scholarly journals Is there really more flu in the south? Surveillance systems show differences in influenza activity across regions. (Preprint)

2019 ◽  
Author(s):  
Kristin Baltrusaitis ◽  
Alessandro Vespignani ◽  
Roni Rosenfeld ◽  
Josh Gray ◽  
Dorrie Raymond ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Season ◽  
The United States ◽  
Data Sources ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Care Providers ◽  
Influenza Like Illness ◽  
Influenza Activity ◽  
Data Source

BACKGROUND The Centers for Disease Control and Prevention (CDC) track influenza-like illness (ILI) using information on patient visits to health care providers through the Outpatient Influenza-like Illness Surveillance Network (ILINet). Because participation in this system is voluntary, the composition, coverage, and consistency of healthcare reports varies from state to state, leading to different measures of ILI activity between regions. The degree to which these measures reflect actual differences in influenza activity or systematic differences in the methods used to collect and aggregate the data is unclear. OBJECTIVE We qualitatively and quantitatively compare national and region-specific ILI activity in the United States (US) across four data sources: CDC ILINet, Flu Near You (FNY), athenahealth, and HealthTweets.org to determine whether these data sources, commonly used as input in influenza modeling efforts, show geographical patterns that are similar to those observed in CDC ILINet’s data. We also compare the yearly percent of FNY participants who sought health-care for ILI symptoms across geographical areas. METHODS We compare the national and regional 2018 ILI activity baselines, calculated using non-influenza weeks from previous years, for each surveillance data source. We also compare measures of ILI activity across geographical areas during three influenza seasons, 2015-2016, 2016-2017, and 2017-2018. Geographical differences in weekly ILI activity within each data source are assessed using relative mean differences and time series heatmaps. National and regional age-adjusted health-care seeking percents are calculated for each influenza season by dividing the number of FNY participants who sought medical care for ILI symptoms by the total number of ILI reports within an influenza season. RESULTS We observe consistent differences in ILI activity across geographical areas for CDC ILINet and athenahealth data. ILI activity for FNY displayed little variation across geographical areas, while differences in ILI activity for HealthTweets.org appear to be associated with the total number of Tweets within a geographical area. The percent of FNY participants seeking health-care for ILI symptoms differs slightly across geographical areas. Specifically, regions with higher health-care seeking percentages correspond to regions with higher CDC ILINet and athenahealth ILI activity. CONCLUSIONS Our findings suggest that differences in ILI activity across geographical areas as reported by a given surveillance system may not accurately reflect true differences in the prevalence of ILI. Instead, these differences may reflect systematic collection and/or aggregation biases that are particular to each system and consistent across influenza seasons. These findings are potentially relevant in the real-time analysis of the influenza season and in the definition of unbiased forecast models.

scholarly journals Differences in Regional Patterns of Influenza Activity Across Surveillance Systems in the United States: Comparative Evaluation

10.2196/13403 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e13403 ◽  
Author(s):  
Kristin Baltrusaitis ◽  
Alessandro Vespignani ◽  
Roni Rosenfeld ◽  
Josh Gray ◽  
Dorrie Raymond ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Influenza Season ◽  
The United States ◽  
Surveillance Data ◽  
Data Sources ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Influenza Activity ◽  
Data Source

Background The Centers for Disease Control and Prevention (CDC) tracks influenza-like illness (ILI) using information on patient visits to health care providers through the Outpatient Influenza-like Illness Surveillance Network (ILINet). As participation in this system is voluntary, the composition, coverage, and consistency of health care reports vary from state to state, leading to different measures of ILI activity between regions. The degree to which these measures reflect actual differences in influenza activity or systematic differences in the methods used to collect and aggregate the data is unclear. Objective The objective of our study was to qualitatively and quantitatively compare national and region-specific ILI activity in the United States across 4 surveillance data sources—CDC ILINet, Flu Near You (FNY), athenahealth, and HealthTweets.org—to determine whether these data sources, commonly used as input in influenza modeling efforts, show geographical patterns that are similar to those observed in CDC ILINet’s data. We also compared the yearly percentage of FNY participants who sought health care for ILI symptoms across geographical areas. Methods We compared the national and regional 2018-2019 ILI activity baselines, calculated using noninfluenza weeks from previous years, for each surveillance data source. We also compared measures of ILI activity across geographical areas during 3 influenza seasons, 2015-2016, 2016-2017, and 2017-2018. Geographical differences in weekly ILI activity within each data source were also assessed using relative mean differences and time series heatmaps. National and regional age-adjusted health care–seeking percentages were calculated for each influenza season by dividing the number of FNY participants who sought medical care for ILI symptoms by the total number of ILI reports within an influenza season. Pearson correlations were used to assess the association between the health care–seeking percentages and baselines for each surveillance data source. Results We observed consistent differences in ILI activity across geographical areas for CDC ILINet and athenahealth data. ILI activity for FNY displayed little variation across geographical areas, whereas differences in ILI activity for HealthTweets.org were associated with the total number of tweets within a geographical area. The percentage of FNY participants who sought health care for ILI symptoms differed slightly across geographical areas, and these percentages were positively correlated with CDC ILINet and athenahealth baselines. Conclusions Our findings suggest that differences in ILI activity across geographical areas as reported by a given surveillance system may not accurately reflect true differences in the prevalence of ILI. Instead, these differences may reflect systematic collection and aggregation biases that are particular to each system and consistent across influenza seasons. These findings are potentially relevant in the real-time analysis of the influenza season and in the definition of unbiased forecast models.

Yoga as Entrée to Complementary and Alternative Medicine and Medically Pluralistic Practices

2012 ◽  
Vol 71 (4) ◽  
pp. 348-357 ◽  
Author(s):  
Jacqueline Sivén ◽  
Joanna Mishtal
Keyword(s):  
Health Care ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
The United States ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Structured Interviews ◽  
Complementary And Alternative ◽  
Yoga Practitioners

Yoga is increasingly ubiquitous in the United States and globally. The growth of yoga's popularity alongside Indian healing philosophies, including Ayurvedic medicine, makes yoga an important influence on conceptualization of health in holistic terms. Because of these philosophies, the growing use of yoga has implications for how healthcare is sought and utilized. Yoga practitioners are likely to engage in pluralistic health care-seeking practices, yet, the underlying perspectives that drive yoga practitioners to engage in particular health practices are poorly understood in anthropological and public health literature. This study examined perspectives on health care-seeking among long-term yoga practitioners in a yoga community in Florida. Based on semi-structured interviews conducted in 2010 with 26 adults in a Florida yoga center who have practiced yoga at least once per week for at least one year, the study found that long-term yoga practitioners utilized yoga and other systems of complementary and alternative medicine (CAM) to address health needs that were not met by biomedicine. Moreover, once individuals embarked on long-term yoga practice, they expanded their health care-seeking practices to other CAMs. This study contributes to understanding of the pluralization of health care-seeking practices, highlights concerns with the biomedical health system, and contributes to current debates on health care reform.

scholarly journals “When the pain is so acute or if I think that I’m going to die”: Health care seeking behaviors and experiences of transgender and gender diverse people in an urban area

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246883
Author(s):  
Mandi L. Pratt-Chapman ◽  
Jeanne Murphy ◽  
Dana Hines ◽  
Ruta Brazinskaite ◽  
Allison R. Warren ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Screening ◽  
Care Coordination ◽  
The United States ◽  
Health Care Seeking ◽  
Provider Communication ◽  
Care Seeking ◽  
Gender Diverse ◽  
And Gender ◽  
Health Care Seeking Behaviors

Introduction Approximately 1.4 million transgender and gender diverse (TGD) adults in the United States have unique health and health care needs, including anatomy-driven cancer screening. This study explored the general healthcare experiences of TGD people in the Washington, DC area, and cancer screening experiences in particular. Methods Twenty-one TGD people were recruited through word of mouth and Lesbian Gay Bisexual Transgender Queer (LGBTQ)-specific community events. Participant interviews were conducted and recorded via WebEx (n = 20; one interview failed to record). Interviews were transcribed using Rev.com. Two coders conducted line-by-line coding for emergent themes in NVivo 12, developed a codebook by consensus, and refined the codebook throughout the coding process. Member checking was conducted to ensure credibility of findings. Results Three major themes served as parent nodes: health-care seeking behaviors, quality care, and TGD-specific health care experiences. Within these parent nodes there were 14 child nodes and 4 grand-child nodes. Subthemes for health care seeking behaviors included coverage and costs of care, convenience, trust/mistrust of provider, and provider recommendations for screening. Subthemes for quality of care included professionalism, clinical competence in transgender care, care coordination, provider communication, and patient self-advocacy. Overall, transgender men were less satisfied with care than transgender women. Conclusions Results suggest a need for improved provider communication skills, including clear explanations of procedures and recommendations for appropriate screenings to TGD patients. Results also suggest a need for improved clinical knowledge and cultural competency. Respondents also wanted better care coordination and insurance navigation. Overall, these findings can inform health care improvements for TGD people.

scholarly journals Low Tuberculosis (TB) Case Detection: A Health Facility-Based Study of Possible Obstacles in Kaffa Zone, Southwest District of Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Mengistu Abayneh ◽  
Shewangizaw HaileMariam ◽  
Abyot Asres
Keyword(s):  
Health Care ◽  
Health Information System ◽  
Case Finding ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Health Care Seeking ◽  
Case Detection ◽  
Care Seeking ◽  
Care Providers ◽  
Sputum Smear Microscopy

Background. In Ethiopia, the national TB case detection rate is becoming improved; still some districts are not able to meet their case detection targets which leads to ongoing spread of TB infections to family members and communities. This study was intended to assess possible obstacles contributing to low TB case detection in Kaffa zone, Southwest Ethiopia. Methods. A cross-sectional descriptive study involving qualitative and quantitative data was conducted from Mar. to Sep. 2019. Sociodemographic characteristics and data on duration of cough, whether sputum smear microscopy was requested or not, and data on TB knowledge and health care-seeking practice were collected from outpatients. Health care delivery barrier for TB case detection was also explored by using in-depth interview and FGD of health staff. Results. From 802 outpatients with coughing for 2 or more weeks of duration, 334 (41.6%) of them were not requested to have TB microscopic diagnosis. Of these, 11/324 (3.4%) of them were positive for TB after sputum smear microscopy. Only 24.2% of the outpatients were aware as they have had health education on TB disease. Twenty-eight percent of patients perceived that TB was due to exposure to cold air, and 13.5% could not mention any sign or symptom of TB. Amazingly, 54.2% of them did not have any information as current TB diagnosis and treatment is free. Thirty-five percent of the patients were taking antibiotics before visiting the health facility. The interrupted supply of TB diagnostic reagents, frequent electricity interruption, shortage of trained TB care providers, weak health information system, and weak active case finding practice were explored as the factors contributing to low TB case detection. Conclusion. Interrupted functioning of diagnostic centers, shortage of trained care providers, limited active TB case finding practice, weak health information system, and inadequate knowledge and health care-seeking practice of the patients were identified as contributors for low TB case detection. Thus, improving functioning of diagnostic centers, active TB case finding activities, and expanding health education on TB disease will help to improve TB case detection in the districts.

Bother Related to Bladder Control and Health Care Seeking Behavior in Adults in the United States

2009 ◽  
Vol 181 (6) ◽  
pp. 2591-2598 ◽  
Author(s):  
Joshua S. Benner ◽  
Russell Becker ◽  
Kristina Fanning ◽  
Zhanna Jumadilova ◽  
Tamara Bavendam ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
The United States ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Bladder Control ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Health Care Seeking Behavior

Trust, Satisfaction, and Confidence in Health Care Providers Among Student and Professional Dancers in France

2016 ◽  
Vol 31 (3) ◽  
pp. 166-173 ◽  
Author(s):  
Stephanie Alimena ◽  
Mary E Air
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Care Providers ◽  
Care Seeking Behavior ◽  
Seeking Behavior ◽  
Professional Dancers ◽  
Trust In Physicians ◽  
Health Care Seeking Behavior

BACKGROUND: Patients who trust their physicians are more likely to communicate about medical problems, adhere to medical advice, and be satisfied with care. Dancers have demonstrated low utilization of physician services for both preventive care and dance injuries. The purpose of this cross-sectional study was to examine trust in physicians as a variable influencing dancers’ health care-seeking behavior. METHODS: The validated Trust in Physician Scale was administered to 45 professional and 34 student ballet/contemporary dancers in France (36.7% male, 63.3% female) to evaluate their trust in medical doctors (MDs) vs physical therapists (PTs). Dancers were also asked about satisfaction and confidence in medical treatment for dance injuries. RESULTS: Dancers indicated greater trust in PTs than MDs (70.61±10.57 vs 65.38±10.79, t=–3.499, p=0.001). Students exhibited significantly less trust in MDs than professional dancers (62.04±9.96 vs 67.65±10.42, t=–2.381, p=0.020). Trust scale scores for PTs did not differ between students and professionals (69.53±8.30 vs 71.68±12.09, t=–0.866, p=0.389). Students were less confident than professional dancers in their physician’s ability to treat their most severe injury (6.7% of students vs 35.7% of professionals “very confident,” X2=9.402, p=0.052). CONCLUSIONS: Dancer patients exhibit lower trust in physicians compared to previously studied non-dancer populations. Our results suggest that reduced trust in physicians and factors related to professional status may influence dancers’ health care-seeking behavior. Student dancers may comprise a unique subpopulation of dancers with distinctive health care needs.

scholarly journals The Rural Household Production of Health Approach: Applying Lessons from Zambia to Rural Cancer Disparities in the U.S.

2022 ◽  
Vol 19 (2) ◽  
pp. 974
Author(s):  
Mutale Chileshe ◽  
Emma Bunkley ◽  
Jean Hunleth
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Household Production ◽  
The United States ◽  
Cancer Disparities ◽  
Rural Household ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Urban Hospital ◽  
The U.S

The recent focus on rural–urban cancer disparities in the United States (U.S.) requires a comprehensive understanding of the processes and relations that influence cancer care seeking and decision making. This is of particular importance for Black, Latino, and Native populations living in rural areas in the U.S., who remain marginalized in health care spaces. In this article, we describe the household production of health approach (HHPH) as a contextually-sensitive approach to examining health care seeking and treatment decisions and actions. The HHPH approach is based on several decades of research and grounded in anthropological theory on the household, gender, and therapy management. This approach directs analytical attention to how time, money, and social resources are secured and allocated within the household, sometimes in highly unequal ways that reflect and refract broader social structures. To demonstrate the benefits of such an approach to the study of cancer in rural populations in the U.S., we take lessons from our extensive HHPH research in Zambia. Using a case study of a rural household, in which household members had to seek care in a distant urban hospital, we map out what we call a rural HHPH approach to bring into focus the relations, negotiations, and interactions that are central to individual and familial health care seeking behaviors and clinical treatment particular to rural regions. Our aim is to show how such an approach might offer alternative interpretations of existing rural cancer research in the U.S. and also present new avenues for questions and for developing interventions that are more sensitive to people’s realities.

Overview of Current Approaches to Aural Rehabilitation for Adults With Cochlear Implants

2020 ◽  
Vol 5 (5) ◽  
pp. 1175-1187
Author(s):  
Rachel Glade ◽  
Erin Taylor ◽  
Deborah S. Culbertson ◽  
Christin Ray
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Cochlear Implants ◽  
Practice Patterns ◽  
The United States ◽  
Care Providers ◽  
Aural Rehabilitation ◽  
Starting Point ◽  
Clinical Models ◽  
Hearing Health

Purpose This clinical focus article provides an overview of clinical models currently being used for the provision of comprehensive aural rehabilitation (AR) for adults with cochlear implants (CIs) in the Unites States. Method Clinical AR models utilized by hearing health care providers from nine clinics across the United States were discussed with regard to interprofessional AR practice patterns in the adult CI population. The clinical models were presented in the context of existing knowledge and gaps in the literature. Future directions were proposed for optimizing the provision of AR for the adult CI patient population. Findings/Conclusions There is a general agreement that AR is an integral part of hearing health care for adults with CIs. While the provision of AR is feasible in different clinical practice settings, service delivery models are variable across hearing health care professionals and settings. AR may include interprofessional collaboration among surgeons, audiologists, and speech-language pathologists with varying roles based on the characteristics of a particular setting. Despite various existing barriers, the clinical practice patterns identified here provide a starting point toward a more standard approach to comprehensive AR for adults with CIs.

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