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Kiarashi J, Halker Singh RB. Diversity, Equity, and Inclusion in Headache Care and Research. Continuum (Minneap Minn) 2024; 30:498-511. [PMID: 38568496 DOI: 10.1212/con.0000000000001416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
ABSTRACT This article reviews the disparities faced by individuals who experience headache disorders and discusses potential solutions to deliver equitable care. Disparities exist in the diagnosis and treatment of headache disorders with regard to race, ethnicity, sex, gender, sexual orientation, geography, and socioeconomic status. Furthermore, research in the realm of headache disparities is inadequate, and the clinical trial representation of patients from underserved communities is poor. Many barriers exist to optimizing care for underserved communities and this article addresses these barriers and presents ways to combat them.
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Nawas GT, Zeidan RS, Edwards CA, El-Desoky RH. Barriers to COVID-19 Vaccines and Strategies to Improve Acceptability and Uptake. J Pharm Pract 2023; 36:900-904. [PMID: 35465688 PMCID: PMC9047593 DOI: 10.1177/08971900221081621] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The COVID-19 pandemic has had a significant impact on communities across the United States (US). Three vaccines have now been granted Emergency Use Authorization by the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) for use in the US. However, barriers to vaccination exist, some of which are well documented in the literature, including lack of knowledge, fear, accessibility, mistrust in the healthcare system, and systemic and operational obstacles. Vaccine hesitancy in the US could potentially hinder all the efforts and resources being used to beat COVID-19, which has resulted in more than 594 000 deaths in the US per the CDC as of early June 2021. In order to overcome this pandemic, vaccine distribution and uptake is crucial. Pharmacists play a crucial role as healthcare providers as they can dismantle vaccine hesitancy and make an outstanding impact on the efforts to overcome this pandemic.
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Affiliation(s)
- George T Nawas
- Division of Clinical and Administrative Sciences,Xavier University of Louisiana, New Orleans, LA, USA
| | - Rana S Zeidan
- Division of Clinical and Administrative Sciences,Xavier University of Louisiana, New Orleans, LA, USA
| | - Cole A Edwards
- Division of Clinical and Administrative Sciences,Xavier University of Louisiana, New Orleans, LA, USA
| | - Rania H El-Desoky
- Department of Pharmacy Practice and Translational Research,University of Houston College of Pharmacy, Houston, TX, USA
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Hood AM, Booker SQ, Morais CA, Goodin BR, Letzen JE, Campbell LC, Merriwether EN, Aroke EN, Campbell CM, Mathur VA, Janevic MR. Confronting Racism in All Forms of Pain Research: A Shared Commitment for Engagement, Diversity, and Dissemination. THE JOURNAL OF PAIN 2022; 23:913-928. [PMID: 35288029 PMCID: PMC9415432 DOI: 10.1016/j.jpain.2022.01.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 01/25/2023]
Abstract
This third paper in the "Confronting Racism in All Forms of Pain Research" series discusses adopting an antiracism framework across all pain research disciplines and highlights the significant benefits of doing so. We build upon the previous call to action and the proposed reframing of study designs articulated in the other papers in the series and seek to confront and eradicate racism through a shared commitment to change current research practices. Specifically, we emphasize the systematic disadvantage created by racialization (ie, the Eurocentric social and political process of ascribing racialized identities to a relationship, social practice, or group) and discuss how engaging communities in partnership can increase the participation of racialized groups in research studies and enrich the knowledge gained. Alongside this critical work, we indicate why diversifying the research environment (ie, research teams, labs, departments, and culture) enriches our scientific discovery and promotes recruitment and retention of participants from racialized groups. Finally, we recommend changes in reporting and dissemination practices so that we do not stigmatize or reproduce oppressive forms of power for racialized groups. Although this shift may be challenging in some cases, the increase in equity, generalizability, and credibility of the data produced will expand our knowledge and reflect the pain experiences of all communities more accurately. PERSPECTIVE: In this third paper in our series, we advocate for a shared commitment toward an antiracism framework in pain research. We identify community partnerships, diversification of research environments, and changes to our dissemination practices as areas where oppressive forms of power can be reduced.
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Affiliation(s)
- Anna M Hood
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
| | - Staja Q Booker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida; Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Calia A Morais
- Department of Community Dentistry and Behavioral Sciences, Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Burel R Goodin
- Department of Psychology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Janelle E Letzen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa C Campbell
- Department of Psychology, East Carolina University, Greenville, North Carolina
| | - Ericka N Merriwether
- Department of Physical Therapy, Steinhardt School of Culture, Education, and Human Development, New York, New York; Department of Medicine, NYU Grossman School of Medicine, New York University, New York, New York
| | - Edwin N Aroke
- School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, and Continuing Care, University of Alabama at Birmingham, Birmingham, Alabama
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Mary R Janevic
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
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Racial Disparities in the Presentation, Early Definitive Surgical Treatment, and Mortality Among Men Diagnosed with Poorly Differentiated/Undifferentiated Non-metastatic Prostate Cancer in the USA. J Racial Ethn Health Disparities 2018; 6:401-408. [PMID: 30506310 DOI: 10.1007/s40615-018-00537-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/18/2018] [Accepted: 10/29/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the influence of race on presentation of poorly differentiated/undifferentiated prostate cancer, use of radical prostatectomy (RP) as primary treatment and survival outcomes. METHODS Using the 2004-2014 files of the Surveillance, Epidemiology, and End Results (SEER) data, we identified 244,167 black and white men diagnosed with poorly differentiated/undifferentiated prostate cancer. Demographic and tumor characteristics of study patients were compared by race. Logistic regression was used to evaluate the influence of race on receipt of RP. Cox proportional hazard models were fitted to determine the impact of RP and race on cancer-specific mortality (CSM) and all-cause mortality (ACM). RESULTS Compared to white men, black men were diagnosed of prostate cancer at a younger age (64.2 years versus (vs) 67.5 years, p < 0.0001) and presented with higher median prostate-specific antigen, PSA (24.4 ng/ml vs 22.1 ng/ml, p < 0.0001) but lower disease stage. Lower proportion of black men received RP compared to white men (33.9% vs 42.6%; p < 0.0001). The odds of receipt of RP were 2 times higher in white men relative to black men. The risks of CSM and ACM were over 2 times and 3 times respectively higher in patients who did not receive RP vs patients who received RP in the study population and in each race. CONCLUSION Despite the younger age at diagnosis of poorly differentiated/undifferentiated prostate cancer and higher PSA at diagnosis in black men, white men had significantly higher odds of receipt of RP relative to black men.
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Defining Innovation in Neurosurgery: Results from an International Survey. World Neurosurg 2018; 114:e1038-e1048. [PMID: 29604357 DOI: 10.1016/j.wneu.2018.03.142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Innovation is a part of the daily practice of neurosurgery. However, a clear definition of what constitutes innovation is lacking and opinions vary from continent to continent, from hospital to hospital, and from surgeon to surgeon. METHODS In this study, we distributed an online survey to neurosurgeons from multiple countries to investigate what neurosurgeons consider innovative, by gathering opinions on several hypothetical cases. The anonymous survey consisted of 52 questions and took approximately 10 minutes to complete. RESULTS A total of 355 neurosurgeons across all continents excluding Antarctica completed the survey. Neurosurgeons achieved consensus (>75%) in considering specific cases to be innovative, including laser resection of meningioma, focused ultrasonography for tumor, oncolytic virus, deep brain stimulation for addiction, and photodynamic therapy for tumor. Although the new dura substitute case was not considered innovative, there was consensus among neurosurgeons indicating that institutional review board approval was still necessary to maintain ethical standards. Furthermore, although 90% of neurosurgeons considered an oncolytic virus for glioblastoma multiforme to be innovative, only 78% believed that institutional review board approval was necessary before treatment. CONCLUSIONS Our results indicate that innovation is a heterogeneous concept among neurosurgeons that necessitates standardization to ensure appropriate patient safety without stifling progress. We discuss both the ethical drawbacks of not having a clear definition of innovation and the challenges in achieving a unified understanding of innovation in neurosurgery and offer suggestions for uniting the field.
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