Socioeconomic status and the effectiveness of treatment for first‐episode psychosis

ObjectiveTo assess whether patient socioeconomic status (SES) moderates the effectiveness of coordinated specialty care for first‐episode psychosis and to investigate possible mechanisms.Data SourcesA secondary analysis of data from the RAISE‐ETP Trial, which was conducted from 2010‐2014.Study DesignRAISE‐ETP was a cluster‐randomized trial comparing a coordinated specialty care (CSC) intervention called NAVIGATE with usual community care. We constructed a patient SES index based on parental education, parental occupational prestige, and race/ethnicity. After identifying correlates of SES, we used OLS regression analysis to estimate treatment effects on the major study outcomes across quartiles of the index. We also examined whether correlates of SES including the duration of untreated psychosis (DUP), and participation in NAVIGATE might account for the observed difference in effectiveness of CSC by SES.Principal FindingsThe trial sample had a similar SES distribution to the US population, and SES was positively correlated with all mental health outcomes and several potential moderators at baseline. CSC substantially improved the main trial outcomes compared to community care for patients in the highest SES quartile but had small and statistically insignificant benefits for the remaining 75% of patients. Intervention participation rates and several potential moderators did not explain this disparity.ConclusionsCSC may be more effective for high‐SES patients with early psychosis than low‐SES patients. Additional research is needed to understand why CSC is less effective for low‐SES patients and to develop methods to increase effectiveness for this subgroup.     

Protocolo del Estudio Poblacional Multinivel de las Desigualdades Socioeconómicas en la Distribución Geográfica de la Incidencia,la Mortalidad y la Supervivencia Neta del Cáncer en España: Estudio DESOCANES

Incidence and mortality provide information on the burden of cancer morbidity and the potential years of life lost due to cancer. The Spanish Deprivation Index (SDI) has been developed as a standardized measure to study socioeconomic deprivation in Spain at the census tract level. In addition, SDI information can be combined with ecological variables at the population level and data from the High-Resolution European Studies in Cancer. The aim of this study is to characterize socioeconomic inequalities in incidence, excess mortality, premature mortality and net survival for three of the most incident cancers (lung, colon-rectum and breast) in Spain using the SDI. This national population-based study will assess the impact of socioeconomic inequalities using a multilevel modelling approach. Spatial analysis, multilevel modeling, net survival and economic impact assessment will be used. The results will be useful for supporting decision-making, planning, and management of public health interventions aimed at reducing the impact of socioeconomic inequalities in the diagnosis and prognosis of cancer patients in Spain.     

Feeding inequality: food insecurity,social status and college student health

A growing but limited body of research has identified the college student population as one that is particularly vulnerable to food insecurity. Early estimates of food insecurity prevalence among college students range from 14 to 60 per cent. The present study utilises original survey data collected from a random sample (n = 300) of college students enrolled at an urban university in the Midwest region of the United States of America (USA). This study examines the impact of food insecurity on health outcomes and the mediation of this relationship by subjective social status among college students. Ordinary least squares (OLS) and logistic regression analyses find that food insecurity is related to worse self-rated, physical and mental health among college students, and Sobel-Goodman tests find that subjective social status plays a significant mediating role in the relationship between food insecurity and health among college students. The implications of these findings in a university context are discussed using a psychosocial framework and insights from the stress process model. In doing so, I discuss food insecurity among college students with an emphasis on the social significance of food and food insecurity.     

贵阳市慢性病综合防控示范区居民重点慢性病死亡及早死概率分析

目的 分析贵阳市慢性病综合防控示范区重点慢性病死亡及早死概率情况,评价慢性病综合防控示范区居民健康水平。方法 利用贵阳市2018年5个慢性病综合防控示范区死亡监测数据,根据WHO推荐的早死概率计算方法,计算慢性病综合防控示范区居民心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病等四类重点慢性病死亡水平和早死概率。结果 贵阳市慢性病综合防控示范区四类重点慢病报告死亡率为463.26/10万,其中男性死亡率为520.27/10万,女性死亡率为402.62/10万;城市居民死亡率为425.87/10万,农村为509.07/10万。四类重点慢病早死概率为15.95%,其中男性早死概率为20.64%,女性为10.87%,男性四大类重点慢病均高于女性;城市居民为14.75%,农村为17.39%,除糖尿病外,其余三类重点慢病农村地区早死概率均高于城市。结论 贵阳市慢性病综合防控示范区创建对降低因慢性非传染性疾病死亡具有积极的影响,应持续加大和推广慢病综合防控示范区建设。同时应对农村地区和男性群体的重点慢性病防控工作给予更多的政策和防控支持。     

河南省地方医学院校人文社科发展现状及改革路径

医学院校人文社科发展水平是影响医学生人文精神培养、医学人文教育教学改革的决定性因素。研究选取河南省两所独立设置的本科医学院校,以河南省20所本科高校为参比对象,发现地方医学院校与综合性大学、其他行业类型高校在人文社科建设投入和产出方面存在较大差距,主要由于基础薄弱、受重视程度不够、资源投入有限等原因造成,医学院校应从重视人文社科发展、遵循学科发展规律、科学制定发展规划、完善激励机制等方面加强人文社科建设工作。     

天津市三级医院临床医生科研情况调查初探

目的:了解天津市三级医院临床医生的科研现状、态度以及存在的问题,为提高临床科研成果转化提供理论依据。方法:2018年7月,采用目的抽样的方法,对天津市三级医院在职在岗的临床医生进行问卷调查,通过网络问卷调查平台收集问卷,共有93位临床医生参与问卷调查,其中三级综合医院62位,三级专科医院31位;利用SPSS19.0进行统计分析。结果:65.6%的临床医生认为有做科研的必要;55.9%的临床医生会选择主动做科研;74.2%的临床医生认为工作繁重,没有多余时间精力是限制其参与科研工作的首要因素;临床医生需要提高的科研技能为:学习科研设计、理论与技术培训、统计学方法的学习。结论:临床医生缺乏充足时间投入科研工作,且不具备实现科研目的能力,应该加强天津市“政、产、学、研”一体化的医学科技创新协作平台建设,不同机构承担不同角色,充分发挥各自优势共同发展,实现成果输出和转化最大化。