Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel ...Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.展开更多
AIM:To identify the role of human development in the incidence and mortality rates of gastrointestinal cancers worldwide.METHODS:The age-standardized incidence and mortality rates for gastrointestinal cancers,includin...AIM:To identify the role of human development in the incidence and mortality rates of gastrointestinal cancers worldwide.METHODS:The age-standardized incidence and mortality rates for gastrointestinal cancers,including cancers of the esophagus,stomach,pancreas,liver,gallbladder,and colorectum,were obtained from the GLOBOCAN 2008 database and United States Cancer Statistics(USCS)report.The human development index(HDI)data were calculated according to the 2011 Human Development Report.We estimated the mortality-toincidence ratios(MIRs)at the regional and national levels,and explored the association of the MIR with development levels as measured by the HDI using a modified"drug dose to inhibition response"model.Furthermore,countries were divided into four groups according to the HDI distribution,and the MIRs of the four HDI groups were compared by one-way ANOVA followed by the Tukey-Kramer post-hoc test.Statespecific MIRs in the United States were predicted from the estimated HDI using the fitted non-linear model,and were compared with the actual MIRs calculated from data in the USCS report.RESULTS:The worldwide incidence and mortality rates of gastrointestinal cancers were as high as 39.4and 54.9 cases per 100000 individuals,respectively.Linear and non-linear regression analyses revealed an inverse correlation between the MIR of gastrointestinal cancers and the HDI at the regional and national levels(<0;P=0.0028 for regional level and<0.0001 for national level,ANOVA).The MIR differed significantly among the four HDI areas(very high HDI,0.620±0.033;high HDI,0.807±0.018;medium HDI,0.857±0.021;low HDI,0.953±0.011;P<0.001,oneway ANOVA).Prediction of the MIRs for individual United States states using best-fitted non-linear models showed little deviation from the actual MIRs in the United States.Except for 28 data points(9.93%of282),the actual MIRs of all gastrointestinal cancers were mostly located in the prediction intervals via the best-fit non-linear regression models.CONCLUSION:The inverse correlation between HD展开更多
AIM:To illustrate the application and utility of Geographic Information System(GIS) in exploring patterns of liver transplantation.Specifically,we aim to describe the geographic distribution of transplant registration...AIM:To illustrate the application and utility of Geographic Information System(GIS) in exploring patterns of liver transplantation.Specifically,we aim to describe the geographic distribution of transplant registrations and identify disparities in access to liver transplantation across United Network of Organ Sharing(UNOS) region 1.METHODS:Based on UNOS data,the number of listed transplant candidates by ZIP code from 2003 to 2012 for Region 1 was obtained.Choropleth(color-coded) maps were used to visualize the geographic distribution of transplant registrations across the region.Spatial interaction analysis was used to analyze the geographicpattern of total transplant registrations by ZIP code.Factors tested included ZIP code log population and log distance from each ZIP code to the nearest transplant center;ZIP code population density;distance from the nearest city over 50000;and dummy variables for state residence and location in the southern portion of the region.RESULTS:Visualization of transplant registrations revealed geographic disparities in organ allocation across Region 1.The total number of registrations was highest in the southern portion of the region.Spatial interaction analysis,after adjusting for the size of the underlying population,revealed statistically significant clustering of high and low rates in several geographic areas could not be predicted based solely on distance to the transplant center or density of population.CONCLUSION:GIS represents a new method to evaluate the access to liver transplantation within one region and can be used to identify the presence of disparities and reasons for their existence in order to alleviate them.展开更多
背景新型冠状病毒感染(简称新冠感染)疫情防控期间,基层卫生是防控的“第一道防线”。各国学术界对新冠感染期间基层卫生工作进行了广泛的研究,但基层卫生制度不同导致研究侧重点有差异。目的了解新冠感染背景下国内与国际上基层卫生相...背景新型冠状病毒感染(简称新冠感染)疫情防控期间,基层卫生是防控的“第一道防线”。各国学术界对新冠感染期间基层卫生工作进行了广泛的研究,但基层卫生制度不同导致研究侧重点有差异。目的了解新冠感染背景下国内与国际上基层卫生相关研究的进展、热点、趋势及差异性,为该领域进一步研究提供参考。方法于2022-07-05,检索新冠感染发生后中国知网(CNKI)与Web of science(WOS)核心数据库收录的基层卫生相关研究的文献,检索时间范围均限定为2020-01-01至2022-06-30,纳入CNKI文献282篇、WOS文献1755篇。利用CiteSpace软件进行可视化分析,实现作者共现分析,关键词共现、聚类、时间线分析,关键词突现分析。结果从文献时序分布上看国内相关研究文献量在疫情发生初期增速较快,后增速逐渐下降,趋于平缓;国际上研究起始稍滞后,但保持较高增速至今。作者合作以小团队与个人为主,无大规模跨团队合作。国内研究热点偏重疫情防控相关体制及机制探讨与管理实践,国际研究关注疫情影响下就医方式的转变、患者就医需求的满足。国内与国际上的研究均重点关注疫情影响下发生的心理问题。结论新冠感染背景下国内与国际的基层卫生相关研究既有共通点也各有侧重,国内研究在不断细化、多样化的进程中可吸收国际经验,重视相关研究力量建设,健全该领域知识体系,积极利用信息化技术完善疫情下基层卫生的服务体系。展开更多
文摘Racial, ethnic, and socioeconomic disparities present daunting hurdles that prevent equitable health outcomes for patients with end-stage kidney disease (ESKD) on hemodialysis. Additional resources, such as the Novel Intervention in Children’s Health (NICH) at Lucille Packard Children’s Hospital Stanford, provide individualized support to best assist families by assessing barriers to care with the goal of improving health outcomes. In this retrospective cohort study, we reviewed patients with ESKD on hemodialysis involved in NICH to explore if NICH serves as a liaison between the patients and multidisciplinary medical team and to explore if NICH helps patients better manage the challenges of end-stage kidney disease. Through the electronic medical record system, EPIC, we reviewed the patients’ surveys to identify barriers to care, which included school and life engagement difficulty, lack of mental health resources, food and transportation insecurity, and cultural/language barriers. We also tracked the number of hospitalizations and ED visits before and during the patients’ enrollment in NICH. We discovered that through NICH, the aforementioned barriers to care were eliminated, the number of hospitalizations and emergency department visits was reduced, and all patients transitioned from inactive to active on the transplant list. NICH successfully improved the health outcomes of these patients and empowered patients to be more engaged in their care.
基金Supported by The National Natural Science Funds for Distinguished Young ScholarsNo.30925033+1 种基金the Innovation and High-Level Talent Training Program of Department of Health of Zhejiang ProvinceChina
文摘AIM:To identify the role of human development in the incidence and mortality rates of gastrointestinal cancers worldwide.METHODS:The age-standardized incidence and mortality rates for gastrointestinal cancers,including cancers of the esophagus,stomach,pancreas,liver,gallbladder,and colorectum,were obtained from the GLOBOCAN 2008 database and United States Cancer Statistics(USCS)report.The human development index(HDI)data were calculated according to the 2011 Human Development Report.We estimated the mortality-toincidence ratios(MIRs)at the regional and national levels,and explored the association of the MIR with development levels as measured by the HDI using a modified"drug dose to inhibition response"model.Furthermore,countries were divided into four groups according to the HDI distribution,and the MIRs of the four HDI groups were compared by one-way ANOVA followed by the Tukey-Kramer post-hoc test.Statespecific MIRs in the United States were predicted from the estimated HDI using the fitted non-linear model,and were compared with the actual MIRs calculated from data in the USCS report.RESULTS:The worldwide incidence and mortality rates of gastrointestinal cancers were as high as 39.4and 54.9 cases per 100000 individuals,respectively.Linear and non-linear regression analyses revealed an inverse correlation between the MIR of gastrointestinal cancers and the HDI at the regional and national levels(<0;P=0.0028 for regional level and<0.0001 for national level,ANOVA).The MIR differed significantly among the four HDI areas(very high HDI,0.620±0.033;high HDI,0.807±0.018;medium HDI,0.857±0.021;low HDI,0.953±0.011;P<0.001,oneway ANOVA).Prediction of the MIRs for individual United States states using best-fitted non-linear models showed little deviation from the actual MIRs in the United States.Except for 28 data points(9.93%of282),the actual MIRs of all gastrointestinal cancers were mostly located in the prediction intervals via the best-fit non-linear regression models.CONCLUSION:The inverse correlation between HD
基金In part Health Resources and Services Administration contract 234-2005-370011CThe content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services,nor does mention of trade names,commercial products,or organizations imply endorsement by the United States Government
文摘AIM:To illustrate the application and utility of Geographic Information System(GIS) in exploring patterns of liver transplantation.Specifically,we aim to describe the geographic distribution of transplant registrations and identify disparities in access to liver transplantation across United Network of Organ Sharing(UNOS) region 1.METHODS:Based on UNOS data,the number of listed transplant candidates by ZIP code from 2003 to 2012 for Region 1 was obtained.Choropleth(color-coded) maps were used to visualize the geographic distribution of transplant registrations across the region.Spatial interaction analysis was used to analyze the geographicpattern of total transplant registrations by ZIP code.Factors tested included ZIP code log population and log distance from each ZIP code to the nearest transplant center;ZIP code population density;distance from the nearest city over 50000;and dummy variables for state residence and location in the southern portion of the region.RESULTS:Visualization of transplant registrations revealed geographic disparities in organ allocation across Region 1.The total number of registrations was highest in the southern portion of the region.Spatial interaction analysis,after adjusting for the size of the underlying population,revealed statistically significant clustering of high and low rates in several geographic areas could not be predicted based solely on distance to the transplant center or density of population.CONCLUSION:GIS represents a new method to evaluate the access to liver transplantation within one region and can be used to identify the presence of disparities and reasons for their existence in order to alleviate them.
文摘背景新型冠状病毒感染(简称新冠感染)疫情防控期间,基层卫生是防控的“第一道防线”。各国学术界对新冠感染期间基层卫生工作进行了广泛的研究,但基层卫生制度不同导致研究侧重点有差异。目的了解新冠感染背景下国内与国际上基层卫生相关研究的进展、热点、趋势及差异性,为该领域进一步研究提供参考。方法于2022-07-05,检索新冠感染发生后中国知网(CNKI)与Web of science(WOS)核心数据库收录的基层卫生相关研究的文献,检索时间范围均限定为2020-01-01至2022-06-30,纳入CNKI文献282篇、WOS文献1755篇。利用CiteSpace软件进行可视化分析,实现作者共现分析,关键词共现、聚类、时间线分析,关键词突现分析。结果从文献时序分布上看国内相关研究文献量在疫情发生初期增速较快,后增速逐渐下降,趋于平缓;国际上研究起始稍滞后,但保持较高增速至今。作者合作以小团队与个人为主,无大规模跨团队合作。国内研究热点偏重疫情防控相关体制及机制探讨与管理实践,国际研究关注疫情影响下就医方式的转变、患者就医需求的满足。国内与国际上的研究均重点关注疫情影响下发生的心理问题。结论新冠感染背景下国内与国际的基层卫生相关研究既有共通点也各有侧重,国内研究在不断细化、多样化的进程中可吸收国际经验,重视相关研究力量建设,健全该领域知识体系,积极利用信息化技术完善疫情下基层卫生的服务体系。
