GAP-REACH: a checklist to assess comprehensive reporting of race, ethnicity, and culture in psychiatric publications.

Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications. The 16-item GAP-REACH checklist was developed through a rigorous process of expert consensus, empirical content analysis in a sample of publications (N = 1205), and interrater reliability (IRR) assessment (N = 30). The items assess each section in the conventional structure of a health research article. Data from the assessment may be considered on an item-by-item basis or as a total score ranging from 0% to 100%. The final checklist has excellent IRR (κ = 0.91). The GAP-REACH may be used by multiple research stakeholders to assess the scope of REC reporting in a research article.

The Medical Education Commission Report 2003: GME production renews physician supply.

Louisiana data for the match entry into Graduate Medical Education, and the renewal of the practicing physician workforce, are essentially parallel to comparable data for the United States as a whole. The State of Louisiana Medical Education Commission offers reports and publications in the Journal of the Louisiana State Medical Society compiling yearly and trend data and analysis. The 2003 result of the match follows the trend of successful completion over the last five years. While Louisiana is similar in many comparable categories to the United States, the state is somewhat higher in primary care growth, now stabilized and leveling, as are total GME and total physicians. Relatively small changes may be baseline fluctuations, and not a trend of longer-term change. The GME system is remarkably stable and successful overall, though complex right down to individual variation.

The Medical Education Commission Report 2002: trends indicate a steady state supply of physicians.

This summary report for 2002 provides the detailed and updated data on all Graduate Medical Education (GME) residents and fellows in Louisiana for the last academic year. The 2002 match results and the trend in matching over the last 4 years depict the consistent successful match by Louisiana institutions. The totals and components of GME in Louisiana are steady. The infusion of gradually increasing numbers of physicians over the last 30 years in the United States and in Louisiana is quantified to indicate the present consistent steady state production and supply. The ripple effect into the physician population of this infusion now shows the expected beginning stabilization, although incomplete at this juncture. While demand for physician services for healthcare delivery is difficult to define and quantify, the inexorable increase of utilization of healthcare services portends a future mismatch of supply and demand, a shortage not a surplus.

Future of genetics of mood disorders research.

This report summarizes the deliberations of a panel with representation from diverse disciplines of relevance to the genetics of mood disorders. The major charge to the panel was to develop a strategic plan to employ the tools of genetics to advance the understanding, treatment, and outcomes for mood disorders. A comprehensive review of the evidence for the role of genetic factors in the etiology of mood disorders was conducted, and the chief impediments for progress in gene identification were identified. The National Institute of Mental Health (NIMH) portfolios in the Genetics Research Branch and the Division of Mental Disorders, Behavioral Sciences, AIDS, and all genetics training activities were reviewed. Despite some promising leads, there are still no confirmed linkage findings for mood disorders. Impediments to gene finding include the lack of phenotypic validity, variation in ascertainment sources and methodology across studies, and genetic complexity. With respect to linkage, the committee recommended that a large-scale, integrated effort be undertaken to examine existing data from linkage and association studies of bipolar disorders using identical phenotypes and statistical methods across studies to determine whether the suggestive linkage findings at some loci can be confirmed. Confirmation would justify more intensive approaches to gene finding. The committee recommended that the NIMH support continued efforts to identify the most heritable subtypes and endophenotypes of major depression using the tools of genetic epidemiology, neuroscience, and behavioral science. The field of genetic epidemiology was identified as an important future direction because population-based, epidemiologic studies of families and unrelated affected individuals assume increasing importance for common chronic diseases. To prepare for shifts to more complex genetic models, the committee recommended that the NIMH develop new interdisciplinary training strategies to prepare for the next generation of genetics research.