Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Diekman S[original query] |
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Sex differences in HIV testing - 20 PEPFAR-supported sub-Saharan African Countries, 2019
Drammeh B , Medley A , Dale H , De AK , Diekman S , Yee R , Aholou T , Lasry A , Auld A , Baack B , Duffus W , Shahul E , Wong V , Grillo M , Al-Samarrai T , Ally S , Nyangulu M , Nyirenda R , Olivier J , Chidarikire T , Khanyile N , Kayange AA , Rwabiyago OE , Kategile U , Bisimba J , Weber RA , Ncube G , Maguwu O , Pietersen I , Mali D , Dzinotyiweyi E , Nelson L , Bosco MJ , Dalsone K , Apolot M , Anangwe S , Soo LK , Mugambi M , Mbayiha A , Mugwaneza P , Malamba SS , Phiri A , Chisenga T , Boyd M , Temesgan C , Shimelis M , Weldegebreal T , Getachew M , Balachandra S , Eboi E , Shasha W , Doumatey N , Adjoua D , Meribe C , Gwamna J , Gado P , John-Dada I , Mukinda E , Lukusa LFK , Kalenga L , Bunga S , Achyut V , Mondi J , Loeto P , Mogomotsi G , Ledikwe J , Ramphalla P , Tlhomola M , Mirembe JK , Nkwoh T , Eno L , Bonono L , Honwana N , Chicuecue N , Simbine A , Malimane I , Dube L , Mirira M , Mndzebele P , Frawley A , Cardo YMR , Behel S . MMWR Morb Mortal Wkly Rep 2020 69 (48) 1801-1806 Despite progress toward controlling the human immunodeficiency virus (HIV) epidemic, testing gaps remain, particularly among men and young persons in sub-Saharan Africa (1). This observational study used routinely collected programmatic data from 20 African countries reported to the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) from October 2018 to September 2019 to assess HIV testing coverage and case finding among adults (defined as persons aged ≥15 years). Indicators included number of HIV tests conducted, number of HIV-positive test results, and percentage positivity rate. Overall, the majority of countries reported higher HIV case finding among women than among men. However, a slightly higher percentage positivity was recorded among men (4.7%) than among women (4.1%). Provider-initiated counseling and testing (PITC) in health facilities identified approximately two thirds of all new cases, but index testing had the highest percentage positivity in all countries among both sexes. Yields from voluntary counseling and testing (VCT) and mobile testing varied by sex and by country. These findings highlight the need to identify and implement the most efficient strategies for HIV case finding in these countries to close coverage gaps. Strategies might need to be tailored for men who remain underrepresented in the majority of HIV testing programs. |
Serial Testing for SARS-CoV-2 and Virus Whole Genome Sequencing Inform Infection Risk at Two Skilled Nursing Facilities with COVID-19 Outbreaks - Minnesota, April-June 2020.
Taylor J , Carter RJ , Lehnertz N , Kazazian L , Sullivan M , Wang X , Garfin J , Diekman S , Plumb M , Bennet ME , Hale T , Vallabhaneni S , Namugenyi S , Carpenter D , Turner-Harper D , Booth M , Coursey EJ , Martin K , McMahon M , Beaudoin A , Lifson A , Holzbauer S , Reddy SC , Jernigan JA , Lynfield R . MMWR Morb Mortal Wkly Rep 2020 69 (37) 1288-1295 SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), can spread rapidly in high-risk congregate settings such as skilled nursing facilities (SNFs) (1). In Minnesota, SNF-associated cases accounted for 3,950 (8%) of 48,711 COVID-19 cases reported through July 21, 2020; 35% of SNF-associated cases involved health care personnel (HCP*), including six deaths. Facility-wide, serial testing in SNFs has been used to identify residents with asymptomatic and presymptomatic SARS-CoV-2 infection to inform mitigation efforts, including cohorting of residents with positive test results and exclusion of infected HCP from the workplace (2,3). During April-June 2020, the Minnesota Department of Health (MDH), with CDC assistance, conducted weekly serial testing at two SNFs experiencing COVID-19 outbreaks. Among 259 tested residents, and 341 tested HCP, 64% and 33%, respectively, had positive reverse transcription-polymerase chain reaction (RT-PCR) SARS-CoV-2 test results. Continued SARS-CoV-2 transmission was potentially facilitated by lapses in infection prevention and control (IPC) practices, up to 12-day delays in receiving HCP test results (53%) at one facility, and incomplete HCP participation (71%). Genetic sequencing demonstrated that SARS-CoV-2 viral genomes from HCP and resident specimens were clustered by facility, suggesting facility-based transmission. Residents and HCP working in SNFs are at risk for infection with SARS-CoV-2. As part of comprehensive COVID-19 preparation and response, including early identification of cases, SNFs should conduct serial testing of residents and HCP, maximize HCP testing participation, ensure availability of personal protective equipment (PPE), and enhance IPC practices(†) (4-5). |
Scaling up testing for human immunodeficiency virus infection among contacts of index patients - 20 countries, 2016-2018
Lasry A , Medley A , Behel S , Mujawar MI , Cain M , Diekman ST , Rurangirwa J , Valverde E , Nelson R , Agolory S , Alebachew A , Auld AF , Balachandra S , Bunga S , Chidarikire T , Dao VQ , Dee J , Doumatey LEN , Dzinotyiweyi E , Dziuban EJ , Ekra KA , Fuller WB , Herman-Roloff A , Honwana NB , Khanyile N , Kim EJ , Kitenge SF , Lacson RS , Loeto P , Malamba SS , Mbayiha AH , Mekonnen A , Meselu MG , Miller LA , Mogomotsi GP , Mugambi MK , Mulenga L , Mwangi JW , Mwangi J , Nicoue AA , Nyangulu MK , Pietersen IC , Ramphalla P , Temesgen C , Vergara AE , Wei S . MMWR Morb Mortal Wkly Rep 2019 68 (21) 474-477 In 2017, the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimated that worldwide, 36.9 million persons were living with human immunodeficiency virus (HIV) infection, the virus infection that causes acquired immunodeficiency syndrome (AIDS). Among persons with HIV infection, approximately 75% were aware of their HIV status, leaving 9.4 million persons with undiagnosed infection (1). Index testing, also known as partner notification or contact tracing, is an effective case-finding strategy that targets the exposed contacts of HIV-positive persons for HIV testing services. This report summarizes data from HIV tests using index testing in 20 countries supported by CDC through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) during October 1, 2016-March 31, 2018. During this 18-month period, 1,700,998 HIV tests with 99,201 (5.8%) positive results were reported using index testing. The positivity rate for index testing was 9.8% among persons aged >/=15 years and 1.5% among persons aged <15 years. During the reporting period, HIV positivity increased 64% among persons aged >/=15 years (from 7.6% to 12.5%) and 67% among persons aged <15 years (from 1.2% to 2.0%). Expanding index testing services could help increase the number of persons with HIV infection who know their status, are initiated onto antiretroviral treatment, and consequently reduce the number of persons who can transmit the virus. |
Associations between pain clinic density and distributions of opioid pain relievers, drug-related deaths, hospitalizations, emergency department visits, and neonatal abstinence syndrome in Florida
Sauber-Schatz EK , Mack KA , Diekman ST , Paulozzi LJ . Drug Alcohol Depend 2013 133 (1) 161-6 BACKGROUND: Community-level associations between pain clinics and drug-related outcomes have not been empirically demonstrated. METHODS: To explore these associations we correlated overdose death rates, hospital-discharge rates for drug-related hospitalizations including neonatal abstinence syndrome, and emergency department rates for drug-related visits with registered pain clinic density and rate of opioid pills dispensed per person at the county-level Florida in 2009. Negative binomial regression was used to model the crude associations and associations adjusted for exposure measures and county demographic characteristics. RESULTS: An estimated 732 pain clinics operated in Florida in 2009, a rate of 3.9/100,000 people. Among the 67 counties in Florida, 23 (34.3%) had no pain clinics, and three had 90 or more. Adjusted negative binomial regression determined no significant association between pain clinic rate and drug-related outcomes. However, rates of drug-caused, opioid-caused, and oxycodone-caused death correlated significantly with rates of opioid and oxycodone pills dispensed per person in adjusted analyses. For every increase of one pill in the rate of oxycodone pills per person, there was a 6% increase in the rate of oxycodone-related overdose death. CONCLUSIONS: Although pain clinics, some of which are "pill mills," are clearly a source of drugs used nonmedically, their impact on health outcomes might be difficult to quantify because the pills they prescribe might be consumed in other counties or states. The impact of "pill mill" laws might be better measured by more proximal measures such as the number of such facilities. |
Smoke alarm giveaway and installation programs: an economic evaluation
Liu Y , Mack KA , Diekman ST . Am J Prev Med 2012 43 (4) 385-91 BACKGROUND: The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. PURPOSE: To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. METHODS: Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. RESULTS: Cost-effectiveness analysis (CEA) resulted in an average cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost-benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit-cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. CONCLUSIONS: Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventions to reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. |
Home fires in America: progress and opportunities
Diekman S , Ballesteros MF , Ahrens M . Am J Lifestyle Med 2011 6 (2) 141-151 Fires are the third leading cause of unintentional home injury deaths. Young children and older adults are especially at risk for home fire deaths. Other high-risk groups include males, people with physical disabilities, people impaired by alcohol or other drugs, and people living in rural communities or in poverty. Lifestyle decisions (eg, choosing products) and behaviors (eg, maintaining working smoke alarms or smoking) can influence the risk of being in and surviving a home fire. Fortunately, medical practitioners can foster safer home environments for their patients by promoting effective fire prevention and protection strategies to reduce home fire risks. This review highlights the association between lifestyle and home fires with a focus on achievable lifestyle changes that can prevent fires and fire-related injuries and deaths. |
The development of the residential Fire H.E.L.P. tool kit: a resource to protect homebound older adults
Diekman S , Huitric M , Netterville L . J Public Health Manag Pract 2010 16 S61-7 This article describes the development of the Fire H.E.L.P. tool kit for training selected Meals On Wheels (MOW) staff in Texas to implement a fire safety program for homebound older adults. We used a formative evaluation approach during the tool kit's development, testing, and initial implementation stages. The tool kit includes instructional curricula on how to implement Fire H.E.L.P., a home assessment tool to determine a residence's smoke alarm needs, and fire safety educational materials. During the tool kit's pilot test, MOW participants showed enhanced fire safety knowledge and high levels of confidence about applying their newfound training skills. After the pilot test, MOW staff used the tool kit to conduct local training sessions, provide fire safety education, and install smoke alarms in the homes of older adults. We believe the approach used to develop this tool kit can be applied to education efforts for other, related healthy home topics. |
A qualitative evaluation of fire safety education programs for older adults
Diekman ST , Stewart TA , Teh SL , Ballesteros MF . Health Promot Pract 2010 11 (2) 216-25 This article presents a qualitative evaluation of six fire safety education programs for older adults delivered by public fire educators. Our main aims were to explore how these programs are implemented and to determine important factors that may lead to program success, from the perspectives of the public fire educators and the older adults. For each program, we interviewed the public fire educator(s), observed the program in action, and conducted focus groups with older adults attending the program. Analysis revealed three factors that were believed to facilitate program success (established relationships with the older adult community, rapport with older adult audiences, and presentation relevance) as well as three challenges (lack of a standardized curriculum and program implementation strategies, attendance difficulties, and physical limitations due to age). More fire safety education should be developed for older adult populations. For successful programs, public fire educators should address the specific needs of their local older adult community. |
Preventing unintentional injury: a review of behavior change theories for primary care
Sleet DA , Gielen AC , Diekman S , Ikeda R . Am J Lifestyle Med 2010 4 (1) 25-31 Many injuries are preventable, and most have a behavioral component on their causal pathway. However, far more effective use of theory-based approaches to behavioral risk management is needed, which remains a challenge for practitioners. This review discusses theories and applications of behavioral change principles for use in primary care and community health settings. Injury-related behaviors cannot be separated from the environments in which they take place. Preventing unintentional injuries requires an understanding of patient knowledge, attitudes, and behaviors, as well as community norms, that lead to injuries. In addition to the role clinicians have in counseling for lifestyle change to prevent injuries, reducing exposure of patients to hazardous products and environments, and fostering social and organizational change to improve public policy, legislation, and enforcement to prevent injuries are equally important. Challenges lie ahead in testing the applicability of these theories in primary care settings and in predicting and understanding injury-related behaviors of patients. Training more medical practitioners in the epidemiology of injury and the science of injury control is an urgent priority. Success will partly depend on how behavioral theories can be integrated into practice and adapted through clinical experience to benefit patients. |
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- Page last updated:Apr 29, 2024
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