RESUMO
Large-scale, multisite data sets offer the potential for exploring the public health benefits of biomedical interventions. Data harmonization is an emerging strategy to increase the comparability of research data collected across independent studies, enabling research questions to be addressed beyond the capacity of any individual study. The National Institute on Drug Abuse recently implemented this novel strategy to prospectively collect and harmonize data across 22 independent research studies developing and empirically testing interventions to effectively deliver an HIV continuum of care to diverse drug-abusing populations. We describe this data collection and harmonization effort, collectively known as the Seek, Test, Treat, and Retain Data Collection and Harmonization Initiative, which can serve as a model applicable to other research endeavors.
Assuntos
Pesquisa Biomédica/métodos , Coleta de Dados/métodos , Infecções por HIV/diagnóstico , National Institute on Drug Abuse (U.S.) , Fármacos Anti-HIV/uso terapêutico , Pesquisa Biomédica/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Direito Penal , Coleta de Dados/normas , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Modelos Organizacionais , Estudos Multicêntricos como Assunto/métodos , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/complicações , Estados Unidos , Populações VulneráveisRESUMO
OBJECTIVES: We conducted a review to examine current literature on the effects of interpersonal and institutional racism and discrimination occurring within health care settings on the health care received by racial/ethnic minority patients. METHODS: We searched the PsychNet, PubMed, and Scopus databases for articles on US populations published between January 1, 2008 and November 1, 2011. We used various combinations of the following search terms: discrimination, perceived discrimination, race, ethnicity, racism, institutional racism, stereotype, prejudice or bias, and health or health care. Fifty-eight articles were reviewed. RESULTS: Patient perception of discriminatory treatment and implicit provider biases were the most frequently examined topics in health care settings. Few studies examined the overall prevalence of racial/ethnic discrimination and none examined temporal trends. In general, measures used were insufficient for examining the impact of interpersonal discrimination or institutional racism within health care settings on racial/ethnic disparities in health care. CONCLUSIONS: Better instrumentation, innovative methodology, and strategies are needed for identifying and tracking racial/ethnic discrimination in health care settings.
Assuntos
Etnicidade , Acessibilidade aos Serviços de Saúde , Pesquisa sobre Serviços de Saúde/métodos , Disparidades em Assistência à Saúde/etnologia , Grupos Raciais , Humanos , Percepção , Preconceito , Projetos de Pesquisa , EstereotipagemRESUMO
Nuclear hormone receptors, such as the ecdysone receptor, often display a large amount of induced fit to ligands. The size and shape of the binding pocket in the EcR subunit changes markedly on ligand binding, making modelling methods such as docking extremely challenging. It is, however, possible to generate excellent 3D QSAR models for a given type of ligand, suggesting that the receptor adopts a relatively restricted number of binding site configurations or 'attractors'. We describe the synthesis, in vitro binding and selected in vivo toxicity data for gamma-methylene gamma-lactams, a new class of high-affinity ligands for ecdysone receptors from Bovicola ovis (Phthiraptera) and Lucilia cuprina (Diptera). The results of a 3D QSAR study of the binding of methylene lactams to recombinant ecdysone receptor protein suggest that this class of ligands is indeed recognised by a single conformation of the EcR binding pocket.
Assuntos
Ligantes , Receptores de Esteroides/antagonistas & inibidores , Acetamidas/síntese química , Acetamidas/química , Acetamidas/toxicidade , Sítios de Ligação , Simulação por Computador , Relação Quantitativa Estrutura-Atividade , Receptores de Esteroides/genética , Receptores de Esteroides/metabolismo , Proteínas Recombinantes/antagonistas & inibidores , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Relação Estrutura-AtividadeAssuntos
Negro ou Afro-Americano/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Nível de Saúde , Disparidades em Assistência à Saúde/etnologia , Saúde do Homem/etnologia , Doença Aguda/epidemiologia , Adolescente , Adulto , Centers for Disease Control and Prevention, U.S. , Criança , Doença Crônica/etnologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
In the Caribbean AIDS has become the leading cause of death among those aged 15-45. The homeless are at high risk due to the nexus of mobility, psychiatric disorders and substance use, particularly crack. Seventy-four homeless, out-of-treatment drug users were recruited in Saint Lucia and Trinidad to assess risk behaviour and healthcare needs. Information was collected in several domains: medical, mental health, substance use, sexual risk, and barriers to care. Ninety-five percent of the sample reported crack cocaine use within the previous 30 days. Approximately 35% of the sample had ever been diagnosed with a sexually transmitted disease and 25% of the sample reported being HIV+. Approximately 40% had a history of trading sex for crack or money. Due to the range of needs in this population, interventions should be multimodal. A focus on the individual, community, and structural levels is warranted to improve chances of program effectiveness.