Mary Nowalk | University of Pittsburgh (original) (raw)

Papers by Mary Nowalk

Research paper thumbnail of Designing a hospital-based pneumococcal vaccination program

American Journal of Health-system Pharmacy, Jul 15, 2003

Page 1. MANAGEMENT CASE STUDIES Vaccination program 1471 Am J Health-Syst Pharm—Vol 60 Jul 15, 20... more Page 1. MANAGEMENT CASE STUDIES Vaccination program 1471 Am J Health-Syst Pharm—Vol 60 Jul 15, 2003 MANAGEMENTCASESTUDIES Management Case Studies describe approaches to real-life management problems in health systems. ...

Research paper thumbnail of Shortage of influenza vaccine in 2000–2001

American Journal of Preventive Medicine, May 1, 2003

Research paper thumbnail of The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis

BMC Infectious Diseases, Nov 8, 2016

Research paper thumbnail of Barriers to Pneumococcal and Influenza Vaccination in Older Community-Dwelling Adults (2000–2001)

Journal of the American Geriatrics Society, 2004

Research paper thumbnail of Interim Estimates of 2017–18 Seasonal Influenza Vaccine Effectiveness — United States, February 2018

Morbidity and Mortality Weekly Report, Feb 16, 2018

Research paper thumbnail of 2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

Clinical Infectious Diseases, Oct 4, 2016

Research paper thumbnail of Impact of Diabetes Status on Immunogenicity of Trivalent Inactivated Influenza Vaccine in Older Adults

medRxiv (Cold Spring Harbor Laboratory), Oct 5, 2021

Individuals with type 2 diabetes mellitus experience high rates of influenza virus infection and ... more Individuals with type 2 diabetes mellitus experience high rates of influenza virus infection and complications. We compared the magnitude and duration of serologic response to trivalent influenza vaccine in adults aged 50-80 with and without type 2 diabetes mellitus. Serologic response to influenza vaccination was similar in both groups: greater fold-increases in antibody titer occurred among individuals with lower pre-vaccination antibody titers. Waning of antibody titers was not influenced by diabetes status.

Research paper thumbnail of Spirituality, quality of life and frailty in community-dwelling adults ≥ 50 years

Psychology of Religion and Spirituality, Mar 1, 2021

Research paper thumbnail of Prior-Season Vaccination and Risk of Influenza During the 2014–2015 Season in the United States

The Journal of Infectious Diseases, Jun 13, 2017

Research paper thumbnail of Influenza vaccine effectiveness among patients with high-risk medical conditions in the United States, 2012–2016

Research paper thumbnail of Compliance to Self-Monitoring of Blood Glucose: A Marked-Item Technique Compared with Self-Report

Diabetes Care, Sep 1, 1985

Research paper thumbnail of Exercise in a behavioural weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes

Diabetologia, Dec 1, 1988

Research paper thumbnail of Cost-effectiveness of an in-development adult-formulated pneumococcal vaccine in older US adults

Research paper thumbnail of Family history of diabetes and its effect on treatment outcome in type II diabetes

Behavior Therapy, 1987

This study was designed to determine whether family history of diabetes affects the response to a... more This study was designed to determine whether family history of diabetes affects the response to a therapeutic intervention in obese Type II diabetic patients. Seventy-seven Type II diabetics were treated in a 12–16 week behavioral weight control program with follow-up one year later. No significant differences in weight loss or glycemic responses were observed between patients with and without a first degree relative with diabetes, or between patients with 0, 1, or 2 diabetic parents. Although family history of Type II diabetes affects the chances of developing the disease, these data suggest that family history does not affect the response to treatment.

Research paper thumbnail of Hospital Policies, State Laws, and Healthcare Worker Influenza Vaccination Rates

Infection Control and Hospital Epidemiology, Aug 1, 2013

This study used hierarchical linear modeling to determine the relative contribution of hospital p... more This study used hierarchical linear modeling to determine the relative contribution of hospital policies and state laws to healthcare worker (HCW) influenza vaccination rates. Hospital mandates with consequences for noncompliance and race were associated with 3%-12% increases in HCW vaccination; state laws were not significantly related to vaccination rates.

Research paper thumbnail of Calorie-counting compared to exchange system diets in the treatment of overweight patients with type II diabetes

Addictive Behaviors, 1986

Patients with diabetes are usually placed on exchange system diets to ensure a nutritionally adeq... more Patients with diabetes are usually placed on exchange system diets to ensure a nutritionally adequate intake. However, there have been few studies which have actually compared the nutritional adequacy of diets selected by patients on exchange system diets, with that selected by patients on the calorie-counting diets typically used in behavioral weight control programs. This study compared the nutritional adequacy of the diets selected by overweight patients with Type II diabetes who had been randomly assigned to either an exchange system diet or a calorie-counting diet. Three-day food diaries were completed by all patients at the start and end of a 16-week weight control program. No significant differences were observed between patients on the calorie-counting diet compared to those on the exchange system diet with respect to nutrient intake, macronutrient distribution, or percent of the RDA obtained. Patients on both types of diet reported decreases in the proportion of calories from fat. The average intake exceeded 100% of the RDA for all nutrients except calcium. This study suggests that patients are able to improve the nutritional adequacy of their intake while following either a calorie-counting or an exchange system diet.

Research paper thumbnail of Cost-effectiveness of increasing vaccination in high-risk adults aged 18–64 Years: a model-based decision analysis

BMC Infectious Diseases, Jan 25, 2018

Research paper thumbnail of Association of Obesity and Chronic Diseases in Taiwan

Asia-Pacific Journal of Public Health, Sep 1, 2006

Research paper thumbnail of Economic Evaluation of Standing Order Programs for Pneumococcal Vaccination of Hospitalized Elderly Patients

Infection Control and Hospital Epidemiology, May 1, 2008

Background.Standing order programs (SOPs), which allow for vaccination without an individual phys... more Background.Standing order programs (SOPs), which allow for vaccination without an individual physician order, are the most effective mechanism to achieve high vaccination rates. Among the suggested settings for the utilization of SOPs are hospital inpatient units, because they provide care for those most likely to benefit from vaccination. The cost-effectiveness of this approach for elderly hospitalized persons is unknown. The purpose of this study was to estimate the cost-effectiveness of SOPs for pneumococcal polysaccharide vaccine (PPV) vaccination for patients 65 years of age or older in 2 types of hospital.Methods.In 2004, a 1,094-bed tertiary care hospital implemented a pharmacy-based SOP for PPV, and a 225-bed community hospital implemented a nursing-based SOP for PPV. Newly admitted patients 65 years of age or older were screened for PPV eligibility and then offered PPV. Vaccination rates before and after initiation of SOPs in the United States, incidence rates of invasive pneumococcal disease in the United States, and US economic data were the bases of the cost-effectiveness analyses. One-way and multivariate sensitivity analyses were conducted.Results.PPV vaccination rates increased 30.5% in the tertiary care hospital and 15.3% in the community hospital. In the base-case cost-effectiveness analysis, using a societal perspective, we found that both pharmacy-based and nursing-based SOPs cost less than 10,000perquality−adjustedlife−yeargained,withprogramcosts(pharmacy−basedSOPscost10,000 per quality-adjusted life-year gained, with program costs (pharmacy-based SOPs cost 10,000perquality−adjustedlife−yeargained,withprogramcosts(pharmacy−basedSOPscost4.16 per patient screened, and nursing-based SOPs cost 4.60perpatientscreened)andvaccinecosts(4.60 per patient screened) and vaccine costs (4.60perpatientscreened)andvaccinecosts(18.33 per dose) partially offset by potential savings from cases of invasive pneumococcal disease avoided ($12,436 per case). Sensitivity analyses showed SOPs for PPV vaccination to be cost-effective, compared with PPV vaccination without SOPs, unless the improvement in vaccination rate was less than 8%.Conclusion.SOPs do increase PPV vaccination rates in hospitalized elderly patients and are economically favorable, compared with PPV vaccination rates without SOPs.

Research paper thumbnail of Seasonal Effectiveness of Live Attenuated and Inactivated Influenza Vaccine

Research paper thumbnail of Designing a hospital-based pneumococcal vaccination program

American Journal of Health-system Pharmacy, Jul 15, 2003

Page 1. MANAGEMENT CASE STUDIES Vaccination program 1471 Am J Health-Syst Pharm—Vol 60 Jul 15, 20... more Page 1. MANAGEMENT CASE STUDIES Vaccination program 1471 Am J Health-Syst Pharm—Vol 60 Jul 15, 2003 MANAGEMENTCASESTUDIES Management Case Studies describe approaches to real-life management problems in health systems. ...

Research paper thumbnail of Shortage of influenza vaccine in 2000–2001

American Journal of Preventive Medicine, May 1, 2003

Research paper thumbnail of The hidden societal cost of antibiotic resistance per antibiotic prescribed in the United States: an exploratory analysis

BMC Infectious Diseases, Nov 8, 2016

Research paper thumbnail of Barriers to Pneumococcal and Influenza Vaccination in Older Community-Dwelling Adults (2000–2001)

Journal of the American Geriatrics Society, 2004

Research paper thumbnail of Interim Estimates of 2017–18 Seasonal Influenza Vaccine Effectiveness — United States, February 2018

Morbidity and Mortality Weekly Report, Feb 16, 2018

Research paper thumbnail of 2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

Clinical Infectious Diseases, Oct 4, 2016

Research paper thumbnail of Impact of Diabetes Status on Immunogenicity of Trivalent Inactivated Influenza Vaccine in Older Adults

medRxiv (Cold Spring Harbor Laboratory), Oct 5, 2021

Individuals with type 2 diabetes mellitus experience high rates of influenza virus infection and ... more Individuals with type 2 diabetes mellitus experience high rates of influenza virus infection and complications. We compared the magnitude and duration of serologic response to trivalent influenza vaccine in adults aged 50-80 with and without type 2 diabetes mellitus. Serologic response to influenza vaccination was similar in both groups: greater fold-increases in antibody titer occurred among individuals with lower pre-vaccination antibody titers. Waning of antibody titers was not influenced by diabetes status.

Research paper thumbnail of Spirituality, quality of life and frailty in community-dwelling adults ≥ 50 years

Psychology of Religion and Spirituality, Mar 1, 2021

Research paper thumbnail of Prior-Season Vaccination and Risk of Influenza During the 2014–2015 Season in the United States

The Journal of Infectious Diseases, Jun 13, 2017

Research paper thumbnail of Influenza vaccine effectiveness among patients with high-risk medical conditions in the United States, 2012–2016

Research paper thumbnail of Compliance to Self-Monitoring of Blood Glucose: A Marked-Item Technique Compared with Self-Report

Diabetes Care, Sep 1, 1985

Research paper thumbnail of Exercise in a behavioural weight control programme for obese patients with Type 2 (non-insulin-dependent) diabetes

Diabetologia, Dec 1, 1988

Research paper thumbnail of Cost-effectiveness of an in-development adult-formulated pneumococcal vaccine in older US adults

Research paper thumbnail of Family history of diabetes and its effect on treatment outcome in type II diabetes

Behavior Therapy, 1987

This study was designed to determine whether family history of diabetes affects the response to a... more This study was designed to determine whether family history of diabetes affects the response to a therapeutic intervention in obese Type II diabetic patients. Seventy-seven Type II diabetics were treated in a 12–16 week behavioral weight control program with follow-up one year later. No significant differences in weight loss or glycemic responses were observed between patients with and without a first degree relative with diabetes, or between patients with 0, 1, or 2 diabetic parents. Although family history of Type II diabetes affects the chances of developing the disease, these data suggest that family history does not affect the response to treatment.

Research paper thumbnail of Hospital Policies, State Laws, and Healthcare Worker Influenza Vaccination Rates

Infection Control and Hospital Epidemiology, Aug 1, 2013

This study used hierarchical linear modeling to determine the relative contribution of hospital p... more This study used hierarchical linear modeling to determine the relative contribution of hospital policies and state laws to healthcare worker (HCW) influenza vaccination rates. Hospital mandates with consequences for noncompliance and race were associated with 3%-12% increases in HCW vaccination; state laws were not significantly related to vaccination rates.

Research paper thumbnail of Calorie-counting compared to exchange system diets in the treatment of overweight patients with type II diabetes

Addictive Behaviors, 1986

Patients with diabetes are usually placed on exchange system diets to ensure a nutritionally adeq... more Patients with diabetes are usually placed on exchange system diets to ensure a nutritionally adequate intake. However, there have been few studies which have actually compared the nutritional adequacy of diets selected by patients on exchange system diets, with that selected by patients on the calorie-counting diets typically used in behavioral weight control programs. This study compared the nutritional adequacy of the diets selected by overweight patients with Type II diabetes who had been randomly assigned to either an exchange system diet or a calorie-counting diet. Three-day food diaries were completed by all patients at the start and end of a 16-week weight control program. No significant differences were observed between patients on the calorie-counting diet compared to those on the exchange system diet with respect to nutrient intake, macronutrient distribution, or percent of the RDA obtained. Patients on both types of diet reported decreases in the proportion of calories from fat. The average intake exceeded 100% of the RDA for all nutrients except calcium. This study suggests that patients are able to improve the nutritional adequacy of their intake while following either a calorie-counting or an exchange system diet.

Research paper thumbnail of Cost-effectiveness of increasing vaccination in high-risk adults aged 18–64 Years: a model-based decision analysis

BMC Infectious Diseases, Jan 25, 2018

Research paper thumbnail of Association of Obesity and Chronic Diseases in Taiwan

Asia-Pacific Journal of Public Health, Sep 1, 2006

Research paper thumbnail of Economic Evaluation of Standing Order Programs for Pneumococcal Vaccination of Hospitalized Elderly Patients

Infection Control and Hospital Epidemiology, May 1, 2008

Background.Standing order programs (SOPs), which allow for vaccination without an individual phys... more Background.Standing order programs (SOPs), which allow for vaccination without an individual physician order, are the most effective mechanism to achieve high vaccination rates. Among the suggested settings for the utilization of SOPs are hospital inpatient units, because they provide care for those most likely to benefit from vaccination. The cost-effectiveness of this approach for elderly hospitalized persons is unknown. The purpose of this study was to estimate the cost-effectiveness of SOPs for pneumococcal polysaccharide vaccine (PPV) vaccination for patients 65 years of age or older in 2 types of hospital.Methods.In 2004, a 1,094-bed tertiary care hospital implemented a pharmacy-based SOP for PPV, and a 225-bed community hospital implemented a nursing-based SOP for PPV. Newly admitted patients 65 years of age or older were screened for PPV eligibility and then offered PPV. Vaccination rates before and after initiation of SOPs in the United States, incidence rates of invasive pneumococcal disease in the United States, and US economic data were the bases of the cost-effectiveness analyses. One-way and multivariate sensitivity analyses were conducted.Results.PPV vaccination rates increased 30.5% in the tertiary care hospital and 15.3% in the community hospital. In the base-case cost-effectiveness analysis, using a societal perspective, we found that both pharmacy-based and nursing-based SOPs cost less than 10,000perquality−adjustedlife−yeargained,withprogramcosts(pharmacy−basedSOPscost10,000 per quality-adjusted life-year gained, with program costs (pharmacy-based SOPs cost 10,000perquality−adjustedlife−yeargained,withprogramcosts(pharmacy−basedSOPscost4.16 per patient screened, and nursing-based SOPs cost 4.60perpatientscreened)andvaccinecosts(4.60 per patient screened) and vaccine costs (4.60perpatientscreened)andvaccinecosts(18.33 per dose) partially offset by potential savings from cases of invasive pneumococcal disease avoided ($12,436 per case). Sensitivity analyses showed SOPs for PPV vaccination to be cost-effective, compared with PPV vaccination without SOPs, unless the improvement in vaccination rate was less than 8%.Conclusion.SOPs do increase PPV vaccination rates in hospitalized elderly patients and are economically favorable, compared with PPV vaccination rates without SOPs.

Research paper thumbnail of Seasonal Effectiveness of Live Attenuated and Inactivated Influenza Vaccine