United States Lag Research Articles

A messaging standard for environmental inspections: is it time?

Environmental health (EH) services in the United States lag behind other areas of public health and health care with respect to information system interoperability and data sharing. This is partly due to an absence of well-defined use cases, the lack of direct economic drivers and resources to improve, the multiple jurisdictional elements that govern EH services across the United States, and no central organization to drive modernization of EH data. We summarize the status of EH information systems; argue for greater interoperability, including use cases for a messaging standard for environmental inspections; and present recommendations to better align EH services and data modernization efforts currently underway in other areas of public health.

Demonstrating the Value of Interventional Radiology.

While national healthcare expenditures per capita in the United States exceed those in all other Organisation for Economic Co-operation and Development (OECD) countries, measures of health outcomes in the United States lag behind those in peer nations. This combination of high healthcare spending and relatively poor health has led to attempts to identify high- and low-value healthcare services and to develop mechanisms to reimburse health care providers based on the value of the care delivered. This article investigates the meaning of value in healthcare and identifies specific services delivered by interventional radiologists that have accrued evidence that they meet criteria for high-value services. Recognizing the shift in reimbursement to high-value care, it is imperative that interventional radiology (IR) develop the evidence needed to articulate to all relevant stakeholders how IR contributes value to the system.

How the Quadruple Aim Widens the Lens on the Transition to Residency.

How the Quadruple Aim Widens the Lens on the Transition to Residency.

A diversity index to measure underrepresented minority enrollment in United States colleges and schools of pharmacy

IntroductionWith an underrepresented minority (URM) student population of <20%, colleges and schools of pharmacy (CoPs) in the United States (US) lag behind the national population, in which URMs account for >30%. Few tools are available to assist the >140 US CoPs in tracking progress in URM diversity among student pharmacists. Thus, the study's purpose was to address this gap by: (1) creating a “diversity index” for pharmacy programs; and (2) determining changes in diversity index scores between 2011 and 2020. MethodsThis was a secondary analysis of 2011–2020 fall URM enrollment data for CoPs and national and state population data. The annual diversity index score for 2011–2020 was calculated for each CoP. Wilcoxon signed-rank tests and Mann-Whitney U tests were conducted. ResultsAmong all CoPs, median URM percent enrollment significantly increased from 7.7% in 2011 to 14.5% in 2020. Median diversity index scores for all CoPs increased from 0.66 in 2011 to 0.76 in 2020, but this change was not statistically significant. Historically Black Colleges and Universities (HBCUs) and Hispanic-Serving Institutions (HSIs) had significantly greater diversity index scores than non-HBCUs/HSIs. Diversity index scores of public vs. private colleges did not differ significantly. ConclusionThis diversity index represents an important step in tracking progress in increasing URM student pharmacist representation in CoPs. The index may be utilized as a tool to support development of diversity best practices and more inclusive environments for student pharmacists, faculty, staff, and stakeholders.

China e a mudança da matriz energética na América Latina: uma abordagem de política econômica global

ABSTRACT China is leading the global change in the energy matrix and mainly Latin America. This change questions the position and leadership of the United States in general and particularly in Latin America. Evidence shows that the United States lags in energy change in technical and institutional terms and is anchored heavily in dirty energy. Evidence also indicates that the US is not allowing China to advance in the region quickly. Power generation from renewable energy sources is rising, with China leading in solar equipment and hydroelectric dams while buying out electric distribution networks from US firms. The consequences for the global economy will be felt on many fronts, from the balance of trade sign change and decreased inflation to currency realignments and power reshuffle as oil prices collapse.

The current opportunities and challenges for offshore wind in the United States

Over the past decade, offshore wind installations have expanded dramatically in Europe and China, increasing renewable energy presence in these markets. However, the United States lags in offshore wind development despite significant coastline and wind resource availability. Each coast of the United States possesses unique opportunities and challenges to installation due to variations in bathymethry and weather patterns. This paper reviews the planning and installation challenges of offshore wind turbines in the United States by incorporating lessons learned from offshore wind plants already in place in other countries. The goal of this paper is to provide a review of offshore wind turbine installation methods by highlighting challenges unique to this form of renewable energy in the United States.

Assessment of interprofessional collaboration at free-standing birth centers: Does collaboration influence outcomes?

Rates of maternal morbidity and mortality in the United States lag behind other high-income countries. One proposed solution is to develop an integrated system of maternity care consisting of levels of care based on medical risk. As smooth transitions between different levels will be necessary, better definition of successful collaboration in this context is needed. To evaluate if collaborative activities between free-standing birth centers and their collaborative obstetric departments are associated with birth outcomes. The American Association of Birth Centers manages a large prospective perinatal registry, and also performs surveys of all known birth centers that collect data on practice characteristics. Specific collaborative activities were mapped to birth outcomes. Outcomes from centers that participated in these activities were compared to practices that did not. Participating in review of transfers, hospital department meetings, and QI activities resulted in statistically significant lower cesarean sections, as did participating in emergency drills. Attending social events with the department and attending classes at the hospital resulted in statistically significant higher rates of transfer from birth center to hospital. These transfers occurred without a concurrent increase in cesarean sections. Certain collaborative activities between birth centers and obstetric departments are associated with improved birth outcomes.

S272 Colorectal Cancer Screening Rates at HRSA-funded Health Centers in the United States Lag Behind the National Rate

S272 Colorectal Cancer Screening Rates at HRSA-funded Health Centers in the United States Lag Behind the National Rate

We carry history within us: Anti-Black racism and the legacy of lynchings on life expectancy in the U.S. South.

The United States lags in life expectancy compared to most of the world's similarly wealthy nations, driven by pronounced regional disparities particularly between the South and the rest of the country. The U.S. South has a violent history of lynchings of Black Americans by White mobs after the ending of slavery and up to the Civil Rights Era. Building on critical race scholarship, the objective of this study was to determine whether there exists an association between historical lynchings and overall life expectancies in the U.S. South. We created a cross-sectional county-level data set with 1221 data points utilizing data from the Equal Justice Initiative and Robert Wood Johnson Foundation Country Health Rankings. The average life expectancy for 2019-2020 was 76.1 years, ranging from 68.2 years to 90.2 years. Overall life expectancy was found to be highest (76.6) in counties with no recorded lynchings, and lowest (75.5) in counties with the most lynchings (p<.001). In the spatially enabled regression model, the history of lynching along with other covariates explained 57.1% of the variance in life expectancies across the study area. Counties with a history of lynchings also score lower compared to the reference group in various socioeconomic indicators, including median household incomes and high school graduation rates. The findings suggest that lynchings were pivotal in creating the social and physical environment affecting health outcomes in the U.S. South today. We call for further public health research which acknowledges and explores this form of violent and institutional anti-Black racism as foundational to the nation's regional health disparities.

HPV Vaccination Champions: Evaluating a Technology-Mediated Intervention for Parents.

Human papillomavirus (HPV) vaccination prevents 6 HPV-related cancers in men and women. Yet, rates of HPV vaccination among adolescents in the United States lag behind other developed nations, revealing a significant public health issue. This feasibility study tested a collaborative online learning environment to cultivate HPV vaccination champions. A 3-month training program recruited parents to serve as proponents and social media influencers to identify solutions to overcome barriers to HPV vaccination. A mixed methods study design included a pretest survey, three online asynchronous focus groups, a posttest survey, as well as a longitudinal follow-up survey at 6 months. Participants included 22 parents who self-identified as female (95.4%) and white (90.9%). Overall, there was a statistically significant difference in knowledge of HPV and HPV vaccination between pretest and posttest (p = 0.0042). This technology-mediated intervention increased parents' confidence and motivated them to speak more freely about HPV vaccination in-person and online with others in their social networks. Participants identified prevalent misinformation about HPV vaccination and learned how to effectively craft messages to address concerns related to safety and side effects, gender, understanding of risk, and sexual activity. Objective measures and qualitative open-ended assessment showed high intervention engagement and treatment satisfaction. All participants (100%) indicated that they enjoyed participating in the intervention. The effectiveness of this feasibility study suggests that social media is an appropriate platform to empower parents to counter vaccine hesitancy and misinformation through HPV vaccination information that is simple and shareable in-person and online.

Occupational reconstructions: resources for social transformation in challenging times

Occupational reconstructions: resources for social transformation in challenging times

Literacy and Digital Problem -solving Skills in the 21st Century: What PIAAC Says about Educators in the United States, Canada, Finland and Japan

ABSTRACTThe purpose of our study is to delve into the education gap between the United States and some countries by examining the literacy and digital problem-solving skills of American educators, and comparing their performance with that of their peers from Canada, Finland, and Japan. We use PIAAC data collected by the Organization for Economic Co-operation and Development (OECD), and define educators as professionals with the highest level of qualification in the area of teacher training and education science. Our findings show that, internationally, U.S. educators are at a great disadvantage vis a vis their peers in Finland and Japan in terms of literacy, and they rank the lowest in digital problem-solving skills among the four studied countries. Other key findings include (a) in Canada and Finland, educators perform significantly higher in literacy than non-educators in their respective countries; (b) young educators in the United States (under age 35) lag far behind the same age group in Finland, Japan, and Canada; and (c) in all four countries, digital problem-solving skills of educators tend to decrease as their age increases. All statistical analyses are based on regression using sampling weights.

Cancer Drugs Provide Positive Value In Nine Countries, But The United States Lags In Health Gains Per Dollar Spent.

Cancer drugs account for a growing share of health care expenditure, raising questions about how much value is gained from their use. We used a proprietary international data set to examine real-world cancer drug consumption and expenditure in the period 2004-14 in Australia, Canada, France, Germany, Italy, Japan, Sweden, the United Kingdom, and the United States and to explore the value obtained. Even after adjusting for population and epidemiological factors, we found that the United States spent more than the other countries on cancer drugs, yet it often had lower utilization. All nine countries-most notably France and Japan-witnessed an improvement in neoplasm-related years of potential life lost, which suggests that although the costs of drugs have risen, their therapeutic benefits have increased as well. Net economic value derived from cancer drug expenditures appears to have remained positive, with base-case analyses indicating that the United States obtained an estimated $32.6billion in net positive return from cancer drug care in 2014. However, the United States lags behind other countries in health gains obtained per dollar spent on cancer drugs, which suggests an opportunity to improve value in the oncology drug market.

Television in the Age of Radio: Modernity, Imagination, and the Making of a MediumPhilip W.Sewell. New Brunswick, NJ: Rutgers University Press, 2014.

Television in the Age of Radio: Modernity, Imagination, and the Making of a Medium Philip W. Sewell. New Brunswick, NJ: Rutgers University Press, 2014.In the first half of the twentieth century, American television was stuck in limbo. It was in the minds and conversations of much of the nation but not in its living rooms. In 1935, television made its first appearance in Germany as part of the Nazi propaganda machine. In 1936, BBC television introduced highbrow entertainment to Great Britain. But it would take another dozen years before NBC and CBS inaugurated the first network broadcasts in America. Why did the United States lag so far behind? Part of the reason is the daunting technological challenge of broadcasting in a country whose borders are separated by thousands rather than hundreds of miles. And of course the Second World War diverted attention elsewhere. But America didn't enter the war until the end of 1941.According to Philip W. Sewell, the main reason for the delay is cultural. When ruled the airwaves, the nation was debating what the new medium ought to do and how it ought to do it. His book is not the standard chronology of technological advancements. Instead it offers up a cultural history of how America imagined television might be, before television actually was.One of the more interesting stories concerns the apparatus: the now forgotten competition between mechanical and electronic versions of television. The former, which used mechanical scanning devices to create an image, had been demonstrated as early as the 1880s. In the years following, people argued over whether images ought to be sent point-to-point (as via telegraph and telephone) or point-to-many-points. The popularity of network settled that debate in favor of broadcasting. They also argued over whether the new medium would transmit still images (like silhouettes and etchings) or moving images. The popularity of motion pictures settled that debate in favor of what were called radio movies. Then in 1927, the first all-electronic television was demonstrated and hailed as the better product. Mechanical television, which Sewell admits was less promising, never received a fair try. It lost early and quickly because the competition was controlled, not by technology but by public relations: network bureaucrats who had brought us broadcast had an unfair advantage.Here's how the debate was swayed. When hobbyists (like ham-radio enthusiasts) asked for do-it-yourself mechanical television sets, the NBC and CBS networks said the low-resolution quality of those sets couldn't measure up to what real television would be. …

Commentary—Toward a Research Agenda for Human-Centered Service System Innovation

Solving service problems has enormous practical consequences for the economy and society because (a) more than 80% of jobs in the United States are in the service sector, with most science, technology, engineering, and mathematics (STEM) graduates working in the service sector; (b) many complex service problems resist traditional optimization solutions; (c) private investments in platform technologies that underlie business and societal service innovations (smart service systems) are on the rise; and (d) the United States lags in public investment in service research behind countries such as Japan, China, Finland, and Germany. The search for service innovation requires new theories and new methods to address problems unique to services, and what little students are being taught about the service sector has not kept up with the rapid growth of STEM jobs in service or with modern entrepreneurial opportunities. We think that effective understanding of complex human-centered service systems requires a new approach that combines multiple methods, perhaps drawing from industrial engineering and operations research, social and behavioral sciences, information systems, and computer science and computational modeling. In this commentary, we outline a series of broad considerations and concerns, fundamental and applied questions, and specific research agenda items for service system innovation.

Cross-National Differences in Academic Achievement: Why the United States Lags behind Other Rich Nations

This article tests the hypothesis that national differences in academic achievement scores of 15-year-olds in 25 developed nations in 2003, 2006, and 2009 can be explained by national differences in national health and family economic security programs, levels of parental education, and national differences in motivation to strive for high levels of academic achievement. We also test for the additional impact, if any, of national differences in educational system characteristics. We then ask what variables account for the low scores of American students on math, science, and reading achievement tests. More highly developed national family health and economic security programs and higher student levels of motivation for academic achievement in other rich countries help explain why scores in the United States are relatively low. Low academic qualifications and prestige for teachers and a lack of national educational goals also differentiate the United States from nations with higher achievement scores.

Tracing the U.S. Deficit in PISA Reading Skills to Early Childhood

Why does the United States lag behind so many other countries on international education assessments? The traditional view targets school-based explanations—U.S. schools attract poorer teachers and lack the proper incentives. But the U.S. educational system may also serve children with comparatively greater academic challenges as a result of poorer social conditions. One way of gaining leverage on this issue is to understand when U.S. students fall behind their international counterparts. I first compare reading/vocabulary test scores for U.S. and Canadian children (ages 4-5) using National Longitudinal Study of Youth 1979–Children and Youth (NLSY79) and Canada’s National Longitudinal Study of Children and Youth (NLSCY). I then compare the magnitude of these differences to similar cohorts of students at ages 15 to 16 using data from the Programme for International Student Assessment (PISA). Findings indicate that while the Canadian advantage in PISA is substantial (0.30 standard deviation units), this advantage already existed at ages 4 to 5, before formal schooling had a chance to matter. I discuss the implications of this pattern for interpreting international test score rankings.

Mothers’ support for voluntary provision of HPV vaccine in schools

HPV vaccination rates among adolescents in the United States lag behind some other developed countries, many of which routinely offer the vaccine in schools. We sought to assess mothers’ willingness to have their adolescent daughters receive HPV vaccine at school. A national sample of mothers of adolescent females ages 11–14 completed our internet survey (response rate = 66%). The final sample ( n = 496) excluded mothers who did not intend to have their daughters receive HPV vaccine in the next year. Overall, 67% of mothers who intended to vaccinate their daughters or had vaccinated their daughters reported being willing to have their daughters receive HPV vaccine at school. Mothers were more willing to allow their daughters to receive HPV vaccine in schools if they had not yet initiated the vaccine series for their daughters or resided in the Midwest or West (all p < .05). The two concerns about voluntary school-based provision of HPV vaccine that mothers most frequently cited were that their daughters’ doctors should keep track of her shots (64%) and that they wished to be present when their daughters were vaccinated (40%). Our study suggests that most mothers who support adolescent vaccination for HPV find school-based HPV vaccination an acceptable option. Ensuring communication of immunization records with doctors and allowing parents to be present during immunization may increase parental support.

United States Lags on Palliative Care at the End of Life

United States Lags on Palliative Care at the End of Life

Why the United States lags in auto safety and lessons it can import

The United States has slipped in recent decades from its role of leadership in combating road crash injuries. The early promise of the country's approach to vehicle safety regulation, adopted by law in 1966, has suffered because of decades of regulatory inertia caused by antiregulatory government policies, industry obstructionism, and failure to set meaningful goals. Meanwhile, other industrial nations have vastly outpaced the United States in reducing crash deaths and injuries. The Obama administration is thus challenged to learn from other nations' successes while reestablishing the US presence as a vigorous proponent of effective crash injury reduction strategies. It can best accomplish this by crafting approaches and objectives that reduce motor vehicle use, reduce harmful disparities within the US vehicle population, and reduce motor vehicle travel speeds.