Journal of health care for the poor and underserved
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J Health Care Poor Underserved · Jan 2016
Gender-affirming Surgeries in the Era of Insurance Coverage: Developing a Framework for Psychosocial Support and Care Navigation in the Perioperative Period.
Transgender people have a gender identity different from their birth-assigned sex. Transgender people may seek gender-affirming surgeries to align their body with their identified gender. ⋯ However the expansion of covered gender-affirming surgeries to safety-net populations has highlighted the need for an expanded presurgical process which includes a psychosocial assessment and care navigation. The proposed framework expands the preoperative assessment to include these components, and can be used to guide both health systems and insurance providers in the development of transgender medicine programs.
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J Health Care Poor Underserved · Nov 2015
ReviewSubstance Use and Related Harms among Aboriginal People in Canada: A Comprehensive Review.
There is evidence of increasing trends in substance use and related harms among Aboriginal populations in Canada. This paper provides a review of data on alcohol, tobacco, and illicit drug use and related harms. ⋯ This review reinforces concerns of many Aboriginal communities and organizations in Canada as well as highlights where prevention, programming, and policy efforts might be most effective.
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J Health Care Poor Underserved · Feb 2015
Prescription practices involving opioid analgesics among Americans with Medicaid, 2010.
Recent state-based studies have shown an increased risk of opioid overdose death in Medicaid populations. To explore one side of risk, this study examines indicators of potential opioid inappropriate use or prescribing among Medicaid enrollees. We examined claims from enrollees aged 18-64 years in the 2010 Truven Health MarketScan® Multi-State Medicaid database, which consisted of weighted and nationally representative data from 12 states. ⋯ Indicators of potential inappropriate use or prescribing included overlapping opioid prescriptions, overlapping opioid and benzodiazepine prescriptions, long acting/extended release opioids for acute pain, and high daily doses. In 2010, Medicaid enrollees with opioid prescriptions obtained an average 6.3 opioid prescriptions, and 40% had at least one indicator of potential inappropriate use or prescribing. These indicators have been linked to opioid-related adverse health outcomes, and methods exist to detect and deter inappropriate use and prescribing of opioids.
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J Health Care Poor Underserved · Feb 2015
Historical ArticlePractice and protest: black physicians and the evolution of race-conscious professionalism.
Throughout history, Black physicians have been bound by a dual obligation: to pursue excellence and success in their profession, and to leverage their professional stature to improve the condition of their communities. This paradigm of race-conscious professionalism has affected greatly the experience of Black physicians, and shaped their formulation of professional identity. This paper explores the relationship between professional life and racial activism in the Black physician community from the pre-Civil War era until the present. ⋯ Before the Civil War, Black physician-activists were forced to relinquish their professional duties in order to engage in activism. In later years, activism emerged as a valuable endeavor in the Black medical community, which offered greater opportunities for activism within the profession. The implications of these findings for contemporary physicians are discussed.
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J Health Care Poor Underserved · May 2014
Community health center provider and staff's Spanish language ability and cultural awareness.
Many community health center providers and staff care for Latinos with diabetes, but their Spanish language ability and awareness of Latino culture are unknown. We surveyed 512 Midwestern health center providers and staff who managed Latino patients with diabetes. Few respondents had high Spanish language (13%) or cultural awareness scores (22%). ⋯ Among all respondents, Spanish skills and Latino cultural awareness were low. Respondents who saw a significant number of Latinos had good access to interpretation services but not cultural competency training. Improved Spanish-language skills and increased access to cultural competency training and Latino cultural knowledge are needed to provide linguistically and culturally tailored care to Latino patients.