Exploring the Need of Social Change Leadership Concerning Health Communication and Health Disparities During the COVID-19 Pandemic

In March of 2020, the United States activated nationwide pandemic response protocols due to the swift spread of Novel Coronavirus Disease 2019, also known as COVID-19. Amidst the domestic response, urgency surrounded the need to build collective awareness of the signs, symptoms, and preventive measures of the virus. As the virus spread and historically marginalized communities were disproportionately impacted with rates of infection, the need to explore the presence of disparities in health communication, health education, and personal health literacy surfaced. The research contained within this study examines the root cause of the gap in health literacy for communities of color and presents actionable next steps to increase positive healthcare outcomes for all.

Psychological Impact of the Hospital Indoor Public Spaces on Patients’ Health, Assessment, and Analysis

Due to the rapid development of social economy, general hospital buildings of China are undergoing changes in their models, technology, and medical systems. Changes in the model of hospitals may affect the functional structure, streamline layout, and spatial form of the hospital building. The biological-psychological-social (biopsychosocial) model covers the overall significant factors in healthcare. The model focuses on the hospital public environment. For the advocacy of patient-centered medical concepts, researchers have put forward newer and higher requirements as well. However, there is scarcity of research that targets the psychological impact of general hospital public space environment construction on the patients’ health. Moreover, there is no unanimously recognized standard questionnaire for the public space environment. The purpose of this article is to investigate the needs of inpatients for the space environment, to understand the influencing factors of various space environments, and to explore the law of patient needs. The research intends to provide a theoretical background for the construction of a patient-centered space environment. A dedicated questionnaire was designed to systematically collect the significant features and factors. Using cluster sampling, a total of four medical and surgical wards were investigated. The data obtained from 430 questionnaires were statistically analyzed by SPSS-10.0. Various statistical operations such as descriptive analysis, independent sample t test, one-way analysis of variance, and linear and logistic regressions were performed over the data. The psychological impact was studied from four aspects. The highest score (3-4 points) obtained for the larger number of patients (84.4%) testifies that the public space environment has a significant impact on patients’ mental health. Besides healthcare, outcomes of the paper may be used in various related domains such as psychological well beings, spatial analysis, social interaction, and public space designing.

Frailty-aware care: giving value to frailty assessment across different healthcare settings

Healthcare systems need to adapt to better serve an aging population with complex presentations. Frailty assessments are a potential means to address this heterogeneity in aging to identify individuals at increased risk for adverse health outcomes. Furthermore, frailty assessments offer an opportunity to optimize patient care in various healthcare settings. While the vast number of frailty assessment tools available can be a source of confusion for clinicians, each tool has features adaptable to the constraints and goals of different healthcare settings. This review discusses and compares barriers, facilitators, and the application of frailty assessments in primary care, the emergency department/intensive care unit and surgical care to cover a breadth of settings with different frailty assessment considerations. The implementation of frailty-aware care across healthcare settings potentiates better healthcare outcomes for older adults.

Chatbots in Healthcare Interventions: A systematic review of randomized controlled trials v (Preprint)

BACKGROUND Chatbot or virtual conversational agent is a typical programme of utilizing AI technology in mimicking human interactions. More robust and high-quality clinical trials have been conducted to test the effectiveness of chatbot-based interventions, however, there was a lack of a synthesis of the best available evidence. OBJECTIVE To examine the best available evidence of the application of chatbot-based interventions in the healthcare context. METHODS Seven databases were searched from inception until October 2021. Two reviewers independently selected the studies, extracted data from the included studies, and assessed the risk of bias. Study qualities were assessed by the RoB 2.0 tool. Silberg Scale was used to evaluate the quality of the chatbots systems utilized in the reviewed studies. RESULTS Twenty-one studies were included in the data synthesis. Studies of using chatbot-based interventions are feasible and an average moderate to a high level of participants acceptability of the intervention was reported. The intervention approaches mainly included cognitive-behavioural interventions, health education/counselling, storytelling acceptance and commitment therapy, and coping skills training. Findings indicate significant improvements in participants’ physical activity and physical function, healthy lifestyle modifications, symptoms/knowledge of the diseases, as well as mental health and psychosocial outcomes. The overall quality varies among the included studies as assessed by the RoB 2.0 tool. The average Silberg score was 5.4 with an SD of 1.6, out of the 9 points. CONCLUSIONS Our review findings indicate that chatbot-based interventions are feasible, acceptability and have positive effects on a variety of healthcare outcomes. Chatbots can provide low threshold access to healthcare services, and they can serve as a medical assistant to support patients’ recovery or health education/promotion needs before or after medical treatment without location restrictions. Also, the chatbot interventions can play an adjunct role and be integrated into the current health systems, which could improve the comprehensiveness of the healthcare services as well as save physicians’ time to see more patients or give more intensive care. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews No.CRD42021262512.

Telemedicine for veterans in the setting of the COVID-19 pandemic: Lessons learned from a virtual urgent care center

Introduction Although telemedicine was predominantly adopted during the COVID-19 pandemic, its impact on healthcare outcomes in the veteran population in achieving first contact resolution, or the ability to safely manage patient care at home from an urgent care perspective, is yet to be determined. Methods This study included 13,090 veteran patient episodes who presented to the Department of Veteran's Affairs Veterans Integrated Services Network 8's Clinical Contact Center, a virtual urgent care organization covering South Georgia, Florida, and U.S. Virgin Islands in providing episodic care, between March 2020 and February 2021. Multivariate logistic regression estimated the probability that veterans with COVID-19-related symptoms stayed at home compared to presenting to the emergency department (ED) or their primary care provider. Results Patients with COVID-related symptoms were 33% less likely to present to the ED compared to patients who presented with non-COVID-related symptoms. Discussion The virtual urgent care center enabled veterans to receive timely care and avoid public places that could potentially lead to a COVID-19 infection or infecting others.

Incorporating Medical Supply and Demand into the Index of Physician Maldistribution Improves the Sensitivity to Healthcare Outcomes

Background: Since the association between disparity in physician distribution and specific healthcare outcomes is poorly documented, we aimed to clarify the association between physician maldistribution and cerebrovascular disease (CeVD), a high-priority health outcome in Japan. Methods: In this cross-sectional study, we conducted multivariable regression analysis with the Physician Uneven Distribution Index (PUDI), a recently developed and adopted policy index in Japan that uniquely incorporates the gap between medical supply and demand, as the independent variable and CeVD death rate as the dependent variable. Population density, mean annual income, and prevalence of hypertension were used as covariates. Results: The coefficient of the PUDI for the CeVD death rate was −0.34 (95%CI: −0.49–−0.19) before adjusting for covariates and was −0.19 (95%CI: −0.30–−0.07) after adjusting. The adjusted R squared of the analysis for the PUDI was 0.71 in the final model. However, the same multivariable regression model showed that the number of physicians per 100,000 people (NPPP) was not associated with the CeVD death rates before or after adjusting for the covariates. Conclusion: Incorporating the gap between the medical supply and demand in physician maldistribution indices could improve the responsiveness of the index for assessing the disparity in healthcare outcomes.

Hiệu quả của mô hình ECHO đối với đào tạo Y khoa liên tục theo phương pháp đánh giá của Moore

Mô hình đào tạo trực tuyến ECHO viết tắt của tiếng Anh là "Extension of Community Healthcare Outcomes", có nghĩa là "Nối dài Chăm sóc Sức khỏe Cộng đồng", là mô hình giáo dục từ xa nhằm tạo điều kiện học tập và giám sát hỗ trợ các cơ sở chăm sóc sức khỏe ban đầu ở nông thôn, vùng sâu và vùng xa. Nghiên cứu đã tiến hành tầm soát và tham khảo nhiều bài viết về mô hình ECHO và các ứng dụng trong đào tạo Y khoa liên tục trên thế giới và Việt Nam. Vì vậy, chúng tôi tiến hành nghiên cứu này với mục tiêu mô tả hiệu quả của mô hình ECHO đối với đào tạo Y khoa liên tục theo phương pháp đánh giá của Moore. Đồng thời đưa ra một số đánh giá tác động của mô hình ECHO đến đào tạo Y khoa liên tục theo phương pháp đánh giá Moore. Các nghiên cứu đã cho thấy việc áp dụng và kế thừa mô hình ECHO sao cho phù hợp với bối cảnh văn hóa - kinh tế - xã hội của mỗi quốc gia là cần thiết. Sự vận dụng từ các mô hình này là bài học kinh nghiệm quý giá để triển khai mô hình ECHO tại Việt Nam đạt hiệu quả.

Design and In Vivo Evaluation of a Novel Transdermal Hydrogen/Oxygen-Generating Patch

Hydrogen/oxygen-generating biomaterials, a new trend in regenerative medicine, generate and supply hydrogen/oxygen to increase the local levels of hydrogen/oxygen to support tissue healing and regeneration. In this study, we carefully defined a strategic plan to develop a gas-permeable layer suitable for use in sanitary products that is capable of supplying hydrogen or oxygen in situ using calcium hydroxides as chemical oxygen sources. In vitro physicochemical evaluations of hydrogen- and oxygen-generation efficiency were performed to determine the amount of hydrogen and oxygen produced. An in vivo permeation study was conducted to assess biological parameters, including blood oxygen (O2) and hydrogen (H+) levels. The stress hormone corticosterone and inflammation marker interleukin 6 (IL-6) were also quantified. The hydrogen/oxygen-generating patch (HOGP) continuously generated H+ or O2 for up to 12 h after activation by water. An in vivo evaluation showed blood H+ peaked at 2 h after application of the HOGP and then progressively decreased until the end of study (24 h), whereas oxygen content (O2(ct)) and oxygen saturation (SO2(SAT)) continuously increased up to 6 h. Hematological and electrolyte parameters did not significantly change compared to baseline. Wearing the stretch fabric used to secure the patch did not significantly increase serum corticosterone or interleukin 6 (IL-6) in the animals. This novel design of a hydrogen/oxygen-generating biomaterial for supplying topical H+/O2 may hold potential for increasing in situ or circulating H+/O2 levels to improve healthcare outcomes.