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1. Access Is Necessary but Not Sufficient: Factors Influencing Delay and Avoidance of Health Care Services

   https://doi.org/10.1177/2381468318760298  

   Smith, Kyle T.; Monti, Denise; Mir, Nageen; Peters, Ellen; Tipirneni, Renuka; Politi, Mary C. (January 2018, MDM Policy & Practice)

   null (Ed.)

   Background: Despite recently expanded access to health insurance, consumers still face barriers to using their coverage to obtain needed health care. Objective: To examine the characteristics of those who delay or avoid health care due to costs. Methods: Participants were recruited via Amazon MTurk and completed a survey assessing demographic characteristics, financial toxicity, health care minimizer-maximizer tendencies, health insurance knowledge, numeracy, delaying/avoiding any care, and delaying/avoiding six common health care services (three preventive and three nonpreventive services). Validated measures were used when available. Delay/avoidance behaviors were categorized into delaying/avoiding any care, preventive care, and nonpreventive care. Logistic regression models examined 1) financial toxicity, 2) minimizer-maximizer tendencies, 3) numeracy, 4) health insurance knowledge, and 5) knowledge of preventive care coverage separately on three forms of delay/avoidance behaviors, controlling for chronic conditions, insurance status, and/or income where appropriate. Results: Of 518 respondents, 470 did not fail attention-check questions and were used in analyses. Forty-five percent of respondents reported delaying/avoiding care due to cost. Multivariable analyses found that financial toxicity was related to delaying/avoiding any care (odds ratio [OR] = 0.884, P < 0.001), preventive care (OR = 0.906, P < 0.001), and nonpreventive care (OR = 0.901, P < 0.001). A tendency to minimize seeking health care (OR = 0.734, P < 0.001) and lower subjective numeracy (OR = 0.794, P = 0.023) were related to delaying/avoiding any care. General health insurance knowledge (OR = 0.989, P = 0.023) and knowledge of preventive care coverage (OR = 0.422, P < 0.001) were related to delaying/avoiding preventive care. Conclusions: Many people delay or avoid health care due to costs, even when insured. Results suggest that there may be different reasons individuals delay or avoid preventive and nonpreventive care. Findings may inform interventions to educate consumers and support discussions about health care costs to facilitate appropriate health care utilization. 

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2. Point-of-care diagnostic devices for periodontitis – current trends and urgent need

   https://doi.org/10.1039/D3SD00317E  

   Griffith, Alexandra; Chande, Charmi; Kulkarni, Sahitya; Morel, Josuel; Cheng, Yu-Hsuan; Shimizu, Emi; Cugini, Carla; Basuray, Sagnik; Kumar, Vivek (July 2024, Sensors & Diagnostics)

   Critical review of point of care devices in oral care. 

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3. The association between the problem list and chronic pain management

   https://doi.org/10.1007/s44250-022-00016-4  

   Rylee, Tina L; Copenhaver, David; Drake, Christiana; Joseph, Jill (December 2023, Discover Health Systems)

   Abstract BackgroundRoughly a quarter of the US population suffers from moderate to severe chronic pain for at least six months in any given year. The complexity of managing chronic pain has encouraged providers to use innovative methods to address it. Research has shown that problem lists are potential tools that support the care of patients with diabetes and chronic kidney disease. ObjectivesTo examine the extent to which the inclusion of chronic pain in a problem list is associated with follow-up specialty pain care. MethodsThe association between chronic pain documentation on the problem list and specialty pain care was investigated in this retrospective cohort study using 4531 patient records. ResultsChronic pain documentation in the problem list was associated with higher odds of receiving specialty pain care. The most common diagnosis was chronic pain (69.7%). A migraine diagnosis was associated with decreased odds of receiving specialty care, and chronic pain syndrome was associated with increased odds of receiving specialty care compared with the other chronic pain groups. ConclusionDocumenting chronic pain on the problem list was associated with a higher likelihood of patients receiving specialty pain care. 

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4. Imagining Caring Futures for Frontline Health Work

   https://doi.org/10.1145/3555581  

   Ismail, Azra; Yadav, Deepika; Gupta, Meghna; Dabas, Kirti; Singh, Pushpendra; Kumar, Neha (November 2022, Proceedings of the ACM on Human-Computer Interaction)

   Care workers are increasingly using digital technology in their daily lives, for monitoring, financial compensation, training, coordination, and more. State and corporate actors have invested significant resources to enable this digital shift, particularly during the COVID-19 pandemic. However, care work has remained chronically underpaid, and continues to rely on women from minoritized and marginalized backgrounds. Our paper examines how care workers carefully navigate digitization, precarity, and complex social relationships, in an attempt to care for their communities and each other. We analyze the emerging digital ecosystem for frontline health workers in India during the COVID-19 pandemic where these dynamics have been highly visible. Our research draws attention to four interconnected ways in which workers practiced care, by directing their efforts towards survival, resilience, advocacy, and/or resistance. We suggest these also as care orientations that can be adopted by researchers and practitioners, to critically reflect on and direct technology design towards enabling more caring futures, for (and with) workers and communities. 

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5. Life history, mating dynamics and the origin of parental care

   https://doi.org/10.1111/jeb.13959  

   Azad, Tamjeed; Alonzo, Suzanne H.; Bonsall, Michael B.; Klug, Hope (November 2021, Journal of Evolutionary Biology)

   Abstract Parental care, mating dynamics and life history co‐evolve. Understanding the diversity of reproductive patterns found in nature is a major focus of evolutionary ecology research. Previous research suggests that the origin of parental care of eggs will be favoured when egg and adult death rates and juvenile survival are relatively high. However, the previous research that explored the link between care and life history did not account for among‐species variation in mating dynamics. As mating dynamics are generally expected to influence care, we explore, theoretically, the life‐history conditions (stage‐specific rates of maturation and survival) that favour parental care across three mating scenarios: reproductive rate (1) is unaffected by males (assuming that some males are present), (2) increases as male abundance increases or (3) decreases as male abundance increases. Across scenarios, all forms of care were most strongly favoured when egg and adult death rates, juvenile survival and female egg maturation rates were relatively high. When reproductive rate was unaffected by male abundance or increased as male abundance increased, as we might expect in systems in which females are mate‐limited, all forms of care were most strongly favoured when male egg maturation rate (i.e. the rate at which male eggs develop, mature and hatch) was moderate or high. When greater male abundance inhibited reproduction, which might occur in systems with intense male–male competition, all forms of care were most strongly favoured when male egg maturation rate was low‐to‐moderate. These results suggest that life history affects the evolution of parental care, and sex‐specific life history can interact with mating dynamics to influence the origin of care. 

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