Trends in Sunscreen Use Among US Middle and High School Students, 2007-2019.

OBJECTIVE: The purpose of this project is to analyze trends in sunscreen usage among middle and high school students from the Centers of Disease Control's National Youth Risk Behavior Surveys (YRBS) from the years 2007 to 2019. METHODS: Data from the 2007-2019 National YRBS were analyzed. YRBS is a cross-sectional survey of health risk behaviors among middle and high school students (grades 6-12) in the United States. Students were asked questions regarding sunscreen usage and demographic information, including age, race/ethnicity, and gender. RESULTS: From 2007 to 2019, the average mean sunscreen usage for all students increased by 4% between every consecutive year studied. Mean sunscreen usage among all racial groups studied, other than Native Hawaiian or Other Pacific Islanders, increased. Females were 92.7% more likely to use sunscreen than males each year. The mean sunscreen usage decreased by 5% with an increase in a student's age. CONCLUSIONS: Though overall sunscreen use in adolescents increased over the time period from 2007 to 2019, sunscreen use still remains limited due to a variety of factors possibly including cost, tanning, and different socio-cultural perceptions of sunscreen.

Factors Influencing Contraceptive Use Among Sexually Active U.S. Middle and High School Students, 2015 to 2019.

Objective The objective of this study is to see whether factors including the age of first sexual intercourse, sexual orientation, age at the time of survey administration, race/ethnicity, and sex affect condom and other types of contraceptive usage among United States middle and high school students. Methods We analyzed data from the Centers for Disease Control's Youth Risk Behavior Surveys from the years 2015 to 2019. Students were asked questions about condom and specific type of contraceptive use (e.g. birth control pills, intrauterine device/implant, shot/patch/ring, withdrawal), age of first sexual intercourse, and sexual orientation, as well as demographic questions. Using a logistic regression model, we tested the linear effects on condom and contraception investigated variables. Results Differing sexual orientations had a significant relationship with both condom and contraceptive usage, with those who identified as lesbian or gay being least likely to use contraception as opposed to those who identified as straight, bisexual, or unsure. Female participants were 31.6% less likely to use contraception overall and 41.7% less likely to use condoms in comparison to male participants. With a one-year increase in the age of first sexual intercourse, contraceptive use overall increased by 23% and condom use specifically increased by 17%. With a one-year increase in a participant's age at the time of survey administration, contraceptive use decreased by 7.4% and condom use decreased by 21%. Between the years 2015 to 2019, there was an average decrease of 5.3% in the usage of condoms. Conclusion We found significant differences in contraceptive and/or condom usage between students of different sexual orientations, sex, age of first sexual intercourse, age at the time of survey administration, and between different years studied. These differences could be attributed to differences in sex education, cultural background, and availability of resources. Further investigations should be conducted to delineate these differences.

Establishing a Multi-Institutional Quality and Patient Safety Consortium: Collaboration Across Affiliates in a Community-Based Medical School.

The landscape of health care delivery and medical education is evolving. Institutions must continually reassess priorities, strategies, and partnerships to align the knowledge and skills of the health care workforce with the delivery of quality, socially accountable, collaborative health care that meets the needs of diverse populations in communities. This article describes the development, implementation, and early outcomes of the University of Missouri-Kansas City's Health Care Quality and Patient Safety Consortium. Inspired by an actual patient safety event, the consortium aimed to improve patient outcomes by establishing quality improvement and patient safety (QIPS) education and scholarship as foundational within its unique, horizontal-matrix academic health center, which comprises 6 affiliated hospitals and 4 university-based health sciences schools. The consortium established a governance structure with leaders who, collectively, represent the diverse members and stakeholders of the consortium. The members share a common agenda and mutual goals. The consortium measures success by applying published conceptual frameworks for evaluating the outcomes of educational programs on learners (Kirkpatrick) and patients (Bzowyckyj and colleagues). Consortium learner and patient outcomes span all levels of these frameworks. Undergraduate and graduate QIPS-based projects with meaningful health system or improved individual health outcomes signify a Level 4 outcome (the highest level) for learners and patients alike. Factors critical to success include a financial gift, leadership buy-in and support, a clear champion, shared goals and a united vision, a willingness to collaborate across health systems with varied strengths and priorities, and a stable communication platform. Aspirational goals of the consortium include increasing involvement across health professional schools, incorporating simulation into QIPS activities, and aligning the consortium's projects with broader community needs.

Correlation of Nutrition with Immune Status in Human Immunodeficiency Virus Outpatients.

Malnutrition has been proven to cause poor outcomes in many chronic diseases. We examined the association between malnutrition and immune status in HIV patients. We used the Nutritional Risk Index to evaluate the nutrition in 812 HIV patients, and correlated this variable with viral loads and CD4 counts. We found a significant correlation between nutritional status and immune status.

Can the use of probiotics reduce the incidence of nosocomial Clostridium difficile infection in 60 years or older patients?

BACKGROUND: Antibiotic-associated diarrhea (AAD) is a common side effect of antibiotic use. The pathogenesis of AAD may be mediated by disruption of the host's normal flora resulting in overgrowth of pathogens. One of these pathogens is Clostridium difficile. Probiotics may help reestablish the disrupted intestinal flora and help clear the pathogen and its toxins from the host. Although numerous studies have been conducted, results are variable due to study design, type of probiotic, differing dose of probiotic, and duration of treatment. Our study aims to assess the efficacy and safety of the probiotics Lactobacillus GG and Saccharomyces boulardii for the prevention of C. difficile associated diarrhea. METHODS: Study data were collected from two community hospitals in Kansas City over a period of 5 months. All patients in the study were initiated on antibiotics and were then given probiotics. This study was controlled and not blinded. RESULTS: In data from two community hospitals, 816 patients who were being treated with antibiotics prior to the investigation served as a control; 14 (1.72%) had C. difficile Infections. During the study using probiotic administration, 803 patients also being treated with antibiotics prior to the investigation were followed and in this population; five patients (0.62%) contracted a C. difficile infection.

Rapid resolution of cellulitis in patients managed with combination antibiotic and anti-inflammatory therapy.

There is some evidence to suggest that host inflammatory response has some effect on the clinical manifestations of cellulitis. The objective of this pilot study was to investigate whether the addition of oral nonsteroidal anti-inflammatory (NSAI) therapy to antibiotic treatment hastens resolution of cellulitis-related inflammation. Patients presenting in the emergency department with signs and symptoms of class II cellulitis were assigned to receive treatment with either antibiotic therapy alone (intravenous, supplemented with oral cephalexin or an equivalent) for 10 days (n = 33) or antibiotic therapy for 10 days plus an oral anti-inflammatory (ibuprofen 400 mg every 6 hours) for 5 days (n = 31). Patients were discharged as soon as possible to complete their therapy on an outpatient basis. The addition of an oral anti-inflammatory agent significantly (P < .05) shortened the time to regression of inflammation and complete resolution of cellulitis. Twenty-four of 29 evaluable patients (82.8%) who received supplemental anti-inflammatory treatment showed regression of inflammation within 1 to 2 days compared with only 3 of 33 patients (9.1%) treated without an anti-inflammatory in the same time frame. All patients receiving adjunctive anti-inflammatory treatment experienced complete resolution of cellulitis in 4 to 5 days or less, while 24.2% (8/33) of patients treated with antibiotic alone required 6 to 7 days, and 6.1% (2/33) required 7 days or more (P < .05). This small preliminary study provides some promising data, suggesting that the supplemental use of anti-inflammatory therapy may hasten the time to regression of inflammation and complete resolution of cellulitis.