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Aim: Delays in care may be a driver of inequities in perforated appendicitis rates. The goal of this study was to explore potential causes of delay in care for children with perforated appendicitis. Methods: We conducted an interview study of caregivers of children admitted with perforated appendicitis to a children's hospital between December 2022 and March 2023. Semi‐structured interviews based on an iteratively revised interview guide were conducted in‐person during the child's admission. All interviews were transcribed, coded and underwent a process of thematic analysis. Results: We reached thematic saturation after 12 interviews. The median age for children was 13.5 years, 50% were male, 83% of caregivers self‐identified as White, and one interview required an interpreter. Through thematic analysis, four major themes for potential causes of delay emerged. The first theme of symptom recognition includes delays related to recognising the symptoms, their severity and the need for medical evaluation. The second theme – accessing care – describes delays that occur after a decision was made to seek care until the child was evaluated. The third theme includes delays that occur in making the diagnosis after evaluation. The last theme captures potential delays in definitive treatment after a diagnosis of appendicitis is made. Conclusion: We identify four major themes from the patient and family perspective, each with multiple sub‐themes, for potential delays in definitive care for children with perforated appendicitis. Additional research is needed to further characterise these potential delays and quantify their role in contributing to inequities in perforation rates. [ABSTRACT FROM AUTHOR]

There is considerable interest among researchers, clinicians, and policy makers in understanding the impact of place on health. In this scoping review and qualitative analysis, we sought to assess area-level socioeconomic deprivation indices used in public health and health outcomes research in the US. We conducted a systematic scoping review to identify area-level socioeconomic deprivation indices commonly used in the US since 2015. We then qualitatively compared the indices based on the input-variable domains, data sources, index creation characteristics, index accessibility, the geography over which the index is applied, and the nature of the output measure or measures. We identified fifteen commonly used indices of area-level socioeconomic deprivation. There were notable differences in the characteristics of each index, particularly in how they define socioeconomic deprivation based on input-variable domains, the geography over which they are applied, and their output measures. These characteristics can help guide future index selection and application in clinical care, research, and policy decisions. [ABSTRACT FROM AUTHOR]

Social determinants of health contribute to inequalities in access to care and inferior outcomes in pediatric populations. Before the coronavirus disease 2019 (COVID-19) pandemic, telemedicine was shown to be an effective tool to bridge the gap between health care providers and rural or underserved populations. The pandemic has rapidly changed the current landscape of health care. Telemedicine has played a critical role in health care delivery between providers and patients because of the need for social distancing. That being said, it has become apparent that SDOH have affected access to telemedicine for communities that already suffer from inequities in health care access. Solutions directed toward addressing issues such as lack of broadband access, digital literacy and language barriers, and obstacles within the health care system are crucial to ensure telemedicine access is equitable for all patients and does not contribute toward worsening health care disparities. [Pediatr Ann. 2022;51(8):e311-e315.]. [ABSTRACT FROM AUTHOR]

The reversible mitochondrial transhydrogenase in Manduca sexta has been characterized and is involved with endocrine-mediated post-embryonic larval development in this model insect. While biochemical in vivo and in vitro studies have been accomplished, robust molecular studies of the transhydrogenase have not been possible due to deicient genomic data. In the present study, using a combination of degenerate oligonucleotide primers and raw genomic data, we have determined the structure and sequence of the transhydrogenase gene from the model insect Manduca sexta. The encoded protein is highly similar to other transhydrogenase proteins and this sequence is the irst lepidopteran sequence reported to date. [ABSTRACT FROM AUTHOR]