Hasil untuk "United States"

M. Cornelius, Teresa W. Wang, Ahmed Jamal et al.

Cigarette smoking remains the leading cause of preventable disease and death in the United States (1). The prevalence of current cigarette smoking among U.S. adults has declined over the past several decades, with a prevalence of 13.7% in 2018 (2). However, a variety of combustible, noncombustible, and electronic tobacco products are available in the United States (1,3). To assess recent national estimates of tobacco product use among U.S. adults aged ≥18 years, CDC analyzed data from the 2019 National Health Interview Survey (NHIS). In 2019, an estimated 50.6 million U.S. adults (20.8%) reported currently using any tobacco product, including cigarettes (14.0%), e-cigarettes (4.5%), cigars (3.6%), smokeless tobacco (2.4%), and pipes* (1.0%).† Most current tobacco product users (80.5%) reported using combustible products (cigarettes, cigars, or pipes), and 18.6% reported using two or more tobacco products.§ The prevalence of any current tobacco product use was higher among males; adults aged ≤65 years; non-Hispanic American Indian/Alaska Native (AI/AN) adults; those whose highest level of educational attainment was a General Educational Development (GED) certificate; those with an annual household income <$35,000; lesbian, gay, or bisexual (LGB) adults; uninsured adults and those with Medicaid; those with a disability; or those with mild, moderate, or severe generalized anxiety disorder. E-cigarette use was highest among adults aged 18-24 years (9.3%), with over half (56.0%) of these young adults reporting that they had never smoked cigarettes. Implementing comprehensive, evidence-based, population level interventions (e.g., tobacco price increases, comprehensive smoke-free policies, high-impact antitobacco media campaigns, and barrier-free cessation coverage), in coordination with regulation of the manufacturing, marketing, and sale of all tobacco products, can reduce tobacco-related disease and death in the United States (1,4). As part of a comprehensive approach, targeted interventions are also warranted to reach subpopulations with the highest prevalence of use, which might vary by tobacco product type.

Irene Papanicolas, L. Woskie, A. Jha

J. Brahney, M. Hallerud, Eric Heim et al.

Here, there, and everywhere No place is safe from plastic pollution. Brahney et al. show that even the most isolated areas in the United States—national parks and national wilderness areas—accumulate microplastic particles after they are transported there by wind and rain (see the Perspective by Rochman and Hoellein). They estimate that more than 1000 metric tons per year fall within south and central western U.S. protected areas. Most of these plastic particles are synthetic microfibers used for making clothing. These findings should underline the importance of reducing pollution from such materials. Science, this issue p. 1257; see also p. 1184 More than 1000 metric tons of plastic per year are deposited on U.S. protected lands through atmospheric transport. Eleven billion metric tons of plastic are projected to accumulate in the environment by 2025. Because plastics are persistent, they fragment into pieces that are susceptible to wind entrainment. Using high-resolution spatial and temporal data, we tested whether plastics deposited in wet versus dry conditions have distinct atmospheric life histories. Further, we report on the rates and sources of deposition to remote U.S. conservation areas. We show that urban centers and resuspension from soils or water are principal sources for wet-deposited plastics. By contrast, plastics deposited under dry conditions were smaller in size, and the rates of deposition were related to indices that suggest longer-range or global transport. Deposition rates averaged 132 plastics per square meter per day, which amounts to >1000 metric tons of plastic deposition to western U.S. protected lands annually.

F. Lessa, Yi Mu, Wendy M. Bamberg et al.

BACKGROUND The magnitude and scope of Clostridium difficile infection in the United States continue to evolve. METHODS In 2011, we performed active population- and laboratory-based surveillance across 10 geographic areas in the United States to identify cases of C. difficile infection (stool specimens positive for C. difficile on either toxin or molecular assay in residents ≥ 1 year of age). Cases were classified as community-associated or health care-associated. In a sample of cases of C. difficile infection, specimens were cultured and isolates underwent molecular typing. We used regression models to calculate estimates of national incidence and total number of infections, first recurrences, and deaths within 30 days after the diagnosis of C. difficile infection. RESULTS A total of 15,461 cases of C. difficile infection were identified in the 10 geographic areas; 65.8% were health care-associated, but only 24.2% had onset during hospitalization. After adjustment for predictors of disease incidence, the estimated number of incident C. difficile infections in the United States was 453,000 (95% confidence interval [CI], 397,100 to 508,500). The incidence was estimated to be higher among females (rate ratio, 1.26; 95% CI, 1.25 to 1.27), whites (rate ratio, 1.72; 95% CI, 1.56 to 2.0), and persons 65 years of age or older (rate ratio, 8.65; 95% CI, 8.16 to 9.31). The estimated number of first recurrences of C. difficile infection was 83,000 (95% CI, 57,000 to 108,900), and the estimated number of deaths was 29,300 (95% CI, 16,500 to 42,100). The North American pulsed-field gel electrophoresis type 1 (NAP1) strain was more prevalent among health care-associated infections than among community-associated infections (30.7% vs. 18.8%, P<0.001). CONCLUSIONS C. difficile was responsible for almost half a million infections and was associated with approximately 29,000 deaths in 2011. (Funded by the Centers for Disease Control and Prevention.).

Carmen DeNavas-Walt, Bernadette D. Proctor

M. Wallin, W. Culpepper, Jonathan D. Campbell et al.

Objective To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets. Methods A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017. Results The estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1–310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1–451.6) for women and 159.7 (95% CI 158.7–160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017. Conclusion The estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

L. Hebert, J. Weuve, P. Scherr et al.

J. Kenney

C. Daly, M. Halbleib, Joseph I. Smith et al.

H. Hedegaard, A. Miniño, M. Warner

A. Guess, M. Lerner, Benjamin A. Lyons et al.

Significance Few people are prepared to effectively navigate the online information environment. This global deficit in digital media literacy has been identified as a critical factor explaining widespread belief in online misinformation, leading to changes in education policy and the design of technology platforms. However, little rigorous evidence exists documenting the relationship between digital media literacy and people’s ability to distinguish between low- and high-quality news online. This large-scale study evaluates the effectiveness of a real-world digital media literacy intervention in both the United States and India. Our largely encouraging results indicate that relatively short, scalable interventions could be effective in fighting misinformation around the world. Widespread belief in misinformation circulating online is a critical challenge for modern societies. While research to date has focused on psychological and political antecedents to this phenomenon, few studies have explored the role of digital media literacy shortfalls. Using data from preregistered survey experiments conducted around recent elections in the United States and India, we assess the effectiveness of an intervention modeled closely on the world’s largest media literacy campaign, which provided “tips” on how to spot false news to people in 14 countries. Our results indicate that exposure to this intervention reduced the perceived accuracy of both mainstream and false news headlines, but effects on the latter were significantly larger. As a result, the intervention improved discernment between mainstream and false news headlines among both a nationally representative sample in the United States (by 26.5%) and a highly educated online sample in India (by 17.5%). This increase in discernment remained measurable several weeks later in the United States (but not in India). However, we find no effects among a representative sample of respondents in a largely rural area of northern India, where rates of social media use are far lower.

D. Commerce

McGinnis Jm, Foege Wh

M. Friedman, A. Schwartz

J. Browning, L. Szczepaniak, R. Dobbins et al.

Kendall Pogue, Jamie L. Jensen, C. Stancil et al.

The COVID-19 pandemic continues to ravage the world, with the United States being highly affected. A vaccine provides the best hope for a permanent solution to controlling the pandemic. However, to be effective, a vaccine must be accepted and used by a large majority of the population. The aim of this study was to understand the attitudes towards and obstacles facing vaccination with a potential COVID-19 vaccine. To measure these attitudes a survey was administered to 316 respondents across the United States by a survey corporation. Structural equation modeling was used to analyze the relationships of several factors with attitudes toward potential COVID-19 vaccination. Prior vaccine usage and attitudes predicted attitudes towards COVID-19 vaccination. Assessment of the severity of COVID-19 for the United States was also predictive. Approximately 68% of all respondents were supportive of being vaccinated for COVID-19, but side effects, efficacy and length of testing remained concerns. Longer testing, increased efficacy and development in the United States were significantly associated with increased vaccine acceptance. Messages promoting COVID-19 vaccination should seek to alleviate the concerns of those who are already vaccine-hesitant. Messaging directed at the benefits of vaccination for the United States as a country would address the second predictive factor. Enough time should be taken to allay concerns about both short- and long-term side effects before a vaccine is released.

S. Moghadas, A. Shoukat, M. Fitzpatrick et al.

Significance Our results highlight that the growing coronavirus disease 2019 (COVID-19) outbreak in the United States could gravely challenge the critical care capacity, thereby exacerbating case fatality rates. In the absence of a preventive vaccine, efforts to contain the outbreak, such as improving self-isolation rates and encouraging better hygiene practices, can alleviate some of the pressures faced by the healthcare system during an outbreak. Both emergency expansion of hospital facilities to treat COVID-19 and government appropriations to facilitate voluntary case isolation are urgently needed. In the wake of community coronavirus disease 2019 (COVID-19) transmission in the United States, there is a growing public health concern regarding the adequacy of resources to treat infected cases. Hospital beds, intensive care units (ICUs), and ventilators are vital for the treatment of patients with severe illness. To project the timing of the outbreak peak and the number of ICU beds required at peak, we simulated a COVID-19 outbreak parameterized with the US population demographics. In scenario analyses, we varied the delay from symptom onset to self-isolation, the proportion of symptomatic individuals practicing self-isolation, and the basic reproduction number R0. Without self-isolation, when R0 = 2.5, treatment of critically ill individuals at the outbreak peak would require 3.8 times more ICU beds than exist in the United States. Self-isolation by 20% of cases 24 h after symptom onset would delay and flatten the outbreak trajectory, reducing the number of ICU beds needed at the peak by 48.4% (interquartile range 46.4–50.3%), although still exceeding existing capacity. When R0 = 2, twice as many ICU beds would be required at the peak of outbreak in the absence of self-isolation. In this scenario, the proportional impact of self-isolation within 24 h on reducing the peak number of ICU beds is substantially higher at 73.5% (interquartile range 71.4–75.3%). Our estimates underscore the inadequacy of critical care capacity to handle the burgeoning outbreak. Policies that encourage self-isolation, such as paid sick leave, may delay the epidemic peak, giving a window of time that could facilitate emergency mobilization to expand hospital capacity.

C. Albulescu

We empirically investigate the effect of the official announcements regarding the COVID-19 new cases of infection and fatality ratio, on the financial markets volatility in the United States (US). We consider both COVID-19 global and US figures and show that the sanitary crisis enhances the S&P 500 realized volatility. Our findings are robust to different model specifications and suggest that the prolongation of the coronavirus pandemic is an important source of financial volatility, challenging the risk management activity.

Ihme COVID-19 Forecasting Team

We use COVID-19 case and mortality data from 1 February 2020 to 21 September 2020 and a deterministic SEIR (susceptible, exposed, infectious and recovered) compartmental framework to model possible trajectories of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the effects of non-pharmaceutical interventions in the United States at the state level from 22 September 2020 through 28 February 2021. Using this SEIR model, and projections of critical driving covariates (pneumonia seasonality, mobility, testing rates and mask use per capita), we assessed scenarios of social distancing mandates and levels of mask use. Projections of current non-pharmaceutical intervention strategies by state—with social distancing mandates reinstated when a threshold of 8 deaths per million population is exceeded (reference scenario)—suggest that, cumulatively, 511,373 (469,578–578,347) lives could be lost to COVID-19 across the United States by 28 February 2021. We find that achieving universal mask use (95% mask use in public) could be sufficient to ameliorate the worst effects of epidemic resurgences in many states. Universal mask use could save an additional 129,574 (85,284–170,867) lives from September 22, 2020 through the end of February 2021, or an additional 95,814 (60,731–133,077) lives assuming a lesser adoption of mask wearing (85%), when compared to the reference scenario. A modeling study using case and mortality data from the first 8 months of the COVID-19 pandemic in the United States explores five potential future scenarios of social distancing mandates and mask use at the state level, with projections of the course of the epidemic through winter 2021.

K. L. Law, Natalie Starr, T. R. Siegler et al.

Plastic waste from the United States contaminates the environment domestically and in countries processing material for recycling. Plastic waste affects environmental quality and ecosystem health. In 2010, an estimated 5 to 13 million metric tons (Mt) of plastic waste entered the ocean from both developing countries with insufficient solid waste infrastructure and high-income countries with very high waste generation. We demonstrate that, in 2016, the United States generated the largest amount of plastic waste of any country in the world (42.0 Mt). Between 0.14 and 0.41 Mt of this waste was illegally dumped in the United States, and 0.15 to 0.99 Mt was inadequately managed in countries that imported materials collected in the United States for recycling. Accounting for these contributions, the amount of plastic waste generated in the United States estimated to enter the coastal environment in 2016 was up to five times larger than that estimated for 2010, rendering the United States’ contribution among the highest in the world.