Evaluation of a social determinants of health screening questionnaire and workflow pilot within an adult ambulatory clinic

Background There is increased recognition in clinical settings of the importance of documenting, understanding, and addressing patients’ social determinants of health (SDOH) to improve health and address health inequities. This study evaluated a pilot of a standardized SDOH screening questionnaire and workflow in an ambulatory clinic within a large integrated health network in Northern California. Methods The pilot screened for SDOH needs using an 11-question Epic-compatible paper questionnaire assessing eight SDOH and health behavior domains: financial resource, transportation, stress, depression, intimate partner violence, social connections, physical activity, and alcohol consumption. Eligible patients for the pilot receiving a Medicare wellness, adult annual, or new patient visits during a five-week period (February-March, 2020), and a comparison group from the same time period in 2019 were identified. Sociodemographic data (age, sex, race/ethnicity, and payment type), visit type, length of visit, and responses to SDOH questions were extracted from electronic health records, and a staff experience survey was administered. The evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Results Two-hundred eighty-nine patients were eligible for SDOH screening. Responsiveness by domain ranged from 55 to 67%, except for depression. Half of patients had at least one identified social need, the most common being stress (33%), physical activity (22%), alcohol (12%), and social connections (6%). Physical activity needs were identified more in females (81% vs. 19% in males, p < .01) and at new patient/transfer visits (48% vs. 13% at Medicare wellness and 38% at adult wellness visits, p < .05). Average length of visit was 39.8 min, which was 1.7 min longer than that in 2019. Visit lengths were longer among patients 65+ (43.4 min) and patients having public insurance (43.6 min). Most staff agreed that collecting SDOH data was relevant and accepted the SDOH questionnaire and workflow but highlighted opportunities for improvement in training and connecting patients to resources. Conclusion Use of evidence-based SDOH screening questions and associated workflow was effective in gathering patient SDOH information and identifying social needs in an ambulatory setting. Future studies should use qualitative data to understand patient and staff experiences with collecting SDOH information in healthcare settings.

Persepsi, Sikap dan Partisipasi Keluarga Pasien/Pengunjung dalam Menciptakan Kebersihan Lingkungan Rumah Sakit di Kabupaten Manokwari Provinsi Papua Barat

This study aims to determine the perceptions, attitudes and expectations of the patient /visitor's family in creating a clean hospital environment and to analyze the factors that influence the participation of the patient's or visitor's family in creating a clean hospital environment. The method used in this research is descriptive method with a quantitative approach. The number of samples taken was 19 samples at each hospital, so the total sample of the study was 38 samples. Data collection was done by means of interviews, observation, and documentation. The results showed that most of the visitors' perceptions of the hospital stated that: (1) hygiene problems are things that must be prioritized and are still being improved, (2) the attitude of the visitors is that most of them agree and support all forms of efforts carried out in the context of hygiene management. hospital environment, (c) the level of visitor participation is mostly in the high category related to the cleanliness of the hospital environment. (4) The results of multiple linear regression analysis show that the variables of formal education, counseling, age and length of visit together have an effect on the level of participation in the cleanliness of the hospital environment. The results of the partial relationship test show that formal education and extension variables have a significant effect on the level of participation. The variables of age and length of visit did not affect the level of participation in the cleanliness of the hospital environment.

Teleconsultation in orthopaedic surgery: A systematic review and meta-analysis of patient and physician experiences

Introduction The primary purpose of this review was to evaluate patient and physician preference and satisfaction for teleconsultation in orthopaedic surgery compared to traditional face-to-face consultation. In addition, we evaluated the effects of teleconsultation on patient length of visit, healthcare costs, range of motion (ROM), pain, quality of life (QOL), and ongoing management plans. Methods A systematic review of MEDLINE, Embase, Web of Science, and Cochrane Library was conducted according to PRISMA guidelines. Randomised control trials and case control studies comparing teleconsultation with traditional, face-to-face consultation in the management of orthopaedic conditions were included. The primary outcome measures were patient and physician preference and satisfaction. Secondary outcomes included patient length of visit, healthcare costs, ROM, pain, QOL, and ongoing management plans. Results A total of 13 articles meeting the eligibility criteria were included for systematic review and 8 for meta-analysis. There was no significant difference in patient satisfaction, length of visit, or time spent with the physician between the telemedicine and in-office control group. The mean difference of patient preference for telemedicine was significantly higher in the telemedicine group compared to the in-office visit group (OR 1.44, 95% CI 1.12–1.87, p = 0.005). Discussion Telemedicine was not inferior to face-to-face office visits in regard to patient and physician preference and satisfaction. Therefore, it would be an effective adjunct to face-to-face office visits, serving as a mechanism of triage and long-term continuity of care.

Health Benefits Derived from Forest: A Review

In this paper the scientific literature on the association between forests, stress relief and relaxation is reviewed with the purpose to understand common patterns of research, the main techniques used for analysis, findings relevant to forest-therapy-oriented management, and knowledge gaps. The database of studies was collected with a keyword search on the Web, which returned a set of 32 studies that were included in the analysis. The main findings and patterns were identified with a text mining analysis of the abstract to search for keyword patterns across studies. The analysis indicates that most studies compared rest and relaxation performances across urban and forest environments and used a combination of self-reported measure of stress or rest collected with validate scales, e.g., the Profile of Mood of States (POMS) and the Restoration Outcome Scale (ROS), and a minority-only set of these two groups of indicators. Results of this review indicate that primary studies identified a positive association between forest exposure and mental well-being, in particular when compared to urban environments, thus suggesting that forest are effective in lowering stress levels. This study found that, to date, the characteristics of forests and characteristics of the visit are little investigated in the literature. For this reason, more research with a focus on forest variables such as tree species composition, tree density and other variables affecting forest landscape should be further investigated to inform forest management. Similarly, the characteristics of the visits (e.g., length of visit and frequency) should be further explored to provide robust forest therapy guidelines.

The Neighbourhood Park Preferences and its Factors among Elderly Residents in Tokiwadaira, Japan

Tokiwadaira is one of the districts most populated by the elderly in Japan. This study compared the preferences of danchi and apartment residents to examine the neighbourhood park preferences as well as factors in park preferences. This research was conducted in three stages, including a spatial preference survey, analysis, and interpretation. Welch’s t-test and factor analysis were applied. Results demonstrated three significant differences between danchi and apartment residents, namely park preference, length of visit, and park elements. There were seven factors of park preferences. These results may help urban planners optimise existing features of neighbourhood parks to encourage use.Keywords: landscape preference; neighbourhood park; urban green space; green space management experience; exposure towards green spaceeISSN 2398-4295 © 2019. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: http://dx.doi.org/10.21834/ajbes.v4i16.178

Travel route scheduling based on user’s preferences using simulated annealing

<p>Nowadays, traveling has become a routine activity for many people, so that many researchers have developed studies in the tourism domain, especially for the determination of tourist routes. Based on prior work, the problem of determining travel route is analogous to finding the solution for travelling salesman problem (TSP). However, the majority of works only dealt with generating the travel route within one day and also did not take into account several user’s preference criteria. This paper proposes a model for generating a travel route schedule within a few days, and considers some user needs criteria, so that the determination of a travel route can be considered as a multi-criteria issue. The travel route is generated based on several constraints, such as travel time limits per day, opening/closing hours and the average length of visit for each tourist destination. We use simulated annealing method to generate the optimum travel route. Based on evaluation result, the optimality of the travel route generated by the system is not significantly different with ant colony result. However, our model is far more superior in running time compared to Ant Colony method.</p>

Characteristics of Tokiwadaira Neighbourhood Park in Matsudo, Japan: A space for the elderly

Tokiwadaira is one of the districts most populated by elderly in Japan. This study compared the preferences of danchi and apartment residents to examine the neighbourhood park preferences as well as neighbourhood park similarity. This research was conducted in three stages, including a spatial preference survey, analysis, and interpretation. A Welch’s t-test and correspondence analysis were applied. Results demonstrated three significant differences between danchi and apartment residents, namely park preference, length of visit, and preferred park elements. There were four similarities among Tokiwadaira neighbourhood parks. These results may help urban planners optimise existing features of neighbourhood parks to encourage use.Keywords: landscape preference; neighbourhood parks; resident participationeISSN: 2398-4287 © 2018. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.https://doi.org/10.21834/e-bpj.v3i9.1513

DEVELOPING AN IPAD® APPLICATION FOR DATA COLLECTION IN A RHEUMATOLOGY RESEARCH CLINIC

Objectives: Clinical research data are often collected on paper and later inputted onto an electronic database. This method is time consuming and potentially introduces errors. Therefore, to make primary data collection more efficient and less error prone we aimed to develop a touch-screen application for data collection in a psoriatic arthritis research clinic and compared it with the pre-existing paper-based system.Methods: We developed a Web application using Java and optimized it for the iPad®. It highlights missing fields for physicians in real time, and only permits submission of data collection form after corrections are made. For its evaluation, seven physicians participated, and before each patient visit they were randomly assigned paper or iPad® data entry. Number of errors, length of visit, and time between clinic visit and completion of data entry were measured.Results: A total of 106 patients seen in the clinic who agreed to participate were randomly assigned to be evaluated by clinic physicians using the iPad® (fifty-three patients) or a paper protocol (fifty-three patients). On average, 3.34 omissions were found per paper form, of which 2.24 would have been detected on the iPad®. The iPad® increased the mean patient encounter time from 37.2 minutes to 46.5 minutes, but eliminated delay between a clinic visit and its data entry.Conclusions: Entering data using the iPad® application makes the patient encounter slightly longer, but reduces “missing fields.” It also eliminates the delay between clinic visit and data entry thus improving the efficiency of clinical data capture in a research setting.