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  1. Article ; Online: Social Determinants of Health in Family Medicine Residency: A National Survey of Program Directors.

    Wright, Katherine M / Ravenna, Paul / Wheat, Santina / Villarreal, Carla M / Clements, Deborah S / Cronholm, Peter F

    Family medicine

    2023  Volume 56, Issue 2, Page(s) 102–107

    Abstract: Background and objectives: Social factors account for most health outcomes, underscoring the need to address social determinants of health (SDH) to eliminate health disparities. Our objectives are (1) to describe the scope of formal SDH curricula in ... ...

    Abstract Background and objectives: Social factors account for most health outcomes, underscoring the need to address social determinants of health (SDH) to eliminate health disparities. Our objectives are (1) to describe the scope of formal SDH curricula in family medicine residency, (2) to identify residency program characteristics associated with integrated core curriculum components to teach SDH, and (3) to identify barriers to addressing SDH in residency.
    Methods: We distributed a cross-sectional survey to all family medicine residency program directors (PDs) accredited by the Accreditation Council for Graduate Medical Education as identified by the Association of Family Medicine Residency Directors.
    Results: Of 624 eligible program directors, 279 completed the survey (45% response rate). Overall, 41.2% of respondents reported significant formal SDH training in their program. Though a majority (93.9%) agreed that screening for social needs should be a standard of care, most (58.9%) did not use standardized screening tools. The most common barriers to addressing SDH were lack of clinical resources (eg, social workers, legal advocates), lack of community resources (eg, food banks, substance use disorder treatment), and inadequate screening instruments or integration into the electronic medical record system. Availability of referral resources was associated with PDs' increased perception of resident SDH competency.
    Conclusions: Nearly all respondents agreed that screening for social needs should be a standard part of care; however, this vision is not yet realized. To better train the next generation of physicians to identify and meaningfully address social needs, additional research is needed. This research might include mixed-methods approaches that incorporate qualitative assessments to define best practices and patient-centered outcomes related to identifying and responding to SDH.
    MeSH term(s) Humans ; Internship and Residency ; Family Practice/education ; Cross-Sectional Studies ; Social Determinants of Health ; Social Factors ; Education, Medical, Graduate ; Surveys and Questionnaires ; Curriculum
    Language English
    Publishing date 2023-09-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639374-3
    ISSN 1938-3800 ; 0742-3225
    ISSN (online) 1938-3800
    ISSN 0742-3225
    DOI 10.22454/FamMed.2023.871989
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A Review of Recent Italian Work on Rheumatism : II.-Chronic Rheumatism.

    Ravenna, P

    Annals of the rheumatic diseases

    2008  Volume 2, Issue 1, Page(s) 1–18

    Language English
    Publishing date 2008-07-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/ard.2.1.1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: A Review of Recent Italian Work on Rheumatism: I.-Rheumatic Fever.

    Ravenna, P

    Annals of the rheumatic diseases

    2008  Volume 1, Issue 3, Page(s) 167–179

    Language English
    Publishing date 2008-07-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 7090-7
    ISSN 1468-2060 ; 0003-4967
    ISSN (online) 1468-2060
    ISSN 0003-4967
    DOI 10.1136/ard.1.3.167
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Diversity, Inclusion, and Health Equity in Academic Family Medicine.

    Jacobs, Christine K / Douglas, Montgomery / Ravenna, Paul / Wilson, Elisabeth / Piggott, Cleveland / Chrusciel, Timothy / Strothers, Harry

    Family medicine

    2022  Volume 54, Issue 4, Page(s) 259–263

    Abstract: Background and objectives: Diversity, inclusion, and health equity (DIHE) are integral to the practice of family medicine. Academic family medicine has been grappling with these issues in recent years, particularly with a focus on racism and health ... ...

    Abstract Background and objectives: Diversity, inclusion, and health equity (DIHE) are integral to the practice of family medicine. Academic family medicine has been grappling with these issues in recent years, particularly with a focus on racism and health inequity. We studied the current state of DIHE activities in academic family medicine departments and suggest a framework for departments to become more diverse, inclusive, antiracist, and focused on health equity and racial justice.
    Methods: As part of a larger annual membership survey, family medicine department chairs were asked for their assessment of departmental DIHE and antioppression activities, and infrastructure and resources committed to increasing DIHE.
    Results: More than 60% of family medicine department chairs participating in this study rate their departments highly in promoting DIHE and antioppression, and 66% of chairs report an institutional infrastructure that is working well. Just over half of departments or institutions have had a climate survey in the past 3 years, 47.3% of departments have a diversity officer, and 26% of departments provide protected time or resources for a diversity officer.
    Conclusions: The majority of family medicine department chairs rate their departments highly on DIHE. However, only 50% of departments have formally assessed climate in the past 3 years, fewer have diversity officers, and even fewer invest resources in their diversity officers. This disconnect should motivate academic family medicine departments to undertake formal self-assessment and implement a strategic plan that includes resource investment in DIHE, measurable outcomes, and sustainability.
    MeSH term(s) Academic Medical Centers ; Family Practice ; Health Equity ; Humans ; Social Justice ; Surveys and Questionnaires
    Language English
    Publishing date 2022-04-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639374-3
    ISSN 1938-3800 ; 0742-3225
    ISSN (online) 1938-3800
    ISSN 0742-3225
    DOI 10.22454/FamMed.2022.419971
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Relation between mental workload and hospital infection in the ICU.

    da Silva, Ravenna Leite / da Silva, Luiz Bueno / Silva, Aryelle Nayra Azevedo

    Work (Reading, Mass.)

    2022  Volume 73, Issue 3, Page(s) 915–925

    Abstract: ... in the ICU and the MWL of the nurses (r = 0.654, p < 0.01); in the nurses' care of patients ... with urinary tract infection, the correlation is 0.546, p < 0.01; if care is provided to patients with lung problems ... the correlation is 0.563, p < 0.01 The ICU presented a favorable environment to nursing practices, with means ...

    Abstract Background: Nursing is among the most stressful professions. Studies that examine possible factors that influence the mental workload (MWL) of nurses are of fundamental importance, because through these results, efforts can be concentrated on improving their working conditions more efficiently.
    Objective: To investigate the influence of hospital infection on the MWL of nurses in an intensive care unit (ICU).
    Method: Cross-sectional and descriptive study, with a quantitative approach. Three research instruments were used: a sociodemographic questionnaire, the NASA Task Load Index (NASA-TLX) and the Nursing Work Index-Revised Brazilian version (B-NWI-R). The sample consisted of 30 nurses from the ICU of a public hospital in João Pessoa city, Brazil, during the daytime period, and the Spearman correlation test (α= 0,05) was applied to verify associations.
    Results: There was a high MWL among nurses, with a NASA-TLX weighted average of 66.38 (SD±15.0). Correlations were found between the levels of hospital infection in the ICU and the MWL of the nurses (r = 0.654, p < 0.01); in the nurses' care of patients with urinary tract infection, the correlation is 0.546, p < 0.01; if care is provided to patients with lung problems, the correlation is 0.563, p < 0.01 The ICU presented a favorable environment to nursing practices, with means lower than 2.5, according to the B-NWI-R.
    Conclusion: The MWL of the nurses was associated with the hospital infection levels of the intensive care sector studied. It was found that the MWL of nurses in relation to hospital infection in the ICU increased by 42.8%. This MWL is impacted by 29.8% when nurses' care is linked to patients with urinary infection. But if care is provided to patients with lung problems, this percentage rises to 31.7.
    MeSH term(s) Humans ; Cross-Sectional Studies ; Workload ; Intensive Care Units ; Surveys and Questionnaires ; Cross Infection ; Nursing Staff, Hospital
    Language English
    Publishing date 2022-08-21
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1394194-x
    ISSN 1875-9270 ; 1051-9815
    ISSN (online) 1875-9270
    ISSN 1051-9815
    DOI 10.3233/WOR-205266
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Global longitudinal strain for prediction of mortality in ST-segment elevation myocardial infarction and aortic stenosis patients: two sides of the same coin.

    Ravenna, E / Locorotondo, G / Manfredonia, L / Diana, G / Filice, M / Graziani, F / Leone, A M / Aurigemma, C / Romagnoli, E / Burzotta, F / Trani, C / Massetti, M / Lombardo, A / Lanza, G A

    European review for medical and pharmacological sciences

    2023  Volume 27, Issue 21, Page(s) 10736–10748

    Abstract: ... occurred in 4 (3.4%) STEMI and 5 (7.8%) AS patients (p=ns). AS patients who died had GLS similar to died ... STEMI patients (9.7±2.1 vs. 11.3±1.7, p=ns). GLS cut-off ≤12% predicted death with 89% sensitivity and ... 70% specificity (AUC 0.84, p=0.001): STEMI and AS patients with GLS ≤12% had worse survival ...

    Abstract Objective: Global longitudinal strain (GLS) predicts major adverse events in ST-segment elevation myocardial infarction (STEMI) and aortic stenosis (AS). Different cut-off values and different end-points have been proposed for prognostic stratification. We aimed to verify whether a single GLS cut-off value can be used to identify increased risk of all-cause death in STEMI and AS.
    Patients and methods: One-hundred- seventeen successfully treated first STEMI (age 63.8±12.5 yrs, 70% men) and 64 AS (age 80.3±6.9 yrs, 44% men) patients, undergoing echocardiography before discharge and before AS treatment, respectively, were retrospectively analyzed. GLS was analyzed, together with pulmonary artery systolic pressure (PASP), Killip class and Genereux stage. End-point was all-cause death at 6-month follow-up.
    Results: All-cause death occurred in 4 (3.4%) STEMI and 5 (7.8%) AS patients (p=ns). AS patients who died had GLS similar to died STEMI patients (9.7±2.1 vs. 11.3±1.7, p=ns). GLS cut-off ≤12% predicted death with 89% sensitivity and 70% specificity (AUC 0.84, p=0.001): STEMI and AS patients with GLS ≤12% had worse survival than STEMI and AS patients with GLS >12% (log-rank p=0.001). At multivariate Cox regression analysis, lower GLS values independently predicted death (HR 0.667, 95% CI 0.451-0.986, p=0.042), and the prediction model was improved when GLS was added to old age, significant comorbidities, PASP and Killip/Genereux stage (χ2 6.691 vs. 1.364, p=0.010).
    Conclusions: Died patients with STEMI and AS show similar values of GLS. A unique cut-off value of GLS can reliably be used to stratify the risk of all-cause death at 6-month follow-up in both two clinical settings.
    MeSH term(s) Male ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; ST Elevation Myocardial Infarction/therapy ; Retrospective Studies ; Global Longitudinal Strain ; Echocardiography ; Prognosis ; Ventricular Function, Left
    Language English
    Publishing date 2023-11-17
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 605550-3
    ISSN 2284-0729 ; 1128-3602 ; 0392-291X
    ISSN (online) 2284-0729
    ISSN 1128-3602 ; 0392-291X
    DOI 10.26355/eurrev_202311_34354
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Developing Equity Report Cards for Residents Training in Primary Care.

    Jean-Jacques, Muriel / Cooper, Andrew J / Gard, Lauren A / Goel, Mita Sanghavi / Ravenna, Paul / Didwania, Aashish / Persell, Stephen / O'Brien, Matthew

    Journal of health care for the poor and underserved

    2021  Volume 31, Issue 4S, Page(s) 260–285

    Abstract: Background: Most residency programs do not provide trainees with health equity data for their clinic patients.: Methods: Equity report cards were developed for internal and family medicine residents in a large health system. After considering which ... ...

    Abstract Background: Most residency programs do not provide trainees with health equity data for their clinic patients.
    Methods: Equity report cards were developed for internal and family medicine residents in a large health system. After considering which equity indictors were available, how to attribute patients to residents, and what level of granularity was feasible, equity reports were created for five ambulatory quality measures. Chi-square tests were used to test the significance of differences in quality measure satisfaction between groups.
    Results: Attributing patients to the physician who had seen them for the greatest proportion of encounters performed best. Creating equity reports for individual resident panels was not possible due to insufficient numbers. Most measures had sufficient patients when combining all residents' patients. Inequities were identified for four of five examined measures.
    Conclusion: Creating aggregate equity reports for all primary care residents across multiple equity indicators was feasible, documenting disparities in health care quality.
    Language English
    Publishing date 2021-12-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1142637-8
    ISSN 1548-6869 ; 1049-2089
    ISSN (online) 1548-6869
    ISSN 1049-2089
    DOI 10.1353/hpu.2020.0153
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Inequality and debt in a model with heterogeneous agents

    Ravenna, Federico / Vincent, Nicolas

    Economics letters Vol. 123, No. 2 , p. 177-182

    2014  Volume 123, Issue 2, Page(s) 177–182

    Author's details Federico Ravenna; Nicolas Vincent
    Keywords Inequality ; Debt ; DSGE model
    Language English
    Size graph. Darst.
    Publisher Elsevier
    Publishing place Amsterdam [u.a.]
    Document type Article
    ZDB-ID 717210-2
    ISSN 0165-1765
    Database ECONomics Information System

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  9. Article ; Online: Coronary microvascular dysfunction and findings of heart failure with preserved ejection fraction in patients with microvascular angina.

    Filice, Monica / Golino, Michele / Denora, Marialessia / Ruscio, Eleonora / Ingrasciotta, Gessica / Lamendola, Priscilla / Manfredonia, Laura / Villano, Angelo / Bisignani, Antonio / Ravenna, Salvatore E / DE Vita, Antonio / Lanza, Oreste / Crea, Filippo / Lanza, Gaetano A

    Minerva medica

    2022  Volume 113, Issue 5, Page(s) 838–845

    Abstract: ... cardiovascular risk factors and higher NT-proBNP levels (P=0.018), and showed a higher prevalence of diastolic ... was also not significantly different among groups (P=0.19). CBF to adenosine was 1.85±0.47, 1.78±0.40 ... 1.49±0.32 in group 1, 2 and 3, respectively (P=0.13). Similarly, CBF response to CPT was 1.57±0.4, 1 ...

    Abstract Background: Coronary microvascular dysfunction (CMD) may cause symptoms of myocardial ischemia (microvascular angina [MVA]), but recent studies suggested that it might also contribute to the syndrome of heart failure with preserved ejection fraction (HFpEF). In this study we assessed the relation of CMD with findings of HFpEF in MVA patients.
    Methods: We enrolled 36 consecutive patients with MVA, in whom we assessed: 1) coronary blood flow (CBF) response to adenosine and cold pressor test (CPT) by color-Doppler echocardiography of the left anterior descending coronary artery; 2) complete echocardiographic examination; 3) N-terminal-pro-B-natriuretic peptide (NT-proBNP); 4) grade of dyspnea by the modified Medical Research Scale.
    Results: Among patients, 15 had definite HFpEF findings (group 1), 12 had equivocal HFpEF findings (group 2) and 9 had no evidence of HFpEF findings (group 3). Group 1 patients were older, had more cardiovascular risk factors and higher NT-proBNP levels (P=0.018), and showed a higher prevalence of diastolic dysfunction. Left ventricle dimensions and systolic function, however, did not differ among groups. Dyspnea was also not significantly different among groups (P=0.19). CBF to adenosine was 1.85±0.47, 1.78±0.40 1.49±0.32 in group 1, 2 and 3, respectively (P=0.13). Similarly, CBF response to CPT was 1.57±0.4, 1.49±0.2 and 1.45±0.3 in the 3 groups, respectively (P=0.74). Both CBF response to adenosine and CPT showed no relation with the severity of dyspnea symptoms.
    Conclusions: Our data suggest that in patients with MVA there is no relation between the grade of impairment of coronary microvascular dilatation and findings of HFpEF.
    MeSH term(s) Humans ; Heart Failure/complications ; Stroke Volume ; Myocardial Ischemia ; Adenosine
    Chemical Substances Adenosine (K72T3FS567)
    Language English
    Publishing date 2022-02-15
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 123586-2
    ISSN 1827-1669 ; 0026-4806
    ISSN (online) 1827-1669
    ISSN 0026-4806
    DOI 10.23736/S0026-4806.21.07135-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: The recessionary impact of stabilizing inflation

    Ravenna, Federico

    Recessions : prospects and developments , p. 65-97

    2009  , Page(s) 65–97

    Author's details Federico Ravenna
    Keywords Inflationsbekämpfung ; Inflationssteuerung ; Konjunktur ; Phillips-Kurve ; Kanada
    Language English
    Size graph. Darst.
    Publisher Nova Science Publ.
    Publishing place New York, NY
    Document type Article
    ISBN 1-604-56866-6 ; 978-1-604-56866-0
    Database ECONomics Information System

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