Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-16 (of 16 Records) |
Query Trace: Loeb M [original query] |
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Persistence of Human Norovirus (GII) in Surface Water: Decay Rate Constants and Inactivation Mechanisms.
Kennedy LC , Costantini VP , Huynh KA , Loeb SK , Jennings WC , Lowry S , Mattioli MC , Vinjé J , Boehm AB . Environ Sci Technol 2023 57 (9) 3671-3679 Human norovirus (HuNoV) is an important cause of acute gastroenteritis and can be transmitted by water exposures, but its persistence in water is not well understood. Loss of HuNoV infectivity in surface water was compared with persistence of intact HuNoV capsids and genome segments. Surface water from a freshwater creek was filter-sterilized, inoculated with HuNoV (GII.4) purified from stool, and incubated at 15 or 20 °C. We measured HuNoV infectivity via the human intestinal enteroid system and HuNoV persistence via reverse transcription-quantitative polymerase chain reaction assays without (genome segment persistence) or with (intact viral capsid persistence) enzymatic pretreatment to digest naked RNA. For infectious HuNoV, results ranged from no significant decay to a decay rate constant ("k") of 2.2 day(-1). In one creek water sample, genome damage was likely a dominant inactivation mechanism. In other samples from the same creek, loss of HuNoV infectivity could not be attributed to genome damage or capsid cleavage. The range in k and the difference in the inactivation mechanism observed in water from the same site could not be explained, but variable constituents in the environmental matrix could have contributed. Thus, a single k may be insufficient for modeling virus inactivation in surface waters. |
The HIV continuum of care for adolescents and young adults attending 13 urban US HIV Care Centers of the NICHD-ATN-CDC-HRSA SMILE Collaborative
Kapogiannis BG , Koenig LJ , Xu J , Mayer KH , Loeb J , Greenberg L , Monte D , Banks-Shields M , Fortenberry JD . J Acquir Immune Defic Syndr 2020 84 (1) 92-100 BACKGROUND: Almost one-quarter of all new HIV diagnoses in the United States occur among persons aged 13-24 years. These youths have the poorest HIV care continuum (HCC) outcomes, yet few empirical youth-specific data are available. METHODS: The Strategic Multisite Initiative for the Identification, Linkage, and Engagement in Care of HIV-infected youth (SMILE) helped HIV-infected (mostly newly diagnosed) youth, aged 12-24 years, link to youth-friendly care, and evaluated each milestone of the HCC (October 2012-September 2014). Numbers of HIV-infected youth referred, linked, engaged, and retained in care were recorded, along with sociodemographics. Viral suppression (VS) was defined as >/=1 HIV viral load (VL) below the level of detection on study. Correlates of VS were examined using Cox proportional hazards models. RESULTS: Among 1411 HIV-infected youth, 1053 (75%) were linked, 839 (59%) engaged, and 473 (34%) retained in care at adolescent health care sites. Antiretroviral therapy was initiated among 474 (34%), and 166 (12%) achieved VS. Predictors of VS included lower VL at baseline [aHR 1.56 (95% CI: 1.32-1.89), P < 0.0001], recent antiretroviral therapy receipt [aHR 3.10 (95% CI: 1.86-5.18), P < 0.0001], and shorter time from HIV testing until referral to linkage coordinator [aHR 2.52 (95% CI: 1.50-4.23), P = 0.0005 for 7 days to 6 weeks and aHR 2.08 (95% CI: 1.08-4.04), P = 0.0294 for 6 weeks to 3 months compared with >3 months]. CONCLUSIONS: Although this large national sample of predominately newly diagnosed youths linked to care at similar rates as adults, they achieved disproportionately lower rates of VS. Prompt referral to youth-friendly linkage services was an independent predictor of VS. Youth-focused interventions are urgently needed to improve their HCC outcomes. |
Variations in healthcare provider use of public health and other information sources by provider type and practice setting during New York City's response to the emerging threat of Zika virus disease, 2016
Quinn C , Poirot E , Sanders Kim A , Viswanath AL , Patel SN , Abramson DM , Piltch-Loeb R . Health Secur 2018 16 (4) 252-261 The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) used multiple methods to provide guidance to healthcare providers on the management and prevention of Zika virus disease during 2016. To better understand providers' use of information sources related to emerging disease threats, this article describes reported use of information sources by NYC providers to stay informed about Zika, and patterns observed by provider type and practice setting. We sent an electronic survey to all email addresses in the Provider Data Warehouse, a system used to maintain information from state and local health department sources on all prescribing healthcare providers in NYC. The survey asked providers about their use of information sources, including specific information products offered by the NYC DOHMH, to stay informed about Zika during 2016. Trends by provider type and practice setting were described using summary statistics. The survey was sent to 44,455 unique email addresses; nearly 20% (8,711) of the emails were undeliverable. Ultimately, 1,447 (5.8%) eligible providers completed the survey. Most respondents (79%) were physicians. Overall, the most frequently reported source of information from the NYC DOHMH was the NYC Health Alert Network (73%). Providers in private practice reported that they did not use any NYC DOHMH source of information about Zika more frequently than did those working in hospital settings (29% vs 23%); similarly, private practitioners reported that they did not use any other source of information about Zika more frequently than did those working in hospital settings (16% vs 8%). Maintaining timely and accurate databases of healthcare provider contact information is a challenge for local public health agencies. Effective strategies are needed to identify and engage independently practicing healthcare providers to improve communications with all healthcare providers during public health emergencies. |
The development and testing of a module on child functioning for identifying children with disabilities on surveys. I: Background
Loeb M , Mont D , Cappa C , De Palma E , Madans J , Crialesi R . Disabil Health J 2018 11 (4) 495-501 This is the first of three papers that will document the development of a survey module on child functioning developed by UNICEF in collaboration with the Washington Group on Disability Statistics (WG), and demonstrate - both conceptually and through test results - the strengths of that module compared with alternative tools for identifying children with disabilities in household surveys. This first paper in the series sets the background and reviews the literature leading to the development of the UNICEF/WG Child Functioning Module (CFM) and presents the WG Short Set of questions (WG-SS) and the Ten Question Screening Instrument (TQSI) as precursors, outlining some of their shortcomings and how the UNICEF/WG CFM was designed to meet those challenges. Subsequent articles will summarize results from the cognitive and field testing of the CFM including comparisons with results derived from the TQSI and the WG-SS. |
The development and testing of a module on child functioning for identifying children with disabilities on surveys. III: Field testing
Cappa C , Mont D , Loeb M , Misunas C , Madans J , Comic T , de Castro F . Disabil Health J 2018 11 (4) 510-518 BACKGROUND: A module on child functioning developed by UNICEF and the Washington Group on Disability Statistics (WG) for use in censuses and surveys reflects current thinking around disability measurement and is intended to produce internationally comparable data. The Child Functioning Module (CFM) was developed in response to limitations of the Ten Question Screening Instrument (TQSI) for use in surveys and builds on the WG Short Set (WG-SS) of questions that was designed to capture disability in censuses, particularly among the adult population. OBJECTIVE: This paper documents the testing of the module and summarizes its results, including a description of prevalence levels across countries using different cut-offs, and comparisons with prevalence levels obtained using the TQSI and the WG-SS. METHODS: Field tests were conducted in Samoa as part of the 2014 Demographic and Health Survey and in Mexico as part of the 2015 National Survey of Boys, Girls and Women. The module was also implemented in Serbia as part of a dedicated survey conducted in the province of Vojvodina, in February 2016. RESULTS: Using the recommended cut-offcut-off, the percentage of children reported as having functional difficulty ranges from 1.1% in Serbia to 2% in Mexico among children aged 2-4 years, and from 3.2% in Samoa to 11.2% in Mexico among children aged 5-17 years. Across all three countries, the prevalence of functional difficulty was highest in the socio-emotional domains. A comparison of the prevalence levels obtained using the WG-SS and the CFM shows that, except for the question on cognition/learning, the WG-SS and the CFM are relatively close for children aged 5-17 years for the domains that are included in both question sets, but the WG-SS excludes many children identified by the CFM in other domains. The comparison between the TQSI and the CFM shows that, while the prevalence estimates are similar for seeing and hearing, significant differences affect other domains, particularly cognition/learning and communication. CONCLUSIONS: The CFM addresses a full range of functional domains that are important for child development. The module represents an improvement on the TQSI in that it allows for scaled responses to determine the degree of difficulty, and so can separate out many potential false positives. The module is also preferred over the WG-SS for collecting data on children, first, because most of the questions in the WG-SS are not suitable for children under the age of 5 years, and second, because the WG-SS leaves out important functional domains for children aged 5-17 years, namely those related to developmental disabilities and behavioural issues. |
Influenza epidemiology and immunization during pregnancy: Final report of a World Health Organization working group
Fell DB , Azziz-Baumgartner E , Baker MG , Batra M , Beaute J , Beutels P , Bhat N , Bhutta ZA , Cohen C , De Mucio B , Gessner BD , Gravett MG , Katz MA , Knight M , Lee VJ , Loeb M , Luteijn JM , Marshall H , Nair H , Pottie K , Salam RA , Savitz DA , Serruya SJ , Skidmore B , Ortiz JR . Vaccine 2017 35 (43) 5738-5750 From 2014 to 2017, the World Health Organization convened a working group to evaluate influenza disease burden and vaccine efficacy to inform estimates of maternal influenza immunization program impact. The group evaluated existing systematic reviews and relevant primary studies, and conducted four new systematic reviews. There was strong evidence that maternal influenza immunization prevented influenza illness in pregnant women and their infants, although data on severe illness prevention were lacking. The limited number of studies reporting influenza incidence in pregnant women and infants under six months had highly variable estimates and underrepresented low- and middle-income countries. The evidence that maternal influenza immunization reduces the risk of adverse birth outcomes was conflicting, and many observational studies were subject to substantial bias. The lack of scientific clarity regarding disease burden or magnitude of vaccine efficacy against severe illness poses challenges for robust estimation of the potential impact of maternal influenza immunization programs. |
Measuring child functioning: The Unicef/ Washington Group Module
Loeb M , Cappa C , Crialesi R , de Palma E . Salud Publica Mex 2017 59 (4) 485-487 This paper describes the development of a standard survey instrument designed to identify children with functional difficulties through censuses and surveys. Using the World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) as a conceptual framework the Washington Group on Disability Statistics (WG) and UNICEF, in collaboration with experts, developed a survey module on child functioning for 2–4 and 5–17 year olds, which was piloted in different countries. To-date, the module has been used in four population surveys, including the Children and Women National Survey in Mexico (ENIM 2015). The availability of a standard method for identifying children with disabilities may help to orient and develop better practices aimed at improving the life conditions and well-being of children. | This paper is based on the working documents of the UNICEF/WG Child Functioning workgroup and work that has been previously published in International Measurement of Disability: Purpose, Method and Application – The work of the Washington Group on Disability Statistics. B. Altman (Ed). (Crialesi et al, 2016). |
Field testing a draft version of the UNICEF/Washington Group Module on child functioning and disability. Background, methodology and preliminary findings from Cameroon and India
Mactaggart I , Cappa C , Kuper H , Loeb M , Polack S . Alter 2016 10 (4) 345-360 BACKGROUND: Global child disability data are generally non-comparable, comprising different tools, methodologies and disability definitions. UNICEF and The Washington Group on Disability Statistics (WG) have developed a new tool on child functioning and disability to address this need. AIMS: The aim of this paper is to describe the development of the new module, and to present an independent field test of the draft module in two contrasting settings. METHODS: UNICEF and the WG developed a parent-reported survey module to identify children aged 2-17 years with functional difficulties in population-based surveys through: review of existing documentation, consultation with experts and cognitive testing. A field test of the draft module was undertaken in Cameroon and India within a population-based survey. Functional limitation in each of 14 domains was scored on a scale comprising "no difficulty", "some difficulty", "a lot of difficulty" and "cannot do". RESULTS: In all, 1713 children in Cameroon and 1101 children in India were assessed. Sixty-four percent of children in Cameroon and 35% of children in India were reported to have at least some difficulty in one or more domain. The proportion reported to have either "a lot of difficulty" or "cannot do" was 9% in Cameroon and 4% in India. There were no significant differences in reported functional difficulties by sex but children aged 2-4 were reported to have fewer functional difficulties of any kind compared with older children in both countries. CONCLUSION: Comparable estimates were generated between the two countries, providing an initial overview of the tool's outputs. The continued development of this standardised questionnaire for the collection of robust and reliable data on child disability is essential. |
Comments on Sabariego et al. Measuring disability: Comparing the impact of two data collection approaches on disability rates. Int. J. Environ. Res. Public Health, 2015, 12, 10329-10351
Madans JH , Mont D , Loeb M . Int J Environ Res Public Health 2015 13 (1) ijerph13010065 In the article, Measuring Disability: Comparing the Impact of Two Data Collection Approaches on Disability Rates, in Volume 12 of the Journal International Journal of Environmental Research and Public Health, Carla Sabariego et al. raise several issues regarding the use of the short set of questions developed by the Washington Group on Disability Statistics (WG) as compared with the approach to disability measurement proposed through the Model Disability Survey (MDS). We address these below. |
Psychological and physical functioning difficulties associated with complex activity limitations among U.S. adults
Loeb M , Jonas BS . Disabil Health J 2014 8 (1) 70-9 BACKGROUND: There is limited research that assesses psychological functioning categorically as a predictor of complex activity limitations either alone or in conjunction with physical functioning. OBJECTIVES: This paper assesses the impact of psychological and/or physical functioning difficulties as predictors of complex activity limitations among U.S. adults, using data from a national survey. METHODS: Data come from the 2006-2010 National Health Interview Survey among U.S. adults 18 or older (n = 124,337). We developed a combined physical/psychological exposure variable with six categories: 1) no/low psychological distress (LPD) and absence of physical functioning difficulties, 2) moderate psychological distress (MPD) only, 3) serious psychological distress (SPD) only, 4) physical functioning difficulty only, 5) MPD and physical functioning difficulties, and 6) SPD and physical functioning difficulties. Selected complex activity limitations include daily living, social and work limitations. RESULTS: Compared to adults with LPD and absence of physical functioning difficulties, the results demonstrated a clear and significant gradient of increasing risk of complex activity limitations beginning with MPD only, SPD only, physical functioning difficulty only, both MPD and physical functioning difficulties, and SPD and physical functioning difficulties. CONCLUSIONS: The data suggest a stronger risk of complex activity limitations when increasing psychological functioning difficulties coexist with physical functioning difficulties, leading to potential interference with a person's ability to accomplish major life activities measured in this study. The sizeable contribution of psychological distress to the prevalence of basic actions difficulty implies that the mental health component of functional limitations is important in the overall assessment of health and well-being. |
Methods to improve international comparability of census and survey measures of disability
Madans JH , Loeb M . Disabil Rehabil 2012 35 (13) 1070-3 PURPOSE: To describe the methods used by the Washington Group on Disability Statistics (WG) to develop internationally comparable questions on disability that can be used worldwide. METHOD: The WG approach to developing disability measures included careful consideration of the theoretical and conceptual issues associated with disability, translating disability concepts into measurement tools, and mixed-method evaluations of the proposed questions using both cognitive and field interviewing methodologies. RESULTS: Disability is a complex construct the measurement of which presents considerable challenges for survey methodologists. The Washington Group on Disability Statistics (WG), a UN Statistical Commission sponsored city group, was established to address the methodological and measurement challenges that have characterized disability statistics and to develop questions for use worldwide that will provide comparable, valid and reliable disability statistics. The WG used a variety of methods to meet these objectives and has finalized a short set disability measure for use in censuses worldwide. CONCLUSIONS: The methodologies adopted by the WG have resulted in question sets that greatly improve the international comparability of disability statistics and will advance our understanding of disability worldwide. |
Surveillance definitions of infections in long-term care facilities: revisiting the McGeer Criteria
Stone ND , Ashraf MS , Calder J , Crnich CJ , Crossley K , Drinka PJ , Gould CV , Juthani-Mehta M , Lautenbach E , Loeb M , Maccannell T , Malani PN , Mody L , Mylotte JM , Nicolle LE , Roghmann MC , Schweon SJ , Simor AE , Smith PW , Stevenson KB , Bradley SF . Infect Control Hosp Epidemiol 2012 33 (10) 965-77 Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections. |
Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: the work of the Washington Group on Disability Statistics
Madans JH , Loeb ME , Altman BM . BMC Public Health 2011 11 Suppl 4 S4 The Washington Group on Disability Statistics is a voluntary working group made up of representatives of over 100 National Statistical Offices and international, non-governmental and disability organizations that was organized under the aegis of the United Nations Statistical Division. The purpose of the Washington Group is to deal with the challenge of disability definition and measurement in a way that is culturally neutral and reasonably standardized among the UN member states. The work, which began in 2001, took on added importance with the passage and ratification of the UN Convention on the Rights of Persons with Disabilities since the Convention includes a provision for monitoring whether those with and without disabilities have equal opportunities to participate in society and this will require the identification of persons with disabilities in each nation. The International Classification of Functioning, Disability and Health (ICF) developed by the World Health Organization provided a framework for conceptualizing disability. Operationalizing an ICF-based approach to disability has required the development of new measurement tools for use in both censuses and surveys. To date, a short set of six disability-related questions suitable for use in national censuses has been developed and adopted by the Washington Group and incorporated by the United Nations in their Principles and Recommendations for Population and Housing Censuses. A series of extended sets of questions is currently under development and some of the sets have been tested in several countries. The assistance of many National and International organizations has allowed for cognitive and field testing of the disability questionnaires in multiple languages and locations. This paper will describe the work of the Washington Group and explicate the applicability of its approach and the questions developed for monitoring the UN Convention on the Rights of Persons with Disabilities. |
Assessing injury-related movement difficulties: a method for analyzing the association between functional limitations and social participation
Loeb M , Chen LH . Disabil Health J 2011 4 (2) 102-11 BACKGROUND: The conceptualization of disability has shifted from a medical to a social model with a consequent focus away from impairments and toward activities and participation. The International Classification of Functioning, Disability and Health (ICF) provides a common point of reference and a common language in a developing disability discourse. OBJECTIVES: We sought to apply a model for the measurement of disability based on the activity and participation constructs of the ICF to persons with movement difficulty as a result of injury-related causes. METHODS: Data from sample adults aged 18 years and over in the 2001-2006 National Health Interview Survey (NHIS) were used for analysis. Disability among adults with injury-related movement difficulty was assessed through measures of difficulty performing basic actions (movement, sensory, emotional, and/or cognitive functioning); and limitations of complex activities (defined through measures of self-care, social participation, and work participation). SUDAAN 9.0 was used in all analyses to account for the complex sampling design and weighting of the NHIS data. RESULTS: Approximately 16% of noninstitutionalized adults who reported movement difficulty mentioned injury as a cause. On average, between 2001 and 2006, about 7.6 million adults had injury-related movement difficulty in the United States. Overall, 50% of adults who experienced injury-related movement difficulty also experienced some complex activity limitation. CONCLUSIONS: Using NHIS data, we have demonstrated the applicability of an approach using basic actions difficulty and complex activity limitations to measure functioning and participation in individuals with a specific type and cause of difficulty: injury-related movement difficulty. The operationalization of these constructs provides a possible tool to monitor progress toward the attainment of the equalization of opportunities among people with injury-related movement difficulty. |
Mood disorders and physical functioning difficulties as predictors of complex activity limitations in young U.S. adults
Jonas BS , Loeb M . Disabil Health J 2010 3 (3) 171-178 BACKGROUND: There is established research that shows associations between basic physical functional difficulties and complex activity limitations. In addition, there is some research that shows associations between mood disorders and complex activity limitations. However, there is limited research looking at the joint association between mood disorders and physical functioning and complex activity limitations. Furthermore, because mood disorders and physical functioning limitations increase with age, there is a lack of information available on younger adults. OBJECTIVES: We assess the impact of mood disorders and physical function difficulties as predictors of complex activity limitations in young U.S. adults, using data from a national survey. METHODS: We use data from the Third National Health and Nutrition Examination Survey (NHANES III) among young U.S. adults 17 to 39 years of age. Selected basic actions difficulties include physical functioning difficulties (motor, visual, or hearing difficulties) and mood disorders (major depressive disorder, dysthymia, or bipolar disorder). Selected complex activity limitations include limitations in activities of daily living (ADLs) (walking inside the home, standing from a chair, getting into and out of bed, eating, and dressing), instrumental activities of daily living (IADLs) (doing chores around the house, preparing meals, and managing money), and/or specific major life activities (limitations in the kind or amount of work or housework they could perform, or being limited in any way because of an impairment or health problem). RESULTS: The prevalence of basic actions difficulty (physical functioning and/or mood disorder difficulties) among young adults is 34%. Among the young adults with basic actions difficulty, nearly 39% have mood disorders. The prevalence rates for ADL/IADL, major life activities, and any complex activity limitation are 8.6%, 8.1%, and 13.6%, respectively. Compared with young adults with no basic actions difficulties, the results showed that young adults with mood disorders alone had elevated adjusted odds ratios (2.5) for limitations in ADLs and/IADLs. For all the complex activity limitations analyzed, compared to those with no basic actions difficulties, young adults with physical functioning difficulties alone had substantially higher adjusted odds ratios (5.4-8.7) and young adults with comorbid mood disorder and physical functioning difficulties had the highest observed odds ratios (9.7-14.0). CONCLUSIONS: The data suggest a stronger risk of complex activity limitations when mood disorders coexist with physical functioning difficulties, leading to potential interference with a person's ability to accomplish the ADLs/IADLs or major life activities measured in this study. Given the magnitude of basic actions difficulty prevalence, and particularly the substantial contribution of mood disorders to this prevalence, further examination of the mental health component of basic actions difficulty is warranted. A possible area for future research could explore coordinated efforts to reduce physical and mental difficulties and facilitate the accomplishment of complex activities. 2010 Elsevier Inc. All rights reserved. |
Functional difficulties among school-aged children: United States, 2001-2007
Pastor PN , Reuben CA , Loeb M . Natl Health Stat Report 2009 (19) 1-23 OBJECTIVE: This report presents estimates of basic actions difficulty, which includes difficulties related to sensory, motor, cognitive, and emotional or behavioral functioning, in U.S. children aged 5-17 years based on questions from the National Health Interview Survey (NHIS). Selected estimates are shown for the educational and health care service use of children with and without basic actions difficulty. METHODS: Estimates of basic actions difficulty were derived from the Family Core and the Sample Child Core questionnaires of the 2001-2007 NHIS. Estimates were generated and compared using SUDAAN, a statistical package that adjusts for the complex sample design of NHIS. RESULTS: Approximately 18% of children aged 5-17 had basic actions difficulty in one or more of the following domains of functioning: sensory, movement, cognitive, or emotional or behavioral. The percentage of children with difficulty in specific domains varied: 3% had sensory difficulty, 2% movement difficulty, 9% cognitive difficulty, and 10% emotional or behavioral difficulty. From 2001 through 2007, the percentage of children aged 5-17 with basic actions difficulty remained stable at about 18%. Children with and without basic actions difficulty differed greatly in their use of both educational and health care services. One-third of children with basic actions difficulty used special education services compared with 2% of children without basic actions difficulty. A substantially higher percentage of children with basic actions difficulty used health care services, including mental health care, other types of therapy, and prescription medication, than children without basic actions difficulty. |
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