A5061070012- Antibiotic Use and Resistance
- Patient Satisfaction in Healthcare
- Research on Leishmaniasis Studies
- Antibiotics Pharmacokinetics and Efficacy
- Healthcare Policy and Management
- Emergency and Acute Care Studies
- Adolescent and Pediatric Healthcare
- Central Venous Catheters and Hemodialysis
- Trypanosoma species research and implications
- Child and Adolescent Health
- Pneumonia and Respiratory Infections
- Pharmaceutical studies and practices
- Healthcare cost, quality, practices
- Health Systems, Economic Evaluations, Quality of Life
- Nosocomial Infections in ICU
- Hematological disorders and diagnostics
- HIV/AIDS Research and Interventions
- Sepsis Diagnosis and Treatment
- Childhood Cancer Survivors' Quality of Life
- Thermal Regulation in Medicine
- Breastfeeding Practices and Influences
- Infant Development and Preterm Care
- Respiratory and Cough-Related Research
- Gestational Diabetes Research and Management
- Food Security and Health in Diverse Populations
Doernbecher Children's Hospital
2015-2025
Oregon Health & Science University
2015-2023
Oregon Medical Research Center
2020
London North West Healthcare NHS Trust
2017
Engineering Associates (United States)
2015
Iowa City Public Library
2015
New York Proton Center
2015
Harvard Pilgrim Health Care
2014
Harvard University
2014
Boston Children's Hospital
2014
Abstract Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over 3-year period in Bangladeshi community. By history, active case detection, and serologic screening, 155 2,356 residents had with onset from 2000 to 2003. Risk was highest persons 3–45 years age, no significant difference by sex seen. In age-adjusted multivariable models, 3 were identified: proximity previous...
OBJECTIVE: The goal of this study was to determine changes in antibiotic-dispensing rates among children 3 health plans located New England [A], the Mountain West [B], and Midwest [C] regions United States. METHODS: Pharmacy outpatient claims from September 2000 August 2010 were used calculate antibiotic dispensing per person-year for aged months 18 years. Differences by year, diagnosis, plan tested using Poisson regression. data analyzed whether there a change rate decline over time....
We examined the epidemiology of kala-azar and asymptomatic leishmanial infection measured by serologic leishmanin skin test results in a Bangladeshi community. In subset, we serum retinol, zinc C-reactive protein (CRP). Kala-azar seroconversion incidence were 15.6 63.1 per 1,000 person-years, respectively. Proximity to previous case increased likelihood both infection. Bed net use protected against (rate ratio = 0.35, P < 0.01), but not subclinical 1.1, 0.82). patients younger (P 0.001)...
BACKGROUND: Health care–associated infections (HAIs) are harmful and costly can result in substantial morbidity for hospitalized children; however, little is known about national trends HAIs neonatal pediatric populations. Our objective was to determine the incidence of among a large sample hospitals United States caring critically ill children from 2007 2012. METHODS: In this cohort study, we included NICUs PICUs located reporting data Centers Disease Control Prevention’s National...
Children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are generally asymptomatic or have mild symptoms low rates of hospitalization (<2%) and death (<0.03%).1 After initial infection, some children, including those who experienced disease, develop other postacute manifestations COVID, multisystem inflammatory in children (MIS-C, not discussed this statement) sequelae SARS-CoV-2 infection. The latter post-COVID condition may be known as long long-haul COVID-19,...
BACKGROUND: Differences in antibiotic knowledge and attitudes between parents of Medicaid-insured commercially insured children have been previously reported. It is unknown whether understanding has improved identified differences persist. METHODS: A total 1500 Massachusetts with a child &lt;6 years old by Medicaid managed care or commercial health plan were surveyed spring 2013. We examined antibiotic-related using χ2 tests. Multivariable modeling was used to assess current...
Abstract Background Over 85% of antibiotic prescribing occurs in outpatient settings such as emergency departments (ED), urgent care centers (UCC), and primary clinics (PCC); almost half antibiotics are prescribed for respiratory infections (RI). Given the rise telehealth visits (TH) both UCC PCC past several years, this study examines effect location sites on RI at our institution. Methods Single-center, retrospective cohort Portland, Oregon, USA. Patients &lt; = 20 years age seen ED,...
OBJECTIVES: Although health systems are increasingly moving toward addressing social determinants of health, risk screening for hospitalized children is largely unexplored. We sought to determine if inpatient was feasible and describe the prevalence among caregivers, with special attention given chronic conditions. METHODS: Caregivers pediatric patients on hospitalist service at a children’s hospital in Pacific Northwest completed survey 2017. This used capture items related caregiver...
Annual leishmanin skin test (LST) surveys were conducted in a visceral leishmaniasis-endemic Bangladeshi community from 2002 through 2004, using Leishmania infantum antigen the same manufacturer and batch. In 2002, 530 (35%) of 1,532 had positive LST results; prevalence increased with increasing age. The result was 24 (51%) 47, 18 (72%) 25, 11 (85%) 13 kala-azar patients treated previous 1-11, 12-23, 24-35 months. A associated protection against subsequent (P < 0.0001). 2003-2004, decreased...
BACKGROUND Policymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals. OBJECTIVE To determine whether the 2008 Centers Medicare Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in compared with non–safety DESIGN Interrupted time-series design. SETTING AND PARTICIPANTS Nonfederal acute hospitals that reported central...
BACKGROUND The 2008 Centers for Medicare & Medicaid Services hospital-acquired conditions policy limited additional payment deemed reasonably preventable. OBJECTIVE To examine whether this was associated with decreases in billing rates 2 targeted conditions, vascular catheter-associated infections (VCAI) and urinary tract (CAUTI). STUDY POPULATION Adult patients admitted to 569 acute care hospitals California, Massachusetts, or New York subject the policy. DESIGN We used an interrupted...
ABSTRACT Several serology-based immunoassays are used to diagnose visceral leishmaniasis (VL), a chronic protozoan parasitic disease caused by the Leishmania donovani complex. These tests primarily designed most severe clinical form of VL, known as kala-azar. However, leishmanial infection is frequently asymptomatic and may manifest only positive serologic response or leishmanin skin test. We modified previously described enzyme-linked immunosorbent assay (ELISA) that detects patient...
Outpatient parenteral antimicrobial therapy (OPAT) is an effective way of treating infections, but complications are common. We identified patient characteristics and OPAT treatment factors associated with increased risk OPAT-related complications.We used a retrospective cohort design that assessed 337 adult patients treated for orthopedic neurosurgical infections between August 1, 2008 May 30, 2010. Independent variables included demographics, infection characteristics, lead time factors,...
BACKGROUND AND OBJECTIVES: The 30-day readmission rate is a common quality metric used by Medicare for adult patients. However, studies in pediatrics have shown lower rates and potentially less preventability. Therefore, some question the utility of time frame pediatrics. Our objective was to describe characteristics patients readmitted within 30 days discharge over 1-year period determine preventability readmissions occurring 0 7 vs 8 after from pediatric hospitalist service at an academic...
Outpatient parenteral or prolonged oral antibiotic therapy (OPAT) programs reduce inpatient healthcare costs by shifting care to outpatient settings. Care coordination (CC) is a necessary component successfully transition patients. Our objective was assess outcomes of provider time spent on nonreimbursable CC activities in pediatric OPAT program. We used qualitative feasibility pilot design and modified the Coordination Measurement Tool. captured activity associated outcome(s) among patients...
Background: Haiti is a country with heavy burden of HIV infection in childbearing women. Previous studies have shown that early infant deaths are common children HIV-infected This study was designed to define the rates and risk factors for systemic bacterial mycobacterial such identify causative agents. Methods: A cohort 120 born mothers between May 2001 December 2003 were prospectively observed 15 months age. They received comprehensive pediatric care at GHESKIO Centers. Children assigned...
Abstract In October 2008, Medicare ceased additional payment for hospital-acquired conditions not present on admission. We evaluated the policy’s differential impact in hospitals with high vs low operating margins. Medicare’s policy may have had an reducing central line–associated bloodstream infections Infect. Control Hosp. Epidemiol. 2015;37(1):100–103
BACKGROUND There are limited qualitative data describing general pediatric hospitalizations through the caregivers’ lens, and most focus on one particular challenge or time during hospitalization. This study aimed to address a gap in description of breadth depth personal challenges caregivers may face entire hospitalization, irrespective severity patient illness diagnosis, explored caregiver-suggested interventions. METHODS Caregivers patients hospitalist service at Pacific Northwest...
Abstract Objective Certain social risk factors (e.g., housing instability, food insecurity) have been shown to directly and indirectly influence pediatric health outcomes; however, there is limited understanding of which are most salient for children admitted the hospital. This study examines how caregiver-reported medical characteristics experiencing an inpatient admission associated with presence future complications. Methods Caregivers (N = 249) completed a predischarge questionnaire...
We conducted a national survey of pediatric infectious diseases (ID) clinicians on outpatient parenteral antibiotic therapy (OPAT) practices and post-discharge ID follow-up. Only 15% sites required consultation for all OPAT. division resources care varied. Opportunities exist to increase involvement in management serious infections.