Community Survey Research Articles

Predictors of Service Awareness: Results from a Community Survey in an Urban Area

ABSTRACT We examined information seeking strategies and predictors of service awareness from a 2019 survey of Detroit area adults. Participants were age 60+ (mean age = 72.10; SD = 8.08), and most were African American (89.0%) and female (86.9%). Most (74.80%) reported finding information most or all of the time, and 87.50% reported awareness of 12 to 15 services. Respondents with more frequent family/friend interaction (OR = 2.374, 95% CI = 1.054, 5.347), greater use of information seeking strategies (OR = 1.188, 95% CI = 15 1.073, 1.315), and higher health status (OR = 3.445, 95% CI =1.625, 7.306) were more likely to be aware of needed services. Women were aware of a greater number of services compared with men (OR = 2.682, 95% CI = 1.005, 7.160), while Hispanics/Latinos were aware of fewer services relative to African Americans (OR = 0.100, 95% CI = 0.012, 0.837. Greater information seeking strategies was associated with higher awareness (OR = 1.328, 95% CI = 1.150, 1.534). Results suggest the need for particular attention to linguistically and culturally appropriate outreach strategies for people who are Hispanic/Latino and those with a low level of social interaction.

Predictors of new persistent opioid use after surgery in adults

PurposePersistent opioid use is one of the most common post-operative complications. Identification of at-risk patients pre-operatively is key to reducing post-operative opioid use. We sought to develop a predictive model for persistent post-operative opioid used and to determine if geographic factors from community databases improve model prediction based solely on electronic health records (EHRs) and claims data.MethodsEHR and claims data for 4,116 opioid-naïve surgical patients older than 18 in North Carolina were linked with census tract-level unemployment data from the American Community Survey and Centers for Disease Control and Prevention data on opioid prescriptions and deaths attributed to drug poisoning. Primary outcome was new persistent opioid use and covariates included patient factors from EHR, claims data, and geographic factors. Multivariable logistic regression models of potential risk factors were evaluated.Results6.0% of patients developed new persistent opioid use. Associated risk factors based on multivariable logistic regressions include age (adjusted odds ratio [AOR] 1.08; 95% confidence interval [CI] 1.00, 1.16), back and neck pain (1.82; 1.39, 2.39), joint disorders (1.58; 1.18, 2.11), mood disorders (1.71; 1.28, 2.28), opioid retail prescription (1.04; 1.00, 1.07) and drug poisoning rates (1.33; 1.09, 1.62). On Monte-Carlo cross-validation, the addition of geographic factors to EHRs and claims may modestly improve prediction performance (area under the curve, AUC) of logistic regression models compared to those based on EHRs and claims data (AUC 0.667 (95% CI 0.619, 0.717) vs AUC 0.653 (0.600, 0.706)).ConclusionsCo-morbidities and area-based factors are predictive of new persistent post-operative opioid use. As the addition of geographic-based factors did not significantly improve performance of multivariable logistic regression, larger samples are needed to fully differentiate models.

Effect of Experimental Warming on Forage Nutritive Value and Storage in Alpine Meadows at Three Different Altitudes of Nianqing Tanggula Mountain, Northern Tibet: A Long-Term Experience

Effects of climate warming on nutrition quality and storage of alpine grasslands are still controversial, which is not conducive to the management and utilization of alpine grasslands. A long-term warming experiment (with open-top chambers used to elevate temperature) was conducted at three elevations (relatively low, mid-, and high elevations with 4313, 4513, and 4693 m) of Northern Tibet in 2010 to compare the differences in forage nutritional quality and storage response to warming among three elevations and to explore the relationships between forage nutritional quality and production. In 2019, community surveys, observations of forage biomass and nutrition quality, and soil physicochemical properties were carried out. Forage nutrition quality included crude protein (CP), acid detergent fiber (ADF), neutral detergent fiber (NDF), ether extract (EE), crude ash (Ash), and water-soluble carbohydrate (WSC) content. Warming did not affect community aboveground biomass (AGB) at the three elevations. Warming improved community nutrition quality by increasing community CP content by 25.80% and decreasing community NDF content by 15.51% at the low elevation. In contrast, warming reduced community nutrition quality by increasing community CP, ADF, and NDF contents by 13.45%, 23.68%, and 17.43%, respectively, and decreasing Ash content by 39.50% at the high elevation. Warming did not affect community CP, ADF, NDF, EE, Ash, or WSC contents at the mid-elevation. Warming increased community nutrition storage by increasing community CP, ADF, and NDF storges by 74.69%, 88.18%, and 79.71%, respectively, at the high elevation. Warming did not affect community nutrition storages at the low or mid-elevations. Overall, forbs had higher CP, EE, Ash, and WSC contents and lower ADF and NDF contents compared with graminoids. Community EE content increased with community AGB, but community CP, ADF, NDF, EE, Ash, and WSC contents were not related to community AGB. Therefore, from the low to high elevation, the effects of warming on forage nutrition quality gradually changed from improving to inhibiting. Warming altered rangeland quality by affecting forage nutrition quality rather than forage production. There were no trade-offs between forage nutrition quality and forage production.

Surveys of the scientific community on the existence of extraterrestrial life

Surveys of the scientific community on the existence of extraterrestrial life

Assessment of the Physicochemical, Microbial Quality, and Consumer’s Perceptions Regarding Packaged Milk Available in the Local Markets of Karachi, Pakistan

Background: Milk, an essential part of diet is comprised of all indispensable nutrients. However, it proves to be beneficial only if it is available in its pure form. Objective: The current study aimed to evaluate packaged milk samples collected from local markets of Karachi and to assess level of consumer awareness about health risks associated with substandard milk consumption. Methods: Package milk samples were assessed collectively for physical parameters, and microbial load. Seventeen colour-based chemical tests were also conducted to detect different dyes, preservatives, and other added chemicals as adulterants in milk. A household-based community survey was conducted to evaluate consumer’s preferences regarding packaged milk consumption. Results: 97% of tested milk samples were observed to have added solids and water in them. Chemical adulterants in tetra packaged milk were detected in order of Glucose > cane sugar, Vegetable fat > Formalin, >Artificial colour > Neutralizer > Detergent >Urea, Annatto dye > starch. For the household-based survey, a total of 266 respondents were interviewed. Although 61.7% of respondents preferred pasteurized milk, potential customer satisfaction with the quality of pasteurized milk was 74.4%. Multivariate analysis showed that customer satisfaction regarding pasteurized milk was significantly associated with the preference of customer [Odds Ratio (OR)=4.18, p=0.004], buying factors like price, offers, and discounts (OR=6.92, p=0.014), quality and availability (OR=4.81, p=0.003), and experienced negative health effects (OR=0.26, p=0.002). Conclusion: The study concluded that more than 70% of the packaged milk samples were adulterated with detergents, artificial flavors and glucose which signify the compromised quality of the packaged milk and their products. Strict regular quality checks should be established and closely monitored by regulatory authorities and the government.

Diversity, Identity, and Data

While quantitative approaches cannot replace disciplinary insights from the social sciences and humanities, they can sometimes provide new perspectives. Building on research from psychology and organizational theory, we use a mathematical framework to study the interplay of two group-level characteristics: diversity, defined as the distribution of identity characteristics, and shared identity, denoting the extent to which these characteristics are shared amongst individuals. Although these quantities are theoretically independent, we find a strong negative correlation between them in two sample data sets, namely, principal creative contributors to Hollywood hit movies and American Community Survey data on state populations.

Associations Between Sociodemographic Factors and Interest in Remote Patient Monitoring Among Arkansas Residents.

Introduction: Remote patient monitoring (RPM) has the power to transform health care delivery, as it allows for the digital transmission of individual health data to health care professionals, providing the most up-to-date information to be able to make medical decisions. Although RPM use has grown exponentially during the pandemic, there is limited information on the association between sociodemographic characteristics and interest in RPM use in underserved areas of the United States after the onset of the pandemic. Methods: We conducted a survey via random digit dialing of 2201 adults living in Arkansas in March of 2022. Weighted estimates were generated using rank ratio estimation to approximate the 2019 American Community Survey 1-year Arkansas estimates for race/ethnicity, age, and gender. We fit a partial proportional odds model using weighted generalized ordered logistic regression to examine adjusted odds ratios (ORs) for interest in RPM. Predictors included sociodemographic characteristics, nativity, health care access, and self-rated health. Results: Results indicate respondents who were age 60 or older had lower odds of interest in RPM than those between the ages 18-39 (OR = 0.61). Hispanic adults had lower odds of reporting interest in RPM (OR = 0.68), and non-Hispanic adults of other races/ethnicities had lower odds of reporting any interest at all (OR = 0.67) or interest greater than a little (OR = 0.67) in RPM compared with non-Hispanic White respondents. However, respondents who had previously used telehealth had greater odds of reporting higher levels of interest in RPM than those who had not previously used it (OR = 1.93). Discussion: Interest in RPM use is associated with several sociodemographic factors. Future work is needed to understand and address RPM reluctance and to increase interest in RPM among marginalized and underserved populations who may need these services.

Household food insecurity, living conditions, and individual sense of security: A cross-sectional survey among Burkina Faso refugees in Ghana.

Food insecurity and achieving adequate nutrition is a major global challenge, especially in vulnerable groups such as refugee communities. In West Africa, thousands of Burkina Faso refugees have crossed the border into northern Ghana due to conflict and instability in their home country. We conducted a one-off cross-sectional survey to assess household food insecurity, living conditions, and sense of security among Burkina Faso refugees currently residing in the Upper East region of Ghana. Study data was collected over 14-21 October 2022 from 498 refugee households, via registered refugee households who were contacted with the help of the community refugee focal persons. We used the validated USAID household food insecurity questionnaire, analysed using Rasch modelling, with descriptive statistics, and linear regression analyses (with significance at p < 0.05) to assess food insecurity. Results revealed that 100% of households experienced food insecurity, with 95.2% defined as moderate or severe, and 70.4% as experiencing severe food insecurity. Refugees from rural areas were less insecure compared to urban refugees (β = -4.25 [CI: -5.79 --2.71], p < .001). Refugees residing in host communities experienced lower food insecurity than those in designated refugee camps (β = -1.56 [CI: -2.74 --0.39,] p = .009). Further, refugees who were dissatisfied with their accommodation size were more likely to experience food insecurity (β = 2.96 [CI: -0.06-2.47], p = .060). Most refugees (73.5%) felt safe and welcomed by host communities. Our results highlight the extremely high prevalence of moderate and severe food insecurity in this vulnerable refugee population. We provide evidence to support the need to improve food distribution logistics, prioritising suitable accommodation, and facilitating access to healthcare. Follow-up research, such as repeated community surveys, can track this evolving situation to continuously inform decision-making for refugee support.

Neighborhood socioeconomic disadvantage and child health: The role of neighborhood mobility networks.

Despite a large body of work on neighborhood effects on health, past studies are limited in their treatment of neighborhoods as largely static spaces with (dis)advantages based primarily on the average characteristics of their residents. In this study, we draw on the triple neighborhood disadvantage perspective to explore how socioeconomic disadvantage in a neighborhood's mobility network uniquely relates to children's overall health levels, independent of residential disadvantage. We investigate this by combining 2019 SafeGraph data on mobility patterns from roughly 40 million U.S. mobile devices with information on children, families, and neighborhoods from the 2015-19 American Community Survey and 2019 Panel Study of Income Dynamics Child Development supplement. We find that mobility-based neighborhood disadvantage (MND) generally predicts child health better than residential neighborhood disadvantage (RND), but associations vary by race and by family income and are contingent on the broader metropolitan context. Our study advances existing research on the effects of mobility networks by shifting from analyzing aggregate-level outcomes to exploring how mobility-based disadvantage affects individual outcomes. Overall, our results indicate that the relationship between neighborhood disadvantage and child health is nuanced and complex. Findings from our study suggest that researchers aiming to understand the influence of neighborhood contexts should examine individuals' residential environments as well as the environments of neighborhoods connected through individuals' everyday mobility.

학교자율시간 운영을 위한 드론 활용 교육프로그램 개발 및 학생 행위주체성 신장 효과

This study aims to develop and implement a drone-based education program for 4th-grade elementary school students during school autonomous hours and to evaluate its impact on student agency. This involved surveys of the educational community and analyses of school infrastructure and characteristics. Using the ADDIE model, a 22-session program was developed. Pre- and post-tests measuring student agency were administered to an experimental group (17) and a control group (32). Additionally, reflections and self-assessment journals from the experimental group were analyzed quantitatively and qualitatively. The findings are summarized as follows: First, the democratic consensus within the educational community played a key role in the design and implementation of the program. By synthesizing the inputs from students, parents, and teachers, a drone education program aligned with environmental and sustainable development education was developed. The program’s activities included theory and piloting practice based on safety education, using drones to solve school problems, and lessons on career and ethics. This process contributed to a sense of responsibility and cooperation among all stakeholders, especially boosting student motivation and interest in learning while maximizing the program’s effectiveness. Second, the analysis of pre- and post-test results on student agency in both the experimental and control groups, as well as the progression reflected in self-assessment journals, revealed improvements across all four domains of student agency—community agency, learning interaction, purposefulness, and responsibility. Third, the study demonstrated the potential of the developed drone education program as a valuable resource for school autonomous hours. It provided a learning experience where students took the initiative to participate, reorganizing the drone utilization from a briefly covered topic in practical arts or creative classes into 22 lessons to cover related contents in depth and foster cooperation within the educational community. The study found that the developed program positively impacted elementary school students' agency. Moreover, the materials are expected to serve as useful references for developing drone programs for elementary school students and structuring autonomous school hours.

USING DATA TO DRIVE POLICY: AN EXAMPLE OF A STATE–UNIVERSITY PARTNERSHIP TO ADVANCE AGE-FRIENDLY COMMUNITIES

Abstract The Pennsylvania Department on Aging (PDA) is developing a “Master Plan for Older Adults” called “Aging Our Way.” The plan will help guide policies and programs for the next 10 years. Agency leadership turned to the University of Pittsburgh to conduct a statewide needs assessment survey as part of a broad stakeholder engagement process that involved community meetings in all 67 counties. The University conducted a statewide telephone survey drawing on the Age-Friendly Community model. A sample of adults age 60 and older was stratified into eight regions to assure that the entire state was represented. To reach non-English speaking adults and disabled adults who might not respond by telephone, a web-based version of the survey was developed and translated into Chinese, Spanish and Russian and distributed via email to stakeholder groups. Paper versions in were mailed to community-based organizations to reach individuals who were not able to access the internet. The telephone survey results (n=900) were weighted to match the 2021 American Community Survey. The web-based survey results (n=6950) are reported separately. Findings were presented to the Long-Term Care Council, a stakeholder group that is convened by the PDA to advise on policy. The Council was formed into several subcommittees that addressed different policy topics (e.g., housing, transportation). The draft report developed by the Council was shared with the University team to develop objectives that could be measured by repeating the survey. The overall collaboration between the University and the PDA led to a strong, empirically based report.

DISABILITY STATUS OF ASIAN OLDER ADULTS IN THE UNITED STATES: FINDINGS FROM THE 2017–2021 AMERICAN COMMUNITY SURVEY

Abstract Little information is available on the disability status of the diverse Asian population in the United States (U.S.). In this study we estimate the prevalence of six types of disability in older adults for six major Asian subgroups using the recently released data from the 2017-2021 American Community Survey. The survey contains a sample of 11,737 Vietnamese; 32,388 Chinese; 24,625 Filipino; 12,125 Japanese; 10,231 Koreans; 16,759 Indians; and 2,412,999 non-Hispanic Whites. All analyses use survey weights for population estimates and the jackknife method for standard errors. We find higher prevalence of disability in independent living for Vietnamese, Chinese, Filipino, Japanese, and Indian compared to non-Hispanic White. For self-care disability, Vietnamese, Chinese, Filipino and Indian have higher prevalence. Cognitive disability is more prevalent in Vietnamese, Filipino, and Japanese. Only Vietnamese older adults have higher prevalence of mobility disability and vision disability. Surprisingly, all Asian subgroups in the study have lower prevalence of hearing disability than the non-Hispanic White group. Overall, the results show Vietnamese older adults have the worst disability profile, whereas Korean older adults have the best profile. Future research is needed to understand the role of fortitude in addressing disability status, especially in the areas of independent living, self-care, and cognition, which are more prevalent in most Asian groups.

COMMUNITY PREVALENCE OF HEARING LOSS AMONG OLDER ADULTA IN MA, RI, CT, AND NH: COMPARING MEASURES

Abstract Background Hearing impairment and hearing loss may negatively impact social engagement and social relationships. Understanding community rates of hearing loss would identify disparities and may inform service delivery and potentially improve quality of life for adults with hearing loss. The aim of this study is to describe community prevalence of hearing loss and to compare two measurement approaches: self-report and clinically derived from Medicare claims. Methods Data were from the Healthy Aging Data Report (healthyagingdatareports.org) for the New England states (MA, NH, CT, and RI) with indicators calculated from the American Community Surveys (MA: 2012-2016; RI:2016-2018; CT: 2014-2018 and NH: 2012-2016), and the Medicare Master Beneficiary Summary Files (MA: 2014-2015; RI: 2016-2017; CT: 2016-2017 and NH: 2014-2015). Results rates derived from CMS clinical diagnosis were higher (MA: 16.1%; RI: 16.4%; CT: 15.7%, and NH: 14.4%) compared to the self-reported ACS rates (MA: 14.2%; RI: 13.9%: CT: 12.4% and NH: 15.0%). The highest community prevalence rate of self-reported hearing loss (36.36%) was in Monroe MA. For clinically diagnosed hearing loss, Hanover NH (home to Dartmouth College and health system) reported the highest rate (26.12%). Having excellent access to health care is associated with higher community rates of clinically diagnosed hearing loss. Results showed that the community prevalence of hearing impairment was variable by community. The potential impact of hearing loss on social, emotional, and physical well-being indicates a need for interventions to diagnose and treat it.

LIFE EXPECTANCY AND COVID-19 MORTALITY DISPARITIES AMONG NATIVE AMERICAN OLDER ADULTS IN WYOMING

Abstract Accumulated inequities contribute to health disparities. Striking evidence of this is found in Native older adults in Wyoming. The history of violence and racism against Native peoples in the US is a national shame. Documenting the health challenges experienced by Native older adults brings awareness and potential remedy to this racist history. American Indian and Alaska Native communities are a historically under-researched population and are at greater risk than non-Hispanic white older adults for many chronic conditions. The current study reports on results from the Wyoming Healthy Aging Data Reports (healthyagingdatareports.org). We compared community rates of life expectancy and COVID-19 mortality in Wyoming and in Fremont County (home to the largest proportion of older Native adults in WY). Data sources include US Census Bureau American Community Survey 2016-2020 (population characteristics), Robert Wood Johnson Foundation (community life expectancy), and the Wyoming Department of Health (COVID-19 infection and mortality rates). Small area estimation techniques were used to calculate rates, and ArcGIS software was used for mapping and geographic analyses. Results show an estimated 2,430 Native American older adults who are 55+ are living in Wyoming, and 56% of them reside in Fremont County. Life expectancy rates in Fremont County (73) are 5 years lower than the state average (78.1). There is also a 1.5x higher COVID mortality rate in Fremont County (513.7) as opposed to the state average (340.4). Communities that have experienced systematic discrimination and inadequate health care services have poor outcomes. Policy interventions to address such inequities are warranted.

Refined Marriage Rates and Coresidential Relationships by Sexual Identity and Age: A Research Note

AbstractThis research note estimates refined marriage rates and coresidential relationships among individuals identifying as gay, lesbian, and straight in the United States seven years after the legalization of same-sex marriage. Data to estimate refined marriage rates or coresidential relationships by sexual identity are not available in a single national dataset so we leverage data from the U.S. Census Bureau's 2022 American Community Survey and Household Pulse Survey, to estimate refined marriage rates and the share in a coresidential union for straight, lesbian, and gay populations aged 18 to 64, based on the unmarried population and age. Findings highlight the importance of considering age alongside sexual identity when analyzing marital behavior and coresidential relationships. Both refined marriage rates and percentage living in coresidential relationships were lower among gay identifying males across all age groups, whereas rates among lesbian identifying females were comparable to those among straight identifying males and females. This study contributes to research on contemporary relationship dynamics as well as calling for new demographic data and investigations into the complexities of marriage and cohabitation among diverse populations.

Prevalence and Distribution of Parasitic Infections in Children in Diwaniyah Hospitals, Iraq

Intestinal parasites are a significant public health concern, particularly among children. These infections can lead to severe health issues, including malnutrition and impaired growth. This study focuses on the prevalence of intestinal parasites among children suffering from diarrhea in Diwaniyah Governorate, specifically at Diwaniyah Teaching Hospital. The study aimed Identify the prevalence of intestinal parasites among children suffering from diarrhea in Diwaniyah Governorate and assess the demographic distribution of infected children, focusing on gender differences, Entrobiais and Hymenolipiasis) are the most prevalent, infecting an estimated one-sixth of the global population. Infection rates are highest in children living in our country, followed by rural areas. Hundreds of millions of people are infected with helminths and intestinal protozoa, particularly children in low- and middle-income countries, we conducted a cross-sectional epidemiological survey in Al-Qadisiyah province communities of six region with sex hospital which including (Alhamza, Al-sanyia, Al-Shamyia hospital, Afak hospital, Al-Diwanyia 2 desert, Al-Diwanyia 1 desert)for 12 months to detect and record all intestinal parasite in patient who admitted to hospital However, a much larger and rapidly growing childhood population in these regions remains untreated and suffering from more than one parasite.

“Are you sure you want to go to that village”; a qualitative review of the challenges, experiences and lessons learnt from a nutritional survey in rural and urban communities in Nigeria

IntroductionThe importance of community-based studies is not in doubt, however only few exist because of the complexity and challenges associated with them. Little data exists on these complexities and challenges in West Africa. This study aimed to describe the experiences, challenges and lessons learnt from a community-based Nutritional survey carried out in Nigeria. This was a qualitative review of the experiences and challenges involved in a community-based research project. A thematic content analysis was done and the findings were presented as themes and sub-themes, with the inclusion of quotes that accurately depicted the themes/sub-themes.ResultsTwo broad themes emerged from the study. For observations and experiences with community entry, sub-themes include the finding that community structure in the books were different from community structure on the ground, there was a general mistrust among community members, poor access to some communities and/or houses, there was a poor perception of need for the research, there was concern about risk to study participants and about benefit to the participants. The five sub-themes that pertained to the data collection process include the issues with timing, gender, data quality, men being at home and safety of the research team. Guided community engagements are recommended.

Surveillance of public health pathogens in Lagos wastewater canals: a cross-sectional study

BackgroundWastewater-based epidemiology (WBE) is already being adopted for the surveillance of health conditions of communities and shows great potential for the monitoring of infectious pathogens of public health importance. There is however paucity of robust data to support extensive WBE in Nigeria. This study evaluated the prevalence of clinically relevant infectious pathogens and provided antimicrobial resistance profiles of bacteria pathogens in wastewater canals in Lagos State at a single point in time.MethodsThis is a cross-sectional survey of wastewater canals in 20 Local Government Areas (LGAs) in Lagos State for detection of bacteria pathogens of public health importance including non-tuberculous mycobacteria and SARS-Cov-2 virus using cultural analysis and conventional Polymerase Chain Reaction (PCR) techniques. Descriptive epidemiological survey of communities around the canals was done using questionnaires to assess exposure pathways. Statistical analysis was done using SPSS version 27 while P value of < 0.05 was considered as significant.ResultsThree thousand and fifty-four (3054) questionnaires were administered to 1215 (39.8%) females and 1658 (54.3%) males in communities situated around 40 canals in 20 LGAs. Although majority (81.8%) reported using water closet toilet system and pit latrine (12.5%), a few of them admitted to open defaecation [101 (3.3%)] while 299 (9.8%) engaged in open field waste disposal. SARS-CoV-2 was not detected from wastewater in this study. Two mycobacterial species that included Mycobacterium fortitium group (13, 32.5%) and Mycobacterium kansasii (11, 27.5%) were identified in 15 out of 20 LGAs sampled. A total of 123 bacteria pathogens were isolated across the 40 canals. Prominent enteropathogens isolated included Escheriachia coli (28.5%), Salmonella spp (16.3%), Vibro cholerae (10.6%) and Shigella spp (5.7%). Extended spectrum beta-lactamase genes were prominent (87.5%) in the wastewater samples with almost a half (42.5%) of the canals containing both SHV and CTX-M.ConclusionThis study highlights the presence of pathogens with potential to cause epidemic in wastewater canals in Lagos State and provides evidence to inform policy and strategies for wastewater monitoring and treatment. Further studies involving longitudinal monitoring of time-based variations is needed to identify trends in pathogen loads and AMR patterns over time.

Epidemiology of Lymphatic Filariasis Antigen and Microfilaria in Samoa, 2019: 7-9 Months Post Triple-Drug Mass Administration.

The elimination of lymphatic filariasis (LF) as a public health problem remains an ongoing challenge in the Pacific region. This study reports on antigen (Ag) and microfilaria (Mf) prevalence in Samoa in 2019, 7-9 months after the completion of the first round of triple-drug mass drug administration (MDA). It evaluates the effectiveness of the intervention for reducing Ag prevalence to below a 2% threshold, and how this differs between 5-9-year-olds and ≥10-year-olds. We surveyed 30 randomly selected and five purposefully selected primary sampling units (PSUs) in Samoa in 2018 (1-3 months post-triple-drug MDA) and, again, in 2019. In each PSU, we conducted a community survey of 15-20 households and a convenience survey of 5-9-year-old children. A finger-prick blood sample was collected from all participants to test for Ag and Mf. Demographic details were also collected. There was no significant change in adjusted Ag prevalence in the 30 randomly selected PSUs between 2018 (3.9% [95% CI: 2.7-5.6%]) and 2019 (4.1% [95% CI 2.7-5.9%]). Significantly higher Ag prevalence was observed in participants aged ≥10 years (4.6%, 95% CIs 3.0-6.7%) compared to 5-9-year-olds (1.1%, 95% CIs 0.5-2.2%), supporting existing evidence that post-MDA surveillance should not be based on Ag prevalence among 6-7-year-olds. A single round of triple-drug MDA was insufficient to break LF transmission in Samoa 7-9 months post-MDA.

New evidence on the labor market effects of scope of practice laws for physicians and nurse practitioners

AbstractWe explore the labor market effects of state‐level scope of practice (SOP) reform for nurse practitioners that grants full practice authority (FPA) on the earnings and labor supply decisions of physicians and nurse practitioners. We employ a difference‐in‐differences research design using data from the American Community Survey between 2010 and 2019 to find that SOP laws granting FPA increase earnings of nurse practitioners and have some impacts on their labor supply. However, we find no effects on the earnings of physicians. To examine mechanisms, we use aggregated Medicare data from the Dartmouth Atlas to show no change on physician reimbursements.