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Patient Complexity, Social Factors, and Hospitalization Outcomes at Academic and Community Hospitals.
JAMA Netw Open
January 2025
Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Importance: There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.
Objective: To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.
Health disparities in patients with pulmonary arterial hypertension (PAH) have not been extensively reported in the United States. The aim of this project was to characterize the extent of demographic and socioeconomic disparities in clinical outcomes within a large, diverse PAH patient population. A retrospective, population-based study of electronic health record data from the OneFlorida Data Trust was completed.
View Article and Find Full Text PDFStress reactivity moderates the association between early experiences of unpredictability and emotional problems in adolescents.
Neurobiol Stress
January 2025
Stanford University, Department of Psychology, 450 Jane Stanford Way, Stanford, CA, 94305, USA.
Researchers have documented that exposure to different kinds of psychosocial stressors can lead to emotional difficulties and, further, that heightened reactivity to stress can moderate these associations. Recently, investigators have distinguished among threat, deprivation, and unpredictability as different dimensions of early life stress (ELS). It is not clear, however, whether reactivity in specific stress response systems functions as a diathesis to lead to emotional difficulties following exposure to these dimensions of ELS.
View Article and Find Full Text PDFA Neighborhood-Level Hispanic Paradox: the Interaction between Hispanic Density, Neighborhood Disadvantage, and Survival in Breast Cancer Patients.
Cancer Epidemiol Biomarkers Prev
January 2025
Memorial Sloan Kettering Cancer Center, New York, United States.
Background: To evaluate the impact of Hispanic ethnic enclaves (EE) on the relationship between neighborhood disadvantage and overall survival (OS) in breast cancer (BCa) patients.
Methods: Data from BCa patients with stage I-IV disease diagnosed between 2005-2017 was used to analyze the effects of Area Deprivation Index (ADI) scores, a measure of neighborhood disadvantage, and census-tract level Hispanic density, a measure of EE, on OS using mixed-effects Cox regression models. The final model included the following individual-level factors (age, income, race, Hispanic/Latino origin, nativity, insurance status, and comorbidities (hypertension, diabetes, and body mass index) and clinical factors (National Comprehensive Cancer Network guideline-concordant treatment, stage, and receptor subtype).
Determinants of Racial and Ethnic Differences in Maternal Cardiovascular Health in Early Pregnancy.
Circ Cardiovasc Qual Outcomes
January 2025
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. (N.A.C., X.H., L.C.P., H.N., N.S.S., A.M.P., P.G., D.M.L.-J., K.N.K., S.S.K.).
Background: Suboptimal cardiovascular health (CVH) in pregnancy is associated with adverse maternal and offspring outcomes. To guide public health efforts to reduce disparities in maternal CVH, we determined the contribution of individual- and neighborhood-level factors to racial and ethnic differences in early pregnancy CVH.
Methods: We included nulliparous individuals with singleton pregnancies who self-identified as Hispanic, non-Hispanic Black (NHB), or non-Hispanic White (NHW) and participated in the nuMoM2b cohort study (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be).
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