Publications by authors named "Kimberly Wright"

9 Publications

  • Page 1 of 1

Salmonellosis Outbreak After a Large-Scale Food Event in Virginia, 2017.

Public Health Rep 2020 Sep/Oct;135(5):668-675. Epub 2020 Aug 13.

2396 Division of Surveillance and Investigation, Virginia Department of Health, Richmond, VA, USA.

Objectives: The Virginia Department of Health (VDH) identified an outbreak of serotype Javiana infections in Virginia after a chili and chowder cook-off with 11 competitors and about 2500 attendees on September 30, 2017. The objectives of this study were to assess the extent of the outbreak and identify the most likely source of exposure.

Methods: To identify people with suspected infection, VDH used press releases and social media posts to recruit event attendees to take an online survey about foods eaten at the cook-off and any gastrointestinal (GI) symptoms experienced. VDH defined a case as reported GI illness that occurred within 1 week after eating food from the cook-off. Confirmed cases required a clinical specimen culture positive for . Probable cases reported diarrhea or related clinical symptoms. "Not ill" people did not report GI illness. Investigators calculated unadjusted relative risks of illness and performed stratified analysis to address potential confounding. Available food samples were tested for . Environmental health specialists interviewed food handlers and inspected restaurants where 3 competitors had prepared food.

Results: Of 438 survey responses, 171 (39%) met the case definition. Of all chilies and chowders consumed, Chowder A was associated with the highest relative risk of illness (8.9; 95% CI, 5.7-13.7). A Chowder A sample tested positive for serotype Javiana. The environmental investigation did not identify an original contamination source but did find deficiencies in maintaining safe cooking temperatures.

Conclusions: Epidemiologic and laboratory findings indicated that Chowder A was the most likely cause of outbreak. Recommendations to prevent future outbreaks include preparation of all food on-site to ensure safe temperatures during food preparation and service.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0033354920944861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485053PMC
September 2020

Trajectories of Change in a Group Behavioral Activation Treatment for Severe, Recurrent Depression.

Behav Ther 2019 05 31;50(3):504-514. Epub 2018 Aug 31.

University of Exeter.

Depression is a common and costly problem. Behavioral Activation (BA) is an effective treatment for depression when delivered 1:1, but group treatments often do not perform as well as 1:1 treatments. One way to begin to understand how group treatments perform is to assess the process of change during treatment. This study examined trajectories of change across 10-session group BA for individuals with severe, chronic, or recurrent forms of depression. We also tested whether individuals who had associated sudden gains or depression spikes had better outcomes than those who did not have these change patterns. We examined psychological and sociodemographic predictors of the patterns of change. Participants were 104 individuals who met diagnostic criteria for major depressive disorder and participated in one of 10 BA groups, provided over a 2-year period. A linear, but not quadratic or cubic, rate of change fit the data and the effect size for the change in mood symptoms from baseline to posttreatment was large, Cohen's d = 1.25. Although 34% (26 of the 77 who provided outcome data) of individuals had a sudden gain and 10% (7/77) had a depression spike, neither sudden gains nor depression spikes predicted posttreatment outcomes. None of the demographic or psychological factors (rumination, behavioral activation) predicted the pattern of change. These results suggest that although group BA may help to reduce depressive symptoms in individuals with severe, recurrent, and/or chronic forms of depression, the overall linear pattern of change is different from quadratic patterns of change reported for 1:1 BA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.beth.2018.08.007DOI Listing
May 2019

Are ball pits located in physical therapy clinical settings a source of pathogenic microorganisms?

Am J Infect Control 2019 04 22;47(4):456-458. Epub 2018 Nov 22.

Department of Biology, University of North Georgia, Dahlonega, GA. Electronic address:

Clinical, therapeutic ball pits commonly used by physical therapists to provide sensory stimulation to children were investigated for microbial colonization. Due to the permissive and hospitable environment provided by these ball pits, microorganisms can accumulate to levels that increase the ease of transmission toexposed individuals. Our study found considerable microbial colonization in ball pits located in clinical settings, including 8 opportunistic pathogenic bacteria and 1 opportunistic pathogenic yeast.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ajic.2018.09.031DOI Listing
April 2019

Incremental Hospital Cost and Length-of-Stay Associated With Treating Adverse Events Among Medicare Beneficiaries Undergoing Lumbar Spinal Fusion During Fiscal Year 2013.

Spine (Phila Pa 1976) 2016 Oct;41(20):1613-1620

Clinical Data Solutions, a Division of HealthTrust Purchasing Group, LLP, Nashville, TN.

Study Design: A retrospective study.

Objectives: To report the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries undergoing a two- or three-level lumbar spinal fusion.

Summary Of Background Data: Hospitals are increasingly at financial risk for the incremental resources consumed in treating patients experiencing adverse events because of public and private third-party payers' efforts to base hospital reimbursement on "pay for performance" measures. However, little is known about average incremental resources consumed in treating patients experiencing adverse events following lumbar spinal fusions.

Methods: The 2013 fiscal year Medicare Provider Analysis and Review file was used to identify 83,658 Medicare beneficiaries who underwent two- or three vertebrae-level lumbar spinal fusion. International Classification of Diseases-9th-Clinical Modification diagnostic and procedure codes were used to identify the frequencies of nine adverse events. This study estimated both the observed and risk-adjusted incremental hospital resources consumed (cost and length of stay [LOS]) in treating Medicare beneficiaries experiencing each adverse event.

Results: Overall, 17.7% of Medicare beneficiaries undergoing lumbar spinal fusion experienced at least one of the study's adverse events. Medicare beneficiaries experiencing any complication consumed significantly more hospital resources (incremental cost of $8911) and had longer LOS (incremental stays of 5.7 days). After adjusting for patient demographics and comorbid conditions, incremental cost of treating adverse events ranged from a high of $32,049 (infection) to a low of $9976 (transfusion).

Conclusion: Adverse events frequently occur and add substantially to the hospital resource costs of patients undergoing spinal fusion. Shared decision-making instruments should clearly provide these risk estimates to the patient before surgical consideration. Investment in activities that have been shown to reduce specific adverse events is warranted, and this project may allow health systems to prioritize performance improvement areas.

Level Of Evidence: 3.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/BRS.0000000000001641DOI Listing
October 2016

The Incremental Hospital Cost and Length-of-Stay Associated With Treating Adverse Events Among Medicare Beneficiaries Undergoing THA During Fiscal Year 2013.

J Arthroplasty 2016 Jan 1;31(1):42-8. Epub 2015 Aug 1.

Clinical Data Solutions, Division of HealthTrust Purchasing Group, LLP, Nashville, Tennessee.

This paper estimates the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries (MBs) undergoing total hip arthroplasty (THA). This retrospective study, using the Medicare Provider Analysis and Review file, identified 174,167 MBs who underwent THA in 2013. Overall, 20.16% of MB undergoing THA experienced at least one adverse event. MB experiencing any adverse event consumed significantly higher hospital cost ($3429) and had longer length of stays (1.0 day). The risk-adjusted incremental cost of treating adverse events ranged from a high of $27,116 (pneumonia) to a low of $2626 (hemorrhage or post-operative shock requiring transfusion). Most major adverse events occurred infrequently, however when adverse events occurred, they add substantially to the hospital resource costs of treating MB.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arth.2015.07.037DOI Listing
January 2016

The incremental hospital cost and length-of-stay associated with treating adverse events among Medicare beneficiaries undergoing TKA.

J Arthroplasty 2015 Jan 6;30(1):19-25. Epub 2014 Sep 6.

OrthoDataSolutions, a Division of Cardiac Data Solutions, Inc., Atlanta, Georgia.

This paper estimates the incremental hospital resource consumption associated with treating selected adverse events experienced by Medicare beneficiaries undergoing TKA. This retrospective study, using the Medicare Provider Analysis and Review file, identified 353,650 Medicare beneficiaries who underwent a primary TKA during 2011. Overall, 11.82% of Medicare beneficiaries (MBs) undergoing TKA experienced at least one of the study's adverse events. MBs experiencing any adverse event consumed significantly more unadjusted hospital resources ($3110 cost) and had longer stays (1.3 days). The risk-adjusting incremental cost of treating adverse events ranged between $30,902 (pneumonia) and $2167 (hemorrhage or post-operative shock requiring transfusion). Most major adverse events occur infrequently; however when an adverse event occurs following TKA, it adds substantially to hospital costs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arth.2014.08.023DOI Listing
January 2015

The interplay of plant and animal disease in a changing landscape: the role of sudden aspen decline in moderating Sin Nombre virus prevalence in natural deer mouse populations.

Ecohealth 2012 Jun 24;9(2):205-16. Epub 2012 Apr 24.

Department of Biology, Fort Lewis College, Durango, CO 81301, USA.

We examined how climate-mediated forest dieback regulates zoonotic disease prevalence using the relationship between sudden aspen decline (SAD) and Sin Nombre virus (SNV) as a model system. We compared understory plant community structure, small mammal community composition, and SNV prevalence on 12 study sites within aspen forests experiencing levels of SAD ranging from <10.0% crown fade to >95.0% crown fade. Our results show that sites with the highest levels of SAD had reduced canopy cover, stand density, and basal area, and these differences were reflected by reductions in understory vegetation cover. Conversely, sites with the highest levels of SAD had greater understory standing biomass, suggesting that vegetation on these sites was highly clustered. Changes in forest and understory vegetation structure likely resulted in shifts in small mammal community composition across the SAD gradient, as we found reduced species diversity and higher densities of deer mice, the primary host for SNV, on sites with the highest levels of SAD. Sites with the highest levels of SAD also had significantly greater SNV prevalence compared to sites with lower levels of SAD, which is likely a result of their abundance of deer mice. Collectively, results of our research provide strong evidence to show SAD has considerable impacts on vegetation community structure, small mammal density and biodiversity and the prevalence of SNV.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10393-012-0765-7DOI Listing
June 2012

Locating pain.

J Am Dent Assoc 2006 Mar;137(3):292, 294; author reply 294

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.14219/jada.archive.2006.0162DOI Listing
March 2006