Ethical Challenges in Chronic Pain.

Health care providers are ethically obligated to provide effective management for patients suffering from chronic pain. Many patients have not had access to such management, and current bioethical principles are not sufficient to create the roadmap needed on how to improve current standard of care. Principles described in the emerging field of urban bioethics greatly enhance the toolbox available to providers regarding chronic pain management.

Expanding buprenorphine treatment to people experiencing homelessness through a mobile, multidisciplinary program in an urban, underserved setting.

Background And Objectives: Inequities in access to buprenorphine treatment remain despite measures to increase access to treatment. "Begin the Turn," a low-barrier, multidisciplinary mobile care unit with access to outreach services, counseling, case management, and buprenorphine treatment addresses these disparities in an urban setting.

Methods: Retrospective medical record review of patients during the initial 6 months of operation abstracted patient demographics and clinical data, including 10 categories of adverse childhood experiences (ACEs) using a total number of ACEs (ACE score) and measuring scores greater than or equal to 4 given higher risk of chronic disease states at this level.

The Intersection of Urban and Global Health.

Providers from high-income countries are often drawn to practicing medicine in settings identified as having greater need, whether that be in a low- or middle-income country or within an underserved area within their own high-income country. Despite sharing the goal of fostering health equity, global health and urban health are often considered in dichotomous ways. This article points a lens at the intersection of these 2 fields, highlighting what they can learn from each other.

What Should Be the Scope of Physicians' Roles in Responding to Gun Violence?

What role, if any, physicians should have in the response to gun violence is a question not only of professionalism but also of law, culture, and ethics. We argue that physicians do have important roles to play in the larger landscape of advocacy, public opinion, and reduction of gun violence, but that it is not ethically or legally appropriate for them to serve as gatekeepers of gun privileges by assessing competency.

Path to health asthma study: A survey of pediatric asthma in an urban community.

Objective: Minority children with asthma who live in low-income urban communities bear a disproportionate burden of the disease. This study explores the perceived health care needs related to asthma care, identifies asthma triggers, potential barriers to care, and assesses the need for additional community resources.

Methods: We conducted a cross-sectional survey of Hispanic and African American adults (n = 53) who take care of a child with asthma and live in an urban community of North Philadelphia.

Impacting Health Disparities in Urban Communities: Preparing Future Healthcare Providers for "Neighborhood-Engaged Care" Through a Community Engagement Course Intervention.

It is well known that health disparities exist and that a significant majority of patients who suffer disproportionately from them are lower income, non-white residents of dense, and diverse urban neighborhoods. It is our belief that factors hindering the reduction of health disparities in these neighborhoods are a lack of a framework and preparation needed to engage these communities in identifying specific health care needs. This paper describes one curricular intervention, a graduate level community engagement course, developed within an academic medical center located in an urban setting, that demonstrates promise in effecting change in the extent to which clinicians are able to engage communities and practice "neighborhood-engaged care" with the central goal of mitigating disparities.

A comparative study of professional student stress.

A study was conducted involving a group of 290 medical and dental students to directly compare perceived stress levels encountered during their education. A modified questionnaire based on Garbee et al.'s Dental Environmental Stress survey was provided to the students by either email or paper.

A cancer pain primer.

Opportunities exist for improving cancer pain management. Medical-surgical nurses must partner with patients and families to achieve optimal pain management. They must use valid tools to assess patients and be knowledgeable about pharmacologic and nonpharmacologic measures to manage pain.