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Inequities in access to palliative and end-of-life care in the black population in Canada: a scoping review.

BackgroundImproving equity and early access to palliative care for underserved populations in Canada is a priority. Little is known regarding access to palliative and end-of-life care in the Black population.MethodsWe undertook a scoping review using the framework by Arksey and O'Malley to identify knowledge, access gaps, and experiences of palliative and end-of-life care among Blacks living with life-limiting illnesses in Canada. Primary studies, discussion papers, books, and reports were considered eligible. We followed a comprehensive search strategy developed by an information scientist. S

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… Improving trust in the health care system and dismantling anti-Black racism are necessary steps in this direction. The lack of data and research with Black peoples in palliative care is also a call to undertake studies in this area. We discuss these below. … Dryden O Nnorom O Time to dismantle systemic anti-black racism in medicine in Canada CMAJ 2021 193 2 E55 7 10.1503/cmaj.201579 33431548 PMC7773037 53. …

Racial and ethnic disparities in childhood and young adult acute lymphocytic leukaemia: secondary analyses of eight Children's Oncology Group cohort trials.

BACKGROUND: Previous studies have identified racial and ethnic disparities in childhood acute lymphocytic leukaemia survival. We aimed to es … dies of relapsed patients, access to and quality of care, and other potential aspects of structural racism are warranted to inform interventions aimed at dismantling racial and ethnic disparities. FUNDING: National Cancer Institute and St Baldrick's Foundation.

The association between maternal and paternal race and preterm birth.

BACKGROUND: Non-Hispanic black maternal race is a known risk factor for preterm birth. However, the contribution of paternal race is not as … gate the mechanisms behind this finding, including determining the contribution of factors, such as racism, maternal and paternal genetics, and epigenetics to an individual's risk of preterm birth.

Дифференциация по признаку расы и места в области многоразового склерозового лечения: качественное исследование опыта пациентов.

Множественный склероз - это нейродегенеративное и нейро-воспалительное заболевание, вызывающее различные симптомы, включая физические и когнитивные области. Предыдущие исследования показали, что расовые диспропорции характерны для многочисленных неврологических результатов склероза, при этом чернокожие люди сталкиваются с более тяжелыми последствиями, чем их белые коллеги. ЦЕЛЬ: Изучение различий по признаку расы и места в опыте оказания многочисленных услуг по склерозу среди чернокожих и белых участников. МЕТОДЫ: Качественные данные были собраны у 20 взрослых с множественным склерозом в ходе

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… It is important to consider the role that systemic racism plays in “Place” and health disparities. For example, redlining has been associated with poor health outcomes and neighborhood environmental characteristics, 27 which may contribute to racial health disparities. … Future research should investigate the role of racism in health disparities within Black populations and other minoritized groups to highlight the mechanisms behind these disparities. …

Социальные детерминанты здоровья, качества ухода за больными и результаты лечения неврологических расстройств: систематический обзор.

СПРАВОЧНАЯ ИНФОРМАЦИЯ: Социальные детерминанты здоровья (SDOH) оказывают значительное влияние на оказание медицинской помощи и ее результаты, однако их конкретное воздействие на качество неврологической медицинской помощи по-прежнему недостаточно синтезировано. ЦЕЛЬ: Цель этого систематического обзора заключалась в обобщении данных о связях между СДОГ и качеством медицинского обслуживания и результатах лечения пациентов в связи с серьезными неврологическими расстройствами. МЕТОДЫ: ПОСЛЕ ПРИСМА 2020 Руководящие принципы, мы систематически искали Пуббмеда, Интернет науки и Эмбазу для исследовани

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… interconnected pathways: increased exposure to vascular and neurotoxic risk factors among disadvantaged populations; 16 , 17 healthcare access barriers that delay diagnosis and limit treatment intensity; 18 health literacy deficits that compromise self-management and care navigation; 19 structural racism … These residual disparities implicate structural racism, provider implicit bias, and healthcare system factors beyond individual socioeconomic circumstances. Sixth, SDOH impacts demonstrate important disease-specific patterns alongside common themes. …

Disparities in Palliative and Hospice Care and Completion of Advance Care Planning and Directives Among Non-Hispanic Blacks: A Scoping Review of Recent Literature.

ObjectivesPublished research in disparities in advance care planning, palliative, and end-of-life care is limited. However, available data points to significant barriers to palliative and end-of-life care among minority adults. The main objective of this scoping review was to summarize the current published research and literature on disparities in palliative and hospice care and completion of advance care planning and directives among non-Hispanc Blacks.MethodsThe scoping review method was used because currently published research in disparities in palliative and hospice cares as well as adva

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… The African American population has also experienced decades of systemic and institutionalized racism and discrimination, in addition to unethical medical experimentation conducted among these groups. …

An overview of cancer health disparities: new approaches and insights and why they matter.

Cancer health disparities remain stubbornly entrenched in the US health care system. The Affordable Care Act was legislation to target these disparities in health outcomes. Expanded access to health care, reduction in tobacco use, uptake of other preventive measures and cancer screening, and improved cancer therapies greatly reduced cancer mortality among women and men and underserved communities in this country. Yet, disparities in cancer outcomes remain. Underserved populations continue to experience an excessive cancer burden. This burden is largely explained by health care disparities, lif

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… Perceived experiences of racism show relationships with breast cancer and cancer-promoting health behaviors, such as increased tobacco and alcohol consumption ( 86 , 87 ). In breast tumors, social isolation may lead to reprogramming of tumor biology ( 88 , 89 ). … Shariff-Marco, S. et al. (2010) Racial/ethnic differences in self-reported racism and its association with cancer-related health behaviors. Am. J. Public Health, 100, 364–374. 88. …

Second-Class Care: How Immigration Law Transforms Clinical Practice in the Safety Net.

This article examines how U.S. immigration law extends into the health care safety net, enacting medical legal violence that diminishes noncitizens' health chances and transforms clinical practices. Drawing on interviews with health care workers in three U.S. states from 2015 to 2020, I ask how federal citizenship-based exclusions within an already stratified health care system shape the clinical trajectories of noncitizens in safety-net institutions. Focusing specifically on cancer care, I find that increasingly anti-immigrant federal policies often reshape clinical practices toward noncitize

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… The former often described dynamics of racial discrimination and structural racism similar to those that patients expressed, whereas the latter focused on inequities related to legal status and language access (for a more in-depth discussion of participants’ relative racialization experiences, see Van … “Law, Structural Racism, and the COVID-19 Pandemic.” Journal of Law and the Biosciences 7(1):1–20. …

Психосоциальные и поведенческие корреляции ВИЧ-инфицированных мужчин, имеющих сексуальные отношения с мужчинами в Португалии: перекрестное исследование.

Справочная информация/задачи: Мужчины, вступающие в половые отношения с мужчинами (МСМ), несут в Португалии непропорционально большую долю ВИЧ-инфекции, однако социально-психологические характеристики ВИЧ-инфицированных лиц по-прежнему недостаточно описаны. В этом перекрестном исследовании изучалось, как навязчивое сексуальное поведение, интернализованный хомонегатив, психологическое расстройство, трудности с регулированием эмоций и употребление веществ связаны с ВИЧ серостатусом, независимо от социально-демографических характеристик. Методы: Удобная выборка из 480 Cisgender MSM (66 человек, ж

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… Rather than considering only comorbidities, the syndemic perspective emphasizes that physical illnesses, mental health conditions, and psychosocial issues, such as violence, substance misuse, stigma, and discrimination, are exacerbated in environments characterized by poverty, racism, sexism, homophobia … homonegativity has been associated with lower uptake of HIV testing and with HIV risk behaviors [ 18 ], and the broader empirical literature on this construct has been systematically mapped [ 19 ]; ongoing work is examining how internalized homonegativity intersects with other internalized stigmas, such as racism …

Феноменологическое понимание старения с множественным склерозом.

СПРАВОЧНАЯ ИНФОРМАЦИЯ И ЗАДАЧИ: По мере увеличения продолжительности жизни сообщества, занимающегося множественным склерозом (МС), необходимы новые новшества и понимание того, что такое возраст «здорового». Опираясь на ряд направлений работы по изучению значения и опыта старения с нетрудоспособным состоянием и показав, как и почему люди, стареющие с MS, по-разному ощущают это явление, эта газета развивает литературу по вопросам старения и инвалидности путем (пере) концептуализации того, что «благосостояние» означает для людей, стареющих с MS, и как благополучие может быть повышено или поставле

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… through everyday situations and contexts, but this type of understanding too was criticized for a “neoliberal construction of Western individualism” ( Mead et al., 2021 , p. 1) that did not appreciate a person’s place within an unequal society and subsequent oppressions they may experience (e.g., sexism, racism … Further, identifying such social oppressions can ensure the representation of aging and MS within wider discussions around ableism, sexism, racism, and classism currently at the heart of physical activity equity discussions ( Hasson et al., 2017 ). …

Real-World Treatment Outcomes in Black, Hispanic, Asian, and White People with Multiple Sclerosis Treated with Fumarates in the USA.

INTRODUCTION: Multiple sclerosis (MS) is a heterogeneous disease affecting a diverse population. Compared with white people with MS (PwMS), Black PwMS have more severe disease and higher incidence of MS, whereas Hispanic PwMS experience earlier onset disease; however, MS is not adequately studied in these groups. We compared the effectiveness of fumarates across Black, Hispanic, Asian, and white PwMS. METHODS: This retrospective analysis using the Komodo Health database included PwMS. Patients with a claim for diroximel fumarate or dimethyl fumarate were followed from disease-modifying therap

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… In the USA, systemic differences in healthcare access, socioeconomic inequalities, cognitive biases, and racism within the healthcare system may contribute to poorer disease-related outcomes in people from minority racial and ethnic groups [ 20 ]. … According to Amezcua et al., Black and Hispanic PwMS often have lower health literacy and face reduced access to specialty care and delays in diagnosis due to systemic and structural racism in healthcare. …

Regional, demographic and temporal trends in anemia and malignant cancer-related mortality in U.S. older adults: a nationwide CDC WONDER analysis (1999-2020).

PurposeAnemia and malignancy concurrently contribute to reduced quality of life, treatment intolerance, and increased morbidity and mortality, disproportionately affecting older adults, socioeconomically disadvantaged groups, and minority populations. Despite its clinical importance, national patterns and population-level disparities in the mortality burden associated with this comorbidity remain poorly characterized. This study aims to examine mortality trends associated with concurrent anemia and malignancy in the United States using CDC WONDER (Centers for Disease Control and Prevention Wid

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… Higher mortality among NH Black populations likely reflects structural racism and social determinants of health (SDOH) interacting with biological risks. … Racism and health: evidence and needed research. Annu Rev Public Health. (2019) 40:105–25. doi: 10.1146/annurev-publhealth-040218-043750, PMID: 56. The Lancet Oncology . Racial disparities in cancer care: can we close the gap? …

Exploring social determinants of health on chemotherapy-induced peripheral neuropathy severity in ovarian cancer: An integrative review.

Ovarian cancer remains a significant public health concern for women despite advancements in cancer management. Despite comprising only 2.5 % of cancers in women, ovarian cancer ranks as the fifth leading cause of cancer-related deaths among women, with patients frequently receiving late diagnoses. Chemotherapy, a primary treatment, frequently causes chemotherapy-induced peripheral neuropathy (CIPN), affecting over 60 % of patients and leading to severe sensory, motor, and autonomic nerve impairments. This often necessitates dosage reduction or discontinuation of treatment, thereby increasing

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… ); 2) studies focusing on ovarian cancer patients undergoing chemotherapy, with specific attention to those addressing CIPN and SDOH as determined by SODH various concepts such as governance, macroeconomic policies, social policies, public policies, cultural values, social class, gender, ethnicity (racism … The socioeconomic position define individuals’ positions within a societal hierarchy influencing access to health, and includes social class, gender, ethnicity (racism), income, education, and occupation ( WHO, 2010 ). …

Racial and ethnic disparities in fecundability: a North American preconception cohort study.

STUDY QUESTION: To what extent are there racial and ethnic disparities in fecundability in North America? SUMMARY ANSWER: In a North Americ … erstand the mechanisms underlying disparities in fecundability, including the effects of structural racism and discrimination, as well as programs and policies to advance reproductive health equity. As more research is conducted on the drivers of these disparities, greater efforts should be made to increase fertility awareness, enhance preconception heal …

US Life Expectancy and Increasing Mortality Rates: An Analysis of the Crisis.

UNLABELLED: Policy Points US life expectancy is shorter than in other high-income countries and the gap has widened dramatically over time, … s in the health care system, socioneconomic precarity, a lax regulatory environment, and structural racism. State-level life expectancy and mortality rates have increased over time and appear associated with policy and increasingly partisan orientations. CONCLUSIONS: The United States faces a mortality crisis that requires attention not only to specific …

`It's not just linguistically, there's much more going on': The experiences and practices of bilingual paediatric speech and language therapists in the UK.

BACKGROUND: Despite the high prevalence of bilingualism in the United Kingdom, few speech and language therapists (SLTs) are bilingual thems … rvice development. Recommendations include using intersectional lenses, providing cultural and anti-racism awareness training to SLTs, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in recruitment processes and increasing accountability at the leadership level. Research giving voice to bili …

Use of Real-World Evidence to Drive Drug Development Strategy and Inform Clinical Trial Design.

Interest in real-world data (RWD) and real-world evidence (RWE) to expedite and enrich the development of new biopharmaceutical products has proliferated in recent years, spurred by the 21st Century Cures Act in the United States and similar policy efforts in other countries, willingness by regulators to consider RWE in their decisions, demands from third-party payers, and growing concerns about the limitations of traditional clinical trials. Although much of the recent literature on RWE has focused on potential regulatory uses (e.g., product approvals in oncology or rare diseases based on sin

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… Social determinants of health are the conditions, systems, and circumstances in which people are born, live, work, and age that relate to conditions of daily life, such as structural racism, level of educational attainment and quality, language proficiency, socioeconomic status, employment status, income … Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation 142, e454–e468 (2020). 65. Shah, J.J. et al . …

Лечение чернокожих и белых пожилых людей с множественной миеломой: анализ SEER-Medicare.

Цель настоящего исследования заключается в том, чтобы описать время начала лечения чернокожих и белых пожилых людей с множественными миеломой (ММ) и проверить гипотезу о том, что различия между чернокожими и белыми в начале лечения с течением времени возросли.65+) диагноз миэломы 2007-2017 были выявлены в базе данных SEER-Medicare. Непрерывное медицинское обслуживание 12 за месяцы до и после диагностики или до смерти, а также по части D 12 - месяцев после диагностики или до смерти. Мы изучали время начала лечения по расовому признаку three период диагностирования2007-10, 2011-2014, 2015-2017)

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… Jones , “ Invited Commentary: ‘Race,’ Racism, and the Practice of Epidemiology ,” American Journal of Epidemiology 154 , no. 4 ( 2001 ): 299 – 304 , 10.1093/aje/154.4.299 . 11495851 23 J. W. …

Community-based adaptation of early adolescent skills for emotions for urban adolescents and caregivers in New York City.

An increasing number of studies have sought to explore the applicability of scalable mental health interventions to bridge the adolescent mental health treatment gap. This study aimed to adapt the World Health Organization's mental health intervention Early Adolescent Skills for Emotion (EASE) for urban communities in New York City (NYC). Following the mental health Cultural Adaptation and Contextualization for Implementation framework and in collaboration with three Brooklyn community-based organizations and the NYC Mayor's Office of Community Mental Health, the intervention was intensively w

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… References Acker J, Aghaee S, Mujahid M, Deardorff J and Kubo A (2023) Structural racism and adolescent mental health disparities in northern California. JAMA Network Open 6(8), e2329825. 10.1001/jamanetworkopen.2023.29825. … Castro-Ramirez F, Al-Suwaidi M, Garcia P, Rankin O, Ricard JR and Nock MK (2021) Racism and poverty are barriers to the treatment of youth mental health concerns. Journal of Clinical Child & Adolescent Psychology 50(4), 534–546. 10.1080/15374416.2021.1941058. …

Bias reported by family caregivers in support received when assisting patients with cancer-related decision-making.

BackgroundFamily caregivers play an increasing role in cancer treatment decision-making. We examined bias reported by family caregivers in the support they and their patient received from their healthcare team when making these decisions, including associations with distress.MethodsAnalysis of 2021 national survey data of family caregivers of patients with cancer (N = 2703). Bias experienced in decision support was assessed with the item: "Have you felt that the support you and the person with cancer have received for making cancer-related decisions by your doctor or healthcare team has been n

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… Levels of racism: a theoretic framework and a gardener's tale. Am J Public Health. 2000;90(8):1212‐1215. Associated Data Supplementary Materials Appendix S1 Click here for additional data file. …