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Tan MC, Stabellini N, Tan JY, Thong JY, Hedrick C, Moore JX, Cullen J, Hines A, Sutton A, Sheppard V, Agarwal N, Guha A. Reducing racial and ethnic disparities in cardiovascular outcomes among cancer survivors. Curr Oncol Rep 2024:10.1007/s11912-024-01578-7. [PMID: 39002054 DOI: 10.1007/s11912-024-01578-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 07/15/2024]
Abstract
PURPOSE OF REVIEW Analyze current evidence on racial/ethnic disparities in cardiovascular outcomes among cancer survivors, identifying factors and proposing measures to address health inequities. RECENT FINDINGS Existing literature indicates that the Black population experiences worse cardiovascular outcomes following the diagnosis of both initial primary cancer and second primary cancer, with a notably higher prevalence of cardio-toxic events, particularly among breast cancer survivors. Contributing socioeconomic factors to these disparities include unfavorable social determinants of health, inadequate insurance coverage, and structural racism within the healthcare system. Additionally, proinflammatory epigenetic modification is hypothesized to be a contributing genetic variation factor. Addressing these disparities requires a multiperspective approach, encompassing efforts to address racial disparities and social determinants of health within the healthcare system, refine healthcare policies and access, and integrate historically stigmatized racial groups into clinical research. Racial and ethnic disparities persist in cardiovascular outcomes among cancer survivors, driven by multifactorial causes, predominantly associated with social determinants of health. Addressing these healthcare inequities is imperative, and timely efforts must be implemented to narrow the existing gap effectively.
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Affiliation(s)
- Min Choon Tan
- Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Nickolas Stabellini
- Department of Cardiovascular Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Case Western Reserve University School of Medicine, Case Western Reserve University, Cleveland, OH, USA
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Jia Yi Tan
- Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ, USA
| | - Jia Yean Thong
- Fudan University Shanghai Medical College, Yangpu District, Shanghai, China
| | - Catherine Hedrick
- Department of Cardiovascular Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | | | - Anika Hines
- Virginia Commonwealth University, Richmond, VA, USA
| | | | | | | | - Avirup Guha
- Department of Cardiovascular Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA.
- Department of Hematology-Oncology, University Hospitals Seidman Cancer Center, Cleveland, OH, USA.
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Liu T, Liu Y, Su Y, Hao J, Liu S. Air pollution and upper respiratory diseases: an examination among medically insured populations in Wuhan, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1123-1132. [PMID: 38507092 DOI: 10.1007/s00484-024-02651-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
Multiple evidence has supported that air pollution exposure has detrimental effects on the cardiovascular and respiratory systems. However, most investigations focus on the general population, with limited research conducted on medically insured populations. To address this gap, the current research was designed to examine the acute effects of inhalable particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), ground-level ozone (O3), and sulfur dioxide (SO2) on the incidence of upper respiratory tract infections (URTI), utilizing medical insurance data in Wuhan, China. Data on URTI were collected from the China Medical Insurance Basic Database for Wuhan covering the period from 2014 to 2018, while air pollutant data was gathered from ten national monitoring stations situated in Wuhan city. Statistical analysis was performed using generalized additive models for quasi-Poisson distribution with a log link function. The analysis indicated that except for ozone, higher exposure to four other pollutants (NO2, SO2, PM2.5, and PM10) were significantly linked to an elevated risk of URTI, particularly during the previous 0-3 days and previous 0-4 days. Additionally, NO2 and SO2 were found to be positively linked with laryngitis. Furthermore, the effects of air pollutants on the risk of URTI were more pronounced during cold seasons than hot seasons. Notably, females and the employed population were more susceptible to infection than males and non-employed individuals. Our findings gave solid proof of the link between ambient air pollution exposure and the risk of URTI in medically insured populations.
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Affiliation(s)
- Tianyu Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yuehua Liu
- Vanke School of Public Health, Tsinghua University, 30 Shuangqing Road, Haidian District, Beijing, China
| | - Yaqian Su
- School of Public Health, Shantou University, Shantou, 515063, Guangdong Province, China
| | - Jiayuan Hao
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Suyang Liu
- School of Public Health, Shantou University, Shantou, 515063, Guangdong Province, China.
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Hirani R, Mullen JT. Letter to the Editor-Better late than never: The significance of health equity education in the core surgical clerkship. Surgery 2024; 175:1621-1622. [PMID: 38040598 DOI: 10.1016/j.surg.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/24/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Rahim Hirani
- School of Medicine, New York Medical College, Valhalla, NY.
| | - John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, MA
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Bishay AE, Hughes NC, Zargari M, Paulo DL, Bishay S, Lyons AT, Morkos MN, Ball TJ, Englot DJ, Bick SK. Disparities in Access to Deep Brain Stimulation for Parkinson's Disease and Proposed Interventions: A Literature Review. Stereotact Funct Neurosurg 2024; 102:179-194. [PMID: 38697047 DOI: 10.1159/000538748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/28/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease (PD), but disparities exist in access to DBS along gender, racial, and socioeconomic lines. SUMMARY Women are underrepresented in clinical trials and less likely to undergo DBS compared to their male counterparts. Racial and ethnic minorities are also less likely to undergo DBS procedures, even when controlling for disease severity and other demographic factors. These disparities can have significant impacts on patients' access to care, quality of life, and ability to manage their debilitating movement disorders. KEY MESSAGES Addressing these disparities requires increasing patient awareness and education, minimizing barriers to equitable access, and implementing diversity and inclusion initiatives within the healthcare system. In this systematic review, we first review literature discussing gender, racial, and socioeconomic disparities in DBS access and then propose several patient, provider, community, and national-level interventions to improve DBS access for all populations.
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Affiliation(s)
- Anthony E Bishay
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA,
| | - Natasha C Hughes
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Michael Zargari
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Danika L Paulo
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Steven Bishay
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Mariam N Morkos
- Arizona College of Osteopathic Medicine, Glendale, Arizona, USA
| | - Tyler J Ball
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Dario J Englot
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Sarah K Bick
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Negrete M, Ademiluyi A, Karayeva E, Eskridge G, Huggins M, Eskridge CM, Price BD, Bendinskas KG, Watson KS, Kim SJ. Bridging the Gap: Engaging Black Men in Lung Cancer Research Through Barbershop Collaboration. Am J Mens Health 2024; 18:15579883241229417. [PMID: 38339791 PMCID: PMC10859066 DOI: 10.1177/15579883241229417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 02/12/2024] Open
Abstract
Health disparities persist among Black men, notably in the context of lung cancer and stress-related health outcomes. This study explores these disparities through a community-based participatory research (CBPR) approach, citizen science, and social network theory, leveraging the expertise and trust of Black barbers as community leaders. The purpose is to understand the nuanced connections between stress and lung cancer in this demographic. Engaging 161 Black men across four Chicago neighborhoods, the study successfully collected hair samples and survey data, emphasizing the importance of culturally sensitive recruitment strategies. Findings highlight the effectiveness of the collaboration, showcasing the role of barbershops as community hubs for research. The study concludes by advocating for sustained partnerships with community leaders, emphasizing transparency in research communication, and promoting culturally grounded approaches to address health disparities and enhance research participation among underrepresented populations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Karriem S. Watson
- National Institutes of Health (NIH) All of Us Research Program, Bethesda, MD, USA
| | - Sage J. Kim
- University of Illinois Chicago, Chicago, IL, USA
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Leyva-Moral JM, Tosun B, Gómez-Ibáñez R, Navarrete L, Yava A, Aguayo-González M, Dirgar E, Checa-Jiménez C, Bernabeu-Tamayo MD. From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students. BMC Nurs 2023; 22:356. [PMID: 37798717 PMCID: PMC10552190 DOI: 10.1186/s12912-023-01521-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. METHODS A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. RESULTS Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. CONCLUSIONS Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.
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Affiliation(s)
- Juan M Leyva-Moral
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - Betül Tosun
- Nursing Department, Faculty of Health Sciences, University of Hasan Kalyoncu, Gaziantep, Turkey
| | - Rebeca Gómez-Ibáñez
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain.
| | - Laura Navarrete
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
- Consorci Corporació Sanitaria Parc Taulí, Barcelona, Spain
| | - Ayla Yava
- Nursing Department, Faculty of Health Sciences, University of Hasan Kalyoncu, Gaziantep, Turkey
| | - Mariela Aguayo-González
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - Ezgi Dirgar
- Midwifery Department, Faculty of Health Sciences, University of Gaziantep, Gaziantep, Turkey
| | - Caterina Checa-Jiménez
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
| | - M Dolors Bernabeu-Tamayo
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Avda. Can Domènech s/n, 08193 Bellaterra, Barcelona, Spain
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Gervasio KA, Camarena J, Hampton J, Chopra N, Kalosza B, Shumate L, Wu AY. Demographic and socioeconomic disparities in receipt of ophthalmology consultation for facial trauma. BMJ Open Ophthalmol 2023; 8:e001259. [PMID: 37797981 PMCID: PMC10551933 DOI: 10.1136/bmjophth-2023-001259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE Functional outcomes following facial and ocular trauma are time-sensitive and require prompt evaluation to minimise long-term vision loss, yet few studies have systematically evaluated disparities in the management of these cases. This study investigates whether a patient's race/ethnicity, primary language, insurance status, gender or age affects receipt of ophthalmology consultation for facial trauma. METHODS AND ANALYSIS This study was a retrospective cohort analysis of patients from the Elmhurst City Hospital Trauma Registry in Queens, New York who were seen for facial trauma including open globe injuries and orbital fractures between January 2014 and May 2016. RESULTS Of the 264 patients included, 43% reported as Hispanic, 23% white, 11% Asian, 8% black and 15% other/unknown. After controlling for confounding variables by multivariable logistic regression, neither race/ethnicity, gender, nor primary language were significantly associated with the likelihood of receiving an ophthalmology consult. However, patients with private insurance had 2.57 times greater odds of receiving an ophthalmology consultation than those with Medicaid or state corrections insurance (95% CI 1.37 to 4.95). As age increased, the likelihood of receiving an ophthalmology consultation decreased (p=0.009); patients 60 years of age and older had one-third the odds of ophthalmology consultation as younger patients (OR 0.33; 95% CI 0.16 to 0.68). CONCLUSIONS This study highlights that lack of ophthalmology consultation in patients with facial trauma is linked to age and underinsurance. Extra attention must be paid during primary assessments to ensure elderly patients and those with public insurance have equitable access to timely and appropriate care for facial trauma.
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Affiliation(s)
- Kalla A Gervasio
- Wills Eye Hospital, Philadelphia, Pennsylvania, USA
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Ophthalmology & Visual Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joab Camarena
- Stanford University School of Medicine, Stanford, California, USA
| | - Jessica Hampton
- Stanford University School of Medicine, Stanford, California, USA
| | - Nitin Chopra
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Trauma Research, Emergency Department, Elmhurst Hospital Center, Elmhurst, Queens, New York, USA
| | - Brittany Kalosza
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lauren Shumate
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Trauma Research, Emergency Department, Elmhurst Hospital Center, Elmhurst, Queens, New York, USA
| | - Albert Y Wu
- Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California, USA
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Da Costa M. How Culture Impacts Health: The Hispanic Narrative. Creat Nurs 2023; 29:273-280. [PMID: 37926958 DOI: 10.1177/10784535231211695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The Hispanic population is the largest and fastest-growing minority group in the United States, and is disproportionately impacted by health problems, including heart disease, stroke, diabetes, obesity, cancer, and unintentional injuries. Factors contributing to these disparities include cultural practices, lack of access to health care, language barriers, and a lack of cultural competence by health-care providers. Family, religion, and gender roles play an essential part in the cultural heritage of Hispanic people, which heavily impacts health outcomes in this population. Nurses must be knowledgeable about the impact of culture on health to dismantle racial/ethnic health disparities and deliver equitable and high-quality care to individuals, families, and communities. This narrative aims to introduce some fundamental cultural factors and beliefs in the Hispanic culture that impact health. It also seeks to provide insights into culturally sensitive practices, to promote quality nursing care and address health disparities within this population.
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Affiliation(s)
- Mariana Da Costa
- School of Nursing, Western Carolina University, Cullowhee, NC, USA
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Lee W, Martins MS, George RB, Fernandez A. Racial and ethnic disparities in obstetric anesthesia: a scoping review. Can J Anaesth 2023; 70:1035-1046. [PMID: 37165125 PMCID: PMC10370345 DOI: 10.1007/s12630-023-02460-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 05/12/2023] Open
Abstract
PURPOSE Health disparities continue to affect racial and ethnic marginalized obstetric patients disproportionally with increased risk of Cesarean delivery and pregnancy-related death. Yet, the literature on what influences such disparities in obstetric anesthesia service and its clinical outcomes is less well known. We set out to describe racial and ethnic disparities in obstetric anesthesia during the peripartum period in the USA via a scoping review of the recent literature. SOURCE Using the Institute of Medicine's definition of disparities, we searched the National Library of Medicine's PubMed/Medline, Embase, Web of Science, APA PsycINFO, and Google Scholar for articles published between 1 January 2000 and 30 June 2022 to identify literature on racial and ethnic disparities in obstetric anesthesia. PRINCIPAL FINDINGS Out of 8,432 articles reviewed, 15 met our inclusion criteria. All but one study was observational. Seven studies were single-institutional while the remaining used multicentre data/databases. All studies compared two or more race and ethnicity classifications. Studies in this review described disparities in the use of labour epidural analgesia, labour epidural request timing, anesthesia for Cesarean deliveries, postpartum pain management, and epidural blood patch for postdural puncture headaches. Several studies reported disparities observed in the unadjusted models becoming no longer significant when adjusted for other covariates. CONCLUSION Based on the findings of the present scoping review on racial and ethnic disparities in obstetric anesthesia, we present an evidence map identifying knowledge gaps and propose a future research agenda.
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Affiliation(s)
- Won Lee
- University of California San Francisco, San Francisco, California
| | | | - Ronald B. George
- University of California San Francisco, San Francisco, California
| | - Alicia Fernandez
- University of California San Francisco, San Francisco, California
- Zuckerberg San Francisco General Hospital, San Francisco, California
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Tsai O, Fakourfar N, Muttalib O, Figueroa C, Kirby KA, Schubl S, Barrios C. Comparing outcomes of cholecystectomies in white vs. minority patients. Am J Surg 2022; 224:1468-1472. [PMID: 36008169 PMCID: PMC10076044 DOI: 10.1016/j.amjsurg.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 05/25/2022] [Accepted: 08/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND This study aimed to investigate the disparity between white and minority patients undergoing cholecystectomies, including presentation, outcomes, and financial burden. METHODS This was an IRB approved retrospective review of all cholecystectomies at an academic medical center from 2013 to 2018. Data collected include demographics, insurance type, charge of admission, and clinical outcomes. RESULTS 1539 patients underwent cholecystectomies. Of those, 36.9% were white and 63.1% were minority. Minority patients presented at a younger age than white patients (45.5 vs 53.9, p < 0.01) and required emergent admission (76.2% vs 68.4%, p < 0.01). No significant difference was found for clinical outcomes between white and minority. Minority patients were more commonly uninsured (32.1%). Among the uninsured, self-pay had a higher charge than emergency MediCal (by 5.46 per 1000 dollars). CONCLUSION Minority patients are more commonly disadvantaged at presentation and charged more due to insurance status despite similar outcomes after cholecystectomies.
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Affiliation(s)
- Olivia Tsai
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA.
| | - Navid Fakourfar
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA.
| | - Omaer Muttalib
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA.
| | - Cesar Figueroa
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA.
| | | | - Sebastian Schubl
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA.
| | - Cristobal Barrios
- Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA.
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Essa M, Ghajar A, Delago A, Hammond-Haley M, Shalhoub J, Marshall D, Salciccioli JD, Sugeng L, Philips B, Faridi KF. Demographic and State-Level Trends in Mortality Due to Ischemic Heart Disease in the United States from 1999 to 2019. Am J Cardiol 2022; 172:1-6. [PMID: 35317929 DOI: 10.1016/j.amjcard.2022.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/02/2022] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Although there have been advances in ischemic heart disease (IHD) care, variation in IHD-related mortality trends across the United States has not been well described. We used the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database to evaluate variation in IHD-related mortality for demographic groups in the United States between 1999 and 2019. Age-adjusted mortality rates (AAMRs) were stratified by gender, race, Hispanic ethnicity, and US state. Crude mortality rates were evaluated using 10-year age groups. IHD-related AAMRs decreased from 195 to 88 per 100,000 nationally, with slower a decrease from 2010 to 2019 (average annual percent change [AAPC] -2.6% [95% confidence interval -2.9% to -2.2%]) compared with 2002 to 2010 (AAPC -5.3% [95% confidence interval -5.6% to -4.9%]). All groups had decreases in AAMRs, although Black populations persistently had the highest AAMR, and women had greater relative decreases than men. AAPC was -3.7% for White men, -4.7% for White women, -3.9% for Black men, -4.9% for Black women, -4.1% for Hispanic men, and -5.1% for Hispanic women. Populations ≥65 years had greater relative mortality decreases than populations <65 years. The median AAMR (2019) and AAPC (1999 to 2019) across states was 86 (range 58 to 134) and -3.8% (range -1.7% to -4.8%), respectively. In conclusion, declines in IHD-related mortality have slowed in the United States, with a significant geographic variation. Black populations persistently had the highest AAMRs, and decreases were relatively greater for women and populations ≥65 years. The impact of demographics and geography on IHD should be further explored and addressed as part of public health measures.
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Affiliation(s)
| | | | | | | | - Joseph Shalhoub
- Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom; Academic Section of Vascular Surgery, Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Dominic Marshall
- British Heart Foundation Centre of Excellence, King's College London, London, United Kingdom
| | | | - Lissa Sugeng
- Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut
| | | | - Kamil F Faridi
- Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut.
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Fernández CR, Licursi M, Wolf R, Lee MT, Green NS. Food insecurity, housing instability, and dietary quality among children with sickle cell disease: Assessment from a single urban center. Pediatr Blood Cancer 2022; 69:e29463. [PMID: 34811867 PMCID: PMC8957542 DOI: 10.1002/pbc.29463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Food insecurity and housing instability, both social determinants of health (SDoH), disproportionately affect economically unstable, under-resourced US communities in which children with sickle cell disease (SCD) live. Association between these SDoH markers and dietary quality among children with SCD is unknown. PROCEDURES We assessed a cross-sectional sample of dyadic parent-child patients and young adult patients up to age 21 from one pediatric SCD center. Food insecurity, housing instability, and dietary quality were measured using validated US instruments and a food frequency questionnaire. Better dietary quality was defined using US dietary guidelines. Multivariate regression assessed for associations among dietary quality and food insecurity with or without (±) housing instability and housing instability alone. RESULTS Of 100 enrolled participants, 53% were Black and 43% Hispanic; mean age 10.6 ± 5.6 years. Overall, 70% reported less than or equal to one economic instability: 40% housing instability alone and 30% both food insecurity and housing instability. Eighty percent received more than or equal to one federal food assistance benefit. Compared to no economic instability, food insecurity ± housing instability was significantly associated with higher intake of higher dairy and pizza, while housing instability alone was significantly associated with higher dairy intake. Food insecurity ± housing instability was significantly associated with lower intake of whole grains compared to housing instability alone. CONCLUSIONS Our sample reported high frequencies of both food insecurity and housing instability; having more than or equal to one SDoH was associated with elements of poorer diet quality. Screening families of children with SCD for food insecurity and housing instability may identify those with potential nutrition-related social needs.
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Affiliation(s)
| | - Maureen Licursi
- Morgan Stanley Children’s Hospital of NewYork-Presbyterian, New York, NY
| | - Randi Wolf
- Teachers College of Columbia University, New York, NY
| | - Margaret T. Lee
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
| | - Nancy S. Green
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY
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Goldin D, Maltseva T, Scaccianoce M, Brenes F. Holistic Psychosocial Approaches in the Care of Hispanic Victims of Trauma: An Overview. J Holist Nurs 2022; 41:7-16. [PMID: 35234058 DOI: 10.1177/08980101221083162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The collapse of the Champlain Towers South (CTS), a condominium in Miami, Florida, left a diverse group of survivors and healthcare clinicians tasked with finding ways of coping with the disaster. Within seconds, the CTS collapse became a global tragedy due to the coastal neighborhood's rich international mix of residents. Although this tragedy impacted communities across globe, a large population of Hispanic victims lived in CTS that were deeply affected. Culturally adaptive interventions and holistic healthcare for Hispanic individuals are highly relevant because Hispanic Americans represent one of the fastest growing demographic groups in the United States. To reach, engage, and address the needs of Hispanic victims, this article provides an overview of psychosocial factors that influence Hispanic victims with trauma and discusses holistic psychotherapeutic approaches in nursing care that can be applied to improve victims' well-being. Culture is an important consideration in health; therefore, this article highlights and operationalizes culturally tailored holistic nursing care that draws from the physical, mental, emotional, and spiritual dimensions of health and well-being that can be used in clinical settings with Hispanic clients who have experienced trauma.
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Affiliation(s)
- Deana Goldin
- 5450Florida International University, 15803Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA
| | - Tatayana Maltseva
- 5450Florida International University, 15803Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA
| | - Monica Scaccianoce
- 5450Florida International University, 15803Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA
| | - Francisco Brenes
- 5450Florida International University, 15803Nicole Wertheim College of Nursing and Health Sciences, Miami, Florida, USA
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Anahideh H, Kang L, Nezami N. Fair and diverse allocation of scarce resources. SOCIO-ECONOMIC PLANNING SCIENCES 2022; 80:101193. [PMID: 34812203 PMCID: PMC8597936 DOI: 10.1016/j.seps.2021.101193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 09/30/2021] [Accepted: 11/07/2021] [Indexed: 06/02/2023]
Abstract
We aim to design a fairness-aware allocation approach to maximize the geographical diversity and avoid unfairness in the sense of demographic disparity. During the development of this work, the COVID-19 pandemic is still spreading in the U.S. and other parts of the world on large scale. Many poor communities and minority groups are much more vulnerable than the rest. To provide sufficient vaccine and medical resources to all residents and effectively stop the further spreading of the pandemic, the average medical resources per capita of a community should be independent of the community's demographic features but only conditional on the exposure rate to the disease. In this article, we integrate different aspects of resource allocation and create a synergistic intervention strategy that gives vulnerable populations higher priority in medical resource distribution. This prevention-centered strategy seeks a balance between geographical coverage and social group fairness. The proposed principle can be applied to other scarce resources and social benefits allocation.
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Affiliation(s)
| | - Lulu Kang
- Illinois Institute of Technology, United States
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15
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Burridge K, Christensen SM, Golden A, Ingersoll AB, Tondt J, Bays HE. Obesity history, physical exam, laboratory, body composition, and energy expenditure: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100007. [PMID: 37990700 PMCID: PMC10661987 DOI: 10.1016/j.obpill.2021.100007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is intended to provide clinicians an overview of the clinical and diagnostic evaluation of patients with pre-obesity/obesity. Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS outlines important components of medical, dietary, and physical activity history as well as physical exams, with a focus on specific aspects unique to managing patients with pre-obesity or obesity. Patients with pre-obesity/obesity benefit from the same preventive care and general laboratory testing as those without an increase in body fat. In addition, patients with pre-obesity/obesity may benefit from adiposity-specific diagnostic testing - both generally and individually - according to patient presentation and clinical judgment. Body composition testing, such as dual energy x-ray absorptiometry, bioelectrical impedance, and other measures, each have their own advantages and disadvantages. Some patients in clinical research, and perhaps even clinical practice, may benefit from an assessment of energy expenditure. This can be achieved by several methods including direct calorimetry, indirect calorimetry, doubly labeled water, or estimated by equations. Finally, a unifying theme regarding the etiology of pre-obesity/obesity and effectiveness of treatments of obesity centers on the role of biologic and behavior efficiencies and inefficiencies, with efficiencies more often associated with increases in fat mass and inefficiencies more often associated with decreases in fat mass. Conclusion The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of pre-obesity/obesity.
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Affiliation(s)
- Karlijn Burridge
- Gaining Health, 528 Pennsylvania Ave #708 Glen Ellyn, IL 60137, USA
| | - Sandra M. Christensen
- Integrative Medical Weight Management, 2611 NE 125th St., Suite 100B, Seattle, WA, 98125, USA
| | - Angela Golden
- NP Obesity Treatment Clinic and NP from Home, LLC, PO Box 25959, Munds Park, AZ, 86017, USA
| | - Amy B. Ingersoll
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA
- University of Louisville School of Medicine, USA
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16
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Sun K, Lin D, Li M, Mu Y, Zhao J, Liu C, Bi Y, Chen L, Shi L, Li Q, Yang T, Wan Q, Wu S, Wang G, Luo Z, Qin Y, Tang X, Chen G, Huo Y, Gao Z, Su Q, Ye Z, Hu R, Wang Y, Qin G, Deng H, Yu X, Shen F, Chen L, Wang W, Ning G, Yan L. Association of education levels with the risk of hypertension and hypertension control: a nationwide cohort study in Chinese adults. J Epidemiol Community Health 2022; 76:jech-2021-217006. [PMID: 34996807 PMCID: PMC8995829 DOI: 10.1136/jech-2021-217006] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 11/08/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Education attainment can improve life expectancy and guide healthy behaviours throughout an entire lifetime. A nationwide longitudinal study of the association of education status with the risk of hypertension and its control in China is lacking. METHODS The China Cardiometabolic Disease and Cancer Cohort Study is a multicentre, population-based, prospective cohort study. We performed the baseline survey from 2011 to 2012. A follow-up visit was conducted during 2014-2016. 101 959 subjects were included in the final data analyses. Cox proportional hazards regression was used to examine the associations of education levels with the risk of hypertension and uncontrolled hypertension. RESULTS During follow-up, 11 189 (19.9%) participants had developed hypertension among subjects without hypertension at baseline. Among the participants with hypertension at baseline, only 40.6% had controlled hypertension. Compared with the participants' education level at elementary school and below, the multivariable-adjusted HR for incident hypertension was 0.76 (95% CI, 0.72 to 0.80) in those with a middle school education level and 0.67 (95% CI, 0.63 to 0.70) in those with a high school degree or above. Correspondingly, multivariable-adjusted HRs associated with uncontrolled hypertension were 0.90 (95% CI, 0.87 to 0.92) in participants with a middle school education level and 0.85 (95% CI, 0.82 to 0.88) in participants with a high school degree or above level. CONCLUSION Participants with education attainment at elementary school and below exhibited excess risks of newly diagnosed hypertension and worse blood pressure control compared with individuals with education attainment at middle school or above.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-Sen University, Guangzhou, China
| | - Diaozhu Lin
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Guangzhou, China
| | - Mian Li
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Yiming Mu
- Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jiajun Zhao
- Department of Endocrinology, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, Jiangsu, China
| | - Yufang Bi
- Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Lulu Chen
- Union Hospital, Tong-ji Medical College, Hua-zhong University of Science and Technology, Wuhan, China, Wuhan, China
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College, Guiyang, China
| | - Qiang Li
- Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Tao Yang
- Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Qin Wan
- Affiliated Hospital of Luzhou Medical College, Luzhou, China
| | - Shengli Wu
- Karamay Municipal People's Hospital, Xinjiang, China
| | - Guixia Wang
- Department of Endocrinology, Jilin University First Hospital, Changchun, Jilin, China
| | - Zuojie Luo
- Department of Endocrinology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Yingfen Qin
- Department of Endocrinology, Guangxi Medical University First Affiliated Hospital, Nanning, Guangxi, China
| | - Xulei Tang
- Department of Endocrinology, Lanzhou University First Affiliated Hospital, Lanzhou, Gansu, China
| | - Gang Chen
- Department of Endocrinology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Yanan Huo
- Department of Endocrinology, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China
| | - Zhengnan Gao
- Department of Endocrinology, Center Hospital of Dalian, Dalian, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Youmin Wang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guijun Qin
- Department of Endocrinology, Zhengzhou University First Affiliated Hospital, Zhengzhou, Henan, China
| | - Huacong Deng
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan, China
| | - Xuefeng Yu
- Department of Endocrinology, Huazhong University of Science and Technology, Wuhan, China
| | - Feixia Shen
- Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Li Chen
- Department of Endocrinology, Shandong University Qilu Hospital, Jinan, Shandong, China
| | - Weiqing Wang
- Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Disease, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Guang Ning
- Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Disease, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Li Yan
- Department of Endocrinology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, China
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Harpet C. Chapitre 4. The recognition and value of traditional care practices in french overseas territories: a singular and contemporary example from French Polynesia. JOURNAL INTERNATIONAL DE BIOETHIQUE ET D'ETHIQUE DES SCIENCES 2021; Vol. 32:71-86. [PMID: 35521957 DOI: 10.3917/jibes.323.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In French Polynesia (the Pacific), the knowledge and practices of traditional therapies, inherited from cultural specificities sometimes thousands of years old, were mostly, during the process of cultural integration that took place during the colonial period, neglected, side-lined, or disqualified by the public powers concerned. A state of tension is palpable in the hospital care service, where, on a daily basis, the medical staff experience socio-cultural resistance and incomprehension for which their education and training have not prepared them. By means of a diachronic approach, the article presents both the ways and the places of the traditional medicine at the heart of the Polynesian world, which are underpinned by a system of cosmogonic and symbolic representations, while also presenting the points of tension which derive from local, social, and sanitary specificities that are currently neither recognized nor taken on board by the powers that be. In this context, the article discusses a singular experiment in medical plurality, carried out by the pulmonology service at the hospital of Papeete. This first ethnological exploration of healthcare in a multicultural overseas territory is part of a healthcare dynamic already being put into practice by a body of carers within the pulmonology service of the Centre Hospitalier en Polynésie Française (CHPF), who are looking for new ways of thinking and caring in touch with local constraint and specificities. Drawing on these various research perspectives, it is important to try and sketch out, by means of an anthropological reflection on care, some paths for understanding a divisive situation which puts in danger the very practice of care.
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Estime SR, Lee HH, Jimenez N, Andreae M, Blacksher E, Navarro R. Diversity, equity, and inclusion in anesthesiology. Int Anesthesiol Clin 2021; 59:81-85. [PMID: 34369397 PMCID: PMC8423145 DOI: 10.1097/aia.0000000000000337] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Stephen R. Estime
- Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois
| | - Helen H. Lee
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois
| | - Nathalia Jimenez
- Department of Anesthesiology, University of Washington, Seattle, Washington
| | - Michael Andreae
- Department of Anesthesiology, Pennsylvania State College of Medicine, Hershey, Pennsylvania
| | - Erika Blacksher
- Center for Practical Bioethics, The University of Kansas, Kansas City, Missouri
| | - Renee Navarro
- Department of Anesthesia and Perioperative Care, Vice Chancellor Diversity and Outreach, University of California, San Francisco, San Francisco, California
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Joyce BT, Gao T, Koss K, Zheng Y, Cardenas A, Heiss J, Just A, Zhang K, van Horn L, Allen NB, Greenland P, Cohen S, Gordon-Larsen P, Mitchell C, McLanahan S, Schneper L, Notterman D, Rifas-Shiman SL, Oken E, Hivert MF, Wright R, Baccarelli A, Lloyd-Jones D, Hou L. Impact of paternal education on epigenetic ageing in adolescence and mid-adulthood: a multi-cohort study in the USA and Mexico. Int J Epidemiol 2021; 51:870-884. [PMID: 34534313 DOI: 10.1093/ije/dyab196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Both parental and neighbourhood socio-economic status (SES) are linked to poorer health independently of personal SES measures, but the biological mechanisms are unclear. Our objective was to examine these influences via epigenetic age acceleration (EAA)-the discrepancy between chronological and epigenetic ages. METHODS We examined three USA-based [Coronary Artery Risk Disease in Adults (CARDIA) study, Fragile Families and Child Wellbeing Study (FFCWS) and Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS)] and one Mexico-based (Project Viva) cohort. DNA methylation was measured using Illumina arrays, personal/parental SES by questionnaire and neighbourhood disadvantage from geocoded address. In CARDIA, we examined the most strongly associated personal, parental and neighbourhood SES measures with EAA (Hannum's method) at study years 15 and 20 separately and combined using a generalized estimating equation (GEE) and compared with other EAA measures (Horvath's EAA, PhenoAge and GrimAge calculators, and DunedinPoAm). RESULTS EAA was associated with paternal education in CARDIA [GEEs: βsome college = -1.01 years (-1.91, -0.11) and β<high school = 1.05 (0.09, 2.01) vs college graduates] and FFCWS [GEEs: β<high school = 0.62 (0.00, 1.24)]. We found stronger associations for some paternal education categories among White adults (for GEE, βsome college = -1.39 (-2.41, -0.38)], men (βsome college = -1.76 (-3.16, -0.35)] and women [β<high school = 1.77 (0.42, 3.11)]. CONCLUSIONS These findings suggest that EAA captures epigenetic impacts of paternal education independently of personal SES later in life. Longitudinal studies should explore these associations at different life stages and link them to health outcomes. EAA could be a useful biomarker of SES-associated health and provide important insight into the pathogenesis and prevention of chronic disease.
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Affiliation(s)
- Brian T Joyce
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tao Gao
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kalsea Koss
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USA
| | - Jonathan Heiss
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Allan Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Kai Zhang
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Linda van Horn
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Norrina Bai Allen
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Philip Greenland
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sheldon Cohen
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Colter Mitchell
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Sara McLanahan
- Department of Sociology, Princeton University, Princeton, NJ, USA
| | - Lisa Schneper
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
| | - Daniel Notterman
- Department of Molecular Biology, Princeton University, Princeton, NJ, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.,Department of Endocrinology, Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Andrea Baccarelli
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Donald Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Center for Global Oncology, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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20
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Campbell CK. Structural and intersectional biographical disruption: The case of HIV disclosure among a sample of black gay and bisexual men. Soc Sci Med 2021; 280:114046. [PMID: 34051554 DOI: 10.1016/j.socscimed.2021.114046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 01/18/2023]
Abstract
HIV disclosure has been considered key to prevention and privileged as a "healthy" behavior for people living with HIV. Although research has documented potential negative outcomes of disclosure, we know little about its potential of these consequences to disrupt one's biography, or the intersectional and structural inequities that shape disclosure/nondisclosure and its outcomes. Exploring HIV disclosure as a discrete, measurable event cannot account for the experience of the self in illness, and how disclosure can fundamentally shift everyday reality and social relationships. To fill this gap, I employed the framework of structural intersectionality, and the medical sociology theory of biographical disruption to explore HIV disclosure among a sample of Black gay and bisexual men living with HIV in the Deep South. Between June 2019 and June 2020, I conducted in-depth qualitative interviews with 30 Black gay and bisexual men living with HIV in the Baton Rouge, Louisiana metropolitan area. Interviews were recorded and transcribed verbatim and analyzed using a grounded theory approach. Disruptions as a result of HIV disclosure included: assaults on self; disturbance to social and familial networks; and socioeconomic impacts. Further, findings illustrate that disruptions were not discrete events, but evolved over time, and that the nature of disruption was constituted by previous traumatic disruptions, social and structural contexts, and men's social location at the intersections of race, class, sexuality, HIV-status, and geography. I highlight that consequences of HIV disclosure among a sample of Black gay and bisexual men, were shaped by their unique social location and the persistence of intersecting structural inequities. Future research should account for preceding and cumulative experiences, how intersecting inequities constitute disclosure experiences, and that disclosure is a complex process occurring in the context of ongoing social relations.
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Affiliation(s)
- Chadwick K Campbell
- Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, San Francisco, CA, 94158, United States; Department of Social and Behavioral Sciences, University of California San Francisco, Box 0612, 490 Illinois Street, Floor 12, San Francisco, CA, 94143, United States.
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21
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Surofchy D, Mnatzaganian C, Sarino L, Kuo G. Perceptions and Attitudes of Pharmacogenomics Through the Lens of Community Pharmacists and Patients. JOURNAL OF CONTEMPORARY PHARMACY PRACTICE 2021. [DOI: 10.37901/jcphp20-00016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background
Pharmacists represent some of the most accessible healthcare workers and are in an opportune position to spearhead new clinical initiatives, such as pharmacogenomics (PGx) services. It is important that we understand the perceptions and attitudes both pharmacists and patients have regarding PGx and potential barriers of implementing it into routine clinical practice.
Methods
A cross-sectional survey study was conducted across one regional division of a large community pharmacy chain to assess the perceptions and attitudes of pharmacists and patients regarding PGx in California. A secondary aim was to determine perceived barriers to PGx implementation into community pharmacies.
Results
The majority (67%) of pharmacists agreed or strongly agreed to understanding PGx compared to 35% of patients being aware of PGx (p<0.001). More patients (62%) preferred their pharmacist compared to pharmacists (43%) preferring themselves as a provider to manage patients' medications based on their PGx results (p<0.01). Many patients (88%) expressed interest in participating in a PGx test; both pharmacists (84%) and patients (85%) were unlikely to have participated or know someone who has participated in PGx testing. Pharmacists and patients expressed similar concerns about privacy of their PGx data by employers (p=0.287) and insurers (p=0.953), a potential barrier to PGx implementation.
Conclusion
Pharmacists are well positioned to spearhead PGx consultations and patients are interested in pharmacists using PGx to help manage their medications; however, various barriers were identified that must be overcome for PGx to become incorporated in routine practice.
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Affiliation(s)
- Dalga Surofchy
- University of California San Diego School of Pharmacy and Pharmaceutical Sciences
| | | | - Lord Sarino
- University of California San Diego School of Pharmacy and Pharmaceutical Sciences
| | - Grace Kuo
- Oregon State University College of Pharmacy
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22
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The incisional hernia epidemic: evaluation of outcomes, recurrence, and expenses using the healthcare cost and utilization project (HCUP) datasets. Hernia 2021; 25:1667-1675. [PMID: 33835324 DOI: 10.1007/s10029-021-02405-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/29/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Incisional hernias (IH) following abdominal surgery persist as morbid, costly, and multi-disciplinary surgical challenges. Using longitudinal, multi-state, administrative claims data (HCUP State Inpatient Databases (SID)); (HCUP State Ambulatory Surgery and Services Databases (SASD)), we aimed to characterize the epidemiology, outcomes, recurrence, and costs of IH. STUDY DESIGN 529,108 patients undergoing abdominal surgery in 2010 across six specialties (colorectal, general/bariatric, hepatobiliary, obstetrics/gynecology, urology, and vascular) were identified within inpatient and ambulatory databases for Florida (FL), Iowa (IA), Nebraska (NE), New York (NY), and Utah (UT). IH repairs, complications, and expenditures were assessed through 2014. Predictive regression modeling was validated using a training set of 1000 bootstrapped repetitions. RESULTS 16,169 (3.1%) patients developed hernias requiring repair (4.3-year mean follow-up), 3176 (20%) underwent recurrent repair, and 731 (23%) underwent re-recurrent repair. Patients with IH had increased readmissions (6.6 vs. 2.4), morbidity (39 vs. 8% surgical and 22 vs. 7% medical), and costs ($46,000 vs. $25,000) when compared to patients without IH (p < 0.001). IH expenditures totaled $875 million: initial ($687 million), recurrent ($155 million), and re-recurrent hernias ($33 million). IH predominated in colorectal (10%), hepatobiliary (8%), and vascular (5%) procedures. Of 31 significant independent IH risk factors (p < 0.001), obesity, age, smoking, open surgery, and prior surgery were pervasive across surgical specialties. CONCLUSION IH represents an unremitting surgical epidemic associated with considerable morbidity, costs, and features consistent with a chronic disease state. We define critical pervasive risk factors (obesity, age, smoking open surgery, and prior surgery) independently associated with IH across surgical disciplines. With failed repairs, subsequent success becomes less likely, increasing morbidity and costs-underscoring the critical importance of optimal treatment and prevention.
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He Z, Zhang C, Wang S, Bishwajit G, Yang X. Socioeconomic Determinants of Maternal HealthCare Utilisation in Zambia: 1997-2014. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211067480. [PMID: 34911372 PMCID: PMC8689614 DOI: 10.1177/00469580211067480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study aims at exploring the trends and socioeconomic inequalities in the use of maternal healthcare utilization between 1997 and 2014. Data were analyzed using descriptive and multivariate regression methods. Women in the higher wealth quintiles (Q4 and Q5) generally had higher prevalence of using health facility delivery and postnatal care services compared with those in the lower wealth quintiles (Q1 and Q2), whereas the prevalence of timely and adequate antenatal care visit was comparatively higher among those in the lower wealth quintiles. Findings indicated important sociodemographic inequalities in using maternal healthcare services, addressing which may help promote the utilization of these services.
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Affiliation(s)
- Zhifei He
- School of Politics and Public Administration, Southwest University of Political Science and Law, Chongqing, China
| | - Caihua Zhang
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Shiming Wang
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
| | - Ghose Bishwajit
- School of International Law, Southwest University of Political Science and Law, Chongqing, China
| | - Xinglong Yang
- School of International Law, Southwest University of Political Science and Law, Chongqing, China
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24
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Pascual KJ, Palosaari A, Ochoa J, Dreyer C. Environmental Health Burdens and Socioeconomic Status in Rhode Island: Using Geographic Information Systems to Examine Health Disparities in Medical School. Cureus 2020; 12:e9816. [PMID: 32953326 PMCID: PMC7494411 DOI: 10.7759/cureus.9816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/17/2020] [Indexed: 11/05/2022] Open
Abstract
Race and class are major predictors of health outcomes in the United States. Health disparities among racial and low-income minorities often have environmental etiologies. Using Rhode Island as a case study, we geocoded and visualized several environmental determinants of health via Geographic Information Systems (GIS) in the entire state and conducted a geospatial analysis to determine whether or not patterns existed along racial and class lines. The variables that we geocoded include elementary schools, fast food restaurants, Superfund sites, and community parks. From a census tract level, we then analyzed the racial and income makeup of each geocoded site. We discovered that, on average, the worst-performing elementary schools, fast food restaurants, and Superfund sites in Rhode Island were clustered in neighborhoods with a larger black population and lower household income. Conversely, community parks and the best elementary schools in Rhode Island tended to be located near neighborhoods with a larger White population and higher household income. Our results provide additional evidence for the pervasiveness of the unequal distribution of environmental health burdens between low-income, minority communities and affluent, predominantly White communities. This summer experiential student project demonstrates the feasibility of incorporating GIS as a practical tool for learning health disparities material at a U.S. medical school. Our study also highlights the value of digital technology and citizen science in helping the public recognize and understand the various environmental factors that perpetuate health disparities.
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Affiliation(s)
- King John Pascual
- Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Andrew Palosaari
- Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA
| | - Jacqueline Ochoa
- Department of Public Health, Tufts University School of Medicine, Boston, USA
| | - Claudia Dreyer
- Department of Biological Sciences, George Washington University, Washington, D.C., USA
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25
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Abstract
Factors contributing to therapeutic inertia related to patients' medication experiences include concerns about side effects and out-of-pocket costs, stigmatization for having diabetes, confusion about frequent changes in evidence-based guidelines, low health literacy, and social determinants of health. A variety of solutions to this multifactorial problem may be necessary, including integrating pharmacists into interprofessional care teams, using medication refill synchronization programs, maximizing time with patients to discuss fears and concerns, being cognizant of language used to discuss diabetes-related topics, and avoiding stigmatizing patients. Managing diabetes successfully is a team effort, and the full commitment of all team members (including patients) is required to achieve desired outcomes through an individualized approach.
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Affiliation(s)
| | - John E Begert
- School of Pharmacy, Pacific University Oregon, Hillsboro, OR
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26
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Eliacin J, Cunningham B, Partin MR, Gravely A, Taylor BC, Gordon HS, Saha S, Burgess DJ. Veterans Affairs Providers' Beliefs About the Contributors to and Responsibility for Reducing Racial and Ethnic Health Care Disparities. Health Equity 2019; 3:436-448. [PMID: 31448354 PMCID: PMC6707034 DOI: 10.1089/heq.2019.0018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: Providers' beliefs about the causes of disparities and the entities responsible for addressing these disparities are important in designing disparity-reduction interventions aimed at providers. This secondary analysis of a larger study is aimed at evaluating perceptions of providers regarding the underlying causes of racial health care disparities and their views of who is responsible for reducing them. Methods: We surveyed 232 providers at 3 Veterans Affairs (VA) Medical Centers. Results: Sixty-nine percent of participants believed that minority patients in the United States receive lower quality health care. Most participants (64%) attributed differences in quality of care for minority patients in the VA health care system primarily to patients' socioeconomic status, followed by patient behavior (43%) and provider behaviors (33%). In contrast, most participants believed that the VA and other health care organizations (75%) and providers (70%) bear the responsibility for reducing disparities, while less than half (45%) believed that patients were responsible. Among provider-level contributors to disparities, providers' poor communication was the most widely endorsed (48%), while differences in prescribing of medications (13%) and in provision of specialty referrals (12%) were the least endorsed. Conclusions: Although most providers in the study did not believe that providers contribute to disparities, they do believe that they, along with health care organizations, have the responsibility to help reduce them. Interventions might focus on directly offering providers concrete ways that they can help reduce disparities, rather than focusing on simply raising awareness about disparities and their contributions to them.
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Affiliation(s)
- Johanne Eliacin
- Center for Health information and Communication, CHIC, Health Services Research & Development, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana
- Department of Psychology, Indiana University Purdue University at Indianapolis, Indianapolis, Indiana
- Health Services Research, Regenstrief Institute, Inc., Indianapolis, Indiana
- ACT Center of Indiana, Indianapolis, Indiana
| | - Brooke Cunningham
- Department of Family Medicine and Community Health, Minneapolis, Minnesota
| | - Melissa R. Partin
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Amy Gravely
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Brent C. Taylor
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Howard S. Gordon
- Jesse Brown Veterans Affairs Medical Center and Center of Innovation for Complex Chronic Healthcare, Chicago, Illinois
- Section of Academic Internal Medicine and Geriatrics, Department of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Somnath Saha
- Section of General Internal Medicine, VA Portland Health Care System, Portland, Oregon
- Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, Oregon
| | - Diana J. Burgess
- Center for Chronic Disease Outcomes Research (a VA HSR&D Center of Excellence), Veterans Affairs Medical Center, Minneapolis, Minnesota
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
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27
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Abstract
PURPOSE OF REVIEW In this review article, we describe the development and application of machine-learning models in the field of rheumatology to improve the detection and diagnosis rates of underdiagnosed rheumatologic conditions, such as ankylosing spondylitis and axial spondyloarthritis (axSpA). RECENT FINDINGS In an attempt to aid in the earlier diagnosis of axSpA, we developed machine-learning models to predict a diagnosis of ankylosing spondylitis and axSpA using administrative claims and electronic medical record data. Machine-learning algorithms based on medical claims data predicted the diagnosis of ankylosing spondylitis better than a model developed based on clinical characteristics of ankylosing spondylitis. With additional clinical data, machine-learning algorithms developed using electronic medical records identified patients with axSpA with 82.6-91.8% accuracy. These two algorithms have helped us understand potential opportunities and challenges associated with each data set and with different analytic approaches. Efforts to refine and validate these machine-learning models are ongoing. SUMMARY We discuss the challenges and benefits of machine-learning models in healthcare, along with potential opportunities for its application in the field of rheumatology, particularly in the early diagnosis of axSpA and ankylosing spondylitis.
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Affiliation(s)
| | | | - Esther Yi
- The University of Texas at Austin, Austin
- Baylor Scott and White Health, Temple, Texas
| | - Yujin Park
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
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28
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Improvement in racial disparity among patients undergoing panniculectomy after bariatric surgery. Am J Surg 2019; 218:37-41. [DOI: 10.1016/j.amjsurg.2019.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/06/2018] [Accepted: 01/07/2019] [Indexed: 12/22/2022]
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Part of the Solution to Address Sexual and Gender Minority Health and Health Care Disparities: Inclusive Professional Education. Dela J Public Health 2019; 5:56-62. [PMID: 34467041 PMCID: PMC8389761 DOI: 10.32481/djph.2019.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Eyler AA, Valko CA, Macchi M, Fershteyn Z, Mazzucca SL, Brownson CA, Lau A, Brownson RC. Adjusting the Equity Lens: Gaps in Addressing Health Equity in State Chronic Disease Prevention. Health Equity 2019; 3:86-91. [PMID: 30944889 PMCID: PMC6445208 DOI: 10.1089/heq.2018.0075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose: Chronic diseases cause a significant proportion of mortality and morbidity in the United States, although risk factors and prevalence rates vary by population subgroups. State chronic disease prevention practitioners are positioned to address these issues, yet little is known about how health equity is being incorporated into their work. The purpose of this study was to explore perceptions of health equity in a sample of state chronic disease practitioners. Methods: Participants were selected in conjunction with a related evaluation of the National Association of Chronic Disease Directors (NACDD) capacity-building and evidence-based efforts. Four states were chosen for study based on variance in capacity. Directors in each of the states were interviewed and using snowball sampling, 8–12 practitioner interviews were conducted in each state, digitally audio recorded and transcribed. Using a comparative coding technique, themes and analyses were developed. Results: Comments from the practitioners fell into three main and inter-related categories. First, they discussed the varying degrees of integration of health equity in their work. The second theme was collaboration and the importance of working within and outside of departments, as well as with the community. The third theme related to measurement and the need for better data that can be used to garner support and measure impact. Conclusion: Chronic disease practitioners can play an important role in achieving health equity. Integrating this work more fully into chronic disease prevention and health promotion, developing strategic partnerships, tracking efforts, and measuring impact will improve practice and ultimately population health.
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Affiliation(s)
- Amy A Eyler
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Cheryl A Valko
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Marti Macchi
- National Association of Chronic Disease Directors, Washington, District of Columbia
| | - Zarina Fershteyn
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Stephanie L Mazzucca
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Carol A Brownson
- National Association of Chronic Disease Directors, Washington, District of Columbia
| | | | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, Missouri.,Division of Public Health Sciences, Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri
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Assessment of Knowledge of Critical Cardiovascular Risk Indicators among College Students: Does Stage of Education Matter? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14030250. [PMID: 28257080 PMCID: PMC5369086 DOI: 10.3390/ijerph14030250] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 02/16/2017] [Accepted: 02/25/2017] [Indexed: 11/17/2022]
Abstract
The health risk of college students in the United States (US) is on the rise, with a significant increase in the prevalence of cardiovascular risk factors. Cardiovascular disease is the leading cause of death in the US, costing approximately $475.3 billion yearly. The goals of this “Know Your Numbers” study were to: (1) estimate the awareness of college students of their critical health numbers (CHN); and (2) compare a college of pharmacy entry class (IP1) with second semester non-commuter freshman college students (FCS) in knowing their numbers. A cross-sectional 15-item pre-test survey was conducted among a convenience sample of IP1 and FCS. All statistical tests were performed at α = 0.05. Awareness of their: cholesterol (7%), blood pressure (BP) (35%), glucose (8%), and body mass index (BMI) (42%) were low. The IP1, compared to FCS, were more knowledgeable of: (1) their BP (46% vs. 28%, p = 0.01); (2) BP normal range (74% vs. 63%, p = 0.02); and (3) BMI normal range (39% vs. 23%, p = 0.04). The IP1s maintained a healthier diet than the FCS (64% vs. 36%, p < 0.0001). Awareness of knowing CHN was very low. Knowledge of one’s CHN was significantly associated with knowledge of normal reference values for BP, glucose, and BMI.
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