8 results on '"LaRocque, Regina C."'
Search Results
2. Pre-travel health care of immigrants returning home to visit friends and relatives.
- Author
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LaRocque RC, Deshpande BR, Rao SR, Brunette GW, Sotir MJ, Jentes ES, Ryan ET, and The Global TravEpiNet Consortium
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Cohort Studies, Emigrants and Immigrants, Female, Health Knowledge, Attitudes, Practice, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Vaccination statistics & numerical data, Young Adult, Communicable Disease Control methods, Delivery of Health Care, Health Planning Guidelines, Public Health, Travel statistics & numerical data
- Abstract
Immigrants returning home to visit friends and relatives (VFR travelers) are at higher risk of travel-associated illness than other international travelers. We evaluated 3,707 VFR and 17,507 non-VFR travelers seen for pre-travel consultation in Global TravEpiNet during 2009-2011; all were traveling to resource-poor destinations. VFR travelers more commonly visited urban destinations than non-VFR travelers (42% versus 30%, P < 0.0001); 54% of VFR travelers were female, and 18% of VFR travelers were under 6 years old. VFR travelers sought health advice closer to their departure than non-VFR travelers (median days before departure was 17 versus 26, P < 0.0001). In multivariable analysis, being a VFR traveler was an independent predictor of declining a recommended vaccine. Missed opportunities for vaccination could be addressed by improving the timing of pre-travel health care and increasing the acceptance of vaccines. Making pre-travel health care available in primary care settings may be one step to this goal.
- Published
- 2013
- Full Text
- View/download PDF
3. Climate Change and the Epidemiology of Infectious Diseases in the United States.
- Author
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Edelson, Paul J, Harold, Rachel, Ackelsberg, Joel, Duchin, Jeffrey S, Lawrence, Steven J, Manabe, Yukari C, Zahn, Matt, and LaRocque, Regina C
- Subjects
COMMUNICABLE disease epidemiology ,COCCIDIOIDOMYCOSIS ,FOSSIL fuels ,AQUATIC microbiology ,INFECTIOUS disease transmission ,DISEASE prevalence ,VECTOR-borne diseases ,DRUG resistance in microorganisms ,CLIMATE change - Abstract
The earth is rapidly warming, driven by increasing atmospheric carbon dioxide and other gases that result primarily from fossil fuel combustion. In addition to causing arctic ice melting and extreme weather events, climatologic factors are linked strongly to the transmission of many infectious diseases. Changes in the prevalence of infectious diseases not only reflect the impacts of temperature, humidity, and other weather-related phenomena on pathogens, vectors, and animal hosts but are also part of a complex of social and environmental factors that will be affected by climate change, including land use, migration, and vector control. Vector- and waterborne diseases and coccidioidomycosis are all likely to be affected by a warming planet; there is also potential for climate-driven impacts on emerging infectious diseases and antimicrobial resistance. Additional resources for surveillance and public health activities are urgently needed, as well as systematic education of clinicians on the health impacts of climate change. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
4. Missed Opportunities for Measles, Mumps, Rubella Vaccination Among Departing U.S. Adult Travelers Receiving Pretravel Health Consultations.
- Author
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Hyle, Emily P., Rao, Sowmya R., Jentes, Emily S., Fiebelkorn, Amy Parker, Hagmann, Stefan H. F., Walker, Allison Taylor, Walensky, Rochelle P., Ryan, Edward T., and LaRocque, Regina C.
- Subjects
VACCINATION ,MEASLES vaccines ,RUBELLA vaccines ,MUMPS vaccines ,PUBLIC health ,DECISION making in clinical medicine - Abstract
Background: Measles outbreaks continue to occur in the United States and are mostly due to infections in returning travelers. Objective: To describe how providers assessed the measles immunity status of departing U.S. adult travelers seeking pretravel consultation and to assess reasons given for nonvaccination among those considered eligible to receive the measles, mumps, rubella (MMR) vaccine. Design: Observational study in U.S. pretravel clinics. Setting: 24 sites associated with Global TravEpiNet (GTEN), a Centers for Disease Control and Prevention–funded consortium. Patients: Adults (born in or after 1957) attending pretravel consultations at GTEN sites (2009 to 2014). Measurements: Structured questionnaire completed by traveler and provider during pretravel consultation. Results: 40 810 adult travelers were included; providers considered 6612 (16%) to be eligible for MMR vaccine at the time of pretravel consultation. Of the MMR-eligible, 3477 (53%) were not vaccinated at the visit; of these, 1689 (48%) were not vaccinated because of traveler refusal, 966 (28%) because of provider decision, and 822 (24%) because of health systems barriers. Most MMR-eligible travelers who were not vaccinated were evaluated in the South (2262 travelers [65%]) or at nonacademic centers (1777 travelers [51%]). Nonvaccination due to traveler refusal was most frequent in the South (1432 travelers [63%]) and in nonacademic centers (1178 travelers [66%]). Limitation: These estimates could underrepresent the opportunities for MMR vaccination because providers accepted verbal histories of disease and vaccination as evidence of immunity. Conclusion: Of U.S. adult travelers who presented for pretravel consultation at GTEN sites, 16% met criteria for MMR vaccination according to the provider's assessment, but fewer than half of these travelers were vaccinated. An increase in MMR vaccination of eligible U.S. adult travelers could reduce the likelihood of importation and transmission of measles virus. Primary Funding Source: Centers for Disease Control and Prevention, National Institutes of Health, and the Steve and Deborah Gorlin MGH Research Scholars Award. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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5. Economics of Malaria Prevention in US Travelers to West Africa.
- Author
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Adachi, Kenji, Coleman, Margaret S., Khan, Nomana, Jentes, Emily S., Arguin, Paul, Rao, Sowmya R., LaRocque, Regina C., Sotir, Mark J., Brunette, Gary, Ryan, Edward T., and Meltzer, Martin I.
- Subjects
MALARIA prevention ,MEDICAL care costs ,TRAVELERS ,PUBLIC health ,VACCINATION ,CHEMOPREVENTION - Abstract
Costs and benefits of malaria prevention are provided during domestic pretravel health consultations. Healthcare payers always, and travelers often, save money when travelers adhere to malaria recommendations and prophylactic regimens in West Africa, especially for longer durations of travel.Background. Pretravel health consultations help international travelers manage travel-related illness risks through education, vaccination, and medication. This study evaluated costs and benefits of that portion of the health consultation associated with malaria prevention provided to US travelers bound for West Africa.Methods. The estimated change in disease risk and associated costs and benefits resulting from traveler adherence to malaria chemoprophylaxis were calculated from 2 perspectives: the healthcare payer's and the traveler's. We used data from the Global TravEpiNet network of US travel clinics that collect de-identified pretravel data for international travelers. Disease risk and chemoprophylaxis effectiveness were estimated from published medical reports. Direct medical costs were obtained from the Nationwide Inpatient Sample and published literature.Results. We analyzed 1029 records from January 2009 to January 2011. Assuming full adherence to chemoprophylaxis regimens, consultations saved healthcare payers a per-traveler average of $14 (9-day trip) to $372 (30-day trip). For travelers, consultations resulted in a range of net cost of $20 (9-day trip) to a net savings of $32 (30-day trip). Differences were mostly driven by risk of malaria in the destination country.Conclusions. Our model suggests that healthcare payers save money for short- and longer-term trips, and that travelers save money for longer trips when travelers adhere to malaria recommendations and prophylactic regimens in West Africa. This is a potential incentive to healthcare payers to offer consistent pretravel preventive care to travelers. This financial benefit complements the medical benefit of reducing the risk of malaria. [ABSTRACT FROM PUBLISHER]
- Published
- 2014
6. Hiding in Plain View: Cholera in Bangladesh.
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Harris, Jason B and Larocque, Regina C
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PREVENTION of cholera , *CHOLERA , *HOSPITALS , *PUBLIC health , *PUBLIC health surveillance - Abstract
The article discusses that the the World Health Organization (WHO) Global Task Force on Cholera Control announced an initiative titled Ending Cholera; and the objective was a 90% reduction in cholera deaths and the elimination of cholera in 20 countries, including Bangladesh, by 2030. It mentions that the introduction of cholera in Haiti in 2010 spurred new partnerships, investments, and calls to action, prompting the establishment of a global stockpile.
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- 2020
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7. Cholera's western front.
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Harris, Jason B., LaRocque, Regina C., Charles, Richelle C., Mazumder, Ramendra N., Khan, Azharul I., and Bardhan, Pradip K.
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CHOLERA , *EPIDEMICS , *PUBLIC health , *DEATH rate - Abstract
The article comments on the impact of the cholera epidemic on the public health landscape of the western hemisphere. It notes that the public health infrastructure in several Latin American and Caribbean countries has been strengthened following the 1991 outbreak. Particular focus is given to the cholera outbreak in Haiti in 2010, along with the case fatality rates of in the past 10 years. It cites the biological and organisational challenges involved in achieving low rates of case fatality during an outbreak.
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- 2010
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8. Implementing expanded COVID-19 testing in Massachusetts community health centers through community partnerships: Protocol for an interrupted time series and stepped wedge study design.
- Author
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Kruse, Gina R., Pelton-Cairns, Leslie, Taveras, Elsie M., Dargon-Hart, Susan, Gundersen, Daniel A., Lee, Rebekka M., Bierer, Barbara E., Lawlor, Erica, LaRocque, Regina C., Marcus, Julia L., Davies, Madeline E., and Emmons, Karen M.
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COVID-19 testing , *COMMUNITY centers , *TIME series analysis , *MEDICAL centers , *PUBLIC health , *COMMUNITIES - Abstract
Community Health Centers (CHCs) are a critical source of care for low-income and non-privately insured populations. During the pandemic, CHCs have leveraged their infrastructure and role as a trusted source of care to engage the communities they serve in COVID-19 testing. To directly address the impact that COVID-19 has had on historically marginalized populations in Massachusetts, we designed a study of community-engaged COVID-19 testing expansion: (1) leveraging existing partnerships to accelerate COVID-19 testing and rapidly disseminate effective implementation strategies; (2) incorporating efforts to address key barriers to testing participation in communities at increased risk for COVID-19; (3) further developing partnerships between communities and CHCs to address testing access and disparities; (4) grounding the study in the development of a shared ethical framework for advancing equity in situations of scarcity; and (5) developing mechanisms for communication and science translation to support community outreach. We use a controlled interrupted time series design, comparing number of COVID-19 tests overall and among people identified as members of high-risk groups served by intervention CHCs compared with six matched control CHCs in Massachusetts, followed by a stepped wedge design to pilot test strategies for tailored outreach by CHCs. Here, we describe a community-partnered strategy to accelerate COVID-19 testing in historically marginalized populations that provides ongoing resources to CHCs for addressing testing needs in their communities. The study aligns with principles of community-engaged research including shared leadership, adequate resources for community partners, and the flexibility to respond to changing needs over time. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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