Medeirosbynum3663

be delivered despite the lockdown.

Prescription and nonprescription opioid misuse and the rising number of dental visits in emergency departments (EDs) are growing public health concerns in the US. Our study objective was to examine the relationship between prescription analgesics (opioids and nonopioids) and the type of ED visits (dental and nondental) at the national level.

We used data from the 2015-2017 National Hospital Ambulatory Medical Care Survey to examine the association between opioid, nonopioid, and combination of opioid and nonopioid analgesic prescriptions and dental and nondental visits in the ED. Covariates included socioeconomic variables, time of visit, provider type, triage level, hospital location (urban vs rural), and pain level. We conducted descriptive, bivariate, and multivariable analyses using weighted estimates.

The final study sample included 57,098 ED visits from approximately 6 million dental and 414 million nondental visits to EDs during 2015-2017 nationally. Among dental visits, 20.8% received nonopioid aiptions in the ED, especially for dental visits.

The number of adults entering the age groups at greatest risk for being diagnosed with cancer is increasing. Projecting cancer incidence can help the cancer control community plan and evaluate prevention strategies aimed at reducing the growing number of cancer cases.

We used data from the Surveillance, Epidemiology, and End Results Program and the US Census Bureau to estimate average, annual, age-standardized cancer incidence rates and case counts (for all sites combined and top 22 invasive cancers) in the US for 2015 and to project cancer rates and counts to 2050. We used age, period, and cohort models to inform projections.

Between 2015 and 2050, we predict the overall age-standardized incidence rate (proxy for population risk for being diagnosed with cancer) to stabilize in women (1%) and decrease in men (-9%). Cancers with the largest change in risk include a 34% reduction for lung and bronchus and a 32% increase for corpus uterine (32%). Because of the growth and aging of the US population, we predict that the annual number of cancer cases will increase 49%, from 1,534,500 in 2015 to 2,286,300 in 2050, with the largest percentage increase among adults aged ≥75 years. Cancers with the largest projected absolute increase include female breast, colon and rectum, and prostate.

By 2050, we predict the total number of incident cases to increase by almost 50% as a result of the growth and aging of the US population. A greater emphasis on cancer risk reduction is needed to counter these trends.

By 2050, we predict the total number of incident cases to increase by almost 50% as a result of the growth and aging of the US population. A greater emphasis on cancer risk reduction is needed to counter these trends.IntroductionThe contribution of healthcare-associated infections (HAI) to mortality can be estimated using statistical methods, but mortality review (MR) is better suited for routine use in clinical settings. The European Centre for Disease Prevention and Control recently introduced MR into its HAI surveillance.AimWe evaluate validity and reproducibility of three MR measures.MethodsThe on-site investigator, usually an infection prevention and control doctor, and the clinician in charge of the patient independently reviewed records of deceased patients with bloodstream infection (BSI), pneumonia, Clostridioides difficile infection (CDI) or surgical site infection (SSI), and assessed the contribution to death using 3CAT definitely/possibly/no contribution to death; WHOCAT sole cause/part of causal sequence but not sufficient on its own/contributory cause but unrelated to condition causing death/no contribution, based on the World Health Organization's death certificate; QUANT Likert scale 0 (no contribution) to 10 (definitely cause of death). Inter-rater reliability was assessed with weighted kappa (wk) and intra-cluster correlation coefficient (ICC). Reviewers rated the fit of the measures.ResultsFrom 2017 to 2018, 24 hospitals (11 countries) recorded 291 cases 87 BSI, 113 pneumonia , 71 CDI and 20 SSI. The inter-rater reliability was 3CAT wk 0.68 (95% confidence interval (CI) 0.61-0.75); WHOCAT wk 0.65 (95% CI 0.58-0.73); QUANT ICC 0.76 (95% CI 0.71-0.81). Inter-rater reliability ranged from 0.72 for pneumonia to 0.52 for CDI. All three measures fitted 'reasonably' or 'well' in > 88%.ConclusionFeasibility, validity and reproducibility of these MR measures was acceptable for use in HAI surveillance.To assess SARS-CoV-2 variants spread, we analysed 36,590 variant-specific reverse-transcription-PCR tests performed on samples from 12 April-7 May 2021 in France. In this period, contrarily to January-March 2021, variants of concern (VOC) β (B.1.351 lineage) and/or γ (P.1 lineage) had a significant transmission advantage over VOC α (B.1.1.7 lineage) in Île-de-France (15.8%; 95% confidence interval (CI) 15.5-16.2) and Hauts-de-France (17.3%; 95% CI 15.9-18.7) regions. This is consistent with VOC β's immune evasion abilities and high proportions of prior-SARS-CoV-2-infected persons in these regions.We describe four secondary fungal infections caused by Mucorales species in COVID-19 patients. Three COVID-19 associated mucormycosis (CAM) occurred in ICU, one outside ICU. All were men aged > 50 years, three died. Clinical presentations included pulmonary, rhino-orbital cerebral and disseminated infection. Infections occurred in patients with and without diabetes mellitus. CAM is an emerging disease and our observations underscore the need to be aware of invasive mucormycosis, including in COVID-19 patients without (poorly controlled) diabetes mellitus and outside ICU.Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), the use of antiretroviral medication to prevent HIV acquisition, is a highly effective biomedical prevention tool. The World Health Organization (WHO) recommends PrEP for people at substantial risk of HIV infection, as part of combination prevention, and highlights the need for robust evaluation of PrEP programmes. SSR128129E Based on suggested WHO core indicators, we created a concise set of HIV PrEP-related dataset variables, to harmonise the monitoring and evaluation of PrEP programmes across five closely related nations (England, Northern Ireland, Ireland, Scotland and Wales). The dataset is based on the PrEP cascade and is intended to represent the minimum variables needed for reporting and comparison of meaningful data at national and multinational level. The dataset can be modified for settings with different health and surveillance systems. It is intended for public health, academic, clinical and health planning, and public audiences. Here we describe the dataset and illustrate its use with data from the first year of the Scottish National PrEP programme.

To explore and provide contextual meaning around issues surrounding food insecurity, namely factors influencing food access, as one domain of food security.

A community-based, qualitative inquiry using semi-structured face-to-face interviews was conducted as part of a larger sequential mixed-methods study.

Cayo District, Belize, May 2019-August 2019.

Thirty English-speaking individuals (eight males, twenty-two females) between the ages of 18-70, with varying family composition residing within the Cayo District.

Participants describe a complex interconnectedness between family- and individual-level barriers to food access. Specifically, family composition, income, education and employment influence individuals' ability to afford and access food for themselves or their families. Participants also cite challenges with transportation and distance to food sources and educational opportunities as barriers to accessing food.

These findings provide insight around food security and food access barriers in a middle-income country and provide avenues for further study and potential interventions. Increased and sustained investment in primary and secondary education, including programmes to support enrollment, should be a priority to decreasing food insecurity. Attention to building public infrastructure may also ease burdens around accessing foods.

These findings provide insight around food security and food access barriers in a middle-income country and provide avenues for further study and potential interventions. Increased and sustained investment in primary and secondary education, including programmes to support enrollment, should be a priority to decreasing food insecurity. Attention to building public infrastructure may also ease burdens around accessing foods.

To determine if solar-powered battery systems could be successfully used for electricity-dependent medical devices by families during a power outage.

We assessed the use of and satisfaction with solar-powered battery systems distributed to 15 families following Hurricane Maria in rural Puerto Rico. Interviews were conducted in July 2018, 3 mo following distribution of the systems.

The solar-powered battery systems powered refrigeration for medications and prescribed diets, asthma therapy, inflatable mattresses to prevent bedsores, and continuous positive airway pressure machines for sleep apnea. Despite some system problems, such as inadequate power, defective cables, and blown fuses, families successfully dealt with these issues with some outside help. Almost all families were pleased with the systems and a majority would recommend solar-powered battery systems to a neighbor.

Families accepted and successfully used solar-powered battery systems to power medical devices. Solar-powered battery systems should be considered as alternatives to generators for power outages after hurricanes and other disasters. Additional research and analysis are needed to inform policy on increasing access to such systems.

Families accepted and successfully used solar-powered battery systems to power medical devices. Solar-powered battery systems should be considered as alternatives to generators for power outages after hurricanes and other disasters. Additional research and analysis are needed to inform policy on increasing access to such systems.

As tap water distrust has grown in the USA with greater levels among Black and Hispanic households, we aimed to examine recent trends in not drinking tap water including the period covering the US Flint Water Crisis and racial/ethnic disparities in these trends.

Cross-sectional analysis. We used log-binomial regressions and marginal predicted probabilities to examine US nationally representative trends in tap and bottled water consumption overall and by race/ethnicity.

The National Health and Nutrition Examination Survey data, 2011-2018.

Nationally representative sample of 9439 children aged 2-19 years and 17268 adults.

Among US children and adults, respectively, in 2017-2018 there was a 63 % (adjusted prevalence ratio (PR) 1·63, 95 % CI (1·25, 2·12), P < 0·001)) and 40 % (PR 1·40, 95 % CI (1·16, 1·69), P = 0·001)) higher prevalence of not drinking tap water compared to 2013-2014 (pre-Flint Water Crisis). For Black children and adults, the probability of not drinking tap water increased significantly from 18·1 % (95 % CI (13·4, 22·8)) and 24·6 % (95 % CI (20·7, 28·4)) in 2013-2014 to 29·3 % (95 % CI (23·5, 35·1)) and 34·5 % (95 % CI (29·4, 39·6)) in 2017-2018.