Gender and ethnicity bias in medicine: a text analysis of 1.8 million critical care records

11 pagesGender and ethnicity biases are pervasive across many societal domains including politics, employment, and medicine. Such biases will facilitate inequalities until they are revealed and mitigated at scale. To this end, over 1.8 million caregiver notes (502 millionwords) from a large US hospitalwere evaluated with natural language processing techniques in search of gender and ethnicity bias indicators. Consistent with nonlinguistic evidence of bias in medicine, physicians focusedmore on the emotions ofwomen compared tomen and focused more on the scientific and bodily diagnoses of men compared to women. Content patterns were relatively consistent across genders. Physicians also attended to fewer emotions for Black/African and Asian patients compared toWhite patients, and physicians demonstrated the greatest need to work through diagnoses for Black/African women compared to other patients. Content disparities were clearer across ethnicities, as physicians focused less on the pain of Black/African and Asian patients compared toWhite patients in their critical care notes. This research provides evidence of gender and ethnicity biases in medicine as communicated by physicians in the field and requires the critical examination of institutions that perpetuate bias in social systems

Chapter 08: Conclusions and Recommendations

Here we review brief summaries by chapter and then derive some integrated conclusions across chapters. Recommendations are presented with respect to further research, outreach and policy consideration. Because several years have passed between the end of our field work and publication of this synthesis volume, we end with an epilogue that highlights changes and key events that happened at San José Llanga (SJL) and with collaborating institutions in Bolivia between 1996-9.https://digitalcommons.usu.edu/sustaining_agropastoralism/1007/thumbnail.jp

Virtually Real, But Not Quite There: Social and Economic Barriers to Meeting Virtual Reality’s True Potential for Mental Health

7 pagesStrategies to mitigate the spread of COVID-19, namely quarantine and social distancing protocols, have exposed a troubling paradox: mandated isolation meant to preserve well-being has inadvertently contributed to its decline. Prolonged isolation has been associated with widespread loneliness and diminished mental health, with effects compounded by limited face-to-face access to clinical and social support systems. While remote communication technologies (e.g., video chat) can connect individuals with healthcare providers and social networks, remote technologies might have limited effectiveness in clinical and social contexts. In this review, we articulate the promise of Virtual Reality as a conduit to clinical resources and social connection. Furthermore, we outline various social and economic factors limiting the virtual reality industry’s ability to maximize its potential to address mental health issues brought upon by the pandemic. These barriers are delineated across five dimensions: sociocultural, content, affordability, supply chain, and equitable design. After examining potential short- and long-term solutions to these hurdles, we outline potential avenues for applied and theoretical research seeking to validate these solutions. Through this evaluation we seek to (a) emphasize virtual reality’s capacity to improve mental health by connecting communities to clinical and social support systems, (b) identify socioeconomic barriers preventing users from accessing these systems through virtual reality, and (c) discuss solutions that ensure these systems can be equitably accessed via changes to existing and future virtual reality infrastructures

Contextual considerations for deception production and detection in forensic interviews

7 pagesMost deception scholars agree that deception production and deception detection effects often display mixed results across settings. For example, some liars use more emotion than truth-tellers when discussing fake opinions on abortion, but not when communicating fake distress. Similarly, verbal and nonverbal cues are often inconsistent predictors to assist in deception detection, leading to mixed accuracies and detection rates. Why are lie production and detection effects typically inconsistent? In this piece, we argue that aspects of the context are often unconsidered in how lies are produced and detected. Greater theory-building related to contextual constraints of deception are therefore required. We reintroduce and extend the Contextual Organization of Language and Deception (COLD) model, a framework that outlines how psychological dynamics, pragmatic goals, and genre conventions are aspects of the context that moderate the relationship between deception and communication behavior such as language. We extend this foundation by proposing three additional aspects of the context — individual differences, situational opportunities for deception, and interpersonal characteristics — for the COLD model that can specifically inform and potentially improve forensic interviewing. We conclude with a forward-looking perspective for deception researchers and practitioners related to the need for more theoretical explication of deception and its detection related to the context

Incorporating Breast Cancer Recurrence Events Into Population-Based Cancer Registries Using Medical Claims: Cohort Study.

BACKGROUND: There is a need for automated approaches to incorporate information on cancer recurrence events into population-based cancer registries. OBJECTIVE: The aim of this study is to determine the accuracy of a novel data mining algorithm to extract information from linked registry and medical claims data on the occurrence and timing of second breast cancer events (SBCE). METHODS: We used supervised data from 3092 stage I and II breast cancer cases (with 394 recurrences), diagnosed between 1993 and 2006 inclusive, of patients at Kaiser Permanente Washington and cases in the Puget Sound Cancer Surveillance System. Our goal was to classify each month after primary treatment as pre- versus post-SBCE. The prediction feature set for a given month consisted of registry variables on disease and patient characteristics related to the primary breast cancer event, as well as features based on monthly counts of diagnosis and procedure codes for the current, prior, and future months. A month was classified as post-SBCE if the predicted probability exceeded a probability threshold (PT); the predicted time of the SBCE was taken to be the month of maximum increase in the predicted probability between adjacent months. RESULTS: The Kaplan-Meier net probability of SBCE was 0.25 at 14 years. The month-level receiver operating characteristic curve on test data (20% of the data set) had an area under the curve of 0.986. The person-level predictions (at a monthly PT of 0.5) had a sensitivity of 0.89, a specificity of 0.98, a positive predictive value of 0.85, and a negative predictive value of 0.98. The corresponding median difference between the observed and predicted months of recurrence was 0 and the mean difference was 0.04 months. CONCLUSIONS: Data mining of medical claims holds promise for the streamlining of cancer registry operations to feasibly collect information about second breast cancer events

Virological and Immunological Effects of Combination Antiretroviral Therapy with Zidovudine, Lamivudine, and Indinavir during Primary Human Immunodeficiency Virus Type 1 Infection

Forty-seven patients presenting with primary human immunodeficiency virus (HIV) infection were treated with zidovudine 200 mg 3 times a day, lamivudine 150 mg 2 times a day, and indinavir 800 mg 3 times a day for 1 year. From a mean pretreatment viral RNA level of 4.93 log10 copies/mL, the proportions of patients having <500 copies/mL at 24 and 52 weeks were 92.0% and 89.2%, respectively. For the 35 patients with data available at 24 and 52 weeks, the corresponding proportions for the <50 copies/mL analysis were 86.6% and 79.3%, respectively. The change in virus load was −2.19 and −2.41 log10 copies/mL at weeks 8 and 52, respectively. CD4 cell counts increased, from a mean of 546 cells/mm3, by 142 cells/mm3 at week 24 and by 210 cells/mm3 at week 52. Three patients discontinued the study because of drug-related toxicity. Six (12.8%) patients had adverse experiences associated with nephrolithiasis. Combination therapy with zidovudine, lamivudine, and indinavir during primary HIV infection results in a profound and sustained reduction in virus load with concurrent recovery of the CD4 cell populatio

Authentic First Impressions Relate to Interpersonal, Social, and Entrepreneurial Success

This paper examines how verbal authenticity influences person perception. Our work combines human judgments and natural language processing to suggest verbal authenticity is a positive predictor of interpersonal interest (Study 1: 294 dyadic conversations), engagement with speeches (Study 2: 2,655 TED talks), entrepreneurial success (Study 3: 478 Shark Tank pitches), and social media engagements (Studies 4a-c; N = 387,039 Tweets). We find that communicating authenticity is associated with increased interest in and perceived connection to another person, more comments and views for TED talks, receiving a financial investment from investors, and more social media likes and retweets. Our work is among the first to evaluate how authenticity relates to person perception and manifests naturally using verbal data

Increased Turnover of T Lymphocytes in HIV-1 Infection and Its Reduction by Antiretroviral Therapy

The mechanism of CD4+ T cell depletion in human immunodeficiency virus (HIV)-1 infection remains controversial. Using deuterated glucose to label the DNA of proliferating cells in vivo, we studied T cell dynamics in four normal subjects and seven HIV-1–infected patients naive to antiretroviral drugs. The results were analyzed using a newly developed mathematical model to determine fractional rates of lymphocyte proliferation and death. In CD4+ T cells, mean proliferation and death rates were elevated by 6.3- and 2.9-fold, respectively, in infected patients compared with normal controls. In CD8+ T cells, the mean proliferation rate was 7.7-fold higher in HIV-1 infection, but the mean death rate was not significantly increased. Five of the infected patients underwent subsequent deuterated glucose labeling studies after initiating antiretroviral therapy. The lymphocyte proliferation and death rates in both CD4+ and CD8+ cell populations were substantially reduced by 5–11 weeks and nearly normal by one year. Taken together, these new findings strongly indicate that CD4+ lymphocyte depletion seen in AIDS is primarily a consequence of increased cellular destruction, not decreased cellular production

Immersive Virtual Reality Field Trips Facilitate Learning About Climate Change

Across four studies, two controlled lab experiments and two field studies, we tested the efficacy of immersive Virtual Reality (VR) as an education medium for teaching the consequences of climate change, particularly ocean acidification. Over 270 participants from four different learning settings experienced an immersive underwater world designed to show the process and effects of rising sea water acidity. In all of our investigations, after experiencing immersive VR people demonstrated knowledge gains or inquisitiveness about climate science and in some cases, displayed more positive attitudes toward the environment after comparing pre- and post-test assessments. The analyses also revealed a potential post-hoc mechanism for the learning effects, as the more that people explored the spatial learning environment, the more they demonstrated a change in knowledge about ocean acidification. This work is unique by showing distinct learning gains or an interest in learning across a variety of participants (high school, college students, adults), measures (learning gain scores, tracking data about movement in the virtual world, qualitative responses from classroom teachers), and content (multiple versions varying in length and content about climate change were tested). Our findings explicate the opportunity to use immersive VR for environmental education and to drive information-seeking about important social issues such as climate change