scholarly journals Seattle Flu Study - Swab and Send: Study Protocol for At-Home Surveillance Methods to Estimate the Burden of Respiratory Pathogens on a City-Wide Scale

Author(s):  
Ashley E. Kim ◽  
Elisabeth Brandstetter ◽  
Chelsey Graham ◽  
Jessica Heimonen ◽  
Audrey Osterbind ◽  
...  

AbstractIntroductionWhile seasonal influenza and other respiratory pathogens cause significant morbidity and mortality each year, the community-based burden of these infections remains incompletely understood. Understanding the prevalence, epidemiology, and transmission dynamics of respiratory pathogen infections among community-dwelling individuals is essential during pandemic and epidemic settings and for developing pandemic-preparedness infrastructure.Methods and AnalysisWe present the protocol for a novel, city-wide home-based cross-sectional study in the Seattle Metropolitan area, utilizing rapid delivery systems for self-collection of a nasal swab and return to the laboratory for respiratory pathogen testing. All participation takes place electronically, including recruitment, consent, and data collection. Within 48 hours of participants self-reporting respiratory symptoms, a nasal swab kit is delivered to the household via a courier service. Demographic and illness characteristics are collected at the time of sample collection and recovery and behavioral information collected one week later. Specimens are tested in the laboratory for multiple respiratory pathogens, and results are available on a public website for participants.Ethics and DisseminationThe study was approved by the University of Washington Institutional Review Board (Protocol #00006181). Results will be disseminated through peer-reviewed publications, talks at conferences, and on the Study Website (www.seattleflu.org).Article SummaryThe findings of this study will inform whether a home-based approach to city-wide respiratory surveillance is possible in epidemic settingsA key strength of this study is that it is conducted across diverse neighborhoods spanning a major metropolitan areaClinical findings may not be generalizable, as they are reliant on self-report (vaccination status, symptoms, healthcare utilization, etc.)

2020 ◽  
Author(s):  
Ashley E. Kim ◽  
Elisabeth Brandstetter ◽  
Naomi Wilcox ◽  
Jessica Heimonen ◽  
Chelsey Graham ◽  
...  

AbstractIntroductionWhile influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure.MethodsFrom October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a human marker. Participant data were recorded via online survey at the time of sample collection and one week later.ResultsOf the 4,572 consented participants, 4,359 (95.3%) received a home swab kit, and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P CRT value of 19.0 (SD: 3.4) and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8 days [IQR: 7.0-14.0].DiscussionHome-based surveillance using online participant enrollment and specimen self-collection is a feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.


2021 ◽  
Vol 59 (5) ◽  
Author(s):  
Ashley E. Kim ◽  
Elisabeth Brandstetter ◽  
Naomi Wilcox ◽  
Jessica Heimonen ◽  
Chelsey Graham ◽  
...  

ABSTRACT While influenza and other respiratory pathogens cause significant morbidity and mortality, the community-based burden of these infections remains incompletely understood. The development of novel methods to detect respiratory infections is essential for mitigating epidemics and developing pandemic-preparedness infrastructure. From October 2019 to March 2020, we conducted a home-based cross-sectional study in the greater Seattle, WA, area, utilizing electronic consent and data collection instruments. Participants received nasal swab collection kits via rapid delivery within 24 hours of self-reporting respiratory symptoms. Samples were returned to the laboratory and were screened for 26 respiratory pathogens and a housekeeping gene. Participant data were recorded via online survey at the time of sample collection and 1 week later. Of the 4,572 consented participants, 4,359 (95.3%) received a home swab kit and 3,648 (83.7%) returned a nasal specimen for respiratory pathogen screening. The 3,638 testable samples had a mean RNase P relative cycle threshold (Crt) value of 19.0 (SD, 3.4), and 1,232 (33.9%) samples had positive results for one or more pathogens, including 645 (17.7%) influenza-positive specimens. Among the testable samples, the median time between shipment of the home swab kit and completion of laboratory testing was 8.0 days (interquartile range [IQR], 7.0 to 14.0). A single adverse event occurred and did not cause long-term effects or require medical attention. Home-based surveillance using online participant enrollment and specimen self-collection is a safe and feasible method for community-level monitoring of influenza and other respiratory pathogens, which can readily be adapted for use during pandemics.


2017 ◽  
Vol 62 (10) ◽  
pp. 735-744 ◽  
Author(s):  
Yu-Chen Kao ◽  
Yin-Ju Lien ◽  
Hsin-An Chang ◽  
Nian-Sheng Tzeng ◽  
Chin-Bin Yeh ◽  
...  

Objective: Stigma resistance (SR) has recently emerged as a prominent aspect of research on recovery from schizophrenia, partly because studies have suggested that the development of stigma-resisting beliefs may help individuals lead a fulfilling life and recover from their mental illness. The present study assessed the relationship between personal SR ability and prediction variables such as self-stigma, self-esteem, self-reflection, coping styles, and psychotic symptomatology. Method: We performed an exploratory cross-sectional study of 170 community-dwelling patients with schizophrenia. Self-stigma, self-esteem, self-reflection, coping skills, and SR were assessed through self-report. Psychotic symptom severity was rated by the interviewers. Factors showing significant association in univariate analyses were included in a stepwise backward regression model. Results: Stepwise regressions revealed that acceptance of stereotypes of mental illness, self-esteem, self-reflection, and only 2 adaptive coping strategies (positive reinterpretation and religious coping) were significant predictors of SR. The prediction model accounted for 27.1% of the variance in the SR subscale score in our sample. Conclusions: Greater reflective capacity, greater self-esteem, greater preferences for positive reinterpretation and religious coping, and fewer endorsements of the stereotypes of mental illness may be key factors that relate to higher levels of SR. These factors are potentially modifiable in tailored interventions, and such modification may produce considerable improvements in the SR of the investigated population. This study has implications for psychosocial rehabilitation and emerging views of recovery from mental illness.


2021 ◽  
Author(s):  
Kathryn E Barber ◽  
Nur Hani Zainal ◽  
Michelle G. Newman

Background: Generalized anxiety disorder (GAD) and major depressive disorder (MDD) often precede and predict one another. Stress reactivity theories of psychopathology posit that patterns of heightened emotional reactions to stressors can result in increased vulnerability to the development of anxiety and depression. However, cross-sectional studies on this topic have hindered causal inferences. Method: The present study examined stress reactivity as a potential mediator of the sequential associations between GAD and MDD symptoms in a sample of 3,294 community-dwelling adults. GAD and MDD symptom severity (Composite International Diagnostic Interview-Short Form) was assessed at two time points (T1 and T3), approximately 18 years apart. Stress reactivity (Multidimensional Personality Questionnaire) was measured at T2. Results: Structural equation mediation modeling demonstrated that higher T1 GAD severity positively predicted more severe T3 MDD symptoms via T2 stress reactivity (d = 0.45–0.50). After controlling for T1 GAD, T2 stress reactivity was not a significant mediator in the relationship between higher T1 MDD symptoms and worse T3 GAD symptoms. Direct effects indicated that T1 GAD positively predicted T3 MDD 18 years later, and vice versa (d = 1.29–1.65). Limitations: Stress reactivity was assessed using a self-report measure, limiting conclusions to perceived (vs. behaviorally indexed) stress reactivity. Conclusions: These findings indicate that stress reactivity may be one mechanism through which GAD leads to later MDD over prolonged durations. Overall, our results suggest that targeting stress reactivity in treatments for GAD may reduce the risk of developing subsequent MDD.


2019 ◽  
Vol 30 (6) ◽  
pp. 587-596
Author(s):  
Miyeong Kim ◽  
Seongkum Heo ◽  
Jung-Yi Hur ◽  
JaeLan Shim ◽  
JinShil Kim

Introduction: Data-based research has rarely addressed advance directives (ADs) in community-dwelling Korean cancer survivors. The purpose of this study was to examine the relationship between AD treatment choices and decisional conflicts among low-income, home-based cancer management recipients. Method: This study uses a cross-sectional, correlational design. The cancer survivors completed the questionnaires (Korean-Advance Directive model and Decisional Conflict Scale). Results: Among the 103 participants (average age 67.92 years), 56.3% had solid cancer. Hospice care was the most desired (68.9%), followed by hemodialysis (18.4%), cardiopulmonary resuscitation/ventilation support (15.5% for each), and chemotherapy (12.6%). Patients who were older, unmarried, unemployed, or underweight/obese; lived alone; or had lower education experienced greater decisional conflicts. In the multivariate analyses, no hospice preference was associated with greater decisional conflicts ( t = −2.63, p = .01). Discussion: Early integration of AD discussion with the nurse-led, home-based service for this vulnerable population could serve as a liaison for quality and continuity of cancer survivorship care.


Author(s):  
S.G. Slezak ◽  
K.B Mahoney ◽  
E.N. Renna ◽  
I.E. Lofgren ◽  
F. Xu ◽  
...  

Objectives: To evaluate the prevalence of sarcopenia in a sample of older, sedentary women using criteria from the European Working Group on Sarcopenia in Older People (EWGSOP), the International Working Group (IWG), and the Foundation for the National Institutes of Health Sarcopenia Project (FNIHSP). Design: Cross-sectional analysis. Setting and Participants: Community-dwelling women (n = 61) aged 71.9 ± 4.6 years (mean±SD) with a BMI 27.3 ± 6.0 kg/m2 who by self-report were healthy and did not exercise were recruited and evaluated for sarcopenia. Measurements: Height, weight, grip strength, gait speed, and appendicular lean mass (via segmental multi-frequency bioelectrical impedance analysis: SMF-BIA) were measured. Prevalence was reported using descriptive statistics and a Fisher’s exact test was used to analyze the distribution frequency of sarcopenia classification by different criteria. Results: In this sample 14.8% met EWGSOP criteria, 6.6% met FNIHSP criteria, and 3.3% met IWG criteria. There was a borderline significant difference in distribution frequency between EWGSOP and IWG classification criteria (p=0.053). Conclusion: The variation in sarcopenia prevalence depending on the diagnostic criteria used is consistent with previous research and there are borderline significant differences between classification criteria in this population. These data suggest the need for additional examination to determine current cut points for ALM measured by SMF-BIA, as well as which established definition of sarcopenia is appropriate for this population.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252208
Author(s):  
Liqun Wang ◽  
Jiangping Li ◽  
Zhizhong Wang ◽  
Yong Du ◽  
Ting Sun ◽  
...  

Background Studies have found that social capital (SC) is associated with the risk of cognitive decline; however, the mechanism explaining how SC leads to cognitive decline is unclear. The current study examines the mediation effect of sleep duration on the relationship between SC and cognitive decline in Chinese older adults. Methods A cross-sectional study of 955 community-dwelling aged 60 or over was conducted. The mini-mental state examination (MMSE), self-report sleep duration questionnaire, and social capital scales were administered during the face-to-face survey. The Bootstrap methods PROCESS program is employed to test the mediation model. Results After controlling for covariates, both social cohesion and social interaction were positively correlated with the MMSE score (p<0.001), and social cohesion was negatively correlated with sleep duration (p = 0.009); On the contrary, sleep duration was negatively correlated with MMSE score (p<0.001). Linear regression analysis showed social cohesion was positively associated with the MMSE score (β = 0.16, p = 0.005), while sleep duration was associated with an increased risk of cognitive decline (β = -0.72, p<0.001). Sleep duration has mediated the relationship between social cohesion and cognitive decline (explaining 21.7% of the total variance). Conclusions Social capital negatively associated with the risk of cognitive decline in this Chinese population, and sleep duration may partly explain this relationship. It may be a suggestive clue to identify those at a higher risk of progressing to cognitive impairment. Further prospective study in need to confirm this finding due to the cross-sectional design.


2016 ◽  
Vol 29 (1) ◽  
pp. 43-52 ◽  
Author(s):  
Júlia PESSINI ◽  
Aline Rodrigues BARBOSA ◽  
Erasmo Benício Santos de Moraes TRINDADE

ABSTRACT Objective: To investigate the association between various chronic diseases, multimorbidity, and handgrip strength in community dwelling older adults in Southern Brazil. Methods: A cross-sectional study carried out with 477 older adults (60 years and older) who resided in Antônio Carlos, Santa Catarina state. Subjects aged 60-79 years were selected by probability sampling (n=343) and all subjects aged 80 years or older (n=134) were evaluated. Chronic diseases were identified by self-report. A mechanical dynamometer verified handgrip strength (i.e., the outcome). Adjustments variables were age, literacy, living arrangement, smoking, body mass index, cognitive function, and comorbid chronic diseases. Sex-stratified analyses were conducted with simple and multiple linear regression. Results: A total of 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years) were assessed. In the adjustment analysis, cancer (β=-3.69; 95%CI=-6.97 to -0.41) and depression (β=-1.65; 95%CI=-3.20 to -0.10) were associated with lower handgrip strength in women. For men, diabetes (β=-5.30; 95%CI=-9.64 to -0.95), chronic lung disease (β=-4.74; 95%CI=-7.98 to -1.50), and coronary heart disease (β=-3.07; 95%CI=-5.98 to -0.16) were associated with lower handgrip strength values. There was an inverse trend between number of diseases and handgrip strength for men only. Conclusion: The results showed an independent association between chronic diseases and handgrip strength. As such, handgrip strength is a valid measure to use for prevention or intervention in chronic disease and multimorbidity.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S976-S976
Author(s):  
Ru Jia ◽  
Dexia Kong ◽  
XinQi Dong

Abstract This study aims to examine the relationship between religiosity and depressive symptoms in a large cohort of community-dwelling U.S. Chinese older adults living in the Greater Chicago area, which has received relatively little research attention. Cross-sectional self-report data was obtained from the Population Study of Chinese Elderly in Chicago between 2011 and 2013 (N=3,157). Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). A score of 5 and above indicated the presence of clinically significant depressive symptoms. Logistic regression analyses were conducted to examine the association between religiosity and depressive symptoms. Out of 3,157 participants, 20.3% participants had a score of or above 5 on PHQ-9. 35.4% reported religiosity as being “important” (24.7%) and “very important” (10.7%); 16% reported attending organized religious services at least once a month (3.1% reported once a month; 12.3% reported once a week; 0.6% reported almost every day); 23% reported having religious services at home at least once a month (10.3% reported once a month; 3.2% reported once a week; 9.5% reported almost daily). Results showed that recognizing religiosity as important is significantly negatively associated with depressive symptoms (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.89-0.99). However, no significant associations between depressive symptoms and religious activity attendance or religious service at home were observed. Findings suggest that senses of belonging and life meaning may help reduce depressive symptoms, rather than the religious activities per se. Future interventions could reduce depressive symptoms of U.S. Chinese older adults through religiosity.


2009 ◽  
Vol 69 (2) ◽  
pp. 119-132 ◽  
Author(s):  
Daniel L. Segal ◽  
Tracy N. Needham ◽  
Frederick L. Coolidge

The attachment patterns of younger and older adults were studied using two-dimensional self-report measures of adult attachment. Community-dwelling younger ( n = 144, M = 22.5 years, SD = 3.6) and older ( n = 106, M = 68.6 years, SD = 8.3) adults completed the Measure of Attachment Qualities (MAQ; Carver, 1997) and the Relationship Style Questionnaire (RSQ; Griffin & Bartholomew, 1994). Although the MAQ and RSQ are believed to be measuring similar constructs, they are derived from different theoretical perspectives. Correlations between the two measures were in the expected directions proving modest evidence for their convergent validity. Regarding cross-sectional results, as was expected, older adults scored lower than younger adults on the ambivalent-worry attachment scale of the MAQ and the preoccupied attachment scale of the RSQ. There were no age differences regarding secure, avoidant, and dismissing attachment. It appears that older adults experience anxious types of attachment less frequently than younger adults. Although these results primarily speak to age differences and possible cohort effects, they also provide some support for socioemotional selectivity theory and its hypothesized improved relationships in later life.


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