Kallin Hermann

Background: The purpose of this study was to understand the current demographics and characteristics of patients undergoing urine drug screening on labor and delivery units with the intention of using this data to create a more evidence-based, equitable policy to reduce bias in the screening process. Methods: A retrospective chart review was performed of 509 instances of drug screening occurring for pregnant and recently delivered patients across three hospitals in Omaha, Nebraska. Demographics of patients, including age, race, ethnicity, and insurance status, as well as reasons for drug screening, patient consent, screening results, and disclosure of results, were analyzed to assess patterns in screening. Results: 509 screening instances were evaluated with 324 unique patients. While Black patients made up 11.6% of the overall patient population, they accounted for 26.2% of the patients undergoing urine drug screenings. 2.88% of all patients self-identified as Hispanic; however, they comprised 13.4% of all patients screened. Consent was documented in 11.3% of cases and a reason for obtaining UDS was documented in 61.5% of cases. The most common reasons cited were history of substance use or current use, medical indications, and suspected use without documented history of use. Conclusions: Establishment of more specific, evidence-based policies for urine drug screening may reduce the impact of implicit biases on current screening practices and serve as one avenue to rebuild trust with patients who have historically been marginalized by the medical community.

Background: Parkinson’s disease (PD) is a progressive neurodegenerative condition characterized by the degradation of dopaminergic pathways in the brain. As the population in the United States continues to age, it is essential to understand the trends in mortality related to PD. This analysis of PD’s mortality characterizes temporal shifts, examines demographic and regional differences, and provides machine-learning predictions. Methods: PD-related deaths in the United States were gathered from CDC WONDER. Age-adjusted mortality rates (AAMR) were collected, and trends were analyzed based on gender, race, region, age, and place of death. Annual percent change and average annual percent change were calculated using Joinpoint Regression program. Forecasts were obtained using the optimal Autoregressive Integrated Moving Average (ARIMA) model. Results: Overall mortality rate due to Parkinson’s increased from 1999 to 2022. Male gender, White race, Southern region, and older ages were associated with higher mortality compared to other groups. Deaths at home decreased and hospice deaths increased during the study period. Conclusions: This study highlights the increasing rate of PD AAMR and how it may become even more prevalent with time, emphasizing the value of increasing knowledge surrounding the disease and its trends to better prepare health systems and individual families for the burden of PD.