RESUMO
Latinx in the USA experience disparities in morbidity and mortality when compared to their non-Hispanic White counterparts. Patient-centered culturally sensitive health care (PC-CSHC) has been deemed a best practice approach to alleviate and eliminate these disparities. However, literature on how Latinx patients perceive their care and what indicators of PC-CSHC may be most related to treatment outcomes is limited. This study collected data from 81 adult Latinx participants who had been admitted to an inpatient care unit to understand the following: (a) their perception of their providers' PC-CSHC in three different areas: Competence/Confidence, Sensitivity/Interpersonal, and Respect/Communication; (b) whether there are differences between English- and Spanish-speaking Latinx patients in their perception of their providers' PC-CSHC; and (c) whether these PC-CSHC indicators were associated to patient satisfaction, patient-provider communication, and therapeutic alliance. Participants were mostly male, older than 55 years of age, and working or lower class, with English as their primary language. Results showed that patients rated their providers' Competence (M = 3.57, SD = .46) higher than both Sensitivity, t(68) = .04, p = .04, (M = 3.49, SD =.54), and Respect, t(53) = 2.765, p = .008, (M = 3.38, SD = .57). English-speaking Latinx were overall less satisfied with their providers than Spanish-speaking Latinx, in particular in their communication. Finally, higher provider cultural sensitivity appears to be a predictor of patient satisfaction, patient-provider communication, and working alliance. Implications for refining provider trainings to treat this vulnerable and understudied (i.e., Latinx) population are discussed.
Assuntos
Assistência à Saúde Culturalmente Competente , Hispânico ou Latino , Satisfação do Paciente , Aliança Terapêutica , Adulto , Comunicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-PacienteRESUMO
The seasonal abundance of Botryosphaeriaceae spp. spores was studied in California vineyards by using glass microscope slides covered with petroleum jelly placed on grapevine cordons and Burkard volumetric spore traps at seven and two different locations, respectively. Correlation analysis was used to determine which meteorological variables (precipitation, relative humidity, temperature, and wind speed) influenced Botryosphaeriaceae spp. spore release. Among all variables, regression analysis resulted in a strong relationship between spore release and precipitation. Additionally, a positive relationship between irrigation and spore release was also observed in the Riverside County vineyard. During the study period, spore discharge of Botryosphaeriaceae spp. occurred from the first fall rain through the last spring rains, coinciding with September to April. However, based on the results obtained from the spore traps, most spores (over 60%) were trapped following rain events during the winter months of December, January, and February, which coincides with the grapevine pruning season. Botryosphaeriaceae spp. spore release was much lower in fall and early spring (22%) and very few or no spores were trapped in late spring and summer (3%). This work suggests that a delay of pruning time in California may be warranted to reduce grapevine infection because the current timing coincides with the greatest period of spore discharge.
RESUMO
Introducción: El tiempo de tratamiento de las infecciones osteoarticulares en pediatría, es controvertido. Se han reportado trabajos que demostraron que en pacientes estrictamente seleccionados y con monitoreo de proteina C reactiva cuantitativa (PCR) la duración podía ser menor a la previamente establecida. Con el objetivo de evaluar la seguridad y eficacia del tratamiento antibiótico acortado en niños monitoreados con PCR cuantitativa se realizó este estudio. Material y métodos: durante mayo 2001 hasta noviembre de 2003 se realizó un estudio prospectivo, descriptivo, no comparativo de 35 pacientes pediátricos con diagnostico de infecciones osteoarticulares agudas. El curso de la enfermedad fue monitoreado con eritrosedimentación y proteína C reactiva para decidir la duración total del tratamiento. Resultados: Se incluyeron 35 pacientes. La edad fue de una mediana de 20 meses (rango: 7 menos 130 m). Veinte pacientes presentaron osteoartritis (57 por ciento), 13 artritis (37 por ciento) y 2 osteomielitis (6 por ciento). La localización más frecuente fue cadera: 17 pacientes (49 por ciento), seguido por la rodilla en 14 pacientes (40 por ciento). El dolor y la inmovilización estuvieron presentes en todos los pacientes; se constató fiebre en 27 pacientes (77 por ciento). Se realizó drenaje quirúrgico en los 17 pacientes con artritis de cadera. El valor de la PCR al ingreso fue: de 15 mg/1 (rango: 5 menos 106). La mediana de normalización de la PCR fue de 5 días (r: 4 menos 7 d).La mediana de eritrosedimentación fue de 47mm/h,(r:25 menos 120) y la mediana de normalización fue de 14 días (r:10 menos 21d). Se obtuvo documentación microbiológica en 8p (23 por ciento). Streptococcus pyogenes se aisló en 3 pacientes. Staphylococcus aureus en 3 pacientes, S. pneumoniae y H. influenzae no b 1 paciente cada uno. La duración del tratamiento endovenoso fue:(mediana) 5 días (r: 2 menos 10d). La duración del tratamiento oral fue: (mediana) de 14 días (r: 9 menos 19d). La du...