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Search Results: 1 - 10 of 4645 matches for " Catherine Staes "
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Predicting the start week of respiratory syncytial virus outbreaks using real time weather variables
Nephi A Walton, Mollie R Poynton, Per H Gesteland, Chris Maloney, Catherine Staes, Julio C Facelli
BMC Medical Informatics and Decision Making , 2010, DOI: 10.1186/1472-6947-10-68
Abstract: Na?ve Bayes (NB) classifier models were constructed using weather data from 1985-2008 considering only variables that are available in real time and that could be used to forecast the week in which an RSV outbreak will occur in Salt Lake County, Utah. Outbreak start dates were determined by a panel of experts using 32,509 records with ICD-9 coded RSV and bronchiolitis diagnoses from Intermountain Healthcare hospitals and clinics for the RSV seasons from 1985 to 2008.NB models predicted RSV outbreaks up to 3 weeks in advance with an estimated sensitivity of up to 67% and estimated specificities as high as 94% to 100%. Temperature and wind speed were the best overall predictors, but other weather variables also showed relevance depending on how far in advance the predictions were made. The weather conditions predictive of an RSV outbreak in our study were similar to those that lead to temperature inversions in the Salt Lake Valley.We demonstrate that Na?ve Bayes (NB) classifier models based on weather data available in real time have the potential to be used as effective predictive models. These models may be able to predict the week that an RSV outbreak will occur with clinical relevance. Their clinical usefulness will be field tested during the next five years.Bronchiolitis is a major cause of hospital admissions during the winter and can cause severe hospital overcrowding. Respiratory syncytial virus (RSV) is a respiratory virus that can cause severe infection in infants and young children and is the leading cause of bronchiolitis in children under one year of age in the United States [1-4]. RSV outbreaks cause a significant increase in hospital admissions during the winter season [2]. The ability to predict the start date of an RSV outbreak using readily available data may allow for the implementation of management strategies in a more timely, effective, and efficient fashion. Some possible improvements may include: improved staff scheduling, improved rescheduling
Identification of pneumonia and influenza deaths using the death certificate pipeline
Kailah Davis, Catherine Staes, Jeff Duncan, Sean Igo, Julio C Facelli
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-37
Abstract: A Death Certificates Pipeline (DCP) was developed to automatically code death certificates and identify pneumonia and influenza cases. The pipeline used MetaMap to code death certificates from the Utah Department of Health for the year 2008. The output of MetaMap was then accessed by detection rules which flagged pneumonia and influenza cases based on the Centers of Disease and Control and Prevention (CDC) case definition. The output from the DCP was compared with the current method used by the CDC and with a keyword search. Recall, precision, positive predictive value and F-measure with respect to the CDC method were calculated for the two other methods considered here. The two different techniques compared here with the CDC method showed the following recall/ precision results: DCP: 0.998/0.98 and keyword searching: 0.96/0.96. The F-measure were 0.99 and 0.96 respectively (DCP and keyword searching). Both the keyword and the DCP can run in interactive form with modest computer resources, but DCP showed superior performance.The pipeline proposed here for coding death certificates and the detection of cases is feasible and can be extended to other conditions. This method provides an alternative that allows for coding free-text death certificates in real time that may increase its utilization not only in the public health domain but also for biomedical researchers and developers.This study did not involved any clinical trials.
Point-of-Care Testing as an Influenza Surveillance Tool: Methodology and Lessons Learned from Implementation
Lisa H. Gren,Christina A. Porucznik,Elizabeth A. Joy,Joseph L. Lyon,Catherine J. Staes,Stephen C. Alder
Influenza Research and Treatment , 2013, DOI: 10.1155/2013/242970
Abstract: Objectives. Disease surveillance combines data collection and analysis with dissemination of findings to decision makers. The timeliness of these activities affects the ability to implement preventive measures. Influenza surveillance has traditionally been hampered by delays in both data collection and dissemination. Methods. We used statistical process control (SPC) to evaluate the daily percentage of outpatient visits with a positive point-of-care (POC) influenza test in the University of Utah Primary Care Research Network. Results. Retrospectively, POC testing generated an alert in each of 4 seasons (2004–2008, median 16 days before epidemic onset), suggesting that email notification of clinicians would be 9 days earlier than surveillance alerts posted to the Utah Department of Health website. In the 2008-09 season, the algorithm generated a real-time alert 19 days before epidemic onset. Clinicians in 4 intervention clinics received email notification of the alert within 4 days. Compared with clinicians in 6 control clinics, intervention clinicians were 40% more likely to perform rapid testing ( ) and twice as likely to vaccinate for seasonal influenza ( ) after notification. Conclusions. Email notification of SPC-generated alerts provided significantly earlier notification of the epidemic onset than traditional surveillance. Clinician preventive behavior was not significantly different in intervention clinics. 1. Introduction Influenza causes significant morbidity and mortality in the United States (US), with associated costs of 10–77 billion dollars [1–3]. Current US influenza surveillance activities include the reporting of the percentage of outpatient visits due to influenza-like illness (ILI), reports of laboratory-confirmed influenza hospitalizations and pediatric deaths, pneumonia- and influenza-associated mortality, and viral culture for subtyping [4]. The reporting lag associated with these surveillance measures is 1–4 weeks, which limits the implementation of prevention and control activities [5–7]. This has led to investigation of alternate data sources and analytic techniques that provide earlier notification of influenza activity. An article reviewing the timeliness of alternate data sources for influenza surveillance found that over-the-counter pharmaceutical sales, emergency visits, absenteeism, and health advice calls appeared to be more timely than ILI reporting or virological confirmation, by 3–24 days [8]. This lag results from both the timing of the surveillance event relative to the epidemic onset (affecting viral culture
A case for using grid architecture for state public health informatics: the Utah perspective
Catherine J Staes, Wu Xu, Samuel D LeFevre, Ronald C Price, Scott P Narus, Adi Gundlapalli, Robert Rolfs, Barry Nangle, Matthew Samore, Julio C Facelli
BMC Medical Informatics and Decision Making , 2009, DOI: 10.1186/1472-6947-9-32
Abstract: This paper presents the rationale for designing and implementing the next-generation state public health information systems using grid computing concepts, methods and tools. Our attempt is to evaluate all grid types including data grids for sharing information and computational grids for accessing computational resources on demand. Public health is a broad domain that requires intensive and collaborative uses of disparate and heterogeneous information to perform three primary functions: assessment, policy development, and assurance. [1] In the United States of America (US), it is the state's responsibility to see that functions and services necessary to address the mission of public health are in place. [2] Therefore, to meet the goals of health monitoring, protection, prevention, and promotion, state public health authorities are involved in diverse program areas that each have their own data sources and needs (i.e., vital records and statistics; communicable disease prevention and control; environmental health and safety; injury control; emergency and disaster preparedness; bioterrorism detection and preparedness; maternal and child health, mental health and substance abuse, chronic disease and conditions, community health assessment and surveillance, and monitoring of access, quality and cost of health care).[2] Similar functions are performed by local, regional, tribal, and national public health agencies, as well as by essential public health partners such as food, agriculture and environmental quality agencies, which create demands to integrate or share information vertically and laterally within and among public health organizations. To date, system integration and interoperability in public health has been limited. The next-generation public health information systems must overcome barriers to integration and interoperability, leverage advances in information technology, address emerging priorities, and meet the needs of all the stakeholders. Grid-based arc
The Relationship between Energy Literacy and Environmental Sustainability  [PDF]
Catherine Dwyer
Low Carbon Economy (LCE) , 2011, DOI: 10.4236/lce.2011.23016
Abstract: Sustainability, first identified as a characteristic of eco-systems, is the capacity to maintain a process indefinitely. Environmental sustainability receives significant public and government attention, triggered by concerns about climate change, decreasing energy supplies, and increasing food costs. Colleges and universities receive positive notice for their greening efforts, and the academy is expected to be a leader in efforts to improve sustainability. Therefore coursework and curricula must be developed to train students about sustainable resource consumption processes. This paper describes curricula materials related to energy literacy, defined as conceptual fluency with the economic and social components of energy use. These materials were developed and piloted over a three year period, and were tested with a pre- and post-course survey administered with questions based on the New Environmental Paradigm (NEP) and Environmentally Responsible Behavior (ERB). The findings of this study suggest that discussion of sustainability with disaster themes triggers anxiety that interferes with the development of ERB. In contrast, materials emphasizing the pragmatic necessity and benefits derived from sustainable practices relate to improvements in ERB. This suggests sustainability curricula should mitigate anxiety aroused by the topic, and instead emphasize pragmatic motivations for changing energy consumption patterns.
Sustainable Happiness and Well-Being: Future Directions for Positive Psychology  [PDF]
Catherine O’Brien
Psychology (PSYCH) , 2012, DOI: 10.4236/psych.2012.312A177

Positive psychology has influenced many disciplines in a very short span of time. This paper argues that positive psychology will realize its most significant and far reaching impact when it is applied to sustainability efforts, locally, nationally and internationally. Such application may accelerate shifts in attitudes, policies, practice and behavior. Specifically, opportunities for integrating positive psychology with sustainability education are discussed including work in the area of sustainable happiness, Education for Sustainable Development (ESD) and positive education. Sustainable happiness underscores the interrelationship between human flourishing and ecological resilience. Thus sustainable happiness and well-being are integral to building sustainable futures, and positive psychology could be increasingly influential in leading research and education that heralds a new era of understanding and political will to embrace sustainability.

Epilepsy versus non-epileptic attack disorder: A diagnostic and therapeutic challenge  [PDF]
Catherine Smith, Jason Ramtahal
Case Reports in Clinical Medicine (CRCM) , 2013, DOI: 10.4236/crcm.2013.21001

Epilepsy and non-epileptic attack disorder (NEAD) share a vast number of clinical features, however the aetiology and management are very different. Video-EEG is the gold standard diagnostic tool and relies on the occurrence of seizure activity during assessment to make a diagnosis. Added complexity arises from the co-existence of epilepsy and NEAD, occurring in a significant proportion of patients. Comprehensive assessment and investigation is therefore required to prevent gross mistreatment in this diagnostically difficult subgroup. We present a case of NEAD with co-existing epilepsy and the challenges that this may present in clinical practice.

Reduced Fasting Protocol for Endoscopic Percutaneous Gastrostomy in Intubated Patients  [PDF]
Catherine Ho, John Culhane
International Journal of Clinical Medicine (IJCM) , 2013, DOI: 10.4236/ijcm.2013.48066

Background: Previous studies have shown that ICU patients receive only a fraction of their calculated nutritional goals, and that cumulative caloric deficit in the ICU has been correlated with poor outcome. One reason for this underfeeding is the frequent interruption of enteral nutrition. Many ICU patients receive enteral feeding formula via a nasogastric (NG) tube. Feeding is typically held for several hours prior to procedures due to the theoretical risk of aspiration. An alternative is to continue feeding up until the procedure begins, then stop the feeding and place the NG to suction. This evacuates the contents of the stomach and minimizes the risk of aspiration, while reducing the interruption of feeding that can result in malnutrition. Methods: This study is a review of prospectively gathered data including 55 sequential patients who underwent bedside percutaneous endoscopic gastrostomy (PEG) placement in a mixed ICU under a reduced fasting protocol. This was compared with a historical cohort of 33 critically ill trauma patients who fasted for at least 8 hours prior to the procedure. Under the reduced fasting protocol, enteral feeding via NG was continued up until the time of the procedure. The NG was then placed to suction, and sedation was given. The NG was left in place until the esophagus was cannulated, then it was removed. The PEG was placed in standard fashion, and feeding was resumed via the PEG immediately following the procedure. Results: We have documented no peri-procedural vomiting or aspiration. New diagnosis of pneumonia within 3

English and Malay Text Messages and What They Say about Texts and Cultures  [PDF]
Ernisa Marzuki, Catherine Walter
Open Journal of Modern Linguistics (OJML) , 2013, DOI: 10.4236/ojml.2013.34037
Abstract: This study of the pragmatics of cross-cultural text messages throws light on the evolution of new hybrid forms of literacy and on the complex ways that culture is expressed and mediated in second language/ second culture contexts. An investigation was carried out into the pragmatics of apology in first-language (L1) and second-language (L2) short messaging service text messages of adult Malay speakers who are proficient users of English, living and studying in an English-speaking university environment; and into L1 English users’ text apologies in the same context. Research questions included whether these proficient L2 English users would perform differently from L1 English users in this high-stakes speech act, and from their own L1 Malay use; and whether apologies in what has been called a hybrid medium would differ from those previously studied in writing, in speech and in other electronic media. Twenty-six native speakers of English and 26 native speakers of Malay responded via text messages to discourse completion tests (DCTs) in L1; the DCTs represented either high or low levels of offence calling for apologies. The Malay native speakers also responded to apology situations in L2 English. Data were coded using an adapted version of Cohen and Olshtain’s (1981) coding scheme. Analysis of the messages sent by participants revealed clear signs of a hybrid type of text that is differently conceptualised by the two communities. It also showed that the Malay users’ second language literacy was shaped in a complex way that sometimes accommodated the second language/second culture and sometimes retained first language/first culture values.
Case Report: Propriospinal Myoclonus  [PDF]
Catherine Smith, Jason Ramtahal
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.36081

This report presents a case of propriospinal myoclonus (PSM) in a previously fit and well female patient who presented with truncal jerking movements when relaxed. Propriospinal myoclonus is a rare condition, of which 80% of the aetiology is idiopathic. It is characterised by involuntary jerking movements of the trunk due to spreading activity via intrinsic propriospinal pathways along the spinal cord. Polymyography is mandatory in the diagnosis of priopriospinal myoclonus however in discerning the differential diagnoses it is inferior to magnetic resonance diffusion tensor imaging. The management of propriospinal myoclonus is dependent on aetiology. Clonazepam has been shown to be effective in the treatment of idiopathic PSM for symptomatic relief.

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