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https://www.readbyqxmd.com/read/29778934/spatial-accessibility-of-primary-health-care-in-china-a-case-study-in-sichuan-province
#1
Xiuli Wang, Huazhen Yang, Zhanqi Duan, Jay Pan
Access to primary health care is considered a fundamental right and an important facilitator of overall population health. Township health centers (THCs) and Community health centers (CHCs) serve as central hubs of China's primary health care system and have been emphasized during recent health care reforms. Accessibility of these hubs is poorly understood and a better understanding of the current situation is essential for proper decision making. This study assesses spatial access to health care provided by primary health care institutions (THCs/CHCs) in Sichuan Province as a microcosm in China...
May 10, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29778396/how-effective-are-approaches-to-migrant-screening-for-infectious-diseases-in-europe-a-systematic-review
#2
REVIEW
Farah Seedat, Sally Hargreaves, Laura B Nellums, Jing Ouyang, Michael Brown, Jon S Friedland
Rates of migration to Europe, and within Europe, have increased in recent years, with considerable implications for health systems. Migrants in Europe face a disproportionate burden of tuberculosis, HIV, and hepatitis B and C, yet experience a large number of barriers to accessing statutory health care on arrival. A better understanding of how to deliver effective and cost-effective screening, vaccination, and health services to this group is now crucial. We did a systematic review to document and assess the effectiveness and cost-effectiveness of approaches used for infectious diseases screening, and to explore facilitators and barriers experienced by migrants to accessing screening programmes...
May 16, 2018: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29778254/long-term-liver-disease-treatment-and-mortality-outcomes-among-17-000-persons-diagnosed-with-chronic-hepatitis-c-virus-infection-current-chronic-hepatitis-cohort-study-status-and-review-of-findings
#3
REVIEW
Anne C Moorman, Loralee B Rupp, Stuart C Gordon, Yuna Zhong, Jian Xing, Mei Lu, Joseph A Boscarino, Mark A Schmidt, Yihe G Daida, Eyasu H Teshale, Philip R Spradling, Scott D Holmberg
Chronic Hepatitis Cohort Study (CHeCS) publications using data from "real-world" patients with hepatitis C virus (HCV) have described demographic disparities in access to care; rates of advanced liver disease, morbidity, and mortality (2.5%-3.5% per year during 2006-10, although only 19% of all CHeCS decedents, and just 30% of those with deaths attributed to liver disease, had HCV listed on death certificate); substantial comorbidities, such as diabetes, advanced liver fibrosis (29% prevalence), renal disease, and depression, and partial reversal of all these with successful antiviral therapy; patient risk behaviors; and use of noninvasive markers to assess liver disease...
June 2018: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/29775173/healthcare-barriers-and-supports-for-american-indian-women-with-cancer
#4
Jessica L Liddell, Catherine E Burnette, Soonhee Roh, Yeon-Shim Lee
Although American Indian (AI) women continue to experience cancer at higher rates and have not seen the same decline in cancer prevalence as the general U.S. population, little research examines how interactions with health care providers may influence and exacerbate these health disparities. The purpose of the study was to understand the experiences of AI women who receive cancer treatment, which is integral for eradication of AI cancer disparities among women. A qualitative descriptive methodology was used with a sample of 43 AI women with breast, cervical, colon, and other types of cancer from the Northern Plains region of South Dakota...
May 18, 2018: Social Work in Health Care
https://www.readbyqxmd.com/read/29773125/regional-overview-of-specific-populations-workforce-considerations-training-and-diseases-in-latin-america
#5
REVIEW
Jose Pablo Stolovitzky, Jacqueline Alvarado
Latin America has significant disparities that make the region vulnerable in the delivery of health care. There is a need to plan comprehensive health care strategies that result in a more robust trained health care workforce, while improving the quality and efficiencies of tertiary public hospitals. This article introduces a survey conducted among otorhinolaryngology leaders in the region that identified the need to strengthen postgraduate programs. Although all countries in Latin America have at least one residency program, more otorhinolaryngology-trained specialists are necessary to address the workforce shortages that are present in about 50% of Latin American countries...
June 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29773072/formal-procedure-to-facilitate-the-decision-to-withhold-or-withdraw-life-sustaining-interventions-in-a-neonatal-intensive-care-unit-a-seven-year-retrospective-study
#6
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29771619/affordable-care-act-impact-in-kentucky-increasing-access-reducing-disparities
#7
Lynn A Blewett, Colin Planalp, Giovann Alarcon
OBJECTIVES: To examine health insurance disparities since Kentucky's implementation of the Affordable Care Act (ACA). METHODS: Using the American Community Survey, we estimated coverage rates by race/ethnicity before and after implementation of the ACA (2013 and 2015), and we estimated whether groups were over- or underrepresented among the uninsured, compared with their share of the state population. RESULTS: Kentucky's uninsurance rate declined from 14...
May 17, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29771351/burn-surgeon-and-palliative-care-physician-attitudes-regarding-goals-of-care-delineation-for-burned-geriatric-patients
#8
Holly B Cunningham, Shannon A Scielzo, Paul A Nakonezny, Brandon R Bruns, Karen J Brasel, Kenji Inaba, Scott C Brakenridge, Jeffrey D Kerby, Bellal A Joseph, M J Mohler, Joseph Cuschieri, Mary E Paulk, Akpofure P Ekeh, Tarik D Madni, Luis R Taveras, Jonathan B Imran, Steven E Wolf, Herb A Phelan
Objective: Palliative care specialists and burn surgeons were surveyed regarding: 1) importance of goals of care conversations for burned seniors; 2) confidence in their own specialty's ability to conduct these conversations; and 3) confidence in the ability of the other specialty to do so. Methods: A 13-item survey was developed by the steering committee of a multi-center consortium dedicated to palliative care in the injured geriatric patient and beta-tested by burn surgeons and palliative care specialists unaffiliated with the consortium...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29771101/-evidence-of-lack-of-concordance-between-hemodialysis-patients-and-nurses-on-the-presence-and-severity-of-symptoms
#9
Christine Cohen, Matteo Antonini, Philippe Delmas
Hemodialysis patients represent a fragile population experiencing many symptoms (e.g., pain, fatigue) that impact their quality of life. The presence and severity of these symptoms are significantly underestimated by health professionals. The purpose of this study is to describe and compare the symptoms perceived by hemodialysis patients versus those detected by nurses and to discuss the possible causes of the disparity observed. A total of 123 patients and 70 nurses working in six hemodialysis centers were included in this study...
March 2018: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29770102/rolling-out-hiv-antiretroviral-therapy-in-sub-saharan-africa-2003-2017
#10
G Taylor
Multiple issues need to be addressed in order to control the HIV pandemic in sub-Saharan Africa. Combination antiretroviral therapy (cART) is key to reducing morbidity and mortality among people living with HIV and has a role in preventing HIV transmission. However, access to cART is very unevenly distributed globally, especially in sub-Saharan Africa. Although cost of cART is no longer a major barrier as effective treatment can be had for under US$100 per year, HIV management is compromised by the inadequate number of trained clinicians, the lack of clinical and laboratory infrastructure and the increased prevalence of co-morbidities (e...
February 1, 2018: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29769080/a-complex-culturally-targeted-intervention-to-reduce-hispanic-disparities-in-living-kidney-donor-transplantation-an-effectiveness-implementation-hybrid-study-protocol
#11
Elisa J Gordon, Jungwha Lee, Raymond H Kang, Juan Carlos Caicedo, Jane L Holl, Daniela P Ladner, Michelle D Shumate
BACKGROUND: The shortage of organs for kidney transplantation for patients with end-stage renal disease (ESRD) is magnified in Hispanics/Latin Americans in the United States. Living donor kidney transplantation (LDKT) is the treatment of choice for ESRD. However, compared to their representation on the transplant waitlist, fewer Hispanics receive a LDKT than non-Hispanic whites. Barriers to LDKT for Hispanics include: lack of knowledge, cultural concerns, and language barriers. Few interventions have been designed to reduce LDKT disparities...
May 16, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29766438/sexual-orientation-differences-in-outpatient-psychiatric-treatment-and-antidepressant-usage-evidence-from-a-population-based-study-of-siblings
#12
Richard Bränström, Mark L Hatzenbuehler, Petter Tinghög, John E Pachankis
In the past two decades, population-based health surveys have begun including measures of sexual orientation, permitting estimates of sexual orientation disparities in psychiatric morbidity and differences in treatment utilization. The present study takes advantage of the high-quality, comprehensive nationwide health registry data available in Sweden to examine whether psychiatric outpatient treatment for various diagnoses and antidepressant medication usage are greater in sexual minority individuals compared to their siblings...
May 15, 2018: European Journal of Epidemiology
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#13
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765545/multi-institution-analysis-of-racial-disparity-among-african-american-men-eligible-for-prostate-cancer-active-surveillance
#14
Michael Dinizo, Weichung Shih, Young Suk Kwon, Daniel Eun, Adam Reese, Laura Giusto, Edouard J Trabulsi, Bertram Yuh, Nora Ruel, Daniel Marchalik, Jonathan Hwang, Shilajit D Kundu, Scott Eggener, Isaac Yi Kim
There is a significant controversy on whether race should be a factor in considering active surveillance for low-risk prostate cancer. To address this question, we analyzed a multi-institution database to assess racial disparity between African-American and White-American men with low risk prostate cancer who were eligible for active surveillance but underwent radical prostatectomy. A retrospective analysis of prospectively collected clinical, pathologic and oncologic outcomes of men with low-risk prostate cancer from seven tertiary care institutions that underwent radical prostatectomy from 2003-2014 were used to assess potential racial disparity...
April 20, 2018: Oncotarget
https://www.readbyqxmd.com/read/29764305/pregnancy-experiences-of-women-in-rural-romania-understanding-ethnic-and-socioeconomic-disparities
#15
Katherine LeMasters, Anne Baber Wallis, Razvan Chereches, Margaret Gichane, Ciprian Tehei, Andreea Varga, Katherine Tumlinson
Women in rural Romania face significant health disadvantages. This qualitative pilot study describes the structural disadvantage experienced during pregnancy by women in rural Romania, focusing on the lived experiences of Roma women. We explore how women in rural communities experience pregnancy, their interactions with the healthcare system, and the role that ethnic and social factors play in pregnancy and childbearing. We conducted 42 semi-structured interviews with health and other professionals, seven narrative interviews with Roma and non-Roma women and a focus group with Roma women...
May 15, 2018: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29763786/born-equal-the-distribution-of-government-medicare-spending-for-children
#16
Kim M Dalziel, Li Huang, Harriet Hiscock, Philip M Clarke
Providing equitable care is an objective of many national healthcare systems. Using the birth cohort of the nationally representative Longitudinal Study of Australian Children linked with the Medicare Benefits Scheme billing data who were recruited in 2004 at ages 0-1 years and assessed biennially for six waves, we assessed the distribution of out-of-hospital government Medicare spending by household income. 4853 children followed over 11 years were included in the study. Distributions of major spending components including general practitioner and specialist care were assessed using concentration indices...
April 25, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29763754/determinants-of-cancer-treatment-and-mortality-in-older-cancer-patients-using-a-multi-state-model-results-from-a-population-based-study-the-incapac-study
#17
Angéline Galvin, Catherine Helmer, Gaëlle Coureau, Brice Amadeo, Pierre Joly, Camille Sabathé, Alain Monnereau, Isabelle Baldi, Muriel Rainfray, Pierre Soubeyran, Fleur Delva, Simone Mathoulin-Pélissier
INTRODUCTION: Several studies have reported disparities in the care management and survival of older cancer patients. The aim of our study was to identify determinants of treatment administration in this population of cancer patients aged over 65 years taking into account competing risks of death. METHODS: The INCAPAC study is a population-based study. Four cancer registries and three prospective cohort studies on older subjects (age ≥65 years) from Gironde, a French department, were merged to identify older cancer patients...
May 12, 2018: Cancer Epidemiology
https://www.readbyqxmd.com/read/29762795/addressing-racism-in-medical-education-an-interactive-training-module
#18
Tanya White-Davis, Jennifer Edgoose, Joedrecka S Brown Speights, Kathryn Fraser, Jeffrey M Ring, Jessica Guh, George W Saba
BACKGROUND AND OBJECTIVES: Education of health care clinicians on racial and ethnic disparities has primarily focused on emphasizing statistics and cultural competency, with minimal attention to racism. Learning about racism and unconscious processes provides skills that reduce bias when interacting with minority patients. This paper describes the responses to a relationship-based workshop and toolkit highlighting issues that medical educators should address when teaching about racism in the context of pernicious health disparities...
May 2018: Family Medicine
https://www.readbyqxmd.com/read/29761510/initiation-of-adjuvant-therapy-following-surgical-resection-of-pancreatic-ductal-adenocarcinoma-pdac-are-patients-from-rural-remote-areas-disadvantaged
#19
Kimberly A Bertens, John D Massman, Scott Helton, Samuel Garbus, Margaret M Mandelson, Bruce Lin, Vincent J Picozzi, Thomas Biehl, Adnan A Alseidi, Flavio G Rocha
BACKGROUND AND OBJECTIVES: Although race and socioeconomic status have been shown to affect outcomes in pancreatic ductal adenocarcinoma (PDAC), the impact of rural residence on the delivery of adjuvant therapy (AT) has not been studied. METHODS: Patients with resected PDAC were identified using the National Cancer Database (NCDB). Individuals were classified as living in a metro area, urban/rural adjacent to a metro area (URA), and urban/rural remote (URR) area...
May 14, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29761263/measuring-the-health-of-an-invisible-population-lessons-from-the-colorado-transgender-health-survey
#20
Robin Christian, Amy Anderson Mellies, Alison Grace Bui, Rita Lee, Leo Kattari, Courtney Gray
BACKGROUND: Transgender people, those whose gender identity does not match their sex assigned at birth, face barriers to receiving health care. These include discrimination, prohibitive cost, and difficulty finding transgender-inclusive providers. As transgender identities are not typically recognized in public health research, the ability to compare the health of the transgender population to the overall population is limited. OBJECTIVE: The Colorado Transgender Health Survey sought to explore current disparities and their effects on the health of transgender people in Colorado...
May 15, 2018: Journal of General Internal Medicine
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