We conducted and analyzed qualitative interviews with 12 persons working on the Healthy Public Housing Initiative in Boston, Massachusetts in 2001. Our goal was to generate ideas and themes related to the ethics of the community-based participatory research in which they were engaged. Specifically, we wanted to see if we found themes that differed from conventional research that is based on an individualistic ethics. There were clearly distinct ethical issues raised with respect to projects and individuals who engage in community-based collaborations. The differences that arose from the interviews were seeking equality between the partners, the need for the community partner to defend the community, dealing with unflattering data, meeting community expectations and producing tangible benefits to the community.
Familism, respect for authority, and a sense of shame/pride are cultural characteristics that might influence research participation of Asian Americans. We compared 79 elderly Asian immigrants, most of whom immigrated from China or Hong Kong, with 58 elders who were not Asian and mostly not immigrants. Responding to hypothetical situations presented on a self-administered questionnaire, the Asian group professed to be more likely to be influenced by a request from a son/daughter, landlord, physician, or advertisement (p<0.001) and by a monetary incentive (p=0.05). Multivariate adjustment for potential confounders attenuated the strength of these relations, but except in the case of the monetary offer, differences remained statistically significant. Within the Asian group, multivariate logistic regression modeling indicated that years lived in the US was associated with more likelihood of refusing requests to participate in research. We conclude that acculturation or assimilation into American society may build resistance to pressure to participate in research. Our findings also suggest that elderly Asian immigrants may need additional protections to achieve truly informed consent.
While Kombucha tea is considered a healthy elixir, the limited evidence currently available raises considerable concern that it may pose serious health risks. Consumption of this tea should be discouraged, as it may be associated with life-threatening lactic acidosis.
Sleep medicine programs in the New York City metropolitan area mostly suspended operations near the start of the COVID-19 pandemic surge in the Northeast; the last diagnostic sleep study in our group was completed on March 16, 2020. Our private practice multispecialty group of more than 800 providers relies on sleep medicine consultation, diagnostic testing, and treatment of sleepdisordered breathing to optimize health care delivery. This suite of services is particularly important for our population with obesity, for whom COVID-19 may carry a higher risk of morbidity and mortality, 1 a noteworthy observation echoed in my own experience working in the intensive care unit at our community hospital. The challenge is how to restart sleep services in a manner that is objectively safe and reassuring to patients and our referring providers. Specifically, we have addressed the screening of sleep referrals for COVID-19 signs and symptoms, the distribution of home sleep apnea testing (HSAT) devices, and the return of HSAT devices with disinfection for reuse.Consistent with American Academy of Sleep Medicine recommendations, 2 telephone screening is completed before all HSAT visits for COVID-19 symptoms, including fever, cough, and shortness of breath. Patients are again screened for COVID-19 symptoms and a noninvasive temperature check is completed upon arrival for HSAT education and device pickup. Medical staff are screened similarly on a daily basis and are required to wear personal protective equipment with every patient.Our sleep center's specific challenge has been to develop a process to minimize any risk of transmission of COVID-19 via contact with HSAT equipment. We communicated with 5 major manufacturers of HSAT devices (
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