8,349 results on '"United States Dept. of Health and Human Services"'
Search Results
52. International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering
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Jon Mankowski, Penney Cowan, Robert Twillman, Phillip S. Keck, Cathleen London, Beverly E. Thorn, Richard L. Stieg, Patti Robinson, Stefan G. Kertesz, Celeste Cheek, Beth D. Darnall, Travis I. Lovejoy, Sally L. Satel, Marie Ljosenvoor, Jessica R. Stewart, Terri A. Lewis, Anne L. J. Burke, Justin Dunaway, Melissa Cady, James B. Lakehomer, Diane E. Hoffman, Ming-Chih J. Kao, Mark A. Lumley, Cynthia E. Laux, Meredith Craigie, Kristine Watford, Stephani Sutherland, Richard L. Martin, Joshua L. Kirz, Marian Wilson, Ajay Manhapra, Kate M. Nicholson, James W. Broatch, Andrea D Furlan, Kate Lorig, Greg Hartley, Brent Van Dorsten, Megan Wilson, Richard A. Lawhern, Peter Grinspoon, Andrea Anderson, Adam J. Gordon, Michael E Schatman, Debra B. Gordon, Kari Kruska, Steven R. Ariens, Melita J. Giummarra, Jessica Whelan, Barby Ingle, Marc S. Rubenstein, Steven R. Henson, Michael S. Leong, Danial Laird, Mark J. Zobrosky, Robert I. Cohen, Lisa Davis Budzinski, Jeffrey Fudin, T. Wade Martin, Kashelle Lockman, Scott E. Hadland, Fiona Hodson, J. Julian Grove, Susan Lawson, Robert W. West, Kathleen S. Brown, Mechele Fillman, Dokyoung S. You, Becky Brandt, Kimeron Hardin, Julio A. Gonzalez-Sotomayor, Carol S. Palackdharry, Rosemary C. Polomano, Geralyn Datz, Jennifer Barnhouse, Jason N. Doctor, Sean Mackey, David N. Juurlink, Maurice D. Gregory, Thérèse Ledantec-Boswell, Aaron Perez, John A. Sturgeon, Chad D. Kollas, Debbie Nickels Heck, Amy Kukucka, Sarah Gray, Pamela Flood, Stephan A. Schug, Marlisa Griffith, Eileen Schonfeld, Joel Katz, Linda Ellsworth, Stacy Ogbeide, Kristie Walters, James Ray, James G. Marx, Heath B. McAnally, Keith Humphreys, Theresa Mallick-Searle, Jennifer Sharpe Potter, Owen Douglas Williamson, Bruce Singer, Roger B. Fillingim, Robert D. Kerns, and Jennifer L. Murphy
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business.industry ,Perspective & Commentary ,Stakeholder ,Tapering ,General Medicine ,Public relations ,Opioid-Related Disorders ,United States ,Analgesics, Opioid ,Anesthesiology and Pain Medicine ,Action (philosophy) ,Opioid ,Humans ,Pain Management ,Medicine ,United States Dept. of Health and Human Services ,Neurology (clinical) ,Practice Patterns, Physicians' ,business ,medicine.drug - Published
- 2018
53. Client Preferences for Contraceptive Counseling: A Systematic Review
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Rachel B. Rosmarin, Arlene Reyna, Lauren B. Zapata, Nikita M. Malcolm, Edith Fox, Susan Moskosky, Brittni N. Frederiksen, and Christine Dehlendorf
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Counseling ,Epidemiology ,Population ,Psychological intervention ,MEDLINE ,Context (language use) ,Medical and Health Sciences ,Article ,Education ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,Behavioral and Social Science ,Humans ,030212 general & internal medicine ,education ,Human services ,Medical education ,education.field_of_study ,030219 obstetrics & reproductive medicine ,Contraception/Reproduction ,Public Health, Environmental and Occupational Health ,Patient Preference ,United States ,Contraception ,Good Health and Well Being ,Systematic review ,Family planning ,Family Planning Services ,United States Dept. of Health and Human Services ,Public Health ,Psychology ,Qualitative research - Abstract
Context Providers can help clients achieve their personal reproductive goals by providing high-quality, client-centered contraceptive counseling. Given the individualized nature of contraceptive decision making, provider attention to clients’ preferences for counseling interactions can enhance client centeredness. The objective of this systematic review was to summarize the evidence on what preferences clients have for the contraceptive counseling they receive. Evidence acquisition This systematic review is part of an update to a prior review series to inform contraceptive counseling in clinical settings. Sixteen electronic bibliographic databases were searched for studies related to client preferences for contraceptive counseling published in the U.S. or similar settings from March 2011 through November 2016. Because studies on client preferences were not included in the prior review series, a limited search was conducted for earlier research published from October 1992 through February 2011. Evidence synthesis In total, 26 articles met inclusion criteria, including 17 from the search of literature published March 2011 or later and nine from the search of literature from October 1992 through February 2011. Nineteen articles included results about client preferences for information received during counseling, 13 articles included results about preferences for the decision-making process, 13 articles included results about preferences for the relationship between providers and clients, and 11 articles included results about preferences for the context in which contraceptive counseling is delivered. Conclusions Evidence from the mostly small, qualitative studies included in this review describes preferences for the contraceptive counseling interaction. Provider attention to these preferences may improve the quality of family planning care; future research is needed to explore interventions designed to meet preferences. Theme information This article is part of a theme issue entitled Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services, which is sponsored by the Office of Population Affairs, U.S. Department of Health and Human Services.
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- 2018
54. Contraceptive Counseling in Clinical Settings: An Updated Systematic Review
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Karen Pazol, Rachel B. Rosmarin, Brittni N. Frederiksen, Lauren B. Zapata, Nikita M. Malcolm, Kathryn M. Curtis, and Christine Dehlendorf
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Counseling ,Comparative Effectiveness Research ,medicine.medical_specialty ,Adolescent ,Epidemiology ,Population ,MEDLINE ,Psychological intervention ,Context (language use) ,Medical and Health Sciences ,Article ,Education ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Clinical Research ,Behavioral and Social Science ,medicine ,Humans ,030212 general & internal medicine ,Young adult ,education ,Human services ,Pediatric ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Prevention ,Public Health, Environmental and Occupational Health ,Health Services ,United States ,Good Health and Well Being ,Contraception ,Systematic review ,Family planning ,Family Planning Services ,Family medicine ,United States Dept. of Health and Human Services ,Public Health ,business - Abstract
Context The objective of this systematic review was to update a prior review and summarize the evidence (newly identified and cumulative) on the impact of contraceptive counseling provided in clinical settings. Evidence acquisition Multiple databases, including PubMed, were searched during 2016–2017 for articles published from March 1, 2011, to November 30, 2016. Evidence synthesis The search strategy identified 24,953 articles; ten studies met inclusion criteria. Two of three new studies that examined contraceptive counseling interventions (i.e., enhanced models to standard of care) among adolescents and young adults found a statistically significant positive impact on at least one outcome of interest. Five of seven new studies that examined contraceptive counseling, in general, or specific counseling interventions or aspects of counseling (e.g., personalization) among adults or mixed populations (adults and adolescents) found a statistically significant positive impact on at least one outcome of interest. In combination with the initial review, six of nine studies among adolescents and young adults and 16 of 23 studies among adults or mixed populations found a statistically significant positive impact of counseling on at least one outcome of interest. Conclusions Overall, evidence supports the utility of contraceptive counseling, in general, and specific interventions or aspects of counseling. Promising components of contraceptive counseling were identified. The following would strengthen the evidence base: improved documentation of counseling content and processes, increased attention to the relationships between client experiences and behavioral outcomes, and examining the comparative effectiveness of different counseling approaches to identify those that are most effective. Theme information This article is part of a theme issue entitled Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services, which is sponsored by the Office of Population Affairs, U.S. Department of Health and Human Services.
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- 2018
55. Integrating Federal Collaboration in HIV Programming: The CAPUS Demonstration Project, 2012-2016
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Gerlinda G. Somerville, Mesfin S. Mulatu, Kim M. Williams, Timothy P. Harrison, Albert E. Barskey, Erica Dunbar, Anita Edwards, and Sonsiere Cobb-Souza
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030505 public health ,Public Health, Environmental and Occupational Health ,Human immunodeficiency virus (HIV) ,HIV Infections ,Health Status Disparities ,medicine.disease_cause ,Health Services Accessibility ,United States ,03 medical and health sciences ,Engineering management ,Interinstitutional Relations ,0302 clinical medicine ,Political science ,Commentary ,medicine ,Humans ,United States Dept. of Health and Human Services ,030212 general & internal medicine ,Centers for Disease Control and Prevention, U.S ,Cooperative Behavior ,0305 other medical science ,Minority Groups - Published
- 2018
56. Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services
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Katherine A. Ahrens and Susan Moskosky
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Process management ,Epidemiology ,Computer science ,media_common.quotation_subject ,Public Health, Environmental and Occupational Health ,MEDLINE ,United States ,Systematic review ,Family planning ,Family Planning Services ,Humans ,United States Dept. of Health and Human Services ,Quality (business) ,Centers for Disease Control and Prevention, U.S ,Systematic Reviews as Topic ,media_common - Published
- 2018
57. Enhancing HIV Prevention and Care Through CAPUS and Other Demonstration Projects Aimed at Achieving National HIV/AIDS Strategy Goals, 2010-2018
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Janet C. Cleveland, Stephen A. Flores, Linda J. Koenig, David W. Purcell, and Jonathan Mermin
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0301 basic medicine ,medicine.medical_specialty ,MEDLINE ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Humans ,Patient Navigation ,Medicine ,030212 general & internal medicine ,Minority Groups ,Acquired Immunodeficiency Syndrome ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,Health Status Disparities ,Continuity of Patient Care ,medicine.disease ,030112 virology ,United States ,Interinstitutional Relations ,Family medicine ,Commentary ,United States Dept. of Health and Human Services ,Centers for Disease Control and Prevention, U.S ,business ,Goals - Published
- 2018
58. Impact of Contraceptive Education on Knowledge and Decision Making: An Updated Systematic Review
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Rachel B. Rosmarin, Lauren B. Zapata, Christine Dehlendorf, Nikita M. Malcolm, Karen Pazol, and Brittni N. Frederiksen
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Health Knowledge, Attitudes, Practice ,Epidemiology ,Decision Making ,Population ,Psychological intervention ,03 medical and health sciences ,0302 clinical medicine ,Contraceptive Agents ,Health care ,Humans ,030212 general & internal medicine ,education ,Contraception Behavior ,Health Education ,Human services ,Reproductive health ,Medical education ,education.field_of_study ,030219 obstetrics & reproductive medicine ,business.industry ,Behavior change ,Public Health, Environmental and Occupational Health ,United States ,Contraception ,Systematic review ,Family planning ,Family Planning Services ,United States Dept. of Health and Human Services ,Centers for Disease Control and Prevention, U.S ,Psychology ,business - Abstract
Context Educational interventions can help individuals increase their knowledge of available contraceptive methods, enabling them to make informed decisions and use contraception correctly. This review updates a previous review of contraceptive education. Evidence acquisition Multiple databases were searched for articles published March 2011–November 2016. Primary outcomes were knowledge, participation in and satisfaction/comfort with decision making, attitudes toward contraception, and selection of more effective methods. Secondary outcomes included contraceptive behaviors and pregnancy. Excluded articles described interventions that had no comparison group, could not be conducted feasibly in a clinic setting, or were conducted outside the U.S. or similar country. Evidence synthesis A total of 24,953 articles were identified. Combined with the original review, 37 articles met inclusion criteria and described 31 studies implementing a range of educational approaches (interactive tools, written materials, audio/videotapes, and text messages), with and without healthcare provider feedback, for a total of 36 independent interventions. Of the 31 interventions for which knowledge was assessed, 28 had a positive effect. Fewer were assessed for their effect on attitudes toward contraception, selection of more effective methods, contraceptive behaviors, or pregnancy—although increased knowledge was found to mediate additional outcomes (positive attitudes toward contraception and contraceptive continuation). Conclusions This systematic review is consistent with evidence from the broader healthcare field in suggesting that a range of interventions can increase knowledge. Future studies should assess what aspects are most effective, the benefits of including provider feedback, and the extent to which educational interventions can facilitate behavior change and attainment of reproductive health goals. Theme information This article is part of a theme issue entitled Updating the Systematic Reviews Used to Develop the U.S. Recommendations for Providing Quality Family Planning Services, which is sponsored by the Office of Population Affairs, U.S. Department of Health and Human Services.
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- 2018
59. CARES Act provider relief fund aid to dermatologists in response to coronavirus disease 2019 (COVID-19)
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Neha, Gupta and Harib H, Ezaldein
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Financing, Government ,Professional Practice Location ,COVID-19 ,Humans ,United States Dept. of Health and Human Services ,United States ,Dermatologists ,Retrospective Studies - Published
- 2021
60. The Urgent Need for Public Health Preparedness Funding and Support
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Kimberley Shoaf, John T. Thompson, David Dyjack, Christopher Atchison, Jonathan Links, Linda C. Degutis, Bernard Turnock, Margaret Potter, Debra Olson, Lisle Hites, and Tomás J. Aragón
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Budgets ,medicine.medical_specialty ,Financing, Government ,business.industry ,Best practice ,Public health ,Public Health, Environmental and Occupational Health ,Disaster Planning ,Public relations ,United States ,First responder ,Work (electrical) ,Political science ,Preparedness ,Opinions, Ideas, & Practice ,Workforce ,medicine ,Criticism ,Humans ,United States Dept. of Health and Human Services ,Public Health ,business ,Curriculum ,Pandemics ,health care economics and organizations - Abstract
Criticism of the Centers for Disease Control and Prevention (CDC) and its efforts to put forth recommendations and data based on core public health practice and principles is contrary to the realities of the work that the CDC has done on preparedness in past decades In 2001, the CDC funded a project intended to facilitate the development of an integrated national system of Academic Centers for Public Health Preparedness (CPHPs) to train frontline public health professionals who respond to bioterrorist incidents and other emerging infectious diseases Nineteen CPHPs were funded until the program was discontinued in August 2010 and replaced by 14 Preparedness and Emergency Response Learning Centers, whose funding ended in 2018 2 CPHPs worked to identify core principles for public health preparedness and response, strategies for local and state data collection, and curricula and best practices for educating the public health and first responder workforce
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- 2021
61. Narrowing but persisting gender pay gap among employees of the US Department of Health and Human Services during 2010-2018
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Zhuo Chen, Yuheng Wang, Ruoxi Wang, Huabin Luo, Yihong Zhang, Janani Rajbhandari-Thapa, Donglan Zhang, and Grace Bagwell-Adams
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Male ,Medicine (General) ,Public Administration ,Occupational segregation ,Health administration ,R5-920 ,0502 economics and business ,050602 political science & public administration ,Humans ,050207 economics ,Occupations ,Human services ,Social policy ,Earnings ,Research ,05 social sciences ,Public Health, Environmental and Occupational Health ,Health services research ,US Department of Health and Human Services ,Gender pay gap ,Health workforce ,United States ,0506 political science ,Workforce ,Income ,Demographic economics ,Female ,United States Dept. of Health and Human Services ,Business ,Public aspects of medicine ,RA1-1270 - Abstract
Background The gender pay gap in the United States (US) has narrowed over the last several decades, with the female/male earnings ratio in the US increased from about 60% before the 1980s to about 79% by 2014. However, the gender pay gap among the healthcare workforce persists. The objective of this study is to estimate the gender pay gap in the US federal governmental public health workforce during 2010–2018. Methods We used an administrative dataset including annual pay rates and job characteristics of employees of the US Department of Health and Human Services. Employees’ gender was classified based on first names. Regression analyses were used to estimate the gender pay gap using the predicted gender. Results Female employees of the DHHS earned about 13% less than men in 2010, and 9.2% less in 2018. Occupation, pay plan, and location explained more than half of the gender pay gap. Controlling for job grade further reduces the gap. The unexplained portion of the gender pay gap in 2018 was between 1.0 and 3.5%. Female employees had a slight advantage in terms of pay increase over the study period. Conclusions While the gender pay gap has narrowed within the last two decades, the pay gap between female and male employees in the federal governmental public health workforce persists and warrants continuing attention and research. Continued efforts should be implemented to reduce the gender pay gap among the health workforce.
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- 2021
62. The Origins and Drafting of the
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Tom L, Beauchamp
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Biomedical Research ,Human Experimentation ,Informed Consent ,National Institutes of Health (U.S.) ,Politics ,Humans ,United States Dept. of Health and Human Services ,History, 20th Century ,History, 21st Century ,United States ,Ethics, Research - Abstract
This article describes the origins and drafting of the Belmont Report by members of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.
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- 2021
63. The Revised Common Rule and Mental Illness: Enduring Gaps in Protections
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Lisa E. Smilan
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medicine.medical_specialty ,Health (social science) ,Biomedical Research ,Coercion ,Mental Disorders ,Decision Making ,General Medicine ,Mental illness ,medicine.disease ,Vulnerable Populations ,United States ,Ethics, Research ,Human Experimentation ,Common Rule ,medicine ,Humans ,Mental Competency ,United States Dept. of Health and Human Services ,Psychiatry ,Psychology ,Law - Published
- 2021
64. What Is Human Research For? Reflections on the Omission of Scientific Integrity from the
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Jonathan, Kimmelman
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Biomedical Research ,Human Experimentation ,Informed Consent ,Research Support as Topic ,Politics ,Scientific Misconduct ,Community Participation ,Humans ,United States Dept. of Health and Human Services ,United States ,Ethics, Research - Abstract
The Belmont Report has provided a useful and virtually universal framework for protecting human subjects from research abuses. However, it provides little to no guidance on the substance of human research. In an environment where major decisions concerning health-care access, funding, and regulation hinge on human research, this omission leaves downstream users of human research virtually unprotected and with few tools or frameworks to protect against a variety of practices that compromise the social value of human research. This essay advocates for the addition of a fourth principle to the Belmont three: "scientific integrity." Such a principle would seek to train human research on important social objectives while maximizing the accessibility, credibility, and generalizability of findings.
- Published
- 2021
65. Surgeon General Tackles Workplace Well-being.
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Suran M
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- Humans, Workplace, Working Conditions, Occupational Health, United States Dept. of Health and Human Services
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- 2022
- Full Text
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66. HHS Releases New Report on Long COVID Experiences.
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Suran M
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- Humans, COVID-19, United States, United States Dept. of Health and Human Services, Post-Acute COVID-19 Syndrome
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- 2022
- Full Text
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67. Essential but Undefined - Reimagining How Policymakers Identify Safety-Net Hospitals
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Paula Chatterjee, Benjamin D. Sommers, and Karen E. Joynt Maddox
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2019-20 coronavirus outbreak ,Financing, Government ,media_common.quotation_subject ,Safety net ,Immigration ,MEDLINE ,Uncompensated Care ,030204 cardiovascular system & hematology ,Medicare ,Reimbursement Mechanisms ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Humans ,030212 general & internal medicine ,Financial circumstances ,Health policy ,media_common ,Finance ,business.industry ,Medicaid ,Health Policy ,COVID-19 ,General Medicine ,United States ,United States Dept. of Health and Human Services ,business ,Safety-net Providers ,Insurance coverage - Abstract
Essential but Undefined Safety-net hospitals provide essential care to patients regardless of their insurance coverage, financial circumstances, or immigration status, and they often operate with t...
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- 2020
68. Pharmacies Partner With HHS to Provide COVID-19 Vaccines
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Rita Rubin
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Pharmacies ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,COVID-19 ,Pharmacy ,General Medicine ,Supply & distribution ,United States ,Family medicine ,medicine ,Humans ,United States Dept. of Health and Human Services ,business - Published
- 2020
69. Children's Hospitals and Impact of COVID-19
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Rajashree Koppolu
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2019-20 coronavirus outbreak ,Financing, Government ,Coronavirus disease 2019 (COVID-19) ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Hospitals, Pediatric ,Virology ,United States ,Pediatrics, Perinatology and Child Health ,Medicine ,Humans ,United States Dept. of Health and Human Services ,Pediatrics, Perinatology, and Child Health ,business ,Child ,Medicaid ,Pandemics ,Safety-net Providers - Published
- 2020
70. Bridging the Gap at Warp Speed — Delivering Options for Preventing and Treating Covid-19
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Janet Woodcock, Shannon E Greene, and Moncef Slaoui
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2019-20 coronavirus outbreak ,Bridging (networking) ,Process management ,Biomedical Research ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Public-Private Sector Partnership ,030204 cardiovascular system & hematology ,Antiviral Agents ,Public-Private Sector Partnerships ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Drug Development ,Drug approval ,Medicine ,Humans ,Immunologic Factors ,030212 general & internal medicine ,Drug Approval ,Pandemics ,Warp drive ,business.industry ,SARS-CoV-2 ,United States Food and Drug Administration ,Antibodies, Monoclonal ,COVID-19 ,General Medicine ,United States Department of Defense ,United States ,Drug development ,United States Dept. of Health and Human Services ,business ,Coronavirus Infections - Abstract
Bridging the Gap at Warp Speed In addition to its goal of delivering safe and effective vaccines quickly, Operation Warp Speed aims to combat Covid-19 by improving the use of existing therapies and...
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- 2020
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71. Policy Lessons from Our Covid Experience
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Gail R. Wilensky
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2019-20 coronavirus outbreak ,Economic growth ,Coronavirus disease 2019 (COVID-19) ,media_common.quotation_subject ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,MEDLINE ,Federal Government ,Security Measures ,Government Agencies ,medicine ,Humans ,Pandemics ,Health policy ,media_common ,business.industry ,Viral Epidemiology ,Health Policy ,COVID-19 ,General Medicine ,medicine.disease ,United States ,Pneumonia ,Unemployment ,United States Dept. of Health and Human Services ,business ,Coronavirus Infections - Abstract
Policy Lessons from Our Covid Experience As the U.S. economy reopens, it’s important to assess how we can be better prepared to stave off such enormous economic losses during the next Covid-19 wave...
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- 2020
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72. A National Commitment to Improve the Care of Patients With Hypertension in the US
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Jerome M. Adams and Janet S. Wright
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Health Policy ,MEDLINE ,General Medicine ,Health Promotion ,United States ,Health promotion ,Family medicine ,Hypertension ,Medicine ,Humans ,United States Dept. of Health and Human Services ,business ,Health policy - Published
- 2020
73. The influence of the U.S. response to COVID-19 in Global Health
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Fabius Vieira, Leineweber and Jorge Antonio Zepeda, Bermudez
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COVID-19 Vaccines ,Economics ,Political Systems ,International Cooperation ,COVID-19 ,Global Health ,Health Services Accessibility ,United States ,Resource Allocation ,COVID-19 Testing ,Costs and Cost Analysis ,Health Resources ,Humans ,United States Dept. of Health and Human Services ,Diffusion of Innovation ,Developing Countries ,Pandemics - Abstract
The American response to the pandemic involves a prominent volume of federal resources, especially for developing and acquiring products for internal use, such as diagnostics or vaccines. Investment mechanisms and historical aspects justify this expenditure. Thus, the social construction of nationalism in American society hinders access to health technologies. The review of such aspects shows how the United States (U.S.) secured a large number of potential products, ensuring excessive local production. This unilateral foreign policy has influenced other countries or regional blocs and undermined global cooperation and solidarity, affecting the collective health of several nations.A resposta americana à pandemia envolve um proeminente volume de recursos federais, em especial destinados ao desenvolvimento e aquisição de produtos no uso interno, como diagnósticos ou vacinas. As justificativas para esse desembolso se baseiam em mecanismos de investimentos e aspectos históricos. Assim, a construção social do nacionalismo na formação na sociedade americana prejudica o acesso a tecnologias em saúde. A revisão desses aspectos demonstra como os Estados Unidos (EUA) garantiram compra de grande quantitativo de produtos em potencial, inclusive assegurando excessiva produção local. Essa política externa unilateral tem influenciado outros países ou blocos regionais e prejudicado a cooperação e a solidariedade global com impacto na saúde coletiva de diversas nações.
- Published
- 2020
74. Struggle for the Soul of Medicaid
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Nicole Huberfeld, Sidney D. Watson, and Alison Barkoff
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media_common.quotation_subject ,MEDLINE ,Eligibility Determination ,Federal Government ,Public administration ,0603 philosophy, ethics and religion ,Health Services Accessibility ,Insurance Coverage ,03 medical and health sciences ,0302 clinical medicine ,Political science ,Humans ,030212 general & internal medicine ,Poverty ,media_common ,Medicaid ,Health Policy ,Patient Protection and Affordable Care Act ,Politics ,06 humanities and the arts ,General Medicine ,United States ,Issues, ethics and legal aspects ,Policy ,Work (electrical) ,Accountability ,United States Dept. of Health and Human Services ,060301 applied ethics ,Soul ,Administration (government) ,Health reform ,State Government - Abstract
Medicaid is uniquely equipped to serve low-income populations. We identify four features that form the “soul” of Medicaid, explain how the administration is testing them, and explore challenges in accountability contributing to this struggle. We highlight the work of watchdogs acting to protect Medicaid and conclude with considerations for future health reform.
- Published
- 2020
75. Tracking Substance Use Complications: A Collaborative Analysis of Public Health and Academic Medical Center Records on Drug Use-Associated Infective Endocarditis
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Elizabeth A. Talbot, Benjamin P Chan, Stephen Conn, David de Gijsel, Martha DesBiens, and David J. Laflamme
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Drug ,Male ,medicine.medical_specialty ,Health Information Exchange ,Substance-Related Disorders ,media_common.quotation_subject ,Datasets as Topic ,Patient Discharge Summaries ,Population health ,030204 cardiovascular system & hematology ,Drug Users ,03 medical and health sciences ,0302 clinical medicine ,Public health surveillance ,medicine ,Immunology and Allergy ,Electronic Health Records ,Humans ,New Hampshire ,030212 general & internal medicine ,media_common ,Retrospective Studies ,Discharge diagnosis ,Academic Medical Centers ,Endocarditis ,business.industry ,Public health ,Middle Aged ,medicine.disease ,United States ,Infectious Diseases ,Infective endocarditis ,Female ,United States Dept. of Health and Human Services ,Tracking (education) ,Medical emergency ,Substance use ,business - Abstract
Background Healthcare systems and public health agencies use different methods to measure the impact of substance use (SU) on population health. We studied the ability of systems to accurately capture data on drug use-associated infective endocarditis (DUA-IE). Methods We conducted a retrospective analysis of patients with IE discharge diagnosis from an academic medical center, 2011–2017, comparing data from hospital Electronic Health Record (EHR) to State Uniform Hospital Discharge Data Set (UHDDS). To identify SU we developed a composite measure. Results EHR identified 472 IE discharges (430 of these were captured in UHDDS); 406 (86.0%) were correctly coded based on chart review. IE discharges increased from 57 to 92 (62%) from 2012 to 2017. Hospitalizations for the subset of DUA-IE identified by any measure of SU increased from 10 to 54 (440%). Discharge diagnosis coding identified 128 (60.7%) of total DUA-IE hospitalizations. The composite measure identified an additional 65 (30.8%) DUA-IE hospitalizations and chart review an additional 18 (8.5%). Conclusions The failure of discharge diagnosis coding to identify DUA-IE in 40% of hospitalizations demonstrates the need for better systems to capture the impact of SU. Collaborative data sharing could help improve surveillance responsiveness to address an emerging public health crises.
- Published
- 2020
76. The Importance of Reestablishing a Pandemic Preparedness Office at the White House
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Gail R. Wilensky
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Pneumonia, Viral ,Disaster Planning ,Federal Government ,Strategic Stockpile ,Betacoronavirus ,Pandemic ,medicine ,Humans ,Pandemics ,Health policy ,White (horse) ,biology ,SARS-CoV-2 ,business.industry ,Pandemic preparedness ,COVID-19 ,General Medicine ,medicine.disease ,biology.organism_classification ,United States ,United States Government Agencies ,Pneumonia ,Emergency medicine ,United States Dept. of Health and Human Services ,Coronavirus Infections ,business - Published
- 2020
- Full Text
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77. Implications of Proposed Changes to Models of Care for Kidney Disease
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Tamara M Kear
- Subjects
medicine.medical_specialty ,business.industry ,Health Policy ,Nephrology Nursing ,MEDLINE ,General Medicine ,medicine.disease ,Kidney Transplantation ,United States ,Renal Dialysis ,Practice Guidelines as Topic ,Medicine ,Humans ,Kidney Failure, Chronic ,Organizational Objectives ,United States Dept. of Health and Human Services ,business ,Intensive care medicine ,General Nursing ,Health policy ,Kidney transplantation ,Kidney disease - Abstract
A foreshadowing of changes for other populations and nursing specialties?
- Published
- 2020
78. COVID-19 and the Need for a National Health Information Technology Infrastructure
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Hardeep Singh and Dean F. Sittig
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Coronavirus disease 2019 (COVID-19) ,Health information technology ,Pneumonia, Viral ,MEDLINE ,Health informatics ,Betacoronavirus ,Pandemic ,medicine ,Electronic Health Records ,Humans ,Bioethical Issues ,Pandemics ,biology ,business.industry ,SARS-CoV-2 ,Data Collection ,Information technology ,COVID-19 ,General Medicine ,biology.organism_classification ,medicine.disease ,United States ,Pneumonia ,Population Surveillance ,United States Dept. of Health and Human Services ,Medical emergency ,Emergencies ,business ,Coronavirus Infections ,Medical Informatics - Published
- 2020
- Full Text
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79. Telemedicine for Diabetes After the COVID-19 Pandemic: We Can’t Put the Toothpaste Back in the Tube or Turn Back the Clock
- Author
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David C. Klonoff
- Subjects
2019-20 coronavirus outbreak ,Telemedicine ,Coronavirus disease 2019 (COVID-19) ,Endocrinology, Diabetes and Metabolism ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Biomedical Engineering ,Bioengineering ,Betacoronavirus ,Special Section: Personal Experiences With COVID-19 and Diabetes: An International Perspective ,Pandemic ,Internal Medicine ,medicine ,Diabetes Mellitus ,Humans ,Tube (container) ,Pandemics ,business.industry ,SARS-CoV-2 ,COVID-19 ,Diabetes mellitus therapy ,medicine.disease ,United States ,United States Dept. of Health and Human Services ,Medical emergency ,business ,Coronavirus Infections - Published
- 2020
80. Regional Differences in the Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2017
- Author
-
Holly, Hedegaard, Brigham A, Bastian, James P, Trinidad, Merianna R, Spencer, and Margaret, Warner
- Subjects
Fentanyl ,Heroin ,Vital Statistics ,Cocaine ,Residence Characteristics ,Poisoning ,Humans ,United States Dept. of Health and Human Services ,Drug Overdose ,United States ,Methamphetamine - Abstract
Objective-This report describes regional differences in the specific drugs most frequently involved in drug overdose deaths in the United States in 2017. Methods-Data from the 2017 National Vital Statistics System-Mortality files were linked to electronic files containing literal text information from death certificates. Drug overdose deaths were identified using International Classification of Diseases, 10th Revision underlying cause-of-death codes X40-X44, X60-X64, X85, and Y10-Y14. Drug mentions were identified using established methods for searching the literal text from death certificates. Deaths were assigned to 1 of 10 U.S. Department of Health and Human Services (HHS) regions based on the decedent's state of residence. The number and age-adjusted death rate was determined for the 10 drugs most frequently involved in drug overdose deaths in 2017, both nationally and for each HHS region. Deaths involving more than one drug were counted in all relevant drug categories (i.e., the same death could be counted in more than one drug category). Results-Among drug overdose deaths in 2017 that mentioned at least 1 specific drug on the death certificate, the 10 drugs most frequently involved included fentanyl, heroin, cocaine, methamphetamine, alprazolam, oxycodone, morphine, methadone, hydrocodone, and diphenhydramine. Regionally, 6 drugs (alprazolam, cocaine, fentanyl, heroin, methadone, and oxycodone) were found among the 10 most frequently involved drugs in all 10 HHS regions, although the relative ranking varied by region. Age-adjusted rates of drug overdose deaths involving fentanyl or deaths involving cocaine were higher in the regions east of the Mississippi River, while age-adjusted rates for drug overdose deaths involving methamphetamine were higher in the West. The regional patterns observed did not change after adjustment for differences in the specificity of drug reporting. Conclusions-The drugs most frequently involved in drug overdose deaths in 2017 varied by HHS region. Understanding the regional differences can help inform local prevention and policy efforts.
- Published
- 2020
81. Public health reporting and outbreak response: synergies with evolving clinical standards for interoperability
- Author
-
Jon Duke, Saugat Karki, Ninad K. Mishra, and Leslie A. Lenert
- Subjects
medicine.medical_specialty ,020205 medical informatics ,0206 medical engineering ,Internet privacy ,Interoperability ,Sexually Transmitted Diseases ,Health Informatics ,02 engineering and technology ,Disease ,Disease Outbreaks ,Health Information Systems ,Public health surveillance ,Health care ,0202 electrical engineering, electronic engineering, information engineering ,medicine ,Electronic Health Records ,Humans ,Public Health Surveillance ,Health Level Seven ,Data collection ,Application programming interface ,business.industry ,Health Information Interoperability ,Information Dissemination ,Public health ,Health information exchange ,United States ,Perspective ,United States Dept. of Health and Human Services ,Public Health ,business ,020602 bioinformatics ,Confidentiality ,Software - Abstract
Public health needs up-to-date information for surveillance and response. As healthcare application programming interfaces become widely available, a novel data gathering mechanism could provide public health with critical information in a timely fashion to respond to a fast-moving epidemic. In this article, we extrapolate from our experiences using a Fast Healthcare Interoperability Resource-based architecture for infectious disease surveillance for sexually transmitted diseases to its application to gather case information for an outbreak. One of the challenges with a fast-moving outbreak is to accurately assess its demand on healthcare resources, since information specific to comorbidities is often not available. These comorbidities are often associated with poor prognosis and higher resource utilization. If the comorbidity data and other clinical information were readily available to public health workers, they could better address community disruption and manage healthcare resources. The use of FHIR resources available through application programming and filtered through tools such as described herein will give public health the flexibility needed to investigate rapidly emerging disease while protecting patient privacy.
- Published
- 2020
82. Perspectives on donor lung allocation from both sides of the Atlantic: The United States
- Author
-
Marie Budev, Laurie D. Snyder, and Wayne Tsuang
- Subjects
United Network for Organ Sharing ,Tissue and Organ Procurement ,Waiting Lists ,030230 surgery ,Article ,Resource Allocation ,Unit (housing) ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Operations management ,Lung ,Human services ,Transplantation ,Government ,business.industry ,Tissue Donors ,United States ,Organ procurement ,General partnership ,United States Dept. of Health and Human Services ,030211 gastroenterology & hepatology ,business ,Lung Transplantation ,Lung allocation score - Abstract
Donor lung allocation in the United States focuses on decreasing waitlist mortality and improving recipient outcomes. The implementation of allocation policy to match deceased donor lungs to waitlisted patients occurs through a unique partnership between government and private organizations, namely the Organ Procurement and Transplantation Network under the Department of Health and Human Services and the United Network for Organ Sharing. In 2005, the donor lung allocation algorithm shifted towards the prioritization of medical urgency of waitlisted patients instead of time accrued on the waitlist. This led to the Lung Allocation Score, which weighs over a dozen clinical variables to predict a one-year estimate of survival benefit, and is used to prioritize waitlisted patients. In 2017 the use of local allocation boundaries was eliminated in favor of a 250 nautical mile radius from the donor hospital as the first unit of distance used in allocation. The next upcoming iteration of donor allocation policy is expected to use a continuous distribution algorithm where all geographic boundaries are eliminated. There are additional opportunities to improve donor lung allocation, such as for patients with high antibody titers with access to a limited number of donors..
- Published
- 2020
83. Mass Air Medical Repatriation of Coronavirus Disease 2019 Patients
- Author
-
Steven Brown, Ray Bennett, Heather M. Shannon, Angela P. Cornelius, Corrine Foster, Stacy McCarthy, Kristy Rodriguez, Steven Bachini, Brian Cornelius, Christine Collins, and Leah Crisafi
- Subjects
medicine.medical_specialty ,China ,business.product_category ,Health Personnel ,Pneumonia, Viral ,Personnel Staffing and Scheduling ,Federal Government ,030204 cardiovascular system & hematology ,Emergency Nursing ,Disaster Medicine ,Article ,Patient Isolation ,03 medical and health sciences ,Betacoronavirus ,0302 clinical medicine ,Health care ,medicine ,Humans ,Respirator ,Medical Waste Disposal ,Personal protective equipment ,Pandemics ,Personal Protective Equipment ,Human services ,Ships ,Infection Control ,business.industry ,SARS-CoV-2 ,COVID-19 ,030208 emergency & critical care medicine ,medicine.disease ,United States ,Disinfection ,Transportation of Patients ,Work (electrical) ,Equipment and Supplies ,Quarantine ,Emergency ,Aerospace Medicine ,Emergency Medicine ,United States Dept. of Health and Human Services ,Medical emergency ,Aviation medicine ,business ,Coronavirus Infections ,Disaster medicine ,Repatriation - Abstract
Recent coronavirus disease 2019 (COVID-19) events have presented challenges to health care systems worldwide. Air medical movement of individuals with potential infectious disease poses unique challenges and threats to crews and receiving personnel. The US Department of Health and Human Services air medical evacuation teams of the National Disaster Medical System directly supported 39 flights, moving over 2,000 individuals. Infection control precautions focused on source and engineering controls, personal protective equipment, safe work practices to limit contamination, and containment of the area of potential contamination. Source control to limit transmission distance was used by requiring all passengers to wear masks (surgical masks for persons under investigation and N95 for known positives). Engineering controls used plastic sheeting to segregate and treat patients who developed symptoms while airborne. Crews used Tyvek (Dupont Richmond, VA) suits with booties and a hood, a double layer of gloves, and either a powered air-purifying respirator or an N95 mask with a face shield. For those outside the 6-ft range, an N95 mask and gloves were worn. Safe work practices were used, which included mandatory aircraft surface decontamination, airflow exchanges, and designated lavatories. Although most patients transported were stable, to the best of our knowledge, this represents the largest repatriation of potentially contagious patients in history without infection of any transporting US Department of Health and Human Services air medical evacuation crews.
- Published
- 2020
84. Navigating the Regulatory Framework for HIV Prevention Research in Adolescents
- Author
-
Zeinab Bakhiet and Quianta Moore
- Subjects
medicine.medical_specialty ,Biomedical Research ,Adolescent ,business.industry ,United States Food and Drug Administration ,Health Policy ,Human immunodeficiency virus (HIV) ,HIV Infections ,General Medicine ,medicine.disease_cause ,Informed Consent By Minors ,United States ,Issues, ethics and legal aspects ,Human Experimentation ,Family medicine ,Government Regulation ,Medicine ,Humans ,Parental Consent ,United States Dept. of Health and Human Services ,business ,Ethics Committees, Research - Published
- 2020
85. Assessing the severity of COVID-19
- Author
-
André Ricardo Ribas, Freitas, Marcelo, Napimoga, and Maria Rita, Donalisio
- Subjects
Hospitalization ,Betacoronavirus ,SARS-CoV-2 ,Health Personnel ,Pneumonia, Viral ,Basic Reproduction Number ,COVID-19 ,Humans ,United States Dept. of Health and Human Services ,Coronavirus Infections ,Pandemics ,United States - Published
- 2020
86. New drug treatment options for HIV antiretroviral therapy
- Author
-
Jeffrey Kwong
- Subjects
medicine.medical_specialty ,Anti-HIV Agents ,Human immunodeficiency virus (HIV) ,MEDLINE ,HIV Infections ,medicine.disease_cause ,03 medical and health sciences ,Drug treatment ,0302 clinical medicine ,Pharmacotherapy ,Medicine ,Humans ,030212 general & internal medicine ,Adverse effect ,Intensive care medicine ,General Nursing ,Human services ,business.industry ,05 social sciences ,Antiretroviral therapy ,United States ,050903 gender studies ,Practice Guidelines as Topic ,Drug Therapy, Combination ,United States Dept. of Health and Human Services ,0509 other social sciences ,Once daily ,business - Abstract
Current treatments for patients with HIV are not only effective at controlling viral replication but are also associated with a more favorable adverse reaction profile, may often be taken once daily, and are increasingly available in combination single-tablet regimens. This article provides an overview and prescribing considerations for several primary drugs currently recommended by the US Department of Health and Human Services.
- Published
- 2020
87. The Time Is Now to End the HIV Epidemic
- Author
-
Brett P. Giroir
- Subjects
medicine.medical_specialty ,Financing, Government ,AJPH Ending the HIV Epidemic ,Hiv epidemic ,HIV Infections ,03 medical and health sciences ,Political science ,medicine ,Humans ,Organizational Objectives ,Epidemics ,Diagnostic Techniques and Procedures ,AIDS Vaccines ,Acquired Immunodeficiency Syndrome ,030505 public health ,Public Health, Environmental and Occupational Health ,United States ,Needle-Exchange Programs ,Leadership ,Anti-Retroviral Agents ,Family medicine ,Pre-Exposure Prophylaxis ,United States Dept. of Health and Human Services ,0305 other medical science ,Administration (government) ,Case Management - Abstract
In his State of the Union Address on February 5, 2019, President Donald J. Trump announced his administration’s goal to end the domestic HIV epidemic. Following the announcement of the Ending the HIV Epidemic: A Plan for America initiative, the president proposed $291 million in new funding for the fiscal year 2020 Department of Health and Human Services (HHS) budget to implement a new initiative to reduce the number of new HIV infections by 75% in the next five years (2025) and by 90% in the next 10 years (2030). This is in addition to the $20 billion the US government already spends each year, domestically, for HIV prevention and care. With this initiative, HHS recognizes that the time to end the HIV epidemic is now: we have the right data, the right biomedical and behavioral tools, and the right leadership. With the new resources, the goal is achievable. This article outlines how this initiative will be accomplished through the implementation of four fundamental strategies that will be tailored by local communities on the basis of their own needs and strengths.
- Published
- 2020
88. Disentangling Conscience Protections
- Author
-
Nadia N. Sawicki
- Subjects
Health (social science) ,Legal liability ,Health Personnel ,media_common.quotation_subject ,Public policy ,Public Policy ,0603 philosophy, ethics and religion ,Political science ,Health care ,Civil Rights ,Humans ,Enforcement ,Human services ,Conscience ,0505 law ,media_common ,050502 law ,business.industry ,Health Policy ,05 social sciences ,Liability ,Liability, Legal ,06 humanities and the arts ,United States ,Philosophy ,Issues, ethics and legal aspects ,Action (philosophy) ,Law ,United States Dept. of Health and Human Services ,060301 applied ethics ,business - Abstract
Earlier this year, the U.S. Department of Health and Human Services announced its intent to strengthen enforcement of legal protections for health care providers' conscience rights. It proposed regulations that would give the DHHS Office of Civil Rights greater authority to ensure that recipients of federal funding comply with federal conscience laws. This recent development creates an opportunity for scholars and policy-makers to revisit the perennial debate about whether and how law should protect health care providers' rights of conscience. Arguments about who should be protected, what actions should be protected, and whether there should be any limitations on the exercise of conscience rights have brought us no closer to a resolution. However, there is one remaining avenue for analysis that has, surprisingly, received very little attention-the question of how providers are protected, and from what consequences. Existing U.S. conscience laws immunize health care providers from a wide range of adverse consequences-including civil liability, criminal prosecution, administrative penalties, adverse action by employers, and discrimination by private actors, among others. However, academic and public policy debates rarely acknowledge the breadth of these protections. It is essential to disentangle this network of possible protections.
- Published
- 2018
89. Identifying Potential Patient Safety Issues From the Federal Electronic Health Record Surveillance Program
- Author
-
Thomas B Pacheco, Aaron Z. Hettinger, and Raj M. Ratwani
- Subjects
Certification ,Medical Records Systems, Computerized ,MEDLINE ,Social Welfare ,Health records ,01 natural sciences ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,Government regulation ,Electronic health record ,Surveys and Questionnaires ,Patient harm ,Research Letter ,Medicine ,Electronic Health Records ,Humans ,030212 general & internal medicine ,0101 mathematics ,Human services ,business.industry ,010102 general mathematics ,General Medicine ,medicine.disease ,humanities ,United States ,Government Regulation ,United States Dept. of Health and Human Services ,Medical emergency ,Patient Safety ,business - Abstract
This study uses Department of Health and Human Services data to analyze surveillance of electronic health records for patient safety issues to identify those with a potential for patient harm, and the frequency of these issues.
- Published
- 2019
90. Amy Killelea, Natalie O. Cramer, and Michael Weir Comment
- Author
-
Natalie O. Cramer, Michael Weir, and Amy Killelea
- Subjects
AIDS Vaccines ,Acquired Immunodeficiency Syndrome ,Financing, Government ,AJPH Ending the HIV Epidemic ,media_common.quotation_subject ,Public Health, Environmental and Occupational Health ,HIV Infections ,Art ,United States ,Needle-Exchange Programs ,Leadership ,Anti-Retroviral Agents ,Weir ,Humans ,Organizational Objectives ,Pre-Exposure Prophylaxis ,United States Dept. of Health and Human Services ,Epidemics ,Humanities ,Case Management ,Diagnostic Techniques and Procedures ,media_common - Published
- 2019
91. Temporal Differences in Utilization of Intracytoplasmic Sperm Injection Among U.S. Regions
- Author
-
Albert L. Hsu, David B. Seifer, Pavel Zagadailov, and Judy E. Stern
- Subjects
Adult ,Male ,0301 basic medicine ,Infertility ,medicine.medical_specialty ,Adolescent ,Pregnancy Rate ,medicine.medical_treatment ,Fertilization in Vitro ,Intracytoplasmic sperm injection ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Sperm Injections, Intracytoplasmic ,Infertility, Male ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,In vitro fertilisation ,business.industry ,Obstetrics ,Age Factors ,Obstetrics and Gynecology ,Retrospective cohort study ,medicine.disease ,United States ,Pregnancy rate ,Treatment Outcome ,030104 developmental biology ,Female ,United States Dept. of Health and Human Services ,business ,Live birth ,Infertility, Female ,Live Birth ,Cohort study - Abstract
OBJECTIVE To analyze changes in intracytoplasmic sperm injection (ICSI) utilization, indications, and outcomes across U.S. regions. METHODS We conducted a retrospective cohort study. Data sets for 2000-2014 were obtained from the Centers for Disease Control and Prevention. Clinics with 100 or greater fresh, nondonor cycles were grouped by 10 nationally recognized Department of Health and Human Services (DHHS) regions and were compared for use of ICSI, frequency of male factor infertility, preimplantation genetic therapies, pregnancy, and live birth rates per cycle among fresh in vitro fertilization cycles in women younger than 35 years of age. RESULTS Nationwide ICSI utilization increased 52% (46.3±6.1% to 70.0±7.1%) from 2000 to 2014, whereas pregnancy and live birth rates per cycle modestly increased by 8.5% (39.2±3.8% to 42.5±2.5%) and 7.6% (34.4±3.6% to 37±2.6%), respectively, showing a positive correlation (r=0.78, P
- Published
- 2018
92. Tying Medicare Part B Drug Prices to International Reference Pricing Will Devastate RD
- Author
-
Daniel Gassull, Duane Schulthess, and Steven Maisel
- Subjects
Drug Industry ,Pharmaceutical Research ,Pharmacy ,Medicare ,030226 pharmacology & pharmacy ,01 natural sciences ,Drug Costs ,010104 statistics & probability ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Pharmacology (medical) ,Medicare Part B ,0101 mathematics ,Pharmacology, Toxicology and Pharmaceutics (miscellaneous) ,Human services ,Actuarial science ,Economic Competition ,business.industry ,Tying ,Public Health, Environmental and Occupational Health ,Drug prices ,United States ,United States Dept. of Health and Human Services ,business ,Reference pricing - Abstract
According to Secretary Azar of Health and Human Services, implementing international reference pricing (IPI) in Medicare Part B will have minimal impacts. He has stated, "These savings, while substantial for American patients and taxpayers, cannot possibly pull out more than 1 percent of RD." As companies traditionally spend 20% of free cash flow on RD, we have measured the IPI impact according to industry standard metrics. The potential negative impacts of the international reference pricing plan, as it is currently structured, are numerous. Companies are likely to avoid developing Medicare Bart B physician-administered drugs in the future if it comes to fruition. Further, if distributing in any of the included countries in the benchmarking exercise that traditionally have prices far below that of the United States has the impact of creating lower US prices where the industry currently derives more than 80% of their global profit, companies will simply not seek market access in those benchmarked countries and patients in those countries will not receive the medicines they need. The idea that companies will be able to unilaterally raise prices in Europe defies logic and practice. Many countries in the EU have been threatening IP rights under the TRIPS clauses of the WTO for several years because of their belief that pharmaceutical pricing is unacceptably high right now, without the IPI. Harnessing real-world evidence would allow for increased competition by faster time to market. One wonders why an approach encompassing the improved time to market was not considered, as the reference pricing proposal as it stands now, ultimately, will reduce RD budgets, impair the overall investment climate, and deprive patients the new medicines.
- Published
- 2019
93. Strengthening Security for Gene Synthesis: Recommendations for Governance
- Author
-
Michael Montague, Thomas V. Inglesby, Rachel West, Gigi Kwik Gronvall, and Amanda Kobokovich
- Subjects
Health (social science) ,Process management ,Health, Toxicology and Mutagenesis ,International Cooperation ,030231 tropical medicine ,Guidelines as Topic ,Chemistry Techniques, Synthetic ,Management, Monitoring, Policy and Law ,Global Health ,Security Measures ,03 medical and health sciences ,0302 clinical medicine ,Humans ,030212 general & internal medicine ,Gene Editing ,Corporate governance ,Public Health, Environmental and Occupational Health ,DNA ,United States ,Genetic Techniques ,Emergency Medicine ,Government Regulation ,United States Dept. of Health and Human Services ,Business ,Safety Research ,Gene synthesis - Abstract
Since the inception of gene synthesis technologies, there have been concerns about possible misuse. Using gene synthesis, pathogens-particularly small viruses-may be assembled "from scratch" in the laboratory, evading the regulatory regimes many nations have in place to control unauthorized access to dangerous pathogens. Progress has been made to reduce these risks. In 2010, the US Department of Health and Human Services (HHS) published guidance for commercial gene synthesis providers that included sequence screening of the orders and customer screening. The industry-led International Gene Synthesis Consortium (IGSC) was formed in 2009 to share sequence and customer screening methods, and it now includes the major international gene synthesis providers among its members. Since the 2010 HHS Guidance was released, however, there have been changes in gene synthesis technologies and market conditions that have reduced the efficacy of these biosecurity protections, leading to questions about whether the 2010 HHS Guidance should be updated, what changes could make it more effective, and what other international governance efforts could be undertaken to reduce the risks of misuse of gene synthesis products. This article describes these conditions and recommends actions that governments should take to reduce these risks and engage other nations involved in gene synthesis research.
- Published
- 2019
94. A Novel Approach for Workforce Surveillance at the US Department of Health and Human Services
- Author
-
Purni Abeysekara, Fátima Coronado, M. Kathleen Glynn, and Patricia M. Simone
- Subjects
Employment ,medicine.medical_specialty ,Ethnic group ,MEDLINE ,Article ,03 medical and health sciences ,0302 clinical medicine ,Resource (project management) ,medicine ,Humans ,Health Workforce ,030212 general & internal medicine ,Human services ,030505 public health ,ComputingMilieux_THECOMPUTINGPROFESSION ,business.industry ,Health Policy ,Public health ,Public Health, Environmental and Occupational Health ,Online database ,Public relations ,Workforce development ,United States ,Workforce ,United States Dept. of Health and Human Services ,Public Health ,0305 other medical science ,business - Abstract
Background Expert groups have recommended ongoing monitoring of the public health workforce to determine its ability to execute designated objectives. Resource- and time-intensive surveys have been a primary data source to monitor the workforce. We evaluated an administrative data source containing US Department of Health and Human Services (HHS) aggregate federal civil service workforce-related data to determine its potential as a workforce surveillance system for this component of the workforce. Methods We accessed FedScope, a publicly available online database containing federal administrative civilian HHS personnel data. Using established guidelines for evaluating surveillance systems and identified workforce characteristics, we evaluated FedScope attributes for workforce surveillance purposes. Results We determined FedScope to be a simple, highly accepted, flexible, stable, and timely system to support analyses of federal civil service workforce-related data. Data can be easily accessed, analyzed, and monitored for changes across years and draw conclusions about the workforce. FedScope data can be used to calculate demographics (eg, sex, race or ethnicity, age group, and education level), employment characteristics (ie, supervisory status, work schedule, and appointment type), retirement projections, and characterize the federal workforce into standard occupational categories. Conclusions This study indicates that an administrative data source containing HHS personnel data can function as a workforce surveillance system valuable to researchers, public health leaders, and decision makers interested in the federal civil service public health workforce. Using administrative data for workforce development is a model that can be applicable to federal and nonfederal public health agencies and ultimately support improvements in public health.
- Published
- 2019
95. In vitro to in vivo extrapolation for high throughput prioritization and decision making
- Author
-
Ted W. Simon, Shannon M. Bell, Grazyna Fraczkiewicz, Judy Strickland, M. Bartels, Kim L. R. Brouwer, Annie Lumen, Alicia Paini, Alice Ke, Nisha S. Sipes, Scott G. Lynn, Paul S. Price, Stephen S. Ferguson, Catherine S. Sprankle, Xiaoqing Chang, Annie M. Jarabek, David G. Allen, Nicole Kleinstreuer, Warren Casey, Caroline Ring, John F. Wambaugh, John A. Troutman, Barbara A. Wetmore, and Neepa Choksi
- Subjects
Animal Use Alternatives ,0301 basic medicine ,Prioritization ,Computer science ,Extrapolation ,Expert Systems ,Guidelines as Topic ,Context (language use) ,Computational toxicology ,Toxicology ,Models, Biological ,Article ,03 medical and health sciences ,Human health ,Chemical safety ,In vivo ,Toxicity Tests ,Animals ,Humans ,Computer Simulation ,United States Environmental Protection Agency ,Throughput (business) ,Decision Making, Computer-Assisted ,Decision Making, Organizational ,Health Priorities ,Computational Biology ,Chemical Safety ,General Medicine ,United States ,High-Throughput Screening Assays ,030104 developmental biology ,Risk analysis (engineering) ,United States Dept. of Health and Human Services ,National Institute of Environmental Health Sciences (U.S.) - Abstract
In vitro chemical safety testing methods offer the potential for efficient and economical tools to provide relevant assessments of human health risk. To realize this potential, methods are needed to relate in vitro effects to in vivo responses, i.e., in vitro to in vivo extrapolation (IVIVE). Currently available IVIVE approaches need to be refined before they can be utilized for regulatory decision-making. To explore the capabilities and limitations of IVIVE within this context, the U.S. Environmental Protection Agency Office of Research and Development and the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods co-organized a workshop and webinar series. Here, we integrate content from the webinars and workshop to discuss activities and resources that would promote inclusion of IVIVE in regulatory decision-making. We discuss properties of models that successfully generate predictions of in vivo doses from effective in vitro concentration, including the experimental systems that provide input parameters for these models, areas of success, and areas for improvement to reduce model uncertainty. Finally, we provide case studies on the uses of IVIVE in safety assessments, which highlight the respective differences, information requirements, and outcomes across various approaches when applied for decision-making.
- Published
- 2018
96. How the 2018 US Physical Activity Guidelines are a Call to Promote and Better Understand Acute Physical Activity for Cognitive Function Gains
- Author
-
Tsung Min Hung, Emmanuel Stamatakis, Yu Kai Chang, and Kirk I. Erickson
- Subjects
medicine.medical_specialty ,Time Factors ,Sports medicine ,Advisory committee ,Physical fitness ,Physical activity ,Guidelines as Topic ,Physical Therapy, Sports Therapy and Rehabilitation ,Scientific evidence ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Exercise ,Human services ,Medical education ,business.industry ,Correction ,030229 sport sciences ,United States ,Commentary ,United States Dept. of Health and Human Services ,business ,Psychology ,Single session - Abstract
The new 2018 edition of the Physical Activity Guidelines for Americans (PAGA18) released by the U.S. Department of Health and Human Services [1] and directly informed by the 779-page 2018 Physical Activity Guidelines Advisory Committee Scientific Report [2] will undoubtedly change how we promote and research physical activity (PA). For the first time, PAGA18 include new insights on the role of a single session of PA for cognitive function and brain health, suggesting that the scientific evidence supporting PA benefits on cognitive function and brain health has matured. In addition, considering the difficulty in initiating and adhering to a long-term exercise program, cognitive function benefits from a single bout may provide a new approach to promote exercise for people who are not ready yet to adopt and adhere to an ongoing habitual exercise routine...
- Published
- 2019
97. Toppling the Ethical Balance — Health Care Refusal and the Trump Administration
- Author
-
Elizabeth Sepper
- Subjects
education ,MEDLINE ,030204 cardiovascular system & hematology ,Morals ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Government regulation ,Health care ,Civil Rights ,Humans ,Medicine ,030212 general & internal medicine ,Human services ,business.industry ,Religion and Medicine ,Refusal to Treat ,General Medicine ,United States ,humanities ,Balance (accounting) ,Ethics, Clinical ,Government Regulation ,United States Dept. of Health and Human Services ,business ,Administration (government) - Abstract
Toppling the Ethical Balance A new rule from the U.S. Department of Health and Human Services creates a wide-ranging right to refuse to provide health care services. If it goes into effect, patient...
- Published
- 2019
98. Promoting Policy Development through Community Participatory Approaches to Health Promotion: The Philadelphia Ujima Experience
- Author
-
Stephen Hayes, Sharon Congleton, Amanda DeVilliers, Lidyvez Sawyer, Bernadette Campoli, Candace Robertson-James, Ana E. Núñez, Diana Robertson, and Stephanie Alexander
- Subjects
Adult ,Community-Based Participatory Research ,Health (social science) ,Community-based participatory research ,Participatory action research ,Health Promotion ,Public administration ,03 medical and health sciences ,0302 clinical medicine ,Political science ,Maternity and Midwifery ,Humans ,030212 general & internal medicine ,Policy Making ,Curriculum ,Health policy ,Human services ,Health Services Needs and Demand ,030505 public health ,Health Policy ,Public Health, Environmental and Occupational Health ,Obstetrics and Gynecology ,Policy analysis ,Community-Institutional Relations ,Organizational Innovation ,United States ,Health promotion ,Women's Health ,Female ,United States Dept. of Health and Human Services ,0305 other medical science ,Inclusion (education) - Abstract
Background The Philadelphia Ujima Coalition for a Healthier Community (Philadelphia Ujima) promotes health improvement of girls, women, and their families using a gender framework and community-based participatory research approach to addressing gender-based disparities. Institutional policies developed through community-based participatory research approaches are integral to sustaining gender-integrated health-promotion programs and necessary for reducing gender health inequities. This paper describes the results of a policy analysis of the Philadelphia Ujima coalition partner sites and highlights two case studies. Methods The policy analysis used a document review and key informant interview transcripts to explore 1) processes that community, faith, and academic organizations engaged in a community participatory process used to develop policies or institutional changes, 2) types of policy changes developed, and 3) initial outcomes and impact of the policy changes on the target population. Results Fifteen policies were developed as a result of the funding from the U.S. Department of Health and Human Services Office on Women's Health. Policy changes included 1) healthy food options guidance, 2) leadership training on sexual and relationship violence, and 3) curricula and programming inclusion and expansion of a sex and gender focus in high school and medical school. Conclusions Organizational practice changes and policies can be activated through individual-level interventions using a community participatory approach. This approach empowers communities to play an integral role in creating health-promoting policies.
- Published
- 2017
99. The New HHS Kidney Innovation Accelerator
- Author
-
Paul T. Conway and Kevin John Fowler
- Subjects
medicine.medical_specialty ,Epidemiology ,medicine.medical_treatment ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Kidney transplant ,03 medical and health sciences ,0302 clinical medicine ,Inventions ,medicine ,Humans ,Precision Medicine ,End-stage kidney disease ,Dialysis ,Transplantation ,Kidney ,business.industry ,General surgery ,medicine.disease ,United States ,Self Care ,medicine.anatomical_structure ,Nephrology ,Kidney Diseases ,United States Dept. of Health and Human Services ,business ,Perspectives ,Kidney disease - Abstract
“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes
- Published
- 2018
100. HHS Initiative to Reduce Health Risks of Climate-Related Hazards.
- Author
-
Suran M
- Subjects
- Disease etiology, Health, Health Impact Assessment, Risk, United States, United States Dept. of Health and Human Services, Climate, Climate Change, Environmental Exposure adverse effects, Public Health
- Published
- 2022
- Full Text
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