Disparities in the use of telehealth during the COVID-19 pandemic.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 87-87
Author(s):  
Cardinale B. Smith ◽  
Aarti Sonia Bhardwaj
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Service Use ◽  
Care Service ◽  
Health Care Service ◽  
Cancer Center ◽  
Third Wave ◽  
Chi Square ◽  
Asian Patients

87 Background: New York City was the epicenter of the COVID-19 pandemic. Public concern about exposure and policies to “flatten the curve” led to abrupt curtailment of health care service use, including cancer. Innovative strategies to mitigate the disruption, including telemedicine, was utilized. However, this may be less accessible to minority populations. We evaluated the differences in telehealth use among minorities and non-minorities with cancer. Methods: Our health system includes an NCI designated cancer center and 8 ambulatory sites across New York City. Utilizing the electronic medical record (EMR) we collected data on all cancer patients with an in-person or telehealth visit during the peak of the pandemic from March 1, 2020 to June 1, 2020. Race/ethnicity and visit type data was collected from the EMR. Telehealth includes video visits and telephone encounters. We used ANOVA and-chi square where appropriate to identify differences between the racial and ethnic groups in terms of use and type of telehealth and compared any differences to baseline cancer center demographics. Results: There were a total of 7,681 telehealth visits during 3/1/2020-6/1/2020; 76% were video visits. At baseline in 2019, < 1% of all patient visits were conducted via telehealth. Within our cancer center our demographic breakdown for patients seen in 2019 includes 42% patients were white, 23% Black, 14% Hispanic and 7% Asian. Among those patients utilizing video visits, 50% patients were white, 17% Black, 8% Asian, and 5% Hispanic. Among those patients utilizing phone encounters, 43% patients were white, 23% Black, 7% Hispanic and 6% Asian. Conclusions: During the COVID-19 pandemic our utilization of telehealth increased exponentially. There were significant disparities observed in the use of telehealth with Black, Hispanic and Asian patients having less utilization. These findings are important as telehealth use will now become more integrated into standard oncologic care, and it is likely that we will have a second or third wave of COVID-19 infections. Future work to understand the determinants of these disparities and interventions are needed. [Table: see text]

Generational differences in the placement of clitic se in New York City Spanish

2021 ◽  
pp. 136700692110165
Author(s):  
Kevin Martillo Viner
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Internal Variables ◽  
Chi Square ◽  
Ongoing Research ◽  
External Variables ◽  
Two Generations ◽  
Finite Verb ◽  
Chi Square Tests

Aims and objectives: This study analyzes the proclitic and enclitic positions of Spanish clitic se (e.g., ella se quería ir / ella quería irse ‘she wanted to go’) across two generations of Spanish speakers in New York City. In an effort to contribute to ongoing research aimed at better understanding Spanish in the US, the following questions are addressed. In syntactic environments that permit variation, does placement of Spanish se differ between the two generations? From the internal variables identified for this study (nonfinite verb type, finite verb, tense of finite verb, grammatical person, use of se, grammatical mood of finite verb, negation), which ones have a statistically significant effect on placement? From the external variables identified for this study (national origin, region, areal origins, sex, age, years in US, socioeconomic class, education, English skill, Spanish skill, general Spanish use), which ones have a statistically significant effect on placement? Design and data: This study is carried out within a variationist-sociolinguistic framework and the sample consists of 50 participants, 25 from the first generation (G1) and 25 from the second (G2). Analysis: Bivariate chi-square tests are performed in order to determine what internal and external variables constrain placement of the dependent variable (clitic se placement). Findings: Generation has a statistically significant effect on placement ( p = .016), wherein proclisis is more frequent amongst the G2 participants. These results corroborate previous research showing an overall preference for proclisis in both monolingual and bilingual/heritage speakers. Further, chi-square tests pinpoint five conditioning effects for G1 (nonfinite verb type, use of se, finite verb, years in US, and English skill), but only two for G2 (use of se and English skill). Originality and implications: The present study is the first to discover strong correlations between the proclitic position and the numerous internal and external variables quantitatively assessed. Future research is thus warranted.

scholarly journals The Prevalence of Asymptomatic COVID-19 infection in Cancer Patients. A Cross-Sectional Study at a Tertiary Cancer Center in New York City.

2021 ◽  
pp. 100346
Author(s):  
Mudathir Ibrahim ◽  
Vijaya Natarajan ◽  
Pooja Murthy ◽  
Trishala Meghal ◽  
Yiquing Xu ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Cancer Patients ◽  
York City ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tertiary Cancer Center

scholarly journals Birth characteristics of children who used early intervention and special education services in New York City

2019 ◽  
Vol 42 (4) ◽  
pp. e401-e411
Author(s):  
Matthew L Romo ◽  
Katharine H McVeigh ◽  
Phoebe Jordan ◽  
Jeanette A Stingone ◽  
Pui Ying Chan ◽  
...  
Keyword(s):  
New York ◽  
Special Education ◽  
New York City ◽  
Early Intervention ◽  
Gestational Age ◽  
York City ◽  
Service Use ◽  
Maternal Obesity ◽  
Use Patterns ◽  
Birth Characteristics

Abstract Background Early intervention (EI) and special education (SE) are beneficial for children with developmental disabilities and/or delays and their families, yet there are disparities in service use. We sought to identify the birth characteristics that predict EI/SE service use patterns. Methods We conducted a retrospective cohort study using linked administrative data from five sources for all children born in 1998 to New York City resident mothers. Multinomial regression was used to identify birth characteristics that predicted predominant patterns of service use. Results Children with service use patterns characterized by late or limited/no EI use were more likely to be first-born children and have Black or Latina mothers. Children born with a gestational age ≤31 weeks were more likely to enter services early. Early term gestational age was associated with patterns of service use common to children with pervasive developmental delay, and maternal obesity was associated with the initiation of speech therapy at the time of entry into school. Conclusions Maternal racial disparities existed for patterns of EI/SE service use. Specific birth characteristics, such as parity and gestational age, may be useful to better identify children who are at risk for suboptimal EI use.

scholarly journals The Hardest Weeks of My Life: A Qualitative Study of Experiences, Practice Changes, and Emotional Burden of New York City Oncology Physicians During the COVID-19 Surge in 2020

2021 ◽  
Author(s):  
Kathleen A. Lynch ◽  
Angela Green ◽  
Leonard Saltz ◽  
Andrew S. Epstein ◽  
Danielle R. Romano ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Well Being ◽  
Cancer Center ◽  
Care Needs ◽  
Goals Of Care ◽  
Medical Oncologists ◽  
Practitioner Training ◽  
Oncology Care

PURPOSE: The COVID-19 pandemic surge in New York City in Spring 2020 resulted in an unprecedented constraint on health care resources. This study aimed to explore the experiences of doctors providing care to oncology patients during this time. METHODS: Hospitalists and medical oncologists from two large inpatient services at a dedicated cancer center participated in virtual in-depth interviews exploring how the pandemic affected their practice and to what extent it may have affected decisions for urgent evaluation or hospital admission, interventions, or goals-of-care discussions. Interviews also explored how the pandemic affected each individual physician's psychologic well-being. Transcripts were analyzed by three independent coders in Atlas.ti v. 7.5, using a thematic analysis approach. RESULTS: Eighteen physicians were interviewed (n = 6 GI medical oncologists, n = 6 gynecologic medical oncologists, and n = 6 hospitalists). Analysis identified five major themes related to fear and distress: (1) perceived patient fears of the hospital during COVID-19, leading to avoidance and delay of acute care needs before admission, (2) physicians' fear and distress delivering oncology care during COVID-19, (3) physician distress resulting from ambiguity in decision making, (4) distress and anxiety balancing the need for patient contact with the need to minimize infection risk, and (5) distress regarding impact of uncertainty and acuity of COVID-19 on goals-of-care discussions. CONCLUSION: Insight into the experiences of physicians providing cancer care during a COVID-19 surge underscores the need for strategies mitigate short-term distress and long-term psychologic impacts. Findings can also inform practitioner training and preparedness for future pandemics in the oncology setting.

HIV-associated lung cancer in New York City.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17589-e17589
Author(s):  
Benjamin Levy ◽  
Rangaswamy Chintapatla ◽  
Jaime Suarez ◽  
Cliff P. Connery ◽  
Faiz Y. Bhora ◽  
...  
Keyword(s):  
Lung Cancer ◽  
New York ◽  
New York City ◽  
York City ◽  
Mutational Analysis ◽  
Tumor Biology ◽  
Cd4 Count ◽  
Cancer Center ◽  
Seer Database ◽  
Kaplan Meier

e17589 Background: Recent evidence suggests that HIV may be a risk factor of lung cancer, independent of smoking . Due to the expanding population of HIV patients with lung cancer, there is a need to define the clinical course and tumor biology of these patients. Our analysis seeks to characterize the clinical and molecular features of HIV associated non small cell lung cancer (HIV-NSCLC) and evaluate outcomes in a New York City Cancer center that serves a racially and economically diverse population. Methods: We searched the Continuum Cancer Center Registry for cases of HIV-NSCLC diagnosed from 2002 to 2012. Charts were reviewed to determine patient and tumor characteristics, treatment and outcomes. Kaplan-Meier curves were constructed for survival and compared by means of the log rank test. Patient characteristics were compared to national data from the SEER database. Mutational analysis of archival tissue was performed by OnkoMatch Tumor genotyping. Results: HIV-NSCLC was idenfied in 74 patients. Median age (MA) was 55 compared to MA of 70 for non HIV-NSCLC. Patients were predominantly male (72%). Histology distribution was reflective of the non-HIV population (SEER): adenocarcinoma [31 (42%)], squamous [18 (24%)], NSCLC NOS [8 (11%)], poorly differentiated [6 (8%)], and other [9 (15%)]. Distribution of stage was similar to SEER with 39 (53%) patients presenting with stage IV. Lowest recorded CD4 count was <200 in 34 patients (68%) with available CD4 counts. Chemotherapy and radiation were administered to 28 (49%) and 19 patients (31%), respectively. Median survival was 5.2 months. Kaplan-Meier curves were not statistically different by CD4 count (> or < 200), or by receipt of chemo or radiation. Mutational analysis on 7 patients demonstrated 3 with cMet overexpression, 2 KRAS mutations and 1 BRAF mutation. Conclusions: Among our HIV-NSCLC cohort, patients were diagnosed at younger age, but had similar stage and histology distributions as SEER database averages. HIV associated lung cancer appears to have a poor prognosis similar to that of the general population. Rates of treatment were low in our cohort and the potential for undertreatment warrants further study. Observed increased rate of cMET overexpression should prompt further molecular profiling in this population.

Obstetric Inpatient and Ultrasound Clinical Personnel Absences during the COVID-19 Pandemic in New York City

2021 ◽  
Author(s):  
Jessica Spiegelman ◽  
Clara Bertozzi-Villa ◽  
Mary E. D'Alton ◽  
Janice J. Aubey ◽  
Karin Fuchs ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Nursing Assistants ◽  
Categorical Variables ◽  
Labor And Delivery ◽  
Columbia University ◽  
Chi Square ◽  
Medical Specialties ◽  
Exact Test

Objective To review obstetric personnel absences at a hospital during the initial peak of coronavirus disease 2019 (COVID-19) infection risk in New York City from March 25 to April 21, 2020. Study Design This retrospective study evaluated absences at Morgan Stanley Children's Hospital. Clinical absences for (1) Columbia University ultrasonographers, (2) inpatient nurses, (3) labor and delivery operating room (OR) technicians, (4) inpatient obstetric nurse assistants, and (5) attending physicians providing inpatient obstetric services were analyzed. Causes of absences were analyzed and classified as illness, vacation and holidays, leave, and other causes. Categorical variables were compared with the chi-square test or Fisher's exact test. Results For nurses, absences accounted for 1,052 nursing workdays in 2020 (17.2% of all workdays) compared with 670 (11.1%) workdays in 2019 (p < 0.01). Significant differentials in days absent in 2020 compared with 2019 were present for (1) postpartum nurses (21.9% compared with 12.9%, p < 0.01), (2) labor and delivery nurses (14.8% compared with 10.6%, p < 0.01), and (3) antepartum nurses (10.2% compared with 7.4%, p = 0.03). Evaluating nursing assistants, 24.3% of workdays were missed in 2020 compared with 17.4% in 2019 (p < 0.01). For ultrasonographers, there were 146 absences (25.2% of workdays) in 2020 compared with 96 absences (16.0% of workdays) in 2019 (p < 0.01). The proportion of workdays missed by OR technicians was 22.6% in 2020 and 18.3% in 2019 (p = 0.25). Evaluating attending physician absences, a total of 78 workdays were missed due to documented COVID-19 infection. Evaluating the causes of absences, illness increased significantly between 2019 and 2020 for nursing assistants (42.6 vs. 57.4%, p = 0.02), OR technicians (17.1 vs. 55.9%, p < 0.01), and nurses (15.5 vs. 33.7%, p < 0.01). Conclusion COVID-19 outbreak surge planning represents a major operational issue for medical specialties such as critical care due to increased clinical volume. Findings from this analysis suggest it is prudent to devise backup staffing plans. Key Points

A Three-Year Study of Chaplains' Professional Activities at Memorial Sloan-Kettering Cancer Center in New York City

2004 ◽  
Vol 20 (2) ◽  
pp. 3-12 ◽  
Author(s):  
Kevin J. Flannelly ◽  
Andrew J. Weaver ◽  
George F. Handzo
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Cancer Center ◽  
Professional Activities

Geographical variation in acute psychiatric admissions within New York City 1990–2000: growing inequalities in service use?

2004 ◽  
Vol 59 (2) ◽  
pp. 361-376 ◽  
Author(s):  
Michael Almog ◽  
Sarah Curtis ◽  
Alison Copeland ◽  
Peter Congdon
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Geographical Variation ◽  
Service Use ◽  
Psychiatric Admissions
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