Objective. Despite the significant health impact of gout, there is no consensus on management standards. To guide physician practice, we sought to develop quality of care indicators for gout management.Methods. A systematic literature review of gout therapy was performed using the Medline database. Two abstractors independently reviewed each of the articles for relevance and satisfaction of minimal inclusion criteria. Based on the review of the literature, 11 preliminary quality indicators were developed and then reviewed and refined by an initial feasibility panel of community and academic rheumatologists. A twelfth indicator was added at the request of the first panel. Using a modification of the RAND/University of California at Los Angeles appropriateness method (bridging teleconference and white-board Internet technology were added), a second expert panel rated each of the proposed indicators for validity using a 9-point scale, in which ratings of 1-3, 4-6, and 7-9 were considered "invalid," "indeterminate," and "highly valid," respectively. Indicators were considered valid if the median panel rating was >7 and there was no evidence of panel disagreement (defined to occur when 2 of 6 panelists provided a validity rating of 1-3 and 2 panelists provided a validity rating of 7-9).Results. Ten of the 12 draft indicators were rated to be valid by our second expert panel. Validated indicators pertained to 1) the use of urate-lowering medications in chronic gout, 2) the use of antiinflammatory drugs, and 3) counseling on lifestyle modifications.Conclusion. Using a combination of evidence and expert opinion, 10 indicators for quality of gout care were developed. These indicators represent an important initial step in quality improvement initiatives for gout care.Preliminary evidence suggests that medical errors in the treatment of gout are common. An older age at onset of gout and the presence of serious comorbid conditions render patients vulnerable to medicationrelated errors and substandard quality of care. Indomethacin, a nonsteroidal antiinflammatory drug (NSAID) routinely used in gout treatment, is among the most commonly prescribed inappropriate medications among the elderly (1). In a prospective investigation involving a large cohort of elderly patients who presented to an emergency room (1), gout was among the treatment indications most commonly associated with selection of inappropriate medications. Such medication-related errors have been reported as a complication in more than one-fourth of all orders for intravenous colchicine administered to inpatients (2) and approximately one-half of orders for administration of allopurinol (3), both of which are drugs that are commonly used in the treatment of gout.Although gout has a substantial health impact and although its treatment appears to be characterized by preventable medical errors, quality of care in gout has not been well studied. A barrier to such research has been a lack of consensus regarding the standards of care in gout therapy. To address this is...

Compared with whites, black women reported significantly less BMD testing and prescription and nonprescription osteoporosis therapy. This disparity was not fully explained by other demographic or risk factor differences.

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PurposeLatinos comprise 12.5 percent of the overall population in the USA, and are the fastest‐growing minority, among which the Mexican‐origin population makes up about 66 percent. Undocumented Latino immigrants are a small, yet important group within the immigrant population. The purpose of this paper is to review the literature and discuss the most important factors that prevent immigrants from accessing health care.Design/methodology/approachLiterature review was conducted from the library database. A total of 50 items of literature related to the subject were reviewed.FindingsBorder states have the highest concentration of Mexican‐origin people. The concentration of immigrants in the border has unique health and economic implications due to the vital role they have in US society, contributing both to the economy and diversity of the USA. Despite their important role, they disproportionately lack health insurance, and receive fewer health care services than US‐born citizens. This lack of insurance puts a burden on the nation's economy, and their health status deteriorates as they become more prone to chronic health conditions, and their complications due to lack of primary medical attention.Originality/valueTailored public health interventions that address the health needs of Latino immigrants in the USA need to be based on reliable data and statistics in order to effectively place resources, and to track achievements and flaws.

Non-pharmaceutical interventions (NPIs) such as stay-at-home orders continue to be the main policy response to the COVID-19 pandemic in countries with limited or slow vaccine rollout.Often, NPI are managed or implemented at the sub-national level, yet little information exists on within country variation in NPI policies. We focus on Latin America, a COVID-19 epicenter, and collect and analyze daily subnational data on public health measures in Argentina,