Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-13 (of 13 Records) |
Query Trace: Radke T[original query] |
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Challenges and recommendations on the conduct of systematic reviews of observational epidemiologic studies in environmental and occupational health
Arroyave WD , Mehta SS , Guha N , Schwingl P , Taylor KW , Glenn B , Radke EG , Vilahur N , Carreon T , Nachman RM , Lunn RM . J Expo Sci Environ Epidemiol 2020 31 (1) 21-30 Systematic reviews are powerful tools for drawing causal inference for evidence-based decision-making. Published systematic reviews and meta-analyses of environmental and occupational epidemiology studies have increased dramatically in recent years; however, the quality and utility of published reviews are variable. Most methodologies were adapted from clinical epidemiology and have not been adequately modified to evaluate and integrate evidence from observational epidemiology studies assessing environmental and occupational hazards, especially in evaluating the quality of exposure assessments. Although many reviews conduct a systematic and transparent assessment for the potential for bias, they are often deficient in subsequently integrating across a body of evidence. A cohesive review considers the impact of the direction and magnitude of potential biases on the results, systematically evaluates important scientific issues such as study sensitivity and effect modifiers, identifies how different studies complement each other, and assesses other potential sources of heterogeneity. Given these challenges of conducting informative systematic reviews of observational studies, we provide a series of specific recommendations based on practical examples for cohesive evidence integration to reach an overall conclusion on a body of evidence to better support policy making in public health. |
Providers' perspectives on treating patients with thalassemia
Radke T , Paulukonis S , Hulihan MM , Feuchtbaum L . J Pediatr Hematol Oncol 2019 41 (7) e421-e426 In recent years, California has experienced a steady rise in Asian immigration which has led to a corresponding increased prevalence of clinically significant thalassemia in this state. As part of the Public Health Research, Education and Surveillance for Hemoglobinopathies emoglobinopathies project, a survey was developed to collect information from California providers who care for thalassemia patients in an effort to better understand their practice patterns, barriers to providing care, and educational needs. When asked about educational needs, providers most frequently expressed a desire for care and management guidelines (65.3%), health educational materials for patients (47.2%), and information on complications and clinical outcomes (32.1%). Only one quarter of providers (24.0%) reported that all of their thalassemia patients have a coordinated care plan. The increase in California thalassemia cases highlights the importance of provider knowledge to effectively serve the patients in their communities. Provider education and dissemination of treatment standards can not only improve knowledge about the disease but also increase awareness about the importance of coordinating care among a multidisciplinary team of specialists. Improvement in these areas will help achieve the overarching goal of better outcomes and quality of life for patients with thalassemia. |
Foodborne illness outbreaks at retail establishments - National Environmental Assessment Reporting System, 16 state and local health departments, 2014-2016
Lipcsei LE , Brown LG , Coleman EW , Kramer A , Masters M , Wittry BC , Reed K , Radke VJ . MMWR Surveill Summ 2019 68 (1) 1-20 PROBLEM/CONDITION: State and local public health departments report hundreds of foodborne illness outbreaks each year to CDC and are primarily responsible for investigations of these outbreaks. Typically, investigations involve epidemiology, laboratory, and environmental health components. Health departments voluntarily report epidemiologic and laboratory data from their foodborne illness outbreak investigations to CDC through the Foodborne Disease Outbreak Surveillance System (FDOSS); however, minimal environmental health data from outbreak investigations are reported to FDOSS. PERIOD COVERED: 2014-2016. DESCRIPTION OF SYSTEM: In 2014, CDC launched the National Environmental Assessment Reporting System (NEARS) to complement FDOSS surveillance and to use these data to enhance prevention efforts. State and local health departments voluntarily report data from their foodborne illness outbreak investigations of retail food establishments. These data include characteristics of foodborne illness outbreaks (e.g., agent), characteristics of establishments with outbreaks (e.g., number of meals served daily), food safety policies and practices of these establishments (e.g., glove use policies), and characteristics of outbreak investigations (e.g., timeliness of investigation activities). NEARS is the only available data source that includes characteristics of retail establishments with foodborne illness outbreaks. RESULTS: During 2014-2016, a total of 16 state and local public health departments reported data to NEARS on 404 foodborne illness outbreaks at retail establishments. The majority of outbreaks with a suspected or confirmed agent were caused by norovirus (61.1%). The majority of outbreaks with identified contributing factors had at least one factor associated with food contamination by a worker who was ill or infectious (58.6%). Almost half (47.4%) of establishments with outbreaks had a written policy excluding ill workers from handling food or working. Approximately one third (27.7%) had a written disposable glove use policy. Paid sick leave was available for at least one worker in 38.3% of establishments. For most establishments with outbreaks (68.7%), environmental health investigators initiated their component of the investigation soon after learning about the outbreak (i.e., the same day) and completed their component in one or two visits to the establishment (75.0%). However, in certain instances, contacting the establishment and completing the environmental health component of the investigation occurred much later (>8 days). INTERPRETATION: Most outbreaks reported to NEARS were caused by norovirus, and contamination of food by workers who were ill or infectious contributed to more than half of outbreaks with contributing factors; these findings are consistent with findings from other national outbreak data sets and highlight the role of workers in foodborne illness outbreaks. The relative lack of written policies for ill workers and glove use and paid sick leave for workers in establishments with outbreaks indicates gaps in food safety practices that might have a role in outbreak prevention. The environmental health component of the investigation for most outbreaks was initiated quickly, yet the longer initiation timeframe for certain outbreaks suggests the need for improvement. PUBLIC HEALTH ACTION: Retail establishments can reduce viral foodborne illness outbreaks by protecting food from contamination through proper hand hygiene and excluding workers who are ill or infectious from working. NEARS data can help prioritize training and interventions for state and local food safety programs and the retail food establishment industry by identifying gaps in food safety policies and practices and types of establishments vulnerable to outbreaks. Improvement of certain outbreak investigation practices (e.g., delayed initiation of environmental health investigations) can accelerate identification of the agent and implementation of interventions. Future analysis comparing establishments with and without outbreaks will contribute knowledge about how establishments' characteristics and food safety policies and practices relate to foodborne illness outbreaks and provide information to develop effective prevention approaches. |
Discussing symptoms with sick food service employees
Charles J , Radke T . J Environ Health 2017 80 (5) 24-26 This special report examines two federal laws, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Americans With Disabilities Act of 1990 (ADA), and considers the role each law plays in discussions about employees' symptoms or illnesses. It is possible that existing state laws might restrict restaurant manager actions on this issue. Industry food safety professionals, however, specifically mentioned federal laws, so this special report will focus on federal regulations. |
Restaurant food allergy practices - six selected sites, United States, 2014
Radke TJ , Brown LG , Faw B , Hedeen N , Matis B , Perez P , Viveiros B , Ripley D . MMWR Morb Mortal Wkly Rep 2017 66 (15) 404-407 Food allergies affect an estimated 15 million persons in the United States (1), and are responsible for approximately 30,000 emergency department visits and 150-200 deaths each year (2). Nearly half of reported fatal food allergy reactions over a 13-year period were caused by food from a restaurant or other food service establishment (3). To ascertain the prevalence of food allergy training, training topics, and practices related to food allergies, CDC's Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal agencies and state and local health departments with six sites, interviewed personnel at 278 restaurants. Fewer than half of the 277 restaurant managers (44.4%), 211 food workers (40.8%), and 156 servers (33.3%) interviewed reported receiving food allergy training. Among those who reported receiving training, topics commonly included the major food allergens and what to do if a customer has a food allergy. Although most restaurants had ingredient lists for at least some menu items, few had separate equipment or areas designated for the preparation of allergen-free food. Restaurants can reduce the risk for allergic reactions among patrons by providing food allergy training for personnel and ingredient lists for all menu items and by dedicating equipment and areas specifically for preparing allergen-free food. |
Vital Signs: Noise-induced hearing loss among adults - United States 2011-2012
Carroll YI , Eichwald J , Scinicariello F , Hoffman HJ , Deitchman S , Radke MS , Themann CL , Breysse P . MMWR Morb Mortal Wkly Rep 2017 66 (5) 139-144 INTRODUCTION: The 2016 National Academies of Sciences report "Hearing Health Care for Adults: Priorities for Improving Access and Affordability" included a call to action for government agencies to strengthen efforts to collect, analyze, and disseminate population-based data on hearing loss in adults. METHODS: CDC analyzed the most recent available data collected both by questionnaire and audiometric tests of adult participants aged 20-69 years in the 2011-2012 National Health and Nutrition Examination Survey (NHANES) to determine the presence of audiometric notches indicative of noise-induced hearing loss. Prevalence of both unilateral and bilateral audiometric notches and their association with sociodemographics and self-reported exposure to loud noise were calculated. RESULTS: Nearly one in four adults (24%) had audiometric notches, suggesting a high prevalence of noise-induced hearing loss. The prevalence of notches was higher among males. Almost one in four U.S. adults who reported excellent or good hearing had audiometric notches (5.5% bilateral and 18.0% unilateral). Among participants who reported exposure to loud noise at work, almost one third had a notch. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Noise-induced hearing loss is a significant, often unrecognized health problem among U.S. adults. Discussions between patients and personal health care providers about hearing loss symptoms, tests, and ways to protect hearing might help with early diagnosis of hearing loss and provide opportunities to prevent harmful noise exposures. Avoiding prolonged exposure to loud environments and using personal hearing protection devices can prevent noise-induced hearing loss. |
Food allergy knowledge and attitudes of restaurant managers and staff: An EHS-Net study
Radke TJ , Brown LG , Hoover ER , Faw BV , Reimann D , Wong MR , Nicholas D , Barkley J , Ripley D . J Food Prot 2016 79 (9) 1588-1598 Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers' food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant's ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction. © 2016, International Association for Food Protection. All rights reserved. |
Influenza vaccine effectiveness for hospital and community patients using control groups with and without non-influenza respiratory viruses detected, Auckland, New Zealand 2014
Pierse N , Kelly H , Thompson MG , Bissielo A , Radke S , Huang QS , Baker MG , Turner N . Vaccine 2015 34 (4) 503-509 BACKGROUND: We aimed to estimate the protection afforded by inactivated influenza vaccine, in both community and hospital settings, in a well characterised urban population in Auckland during 2014. METHODS: We used two different comparison groups, all patients who tested negative for influenza and only those patients who tested negative for influenza and had a non-influenza respiratory virus detected, to calculate the vaccine effectiveness in a test negative study design. Estimates were made separately for general practice outpatient consultations and hospitalised patients, stratified by age group and by influenza type and subtype. Vaccine status was confirmed by electronic record for general practice patients and all respiratory viruses were detected by real time polymerase chain reaction. RESULTS: 1039 hospitalised and 1154 general practice outpatient consultations met all the study inclusion criteria and had a respiratory sample tested for influenza and other respiratory viruses. Compared to general practice patients, hospitalised patients were more likely to be very young or very old, to be Maori or Pacific Islander, to have a low income and to suffer from chronic disease. Vaccine effectiveness (VE) adjusted for age and other participant characteristics using all influenza negative controls was 42% (95% CI: 16 to 60%) for hospitalised and 56% (95% CI: 35 to 70%) for general practice patients. The vaccine appeared to be most effective against the influenza A(H1N1)pdm09 strain with an adjusted VE of 62% (95% CI:38 to 77%) for hospitalised and 59% (95% CI:36 to 74%) for general practice patients, using influenza virus negative controls. Similar results found when patients testing positive for a non-influenza respiratory virus were used as the control group. CONCLUSION: This study contributes to validation of the test negative design and confirms that inactivated influenza vaccines continue to provide modest but significant protection against laboratory-confirmed influenza. |
Interim estimates of the effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2014
Turner N , Pierse N , Huang Q , Radke S , Bissielo A , Thompson M , Kelly H . Euro Surveill 2014 19 (42) We present preliminary results of influenza vaccine effectiveness (VE) in New Zealand using a case test-negative design for 28 April to 31 August 2014. VE adjusted for age and time of admission among all ages against severe acute respiratory illness hospital presentation due to laboratory-confirmed influenza was 54% (95% CI: 19 to 74) and specifically against A(H1N1)pdm09 was 65% (95% CI:33 to 81). For influenza-confirmed primary care visits, VE was 67% (95% CI: 48 to 79) overall and 73% (95% CI: 50 to 85) against A(H1N1)pdm09. |
Estimating contact rates at a mass gathering by using video analysis: a proof-of-concept project
Rainey JJ , Cheriyadat A , Radke RJ , Crumly JS , Koch DB . BMC Public Health 2014 14 1101 BACKGROUND: Current approaches for estimating social mixing patterns and infectious disease transmission at mass gatherings have been limited by various constraints, including low participation rates for volunteer-based research projects and challenges in quantifying spatially and temporally accurate person-to-person interactions. We developed a proof-of-concept project to assess the use of automated video analysis for estimating contact rates of attendees of the GameFest 2013 event at Rensselaer Polytechnic Institute (RPI) in Troy, New York. METHODS: Video tracking and analysis algorithms were used to estimate the number and duration of contacts for 5 attendees during a 3-minute clip from the RPI video. Attendees were considered to have a contact event if the distance between them and another person was ≤1 meter. Contact duration was estimated in seconds. We also simulated 50 attendees assuming random mixing using a geo-spatially accurate representation of the same GameFest location. RESULTS: The 5 attendees had an overall median of 2 contact events during the 3-minute video clip (range: 0-6). Contact events varied from less than 5 seconds to the full duration of the 3-minute clip. The random mixing simulation was visualized and presented as a contrasting example. CONCLUSION: We were able to estimate the number and duration of contacts for 5 GameFest attendees from a 3-minute video clip that can be compared to a random mixing simulation model at the same location. The next phase will involve scaling the system for simultaneous analysis of mixing patterns from hours-long videos and comparing our results with other approaches for collecting contact data from mass gathering attendees. |
Effectiveness of seasonal trivalent inactivated influenza vaccine in preventing influenza hospitalisations and primary care visits in Auckland, New Zealand, in 2013
Turner N , Pierse N , Bissielo A , Huang Q , Radke S , Baker M , Widdowson M , Kelly H . Euro Surveill 2014 19 (34) This study reports the first vaccine effectiveness (VE) estimates for the prevention of general practice visits and hospitalisations for laboratory-confirmed influenza from an urban population in Auckland, New Zealand, in the same influenza season (2013). A case test-negative design was used to estimate propensity-adjusted VE in both hospital and community settings. Patients with a severe acute respiratory infection (SARI) or influenza-like illness (ILI) were defined as requiring hospitalisation (SARI) or attending a general practice (ILI) with a history of fever or measured temperature >/=38 degrees C, cough and onset within the past 10 days. Those who tested positive for influenza virus were cases while those who tested negative were controls. Results were analysed to 7 days post symptom onset and adjusted for the propensity to be vaccinated and the timing during the influenza season. Influenza vaccination provided 52% (95% CI: 32 to 66) protection against laboratory-confirmed influenza hospitalisation and 56% (95% CI: 34 to 70) against presenting to general practice with influenza. VE estimates were similar for all types and subtypes. This study found moderate effectiveness of influenza vaccine against medically attended and hospitalised influenza in New Zealand, a temperate, southern hemisphere country during the 2013 winter season. |
Dengue outbreak in Key West, Florida, USA, 2009
Radke EG , Gregory CJ , Kintziger KW , Sauber-Schatz EK , Hunsperger EA , Gallagher GR , Barber JM , Biggerstaff BJ , Stanek DR , Tomashek KM , Blackmore CG . Emerg Infect Dis 2012 18 (1) 135-7 After 3 dengue cases were acquired in Key West, Florida, we conducted a serosurvey to determine the scope of the outbreak. Thirteen residents showed recent infection (infection rate 5%; 90% CI 2%-8%), demonstrating the reemergence of dengue in Florida. Increased awareness of dengue among health care providers is needed. |
Tomato handling practices in restaurants
Kirkland E , Green LR , Stone C , Reimann D , Nicholas D , Mason R , Frick R , Coleman S , Bushnell L , Blade H , Radke V , Selman C , EHS-Net Working Group . J Food Prot 2009 72 (8) 1692-8 In recent years, multiple outbreaks of Salmonella infection have been associated with fresh tomatoes. Investigations have indicated that tomato contamination likely occurred early in the farm-to-consumer chain, although tomato consumption occurred mostly in restaurants. Researchers have hypothesized that tomato handling practices in restaurants may contribute to these outbreaks. However, few empirical data exist on how restaurant workers handle tomatoes. This study was conducted to examine tomato handling practices in restaurants. Members of the Environmental Health Specialists Network (EHS-Net) observed tomato handling practices in 449 restaurants. The data indicated that handling tomatoes appropriately posed a challenge to many restaurants. Produce-only cutting boards were not used on 49% of tomato cutting observations, and gloves were not worn in 36% of tomato cutting observations. Although tomatoes were washed under running water as recommended in most (82%) of the washing observations, tomatoes were soaked in standing water, a practice not recommended by the U.S. Food and Drug Administration (FDA), in 18% of observations, and the temperature differential between the wash water and tomatoes did not meet FDA guidelines in 21% of observations. About half of all batches of cut tomatoes in holding areas were above 41 degrees F (5 degrees C), the temperature recommended by the FDA. The maximum holding time for most (73%) of the cut tomatoes held above 41 degrees F exceeded the FDA recommended holding time of 4 h for unrefrigerated tomatoes (i.e., tomatoes held above 41 degrees F). The information provided by this study can be used to inform efforts to develop interventions and thus prevent tomato-associated illness outbreaks. |
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