Search

Background Antibiotic use is common for acute respiratory infections (ARIs) in children, but much of this use is inappropriate. Few studies have examined whether rurality of residence is associated with inappropriate antibiotic use. We examined whether rates of ARI-related inappropriate antibiotic use among children vary by rurality of residence. Methods We conducted a retrospective cohort study of children aged 2 months–5 years enrolled in Tennessee Medicaid between 2007 and 2017 and diagnosed with ARI in the outpatient setting. Study outcomes included ARI, ARI-related antibiotic use, and ARI-related inappropriate antibiotic use. Multivariable Poisson regression was used to measure associations between rurality of residence, defined by the US Census Bureau, and the rate of study outcomes, while accounting for other factors including demographics and underling comorbidities. Results A total of 805 332 children met selection criteria and contributed 1 840 048 person-years (p-y) of observation. Children residing in completely rural, mostly rural, and mostly urban counties contributed 70 369 (4%) p-y, 479 121 (26%) p-y, and 1 290 558 p-y (70%), respectively. Compared with children in mostly urban counties (238 per 1000 p-y), children in mostly rural (450 per 1000 p-y) and completely rural counties (468 per 1000 p-y) had higher rates of inappropriate antibiotic use (adjusted incidence rate ratio [aIRR] = 1.34, 95% confidence interval [CI] = 1.33–1.35 and aIRR = 1.33, 95% CI = 1.32–1.35, respectively). Conclusions Inappropriate antibiotic use is common among young children with ARI, with higher rates in rural compared with urban counties. These differences should inform targeted outpatient antibiotic stewardship efforts. [ABSTRACT FROM AUTHOR]

This special issue includes six essays that consider the gendered dimensions of property television in the UK, Canada and the US as they have emerged since the financial crises of 2008. [ABSTRACT FROM AUTHOR]

This article argues that the property television programme, Love It or List It (2008–), employs conventions from the classic screwball comedy to both consolidate its position within the lucrative realty TV market – especially in response to the recent (2008) recession – and negotiate modern gender dynamics within the home. Its Depression-era (1930s) financial and aesthetic resonances are not incidental. And, as with much contemporary culture, this modern iteration of the screwball comedy is not discretely contained by medium or genre of influence: Love It or List It also borrows flourishes from documentary, tabloid TV, melodrama and the gothic novel. In keeping with its reference to a kind of baseball pitching style that is difficult for hitters to anticipate, the screwball’s tendency to suddenly switch course has been identified as its central means for engaging in cultural critique. Love It or List It as an exemplar of reality TV’s recombinant style is still very much like its cinematic predecessor: it has the adeptness to say many things to many audiences. This article makes no claims for Love It or List It’s progressive politics; rather, as with some classic screwball comedies, it explores the possibility that equivocating, shifting course or otherwise abandoning narrative logic register a profound ambivalence about marriage, coupledom and the family home as sacrosanct loci of modern life. [ABSTRACT FROM AUTHOR]

Holmes on Homes is a Canadian home improvement television program and the centrepiece of HGTV (Home and Garden Television), featuring Mike Holmes as the series' star contractor and host. This paper argues that by looking back at earlier incarnations of film and television melodrama, we can determine the way in which Holmes on Homes reinvents the home improvement subgenre. By playing out reality TV's central tension between fiction and non-fiction, Holmes on Homes reveals its larger themes of justice and redemption, which befit its unique position between the documentary and the classic melodrama. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including one on the reality television program "Canadian Idol" by Doris Baltruschat, one on public television by Derek Foster, and one by the editor on home improvement programs.

The US Preventive Services Task Force has recommended offering preexposure prophylaxis (PrEP) to individuals who are at high risk of human immunodeficiency virus acquisition. Because PrEP treatment does not prevent bacterial sexually transmitted infections (STIs), Centers for Disease Control and Prevention treatment guidelines recommend STI screening for individuals taking PrEP every 3 to 6 months. No known studies estimate STI screening among individuals using PrEP in the US South, a geographic region with high rates of human immunodeficiency virus and bacterial STIs. Objectives: The purpose of this study was to measure sexually transmitted infection (STI) testing among Medicaid enrollees initiating preexposure prophylaxis (PrEP) to prevent human immunodeficiency virus. Secondary data are in the form of Medicaid enrollment and claims data in six states in the US South. Methods: Research partnerships in six states in the US South developed a distributed research network to accomplish study aims. Each state identified all first-time PrEP users in fiscal year 2017–2018 (combined N = 990) and measured the presence of STI testing for chlamydia, syphilis, and gonorrhea through 2019. Each state calculated the percentage of individuals with at least one STI test during 3-, 6-, and 12-month follow-up periods. Results: The proportion of first-time PrEP users that received an STI test varied by state: 37% to 67% of all of the individuals in each state who initiated PrEP received a test within the first 6 months of PrEP treatment and 50% to 77% received a test within the first 12 months. Conclusions: Although the Centers for Disease Control and Prevention recommends STI testing at least every 6 months for PrEP users, our analysis of Medicaid data suggests that STI testing occurs less frequently than recommended in populations at elevated risk of syphilis, gonorrhea, and chlamydia. [ABSTRACT FROM AUTHOR]

Introduction: The rates of syphilis among pregnant women and infants have increased in recent years, particularly in the U.S. South. Although state policies require prenatal syphilis testing, recent screening rates comparable across Southern states are not known. The purpose of this study is to measure syphilis screening among Medicaid enrollees with delivery in states in the U.S. South.Methods: A total of 6 state-university research partnerships in the U.S. South developed a distributed research network to analyze Medicaid claims data using a common analytic approach for enrollees with delivery in fiscal years 2017-2018 and 2018-2019 (combined N=504,943). In 2020-2021, each state calculated the percentage of enrollees with delivery with a syphilis screen test during the first trimester, third trimester, and at any point during pregnancy. Percentages for those with first-trimester enrollment were compared with the percentages of those who enrolled in Medicaid later in pregnancy.Results: Prenatal syphilis screening during pregnancy ranged from 56% to 91%. Screening was higher among those enrolled in Medicaid during the first trimester than in those enrolled later in pregnancy.Conclusions: Despite state laws requiring syphilis screening during pregnancy, screening was much lower than 100%, and states varied in syphilis screening rates among Medicaid enrollees. Findings indicate that access to Medicaid in the first trimester is associated with higher rates of syphilis screening and that efforts to improve access to screening in practice settings are needed. [ABSTRACT FROM AUTHOR]