Running head UNIT 8 PROJECT1UNIT 8 PROJECT2Unit 8 Proj.docxjoellemurphey
油
Running head: UNIT 8 PROJECT
1
UNIT 8 PROJECT
2
Unit 8 Project
Name
Community Health Assessment
Affiliated University
April 02, 2015
Abstract
This project is designed to give a bigger picture of the information so far covered in this course unit. It will provide information from project four which was about social behavior theories and its roots and unit six that concerned about Influenza vaccination in senior citizens 65 and over. It will also give some information from project two which was about the role of assessment in public health. Information about child obesity as a health problem in my community will be provided, and a detailed description of how data will be provided for this health problem assessment. A completed health assessment information using a U.S Census on my community and the evaluation of this information, and the information about who may be affected by this child obesity health evaluation and a plan of action, conclusion and a reference page where information was gathered.
Unit 8 Project
U.S Census data on my County in the State of Maryland
Montgomery County is where I live, located in the state of Maryland. Its population as of 2013 was estimated to be 1,016,677 according to (United States Census Bureau), with a racial breakdown of 62.6% white alone, 18.6% Black and African American alone,0.7% American Indian and Alaskan Natives alone, Asians 14.9%,Native Hawaiian and pacific Islanders 0.1%,Two or more races 3.1%,Hispanic and Latino 18.3%.Those who are not Latinos or Hispanic comprise of 47.0% .Female persons comprise of 51.8% and no information was provided about male. Senior citizens sixty five years and over take up 13.3% .Information for people who are disabled was not provided where as children under five years take up a 6.5% and those under 18 years comprised of 23.6%. (United States Census Bureau)
Influenza Vaccination Health Assessment from Unit 6
Influenza is a deadly virus that attacks the nose, throat and lungs and it can be spread from one person to another if a sick person sneezes or coughs without covering their mouth and the other person inhales it. In United States alone, Influenza is estimated to be responsible for 36,000 deaths, and 110,000 to 200,000 hospitalizations ("Influenza vaccination," 2003). It is a virus that is prevented mainly through immunization. The world at large and the U.S government in particular, has tried their level best to conduct public health campaigns that encourage influenza vaccination but despite all the effort, a number of people do not turn up due to varied reasons. In such helpless situations an assessment can be carried out to help health care advocates find out factors affecting vaccine commitment. A good example of this is from county of Los Angeles where immunization was carried out to people who are 65 and over noted to be one of those at high risk but to their surprise a few categories of people didnt turn up for immunization. Results from Los Angeles Cou ...
Epidemiology has several common practical applications. It is used to investigate infectious diseases through routine surveillance by health departments. Epidemiologists in hospitals explore causes of hospital-acquired infections. It also evaluates the impact of public health policies on trends like smoking rates and obesity. Overall, epidemiology provides data to understand community health issues and disease risks, identify disease syndromes, uncover disease causes, and evaluate treatments and interventions.
New Study Identifies Population-Wide Immune Setpoint for COVID-19 Antibodies.pdfThe Lifesciences Magazine
油
The researchers showed that despite variability in individual responses to infections and immunizations, population-wide antibody levels against the SARS-CoV-2 spike protein tended to converge toward a unique immune setpoint for COVID-19 antibodies.
Global HIV cohort studies among IDU and future vaccine trialsThira Woratanarat
油
The author reviewed data on the global HIV epidemic among injecting drug users (IDUs) and identified potential cohorts of IDUs that could participate in future HIV vaccine trials. High HIV prevalence rates were observed among IDUs in many countries in Asia, Eastern Europe, Latin America, and parts of Africa and North America. Several cohort studies also showed high HIV incidence rates among IDUs in China, Thailand, Canada, and Spain. These findings emphasize the seriousness of the IDU epidemic globally and the potential for IDU cohorts to participate in HIV vaccine trials due to demonstrated high participation and retention rates in past studies.
The document discusses HIV epidemiology in Saskatchewan, highlighting that the province has seen a rapid increase in new HIV cases and now has the highest rates in Canada. It summarizes Saskatchewan's 2010-2013 HIV Strategy, which aims to reduce new infections and improve quality of life for those living with HIV through improved surveillance, clinical management, prevention, and harm reduction programs. The strategy goals include earlier detection of cases, decreasing new infections and sexually transmitted infections, and increasing access to testing, care, and prevention services.
e632 www.thelancet.comhiv Vol 6 September 2019ViewpoiAlyciaGold776
油
e632 www.thelancet.com/hiv Vol 6 September 2019
Viewpoint
The disconnect between individual-level and population-level
HIV prevention benefits of antiretroviral treatment
Stefan Baral, Amrita Rao, Patrick Sullivan, Nancy Phaswana-Mafuya, Daouda Diouf, Greg Millett, Helgar Musyoki, Elvin Geng, Sharmistha Mishra
In 2019, the HIV pandemic is growing and soon over 40 million people will be living with HIV. Effective population-
based approaches to decrease HIV incidence are as relevant as ever given modest reductions observed over the past
decade. Treatment as prevention is often heralded as the path to improve HIV outcomes and to reduce HIV
incidence. Although treatment of an individual does eliminate onward transmission to serodifferent partners
(unde tectable=untransmittable or U=U), population-level observational and experimental data have not shown a similar
effect with scale-up of treatment on reducing HIV incidence. This disconnect might be the result of little attention given
to heterogeneities of HIV acquisition and transmission risks that exist in people at risk for and living with HIV, even in
the most broadly generalised epidemics. Available data suggest that HIV treatment is treatment, HIV prevention is
prevention, and specificity of HIV treatment approaches towards people at highest risk of onward transmission drives
the intersection between the two. All people living with HIV deserve HIV treatment, but both more accurately estimating
and optimising the potential HIV prevention effects of universal treatment approaches necessitates understanding who
is being supported with treatment rather than a focus on treatment targets such as 90-90-90 or 95-95-95.
Introduction
In 2019, we are at a pivotal time in the global HIV response
in that many people believe that the HIV pandemic is
over given the advances in HIV treatment.1 Yet the HIV
pandemic continues to grow as defined by numbers of
people living with HIV. Specifically, given the encouraging
decreases in overall mortality among people living with
HIV, in the context of universal treat ment as prevention,
approximately 930 000 more people annually (1揃7 million
new infections minus 770 000 deaths of people living with
HIV) require anti retroviral therapy (ART) and many more
would need to change ART regimens. At the current rate
of new infections, over 40 million people will be living
with HIV by 2025.2 The global optimism about the HIV
pandemic has not been matched by decreases in new
HIV infections. New infections have declined by less than
2% per year since 2005, which means that between
1揃8 and 2揃5 million people acquired HIV in 2017.2,3 To
date, just over 60% of the 37揃9 million people living with
HIV are on ART; of those 37揃9 million, just over half
(20揃1 million) are estimated to have achieved viral sup足
pression.2 Taken together, these data suggest that an
estimated 18 million people living with HIV require ART
or improved ART regimens giv ...
The document discusses guidelines for diagnosing and treating high blood pressure from the National High Blood Pressure Education Program Coordinating Committee. It notes that systolic blood pressure is more important than diastolic pressure for those over 50 years old. It also discusses "prehypertension" between 120-139/80-89 mm Hg and treatment thresholds. The JNC 7 guidelines were issued in 1997 while JNC 8 included treatment algorithms and differences from JNC 7.
The document discusses guidelines for diagnosing and treating high blood pressure from the National High Blood Pressure Education Program Coordinating Committee. It notes that systolic blood pressure is more important than diastolic pressure for those over 50 years old. It also discusses "prehypertension" between 120-139/80-89 mm Hg and treatment thresholds. The JNC 7 guidelines were issued in 1997 while the JNC 8 guidelines from 2013 include treatment algorithms and comparisons to JNC 7.
This document contains a final exam for HSA 535 that covers topics in epidemiology, including descriptive epidemiology, measures of disease frequency and association, study designs, screening and prevention. It includes 30 multiple choice questions testing knowledge of concepts like rates, cohorts, screening test validation, chronic disease risk factors and occupational health studies. It also provides short discussions on applying epidemiology principles to address issues like type 2 diabetes and cancer screening programs. The exam evaluates understanding of key epidemiology topics and how to apply them to analyze health problems and propose evidence-based solutions.
NUR 440 Evidence TableStudy CitationDesignMethodSample.docxvannagoforth
油
NUR 440 Evidence Table
Study Citation
Design
Method
Sample
Data Collection
Data Analysis
Validity
Reliability
Magill, S. S., OLeary, E., Janelle, S. J., Thompson, D. L., Dumyati, G., Nadle, J., & Ray, S. M. (2018). Changes in prevalence of health careassociated infections in US Hospitals.油New England Journal of Medicine,油379(18), 1732-1744.
Longitudinal and multivariable log-binomial regression modeling
At Emerging Infections Program sites in 10 states, we recruited up to 25 hospitals in each site area, prioritizing hospitals that had participated in the 2011 survey.
Random samples of patients in acute care locations were selected from hospitals morning censuses on the survey date with the use of the method that had been used in the 2011 survey
Trained staff of the Emerging Infections Program sites reviewed medical records on the survey date or retrospectively to collect basic demographic and clinical data.
In 2015, a total of 12,299 patients in 199 hospitals were surveyed, as compared with 11,282 patients in 183 hospitals in 2011. Pneumonia, gastrointestinal infections and surgical-site infections were the most common health careassociated infections.
The CDC determined the survey to be a non-research activity.
Point-prevalence surveys of health careassociated infections in health care settings complement location- or infection-specific National Healthcare Safety Network data.
Zuarez-Easton, S., Zafran, N., Garmi, G., & Salim, R. (2017). Postcesarean wound infection: prevalence, impact, prevention, and management challenges.油International journal of women's health,油9, 81.
Randomized trials, cohort, casecontrol, review, and meta-analysis were eligible.
Several electronic databases were searched from inception through June 2016: MEDLINE, PubMed, Ovid, and the Cochrane Library.
100,000 maternities compared to the period between 2003 and 2005
Data was collected through maternal comorbidities, appropriate antibiotic prophylaxis, and evidence-based surgical techniques practices.
Cesarean delivery is one of the most frequent surgical interventions performed worldwide and accounts for up to 60% of deliveries in a number of countries
Two authors (SZE and RS) selected articles first through focused review of abstracts. Eligible studies underwent full-text review.
The research Reviewed maternal death in the UK over a period of 3 years (20062008).
Chu, K., Maine, R., & Trelles, M. (2015). Cesarean section surgical site infections in sub-Saharan Africa: a multi-country study from Medecins Sans Frontieres.油World journal of surgery,油39(2), 350-355.
Logistic regression was used to model determinants of SSI.
This study included data from four emergency obstetric programs supported by Medecins sans Frontieres, from Burundi, the Democratic Republic of Congo (DRC), and Sierra Leone.
1,276 women underwent CS.
Data were prospectively collected using a standardized paper form and then entered into an electronic database.
Baseline characteristics w ...
RESEARCH ARTICLEWill Combined Prevention Eliminate Racia.docxronak56
油
RESEARCH ARTICLE
Will "Combined Prevention" Eliminate Racial/
Ethnic Disparities in HIV Infection among
Persons Who Inject Drugs in New York City?
Don Des Jarlais1*, Kamyar Arasteh1, Courtney McKnight1, Jonathan Feelemyer1,
Holly Hagan2, Hannah Cooper3, Aimee Campbell4, Susan Tross4, David Perlman1
1 The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York,
New York, United States of America, 2 College of Nursing, New York University, New York, New York,
United States of America, 3 Rollins School of Public Health at Emory University, Atlanta, Georgia, United
States of America, 4 Department of Psychiatry, Columbia University, New York, New York, United States of
America
* [email油protected]
Abstract
It has not been determined whether implementation of combined prevention programming
for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine
racial/ethnic disparities in New York City among persons who inject drugs after implementa-
tion of the New York City Condom Social Marketing Program in 2007. Quantitative inter-
views and HIV testing were conducted among persons who inject drugs entering Mount
Sinai Beth Israel drug treatment (20072014). 703 persons who inject drugs who began in-
jecting after implementation of large-scale syringe exchange were included in the analyses.
Factors independently associated with being HIV seropositive were identified and a pub-
lished model was used to estimate HIV infections due to sexual transmission. Overall HIV
prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted
odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI
1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced
HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6
0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Ra-
cial/ethnic disparities among persons who inject drugs were not significantly different from
previous disparities. Reducing these persistent disparities may require new interventions
(treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
Introduction
Significant racial/ethnic disparities in HIV infection among persons who inject drugs (PWID)
have been observed in many countries, with ethnic minority group members [1] and females
[2] typically having higher HIV prevalence. There are effective interventions to reduce HIV
transmission among PWID, and the logic of combined prevention programming is that
PLOS ONE | DOI:10.1371/journal.pone.0126180 May 12, 2015 1 / 11
OPEN ACCESS
Citation: Des Jarlais D, Arasteh K, McKnight C,
Feelemyer J, Hagan H, Cooper H, et al. (2015) Will
"Combined Prevention" Eliminate Racial/Ethnic
Disparities in HIV Infection among Persons Who
Inject Drugs in New York City? PLoS ONE 10(5):
e0126180. doi:10.1371/journal.pone.0126 ...
This document reviews literature on anaesthetic considerations for HIV-positive parturients. Several studies found that regional anaesthesia can be safely administered and does not negatively impact immune function or disease progression in asymptomatic HIV-positive women. While some early concerns existed around potential neurological complications, more recent research has found no increased risk. The choice of anaesthesia should be based on standard obstetric factors, with regional anaesthesia being a good option for caesarean delivery when there are no contraindications. Overall, the literature indicates that with proper clinical management including antiretroviral therapy, both general and regional anaesthesia can be used safely in HIV-positive parturients.
Cancer Biomarkers Research, HPV and Cancer, HPV VaccineJames Lyons-Weiler
油
The document discusses HPV (human papillomavirus) and cancer biomarkers. It notes that HPV vaccines target certain high-risk HPV types linked to cancers like cervical cancer. Some studies have found evidence of "type replacement" where non-vaccine HPV types increase in prevalence after vaccination, potentially limiting vaccine effectiveness. However, other studies have not found clear evidence of type replacement or have dismissed observed increases in non-vaccine types. There is ongoing debate about the ability of HPV vaccines to prevent cancer and their long-term safety profile based on limitations in clinical trials.
Syringe exchange programs (SEPs) have been shown to be a cost-effective intervention for preventing HIV among injection drug users (IDUs). SEPs are associated with an 80% reduction in HIV incidence among IDUs over the last 20 years. While HIV rates have decreased among most groups, IDUs have seen one of the largest improvements due in large part to SEPs increasing access to sterile syringes. However, SEPs remain controversial in the US despite evidence that they are cost-effective and reduce HIV transmission by providing sterile injection equipment and linking IDUs to healthcare. Further advocacy is needed to restore federal funding for expanding SEPs.
HIV surveillance involves systematically collecting and analyzing HIV/AIDS data to guide prevention and treatment programs. Key aspects of HIV surveillance include monitoring prevalence, incidence, opportunistic infections, and antiretroviral drug resistance. Accurate case definitions and timely reporting are important for effective surveillance. The goals of HIV surveillance are to detect trends in the epidemic, identify at-risk groups, evaluate prevention programs, and inform research and policy.
This document analyzes racial disparities in flu vaccination rates in the United States using data from the 2010 National Health Interview Survey. It finds that minorities, especially Black individuals, have significantly lower flu vaccination rates than whites, likely due to barriers to healthcare access. Married individuals and those who are employed have higher vaccination rates than unmarried or unemployed individuals. The document controls for variables like age, sex, and employment status to better understand the independent effect of race and marital status on vaccination rates.
Multiple health problems in elderly peoplepage 950Ex.docxgilpinleeanna
油
Multiple health
problems in
elderly people
page 950
Excessive
drinking in
young women
page 952
Adverse drug
reactions in
elderly people
page 956
Palliative care
beyond cancer
page 958
Drug resistant
infections in
poor countries
page 948
Management
of chronic pain
page 954
M
A
K
IN
G
A
D
IF
FE
R
E
N
C
E
945BMJ | 26 APRIL 2008 | VOLUME 336
BMJ | Making a difference | 26 april 2008 | VoluMe 336 947
Running the gauntlet to improve
patient care
This supplement is the result of a gauntlet
thrown down, and picked up, during a dinner
in London just over a year ago. The gauntlet
thrower was Don Berwick, president of the
Institute for Healthcare Improvement in Boston.
What, he asked, was the BMJ Publishing Group
really for? What were we trying to achieve? In
reply, I and our chief executive, Stella Dutton,
were quick to quote the BMJs mission, which
ends with the crucial words to improve
outcomes for patients. Fine, said Don, but how
about being more specific: which outcomes,
what patients, by how much?
We took his suggestion seriously. Why not
target a few important healthcare problems,
taking a quality improvement approach
and focusing on the evidence on how to
make a difference in these areas? But how
to choose which issues to tackle among
the many millions of pressing healthcare
challenges facing the world? We turned in the
first instance to BMJ readers. In May 2007
we asked you to tell us what information was
most needed to improve the quality of care of
patients in clinical practice. From your many
rapid responses we harvested more than 200
ideas. After categorising these and matching
them against the priorities of national and
international bodies, we created a shortlist
of 12. With the help of an expert panel (see
http://makingadifference.bmj.com) we cut
these down to six.
Inevitably the choice of topics is subjective
rather than scientific, but the six we have
ended up with are interesting. Several turn the
spotlight on areas that are less than glamorous
and are perhaps all too often passed over, even
as their impact on individual lives and society
increases. Two topics deal with problems of
old age: multiple illness and adverse drug
reactions. Two deal with palliation: of chronic
pain and in dying from non-malignant disease.
The remaining topics deal with two very
different but serious and growing public health
challenges: drug resistant infections in the
developing world and excessive drinking in
young women. You will no doubt find important
gaps in what we have chosen. But if this
initiative proves useful we can expand it further.
On each of the six topics weve invited
leading commentators to write the pairs
of articles that make up this supplement.
One article in each pair aims to describe
the importance of the problem in terms of
its health and societal impact. The other
looks at the available evidence on quality
improvement initiat ...
Imperial college-covid19-npi-modelling-16-03-2020Mumbaikar Le
油
This document summarizes the results of epidemiological modelling to assess the potential impact of non-pharmaceutical interventions (NPIs) aimed at reducing COVID-19 transmission in the UK and US. It finds that while mitigation strategies could reduce healthcare demand and deaths, hundreds of thousands may still die and healthcare systems would be overwhelmed. Suppression, including social distancing and case isolation, is the preferred option but would need to be maintained until a vaccine is available, around 18 months. Intermittent distancing may allow temporary relaxation but cases would likely rebound without continuous measures. Experience in China and South Korea shows suppression is possible short-term, but long-term feasibility and economic costs require further analysis.
Powepoint On Epidemiological INDICES OF TB
Suitable For Community Medicine Students - KUHS
KERALA MEDICAL BOARD
Prepared By A Student from
Mount Zion Medical College , Chayalode Adoor
Imperial college covid19 europe estimates and npi impactValentina Corona
油
The document summarizes estimates from a model analyzing COVID-19 mortality data from 11 European countries. Key findings include:
- Millions of infections have likely occurred, far more than the number detected. Italy may have had 5.9 million infections (9.8% of population) as of March 28th.
- Non-pharmaceutical interventions have likely reduced the reproduction number (Rt) substantially, though estimates vary by country. On average, interventions represent a 64% reduction from initial Rt of around 3.87.
- Interventions may have averted 59,000 deaths by March 31st across the 11 countries. More data is needed to determine if Rt has been driven below 1 in
This document summarizes key information about influenza, including its prevention, diagnosis, treatment, and practice improvement. It notes that influenza is an acute viral respiratory disease that causes millions of medical visits and thousands of deaths annually in the US. Elderly persons have the highest risk of hospitalization and death. The primary prevention method is annual vaccination, with early antiviral treatment providing the greatest clinical benefit for those infected. High-risk groups who should receive vaccination include young children, elderly adults, pregnant women, and those with certain chronic medical conditions. Vaccine effectiveness varies depending on antigenic matching between vaccine and circulating virus strains but is moderately effective at preventing influenza infections.
Vaccine delivery with speed, scale and equityKelley Hodge
油
For current and future COVID-19 vaccine rollouts, robust delivery strategies are essential to manage the initial scarce supply and adapt to the dynamic demand for COVID-19 vaccines.
To maximize the public health benefit from vaccines, we must integrate the evidence base on how to design delivery channels that vaccinate with speed, scale and equity.
The value of real-world evidence for clinicians and clinical researchers in t...Arete-Zoe, LLC
油
In the midst of a rapidly spreading global pandemic, real-world evidence can offer invaluable insight into the most promising treatments, risk factors, and not only predict but suggest how to improve outcomes. Despite overwhelming news coverage, significant knowledge gaps regarding COVID-19 persist. The current uncertainties regarding incidence and the case fatality rate can only be addressed by widespread testing. But the paucity of testing, and diversity of approaches implemented in different countries, particularly among the general asymptomatic public, perpetuates a lack of understanding about spread and infectivity. The essential indicators that would describe the pandemic more accurately can be obtained using real-world data (RWD). To that purpose, we designed a data collection tool to collect data from hospitals that treat COVID-19 patients. The captured data will enhance our understanding of the COVID-19 pandemic, identify risk factors relevant for triage, relate to other similar seasonal infections and gain insight into the safety and efficacy of experimental and off-label therapies. Knowledge derived from a focused data collection effort will enable clinicians to adjust rapidly clinical protocols and discontinue interventions that turn out to be ineffective or harmful. By deploying our elegantly designed survey to capture routine clinical indicators, we avoid placing an additional burden on practitioners. Systematically generating real-world evidence can decrease the time to insight compared to randomized clinical trials, improving the odds for patients in rapidly changing conditions.
Infectious diseases pose a major risk to public health in Canada. There are several contributing factors, including rising antimicrobial resistance due to overprescription of antibiotics, increased risk of vector-borne and waterborne diseases due to climate change, and higher rates of sexually transmitted and healthcare-associated infections. Better surveillance systems, public health initiatives, and prevention programs are needed to address this growing threat.
CloudMonitor - Architecture Audit Review February 2025.pdfRodney Joyce
油
CloudMonitor FinOps is now a Microsoft Certified solution in the Azure Marketplace. This little badge means that we passed a 3rd-party Technical Audit as well as met various sales KPIs and milestones over the last 12 months.
We used our existing Architecture docs for CISOs and Cloud Architects to craft an Audit Response - I've shared it below to help others obtain their cert.
Interestingly, 90% of our customers are in the USA, with very few in Australia. This is odd as the first thing I hear in every meetup and conference, from partners, customers and Microsoft, is that they want to optimise their cloud spend! But very few Australian companies are using the FinOps Framework to lower Azure costs.
More Related Content
Similar to COVID-19 Analysis in India presentation.pptx (20)
e632 www.thelancet.comhiv Vol 6 September 2019ViewpoiAlyciaGold776
油
e632 www.thelancet.com/hiv Vol 6 September 2019
Viewpoint
The disconnect between individual-level and population-level
HIV prevention benefits of antiretroviral treatment
Stefan Baral, Amrita Rao, Patrick Sullivan, Nancy Phaswana-Mafuya, Daouda Diouf, Greg Millett, Helgar Musyoki, Elvin Geng, Sharmistha Mishra
In 2019, the HIV pandemic is growing and soon over 40 million people will be living with HIV. Effective population-
based approaches to decrease HIV incidence are as relevant as ever given modest reductions observed over the past
decade. Treatment as prevention is often heralded as the path to improve HIV outcomes and to reduce HIV
incidence. Although treatment of an individual does eliminate onward transmission to serodifferent partners
(unde tectable=untransmittable or U=U), population-level observational and experimental data have not shown a similar
effect with scale-up of treatment on reducing HIV incidence. This disconnect might be the result of little attention given
to heterogeneities of HIV acquisition and transmission risks that exist in people at risk for and living with HIV, even in
the most broadly generalised epidemics. Available data suggest that HIV treatment is treatment, HIV prevention is
prevention, and specificity of HIV treatment approaches towards people at highest risk of onward transmission drives
the intersection between the two. All people living with HIV deserve HIV treatment, but both more accurately estimating
and optimising the potential HIV prevention effects of universal treatment approaches necessitates understanding who
is being supported with treatment rather than a focus on treatment targets such as 90-90-90 or 95-95-95.
Introduction
In 2019, we are at a pivotal time in the global HIV response
in that many people believe that the HIV pandemic is
over given the advances in HIV treatment.1 Yet the HIV
pandemic continues to grow as defined by numbers of
people living with HIV. Specifically, given the encouraging
decreases in overall mortality among people living with
HIV, in the context of universal treat ment as prevention,
approximately 930 000 more people annually (1揃7 million
new infections minus 770 000 deaths of people living with
HIV) require anti retroviral therapy (ART) and many more
would need to change ART regimens. At the current rate
of new infections, over 40 million people will be living
with HIV by 2025.2 The global optimism about the HIV
pandemic has not been matched by decreases in new
HIV infections. New infections have declined by less than
2% per year since 2005, which means that between
1揃8 and 2揃5 million people acquired HIV in 2017.2,3 To
date, just over 60% of the 37揃9 million people living with
HIV are on ART; of those 37揃9 million, just over half
(20揃1 million) are estimated to have achieved viral sup足
pression.2 Taken together, these data suggest that an
estimated 18 million people living with HIV require ART
or improved ART regimens giv ...
The document discusses guidelines for diagnosing and treating high blood pressure from the National High Blood Pressure Education Program Coordinating Committee. It notes that systolic blood pressure is more important than diastolic pressure for those over 50 years old. It also discusses "prehypertension" between 120-139/80-89 mm Hg and treatment thresholds. The JNC 7 guidelines were issued in 1997 while JNC 8 included treatment algorithms and differences from JNC 7.
The document discusses guidelines for diagnosing and treating high blood pressure from the National High Blood Pressure Education Program Coordinating Committee. It notes that systolic blood pressure is more important than diastolic pressure for those over 50 years old. It also discusses "prehypertension" between 120-139/80-89 mm Hg and treatment thresholds. The JNC 7 guidelines were issued in 1997 while the JNC 8 guidelines from 2013 include treatment algorithms and comparisons to JNC 7.
This document contains a final exam for HSA 535 that covers topics in epidemiology, including descriptive epidemiology, measures of disease frequency and association, study designs, screening and prevention. It includes 30 multiple choice questions testing knowledge of concepts like rates, cohorts, screening test validation, chronic disease risk factors and occupational health studies. It also provides short discussions on applying epidemiology principles to address issues like type 2 diabetes and cancer screening programs. The exam evaluates understanding of key epidemiology topics and how to apply them to analyze health problems and propose evidence-based solutions.
NUR 440 Evidence TableStudy CitationDesignMethodSample.docxvannagoforth
油
NUR 440 Evidence Table
Study Citation
Design
Method
Sample
Data Collection
Data Analysis
Validity
Reliability
Magill, S. S., OLeary, E., Janelle, S. J., Thompson, D. L., Dumyati, G., Nadle, J., & Ray, S. M. (2018). Changes in prevalence of health careassociated infections in US Hospitals.油New England Journal of Medicine,油379(18), 1732-1744.
Longitudinal and multivariable log-binomial regression modeling
At Emerging Infections Program sites in 10 states, we recruited up to 25 hospitals in each site area, prioritizing hospitals that had participated in the 2011 survey.
Random samples of patients in acute care locations were selected from hospitals morning censuses on the survey date with the use of the method that had been used in the 2011 survey
Trained staff of the Emerging Infections Program sites reviewed medical records on the survey date or retrospectively to collect basic demographic and clinical data.
In 2015, a total of 12,299 patients in 199 hospitals were surveyed, as compared with 11,282 patients in 183 hospitals in 2011. Pneumonia, gastrointestinal infections and surgical-site infections were the most common health careassociated infections.
The CDC determined the survey to be a non-research activity.
Point-prevalence surveys of health careassociated infections in health care settings complement location- or infection-specific National Healthcare Safety Network data.
Zuarez-Easton, S., Zafran, N., Garmi, G., & Salim, R. (2017). Postcesarean wound infection: prevalence, impact, prevention, and management challenges.油International journal of women's health,油9, 81.
Randomized trials, cohort, casecontrol, review, and meta-analysis were eligible.
Several electronic databases were searched from inception through June 2016: MEDLINE, PubMed, Ovid, and the Cochrane Library.
100,000 maternities compared to the period between 2003 and 2005
Data was collected through maternal comorbidities, appropriate antibiotic prophylaxis, and evidence-based surgical techniques practices.
Cesarean delivery is one of the most frequent surgical interventions performed worldwide and accounts for up to 60% of deliveries in a number of countries
Two authors (SZE and RS) selected articles first through focused review of abstracts. Eligible studies underwent full-text review.
The research Reviewed maternal death in the UK over a period of 3 years (20062008).
Chu, K., Maine, R., & Trelles, M. (2015). Cesarean section surgical site infections in sub-Saharan Africa: a multi-country study from Medecins Sans Frontieres.油World journal of surgery,油39(2), 350-355.
Logistic regression was used to model determinants of SSI.
This study included data from four emergency obstetric programs supported by Medecins sans Frontieres, from Burundi, the Democratic Republic of Congo (DRC), and Sierra Leone.
1,276 women underwent CS.
Data were prospectively collected using a standardized paper form and then entered into an electronic database.
Baseline characteristics w ...
RESEARCH ARTICLEWill Combined Prevention Eliminate Racia.docxronak56
油
RESEARCH ARTICLE
Will "Combined Prevention" Eliminate Racial/
Ethnic Disparities in HIV Infection among
Persons Who Inject Drugs in New York City?
Don Des Jarlais1*, Kamyar Arasteh1, Courtney McKnight1, Jonathan Feelemyer1,
Holly Hagan2, Hannah Cooper3, Aimee Campbell4, Susan Tross4, David Perlman1
1 The Baron Edmond de Rothschild Chemical Dependency Institute, Mount Sinai Beth Israel, New York,
New York, United States of America, 2 College of Nursing, New York University, New York, New York,
United States of America, 3 Rollins School of Public Health at Emory University, Atlanta, Georgia, United
States of America, 4 Department of Psychiatry, Columbia University, New York, New York, United States of
America
* [email油protected]
Abstract
It has not been determined whether implementation of combined prevention programming
for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine
racial/ethnic disparities in New York City among persons who inject drugs after implementa-
tion of the New York City Condom Social Marketing Program in 2007. Quantitative inter-
views and HIV testing were conducted among persons who inject drugs entering Mount
Sinai Beth Israel drug treatment (20072014). 703 persons who inject drugs who began in-
jecting after implementation of large-scale syringe exchange were included in the analyses.
Factors independently associated with being HIV seropositive were identified and a pub-
lished model was used to estimate HIV infections due to sexual transmission. Overall HIV
prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted
odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI
1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced
HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6
0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Ra-
cial/ethnic disparities among persons who inject drugs were not significantly different from
previous disparities. Reducing these persistent disparities may require new interventions
(treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
Introduction
Significant racial/ethnic disparities in HIV infection among persons who inject drugs (PWID)
have been observed in many countries, with ethnic minority group members [1] and females
[2] typically having higher HIV prevalence. There are effective interventions to reduce HIV
transmission among PWID, and the logic of combined prevention programming is that
PLOS ONE | DOI:10.1371/journal.pone.0126180 May 12, 2015 1 / 11
OPEN ACCESS
Citation: Des Jarlais D, Arasteh K, McKnight C,
Feelemyer J, Hagan H, Cooper H, et al. (2015) Will
"Combined Prevention" Eliminate Racial/Ethnic
Disparities in HIV Infection among Persons Who
Inject Drugs in New York City? PLoS ONE 10(5):
e0126180. doi:10.1371/journal.pone.0126 ...
This document reviews literature on anaesthetic considerations for HIV-positive parturients. Several studies found that regional anaesthesia can be safely administered and does not negatively impact immune function or disease progression in asymptomatic HIV-positive women. While some early concerns existed around potential neurological complications, more recent research has found no increased risk. The choice of anaesthesia should be based on standard obstetric factors, with regional anaesthesia being a good option for caesarean delivery when there are no contraindications. Overall, the literature indicates that with proper clinical management including antiretroviral therapy, both general and regional anaesthesia can be used safely in HIV-positive parturients.
Cancer Biomarkers Research, HPV and Cancer, HPV VaccineJames Lyons-Weiler
油
The document discusses HPV (human papillomavirus) and cancer biomarkers. It notes that HPV vaccines target certain high-risk HPV types linked to cancers like cervical cancer. Some studies have found evidence of "type replacement" where non-vaccine HPV types increase in prevalence after vaccination, potentially limiting vaccine effectiveness. However, other studies have not found clear evidence of type replacement or have dismissed observed increases in non-vaccine types. There is ongoing debate about the ability of HPV vaccines to prevent cancer and their long-term safety profile based on limitations in clinical trials.
Syringe exchange programs (SEPs) have been shown to be a cost-effective intervention for preventing HIV among injection drug users (IDUs). SEPs are associated with an 80% reduction in HIV incidence among IDUs over the last 20 years. While HIV rates have decreased among most groups, IDUs have seen one of the largest improvements due in large part to SEPs increasing access to sterile syringes. However, SEPs remain controversial in the US despite evidence that they are cost-effective and reduce HIV transmission by providing sterile injection equipment and linking IDUs to healthcare. Further advocacy is needed to restore federal funding for expanding SEPs.
HIV surveillance involves systematically collecting and analyzing HIV/AIDS data to guide prevention and treatment programs. Key aspects of HIV surveillance include monitoring prevalence, incidence, opportunistic infections, and antiretroviral drug resistance. Accurate case definitions and timely reporting are important for effective surveillance. The goals of HIV surveillance are to detect trends in the epidemic, identify at-risk groups, evaluate prevention programs, and inform research and policy.
This document analyzes racial disparities in flu vaccination rates in the United States using data from the 2010 National Health Interview Survey. It finds that minorities, especially Black individuals, have significantly lower flu vaccination rates than whites, likely due to barriers to healthcare access. Married individuals and those who are employed have higher vaccination rates than unmarried or unemployed individuals. The document controls for variables like age, sex, and employment status to better understand the independent effect of race and marital status on vaccination rates.
Multiple health problems in elderly peoplepage 950Ex.docxgilpinleeanna
油
Multiple health
problems in
elderly people
page 950
Excessive
drinking in
young women
page 952
Adverse drug
reactions in
elderly people
page 956
Palliative care
beyond cancer
page 958
Drug resistant
infections in
poor countries
page 948
Management
of chronic pain
page 954
M
A
K
IN
G
A
D
IF
FE
R
E
N
C
E
945BMJ | 26 APRIL 2008 | VOLUME 336
BMJ | Making a difference | 26 april 2008 | VoluMe 336 947
Running the gauntlet to improve
patient care
This supplement is the result of a gauntlet
thrown down, and picked up, during a dinner
in London just over a year ago. The gauntlet
thrower was Don Berwick, president of the
Institute for Healthcare Improvement in Boston.
What, he asked, was the BMJ Publishing Group
really for? What were we trying to achieve? In
reply, I and our chief executive, Stella Dutton,
were quick to quote the BMJs mission, which
ends with the crucial words to improve
outcomes for patients. Fine, said Don, but how
about being more specific: which outcomes,
what patients, by how much?
We took his suggestion seriously. Why not
target a few important healthcare problems,
taking a quality improvement approach
and focusing on the evidence on how to
make a difference in these areas? But how
to choose which issues to tackle among
the many millions of pressing healthcare
challenges facing the world? We turned in the
first instance to BMJ readers. In May 2007
we asked you to tell us what information was
most needed to improve the quality of care of
patients in clinical practice. From your many
rapid responses we harvested more than 200
ideas. After categorising these and matching
them against the priorities of national and
international bodies, we created a shortlist
of 12. With the help of an expert panel (see
http://makingadifference.bmj.com) we cut
these down to six.
Inevitably the choice of topics is subjective
rather than scientific, but the six we have
ended up with are interesting. Several turn the
spotlight on areas that are less than glamorous
and are perhaps all too often passed over, even
as their impact on individual lives and society
increases. Two topics deal with problems of
old age: multiple illness and adverse drug
reactions. Two deal with palliation: of chronic
pain and in dying from non-malignant disease.
The remaining topics deal with two very
different but serious and growing public health
challenges: drug resistant infections in the
developing world and excessive drinking in
young women. You will no doubt find important
gaps in what we have chosen. But if this
initiative proves useful we can expand it further.
On each of the six topics weve invited
leading commentators to write the pairs
of articles that make up this supplement.
One article in each pair aims to describe
the importance of the problem in terms of
its health and societal impact. The other
looks at the available evidence on quality
improvement initiat ...
Imperial college-covid19-npi-modelling-16-03-2020Mumbaikar Le
油
This document summarizes the results of epidemiological modelling to assess the potential impact of non-pharmaceutical interventions (NPIs) aimed at reducing COVID-19 transmission in the UK and US. It finds that while mitigation strategies could reduce healthcare demand and deaths, hundreds of thousands may still die and healthcare systems would be overwhelmed. Suppression, including social distancing and case isolation, is the preferred option but would need to be maintained until a vaccine is available, around 18 months. Intermittent distancing may allow temporary relaxation but cases would likely rebound without continuous measures. Experience in China and South Korea shows suppression is possible short-term, but long-term feasibility and economic costs require further analysis.
Powepoint On Epidemiological INDICES OF TB
Suitable For Community Medicine Students - KUHS
KERALA MEDICAL BOARD
Prepared By A Student from
Mount Zion Medical College , Chayalode Adoor
Imperial college covid19 europe estimates and npi impactValentina Corona
油
The document summarizes estimates from a model analyzing COVID-19 mortality data from 11 European countries. Key findings include:
- Millions of infections have likely occurred, far more than the number detected. Italy may have had 5.9 million infections (9.8% of population) as of March 28th.
- Non-pharmaceutical interventions have likely reduced the reproduction number (Rt) substantially, though estimates vary by country. On average, interventions represent a 64% reduction from initial Rt of around 3.87.
- Interventions may have averted 59,000 deaths by March 31st across the 11 countries. More data is needed to determine if Rt has been driven below 1 in
This document summarizes key information about influenza, including its prevention, diagnosis, treatment, and practice improvement. It notes that influenza is an acute viral respiratory disease that causes millions of medical visits and thousands of deaths annually in the US. Elderly persons have the highest risk of hospitalization and death. The primary prevention method is annual vaccination, with early antiviral treatment providing the greatest clinical benefit for those infected. High-risk groups who should receive vaccination include young children, elderly adults, pregnant women, and those with certain chronic medical conditions. Vaccine effectiveness varies depending on antigenic matching between vaccine and circulating virus strains but is moderately effective at preventing influenza infections.
Vaccine delivery with speed, scale and equityKelley Hodge
油
For current and future COVID-19 vaccine rollouts, robust delivery strategies are essential to manage the initial scarce supply and adapt to the dynamic demand for COVID-19 vaccines.
To maximize the public health benefit from vaccines, we must integrate the evidence base on how to design delivery channels that vaccinate with speed, scale and equity.
The value of real-world evidence for clinicians and clinical researchers in t...Arete-Zoe, LLC
油
In the midst of a rapidly spreading global pandemic, real-world evidence can offer invaluable insight into the most promising treatments, risk factors, and not only predict but suggest how to improve outcomes. Despite overwhelming news coverage, significant knowledge gaps regarding COVID-19 persist. The current uncertainties regarding incidence and the case fatality rate can only be addressed by widespread testing. But the paucity of testing, and diversity of approaches implemented in different countries, particularly among the general asymptomatic public, perpetuates a lack of understanding about spread and infectivity. The essential indicators that would describe the pandemic more accurately can be obtained using real-world data (RWD). To that purpose, we designed a data collection tool to collect data from hospitals that treat COVID-19 patients. The captured data will enhance our understanding of the COVID-19 pandemic, identify risk factors relevant for triage, relate to other similar seasonal infections and gain insight into the safety and efficacy of experimental and off-label therapies. Knowledge derived from a focused data collection effort will enable clinicians to adjust rapidly clinical protocols and discontinue interventions that turn out to be ineffective or harmful. By deploying our elegantly designed survey to capture routine clinical indicators, we avoid placing an additional burden on practitioners. Systematically generating real-world evidence can decrease the time to insight compared to randomized clinical trials, improving the odds for patients in rapidly changing conditions.
Infectious diseases pose a major risk to public health in Canada. There are several contributing factors, including rising antimicrobial resistance due to overprescription of antibiotics, increased risk of vector-borne and waterborne diseases due to climate change, and higher rates of sexually transmitted and healthcare-associated infections. Better surveillance systems, public health initiatives, and prevention programs are needed to address this growing threat.
CloudMonitor - Architecture Audit Review February 2025.pdfRodney Joyce
油
CloudMonitor FinOps is now a Microsoft Certified solution in the Azure Marketplace. This little badge means that we passed a 3rd-party Technical Audit as well as met various sales KPIs and milestones over the last 12 months.
We used our existing Architecture docs for CISOs and Cloud Architects to craft an Audit Response - I've shared it below to help others obtain their cert.
Interestingly, 90% of our customers are in the USA, with very few in Australia. This is odd as the first thing I hear in every meetup and conference, from partners, customers and Microsoft, is that they want to optimise their cloud spend! But very few Australian companies are using the FinOps Framework to lower Azure costs.
Cost sheet. with basics and formats of sheetsupreetk82004
油
Cost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheetCost sheet. with basics and formats of sheet
Deep-QPP: A Pairwise Interaction-based Deep Learning Model for Supervised Que...suchanadatta3
油
Motivated by the recent success of end-to-end deep neural models
for ranking tasks, we present here a supervised end-to-end neural
approach for query performance prediction (QPP). In contrast to
unsupervised approaches that rely on various statistics of document
score distributions, our approach is entirely data-driven. Further,
in contrast to weakly supervised approaches, our method also does
not rely on the outputs from different QPP estimators. In particular, our model leverages information from the semantic interactions between the terms of a query and those in the top-documents retrieved with it. The architecture of the model comprises multiple layers of 2D convolution filters followed by a feed-forward layer of parameters. Experiments on standard test collections demonstrate
that our proposed supervised approach outperforms other state-of-the-art supervised and unsupervised approaches.
A Relative Information Gain-based Query Performance Prediction Framework with...suchanadatta3
油
To improve the QPP estimate for neural models, we propose to use additional information from a set of queries that express a similar information need to the current one (these queries are called variants). The key idea of our proposed method, named Weighted Relative Information Gain (WRIG), is to estimate the performance of these variants, and then to improve the QPP estimate of the original query based on the relative differences with the variants. The hypothesis is that if a querys estimate is significantly higher than the average QPP score of its variants, then the original query itself is assumed (with a higher confidence) to be one for which a retrieval model works well.
1. COVID-19 Analysis in India
ANALYZING TRENDS, VACCINATION COVERAGE, AND
RELATIONSHIPS BETWEEN CASES AND VACCINATION EFFORTS.
This presentation provides an in-depth analysis of COVID-19 cases,
vaccination coverage, and testing trends across India. By exploring
datasets that track daily case updates, state wise vaccination progress,
and testing efforts, we aim to uncover insights that can guide decisions in
managing the pandemic.
2. Data Sources
COVID-19 India Dataset: Daily updates on confirmed cases, recoveries, and deaths across
Indian states.
COVID-19 Vaccine Data: Progress on vaccinations in different states, including gender
distribution.
State wise Testing Data: Statistics on COVID-19 testing, number of tests conducted by state
3. COVID-19 Cases Over Time
A time-series visualization showing the trend of confirmed, active, cured, and death cases.
Key Insight: The confirmed and active cases saw significant increases over time, but recovered and death cases also
followed upward trends.
4. State wise COVID-19 Death Rate
The death rate was calculated as the number of deaths divided by confirmed cases.
Key Insight: Certain states had significantly higher death rates compared to others.
5. Top 10 States with Highest Cured Cases
The top 10 states with the highest number of cured cases were analyzed.
Key Insight: These states had a higher recovery rate, helping in managing the
pandemic effectively.
6. Vaccination Coverage by Gender
A breakdown of the vaccination distribution by gender (male, female, transgender).
Key Insight: The majority of the vaccinations were administered to males, followed by
females and a small portion to transgender individuals.
7. Vaccination Coverage in Different States
Total number of individuals vaccinated across different states.
Key Insight: Some states achieved much higher coverage, playing a key role in
controlling the spread of the virus.
8. Correlation between COVID-19 Cases and Vaccinations
An analysis of the relationship between the total number of confirmed cases and vaccine doses
administered.
Key Insight: There was a correlation between higher vaccination coverage and a reduction in
COVID-19 cases.
9. Summary of Findings
Trends show a rapid increase in cases followed by recovery spikes.
Vaccination efforts are crucial in managing case numbers.
High variation in death rates and vaccination coverage across states.
Effective recovery strategies in some states.
Strong correlation between vaccination and reduced case numbers.