Successful integration of health care in rural and underserved communities requires attention to power structures, trust, and disciplinary boundaries that inhibit team-based integration of behavioral and primary health care. This paper reports on perceived successes and ongoing challenges of integrating primary and behavioral health care from the perspectives of providers, community leaders, and community members. Data collection consisted of semi-structured qualitative interviews and focus groups conducted as part of a regional health equity assessment in northern Arizona. The authors explore barriers and successes in integrating health care in rural clinics using the perspective of a social ecological framework and the mediating role of culture. Differing expectations, differing professional areas, and interpersonal interactions were primary factors challenging movement toward integrated health care. Results suggest that providers and policymakers working toward health care integration should consider culture and interpersonal interaction as dynamic mediators, particularly in underserved and rural health care contexts.BACKGROUND U.S. medical schools have been unsuccessful in creating a diverse physician workforce. Implicit bias is pervasive in medicine, including potentially in medical school admissions. METHODS We invited all 2018-2019 interviewees at one U.S. medical school to complete the eight-item Everyday Discrimination Scale (EDS) asking about experiences of bias during interview experiences to date. RESULTS Three hundred forty-seven (30%) of 1,175 interviewees completed the survey, with participant demographic characteristics matching those of the broader interviewee pool. Seventy-two (21%) responded affirmatively to one or more EDS items. Gender, age, race, religion, and sexual orientation were all sources of discrimination. Those reporting bias had completed more interviews (5.2 vs. 3.9, P less then .05) and were more likely to be Latinx (30.6% vs. 16.4%, P less then .05) than their counterparts. Only three (4%) reported the incident to the institution where it occurred. CONCLUSION Further work exploring experiences of bias during medical school admissions and how to decrease their frequency is warranted.Compared with the general population, justice-involved youth have substantially higher rates of several health conditions. Less is known about their use of health services to address these conditions. Using data from a statewide survey of 217 youth in juvenile correctional facilities and 164,832 youth in public schools, we examined selfreported health (health overall, weight status, disability, asthma, allergy, mental health) and receipt of care. Justice-involved youth reported a high number of physical health concerns; however, physical health conditions were not related to receipt of care. Youth who reported experiencing depressive symptoms with or without suicidal ideation, and those who had attempted suicide, were more likely than their peers without these mental health issues to have received mental health treatment in the past year. However, many youth with serious mental health concerns had not received treatment. https://www.selleckchem.com/products/l-ornithine-l-aspartate.html Results from this study demonstrate unmet health care needs among a sample of youth in juvenile correctional facilities.In the U.S., 54.8% of non-Hispanic Black women are obese, a rate that is 1.4 times greater than in White women. The drivers of this racial disparity are not yet clearly understood. We sought to disentangle race, household poverty, neighborhood racial composition, and neighborhood poverty to better understand the racial disparity in obesity among women. We used data from the 1999-2004 National Health and Nutrition Examination Survey and the 2000 U.S. Census to examine the role of individual race, individual poverty, neighborhood racial composition, and neighborhood poverty on women's risk of obesity. We found that individual race was the primary risk factor for obesity among women. Neighborhood effects did not account for the racial disparity. Understanding that race is a social, not a biologic construct, more work is needed to uncover what it is about race that produces racial disparities in obesity among women.Maternal mortality in sub-Saharan Africa remains high. Knowing about obstetric danger signs is the first step to responding immediately in emergency. To understand factors that affect knowledge of women of obstetric danger signs, we conducted a cross-sectional study on 735 women in Farta, Ethiopia. Two hundred and ten (210) (28.6%), 255 (34.7%) and 169 (23%) of respondents affirmed having experienced three or more obstetric danger signs during pregnancy, childbirth, and the postpartum period, respectively. Urban residency [a danger sign associated with pregnancy (AOR=4.01, 95% CI=1.85-8.69), childbirth (AOR=2.47, 95% CI=1.12-5.43) and the postpartum period (AOR=3.39, 95% CI=1.60-7.18)]; having antenatal care follow-up in their last pregnancy [a danger sign associated with pregnancy (AOR=3.47, 95% CI=1.95-6.18), childbirth (AOR=2.36, 95%CI=1.41-3.96) and the postpartum period (AOR=2.48, 95% CI=1.49-4.13)]; and giving birth at a health institution (AOR=1.43, 95% CI=1.01-2.02) were significant factors. Increasing antenatal-care coverage, educating women and increasing institutional delivery would increase mothers' knowledge about obstetric danger signs.BACKGROUND AND AIMS Hepatitis C virus (HCV) infection is highly prevalent among homeless individuals, but the scope of HCV-associated liver fibrosis in this population is poorly understood. METHODS Using the FIB-4 Index, we describe the prevalence and correlates of advanced fibrosis among a retrospective cohort of all homeless-experienced adults with HCV seen at Boston Health Care for the Homeless Program (BHCHP) over a one-year period. RESULTS Of 832 BHCHP patients with HCV, 15.8% had advanced fibrosis. In multivariable regression analysis, alcohol use disorder (adjusted odds ratio [aOR] 2.50, 95% confidence interval [CI] 1.65-3.81) and having unknown or poorly characterized housing circumstances (aOR 2.88, 95% CI 1.02-8.14, relative to housed patients) were independently associated with advanced fibrosis. CONCLUSIONS The prevalence of advanced fibrosis in this cohort of homeless adults with HCV appears similar to national estimates among housed individuals, but their psychosocial complexity is greater, especially among those who are older.