scholarly journals Survey of partner notification practices for sexually transmissible infections in the United States

Sexual Health ◽  
2016 ◽  
Vol 13 (2) ◽  
pp. 162 ◽  
Author(s):  
Fidel A. Desir ◽  
Jessica H. Ladd ◽  
Charlotte A. Gaydos
Keyword(s):  
United States ◽  
Control Method ◽  
Partner Notification ◽  
The United States ◽  
Planned Parenthood ◽  
Syphilis Infection ◽  
Convenience Sample ◽  
Sexually Transmissible Infections ◽  
Cooperation Rate ◽  
Control And Prevention

Background Partner notification (PN) for sexually transmissible infections (STIs) is a vital STI control method. The most recent evaluation of PN practices in the United States, conducted in 1999, indicated that few STI patients were offered PN services. The objectives of this study were to obtain a preliminary understanding of the current provision of PN services in HIV/STI testing sites throughout the US and to determine the types of PN services available. Methods: A convenience sample of 300 randomly selected testing sites was contacted to administer a phone survey about PN practices. These sites were from a large database maintained by the Centers for Disease Control and Prevention. Sites were eligible to participate if they provided testing services for chlamydia, gonorrhoea, HIV or syphilis and were not hospitals or Planned Parenthood locations. Results: Of the 300 eligible sites called, 79 sites were successfully reached, of which 74 agreed to participate, yielding a response rate of 24.7% and a cooperation rate of 93.7%. Most surveyed testing sites provided some form of PN service (anonymous or non-anonymous) on site or through an affiliate for chlamydia (100%), gonorrhoea (97%), HIV (91%) and syphilis (96%) infection. Anonymous PN services were available at 67–69% of sites. Only 6–9% of sites offered Internet-based PN services. Conclusions: Most surveyed testing sites currently offer some type of PN service for chlamydia, gonorrhoea, HIV or syphilis infection. However, approximately one-third of surveyed sites do not offer anonymous services. Novel, Internet-based methods may be warranted to increase the availability of anonymous services.

scholarly journals 2404. Molecular Epidemiology of Clostridioides difficile in the United States, 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S830-S830 ◽  
Author(s):  
Ashley Paulick ◽  
Michelle Adamczyk ◽  
Lauren C Korhonen ◽  
Alice Guh ◽  
Amy Gargis ◽  
...  
Keyword(s):  
United States ◽  
Molecular Epidemiology ◽  
The United States ◽  
Emerging Infections ◽  
Convenience Sample ◽  
Clostridioides Difficile ◽  
Positive Stool ◽  
Control And Prevention ◽  
Clostridioides Difficile Infection ◽  
Healthcare Associated

Abstract Background In 2009, the Centers for Disease Control and Prevention (CDC) implemented Clostridioides difficile infection (CDI) surveillance through the Emerging Infections Program (EIP) to monitor the incidence and evolving epidemiology of CDI in the United States. Since 2012, ribotypes (RTs) 027, 106, 002, 014, and 020 have constituted the top five strain types among both US community- and healthcare-associated isolates. Here we describe the changes in molecular epidemiology of C. difficile isolates collected in the United States in 2017. Methods In 2017, CDI surveillance was conducted at 10 EIP sites (CA, CO, CT, GA, MD, MN, NM, NY, OR, and TN). A convenience sample of clinical laboratories across EIP sites submitted C. difficile-positive stool specimens to the MN Department of Health Public Health Laboratory and Hines VA Hospital (IL) for culture. Isolates were forwarded to CDC and characterized by capillary-based PCR-ribotyping and PCR detection of tcdA, tcdB, cdtA, cdtB, and deletions in tcdC. Results In 2017, 1,051 C. difficile isolates were submitted; the total number of isolates received from each site ranged from 11 to 286 with a median of 85.5. In total, 143 RTs were observed, with the majority of isolates harboring toxin genes tcdA and tcdB (95%) and a wild-type tcdC sequence (71%). Among 556 healthcare-associated isolates, RT 027 was the most prevalent and the top RT at 5 sites (CA, GA, MD, NM, TN). Ribotype 106 was the most prevalent among 495 community-associated CA isolates and the top RT at 6 sites (CO, CT, GA, MD, MN, TN). Ribotype 027 significantly decreased from 2012 to 2017 among both healthcare-associated (21% vs 15%; p = 0.02) and community-associated isolates (17% vs 6%; P < 0.0001). Among healthcare-associated isolates, RT 076, which was observed in 8 EIP sites, increased from 2% in 2016 to 5% in 2017 (p = 0.05) and replaced RT 020 as one of the top 5 healthcare-associated RTs in 2017. Conclusion Despite an overall decline since 2012, RT 027 remained the most prevalent RT among healthcare-associated isolates submitted in 2017. The increased frequency of RT 076 among healthcare-associated isolates submitted in 2017 highlights the evolving molecular epidemiology of C. difficile and the need for continued surveillance to monitor potential emerging strains. Disclosures All authors: No reported disclosures.

Professional values, job satisfaction, career development, and intent to stay

2016 ◽  
Vol 24 (6) ◽  
pp. 675-685 ◽  
Author(s):  
Susan Yarbrough ◽  
Pam Martin ◽  
Danita Alfred ◽  
Charleen McNeill
Keyword(s):  
United States ◽  
Job Satisfaction ◽  
Career Development ◽  
Intent To Stay ◽  
The United States ◽  
Early Career ◽  
Professional Values ◽  
Convenience Sample ◽  
Hospital System ◽  
The Future

Background: Hospitals are experiencing an estimated 16.5% turnover rate of registered nurses costing from $44,380 - $63,400 per nurse—an estimated $4.21 to $6.02 million financial loss annually for hospitals in the United States of America. Attrition of all nurses is costly. Most past research has focused on the new graduate nurse with little focus on the mid-career nurse. Attrition of mid-career nurses is a loss for the profession now and into the future. Research objective: The purpose of the study was to explore relationships of professional values orientation, career development, job satisfaction, and intent to stay in recently hired mid-career and early-career nurses in a large hospital system. Research design: A descriptive correlational study of personal and professional factors on job satisfaction and retention was conducted. Participants and research context: A convenience sample of nurses from a mid-sized hospital in a metropolitan area in the Southwestern United States was recruited via in-house email. Sixty-seven nurses met the eligibility criteria and completed survey documents. Ethical considerations: Institutional Review Board approval was obtained from both the university and hospital system. Findings: Findings indicated a strong correlation between professional values and career development and that both job satisfaction and career development correlated positively with retention. Discussion: Newly hired mid-career nurses scored higher on job satisfaction and planned to remain in their jobs. This is important because their expertise and leadership are necessary to sustain the profession into the future. Conclusion: Nurse managers should be aware that when nurses perceive value conflicts, retention might be adversely affected. The practice environment stimulates nurses to consider whether to remain on the job or look for other opportunities.

The Under-Enrollment of HIV-infected Foster Children in Clinical Trials and Protocols and the Need for Corrective State Action

1994 ◽  
Vol 20 (3) ◽  
pp. 231-249
Author(s):  
Briar McNutt
Keyword(s):  
United States ◽  
New York ◽  
Hiv Infection ◽  
The United States ◽  
Hiv And Aids ◽  
Medical Community ◽  
State Action ◽  
Pediatric Aids ◽  
Control And Prevention ◽  
Year 2000

The incidence of HIV infection and AIDS in children has grown at an alarming rate. Approximately one million children worldwide have HIV infection. By the year 2000, an estimated ten million children will suffer from the disease. Currently, the United States has a population of an estimated 10,000 to 20,000 HIV-infected children. As of June 30, 1993, the Centers for Disease Control and Prevention (CDC) reported 4,710 known AIDS cases in children twelve years-old and younger. At that point, New York City reported 1,124 pediatric AIDS cases which represented twenty-four percent of all cases in the United States.With the rising number of HIV-infected children, the medical community in the United States has begun to search for HIV-and AIDS-related treatments particularized for children. In addition to establishing guidelines for HIV-infected children's frequent check-ups and timely immunizations, the medical community has initiated research studies involving HIV-infected children.

Abstract P636: Social Determinants of Stroke Hospitalization and Mortality in the United States

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Randhir Sagar Yadav ◽  
Durgesh Chaudhary ◽  
Shima Shahjouei ◽  
Jiang Li ◽  
Vida Abedi ◽  
...  
Keyword(s):  
United States ◽  
Income Inequality ◽  
Social Determinants ◽  
Hemorrhagic Stroke ◽  
The United States ◽  
Care Physician ◽  
County Level ◽  
Medicare Beneficiaries ◽  
Level Data ◽  
Control And Prevention

Introduction: Stroke hospitalization and mortality are influenced by various social determinants. This ecological study aimed to determine the associations between social determinants and stroke hospitalization and outcome at county-level in the United States. Methods: County-level data were recorded from the Centers for Disease Control and Prevention as of January 7, 2020. We considered four outcomes: all-age (1) Ischemic and (2) Hemorrhagic stroke Death rates per 100,000 individuals (ID and HD respectively), and (3) Ischemic and (4) Hemorrhagic stroke Hospitalization rate per 1,000 Medicare beneficiaries (IH and HH respectively). Results: Data of 3,225 counties showed IH (12.5 ± 3.4) and ID (22.2 ± 5.1) were more frequent than HH (2.0 ± 0.4) and HD (9.8 ± 2.1). Income inequality as expressed by Gini Index was found to be 44.6% ± 3.6% and unemployment rate was 4.3% ± 1.5%. Only 29.8% of the counties had at least one hospital with neurological services. The uninsured rate was 11.0% ± 4.7% and people living within half a mile of a park was only 18.7% ± 17.6%. Age-adjusted obesity rate was 32.0% ± 4.5%. In regression models, age-adjusted obesity (OR for IH: 1.11; HH: 1.04) and number of hospitals with neurological services (IH: 1.40; HH: 1.50) showed an association with IH and HH. Age-adjusted obesity (ID: 1.16; HD: 1.11), unemployment (ID: 1.21; HD: 1.18) and income inequality (ID: 1.09; HD: 1.11) showed an association with ID and HD. Park access showed inverse associations with all four outcomes. Additionally, population per primary-care physician was associated with HH while number of pharmacy and uninsured rate were associated with ID. All associations and OR had p ≤0.04. Conclusion: Unemployment and income inequality are significantly associated with increased stroke mortality rates.

scholarly journals Validation of the Revised Physical Therapist Clinical Performance Instrument (PT CPI): Version 2006

2012 ◽  
Vol 92 (3) ◽  
pp. 416-428 ◽  
Author(s):  
Kathryn E. Roach ◽  
Jody S. Frost ◽  
Nora J. Francis ◽  
Scott Giles ◽  
Jon T. Nordrum ◽  
...  
Keyword(s):  
United States ◽  
Student Performance ◽  
Physical Therapist ◽  
Clinical Performance ◽  
The United States ◽  
Final Evaluation ◽  
Convenience Sample ◽  
Evaluation Data ◽  
Physical Therapist Students ◽  
Clinical Performance Instrument

Background Based on changes in core physical therapy documents and problems with the earlier version, the Physical Therapist Clinical Performance Instrument (PT CPI): Version 1997 was revised to create the PT CPI: Version 2006. Objective The purpose of this study was to validate the PT CPI: Version 2006 for use with physical therapist students as a measure of clinical performance. Design This was a combined cross-sectional and prospective study. Methods A convenience sample of physical therapist students from the United States and Canada participated in this study. The PT CPI: Version 2006 was used to collect CPI item–level data from the clinical instructor about student performance at midterm and final evaluation periods in the clinical internship. Midterm evaluation data were collected from 196 students, and final evaluation data were collected from 171 students. The students who participated in the study had a mean age of 24.8 years (SD=2.3, range=21–41). Sixty-seven percent of the participants were from programs in the United States, and 33% were from Canada. Results The PT CPI: Version 2006 demonstrated good internal consistency, and factor analysis with varimax rotation produced a 3-factor solution explaining 94% of the variance. Construct validity was supported by differences in CPI item scores between students on early compared with final clinical experiences. Validity also was supported by significant score changes from midterm to final evaluations for students on both early and final internships and by fair to moderate correlations between prior clinical experience and remaining course work. Limitations This study did not examine rater reliability. Conclusion The results support the PT CPI: Version 2006 as a valid measure of physical therapist student clinical performance.

scholarly journals Levofloxacin-Resistant Invasive Streptococcus pneumoniae in the United States: Evidence for Clonal Spread and the Impact of Conjugate Pneumococcal Vaccine

2004 ◽  
Vol 48 (9) ◽  
pp. 3491-3497 ◽  
Author(s):  
Mathias W. R. Pletz ◽  
Lesley McGee ◽  
James Jorgensen ◽  
Bernard Beall ◽  
Richard R. Facklam ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Pneumoniae ◽  
The United States ◽  
Fluoroquinolone Resistance ◽  
Active Efflux ◽  
Vaccine Serotypes ◽  
Drug Classes ◽  
Control And Prevention ◽  
Clonal Spread ◽  
The Impact

ABSTRACT The emergence of fluoroquinolone resistance in sterile-site isolates of Streptococcus pneumoniae is documented in this study characterizing all invasive levofloxacin-resistant (MIC, ≥8 mg/liter) S. pneumoniae isolates (n = 50) obtained from the Centers for Disease Control and Prevention Active Bacterial Core Surveillance from 1998 to 2002. Resistance among all isolates increased from 0.1% in 1998 to 0.6% in 2001 (P = 0.008) but decreased to 0.4% in 2002, while resistance among vaccine serotypes continued to increase from 0.3% in 1998 to 1.0% in 2002, suggesting that fluoroquinolones continue to exert selective pressure on these vaccine serotypes. Only 22% of resistant isolates were not covered by the conjugate vaccine serogroups. Multilocus sequence typing revealed that 58% of resistant strains were related to five international clones identified by the Pneumococcal Molecular Epidemiology Network, with the Spain23F-1 clone being most frequent (16% of all isolates). Thirty-six percent of the isolates were coresistant to penicillin, 44% were coresistant to macrolides, and 28% were multiresistant to penicillin, macrolides, and fluoroquinolones. Fifty percent of the isolates were resistant to any three drug classes. Ninety-four percent of the isolates had multiple mutations in the quinolone resistance-determining regions of the gyrA, gyrB, parC, and parE genes. In 16% of the isolates, there was evidence of an active efflux mechanism. An unusual isolate was found that showed only a single parE mutation and for which the ciprofloxacin MIC was lower (2 mg/liter) than that of levofloxacin (8 mg/liter). Our results suggest that invasive pneumococcal isolates resistant to levofloxacin in the United States show considerable evidence of multiple resistance and of clonal spread.

scholarly journals Evoluzione della giurisprudenza costituzionale statunitense in materia d’aborto (II)

2011 ◽  
Vol 60 (5) ◽  
Author(s):  
Fabio Persano
Keyword(s):  
United States ◽  
Supreme Court ◽  
Single Case ◽  
The United States ◽  
Planned Parenthood ◽  
Abortion Debate ◽  
The Supreme Court ◽  
Long Time ◽  
The Right ◽  
Roe V Wade

Negli Stati Uniti il dibattito sull’aborto è sempre un tema molto caldo. Questo saggio, diviso in due parti (la prima parte è stata pubblicata sul precedente numero della rivista) prova a ripercorrere l’evoluzione della giurisprudenza costituzionale statunitense in materia d’aborto, evidenziando i cambiamenti che ciascuna decisione ha apportato al quadro giuridico precedente. In questa seconda parte, la dissertazione sui singoli casi giurisprudenziali decisi dalla Suprema Corte prosegue con il caso Planned Parenthood v. Casey. Esso è stato una vera occasione mancata nella storia dell’aborto negli Stati Uniti, perchè venne sfiorata la overrule di Roe v. Wade. Ciononostante, venne sostanzialmente confermato l’impianto delle decisioni precedenti, in considerazione del fatto che una decisione contraria all’aborto avrebbe spiazzato un popolo che per decenni aveva organizzato la propria vita in funzione anche della possibilità di abortire. Con questa decisione si distinse la gravidanza in due periodi: quello della pre-viabilità, in cui la donna era completamente libera di abortire in accordo col medico; quello della post-viabilità, in cui gli Stati avrebbero potuto legiferare, pur dovendo consentire l’aborto nel caso di pericolo per la vita o la salute della madre. Inoltre il diritto d’aborto venne radicato nella libertà riconosciuta nel XIV Emendamento della Costituzione. Nel successivo caso Stenberg v. Carhart fu oggetto di giudizio l’aborto a nascita parziale: una legge del Nebraska aveva bandito questa pratica, ma la legge fu annullata dalla Corte Suprema, nonostante il duro dissenso di ben quattro giudici, fra cui Anthony Kennedy. Successivamente a questa decisione, il Congresso prese l’iniziativa di emanare il Partial Birth Abortion Ban Act. Questa legge fu impugnata in via d’azione davanti alla Corte Suprema e ne scaturì la sentenza Gonzalez v. Carhart. In questa decisione la Corte fece un passo indietro rispetto a Stenberg, affermò la legittimità del bando, sostenne che l’aborto a nascita parziale non è mai necessario per tutelare la vita della donna e che Stenberg era fondato su convinzioni erronee sul punto. Il saggio si conclude con delle interessanti considerazioni in merito ai possibili sviluppi futuri circa il tema dell’aborto negli Stati Uniti, auspica la “liberalizzazione del diritto alla vita” ed avanza una originale proposta, valida per tutti i Paesi in cui l’aborto è legalizzato. ---------- Abortion debate is always a hot subject in the United States. This essay, divided into two parts (the first part has been published on the previous issue of this review) tries to go along the development of U.S. constitutional caselaw about abortion, pointing out the change that each judgement caused to the previous law framework. In this second part, the dissertation about U.S. Supreme Court single case-law goes on by Planned Parenthood v. Casey. It was a real missed occasion in the abortion affair in the United States, because it was on the verge of overruling Roe v. Wade. However, the framework of the previous cases was substantially confirmed, considering that a decision against abortion would place out people who for a long time organized their own life in connection to the right of abortion. By this judgement, pregnancy was divided into two periods: pre-viability, when woman was completely free to have an abortion in agreement with her doctor; post-viability, when States could restrict abortion, except for woman life or health risks. Moreover, abortion right was founded on liberty, acknowledged by XIV Amendement. In the following case Gonzalez v. Carhart, partial-birth abortion was judged: a statute of Nebraska banned this activity, but it was stroked down by Supreme Court, despite of the dissenting opinion of four judges (Anthony Kennedy was one of them). After this judgement, the Congress wanted to issue Partial Birth Abortion Ban Act. This statute was pre-enforcement challenged to the Supreme Court, and Gonzalez v. Carhart was poured. In this judgment, the Court drew back Stenberg, it stated the ban was legitimate, partial-birth abortion never is necessary to safeguard woman health, and Stenberg was founded on wrong beliefs on this matter. This essay concludes with interesting considerations about possible developments about abortion affair in the United States, wishes “liberty of right to life” and proposes a solution for all the countries where abortion is legal.

scholarly journals Covid-19 pandemic: What is the truth?

2021 ◽  
Vol 12 ◽  
pp. 591
Author(s):  
Russell L. Blaylock
Keyword(s):  
United States ◽  
Young People ◽  
Severe Acute Respiratory Syndrome ◽  
Early Treatment ◽  
The United States ◽  
Treatment Protocols ◽  
Scientific Support ◽  
Control And Prevention ◽  
History Of ◽  
Irreparable Damage

The ongoing “pandemic” involving the severe acute respiratory syndrome coronavirus 2 virus (SARS-CoV-2) has several characteristics that make it unique in the history of pandemics. This entails not only the draconian measures that some countries and individual states within the United States and initiated and made policy, most of which are without precedent or scientific support, but also the completely unscientific way the infection has been handled. For the 1st time in medical history, major experts in virology, epidemiology, infectious diseases, and vaccinology have not only been ignored, but are also demonized, marginalized and in some instances, become the victim of legal measures that can only be characterized as totalitarian. Discussions involving various scientific opinions have been eliminated, top scientists have been frightened into silence by threats to their careers, physicians have lost their licenses, and the concept of early treatment has been virtually eliminated. Hundreds of thousands of people have died needlessly as a result of, in my opinion and the opinion of others, poorly designed treatment protocols, mostly stemming from the Center for Disease Control and Prevention, which have been rigidly enforced among all hospitals. The economic, psychological, and institutional damage caused by these unscientific policies is virtually unmeasurable. Whole generations of young people will suffer irreparable damage, both physical and psychological, possibly forever. The truth must be told.

In vitro susceptibility of ceftolozane/tazobactam against typhoidal, non-typhoidal and extended spectrum β-lactamase-producing Salmonella

2021 ◽  
Author(s):  
Jade L. L. Teng ◽  
Elaine Chan ◽  
Asher C. H. Dai ◽  
Gillian Ng ◽  
Tsz Tuen Li ◽  
...  
Keyword(s):  
United States ◽  
Antimicrobial Agents ◽  
The United States ◽  
Drug Resistant ◽  
Broth Microdilution ◽  
In Vitro Susceptibility ◽  
Extended Spectrum ◽  
Control And Prevention ◽  
Esbl Producers

Both typhoidal and non-typhoidal salmonellae are included in the top 15 drug-resistant threats described by the Center for Disease Control and Prevention of the United States. There is an urgent need to look for alternative antibiotics for the treatment of Salmonella infections. We examined the in vitro susceptibilities of ceftolozane/tazobactam and six other antibiotics on typhoidal and non-typhoidal salmonellae, including isolates that are extended-spectrum β-lactamase (ESBL)-positive, using the broth microdilution test. Of the 313 (52 typhoidal and 261 non-typhoidal) Salmonella isolates tested, 98.7% were susceptible to ceftolozane/tazobactam. Based on the overall MIC 50/90 values, Salmonella isolates were more susceptible to ceftolozane/tazobactam (0.25/0.5 mg/L) compared to all other comparator agents: ampicillin (≥64/≥64 mg/L), levofloxacin (0.25/1 mg/L), azithromycin (4/16 mg/L), ceftriaxone (≤0.25/4 mg/L), chloramphenicol (8/≥64 mg/L) and trimethoprim/sulfamethoxazole (1/≥8 mg/L). When comparing the activity of the antimicrobial agents against non-typhoidal Salmonella isolates according to their serogroup, ceftolozane/tazobactam had the highest activity (100%) against Salmonella serogroups D, G, I and Q isolates, whereas the lowest activity (85.7%) was observed against serogroup E isolates. All the 10 ESBL-producing Salmonella (all non-typhoidal) isolates, of which 8 were CTX-M-55-producers and 2 were CTX-M-65-producers, were sensitive to ceftolozane/tazobactam albeit with a higher MIC 50/90 value (1/2 mg/L) than non-ESBL-producers (0.25/0.5 mg/L). In summary, our data indicate that ceftolozane/tazobactam is active against most strains of both typhoidal and non-typhoidal salmonellae and also active against ESBL-producing salmonellae.

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