Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

Epi Notes

The South Carolina Department of Health and Environmental Control, Bureau of Disease Control publishes Epi Notes, with articles on epidemiology of reportable conditions; surveillance and reporting of diseases/conditions, outbreaks, and events of public health significance; prevention and treatment of disease; and other topics of interest to DHEC’s disease reporting partners.

General ledger account coding

The Supplier-Relationship Management system is used by SC Department of Motor Vehicles personnel to requisition most purchases of services and materials for DMV purposes. General ledger account codes are first assigned by the shopping cart preparer. Administrative departments such as procurement, payables and budget regularly correct general ledger codes during the purchasing cycle to ensure proper reporting. DMV goals are consistent with accurate reporting of expenditures by general ledger account code. Incorrect reporting would be contrary to DMV' s vision of promoting effective and efficient business processes. Journal entries increased from 34 to 66 in FY2014 and FY20152 ; with a notable amount correcting the general ledger code. This project examines the assignment or correction of general ledger account codes for DMV's planned purchases for the purpose of process improvement.

L'Intégration d'un Module d'Étude Internet Dans la Classe de Comptabilité: Perceptions des Élèves et les Résultats Académiques

Implemented in the context of Business Administration students enrolled in a college level three year technology program, this research investigated students’ perceptions and academic results concurrent with the implementation of an online web module designed to facilitate student self-study. The students involved in this research were enrolled in a program that, while offering a broad education in business disciplines, specialized in the field of accounting. As a result, students were enrolled in academically rigorous accounting courses in each of the six semesters of the program. The weighting of these accounting courses imposes a significant self-study component – typically matching or exceeding the time spent in class. In this context many of the students enrolled in the Business Administration Program have faced difficulties completing the self-study component of the course effectively as demonstrated in low homework completion rates, low homework grade averages and ultimately low success rates in the courses. In an attempt to address this situation this research studied the implementation of a web-based self-study module. Through this module students could access a number of learning tools that were designed to facilitate the self-study process under the premise that more effective self-study learning tools will help remove obstacles and provide more timely confirmation of learning during student self-study efforts. This research collected data from a single cohort of students drawn from the first three sequential accounting courses of the Business Administration Program. The web-based self-study module was implemented in the third of the three sequential accounting courses. The first two of these courses implemented a traditional manual self-study environment. Data collected from the three accounting courses included homework completion rates, homework, exam and final grades for the respective courses. In addition the web-study module allowed the automatic reporting of student usage of a number of specific online learning tools. To complement the academic data, students were surveyed to gain insight into their perceptions of the effectiveness of the web-based system. The research provided a number of interesting insights. First among these was a confirmation of the importance of the self-study process in the academic achievement of the learners. Regardless of the self-study environment, manual or web-enhanced, a significant positive correlation existed between the students’ self-study results, demonstrated in both homework completion rates and homework averages and the corresponding final grades. These results confirm the importance of self-study found generally in the prevailing academic literature regarding students enrolled in higher education. In addition, the web-enhanced learning environment implemented during the third accounting course coincided with significantly higher homework completion rates and corresponding homework averages: homework completion rates in particular increased from a combined average of 63% in the first two accounting courses to 93% in the web-enhanced context of the third accounting course. Moreover, the homework completion rates of the web-enhanced course were evenly distributed across the cohort of students. A quartile-based analysis was subsequently completed. Quartiles were constructed by ranking the students according to their combined average homework completion rates from the first two manual self-study courses, Accounting I and II. The quartile-based homework completion rates for the manual self-study courses Accounting I and II were subsequently compared to the results these same quartiles of students achieved in the web-based self-study within Accounting III. While the first two courses demonstrated significantly uneven homework completion rates across the quartiles ranging from 31% to 91% homework completion rates, the differences among the four quartiles within the web-enhanced module, with an average homework completion rate of 93%, were statistically insignificant. Congruent with the positive academic results observed in the third, web-enhanced course, through the corresponding survey, students expressed a strong attitude in favor of the online self-study environment. This research was designed to add to the existing research that studies the implementation of learning in an online setting. Specifically, the research was designed to explore a middle ground of online learning – a web-enhanced course – a context that supplements the classroom experience rather than replacing it. The web-enhanced accounting course demonstrated impressive favorable results, both academically and in terms of students' perception of the system; these results suggest that a web-enhanced environment can provide learning tools that facilitate the self-study process while providing a structured learning environment that can help developing learners reach their potential.

Endemic zoonoses: a one health approach

Endemic zoonotic diseases remain a serious but poorly recognised problem in affected communities in developing countries. Despite the overall burden of zoonoses on human and animal health, information about their impacts in endemic settings is lacking and most of these diseases are continuously being neglected. The non-specific clinical presentation of these diseases has been identified as a major challenge in their identification (even with good laboratory diagnosis), and control. The signs and symptoms in animals and humans respectively, are easily confused with other non-zoonotic diseases, leading to widespread misdiagnosis in areas where diagnostic capacity is limited. The communities that are mostly affected by these diseases live in close proximity with their animals which they depend on for livelihood, which further complicates the understanding of the epidemiology of zoonoses. This thesis reviewed the pattern of reporting of zoonotic pathogens that cause febrile illness in malaria endemic countries, and evaluates the recognition of animal associations among other risk factors in the transmission and management of zoonoses. The findings of the review chapter were further investigated through a laboratory study of risk factors for bovine leptospirosis, and exposure patterns of livestock coxiellosis in the subsequent chapters. A review was undertaken on 840 articles that were part of a bigger review of zoonotic pathogens that cause human fever. The review process involves three main steps: filtering and reference classification, identification of abstracts that describe risk factors, and data extraction and summary analysis of data. Abstracts of the 840 references were transferred into a Microsoft excel spread sheet, where several subsets of abstracts were generated using excel filters and text searches to classify the content of each abstract. Data was then extracted and summarised to describe geographical patterns of the pathogens reported, and determine the frequency animal related risk factors were considered among studies that investigated risk factors for zoonotic pathogen transmission. Subsequently, a seroprevalence study of bovine leptospirosis in northern Tanzania was undertaken in the second chapter of this thesis. The study involved screening of serum samples, which were obtained from an abattoir survey and cross-sectional study (Bacterial Zoonoses Project), for antibodies against Leptospira serovar Hardjo. The data were analysed using generalised linear mixed models (GLMMs), to identify risk factors for cattle infection. The final chapter was the analysis of Q fever data, which were also obtained from the Bacterial Zoonoses Project, to determine exposure patterns across livestock species using generalized linear mixed models (GLMMs). Leptospira spp. (10.8%, 90/840) and Rickettsia spp. (10.7%, 86/840) were identified as the most frequently reported zoonotic pathogens that cause febrile illness, while Rabies virus (0.4%, 3/840) and Francisella spp. (0.1%, 1/840) were least reported, across malaria endemic countries. The majority of the pathogens were reported in Asia, and the frequency of reporting seems to be higher in areas where outbreaks are mostly reported. It was also observed that animal related risk factors are not often considered among other risk factors for zoonotic pathogens that cause human fever in malaria endemic countries. The seroprevalence study indicated that Leptospira serovar Hardjo is widespread in cattle population in northern Tanzania, and animal husbandry systems and age are the two most important risk factors that influence seroprevalence. Cattle in the pastoral systems and adult cattle were significantly more likely to be seropositive compared to non-pastoral and young animals respectively, while there was no significant effect of cattle breed or sex. Exposure patterns of Coxiella burnetii appear different for each livestock species. While most risk factors were identified for goats (such as animal husbandry systems, age and sex) and sheep (animal husbandry systems and sex), there were none for cattle. In addition, there was no evidence of a significant influence of mixed livestock-keeping on animal coxiellosis. Zoonotic agents that cause human fever are common in developing countries. The role of animals in the transmission of zoonotic pathogens that cause febrile illness is not fully recognised and appreciated. Since Leptospira spp. and C. burnetii are among the most frequently reported pathogens that cause human fever across malaria endemic countries, and are also prevalent in livestock population, control and preventive measures that recognise animals as source of infection would be very important especially in livestock-keeping communities where people live in close proximity with their animals.

Ideación suicida y desesperanza en pacientes con cáncer

El objetivo de la presente investigación fue identificar la relación entre ideación suicida y desesperanza en 160 pacientes con cáncer. La ideación suicida se midió a través de dos ítems de una entrevista semiestructurada, la escala de ideación suicida (ISS), el ítem 9 del inventario de depresión de Beck (BDI-IA). La desesperanza se midió con la escala de desesperanza de Beck (BHS). Los resultados obtenidos indicaron una relación significativa (p=.000) entre ideación suicida y desesperanza; una prevalencia de ideación suicida en los pacientes con cáncer entre 4.4% y 13.8% y de riesgo de suicidio entre 5.6% y 30.6%; y algún grado de desesperanza en 31.9 % de los participantes. De acuerdo con lo anterior, se confirma que existe relación entre la desesperanza y la ideación suicida en pacientes oncológicos adultos. Adicionalmente, que estas variables están presentes en los pacientes y que ameritan atención en la intervención interdisciplinaria.

Perfil epidemiológico y análisis de la formulación antibiótica en pacientes con infección urinaria nosocomial en la Fundación Cardioinfantil en el año 2014

Introducción: La IVU es muy frecuenten en la (FCI - IC), Alrededor el 60% de los pacientes con diagnóstico de IVU nosocomial corresponden a gérmenes resistente, Desde el año 2010 el CLSI disminuyó los puntos de corte de sensibilidad en las enterobacteriaceae y removió la necesidad de tamizaje y confirmación de (BLEE), en el presente trabajo se pretende determinar el perfil epidemiológico de la formulación antibiótica en pacientes con IVU nosocomial. Diseño: Se realizó un estudio observacional analítico de corte transversal. Métodos: Se realizó un análisis univariado, bivariado y multivariado. El análisis bivariado y multivariado se realizó para determinar la medida de asociación teniendo en cuenta la formulación de Carbapenemico la variable dependiente, evaluándose mediante chi cuadrado. Resultados: Se revisaron 131 urocultivos, se incluyeron 116. Los aislamientos microbiológicos más frecuentemente encontrados fueron E. Coli y K. Pneumoniae, el 43.4% de los aislamientos, presentaron expresión de BLEE, 90% de los aislamientos fueron sensibles a Cefepime. La mayoría de los modelos obtenidos mostraron una fuerte asociación entre el reporte de BLEE en antibiograma con la formulación de carbapenémicos como terapia final OR 33,12 IC 95% (2,90 – 337,4). Conclusión: La epidemiologia de la IVU nosocomial en la FCI-IC no difiere de las referencias internacionales, no hay adherencia a las guías de manejo intrahospitalario y el reporte de la palabra BLEE en el antibiograma predice la formulación de antibiótico carbapenémico por el médico que lee el urocultivo

Seguridad del monitoreo hemodinámico invasivo versus mínimamente invasivo en pacientes con choque cardiogénico en cuidado intensivo adultos. Revisión sistemática

Introducción: El monitoreo hemodinámico es una herramienta para diagnosticar el choque cardiogénico y monitorear la respuesta al tratamiento; puede ser invasivo, mínimamente invasivo o no invasivo. Se realiza rutinariamente con catéter de arteria pulmonar (CAP) o catéter de Swan Ganz; nuevas técnicas de monitoreo hemodinámico mínimamente invasivo tienen menor tasa de complicaciones. Actualmente se desconoce cuál técnica de monitoreo cuenta con mayor seguridad en el paciente con choque cardiogénico. Objetivo: Evaluar la seguridad del monitoreo hemodinámico invasivo comparado con el mínimamente invasivo en pacientes con choque cardiogénico en cuidado intensivo adultos. Diseño: Revisión sistemática de la literatura. Búsqueda en Pubmed, EMBASE, OVID - Cochrane Library, Lilacs, Scielo, registros de ensayos clínicos, actas de conferencias, repositorios, búsqueda de literatura gris en Google Scholar, Teseo y Open Grey hasta agosto de 2016, publicados en inglés y español. Resultados: Se identificó un único estudio con 331 pacientes críticamente enfermos que comparó el monitoreo hemodinámico con CAP versus PiCCO que concluyó que después de la corrección de los factores de confusión, la elección del tipo de monitoreo no influyó en los resultados clínicos más importantes en términos de complicaciones y mortalidad. Dado que se incluyeron otros diagnósticos, no es posible extrapolar los resultados sólo a choque cardiogénico. Conclusión: En la literatura disponible no hay evidencia de que el monitoreo hemodinámico invasivo comparado con el mínimamente invasivo, en pacientes adultos críticamente enfermos con choque cardiogénico, tenga diferencias en cuanto a complicaciones y mortalidad.