Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-16 (of 16 Records) |
Query Trace: Harrist A[original query] |
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Notes from the Field: Diagnosis and Investigation of Pneumonic Plague During a Respiratory Disease Pandemic - Wyoming, 2021.
Siu AW , Tillman C , Van Houten C , Busacker A , Harrist A . MMWR Morb Mortal Wkly Rep 2022 71 (24) 806-807 In September 2021, the Wyoming Department of Health (WDH) was notified of a suspected case of pneumonic plague in an adult who was admitted to a Wyoming hospital following a 48-hour history of worsening cough, dyspnea, and acute onset of hemoptysis. The patient reported no recent travel history or ill contacts but noted interacting with two pet cats that were ill. Health care providers initially suspected COVID-19 because of compatible symptoms, no history of COVID-19 vaccination, and increased SARS-CoV-2 (the virus that causes COVID-19) community transmission in Wyoming during this period. | | Approximately 48 hours after symptom onset, the patient received a negative SARS-CoV-2 antigen test result at a provider’s office. The patient was hospitalized later that day for worsening symptoms and received two negative SARS-CoV-2 laboratory-based nucleic acid amplification test results. Lung imaging was consistent with community-acquired pneumonia. Respiratory specimens tested negative for common viral pathogens on a respiratory panel. Within 48 hours of admission, the patient required mechanical ventilation and developed sepsis. The patient was treated for pneumonia and sepsis with azithromycin, piperacillin-tazobactam, and vancomycin. Seventy-two hours after the patient was admitted to the hospital, blood and sputum cultures did not indicate a causative pathogen. Because of the patient’s history of exposure to cats that were ill, an infectious diseases specialist recommended repeating a sputum culture with Gram stain and empiric treatment with ciprofloxacin. Gram-negative bacilli were detected, and the Wyoming Public Health Laboratory subsequently confirmed Yersinia pestis as the pathogen. |
Developing National Genotype-Independent Indicators for Recent Mycobacterium Tuberculosis Transmission Using Pediatric Cases-United States, 2011-2017
Harrist AV , McDaniel CJ , Wortham JM , Althomsons SP . Public Health Rep 2021 137 (1) 81-86 INTRODUCTION: Pediatric tuberculosis (TB) cases are sentinel events for Mycobacterium tuberculosis transmission in communities because children, by definition, must have been infected relatively recently. However, these events are not consistently identified by genotype-dependent surveillance alerting methods because many pediatric TB cases are not culture-positive, a prerequisite for genotyping. METHODS: We developed 3 potential indicators of ongoing TB transmission based on identifying counties in the United States with relatively high pediatric (aged <15 years) TB incidence: (1) a case proportion indicator: an above-average proportion of pediatric TB cases among all TB cases; (2) a case rate indicator: an above-average pediatric TB case rate; and (3) a statistical model indicator: a statistical model based on a significant increase in pediatric TB cases from the previous 8-quarter moving average. RESULTS: Of the 249 US counties reporting ≥2 pediatric TB cases during 2009-2017, 240 and 249 counties were identified by the case proportion and case rate indicators, respectively. The statistical model indicator identified 40 counties with a significant increase in the number of pediatric TB cases. We compared results from the 3 indicators with an independently generated list of 91 likely transmission events involving ≥2 pediatric cases (ie, known TB outbreaks or case clusters with reported epidemiologic links). All counties with likely transmission events involving multiple pediatric cases were identified by ≥1 indicator; 23 were identified by all 3 indicators. PRACTICE IMPLICATIONS: This retrospective analysis demonstrates the feasibility of using routine TB surveillance data to identify counties where ongoing TB transmission might be occurring, even in the absence of available genotyping data. |
Screening for SARS-CoV-2 Infection Within a Psychiatric Hospital and Considerations for Limiting Transmission Within Residential Psychiatric Facilities - Wyoming, 2020.
Callaghan AW , Chard AN , Arnold P , Loveland C , Hull N , Saraiya M , Saydah S , Dumont W , Frakes LG , Johnson D , Peltier R , Van Houten C , Trujillo AA , Moore J , Rose DA , Honein MA , Carrington D , Harrist A , Hills SL . MMWR Morb Mortal Wkly Rep 2020 69 (26) 825-829 In the United States, approximately 180,000 patients receive mental health services each day at approximately 4,000 inpatient and residential psychiatric facilities (1). SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), can spread rapidly within congregate residential settings (2-4), including psychiatric facilities. On April 13, 2020, two patients were transferred to Wyoming's state psychiatric hospital from a private psychiatric hospital that had confirmed COVID-19 cases among its residents and staff members (5). Although both patients were asymptomatic at the time of transfer and one had a negative test result for SARS-CoV-2 at the originating facility, they were both isolated and received testing upon arrival at the state facility. On April 16, 2020, the test results indicated that both patients had SARS-CoV-2 infection. In response, the state hospital implemented expanded COVID-19 infection prevention and control (IPC) procedures (e.g., enhanced screening, testing, and management of new patient admissions) and adapted some standard IPC measures to facilitate implementation within the psychiatric patient population (e.g., use of modified face coverings). To assess the likely effectiveness of these procedures and determine SARS-CoV-2 infection prevalence among patients and health care personnel (HCP) (6) at the state hospital, a point prevalence survey was conducted. On May 1, 2020, 18 days after the patients' arrival, 46 (61%) of 76 patients and 171 (61%) of 282 HCP had nasopharyngeal swabs collected and tested for SARS-CoV-2 RNA by reverse transcription-polymerase chain reaction. All patients and HCP who received testing had negative test results, suggesting that the hospital's expanded IPC strategies might have been effective in preventing the introduction and spread of SARS-CoV-2 infection within the facility. In congregate residential settings, prompt identification of COVID-19 cases and application of strong IPC procedures are critical to ensuring the protection of other patients and staff members. Although standard guidance exists for other congregate facilities (7) and for HCP in general (8), modifications and nonstandard solutions might be needed to account for the specific needs of psychiatric facilities, their patients, and staff members. |
Notes from the Field: Carbapenem-resistant Klebsiella pneumoniae with mcr-1 Gene Identified in a Hospitalized Patient - Wyoming, January 2019.
Rhodes H , Loveland C , Van Houten C , Hull N , Harrist A . MMWR Morb Mortal Wkly Rep 2020 69 (6) 171-172 In mid-December 2018, an adult with a history of recurrent urinary tract infections was admitted to a Wyoming hospital with acute confusion. Because of a history of methicillin-resistant Staphylococcus aureus, the patient was placed on contact precautions in a private room. Admission urine culture and antimicrobial susceptibility testing identified carbapenem-resistant Klebsiella pneumoniae with extended-spectrum beta-lactamase production. Susceptibility to colistin, an antibiotic of last resort, was not tested. Carbapenem-resistant Enterobacteriaceae (CRE) infections are reportable to the Wyoming Department of Health (WDH), and the isolate was sent to the Wyoming Public Health Laboratory (WPHL), where ertapenem resistance was confirmed. Further testing identified resistance to 16 antibiotics* and susceptibility to amikacin, imipenem, meropenem, and tigecycline. Using the Carba NP assay (1), carbapenemase production was not found. WPHL sent the isolate to the Texas Antibiotic Resistance (AR) Laboratory Network regional laboratory for further characterization. Because of known sensitivity issues with the Carba NP assay (2), repeat testing used the modified carbapenem inactivation method. Texas AR Laboratory Network confirmed WPHL results. Colistin susceptibility testing by broth microdilution found that the minimum inhibitory concentration was >4 μg/mL, which was above the Clinical and Laboratory Standards Institute’s epidemiologic cutoff value for wild type Enterobacteriaceae (≤2 μg/mL) (3). The plasmid-mediated mcr-1 colistin resistance gene was detected using a CDC-developed multiplex real-time polymerase chain reaction assay (4). In early January 2019, Texas AR Laboratory Network alerted WDH that the isolate carried the mcr-1 gene. |
Evaluating the public health response to a mass bat exposure - Wyoming, 2017
Cote A , Wallace RM , Jackson DA , Said MA , Musgrave K , Tran CH , Van Houten C , Harrist A , Buttke D , Busacker A , Pickens V , Guagliardo SAJ . Zoonoses Public Health 2019 66 (5) 504-511 Mass bat exposures (MBEs) occur when multiple people are exposed to a bat or a bat colony, often over an extended period. In August 2017, a public health investigation was started in response to an MBE that occurred during May-August 2017 at a national park research station in Wyoming. We identified 176 people who had slept primarily in two lodges (Lodges A and B) at the research station, and successfully contacted 165 (93.8%) of these individuals. Risk assessments (RAs) were administered to all 165 individuals to determine degree and type of exposures to bats (e.g., biting or scratching). Exposure status for research station guests was classified as "non-exposed," "low risk" or "high risk," and counselling was provided to guide post-exposure prophylaxis (PEP) recommendations. Prior to public health notification and intervention, 19 persons made the decision to pursue PEP. The healthcare-seeking behaviours of this group were taken to represent outcomes in the absence of public health intervention. (These persons received a RA, and their risk classification was retrospectively assigned.) Approximately 1-2 weeks after conducting the RAs, we conducted a follow-up survey to determine whether recommendations regarding PEP were ultimately followed. The proportion of individuals that unnecessarily pursued PEP was higher among the 19 individuals that sought health care prior to receiving the RA (p < 0.00001). Among those receiving the RA first, all persons classified as high risk followed public health guidance to seek PEP treatment. Despite this, upon re-interview, only 21/79 (26.6%) of guests could accurately recall their risk classification, with most people (55.7%) overestimating their risk. Study findings demonstrate that early public health interventions such as RAs can reduce unnecessary use of PEP and that messaging used during rabies counselling should be clear. |
Francisella tularensis exposure among National Park Service employees during an epizootic: Devils Tower National Monument, Wyoming, 2015
Harrist A , Cherry C , Kwit N , Bryan K , Pappert R , Petersen J , Buttke D , Wong D , Nelson C . Vector Borne Zoonotic Dis 2019 19 (5) 316-322 Introduction: Tularemia is a zoonotic infection caused by the highly infectious bacterium Francisella tularensis. Persons having outdoor professions are more likely than others to be exposed to F. tularensis through increased contact with arthropods, infected animals, and contaminated aerosols. Materials and Methods: After a tularemia epizootic during July and August 2015 at Devils Tower National Monument and an associated tularemia infection in a park employee, we assessed seroprevalence of F. tularensis antibodies, risk factors for F. tularensis seropositivity, and use of protective measures among park employees. Results: Seroprevalence among participating employees was 13% (3/23). Seropositive employees reported multiple risk factors for F. tularensis exposure through both job-related and recreational activities. Activities reported by more seropositive than seronegative employees included using a power blower (67% vs. 5%, p = 0.03), collecting animal carcasses (100% vs. 30%, p = 0.047), and hunting prairie dogs recreationally (67% vs. 5%, p = 0.03). Seropositive employees reported exposure to more ticks (median 30, range 25-35) than seronegative employees (median 6, range 0-25, p = 0.001). Most employees used protective measures (e.g., insect repellent) inconsistently but increased use after receiving educational materials. Conclusions: Educating and enabling at-risk employees to use protective measures consistently, both at work and during recreational activities, can reduce exposure during epizootics. |
Statistical Method to Detect Tuberculosis Outbreaks among Endemic Clusters in a Low-Incidence Setting.
Althomsons SP , Hill AN , Harrist AV , France AM , Powell KM , Posey JE , Cowan LS , Navin TR . Emerg Infect Dis 2018 24 (3) 573-575 We previously reported use of genotype surveillance data to predict outbreaks among incident tuberculosis clusters. We propose a method to detect possible outbreaks among endemic tuberculosis clusters. We detected 15 possible outbreaks, of which 10 had epidemiologic data or whole-genome sequencing results. Eight outbreaks were corroborated. |
Evaluation of the completeness, data quality, and timeliness of fetal mortality surveillance in Wyoming, 2006-2013
Harrist AV , Busacker A , Kroelinger CD . Matern Child Health J 2017 21 (9) 1808-1813 Purpose The number of fetal deaths in the United States each year exceeds that of infant deaths. High quality fetal death certificate data are necessary for states to effectively address preventable fetal deaths. We evaluated completeness of detection of fetal deaths among Wyoming residents that occur out-of-state, quality of cause-of-death data, and timeliness of Wyoming fetal death certificate registration during 2006-2013. Description The numbers of out-of-state fetal deaths among Wyoming residents recorded by Wyoming surveillance and reported by the National Vital Statistics System were compared. Quality of cause-of-death data was assessed by calculating percentage of fetal death certificates completed in Wyoming with ill-defined, unknown, or missing cause-of-death entries. Timeliness was determined using the time between the fetal death and filing of the fetal death certificate with the Wyoming Department of Health Vital Statistics Service. Assessment Wyoming surveillance detected none of the 76 out-of-state fetal deaths among Wyoming residents reported by the National Vital Statistics System. Among 263 fetal death certificates completed in Wyoming and collected by Wyoming surveillance, 108 (41%) contained ill-defined, unknown, or missing cause-of-death entries. Median duration between the fetal death and filing with the Wyoming Vital Statistics Service was 33 days. Conclusion Wyoming fetal mortality surveillance is limited by failure to register out-of-state fetal deaths among residents, poor quality of cause-of-death data, and lack of timeliness. Strategies to improve surveillance include automating interjurisdictional sharing of fetal death data, certifier education, and electronic fetal death registration. |
Gastrointestinal illness associated with rancid tortilla chips at a correctional facility - Wyoming, 2015
Lupcho T , Harrist A , Van Houten C . MMWR Morb Mortal Wkly Rep 2016 65 (42) 1170-1173 On October 12, 2015, a county health department notified the Wyoming Department of Health of an outbreak of gastrointestinal illness among residents and staff members at a local correctional facility. The majority of ill persons reported onset of symptoms within 1-3 hours after eating lunch served at the facility cafeteria at noon on October 11. Residents and staff members reported that tortilla chips served at the lunch tasted and smelled like chemicals. The Wyoming Department of Health and county health department personnel conducted case-control studies to identify the outbreak source. Consuming lunch at the facility on October 11 was highly associated with illness; multivariate logistic regression analysis found that tortilla chips were the only food item associated with illness. Hexanal and peroxide, markers for rancidity, were detected in tortilla chips and composite food samples from the lunch. No infectious agent was detected in human stool specimens or food samples. Extensive testing of lunch items did not identify any unusual chemical. Epidemiologic and laboratory evidence implicated rancid tortilla chips as the most likely source of illness. This outbreak serves as a reminder to consider alternative food testing methods during outbreaks of unusual gastrointestinal illness when typical foodborne pathogens are not identified. For interpretation of alternative food testing results, samples of each type of food not suspected to be contaminated are needed to serve as controls. |
Human rabies - Wyoming and Utah, 2015
Harrist A , Styczynski A , Wynn D , Ansari S , Hopkin J , Rosado-Santos H , Baker J , Nakashima A , Atkinson A , Spencer M , Dean D , Teachout L , Mayer J , Condori RE , Orciari L , Wadhwa A , Ellison J , Niezgoda M , Petersen B , Wallace R , Musgrave K . MMWR Morb Mortal Wkly Rep 2016 65 (21) 529-33 In September 2015, a Wyoming woman was admitted to a local hospital with a 5-day history of progressive weakness, ataxia, dysarthria, and dysphagia. Because of respiratory failure, she was transferred to a referral hospital in Utah, where she developed progressive encephalitis. On day 8 of hospitalization, the patient's family told clinicians they recalled that, 1 month before admission, the woman had found a bat on her neck upon waking, but had not sought medical care. The patient's husband subsequently had contacted county invasive species authorities about the incident, but he was not advised to seek health care for evaluation of his wife's risk for rabies. On October 2, CDC confirmed the patient was infected with a rabies virus variant that was enzootic to the silver-haired bat (Lasionycteris noctivagans). The patient died on October 3. Public understanding of rabies risk from bat contact needs to be improved; cooperation among public health and other agencies can aid in referring persons with possible bat exposure for assessment of rabies risk. |
Travel-associated Zika virus disease cases among U.S. residents - United States, January 2015-February 2016
Armstrong P , Hennessey M , Adams M , Cherry C , Chiu S , Harrist A , Kwit N , Lewis L , McGuire DO , Oduyebo T , Russell K , Talley P , Tanner M , Williams C , Basile J , Brandvold J , Calvert A , Cohn A , Fischer M , Goldman-Israelow B , Goodenough D , Goodman C , Hills S , Kosoy O , Lambert A , Lanciotti R , Laven J , Ledermann J , Lehman J , Lindsey N , Mead P , Mossel E , Nelson C , Nichols M , O'Leary D , Panella A , Powers A , Rabe I , Reagan-Steiner S , Staples JE , Velez J . MMWR Morb Mortal Wkly Rep 2016 65 (11) 286-9 Zika virus is an emerging mosquito-borne flavivirus. Recent outbreaks of Zika virus disease in the Pacific Islands and the Region of the Americas have identified new modes of transmission and clinical manifestations, including adverse pregnancy outcomes. However, data on the epidemiology and clinical findings of laboratory-confirmed Zika virus disease remain limited. During January 1, 2015-February 26, 2016, a total of 116 residents of 33 U.S. states and the District of Columbia had laboratory evidence of recent Zika virus infection based on testing performed at CDC. Cases include one congenital infection and 115 persons who reported recent travel to areas with active Zika virus transmission (n = 110) or sexual contact with such a traveler (n = 5). All 115 patients had clinical illness, with the most common signs and symptoms being rash (98%; n = 113), fever (82%; 94), and arthralgia (66%; 76). Health care providers should educate patients, particularly pregnant women, about the risks for, and measures to prevent, infection with Zika virus and other mosquito-borne viruses. Zika virus disease should be considered in patients with acute onset of fever, rash, arthralgia, or conjunctivitis, who traveled to areas with ongoing Zika virus transmission (http://www.cdc.gov/zika/geo/index.html) or who had unprotected sex with a person who traveled to one of those areas and developed compatible symptoms within 2 weeks of returning. |
Notes from the field: Group A streptococcal pharyngitis misdiagnoses at a rural urgent-care clinic - Wyoming, March 2015
Harrist A , Van Houten C , Shulman ST , Van Beneden C , Murphy T . MMWR Morb Mortal Wkly Rep 2016 64 1383-5 Group A Streptococcus (GAS) is the most common bacterial cause of pharyngitis, implicated in 20%-30% of pediatric and 5%-15% of adult health care visits for sore throat. Along with the sudden onset of throat pain, GAS pharyngitis symptoms include fever, headache, and bilateral tender cervical lymphadenopathy. Accurate diagnosis and management of GAS pharyngitis is critical for limiting antibiotic overuse and preventing rheumatic fever, but distinguishing between GAS and viral pharyngitis clinically is challenging. Guidelines for diagnosis and management of GAS pharyngitis have been published by the Infectious Diseases Society of America (IDSA). IDSA recommends that patients with sore throat be tested for GAS to distinguish between GAS and viral pharyngitis; however, IDSA emphasizes the use of selective testing based on clinical symptoms and signs to avoid identifying GAS carriers rather than acute GAS infections. Therefore, testing for GAS usually is not recommended for the following: patients with sore throat and accompanying symptoms (e.g., cough, rhinorrhea) that strongly suggest a viral etiology; children aged <3 years, because acute rheumatic fever is extremely rare in this age group; and asymptomatic household contacts of patients with GAS pharyngitis. IDSA recommends penicillin or amoxicillin as the treatment of choice based on effectiveness and narrow spectrum of activity. To date, penicillin-resistant GAS has never been documented. |
The association of variants in the FTO gene with longitudinal body mass index profiles in non-Hispanic white children and adolescents.
Hallman DM , Friedel VC , Eissa MA , Boerwinkle E , Huber JC Jr , Harrist RB , Srinivasan SR , Chen W , Dai S , Labarthe DR , Berenson GS . Int J Obes (Lond) 2012 36 (1) 61-8 OBJECTIVE: To investigate possible age-related changes in associations between polymorphisms in the fat mass and obesity-associated (FTO) gene and higher body mass index (BMI). DESIGN AND SUBJECTS: Multilevel mixed regression models were used to examine associations between four FTO variants and longitudinal BMI profiles in non-Hispanic white and African American children and adolescents 8-17 years of age from two different longitudinal cohort studies, the Bogalusa Heart Study (BHS) and Project HeartBeat! (PHB). In the BHS, there were 1551 examinations of 478 African Americans and 3210 examinations of 1081 non-Hispanic whites; in PHB, there were 971 examinations of 131 African Americans and 4458 examinations of 505 non-Hispanic whites. RESULTS: In African Americans, no significant FTO associations with BMI were found. In non-Hispanic whites, linkage disequilibrium among all four variants made haplotype analysis superfluous, so we focused on the single-nucleotide polymorphism, rs9939609. In longitudinal multilevel models, the A/A genotype of rs9939609 was associated with higher BMI in non-Hispanic whites in both cohorts at all ages. A significant age-by-genotype interaction found only in the BHS cohort predicted that in those with the A/A genotype, BMI would be approximately 0.7 kg m(-2) higher at age 8 and approximately 1.6 kg m(-2) higher at age 17 than in those with A/T or T/T genotypes. The design of PHB limited follow-up of any single individual to 4 years, and may have reduced the ability to detect any age-by-genotype interaction in this cohort. CONCLUSIONS: The A/A genotype of rs9939609 in the FTO gene is associated with higher longitudinal BMI profiles in non-Hispanic whites from two different cohorts. The association may change with age, with the A/A genotype being associated with a larger BMI difference in late adolescence than in childhood, though this was observed only in the BHS cohort and requires verification. |
Associations of BMI and its fat-free and fat components with blood lipids in children: Project HeartBeat!
Dai S , Eissa MA , Steffen LM , Fulton JE , Harrist RB , Labarthe DR . Clin Lipidol 2011 6 (2) 235-244 AIM: This study aimed to distinguish between the roles of the two components of BMI, the fat mass (FM) index and the fat-free mass (FFM) index, in BMI's association with blood lipids in children and adolescents. METHODS: A total of 678 children (49.1% female, 79.9% non-black), initially aged 8, 11 and 14 years, were followed at 4-month intervals for up to 4 years (1991-1995). Total cholesterol (TC), LDL-C, HDL-C and triglycerides were determined in fasting blood samples. FFM index and FM index were calculated as FFM (kg)/height (m(2)) and FM (kg)/height (m(2)), respectively. Using a multilevel linear model, repeated measurements of blood lipids were regressed on concurrent measures of BMI or its components, adjusting for age, sex and race and, in a subsample, also for physical activity, energy intake and sexual maturity. RESULTS: Estimated regression coefficients for the relations of TC with BMI, FFM index and FM index were 1.539, -0.606 (p > 0.05) and 3.649, respectively. When FFM index and FM index were entered into the TC model simultaneously, regression coefficients were -0.855 and 3.743, respectively. An increase in BMI was related to an increase in TC; however, an equivalent increase in FM index was related to a greater increase in TC and, when FFM index was tested alone or with FM index, an increase in FFM index was related to a decrease in TC. Similar results were observed for LDL-C. FFM index and FM index were both inversely related to HDL-C and directly to triglycerides. Compared with FFM index, the equivalent increase in FM index showed a greater decrease in HDL-C. CONCLUSION: Greater BMI was related to adverse levels of blood lipids in children and adolescents, which was mainly attributable to BMI's fat component. It is important to identify weight management strategies to halt the childhood obesity epidemic and subsequently prevent heart disease in adulthood. 2011 Future Medicine Ltd. |
The epidemiology of upper extremity musculoskeletal symptoms on a college campus
Menendez CC , Amick Iii BC , Joe Chang CH , Dennerlein JT , Harrist RB , Jenkins M , Robertson M , Katz JN . Work 2009 34 (4) 401-8 OBJECTIVE: The study examines temporal variations in upper-extremity musculoskeletal symptoms throughout the day, over a week and throughout the semester. METHODS: 30 undergraduates were followed in a repeated measures study throughout a semester. Upper extremity musculoskeletal symptoms data were collected on handheld computers randomly throughout the day for seven days over three data collection periods. Multilevel statistical models evaluated associations between time-related predictors and symptoms. RESULTS: In adjusted models, pain reported at baseline was associated with increased odds of experiencing both any symptoms (OR=15.64; 90% CI 7.22-33.88) and moderate or greater symptoms (OR=16.44; 90% CI 4.57-29.99). Any symptoms were less likely to be reported if responses occurred at 58-76 days (OR=0.66; 90% CI 0.49-0.86), 77-90 days (OR=0.29; 90% CI 0.20-0.42) and 91-117 days (OR=0.54; 90% CI 0.39-0.75) into the semester compared to 35-57 days. Similarly, responding after midnight was associated with greater odds of reporting moderate or greater symptoms (OR=21.33; 90% CI 6.49-65.97). There was no association observed for day of week and symptoms. CONCLUSION: This pilot work suggests upper extremity musculoskeletal symptoms exhibit temporal variations related to time of day and days into semester. Understanding the natural history of musculoskeletal symptoms and disorders is needed when designing epidemiologic research and/or intervention studies using symptom outcome measures. |
Evaluation of two posture survey instruments for assessing computing postures among college students
Menendez CC , Amick Iii BC , Joe Chang CH , Harrist RB , Jenkins M , Robertson M , Janowitz I , Rempel DM , Katz JN , Dennerlein JT . Work 2009 34 (4) 421-30 OBJECTIVE: To determine agreement between two posture assessment survey instruments and which, if any, were correlated with experiencing upper extremity musculoskeletal symptoms. METHODS: Thirty undergraduate participants had three postural assessment surveys completed, one each for three separate 7-day data collection periods during a semester. Two observation assessment tools were used, a modified Rapid Upper Limb Assessment (mRULA) for computer users for the right and left limbs and the University of California Computer Use Checklist. Concurrently, upper extremity musculoskeletal symptom experience paired to each postural assessment was measured. Lin's concordance correlation coefficient evaluated survey agreement and multi-level statistical models described associations between survey responses and symptoms. RESULTS: There was no agreement between the two postural assessment tool scores (p> 0.85). In adjusted models, the UC Computer Use Checklist was positively associated with symptoms occurrence (OR=1.4, 90% CI 1.2-1.6 for any symptoms; OR=1.3, 90% CI 1.0-1.6 for moderate or greater symptoms). Associations with mRULA scores were inconsistent in that they were sometimes protective and sometimes indicators of risk, depending on the covariates included in the models. CONCLUSION: The mRULA for computer users and the UC Computer Use Checklist were independent of each other; however, due to the inconsistent associations with symptoms we cannot conclude one instrument is superior to the other. Our data do suggest the UC Computer Use Checklist demonstrates a traditional relationship with symptoms, where increasing scores signifiy greater risk. We observed a nontraditional relationship with symptoms for the mRULA for computer users that needs to be further examined. This is a pilot study and, thus, findings should be interpreted as exploratory. Associations observed in the current study will be used to test hypotheses in the cohort study recently conducted. |
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