The Mount Sinai journal of medicine, New York
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Having a small sick baby in a neonatal intensive care unit can be an extremely difficult experience for any family. A minority family brings to this setting the additional burden of a concern that racism may affect the care their child receives. ⋯ In some cases, these parental perceptions lead to a charge of experimentation. An increased understanding by health care providers of the cultural differences and life experiences that families bring to stressful situations can improve communication.
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The justifications of affirmative action, the compensatory, corrective and redistributive, have been widely recognized in legal thinking. They have been applied, principally, to employment practices. ⋯ At the very least, these arguments mandate much needed research into the causes of minorities' poor health. Without such research, racism remains the presumptive cause of, and affirmative action the appropriate remedy for, the health care problems minorities face.
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The African American community's response to the AIDS epidemic has reflected the profound mistrust of the medical establishment which many African Americans feel. Among African Americans, the belief that the epidemic originated in a genocidal plot is widespread. ⋯ If we look at African Americans' historical relationship to the medical establishment from the era of slavery to the recent past, the suspicious attitudes which make such beliefs possible can be seen as an intelligible response to a new disease which disproportionately affects African Americans. Successful medical and public health responses to the epidemic have depended and will continue to depend upon overcoming the historical legacy of suspicion and gaining the trust of the community.
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Asian patients receive, with significant frequency, suboptimal medical care. The sources of shortcomings in the treatment of the Asian American patient are examined in this paper. ⋯ Misunderstanding begets further "noncompliance," initiating a downward spiral. The way out of such spirals lies, I argue, in seeking a more adequate understanding of the patient's beliefs and their behavioral consequences.
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Successful outcome from a traumatic cervical spinal cord injury (SCI) depends heavily upon the quality of the acute care rendered to the affected individual. In recent years, there have been significant advances in the acute management of SCI. We discuss current management strategies in the areas of prehospital care and transport, emergency room management, surgical considerations and pharmacotherapy.