Perception and barriers to virtual medicine in Hispanics and underrepresented populations.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 169-169
Author(s):  
Alvaro G. Menendez ◽  
Katarina Bade ◽  
Emily Hsu ◽  
Jyoti Chhabra
Keyword(s):  
Behavioral Interventions ◽  
Multivariable Analysis ◽  
Healthcare Delivery ◽  
Perceived Barriers ◽  
Healthcare Outcomes ◽  
Chi Square ◽  
Oncological Care ◽  
Home Based ◽  
Significant Difference ◽  
Virtual Medicine

169 Background: Perceptions and barriers to virtual medicine (VM) in Hispanics and underrepresented population (H/UP) are unknown. We investigated these parameters in a multicenter oncology trial in hopes of improving quality of care and minimizing potentially negative healthcare outcomes related to this increasingly popular healthcare delivery (HD) technique. Methods: An IRB-approved, 14-item questionnaire was offered in English and Spanish to all pts. receiving care at participating cancer centers over a 6-month period. Examined variables included demographic information, preferences and perceived barriers regarding VM. Multivariable analysis was performed using Chi Square test to determine association between demographic variables and participants preferences and perceived barriers. Results: A total of 180 pts were enrolled. H/UP rely more on social media to receive health information (32.6% vs 23.9%) as opposed to face-to-face. Fewer H/UP have received oncological care through VM (27.9% vs 32.9%) despite comparable preferences regarding incorporation or exclusive use of VM in HD (23.2 % vs 24.6%). Similar levels of satisfaction with current HD methods were reported (83.7% vs 86%). No significant difference by age, level of education, marital status or Hispanic ethnicity was noted although Spanish as primary language was statistically significant (p = 0.001) in patient satisfaction and preferences regarding use of VM. H/UP involve family members more frequently through VM (48.8% vs 29.1). H/UP have more technical barriers to VM as they were up to 2.6 times more likely to not have a phone/ipad/similar or have access to broadband connectivity (23.3% vs 9%; and 16.3% vs 8.2% respectively). Conclusions: H/UP are equally interested and satisfied in receiving oncological care through VM. Given the shift towards outpatient and home-based care, an aging population, and cultural appropriations, VM excitedly allows re-incorporation of family/caregiver in medical engagement. However, fewer H/UP are currently utilizing VM which could be secondary to H/UP’s specific barriers or healthcare bias. Although behavioral interventions may be explored, H/UP barriers are predominantly technical and targetable with appropriate policies that take into consideration institutional and reimbursement programs.

Abstract P415: Is Hemostatic Efficacy of Four Factor Prothrombin Complex Concentrate Similar in Intracerebral Hemorrhage Patients Receiving Warfarin vs Non-Vitamin K Anticoagulants?

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Gregory Pon ◽  
Brittany Pelsue ◽  
Xu Zhang ◽  
Brian Gulbis ◽  
Sujan T Reddy ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Vitamin K ◽  
Prothrombin Complex Concentrate ◽  
Multivariable Analysis ◽  
Chi Square ◽  
Significant Difference ◽  
Forward Stepwise ◽  
Multivariable Regression ◽  
Baseline Characteristics ◽  
Hemostatic Efficacy

Introduction: Four Factor Prothrombin Complex Concentrate (4F-PCC) is indicated for reversal of warfarin-induced coagulopathy. In small cohort studies, 4F-PCC has similar hemostatic efficacy rates reversing non-vitamin K anticoagulants (NOACs). There are no comparison studies evaluating 4F-PCC for the reversal of warfarin versus NOACs in the setting of intracerebral hemorrhage (ICH). Methods: A multicenter retrospective cohort study was conducted between 2013-2020 at a comprehensive stroke system in ICH patients who received 4F-PCC for the reversal of warfarin or a NOAC. Patients were included if they were adults with an acute ICH, anticoagulant regimen of warfarin (INR 1.3 or greater) or NOAC, and 2 head CT scans within 24 hours to determine hemostatic efficacy. Hemostatic efficacy was evaluated by the Sarode scale. The chi square and t-test were used as appropriate for demographic and clinical data, with multivariable regression analysis conducted in a forward stepwise manner, retaining variables with significance less than 0.05. Results: One hundred fifty-seven patients were included (baseline characteristics in Table 1). There was no statistically significant difference in effective hemostasis observed between warfarin and NOAC patients (83% vs 75%, p=0.33). Similarly, multivariable analysis did not demonstrate a significant difference in effective hemostasis (OR 0.55, 95% CI: 0.2-1.3, p=0.2). However, due to wide 95% confidence intervals, we cannot exclude a key treatment effect from PCC. After controlling for baseline characteristics, patients treated with NOACs had 53% lower odds of a good clinical outcome compared to those treated with warfarin (Figure 1; OR 0.47, 95% CI: 0.2-1.3, p=0.13). Conclusions: In conclusion, there was no statistically significant difference in hemostatic efficacy or clinical outcomes between warfarin and NOAC patients following reversal with 4F-PCC.

Social determinants of health and the Barrio Advantage among Hispanics during the COVID-19 pandemic.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 133-133
Author(s):  
Nerea Lopetegui-Lia ◽  
Jasmin Hundal ◽  
Katarina Bade ◽  
Emily Hsu ◽  
Jyoti Chhabra ◽  
...  
Keyword(s):  
Community Health ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
English Proficiency ◽  
Multivariable Analysis ◽  
Healthcare Delivery ◽  
Determinants Of Health ◽  
Similar Amount ◽  
Chi Square ◽  
Acculturation Process

133 Background: Institutional data confirmed that despite Hispanics having a higher morbidity related to COVID19, mortality and outcomes were more favorable compared to other ethnic counterparts. We decided to study the role of the Barrio Advantage (BA), living in ethnically similar communities leading to health advantage, by taking into account acculturation in our patients in hopes of identifying potential avenues to educate our population and minimize healthcare delivery gaps. Methods: A 15-item IRB-approved questionnaire was administered to cancer patients receiving care at participating cancer centers in English and Spanish. Multivariable analysis was performed using Chi Square test to determine associations between examined variables which included socio-demographic information, fears and attitudes related to COVID19. Results: A total of 251 surveys were analyzed. 43.4% were Hispanic with 72% of them listing Spanish and 28% English as their preferred language. Similar amount of English Speaking Hispanics (ESH) and Spanish Speaking Hispanics (SSH) had no personal or family exposure to COVID19 (66.7% and 59.5%, respectively). SSH have a lower degree of education (33% with at least some college, vs 53.3%). More SSH depend on government issued insurance or have no insurance at all (78.5% vs 63.3%). COVID19 has disproportionately worsened fears in SSH (Table). The Barrio Advantage effect was evidenced by the fact that SSH rely more on faith-based institutions or family/friends for emotional support and healthcare inquiries (22.8% vs 13.3%) although more ESH would do so in the case of food security (53.3% vs 41.8%). Comparison of fears to financial, personal and community health based on English proficiency. Conclusions: Financial, personal and community health concerns are deepened in Hispanics, particularly for SSH, potentially due to the lack of acculturation process. Understanding Hispanics and other underrepresented populations are far from monolithic. Loco-regional social determinants of health must be studied in an attempt minimize health disparities including those related to COVID19. The BA, English proficiency and the acculturation process should be considered when developing interventions aimed at decreasing negative outcomes in this dynamic population.[Table: see text]

Swabs by emergency responders (SWABBER): Enhancing care beyond the cancer center during the COVID-19 pandemic.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 97-97
Author(s):  
Olivia S. Allen ◽  
Mark Liu ◽  
Kevin Munjal ◽  
Rex Lomboy ◽  
Aarti Sonia Bhardwaj ◽  
...  
Keyword(s):  
New York ◽  
Patient Experience ◽  
Healthcare Delivery ◽  
Cancer Center ◽  
Coordinated Care ◽  
Chi Square ◽  
Limited Mobility ◽  
Emergency Responders ◽  
Significant Difference ◽  
Patient Use

97 Background: The COVID-19 pandemic caused sudden changes in healthcare delivery, and new policies were rapidly implemented to ensure safety for patients and staff. However, COVID-19 testing requirements presented a barrier for many patients. Outdoor testing in New York City became less feasible during colder months, and oncology patients have additional concerns, such as limited mobility and immunosuppression. To address these barriers, we created an in-home COVID-19 testing program through a partnership between Community Paramedicine and Oncology: SWABBER (SWABS by Emergency Responders). We evaluated patient use of and satisfaction with SWABBER. Methods: SWABBER began in September 2020 as an interdisciplinary initiative to offer in-home, asymptomatic COVID-19 PCR testing for patients on active treatment in an effort to provide more coordinated care and improve patient experience. Tests were performed prior to the first day of each treatment cycle at no cost to patients. Randomly selected patients completed a brief survey about their experiences with the program, with questions on a seven-point Likert scale. Sociodemographic data was collected from the EMR, and we used a chi-square test to identify differences in patient use of SWABBER by race. Results: From September 8, 2020–April 1, 2021, we saw 7,204 patients for infusion, of whom 993 (14%) participated in SWABBER. The cohort of all patients receiving treatment was 45% White, 19% Black, 6% Asian, 29% Other, and 1% Unknown race. The SWABBER cohort was 36% White, 21% Black, 12% Asian, 29% Other, and 1% Unknown race. There was a significant difference in patient race between these two groups (P < 0.00001), with more Black and Asian patients in SWABBER compared to all patients receiving treatment. A total of 406 (41%) SWABBER patients completed the patient experience survey. The mean scores for overall experience and likelihood of recommending the program were 6.9, with standard deviations of 0.56 and 0.44, respectively. Conclusions: SWABBER enabled us to deliver care directly to patients’ homes, mitigating COVID-19 exposure while promoting accessible care and providing an increased benefit for minority patients. Through SWABBER, we achieved near-perfect patient experience ratings, reduced the burden of testing, created a safer environment for patients and staff, and kept cancer care on track. Future work will evaluate ways to maintain elevated patient experience and continue striving for inclusive care beyond the pandemic.[Table: see text]

Personal Audio System: Hearing Symptoms, Habits, and Sound Pressure Levels Measured in Real Ear and a Manikin

2020 ◽  
Vol 63 (6) ◽  
pp. 2016-2026
Author(s):  
Tamara R. Almeida ◽  
Clayton H. Rocha ◽  
Camila M. Rabelo ◽  
Raquel F. Gomes ◽  
Ivone F. Neves-Lobo ◽  
...  
Keyword(s):  
Sound Pressure ◽  
Daily Basis ◽  
Cross Sectional Study ◽  
Normal Hearing ◽  
Chi Square ◽  
Cross Sectional ◽  
The Real ◽  
Significant Difference ◽  
Sound Pressure Levels ◽  
Audio System

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435

The Influence of Age and Gender on Mandibular Indices among the Libyan Population

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Negative Correlation ◽  
Bone Mineralization ◽  
Age Groups ◽  
T Test ◽  
Chi Square ◽  
Age And Gender ◽  
Significant Difference ◽  
Chi Square Test ◽  
And Gender ◽  
Libyan Population

Radiographic Mandibular Indices serve as easy and relatively cheap tools for evaluating bone mineralization. Objectives: To examine the effect of age and gender on three mandibular indices: the panoramic mandibular index (PMI), the mandibular ratio (MR) and the mandibular cortical index (MCI), among Libyan population. Methods: The three indices were measured on 317 digital (OPGs) of adult humans (155 males, 162 females). The sample was divided into six age groups (from 18-25 years through 56-65 years). The measurements were analyzed for interactions with age and sex, using SPSS (Statistical Package for Social Studies) software version no. 22. The tests employed were two way ANOVA, the unpaired T-test and chi-square test. Results: The mean PMI fluctuated between 0.37 s.d. 0.012 and 0.38 s.d. 0.012. among the sixth age groups. One-way ANOVA statistical test revealed no significant of age on PMI. On the other hand gender variation has effect on PMI, since independent sample t-test disclosed that the difference between the male and female PMI means statistically significant. ANOVA test showed that the means of MR among age groups showed a negative correlation i.e. MR mean declined from 3.01 in 18-25 age groups to 2.7 in 55-65 age groups. In contrary, the gender showed no effect on MR according two sample t-test at p> 0.05. In regards with MCI, statistical analysis showed that it affected by age that is C1 was decreasing by age while C2 and C3 were increased by age. Using chi square test the result indicated that there is a significant difference among the different age group and the two genders in MCI readings. Conclusion: PMI was influenced significantly by age but minimally by the gender. MR is not affected by gender but has a negative correlation with age. MCI is affected by both age and gender

Nomophobia: An emerging fear

2020 ◽  
Vol 11 (01) ◽  
Author(s):  
Madhu Bala ◽  
Neetu Chaudhary
Keyword(s):  
Cell Phones ◽  
Administrative Authority ◽  
Chi Square ◽  
Current Time ◽  
Gender And Age ◽  
Significant Difference ◽  
Minimum Age ◽  
Multiple Cell ◽  
Negative Face ◽  
Agra City

In the current time, the use of technologies has become propensity more than necessity. Nobody has gotten away from them nor left youth or old. It's totally relying upon us How to utilize it? One such live innovation is a Smartphone. At only one touch we approach any data about the entire world. It is very easy to carry in our pocket so everyone can use it anytime whenever. Smartphone has some constructive as well as some cynical aspects too. Nomophobia is a negative face of the smartphone. Nomophobia is the irrational dread of being without cell phones or being not able to utilize phones (situational phobia) for some reason such as some signal or battery issues. Theprimary point of the current research is to find out the proportion of Nomophobia among understudies with regardof gender and age in Agra city. For this purpose, a total number of 300 students were selected by randomization (150 males and 150 females) from the age scope of 15-20 years. The data was taken by using a self-administered questionnaire NMP-Q developed by Yilidirim and Correia. The obtained data were analyzed using descriptive statistics, Mean and Chi-square. Results revealed that there is a significant difference between male and female score on nomophobia. The other result indicates that early adolescents positively related to Nomophobia as compare to late adolescents. In India, one person can use multiple cell phones. There is no minimum age to use mobile phones. It is adding fuel to the pre-existing problem of Nomophobia. Telecom Administrative Authority of India (TRAI) should assume a functioning job by making an arrangement/law that "setting based methodology" on cell phone limitations among individuals ought to be followed. A demonstration will be detailed, under this demonstration. There ought to choose the least age for portable use. It will assist a great deal with curbing the circumstance.

Fecundity and Gonado-somatic Index of Trichiurus lepturus (Linnaeus, 1758) Along the Zamboanga del Norte Coast

2018 ◽  
Vol 6 (7) ◽  
pp. 120
Author(s):  
Ma. Dulce C. Guillena
Keyword(s):  
Sex Ratio ◽  
Stock Assessment ◽  
Chi Square ◽  
Moon Phases ◽  
Ovary Weight ◽  
Moment Coefficient ◽  
Trichiurus Lepturus ◽  
Significant Difference ◽  
The Relationship ◽  
Somatic Index

Gonado-somatic index and fecundity are tools for measuring the sexual maturity and ability of animals to reproduce.  This study investigates the reproduction of Trichiurus lepturus. Specifically, this aimed to determine the sex ratio, the GSI, the relationship between fecundity and total length, fecundity and total weight, fecundity and ovary weight. The Descriptive Method of research was used.  Percentage and chi-square was utilized in determining the percentage of occurrence and sex ratio respectively.   Pearson r Product Moment Coefficient of Correlation was used to determine the relationships of the parameters. The study revealed that females outnumbered males and the sex ratio for different month showed significant difference.  Spawning season was observed to occur in November and December as revealed in its GSI values and it synchronized with the full and new moon phases.  Fecundity is positively correlated with body weight, body size, and ovary weight where ovary weight is observed to be the best index for fecundity.  The results of this study could be used further for formal stock assessment of cutlassfish fishery.

EVALUTING THE EFFECTS OF EARLY INTERVENTION PROGRAM FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES IN COMMUNITY

2011 ◽  
pp. 70-76
Author(s):  
Keyword(s):  
Social Cognition ◽  
Early Intervention ◽  
Developmental Delay ◽  
Intervention Program ◽  
Language Skills ◽  
Early Intervention Program ◽  
Self Help ◽  
Home Based ◽  
Significant Difference ◽  
One Year

Objectives: To evualate the effects of early intervention program after one year for 33 disabled children in Hue city in 2010. Objects and Methods: Conduct with practical work and assessment on developing levels at different skills of the children with developmental delay under 6 years old who are the objects of the program. Results: With the Portage checklist used as a tool for implementing the intervention at the community and assessing developing skills on Social, Cognition, Motor, Self-help and Language skills for children with developmental delay, there still exists significant difference (p ≤ 0.05) at developing level of all areas in the first assessment (January, 2010) and the second assessment (December, 2010) after 12 months. In comparison among skills of different types of disabilities, there is significant difference of p ≤ 0.05 of social, cognition and language skills in the first assessment and of social, cognition, motor and language skills in the second assessment. Conclusion: Home-based Early Intervention Program for children with developmental delay has achieved lots of progress in improving development skills of the children and enhancing the parents’ abilities in supporting their children at home.

Association of Rugae Pattern with Skeletal Malocclusion in Orthodontic Patients Visiting Tertiary Care Hospital

2020 ◽  
Author(s):  
Sarwat Memon
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Class Iii ◽  
Chi Square ◽  
Cross Sectional ◽  
Skeletal Malocclusion ◽  
Palatal Rugae ◽  
Significant Difference ◽  
Orthodontic Patients

Background: The palatal rugae are special constructions that are inalterable in their position and pattern during the lifestyles of an individual. This imparts them an exceptional role in the forensic dentistry and may play potential role in malocclusion identification. This study was aimed to see association of rugae pattern with sagittal skeletal malocclusion in orthodontic patients visiting tertiary care hospital. Methods: This cross-sectional examination was completed on pretreatment records (lateral Cephalometric radiographs and maxillary dental casts) of 384 subjects at the orthodontic department of Ziauddin Dental Hospital, Karachi. The study duration was from January to July 2019. The samples were sub-divided into three sagittal skeletal groups based on ANB angle proposed by Steiner’s on lateral Cephalometric radiographs (Class I with ANB angle between 0° to 4°; Class II: ANB angle greater than 5°; Class III: ANB angle less than 0°). The shapes of three most-anterior primary rugae were then evaluated bilaterally using Kapali et al., Classification. Chi Square test was applied to find association of rugae pattern among sagittal skeletal malocclusions groups. Results: Circular and curved rugae shapes were the most prevalent in all skeletal malocclusions. The primary palatal rugae pattern was seen to be significantly different among three skeletal malocclusion groups (p<0.05). The right and left sided palatal rugae pattern showed significant difference in all three skeletal malocclusion groups (p<0.05). Conclusion: The present study showed no specific palatal rugae pattern associated with sagittal skeletal malocclusion. Further studies on larger sample and use of modern 3D technologies to scan the maxillary casts are required for results that are more precise.

Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

2020 ◽  
Vol 2 (1) ◽  
pp. 36-44
Author(s):  
Satyawan G. Damle ◽  
Ritika Bansal ◽  
Dhanashree D. Sakhare
Keyword(s):  
Success Rate ◽  
Study Groups ◽  
Primary Molars ◽  
Control Group ◽  
Second Primary ◽  
Chi Square ◽  
Exact Test ◽  
Root Canals ◽  
Significant Difference ◽  
Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p>0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

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