جستجوی مقالات مرتبط با کلیدواژه « health disparity » در نشریات گروه « پزشکی »

 Roughly 10% of children aged 3 -17 in the USA are diagnosed with attention-deficit hyperactivity disorder (ADHD), and minorities are less likely to initiate common pharmacologic treatment. We conducted a review of the literature to examine meditation as a safe, effective, and low-cost alternative.

 We searched PubMed and other journals using “meditation,” “mindfulness,” “minority,” related keywords, and relevant MeSH terms. Eligible studies involved racial/ethnic minorities in the USA, reported quantitative psychosocial outcomes, and were published in a peer-reviewed, English-language journal.

 Out of 119 “hits,” 111 were eliminated as duplicates or were not relevant. A full-text review of the remaining eight revealed that none fully met our eligibility criteria. Besides the obvious lack of studies, those reviewed reported incomplete demographic and clinical data. They also employed different and inconsistent research methodologies, interventions and modalities, and statistical analyses. This hindered understanding exactly which populations may benefit from meditation, and for which specific symptoms.

 We recommend a socio-ecological model in examining intervention modalities, especially in the context of intrapersonal, interpersonal, organizational, environmental, and policy domains. We also suggest the possible inclusion of research older than 10 years, conducted outside of the USA, on minority and non-minority populations, for supplementary and confirmatory data. We advocate for consistency in study design and data collection, which would help align research conducted in different countries. Searches should also include variations of meditation such as “mindfulness” and “guided imagery,” and associated symptoms and comorbidities of ADHD, including “learning disorder” and “behavioral problems.”

Carspecken’s critical ethnography method has gained prominence in nursing research, necessitating a fresh perspective on its practicality and advantages. This study aims to provide a unique viewpoint on using critical ethnography as a foundational methodology to uncover health disparity culture in intensive care units.

Methods & Materials: 

While emphasizing its review design with original examples, this perspective piece provides a practical explanation of Carspecken’s five-stage critical ethnography approach. Grounded in the ontological and epistemological paradigm, this essay examines critical ethnography as a crucial approach to illuminating the discursive culture surrounding health disparities. Also, this study presents original instances of monological and dialogical data, reconstructive analysis, and findings from a study that was carried out to provide more perspective on implementation. It also mentions how it relates the findings to social factors and sociopolitical theories.

The study reveals nuanced insights into the practicality and advantages of Carspecken’s method, shedding light on social processes contributing to health disparities in intensive care units. This method allowed us to identify how external powers extend to the intensive care unit, revealing a concealed culture that disrupts service provision balance. It exposed individual, organizational, and systemic roots contributing to disparities. Additionally, it highlighted how individual diversities can lead to disparity.

This study highlights the significance of Carspecken’s critical ethnography in nursing studies within the critical theory tradition. It is argued that Carspecken’s approach to critical ethnography is particularly instrumental in elucidating the social structures contributing to health disparities.

Background  Pneumonia is one of the leading causes of hospital admission in the United States with a global health burden of about 6.8 million hospitalizations and 1.1 million deaths in patients over 65 years old in 2015. This study aimed to identify possible patient and hospital-related risk factors for in-hospital pneumonia death across US hospitals.Methods  The National Inpatient Sample (NIS) was used to identify nationwide pneumonia patients (n = 374 766, weighted n = 1 873 828) from 2016 to 2019. We examined the characteristics of the study sample and their association with in-hospital death. Multivariate survey logistic regression models were used to identify risk factors.Results  During the study periods, in-hospital death rates continuously decreased (2.45% in 2016 to 2.19% in 2019). Descriptive statistics showed that patient and hospital factors had varied in-hospital death rates. Survey logistic regression results suggested that male, very low income, non-Medicare, government hospitals, rural hospitals, and specific hospital regions were associated with higher in-hospital death rates than their reference groups.Conclusion  Socioeconomic factors, including income and insurance, are associated with pneumonia mortality. Census region, hospital ownership, and rural location are also related to in-hospital mortality. Such findings in underserved, impoverished, and rural areas to identify possible health disparities.

Our objective was to determine the frequency of inadequate functional health literacy (FHL) among adult Kurd population, and infer the contribution index of sociodemographic factors for FHL across gender.  In this cross-sectional study, multistage cluster sampling was employed to recruit 1000 people older than 18 years from 38 urban and 14 rural healthcare centers in Sanandaj, Iran. Data on FHL was collected from May to July 2019, through face-to-face interviews by using the validated Persian version of the Test of functional health literacy in adults (TOFHLA). The concentration index method was used to measure inequality in FHL.  Overall, 869 respondents (response rate: 86.9%) with a mean age of 33.68 (±13.0) completed the TOFHLA questionnaire. The average TOFHLA score was 51.9, which was 52.2 (±0.46) among males and 50.7 (±0.40) among females, p<0.001. Among females, the place of residence, monthly income, age, education level, and being head of the household contributed to 43%, 32%, 13%, 11.5%,  and 11% of FHL inequality, respectively. While, among males, the place of residence (45.2%), household size (15.1%), and monthly income (13.5%) contributed most to inequality in FHL.  FHL has disparities by gender and location. Males and rural people are at particular risk for poor FHL. For ease and better resolution of poor FHL, each population, gender, and area type should be considered as a stand-alone, which may help in identifying tailored interventions for males and females with low levels of FHL.

Health information-seeking behavior (HISB) of college students is of importance due to health information inconsistencies at a time when personal independence and concurrent personal health decision making may be increased. Currently, there is a dearth of research about the HISB of college students, especially from diverse backgrounds. Therefore, the purpose of this study was to identify and describe the sources college students use when engaging in HISB; and to explore associations between HISB and demographic factors.

 This cross-sectional study was conducted with undergraduate students at a diverse, public institution in New York City. The sample was drawn from an institutional social science research pool and asked to complete a survey on HISB. A total of 226 respondents completed the survey.

 The believed accuracy of the information found online was positively correlated with related behaviors and beliefs. The number of followers on Instagram proved to be an important mediator of HISB of college students. The number of followers a health information provider has was fittingly positively correlated with the belief that social media is a helpful resource for health information r(233)=0.18, P=0.01. Students from families with two or more generations living in the United States accessed health professionals more frequently than students from one or less generation (χ2=8.107(2), P=0.017).

 Targeted educational programs designed to increase health information seeking skills, including discernment of information quality should be a priority for college students.

Regional disparity is an imperative component of health disparity. In particular, providing emergency care that is equally available in rural areas is an essential part of reducing the urban–rural disparity. The objective of this study was to examine the worsening admission rate among Cambodian emergency patients in a rural area and determine their background characteristics that cause this decline.

To investigate the disparity among patients who visited Sunrise Japan Hospital (SJH), a major general private hospital in the capital, patient data from November 2016 to September 2019 were obtained from the electronic reception patient database. The primary outcome was defined as the proportion of admission patients as an indicator of illness severity. The patients’ addresses were classified into 4 areas based on distance from the capital.

A total of 6167 patients who visited the emergency department at SJH between January 2017 and September 2019 were included in the analysis. The proportion of patients who needed to be hospitalized or transferred increased with the distance from the capital. The proportion of patients who finished consultation decreased with the distance from the capital (P < .01: Chi- square test). The results of the logistic regression analysis showed that the admission rate in rural areas was significantly higher only among males as compared to that of the capital in multivariate analyses adjusted for age, time, and season.

The admission rate of emergency patients who visited a private general hospital in Cambodia’s capital city increased with distance from the capital city. To improve regional disparity among emergency patients, further research is necessary to identify the issues among emergency patients, especially those who are vulnerable.

Health inequities are among debatable and challenging aspects of health systems. Achieving equity through social determinants of health approach has been mentioned in most upstream national plans and acts in Iran. This paper reports the findings of a systematic review of the current synthesized evidence on health equity in Iran.

This is a narrative systematic review. The relevant concepts and terminology in health equity was found through MeSH. We retrieved the relevant studies from PubMed/MedLine, Social Sciences Database, and Google Scholar in English, plus the Jihad University Database (SID), and Google Scholar in Farsi databases from 1979 until the end of January 2018. The retrieved evidence has been assessed primarily based on PICOS criteria and then Ottawa-Newcastle Scale, and CASP for qualitative studies. We used PRISMA flow diagram and a narrative approach for synthesizing the evidence.

We retrieved 172 455 studies. Following the primary and quality appraisal process, 114 studies were entered in the final phase of the analysis. The main part (approximately 95%) of the final phase included cross-sectional studies that had been analyzed through current descriptive inequality analysis indicators, analytical regression, or decomposition-based approaches. The studies were categorized within 3 main groups: health outcomes (40.3%), health utilization (32%), and health expenditures (27%).

As a part of understanding the current situation of health equity in the policymakers’ need to refer the retrieved evidence in this study, they need more inputs specially regarding the social determinants of health approach. It seems that health equity research plan in Iran needs to be redirected in new paths that give appropriate weights to biological, gene-based, environmental and context-based, economic, social, and political aspects of health as well.
We advocate addressing the aspects of Social Determinant of Health (SDH) in analyzing health inequalities.