J Natl Med Assoc
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Review
Factors that Influence Mammography Use for Breast Cancer Screening among African American Women.
The purpose of this study was to assess factors that influence use of mammography screening among African American women, with a focus on social and cultural influences using Andersen's behavioral model (ABM), and to assess the methodological quality of the included studies. ⋯ Financial and cultural issues were important hindrances to breast cancer screening in African American women. These findings highlight the importance of affordable health care for preventive health services as well as the relevance of culturally embedded issues to health, while the MQS accentuates the need for more rigorous research articles. Breast cancer screening interventions in this population should attend to barriers identified in this review.
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This study investigates possible race- and ethnicity-related disparities in the treatment of acne, atopic dermatitis, and psoriasis of newly approved treatments as well as existing therapies. ⋯ This study demonstrates a racial and ethnic disparity in accessing newly approved and standard of care medical therapies for acne, atopic dermatitis, and psoriasis within the past three years.
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Editorial Randomized Controlled Trial
Tomosynthesis mammographic Imaging Screening Trial (TMIST): An Invitation and Opportunity for the National Medical Association Community to Shape the Future of Precision Screening for Breast Cancer.
To determine the best screening modality for breast cancer, a large randomized clinical trial is underway to compare the mammographic accuracy between the standard digital and tomosynthesis mammography. The Tomosynthesis Mammographic Imaging Screening Trial (TMIST) is also building the world's largest biorepository of breast cancer specimens from all biopsies at screening and wants to ensure it is representative of the US population. ⋯ The outcome of the trial will help to advance precision screening, individually tailoring screening decisions based on breast density, tumor subtyping and genomics. The partnership with NMA is essential to building trust, dispelling misconceptions about clinical trials in the community as well as to support a cadre of African American physicians and researchers who can contribute to the current understanding of the social determinants of breast cancer.
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As of 2017 the Centers for Disease Control and Prevention (CDC) estimated that there were over one million individuals living with HIV/AIDS in the United States (CDC, 2017). Regionally the epicenter of HIV infection is in Washington DC with a prevalence rate of 1.9% (HAHSTA, 2018). Several wards including 5, 6, 7 and 8 are disproportionately impacted. Although the lack of insurance has been identified as a challenge for HIV detection and linkage to care, many insured individuals deny previous HIV testing. We implemented a routine HIV screening program in our institution since 2006. We present an analysis of our HIV testing data over a 42-month period to assess factors leading to lower HIV testing rates in an urban insured population. ⋯ 1637 of those insured reported no previous HIV testing. Age greater than 50 and unprotected sex were significant risk factors. Health insurance status did not always correlate with previous testing. HIV prevention efforts should target this population with appropriate messaging and screening during routine evaluations.
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Charlottesville is a resettlement site for Liberian refugees. Many receive care at the International Family Medicine Clinic (IFMC). IFMC physicians note reduced adherence to chronic disease medications among refugee patients. ⋯ Topics included concept of disease, health care access, disease burden, acculturation, and socioeconomic factors. Transcripts were analyzed according to the explanatory model of disease and Krueger's framework analysis. This study can assist providers in tailoring their practices to meet the needs of refugee patients and inform future public health interventions.