J Natl Med Assoc
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Cervical cancer is the fourth most common cancer amongst women worldwide. In the United States, its incidence and mortality have been declining due to the wide scale implementation of cytological screening programs. However, there have been geographic disparities in cervical cancer, particularly in the US. ⋯ By addressing these disparities via increased education, access to care, and the expansion of screening and vaccination programs, reductions in cervical cancer incidence and mortality may be achieved.
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The annual heart failure (HF) mortality rate in Africa is 34% according to the INTERHF study. This is twice the world average of 16.5% and 3.7 times that of South America, 9%. We review evidence-based explanations for the Hyper-mortality of HF, by comparison of North American, Caribbean, Afro-Brazilian with Sub-Saharan African (SSA) nations profiles, and suggest amelioration. 1 year HF mortality rates in SSA ranged from 29% to 58%, and intra-hospital mortality rate from 8 to 26% (n = 8). ⋯ There was sub-optimal use of guideline directed medical therapy (GDMT) and intracardiac device (ICD) unavailability. Gross Domestic Product -per purchasing power parity (GDP-PPP), which is low in SSA, was inversely correlated both to higher intra-hospital mortality rate % (r = -0.73, r 2 = 0.54 p = 0.038) and higher 1 year HF mortality rate % (r = -0.62, r 2 = 0.38, = 0.098). Localized primary prevention, early detection and prompt treatment of hypertension, diabetes, rheumatic fever, early cardiac valve repair and use of cardiovascular polypill, optimal use of GDMT, national health insurance scheme are advocated to stem the dismal mortality and cost burden of HF.
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To systematically review published research exploring workplace discrimination toward physicians of color with a focus on discrimination from patients. ⋯ With physicians of color comprising a growing percentage of the U.S. physician workforce, healthcare organizations must examine and implement effective ways to ensure a healthy and supportive work environment.
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To systematically review published research exploring workplace discrimination toward physicians of color with a focus on discrimination from patients. ⋯ With physicians of color comprising a growing percentage of the U.S. physician workforce, healthcare organizations must examine and implement effective ways to ensure a healthy and supportive work environment.