Reducing Health Disparity in People with Intellectual Disabilities: A Report from Health Issues Special Interest Research Group of the International Association for the Scientific Study of Intellectual Disabilities
Scheepers, M.; Kerr, M.; O'Hara, D.; Bainbridge, D.; Cooper, S.-A.; Davis, R.; Fujiura, G.; Heller, T.; Holland, A.; Krahn, G.; Lennox, N.; Meaney, J.; Wehmeyer, M.
Disparities in the health status and care experienced by people with intellectual disabilities are increasingly being recognized. This special report presents the results of an international expert consensus workshop held under the auspices of the Health Issues Special Interest Research Group of the International Association for the Scientific…
The Upgraded Coal Interest Group (UCIG) is an EPRI 'users group' that focuses on clean, low-cost options for coal-based power generation. The UCIG covers topics that involve (1) pre-combustion processes, (2) co-firing systems and fuels, and (3) reburn using coal-derived or biomass-derived fuels. The UCIG mission is to preserve and expand the economic use of coal for energy. By reducing the fuel costs and environmental impacts of coal-fired power generation, existing units become more cost effective and thus new units utilizing advanced combustion technologies are more likely to be coal-fired.
Millard, Richard M.
The history of the interrelation among state approval, accreditation, and institutional eligibility is considered. It is suggested that faculty and college administrators can be either an internal or external group in relationship to the planning process. The federal government, or the state government, passes legislation that may have both…
Lazio, T. Joseph W.; Cosmic Origins Program Analysis Group
Cosmic Dawn was identified as one of the three science objectives for this decade in the _New Worlds, New Horizons_ Decadal report, and it will likely continue to be a research focus well into the next decade. Cosmic Dawn refers to the interval during which the Universe transitioned from a nearly completely neutral state back to a nearly fully ionized state and includes the time during which the first stars formed and the first galaxies assembled.The Cosmic Dawn Science Interest Group (SIG) was formed recently under the auspices of the Cosmic Origins Program Analysis Group (COPAG). The Cosmic Dawn SIG focusses on the science cases, observations, and technology development needed to address the "great mystery" of Cosmic Origins. The reach of this SIG is broad, involving the nature of the first stars and the detectability of gamma-ray bursts at high redshifts, the extent to which the first galaxies and first supermassive black holes grew together, and the technology required to pursue these questions.For further information, consult the Cosmic Dawn SIG Web site http://cd-sig.jpl.nasa.gov/ and join the mailing list (by contacting the author).Part of this research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration.
Tarakci, Murat; Greer, Lindred L; Groenen, Patrick J F
Power differences are ubiquitous in social settings. However, the question of whether groups with higher or lower power disparity achieve better performance has thus far received conflicting answers. To address this issue, we identify 3 underlying assumptions in the literature that may have led to these divergent findings, including a myopic focus on static hierarchies, an assumption that those at the top of hierarchies are competent at group tasks, and an assumption that equality is not possible. We employ a multimethod set of studies to examine these assumptions and to understand when power disparity will help or harm group performance. First, our agent-based simulation analyses show that by unpacking these common implicit assumptions in power research, we can explain earlier disparate findings--power disparity benefits group performance when it is dynamically aligned with the power holder's task competence, and harms group performance when held constant and/or is not aligned with task competence. Second, our empirical findings in both a field study of fraud investigation groups and a multiround laboratory study corroborate the simulation results. We thereby contribute to research on power by highlighting a dynamic understanding of power in groups and explaining how current implicit assumptions may lead to opposing findings.
Bauch, Chris T; Galvani, Alison P; Earn, David J D
The recent threat of bioterrorism has fueled debate on smallpox vaccination policy for the United States. Certain policy proposals call for voluntary mass vaccination; however, if individuals decide whether to vaccinate according to self-interest, the level of herd immunity achieved may differ from what is best for the population as a whole. We present a synthesis of game theory and epidemic modeling that formalizes this conflict between self-interest and group interest and shows that voluntary vaccination is unlikely to reach the group-optimal level. This shortfall results in a substantial increase in expected mortality after an attack.
Curseu, Petru Lucian; Sari, Kimzana
This study sets up to test the extent to which gender variety moderates the impact of power disparity on group cognitive complexity (GCC) and satisfaction with the group in a collaborative learning setting. Using insights from gender differences in perceptions, orientations and conflict handling behavior in negotiation, as well as gender…
Nastas, George, III
Describes the Marketing Environment Group Project to be used by a marketing instructor. Indicates that through this teaching method, students have an increased interest in marketing and a greater understanding of how an organization's marketing strategy must adapt to its changing environment. (JOW)
Schaal, Jennifer C.; Lightfoot, Alexandra F.; Black, Kristin Z.; Stein, Kathryn; White, Stephanie Baker; Cothern, Carol; Gilbert, Keon; Hardy, Christina Yongue; Jeon, Janet Y.; Mann, Lilli; Mouw, Mary Sherwyn; Robertson, Lyn; Waters, Emily M.; Yonas, Michael A.; Eng, Eugenia
Background Accountability for Cancer Care through Undoing Racism and Equity (ACCURE) is a systems-change intervention addressing disparities in treatment initiation and completion and outcomes for early stage Black and White breast and lung cancer patients. Using a community-based participatory research approach, ACCURE is guided by a diverse partnership involving academic researchers, a non-profit community-based organization, its affiliated broader-based community coalition, and providers and staff from two cancer centers. Objectives This paper describes the collaborative process our partnership used to conduct focus groups and to code and analyze the data to inform two components of the ACCURE intervention: 1) a “power analysis” of the cancer care system, and 2) the development of the intervention’s training component, Healthcare Equity Education and Trainings, for cancer center providers and staff. Methods Utilizing active involvement of community and academic partners at every stage in the process, we engaged Black and White breast and lung cancer survivors at two partner cancer centers in eight focus group discussions organized by race and cancer type. Participants were asked to describe “pressure point encounters” or critical incidents during their journey through the cancer system that facilitated or hindered their willingness to continue treatment. Community and academic members collaborated to plan and develop materials, conduct focus groups, and code and analyze data. Conclusions A collaborative qualitative data analysis process strengthened the capacity of our community-medical-academic partnership, enriched our research moving forward, and enhanced the transparency and accountability of our research approach. PMID:27018365
Li, Y.; Graubard, B. I.; Huang, P.; Gastwirth, J. L.
Determining the extent of a disparity, if any, between groups of people, for example, race or gender, is of interest in many fields, including public health for medical treatment and prevention of disease. An observed difference in the mean outcome between an advantaged group (AG) and disadvantaged group (DG) can be due to differences in the distribution of relevant covariates. The Peters–Belson (PB) method fits a regression model with covariates to the AG to predict, for each DG member, their outcome measure as if they had been from the AG. The difference between the mean predicted and the mean observed outcomes of DG members is the (unexplained) disparity of interest. We focus on applying the PB method to estimate the disparity based on binary/multinomial/proportional odds logistic regression models using data collected from complex surveys with more than one DG. Estimators of the unexplained disparity, an analytic variance–covariance estimator that is based on the Taylor linearization variance–covariance estimation method, as well as a Wald test for testing a joint null hypothesis of zero for unexplained disparities between two or more minority groups and a majority group, are provided. Simulation studies with data selected from simple random sampling and cluster sampling, as well as the analyses of disparity in body mass index in the National Health and Nutrition Examination Survey 1999–2004, are conducted. Empirical results indicate that the Taylor linearization variance–covariance estimation is accurate and that the proposed Wald test maintains the nominal level. PMID:25382235
Mau, Wei-Cheng; And Others
A mapping procedure is presented for studying the construct validity of interest inventories that assess the six interest types defined by J. L. Holland. The 1989 revision of the American College Testing Program Interest Inventory (UNIACT) was used to assess the interests of 1,078 12th-grade students (497 males and 581 females) and 725 adults aged…
Wheeler, David C.; Waller, Lance A.; Elliott, John O.
SUMMARY The Centers for Disease Control and Prevention defined epilepsy as an emerging public health issue in a recent report and emphasized the importance of epilepsy studies in minorities and people of low socioeconomic status. Previous research has suggested that the incidence rate for epilepsy is positively associated with various measures of social and economic disadvantage. In response, we utilize hierarchical Bayesian models to analyze health disparities in epilepsy and seizure risks among multiple ethnicities in the city of Philadelphia, Pennsylvania. The goals of the analysis are to highlight any overall significant disparities in epilepsy risks between the populations of Caucasians, African Americans, and Hispanics in the study area during the years 2002–2004 and to visualize the spatial pattern of epilepsy risks by ethnicity to indicate where certain ethnic populations were most adversely affected by epilepsy within the study area. Results of the Bayesian model indicate that Hispanics have the highest epilepsy risk overall, followed by African Americans, and then Caucasians. There are significant increases in relative risk for both African Americans and Hispanics when compared with Caucasians, as indicated by the posterior mean estimates of 2.09 with a 95 per cent credible interval of (1.67, 2.62) for African Americans and 2.97 with a 95 per cent credible interval of (2.37, 3.71) for Hispanics. Results also demonstrate that using a Bayesian analysis in combination with geographic information system (GIS) technology can reveal spatial patterns in patient data and highlight areas of disparity in epilepsy risk among subgroups of the population. PMID:18381676
Group discussion allows students to learn how to "talk to someone." Through group discussion, students can acquire or refine a broad range of attributes, from basic oratory skills to a more sophisticated development of communicative competence to embracing and valuing dialogic interchange and reflexivity. In this article, the author explains how…
Basic information about cancer disparities in the U.S., factors that contribute to the disproportionate burden of cancer in some groups, and examples of disparities in incidence and mortality among certain populations.
Bethel, Jeffrey W; Burke, Sloane C; Britt, Amber F
Objective The objective of this study was to examine the association between race/ethnicity (including language subgroups among Hispanics) and disaster preparedness among Behavioral Risk Factor Surveillance System (BRFSS) survey respondents. Methods BRFSS data were obtained for eight states which implemented the optional general preparedness module from 2006 through 2010. Three dependent variables were analyzed including presence of four preparedness items (i.e., food, water, flashlight, and radio), emergency evacuation plan, and 3-d supply of medication. Primary independent variable included race/ethnicity accounting for language of survey. Data were analyzed in 2011 and accounted for BRFSS sampling design. Results Black (OR = 0.66, 95% CI = 0.56, 0.79), English-speaking Hispanic (OR = 0.48, 95% CI = 0.34, 0.69) and Spanish-speaking Hispanic respondents (OR = 0.20, 95% CI = 0.13, 0.29) were less likely than non-Hispanic white respondents to live in a household in which all members requiring medication had a 3-d supply. Results varied regarding presence of four preparedness items and an emergency evacuation plan. Conclusions Racial/ethnic minority groups were less likely to have medication supplies but only Spanish-speaking Hispanics were less likely to have an emergency evacuation plan than white respondents. Public health officials can use these findings to support targeting racial/ethnic minorities to increase the presence of preparedness items important to mitigate the effects of disasters, with particular emphasis on medication supplies and Spanish-speaking Hispanics.
Bethel, Jeffrey W; Burke, Sloane C; Britt, Amber F
Objective The objective of this study was to examine the association between race/ethnicity (including language subgroups among Hispanics) and disaster preparedness among Behavioral Risk Factor Surveillance System (BRFSS) survey respondents. Methods BRFSS data were obtained for eight states which implemented the optional general preparedness module from 2006 through 2010. Three dependent variables were analyzed including presence of four preparedness items (i.e., food, water, flashlight, and radio), emergency evacuation plan, and 3-d supply of medication. Primary independent variable included race/ethnicity accounting for language of survey. Data were analyzed in 2011 and accounted for BRFSS sampling design. Results Black (OR = 0.66, 95% CI = 0.56, 0.79), English-speaking Hispanic (OR = 0.48, 95% CI = 0.34, 0.69) and Spanish-speaking Hispanic respondents (OR = 0.20, 95% CI = 0.13, 0.29) were less likely than non-Hispanic white respondents to live in a household in which all members requiring medication had a 3-d supply. Results varied regarding presence of four preparedness items and an emergency evacuation plan. Conclusions Racial/ethnic minority groups were less likely to have medication supplies but only Spanish-speaking Hispanics were less likely to have an emergency evacuation plan than white respondents. Public health officials can use these findings to support targeting racial/ethnic minorities to increase the presence of preparedness items important to mitigate the effects of disasters, with particular emphasis on medication supplies and Spanish-speaking Hispanics. PMID:28228993
McCubbin, M; Cohen, D
We have tried to show, first, that there exists a wide divergence between the interests of psychiatry and clients: none of the three major models underpinning society's trust in psychiatrists justify confidence that the interests of psychiatry and its clients converge enough to warrant psychiatrists' speaking and acting for clients in the development of the mental health system and its policies. Second, the distribution of power between psychiatrists and clients is highly unequal: the voices of clients have been co-opted or submerged by those of other groups, particularly organized psychiatry and family-dominated advocacy organizations. Our argument is not based on any particular conception of what the "needs" of clients are--we have not claimed to know what they are, nor, indeed, that they are determinable. However, our point is that the mental health system remains with no good theory to support a proposition that needs will be met, leaving no basis upon which to evaluate the system's success. Therefore, insofar as the "purpose" of this system is to meet client needs, we consider the system to be irrational. The numbers of clients and their presumed intensity of interest in mental health policy should have guaranteed them a place of importance in the political processes shaping the mental health system. There are several structural reasons why this has not been the case: client passivity due to the medical model therapeutic context; hesitancy to engage in public action due to the enduring stigma of mental illness; incapacities caused by psychological distress as well as by iatrogenic dysfunction; organizational weakness due to the free-rider problem of voluntary client groups compared with the ability of psychiatry to encourage contributions to its lobbying efforts; marked client disadvantages in obtaining external funding. If we judge one of the positive features of a liberal democracy to be its stability (in that individuals and groups do not need to resort to
Armstrong, Patrick Ian; Fouad, Nadya A.; Rounds, James; Hubert, Lawrence
Research on group differences in interests has often focused on structural hypotheses and mean-score differences in Holland's (1997) theory, with comparatively little research on basic interest measures. Group differences in interest profiles were examined using statistical methods for matching individuals with occupations, the C-index, Q…
Stephens, E. Robert; Haughey, Charles F.
In many states, rural school districts or interested individuals have formed statewide interest groups to influence policy decisions related to rural education. Potential state rural education interest groups were identified through contacts with national and regional education associations and regional educational laboratories. Of 19 identified…
Steinberg, Marc L.; Griffiths, Kim Gesell; Cooperman, Nina
Smokers with co-occurring mental illness or substance use disorders are not designated a disparity group or priority population by most national public health and tobacco control groups. These smokers fulfill the criteria commonly used to identify groups that merit special attention: targeted marketing by the tobacco industry, high smoking prevalence rates, heavy economic and health burdens from tobacco, limited access to treatment, and longer durations of smoking with less cessation. A national effort to increase surveillance, research, and treatment is needed. Designating smokers with behavioral health comorbidity a priority group will bring much-needed attention and resources. The disparity in smoking rates among persons with behavioral health issues relative to the general population will worsen over time if their needs remain unaddressed. PMID:23865661
Jennings, Robert E.
The objective of this study was to determine the influence of changes in New York State political and legislative processes on the political behavior and strategies of education interest groups in seeking State policy change for education. Historical methods were utilized in examining the problem. As interest groups seek their objectives, they…
Kantamneni, Neeta; Fouad, Nadya
This study was designed to examine the structure of vocational interests in a diverse sample of individuals who completed the 2005 revision of the Strong Interest Inventory. We examined the fit of three racial/ethnic groups (African American, Caucasian, and Latino/a), both genders, and three levels of professional status (GRS participant, student,…
Chubb offers new perspectives on government policies that affect energy supply and demand. He uses organizational theory to determine policy outcomes and to uncover relationships between interest groups and federal energy agencies. This approach helps to explain recent bureaucratic reorganizations in federal energy agencies. Chubb carefully assesses the political difficulties of implementing a national energy plan. His views are relevant for both current and long-term bureaucratic strategies and interest-group initiatives in major energy areas, especially nuclear and oil.
Guerrero, Erick G; Marsh, Jeanne C; Duan, Lei; Oh, Christine; Perron, Brian; Lee, Benedict
Objective To evaluate disparities in substance abuse treatment completion between and within racial and ethnic groups in publicly funded treatment in Los Angeles County, California. Data Source The Los Angeles County Participant Reporting System with multicross-sectional annual data (2006–2009) for adult participants (n = 16,637) who received treatment from publicly funded programs (n = 276) for the first time. Study Design Retrospective analyses of county discharge and admission data. Hierarchical linear regressions models were used to test the hypotheses. Data Collection Client data were collected during personal interviews at admission and discharge for most participants. Principal Findings African Americans and Latinos reported lower odds of completing treatment compared with Whites. Within-group analysis revealed significant heterogeneity within racial and ethnic groups, highlighting primary drug problem, days of drug use before admission, and homelessness as significant factors affecting treatment completion. Service factors, such as referral by the criminal justice system, enabled completion among Latinos and Whites only. Conclusions These findings have implications for reducing health disparities among members of racial and ethnic minorities by identifying individual and service factors associated with treatment adherence, particularly for first-time clients. PMID:23350871
Heaney, Michael T
Assuming a position as broker between disconnected interests is one way for an interest group to influence the making of federal health policy. This study demonstrates how groups use their connections with political parties and lobbying coalitions to augment their brokerage positions and enhance their influence over policy making. Evidence is drawn from statistical analysis of 263 interviews with health policy elites and a qualitative case study of the debate over the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The results explain, in part, how interest groups play their brokerage roles as dispersed actors in a decentralized system, rather than as central mediators that intervene in a wide range of policy disputes.
Guenther, Timothy M; Coker, Timothy J; Chen, Steve I; Carlson, Mark A
Medical student interest groups are organizations that help expose students to different medical specialties and fields of medicine while in medical school. Military medicine interest groups (MMIGs) are a particular type of interest group that spreads information about military medicine, fosters mentorship, and camaraderie between students and military faculty, and increases the opportunities for leadership while in medical school. Surveys were sent to all U.S. medical schools to determine how many schools had an MMIG. If a medical school had a group, a second survey was sent to the student leader to determine more information about how their group operated (such as type of participants, funding sources, activities, faculty involvement, military health care provider involvement, etc.). Fifty-six percent of U.S. medical schools who responded were found to have an MMIG and most participants were students in the Health Professions Scholarship Program. Information about military medicine was found to be the biggest impact of having a group at a medical school and student leaders expressed they wished to have more military health care provider involvement. The results of this study could help start MMIGs at other medical schools, as well as give ideas to current MMIGs on how other groups operate.
Ratliff, Gerald Lee
Residential Freshman Interest Groups (FIGS) have recently become a popular instructional and social model for academic and student affairs colleagues who are concerned that millennial students learn to reflect on life experiences and daily events as part of the learning process. An introductory FIG program recognizes that millennial students are…
Jarosewich, Tania; Essenmacher, Victoria L.; Lynch, Christina Olenik; Williams, Jennifer E.; Doino-Ingersoll, Jo Ann
The American Evaluation Association's (AEA) Independent Consulting Topical Interest Group (IC TIG) has a membership of over eight hundred individuals who generally work as sole proprietors, in partnerships, or in small consulting firms. Well over a decade ago, the IC TIG conducted a survey of its membership (Bonnet, 1992). To gather current data…
Ratliff, Gerald Lee
Freshman Interest Groups (FIGS) have become a popular model for academic and student affairs colleagues who are concerned that first-year students learn to reflect on life experiences and daily events as part of the learning process. A well-designed FIG model meets the academic, social and career concerns for first-year students by providing an…
Peterson, Paul E.; Rabe, Barry G.
Interest groups have historically contributed more to the maintenance of existing national educational policies and programs than to the creation or shaping of new ones. The uncertain political acceptance of the recently increased federal role in education complicates attempts to predict the degree of change in policy development to expect during…
Sharp, Richard R; Foster, Morris W
Strategies for protecting historically disadvantaged groups have been extensively debated in the context of genetic variation research, making this a useful starting point in examining the protection of social groups from harm resulting from biomedical research. We analyze research practices developed in response to concerns about the involvement of indigenous communities in studies of genetic variation and consider their potential application in other contexts. We highlight several conceptual ambiguities and practical challenges associated with the protection of group interests and argue that protectionist strategies developed in the context of genetic research will not be easily adapted to other types of research in which social groups are placed at risk. We suggest that it is this set of conceptual and practical issues that philosophers, ethicists, and others should focus on in their efforts to protect identifiable social groups from harm resulting from biomedical research.
Abed, Riadh; St John-Smith, Paul
Evolutionary science remains an overlooked area in psychiatry and medicine. The newly established Royal College of Psychiatrists' Evolutionary Psychiatry Special Interest Group aims to reverse this trend by raising the profile of evolutionary thinking among College members and others further afield. Here we provide a brief outline of the importance of the evolutionary approach to both the theory and practice of psychiatry and for future research. PMID:27752339
Jones, David S.
Disparities in health status between American Indians and other groups in the United States have persisted throughout the 500 years since Europeans arrived in the Americas. Colonists, traders, missionaries, soldiers, physicians, and government officials have struggled to explain these disparities, invoking a wide range of possible causes. American Indians joined these debates, often suggesting different explanations. Europeans and Americans also struggled to respond to the disparities, sometimes working to relieve them, sometimes taking advantage of the ill health of American Indians. Economic and political interests have always affected both explanations of health disparities and responses to them, influencing which explanations were emphasized and which interventions were pursued. Tensions also appear in ongoing debates about the contributions of genetic and socioeconomic forces to the pervasive health disparities. Understanding how these economic and political forces have operated historically can explain both the persistence of the health disparities and the controversies that surround them. PMID:17077399
Cvijanović, Milena; Ivanović, Ana; Kalezić, Miloš L; Zelditch, Miriam L
Comparative studies of ontogenies of closely related species provide insights into the mechanisms responsible for morphological diversification. Using geometric morphometrics, we investigated the ontogenetic dynamics of postlarval skull shape and disparity in three closely related crested newt species. The skull shapes of juveniles just after metamorphosis (hereafter metamorphs) and adult individuals were sampled by landmark configurations that describe the shape of the dorsal and ventral side of the newt skull, and analyzed separately. The three species differ in skull size and shape in metamorphs and adults. The ontogenies of dorsal and ventral skull differ in the orientation but not lengths of the ontogenetic trajectories. The disparity of dorsal skull shape increases over ontogeny, but that of ventral skull shape does not. Thus, modifications of ontogenetic trajectories can, but need not, increase the disparity of shape. In species with biphasic life-cycles, when ontogenetic trajectories for one stage can be decoupled from those of another, increases and decreases in disparity are feasible, but our results show that they need not occur.
Discusses the possible conflict of interest resulting from the Environmental Protection Agency's participation with the automobile and oil industries in the Coordinating Research Council - Air Pollution Research Advisory Committee, an organization which has sponsored much of the research important to federal regulation of clean air. (JR)
Su, Rong; Rounds, James
The degree of women's underrepresentation varies by STEM fields. Women are now overrepresented in social sciences, yet only constitute a fraction of the engineering workforce. In the current study, we investigated the gender differences in interests as an explanation for the differential distribution of women across sub-disciplines of STEM as well as the overall underrepresentation of women in STEM fields. Specifically, we meta-analytically reviewed norm data on basic interests from 52 samples in 33 interest inventories published between 1964 and 2007, with a total of 209,810 male and 223,268 female respondents. We found gender differences in interests to vary largely by STEM field, with the largest gender differences in interests favoring men observed in engineering disciplines (d = 0.83–1.21), and in contrast, gender differences in interests favoring women in social sciences and medical services (d = −0.33 and −0.40, respectively). Importantly, the gender composition (percentages of women) in STEM fields reflects these gender differences in interests. The patterns of gender differences in interests and the actual gender composition in STEM fields were explained by the people-orientation and things-orientation of work environments, and were not associated with the level of quantitative ability required. These findings suggest potential interventions targeting interests in STEM education to facilitate individuals' ability and career development and strategies to reform work environments to better attract and retain women in STEM occupations. PMID:25762964
Culhane, Paul J.
Since Earth Day 1970, the number of environmental groups has approximately doubled and the movement articulates a much broader and comprehensive philosophy than earlier conservation or preservation movements. The Lake Michigan Federation, one of the new environmental groups developed from the Open Lands Project, was publicly proclaimed in…
In continuation of our work to strengthen alliances with key organizations in the Earth and space science community, AGU president Michael McPhaden, president-elect Carol Finn, and I held a series of meetings with leaders from other science societies during the 2011 Fall Meeting. Over the course of 2 days we met with leaders from the Geophysical Society of America, European Geosciences Union, Japan Geosciences Union, Ethiopian Geophysical Union, Asia Oceania Geosciences Society, Chinese Geophysical Society, and Asociación Latinoamericana de Geofísica Espacial. This gave us a valued opportunity to discuss the common interests and challenges we all face and to learn from each other's experience. The meetings allowed AGU to strengthen existing cooperative agreements and reach new levels of understanding between us and other societies. Additionally, we met with representatives from the Korean Ocean Research and Development Institute to discuss their intention to establish a geophysical union modeled after AGU.
Boehnlein, Amber; Matthews, Brian; Proffen, Thomas; Schluenzen, Frank
Scientific research data provides unique challenges that are distinct from classic “Big Data” sources. One common element in research data is that the experiment, observations, or simulation were designed, and data were specifically acquired, to shed light on an open scientific question. The data and methods are usually “owned” by the researcher(s) and the data itself might not be viewed to have long-term scientific significance after the results have been published. Often, the data volume was relatively low, with data sometimes easier to reproduce than to catalog and store. Some data and meta-data were not collected in a digital form, or were stored on antiquated or obsolete media. Generally speaking, policies, tools, and management of digital research data have reflected an ad hoc approach that varies domain by domain and research group by research group. This model, which treats research data as disposable, is proving to be a serious limitation as the volume and complexity of research data explodes. Changes are required at every level of scientific research: within the individual groups, and across scientific domains and interdisciplinary collaborations. Enabling researchers to learn about available tools, processes, and procedures should encourage a spirit of cooperation and collaboration, allowing researchers to come together for the common good. In conclusion, these community-oriented efforts provide the potential for targeted projects with high impact.
Boehnlein, Amber; Matthews, Brian; Proffen, Thomas; ...
Scientific research data provides unique challenges that are distinct from classic “Big Data” sources. One common element in research data is that the experiment, observations, or simulation were designed, and data were specifically acquired, to shed light on an open scientific question. The data and methods are usually “owned” by the researcher(s) and the data itself might not be viewed to have long-term scientific significance after the results have been published. Often, the data volume was relatively low, with data sometimes easier to reproduce than to catalog and store. Some data and meta-data were not collected in a digital form,more » or were stored on antiquated or obsolete media. Generally speaking, policies, tools, and management of digital research data have reflected an ad hoc approach that varies domain by domain and research group by research group. This model, which treats research data as disposable, is proving to be a serious limitation as the volume and complexity of research data explodes. Changes are required at every level of scientific research: within the individual groups, and across scientific domains and interdisciplinary collaborations. Enabling researchers to learn about available tools, processes, and procedures should encourage a spirit of cooperation and collaboration, allowing researchers to come together for the common good. In conclusion, these community-oriented efforts provide the potential for targeted projects with high impact.« less
Viets, Vanessa Lopez; Baca, Catherine; Verney, Steven P.; Venner, Kamilla; Parker, Tassy; Wallerstein, Nina
Purpose Ethnic minority faculty members are vastly underrepresented in academia. Yet, the presence of these individuals in academic institutions is crucial, particularly because their professional endeavors often target issues of health disparities. One promising way to attract and retain ethnic minority faculty is to provide them with formal mentorship. This report describes a culturally centered mentorship program, the Southwest Addictions Research Group (SARG, 2003–2007), at the University of New Mexico (UNM) that trained a cadre of minority researchers dedicated to reducing health disparities associated with substance abuse. Method The SARG was based at UNM’s School of Medicine’s Institute for Public Health, in partnership with the UNM’s Center on Alcoholism, Substance Abuse, and Addictions. The program consisted of regular research meetings, collaboration with the Community Advisory Board, monthly symposia with renowned professionals, pilot projects, and conference support. The authors collected data on mentee research productivity as outcomes and conducted separate mentee and mentor focus-group interviews to assess the strengths and weaknesses of the SARG program. Results The SARG yielded positive outcomes as evidenced by mentee increase in grant submissions, publications, and professional presentations. Focus-group qualitative data highlighted program and institutional barriers as well as successes that surfaced during the program. Based on this evaluation, a Culturally Centered Mentorship Model (CCMM) emerged. Conclusions The CCMM can help counter institutional challenges by valuing culture, community service, and community-based participatory research to support the recruitment and advancement of ethnic minority faculty members in academia. PMID:19638783
Stewart, David G; Moise-Campbell, Claudine; Chapman, Meredith K; Varma, Malini; Lehinger, Elizabeth
Ethnic minority youth are disproportionately affected by substance use-related consequences, which may be best understood through a social ecological lens. Differences in psychosocial consequences between ethnic majority and minority groups are likely due to underlying social and environmental factors. The current longitudinal study examined the outcomes of a school-based motivational enhancement treatment intervention in reducing disparities in substance use consequences experienced by some ethnic minority groups with both between and within-subjects differences. Students were referred to the intervention through school personnel and participated in a four-session intervention targeting alcohol and drug use. Participants included 122 youth aged 13-19 years. Participants were grouped by ethnicity and likelihood of disparate negative consequences of substance use. African American/Hispanic/Multiethnic youth formed one group, and youth identifying as White or Asian formed a second group. We hypothesized that (1) there would be significant disparities in psychosocial, serious problem behavior, and school-based consequences of substance use between White/Asian students compared to African American/Hispanic/Multiethnic students at baseline; (2) physical dependence consequences would not be disparate at baseline; and (3) overall disparities would be reduced at post-treatment follow-up. Results indicated that African American/Hispanic/Multiethnic adolescents demonstrated statistically significant disparate consequences at baseline, except for physical dependency consequences. Lastly, significant reductions in disparities were evidenced between groups over time. Our findings highlight the efficacy of utilizing school-based substance use interventions in decreasing ethnic health disparities in substance use consequences.
Brannon, Tiffany N; Walton, Gregory M
In the present research, we examined the hypothesis that cues of social connectedness to a member of another social group can spark interest in the group's culture, and that such interest, when freely enacted, contributes to reductions in intergroup prejudice. In two pilot studies and Experiment 1, we found that extant and desired cross-group friendships and cues of social connectedness to an out-group member predicted increased interest in the target group's culture. In Experiments 2 and 3, we manipulated cues of social connectedness between non-Latino American participants and a Latino American (i.e., Mexican American) peer and whether participants freely worked with this peer on a Mexican cultural task. This experience reduced the participants' implicit bias against Latinos, an effect that was mediated by increased cultural engagement, and, 6 months later in an unrelated context, improved intergroup outcomes (e.g., interest in interacting with Mexican Americans; Experiment 4). The Discussion section addresses the inter- and intragroup benefits of policies that encourage people to express and share diverse cultural interests in mainstream settings.
French, Kimberly A.; Kottke, Janet L.
Multilevel modeling is used to examine the impact of teamwork interest and group extraversion on group satisfaction. Participants included 206 undergraduates in 65 groups who were surveyed at the beginning and end of a requisite term-length group project for an upper-division university course. We hypothesized that teamwork interest and both…
Follins, Lourdes D.; Paler, Lisa K.; Nanin, Jose E.
This article describes the creation and implementation of a faculty interest group for historically underrepresented faculty at a large, urban community college in the Northeast. Faculty interest groups provide opportunities for faculty across disciplines to meet to explore common interests and share concerns and best practices. The faculty…
Pavlinov, I Ia; Nanova, O G; Spasskaia, N N
Interrelations between some forms of group variation (FGVs) (age, sex, geographic, inter-species, differences among breeds) of 12 to 15 measurable skull traits are studied in 6 mammal species (pine marten, polar fox, Przewalskii horse, and 3 jird species) by means of dispersion analysis (model III, MANOVA). The above FGVs are considered as factors in the MANOVA, and skull traits are considered as dependent variables. To obtaine commeasurables estimates for the FGVs, each of them is assessed numerically as a portion of its dispersion in the entire morphological disparity defined for each character (or a set of characters) by MANOVA. The data obtained indicate a wide diversity of interrelations between FGVs. It is shown that statistical analysis of significance of joint effects of FGVs does not substitute the analysis of numerical interrelations of their dispersion portions. It is concluded that it is unproductive to study such interrelations as simple "statistical regularities" like the Kluge-Kerfoot phenomenon, so the character sets are not to be considered as statistical ensembles. A kind of content-wise null-model for FGVs of measurable traits is formulated according to which there is a "background" age variation while other FGVs are its derivatives. Respectively, other factors structuring the morphological disparity under investigation being absent, a positive correlation between FGVs is to be anticipated (strong succession). With the significant deviations of the postulated correlation being observed, other factors regulating respective FGVs that cannot be reduced to the age variation are to be supposed (weak succession). Possible interpretations of interrelations between age variation and some other FGVs in carnivores are considered. Craniological variation in the Przewalskii horse is just slightly effected by maintenance conditions under its domestication, a significant influence of other factors is to be supposed. Negative correlation between geographic and
Poteat, V. Paul; Scheer, Jillian R.; Chong, Eddie S. K.
There is little data on whether school discipline or juvenile justice sanctions are directed disproportionately toward sexual minority youth (e.g., lesbian, gay, bisexual, or questioning; LGBQ) compared with heterosexual youth and even less on factors that may relate to such disparities. We tested for sexual orientation-based disparities in school…
Katz-Wise, Sabra L; Blood, Emily A; Milliren, Carly E; Calzo, Jerel P; Richmond, Tracy K; Gooding, Holly C; Austin, S Bryn
Obesity is a key public health issue for US youth. Previous research with primarily white samples of youth has indicated that sexual minority females have higher body mass index (BMI) and sexual minority males have lower BMI than their same-gender heterosexual counterparts, with sexual orientation differences in males increasing across adolescence. This research explored whether gender and sexual orientation differences in BMI exist in nonwhite racial/ethnic groups. Using data from Waves I-IV (1995-2009) of the US National Longitudinal Study of Adolescent Health (N = 13,306, ages 11-34 years), we examined associations between sexual orientation and BMI (kg/m2) over time, using longitudinal linear regression models, stratified by gender and race/ethnicity. Data were analyzed in 2013. Among males, heterosexual individuals showed greater one-year BMI gains than gay males across all race/ethnicity groups. Among females, white and Latina bisexual individuals had higher BMI than same-race/ethnicity heterosexual individuals regardless of age; there were no sexual orientation differences in black/African Americans. Sexual orientation disparities in BMI are a public health concern across race/ethnicity groups. Interventions addressing unhealthy weight gain in youth must be relevant for all sexual orientations and race/ethnicities.
Jalalat, Sheila Z; Wagner, Richard F
The open access University of Texas Dermatology Interest Group blog was established in 2004 for the purposes of increasing communication and collaboration between medical students and dermatology faculty, residents, and alumni, as well as to promote educational opportunities and the missions for which the interest group was created. This blog is unique because of its longevity and continuous postings directed toward the educational and professional needs of medical students and residents. A blog user survey was performed to assess viewers' thoughts, purpose of viewing, demographic profile, subscriber status, usage of the blog and other Web 2.0 tools (forums, Facebook, blogs, Twitter, podcasts), and perceived usefulness. Sixty-one anonymous online surveys were completed during a 1-month period. Statistical analyses of the responses demonstrated that the utilization of web-based tools and the blog were valuable resources for students, especially for blog subscribers, those more involved in an interest group, and those reading the blog for a longer period of time. The usefulness and impact of this method of communication and dissemination of information in medical education may encourage other student groups, faculty advisors, and educators to implement similar educational tools at their institutions.
Shah, Vallabh O.; Ghahate, Donica M; Bobelu, Jeanette; Sandy, Phillip; Newman, Sara; Helitzer, Deborah L.; Faber, Thomas; Zager, Philip
The Zuni Pueblo is home to an economically disadvantaged population, which faces a public health challenge from the interrelated epidemics of obesity, diabetes and kidney disease. Efforts to decrease the impact of these epidemics have been complicated by historical, economic and cultural barriers, which may limit health-care utilization. The NIH supported Zuni Health Initiative (ZHI) conducted a study to identify barriers to heath care in the Zuni Pueblo. Community health representatives (CHRs) led 14 one-hour focus group sessions at which a total of 112 people participated posed unique questions that took into account the Zuni culture to elicit information on perceived barriers to health care. Audiotapes were translated and transcribed by bilingual ZHI staff. We reduced the text to thematic categories, constructed a coding dictionary and inserted the text into NVivo 9 program. We identified nine themes emerged regarding the barriers experienced in receiving health care and adhering to medical advice. These included distance; transportation; embarrassment; relating to healthcare professionals; navigating the medical system; awareness of available resources; waiting times; adhering to medication; and incentives in health promotion. In conclusion the implementation of culturally appropriate community based health promotion programs and preventive screening techniques will improve access to health care and diminish health disparities. PMID:24528897
Health councils have developed in Brazil in keeping with arrangements under the 1988 Constitution, and the logic of their political consensus has expanded among interest groups relevant to public policy. Collegiate bodies, such as intergovernmental commissions, represent an extension of that logic to executive relationships and also express political intermediation by expertise, following the tradition of the European Welfare State. The state technical bureaucracy has thus developed a remarkable role in policy-making and in State-level modeling of interest groups. This article argues that such collegiate bodies should be analyzed through State action and defines two models for health councils. One, the vocal political model, is characterized by a prevalence of outspoken denunciation and an overload of demands on the political agenda. The other, the consensus model, expresses self-limitation amongst interest groups in drafting demands. These models are not hierarchically fixed and are usually linked to the political platforms of interest groups participating in the collegiate bodies.
... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Establishment and maintenance of registry... AMENDED Communications From Individuals and Groups § 51.32 Establishment and maintenance of registry of interested individuals and groups. The Attorney General shall establish and maintain a Registry of...
... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Establishment and maintenance of registry... AMENDED Communications From Individuals and Groups § 51.32 Establishment and maintenance of registry of interested individuals and groups. The Attorney General shall establish and maintain a Registry of...
... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Establishment and maintenance of registry... AMENDED Communications From Individuals and Groups § 51.32 Establishment and maintenance of registry of interested individuals and groups. The Attorney General shall establish and maintain a Registry of...
... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Establishment and maintenance of registry... AMENDED Communications From Individuals and Groups § 51.32 Establishment and maintenance of registry of interested individuals and groups. The Attorney General shall establish and maintain a Registry of...
Jones, Katherine J.; Vandenberg, Edward V.; Bottsford, Lisa
The authors describe the prevalence, formation, maintenance, and evaluation of student aging interest groups. They conducted a cross-sectional electronic survey of the 46 academic medical centers funded by the Donald W. Reynolds Foundation. To evaluate their group of approximately 50 students, the authors conducted an electronic pretest and…
Diez Roux, Ana V.
Scientific and policy interest in health disparities, defined as systematic, plausibly avoidable health differences adversely affecting socially disadvantaged groups, has increased markedly over the past few decades. Like other research, research in health disparities is strongly influenced by the underlying conceptual model of the hypothetical causes of disparities. Conceptual models are important and a major source of debate because multiple types of factors and processes may be involved in generating disparities, because different disciplines emphasize different types of factors, and because the conceptual model often drives what is studied, how results are interpreted, and which interventions are identified as most promising. This article reviews common conceptual approaches to health disparities including the genetic model, the fundamental cause model, the pathways model, and the interaction model. Strengths and limitations of the approaches are highlighted. The article concludes by outlining key elements and implications of an integrative systems-based conceptual model. PMID:22224879
Sparks, Erin; Schinkel, Meghan G; Moore, Chris
Young children's willingness to share with others is selective, and is affected by their level of affiliation with the recipients of their generosity. We explored affiliation's impact on sharing behavior with two experiments comparing the effects of two distinct affiliative cues-minimal group membership and shared interests. Children (4- to 6-year-olds) completed a resource allocation task, making forced-choice decisions as to how to distribute stickers between themselves and others. In Experiment 1, the sharing partners were minimal in- and out-group members; in Experiment 2, they differed in their opinion of the participants' interests. Both experiments' manipulations affected feelings of affiliation, as indicated by children's stated friendship preferences and perceptions of similarity. More notably, both minimal group membership and interests affected sharing behavior. Children made fewer generous allocations toward out-group members than toward in-group members. Similarly, children made fewer generous allocations when recipients disliked their interests than when recipients shared those interests or when their opinions were unknown. Across experiments, the recipient manipulations' effects on generosity were similar in their pattern and magnitude despite fundamental differences between the two affiliative cues. These findings highlight the broad impact of affiliation on young children's sharing behavior.
McCool, Stephen F.; Benson, Robert E.; Ashor, Joseph L.
A total of 25 scenes representing the five visual quality objectives in the US Department of Agriculture Forest Service visual management system were presented to 18 professional and public interest groups in western Montana. The results indicate that nearly all the groups have similar rank orderings of the scenes in terms of visual preference. However, the groups differ according to the absolute values of their ratings. Most groups were unable, in a statistical sense, to differentiate the scenic quality of areas in the preservation and retention visual quality objectives. Landscape architects tended to rate scenes in a way similar to professional forest management groups.
Background: There is an increasing interest in the notion of health disparities, inequities and inequalities in Canada and elsewhere. In Canada, individuals with disabilities represent one of six groups identified as particularly vulnerable to health disparities. Method: This paper combines the literature related to the concepts of inequity and…
Hinnant, Amanda; Oh, Hyun Jee; Caburnay, Charlene A.; Kreuter, Matthew W.
News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C "et al." Unintended…
Hobbs, Suzanne Havala; Ricketts, Thomas C; Dodds, Janice M; Milio, Nancy
Regulatory changes proposed by the US Department of Agriculture in 1994 promised to bring progressive changes to school meals. However, lobbying by interest groups resulted in substantial changes to the final rule. This analysis retrospectively examines the federal school meals policy-making process during 1992 to 1996. Key questions address why the policy changed and what the role of interest groups was in affecting the shape, pace, and direction of the policy. The study provides suggestions for using the experiences of 1992 to 1996 to guide future advocacy efforts and for adapting the approach for application to other food and nutrition policies.
Racial, ethnic and class disparities in cancer incidence and mortality have been well documented. Disparities in the utilization of preventive, curative and treatment services among ethnic minorities have been reported. Screening can be effective at detecting cancer at treatable stages, but a large proportion of people at risk have not been screened or are not regularly screened, as recommended by the American Cancer Society's national guidelines. Early detection technologies have the potential of both influencing mortality from cancer, as well as enhancing primary prevention through detection and removal of lesions that could potentially develop into cancer. Cancer is an epigenetic disease characterized by the breakdown of DNA methylation and histones modification patterns. Epigenetic approaches may contribute to a reduction in cancer health disparities impacting early detection and increasing cancer treatment options. Epigenetic events represent important mechanism(s) by which gene function is selectively activated or inactivated, through genetic and non-genetic manifestations. Emerging evidence indicates that various epigenetic alterations, such as global histones modifications and DNA hypomethylation, common to most types of cancer, are modified by environmental exposures throughout the life course. A simple, easily explained and easy to understand non-invasive test, such as the DNA methylation index, that may screen for several cancer sites at once, may remove some of the existing barriers to cancer screening utilization, and contribute to the reduction of cancer disparities. Epigenetic approaches may also prove to be useful in identifying environmental and lifestyle factors that contribute to the prevalence of other chronic conditions in high risk populations, such as Puerto Rican populations in the United States and Puerto Rico.
Superfine, Benjamin Michael; Thompson, Alea R.
In "Vergara v. California" (2014), a trial-level court ruled that California laws governing teacher tenure and dismissal were unconstitutional. This study analyzes "Vergara" in light of the shifting use of the courts to promote equal educational opportunities and the changing power bases of educational interest groups,…
Florig, H Keith
The history of radiation risk management is replete with contentious public debate between public interest groups and the technical community of radiation protection professionals. To promote a deeper understanding of this phenomenon, this paper describes the rationales and values underlying public-interest group positions in one radiation risk domain (low-level waste) and contrasts them with those of the technical community. Public interest group objections to recycling of radioactivity-contaminated materials and to discarding of other low-level wastes are made on fairness, risk assessment, and energy-policy grounds. Concerns about procedural fairness stem from the continuing use of top-down expert-driven, rather than deliberative, systems for low-level waste policy-making. Concerns about distributional fairness arise because the benefits and risks of alterative low-level waste policies accrue to different stakeholders. Risk assessment is faulted for failure to acknowledge hidden subjective assumptions (e.g., on screening vigilance in materials recycling, on integrity of disposal facilities in the far future). Skepticism of technological risk management arises from a history peppered with unexpected untoward events that lay outside the design bases of protection systems. Finally, public interest groups view low-level waste issues as part of a larger debate on wise and legitimate energy policy, and are reluctant to support measures that provide relief to a nuclear industry that, in their view, established itself outside the democratic process.
Jackman, Diane H., Ed.
This proceedings consists of five research papers presented during the 1997 annual meeting of the American Educational Research Association (AERA). The papers were presented during the sessions of the AERA Vocational Education Special Interest Group. "Predictors of Occupational Choice among Rural Youth: Implications for Career Education and…
... 10 Energy 2 2010-01-01 2010-01-01 false List of interested organizations and groups. 51.122 Section 51.122 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy...
... 10 Energy 2 2013-01-01 2013-01-01 false List of interested organizations and groups. 51.122 Section 51.122 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy...
... 10 Energy 2 2012-01-01 2012-01-01 false List of interested organizations and groups. 51.122 Section 51.122 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy...
... 10 Energy 2 2014-01-01 2014-01-01 false List of interested organizations and groups. 51.122 Section 51.122 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy...
... 10 Energy 2 2011-01-01 2011-01-01 false List of interested organizations and groups. 51.122 Section 51.122 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) ENVIRONMENTAL PROTECTION REGULATIONS FOR DOMESTIC LICENSING AND RELATED REGULATORY FUNCTIONS National Environmental Policy...
Mulder, Martin, Ed.
This document contains 7 of the 10 papers presented at the 1995 program of the American Educational Research Association's special interest group, Training in Business and Industry. The following papers are included: "A Multi-Disciplinary Approach to Integrating Evaluation and Training" (Jo D. Gallagher); "Comparing Managers and…
... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Establishment and maintenance of registry of interested individuals and groups. 51.32 Section 51.32 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PROCEDURES FOR THE ADMINISTRATION OF SECTION 5 OF THE VOTING RIGHTS ACT OF 1965,...
Stewart, David W.
Discusses the genesis and formulation of the bill which became the Lifelong Learning Act. Examines cooperative efforts and political activities of supporters (Minnesota Learning Society, Coalition of Adult Education Organizations, and other interest groups) who helped get the bill passed. President Carter has asked Congress for $5 million to…
Duran, Robert L.; Colarulli, Guy C.; Barrett, Karen A.; Stevenson, Catherine B.
A first-year interest group (FIG) is a learning community using course clusters. An effective model of FIGs and an innovative faculty development process are briefly described. Evaluation results found that University of Hartford FIGs improved student learning, improved curricular integration, fostered student community, and promoted faculty…
This qualitative study examined first-year Interest Groups (FIGs) that resulted in higher graduation rates at the University of Wisconsin-Stevens Point. Participants in this study included eight former FIG participants from the academic years 2008-2011. This researcher created a questionnaire guided by Astin's theory of involvement, that analyzed…
Michaelidis, Constantinos I; Zimmerman, Richard K; Nowalk, Mary Patricia; Smith, Kenneth J
Influenza is a major cause of preventable morbidity and mortality in the United States, particularly among the elderly. Yet, there remain large disparities in influenza vaccination rates across elderly Caucasian (70%), African-American (50%) and Hispanic (55%) populations, with substantial mortality consequences. In this study, we built a decision-analysis model to estimate the cost-effectiveness of a hypothetical national vaccination program designed to eliminate these disparities in influenza vaccination rates. Taking a societal perspective, we developed a Markov model with a one-year cycle length and lifetime time horizon. In the base case, we conservatively assumed that the cost of promoting the vaccination program was $10 per targeted elder per year and that by year 10, the vaccination rate of the elderly African-American and Hispanic populations would equal the vaccination rate of the elderly Caucasian population (70%). The cost-effectiveness of the vaccination program compared to no vaccination program was $48,617 per QALY saved. Probabilistic sensitivity analyses suggested that at willingness-to-pay thresholds of $50,000 and $100,000 per QALY saved, the likelihood of the vaccination program being cost-effective was 38% and 92%, respectively. In an analysis using conservative assumptions, we found that a hypothetical program to ameliorate disparities in influenza vaccination rates has a moderate to high likelihood of being cost-effective.
Maguire, Mariana C.
The clean energy revolution in the United States is not going to happen until diverse stakeholders in the coalition of clean energy proponents strengthen their cohesion and influence—two critical tools for interest group's to be successful in driving the formulation of public policy. Currently, clean energy technology and resource development is supported by a highly diverse coalition of interest groups such as environmental groups, health organizations, industry, and the Defense Department, whose primary goals are often unrelated. Yet their objectives are increasingly well served by pursuing clean energy development by pushing lawmakers for supportive policies. However, characteristics of this ad hoc coalition can hinder its influence and cohesion. Whereas, fossil fuel interests—exemplified by the coalition of oil proponents—are highly cohesive and influential. This thesis will analyze whether there is a correlation between public policies on clean energy, and the strength of interest group influence over those policy decisions. It will begin with an analysis of interest group theories. Next it will analyze the histories of the oil industry as the model opponent of clean energy policies, and the biofuels, wind energy, and solar energy industries as the model proponents of clean energy policies. The composition of the respective coalitions will reveal if they are diverse or similar, with broad or narrow goals, and other important characteristics. Their respective policy positions and messages will show what values are important to them, and the presidential support each coalition has been achieved, or failed to achieve, will provide further insight into their effectiveness. This thesis will then apply interest group theories to the supporter and opponent coalitions. Results obtained indicate that the coalition of oil interests is large, yet very cohesive and influential, while the coalition for clean energy is large, generally diffuse but with some important
Leggat, Peter A; Zwar, Nicholas; Hudson, Bernie
The Travel Health Advisory Group (THAG), established in 1997, is a joint initiative between the travel industry and travel health professionals in Australia that aims to promote healthy travel. THAG seeks to promote cooperation in improving the health of travellers between the travel industry and travel medicine professionals and to raise public awareness of the importance of travel health. From 2011, THAG has been a Special Interest Group of The Australasian College of Tropical Medicine and its membership has been active in several areas, including web-based travel health information, travel health promotion, media releases, research and education in Australia. Information is given on the objectives, membership and an overview of the various activities of the group.
Wharton, Tracy C.; Kazi, Mansoor A.
With increased pressure on programs to evaluate outcomes, the issue of evaluation in social work has never been so topical. In response to these pressures, there has been a growing interest in evidence-based practice and strategies for the evaluation of social work programs. The American Evaluation Association (AEA) is an international…
Bouye, Karen E.; Skillen, Elizabeth; Lee, Charles; Whitehead, LaToria; Rashid, Jamila R.
In 2006, the Federal Collaboration on Health Disparities Research (FCHDR) identified the built environment as a priority for eliminating health disparities, and charged the Built Environment Workgroup with identifying ways to eliminate health disparities and improve health outcomes. Despite extensive research and the development of a new conceptual health factors framework, gaps in knowledge exist in areas such as disproportionate environmental and community hazards, individual and cumulative risks, and other factors. The FCHDR provides the structure and opportunity to mobilize and partner with built environment stakeholders, federal partners, and interest groups to develop tools, practices, and policies for translating and disseminating the best available science to reduce health disparities. PMID:21389288
Hutch, Daniel J; Bouye, Karen E; Skillen, Elizabeth; Lee, Charles; Whitehead, Latoria; Rashid, Jamila R
In 2006, the Federal Collaboration on Health Disparities Research (FCHDR) identified the built environment as a priority for eliminating health disparities, and charged the Built Environment Workgroup with identifying ways to eliminate health disparities and improve health outcomes. Despite extensive research and the development of a new conceptual health factors framework, gaps in knowledge exist in areas such as disproportionate environmental and community hazards, individual and cumulative risks, and other factors. The FCHDR provides the structure and opportunity to mobilize and partner with built environment stakeholders, federal partners, and interest groups to develop tools, practices, and policies for translating and disseminating the best available science to reduce health disparities.
Smith, M A; Acheson, L S; Byrd, J E; Curtis, P; Day, T W; Frank, S H; Franks, P; Graham, A V; LeFevre, M; Resnick, J
A critical review of the literature regarding important aspects of labor and delivery was conducted by members of the Obstetrical Interest Group of the North American Primary Care Research Group using computerized searches, personal communication, and literature exchange between group members. Each written topic summary was carefully reviewed by a second group member, and a consensus was reached regarding conclusions and recommendations by the group. The topics include family involvement, comfort measures, fetal heart rate monitoring, labor augmentation, birth positions, and episiotomies. Each topic summary is preceded by conclusions and recommendations given in the order of least invasive to most invasive of the woman in labor. The strength of these conclusions and recommendations is based on the amount and type of supportive data in the literature and is indicated by one to three stars preceding that statement. One-star conclusions are not well supported in the literature but reflect a family practice style and were reached through consensus from the group. Three-star conclusions are supported by data from clinical trials.
Lim, Fidelindo A; Nadeau, Cheryl A
The current emphasis to make nurses full partners in health care dialogue, education, research, practice, and policy-making has made nursing education more challenging and exciting. Competing themes in an already saturated curriculum allow little room for adding more content to formal teaching-learning activities. Well-organized student-led interest groups are an excellent avenue for conducting focused extracurricular offerings that allow students to exercise their leadership and organizational skills, advocate for academic excellence, and add specialty topics missing in the generalist curriculum. As an adjunct to the formal curriculum, professional development events organized by student-led interest groups promote student engagement, lifelong learning, and learner-centered education.
Braun, Joshua A
This article examines some of the story conventions of network television news to explain the ways in which healthcare interest groups develop and maintain their presence in this medium - a process that has significant implications for public understanding of healthcare issues, and therefore to bioethics. The article is divided into three sections. The first section focuses on three major normative conventions of television news: adherence to a simple narrative structure, the balance ethic, and avoidance of the "think-piece" and outlines the basic strategies available to interest groups for exploiting these normative conventions. Section two introduces three case studies of organizations and individuals who have run high-profile media campaigns. Section three explores the implications for bioethics of the observations made in this article.
O'Brien, Laurie T; Garcia, Donna; Crandall, Christian S; Kordys, Justin
We focused on a powerful objection to affirmative action - that affirmative action harms its intended beneficiaries by undermining their self-esteem. We tested whether White Americans would raise the harm to beneficiaries objection particularly when it is in their group interest. When led to believe that affirmative action harmed Whites, participants endorsed the harm to beneficiaries objection more than when led to believe that affirmative action did not harm Whites. Endorsement of a merit-based objection to affirmative action did not differ as a function of the policy's impact on Whites. White Americans used a concern for the intended beneficiaries of affirmative action in a way that seems to further the interest of their own group.
Khan, Arifa S; Vacante, Dominick A; Cassart, Jean-Pol; Ng, Siemon H S; Lambert, Christophe; Charlebois, Robert L; King, Kathryn E
Several nucleic-acid based technologies have recently emerged with capabilities for broad virus detection. One of these, high throughput sequencing, has the potential for novel virus detection because this method does not depend upon prior viral sequence knowledge. However, the use of high throughput sequencing for testing biologicals poses greater challenges as compared to other newly introduced tests due to its technical complexities and big data bioinformatics. Thus, the Advanced Virus Detection Technologies Users Group was formed as a joint effort by regulatory and industry scientists to facilitate discussions and provide a forum for sharing data and experiences using advanced new virus detection technologies, with a focus on high throughput sequencing technologies. The group was initiated as a task force that was coordinated by the Parenteral Drug Association and subsequently became the Advanced Virus Detection Technologies Interest Group to continue efforts for using new technologies for detection of adventitious viruses with broader participation, including international government agencies, academia, and technology service providers.
Imperato, Pascal James; Imperato, Gavin H; Imperato, Austin C
In the late nineteenth and early twentieth centuries, a number of European expeditions traveled to the region of Lake Rudolf, now largely in northern Kenya. Although diverse in intent, many of these were undertaken in the interests of furthering colonial territorial claims. In 1900-1901, Major Herbert Henry Austin led a British expedition down to the lake from Khartoum in the north. Of the 62 African, Arab, and European members of this expedition, only 18 (29 %) arrived at its final destination at Lake Baringo in Kenya. Because of a confluence of adverse climatic, social, and political conditions, the expedition ran short of food supplies when it arrived at the northern end of the lake in April 1901. For the next 4 months, the members of the expedition struggled down the west side of the lake and beyond. The greatest mortality (91 %) occurred among the 32 African transport drivers who were the most marginally nourished at the outset of the trip. The lowest mortality among the Africans on the expedition (15 %) occurred among the members of the Tenth Sudanese Rifles Battalion, who had an excellent nutritional status at the start of the expedition. Major Austin himself suffered from severe scurvy with retinal hemorrhages which left him partially blind in his right eye. An analysis of the mortality rates among the groups that participated in this expedition was undertaken. This revealed that poor nutritional status at the start of the trip was predictive of death from starvation.
Williams, R.G.; Payne, B.A.
This paper discusses the two components of the facilitative setting that are important for group formation. The first component, the ideological component, provides the basic ideas that are adopted by the emerging group. The ideological setting for group formation is produced by such things as antinuclear news coverage and concentration of news stories on hazardous waste problems, on ideas concerning the credibility of the federal government, and on the pervasivensee of ideas about general environmental problems. The organizational component of the facilitative setting provides such things as leadership ability, flexible time, resources, and experience. These are important for providing people, organization, and money to achieve group goals. By and large, the conditions conducive to group formation, growth, and survival are outside the control of decision-makers. Agencies and project sponsors are currently caught in a paradox. Actively involving the public in the decision-making process tends to contribute to the growth and survival of various interest groups. Not involving the public means damage to credibility and conflict with values concerning participatory democracy. Resolution in this area can only be achieved when a comprehensive, coordinated national approach to hazardous waste management emerges. 26 refs.
Ryu, Soyoung; Payne, Samuel H.; Schaab, Christoph; Xiao, Wenzhong
Mass spectrometry special interest group (MS-SIG) aims to bring together experts from the global research community to discuss highlights and challenges in the field of mass spectrometry (MS)-based proteomics and computational biology. The rapid echnological developments in MS-based proteomics have enabled the generation of a large amount of meaningful information on hundreds to thousands of proteins simultaneously from a biological sample; however, the complexity of the MS data require sophisticated computational algorithms and software for data analysis and interpretation. This year’s MS-SIG meeting theme was ‘Beyond the Proteome’ with major focuses on improving protein identification/quantification and using proteomics data to solve interesting problems in systems biology and clinical research.
Despite the substantial and prolonged sociological interest in health disparities, much remains unknown about the processes that initiate them. To investigate this topic, we focus on the case study of cocaine use, for which a socioeconomic disparity emerged across all age groups in a short period of time around 1990. We examine whether the…
Weber, W.; Lebowitz, H.E.
The objectives of the Upgraded Coal Interest Group (UCIG) are as follows: Review and update the status of various coal upgrading technologies and developments and critically assess the results. Perform engineering screening analyses on various coal upgrading approaches. Perform commercialization analyses that will promote the availability and use of upgraded coal products by quantifying the benefits of using them. Identify market opportunities for introduction of upgraded coals. Perform critical analyses on a variety of coals and technologies in areas important to users but not readily available. Perform critical experiments which will show the differences between technologies.
Vladeck, B C
Examination of the provisions of the National Health Planning and Resources Development Act, P.L. 93-641, concerning the composition of Health Systems Agencies, which are to be the primary building-blocks of local health planning, suggests that expectations of substantial change may be unrealistic. Specifically, in its provision for representation on the HSAs, Congress appears to have been accepting an implicit theory of pluralist interest-group representation that has long been prevalent in other sectors of public life in the United States, and long subject to significant criticism. Such forms of representation tend to lead to bargaining, log-rolling, and collusive competition among narrowly-defined special interests, with the interests of the broader general public less well-served. The application of this theory to health planning in P.L. 93-641 is examined, and predictions drawn about the implications of this analysis for health planning and health policy in the United States in general. PMID:831558
National Inst. of Child Health and Human Development (NIH), Bethesda, MD.
This document details the strategic plan of the National Institute of Child Health and Human Development to address disparities in health and developmental outcomes among Americans, particularly between and among racial and ethnic groups. Following a description of the plan's development, scientific areas of interest, and important themes, the…
Lieber, Bryan A; Wilson, Taylor A; Bell, Randy S; Ashley, William W; Barrow, Daniel L; Wolfe, Stacey Quintero
Indirect costs of the interview tour can be prohibitive. The authors sought to assess the desire of interviewees to mitigate these costs through ideas such as sharing hotel rooms and transportation, willingness to stay with local students, and the preferred modality to coordinate this collaboration. A survey link was posted on the Uncle Harvey website and the Facebook profile page of fourth-year medical students from 6 different medical schools shortly after the 2014 match day. There were a total of 156 respondents to the survey. The majority of the respondents were postinterview medical students (65.4%), but preinterview medical students (28.2%) and current residents (6.4%) also responded to the survey. Most respondents were pursuing a field other than neurosurgery (75.0%) and expressed a desire to share a hotel room and/or transportation (77.4%) as well as stay in the dorm room of a medical student at the program in which they are interviewing (70.0%). Students going into neurosurgery were significantly more likely to be interested in sharing hotel/transportation (89.2% neurosurgery vs 72.8% nonneurosurgery; p = 0.040) and in staying in the dorm room of a local student when on interviews (85.0% neurosurgery vs 57.1% nonneurosurgery; p = 0.040) than those going into other specialties. Among postinterview students, communication was preferred to be by private, email identification-only chat room. Given neurosurgery resident candidates' interest in collaborating to reduce interview costs, consideration should be given to creating a system that could allow students to coordinate cost sharing between interviewees. Moreover, interviewees should be connected to local students from neurosurgery interest groups as a resource.
Pulte, Dianne; Redaniel, Maria Theresa; Jansen, Lina; Brenner, Hermann; Jeffreys, Mona
The survival of younger patients with acute leukemia has improved in the early 21(st) century, but it is unknown whether people of all ethnic and racial backgrounds have benefited equally. Using cancer registry data from the Surveillance, Epidemiology and End Results Program, we assessed trends in 5-year relative survival for patients aged 15 years or more with acute lymphoblastic leukemia and acute myeloblastic leukemia divided by racial and ethnic group, including non-Hispanic whites, African-Americans, Hispanics, and Asian-Pacific Islanders in the 1990s and the early 21(st) century. Modeled period analysis was used to obtain the most up-to-date estimates of survival. Overall, the 5-year survival increased from 31.6% in 1997-2002 to 39.0% in 2003-2008 for patients with acute lymphoblastic leukemia and from 15.5% in 1991-1996 to 22.5% in 2003-2008 for those with acute myeloblastic leukemia. Nevertheless, among patients with acute lymphoblastic leukemia, age-adjusted 5-year relative survival rates remained lower for African-Americans and Hispanics than for non-Hispanic whites. Among patients with acute myeloblastic leukemia, the increase in survival was greatest (from 32.6% in 1991-1996 to 47.1% in 2003-2008) for younger patients (15-54 years), and was more pronounced for non-Hispanic whites (+16.4% units) than for other patients (+10.8% units). Increases in survival are observed in all ethnic or racial groups. Nevertheless, among patients with acute leukemias, disparities in survival persist between non-Hispanic white people and people of other ethnic or racial groups. Disparities are increasing in younger patients with acute myeloblastic leukemia. Improvements in access to treatment, especially for minority patients, may improve outcomes.
Semyonov, Moshe; Lewin-Epstein, Noah
This research examines wealth distribution across ethnic groups in Israel and evaluates the role of labor market rewards and intergenerational transfers in producing ethnic disparities. Israel SHARE data from 2005-2006 are used in the analyses. The findings reveal considerable ethnic disparities in wealth. Wealth disparities are most pronounced…
Kuniansky, Eve L.
This fifth workshop is a joint workshop of the USGS Karst Interest Group and University of Arkansas HydroDays workshop, sponsored by the USGS, the Department of Geosciences at the University of Arkansas in Fayetteville. Additional sponsors are: the National Cave and Karst Research Institute, the Edwards Aquifer Authority, San Antonio, Texas, and Beaver Water District, northwest Arkansas. The majority of funding for the proceedings preparation and workshop was provided by the USGS Groundwater Resources Program, National Cooperative Mapping Program, and the Regional Executives of the Northeast, Southeast, Midwest, South Central and Rocky Mountain Areas. The University of Arkansas provided the rooms and facilities for the technical and poster presentations of the workshop, vans for the field trips, and sponsored the HydroDays banquet at the Savoy Experimental Watershed on Wednesday after the technical sessions.
Hutter, Bridget M; Lloyd-Bostock, Sally
This paper considers a key aspect of the 'risk society' thesis: the belief that we should be able to manage risks and control the world around us. In particular it focuses on the interface between risk and risk events as socially constructed and the insights that 'critical situations' give us into 'the routine and mundane', the otherwise taken for granted assumptions underlying risk regulation. It does this with reference to the events precipitated by the April 2010 volcanic eruption in the Eyjafjallajökull area of Iceland. The resulting cloud of volcanic ash spread across Europe and much of Europe's airspace was closed to civil aviation for six days, with far reaching consequences including huge financial losses for airlines. The social processes of defining and reacting to risk and crisis both reveal and generate dilemmas and challenges in regulation. This paper examines the role of different interest groups in defining risk expectations and thereby redefining the ash crisis as a regulatory crisis.
Hammer, Adam M.; Morris, Niya L.; Cannon, Abigail R.; Shults, Jill A.; Curtis, Brenda; Casey, Carol A.; Sueblinvong, Viranuj; Persidsky, Yuri; Nixon, Kimberly; Brown, Lou Ann; Waldschmidt, Thomas; Mandrekar, Pranoti; Kovacs, Elizabeth J.; Choudhry, Mashkoor A.
On November 21, 2014 the 19th annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at Loyola University Chicago Health Sciences Campus in Maywood, Illinois. The meeting focused broadly on inflammatory cell signaling responses in the context of alcohol and alcohol use disorders, and was divided into four plenary sessions focusing on the gut and liver, lung infections, general systemic effects of alcohol, and neuro-inflammation. One common theme amongst many talks was the differential roles of macrophages following both chronic and acute alcohol intoxication. Macrophages were shown to play significant roles in regulating inflammation, oxidative stress, and viral infection following alcohol exposure in the liver, lungs, adipose tissue, and brain. Other work examined the role of alcohol on disease progression in a variety of pathologies including psoriasis, advanced stage lung disease, and cancer. PMID:26520175
A central sociological premise is that health care systems are organizations that are embedded within larger institutions, which have been shaped by historical precedents and operate within a specific cultural context. Although bound by policy legacies, embedded constituencies, and path dependent processes, health care systems are not rigid, static, and impervious to change. The success of health care reform in 2010 has shown that existing regimes do have the capacity to respond to new needs in ways that transcend their institutional and ideological limits. For the United States the question is how health care reform will reconfigure the existing network of public and private benefits and the power relationships between the numerous constituencies surrounding them. This article considers how institutions, interest groups, and ideology have affected the organization of the health care system in the United States as well as in other nations. It then discusses issues for future research in the aftermath of the 2009-10 health care reform debate.
Ippolito, Jill A; Curtis, Brenda J; Choudhry, Mashkoor A; Kovacs, Elizabeth J
On October 27, 2012, the 17th annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at the Grand Wailea Hotel in Maui, Hawaii as a satellite meeting to the 2012 Society of Leukocyte Biology conference. This year's meeting focused on the influence of alcohol on signal transduction pathways in various disease and injury models. Three plenary sessions were held where invited speakers shared their research on alcohol-mediated alterations of cell signaling components, immune cell subsets, and inflammation. These studies suggested alcohol has a negative effect on cell signaling machinery and immune cell homeostasis, resulting in disease, disease progression, and increased mortality. Researchers also identified tissue-specific alcohol-linked elevations in markers of inflammation, including cold-shock proteins and microRNAs. Additionally, one study revealed the effects of alcohol on immune cell subsets in a model of allergic asthma.
de Lima Verde Brito, Thiago Delevidove; Baptista, Roberto Silva; de Lima Lopes, Paulo Roberto; Haddad, Ana Estela; Messina, Luiz Ary; Torres Pisa, Ivan
In Brazil the Telemedicine University Network (Rede Universitária de Telemedicina RUTE) is an initiative that among others promotes collaboration between university hospitals, universities, and health professionals through information technology infrastructure and special interest groups (SIGs) support. This paper presents results of analyses on collaboration during implementation and coordination activities of RUTE SIGs. This study is based on descriptive statistics and data visualization previously collected by RUTE national coordination relative to the status in July 2014. The analysis through collaboration graph identified the strongest collaboration RUTE units. The graph also highlights the collaborative relationship of RUTE units in form of communities, the most collaborative with each other in a communion in the same SIGs, and the less the collaborative units in the network. It should be stated that the most active units are also the oldest in the community.
Bretonnière, Pierre-Antoine; Benincasa, Francesco
Research Data Alliance's Interest Group on "Weather, Climate and Air Quality" More than ever in the history of Earth sciences, scientists are confronted with the problem of dealing with huge amounts of data that grow continuously at a rate that becomes a challenge to process and analyse them using conventional methods. Data come from many different and widely distributed sources, ranging from satellite platforms and in-situ sensors to model simulations, and with different degrees of openness. How can Earth scientists deal with this diversity and big volume and extract useful information to understand and predict the relevant processes? The Research Data Alliance (RDA, https://rd-alliance.org/), an organization that promotes and develops new data policies, data standards and focuses on the development of new technical solutions applicable in many distinct areas of sciences, recently entered in its third phase. In this framework, an Interest Group (IG) comprised of community experts that are committed to directly or indirectly enable and facilitate data sharing, exchange, or interoperability in the fields of weather, climate and air quality has been created recently. Its aim is to explore and discuss the challenges for the use and efficient analysis of large and diverse datasets of relevance for these fields taking advantage of the knowledge generated and exchanged in RDA. At the same time, this IG intends to be a meeting point between members of the aforementioned communities to share experiences and propose new solutions to overcome the forthcoming challenges. Based on the collaboration between several research meteorological and European climate institutes, but also taking into account the input from the private (from the renewable energies, satellites and agriculture sectors for example) and public sectors, this IG will suggest practical and applicable solutions for Big Data issues, both at technological and policy level, encountered by these communities. We
Jones, W; Keiser, R
Ideological and interest-group influences attempt to influence policy formulation during the legislative process. In health and safety policy-making these interest-group influences, which are some of the best organized groups, are related to ideological and interest-group orientations of the legislators themselves. The authors analyzed Senate health care voting in the 95th U.S. Congress. General ideology, structured along the left-right dimension was important, but it was not the overriding factor. The senators voted as supporters or opponents of environmentalism as much or even more than as adherents of either liberal or conservative beliefs.
Khan, Md. Mobarak Hossain; Zanuzdana, Arina; Kraemer, Alexander
Background And Objectives Although Bangladesh has already achieved noticeable progress in the field of development and health, disparities in public health indicators for several markers are still reported. To assess public health development in Bangladesh during the last two decades, firstly, we analysed levels, trends and disparities in public-health-related indicators by rural versus urban as well as by the richest versus poorest group of women who have ever been married. Secondly, using the most recent data set we performed multiple analyses to check whether urban-rural and richest-poorest disparities were still significant. Methods The analysis was based on six nationally representative data sets from the Bangladesh Demographic and Health Surveys (BDHS) conducted in 1993-94 (n=9,640), 1996-1997 (n=9,127), 1999-2000 (n=10,544), 2004 (n=11,440), 2007 (n=10,996) and 2011 (n=17,749). The outcome variables were six selected public-health-related indicators. We performed various types of analyses, including multiple logistic regressions. Results The trend of all indicators except being overweight (1993-2011) displayed gradual improvements for both markers. However, the urban and richest groups revealed a better situation than their counterparts in both simple and multiple analyses. Disparities between richest-poorest groups were more pronounced than urban-rural disparities. For instance, the prevalence of delivery at any healthcare facility in 2011 was 20.4% in rural areas and 46.5% in urban areas, whereas it was 9.1% in the poorest group and 57.6% in the richest group. Conclusion The public health sector in Bangladesh has achieved some successes over the last two decades. However, urban-rural and richest-poorest disparities are still considerable and therefore more public health strategies and efforts are clearly needed for the rural and poorest groups of women in order to reduce these gaps further. PMID:24086485
Scherer, K; Brockow, K; Aberer, W; Gooi, J H C; Demoly, P; Romano, A; Schnyder, B; Whitaker, P; Cernadas, J S R; Bircher, A J
Drug hypersensitivity may deprive patients of drug therapy, and occasionally no effective alternative treatment is available. Successful desensitization has been well documented in delayed drug hypersensitivity reactions. In certain situations, such as sulfonamide hypersensitivity in HIV-positive patients or hypersensitivity to antibiotics in patients with cystic fibrosis, published success rates reach 80%, and this procedure appears helpful for the patient management. A state of clinical tolerance may be achieved by the administration of increasing doses of the previously offending drug. However, in most cases, a pre-existent sensitization has not been proven by positive skin tests. Successful re-administration may have occurred in nonsensitized patients. A better understanding of the underlying mechanisms of desensitization is needed. Currently, desensitization in delayed hypersensitivity reactions is restricted to mild, uncomplicated exanthems and fixed drug eruptions. The published success rates vary depending on clinical manifestations, drugs, and applied protocols. Slower protocols tend to be more effective than rush protocols; however, underreporting of unsuccessful procedures is very probable. The decision to desensitize a patient must always be made on an individual basis, balancing risks and benefits. This paper reviews the literature and presents the expert experience of the Drug Hypersensitivity Interest Group of the European Academy of Allergy and Clinical Immunology.
Weber, W.; Lebowitz, H.E.
The interest group got under way effective January 1, 1994, with nine utility members, EPRI, Bechtel, and the Illinois Clean Coal Institute. DOE participation was effective October 1, 1994. The first meeting was held on April 22, 1994 in Springfield, Illinois and the second meeting was held on August 10--11, 1994 at Johnstown, Pennsylvania. Technical reviews were prepared in several areas, including the following: status of low rank coal upgrading, advanced physical coal cleaning, organic sulfur removal from coal, handling of fine coal, combustion of coal water slurries. It was concluded that, for bituminous coals, processing of fines from coal cleaning plants or impoundments was going to be less costly than processing of coal, since the fines were intrinsically worth less and advanced upgrading technologies require fine coal. Penelec reported on benefits of NOX reductions when burning slurry fuels. Project work was authorized in the following areas: Availability of fines (CQ, Inc.), Engineering evaluations (Bechtel), and Evaluation of slurry formulation and combustion demonstrations (EER/MATS). The first project was completed.
Meeks, Karlijn A C; Freitas-Da-Silva, Deivisson; Adeyemo, Adebowale; Beune, Erik J A J; Modesti, Pietro A; Stronks, Karien; Zafarmand, Mohammad H; Agyemang, Charles
Many ethnic minorities in Europe have a higher type 2 diabetes (T2D) prevalence than their host European populations. The risk size differs between ethnic groups, but the extent of the differences in the various ethnic minority groups has not yet been systematically quantified. We conducted a meta-analysis of published data on T2D in various ethnic minority populations resident in Europe compared to their host European populations. We systematically searched MEDLINE (using PUBMED) and EMBASE for papers on T2D prevalence in ethnic minorities in Europe published between 1994 and 2014. The ethnic minority groups were classified into five population groups by geographical origin: South Asian (SA), Sub-Saharan African (SSA), Middle Eastern and North African (MENA), South and Central American (SCA), and Western Pacific (WP). Pooled odds ratios with corresponding 95 % confidence interval (CI) were calculated using Review Manager 5.3. Twenty articles were included in the analysis. Compared with the host populations, SA origin populations had the highest odds for T2D (3.7, 95 % CI 2.7-5.1), followed by MENA (2.7, 95 % CI 1.8-3.9), SSA (2.6, 95 % CI 2.0-3.5), WP (2.3, 95 % CI 1.2-4.1), and lastly SCA (1.3, 95 % CI 1.1-1.6). Odds ratios were in all ethnic minority populations higher for women than for men except for SCA. Among SA subgroups, compared with Europeans, Bangladeshi had the highest odds ratio of 6.2 (95 % CI 3.9-9.8), followed by Pakistani (5.4, 95 % CI 3.2-9.3) and Indians (4.1, 95 % CI 3.0-5.7). The risk of T2D among ethnic minority groups living in Europe compared to Europeans varies by geographical origin of the group: three to five times higher among SA, two to four times higher among MENA, and two to three times higher among SSA origin. Future research and policy initiatives on T2D among ethnic minority groups should take the interethnic differences into account.
Chantada, Guillermo L; Doz, François; Orjuela, Manuela; Qaddoumi, Ibrahim; Sitorus, Rita S; Kepak, Tomas; Furmanchuk, Anna; Castellanos, Mauricio; Sharma, Tarun; Chevez-Barrios, Patricia; Rodriguez-Galindo, Carlos
Following from the publication of the International Retinoblastoma Staging System, an open internet discussion group was created at the www.cure4kids.org resource. The results of a survey distributed among participants are discussed. Although most patients with retinoblastoma were treated under prospective protocols, there was a wide variation in the definition of risk criteria and in the criteria for giving adjuvant chemotherapy following enucleation. Definition of high-risk histological features and the criteria for use of adjuvant therapy will be standardized in future studies. Internet meetings are a valuable mechanism for enabling participation from under-resourced countries in the development of cooperative studies.
Pratt, Rebekah; Ahmed, Nimo; Noor, Sahra; Sharif, Hiba; Raymond, Nancy; Williams, Chris
To test the feasibility and acceptability of implementing an evidence-based, peer-delivered mental health intervention for Somali women in Minnesota, and to assess the impact of the intervention on the mental health of those who received the training. In a feasibility study, 11 Somali female community health workers were trained to deliver an 8-session cognitive behavioral therapy intervention. Each of the trainers recruited 5 participants through community outreach, resulting in 55 participants in the intervention. Self-assessed measures of mood were collected from study participants throughout the intervention, and focus groups were conducted. The 55 Somali women who participated recorded significant improvements in mood, with self-reported decreases in anxiety and increases in happiness. Focus group data showed the intervention was well received, particularly because it was delivered by a fellow community member. Participants reported gaining skills in problem solving, stress reduction, and anger management. Participants also felt that the intervention helped to address some of the stigma around mental health in their community. Delivery of cognitive behavioral therapy by a community health workers offered an acceptable way to build positive mental health in the Somali community.
Vanderbilt, Susanne K.; Wynia, Matthew K.; Gadon, Margaret; Alexander, G. Caleb
Despite calls for physician engagement to reduce disparities, little is known about what drives physicians to become engaged or what engaged physicians are doing. We conducted in-depth interviews with a group of highly engaged physicians and used qualitative methods to identify how these physicians became interested in alleviating healthcare disparities and what strategies they use to improve care for their minority patients. We found that most participants have experienced being a minority, though only half were racial minorities, and many related extensive childhood experiences with minorities. Participants identified several key barriers to quality care for minorities, including language barriers, resource limitations, lack of patient education and low patient empowerment. When asked how physicians can reduce health disparities, most subjects emphasized interpersonal respect, though some promising non-interpersonal approaches to reducing disparities were also identified. These interviews document the lived experiences of a group of physicians who are highly engaged in reducing disparities and suggest that connecting with experiences as a minority and other early life experiences can prompt later professional engagement in this important issue. PMID:18229768
Nkansah-Amankra, Stephen; Agbanu, Samuel Kwami; Miller, Reuben Jonathan
Problems of poverty, poor health, and incarceration are unevenly distributed among racial and ethnic minorities in the United States. We argue that this is due, in part, to the ascendance of United States-style neoliberalism, a prevailing political and economic doctrine that shapes social policy, including public health and anti-poverty intervention strategies. Public health research most often associates inequalities in health outcomes, poverty, and incarceration with individual and cultural risk factors. Contextual links to structural inequality and the neoliberal doctrine animating state-sanctioned interventions are given less attention. The interrelationships among these are not clear in the extant literature. Less is known about public health and incarceration. Thus, the authors describe the linkages between neoliberalism, public health, and criminal justice outcomes. We suggest that neoliberalism exacerbates racial disparities in health, poverty, and incarceration in the United States. We conclude by calling for a new direction in public health research that advances a pro-poor public health agenda to improve the general well-being of disadvantaged groups.
Maner, Jon K; Mead, Nicole L
Throughout human history, leaders have been responsible for helping groups attain important goals. Ideally, leaders use their power to steer groups toward desired outcomes. However, leaders can also use their power in the service of self-interest rather than effective leadership. Five experiments identified factors within both the person and the social context that determine whether leaders wield their power to promote group goals versus self-interest. In most cases, leaders behaved in a manner consistent with group goals. However, when their power was tenuous due to instability within the hierarchy, leaders high (but not low) in dominance motivation prioritized their own power over group goals: They withheld valuable information from the group, excluded a highly skilled group member, and prevented a proficient group member from having any influence over a group task. These self-interested actions were eliminated when the group was competing against a rival outgroup. Findings provide important insight into factors that influence the way leaders navigate the essential tension between leadership and power.
Apostal, Robert A.
Estimated the relatedness of category placements of the Occupational Scales of the Strong-Campbell Interest Inventory for 87 college women. Results showed the Campbell and Hansen placements of 44 Occupational Scales were classified as related; 19 were discrepant by one criteria and 12 were discripant by both study criteria. (JAC)
Crumley, Kristie; Demarest, Kate
Carroll Community College connects students to their peers and to educators who share similar academic, personal, and career interests. Students get involved in hands-on experiences inside and outside of the classroom. The results include higher retention, reduced student anonymity, and an institutional commitment to student success.
Member of Parliament John Bryden has introduced a private member's bill that would force 175 000 nonprofit groups to disclose the salaries of their executives. He took particular aim at antismoking groups, a move that has angered many physicians. In April they responded with a strongly worded advertisement in an Ottawa newspaper that attacked Bryden's bill. However, Bryden insists that he is simply seeking greater public accountability from nonprofit groups.
group’s efforts is the decision-maker possessing the power to influence events. Jürgen Habermas described the differences in public and quasi-public...Huntington, "The Erosion of American National Interests," Foreign Affairs, 76, no. 5 (September/October 1997): 40. 4 Jürgen Habermas , "On the...Concept of Public Opinion," in The Habermas Reader, ed. William Outhwaite (Oxford, U.K.: Blackwell Publishers Ltd, 1996), 37. 26 Chapter 6 Conclusion Will a
Miller, Kristell A.; Snyder, Stephanie A.; Kilgore, Mike A.; Davenport, Mae A.
In 2012, focus groups were organized with individuals owning 20+ acres in the Lake States region of the United States (Michigan, Minnesota, and Wisconsin) to discuss various issues related to forest carbon offsetting. Focus group participants consisted of landowners who had responded to an earlier mail-back survey (2010) on forest carbon offsets. Two focus groups were held per state with an average of eight participants each (49 total). While landowner participant types varied, overall convergence was reached on several key issues. In general, discussion results found that the current payment amounts offered for carbon credits are not likely, on their own, to encourage participation in carbon markets. Landowners are most interested in other benefits they can attain through carbon management (e.g., improved stand species mix, wildlife, and trails). Interestingly, landowner perceptions about the condition of their own forest land were most indicative of prospective interest in carbon management. Landowners who felt that their forest was currently in poor condition, or did not meet their forest ownership objectives, were most interested in participating. While the initial survey sought landowner opinions about carbon markets, a majority of focus group participants expressed interest in general carbon management as a means to achieve reduced property taxes.
Caplan, Lee S.; Akintobi, Tabia H.; Gordon, Tandeca King; Zellner, Tiffany; Smith, Selina A.; Blumenthal, Daniel S.
Background For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master’s degree students for careers dedicated to cancer disparities research. Method A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is based on monitoring achievement of evaluation indicators and included a mixed-method approach with included both quantitative and qualitative approach. Results In its first three years, the program graduated 20 trainees, all of whom were minorities (18 African Americans and two Asians). When asked about career goals, two-thirds of the trainees indicated interest in pursuing careers in research in cancer prevention and control. The trainees expressed high satisfaction with the courses, instructor, materials, and curriculum. Although trainees had suggestions about course details, evaluations overall were positive. Across focus groups, three recurrent themes emerged regarding activities to enhance the trainee experience: having a wider variety of topics, more guest speakers, and field trips. Conclusion The CDRTP was intended to recruit students – primarily African Americans – into research on prevention and control of cancer disparities. Although final evaluation of the program’s overall outcome will not be available for several years, this preliminary evaluation indicates early program success. PMID:27722034
Tsuruhara, Aki; Kaneko, Hirohiko; Kanazawa, So; Otsuka, Yumiko; Shirai, Nobu; Yamaguchi, Masami K.
Both horizontal and vertical binocular disparities produce depth perception in adults. In developmental studies, infants aged around 4 to 6 months were shown to perceive depth from horizontal disparity. However, infants' sensitivity to vertical disparity has not been shown clearly. To examine the sensitivity in infants, this study measured preferential looking behavior of infants aged 20 to 27 weeks. Results showed a significant preference for the stimulus with vertical disparity, providing the first evidence of infants' sensitivity to vertical disparity. The infants in the same age group did not show preference for stimulus with horizontal disparity when the stimulus were comparable to the stimulus with vertical disparity, while their sensitivity to horizontal disparity was confirmed with the stimuli used in a previous study. Our results would suggest that properties in processing horizontal and vertical disparities are different in infancy, and that the sensitivity to horizontal disparity are still premature in 27 weeks after birth.
Betenbough, T. J., Ed.; Biggs, Shirley A., Ed.
This eighth yearbook of innovative learning strategies presents the following articles, grouped in three major sections. The first section, Program Models, contains: (1) "Welcome Back: Meeting the Needs of Nontraditional Students" (Kathy Carpenter); (2) "A Model Coordinated Curriculum for the First-Term Community College Learning Disabled Student"…
Sipple, John W.; Miskel, Cecil G.; Matheney, Timothy M.; Kearney, C. Philip
Since business leaders have become increasingly involved in setting education reform agendas, understanding their motives would be helpful. Using five interest-group theories and longitudinal data, this article examines the formation, agenda setting, and maintenance of an organization of business leaders. Moderate support was found for each…
Milstein, Mike M.; Jennings, Robert E.
This study compares the perceptions of the educational policymaking process held by education interest group staffs with those of State legislators. Structured interviews were held with executive officers in six major education organizations, and 207 legislators were surveyed by personal interviews during the 1969 legislative session. Categories…
Garfinkel, Alan, Ed.; And Others
This issue of the Language by Radio Interest Group newsletter contains: an article by Paul A. Gaeng on his experience as a radio listener, an article by Richard E. Wood on "Radio Peking," and a partial reprint of frequency listings from the January 1976 number. Gaeng reports that, when he was a student in Geneva, he developed skills as a…
Dydykin, Sergey; Kapitonova, Marina
Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating…
National Clearinghouse for Alcohol Information (DHEW/PHS), Rockville, MD.
This Grouped Interest Guide is published by the National Institute on Alcohol Abuse and Alcoholism. Its purpose is to provide the reader with a regularly published set of bibliographic references for recent, topical literature in designated areas. Topics included in this guide are Youth, Children of Alcoholic Parents, and Social Forces. A wide…
Fiore, Alice Marie
Efforts of educational interest groups to defeat merit pay for Pennsylvania teachers during 1983-1986 are explored in this case study. Political systems theory and allocative theory provide the conceptual framework. Deutsch's (1973) outline of variables that affect the course of conflict was used to organize indepth personal interviews and a…
Mackie, Sarah L; Arat, Seher; da Silva, Jose; Duarte, Catia; Halliday, Sue; Hughes, Rod; Morris, Marianne; Pease, Colin T; Sherman, Jeffrey W; Simon, Lee S; Walsh, Maggie; Westhovens, René; Zakout, Samy; Kirwan, John R
We worked toward developing a core outcome set for clinical research studies in polymyalgia rheumatica (PMR) by conducting (1) patient consultations using modified nominal group technique; (2) a systematic literature review of outcome measures in PMR; (3) a pilot observational study of patients presenting with untreated PMR, and further discussion with patient research partners; and (4) a qualitative focus group study of patients with PMR on the meaning of stiffness, using thematic analysis. (1) Consultations included 104 patients at 4 centers. Symptoms of PMR included pain, stiffness, fatigue, and sleep disturbance. Function, anxiety, and depression were also often mentioned. Participants expressed concerns about diagnostic delay, adverse effects of glucocorticoids, and fear of relapse. (2) In the systematic review, outcome measures previously used for PMR include pain visual analog scores (VAS), morning stiffness, blood markers, function, and quality of life; standardized effect sizes posttreatment were large. (3) Findings from the observational study indicated that asking about symptom severity at 7 AM, or "on waking," appeared more relevant to disease activity than asking about symptom severity "now" (which depended on the time of assessment). (4) Preliminary results were presented from the focus group qualitative study, encompassing broad themes of stiffness, pain, and the effect of PMR on patients' lives. It was concluded that further validation work is required before a core outcome set in PMR can be recommended. Nevertheless, the large standardized effect sizes suggest that pain VAS is likely to be satisfactory as a primary outcome measure for assessing response to initial therapy of PMR. Dissection of between-patient heterogeneity in the subsequent treatment course may require attention to comorbidity as a potential confounding factor.
Dydykin, Sergey; Kapitonova, Marina
Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia.
Kuniansky, Eve L.
States are developed in carbonate rocks and karst areas. These aquifers and the springs that discharge from them, serve as major water-supply sources and as unique biological habitats. Commonly, there is competition for the water resources of karst aquifers, and urban development in karst areas can impact the ecosystem and water quality of these aquifers. The concept for developing a Karst Interest Group evolved from the November 1999 National Ground-Water Meeting of the U.S. Geological Survey (USGS), Water Resources Division. As a result, the Karst Interest Group was formed in 2000. The Karst Interest Group is a loose-knit grass-roots organization of USGS employees devoted to fostering better communication among scientists working on, or interested in, karst hydrology studies. The mission of the Karst Interest Group is to encourage and support interdisciplinary collaboration and technology transfer among USGS scientists working in karst areas. Additionally, the Karst Interest Group encourages cooperative studies between the different disciplines of the USGS and other Department of Interior agencies and university researchers or research institutes. The first Karst Interest Group workshop was held in St. Petersburg, Florida, February 13-16, 2001, in the vicinity of karst features of the Floridan aquifer system. The proceedings of that first meeting, Water-Resources Investigations Report 01-4011 are available online at: http://water.usgs.gov/ogw/karst/ The second Karst Interest Group workshop was held August 20-22, 2002, in Shepherdstown, West Virginia, in close proximity to the carbonate aquifers of the northern Shenandoah Valley. The proceedings of the second workshop were published in Water-Resources Investigations Report 02-4174, which is available online at the previously mentioned website. The third workshop of the Karst Interest Group was held September, 12-15, 2005, in Rapid City, South Dakota, which is in close proximity to karst features
Stork, LeAnna M.; Gennings, Chris; Carchman, Richard; Carter, Jr., Walter H.; Pounds, Joel G.; Mumtaz, Moiz
Several assumptions, defined and undefined, are used in the toxicity assessment of chemical mixtures. In scientific practice mixture components in the low-dose region, particularly subthreshold doses, are often assumed to behave additively (i.e., zero interaction) based on heuristic arguments. This assumption has important implications in the practice of risk assessment, but has not been experimentally tested. We have developed methodology to test for additivity in the sense of Berenbaum (Advances in Cancer Research, 1981), based on the statistical equivalence testing literature where the null hypothesis of interaction is rejected for the alternative hypothesis of additivity when data support the claim. The implication of this approach is that conclusions of additivity are made with a false positive rate controlled by the experimenter. The claim of additivity is based on prespecified additivity margins, which are chosen using expert biological judgment such that small deviations from additivity, which are not considered to be biologically important, are not statistically significant. This approach is in contrast to the usual hypothesis-testing framework that assumes additivity in the null hypothesis and rejects when there is significant evidence of interaction. In this scenario, failure to reject may be due to lack of statistical power making the claim of additivity problematic. The proposed method is illustrated in a mixture of five organophosphorus pesticides that were experimentally evaluated alone and at relevant mixing ratios. Motor activity was assessed in adult male rats following acute exposure. Four low-dose mixture groups were evaluated. Evidence of additivity is found in three of the four low-dose mixture groups.The proposed method tests for additivity of the whole mixture and does not take into account subset interactions (e.g., synergistic, antagonistic) that may have occurred and cancelled each other out.
Background Legislating restrictions on alcohol advertising is a cost-effective measure to reduce consumption of alcohol. Yet Australia relies upon industry self-regulation through voluntary codes of practice regarding the content, timing and placement of alcohol advertising. Ending industry self-regulation was recommended by the National Preventative Health Taskforce; a suggestion contested by the drinks industry. Debates about emerging alcohol-control policies regularly play out in the news media, with various groups seeking to influence the discussion. This paper examines news coverage of recommendations to restrict alcohol advertising to see how supporters and opponents frame the debate, with a view to providing some suggestions for policy advocates to advance the discussion. Methods We used content and framing analyses to examine 329 Australian newspaper items mentioning alcohol advertising restrictions over 24 months. All items were coded for mentions of specific types of advertising and types of advertising restrictions, the presence of news frames that opposed or endorsed advertising restrictions, statements made within each frame and the news-actors who appeared. Results Restrictions were the main focus in only 36% of 329 items. Alcohol advertising was conceived of as television (47%) and sport-related (56%). Restrictions were mentioned in non-specific terms (45%), or specified as restrictions on timing and placement (49%), or content (22%). Public health professionals (47%) appeared more frequently than drinks industry representatives (18%). Five supportive news frames suggested the policy is a sensible public health response, essential to protect children, needed to combat the drinks industry, required to stop pervasive branding, or as only an issue in sport. Four unsupportive frames positioned restrictions as unnecessary for a responsible industry, an attack on legitimate commercial activities, ineffective and ‘nannyist’, or inessential to government
Lappin, Joseph S.
What are the geometric primitives of binocular disparity? The Venetian blind effect and other converging lines of evidence indicate that stereoscopic depth perception derives from disparities of higher-order structure in images of surfaces. Image structure entails spatial variations of intensity, texture, and motion, jointly structured by observed surfaces. The spatial structure of binocular disparity corresponds to the spatial structure of surfaces. Independent spatial coordinates are not necessary for stereoscopic vision. Stereopsis is highly sensitive to structural disparities associated with local surface shape. Disparate positions on retinal anatomy are neither necessary nor sufficient for stereopsis. PMID:25161634
The physical infrastructure and housing make human interaction possible and provide shelter. How well that infrastructure performs and which groups it serves have important implications for social equity and health. Populations in inadequate housing are more likely to have environmental diseases and injuries. Substantial disparities in housing have remained largely unchanged. Approximately 2.6 million (7.5%) non-Hispanic Blacks and 5.9 million Whites (2.8%) live in substandard housing. Segregation, lack of housing mobility, and homelessness are all associated with adverse health outcomes. Yet the experience with childhood lead poisoning in the United States has shown that housing-related disparities can be reduced. Effective interventions should be implemented to reduce environmental health disparities related to housing. PMID:21551378
Ramírez, Mildred; Ford, Marvella E; Stewart, Anita L; A Teresi, Jeanne
Background Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse groups. Measurement error might lead to biased results, e.g., estimates of prevalence, magnitude of risks, and differences in mean scores. Addressing measurement issues in the assessment of health status may contribute to a better understanding of health issues in cross-cultural research. Objective To provide a brief overview of issues regarding measurement in diverse populations. Findings Approaches used to assess the magnitude and nature of bias in measures when applied to diverse groups include qualitative analyses, classic psychometric studies, as well as more modern psychometric methods. These approaches should be applied sequentially, and/or iteratively during the development of measures. Conclusions Investigators performing comparative studies face the challenge of addressing measurement equivalence, crucial for obtaining accurate results in cross-cultural comparisons. PMID:16179000
Hoover, Karen; Bohm, Michele; Keppel, Kenneth
The Centers for Disease Control and Prevention (CDC) defines a health disparity as a "[health] difference that occurs by gender, race or ethnicity, education or income, disability, geographic location, or sexual orientation." Health equity is achieved by eliminating health disparities or inequalities. Measuring health disparities is a critical first step toward reducing differences in health outcomes. To determine the methods to be used in measuring a health disparity, several decisions must be made, which include: (1) selecting a reference group for the comparison of 2 or more groups; (2) determining whether a disparity should be measured in absolute or in relative terms; (3) opting to measure health outcomes or health indicators expressed as adverse or favorable events; (4) selecting a method to monitor a disparity over time; and (5) choosing to measure a disparity as a pair-wise comparison between 2 groups or in terms of a summary measure of disparity among all groups for a particular characteristic. Different choices may lead to different conclusions about the size and direction of health disparities at a point in time and changes in disparities over time.The objective of this article is to review the methods for measuring health disparities, provide examples of their use, and make specific recommendations for measuring disparities in the incidence of sexually transmitted diseases (STDs).
Koontz, Lynne; Hoag, Dana; DeLong, Don
For resource decisions to make the most possible progress toward achieving agency mandates, managers must work with stakeholders and may need to at least partially accommodate some of their key underlying interests. To accommodate stakeholder interests, while also substantively working toward fulfilling legal mandates, managers must understand the sociopolitical factors that influence the decision-making process. We coin the phrase disparate stakeholder management (DSM) to describe situations with disparate stakeholders and disparate management solutions. A DSM approach (DSMA) requires decision makers to combine concepts from many sciences, thus releasing them from disciplinary bonds that often constrain innovation and effectiveness. We combined three distinct approaches to develop a DSMA that assisted in developing a comprehensive range of elk and bison management alternatives in the Southern Greater Yellowstone Area. The DSMA illustrated the extent of compromise between meeting legal agency mandates and accommodating the preferences of certain stakeholder groups.
Clinical practice guidelines are one of the foundations of efforts to improve health care. In 1999, we authored a paper about methods to develop guidelines. Since it was published, the methods of guideline development have progressed both in terms of methods and necessary procedures and the context for guideline development has changed with the emergence of guideline clearing houses and large scale guideline production organisations (such as the UK National Institute for Health and Clinical Excellence). It therefore seems timely to, in a series of three articles, update and extend our earlier paper. In this first paper we discuss: the target audience(s) for guidelines and their use of guidelines; identifying topics for guidelines; guideline group composition (including consumer involvement) and the processes by which guideline groups function and the important procedural issue of managing conflicts of interest in guideline development. PMID:22762776
Oyston, Jack W.; Hughes, Martin; Wagner, Peter J.; Gerber, Sylvain; Wills, Matthew A.
The morphological disparity of species within major clades shows a variety of trajectory patterns through evolutionary time. However, there is a significant tendency for groups to reach their maximum disparity relatively early in their histories, even while their species richness or diversity is comparatively low. This pattern of early high-disparity suggests that there are internal constraints (e.g. developmental pleiotropy) or external restrictions (e.g. ecological competition) upon the variety of morphologies that can subsequently evolve. It has also been demonstrated that the rate of evolution of new character states decreases in most clades through time (character saturation), as does the rate of origination of novel bodyplans and higher taxa. Here, we tested whether there was a simple relationship between the level or rate of character state exhaustion and the shape of a clade's disparity profile: specifically, its centre of gravity (CG). In a sample of 93 extinct major clades, most showed some degree of exhaustion, but all continued to evolve new states up until their extinction. Projection of states/steps curves suggested that clades realized an average of 60% of their inferred maximum numbers of states. Despite a weak but significant correlation between overall levels of homoplasy and the CG of clade disparity profiles, there were no significant relationships between any of our indices of exhaustion curve shape and the clade disparity CG. Clades showing early high-disparity were no more likely to have early character saturation than those with maximum disparity late in their evolution. PMID:26640649
Oyston, Jack W; Hughes, Martin; Wagner, Peter J; Gerber, Sylvain; Wills, Matthew A
The morphological disparity of species within major clades shows a variety of trajectory patterns through evolutionary time. However, there is a significant tendency for groups to reach their maximum disparity relatively early in their histories, even while their species richness or diversity is comparatively low. This pattern of early high-disparity suggests that there are internal constraints (e.g. developmental pleiotropy) or external restrictions (e.g. ecological competition) upon the variety of morphologies that can subsequently evolve. It has also been demonstrated that the rate of evolution of new character states decreases in most clades through time (character saturation), as does the rate of origination of novel bodyplans and higher taxa. Here, we tested whether there was a simple relationship between the level or rate of character state exhaustion and the shape of a clade's disparity profile: specifically, its centre of gravity (CG). In a sample of 93 extinct major clades, most showed some degree of exhaustion, but all continued to evolve new states up until their extinction. Projection of states/steps curves suggested that clades realized an average of 60% of their inferred maximum numbers of states. Despite a weak but significant correlation between overall levels of homoplasy and the CG of clade disparity profiles, there were no significant relationships between any of our indices of exhaustion curve shape and the clade disparity CG. Clades showing early high-disparity were no more likely to have early character saturation than those with maximum disparity late in their evolution.
Canino, Glorisa; McQuaid, Elizabeth L.; Rand, Cynthia S.
Substantial research has documented pervasive disparities in the prevalence, severity, and morbidity of asthma among minority populations compared to non-Latino whites. The underlying causes of these disparities are not well understood, and as a result, the leverage points to address them remain unclear. A multilevel framework for integrating research in asthma health disparities is proposed in order to advance both future research and clinical practice. The components of the proposed model include health care policies and regulations, operation of the health care system, provider/clinician-level factors, social/environmental factors, and individual/family attitudes and behaviors. The body of research suggests that asthma disparities have multiple, complex and inter-related sources. Disparities occur when individual, environmental, health system, and provider factors interact with one another over time. Given that the causes of asthma disparities are complex and multilevel, clinical strategies to address these disparities must therefore be comparably multilevel and target many aspects of asthma care. Clinical Implications: Several strategies that could be applied in clinical settings to reduce asthma disparities are described including the need for routine assessment of the patient’s beliefs, financial barriers to disease management, and health literacy, and the provision of cultural competence training and communication skills to health care provider groups. PMID:19447484
Prins, Esther; Mooney, Angela
This chapter explores the relationship between literacy and health disparities, focusing on the concept of health literacy. Recommendations are provided for ways to bridge the health literacy gap for learners in adult basic education and family literacy programs.
Oliveira, Fabrício Marcus Silva; Neumann, Elisabeth; Gomes, Maria Aparecida; Caliari, Marcelo Vidigal
Amebiasis is a disease caused by the protozoan parasite Entamoeba histolytica. This ameba can colonize the human intestine and persist as a commensal parasite, similar to Entamoeba dispar, an ameba considered to be non-pathogenic. The similarities between E. histolytica and E. dispar make the latter an attractive model for studies aimed at clarifying the pathogenesis of amebiasis. However, in addition to being an interesting experimental model, this relative of E. histolytica remains poorly understood. In the 1990, it was believed that E. dispar was unable to produce significant experimental lesions. This scenario began to change in 1996, when E. dispar strains were isolated from symptomatic patients in Brazil. These strains were able to produce liver and intestinal lesions that were occasionally indistinguishable from those produced by E. histolytica. These and other findings, such as the detection of E. dispar DNA sequences in samples from patients with amebic liver abscess, have revived the possibility that this species can produce lesions in humans. The present paper presents a series of studies on E. dispar that begin to reveal a new facet of this protozoan. PMID:25709947
Mayorga, C; Celik, G; Rouzaire, P; Whitaker, P; Bonadonna, P; Rodrigues-Cernadas, J; Vultaggio, A; Brockow, K; Caubet, J C; Makowska, J; Nakonechna, A; Romano, A; Montañez, M I; Laguna, J J; Zanoni, G; Gueant, J L; Oude Elberink, H; Fernandez, J; Viel, S; Demoly, P; Torres, M J
Drug hypersensitivity reactions (DHRs) are a matter of great concern, both for outpatient and in hospital care. The evaluation of these patients is complex, because in vivo tests have a suboptimal sensitivity and can be time-consuming, expensive and potentially risky, especially drug provocation tests. There are several currently available in vitro methods that can be classified into two main groups: those that help to characterize the active phase of the reaction and those that help to identify the culprit drug. The utility of these in vitro methods depends on the mechanisms involved, meaning that they cannot be used for the evaluation of all types of DHRs. Moreover, their effectiveness has not been defined by a consensus agreement between experts in the field. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology has organized a task force to provide data and recommendations regarding the available in vitro methods for DHR diagnosis. We have found that although there are many in vitro tests, few of them can be given a recommendation of grade B or above mainly because there is a lack of well-controlled studies, most information comes from small studies with few subjects and results are not always confirmed in later studies. Therefore, it is necessary to validate the currently available in vitro tests in a large series of well-characterized patients with DHR and to develop new tests for diagnosis.
Wu-Pong, Susanna; Gobburu, Jogarao; O'Barr, Stephen; Shah, Kumar; Huber, Jason; Weiner, Daniel
Despite pharma's recent sea change in approach to drug discovery and development, U.S. pharmaceutical sciences graduate programs are currently maintaining traditional methods for master's and doctoral student education. The literature on graduate education in the biomedical sciences has long been advocating educating students to hone soft skills like communication and teamwork, in addition to maintaining excellent basic skills in research. However, recommendations to date have not taken into account the future trends in the pharmaceutical industry. The AACP Graduate Education Special Interest Group has completed a literature survey of the trends in the pharmaceutical industry and graduate education in order to determine whether our graduate programs are strategically positioned to prepare our graduates for successful careers in the next few decades. We recommend that our pharmaceutical sciences graduate programs take a proactive leadership role in meeting the needs of our future graduates and employers. Our graduate programs should bring to education the innovation and collaboration that our industry also requires to be successful and relevant in this century.
Churak, Joanne M.
Racial and ethnic disparities exist in renal transplantation. The causes are multifactorial and include but are not limited to racism, socioeconomic status and class, unfavorable geographical location, lack of organ donation by minority groups, and differences in social networks, health beliefs culture and HLA typing. These disparities affect blacks, Hispanic Americans, Native Americans, Alaskan natiives and Asians. Elimination of these disparities is difficult, since many of the causes are intertwined, and it is difficult todiscern attributable disparity risk associated with the various factors. The possible solutions and recommendations are numerous. Since it is difficult to identify which may be successsful, thorough evaluation is required to determine which should be implemented. Some recommendations may not be easily implemented. Those selected for implementation must be continuously monitored for the expected results and effects. PMID:15712778
Association for Education in Journalism and Mass Communication.
The Science Communication Interest Group section of the proceedings contains the following seven papers: "Using Television to Foster Children's Interest in Science" (Marie-Louise Mares and others); "Trends in Newspaper Coverage of Science over Three Decades: A Content Analytic Study" (Marianne G. Pellechia); "Media…
Short, Edmund C.; And Others
The American Educational Research Association's (AERA) Special Interest Group (SIG) on "Creation and Utilization of Curriculum Knowledge" was formed in 1971 by researchers whose work focused upon the advancement of knowledge in curriculum. The interest area for this SIG centered on generic knowledge about: (1) curriculum definitions; (2)…
Diket, Read M., Ed.
The papers gathered in this volume were presented at the 1995 meeting of the American Educational Research Association; many were part of the Arts and Learning Special Interest Group programs. Papers in the volume explore a range of research interests and conceptualizations for the arts. Following an editorial, papers are: "Beyond the Public…
Kuniansky, Eve L.; Spangler, Lawrence E.; Kuniansky, Eve L.; Spangler, Lawrence E.
strong interest in the study of karst terrains.Many of the major springs and aquifers in the United States have developed in carbonate rocks, such as the Floridan aquifer system in Florida and parts of Alabama, Georgia, and South Carolina; the Ozark Plateaus aquifer system in parts of Arkansas, Kansas, Missouri, and Oklahoma; and the Edwards-Trinity aquifer system in west-central Texas. These aquifers, and the springs that discharge from them, serve as major water-supply sources and as unique ecological habitats. Competition for the water resources of karst aquifers is common, and urban development and the lack of attenuation of contaminants in karst areas can impact the ecosystem and water quality of these aquifers.The concept for developing a platform for interaction among scientists within the U.S. Geological Survey (USGS) working on karst-related studies evolved from the November 1999 National Ground-Water Meeting of the USGS. As a result, the Karst Interest Group (KIG) was formed in 2000. The KIG is a loose-knit, grass-roots organization of USGS and non-USGS scientists and researchers devoted to fostering better communication among scientists working on, or interested in, karst science. The primary mission of the KIG is to encourage and support interdisciplinary collaboration and technology transfer among scientists working in karst areas. Additionally, the KIG encourages collaborative studies between the different mission areas of the USGS as well as other federal and state agencies, and with researchers from academia and institutes. The KIG also encourages younger scientists by participation of students in the poster and oral sessions.To accomplish its mission, the KIG has organized a series of workshops that are held near nationally important karst areas. To date (2014) six KIG workshops, including the workshop documented in this report, have been held. The workshops typically include oral and poster sessions on selected karst-related topics and research, as well
Crawford, Margaret A.; Mendoza-Vasconez, Andrea S.; Larsen, Britta A.
The rates of diabetes in the U.S. are rapidly increasing, and vary widely across different racial/ethnic groups. This paper explores the potential contribution of body composition, diet, and physical activity in explaining diabetes disparities across women of different racial and ethnic backgrounds. For body composition, racial/ethnic groups differ widely by BMI, distribution of body mass, and quantity and type of adipose tissue. Dietary patterns that vary across race/ethnicity include consumption of meat, added sugars, high-glycemic carbohydrates, and fast food. Additionally, physical activity patterns of interest include aerobic vs. muscle-strengthening exercises, and the purpose of physical activity (leisure, occupation, or transportation). Overall, these variables provide a partial picture of the source of these widening disparities, and could help guide future research in addressing and reducing diabetes disparities. PMID:26648099
Okun, Morris Alan; Berlin, Anna; Hanrahan, Jeanne; Lewis, James; Johnson, Kathryn
Supplemental instruction (SI) is a small-group, peer-mentored programme which is compatible with the learning preferences of American Indian students. We tested the hypothesis that SI is a compensatory strategy that reduces the differences in the grades earned in introduction to psychology by Euro-American and American Indian students. The sample…
Adams, Caralee J.; Robelen, Erik W.; Shah, Nirvi
New nationwide data collected by the U.S. Department of Education's civil rights office reveal stark racial and ethnic disparities in student retentions, with black and Hispanic students far more likely than white students to repeat a grade, especially in elementary and middle school. The contrast is especially strong for African-Americans. In the…
Logan, Jennifer L
In the United States, health disparities exist among ethnic minority groups, the uninsured, and those with other barriers to health care access. Health disparities exist for many diseases, but are especially pronounced for preventive health services and preventable diseases. Persons affected by disparities experience higher incidences of vaccine-preventable diseases, such as influenza, and are more likely to die from those diseases as well. Although influenza vaccines are relatively safe, inexpensive, and effective in reducing infection and disease complications, many groups in the United States do not yet benefit from this potentially lifesaving intervention. Possible explanations for disparities in influenza vaccination include: (1) barriers to access such as cost, insurance status, and language differences; (2) underestimation of personal risk and misunderstanding of vaccination risks; (3) mistrust toward the health care system. Proposed strategies to minimize these disparities include: (1) changes to health care system structural factors that serve as access barriers, (2) education to increase awareness and improve demand for vaccines, (3) involvement of community-based organizations to assess local needs and design responsive solutions.
Penner, Louis A.; Hagiwara, Nao; Eggly, Susan; Gaertner, Samuel L.; Albrecht, Terrance L.; Dovidio, John F.
Around the world, members of racial/ethnic minority groups typically experience poorer health than members of racial/ethnic majority groups. The core premise of this article is that thoughts, feelings, and behaviors related to race and ethnicity play a critical role in healthcare disparities. Social psychological theories of the origins and consequences of these thoughts, feelings, and behaviors offer critical insights into the processes responsible for these disparities and suggest interventions to address them. We present a multilevel model that explains how societal, intrapersonal, and interpersonal factors can influence ethnic/racial health disparities. We focus our literature review, including our own research, and conceptual analysis at the intrapersonal (the race-related thoughts and feelings of minority patients and non-minority physicians) and interpersonal levels (intergroup processes that affect medical interactions between minority patients and non-minority physicians). At both levels of analysis, we use theories of social categorization, social identity, contemporary forms of racial bias, stereotype activation, stigma, and other social psychological processes to identify and understand potential causes and processes of health and healthcare disparities. In the final section, we identify theory-based interventions that might reduce ethnic/racial disparities in health and healthcare. PMID:25197206
A comparative analysis of the process by which conflicting interests are implemented in the higher education systems of the United States, England, Sweden, and France is presented. Attention is also directed to differentiation in these systems, and to the systems' receptiveness to such differentiation (i.e., splitting up existing functions, or…
Kieffer, Edith C; Willis, Sharla K; Odoms-Young, Angela M; Guzman, J Ricardo; Allen, Alex J; Two Feathers, Jackie; Loveluck, Jimena
Diabetes is prevalent among African-American and Latino Detroit residents, with profound consequences to individuals, families, and communities. The REACH Detroit Partnership engaged eastside and southwest Detroit families in focus groups organized by community, age, gender, and language, to plan community-based participatory interventions to reduce the prevalence and impact of diabetes and its risk factors. Community residents participated in planning, implementing, and analyzing data from the focus groups and subsequent planning meetings. Major themes included: 1) diabetes is widespread and risk begins in childhood, with severe consequences for African Americans and Latinos; 2) denial and inadequate health care contribute to lack of public awareness about pre-symptomatic diabetes; 3) diabetes risks include heredity, high sugar, fat and alcohol intake, overweight, lack of exercise, and stress; and 4) cultural traditions, lack of motivation, and lack of affordable, accessible stores, restaurants, and recreation facilities and programs, are barriers to adopting preventive lifestyles. Participants identified community assets and made recommendations that resulted in REACH Detroit's multi-level intervention design and programs. They included development of: 1) family-oriented interventions to support lifestyle change at all ages; 2) culturally relevant community and health provider education and materials; 3) social support group activities promoting diabetes self-management, exercise, and healthy eating; and 4) community resource development and advocacy.
....00 Foreign Passive +1.20 −0.68 0 +0.52 Foreign General +10.80 −8.32 0 +2.48 These adjustments yield... Foreign Passive 0 5 5 10 Foreign General 0 70 35 105 (ii) Step 1: Computation of consolidated taxable...: Apportioned interest expense X Y Z Total Domestic 105.00 0 0 105.00 Foreign Passive 3.50 0......
....00 Foreign Passive +1.20 −0.68 0 +0.52 Foreign General +10.80 −8.32 0 +2.48 These adjustments yield... Foreign Passive 0 5 5 10 Foreign General 0 70 35 105 (ii) Step 1: Computation of consolidated taxable...: Apportioned interest expense X Y Z Total Domestic 105.00 0 0 105.00 Foreign Passive 3.50 0......
Gehlert, Sarah; Colditz, Graham A.
Background The first 20 years of publication of Cancer Epidemiology, Biomarkers & Prevention occurred during a period of increased attention to health disparities and advances in knowledge about their determinants. Yet, despite clear documentation of disparities and advanced understanding of determinants, we have made little headway in reducing disparities at the population level. Multilevel models, such as one produced by the Centers for Population Health and Health Disparities (CPHHD), hold promise for understanding the complex determinants of cancer disparities and their interactions as well as translating scientific discoveries into solutions. The CPHHD model maps across a range of scientific disciplines, from the biological to the social, each with its own disciplinary language and methods. The ability to work effectively across disciplinary boundaries is essential to framing comprehensive solutions. Methods After briefly characterizing the current state of knowledge about health disparities, we outline three major challenges faced by disparities researchers and practitioners and offer suggestions for addressing these challenges. Results These challenges are how to consider race and ethnicity in disparities research, how best to translate discoveries into public health solutions to cancer disparities, and how to create a research environment that supports the successful execution of multilevel research. Conclusions Attention to all three of the challenges outlined above is urgently needed to advance our efforts to eliminate cancer disparities. Impact Addressing the challenges outlined above will help to eliminate disparities in the future. PMID:21784956
Black, Dan A.; Haviland, Amelia M.; Sanders, Seth G.; Taylor, Lowell J.
We examine gender wage disparities for four groups of college-educated women--black, Hispanic, Asian, and non-Hispanic white--using the National Survey of College Graduates. Raw log wage gaps, relative to non-Hispanic white male counterparts, generally exceed -0.30. Estimated gaps decline to between -0.08 and -0.19 in nonparametric analyses that…
In an Internet forum run by the Libertarian National Socialist Green Party, an organization espousing neo-Nazi views, Jeff Weise made his comments about the group in the year leading up to his deadly armed assault at Red Lake High School in Minnesota. The forum lists 34 postings written by the 16-year-old Native American youth. The commentary Mr.…
Association for Education in Journalism and Mass Communication.
The Civic Journalism Interest Group section of the proceedings contains the following five papers: "A Tale of Two Cities: Do Small-Town Dailies Practice Public Journalism Without Knowing It?" (David Loomis); "Engaging the Literature: A Civic Approach" (Kathryn B. Campbell); "Resolving Public Conflict: Civic Journalism and…
Association for Education in Journalism and Mass Communication.
The Science Communication Interest Group section of the proceedings contains the following 6 selected papers: "The Internet and the Environmental Protection Agency: Public Access to Toxic Chemical Off-Site Consequence Information" (James F. Carstens); "Motivations To Participate in Riparian Improvement Programs: Applying the Theory…
Bresler, Liora, Ed.; Ellis, Nancy C., Ed.
This volume contains papers which encompass visual arts, drama, music, literature, and poetry education, creating a space for scholars from diverse intellectual traditions. Following editorial notes and a message from the Arts and Learning Special Interest Group Chair, David Betts, are the papers of part 1, The Interconnectedness of Issues across…
Association for Education in Journalism and Mass Communication.
The Science Communication Interest Group section of the proceedings contains the following five papers: "Accounting for the Complexity of Causal Explanations in the Wake of an Environmental Risk" (LeeAnn Kahlor, Sharon Dunwoody and Robert J. Griffin); "Construction of Technology Crisis and Safety: News Media's Framing the Y2K…
Purdie, John R., II; Williams, James E.; Ellersieck, Mark R.
All first-year students who entered the University of Missouri-Columbia as animal science majors between the fall of 1998 and 2004 (n = 619) had the opportunity to participate in a residentially-based Freshmen Interest Group (FIG) and/or a learning community specifically designed for them. The odds of graduating is significant for all three…
Association for Education in Journalism and Mass Communication.
The Graduate Education Interest Group section of the proceedings contains the following five papers: "The Press, President, and Presidential Popularity During Ronald Reagan's War on Drugs" (Hyo-Seong Lee); "Malaysia's Broadcasting Industry in Transition: Effect of New Competitions on Traditional Television Channels" (Tee-Tuan…
Bresler, Liora, Ed.; Ellis, Nancy C., Ed.
This volume highlights thought-provoking issues in visual arts, drama, and music education presented at the 1998 meeting of the American Educational Research Association. Following a message from the Special Interest Group Chair, Larry Kantner, and an editorial, articles in section 1 are: "Art Beginnings" (L. A. Kantner); "Teachers'…
Collins, Yvonne; Holcomb, Kevin; Chapman-Davis, Eloise; Khabele, Dineo; Farley, John H.
Objectives To review the extent of health disparities in gynecologic cancer care and outcomes and to propose recommendations to help counteract the disparities. Methods We searched the electronic databases PubMed and the Cochrane Library. We included studies demonstrating quantifiable differences by race and ethnicity in the incidence, treatment, and survival of gynecologic cancers in the United States (US). Most studies relied on retrospective data. We focused on differences between Black and White women, because of the limited number of studies on non-Black women. Results White women have a higher incidence of ovarian cancer compared to Black women. However, the all-cause ovarian cancer mortality in Black women is 1.3 times higher than that of White women. Endometrial and cervical cancer mortality in Black women is twice that of White women. The etiology of these disparities is multifaceted. However, much of the evidence suggests that equal care leads to equal outcomes for Black women diagnosed with gynecologic cancers. Underlying molecular factors may play an additional role in aggressive tumor biology and endometrial cancer disparities. Conclusion Gynecologic cancer disparities exist between Black and White women. The literature is limited by the lack of large prospective trials and adequate numbers of non-Black racial and ethnic groups. We conclude with recommendations for continued research and a multifaceted approach to eliminate gynecologic cancer disparities. PMID:24406291
Berninger, Kati; Adamowicz, Wiktor; Kneeshaw, Daniel; Messier, Christian
The challenge of sustainable forest management is to integrate diverse and sometimes conflicting management objectives. In order to achieve this goal, we need a better understanding of the aspects influencing the preferences of diverse groups and how these groups make trade-offs between different attributes of SFM. We compare the SFM preferences of interest groups in regions with different forest use histories based on the reasoning that the condition of the forest reflects the forest use history of the area. The condition of the forest also shapes an individual's forest values and attitudes. These held values and attitudes are thought to influence SFM preferences. We tested whether the SFM preferences vary amongst the different interest groups within and across regions. We collected data from 252 persons using a choice experiment approach, where participants chose multiple times among different options described by a combination of attributes that are assigned different levels. The novelty of our approach was the use of choice experiments in the assessment of regional preference differences. Given the complexity of inter-regional comparison and the small sample size, this was an exploratory study based on a purposive rather than random sample. Nevertheless, our results suggest that the aggregation of preferences of all individuals within a region does not reveal all information necessary for forest management planning since opposing viewpoints could cancel each other out and lead to an interpretation that does not reflect possibly polarised views. Although based on a small sample size, the preferences of interest groups within a region are generally statistically significantly different from each other; however preferences of interest groups across regions are also significantly different. This illustrates the potential importance of assessing heterogeneity by region and by group.
Tannery, Thomas Allan
The purpose of this research was to elicit and compare the open-space preferences of citizens and openspace experts in Albuquerque, New Mexico, USA. A randomly selected sample of 492 citizens and 35 open-space experts participated in a telephone survey during May 5 18, 1986. The following hypothesis was tested and used as a guideline for the study: HO1: There is no significant difference between respondents' status and preference for open space in Albuquerque, New Mexico. The hypothesis was rejected. Findings confirmed respondents' status affected preference for open space. Of the eight issues on which the citizen and expert groups were compared, five recorded significant differences in response profiles. The open-space expert group was significantly more supportive of using open space to accommodate offroad vehicle facilities, wildlife preserves, a citywide recreational trail, and a trail system along the arroyos and city ditches. The citizen sample was significantly more supportive of using open space to accommodate overnight camping facilities. Both groups equally supported using open space to accommodate an outdoor amphitheater, outdoor education facilities, and rafting, kayaking, and canoeing facilities. The finding indicated that expert preferences did not represent an aggregate of citizen preferences for managing open-space resources. Understanding both expert and citizen positions will facilitate decision-making processes and help resolve environmental disputes.
Ip, Ifan Betina; Minini, Loredana; Dow, James; Parker, Andrew J; Bridge, Holly
Purpose Perceiving binocular depth relies on the ability of our visual system to precisely match corresponding features in the left and right eyes. Yet how the human brain extracts interocular disparity correlation is poorly understood. Methods We used functional magnetic resonance imaging (fMRI) to characterize brain regions involved in processing interocular disparity correlation. By varying the amount of interocular correlation of a disparity-defined random-dot-stereogram, we concomitantly controlled the perception of binocular depth and measured the percent Blood-Oxygenation-Level-Dependent (%BOLD)-signal in multiple regions-of-interest in the human occipital cortex and along the intra-parietal sulcus. Results A linear support vector machine classification analysis applied to cortical responses showed patterns of activation that represented different disparity correlation levels within regions-of-interest in the visual cortex. These also revealed a positive trend between the difference in disparity correlation and classification accuracy in V1, V3 and lateral occipital cortex. Classifier performance was significantly related to behavioural performance in dorsal visual area V3. Cortical responses to random-dot-stereogram stimuli were greater in the right compared to the left hemisphere. Conclusions Our results show that multiple regions in the cerebral cortex are sensitive to changes in interocular disparity correlation, and that dorsal area V3 may play an important role in the early transformation of binocular disparity to depth perception. PMID:24588533
Lee, Peter A; Houk, Christopher P
In the era of advocacy groups, it seems appropriate to contemplate how best to utilize them for patient benefit in the management of those with disorders of sex development (DSD), including those with congenital adrenal hyperplasia (CAH). Such interactions, to be constructive, require a spirit of cooperation to optimize outcomes. A traditional view of advocacy groups as a type of defender of patients' rights appears outdated and it is time that the benefits of their participation be fully realized. Open dialogue with all patients/families, including those who feel harmed by prior care are paramount. We discuss several recent examples of interactions that illustrate how dialogue in the name of "advocacy" can have a negative impact on developing a framework for ongoing constructive dialogue and actions. Such approaches completely change the dynamics of subsequent interactions. Physicians involved in the care of individuals with DSD, including those with CAH, and patients should be aware of confrontational techniques and legal implications that may be used by some advocacy groups. Hopefully recent efforts to promote a multidisciplinary care approach for patients with DSD/CAH will continue to foster mutual cooperation between team members, where the common goal is improving patient/family outcomes and quality of life.
Deshmukh, Sachin K; Azim, Shafquat; Ahmad, Aamir; Zubair, Haseeb; Tyagi, Nikhil; Srivastava, Sanjeev K; Bhardwaj, Arun; Singh, Seema; Rocconi, Rodney P; Singh, Ajay P
Last few decades have witnessed remarkable progress in our understanding of cancer initiation and progression leading to refinement of prevention and treatment approaches. Although these advances have improved the survival of cancer patients in general, certain racial/ethnic groups have benefited only partially. Footprints of cancer-associated racial disparities are very much evident in cancers of the prostate, breast, cervical, colorectal, endometrium, liver and lung. These health inequalities are mostly attributed to socioeconomic differences among races, but there is a growing realization that these may actually be due to inherent biological differences as well. Indeed, significant data now exist to support the biological basis of racial disparities in cancer, warranting basic research investigations, using appropriate tools and model systems. In this article, we have aimed to succinctly review the literature supporting the biological bases of racial disparities in cancer, along with available resources, databases and model systems that will be of interest to researchers. Moreover, we have highlighted the specific areas that need attention in terms of development of resources and/or tools, and discuss the opportunities and challenges in basic biological research in cancer health disparities. PMID:28123843
This study explores how concerns about the environment have escalated in the past three decades from being peripheral to that of a mainstream social movement. Most environmental concerns stem from the deployment of technologies where technical expertise is essential to effective participation in the decision-making process. The manner in which the current policy for the disposal of low-level radioactive waste was devised and passed by Congress provides the information base through which the role of citizen groups in the decision-making process in a science-intensive culture is explored, as they seek to overcome the adverse environmental impacts and economic inequities of this Act. The actual process by which citizens have confronted this current flawed policy is described, which includes how technical expertise from various sources made the citizens' case credible and effective. Several existing and theoretical models of citizen participation are described. Recommendations and conclusions are presented briefly, and a recommended model based on the concept of sustainable development is proposed.
Fiscella, Kevin; Sanders, Mechelle R
The annual National Healthcare Quality and Disparities Reports document widespread and persistent racial and ethnic disparities. These disparities result from complex interactions between patient factors related to social disadvantage, clinicians, and organizational and health care system factors. Separate and unequal systems of health care between states, between health care systems, and between clinicians constrain the resources that are available to meet the needs of disadvantaged groups, contribute to unequal outcomes, and reinforce implicit bias. Recent data suggest slow progress in many areas but have documented a few notable successes in eliminating these disparities. To eliminate these disparities, continued progress will require a collective national will to ensure health care equity through expanded health insurance coverage, support for primary care, and public accountability based on progress toward defined, time-limited objectives using evidence-based, sufficiently resourced, multilevel quality improvement strategies that engage patients, clinicians, health care organizations, and communities.
Working across boundaries of power, identity, and political geography is fraught with difficulties and contradictions. In Tali Tal and Iris Alkaher's, " Collaborative environmental projects in a multicultural society: Working from within separate or mutual landscapes?" the authors describe their efforts to do this in the highly charged atmosphere of Israel. This forum article offers a response to their efforts. Writing from a framework of critical pedagogy, I use the concepts of space and time to anchor my analysis, as I examine the issue of power in this Jew/Arab collaborative environmental project. This response problematizes "sharing" in a landscape fraught with disparities. It also looks to further Tal and Alkaher's work by geographically and politically grounding it in the broader current conflict and by juxtaposing sustainability with equity.
Kelly, Krista R.; Felius, Joost; Ramachandran, Santoshi; John, Blesson A.; Jost, Reed M.; Birch, Eileen E.
Purpose We examined whether congenital impairment of disparity vergence in infantile esotropia (ET) exists in children with short duration ET (≤3 months) compared with long-duration ET and healthy controls. A short duration of misalignment would allow for a substantial amount of balanced binocular input during the critical period of binocular disparity development. Methods A total of 19 children aged 5 to 12 years and treated for infantile ET with a short (≤3 months; n = 10) or long (≥5 months; n = 9) duration of constant misalignment before alignment were enrolled. A total of 22 healthy control children were enrolled as a comparison group. Eye movements during disparity vergence and accommodative vergence were recorded using an EyeLink 1000 binocular eye tracker. Mean response gain was compared between and within groups to determine the effect of duration of misalignment and viewing condition. Results Compared with controls, children with short (P = 0.002) and long (P < 0.001) duration infantile ET had reduced response gains for disparity vergence, but not for accommodative vergence (P = 0.19). Conclusions Regardless of duration of misalignment, children with infantile ET had reduced disparity vergence, consistent with a congenital impairment of disparity vergence in infantile ET. Although early correction of misalignment increases the likelihood that some level of binocular disparity sensitivity will be present, normal levels may never be achieved. PMID:27159445
Oyston, Jack W.; Hughes, Martin; Gerber, Sylvain; Wills, Matthew A.
Background Disparity refers to the morphological variation in a sample of taxa, and is distinct from diversity or taxonomic richness. Diversity and disparity are fundamentally decoupled; many groups attain high levels of disparity early in their evolution, while diversity is still comparatively low. Diversity may subsequently increase even in the face of static or declining disparity by increasingly fine sub-division of morphological ‘design’ space (morphospace). Many animal clades reached high levels of disparity early in their evolution, but there have been few comparable studies of plant clades, despite their profound ecological and evolutionary importance. This study offers a prospective and some preliminary macroevolutionary analyses. Methods Classical morphometric methods are most suitable when there is reasonable conservation of form, but lose traction where morphological differences become greater (e.g. in comparisons across higher taxa). Discrete character matrices offer one means to compare a greater diversity of forms. This study explores morphospaces derived from eight discrete data sets for major plant clades, and discusses their macroevolutionary implications. Key Results Most of the plant clades in this study show initial, high levels of disparity that approach or attain the maximum levels reached subsequently. These plant clades are characterized by an initial phase of evolution during which most regions of their empirical morphospaces are colonized. Angiosperms, palms, pines and ferns show remarkably little variation in disparity through time. Conifers furnish the most marked exception, appearing at relatively low disparity in the latest Carboniferous, before expanding incrementally with the radiation of successive, tightly clustered constituent sub-clades. Conclusions Many cladistic data sets can be repurposed for investigating the morphological disparity of plant clades through time, and offer insights that are complementary to more focused
Cosgrove, Lisa; Krimsky, Sheldon; Wheeler, Emily E; Peters, Shannon M; Brodt, Madeline; Shaughnessy, Allen F
Because of increased attention to the issue of trustworthiness of clinical practice guidelines, it may be that both transparency and management of industry associations of guideline development groups (GDGs) have improved. The purpose of the present study was to assess a) the disclosure requirements of GDGs in a cross-section of guidelines for major depression; and, b) the extent and type of conflicts of panel members. Treatment guidelines for major depression were identified and searched for conflict of interest policies and disclosure statements. Multi-modal screens for undeclared conflicts were also conducted. Fourteen guidelines with a total of 172 panel members were included in the analysis. Eleven of the 14 guidelines (78%) had a stated conflict of interest policy or disclosure statement, although the policies varied widely. Most (57%) of the guidelines were developed by panels that had members with industry financial ties to drug companies that manufacture antidepressant medication. However, only a minority of total panel members (18%) had such conflicts of interest. Drug company speakers bureau participation was the most common type of conflict. Although some progress has been made, organizations that develop guidelines should continue to work toward greater transparency and minimization of financial conflicts of interest.
Mundorf, Adrienne R; Willits-Smith, Amelia; Rose, Donald
Inadequate access to healthy food is a problem in many urban neighborhoods, particularly for racial-ethnic minorities and low-income groups who are more likely to reside in food deserts. Although substantial research throughout the country has documented the existence of these disparities, few studies have focused on how this access changes over time or is affected by environmental shocks. This study examined citywide supermarket access in New Orleans as well as racial-ethnic disparities in this access, prior to Hurricane Katrina and at three times afterwards. On-the-ground verification of supermarket locations was conducted in 2004-2005, 2007, 2009, and 2014 and was mapped with secondary demographic data. Census tracts were defined as predominantly African-American neighborhoods if 80 % or more of the population identified as such. HLM Poisson regression analyses were conducted in 2014 to identify the difference in likelihood of finding supermarkets in a neighborhood by race-ethnicity and across all years of interest. Racial-ethnic disparities existed before the storm and worsened after it (IRR = 0.35; 95 % CI = 0.21, 0.60). Improvements in disparities to pre-storm levels were not seen until 2009, 4 years after the storm. By 2014, supermarket access, on average, was not significantly different in African-American neighborhoods than in others (IRR = 0.90; 95 % CI = 0.65, 1.26). The slow recovery of New Orleans' retail food infrastructure after Hurricane Katrina highlights the need for an increased focus on long-term planning to address disparities, especially those that may be exaggerated by shocks.
Wernli, Karen J; Kitahara, Cari M; Tamers, Sara L; Al-Temimi, Mohammed H; Braithwaite, Dejana
The mission of the American Society for Preventive Oncology Special Interest Group in International Issues in Cancer is to serve as a worldwide cancer prevention resource. At the 2013 annual meeting, we presented three early career investigators who conducted research with international collaborators as part of postdoctoral studies. We present a synopsis of each of the scientific presentations. The investigators also highlight useful strategies to encourage a more successful international collaboration, including seeking out existing collaborations between colleagues and international researchers, maintaining awareness and sensitivity of cultural norms, establishing clear communication about investigator roles and expectations, and persevering in the face of potential challenges due to the nature of these collaborations. Incorporation of these key elements could prove useful for researchers interested in pursuing cross-country projects.
Emlet, Charles A.
LGBT older adults are a heterogeneous population with collective and unique strengths and challenges. Health, personal, and economic disparities exist in this group when compared to the general population of older adults, yet subgroups such as transgender and bisexual older adults and individuals living with HIV are at greater risk for disparities and poorer health outcomes. As this population grows, further research is needed on factors that contribute to promoting health equity, while decreasing discrimination and improving competent service delivery. PMID:28366981
James, Wesley; Jia, Chunrong; Kedia, Satish
This study examines race- and income-based disparities in cancer risks from air toxics in Cancer Alley, LA, USA. Risk estimates were obtained from the 2005 National Air Toxics Assessment and socioeconomic and race data from the 2005 American Community Survey, both at the census tract level. Disparities were assessed using spatially weighted ordinary least squares (OLS) regression and quantile regression (QR) for five major air toxics, each with cancer risk greater than 10−6. Spatial OLS results showed that disparities in cancer risks were significant: People in low-income tracts bore a cumulative risk 12% more than those in high-income tracts (p < 0.05), and those in black-dominant areas 16% more than in white-dominant areas (p < 0.01). Formaldehyde and benzene were the two largest contributors to the disparities. Contributions from emission sources to disparities varied by compound. Spatial QR analyses showed that magnitude of disparity became larger at the high end of exposure range, indicating worsened disparity in the poorest and most highly concentrated black areas. Cancer risk of air toxics not only disproportionately affects socioeconomically disadvantaged and racial minority communities, but there is a gradient effect within these groups with poorer and higher minority concentrated segments being more affected than their counterparts. Risk reduction strategies should target emission sources, risk driver chemicals, and especially the disadvantaged neighborhoods. PMID:23208297
Lion, K Casey; Raphael, Jean L
Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction.
Wehby, George L; Pawluk, Mariela; Nyarko, Kwame A; López-Camelo, Jorge S
Little is understood about racial/ethnic disparities in infant health in South America. We quantified the extent to which the disparity in preterm birth (PTB; <37 gestational weeks) rate between infants of Native only ancestry and those of European only ancestry in Argentina and Ecuador are explained by household socio-economic, demographic, healthcare use, and geographic location indicators. The samples included 5199 infants born between 2000 and 2011 from Argentina and 1579 infants born between 2001 and 2011 from Ecuador. An Oaxaca-Blinder type decomposition model adapted to binary outcomes was estimated to explain the disparity in PTB risk across groups of variables and specific variables. Maternal use of prenatal care services significantly explained the PTB disparity, by nearly 57% and 30% in Argentina and Ecuador, respectively. Household socio-economic status explained an additional 26% of the PTB disparity in Argentina. Differences in maternal use of prenatal care may partly explain ethnic disparities in PTB in Argentina and Ecuador. Improving access to prenatal care may reduce ethnic disparities in PTB risk in these countries.
Lion, K. Casey
Disparities in pediatric health care quality are well described in the literature, yet practical approaches to decreasing them remain elusive. Quality improvement (QI) approaches are appealing for addressing disparities because they offer a set of strategies by which to target modifiable aspects of care delivery and a method for tailoring or changing an intervention over time based on data monitoring. However, few examples in the literature exist of QI interventions successfully decreasing disparities, particularly in pediatrics, due to well-described challenges in developing, implementing, and studying QI with vulnerable populations or in underresourced settings. In addition, QI interventions aimed at improving quality overall may not improve disparities, and in some cases, may worsen them if there is greater uptake or effectiveness of the intervention among the population with better outcomes at baseline. In this article, the authors review some of the challenges faced by researchers and frontline clinicians seeking to use QI to address health disparities and propose an agenda for moving the field forward. Specifically, they propose that those designing and implementing disparities-focused QI interventions reconsider comparator groups, use more rigorous evaluation methods, carefully consider the evidence for particular interventions and the context in which they were developed, directly engage the social determinants of health, and leverage community resources to build collaborative networks and engage community members. Ultimately, new partnerships between communities, providers serving vulnerable populations, and QI researchers will be required for QI interventions to achieve their potential related to health care disparity reduction. PMID:25560436
Nyarko, Kwame A.; Lopez-Camelo, Jorge; Castilla, Eduardo E.
Objectives. We sought to quantify how socioeconomic, health care, demographic, and geographic effects explain racial disparities in low birth weight (LBW) and preterm birth (PTB) rates in Brazil. Methods. We employed a sample of 8949 infants born between 1995 and 2009 in 15 cities and 7 provinces in Brazil. We focused on disparities in LBW (< 2500 g) and PTB (< 37 gestational weeks) prevalence between infants of African ancestry alone or African mixed with other ancestries, and European ancestry alone. We used a decomposition model to quantify the contributions of conceptually relevant factors to these disparities. Results. The model explained 45% to 94% of LBW and 64% to 94% of PTB disparities between the African ancestry groups and European ancestry. Differences in prenatal care use and geographic location were the most important contributors, followed by socioeconomic differences. The model explained the majority of the disparities for mixed African ancestry and part of the disparity for African ancestry alone. Conclusions. Public policies to improve children’s health should target prenatal care and geographic location differences to reduce health disparities between infants of African and European ancestries in Brazil. PMID:26313046
Duerksen, Susan C; Mikail, Amy; Tom, Laura; Patton, Annie; Lopez, Janina; Amador, Xavier; Vargas, Reynaldo; Victorio, Maria; Kustin, Brenda; Sadler, Georgia Robins
Background Disparities in health status among ethnic groups favor the Caucasian population in the United States on almost all major indicators. Disparities in exposure to health-related mass media messages may be among the environmental factors contributing to the racial and ethnic imbalance in health outcomes. This study evaluated whether variations exist in health-related advertisements and health promotion cues among lay magazines catering to Hispanic, African American and Caucasian women. Methods Relative and absolute assessments of all health-related advertising in 12 women's magazines over a three-month period were compared. The four highest circulating, general interest magazines oriented to Black women and to Hispanic women were compared to the four highest-circulating magazines aimed at a mainstream, predominantly White readership. Data were collected and analyzed in 2002 and 2003. Results Compared to readers of mainstream magazines, readers of African American and Hispanic magazines were exposed to proportionally fewer health-promoting advertisements and more health-diminishing advertisements. Photographs of African American role models were more often used to advertise products with negative health impact than positive health impact, while the reverse was true of Caucasian role models in the mainstream magazines. Conclusion To the extent that individual levels of health education and awareness can be influenced by advertising, variations in the quantity and content of health-related information among magazines read by different ethnic groups may contribute to racial disparities in health behaviors and health status. PMID:16109157
Green, Alexander R
In the last 20 years, the issue of disparities in health between racial/ethnic groups has moved from the realm of common sense and anecdote to the realm of science. Hard, cold data now force us to consider what many had long taken for granted. Not only does health differ by race/ethnicity, but our health care system itself is deeply biased. From lack of diversity in the leadership and workforce, to ethnocentric systems of care, to biased clinical decision-making, the American health care system is geared to treat the majority, while the minority suffers. The photos shown here are of patients and scenes that recall some of the important landmarks in research on racial/ethnic disparities in health. The purpose is to put faces and humanity onto the numbers. While we now have great bodies of evidence upon which to lobby for change, in the end, each statistic still represents a personal tragedy or an individual triumph.
Pellerone, Monica; Passanisi, Alessia; Bellomo, Mario Filippo Paolo
Background Forming one’s identity is thought to be the key developmental task of adolescence, but profound changes in personality traits also occur in this period. The negotiation of complex social settings, the creation of an integrated identity, and career choice are major tasks of adolescence. The adolescent, having to make choices for his or her future, has not only to consider his or her own aspirations and interests but also to possess a capacity for exploration and commitment; in fact, career commitments can be considered as a fit between the study or career that is chosen and personal values, skills, and preferences. Methods The objective of the study reported here was to investigate the role of identity on profile of interests; the relation between identity and decisional style; the correlation between identity, aptitudes, interests, and school performance; and the predictive variables to school success. The research involved 417 Italian students who live in Enna, a small city located in Sicily, Italy, aged 16–19 years (197 males and 220 females) in the fourth year (mean =17.2, standard deviation =0.52) and the fifth year (mean =18.2, standard deviation =0.64) of senior secondary school. The research lasted for one school year; the general group of participants consisted of 470 students, and although all participants agreed to be part of the research, there was a dropout rate of 11.28%. They completed the Ego Identity Process Questionnaire to measure their identity development, the Intelligence Structure Test to investigate aptitudes, the Self-Directed Search to value interests, and General Decision Making Style questionnaire to describe their individual decisional style. Results The data showed that high-school performance was positively associated with rational decision-making style and identity diffusion predicted the use of avoidant style. Interests were related to identity exploration; the differentiation of preferences was related to identity
Ramnitz, Mary Scott; Lodish, Maya B
The question of whether or not children, particularly girls, are entering puberty earlier than they did in the past has been a concern in both the medical community and the general population. A secular trend analysis of the current data on pubertal timing in boys and girls is limited by variations in the study design, the population assessed, and the methods used to determine pubertal development. These differences present a challenge when interpreting the available data, especially when comparing multiple studies. The influence of race on pubertal timing and development had not been assessed before the 1970s. The purpose of this article is to review the reported variations in pubertal timing among different racial/ethnic groups. Data suggest African American girls enter puberty earlier and reach menarche earlier than Caucasian and Hispanic girls. In addition, the trend toward earlier timing of puberty seems to be occurring faster in African American girls compared with Caucasian girls over the past 25 years. While the mechanism and understanding of the cause of racial disparities in pubertal development remain to be discerned, genetic and/or environmental factors may play a role and require further investigation.
Read, Jenny C. A.; Phillipson, Graeme P.; Glennerster, Andrew
The literature on vertical disparity is complicated by the fact that several different definitions of the term “vertical disparity” are in common use, often without a clear statement about which is intended or a widespread appreciation of the properties of the different definitions. Here, we examine two definitions of retinal vertical disparity: elevation-latitude and elevation-longitude disparity. Near the fixation point, these definitions become equivalent, but in general, they have quite different dependences on object distance and binocular eye posture, which have not previously been spelt out. We present analytical approximations for each type of vertical disparity, valid for more general conditions than previous derivations in the literature: we do not restrict ourselves to objects near the fixation point or near the plane of regard, and we allow for non-zero torsion, cyclovergence and vertical misalignments of the eyes. We use these expressions to derive estimates of the latitude and longitude vertical disparity expected at each point in the visual field, averaged over all natural viewing. Finally, we present analytical expressions showing how binocular eye position – gaze direction, convergence, torsion, cyclovergence, and vertical misalignment – can be derived from the vertical disparity field and its derivatives at the fovea. PMID:20055544
Zhu, Shu-Hong; Hebert, Kiandra; Wong, Shiushing; Cummins, Sharon; Gamst, Anthony
Can an intervention program that is highly effective in reducing the prevalence of an unhealthy behavior in the general population also reduce the disparity among its subgroups? That depends on what measure of disparity is used. Using simple algebraic models, this study demonstrates that disparity measured in terms of relative difference between two groups tends to increase when the prevalence of the behavior is in decline. The study then shows an empirical example, by analyzing the effects of the California tobacco control program on smoking prevalence of two education groups, the lowest (less than 12 years) and the highest (16 years or more). It examines the data from four California Tobacco Surveys covering the years 1996, 1999, 2002, and 2005. The effects of three components of the tobacco control program known to be effective in decreasing prevalence (media, worksite policy, and price) on the two education groups are assessed. The smoking prevalence for the two groups is obtained from these four surveys and a regression line is computed for each education group from 1996 to 2005. Results show that the California program is effective with both low education and high education groups and that the rate of decline in smoking prevalence from 1996 to 2005 is no smaller for the low education group than for the high education group. The paper then discusses that an analysis of disparity based on relative difference, however, could result in misleading recommendations that an intervention like the California tobacco program needs to change from its current whole-population approach to one that focuses on targeting subgroups because it has not reduced disparity. It proposes that research should focus more on increasing the rate of change among less advantage groups and less on the relative disparity compared to some other group.
Moy, Ernest; Freeman, William
Health care is an important lever for moderating the effects of social determinants on health. We present a model that describes the relationships among social disadvantage, health-care disparities, and health disparities. Improving access to health care and enhancing patient-provider interaction are critical pathways for reducing disparities. Increasing the diversity of the public health and health-care workforces is an efficient strategy for reducing disparities because it impacts both access to care and patient-provider communication. Federal policy makers should continue interest in workforce diversity to optimize the health of all Americans.
Epplein, Meira; Bostick, Roberd M; Mu, Lina; Ogino, Shuji; Braithwaite, Dejana; Kanetsky, Peter A
The International Agency for Research on Cancer estimates that over half of the new cancer cases and almost two-thirds of the cancer deaths in 2012 occurred in low and middle income countries. To discuss the challenges and opportunities to reducing the burden of cancer worldwide, the Molecular Epidemiology and the Environment and the International Issues in Cancer Special Interest Groups joined forces to hold a session during the 38th Annual Meeting of the American Society of Preventive Oncology (March 2014, Arlington, Virginia). The session highlighted three topics of particular interest to molecular cancer prevention researchers working internationally, specifically: 1) biomarkers in cancer research; 2) environmental exposures and cancer; and 3) molecular pathological epidemiology. A major factor for successful collaboration illuminated during the discussion was the need for strong, committed, and reliable international partners. A key element of establishing such relationships is to thoroughly involve individual international collaborators in the development of the research question; engaged international collaborators are particularly motivated to champion and shepherd the project through all necessary steps, including issues relating to institutional review boards, political sensitivity, laboratory-based assays, and tumor subtyping. Also essential is allotting time for the building, maintaining, and investing in such relationships so that successful international collaborations may take root and bloom. While there are many challenges inherent to international molecular cancer research, the opportunities for furthering the science and prevention of cancer worldwide are great, particularly at this time of increasing cancer incidence and prevalence in low and middle income countries.
Misery, Laurent; Ständer, Sonja; Szepietowski, Jacek C; Reich, Adam; Wallengren, Joanna; Evers, Andrea W M; Takamori, Kenji; Brenaut, Emilie; Le Gall-Ianotto, Christelle; Fluhr, Joachim; Berardesca, Enzo; Weisshaar, Elke
Sensitive skin is a frequent complaint in the general population, in patients, and among subjects suffering from itch. The International Forum for the Study of Itch (IFSI) decided to initiate a special interest group (SIG) on sensitive skin. Using the Delphi method, sensitive skin was defined as "A syndrome defined by the occurrence of unpleasant sensations (stinging, burning, pain, pruritus, and tingling sensations) in response to stimuli that normally should not provoke such sensations. These unpleasant sensations cannot be explained by lesions attributable to any skin disease. The skin can appear normal or be accompanied by erythema. Sensitive skin can affect all body locations, especially the face". This paper summarizes the background, unresolved aspects of sensitive skin and the process of developing this definition.
Germany and the United States, although similar in their industrialization and political structures, reveal marked differences in their national energy policies. Variability in energy policies and the resulting renewable energy deployment in each country have been attributed to political decision-making, international energy regimes and legislative frameworks, in addition to economic mechanisms. This research comes to the conclusion that although a variety of factors lead to coherent renewable energy policy at the federal level, the lobbying efforts of fossil fuel industries serve to depress the ability, in the United States, for sustainable and renewable energy movements to gain headway. As this research shows, the strength of a lobby group or associations can influence policy measures by framing the political landscape, influencing the content of legislation, and achieving political alignment to prime a state for renewable energy policy or not depending on what interests are represented.
... dental sealant programs can help achieve this goal. Community water fluoridation reduces and aids in preventing tooth decay among different socioeconomic, racial, and ethnic groups. Currently, ...
Mission of the Future. Proceedings of the Annual Convention of the Association for the Development of Computer-Based Instructional Systems. Volume III: Users Interest Groups (San Diego, California, February 27 to March 1, 1979).
Association for the Development of Computer-based Instructional Systems.
The third of three volumes of papers presented at the 1979 ADCIS convention, this collection includes 30 papers presented to special interest groups--implementation, minicomputer users, National Consortium for Computer Based Music Instruction, and PLATO users. Papers presented to the implementation interest group were concerned with faculty…
Roe, Anna W; Parker, Andrew J; Born, Richard T; DeAngelis, Gregory C
The past decade has seen a dramatic increase in our knowledge of the neural basis of stereopsis. New cortical areas have been found to represent binocular disparities, new representations of disparity information (e.g., relative disparity signals) have been uncovered, the first topographic maps of disparity have been measured, and the first causal links between neural activity and depth perception have been established. Equally exciting is the finding that training and experience affects how signals are channeled through different brain areas, a flexibility that may be crucial for learning, plasticity, and recovery of function. The collective efforts of several laboratories have established stereo vision as one of the most productive model systems for elucidating the neural basis of perception. Much remains to be learned about how the disparity signals that are initially encoded in primary visual cortex are routed to and processed by extrastriate areas to mediate the diverse capacities of three-dimensional vision that enhance our daily experience of the world.
between Pierre de Fermat (1608-1672) and Blaise Pascal (1623-1662) that began the development of modern probability theory. Their correspondence...34] Table 1: Reproduction of the table that appears in Graunt (1662). Huygens wrote up the solution of Ferrnat and Pascal , and is thus credited with...permutations and combinations, the weak law of large numbers as well as the binomial theorem. What interested Bernoulli was to apply the Fermat- Pascal idea of
Prince, Keith R.; Galloway, Devin L.; Leake, Stanley A.
with this unprecedented increase in pumpage, substantial amounts of land subsidence were observed in several areas of the United States, most notably in Arizona, California, and Texas. Beginning in 1955, under the direction of Joseph Poland, the Geological Survey began the "Mechanics of Aquifers Project," which focused largely on the processes that resulted in land subsidence due to the withdrawal of ground water. This research team gained international renown as they advanced the scientific understanding of aquifer mechanics and land-subsidence theory. The results of field studies by members of this research group not only verified the validity of the application of Terzaghi's consolidation theory to compressible aquifers, but they also provided definitions, methods of quantification, and confirmation of the interrelation among hydraulic head declines, aquifer-system compaction, and land subsidence. In addition to conducting pioneering research, this group also formed a "center of expertise," providing a focal point within the Geological Survey for the dissemination of technology and scientific understanding in aquifer mechanics. However, when the "Mechanics of Aquifers Project" was phased out in 1984, the focal point for technology transfer no longer existed. Interest among various state and local agencies in land subsidence has persisted, and the Geological Survey has continued to participate in a broad spectrum of cooperative and Federally funded projects in aquifer mechanics and land subsidence. These projects are designed to identify and monitor areas with the potential for land subsidence, to conduct basic research in the processes that control land subsidence and the development of earth fissures, as well as to develop new quantitative tools to predict aquifer-system deformation. In 1989 an ad hoc "Aquifer Mechanics and Subsidence Interest Group" (referred to herein as the "Subsidence Interest Group") was formed
Meyer, Pamela A; Yoon, Paula W; Kaufmann, Rachel B
This supplement is the second CDC Health Disparities and Inequalities Report (CHDIR). The 2011 CHDIR was the first CDC report to assess disparities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health-care access (CDC. CDC Health Disparities and Inequalities Report-United States, 2011. MMWR 2011;60[Suppl; January 14, 2011]). The 2013 CHDIR provides new data for 19 of the topics published in 2011 and 10 new topics. When data were available and suitable analyses were possible for the topic area, disparities were examined for population characteristics that included race and ethnicity, sex, sexual orientation, age, disability, socioeconomic status, and geographic location. The purpose of this supplement is to raise awareness of differences among groups regarding selected health outcomes and health determinants and to prompt actions to reduce disparities. The findings in this supplement can be used by practitioners in public health, academia and clinical medicine; the media; the general public; policymakers; program managers; and researchers to address disparities and help all persons in the United States live longer, healthier, and more productive lives.
Addressing health disparities has been a national challenge for decades. The NIH-sponsored Centers for Population Health and Health Disparities (CPHHDs) represent the first federal initiative to support transdisciplinary multilevel research on the determinants of health disparities. Using preliminar...
Schroth, Volkhard; Joos, Roland; Jaschinski, Wolfgang
In optometry of binocular vision, the question may arise whether prisms should be included in eyeglasses to compensate an oculomotor and/or sensory imbalance between the two eyes. The corresponding measures of objective and subjective fixation disparity may be reduced by the prisms, or the adaptability of the binocular vergence system may diminish effects of the prisms over time. This study investigates effects of wearing prisms constantly for about 5 weeks in daily life. Two groups of 12 participants received eyeglasses with prisms having either a base-in direction or a base-out direction with an amount up to 8 prism diopters. Prisms were prescribed based on clinical fixation disparity test plates at 6 m. Two dependent variables were used: (1) subjective fixation disparity was indicated by a perceived offset of dichoptic nonius lines that were superimposed on the fusion stimuli and (2) objective fixation disparity was measured with a video based eye tracker relative to monocular calibration. Stimuli were presented at 6 m and included either central or more peripheral fusion stimuli. Repeated measurements were made without the prisms and with the prisms after about 5 weeks of wearing these prisms. Objective and subjective fixation disparity were correlated, but the type of fusion stimulus and the direction of the required prism may play a role. The prisms did not reduce the fixation disparity to zero, but induced significant changes in fixation disparity with large effect sizes. Participants receiving base-out prisms showed hypothesized effects, which were concurrent in both types of fixation disparity. In participants receiving base-in prisms, the individual effects of subjective and objective effects were negatively correlated: the larger the subjective (sensory) effect, the smaller the objective (motor) effect. This response pattern was related to the vergence adaptability, i.e. the individual fusional vergence reserves.
Smith, Caren E; Fullerton, Stephanie M; Dookeran, Keith A; Hampel, Heather; Tin, Adrienne; Maruthur, Nisa M; Schisler, Jonathan C; Henderson, Jeffrey A; Tucker, Katherine L; Ordovás, José M
Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened. Addressing this issue will require integrated strategies, including expanding genetic research, improving genetic literacy, and enhancing access to genetic technologies among minority populations in a way that avoids harms such as stigmatization.
Smith, Caren E.; Fullerton, Stephanie M.; Dookeran, Keith A.; Hampel, Heather; Tin, Adrienne; Maruthur, Nisa M.; Schisler, Jonathan C.; Henderson, Jeffrey A.; Tucker, Katherine L.; Ordovás, José M.
Evidence shows that both biological and nonbiological factors contribute to health disparities. Genetics, in particular, plays a part in how common diseases manifest themselves. Today, unprecedented advances in genetically based diagnoses and treatments provide opportunities for personalized medicine. However, disadvantaged groups may lack access to these advances, and treatments based on research on non-Hispanic whites might not be generalizable to members of minority groups. Unless genetic technologies become universally accessible, existing disparities could be widened. Addressing this issue will require integrated strategies, including expanding genetic research, improving genetic literacy, and enhancing access to genetic technologies among minority populations in a way that avoids harms such as stigmatization. PMID:27503959
Spong, Catherine Y; Iams, Jay; Goldenberg, Robert; Hauck, Fern R; Willinger, Marian
Infant mortality, stillbirths, and preterm births are major public health priorities with significant disparities based on race and ethnicity. Interestingly, when evaluating the rates over the past 30 to 50 years, the disparity persists in all three and is remarkably consistent. In the United States, the infant mortality rate is 6.7 deaths per 1,000 live births, the stillbirth rate is 6.2 per 1,000 deliveries, and the preterm birth rate is 12.8% of live births. The rates among non-Hispanic African Americans are dramatically higher, nearly double the infant mortality at 13.4 infant deaths per 1,000 live births, nearly double the stillbirth rate at 11.1 stillbirths per 1,000 deliveries, and one third higher with preterm births at 18.4% of live births. Despite numerous conferences, workshops, articles, and investigators focusing on this line of work, the disparities persist and, in some cases, are growing. In this article, we summarize a Eunice Kennedy Shriver National Institute of Child Health and Human Development workshop that focused on these disparities to identify the associated factors to determine their relative contributions, identify gaps in knowledge, and develop specific strategies to address the disparities in the short-term and long-term.
Risbud, Makarand V.; Schoepflin, Zachary R.; Mwale, Fackson; Kandel, Rita A.; Grad, Sibylle; Iatridis, James C.; Sakai, Daisuke; Hoyland, Judith A.
Low back pain is a major physical and socioeconomic problem. Degeneration of the intervertebral disc and especially that of nucleus pulposus (NP) has been linked to low back pain. In spite of much research focusing on the NP, consensus among the research community is lacking in defining the NP cell phenotype. A consensus agreement will allow easier distinguishing of NP cells from annulus fibrosus (AF) cells and endplate chondrocytes, a better gauge of therapeutic success, and a better guidance of tissue-engineering-based regenerative strategies that attempt to replace lost NP tissue. Most importantly, a clear definition will further the understanding of physiology and function of NP cells, ultimately driving development of novel cell-based therapeutic modalities. The Spine Research Interest Group at the 2014 Annual ORS Meeting in New Orleans convened with the task of compiling a working definition of the NP cell phenotype with hope that a consensus statement will propel disc research forward into the future. Based on evaluation of recent studies describing characteristic NP markers and their physiologic relevance, we make the recommendation of the following healthy NP phenotypic markers: stabilized expression of HIF-1α, GLUT-1, aggrecan/collagen II ratio >20, Shh, Brachyury, KRT18/19, CA12, and CD24. PMID:25411088
Brockow, K; Aberer, W; Atanaskovic-Markovic, M; Bavbek, S; Bircher, A; Bilo, B; Blanca, M; Bonadonna, P; Burbach, G; Calogiuri, G; Caruso, C; Celik, G; Cernadas, J; Chiriac, A; Demoly, P; Oude Elberink, J N G; Fernandez, J; Gomes, E; Garvey, L H; Gooi, J; Gotua, M; Grosber, M; Kauppi, P; Kvedariene, V; Laguna, J J; Makowska, J S; Mosbech, H; Nakonechna, A; Papadopolous, N G; Ring, J; Romano, A; Rockmann, H; Sargur, R; Sedlackova, L; Sigurdardottir, S; Schnyder, B; Storaas, T; Torres, M; Zidarn, M; Terreehorst, I
The strongest and best-documented risk factor for drug hypersensitivity (DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation.
Brudney, Daniel; Lantos, John D
Whose interests should count and how should various interests be balanced at the pediatric patient's bedside? The interests of the child patient clearly count. Recently, however, many authors have argued that the family's interests also count. But how should we think about the interests of others? What does it mean to talk about "the family" in this context? Does it really just mean the interests of each individual family member? Or is the family itself a moral entity that has interests of its own independent of the interests of each of its members? Are such interests important only as they affect the patient's interest or also for their own sake? In this special supplement to Pediatrics, a group of pediatricians, philosophers, and lawyers grapple with these questions. They examine these issues from different angles and reach different conclusions. Jointly, they demonstrate the ethical importance and, above all, the ethical complexity of the family's role at the bedside.
Chornokur, Ganna; Amankwah, Ernest K.; Schildkraut, Joellen M.; Phelan, Catherine M.
Objective The objective of this article is to broadly review the scientific literature and summarize the most up-to-date findings on ovarian cancer health disparities worldwide and in the United States (U.S.). Methods The present literature on disparities in ovarian cancer was reviewed. Original research and relevant review articles were included. Results Ovarian cancer health disparities exist worldwide and in the U.S. Ovarian cancer disproportionately affect African American women at all stages of the disease, from presentation through treatment, and ultimately increased mortality and decreased survival, compared to non-Hispanic White women. Increased mortality is likely to be explained by unequal access to care and non-standard treatment regimens frequently administered to African American women, but may also be attributed to genetic susceptibility, acquired co-morbid conditions and increased frequency of modifiable risk factors, albeit to substantially lesser extent. Unequal access to care is, in turn, largely a consequence of lower socioeconomic status and lack of private health insurance coverage among the African American population. Conclusions Our findings suggest the need for policy changes aimed at facilitating equal access to quality medical care. At the same time, further research is necessary to fully resolve racial disparities in ovarian cancer. PMID:23266352
Disparities in suspension rates for White, Black, Hispanic, and American Indian students are more often a result of inequitable disciplinary actions than differences in behavior. Exclusionary discipline undermines students' academic achievement by weakening their connection with school and removing them from the classroom. Students who experience…
Mantwill, Sarah; Monestel-Umaña, Silvia; Schulz, Peter J.
Objectives Health literacy is commonly associated with many of the antecedents of health disparities. Yet the precise nature of the relationship between health literacy and disparities remains unclear. A systematic review was conducted to better understand in how far the relationship between health literacy and health disparities has been systematically studied and which potential relationships and pathways have been identified. Methods Five databases, including PubMed/MEDLINE and CINAHL, were searched for peer-reviewed studies. Publications were included in the review when they (1) included a valid measure of health literacy, (2) explicitly conceived a health disparity as related to a social disparity, such as race/ethnicity or education and (3) when results were presented by comparing two or more groups afflicted by a social disparity investigating the effect of health literacy on health outcomes. Two reviewers evaluated each study for inclusion and abstracted relevant information. Findings were ordered according to the disparities identified and the role of health literacy in explaining them. Results 36 studies were included in the final synthesis. Most of the studies investigated racial/ethnic disparities, followed by some few studies that systematically investigated educational disparities. Some evidence was found on the mediating function of health literacy on self-rated health status across racial/ethnic and educational disparities, as well as on the potential effect of health literacy and numeracy on reducing racial/ethnic disparities in medication adherence and understanding of medication intake. Conclusion Overall the evidence on the relationship between health literacy and disparities is still mixed and fairly limited. Studies largely varied with regard to health(-related) outcomes under investigation and the health literacy assessments used. Further, many studies lacked a specific description of the nature of the disparity that was explored and a clear
Lee, J.Y.; Divaris, K.
Health disparities are preventable differences in the burden of disease or opportunities to achieve optimal health that are experienced by socially disadvantaged population groups. Reducing health disparities has been identified as an ethical imperative by the World Health Organization’s Commission on Social Determinants of Health and numerous other national and international bodies. Significant progress has been made over the past years in identifying vulnerable groups, and ‘distal’ factors including political, economic, social, and community characteristics are now considered pivotal. It is thus unsurprising that the remarkable advances in the science and practice of dentistry have not led to notable reductions in oral health disparities. In this review, we summarize recent work and emphasize the need for a solid theoretical framing to guide oral health disparities research. We provide a theoretical framework outlining pathways that operate across the continuum of oral health determinants during the lifecourse and highlight potential areas for intervention. Because oral health disparities emanate from the unequal distribution of social, political, economic, and environmental resources, tangible progress is likely to be realized only by a global movement and concerted efforts by all stakeholders, including policymakers, the civil society, and academic, professional, and scientific bodies. PMID:24189268
... and socioeconomic disparities persist. Text version of this graph Source: CDC's National Center for Health Statistics. National ... map Top of Page Text version of this graph Top of Page Community Rates and Disparities Across ...
Amzel, Anouk; Ghosh, Chandak
OBJECTIVES: To assess American newspaper coverage regarding racial and ethnic minority health disparities (MHDs). METHODS: LexisNexis was queried with specific word combinations to elicit all MHD articles printed in 257 newspapers from 2000-2004. The full texts were read and articles categorized by racial/ethnic group and specific MHD topics mentioned. RESULTS: In the five years from 2000-2004, 1188 MHD articles were published, representing 0.09% of all articles about health. Newspapers gave much attention to MHD when discussed in conferences and meetings and speeches by senior health officials and politicians. Cancer, cardiovascular disease and HIV/AIDS were most frequent among disease-specific mentions. Articles about African Americans comprised 60.4% of all race/ethnicity-mentioning articles. CONCLUSIONS: Despite the release of major organizational reports and the publication of many studies confirming the prevalence of MHD, few newspaper articles have been published explaining MHD to the public. Because of the general public's low rate of health literacy, the health world should collaborate with the media to present a consistent, simple message concerning gaps in care experienced by all racial/ethnic minority groups. In a time of consumer-directed healthcare, if Americans understand that MHDs exist, they may galvanize to advocate for disparity elimination and quality improvement. PMID:17987915
Yoo, Byung-Kwang; Hasebe, Takuya; Szilagyi, Peter G.
While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010–2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N= 6,095/19.2million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates—including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions —to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p<.001), 25.7 pp (W-SH disparity, p<.001) and 0.6 pp (W-EH disparity, p>.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional
Yoo, Byung-Kwang; Hasebe, Takuya; Szilagyi, Peter G
While persistent racial/ethnic disparities in influenza vaccination have been reported among the elderly, characteristics contributing to disparities are poorly understood. This study aimed to assess characteristics associated with racial/ethnic disparities in influenza vaccination using a nonlinear Oaxaca-Blinder decomposition method. We performed cross-sectional multivariable logistic regression analyses for which the dependent variable was self-reported receipt of influenza vaccine during the 2010-2011 season among community dwelling non-Hispanic African-American (AA), non-Hispanic White (W), English-speaking Hispanic (EH) and Spanish-speaking Hispanic (SH) elderly, enrolled in the 2011 Medicare Current Beneficiary Survey (MCBS) (un-weighted/weighted N=6,095/19.2 million). Using the nonlinear Oaxaca-Blinder decomposition method, we assessed the relative contribution of seventeen covariates - including socio-demographic characteristics, health status, insurance, access, preference regarding healthcare, and geographic regions - to disparities in influenza vaccination. Unadjusted racial/ethnic disparities in influenza vaccination were 14.1 percentage points (pp) (W-AA disparity, p<0.001), 25.7 pp (W-SH disparity, p<0.001) and 0.6 pp (W-EH disparity, p>.8). The Oaxaca-Blinder decomposition method estimated that the unadjusted W-AA and W-SH disparities in vaccination could be reduced by only 45% even if AA and SH groups become equivalent to Whites in all covariates in multivariable regression models. The remaining 55% of disparities were attributed to (a) racial/ethnic differences in the estimated coefficients (e.g., odds ratios) in the regression models and (b) characteristics not included in the regression models. Our analysis found that only about 45% of racial/ethnic disparities in influenza vaccination among the elderly could be reduced by equalizing recognized characteristics among racial/ethnic groups. Future studies are needed to identify additional
Prince, Keith R.; Leake, Stanley A.
Introducation to Papers: This report is a compilation of short papers that are based on oral presentations summarizing the results of recent research that were given at the third meeting of the Subsidence Interest Group held in Las Vegas, Nevada, February 14?16, 1995. The report includes case studies of land subsidence and aquifer-system deformation resulting from fluid withdrawal, geothermal development, and mine collapse. Methods for monitoring land subsidence using Global Positioning System technology for the rapid and accurate measurement of changes in land-surface altitude also are described. The current status of numerical simulation of land subsidence in the USGS is summarized, and several of the short papers deal with the development and application of new numerical techniques for simulation and quantification of aquifersystem deformation. Not all oral presentations made at the meeting are documented in this report. Several of the presentations were of ongoing research and as such, the findings were provisional in nature and were offered at the meeting to stimulate scientific discussion and debate among colleagues. The information presented in this report, although only a subset of the proceedings of the meeting in Las Vegas, should help expand the scientific basis for management decisions to mitigate or control the effects of land subsidence. The short papers describing the results of these studies provide a cross section of ongoing research in aquifer mechanics and land subsidence and also form an assessment of the current technology and 'state of the science.' The analytical and interpretive methods described in this report will be useful to scientists involved in studies of ground-water hydraulics and aquifer-system deformation.
... 29 Labor 4 2010-07-01 2010-07-01 false Disparate treatment. 1607.11 Section 1607.11 Labor... EMPLOYEE SELECTION PROCEDURES (1978) General Principles § 1607.11 Disparate treatment. The principles of disparate or unequal treatment must be distinguished from the concepts of validation. A selection...
Exceptional Parent, 2011
This article is the third of a 4-part series on "Health Promotion and Wellness" from the American Association on Health and Disability (AAHD). It focuses on health disparities and people with disabilities. Health disparities are differences in health outcomes between groups that reflect social inequalities. Disability rates vary by ethnicity, age,…
Crause, Candi; Vaid, Awais; Albarracín, Dolores
Compared to European-Americans, African-Americans have greater probability of becoming infected with HIV, as well as worse outcomes when they become infected. Therefore, adequate health communications should ensure that they capture the attention of African-Americans and do not perpetuate disadvantages relative to European-Americans. The objective of this report was to examine if racial disparities in attention to health information parallel racial disparities in health outcomes. Participants were clients of a public health clinic (Study 1 n = 64; Study 2 n = 55). Unobtrusive observation in a public health waiting room, message reading times, and response-time on a modified flanker task were used to examine attention to HIV- and flu-information across racial groups. In Study 1, participants were observed for the duration of their time in a public health clinic waiting room (average duration 31 minutes). In Study 2, participants completed tasks in a private room at the public health clinic (average duration 21 minutes). Across all attention measures, results suggest an interaction between race and information type on attention to health information. In particular, African-Americans differentially attended to information as a function of information type, with decreased attention to HIV versus flu information. In contrast, European-Americans attended equally to both HIV and flu information. As such, disparities in attention yielded less access to certain health information for African- than European-Americans in a health setting. The identified disparities in attention are particularly problematic because they disadvantage African-Americans at a time of great effort to correct racial disparities. Modifying the framing of health information in ways that ensure attention by all racial groups may be a strategy to increase attention, and thereby reduce disparities in health outcomes. Future research should find solutions that increase attentional access to health
Earl, Allison; Crause, Candi; Vaid, Awais; Albarracín, Dolores
Compared to European-Americans, African-Americans have greater probability of becoming infected with HIV, as well as worse outcomes when they become infected. Therefore, adequate health communications should ensure that they capture the attention of African-Americans and do not perpetuate disadvantages relative to European-Americans. The objective of this report was to examine if racial disparities in attention to health information parallel racial disparities in health outcomes. Participants were clients of a public health clinic (Study 1 n = 64; Study 2 n = 55). Unobtrusive observation in a public health waiting room, message reading times, and response-time on a modified flanker task were used to examine attention to HIV- and flu-information across racial groups. In Study 1, participants were observed for the duration of their time in a public health clinic waiting room (average duration: 31 min). In Study 2, participants completed tasks in a private room at the public health clinic (average duration: 21 min). Across all attention measures, results suggest an interaction between race and information type on attention to health information. In particular, African-Americans differentially attended to information as a function of information type, with decreased attention to HIV- versus flu-information. In contrast, European-Americans attended equally to both HIV- and flu-information. As such, disparities in attention yielded less access to certain health information for African- than European-Americans in a health setting. The identified disparities in attention are particularly problematic because they disadvantage African-Americans at a time of great effort to correct racial disparities. Modifying the framing of health information in ways that ensure attention by all racial groups may be a strategy to increase attention, and thereby reduce disparities in health outcomes. Future research should find solutions that increase attentional access to health
Wang, Qi; Jiao, Jie
China is one of the largest and most populated countries in the world. It has undergone rapid economic growth in recent years. However, the development is not equitable, and the distribution of wealth significantly varies among the regions in China. Geographical and socioeconomic inequalities, together with the lack of an equitable national social support system, cause the high variance of health outcomes among the regions. Furthermore, the fast growth of the economy has evoked many environmental challenges and puts much pressure on the population. The severe environmental deterioration, especially of the atmosphere and water bodies, has affected the health of the people living in China. As a result, cancer has become a major public health issue, and an alarming increase in incidence and mortality has been reported. However, cancer incidence and mortality vary in different areas in China. Cancer and cancer treatment disparities have existed for years. This article will discuss the existing health and cancer disparities associated with the risk factors and how these disparities are managed in China. PMID:28083550
Crespo, Carlos J.
American cultural diversity makes it difficult to promote one single fitness and health program. Health disparities exist between racial and ethnic groups. Healthy People 2000 and 2010 are designed to encourage physical activity for all, regardless of race, ethnicity, or economic status. Physicians need to understand these inequities and consider…
Background/Context: The overrepresentation of some minority groups in special education in the United States raises concerns about racial inequality and stratification within schools. While many actors and mechanisms within the school system may contribute to racial disparities in special education, the role of teachers is particularly important…
Dudley, Katherine A.; Patel, Sanjay R.
Obstructive sleep apnea (OSA) is an increasingly prevalent condition. A growing body of literature supports substantial racial disparities in the prevalence, risk factors, presentation, diagnosis and treatment of this disease. Craniofacial structure among Asians appears to confer an elevated risk of OSA despite lower rates of obesity. Among African Americans, Native Americans, and Hispanics, OSA prevalence is increased, likely due in part to obesity. Burden of symptoms, particularly excessive daytime sleepiness, is higher among African Americans, though Hispanics more often report snoring. Limited data suggest African Americans may be more susceptible to hypertension in the setting of OSA. While differences in genetic risk factors may explain disparities in OSA burden, no definitive genetic differences have yet been identified. In addition to disparities in OSA development, disparities in OSA diagnosis and treatment have also been identified. Increased severity of disease at diagnosis among African Americans suggests a delay in diagnosis. Treatment outcomes are also suboptimal among African Americans. In children, tonsillectomy is less likely to cure OSA and more commonly associated with complications in this group. Among adults, adherence to continuous positive airway pressure (CPAP) is substantially lower in African Americans. The reasons for these disparities, particularly in outcomes, are not well understood and should be a research priority. PMID:26428843
Braveman, Paula; Barclay, Colleen
In this article we argue for the utility of the life-course perspective as a tool for understanding and addressing health disparities across socioeconomic and racial or ethnic groups, particularly disparities that originate in childhood. Key concepts and terms used in life-course research are briefly defined; as resources, examples of existing literature and the outcomes covered are provided along with examples of longitudinal databases that have often been used for life-course research. The life-course perspective focuses on understanding how early-life experiences can shape health across an entire lifetime and potentially across generations; it systematically directs attention to the role of context, including social and physical context along with biological factors, over time. This approach is particularly relevant to understanding and addressing health disparities, because social and physical contextual factors underlie socioeconomic and racial/ethnic disparities in health. A major focus of life-course epidemiology has been to understand how early-life experiences (particularly experiences related to economic adversity and the social disadvantages that often accompany it) shape adult health, particularly adult chronic disease and its risk factors and consequences. The strong life-course influences on adult health could provide a powerful rationale for policies at all levels--federal, state, and local--to give more priority to investment in improving the living conditions of children as a strategy for improving health and reducing health disparities across the entire life course.
Dudley, Katherine A; Patel, Sanjay R
Obstructive sleep apnea (OSA) is an increasingly prevalent condition. A growing body of literature supports substantial racial disparities in the prevalence, risk factors, presentation, diagnosis, and treatment of this disease. Craniofacial structure among Asians appears to confer an elevated risk of OSA despite lower rates of obesity. Among African Americans, Native Americans, and Hispanics, OSA prevalence is increased, likely due in part to obesity. The burden of symptoms, particularly excessive daytime sleepiness, is higher among African Americans, although Hispanics more often report snoring. Limited data suggest that African Americans may be more susceptible to hypertension in the setting of OSA. While differences in genetic risk factors may explain disparities in OSA burden, no definitive genetic differences have yet been identified. In addition to disparities in OSA development, disparities in OSA diagnosis and treatment have also been identified. Increased severity of disease at diagnosis among African Americans suggests a delay in diagnosis. Treatment outcomes are also suboptimal among African Americans. In children, tonsillectomy is less likely to cure OSA and more commonly associated with complications in this group. Among adults, adherence to continuous positive airway pressure (CPAP) is substantially lower in African Americans. The reasons for these disparities, particularly in outcomes, are not well understood and should be a research priority.
Neff, Roni A.; Palmer, Anne M.; Mckenzie, Shawn E.; Lawrence, Robert S.
The United States has set a national goal to eliminate health disparities. This article emphasizes the importance of food systems in generating and exacerbating health disparities in the United States and suggests avenues for reducing them. It presents a conceptual model showing how broad food system conditions interplay with community food environments—and how these relationships are filtered and refracted through prisms of social disparities to generate and exacerbate health disparities. Interactions with demand factors in the social environment are described. The article also highlights the separate food systems pathway to health disparities via environmental and occupational health effects of agriculture. PMID:23173027
Understanding, Dynamic Image Analysis , Disparity Analysis, Optical Flow, Real-Time Processing ___ 20. ABSTRACT (Continue on revere side If necessary aid identify...three aspects of dynamic image analysis must be studied: effectiveness, generality, and efficiency. In addition, efforts must be made to understand the...environment. A better understanding of the need for these Limiting constraints is required. Efficiency is obviously important if dynamic image analysis is
Owusu-Edusei, Kwame; Chesson, Harrell W.; Leichliter, Jami S.; Kent, Charlotte K.; Aral, Sevgi O.
Objectives. We examined the association between racial disparity in income and reported race-specific county-level bacterial sexually transmitted infections (STIs) in the United States focusing on disparities between Blacks and Whites. Methods. Data are from the US 2000 decennial census. We defined 2 race–income county groups (high and low race–income disparity) on the basis of the difference between Black and White median household incomes. We used 2 approaches to examine disparities in STI rates across the groups. In the first approach, we computed and compared race-specific STI rates for the groups. In the second approach, we used spatial regression analyses to control for potential confounders. Results. Consistent with the STI literature, chlamydia, gonorrhea, and syphilis rates for Blacks were substantially higher than were those for Whites. We also found that racial disparities in income were associated with racial disparities in chlamydia and gonorrhea rates and, to a lesser degree, syphilis rates. Conclusions. Racial disparities in household income may be a more important determinant of racial disparities in reported STI morbidity than are absolute levels of household income. PMID:23488482
Wilson, Laura A B
In this study, allometric trajectories for 51 rodent species, comprising equal representatives from each of the major clades (Ctenohystrica, Muroidea, Sciuridae), are compared in a multivariate morphospace (=allometric space) to quantify magnitudes of disparity in cranial growth. Variability in allometric trajectory patterns was compared to measures of adult disparity in each clade, and dietary habit among the examined species, which together encapsulated an ecomorphological breadth. Results indicate that the evolution of allometric trajectories in rodents is characterized by different features in sciurids compared with muroids and Ctenohystrica. Sciuridae was found to have a reduced magnitude of inter-trajectory change and growth patterns with less variation in allometric coefficient values among members. In contrast, a greater magnitude of difference between trajectories and an increased variation in allometric coefficient values was evident for both Ctenohystrica and muroids. Ctenohystrica and muroids achieved considerably higher adult disparities than sciurids, suggesting that conservatism in allometric trajectory modification may constrain morphological diversity in rodents. The results provide support for a role of ecology (dietary habit) in the evolution of allometric trajectories in rodents. PMID:23610638
Golden, Sherita Hill; Purnell, Tanjala; Halbert, Jennifer P; Matens, Richard; Miller, Edgar R Pete; Levine, David M; Nguyen, Tam H; Gudzune, Kimberly A; Crews, Deidra C; Mahlangu-Ngcobo, Mankekolo; Cooper, Lisa A
To overcome cardiovascular disease (CVD) disparities impacting high-risk populations, it is critical to train researchers and leaders in conducting community-engaged CVD disparities research. The authors summarize the key elements, implementation, and preliminary outcomes of the CVD Disparities Fellowship and Summer Internship Programs at the Johns Hopkins University Schools of Medicine, Nursing, and Bloomberg School of Public Health. In 2010, program faculty and coordinators established a transdisciplinary CVD disparities training and career development fellowship program for scientific investigators who desire to conduct community-engaged clinical and translational disparities research. The program was developed to enhance mentorship support and research training for faculty, postdoctoral fellows, and predoctoral students interested in conducting CVD disparities research. A CVD Disparities Summer Internship Program for undergraduate and preprofessional students was also created to provide a broad experience in public health and health disparities in Baltimore, Maryland, with a focus on CVD. Since 2010, 39 predoctoral, postdoctoral, and faculty fellows have completed the program. Participating fellows have published disparities-related research and given presentations both nationally and internationally. Five research grant awards have been received by faculty fellows. Eight undergraduates, one postbaccalaureate, and two medical professional students representing seven universities have participated in the summer undergraduate internship. Over half of the undergraduate students are applying to or have been accepted into medical or graduate school. The tailored CVD health disparities training curriculum has been successful at equipping varying levels of trainees (from undergraduate students to faculty) with clinical research and public health expertise to conducting community-engaged CVD disparities research.
Golden, Sherita Hill; Purnell, Tanjala; Halbert, Jennifer P.; Matens, Richard; Miller, Edgar R. “Pete”; Levine, David M.; Nguyen, Tam H.; Gudzune, Kimberly A.; Crews, Deidra C.; Mahlangu-Ngcobo, Mankekolo; Cooper, Lisa A.
To overcome cardiovascular disease (CVD) disparities impacting high-risk populations, it is critical to train researchers and leaders in conducting community-engaged CVD disparities research. The authors summarize the key elements, implementation, and preliminary outcomes of the CVD Disparities Fellowship and Summer Internship Programs at the Johns Hopkins University Schools of Medicine, Nursing, and Bloomberg School of Public Health. In 2010, program faculty and coordinators established a trans-disciplinary CVD disparities training and career development fellowship program for scientific investigators who desire to conduct community-engaged clinical and translational disparities research. The program was developed to enhance mentorship support and research training for faculty, post-doctoral fellows, and pre-doctoral students interested in conducting CVD disparities research. A CVD Disparities Summer Internship Program for undergraduate and pre-professional students was also created to provide a broad experience in public health and health disparities in Baltimore, Maryland, with a focus on CVD. Since 2010, 39 pre-doctoral, post-doctoral, and faculty fellows have completed the program. Participating fellows have published disparities-related research and given presentations both nationally and internationally. Five research grant awards have been received by faculty fellows. Eight undergraduates, 1 post-baccalaureate, and 2 medical professional students representing seven universities have participated in the summer undergraduate internship. Over half of the undergraduate students are applying to or have been accepted into medical or graduate school. The tailored CVD health disparities training curriculum has been successful at equipping varying levels of trainees (from undergraduate students to faculty) with clinical research and public health expertise to conducting community-engaged CVD disparities research. PMID:25054421
Hughes, Martin; Gerber, Sylvain; Wills, Matthew Albion
There are few putative macroevolutionary trends or rules that withstand scrutiny. Here, we test and verify the purported tendency for animal clades to reach their maximum morphological variety relatively early in their evolutionary histories (early high disparity). We present a meta-analysis of 98 metazoan clades radiating throughout the Phanerozoic. The disparity profiles of groups through time are summarized in terms of their center of gravity (CG), with values above and below 0.50 indicating top- and bottom-heaviness, respectively. Clades that terminate at one of the “big five” mass extinction events tend to have truncated trajectories, with a significantly top-heavy CG distribution overall. The remaining 63 clades show the opposite tendency, with a significantly bottom-heavy mean CG (relatively early high disparity). Resampling tests are used to identify groups with a CG significantly above or below 0.50; clades not terminating at a mass extinction are three times more likely to be significantly bottom-heavy than top-heavy. Overall, there is no clear temporal trend in disparity profile shapes from the Cambrian to the Recent, and early high disparity is the predominant pattern throughout the Phanerozoic. Our results do not allow us to distinguish between ecological and developmental explanations for this phenomenon. To the extent that ecology has a role, however, the paucity of bottom-heavy clades radiating in the immediate wake of mass extinctions suggests that early high disparity more probably results from the evolution of key apomorphies at the base of clades rather than from physical drivers or catastrophic ecospace clearing. PMID:23884651
Hughes, Martin; Gerber, Sylvain; Albion Wills, Matthew
There are few putative macroevolutionary trends or rules that withstand scrutiny. Here, we test and verify the purported tendency for animal clades to reach their maximum morphological variety relatively early in their evolutionary histories (early high disparity). We present a meta-analysis of 98 metazoan clades radiating throughout the Phanerozoic. The disparity profiles of groups through time are summarized in terms of their center of gravity (CG), with values above and below 0.50 indicating top- and bottom-heaviness, respectively. Clades that terminate at one of the "big five" mass extinction events tend to have truncated trajectories, with a significantly top-heavy CG distribution overall. The remaining 63 clades show the opposite tendency, with a significantly bottom-heavy mean CG (relatively early high disparity). Resampling tests are used to identify groups with a CG significantly above or below 0.50; clades not terminating at a mass extinction are three times more likely to be significantly bottom-heavy than top-heavy. Overall, there is no clear temporal trend in disparity profile shapes from the Cambrian to the Recent, and early high disparity is the predominant pattern throughout the Phanerozoic. Our results do not allow us to distinguish between ecological and developmental explanations for this phenomenon. To the extent that ecology has a role, however, the paucity of bottom-heavy clades radiating in the immediate wake of mass extinctions suggests that early high disparity more probably results from the evolution of key apomorphies at the base of clades rather than from physical drivers or catastrophic ecospace clearing.
The Entertainment Studies Interest Group of the proceedings contains the following 9 papers: "Beyond Modern Racism: Backlash and Brutality on 'The Shield'" (John D. Richardson); "Big Brother and the T-Group: How We Might Learn from Reality Television" (Rod Allen and Nod Miller); "Hegemony and Counterhegemony in Bravo's…
Marhefka, Stephanie L; Fuhrmann, Hollie J; Gilliam, Patricia; Lopez, Bernice; Baldwin, Julie
Novel strategies are needed to expand access to effective behavioral interventions for HIV prevention. Delivering effective group-based interventions to people living with HIV using video-conferencing technology is an innovative approach that may address this need, but has not been explored. Twenty-seven women living with HIV (WLH) who had just completed Healthy Relationships, a group-based behavioral program for WLH, participated in focus groups to share their thoughts about potentially participating in Healthy Relationships via a video-conferencing group. Overall, WLH supported the idea of video-group delivery of the program. They had numerous questions about logistics, expressed concerns about safety and confidentiality, and indicated a preference for accessing video-groups via special video-phones versus computers. Findings warrant further research into the feasibility, acceptability, and effectiveness of video-group delivery of HIV prevention interventions and suggest important considerations for researchers and practitioners who may employ video-conferencing for intervention delivery.
Wehby, George L.; Gili, Juan A.; Pawluk, Mariela; Castilla, Eduardo E.; López-Camelo, Jorge S.
Objective We examine disparities in birth weight and gestational age by ethnic ancestry in 2000–2011 in eight South American countries. Methods The sample included 60480 singleton live-births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Results Significant disparities were found in seven countries. In four countries – Brazil, Ecuador, Uruguay, and Venezuela – we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Conclusions Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them. PMID:25542227
Cottereau, Benoit R.; Ales, Justin M.; Norcia, Anthony M.
We used fMRI-informed EEG source-imaging in humans to characterize the dynamics of cortical responses during a disparity-discrimination task. After the onset of a disparity-defined target, decision-related activity was found within an extended cortical network that included several occipital regions of interest (ROIs): V4, V3A, hMT+ and the Lateral Occipital Complex (LOC). By using a response-locked analysis, we were able to determine the timing relationships in this network of ROIs relative to the subject's behavioral response. Choice-related activity appeared first in the V4 ROI almost 200 ms before the button press and then subsequently in the V3A ROI. Modeling of the responses in the V4 ROI suggests that this area provides an early contribution to disparity discrimination. Choice-related responses were also found after the button-press in ROIs V4, V3A, LOC and hMT+. Outside the visual cortex, choice-related activity was found in the frontal and temporal pole before the button-press. By combining the spatial resolution of fMRI-informed EEG source imaging with the ability to sort out neural activity occurring before, during and after the behavioral manifestation of the decision, our study is the first to assign distinct functional roles to the extra-striate ROIs involved in perceptual decisions based on disparity, the primary cue for depth. PMID:24513152
Emmett, Edward A.; Desai, Chintan
We address how information developed and effectively communicated through community based participatory research (CBPR) can reverse long-standing information disparities, empower a community, and be an agent for sustained change. Substantial information and power disparities existed between the polluted community and both the pollution industry and governmental regulators. An environmental justice partnership between a local community organization, physicians, and university performed CBPR and then developed a novel communication strategy to address a series of information disparities around a local water pollution issue. The community established a set of principles to govern the communication of results as soon as they were determined to be scientifically valid, including informing study participants and the community before other interested parties. CBPR results combined with a community-first communication strategy reversed the preexisting information disparities. The novel communication flow reversed the preferential information flow to industry and government associated with the usual scientific publication process. The community was empowered, and industry and government agencies responded positively to study recommendations. The CBPR results together with community first communication led to adoption of both community-wide and individual solutions and provided powerful motivation for behavioral change by industry and residents. PMID:21546988
McKee, Suzanne P.; Verghese, Preeti
Several studies (Vision Research 15 (1975) 583; Perception 9 (1980) 671) have shown that binocular fusion is limited by the disparity gradient (disparity/distance) separating image points, rather than by their absolute disparity values. Points separated by a gradient >1 appear diplopic. These results are sometimes interpreted as a constraint on human stereo matching, rather than a constraint on fusion. Here we have used psychophysical measurements on stereo transparency to show that human stereo matching is not constrained by a gradient of 1. We created transparent surfaces composed of many pairs of dots, in which each member of a pair was assigned a disparity equal and opposite to the disparity of the other member. For example, each pair could be composed of one dot with a crossed disparity of 6' and the other with uncrossed disparity of 6', vertically separated by a parametrically varied distance. When the vertical separation between the paired dots was small, the disparity gradient for each pair was very steep. Nevertheless, these opponent-disparity dot pairs produced a striking appearance of two transparent surfaces for disparity gradients ranging between 0.5 and 3. The apparent depth separating the two transparent planes was correctly matched to an equivalent disparity defined by two opaque surfaces. A test target presented between the two transparent planes was easily detected, indicating robust segregation of the disparities associated with the paired dots into two transparent surfaces with few mismatches in the target plane. Our simulations using the Tsai-Victor model show that the response profiles produced by scaled disparity-energy mechanisms can account for many of our results on the transparency generated by steep gradients.
Environmental Activism Revisited: The Changing Nature of Communication through Organizational Public Relations, Special Interest Groups and the Mass Media. Monographs in Environmental Education and Environmental Studies, Volume V.
Grunig, Larissa A., Ed.
The environmental movement of the 1960's and early 1970's resulted in unprecedented attention to environmental issues both in the mass media and in the scholarly literature. Interest has waned in recent years, with a concomitant erosion of coverage of what many consider enduring problems--particularly in water and air pollution and nuclear power.…
Gauchey, Samuel; Girard, Catherine; Adnet, Sylvain; Renaud, Sabrina
The shape of features involved in key biological functions, such as teeth in nutrition, can provide insights into ecological processes even in ancient time, by linking the occupation of the morphological space (disparity) to the occupation of the ecological space. Investigating disparity in radiating groups may provide insights into the ecological diversification underlying evolution of morphological diversity. Actinopterygian fishes initiated their radiation in the Devonian, a period characterized by the diversification of marine ecosystem. Although a former morpho-functional analysis of jaw shape concluded to conservative and poorly diversified morphologies in this early part of their history, fish tooth disparity evidenced here an unsuspected diversity of possible functional significance in the pivotal period of the Late Devonian (Famennian). All teeth being caniniforms, some were stocky and robust, in agreement with expectations for active generalist predators. More surprisingly, elongated teeth also occurred at the beginning of Famennian. Their needle-like shape challenges morpho-functional interpretations by making them fragile in response to bending or torsion. The occurrence of both types of fish teeth during the beginning of the Famennian points to a discrete but real increase in disparity, thus testifying a first burst of feeding specialization despite overall conservative jaw morphology. The disappearance of these needle-like teeth in the Late Famennian might have been related to a relay in dental diversity with abundant co-occurring groups, namely conodonts and chondrichthyans (sharks).
Olshansky, Ellen; Sacco, Diane; Braxter, Betty; Dodge, Pamela; Hughes, Ebony; Ondeck, Michele; Stubbs, Margaret L; Upvall, Michele J
Participatory action research (PAR) is an excellent way to systematically learn about the conditions under which people experience health disparities, what it is like from the perspective of those experiencing such disparities and, even more importantly, how to ameliorate this major public health problem and create a more equitable and effective health care system. This article describes the method of PAR, supports the appropriateness of PAR to learn about and reduce health disparities, and then presents some specific examples of research projects that have employed or are planning to employ PAR. These examples are from the work of several authors of this article, who are members of an interdisciplinary working group that serves as a forum for discussion of issues related to qualitative research methods and facilitates the development of qualitative studies. All of the authors of this article are part of a task force of this working group that is focusing specifically on community outreach with the goal of reducing health disparities within specific communities.
Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann
In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field.
This article articulates the theoretical construct of empowerment and its importance for health-enhancing strategies to reduce health disparities. Powerlessness is explored as a risk factor in the context of social determinants, such as poverty, discrimination, workplace hazards, and income inequities. Empowerment is presented and compared with social capital and community capacity as strategies to strengthen social protective factors. A case study of a youth empowerment and policy project in New Mexico illustrates the usefulness of empowerment strategies in both targeting social determinants, such as public policies which are detrimental to youth, and improving community capacities of youth to be advocates for social change. Challenges for future practice and research are articulated.
Shin, Michael S
In recent years, numerous medical studies and reports have documented startling disparities between the health status of African Americans and White Americans. The literature is replete with evidence that one of the main causes of these racial disparities is the different treatment of patients of different racial groups. This Comment addresses the possibility that implicit cognitive bias, in the form of implicit attitudes and stereotypes, significantly contributes to these racial disparities in medical treatment. Finding existing legal frameworks inadequate to address current disparities in health care, this Comment recommends avenues for the reworking of Title VI of the Civil Rights Act of 1964. Specifically, it suggests that disparate-treatment provisions that encompass claims arising from unintentional discrimination should be incorporated into Title VI, and it offers the employment law frameworks of Title VII and the Age Discrimination in Employment Act as models for such reform.
Canino, Glorisa; McQuaid, Elizabeth L.; Alvarez, Maria; Colon, Angel; Esteban, Cynthia; Febo, Vivian; Klein, Robert B.; Mitchell, Daphne Koinis; Kopel, Sheryl J.; Montealegre, Federico; Ortega, Alexander N.; Rodriguez-Santana, Jose; Seifer, Ronald; Fritz, Gregory K.
Summary Background Epidemiologic studies have documented higher rates of asthma prevalence and morbidity in minority children compared to non-Latino white (NLW) children. Few studies focus on the mechanisms involved in explaining this disparity, and fewer still on the methodological challenges involved in rigorous disparities research. Objectives and Methods This article provides an overview of challenges and potential solutions to research design for studies of health disparities. The methodological issues described in this article were framed on an empirical model of asthma health disparities that views disparities as resulting from several factors related to the healthcare system and the individual/community system. The methods used in the Rhode Island–Puerto Rico Asthma Center are provided as examples, illustrating the challenges in executing disparities research. Results Several methods are described: distinguishing ethnic/racial differences from methodological artifacts, identifying and adapting culturally sensitive measures to explain disparities, and addressing the challenges involved in determining asthma and its severity in Latino and other minority children. The measures employed are framed within each of the components of the conceptual model presented. Conclusions Understanding ethnic and/or cultural disparities in asthma morbidity is a complicated process. Methodologic approaches to studying the problem must reflect this complexity, allowing us to move from documenting disparities to understanding them, and ultimately to reducing them. PMID:19658111
Howell, Elizabeth A; Zeitlin, Jennifer
Growing attention is being paid to obstetric quality of care as patients are pressing the health care system to measure and improve quality. There is also an increasing recognition of persistent racial and ethnic disparities prevalent in obstetric outcomes. Yet few studies have linked obstetric quality of care with racial and ethnic disparities. This article reviews definitions of quality of care, health disparities, and health equity as they relate to obstetric care and outcomes; describes current efforts and challenges in obstetric quality measurement; and proposes 3 steps in an effort to develop, track, and improve quality and reduce disparities in obstetrics.
Weiman, Carl F. R.
Discrete Gabor filters proposed for use in determining binocular disparity - difference between positions of same feature or object depicted in stereoscopic images produced by two side-by-side cameras aimed in parallel. Magnitude of binocular disparity used to estimate distance from cameras to feature or object. In one potential application, cameras charge-coupled-device video cameras in robotic vision system, and binocular disparities and distance estimates used as control inputs - for example, to control approaches to objects manipulated or to maintain safe distances from obstacles. Binocular disparities determined from phases of discretized Gabor transforms.
Dykes, Daryll C; White, Augustus A
The 2001 Institute of Medicine report entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care pointed out extensive healthcare disparities in the United States even when controlling for disease severity, socioeconomic status, education, and access. The literature identifies several groups of Americans who receive disparate healthcare: ethnic minorities, women, children, the elderly, the handicapped, the poor, prisoners, lesbians, gays, and the transgender population. Disparate healthcare represents an enormous current challenge with substantial moral, ethical, political, public health, public policy, and economic implications, all of which are likely to worsen over the next several decades without immediate and comprehensive action. A review of recent literature reveals over 100 general and specific suggestions and solutions to eliminate healthcare disparities. While healthcare disparities have roots in multiple sources, racial stereotypes and biases remain a major contributing factor and are prototypical of biases based on age, physical handicap, socioeconomic status, religion, sexual orientation or other differences. Given that such disparities have a strong basis in racial biases, and that the principles of racism are similar to those of other "isms", we summarize the current state of healthcare disparities, the goals of their eradication, and the various potential solutions from a conceptual model of racism affecting patients (internalized racism), caregivers (personally mediated racism), and society (institutionalized racism).
Maguire-Jack, Kathryn; Lanier, Paul; Johnson-Motoyama, Michelle; Welch, Hannah; Dineen, Michael
There are documented disparities in the rates at which black children come into contact with the child welfare system in the United States compared to white children. A great deal of research has proliferated aimed at understanding whether systematic biases or differential rates of risk among different groups drive these disparities (Drake et al., 2011). In the current study, county rates of maltreatment disparity are compared across the United States and examined in relation to rates of poverty disparity as well as population density. Specifically, using hierarchical linear modeling with a spatially lagged dependent variable, the current study examined data from the National Child Abuse and Neglect Data System (NCANDS) and found that poverty disparities were associated with rates of maltreatment disparities, and densely populated metropolitan counties tended to have the greatest levels of maltreatment disparity for both black and Hispanic children. A significant curvilinear relationship was also observed between these variables, such that in addition to the most densely populated counties, the most sparsely populated counties also tended to have higher rates of maltreatment disparity for black and Hispanic children.
Young British adults (n=47) identified situations for which they needed basic skills and barriers to skill development: low self-confidence, negative learning attitudes, peer pressure, cost, and scheduling. Results suggested the importance of grounding basic skills in everyday contexts; offering accessible classes, small groups, and individual…
Quintana, Stephen M.; Mahgoub, Lana
We review the scope and sources of ethnic and racial disparities in education with a focus on the the implications of psychological theory and research for understanding and redressing these disparities. We identify 3 sources of ethnic and racial disparities including (a) social class differences, (b) differential treatment based on ethnic and…
Awosogba, Temitope; Betancourt, Joseph R.; Conyers, F. Garrett; Estapé, Estela S.; Francois, Fritz; Gard, Sabrina J.; Kaufman, Arthur; Lunn, Mitchell R.; Nivet, Marc A.; Oppenheim, Joel D.; Pomeroy, Claire; Yeung, Howa
Despite yearly advances in life-saving and preventive medicine, as well as strategic approaches by governmental and social agencies and groups, significant disparities remain in health, health quality, and access to health care within the United States. The determinants of these disparities include baseline health status, race and ethnicity, culture, gender identity and expression, socioeconomic status, region or geography, sexual orientation, and age. In order to renew the commitment of the medical community to address health disparities, particularly at the medical school level, we must remind ourselves of the roles of doctors and medical schools as the gatekeepers and the value setters for medicine. Within those roles are responsibilities toward the social mission of working to eliminate health disparities. This effort will require partnerships with communities as well as with academic centers to actively develop and to implement diversity and inclusion strategies. Besides improving the diversity of trainees in the pipeline, access to health care can be improved, and awareness can be raised regarding population-based health inequalities. PMID:23659676
Schmitt, Michael T.; Wirth, James H.
Numerous studies have found that, compared to women, men express higher levels of social dominance orientation (SDO), an individual difference variable reflecting support for unequal, hierarchical relationships between groups. Recent research suggests that the often-observed gender difference in SDO results from processes related to gender group…
Hudson, R L; Gerakines, P A; Loeffler, M J
New measurements are reported on the weak ν1 and ν2 fundamentals of frozen CH4, a solid of considerable astrochemical interest. Infrared spectra in the ν1 and ν2 regions are presented for three CH4-ice phases at 10-30 K with new absorption coefficients and band strengths to quantify the results. In contrast to the situation with the two crystalline phases of CH4, both ν1 and ν2 were seen clearly in methane's amorphous phase. To support our CH4 work, we also present new results for NH4SH, a component of Jupiter's atmosphere, showing that the ν2 vibration of NH4(+) undergoes a dramatic loss of intensity during an amorphous-to-crystalline phase transition, but is regenerated in equally-dramatic fashion by radiation-induced amorphization of the sample. Results are compared to work recently published in this journal and elsewhere.
Association for Education in Journalism and Mass Communication.
The Religion and Media Interest Group section of the proceedings contains the following nine papers: "The Effect of Age and Background of Religious Broadcasting Executives on Digital Television Implementation" (Brad Schultz); "Environmental Reporting, Religion Reporting, and the Question of Advocacy" (Rick Clifton Moore);…
Arts and Learning Research, 1992-1993. The Journal of the Arts and Learning Special Interest Group of the American Educational Research Association (San Francisco, California, April 1992; Atlanta, Georgia, April 1993).
Blair, Lorrie, Ed.; Morbey, Mary Leigh, Ed.
The research papers gathered in this volume were presented at the 1992 and 1993 meetings of the American Educational Research Association most were part of the Arts and Learning Special Interest Group programs. Papers focus on the following themes: assessing student learning; women's movement in art education; and art education in various…
The Science Communication Interest Group Division of the proceedings contains the following 7 papers: "Forecasting the Future: How Television Weathercasters' Attitudes and Beliefs about Climate Change Affect Their Cognitive Knowledge on the Science" (Kris Wilson); "The Web and E-Mail in Science Communication: Results of In-Depth…
Association for Education in Journalism and Mass Communication.
The Religion and Media Interest Group section of the proceedings contains the following 4 selected papers: "'Where All Things Are Pure and of Good Report': The Doctrinal Theology, Religious Practice, and Media Manipulation of the Christian Science Church" (Douglas J. Swanson); "Religion and Topoi in the News: An Analysis of the…
Association for Education in Journalism and Mass Communication.
The Religion and Media Interest Group section of the Proceedings contains the following 4 papers: "Not Alone in a Crowd: Religion, Media and Community Connectedness at the Dawn of the Twenty-First Century" (Michael A. Longinow); "Hollywood's God: The Problem of Divine Providence" (Jeffery A. Smith); "The Press and the…
The Science Communication Interest Group of the proceedings contains the following 7 papers: "Risk Perceptions and Food Safety: A Test of the Psychometric Paradigm" (Joye C. Gordon); "An Entertainment-Education Video as a Tool to Influence Mammography Compliance Behavior in Latinas" (Gail D. Love); "Promise or Peril: How…
Diket, Read M., Ed.; Klein, Sheri R., Ed.
The papers gathered in this volume were presented at the 1996 meeting of the American Educational Research Association, mostly at programs of the Arts and Learning Special Interest Group. Papers in the volume focus on research in the arts in the areas of profiles of learning and assessment (section 1), community-based art education (section 2),…
Kirk, David S
This study assesses the role of social context in explaining racial and ethnic disparities in arrest, with afocus on how distinct neighborhood contexts in which different racial and ethnic groups reside explain variations in criminal outcomes. To do so, I utilize a multilevel, longitudinal research design, combining individual-level data with contextual data from the Project on Human Development in Chicago Neighborhoods (PHDCN). Findings reveal that black youths face multiple layers of disadvantage relative to other racial and ethnic groups, and these layers work to create differences in arrest. At the family level, results show that disadvantages in the form of unstable family structures explain much of the disparities in arrest across race and ethnicity. At the neighborhood level, black youths tend to reside in areas with both significantly higher levels of concentrated poverty than other youths as well as lower levels of collective efficacy than white youths. Variations in neighborhood tolerance of deviance across groups explain little of the arrest disparities, yet tolerance of deviance does influence the frequency with which a crime ultimately ends in an arrest. Even after accounting for relevant demographic, family, and neighborhood-level predictors, substantial residual arrest differences remain between black youths and youths of other racial and ethnic groups.
BENNETT, WILLIAM S., JR.
THE RELATIONSHIP BETWEEN THE CLASSES OF COGNITIVE PHENOMENA WAS INVESTIGATED, I.E., THE MOTIVATIONAL STRUCTURE AND THE DEGREE OF PERCEIVED ROLE DISPARITY OF TEACHERS. ONE ELEMENT OF MOTIVATION, CALLED "ORIENTATION FOR CHANGE," WAS RELATED TO DIFFERENT TYPES OF ROLE DISPARITY, INCLUDING "OPTIMISM" OR THE EXTENT IN WHICH THE…
Kashyap, Meghana V; Nolan, Michael; Sprouse, Marc; Chakraborty, Ranajit; Cross, Deanna; Roby, Rhonda; Vishwanatha, Jamboor K
The Texas Center for Health Disparities, a National Institute on Minority Health and Health Disparities Center of Excellence, presents an annual conference to discuss prevention, awareness education, and ongoing research about health disparities both in Texas and among the national population. The 2014 Annual Texas Conference on Health Disparities brought together experts in research, patient care, and community outreach on the “Role of Genomics in Eliminating Health Disparities.” Rapid advances in genomics and pharmacogenomics are leading the field of medicine to use genetics and genetic risk to build personalized or individualized medicine strategies. We are at a critical juncture of ensuring such rapid advances benefit diverse populations. Relatively few forums have been organized around the theme of the role of genomics in eliminating health disparities. The conference consisted of three sessions addressing “Gene-Environment Interactions and Health Disparities,” “Personalized Medicine and Elimination of Health Disparities,” and “Ethics and Public Policy in the Genomic Era.” This article summarizes the basic science, clinical correlates, and public health data presented by the speakers. PMID:26435701
The author documents pervasive racial disparities in the health of American children and analyzes how and how much those disparities contribute to racial gaps in school readiness. She explores a broad sample of health problems common to U.S. children, such as attention deficit hyperactivity disorder, asthma, and lead poisoning, as well as maternal…
Johnson, Erik P.; Clark, Sonja; Donald, Matthew; Pedersen, Rachel; Pichotta, Catherine
Minnesota has been recognized by several studies as a state with a significant amount of racial disparity in its child protection system. This study, using 2001 data from Minnesota's Social Services Information Service, was conducted to determine at which of the six decision points in Minnesota's child welfare system racial disparities are…
Crutchfield, Robert D.; Haggerty, Kevin P.; McGlynn, Anne; Catalano, Richard F.
Criminologists agree the race disparity in arrests cannot be fully explained by differences in criminal behavior. We examine social environment factors that may lead to racial differences in police contact in early adolescence, including family, peers, school, and community. Data are from 331 8th-grade students. Blacks were almost twice as likely as Whites to report a police contact. Blacks reported more property crime but not more violent crime than Whites. Police contacts were increased by having a parent who had been arrested, a sibling involved in criminal activity, higher observed reward for negative behavior, having school disciplinary actions, and knowing adults who engaged in substance abuse or criminal behavior. Race differences in police contacts were partially attributable to more school discipline. PMID:24363956
Hulsey, C Darrin; Wainwright, Peter C
In no group of organisms has the link between species richness, morphological disparity, disparity in mechanics and functional or ecological diversification been made explicit. As a step towards integrating these measures of diversity, we examine how the mechanics of the anterior-jaw four-bar linkages of 104 species of Great Barrier Reef (GBR) labrid fishes maps into a scale-independent morphospace. As predicted from theory, no relationship exists between overall size and the mechanics of velocity and force transmission in labrid anterior-jaw linkages. Nonetheless, mechanics associated with the anterior jaw appear to have constrained diversification of labrid anterior-jaw morphology. Furthermore, simulations depict a generally nonlinear relationship between the length of individual links and transmission of motion. In addition, no relationship was found between morphological disparity and mechanical disparity among the most species-rich labrid groups from the GBR. It is also established that regions of morphospace equivalent in morphological disparity differ over nearly an order of magnitude in mechanical disparity. These results illustrate that without an explicit interpretation of the consequences of per unit change in morphology, conclusions about diversification drawn only from morphological disparity may be misleading. PMID:11839201
Broadbent, Talmage; Bingham, Brian; Mawn, Louise A
Cutaneous malignancies make up the majority of periocular tumors diagnosed and treated by ophthalmologists. In this review, we examine literature regarding ethnic and socioeconomic disparities in incidence and clinical outcomes of the three most common cutaneous periocular tumors: basal cell carcinoma, squamous cell carcinoma, and melanoma. In all three tumor types, the literature shows an increased incidence among two groups: those with lightly pigmented skin and those of higher socioeconomic status. While incidence is high in these groups, clinical outcomes for these patients tend to be good. Those with lower socioeconomic status and ethnic minorities, on the other hand, have a low incidence but are more likely to have poor clinical outcomes. These disparities are likely the result of both biologic and behavioral differences between patients and could provide opportunities for intervention to change risk perception and improve outcomes.
Momeni Moghadam, Hamed; A Goss, David; Yekta, Abbas A; Ehsani, Marzieh
Background Research suggests that fixation disparity data are extremely useful in the assessment of the binocular and accommodative systems. Objectives The purpose of this study was to evaluate fixation disparity curve (FDC) parameters with a modified near Mallett unit in symptomatic and asymptomatic students of Paramedical Sciences School of Mashhad University of Medical Sciences in 2007. Patients and Methods In this analytical-descriptive study, 100 students were selected randomly and divided into symptomatic and asymptomatic groups. Fixation disparity curve parameters were determined for each subject and compared in symptomatic and asymptomatic groups. Results There were more subjects with exo fixation disparity than eso fixation disparity in the study sample. The means for fixation disparity, fixation disparity curve x-intercept, and slope with the modified Mallett unit were each significantly different by Mann-Whitney U test in the symptomatic and asymptomatic groups. Also there was a significant difference in the distributions of fixation disparity curve types in the two symptom groups by Chi-square test. Conclusions The X-intercepts (point at which the FDC crosses the X-axis) were on average more in the base-in direction, Y-intercepts (point at which the FDC crosses the Y-axis) were shifted in the exo direction, and slopes were steeper in the symptomatic group. PMID:24719687
Williams, Jerome D; Crockett, David; Harrison, Robert L; Thomas, Kevin D
Marketing activities have attracted increased attention from scholars interested in racial disparities in obesity prevalence, as well as the prevalence of other preventable conditions. Although reducing the marketing of nutritionally poor foods to racial/ethnic communities would represent a significant step forward in eliminating racial disparities in health, we focus instead on a critical-related question. What is the relationship between marketing activities, food culture, and health disparities? This commentary posits that food culture shapes the demand for food and the meaning attached to particular foods, preparation styles, and eating practices, while marketing activities shape the overall environment in which food choices are made. We build on prior research that explores the socio-cultural context in which marketing efforts are perceived and interpreted. We discuss each element of the marketing mix to highlight the complex relationship between food culture, marketing activities, and health disparities.
Woolf, Steven H; Braveman, Paula
Health disparities by racial or ethnic group or by income or education are only partly explained by disparities in medical care. Inadequate education and living conditions-ranging from low income to the unhealthy characteristics of neighborhoods and communities-can harm health through complex pathways. Meaningful progress in narrowing health disparities is unlikely without addressing these root causes. Policies on education, child care, jobs, community and economic revitalization, housing, transportation, and land use bear on these root causes and have implications for health and medical spending. A shortsighted political focus on reducing spending in these areas could actually increase medical costs by magnifying disease burden and widening health disparities.
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Comparative phylogeography of the Smilax hispida group (Smilacaceae) in eastern Asia and North America--implications for allopatric speciation, causes of diversity disparity, and origins of temperate elements in Mexico.
Zhao, Yunpeng; Qi, Zhechen; Ma, Weiwei; Dai, Qiongyan; Li, Pan; Cameron, Kenneth M; Lee, Joongku; Xiang, Qiu-Yun Jenny; Fu, Chengxin
The Smilax hispida group (Smilacaceae) exhibits a discontinuous distribution in eastern Asia, eastern and western United States, and Mexico. A broad scale phylogeographic analysis was conducted for this group to evaluate the hypotheses of accelerated allopatric divergence in eastern Asia and a northern origin of the temperate elements in Mexico. Phylogeny was inferred using seven plastid and nuclear DNA sequences. Species delineation was assessed using genealogical sorting indices (GSI). Lineage divergence time, haplotype diversification rates, and ancestral distributions were estimated using Bayesian methods. Phylogeographic patterns in eastern Asia and North America were compared by analyzing 539 individuals from 64 populations to assess allopatric diversification. Results strongly supported delineation of six allopatric species, the origin of this group from a Mexican ancestor around 11.42mya, and Mexican origins of the temperate species in Mexico. Significant geographic structure of haplotypes was found in eastern Asia, and greater haplotype diversification rate was observed for the North American lineage. Our data support allopatric speciation in eastern Asia but do not find evidence of an elevated diversification rate. Greater species diversity of the study system in eastern Asia may be due to a longer evolutionary history. Our results do not support northern origins of the Mexican temperate species.
Guan, Wei; Yamabe, Shinichi; Sakaki, Shigeyoshi
Systematic DFT calculations were carried out on a series of heterodinuclear complexes [(o-(Ph2P)C6H4)3M(1)M(2)Cl](+) (M(1) = As, Sb, or Bi; M(2) = Pd or Pt) to investigate the mechanism of colorimetric sensing function for the fluoride anion. The fluoride anion binds with the M(1) center to afford a hypervalent M(1) species with large stabilization energy. For instance, the stabilization energy by the fluoride adduct formation is -15.5 kcal mol(-1) for 3 (M(1) = Sb; M(2) = Pd) and -16.2 kcal mol(-1) for 6 (M(1) = Sb; M(2) = Pt), where a negative value represents stabilization. Interestingly, the allosteric coordination of the third phosphine with the M(2) center is induced by the fluoride adduct formation. For chloride, bromide, and thiocyanide anions, the binding energies are positive (~4.5 kcal mol(-1)), and the allosteric coordination does not occur. The allosteric coordination plays a crucial role in the absorption spectrum change induced by the fluoride adduct formation. For instance, the fluoride adduct formation quenches the absorption band of 3 around 400 nm and newly exhibits two absorption peaks at longer wavelength, 475 and 451 nm. These two peaks are assigned to ligand-field transitions (d(xy)→ d(z(2)) and d(x(2)-y(2))→ d(z(2))) including metal-to-ligand charge transfer character. We discussed the reasons why the allosteric coordination can occur only in the fluoride adduct and induces these two absorptions in the longer wavelength region. In addition, the Bi-Pd combination is also recommended for a fluoride sensing material, while the Sb-Pt combination is recommended for cyanide sensing.
Ahlberg, Per Erik; Smith, Moya M; Johanson, Zerina
Although the lungfish (Dipnoi) belong within the Osteichthyes, their dentitions are radically different from other osteichthyans. Lungfish dentitions also show a uniquely high structural disparity during the early evolution of the group, partly owing to the independent variation of odontogenic and odontoclastic processes that are tightly and stereotypically coordinated in other osteichthyans. We present a phylogenetic analysis of early lungfishes incorporating a novel approach to coding these process characters in preference to the resultant adult dental morphology. The results only partially resolve the interrelationships of Devonian dipnoans, but show that the widely discussed hypothesis of separate tooth-plated, dentine-plated, and denticulated lineages is unlikely to be true. The dipnoan status of Diabolepis is corroborated. Lungfish dentitions seem to have undergone extensive and nonparsimonious evolution during the early history of the group, but much of the resulting disparity can be explained by a modest number of evolutionary steps in the underlying developmental processes, those for dental formation (odontogenic) and those for the remodeling of dentine tissue (odontoclastic). Later in lungfish evolution, this disparity was lost as the group settled to a pattern of dental development that is just as stereotypic as, but completely different from, that of other osteichthyans.
Meyer, Mary Hockenberry
Focus groups arranged by local Native American Master Gardeners on two Minnesota reservations determined community interest in extension-horticulture programs. Topics of interest included food preservation and historical Native-American uses of plants. (SK)
Zahodne, Laura B; Manly, Jennifer J; Smith, Jacqui; Seeman, Teresa; Lachman, Margie E
Racial disparities in cognitive performance exist across the life course, but it is not known whether mediators of disparities differ by age. Understanding sources of cognitive disparities at different ages can inform policies and interventions. Data were obtained for non-Hispanic Black and White respondents to The National Survey of Midlife Development in the United States from 3 age groups: 28-44 (N = 1210; 20% Black); 45-64 (N = 2693; 15% Black); and 65-85 (N = 1298; 11% Black). Moderated mediation models characterized direct and indirect effects of race on episodic memory and executive function composite scores through economic, health, and psychosocial variables as a function of age group. Education, income, chronic health conditions, and external locus of control mediated cognitive disparities across the life course, although income was a stronger mediator at younger ages. Perceived discrimination was a weaker mediator among young adults due to an absence of racial differences in perceived discrimination in that group. Despite multiple indirect effects, there were still significant unexplained effects of race on cognition that were not moderated by age group. Interventional work is needed to determine whether increasing educational attainment and income, and reducing chronic health conditions and perceived constraints among Blacks, reduce cognitive disparities. Targeting income inequality and discrimination (or buffering the impact of those variables) may be differently effective at reducing cognitive disparities at different stages of the adult life course. (PsycINFO Database Record
Sauerbrun-Cutler, May-Tal; Segars, James H
Health disparities exist in reproductive medicine as discussed in detail in the subsequent articles of this issue; however, in most cases, the exact cause of these differences is unknown. Some of these disparities can be linked to environmental exposures such as alcohol and other hazardous toxic exposures (polycarbonate, pesticides, nicotine) in adults. In addition, low socioeconomic status, behavioral risk factors, and lack of education have been linked to poor obstetric and reproductive outcomes in minority groups. Aside from these various environmental exposures later in life, there is evidence that adverse events in utero could contribute to poor reproductive outcome in specific minority groups. We will focus on the developmental origins of health and disease as a possible causal mechanism for health disparities in reproductive diseases, as this perspective may suggest tractable solutions of how to address and eliminate these health disparities.
Sims, Mario; Sims, Tammy L.; Bruce, Marino A.
This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity. PMID:17444423
Sims, Mario; Sims, Tammy L; Bruce, Marino A
This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.
In the United States, racial/ethnic disparities exist across an array of domains. A broad literature addresses how racial/ethnic disparities have developed and persisted over time in the context of historical and structural racism that has shaped policies, practices, and programs in ways that create disadvantage for certain groups. In recognition…
Maxwell, James; Tong, Jianliang; Schor, Clifton M
Main sequences, the function describing the relationship between eye movement amplitude and velocity, have been used extensively in oculomotor research as an indicator of first-order dynamics yet it is difficult to find main sequence analyses for accommodative vergence or for disparity vergence in isolation when all mitigating factors have been well controlled and there are no studies in which accommodative vergence and disparity vergence main sequences have been generated for the same group of subjects. The present study measured main sequences in: (1) accommodative vergence with disparity vergence open loop, (2) disparity vergence with accommodation open loop, and (3) combinations of accommodative and disparity vergence. A dynamic AC/A ratio was defined and was found to be similar to the traditional static AC/A ratio. Vergence acceleration was measured for all conditions. A pulse-step model of accommodation and convergence was constructed to interpret the dynamics of the crosslinked interactions between the two systems. The model supports cross-coupling of both the pulse and step components and simulates the primary empirical findings that: (1) disparity vergence has a higher main sequence slope than accommodative vergence, (2) both accommodative and disparity vergence acceleration increase with response amplitude whereas accommodation acceleration does not.
Despite an accumulating body of literature addressing racial/ethnic disparities in children’s health and health care, there have been few published studies of interventions that have been successful in eliminating these disparities. The objectives of this article, therefore, are to (1) describe 3 interventions that have been successful in eliminating racial/ethnic disparities in children’s health and health care, (2) high-light tips and pitfalls regarding devising, implementing, and evaluating pediatric disparities interventions, and (3) propose a research agenda for pediatric disparities interventions. Key characteristics of the 3 successful interventions include rigorous study designs; large sample sizes; appropriate comparison groups; community-based interventions that are culturally and linguistically sensitive and involve collaboration with participants; research staff from the same community as the participants; appropriate blinding of outcomes assessors; and statistical adjustment of outcomes for relevant covariates. On the basis of these characteristics, I propose tips, pitfalls, an approach, and a research agenda for devising, implementing, and evaluating successful pediatric disparities interventions. Examination of 3 successful interventions indicates that pediatric health care disparities can be eliminated. Achievement of this goal requires an intervention that is rigorous, evidence-based, and culturally and linguistically appropriate. The intervention must also include community collaboration, minimize attrition, adjust for potential confounders, and incorporate mechanisms for sustainability. PMID:19861473
Despite an accumulating body of literature addressing racial/ethnic disparities in children's health and health care, there have been few published studies of interventions that have been successful in eliminating these disparities. The objectives of this article, therefore, are to (1) describe 3 interventions that have been successful in eliminating racial/ethnic disparities in children's health and health care, (2) highlight tips and pitfalls regarding devising, implementing, and evaluating pediatric disparities interventions, and (3) propose a research agenda for pediatric disparities interventions. Key characteristics of the 3 successful interventions include rigorous study designs; large sample sizes; appropriate comparison groups; community-based interventions that are culturally and linguistically sensitive and involve collaboration with participants; research staff from the same community as the participants; appropriate blinding of outcomes assessors; and statistical adjustment of outcomes for relevant covariates. On the basis of these characteristics, I propose tips, pitfalls, an approach, and a research agenda for devising, implementing, and evaluating successful pediatric disparities interventions. Examination of 3 successful interventions indicates that pediatric health care disparities can be eliminated. Achievement of this goal requires an intervention that is rigorous, evidence-based, and culturally and linguistically appropriate. The intervention must also include community collaboration, minimize attrition, adjust for potential confounders, and incorporate mechanisms for sustainability.
Disparities in cancer risk exist between ethnic groups in the United States. These disparities often result from differential access to healthcare, differences in socioeconomic status and differential exposure to carcinogens. This study uses cancer incidence data from the population based Texas Cancer Registry to investigate the disparities in digestive and respiratory cancers from 2000 to 2008. A Bayesian hierarchical regression approach is used. All models are fit using the INLA method of Bayesian model estimation. Specifically, a spatially varying coefficient model of the disparity between Hispanic and Non-Hispanic incidence is used. Results suggest that a spatio-temporal heterogeneity model best accounts for the observed Hispanic disparity in cancer risk. Overall, there is a significant disadvantage for the Hispanic population of Texas with respect to both of these cancers, and this disparity varies significantly over space. The greatest disparities between Hispanics and Non-Hispanics in digestive and respiratory cancers occur in eastern Texas, with patterns emerging as early as 2000 and continuing until 2008. PMID:26421245
Cox, Raymond L
The United States spends more than the rest of the world on healthcare. In 2000, the U.S. health bill was 1.3 trillion dollars, 14.5% of its gross domestic product. Yet, according to the WHO World Health Report 2000, the United States ranked 37th of 191 member nations in overall health system performance. Racial/ethnic disparities in health outcomes are the most obvious examples of an unbalanced healthcare system. This presentation will examine health disparities in the United States and reveal how health disparities among and within countries affect the health and well-being of the African Diaspora.
Schmid, Stephan; Fritsch, Dieter
Previous work on disparity map fusion has mostly focused on geometric or statistical properties of disparity maps. Since failure of stereo algorithms is often consistent in many frames of a scene, it cannot be detected by such methods. Instead, we propose to use radiometric information from the original camera images together with externally supplied camera pose information to detect mismatches. As radiometric information is local information, the computations in the proposed algorithm for disparity fusion can be decoupled and parallelized to a very large degree, which allows us to easily achieve real-time performance.
Willis, Earnestine; McManus, Patricia; Magallanes, Norma; Johnson, Sheri; Majnik, Amber
Infant mortality rate (IMR) is a reference indicator for societal health status. Trend analysis of IMR highlights 2 challenges to overcome in the United States: (1) US IMR is higher than most industrialized countries and (2) there are persistent racial/ethnic disparities in birth outcomes, especially for blacks. Racial/ethnic infant mortality disparities result from the complex interplay of adverse social, economic, and environmental exposures. In this article, racial/ethnic disparities are discussed, highlighting trends, the role of epigenetics in understanding mechanisms, key domains of community action planning, and programs and policies addressing the racial gaps in adverse birth outcomes.
Baptiste-Roberts, Kesha; Oranuba, Ebele; Werts, Niya; Edwards, Lorece V
There is evidence of health disparities between sexual minority and heterosexual populations. Although the focus of lesbian, gay, bisexual, and transgender health research has been human immunodeficiency virus/acquired immunodeficiency syndrome and sexually transmitted infection among men who have sex with men, there are health disparities among sexual minority women. Using the minority stress framework, these disparities may in part be caused by individual prejudice, social stigma, and discrimination. To ensure equitable health for all, there is urgent need for targeted culturally sensitive health promotion, cultural sensitivity training for health care providers, and intervention-focused research.
Adamack, Monica; Rush, Kathy L
The purpose of this qualitative study was to understand multiple stakeholder perspectives of new graduate (NG) transition programs. It was part of a larger mixed-methods study (2011) designed to provide a comprehensive assessment of new graduate nurse transition best practices, across six British Columbia health authorities. Data collection involved individual interviews with academic nurse educators (n=4) and separate focus groups with new graduate (n=48) and front-line nurse leaders (n=69). Disparity emerged as the overriding theme and described differences between stakeholder group perspectives, between expectations and reality, and within and across programs. Four disparities emerged: entry-level education and practice, perspectives on employment and career planning, transition program elements and support. Despite general satisfaction with undergraduate preparation, theory-practice gaps were identified. New Graduates experienced misalignments between their employment expectations and their realities. The employed student nurse program in which many new graduates had participated did not always yield employment, but when it did, differences in transitional expectations arose between new graduates and leaders. There was considerable variation across and within provincial new graduate programs with respect to orientation, supernumerary time and preceptorship characteristics, including lack of training. Disparities arose in the nature, amount of and access to support and the monitoring of new graduate progress. Findings reinforced organizational complexities and the importance of communication across education and practice sectors. This paper uncovers the tensions between the perspectives of new graduates and nurse leaders about transitional programs and opens the opportunity to collaborate in aligning the perspectives.
McGinnis, Kara; Montiel-Ishino, F Alejandro; Standifer, Maisha Kambon; Wathington, Deanna; Goldsmith, Johnetta; Baldwin, Julie A
Medically underserved and underrepresented communities have high rates of health disparities. In the greater Tampa Bay area, communities of color are disproportionately affected by chronic diseases such as cancer. In response to these concerns and as part of a lay health advisory program being implemented by the Center for Equal Health, a University of South Florida/H. Lee Moffitt Cancer Center & Research Institute partnership, our group created a photonovel, an educational tool which explains topics using a graphic novel style. The photonovel was designed to educate community members about prostate cancer and was compared to standard cancer educational materials currently used for cancer outreach. We found that our photonovel served as an effective health education tool to address cancer health disparities in medically underserved and underrepresented populations in Tampa Bay.
Walker, Deborah Klein; Correa-De-Araujo, Rosaly
Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness. PMID:25689212
Chin, Marshall H
Deep-rooted structural problems drive health care disparities. Compounding the difficulty of attaining health equity, solutions in clinics and hospitals require the cooperation of clinicians, administrators, patients, and the community. Recent protests over police brutality and racism on campuses across America have opened fresh wounds over how best to end racism, with lessons for achieving health equity. Movement advocacy, the mobilizing of the people to raise awareness of an injustice and to advocate for reform, can break down ingrained structural barriers and policies that impede health equity. However, simultaneously advocates, clinicians, and health care organizations must build trusting relationships and resolve conflict with mutual respect and honesty. Tension is inherent in discussions about racial and ethnic disparities. Yet, tension can be constructive if it forces self-examination and spurs systems change and personal growth. We must simultaneously advocate for policy reform, build personal relationships across diverse groups, and honestly examine our biases.
Burke, J P
Distance-near disparity esotropias are a group of heterogenous usually acquired strabismus disorders, where the angle of misalignment at near exceeds that at distance by 10 prism diopters or more, where the accurate correction of refractive errors and ambylopia are important early objectives. These aetiologically diverse entities respond non-uniformally to strabismus surgery and bifocals. The management challenge is one of 'shrinking' the disparity so that the affected individuals can develop and comfortably maintain binocular single vision and/or optimal alignment. Surgical procedures have continued to evolve but none of the current operative procedures are superior for all patients. Subclassifying this strabismus and highlighting publication data from more homogenous clinical series may assist with the optimisation of future management and treatment outcomes.
Krahn, Gloria L; Walker, Deborah Klein; Correa-De-Araujo, Rosaly
Disability is an emerging field within public health; people with significant disabilities account for more than 12% of the US population. Disparity status for this group would allow federal and state governments to actively work to reduce inequities. We summarize the evidence and recommend that observed differences are sufficient to meet the criteria for health disparities: population-level differences in health outcomes that are related to a history of wide-ranging disadvantages, which are avoidable and not primarily caused by the underlying disability. We recommend future research and policy directions to address health inequities for individuals with disabilities; these include improved access to health care and human services, increased data to support decision-making, strengthened health and human services workforce capacity, explicit inclusion of disability in public health programs, and increased emergency preparedness.
... Causes of Death Among American Indians and Alaska Natives African American Women and Mass Media Campaign Partners Related Links Stay Informed Cancer Home Basic Information About Health Disparities in Cancer Language: English Español (Spanish) Recommend ...
The National Cancer Institute has targeted the reduction of cancer-related health disparities, differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions, as an important challenge.
Lie, Celia; Alsop, Brent
The present experiment examined the effects of varying stimulus disparity and relative punisher frequencies on signal detection by humans. Participants were placed into one of two groups. Group 3 participants were presented with 1:3 and 3:1 punisher frequency ratios, while Group 11 participants were presented with 1:11 and 11:1 punisher frequency…
Black, Dan A.; Haviland, Amelia; Sanders, Seth G.; Taylor, Lowell J.
In the U.S. college-educated women earn approximately 30 percent less than their non-Hispanic white male counterparts. We conduct an empirical examination of this wage disparity for four groups of women—non-Hispanic white, black, Hispanic, and Asian—using the National Survey of College Graduates, a large data set that provides unusually detailed information on higher-level education. Nonparametric matching analysis indicates that among men and women who speak English at home, between 44 and 73 percent of the gender wage gaps are accounted for by such pre-market factors as highest degree and major. When we restrict attention further to women who have “high labor force attachment” (i.e., work experience that is similar to male comparables) we account for 54 to 99 percent of gender wage gaps. Our nonparametric approach differs from familiar regression-based decompositions, so for the sake of comparison we conduct parametric analyses as well. Inferences drawn from these latter decompositions can be quite misleading. PMID:26097255
Bates, K. T.; Schachner, E. R.
This study aims to investigate functional disparity in the locomotor apparatus of bipedal archosaurs. We use reconstructions of hindlimb myology of extant and extinct archosaurs to generate musculoskeletal biomechanical models to test hypothesized convergence between bipedal crocodile-line archosaurs and dinosaurs. Quantitative comparison of muscle leverage supports the inference that bipedal crocodile-line archosaurs and non-avian theropods had highly convergent hindlimb myology, suggesting similar muscular mechanics and neuromuscular control of locomotion. While these groups independently evolved similar musculoskeletal solutions to the challenges of parasagittally erect bipedalism, differences also clearly exist, particularly the distinct hip and crurotarsal ankle morphology characteristic of many pseudosuchian archosaurs. Furthermore, comparative analyses of muscle design in extant archosaurs reveal that muscular parameters such as size and architecture are more highly adapted or optimized for habitual locomotion than moment arms. The importance of these aspects of muscle design, which are not directly retrievable from fossils, warns against over-extrapolating the functional significance of anatomical convergences. Nevertheless, links identified between posture, muscle moments and neural control in archosaur locomotion suggest that functional interpretations of osteological changes in limb anatomy traditionally linked to postural evolution in Late Triassic archosaurs could be constrained through musculoskeletal modelling. PMID:22112652
Florida Department of Corrections (FDOC) as a model for elucidating the genetic, epigenetic , and socio-environmental etiologies of prostate cancer . 9 | P...TITLE: Prostate Cancer Disparities in an Incarcerated Community PRINCIPAL INVESTIGATOR: Meghan E. Borysova, Ph.D...1 Sep 2011 - 31 Aug 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Prostate Cancer Disparities in an Incarcerated Community 5b. GRANT NUMBER
Harper, Sam; Lynch, John; Meersman, Stephen C; Breen, Nancy; Davis, William W; Reichman, Marsha E
The authors provide an overview of methods for summarizing social disparities in health using the example of lung cancer. They apply four measures of relative disparity and three measures of absolute disparity to trends in US lung cancer incidence by area-socioeconomic position and race-ethnicity from 1992 to 2004. Among females, measures of absolute and relative disparity suggested that area-socioeconomic and race-ethnic disparities increased over these 12 years but differed widely with respect to the magnitude of the change. Among males, the authors found substantial disagreement among summary measures of relative disparity with respect to the magnitude and the direction of change in disparities. Among area-socioeconomic groups, the index of disparity increased by 47% and the relative concentration index decreased by 116%, while for race-ethnicity the index of disparity increased by 36% and the Theil index increased by 13%. The choice of a summary measure of disparity may affect the interpretation of changes in health disparities. Important issues to consider are the reference point from which differences are measured, whether to measure disparity on the absolute or relative scale, and whether to weight disparity measures by population size. A suite of indicators is needed to provide a clear picture of health disparity change.
Nesbitt, Shawna; Palomarez, Rigo Estevan
The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient’s cultural background to promote healthy behaviors PMID:27103768
Lewis, Kristina H; Edwards-Hampton, Shenelle A; Ard, Jamy D
There are clear and persistent disparities in obesity prevalence within the USA. Some of these disparities fall along racial/ethnic lines; however, there are a number of other social and demographic constructs where obesity disparities are present. In addition to differing rates of obesity across groups, there is growing evidence that subgroups of patients both seek out and respond to obesity treatment differently. This review article explores the epidemiology of obesity disparities, as well as the existing evidence around how different groups may respond to behavioral, medical, and surgical therapies, and potential reasons for differential uptake and response, from culture, to access, to physiology. We find that the vast majority of evidence in this area has focused on the observation that African Americans tend to lose less weight in clinical trials compared to non-Hispanic whites and mainly pertains to behavioral interventions. Moving forward, there will be a need for studies that broaden the notion of health disparity beyond just comparing African Americans and non-Hispanic whites. Additionally, a more thorough examination of the potential for disparate outcomes after medical and surgical treatments of obesity is needed, coupled with the careful study of possible physiologic drivers of differential treatment response.
Lau, May; Lin, Hua; Flores, Glenn
Objective To examine racial/ethnic disparities in medical and oral health status, access to care, and use of services in U.S. adolescents. Data Source Secondary data analysis of the 2003 National Survey of Children's Health. The survey focus was children 0–17 years old. Study Design Bivariate and multivariable analyses were conducted for white, African American, Latino, Asian/Pacific Islander, American Indian/Alaskan Native, and multiracial adolescents 10–17 years old (n = 48,742) to identify disparities in 40 measures of health and health care. Principal Findings Certain disparities were especially marked for specific racial/ethnic groups and multiracial youth. These disparities included suboptimal health status and lack of a personal doctor or nurse for Latinos; suboptimal oral health and not receiving all needed medications in the past year for African Americans; no physician visit or mental health care in the past year for Asian/Pacific Islanders; overweight/obesity, uninsurance, problems getting specialty care, and no routine preventive visit in the past year for American Indian/Alaska Natives; and not receiving all needed dental care in multiracial youth. Conclusions U.S. adolescents experience many racial/ethnic disparities in health and health care. These findings indicate a need for ongoing identification and monitoring of and interventions for disparities for all five major racial/ethnic groups and multiracial adolescents. PMID:22417169
LaVeist, Thomas; Pollack, Keshia; Thorpe, Roland; Fesahazion, Ruth; Gaskin, Darrell
Much of the current health disparities literature fails to account for the fact that the nation is largely segregated, leaving racial groups exposed to different health risks and with variable access to health services based on where they live. We sought to determine if racial health disparities typically reported in national studies remain the same when black and white Americans live in integrated settings. Focusing on a racially integrated, low-income neighborhood of Southwest Baltimore, Maryland, we found that nationally reported disparities in hypertension, diabetes, obesity among women, and use of health services either vanished or substantially narrowed. The sole exception was smoking: We found that white residents were more likely than black residents to smoke, underscoring the higher rates of ill health in whites in the Baltimore sample than seen in national data. As a result, we concluded that racial differences in social environments explain a meaningful portion of disparities typically found in national data. We further concluded that when social factors are equalized, racial disparities are minimized. Policies aimed solely at health behavior change, biological differences among racial groups, or increased access to health care are limited in their ability to close racial disparities in health. Such policies must address the differing resources of neighborhoods and must aim to improve the underlying conditions of health for all.
Nesbitt, Shawna; Palomarez, Rigo Estevan
The focus of this review is to highlight health care disparities and trends in several common diseases in selected populations while offering evidence-based approaches to mitigating health care disparities. Health care disparities cross many barriers and affect multiple populations and diseases. Ethnic minorities, the elderly, and those of lower socioeconomic status (SES) are more at-risk than others. However, many low SES Whites and higher SES racial minorities have poorer health than their racial or SES peers. Also, recent immigrant groups and Hispanics, in particular, maintain high health ratings. The so-called Hispanic Paradox provides an example of how culture and social background can be used to improve health outcomes. These groups have unique determinants of disparity that are based on a wide range of cultural and societal factors. Providing improved access to care and reducing the social determinants of disparity is crucial to improving public health. At the same time, for providers, increasing an understanding of the social determinants promotes better models of individualized care to encourage more equitable care. These approaches include increasing provider education on disparities encountered by different populations, practicing active listening skills, and utilizing a patient's cultural background to promote healthy behaviors.
Mensah, George A.
This inaugural memorial lecture provides an opportunity to celebrate the life of Elijah B. Saunders, MD, FACC and pays tribute to his pioneering spirit in the quest to advance health equity in the prevention and control of hypertension and cardiovascular diseases. It also enables an assessment of the state of the global burden of hypertension and related disparities. Despite the remarkable biomedical research progress made over the last half-century, hypertension remains the leading risk factor for global disease burden and the major preventable contributor to cardiovascular and all-cause mortality. Additionally, disparities in hypertension-related morbidity and mortality remain pervasive worldwide. National hypertension control rates showing progress often mask important suboptimal treatment and control in population groups defined by sex, race, ethnicity, geography, and social and environmental determinants. Within these groups, many hypertension-related disparities remain largely unchanged while other gaps have widened. In essence, current research has been relatively ineffective in guiding large-scale, sustained elimination of hypertension-related disparities. An important explanation for these observations may be the significant advances made in observational epidemiological research, especially in improved surveillance and data collection that document the extent of disparities in marked contrast to the relative paucity of interventional disparities research. The paucity of these interventional research studies remains a continuing challenge. The time has come for renewed efforts in building strategic partnerships that leverage transdisciplinary, multi-sectoral expertise to provide global leadership in interventional implementation research for hypertension control and elimination of related disparities. Developing an appropriately skilled implementation research workforce will be crucial. The National Heart, Lung, and Blood Institute and its biomedical
Wallington, Sherrie Flynt; Blake, Kelly D; Taylor-Clark, Kalahn; Viswanath, K
News coverage of health topics influences knowledge, attitudes, and behaviors at the individual level, and agendas and actions at the institutional and policy levels. Because disparities in health often are the result of social inequalities that require community-level or policy-level solutions, news stories employing a health disparities news frame may contribute to agenda-setting among opinion leaders and policymakers and lead to policy efforts aimed at reducing health disparities. This study objective was to conduct an exploratory analysis to qualitatively describe barriers that health journalists face when covering health disparities in local media. Between June and October 2007, 18 journalists from television, print, and radio in Boston, Lawrence, and Worcester, Massachusetts, were recruited using a purposive sampling technique. In-depth, semi-structured interviews were conducted by telephone, and the crystallization/immersion method was used to conduct a qualitative analysis of interview transcripts. Our results revealed that journalists said that they consider several angles when developing health stories, including public impact and personal behavior change. Challenges to employing a health disparities frame included inability to translate how research findings may impact different socioeconomic groups, and difficulty understanding how findings may translate across racial/ethnic groups. Several journalists reported that disparities-focused stories are "less palatable" for some audiences. This exploratory study offers insights into the challenges that local news media face in using health disparities news frames in their routine coverage of health news. Public health practitioners may use these findings to inform communication efforts with local media in order to advance the public dialogue about health disparities.
Background In a cancer cell the number of copies of a locus may vary due to amplification and deletion and these variations are denoted as copy number alterations (CNAs). We focus on the disparity of CNAs in tumour samples, which were compared to those in blood in order to identify the directional loss of heterozygosity. Methods We propose a numerical algorithm and apply it to data from the Illumina 109K-SNP array on 112 samples from breast cancer patients. B-allele frequency (BAF) and log R ratio (LRR) of Illumina were used to estimate Euclidian distances. For each locus, we compared genotypes in blood and tumour for subset of samples being heterozygous in blood. We identified loci showing preferential disparity from heterozygous toward either the A/B-allele homozygous (allelic disparity). The chi-squared and Cochran-Armitage trend tests were used to examine whether there is an association between high levels of disparity in single nucleotide polymorphisms (SNPs) and molecular, clinical and tumour-related parameters. To identify pathways and network functions over-represented within the resulting gene sets, we used Ingenuity Pathway Analysis (IPA). Results To identify loci with a high level of disparity, we selected SNPs 1) with a substantial degree of disparity and 2) with substantial frequency (at least 50% of the samples heterozygous for the respective locus). We report the overall difference in disparity in high-grade tumours compared to low-grade tumours (p-value < 0.001) and significant associations between disparity in multiple single loci and clinical parameters. The most significantly associated network functions within the genes represented in the loci of disparity were identified, including lipid metabolism, small-molecule biochemistry, and nervous system development and function. No evidence for over-representation of directional disparity in a list of stem cell genes was obtained, however genes appeared to be more often altered by deletion than by
Kegler, Michelle C.; Hall, Sarah M.; Kiser, Mimi
Interest in partnering with faith-based organizations (FBOs) to address health disparities has grown in recent years. Yet relatively little is known about these types of partnerships. As part of an evaluation of the Institute for Faith and Public Health Collaborations, representatives of 34 faith--health teams (n = 61) completed semi-structured…
Moore, Rachael; Reitner, Joachim; Braiser, Martin; Donoghue, Phil; Schirrmeister, Bettina
Prokaryotes have dominated life on Earth for over 2 billion years. Throughout the Precambrian, prokaryotes acted as the major biological impetus for both large and small scale environmental changes. Yet, very little is known about the composition, diversity and evolution of ancient microbial communities due to poor preservation during the Precambrian period. Previous studies of fossils that date to this period relied mainly on light microscopy to identify microfossil morphology and abundance, with limited success. Here we present novel analyses of the microbial remains found in Precambrian stromatolites using Synchrotron Radiation x-Ray Tomographic Microscopy (SRXTM). Microfossils found in samples of three Precambrian deposits, 3.45 Ga Strelley Pool, Australia, 2.1 Ga Gunflint Chert, Canada, and 650 Ma Rasthof Cap Carbonate, Namibia, have been reconstructed in 3D. Based on four scans from each sample, we estimated size and abundance of spheroidal microfossils within those deposits. Our findings show that while cell abundance decreased towards the end of the Precambrian, the biovolume of microfossils within the host rock remained relatively constant. Additionally, both size and disparity increase through time. Constant biovolumes and yet different sizes for these three deposits, point towards a negative correlation of large cell size and cell abundance. This negative correlation indicates that the systems in which these prokaryotes lived may have been biolimited. Both, gas exchange and nutrient uptake in prokaryotes function via diffusion. Therefore, one would expect bacteria to evolve towards an increasing surface to volume ratio. Increased cell sizes, and hence decreased overall surface to volume ratio observed in our data, suggest the influence of other selective factors. Decreased abundance and increased cell size could potentially be associated to changes in nutrient availability and the occurrence of predation. As cells increased in size, more nutrients would
Freeman, Michele; Toure, Joahd; Tippens, Kimberly M.; Weeks, Christine; Ibrahim, Said
Objectives To better understand the causes of racial disparities in health care, we reviewed and synthesized existing evidence related to disparities in the “equal access” Veterans Affairs (VA) health care system. Methods We systematically reviewed and synthesized evidence from studies comparing health care utilization and quality by race within the VA. Results Racial disparities in the VA exist across a wide range of clinical areas and service types. Disparities appear most prevalent for medication adherence and surgery and other invasive procedures, processes that are likely to be affected by the quantity and quality of patient–provider communication, shared decision making, and patient participation. Studies indicate a variety of likely root causes of disparities including: racial differences in patients’ medical knowledge and information sources, trust and skepticism, levels of participation in health care interactions and decisions, and social support and resources; clinician judgment/bias; the racial/cultural milieu of health care settings; and differences in the quality of care at facilities attended by different racial groups. Conclusions Existing evidence from the VA indicates several promising targets for interventions to reduce racial disparities in the quality of health care. PMID:18301951
Owen, Carter M; Goldstein, Ellen H; Clayton, Janine A; Segars, James H
Racial and ethnic health disparities in reproductive medicine exist across the life span and are costly and burdensome to our healthcare system. Reduction and ultimate elimination of health disparities is a priority of the National Institutes of Health who requires reporting of race and ethnicity for all clinical research it supports. Given the increasing rates of admixture in our population, the definition and subsequent genetic significance of self-reported race and ethnicity used in health disparity research is not straightforward. Some groups have advocated using self-reported ancestry or carefully selected single-nucleotide polymorphisms, also known as ancestry informative markers, to sort individuals into populations. Despite the limitations in our current definitions of race and ethnicity in research, there are several clear examples of health inequalities in reproductive medicine extending from puberty and infertility to obstetric outcomes. We acknowledge that socioeconomic status, education, insurance status, and overall access to care likely contribute to the differences, but these factors do not fully explain the disparities. Epigenetics may provide the biologic link between these environmental factors and the transgenerational disparities that are observed. We propose an integrated view of health disparities across the life span and generations focusing on the metabolic aspects of fetal programming and the effects of environmental exposures. Interventions aimed at improving nutrition and minimizing adverse environmental exposures may act synergistically to reverse the effects of these epigenetic marks and improve the outcome of our future generations.
Yang, Jie; Ortega-Hernández, Javier; Gerber, Sylvain; Butterfield, Nicholas J.; Hou, Jin-bo; Lan, Tian; Zhang, Xi-guang
We describe Collinsium ciliosum from the early Cambrian Xiaoshiba Lagerstätte in South China, an armored lobopodian with a remarkable degree of limb differentiation including a pair of antenna-like appendages, six pairs of elongate setiferous limbs for suspension feeding, and nine pairs of clawed annulated legs with an anchoring function. Collinsium belongs to a highly derived clade of lobopodians within stem group Onychophora, distinguished by a substantial dorsal armature of supernumerary and biomineralized spines (Family Luolishaniidae). As demonstrated here, luolishaniids display the highest degree of limb specialization among Paleozoic lobopodians, constitute more than one-third of the overall morphological disparity of stem group Onychophora, and are substantially more disparate than crown group representatives. Despite having higher disparity and appendage complexity than other lobopodians and extant velvet worms, the specialized mode of life embodied by luolishaniids became extinct during the Early Paleozoic. Collinsium and other superarmored lobopodians exploited a unique paleoecological niche during the Cambrian explosion. PMID:26124122
Yang, Jie; Ortega-Hernández, Javier; Gerber, Sylvain; Butterfield, Nicholas J; Hou, Jin-Bo; Lan, Tian; Zhang, Xi-guang
We describe Collinsium ciliosum from the early Cambrian Xiaoshiba Lagerstätte in South China, an armored lobopodian with a remarkable degree of limb differentiation including a pair of antenna-like appendages, six pairs of elongate setiferous limbs for suspension feeding, and nine pairs of clawed annulated legs with an anchoring function. Collinsium belongs to a highly derived clade of lobopodians within stem group Onychophora, distinguished by a substantial dorsal armature of supernumerary and biomineralized spines (Family Luolishaniidae). As demonstrated here, luolishaniids display the highest degree of limb specialization among Paleozoic lobopodians, constitute more than one-third of the overall morphological disparity of stem group Onychophora, and are substantially more disparate than crown group representatives. Despite having higher disparity and appendage complexity than other lobopodians and extant velvet worms, the specialized mode of life embodied by luolishaniids became extinct during the Early Paleozoic. Collinsium and other superarmored lobopodians exploited a unique paleoecological niche during the Cambrian explosion.
Broadbent, M; Moxham, L
This paper examines the notion of collegiate presence. Collegiate presence is defined as a mutual connection between two or more professional individuals or groups who share a common work focus and who are mindful of cultural differences. This concept emerged as a result of an ethnographic study of two groups of triage nurses; emergency department, and mental health nurses. Data analysis exposed a number of concepts and themes including collegiality and presence. These two concepts were seen to be so closely connected that the term collegiate presence was constructed. This paper explores the notion of collegiate presence and examines factors that affect this phenomenon between what are homogenous (nurses) but disparate cultural groups (emergency department nurses and mental health triage nurses) in a health-care organization. Findings indicate that culturally disparate groups are challenged to develop functional and collaborative working relationships without a deep understanding of, and appreciation for, each other's culture. Developing collegiate presence requires effective communication, social and professional conversations, and physical presence.
Peek, Monica E.; Wilson, Shannon C.; Bussey-Jones, Jada; Lypson, Monica; Cordasco, Kristina; Jacobs, Elizabeth A.; Bright, Cedric; Brown, Arleen F.
Purpose To characterize national physician organizations’ efforts to reduce health disparities and identify organizational characteristics associated with such efforts. Method This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [<1,000 members] versus large [>5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. Results The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organiza-tional characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P < .001). Primary care (versus subspecialty) organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. Conclusions Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts. PMID:22534593
Borysova, Meghan E; Mitchell, Ojmarrh; Sultan, Dawood H; Williams, Arthur R
Alarming disparities in population health and wellness in the United States have led to multidisciplinary research efforts to create health equity. Identifying disparities, elucidating the etiological bases of disparities, and implementing solutions to eliminate disparities are part of the U.S. national health agenda. Racial and ethnic disparities have been identified throughout the cancer control continuum, in cardiovascular disease, diabetes and a multitude of other conditions. The causes of disparities are complex, condition specific, and conjectured to result from combinations of biological and socio-behavioral factors. Racial and ethnic health disparities within the vast incarcerated communities have been excluded from most studies, yet are of significant ethical and fiscal concern to inmates, governing bodies, and non-incarcerated communities into which inmates return. Importantly, research on racial and ethnic disparities in this unique population may shed light on the relative etiologies of health disparities and solutions for creating health equity throughout the general population in the United States.
Mack, Dominic; Zhang, Shun; Douglas, Megan; Sow, Charles; Strothers, Harry; Rust, George
This study evaluates electronic health record (EHR) adoption by primary care providers in Georgia to assess adoption disparities according to practice size and type, payer mix, and community characteristics. Frequency variances of EHR “Go Live” status were estimated. Odds ratios were calculated by univariate and multivariate logistic regression models. Large practices and community health centers (CHCs) were more likely to Go Live (>80% EHR adoption) than rural health clinics and other underserved settings (53%). A significantly lower proportion (68.9%) of Medicaid predominant providers had achieved Go Live status and had a 47% higher risk of not achieving Go Live status than private insurance predominant practices. Disparities in EHR adoption rates may exacerbate existing disparities in health outcomes of patients served by these practices. Targeted support such as that provided to CHCs would level the playing field for practices now at a disadvantage. PMID:27587942
Underhill, Meghan L; Jones, Tarsha; Habin, Karleen
Scientific and technologic advances in genomics have revolutionized genetic counseling and testing, targeted therapy, and cancer screening and prevention. Among younger women, African American and Hispanic women have a higher rate of cancers that are associated with hereditary cancer risk, such as triple-negative breast cancer, which is linked to poorer outcomes. Therefore, genetic testing is particularly important in diverse populations. Unfortunately, all races and ethnic groups are not well represented in current genetic testing practices, leading to disparities in cancer prevention and early detection.
Hu, Ruwei; Shi, Leiyu; Liang, Hailun; Haile, Geraldine Pierre
Introduction Racial and ethnic disparities exist in diabetes prevalence, access to diabetes care, diabetes-related complications and mortality rates, and the quality of diabetes care among Americans. We explored racial and ethnic disparities in primary care quality among Americans with type 2 diabetes. Methods We analyzed data on adults with type 2 diabetes derived from the household component of the 2012 Medical Expenditure Panel Survey. Multiple regression and multivariate logistic regressions were used to examine the association between race/ethnicity and primary care attributes related to first contact, longitudinality, comprehensiveness, and coordination, and clusters of confounding factors were added sequentially. Results Preliminary findings indicated differences in primary care quality between racial/ethnic minorities and whites across measures of first contact, longitudinality, comprehensiveness, and coordination. After controlling for confounding factors, these differences were no longer apparent; all racial/ethnic categories showed similar rates of primary care quality according to the 4 primary care domains of interest in the study. Conclusion Results indicate equitable primary care quality for type 2 diabetes patients across 4 key domains of primary care after controlling for socioeconomic characteristics. Additional research is necessary to support these findings, particularly when considering smaller racial/ethnic groups and investigating outcomes related to diabetes. PMID:27490365
Gavaler, Judith S; Deal, Stephen R; Rosenblum, Elaine R
The Postmenopausal Health Disparities Study (PHD Study) is a model for unraveling the underlying factors that may play a role in the health status and life expectancy disparities among racial and ethnic groups, with particular attention to effects of alcoholic beverage consumption. The study is bioepidemiologic; underlying mechanisms, rather than end points per se, are evaluated. The design is cross-sectional with historical prospective elements. Data were collected from responses to three questionnaires and examination findings from a clinic visit. There were significant differences among racial and ethnic groups in patterns of alcoholic beverage consumption and selected demographic factors, body mass index, measures of physical activity and fitness, and nutritional factors. Predictors of body mass index included both moderate drinking and hormonal factors. To address the current controversy about risks and benefits of hormone replacement therapy (HRT) we examined the predictors of control-based categories of estradiol among treated women; predictors included drinking of alcohol, hormonal variables, and being Caucasian. In addition, a substantial proportion of the variables examined differed significantly between alcohol drinkers and abstainers. The significant differences between alcohol drinkers and abstainers, and among racial and ethnic groups, demonstrate the value of studying multiple racial and ethnic groups simultaneously. The PHD Study provides a unique and productive model that can be used in other populations.
Sen, Hatice Nida; Davis, Janet; Ucar, Didar; Fox, Austin; Chan, Chi Chao; Goldstein, Debra A.
Ocular inflammatory disorders disproportionately affect women, and the majority of affected women are of childbearing age. The role of sex or reproductive hormones has been proposed in many other inflammatory or autoimmune disorders, and findings from non-ocular autoimmune diseases suggest a complex interaction between sex hormones, genetic factors and the immune system. However, despite the age and sex bias, factors that influence this disparity are complicated and unclear. This review aims to evaluate the gender disparities in prevalence, incidence and severity of the most common infectious and non-infectious ocular inflammatory disorders. PMID:24987987
Ferris, Timothy G; Blumenthal, David
Robert Hurley and colleagues find growing disparities in health care. Their methods are rigorous, but key-informant interviews have limitations. Part of their argument rests on observations regarding the diffusion of technological and administrative innovations. The development of disparities will depend on how quickly innovations diffuse to underserved populations. While we look for other supporting data, decreasing public coverage for the poor, medications, and mental health services sends a clear signal from emergency departments. Human suffering reinforces the need to redouble our efforts to patch up coverage holes during good times and keep coverage from unraveling during lean times.
Gerber, Sylvain; Eble, Gunther J; Neige, Pascal
Here, we advance novel uses of allometric spaces--multidimensional spaces specifically defined by allometric coefficients--with the goal of investigating the focal role of development in shaping the evolution of morphological disparity. From their examination, operational measures of allometric disparity can be derived, complementing standard signals of morphological disparity through an intuitive and process-oriented refinement of established analytical protocols used in disparity studies. Allometric spaces thereby become a promising context to reveal different patterns of evolutionary developmental changes and to assess their relative prevalence and importance. Such spaces offer a novel domain of investigation of phenotypic variation and should help in detecting large-scale trends, thus placing various macroevolutionary phenomena in an explicitly developmental context. Ammonoidea (Cephalopoda) at the Lower-Middle Jurassic transition were chosen as a case study to illustrate this methodological approach. We constructed two phenotypic spaces: a static, adult one (adult morphospace) and a dynamic, developmental one (allometric space). Comparative disparity analyses show a strikingly stable occupation in both spaces, despite extensive change in taxonomic composition. In contrast, disparity analyses of subclades reveal clearly distinct morphological and allometric disparity dynamics. Allometric approaches allow developmental insights into morphological diversification otherwise intractable from the analysis of adult morphospace alone.
Paskett, Electra D.; Lengerich, Eugene J.; Schoenberg, Nancy E.; Kennedy, Stephenie K.; Conn, Mary Ellen; Roberto, Karen A.; Dwyer, Sharon K.; Fickle, Darla; Dignan, Mark
There are meaningful cancer-related disparities in the Appalachian region of the U.S. To address these disparities, the Appalachia Community Cancer Network (ACCN), a collaboration of investigators and community partners in five states (Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia), is involved in increasing cancer education and awareness, conducting community-based participatory research (CBPR), and creating mentorship and training opportunities. The primary objective of this paper is to describe cancer-related disparities in the Appalachian region of the U.S. as an example of the disparities experienced by underserved, predominantly white, rural populations, and to describe ACCN activities designed to intervene regarding these disparities. An ACCN overview/history and the diverse activities of ACCN-participating states are presented in an effort to suggest potential useful strategies for working to reduce health-related disparities in underserved white populations. Strengths that have emerged from the ACCN approach (e.g., innovative collaborations, long-standing established networks) and remaining challenges (e.g., difficulties with continually changing communities, scarce resources) are described. Important recommendations that have emerged from the ACCN are also presented, including the value of allowing communities to lead CBPR efforts. Characteristics of the community-based work of the ACCN provide a framework for reducing health-related disparities in Appalachia and in other underserved white and rural populations. PMID:21873582
Hirsh, Adam T; George, Steven Z; Robinson, Michael E
Pain assessment and treatment is influenced by patient demographic characteristics and nonverbal expressions. Methodological challenges have limited the empirical investigation of these issues. The current analogue study employed an innovative research design and novel virtual human (VH) technology to investigate disparities in pain-related clinical decision-making. Fifty-four nurses viewed vignettes consisting of a video clip of the VH patient and clinical summary information describing a post-surgical context. Participants made assessment (pain intensity and unpleasantness) and treatment (non-opioid and opioid medications) decisions on computerized visual analogue scales. VH demographic cues of sex, race, and age, as well as facial expression of pain, were systematically manipulated and hypothesized to influence decision ratings. Idiographic and nomothetic statistical analyses were conducted to test these hypotheses. Idiographic results indicated that sex, race, age, and pain expression cues accounted for significant, unique variance in decision policies among many nurses. Pain expression was the most salient cue in this context. Nomothetic results indicated differences within VH cues of interest; the size and consistency of these differences varied across policy domains. This study demonstrates the application of VH technology and lens model methodology to the study of disparities in pain-related decision-making. Assessment and treatment of acute post-surgical pain often varies based on VH demographic and facial expression cues. These data contribute to the existing literature on disparities in pain practice and highlight the potential of a novel approach that may serve as a model for future investigation of these critical issues.
Fleming, Erik S.; Perkins, James; Easa, David; Conde, José G.; Baker, Richard S.; Southerland, William M.; Dottin, Robert; Benabe, Julio E.; Ofili, Elizabeth O.; Bond, Vincent C.; McClure, Shelia A.; Sayre, Michael H.; Beanan, Maureen J.; Norris, Keith C.
The national research leadership has recently become aware of the tremendous potential of translational research as an approach to address health disparities. The Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) is a research network that supports multi-institutional, multidisciplinary collaboration with a focus on key diseases and conditions for which disproportionately adverse racial and ethnic health disparities exist. The RTRN is designed to facilitate the movement of scientific advances across the translational research spectrum by providing researchers at different institutions with the infrastructure and tools necessary to collaborate on interdisciplinary and transdisciplinary research projects relating to specific health outcomes for which major racial/ethnic disparities exist. In the past, the difficulty of overcoming the restrictions imposed by time and space have made it difficult to carry out this type of large-scale, multilevel collaboration efficiently. To address this formidable challenge, the RTRN will deploy a translational research cluster system that uses “cyber workspaces” to bring researchers with similar interests together by using online collaboratory technology. These virtual meeting environments will provide a number of tools, including videoconferences (seminars, works in progress, meetings); project management tools (WebCT, Microsoft Share Point); and posting areas for projects, concepts, and other research and educational activities. This technology will help enhance access to resources across institutions with a common mission, minimize many of the logistical hurdles that impede intellectual exchange, streamline the planning and implementation of innovative interdisciplinary research, and assess the use of protocols and practices to assist researchers in interacting across and within cyber workspaces. PMID:18646341
Henriksen, Lisa; Rose, Shyanika W.; Moreland-Russell, Sarah; Ribisl, Kurt M.
We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues. PMID:26180986
Brach, Cindy; Fraser, Irene
Finding ways to deliver high-quality health care to an increasingly diverse population is a major challenge for the American health care system. The persistence of racial and ethnic disparities in health care access, quality, and outcomes has prompted considerable interest in increasing the cultural competence of health care, both as an end in its own right and as a potential means to reduce disparities. This article reviews the potential role of cultural competence in reducing racial and ethnic health disparities, the strength of health care organizations’ current incentives to adopt cultural competence techniques, and the limitations inherent in these incentives that will need to be overcome if cultural competence techniques are to become widely adopted. PMID:12938253
Lee, Joseph G L; Henriksen, Lisa; Rose, Shyanika W; Moreland-Russell, Sarah; Ribisl, Kurt M
We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.
Brach, Cindy; Fraser, Irene
Finding ways to deliver high-quality health care to an increasingly diverse population is a major challenge for the American health care system. The persistence of racial and ethnic disparities in health care access, quality, and outcomes has prompted considerable interest in increasing the cultural competence of health care, both as an end in its own right and as a potential means to reduce disparities. This article reviews the potential role of cultural competence in reducing racial and ethnic health disparities, the strength of health care organizations' current incentives to adopt cultural competence techniques, and the limitations inherent in these incentives that will need to be overcome if cultural competence techniques are to become widely adopted.
Feng, David; McCarthy, Chris
We present a novel approach for enhancing structurally significant features in a scene to facilitate safe mobility with prosthetic vision. Previous approaches rely on visually salient features (e.g., intensity gradients, size, texture), or surface fitting (e.g., ground plane extraction), to determine and convey regions of structural change in the scene. Such approaches can be costly to compute, and/or are not guaranteed to detect all features relevant to the needs of safe mobility (e.g., small, low-contrast trip hazards). Assuming a dense disparity image, we propose a novel feature using iso-disparity contours. Regions of significant structural change are detected via a cost function based on local comparisons of iso-disparity contour orientations. Through this, structurally interesting features such as surface boundaries and general clutter are extracted and emphasised in the output visual representation. Our approach is real-time, and requires no surface fitting. Experimental results quantitatively and qualitatively validate our approach.
Das, Dinesh; Pathak, Minakshee
The paper critically examines the understanding, approach and indicators that have been used to measure the degree of disparity. It is fact that disparity exists everywhere. However, this paper highlights on disparities existing between rural and urban areas. In this context, it talks about 'whyí and 'howí disparities exist between rural and urban areas. The study suggests that 'incomeí is not a sufficient indicator to capture the magnitude of disparities at any level. It is, therefore, necessary to develop some indicators representing human resource development and infrastructure facility to understand the growing rural-urban disparity in India.
Baraliakos, Xenofon; van der Heijde, Desirée; Braun, Jurgen; Landewé, Robert B M
The ASAS/OMERACT MRI group recently described and defined magnetic resonance imaging (MRI) findings in sacroiliac joints (SIJ) that are essential for the diagnosis of sacroiliitis in patients with axial spondyloarthritis, including ankylosing spondylitis (AS). At the Outcome Measures in Rheumatology Clinical Trials (OMERACT) 2010 meeting, a special interest group (SIG) was formed to design a research agenda for the definition and description of structural lesions in the SIJ and the spine in patients with established AS. During the SIG, a summary of the previous work of the group was presented to all participants, containing: (1) a description of the current definitions of structural SIJ changes; (2) available scoring methods for SIJ changes; (3) data from a previous pilot MRI exercise on chronic SIJ changes performed by members of the group; and (4) a proposal for a research agenda for OMERACT 11. The group agreed on the project's scientific merits and the need to evaluate all available scoring methods and to have clear definitions for all possible abnormalities that can be seen on MRI, prior to the start of the exercise. It was also agreed that the exercise should include scoring of both structural and inflammatory lesions, due to lack of agreement about the best scoring method for assessing both types of lesions in AS. Participants agreed that longitudinal MRI over a certain period are needed to learn about the time sequence of pathologic changes and to understand the course of the disease. Finally, participants asked the group to add the development of a scoring method for structural changes in the spine in a subsequent exercise. Further to these objectives, all experts who agreed to contribute in the exercise will collaborate to achieve consensus on definitions and to organize training in the different scoring systems prior to the start of the project, with the aim to finalize the multiple reader exercise by the end of 2011, in time for OMERACT 11.
Davis, Brigette A; Aminawung, Jenerius A; Abu-Khalaf, Maysa M; Evans, Suzanne B; Su, Kevin; Mehta, Rajni; Wang, Shi-Yi; Gross, Cary P
Background: Racial disparities have been reported in breast cancer care, yet little is known about disparities in access to gene expression profiling (GEP) tests. Given the impact of GEP test results, such as those of Oncotype DX (ODx), on treatment decision-making for hormone receptor-positive (HR+) breast cancer, it is particularly important to assess disparities in its use. Methods: We conducted a retrospective population-based study of 8,784 patients diagnosed with breast cancer in Connecticut during 2011 through 2013. We assessed the association between race, ethnicity, and ODx receipt among women with HR+ breast cancer for whom NCCN does and does not recommend ODx testing, using bivariate and multivariate logistic analyses. Results: We identified 5,294 women who met study inclusion criteria: 83.8% were white, 6.3% black, and 7.4% Hispanic. Overall, 50.9% (n=4,131) of women in the guideline-recommended group received ODx testing compared with 18.5% (n=1,163) in the nonrecommended group. More white women received the ODx test compared with black and Hispanic women in the recommended and nonrecommended groups (51.4% vs 44.6% and 47.7%; and 21.2% vs 9.0% and 9.7%, respectively). After adjusting for tumor and clinical characteristics, we observed significantly lower ODx use among black (odds ratio [OR], 0.64; 95% CI, 0.47-0.88) and Hispanic women (OR, 0.59; 95% CI, 0.45-0.77) compared with white women in the recommended group and in the guideline-discordant group (blacks: OR, 0.39; 95% CI, 0.20-0.78, and Hispanics: OR, 0.44; 95% CI, 0.23-0.85). Conclusions: In this population-based study, we identified racial disparities in ODx testing. Disparities in access to innovative cancer care technologies may further exacerbate existing disparities in breast cancer outcomes.
McKee, Suzanne P.; Norcia, Anthony M.
The human stereoscopic system is remarkable in its ability to utilize widely separated features as references to support fine depth discrimination. In a search for possible neural substrates of this ability, we recorded high-density EEG and used a distributed inverse technique to estimate population-level disparity responses in five regions of interest (ROIs): V1, V3A, hMT+, V4, and lateral occipital complex (LOC). The stimulus was a central modulating disk surrounded by a correlated “reference” annulus presented in the fixation plane. We varied a gap separating the disk from the annulus parametrically from 0 to 5.5° as a test of long-range disparity integration. In the V1, LOC, and hMT+ ROIs, the responses with gaps >0.5° were equal to those obtained in a control condition where the surround was composed of uncorrelated noise (no reference). By contrast, in the V4 and V3A ROIs, responses with gaps as large as 5.5° were still significantly higher than the control. As a test of the spatial distribution of the disparity reference information, we manipulated the properties of the stimulus by placing noise between the center and the surround or throughout the surround. The V3A ROI was particularly sensitive to disparity noise between the center and annulus regions, suggesting an important contribution of disparity edge detectors in this ROI. PMID:22323636
Chávez-Munguía, Bibiana; Talamás-Rohana, Patricia; Castañón, Guadalupe; Salazar-Villatoro, Lizbeth; Hernández-Ramírez, Verónica; Martínez-Palomo, Adolfo
The rapid redistribution of surface antigen-antibody complexes in trophozoites of the human protozoan parasite Entamoeba histolytica, in a process known as capping, has been considered as a means of the parasite to evade the host immune response. So far, capping has been documented in the invasive E. histolytica, whereas the mobility of surface components in the non-invasive Entamoeba dispar is not known. E. dispar does not induce liver lesions in rodent experimental models, in contrast to the liver abscesses produced by E. histolytica in the same animal model. We have therefore analyzed the mobility of surface receptors to the lectin concanavalin A and of Rab11, a membrane-associated protein, in both species of Entamoebae by confocal fluorescence microscopy and transmission and scanning electron microscopy. The great majority of E. histolytica trophozoites became morphologically polarized through the formation of well-defined caps at the posterior pole of the parasite. Actin colocalized with the lectin caps. Antibodies against the membrane protein Rab 11 also produced capping. In striking contrast, in E. dispar, the mobility of concanavalin A surface receptors was restricted to the formation of irregular surface patches that did no progress to constitute well-defined caps. Also, anti-Rab 11 antibodies did not result in capping in E. dispar. Whether the failure of E. dispar to efficiently mobilize surface molecules in response to lectin or antibodies as shown in the present results is related to its non-invasive character represents an interesting hypothesis requiring further analysis.
Arnoldussen, David M.; Goossens, Jeroen; van Den Berg, Albert V.
Recent fMRI studies have shown fusion of visual motion and disparity signals for shape perception (Ban et al., 2012), and unmasking camouflaged surfaces (Rokers et al., 2009), but no such interaction is known for typical dorsal motion pathway tasks, like grasping and navigation. Here, we investigate human speed perception of forward motion and its representation in the human motion network. We observe strong interaction in medial (V3ab, V6) and lateral motion areas (MT+), which differ significantly. Whereas the retinal disparity dominates the binocular contribution to the BOLD activity in the anterior part of area MT+, headcentric disparity modulation of the BOLD response dominates in area V3ab and V6. This suggests that medial motion areas not only represent rotational speed of the head (Arnoldussen et al., 2011), but also translational speed of the head relative to the scene. Interestingly, a strong response to vergence eye movements was found in area V1, which showed a dependency on visual direction, just like vertical-size disparity. This is the first report of a vertical-size disparity correlate in human striate cortex. PMID:25759642
Burgess, Diana; Olayinka, Abimbola; Whembolua, Guy Lucien S.; Okuyemi, Kolawole S.
Introduction: Disparities in tobacco’s harm persist. Declines in smoking among the general population have not been experienced to the same extent by vulnerable populations. Innovative strategies are required to diminish disparities in tobacco’s harm. As novel tools, anthropological concepts and methods may be applied to improve the design and outcomes of tobacco cessation interventions. Methods: We reviewed over 60 articles published in peer-reviewed journals since 1995 for content on anthropology and smoking cessation. The specific questions framing the review were: (a) “How can lessons learned from anthropological studies of smoking improve the design and effectiveness of smoking cessation interventions?” (b) How can anthropology be applied to diminish disparities in smoking cessation? and (c) How can qualitative methods be used most effectively in smoking cessation intervention research? Results: Three specific disciplinary tools were identified and examined: (a) culture, (b) reflexivity, and (c) qualitative methods. Examining culture as a dynamic influence and understanding the utilities of smoking in a particular group is a precursor to promoting cessation. Reflexivity enables a deeper understanding of how smokers perceive quitting and smoking beyond addiction and individual health consequences. Qualitative methods may be used to elicit in-depth perspectives on quitting, insights to inform existing community-based strategies for making behavior changes, and detailed preferences for cessation treatment or programs. Conclusions: Anthropological tools can be used to improve the effectiveness of intervention research studies targeting individuals from vulnerable groups. Synthesized applications of anthropological concepts can be used to facilitate translation of findings into clinical practice for providers addressing tobacco cessation in vulnerable populations. PMID:22271609
Jurkowski, Janine M; Paul-Ward, Amy
Eliminating health disparities is a national priority. People with intellectual disabilities (PWID) are a vulnerable group that experiences health disparities. However, their health disparities have largely been overlooked. Photovoice is an effective method for engaging PWID in health promotion planning and research. This article discusses the importance of including PWID as a priority group, presents a Photovoice project among Latinos with ID, and concludes with recommendations for employing Photovoice with PWID. The Photovoice project was a part of a larger pilot study that aimed to enable the voices of Latinos with ID and guide the development of health promotion programs at a community agency. The findings were presented in reports and at a town hall meeting during which attendees responded and developed actions steps for improving health promotion for PWID. Each Photovoice participant received a scrapbook of their photographs as a keepsake of their experiences participating in the project [corrected
Kalajian, Peter; Makarova, Maria
Humans have evolved to follow their intuition, but as any high school physics teacher knows, relying on intuition often leads students to predict outcomes that are at odds with evidence. Over the years, we have attempted to make this intuition-outcome disparity a central theme running throughout our physics classes, with limited success. Part of…
Tfaily, Rania; Diab, Hassan; Kulczycki, Andrzej
This article examines the impact of Lebanon's civil war (1975-1991) on disparities in education among the country's main religious sects and across various regions. District of registration is adopted as a proxy for religious affiliation through a novel, detailed classification to assess sectarian differentials by region and regional differentials…
Findik, Leyla Yilmaz
Turkey has been concerned about gender inequality in education for many years and has implemented various policy instruments. However, gender disparity still seems to prevail today. This study seeks to provide an insight to the gender differences in terms of enrollment rates, level of education, fields of education and number of graduates in…
JF, Levine AC. Inhibition of cyclooxygenase-2 suppresses angiogenesis and the growth of prostate cancer in vivo. J Urol 2000:164:820-5 10. Mahmud...Tzivony Y, Flescher E. Contrasting effects of aspirin on prostate cancer cells: suppression of proliferation and induction of drug resistance...TITLE: Reduction of Racial Disparities in Prostate Cancer PRINCIPAL INVESTIGATOR: Nicholas Daniels, MD MPH, Principal Investigator
Barker, Lawrence E.; Chu, Susan Y.; Li, Qian; Shaw, Kate M.; Santoli, Jeanne M.
INTRODUCTION: A recent study has shown that the national-scale difference in immunization coverage between non-Hispanic white (abbreviated "white") and non-Hispanic African-American (abbreviated "African-American") children aged 19-35 months in the United States has increased by about 1 percentage point annually. We examined how this widening gap differs with geography and income. METHODS: We used data from the National Immunization Survey, 1998-2003, a national telephone survey. We examined differences between white and African-American children in immunization coverage within income groups (at or above versus below the federal poverty level) for each census region (northeast, south, midwest and west). We tested the hypothesis of constant disparity over time. RESULTS: Among households at or above the federal poverty level in the northeast census region, disparity is widening (white coverage minus African-American coverage was -0.5 in 1998 but 15.5 in 2003). Among household at or above the federal poverty level in the midwest census region, disparity is narrowing (white coverage minus African-American coverage was 13.9 in 1998 but 2.5 in 2003). We found no significant evidence of a trend in other groups. CONCLUSIONS: Widening national-level disparity in immunization coverage is primarily attributable to trends in the northeast census region. Addressing the widening disparity in coverage requires new strategies that consider current social and economic contexts. PMID:16708496
Introduction The 2010 Census revealed the population of Latino and Asian children grew by 5.5 million, while the population of white children declined by 4.3 million from 2000-2010, and minority children will outnumber white children by 2020. No prior analyses, however, have examined time trends in racial/ethnic disparities in children’s health and healthcare. The study objectives were to identify racial/ethnic disparities in medical and oral health, access to care, and use of services in US children, and determine whether these disparities have changed over time. Methods The 2003 and 2007 National Surveys of Children’s Health were nationally representative telephone surveys of parents of 193,995 children 0-17 years old (N = 102,353 in 2003 and N = 91,642 in 2007). Thirty-four disparities indicators were examined for white, African-American, Latino, Asian/Pacific-Islander, American Indian/Alaskan Native, and multiracial children. Multivariable analyses were performed to adjust for nine relevant covariates, and Z-scores to examine time trends. Results Eighteen disparities occurred in 2007 for ≥1 minority group. The number of indicators for which at least one racial/ethnic group experienced disparities did not significantly change between 2003-2007, nor did the total number of specific disparities (46 in 2007). The disparities for one subcategory (use of services), however, did decrease (by 82%). Although 15 disparities decreased over time, two worsened, and 10 new disparities arose. Conclusions Minority children continue to experience multiple disparities in medical and oral health and healthcare. Most disparities persisted over time. Although disparities in use of services decreased, 10 new disparities arose in 2007. Study findings suggest that urgent policy solutions are needed to eliminate these disparities, including collecting racial/ethnic and language data on all patients, monitoring and publicly disclosing disparities data annually, providing
Maldonado, Maria E; Fried, Ethan D; DuBose, Thomas D; Nelson, Consuelo; Breida, Margaret
Despite the 2002 Institute of Medicine report that described the moral and financial impact of health care disparities and the need to address them, it is evident that health care disparities persist. Recommendations for addressing disparities include collecting and reporting data on patient race and ethnicity, supporting language interpretation services, increasing awareness of health care disparities through education, requiring cultural competency training for all health care professionals, and increasing diversity among those delivering health care. The Accreditation Council on Graduate Medical Education places strong emphasis on graduate medical education's role in eliminating health care disparities by asking medical educators to objectively evaluate and report on their trainees' ability to practice patient-centered, culturally competent care. Moreover, one of the objectives of the Accreditation Council on Graduate Medical Education Clinical Learning Environment Review visits as part of the Next Accreditation System is to identify how sponsoring institutions engage residents and fellows in the use of data to improve systems of care, reduce health care disparities, and improve patient outcomes. Residency and fellowship programs should ensure the delivery of meaningful curricula on cultural competency and health care disparities, for which there are numerous resources, and ensure resident assessment of culturally competent care. Moreover, training programs and institutional leadership need to collaborate on ensuring data collection on patient satisfaction, outcomes, and quality measures that are broken down by patient race, cultural identification, and language. A diverse physician workforce is another strategy for mitigating health care disparities, and using strategies to enhance faculty diversity should also be a priority of graduate medical education. Transparent data about institutional diversity efforts should be provided to interested medical students
A study was conducted to assess the dimensions of a National Public Radio (NPR) audience's interests in programing, and how these interests define subaudience groups. Telephone surveys were conducted with 276 persons who were over 18 years of age and who usually listened to the local university operated NPR station at least one day per week. The…
Costa, Luciano J; Huang, Jia-Xing; Hari, Parameswaran N
Autologous hematopoietic cell transplantation (AHCT) is an established therapy for multiple myeloma (MM), with an impact on quality of remission and survival. We analyzed the role of race, ethnicity, sex, and age disparities in AHCT utilization in the United States. We combined MM incidence derived from the Surveillance, Epidemiology and End Results program with transplantation activity reported to the Center for International Blood and Marrow Transplant Research for the period of 2005 to 2009 to assess the impact of disparities in AHCT. Utilization (number of transplantations/new cases) was compared between groups using the relative utilization ratio (RUR), defined as [utilization for a given category]/[utilization for the entire population]. Data were obtained from 22,462 actual MM cases and 13,311 AHCT. The age-adjusted RUR was 1.17 (95% confidence interval [CI], 1.15 to 1.19) among non-Hispanic Whites (NHW), higher than in non-Hispanic Blacks (NHB) (age-adjusted RUR, .69; 95% CI, .67 to .72; P < .0002), Hispanics (age-adjusted RUR, .64; 95% CI, .60 to .69; P < .002), and Asians (age-adjusted RUR, .65; 95% CI, .58 to .73; P < .0002]. AHCT utilization was higher in men than in women among Hispanics (age-adjusted RUR .72 versus .56, P = .007), but not among NHW, NHB, or Asians. Sex disparity prevents 1.3% of potential AHCTs in patients with MM (10.4% among Hispanics). Racial-ethnic disparities prevent 13.8% of AHCTs (44.7% in Hispanic and Asians, 39.9% in NHBs). Race-ethnicity disparity greatly affects AHCT utilization in MM. Sex disparity plays a lesser role, except among Hispanics. The ongoing decrease in age disparity will continue to drive major increase of AHCT activity. Two-year and 5-year increases in the age of the AHCT population would result in 12% and 32% increases, respectively, in volume of AHCT.
Li, Yue; Ye, Zhiqiu; Glance, Laurent G.; Temkin-Greener, Helena
Background Providing equitable and patient-centered care is critical to ensuring high quality of care. Although racial/ethnic disparities in quality are widely reported for nursing facilities, it is unknown whether disparities exist in consumer experiences with care and how public reporting of consumer experiences affects facility performance and potential racial disparities. Methods We analyzed trends of consumer ratings publicly reported for Maryland nursing homes during 2007–2010, and determined whether racial/ethnic disparities in experiences with care changed during this period. Multivariate longitudinal regression models controlled for important facility and county characteristics and tested changes overall and by facility groups (defined based on concentrations of black residents). Consumer ratings were reported for: overall care; recommendation of the facility; staff performance; care provided; food & meals; physical environment; and autonomy & personal rights. Results Overall ratings on care experience remained relatively high (mean=8.3 on a one-to-ten scale) during 2007–2010. Ninety percent of survey respondents each year would recommend the facility to someone who needs nursing home care. Ratings on individual domains of care improved among all nursing homes in Maryland (p<0.01) except for food & meals (p=0.827 for trend). However, site-of-care disparities existed in each year for overall ratings, recommendation rate, and ratings on all domains of care (p<0.01 in all cases), with facilities more predominated by black residents having lower scores; such disparities persisted over time (p>0.2 for trends in disparities). Conclusions Although Maryland nursing homes showed maintained or improved consumer ratings during the first 4 years of public reporting, gaps persisted between facilities with high versus low concentrations of minority residents. PMID:24926712
Hu, Guoqing; Baker, Susan P.; Baker, Timothy D.
Context: Urban-rural disparity is an important issue for injury control in China. Details of the urban-rural disparities in fatal injuries have not been analyzed. Purpose: To target key injury causes that most contribute to the urban-rural disparity, we decomposed total urban-rural differences in 2006 injury mortality by gender, age, and cause.…
Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, David R.
Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce…
Brosch, Nicole; Nezveda, Matej; Gelautz, Margrit; Seitner, Florian
We propose an efficient disparity map enhancement method that improves the alignment of disparity edges and color edges even in the presence of mixed pixels and provides alpha values for pixels at disparity edges as a byproduct. In contrast to previous publications, the proposed method addresses mixed pixels at disparity edges and does not introduce mixed disparities that can lead to object deformations in synthesized views. The proposed algorithm computes transparencies by performing alpha matting per disparity-layer. These alpha values indicate the degree of affiliation to a disparity-layer and can hence be used as an indicator for a disparity reassignment that aligns disparity edges with color edges and accounts for mixed pixels. We demonstrate the capabilities of the proposed method on various images and corresponding disparity maps, including images that contain fuzzy object borders (e.g., fur). Furthermore, the proposed method is qualitatively and quantitatively evaluated using disparity ground truth and compared to previously published disparity post-processing methods.
Job Training Partnership Act. Racial and Gender Disparities in Services. Report to the Chairman, Legislation and National Security Subcommittee, Committee on Government Operations, House of Representatives.
General Accounting Office, Washington, DC. Div. of Human Resources.
The services provided to various demographic groups under the Job Training Partnership Act (JTPA) were reviewed to determine the extent to which disparities occur in the services provided to women and minorities, factors within the operation of local projects that contribute to such disparities, and efforts by states and the Department of Labor to…
Cooper, Lisa A; Hill, Martha N; Powe, Neil R
A large number of factors contribute to racial and ethnic disparities in health status. Health care professionals, researchers, and policymakers have believed for some time that access to care is the centerpiece in the elimination of these health disparities. The Institute of Medicine's (IOM) model of access to health services includes personal, financial, and structural barriers, health service utilization, and mediators of care. This model can be used to describe the interactions among these factors and their impact on health outcomes and equity of services among racial and ethnic groups. We present a modified version of the IOM model that incorporates the features of other access models and highlights barriers and mediators that are relevant for interventions designed to eliminate disparities in U.S. health care. We also suggest that interventions to eliminate disparities and achieve equity in health care services be considered within the broader context of improving quality of care. Some health service intervention studies have shown improvements in the health of disadvantaged groups. If properly designed and implemented, these interventions could be used to reduce health disparities. Successful features of interventions include the use of multifaceted, intense approaches, culturally and linguistically appropriate methods, improved access to care, tailoring, the establishment of partnerships with stakeholders, and community involvement. However, in order to be effective in reducing disparities in health care and health status, important limitations of previous studies need to be addressed, including the lack of control groups, nonrandom assignment of subjects to experimental interventions, and use of health outcome measures that are not validated. Interventions might be improved by targeting high-risk populations, focusing on the most important contributing factors, including measures of appropriateness and quality of care and health outcomes, and prioritizing
Eliazar, Iddo; Cohen, Morrel H.
From the Old Testament to the Communist Manifesto, and from the French Revolution to the Occupy Wall Street protests, social inequality has always been at the focal point of public debate, as well as a major driver of political change. Although being of prime interest since Biblical times, the scientific investigation of the distributions of wealth and income in human societies began only at the close of the nineteenth century, and was pioneered by Pareto, Lorenz, Gini, and Pietra. The methodologies introduced by these trailblazing scholars form the bedrock of the contemporary science of social inequality. Based on this bedrock we present a new quantitative approach to the analysis of wealth and income distributions, which sets its spotlight on the most heated facet of the current global debate on social inequality-the rich-poor disparity. Our approach offers researchers highly applicable quantitative tools to empirically track and statistically analyze the growing gap between the rich and the poor.
Benatar, S R
Widening disparities in health and human rights at a global level represent the dark side of progress associated with escalation of economic and military exploitation and exponential population growth in the 20th century. Even the most basic universal human rights cannot be achieved for all under these circumstances. The goal of improved population health will be similarly elusive while medical care is commodified and exploited for commercial gain in the marketplace. Recognition of the powerful forces that polarize our world and commitment to reversing them are essential for the achievement of human rights for all, for the improvement of public health, and for the peaceful progress required to protect the "rational self-interest" of the most privileged people on earth against the escalation of war, disease, and other destructive forces arising from widespread poverty and ecological degradation. PMID:9491027
Benn, Emma K T; Goldfeld, Keith S
Moving from a descriptive focus to a comprehensive analysis grounded in causal inference can be particularly daunting for disparities researchers. However, even a simple model supported by the theoretical underpinnings of causality gives researchers a better chance to make correct inferences about possible interventions that can benefit our most vulnerable populations. This commentary provides a brief description of how race/ethnicity and context relate to questions of causality, and uses a hypothetical scenario to explore how different researchers might analyze the data to estimate causal effects of interest. Perhaps although not entirely removed of bias, these causal estimates will move us a step closer to understanding how to intervene. (PsycINFO Database Record
Basu, Sanjay; Hong, Anthony; Siddiqi, Arjumand
To lower the prevalence of hypertension and racial disparities in hypertension, public health agencies have attempted to reduce modifiable risk factors for high blood pressure, such as excess sodium intake or high body mass index. In the present study, we used decomposition methods to identify how population-level reductions in key risk factors for hypertension could reshape entire population distributions of blood pressure and associated disparities among racial/ethnic groups. We compared blood pressure distributions among non-Hispanic white, non-Hispanic black, and Mexican-American persons using data from the US National Health and Nutrition Examination Survey (2003–2010). When using standard adjusted logistic regression analysis, we found that differences in body mass index were the only significant explanatory correlate to racial disparities in blood pressure. By contrast, our decomposition approach provided more nuanced revelations; we found that disparities in hypertension related to tobacco use might be masked by differences in body mass index that significantly increase the disparities between black and white participants. Analysis of disparities between white and Mexican-American participants also reveal hidden relationships between tobacco use, body mass index, and blood pressure. Decomposition offers an approach to understand how modifying risk factors might alter population-level health disparities in overall outcome distributions that can be obscured by standard regression analyses. PMID:26199379
Basu, Sanjay; Hong, Anthony; Siddiqi, Arjumand
To lower the prevalence of hypertension and racial disparities in hypertension, public health agencies have attempted to reduce modifiable risk factors for high blood pressure, such as excess sodium intake or high body mass index. In the present study, we used decomposition methods to identify how population-level reductions in key risk factors for hypertension could reshape entire population distributions of blood pressure and associated disparities among racial/ethnic groups. We compared blood pressure distributions among non-Hispanic white, non-Hispanic black, and Mexican-American persons using data from the US National Health and Nutrition Examination Survey (2003-2010). When using standard adjusted logistic regression analysis, we found that differences in body mass index were the only significant explanatory correlate to racial disparities in blood pressure. By contrast, our decomposition approach provided more nuanced revelations; we found that disparities in hypertension related to tobacco use might be masked by differences in body mass index that significantly increase the disparities between black and white participants. Analysis of disparities between white and Mexican-American participants also reveal hidden relationships between tobacco use, body mass index, and blood pressure. Decomposition offers an approach to understand how modifying risk factors might alter population-level health disparities in overall outcome distributions that can be obscured by standard regression analyses.
Kruse, Lakota K; Deshpande, Sandy; Vezina, Melissa
We examined the race/ethnicity variation in the risk of hospitalization among children seen in the emergency department (ED) for asthma. ED and hospitalization records for children 1 to 19 years of age in New Jersey for 2004 and 2005 were linked. The dataset identified 47,548 ED and hospitalizations among 37,216 children. ED and hospitalization rates indicated persistent disparities in pediatric asthma. ED admission rates were similar across race/ethnic groups, suggesting similar management of pediatric asthma patients once they are seen in the ED. Integrating existing ED and hospitalization records will enhance asthma surveillance and the targeting of interventions to reduce race/ethnicity disparities.
Zekeri, Andrew A.; Habtemariam, Tsegaye
Objective: This study examined African American college students' perceptions of psychosocial factors that influence racial disparities in health. Methods: We conducted focus groups in two Alabama Black Belt Counties from June to August 2005. Data were collected using a standardized discussion guide, augmented by prompts for clarification.…
Wesley Schultz, P.; Hernandez, Paul R.; Woodcock, Anna; Estrada, Mica; Chance, Randie C.; Aguilar, Maria; Serpe, Richard T.
For more than 40 years, there has been a concerted national effort to promote diversity among the scientific research community. Yet given the persistent national-level disparity in educational achievements of students from various ethnic and racial groups, the efficacy of these programs has come into question. The current study reports results…
Des Jarlais, Don C.; McCarty, Dennis; Vega, William A.; Bramson, Heidi
Racial/ethnic disparities in HIV infection, with minority groups typically having higher rates of infection, are a formidable public health challenge. In the United States, among both men and women who inject drugs, HIV infection rates are elevated among Hispanics and non-Hispanic Blacks. A meta-analysis of international research concluded that…
Miller, Raegen; Epstein, Diana
It's hard to debunk a myth that's not a myth, but Jason Richwine of the Heritage Foundation has given it a try in his recent backgrounder, "The Myth of Racial Disparities in Public School Financing." The report suggests that public education spending is broadly similar across racial and ethnic groups, and it has found a predictably receptive…
Zhang, Shun; Cardarelli, Kathryn; Shim, Ruth; Ye, Jiali; Booker, Karla L.; Rust, George
To explore racial-ethnic disparities in adverse pregnancy outcomes among Medicaid recipients, and to estimate excess Medicaid costs associated with the disparities. Cross-sectional study of adverse pregnancy outcomes and Medicaid payments using data from Medicaid Analytic eXtract files on all Medicaid enrollees in fourteen southern states. Compared to other racial and ethnic groups, African American women tended to be younger, more likely to have a Cesarean section, to stay longer in the hospital and to incur higher Medicaid costs. African-American women were also more likely to experience preeclampsia, placental abruption, preterm birth, small birth size for gestational age, and fetal death/stillbirth. Eliminating racial disparities in adverse pregnancy outcomes (not counting infant costs), could generate Medicaid cost savings of $114 to $214 million per year in these 14 states. Despite having the same insurance coverage and meeting the same poverty guidelines for Medicaid eligibility, African American women have a higher rate of adverse pregnancy outcomes than White or Hispanic women. Racial disparities in adverse pregnancy outcomes not only represent potentially preventable human suffering, but also avoidable economic costs. There is a significant financial return-on-investment opportunity tied to eliminating racial disparities in birth outcomes. With the Affordable Care Act expansion of Medicaid coverage for the year 2014, Medicaid could be powerful public health tool for improving pregnancy outcomes. PMID:23065298
Hamzah, Zulhainan; Petmitr, Songsak; Mungthin, Mathirut; Leelayoova, Saovanee; Chavalitshewinkoon-Petmitr, Porntip
Multiplex real-time polymerase chain reaction (PCR) was developed for differential detection of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii. Specific primers were designed for all three species, and then differentiation of E. histolytica and E. dispar was achieved simultaneously using a hybridization probe and melting curve analysis, whereas E. moshkovskii was detected with a separate probe under the same condition. This assay detected as little as 0.2 pg of E. histolytica DNA and 2 pg each for E. dispar and E. moshkovskii DNA. Thirty-five clinical samples suspected to be E. histolytica infection by microscopy were tested. The results showed 32 positive samples; four samples were E. histolytica and 28 samples were E. dispar. Interestingly, one E. dispar positive sample showed a mixed infection with E. moshkovskii. This is the first report of E. moshkovskii infection from Thailand and this assay is currently the most rapid and sensitive method to differentiate these human amoebas.
Meade, Cathy D.; Menard, Janelle M.; Luque, John S.; Martinez-Tyson, Dinorah; Gwede, Clement K.
To effectively attenuate cancer disparities in multiethnic, medically underserved populations, interventions must be developed collaboratively through solid community–academic partnerships and driven by community-based participatory research (CBPR). The Tampa Bay Community Cancer Network (TBCCN) has been created to identify and implement interventions to address local cancer disparities in partnership with community-based nonprofit organizations, faith-based groups, community health centers, local media, and adult literacy and education organizations. TBCCN activities and research efforts are geared toward addressing critical information and access issues related to cancer control and prevention in diverse communities in the Tampa Bay area. Such efforts include cross-cultural health promotion, screening, and awareness activities in addition to applied research projects that are rooted in communities and guided by CBPR methods. This article describes these activities as examples of partnership building to positively affect cancer disparities, promote community health, and set the stage for community-based research partnerships. PMID:19822724
Hovmand, Peter; Pfeiffer, Debbie J.; Fairchild, Maggie; Rath, Suchitra; Golla, Balaji; Casey, Chris
The prevailing approach to improving population health focuses on shifting population means through a few targeted and universal interventions. The success of this approach for eliminating health disparities depends on an assumption about the distribution of demand for such interventions. We explored whether long tail thinking from business might yield greater progress in eliminating disparities. We examined 2011 to 2013 data from 513 state and local health agency representatives in 47 states who used an online system to create 4351 small media and client reminder products promoting colorectal cancer screening. Products in the long tail were more likely to target minority groups with higher rates of colorectal cancer and lower rates of screening than Whites. Long tail thinking could help improve the public's health and eliminate disparities. PMID:25322308
Cruz-Correa, Marcia; Pérez-Mayoral, Julyann; Dutil, Julie; Echenique, Miguel; Mosquera, Rafael; Rivera-Román, Keila; Umpierre, Sharee; Rodriguez-Quilichini, Segundo; Gonzalez-Pons, Maria; Olivera, Myrta I; Pardo, Sherly
The three major hereditary cancer syndromes in Latinos (Hereditary Breast and Ovarian Cancer, Familial Adenomatous Polyposis and Lynch Syndrome) have been shown to exhibit geographic disparities by country of origin suggesting admixture-based disparities. A solid infrastructure of clinical genetics geared towards diagnosis and prevention could aid in reducing the mortality of these cancer syndromes in Latinos. Currently, clinical cancer genetic services in Latin America are scarce. Moreover, limited studies have investigated the mutational spectrum of these cancer syndromes in Latinos resulting in gaps in personalized medicine affecting diagnosis, treatment and prevention. The following commentary discusses available genotype and clinical information on hereditary cancer in Latinos and highlights the limited access for cancer genetic services in Latin America including barriers to genetic testing and alternatives for providing better access to genetic services. In this review, we discuss the status of clinical genetic cancer services for both US Latinos and those Latinos living in Latin America.
In these days of financial turmoil, there is greater interest in depositing one's money in the bank--at least one might hope for greater interest. Banks and various trusts pay compound interest at regular intervals: this means that interest is paid not only on the original sum deposited, but also on previous interest payments. This article…
Growing socioeconomic disparity is a global concern, as it could affect population health. The author and colleagues have investigated the health impacts of socioeconomic disparities as well as the pathways that underlie those disparities. Our meta-analysis found that a large population has risks of mortality and poor self-rated health that are attributable to income inequality. The study results also suggested the existence of threshold effects (ie, a threshold of income inequality over which the adverse impacts on health increase), period effects (ie, the potential for larger impacts in later years, specifically after the 1990s), and lag effects between income inequality and health outcomes. Our other studies using Japanese national representative survey data and a large-scale cohort study of Japanese older adults (AGES cohort) support the relative deprivation hypothesis, namely, that invidious social comparisons arising from relative deprivation in an unequal society adversely affect health. A study with a natural experiment design found that the socioeconomic gradient in self-rated health might actually have become shallower after the 1997-98 economic crisis in Japan, due to smaller health improvements among middle-class white-collar workers and middle/upper-income workers. In conclusion, income inequality might have adverse impacts on individual health, and psychosocial stress due to relative deprivation may partially explain those impacts. Any study of the effects of macroeconomic fluctuations on health disparities should also consider multiple potential pathways, including expanding income inequality, changes in the labor market, and erosion of social capital. Further studies are needed to attain a better understanding of the social determinants of health in a rapidly changing society.
necessary to move forward in a career focused on resolving the major issues of racial and ethnic health inequities in the U.S. The scientific purpose of...disparities. The scientific results from the second year include a vast amount of data on the cross-racial and ethnic mortality within an incarcerated...year have focused on (1) the continuous development of a strong community partnership; (2) scientific and community networking and training related
Suriyawongpaisa, Paibul; Thakkinstian, Ammarin; Rangpueng, Aratta; Jiwattanakulpaisarn, Piyapong; Techakamolsuk, Pimpa
The dispersion of motorcycle related injuries and deaths might be a result of disparity in motorcycle helmet use. This study uses national roadside survey data, injury sentinel surveillance data and other national data sets in 2010 of Thailand, a country with high mortality related to motorcycle injuries, to explore the disparity in helmet use, explanatory factors of the disparity. It also assessed potential agreement and correlation between helmet use rate reported by the roadside survey and the injury sentinel surveillance. This report revealed helmet use rate of 43.7%(95% CI:43.6,43.9) nationwide with the highest rate (81.8%; 95% CI: 44.0,46.4) in Bangkok. Helmet use rate in drivers (53.3%; 95% CI: 53.2,53.8) was 2.5 times higher than that in passengers (19.3%; 95% CI:18.9,19.7). In relative terms (highest-to-lowest ratio,HLR), geographical disparity in helmet use was found to be higher in passengers (HLR = 28.5). Law enforcement activities as indicated by the conviction rate of motorcyclists were significantly associated with the helmet use rate (spline regression coefficient = 3.90, 95% CI: 0.48,7.33). Together with the finding of HLR for conviction rate of 87.24, it is suggested that more equitable improvement in helmet use could be achieved by more equitable distribution of the police force. Finally, we found poor correlation (r = 0.01; p value = 0.76) and no agreement (difference = 34.29%; 95% CI:13.48%, 55.09%) between roadside survey and injury sentinel surveillance in estimating helmet use rate. These findings should be considered a warning for employing injury surveillance to monitor policy implementation of helmet use.
Almeida, R A; Wannemuehler, M J; Rosenbusch, R F
The capacity to avoid phagocytosis and the activation of bovine alveolar macrophages (BAM) by encapsulated Mycoplasma dispar or purified M. dispar capsule was investigated. Encapsulated and unencapsulated M. dispar were cocultured with BAM in the presence or absence of antisera prepared against unencapsulated M. dispar or purified capsule antiserum. Unopsonized mycoplasmas resisted phagocytosis, while only anti-capsule antibodies enhanced the phagocytosis of encapsulated mycoplasmas. BAM were cultured in the presence of purified M. dispar capsule or either live or heat-killed encapsulated or unencapsulated M. dispar. These BAM were then activated with Escherichia coli endotoxin or left without further activation. The supernatants of these cultures were assayed for tumor necrosis factor, interleukin 1, and glucose consumption as indicators of macrophage activation. Tumor necrosis factor and interleukin 1 were produced by BAM stimulated with unencapsulated M. dispar but not when encapsulated M. dispar or its purified capsule was used. Similarly, glucose consumption was increased in the presence of unencapsulated M. dispar, but not when BAM were cocultured with encapsulated M. dispar or purified capsule. When BAM were treated with purified capsule or encapsulated mycoplasmas, they could not be subsequently activated by endotoxin. These results indicate that encapsulated M. dispar or purified capsule exerts an inhibitory effect on the activity of BAM and prevents the activation of these cells. PMID:1612758
Langston, Michael A.; Levine, Robert S.; Kilbourne, Barbara J.; Rogers, Gary L.; Kershenbaum, Anne D.; Baktash, Suzanne H.; Coughlin, Steven S.; Saxton, Arnold M.; Agboto, Vincent K.; Hood, Darryl B.; Litchveld, Maureen Y.; Oyana, Tonny J.; Matthews-Juarez, Patricia; Juarez, Paul D.
Despite staggering investments made in unraveling the human genome, current estimates suggest that as much as 90% of the variance in cancer and chronic diseases can be attributed to factors outside an individual’s genetic endowment, particularly to environmental exposures experienced across his or her life course. New analytical approaches are clearly required as investigators turn to complicated systems theory and ecological, place-based and life-history perspectives in order to understand more clearly the relationships between social determinants, environmental exposures and health disparities. While traditional data analysis techniques remain foundational to health disparities research, they are easily overwhelmed by the ever-increasing size and heterogeneity of available data needed to illuminate latent gene x environment interactions. This has prompted the adaptation and application of scalable combinatorial methods, many from genome science research, to the study of population health. Most of these powerful tools are algorithmically sophisticated, highly automated and mathematically abstract. Their utility motivates the main theme of this paper, which is to describe real applications of innovative transdisciplinary models and analyses in an effort to help move the research community closer toward identifying the causal mechanisms and associated environmental contexts underlying health disparities. The public health exposome is used as a contemporary focus for addressing the complex nature of this subject. PMID:25310540
Vuong, Quoc C; Domini, Fulvio; Caudek, Corrado
In two experiments, we tested whether disparity and shading cues cooperated for surface interpolation. Observers adjusted a probe dot to/lie on a surface specified either by a sparse disparity field, a continuous stereo shading or monocular shading gradient, or both cues. Observers' adjustments were very consistent with disparity information but their adjustments were much more variable with shading information. However, observers significantly improved their precision when both cues were present, relative to when only disparity information was present. These results cannot be explained by assuming that separate modules analyze disparity and shading information, even if observers optimally combined these cues. Rather, we attribute this improvement to a process through which the shading gradient constrains the disparity field in regions where disparities cannot be directly measured. This cooperative process may be based on the natural covariation existing between these cues produced by the retinal projection of smooth surfaces.
Grandner, Michael A.; Williams, Natasha J.; Knutson, Kristen L.; Roberts, Dorothy; Jean-Louis, Girardin
Sleep represents a set of biological functions necessary for the maintenance of life. Performing these functions, though, requires that an individual engage in behaviors, which are affected by social and environmental factors. Race/ethnicity and socioeconomic position represent categories of factors that likely play a role in the experience of sleep in the community. Previous studies have suggested that racial/ethnic minorities and the socioeconomically disadvantaged may be more likely to experience sleep patterns that are associated with adverse health outcomes. It is possible that disparities in sleep represent a pathway by which larger disparities in health emerge. This review (1) contextualizes the concept of race/ethnicity in biomedical research, (2) summarizes previous studies that describe patterns of sleep attainment across race/ethnicity groups, (3) discusses several pathways by which race/ethnicity may be associated with sleep, (4) introduces the potential role of socioeconomic position in the patterning of sleep, and (5) proposes future research directions to address this issue. PMID:26431755
Lin, Chyongchiou Jeng; Musa, Donald; Silverman, Myrna; Degenholtz, Howard B
This study was designed to determine whether managed care plans reduce racial disparities in use of influenza vaccination, mammography, and prostate-specific antigen screening. The study analyzed the use of three types of preventive care in a population-based sample of adults who were 65 years or older and were enrolled in a Medicare managed care (MMC) or fee-for-service (FFS) plan in Allegheny County, Pennsylvania. The study sample included 463 African Americans and 592 whites. Fewer African Americans than whites reported having had an influenza vaccination (64.4% versus 76.5%; p < 0.01) or a prostate-specific antigen test (64% versus 71.2%; p = 0.09) during the previous year. Slightly more African Americans than white women reported having had a mammogram (66.1% versus 63.8%). Logistic regression showed that, regardless of health plan type, African Americans were significantly less likely than whites to have an influenza vaccination (p < 0.05). A MMC plan did not narrow racial differences in preventive care. Reducing disparities may require interventions developed for specific racial/ethnic groups.
Sabbath, Erika L; Boden, Leslie I; Williams, Jessica Ar; Hashimoto, Dean; Hopcia, Karen; Sorensen, Glorian
Objectives Underreporting of occupational injuries is well documented, but underreporting patterns may vary by worker characteristics, obscuring disparities. We tested for racial and ethnic differences in injury reporting patterns by comparing injuries reported via research survey and administrative injury database in the same group of healthcare workers in the US. Methods We used data from a cohort of 1568 hospital patient-care workers who were asked via survey whether they had been injured at work during the year prior (self-reported injury; N=244). Using the hospital's injury database, we determined whether the same workers had reported injuries to the hospital's occupational health service during that year (administratively reported injury; N=126). We compared data sources to test for racial and ethnic differences in injury reporting practices. Results In logistic regression models adjusted for demographic and occupational characteristics, black workers' odds of injury as measured by self-report data were 1.91 [95% confidence interval (95% CI) 1.04-3.49] compared with white workers. The same black workers' odds of injury as measured by administrative data were 1.22 (95% CI 0.54-2.77) compared with white workers. Conclusions The undercount of occupational injuries in administrative versus self-report data may be greater among black compared to white workers, leading to underestimates of racial disparities in workplace injury.
Garrett, Bridgette E.; Dube, Shanta R.; Babb, Stephen; McAfee, Tim
Introduction Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Methods Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Results Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Conclusions Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities. PMID:25516538
Oman, Matthew; Patel, Aatish M.; Vega, Kenneth J.
In the 2010 Census, just over one-third of the United States (US) population identified themselves as being something other than being non-Hispanic white alone. This group has increased in size from 86.9 million in 2000 to 111.9 million in 2010, representing an increase of 29 percent over the ten year period. Per the American Cancer Society, racial and ethnic minorities are more likely to develop cancer and die from it when compared to the general population of the United States. This is particularly true for colorectal cancer (CRC). The primary aim of this review is to highlight the disparities in CRC among racial and ethnic minorities in the United States. Despite overall rates of CRC decreasing nationally and within certain racial and ethnic minorities in the US, there continue to be disparities in incidence and mortality when compared to non-Hispanic whites. The disparities in CRC incidence and mortality are related to certain areas of deficiency such as knowledge of family history, access to care obstacles, impact of migration on CRC and paucity of clinical data. These areas of deficiency limit understanding of CRC’s impact in these groups and when developing interventions to close the disparity gap. Even with the implementation of the Patient Protection and Affordable Healthcare Act, disparities in CRC screening will continue to exist until specific interventions are implemented in the context of each of racial and ethnic group. Racial and ethnic minorities cannot be viewed as one monolithic group, rather as different segments since there are variations in incidence and mortality based on natural history of CRC development impacted by gender, ethnicity group, nationality, access, as well as migration and socioeconomic status. Progress has been made overall, but there is much work to be done. PMID:27034811
Mangan, Katherine S.
Decline in interest and employment in public-interest law may be due to cuts in legal services funding, heightened recruiting by private firms, mounting law student debt burdens, growing salary disparities in public-interest and corporate law, inadequate curricular attention to public-interest issues, and private law firm prestige. (MSE)
The author documents pervasive racial disparities in the health of American children and analyzes how and how much those disparities contribute to racial gaps in school readiness. She explores a broad sample of health problems common to U.S. children, such as attention deficit hyperactivity disorder, asthma, and lead poisoning, as well as maternal health problems and health-related behaviors that affect children's behavioral and cognitive readiness for school. If a health problem is to affect the readiness gap, it must affect many children, it must be linked to academic performance or behavior problems, and it must show a racial disparity either in its prevalence or in its effects. The author focuses not only on the black-white gap in health status but also on the poor-nonpoor gap because black children tend to be poorer than white children. The health conditions Currie considers seriously impair cognitive skills and behavior in individual children. But most explain little of the overall racial gap in school readiness. Still, the cumulative effect of health differentials summed over all conditions is significant. Currie's rough calculation is that racial differences in health conditions and in maternal health and behaviors together may account for as much as a quarter of the racial gap in school readiness. Currie scrutinizes several policy steps to lessen racial and socioeconomic disparities in children's health and to begin to close the readiness gap. Increasing poor children's eligibility for Medicaid and state child health insurance is unlikely to be effective because most poor children are already eligible for public insurance. The problem is that many are not enrolled. Even increasing enrollment may not work: socioeconomic disparities in health persist in Canada and the United Kingdom despite universal public health insurance. The author finds more promise in strengthening early childhood programs with a built-in health component, like Head Start; family
Geriatric assessment in daily oncology practice for nurses and allied health care professionals: Opinion paper of the Nursing and Allied Health Interest Group of the International Society of Geriatric Oncology (SIOG).
Burhenn, Peggy S; McCarthy, Alexandra L; Begue, Aaron; Nightingale, Ginah; Cheng, Karis; Kenis, Cindy
The management of older persons with cancer has become a major public health concern in developed countries because of the aging of the population and the steady increase in cancer incidence with advancing age. Nurses and allied health care professionals are challenged to address the needs of this growing population. The International Society of Geriatric Oncology (SIOG) Nursing and Allied Health (NAH) Interest Group described key issues that nurses and allied health care professionals face when caring for older persons with cancer. The domains of the Geriatric Assessment (GA) are used as a guiding framework. The following geriatric domains are described: demographic data and social support, functional status, cognition, mental health, nutritional status, fatigue, comorbidities, polypharmacy, and other geriatric syndromes (e.g. falls, delirium). In addition to these geriatric domains, quality of life (QoL) is described based on the overall importance in this particular population. Advice for integration of assessment of these geriatric domains into daily oncology practice is made. Research has mainly focused on the role of treating physicians but the involvement of nurses and allied health care professionals is crucial in the care of older persons with cancer through the GA process. The ability of nurses and allied health care professionals to perform this assessment requires specialized training and education beyond standard oncology knowledge.
Morgenstern, Lewis B.; Smith, Melinda A.; Sanchez, Brisa N.; Brown, Devin L.; Zahuranec, Darin B.; Garcia, Nelda; Kerber, Kevin A.; Skolarus, Lesli E.; Meurer, William J.; Burke, James F.; Adelman, Eric E.; Baek, Jonggyu; Lisabeth, Lynda D.
Objective To determine trends in ischemic stroke incidence among Mexican Americans and non-Hispanic whites. Methods We performed population-based stroke surveillance from January 1, 2000 to December 31, 2010 in Corpus Christi, Texas. Ischemic stroke patients 45 years and older were ascertained from potential sources, and charts were abstracted. Neurologists validated cases based on source documentation blinded to ethnicity and age. Crude and age-, sex-, and ethnicity-adjusted annual incidence was calculated for first ever completed ischemic stroke. Poisson regression models were used to calculate adjusted ischemic stroke rates, rate ratios, and trends. Results There were 2,604 ischemic strokes in Mexican Americans and 2,042 in non-Hispanic whites. The rate ratios (Mexican American:non-Hispanic white) were 1.94 (95% confidence interval [CI] = 1.67–2.25), 1.50 (95% CI = 1.35– 1.67), and 1.00 (95% CI = 0.90–1.11) among those aged 45 to 59, 60 to 74, and 75 years and older, respectively, and 1.34 (95% CI = 1.23–1.46) when adjusted for age. Ischemic stroke incidence declined during the study period by 35.9% (95% CI = 25.9–44.5). The decline was limited to those aged ≥60 years, and happened in both ethnic groups similarly (p > 0.10), implying that the disparities seen in the 45- to 74-year age group persist unabated. Interpretation Ischemic stroke incidence rates have declined dramatically in the past decade in both ethnic groups for those aged ≥60 years. However, the disparity between Mexican American and non-Hispanic white stroke rates persists in those <75 years of age. Although the decline in stroke is encouraging, additional prevention efforts targeting young Mexican Americans are warranted. PMID:23868398
Read, Jenny C. A.
Primary visual cortex is often viewed as a “cyclopean retina”, performing the initial encoding of binocular disparities between left and right images. Because the eyes are set apart horizontally in the head, binocular disparities are predominantly horizontal. Yet, especially in the visual periphery, a range of non-zero vertical disparities do occur and can influence perception. It has therefore been assumed that primary visual cortex must contain neurons tuned to a range of vertical disparities. Here, I show that this is not necessarily the case. Many disparity-selective neurons are most sensitive to changes in disparity orthogonal to their preferred orientation. That is, the disparity tuning surfaces, mapping their response to different two-dimensional (2D) disparities, are elongated along the cell's preferred orientation. Because of this, even if a neuron's optimal 2D disparity has zero vertical component, the neuron will still respond best to a non-zero vertical disparity when probed with a sub-optimal horizontal disparity. This property can be used to decode 2D disparity, even allowing for realistic levels of neuronal noise. Even if all V1 neurons at a particular retinotopic location are tuned to the expected vertical disparity there (for example, zero at the fovea), the brain could still decode the magnitude and sign of departures from that expected value. This provides an intriguing counter-example to the common wisdom that, in order for a neuronal population to encode a quantity, its members must be tuned to a range of values of that quantity. It demonstrates that populations of disparity-selective neurons encode much richer information than previously appreciated. It suggests a possible strategy for the brain to extract rarely-occurring stimulus values, while concentrating neuronal resources on the most commonly-occurring situations. PMID:20421992
Howell, Elizabeth A; Padrón, Norma A; Beane, Susan J; Stone, Joanne; Walther, Virginia; Balbierz, Amy; Kumar, Rashi; Pagán, José A
Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk. The program includes a social work/care management component and a payment system redesign with a cost-sharing arrangement between the health system and the Medicaid managed care plan to cover the cost of staff, clinician education, performance feedback, and clinic/clinician financial incentives. The goal is to enroll 510 high-risk postpartum mothers. Assessment The primary outcome of interest is a timely postpartum visit in accordance with NCQA healthcare effectiveness data and information set guidelines. Secondary outcomes include care process measures for women with specific high-risk conditions, emergency room visits, postpartum readmissions, depression screens, and health care costs. Conclusion Our evidence-based program focuses on an important area of maternal health, targets racial/ethnic disparities in postpartum care, utilizes an innovative payment reform strategy, and brings together insurers, researchers, clinicians, and policy experts to work together to foster health and wellness for postpartum women and reduce disparities.
Chen, Sung-Lang; Wang, Shao-Chuan; Ho, Cheng-Ju; Kao, Yu-Lin; Hsieh, Tzuo-Yi; Chen, Wen-Jung; Chen, Chih-Jung; Wu, Pei-Ru; Ko, Jiunn-Liang; Lee, Huei; Sung, Wen-Wei
The variation in mortality-to-incidence ratios (MIRs) among countries reflects the clinical outcomes and the available interventions for colorectal cancer treatments. The association between MIR of prostate cancer and cancer care disparities among countries is an interesting issue that is rarely investigated. For the present study, cancer incidence and mortality rates were obtained from the GLOBOCAN 2012 database. The rankings and total expenditures on health of various countries were obtained from the World Health Organization (WHO). The association between variables was analyzed by linear regression analyses. In this study, we estimated the role of MIRs from 35 countries that had a prostate cancer incidence greater than 5,000 cases per year. As expected, high prostate cancer incidence and mortality rates were observed in more developed regions, such as Europe and the Americas. However, the MIRs were 2.5 times higher in the less developed regions. Regarding the association between MIR and cancer care disparities, countries with good WHO ranking and high total expenditures on health/gross domestic product (GDP) were significant correlated with low MIR. The MIR variation for prostate cancer correlates with cancer care disparities among countries further support the role of cancer care disparities in clinical outcome. PMID:28051150
Cottereau, Benoit R.; McKee, Suzanne P.; Ales, Justin M.; Norcia, Anthony M.
Using cortical source estimation techniques based on high-density EEG and fMRI measurements in humans, we measured how a disparity-defined surround influenced the responses to the changing disparity of a central disk within five visual ROIs: V1, V4, lateral occipital complex (LOC), hMT+, and V3A. The responses in the V1 ROI were not consistently affected either by changes in the characteristics of the surround (correlated or uncorrelated) or by its disparity value, consistent with V1 being responsive only to absolute, not relative, disparity. Correlation in the surround increased the responses in the V4, LOC, and hMT+ ROIs over those measured with the uncorrelated surround. Thus, these extrastriate areas contain neurons that are sensitive to disparity differences. However, their evoked responses did not vary systematically with the surround disparity. Responses in the V3A ROI, in contrast, were increased by correlation in the surround and varied with its disparity. We modeled these V3A responses as attributable to a gain modulation of the absolute disparity response, where the gain amplitude is proportional to the center–surround disparity difference. An additional experiment identified a nonlinear center–surround interaction in V3A that facilitates the responses when center and surround are misaligned but suppresses it when they share the same disparity plane. PMID:22262881
Hansen, Jo-Ida C.
The assessment of interests through the use of interest inventories is big business in the field of testing today. The assessment of interests originally developed as an outgrowth of efforts in education and in industry to supplement special and general abilities information about individuals. Interest inventories used today differ from early…
Harrold, Timothy C.; Randall, Deborah A.; Falster, Michael O.; Lujic, Sanja; Jorm, Louisa R.
Objectives To quantify the independent roles of geography and Indigenous status in explaining disparities in Potentially Preventable Hospital (PPH) admissions between Indigenous and non-Indigenous Australians. Design, setting and participants Analysis of linked hospital admission data for New South Wales (NSW), Australia, for the period July 1 2003 to June 30 2008. Main outcome measures Age-standardised admission rates, and rate ratios adjusted for age, sex and Statistical Local Area (SLA) of residence using multilevel models. Results PPH diagnoses accounted for 987,604 admissions in NSW over the study period, of which 3.7% were for Indigenous people. The age-standardised PPH admission rate was 76.5 and 27.3 per 1,000 for Indigenous and non-Indigenous people respectively. PPH admission rates in Indigenous people were 2.16 times higher than in non-Indigenous people of the same age group and sex who lived in the same SLA. The largest disparities in PPH admission rates were seen for diabetes complications, chronic obstructive pulmonary disease and rheumatic heart disease. Both rates of PPH admission in Indigenous people, and the disparity in rates between Indigenous than non-Indigenous people, varied significantly by SLA, with greater disparities seen in regional and remote areas than in major cities. Conclusions Higher rates of PPH admission among Indigenous people are not simply a function of their greater likelihood of living in rural and remote areas. The very considerable geographic variation in the disparity in rates of PPH admission between Indigenous and non-Indigenous people indicates that there is potential to reduce unwarranted variation by characterising outlying areas which contribute the most to this disparity. PMID:24859265
Girard, Catherine; Renaud, Sabrina
Early periods in Earth's history have seen a progressive increase in complexity of the ecosystems, but also dramatic crises decimating the biosphere. Such patterns are usually considered as large-scale changes among supra-specific groups, including morphological novelties, radiation, and extinctions. Nevertheless, in the same time, each species evolved by the way of micro-evolutionary processes, extended over millions of years into the evolution of lineages. How these two evolutionary scales interacted is a challenging issue because this requires bridging a gap between scales of observation and processes. The present study aims at transferring a typical macro-evolutionary approach, namely disparity analysis, to the study of fine-scale evolutionary variations in order to decipher what processes actually drove the dynamics of diversity at a micro-evolutionary level. The Late Frasnian to Late Famennian period was selected because it is punctuated by two major macro-evolutionary crises, as well as a progressive diversification of marine ecosystem. Disparity was estimated through this period on conodonts, tooth-like fossil remains of small eel-like predators that were part of the nektonic fauna. The study was focused on the emblematic genus of the period, Palmatolepis. Strikingly, both crises affected an already impoverished Palmatolepis disparity, increasing risks of random extinction. The major disparity signal rather emerged as a cycle of increase and decrease in disparity during the inter-crises period. The diversification shortly followed the first crisis and might correspond to an opportunistic occupation of empty ecological niche. The subsequent oriented shrinking in the morphospace occupation suggests that the ecological space available to Palmatolepis decreased through time, due to a combination of factors: deteriorating climate, expansion of competitors and predators. Disparity changes of Palmatolepis thus reflect changes in the structure of the ecological
deShazo, Richard D; Parker, Sara Bolen
Many people see telemedicine as a solution to the nation's health disparities and in Mississippi as a solution to our last place in health. More than 13 years ago, the University of Mississippi Medical Center developed a successful TelEmergency program that saved rural Critical Access Hospitals and now provides telehealth services throughout the state. This occurred without acrimony because of partnerships that the University of Mississippi Medical Center developed with telecommunications companies, state government, health professions' licensure boards, and private donors. Today, the telemedicine market is exploding across the country with the entry of for-profit corporations into the medical market. These corporations often are more inclined to work with legislators rather than physicians, and some physician groups have attempted to limit their expansion. With the future of telemedicine now determined in part by the courts, rather than the providers, new pitfalls have arisen. The Mississippi experience may be helpful in navigating this new territory.
Harris, Jenine K; Beatty, Kate; Leider, J P; Knudson, Alana; Anderson, Britta L; Meit, Michael
Residents of rural jurisdictions face significant health challenges, including some of the highest rates of risky health behaviors and worst health outcomes of any group in the country. Rural communities are served by smaller local health departments (LHDs) that are more understaffed and underfunded than their suburban and urban peers. As a result of history and current need, rural LHDs are more likely than their urban peers to be providers of direct health services, leading to relatively lower levels of population-focused activities. This review examines the double disparity faced by rural LHDs and their constituents: pervasively poorer health behaviors and outcomes and a historical lack of investment by local, state, and federal public health entities.
Frenn, Marilyn; Malin, Shelly; Bansal, Naveen; Delgado, Mary; Greer, Yvonne; Havice, Michael; Ho, Mary; Schweizer, Heidi
Those with low income, especially women of African American and Hispanic heritage have the greatest risk of inactivity and obesity. A 4-session (Internet and video) intervention with healthy snack and gym labs was tested in 2 (gym lab in 1) urban low-middle-income middle schools to improve low fat diet and moderate and vigorous physical activity.1 The gym lab was particularly beneficial (p =.002). Fat in diet decreased with each Internet session in which students participated. Percentage of fat in food was reduced significantly p =.018 for Black, White, and Black/Native American girls in the intervention group. Interventions delivered through Internet and video may enable reduction of health disparities in students by encouraging those most at risk to consume 30% or less calories from fat and to engage in moderate and vigorous physical activity.
Singleton, Chelsea R.; Affuso, Olivia; Sen, Bisakha
Introduction Racial disparities in obesity exist at the individual and community levels. Retail food environment has been hypothesized to be associated with racial disparities in obesity prevalence. This study aimed to quantify how much food environment measures explain racial disparities in obesity at the county level. Methods Data from 2009 to 2010 on 3,135 U.S. counties were extracted from the U.S. Department of Agriculture Food Environment Atlas and the Behavioral Risk Factor Surveillance System and analyzed in 2013. Oaxaca–Blinder decomposition was used to quantify the portion of the gap in adult obesity prevalence observed between counties with a high and low proportion of African American residents is explained by food environment measures (e.g., proximity to grocery stores, per capita fast food restaurants). Counties were considered to have a high African American population if the percentage of African American residents was >13.1%, which represents the 2010 U.S. Census national estimate of percentage African American citizens. Results There were 665 counties (21%) classified as a high African American county. The total gap in mean adult obesity prevalence between high and low African American counties was found to be 3.35 percentage points (32.98% vs 29.63%). Retail food environment measures explained 13.81% of the gap in mean age-adjusted adult obesity prevalence. Conclusions Retail food environment explains a proportion of the gap in adult obesity prevalence observed between counties with a high proportion of African American residents and counties with a low proportion of African American residents. PMID:26507301
Kurian, N J
India is often characterized as an emerging economic super power. The huge demographic dividend, the high quality engineering and management talent, the powerful Indian diaspora and the emerging Indian transnational--kneeling the optimism. In contrast, there is another profile of India which is rather gloomy. This is the country with the largest number of the poor, illiterates and unemployed in the world. High infant mortality, morbidity and widespread anaemia among women and children continue. India suffers from acute economic and social disparities. This article addresses four dimensions of such disparities, viz. regional, rural-urban, social, and gender. There is empirical evidence to indicate that during the last two decades all these disparities have been increasing. As a result of economic reforms, the southern and western States experienced accelerated economic and social development as compared to northern and eastern States. This has led to widening gap in income, poverty and other indicators of development between the two regions. Rural-urban divide also widened in the wake of reforms. While large and medium cities experience unprecedented economic prosperity, the rural areas experience economic stagnation. As a result, there is widespread agrarian distress which results in farmers' suicide and rural unrest. Socially backward sections, especially scheduled castes and tribes (SCs and STs) have gained little from the new prosperity which rewards disproportionately those with assets, skills and higher education. STs have often been victims of development as a result of displacement. The gender gap in social and economic status, traditionally more in India as compared to other societies; has further widened by the economic reforms and globalization. The approach paper to the Eleventh Plan stresses the importance of more inclusive economic growth. It emphasizes the need for bridging the divides discussed in this article. Unless these are achieved in a time
Nayani, Rahul; Ashktorab, Hassan; Brim, Hassan; Laiyemo, Adeyinka O.
African Americans suffer the highest burden from colorectal cancer (CRC) in the USA. Studies have suggested that healthcare access and poorer utilization of preventive services may be playing more of a role in this disparity. However, African Americans also tend to develop CRC at younger ages and are more likely to have proximal cancers. This raises the possibility of higher genetic predisposition to CRC among African Americans and this has not been well studied. In this article, we reviewed possible genetic basis underpinning biological differences in CRC burden in the USA. PMID:26997937
Foth, C; Brusatte, S L; Butler, R J
Disparity, or morphological diversity, is often quantified by evolutionary biologists investigating the macroevolutionary history of clades over geological timescales. Disparity is typically quantified using proxies for morphology, such as measurements, discrete anatomical characters, or geometric morphometrics. If different proxies produce differing results, then the accurate quantification of disparity in deep time may be problematic. However, despite this, few studies have attempted to examine disparity of a single clade using multiple morphological proxies. Here, as a case study for this question, we examine the disparity of the volant Mesozoic fossil reptile clade Pterosauria, an intensively studied group that achieved substantial morphological, ecological and taxonomic diversity during their 145+ million-year evolutionary history. We characterize broadscale patterns of cranial morphological disparity for pterosaurs for the first time using landmark-based geometric morphometrics and make comparisons to calculations of pterosaur disparity based on alternative metrics. Landmark-based disparity calculations suggest that monofenestratan pterosaurs were more diverse cranially than basal non-monofenestratan pterosaurs (at least when the aberrant anurognathids are excluded), and that peak cranial disparity may have occurred in the Early Cretaceous, relatively late in pterosaur evolution. Significantly, our cranial disparity results are broadly congruent with those based on whole skeleton discrete character and limb proportion data sets, indicating that these divergent approaches document a consistent pattern of pterosaur morphological evolution. Therefore, pterosaurs provide an exemplar case demonstrating that different proxies for morphological form can converge on the same disparity signal, which is encouraging because often only one such proxy is available for extinct clades represented by fossils. Furthermore, mapping phylogeny into cranial morphospace
Tehranifar, Parisa; Neugut, Alfred I.; Phelan, Jo C.; Link, Bruce G.; Liao, Yuyan; Desai, Manisha; Terry, Mary Beth
BACKGROUND Although advances in early detection and treatment of cancer improve overall population survival, these advances may not benefit all population groups equally, and may heighten racial/ethnic (R/E) differences in survival. METHODS We identified cancer cases in the Surveillance, Epidemiology, and End Results program, who were ≥ 20 years and diagnosed with one invasive cancer in 1995–1999 (n=580,225). We used 5-year relative survival rates (5Y-RSR) to measure the degree to which mortality from each cancer is amenable to medical interventions (amenability index). We used Kaplan-Meier methods and Cox proportional hazards regression to estimate survival differences between each R/E minority group relative to whites, by the overall amenability index, and three levels of amenability (non-amenable, partly and mostly amenable cancers, corresponding to cancers with 5Y-RSR <40%, 40–69% and ≥ 70%, respectively), adjusting for gender, age, disease stage and county-level poverty concentration. RESULTS As amenability increased, R/E differences in cancer survival increased for African Americans, American Indians/Native Alaskans and Hispanics relative to whites. For example, the hazard rate ratios (95% confidence intervals) for African Americans vs. whites from non-amenable, partly amenable and mostly amenable cancers were 1.05 (1.03, 1.07), 1.38 (1.34,1.41), and 1.41 (1.37, 1.46), respectively. Asians/Pacific Islanders had similar or longer survival relative to whites across amenability levels; however, several subgroups experienced increasingly poorer survival with increasing amenability. CONCLUSIONS Cancer survival disparities for most R/E minority populations widen as cancers become more amenable to medical interventions. Efforts in developing cancer control measures must be coupled with specific strategies for reducing the expected disparities. PMID:19789367
Chin, Marshall H; Walters, Amy E; Cook, Scott C; Huang, Elbert S
In 2005, the Robert Wood Johnson Foundation created Finding Answers: Disparities Research for Change, a program to identify, evaluate, and disseminate interventions to reduce racial and ethnic disparities in the care and outcomes of patients with cardiovascular disease, depression, and diabetes. In this introductory paper, we present a conceptual model for interventions that aim to reduce disparities. With this model as a framework, we summarize the key findings from the six other papers in this supplement on cardiovascular disease, diabetes, depression, breast cancer, interventions using cultural leverage, and pay-for-performance and public reporting of performance measures. Based on these findings, we present global conclusions regarding the current state of health disparities interventions and make recommendations for future interventions to reduce disparities. Multifactorial, culturally tailored interventions that target different causes of disparities hold the most promise, but much more research is needed to investigate potential solutions and their implementation.
Rivers, Brian M; Bernhardt, Jay M; Fleisher, Linda; Green, Bernard Lee
During a panel presentation at the American Association for Cancer Research Cancer Health Disparities Conference titled 'Opportunities and challenges of using technology to address health disparities', the latest scientific advances in the application and utilization of mobile technology and/or mobile-health (mHealth) interventions to address cancer health disparities were discussed. The session included: an examination of overall population trends in the uptake of technology and the potential of addressing health disparities through such media; an exploration of the conceptual issues and challenges in the construction of mHealth interventions to address disparate and underserved populations; and a presentation of pilot study findings on the acceptability and feasibility of using mHealth interventions to address prostate cancer disparities among African-American men.
Kawai, Takashi; Atsuta, Daiki; Tomiyama, Yuya; Kim, Sanghyun; Morikawa, Hiroyuki; Mitsuya, Reiko; Häkkinen, Jukka
This paper describes a study that focuses on disparity changes in emotional scenes of stereoscopic (3D) images, in which an examination of the effects on pleasant and arousal was carried out by adding binocular disparity to 2D images that evoke specific emotions, and applying disparity modification based on the disparity analysis of famous 3D movies. From the results of the experiment, for pleasant, a significant difference was found only for the main effect of the emotions. On the other hand, for arousal, there was a trend of increasing the evaluation values in the order 2D condition, 3D condition and 3D condition applied the disparity modification for happiness, surprise, and fear. This suggests the possibility that binocular disparity and the modification affect arousal.
Gudino, Omar G.; Lau, Anna S.; Yeh, May; McCabe, Kristen M.; Hough, Richard L.
The authors examined racial/ethnic disparities in mental health service use based on problem type (internalizing/externalizing). A diverse sample of youth in contact with public sectors of care and their families provided reports of youth's symptoms and functional impairment during an initial interview. Specialty and school-based mental health…
Skurikhin, Alexei N; Pope, Paul A
A quad chart provides an overview on the on-going project 'Broad Area Search for Regions and Objects of Interest' funded by the DOE Office of Nonproliferation and Verification Research and Development. Specifically, the quad chart shows: (1) Project title 'Broad Area Search for Regions and Objects of Interest'; (2) PI and Co-investigators; (3) Concept Panel outlining the project's approach built upon front-end scale-space image analysis; (4) Technical Challenges posed by the project, such as robustness, non-conformities, disparate spatial configuration and weak correlation between presence of objects of interest and low-level description of the surrounding geospatial background; and (5) Planned Accomplishment.
Edberg, Mark; Hayes, Barbara E.; Montgomery-Rice, Valerie; Tchounwou, Paul B.
Health disparities have been defined as a particular type of health difference closely linked with social, economic and/or environmental disadvantage. The National Institute on Minority Health and Health Disparities (NIMHD) at the National Institutes of Health, has a comprehensive portfolio of grants that fund scientific research to improve racial/ethnic minority health and eliminate health disparities. The 2014 Minority Health and Health Disparities Grantees’ Conference highlighted excellence and innovation in biological, environmental, sociocultural, clinical and behavioral research supported by NIMHD. This special issue of the International Journal of Environmental Research and Public Health includes peer-reviewed publications from investigators who participated in this conference.
Wheeler, Sarahn M; Bryant, Allison S
A health disparity is defined as an increased burden of an adverse health outcome or health determinant within a specific subset of the population. There are well-documented racial and ethnic disparities throughout health care at the patient, provider, and health care system levels. As the minority populations within the United States grow to record numbers, it is increasingly important to invest in efforts to characterize, understand, and end racial and ethnic disparities in health care. Inequities in health outcomes and care pose real threats to the entire nation's well-being. Eliminating health disparities is fundamental to the well-being, productivity, and viability of the entire nation.
Socioeconomic status fundamentally affects most health and disease outcomes, but black Americans are doubly disadvantaged by low status, discrimination, and residential segregation. Improving health and removing disparities are essential goals, but some efforts that improve the health of blacks in important ways also increase black-white disparity ratios. People with more information, influence, resources, and social networks may be better able to take advantage of new technologies and scientific developments, initially increasing disparities. Better health and reduced mortality should be the key policy criteria, but these criteria should be linked with consideration of careful targeting to level the playing field and close disparities.
Lovell, Paul G; Bloj, Marina; Harris, Julie M
We explore the relative utility of shape from shading and binocular disparity for depth perception. Ray-traced images either featured a smooth surface illuminated from above (shading-only) or were defined by small dots (disparity-only). Observers judged which of a pair of smoothly curved convex objects had most depth. The shading cue was around half as reliable as the rich disparity information for depth discrimination. Shading- and disparity-defined cues where combined by placing dots in the stimulus image, superimposed upon the shaded surface, resulting in veridical shading and binocular disparity. Independently varying the depth delivered by each channel allowed creation of conflicting disparity-defined and shading-defined depth. We manipulated the reliability of the disparity information by adding disparity noise. As noise levels in the disparity channel were increased, perceived depths and variances shifted toward those of the now more reliable shading cue. Several different models of cue combination were applied to the data. Perceived depths and variances were well predicted by a classic maximum likelihood estimator (MLE) model of cue integration, for all but one observer. We discuss the extent to which MLE is the most parsimonious model to account for observer performance.
Mitchell, Sandra K.; And Others
The construction and early validation of an ipsative, forced-choice vocational interest inventory (VII) to measure Roe's eight foci of occupational activity is detailed. Designed for counseling the broad range of high school students, the VII produced consistently interpretable mean profiles for groups of high school juniors having only tentative…
Dovidio, John F; Fiske, Susan T
Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love-hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health.
Interest rates can significantly influence people's behavior. When rates decline, homeowners rush to buy new homes and refinance old mortgages; automobile buyers scramble to buy new cars; the stock market soars, and people tend to feel more optimistic about the future. But even though individuals respond to changes in rates, they may not fully…
Eryurt, Mehmet Ali; Koç, Ismet
The United Nations Children's Fund (UNICEF) defines child poverty as the inability of the child to realize their existing potential due to their inability to access resources across different dimensions of life (income, health, nutrition, education, environment, etc.). On the basis of this definition, an attempt has been made in this study to put forth the disadvantaged positions children have in different dimensions of their lives, specifically by taking regional disparities into account. As the data source, the Turkey Demographic and Health Survey 2008 is used, a survey that consists of detailed information about the different dimensions of child poverty. In this study, in order to measure poverty in four different dimensions (education and work, health and nutrition, family environment, and domestic environment), a total of 25 variables were used and descriptive and multivariate analyses were made in order to highlight the regional disparities in child poverty. Principle components analysis conducted through the use of a deficit approach reveals that the variables closely related with education and health and nutrition were the critical dimensions behind child poverty in Turkey. The results of this study indicate that 22.4% of children in Turkey are poor when various dimensions of life are taken into account; the region with the highest child poverty is Central East Anatolia, at 34.9%, while the region with the lowest rate is East Marmara, at 15.6%.
Lynce, Filipa; Graves, Kristi D.; Jandorf, Lina; Ricker, Charité; Castro, Eida; Moreno, Laura; Augusto, Bianca; Fejerman, Laura; Vadaparampil, Susan T.
Background Breast cancer is the most common cancer diagnosed among Latinas in the United States and the leading cause of cancer-related death among this population. Latinas tend to be diagnosed at a later stage and have worse prognostic features than their non-Hispanic white counterparts. Genetic and genomic factors may contribute to observed breast cancer health disparities in Latinas. Methods We provide a landscape of our current understanding and the existing gaps that need to be filled across the cancer prevention and control continuum. Results We summarize available data on mutations in high and moderate penetrance genes for inherited risk of breast cancer and the associated literature on disparities in awareness of and uptake of genetic counseling and testing in Latina populations. We also discuss common genetic polymorphisms and risk of breast cancer in Latinas. In the treatment setting, we examine tumor genomics and pharmacogenomics in Latina patients with breast cancer. Conclusions As the US population continues to diversify, extending genetic and genomic research into this underserved and understudied population is critical. By understanding the risk of breast cancer among ethnically diverse populations, we will be better positioned to make treatment advancements for earlier stages of cancer, identify more effective and ideally less toxic treatment regimens, and increase rates of survival. PMID:27842325
Garzarella, Katherine; Caswell, Michael
Regulatory agencies throughout the world have developed exclusive methodologies for assessing and classifying sunscreen product efficacy in their respective markets. Three prevalent methods, the Food and Drug Administration-Final Monograph (FDA-FM) method, the Australia/New Zealand (Aus/NZ) method, and the COLIPA International (International) method, contain procedural and statistical dissimilarities with undefined significance. The objective of our clinical trials was to evaluate the influence of these disparities on sun protection factor (SPF) values. Our clinical trials evaluated the SPF of 59 test materials, using two or all three of the aforementioned methods in simultaneous trials, providing two or three SPF values for each formulation. A total of 135 trials were conducted. The consequent mean SPF values generated per trial were used to compare methods in a correlation and variance analysis. The correlation coefficients for each method pair, International vs. FDA-FM, Aus/NZ vs. FDA-FM, and International vs. Aus/NZ, were each ≥0.94. The difference in least square mean SPF for each method pair was 0.12, 0.62, and 0.81, respectively. Our juxtaposition of the mean SPFs produced by these methods clearly illustrate that any disparities between average SPF values produced by these methods are not clinically or statistically significant and that using one method should be sufficient for SPF labeling in all three respective markets.
Jones, Katherine M.; Queenan, John T.; Schulkin, Jay
Abstract This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted. Racial and ethnic minority women continue to have lower breastfeeding rates than white women and are not close to meeting the Healthy People 2020 goals. Minority women report many barriers to breastfeeding. Major efforts are still needed to improve breastfeeding initiation and duration rates among minority women in the United States. Obstetrician-gynecologists have a unique opportunity to promote and support breastfeeding through their clinical practices and public policy, and their efforts can have a meaningful impact on the future health of the mother and child. PMID:25831234
Hagay, Galit; Baram-Tsabari, Ayelet
Many students feel the curriculum is detached from their lives and interests. Indeed, about half the questions asked by high school biology students are not addressed by the curriculum. This study presents a strategy to incorporate students' curiosity questions into the curriculum as a way to reduce the disparity between students' interests and…
Kritek, Phyllis Beck; Hargraves, Martha; Cuellar, Ernestine H.; Dallo, Florence; Gauthier, Donna M.; Holland, Christi A.; Ilkiw, Connie; Swanson, Jane W.; Swanson, Reid
A national conference convened in May 2001 explored health disparities among minority women. It included 5 one-hour workshops that randomly assigned each participant to 1 of 4 groups. Groups generated recommendations on conference topics and from these identified priority recommendations. Trained facilitators guided groups through brainstorming and weighted voting processes; individual recommendations were submitted in writing. Participants generated 598 recommendations, 71 of them voted as priorities; these were analyzed to capture participants' “messages.” Central themes focused on access issues and cultural incompetence as deterrents to the elimination of health disparities and on education, funding, and community-based, community-driven research as mechanisms for change. Strategies for change included reinventing or expanding the role of minority communities and changing health care itself and “how” it does its work. The essential element in all recommendations was community leadership and control. PMID:11919057
Thomas, Lucinda E.; and others
Findings partially support assumption that educational interests are factors related to academic success. Seven areas of the Educational Interest Inventory used were: Business Administration, Botany, Chemistry, History and Political Science, Sociology, Economics, and Mathematics. (Author/CJ)
This paper selectively reviews research on the relationship between topic interest and prior knowledge, and discusses the optimal association between these variables. The paper points out that interest has a facilitating impact on learning, and at least part of this effect must be ascribed to prior knowledge. While the interest-knowledge…
Cao, ChuanWang; Sun, LiLi; Wen, RongRong; Shang, QingLi; Ma, Ling; Wang, ZhiYing
Although the Asian gypsy moth Lymantria dispar causes extensive forest damage worldwide, little is known regarding the genes involved in its development or response to insecticides. Accordingly, characterization of the transcriptome of L. dispar larvae would promote the development of toxicological methods for its control. RNA-seq analysis of L. dispar larvae messenger RNA (mRNA) generated 62,063 unigenes with N50 of 993 bp, from which 23,975 unique sequences (E-value < 10(-5)) were identified using a BLASTx search of the NCBI non-redundant (nr) database. Using functional classification in the Gene Ontology (GO) and Clusters of Orthologous Groups (COG) databases, 7,309 indentified sequences were categorized into 51 functional groups and 8,079 sequences were categorized into 25 functional groups, respectively. Moreover, we identified a large number of transcripts encoding known insecticide targets, or proteins involved in the metabolism of insecticides. Reads per kilobase of unigene length per million mapped reads (RPKM) analysis identified 39 high abundance transcripts, of which 27 exhibited significantly altered expression patterns across the egg, larvae, pupae, male and female adult stages. Our study provides the most comprehensive transcriptomic sequence resource for L. dispar, which will form the basis for future identification of candidate insecticide resistance genes in L. dispar.
This paper interprets the British legislative process that initiated the first comprehensive national regulation of embryo research and fertility services and examines subsequent efforts to restrain the assisted reproduction industry. After describing and evaluating British regulatory measures, I consider successive failures to control the assisted reproduction industry in the US. I discuss disparities between UK and US regulatory initiatives and their bearing on regulation in other countries. Then I turn to the political and social structures in which the assisted reproduction industry is embedded. I argue that regulatory bodies are seldom neutral arbiters. They tend to respond most readily to special interests and neglect strategies that could more effectively meet the health needs of the people they represent. Neither national nor international bodies have aggressively pursued policies to harness the industry, reduce infertility rates, or meet the needs of people whose fertility is threatened by substandard healthcare and environmental neglect. In conclusion, I consider recent initiatives by activist groups to mount an alternative response to the industry's current practices and build a transnational reproductive justice movement.
Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy
In Philadelphia, 66% of new HIV infections are among African Americans and 2% of African Americans are living with HIV. The city of Philadelphia has among the largest numbers of faith institutions of any city in the country. Although faith-based institutions play an important role in the African American community, their response to the AIDS epidemic has historically been lacking. We convened 38 of Philadelphia's most influential African American faith leaders for in-depth interviews and focus groups examining the role of faith-based institutions in HIV prevention. Participants were asked to comment on barriers to engaging faith-based leaders in HIV prevention and were asked to provide normative recommendations for how African American faith institutions can enhance HIV/AIDS prevention and reduce racial disparities in HIV infection. Many faith leaders cited lack of knowledge about Philadelphia's racial disparities in HIV infection as a common reason for not previously engaging in HIV programs; others noted their congregations' existing HIV prevention and outreach programs and shared lessons learned. Barriers to engaging the faith community in HIV prevention included: concerns about tacitly endorsing extramarital sex by promoting condom use, lack of educational information appropriate for a faith-based audience, and fear of losing congregants and revenue as a result of discussing human sexuality and HIV/AIDS from the pulpit. However, many leaders expressed a moral imperative to respond to the AIDS epidemic, and believed clergy should play a greater role in HIV prevention. Many participants noted that controversy surrounding homosexuality has historically divided the faith community and prohibited an appropriate response to the epidemic; many expressed interest in balancing traditional theology with practical public health approaches to HIV prevention. Leaders suggested the faith community should: promote HIV testing, including during or after worship services and in
Nunn, Amy; Cornwall, Alexandra; Chute, Nora; Sanders, Julia; Thomas, Gladys; James, George; Lally, Michelle; Trooskin, Stacey; Flanigan, Timothy
In Philadelphia, 66% of new HIV infections are among African Americans and 2% of African Americans are living with HIV. The city of Philadelphia has among the largest numbers of faith institutions of any city in the country. Although faith-based institutions play an important role in the African American community, their response to the AIDS epidemic has historically been lacking. We convened 38 of Philadelphia’s most influential African American faith leaders for in-depth interviews and focus groups examining the role of faith-based institutions in HIV prevention. Participants were asked to comment on barriers to engaging faith-based leaders in HIV prevention and were asked to provide normative recommendations for how African American faith institutions can enhance HIV/AIDS prevention and reduce racial disparities in HIV infection. Many faith leaders cited lack of knowledge about Philadelphia’s racial disparities in HIV infection as a common reason for not previously engaging in HIV programs; others noted their congregations’ existing HIV prevention and outreach programs and shared lessons learned. Barriers to engaging the faith community in HIV prevention included: concerns about tacitly endorsing extramarital sex by promoting condom use, lack of educational information appropriate for a faith-based audience, and fear of losing congregants and revenue as a result of discussing human sexuality and HIV/AIDS from the pulpit. However, many leaders expressed a moral imperative to respond to the AIDS epidemic, and believed clergy should play a greater role in HIV prevention. Many participants noted that controversy surrounding homosexuality has historically divided the faith community and prohibited an appropriate response to the epidemic; many expressed interest in balancing traditional theology with practical public health approaches to HIV prevention. Leaders suggested the faith community should: promote HIV testing, including during or after worship services
Schetter, Christine Dunkel; Schafer, Peter; Lanzi, Robin Gaines; Clark-Kauffman, Elizabeth; Raju, Tonse N. K.; Hillemeier, Marianne M.
Health disparities are large and persistent gaps in the rates of disease and death between racial/ethnic and socioeconomic status subgroups in the population. Stress is a major pathway hypothesized to explain such disparities. The Eunice Kennedy Shriver National Institute of Child Health and Human Development formed a community/research collaborative—the Community Child Health Network—to investigate disparities in maternal and child health in five high-risk communities. Using community participation methods, we enrolled a large cohort of African American/Black, Latino/Hispanic, and non-Hispanic/White mothers and fathers of newborns at the time of birth and followed them over 2 years. A majority had household incomes near or below the federal poverty level. Home interviews yielded detailed information regarding multiple types of stress such as major life events and many forms of chronic stress including racism. Several forms of stress varied markedly by racial/ethnic group and income, with decreasing stress as income increased among Caucasians but not among African Americans; other forms of stress varied by race/ethnicity or poverty alone. We conclude that greater sophistication in studying the many forms of stress and community partnership is necessary to uncover the mechanisms underlying health disparities in poor and ethnic-minority families and to implement community health interventions. PMID:26173227
Chapman, Elizabeth N; Kaatz, Anna; Carnes, Molly
Although the medical profession strives for equal treatment of all patients, disparities in health care are prevalent. Cultural stereotypes may not be consciously endorsed, but their mere existence influences how information about an individual is processed and leads to unintended biases in decision-making, so called "implicit bias". All of society is susceptible to these biases, including physicians. Research suggests that implicit bias may contribute to health care disparities by shaping physician behavior and producing differences in medical treatment along the lines of race, ethnicity, gender or other characteristics. We review the origins of implicit bias, cite research documenting the existence of implicit bias among physicians, and describe studies that demonstrate implicit bias in clinical decision-making. We then present the bias-reducing strategies of consciously taking patients' perspectives and intentionally focusing on individual patients' information apart from their social group. We conclude that the contribution of implicit bias to health care disparities could decrease if all physicians acknowledged their susceptibility to it, and deliberately practiced perspective-taking and individuation when providing patient care. We further conclude that increasing the number of African American/Black physicians could reduce the impact of implicit bias on health care disparities because they exhibit significantly less implicit race bias.
Koh, Howard K; Judge, Christine M; Ferrer, Barbara; Gershman, Susan T
Identifying and eliminating social disparities in cancer depend upon the availability and ready use of public health surveillance data at the national, state and local levels. As an example of advancing a statewide research agenda in cancer disparities, we present descriptive statistics from major public health surveillance data systems in Massachusetts. Disparities highlighted include higher breast cancer mortality rates among African-American women than women of other racial groups, lower rates of colorectal and cervical cancer screening among Asian-American residents, and striking gradients in cancer risk factor prevalence and screening by income and education. Challenges in utilizing public health surveillance data include lack of information in many domains of social inequity beyond race/ethnicity, uneven quality, and lack of stable, reportable data for smaller populations. Opportunities to maximize the usefulness of cancer registry data include application of geographic information systems and linkage with other data systems tracking information on health services outcomes and clinical trial participation. Analyses of surveillance data can spark advances not only in community-based participatory research but also in programs and policies that may ultimately eliminate disparities along the cancer continuum.
Turner, D P
While the socioeconomic and environmental factors associated with cancer disparity have been well documented, the contribution of biological factors is an emerging field of research. Established disparity factors such as low income, poor diet, drinking alcohol, smoking, and a sedentary lifestyle may have molecular effects on the inherent biological makeup of the tumor itself, possibly altering cell signaling events and gene expression profiles to profoundly alter tumor development and progression. Our understanding of the molecular and biological consequences of poor lifestyle is lacking, but such information may significantly change how we approach goals to reduce cancer incidence and mortality rates within minority populations. In this review, we will summarize the biological, socioeconomic, and environmental associations between a group of reactive metabolites known as advanced glycation end-products (AGEs) and cancer health disparity. Due to their links with lifestyle and the activation of disease-associated pathways, AGEs may represent both a biological consequence and a bio-behavioral indicator of poor lifestyle which may be targeted within specific populations to reduce disparities in cancer incidence and mortality.
Hopkins, M J
Although discordance between taxonomic diversity and morphological disparity is common, little is known about the underlying dynamics that drive this decoupling. Early in the history of the Cambrian trilobite family Pterocephaliidae, there was an increase in taxonomic diversity and morphological diversity. As taxonomic diversity declined in the later history of the clade, range of variation stayed high and disparity continued to increase. However, per-branch rates of morphological evolution estimated from a recent phylogeny decreased with time. Neither within-trait nor within-species variation increased or decreased, suggesting that the declining rates of morphological evolution were more likely related to ecological opportunity or niche partitioning, rather than increasing intrinsic constraints. This is further supported by evidence for increased biofacies associations throughout the time period. Thus, the high disparity seen at low taxonomic diversity late in the history of this clade was due to extinction - either random or targeting mean forms - rather than increased rates of morphological evolution. This pattern also provides a scenario that could account for instances of low taxonomic diversity but high morphological disparity in modern groups.
Langellier, Brent A; Chen, Jie; Vargas-Bustamante, Arturo; Inkelas, Moira; Ortega, Alexander N
It is important to understand the source of health-care disparities between Latinos and other children in the United States. We examine parent-reported health-care access and utilization among Latino, White, and Black children (≤17 years old) in the United States in the 2006–2011 National Health Interview Survey. Using Blinder-Oaxaca decomposition, we portion health-care disparities into two parts (1) those attributable to differences in the levels of sociodemographic characteristics (e.g., income) and (2) those attributable to differences in group-specific regression coefficients that measure the health-care ‘return’ Latino, White, and Black children receive on these characteristics. In the United States, Latino children are less likely than Whites to have a usual source of care, receive at least one preventive care visit, and visit a doctor, and are more likely to have delayed care. The return on sociodemographic characteristics explains 20–30% of the disparity between Latino and White children in the usual source of care, delayed care, and doctor visits and 40–50% of the disparity between Latinos and Blacks in emergency department use and preventive care. Much of the health-care disadvantage experienced by Latino children would persist if Latinos had the sociodemographic characteristics as Whites and Blacks. PMID:25395597
Dixon, Brittany; Peña, Michelle-Marie; Taveras, Elsie M.
Eliminating racial/ethnic disparities in health and health care is a national priority, and obesity is a prime target. During the last 30 y in the United States, the prevalence of obesity among children has dramatically increased, sparing no age group. Obesity in childhood is associated with adverse cardio-metabolic outcomes such as hypertension, hyperlipidemia, and type II diabetes and with other long-term adverse outcomes, including both physical and psychosocial consequences. By the preschool years, racial/ethnic disparities in obesity prevalence are already present, suggesting that disparities in childhood obesity prevalence have their origins in the earliest stages of life. Several risk factors during pregnancy are associated with increased risk of offspring obesity, including excessive maternal gestational weight gain, gestational diabetes, smoking during pregnancy, antenatal depression, and biological stress. During infancy and early childhood, rapid infant weight gain, infant feeding practices, sleep duration, child’s diet, physical activity, and sedentary practices are associated with the development of obesity. Studies have found substantial racial/ethnic differences in many of these early life risk factors for childhood obesity. It is possible that racial/ethnic differences in early life risk factors for obesity might contribute to the high prevalence of obesity among minority preschool-age children and beyond. Understanding these differences may help inform the design of clinical and public health interventions and policies to reduce the prevalence of childhood obesity and eliminate disparities among racial/ethnic minority children. PMID:22332105
Hashim, Dana; Manczuk, Marta; Holcombe, Randall; Lucchini, Roberto; Boffetta, Paolo
The East Harlem (EH), Central Harlem (CH), and Upper East Side (UES) neighborhoods of New York City are geographically contiguous to tertiary medical care, but are characterized by cancer mortality rate disparities. This ecological study aims to disentangle the effects of race and neighborhood on cancer deaths. Mortality-to-incidence ratios were determined using neighborhood-specific data from the New York State Cancer Registry and Vital Records Office (2007-2011). Ecological data on modifiable cancer risk factors from the New York City Community Health Survey (2002-2006) were stratified by sex, age group, race/ethnicity, and neighborhood and modeled against stratified mortality rates to disentangle race/ethnicity and neighborhood using logistic regression. Significant gaps in mortality rates were observed between the UES and both CH and EH across all cancers, favoring UES. Mortality-to-incidence ratios of both CH and EH were similarly elevated in the range of 0.41-0.44 compared with UES (0.26-0.30). After covariate and multivariable adjustment, black race (odds ratio=1.68; 95% confidence interval: 1.46-1.93) and EH residence (odds ratio=1.20; 95% confidence interval: 1.07-1.35) remained significant risk factors in all cancers' combined mortality. Mortality disparities remain among EH, CH, and UES neighborhoods. Both neighborhood and race are significantly associated with cancer mortality, independent of each other. Multivariable adjusted models that include Community Health Survey risk factors show that this mortality gap may be avoidable through community-based public health interventions.
DeLoss, Denton J.; Andersen, George J.
The present study examined age-related differences in multisensory integration and the effect of spatial disparity on the sound-induced flash illusion—-an illusion used in previous research to assess age-related differences in multisensory integration. Prior to participation in the study, both younger and older participants demonstrated their ability to detect 1–2 visual flashes and 1–2 auditory beep presented unimodally. After passing the pre-test, participants were then presented 1–2 flashes paired with 0–2 beeps that originated from one of five speakers positioned equidistantly 100cm from the participant. One speaker was positioned directly below the screen, two speakers were positioned 50cm to the left and right from the center of the screen, and two more speakers positioned to the left and right 100cm from the center of the screen. Participants were told to report the number of flashes presented and to ignore the beeps. Both age groups showed a significant effect of the beeps on the perceived number of flashes. However, neither younger nor older individuals showed any significant effect of spatial disparity on the sound-induced flash illusion. The presence of a congruent number of beeps increased accuracy for both older and younger individuals. Reaction time data was also analyzed. As expected, older individuals showed significantly longer reaction times when compared to younger individuals. In addition, both older and younger individuals showed a significant increase in reaction time for fusion trials, where two flashes and one beep are perceived as a single flash, as compared to congruent single flash trials. This increase in reaction time was not found for fission trials, where one flash and two beeps were perceived as two flashes. This suggests that processing may differ for the two forms for fission as compared to fusion illusions. PMID:26619352
El-Fallah, A.; Zatezalo, A.; Mahler, R.; Mehra, R. K.; Donatelli, D.
Dynamic sensor management of dispersed and disparate sensors for space situational awareness presents daunting scientific and practical challenges as it requires optimal and accurate maintenance of all Resident Space Objects (RSOs) of interest. We demonstrate an approach to the space-based sensor management problem by extending a previously developed and tested sensor management objective function, the Posterior Expected Number of Targets (PENT), to disparate and dispersed sensors. This PENT extension together with observation models for various sensor platforms, and a Probability Hypothesis Density Particle Filter (PHD-PF) tracker provide a powerful tool for tackling this challenging problem. We demonstrate the approach using simulations for tracking RSOs by a Space Based Visible (SBV) sensor and ground based radars.
Gibbs, Kenneth D; McGready, John; Bennett, Jessica C; Griffin, Kimberly
Increasing biomedical workforce diversity remains a persistent challenge. Recent reports have shown that biomedical sciences (BMS) graduate students become less interested in faculty careers as training progresses; however, it is unclear whether or how the career preferences of women and underrepresented minority (URM) scientists change in manners distinct from their better-represented peers. We report results from a survey of 1500 recent American BMS Ph.D. graduates (including 276 URMs) that examined career preferences over the course of their graduate training experiences. On average, scientists from all social backgrounds showed significantly decreased interest in faculty careers at research universities, and significantly increased interest in non-research careers at Ph.D. completion relative to entry. However, group differences emerged in overall levels of interest (at Ph.D. entry and completion), and the magnitude of change in interest in these careers. Multiple logistic regression showed that when controlling for career pathway interest at Ph.D. entry, first-author publication rate, faculty support, research self-efficacy, and graduate training experiences, differences in career pathway interest between social identity groups persisted. All groups were less likely than men from well-represented (WR) racial/ethnic backgrounds to report high interest in faculty careers at research-intensive universities (URM men: OR 0.60, 95% CI: 0.36-0.98, p = 0.04; WR women: OR: 0.64, 95% CI: 0.47-0.89, p = 0.008; URM women: OR: 0.46, 95% CI: 0.30-0.71, p<0.001), and URM women were more likely than all other groups to report high interest in non-research careers (OR: 1.93, 95% CI: 1.28-2.90, p = 0.002). The persistence of disparities in the career interests of Ph.D. recipients suggests that a supply-side (or "pipeline") framing of biomedical workforce diversity challenges may limit the effectiveness of efforts to attract and retain the best and most diverse
Dunn, Richard A.; Yen, Steven T.
Abstract Background This study investigates ethnic disparities in metabolic syndrome in Malaysia. Methods Data were obtained from the Malaysia Non-Communicable Disease Surveillance-1 (2005/2006). Logistic regressions of metabolic syndrome health risks on sociodemographic and health–lifestyle factors were conducted using a multiracial (Malay, Chinese, and Indian and other ethnic groups) sample of 2,366 individuals. Results Among both males and females, the prevalence of metabolic syndrome amongst Indians was larger compared to both Malays and Chinese because Indians are more likely to exhibit central obesity, elevated fasting blood glucose, and low high-density lipoprotein cholesterol. We also found that Indians tend to engage in less physical activity and consume fewer fruits and vegetables than Malays and Chinese. Although education and family history of chronic disease are associated with metabolic syndrome status, differences in socioeconomic attributes do not explain ethnic disparities in metabolic syndrome incidence. The difference in metabolic syndrome prevalence between Chinese and Malays was not statistically significant. Whereas both groups exhibited similar obesity rates, ethnic Chinese were less likely to suffer from high fasting blood glucose. Conclusions Metabolic syndrome disproportionately affects Indians in Malaysia. Additionally, fasting blood glucose rates differ dramatically amongst ethnic groups. Attempts to decrease health disparities among ethnic groups in Malaysia will require greater attention to improving the metabolic health of Malays, especially Indians, by encouraging healthful lifestyle changes. PMID:21815810
... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Disparate treatment. 60-3.11 Section 60-3.11 Public Contracts and Property Management Other Provisions Relating to Public... treatment. The principles of disparate or unequal treatment must be distinguished from the concepts...
Barranco, Francisco; Diaz, Javier; Gibaldi, Agostino; Sabatini, Silvio P; Ros, Eduardo
This paper presents an architecture for computing vector disparity for active vision systems as used on robotics applications. The control of the vergence angle of a binocular system allows us to efficiently explore dynamic environments, but requires a generalization of the disparity computation with respect to a static camera setup, where the disparity is strictly 1-D after the image rectification. The interaction between vision and motor control allows us to develop an active sensor that achieves high accuracy of the disparity computation around the fixation point, and fast reaction time for the vergence control. In this contribution, we address the development of a real-time architecture for vector disparity computation using an FPGA device. We implement the disparity unit and the control module for vergence, version, and tilt to determine the fixation point. In addition, two on-chip different alternatives for the vector disparity engines are discussed based on the luminance (gradient-based) and phase information of the binocular images. The multiscale versions of these engines are able to estimate the vector disparity up to 32 fps on VGA resolution images with very good accuracy as shown using benchmark sequences with known ground-truth. The performances in terms of frame-rate, resource utilization, and accuracy of the presented approaches are discussed. On the basis of these results, our study indicates that the gradient-based approach leads to the best trade-off choice for the integration with the active vision system.
Martins, Jaime A.; Rodrigues, João M. F.; du Buf, Hans
The visual cortex is able to extract disparity information through the use of binocular cells. This process is reflected by the Disparity Energy Model, which describes the role and functioning of simple and complex binocular neuron populations, and how they are able to extract disparity. This model uses explicit cell parameters to mathematically determine preferred cell disparities, like spatial frequencies, orientations, binocular phases and receptive field positions. However, the brain cannot access such explicit cell parameters; it must rely on cell responses. In this article, we implemented a trained binocular neuronal population, which encodes disparity information implicitly. This allows the population to learn how to decode disparities, in a similar way to how our visual system could have developed this ability during evolution. At the same time, responses of monocular simple and complex cells can also encode line and edge information, which is useful for refining disparities at object borders. The brain should then be able, starting from a low-level disparity draft, to integrate all information, including colour and viewpoint perspective, in order to propagate better estimates to higher cortical areas. PMID:26107954
Sharma, Sheena; Gupta, Priti; Markan, C. M.
Stereopsis or depth perception is a critical aspect of information processing in the brain and is computed from the positional shift or disparity between the images seen by the two eyes. Various algorithms and their hardware implementation that compute disparity in real time have been proposed; however, most of them compute disparity through complex mathematical calculations that are difficult to realize in hardware and are biologically unrealistic. The brain presumably uses simpler methods to extract depth information from the environment and hence newer methodologies that could perform stereopsis with brain like elegance need to be explored. This paper proposes an innovative aVLSI design that leverages the columnar organization of ocular dominance in the brain and uses time-staggered Winner Take All (ts-WTA) to adaptively create disparity tuned cells. Physiological findings support the presence of disparity cells in the visual cortex and show that these cells surface as a result of binocular stimulation received after birth. Therefore, creating in hardware cells that can learn different disparities with experience not only is novel but also is biologically more realistic. These disparity cells, when allowed to interact diffusively on a larger scale, can be used to adaptively create stable topological disparity maps in silicon. PMID:27243029
Bell, Ronny A
Health disparities--differences in the provision and outcomes of health care in 2 distinct populations--are pervasive and long-standing in North Carolina. Although some strategies for closing these gaps have been effective, many disparities have resisted attempts to eliminate them. Future efforts should focus on policy implementation and the translation of research findings into effective interventions.
0802 TITLE: Racial Disparities in Palliative Care for Prostate Cancer PRINCIPAL INVESTIGATOR: Alfred I. Neugut, MD, PhD...Disparities in Palliative Care for Prostate Cancer 5b. GRANT NUMBER W81XWH-10-1-0802 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S... palliative treatments. 15. SUBJECT TERMS Prostate cancer, palliative care , ureteral obstruction, cord compression 16. SECURITY CLASSIFICATION OF
Earnshaw, Valerie A.; Bogart, Laura M.; Dovidio, John F.; Williams, Davird R.
Prior research suggests that stigma plays a role in racial/ethnic health disparities. However, there is limited understanding about the mechanisms by which stigma contributes to HIV-related disparities in risk, incidence and screening, treatment, and survival and what can be done to reduce the impact of stigma on these disparities. We introduce the Stigma and HIV Disparities Model to describe how societal stigma related to race and ethnicity is associated with racial/ethnic HIV disparities via its manifestations at the structural level (e.g., residential segregation) as well as the individual level among perceivers (e.g., discrimination) and targets (e.g., internalized stigma). We then review evidence of these associations. Because racial/ethnic minorities at risk of and living with HIV often possess multiple stigmas (e.g., HIV-positive, substance use), we adopt an intersectionality framework and conceptualize interdependence among co-occurring stigmas. We further propose a resilience agenda and suggest that intervening on modifiable strength-based moderators of the association between societal stigma and disparities can reduce disparities. Strengthening economic and community empowerment and trust at the structural level, creating common ingroup identities and promoting contact with people living with HIV among perceivers at the individual level, and enhancing social support and adaptive coping among targets at the individual level can improve resilience to societal stigma and ultimately reduce racial/ethnic HIV disparities. PMID:23688090
Buki, Lydia P.
This reaction to the Major Contribution presents a conceptualization of health disparities as another form of oppression of marginalized populations in our society. Consistent with this view, health disparities are then situated within a larger, national context, showing that counseling psychologists' involvement is an integral part of a…
Newman, Lori M; Berman, Stuart M
This article reviews the epidemiology of sexually transmitted disease (STD) disparities for African American communities in the United States. Data are reviewed from a variety of sources such as national case reporting and population-based studies. Data clearly show a disproportionately higher burden of STDs in African American communities compared with white communities. Although disparities exist for both viral and bacterial STDs, disparities are greatest for bacterial STDs such as gonorrhea, chlamydia, and syphilis. Gonorrhea rates among African Americans are highest for adolescents and young adults, and disparities are greatest for adolescent men. Although disparities for men who have sex with men (MSM) are not as great as for heterosexual populations, STD rates for both white and African American MSM populations are high, so efforts to address disparities must also include African American MSM. Individual risk behavior and sociodemographic characteristics of African Americans do not seem to account fully for increased STD rates for African Americans. Population-level determinants such as sexual networks seem to play an important role in STD disparities. An understanding of the epidemiology of STD disparities is critical for identifying appropriate strategies and tailoring strategies for African American communities. Active efforts are needed to reduce not only the physical consequences of STDs, such as infertility, ectopic pregnancy, chronic pelvic pain, newborn disease, and increased risk of HIV infection, but also the social consequences of STDs such as economic burden, shame, and stigma.
Morgan, Paul L.; Hillemeier, Marianne M.; Farkas, George; Maczuga, Steve
Background: Whether and to what extent racial/ethnic disparities in attention-deficit/hyperactivity disorder (ADHD) diagnosis occur by kindergarten entry is currently unknown. We investigated risk factors associated with an ADHD diagnosis by kindergarten entry generally, and specifically whether racial/ethnic disparities in ADHD diagnosis occur by…
Baker, Bruce D.; Welner, Kevin G.
Two interlocking claims are being increasingly made around school finance: that states have largely met their obligations to resolve disparities between local public school districts and that the bulk of remaining disparities are those that persist within school districts. These local decisions are described as irrational and unfair school…
Grabowski, David C.; McGuire, Thomas G.
Nursing homes serve many severely ill poor people, including large numbers of racial/ethnic minority residents. Previous research indicates that blacks tend to receive care from lower quality nursing homes (Grabowski, 2004). Using the Institute of Medicine (IOM) definition of racial-ethnic disparities, this study decomposes nursing home disparities into within and across facility components. Using detailed person-level nursing home data, we find meaningful black-white disparities for one of the four risk-adjusted quality measures, with both within and across nursing home components of the disparity. The IOM approach, which recognizes mediation through payer status and education, has a small effect on measured disparities in this setting. Although we did not find disparities across the majority of quality measures and alternate disparity definitions, this approach can be applied to other health care services in an effort to disentangle the role of across and within facility variation and the role of potential mediators on racial/ethnic disparities. PMID:20160968
Guo, Congbin; Tsang, Mun C.; Ding, Xiaohao
Gender disparities in science and engineering majors in Chinese universities have received increasing attention from researchers and educators in China in recent years. Using data from a national survey of college students who graduated in 2005, this study documents gender disparities in enrollment and academic performance in science and…
Thomas, Stephen B; Quinn, Sandra Crouse
The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.
Purpose. The racial disparity in preterrn birth (PTB) is a persistent feature of perinatal epidemiology, inconsistently modeled in the literature. Rather than include race as an explanatory variable, or employ race-stratified models, we sought to directly model the PTB disparity ...
Appel, Margaret A.; Campos, Joseph J.
The ability of forty 8-week-old infants to discriminate between projected-stereograms with and without retinal disparity was tested with an habituation-dishabituation paradigm. Results were interpreted as indicating that the infants could discriminate between stimuli when the only difference between them was binocular disparity. (MS)
Disparities in asthma management are a burden on African American youth. The objective of this study is to describe and compare the discourses of asthma management disparities (AMDs) in African American adolescents in Seattle to existing youth-related asthma policies in Washington State. Adolescents participated in a three-session photovoice…
Carron, Gabriel, Ed.; Chau, Ta Ngoc, Ed.
Four lengthy papers and an introduction discuss case studies of regional disparities in educational development in Cameroon, Madagascar, Kenya, Tanzania, and Thailand. In considering the specific political and socioeconomic contexts of these countries, the papers focus on methods of both analyzing the causes of disparities and reducing the…
McConnell-Henry, Tracy; Chapman, Ysanne; Francis, Karen
Introduced as an alternative to empirical science, phenomenology offers nursing an insightful means for understanding nursing phenomena specifically in relation to lived experiences. However, not all phenomenologies were created equal, a point which has left many a nursing researcher not only confused. Furthermore, this confusion might result in the choosing of a philosophical framework that is neither cognizant with the research question nor the epistemological lens through which the researcher operates. Drawing on common nursing examples to illustrate concepts, the authors closely examine and debate the disparities between Husserl's transcendental phenomenology and Heidegger's hermeneutic approach to phenomenology. The aim of the article is to demystify the dense language used and present the fundamental beliefs of each philosopher in a format that is accessible to novice phenomenologists.
Lew, Jae Young
To manipulate large payloads typical of space construction, the concept of a small arm mounted on the end of a large arm is introduced. The main purposes of such a configuration are to increase the structural stiffness of the robot by bracing against or locking to a stationary frame, and to maintain a firm position constraint between the robot's base and workpieces by grasping them. Possible topologies for a combination of disparate large and small arms are discussed, and kinematics, dynamics, controls, and coordination of the two arms, especially when they brace at the tip of the small arm, are developed. The feasibility and improvement in performance are verified, not only with analytical work and simulation results but also with experiments on the existing arrangement Robotic Arm Large and Flexible and Small Articulated Manipulator.
Zhou, YE; Yeung, P. K.; Brasseur, James G.
To study the effect of cancellations within long-range interactions on local isotropy at the small scales, we calculate explicitly the degree of cancellation in distant interactions in the simulations of Yeung & Brasseur and Yeung, Brasseur & Wang using the single scale disparity parameter 's' developed by Zhou. In the simulations, initially isotropic simulated turbulence was subjected to coherent anisotropic forcing at the large scales and the smallest scales were found to become anisotropic as a consequence of direct large-small scale couplings. We find that the marginally distant interactions in the simulation do not cancel out under summation and that the development of small-scale anisotropy is indeed a direct consequence of the distant triadic group, as argued by Yeung, et. al. A reduction of anisotropy at later times occurs as a result of the isotropizing influences of more local energy-cascading triadic interactions. Nevertheless, the local-to-nonlocal triadic group persists as an isotropizing influence at later times. We find that, whereas long-range interactions, in general, contribute little to net energy transfer into or out of a high wavenumber shell k, the anisotropic transfer of component energy within the shell increases with increasing scale separations. These results are consistent with results by Zhou, and Brasseur & Wei, and suggest that the anisotropizing influences of long range interactions should persist to higher Reynolds numbers. The residual effect of the forced distant group in this low-Reynolds number simulation is found to be forward cascading, on average.
Morley, Christopher P
The regional study by Baumgardner and colleagues converges with existing literature to clearly show that the distribution of ADHD diagnosis falls along socioeconomic lines, according to the relative wealth of neighborhoods. This adds additional evidence that trends in the diagnosis and treatment for ADHD in children move in the exact opposite direction from those who are at highest risk for meeting criteria, for experiencing impairment, for and downstream socioeconomic sequelae. Contributing factors, such as marginal diagnoses (such as when parent and teacher symptom reports diverge), inadequate insurance coverage, limited time, and lack of familiarity and comfort with diagnostic and prescribing guidelines, may leave the door open to misdiagnosis and treatment. In some cases, this may take the form of over-diagnosis and over-treatment, in the form of false-positive diagnoses with ADHD, and treatments for it, or may alternatively take the form of false-negative diagnoses. If the social and epidemiological data are any indication, it is furthermore likely that such false-positive or false-negative outcomes may break along socioeconomic lines. Increased use of formal screening tools, increased curricular time for mental health in primary care residencies, support for physicians in the field in the form of referral options and remote consultation and support, may all serve to improve quality of care for individual patients, and may also serve to regularize treatment across socioeconomic and sociodemographic lines, hence reducing disparities. Further research is needed to study the root causes and dynamics that create such disparities, but the steps outlined above may help in the near term.
Genetics is becoming increasingly integrated into peoples' lives. Different measures have been taken to try and better genetics education. This thesis examined undergraduate students at the University of North Texas not majoring in the life sciences interest in genetic concepts through the means of a Likert style survey. ANOVA analysis showed there was variation amongst the interest level in different genetic concepts. In addition age and lecture were also analyzed as contributing factors to students' interest. Both age and lecture were evaluated to see if they contributed to the interest of students in genetic concepts and neither showed statistical significance. The Genetic Interest Assessment (GIA) serves to help mediate the gap between genetic curriculum and students' interest.
O’Keefe, Eileen B.; Meltzer, Jeremy P.; Bethea, Traci N.
Declining cancer incidence and mortality rates in the United States (U.S.) have continued through the first decade of the twenty-first century. Reductions in tobacco use, greater uptake of prevention measures, adoption of early detection methods, and improved treatments have resulted in improved outcomes for both men and women. However, Black Americans continue to have the higher cancer mortality rates and shorter survival times. This review discusses and compares the cancer mortality rates and mortality trends for Blacks and Whites. The complex relationship between socioeconomic status and race and its contribution to racial cancer disparities is discussed. Based on current trends and the potential and limitations of the patient protection and affordable care act with its mandate to reduce health care inequities, future trends, and challenges in cancer mortality disparities in the U.S. are explored. PMID:25932459
Okechukwu, Cassandra A.; Souza, Kerry; Davis, Kelly D.; de Castro, A. Butch
This paper synthesizes research on the contribution of workplace injustices – discrimination, harassment, abuse and bullying – to occupational health disparities. A conceptual framework is presented to illustrate the pathways through which injustices at the interpersonal and institutional level lead to differential risk of vulnerable workers to adverse occupational health outcomes. Members of demographic minority groups are more likely to be victims of workplace injustice and suffer more adverse outcomes when exposed to workplace injustice compared to demographic majority groups. A growing body of research links workplace injustice to poor psychological and physical health, and a smaller body of evidence links workplace injustice to unhealthy behaviors. Although not as well studied, studies also show that workplace injustice can influence workers’ health through effects on workers’ family life and job-related outcomes. Lastly, this paper discusses methodological limitations in research linking injustices and occupational health disparities and makes recommendations to improve the state of research. PMID:23813664
Wang, Xingzheng; Tian, Yushi; Wang, Haoqian; Zhang, Yongbing
Stereo matching is essential and fundamental in computer vision tasks. In this paper, a novel stereo matching algorithm based on disparity propagation using edge-aware filtering is proposed. By extracting disparity subsets for reliable points and customizing the cost volume, the initial disparity map is refined through filtering-based disparity propagation. Then, an edge-aware filter with low computational complexity is adopted to formulate the cost column, which makes the proposed method independent on the local window size. Experimental results demonstrate the effectiveness of the proposed scheme. Bad pixels in our output disparity map are considerably decreased. The proposed method greatly outperforms the adaptive support-weight approach and other conditional window-based local stereo matching algorithms.
Hetey, Rebecca C; Eberhardt, Jennifer L
During the past few decades, punitive crime policies have led to explosive growth in the United States prison population. Such policies have contributed to unprecedented incarceration rates for Blacks in particular. In this article, we consider an unexamined relationship between racial disparities and policy reform. Rather than treating racial disparities as an outcome to be measured, we exposed people to real and extreme racial disparities and observed how this drove their support for harsh criminal-justice policies. In two experiments, we manipulated the racial composition of prisons: When the penal institution was represented as "more Black," people were more concerned about crime and expressed greater acceptance of punitive policies than when the penal institution was represented as "less Black." Exposure to extreme racial disparities, then, can lead people to support the very policies that produce those disparities, thus perpetuating a vicious cycle.
Binocular vision refers to the integration of images in the two eyes for improved visual performance and depth perception. One aspect of binocular vision is the fixation disparity, which is a suboptimal condition in individuals with respect to binocular eye movement control and subsequent neural processing. The objective fixation disparity refers to the vergence angle between the visual axes, which is measured with eye trackers. Subjective fixation disparity is tested with two monocular nonius lines which indicate the physical nonius separation required for perceived alignment. Subjective and objective fixation disparity represent the different physiological mechanisms of motor and sensory fusion, but the precise relation between these two is still unclear. This study measures both types of fixation disparity at viewing distances of 40, 30, and 24 cm while observers fixated a central stationary fusion target. 20 young adult subjects with normal binocular vision were tested repeatedly to investigate individual differences. For heterophoria and subjective fixation disparity, this study replicated that the binocular system does not properly adjust to near targets: outward (exo) deviations typically increase as the viewing distance is shortened. This exo proximity effect—however—was not found for objective fixation disparity, which–on the average–was zero. But individuals can have reliable outward (exo) or inward (eso) vergence errors. Cases with eso objective fixation disparity tend to have less exo states of subjective fixation disparity and heterophoria. In summary, the two types of fixation disparity seem to respond in a different way when the viewing distance is shortened. Motor and sensory fusion–as reflected by objective and subjective fixation disparity–exhibit complex interactions that may differ between individuals (eso versus exo) and vary with viewing distance (far versus near vision). PMID:28135308
Payne, Gayle Holmes; James, Stephen D.; Hawley, Lisa; Corrigan, Bethany; Kramer, Rachel E.; Overton, Samantha N.; Farris, Rosanne P.; Wasilewski, Yvonne
Obesity has been on the rise in the United States over the past three decades, and is high. In addition to population-wide trends, it is clear that obesity affects some groups more than others and can be associated with age, income, education, gender, race and ethnicity, and geographic region. To reverse the obesity epidemic, the Centers for Disease Control and Prevention) promotes evidence-based and practice-informed strategies to address nutrition and physical activity environments and behaviors. These public health strategies require translation into actionable approaches that can be implemented by state and local entities to address disparities. The Centers for Disease Control and Prevention used findings from an expert panel meeting to guide the development and dissemination of the Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities (available at http://www.cdc.gov/obesity/health_equity/toolkit.html). The Toolkit helps public health practitioners take a systematic approach to program planning using a health equity lens. The Toolkit provides a six-step process for planning, implementing, and evaluating strategies to address obesity disparities. Each section contains (a) a basic description of the steps of the process and suggested evidence-informed actions to help address obesity disparities, (b) practical tools for carrying out activities to help reduce obesity disparities, and (c) a “real-world” case study of a successful state-level effort to address obesity with a focus on health equity that is particularly relevant to the content in that section. Hyperlinks to additional resources are included throughout. PMID:24962967
Payne, Gayle Holmes; James, Stephen D; Hawley, Lisa; Corrigan, Bethany; Kramer, Rachel E; Overton, Samantha N; Farris, Rosanne P; Wasilewski, Yvonne
Obesity has been on the rise in the United States over the past three decades, and is high. In addition to population-wide trends, it is clear that obesity affects some groups more than others and can be associated with age, income, education, gender, race and ethnicity, and geographic region. To reverse the obesity epidemic, the Centers for Disease Control and Prevention) promotes evidence-based and practice-informed strategies to address nutrition and physical activity environments and behaviors. These public health strategies require translation into actionable approaches that can be implemented by state and local entities to address disparities. The Centers for Disease Control and Prevention used findings from an expert panel meeting to guide the development and dissemination of the Health Equity Resource Toolkit for State Practitioners Addressing Obesity Disparities (available at http://www.cdc.gov/obesity/health_equity/toolkit.html). The Toolkit helps public health practitioners take a systematic approach to program planning using a health equity lens. The Toolkit provides a six-step process for planning, implementing, and evaluating strategies to address obesity disparities. Each section contains (a) a basic description of the steps of the process and suggested evidence-informed actions to help address obesity disparities, (b) practical tools for carrying out activities to help reduce obesity disparities, and (c) a "real-world" case study of a successful state-level effort to address obesity with a focus on health equity that is particularly relevant to the content in that section. Hyperlinks to additional resources are included throughout.
Schraufnagel, Dean E; Blasi, Francesco; Kraft, Monica; Gaga, Mina; Finn, Patricia; Rabe, Klaus F
Health disparities, defined as a significant difference in health between populations, are more common for diseases of the respiratory system than for those of other organ systems, because of the environmental influence on breathing and the variation of the environment among different segments of the population. The lowest social groups are up to 14 times more likely to have respiratory diseases than are the highest. Tobacco smoke, air pollution, environmental exposures, and occupational hazards affect the lungs more than other organs and occur disproportionately in ethnic minorities and those with lower socioeconomic status. Lack of access to quality healthcare contributes to disparities. The executive committees of the American Thoracic Society (ATS) and European Respiratory Society (ERS) established a writing committee to develop a policy on health disparities. The document was reviewed, edited, and approved by their full executive committees and boards of directors of the societies. This document expresses a policy to address health disparities by promoting scientific inquiry and training, disseminating medical information and best practices, and monitoring and advocating for public respiratory health. The ERS and the ATS have strong international commitments and work with leaders from governments, academia, and other organisational bodies to address and reduce avoidable health inequalities. Their training initiatives improve the function of healthcare systems and health equality. Both the ATS and the ERS support all aspects of this document, confer regularly, and act together when possible, but the activities to bring about change may vary because of the differences in the continents where the two organisations carry out most of their activities. The ATS and ERS pledge to frame their actions to reduce respiratory health disparities. The vision of the ATS and ERS is that all persons attain better and sustained respiratory health. They call on all their members
Thomas, Tami L.; DiClemente, Ralph; Snell, Samuel
Objective: To discuss how the effects of culture, economy, and geographical location intersect to form a gestalt triad determining health-related disparities in rural areas. Methods: We critically profile each component of the deterministic triad in shaping current health-related disparities in rural areas; evaluate the uniquely composed…
Background Although black women experienced greater cervical cancer incidence and mortality rate reduction in recent years, they continue to have higher incidence rates than whites. Great variations also exist among geographic regions of the US, with the South having both the highest incidence and mortality rates compared to other regions. The present study explores the question of whether living in the South is associated with greater racial disparity in cervical cancer incidence and mortality by examining race- and region-specific rates and the trend between 2000 and 2012. Methods The Surveillance, Epidemiology, and End Results (SEER) 18 Program data was used. Cervical cancer incidence and mortality rates, annual percent changes, and disparity ratios were calculated using SEER*Stat software and Joinpoint regression for four groups: US14-Non-Hispanic White (NHW), US14-Non-Hispanic Black (NHB), South-NHW, and South-NHB, where South included 4 registries from Georgia and Louisiana and US14 were 14 US registries except the four South registries. Results The average age-adjusted cervical cancer incidence rate was the highest among South-NHBs (11.1) and mortality rate was the highest among US14-NHBs (5.4). In 2012, the degree of racial disparities between South-NHBs and South-NHWs was greater in terms of mortality rates (NHB:NHW = 1.80:1.35) than incidence rates (NHB:NHW = 1.45:1.15). While mortality disparity ratios decreased from 2000–2012 for US14-NHB (APC: -1.9(-2.3,-1.4), mortality disparity ratios for South-NHWs (although lower than NHBs) increased compared to US14-NHW. Incidence rates for NHBs continued to increase with increasing age, whereas rates for NHWs decreased after age 40. Mortality rates for NHBs dramatically increased at age 65 compared to a relatively stable trend for NHWs. The increasing racial disparity with increasing age in terms of cervical cancer incidence rates became more pronounced when corrected for hysterectomy prevalence. Conclusions
Godfrey-Smith, Peter; Martínez, Manolo
Explaining the maintenance of communicative behavior in the face of incentives to deceive, conceal information, or exaggerate is an important problem in behavioral biology. When the interests of agents diverge, some form of signal cost is often seen as essential to maintaining honesty. Here, novel computational methods are used to investigate the role of common interest between the sender and receiver of messages in maintaining cost-free informative signaling in a signaling game. Two measures of common interest are defined. These quantify the divergence between sender and receiver in their preference orderings over acts the receiver might perform in each state of the world. Sampling from a large space of signaling games finds that informative signaling is possible at equilibrium with zero common interest in both senses. Games of this kind are rare, however, and the proportion of games that include at least one equilibrium in which informative signals are used increases monotonically with common interest. Common interest as a predictor of informative signaling also interacts with the extent to which agents' preferences vary with the state of the world. Our findings provide a quantitative description of the relation between common interest and informative signaling, employing exact measures of common interest, information use, and contingency of payoff under environmental variation that may be applied to a wide range of models and empirical systems.
Rugg, Mary E.; Wood, Sue Sims
The Preschool Interest Inventory (PSII) has been developed to meet the need for an informal measure of the interests, play behaviors, and communication skills of young children between the ages of 2 and 6 years, particularly those exhibiting delays in language development. The first step in the Inventory process is the Caregiver Interview. In the…
Kish, George B.; Donnenwerth, Gregory V.
Examines relationships between Sensation-Seeking Scale (SSS) and vocational interests measured by the Kuder and Strong Vocational Interest Blank, among alcoholics and undergraduates. Results support construct validity of the SSS and provide further evidence of modes of expression of stimulus-seeking needs in personality. (Author/CJ)
Pfeffer, Fabian T.; Danziger, Sheldon; Schoeni, Robert F.
The collapse of the labor, housing, and stock markets beginning in 2007 created unprecedented challenges for American families. This study examines disparities in wealth holdings leading up to the Great Recession and during the first years of the recovery. All socioeconomic groups experienced declines in wealth following the recession, with higher wealth families experiencing larger absolute declines. In percentage terms, however, the declines were greater for less-advantaged groups as measured by minority status, education, and pre-recession income and wealth, leading to a substantial rise in wealth inequality in just a few years. Despite large changes in wealth, longitudinal analyses demonstrate little change in mobility in the ranking of particular families in the wealth distribution. Between 2007 and 2011, one fourth of American families lost at least 75 percent of their wealth, and more than half of all families lost at least 25 percent of their wealth. Multivariate longitudinal analyses document that these large relative losses were disproportionally concentrated among lower income, less educated, and minority households. PMID:25332508
Liu, Huake; Qin, Guangzhao; Lin, Yuan; Hu, Ming
Two-dimensional (2D) carbon allotrope called penta-graphene was recently proposed from first-principles calculations and various similar penta-structures emerged. Despite significant effort having been dedicated to electronic structures and mechanical properties, little research has been focused on thermal transport in penta-structures. Motivated by this, we performed a comparative study of thermal transport properties of three representative pentagonal structures, namely penta-graphene, penta-SiC2, and penta-SiN2, by solving the phonon Boltzmann transport equation with interatomic force constants extracted from first-principles calculations. Unexpectedly, the thermal conductivity of the three penta-structures exhibits diverse strain dependence, despite their very similar geometry structures. While the thermal conductivity of penta-graphene exhibits standard monotonic reduction by stretching, penta-SiC2 possesses an unusual nonmonotonic up-and-down behavior. More interestingly, the thermal conductivity of penta-SiN2 has 1 order of magnitude enhancement due to the strain induced buckled to planar structure transition. The mechanism governing the diverse strain dependence is identified as the competition between the change of phonon group velocity and phonon lifetime of acoustic phonon modes with combined effect from the unique structure transition for penta-SiN2. The disparate thermal transport behavior is further correlated to the fundamentally different bonding nature in the atomic structures with solid evidence from the distribution of deformation charge density and more in-depth molecular orbital analysis. The reported giant and robust tunability of thermal conductivity may inspire intensive research on other derivatives of penta-structures as potential materials for emerging nanoelectronic devices. The fundamental physics understood from this study also solidifies the strategy to engineer thermal transport properties of broad 2D materials by simple mechanical
Doshi, Pratik; Tilford, J Mick; Ounpraseuth, Songthip; Kuo, Dennis Z; Payakachat, Nalin
Objective The study investigated whether state mandates for private insurers to provide services for children with autism influence racial disparities in outcomes. Methods The study used 2005/2006 and 2009/2010 waves of the National Survey of Children with Special Health Care Needs. Children with a current diagnosis of autism were included in the sample. Children residing in 14 states and the District of Columbia that were not covered by the mandate in the 2005/2006 survey, but were covered in the 2009/2010 survey, served as the mandate group. Children residing in 32 states that were not covered by a mandate in either wave served as the comparison group. Outcome measures assessed included care quality, family economics, and child health. A difference-in-difference-in-differences (DDD) approach was used to assess the impact of the mandates on racial disparities in outcomes. Results Non-white children had less access to family-centered care compared to white children in both waves of data, but this difference was not apparent across mandate and comparison states as only the comparison states had significant differences. Parents of non-white children reported paying less in annual out-of-pocket expenses compared to parents of white children across waves and groups. DDD estimates did not provide evidence that the mandates had statistically significant effects on improving or worsening racial disparities for any outcome measure. Conclusions This study did not find evidence that state mandates on private insurers affected racial disparities in outcomes for children with autism.
Choi, Jae-Young; Kuo, Yong-Fang; Goodwin, James S.
Objectives Disparities in healthcare among minority groups can result in disparate treatments for similar severities of symptoms, unequal access to medical care, and a wide deviation in health outcomes. Such racial disparities may be reduced via use of an Electronic Medical Record (EMR) system. However, there has been little research investigating the impact of EMR systems on the disparities in health outcomes among minority groups. Methods This study examined the impact of EMR systems on the following four outcomes of black patients: length of stay, inpatient mortality rate, 30-day mortality rate, and 30-day readmission rate, using patient and hospital data from the Medicare Provider Analysis and Review and the Healthcare Information and Management Systems Society between 2000 and 2007. The difference-in-difference research method was employed with a generalized linear model to examine the association of EMR adoption on health outcomes for minority patients while controlling for patient and hospital characteristics. Results We examined the association between EMR adoption and the outcomes of minority patients, specifically black patients. However, after controlling for patient and hospital characteristics we could not find any significant changes in the four health outcomes of minority patients before and after EMR implementation. Conclusions EMR systems have been reported to support better coordinated care, thus encouraging appropriate treatment for minority patients by removing potential sources of bias from providers. Also, EMR systems may improve the quality of care provided to patients via increased responsiveness to care processes that are required to be more time-sensitive and through improved communication. However, we did not find any significant benefit for minority groups after EMR adoption. PMID:27200220
Hambleton, Ian R.; Unwin, Nigel
Background Data on disparities in mortality within low and middle income countries are limited, with little published data from the Caribbean or Central America. Our aim was to investigate disparities in overall and cause specific premature adult mortality in the multi-ethnic middle income country of Belize. Methods Mortality data from Belize 2008–2010 classified using the International Classification of Diseases 10 and the 2010 census stratified by age and ethnicity were used to calculate age, sex, and ethnic specific mortality rates for those 15–59 years, and life table analysis was used to estimate the probability of death between the ages of 15 and 59 (45q15). Results The probability of death among those aged 15 to 59 years was 18.1% (women 13.5%, men 22.7%). Creole and Garifuna ethnic groups have three times the 45q15 probability of death compared to Mayan and Mestizo groups (Creole 31.2%, Garifuna 31.1%, Mayan 10.2%, Mestizo 12.0%). This pattern of ethnic disparity existed in both sexes but was greater in men. The probability of death from injuries was 14.8% among Creole men, more than twice the rate of other ethnicities and peaks among young Creole men. These deaths are dominated by homicides and unspecified deaths involving firearms Conclusions Marked disparities in mortality between ethnic groups exist in this Central American/Caribbean country, from rates that are typical of high-income countries to those of low-income countries. The pattern of these extreme differences likely suggests that they reflect underlying social determinants rooted in the country’s colonial past. PMID:27643696
Thompson, Beti; Molina, Yamile; Viswanath, Kasisomayajula; Warnecke, Richard; Prelip, Michael L
Community-based participatory research is a promising approach to reducing health disparities. It empowers individuals and communities to become the major players in solving their own health problems. We discuss the use of community-based participatory research and other strategies to enhance empowerment. We also discuss projects from the Centers for Population Health and Health Disparities that have empowered communities to achieve positive health outcomes aimed at reducing disparities. We offer recommendations to policy makers for involving residents in efforts to achieve health equity.
Lurie, Nicole; Somers, Stephen A; Fremont, Allen; Angeles, January; Murphy, Erin K; Hamblin, Allison
The authors consider the challenges to quantifying both the business case and the social case for addressing disparities, which is central to achieving equity in the U.S. health care system. They describe the practical and methodological challenges faced by health plans exploring the business and social cases for undertaking disparity-reducing interventions. Despite these challenges, sound business and quality improvement principles can guide health care organizations seeking to reduce disparities. Place-based interventions may help focus resources and engage health care and community partners who can share in the costs of-and gains from-such efforts.
Brown, Tyson; Hargrove, Taylor W.; Griffith, Derek M.
This study uses data from the Health and Retirement Study and an approach informed by the Biopsychosocial Model of Racism as a Stressor to examine the extent to which SES, stressors, discrimination and neighborhood conditions are mechanisms underlying racial/ethnic disparities in functional limitations among men. Results reveal that racial/ethnic differences in SES, stressors, discrimination and neighborhood conditions—individually and collectively—account for a substantial proportion of racial/ethnic disparities in functional limitations. Findings suggest that the social determinants of health for men of color need to be more seriously considered in investigations of and efforts to address health disparities. PMID:26291191
Paasche-Orlow, Michael K; Wolf, Michael S
Limited health literacy has been linked to worse health outcomes for a range of medical conditions. In addition, limited health literacy is more prevalent among specific racial and ethnic minorities. Although these findings have been widely acknowledged, little systematic research has been conducted to elucidate the role of health literacy in the creation of health disparities or to evaluate the possibility that interventions relating to health literacy may help eliminate health disparities. This paper presents recommendations for a research agenda that is focused on advancing the science for how health literacy research can promote the effort to eliminate health disparities.
Smith, Arfon M.
BSc Chemistry, The University of Sheffield 2001... PhD Astrochemistry, The University of Nottingham 2006... Scientist at GitHub Inc. 2013.From the outside, the path an individual has taken from academia to industry is not an obvious one. In this session I'll (try and) explain how an interest in software, engineering and chasing interesting problems makes internet startup in San Francisco a great home.
Reanalyzes H. Thomas's 1980s data, which used teaching group as the unit of analysis and illuminated some institutional disparities in provision of General Certificate of Education (GCE) A-levels. Uses multilevel analysis to focus on individual students in a hierarchical framework. Among the study institutions, school sixth forms appear less…
Nicholson, Lisa M.; Browning, Christopher R.
Neighborhood disadvantage in early adolescence may help explain racial and ethnic disparities in obesity during the transition to adulthood; however the processes may work differently for males and females and for minority groups compared to Whites. The present study examines the relationship between neighborhood disadvantage and young adult…
Bodie, Graham D; Dutta, Mohan Jyoti
Even despite policy efforts aimed at reducing health-related disparities, evidence mounts that population-level gaps in literacy and healthcare quality are increasing. This widening of disparities in American culture is likely to worsen over the coming years due, in part, to our increasing reliance on Internet-based technologies to disseminate health information and services. The purpose of the current article is to incorporate health literacy into an Integrative Model of eHealth Use. We argue for this theoretical understanding of eHealth literacy and propose that macro-level disparities in social structures are connected to health disparities through the micro-level conduits of eHealth literacy, motivation, and ability. In other words, structural inequities reinforce themselves and continue to contribute to healthcare disparities through the differential distribution of technologies that simultaneously enhance and impede literacy, motivation, and ability of different groups (and individuals) in the population. We conclude the article by suggesting pragmatic implications of our analysis.
Des Jarlais, Don; Arasteh, Kamyar; McKnight, Courtney; Feelemyer, Jonathan; Hagan, Holly; Cooper, Hannah; Campbell, Aimee; Tross, Susan; Perlman, David
It has not been determined whether implementation of combined prevention programming for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine racial/ethnic disparities in New York City among persons who inject drugs after implementation of the New York City Condom Social Marketing Program in 2007. Quantitative interviews and HIV testing were conducted among persons who inject drugs entering Mount Sinai Beth Israel drug treatment (2007-2014). 703 persons who inject drugs who began injecting after implementation of large-scale syringe exchange were included in the analyses. Factors independently associated with being HIV seropositive were identified and a published model was used to estimate HIV infections due to sexual transmission. Overall HIV prevalence was 4%; Whites 1%, African-Americans 17%, and Hispanics 4%. Adjusted odds ratios were 21.0 (95% CI 5.7, 77.5) for African-Americans to Whites and 4.5 (95% CI 1.3, 16.3) for Hispanics to Whites. There was an overall significant trend towards reduced HIV prevalence over time (adjusted odd ratio = 0.7 per year, 95% confidence interval (0.6-0.8). An estimated 75% or more of the HIV infections were due to sexual transmission. Racial/ethnic disparities among persons who inject drugs were not significantly different from previous disparities. Reducing these persistent disparities may require new interventions (treatment as prevention, pre-exposure prophylaxis) for all racial/ethnic groups.
Irvine, Peter J.; Ridgwell, Andy; Lunt, Daniel J.
Solar Radiation Management (SRM) Geoengineering may ameliorate many consequences of global warming but also has the potential to drive regional climates outside the envelope of greenhouse-gas induced warming, creating ‘novel’ conditions, and could affect precipitation in some regions disproportionably. Here, using a fully coupled climate model we explore some new methodologies for assessing regional disparities in geoengineering impacts. Taking a 4 × CO2 climate and an idealized ‘sunshade’ SRM strategy, we consider different fractions of the maximum theoretical, 4 × CO2-cancelling global mean cooling. Whilst regional predictions in particularly relatively low resolution global climate models must be treated with caution, our simulations indicate that it might be possible to identify a level of SRM geoengineering capable of meeting multiple targets, such as maintaining a stable mass balance of the Greenland ice sheet and cooling global climate, but without reducing global precipitation below pre-industrial or exposing significant fractions of the Earth to ‘novel’ climate conditions.