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IntroductionEffective, equity-promoting interventions implemented by health care systems are needed to address health care disparities and population-level health disparities. We evaluated the impact of a clinical decision support tool to improve evidence-based thiazide diuretic prescribing among Black patients to address racial disparities in hypertension control.MethodsWe employed an interrupted time series design and qualitative interviews to evaluate the implementation of the tool. Our primary outcome measure was the monthly rate of thiazide use among eligible patients before and after implementation of the tool (January 2013-December 2016). We modeled month-to-month changes in thiazide use for Black and White patients, overall, and by sex and medical center racial composition. We conducted key informant interviews to identify modifiable facilitators and barriers to implementation of the tool across medical centers.ResultsOf the 318,720 patients, 15.5% were Black. We observed no change in thiazide use or blood pressure control following the implementation of the tool in either racial subgroup. There was a slight but statistically significant reduction (2.32 percentage points, p < 0.01) in thiazide use among Black patients following the removal the tool that was not observed among White patients. Factors affecting the tool's implementation included physician and pharmacist resistance to thiazide use and a lack of ongoing promotion of the tool.DiscussionThe clinical decision support tool was insufficient to change prescribing practices and improve blood pressure control among Black patients.ConclusionsFuture interventions should consider physician attitudes about thiazide prescribing and the importance of multilevel approaches to address hypertension disparities.

This is a review of the book Harry Potter and the Other; Race, Justice and Difference in the Wizarding World edited by Sarah Park Dahlen and Ebony Elizabeth Thomas. of MacDonald's more unorthodox beliefs and how they actually fit into traditional interpretations of Christianity rather than being outlandish or sui generis, as is sometimes said about MacDonald's ideas. Moreover, this work demonstrates how MacDonald was both a visionary and also a man of his times, a voice of hope in a world that had gone dark, a reassuring presence in a world that seemed destined for chaos. --James Hamby, Harry Potter and the Other; Race, Justice and Difference in the Wizarding World, edited by Sarah Park Dahlen and Ebony Elizabeth Thomas, and Open at the Close: Literary Essays on [...]

Primary nonadherence, a form of prescription nonadherence, is defined as failure to fill and pick up a prescription medication. Little is known about the relationship between distance to pharmacy and primary nonadherence in dermatology. In this study, we investigated the association between primary nonadherence and distance between a patient’s home and pharmacy. We focused on a low-income patient population within the dermatology clinic of a large, urban county hospital system in which patients were enrolled in a pharmacy benefit within a closed-system. Among 678 patients who were prescribed a total of 1156 prescription medications for dermatologic conditions, 11.7% did not pick up any of their prescriptions. After adjusting for patient demographics of race/ethnicity, sex, age, language, and relationship status, there was no association between primary nonadherence and distance traveled between a patient’s home and pharmacy. Results of this study are consistent with other studies in non-dermatologic patients and suggtableest that distance from a pharmacy may not be strongly associated with primary nonadherence for dermatologic medications.

MEDIEVALISM IN A SONG OF ICE AND FIRE AND GAME OF THRONES. By Shiloh Carroll. D.S. Brewer, 2018. 192 p. ISBN 978-1843844846. $33.67. $20.99 Kindle format. 'This book explores Martin's [...]

GAME OF THRONES VERSUS HISTORY: WRITTEN IN BLOOD. Brian Pavlac. Wiley-Blackwell, 2017. ISBN 978-1119249422. $18.95. Kindle $7.99. IN 2016 an exercise in career development placed me on the review panel [...]

We present two simulations designed to convey the strategic nature of terrorism and counterterrorism. The first is a simulated hostage crisis, designed primarily to illustrate the concepts of credible commitment and costly signaling. The second explores high-level decision making of both a terrorist group and the state, and is designed to highlight scarce-resource allocation and organizational dynamics. The simulations should be useful both in a traditional classroom setting as well as to the larger public. We provide a primer on the subject matter, and all the material necessary to run the simulations.