Objective To review systematically the role of e-mails in patient–provider communication in terms of e-mail content, and perspectives of providers and patients on e-mail communication in health care. Methods A systematic review of studies on e-mail communication between patients and health providers in regular health care published from 2000 to 2008. Results A total of 24 studies were included in the review. Among these studies, 21 studies examined e-mail communication between patients and providers, and three studies examined the e-mail communication between parents of patients in pediatric primary care and pediatricians. In the content analyses of e-mail messages, topics well represented were medical information exchange, medical condition or update, medication information, and subspecialty evaluation. A number of personal and institutional features were associated with the likelihood of e-mail use between patients and providers. While benefits of e-mails in enhancing communication were recognized by both patients and providers, concerns about confidentiality and security were also expressed. Conclusion The e-mail is transforming the relationship between patients and providers. The rigorous exploration of pros and cons of electronic interaction in health care settings will help make e-mail communication a more powerful, mutually beneficial health care provision tool. Practice implications It is important to develop an electronic communication system for the clinical practice that can address a range of concerns. More efforts need to be made to educate patients and providers to appropriately and effectively use e-mail for communication.

PURPOSE We assessed the prevalence of major cardiovascular disease (CVD) risk factors among Chinese, Asian Indian, Filipino, and other Asian populations compared to non-Hispanic Whites in the United States. METHODS We analyzed aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005. Bivariate analyses were used to determine differences in the prevalence of CVD risk factors among Asian subgroups and white adults. Logistic regression analyses were also conducted to compare each Asian subgroup with white adults after taking sociodemographic variables into account. RESULTS The unadjusted prevalence of physical inactivity was highest among Asian Indians and other Asians. After we controlled for covariates, Asian Indians still had higher odds of physical inactivity than Whites (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.22–1.84). All Asian ethnic groups were significantly less likely than Whites to report smoking, obesity, and binge drinking. Compared with Whites, Filipinos were more likely to have hypertension (OR = 1.18, 95% CI = 1.02–1.44) and Asian Indians were more likely to have diabetes (OR = 2.27, 95% CI = 1.63–3.20). CONCLUSION Although Asian race was generally associated with lower risk for CVD, certain risk factors were particularly high among some Asian subgroups. Future interventions should specify the needs of specific subgroups and design culturally specific programs to reduce health risk behaviors in each Asian subpopulation.

Background Depression remains a major public health problem that is most often evaluated and treated in primary care settings. The objective of this study was to examine the prevalence, treatment, and control of depressive symptoms in a national data sample using a common primary care screening tool for depression. Methods We analyzed a sample of adults (n = 4836) from 2005 to 2008 National Health and Nutrition Examination Survey data. Depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9) to determine the overall prevalence, rates of treatment, and antidepressant control of mild, moderate, moderately severe, and severe depressive symptoms. Results Of the sample, 20.1% reported significant depressive symptoms (PHQ-9) score, ≥5), the majority of whom had mild depressive symptoms (PHQ-9) score, 5–9). Even among individuals with severe depressive symptoms, a large percentage (36.9%) received no treatment from a mental health professional or with antidepressant medication. Of those taking antidepressants, 26.4% reported mild depressive symptoms and 18.8% had moderate, moderately severe, or severe depressive symptoms. Conclusions Despite greater awareness and treatment of depression in primary care settings, the prevalence of depressive symptoms remains high, treatment levels remain low, and control of depressive symptoms are suboptimal. Primary care providers need to continue to focus their efforts on diagnosing and effectively treating this important disease.

This study investigates the relationships between sociocultural and psychological aspects of cross‐cultural adaptation of Chinese international students in the United States, and the support that they perceive they receive from traditional support networks and online ethnic social groups. An online survey was conducted among 135 Chinese students who attended universities in the United States. The results suggest that perceived support from interpersonal networks in the host country and from online ethnic social groups was negatively related to social difficulties, while perceived support from interpersonal networks and long‐distance networks in the home country was negatively associated with mood disturbance. The study also found that, compared to those who had lived in the United States for a longer period of time, new arrivals reported higher perceived support from online ethnic social groups. In addition, the more students perceived receiving support from these groups, the more likely they were to be actively engaged in online group activities.

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Seed size and weight are key traits determining crop yield, which often undergo strongly artificial selection during crop domestication. Although seed sizes differ significantly between oil flax and fiber flax, the genetic basis of morphological differences and artificial selection characteristics in seed size remains largely unclear. Here we resequenced 200 flax cultivated accessions to generate a genome variation map based on chromosome assembly reference genomes. We provide evidence that oil flax group is the ancestor of cultivated flax, and the oil-fiber dual purpose group (OF) is the evolutionary intermediate transition state between oil and fiber flax. Genome-wide association studies (GWAS) were combined with LD Heatmap to identify candidate regions related to seed size and weight, then candidate genes were screened based on detailed functional annotations and estimation of nucleotide polymorphism effects. Using this strategy, we obtained 13 candidate genes related to seed size and weight. Selective sweeps analysis indicates human-involved selection of small seeds during the oil to fiber flax transition. Our study shows the existence of elite alleles for seed size and weight in flax germplasm and provides molecular insights into approaches for further improvement.

1,2 ED visits by uninsured patients create a special problem for hospitals and society because the burden of indigent care in a costly ED setting is borne by other patients, payors, and their communities. In most states, uninsured rates are higher in rural areas than in urban areas, and the financial burden of uninsured ED visits has a direct impact on the financial viability of small rural hospitals.

This study investigated the relationships between acculturative stress of East Asian international students and their use of the Internet, taking into account Internet types (English-language Internet and native-language Internet) and Internet motives. A survey was conducted among 115 East Asian international students who attended a large urban university in the southeastern United States. On average, students used English-language Internet more than native-language Internet. A positive correlation was found between using English-language Internet and English proficiency. The analysis identified three Internet motives: information seeking, relaxation/entertainment, and social utility. Perceived discrimination was a positive predictor of the motives of social utility and relax/entertainment. Fear was a positive predictor of the motive of social utility.