Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Stinson D[original query] |
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School connectedness and risk behaviors and experiences among high school students - Youth Risk Behavior Survey, United States, 2021
Wilkins NJ , Krause KH , Verlenden JV , Szucs LE , Ussery EN , Allen CT , Stinson J , Michael SL , Ethier KA . MMWR Suppl 2023 72 (1) 13-21 School connectedness, defined as students' belief that adults and peers in their school care about their learning as well as about them as persons, has been linked to positive educational, behavioral, and health outcomes in adolescence and into adulthood. Data from the 2021 nationally representative Youth Risk Behavior Survey, conducted during the COVID-19 pandemic, were used to estimate prevalence of students' perception of school connectedness and examine associations between school connectedness and seven risk behaviors and experiences: poor mental health, marijuana use, prescription opioid misuse, sexual intercourse, unprotected sex, experiencing forced sex, and missing school because of feeling unsafe. Prevalence estimates were generated and pairwise t-tests were used to detect differences among student subpopulations by sex, grade, race and ethnicity, and sexual identity; Wald chi-square tests were used to detect differences in risk behaviors by level of connectedness within a subpopulation. Logistic regression models were used to estimate prevalence ratios comparing the prevalence of risk behaviors and experiences of students with high connectedness with students with low connectedness, stratified by demographics. During 2021, 61.5% of U.S. high school students reported feeling connected to others at school. In addition, school connectedness was associated with lower prevalence of every risk behavior and experience examined in this study, although certain associations differed by race and ethnicity and sexual identity (e.g., school connectedness was associated with better mental health outcomes for youths with heterosexual, bisexual, and questioning or other sexual identities, but not for youths who identified as lesbian or gay). These findings can guide public health interventions that promote youth well-being by creating school environments where all youths have a sense of belonging and feel they are cared for and supported. |
The increasing utility of school health data to guide evidence-based interventions
Smith Grant J , Pierre K , Stinson J , Thornton J , Mpofu JJ , Rasberry CN , Sims VM , Underwood JM . J Sch Health 2022 92 (12) 1214-1216 The Centers for Disease Control and Prevention's (CDC) Division of Adolescent and School Health (DASH) works with local decision makers, schools, youth-serving organizations, and parents across the nation to equip youth with knowledge, skills, and resources needed for healthy adolescence and adulthood. Aligned with this effort, DASH maintains high-quality surveillance systems to understand youth health behaviors and assess school health programs and policies. The Youth Risk Behavior Surveillance System (YRBSS) is a system of surveys administered every other year to high school students. In addition to the national Youth Risk Behavior Survey conducted by CDC, YRBSS features Youth Risk Behavior Surveys (YRBS) conducted by state, territorial, and local education and health agencies and tribal governments across the nation.1 Local decision makers collaborate with partners to develop questionnaires for their respective YRBS, then coordinate data dissemination and utilization. Since its inception in 1991, YRBSS has collected data from more than 5 million high school students in approximately 2200 separate surveys across the United States.1 The School Health Profiles (Profiles) is a system of surveys conducted by state, territorial, and local education and health agencies and tribal governments. These surveys collect data every other year from principals and lead health education teachers to assess school-implemented health programs and policies.2 Since 1994, Profiles data have helped evaluate health programs and informed professional development needs for educators in middle and high schools.2 Together, YRBSS and Profiles offer metrics to inform public health needs, which are then translated into evidence-based programs to protect youth. |
Thin silk fibroin films as a dried format for temperature stabilization of inactivated polio vaccine
Stinson JA , Palmer CR , Miller DP , Li AB , Lightner K , Jost H , Weldon WC , Oberste MS , Kluge JA , Kosuda KM . Vaccine 2020 38 (7) 1652-1660 Current inactivated polio vaccine (IPV) products are sensitive to both freezing and elevated temperatures and therefore must be shipped and stored between 2 degrees C and 8 degrees C, a requirement that imposes financial and logistical challenges for global distribution. As such, there is a critical need for a robust, thermally stable IPV to support global polio eradication and post-eradication immunization needs. Here, we present the development of air-dried thin films for temperature stabilization of IPV using the biomaterial silk fibroin. Thin-film product compositions were optimized for physical properties as well as poliovirus D-antigen recovery and were tested under accelerated and real-time stability storage conditions. Silk fibroin IPV films maintained 70% D-antigen potency after storage for nearly three years at room temperature, and greater than 50% potency for IPV-2 and IPV-3 serotypes at 45 degrees C for one year. The immunogenicity of silk fibroin IPV films after 2-week storage at 45 degrees C was assessed in Wistar rats and the stressed films generated equivalent neutralizing antibody responses to commercial vaccine for IPV-1 and IPV-2. However, the absence of IPV-3 responses warrants further investigation into the specificity of ELISA for intact IPV-3 D-antigen. By demonstrating immunogenicity post-storage, we offer the air-dried silk film format as a means to increase IPV vaccine access through innovative delivery systems such as microneedles. |
Hepatitis C Virus Potentially Transmitted by Opioid Drug Diversion from a Nurse - Washington, August 2017-March 2018.
Njuguna HN , Stinson D , Montgomery P , Turner N , D'Angeli M , Carr J , Podczervinski S , Wasserman C , Ramachandran S , Lucas T , Bixler D , Perkins K , Benowitz I , Moorman A . MMWR Morb Mortal Wkly Rep 2019 68 (16) 374-376 During January 22-March 23, 2018, a local health department in Washington was notified of two patients who received a diagnosis of acute hepatitis C virus (HCV) infection. Neither patient had behavioral risk factors associated with HCV acquisition; however, both had received injectable narcotic (opioid) drugs from the same nurse during separate visits to an emergency department (ED) at a local hospital on December 6 and December 16, 2017. Investigation revealed that the nurse had accessed the automated drug dispensing system at a higher frequency than had other staff members, admitted diverting* patients' injectable narcotic and antihistamine drugs for personal use, and tested positive for HCV antibodies (anti-HCV) on March 19, 2018, but did not have quantifiable HCV RNA. Specimens from both patients were sent to CDC for genetic testing, and HCV viral variants analysis found a significant level of genetically similar HCV variants in both patients, indicating a common source of infection. Further investigation was conducted to confirm the infection source, identify other potentially exposed patients, and treat any new patients who received an HCV diagnosis. Monitoring frequency of access to drug dispensing systems can help identify staff members with abnormal dispensing patterns, including diversion activities (1). U.S. health care facilities are required to prevent, identify, and report any loss, diversion, or theft of controlled substances (2). |
Public health economic burden associated with two single measles case investigations - Colorado, 2016-2017
Marx GE , Chase J , Jasperse J , Stinson K , McDonald CE , Runfola JK , Jaskunas J , Hite D , Barnes M , Askenazi M , Albanese B . MMWR Morb Mortal Wkly Rep 2017 66 (46) 1272-1275 During July 2016-January 2017, two unrelated measles cases were identified in the Denver, Colorado area after patients traveled to countries with endemic measles transmission. Each case resulted in multiple exposures at health care facilities and public venues, and activated an immediate and complex response by local and state public health agencies, with activities led by the Tri-County Health Department (TCHD), which serves Adams, Arapahoe, and Douglas counties. To track the economic burden associated with investigating and responding to single measles cases, personnel hours and supply costs incurred during each investigation were tracked prospectively. No secondary cases of measles were identified in either investigation. Postexposure prophylaxis (PEP) was administered to 31 contacts involving the first case; no contacts of the second case were eligible for PEP because of a delay in diagnosing measles disease. Public health costs of disease investigation in the first and second case were estimated at $49,769 and $18,423, respectively. Single measles cases prompted coordinated public health action and were costly and resource-intensive for local public health agencies. |
Changes in estimated glomerular filtration rate over time in South African HIV-1-infected patients receiving tenofovir: a retrospective cohort study
De Waal R , Cohen K , Fox MP , Stinson K , Maartens G , Boulle A , Igumbor EU , Davies MA . J Int AIDS Soc 2017 20 (1) 1-8 INTRODUCTION: Tenofovir has been associated with decline in kidney function, but in patients with low baseline kidney function, improvements over time have been reported. Additionally, the magnitude and trajectory of estimated glomerular filtration rate (eGFR) changes may differ according to how eGFR is calculated. We described changes in eGFR over time, and the incidence of, and risk factors for, kidney toxicity, in a South African cohort. METHODS: We included antiretroviral-naive patients ≥16 years old who started tenofovir-containing antiretroviral therapy (ART) between 2002 and 2013. We calculated eGFR using the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Cockcroft-Gault equations. We described changes in eGFR from ART initiation using linear mixed effects regression. We described the incidence of eGFR <30 mL/min on treatment, and identified associations with low eGFR using Cox regression. RESULTS: We included 15156 patients with median age of 35.4 years (IQR 29.9-42.0), median CD4 cell count of 168 cells/microL (IQR 83-243), and median eGFR (MDRD) of 98.6 mL/min (IQR 84.4-115.6). Median duration of follow up on tenofovir was 12.9 months (IQR 5.1-23.3). Amongst those with a baseline and subsequent eGFR available, mean eGFR change from baseline at 12 months was -4.4 mL/min (95% CI -4.9 to -4.0), -2.3 (-2.5 to -2.1), and 0.6 (0.04 to 1.2) in those with baseline eGFR ≥90 mL/min; and 11.9 mL/min (11.0 to 12.7), 14.6 (13.5 to 15.7), and 11.0 (10.3 to 11.7), in those with baseline eGFR <90 mL/min, according to the MDRD, CKD-EPI (n = 11 112), and Cockcroft-Gault (n = 9 283) equations, respectively. Overall, 292 (1.9%) patients developed eGFR <30 mL/min. Significant associations with low eGFR included older age, baseline eGFR <60 mL/min, CD4 count <200 cells/microL, body weight <60 kg, and concomitant protease inhibitor use. CONCLUSION: Patients on tenofovir with baseline eGFR ≥90 mL/min experienced small but significant declines in eGFR over time when eGFR was estimated using the MDRD or CKD-EPI equations. However, eGFR increased in patients with eGFR <90 mL/min, regardless of which estimating equation was used. Decreases to below 30 mL/min were uncommon. In settings with limited access to laboratory testing, monitoring guidelines should consider focusing on higher risk patients. |
First-line antiretroviral drug discontinuations in children
Fortuin-de Smidt M , de Waal R , Cohen K , Technau KG , Stinson K , Maartens G , Boulle A , Igumbor EU , Davies MA . PLoS One 2017 12 (2) e0169762 INTRODUCTION: There are a limited number of paediatric antiretroviral drug options. Characterising the long term safety and durability of different antiretrovirals in children is important to optimise management of HIV infected children and to determine the estimated need for alternative drugs in paediatric regimens. We describe first-line antiretroviral therapy (ART) durability and reasons for discontinuations in children at two South African ART programmes, where lopinavir/ritonavir has been recommended for children <3 years old since 2004, and abacavir replaced stavudine as the preferred nucleoside reverse transcriptase inhibitor in 2010. METHODS: We included children (<16 years at ART initiation) who initiated ≥3 antiretrovirals between 2004-2014 with ≥1 follow-up visit on ART. We estimated the incidence of first antiretroviral discontinuation using Kaplan-Meier analysis. We determined the reasons for antiretroviral discontinuations using competing risks analysis. We used Cox regression to identify factors associated with treatment-limiting toxicity. RESULTS: We included 3579 children with median follow-up duration of 41 months (IQR 14-72). At ART initiation, median age was 44 months (IQR 13-89) and median CD4 percent was 15% (IQR 9-21%). At three and five years on ART, 72% and 26% of children respectively remained on their initial regimen. By five years on ART, the most common reasons for discontinuations were toxicity (32%), treatment failure (18%), treatment simplification (5%), drug interactions (3%), and other or unspecified reasons (18%). The incidences of treatment limiting toxicity were 50.6 (95% CI 46.2-55.4), 1.6 (0.5-4.8), 2.0 (1.2-3.3), and 1.3 (0.6-2.8) per 1000 patient years for stavudine, abacavir, efavirenz and lopinavir/ritonavir respectively. CONCLUSIONS: While stavudine was associated with a high risk of treatment-limiting toxicity, abacavir, lopinavir/ritonavir and efavirenz were well-tolerated. This supports the World Health Organization recommendation to replace stavudine with abacavir or zidovudine in paediatric first-line ART regimens in order to improve paediatric first-line ART durability. |
Notes from the Field: Hantavirus pulmonary syndrome in a migrant farm worker - Colorado, 2016
Marx G , Stinson K , Deatrich M , Albanese B . MMWR Morb Mortal Wkly Rep 2017 66 (2) 62-63 On August 8, 2016, Tri-County Health Department (Adams, Arapahoe, and Douglas counties) in Colorado was notified of a confirmed case of hantavirus pulmonary syndrome (HPS). The patient was a previously healthy male migrant farm worker aged 25 years, living in farm quarters, and working in vegetable fields for 8 weeks before symptom onset. On July 20, he experienced sudden onset of fever, severe headache, myalgias, cough, and nosebleed. He was evaluated at an emergency department on July 23, where his temperature was 103.9 degrees F (40.0 degrees C), and his physical exam was notable for bronchial breath sounds and pulmonary crackles. Chest radiograph revealed bilateral interstitial infiltrates and small pleural effusions, and thrombocytopenia (47,000/muL) was a noted laboratory finding. The patient was hospitalized for 3 days, required minimal oxygen and supportive care, and survived. Serology obtained on hospital admission was positive for hantavirus immunoglobulin M (IgM) and immunoglobulin G antibodies, with a positive result for Sin Nombre virus (SNV) (the primary etiologic agent of HPS in the United States) IgM at 1:6400, consistent with acute infection. |
Validation of an HPLC-MS/MS and wipe procedure for mitomycin C contamination
B'Hymer C , Connor T , Stinson D , Pretty J . J Chromatogr Sci 2014 53 (4) 619-24 A high-performance liquid chromatography-tandem mass spectrometric (HPLC-MS/MS) method was developed for the determination of mitomycin C, an anticancer drug, from contamination on various surfaces. Mitomycin C is often used in various forms of intraperitoneal chemotherapy, and operating room healthcare worker exposure to this drug is possible. The surface testing method consisted of a wiping procedure utilizing a solution of 20/45/35 (v/v/v) of acetonitrile-isopropanol-water made 0.01 M in ammonium citrate (apparent pH 7.0). The wipe solutions were analyzed by means of HPLC-MS/MS using a reversed-phase gradient system and electrospray ionization in positive ion mode with a triple-quadrupole MS detector. Accuracy and precision of this method were demonstrated by a series of recovery studies of both spiked solutions and extracted wipes from various surfaces (stainless steel, vinyl and Formica(R)) spiked with known levels of mitomycin C. Recoveries of spiked solutions containing the analyte demonstrate mean recoveries (accuracy) ranged from 93 to 105%. Precision as measured by the relative standard deviation (% RSD) of multiple samples (n= 10) at each concentration level demonstrated values of 7.5% or less. The recoveries from spiked surfaces varied from 30 to 99%. The limit of detection for this methodology is approximately 2 ng/100 cm2 equivalent surface area, and the limit of quantitation is approximately 6 ng/100 cm2. |
Health facility characteristics and their relationship to coverage of PMTCT of HIV services across four African countries: the PEARL Study
Ekouevi DK , Stringer E , Coetzee D , Tih P , Creek T , Stinson K , Westfall AO , Welty T , Chintu N , Chi BH , Wilfert C , Shaffer N , Stringer J , Dabis F . PLoS One 2012 7 (1) e29823 BACKGROUND: Health facility characteristics associated with effective prevention of mother-to-child transmission of HIV (PMTCT) coverage in sub-Saharan are poorly understood. METHODOLOGY/PRINCIPAL FINDINGS: We conducted surveys in health facilities with active PMTCT services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. Data was compiled via direct observation and exit interviews. We constructed composite scores to describe provision of PMTCT services across seven topical areas: antenatal quality, PMTCT quality, supplies available, patient satisfaction, patient understanding of medication, and infrastructure quality. Pearson correlations and Generalized Estimating Equations (GEE) to account for clustering of facilities within countries were used to evaluate the relationship between the composite scores, total time of visit and select individual variables with PMTCT coverage among women delivering. Between July 2008 and May 2009, we collected data from 32 facilities; 78% were managed by the government health system. An opt-out approach for HIV testing was used in 100% of facilities in Zambia, 63% in Cameroon, and none in Cote d'Ivoire or South Africa. Using Pearson correlations, PMTCT coverage (median of 55%, (IQR: 33-68) was correlated with PMTCT quality score (rho = 0.51; p = 0.003); infrastructure quality score (rho = 0.43; p = 0.017); time spent at clinic (rho = 0.47; p = 0.013); patient understanding of medications score (rho = 0.51; p = 0.006); and patient satisfaction quality score (rho = 0.38; p = 0.031). PMTCT coverage was marginally correlated with the antenatal quality score (rho = 0.304; p = 0.091). Using GEE adjustment for clustering, the, antenatal quality score became more strongly associated with PMTCT coverage (p<0.001) and the PMTCT quality score and patient understanding of medications remained marginally significant. CONCLUSIONS/RESULTS: We observed a positive relationship between an antenatal quality score and PMTCT coverage but did not identify a consistent set of variables that predicted PMTCT coverage. |
Coverage of nevirapine-based services to prevent mother-to-child HIV transmission in 4 African countries
Stringer EM , Ekouevi DK , Coetzee D , Tih PM , Creek TL , Stinson K , Giganti MJ , Welty TK , Chintu N , Chi BH , Wilfert CM , Shaffer N , Dabis F , Stringer JS . JAMA 2010 304 (3) 293-302 CONTEXT: Few studies have objectively evaluated the coverage of services to prevent transmission of human immunodeficiency virus (HIV) from mother to child. OBJECTIVE: To measure the coverage of services to prevent mother-to-child HIV transmission in 4 African countries. DESIGN, SETTING, AND PATIENTS: Cross-sectional surveillance study of mother-infant pairs using umbilical cord blood samples collected between June 10, 2007, and October 30, 2008, from 43 randomly selected facilities (grouped as 25 service clusters) providing delivery services in Cameroon, Cote d'Ivoire, South Africa, and Zambia. All sites used at least single-dose nevirapine to prevent mother-to-child HIV transmission and some sites used additional prophylaxis drugs. MAIN OUTCOME MEASURE: Population nevirapine coverage, defined as the proportion of HIV-exposed infants in the sample with both maternal nevirapine ingestion (confirmed by cord blood chromatography) and infant nevirapine ingestion (confirmed by direct observation). RESULTS: A total of 27,893 cord blood specimens were tested, of which 3324 were HIV seropositive (12%). Complete data for cord blood nevirapine results were available on 3196 HIV-seropositive mother-infant pairs. Nevirapine coverage varied significantly by site (range: 0%-82%). Adjusted for country, the overall coverage estimate was 51% (95% confidence interval [CI], 49%-53%). In multivariable analysis, failed coverage of nevirapine-based services was significantly associated with maternal age younger than 20 years (adjusted odds ratio [AOR], 1.44; 95% CI, 1.18-1.76) and maternal age between 20 and 25 years (AOR, 1.28; 95% CI, 1.07-1.54) vs maternal age of older than 30 years; 1 or fewer antenatal care visits (AOR, 2.91; 95% CI, 2.40-3.54), 2 or 3 antenatal care visits (AOR, 1.93; 95% CI, 1.60-2.33), and 4 or 5 antenatal care visits (AOR, 1.56; 95% CI, 1.34-1.80) vs 6 or more antenatal care visits; vaginal delivery (AOR, 1.22; 95% CI, 1.03-1.44) vs cesarean delivery; and infant birth weight of less than 2500 g (AOR, 1.34; 95% CI, 1.11-1.62) vs birth weight of 3500 g or greater. CONCLUSION: In this random sampling of sites with services to prevent mother-to-child HIV transmission, only 51% of HIV-exposed infants received the minimal regimen of single-dose nevirapine. |
Concomitant administration of recombinant PsaA and PCV7 reduces Streptococcus pneumoniae serotype 19A colonization in a murine model
Whaley MJ , Sampson JS , Johnson SE , Rajam G , Stinson-Parks A , Holder P , Mauro E , Romero-Steiner S , Carlone GM , Ades EW . Vaccine 2010 28 (18) 3071-5 A murine colonization model was used to determine the effect of co-administering 7-valent polysaccharide-protein conjugate vaccine and pneumococcal surface adhesin A. Mice were challenged intranasally with either PCV7 serotypes, 4 or 14, or a non-PCV7 serotype, 19A. Post-challenge samples were evaluated for IgG antibody levels, opsonophagocytic activity, and nasopharyngeal colonization. No interference was observed between immune responses from the concomitant and individual immunizations. Concomitant immunizations reduced carriage for tested serotypes; largest reduction was observed for 19A. From these mouse studies, co-administering pneumococcal antigens appear to expand coverage and reduce colonization against a non-PCV7 serotype without inhibiting immunogenicity to other serotypes. |
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