Lessons (Not) Learned: Chicago Death Inequities during the 1918 Influenza and COVID-19 Pandemics.

During historical and contemporary crises in the U.S., Blacks and other marginalized groups experience an increased risk for adverse health, social, and economic outcomes.

Black Mothers in Racially Segregated Neighborhoods Embodying Structural Violence: PTSD and Depressive Symptoms on the South Side of Chicago.

This study employs multi-level and mixed-methods approaches to examine how structural violence affects the health of low-income, single Black mothers. We use multilevel regression models to examine how feeling "trapped" in racially segregated neighborhoods with high levels of violence on the South Side of Chicago affects mothers' (N = 69) reports of posttraumatic stress disorder and depressive symptoms. The relationship between feeling "trapped" and variations in expression of mRNA for the glucocorticoid receptor gene NR3C1 using microarray assays was also examined.

Transcriptomic analyses of black women in neighborhoods with high levels of violence.

Chronic stress threatens an individual's capacity to maintain psychological and physiological homeostasis, but the molecular processes underlying the biological embedding of these experiences are not well understood. This is particularly true for marginalized groups, presenting a fundamental challenge to decreasing racial, economic, and gender-based health disparities. Physical and social environments influence genome function, including the transcriptional activity of core stress responsive genes.

Involving Urban Single Low-Income African American Mothers in Genomic Research: Giving Voice to How Place Matters in Health Disparities and Prevention Strategies.

This article describes the process of using principles from community-based participatory action research to involve low-income, single, African American mothers on the south side of Chicago in genomic research, including as citizen scientists. The South Chicago Black Mothers' Resiliency Project used a mixed methods design to investigate how the stress of living in neighborhoods with high levels of violence affects mothers' mental and physical health. This article seeks to serve as a model for physicians and scholars interested in successfully involving low-income African American mothers in genomic research, and other health-related activities in ways that are culturally sensitive and transformative.

Impact of the Chicago Earned Income Tax Periodic Payment intervention on food security.

This article examines the Earned Income Tax Credit Periodic Payment Pilot and its effectiveness in reducing food insecurity for low-income households. Low-income families in Chicago who were eligible for the Earned Income Tax Credit provided data over four waves of data collection between 2014 and 2015. We utilize longitudinal random effects logit models to test the likelihood of experiencing food insecurity.

The Medicalization of Poverty in the Lives of Low-Income Black Mothers and Children.

Scholars are beginning to use the concept medicalization of poverty to theorize how the United States spends large amounts of money on illnesses related to poverty but invests much less in preventing these illnesses and the conditions that create them (e.g., economic insecurity, housing instability, continuous exposure to violence, and racism).

Fifteen years later: can residential mobility programs provide a long-term escape from neighborhood segregation, crime, and poverty?

We examined whether the Gautreaux residential mobility program, which moved poor black volunteer families who were living in inner-city Chicago into more-affluent and integrated neighborhoods, produced long-run improvements in the neighborhood environments of the participants. We found that although all the participants moved in the 6 to 22 years since their initial placements, they continued to reside in neighborhoods with income levels that matched those of their placement neighborhoods. Families who were placed in higher-income, mostly white neighborhoods were currently living in the most-affluent neighborhoods.

Factors that influence use of a home cardiorespiratory monitor for infants: the collaborative home infant monitoring evaluation.

Background: As part of the Collaborative Home Infant Monitoring Evaluation, a home monitor was developed to record breathing, heart rate, other physiologic variables, and the time the monitor was used.

Objective: To determine the frequency of monitor use, factors that influence use, and validity of a model developed to predict use.

Design: We developed a model to predict monitor use using multiple linear regression analysis; we then tested the validity of this model to predict adherence for the first week of monitoring and for the subsequent 4-week period (weeks 2-5).

Designing fault-tolerant distributed archives for picture archiving and communication systems.

Purpose: Distributed archives in a picture archiving and communication system (PACS) environment can provide added fault tolerance and fail-over capability, as well as increased load capacity at a more economical price than traditional 'high-availability" systems. Systems can be configured with varying levels of fault tolerance, depending on the amount of redundancy desired. There is, however, a direct correlation between the level of hardware redundancy and cost to implement.

Study status consistency and duplicate-read protection in a distributed architecture.

Unlabelled: This presentation will discuss the benefits and pitfalls of implementing a study status and duplicate-read protection mechanism within a distributed picture archiving and communication system (PACS) architecture. There are many advantages to a distributed PACS network in which image studies are proactively pushed to reading stations before they are required by a radiologist. The absence of a central server, which serves on demand, makes managing study status and protecting against duplicate reads challenging.

An electronic simulator for testing infant apnoea monitors that uses actual physiologic data.

An electronic simulator of physiologic signals used in infant monitoring has been designed, constructed and applied in the Collaborative Home Infant Monitor Evaluation (CHIME). A unique feature of the simulator is that it contains actual physiologic waveforms recorded from infants rather than artificial, idealized signals. The simulator stores breathing waveforms that can be used to test transthoracic-impedance- and inductance-plethysmography-based monitors, and heart rate channels are tested by playing a neonatal QRS complex at preset fixed rates or a variable rate as determined from infant recordings.

Cardiopulmonary monitoring at home: the CHIME monitor.

A new physiologic monitor for use in the home has been developed and used for the Collaborative Home Infant Monitor Evaluation (CHIME). This monitor measures infant breathing by respiratory inductance plethysmography and transthoracic impedance; infant electrocardiogram, heart rate and R-R interval; haemoglobin O2 saturation of arterial blood at the periphery and sleep position. Monitor signals from a representative sample of 24 subjects from the CHIME database were of sufficient quality to be clinically interpreted 91.

Are physicians sensitive to the special problems of older patients?

The sensitivity of primary care physicians to the health care needs of older patients was explored by means of an analysis of the use of diagnostic tests and therapeutic procedures during ambulatory visits. Survey data on a total of 28,265 visits to internists, family and general practitioners were examined to determine possible age-related differences in care. The study found that diagnostic testing falls off significantly for patients 75 years of age or older and that internists use substantially more tests for each age group than do family and general practitioners.

Do physicians spend less time with older patients?

In view of the additional time that older persons require for giving and receiving information, as well as for the examination process, it is important for manpower and reimbursement planning to better understand the nature of the physician-patient encounter with the elderly. We examined a series of national surveys of physicians' professional activities and found that physicians tend to spend less time with their older patients and also that encounter time by physicians in different specialties varies widely. Internists and cardiologists spend substantially more time with patients compared with general and family practitioners.

Case-mix and treatment in end-stage renal disease: hemodialysis v peritoneal dialysis.

The University of Southern California School of Medicine conducted a nationwide survey of 336 nephrologists to obtain demographic and clinical data on 6,411 patients with end-stage renal disease (ESRD). Patient demographic data, along with ESRD etiology and comorbid conditions noted by the physician, were compared across various modalities of dialysis. Characteristics of the treatment provided were differentiated by the mode of dialysis and the location of the patient encounter.

Patient counselling by primary care physicians: results of a nationwide survey.

The rate of patient counseling in primary care medicine is a pivotal element of inter-specialty differences in styles of care. Using national data on patient care provided in both ambulatory care settings and in the hospital, this study examines the use of counseling by general and family practitioners, pediatricians, internists, and obstetrician/gynecologists. The findings show substantial differences based on physician specialty, with highest rates of counseling for family practitioners and internists, and rates of patient education for these two specialties almost three times that for general practitioners.

Styles of care provided to children in the United States: a comparison by physician specialty.

This study was based on findings from a national survey of physicians that was conducted from 1975 to 1977. The data concern face-to-face encounters with children in the ambulatory care setting. Over one half of the practices of pediatricians consisted of infants and preschoolers, whereas well over 50 percent of the child patients of other types of physicians were 10 to 19 years old.

Who provides health care to children and adolescents in the United States?

Face-to-face visits by children and adolescents in office-based practice in the mid-1970s were studied. Pediatricians, family physicians, and general practitioners accounted for 35%, 6%, and 30%, respectively, of all child visits. Although 40% to 45% of preventive and medical encounters were with pediatricians, only 12% of visits for minor surgery, 20% of visits for psychosocial problems, and 9% of visits for combined medical-surgical reasons were to pediatricians.

The relative complexity of primary care provided by medical specialists.

Utilizing national data on patient care provided by family practitioners, general internists, and subspecialists in internal medicine, this study examines the complexity of care provided by generalist physicians versus subspecialty physicians on a disease-specific basis. Limiting the analysis to "principal care" provided by office-based physicians, the study finds the complexity of care provided by cardiologists for heart disease and by endocrinologists for diabetes mellitus to be somewhat greater than that provided by family practitioners and general internists, though the magnitude of the differences is not large. For chronic obstructive pulmonary disease, however, pulmonary disease specialists are shown to provide care that is substantially more complex than that provided by their generalist colleagues.

A profile of pediatric practice in the United States.

We profiled pediatric practice in the United States through a second-order analysis of data gathered in 1977 from 429 practicing pediatricians. Age, sex, board certification status, practice arrangement, and practice location of pediatricians in the United States were evaluated, as well as their patterns of practice. The number of and reasons for visits made to pediatricians by patient age and sex were tabulated.

Effect of patient age on duration of medical encounters with physicians.

The authors analyzed the USC/DRME Practice Study data to determine if the characteristics of physician patient encounters change with patient age. The only significant change observed was a decline in encounter time for patients 65 years of age and older compared with those 45 through 64 years of age. This decrease was significant for raw data and for data weighted for the number of physicians of various types and standardized for complexity of case mix in various age groups, also for both nonhospital and hospital encounters and for almost all classes of encounters.

Manpower for obstetrics-gynecology. III. Contributions to total female medical care.

This final report from the cooperative manpower study of the University of Southern California and The American College of Obstetricians and Gynecologists describes the development of a female data file that outlines the care of women patients by all specialties. Obstetrician-gynecologists are compared to other specialists; they see 300,000 women per day in the United States and provide a wide range of care. Preventive care plays a larger role than in other major specialties, patient counseling and education are emphasized, and obstetric care is a major commitment.

The professional role of physician's assistants in adult ambulatory care practices.

This article describes the methodology and findings of a national survey of Physician's Assistants (PAs) in adult, ambulatory care practices. Data on patient care roles and other professional activities were collected for a three-day period via a comprehensive self-reporting, log-diary instrument. Completing the instrument were 356 (50.