12 results on '"Stone, Valerie E."'
Search Results
2. Recommendations for teaching about racial and ethnic disparities in health and health care
- Author
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Smith, Wally R., Betancourt, Joseph R., Wynia, Matthew K., Bussey-Jones, Jada, Stone, Valerie E., Phillips, Christopher O., Fernandez, Alicia, Jacobs, Elizabeth, and Bowles, Jacqueline
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Medical personnel -- Education ,Discrimination in medical care -- Social aspects ,Discrimination in medical care -- Educational aspects ,Health - Abstract
Racial and ethnic minorities often receive lower-quality health care than white patients, even when socioeconomic status, education, access, and other factors are used as controls. To address these pervasive disparities, health care professionals should learn more about them and the roles they can play in eliminating them, but few curricula are focused on understanding and addressing racial and ethnic health disparities, and well-accepted guidelines on what and how to teach in this complex area are lacking. The Society of General Internal Medicine Health Disparities Task Force used a review and consensus process to develop specific recommendations and guidelines for curricula focusing on health disparities. Learning objectives, content, methods for teaching, and useful resources are provided. Although the guidelines were developed primarily for teaching medical students, residents, and practitioners in primary care, the Task Force's general recommendations can apply to learners in any specialty. The Task Force recommends that a curricula address 3 areas of racial and ethnic health disparities and focus on the following specific learning objectives: 1) examining and understanding attitudes, such as mistrust, subconscious bias, and stereotyping, which practitioners and patients may bring to clinical encounters; 2) gaining knowledge of the existence and magnitude of health disparities, including the multifactorial causes of health disparities and the many solutions required to diminish or eliminate them; and 3) acquiring the skills to effectively communicate and negotiate across cultures, languages, and literacy levels, including the use of key tools to improve communication. The broad goal of a curriculum on disparities should be for learners to develop a commitment to eliminating inequities in health care quality by understanding and assuming their professional role in addressing this pressing health care crisis.
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- 2007
3. Provider attitudes regarding participation of women and persons of color in AIDS clinical trials
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Stone, Valerie E., Mauch, Maya Y., and Steger, Kathleen A.
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AIDS (Disease) -- Research ,Clinical trials -- Demographic aspects ,Health - Abstract
Underreprestation of women and people of color in AIDS clinical trials may be, at least in part, the result of the perceptions of providers. Despite the fact that AIDS is disproportionately present among women and blacks and Latinos, fewer people of these groups are involved in clinical trials. Providers, responding to questions, felt a lack of confidence explaining trials to non-English speaking people. They also believed the interest of African Americans and Latinos and Haitians to be lower than average, suggesting suspicion about trials was the reason. These attitudes were held despite the race or gender of the provider.
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- 1998
4. Cardiac manifestations of HIV/AIDS: a review of disease spectrum and clinical management
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Yunis, Nidal A. and Stone, Valerie E.
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HIV infection -- Complications ,Heart diseases -- Causes of ,Pericardium -- Diseases ,Myocarditis -- Causes of ,Pericardial effusion -- Causes of ,Health - Abstract
HIV infection can cause pericardial effusion, myocarditis, dilated cardiomyopathy, and other types of heart disease. Immune system decline and opportunistic infections can lead to multiple organ system dysfunction, including heart conditions. As many as 40% of HIV patients may have accumulations of fluid in the pericardium, a membrane around the heart which can also become infected. Inflammation of the heart muscle is discovered in autopsies of approximately half of HIV patients. Inflammation of coronary arteries may also complicated infection with HIV.
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- 1998
5. The effects of intravenous drug use and gender on the cost of hospitalization for patients with AIDS
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Seage, George R., III, Hertz, Tom, Stone, Valerie E., and Epstein, Arnold M.
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Drug addicts -- Care and treatment ,AIDS patients -- Hospital care ,Hospital utilization -- Demographic aspects ,Intravenous drug abuse -- Economic aspects ,Health - Abstract
The cost of hospitalization may be higher for intravenous drug users (IVDUs) with AIDS than for other AIDS patients. Among 291 patients who were diagnosed with AIDS in Massachusetts during 1987, 74 were male IVDUs; 69 were women, including 32 IVDUs, and 148 were men who did not use intravenous drugs. IVDUs with AIDS were hospitalized 42% longer than than male non-IVDU homosexual men with AIDS. The cost for each hospitalization was also 38% higher for IVDUs. The patient's gender did not affect significantly the length of hospital stay or the cost of each hospitalization significantly. IVDUs survived an average of 352 days after diagnosis, compared with an average of 468 days for homosexual men. The incidence of HIV infection increased significantly among IVDUs during the late 1980s, and this is apparently leading to higher AIDS care costs.
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- 1993
6. Open notes: Unintended consequences and teachable moments
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Hutchins, George Patrick Joseph, Stone, Valerie E, and Hall, Kathryn T
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- 2023
- Full Text
- View/download PDF
7. Promoting Success: A Professional Development Coaching Program for Interns in Medicine
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Palamara, Kerri, Kauffman, Carol, Stone, Valerie E., Bazari, Hasan, and Donelan, Karen
- Abstract
ABSTRACTBackground Residency is an intense period. Challenges, including burnout, arise as new physicians develop their professional identities. Residency programs provide remediation, but emotional support for interns is often limited. Professional development coaching of interns, regardless of their performance, has not been reported.Objective Design, implement, and evaluate a program to support intern professional development through positive psychology coaching.Methods We implemented a professional development coaching program in a large residency program. The program included curriculum development, coach-intern interactions, and evaluative metrics. A total of 72 internal medicine interns and 26 internal medicine faculty participated in the first year. Interns and coaches were expected to meet quarterly; expected time commitments per year were 9 hours (per individual coached) for coaches, 5 1/2 hours for each individual coachee, and 70 hours for the director of the coaching program. Coaches and interns were asked to complete 2 surveys in the first year and to participate in qualitative interviews.Results Eighty-two percent of interns met with their coaches 3 or more times. Coaches and their interns assessed the program in multiple dimensions (participation, program and professional activities, burnout, coping, and coach-intern communication). Most of the interns (94) rated the coaching program as good or excellent, and 96 would recommend this program to other residency programs. The experience of burnout was lower in this cohort compared with a prior cohort.Conclusions There is early evidence that a coaching program of interactions with faculty trained in positive psychology may advance intern development and partially address burnout.
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- 2015
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8. Ambulatory Training for Primary Care General Internists: Innovation With the Affordable Care Act in Mind
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Rieselbach, Richard E., Feldstein, David A., Lee, Patrick T., Nasca, Thomas J., Rockey, Paul H., Steinmann, Alwin F., and Stone, Valerie E.
- Abstract
AbstractBackgroundAlthough primary care general internists (PCGIs) are essential to the physician workforce and the success of the Affordable Care Act, they are becoming an endangered species.ObjectiveWe describe an expanded program to educate PCGIs to meet the needs of a reformed health care system and detail the competencies PCGIs will need for their roles in team-based care.InterventionWe recommended 5 initiatives to stabilize and expand the PCGI workforce: (1) caring for a defined patient population, (2) leading and serving as members of multidisciplinary health care teams, (3) participating in a medical neighborhood, (4) improving capacity for serving complex patients in group practices and accountable care organizations, and (5) finding an academic role for PCGIs, including clinical, population health, and health services research. A revamped approach to PCGI education based in teaching health centers formed by community health center and academic medical center partnerships would facilitate these curricular innovations.Anticipated OutcomesNew approaches to primary care education would include multispecialty group practices facilitated by electronic consultation and clinical decision-support systems provided by the academic medical center partner. Multiprofessional and multidisciplinary education would prepare PCGI trainees with relevant skills for 21st century practice. The centers would also serve as sites for state and federal Medicaid graduate medical education (GME) expansion funding, making this funding more accountable to national health workforce priorities.ConclusionsThe proposed innovative approach to PCGI training would provide an innovative educational environment, enhance general internist recruitment, provide team-based care for underserved patients, and ensure accountability of GME funds.
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- 2014
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9. Race, Gender, Drug Use, and Participation in AIDS Clinical Trials: Lessons from a Municipal Hospital Cohort
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Stone, Valerie E., Mauch, Maya Y., Steger, Kathleen, Janas, Stephen F., and Craven, Donald E.
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To determine whether participation rates of women, persons of color, and injection drug users in AIDS clinical trials are similar to those of other HIV/AIDS patients, and to examine whether differences in patients' knowledge of clinical trials or reasons for not participating explain differences in participation rates by gender, race, or drug use. Cross-sectional survey of patients with HIV disease. Ambulatory practice of a municipal teaching hospital. Two hundred sixty patients receiving primary care for HIV disease. Overall, 22.3% of patients had participated in a clinical trial. Women, patients of color, and drug users were significantly less likely to have ever participated in an AIDS clinical trial (p < .05). Multiple logistic regression confirmed being a person of color (odds ratio [OR] 2.14; 95% confidence interval [CI] 1.12-4.08) and injection drug use (OR 2.09; 95% CI 1.08-4.04) as significant predictors of nonparticipation in AIDS clinical trials (p < .05). Patients of color and women reported less knowledge of clinical trials, and were less likely to have been told about clinical trials for which they were eligible (p < .05). Patients of color were half as likely as whites to cite ineligibility as their reason for not participating (10.4% vs 22.4%), and more likely to hold unfavorable opinions of clinical research (50.7% vs. 40.5%). Reasons for nonparticipation did not differ by gender. Even when AIDS clinical trials are available on-site, persons of color, women, and drug users are less likely to participate. Educational efforts for patients and providers are needed to remedy continuing disparities in participation by race, gender, and risk factor group in AIDS clinical trials.
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- 1997
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10. Social Interaction and Social Development in Virtual Environments
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Stone, Valerie E.
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Like most new technologies, virtual reality (VR) has been the subject of a great deal of idealization. This paper both debunks that idealization by discussing some problems that certain types of VR could cause and emphasizes how other types of VR could bring the technology closer to its ideal. Virtual reality is divided into four types: social (there are real other people to interact with), nonsocial (other interactants are simulations of people), creative (users can create elements in the virtual environment), and noncreative (users interact with a fixed environment created for them). Nonsocial VR may cause problems by making it difficult for children and adolescents to learn social skills. Noncreative VR is problematic because it places limits on users' creativity and freedom. Engineers developing VR technology are encouraged to develop social and creative VR.
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- 1993
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11. A Key Strategy for Reducing HIV in African American Communities: Promoting HIV Testing
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Arya, Monisha., Tionne Williams, Lena., Stone, Valerie E., Louise Behforouz, Heidi., Viswanath, Kasisomayajula., and Peter Giordano, Thomas.
- Abstract
This publication resulted in part from research supported by the Harvard University Center for AIDS Research, a program funded by the National Institutes of Health (NIH) (P30AI060354) that is supported by the following NIH institutes and centers (National Institute of Allergy and Infectious Diseases, National Cancer Institute, National Institute of Mental Health, National Institute on Drug Abuse, National Institute of Child Health and Human Development, National Heart, Lung, and Blood Institute, National Center for Complementary and Alternative Medicine). This work was supported in part by the Houston Veterans Affairs Health Services Research and Development Service Center of Excellence (HFP90-020).
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- 2010
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12. Rejoinder to the responses
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Carroll, Joseph
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Fashion and beauty - Abstract
4. Conclusions Marxists used to speak of the inevitability of the historical process leading to the triumph of the proletariat--a secular version of the Christian eschatology. The obsolete status both [...]
- Published
- 2008
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