Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-30 (of 66 Records) |
Query Trace: Decker J [original query] |
---|
Perceived feasibility and acceptability of HIV prevention research with daily oral PrEP among young transgender women (YTGW) who sell or trade sex in Bangkok and Pattaya, Thailand
Chemnasiri T , Varangrat A , Wirtz AL , Decker MR , Okanurak K , Janyam S , Linjongrat D , Dunne EF , Mon SHH , Weir B , Woodring J , Hickey A , Beyrer C . AIDS Educ Prev 2024 36 (4) 244-260 Young transgender women (YTGW) who sell or trade sex have among the highest HIV incidence rates in Thailand. Using qualitative methods, we assessed perceived acceptability, feasibility, and optimal design of a combination HIV prevention intervention including PrEP for YTGW. Key informant interviews were conducted during July 2016-July 2018 with 21 YTGW, aged 18-26 years, who sold sex and resided in Bangkok or Pattaya, Thailand. Grounded theory and content analysis were used for data analysis. Most YTGW interviewed reported high interest in HIV prevention research and believed participation in it supported sexual health. However, participants perceived HIV studies as complicated and time-consuming. Regarding PrEP, participants suggested more PrEP options beyond daily oral PrEP and expressed concerns related to perceived side effects of PrEP, including interaction with gender-affirming hormone therapy. Improving PrEP knowledge, being able to self-assess HIV risk, and reducing HIV/PrEP stigma could increase interest in research and PrEP uptake among YTGW. |
High PrEP uptake, adherence, persistence and effectiveness outcomes among young Thai men and transgender women who sell sex in Bangkok and Pattaya, Thailand: findings from the open-label combination HIV prevention effectiveness (COPE) study
Weir BW , Wirtz AL , Chemnasiri T , Baral SD , Decker M , Dun C , Hnin Mon SH , Ungsedhapand C , Dunne EF , Woodring J , Pattanasin S , Sukwicha W , Thigpen MC , Varangrat A , Warapornmongkholkul A , O'Connor S , Ngo JP , Qaragholi N , Sisel HI , Truong JM , Janyam S , Linjongrat D , Sriplienchan S , Sirivongrangson P , Rooney JF , Sullivan P , Chua-Intra B , Hickey AC , Beyrer C . Lancet Reg Health Southeast Asia 2023 15 100217 BACKGROUND: Daily oral pre-exposure prophylaxis (PrEP) is effective in preventing HIV infection, but no study has evaluated combination prevention interventions with PrEP for transgender women (TGW) and men who have sex with men (MSM) who sell sex. METHODS: The Combination Prevention Effectiveness (COPE) study was a community-based, non-randomized implementation study in Bangkok and Pattaya, Thailand. Participants were HIV-negative MSM and TGW aged 18-26 years who reported exchanging sex with men in the prior 12 months and who met 2014 U.S. Public Health Service PrEP eligibility criteria. The intervention included quarterly HIV testing, semiannual testing for sexually transmitted infections, provision of condoms with lubricant, and the opportunity to initiate or end daily oral PrEP use at any time during study participation. Participants taking PrEP received monthly adherence counseling and short message service reminders. The primary outcome was HIV incidence rate ratio (IRR) on PrEP vs. not on PrEP. Secondary outcomes were PrEP initiation, PrEP use at 12 months, and PrEP adherence. FINDINGS: From October 2017 to August 2019, 846 participants were enrolled: 531 (62.8%) immediately initiated PrEP; 104 (12.3%) subsequently initiated PrEP, and 211 (24.9%) never initiated PrEP. Among those initiating PrEP within 30 days of enrollment; 85.9% were on PrEP at the 12-months. When taking PrEP, participants reported adherent PrEP use at 94.2% of quarterly assessments. Ten HIV seroconversions occurred without PrEP use (incidence rate [IR] = 3.42 per 100 person-years [PY]; 95% CI = 1.64-6.30), while zero cases occurred with PrEP use (IR = 0.0 per 100PY; 95% CI = 0.0-0.62), with IRR = 0.0 (95% CI = 0.0-0.22; p < 0.001). INTERPRETATION: Young Thai MSM and TGW who exchange sex can have high PrEP uptake, persistence and adherence, and low HIV incidence when offered in supportive community-based settings. FUNDING: U.S. National Institute of Allergy and Infectious Diseases; Centers for Disease Control and Prevention. |
Japanese encephalitis in a U.S. traveler returning from Vietnam, 2022
Janatpour ZC , Boatwright MA , Yousif SM , Bonilla MF , Fitzpatrick KA , Hills SL , Decker CF . Travel Med Infect Dis 2023 52 102536 Japanese encephalitis virus (JEV) is a mosquito-borne flavivirus which is endemic throughout most of Asia and parts of the Western Pacific [1,2]. Since the availability of a JE vaccine in the United States (U.S.) in 1993, a total of 13 JE cases in U.S. travelers or expatriates have been reported [[3], [4], [5], [6]]. We describe a case of severe JE in an unvaccinated returning traveler. | | A 37-year-old woman presented to Cleveland Clinic in Abu Dhabi, United Arab Emirates with 4 days of headache, fever and confusion. The patient is a U.S. citizen and had been living in Abu Dhabi for the past 2 years. She had returned from a 2-week vacation to Vietnam, where she primarily stayed in urban locales. However, she did participate in a 2-day hike within the Sa Pa region of Northern Vietnam, where she stayed in unscreened lodging and sustained multiple mosquito bites despite using preventive measures. She had not received the JE vaccine prior to travel. Her symptoms began while still in country on day 13 of the 14-day trip. |
Diverse contexts and social factors among young cisgender men and transgender women who sell or trade sex in Bangkok and Pattaya, Thailand: formative research for a PrEP program implementation study
Truong JM , Chemnasiri T , Wirtz AL , Mon SHH , Varangrat A , Decker M , Janyam S , Linjongrat D , Sirivongrangson P , Hickey AC , Weir BW , Beyrer C . AIDS Care 2022 34 (11) 1-9 HIV incidence is high and persistent among cisgender men who have sex with men (MSM) and transgender women (TGW) who have sex with men, particularly among those who sell or trade sex. In preparation for an open-label combination HIV pre-exposure prophylaxis (PrEP) program for these groups, we conducted formative research to explore the context of sex work/trade and factors that affect implementation of PrEP interventions. This study analyzed interviews with 20 young (aged 18-26 years) MSM and TGW who sell/trade sex and three sex work venue managers in Bangkok and Pattaya, Thailand. Participants described diverse contexts of sex work/trade, including in multiple informal and formal sex venues. Several participants reported mobility across provinces and out of the country, which led to intermittent sex work/trade. TGW sex workers reported challenges with access and cost of femininizing hormones and limited employment opportunities. Factors that could facilitate or challenge PrEP program implementation included HIV stigma, the role of venue management in sexual health practice, lack of PrEP knowledge, lower perceived HIV risk, and interest in personal health and wellbeing. Program implementers must consider myriad factors to successfully implement PrEP among young MSM and TGW engaged in sex work or trade in Thailand. |
Forklift safety: a pilot study evaluation of retrofit lights
Bobick TG , Hause M , Socias-Morales C , Gwilliam M , Decker T . Prof Saf 2020 65 (12) 41-45 Forklift vehicles are important in many U.S. industries. From 2009 to 2018, slightly less than 1.7 million powered industrial trucks, including forklifts, were shipped from manufacturers to customers in the U.S. (ITA, 2019). Forklifts are used to move supplies and products throughout facilities and onto tractor-trailer vehicles for delivery to customers nationwide. For each forklift being used, typically one or two pedestrian workers in the same area are exposed to the mobile forklifts. Thus, numerous pedestrian workers are at risk of being injured, sometimes fatally. The initial research conducted on forklifts by NIOSH (2001) indicates that forklift injuries and fatalities are mainly due to vehicle overturns, bystander (pedestrian worker) struck-by events and crushed-by-forklift events. ... KEY TAKEAWAYS: 1. Blue and red lights were retrofitted onto three forklifts and used for 4 months in a warehouse environment to increase the awareness of approaching vehicles. 2. A short list of open-ended discussion questions pertaining to the retrofit lights was administered to nine employees who were operators and pedestrians. 3. Feedback indicates that all nine employees thought the addition of the lights increased the visibility of the forklifts and improved safety by making the vehicles more conspicuous. ... Future studies are needed to expand on this pilot study and confirm the efficacy of the blue and red lights in reducing injuries or forklift damage due to collisions. This could include comparing retrofit blue and red lights on forklifts between larger groups of employees and managers at different work sites, over longer observation periods and collecting more in-depth measures regarding their effectiveness (e.g., changes in annual number of injuries per 1,000 workers, dollar cost in damage to forklifts, annual number of workers' compensation claims). ... Not enough information is available about the use of retrofit lights on existing forklifts. Because of this lack of information, it would be beneficial to other safety professionals if the unsafe situations, which might be avoided in the future because of using the lights, were documented and published in a safety-related journal to help educate others in the safety community. OSH professionals in other warehousing operations can use the results from this pilot study to develop safe working conditions for their operations. |
A replicable approach to promoting best practices: Translating cardiovascular disease prevention research
Hawkins NA , Bhuiya AR , Shantharam S , Chapel JM , Taylor LN , Thigpen S , Decker A , Moeti R , Bernard S , Jones CD , Schooley M . J Public Health Manag Pract 2020 27 (2) 109-116 OBJECTIVE: Significant delays in translating health care-related research into public health programs and medical practice mean that people may not get the best care when they need it. Regarding cardiovascular disease, translation delays can mean lives may be unnecessarily lost each year. To facilitate the translation of knowledge to action, we created a Best Practices Guide for Cardiovascular Disease Prevention Programs. DESIGN: Using the Rapid Synthesis Translation Process and the Best Practices Framework as guiding frameworks, we collected and rated research evidence for hypertension control and cholesterol management strategies. After identifying best practices, we gathered information about programs that were implementing the practices and about resources useful for implementation. Research evidence and supplementary information were consolidated in an informational resource and published online. Web metrics were collected and analyzed to measure use and reach of the guide. RESULTS: The Best Practices Guide was released in January 2018 and included background information and resources on 8 best practice strategies. It was published as an online resource, publicly accessible from the Centers for Disease Control and Prevention Web site in 2 different formats. Web metrics show that in the first year after publication, there were 25 589 Web page views and 2467 downloads. A query of partner use of the guide indicated that it was often shared in partners' own resources, newsletters, and online material. CONCLUSION: In following a systematic approach to creating the Best Practices Guide and documenting the steps taken in its development, we offer a replicable approach for translating research on health care practices into a resource to facilitate implementation. The success of this approach is attributed to 3 key factors: using a prescribed and documented approach to evidence translation, working closely with stakeholders throughout the process, and prioritizing the content design and accessibility of the final product. |
Testing the effectiveness and cost-effectiveness of a combination HIV prevention intervention among young cisgender men who have sex with men and transgender women who sell or exchange sex in Thailand: Protocol for the Combination Prevention Effectiveness Study
Wirtz AL , Weir BW , Mon SHH , Sirivongrangson P , Chemnasiri T , Dunne EF , Varangrat A , Hickey AC , Decker MR , Baral S , Okanurak K , Sullivan P , Valencia R , Thigpen MC , Holtz TH , Mock PA , Cadwell B , Adeyeye A , Rooney JF , Beyrer C . JMIR Res Protoc 2020 9 (1) e15354 BACKGROUND: Pre-exposure prophylaxis (PrEP) is highly effective in the prevention of HIV acquisition, particularly for men who have sex with men (MSM). Questions remain on the benefits of PrEP and implementation strategies for those at occupational risk of HIV acquisition in sex work, as well as on methods to support adherence among young people who initiate PrEP. OBJECTIVE: The Combination Prevention Effectiveness study for young cisgender MSM and transgender women (TGW) aims to assess the effectiveness and cost-effectiveness of a combination intervention among HIV-uninfected young MSM and TGW engaged in sex work in Thailand. METHODS: This open-label, nonrandomized assessment compares the relative effectiveness of a combination prevention intervention with and without daily oral emtricitabine and tenofovir disoproxil fumarate (Truvada) PrEP with SMS-based adherence support. HIV-uninfected young MSM and TGW aged 18 to 26 years in Bangkok and Pattaya who self-report selling/exchanging sex at least once in the previous 12 months are recruited by convenience sampling and peer referral and are eligible regardless of their intent to initiate PrEP. At baseline, participants complete a standard assessment for PrEP eligibility and may initiate PrEP then or at any time during study participation. All participants complete a survey and HIV testing at baseline and every 3 months. Participants who initiate PrEP complete monthly pill pickups and may opt-in to SMS reminders. All participants are sent brief weekly SMS surveys to assess behavior with additional adherence questions for those who initiated PrEP. Adherence is defined as use of 4 or more pills within the last 7 days. The analytic plan uses a person-time approach to assess HIV incidence, comparing participant time on oral PrEP to participant time off oral PrEP for 12 to 24 months of follow-up, using a propensity score to control for confounders. Enrollment is based on the goal of observing 620 person-years (PY) on PrEP and 620 PY off PrEP. RESULTS: As of February 2019, 445 participants (417 MSM and 28 TGW) have contributed approximately 168 PY with 95% (73/77) retention at 12 months. 74.2% (330/445) of enrolled participants initiated PrEP at baseline, contributing to 134 PY of PrEP adherence, 1 PY nonadherence, and 33 PY PrEP nonuse/noninitiation. Some social harms, predominantly related to unintentional participant disclosure of PrEP use and peer stigmatization of PrEP and HIV, have been identified. CONCLUSIONS: The majority of cisgender MSM and TGW who exchange sex and participate in this study are interested in PrEP, report taking sufficient PrEP, and stay on PrEP, though additional efforts are needed to address community misinformation and stigma. This novel multilevel, open-label study design and person-time approach will allow evaluation of the effectiveness and cost-effectiveness of combination prevention intervention in the contexts of both organized sex work and exchanged sex. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/15354. |
Revision and Update of the Consensus Definitions of Invasive Fungal Disease From the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium
Donnelly JP , Chen SC , Kauffman CA , Steinbach WJ , Baddley JW , Verweij PE , Clancy CJ , Wingard JR , Lockhart SR , Groll AH , Sorrell TC , Bassetti M , Akan H , Alexander BD , Andes D , Azoulay E , Bialek R , Bradsher RW , Bretagne S , Calandra T , Caliendo AM , Castagnola E , Cruciani M , Cuenca-Estrella M , Decker CF , Desai SR , Fisher B , Harrison T , Heussel CP , Jensen HE , Kibbler CC , Kontoyiannis DP , Kullberg BJ , Lagrou K , Lamoth F , Lehrnbecher T , Loeffler J , Lortholary O , Maertens J , Marchetti O , Marr KA , Masur H , Meis JF , Morrisey CO , Nucci M , Ostrosky-Zeichner L , Pagano L , Patterson TF , Perfect JR , Racil Z , Roilides E , Ruhnke M , Prokop CS , Shoham S , Slavin MA , Stevens DA , Thompson GR , Vazquez JA , Viscoli C , Walsh TJ , Warris A , Wheat LJ , White PL , Zaoutis TE , Pappas PG . Clin Infect Dis 2019 71 (6) 1367-1376 BACKGROUND: Invasive fungal diseases (IFDs) remain important causes of morbidity and mortality. The consensus definitions of the Infectious Diseases Group of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group have been of immense value to researchers who conduct clinical trials of antifungals, assess diagnostic tests, and undertake epidemiologic studies. However, their utility has not extended beyond patients with cancer or recipients of stem cell or solid organ transplants. With newer diagnostic techniques available, it was clear that an update of these definitions was essential. METHODS: To achieve this, 10 working groups looked closely at imaging, laboratory diagnosis, and special populations at risk of IFD. A final version of the manuscript was agreed upon after the groups' findings were presented at a scientific symposium and after a 3-month period for public comment. There were several rounds of discussion before a final version of the manuscript was approved. RESULTS: There is no change in the classifications of "proven," "probable," and "possible" IFD, although the definition of "probable" has been expanded and the scope of the category "possible" has been diminished. The category of proven IFD can apply to any patient, regardless of whether the patient is immunocompromised. The probable and possible categories are proposed for immunocompromised patients only, except for endemic mycoses. CONCLUSIONS: These updated definitions of IFDs should prove applicable in clinical, diagnostic, and epidemiologic research of a broader range of patients at high-risk. |
Maternal and infant bone mineral density 1 year after delivery in a randomized, controlled trial of maternal tenofovir disoproxil fumarate to prevent mother-to-child transmission of hepatitis B virus
Salvadori N , Fan B , Teeyasoontranon W , Ngo-Giang-Huong N , Phanomcheong S , Luvira A , Puangsombat A , Suwannarat A , Srirompotong U , Putiyanun C , Cressey TR , Decker L , Khamduang W , Harrison L , Tierney C , Shepherd JA , Kourtis AP , Bulterys M , Siberry GK , Jourdain G . Clin Infect Dis 2019 69 (1) 144-146 In a randomized, double-blind, placebo-controlled trial of tenofovir disoproxil fumarate (TDF) use from 28 weeks gestational age to 2 months postpartum to prevent mother-to-child transmission of hepatitis B virus, there was no significant effect of maternal TDF use on maternal or infant bone mineral density 1 year after delivery/birth. Clinical Trials Registration. NCT01745822. |
Association of obesity with hearing impairment in adolescents
Scinicariello F , Carroll Y , Eichwald J , Decker J , Breysse PN . Sci Rep 2019 9 (1) 1877 Hearing loss (HL) is the third most common chronic physical condition in the United States. Obesity has become an increasingly important public health concern, as the prevalence in children, adolescents and adults has increased over the past few decades. The objectives of this study is to investigate whether obesity is associated with audiometric notches indicative of noise-induced hearing loss (NIHL), speech frequency hearing loss (SFHL), and high frequency hearing loss (HFHL) in adolescent participants of the National Health and Nutrition Examination Survey 2007-2010. The prevalence of overall audiometric notches in the adolescent population was 16.0% with higher prevalence in females than males. The prevalence of SFHL and HFHL were higher in males than females (SFHL, 7.3% vs. 5.4%, respectively; and HFHL 14.3% vs. 8.1%, respectively). Obese adolescents had a higher adjusted OR to have audiometric notches (OR = 1.93; 95% CI: 1.33-2.81) and HFHL (OR = 1.95; 95% CI: 1.19-3.21). Continued preventative efforts towards reducing obesity might also help to reduce the risk for HL and NIHL. |
Youth-friendly family planning services for young people: A systematic review update
Brittain AW , Loyola Briceno AC , Pazol K , Zapata LB , Decker E , Rollison JM , Malcolm NM , Romero LM , Koumans EH . Am J Prev Med 2018 55 (5) 725-735 CONTEXT: Youth-friendly family planning services may improve youth reproductive health outcomes. A systematic review conducted in 2011 was updated in 2016 to incorporate recent data examining the effects of youth-friendly family planning services on reproductive health outcomes and the facilitators and barriers facing young people in accessing family planning services. EVIDENCE ACQUISITION: PubMed, POPLINE, EMBASE, and other databases were used to identify relevant articles published from March 2011 through April 2016. EVIDENCE SYNTHESIS: Eighteen studies met inclusion criteria and were added to 19 studies from the review conducted in 2011. Of these, seven assessed the effect of youth-friendly services on outcomes: two showed a positive effect on reducing teen pregnancy, three on contraceptive use, and three on knowledge and patient satisfaction (not mutually exclusive). Facilitators or barriers were described in 32 studies. However, none were RCTs and most were at high risk for bias due to selection, self-report, and recall bias among others. CONCLUSIONS: The studies in this review suggest some positive effects of youth-friendly family planning services on reproductive health outcomes, but the need for more rigorous research persists. This review identified numerous factors relevant to young people's access to family planning services, reaffirming findings from the initial review: young people value confidentiality, supportive provider interaction, specialized provider training, and the removal of logistic barriers. Further, it illuminates the importance young people place on receiving comprehensive, client-centered family planning counseling. These findings should be considered when developing, implementing, and evaluating reproductive health services for young people. THEME INFORMATION: This article is part of a theme issue entitled Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services, which is sponsored by the Office of Population Affairs, U.S. Department of Health and Human Services. |
Tenofovir exposure during pregnancy and postpartum in women receiving tenofovir disoproxil fumarate for the prevention of mother-to-child transmission of hepatitis B virus
Cressey TR , Harrison L , Achalapong J , Kanjanavikai P , Patamasingh Na Ayudhaya O , Liampongsabuddhi P , Siriwachirachai T , Putiyanun C , Suriyachai P , Tierney C , Salvadori N , Chinwong D , Decker L , Tawon Y , Murphy TV , Ngo-Giang-Huong N , Siberry GK , Jourdain G . Antimicrob Agents Chemother 2018 62 (12) We assessed tenofovir exposure during pregnancy and postpartum in hepatitis B virus (HBV)-infected, HIV-uninfected, women receiving tenofovir disoproxil fumarate (TDF) to prevent mother-to-child transmission of HBV. Data from 154 women who received TDF within a randomized-controlled trial were included. Individual plasma tenofovir exposures (AUC0-24) were estimated using a population pharmacokinetic approach. Estimated geometric mean tenofovir AUC0-24 was 20% (95% CI: 19-21%) lower during pregnancy compared to postpartum; this modest reduction in the absence of HBV transmission suggests no dose adjustment is needed. |
Age and sex differences in hearing loss association with depressive symptoms: analyses of NHANES 2011-2012
Scinicariello F , Przybyla J , Carroll Y , Eichwald J , Decker J , Breysse PN . Psychol Med 2018 49 (6) 1-7 BACKGROUND: Depression is a common and significant health problem. Hearing loss is the third most common chronic physical condition in the USA and might be a factor in depression. To determine whether hearing loss is associated with depressive symptoms in US adults ages 20-69 years. METHODS: National Health and Nutrition Examination Survey (NHANES) data (2011-2012) were used to assess the potential relationship between hearing loss and depression, in adults (20-69 years) who answered the Patient Health Questionnaire (PHQ-9) depression screening module, with pure tone audiometry measurements, and complete information on the co-variates data (n = 3316). The degree of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) were defined as slight/mild hearing loss 26-40 dB; moderate/worse hearing loss 41 dB by pure tone audiometry examination. RESULTS: Moderate/worse HFHL was statistically significantly associated with depressive symptoms (OR 1.54, 95% CL 1.04-2.27) when the analyses were conducted among all participants. Further stratification by gender and age groups found that moderate/worse HFHL (OR 3.85, 95% CL 1.39-10.65) and moderate/worse SFHL (OR 5.75, 95% CL 1.46-22.71) were associated with depressive symptoms in women ages 52-69 years. CONCLUSIONS: Moderate/worse speech frequency and HFHL are associated with depression in women ages 52-69 years, independent of other risk factors. Hearing screenings are likely to reduce delays in diagnosis and provide early opportunities for noise prevention counseling and access to hearing aids. Health professionals should be aware of depressive signs and symptoms in patients with hearing loss. |
Unintended pregnancy and interpregnancy interval by maternal age, National Survey of Family Growth
Ahrens KA , Thoma M , Copen C , Frederiksen B , Decker E , Moskosky S . Contraception 2018 98 (1) 52-55 BACKGROUND: The relationship between unintended pregnancy and interpregnancy interval (IPI) across maternal age is not clear. METHODS: Using data from the National Survey of Family Growth, we estimated the percentages of pregnancies that were unintended among IPI groups (<6, 6-11, 12-17, 18-23, 24+ months) by maternal age at last live birth (15-19, 20-24, 25-29, 30-44years). RESULTS: Approximately 40% of pregnancies were unintended and 36% followed an IPI<18months. Within each maternal age group, the percentage of pregnancies that were unintended decreased as IPI increased. CONCLUSION: Unintended pregnancies are associated with shorter IPI across the reproductive age spectrum. |
Tenofovir versus Placebo to Prevent Perinatal Transmission of Hepatitis B.
Jourdain G , Ngo-Giang-Huong N , Harrison L , Decker L , Khamduang W , Tierney C , Salvadori N , Cressey TR , Sirirungsi W , Achalapong J , Yuthavisuthi P , Kanjanavikai P , Na Ayudhaya OP , Siriwachirachai T , Prommas S , Sabsanong P , Limtrakul A , Varadisai S , Putiyanun C , Suriyachai P , Liampongsabuddhi P , Sangsawang S , Matanasarawut W , Buranabanjasatean S , Puernngooluerm P , Bowonwatanuwong C , Puthanakit T , Klinbuayaem V , Thongsawat S , Thanprasertsuk S , Siberry GK , Watts DH , Chakhtoura N , Murphy TV , Nelson NP , Chung RT , Pol S , Chotivanich N . N Engl J Med 2018 378 (10) 911-923 BACKGROUND: Pregnant women with an elevated viral load of hepatitis B virus (HBV) have a risk of transmitting infection to their infants, despite the infants' receiving hepatitis B immune globulin. METHODS: In this multicenter, double-blind clinical trial performed in Thailand, we randomly assigned hepatitis B e antigen (HBeAg)-positive pregnant women with an alanine aminotransferase level of 60 IU or less per liter to receive tenofovir disoproxil fumarate (TDF) or placebo from 28 weeks of gestation to 2 months post partum. Infants received hepatitis B immune globulin at birth and hepatitis B vaccine at birth and at 1, 2, 4, and 6 months. The primary end point was a hepatitis B surface antigen (HBsAg)-positive status in the infant, confirmed by the HBV DNA level at 6 months of age. We calculated that a sample of 328 women would provide the trial with 90% power to detect a difference of at least 9 percentage points in the transmission rate (expected rate, 3% in the TDF group vs. 12% in the placebo group). RESULTS: From January 2013 to August 2015, we enrolled 331 women; 168 women were randomly assigned to the TDF group and 163 to the placebo group. At enrollment, the median gestational age was 28.3 weeks, and the median HBV DNA level was 8.0 log10 IU per milliliter. Among 322 deliveries (97% of the participants), there were 319 singleton births, two twin pairs, and one stillborn infant. The median time from birth to administration of hepatitis B immune globulin was 1.3 hours, and the median time from birth to administration of hepatitis B vaccine was 1.2 hours. In the primary analysis, none of the 147 infants (0%; 95% confidence interval [CI], 0 to 2) in the TDF group were infected, as compared with 3 of 147 (2%; 95% CI, 0 to 6) in the placebo group (P=0.12). The rate of adverse events did not differ significantly between groups. The incidence of a maternal alanine aminotransferase level of more than 300 IU per liter after discontinuation of the trial regimen was 6% in the TDF group and 3% in the placebo group (P=0.29). CONCLUSIONS: In a setting in which the rate of mother-to-child HBV transmission was low with the administration of hepatitis B immune globulin and hepatitis B vaccine in infants born to HBeAg-positive mothers, the additional maternal use of TDF did not result in a significantly lower rate of transmission. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development; ClinicalTrials.gov number, NCT01745822 .). |
Healthcare-associated infections studies project: An American Journal of Infection Control and National Healthcare Safety Network data quality collaboration: Location mapping
Wright MO , Decker SG , Allen-Bridson K , Hebden JN , Leaptrot D . Am J Infect Control 2018 46 (5) 577-578 This case study is part of a series centered on the Centers for Disease Control and Prevention/National Healthcare Safety Network (NHSN) health care-associated infection (HAI) surveillance definitions. This specific case study focuses on appropriately mapping locations within an NHSN-enrolled facility. The intent of the case study series is to foster standardized application of the NHSN HAI surveillance definitions among IPs and encourage accurate determination of HAI events. An online survey link is provided where participants may confidentially answer questions related to the case study and receive immediate feedback in the form of correct answers and explanations and rationales. Details of the case study, answers, and explanations have been reviewed and approved by NHSN staff. We hope that participants take advantage of this educational offering and thereby gain a greater understanding of NHSN HAI surveillance definitions. |
Trends in health insurance coverage of Title X Family Planning Program clients, 2005-2015
Decker EJ , Ahrens KA , Fowler CI , Carter M , Gavin L , Moskosky S . J Womens Health (Larchmt) 2017 27 (5) 684-690 BACKGROUND: The federal Title X Family Planning Program supports the delivery of family planning services and related preventive care to 4 million individuals annually in the United States. The implementation of the 2010 Affordable Care Act's (ACA's) Medicaid expansion and provisions expanding access to health insurance, which took effect in January 2014, resulted in higher rates of health insurance coverage in the U.S. population; the ACA's impact on individuals served by the Title X program has not yet been evaluated. METHODS: Using administrative data we examined changes in health insurance coverage among Title X clinic patients during 2005-2015. RESULTS: We found that the percentage of clients without health insurance decreased from 60% in 2005 to 48% in 2015, with the greatest annual decrease occurring between 2013 and 2014 (63% to 54%). Meanwhile, between 2005 and 2015, the percentage of clients with Medicaid or other public health insurance increased from 20% to 35% and the percentage of clients with private health insurance increased from 8% to 15%. CONCLUSIONS: Although clients attending Title X clinics remained uninsured at substantially higher rates compared with the national average, the increase in clients with health insurance coverage aligns with the implementation of ACA-related provisions to expand access to affordable health insurance. |
Review of hazards to female reproductive health in veterinary practice
Scheftel JM , Elchos BL , Rubin CS , Decker JA . J Am Vet Med Assoc 2017 250 (8) 862-872 OBJECTIVE To review publications that address female reproductive health hazards in veterinary practice, summarize best practices to mitigate reproductive risks, and identify current knowledge gaps. DESIGN Systematized review. SAMPLE English-language articles describing chemical, biological, and physical hazards present in the veterinary workplace and associations with adverse reproductive outcomes or recommendations for minimizing risks to female reproductive health. PROCEDURES Searches of the CAB abstracts database were performed in July 2012 and in May 2015 with the following search terms: veterinarians AND occupational hazards and vets.id AND occupational hazards.sh. Searches of the PubMed database were conducted in November 2012 and in May 2015 with the following medical subject heading terms: occupational exposure AND veterinarians; anesthetics, inhalation/adverse effects AND veterinarians; risk factors AND pregnancy AND veterinarians; pregnancy outcome AND veterinarians; and animal technicians AND occupational exposure. Two additional PubMed searches were completed in January 2016 with the terms disinfectants/toxicity AND female AND fertility/drug effects and veterinarians/psychology AND stress, psychological. No date limits were applied to searches. RESULTS 4 sources supporting demographic trends in veterinary medicine and 118 resources reporting potential hazards to female reproductive health were identified. Reported hazards included exposure to anesthetic gases, radiation, antineoplastic drugs, and reproductive hormones; physically demanding work; prolonged standing; and zoonoses. CONCLUSIONS AND CLINICAL RELEVANCE Demographic information suggested that an increasing number of women of reproductive age will be exposed to chemical, biological, and physical hazards in veterinary practice. Information on reproductive health hazards and minimizing risk, with emphasis on developing a safety-focused work culture for all personnel, should be discussed starting in veterinary and veterinary technical schools and integrated into employee training. |
Prevention of mother-to-child transmission of hepatitis B virus: a phase III, placebo-controlled, double-blind, randomized clinical trial to assess the efficacy and safety of a short course of tenofovir disoproxil fumarate in women with hepatitis B virus e-antigen
Jourdain G , Ngo-Giang-Huong N , Cressey TR , Hua L , Harrison L , Tierney C , Salvadori N , Decker L , Traisathit P , Sirirungsi W , Khamduang W , Bowonwatanuwong C , Puthanakit T , Siberry GK , Watts DH , Murphy TV , Achalapong J , Hongsiriwon S , Klinbuayaem V , Thongsawat S , Chung RT , Pol S , Chotivanich N . BMC Infect Dis 2016 16 393 BACKGROUND: Chronic hepatitis B virus (HBV) infection is complicated by cirrhosis and liver cancer. In Thailand, 6-7 % of adults are chronically infected with HBV. The risk of mother-to-child transmission (MTCT) of HBV has been estimated to be about 12 % when mothers have a high hepatitis B viral load, even if infants receive passive-active prophylaxis with HBV immunoglobulin (HBIg) and initiate the hepatitis B vaccine series at birth. We designed a study to assess the efficacy and safety of a short course of maternal tenofovir disoproxil fumarate (TDF) among women with a marker of high viral load for the prevention of MTCT of HBV. METHODS: The study is a phase III, multicenter (17 sites in Thailand), placebo-controlled, double-blind, randomized 1:1, two-arm clinical trial of TDF 300 mg once daily versus placebo among pregnant women from 28 weeks' gestation through 2-month post-partum. All infants receive HBIg at birth, and a hepatitis B (HB) vaccination series according to Thai guidelines: birth, and age 1, 2, 4 and 6 months. Participant women at study entry must be age ≥18 years, hepatitis B surface antigen (HBsAg) and e-antigen (HBeAg) positive, have alanine aminotransferase (ALT) level < 30 IU/L at screening (confirmed < 60 IU/L pre-entry), negative hepatitis C serology, creatinine clearance >50 mL/min, and no history of anti-HBV antiviral treatment. The target sample size of 328 mother/infant pairs assumed 156 evaluable cases per arm to detect a ≥9 % difference in MTCT transmission (3 % experimental arm versus 12 % placebo arm) with 90 % power. Mothers and infants are followed until 12 months after delivery. The primary infant endpoint is detection of HBsAg, confirmed by detection of HBV DNA at six months of age. Secondary endpoints are maternal and infant adverse events, acute exacerbations of maternal hepatitis B disease (ALT >300 IU/L, defined as a "flare") following discontinuation of study treatment, infant HBV infection status and growth up to 12 months of age. DISCUSSION: The results of this randomized trial will clarify the efficacy and safety of a short course of antiviral treatment to prevent mother-to-child transmission of HBV and inform international guidelines. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01745822 . |
Characteristics of Medicare Advantage and fee-for-service beneficiaries upon enrollment in Medicare at age 65
Miller EA , Decker SL , Parker JD . J Ambul Care Manage 2016 39 (3) 231-41 Previous research has found differences in characteristics of beneficiaries enrolled in Medicare fee-for-service versus Medicare Advantage (MA), but there has been limited research using more recent MA enrollment data. We used 1997-2005 National Health Interview Survey data linked to 2000-2009 Medicare enrollment data to compare characteristics of Medicare beneficiaries before their initial enrollment into Medicare fee-for-service or MA at age 65 and whether the characteristics of beneficiaries changed from 2006 to 2009 compared with 2000 to 2005. During this period of MA growth, the greatest increase in enrollment appears to have come from those with no chronic conditions and men. |
Health information technology adoption in the emergency department
Selck FW , Decker SL . Health Serv Res 2016 51 (1) 32-47 OBJECTIVE: To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use. DATA SOURCES: 2007-2010 National Hospital Ambulatory Medical Care Survey - ED Component. STUDY DESIGN: We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use. PRINCIPAL FINDINGS: The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT-equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1-year lag, advanced systems also showed an increase in the number of medications and images ordered per visit. CONCLUSIONS: Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care. |
Association between diagnosed diabetes and trouble seeing, National Health Interview Survey, 2011-13
Lipton BJ , Decker SL . J Diabetes 2015 7 (5) 743-6 Approximately 21 million individuals in the US have diagnosed diabetes.1 Diabetic retinopathy, a progressive condition that can ultimately lead to blindness, affects approximately 29% of adults aged 40 years and older with diabetes.2 Diabetes is also associated with an increased likelihood of other conditions that may affect vision, such as cataracts and glaucoma.3 We assessed the association between diagnosed diabetes and self-reported trouble seeing while controlling for other covariates that may affect vision. | | The present study used 2011–13 data from the National Health Interview Survey (NHIS).4 The NHIS is a nationally representative sample of US households, with one adult member of each family selected to complete a more in-depth survey. Final 2011–13 sample adult response rates ranged from 61% to 66%. Respondents were asked if they had trouble seeing even when wearing usual vision correction. Possible responses included “yes”, “no”, and “don’t know”, and were used to create a binary variable equal to one for those who did and zero for those who did not report trouble seeing (responses of “don’t know” and refusals [accounting for <0.01% of responses] were considered missing). Those who reported receiving a diabetes diagnosis from a healthcare provider were classified as having diabetes. The sample consisted of adults aged 25 years and older with complete demographic, comorbidity, vision, and diabetes information.5 |
The effect of health insurance coverage on medical care utilization and health outcomes: evidence from Medicaid adult vision benefits
Lipton BJ , Decker SL . J Health Econ 2015 44 320-32 Increasing the proportion of adults that have regular, comprehensive eye exams and reducing visual impairment due to uncorrected refractive error and other common eye health problems are federal health objectives. We examine the effect of vision insurance on eye care utilization and vision health outcomes by taking advantage of quasi-experimental variation in Medicaid coverage of adult vision care. Using a difference-in-difference-in-difference approach, we find that Medicaid beneficiaries with vision coverage are 4.4 percentage points (p<0.01) more likely to have seen an eye doctor in the past year, 5.3 percentage points (p<0.01) less likely to report needing but not purchasing eyeglasses or contacts due to cost, 2.0 percentage points (p<0.05) less likely to report difficulty seeing with usual vision correction, and 1.2 percentage points (p<0.01) less likely to have a functional limitation due to vision. |
The effect of Medicaid adult vision coverage on the likelihood of appropriate correction of distance vision: evidence from the National Health and Nutrition Examination Survey
Lipton BJ , Decker SL . Soc Sci Med 2015 150 258-67 BACKGROUND: Medicaid is the main public health insurance program for individuals with low income in the United States. Some state Medicaid programs cover preventive eye care services and vision correction, while others cover emergency eye care only. Similar to other optional benefits, states may add and drop adult vision benefits over time. RESEARCH OBJECTIVE: This article examines whether providing adult vision benefits is associated with an increase in the percentage of low-income individuals with appropriately corrected distance vision as measured during an eye exam. METHODOLOGY: We estimate the effect of Medicaid vision coverage on the likelihood of having appropriately corrected distance vision using examination data from the 2001-2008 National Health and Nutrition Examination Survey. We compare vision outcomes for Medicaid beneficiaries (n = 712) and other low income adults not enrolled in Medicaid (n = 4786) before and after changes to state vision coverage policies. FINDINGS: Between 29 and 33 states provided Medicaid adult vision benefits during 2001-2008, depending on the year. Our findings imply that Medicaid adult vision coverage is associated with a significant increase in the percentage of Medicaid beneficiaries with appropriately corrected distance vision of up to 10 percentage points. CONCLUSION: Providing vision coverage to adults on Medicaid significantly increases the likelihood of appropriate correction of distance vision. Further research on the impact of vision coverage on related functional outcomes and the effects of Medicaid coverage of other services may be appropriate. |
Do Medicaid benefit expansions have teeth? The effect of Medicaid adult dental coverage on the use of dental services and oral health
Decker SL , Lipton BJ . J Health Econ 2015 44 212-225 This article examines the effect of Medicaid adult dental coverage on use of dental care and dental health outcomes using state-level variation in dental coverage during 2000-2012. Our findings imply that dental coverage is associated with an increase in the likelihood of a recent dental visit, with the size of the effect increasing with Medicaid payment rates to dentists, and a reduction in the likelihood of untreated dental caries. We are among the first to detect an effect of Medicaid coverage on a clinical health outcome other than mortality. These findings may have implications for states expanding Medicaid coverage to adults with incomes of up to 138% of the federal poverty threshold under the Affordable Care Act as most of these states offer an adult dental benefit. |
Did the 2009 American Recovery and Reinvestment Act affect dietary intake of low-income individuals?
Waehrer G , Deb P , Decker SL . Econ Hum Biol 2015 19 170-183 This paper examines the relationship between increased Supplemental Nutritional Assistance Program (SNAP) benefits following the 2009 American Recovery and Reinvestment Act (ARRA) and the diet quality of individuals from SNAP-eligible compared to ineligible (those with somewhat higher income) households using data from the 2007-2010 National Health and Nutrition Examination Survey. The ARRA increased SNAP monthly benefits by 13.6% of the maximum allotment for a given household size, equivalent to an increase of $24 to $144 for one-to-eight person households respectively. In the full sample, we find that these increases in SNAP benefits are not associated with changes in nutrient intake and diet quality. However, among those with no more than a high school education, higher SNAP benefits are associated with a 46% increase in the mean caloric share from sugar-sweetened beverages (SSBs) and a decrease in overall diet quality especially for those at the lower end of the diet quality distribution, amounting to a 9% decline at the 25th percentile. |
ACA provisions associated with increase in percentage of young adult women initiating and completing the HPV vaccine
Lipton BJ , Decker SL . Health Aff (Millwood) 2015 34 (5) 757-64 Affordable Care Act provisions implemented in 2010 required insurance plans to offer dependent coverage to people ages 19-25 and to provide targeted preventive services with zero cost sharing. These provisions both increased the percentage of young adults with any source of health insurance coverage and improved the generosity of coverage. We examined how these provisions affected use of the human papillomavirus (HPV) vaccine, which is among the most expensive of recommended vaccines, among young adult women. Using 2008-12 data from the National Health Interview Survey, we estimated that the 2010 policy implementation increased the likelihood of HPV vaccine initiation and completion by 7.7 and 5.8 percentage points, respectively, for women ages 19-25 relative to a control group of women age 18 or 26. These estimates translate to approximately 1.1 million young women initiating and 854,000 young women completing the vaccine series. |
Demographic trends of sick leave absenteeism among civil service employees at a federal agency from 2004 to 2012
Gajewski K , Burris D , Spears DR , Sullivan K , Oyinloye O , McNeil C , Meechan P , Warnock E , Trapp J , Decker KC , Chapman S . J Occup Environ Med 2015 57 (3) 277-83 OBJECTIVE: To investigate the associations between demographic variables and sick leave use. METHODS: We analyzed sick leave use among civil servants at a federal agency (FA) from 2004 to 2012 by demographic and FA-specific variables. We used a mixed methods approach and type III analysis to build a descriptive model of sick leave proportions and demographic variables. RESULTS: Sick absenteeism usage varied significantly (variation of greater than one sick day per year) by sex, Emergency Operations Center response tier, length of service at the FA, age, and general schedule pay grade level. Our final descriptive model contained age, sex, response tier and an interaction term between age and sex. CONCLUSIONS: Future studies should examine these associations on smaller time scales, perhaps breaking the data down by month or day of the week. |
Acceptance of new Medicaid patients by primary care physicians and experiences with physician availability among children on Medicaid or the Children's Health Insurance Program
Decker SL . Health Serv Res 2015 50 (5) 1508-27 OBJECTIVE: To estimate the relationship between physicians' acceptance of new Medicaid patients and access to health care. DATA SOURCES: The National Ambulatory Medical Care Survey (NAMCS) Electronic Health Records Survey and the National Health Interview Survey (NHIS) 2011/2012. STUDY DESIGN: Linear probability models estimated the relationship between measures of experiences with physician availability among children on Medicaid or the Children's Health Insurance Program (CHIP) from the NHIS and state-level estimates of the percent of primary care physicians accepting new Medicaid patients from the NAMCS, controlling for other factors. PRINCIPAL FINDINGS: Nearly 16 percent of children with a significant health condition or development delay had a doctor's office or clinic indicate that the child's health insurance was not accepted in states with less than 60 percent of physicians accepting new Medicaid patients, compared to less than 4 percent in states with at least 75 percent of physicians accepting new Medicaid patients. Adjusted estimates and estimates for other measures of access to care were similar. CONCLUSIONS: Measures of experiences with physician availability for children on Medicaid/CHIP were generally good, though better in states where more primary care physicians accepted new Medicaid patients. |
The effects of mandated health insurance benefits for autism on out-of-pocket costs and access to treatment
Chatterji P , Decker SL , Markowitz S . J Policy Anal Manage 2015 34 (2) 328-53 As of 2014, 37 states have passed mandates requiring many private health insurance policies to cover diagnostic and treatment services for autism spectrum disorders (ASDs). We explore whether ASD mandates are associated with out-of-pocket costs, financial burden, and cost or insurance-related problems with access to treatment among privately insured children with special health care needs (CSHCNs). We use difference-in-difference and difference-in-difference-in-difference approaches, comparing pre-post mandate changes in outcomes among CSHCN who have ASD versus CSHCN other than ASD. Data come from the 2005 to 2006 and the 2009 to 2010 waves of the National Survey of CSHCN. Based on the model used, our findings show no statistically significant association between state ASD mandates and caregivers' reports about financial burden, access to care, and unmet need for services. However, we do find some evidence that ASD mandates may have beneficial effects in states in which greater percentages of privately insured individuals are subject to the mandates. We caution that we do not study the characteristics of ASD mandates in detail, and most ASD mandates have gone into effect very recently during our study period. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Sep 23, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure