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LI, JOHN, GULZAR H. SHAH e CRAIG HEDBERG. "Complaint-Based Surveillance for Foodborne Illness in the United States: A Survey of Local Health Departments". Journal of Food Protection 74, n.º 3 (1 de março de 2011): 432–37. http://dx.doi.org/10.4315/0362-028x.jfp-10-353.
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Foodborne illnesses are an important public health problem in the United States in terms of both the burden of illness and cost to the health care system. Strengthening foodborne illness surveillance helps address the growing issues of food safety in the United States. Very little is known about the use of consumer complaint surveillance systems for foodborne illness. This study evaluates the use of these surveillance systems by local health departments (LHDs) in the United States and their practices and policies for investigating complaints. Data for this study were collected through two Web-based surveys based on a representative sample of LHDs in the United States; 81% of LHDs use complaint-based surveillance. Of those that did not have a complaint system, 64% reported that the state health department or another agency ran their complaint system. Health departments collect a wide variety of information from callers through their complaint systems, including food intake history. Most of the LHDs, however, do not store the information in an electronic database. Outbreak rates and complaint rates were found to be positively correlated, with a Pearson's correlation coefficient of 0.38. Complaints were the most common outbreak detection mechanism reported by respondents, with a median of 69% of outbreaks during the previous year found through complaints. Complaint systems are commonly used in the United States. Increasing the rate at which illnesses are reported by the public and improving investigation practices could help increase the number of outbreaks detected through complaint surveillance.
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McAdams, A. James. "Spying on Terrorists: Germany in Comparative Perspective". German Politics and Society 25, n.º 3 (1 de setembro de 2007): 70–88. http://dx.doi.org/10.3167/gps.2007.250304.
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Intelligence and law enforcement agencies in western democracies are turning increasingly to electronic surveillance tools in their efforts to identify and combat new terrorist threats. But this does not mean that they are equally equipped to undertake these measures. As the author shows by comparing surveillance activities in three countries—Great Britain, the United States, and Germany—the Federal Republic's more restrictive legal norms and institutions provide its government with much less freedom of maneuver than its allies.
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Peterson, Kelly S., Julia Lewis, Olga V. Patterson, Alec B. Chapman, Daniel W. Denhalter, Patricia A. Lye, Vanessa W. Stevens et al. "Automated Travel History Extraction From Clinical Notes for Informing the Detection of Emergent Infectious Disease Events: Algorithm Development and Validation". JMIR Public Health and Surveillance 7, n.º 3 (24 de março de 2021): e26719. http://dx.doi.org/10.2196/26719.
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Background Patient travel history can be crucial in evaluating evolving infectious disease events. Such information can be challenging to acquire in electronic health records, as it is often available only in unstructured text. Objective This study aims to assess the feasibility of annotating and automatically extracting travel history mentions from unstructured clinical documents in the Department of Veterans Affairs across disparate health care facilities and among millions of patients. Information about travel exposure augments existing surveillance applications for increased preparedness in responding quickly to public health threats. Methods Clinical documents related to arboviral disease were annotated following selection using a semiautomated bootstrapping process. Using annotated instances as training data, models were developed to extract from unstructured clinical text any mention of affirmed travel locations outside of the continental United States. Automated text processing models were evaluated, involving machine learning and neural language models for extraction accuracy. Results Among 4584 annotated instances, 2659 (58%) contained an affirmed mention of travel history, while 347 (7.6%) were negated. Interannotator agreement resulted in a document-level Cohen kappa of 0.776. Automated text processing accuracy (F1 85.6, 95% CI 82.5-87.9) and computational burden were acceptable such that the system can provide a rapid screen for public health events. Conclusions Automated extraction of patient travel history from clinical documents is feasible for enhanced passive surveillance public health systems. Without such a system, it would usually be necessary to manually review charts to identify recent travel or lack of travel, use an electronic health record that enforces travel history documentation, or ignore this potential source of information altogether. The development of this tool was initially motivated by emergent arboviral diseases. More recently, this system was used in the early phases of response to COVID-19 in the United States, although its utility was limited to a relatively brief window due to the rapid domestic spread of the virus. Such systems may aid future efforts to prevent and contain the spread of infectious diseases.
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Vassallo, Amy J., Claire Hiller, Emmanuel Stamatakis e Evangelos Pappas. "Epidemiology of Dance-Related Injuries Presenting to Emergency Departments in the United States, 2000-2013". Medical Problems of Performing Artists 32, n.º 3 (1 de setembro de 2017): 170–75. http://dx.doi.org/10.21091/mppa.2017.3028.
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Dance is a popular activity associated with many physical and mental health benefits, but injuries are a concern for all skill levels. Previous studies have focused on professional dancers or particular genres, meaning the population-wide characteristics of injuries is unknown. This study’s objective was to identify the incidence and types of dance-related injuries evaluated in emergency departments in the United States over the 14-year period 2000-2013. METHODS: Data were obtained from the nationally representative National Electronic Injury Surveillance System from 2000–2013. National estimates of injuries were determined using complex sample design. Trends using 2-year intervals were calculated using linear regression and injury proportion ratios using Pearson’s X2. RESULTS: The average annual incidence of dance-related injuries requiring emergency medical attention was 17,145 per year. The number of injuries grew from 14,204 in 2000/1 to 21,356 in 2012/3, a change of 33.4% after accounting for population growth. Lower limb injuries were most common, particularly ankle and knee sprains. Females presented with a greater proportion of ankle (injury proportion ratio [IPR]=1.34, p=0.029) and foot sprains (IPR=2.11, p<0.001) but a lower proportion of shoulder sprains (IPR=0.41, p<0.001) and face lacerations (IPR=0.13, p<0.001). Younger dancers presented with a lower proportion of knee (IPR=0.79, p=0.006) and low back sprains (IPR=0.68, p=0.019). CONCLUSIONS: The average annual incidence of dance-related injuries of a serious enough nature to require presentation to the emergency department in the United States was 17,145 per year, with ankle and knee sprains being the most common. Injury numbers have increased in recent years.
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Wang, Qian, Changchuan Jiang, Hui Xie, Zhiting Tang, Yannan Li, Matthew M. Mirsky, Chi Wen et al. "E-cigarette use and United States Preventive Services Task Force (USPSTF) lung cancer screening (LCS) eligibility." Journal of Clinical Oncology 42, n.º 16_suppl (1 de junho de 2024): 10531. http://dx.doi.org/10.1200/jco.2024.42.16_suppl.10531.
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10531 Background: Electronic cigarettes (E-cigarettes) have become frequently used as a smoking cessation tool. Emerging research has shown that e-cigarettes have similar carcinogenic effects as combustible cigarettes. While current lung cancer screening (LCS) guidelines primarily rely on individuals’ smoking history, it's becoming increasingly important to understand the prevalence of e-cigarette use among individuals, especially in the context of their LCS eligibility. Methods: Individuals aged 40-80 years were extracted from the 2022 Behavioral Risk Factor Surveillance System. Eligibility was defined using the 2021 USPSTF LCS criteria, i.e., aged 50-80 years who ever smoked, with at least a 20-pack-year smoking history, currently smoke or quit within the past 15 years. We compared the prevalence of current and ever e-cigarette use among LCS-eligible and non-eligible populations, overall and by smoking (combustible cigarettes) status using chi-square tests. All analyses were weighted. The significance level was set at a 2-sided p-value of <0.05. Results: Among the 208,317 individuals included, 9.9% were eligible for LCS. Overall, 3.8% and 22.1% reported current and ever cigarette use, respectively. Fewer LCS-ineligible individuals reported currently using e-cigarettes than their LCS-eligible counterparts (Table). Among former combustible cigarette users, LCS-ineligible individuals were less likely to be current e-cigarette user than LCS-eligible individuals. However, among current combustible cigarette users, LCS-ineligible individuals were more likely to be current e-cigarettes users than LCS-eligible individuals. When examining the prevalence of ever e-cigarette use, similar findings were observed. Conclusions: Our study reveals a significant prevalence of e-cigarette usage among older adults (aged 40-80), with 1 in 5 individuals reporting ever having used e-cigarettes. Moreover, current cigarette users who were ineligible for LCS were more likely to use e-cigarette than their LCS-eligible counterparts. Future epidemiological studies are warranted to assess the risk of e-cigarette use (including intensity, duration and interactions with combustible cigarettes) and lung cancer risks. E-cigarette use may need to be considered in formulating future LCS guidelines. [Table: see text]
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Rasmusson, Jenna, Jean Barth, Sarah Bellows Mahler, Debra Apenhorst, Mary Dalton, Laura Senst, Leah Siple, Rebecca Faller e Priya Sampathkumar. "Leveraging the Electronic Medical Record to Identify Patients at Risk of Antibiotic Resistant Organisms". Infection Control & Hospital Epidemiology 41, S1 (outubro de 2020): s313. http://dx.doi.org/10.1017/ice.2020.903.
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Background: Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) pose a serious public health threat. The CDC guidelines for combating CP-CRE include a recommendation to screen selected high-risk patients. Objective: We describe a program to identify and screen patients at risk for CP-CRE. Setting: An academic, tertiary-care center with 1,297 licensed beds and 62,071 admissions per year. Methods: A report was created in the electronic medical record (EMR) to identify adult patients admitted in the previous 24 hours from countries and states with known CP-CRE transmission based on address and ZIP code. Patients with a known travel history outside the United States were also reviewed, but these data were inaccurate. Initially, a physician from Infection Prevention and Control (IPAC) placed orders for CP-CRE screening of these patients. Subsequently, a nursing protocol was developed to facilitate infection preventionists placing orders for CP-CRE screening earlier in the eligible patient’s hospital stay. An electronic communication is sent via the EMR alerting the patient care team to the order, the rationale for the order, and links to a tool kit with resources to help answer patient questions. A single perirectal swab is obtained by the nurse caring for the patient and is tested for Klebsiella pneumoniae carbapenemase (KPC), New Delhi metallo-β-lactamase (NDM), oxacillinase-48 (OXA-48), and Verona integron-encoded metallo-β-lactamase (VIM) by polymerase chain reaction (PCR). Results: From May 2018 to November 2019, 688 patients were screened for CP-CRE using the case-finding report and the nursing protocol. Overall, 9 patients with CP-CRE were identified: 1 KPC, 2 NDM, and 5 OXA-48, and 1 patient was identified to have both NDM and OXA-48. The yield of 1.3% from this screening is higher than that reported previously in the literature. Use of the nursing protocol has enabled IPAC to complete timely CP-CRE surveillance and prevent transmission to other patients. We are currently using a similar process to identify and screen persons at risk for the emerging infection Candida auris.Conclusions: The EMR can be leveraged for early identification and screening of patients with epidemiologically significant pathogens. Protocols within the EMR can be effectively replicated and modified to respond to emerging infections and changing surveillance guidelines.Funding: NoneDisclosures: Consulting fee-—Merck (Priya Sampathkumar)
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Sarles, Samantha Emma, Edward C. Hensel e Risa J. Robinson. "Surveillance of U.S. Corporate Filings Provides a Proactive Approach to Inform Tobacco Regulatory Research Strategy". International Journal of Environmental Research and Public Health 18, n.º 6 (16 de março de 2021): 3067. http://dx.doi.org/10.3390/ijerph18063067.
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The popularity of electronic cigarettes in the United States and around the world has led to a startling rise in youth nicotine use. The Juul® e-cigarette was introduced in the U.S. market in 2015 and had captured approximately 13% of the U.S. market by 2017. Unlike many other contemporary electronic cigarette companies, the founders behind the Juul® e-cigarette approached their product launch like a traditional high-tech start-up company, not like a tobacco company. This article presents a case study of Juul’s corporate and product development history in the context of US regulatory actions. The objective of this article is to demonstrate the value of government-curated archives as leading indicators which can (a) provide insight into emergent technologies and (b) inform emergent regulatory science research questions. A variety of sources were used to gather data about the Juul® e-cigarette and the corporations that surround it. Sources included government agencies, published academic literature, non-profit organizations, corporate and retail websites, and the popular press. Data were disambiguated, authenticated, and categorized prior to being placed on a timeline of events. A timeline of four significant milestones, nineteen corporate filings and events, twelve US regulatory actions, sixty-four patent applications, eighty-seven trademark applications, twenty-three design patents and thirty-two utility patents related to Juul Labs and its associates is presented, spanning the years 2004 through 2020. This work demonstrates the probative value of findings from patent, trademark, and SEC filing literature in establishing a premise for emergent regulatory science research questions which may not yet be supported by traditional archival research literature. The methods presented here can be used to identify key aspects of emerging technologies before products actually enter the market; this shifting policy formulation and problem identification from a paradigm of being reactive in favor of becoming proactive. Such a proactive approach may permit anticipatory regulatory science research and ultimately shorten the elapsed time between market technology innovation and regulatory response.
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Titorenko, V. E. "The geopolitical landscape in the Sahara-Sahel zone". Diplomaticheskaja sluzhba (Diplomatic Service), n.º 1 (31 de janeiro de 2024): 75–86. http://dx.doi.org/10.33920/vne-01-2401-10.
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The article is devoted to the analysis of the geopolitical and regional significance of the Sahara-Sahel zone (SSZ) of Africa in the current coordinate system of international relations, primarily taking into account the increased interest of Russia in this region in the last few years. An assessment of the economic potential of the SSZ is given to determine the feasibility of investments in the development of its countries, including from the point of view of their importance for the strategic and military-political interests of Russia and its main competitors there, primarily France and the United States. The prospect of maintaining Russia's active presence in the region and the cost of this is assessed. The reasons for the curtailment of the French military-political presence in the main countries of this region and the desire of the United States to maintain its intelligence surveillance bases there are explained. Conclusions and suggestions are made regarding what Russia needs to do to ensure its interests in the SSZ with minimal costs.
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Ulcickas Yood, Marianne, Susan Jick, Catherine Vasilakis-Scaramozza, Bonnie M. K. Donato, Ioannis Tomazos, Gilbert L'Italien, Nicholas Sicignano e Brian L. Feldman. "The Value of Population Based Data to Study Rare Diseases: An Example Using the Department of Defense Healthcare System". Blood 132, Supplement 1 (29 de novembro de 2018): 5829. http://dx.doi.org/10.1182/blood-2018-99-113497.
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Abstract Background: For patients suffering from rare diseases, accurate and early diagnosis is critical and often lifesaving, whereas misdiagnosis can be fatal. While patient registries are useful and necessary, they may not provide reliable patient population denominators or sufficient longitudinal clinical follow-up. Access to complete and integrated patient records necessary to capture full clinical history can be challenging. Commonly, there is a lack of centralized and continuous care in the health care systems of many countries, including the United States (US). It is also challenging to identify a sufficient number of cases to provide robust results because of the rare nature of these diseases. We describe a healthcare system that can identify patients for research purposes, who have rare diseases, by accessing de-identified electronic clinical details. We used Paroxysmal Nocturnal Hemoglobinuria (PNH) as an example of a rare disease for this abstract. Methods: The Department of Defense (DOD) healthcare system is a US-based, longitudinal electronic health record (EHR) and claims database with health information on approximately 10 million active beneficiaries across the country. We evaluated the feasibility to conduct studies of rare diseases in the DOD healthcare system by assessing the capability to identify patients with PNH and to describe their course of disease and treatment. We used ICD 9/10 diagnosis codes, NDC and HCPCS codes, laboratory data and PNH treatment codes to identify patients with a clinical course consistent with PNH. Patients were classified as definite/likely, probable/possible or unlikely PNH based on the available clinical evidence and then findings were validated against review of patient records by a clinical expert. Individuals classified as unlikely PNH were excluded from the study. The clinical information on these patients will be used to understand the course of PNH in patients with and without treatments and to describe their treatment adherence and disease activity over time. Results: We identified 244 people with a diagnosis or treatment code that was indicative of PNH during years 2007-2017; 71% of the patients had electronic records that covered 10 or more years starting as early as 2003 and extending as far as 2017. From these 244 patients, we identified 73 patients with a definite/likely or probable/ possible PNH diagnosis. An ICD-10 code for PNH or a prescription for eculizumab (PNH treatment) were required, but not sufficient to confirm the presence of PNH. There is no ICD-9 code for PNH. Cases had no other indication for eculizumab use and had to have appropriate symptoms, comorbidities or lab results to be considered a case. Patients with only 1 code for PNH and no treatment were assumed to have unconfirmed disease and were excluded. 27 cases, including those with no eculizumab and a random sample of likely cases, were reviewed to validate the PNH diagnoses in collaboration with DOD treating physicians. Conclusion: The DOD healthcare system is a valuable and cost effective resource for the study of rare diseases in a timely manner. We have demonstrated the ability to identify a validated series of PNH cases that will provide important clinical insights for identifying and treating new PNH cases. This healthcare system provides long patient follow-up, demographics similar to the US population, and access to records in an integrated inpatient, outpatient and ER system that encompasses all patient care. Disclaimer Statement: Research data were derived from an approved Naval Medical Center, Portsmouth, VA IRB protocol (NMCP.2017.0080). The views expressed in this abstract are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the United States Government. Copyright Notice: CAPT Brian Feldman is a military service member. This work was prepared as part of his official duties. Title 17 U.S.C. 105 provides that 'Copyright protection under this title is not available for any work of the United States Government.' Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member or employee of the United States Government as part of that person's official duties. Disclosures Ulcickas Yood: Alexion Pharmaceuticals, Inc.: Other: Employee of EpiSource, LLC, which was contracted by Alexion Pharmaceuticals, Inc. EpiSource had the final decision on content. . Jick:Alexion Pharmaceuticals, Inc.: Other: Employee of the Boston Collaborative Drug Surveillance Program, which was contracted and paid by Alexion Pharmaceuticals, Inc. to work on a study of PNH using DOD data. . Vasilakis-Scaramozza:Alexion Pharmaceuticals, Inc.: Other: Employee of the Boston Collaborative Drug Surveillance Program, which was contracted and paid by Alexion Pharmaceuticals, Inc. to work on a study of PNH using DOD data.. Donato:Alexion Pharmaceuticals Inc: Employment, Equity Ownership. Tomazos:Alexion Pharmaceuticals, Inc.: Employment, Equity Ownership. L'Italien:Alexion Pharmaceuticals, Inc.: Equity Ownership, Other: Former employee and current stockholder of Alexion Pharmaceuticals, Inc. . Sicignano:Alexion Pharmaceuticals, Inc.: Other: Employee of Health ResearchTx, which has a business relationship with Alexion Pharmaceuticals, Inc.. Feldman:Alexion Pharmaceuticals, Inc.: Other: Employee, Department of Navy, United States Government..
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MacDonald, Madeline, Abu-Sayeef Mirza, Rahul Mhaskar, Aldenise Ewing, Liwei Chen, Katherine Robinson, Yuanyuan Lu et al. "Preventative Cancer Screening Rates Among Uninsured Patients in Free Clinics: A Retrospective Cohort Study of Cancer Survivors and Non-cancer Survivors". Cancer Control 29 (janeiro de 2022): 107327482110729. http://dx.doi.org/10.1177/10732748211072983.
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Background There is limited research on screening rates among uninsured cancer survivors. Uninsured cancer survivors are at higher risk of poorer health outcomes than the insured due to limited access to preventative screening for secondary cancers. This study examines the rates of surveillance and screening of uninsured cancer survivors and compares to uninsured patients without a cancer history seen in free clinics. Methods Data were collected retrospectively from electronic medical records and paper charts of patients from 10 free clinics between January 2016 and December 2018 in the Tampa Bay area. The prevalence of socioeconomic characteristics, cancer diagnoses, and screening practices were compared for cancer survivors and free clinic patients without a history of cancer. Study participants were determined to be eligible for cancer screenings based on the United States Preventive Services Task Force guidelines. Results Out of 13 982 uninsured patients frequenting free clinics between 2016 and 2018, 402 (2.9%) had a documented history of cancer. Out of the 285 eligible cancer survivors, 44 (15.4%) had completed age-appropriate colon cancer screening. Among the 170 female cancer survivors, 75 (44.1%) had completed breast cancer screenings, and only 5.9% (59/246) had completed cervical cancer screenings. After adjusting for age, gender, race, salary, employment status, and household size, cancer survivors were more likely to undergo colorectal cancer screening (OR: 3.59, 95% CI: 2.10–6.15) and breast cancer screening (OR: 2.13, 95% CI: 1.30–3.84) than patients without a cancer history. This difference was not seen for cervical cancer screening (OR: 0.99, 95% CI: .62–1.58). Conclusions Uninsured cancer survivors frequenting free clinics represent a unique population that is underrepresented in the medical literature. Our results suggest that uninsured survivors use screening services at higher rates when compared to uninsured patients without a reported cancer diagnosis. However, these rates are suboptimal when compared to national screening rates of insured cancer survivors.
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Hosier, Hillary, Sangini S. Sheth, Carlos R. Oliveira, Lauren E. Perley e Alla Vash-Margita. "Unindicated Cervical Cancer Screening in Adolescent Females Within a Large Healthcare System in the United States". Obstetrical & Gynecological Survey 78, n.º 8 (agosto de 2023): 470–72. http://dx.doi.org/10.1097/ogx.0000000000001179.
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ABSTRACT The increasingly complicated nature of screening guidelines for cervical cancer includes multiple component tests (cytology, genotyping, and high-risk human papilloma virus [HPV] testing) and evolving recommendations. The aim of this study was assessing single-large-healthcare-system trends over time associated with adolescent females and unindicated cervical cancer screening tests. This repeated cross-sectional study analyzed electronic medical records of provider- and patient-specific variables from the Yale New Haven Health System. Included in the study were all 13- to 20-year-old Yale New Haven Health System patients who underwent screening for cervical cancer via either HPV testing or cytology between January 1, 2012 and December 31, 2018. Age, medical histories, surgical histories, self-reported race and ethnicity, and prescribed medications were all patient-specific variables. Provider-specific variables included clinical practice affiliation, clinical degree, and adolescent patient volume (number of medical visits completed by a patient less than 21 every 6 months). In terms of this study, definition of practice setting was either academic (low-income teaching hospitals) or community-based (private practice setting with primarily insured women). Cytologies were categorized as either unindicated or indicated, based on cervical cancer screening guidelines from 2012 (recorded as unindicated for index specimens collected before the 21st birthday in patients lacking immunocompromised conditions). Should an HPV test be performed, any results other than “atypical squamous cells of undetermined significance” received an unindicated status. The final sample size in the study included 794 women from 118 providers (53% community setting and 47% academic setting). Results from analysis of 900 cervical cancer screenings demonstrated that unindicated tests made up the majority of tests (90%), with 87% of these being unindicated cytology testing only and 14% with unindicated HPV testing as well. Reasons for obtaining unindicated tests as recorded in the original clinical history were lacking, as 62% had no justification listed for testing, and those with reasons failed current guideline compliance. The incidence rate (IR) of adolescent unindicated tests decreased by 33% between 2012 and 2018. Although a significantly lower IR of unindicated screening existed in the academic setting, the rate of decline in the IR of unindicated screening during this period was significantly greater in the community than in the academic setting by 11%. A strength of the study included its ability to calculate IRs in all encounters, including sexually transmitted infection or contraception screenings. Limitations included utilization of hospital system cytology reports for obtaining data, thereby hindering any access to data necessary for validation of screening or surveillance indications from previously performed antecedent cytology. Furthermore, the study failed to collect information regarding another guideline-adherence marker: number of indicated index cervical cancer screenings for patients beginning at 21 years. According to an examination by Becerra-Culqui of women having an encounter at the age of 21 years or beyond, 65% missed opportunities for screening. Finally, the authors were unable to comment on both immunocompromised women and eligible young women who missed indicated screening due to collection of data via pathology reports rather than well-woman examinations. Although unindicated screening for women ages 21 and younger experienced significant reductions, areas for improvement remained. As recent guidelines updates may present greater provider and patient challenges, evidence-based strategies are more important than ever in terms of guideline adherence and dissemination.
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Hearn, Darren W., Zachary Y. Kerr, Erik A. Wikstrom, Donald L. Goss, Kenneth L. Cameron, Stephen W. Marshall e Darin A. Padua. "Lower Extremity Musculoskeletal Injury in US Military Academy Cadet Basic Training: A Survival Analysis Evaluating Sex, History of Injury, and Body Mass Index". Orthopaedic Journal of Sports Medicine 9, n.º 10 (1 de outubro de 2021): 232596712110398. http://dx.doi.org/10.1177/23259671211039841.
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Background: Injury incidence for physically active populations with a high volume of physical load can exceed 79%. There is little existing research focused on timing of injury and how that timing differs based on certain risk factors. Purpose/Hypothesis: The purpose of this study was to report both the incidence and timing of lower extremity injuries during cadet basic training. We hypothesized that women, those with a history of injury, and those in underweight and obese body mass index (BMI) categories would sustain lower extremity musculoskeletal injury earlier in the training period than men, those without injury history, and those in the normal-weight BMI category. Study Design: Cohort study; Level of evidence, 2. Methods: Cadets from the class of 2022, arriving in 2018, served as the study population. Baseline information on sex and injury history was collected via questionnaire, and BMI was calculated from height and weight taken during week 1 at the United States Military Academy. Categories were underweight (BMI <20), middleweight (20-29.99), and obese (≥30). Injury surveillance was performed over the first 60 days of training via electronic medical record review and monitoring. Kaplan-Meier survival curves were used to estimate group differences in time to the first musculoskeletal injury. Cox proportional hazard regression was used to estimate hazard ratios (HRs). Results: A total of 595 cadets participated. The cohort was 76.8% male, with 29.9% reporting previous injury history and 93.3% having a BMI between 20 and 30. Overall, 16.3% of cadets (12.3% of male cadets and 29.7% of female cadets) experienced an injury during the follow-up period. Women experienced significantly greater incident injury than did men ( P < .001). Separation of survival curves comparing the sexes and injury history occurred at weeks 3 and 4, respectively. Hazards for first musculoskeletal injury were significantly greater for women versus men (HR, 2.63; 95% CI, 1.76-3.94) and for those who reported a history of injury versus no injury history (HR, 1.76; 95% CI, 1.18-2.64). No differences were observed between BMI categories. Conclusion: Female cadets and those reporting previous musculoskeletal injury demonstrated a greater hazard of musculoskeletal injury during cadet basic training. This study did not observe an association between BMI and injury.
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Dallas, Ronald H. "#46 A Multicenter Study Exploring the Epidemiology and Outcomes of COVID-19 Among Pediatric Hematopoietic Cell Transplant, Cellular Therapy and Solid Organ Transplant Recipients: Preliminary Results from the Pediatric COVID-19 U.S. Registry." Journal of the Pediatric Infectious Diseases Society 11, Supplement_1 (14 de junho de 2022): S2—S3. http://dx.doi.org/10.1093/jpids/piac041.007.
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Abstract Background While most pediatric patients with COVID-19 experience mild disease, children with a history of hematopoietic cell transplant or cellular therapy (HCT/CT) or solid organ transplant (SOT) may be at increased risk for severe disease. Despite this, there is a dearth of data from multicenter studies examining COVID-19 outcomes among pediatric HCT/CT and SOT recipients. We present descriptive results from the Pediatric COVID-19 U.S. registry to characterize COVID-19 illness among pediatric HCT/CT and SOT recipients across the United States. Method Demographic, medical history, and COVID-19 related data were extracted from HCT/CT and SOT recipient medical records and submitted to the Pediatric COVID-19 U.S. Registry, a passive surveillance registry of pediatric patients less than 21 years old diagnosed with COVID-19 between March 2020 and April 2021. Participating US centers (n=170) submitted de-identified information for inpatients and outpatients at 7- and 28-days post COVID-19 diagnosis via a publicly available REDCap electronic survey. Data were summarized descriptively to characterize COVID-19 hospitalizations among HCT/CT and SOT recipients. Results Of the 13,140 registry COVID-19 cases, a total of 202 (1.5%) were patients with history of HCT/CT (n=58) or SOT (n=144). Median age at COVID-19 diagnosis among HCT/CT was 9.5 years (range 0.66 to 18) and SOT was 13.5 years (range 1 to 20). Over half of HCT (64%) and SOT (53.8%) patients were White/Caucasian and 26% of HCT and 39% of SOT here Hispanic/Latino. Hospitalizations among HCT/CT and SOT accounted for approximately 12% of all hospitalizations reported to the registry (n = 1683). Almost half of the reported HCT/CT (48%) and SOT (44%) cases were hospitalized. In those hospitalized, 11 (19%) HCT and 18 (12.5%) SOT cases required ICU admission. Half (50%) of HCT hospitalized cases received oxygen support and 3 (11%) required mechanical ventilation while only 2 (0.6%) SOT cases received oxygen support, and none required mechanical ventilation. The majority of HCT/CT cases (64%) were hospitalized between Days 100 and 365 post-transplant. Approximately half (48%) of the HCT cases had received an allogenic HCT. Myeloablative conditioning was the most common regimen reported (48%) among hospitalized HCT cases. Approximately half of SOT hospitalized cases had received a kidney transplant (48%) followed by liver (30%) and heart (19%). Of the 63 hospitalized SOT cases, the majority (87%) were receiving tacrolimus at COVID-19 diagnosis. One SOT death related to COVID-19 was reported, while no related deaths were reported in the HCT/CT group. Conclusion Although HCT/CT and SOT cases were low in comparison to all cases submitted to the registry, almost half of these cases required hospitalization. Only one COVID-19 related death was reported (SOT group); however, up to 20% of cases received ICU care. This data may aid clinicians developing future prospective studies examining COVID-19 risk mitigation and effective treatment strategies among this increased-risk population.
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Alsaed, O., A. Poil, M. Ahmed e S. Al Emadi. "AB0489 MAJOR ADVERSE CARDIOVASCULAR EVENTS AND MALIGNANCY POST JAK INHIBITORS INITIATION, A 4-YEAR EXPERIENCE FROM QATAR POPULATION". Annals of the Rheumatic Diseases 82, Suppl 1 (30 de maio de 2023): 1439.1–1439. http://dx.doi.org/10.1136/annrheumdis-2023-eular.1929.
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BackgroundIn contrast to ORAL Surveillance data, reports from real world data did not show difference in rates of major adverse cardiovascular events (MACE) and malignancy between tofacitinib and biologic disease modifying anti-rheumatic drugs (b-DMARDs) [1-3].ObjectivesInvestigate the rate of MACE and malignancy post janus kinase inhibitors (JAK-i) initiation in Qatar population.MethodsAll JAK-i prescriptions were captured electronically from the database of the pharmacy of Hamad Medical Corporation (HMC) from January 2018 to November 2022. Patients with non-dispensed prescriptions were excluded from the analysis. Electronic medical records of patients who received any class of JAK-i were reviewed retrospectively to identify demographic and clinical characteristics, starting and stopping date of JAK-i, MACE and malignancy events post JAK-i initiation.Results219 JAK-i course therapies (tofacitinib 193, upadacitinib 14 and baricitinib 12) were identified from the database of the pharmacy of HMC. Six patients were excluded from the analysis as they were prescribed with JAK-i but their prescriptions were not dispensed. Five patients received two classes of JAK-i due to treatment failure. Mean (standard deviation [SD]) time of JAK-i exposure was 25 (17) months.A total of 208 patients included in the analysis with mean (SD) age at JAK-i initiation was 45.9 (14) years. Females were 72% of the cohort. JAK-i was prescribed for the following indications: rheumatoid arthritis 129 (60%), psoriatic arthritis 28 (13.1%), alopecia 29 (13.6%), spondyloarthropathy (SPA) 16 (7.5%), inflammatory bowel disease (IBD) 8 (3.8%), other rheumatic diseases 5 (2.3%). Two patients were having IBD with peripheral and axial SPA involvement. In patients with rheumatic diseases, JAK-i was received in 102 (55%) b-DMARDs naïve patients, post one b-DMARDs in 38 (20%) and post ≥ 2 in 46 (25%) patients. The comorbidity profile (hypertension, dyslipidemia, diabetes mellitus, and coronary artery disease) was 27%,25%, 23%, and 5.6%, respectively.New cancer diagnosis (follicular thyroid) was confirmed in one patient post tofacitinib and one patient developed lymphoma relapse after tofacitinib initiation. One ischemic cerebrovascular accident (CVA) identified post tofacitinib initiation. This patient was in atrial fibrillation when CVA occurred. No venous thromboembolism events reported from this cohort.ConclusionMACE and malignancy rates are very low in JAK-i users in Qatar population. Comparator group is needed for further evaluation the association of the use of JAK-i and risk of MACE and malignancy.References[1]Ytterberg SR, Bhatt DL, Mikuls TR, Koch GG, Fleischmann R, Rivas JL, et al. Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis. N Engl J Med. 2022;386(4):316-26.[2]Charles-Schoeman C, Buch MH, Dougados M, Bhatt DL, Giles JT, Ytterberg SR, et al. Risk of major adverse cardiovascular events with tofacitinib versus tumour necrosis factor inhibitors in patients with rheumatoid arthritis with or without a history of atherosclerotic cardiovascular disease: a post hoc analysis from ORAL Surveillance. Ann Rheum Dis. 2023;82(1):119-29.[3]Kremer JM, Bingham CO, 3rd, Cappelli LC, Greenberg JD, Madsen AM, Geier J, et al. Postapproval Comparative Safety Study of Tofacitinib and Biological Disease-Modifying Antirheumatic Drugs: 5-Year Results from a United States-Based Rheumatoid Arthritis Registry. ACR Open Rheumatol. 2021;3(3):173-84.Acknowledgements:NIL.Disclosure of InterestsNone Declared.
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BOKMA, BOB H., CHERYL HALL, LYNNE M. SIEGFRIED e J. TODD WEAVER. "Surveillance for Avian Influenza in the United States". Annals of the New York Academy of Sciences 1081, n.º 1 (outubro de 2006): 163–68. http://dx.doi.org/10.1196/annals.1373.018.
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Omura, John D., Geoffrey P. Whitfield, Tiffany J. Chen, Eric T. Hyde, Emily N. Ussery, Kathleen B. Watson e Susan A. Carlson. "Surveillance of Physical Activity and Sedentary Behavior Among Youth and Adults in the United States: History and Opportunities". Journal of Physical Activity and Health 18, S1 (1 de agosto de 2021): S6—S24. http://dx.doi.org/10.1123/jpah.2021-0179.
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Background: Surveillance is a core function of public health, and approaches to national surveillance of physical activity and sedentary behavior have evolved over the past 2 decades. The purpose of this paper is to provide an overview of surveillance of physical activity and sedentary behavior in the United States over the past 2 decades, along with related challenges and emerging opportunities. Methods: The authors reviewed key national surveillance systems for the assessment of physical activity and sedentary behavior among youth and adults in the United States between 2000 and 2019. Results: Over the past 20 years, 8 surveillance systems have assessed physical activity, and 5 of those have assessed sedentary behavior. Three of the 8 originated in nonpublic health agencies. Most systems have assessed physical activity and sedentary behavior via surveys. However, survey questions varied over time within and also across systems, resulting in a wide array of available data. Conclusion: The evolving nature of physical activity surveillance in the United States has resulted in both broad challenges (eg, balancing content with survey space; providing data at the national, state, and local level; adapting traditional physical activity measures and survey designs; and addressing variation across surveillance systems) and related opportunities.
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Lee, Keon-Su. "A study on the electronic surveillance system in the United States". Legal Theory & Practice Review 10, n.º 2 (31 de maio de 2022): 239–69. http://dx.doi.org/10.30833/ltpr.2022.05.10.2.239.
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Ericson, Richard V., e William G. Staples. "The Culture of Surveillance: Discipline and Social Control in the United States." Social Forces 76, n.º 3 (março de 1998): 1154. http://dx.doi.org/10.2307/3005718.
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Smith, Michael M. "The Mexican Secret Service in the United States, 1910-1920". Americas 59, n.º 1 (julho de 2002): 65–85. http://dx.doi.org/10.1353/tam.2002.0091.
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Throughout the era of the Mexican Revolution, the United States provided sanctuary for thousands of political exiles who opposed the regimes of Porfirio Díaz, Francisco Madero, Victoriano Huerta, and Venustiano Carranza. Persecuted enemies of Don Porfirio and losers in the bloody war of factions that followed the ouster of the old regime continued their struggle for power from bases of operation north of the international boundary in such places as San Francisco, Los Angeles, El Paso, San Antonio, New Orleans, and New York. As a consequence, Mexican regimes were compelled not only to combat their enemies on domestic battlefields but also to wage more subtle campaigns against their adversaries north of the Río Bravo. The weapons in this shadowy war included general intelligence gathering, surveillance, espionage, counter-espionage, and propaganda; the agency most responsible for these activities was the Mexican Secret Service.
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Dye, Bruce A., e Gina Thornton-Evans. "A Brief History of National Surveillance Efforts for Periodontal Disease in the United States". Journal of Periodontology 78, n.º 7s (julho de 2007): 1373–79. http://dx.doi.org/10.1902/jop.2007.060210.
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Wunderlin, Clarence E. "Paradox of Power: Infiltration, Coastal Surveillance, and the United States Navy in Vietnam, 1965-68". Journal of Military History 53, n.º 3 (julho de 1989): 275. http://dx.doi.org/10.2307/1985874.
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Jefferson, Robert F., e Mark Ellis. "Race, War, and Surveillance: African Americans and the United States Government during World War I". Journal of Military History 66, n.º 4 (outubro de 2002): 1222. http://dx.doi.org/10.2307/3093302.
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Bharucha, Ashok J., Alex John London, David Barnard, Howard Wactlar, Mary Amanda Dew e Charles F. Reynolds. "Ethical Considerations in the Conduct of Electronic Surveillance Research". Journal of Law, Medicine & Ethics 34, n.º 3 (2006): 611–19. http://dx.doi.org/10.1111/j.1748-720x.2006.00075.x.
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Nearly 2.5 million Americans currently reside in nursing homes and assisted living facilities in the United States, accounting for approximately five percent of persons sixty-five and older. The aging of the “Baby Boomer” generation is expected to lead to an exponential growth in the need for some form of long-term care (LTC) for this segment of the population within the next twenty-five years. In light of these sobering demographic shifts, there is an urgency to address the profound concerns that exist about the quality-of-care (QoC) and quality-of-life (QoL) of this frailest segment of our population.
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Tréguer, Félix. "The Virus of Surveillance: How the covid-19 Pandemic Is Fuelling Technologies of Control". Political Anthropological Research on International Social Sciences 2, n.º 1 (13 de julho de 2021): 16–46. http://dx.doi.org/10.1163/25903276-bja10018.
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Abstract While it is too early to provide a definitive analysis of the impact that the covid-19 health crisis will have on digital state surveillance, this article aims to provide a first assessment. It starts by situating states’ response to the crisis in the longer history of epidemics and their connections to what philosopher Michel Foucault called “regimes of power.” By surveying various surveillance discourses and practices in countries like France, Italy, the United Kingdom, the United States or Israel in the Spring of 2020, the article identifies three key trends magnified by the crisis, namely, the crystallisation of new public-private assemblages in the management of health data, a shift towards health-based justification regimes for legitimising controversial surveillance and urban policing technologies, as well as mounting human rights threats and oversight failures in a context marked by a “state of health emergency”.
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Capozzola, Christopher, e Mark Ellis. "Race, War, and Surveillance: African Americans and the United States Government during World War I". Journal of American History 89, n.º 3 (dezembro de 2002): 1097. http://dx.doi.org/10.2307/3092447.
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Kamali, Sara. "Informants, Provocateurs, and Entrapment: Examining the Histories of the FBI’s PATCON and the NYPD’s Muslim Surveillance Program". Surveillance & Society 15, n.º 1 (28 de fevereiro de 2017): 68–78. http://dx.doi.org/10.24908/ss.v15i1.5254.
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Since September 11, 2001, the U.S. government and police departments across the United States, most notably the New York City Police Department, have been collecting intelligence targeting Muslim American communities. The controversial surveillance practices include the use of confidential informants, undercover operations, and entrapment, and infringing upon civil rights and civil liberties in the name of national security. A decade before 9/11, however, the Federal Bureau of Investigation (FBI) conducted the same practices against a completely different demographic – Christian Right militants, through a program called PATCON, short for Patriot Conspiracy. Building upon the concept of surveillance as social sorting (Lyon 2013) and surveillance and terrorism (Monahan 2013), This article will compare the history of surveillance tactics used by the FBI against Christian Right militants and those used by the NYPD against non-militant Muslim Americans, and assess their implications in the context of civil rights, leaving a legacy of mistrust between these respective groups and the federal government that further undermines the national security interests of the United States.
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Poon, Jessie P. H. "Regulating the global illicit economy: Singapore's role in United States' spatial financial surveillance". Political Geography 91 (novembro de 2021): 102493. http://dx.doi.org/10.1016/j.polgeo.2021.102493.
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Goldman, GS, e PG King. "Vaccination to prevent varicella". Human & Experimental Toxicology 33, n.º 8 (25 de novembro de 2013): 886–93. http://dx.doi.org/10.1177/0960327113512340.
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Background: There is increasing evidence that herpes zoster (HZ) incidence rates among children and adults (aged <60 years) with a history of natural varicella are influenced primarily by the frequency of exogenous exposures, while asymptomatic endogenous reactivations help to cap the rate at approximately 550 cases/100,000 person-years when exogenous boosting becomes rare. The Antelope Valley Varicella Active Surveillance Project was funded by the Centers for Disease Control and Prevention in 1995 to monitor the effects of varicella vaccination in one of the three representative regions of the United States. The stability in the data collection and number of reporting sites under varicella surveillance from 1995–2002 and HZ surveillance during 2000–2001 and 2006–2007 contributed to the robustness of the discerned trends. Discussion: Varicella vaccination may be useful for leukemic children; however, the target population in the United States is all children. Since the varicella vaccine inoculates its recipients with live, attenuated varicella–zoster virus (VZV), clinical varicella cases have dramatically declined. Declining exogenous exposures (boosts) from children shedding natural VZV have caused waning cell-mediated immunity. Thus, the protection provided by varicella vaccination is neither lifelong nor complete. Moreover, dramatic increases in the incidence of adult shingles cases have been observed since HZ was added to the surveillance in 2000. In 2013, this topic is still debated and remains controversial in the United States. Summary: When the costs of the booster dose for varicella and the increased shingles recurrences are included, the universal varicella vaccination program is neither effective nor cost-effective.
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Ford, Nancy Gentile. "Race, War, and Surveillance: African Americans and the United States Government during World War I". Journal of American Ethnic History 22, n.º 3 (1 de abril de 2003): 121–23. http://dx.doi.org/10.2307/27501337.
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LYNN, TRACEY, NINA MARANO, TRACEE TREADWELL e BOB BOKMA. "Linking Human and Animal Health Surveillance for Emerging Diseases in the United States". Annals of the New York Academy of Sciences 1081, n.º 1 (outubro de 2006): 108–11. http://dx.doi.org/10.1196/annals.1373.011.
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Lantos, Paul M., Mark Janko, Lise E. Nigrovic, Felicia Ruffin, Takaaki Kobayashi, Yvonne Higgins e Paul G. Auwaerter. "Mapping the distribution of Lyme disease at a mid-Atlantic site in the United States using electronic health data". PLOS ONE 19, n.º 5 (31 de maio de 2024): e0301530. http://dx.doi.org/10.1371/journal.pone.0301530.
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Lyme disease is a spatially heterogeneous tick-borne infection, with approximately 85% of US cases concentrated in the mid-Atlantic and northeastern states. Surveillance for Lyme disease and its causative agent, including public health case reporting and entomologic surveillance, is necessary to understand its endemic range, but currently used case detection methods have limitations. To evaluate an alternative approach to Lyme disease surveillance, we have performed a geospatial analysis of Lyme disease cases from the Johns Hopkins Health System in Maryland. We used two sources of cases: a) individuals with both a positive test for Lyme disease and a contemporaneous diagnostic code consistent with a Lyme disease-related syndrome; and b) individuals referred for a Lyme disease evaluation who were adjudicated to have Lyme disease. Controls were individuals from the referral cohort judged not to have Lyme disease. Residential address data were available for all cases and controls. We used a hierarchical Bayesian model with a smoothing function for a coordinate location to evaluate the probability of Lyme disease within 100 km of Johns Hopkins Hospital. We found that the probability of Lyme disease was greatest in the north and west of Baltimore, and the local probability that a subject would have Lyme disease varied by as much as 30-fold. Adjustment for demographic and ecological variables partially attenuated the spatial gradient. Our study supports the suitability of electronic medical record data for the retrospective surveillance of Lyme disease.
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Glover, Lisa. "Creditworthy: A History of Consumer Surveillance and Financial Identity in America by Josh Lauer". Journal of Intellectual Freedom and Privacy 2, n.º 3-4 (9 de abril de 2018): 33. http://dx.doi.org/10.5860/jifp.v2i3-4.6482.
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In September of 2017 Equifax, one of the three major consumer credit reporting agencies in the United States, announced its system security had been breached and confidential consumer information may have fallen into the hands of hackers. Although reports of system intrusions are released almost daily, this breach was of particular significance: sensitive data, including personal, identifying and financial data, was compromised for an estimated 143 million consumers in the United States. Just this week, Equifax further disclosed another 15 million client records were breached in the United Kingdom. Any consumer who has received credit of any kind is familiar with the big three credit reporting agencies—Equifax, TransUnion, and Experian—as these agencies house the financial identities American consumers. With such vast data stores, credit reporting agencies are prime and potentially profitable targets for hackers. All the information a hacker needs to steal a financial identify of a victim resides in the agencies’ files. Clearly, credit reporting agencies play a critical role in the financial marketplace. How these agencies became the powerful guardians and suppliers of consumer financial information is the topic of Josh Lauer’s book, Creditworthy: A History of Consumer Surveillance and Financial Identity in America. This is the first book authored by Lauer, who is an associate professor of media studies at the University of New Hampshire with specialties in media history and theory, communication technology, consumer and financial culture, and surveillance. Lauer relates in great detail how we moved from a society of relationships and human interaction to one of faceless data designed to symbolize character and reputation. Lauer’s history takes us from a time when Americans desired access to goods and services more than they valued confidentiality, to the financial privacy concerns of these surveillance systems today.
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Ortel, Thomas L., Katie Arnold, Michele Beckman, Audrey Brown, Nimia Reyes, Ibrahim Saber, Ryan Schulteis, Bhavana Pendurthi Singh, Andrea Sitlinger e Elizabeth H. Thames. "Design and Implementation of a Comprehensive Surveillance System for Venous Thromboembolism in a Defined Region Using Electronic and Manual Approaches". Applied Clinical Informatics 10, n.º 03 (maio de 2019): 552–62. http://dx.doi.org/10.1055/s-0039-1693711.
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Background Systematic surveillance for venous thromboembolism (VTE) in the United States has been recommended by several organizations. Despite adoption of electronic medical records (EMRs) by most health care providers and facilities, however, systematic surveillance for VTE is not available. Objectives This article develops a comprehensive, population-based surveillance strategy for VTE in a defined geographical region. Methods The primary surveillance strategy combined computerized searches of the EMR with a manual review of imaging data at the Duke University Health System in Durham County, North Carolina, United States. Different strategies of searching the EMR were explored. Consolidation of results with autopsy reports (nonsearchable in the EMR) and with results from the Durham Veterans' Administration Medical Center was performed to provide a comprehensive report of new VTE from the defined region over a 2-year timeframe. Results Monthly searches of the primary EMR missed a significant number of patients with new VTE who were identified by a separate manual search of radiology records, apparently related to delays in data entry and coding into the EMR. Comprehensive searches incorporating a location-restricted strategy were incomplete due to the assigned residence reflecting the current address and not the address at the time of event. The most comprehensive strategy omitted the geographic restriction step and identified all patients with VTE followed by manual review of individual records to remove incorrect entries (e.g., outside the surveillance time period or geographic location; no evidence for VTE). Consolidation of results from the EMR searches with results from autopsy reports and the separate facility identified additional patients not diagnosed within the Duke system. Conclusion We identified several challenges with implementing a comprehensive VTE surveillance program that could limit accuracy of the results. Improved electronic strategies are needed to cross-reference patients across multiple health systems and to minimize the need for manual review and confirmation of results.
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Cortez, Jonathan. "Ruminations on the Camp Space in the United States during the 20th Century". SHS Web of Conferences 136 (2022): 04002. http://dx.doi.org/10.1051/shsconf/202213604002.
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This paper is a brief stream of thought on the function of encampments in the United States during the 20th century. This work derives directly from my still-in-progress dissertation, “The Age of Encampment: Race, Surveillance, and the Power of Spatial Scripts, 19331950.” The dissertation charts a history of the creation of federally-funded camps and their lasting legacies beginning with the creation of New Deal-era liberal policies through the incarceration of enemies of the state during WWII. By revealing the history of federally-funded encampments in the US, I argue that camp spaces were racialized and classist projects dependent on a pathologized “other.” Further, the materialization of camp spaces became a tool used by the US government to surveille bodies deemed threatening to the local community and/or nation-state – a theory I call “spatial scripts.”
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Chappell, Duane E., D. Craig Barnett, Kaitlyn James, Bryant Craig, Fairfield Bain, Earl Gaughan, Chrissie Schneider, Wendy Vaala, Samantha M. Barnum e Nicola Pusterla. "Voluntary Surveillance Program for Equine Influenza Virus in the United States during 2008–2021". Pathogens 12, n.º 2 (27 de janeiro de 2023): 192. http://dx.doi.org/10.3390/pathogens12020192.
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A voluntary upper respiratory biosurveillance program in the USA received 9740 nasal swab submissions during the years 2008–2021 from 333 veterinarians and veterinary clinics. The nasal swabs were submitted for qPCR testing for six common upper respiratory pathogens:equine influenza virus (EIV), equine herpesvirus-1 (EHV-1), equine herpesvirus-4 (EHV-4), Streptococcus equi subspecies equi (S. equi), equine rhinitis A virus (ERAV), and equine rhinitis B virus (ERBV). Additional testing was performed for equine gamma herpesvirus-2 (EHV-2) and equine gamma herpesvirus-5 (EHV-5) and the results are reported. Basic frequency statistics and multivariate logistic regression models were utilized to determine the associations between risk factors and EIV positivity. The EIV qPCR-positivity rate was 9.9%. Equids less than 9 years of age with a recent history of travel and seasonal occurrence in winter and spring were the most common population that were qPCR positive for EIV. This ongoing biosurveillance program emphasizes the need for molecular testing for pathogen identification, which is critical for decisions associated with therapeutics and biosecurity intervention for health management and vaccine evaluations and development.
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Emanuele, Carlos A., Anne E. Jean Baptiste, Ana E. Chévez, Mirta Magarinos, Maite V. Antelo, Sonia Arza, Emilia Cain, Gloria Rey-Benito, Martha Velandia-Gonzalez e Daniel Salas. "Maintaining the Region of the Americas free of polio: best practices for incident management support teams". Revista Panamericana de Salud Pública 48 (1 de abril de 2024): 1. http://dx.doi.org/10.26633/rpsp.2024.23.
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The Pan American Health Organization (PAHO) and its Member States have been leading the efforts to eradicate wild poliovirus in the Region of Americas since smallpox's successful elimination in 1971. The region became the first to be certified free of wild poliovirus in 1994. However, in July 2022, an unvaccinated patient with no recent travel history was diagnosed with poliomyelitis in the United States of America. In response to the emergence of a circulating vaccine-derived poliovirus in the United States, PAHO established the Polio Incident Management Support Team. This team has been coordinating response efforts, focusing on: coordination, planning, and monitoring; risk communication and community engagement; surveillance and case investigation; vaccination; and rapid response. In this paper, we identified and documented best practices observed following establishment of the Incident Management Support Team (September 2022–2023) through a comprehensive review and analysis of various data sources and country-specific data from the polio surveillance dashboard. The aim was to share these best practices, highlighting technical support and implementation of polio measures by Member States. Despite several challenges, the Americas region remains polio-free. Polio risk is declining, with a July 2023 assessment showing fewer countries at medium, high, and very high risk. This progress reflects improved immunization coverage, surveillance, containment, health determinants, and outbreak preparedness and response. The PAHO Polio Incident Management Support Team has played a key role in supporting these efforts.
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Min, Jae, Kelly K. Gurka, Bindu Kalesan, Jiang Bian e Mattia Prosperi. "Injury Burden in the United States: Accurate, Reliable, and Timely Surveillance Using Electronic Health Care Data". American Journal of Public Health 109, n.º 12 (dezembro de 2019): 1702–6. http://dx.doi.org/10.2105/ajph.2019.305306.
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Phares, Christina R., Yecai Liu, Zanju Wang, Drew L. Posey, Deborah Lee, Emily S. Jentes, Michelle Weinberg et al. "Disease Surveillance Among U.S.-Bound Immigrants and Refugees — Electronic Disease Notification System, United States, 2014–2019". MMWR. Surveillance Summaries 71, n.º 2 (21 de janeiro de 2022): 1–21. http://dx.doi.org/10.15585/mmwr.ss7102a1.
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Berkay, Fehmi, Arjun Minhas, JosephG Lyons, Elizabeth Fonte e Norah Foster. "Epidemiology of C2 fractures in the United States: A National Electronic Injury Surveillance System database study". Journal of Craniovertebral Junction and Spine 14, n.º 2 (2023): 187. http://dx.doi.org/10.4103/jcvjs.jcvjs_37_23.
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Hong, Gloria H., Ana M. Ortega-Villa, Sally Hunsberger, Ploenchan Chetchotisakd, Siriluck Anunnatsiri, Piroon Mootsikapun, Lindsey B. Rosen, Christa S. Zerbe e Steven M. Holland. "Natural History and Evolution of Anti-Interferon-γ Autoantibody-Associated Immunodeficiency Syndrome in Thailand and the United States". Clinical Infectious Diseases 71, n.º 1 (20 de agosto de 2019): 53–62. http://dx.doi.org/10.1093/cid/ciz786.
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Abstract Background The natural history of anti-interferon-γ (IFN-γ) autoantibody-associated immunodeficiency syndrome is not well understood. Methods Data of 74 patients with anti-IFN-γ autoantibodies at Srinagarind Hospital, Thailand, were collected annually (median follow-up duration, 7.5 years). Annual data for 19 patients and initial data for 4 patients with anti-IFN-γ autoantibodies at the US National Institutes of Health were collected (median follow-up duration, 4.5 years). Anti-IFN-γ autoantibody levels were measured in plasma samples. Results Ninety-one percent of US patients were of Southeast Asian descent; there was a stronger female predominance (91%) in US than Thai (64%) patients. Mycobacterium abscessus (34%) and Mycobacterium avium complex (83%) were the most common nontuberculous mycobacteria in Thailand and the United States, respectively. Skin infections were more common in Thailand (P = .001), whereas bone (P < .0001), lung (P = .002), and central nervous system (P = .03) infections were more common in the United States. Twenty-four percent of Thai patients died, most from infections. None of the 19 US patients with follow-up data died. Anti-IFN-γ autoantibody levels decreased over time in Thailand (P < .001) and the United States (P = .017), with either cyclophosphamide (P = .01) or rituximab therapy (P = .001). Conclusions Patients with anti-IFN-γ autoantibodies in Thailand and the United States had distinct demographic and clinical features. While titers generally decreased with time, anti-IFN-γ autoantibody disease had a chronic clinical course with persistent infections and death. Close long-term surveillance for new infections is recommended.
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Holt, Jennifer, e Michael Palm. "More than a number: The telephone and the history of digital identification". European Journal of Cultural Studies 24, n.º 4 (7 de março de 2021): 916–34. http://dx.doi.org/10.1177/1367549421994571.
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This article examines the telephone’s entangled history within contemporary infrastructural systems of ‘big data’, identity and, ultimately, surveillance. It explores the use of telephone numbers, keypads and wires to offer new perspective on the imbrication of telephonic information, interface and infrastructure within contemporary surveillance regimes. The article explores telephone exchanges as arbiters of cultural identities, keypads as the foundation of digital transactions and wireline networks as enacting the transformation of citizens and consumers into digital subjects ripe for commodification and surveillance. Ultimately, this article argues that telephone history – specifically the histories of telephone numbers and keypads as well as infrastructure and policy in the United States – continues to inform contemporary practices of social and economic exchange as they relate to consumer identity, as well as to current discourses about surveillance and privacy in a digital age. This article is based on a paper presented at the Media in Transition symposium (Utrecht, June 28, 2018), in the Industries and Infrastructures panel organised by Judith Keilbach. Also published in this issue of ECS are Amanda D. Lotz, ‘Unpopularity and cultural power in the age of Netflix: new questions for cultural studies’ approaches to television texts’ and Vicki Mayer, ‘From peat to Google power: communications infrastructures and structures of feeling in Groningen.’
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Bassett, David R., Dinesh John, Scott A. Conger, Eugene C. Fitzhugh e Dawn P. Coe. "Trends in Physical Activity and Sedentary Behaviors of United States Youth". Journal of Physical Activity and Health 12, n.º 8 (agosto de 2015): 1102–11. http://dx.doi.org/10.1123/jpah.2014-0050.
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Background:Increases in childhood and adolescent obesity are a growing concern in the United States (U.S.), and in most countries throughout the world. Declines in physical activity are often postulated to have contributed to the rise in obesity rates during the past 40 years.Methods:We searched for studies of trends in physical activity and sedentary behaviors of U.S. youth, using nontraditional data sources. Literature searches were conducted for active commuting, physical education, high-school sports, and outdoor play. In addition, trends in sedentary behaviors were examined.Results:Data from the Youth Risk Behavior Surveillance System (YRBSS) and other national surveys, as well as longitudinal studies in the transportation, education, electronic media, and recreation sectors showed evidence of changes in several indicators. Active commuting, high school physical education, and outdoor play (in 3- to 12-year-olds) declined over time, while sports participation in high school girls increased from 1971 to 2012. In addition, electronic entertainment and computer use increased during the first decade of the 21st century.Conclusions:Technological and societal changes have impacted the types of physical activities performed by U.S. youth. These data are helpful in understanding the factors associated with the rise in obesity, and in proposing potential solutions.
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Midgley, Claire, Brian Rha, Joana Y. Lively, Angela P. Campbell, Julie A. Boom, Parvin H. Azimi, Geoffrey A. Weinberg et al. "2639. Respiratory Virus Detections in Asthma-Related Pediatric Hospitalizations: New Vaccine Surveillance Network, United States". Open Forum Infectious Diseases 6, Supplement_2 (outubro de 2019): S922—S923. http://dx.doi.org/10.1093/ofid/ofz360.2317.
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Abstract Background Respiratory viruses are associated with most asthma exacerbations (AEx) in children; however, the role of different viruses in AEx is unclear. We describe respiratory virus detections among pediatric inpatients with AEx (AEx-inpatients). Methods Through active, prospective surveillance at 7 US medical centers, we enrolled inpatients (<18 years) with acute respiratory illness (ARI) during November 1, 2015–June 30, 2016. We defined an AEx-inpatient as an inpatient with a principal admission or discharge diagnosis of asthma (ICD-10-CM, J45.xx). Mid-turbinate nasal and/or throat swabs were tested by molecular assays for influenza A or B, respiratory syncytial virus (RSV), parainfluenza virus 1–3, rhinovirus or enterovirus (RV/EV), human metapneumovirus and adenovirus. We assessed virus detections among AEx-inpatients throughout the surveillance period or by season (winter: December–February; spring: March–May), and by patient age and history of asthma/reactive airway disease (asthma/RAD). Results We tested 3,897 inpatients with ARI; of whom, 954 were AEx-inpatients. Most AEx-inpatients (741/954 [78%]) reported an asthma/RAD history. Viruses were more frequently detected among AEx-inpatients <5 years (350/458 [76%]) than 5–17 years (305/496 [61%], P < 0.001). Most (615/655 [94%]) detections were of single viruses. The most frequent single virus detections were RV/EV (474/954 [50%]) and RSV (76/954 [8%]) but the frequency of each virus varied by season and age group (figure). Single RV/EVs were the most common virus detections in both seasons and all groups. Single RSV detections were prominent among <5 year olds in winter (40/185 [22%]). Among those with single RV/EV or RSV detections, 285/474 (60%) and 49/76 (64%) required supplemental oxygen, respectively (P = 0.676); median length of stay was 1 day (range: 0–45; IQR: 1–2) and 2 days (range: 0–6; IQR: 1–2.5), respectively (P < 0.001). Conclusion AEx-inpatients <5 years were more likely to have respiratory virus detections than those 5–17 years. Single RV/EVs formed the majority of virus detections throughout the surveillance period, regardless of age. RSV played a notable role in winter among patients <5 years. These findings could inform prevention or treatment strategies for virus-associated AEx. Disclosures All authors: No reported disclosures.
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Zhang, Yutong, Ryan B. Simpson, Lauren E. Sallade, Emily Sanchez, Kyle M. Monahan e Elena N. Naumova. "Evaluating Completeness of Foodborne Outbreak Reporting in the United States, 1998–2019". International Journal of Environmental Research and Public Health 19, n.º 5 (2 de março de 2022): 2898. http://dx.doi.org/10.3390/ijerph19052898.
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Public health agencies routinely collect time-referenced records to describe and compare foodborne outbreak characteristics. Few studies provide comprehensive metadata to inform researchers of data limitations prior to conducting statistical modeling. We described the completeness of 103 variables for 22,792 outbreaks publicly reported by the United States Centers for Disease Control and Prevention’s (US CDC’s) electronic Foodborne Outbreak Reporting System (eFORS) and National Outbreak Reporting System (NORS). We compared monthly trends of completeness during eFORS (1998–2008) and NORS (2009–2019) reporting periods using segmented time series analyses adjusted for seasonality. We quantified the overall, annual, and monthly completeness as the percentage of outbreaks with blank records per our study period, calendar year, and study month, respectively. We found that outbreaks of unknown genus (n = 7401), Norovirus (n = 6414), Salmonella (n = 2872), Clostridium (n = 944), and multiple genera (n = 779) accounted for 80.77% of all outbreaks. However, crude completeness ranged from 46.06% to 60.19% across the 103 variables assessed. Variables with the lowest crude completeness (ranging 3.32–6.98%) included pathogen, specimen etiological testing, and secondary transmission traceback information. Variables with low (<35%) average monthly completeness during eFORS increased by 0.33–0.40%/month after transitioning to NORS, most likely due to the expansion of surveillance capacity and coverage within the new reporting system. Examining completeness metrics in outbreak surveillance systems provides essential information on the availability of data for public reuse. These metadata offer important insights for public health statisticians and modelers to precisely monitor and track the geographic spread, event duration, and illness intensity of foodborne outbreaks.
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Valvi, Nimish, Timothy McFarlane, Katie S. Allen, P. Joseph Gibson e Brian Edward Dixon. "Identification of Hypertension in Electronic Health Records Through Computable Phenotype Development and Validation for Use in Public Health Surveillance: Retrospective Study". JMIR Formative Research 7 (27 de dezembro de 2023): e46413. http://dx.doi.org/10.2196/46413.
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Background Electronic health record (EHR) systems are widely used in the United States to document care delivery and outcomes. Health information exchange (HIE) networks, which integrate EHR data from the various health care providers treating patients, are increasingly used to analyze population-level data. Existing methods for population health surveillance of essential hypertension by public health authorities may be complemented using EHR data from HIE networks to characterize disease burden at the community level. Objective We aimed to derive and validate computable phenotypes (CPs) to estimate hypertension prevalence for population-based surveillance using an HIE network. Methods Using existing data available from an HIE network, we developed 6 candidate CPs for essential (primary) hypertension in an adult population from a medium-sized Midwestern metropolitan area in the United States. A total of 2 independent clinician reviewers validated the phenotypes through a manual chart review of 150 randomly selected patient records. We assessed the precision of CPs by calculating sensitivity, specificity, positive predictive value (PPV), F1-score, and validity of chart reviews using prevalence-adjusted bias-adjusted κ. We further used the most balanced CP to estimate the prevalence of hypertension in the population. Results Among a cohort of 548,232 adults, 6 CPs produced PPVs ranging from 71% (95% CI 64.3%-76.9%) to 95.7% (95% CI 84.9%-98.9%). The F1-score ranged from 0.40 to 0.91. The prevalence-adjusted bias-adjusted κ revealed a high percentage agreement of 0.88 for hypertension. Similarly, interrater agreement for individual phenotype determination demonstrated substantial agreement (range 0.70-0.88) for all 6 phenotypes examined. A phenotype based solely on diagnostic codes possessed reasonable performance (F1-score=0.63; PPV=95.1%) but was imbalanced with low sensitivity (47.6%). The most balanced phenotype (F1-score=0.91; PPV=83.5%) included diagnosis, blood pressure measurements, and medications and identified 210,764 (38.4%) individuals with hypertension during the study period (2014-2015). Conclusions We identified several high-performing phenotypes to identify essential hypertension prevalence for local public health surveillance using EHR data. Given the increasing availability of EHR systems in the United States and other nations, leveraging EHR data has the potential to enhance surveillance of chronic disease in health systems and communities. Yet given variability in performance, public health authorities will need to decide whether to seek optimal balance or declare a preference for algorithms that lean toward sensitivity or specificity to estimate population prevalence of disease.
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Hammig, Bart, e Ches Jones. "Epidemiology of Chain Saw Related Injuries, United States: 2009 through 2013". Advances in Emergency Medicine 2015 (17 de setembro de 2015): 1–4. http://dx.doi.org/10.1155/2015/459697.
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Problem. Chain saws are a commonly used tool with the potential to inflict severe injuries. Methods. Descriptive epidemiological estimates for emergency department (ED) visits for injuries associated with the use of a chain saw were calculated using data from the National Electronic Injury Surveillance System for the years 2009–2013. Results. A total of 115,895 ED visits for injuries related to the use of a chain saw occurred during the study period. Most injury visits occurred among males (95%) and persons aged 30–59 years and during the months of September through November. The main body sites injured were the hand/fingers and knee. The majority of injuries were lacerations (80%). Conclusions. Chain saw injuries present with characteristic patterns which can aid in prevention of injuries related to the use of these tools. Examination of the epidemiology of chain saw injuries will help to ascertain targeted needs for prevention and control efforts.
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Naiyer, Nada, Thiphalak Chounthirath e Gary A. Smith. "Pediatric Cheerleading Injuries Treated in Emergency Departments in the United States". Clinical Pediatrics 56, n.º 11 (12 de abril de 2017): 985–92. http://dx.doi.org/10.1177/0009922817702938.
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This study investigates the epidemiology of cheerleading injuries to children in the United States. Data were analyzed from the National Electronic Injury Surveillance System for children 5 through 18 years of age treated in US emergency departments for cheerleading injuries from 1990 through 2012. An estimated 497 095 children ages 5 to 18 years were treated in US emergency departments for a cheerleading injury during the 23-year study period, averaging 21 613 injured children per year. From 1990 to 2012, the annual cheerleading injury rate increased significantly by 189.1%; and from 2001 to 2012, the annual rate of cheerleading-related concussion/closed head injury increased significantly by 290.9%. Falls were the most common mechanism of injury (29.4%) and were more likely to lead to hospitalization (relative risk = 2.47; 95% confidence interval = 1.67-3.68) compared with other injury mechanisms. The rising number and rate of pediatric cheerleading injuries underscore the need for increased efforts to prevent these injuries.
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Zhang, Alexia Y., Sarah Shrum, Sabrina Williams, Sarah Petnic, Joelle Nadle, Helen Johnston, Devra Barter et al. "The Changing Epidemiology of Candidemia in the United States: Injection Drug Use as an Increasingly Common Risk Factor—Active Surveillance in Selected Sites, United States, 2014–2017". Clinical Infectious Diseases 71, n.º 7 (2 de novembro de 2019): 1732–37. http://dx.doi.org/10.1093/cid/ciz1061.
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Abstract Background Injection drug use (IDU) is a known, but infrequent risk factor on candidemia; however, the opioid epidemic and increases in IDU may be changing the epidemiology of candidemia. Methods Active population-based surveillance for candidemia was conducted in selected US counties. Cases of candidemia were categorized as IDU cases if IDU was indicated in the medical records in the 12 months prior to the date of initial culture. Results During 2017, 1191 candidemia cases were identified in patients aged >12 years (incidence: 6.9 per 100 000 population); 128 (10.7%) had IDU history, and this proportion was especially high (34.6%) in patients with candidemia aged 19–44. Patients with candidemia and IDU history were younger than those without (median age, 35 vs 63 years; P < .001). Candidemia cases involving recent IDU were less likely to have typical risk factors including malignancy (7.0% vs 29.4%; relative risk [RR], 0.2 [95% confidence interval {CI}, .1–.5]), abdominal surgery (3.9% vs 17.5%; RR, 0.2 [95% CI, .09–.5]), and total parenteral nutrition (3.9% vs 22.5%; RR, 0.2 [95% CI, .07–.4]). Candidemia cases with IDU occurred more commonly in smokers (68.8% vs 18.5%; RR, 3.7 [95% CI, 3.1–4.4]), those with hepatitis C (54.7% vs 6.4%; RR, 8.5 [95% CI, 6.5–11.3]), and in people who were homeless (13.3% vs 0.8%; RR, 15.7 [95% CI, 7.1–34.5]). Conclusions Clinicians should consider injection drug use as a risk factor in patients with candidemia who lack typical candidemia risk factors, especially in those with who are 19–44 years of age and have community-associated candidemia.
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Peckham, Robert. "Viral surveillance and the 1968 Hong Kong flu pandemic". Journal of Global History 15, n.º 3 (novembro de 2020): 444–58. http://dx.doi.org/10.1017/s1740022820000224.
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AbstractThis article traces the diffusion of the 1968 Hong Kong influenza pandemic against the backdrop of scientific and global health developments, a global wave of social protests, and Cold War tensions between the United States and the People’s Republic of China. Although the outbreak was far less severe than the 1918–19 ‘Spanish’ influenza pandemic, the ease with which influenza spread globally between 1968 and 1970 contributed to a reformulation of global health that emphasized the need for enhanced preparedness and rapid vaccine production. From the 1950s through the 1960s, the scope of disease surveillance expanded, with China increasingly identified as the global epicentre of viral threats. In so arguing, the article challenges histories of global health that suggest that this was a period when concerns for infectious disease receded, in contrast to the final two decades of the twentieth century that saw the ascendancy of an ‘emerging diseases worldview’.
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Akil, Luma, e Hafiz Anwar Ahmad. "Socioeconomic impacts of COVID-19 pandemic on foodborne illnesses in the United States". European Journal of Environment and Public Health 7, n.º 2 (1 de abril de 2023): em0128. http://dx.doi.org/10.29333/ejeph/12585.
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Foodborne diseases continue to impact human health and the economy. The COVID-19 pandemic has dramatically affected the food system from production to consumption. This project aims to determine the impact of the COVID-19 pandemic on the spread of foodborne diseases and the factors that may have contributed, including environmental, behavioral, political, and socioeconomic. Data for this study were collected from The Foodborne Diseases Active Surveillance Network (FoodNet) for 2015-2020. FoodNet personnel located at state health departments regularly contact the clinical laboratories in Connecticut (CT), Georgia (GA), Maryland (MD), Minnesota (MN), New Mexico (NM), Oregon (OR), Tennessee (TN), and selected counties in California (CA), Colorado (CO), and New York (NY). Data were analyzed using SAS to determine the changes in rates of foodborne pathogens reported in FoodNet before and during the COVID-19 pandemic in the ten reporting states. Results of the study showed a significant decline in the incidences of foodborne diseases ranging between 25% and 60%. A geographical variation was also observed between California and states with the highest decline rate of foodborne illnesses. Policies and restrictions, in addition to environmental and behavioral changes during the COVID-19 pandemic, may have reduced rates of foodborne diseases.