Completing the circle: follow-up screening of STD patients in three clinics of the United States Indian Health Service

Abstract Background Rat-bite fever is a rare disease associated with rat bites or direct/indirect rodent contact. Methods We examined rat-bite fever and rat-bite injury diagnoses in the United States during 2001–2015. We analyzed national, state, and Indian Health Service healthcare encounter datasets for rat-bite fever and rat-bite injury diagnoses. We calculated average-annual encounter rates per 1 000 000 persons. Results Nationally, the rat-bite fever Emergency Department visit rate was 0.33 (95% confidence interval [CI], 0.19–0.47) and the hospitalization rate was 0.20 (95% CI, 0.17–0.24). The rat-bite injury Emergency Department visit rate was 10.51 (95% CI, 10.13–10.88) and the hospitalization rate was 0.27 (95% CI, 0.23–0.30). The Indian Health Service Emergency Department/outpatient visit rate was 3.00 for rat-bite fever and 18.89 for rat-bite injury. The majority of rat-bite fever encounters were among individuals 0–19 years of age. Conclusions Our results support the literature that rat-bite fever is rare and affects children and young adults. Targeted education could benefit specific risk groups.

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HIV, Chlamydia, Gonorrhea, and Primary and Secondary Syphilis among American Indians and Alaska Natives Within Indian Health Service Areas in the United States, 2007–2010

Journal of Community Health ◽

10.1007/s10900-014-9961-4 ◽

2014 ◽

Vol 40 (3) ◽

pp. 484-492 ◽

Cited By ~ 14

Author(s):

Frances J. Walker ◽

Eloisa Llata ◽

Mona Doshani ◽

Melanie M. Taylor ◽

Jeanne Bertolli ◽

...

Keyword(s):

United States ◽

Health Service ◽

American Indians ◽

The United States ◽

Alaska Natives ◽

Secondary Syphilis ◽

Indian Health Service ◽

Indian Health ◽

Service Areas

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How Hands-On Pain Skills Intensive Trainings Complement ECHO Pain and Opioid Management Programs: A Program Evaluation with the Indian Health Service

Pain Medicine ◽

10.1093/pm/pnaa151 ◽

2020 ◽

Vol 21 (9) ◽

pp. 1769-1778

Author(s):

Joanna G Katzman ◽

Kathleen Gygi ◽

Robin Swift ◽

George Comerci ◽

Snehal Bhatt ◽

...

Keyword(s):

Chronic Pain ◽

Health Service ◽

Focus Groups ◽

Indian Health Service ◽

Opioid Use ◽

Prescribing Practices ◽

Indian Health ◽

Hands On ◽

The Impact

Abstract Objective To evaluate the impact of Pain Skills Intensive trainings (PSIs) as a complement to the Indian Health Service (IHS) and the Chronic Pain and Opioid Management TeleECHO Program (ECHO Pain) collaboration. Design On-site PSIs conducted over two to three days were added to complement ECHO Pain at various IHS areas to enhance pain skills proficiency among primary care teams and to expand the reach of ECHO collaboration to ECHO nonparticipants. Setting This evaluation focuses on two PSI trainings offered to IHS clinicians in Albuquerque, New Mexico, and Spokane, Washington, in 2017. Methods The mixed-methods design comprises CME surveys and focus groups at the end of training and 12 to 18 months later. Quality of training and perceived competence were evaluated. Results Thirty-eight participants attended the two PSI workshops. All provided CME survey results, and 28 consented to use of their postsession focus group results. Nine clinicians participated in the virtual follow-up focus groups. IHS clinicians rated the PSIs highly, noting their hands-on and interdisciplinary nature. They reported above-average confidence in their skills. Follow-up focus groups indicated they were pursuing expanded options for their patients, consulting other clinicians, serving as pain consultants to their peers, and changing prescribing practices clinic-wide. However, rurality significantly limits access to ancillary and complementary services for many. Clinicians reported the need for additional training in integrating behavioral health into their practice. Conclusions Hands-on pain skills and information on medication-assisted treatment (MAT) are critical to the successful treatment of chronic pain and opioid use disorder. The PSIs provide clinicians with critical competencies in assessment and screening, pain management, and communication skills, complementing required IHS training and telementoring from ECHO Pain.

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American Indians fitting into Medical School

The Australian Journal of Indigenous Education ◽

10.1017/s1326011100600522 ◽

1999 ◽

Vol 27 (2) ◽

pp. 5-11

Author(s):

Apanakhi Buckley

Keyword(s):

United States ◽

Medical School ◽

American Indians ◽

Alaska Native ◽

White Women ◽

The United States ◽

Alaska Natives ◽

Indian Health Service ◽

Native Women ◽

Indian Health

This paper describes a qualitative study of how indigenous people experience medical school in the United States. Nine American Indians and Alaska Natives participated in the study: five women and four men. They came from eight different tribes, but they have asked me to protect their confidentiality, so I will not identify their tribes. Their ages ranged from 27 to 39. Five of them had children. Two of them were unmarried.In the United States, the need for indigenous physicians is great. Twice as many American Indians die from homicide and suicide as non-Indians in the United States (Wallace, Kirk, Houston, Amnest, and Emrich, 1993); three times as many die from accidents and more than four times as many die from alcoholism (Indian Health Service, 1996). Diabetes is rampant among American Indians and Alaska Natives. Women are the hardest hit (Gilliland, Gilliland, and Carter; 1997). More than five times as many American Indian and Alaska Native women die from diabetes than non-Latina white women.

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Siu G. Wong, O.D., M.P.H.

Hindsight Journal of Optometry History ◽

10.14434/hindsight.v51i2.30282 ◽

2020 ◽

Vol 51 (2) ◽

pp. 53-59

Author(s):

Siu G. Wong

Keyword(s):

Public Health ◽

Health Service ◽

Low Income ◽

Chinese Americans ◽

The United States ◽

Indian Health Service ◽

Care Hospital ◽

Special Olympics ◽

Indian Health ◽

The University

This memoir, written by Dr. Siu G. Wong, chronicles her early influences and education, and profiles her first career as a public health optometrist and her second career as a community activist and public historian. Dr. Wong graduated from the University of California, Berkeley with her doctorate in optometry in 1970 and received her master's in public health in 1973. Her first position as an educator at the University of Houston (UH) included pioneering an interdisciplinary community health program in a low-income neighborhood as well as coordinating the first externship program for UH optometry students with the United States Public Health Service-Indian Health Service (USPHS-IHS). Dr. Wong joined the USPHS in 1978 where she was the first female commissioned officer assigned to the Indian Health Service (IHS), the first chief optometrist of an administrative region, and eventually the first woman to hold the position of chief optometric consultant to the IHS. During her tenure, she spearheaded quality assurance programs and was active in both the American Optometric Association (AOA) and the American Public Health Association (APHA), serving in leadership roles in the AOA's Council on Clinical Optometric Care, Hospital Privileges Committee, the QA Committee, and the Multidisciplinary Practice Section. She also became a member of the APHA's Vision Care Section and the Armed Forces Optometric Society. After retirement, Dr. Wong continued her role in public service, serving as the Clinical Director for the Special Olympics Opening Eyes program and as a clnical consultant. She became active also in public history, joining the Chinese American Citizens Alliance where she works to raise awareness of the contributions of Chinese Americans to American history. This article was annotated by Kirsten Hebert.

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Incidence, deaths, and lifetime costs of injury among American Indians and Alaska Natives

Injury Epidemiology ◽

10.1186/s40621-019-0221-z ◽

2019 ◽

Vol 6 (1) ◽

Author(s):

Amanda A. Honeycutt ◽

Olga Khavjou ◽

Simon J. Neuwahl ◽

Grant A. King ◽

Meredith Anderson ◽

...

Keyword(s):

Health Service ◽

Injury Prevention ◽

American Indians ◽

Motor Vehicle ◽

Medical Costs ◽

The United States ◽

Indian Health Service ◽

Service Users ◽

Indian Health ◽

Productivity Losses

Abstract Background In the United States, the mortality burden of injury is higher among American Indians and Alaska Natives (AI/AN) than any other racial/ethnic group, and injury contributes to considerable medical costs, years of potential life lost (YPLL), and productivity loss among AI/AN. This study assessed the economic burden of injuries for AI/AN who are eligible for services through Indian Health Service, analyzing direct medical costs of injury for Indian Health Service’s users and years of potential life lost (YPLL) and the value of productivity losses from injury deaths for AI/AN in the Indian Health Service population. Methods Injury-related lifetime medical costs were estimated for Indian Health Service users with medically treated injuries using data from the 2011–2015 National Data Warehouse. Productivity costs and YPLL were estimated using data on injury-related deaths among AI/AN in Indian Health Service’s 2008–2010 service population. Costs were reported in 2017 U.S. dollars. Results The total estimated costs of injuries per year, including injuries among Indian Health Service users and productivity losses from injury-related deaths, were estimated at $4.5 billion. Lifetime medical costs to treat annual injuries among Indian Health Service users were estimated at $549 million, with the largest share ($131 million) going toward falls, the most frequent injury cause. Total estimated YPLL from AI/AN injury deaths in Indian Health Service’s service population were 106,400. YPLL from injury deaths for men (74,000) were 2.2 times YPLL for women (33,000). Productivity losses from all injury-related deaths were $3.9 billion per year. The highest combined lifetime medical and mortality costs were for motor vehicle/traffic injuries, with an estimated cost of $1.6 billion per year. Conclusions Findings suggest that targeted injury prevention efforts by Indian Health Service likely contributed to lower rates of injury among AI/AN, particularly for motor vehicle/traffic injuries. However, because of remaining disparities in injury-related outcomes between AI/AN and all races in the United States, Indian Health Service should continue to monitor changes in injury incidence and costs over time, evaluate the impacts of previous injury prevention investments on current incidence and costs, and identify additional injury prevention investment needs.

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Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014

Public Health Reports ◽

10.1177/0033354920937284 ◽

2020 ◽

Vol 135 (4) ◽

pp. 461-471

Author(s):

Mary E. Evans ◽

Marissa Person ◽

Brigg Reilley ◽

Jessica Leston ◽

Richard Haverkate ◽

...

Keyword(s):

Drug Use ◽

Health Service ◽

Injection Drug Use ◽

Temporal Trends ◽

The United States ◽

Hcv Infection ◽

Injection Drug ◽

Indian Health Service ◽

Opioid Use ◽

Indian Health

Objectives Hepatitis C virus (HCV) and HIV transmission in the United States may increase as a result of increasing rates of opioid use disorder (OUD) and associated injection drug use (IDU). Epidemiologic trends among American Indian/Alaska Native (AI/AN) persons are not well known. Methods We analyzed 2010-2014 Indian Health Service data on health care encounters to assess regional and temporal trends in IDU indicators among adults aged ≥18 years. IDU indicators included acute or chronic HCV infection (only among adults aged 18-35 years), arm cellulitis and abscess, OUD, and opioid-related overdose. We calculated rates per 10 000 AI/AN adults for each IDU indicator overall and stratified by sex, age group, and region and evaluated rate ratios and trends by using Poisson regression analysis. Results Rates of HCV infection among adults aged 18-35 increased 9.4% per year, and rates of OUD among all adults increased 13.3% per year from 2010 to 2014. The rate of HCV infection among young women was approximately 1.3 times that among young men. Rates of opioid-related overdose among adults aged <50 years were approximately 1.4 times the rates among adults aged ≥50 years. Among young adults with HCV infection, 25.6% had concurrent OUD. Among all adults with arm cellulitis and abscess, 5.6% had concurrent OUD. Conclusions Rates of HCV infection and OUD increased significantly in the AI/AN population. Strengthened public health efforts could ensure that AI/AN communities can address increasing needs for culturally appropriate interventions, including comprehensive syringe services programs, medication-assisted treatment, and opioid-related overdose prevention and can meet the growing need for treatment of HCV infection.

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Clinical Performance of Bulk-Fill Resin Composite Restorations Using the United States Public Health Service and Federation Dentaire Internationale Criteria: A 12-Month Randomized Clinical Trial

European Journal of Dentistry ◽

10.1055/s-0040-1718639 ◽

2020 ◽

Author(s):

Márcia de Almeida Durão ◽

Ana Karina Maciel de Andrade ◽

Maria do Carmo Moreira da Silva Santos ◽

Marcos Antônio Japiassú Resende Montes ◽

Gabriela Queiroz de Melo Monteiro

Keyword(s):

Public Health ◽

United States ◽

Health Service ◽

Public Health Service ◽

Clinical Performance ◽

Resin Composite ◽

United States Public Health ◽

The United States ◽

Resin Composites

Abstract Objective This study was aimed to compare the 12-month clinical performance of two full-body bulk-fill resin composites Filtek bulk fill/3M ESPE (FBF) and Tetric EvoCeram bulk fill/Ivoclar Vivadent (TBF) and a conventional microhybrid resin composite Filtek Z250/3M ESPE (Z250) using the modified the United States Public Health Service (USPHS) and Federation Dentaire Internationale (FDI) criteria. Also, the agreement between the two evaluation criteria was evaluated at baseline and after 12 months of follow-up. Materials and Methods A total of 138 class I and II restorations were placed in posterior teeth (split-mouth design) of 46 volunteers following manufacturer’s instructions and bonded with a self-etching bonding agent (Clear fill SE Bond/Kuraray). The restorations were evaluated at baseline and after 12 months of follow-up by three previously calibrated dentists (Cohen’s K = 0.84). Statistical Analysis Fisher’s exact test and Pearson’s Chi-squared test were used to evaluating the homogeneity of distribution of the clinical characteristics. Friedman’s test was applied to evaluate differences among the resin composites. The results obtained for the USPHS and FDI criteria at the different observation times were compared using the Wilcoxon test. A level of significance of 0.05 was adopted for all tests. Results After 12 months (recall rate, 78.3%, n = 36 patients), the overall success rate was 99.07% for both criteria. Only one failed restoration (0.93%) was detected for each system during follow-up in the TBF group. Conclusion The bulk-fill resin composites showed satisfactory clinical performance compared with conventional resin composite after 12 months. The percentage of the acceptable scores was significantly higher for the USPHS criteria, due to discrepancies in the score description for each criterion.

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