RESUMEN
BACKGROUND: The Council of State and Territorial Epidemiologists (CSTE) implemented the Applied Epidemiology Fellowship (AEF) in 2003 to train public health professionals in applied epidemiology and strengthen applied epidemiology capacity within public health institutions to address the identified challenges. The CSTE recently evaluated the outcomes of the fellowship across the last 9 years. PURPOSE: To review the findings from the outcome evaluation of the first nine classes of AEF alumni with particular attention to how the fellowship affected alumni careers, mentors' careers, host site agency capacity, and competencies of the applied epidemiology workforce. METHODS: The mixed-methods evaluation used surveys and administrative data. Administrative data were gathered over the past 9 years and the surveys were collected in late 2013 and early 2014. Descriptive statistics and qualitative thematic analysis were conducted in early 2014 to examine the data from more than 130 alumni and 150 mentors. RESULTS: More than half the alumni (67%) indicated the fellowship was essential to their long-term career. In addition, 79% of the mentors indicated that participating in the fellowship had a positive impact on their career. Mentors also indicated significant impacts on host site capacity. A majority (88%) of alumni had worked for at least 1 year or more in government public health environments after the fellowship. CONCLUSIONS: Evaluation findings support previous research indicating need for competency-based field-based training programs that include a strong mentoring component. These characteristics in a field-based training program can increase applied epidemiology capacity in various ways.
Asunto(s)
Epidemiología/educación , Becas , Movilidad Laboral , Centers for Disease Control and Prevention, U.S. , Humanos , Mentores , Competencia Profesional , Evaluación de Programas y Proyectos de Salud , Gobierno Estatal , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Reports of health care--associated viral hepatitis transmission have been increasing in the United States. Transmission due to poor infection control practices during myocardial perfusion imaging (MPI) has not previously been reported. The aim of this study was to identify the source of incident hepatitis C virus (HCV) infection in a patient without identified risk factors who had undergone MPI 6 weeks before diagnosis. Practices at the cardiology clinic and nuclear pharmacy were evaluated, and HCV testing was performed in patients with shared potential exposures. Clinical and epidemiologic information was obtained for patients with HCV infection, and molecular testing was performed to assess viral relatedness. Evidence of HCV transmission among patients who had undergone MPI at the cardiology clinic on 2 separate dates was found, involving 2 potential source patients and a total of 5 newly infected patients. Molecular testing identified a high degree of genetic homology among viruses from patients with common procedure dates. The nuclear medicine technologist routinely drew up flush from multidose vials of saline solution using the same needle and syringe that had been used to administer radiopharmaceutical doses. Multipatient use of vials was not observed, but a review of purchasing invoices and interviews with staff members suggested that this had occurred. No evidence of transmission via contamination of radiopharmaceuticals at the nuclear pharmacy was found. In conclusion, transmission of HCV occurred because of unsafe injection practices during MPI. Cardiologists should carefully review their infection control practices and the practices of other staff members involved with these procedures.
Asunto(s)
Instituciones de Atención Ambulatoria , Infección Hospitalaria/transmisión , Contaminación de Medicamentos , Hepatitis C/transmisión , Imagen de Perfusión Miocárdica/efectos adversos , Jeringas/virología , Infección Hospitalaria/epidemiología , Infección Hospitalaria/virología , ADN Viral/análisis , Estudios de Seguimiento , Hepacivirus/genética , Hepatitis C/virología , Humanos , Incidencia , Inyecciones/efectos adversos , Masculino , Persona de Mediana Edad , North Carolina/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Jeringas/efectos adversosAsunto(s)
Planificación en Desastres/organización & administración , Gripe Humana/epidemiología , Animales , Aves , Brotes de Enfermedades , Humanos , Subtipo H5N1 del Virus de la Influenza A/patogenicidad , Gripe Aviar , Gripe Humana/tratamiento farmacológico , Gripe Humana/etiología , Gripe Humana/virología , North Carolina/epidemiologíaRESUMEN
We report an outbreak of norovirus in a locked pediatric inpatient psychiatric unit with attack rates of 75% among 4 patients and 26% among 38 staff. Factors contributing to the outbreak included environmental contamination, close staff-patient contact including sharing meals, and inability to confine the index patient with the use of contact precautions.