JAMA network open
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Multicenter Study
Patient-Reported Opioid Consumption and Pain Intensity After Common Orthopedic and Urologic Surgical Procedures With Use of an Automated Text Messaging System.
Surgeons must balance management of acute postoperative pain with opioid stewardship. Patient-centered methods that immediately evaluate pain and opioid consumption can be used to guide prescribing and shared decision-making. ⋯ In this quality improvement study of adult patients reporting use of opioids after common orthopedic and urologic surgical procedures through a text messaging system, the quantities of opioids prescribed and the quantity consumed differed. Patient-reported data collected through text messaging may support clinicians in tailoring prescriptions and guide shared decision-making to limit excess quantities of prescribed opioids.
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Comparative Study
Estimation and Comparison of Current and Future Racial/Ethnic Representation in the US Health Care Workforce.
The COVID-19 pandemic coupled with health disparities have highlighted the disproportionate burden of disease among Black, Hispanic, and Native American (ie, American Indian or Alaska Native) populations. Increasing transparency around the representation of these populations in health care professions may encourage efforts to increase diversity that could improve cultural competence among health care professionals and reduce health disparities. ⋯ This study found that Black, Hispanic, and Native American people were underrepresented in the 10 health care professions analyzed. Although some professions had greater diversity than others and there appeared to be improvement among graduates in the educational pipeline compared with the current workforce, additional policies are needed to further strengthen and support a workforce that is more representative of the population.
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Acute kidney injury (AKI) occurs in up to half of patients hospitalized with coronavirus disease 2019 (COVID-19). The longitudinal effects of COVID-19-associated AKI on kidney function remain unknown. ⋯ In this cohort study of US patients who experienced in-hospital AKI, COVID-19-associated AKI was associated with a greater rate of eGFR decrease after discharge compared with AKI in patients without COVID-19, independent of underlying comorbidities or AKI severity. This eGFR trajectory may reinforce the importance of monitoring kidney function after AKI and studying interventions to limit kidney disease after COVID-19-associated AKI.
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Face masks are recommended to prevent transmission of coronavirus disease 2019 (COVID-19); however, there is scarce evidence on their protection efficacy and ways to improve it. ⋯ In this study of face mask fit among participants in China, although most people used face masks in public places, compromised protection due to suboptimal airtightness was common. The simple approach of sealing the upper edge of the face mask with an adhesive tape strip was associated with substantially improved its airtightness.