Tuesday, January 31, 2017

The Republicanization of evangelical Protestants in the United States: An examination of the sources of political realignment

 2017 Feb;62:238-254. doi: 10.1016/j.ssresearch.2016.08.010. Epub 2016 Aug 25.

The Republicanization of evangelical Protestants in the United States: An examination of the sources of political realignment.

Author information

  • 1University of Nebraska-Lincoln, 740 Oldfather Hall, P.O. Box 880324, Lincoln, NE 68588-0324, USA. Electronic address: pschwadel2@unl.edu.

Abstract

Although the association between evangelical Protestant and Republican affiliations is now a fundamental aspect of American politics, this was not the case as recently as the early 1980s. Following work on secular political realignment and the issue evolution model of partisan change, I use four decades of repeated cross-sectional survey data to examine the dynamic correlates of evangelical Protestant and Republican affiliations, and how these factors promote changes in partisanship. Results show that evangelical Protestants have become relatively more likely to attend religious services and to oppose homosexuality, abortion, and welfare spending. Period-specific mediation models show that opposition to abortion, homosexuality, and welfare spending have become more robust predictors of Republican affiliation. By the twenty-first century, differences in Republican affiliation between evangelical Protestants and other religious affiliates are fully mediated by views of homosexuality, abortion, and welfare spending; and differences in Republican affiliation between evangelicals and the religiously unaffiliated are substantially mediated by views of homosexuality, abortion, welfare spending, and military spending. These results further understanding of rapid changes in politico-religious alignments and the increasing importance of moral and cultural issues in American politics, which supports a culture wars depiction of the contemporary political landscape.

"By the turn of the century, as evidenced by a 1906 Metropolitan Museum of Art article, book collecting was no longer disparaged."


Bibliomania: the strange history of compulsive book buying



An essayist looks into the curious past of pathological collectors – and considers her own lifelong urge to hoard ever more volumes


"By the turn of the century, as evidenced by a 1906 Metropolitan Museum of Art article, book collecting was no longer disparaged. Skill was required to separate the gold from the dross; book collecting was now a “whole science” and readers were told that they, too, could score a find, as long as they possessed “keen judgment, faultless taste, inexhaustible patience – and contempt for ridicule”. As the author points out, it takes special knowledge to know that Franklin Evans’s The Story of an Inebriate – a book many would throw away – was actually Walt Whitman’s “first published work, and that it is rare and valuable”. Bibliomania was now a bragging right."

Fat shaming can lead to a host of health problems

Fat shaming can lead to a host of health problems


"The study authors said obese people are often viewed as lazy, lacking willpower, incompetent, unattractive, and to blame for their excess weight.
This leaves them feeling stigmatized. Previous research has linked feeling stigmatized about weight to weight gain and emotional distress. The new study suggests it’s not just the stigmatizing, but also the level of a person’s reaction to fat-shaming that can impair health."


"There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace."

 2017 Jan 30;1:CD009778. doi: 10.1002/14651858.CD009778.pub2. [Epub ahead of print]

Interventions for prevention of bullying in the workplace.

Author information

  • 1Institute of Nursing and Health Research, Ulster University, Jordanstown, Newtownabbey, Northern Ireland, UK, BT37 0QB.
  • 2Nursing, Midwifery and Allied Health Professions Research and Development, Southern Health and Social Care Trust, 68 Lurgan Road, Portadown, UK, BT63 5QQ.
  • 3School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland.
  • 4Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • 5Institute of Psychology, Health and Society, University of Liverpool, 1-5 Brownlow Street, Block B Waterhouse Blds, Liverpool, UK, L69 3GL.

Abstract

BACKGROUND:

Bullying has been identified as one of the leading workplace stressors, with adverse consequences for the individual employee, groups of employees, and whole organisations. Employees who have been bullied have lower levels of job satisfaction, higher levels of anxiety and depression, and are more likely to leave their place of work. Organisations face increased risk of skill depletion and absenteeism, leading to loss of profit, potential legal fees, and tribunal cases. It is unclear to what extent these risks can be addressed through interventions to prevent bullying.

OBJECTIVES:

To explore the effectiveness of workplace interventions to prevent bullying in the workplace.

SEARCH METHODS:

We searched: the Cochrane Work Group Trials Register (August 2014); Cochrane Central Register of Controlled Trials (CENTRAL; The Cochrane Library 2016, issue 1); PUBMED (1946 to January 2016); EMBASE (1980 to January 2016); PsycINFO (1967 to January 2016); Cumulative Index to Nursing and Allied Health Literature (CINAHL Plus; 1937 to January 2016); International Bibliography of the Social Sciences (IBSS; 1951 to January 2016); Applied Social Sciences Index and Abstracts (ASSIA; 1987 to January 2016); ABI Global (earliest record to January 2016); Business Source Premier (BSP; earliest record to January 2016); OpenGrey (previously known as OpenSIGLE-System for Information on Grey Literature in Europe; 1980 to December 2014); and reference lists of articles.

SELECTION CRITERIA:

Randomised and cluster-randomised controlled trials of employee-directed interventions, controlled before and after studies, and interrupted time-series studies of interventions of any type, aimed at preventing bullying in the workplace, targeted at an individual employee, a group of employees, or an organisation.

DATA COLLECTION AND ANALYSIS:

Three authors independently screened and selected studies. We extracted data from included studies on victimisation, perpetration, and absenteeism associated with workplace bullying. We contacted study authors to gather additional data. We used the internal validity items from the Downs and Black quality assessment tool to evaluate included studies' risk of bias.

MAIN RESULTS:

Five studies met the inclusion criteria. They had altogether 4116 participants. They were underpinned by theory and measured behaviour change in relation to bullying and related absenteeism. The included studies measured the effectiveness of interventions on the number of cases of self-reported bullying either as perpetrator or victim or both. Some studies referred to bullying using common synonyms such as mobbing and incivility and antonyms such as civility. Organisational/employer level interventionsTwo studies with 2969 participants found that the Civility, Respect, and Engagement in the Workforce (CREW) intervention produced a small increase in civility that translates to a 5% increase from baseline to follow-up, measured at 6 to 12 months (mean difference (MD) 0.17; 95% CI 0.07 to 0.28).One of the two studies reported that the CREW intervention produced a small decrease in supervisor incivility victimisation (MD -0.17; 95% CI -0.33 to -0.01) but not in co-worker incivility victimisation (MD -0.08; 95% CI -0.22 to 0.08) or in self-reported incivility perpetration (MD -0.05 95% CI -0.15 to 0.05). The study did find a decrease in the number of days absent during the previous month (MD -0.63; 95% CI -0.92 to -0.34) at 6-month follow-up. Individual/job interface level interventionsOne controlled before-after study with 49 participants compared expressive writing with a control writing exercise at two weeks follow-up. Participants in the intervention arm scored significantly lower on bullying measured as incivility perpetration (MD -3.52; 95% CI -6.24 to -0.80). There was no difference in bullying measured as incivility victimisation (MD -3.30 95% CI -6.89 to 0.29).One controlled before-after study with 60 employees who had learning disabilities compared a cognitive-behavioural intervention with no intervention. There was no significant difference in bullying victimisation after the intervention (risk ratio (RR) 0.55; 95% CI 0.24 to 1.25), or at the three-month follow-up (RR 0.49; 95% CI 0.21 to 1.15), nor was there a significant difference in bullying perpetration following the intervention (RR 0.64; 95% CI 0.27 to 1.54), or at the three-month follow-up (RR 0.69; 95% CI 0.26 to 1.81). Multilevel InterventionsA five-site cluster-RCT with 1041 participants compared the effectiveness of combinations of policy communication, stress management training, and negative behaviours awareness training. The authors reported that bullying victimisation did not change (13.6% before intervention and 14.3% following intervention). The authors reported insufficient data for us to conduct our own analysis.Due to high risk of bias and imprecision, we graded the evidence for all outcomes as very low quality.

AUTHORS' CONCLUSIONS:

There is very low quality evidence that organisational and individual interventions may prevent bullying behaviours in the workplace. We need large well-designed controlled trials of bullying prevention interventions operating on the levels of society/policy, organisation/employer, job/task and individual/job interface. Future studies should employ validated and reliable outcome measures of bullying and a minimum of 6 months follow-up.

Sunday, January 29, 2017

Zombie allusions: They just keep on coming™: possessing "negligible enzymatic activity relative to their catalytically active cousins."

 2016 Nov 11;14(1):98.

The evolving world of pseudoenzymes: proteins, prejudice and zombies.

Author information

  • 1Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, UK. Patrick.eyers@liverpool.ac.uk.
  • 2The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville, VIC, Australia. jamesm@wehi.edu.au.
  • 3Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia. jamesm@wehi.edu.au.

"A pseudoenzyme contains a protein domain with a fold that resembles, or is predicted to resemble, a catalytically active, conventional protein domain counterpart. However, the pseudoenzyme possesses vestigial or zero catalytic activity owing to the absence of key catalytic amino acids or motifs. Such proteins have been long acknowledged to exist within proteomes and have also been termed nonenyzmes []. In a sense, pseudoenzymes can be considered to be ‘zombie’ versions of proteins: ‘undead’ in the sense that they still perform important cellular functions, but at the same time ‘dead’ since they possess negligible enzymatic activity relative to their catalytically active cousins."

How religion deters gambling

 2017 Feb;62:204-218. doi: 10.1016/j.ssresearch.2016.07.007. Epub 2016 Jul 30.

Faith's wager: How religion deters gambling.

Author information

  • 1University of Notre Dame, Sociology Department, USA.
  • 2University of Arizona, School of Sociology, USA. Electronic address: jeffsallaz@gmail.com.

Abstract

The relationship between religion and gambling has only rarely been investigated in sociology and related fields. Prior studies have found that religion, broadly defined, deters gambling, with different religious traditions exhibiting varying degrees of deterrence. Our study, a quantitative analysis of a recent representative sample of U.S. adults, theorizes and tests how three different dimensions of religion affect three distinct forms of gambling. Religious tradition and religious service attendance are found to reduce the likelihood of casino gambling and lottery play; while religious salience is the only dimension that constrains online gambling. We argue that these findings reflect variation in the social visibility, time intensity, and broader legitimacy associated with gambling forms, and that this variation is crucial for understanding the deterring effects of faith.

#InSituPathologists: how the #USCAP2015 meeting went viral on Twitter and founded the social media movement for the United States and Canadian Academy of Pathology

 2017 Jan 13;(2):160-168. doi: 10.1038/modpathol.2016.223. [Epub ahead of print]

#InSituPathologists: how the #USCAP2015 meeting went viral on Twitter and founded the social media movement for the United States and Canadian Academy of Pathology.

Author information

  • 1Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA.
  • 2Department of Pathology, The University of Texas Medical Branch, Galveston, TX, USA.
  • 3Department of Pathology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
  • 4Department of Pathology, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA.
  • 5Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 6Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA.
  • 7Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
  • 8Department of Pathology, Montefiore Medical Center, Bronx, NY, USA.
  • 9Kimberly Jewett Consulting, Inc., Plainfield, IL, USA.
  • 10Department of Pathology, Duke University, Durham, NC, USA.
  • 11Publisher, tissuepathology.com, Charlotte, NC, USA.
  • 12Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.
  • 13Adirondack Pathology, Glens Falls, NY, USA.
  • 14Cunningham Pathology (An Aurora Dx Partner), Birmingham, AL, USA.
  • 15Department of Pathology, University of Wisconsin Hospital & Clinics, Madison, WI, USA.
  • 16Hospital Pathology Associates, Minneapolis, MN, USA.
  • 17Treasure Coast Pathology, Stuart, FL, USA.
  • 18Departments of Pathology and Dermatology, Mount Sinai Hospital, New York, NY, USA.
  • 19OakBend Medical Center & PATHO-L, Richmond, TX, USA.
  • 20IHA Pathology and Laboratory Medicine and St Joseph Mercy Hospital, Ann Arbor, MI, USA.
  • 21Department of Pathology, Henry Ford Health System, Detroit, MI, USA.
  • 22Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA.

Abstract

Professional medical conferences over the past five years have seen an enormous increase in the use of Twitter in real-time, also known as "live-tweeting". At the United States and Canadian Academy of Pathology (USCAP) 2015 annual meeting, 24 attendees (the authors) volunteered to participate in a live-tweet group, the #InSituPathologists. This group, along with other attendees, kept the world updated via Twitter about the happenings at the annual meeting. There were 6,524 #USCAP2015 tweets made by 662 individual Twitter users; these generated 5,869,323 unique impressions (potential tweet-views) over a 13-day time span encompassing the dates of the annual meeting. Herein we document the successful implementation of the first official USCAP annual meeting live-tweet group, including the pros/cons of live-tweeting and other experiences of the original #InSituPathologists group members. No prior peer-reviewed publications to our knowledge have described in depth the use of an organized group to "live-tweet" a pathology meeting. We believe our group to be the first of its kind in the field of pathology.

Obesity rates increase, as more Latin Americans eat processed (junk) food

Obesity rates increase, as more Latin Americans eat processed (junk) food


"Nearly 58 percent of the region’s inhabitants, or close to 360 million people, is either overweight or obese, said the report by the United Nations’ Food and Agriculture Organization (FAO) and the Pan American Health Organization (PAHO).
The rapid jump in obesity rates has crisscrossed the region, affecting Latin Americans “regardless of their economic situation, place of residence or ethnic origin,” it said."

Friday, January 27, 2017

Nannystate: "Offering free refills from self-service soda fountains has been uncommon in France, but now the practice is illegal."

No More Free Soda Refills on Tap in France



"PARIS (AP) — Offering free refills from self-service soda fountains has been uncommon in France, but now the practice is illegal.
A governmental decree prohibiting restaurants, hotels and catering facilities from allowing customers to top up their drinks for free went into effect on Friday. The move is aimed at combatting obesity."

Monday, January 23, 2017

"In one of his first official acts, President Trump designated Commissioner Ajit Pai as the new chairman of the Federal Communications Commission."

President Trump Designates Ajit Pai as Chairman of FCC

"In one of his first official acts, President Trump designated Commissioner Ajit Pai as the new chairman of the Federal Communications Commission. He is the first newly appointed Republican chairman since Kevin Martin nearly 12 years ago. Many have asked: how will the FCC change under Chairman Pai?"


HT:MC

Friday, January 20, 2017

Living Large: Texans Land on Fattest List

Living Large: Texans Land on Fattest List



'You have to eat more fruits and vegetables. That's the bottom line," Prince said. "Right now the obesity epidemic is a $200 billion crisis. It's crazy."

Trump said to elevate Ajit Pai to FCC chairman

Trump said to elevate Ajit Pai to FCC chairman




"Pai, who met with Trump in New York on Monday, had been seen by many as a top contender for the job given his reputation as a telecom law expert who’s comfortable in front of the camera. But his selection is also somewhat of a departure for the incoming administration, which has tapped people outside of Washington for many top positions.

By contrast, Pai is already a familiar name in tech and telecom policy debates. He’s a fierce and vocal critic of many regulations passed by the commission's Democratic majority, including the 2015 net neutrality rules that require internet service providers to treat all web traffic equally and are opposed by the major broadband companies. As chairman, Pai will be able to start the process of undoing the net neutrality order and pursuing other deregulatory efforts."

Saturday, January 14, 2017

Nannystate: In-home interventions planned for obese Aussie kids (Parents?)

In-home interventions planned for obese Aussie kids



"Researchers will go into the homes of 20 Victorian families with children aged 3-11 in the six month trial and implement changes like using smaller dinner plates, traffic light stickers on food storage containers, rearranging the pantry to put healthy food in front and hiding junk food, and making sporting equipment more visible and accessible to children."

A legal perspective on athlete screening and disqualification

 2017 Jan;27(S1):S104-S109. doi: 10.1017/S1047951116002328.

legal perspective on athlete screening and disqualification.

Author information

  • 11Methodist Hospital and Methodist Cardiovascular Consultants,Dallas,TX.
  • 22Jersey Shore University Medical Center and Monmouth Medical Center Southern Campus,Neptune City,NJ.
  • 33Aurora St. Lukes Medical Center,Aurora,WI.
  • 44Division of Cardiology,Mayo Clinic,Rochester, MN,United States of America.

Abstract

Physicians participate in the screening, routine medical supervision, and disqualification of student-athletes. In doing so, they should understand that eligibility/disqualification decisions inevitably have associated liability issues. It is the responsibility of physicians to take the lead role in the student-athlete medical assessment process to allow for optimum safety in sports programmes. The first duty of the physician is to protect the health and well-being of the student-athlete. However, because there is potential liability associated with the screening/disqualification process, physicians are wise to develop sound and reasonable strategies that are in strict compliance with the standard of care. This article focusses on cardiac screening and disqualification for participation in sports.

"Next time you feel like making fun of your obese friends for not sticking to their gym routines, think twice."

Obese People Can’t Stick To Gym Routines Because Of Altered Dopamine Receptors


"Next time you feel like making fun of your obese friends for not sticking to their gym routines, think twice. Because obese people may have altered dopamine receptors, causing them to have little motivation to exercise, according to a new study which may explain why some overweight people find it difficult to stick to exercise programmes."

#InSituPathologists: how the #USCAP2015 meeting went viral on Twitter...

 2017 Jan 13;(2):160-168. doi: 10.1038/modpathol.2016.223. [Epub ahead of print]

#InSituPathologists: how the #USCAP2015 meeting went viral on Twitter and founded the social media movement for the United States and Canadian Academy of Pathology.

Author information

  • 1Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, TX, USA.
  • 2Department of Pathology, The University of Texas Medical Branch, Galveston, TX, USA.
  • 3Department of Pathology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
  • 4Department of Pathology, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA.
  • 5Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
  • 6Department of Pathology, Indiana University School of Medicine, Indianapolis, IN, USA.
  • 7Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
  • 8Department of Pathology, Montefiore Medical Center, Bronx, NY, USA.
  • 9Kimberly Jewett Consulting, Inc., Plainfield, IL, USA.
  • 10Department of Pathology, Duke University, Durham, NC, USA.
  • 11Publisher, tissuepathology.com, Charlotte, NC, USA.
  • 12Department of Pathology, Johns Hopkins University, Baltimore, MD, USA.
  • 13Adirondack Pathology, Glens Falls, NY, USA.
  • 14Cunningham Pathology (An Aurora Dx Partner), Birmingham, AL, USA.
  • 15Department of Pathology, University of Wisconsin Hospital & Clinics, Madison, WI, USA.
  • 16Hospital Pathology Associates, Minneapolis, MN, USA.
  • 17Treasure Coast Pathology, Stuart, FL, USA.
  • 18Departments of Pathology and Dermatology, Mount Sinai Hospital, New York, NY, USA.
  • 19OakBend Medical Center & PATHO-L, Richmond, TX, USA.
  • 20IHA Pathology and Laboratory Medicine and St Joseph Mercy Hospital, Ann Arbor, MI, USA.
  • 21Department of Pathology, Henry Ford Health System, Detroit, MI, USA.
  • 22Department of Pathology and Laboratory Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA.

Abstract

Professional medical conferences over the past five years have seen an enormous increase in the use of Twitter in real-time, also known as "live-tweeting". At the United States and Canadian Academy of Pathology (USCAP) 2015 annual meeting, 24 attendees (the authors) volunteered to participate in a live-tweet group, the #InSituPathologists. This group, along with other attendees, kept the world updated via Twitter about the happenings at the annual meeting. There were 6,524 #USCAP2015 tweets made by 662 individual Twitter users; these generated 5,869,323 unique impressions (potential tweet-views) over a 13-day time span encompassing the dates of the annual meeting. Herein we document the successful implementation of the first official USCAP annual meeting live-tweet group, including the pros/cons of live-tweeting and other experiences of the original #InSituPathologists group members. No prior peer-reviewed publications to our knowledge have described in depth the use of an organized group to "live-tweet" a pathology meeting. We believe our group to be the first of its kind in the field of pathology.Modern Pathology advance online publication, 

Depression May Up Heart Disease Risk As Much As Obesity ("...only high blood pressure and smoking are associated with a greater risk...)

Depression May Up Heart Disease Risk As Much As Obesity



“Our investigation shows that the risk of a fatal cardiovascular disease due to depression is almost as great as that due to elevated cholesterol levels or obesity,” Ladwig said.
The results show that only high blood pressure and smoking are associated with a greater risk, he said.

Friday, January 13, 2017

Oliver Smithies, 2007 Nobel Prize winner in medicine, dies

Oliver Smithies, 2007 Nobel Prize winner in medicine, dies


"Smithies' work aided in the creation and use of "knockout mice," which have helped scientists understand how individual genes work. According to a National Institutes of Health genome research webpage, knockout mice are mice in which researchers have inactivated, or "knocked out," an existing gene and replaced or disrupted it with an artificial piece of DNA."

The Charter on Professionalism for Health Care Organizations

 2017 Jan 10. doi: 10.1097/ACM.0000000000001561. [Epub ahead of print]

The Charter on Professionalism for Health Care Organizations.

Author information

  • 1B.E. Egener is medical director, Foundation for Medical Excellence, Portland, Oregon. D.J. Mason is codirector, Center for Health, Media & Policy, New York, New York. W.J. McDonald is emeritus professor of medicine, Oregon Health Sciences University, Portland, Oregon, and senior vice president, QHC (Quality in Healthcare) Advisory Group, Huntington, New York. S. Okun is vice president for advocacy, policy and patient safety, PatientsLikeMe, Inc., Cambridge, Massachusetts. M.E. Gaines is distinguished clinical professor of law and director, Center for Patient Partnerships, University of Wisconsin Law School, Madison, Wisconsin. D.A. Fleming is professor and chair of medicine and codirector, Center for Health Ethics, University of Missouri School of Medicine, Columbia, Missouri. B.M. Rosof is professor of medicine, Hofstra Northwell School of Medicine, Hempstead, New York, and chief executive officer, QHC (Quality in Healthcare) Advisory Group, Huntington, New York. D. Gullen is codirector, Communication in Healthcare Program, Mayo Clinic in Arizona, Scottsdale, Arizona. M.-L. Andresen is vice president, QHC (Quality in Healthcare) Advisory Group, Huntington, New York.

Abstract

In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems.This article contains the Charter on Professionalism for Health Care Organizations, as well as the process and rationale for its development. For hospitals and hospital systems to effectively care for patients, maintain a healthy workforce, and improve the health of populations, they must attend to the four domains addressed by the Charter: patient partnerships, organizational culture, community partnerships, and operations and business practices. Impacting the social determinants of health will require collaboration among health care organizations, government, and communities.Transitioning to the model hospital described by the Charter will challenge historical roles and assumptions of both its leadership and staff. While the Charter is aspirational, it also outlines specific institutional behaviors that will benefit both patients and workers. Lastly, this article considers obstacles to implementing the Charter and explores avenues to facilitate its dissemination.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

"Racial and ethnic disparities in the delivery of guideline-based care are the highest in high-volume hospitals."

 2017 Jan 9. doi: 10.1097/AOG.0000000000001819. [Epub ahead of print]

Association of Hospital Volume With Racial and Ethnic Disparities in Locally Advanced Cervical Cancer Treatment.

Author information

  • 1Division of Gynecologic Oncology, the Institute for Healthcare Policy and Innovation, the Department of Radiation Oncology, and the Department of Diagnostic Radiology, University of Michigan, Ann Arbor, Michigan; the Division of Gynecologic Oncology, University of Wisconsin, Madison, Wisconsin; and the Division of Gynecologic Oncology, Vincent Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Abstract

OBJECTIVE:

To evaluate racial-ethnic disparities in guideline-based care in locally advanced cervical cancer and their relationship to hospital case volume.

METHODS:

Using the National Cancer Database, we performed a retrospective cohort study of women diagnosed between 2004 and 2012 with locally advanced squamous or adenocarcinoma of the cervix undergoing definitive primary radiation therapy. The primary outcome was the race-ethnicity-based rates of adherence to the National Comprehensive Cancer Network guideline-based care. The secondary outcome was the effect of guideline-based care on overall survival. Multivariable models and propensity matching were used to compare the hospital risk-adjusted rates of guideline-based adherence and overall survival based on hospital case volume.

RESULTS:

The final cohort consisted of 16,195 patients. The rate of guideline-based care was 58.4% (95% confidence interval [CI] 57.4-59.4%) for non-Hispanic white, 53% (95% CI 51.4-54.9%) for non-Hispanic black, and 51.5% (95% CI 49.4-53.7%) for Hispanic women (P<.001). From 2004 to 2012, the rate of guideline-based care increased from 49.5% (95% CI 47.1-51.9%) to 59.1% (95% CI 56.9-61.2%) (Ptrend<.001). Based on a propensity score-matched analysis, patients receiving guideline-based care had a lower risk of mortality (adjusted hazard ratio 0.65, 95% CI 0.62-0.68). Compared with low-volume hospitals, the increase in adherence to guideline-based care in high-volume hospitals was 48-63% for non-Hispanic white, 47-53% for non-Hispanic black, and 41-54% for Hispanic women.

CONCLUSION:

Racial and ethnic disparities in the delivery of guideline-based care are the highest in high-volume hospitals. Guideline-based care in locally advanced cervical cancer is associated with improved survival.

Diabetes diagnoses doubles across pediatric population: "...runs counter to the common appellation of "adult-onset diabetes" for type 2 diabetes."

White paper: Diabetes diagnoses doubles across pediatric population


NEW YORK  — Private health insurance claim lines with a type 2 diabetes diagnosis more than doubled in the pediatric population (ages 0 to 22 years) from 2011 to 2015, increasing 109%, according to data from FAIR Health, a national, independent, nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information.

This finding, reported in the new FAIR Health white paper, runs counter to the common appellation of "adult-onset diabetes" for type 2 diabetes.

Drawing on FAIR Health's database of over 21 billion privately billed healthcare claims, the new report shows that claim lines with a diagnosis of obesity, a condition that contributes to type 2 diabetes, also increased across the pediatric population from 2011 to 2015. The largest increase among pediatric patients is 154%, in the age group 19 to 22 years.