BACKGROUND: Because of the impact of continuous pulse oximetry (CPOX) on the overdiagnosis of hypoxemia in bronchiolitis, the American Academy of Pediatrics and the Choosing Wisely campaign have issued recommendations for intermittent monitoring. Parental preferences for monitoring may impact adoption of these recommendations, but these perspectives are poorly understood.METHODS: Using this cross-sectional survey, we explored parental perspectives on CPOX monitoring before discharge and 1 week after bronchiolitis hospitalizations. During the 1week call, half of the participants were randomly assigned to receive a verbal statement on the potential harms of CPOX to determine if conveying the concept of overdiagnosis can change parental preferences on monitoring frequency. An aggregate variable measuring favorable perceptions of CPOX was created to determine CPOX affinity predictors. RESULTS:In-hospital interviews were completed on 357 patients, of which 306 (86%) completed the 1-week follow-up. Although 25% of parents agreed or strongly agreed that hospital monitors made them feel anxious, 98% agreed that the monitors were helpful. Compared to other vital signs, respiratory rate (87%) and oxygen saturation (84%) were commonly rated as "extremely important." Providing an educational statement on CPOX comparatively decreased parental desire for continuous monitoring (40% vs 20%; P , .001). Although there were no significant predictors of CPOX affinity, the effect size of the educational intervention was higher in college-educated parents.CONCLUSIONS: Parents find security in CPOX. A brief statement on the potential harms of CPOX use had an impact on stated monitoring preferences. Parental perspectives are important to consider because they may influence the adoption of intermittent monitoring.
Aim Seasonality has been shown to affect incidence of emergency surgical conditions in the West. There is yet no local data to suggest the causal relationship between seasonality and emergency surgical conditions. We aim to investigate on the effects of seasonal variation on common general surgical conditions for (i) ruptured abdominal aortic aneurysm, (ii) perforated peptic ulcer disease, (iii) ischaemic bowel, and (iv) acute cholecystitis in the New Territory West Cluster (NTWC). Method The present study was a retrospective study of 7653 patients who underwent emergency operations from 1 July 2008 to 30 June 2018 in the NTWC. Seasonality was defined according to the Chinese lunar calendar. Seasonal variation in the aforementioned surgical conditions were studied by emergency operations performed and recorded by the cluster's Surgical Outcomes Monitoring and Improvement Programme (SOMIP) data. The primary outcome is to analyse the presence of overall seasonal variation across the four seasons for each surgical condition by the goodness of fit test. The secondary outcome is to analyse the relationship of each season (Spring, Summer, Fall, Winter) and extreme weather condition, in this study, the cold weather warning signal, on the surgical conditions by the 2 × 2 Chi‐square test. Results For primary outcome, statistically significant variation exists in all general surgical conditions except ischaemic bowel across the four seasons. For secondary outcomes, statistically significant relationships exist between each season and different surgical conditions. Moreover, cold weather warning has a statistically significant relationship with emergent surgeries for perforated peptic ulcer disease and ruptured abdominal aortic aneurysm. Conclusion There is seasonal variation in emergency surgical conditions.
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