American journal of preventive medicine
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Routine alcohol screening of people with chronic health conditions that are exacerbated by alcohol can help to prevent morbidity and mortality. The U.S. Affordable Care Act and other recent health reforms expanded insurance coverage and supported alcohol screening in primary care. This study assessed increases in alcohol screening following health reform and insurance-related and racial and ethnic disparities in screening. ⋯ Alcohol screening of primary care patients with chronic conditions increased following health reform, but persistent disparities among patients with private insurance and specific chronic conditions underscore the need to address drivers of unequal preventive care.
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Testing for immunity to measles, mumps, and rubella should include only immunoglobulin G (IgG); immunoglobulin M (IgM) testing is appropriate only if acute illness is suspected. The appropriateness of measles, mumps, and rubella IgM testing was evaluated in a national administrative dataset. ⋯ The majority of IgM testing for measles, mumps, and rubella during this period appeared inappropriate. Clinicians and health systems could ensure that IgG testing alone is performed when evaluating for immunity through modifications to electronic medical records and commercial laboratories could ensure that providers are able to test for IgG alone when evaluating immunity.
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Updating the Quality Family Planning recommendations is an essential step toward offering all people evidenced-informed, person-centered, equitable, and inclusive sexual and reproductive health care. What constitutes quality sexual and reproductive health care constantly evolves as scientific research generates new evidence. ⋯ Today's sexual and reproductive health context is also complex and evolving against the backdrop of an increasing awareness of the impact of structural and interpersonal racism, classism, discrimination (or bias) based on sexual orientation and/or gender identity, and ableism on health and sexual and reproductive health care. The Office of Population Affairs of the HHS sought to be responsive to these complex conditions by centering equity in the update of its Quality Family Planning recommendations from start to finish, including in its approach to reviews of published literature, the creation of expert and technical workgroups to assess the literature and make recommendations, and actively engaging persons with lived experience to gather their insights so that the final product could genuinely respond to the needs of the community.
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Prior work has found incongruencies in injury information reported by crash and hospital records. However, no work has focused on child passengers. The objective of this study was to compare crash scene and hospital-reported injury information for crash-involved child passengers. This study also explored injury location and severity by child age and restraint type. ⋯ Crash reports overestimated the number of injured child passengers and misrepresented injury severity and locations. Child restraint systems mitigated a child's injury risk. Importantly, injury information documented on crash reports currently informs the allocation of traffic safety resources. These results highlight the importance of improving these reports' accuracy and underscore calls to link administrative datasets for public health efforts.