Agents of scientific uncertainty: Conflicts over evidence and expertise in gender-affirming care bans for minors.

Globally, as medical and mental health associations increasingly have expressed support for the gender-affirming care model for trans and gender expansive youth, this model has been paradoxically banned across the United States. Ban proponents have deemed the science behind gender-affirming care to be dangerously uncertain. Examining the first gender-affirming care ban for minors, Arkansas's Save Adolescents from Experimentation (SAFE) Act of 2021, we addressed the following two questions: 1) who are the scientists, clinicians, and political organizations that promote SAFE and similar bans?; and 2) what are the scientific arguments they make to defend SAFE in federal court? First, we developed a typology of the various "agents of scientific uncertainty" behind these bans, drawing on literature from the sociology and history of science and medicine as well as the political economy of scientific doubt. Second, we created and qualitatively analyzed a dataset featuring 375 unique citations referenced throughout federal litigation over SAFE to identify these agents of scientific uncertainty's arguments. We sorted these arguments into eight categories, which reveal how agents distorted scientific evidence and exaggerated real uncertainties and risks in gender-affirming care. This case study establishes a frame for understanding the growing prevalence and legal impact of scientific arguments against gender-affirming care.

Development of a job-exposure matrix-like exposure assessment method for the US general population based on Occupational Information Network (O*NET) job tasks.

BACKGROUND: Job-exposure matrices (JEMs) are often used for exposure assessment in occupational exposure and epidemiology studies. However, general population JEMs are difficult to find and access for workers in the United States of America. OBJECTIVE: We aimed to use publicly available information to develop a JEM-like exposure assessment method to determine exposure to a wide range of occupational agents in a wide range of occupations for US general population studies. METHODS: We used information from the US Department of Labor's Occupational Information Network database (O*NET) for 19,636 job tasks and 974 civilian occupations. We used automated keyword searches to identify 1,804 job tasks that involved exposure to 50 occupational agents. We had 2 reviewers determine whether each identified job task actually involved exposure to the 50 occupational agents. We had a third reviewer, a certified industrial hygienist, assess any job task and exposure for which the first 2 reviewers disagreed. For each U.S. Census 2010 occupation code, we used this information to derive 3 exposure variables for each occupational agent: ever exposure, number of job tasks of exposure, and frequency of exposure. RESULTS: Our keyword searches identified a median of 10 (interquartile range [IQR]: 43.75) job tasks for each occupational agent, and the maximum was 308. We determined job tasks actually involved exposure to 45 occupational agents, including solvents, air pollution, pesticides, radiation, metals, etc. We derived the 3 exposure variables for these 45 occupational agents for 516 U.S. Census 2010 occupation codes. The median percentage for ever exposure to individual occupational agents was 1.16% (IQR: 1.74%), and the maximum was 11.43%. CONCLUSIONS: Our JEM-like exposure assessment method based on O*NET information can be used to determine exposure to a wide range of occupational agents in a wide range of occupations for the US general population.

Industry-Sponsored Research Payments to Gastroenterologists and Hepatologists in the United States Between 2014 and 2021.

Aim This cross-sectional study aimed to examine the scale and trends of industry-sponsored research payments to gastroenterologists and hepatologists in the United States from 2014 to 2021.  Methods Using the Open Payments Database and the National Plan and Provider Enumeration System (NPPES), the study analyzed both grant and research payments made to individual gastroenterologists and associated payments made for research where gastroenterologists and hepatologists served as principal investigators.  Results After adjusting for inflation, the study found that a total of $1.5 billion was allocated to gastroenterologists by 284 companies during this period. Only 15.9% of the 20,986 gastroenterologists received at least one research payment, with associated research payments accounting for 97.6% of all payments. The study also revealed a significant increase in the number of gastroenterologists receiving associated research payments and a more than twofold increase in payments for registered clinical trials from 2014 to 2021.  Conclusion The healthcare industry allocated large amounts of research funding to gastroenterologists and hepatologists. The study underscores the critical role of industry-sponsored clinical trials in advancing gastroenterological research and treatments.

Sports Gambling Intention Comparison Between Males and Females in the United States.

The focus of this research is to understand the sports gambling intentions of Gen Z (those born between 1997 and 2012) that can potentially lead to problematic gambling behavior. Rooted in the theory of planned behavior, the study delves into the roles of attitude, subjective norms, and perceived behavior control in shaping these intentions. A cross-sectional study of 513 Gen Z's in the United States was conducted. The partial least square structural equation modeling was used to analyze the relationship and compare the differences between males and females with multigroup analysis. The results indicate that attitude and perceived behavior control have a significant impact on this intention, while subjective norms do not exert substantial influence. Notably, gender differences are observed, with males showing a stronger association with perceived behavior control and females with attitude. The model effectively accounts for significant variations in sports gambling intention, highlighting a higher inclination among females as compared to males. This study provides a new perspective for analyzing disparities in sports gambling intention between genders and delves into the underlying motivations that can potentially contribute to the development of problematic gambling disorders. Given the significant societal impact and the adverse effects that gambling disorders have on those affected, it is imperative to conduct research aimed at understanding the reasons behind Gen Z's engagement in gambling. The findings can then be harnessed to inform the development of preventive programs aimed at curbing problematic gambling behaviors.

Malignant cardiac neoplasms and associated malignancies over 16 years in the USA.

BACKGROUND: Malignant cardiac neoplasms (MCNs), both primary and metastatic, are rare with few epidemiologic studies. METHODS: This retrospective study used the Healthcare Utilization Project/Nationwide Inpatient Sample database from 2002 to 2018 to evaluate the co-occurrences with other malignancies, and mortality of MCNs in the USA. RESULTS: The data contained 7207 weighted discharges of MCN. Median patient age was 51.4 years, 52.29 % were male, in-hospital mortality was 10.51 %, mean cost of hospitalization was $34,280 USD. Lung, mediastinum, and airways were the most common primary cancers associated with metastatic MCN. CONCLUSIONS: MCN are rare in the USA, however they carry a high in-hospital mortality, high morbidity, and hospital cost.

Mortality and Outcomes in Cerebrovascular Disease Patients With Emphasis on COVID-19: A Cross-Sectional Analysis of the National Inpatient Sample 2020.

Background COVID-19-related pulmonary complications have been explored extensively in the recent past. There is also a significant amount of literature on the neurological manifestations of COVID-19. However, there exists an unmet need to assess the impact of COVID-19 on patients with cerebrovascular diseases and its role in affecting mortality in such patients. Methods In this cross-sectional study, we analyzed 401,318 hospitalized patients with cerebrovascular diseases using the discharge data from the National Inpatient Sample 2020 to assess the association of COVID-19 with multiple clinical conditions, along with additional factors, such as length of stay in the hospital, total charges incurred, region and type of hospital, and primary insurance/payer in the United States of America. We used a multivariable logistic regression model to predict factors relating to mortality in such patients. Results The mortality during hospitalization in patients with cerebrovascular disease who were also diagnosed with COVID-19 was significantly higher than the patients without COVID-19 (22.50% vs 5.44%, p-value <0.0001). COVID-19 independently increased the odds of death significantly in patients with cerebrovascular diseases (adjusted OR = 4.81, p-value <0.0001). Other statistically and clinically significant factors that contributed to increased odds of mortality in such patients were comorbidities such as moderate/severe liver disease, myocardial infarction, congestive heart failure, and complications such as the development of a saddle pulmonary embolus. Conclusion COVID-19 was associated with higher mortality in patients with cerebrovascular diseases. It also significantly increased the duration of hospital stay and odds of mortality in such patients.

The Role of Time Perspective and Mindfulness on Life Satisfaction in the United States of America, Spain, Poland and Japan: A Cross-Cultural Study.

We assessed the cross-cultural role of Time Perspective (TP) tendencies [Past Positive (PP), Past Negative (PN), Present Hedonistic (PH), Present Fatalistic (PF), and Future (F)], the Deviation from a Balanced Time Perspective (DBTP) profile, the Deviation from a Negative Time Perspective (DNTP) profile, and mindfulness on life satisfaction (LS). The sample consisted of psychology undergraduate students (N= 867, MAGE= 20.19, SD= 3.417) in four countries: USA, Spain, Poland and Japan. We used a 17-item short version of the Zimbardo Time Perspective Inventory (ZTPI), the Mindful Attention Awareness Scale (MAAS), and the Satisfaction with Life Scale (SWLS) in all countries. For ensuring measurement invariance, we conducted pairwise CFAs for the ZTPI-17, MAAS and SWLS. Regression analyses showed that PN predicted decreased LS in Poland and Japan. PP predicted increased LS in Spain. F predicted increased LS in Poland. DNTP predicted decreased LS in Poland. Mindfulness predicted decreased LS in Japan and increased LS in USA, Spain and Poland. Moreover, mediation analyses revealed that the DBTP partially mediated the relationship between mindfulness and LS in Spain and USA. The DNTP partially mediated the relationship between mindfulness and LS in Spain, Poland and Japan (opposite direction). The findings suggest that the association of TP, mindfulness and LS differs across the investigated countries as a function of culture.

Reducing Maternal Mortality Rates in Alabama Through Patient Education: A Scoping Review.

Maternal mortality continues to rise in the United States and disproportionately affects those in Alabama. Lack of patient education on warning signs is a preventable cause of maternal mortality. This article aims to systematically quantify existing research investigating the effect of patient education on maternal outcomes. The inclusion criteria required an article to be (a) original research, (b) conducted within the United States, (c) in English, and (d) published between January 2012 and September 2022. PubMed® and Embase® databases were searched using key words and filters. Rayyan®, a systematic review research tool, was utilized to assess articles in a blinded two-person review process. A blinded third researcher resolved conflicts. A total of 3,139 articles were compiled; 3,115 articles did not meet inclusion criteria, and 24 articles were retrieved after an abstract review. Ultimately, 11 articles were included after a full-text review. None of these articles were specific to Alabama. However, they did contain evidence for patient education improving maternal mortality. More research is required in Alabama to demonstrate the effect of educating patients on maternal mortality. These articles contain evidence for education as a tool to improve maternal outcomes.

Racial Disparities In In-Hospital Mortality of Children and Adolescents Under 20 Years With Type 1 Diabetes Mellitus.

BACKGROUND: In the United States, racial disparities in health outcomes continue to be a major problem with far-reaching effects on equity in healthcare and public health. Children and teenagers with type 1 diabetes are a disadvantaged demographic that has particular difficulties in managing their condition and getting access to healthcare. Despite improvements in the treatment of diabetes, little study has examined how much racial disparities in in-hospital mortality affect this particular demographic. By examining racial differences in in-hospital mortality rates among children and adolescents with type 1 diabetes in the United States, this study seeks to close this gap. METHODS: This cross-sectional study utilized data from the Healthcare Cost and Utilization Project's (HCUP) Kids' Inpatient Database (KID) for 2012. The KID is a nationally representative sample of pediatric discharges from US hospitals. A total of 20,107 patients who were admitted with type 1 diabetes were included in this study. The primary outcome was the patient's in-hospital mortality status. The primary predictor variable was the race of the patient. Six potential confounders were chosen based on previous literature: age, sex, hospital location, obesity, weight loss, electrolyte disorders status, and median household income. Descriptive statistics and bivariate analyses were done. Multivariate analysis was conducted while controlling for potential confounders. Odd ratios with a 95% confidence interval and probability value were reported. Statistical Analysis System (SAS) version 9.4 for Windows (SAS Institute Inc., Cary, NC, USA) was used for the statistical analysis. RESULTS: A total of 20,107 patients were included in this study. Of the patients included, 78.6%, 5.3%, 5.9%, and 10.2% were of age groups <4, 5-9, 10-14, and 15-18, respectively. Among the patients, 64.3% were female. Whites stood at 54.3%, while Hispanic, Black, and other races accounted for 17.2%, 21.8%, and 6.7% respectively. After adjusting for all other variables, children, and young adults of Asian and Pacific Islanders (OR=1.948; 95% CI 1.015,3.738) had 94% higher odds of in-hospital mortality compared to their White counterparts. Children and young adults aged 5-9 (OR=0.29; 95% CI 0.13,0.649) had 71% lower odds of in-hospital mortality compared to those aged 4 or under. Those aged 10-14 (OR=0.155; 95% CI 0.077,0.313) had 85% lower odds of in-hospital mortality compared to those aged 4 or under, while those aged 15-19 (OR=0.172; 95% CI 0.100,0.296) had 83% lower odds of in-hospital mortality compared to those aged 4 or under. Children and young adults who had weight loss (OR=4.474; 95% CI 2.557,7.826) had almost five times higher odds of in-hospital mortality compared to those without weight loss, while children and young adults who had electrolyte disorders (OR=5.131; 95% CI 3.429,7.679) had five times higher odds of in-hospital mortality compared to those without electrolyte disorders. CONCLUSION: The results show young adults of Asian and Pacific Islanders have higher odds of in-hospital mortality compared to their White counterparts and this study highlights the urgent need for focused measures designed to lessen these inequalities and enhance health equity. The implementation of culturally sensitive healthcare practices, addressing social determinants of health, and enhancing access to high-quality diabetes care should all be priorities.

A Descriptive Analysis of Febrile Seizure Hospitalizations in Children with Congenital Heart Disease in the United States.

BACKGROUND: Febrile seizure (FS) is the most common convulsive disorder in children. This study analyzed the national proportion of congenital heart disease (CHD) and hospital resource utilization among children admitted for FSs in the U.S. METHODS: This is a retrospective cross-sectional analysis of pediatric patients up to six years with a primary diagnosis of FS in 2016 and 2019 using the Kids Inpatient Database (KID). The demographic, hospital, and clinical characteristics of children with and without CHD were compared using the chi-square test for categorical variables and linear regressions for continuous variables. Multivariate logistic analysis was conducted to evaluate the impact of CHD on the mean length of hospital stay. RESULTS: An estimated 10,039 children were admitted with the primary diagnosis of FS. Out of these, 117 (1.2%) had a discharge diagnosis of CHD. The mean age for children with and without CHD was 1.4 years (SD 1.60) and 1.5 years (SD 1.501), respectively. Children with CHD who required hospitalization for FS had longer mean lengths of hospital stay (2.1 days vs. 1.6 days), with an adjusted odd ratio of 0.43 (95% CI: 0.07-0.99; p-value: 0.017). Similarly, the hospital charges for children with CHD were higher than those without CHD ($30,960.28 vs. $21,005.11). CONCLUSION: Children with CHD who required inpatient admission for FSs in the U.S. were associated with increased length of hospital stay and higher resource utilization when compared with those without CHD. This highlights the need for preventive measures among this vulnerable population.

Longitudinal analysis of differences and similarities in antimicrobial resistance among commensal Escherichia coli isolated from market swine and sows at slaughter in the United States of America, 2013-2019.

The emergence of antimicrobial resistance in swine enteric bacteria poses a significant public health challenge. Our study evaluated publicly available data collected by the National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS) between 2013 and 2019 at slaughter plants across the United States of America, focusing on commensal E. coli isolated from swine cecal contents originating from two distinct swine production systems: market hogs (n = 2090) and sows (n = 1147). In both production types, the highest pairwise correlations were detected among ß-lactam antimicrobials, including resistance to amoxicillin-clavulanic acid, ceftriaxone, and cefoxitin, suggesting a co-selection for resistance. Compared to 2013, an increase in the rate of E. coli isolates that were resistant to ß-lactam antimicrobials was higher in 2017, 2018, and 2019, and this increase was more pronounced in isolates obtained from market hogs. Differences in antimicrobial resistance between these two distinct swine production systems warrant production-type focused mitigation efforts.

Journey across the world to study medicine: The Anandi Joshi story.

Women faced significant barriers to pursue education in the 19th century, yet modern history has witnessed bold women overcoming insurmountable odds in this quest. To this end, Anandi Joshi braved monumental odds to successfully become the first female physician in India. Born in 1865, Anandi was one of 10 children. Her zeal for knowledge was noted early by her father, who ensured that his daughter was well-educated. She married Gopalrao Joshi as a child when she was nine; a practice that was common at the time. Anandi's quest to become a physician stemmed from a traumatic event which saw the death of her child due to the lack of medical care. Despite the numerous prevalent barriers which prevented women from indulging in education, Anandi was determined. She travelled to the United States, where through sheer persistence, she was admitted to the Women's Medical College of Pennsylvania, where she graduated with a Doctor of Medicine (MD) degree in 1886. She subsequently returned to her home country, making her the first female physician in India. Despite her untimely death, Anandi became immortalised as a legend, a beacon of hope, and continues to serve as an inspiration for generations of Indian women.

Clinician-associated traumatization from difficult medical encounters: Results from a qualitative interview study on the Ehlers-Danlos Syndromes.

Patients with hypermobile Ehlers Danlos Syndrome often experience psychological distress resulting from the perceived hostility and disinterest of their clinicians. We conducted 26 in-depth interviews with patients to understand the origins of this trauma and how it could be addressed in practice. We found that the cumulative effects of numerous negative encounters lead patients to lose trust in their healthcare providers and the healthcare system, and to develop acute anxiety about returning to clinic to seek further care. We describe this as clinician-associated traumatization. Ultimately, our interviewees described the result of this traumatization as worse - but preventable - health outcomes.

African growth and opportunity act (AGOA) and exports of Sub-Saharan African countries to the United States of America: Does credit matter?

The Africa Growth and Opportunity Act was introduced by the United States of America to enable beneficiary countries to boost their export volumes and make way for growth and development. The study aims at estimating the effect of the Act on export from sub-Saharan African countries to the United States of America considering the role of credit. A panel data for 49 countries sourced from IMF DOTS, WDI, and CEPII for the period 1980 to 2020 was employed. Using the GMM, and the differences in differences estimation techniques, the findings showed that the AGOA trade preference has not achieved the purpose for which it was introduced. It is however found that export to the United States can be improved under the trade preference if credit is provided to the private sector. It is therefore recommended that credit accessibility should be made easy to make way for private sector investment in the production process to feed the export sector.

Integrating diversity, equity, and inclusion principles into instruction: Case studies from the University of Florida's Health Science Center Libraries.

Librarians at the University of Florida Health Science Center Libraries have begun to intentionally incorporate diversity, equity, and inclusion (DEI) principles into teaching during design, implementation, and evaluation. This article uses four case studies to provide an overview of the librarians' approaches to inclusive teaching (1) an annual workshop for Physical Therapy students on the intersection between DEI, health literacy, and patient education; (2) a librarian-taught one-credit course for public health students, which was revised to create a more inviting syllabus and integrate elements of universal design; (3) an annual project for first year medical students highlighting health disparities and community resources; and (4) piloting the application of critical librarianship principles in library standalone sessions on database searching and reference management. Suggestions are provided for other librarians who are interested in developing a culture of inclusive teaching in their own libraries.

Climate change: Comparing "green" and "polluting" nation-states.

Some nation-states, i.e., Norway, Sweden, and Denmark, repeatedly score the highest in environmental indicators such as the Environmental Performance Index (EPI) and the Climate Change Performance Index (CCPI). Their cities win environmental awards; they have well-developed recycling systems; they perform well with biodegradable waste; and their citizens show awareness of environmental problems, protesting publicly and even sueing their governing bodies if they don't do the same. For these and other reasons, recent scholarship defined these countries as "exemplary" green nation-states. The question is, which factors pushed them toward the green transition faster than others? And overall, what stops top polluting countries such as China, the United States and Russia from walking the same path? This article attempts to answer these questions by looking at climate change through a theoretical framework based on theories of nationalism and case studies of green nation-states. It compares three of said top polluting countries, China, the United States, and Russia, with "exemplary" green nation-states, and argues that the pace of greener nation-states rests on (1) a tradition of ecologism and environmentalism rooted in the long run, (2) the lock in of "green nationalism," a form of nationalism grounded on sustainability, (3) free and effective environmental movements, (4) inclusivity and welfare, and (5) a sense of national pride in environmental achievements. The available evidence seems to suggest that top polluting nation-states lack one or more of these factors.

Usability of telehealth among healthcare providers during COVID-19 pandemic in Nineveh Governorate, Iraq.

Objectives: To identify the usability of telehealth services and barriers during the coronavirus disease (COVID-19) pandemic among healthcare providers in Nineveh Governorate-Iraq. Study design: This was a multicenter cross-sectional survey. Methods: We collected the required data from April to July 2022 using self-administered open-ended questionnaires. The healthcare providers were physicians, pharmacists, and nurses with at least six months of services at hospitals. A modified form of the Telehealth Usability Questionnaire (TUQ) was used to assess the usability of telehealth services. Results: There were 460 healthcare providers, of which 269/460 (58.5%) were users of telehealth services. These were mostly physicians (n = 167/269, 62.1%), nurses (52/269, 19.3%), and pharmacists (n = 50/269, 18.6%), with a p-value of 0.001. During the COVID-19 pandemic, physicians (n = 100/167, 60.0%) and pharmacists (n = 28/50, 56.0%) increased their provision of telehealth services. Approximately 60% of physicians and nurses preferred to provide telehealth services in a synchronized manner. The participants mostly used smartphones to provide telehealth services through Messenger/Facebook and WhatsApp applications, specifically utilizing voice and/or video messages. There was some agreement among the participants (n = 269) regarding the usability of telehealth services. The overall mean score (±SD) was 4.8 (±0.88). The most reported barriers to telehealth services were poor Internet services, the presence of specific diseases, lack of technical comprehension, and insufficient time allocated to the service. Conclusion: Healthcare providers demonstrated a tendency towards the usability of telehealth services. Despite the available barriers, triage collaborations among patients, healthcare providers, and healthcare institutions are needed to achieve more successful adoption of these services.

Board gender diversity and corporate social responsibility: A bibliometric analysis.

The objective of this study to analyze developments in relating to board gender diversity (BGD) and corporate social responsibility (CSR) research and provide future researchers with new avenues for research in the field. A bibliometric analysis was conducted by focusing on the most productive articles, authors, journals, institutions, sponsors, and countries and as co-occurrence analyses based on 1961 peer-reviewed articles published between January 1966 and April 2021 in the Scopus database. Results revealed that the number of publications relevant to BGD and CSR has been gradually increasing, and a significant increase has been observed since 2010. Keywords such as "gender," "gender equality," "sustainable development," and "corporate social responsibility" reveal the key themes in BGD and CSR research. Cluster analysis revealed three clusters: Cluster 1 focused primarily on the board composition and board structure, Cluster 2 focused on board composition and its connection to CSR or philanthropy, and Cluster 3 (comprising more recent articles) mainly stressed the impact of gender diversity on CSR or sustainability initiatives. Results also provided different implications with future research directions. It reveals the collaboration between authors in conducting research in the domain of BGD and CSR is still lacking, suggesting further research in collaboration different authors in CSR and BGD. Journal of business ethics, Corporate governance: an international review, and Academy of management journal were the top-ranking journals in term of source co-citation, and thus journals ought to be further expanded more research in CSR and BGD to enhance their source co-citations. The most productive sponsors and institutions were in developed countries, while country co-authorship analysis revealed more research need to cooperatively be undertaken in developing countries.

Asymptomatic Plasmodium infection among primary schoolchildren and Anopheles-mediated malaria transmission: A cross-sectional study in Ouidah; south-western Benin.

Understanding the contribution of asymptomatic Plasmodium carriers in malaria transmission might be helpful to design and implement new control measures. The present study explored the prevalence of asymptomatic and symptomatic Plasmodium infections (asexual and sexual stages) and the contribution of asymptomatic P. falciparum carriers to Anopheles-mediated malaria transmission in Ouidah (Benin). Thick and thin blood smears were examined from finger-prick blood specimens using light microscopy, and the density of both asexual and sexual stages of Plasmodium species was calculated. Infectivity of gametocyte-infected blood samples to Anopheles gambiae was assessed through direct membrane feeding assays. The prevalence of asymptomatic Plasmodium infections was 28.73% (289/1006). All the asymptomatic gametocyte-carriers (19/19), with gametocytaemia ranging from 10 - 1200 gametocytes/µL of blood, were infectious to An. gambiae mosquitoes. The mean oocyst prevalences varied significantly (χ 2  = 16.42, df = 7, p = 0.02) among laboratory mosquito strains (6.9 - 39.4%) and near-field mosquitoes (4.9 - 27.2%). Likewise, significant variation (χ 2  = 56.85, df = 7, p = 6.39 × 10-10) was observed in oocyst intensity. Our findings indicate that asymptomatic Plasmodium carriers could significantly contribute to malaria transmission. Overall, this study highlights the importance of diagnosing and treating asymptomatic and symptomatic infection carriers during malaria control programmes.

A 10-year follow-up survey of US academic libraries highlights the COVID-19 experience and greater interest in health information outreach.

BACKGROUND: As follow-up to their previous survey on health information outreach (HIO) in 2010, the authors became interested in the evolving nature of HIO activities at academic libraries within the past decade. OBJECTIVES: The aim of this study was to understand how HIO activities at academic libraries have evolved since 2010, especially considering the current COVID-19 pandemic. METHODS: An online survey, designed to collect quantitative data on general HIO activities and qualitative data specifically on COVID-19 information outreach, was distributed to over 1700 librarians at US general academic and academic health science libraries. RESULTS: Two hundred and fifty-five respondents completed the survey. Quantitative findings generally paralleled the 2010 results, except in a few areas. Most notably, a greater percentage of librarians in 2020 were participating in HIO (44%) than in 2010 (37%). Qualitative findings revealed that librarians are leveraging traditional information services and implementing innovative partnerships to promote reputable health information resources on COVID-19. DISCUSSION: Evidence suggests that further engagement and campus partnerships can enhance libraries' supportive roles as trustworthy purveyors of quality health information. CONCLUSION: US academic librarians are increasingly engaging in HIO to support the health information needs of campus communities and should consider aligning outreach activities with national health goals.