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Search Results: 1 - 10 of 402576 matches for " Diane M. Harper "
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Next Generation Cancer Protection: The Bivalent HPV Vaccine for Females
Diane M. Harper,Stephen L. Vierthaler
ISRN Obstetrics and Gynecology , 2011, DOI: 10.5402/2011/457204
Quantifying Clinical HPV4 Dose Inefficiencies in a Safety Net Population
Diane M. Harper, Inge Verdenius, Felicia Ratnaraj, Anne M. Arey, Beth Rosemergey, Gerard J. Malnar, Jeffrey Wall
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0077961
Abstract: Purpose HPV4 is the most expensive vaccine requiring three appropriately timed doses to provide maximal efficacy against two oncogenic HPV types. The primary purpose of this study is to quantify the use of HPV4 vaccine in a safety net health care system in terms of its inefficiencies. Methods A retrospective study of HPV4 dosing from 2006–2009, among females 10–26 years old who sought care in a safety net health care system was conducted to determine dose usage patterns among those at highest risk for cervical cancer. Dose descriptors abstracted from the electronic medical record (EMR) included timing and number in series as well as characteristics of the person to whom and visit at which the dose was given. Dose inefficiencies were separated into “less than three doses” and “mistimed doses” for analysis. Results The majority (66%) of HPV4 doses administered were insufficient to induce the maximal immune response necessary for HPV infection prevention. Among on-time doses, 58% were singleton or doublet doses. Mistimed doses accounted for 19% of all doses administered with late intervals being more common than early intervals among those receiving more than one dose (9% vs. 4%, p<0.001). Third doses were mistimed twice as often as second doses (10% vs. 5%, p<0.001). Black women were more likely to have a mistimed second dose and Hispanic women more likely to have a mistimed third dose compared to white women (OR = 1.70 (95% CI: 1.11, 2.61 and 2.44 (1.19, 5.00), respectively). The HPV4-only visit type at which HPV4 was initiated was the most significant predictor of on-time doublet completion. Conclusions In a safety net health care system the large inefficiencies associated with HPV4 vaccination must be addressed in order to maximize our patient’s cervical cancer prevention.
Long-Term Follow-Up of HPV16-Positive Women: Persistence of the Same Genetic Variant and Low Prevalence of Variant Co-Infections
Daan T. Geraets, Leen-Jan van Doorn, Bernhard Kleter, Brigitte Colau, Diane M. Harper, Wim G. V. Quint
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0080382
Abstract: HPV16 variants correlate with geographic origin and ethnicity. The association between infection with a specific variant and the cervical disease risk remains unclear. We studied the prevalence, persistence and association with cervical intraepithelial neoplasia (CIN) of different HPV16 variants, using cervical swabs and whole tissue sections (WTS) of biopsies from 548 women in the placebo group of a HPV16/18 vaccine trial. In HPV16-positive samples, HPV16 variants were identified by a reverse hybridization assay (RHA). Laser-capture micro-dissection (LCM) was performed for localized detection of HPV. HPV16 variants were determined in 47 women. Frequency of mixed HPV16 variant infections was lower (8.5%) than for multiple HPV genotypes (39.1%). Among 35 women having consecutive HPV16 variant-positive swabs, 32 (91.4%) had the same variant while in three (8.6%) women a change in variant(s) was observed. HPV16-positive WTS were obtained from 12 women having consecutive HPV16 variant-positive swabs. The same variant was present in WTS of 10 women, while two were negative. WTS of five women were histologically normal. A single HPV16 variant was detected in four women having CIN1-3, while additional HPV genotypes were found in three other women having CIN2 and CIN3. In the WTS of one woman with mixed genotypes, the HPV16 variant was assigned to a CIN2 lesion by LCM. HPV16 variant infections can be effectively studied in cervical swabs and tissue specimens by the HPV16 variant RHA. Multiple HPV16 variants in one woman are rare. The HPV16 genotype consistently detected in follow-up samples usually involves a persistent infection with the same variant.
Urban and Rural Safety Net Health Care System Clinics: No Disparity in HPV4 Vaccine Completion Rates
Kelly Jo Sandri, Inge Verdenius, Mitchell J. Bartley, Britney M. Else, Christopher A. Paynter, Beth E. Rosemergey, George D. Harris, Gerard J. Malnar, Sean M. Harper, R. Stephen Griffith, Aaron J. Bonham, Diane M. Harper
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0096277
Abstract: Objective Safety net health care centers in the US serve vulnerable and underinsured females. The primary aim of this work was to determine if HPV4 dosing compliance differs between females who receive doses at rural vs. urban core safety net health care locations. Methods Females exclusively receiving health care in the Truman Medical Center (TMC) safety net system at the urban core and rural locations were identified by their HPV4 vaccine records. Dates and number of HPV4 doses as well as age, gravidity, parity and race/ethnicity were recorded from the electronic medical record (EMR). Appropriate HPV4 dosing intervals were referenced from the literature. Results 1259 females, 10–26 years of age, received HPV4 vaccination at either the rural (23%) or urban core location (77%). At the rural location, 23% received three doses on time, equal to the 24% at the urban core. Females seen in the urban core were more likely to receive on-time doublet dosing than on-time triplet dosing (82% vs. 67%, p<0.001). Mistimed doses occurred equally often among females receiving only two doses, as well as those receiving three doses. Conclusions Compliance with on-time HPV4 triplet dose completion was low at rural and urban core safety net health clinics, but did not differ by location.
Quantifying the Decisional Satisfaction to Accept or Reject the Human Papillomavirus (HPV) Vaccine: A Preference for Cervical Cancer Prevention
Diane M. Harper, Billy B. Irons, Natalie M. Alexander, Johanna C. Comes, Melissa S. Smith, Melinda A. Heutinck, Sandra M. Handley, Debra A. Ahern
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0088493
Abstract: Objective Only a portion of the US population is willing to consider HPV vaccination to date. The primary aim of this study is to determine the decisional satisfaction associated with HPV vaccination. Study Design This is a prospective survey conducted at an urban college where women 18–26 years old completed a decisional satisfaction survey about their HPV vaccine experience. Results Regardless of the decision to accept or reject HPV vaccination, the decisional satisfaction was very high (mean 5-item score = 21.2 (SD 3.8)). Women without HPV vaccination were decisionally neutral significantly more often than those already vaccinated; 22% were decisionally neutral for the option to accept HPV vaccination at that visit. Cervical cancer prevention was preferred significantly more often than genital wart prevention in all analyses. Conclusions Targeting those who are decisionally neutral about HPV vaccination may result in a higher uptake of HPV vaccination.
Smoking Enhances Risk for New External Genital Warts in Men
Dorothy J. Wiley,David Elashoff,Emmanuel V. Masongsong,Diane M. Harper,Karen H. Gylys,Michael J. Silverberg,Robert L. Cook,Lisette M. Johnson-Hill
International Journal of Environmental Research and Public Health , 2009, DOI: 10.3390/ijerph6031215
Abstract: Repeat episodes of HPV-related external genital warts reflect recurring or new infections. No study before has been sufficiently powered to delineate how tobacco use, prior history of EGWs and HIV infection affect the risk for new EGWs. Behavioral, laboratory and examination data for 2,835 Multicenter AIDS Cohort Study participants examined at 21,519 semi-annual visits were evaluated. Fourteen percent (391/2835) of men reported or were diagnosed with EGWs at 3% (675/21,519) of study visits. Multivariate analyses showed smoking, prior episodes of EGWs, HIV infection and CD4+ T-lymphocyte count among the infected, each differentially influenced the risk for new EGWs.
Predictors of Three Dose On-Time Compliance with HPV4 Vaccination in a Disadvantaged, Underserved, Safety Net Population in the US Midwest
Inge Verdenius, Diane M. Harper, George D. Harris, R. Stephen Griffith, Jeffrey Wall, Laura K. Hempstead, Gerard J. Malnar, Ruud L. M. Bekkers
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0071295
Abstract: Background HPV4 is approved as a series of three timed doses expected to result in efficacy against specific HPV infections. Completion rates in the US are quite low at the same time the structure of health care delivery is changing. The aim of this study was to determine how the patient-, clinic- and systems-level characteristics facilitate or hinder the timely completion of three HPV4 doses in both adolescent and adult female populations in a high-risk safety net population. Methods This is a retrospective study in which patient-, clinic- and systems-level data are abstracted from the electronic medical record (EMR) for all females 10–26 years of age receiving at least one dose of HPV4 between July 1, 2006 and October 1, 2009. Results Adults were more likely to complete the three dose series if they had at least one health care visit in addition to their HPV4 visit, (aOR = 1.54 (95% CI:1.10, 2.15). Adults were less likely to complete the three dose series if they received their second HPV4 dose at an acute health care, preventive care or postpartum visits compared to an HPV4-only visit (aOR = 0.31 (95% CI: 0.13, 0.72), 0.12 (0.04, 0.35), 0.30 (0.14, 0.62), respectively). Hispanic adults were less likely than whites to complete the series (aOR = 0.24 (95% CI:0.10, 0.59). 39% of adolescents who completed two doses completed the series. Conclusions HPV4 is more likely to be effectively administered to adults in a safety net population if multiple health care needs can be met within the health care system.
The VL2-Spoken Language Phonological Awareness (VL2-SLPA) Measure  [PDF]
M. Diane Clark
Psychology (PSYCH) , 2012, DOI: 10.4236/psych.2012.310137
Abstract: Tests of phonological awareness have been developed for spoken languages that require spoken responses. For many deaf individuals, spoken measures of phonological awareness (PA) are not appropriate, as these deaf individuals do not use any spoken language or their oral language is rated as low on levels of aural comprehension. Given the need to have accessible measures of spoken language PA for deaf children, the VL2 Spoken Language Phonological Awareness Measure (VL2-SLPA) was developed. The VL2-SLPA can also determine if participants use a phonological code or an orthographic code to identify the two pictures that have the same first or last “sound”. The VL2-SLPA showed strong convergent validity to the Phoneme Detection Test, another measure developed for deaf individuals, which does not require a verbal response.
3q26 Amplification Is an Effective Negative Triage Test for LSIL: A Historical Prospective Study
Erica R. Heitmann, Kamani M. Lankachandra, Jeff Wall, George D. Harris, Hollie J. McKinney, G. Reza Jalali, Yogita Verma, Eric Kershnar, Michael W. Kilpatrick, Petros Tsipouras, Diane M. Harper
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0039101
Abstract: Background Women with low grade squamous intraepithelial lesions (LSIL) at cervical cancer screening are currently referred for further diagnostic work up despite 80% having no precancerous lesion. The primary purpose of this study is to measure the test characteristics of 3q26 chromosome gain (3q26 gain) as a host marker of carcinogenesis in women with LSIL. A negative triage test may allow these women to be followed by cytology alone without immediate referral to colposcopy. Methods and Findings A historical prospective study was designed to measure 3q26 gain from the archived liquid cytology specimens diagnosed as LSIL among women attending colposcopy between 2007 and 2009. 3q26 gain was assessed on the index liquid sample; and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were measured at immediate triage and at 6–16 months after colposcopic biopsy. The sensitivity of 3q26 gain measured at immediate triage from automated and manually reviewed tests in 65 non-pregnant unique women was 70% (95% CI: 35, 93) with a NPV of 89% (95% CI: 78, 96). The sensitivity and NPV increased to 80% (95% CI: 28, 99) and 98% (95% CI: 87, 100), respectively, when only the automated method of detecting 3q26 gain was used. Conclusions 3q26 gain demonstrates high sensitivity and NPV as a negative triage test for women with LSIL, allowing possible guideline changes to routine surveillance instead of immediate colposcopy. Prospective studies are ongoing to establish the sensitivity, specificity, PPV and NPV of 3q26 gain for LSIL over time.
Age Does Not Affect the Induction of Mortality by the Foodborne Pathogen Salmonella enterica in Caenorhabditis elegans  [PDF]
Dawn M. F. Burns, James M. Harper, Aaron M. Lynne
Advances in Microbiology (AiM) , 2017, DOI: 10.4236/aim.2017.710054
Salmonella is a common cause of foodborne illness within the United States with the severity of the infection being a factor of both the age and overall health of the infected individual. The nematode worm Caenorhabditis elegans has proven to be a useful model to study infection dynamics of pathogenic bacteria, including Salmonella enterica, and its short lifespan makes it a powerful model system to assess the effect of organismal age on infection severity. In this study, we infected C. elegans with each of 6 serovars of S. enterica at 1, 3 or 5 days of worm age and monitored their survival. Worms infected with E. coli OP50 were used as a control. Infection with S. enterica resulted in a significant reduction in mean longevity relative to OP50 (p < 0.05); however, there was no significant effect of age on mean survival time regardless of the strain of bacteria used.
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