1,198 research outputs found

    A student\u27s lesson in healthcare disparities

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    This narrative was born out of a desire to examine the effects of healthcare disparities among minority populations. As a medical student, I had the opportunity to spend a 4-week rotation working with physicians specializing in palliative care during what is arguably the most challenging public health crisis in over a century. This provided a unique perspective that allowed the observation of the intersection of healthcare systems with underserved and vulnerable minority populations, and palliative medicine. It also allowed us to observe the negative consequences it has had, particularly during a hard-hitting global pandemic. The paper gives a brief introduction to the problem of healthcare disparities as described by the WHO and CDC. We discuss some of the statistical data that show how certain demographics like workers in service industries, or meat-packing facilities are more likely to contract the COVID-19 virus, and how these same populations are disproportionately affected by the pandemic due to their limited access to healthcare systems. We then discuss the case of a COVID-19 patient that was treated by a multidisciplinary team during this period. This patient, like many others, was an immigrant with limited proficiency in the English language, as well as a limited medical education. We provide details about his medical course during his admission, and we try to highlight some of the pitfalls in the healthcare system as it relates to this patient’s prognosis and healthcare outcome. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

    The Framing Effects of Professionalism: Is There a Lawyer Cast of Mind? Lessons from Compliance Programs

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    Professionals working inside companies may bring with them frames of mind set by their professional experience and socialization. Lawyers, in particular, are said to think like a lawyer -to have a lawyer cast of mind. In seeking power within a company and in exercising the power that they obtain, professionals may draw on their professional background to frame, name, diagnose, and prescribe a remedy for the company\u27s problems. In making decisions about their compliance with the law, companies are constrained not only by their environment, but also by their agents\u27 understanding of whose (or what) interests the company should serve. In particular, compliance managers\u27 understandings will frame and influence their companies\u27 calculations of the value, benefits, and costs of compliance activities. The profession of the compliance manager then may influence how the company complies with the law. This Article uses data from a survey of 999 large Australian businesses to examine the professional background of the person in charge of compliance and (1) how they analyze the costs, benefits and risks of non-compliance; and (2) their company\u27s structures and practices of compliance. Contrary to our hypotheses, we find that the professional background of the individual responsible for compliance has little impact on a company\u27s compliance management structures and practices or assessment of stakeholders. The exceptions are that having a lawyer in charge of compliance is associated with the company\u27s perception of heightened legal risk; and where the person in charge of compliance is a lawyer, the company compliance efforts will be marked by manuals and training programs, but not more fulsome compliance structures, which are present when a compliance specialist leads the department. Unfortunately, our data also reveals that these compliance structures are generally merely formal-and likely largely symbolic

    The Framing Effects of Professionalism: Is There a Lawyer Cast of Mind? Lessons from Compliance Programs

    Get PDF
    Professionals working inside companies may bring with them frames of mind set by their professional experience and socialization. Lawyers, in particular, are said to think like a lawyer -to have a lawyer cast of mind. In seeking power within a company and in exercising the power that they obtain, professionals may draw on their professional background to frame, name, diagnose, and prescribe a remedy for the company\u27s problems. In making decisions about their compliance with the law, companies are constrained not only by their environment, but also by their agents\u27 understanding of whose (or what) interests the company should serve. In particular, compliance managers\u27 understandings will frame and influence their companies\u27 calculations of the value, benefits, and costs of compliance activities. The profession of the compliance manager then may influence how the company complies with the law. This Article uses data from a survey of 999 large Australian businesses to examine the professional background of the person in charge of compliance and (1) how they analyze the costs, benefits and risks of non-compliance; and (2) their company\u27s structures and practices of compliance. Contrary to our hypotheses, we find that the professional background of the individual responsible for compliance has little impact on a company\u27s compliance management structures and practices or assessment of stakeholders. The exceptions are that having a lawyer in charge of compliance is associated with the company\u27s perception of heightened legal risk; and where the person in charge of compliance is a lawyer, the company compliance efforts will be marked by manuals and training programs, but not more fulsome compliance structures, which are present when a compliance specialist leads the department. Unfortunately, our data also reveals that these compliance structures are generally merely formal-and likely largely symbolic

    DNA methylation age is accelerated in alcohol dependence.

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    Alcohol dependence (ALC) is a chronic, relapsing disorder that increases the burden of chronic disease and significantly contributes to numerous premature deaths each year. Previous research suggests that chronic, heavy alcohol consumption is associated with differential DNA methylation patterns. In addition, DNA methylation levels at certain CpG sites have been correlated with age. We used an epigenetic clock to investigate the potential role of excessive alcohol consumption in epigenetic aging. We explored this question in five independent cohorts, including DNA methylation data derived from datasets from blood (n = 129, n = 329), liver (n = 92, n = 49), and postmortem prefrontal cortex (n = 46). One blood dataset and one liver tissue dataset of individuals with ALC exhibited positive age acceleration (p < 0.0001 and p = 0.0069, respectively), whereas the other blood and liver tissue datasets both exhibited trends of positive age acceleration that were not significant (p = 0.83 and p = 0.57, respectively). Prefrontal cortex tissue exhibited a trend of negative age acceleration (p = 0.19). These results suggest that excessive alcohol consumption may be associated with epigenetic aging in a tissue-specific manner and warrants further investigation using multiple tissue samples from the same individuals

    Interleukin-6, age, and corpus callosum integrity.

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    The contribution of inflammation to deleterious aging outcomes is increasingly recognized; however, little is known about the complex relationship between interleukin-6 (IL-6) and brain structure, or how this association might change with increasing age. We examined the association between IL-6, white matter integrity, and cognition in 151 community dwelling older adults, and tested whether age moderated these associations. Blood levels of IL-6 and vascular risk (e.g., homocysteine), as well as health history information, were collected. Processing speed assessments were administered to assess cognitive functioning, and we employed tract-based spatial statistics to examine whole brain white matter and regions of interest. Given the association between inflammation, vascular risk, and corpus callosum (CC) integrity, fractional anisotropy (FA) of the genu, body, and splenium represented our primary dependent variables. Whole brain analysis revealed an inverse association between IL-6 and CC fractional anisotropy. Subsequent ROI linear regression and ridge regression analyses indicated that the magnitude of this effect increased with age; thus, older individuals with higher IL-6 levels displayed lower white matter integrity. Finally, higher IL-6 levels were related to worse processing speed; this association was moderated by age, and was not fully accounted for by CC volume. This study highlights that at older ages, the association between higher IL-6 levels and lower white matter integrity is more pronounced; furthermore, it underscores the important, albeit burgeoning role of inflammatory processes in cognitive aging trajectories

    A stem cell strategy identifies glycophorin C as a major erythrocyte receptor for the rodent malaria parasite Plasmodium berghei

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    The clinical complications of malaria are caused by the parasite expansion in the blood. Invasion of erythrocytes is a complex process that depends on multiple receptor-ligand interactions. Identification of host receptors is paramount for fighting the disease as it could reveal new intervention targets, but the enucleated nature of erythrocytes makes genetic approaches impossible and many receptors remain unknown. Host-parasite interactions evolve rapidly and are therefore likely to be species-specific. As a results, understanding of invasion receptors outside the major human pathogen Plasmodium falciparum is very limited. Here we use mouse embryonic stem cells (mESCs) that can be genetically engineered and differentiated into erythrocytes to identify receptors for the rodent malaria parasite Plasmodium berghei. Two proteins previously implicated in human malaria infection: glycophorin C (GYPC) and Band-3 (Slc4a1) were deleted in mESCs to generate stable cell lines, which were differentiated towards erythropoiesis. In vitro infection assays revealed that while deletion of Band-3 has no effect, absence of GYPC results in a dramatic decrease in invasion, demonstrating the crucial role of this protein for P. berghei infection. This stem cell approach offers the possibility of targeting genes that may be essential and therefore difficult to disrupt in whole organisms and has the potential to be applied to a variety of parasites in diverse host cell types

    The future of human nature: a symposium on the promises and challenges of the revolutions in genomics and computer science, April 10, 11, and 12, 2003

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    This repository item contains a single issue of the Pardee Conference Series, a publication series that began publishing in 2006 by the Boston University Frederick S. Pardee Center for the Study of the Longer-Range Future. This was the Center's Symposium on the Promises and Challenges of the Revolutions in Genomics and Computer Science took place during April 10, 11, and 12, 2003. Co-organized by Charles DeLisi and Kenneth Lewes; sponsored by Boston University, the Frederick S. Pardee Center for the Study of the Longer-Range Future.This conference focused on scientific and technological advances in genetics, computer science, and their convergence during the next 35 to 250 years. In particular, it focused on directed evolution, the futures it allows, the shape of society in those futures, and the robustness of human nature against technological change at the level of individuals, groups, and societies. It is taken as a premise that biotechnology and computer science will mature and will reinforce one another. During the period of interest, human cloning, germ-line genetic engineering, and an array of reproductive technologies will become feasible and safe. Early in this period, we can reasonably expect the processing power of a laptop computer to exceed the collective processing power of every human brain on the planet; later in the period human/machine interfaces will begin to emerge. Whether such technologies will take hold is not known. But if they do, human evolution is likely to proceed at a greatly accelerated rate; human nature as we know it may change markedly, if it does not disappear altogether, and new intelligent species may well be created

    The future of human nature: a symposium on the promises and challenges of the revolutions in genomics and computer science, April 10, 11, and 12, 2003

    Full text link
    This repository item contains a single issue of the Pardee Conference Series, a publication series that began publishing in 2006 by the Boston University Frederick S. Pardee Center for the Study of the Longer-Range Future. This was the Center's Symposium on the Promises and Challenges of the Revolutions in Genomics and Computer Science took place during April 10, 11, and 12, 2003. Co-organized by Charles DeLisi and Kenneth Lewes; sponsored by Boston University, the Frederick S. Pardee Center for the Study of the Longer-Range Future.This conference focused on scientific and technological advances in genetics, computer science, and their convergence during the next 35 to 250 years. In particular, it focused on directed evolution, the futures it allows, the shape of society in those futures, and the robustness of human nature against technological change at the level of individuals, groups, and societies. It is taken as a premise that biotechnology and computer science will mature and will reinforce one another. During the period of interest, human cloning, germ-line genetic engineering, and an array of reproductive technologies will become feasible and safe. Early in this period, we can reasonably expect the processing power of a laptop computer to exceed the collective processing power of every human brain on the planet; later in the period human/machine interfaces will begin to emerge. Whether such technologies will take hold is not known. But if they do, human evolution is likely to proceed at a greatly accelerated rate; human nature as we know it may change markedly, if it does not disappear altogether, and new intelligent species may well be created
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