scholarly journals 916. Finding the Missing Millions and Addressing Health Disparities: Automated Hepatitis B Screening and Linkage to Care

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S549-S550
Author(s):  
Binghong Xu ◽  
Su Wang ◽  
Ruth P Brogden ◽  
Jaymie Yango ◽  
Mary O Adedeji
Keyword(s):  
Health Disparities ◽  
Linkage To Care ◽  
Inpatient Setting ◽  
Insurance Status ◽  
Newly Diagnosed ◽  
Research Support ◽  
Essex County ◽  
The Us ◽  
Hbv Prevalence ◽  
The World

Abstract Background Globally, HBV is the most common blood-borne infection. An estimated 1.2 million people in the US and 350 million worldwide lived with HBV, a primary driver of liver cancer. It is endemic in many parts of the world and is a major health disparity in immigrant communities, including the US, which has the largest immigrant population in the world. Asian American Pacific Islanders are 5% of the total population in the US, but represent 50% of people living with HBV. In 2016, WHO set a goal of hepatitis elimination by 2030 but with only 10% of those living with HBV diagnosed, screening must be scaled up. Methods Modifications were made in the electronic medical record (EMR) to automate screening, with HBV (HBsAg) orders triggered by a patient’s country of birth or race. The began in the Emergency Department and later expanded to the Inpatient setting. Automated notifications are sent to nurse for eligible patients and then to the patient navigator (PN) for positive tests. The PN contacts the patient to provide education and arrange linkage-to-care (LTC) for evaluation and care. Results From Mar 2018 to Mar 2021, we conducted 23,883 HBV screenings. The patients originated from 173 countries based on registration; top 5 countries of origin were Haiti, Jamaica, Ecuador, Guyana, and Portugal. We found 228 (1.0%) patients with HBV infection, 101 (47%) were newly diagnosed and 182 (85%) were linked to care. We examined race and insurance status for any association with those previously tested versus newly diagnosed. Blacks were more likely to be newly identified HBV versus Asians (61.6% vs. 28.9%, p< .001), as were self-pay (uninsured) versus insured patients (66.7% vs 47.2%, p=0.043). Compared to the approximately 0.4% HBV prevalence in the US, the HBV prevalence in several towns around our hospital in Essex County is two to four times higher. Table 1. The HBV Prevalence in Towns of Essex County Conclusion Our community is diverse and social determinants of health, like race and insurance status, may contribute to provider behaviors of HBV screening with blacks receiving less screening than Asians. Automated testing programs can address health disparities and scale up screening. Such micro-elimination approaches are important for achieving global hepatitis elimination by 2030. Disclosures Su Wang, MD MPH, Gilead Sciences (Grant/Research Support)Gilead Sciences (Grant/Research Support)

Innovation Policy, Structural Inequality, and COVID-19

2020 ◽  
Vol 7 (2) ◽  
pp. 104-109
Author(s):  
Shobita Parthasarathy
Keyword(s):  
Health Disparities ◽  
Research Funding ◽  
Innovation Policy ◽  
Equal Treatment ◽  
Structural Inequality ◽  
Marginalized Communities ◽  
Innovation Research ◽  
The Us ◽  
The World ◽  
Policies And Programs

COVID-19 has shown the world that public policies tend to benefit the most privileged among us, and innovation policy is no exception. While the US government’s approach to innovation—research funding and patent policies and programs that value scientists’ and private sector freedoms—has been copied around the world due to its apparent success, I argue that it has hurt poor and marginalized communities. It has limited our understanding of health disparities and how to address them, and hampered access to essential technologies due to both lack of coordination and high cost. Fair and equal treatment of vulnerable citizens requires sensitive and dedicated policies that attend explicitly to the fact that the benefits of innovation do not simply trickle down.

Historical Overview of Health Disparities in the United States

2021 ◽  
pp. 18-30
Keyword(s):  
United States ◽  
Health Disparities ◽  
The United States ◽  
Cultural Bias ◽  
Demographic Groups ◽  
Majority Group ◽  
The Us ◽  
The World ◽  
The Status ◽  
History Of

Health disparities in the United States and around the world carry with them a history of cultural bias, fear of the unknown, racism, sexism, ageism, intolerance of religious beliefs, and a desire to retain the status quo. Some people perceive a majority group as superior to demographic groups that are believed to be inferior. However, as the US population becomes increasingly diverse, changes will come. Internationally, globalization and immigration merge the worlds of the poor and rich, as each social class struggles to find their socioeconomic and healthcare footprint in modern-day society. All US citizens will be affected by a failure to unite.

Searching for new Sources of growth. Are the Developing Countries Catching up with the Developed ones?

2015 ◽  
pp. 30-53
Author(s):  
V. Popov
Keyword(s):  
Developing Countries ◽  
Western Europe ◽  
Gdp Per Capita ◽  
The West ◽  
Catching Up ◽  
The Us ◽  
The World ◽  
Economic Divergence ◽  
Per Capita ◽  
Relative Standing

This paper examines the trajectory of growth in the Global South. Before the 1500s all countries were roughly at the same level of development, but from the 1500s Western countries started to grow faster than the rest of the world and PPP GDP per capita by 1950 in the US, the richest Western nation, was nearly 5 times higher than the world average and 2 times higher than in Western Europe. Since 1950 this ratio stabilized - not only Western Europe and Japan improved their relative standing in per capita income versus the US, but also East Asia, South Asia and some developing countries in other regions started to bridge the gap with the West. After nearly half of the millennium of growing economic divergence, the world seems to have entered the era of convergence. The factors behind these trends are analyzed; implications for the future and possible scenarios are considered.

Russian Policy of Agriculture Support and the Necessity of Its Modification after WTO Accession

2012 ◽  
pp. 132-149 ◽  
Author(s):  
V. Uzun
Keyword(s):  
Comparative Analysis ◽  
World Trade Organization ◽  
Agricultural Production ◽  
World Trade ◽  
The Us ◽  
The World ◽  
Wto Accession ◽  
The Eu ◽  
Agriculture Support

The article deals with the features of the Russian policy of agriculture support in comparison with the EU and the US policies. Comparative analysis is held considering the scales and levels of collective agriculture support, sources of supporting means, levels and mechanisms of support of agricultural production manufacturers, its consumers, agrarian infrastructure establishments, manufacturers and consumers of each of the principal types of agriculture production. The author makes an attempt to estimate the consequences of Russia’s accession to the World Trade Organization based on a hypothesis that this will result in unification of the manufacturers and consumers’ protection levels in Russia with the countries that have long been WTO members.

Too WEIRD, Too Fast: Preprints about COVID-19 in the Psychological Sciences

2020 ◽  
Author(s):  
Arathy Puthillam
Keyword(s):  
Overwhelming Majority ◽  
Global Pandemic ◽  
The Us ◽  
The World ◽  
The Face ◽  
Conducting Research ◽  
Psychological Studies

That American and European participants are overrepresented in psychological studies has been previously established. In addition, researchers also often tend to be similarly homogenous. This continues to be alarming, especially given that this research is being used to inform policies across the world. In the face of a global pandemic where behavioral scientists propose solutions, we ask who is conducting research and on what samples. Forty papers on COVID-19 published in PsyArxiV were analyzed; the nationalities of the authors and the samples they recruited were assessed. Findings suggest that an overwhelming majority of the samples recruited were from the US and the authors were based in US and German institutions. Next, men constituted a large proportion of primary and sole authors. The implications of these findings are discussed.

A Bibliometric Analysis of Global Research on Lophomonas sp. in Scopus (1933-2019)

2020 ◽  
Vol 20 ◽  
Author(s):  
Masoud Keighobadi ◽  
Maryam Nakhaei ◽  
Ali Sharifpour ◽  
Ali Akbar Khasseh ◽  
Sepideh Safanavaei ◽  
...  
Keyword(s):  
Bibliometric Analysis ◽  
International Collaboration ◽  
Research Articles ◽  
High Quality ◽  
The Real ◽  
The Us ◽  
The World ◽  
Scopus Database ◽  
Number Of Publications ◽  
Global Research

Background: This study was designed to analyze the global research on Lophomonas spp. using bibliometric techniques. Methods: A bibliometric research was carried out using the Scopus database. The analysis unit was the research articles conducted on Lophomonas spp. Results: Totally, 56 articles about Lophomonas spp. were indexed in the Scopus throughout 1933-2019 ( 87 years ) with the following information: (A) The first article was published in 1933; (B) 21 different countries contributed in studies related to Lophomonas spp.; (C) China ranked first with 16 publications about Lophomonas spp.; and (D) “Brugerolle, G” and “Beams, H.W.” from France and the US participated in 4 articles respectively, as the highest number of publications in the Lophomonas spp. network. Discussion: After 87 years, Lophomonas still remains unknown for many researchers and physicians around the world. Further studies with high quality and international collaboration are urgently needed to determine different epidemiological aspects and the real burden of the mysterious parasite worldwide.

War and Terror

2017 ◽  
Author(s):  
Avinash Paliwal
Keyword(s):  
War On Terror ◽  
Global War On Terror ◽  
Military Action ◽  
Global Trend ◽  
The Us ◽  
The World ◽  
Global War

The Taliban’s destruction of the Bamiyan Buddha in March 2001 outraged India (and the world). It killed any scope for conciliation with the Taliban. In this context, the US decision to take military action in Afghanistan after the 9/11 attacks was welcomed by many in India. However, Washington’s decision to undertake such action without UN approval (which came only in December 2001) sparked another round of debate between the partisans and the conciliators. As this chapter shows, the former were enthusiastic about supporting the US in its global war on terror, but the latter advocated caution given Washington’s willingness to partner with Islamabad. Despite the global trend to ‘fight terrorism’, the conciliators were successful in steering India away from getting involved in Afghanistan militarily.

The Great Influenza

2018 ◽  
Author(s):  
Samuel K. Cohn, Jr.
Keyword(s):  
Social Behaviour ◽  
East Coast ◽  
World History ◽  
Collective Violence ◽  
Large Cities ◽  
Surgeon General ◽  
The Us ◽  
History Of Disease ◽  
The World ◽  
History Of

This chapter examines evidence principally from the US that the Great Influenza provoked profiteering by landlords, undertakers, vendors of fruit, pharmacists, and doctors, but shows that such complaints were rare and confined mostly to large cities on the East Coast. It then investigates anti-social advice and repressive decrees on the part of municipalities, backed by advice from the US Surgeon General and prominent physicians attacking ‘spitters, coughers, and sneezers’, which included state and municipal ordinances against kissing and even ‘big talkers’. It then surveys legislation on compulsory and recommended mask wearing. Yet this chapter finds no protest or collective violence against the diseased victims or any other ‘others’ suspected of disseminating the virus. Despite physicians’ and lawmakers’ encouragement of anti-social behaviour, mass volunteerism and abnegation instead unfolded to an extent never before witnessed in the world history of disease.

The Historiography of Environmental History

2018 ◽  
Author(s):  
J. R. McNeill
Keyword(s):  
Climate Change ◽  
Environmental History ◽  
Industrial Pollution ◽  
Full Scale ◽  
Environmental Concerns ◽  
The Us ◽  
The World ◽  
History Of ◽  
The 1960S ◽  
The Relationship

This chapter discusses the emergence of environmental history, which developed in the context of the environmental concerns that began in the 1960s with worries about local industrial pollution, but which has since evolved into a full-scale global crisis of climate change. Environmental history is ‘the history of the relationship between human societies and the rest of nature’. It includes three chief areas of inquiry: the study of material environmental history, political and policy-related environmental history, and a form of environmental history which concerns what humans have thought, believed, written, and more rarely, painted, sculpted, sung, or danced that deals with the relationship between society and nature. Since 1980, environmental history has come to flourish in many corners of the world, and scholars everywhere have found models, approaches, and perspectives rather different from those developed for the US context.

scholarly journals AB1059 A RANDOMIZED, PLACEBO-CONTROLLED STUDY OF ANAKINRA IN PATIENTS WITH STILL´S DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1819.2-1820
Author(s):  
L. Schanberg ◽  
P. Nigrovic ◽  
A. Cooper ◽  
W. Chatham ◽  
S. Akoghlanian ◽  
...  
Keyword(s):  
Early Onset ◽  
Disease Onset ◽  
Study Drug ◽  
Placebo Patient ◽  
Controlled Study ◽  
Symptom Duration ◽  
Newly Diagnosed ◽  
Still’S Disease ◽  
Research Support ◽  
Still's Disease

Background:Adult-onset Still’s disease (AOSD) and systemic juvenile idiopathic arthritis (SJIA) are rare autoinflammatory disorders associated with an activated IL-1 pathway, characterized by spiking fever, rash, arthritis, lymphadenopathy, hepatosplenomegaly and serositis. There is a growing understanding that SJIA and AOSD are one disease with different ages of onset, i.e. Still’s disease. The anaSTILLs study (anakinra inStill´sdisease) was designed to further evaluate efficacy and safety of anakinra in patients with Still´s disease across all age groups.Objectives:The primary objective was to demonstrate efficacy of anakinra versus placebo as assessed by ACR30 response with absence of fever at Week 2. Secondary objectives included: early onset of efficacy, sustained efficacy, time to study drug discontinuation, safety, pharmacokinetics, clinical signs and biomarkers.Methods:‘anaSTILLs’ was a randomized, double-blind, placebo-controlled, 12-week study including patients with active and newly diagnosed (6 months) Still´s disease according to adapted ILAR criteria if <16, or Yamaguchi criteria, if ≥16 years of age at disease onset. Patients were randomized to anakinra 2 mg/kg (max 100 mg/day), 4 mg/kg (max 200 mg/day) or placebo.Results:12 patients were randomized and received study drug: 6 anakinra (2 mg/kg n=2, 4 mg/kg n=4) and 6 placebo, the study was terminated early due to slow recruitment. 1 patient on placebo had lymphoma, not Still’s disease, and was excluded; thus in total 11 patients were analyzed for efficacy, 8 were children [median (range) age=4.0 (1-11) years] and 3 were adults [median (range) age=32.0 (25-51) years]. 55% were male and the mean symptom duration was 74.2 days. All patients on anakinra but none on placebo achieved ACR30 response with absence of fever at Week 2 (p-value=0.0022). The efficacy of anakinra was further demonstrated by superiority to placebo in ACR50/70/90 responses with absence of fever at Week 2. All placebo patients discontinued the study within 6 weeks, 2 due to progressive disease, 2 due to lack of efficacy and 1 due to withdrawal by patient. There was a numerically higher proportion with early onset of efficacy (Week 1) in the anakinra group compared to placebo. The ACR30/50/70/90 responses in the anakinra group were sustained throughout the study period. Patients in the anakinra group had a prompt and persistent decrease in CRP and ferritin levels at Week 1, which was not observed in the placebo group. There were no unexpected safety findings. All anakinra patients developed anti-drug antibodies (ADAs) at some timepoint during the study. ADAs were persistent throughout the treatment period, except in one patient. Titers were low to moderate. One placebo patient had low ADA titers at one occasion. No neutralizing antibodies were observed and the ADAs did not appear to impact clinical efficacy or safety.Conclusion:Anakinra is superior to placebo in the treatment of Still’s disease. ADAs occur frequently but do not appear to adversely impact efficacy or safety. These results confirm the benefits of anakinra treatment in patients with active, newly diagnosed Still´s disease across ages.Disclosure of Interests:Laura Schanberg Grant/research support from: Sobi, BMS, Consultant of: Aurinia, UCB, Sanofi, Peter Nigrovic Grant/research support from: Novartis, BMS, Pfizer, Consultant of: Novartis, BMS, Pfizer, Sobi, Miach Orthopedics, Simcere, XBiotech, Quench Bio, Ashley Cooper: None declared, Winn Chatham Grant/research support from: Sobi, Consultant of: Sobi, Shoghik Akoghlanian: None declared, Namrata Singh: None declared, Egla Rabinovich Grant/research support from: AbbVie, UCB Pharma, Janssen Research & Development, Akaluck Thatayatikom: None declared, Alysha Taxter: None declared, Jonathan Hausmann Consultant of: Novartis, Milan Zdravkovic Shareholder of: Sobi, Employee of: Sobi, Sven Ohlman Shareholder of: Sobi, Employee of: Former employee of Sobi, Henrik Andersson Employee of: Sobi, Susanna Cederholm Shareholder of: Sobi, Employee of: Sobi, Margareta Wikén Shareholder of: Sobi, Employee of: Former employee of Sobi, Rayfel Schneider Grant/research support from: Roche, Novartis, Sobi, Pfizer, Consultant of: Sobi, Novartis, Novimmune, Fabrizio De Benedetti Grant/research support from: AbbVie, Pfizer, Novartis, Novimmune, Sobi, Sanofi, Roche, Speakers bureau: AbbVie, Novartis, Roche, Sobi

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