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Papers by david alejandro aviña acosta
2013 International Conference on New Concepts in Smart Cities: Fostering Public and Private Alliances (SmartMILE), 2013
This paper explains the main contents of a project intended to be a Master Thesis in Telecommunic... more This paper explains the main contents of a project intended to be a Master Thesis in Telecommunications Engineering. The project is based in the idea of a system to manage the access control in the buildings in Smart Cities. This system pretends to facilitate the access to people by means of the use of wireless systems and new technologies. It pretends to facilitate the task of manage the access in urban areas but also to be a cost-effective solution, versatile and easy to add to systems already installed.
Hawai'i journal of medicine & public health, 2013
Reducing health care disparities among disenfranchised populations remains a major challenge in t... more Reducing health care disparities among disenfranchised populations remains a major challenge in the United States, and those affected are integral to better understanding causes and solutions. Community-based participatory research (CBPR) provides a process for obtaining input by partnering community members with academic researchers to jointly define issues needing study. The University of Washington (UW) School of Medicine Center for Equity, Diversity and Inclusion (CEDI) adopted and translated the principles/processes of CBPR to develop a new curriculum tool for medical educators—the community-based participatory curriculum development (CBPCD) tool - designed to partner community members with medical educators to jointly define issues to teach our future physician workforce. The critical elements are: (1) recognition that the community has important expertise; (2) partner community members with medical educators; (3) mutual sharing of knowledge, skills, resources and power; (4) p...
The Journal of the American Board of Family Medicine, 1997
Background: Cervical pregnancy is a rare form of ectopic pregnancy that is associated with consid... more Background: Cervical pregnancy is a rare form of ectopic pregnancy that is associated with considerable maternal morbidity and a high mortality rate if early diagnosis and treatment are not carried out in a timely fashion. Methods: The current medical literature was reviewed by searching MEDLINE files from 1985 to 1996, using the key words “ectopic pregnancy” and “cervical pregnancy.” Older articles were accessed from cross-reference of the more recent publications. Results: The incidence of cervical pregnancy is 1 in 2400 deliveries and represents less than 1.0 percent of all ectopic pregnancies. No clear cause of cervical pregnancy has been described, and criteria for the clinical, pathologic, and sonographic diagnosis have been well established. The most common clinical complaint is painless vaginal bleeding. Routine transvaginal sonography early on allows for conservative management and avoids adverse outcomes. Methotrexate administered systemically and by intra-amniotic instill...
JAMA Cardiology, 2019
workforce diversity will expand the talent of the applicant pool and may reduce health care dispa... more workforce diversity will expand the talent of the applicant pool and may reduce health care disparities. OBJECTIVE To assess US cardiology physician workforce demographics by sex and race/ethnicity in the context of the US population and the available pipelines of trainees. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Association of American Medical Colleges, the American Medical Association, and the American Board of Internal Medicine to stratify medical students, resident physicians, fellows, and cardiologists by sex and race/ethnicity. Additionally, proportional changes from 2006 through 2016 were assessed for adult and pediatric cardiology. Data analysis took place from August 2018 to January 2019. MAIN OUTCOMES AND MEASURES Percentage of cardiologists and trainees by sex and race/ethnicity in 2016, as well as changes in proportions between 2006 and 2016. RESULTS Despite a high percentage of female internal medicine resident physicians (10 765 of 25 252 [42.6%]), female physicians were underrepresented in adult general cardiology fellowships (584 of 2720 [21.5%]) and procedural subspecialty fellowships (interventional cardiology, 30 of 305 [9.8%]; electrophysiology, 24 of 175 [13.7%]). The percentage of female adult cardiologists slightly increased from 2006 through 2016 (from 8.9% to 12.6%; slope, 0.36; P < .001) but remained low. Female physicians made up a disproportionately higher number of pediatric residency positions (6439 of 8832 [72.9%]). Trends showed an increase in female pediatric cardiology fellows (from 40.4% to 50.5%; slope, 1.25; P < .001), which resulted in an increase in the percentage of female pediatric cardiologists (from 27.1% to 34.0%; slope, 0.64; P < .001). The percentages of members of underrepresented minority groups in adult and pediatric cardiology fellowships (from 11.1% to 12.4%; slope, 0.15; P = .01; and from 7.7% to 9.9%; slope, 0.29; P = .009; respectively) were low and increased only slightly over time. Additionally, members of underrepresented minorities made up less than 8% of practicing adult and pediatric cardiologists. Although Asian individuals are 5.2% of the US general population, they are not considered underrepresented because they are 22.1% of US medical school graduates (n = 4202 of 18 999), 38.1% of internal medicine resident physicians (n = 9618 of 25 252), 40.4% of adult cardiology fellows (n = 1098 of 2720), 19.9% of adult cardiologists (n = 5973 of 30 016), 22.6% of pediatric resident physicians (n = 1998 of 8832), 28.0% of pediatric cardiology fellows (n = 122 of 436), and 20.1% of pediatric cardiologists (n = 574 of 2860). CONCLUSIONS AND RELEVANCE Female physicians remain underrepresented in adult cardiology, despite a robust pipeline of female medical students and internal medicine resident physicians. Women in pediatric cardiology are underrepresented but increasing in number. Members of several racial/ethnic minority groups remain underrepresented in adult and pediatric cardiology, and the percentages of trainees and medical students from these groups were also low. Different strategies are needed to address the continuing lack of diversity in cardiology for underrepresented minority individuals and women.
Health Equity, 2019
In accordance with Liaison Committee on Medical Education (LCME) curriculum content standards, me... more In accordance with Liaison Committee on Medical Education (LCME) curriculum content standards, medical schools are expected to teach physician communication skills and cultural competence. Given the sustained U.S. Spanish-speaking population growth, importance of language in diagnosis, and benefits of patient-physician language concordance, addressing LCME standards equitably should involve linguistic preparedness education. The authors present strategies for implementation of linguistic preparedness education in medical schools by discussing (1) examples of institutional approaches to dedicated medical Spanish courses that meet best practice guidelines and (2) a partnership model with medical interpreters to implement integrated global linguistic competencies in undergraduate medical curricula.
Academic medicine : journal of the Association of American Medical Colleges, Jan 30, 2017
The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses ... more The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses to the 2017 Association of American Medical Colleges Graduation Questionnaire, 39.3% of medical students nationally reported being mistreated. Many articles have been published on the topic of mistreatment at medical schools over the last 20 years. These articles have focused primarily on the definition of mistreatment, the impact of mistreatment, and initiatives put into place to help mitigate the problem. To date, very little attention has been paid to repairing the harm caused by mistreatment and rebuilding community trust. Academic medicine is in need of new forums of interaction to achieve more positive learning and workplace environments.The authors discuss restorative justice practices and the potential applications that they may have in academic medicine learning and workplace environments to serve vulnerable students, faculty, and staff who are targets of mistreatment. Restorati...
Academic Medicine, 2017
What will an inclusive workplace look like when it's achieved? Demonstrated Commitment to Diversi... more What will an inclusive workplace look like when it's achieved? Demonstrated Commitment to Diversity In an inclusive organization, visible and invisible heterogeneity is present throughout all departments and at all levels of responsibility. Human differences and similarities are welcomed, valued and utilized at all levels across all formal and informal organizational systems. Holistic View of Employees An inclusive organization is one in which all employees are viewed and respected as whole persons with identities and family lives which extend beyond the organization and, to the greatest extent appropriate, are free to behave truthfully in the work environment. Access to Opportunity An inclusive organization is one that creates a professionally nurturing environment in which all employees have equitable access to opportunities for personal and professional growth.
The Journal of the American Board of Family Practice, Mar 1, 1997
Al Dr. Nicolás Vásquez por su acertada supervisión en el desarrollo de este proyecto. A los profe... more Al Dr. Nicolás Vásquez por su acertada supervisión en el desarrollo de este proyecto. A los profesores de la Facultad de Ciencias, quienes han contribuido en mi formación académica. A mis padres y hermanos por su apoyo incondicional para el cumplimiento de mis metas. A los amigos y compañeros de la Facultad de Ciencias por la amistad y ayuda brindada.
The Journal of the American Board of Family Practice, Sep 1, 1997
Ctrl Control Strategias, 2013
2013 International Conference on New Concepts in Smart Cities: Fostering Public and Private Alliances (SmartMILE), 2013
This paper explains the main contents of a project intended to be a Master Thesis in Telecommunic... more This paper explains the main contents of a project intended to be a Master Thesis in Telecommunications Engineering. The project is based in the idea of a system to manage the access control in the buildings in Smart Cities. This system pretends to facilitate the access to people by means of the use of wireless systems and new technologies. It pretends to facilitate the task of manage the access in urban areas but also to be a cost-effective solution, versatile and easy to add to systems already installed.
2013 International Conference on New Concepts in Smart Cities: Fostering Public and Private Alliances (SmartMILE), 2013
This paper explains the main contents of a project intended to be a Master Thesis in Telecommunic... more This paper explains the main contents of a project intended to be a Master Thesis in Telecommunications Engineering. The project is based in the idea of a system to manage the access control in the buildings in Smart Cities. This system pretends to facilitate the access to people by means of the use of wireless systems and new technologies. It pretends to facilitate the task of manage the access in urban areas but also to be a cost-effective solution, versatile and easy to add to systems already installed.
Hawai'i journal of medicine & public health, 2013
Reducing health care disparities among disenfranchised populations remains a major challenge in t... more Reducing health care disparities among disenfranchised populations remains a major challenge in the United States, and those affected are integral to better understanding causes and solutions. Community-based participatory research (CBPR) provides a process for obtaining input by partnering community members with academic researchers to jointly define issues needing study. The University of Washington (UW) School of Medicine Center for Equity, Diversity and Inclusion (CEDI) adopted and translated the principles/processes of CBPR to develop a new curriculum tool for medical educators—the community-based participatory curriculum development (CBPCD) tool - designed to partner community members with medical educators to jointly define issues to teach our future physician workforce. The critical elements are: (1) recognition that the community has important expertise; (2) partner community members with medical educators; (3) mutual sharing of knowledge, skills, resources and power; (4) p...
The Journal of the American Board of Family Medicine, 1997
Background: Cervical pregnancy is a rare form of ectopic pregnancy that is associated with consid... more Background: Cervical pregnancy is a rare form of ectopic pregnancy that is associated with considerable maternal morbidity and a high mortality rate if early diagnosis and treatment are not carried out in a timely fashion. Methods: The current medical literature was reviewed by searching MEDLINE files from 1985 to 1996, using the key words “ectopic pregnancy” and “cervical pregnancy.” Older articles were accessed from cross-reference of the more recent publications. Results: The incidence of cervical pregnancy is 1 in 2400 deliveries and represents less than 1.0 percent of all ectopic pregnancies. No clear cause of cervical pregnancy has been described, and criteria for the clinical, pathologic, and sonographic diagnosis have been well established. The most common clinical complaint is painless vaginal bleeding. Routine transvaginal sonography early on allows for conservative management and avoids adverse outcomes. Methotrexate administered systemically and by intra-amniotic instill...
JAMA Cardiology, 2019
workforce diversity will expand the talent of the applicant pool and may reduce health care dispa... more workforce diversity will expand the talent of the applicant pool and may reduce health care disparities. OBJECTIVE To assess US cardiology physician workforce demographics by sex and race/ethnicity in the context of the US population and the available pipelines of trainees. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Association of American Medical Colleges, the American Medical Association, and the American Board of Internal Medicine to stratify medical students, resident physicians, fellows, and cardiologists by sex and race/ethnicity. Additionally, proportional changes from 2006 through 2016 were assessed for adult and pediatric cardiology. Data analysis took place from August 2018 to January 2019. MAIN OUTCOMES AND MEASURES Percentage of cardiologists and trainees by sex and race/ethnicity in 2016, as well as changes in proportions between 2006 and 2016. RESULTS Despite a high percentage of female internal medicine resident physicians (10 765 of 25 252 [42.6%]), female physicians were underrepresented in adult general cardiology fellowships (584 of 2720 [21.5%]) and procedural subspecialty fellowships (interventional cardiology, 30 of 305 [9.8%]; electrophysiology, 24 of 175 [13.7%]). The percentage of female adult cardiologists slightly increased from 2006 through 2016 (from 8.9% to 12.6%; slope, 0.36; P < .001) but remained low. Female physicians made up a disproportionately higher number of pediatric residency positions (6439 of 8832 [72.9%]). Trends showed an increase in female pediatric cardiology fellows (from 40.4% to 50.5%; slope, 1.25; P < .001), which resulted in an increase in the percentage of female pediatric cardiologists (from 27.1% to 34.0%; slope, 0.64; P < .001). The percentages of members of underrepresented minority groups in adult and pediatric cardiology fellowships (from 11.1% to 12.4%; slope, 0.15; P = .01; and from 7.7% to 9.9%; slope, 0.29; P = .009; respectively) were low and increased only slightly over time. Additionally, members of underrepresented minorities made up less than 8% of practicing adult and pediatric cardiologists. Although Asian individuals are 5.2% of the US general population, they are not considered underrepresented because they are 22.1% of US medical school graduates (n = 4202 of 18 999), 38.1% of internal medicine resident physicians (n = 9618 of 25 252), 40.4% of adult cardiology fellows (n = 1098 of 2720), 19.9% of adult cardiologists (n = 5973 of 30 016), 22.6% of pediatric resident physicians (n = 1998 of 8832), 28.0% of pediatric cardiology fellows (n = 122 of 436), and 20.1% of pediatric cardiologists (n = 574 of 2860). CONCLUSIONS AND RELEVANCE Female physicians remain underrepresented in adult cardiology, despite a robust pipeline of female medical students and internal medicine resident physicians. Women in pediatric cardiology are underrepresented but increasing in number. Members of several racial/ethnic minority groups remain underrepresented in adult and pediatric cardiology, and the percentages of trainees and medical students from these groups were also low. Different strategies are needed to address the continuing lack of diversity in cardiology for underrepresented minority individuals and women.
Health Equity, 2019
In accordance with Liaison Committee on Medical Education (LCME) curriculum content standards, me... more In accordance with Liaison Committee on Medical Education (LCME) curriculum content standards, medical schools are expected to teach physician communication skills and cultural competence. Given the sustained U.S. Spanish-speaking population growth, importance of language in diagnosis, and benefits of patient-physician language concordance, addressing LCME standards equitably should involve linguistic preparedness education. The authors present strategies for implementation of linguistic preparedness education in medical schools by discussing (1) examples of institutional approaches to dedicated medical Spanish courses that meet best practice guidelines and (2) a partnership model with medical interpreters to implement integrated global linguistic competencies in undergraduate medical curricula.
Academic medicine : journal of the Association of American Medical Colleges, Jan 30, 2017
The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses ... more The mistreatment of learners is an ongoing issue at U.S. medical schools. According to responses to the 2017 Association of American Medical Colleges Graduation Questionnaire, 39.3% of medical students nationally reported being mistreated. Many articles have been published on the topic of mistreatment at medical schools over the last 20 years. These articles have focused primarily on the definition of mistreatment, the impact of mistreatment, and initiatives put into place to help mitigate the problem. To date, very little attention has been paid to repairing the harm caused by mistreatment and rebuilding community trust. Academic medicine is in need of new forums of interaction to achieve more positive learning and workplace environments.The authors discuss restorative justice practices and the potential applications that they may have in academic medicine learning and workplace environments to serve vulnerable students, faculty, and staff who are targets of mistreatment. Restorati...
Academic Medicine, 2017
What will an inclusive workplace look like when it's achieved? Demonstrated Commitment to Diversi... more What will an inclusive workplace look like when it's achieved? Demonstrated Commitment to Diversity In an inclusive organization, visible and invisible heterogeneity is present throughout all departments and at all levels of responsibility. Human differences and similarities are welcomed, valued and utilized at all levels across all formal and informal organizational systems. Holistic View of Employees An inclusive organization is one in which all employees are viewed and respected as whole persons with identities and family lives which extend beyond the organization and, to the greatest extent appropriate, are free to behave truthfully in the work environment. Access to Opportunity An inclusive organization is one that creates a professionally nurturing environment in which all employees have equitable access to opportunities for personal and professional growth.
The Journal of the American Board of Family Practice, Mar 1, 1997
Al Dr. Nicolás Vásquez por su acertada supervisión en el desarrollo de este proyecto. A los profe... more Al Dr. Nicolás Vásquez por su acertada supervisión en el desarrollo de este proyecto. A los profesores de la Facultad de Ciencias, quienes han contribuido en mi formación académica. A mis padres y hermanos por su apoyo incondicional para el cumplimiento de mis metas. A los amigos y compañeros de la Facultad de Ciencias por la amistad y ayuda brindada.
The Journal of the American Board of Family Practice, Sep 1, 1997
Ctrl Control Strategias, 2013
2013 International Conference on New Concepts in Smart Cities: Fostering Public and Private Alliances (SmartMILE), 2013
This paper explains the main contents of a project intended to be a Master Thesis in Telecommunic... more This paper explains the main contents of a project intended to be a Master Thesis in Telecommunications Engineering. The project is based in the idea of a system to manage the access control in the buildings in Smart Cities. This system pretends to facilitate the access to people by means of the use of wireless systems and new technologies. It pretends to facilitate the task of manage the access in urban areas but also to be a cost-effective solution, versatile and easy to add to systems already installed.