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https://www.readbyqxmd.com/read/29140918/integrating-social-determinants-of-health-into-graduate-medical-education-a-call-for-action
#1
Jennifer Siegel, David L Coleman, Thea James
Social determinants of health (SDH) are the major drivers of health and disparate health outcomes across communities and populations. Given this, the authors assert that competency in recognizing and mitigating SDH should become a vital component of graduate medical education in all specialties. While the most effective approaches to educating trainees about SDH are uncertain, in this Invited Commentary, the authors offer several key principles for implementing curricula focusing on SDH. These include universalization of the material, integration into clinical education, identification of space for trainee introspection, clarification of specific competencies in identification and mitigation of SDH, and creation of robust faculty development programming...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140916/gender-disparities-in-medical-student-research-awards-a-thirteen-year-study-from-the-yale-school-of-medicine
#2
Joseph T King, Nancy R Angoff, John N Forrest, Amy C Justice
PURPOSE: Instruction in research conduct is currently required, and many U.S. medical schools require students to complete a research project. Each year all Yale School of Medicine (YSM) graduating students submit a research thesis, and ~5% are awarded highest honors. Gender disparities exist in areas related to physician research productivity, including academic rank, research funding, and publications. The authors asked whether gender disparities exist for medical student research. METHOD: The authors conducted a retrospective review of 1,120 theses submitted by graduating medical students from 2003-2015 at YSM and collected data on gender, mentoring, research type, sponsoring department, and other characteristics...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140915/the-actual-versus-idealized-self-exploring-responses-to-feedback-about-implicit-bias-in-health-professionals
#3
Javeed Sukhera, Alexandra Milne, Pim W Teunissen, Lorelei Lingard, Chris Watling
PURPOSE: Implicit bias can adversely affect health disparities. The implicit association test (IAT) is a prompt to stimulate reflection; however, feedback about bias may trigger emotions that reduce the effectiveness of feedback interventions. Exploring how individuals process feedback about implicit bias may inform bias recognition and management curricula. The authors sought to explore how health professionals perceive the influence of the experience of taking the IAT and receiving their results...
November 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29140619/-i-would-go-if-my-arm-were-hanging-off-a-qualitative-study-of-healthcare-seeking-behaviors-of-small-farm-owners-in-central-new-york-state
#4
David J Droullard, Pamela J Tinc, Julie A Sorensen
Compared to their rural non-farming peers, farmers are less likely to access preventive healthcare services; however, the reasons for this disparity are poorly understood. We conducted semi-structured interviews with a total of 30 farm household members in central New York. Interview topics included farming identity, perceptions of one's health, past experiences with acute and preventive healthcare, and attitudes toward seeking healthcare services. Grounded Theory analysis of the interview transcripts revealed that (1) utilizing healthcare services is felt to be in conflict with the farming identity, (2) the need to conserve time and money for farm applications poses a barrier to healthcare utilization, (3) farmers decide to seek healthcare when they believe it is necessary to ensure survival of the farm, and (4) the decision to seek healthcare is most strongly driven by the presence of intolerable symptoms, prompting from others, and the perception that treatment will yield clear benefits...
January 26, 2017: Journal of Agricultural Safety and Health
https://www.readbyqxmd.com/read/29140597/improving-omics-based-research-and-precision-health-in-minority-populations-recommendations-for-nurse-scientists
#5
Jacquelyn Y Taylor, Veronica Barcelona de Mendoza
PURPOSE: The purpose of this article is to provide an overview of the role of nurse scientists in -omics-based research and to promote discussion around the conduct of -omics-based nursing research in minority communities. Nurses are advocates, educators, practitioners, scientists, and researchers, and are crucial to the design and successful implementation of -omics studies, particularly including minority communities. The contribution of nursing in this area of research is crucial to reducing health disparities...
November 15, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/29140535/socioeconomic-disparities-in-small-for-gestational-age-birth-and-preterm-birth
#6
Tracey Bushnik, Seungmi Yang, Jay S Kaufman, Michael S Kramer, Russell Wilkins
BACKGROUND: Maternal socioeconomic disadvantage has been associated with increased risk of small-for-gestational-age birth and preterm birth. Few studies, however, have considered maternal education and income simultaneously to better understand the mechanisms underlying perinatal health disparities. This analysis examines both maternal education and income and their association with the risk of small-for-gestational-age birth and preterm birth. DATA AND METHODS: The study is based on 127,694 singleton live births from the 2006 Canadian Birth-Census Cohort, a national cohort of births registered from May 2004 to May 2006 that were linked to the 2006 long-form Census...
November 15, 2017: Health Reports
https://www.readbyqxmd.com/read/29138303/cxc-chemokines-exhibit-bactericidal-activity-against-multidrug-resistant-gram-negative-pathogens
#7
Matthew A Crawford, Debra J Fisher, Lisa M Leung, Sara Lomonaco, Christine Lascols, Antonio Cannatelli, Tommaso Giani, Gian Maria Rossolini, Yohei Doi, David R Goodlett, Marc W Allard, Shashi K Sharma, Erum Khan, Robert K Ernst, Molly A Hughes
The continued rise and spread of antimicrobial resistance among bacterial pathogens pose a serious challenge to global health. Countering antimicrobial-resistant pathogens requires a multifaceted effort that includes the discovery of novel therapeutic approaches. Here, we establish the capacity of the human CXC chemokines CXCL9 and CXCL10 to kill multidrug-resistant Gram-negative bacteria, including New Delhi metallo-beta-lactamase-1-producing Klebsiella pneumoniae and colistin-resistant members of the family Enterobacteriaceae that harbor the mobile colistin resistance protein MCR-1 and thus possess phosphoethanolamine-modified lipid A...
November 14, 2017: MBio
https://www.readbyqxmd.com/read/29138129/patient-portal-utilization-among-ethnically-diverse-low-income-older-adults-observational-study
#8
Thomas A Arcury, Sara A Quandt, Joanne C Sandberg, David P Miller, Celine Latulipe, Xiaoyan Leng, Jenifer W Talton, Kathryn P Melius, Alden Smith, Alain G Bertoni
BACKGROUND: Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization. OBJECTIVE: The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities...
November 14, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29137950/linking-race-cancer-outcomes-and-tissue-repair
#9
REVIEW
Jung S Byun, Samson Park, Ambar Caban, Alana Jones, Kevin Gardner
The burden of cancer in the United States is unevenly spread across its different populations, with stark differences in both disease prevalence and outcome based on race and ethnicity. Although a large portion of these differences can be explained by a variety of socio-behavioral and socio-economic factors, even after these exposures are taken into consideration, significant disparities persist. In this review, we explore a conceptual framework of biological theories and unifying concepts, based on an evolutionary perspective, that may help better define common guiding principles for exploration of underlying etiologies of cancer health disparities...
November 11, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/29137949/the-science-of-cancer-health-disparities
#10
EDITORIAL
Kevin Gardner
This Guest Editorial highlights the reviews in Race in Cancer Health Disparities Theme Issue that improve our understanding of the complex role of race in disparities in cancer frequency and outcome.
November 11, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/29137948/analysis-of-tumor-biology-to-advance-cancer-health-disparity-research
#11
REVIEW
Cheryl Jacobs Smith, Tsion Zewdu Minas, Stefan Ambs
Cancer mortality rates in the US continue to decline. Reductions in tobacco use, uptake of preventive measures, adoption of early detection methods, and better treatments have resulted in improved cancer outcomes for men and women. Despite this progress, some population groups continue to experience an excessive cancer burden when compared with other population groups. One of the most prominent cancer health disparities exists in prostate cancer. Prostate cancer mortality rates are highest among men of African ancestry when compared with other men, both in the US and globally...
November 11, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/29136491/fitness-trends-and-disparities-among-school-aged-children-in-georgia-2011-2014
#12
Yang Bai, Pedro F Saint-Maurice, Gregory J Welk
OBJECTIVES: Although FitnessGram fitness data on aerobic capacity and body mass index (BMI) have been collected in public schools in Georgia since the 2011-2012 school year, the data have not been analyzed. The primary objective of our study was to use these data to assess changes in fitness among school-aged children in Georgia between 2011 and 2014. A secondary objective was to determine if student fitness differed by school size and socioeconomic characteristics. METHODS: FitnessGram classifies fitness into the Healthy Fitness Zone (HFZ) or not within the HFZ for aerobic capacity and BMI...
November 2017: Public Health Reports
https://www.readbyqxmd.com/read/29135791/an-ecological-approach-to-understanding-preventive-service-utilization-among-the-underserved
#13
Bettie Coplan
Preventive services have the potential to reduce health disparities; however, these services are underutilized, particularly among the underserved. Patients with low socioeconomic status and racial and ethnic minorities experience significant health disparities related to cancer and infectious and chronic diseases but face multilevel challenges accessing preventive care. The purpose of this article is to enhance understanding of preventive service utilization among underserved patients by providing an ecological framework that addresses factors at multiple levels that influence patient care...
January 2018: Family & Community Health
https://www.readbyqxmd.com/read/29135790/using-a-cultural-framework-to-assess-motivation-for-physical-activity-among-older-hispanic-women-application-of-the-pen-3-model
#14
Adriana Perez, Julie Fleury
Culturally relevant strategies for intervention design and implementation, emphasizing strengths and resources, are essential to address cardiovascular health disparities among older Hispanic women. The purpose of this article is to present the process and results of focus group discussions conducted to understand the meaning of cultural, social, and contextual strengths to promote motivation for physical activity and cardiovascular health in this population. The PEN-3 model guided analysis of focus group data...
January 2018: Family & Community Health
https://www.readbyqxmd.com/read/29135782/examining-race-and-ethnicity-information-in-medicare-administrative-data
#15
Clara E Filice, Karen E Joynt
Racial and ethnic disparities are observed in the health status and health outcomes of Medicare beneficiaries. Reducing these disparities is a national priority, and having high-quality data on individuals' race and ethnicity is critical for researchers working to do so. However, using Medicare data to identify race and ethnicity is not straightforward. Currently, Medicare largely relies on Social Security Administration data for information about Medicare beneficiary race and ethnicity. Directly self-reported race and ethnicity information is collected for subsets of Medicare beneficiaries but is not explicitly collected for the purpose of populating race/ethnicity information in the Medicare administrative record...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135781/defining-rurality-in-medicare-administrative-data
#16
John E Snyder, Matthew Jensen, Nguyen X Nguyen, Clara E Filice, Karen E Joynt
Rural beneficiaries make up nearly one quarter of the Medicare population, yet rural providers and patients face specific challenges with health and health care delivery that remain inadequately understood. Health disparities between rural and urban residents are widespread, barriers to health care in rural communities persist, and the rural health care workforce is limited. To better understand and track the relationship between rurality and performance under Medicare's payment programs, researchers must be able to identify rural beneficiaries, providers, and hospitals...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135780/examining-measures-of-income-and-poverty-in-medicare-administrative-data
#17
Lok Wong Samson, Kenneth Finegold, Azeem Ahmed, Matthew Jensen, Clara E Filice, Karen E Joynt
Disparities by economic status are observed in the health status and health outcomes of Medicare beneficiaries. For health services and health policy researchers, one barrier to addressing these disparities is the ability to use Medicare data to ascertain information about an individual's income level or poverty, because Medicare administrative data contains limited information about individual economic status. Information gleaned from other sources-such as the Medicaid and Supplemental Security Income programs-can be used in some cases to approximate the income of Medicare beneficiaries...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29135623/patient-ethnicity-predicts-poor-health-access-and-gaps-in-perception-of-personal-cardiovascular-risk-factors
#18
Yeunjung Kim, Kathryn Hogan, Gail D'Onofrio, Sharon Chekijian, Basmah Safdar
BACKGROUND: Focus of health literacy campaigns has centered around raising awareness. It is unknown whether awareness of coronary artery disease risk factors accurately reflects personalization of one's own cardiovascular risk. METHODS: A cross-sectional survey was performed in consecutive patients presenting with chest pain admitted to an observation unit of a tertiary care hospital. A 32-item questionnaire in English or Spanish examined knowledge of coronary artery disease risk factors...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29134325/spatial-context-and-health-inequity-reconfiguring-race-place-and-poverty
#19
Elizabeth L Tung, Kathleen A Cagney, Monica E Peek, Marshall H Chin
Intimate connections among race, place, and poverty are increasingly featured in the health disparities literature. However, few models exist that can guide our understanding of these interconnections. We build on the Chicago School of Sociology's contributions in urban research and one of its contemporary elaborations, often described as the "neighborhood effects approach," to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity...
November 13, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/29132627/examining-health-disparities-by-gender-a-multimorbidity-network-analysis-of-electronic-medical-record
#20
Pankush Kalgotra, Ramesh Sharda, Julie M Croff
PROBLEM: Multimorbidity health disparities have not been well examined by gender. Co-occurring diseases may be mutually deleterious, co-occurring independently, or co-occurring from a common antecedent. Diseases linked by a common antecedent may be caused by biological, behavioral, social, or environmental factors. This paper aims to address the co-occurrences of diseases using network analysis. METHODS: In this study, we identify these multi-morbidities from a large electronic medical record (EMR) containing diagnoses, symptoms and treatment data on more than 22...
December 2017: International Journal of Medical Informatics
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