Journal of general internal medicine
-
Active surveillance (AS) is the guideline-recommended treatment for low-risk prostate cancer and involves routine provider visits, lab tests, imaging, and prostate biopsies. Despite good uptake, adherence to AS, in terms of receiving recommended follow-up testing and remaining on AS in the absence of evidence of cancer progression, remains challenging. ⋯ These themes reflect opportunities for interventions at the care team, community (family and peers), and health system levels that could better support individualized care and overcome challenges to AS adherence through team-based approaches.
-
Healthcare-based social need screening and referral (S&R) among adult populations has produced equivocal results regarding social need resource connection. ⋯ Among VHA-enrolled Veterans, a high-intensity S&R intervention was associated with a non-statistically significant increase in connection to social need resources. Further study needed to establish S&R efficacy.
-
Following the birth of Black Lives Matter, USA medical students advocated for greater commitment to health equity from their schools. In response to such concerns, in 2015, the Yale School of Medicine formed a committee for diversity, inclusion, and social justice and a committee on lesbian, gay, bisexual, transgender, queer, questioning, and intersex affairs. Based on their efforts, our Educational Policy and Curriculum Committee commissioned a student-faculty-led task force to survey the curriculum and make recommendations toward the creation of a health equity curriculum. We conducted a national review of reforms in medical schools' health equity curricula and reviewed health equity content throughout ours. ⋯ We designed best practices for incorporating health equity into the curriculum, and a plan for a health equity thread spanning all its core components. We identified that classroom teaching is not sufficient, and recommended a required experiential learning practicum responsive to community needs. Lastly, we made recommendations regarding faculty and housestaff health equity education given the critical role they play in undergraduate medical education.
-
The importance of integrating physical and psychosocial factors in assessing frailty -health outcomes has been increasingly acknowledged, while the related evidence is lacking. We sought to investigate the associations of joint physical-psychosocial frailty with risk of premature mortality and evaluate the relative importance of individual physical and psychosocial factors. ⋯ In this cohort study of UK Biobank participants, joint physical-psychosocial frailty is significantly associated with risks of all-cause and cause-specific premature mortality, highlighting the importance to jointly assess physical and psychosocial factors in determining aging-related health.