Dean's Day

Dean’s Day is our annual showcase of student research featuring poster sessions during which students present their work to the multidisciplinary Pitt Public Health community.

To participate, students must prepare and submit an abstract. All currently matriculated Pitt Public Health students are eligible to compete, with the exception of the previous year’s first place master’s and doctoral winners. 

Dean's Day 2023 was a success! 

Thank you for participating in our Dean's Day program and congratulations to our winners! 

2023 Dean's Day Winners coming soon!

Master's category

First Place: Harika Dyer

MPH student, EPIDEM

Introduction: Black communities in the US are more likely to experience COVID-19 infection, hospitalization, and death. Vaccines are demonstrated to improve outcomes. However, there are considerable racial inequities in vaccine uptake and access. Efforts to address vaccine uptake and access among Black adults will be relevant for continued COVID-19 eradication efforts and can be transferable to other prevention efforts in future pandemics. This study investigated factors related to COVID-19 vaccine uptake and access among Black residents in Allegheny County, PA.

Methods: Surveys were administered electronically from October 2021 to January 2022 to Black Allegheny County residents aged 18 and older. Questions included thoughts on COVID mitigation strategies, vaccination status, intention to vaccinate children, trust of COVID-19 information sources and vaccines, and social media use to access information. Descriptive statistics and significant correlates of being vaccinated using adjusted logistic regression models are reported.

Results: Of the overall sample (N=397), the majority were fully vaccinated (n=306, 77%). Fully vaccinated participants were more likely to be female (62.5%, p=0.010), 60 years or older (34.3%, p=0.0002), have some college education (23.2%, p<0.0001) and be employed full time (50.0%, p=0.0001) compared to non-vaccinated individuals. Among unvaccinated participants (n=91), the primary reason was fear of illness (8.9%), long term effects (6.5%) vaccine mistrust (6.3%), and needing more information (4.5%). Vaccine hesitant participants were more likely to be unvaccinated (a OR=2.3, 95% CI 1.25-4.14) after adjusting for age, education, employment, insurance, health status and income.

Conclusion: The majority of Black adults in this sample were vaccinated and reported keeping themselves and their families safe as the primary reason for vaccination. Vaccine hesitancy may be improved by directly addressing fear of illness resulting from vaccines and improving clarity in the vaccine development and approval process to improve uptake among Black adults.

Second Place: Shravan Leonard-Murali

MS student, EPIDEM

"Uveal Melanoma Immunogenomics Predict Immunotherapy Susceptibility and Resistance" 

Introduction

Immune checkpoint inhibition (ICI) has shown significant efficacy in select metastatic cancers with high tumor mutational burden (TMB). However, most solid cancers have low TMB and are ICI-resistant. We hypothesized that immunogenomics of metastatic uveal melanoma (UM), a prototypic ICI-resistant cancer, would provide insights toward developing therapies for immune-resistant cancers.

Methods

Freshly resected UM metastases (n=100) were procured from patients (n=84) enrolled in NCT01814046 and NCT03467516. No patients had responses to ICI. Metastases were profiled with whole genome sequencing, total RNAseq, TCR repertoire analyses, single-cell RNAseq, and ex vivo tumor-infiltrating lymphocyte (TIL) culture expansion and anti-tumor reactivity testing.

Results

Unbiased correlative principal component analysis of total RNAseq segregated metastases by canonical immune pathways. Immune axis gene loadings were used to create an unbiased enrichment score: Uveal Melanoma Immunogenomic Score (UMIS). Single-cell RNAseq revealed T cell-inflamed microenvironments in high versus low UMIS metastases, as evidenced by increased exhausted CD8 T cells (ratio=40.73, P<0.001) and antigen presenting cell function. Low UMIS tumor cells upregulated CTNNB1 (beta-catenin) and SNHG7 (lncRNA), which have been linked to tumor immune resistance. As validation, UMIS predicted ex vivo expansion of tumor reactive TIL (rho=+0.47, P<0.001; AUC=0.85, P<0.001). Interestingly, UMIS correlated with TCR diversity (rho=+0.54, P<0.001) but not clonality (rho=+0.02, P=ns). Ex vivo culture rescued TIL cell count and clonality (P=0.004). Finally, when retrospectively applied to NCT01814046, UMIS predicted magnitude of tumor regression (rho=-0.68, P=0.001) and survival after TIL adoptive transfer (PFS: HR=0.36, P=0.044; OS: HR=0.24, P=0.009).

Conclusions

We demonstrate a novel transcriptomic score, UMIS, that predicts anti-tumor reactivity and clinical efficacy of TIL adoptively transferred into patients with metastatic UM. UMIS is now being adapted for other immune-resistant cancers.

Third Place: Rina Mahoney

MPH student, HUGEN

"Assessment of Barriers to Family Medicine Practitioners Implementing Population-Based Carrier Screening in Primary Care"

Historically, carrier screening has been recommended only to certain individuals for specific conditions based on their reported ethnicity or family history. These screening paradigms are inadequate as they fail to detect many individuals who carry a significant genetic disorder while reinforcing the stigmatization of carrier screening. The American College of Medical Genetics and Genomics and the National Society of Genetic Counselors now recommend population-based carrier screening, which involves testing all individuals who desire biological children for a large number of recessive conditions. In order to offer population-based carrier screening to a greater proportion of patients at the University of Pittsburgh Medical Center (UPMC), a group of clinicians and genetic counselors have started to develop an initiative in which the UPMC Department of Family Medicine clinicians will facilitate delivery of asynchronous genetic counseling materials to interested patients and consent them for testing. The literature has identified multiple barriers that prevent primary care clinicians, including family medicine clinicians, from incorporating genetics services into their practices such as insufficient genetics knowledge, a lack of confidence in providing genetic services, competing priorities, concern for patients, and a lack of support from genetics providers. This project aims to understand what barriers may prevent family medicine clinicians from integrating genetics services such as the population-based carrier screening initiative into their practices. A 36-question survey that assesses clinicians’ current practices regarding carrier screening and their attitudes towards potential barriers to implementing genetic services in their practices was developed based on the barriers identified in the literature. This survey was administered to UPMC family medicine clinicians via listserv and is currently collecting responses. The results of the survey will be used to ensure that the population-based carrier screening initiative’s materials and program structure address areas that clinicians identify as barriers. The family medicine clinicians will act as the point of access to carrier screening for their patient populations, so it is of public health importance that the clinicians feel supported and actively participate in this initiative.

Diversity, Equity and Inclusion Award: Aparna Ramani

HPM

"HDPulse: A resource for understanding disparities in mental health outcomes" 

Abstract
Suicide and self-inflicted injury are public health problems affecting millions of Americans and are associated with poor physical and mental health. A higher burden is often present in certain populations experiencing health disparities. Data show a higher prevalence in American Indian/Alaskan Native (AI/AN) males between 20-39 years of age. AI/AN individuals often experience racial discrimination, lack of access to health services, stigma of mental health disorders, distrust in US medical system, among other social justice concerns. Health disparities data on suicide and self-inflicted injury are available from numerous sources but dispersed and sometimes challenging to access. The HDPulse Data Portal, a resource from the National Institute on Minority Health and Health Disparities, provides comprehensive, high quality data that allows researchers to examine suicide and self-inflicted injury among populations that are significantly impacted.

The Data Portal includes health outcome data on suicide, such as prevalence rates, historical trends, and 5 year rate changes. Data are provided at the national, state, and county levels by race/ethnicity, sex, and age group from 2000-2019. The portal also includes data to examine determinants of suicide along a social ecological framework. Users can focus county and community-relevant interventions to mitigate suicide and self-inflicted injury disparities where they are needed most.

Catherine Cartier Ulrich Award: Harika Dyer and Kayla Ortiz

Harika Dyer, EPIDEM MPH student

"Correlates of COVID-19 Vaccine Updates in Black Adults in Allegheny County, PA"

Abstract

Introduction Black communities in the US are more likely to experience COVID-19 infection, hospitalization, and death. Vaccines are demonstrated to improve outcomes. However, there are considerable racial inequities in vaccine uptake and access. Efforts to address vaccine uptake and access among Black adults will be relevant for continued COVID-19 eradication efforts and can be transferable to other prevention efforts in future pandemics. This study investigated factors related to COVID-19 vaccine uptake and access among Black residents in Allegheny County, PA.

Methods Surveys were administered electronically from October 2021 to January 2022 to Black Allegheny County residents aged 18 and older. Questions included thoughts on COVID mitigation strategies, vaccination status, intention to vaccinate children, trust of COVID-19 information sources and vaccines, and social media use to access information. Descriptive statistics and significant correlates of being vaccinated using adjusted logistic regression models are reported.

Results Of the overall sample (N=397), the majority were fully vaccinated (n=306, 77%). Fully vaccinated participants were more likely to be female (62.5%, p=0.010), 60 years or older (34.3%, p=0.0002), have some college education (23.2%, p<0.0001) and be employed full time (50.0%, p=0.0001) compared to non-vaccinated individuals. Among unvaccinated participants (n=91), the primary reason was fear of illness (8.9%), long term effects (6.5%) vaccine mistrust (6.3%), and needing more information (4.5%). Vaccine hesitant participants were more likely to be unvaccinated (a OR=2.3, 95% CI 1.25-4.14) after adjusting for age, education, employment, insurance, health status and income.

Conclusion The majority of Black adults in this sample were vaccinated and reported keeping themselves and their families safe as the primary reason for vaccination. Vaccine hesitancy may be improved by directly addressing fear of illness resulting from vaccines and improving clarity in the vaccine development and approval process to improve uptake among Black adults.

Kayla Ortiz, BCHS MPH student

"Using Visual Voices to Examine Intimate Partner Violence (IPV) Experiences Among Transgender and Nonbinary Survivors of IPV" (Ortiz)

Abstract

The purpose of this research study is to explore the intimate partner violence (IPV) victimization experiences of transgender and nonbinary (TNB) individuals. To address this, I developed an arts-based project based in Allegheny County that investigates IPV experiences among a group of seven TNB individuals to deepen our understanding of IPV among TNB survivors. Transgender and nonbinary individuals report IPV at disproportionate rates compared to cisgender individuals (James et al., 2016; Peitzmeier et al., 2020). Additionally, TNB individuals are vulnerable to IPV tactics specifically related to their TNB identity (Guadalupe-Diaz, 2013; Peitzmeier et al., 2020). IPV victimization is associated with several adverse health outcomes, including increased risk of mental health issues, chronic physical health issues, injury, and transmission of STIs (Leemis et al., 2022; Miller & McCaw, 2019).

Despite this increased risk and vulnerability, most IPV research and services are centered around the dominant narrative of the cisgender, heterosexual woman survivor of IPV (Guadalupe-Diaz & Jasinski, 2017; Kurdyla, 2021). The present study used a Visual Voices method, adapted from previous projects using the same method (Ochtera et al., 2014; Yonas et al., 2013). This Visual Voices project consisted of two sessions of painting, drawing, writing, and focused discussion with seven participants. The third session consisted of participants constructing the “Visual Voice” of the group by combining and collaging the groups paintings, drawings, and writings.

I am conducting a partially inductive, thematic analysis of the discussions and the art. Preliminary results indicate that some important themes shaping IPV experiences for TNB individuals are community, growth, and navigating societal norms.

Epidemiology Award: Pooja Tallapaneni

 

Doctoral category

First Place: Nathan Raabe 

EPIDEM

"Genomic Epidemiologic Investigation of a Hospital Outbreak of NDM-5-Producing Gram-Negative Enterobacterales Infections" 

Background: New Delhi Metallo-β-lactamase (NDM) represents an emergent mechanism of carbapenem resistance associated with high mortality and limited antimicrobial treatment options. Because the bla_NDM resistance gene is often carried on plasmids, traditional infection prevention and control (IPC) surveillance methods using reactive whole genome sequencing (WGS) may not detect plasmid transfer in multispecies outbreaks.

Methods: Initial outbreak detection of NDM-producers identified at UPMC Presbyterian Hospital (UPMC-PUH) occurred via traditional IPC methods and was supplemented by real-time whole genome sequencing (WGS) surveillance. WGS was performed weekly using the Illumina platform. To resolve NDM-encoding plasmids, we performed long-read Nanopore sequencing and constructed hybrid assemblies using Illumina and Nanopore sequencing data. Reports of relatedness between NDM-producing organisms and reactive WGS for suspected outbreaks were shared with the IPC team for assessment and intervention.

Results: We observed a multispecies outbreak of NDM-5-producing Enterobacterales isolated from 15 patients between February 2021 and February 2023. The 19 clinical isolates sequenced were comprised of seven distinct bacterial species each encoding the same NDM-5 plasmid, which showed high homology to NDM plasmids previously observed in Asia. WGS surveillance and epidemiologic investigation characterized ten horizontal plasmid transfer events and six bacterial transmission events between patients housed in varying hospital units.

Conclusions: Our investigation revealed a complex, multispecies outbreak of NDM that involved multiple plasmid transfer and bacterial transmission events. The same NDM-5 plasmid was transmitted between multiple species, with subsequent bacterial transmission to multiple patients, units, and hospital facilities. Our investigation highlights the utility of combining traditional IPC and genomic methods in identifying and containing plasmid-associated outbreaks.

Keywords: New Delhi Metallo-β-lactamase; Outbreak Investigation; Infection Prevention; Whole Genome Sequencing Surveillance; Plasmid

Second Place: Arpita Tripathi

BCHS

" 'Mix some damn juice'; A Discourse Analysis of a 'Do-it-yourself' (DIY) E-cigarette Community on Reddit" 

Arpita Tripathi, MA; Beth L. Hoffman, MPH; Havana Tung; Una Medea Hanes; Robert Hoffman, MD; Kar-Hai Chu, PhD MS.

 

Issue: The popularity of flavored e-cigarettes continues to be a public health challenge. In 2020, the FDA banned e-cigarettes flavors that were popular among teenagers. Such bans, however, were circumvented by “do-it-yourself” (DIY) methods for making e-cigarette liquids, or e-juice, by combining commonly available ingredients. Spread online, unregulated methods for making e-juice are openly shared. Thus, understanding the discourse in DIY communities is crucial for analyzing health policies.

The goals of this study are: 1) to describe the discourse in DIY e-juice communities on Reddit, 2) analyze the effects of the 2020 flavors ban.

Methods: Posts between January 1, 2019, and January 2, 2021, were collected from r\DIY_eJuice, the most popular subreddit for “DIY” methods with ~71000 members. Data were stratified between pre-ban (n=2742 posts) and post-ban (n=2368) periods. For codebook development, 2% of the dataset were used to identify and characterize salient themes. Using identified categories, a random 10% subsample (n=500) were coded. 

Results: The most popular themes were DIY mixing methods (n=319), flavors (n=240), and the supply and shipping of products (n=85).  Discussions around safety were less popular (n=52). There was a statistically significant difference in discussions around the flavor ban between 2019 and 2020 (p=0.05). 

Conclusion: Online communities, including Reddit, offer quantitative and qualitative opportunities to understand the current discourse around emerging tobacco products. Our results suggest that despite the flavor ban, sharing and seeking information about e-cigarette flavors remained popular. Further, we found that even though the DIY methods are complicated, few members discussed their safety.

Third Place: Ziling Mao

EPIDEM

"Associations between the total energy intake and eating window with all-cause and cardiovascular disease mortality in U.S. adults" 

Ziling Mao, MPH; Anne B. Newman, MD, MPH; Samaneh Farsijani, PhD, RD

Background: While low energy intake has been linked to longevity in non-human studies, this relationship has not been established in large-scale long-term human studies. Additionally, emerging evidence suggests that the time of food intake influences cardiometabolic disease risk via entraining the body’s circadian clock. Yet, few population-based studies exist on the relationship between meal timing and mortality. Therefore, we determined the associations between total energy intake and timing of food intake with all-cause and cardiovascular disease (CVD) mortality in US adults.

Hypothesis: There are non-linear associations between total energy intake and eating window with mortality.

Methods: We included 33,646 US adults (age >19 years; 52.4% women) from the National Health and Nutrition Examination Survey (2003-2018). Total daily energy intake and eating window (i.e., time elapsed between the first and last calorie intakes) were extracted from two 24-hour food recalls. Mortality was ascertained through December 2019 using the National Death Index. Survey-weighted multivariable cox proportional hazard models were performed to calculate all-cause and CVD hazard ratios (HR) across categories of daily energy intake, eating window, and BMI.

Results: During a median follow-up of 96 months, 4,356 participants died (1,344 from CVD). Energy intake < 1,000 kcal/d was associated with higher mortality (HR_all-cause=1.6 and HR_CVD= 2.1 (both P<0.001)) vs. the reference category (2,000-2,500 kcal/d) independent of age, sex, race, BMI, and income. Energy intake ≥4,000 kcal/d was also associated with higher mortality, though HRs were not statistically significant. Median eating window was 12.10±0.02 h/d. Lower (< 10 h/d) and higher (14-16 h/d) eating windows were associated with higher all-cause and CVD mortality (P<0.05), vs. the reference category (12-13 h/d), independent of age, sex, race, BMI, energy, and income. Lower (>20) and higher (≥35 kg/m²) BMI were associated with higher all-cause and CVD mortality risk.

Conclusion: Our result showed a U-shaped relationship between total energy intake and eating window with mortality, which is similar to the previously reported U-shaped relationship between BMI and mortality.

Diversity, Equity and Inclusion Award: Anna Lewis

IDM

"Racial and Ethnic Disparities in Permanent Supportive Housing Placement" 

Anna Lewis, MSW, LCSW, Sujoy Chakravarty, PhD, & Eric Roberts, PhD

Research Objective: To examine racial and ethnic disparities in permanent supportive housing (PSH) placement among adults experiencing homelessness. PSH programs integrate housing, without a time limit on residence, with other social services. These programs often maintain waitlists for clients needing placement due to lack of availability. Compared to their representation in the US population, non-Hispanic Black individuals are 3 times more likely to be homeless and Hispanic/Latinx individuals are 1.2 times more likely. However, whether Black and Hispanic adults are placed into PSH at comparable or slower rates than non-Hispanic White adults remains unknown.

Study Design: We analyzed Medicaid enrollment data linked to Housing Management Information System (HMIS) housing services-related data in Pennsylvania. We calculated the time from an initial housing service encounter that was not PSH-related but that indicated homelessness to subsequent PSH placement. We conducted Cox proportional-hazards regression analyses to examine how baseline demographic, health, and socioeconomic variables are associated with differences in the rate of PSH placement over time.

Population Studied: HMIS service encounters from 2012-2016 were linked with individuals’ Medicaid enrollment files providing demographic information. Analyses included 17,242 individuals with an HMIS service other than PSH indicating homelessness. Of the identified individuals, 788 of them were ultimately placed with PSH programs within 0 to 60 months from receiving the index service.

Principal Findings: Initial unadjusted analyses indicate distinct racial and ethnic disparities in PSH placement overall. Non-Hispanic Black individuals were placed into PSH at 32.5% slower rate (p<0.001) as compared with their non-Hispanic white counterparts. Likewise, Hispanic/Latinx individuals were placed into PSH at a 34.7% slower rate (p=0.034) as compared to non-Hispanic white individuals. These relationships remain significant for non-Hispanic Black individuals, even when adjusting for age, gender, disability status, and basis of Medicaid eligibility (e.g., expansion pathway). In the adjusted model, non-Hispanic Black individuals were placed at a 31.4% slower rate (p<0.001) as compared to their non-Hispanic white counterparts. Hispanic/Latinx individuals were placed at a 30.9% slower rate, but this difference was no longer statistically significant (p=0.066). When adjusting for the above and comorbidities, non-Hispanic Black individuals were placed at a 27.5% slower rate (p<0.001).

Conclusions: There are clear and distinct racial and ethnic disparities in PSH placement. These disparities persist even when controlling for demographic and social factors (such as Medicaid eligibility category and disability status).

Implications for Policy or Practice: PSH services represent a unique opportunity for addressing chronic homelessness, but this relies upon the individual being deemed eligible and subsequently receiving a PSH placement. We found stark racial and ethnic disparities in PSH placement, which suggest the need for widespread dissemination of findings to housing-service agencies as well as practice-based interventions to ensure that homeless individuals who are eligible for PSH, specifically minorities, have equitable access to such services.

Catherine Cartier Ulrich Memorial Award for Public Health Service to the Underserved: Adrianna Acevedo-Fontanez

The Ulrich Award honors outstanding students from the school's professional-degree programs committed to serving the needs of disadvantaged communities. The award is open to all Dean's Day projects that show a commitment to the public health service and the underserved.

EPIDEM

"Reallocation of Sedentary Time with Light Physical Activity is Associated with Higher Sleep Efficiency in African Caribbeans" 

Adrianna I. Acevedo-Fontanez , Ryan K. Cvejkus , Marquis Hawkins, Allison L. Kuipers, Megan M. Marron, Joseph M. Zmuda, Emma Barinas-Mitchell, Victor W. Wheeler, and Iva Miljkovic 

Introduction: Sleep efficiency (or sleep continuity, i.e., a ratio of time spent sleeping to time spent in bed), is inversely associated with hypertension, impaired glucose metabolism, CVD risk, and mortality risk. Prolonged sedentary behavior and physical activity are independently associated with sleep efficiency. However, it is not well documented how substituting time in sedentary behavior with physical activity affects sleep efficiency, especially among African-ancestry populations, who are at high risk for CVD.

Aim: To determine if displacement of sedentary time with activity was cross-sectionally associated with higher sleep efficiency among African Caribbean men (n=235) and women (n=673) from the Tobago Health Study.

Methods: Sleep efficiency, sedentary behavior (SB), light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were collected using a SenseWear Pro Armband. Participants wore the armband at all times, except in water, for 4-7 days. We used the Isotemporal Substitution Framework paired with linear regression to examine associations of SB, LPA and MVPA with sleep efficiency adjusting for age, education, BMI, hypertension, diabetes, smoking, alcohol consumption, caffeine intake, and sleep medication.

Results: Men (mean age ± Standard deviation: 63.2 ± 8.2 years; mean BMI 28.2 ± 4.8 kg/m²) spent on average less time in SB (12.4 ± 2.9 hours/day) and more time in LPA (4.7 ± 2.1 hours /day) and MVPA (0.92 ± 0.88 hours/day) than women (mean age 55.6 ± 8.7 years; mean BMI 31.8 ± 6.4 kg/m²) (all p-vales <0.001). Men had lower sleep efficiency (74.6% ± 10.4) than women (81.2% ± 0.96; p-value <0.001). Cross-sectionally reallocating 1 hour of SB with LPA was associated with a 1% higher sleep efficiency (p-value=0.013) in men and with a 0.38% higher sleep efficiency in women (p-value=0.065). In men, reallocating 1 hour of SB with MVPA and 1 hour of LPA with MVPA were significantly associated with lower sleep efficiency [-1.9% (p-value=0.013) and -2.8% (p-value=0.004), respectively]; in women these associations were not statistically significant. Interaction term for sex and sleep efficiency was statistically significant (p-value <0.0001).

Conclusions: In this population with short sleep duration, reallocating 1 hour of SB with LPA was associated with higher sleep efficiency in both genders. In contrast, among men only, reallocating 1 hour of SB to MVPA and 1 hour of LPA to MVPA were unexpectedly associated with lower sleep efficiency. Further research is warranted to understand these relationships longitudinally to determine how truly replacing SB for activities of different intensities impacts sleep health, which could then potentially inform lifestyle guidelines in older Caribbeans. In this highly sedentary population, interventions aimed at increasing LPA may be easier to implement and maintain and provide greater sleep and overall health benefit.

Epidemiology Award: Lauren Shaver Roe

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Rosenkranz Award: Samantha Rosenberg

MPH student, BCHS

"Representation of Minorities in Alzheimer's Disease and Related Dementias (ADRD) Clinical Trials: An Overview of Reviews" 

Center for Public Health Practice Award: Dara Czernikowski

The CPHP award honors the Dean's Day project(s) best demonstrating a contribution to policy making and/or applications for improving practice. 

MPH student, BCHS

"Filtering Out the Bad: Measuring Healthcare Worker Practice Compliance in a Pediatric Dialysis Setting"

Dara Czernikowski, Lindsay Montoya

Central line associated bloodstream infections (CLABSIs) are one of the most costly healthcare associated infections to patient health and hospitals, incurring approximately $48,000 extra expenses per episode [1]. Without proper maintenance of central line sites, pathogens can take the opportunity to colonize and develop infection in the area. CLABSIs occur in 70% of hemodialysis patients, made more susceptible to this infection due to the direct bloodstream access provided by their central venous catheters [2]. This kind of infection can set a patient’s stay and recovery progress back weeks, and if serious enough, cause septic shock and death. The infection prevention team at UPMC Children’s Hospital of Pittsburgh performed surveillance of current dialysis practices by the pediatric dialysis staff over two months. Through this audit process, the objective was to review whether any areas in the dialysis procedure required improvement based on staff compliance of steps. Through this evaluation, the team expected overall good compliance, and aimed to follow up with recommendations to improve compliance rates, if necessary, standardize methods across the UPMC system, and mitigate risks for CLABSI development in patients. Compliance of dialysis staff was measured using a CDC audit tool, developed through the CDC Dialysis Collaborative, which outlined necessary steps within five areas of dialysis: (1) connection, (2) disconnection, (3) medication preparation, (4) medication administration, and (5) hand hygiene opportunities.

Overall compliance reported for connection, disconnection, medication preparation, medication administration, and hand hygiene opportunities were 59%, 47%, 0%, 100%, and 94%, respectively. Once the overall compliance was broken down further, the team identified areas in each category needing improvement. Steps such as “catheter hub scrub/dry time” during connection and disconnection events were inconsistent, having a designated area of medication preparation, and aseptic connection/disconnection of blood lines were observed to have reduced compliance. To improve these areas, the team recommended several strategies including the standardization of catheter hub “scrub” and drying times, initiating sterility for the entire disconnection process, and establishing a designated medication preparation counter within the unit. This method of auditing and providing feedback can be replicated in other dialysis settings of health care facilities to maintain or improve upon compliance. This care in attention to proper maintenance may help to reduce risks of developing healthcare associated infections. In turn, by reducing risk of healthcare associated infections, costs associated with extra hospitalizations and care from these infections would be decreased as well.

References:

[1] “Central Line-Associated Bloodstream Infection (CLABSI): An Introduction.” Centers for Disease Control and Prevention. https://www.cdc.gov/infectioncontrol/pdf/strive/CLABSI101-508.pdf

[2] Heidempergher, M., Sabiu, G., Orani, M. A., Tripepi, G., & Gallieni, M. (2021). Targeting COVID-19 prevention in hemodialysis facilities is associated with a drastic reduction in central venous catheter-related infections. Journal of nephrology, 34(2), 345–353. https://doi.org/10.1007/s40620-020-00900-3

Department of Epidemiology Health Disparities Award: Samantha Hernandez

 

2022 Dean's Day Winners

Dean’s Day first place master’s: Rachel Merritt, IDM
Dean’s Day second place, master’s: Monica Henderson, BCHS
Dean’s Day third place, master’s: Haley Director, HUGEN

Dean’s Day first place doctoral: Chinwoke Isiguzo, BCHS
Dean’s Day second place, doctoral: Jessie Klousnitzer, EOH
Dean’s Day third place, doctoral: Alice Gao, HPM

Rosenkranz Award for the project judged to be the most significant contribution to the public health field: Bethany Flage, IDM

Diversity, Equity, and Inclusion Award, master's: Emily Arthur, EPI
Diversity, Equity, and Inclusion Award, doctoral: Donald Bourne, HPM

Department of Epidemiology master's award: Teja Pulavarthi
Department of Epidemiology doctoral award: team of John Herberger, Rebecca McAdams, Alice Arcury-Quandt, Adrianna Acevedo-Fontanez
Department of Epidemiology diversity award: Carly Belz