Int J Health Serv
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Review
Addressing Racial Biases in Medicine: A Review of the Literature, Critique, and Recommendations.
This article reviews the literature on racism in medicine in the United States and reflects on the persistent barriers to diminishing racial biases in the U. S. health care system. Espoused strategies for decreasing racial disparities and reducing racial biases among physicians are critiqued, and recommendations are offered. Those recommendations include increasing the number of minority students in medical school, using Xavier University in New Orleans, Louisiana, as the model for medical school preparation; revamping the teaching of cultural competence; ensuring the quality of non-clinical staff; and reducing the risk of burnout among medical providers.
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This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant "grey" literature and websites. ⋯ Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.
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This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant "grey" literature and websites. ⋯ Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.
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Mineral mining is among the world's most hazardous occupations. It is especially dangerous in southern Africa, where mining activity is a leading cause of HIV and tuberculosis epidemics. Inside mines, silica dust exposure causes long-term pulmonary damage. ⋯ Miners in high-income countries, working for the same transnational companies, do not experience elevated rates of death and disability. Cost-effective interventions can reduce HIV incidence through social housing, curb trafficking of high-risk groups, stop tuberculosis spread through screening and detection, and reduce drug resistance by standardizing cross-border care. Urgent action is needed to respond to mining's staggering, yet avoidable disease toll in sub-Saharan Africa.
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This article reviews the deteriorating health situation of the Palestinian population during the post-Oslo period of the Palestinian Authority and during the current Intifada. It seeks to record findings obtained through primary participants and documents and from personal observations in the field that situate Palestinian health conditions within their political framework. The ongoing crisis highlights longstanding problems in the Palestinian health infrastructure, which make it more vulnerable to Israeli policies, especially the movement restrictions and closures. ⋯ Israel's indiscriminate obstructions to the coordinated functioning of a health care system in Palestine increase morbidity, degrade health, promote premature deaths, and damage the medical infrastructure. Moreover, the Israeli actions transgress international law and, ultimately, make peace in the region much less likely. This analysis provides further evidence of the social justice violations and the wide-ranging effects on health experienced daily by the Palestinian people as a direct result of the Israeli military occupation.