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Publications (5)4.96 Total impact

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    ABSTRACT: Infection with influenza viruses can cause severe morbidity and mortality among all age groups. Children, particularly those aged <5 years, have the highest incidence of infection during epidemic periods; however, the highest rates of influenza-associated hospitalizations and deaths are among the elderly (aged ≥65 years), children aged <2 years, and those of any age with underlying medical conditions. Each year, influenza-related complications are estimated to result in more than 226,000 hospitalizations. During 1976-2006, estimates of influenza-associated deaths in the United States ranged from approximately 3,000 to an estimated 49,000 persons. Annual vaccination is the most effective strategy for preventing influenza virus infection and its complications.
    MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC 11/2013; 62(SU-3):65-68.
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    ABSTRACT: BACKGROUND: Seasonal influenza vaccination has been routinely recommended for adults with high-risk conditions. The Advisory Committee on Immunization Practices recommended that persons 25 to 64 years of age with high-risk conditions be one of the initial target groups to receive H1N1 vaccination during the 2009-2010 season. METHODS: We used data from the 2009-2010 Behavioral Risk Factor Surveillance System survey. Vaccination levels of H1N1 and seasonal influenza vaccination among respondents 25 to 64 years with high-risk conditions were assessed. Multivariable logistic regression models were performed to identify factors independently associated with vaccination. RESULTS: Overall, 24.8% of adults 25 to 64 years of age were identified to have high-risk conditions. Among adults 25 to 64 years of age with high-risk conditions, H1N1 and seasonal vaccination coverage were 26.3% and 47.6%, respectively. Characteristics independently associated with an increased likelihood of H1N1 vaccination were as follows: higher age; Hispanic race/ethnicity; medical insurance; ability to see a doctor if needed; having a primary doctor; a routine checkup in the previous year; not being a current smoker; and having high-risk conditions other than asthma, diabetes, and heart disease. Characteristics independently associated with seasonal influenza vaccination were similar compared with factors associated with H1N1 vaccination. CONCLUSION: Immunization programs should work with provider organizations to review efforts made to reach adults with high-risk conditions during the recent pandemic and assess how and where they can increase vaccination coverage during future pandemics.
    American journal of infection control 02/2013; 41(8). DOI:10.1016/j.ajic.2012.10.027 · 2.33 Impact Factor
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    Suzan L Carmichael, Amparo G Gonzalez-Feliciano, Chen Ma, Gary M Shaw, Mary E Cogswell
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    ABSTRACT: Phytoestrogens may be associated with a variety of different health outcomes, including outcomes related to reproductive health. Recently published data on phytoestrogen content of a wide range of foods provide an opportunity to improve estimation of dietary phytoestrogen intake. Using the recently published data, we estimated intake among a representative sample of 6,584 women of reproductive age from a multi-site, population-based case-control study, the National Birth Defects Prevention Study (NBDPS). The NBDPS uses a shortened version of the Willett food frequency questionnaire to estimate dietary intake during the year before pregnancy. We estimated intake among NBDPS control mothers. Lignans contributed 65% of total phytoestrogen intake; isoflavones, 29%; and coumestrol, 5%. Top contributors to total phytoestrogen intake were vegetables (31%) and fruit (29%); for isoflavones, dairy (33%) and fruit (21%); for lignans, vegetables (40%) and fruit (29%); and for coumestans, fruit (55%) and dairy (18%). Hispanic women had higher phytoestrogen intake than non-Hispanic white or black women. Associations with maternal age and folic acid-containing supplements were more modest but indicated that older mothers and mothers taking supplements had higher intake. The advantage of the approach used for the current analysis lies in its utilization of phytoestrogen values derived from a single laboratory that used state-of-the-art measurement techniques. The database we developed can be applied directly to other studies using food frequency questionnaires, especially the Willett questionnaire. The database, combined with consistent dietary intake assessment, provides an opportunity to improve our ability to understand potential associations of phytoestrogen intake with health outcomes.
    Nutrition Journal 10/2011; 10:105. DOI:10.1186/1475-2891-10-105 · 2.64 Impact Factor
  • Elizabeth Monsell, Amparo Gonzalez-Feliciano, Gary Euler, James Singleton
    Public Health Informatics Conference 2011 Centers for Disease Control and Prevention; 08/2011
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    ABSTRACT: Vaccines are among the greatest public health achievements of the 20th century. The majority of Healthy People 2010 (HP2010) objectives for early childhood vaccination coverage were met by the end of 2010, and progress has been made toward eliminating disparities in vaccination coverage among children. Remarkable progress also has been made in improving coverage and reducing disparities in coverage for adolescent vaccinations recommended since 2005. Although childhood vaccination programs in the United States have been successful, adolescent programs remain relatively new and adult vaccination programs, although well established, have not achieved acceptable levels of success. Among adults, substantial disparities in vaccination coverage have persisted. A particular challenge for prevention of influenza is the need for annual vaccination. During 1989--1999, national influenza vaccination coverage among persons aged ≥65 years increased each year for all racial/ethnic groups; however, the rate of increase slowed during 1997--2001, and vaccination coverage among non-Hispanic blacks and Hispanics remained lower compared with non-Hispanic whites throughout the entire period (1989--2001).
    MMWR. Surveillance summaries: Morbidity and mortality weekly report. Surveillance summaries / CDC 01/2011; 60 Suppl:38-41.