Patient Satisfaction with Telehealth During COVID-19: Experience in a Rural County on the United States-Mexico Border.

Background: The aim of this study was to analyze patient satisfaction with telehealth in a rural county on the United States-Mexico border after rapid expansion of telehealth services during the COVID-19 pandemic. Materials and Methods: Chiricahua Community Health Centers, Inc., a federally qualified health center in southeastern Arizona, conducted phone surveys with 562 patients to measure various outcomes related to patient satisfaction and experience with telehealth between June and August 2020. Data from patient surveys were analyzed within the following age categories: <18 years (37%), 18-34 years (19%), 35-54 years (15%), and 55+ years (29%). Results and Discussion: Patients were overall satisfied with telehealth (87%) and believed the quality of care was just as good as or better than in-person appointments (88%). Many would be willing to try telehealth in the future (54%). Distance/convenience (odds ratio [OR] = 5.01, 95% confidence interval [CI] 2.80-8.97), ease of scheduling (OR = 3.82, 95% CI 1.30-11.21), and protection from potential exposure to coronavirus (OR = 3.01, 95% CI 1.57-5.75) were all strongly predictive of overall satisfaction scores. Adults within the 35-54 (OR = 0.29, 95% CI 0.10-0.81) and 55+ (OR = 0.37, 95% CI 0.14-0.95) age groups were overall less satisfied with telehealth compared with younger adults 18-34 years. Underlying health conditions and primary language were not correlated with satisfaction in using telehealth. Conclusions: Telehealth may be an effective tool for overcoming barriers and providing rural patients with access to health care without compromising patient satisfaction.

Infant pacifier sanitization and risk of challenge-proven food allergy: A cohort study.

BACKGROUND: Environmental microbial exposure plays a role in immune system development and susceptibility to food allergy. OBJECTIVE: We sought to investigate whether infant pacifier use during the first postnatal year, with further consideration of sanitization, alters the risk of food allergy by age 1 year. METHODS: The birth cohort recruited pregnant mothers at under 28 weeks' gestation in southeast Australia, with 894 families followed up when infants turned 1 year. Infants were excluded if born under 32 weeks, with a serious illness, major congenital malformation, or genetic disease. Questionnaire data, collected at recruitment and infant ages 1, 6, and 12 months, included pacifier use and pacifier sanitization (defined as the joint exposure of a pacifier and cleaning methods). Challenge-proven food allergy was assessed at 12 months. RESULTS: Any pacifier use at 6 months was associated with food allergy (adjusted odds ratio, 1.94; 95% CI, 1.04-3.61), but not pacifier use at other ages. This overall association was driven by the joint exposure of pacifier-antiseptic use (adjusted odds ratio, 4.83; 95% CI, 1.10-21.18) compared with no pacifier use. Using pacifiers without antiseptic at 6 months was not associated with food allergy. Among pacifier users, antiseptic cleaning was still associated with food allergy (adjusted odds ratio, 3.56; 95% CI, 1.18-10.77) compared with no antiseptic use. Furthermore, persistent and repeated antiseptic use over the first 6 months was associated with higher food allergy risk (P = .029). CONCLUSIONS: This is the first report of a pacifier-antiseptic combination being associated with a higher risk of subsequent food allergy. Future work should investigate underlying biological pathways.

High-Volume Hydraulic Fracturing and Human Health Outcomes: A Scoping Review.

OBJECTIVE: Examine extent of peer-reviewed literature exploring human health effects of hydraulic fracturing (HVHF). METHODS: A scoping review methodology was used to examine peer-reviewed studies published from 2000 through 2017 that empirically examine direct health impacts of hydraulic fracturing. RESULTS: Through September 2017, only 18 studies were found published in peer-reviewed journals that met our requirements for inclusion in the review. Most of these studies resulted in positive or mixed findings of health outcomes. CONCLUSIONS: The paucity of studies reflects the difficulty in drawing direct connections between HVHF and human health outcomes. Many health outcomes may take years to emerge, exposure often occurs in lightly populated rural areas with older, poorer, and sicker residents, and diagnosis is difficult without physician knowledge of prior exposure. Primary care providers should record thorough histories to help guide future treatment.

Paying for retirement: sex differences in inclusion in employer-provided retirement plans.

PURPOSE: This study examines sex differences among Baby Boom workers in the likelihood of coverage by an employer-provided retirement plan. DESIGN AND METHODS: This study used a sample of Baby Boom workers drawn from the 2009 Current Population Survey. Independent variables were selected to replicate as closely as possible those in two 1995 studies of retired workers and pension plans. Three new variables were added to reflect major social and economic shifts since 1995. Logistic regression was performed to analyze the effect of the independent variables on the likelihood of retirement plan coverage. RESULTS: In this cohort, the proportions of men and women included in employer-provided retirement plans were almost the same. The overall odds of women being included in a plan were only slightly less than even and in certain cases were significantly higher than the odds for men. Predictors of inclusion that were most important for both women and men were minority status, employment in a core industry or in a government position, educational level, and marital status. IMPLICATIONS: Although a much larger group of workers is included in retirement plans than in previous studies, and Baby Boom women are less disadvantaged in this regard than women in earlier studies, minority and immigrant workers continue to be disadvantaged, and the security of government retirement plans may be weakening with current economic difficulties.