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Background: Inclusion of racial/ethnic mi­norities in cancer-related research remains inadequate, continuing to impact disparate health outcomes. Data regarding enrollment of racial/ethnic minorities in nontherapeu­tic, health-related research is sparse, and even less is known about enrollment of those with a double disparity of racial/ethnic minorities in rural settings.Objective: To examine perspectives of Latinx and African American (AA) healthy volun­teers from rural and urban settings in five southern US states and Puerto Rico regarding their trust in research and their willingness to participate in nontherapeutic research trials based on who conducts the research.Methods: This study was conducted in 2013 in rural and urban communities across Alabama, Florida, Georgia, Missis­sippi, Louisiana, and Puerto Rico. A 38-item questionnaire based on the Tuskegee Legacy Project Questionnaire assessed willingness, motivators, and barriers to participation in nontherapeutic cancer-related research. The sample was segmented into four subgroups by urban/rural location and race/ethnicity.Results: Of 553 participants (rural Latinx=151, urban Latinx=158, rural AA=122, urban AA=122), more than 90% had never been asked to participate in research, yet 75% of those asked agreed to participate. Most had positive views regard­ing health-related research. Trust in who conducted research varied by subgroup. Personal doctors and university hospitals were most trusted by all subgroups; for-profit and tobacco companies were least trusted. Both Latinx subgroups trusted pharmaceutical companies more than AAs; local hospitals and for-profit businesses were more trusted by AAs. Both rural subgroups trusted research by insurance companies more than their urban counterparts.Conclusions: If asked, rural and urban AA and Latinx healthy volunteers were willing to participate in health-related research, with personal doctors and university hos­pitals considered the most trusted sources to encourage/conduct research.Ethn Dis. 2021;31(2):263-272; doi:10.18865/ed.31.2.263

Healthcare providers in the American medical system may find that patients from different cultures bring unfamiliar expectations, anxieties, and needs into the examination room. To provide optimal care for all patients, it is important to see differences from the patient's perspective and to work with patients from a range of demographics.Caring for Patients from Different Cultureshas been a vital resource for nurses and physicians for more than twenty years, offering hundreds of case studies that illustrate crosscultural conflicts or misunderstandings as well as examples of culturally competent health care. Now in its fifth edition,Caring for Patients from Different Culturescovers a wide range of topics, including birth, end of life, communication, traditional medicine, mental health, pain, religion, and multicultural staff challenges. This edition includes more than sixty new cases with an expanded appendix, introduces a new chapter on improving adherence, and updates the concluding chapter with examples of changes various hospitals have made to accommodate cultural differences. Grounded in concepts from the fields of cultural diversity and medical anthropology,Caring for Patients from Different Culturesprovides healthcare workers with a frame of reference for understanding cultural differences and sound alternatives for providing the best possible care to multicultural communities.

Assessment of Alzheimer's disease (AD)-related neurofibrillary pathology requires a procedure that permits a sufficient differentiation between initial, intermediate, and late stages. The gradual deposition of a hyperphosphorylated tau protein within select neuronal types in specific nuclei or areas is central to the disease process. The staging of AD-related neurofibrillary pathology originally described in 1991 was performed on unconventionally thick sections (100 mum) using a modern silver technique and reflected the progress of the disease process based chiefly on the topographic expansion of the lesions. To better meet the demands of routine laboratories this procedure is revised here by adapting tissue selection and processing to the needs of paraffin-embedded sections (5-15 mum) and by introducing a robust immunoreaction (AT8) for hyperphosphorylated tau protein that can be processed on an automated basis. It is anticipated that this revised methodological protocol will enable a more uniform application of the staging procedure.

Case Studies in Palliative and End-of-Life Care uses a case-based approach to provide students and practitioners with an important learning tool to improve critical thinking skills and encourage discussion toward improving experiences for patients and their families.

Online surveys are a popular source of data collection across organizations and academic settings. Insufficient effort responding (IER) to surveys occurs when participants fail to carefully read survey instructions or item content. Researchers commonly analyze IER as a methodological nuisance. The purpose of this article is to examine the extent to which negative emotions and thoughts predict proactive and reactive IER indicators. A sample of 625 participants completed an online survey containing a background questionnaire, the agreeableness and conscientiousness subscales of the Mini-International Personality Item Pool, the intrinsic motivation subscale of the Situational Motivational Scale, the Boredom Proneness Scale, and three proactive and six reactive IER indices. Binary logistic regression analysis results showed participants who experienced higher levels of state anxiety, distress, and sadness while completing the survey were more likely to not pay attention and/or violate test instructions. Participants who indicated they regretted agreeing to participate in the survey, were more likely to not pay attention, respond dishonestly, respond too quickly, and/or self-report that they had exerted little effort and attention. These findings suggest that IER behaviors are, in part, a manifestation of participants' negative emotions and thoughts. Les sondages en ligne sont des outils populaires pour la collecte de données pour les besoins des organisations, notamment dans un contexte de recherche. On parle d'un effort insuffisant pour répondre aux sondages lorsque les participants ne lisent pas avec soin les consignes ou les énoncés des questions. Généralement, les chercheurs analysent cette insuffisance d'effort en tant que nuisance méthodologique. Cet article a pour but d'examiner la mesure dans laquelle les émotions et les pensées négatives prédisent des indicateurs proactifs et réactifs d'un effort insuffisant. Un échantillon de 625 participants a répondu à un sondage en ligne composé d'un questionnaire sur les antécédents, des sous-échelles «caractère consciencieux » et « amabilité » du Mini-International Personality Item Pool, de la sous-échelle de la motivation intrinsèque de l'Échelle d'évaluation motivationnelle, de l'Échelle de la propension à l'ennui ainsi que des trois indices proactifs et des six indices réactifs de l'effort insuffisant. Les résultats d'une analyse de régression logistique binaire ont révélé que les participants qui présentaient les plus hauts niveaux d'anxiété, de détresse et de tristesse pendant qu'ils répondaient au sondage étaient plus susceptibles de ne pas prêter attention aux consignes de l'exercice ou de les enfreindre. Les participants qui avaient indiqué qu'ils regrettaient d'avoir accepté de participer au sondage étaient plus susceptibles de ne pas prêter attention, de ne pas répondre honnêtement, de répondre trop vite ou encore d'avouer qu'ils y ont consacré peu d'effort et d'attention. Ces résultats laissent supposer que l'insuffisance d'effort est, en partie, une manifestation des émotions et des pensées négatives des participants. Public Significance Statement Insufficient effort responding (IER) can be considered a subtle avoidance behavior in response to negative emotions and thoughts experienced during survey completion. This idea was supported by the results of this study, which showed that participants who reported greater negative emotions and thoughts were more likely to not pay attention, ignore test instructions, respond dishonestly, respond too quickly, and self-report they exerted little effort and attention when completing an online study.

Wiley-Blackwell's Clinical Cases series is designed to recognize the centrality of clinical cases to the profession by providing actual cases with an academic backbone. Clinical Cases in Orthodontics applies both theory and practice to real-life orthodontic cases in a clinically relevant format. This unique approach supports the new trend in case-based and problem-based learning, thoroughly covering topics ranging from Class I malocclusions to orthognathic surgery. Highly illustrated in full color, Clinical Cases in Orthodontics' format fosters independent learning and prepares the reader for case-based examinations.

Precision medicine research designed to reduce health disparities often involves studying multi-level datasets to understand how diseases manifest disproportionately in one group over another, and how scarce health care resources can be directed precisely to those most at risk for disease. In this article, we provide a structured tutorial for medical and public health researchers on the application of machine learning methods to conduct precision medicine research designed to reduce health disparities. We review key terms and concepts for understanding machine learning papers, including supervised and unsupervised learning, regularization, cross-validation, bagging, and boosting. Metrics are reviewed for evaluating machine learners and major families of learning approaches, including tree-based learning, deep learning, and ensemble learning. We highlight the advantages and disadvantages of different learning approaches, describe strategies for interpreting “black box” models, and demonstrate the application of common methods in an example dataset with open-source statistical code in R. Ethu Dis.

Carefully categorized postmortem human brains are crucial for research. The lack of generally accepted methods for processing human postmortem brains for research persists. Thus, brain banking is essential; however, it cannot be achieved at the cost of the teaching mission of the academic institution by routing brains away from residency programs, particularly when the autopsy rate is steadily decreasing. A consensus must be reached whereby a brain can be utilizable for diagnosis, research, and teaching. The best diagnostic categorization possible must be secured and the yield of samples for basic investigation maximized. This report focuses on integrated, novel methods currently applied at the New York Brain Bank, Columbia University, New York, which are designed to reach accurate neuropathological diagnosis, optimize the yield of samples, and process fresh-frozen samples suitable for a wide range of modern investigations. The brains donated for research are processed as soon as possible after death. The prosector must have a good command of the neuroanatomy, neuropathology, and the protocol. One half of each brain is immersed in formalin for performing the thorough neuropathologic evaluation, which is combined with the teaching task. The contralateral half is extensively dissected at the fresh state. The anatomical origin of each sample is recorded using the map of Brodmann for the cortical samples. The samples are frozen at −160°C, barcode labeled, and ready for immediate disbursement once categorized diagnostically. A rigorous organization of freezer space, coupled to an electronic tracking system with its attached software, fosters efficient access for retrieval within minutes of any specific frozen samples in storage. This report describes how this achievement is feasible with emphasis on the actual processing of brains donated for research.