Audrey Steenbeek
Dalhousie University, School of Nursing, Faculty Member
Sexually transmitted infections are leading causes of morbidity for Canadian Aboriginal women. To date, very few initiatives have been successful in screening, treating, and limiting these infections among these populations. To evaluate... more
Sexually transmitted infections are leading causes of morbidity for Canadian Aboriginal women. To date, very few initiatives have been successful in screening, treating, and limiting these infections among these populations. To evaluate the efficacy of universal screening, treatment and contact tracing as a means of capturing a more accurate count of chlamydia and gonorrhea prevalence and limiting transmission among Inuit communities. 181 participants were screened for chlamydia and gonorrhea and interviewed in a cross-sectional survey (Aug-Sept/03). Information was collected on demographics, use of health services, sexual histories and STI knowledge among others. A random sample (n = 100) from the cross-sectional group was selected for the longitudinal cohort. Individuals were followed every two months post baseline for four visits (Oct/03-May/04). At each visit, participants were screened for chlamydia/gonorrhea. All positive cases and their partners were treated and contact tracing completed. Logistic Regression analysis and the McNemar Test of Correlated Proportions were used to analyze the data. Overall, 35 cases of chlamydia were detected, with 21 detected at baseline and 14 during follow-up. The baseline prevalence was 11.6% in comparison with 2.7% that was previously estimated. No gonorrhea was detected. The strongest factor associated with a positive chlamydia was having recent STI (OR 9.82, CI: 2.70, 35.77). Consistent with the literature, the results support the use of universal screening followed by prompt treatment and contact tracing in populations with greater than 10% chlamydia prevalence.
Research Interests:
The World Health Organization's Strategic Advisory Group of Experts on Immunization has declared that maternal immunization is a key priority. Robust adverse event following immunization (AEFI) surveillance systems that capture... more
The World Health Organization's Strategic Advisory Group of Experts on Immunization has declared that maternal immunization is a key priority. Robust adverse event following immunization (AEFI) surveillance systems that capture outcomes in pregnant women and their infants are needed to ensure the safety of maternal immunization programs. We sought to identify the active and passive AEFI surveillance systems for pregnant women and their offspring described in the literature. A systematic literature review was conducted of the MEDLINE, CINAHL, and EMBASE databases from 1990 to 2014. English-language articles were reviewed if they included pregnant women as the population of interest and described the surveillance method used. Of 619 articles retrieved from the search, 16 met the criteria for review. These included reports of AEFI surveillance for pregnant women, their offspring, or both. The majority of reports (11/16) came from the USA and described findings on two active and fou...
Research Interests:
To review the evidence and provide recommendations on immunization in pregnancy. Outcomes evaluated include effectiveness of immunization, and risks and benefits for mother and fetus. The Medline and Cochrane databases were searched for... more
To review the evidence and provide recommendations on immunization in pregnancy. Outcomes evaluated include effectiveness of immunization, and risks and benefits for mother and fetus. The Medline and Cochrane databases were searched for articles published up to June 2007 on the topic of immunization in pregnancy. The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada (SOGC) under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care. Implementation of the recommendations in this guideline should result in more appropriate immunization of pregnant and breastfeeding women, decreased risk of contraindicated immunization, and better disease prevention. Recommendations 1. All women of childbearing age should be evaluated for the possibility of pregnancy before immunization. (III-A) 2. Health car...
Research Interests:
To review the evidence and provide recommendations on the use of antibiotics in preterm premature rupture of the membranes (PPROM). Outcomes evaluated include the effect of antibiotic treatment on maternal infection, chorioamnionitis, and... more
To review the evidence and provide recommendations on the use of antibiotics in preterm premature rupture of the membranes (PPROM). Outcomes evaluated include the effect of antibiotic treatment on maternal infection, chorioamnionitis, and neonatal morbidity and mortality. Published literature was retrieved through searches of Medline, EMBASE, CINAHL, and The Cochrane Library, using appropriate controlled vocabulary and key words (PPROM, infection, and antibiotics). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and new material incorporated in the guideline to July 2008. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and internat...
Research Interests: Obstetrics, Evidence Based Medicine, Treatment Outcome, Canada, Prospective studies, and 24 morePregnancy, Humans, Female, American, Amniotic Fluid, Randomized Trial, Tennessee, Newborn Infant, Spectrum, Anti-Bacterial Agents, Adult, Kentucky, Morbidity, Time Factors, Adverse Event, Group, Study design, Combination drug therapy, Randomized Clinical Trial, Chorioamnionitis, Ampicillin, Gestational Age, Fetal death, and Pregnancy Outcome
Prior research has demonstrated that people who die shortly after receiving a cancer diagnosis are at increased risk for not being referred to palliative care. No previous studies have empirically derived the length of time between... more
Prior research has demonstrated that people who die shortly after receiving a cancer diagnosis are at increased risk for not being referred to palliative care. No previous studies have empirically derived the length of time between diagnosis and death associated with increased risk. The objective of this study was to identify the length of time between diagnosis and death associated with increased risk for non-enrolment in a palliative care programme. Binary recursive partitioning was employed to derive the cut-point for the number of days from colorectal cancer diagnosis to death predictive of a high risk for non-enrolment in a palliative care programme in two health districts in Nova Scotia, Canada. The study included all adults (≥20 years) who were diagnosed with colorectal cancer in the two districts between 1 January 2001 and 31 December 2005 and who died between 1 January 2001 and 31 December 2008 (n=894). Individuals who died within 18.5 days following diagnosis were at highest risk for non-enrolment in palliative care. Of the 60 adults who died in <18.5 days, 16.7% were enrolled in a palliative care programme; of the 835 adults who died ≥18.5 days after diagnosis, 65.9% were enrolled. This data-driven approach may be used to define the short diagnosis-to-death time frame at which individuals are at increased risk for non-enrolment in palliative care programmes. This approach allows researchers to further investigate and compare empirically-derived cut-points that identify those who die quickly and are at risk of not receiving palliative care.