scholarly journals Enhanced Surveillance for Histoplasmosis—9 States, 2018–2019

2020 ◽  
Vol 7 (9) ◽  
Author(s):  
Kaitlin Benedict ◽  
Stephanie McCracken ◽  
Kimberly Signs ◽  
Malia Ireland ◽  
Victoria Amburgey ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
General Population ◽  
Median Time ◽  
Care Provider ◽  
The United States ◽  
Daily Activities ◽  
Routine Surveillance ◽  
Antibacterial Medication ◽  
Delays In Diagnosis

Abstract Background Histoplasmosis is often described as the most common endemic mycosis in the United States, but much remains unknown about its epidemiology among the general population. Methods We conducted enhanced surveillance in 9 states during 2018–2019 by identifying cases through routine surveillance and interviewing 301 patients about their clinical features and exposures. Results Before being tested for histoplasmosis, 60% saw a health care provider ≥3 times, and 53% received antibacterial medication. The median time from seeking health care to diagnosis (range) was 23 (0–269) days. Forty-nine percent were hospitalized, and 69% said that histoplasmosis interfered with their daily activities (median [range], 56 [2–3960] days). Possible exposures included handling plants (48%) and bird or bat droppings (24%); 22% reported no specific exposures. Only 15% had heard of histoplasmosis before their illness. Conclusions Histoplasmosis can be severe and prolonged. Additional educational efforts to increase public and provider awareness and reduce delays in diagnosis are needed.

scholarly journals A Rapid Review of the Impact of Systems-Level Policies and Interventions on Population-Level Outcomes Related to the Opioid Epidemic, United States and Canada, 2014-2018

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 100S-127S ◽  
Author(s):  
Bahareh Ansari ◽  
Katherine M. Tote ◽  
Eli S. Rosenberg ◽  
Erika G. Martin
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
The United States ◽  
Health Insurer ◽  
Pain Clinic ◽  
Rapid Review ◽  
Opioid Use ◽  
Patient Health

Objectives In the United States, rising rates of overdose deaths and recent outbreaks of hepatitis C virus and HIV infection are associated with injection drug use. We updated a 2014 review of systems-level opioid policy interventions by focusing on evidence published during 2014-2018 and new and expanded opioid policies. Methods We searched the MEDLINE database, consistent with the 2014 review. We included articles that provided original empirical evidence on the effects of systems-level interventions on opioid use, overdose, or death; were from the United States or Canada; had a clear comparison group; and were published from January 1, 2014, through July 19, 2018. Two raters screened articles and extracted full-text data for qualitative synthesis of consistent or contradictory findings across studies. Given the rapidly evolving field, the review was supplemented with a search of additional articles through November 17, 2019, to assess consistency of more recent findings. Results The keyword search yielded 535 studies, 66 of which met inclusion criteria. The most studied interventions were prescription drug monitoring programs (PDMPs) (59.1%), and the least studied interventions were clinical guideline changes (7.6%). The most common outcome was opioid use (77.3%). Few articles evaluated combination interventions (18.2%). Study findings included the following: PDMP effectiveness depends on policy design, with robust PDMPs needed for impact; health insurer and pharmacy benefit management strategies, pill-mill laws, pain clinic regulations, and patient/health care provider educational interventions reduced inappropriate prescribing; and marijuana laws led to a decrease in adverse opioid-related outcomes. Naloxone distribution programs were understudied, and evidence of their effectiveness was mixed. In the evidence published after our search’s 4-year window, findings on opioid guidelines and education were consistent and findings for other policies differed. Conclusions Although robust PDMPs and marijuana laws are promising, they do not target all outcomes, and multipronged interventions are needed. Future research should address marijuana laws, harm-reduction interventions, health insurer policies, patient/health care provider education, and the effects of simultaneous interventions on opioid-related outcomes.

Health Care Provider Surveys in the United States, 2000–2010

2013 ◽  
Vol 36 (1) ◽  
pp. 106-126 ◽  
Author(s):  
Caroline C. McLeod ◽  
Carrie N. Klabunde ◽  
Gordon B. Willis ◽  
Debra Stark
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
The United States ◽  
Provider Surveys

scholarly journals The Continued Mistreatment of Women During Pregnancy and Childbirth

2019 ◽  
Vol 28 (4) ◽  
pp. 183-185
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Maternity Care ◽  
The United States ◽  
Place Of Birth ◽  
Pregnancy And Childbirth ◽  
Childbearing Women

Mistreatment of women during pregnancy and childbirth continues to define our American way of birth in spite of decades of awareness and concern. The Giving Voice to Mothers study identifies the incidence of mistreatment of childbearing women in the United States, the factors that increase a woman's risk of being mistreated including socio economic and racial characteristics, place of birth, and health-care provider. This editorial highlights the study findings, the role of the current maternity care system in perpetuating inequality and mistreatment, and calls on all stakeholders to create a culture that cares for women with respect and dignity. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth.

scholarly journals A population-based estimate of the substantial burden of diarrhoeal disease in the United States; FoodNet, 1996–2003

2006 ◽  
Vol 135 (2) ◽  
pp. 293-301 ◽  
Author(s):  
T. F. JONES ◽  
M. B. McMILLIAN ◽  
E. SCALLAN ◽  
P. D. FRENZEN ◽  
A. B. CRONQUIST ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Diarrhoeal Disease ◽  
The United States ◽  
Population Based ◽  
Daily Activities ◽  
Medical Provider ◽  
Weighted Prevalence ◽  
Over Time

From 1996 to 2003, four 12-month population-based surveys were performed in FoodNet sites to determine the burden of diarrhoeal disease in the population. Acute diarrhoeal illness (ADI) was defined as [ges ]3 loose stools in 24 hours with impairment of daily activities or duration of diarrhoea >1 day. A total of 52840 interviews were completed. The overall weighted prevalence of ADI in the previous month was 5·1% (95% CI±0·3%), corresponding to 0·6 episodes of ADI per person per year. The average monthly prevalence of ADI was similar in each of the four survey cycles (range 4·5–5·2%). Rates of ADI were highest in those age <5 years. Of those with ADI, 33·8% (95% CI±2·7%) reported vomiting, 19·5% (95% CI±2·1%) visited a medical provider, and 7·8% (95% CI±1·4%) took antibiotics. Rates of ADI were remarkably consistent over time, and demonstrate the substantial burden placed on the health-care system.

scholarly journals Health Care Provider Barriers to HIV Pre-Exposure Prophylaxis in the United States: A Systematic Review

2020 ◽  
Vol 34 (3) ◽  
pp. 111-123 ◽  
Author(s):  
Benedikt Pleuhs ◽  
Katherine G. Quinn ◽  
Jennifer L. Walsh ◽  
Andrew E. Petroll ◽  
Steven A. John
Keyword(s):  
United States ◽  
Systematic Review ◽  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
The United States ◽  
Provider Barriers ◽  
Exposure Prophylaxis
Sign in / Sign up

Export Citation Format

Share Document