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Underserved populations

Antonio J Salazar, Javier A Romero, Oscar A Bernal, Angela P Moreno, Sofía C Velasco, Xavier A Díaz
Objective. The aim of this study was to evaluate and compare the clinical performance of different alternatives to implement low-cost screening telemammography. We compared computed radiography, film printed images, and digitized films produced with a specialized film digitizer and a digital camera. Material and Methods. The ethics committee of our institution approved this study. We assessed the equivalence of the clinical performance of observers for cancer detection. The factorial design included 70 screening patients, four technological alternatives, and cases interpreted by seven radiologists, for a total of 1,960 observations...
2016: International Journal of Telemedicine and Applications
Ikenna C Nweze, Jody C DiGiacomo, Silvia S Shin, Camilla Gupta, Rema Ramakrishnan, Lambros D G Angus
BACKGROUND: Alcohol-related trauma remains high among underserved patients despite ongoing preventive measures. Geographic variability in prevalence of alcohol-related injury has prompted reexamination of this burden across different regions. We sought to elucidate demographic and socioeconomic factors influencing the prevalence of alcohol-related trauma among underserved patients and determine alcohol effects on selected outcomes. METHODS: A retrospective analysis examined whether patients admitted to a suburban trauma center differed according to their blood alcohol concentration (BAC) on admission...
October 18, 2016: Injury
Paulette Cutruzzula, Daniel Edwards, David Cahn, Carmen Tong, Dana Kivlin, Laurence Belkoff
A 69 year-old homeless African American male with prostate cancer diagnosed 2 years prior presents a large mass in the right thigh. Evaluation of the patient revealed a PSA of 9,362 ng/ml. IR biopsy of the leg mass was performed and final pathology indicated metastatic adenocarcinoma of the prostate. While metastatic prostate cancer presents most commonly in bone, lymph nodes, lungs and liver, metastatic disease presenting as a soft tissue mass is extremely rare.(1,2,3) Advent of screening with PSA has led to earlier diagnosis of lower grade disease, yet underserved populations continue to present with aggressive and morbid disease...
October 17, 2016: Urology
Fernando A Wagner, Payam Sheikhattari, Jane Buccheri, Mary Gunning, Lisa Bleich, Christine Schutzman
: Smoking disproportionally affects minority and underserved populations but only a handful of interventions tailored to these populations have demonstrated effectiveness in real-life situations. We use community-based participatory research (CBPR) to test two interventions delivered by a community-based health care center. METHODS: Participants randomly assigned to individual or group-based intervention for smoking cessation (N= 400). Both included cessation counseling and health education, a contingency behavioral program, Nicotine Replacement Therapy, and health care for other comorbidities...
2016: Journal of Health Care for the Poor and Underserved
Joshua J Fenton, Kevin Fiscella, Anthony F Jerant, Francis Sousa, Mark Henderson, Tonya Fancher, Peter Franks
A diverse physician workforce is needed to increase access to care for underserved populations, particularly as the Affordable Care Act expands insurance coverage. Yet legal restrictions constrain the extent to which medical schools may use race/ethnicity in admissions decisions. We conducted simulations using academic metrics and socioeconomic data from applicants to a California public medical school from 2011 to 2013. The simulations systematically adjusted medical school applicants' academic metrics for socioeconomic disadvantage...
2016: Journal of Health Care for the Poor and Underserved
Chad K Gentry, Robin P Parker, Christian Ketel, S Trent Rosenbloom, Terri D Crutcher, Aaron W Scott, Jannyse L Starks, Heather A Davidson, Bonita A Pilon
This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.
2016: Journal of Health Care for the Poor and Underserved
Michelle A Fritsch, Nathan Culver, Nicole Culhane, Jonathan Thigpen, Anne Lin
Objective. To incorporate direct patient care and service components throughout a 4-year pharmacy program to enable students to apply knowledge learned in the classroom and develop the human and caring dimensions of Fink's Taxonomy of Significant Learning. Design. Groups of 10-12 students and a faculty advisor partnered with a local agency serving an underserved population of the greater Baltimore area to provide seven hours of service per student each semester. Activities were determined based on students' skills and agency needs...
September 25, 2016: American Journal of Pharmaceutical Education
António Dos Anjos Luis, Pedro Cabral
BACKGROUND: Access to healthcare services has an essential role in promoting health equity and quality of life. Knowing where the places are and how much of the population is covered by the existing healthcare network is important information that can be extracted from Geographical Information Systems (GIS) and used in effective healthcare planning. The aim of this study is to measure the geographic accessibility of population to existing Healthcare Centers (HC), and to estimate the number of persons served by the health network of Mozambique...
October 18, 2016: International Journal for Equity in Health
Stephen W Duffy, Jonathan P Myles, Roberta Maroni, Abeera Mohammad
OBJECTIVE: Screening participation is spread differently across populations, according to factors such as ethnicity or socioeconomic status. We here review the current evidence on effects of interventions to improve cancer screening participation, focussing in particular on effects in underserved populations. METHODS: We selected studies to review based on their characteristics: focussing on population screening programmes, showing a quantitative estimate of the effect of the intervention, and published since 1990...
October 17, 2016: Journal of Medical Screening
Caroline Kingori, Camila LeMaster Esquivel, Qorsho Hassan, Abdul Elmi, Bakali Mukasa, Michael Reece
African-born immigrants and refugees have HIV infection rates six times higher than any other minority groups in the United States. Despite the increase in the population size and diversity of Somali immigrants and refugees in the United States, Somalis are one of the medically underserved population subgroups in this region. The lack of aggregate HIV infection rates among African-born immigrants, for example, Somali refugees, is a cause for alarm and calls for more research to be conducted in this subgroup...
October 2016: AIDS Patient Care and STDs
Deborah Q Shelef, Cynthia Rand, Randi Streisand, Ivor B Horn, Kabir Yadav, Lisa Stewart, Naja Foushee, Damian Waters, Stephen J Teach
BACKGROUND: Stakeholder engagement has the potential to develop research interventions which are responsive to patient and provider preferences. This approach contrasts with traditional models of clinical research, in which researchers determine the study's design. OBJECTIVE: This article describes the impact of stakeholder engagement on the design of a randomized trial of an intervention designed to improve child asthma outcomes by reducing parental stress. METHODS: The study team developed and implemented a stakeholder engagement process that provided iterative feedback regarding the study design, patient-centered outcomes, and intervention...
October 12, 2016: Journal of Allergy and Clinical Immunology
Lorie Donelle, Jodi Hall
Health promotion is the process of enabling people to increase control over, and to improve, their health. For criminalized women, opportunities to engage in health-promoting activities are obstructed by factors related to the context of their lives prior to and during incarceration. The purpose of this study was to gain insight into criminalized women's health and their access to health information and services. Thematic data analysis of body maps and interview transcripts revealed a central theme related to barriers and facilitators to health resources as contingent on being "inside" or "outside" of the incarceration setting...
October 2016: Journal of Correctional Health Care
Kirsten Maertens, Tessa Braeckman, Geert Top, Pierre Van Damme, Elke Leuridan
In Belgium, pertussis vaccination is recommended for all pregnant women in every pregnancy. Adults in close contact with young infants are equally advised to receive a pertussis containing booster dose. Maternal influenza vaccination is likewise recommended in Belgium in the second or third trimester of pregnancy, within the influenza season. A quantitative multicenter survey study has been performed between October 2014 and May 2015 in both postpartum women (N=823, response rate=89.2%) and health care workers (HCWs) (N=261) to assess the coverage of both vaccines during pregnancy along with the coverage of the pertussis cocoon strategy, and to evaluate the knowledge and recommending attitude of HCWs towards the maternal vaccination strategies and the cocoon strategy among surveyed women and HCWs...
October 11, 2016: Vaccine
Lori L Jervis, Sherry Hamby, Scott R Beach, Mary L Williams, Valerie Maholmes, Dorothy M Castille
This article provides an overview of the status of research on elder mistreatment among underserved populations in the United States, including gaps in our current knowledge base, scientific and structural barriers to growing research on the exploitation, neglect, and abuse of older people from diverse and disadvantaged ethnic/racial, geographic, sexual identity, and socioeconomic groups. High priority areas in need of new elder mistreatment research with underserved populations are identified, and suggestions are given for how this research can be facilitated by researchers, university institutional review boards, and funding agencies...
October 14, 2016: Journal of Elder Abuse & Neglect
Matthew A R Stokes, Glenn D Guest, Perista Mamadi, Westin Seta, Noel Yaubihi, Grace Karawiga, Billy Naidi, David A K Watters
BACKGROUND: Timely access to emergency and essential surgical care (EESC) and anaesthesia in low- and middle-income countries (LMICs) prevents premature death, minimises lifelong disability and reduces their economic impact on families and communities. Papua New Guinea is one of the poorest countries in the Pacific region, and provides much of its surgical care at a district hospital level. We aimed to evaluate the surgical capacity of a district hospital in PNG and estimate the effectiveness of surgical interventions provided...
October 13, 2016: World Journal of Surgery
Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael Chin, John Sullivan, Shyamsundar Raithatha, Robert Goldberg, Somashekhar Nimbalkar, Jeroan Allison, Sunil Thanvi, David McManus
BACKGROUND: Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly. OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor...
October 13, 2016: JMIR Public Health and Surveillance
Mehmet I Gökce, Xuemei Wang, Jacqueline Frost, Pamela Roberson, Robert J Volk, Durado Brooks, Steven E Canfield, Curtis A Pettaway
BACKGROUND: The American Cancer Society (ACS) recommends men have the opportunity to make an informed decision about screening for prostate cancer (PCa). The ACS developed a unique decision aid (ACS-DA) for this purpose. However, to date, studies evaluating the efficacy of the ACS-DA are lacking. The authors evaluated the ACS-DA among a cohort of medically underserved men (MUM). METHODS: A multiethnic cohort of MUM (n = 285) was prospectively included between June 2010 and December 2014...
October 11, 2016: Cancer
Satya Surbhi, Kiraat D Munshi, Paula C Bell, James E Bailey
OBJECTIVES: First, to investigate the prevalence and types of drug therapy problems and medication discrepancies among super-utilizers, and associated patient characteristics. Second, to examine the outcomes of pharmacist recommendations and estimated cost avoidance through care transitions support focused on medication management. DESIGN: Retrospective analysis of the pharmacist-led interventions as part of the SafeMed Program. SETTING: A large nonprofit health care system serving the major medically underserved areas in Memphis, Tennessee...
October 6, 2016: Journal of the American Pharmacists Association: JAPhA
Craig N Sawchuk, Peter Roy-Byrne, Carolyn Noonan, Julia R Craner, Jack Goldberg, Spero Manson, Dedra Buchwald
Panic disorder is a common mental health condition, but little is known about panic disorder in non-Caucasian populations. The purpose of this study is to describe the epidemiology, clinical features, and comorbidities of panic attacks and panic disorder in two large American Indian (AI) tribes (N=3084). A culturally-adapted version of the Composite International Diagnostic Interview assessed panic attacks, panic disorder, and various psychiatric comorbidities. After adjusting for age, gender, and tribe, linear and logistic regression analyses were conducted to compare AIs with panic disorder to those with panic attacks only on clinical characteristics and panic symptoms...
October 5, 2016: Journal of Anxiety Disorders
Antonella Surbone, Michael T Halpern
The number of individuals diagnosed with cancer is growing worldwide. Cancer patients from underserved populations have widely documented disparities through the continuum of cancer care. As the number of cancer survivors (i.e., individuals who have completed cancer treatment) from underserved populations also continue to grow, these individuals may continue to experience barriers to survivorship care, resulting in persistent long-term negative impacts on health and quality of life. In addition, there is limited participation of survivors from underserved populations in clinical trials and other research studies...
October 6, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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