Journal of the National Medical Association最新文献

Plastic surgery is a specialty crucial for addressing the needs of diverse patient, yet it faces significant underrepresentation of African Americans, especially in academic leadership. This imbalance persists throughout medical education, training, and professional advancement. Dr. Arthur L. Garnes, the first board-certified African American plastic surgeon, overcame profound challenges, inspiring subsequent generations. Notable figures like Dr. Camille Cash and Dr. Steven Williams further exemplify resilience in the face of barriers. Mentorship emerges as pivotal, fostering diversity and inclusion within plastic surgery. Initiatives promoting mentorship, financial support, and recruitment are essential to rectifying disparities, ensuring equitable representation, and improving access to care for minority patients.

People with sickle cell disease (SCD) have an increased risk of pregnancy loss and severe maternal morbidity in pregnancy yet there is little data on the outcomes of abortions or pregnancy loss among these individuals. This retrospective review aimed to describe the clinical outcomes of procedurally managed abortions and early pregnancy losses among individuals with sickle cell disease at a single center. We identified 19 individuals with sickle cell disease who underwent 24 procedures for the management of abortion (n = 18) or pregnancy loss (n = 6) at our center from 2013 to 2022. There were few procedure-related complications. Most of the post-procedural complications were painful crises. Individuals with a high frequency of painful crises before the procedure had a 1.2 higher odds of experiencing post-procedural painful crises (95 % CI: 1.0-1.4). Individuals with higher baseline rates of painful crises were more likely to develop post-procedural pain crises. This study is the first since 1995 to report on abortion and pregnancy loss outcomes in SCD. As threats to accessing reproductive health care continue to grow in the U.S., we must refine practice models to deliver safe care to patients with SCD who seek reproductive health services.

Osteoarthritis (OA) is the most common form of arthritis in the United States, affecting approximately 24 % of adults. This literature review aims to summarize racial and ethnic disparities in OA prevalence, presentation, disability, diagnosis, and management among different groups in the U.S. The review found significant disparities, particularly affecting African Americans (AAs) and Hispanics (HISs) compared to non-Hispanic whites (WHs). AAs showed higher odds of developing symptomatic and radiological knee OA, with more severe radiological features. Pain and disability due to OA were also more pronounced in AAs and HISs. Disparities extended to imaging workup, with AAs less likely to undergo hip X-rays and MRIs for hip OA. Management strategies, including physical therapy, pharmacological treatments, and surgical interventions, were less utilized by AAs and HISs compared to WHs. These disparities are influenced by complex, multifaceted factors including socioeconomic status, education level, and healthcare access. The review highlights the urgent need for targeted interventions and policy changes to address these racial-ethnic disparities in OA care and outcomes.

Introduction: It has been well documented that underrepresented faculty in academic medicine are concentrated in lower faculty ranks than their well represented counterparts. This promotion disparity has resulted in concerted efforts by medical institutions to change academic culture and climate surrounding this group. This study provides a more detailed characterization of minority faculty underrepresentation, evaluating longitudinal trends in faculty rank among US medical schools looking particularly at academic rank, region, ownership, institution type, social mission score and research intensity ranking.

Materials and methods: Using data from the AAMC Faculty Roster, AAMC Organizational database, and Mullan et al.'s social mission score, multiple adjusted Generalized Estimating Equation (GEE) models were constructed to evaluate trends in faculty number by race/ethnicity, academic rank, and specific institutional characteristics as noted above.

Results and discussion: Compared to URM faculty in the South, the change rate of URM faculty is higher by 1.7 % in the West. At the Instructor rank, there are increased rates of change for all racial groups in the West when compared to the South by 6.3 % for Asian faculty, 5.1 % for White faculty, and 5 % for URM faculty. URM faculty at HBCUs at the Instructor level have decreased rates of change by 4.9 % as compared to predominantly white institutions. URM Professor rank faculty at private institutions showed significant increased rates of change of 1.7 % as compared to public institutions. URM faculty at the Professor rank had a decreased rate of 1.4 % at schools with high social mission score compared to low social mission scores.

Implications: There are differences in overall URM faculty trends based on region, ownership, institution type, social mission score and research intensity ranking. All institutional characteristics showed different effects on URM faculty at specific academic ranks and the reasons for these differences need further study to be more fully understood.

Minimally-melanated skin has been the standard for dermatologic education. Research has shown that the lack of brown and black images in dermatologic medical education may contribute to unequal early recognition of diseases across different skin types. Promoting visual equity in educational resources throughout undergraduate medical education may allow for students to improve their confidence in identifying skin lesions in patients of color. Dermatology lectures at Rutgers New Jersey Medical School (NJMS) were examined using the New Immigrant Survey (NIS) Skin Color Scale. Four pre-clerkship lectures featuring various skin lesions were analyzed and images were categorized as light/white, medium/brown, and dark/black skin types. The light/white skin category was the most heavily represented accounting for 59.5 % (n = 185) of all images across the four lectures, medium/brown skin type accounted for 16.1 % (n = 50), and dark/black skin type was 24.4 % (n = 76). Across the four lectures, there were 109 dermatologic conditions covered. Of the 109, 35 (32 %) only included images from one skin tone, which was usually light/white skin, whereas 17 (16 %) included images of all three skin types. INSTITUTION is located in Newark, New Jersey a diverse community with 48.2 % of its residents identifying as Black/African American and 36.8 % identifying as Hispanic/Latino in 2022. Currently, there have been efforts at INSTITUTION to promote visual learning equity, especially to represent the community it resides in. Addressing this disparity in medical education is a vital step toward achieving more equitable healthcare practices and outcomes for patients.

To date there have been multiple clinical reports of pediatric patients with Williams Beuren syndrome developing non-Hodgkin lymphoma. However, there is no clear evidence of an association between this microdeletion syndrome and lymphoma risk and as of yet there are no recommendations for cancer surveillance in the follow-up of these patients. In this report we descibe two patients with Williams Beuren syndrome, both of whom were diagnosed with non-Hodgkin lymphoma, one at the age of 2 years and the other at the age of 6 years during clinical follow-up. Although Williams-Beuren syndrome is not a cancer-predisposing genetic syndrome, rare cases of malignancy have been reported in these patients, necessitating consideration of this fact during patient follow-up.

Objective: To assess prevalence of concern and experiences with police-involved shootings among Colorado adults and differential impact on sociodemographic groups.

Methods: We analyzed a biennial state-representative online survey of Colorado adults, administered April-May 2023. Participants included the Ipsos KnowledgePanel of Colorado adults and additional opt-in respondents (n = 1,520). Main outcomes were self-reported concern about and personal experience with a police-involved shooting.

Results: Overall, 43.3 % of Colorado adults were concerned about a police-involved shooting occurring in their community and 26.1 % were concerned about a police-involved shooting occurring to themselves or their family. Black and Hispanic adults had significantly higher rates of concern compared to White and non-Hispanic adults, respectively. Of all Colorado adults, 4.4 % reported personal experiences with police-involved shootings; Hispanic adults report significantly higher rates to non-Hispanics (p<.001).

Conclusions: Results highlight pervasive levels of concern with police-involved shootings, with highest rates of both concern and personal experiences among Black and Hispanic adults. These findings underscore the need for comprehensive and reliable data to understand police-involved shootings and concerns about police-involved violence among diverse populations and the impact on communities' health.

This study tackles creating Python code for beginners with generative AI and analyzing trends in mental distress among Alzheimer's patients in the US (2015-2022 CDC data). It guides beginners through using AI to generate code for visualizing these trends by age and sex. The findings reveal females, particularly those 50-64 years old, experience the highest rates of mental distress. This emphasizes the importance of considering age and sex when developing care and interventions for mental distress in Alzheimer's patients.

The Medical Student Scholars for Health Equity in Myeloma Mentoring program is sponsored by the International Myeloma Foundation (IMF) and the W. Montague Cobb/NMA Health Institute's Cobb Scholars Program. The initiative focuses on mentoring minority medical students to enhance the representation of minority physicians committed to myeloma health equity. By supporting innovative projects aimed at reducing health disparities in myeloma, the program seeks to inspire medical students and address diversity gaps in the field.

Introduction: Black women in the US, including Black African immigrant women, have the lowest rates of physical activity (PA). This study aimed to identify sociodemographic, anthropometric, and health characteristics associated with PA engagement among African-born Black women immigrants.

Methods: The sample consisted of 736 Black African-born women respondents the 2011-2018 National Health Interview Surveys. The outcomes of interest were aerobic activity, strengthening activity, and combined aerobic and strengthening activity. Independent variables of interest included sociodemographic characteristics, health behaviors, and anthropometrics. Descriptive statistics and multivariable adjusted logistic regression analyses were performed.

Results and discussion: Of the 736 women, 43.1 % were sufficiently active in aerobic activities and 17.4 % met the strengthening activity guidelines. Overall, only 15.7 % of the participants met the guidelines for total PA (aerobic and strength), while 55 % did not meet any guidelines. Participants who consumed alcohol were more likely to be sufficiently active in aerobic activity compared to those who abstained (AOR = 3.54, 95 % CI [2.43,5.16]). Factors negatively associated with sufficient aerobic activity were smoking (AOR = 0.42, 95 % CI [0.19,0.92] and having obesity (AOR = 0.50, 95 % CI [0.33,0.75]). The odds of meeting strengthening activity guidelines were greater among those with high school education (AOR = 2.94, 95 % CI [1.20, 7.20]) and more than high school (AOR = 2.54, 95 % CI [1.09,5.95]) than among those with less than high school education, Additionally, being in the US 15 years or more (AOR = 2.15, 95 % CI [1.18-3.91]). and a current drinker (AOR = 2.14, 95 % CI [1.22-3.75]) was positively associated with meeting strength guidelines.

Implications: Findings provide missing information about Black African immigrant women's participation in PA and suggest that more research is needed to understand how African immigrant women make decisions about PA. The findings join calls to disaggregate data and health related research on Africans.