Unequal rates of postoperative complications in relatively healthy bariatric surgical patients of white and black race

BackgroundRacial disparities in postsurgical complications are often presumed to be due to a higher preoperative co-morbidity burden among patients of black race, although being relatively healthy is not a prerequisite for a complication-free postoperative course.ObjectivesTo examine the association of race with short-term postbariatric surgery complications in seemingly healthy patients.SettingsMetabolic and Bariatric Surgery Accreditation and Quality Improvement Program database (2015–2018).MethodsWe studied a relatively healthy (American Society of Anesthesiologists physical status 1 or 2), propensity score–matched cohort of adult non-Hispanic black and non-Hispanic white bariatric surgery patients. We compared the risk-adjusted incidences of postoperative complications, serious adverse events, and measures of postoperative resource utilization across racial groups.ResultsWe identified 44,090 matched pairs of relatively healthy black and white bariatric surgery patients. Patients of black race were 72% more likely than those of white race to develop 1 or more postoperative complications (.7% versus .4%, respectively; odds ratio [OR], 1.72; 95% confidence interval [CI], 1.32–2.24; P < .01). Measures of postbariatric resource utilization were significantly higher in patients of black race than those of white race, including unplanned reoperations (1.3% versus 1.0%, respectively; OR, 1.28; 95% CI, 1.07–1.52; P = .01), unplanned readmissions (4.5% versus 3.0%, respectively; OR, 1.53; 95% CI, 1.38–1.69; P < .01), unplanned interventions (1.6% versus 1.2%, respectively; OR, 1.36; 95% CI, 1.16–1.60; P < .01), and extended hospital lengths of stay (51.2% versus 42.7%, respectively; OR, 1.41; 95% CI, 1.36–1.46; P < .01).ConclusionEven among relatively healthy patients, race appears to be an important determinant of postbariatric surgery complications and resource utilization. Research and interventions aimed at narrowing the racial disparities in bariatric surgery outcomes may need to broaden the focus beyond the racial variation in the preoperative co-morbidity burden.     

Systematic assessment of South Korea’s capabilities to control COVID-19

South Korea’s COVID-19 control strategy has been widely emulated. Korea’s ability to rapidly achieve disease control in early 2020 without a “Great Lockdown” despite its proximity to China and high population density make its achievement particularly intriguing. This paper helps explain Korea’s pre-existing capabilities which enabled the rapid and effective implementation of its COVID-19 control strategies. A systematic assessment across multiple domains demonstrates that South Korea’s advantages in controlling its epidemic are owed tremendously to legal and organizational reforms enacted after the MERS outbreak in 2015. Successful implementation of the Korean strategy required more than just a set of actions, measures and policies. It relied on a pre-existing legal framework, financing arrangements, governance and a workforce experienced in outbreak management.     

淫羊藿、人参耐缺氧、耐疲劳及抗氧化作用的实验研究

目的 探讨淫羊藿、人参耐缺氧、耐疲劳及抗氧化作用。方法 采用单独和联合给药的方法对老龄小鼠进行抗缺氧实验,耐疲劳实验,按硫代巴比妥法测定血浆和组织MDA,按EistnerFF法测定红细胞SOD的活性。结果与结论 人参能提高小鼠耐缺氧的能力,淫羊藿可加强其作用;两者都能提高小鼠耐疲劳的能力。淫羊藿和人参均有抗氧化作用,可使血浆和组织中的MDA降低,红细胞的SOD活性增加。两药配伍使用有协同作用。     

炭药的炮制工艺改进及质量标准初探

采用加入介质和改变火力的方法改进传统的炭药炮制工艺,用ｐＨ值测定法控制炭药质量,通过测定山楂不同炮制工艺所得标准炭品的ｐＨ值和酸性物质含量,以及相关的药理实验,来验证改进工艺的可行性。     

西洋参DNA导入大豆实现遗传转化的研究Ⅱ.导入后代异黄酮类成分的含？…

用高效液相色谱法测定了西洋参 DNA导入大豆后代的异黄酮类成分、大豆苷 (daidzin)、大豆黄素(daidzein)、染料木苷 (genistin)、染料木素 (genistein)的含量 ,采用 U nisil Q C1 8柱 ,4.6 mm× 2 5 0 m m,流动相乙腈 - 0 .0 0 3mol/L 磷酸氢二钠 (17∶ 83) ,流速 1.0 m L/min,检测波长 2 5 4nm,结果表明 ,4种成分分离效果好 ,成分含量发生了广泛变异 ,从中可筛选出有效成分含量较高的新材料     

鸡蛋参的化学成分研究

从鸡蛋参Ｃｏｄｏｎｏｐｓｉｓ ｃｏｎｖｏｌｖｕｌａｃｅａ的干燥块根中分行９个化合物,经理化性质和光谱分析分别鉴定为：（２Ｅ）－２－乙基－二十九－２－烯醛（Ⅰ）,１,２－丙二醇双十七酸酯（Ⅱ）,豆甾烷醇（Ⅲ）,α－菠甾醇（Ⅳ）,α菠甾酮（Ⅴ）,二十五烷（Ⅵ）,木栓酮（Ⅶ）,β－香树脂乙酸酯（Ⅷ）和羽扇豆醇乙酯（Ⅸ）,其中Ⅰ为一新化合物,Ⅱ,Ⅲ,Ⅷ和Ⅸ为首次从党参属植物中分得。     

安胃降逆饮对大鼠胃功能的影响

目的 观察安胃降逆饮对胃功能的影响,分析其镇吐作用机制。方法 采用大鼠离体胃条法测定胃条张力,小鼠粉红排空试验法测定胃排空量和０．１ｍｏｌ／Ｌ ＮａＯＨ滴定法测定胃酸含量。结果安胃降逆饮对大鼠胃肌物基础张力和乙酰胆碱引起的痉挛性收缩有明显抑制作用（Ｐ〈０．０１）,对小鼠胃排空,大鼠胃液量,胃液酸度及总酸度无明显影响（Ｐ〉０．０５）。结论 安胃降逆饮的镇吐作用至少部分是通过抑制胃肠平滑肌蠕动而发挥作     

直序商陆炮制品毒性成分测定

目的：探讨炮制对直序商陆毒性成分的影响。方法：采用薄层扫描法测定直序商陆不同炮制饮片中商陆毒素的含量。结果：清蒸品、醋煮品及醋品中商陆毒素的含量仅分别为原药材的１６．;７３％、２１．８８％及４５．８５％。结论：清蒸法和醋煮法为直序商陆炮制的最佳工艺。     

Competencies and problems reported by parents of Greek and American children,ages 6–11

This study compared parent-reported competencies and behavioral/emotional problems in demographically-matched samples of Greek and American children, ages 6–11. Parents of 356 children of each nationality completed the Child Behavior Checklist (CBCL). Competence scores were higher for American children, except on Academic Competence, where scores were higher for Greek children. Greek scores were significantly higher than American scores on the Withdrawn, Anxious/Depressed, Attention Problems, Delinquent Behavior, Aggressive Behavior, Internalizing, Externalizing, and Total Problem scales. On the Anxious/Depressed syndrome, nationality accounted for 14% of the variance. There were few main effects for sex and age and fewer interactions. The higher problem scores in the Greek sample were partly due to the tendency of Greek parents to use extreme item scores. When items were scored present v. absent, Greek scores were higher only on Withdrawn, Anxious/Depressed, Internalizing, and Total Problems, while American scores were higher on Somatic Complaints and Thought Problems. Nationality differences in rates of referral for mental health services and sample differences in exclusion criteria for prior mental health services may have contributed to differences in problem scores. Results are compared to findings from other cross-cultural studies.

---

Zusammenfassung Diese Studie vergleicht die Fähigkeiten und Verhaltens- bzw. emotionalen Auffälligkeiten in demographisch parallelisierten Stichproben von griechischen und amerikanischen Kindern im Alter von 6-11 Jahren. Die Eltern von 356 Kindern der beiden Nationalitäten füllten die Child Behavior Checklist (CBCL) aus. Die Kompetenzwerte waren bei den amerikanischen Kindern mit Ausnahme der akademischen Fähigkeiten höher. Die griechischen Werte waren signifikant höher als die amerikanischen im Hinblick auf die Skalen Zurückhaltung, ängstlich/depressiv, Aufmerksamkeitsstörungen, delinquentes Verhalten, aggressives Verhalten, Internalisation, Externalisation und Gesamtauffälligkeiten. Im Hinblick auf das ängstlich/depressive Syndrom war die Nationalität für 14% der Varianz verantwortlich. Nur vereinzelt wurden Haupteffekte im Hinblick auf Geschlecht und Alter und eine geringere Anzahl Interaktionen festgestellt. Die höheren Problemwerte in der griechischen Stichprobe waren teilweise durch die Tendenz der griechischen Eltern bedingt, extreme Werte anzukreuzen. Bei den Items, die als vorhanden bzw. nicht vorhanden gewertet werden mußten, waren die griechischen Werte nur bei den Skalen Zurückhaltung, ängstlich/depressiv, Internalisation und Gesamtprobleme höher, während amerikanische Werte für die Skalen körperliche Beschwerden und Denkstörungen höher lagen. Nationalitätsunterschiede der Zuweisungsraten zu psychosozialen Diensten und Stichprobenunterschieden im Hinblick auf die Ausschlußkriterien für vorangegangene Inanspruchnahme psychosozialer Dienste könnten zu den unterschiedlichen Problemwerten beigetragen haben. Die Ergebnisse werden verglichen mit anderen transkulturellen Studien.

---

Résumé Cette étude a comparé les compétences et les problèmes de comportement et affectifs rapportés par les parents d'un échantillon d'enfants grecs et américains âgés de 6 à 11 ans appariés démographiquement. Les parents de 356 enfants de chaque nationalité ont rempli la Child Behavior Checklist (CBCL). Les scores de compétence étaient plus élevés pour les enfants américains excepté pour la compétence scolaire pour laquelle les scores étaient plus élevés chez les enfants grecs. Les scores grecs étaient significativement plus hauts que les scores américains quant au retrait, l'anxiété-dépression, les problèmes d'attention, le comportement délinquant, le comportement agressif, les échelles d'internalisation, d'externalisation et de problèmes totaux. Pour le syndrome anxiodépressif, la nationalité intervenait pour une variance de 14%. Il y avait peu d'effets principaux en ce qui concerne le sexe et l'âge. Les scores de problèmes les plus élevés dans les échantillons grecs étaient en partie dûs à la tendance des parents grecs à utiliser des items extrêmes. Quand les items étaient cotés présents versus absents, les scores grecs étaient plus élevés seulement en ce qui concerne le retrait, l'anxiété-dépression, l'internalisation et les problèmes totaux tandis que les scores américains étaient plus hauts en ce qui concerne les plaintes somatiques et les problèmes de pensée. Les différences de nationalité en ce qui concerne les taux de référence à des services de santé mentale et les différences des échantillons dans les critères d'exclusion pour l'utilisation antérieure de services de santé mentale, peuvent avoir contribué aux différences dans les scores de problèmes. Les résultats sont comparés aux autres études transculturelles.

     

Establishing a new university department of rural health: the first 2 years of the South Australian Centre for Rural and Remote Health

ABSTRACT: This study aimed to describe the establishment of a new University Department of Rural Health (UDRH) in South Australia and to report early achievements. In May 1997, the UDRH was established, key staff were recruited, infrastructure was developed and in April 1998 a Joint University Committee on Rural and Remote Health was formed. By mid-1999, 14 full-time equivalent staff were employed in Whyalla and Adelaide. Early achievements include: review of undergraduate rural placements; increased rural clinical placements by 1000 student-weeks; partnership with the Dental School resulting in training opportunities and falling public dental waiting lists; multidisciplinary teaching practices in four rural sites; priority public health projects established; competitive research grants won; and a capital grant to strengthen Aboriginal health services infrastructure secured. These early achievements demonstrate UDRH potential to have a real impact on health worker education, service delivery, and public health status in rural and remote areas. This strong foundation must now be built on.