25-item questionnaire explored physician knowledge of clinical, epidemiological and preventive aspects of RMSF. Results Only 62% of physicians agreed that doxycycline should be used as the first choice treatment for children under 8 years with suspected RMSF. Additionally, 40% of primary care physicians correctly identified the time to initiate doxycycline, and 32% correctly identified the case-fatality rate of untreated RMSF in all patients. Conclusions Inadequate medical knowledge may adversely affect how patients infected with Rickettsia rickettsii are diagnosed and treated. Educational programs that improve the risk perception and medical knowledge about RMSF should be targeted at physicians most likely to have initial contact with diseased patients.
Collapse
Affiliation(s)
- Gerardo Alvarez-Hernandez
- Department of Medicine and Health Sciences, University of Sonora, Mexico; Hermosillo, Sonora, México, C.P. 83000
| | - Kacey Ernst
- Epidemiology and Biostatistics Department, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States 85724
| | | | | | | |
Collapse
|
40
|
Barnes SR, Wansaula Z, Herrick K, Oren E, Ernst K, Olsen SJ, Casal MG. Mortality estimates among adult patients with severe acute respiratory infections from two sentinel hospitals in southern Arizona, United States, 2010-2014. BMC Infect Dis 2018; 18:78. [PMID: 29433471 PMCID: PMC5809880 DOI: 10.1186/s12879-018-2984-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 01/31/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND From October 2010 through February 2016, Arizona conducted surveillance for severe acute respiratory infections (SARI) among adults hospitalized in the Arizona-Mexico border region. There are few accurate mortality estimates in SARI patients, particularly in adults ≥ 65 years old. The purpose of this study was to generate mortality estimates among SARI patients that include deaths occurring shortly after hospital discharge and identify risk factors for mortality. METHODS Patients admitted to two sentinel hospitals between 2010 and 2014 who met the SARI case definition were enrolled. Demographic data were used to link SARI patients to Arizona death certificates. Mortality within 30 days after the date of admission was calculated and risk factors were identified using logistic regression models. RESULTS Among 258 SARI patients, 47% were females, 51% were white, non-Hispanic and 39% were Hispanic. The median age was 63 years (range, 19 to 97 years) and 80% had one or more pre-existing health condition; 9% died in hospital. Mortality increased to 12% (30/258, 30% increase) when electronic vital records and a 30-day post-hospitalization time frame were used. Being age ≥ 65 years (OR = 4.0; 95% CI: 1.6-9.9) and having an intensive care unit admission (OR = 7.4; 95% CI: 3.0-17.9) were independently associated with mortality. CONCLUSION The use of electronic vital records increased SARI-associated mortality estimates by 30%. These findings may help guide prevention and treatment measures, particularly in high-risk persons in this highly fluid border population.
Collapse
Affiliation(s)
- Steve R. Barnes
- Arizona Department of Health Services, Border Infectious Disease Surveillance Program, 400 West Congress, Suite 116, Tucson, AZ 85701 USA
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Zimy Wansaula
- Arizona Department of Health Services, Border Infectious Disease Surveillance Program, 400 West Congress, Suite 116, Tucson, AZ 85701 USA
| | - Kristen Herrick
- Arizona Department of Health Services, Office of Infectious Disease Services, 150 N 18th Ave Phoenix, Phoenix, AZ 85007 USA
| | - Eyal Oren
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724 USA
| | - Sonja J. Olsen
- Influenza Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027 USA
| | - Mariana G. Casal
- Arizona Department of Health Services, Border Infectious Disease Surveillance Program, 400 West Congress, Suite 116, Tucson, AZ 85701 USA
| |
Collapse
|
41
|
Donner A, Belemvire A, Johns B, Mangam K, Fiekowsky E, Gunn J, Hayden M, Ernst K. Equal Opportunity, Equal Work: Increasing Women's Participation in the U.S. President's Malaria Initiative Africa Indoor Residual Spraying Project. Glob Health Sci Pract 2017; 5:603-616. [PMID: 29242251 PMCID: PMC5752607 DOI: 10.9745/ghsp-d-17-00189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 09/29/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND One of the primary control measures for malaria transmission is indoor residual spraying (IRS). Historically, few women have worked in IRS programs, despite the income-generating potential. Increasing women's roles in IRS requires understanding the barriers to women's participation and implementing measures to address them. The U.S. President's Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project is the largest implementer of IRS globally. To address gender inequity in IRS operations, PMI AIRS assessed the barriers to the participation of women and developed and implemented policies to address these barriers. METHODS The PMI AIRS Project initially identified barriers through a series of informal assessments with key stakeholders. PMI AIRS then implemented a series of gender-guided policies, starting in 2015, in Benin, Ethiopia, Ghana, Mali, Madagascar, Mozambique, Rwanda, Senegal, Zambia, and Zimbabwe. The policies included adapting physical work environments to ensure privacy for women; ensuring the safety of women in the workplace; guaranteeing safety and job security of women during pregnancy; and encouraging qualified women to apply for supervisory positions. The project collected routine programmatic data on staff, spray quality, and spray efficiency; data from 2012 through the end of 2015 were analyzed (up through 1 year after implementation of the gender policies). In addition, PMI AIRS conducted surveys in 2015, 2016, and 2017 before and after the spray campaigns in 4 countries to determine changes in gender norms among spray operators through questions about decision making and agency. RESULTS The PMI AIRS Project increased women's employment with the program. Specifically, women's employment increased overall from 23% in 2012 to 29% in 2015, with a 2015 range from 16% (Mali) to 40% (Madagascar). Growth among supervisor roles was even stronger, with the percentage of women in supervisory roles increasing from 17% in 2012 to 46% in 2015, with a 2015 range from 9% (Mali) to 50% (Madagascar). While the data showed that in most countries women sprayed fewer houses per day than men in 2015, the differences were not meaningful, ranging from 0.1 to 1.2 households per day. Gender norms shifted toward more egalitarian views in 2 of the 4 countries with survey data. CONCLUSION Preliminary results suggest the PMI AIRS Project gender policies are increasing the engagement of women in all aspects of spray operations, especially in supervisory roles. Expansion of these policies to all countries implementing IRS and to malaria control implementation more broadly is recommended.
Collapse
Affiliation(s)
- Abigail Donner
- U.S. President's Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project, Abt Associates, Bethesda, MD, USA.
| | | | - Ben Johns
- U.S. President's Malaria Initiative (PMI) Africa Indoor Residual Spraying (AIRS) Project, Abt Associates, Bethesda, MD, USA
| | | | | | - Jayleen Gunn
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mary Hayden
- Research Applications Laboratory, National Center for Atmospheric Research, Boulder, CO, USA
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, College of Public Health, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
42
|
Duncan J, Gordon-Johnson KA, Tulloch-Reid MK, Cunningham-Myrie C, Ernst K, McMorris N, Grant A, Graham M, Chin D, Webster-Kerr K. Chikungunya: important lessons from the Jamaican experience. Rev Panam Salud Publica 2017. [PMID: 28902273 PMCID: PMC6612717 DOI: 10.26633/rpsp.2017.60] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives. To describe the clinical presentation of chikungunya virus (CHIKV) illness in adults during the 2014 outbreak in Jamaica and to determine the predictive value of the case definition. Methods. A cross-sectional study was conducted using clinical data from suspected cases of CHIKV that were reported to the Ministry of Health in April – December 2014. In addition, charts were reviewed of all individuals over 15 years of age with suspected CHIKV based on a diagnosis of CHIKV or “acute viral illness” that presented to four major health centers in Jamaica during the week prior to and the peak week of the epidemic. Data abstracted from these charts using a modified CHIKV Case Investigation Form included demographics, clinical findings, and laboratory tests. Results. In 2014, the Ministry of Health of Jamaica received 4 447 notifications of CHIKV infection. PCR testing was conducted on 137 suspected CHIKV cases (56 men and 81 women; median age 28 years) and was positive for 89 (65%) persons. In all, 205 health charts were identified that met the selection criteria (51 men and 154 women, median age 43 years). The most commonly reported symptoms were arthralgia (86%) and fever (76%). Of those who met the epidemiologic case definition for CHIKV as defined by the Pan American Health Organization, only 34% had this diagnosis recorded. Acute viral illness was the most frequently recorded diagnosis (n = 79; 58%). Conclusions. Broader case definitions for acute CHIKV illness may be needed to identify suspected cases during an outbreak. Standardized data collection forms and validation of case definitions may be useful for future outbreaks.
Collapse
Affiliation(s)
| | | | - Marshall K Tulloch-Reid
- Epidemiology Research Unit, Caribbean Institute for Health Research, University of the West Indies, Kingston, Jamaica
| | | | - Kacey Ernst
- Epidemiology and Biostatistics Department, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tuscon, Arizona, United States of America
| | | | | | | | | | | |
Collapse
|
43
|
Valencia CI, Ernst K, Rosales CB. Tuberculosis Treatment Completion in a United States/Mexico Binational Context. Front Public Health 2017; 5:118. [PMID: 28596953 PMCID: PMC5442199 DOI: 10.3389/fpubh.2017.00118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/05/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a salient public health issue along the U.S./Mexico border. This study seeks to identify the social and structural factors, which are associated with TB disease burden in the binational geographic region. Identification of barriers of treatment completion provides the necessary framework for developing evidence-based interventions that are culturally relevant and context specific for the U.S./Mexico border region. METHODS Retrospective study of data extracted from medical charts (n = 439) from Yuma County Health Department (YCHD) (n = 160) and Centro de Salud San Luis Río Colorado (n = 279). Patients currently accessing TB treatment at either facility were excluded from the study. Chi-square, unadjusted odds ratios, and logistic regression were utilized to identify characteristics associated with successful TB treatment in this population. FINDINGS The study population was predominantly male (n = 327). Females were more likely to complete TB treatment (OR = 3.71). The absence of drug use and/or the absence of an HIV positive diagnosis were found to be predictors of TB treatment completion across both clinical sites. Forty-four percent (43.59%) (n = 85) TB patients treated at CDS San Luis did not complete treatment versus 40.35% (n = 49) of TB patients who did not complete treatment at YCHD. Moving from the area or being deported was the highest category (20.78%) for incomplete TB treatment in the population (n = 64) across both clinical sites.
Collapse
Affiliation(s)
- Celina I Valencia
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Kacey Ernst
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Cecilia Ballesteros Rosales
- Division of Public Health Practice and Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
44
|
Stoenescu A, Ebner F, Polasik A, Schramm A, Ernst K, Pau S, Mian E, Schochter F, de Gregorio N, Janni W, Reister F, Friedl TWP. Neonatales Outcome von Zwillingen in Abhängigkeit vom Geburtsmodus – Erfahrungen eines Perinatalzentrums aus zwei Jahrzehnten. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
45
|
Polasik A, Jückstock J, Eisenmann P, Alba Alejandre I, Friedl TW, Lato K, Friebe-Hoffmann U, De Gregorio N, Ernst K, Schramm A, Stoenescu A, Schochter F, Wallwiener LM, Weissenbacher T, Hutter S, Reister F, Janni W, Kästner R, Mahner S, Ebner F. Altersentwicklung und Kaiserschnittraten von Erstgebärenden im Zeitraum von 2001 bis 2013 – Eine kombinierte Datenanalyse der UFK Ulm und der Frauenklinik Maistraße der LMU München. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
46
|
Ernst K, Hartl E, Goc J, Noachtar S, Vollmar C. EP 113. Increased coherence to the midline in interictal EEG predicts generalized seizures in focal epilepsy. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Onyemkpa C, Ernst K, Oparaocha D, Osuchukwu O. Traumatic head injury in a low resource country: Profile and predictors
of mortality in a tertiary care center in South-Eastern Nigeria. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
48
|
Beamer PI, Lothrop N, Lu Z, Ascher R, Ernst K, Stern DA, Billheimer D, Wright AL, Martinez FD. Spatial clusters of child lower respiratory illnesses associated with community-level risk factors. Pediatr Pulmonol 2016; 51:633-42. [PMID: 26436763 PMCID: PMC5349765 DOI: 10.1002/ppul.23332] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/11/2015] [Accepted: 09/07/2015] [Indexed: 11/06/2022]
Abstract
Identifying geographic areas with increased incidence of disease may elucidate community-level risk factors for intervention development. Lower respiratory illnesses (LRIs) are the leading cause of death in children and are associated with other morbidities. We assessed geographic clustering of LRIs and evaluated if these spatial patterns and associated risk factors differed by phenotype. Participants enrolled at birth in the Tucson Children's Respiratory Study were followed through age three for physician diagnosed LRIs. Spatial clustering analysis, based upon each participant's birth address, was performed for four LRI phenotypes. We conducted principal component analysis at the census tract level to generate indices for lower socioeconomic status (SES), poorer housing conditions, and increased air pollution. Enrollment addresses were mapped for 812 subjects, of whom 58.4%, 33.5%, 34.2%, and 23.4% had any LRI, a wheezing LRI, a viral LRI, and a respiratory syncytial virus (RSV) LRI, respectively. Patterns of spatial clustering and associated risk factors differed by LRI phenotype. Multivariable regression analyses showed that wheezing LRI clusters were associated with increased air pollution (OR = 1.18, P = 0.01). Being in a viral cluster was associated with poorer housing conditions (OR = 1.28, P = 0.01), while being in a RSV cluster was associated with increased air pollution (OR = 1.14, P = 0.006), poorer housing conditions (OR = 1.54, P = 0.003), and higher SES (OR = 0.77, P = 0.001). Our use of social and environmental indices allowed us to identify broad contextual factors that may contribute to increased incidence of LRIs in specific geographic regions. To reduce LRI incidence, multifaceted interventions should be developed at the community level. Pediatr Pulmonol. 2016;51:633-642. © 2015 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Paloma I Beamer
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona.,Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.,Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Zhenqiang Lu
- Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Rebecca Ascher
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Kacey Ernst
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Debra A Stern
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona
| | - Dean Billheimer
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.,Bio5 Institute, University of Arizona, Tucson, Arizona
| | - Anne L Wright
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona
| | - Fernando D Martinez
- Arizona Respiratory Center, University of Arizona, Tucson, Arizona.,Bio5 Institute, University of Arizona, Tucson, Arizona
| |
Collapse
|
49
|
Jones JM, Lopez B, Adams L, Gálvez FJN, Núñez AS, Santillán NAH, Plante L, Hemme RR, Casal M, Hunsperger EA, Muñoz-Jordan J, Acevedo V, Ernst K, Hayden M, Waterman S, Gomez D, Sharp TM, Komatsu KK. Binational Dengue Outbreak Along the United States-Mexico Border - Yuma County, Arizona, and Sonora, Mexico, 2014. MMWR Morb Mortal Wkly Rep 2016; 65:495-9. [PMID: 27196619 DOI: 10.15585/mmwr.mm6519a3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Dengue is an acute febrile illness caused by any of four dengue virus types (DENV-1-4). DENVs are transmitted by mosquitos of the genus Aedes (1) and are endemic throughout the tropics (2). In 2010, an estimated 390 million DENV infections occurred worldwide (2). During 2007-2013, a total of three to 10 dengue cases were reported annually in Arizona and all were travel-associated. During September-December 2014, coincident with a dengue outbreak in Sonora, Mexico, 93 travel-associated dengue cases were reported in Arizona residents; 70 (75%) cases were among residents of Yuma County, which borders San Luis Río Colorado, Sonora, Mexico. San Luis Río Colorado reported its first case of locally acquired dengue in September 2014. To investigate the temporal relationship of the dengue outbreaks in Yuma County and San Luis Río Colorado and compare patient characteristics and signs and symptoms, passive surveillance data from both locations were analyzed. In addition, household-based cluster investigations were conducted near the residences of reported dengue cases in Yuma County to identify unreported cases and assess risk for local transmission. Surveillance data identified 52 locally acquired cases (21% hospitalized) in San Luis Río Colorado and 70 travel-associated cases (66% hospitalized) in Yuma County with illness onset during September-December 2014. Among 194 persons who participated in the cluster investigations in Yuma County, 152 (78%) traveled to Mexico at least monthly during the preceding 3 months. Four (2%) of 161 Yuma County residents who provided serum samples for diagnostic testing during cluster investigations had detectable DENV immunoglobulin M (IgM); one reported a recent febrile illness, and all four had traveled to Mexico during the preceding 3 months. Entomologic assessments among 105 households revealed 24 water containers per 100 houses colonized by Ae. aegypti. Frequent travel to Mexico and Ae. aegypti colonization indicate risk for local transmission of DENV in Yuma County. Public health officials in Sonora and Arizona should continue to collaborate on dengue surveillance and educate the public regarding mosquito abatement and avoidance practices. Clinicians evaluating patients from the U.S.-Mexico border region should consider dengue in patients with acute febrile illness and report suspected cases to public health authorities.
Collapse
|
50
|
Monaghan AJ, Morin CW, Steinhoff DF, Wilhelmi O, Hayden M, Quattrochi DA, Reiskind M, Lloyd AL, Smith K, Schmidt CA, Scalf PE, Ernst K. On the Seasonal Occurrence and Abundance of the Zika Virus Vector Mosquito Aedes Aegypti in the Contiguous United States. PLoS Curr 2016; 8:ecurrents.outbreaks.50dfc7f46798675fc63e7d7da563da76. [PMID: 27066299 PMCID: PMC4807952 DOI: 10.1371/currents.outbreaks.50dfc7f46798675fc63e7d7da563da76] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION An ongoing Zika virus pandemic in Latin America and the Caribbean has raised concerns that travel-related introduction of Zika virus could initiate local transmission in the United States (U.S.) by its primary vector, the mosquito Aedes aegypti. METHODS We employed meteorologically driven models for 2006-2015 to simulate the potential seasonal abundance of adult Aedes aegypti for fifty cities within or near the margins of its known U.S. range. Mosquito abundance results were analyzed alongside travel and socioeconomic factors that are proxies of viral introduction and vulnerability to human-vector contact. RESULTS Meteorological conditions are largely unsuitable for Aedes aegypti over the U.S. during winter months (December-March), except in southern Florida and south Texas where comparatively warm conditions can sustain low-to-moderate potential mosquito abundance. Meteorological conditions are suitable for Aedes aegypti across all fifty cities during peak summer months (July-September), though the mosquito has not been documented in all cities. Simulations indicate the highest mosquito abundance occurs in the Southeast and south Texas where locally acquired cases of Aedes-transmitted viruses have been reported previously. Cities in southern Florida and south Texas are at the nexus of high seasonal suitability for Aedes aegypti and strong potential for travel-related virus introduction. Higher poverty rates in cities along the U.S.-Mexico border may correlate with factors that increase human exposure to Aedes aegypti. DISCUSSION Our results can inform baseline risk for local Zika virus transmission in the U.S. and the optimal timing of vector control activities, and underscore the need for enhanced surveillance for Aedes mosquitoes and Aedes-transmitted viruses.
Collapse
|