Risk Factors for Recurrent Urinary Tract Infections Among Women in a Large Integrated Health Care Organization in the United States.

Background: Urinary tract infections (UTIs) occur commonly and often recur. However, recent data on the epidemiology of recurrent UTI (rUTI) are scarce.

Methods: Between 1 January 2016 and 31 December 2020, index uncomplicated UTIs (uUTIs) from office, emergency department, hospital, and virtual care settings were identified from the electronic health records of women at Kaiser Permanente Southern California.

Antibiotic Resistance of Urinary Tract Infection Recurrences in a Large Integrated US Healthcare System.

Background: Data on antibiotic resistance of uropathogens for urinary tract infection (UTI) recurrences are lacking.

Methods: In a retrospective cohort of adults at Kaiser Permanente Southern California with culture-confirmed index uncomplicated UTI (uUTI) between January 2016 and December 2020, we examined the number and characteristics of subsequent culture-confirmed UTIs through 2021.

Results: We identified 148 994 individuals with a culture-confirmed index uUTI (88% female, 44% Hispanic; mean age, 51 years [standard deviation, 19 years]), of whom 19% developed a subsequent culture-confirmed UTI after a median 300 days (interquartile range, 126-627 days).

Dexamethasone Suppression Testing in a Contemporary Cohort with Adrenal Incidentalomas in Two U.S. Integrated Healthcare Systems.

Autonomous cortisol secretion (ACS) from an adrenal adenoma can increase the risk for comorbidities and mortality. The dexamethasone suppression test (DST) is the standard method to diagnose ACS. A multi-site, retrospective cohort of adults with diagnosed adrenal tumors was used to understand patient characteristics associated with DST completion and ACS.

A Blueprint for Increasing Ethnic and Racial Diversity in U.S. Residency Training Programs.

Problem: People who identify as African Americans, Latinos, or from indigenous backgrounds, are dramatically underrepresented in the U.S. physician workforce.

Biallelic loss of in a patient with pediatric medulloblastoma.

Genome sequencing was performed on matched normal and tumor tissue from a 6.5-yr-old boy with a diagnosis of recurrent medulloblastoma. A pathogenic heterozygous c.

A Randomized, Controlled Trial of the Analytic and Diagnostic Performance of Singleton and Trio, Rapid Genome and Exome Sequencing in Ill Infants.

The second Newborn Sequencing in Genomic Medicine and Public Health study was a randomized, controlled trial of the effectiveness of rapid whole-genome or -exome sequencing (rWGS or rWES, respectively) in seriously ill infants with diseases of unknown etiology. Here we report comparisons of analytic and diagnostic performance. Of 1,248 ill inpatient infants, 578 (46%) had diseases of unknown etiology.

Aplicación de la teoría de aprendizaje en el entrenamiento acerca de seguridad y salud para trabajadores inmigrantes en las lecherías.

Resumen Con el propósito de prevenir lesiones y enfermedades ocupacionales, diseñamos un currículo de seguridad y salud para trabajadores inmigrantes en la industria lechera para aumentar el conocimiento, fomentar prácticas de seguridad, y reducir inequidades en la comunicación. El currículo se basa principalmente en la Taxonomía para el Aprendizaje Significativo-TAS ( Taxonomy of Significant Learning) e incorpora teorías de la conducta y de aprendizaje para adultos, así como también los principios de control de riesgos ocupacionales. Los entrenamientos se implementaron con 836 trabajadores de habla hispana de 67 lecherías en el estado de Wisconsin, en los Estados Unidos.

An overview and impact assessment of OSHA large dairy local emphasis programs in New York and Wisconsin.

Background: Farming has been exempted from most labor regulations and shielded from regulatory scrutiny by the Occupational Safety and Health Administration (OSHA). Yet, agriculture and dairy in particular, has relatively high injury and fatality rates.

Methods: A recent shift in OSHA's approach to agricultural worker safety and health includes two dairy-focused Local Emphasis Programs (LEPs), one launched in Wisconsin in 2011 and the other in New York in 2014.

The nasal microbiota of dairy farmers is more complex than oral microbiota, reflects occupational exposure, and provides competition for staphylococci.

Allergic and autoimmune diseases had been attributed to lack of exposure to biodiversity, an important factor in regulating immune homeostasis in a healthy host. We posit that the microbiome of healthy dairy farmers (DF) will be richer than non-farmers (NF) living in urban settings due to exposure to a greater biodiversity in the dairy environment. However, no studies have investigated the relationships between microbiota of dairy farmers (DF) compared with urban non-farmers (NF).

Applying Learning Theory to Safety and Health Training for Hispanic Immigrant Dairy Workers.

We designed a safety and health curriculum for dairy immigrant workers aiming to increase knowledge, encourage safe behavior, and reduce worker communication inequalities to prevent occupational injury and diseases. The design is largely based on the Taxonomy of Significant Learning and incorporated behavioral and adult learning theories and principles of occupational hazard control. Trainings were implemented with 836 Spanish-speaking workers from 67 farms in Wisconsin.

An Evaluation Tool for Agricultural Health and Safety Mobile Applications.

As the use of mobile devices and their software applications, or apps, becomes ubiquitous, use amongst agricultural working populations is expanding as well. The smart device paired with a well-designed app has potential for improving workplace health and safety in the hands of those who can act upon the information provided. Many apps designed to assess workplace hazards and implementation of worker protections already exist.

Immigrant dairy workers' perceptions of health and safety on the farm in America's Heartland.

Background: Dairy farming is dangerous. Yearly, farms grow fewer and larger by employing immigrant workers, who have limited industrial agriculture experience and safety and health training.

Methods: We examined results of five focus groups with 37 Hispanic, immigrant dairy workers.

Environmental Justice and Community-Based Research in Texas Borderland Colonias.

Objective: An innovative academic-community partnership studied daily decisions in communities of mostly Spanish-speaking, low-income residents of colonias in Hidalgo County, TX, about risk of exposure to fish contaminated by PCBs at an Environmental Protection Agency (EPA) Superfund site.

Design And Sample: The team used focus group interviews with colonia residents and content analysis to assess knowledge of risk related to the Superfund site, the Donna Reservoir and Canal System.

Results: (1) many lacked knowledge of the Superfund site contamination; (2) a few participants fished at the lake, knew people who did so, and consumed the catch, but most participants feared going there; (3) some participants remember receiving messages saying not to fish at the site, although they recalled nothing about contamination, but most participants knew of no such messages; (4) many use cell phones to get local information through personal networks and several Spanish-language news sources, but they have no consistent, culturally tailored local information source.

Farm Mapping to Assist, Protect, and Prepare Emergency Responders: Farm MAPPER.

Responders such as firefighters and emergency medical technicians who respond to farm emergencies often face complex and unknown environments. They may encounter hazards such as fuels, solvents, pesticides, caustics, and exploding gas storage cylinders. Responders may be unaware of dirt roads within the farm that can expedite their arrival at critical sites or snow-covered manure pits that act as hidden hazards.

The use of audience response system technology with limited-english-proficiency, low-literacy, and vulnerable populations.

Audience response systems (ARS) have long been used to improve the interactivity of educational activities. Most studies of ARS have addressed education of literate trainees. How well these devices work with low-literacy subjects is not well studied.