scholarly journals Pregnancy rates and outcomes in women with and without MS in the United States

Neurology ◽  
2018 ◽  
Vol 91 (17) ◽  
pp. e1559-e1569 ◽  
Author(s):  
Maria K. Houtchens ◽  
Natalie C. Edwards ◽  
Gary Schneider ◽  
Kevin Stern ◽  
Amy L. Phillips
Keyword(s):  
Linear Trend ◽  
The United States ◽  
Pregnancy Rates ◽  
Administrative Claims ◽  
Sexually Transmitted ◽  
Fetal Malformations ◽  
Nationally Representative ◽  
The Difference ◽  
Acquired Coagulation Disorders ◽  
Procedure Codes

ObjectiveTo compare pregnancy prevalence and complications in women with and without multiple sclerosis (MS).MethodsThis retrospective US administrative claims study used data from January 1, 2006, to June 30, 2015. All data for women with MS were included. A nationally representative 5% random sample from approximately 58 million women without MS was used to compute the dataset. Annual pregnancy rates, identified via diagnosis/procedure codes and adjusted for covariates, were estimated via logistic regression. Claims for pregnancy and labor/delivery complications were compared using propensity score matching.ResultsFrom 2006 to 2014, the adjusted proportion of women with MS and pregnancy increased from 7.91% to 9.47%; the adjusted proportion without MS and with pregnancy decreased from 8.83% to 7.75%. The difference in linear trend (0.17% increase and 0.15% decrease in per-annum pregnancy rates) was significant (t statistic = 7.8; p < 0.0001). After matching (n = 2,115 per group), a higher proportion of women with MS than without had claims for premature labor (31.4% vs 27.4%; p = 0.005), infection (13.3% vs 10.9%; p = 0.016), cardiovascular disease (3.0% vs 1.9%; p = 0.028), anemia/acquired coagulation disorders (2.5% vs 1.3%; p = 0.007), neurologic complications (1.6% vs 0.6%; p = 0.005), sexually transmitted diseases (0.4% vs 0.1%; p = 0.045), acquired fetal damage (27.8% vs 23.5%; p = 0.002), and congenital fetal malformations (13.2% vs 10.3%; p = 0.004).ConclusionsPregnancy rates in this population of women with MS have been increasing. High rates of claims for several peripartum complications were observed in women with and those without MS. Claims data provide knowledge of interactions patients have with the health care system and are valuable initial exploratory analyses.

scholarly journals Using an agent-based sexual-network model to guide mitigation efforts for controlling chlamydia

2017 ◽  
Author(s):  
Asma Azizi ◽  
Jeremy Dewar ◽  
James M. Hyman
Keyword(s):  
Network Model ◽  
The United States ◽  
Chlamydia Screening ◽  
Model Parameters ◽  
Bipartite Network ◽  
Transmitted Infection ◽  
Agent Based ◽  
Infected People ◽  
Sexually Transmitted ◽  
The Difference

AbstractWe create and analyze a stochastic heterosexual agent-based bipartite network model to help understand the spread of chlamydia trachomatis. Chlamydia is the most common sexually transmitted infection in the United States and is major cause of infertility, pelvic inflammatory disease, and ectopic pregnancy among women. We use an agent-based network model to capture the complex heterogeneous assortative sexual mixing network of men and women. Both long-term and casual partnerships are modeled with different sexual contact frequencies and condom use. We use simulations to compare the effectiveness of intervention strategies based on randomly screening people for infection, treating the partners of infected people, and rescreening for infection after treatment. We compare the difference between treating the partners of an infected person both with, and without, testing them first for infection. The highest prevalence is among young sexually active individuals. We calibrate the model parameters to agree with recent survey data showing chlamydia prevalence of 14% of the women and 9% of the men in the 15 – 25 year-old African American residents of New Orleans, Louisiana. We observed that although increased chlamydia screening and treating most of the partners of infected people will reduce the incidence, these mitigations alone are not sufficient to control the epidemic. The model predicts that the current epidemic can brought under control once over half of the partners of infected people are tested and treated.

scholarly journals Gonorrhea testing, morbidity, and reporting using an integrated sexually transmitted disease registry in Indiana: 2004–2016

2020 ◽  
pp. 095646242095371
Author(s):  
Opeyemi C Ojo ◽  
Janet N Arno ◽  
Guoyu Tao ◽  
Chirag G Patel ◽  
Zuoyi Zhang ◽  
...  
Keyword(s):  
Sexually Transmitted Disease ◽  
Case Reports ◽  
Transmitted Disease ◽  
Population Level ◽  
The United States ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Level Data ◽  
The Difference ◽  
Number Of Individuals

Surveillance of gonorrhea (GC), the second most common notifiable disease in the United States, depends on case reports. Population-level data that contain the number of individuals tested in addition to morbidity are lacking. We performed a cross-sectional analysis of data obtained from individuals tested for GC recorded in a sexually transmitted disease (STD) registry in the state of Indiana. Descriptive statistics were performed, and a Poisson generalized linear model was used to evaluate the number of individuals tested for GC and the positivity rate. GC cases from a subset of the registry were compared to CDC counts to determine the completeness of the registry. A total of 1,870,811 GC tests were linked to 627,870 unique individuals. Individuals tested for GC increased from 54,334 in 2004 to 269,701 in 2016; likewise, GC cases increased from 2,039 to 5,997. However, positivity rate decreased from 3.75% in 2004 to 2.22% in 2016. The difference in the number of GC cases captured by the registry and those reported to the CDC was not statistically significant (P = 0.0665). Population-level data from an STD registry combining electronic medical records and public health case data may inform STD control efforts. In Indiana, increased testing rates appeared to correlate with increased GC morbidity.

scholarly journals Health Care Policies and COVID-19 Prevalence: Is There Any Association?

2021 ◽  
pp. 002073142199394
Author(s):  
Seyed A. Nejadghaderi ◽  
Amene Saghazadeh ◽  
Nima Rezaei
Keyword(s):  
United States ◽  
United States Of America ◽  
Linear Trend ◽  
Public Awareness ◽  
The United States ◽  
Regional Strategies ◽  
Health Care Policies ◽  
The Difference ◽  
Almost All ◽  
Close Contacts

The coronavirus disease 2019 (COVID-19) pandemic has affected almost all countries and territories. As of December 6, 2020, the United States of America and India have the highest prevalence. Each country has implemented different strategies to control and reduce the spread of disease. Here, the association between prevalence number and health policies is evaluated by comparing 2 groups of countries: (1) Italy, the United States of America, Germany, Spain, and India with a higher prevalence than a linear trend line; and (2) Singapore and China with a lower or equal prevalence than linear forecasts. A rapid overview revealed that many countries have similar strategies for controlling COVID-19, including the suspension of air travel, the lockdown on the cities with the most cases detected, active case findings, monitoring of close contacts, and raising public awareness. Also, they used a gradual and phased plan to reopen activities. So, the difference between countries in the burden of COVID-19 can be attributable to the strict mode and nonstrict mode of implementation of strategies. Limitations at the national levels call for systemic rather than regional strategies.

Insurance Status of U.S. Organ Donors and Transplant Recipients: The Uninsured Give, but Rarely Receive

2008 ◽  
Vol 38 (4) ◽  
pp. 641-652 ◽  
Author(s):  
Andrew A. Herring ◽  
Steffie Woolhandler ◽  
David U. Himmelstein
Keyword(s):  
The United States ◽  
Insurance Status ◽  
Organ Donors ◽  
Transplant Recipients ◽  
National Inpatient Sample ◽  
Life Saving ◽  
Hospital Stays ◽  
Nationally Representative ◽  
Few Data ◽  
Procedure Codes

Organ transplantation is an expensive, life-saving technology. Previous studies have found that few transplant recipients in the United States lack health insurance (in part because patients may become eligible for special coverage because of their disability and transplant teams vigorously advocate for their patients). Few data are available on the insurance status of U.S. organ donors. The authors analyzed the 2003 National Inpatient Sample (NIS), a nationally representative 20 percent sample of U.S. hospital stays, and identified incident organ donors and recipients using ICD-9-CM diagnosis and procedure codes. The NIS sample included 1,447 organ donors and 4,962 transplant recipients, equivalent after weighting to 6,517 donors and 23,656 recipients nationwide; 16.9 percent of organ donors but only 0.8 percent of transplant recipients were uninsured. In multivariate analysis, compared with other inpatients organ donors were much more likely to be uninsured (OR 3.41, 95% CI 2.81–4.15), whereas transplant recipients were less likely to lack coverage (OR 0.08, 95% CI 0.06–0.12). Many uninsured Americans donate organs, but they rarely receive them.

scholarly journals Factors Correlated with Pre-Exposure Prophylaxis (PrEP) Awareness and Use among Black Adults in the United States: Implications for Improving PrEP Uptake

2021 ◽  
Author(s):  
Kennethea A. Wilson ◽  
Sarahmona M. Przybyla ◽  
Jacob Bleasdale ◽  
Steven Gabriel ◽  
Natalie Leblanc ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Black Adults ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
History Of ◽  
Nationally Representative ◽  
Prep Awareness ◽  
Exposure Prophylaxis

Abstract In the United States, low rates of pre-exposure prophylaxis (PrEP) awareness and utilization persist among Black adults. To date, few studies have assessed PrEP awareness and use among a nationally representative sample of Black adults. The present study explored factors associated with PrEP awareness and use among Black adults in the United States. Most participants were unaware of PrEP (71%). Those reporting a history of incarceration [aOR 1.73 (1.04, 2.90), p <.05] and lifetime sexually transmitted infection testing [aOR 1.76 (1.19, 2.59), p <.05] had greater odds of awareness. In the sample, only 6% of participants had ever taken PrEP. Those with a history of incarceration [aOR 9.96 (2.82, 35.14), p <.05], concurrent sexual partners [aOR 1.09 (1.00, 1.18), p <.05], and substance use during sex [aOR 4.23 (1.02, 17.48), p <.05] had greater odds of use. Interventions to improve PrEP uptake among Black adults must consider the contextual factors associated with awareness and use.

scholarly journals Association between Chlamydia and routine place for healthcare in the United States: NHANES 1999–2016

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251113
Author(s):  
Cornelius D. Jamison ◽  
Margaret Greenwood-Ericksen ◽  
Caroline R. Richardson ◽  
Hwajung Choi ◽  
Tammy Chang
Keyword(s):  
United States ◽  
Representative Sample ◽  
The United States ◽  
Treatment Programs ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Logistic Regression Models ◽  
Positive Urine ◽  
Nationally Representative ◽  
Doctor's Office

Background The United States is experiencing a surge in Chlamydia trachomatis (CT) infections representing a critical need to improve sexually transmitted infection (STI) screening and treatment programs. To understand where patients with STIs seek healthcare, we evaluated the relationship between CT infections and the place where individuals report usually receiving healthcare. Methods Our study used a nationally representative sample from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. The study population is adult patients, aged 18 to 39 years in whom a urine CT screen was obtained. Logistic regression models were used to determine if location of usual healthcare was predictive of a positive urine CT screen result. Models were adjusted for known confounders including age, gender, race/ethnicity, education, and insurance status. Results In this nationally representative sample (n = 19,275; weighted n = 85.8 million), 1.9% of individuals had a positive urine CT result. Participants reported usually going to the doctor’s office (70.3%), “no place” (24.8%), Emergency Department (ED) (3.3%), or “other” place (1.7%) for healthcare. In adjusted models, the predicted probability of having a positive urine CT result is higher (4.9% vs 3.2%, p = 0.022; OR = 1.58) among those that reported the ED as their usual place for healthcare compared to those that reported going to a doctor’s office or clinic. Conclusions Individuals having a positive urine CT screen are associated with using the ED as a usual source for healthcare. Understanding this association has the potential to improve STI clinical and policy interventions as the ED may be a critical site in combatting the record high rates of STIs.

Partners’ Educational Pairings and Fertility Intentions in the United States: Evidence from 2015–2017 National Survey of Family Growth

2020 ◽  
Vol 7 (4) ◽  
pp. 299-309
Author(s):  
Danielle Xiaodan Morales
Keyword(s):  
National Survey ◽  
Estimating Equation ◽  
The United States ◽  
Fertility Intentions ◽  
Generalized Estimating Equation ◽  
Highly Educated ◽  
Family Growth ◽  
Nationally Representative ◽  
The Difference ◽  
The Relationship

In light of the ongoing educational shift from favoring men to favoring women, this study contributes to the literature on fertility by investigating the relationship between educational pairings and fertility intentions. To test two competing hypotheses, nationally representative data from the latest wave (2015–2017) of the National Survey of Family Growth were used, and four generalized estimating equation models were estimated. Results indicate that women’s intentions for additional children were influenced by educational pairings. Specifically, when highly educated women had a highly educated partner, their fertility intentions were higher than lower-educated women, but this difference disappeared if those women were in hypogamous relationships; when lower-educated women had lower- or medium-educated partners, their intentions for additional children were significantly lower than highly educated women, but the difference disappeared when she had a highly educated partner. Findings from this study provide new insights into fertility intentions by taking into account both partners’ education.

Suicidal Behavior and Non-Suicidal Self-Injury in Emergency Departments Underestimated by Administrative Claims Data

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 318-325 ◽  
Author(s):  
Barbara Stanley ◽  
Glenn W. Currier ◽  
Megan Chesin ◽  
Sadia Chaudhury ◽  
Shari Jager-Hyman ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Suicide Attempts ◽  
The United States ◽  
Administrative Claims ◽  
Suicide Attempters ◽  
Self Injury ◽  
Axis I ◽  
Ed Visits ◽  
External Causes ◽  
Severe Psychopathology

Abstract. Background: External causes of injury codes (E-codes) are used in administrative and claims databases for billing and often employed to estimate the number of self-injury visits to emergency departments (EDs). Aims: This study assessed the accuracy of E-codes using standardized, independently administered research assessments at the time of ED visits. Method: We recruited 254 patients at three psychiatric emergency departments in the United States between 2007 and 2011, who completed research assessments after presenting for suicide-related concerns and were classified as suicide attempters (50.4%, n = 128), nonsuicidal self-injurers (11.8%, n = 30), psychiatric controls (29.9%, n = 76), or interrupted suicide attempters (7.8%, n = 20). These classifications were compared with their E-code classifications. Results: Of the participants, 21.7% (55/254) received an E-code. In all, 36.7% of research-classified suicide attempters and 26.7% of research-classified nonsuicidal self-injurers received self-inflicted injury E-codes. Those who did not receive an E-code but should have based on the research assessments had more severe psychopathology, more Axis I diagnoses, more suicide attempts, and greater suicidal ideation. Limitations: The sample came from three large academic medical centers and these findings may not be generalizable to all EDs. Conclusion: The frequency of ED visits for self-inflicted injury is much greater than current figures indicate and should be increased threefold.

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