Use of social media for receiving professional support in enhancing mothers’ lactation self-efficacy

Background: Insufficient support for breastfeeding and limited exclusive breastfeeding rates emphasize the need for high-impact approaches to enhance maternal confidence in lactation. Social media has emerged as a promising platform for professional support and information dissemination in this context. This review aims to examine the role of social media in providing professional lactation support to mothers in enhancing their lactation self-efficacy.Method: Employing PRISMA guidelines, the review sought relevant literature on professional assistance in enhancing breastfeeding self-efficacy. Major databases, including PubMed, CINAHL, Google Scholar, and Science Direct, were meticulously queried using targeted keywords. Every selected article underwent screening for English language and full-text accessibility.Results: The search yielded 15,746 hits, and after a meticulous screening process, 33 studies were included for synthesis. The synthesized literature revealed a dearth of studies investigating mothers\u27 viewpoints on utilizing social media for professional support to enhance breastfeeding self-efficacy, particularly within the context of Karachi, Pakistan. Despite this gap, the selected studies highlighted the potential of social media, to positively influence breastfeeding practices, provide emotional support, and deliver valuable information to mothers.Conclusion: The findings show a lack of specific studies conducted in Pakistan, which highlights the importance of conducting research that is customized to understand how mothers perceive the use of social media for professional breastfeeding support. The results emphasize the untapped opportunities presented by online platforms in promoting mothers\u27 confidence in breastfeeding and suggest the need for focused interventions that influence these digital channels to improve both maternal breastfeeding confidence and infant health

Proximity of Residence to Bodies of Water and Risk for West Nile Virus Infection: A Case-Control Study in Houston, Texas

West Nile virus (WNV), a mosquito-borne virus, has clinically affected hundreds of residents in the Houston metropolitan area since its introduction in 2002. This study aimed to determine if living within close proximity to a water source increases one's odds of infection with WNV. We identified 356 eligible WNV-positive cases and 356 controls using a population proportionate to size model with US Census Bureau data. We found that living near slow moving water sources was statistically associated with increased odds for human infection, while living near moderate moving water systems was associated with decreased odds for human infection. Living near bayous lined with vegetation as opposed to concrete also showed increased risk of infection. The habitats of slow moving and vegetation lined water sources appear to favor the mosquito-human transmission cycle. These methods can be used by resource-limited health entities to identify high-risk areas for arboviral disease surveillance and efficient mosquito management initiatives

Model-Based Recursive Partitioning of Patients’ Return Visits to Multispecialty Clinic During the 2009 H1N1 Pandemic Influenza (pH1N1)

Background During the 2009 H1N1 influenza pandemic (pH1N1), the proportion of outpatient visits to emergency departments, clinics and hospitals became elevated especially during the early months of the pandemic due to surges in sick, ‘worried well’ or returning patients seeking care. We determined the prevalence of return visits to a multispecialty clinic during the 2009 H1N1 influenza pandemic and identify subgroups at risk for return visits using model-based recursive partitioning. Methods This was a retrospective analysis of ILI-related medical care visits to multispecialty clinic in Houston, Texas obtained as part of the Houston Health Department Influenza Sentinel Surveillance Project (ISSP) during the 2009 H1N1 pandemic influenza (April 2009 – April 2010). The data comprised of 2680 individuals who made a total of 2960 clinic visits. Return visit was defined as any visit following the index visit after the wash-out phase prior to the study period. We applied nominal logistic regression and recursive partition models to determine the independent predictors and the response probabilities of return visits. The sensitivity and specificity of the outcomes probabilities was determined using receiver operating characteristic (ROC) curve. Results Overall, 4.56% (Prob. 0.0%-17.5%) of the cohort had return visits with significant variations observed attributed to age group (76.0%) and type of vaccine received by patients (18.4%) and Influenza A (pH1N1) test result (5.6%). Patients in age group 0-4 years were 9 times (aOR: 8.77, 95%CI: 3.39-29.95, p<0.0001) more likely than those who were 50+ years to have return visits. Similarly, patients who received either seasonal flu (aOR: 1.59, 95% CI 1.01-2.50, p=0.047) or pH1N1 (aOR: 1.74, 95%CI: 1.09-2.75, p=0.022) vaccines were about twice more likely to have return visits compared to those with no vaccination history. Model-based recursive partitioning yielded 19 splits with patients in subgroup I (patients of age group 0-4 years, who tested positive for pH1N1, and received both seasonal flu and pH1N1 vaccines) having the highest risk of return visits (Prob.=17.5%). The area under the curve (AUC) for both return and non-return visits was 72.9%, indicating a fairly accurate classification of the two groups. Conclusions Return visits in our cohort was more prevalent among children and young adults and those that received either seasonal flu or pH1N1 or both vaccines. Understanding the dynamics in care-seeking behavior during pandemic would assist policymakers with appropriate resource allocation, and in the design of initiatives aimed at mitigating surges and recurrent utilization of the healthcare system. Keywords: Model-based recursive partitioning, subgroup analysis, Influenza-like-illness, H1N1, influenza pandemic, care-seeking behavior, return visi

Carbapenem Resistant Enterobacteriaceae infections in Houston, Texas: An outline

ObjectiveTo examine demographic as well as clinical characteristics of theCarbapenam Resistant Enteriobacteriacae (CRE) Organisms cases inHouston, Texas, 2015-2016IntroductionAccording to CDC, CRE is used to describe bacteria that are non-susceptible to one or more carbapenems; doripenem, meropenemor imipenem and resistant to third generation cephalosporins likeceftriaxone, cefotaxime and ceftazidime. These organisms causeinfections that are associated with high mortality rates and they havethe potential to spread widely. Antibiotic resistant bacteria causemore than 2 million illnesses and at least 23,000 deaths each year inUnited States. CREs are found in many health care settings like acutecare hospitals, long term care facilities, nursing homes, rehabilitationfacilities and other health care settings. Although CREs includes anumber of species, reporting in State of Texas is limited to CRE-Klebsiellaspecies and CRE-E.coli.MethodsPopulation-based surveillance data was generated from Houston’selectronic disease surveillance system reported to Houston HealthDepartment (HHD) from October 2015 to July 2016. Descriptiveanalysis was performed to examine demographic and clinicalcharacteristics across different age groups, gender and race/ethnicity.HHD has received a total of 463 CRE cases during the time period,out of which 72 were non-reportable and did not meet the casecriteria, 187 were out of jurisdiction. The remaining 204 cases wereincluded in this study.ResultsOut of a total of 204 cases, males and females were representedequally (50% each). The mean age of the cases was 67 years(age ranges from 22-98). Majority of the cases were in the older agegroup, 70 years and above 53 (26%), followed by 48 (24%) in agegroup 80 and above years. Among the different race/ethnic groups,African-Americans comprised of 82 (40%), followed by Whites67 (33%) and Hispanics 33 (16%). Out of 204 cases, 156 (76%)were hospitalized, which included acute care hospital, long-termacute care or nursing home. Out of 156 hospitalized cases, 71 (34%)were in Intensive Care Unit (ICU) and 136 (67%) had an invasiveor indwelling device. Of all the cases, 80% had CREKlebsiellapneumoniae, followed by 11% who had CRE- E coli. The cases weredistributed evenly across the city when plotted on ArcGIS with theirresidential addresses.ConclusionsCRE cases are found to be more common among older age groups,African American population and in hospitalized patients. CRE canbe a ground for increasing infectious diseases in the community andone of the reason may be unnecessary use of antimicrobial agents.This study provides a glimpse into the number of CRE cases reportedin Houston since CREs are classified a separate disease in Texas.Further studies are needed to explore the occurrence of anti-microbialdrug resistance among the specific population groups and how thecase investigation efforts can be targeted to enhance prevention

Carbapenem Resistant Enterobacteriaceae infections in Houston, Texas: An outline

ObjectiveTo examine demographic as well as clinical characteristics of theCarbapenam Resistant Enteriobacteriacae (CRE) Organisms cases inHouston, Texas, 2015-2016IntroductionAccording to CDC, CRE is used to describe bacteria that are non-susceptible to one or more carbapenems; doripenem, meropenemor imipenem and resistant to third generation cephalosporins likeceftriaxone, cefotaxime and ceftazidime. These organisms causeinfections that are associated with high mortality rates and they havethe potential to spread widely. Antibiotic resistant bacteria causemore than 2 million illnesses and at least 23,000 deaths each year inUnited States. CREs are found in many health care settings like acutecare hospitals, long term care facilities, nursing homes, rehabilitationfacilities and other health care settings. Although CREs includes anumber of species, reporting in State of Texas is limited to CRE-Klebsiellaspecies and CRE-E.coli.MethodsPopulation-based surveillance data was generated from Houston’selectronic disease surveillance system reported to Houston HealthDepartment (HHD) from October 2015 to July 2016. Descriptiveanalysis was performed to examine demographic and clinicalcharacteristics across different age groups, gender and race/ethnicity.HHD has received a total of 463 CRE cases during the time period,out of which 72 were non-reportable and did not meet the casecriteria, 187 were out of jurisdiction. The remaining 204 cases wereincluded in this study.ResultsOut of a total of 204 cases, males and females were representedequally (50% each). The mean age of the cases was 67 years(age ranges from 22-98). Majority of the cases were in the older agegroup, 70 years and above 53 (26%), followed by 48 (24%) in agegroup 80 and above years. Among the different race/ethnic groups,African-Americans comprised of 82 (40%), followed by Whites67 (33%) and Hispanics 33 (16%). Out of 204 cases, 156 (76%)were hospitalized, which included acute care hospital, long-termacute care or nursing home. Out of 156 hospitalized cases, 71 (34%)were in Intensive Care Unit (ICU) and 136 (67%) had an invasiveor indwelling device. Of all the cases, 80% had CREKlebsiellapneumoniae, followed by 11% who had CRE- E coli. The cases weredistributed evenly across the city when plotted on ArcGIS with theirresidential addresses.ConclusionsCRE cases are found to be more common among older age groups,African American population and in hospitalized patients. CRE canbe a ground for increasing infectious diseases in the community andone of the reason may be unnecessary use of antimicrobial agents.This study provides a glimpse into the number of CRE cases reportedin Houston since CREs are classified a separate disease in Texas.Further studies are needed to explore the occurrence of anti-microbialdrug resistance among the specific population groups and how thecase investigation efforts can be targeted to enhance prevention

Factors associated with hospitalization due to streptococcal infection in Houston, Texas 2015-2016

ObjectiveTo study the factors associated with streptococcal infection that led to hospitalization in Houston, Texas for years 2015-2016IntroductionDifferent studies have shown that Streptococcal infections in adults are more common among older age, blacks, and underlying chronic medical conditions like diabetes, cardiovascular and kidney diseases.In specific, other studies have demonstrated that streptococcal pyogenes can cause severe illnesses and dramatic hospital outbreaks.Furthermore, community-acquired pneumonia studies had also suggested that cardiovascular disease, severe renal disease, chronic lung disease and diabetes were associated with increased odds of hospitalization.MethodsData were extracted from Houston Electronic Disease Surveillance System (HEDSS) beginning January 1, 2015 to December 31, 2016. A total of 512 confirmed cases were investigated and analyzed during the study period. Frequencies and percentages were calculated and chi square test was used to examine the association between hospitalization and other risk factors. Odds ratio was calculated using unconditional logistic regression to determine the association of risk factors with hospitalization in streptococcal patients.ResultsA total of 414 patients (81 %) of the confirmed cases were hospitalized.Age, race, fever, sepsis, diabetes, cardiovascular and kidney diseases were significantly associated with hospitalization in the bivariate analysis.Logistic regression analysis adjusted for confounding factors demonstrated that among clinical characteristics, fever (OR 2.9; 95% CI 1.66-5.38) was three times more prevalent among hospitalized patients with streptococcal infection.Patients with diabetes (OR 7.92; 95% CI 3.08-20.36) were almost eight times more likely to be hospitalized than patients without diabetes among streptococcal patients, followed by cardiovascular disease (OR 2.84; CI 1.32-6.10) which was three times more likely to be present.ConclusionsCommon clinical sign like fever was associated with hospitalization among streptococcal patient. Similarly, risk factors like diabetes and cardiovascular diseases were significantly associated with hospitalization in streptococcal patients.Prevention strategies need to be focused on streptococcal patients with chronic risk factors like diabetes, and cardiovascular disease.ReferencesParks t, Barret L, Jones N. Invasive streptococcal disease: a review for clinicians. British Med Bulletin, 2015; 115 (7): 77-89.Skoff TH, Farley MM, Petit S, et al. Increasing Burden of Invasive Group B Streptococcal Disease in Nonpregnant Adults, 1990-2007. CID 2009; 49 (7): 85-92

Association between Influenza-like Illnesses and Social Determinants of Health by Census Tract in Houston/Harris County

The Houston Department of Health Department of Health and Human Services (HDHHS) monitors emergency departments (ED) chief complaints across the Houston metropolitan area, Harris County, and the surrounding jurisdictions by Real-time Outbreak Disease Surveillance (RODS). The influenza-like illnesses (ILI) data is collected by sentinel surveillance provider network of 12 physicians and RODS, an electronic syndromic surveillance database consisting of about 30 EDs in metropolitan Houston. Previous research indicates that there is a relationship between new HIV diagnoses and neighborhood poverty. However, there is limited research on health disparity to investigate the association between influenza-like illnesses (ILI) and social determinants of health (SDH), such as poverty. This cross-sectional study investigates the relationship between ILI and SDH

Evaluating the Ability of a Syndromic Surveillance System to Detect Heat-Related Illnesses in Houston, TX, 2009-2012

Preparing for extreme heat events and monitoring their effects on public health is a vital role for the Houston Department of Health and Human Services (HDHHS). Since heat-related illnesses are not a reportable condition in the state of Texas, this study is aimed at evaluating the ability of a syndromic surveillance system (RODS) to detect heat-related illnesses during heat event of the years 2009-2012 as well as identifying the areas of Houston that had the highest incidence of heat-related morbidity. Preliminary results indicate that RODS was able detected an increase in heat-related illnesses during the record-setting summer of 2011

Evaluating the Ability of a Syndromic Surveillance System to Detect Heat-Related Illnesses in Houston, TX, 2009-2012

Preparing for extreme heat events and monitoring their effects on public health is a vital role for the Houston Department of Health and Human Services (HDHHS). Since heat-related illnesses are not a reportable condition in the state of Texas, this study is aimed at evaluating the ability of a syndromic surveillance system (RODS) to detect heat-related illnesses during heat event of the years 2009-2012 as well as identifying the areas of Houston that had the highest incidence of heat-related morbidity. Preliminary results indicate that RODS was able detected an increase in heat-related illnesses during the record-setting summer of 2011

Enhanced Monitoring of Antiretroviral Resistance in Persons Living with HIV/AIDS

In recent years the transmission of HIV drug-resistant strains among infected persons has been an on-going concern. Measuring the burden of antiretroviral resistance has risen in importance, ranking alongside other major public health concerns when planning HIV prevention campaigns. The aim of this presentation is to illustrate a public health surveillance method for monitoring antiretroviral drug resistance in persons diagnosed with human immunodeficiency virus infection. We developed procedures for examining HIV related electronic laboratory reports (ELR) transmitted to our health department surveillance system that link to corresponding clinical and demographic data for patients with varying degrees of antiretroviral drug resistance