Understanding Hispanic Patient Satisfaction with Telehealth During COVID-19

BackgroundRecent studies have described the use of telehealth for pediatric surgical care during the COVID-19 pandemic. We aimed to evaluate equity in telehealth use by comparing rates of utilization and satisfaction with pediatric surgical telemedicine among Hispanic patients.MethodsWe conducted a retrospective cohort study of patients seen by a surgical subspecialty provider in the outpatient setting at a quaternary pediatric hospital between April 1 and June 30, 2020. Patients evaluated in the same three-month period in 2019 were analyzed as a historic control. Differences in Family Experience Survey (FES) responses based on race and ethnicity and preferred language of care were assessed using univariable and multivariable generalized linear modeling.ResultsThe pandemic cohort included fewer patients of Hispanic ethnicity and fewer Spanish-speakers. After controlling for visit type, comparison of Spanish-speaking and English-speaking patients revealed that Spanish-speaking families had significantly lower scores for FES items that evaluated healthcare provider explaining (IRR 0.74, 95% CI: 0.61–0.90), listening (IRR 0.76, 95% CI: 0.63–0.92), and time spent with the family (IRR 0.73, 95% CI: 0.60–0.89). There were no differences in FES responses based on insurance status or degree of medical complexity.ConclusionsTelehealth services were less commonly used among Hispanic and Spanish-speaking patients. Language may differentially affect family satisfaction with healthcare and telehealth solutions. Strategies to mitigate these inequities are needed and may include strengthening interpreter services and providing language-concordant care.Level of evidenceLevel IV.     

Morbidity and Mortality in Jeju Residents over 50-Years of Age with Hip Fracture with Mean 6-Year Follow-Up: A Prospective Cohort Study

This prospective cohort study was performed to estimate the morbidity and mortality with 790 patients over 50-yr of age that sustained a femoral neck or intertrochanteric fracture from 2002 to 2006, followed-up for a mean of 6 yr (range, 4 to 9 yr). Crude and annual standardized mortality ratios (SMRs) were calculated; and mortalities in the cohort and the age and sex matched general population were compared. The risk factors on mortality and activities pre- and post-injury were assessed. Accumulated mortality was 16.7% (132 patients) at 1 yr, 45.8% (337 patients) at 5 yr, and 60% (372 patients) at 8 yr. SMR at 5 yr post-injury was 1.3 times that of the general population. Multivariate analysis demonstrated that age (OR, 1.074; 95% CI, 1.050-1.097; P<0.001), woman (OR, 1.893; 95% CI, 1.207-2.968; P=0.005), and medical comorbidity (OR, 1.334; 95% CI, 1.167-1.524 P<0.001) were independently associated with mortality after hip fracture. Only 59 of the 150 patients (39.3%) who were able to ambulate normally outdoors at preinjury retained this ability at final follow-up. Patients with a hip fracture exhibits higher mortality at up to 5 yr than general population. Age and a preinjury comorbidity are associated with mortality.     

不同比例五味子宁神口服液镇静催眠作用研究

目的:寻找五味子宁神口服液镇静催眠作用的最佳配伍比例。方法:通过对小鼠自发活动的影响、对戊巴比妥钠的协同作用、对中枢神经递质的影响等3方面药理学研究,探讨五味子宁神口服液不同配伍比例的镇静催眠作用。结果:五味子宁神口服液以原方用药25%五味子比例作用最好。结论:五味子宁神口服液组方配伍是合理的。     

Local recurrence in breast carcinoma patients with T(1-2) and 1-3 positive nodes: indications for radiotherapy.

AIMS: To investigate the relationship between local recurrence (LR) and distant recurrence (DR) and to determine a subgroup of patients who could benefit from radiotherapy among breast carcinoma patients with T(1-2) and N(1a). METHODS: Univariate and multivariate Cox regression analyses were carried out in the retrospective data of 326 eligible patients. RESULTS: Fourteen (4.3%) patients had LR and 46 (14.1%) patients suffered DR, in their follow-up periods. The multivariate time-dependent Cox model for DR showed that ratio of positive nodes (PN) (p=0.004; hazard ratio (HR), 1.05; 95% confidence interval (CI), 1.02-1.09) and LR (p=0.05; HR, dependent on time) were strongly associated with DR. In the multivariate Cox analysis for LR, age (35 years; p<0.0001; HR, 6.8; CI, 2.3-19.9), lymphatic vascular invasion (LVI) (yes vs no; p=0.03; HR, 3.3; CI, 1.2-9.8), and a ratio of PN (>15% vs 相似文献   

四种血脂脂蛋白比值对冠心病诊断价值的比较

目的比较总胆固醇/高密度脂蛋白胆固醇(TC/HDL-C)、甘油三酯/HDL-C(TG/HDL-C)、低密度脂蛋白胆固醇/HDL-C(LDL-C/HDL-C)、载脂蛋白B/载脂蛋白A1(ApoB/ApoA1)四项比值对冠心病(CHD)的诊断价值。方法分析453例CHD患者和98例正常对照组的TC、TG、HDL-C、LDL-C、ApoB、ApoA1水平,计算TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、ApoB/ApoA1比值,进行分析比较。结果CHD组TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、ApoB/ApoA1比值分别为4．88±1．66、1．78±1．76、3．16±1．24、0．87±0．32,显著高于正常对照组的3．85±0．99、0．90±0．49、2．32±0．77、0．75±0．19(t=5．932、4．930、6．403、3．477,P＜0．001)。CHD组四项比值的异常率分别为42．6%、46．3%、47．2%、34．2%,明显高于正常对照组的14．3%、17．3%、11．2%、18．4%(x~2=27．549、27．991、43．258、9．396,P＜0．01)。LDL-C/HDL-C比值的异常率及OR值高于其它血脂指标。结论TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、ApoB/ApoA1比值对CHD的诊断价值均大于各单项血脂指标,而LDL-C/HDL-C和TG/HDL-C比值水平与CHD的相关更强。     

Excel软件在药效评价Meta分析中的应用

目的探讨Excel表格软件在药效评价Meta分析中的可行性。方法通过单元格引用和函数引用的方法,编写Excel表格程序。结果实例分析表明,基于Excel表格的Peto法Meta分析,其异质性检验、综合效应分析结果以及森林图和漏斗图与RevMan 4.2软件是一致的。结论在计数资料Meta分析的固定效应模型中,可以采用Excel软件进行Peto法Meta分析。     

钢铁行业总粉尘与呼吸性粉尘浓度比值的研究

[目的]为探讨总粉尘与呼吸性粉尘浓度比值的关系。[方法]对某钢铁公司所属炼铁和采矿分公司的1504名接尘工人进行调查研究,通过进行矽肺病流行病学调查分析,把40年来的总粉尘浓度换算成呼吸性粉尘浓度。[结果]表明T/R比值在不同作业场所结果不一,配料和掘进两个工种呼吸性粉尘浓度较其他工种高,且患病率也高于其他工种。[结论]说明粉尘的生物学作用与呼吸性粉尘联系密切,进一步说明了呼吸性粉尘浓度比总粉尘浓度更能反映工人接尘的实际危害程度。