121 research outputs found
sj-docx-1-jtt-10.1177_1357633X231199522 - Supplemental material for Telehealth access, willingness, and barriers during the COVID-19 pandemic among a nationally representative diverse sample of U.S. adults with and without chronic health conditions
No full textSupplemental material, sj-docx-1-jtt-10.1177_1357633X231199522 for Telehealth access, willingness, and barriers during the COVID-19 pandemic among a nationally representative diverse sample of U.S. adults with and without chronic health conditions by Randy Le , Izabelle Mendez, Stephanie A Ponce, Alexis Green, Sherine El-Toukhy, Anna M Nápoles and Paula D Strassle in Journal of Telemedicine and Telecare</p
sj-pdf-1-asu-10.1177_00031348221101522 – Supplemental Material for Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey
No full textSupplemental Material, sj-pdf-1-asu-10.1177_00031348221101522 for Perceptions of Gender Disparities in Access to Surgical Care in Malawi: A Community Based Survey by Trista Reid, Jennifer Kincaid, Riju Shrestha, Paula D. Strassle, Rebecca Maine, Anthony Charles, Jared Gallaher, Mphatso Manjolo, Jotham Gondwe and Sherry M. Wren in The American Surgeon</p
INCIDENCE AND RISK FACTORS FOR NON-DEVICE ASSOCIATED HEALTHCARE ASSOCIATED INFECTIONS
No full textDue to current targeted surveillance programs of healthcare associated infections (HAIs), there is a paucity of research on non-device associated urinary tract infections (ND-UTIs), non-device associated pneumonia (ND-pneumonia), and non-device associated bloodstream infections (ND-BSIs). However, limited data that do exist suggest that the proportion of all HAIs that were non-device associated have increased over the last decade. Thus, the purpose of this study was to update current estimates of ND-HAI rates and their frequency relative to device associated infections, assess temporal trends, and identify potential risk factors for ND-HAIs among adult patients hospitalized at the University of North Carolina (UNC) Hospitals between 2013 – 2017. Between 2013 and 2017, the rates of ND-UTIs and ND-pneumonia remained relatively stable, and the rate of ND-BSIs increased. Additionally, ND-UTIs and ND-pneumonia cases represent the majority of infections, with almost 3 in 4 UTIs and pneumonia cases being non-device associated in 2017. One in three BSIs are non-device associated at UNC Hospitals. Females, older adults, peptic ulcer disease, paralysis, immunosuppression, opioid use, TPN, and trauma patients all had a higher risk of ND-UTI. Urinary retention, suprapubic catheters and nephrostomy tubes may also increase patient risk of ND-UTI, although estimates were imprecise. Risk factors for ND-pneumonia included male sex, older age, ICU admission, and chronic bronchitis/emphysema, congestive heart failure, paralysis, and immunosuppression. Finally, risk factors for ND-BSIs included male sex, peptic ulcer disease, paralysis, general anesthesia, opioids, and peripheral venous catheters; higher Morse Fall Risk score, beta-blockers, and UTIs (device or non-device associated) also appeared to increase patient risk. These results all suggest that specific patient and clinical characteristics may increase the risk for certain ND-HAIs, and future studies should explore targeting modifiable risk factors for potential prevention strategies.Doctor of Philosoph
Birth Defects Res A Clin Mol Teratol
No full textBackgroundNonresponse bias assessment is an important and underutilized tool in survey research to assess potential bias due to incomplete participation. This study illustrates a nonresponse bias sensitivity assessment using a survey on perceived barriers to care for children with orofacial clefts in North Carolina.MethodsChildren born in North Carolina between 2001 and 2004 with an orofacial cleft were eligible for inclusion. Vital statistics data, including maternal and child characteristics, were available on all eligible subjects. Missing \ue2\u20ac\u2dcresponses\ue2\u20ac\u2122 from nonparticipants were imputed using assumptions based on the distribution of responses, survey method (mail or phone), and participant maternal demographics.ResultsOverall, 245 of 475 subjects (51.6%) responded to either a mail or phone survey. Cost as a barrier to care was reported by 25.0% of participants. When stratified by survey type, 28.3% of mail respondents and 17.2% of phone respondents reported cost as a barrier. Under various assumptions, the bias-adjusted estimated prevalence of cost as barrier to care ranged from 16.1% to 30.0%. Maternal age, education, race, and marital status at time of birth were not associated with subjects reporting cost as a barrier.ConclusionAs survey response rates continue to decline, the importance of assessing the potential impact of nonresponse bias has become more critical. Birth defects research is particularly conducive to nonresponse bias analysis, especially when birth defect registries and birth certificate records are used. Future birth defect studies which use population-based surveillance data and have incomplete participation could benefit from this type of nonresponse bias assessment.5U01 DD000488/DD/NCBDD CDC HHS/United StatesIVV7/Intramural CDC HHS/United States2015-10-14T00:00:00Z26173046PMC451401
Regional differences in right versus left congenital heart disease diagnoses in neonates in the United States
No full textBirth Defects Res A Clin Mol Teratol
No full textBackgroundLittle is known about the barriers faced by families of children with birth defects in obtaining healthcare. We examined reported perceived barriers to care and satisfaction with care among mothers of children with orofacial clefts.MethodsIn 2006, a validated barriers to care mail/phone survey was administered in North Carolina to all resident mothers of children with orofacial clefts born between 2001 and 2004. Potential participants were identified using the North Carolina Birth Defects Monitoring Program, an active, state-wide, population-based birth defects registry. Five barriers to care subscales were examined: pragmatics, skills, marginalization, expectations, and knowledge/beliefs. Descriptive and bivariate analyses were conducted using chi-square and Fisher's exact tests. Results were stratified by cleft type and presence of other birth defects.ResultsOf 475 eligible participants, 51.6% (n = 245) responded. The six most commonly reported perceived barriers to care were all part of the pragmatics subscale: having to take time off work (45.3%); long waits in the waiting rooms (37.6%); taking care of household responsibilities (29.7%); meeting other family members' needs (29.5%); waiting too many days for appointments (27.0%); and cost (25.0%). Most respondents (72.3%, 175/242) felt \u201cvery satisfied\u201d with their child's cleft care.ConclusionAlthough most participants reported being satisfied with their child's care, many perceived barriers to care were identified. Due to the limited understanding and paucity of research on barriers to care for children with birth defects, including orofacial clefts, additional research on barriers to care and factors associated with them are needed.IVV7/Intramural CDC HHS/United StatesU50/CCU422096/PHS HHS/United State
Endotoxin enhances respiratory effects of phthalates in adults: Results from NHANES 2005-6
No full textPhthalates have been associated with respiratory symptoms in adults; they may enhance effects of inflammatory compounds. To assess the potential interactions of phthalates and endotoxin on respiratory and allergic symptoms in adults, we used cross-sectional information from the 1091 adults with complete data on urinary phthalates and house dust endotoxin from NHANES 2005-2006. We used multivariable logistic regression to assess whether endotoxin levels modified the association between nine phthalate metabolites and four current allergic symptoms (asthma, wheeze, hay fever, and rhinitis). Endotoxin was classified into tertiles (25EU/mg dust). Urinary phthalate and dust endotoxin levels were not correlated (r < |0.02|). Under low endotoxin conditions, no associations between phthalates and respiratory outcomes were observed. Under medium or high endotoxin conditions, exposure-response relationships were observed between specific phthalates and wheeze and asthma. For wheeze, three phthalates (mono-benzyl phthalate (MBzP), mono(carboxyoctyl) phthalate (MCOP), and di-ethylhexyl phthalate (DEHP) had significant interactions with endotoxin); for asthma, two phthalates (MCOP and mono(carboxyoctyl) phthalate (MCNP)) had significant interactions. Endotoxin did not modify the associations between phthalates and hay fever or rhinitis. These results are consistent with the hypothesis that endotoxin enhances the respiratory toxicity of phthalates; however this cross-sectional study cannot address key temporal issues. The lack of an association between wheeze or asthma and phthalates when endotoxin exposure was low suggests that phthalates alone may not increase these symptoms
Transhiatal vs. Transthoracic Esophagectomy: A NSQIP Analysis of Postoperative Outcomes and Risk Factors for Morbidity
No full textDo Hospital or Surgeon Volume Affect Outcomes After Surgical Management of Tibial Shaft Fractures?
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