scholarly journals (A182) Model to Assess Geo-Temporal Spread of Disease by Air Travel from Major World Cities to the United States

2011 ◽  
Vol 26 (S1) ◽  
pp. s51-s51
Author(s):  
G.M. Hwang ◽  
T. Wilson
Keyword(s):  
Assessment Tool ◽  
Metropolitan Areas ◽  
Infected Individual ◽  
Population Data ◽  
The United States ◽  
Air Travel ◽  
Disease Spread ◽  
Mitigation Measures ◽  
The Us ◽  
Control And Prevention

With increasing numbers of international flights and air travelers arriving in the US annually, the rapid spread of communicable diseases has grown. Epidemics of novel infectious diseases have emerged and rapidly spread globally in association with air travel, including the severe acute respiratory syndrome (SARS) outbreak in 2003 and H1N1 in 2009. In order to anticipate and mitigate the consequences of future rapid disease spread, the MITRE Corporation, in collaboration with the (US) Centers for Disease Control and Prevention, developed a risk assessment tool using a Susceptible-Exposed-Infectious-Recovered model and detailed flight and population data. The emergence and spread of prototypic pandemic influenza was simulated based on a theoretical geographical point of origin and its communicability. More than 50 international metropolitan areas were analyzed as potential points of origin to simulate the rapidity of spread to the US. The basic reproduction number (Ro), defined as the average number of persons to whom one infected individual transmits disease in an immune naive population, was varied from 1.4 to 1.9. The starting numbers of infectious persons at each origin also were varied (100 or 500 persons, 5% infectious may travel). Waves were computed as aggregate across metropolitan areas modeled in the US. The visualization of the first pandemic wave was most apparent in simulations of Ro = 1.9, resulting from 500 infectious persons at each origin. More than 50% of origins indicated that aggregate waves peaked around Day 125, while 30% of origins peaked around Day 90. Additionally, the time, in days, from its origin in six continents into the US was compared, and a two-week delay was found from South America compared with other continents. This simulation tool better equips policy makers and public health officials to quickly assess risk and leverage resources efficiently via targeted and scalable border mitigation measures during a rapid global outbreak.

Decision-making preferences of advanced cancer Hispanic patients from the United States and Latin America.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9063-9063
Author(s):  
Henrique Afonseca Parsons ◽  
Sriram Yennurajalingam ◽  
Eva Rosina Duarte ◽  
Alejandra Palma ◽  
Sofia Bunge ◽  
...  
Keyword(s):  
Decision Making ◽  
Latin America ◽  
Advanced Cancer ◽  
Family Involvement ◽  
Assessment Tool ◽  
The United States ◽  
Demographic Variables ◽  
The Family ◽  
The Us ◽  
Hispanic Patients

9063 Background: To determine whether preferences in frequency of passive decision making differ between Hispanic patients from Latin America (HLA) and Hispanic-American (HA) patients. Methods: We conducted a survey of advanced cancer Hispanic patients referred to outpatient palliative care clinics in the U.S, Chile, Argentina, and Guatemala. Information on demographic variables, PS,andMarin Acculturation Assessment Tool (only U.S. patients) was collected. Decision-making preference was evaluated by the decision-making assessment tool. Results: A total of 387 patients with advanced cancer were surveyed: 91 (24%) in the US, 100 (26%) in Chile, 94 (25%) in Guatemala, and 99 (26%) in Argentina. Median age was 59 years, and 61% were female. HLA preferred passive decision-making strategies significantly more frequently with regard to involvement of the family (24% versus 10%, p=0.009) or the physician (35% versus 26%, p<0.001), even after controlling for age and education (OR 3.8, p<0.001 for physician and 2.4, p=0.03 for family) (Table 1). 76/91 HA (83.5%), and 242/293 HLA (82%) preferred family involvement in decision-making (p=NS). No differences were found in decision-making preferences between low- and highly acculturated U.S. Hispanics. Conclusions: HA prefer more active decision-making as compared to HLA. Among HA, acculturation did not seem to play a role in decision-making preference determination. Our findings in this study confirm the importance of family participation in decision making in both HA and HLA. However, HA patients were much less likely to want family members or physicians to make decisions on their behalf. [Table: see text] [Table: see text]

scholarly journals Issues in Chemical and Biological Terrorism

2003 ◽  
Vol 22 (6) ◽  
pp. 465-471 ◽  
Author(s):  
Harry Salem
Keyword(s):  
The United States ◽  
Water Soluble ◽  
Weapons Of Mass Destruction ◽  
Potential Threat ◽  
Us Army ◽  
Biological Terrorism ◽  
The Us ◽  
Control And Prevention ◽  
23Rd Annual Meeting ◽  
Biological Solutions

This manuscript describes the overview presented at the 23rd Annual Meeting of the American College of Toxicology in 2002. Although it is recognized that weapons of mass destruction that can be used against our military and civilian populations include chemical, biological, radiological, and nuclear (CBRN) agents, this overview is limited primarily to chemical and biological (CB) agents. The issues of CB terrorism are discussed in terms of When, What, How, and Who. The US Army has been providing chemical and biological solutions since 1917, and has since 1996 applied these solutions to homeland defense and domestic preparedness. The use of chemical and biological agents as terrorist weapons both in the United States and elsewhere in the world is reviewed. The CB threat spectrum is presented, as is the further categorization of biological threat agents by the Centers for Disease Control and Prevention (CDC). In addition, the CB agents considered to be a potential threat to our water supply are also presented. These are agents that are water soluble, stable, and resistant to water treatment and/or disinfection. The overview concludes with the chronological accomplishments of ECBC since 1917.

scholarly journals Discrepancies in Written Versus Calculated Durations in Opioid Prescriptions: Pre-Post Study (Preprint)

2019 ◽  
Author(s):  
Benjamin H Slovis ◽  
John Kairys ◽  
Bracken Babula ◽  
Melanie Girondo ◽  
Cara Martino ◽  
...  
Keyword(s):  
The United States ◽  
Opioid Use ◽  
Duration Of Treatment ◽  
Record System ◽  
Opioid Prescription ◽  
Increased Risk ◽  
The Us ◽  
Control And Prevention ◽  
Opioid Medications

BACKGROUND The United States is in the midst of an opioid epidemic. Long-term use of opioid medications is associated with an increased risk of dependence. The US Centers for Disease Control and Prevention makes specific recommendations regarding opioid prescribing, including that prescription quantities should not exceed the intended duration of treatment. OBJECTIVE The purpose of this study was to determine if opioid prescription quantities written at our institution exceed intended duration of treatment and whether enhancements to our electronic health record system improved any discrepancies. METHODS We examined the opioid prescriptions written at our institution for a 22-month period. We examined the duration of treatment documented in the prescription itself and calculated a duration based on the quantity of tablets and doses per day. We determined whether requiring documentation of the prescription duration affected these outcomes. RESULTS We reviewed 72,314 opioid prescriptions, of which 16.96% had a calculated duration that was greater than what was documented in the prescription. Making the duration a required field significantly reduced this discrepancy (17.95% vs 16.21%, <i>P</i>&lt;.001) but did not eliminate it. CONCLUSIONS Health information technology vendors should develop tools that, by default, accurately represent prescription durations and/or modify doses and quantities dispensed based on provider-entered durations. This would potentially reduce unintended prolonged opioid use and reduce the potential for long-term dependence.

scholarly journals Rural-Urban Disparities in Place of Death in Hematologic Malignancies in the US from 2003 to 2019

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4137-4137
Author(s):  
Syed M. Qasim Hussaini ◽  
Arjun Gupta
Keyword(s):  
United States ◽  
Metropolitan Area ◽  
Rural Areas ◽  
Hospice Care ◽  
Metropolitan Areas ◽  
Hematologic Malignancies ◽  
The United States ◽  
Medical Facility ◽  
Nursing Facility ◽  
The Us

Abstract Background: more than 60,000 people die annually from hematologic malignancies in the united states (us). Patients with hematologic malignancies more frequently receive aggressive care toward the end-of-life and are more likely to die in a hospital compared to those with a solid tumor. Appropriate care of such patients is very dependent on an existing healthcare infrastructure. There are notable challenges to rural healthcare in the united states which contains less than 1/5th of all hospices in the us. In this study, we sought to investigate rural-urban disparities in place of death the us in individuals that died from hematologic malignancies. Methods: we utilized the us centers for disease control and prevention wide-ranging online data for epidemiologic research database to analyze all deaths from hematologic malignancies in the us from 2003 to 2019. A population classification utilizing the 2013 us census was made using the national center for health statistics urban-rural classification scheme. These classifications included: large metropolitan area (1 million), small- or medium-sized metropolitan area (50 000-999 999), and rural area (&lt;50 000). We estimated deaths in a medical facility, hospice, home, or nursing care facility. We stratified the results by age, sex, and race/ethnicity. The annual percentage change (apc) in deaths was estimated. All data was publicly available and de-identified. Findings: from 2003-2019, there were a total 1,088,589 deaths form hematologic malignancies in the united states, predominantly in large metropolitan areas (50.2%), followed by small or medium sized metropolitan areas (31.7%) and rural areas (18.2%). All regions noted decreases in medical facility and nursing facility related deaths, and increase in hospice and home deaths. While rural areas demonstrated the quickest uptake of hospice care (apc 61.5), they had the lowest overall presence of hospice care (8.3% of all rural deaths in 2019 vs. 14.9% for small or medium metropolitan vs. 12% for large metropolitan) and larger share of nursing facility related deaths (15.8% of all rural deaths in 2019 vs 12.3% for small or medium metropolitan vs 10.6% for large metropolitan). Discussion: we demonstrate end-of-life disparities in hematologic malignancies based on where an individual resides in the us with rural areas having notably lower share of deaths in hospice facilities. Older infrastructure, inadequate access to care, and financial barriers add to the medical complexity of care for all patients, and especially hematologic patients with high needs and complex treatment planning. These have been aggravated by rural hospital closures in the previous 18 months. The us senate is currently debating a bipartisan infrastructure that may add billions in building rural healthcare infrastructure to state budgets. Our findings are timely in helping inform congressional policy. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals State-level tracking of COVID-19 in the United States

2020 ◽  
Author(s):  
H. Juliette T. Unwin ◽  
Swapnil Mishra ◽  
Valerie C. Bradley ◽  
Axel Gandy ◽  
Thomas A. Mellan ◽  
...  
Keyword(s):  
State Level ◽  
The United States ◽  
Bayesian Hierarchical ◽  
Secondary Infections ◽  
The Us ◽  
Control And Prevention ◽  
Credible Intervals ◽  
Behaviour Changes ◽  
The Impact ◽  
Number Of Individuals

AbstractAs of 1st June 2020, the US Centers for Disease Control and Prevention reported 104,232 confirmed or probable COVID-19-related deaths in the US. This was more than twice the number of deaths reported in the next most severely impacted country. We jointly modelled the US epidemic at the state-level, using publicly available death data within a Bayesian hierarchical semi-mechanistic framework. For each state, we estimate the number of individuals that have been infected, the number of individuals that are currently infectious and the time-varying reproduction number (the average number of secondary infections caused by an infected person). We used changes in mobility to capture the impact that non-pharmaceutical interventions and other behaviour changes have on the rate of transmission of SARS-CoV-2. On 1st June, we estimated that Rt was only below one in 23 states. We also estimated that 3.7% [3.4%-4.0%] of the total population of the US had been infected, with wide variation between states, and approximately 0.01% of the population was infectious. We demonstrate good 3 week model forecasts of deaths with low error and good coverage of our credible intervals.

scholarly journals The COVID States Project #75: Attitudes toward COVID-19 boosters before and after Omicron

2021 ◽  
Author(s):  
Roy H. Perlis ◽  
Matthew Baum ◽  
Kristin Lunz Trujillo ◽  
David Lazer ◽  
Alauna Safarpour ◽  
...  
Keyword(s):  
District Of Columbia ◽  
The United States ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Dominant Form ◽  
The Us ◽  
Before And After ◽  
Control And Prevention ◽  
Health Organization ◽  
To Receive

Recognizing that the protection conferred by COVID-19 vaccines may wane over time, the US Centers for Disease Control and Prevention (CDC) has encouraged adults in the United States to receive booster shots that can augment their immunity to the virus. While the Biden administration sought to encourage all adults to receive boosters, the CDC initially authorized the shots only for higher-risk individuals. Subsequently, authorization was broadened to all adults, although only higher-risk individuals were encouraged to pursue boosters. Most recently, after substantial criticism, the CDC changed its language to encourage all adults to receive boosters.But regardless of the language, are US adults sufficiently convinced to seek booster shots? Will the same factors that contributed to COVID-19 vaccine hesitancy and vaccine resistance impact booster shots? The answers may have profound public health implications as the US enters the season during which respiratory viruses typically have the greatest impact, and the highly-transmissible Omicron variant rapidly becomes the dominant form of COVID-19, after being labeled a variant of concern by the World Health Organization on November 26th.Between November 3rd and December 3rd, 2021, the COVID States Project asked 22,277 adults in all 50 US states and the District of Columbia about their attitudes and behaviors regarding COVID-19. In particular, we asked about whether people are vaccinated or intend to be vaccinated, and whether they had sought booster shots or intend to seek a booster shot. In this brief report, we examine attitudes toward COVID-19 booster shots, and whether they differ across particular groups of people. Since the survey was ongoing when news about Omicron emerged in the US, we also take an initial look at whether these attitudes have begun to shift along with perceptions of the threat posed by COVID-19 subsequent to the November 26th announcement.

scholarly journals Are we there yet? An adaptive SIR model for continuous estimation of COVID-19 infection rate and reproduction number in the United States (Preprint)

2020 ◽  
Author(s):  
Mark Shapiro ◽  
Fazle Karim ◽  
Guido Muscioni ◽  
Abel Saju Augustine
Keyword(s):  
Infection Rate ◽  
Reproduction Number ◽  
Infected Individual ◽  
Local Population ◽  
The United States ◽  
Mitigation Measures ◽  
Simple Method ◽  
Wide Range ◽  
Continuous Estimation ◽  
The Impact

BACKGROUND The dynamics of the COVID-19 epidemic vary due to local population density and policy measures. When making decisions, policy makers consider an estimate of the effective reproduction number R_t which is the expected number of secondary infections by a single infected individual. OBJECTIVE We propose a simple method for estimating the time-varying infection rate and reproduction number R_t . METHODS We use a sliding window approach applied to a Susceptible-Infectious-Removed model. The infection rate is estimated using the reported cases for a seven-day window to obtain continuous estimation of R_t. The proposed adaptive SIR (aSIR) model was applied to data at the state and county levels. RESULTS The aSIR model showed an excellent fit for the number of reported COVID-19 positive cases, a one-day forecast MAPE was less than 2.6% across all states. However, a seven-day forecast MAPE reached 16.2% and strongly overestimated the number of cases when the reproduction number was high and changing fast. The maximal R_t showed a wide range of 2.0 to 4.5 across all states, with the highest values for New York (4.4) and Michigan (4.5). We demonstrate that the aSIR model can quickly adapt to an increase in the number of tests and associated increase in the reported cases of infections. Our results also suggest that intensive testing may be one of the effective methods of reducing R_t. CONCLUSIONS The aSIR model provides a simple and accurate computational tool to obtain continuous estimation of the reproduction number and evaluate the impact of mitigation measures.

scholarly journals The Check and Report Ebola (CARE+) Program to Monitor Travelers for Ebola After Arrival to the United States, 2014-2016

2019 ◽  
Vol 134 (6) ◽  
pp. 592-598 ◽  
Author(s):  
Heather A. Joseph ◽  
Abbey E. Wojno ◽  
Kelly Winter ◽  
Onalee Grady-Erickson ◽  
Erin Hawes ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
West Africa ◽  
Emerging Infectious Diseases ◽  
Care Program ◽  
The United States ◽  
The Us ◽  
Us Government ◽  
Public Health Authorities ◽  
Control And Prevention

The 2014-2016 Ebola epidemic in West Africa influenced how public health officials considered migration and emerging infectious diseases. Responding to the public’s concerns, the US government introduced enhanced entry screening and post-arrival monitoring by public health authorities to reduce the risk of importation and domestic transmission of Ebola while continuing to allow travel from West Africa. This case study describes a new initiative, the Check and Report Ebola (CARE+) program that engaged travelers arriving to the United States from countries with Ebola outbreaks. The Centers for Disease Control and Prevention employed CARE ambassadors, who quickly communicated with incoming travelers and gave them practical resources to boost their participation in monitoring for Ebola. The program aimed to increase travelers’ knowledge of Ebola symptoms and how to seek medical care safely, increase travelers’ awareness of monitoring requirements, reduce barriers to monitoring, and increase trust in the US public health system. This program could be adapted for use in future outbreaks that involve the potential importation of disease and require the education and active engagement of travelers to participate in post-arrival monitoring.

scholarly journals Understanding Implementation Challenges to Genetic Testing for Familial Hypercholesterolemia in the United States

2019 ◽  
Vol 9 (1) ◽  
pp. 9 ◽  
Author(s):  
Rachele Hendricks-Sturrup ◽  
Christine Lu
Keyword(s):  
United States ◽  
Genetic Testing ◽  
Familial Hypercholesterolemia ◽  
Ethnic Diversity ◽  
Heart Association ◽  
The United States ◽  
Cvd Risk ◽  
Implementation Challenges ◽  
The Us ◽  
Control And Prevention

Cardiovascular disease (CVD) is the leading cause of death in the United States (US), with familial hypercholesterolemia (FH) being a major inherited and genetic risk factor for premature CVD and atherosclerosis. Genetic testing has helped patients and providers confirm the presence of known pathogenic and likely pathogenic variations in FH-associated genes. Key organizations, such as the Centers for Disease Control and Prevention (CDC), American Heart Association (AHA), FH Foundation, and National Lipid Association (NLA), have recognized the clinical utility of FH genetic testing. However, FH genetic testing is underutilized in clinical practice in the US for reasons that are underexplored through the lens of implementation science. In this commentary, we discuss seven key implementation challenges that must be overcome to strengthen the clinical adoption of FH genetic testing in the US. These implementation challenges center on evidence of cost-effectiveness, navigating patient and provider preferences and concerns, gender and ethnic diversity and representation in genetic testing, and establishing clinical consensus around FH genetic testing based on the latest and most relevant research findings. Overcoming these implementation challenges is imperative to the mission of reducing CVD risk in the US.

scholarly journals State-level tracking of COVID-19 in the United States

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
H. Juliette T. Unwin ◽  
Swapnil Mishra ◽  
Valerie C. Bradley ◽  
Axel Gandy ◽  
Thomas A. Mellan ◽  
...  
Keyword(s):  
State Level ◽  
The United States ◽  
Bayesian Hierarchical ◽  
Secondary Infections ◽  
The Us ◽  
Control And Prevention ◽  
Credible Intervals ◽  
Behaviour Changes ◽  
The Impact ◽  
Number Of Individuals

AbstractAs of 1st June 2020, the US Centres for Disease Control and Prevention reported 104,232 confirmed or probable COVID-19-related deaths in the US. This was more than twice the number of deaths reported in the next most severely impacted country. We jointly model the US epidemic at the state-level, using publicly available death data within a Bayesian hierarchical semi-mechanistic framework. For each state, we estimate the number of individuals that have been infected, the number of individuals that are currently infectious and the time-varying reproduction number (the average number of secondary infections caused by an infected person). We use changes in mobility to capture the impact that non-pharmaceutical interventions and other behaviour changes have on the rate of transmission of SARS-CoV-2. We estimate that Rt was only below one in 23 states on 1st June. We also estimate that 3.7% [3.4%–4.0%] of the total population of the US had been infected, with wide variation between states, and approximately 0.01% of the population was infectious. We demonstrate good 3 week model forecasts of deaths with low error and good coverage of our credible intervals.

Sign in / Sign up

Export Citation Format

Share Document