Land Information Access Association

BackgroundGlobal surges attributed to whooping cough, caused by Bordetella pertussis, are widespread. Maternal Tdap demonstrates success in preventing infant morbidity and mortality, however, cases predominate in adolescents. Unvaccinated individuals are at risk of infection. However, further exploration is warranted regarding waning immunity. This investigation outlines a whooping cough outbreak.Methods38 cases were identified from July 2024-December 2024 through health facilities, schools, families and the Michigan Disease Surveillance System (MDSS). Cases were investigated using the MDSS pertussis case investigation form for demographics, symptoms, hospitalization, vaccination, treatment and contact tracing. Close contacts were notified for mitigation. Immunizations and waiver data was obtained through the Michigan Care Improvement Registry (MCIR).Results38 cases were identified, 1-84 years old (median 14). 61% (n=23) of infections occurred in 11-18 years, 13% (n=5) each in 1-6, 7-10, and 19+ age cohorts. 61% were fully vaccinated (n=23), 26% unvaccinated (n=10), 14% outdated/unknown status (n=5). Average time since last dose among fully vaccinated was 23.5 months in 1-6 years (n=2), 66.25 in 7-10 (n=4), 48.5 in 11-18 (n=16) and 62 in 19+(n=1) cohorts. Primary symptoms were cough (100%), paroxysms of cough (68%), inspiratory whoop (21%), post-tussive vomiting (21%). 100% received treatment, 2 were hospitalized, no deaths and no cases in < 1-year olds. 11 schools and 1 daycare were affected. Among the top two schools with students impacted, immunization waiver percentages were 14% each, compared to county waivers of 8%.ConclusionTwo major factors are seen in our outbreak: 1) prolonged time since last dose for fully vaccinated individuals, and 2) non/under vaccinated people. Immunizations waivers place unvaccinated at high risk for infection. Efforts to encourage vaccination continue. However, the number of cases in fully vaccinated youth underscore the need to investigate waning immunity. The economic impact on individuals, families and society causing classroom shutdowns, sick time, lost wages, and over-utilization of healthcare and personnel resources persist. Consideration of boosters after adolescent Tdap or improved vaccine development are necessary.DisclosuresSeema Joshi, MD, Cephied: Grant/Research Support Marcus Zervos, MD, merck: Honoraria

The malicious use of artificial intelligence is growing rapidly, creating major security threats for individuals and the healthcare sector. Individuals with mental illness may be especially vulnerable. Healthcare provider data are a prime target for cybercriminals. There is a need to improve cybersecurity to detect and prevent cyberattacks against individuals and the healthcare sector, including the use of artificial intelligence predictive tools.

This narrative review discusses how the safe and effective use of clinical artificial intelligence (AI) prediction tools requires recognition of the importance of human intelligence. Human intelligence, creativity, situational awareness, and professional knowledge, are required for successful implementation. The implementation of clinical AI prediction tools may change the workflow in medical practice resulting in new challenges and safety implications. Human understanding of how a clinical AI prediction tool performs in routine and exceptional situations is fundamental to successful implementation. Physicians must be involved in all aspects of the selection, implementation, and ongoing product monitoring of clinical AI prediction tools.

Errorless compliance training (ECT) is a success‐based, nonaversive intervention to reduce child noncompliance that has been shown to be effective in both home and special education settings. In the current study, ECT was evaluated in a multiple‐baseline across‐subjects design with three kindergarten students who displayed noncompliant behavior in their general education classrooms. The researcher delivered a range of classroom requests to each student to determine the probability of compliance for each request. Requests were then arranged in a hierarchy, ranging from those initially yielding high compliance probabilities (level 1) to those yielding low compliance (level 4). At the beginning of treatment, students were presented with a high number of level 1 requests and provided verbal praise for compliance. Over several weeks, lower probability requests were faded in. The three students demonstrated considerable improvement in compliance levels during and following treatment. Improved compliance generalized to low‐probability requests not used in treatment. When the teacher delivered requests, results of generalization were mixed. The results provide preliminary support for the use of errorless compliance training in the general education setting. Copyright © 2014 John Wiley &amp; Sons, Ltd.

Back to table of contents Previous article Next article ARTICLENo AccessHEREDITARY CHOREA (HUNTINGTON'S)Beatrice A. Stevenson, and H. D. PurdumBeatrice A. StevensonSearch for more papers by this author, and H. D. PurdumSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.66.1.129AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Volume 66Issue 1 July 1909Pages 129-132 Metrics PDF download History Published online 1 April 2006 Published in print 1 July 1909