Biomedical subjects

Andrew E Clark

Publications and source records attributed to Andrew E Clark.

6 recordsLinked to original sources

PubMed2024

Antibiotic resistance genotype, phenotype, and clinical outcomes in patients with Gram-negative infections at Rabin Medical Center in Israel.

UNLABELLED: Antibiotic resistance is a major cause of morbidity and mortality. However, a better understanding of the relationship between bacterial genetic markers, phenotypic resistance, and clinical outcomes is needed. We performed whole-genome sequencing on five medically important pathogens (Acinetobacter baumannii, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) to investigate how resistance genes impact patient outcomes. A total of 168 isolates from 162 patients with Gram-negative infections admitted to Beilinson Hospital at Rabin Medical Center in Israel were included for final analysis. Genomes were analyzed for resistance determinants and correlated with microbiologic and clinical data. Thirty-day mortality from time of culture was 26.5% (43/162). Twenty-nine patients had carbapenem-resistant isolates (29/168, 17.2%), while 63 patients had multidrug-resistant isolates (63/168, 37.5%). Albumin levels were inversely associated with mortality and length of stay, while arrival from a healthcare facility and cancer chemotherapy predicted having a multidrug-resistant isolate. Sequencing revealed possible patient-to-patient transmission events. blaCTX-M-15 was associated with multidrug-resistance in E. coli (OR = 3.888, P = 0.023) on multivariate analysis. Increased blaOXA-72 copy number was associated with carbapenem-resistance in A. baumannii (P = 0.003) and meropenem minimum inhibitory concentration (P = 0.005), yet carbapenem-resistant isolates retained sensitivity to cefiderocol and sulbactam-durlobactam. RJX84154 was associated with multidrug-resistance across all pathogens (P = 0.0018) and in E. coli (P = 0.0024). Low albumin levels were associated with mortality and length of stay in this sample population. blaCTX-M-15 was correlated with multidrug-resistance in E. coli, and blaOXA-72 depth predicted meropenem minimum inhibitory concentration in A. baumannii. RJX84154 may play a role in multidrug-resistance. IMPORTANCE: While there have been several studies that attempt to find clinical predictors of outcomes in patients hospitalized with bacterial infections, less has been done to combine clinical data with genomic mechanisms of antibiotic resistance. This study focused on a hospitalized patient population in Israel with infections due to medically important bacterial pathogens as a way to build a framework that would unite clinical data with both bacterial antibiotic susceptibility and genomic data. Merging both clinical and genomic data allowed us to find both bacterial and clinical factors that impact certain clinical outcomes. As genome sequencing of bacteria becomes both rapid and commonplace, near real-time monitoring of resistance determinants could help to optimize clinical care and potentially improve outcomes in these patients.

Humans↗

PubMed2006

"It wasn't me, it was them!" social influence in risky behavior by adolescents.

Many years of concerted policy effort in Western countries has not prevented young people from experimenting with cigarettes, alcohol and marijuana. One potential explanation is that social interactions make consumption "sticky". We use detailed panel data from the Add Health survey to examine risky behavior (the consumption of tobacco, alcohol and marijuana) by American adolescents. We find that, even controlling for school fixed effects, these behaviors are correlated with lagged peer group behavior. Peer group effects are strongest for alcohol use, and young males are more influential than young females. Last, we present some evidence of non-linearities in social interactions.

Adolescent↗

PubMed2006

Don't give up on me baby: spousal correlation in smoking behaviour.

We use nine waves of BHPS data to examine interactions between spouses in terms of a behaviour with important health repercussions: cigarette smoking. Correlation between partners' behaviours may be due to correlated effects, as a consequence of matching or information revealed by others' behaviours, or to endogenous effects generated by bargaining within marriage. A simple bivariate probit reveals a positive correlation between own current smoking and partner's past smoking, which is consistent with endogenous effects. However, after controlling for individual effects, we find that own current smoking and partner's past smoking are statistically independent: all of the correlation in smoking status works through the correlation in individual effects. As such the correlation in the raw smoking data is consistent with positive assortative matching in marriage over smoking, rather than bargaining within the couple or social learning.

Data Collection↗

PubMed2004

Unemployment alters the set point for life satisfaction.

According to set-point theories of subjective well-being, people react to events but then return to baseline levels of happiness and satisfaction over time. We tested this idea by examining reaction and adaptation to unemployment in a 15-year longitudinal study of more than 24,000 individuals living in Germany. In accordance with set-point theories, individuals reacted strongly to unemployment and then shifted back toward their baseline levels of life satisfaction. However, on average, individuals did not completely return to their former levels of satisfaction, even after they became reemployed. Furthermore, contrary to expectations from adaptation theories, people who had experienced unemployment in the past did not react any less negatively to a new bout of unemployment than did people who had not been previously unemployed. These results suggest that although life satisfaction is moderately stable over time, life events can have a strong influence on long-term levels of subjective well-being.

Humans↗

PubMed2003

Reexamining adaptation and the set point model of happiness: reactions to changes in marital status.

According to adaptation theory, individuals react to events but quickly adapt back to baseline levels of subjective well-being. To test this idea, the authors used data from a 15-year longitudinal study of over 24.000 individuals to examine the effects of marital transitions on life satisfaction. On average, individuals reacted to events and then adapted back toward baseline levels. However, there were substantial individual differences in this tendency. Individuals who initially reacted strongly were still far from baseline years later, and many people exhibited trajectories that were in the opposite direction to that predicted by adaptation theory. Thus, marital transitions can be associated with long-lasting changes in satisfaction, but these changes can be overlooked when only average trends are examined.

Adaptation, Psychological↗

PubMed2002

A simple statistical method for measuring how life events affect happiness.

BACKGROUND: Life events-like illness, marriage, or unemployment-have important effects on people. But there is no accepted way to measure the different sizes of these events upon human happiness and psychological health. By using happiness regression equations, economists have recently developed a method. METHODS: We estimate happiness regressions using large random samples of individuals. The relative coefficients of income and life events on happiness allow us to calculate a monetary 'compensating amount' for each kind of life event. RESULTS: The paper calculates the impact of different life events upon human well-being. Getting married, for instance, is calculated to bring each year the same amount of happiness, on average, as having an extra pound 70 000 of income per annum. The psychological costs of losing a job greatly exceed those from the pure drop in income. Health is hugely important to happiness. Widowhood brings a degree of unhappiness that would take, on average, an extra pound 170 000 per annum to offset. Well-being regressions also allow us to assess one of the oldest conjectures in social science-that well-being depends not just on absolute things but inherently on comparisons with other people. We find evidence for comparison effects. CONCLUSION: We believe that the new statistical method has many applications. In principle, it can be used to value any kind of event in life.

Data Interpretation, Statistical↗