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1.
Am J Transplant ; 24(3): 448-457, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37898318

RESUMO

Children exposed to disproportionately higher levels of air pollution experience worse health outcomes. In this population-based, observational registry study, we examine the association between air pollution and graft failure/death in children following liver transplantation (LT) in the US. We modeled the associations between air pollution (PM2.5) levels localized to the patient's ZIP code at the time of transplant and graft failure or death using Cox proportional-hazards models in pediatric LT recipients aged <19 years in the US from 2005-2015. In univariable analysis, high neighborhood PM2.5 was associated with a 56% increased hazard of graft failure/death (HR: 1.56; 95% CI: 1.32, 1.83; P < .001). In multivariable analysis, high neighborhood PM2.5 was associated with a 54% increased risk of graft failure/death (HR: 1.54; 95% CI: 1.29, 1.83; P < .001) after adjusting for race as a proxy for racism, insurance status, rurality, and neighborhood socioeconomic deprivation. Children living in high air pollution neighborhoods have an increased risk of graft failure and death posttransplant, even after controlling for sociodemographic variables. Our findings add further evidence that air pollution contributes to adverse health outcomes for children posttransplant and lay the groundwork for future studies to evaluate underlying mechanisms linking PM2.5 to adverse LT outcomes.


Assuntos
Poluição do Ar , Transplante de Fígado , Humanos , Criança , Transplante de Fígado/efeitos adversos , Poluição do Ar/efeitos adversos , Cobertura do Seguro , Sistema de Registros , Material Particulado/efeitos adversos , Exposição Ambiental
2.
Sex Transm Infect ; 100(3): 143-149, 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38355296

RESUMO

BACKGROUND: Intimate partner violence (IPV) against women can significantly impact their overall health. While numerous studies in developing nations highlight the association between IPV and sexually transmitted infections (STIs), the evidence available within the Indian context remains limited. Therefore, this study aims to fill this knowledge gap by investigating the relationship between exposure to different forms of IPV and the occurrence of STIs, using a quasi-experimental approach. METHODS: The study used a sample of 63 851 women aged 15-49 years from the latest National Family Health Survey-5. Propensity score matching (PSM) was employed to assess the 'treatment effect' from exposure to IPV (physical, emotional or sexual) in the past 12 months on STIs. RESULTS: About 12.2% of women (95% CI: 11.7% to 12.8%) reported symptoms of STIs at the time of the survey. Approximately 31.9% (95% CI: 31.2% to 32.7%) of women reported experiencing at least one form of IPV-either physical, emotional or sexual IPV. Of all forms of IPV, physical IPV was the most prevalent, reported by 28.6%, followed by emotional IPV (13.2%) and sexual IPV (5.7%). Women who experienced any form of IPV-whether physical, sexual or emotional-reported a higher prevalence of STIs (17.8%) as compared with those who did not experience any IPV (9.5%). The findings from the PSM analysis indicated that among the three forms of IPV, the impact of sexual IPV on STIs was the most pronounced. The average treatment effect on the treated from exposure to sexual IPV on STIs was 0.15 (95% CI 0.13 to 0.17). CONCLUSION: This study provides evidence of a significant association between IPV and STIs among women in India and underscores the urgent need for intensified efforts and interventions to address both IPV and STIs, to improve the overall health and well-being of women in India.


Assuntos
Violência por Parceiro Íntimo , Infecções Sexualmente Transmissíveis , Humanos , Feminino , Pontuação de Propensão , Fatores de Risco , Infecções Sexualmente Transmissíveis/epidemiologia , Índia/epidemiologia , Prevalência , Parceiros Sexuais/psicologia
3.
Palliat Med ; 38(7): 692-710, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38835188

RESUMO

BACKGROUND: People living with terminal illness are at higher risk of experiencing financial insecurity. The variance in definitions of financial insecurity, in addition to its impact on the well-being of this population has not yet been systematically analysed. AIM: To understand the definition, prevalence and impact of financial insecurity on the physical and psychological well-being of people living with terminal illness. DESIGN: A systematic review with a narrative synthesis (prospectively registered; CRD42023404516). DATA SOURCES: Medline, Embase, CINAHL, AMED, PsycINFO, ProQuest Central and Cochrane Central Register of Controlled Trials, from inception to May 2023. Included studies had to measure or describe the impact of financial insecurity on an aspect of participants' physical or mental well-being. Study quality was assessed using the Hawker tool. RESULTS: A total of 26 studies were included in the review. Financial insecurity was defined using many different definitions and terminology. Out of 4824 participants, 1126 (23%) reported experiencing high levels of financial insecurity. Nine studies reported 21 unique analyses across three domains of physical well-being. Out of those 21 analyses, 10 (48%) reported a negative result (an increase in financial insecurity was reported with a decrease in physical well-being). Twenty-one studies reported 51 unique analyses across nine domains of psychological well-being. Out of these analyses, 35 (69%) reported a negative result (an increase in financial insecurity was reported with a decrease in psychological well-being). CONCLUSIONS: People living with terminal illness require support with their financial situation to ensure their well-being is not negatively impacted by financial insecurity.


Assuntos
Doente Terminal , Humanos , Doente Terminal/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Estresse Financeiro/psicologia , Adulto , Qualidade de Vida/psicologia , Saúde Mental , Idoso de 80 Anos ou mais , Bem-Estar Psicológico
4.
BMC Health Serv Res ; 24(1): 172, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326871

RESUMO

BACKGROUND: Qualitative social research has made valuable contributions to understanding technology-based interventions in global health. However, we have little evidence of who is carrying out this research, where, how, for what purpose, or the overall scope of this body of work. To address these questions, we undertook a systematic evidence mapping of one area of technology-focused research in global health, related to the development, deployment and use of point-of-care tests (POCTs) for low-and middle-income countries (LMICs). METHODS: We conducted an exhaustive search to identify papers reporting on primary qualitative studies that explore the development, deployment, and use of POCTs in LMICs and screened results to identify studies meeting the inclusion criteria. Data were extracted from included studies and descriptive analyses were conducted. RESULTS: One hundred thirty-eight studies met our inclusion criteria, with numbers increasing year by year. Funding of studies was primarily credited to high income country (HIC)-based institutions (95%) and 64% of first authors were affiliated with HIC-based institutions. Study sites, in contrast, were concentrated in a small number of LMICs. Relatively few studies examined social phenomena related to POCTs that take place in HICs. Seventy-one percent of papers reported on studies conducted within the context of a trial or intervention. Eighty percent reported on studies considering POCTs for HIV and/or malaria. Studies overwhelmingly reported on POCT use (91%) within primary-level health facilities (60%) or in hospitals (30%) and explored the perspectives of the health workforce (70%). CONCLUSIONS: A reflexive approach to the role, status, and contribution of qualitative and social science research is crucial to identifying the contributions it can make to the production of global health knowledge and understanding the roles technology can play in achieving global health goals. The body of qualitative social research on POCTs for LMICs is highly concentrated in scope, overwhelmingly focuses on testing in the context of a narrow number of donor-supported initiatives and is driven by HIC resources and expertise. To optimise the full potential of qualitative social research requires the promotion of open and just research ecosystems that broaden the scope of inquiry beyond established public health paradigms and build social science capacity in LMICs.


Assuntos
Ecossistema , Saúde Global , Humanos , Renda , Testes Imediatos , Países em Desenvolvimento
5.
Med Teach ; 46(1): 126-131, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37542359

RESUMO

OBJECTIVE: This study investigated how students as stakeholders viewed behavioral and social science (BSS) content in a preclinical longitudinal course entitled "Medicine, Body, and Society" (MBS) at UT Health San Antonio Long School of Medicine (LSOM). We present students' perceptions of successes and challenges tied to "altruism" and other non-biomedical objectives outlined by this institution. METHODS: We conducted a qualitative thematic analysis of MBS course evaluation data. Two researchers independently performed initial coding followed by interrater reliability checks to revise codes and a final MAXQDA lexical search to refine three themes. RESULTS: Three major themes emerged: (1) Students shared pedagogical preferences strongly favoring stories. (2) Students detected deficits in the module content tied to identities. (3) Students labelled BSS content as "soft," "subjective," and "siloed" which confounded its role in the course. CONCLUSIONS: Advancing altruism aligned with BSS content in preclinical medical education remains a challenge. A closer review of student evaluations framed as learner-centeredness is key to a greater understanding and resolution of competency issues in preclinical curriculum and its impact on mastery in subsequent clinical education and practice.


Assuntos
Educação de Graduação em Medicina , Educação Médica , Estudantes de Medicina , Humanos , Altruísmo , Reprodutibilidade dos Testes , Currículo
6.
Int J Neurosci ; : 1-6, 2024 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-38709678

RESUMO

Cognitive and behavioral neuroscience is essential for understanding brain tumors and their effects. Researchers have realized that an important step is to start looking for cognitive impairment at the time of diagnosis to see what deficits the brain tumor has left the patient with. Then cognitive assessment should be made after the tumor has been removed to see how it changes. The aim of this study was to assess the current research on tumor diagnosis and prevention through a filter of emotion and cognition; and then look at what future steps need to be taken. This review reports what research has already been done and what research still needs to be accomplished, including addressing the need for more data on cognitive impairment while the brain tumor is active, in the literature.

7.
Rev Panam Salud Publica ; 48: e56, 2024.
Artigo em Espanhol | MEDLINE | ID: mdl-38933473

RESUMO

The development of public health in Latin America during the 20th century combined, early on, the social medicine framework on the social, political, and environmental origins of disease with the contributions of medical anthropological fieldwork. Despite the hegemony of the medical model, the surge of the preventive medicine framework further legitimized the involvement of social scientists in the study of the multicausality of disease. However, the limitations brought by the preventive medicine model's lack of historical and political contextualization gave way to the Latin American social medicine movement, which was grounded in historical materialism, and the development of both critical epidemiology and critical medical anthropology.


Desde o início, a evolução da saúde pública na América Latina ao longo do século XX combinou o marco teórico da medicina social sobre as origens sociais, políticas e ambientais das doenças com as contribuições derivadas do trabalho de campo da antropologia médica. Apesar da hegemonia do modelo médico, o surgimento do modelo de medicina preventiva legitimou ainda mais a participação dos cientistas sociais no estudo da multicausalidade das doenças. Entretanto, as limitações causadas pela falta de contextualização histórica e política do modelo de medicina preventiva abriram espaço para o movimento latino-americano de medicina social, fundamentado no materialismo histórico, e para o desenvolvimento da epidemiologia crítica e da antropologia médica crítica.

8.
Entropy (Basel) ; 26(5)2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38785599

RESUMO

In this work, satellite data from the Clouds and Earth's Radiant Energy System (CERES) and Moderate Resolution Imaging Spectroradiometer (MODIS) instruments are analyzed to determine how the global absorbed sunlight and global entropy production rates have changed from 2002 to 2023. The data is used to test hypotheses derived from the Maximum Power Principle (MPP) and Maximum Entropy Production Principle (MEP) about the evolution of Earth's surface and atmosphere. The results indicate that both the rate of absorbed sunlight and global entropy production have increased over the last 20 years, which is consistent with the predictions of both hypotheses. Given the acceptance of the MPP or MEP, some peripheral extensions and nuances are discussed.

9.
Br J Sociol ; 75(3): 322-346, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38549173

RESUMO

How do parenthood and publishing contribute to gender gaps in academic career advancement? While extensive research examines the causes of gender disparities in science, technology, engineering, and mathematics (STEM) careers, we know much less about the factors that constrain women's advancement in the social sciences. Combining detailed career- and administrative register data on 976 Danish social scientists in Business and Management, Economics, Political Science, Psychology, and Sociology (5703 person-years) that obtained a PhD degree between 2000 and 2015, we estimate gender differences in attainment of senior research positions and parse out how publication outputs, parenthood and parental leave contribute to these differences. Our approach is advantageous over previous longitudinal studies in that we track the careers and publication outputs of graduates from the outset of their PhD education and match this data with time-sensitive information on each individual's publication activities and family situation. In discrete time-event history models, we observe a ∼24 per cent female disadvantage in advancement likelihoods within the first 7 years after PhD graduation, with gender differences increasing over the observation period. A decomposition indicates that variations in publishing, parenthood and parental leave account for ∼ 40 per cent of the gender gap in career advancement, suggesting that other factors, including recruitment disparities, asymmetries in social capital and experiences of unequal treatment at work, may also constrain women's careers.


Assuntos
Mobilidade Ocupacional , Ciências Sociais , Humanos , Feminino , Masculino , Editoração , Dinamarca , Licença Parental , Fatores Sexuais , Adulto , Pais/psicologia , Sexismo , Estudos Longitudinais
10.
J Hist Behav Sci ; 60(4): e22321, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39056568

RESUMO

Between the years 1925 and 1934, the Social Science Research Council (SSRC) awarded 198 postdoctoral research fellowships to early-career social scientists, among which 29 were awarded to women. This article, which is based on the SSRC directory and Rockefeller institutions' records, examines the professional paths of these female fellows to shed light on the presence of women in the social sciences and to probe the peculiarities of their professional trajectories. The SSRC fellowships represented a significant professional prospect for brilliant young female graduates who were often denied similar opportunities in other fields. Nonetheless, they did not eradicate all gender discrimination that remained prevalent, not only in the vertical sense by preventing women from progressing in the academic hierarchy, but also in the horizontal sense by retaining them in designated spaces (specific disciplines or institutions) that were underrecognized. Ultimately, the analysis of women's professional paths underscores the importance of examining the private or intimate lives of scientists to gain a more in-depth understanding of the social structure of science and its impact on its protagonists.


Assuntos
Bolsas de Estudo , Sexismo , Ciências Sociais , Humanos , Ciências Sociais/história , Feminino , História do Século XX , Bolsas de Estudo/história , Sexismo/história , Mobilidade Ocupacional
11.
Crit Rev Food Sci Nutr ; 63(15): 2480-2493, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34494476

RESUMO

Scientific research generally follows two main methods: empirico-inductive (EI), gathering scattered, real-world qualitative/quantitative data to elaborate holistic theories, and the hypothetico-deductive (HD) approach, testing the validity of hypothesized theory in specific conditions, generally according to reductionist methodologies or designs, with the risk of over simplifying the initial complexity empirically perceived in its holistic view. However, in current food and nutrition research, new hypotheses are often elaborated from reductionist data obtained with the HD approach, and aggregated to form (ultra)reductionist theories, with no application of EI observations, limiting the applicability of these hypotheses in real life. This trend and the application of the EI method are illustrated as regards with the global health issue through the examples of food classifications/scoring, clinical studies, the definition of a sustainable diet, the "matrix effect"-related hypothesis, the concept of healthy core metabolism, and obesity prevention within the perspective of social sciences. To be efficient for producing food and nutritional data appropriable by the society, it finally appears that not only both approaches are necessary, starting with the EI method then the HD one, but also a back and forth between the two, this being not always realized, potentially leading to confusion and misunderstanding in society.


Assuntos
Dieta , Saúde Global , Pesquisa , Tecnologia de Alimentos , Alimentos
12.
Philos Trans A Math Phys Eng Sci ; 381(2252): 20220283, 2023 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-37334451

RESUMO

Energy has had a definitive impact on human life throughout history. Beginning with the harnessing of fire, which offered warmth, improved shelter and more food, humanity's standard of living has been defined by the power derived from fuels and food. Access to energy is the briefest way in which to summarize the history of the world. Direct and indirect causes of war have involved access to energy, and the results of conflicts have been determined by who controlled the energy resources. Therefore, the scientific literature reveals very close interactions between energy studies and social science studies. The Scopus database contains about 118 000 publications in the fields of social sciences and energy. The current study aims to exploit this resource to identify the interactions that exist between the fields so that future research can investigate these more deeply and thus develop solutions to the problems of the modern world. The present article will analyse these publications systematically according to author, country, institution and year, in addition to examining the changes in keywords that have occurred in these studies over the years. This article is part of the theme issue 'Thermodynamics 2.0: Bridging the natural and social sciences (Part 1)'.


Assuntos
Bibliometria , Publicações , Humanos , Fenômenos Físicos , Bases de Dados Factuais , Ciências Sociais
13.
Multivariate Behav Res ; 58(6): 1160-1164, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37038660

RESUMO

This article proposes the Shiny app 'CLC Estimator' -Congeneric Latent Construct Estimator- to address the problem of estimating latent unidimensional constructs via congeneric approaches. While congeneric approaches provide more rigorous results than suboptimal parallel-based scoring methods, most statistical packages do not provide easy access to congeneric approaches. To address this issue, the CLC Estimator allows social scientists to use congeneric approaches to estimate latent unidimensional constructs smoothly. The present app provides a novel solution to the challenge of limited access to congeneric estimation methods in survey research.


Assuntos
Projetos de Pesquisa , Método de Monte Carlo
14.
J Health Polit Policy Law ; 48(4): 463-484, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-36693182

RESUMO

Abortion is central to the American political landscape and a common pregnancy outcome, yet research on abortion has been siloed and marginalized in the social sciences. In an empirical analysis, the authors found only 22 articles published in this century in the top economics, political science, and sociology journals. This special issue aims to bring abortion research into a more generalist space, challenging what the authors term "the abortion research paradox," wherein abortion research is largely absent from prominent disciplinary social science journals but flourishes in interdisciplinary and specialized journals. After discussing the misconceptions that likely contribute to abortion research siloization and the implications of this siloization for abortion research as well as social science knowledge more generally, the authors introduce the articles in this special issue. Then, in a call for continued and expanded research on abortion, the introduction to this special issue closes by offering three guiding practices for abortion scholars-both those new to the topic and those deeply familiar with it-in the hopes of building an ever-richer body of literature on abortion politics, policy, and law. The need for such a robust literature is especially acute following the US Supreme Court's June 2022 overturning of the constitutional right to abortion.


Assuntos
Aborto Induzido , Aborto Legal , Feminino , Estados Unidos , Gravidez , Humanos , Política
15.
Health Info Libr J ; 40(4): 343-358, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37903740

RESUMO

BACKGROUND: The COVID-19 pandemic has triggered a significant increase in academic research in the realm of social sciences. As such, there is an increasing need for the scientific community to adopt effective and efficient methods to examine the potential role and contribution of social sciences in the fight against COVID-19. OBJECTIVES: This study aims to identify the key topics and explore publishing trends in social science research pertaining to COVID-19 via automated literature analysis. METHODS: The automated literature analysis employed utilizes keyword analysis and topic modelling technique, specifically Latent Dirichlet Allocation, to highlight the most relevant research terms, overarching research themes and research trends within the realm of social science research on COVID-19. RESULTS: The focus of research and topics were derived from 9733 full-text academic papers. The bulk of social science research on COVID-19 centres on the following themes: 'Clinical Treatment', 'Epidemic Crisis', 'Mental Influence', 'Impact on Students', 'Lockdown Influence' and 'Impact on Children'. CONCLUSION: This study adds to our understanding of key topics in social science research on COVID-19. The automated literature analysis presented is particularly useful for librarians and information specialists keen to explore the role and contributions of social science topics in the context of pandemics.


Assuntos
COVID-19 , Mídias Sociais , Humanos , Controle de Doenças Transmissíveis , Pandemias , SARS-CoV-2 , Ciências Sociais
16.
Z Gerontol Geriatr ; 56(1): 5-8, 2023 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-36459190

RESUMO

OBJECTIVE: Critical gerontology remained unheard of in German language research on ageing for a long time and has so far only hesitantly been taken up in the discourse. This article first traces the development of the approaches that today are assembled under the label of the "thought space" of critical gerontology. Subsequently, the concept of the critique of critical gerontology is examined more closely in order to clarify the question of what is critical about critical gerontology and which social theoretical considerations underlie the respective directions. RESULTS: It is argued that despite their shared orientation towards the emancipation and autonomy of older and old people, the individual approaches differ considerably in their understanding of critique and their conception of the status of scientific theories. Thus, it remains diffuse what the specific perspective of critical gerontology is in order to distinguish it from other social gerontological approaches. CONCLUSION: A total of four criteria are formulated that critical gerontology should fulfil.


Assuntos
Geriatria , Humanos , Envelhecimento , Idioma
17.
Am J Transplant ; 22(3): 937-946, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34837457

RESUMO

Adolescent transplant recipients may encounter a range of potentially traumatic events (PTEs) pre- and posttransplant, yet little is known about the relationship between posttraumatic stress symptoms (PTSS) and medication adherence in this population. In the present study, adolescent recipients and caregivers completed psychosocial questionnaires at enrollment. Outpatient tacrolimus trough level data were collected over 1 year to calculate the Medication Level Variability Index (MLVI), a measure of medication adherence. Nonadherence (MLVI ≥2) was identified in 34.8% of patients, and most (80.7%) reported ≥1 PTE exposure. Levels of PTSS indicating likely posttraumatic stress disorder (PTSD) were endorsed by 9.2% of patients and 43.7% of caregivers. PTSS and MLVI were significantly correlated in the liver subgroup (r = .30, p = .04). Hierarchical multivariable linear regression analyses revealed overall patient PTSS were significantly associated with QoL (p < .001). PTEs are common in adolescent recipients; a minority may meet criteria for PTSD. PTSS screening to identify nonadherence risk requires further investigation and addressing PTSS may improve QoL. Caregivers appear at greater risk for PTSD and may require their own supports. The study was approved by each participating center's Institutional Review Board.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Adolescente , Criança , Humanos , Adesão à Medicação , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Inquéritos e Questionários , Transplantados/psicologia
18.
Am J Transplant ; 22(12): 2781-2785, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35841261

RESUMO

Recent health system initiatives and government legislation have enhanced electronic health information (EHI) sharing in the healthcare technology environment. These measures are favorably viewed by most patients and clinicians. The 21st Century Cures Act, whose final rules went into effect in the United States in 2021, prohibits information blocking practices except in the case of potential harm. The definition of such harm, particularly regarding psychosocial EHI, is unclear and little guidance has been published. No articles address the matter in solid organ transplantation (SOT) despite the crucial role of psychosocial data in organ allocation. This article describes the implications of patient and family access to psychosocial EHI in SOT, discusses potential mechanisms of harm, and suggests practical communication strategies relevant to clinicians of all disciplines to promote high quality care and favorable interactions with patients and families.


Assuntos
Transplante de Órgãos , Humanos , Estados Unidos , Documentação , Eletrônica
19.
Am J Transplant ; 22(2): 474-488, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34559944

RESUMO

Hispanic patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites (NHWs). The Northwestern Medicine Hispanic Kidney Transplant Program (HKTP), designed to increase Hispanic LDKTs, was evaluated as a nonrandomized, implementation-effectiveness hybrid trial of patients initiating transplant evaluation at two intervention and two similar control sites. Using a mixed method, observational design, we evaluated the fidelity of the HKTP implementation at the two intervention sites. We tested the impact of the HKTP intervention by evaluating the likelihood of receiving LDKT comparing pre-intervention (January 2011-December 2016) and postintervention (January 2017-March 2020), across ethnicity and centers. The HKTP study included 2063 recipients. Intervention Site A exhibited greater implementation fidelity than intervention Site B. For Hispanic recipients at Site A, the likelihood of receiving LDKTs was significantly higher at postintervention compared with pre-intervention (odds ratio [OR] = 3.17 95% confidence interval [1.04, 9.63]), but not at the paired control Site C (OR = 1.02 [0.61, 1.71]). For Hispanic recipients at Site B, the likelihood of receiving an LDKT did not differ between pre- and postintervention (OR = 0.88 [0.40, 1.94]). The LDKT rate was significantly lower for Hispanics at paired control Site D (OR = 0.45 [0.28, 0.90]). The intervention significantly improved LDKT rates for Hispanic patients at the intervention site that implemented the intervention with greater fidelity. Registration: ClinicalTrials.gov registered (retrospectively) on September 7, 2017 (NCT03276390).


Assuntos
Transplante de Rim , Doadores Vivos , Assistência à Saúde Culturalmente Competente , Humanos , Rim , Estudos Retrospectivos
20.
Am J Transplant ; 22(10): 2293-2301, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35583111

RESUMO

Health equity research in transplantation has largely relied on national data sources, yet the availability of social determinants of health (SDOH) data varies widely among these sources. We sought to characterize the extent to which national data sources contain SDOH data applicable to end-stage organ disease (ESOD) and transplant patients. We reviewed 10 active national data sources based in the United States. For each data source, we examined patient inclusion criteria and explored strengths and limitations regarding SDOH data, using the National Institutes of Health PhenX toolkit of SDOH as a data collection instrument. Of the 28 SDOH variables reviewed, eight-core demographic variables were included in ≥80% of the data sources, and seven variables that described elements of social status ranged between 30 and 60% inclusion. Variables regarding identity, healthcare access, and social need were poorly represented (≤20%) across the data sources, and five of these variables were included in none of the data sources. The results of our review highlight the need for improved SDOH data collection systems in ESOD and transplant patients via: enhanced inter-registry collaboration, incorporation of standardized SDOH variables into existing data sources, and transplant center and consortium-based investigation and innovation.


Assuntos
Equidade em Saúde , Transplante de Órgãos , Coleta de Dados , Humanos , Armazenamento e Recuperação da Informação , Determinantes Sociais da Saúde , Estados Unidos/epidemiologia
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