Medicine and Health Sciences Commons^™

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

Disparities Among Minority Women With Breast Cancer Living In Impoverished Areas Of California, Sundus Haji-Jama, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Background: Interaction effects of poverty and health care insurance coverage on overall survival rates of breast cancer among women of color and non-Hispanic white women were explored. Methods: We analyzed California registry data for 2,024 women of color (black, Hispanic, Asian, Pacific Islander, American Indian, or other ethnicity) and 4,276 non-Hispanic white women (Anglo-European ancestries and no Hispanic-Latin ethnic backgrounds) diagnosed with breast cancer between the years 1996 and 2000 who were then followed until 2011. The 2000 US census categorized rates of neighborhood poverty. Health care insurance coverage was either private, Medicare, Medicaid, or none. Cox regression was used …

Eliminating Gender-, Racial- And Age-Biases In Medical Diagnostic Reasoning (Paper), Brian Macpherson Dr.

OSSA Conference Archive

Much attention has been paid in the literature to the deleterious effects of errors in diagnostic reasoning due to underlying cognitive biases. This is an important topic since people’s lives and well-being are at stake. Empirical studies cited by Chapman et al. (2013) corroborate the view that gender, racial, or age biases exist in a significant number of clinicians, thereby limiting objective diagnosis. Croskerry (2003, 2013) endorses a so-called metacognitive (or cognitive ‘forcing’) approach to achieve de-biasing in clinicians, a key component of which is critical self-reflection on one’s own diagnostic reasoning (Croskerry, 2003). However, the first empirical study of …

Commentary On “Eliminating Gender-, Racial- And Age-Biases In Medical Diagnostic Reasoning”, Steve Oswald

OSSA Conference Archive

No abstract provided.

The Normative Significance Of Deep Disagreement, Tim Dare

OSSA Conference Archive

Some normative problems are difficult because of the number and complexity of the issues they involve. Rational resolution might be hard but it seems at least possible. Other problems are not merely complex and multi-faceted but ‘deep’. They have a logical structure that precludes rational resolution. Treatments of deep disagreement often hint at sinister implications. If doubt is cast on our 'final vocabulary', writes Richard Rorty, we are left with "no noncircular argumentative recourse .... [B]eyond them there is only helpless passivity or a resort to force.” I will argue that some normative problems are deep, but that we need …

Heredity In The Epigenetic Era: Are We Facing A Politics Of Reproductive Obligations?, Michael J. Crawford

Biological Sciences Publications

Recent research in the emerging field of epigenetics has implications with the potential to re-ignite acrimony in the discourse of reproductive rights, medical ethics, and the role of the state in our homes and in our lives. For scientists, epigenetics has profoundly realigned our understanding of heredity: epigenetics provides a mechanism through which the environmental challenges met in one generation can be inscribed and transmitted to future offspring. Although both genetic parents have the potential to transmit heritable epigenetic changes to their offspring, mothers have a particularly potent effect because nutrition in the uterine environment can exert a supplemental effect …

Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman

Sociology, Anthropology, and Criminology Publications

This paper reports on a social marketing campaign directed toward high-risk men who have sex with men (MSM) in Toronto and Ottawa to: encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and post-campaign survey of sexually active MSM and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an …

Hivpositive People's Perspectives On Canadian Criminal Law And Non-Disclosure, Barry D. Adam, Jason Globerman, Richard Elliott, Patrice Corriveau, Ken English, Sean Rourke

Sociology, Anthropology, and Criminology Publications

The largest survey to date of people living with HIV regarding attitudes toward criminalization of HIV non-disclosure, this study investigates: sources of legal information available to HIV-positive people; perceptions of how criminal prosecutions and media coverage affect understanding of rights and responsibilities of self and others; and where HIV-positive people themselves stand on the role the criminal justice system should play. While mainstream media constructions of criminal iconography do affect PHA views, those who have higher levels of formal education, are active in the dating scene, and have been living longer with HIV hold less punitive views than those who …

Gender Differences On The Interacting Effects Of Marital Status And Health Insurance On Long-Term Colon Cancer Survival In California, 1995-2014, Derek Campbell, Kevin M. Gorey, Isaac N. Luginaah, Guangyong Zou, Caroline Hamm, Eric J. Holowaty

Social Work Publications

Objectives. Long-term colon cancer survival is not well explained by main effects. We explored the interaction of age, gender, marital status, health insurance and poverty on 10-year colon cancer survival.

Methods. California registry data were analyzed for 5,776 people diagnosed from 1995 to 2000; followed until 2014. Census data classified neighborhood poverty. We tested interactions with regressions and described them with standardized rates and rate ratios (RR).

Results. The 5-way interaction was significant, suggesting larger 4-way disadvantages among non-Medicare-eligible people. A significant 4-way interaction was a 3-way interaction in non-high poverty neighborhoods only. Private insurance was protective for unmarried …