J Natl Med Assoc
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Red blood cell distribution width (RDW) has been shown to be an important predictor of the occurrence of various inflammatory and infectious diseases. However, the predictive value of RDW for pulmonary infection in elderly patients undergoing abdominal surgery under general anesthesia with endotracheal intubation remains unclear. ⋯ RDW at admission had predictive value for pulmonary infection in elderly patients undergoing abdominal surgery under general anesthesia with endotracheal intubation.
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Rape has fast become an issue of relevance to global health cutting across geographical and cultural divides. Most studies on the subject are urban based and among adults. This study was conducted to assess the perception, prevalence and perpetrators among in-school adolescents which represent a unique group and in a rural setting. ⋯ The perception of in-school adolescents on rape still leaves much to be desired. Perpetration and experience of rape remain important global health issues.
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With data available since 1981, firearm death rates in American children and adolescents can be evaluated for trends during the 13 years before, the decade of, and during 16 years since the United States (U.S.) 1994-2004 Federal Assault Weapons Ban (FAWB). ⋯ Firearm death rates in 0-14 year-olds before, during, and after the FAWB, and no other type of injury, implicate the FAWB as having had a beneficial effect. Legislation to mitigate firearm mortality and injury inclusive of a FAWB should be especially beneficial to children and young adolescents, and regardless of sex, race/ethnicity or region in the U.S.
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Systemic injustice has resulted in significant baseline inequality amongst populations according to gradients of privilege. What is the ethical approach to situations wherein equity may require differential treatment to correct for baseline disadvantages as a necessary means to its attainment? We explore this concept through the issue of patient requests for clinician identity concordance, when patients request a clinician who matches their race, ethnicity, or gender. ⋯ Next, we explore the ethics surrounding conditional acceptance through the frames of intent and clinical outcomes. We note the legacy of trauma experienced by marginalized patients at the hands of medicine and the abundance of data suggesting that identity concordance can mitigate disparities.
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Recent trends in healthcare policy from high-volume service models to "high-value" delivery systems have refocused the need for patient-centered approaches to quality care. However, benchmarks of how to define and evaluate successful patient-centeredness have not been sufficiently established. Such ill-defined evaluation criteria can further exacerbate systemic inequities in maximum quality health care delivery, especially based on the intersectional diversity of various patient populations. ⋯ Moreover, treating Black patients as "knowers" emphasizes the prioritization of patient values at the core of providing valuable healthcare. Such an academic, policy, and clinical approach to medicine agrees with well-established principles of medical ethics. In addition, the framework of a phenomenology of medicine can better facilitate physician-patient communication and interaction by delineating often muddled hermeneutics.