Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Marovich S[original query] |
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Pharmacists' answer to the COVID-19 pandemic: Contribution of the federal retail pharmacy program to COVID-19 vaccination across sociodemographic characteristics- United States
El Kalach RR , Jones-Jack NH , Grabenstein JD , Elam M , Olorukooba A , deMartino AK , Vazquez M , Stokley S , Meyer SA , Wang TW , Himsel A , Medernach C , Jenkins K , Marovich S , Bradley MD , Manns BJ , Romerhausen D , Moore LB . J Am Pharm Assoc (2003) 2024 102305 BACKGROUND: The Federal Retail Pharmacy Program (FRPP) integrated pharmacies as partners in the national effort to maximize vaccination during the COVID-19 public health emergency. OBJECTIVES: The objective of this study was to quantify the contribution of pharmacies participating in FRPP to COVID-19 vaccination efforts during December 2020-September 2023 across sociodemographic groups in the United States. METHODS: Data on COVID-19 vaccine doses administered reported to CDC by FRPP and jurisdictional immunization information systems (IIS) of all 50 states, the District of Columbia, and U.S. territories were analyzed to estimate FRPP contributions. RESULTS: Approximately 314.9 million COVID-19 vaccine doses were administered by FRPP throughout this period, constituting 48.9% of all COVID-19 vaccine doses administered. FRPP contributions to COVID-19 vaccination ranged from 12.9% to 56.8% for persons aged 6 months-4 years and 12-17 years, respectively. FRPP made the highest contribution to administering COVID-19 doses to Non-Hispanic Asian (48.7%) and Hispanic/Latino (49.8%) persons. The proportion of COVID-19 doses given by FRPP pharmacies was found to be higher in urban areas (57%) compared with rural areas (45%). CONCLUSION: FRPP administered a substantial proportion of COVID-19 vaccine doses in the United States and provided vaccine access for persons across a wide range of groups. Pharmacies can complement vaccination efforts during public health emergency situations and in routine vaccination programs. |
Seroprevalence of SARS-CoV-2 following the largest initial epidemic wave in the United States: Findings from New York City, May 13-July 21, 2020.
Pathela P , Crawley A , Weiss D , Maldin B , Cornell J , Purdin J , Schumacher PK , Marovich S , Li J , Daskalakis D . J Infect Dis 2021 224 (2) 196-206 BACKGROUND: New York City (NYC) was the U.S. epicenter of the Spring 2020 COVID-19 pandemic. We present seroprevalence of SARS-CoV-2 infection and correlates of seropositivity immediately after the first wave. METHODS: From a serosurvey of adult NYC residents (May 13-July 21, 2020), we calculated the prevalence of SARS-CoV-2 antibodies stratified by participant demographics, symptom history, health status, and employment industry. We used multivariable regression models to assess associations between participant characteristics and seropositivity. RESULTS: Seroprevalence among 45,367 participants was 23.6% (95% CI, 23.2%-24.0%). High seroprevalence (>30%) was observed among Black and Hispanic individuals, people from high poverty neighborhoods, and people in health care or essential worker industry sectors. COVID-19 symptom history was associated with seropositivity (adjusted relative risk=2.76; 95% CI, 2.65-2.88). Other risk factors included sex, age, race/ethnicity, residential area, employment sector, working outside the home, contact with a COVID-19 case, obesity, and increasing numbers of household members. CONCLUSIONS: Based on a large serosurvey in a single U.S. jurisdiction, we estimate that just under one-quarter of NYC adults were infected in the first few months of the COVID-19 epidemic. Given disparities in infection risk, effective interventions for at-risk groups are needed during ongoing transmission. |
Why surveillance informatics is an integral part of a safe patient handling program: occupational injuries due to patient handling and Movement in 116 US hospitals, Occupational Health Safety Network, 2012-2016
Gomaa A , Groenewold MR , Vanoli K , Nowlin S , Marovich S . J Assoc Occup Health Pro Healthc 2020 40 (3) 16-25 Workplace musculoskeletal injuries due to patient handling and movement (PHM) are a significant occupational hazard for healthcare workers in the United States. Study authors Ahmed Gomaa, MD, ScD; Matthew R. Groenewold, PhD, MSPH; Kelly Vanoli; Susan Nowlin; and Stacey Marovich, MHI, MS, PMP, MCTS analyzed workplace musculoskeletal injuries surveillance data submitted by 116 hospitals participating in the Occupational Health Safety Network (OHSN) from 2012 to 2016. The detailed analysis of patient injury data showed nursing assistants, radiology technicians, and nurses are at the highest risk for injury. Improved data collection is needed to improve safe patient handling programs (SPHPs), and surveillance information is key for providing evidence on all aspects of SPHP. |
Clinical decision support for worker health: A five-site qualitative needs assessment in primary care settings
Ash JS , Chase D , Baron S , Filios MS , Shiffman RN , Marovich S , Wiesen J , Luensman GB . Appl Clin Inform 2020 11 (4) 635-643 BACKGROUND: Although patients who work and have related health issues are usually first seen in primary care, providers in these settings do not routinely ask questions about work. Guidelines to help manage such patients are rarely used in primary care. Electronic health record (EHR) systems with worker health clinical decision support (CDS) tools have potential for assisting these practices. OBJECTIVE: This study aimed to identify the need for, and barriers and facilitators related to, implementation of CDS tools for the clinical management of working patients in a variety of primary care settings. METHODS: We used a qualitative design that included analysis of interview transcripts and observational field notes from 10 clinics in five organizations. RESULTS: We interviewed 83 providers, staff members, managers, informatics and information technology experts, and leaders and spent 35 hours observing. We identified eight themes in four categories related to CDS for worker health (operational issues, usefulness of proposed CDS, effort and time-related issues, and topic-specific issues). These categories were classified as facilitators or barriers to the use of the CDS tools. Facilitators related to operational issues include current technical feasibility and new work patterns associated with the coordinated care model. Facilitators concerning usefulness include users' need for awareness and evidence-based tools, appropriateness of the proposed CDS for their patients, and the benefits of population health data. Barriers that are effort-related include additional time this proposed CDS might take, and other pressing organizational priorities. Barriers that are topic-specific include sensitive issues related to health and work and the complexities of information about work. CONCLUSION: We discovered several themes not previously described that can guide future CDS development: technical feasibility of the proposed CDS within commercial EHRs, the sensitive nature of some CDS content, and the need to assist the entire health care team in managing worker health. |
Opportunities at the intersection of work and health: Developing the occupational data for health information model
Marovich S , Luensman GB , Wallace B , Storey E . J Am Med Inform Assoc 2020 27 (7) 1072-1083 OBJECTIVE: The study sought to develop an information model of data describing a person's work for use by health information technology (IT) systems to support clinical care, population health, and public health. MATERIALS AND METHODS: Researchers from the National Institute for Occupational Safety and Health worked with stakeholders to define relationships and structure, vocabulary, and interoperability standards that would be useful and collectable in health IT systems. RESULTS: The Occupational Data for Health (ODH) information model illustrates relationships and attributes for a person's employment status, retirement dates, past and present jobs, usual work, and combat zone periods. Key data about the work of a household member that could be relevant to the health of a minor were also modeled. Existing occupation and industry classification systems were extended to create more detailed value sets that enable self-reporting and support patient care. An ODH code system, available in the Public Health Information Network Vocabulary Access and Distribution System, was established to identify the remaining value sets. ODH templates were prepared in all 3 Health Level 7 Internationalinteroperability standard formats. DISCUSSION: The ODH information model suggests data elements ready for use by health IT systems in the United States. As new data elements and values are better defined and refined by stakeholders and feedback is obtained through experience using ODH in clinical settings, the model will be updated. CONCLUSION: The ODH information model suggests standardized work information for trial use in health IT systems to support patient care, population health, and public health. |
Recognition of the relationship between patients' work and health: A qualitative evaluation of the need for clinical decision support (CDS) for worker health in five primary care practices
Baron S , Filios MS , Marovich S , Chase D , Ash JS . J Occup Environ Med 2017 59 (11) e245-e250 OBJECTIVE: The aim of this study was to determine the perceived value and feasibility of increased access to information about workers' health for primary care providers (PCPs) by evaluating the need for clinical decision support (CDS) related to worker health in primary care settings. METHODS: Qualitative methods, including semi-structured interviews and observations, were used to evaluate the value and feasibility of three examples of CDS relating work and health in five primary care settings. RESULTS: PCPs and team members wanted help addressing patients' health in relation to their jobs; the proposed CDS examples were perceived as valuable because they provided useful information, promoted standardization of care, and were considered technically feasible. Barriers included time constraints and a perceived inability to act on the findings. CONCLUSION: PCPs recognize the importance and impact of work on their patients' health but often lack accessible knowledge at the right time. Occupational health providers can play an important role through contributions to the development of CDS that assists PCPs in recognizing and addressing patients' health, as well as through the provision of referral guidelines. |
Central nervous system viral invasion and inflammation during acute HIV infection
Valcour V , Chalermchai T , Sailasuta N , Marovich M , Lerdlum S , Suttichom D , Suwanwela NC , Jagodzinski L , Michael N , Spudich S , van Griensven F , de Souza M , Kim J , Ananworanich J . J Infect Dis 2012 206 (2) 275-282 BACKGROUND: Understanding the earliest central nervous system (CNS) events during human immunodeficiency virus (HIV) infection is crucial to knowledge of neuropathogenesis, but these have not previously been described in humans. METHODS: Twenty individuals who had acute HIV infection (Fiebig stages I-IV), with average 15 days after exposure, underwent clinical neurological, cerebrospinal fluid (CSF), magnetic resonance imaging, and magnetic resonance spectroscopy (MRS) characterization. RESULTS: HIV RNA was detected in the CSF from 15 of 18 subjects as early as 8 days after estimated HIV transmission. Undetectable CSF levels of HIV (in 3 of 18) was noted during Fiebig stages I, II, and III, with plasma HIV RNA levels of 285 651, 2321, and 81 978 copies/mL, respectively. On average, the CSF HIV RNA level was 2.42 log(10) copies/mL lower than that in plasma. There were no cases in which the CSF HIV RNA level exceeded that in plasma. Headache was common during the acute retroviral syndrome (in 11 of 20 subjects), but no other neurological signs or symptoms were seen. Intrathecal immune activation was identified in some subjects with elevated CSF neopterin, monocyte chemotactic protein/CCL2, and interferon gamma-induced protein 10/CXCL-10 levels. Brain inflammation was suggested by MRS. CONCLUSIONS: CSF HIV RNA was detectable in humans as early as 8 days after exposure. CNS inflammation was apparent by CSF analysis and MRS in some individuals during acute HIV infection. |
Impact of multi-targeted antiretroviral treatment on gut T cell depletion and HIV reservoir seeding during acute HIV infection
Ananworanich J , Schuetz A , Vandergeeten C , Sereti I , de Souza M , Rerknimitr R , Dewar R , Marovich M , van Griensven F , Sekaly R , Pinyakorn S , Phanuphak N , Trichavaroj R , Rutvisuttinunt W , Chomchey N , Paris R , Peel S , Valcour V , Maldarelli F , Chomont N , Michael N , Phanuphak P , Kim JH . PLoS One 2012 7 (3) e33948 BACKGROUND: Limited knowledge exists on early HIV events that may inform preventive and therapeutic strategies. This study aims to characterize the earliest immunologic and virologic HIV events following infection and investigates the usage of a novel therapeutic strategy. METHODS AND FINDINGS: We prospectively screened 24,430 subjects in Bangkok and identified 40 AHI individuals. Thirty Thais were enrolled (8 Fiebig I, 5 Fiebig II, 15 Fiebig III, 2 Fiebig IV) of whom 15 completed 24 weeks of megaHAART (tenofovir/emtricitabine/efavirenz/raltegravir/maraviroc). Sigmoid biopsies were completed in 24/30 at baseline and 13/15 at week 24. At baseline, the median age was 29 years and 83% were MSM. Most were symptomatic (87%), and were infected with R5-tropic (77%) CRF01_AE (70%). Median CD4 was 406 cells/mm(3). HIV RNA was 5.5 log(10) copies/ml. Median total blood HIV DNA was higher in Fiebig III (550 copy/10(6) PBMC) vs. Fiebig I (8 copy/10(6) PBMC) (p = 0.01) while the median %CD4+CCR5+ gut T cells was lower in Fiebig III (19%) vs. Fiebig I (59%) (p = 0.0008). After 24 weeks of megaHAART, HIV RNA levels of <50 copies were achieved in 14/15 in blood and 13/13 in gut. Total blood HIV DNA at week 0 predicted reservoir size at week 24 (p<0.001). Total HIV DNA declined significantly and was undetectable in 3 of 15 in blood and 3 of 7 in gut. Frequency of CD4+CCR5+ gut T cells increased from 41% at baseline to 64% at week 24 (p>0.050); subjects with less than 40% at baseline had a significant increase in CD4+CCR5+ T cells from baseline to week 24 (14% vs. 71%, p = 0.02). CONCLUSIONS: Gut T cell depletion and HIV reservoir seeding increases with progression of AHI. MegaHAART was associated with immune restoration and reduced reservoir size. Our findings could inform research on strategies to achieve HIV drug-free remission. |
A phase 1/2 study of a multiclade HIV-1 DNA plasmid prime and recombinant adenovirus serotype 5 boost vaccine in HIV-uninfected East Africans (RV 172)
Kibuuka H , Kimutai R , Maboko L , Sawe F , Schunk MS , Kroidl A , Shaffer D , Eller LA , Kibaya R , Eller MA , Schindler KB , Schuetz A , Millard M , Kroll J , Dally L , Hoelscher M , Bailer R , Cox JH , Marovich M , Birx DL , Graham BS , Michael NL , de Souza MS , Robb ML . J Infect Dis 2010 201 (4) 600-7 ![]() BACKGROUND: Human immunodeficiency virus (HIV) vaccine development remains a global priority. We describe the safety and immunogenicity of a multiclade DNA vaccine prime with a replication-defective recombinant adenovirus serotype 5 (rAd5) boost. METHODS: The vaccine is a 6-plasmid mixture encoding HIV envelope (env) subtypes A, B, and C and subtype B gag, pol, and nef, and an rAd5 expressing identical genes, with the exception of nef. Three hundred and twenty-four participants were randomized to receive placebo (n=138), a single dose of rAd5 at 10(10) (n = 24) or 10(11) particle units (n = 24), or DNA at 0, 1, and 2 months, followed by rAd5 at either 10(10) (n= 114) or 10(11) particle units (n = 24) boosting at 6 months. Participants were followed up for 24 weeks after the final vaccination. RESULTS: The vaccine was safe and well tolerated. HIV-specific T cell responses were detected in 63% of vaccinees. Titers of preexisting Ad5 neutralizing antibody did not affect the frequency and magnitude of T cell responses in prime-boost recipients but did affect the response rates in participants that received rAd5 alone (P = .037). CONCLUSION: The DNA/rAd5 vaccination regimen was safe and induced HIV type 1 multi-clade T cell responses, which were not significantly affected by titers of preexisting rAd5 neutralizing antibody. Trial Registration. ClinicalTrials.gov identifier: NCT00123968 . |
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