Achieving Equitable Cardiovascular Care for All: ACC Board of Trustees Health Equity Task Force Action Plan.

Advancements in cardiovascular (CV) disease management are notable, yet health inequities prevail, associated with increased morbidity and mortality noted among non-Hispanic African Americans in the United States. The 2002 Institute of Medicine Report revealed ongoing racial and ethnic health care disparities, spearheading a deeper understanding of the social determinants of health and systemic racism to develop strategies for CV health equity (HE). This article outlines the strategic HE approach of the American College of Cardiology, comprising 6 strategic equity domains: workforce pathway inclusivity, health care, data, science, and tools; education and training; membership, partnership, and collaboration; advocacy and policy; and clinical trial diversity. The American College of Cardiology's Health Equity Task Force champions the improvement of patients' lived experiences, population health, and clinician well-being while reducing health care costs-the Quadruple Aim of Health Equity. Thus, we examine multifaceted HE interventions and provide evidence for scalable real-world interventions to promote equitable CV care.

Sexual behavior and HPV infection in British women, by postal questionnaires and telephone interviews.

Sexually transmitted human papillomaviruses (HPVs), most frequently HPV 16, are the primary cause of cervical carcinogenesis. The aim of this study was to evaluate the relationship between sexual behavior and prevalence and acquisition of HPV infection among British women attending regular cervical screening who responded to postal questionnaires and/or telephone interviews. A total of 1,880 women who had been tested for HPV in the ARTISTIC (A Randomized Trial In Screening To Improve Cytology) trial were randomized to three methods of data collection: group 1 (questionnaire including sexual history, no interview), group 2 (questionnaire excluding sexual history, short interview including sexual history), and group 3 (questionnaire and long interview including sexual history in both). Questions on sexual history included age at first sexual intercourse, sexually transmitted diseases, lifetime (total and regular) sexual partners, and number of partners in the last 5 years (total and new). Demographics, reproductive, cervical screening, and smoking history were also collected in questionnaires. The overall participation rate was 35%. There was good agreement (87.4-95.5%) on sexual behavior answers in questionnaires and interviews in women in group 3 and no significant differences between data obtained by questionnaire or interview. Odds ratios (OR) for both HPV prevalence and acquisition increased consistently with increasing numbers of lifetime sexual partners, regular partners, and new partners in the last 5 years (recent partners). No significant association was found for other characteristics investigated. The effect of recent sexual partners on HPV acquisition (OR for 2+ recent partners: 4.4, 95% CI: 1.7-11.2) was stronger than that of earlier (> 5 years ago) partners (OR for 2+ earlier partners: 2.2, 95% CI: 0.7-6.7) suggesting that most incident HPV infections are newly acquired rather than recurrent.

The risks and benefits of antidepressant treatment for youth depression.

The U.S. Food and Drug Administration (FDA) has mandated that all antidepressants carry a 'black box' warning label indicating that antidepressants increase the risk of suicidality in youth taking these medications. In the U.K., the Medicine and Healthcare Products Regulatory Agency (MHRA) has determined that the balance of risks and benefits favors only the use of fluoxetine in the treatment of depressive illness in children and adolescents. This article reviews the FDA's analysis linking antidepressant medication use and pediatric suicidality in major depressive disorder, discusses the efficacy of antidepressants in treating depression in children and adolescents, and offers suggestions to aid clinicians, patients, and families in making clinical decisions based on an accurate assessment of the benefits and risks of medication and psychosocial treatments for pediatric depression.