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Hispanic Americans are less likely to be insured and they experience cultural and linguistic barriers that may prevent them from obtaining necessary and preventive healthcare. Adoption of Patient Centered Medical Home (PCMH) concepts in healthcare settings utilized by Hispanics could improve Hispanic patients' satisfaction with their healthcare providers. This study examined the association between Spanish-speaking and non-Spanish-speaking patients' perceptions of PCMH characteristics and satisfaction with the provider. Data were collected using a self-administered survey from two unaffiliated free clinics. Logistic regression modeled the associations between patients' perceptions of PCMH and their satisfaction with their provider, and their desire to see the same provider in the future. The sample consisted of 367 adults; 44 % were Spanish-speaking. Spanish-speaking patients were younger, less educated, and had fewer chronic conditions than non-Spanish-speaking patients. In adjusted analyses for each population, better ratings of the provider's communication skills were associated with increased satisfaction with the provider (Spanish-speaking: OR = 8.33, 95 % CI = 2.19-31.76; non-Spanish-speaking: OR = 31.39, 95 % CI = 6.91-142.62), and willingness to see the provider again (Spanish-speaking: OR = 12.54, 95 % CI = 2.80-56.24; non-Spanish-speaking: OR = 8.77, 95 % CI = 2.40-31.96). Among Spanish-speakers, lower perceived discrimination was associated with 137 % increased odds and higher perceived staff helpfulness had 212 % increased odds of seeing the provider again. Relative to other PCMH components, interpersonal skills were the most important factors in patient satisfaction with free clinics. Increased training for clinicians on cultural competence and clinician-patient communication may lead to improved patient satisfaction for both Spanish and non-Spanish speakers seen at free clinics, particularly clinics in states without Medicaid expansion.

The aim of this study was to determine the frequency of apparent injury incidents in men's international soccer and attempt to estimate what proportion of these incidents are authentic. Broadcast recordings of 89 group stage games from 4 tournaments were reviewed to identify incidents in which a player behaved as if injured. Apparent injuries were considered definite if a player withdrew from participation within 5  min or if bleeding was visible. The remaining incidents were considered questionable. A total of 980 apparent injuries were observed at a rate of 5.63/team game. The definite injury rate was only 0.41/team game vs. 5.22/team game for questionable injuries. Definite injuries were associated with on-field treatment (P<0.001) and stretcher (P<0.001) while questionable injuries were associated with fouls (P<0.001), yellow cards (P=0.013), and the first half (P=0.001). Questionable injuries were more associated with the final 1/3 of the second half than the initial 2/3 (P=0.039). For the 24 games of the 2007 AFC Asian Cup there was an association between questionable injuries and a contact mechanism (P<0.001). The range of the rate of questionable injury was 4.17-5.4 by confederation. This information may assist soccer governing bodies in developing plans to prevent injury simulation behavior.

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