UNASSIGNED: Young men who have sex with men and young transgender women (YMSM-YTW) use online spaces to meet sexual partners with increasing regularity, and research shows that experiences of racism online mimics the real world.
UNASSIGNED: We analyzed differences by race and ethnicity in web-based and mobile apps used to meet sexual partners as reported by Chicago-based YMSM-YTW in 2016-2017.
UNASSIGNED: A racially and ethnically diverse sample of 643 YMSM-YTW aged 16-29 years were asked to name websites or mobile apps used to seek a sexual partner in the prior 6 months, as well as provide information about sexual partnerships from the same period. We used logistic regression to assess the adjusted association of race and ethnicity with (1) use of any website or mobile apps to find a sexual partner, (2) use of a \"social network\" to find a sexual partner compared to websites or mobile apps predominantly used for dating or hookups, (3) use of specific websites or mobile apps, and (4) reporting successfully meeting a sexual partner online among website or mobile app users.
UNASSIGNED: While most YMSM-YTW (454/643, 70.6%) used websites or mobile apps to find sexual partners, we found that Black non-Hispanic YMSM-YTW were significantly less likely to report doing so (comparing White non-Hispanic to Black non-Hispanic: adjusted odds ratio [aOR] 1.74, 95% CI 1.10-2.76). Black non-Hispanic YMSM-YTW were more likely to have used a social network site to find a sexual partner (comparing White non-Hispanic to Black non-Hispanic: aOR 0.20, 95% CI 0.11-0.37), though this was only reported by one-third (149/454, 32.8%) of all app-using participants. Individual apps used varied by race and ethnicity, with Grindr, Tinder, and Scruff being more common among White non-Hispanic YMSM-YTW (93/123, 75.6%; 72/123, 58.5%; and 30/123, 24.4%, respectively) than among Black non-Hispanic YMSM-YTW (65/178, 36.5%; 25/178, 14%; and 4/178, 2.2%, respectively) and Jack\'d and Facebook being more common among Black non-Hispanic YMSM-YTW (105/178, 59% and 64/178, 36%, respectively) than among White non-Hispanic YMSM-YTW (6/123, 4.9% and 8/123, 6.5%, respectively). Finally, we found that while half (230/454, 50.7%) of YMSM-YTW app users reported successfully meeting a new sexual partner on an app, Black non-Hispanic YMSM-YTW app users were less likely to have done so than White non-Hispanic app users (comparing White non-Hispanic to Black non-Hispanic: aOR 2.46, 95% CI 1.50-4.05).
UNASSIGNED: We found that Black non-Hispanic YMSM-YTW engaged with websites or mobile apps and found sexual partners systematically differently than White non-Hispanic YMSM-YTW. Our findings give a deeper understanding of how racial and ethnic sexual mixing patterns arise and have implications for the spread of sexually transmitted infections among Chicago\'s YMSM-YTW.

BACKGROUND: While timely activation and collaborative teamwork of Rapid Response Teams (RRTs) are crucial to promote a culture of safety and reduce preventable adverse events, these do not always occur. Understanding nurses\' perceptions of and experiences with RRTs is important to inform education and policy that improve nurse performance, RRT effectiveness, and patient outcomes.
OBJECTIVE: The aim of this study was to explore nurse perceptions of detecting patient deterioration, deciding to initiate RRTs, and experience during and at conclusion of RRTs.
METHODS: A qualitative descriptive study using semi-structured focus group interviews was conducted with 24 nurses in a Chicago area hospital. Interviews were audio-recorded, transcribed verbatim, and coded independently by investigators. Thematic analysis identified and organized patterns of meaning across participants. Several strategies supported trustworthiness.
RESULTS: Data revealed five main themes: identification of deterioration, deciding to escalate care, responsiveness of peers/team, communication during rapid responses, and perception of effectiveness.
CONCLUSIONS: Findings provide insight into developing a work environment supportive of nurse performance and interprofessional collaboration to improve RRT effectiveness. Nurses described challenges in identification of subtle changes in patient deterioration. Delayed RRT activation was primarily related to negative attitudes of responders and stigma. RRT interventions were often considered a temporary fix leading to subsequent RRTs, especially when patients needing a higher level of care were not transferred. Implications include the need for ongoing RRT monitoring and education on several areas such as patient hand-off, RRT activation, nurse empowerment, interprofessional communication, role delineation, and code status discussions.

UNASSIGNED: Whether early childhood education is associated with a wide range of adult outcomes above and beyond individual- and family-level outcomes is unknown. As a consequence of improving educational and career success, it is postulated that participation in high quality, comprehensive programs can promote residence in more supportive community contexts in adulthood.
UNASSIGNED: To investigate whether participation in high-quality early childhood programs (ECP) in high-poverty neighborhoods is associated with neighborhood-level social determinants of health (SDH) at midlife.
UNASSIGNED: This cohort study analyzed data from the Chicago Longitudinal Study, a prospective cohort investigation following-up 989 children aged 3 to 4 years attending the Child-Parent Center (CPC) preschool program between 1983 and 1985 and a comparison group of 550 children using a nonrandomized trial design. Participants from the original sample who completed a telephone interview on health and well-being between ages 32 and 37 years were included in this analysis. Data analysis was conducted from April to June 2024.
UNASSIGNED: Participation in a CPC program, which includes preschool (ages 3 to 4 years) and school-age (kindergarten through third grade), vs usual early education programs.
UNASSIGNED: The study used a new SDH measure (Index of Structural Equality and Support [I-SES]) based on the Healthy People 2030 framework. This 9-item index score included neighborhood-level assessment, measurement of the quality of education and health services, and assessment of racial discrimination in social and community contexts. Years of education by age 34 years was assessed as the key mediator of influence.
UNASSIGNED: A total of 1124 individuals (mean [SD] age at survey completion, 34.9 [1.4] years; 614 women [54.6%]; 1054 non-Hispanic Black [93.8%]; 69 Hispanic [6.2%]; 1 non-Hispanic White [<0.1%]) were included in the study, of whom 740 were in the CPC cohort and 384 were in the comparison cohort. After adjustment for baseline attributes and attrition, compared with no CPC preschool, CPC preschool was associated with significantly higher mean (SD) I-SES scores (5.93 vs 5.53; mean difference, 0.40; 95% CI, 0.16-0.65; standardized mean difference = 0.22). Compared with CPC participation for 0 to 3 years, CPC participation for 4 to 6 years showed a similar pattern of positive associations (adjusted mean I-SES score, 5.97 vs 5.69; mean difference, 0.28; 95% CI, 0.06-0.50; P = .01; SMD = 0.15). CPC participation had a larger-magnitude association with I-SES in married vs single-parent households. Years of education partially mediated the association of CPC with I-SES (up to 41%), especially among those growing up in the highest-poverty neighborhoods.
UNASSIGNED: This cohort study found that early childhood programming is associated with SDH in adulthood. These findings reinforce the importance of early childhood education in addressing health disparities and contributing to healthier, more equitable communities and suggest that educational attainment is a key mechanism for health promotion.

UNASSIGNED: We investigated the associations of lifetime and everyday discrimination with cognitive function.
UNASSIGNED: Data were from the Chicago Community Adult Health Study (n=2952, mean age=43 years [SD=17]). We fitted multivariable linear regression models to quantify the discrimination-cognition associations.
UNASSIGNED: Major lifetime (β1 vs 0 episodes of discrimination  = 0.56; 95% CI, 0.15-0.96; β2+ vs 0 episodes of discrimination  = 0.64, 95% CI, 0.31-0.97) and everyday (β=0.10, 95% CI, 0.06-0.14) discrimination were positively associated with cognition, and these associations did not differ by race/ethnicity. Among older adults, major lifetime discrimination, but not everyday discrimination, was positively associated with cognition (β2+ vs 0 episodes of discrimination =1.79; 95% CI, 0.79-2.79).
UNASSIGNED: Measurement and selection bias may partially explain the counterintuitive study findings. We call for longitudinal research to further investigate the discrimination-cognition relationship.

None.

None.

BACKGROUND: Inequities in COVID-19 infection and vaccine uptake among historically marginalised racial and ethnic groups in the USA persist. Individuals with rheumatic conditions, especially those who are immunocompromised, are especially vulnerable to severe infection, with significant racialised inequities in infection outcomes and in vaccine uptake. Structural racism, historical injustices and misinformation engender racial and ethnic inequities in vaccine uptake. The Popular Opinion Lleader (POL) model, a community-based intervention that trains trusted community leaders to disseminate health information to their social network members (eg, friends, family and neighbours), has been shown to reduce stigma and improve care-seeking behaviours.
METHODS: This is a community-based cluster randomised controlled trial led by a team of community and academic partners to compare the efficacy of training POLs with rheumatic or musculoskeletal conditions using a curriculum embedded with a racial justice vs a biomedical framework to increase COVID-19 vaccine uptake and reduce vaccine hesitancy. This trial began recruitment in February 2024 in Boston, Massachusetts and Chicago, Illinois, USA. Eligible POLs are English-speaking adults who identify as Black and/or of African descent, have a diagnosis of a rheumatic or musculoskeletal condition and have received >=1 COVID-19 vaccine after 31 August 2022. POLs will be randomised to a 6-module virtual educational training; the COVID-19 and vaccine-related content will be the same for both groups however the framing for arm 1 will be with a racial justice lens and for arm 2, a biomedical preventative care-focused lens. Following the training, POLs will disseminate the information they learned to 12-16 social network members who have not received the most recent COVID-19 vaccine, over 4 weeks. The trial\'s primary outcome is social network member COVID-19 vaccine uptake, which will be compared between intervention arms.
BACKGROUND: This trial has ethical approval in the USA. This has been approved by the Mass General Brigham Institutional Review Board (IRB, 2023P000686), the Northwestern University IRB (STU00219053), the Boston University/Boston Medical Center IRB (H-43857) and the Boston Children\'s Hospital IRB (P00045404). Results will be published in a publicly accessible peer-reviewed journal.
BACKGROUND: NCT05822219.

暂无摘要。

BACKGROUND: The maldistribution of pharmacy services in underserved areas is a national issue. Analysis of data from the 2019 National Pharmacist Workforce Study indicated that 13.9% of pharmacists were working in a rural community. However, the percentage of people living in rural communities in the United States is 20.0%. Currently, there are 20 rural pharmacy programs in the United States, including the Rural Pharmacy Education (RPHARM) Program at University of Illinois Chicago (UIC) College of Pharmacy, which contain both didactic and experiential rural components. This research project examines the practice outcomes of the RPHARM Program graduates.
METHODS: Descriptive analysis was used to examine the practice outcome characteristics of RPHARM Program graduates between 2014 and 2023. The characteristics of the RPHARM graduates included the rurality of hometowns, practice locations and populations, and distance of practice locations to hometowns. Rural practice outcomes were described utilizing frequently used rural definitions. The practice locations of 54 of the 61 RPHARM graduates were used in the analysis.
RESULTS: Approximately 41% of the practicing RPHARM graduates were from rural hometowns and two-thirds were female. RPHARM graduates mostly work in either a community setting (44.4%) or a hospital setting (37.0%). Approximately 11% worked in a federal government organization and 5.6% worked in a long-term care pharmacy. When examining job location, 42.6% were working in a rural location based on Rural-Urban Commuting Area Version 3.0 and 35.2% of RPHARM graduates had always worked in a rural location. Approximately 57% of practicing RPHARM graduates are working in a location < 50 miles from their hometown, and 13% are working 50 to 100 miles from their hometown. Approximately 74% of RPHARM graduates are practicing in Illinois.
CONCLUSIONS: Approximately 40% of RPHARM graduates practice in rural locations. A significant portion (35.2%) of RPHARM graduates have always practiced in rural locations, and many (57.4%) are practicing near their hometowns. Results indicate that the RPHARM Program is making meaningful contributions to increasing the rural pharmacy workforce. Due to the lack of information on rural pharmacy practice outcomes, all programs with rural pharmacy content are encouraged to track graduates\' practice locations.

暂无摘要。