Implementation of the National Partnership for Action to End Health Disparities: A Three-Year Retrospective

In April 2011, the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH) launched the National Partnership for Action to End Health Disparities (NPA) to increase the effectiveness of efforts to eliminate health disparities by coordinating partners, leaders, and stakeholders committed to action. At its core, the NPA is an experiment in collaboration that relies heavily on those on the front line who are actively engaged in minority health work at multiple levels. It gives them the responsibility of identifying and helping to define core actions, new approaches, and new partnerships that ultimately will help to close the health gap in the United States. This paper provides a retrospective examination of the NPA’s creation and development of health equity coalitions at the federal and regional levels and its establishment of strategic national partnerships to move a health equity agenda forward. The article explores how the development of this infrastructure has, in turn, led to the implementation of actions and activities to address health disparities. The article concludes with a reflection on emerging opportunities for improvement and ways forward to continue the initiative’s evaluation and secure its sustainability

Healthcare Professionals’ Perspectives of Barriers to Cancer Care Delivery for American Indian, Rural, and Frontier Populations

Objective: This descriptive qualitative study sought to understand the barriers affecting cancer care delivery from the perspective of healthcare professionals (HCPs) serving American Indian (AI), rural, and frontier populations. Methods: One-on-one, semi-structured interviews with multidisciplinary HCPs (N = 18) who provide cancer care to AI, rural, and frontier populations were conducted between January and April 2022. Interviews were conducted via Zoom. Data were analyzed following thematic content analysis methodologies. Results: Thematic content analysis revealed three major themes: (a) Access, (b) Time, and (c) Isolation. The themes represent the HCP perspectives of the needs and barriers of persons with cancer to whom they provide cancer care. Furthermore, these themes also reflect the barriers HCPs experience while providing cancer care to AI, rural and frontier populations. Conclusions: This study provides preliminary evidence for the need and strong multidisciplinary support for an early palliative care intervention in rural and frontier South Dakota (SD). This intervention could support the needs of persons with advanced cancer as well as the HCPs delivering cancer care in rural settings. Innovation: This study is the initial step to develop the first culturally responsive, nurse-led, early palliative care intervention for AI, rural, and frontier persons with advanced cancer in SD

Patient Compliance with Colorectal Cancer Screening: A Scoping Review

Purpose/Background Colorectal cancer (CRC) is a leading cause of cancer deaths for women and men. Routine screening based on current national guidelines can decrease morbidity and mortality. Unfortunately, patient compliance with CRC screening remains low. This scoping review will evaluate the literature and examine the association between colorectal cancer screening modality and patient compliance. Methods Individual searches within PubMed, EBSCO, and Medline were completed using MeSh with the following key words: colorectal cancer screening, patient compliance, stool-based screening, direct visualization, and others. A literature review was completed for 10 critically appraised articles published between 2010 and 2020. The association of the modality of CRC screening, patient compliance, and patient education was assessed and compared. A summary evaluation table was composed to determine the associations between CRC screening and patient compliance. Results The articles included consisted of four systematic reviews/meta-analysis, three randomized controlled trials, one controlled trial without randomization, and two cohort/case-control studies. Of the study sample (N=10), all but one demonstrated statistically significant findings concerning patient education, CRC screening, and compliance. Noninvasive stool-based studies have a higher patient compliance rate than direct visualization tests. Direct visualization tests offer same-session detection and biopsy with polyp removal leading to decreased mortality. Implications for Nursing Practice Results provided in this scoping review highlight the importance of colorectal cancer screening in decreasing mortality. Patient compliance can be improved with comprehensive education, discussing the risks and benefits of screenings, and evaluating individual health beliefs or fears. Patients still hesitant with direct visualization tests should begin with noninvasive studies. All positive screenings from stool-based screenings require follow-up with a colonoscopy

Potentiality in Biology

We take the potentialities that are studied in the biological sciences (e.g., totipotency) to be an important subtype of biological dispositions. The goal of this paper is twofold: first, we want to provide a detailed understanding of what biological dispositions are. We claim that two features are essential for dispositions in biology: the importance of the manifestation process and the diversity of conditions that need to be satisfied for the disposition to be manifest. Second, we demonstrate that the concept of a disposition (or potentiality) is a very useful tool for the analysis of the explanatory practice in the biological sciences. On the one hand it allows an in-depth analysis of the nature and diversity of the conditions under which biological systems display specific behaviors. On the other hand the concept of a disposition may serve a unificatory role in the philosophy of the natural sciences since it captures not only the explanatory practice of biology, but of all natural sciences. Towards the end we will briefly come back to the notion of a potentiality in biology

Mechanisms, Then and Now: From Metaphysics to Practice

For many old and new mechanists, Mechanism is both a metaphysical position and a thesis about scientific methodology. In this paper we discuss the relation between the metaphysics of mechanisms and the role of mechanical explanation in the practice of science, by presenting and comparing the key tenets of Old and New Mechanism. First, by focusing on the case of gravity, we show how the metaphysics of Old Mechanism constrained scientific explanation, and discuss Newton’s critique of Old Mechanism. Second, we examine the current mechanistic metaphysics, arguing that it is not warranted by the use of the concept of mechanism in scientific practice, and motivate a thin conception of mechanism (the truly minimal view), according to which mechanisms are causal pathways for a certain effect or phenomenon. Finally, we draw analogies between Newton’s critique of Old Mechanism and our thesis that the metaphysical commitments of New Mechanism are not necessary in order to illuminate scientific practice

Delay aversion but preference for large and rare rewards in two choice tasks: implications for the measurement of self-control parameters

BACKGROUND: Impulsivity is defined as intolerance/aversion to waiting for reward. In intolerance-to-delay (ID) protocols, animals must choose between small/soon (SS) versus large/late (LL) rewards. In the probabilistic discount (PD) protocols, animals are faced with choice between small/sure (SS) versus large/luck-linked (LLL) rewards. It has been suggested that PD protocols also measure impulsivity, however, a clear dissociation has been reported between delay and probability discounting. RESULTS: Wistar adolescent rats (30- to 46-day-old) were tested using either protocol in drug-free state. In the ID protocol, animals showed a marked shift from LL to SS reward when delay increased, and this despite adverse consequences on the total amount of food obtained. In the PD protocol, animals developed a stable preference for LLL reward, and maintained it even when SS and LLL options were predicted and demonstrated to become indifferent. We demonstrate a clear dissociation between these two protocols. In the ID task, the aversion to delay was anti-economical and reflected impulsivity. In the PD task, preference for large reward was maintained despite its uncertain delivery, suggesting a strong attraction for unitary rewards of great magnitude. CONCLUSION: Uncertain delivery generated no aversion, when compared to delays producing an equivalent level of large-reward rarefaction. The PD task is suggested not to reflect impulsive behavior, and to generate patterns of choice that rather resemble the features of gambling. In summary, present data do indicate the need to interpret choice behavior in ID and PD protocols differently

Drift as a Force of Evolution: A Manipulationist Account

Can evolutionary theory be properly characterised as a “theory of forces”, like Newtonian mechanics? One common criticism to this claim concerns the possibility to conceive genetic drift as a causal process endowed by a specific magnitude and direction. In this article, we aim to offer an original response to this criticism by pointing out a connection between the notion of force and the notion of explanatory depth, as depicted in Hitchcock and Woodward’s manipulationist account of causal explanation. In a nutshell, our argument is that, since force-explanations can be consistently reframed as deep explanations and vice versa, and the notion of drift can be characterised in manipulationist terms as constitutively intervening in evolutionary deep explanations, then drift-explanations can be consistently reframed as force-explanations, and drift can be properly considered as a force of evolution. Insofar as similar considerations may be extended also to other evolutionary factors – chiefly selection –, our analysis offers an important support to the claim that evolutionary theory is a theory of forces.info:eu-repo/semantics/publishedVersio

Speckle-free laser imaging

Many imaging applications require increasingly bright illumination sources, motivating the replacement of conventional thermal light sources with light emitting diodes (LEDs), superluminescent diodes (SLDs) and lasers. Despite their brightness, lasers and SLDs are poorly suited for full-field imaging applications because their high spatial coherence leads to coherent artifacts known as speckle that corrupt image formation. We recently demonstrated that random lasers can be engineered to provide low spatial coherence. Here, we exploit the low spatial coherence of specifically-designed random lasers to perform speckle-free full-field imaging in the setting of significant optical scattering. We quantitatively demonstrate that images generated with random laser illumination exhibit higher resolution than images generated with spatially coherent illumination. By providing intense laser illumination without the drawback of coherent artifacts, random lasers are well suited for a host of full-field imaging applications from full-field microscopy to digital light projector systems.Comment: 5 pages, 4 figure

Selection in a Complex World: Deriving Causality from Stable Equilibrium

It is an ongoing controversy whether natural selection is a cause of population change, or a mere statistical description of how individual births and deaths accumulate. In this paper I restate the problem in terms of the reference class problem, and propose how the structure of stable equilibrium can provide a solution in continuity with biological practice. Insofar natural selection can be understood as a tendency towards equilibrium, key statisticalist criticisms are avoided. Further, in a modification of the Newtonian-force analogy, it can be suggested that a better metaphor for natural selection is that of an emergent force, similar in nature to entropic forces: with magnitude and direction, but lacking a spatiotemporal origin or point of application.status: publishe