Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Dela Cruz J[original query] |
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Disaggregating Data to Measure Racial Disparities in COVID-19 Outcomes and Guide Community Response - Hawaii, March 1, 2020-February 28, 2021.
Quint JJ , Van Dyke ME , Maeda H , Worthington JK , Dela Cruz MR , Kaholokula JK , Matagi CE , Pirkle CM , Roberson EK , Sentell T , Watkins-Victorino L , Andrews CA , Center KE , Calanan RM , Clarke KEN , Satter DE , Penman-Aguilar A , Parker EM , Kemble S . MMWR Morb Mortal Wkly Rep 2021 70 (37) 1267-1273 Native Hawaiian and Pacific Islander populations have been disproportionately affected by COVID-19 (1-3). Native Hawaiian, Pacific Islander, and Asian populations vary in language; cultural practices; and social, economic, and environmental experiences,(†) which can affect health outcomes (4).(§) However, data from these populations are often aggregated in analyses. Although data aggregation is often used as an approach to increase sample size and statistical power when analyzing data from smaller population groups, it can limit the understanding of disparities among diverse Native Hawaiian, Pacific Islander, and Asian subpopulations(¶) (4-7). To assess disparities in COVID-19 outcomes among Native Hawaiian, Pacific Islander, and Asian populations, a disaggregated, descriptive analysis, informed by recommendations from these communities,** was performed using race data from 21,005 COVID-19 cases and 449 COVID-19-associated deaths reported to the Hawaii State Department of Health (HDOH) during March 1, 2020-February 28, 2021.(††) In Hawaii, COVID-19 incidence and mortality rates per 100,000 population were 1,477 and 32, respectively during this period. In analyses with race categories that were not mutually exclusive, including persons of one race alone or in combination with one or more races, Pacific Islander persons, who account for 5% of Hawaii's population, represented 22% of COVID-19 cases and deaths (COVID-19 incidence of 7,070 and mortality rate of 150). Native Hawaiian persons experienced an incidence of 1,181 and a mortality rate of 15. Among subcategories of Asian populations, the highest incidences were experienced by Filipino persons (1,247) and Vietnamese persons (1,200). Disaggregating Native Hawaiian, Pacific Islander, and Asian race data can aid in identifying racial disparities among specific subpopulations and highlights the importance of partnering with communities to develop culturally responsive outreach teams(§§) and tailored public health interventions and vaccination campaigns to more effectively address health disparities. |
Activated CD4+ T cells and CD14hiCD16+ monocytes correlate with antibody response following influenza virus infection in humans
Wong SS , Oshansky CM , Guo XZJ , Ralston J , Wood T , Reynolds GE , Seeds R , Jelley L , Waite B , Jeevan T , Zanin M , Widdowson MA , Huang QS , Thomas PG , Webby RJ , Turner N , Baker M , Grant C , McArthur C , Roberts S , Trenholmes A , Wong C , Taylor S , Thompson M , Gross D , Duque J , Haven K , Aley D , Muponisi P , Chand B , Chen Y , Plewes L , Sawtell F , Lawrence S , Cogcoy R , Smith J , Gravidez F , Ma M , Chamberlin S , Davey K , Knowles T , McLeish JA , Todd A , Bocacao J , Gunn W , Kawakami P , Walker S , Madge R , Moore N , Rahnama F , Qiao H , Tse F , Zibaei M , Korrapadu T , Optland L , Dela Cruz C , The Shivers Investigation Team . Cell Rep Med 2021 2 (4) 100237 The failure to mount an antibody response following viral infection or seroconversion failure is a largely underappreciated and poorly understood phenomenon. Here, we identified immunologic markers associated with robust antibody responses after influenza virus infection in two independent human cohorts, SHIVERS and FLU09, based in Auckland, New Zealand and Memphis, Tennessee, USA, respectively. In the SHIVERS cohort, seroconversion significantly associates with (1) hospitalization, (2) greater numbers of proliferating, activated CD4+ T cells, but not CD8+ T cells, in the periphery during the acute phase of illness, and (3) fewer inflammatory monocytes (CD14hiCD16+) by convalescence. In the FLU09 cohort, fewer CD14hiCD16+ monocytes during early illness in the nasal mucosa were also associated with the generation of influenza-specific mucosal immunoglobulin A (IgA) and IgG antibodies. Our study demonstrates that seroconversion failure after infection is a definable immunological phenomenon, associated with quantifiable cellular markers that can be used to improve diagnostics, vaccine efficacy, and epidemiologic efforts. |
Antibiotic stewardship in the intensive care unit. An Official American Thoracic Society Workshop Report in Collaboration with the AACN, CHEST, CDC, and SCCM
Wunderink RG , Srinivasan A , Barie PS , Chastre J , Dela Cruz CS , Douglas IS , Ecklund M , Evans SE , Evans SR , Gerlach AT , Hicks LA , Howell M , Hutchinson ML , Hyzy RC , Kane-Gill SL , Lease ED , Metersky ML , Munro N , Niederman MS , Restrepo MI , Sessler CN , Simpson SQ , Swoboda SM , Guillamet CV , Waterer GW , Weiss CH . Ann Am Thorac Soc 2020 17 (5) 531-540 Intensive care units (ICUs) are an appropriate focus of antibiotic stewardship program efforts because a large proportion of any hospital's use of parenteral antibiotics, especially broad-spectrum, occurs in the ICU. Given the importance of antibiotic stewardship for critically ill patients and the importance of critical care practitioners as the front line for antibiotic stewardship, a workshop was convened to specifically address barriers to antibiotic stewardship in the ICU and discuss tactics to overcome these. The working definition of antibiotic stewardship is "the right drug at the right time and the right dose for the right bug for the right duration." A major emphasis was that antibiotic stewardship should be a core competency of critical care clinicians. Fear of pathogens that are not covered by empirical antibiotics is a major driver of excessively broad-spectrum therapy in critically ill patients. Better diagnostics and outcome data can address this fear and expand efforts to narrow or shorten therapy. Greater awareness of the substantial adverse effects of antibiotics should be emphasized and is an important counterargument to broad-spectrum therapy in individual low-risk patients. Optimal antibiotic stewardship should not focus solely on reducing antibiotic use or ensuring compliance with guidelines. Instead, it should enhance care both for individual patients (by improving and individualizing their choice of antibiotic) and for the ICU population as a whole. Opportunities for antibiotic stewardship in common ICU infections, including community- and hospital-acquired pneumonia and sepsis, are discussed. Intensivists can partner with antibiotic stewardship programs to address barriers and improve patient care. |
All that glitters is not gold: Mercury poisoning in a family mimicking an infectious illness
Atti SK , Silver EM , Chokshi Y , Casteel S , Kiernan E , Dela Cruz R , Kazzi Z , Geller RJ . Curr Probl Pediatr Adolesc Health Care 2020 50 (2) 100758 Three siblings with inhalational elemental mercury toxicity presented with fever, rash, and upper respiratory tract symptoms. The patients were heavily exposed to elemental mercury that was spilled in their home and then vacuumed. Initial whole blood mercury levels were elevated at >200 microg/L, 153 microg/L and 130 microg/L (Mayo Clinic Laboratories lab reference range <9 microg/L) for Cases 1, 2, and 3, respectively. All three required chelation with succimer. Clinically significant elemental mercury toxicity can resemble an infectious illness. Severe morbidity and mortality can be prevented if heavy metal poisoning is considered early, through a detailed history including an environmental exposure history. For elemental mercury spills in the home, safe and effective clean-up steps are needed. Improved public health education is needed to prevent similar household exposures. |
A systematic meta-review of evaluations of youth violence prevention programs: common and divergent findings from 25years of meta-analyses and systematic reviews
Matjasko JL , Vivolo-Kantor AM , Massetti GM , Holland KM , Holt MK , Dela Cruz J . Aggress Violent Behav 2012 17 (6) 540-552 Violence among youth is a pervasive public health problem. In order to make progress in reducing the burden of injury and mortality that result from youth violence, it is imperative to identify evidence-based programs and strategies that have a significant impact on violence. There have been many rigorous evaluations of youth violence prevention programs. However, the literature is large, and it is difficult to draw conclusions about what works across evaluations from different disciplines, contexts, and types of programs. The current study reviews the meta-analyses and systematic reviews published prior to 2009 that synthesize evaluations of youth violence prevention programs. This meta-review reports the findings from 37 meta-analyses and 15 systematic reviews; the included reviews were coded on measures of the social ecology, prevention approach, program type, and study design. A majority of the meta-analyses and systematic reviews were found to demonstrate moderate program effects. Meta-analyses yielded marginally smaller effect sizes compared to systematic reviews, and those that included programs targeting family factors showed marginally larger effects than those that did not. In addition, there are a wide range of individual/family, program, and study moderators of program effect sizes. Implications of these findings and suggestions for future research are discussed. |
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