In Vitro Antibiotic Resistance among Bacteria from the Cornea in the Antibiotic Resistance Monitoring in Ocular MicRoorganisms Surveillance Study.

PURPOSE: This study aimed to report on in vitro susceptibility patterns among corneal isolates collected in the Antibiotic Resistance Monitoring in Ocular micRoorganisms (ARMOR) study. METHODS: Each year, from 2009 to 2019, Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae isolates cultured from patients with ocular infections at participating ARMOR sites were submitted to a central laboratory for species confirmation and antibiotic susceptibility testing. In this analysis of corneal isolates, odds ratios for concurrent resistance were based on sample proportions, one-way ANOVA was used to evaluate resistance by patient age, and Cochran-Armitage tests were used to examine changes in antibiotic resistance over time. RESULTS: A total of 1499 corneal isolates were collected from 61 sites over the 11-year period. Overall, 34.5% (148 of 429) of S. aureus and 41.9% (220 of 525) of CoNS isolates were methicillin resistant and had higher odds ratios for concurrent resistance to azithromycin (17.44 and 5.67), ciprofloxacin (39.63 and 12.81), and tobramycin (19.56 and 19.95), respectively, relative to methicillin-susceptible isolates (P < .001, all); also, a high proportion of methicillin-resistant S. aureus (85.1%) and methicillin-resistant CoNS (81.8%) were multidrug resistant (at least three classes of antibiotics). Resistance among S. pneumoniae isolates was highest for azithromycin (33.1%), whereas P. aeruginosa and H. influenzae isolates demonstrated low resistance overall. Among staphylococci, antibiotic resistance differed by patient age (S. aureus: F = 6.46, P < .001; CoNS: F = 4.82, P < .001), and few small changes in resistance (≤3.60% per year), mostly decreases, were observed over time. CONCLUSIONS: Although rates of in vitro antibiotic resistance among presumed keratitis isolates obtained in ARMOR seemed stable between 2009 and 2019, resistance among staphylococci and pneumococci remains high (and should be considered when treating keratitis).

Antibiotic resistance among ocular pathogens: current trends from the ARMOR surveillance study (2009-2016).

BACKGROUND: The Antibiotic Resistance Monitoring in Ocular micRoorganisms study is an ongoing surveillance study that tracks antibiotic resistance among bacterial isolates from ocular infections across the United States. We report antibiotic resistance rates and trends from 2009 through 2016. MATERIALS AND METHODS: Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae from various ocular infections were obtained from participating United States centers. Isolates were sent to a central laboratory for determination of antibiotic resistance profiles. Minimum inhibitory concentrations were determined by broth microdilution according to the Clinical and Laboratory Standards Institute for drugs from more than ten antibiotic classes, and isolates were classified as susceptible or resistant based on systemic breakpoints, wherever available. Resistance rates were also evaluated based on decade of patient life and longitudinally over the 8-year time period. RESULTS: A total of 1,695 S. aureus, 1,475 CoNS, 474 S. pneumoniae, 586 H. influenzae, and 599 P. aeruginosa were collected from 87 sites. Resistance was high among staphylococci and pneumococci, with methicillin resistance detected in 621 (36.6%) S. aureus and 717 (48.6%) CoNS isolates. Multidrug resistance (≥3 drug classes) was observed among staphylococci, particularly in methicillin-resistant (MR) isolates (MR S. aureus [MRSA]: 76.2%; MR CoNS [MRCoNS]: 73.5%). Differences in methicillin resistance among staphylococci were observed based on patient age, with higher rates observed in older patients (P<0.0001). For certain organism-antibiotic combinations, there were significant changes in resistance over time, including a decrease in methicillin resistance among S. aureus (but not CoNS); no notable trends were observed for S. pneumoniae. CONCLUSION: Antibiotic resistance was prevalent among gram-positive organisms, and MR staphylococcal isolates were more likely to be multidrug resistant. Although a small decrease in methicillin resistance was observed among S. aureus over time, the continued high prevalence of in vitro methicillin resistance should be considered when treating patients with ocular infections.

Correction: Perceptions of health risks of cigarette smoking: A new measure reveals widespread misunderstanding.

[This corrects the article DOI: 10.1371/journal.pone.0182063.].

Recruiting and retaining youth and young adults: challenges and opportunities in survey research for tobacco control.

INTRODUCTION: Evaluation studies of population-based tobacco control interventions often rely on large-scale survey data from numerous respondents across many geographic areas to provide evidence of their effectiveness. Significant challenges for survey research have emerged with the evolving communications landscape, particularly for surveying hard-to-reach populations such as youth and young adults. This study combines the comprehensive coverage of an address-based sampling (ABS) frame with the timeliness of online data collection to develop a nationally representative longitudinal cohort of young people aged 15-21. METHODS: We constructed an ABS frame, partially supplemented with auxiliary data, to recruit this hard-to-reach sample. Branded and tested mail-based recruitment materials were designed to bring respondents online for screening, consent and surveying. Once enrolled, respondents completed online surveys every 6 months via computer, tablet or smartphone. Numerous strategies were utilized to enhance retention and representativeness RESULTS: Results detail sample performance, representativeness and retention rates as well as device utilization trends for survey completion among youth and young adult respondents. Panel development efforts resulted in a large, nationally representative sample with high retention rates. CONCLUSIONS: This study is among the first to employ this hybrid ABS-to-online methodology to recruit and retain youth and young adults in a probability-based online cohort panel. The approach is particularly valuable for conducting research among younger populations as it capitalizes on their increasing access to and comfort with digital communication. We discuss challenges and opportunities of panel recruitment and retention methods in an effort to provide valuable information for tobacco control researchers seeking to obtain representative, population-based samples of youth and young adults in the U.S. as well as across the globe.

Perceptions of health risks of cigarette smoking: A new measure reveals widespread misunderstanding.

Most Americans recognize that smoking causes serious diseases, yet many Americans continue to smoke. One possible explanation for this paradox is that perhaps Americans do not accurately perceive the extent to which smoking increases the probability of adverse health outcomes. This paper examines the accuracy of Americans' perceptions of the absolute risk, attributable risk, and relative risk of lung cancer, and assesses which of these beliefs drive Americans' smoking behavior. Using data from three national surveys, statistical analyses were performed by comparing means, medians, and distributions, and by employing Generalized Additive Models. Perceptions of relative risk were associated as expected with smoking onset and smoking cessation, whereas perceptions of absolute risk and attributable risk were not. Additionally, the relation of relative risk with smoking status was stronger among people who held their risk perceptions with more certainty. Most current smokers, former smokers, and never-smokers considerably underestimated the relative risk of smoking. If, as this paper suggests, people naturally think about the health consequences of smoking in terms of relative risk, smoking rates might be reduced if public understanding of the relative risks of smoking were more accurate and people held those beliefs with more confidence.

An algorithm for the management of allergic conjunctivitis.

Allergic conjunctivitis has been reported to be increasing in prevalence in the United States. It significantly impacts patient quality of life and reduces their productivity. It has been noted that nasal and ocular symptoms are equally bothersome in the majority of patients. Despite the development of new therapeutic interventions, ocular allergy is often underdiagnosed and undertreated. This article outlines current best practices regarding diagnosis and treatment of allergic conjunctivitis; suggests criteria for referral to a colleague with different expertise; and provides an algorithm for step recommendations including treatment with antihistamines, mast cell stabilizers, corticosteroids, nonsteroidal anti-inflammatory drugs, and immunotherapy.

Relationship of military deployment recency, frequency, duration, and combat exposure to alcohol use in the Air Force.

OBJECTIVE: With today's new military deployment environment, characterized by more frequent and longer deployments, significant attention has focused on the effects of deployment on problem behaviors, including alcohol use. The current study examined the relationship between aspects of deployment and alcohol use. METHOD: The data for the current study were collected as part of the Air Force Community Assessment survey, an anonymous Web-based survey of Air Force members. The survey was administered to a stratified random sample of 56,137 active duty Air Force members across 80 bases worldwide; 78% were male and 22% were female. The Alcohol Use Disorders Identification Test measured the rate of alcohol problems. Deployment histories were collected using a series of questions that asked respondents about various aspects and characteristics of their recent deployments. RESULTS: Logistic regression was used to examine the impact of various aspects of deployment on problem drinking. After controlling for demographic variables related to the likelihood of problem drinking, both a higher frequency of deployment and a greater total cumulative length of time deployed since September 11, 2001, were associated with a higher likelihood of problem drinking. For each increase in deployment frequency category the odds that an Air Force member was a problem drinker increased by 14%, and for each additional year spent deployed the odds increased by 23%. CONCLUSIONS: These findings indicate a significant relationship between deployment and problem drinking. However, most members who deployed multiple times remained resilient. This points to the need for future research on protective factors that foster resiliency.

Reducing drinking among junior enlisted Air Force members in five communities: early findings of the EUDL program's influence on self-reported drinking behaviors.

OBJECTIVE: In the fall of 2006, the Office of Juvenile Justice and Delinquency Prevention awarded discretionary grants to five communities in four states as part of the Enforcing Underage Drinking Laws initiative. These 3-year grants were designed to support implementation of a set of interventions using an environmental strategies approach to reduce drinking and associated alcohol-related misconducts among active-duty Air Force members ages 18-25, with a specific focus on the underage population. The current article presents findings from Year 1 of the evaluation. METHOD: Data on alcohol use were obtained from a large-scale, anonymous survey that fielded in the spring of 2006 (i.e., pretest) and the spring of 2008 (i.e., posttest) from a stratified random sample of Air Force members at five demonstration and five comparison communities. RESULTS: The percentage of junior enlisted personnel at risk for an alcohol problem dropped 6.6% in the Air Force overall during the last 2 years but dropped as much as 13.6% and 9.8% in two Arizona demonstration communities that implemented the intervention. CONCLUSIONS: The first-year results suggest that the Enforcing Underage Drinking Laws intervention may have been one factor that helped to reduce the percentage of junior enlisted Air Force members at risk for an alcohol problem in the demonstration communities.

Cost-benefit analysis involving addictive goods: contingent valuation to estimate willingness-to-pay for smoking cessation.

The valuation of changes in consumption of addictive goods resulting from policy interventions presents a challenge for cost-benefit analysts. Consumer surplus losses from reduced consumption of addictive goods that are measured relative to market demand schedules overestimate the social cost of cessation interventions. This article seeks to show that consumer surplus losses measured using a non-addicted demand schedule provide a better assessment of social cost. Specifically, (1) it develops an addiction model that permits an estimate of the smoker's compensating variation for the elimination of addiction; (2) it employs a contingent valuation survey of current smokers to estimate their willingness-to-pay (WTP) for a treatment that would eliminate addiction; (3) it uses the estimate of WTP from the survey to calculate the fraction of consumer surplus that should be viewed as consumer value; and (4) it provides an estimate of this fraction. The exercise suggests that, as a tentative first and rough rule-of-thumb, only about 75% of the loss of the conventionally measured consumer surplus should be counted as social cost for policies that reduce the consumption of cigarettes. Additional research to estimate this important rule-of-thumb is desirable to address the various caveats relevant to this study.

Self-reported smoking in online surveys: prevalence estimate validity and item format effects.

OBJECTIVES: We assessed validity of self-reported smoking prevalence estimates from an online sample, and explored the impact of different item response formats on estimates. METHODS: Self-reported current smoking status was obtained from 110,837 respondents from the Harris Poll Online (HPOL) panel from April 2004 to January 2005. Current smoking prevalence was compared with national estimates from the 2004 Behavioral Risk Factor Surveillance System (BRFSS), 2003 National Health Interview Survey (NHIS), and 2001-2002 National Health and Nutrition Examination Survey (NHANES). All estimates were weighted to reflect the US population. A separate survey section measured smoking prevalence using randomly assigned response formats, including yes/no grid, multiple response, numeric box, category grid, and drop-down box formats. RESULTS: 24.0% (95% confidence interval [CI] = 23.7-24.4) of HPOL respondents reported current smoking. BRFSS, NHIS, and NHANES estimates found 20.9%, 21.5% (95% CI = 20.9-22.1), and 24.9% (95% CI = 22.4-27.5), respectively, reporting current smoking. An additional 4.5% of NHANES respondents reporting not smoking had cotinine levels > or =15 ng/mL, indicating current smoking. Estimates of smoking prevalence varied by prevalence period and response format. CONCLUSIONS: Prevalence estimates obtained from the HPOL panel are comparable to those from national surveys. Online response format choices result in variation in estimated behavioral prevalence. Online surveys may be useful for public health surveillance of the US population.

History of childhood candy cigarette use is associated with tobacco smoking by adults.

OBJECTIVE: We examined whether childhood candy cigarette use was associated with adult tobacco smoking. METHODS: 25,887 U.S. adults from the Harris Poll Online (HPOL) were surveyed about current smoking status from November 2005 to May 2006. Respondents were randomly assigned to a yes/no item or a dose-response scale to assess candy cigarette use. Data were weighted to reflect the U.S. adult population. RESULTS: 26.4% of respondents reported current smoking and 29.4% reported former smoking. Candy cigarette use was reported by 88% of both current and former smokers and 78% of never smokers (p