New algorithm maps safest routes for city drivers

Peer-Reviewed Publication

UNIVERSITY OF BRITISH COLUMBIA

 

IMAGE: DR. TAREK SAYED, PROFESSOR OF CIVIL ENGINEERING, UNIVERSITY OF BRITISH COLUMBIA view more 

CREDIT: UNIVERSITY OF BRITISH COLUMBIA

Most navigation apps can show you the fastest possible route to your destination and some can even suggest an eco-friendly route calculated to produce the least amount of carbon emissions.

But what if they could also map the safest route with the lowest possible risk of a crash?

A new algorithm developed by UBC researchers could make this a reality. Led by Dr. Tarek Sayed, professor in the UBC department of civil engineering, and PhD student Tarek Ghoul, the group developed a new approach which identifies the safest possible route in an urban network using real-time crash risk data, and can be incorporated into navigation apps such as Google Maps.

To conduct their research, the team used data from 10 drones hovering over downtown Athens, Greece, over multiple days and recording factors including vehicle position, speed and acceleration. They used this information to identify near-misses between vehicles and then predicted the risk of crashes in real-time.

“This research is the first to use real-time crash risk data to provide navigation directions and give you the safest possible driving route through a city,” said Dr. Sayed. “The algorithm is capable of adjusting directions in real-time, suggesting detours to avoid hazardous locations. This helps enhance road safety for all users. For instance, companies will be able to route their fleet efficiently, prioritizing safety and reducing crash risk.”

Fastest route not always the safest

The study also found that the fastest routes are not always the safest. For example, the team analyzed a small section of Athens’ urban road network and found only 23 per cent of the fastest routes were also considered to be the safest routes. On average, the safest route used 54 per cent of the roads used in the fastest route. This indicates that road users should consider a mix of safety and efficiency when choosing directions, said Ghoul.

“In the network we looked at, there was a clear trade-off between safety and mobility: The safest route tended to be 22 per cent safer than the fastest route, while the fastest route was only 11 per cent faster than the safest route. This suggests that there are considerable gains in safety on the safest routes with just a small increase in travel time. As well, intermediate routes, which consider both safety and mobility, would yield larger safety benefits that would by far outweigh the increased travel time.”

Connected cities

The researchers are currently extending their research into other cities, including Boston, where autonomous vehicles are being tested that produce not only information about themselves and their navigation, but also about traffic routes and crash risk.

“If an urban road network has access to new technologies such as autonomous vehicle data, cameras and other sensing technologies, new possibilities open up for real-time safety measurement and effective routing,” said Dr. Sayed. “These technologies are now generating unprecedented amounts of data, giving rise to new smart mobility applications in the future.”

The algorithm could also be used for bike routing, with cyclists and pedestrians being some of the most vulnerable users of road networks. “Including pedestrian and cyclist data in future algorithms or navigation tools will allow us to improve their safety significantly,” said Dr. Sayed.

It’s important to use real-time crash risk data in any crash prediction or safety optimization algorithm, he added, in order to reflect current conditions, provide more accurate crash risk estimates, and reduce the number of road collisions. Using this data and advanced modelling techniques allows a safer route algorithm that helps road users prioritize safety without compromising efficiency.

Interview language(s) English (Sayed, Ghoul)

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JOURNAL

Analytic Methods in Accident Research

DOI

10.1016/j.amar.2023.100277 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Real-time safest route identification: Examining the trade-off between safest and fastest routes

ARTICLE PUBLICATION DATE

1-Sep-2023

 

Researchers develop field identification process for invasive reeds

Peer-Reviewed Publication

CAMBRIDGE UNIVERSITY PRESS

A team of researchers recently set out to determine whether it is possible to identify invasive common reed reliably in the field – reducing the need for time-consuming and costly genetic testing. In a study featured in volume 16, issue 2 of the journal Invasive Plant Science and Management, they examined multiple populations of both introduced and native common reed to determine distinguishing features.

Nearly two dozen observable traits were compared, such as stem color, the presence or absence of round-stem fungal spots, the presence or absence of dark red pigmentation on lower internodes, and the retention of leaf sheaths on dead stems.

Based on the data collected, an easy-to-use, five-part checklist was developed to help land managers quickly determine whether a given specimen of common reed is a native plant or an introduced invasive weed. Since geographical variations are possible, the team says the checklist will be most applicable in the Great Lakes region where their research was based. The same data can be used, though, to inform field identification best practices in other regions.

“With this new tool, land managers should be able to focus their limited resources more effectively,” says Michael McTavish, a postdoctoral research fellow at the University of Toronto. “They can target invasive reed populations and also protect desirable native plants from accidental removal.”

The article “Morphological traits for rapid and simple separation of native and introduced Phragmites australis” is now available at https://doi.org/10.1017/inp.2023.15

About Invasive Plant Science and Management

Invasive Plant Science and Management is a journal of the Weed Science Society of America, a nonprofit scientific society focused on weeds and their impact on the environment. The publication focuses on invasive plant species.

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JOURNAL

Invasive Plant Science and Management

DOI

10.1017/inp.2023.15 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Morphological traits for rapid and simple separation of native and introduced common reed (Phragmites australis)

 

Older adults who identify as sexual and gender minorities experience disproportionate age-related decline

Researchers develop tool to measure, compare the burden of frailty in first-of-its-kind study

Peer-Reviewed Publication

BETH ISRAEL DEACONESS MEDICAL CENTER

BOSTON – In June, the U.S. Census Bureau announced that the average age of the U.S. population reached a new high of nearly 39 years old. Today, roughly three million older adults who belong to a sexual and gender minority (individuals who self-describe as LGBTQ+ or as having discordant gender and sex assigned at birth) live in the U.S., a number that is projected to grow to more than five million by 2030. Prior studies have demonstrated that this demographic is at disproportionate risk of chronic conditions, mental health issues, cognitive decline and health risk behaviors compared to the general population. However, there’s little data available to characterize the way this population is aging.

In a new study led by Chelsea N. Wong, MD,  an advanced geriatric medicine fellow at Beth Israel Deaconess Medical Center, investigators developed an index to describe and compare frailty—a measure of physiological reserve or vulnerability—between older sexual and gender minority (OSGM) adults and non-OSGM participants. Using the frailty index they constructed, Wong and colleagues showed that, overall, OSGM had higher rates of frailty, starting at younger ages and continuing into older age, compared to non-OSGM. The team’s work appears in the Journal of Gerontology: Medical Sciences.

“We found that older individuals who belong to sexual and gender minorities have a higher burden of frailty, maintained across the lifespan and a higher magnitude of mortality risk,” said Wong, who is also entering a T32 Post-Doctoral Fellowship with the Harvard Translation Research in Aging Training Program at Hebrew SeniorLife. “To our knowledge this is the first study to examine frailty among this marginalized population.”

Frailty is the state of vulnerability caused by age-associated decline across multiple functions, and it is associated with an increased risk of falls, disability, hospitalization, and mortality. While no single symptom confirms a frailty diagnosis, it commonly involves muscle loss and weakness, fatigue, slow walking speed and impaired cognition. Taken together, the symptoms of frailty can lead to social isolation or make independent living impossible.

Wong and colleagues constructed their frailty index using data from the All of Us Research Program, a program funded by the National Institutes of Health designed to recruit a diverse cohort of participants who have been historically underrepresented in biomedical research. The team built their frailty index to calculate based on 33 factors where individuals may experience deficits, including cognition, cardiovascular diseases, the ability to bathe or run errands alone, maintain a social life, fatigue, anxiety and depression, hearing and sight.

When the researchers applied the Frailty Index to a sample of more than 76,000 eligible All of Us participants, they saw clear patterns. The 9,110 OSGM participants had a higher burden of frailty than their counterparts, with 41 percent robust (not frail), 34 percent pre-frail, and 26 percent frail. In comparison, non-OSGM participants, 50 percent were robust, 32 percent were pre-frail and 19 percent were frail. Further, the risk of mortality associated with frailty was higher among OSGM compared to non-OSGM.

These disparities, the authors note, are understood through the minority stress theory, which describes how the external stressors of discrimination become internalized. Previous research has demonstrated that minority stress is associated with negative health consequences, including changes in inflammation immune and endocrine function, which in turn contribute to poor cardiovascular, metabolic and immunologic clinical outcomes.

“This current generation of older adults who identify as sexual and gender minorities experienced significant events specific to their minority identity, including homosexuality being officially labeled as a mental illness, the Lavender Scare where there was mass dismissal of SGM workers from U.S. government employment, and the advent of the HIV/AIDS epidemic,” said Wong. “The minority stress experience of chronic additive stress associated with social stigmatization and discrimination may lead to systematic inflammation and contribute to the development of frailty at relatively younger ages. These findings emphasize the need for early geriatric assessment among OSGM and future work should identify potential targets to mitigate frailty.”

Co-authors included Michael P. Wilczek, PhD, Louisa H. Smith, PhD, Robert Cavanaugh, MS, PhD, Justin Manjourides, PhD, Brianne Oliveri-Mui, PhD, and Jordon D. Bosse, PhD, RN, of Northeastern University; Erin L. Richard, PhD of University of California San Diego; and Ariela R. Orkaby, MD, MPH, of Veterans Affairs Boston Healthcare System and Brigham & Women’s Hospital.

Orkaby is supported by the U.S. Department of Veterans Affairs (grant VA CSR&D CDA-2 award IK2-CX001800). The All of Us Research Program is supported by the National Institutes of Health (NIH). Please see the publication for a complete list of grants. The authors report no conflicts of interest.  

 

About Beth Israel Deaconess Medical Center

Beth Israel Deaconess Medical Center is a leading academic medical center, where extraordinary care is supported by high-quality education and research. BIDMC is a teaching affiliate of Harvard Medical School, and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding. BIDMC is the official hospital of the Boston Red Sox.

Beth Israel Deaconess Medical Center is a part of Beth Israel Lahey Health, a health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,800 physicians and 36,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.

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JOURNAL

Journal of Gerontology

 

Brazilian researchers identify gynecological concerns of caregivers of young girls and women with Down syndrome

Concerns regarding gynecological aspects of Brazilian girls and women with Down syndrome: a cross-sectional study of caregivers’ opinion

Peer-Reviewed Publication

AMERICAN ACADEMY OF FAMILY PHYSICIANS

Brazilian researchers conducted a cross-sectional study to explore the concerns of caregivers of Brazilian girls with Down syndrome (DS) regarding gynecological aspects of DS including menstruation, contraception and sexual practices. The study included 100 caregivers of females aged 9 years or older with DS who had reached menarche. Participating caregivers completed a questionnaire about their concerns around puberty, menstruation, sexuality and contraceptive methods.

Caregivers commonly expressed concerns around menstrual bleeding. Most caregivers (57%) reported that they would permit their child to engage in romantic relationships, including sexual relationships, with 2% of caregivers surveyed reported that their child had already engaged in sexual intercourse. According to information from surveyed caregivers, 14 of 78 (17.9%) individuals had used contraceptive methods, with weight gain being the most common side effect (43%). In the study sample, researchers concluded that women with DS had sexual development comparable to women without DS. These women are increasingly independent, which the authors argue makes it necessary to guide caregivers and primary care physicians on addressing difficulties related to menstruation, contraception and sexual practices.

What We Know: Women with Down syndrome (DS) and their caregivers may have more difficulties with puberty, menstruation, sexuality and contraception use. In this study, Brazilian researchers aimed to understand the concerns of the caregivers of girls and women with DS-related gynecological issues.

What This Study Adds: The findings of this study offer valuable insights into the specific gynecological care requirements of young girls and women with DS and sheds light on the primary concerns expressed by their caregivers. These results can contribute to a deeper understanding of the unique needs of individuals with DS and serve as a means to sensitize physicians, regardless of their specialization, who may encounter patients with DS and require guidance in effectively addressing their families' inquiries and concerns.

Concerns Regarding Gynecological Aspects of Brazilian Girls and Women With Down Syndrome: A Cross-Sectional Study of Caregivers’ Opinion

Renato Nisihara, PhD
Federal University of Paraná Medicine, University Positivo and Mackenzie Evangelical School of Medicine Paraná, Curitiba, Paraná, Brazil
Permanent link

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JOURNAL

The Annals of Family Medicine

HEY KIDZ

Meta-analysis of research on acne reveals that oral isotretinoin, followed by topical antibiotic, benzoyl peroxide and retinoid, are most effective treatments

Comparative efficacy of pharmacological treatments for acne vulgaris: a network meta-analysis of 221 randomized controlled trials

Peer-Reviewed Publication

AMERICAN ACADEMY OF FAMILY PHYSICIANS

In their comprehensive meta-analysis (comprising 221 randomized controlled trials involving 65,601 patients), researchers investigated the effectiveness of various pharmacological therapies for acne vulgaris across diverse age groups and genders. The articles described 37 interventions, with a median patient age of 20 years old and median duration of treatment of 12 weeks. The median total, inflammatory and non-inflammatory lesion counts were 71.5, 27 and 44, respectively.

The study revealed that oral isotretinoin was the most effective treatment (mean difference 48.41; p-score 1.00), followed in efficacy by a triple therapy containing a topical antibiotic, a topical retinoid and benzoyl peroxide (BPO) (MD 38.15; p-score 0.95) and another triple therapy containing an oral antibiotic, a topical retinoid and BPO (MD 34.83; p-score 0.90). For monotherapies besides isotretinoin, antibiotics or topical retinoids have comparable efficacy for inflammatory lesions, while antibiotics have less effect on non-inflammatory lesions.  Additionally, the authors present a comprehensive comparison of each intervention, providing a valuable resource for clinical decision-making.

What We Know: Acne is a common skin disease with an estimated global presence of 9.4% and an annual cost of $3 billion in the United States. Although guidelines that recommend medications are generally supported by high-quality, randomized controlled trials, research is lacking on the efficacy of certain medications, particularly when comparing treatment options that have markedly inconsistent drug prescribing patterns among countries and among prescriber specialties.

What This Study Adds: Based on a comprehensive meta-analysis of 210 articles, comprising 221 trials and examining 37 interventions involving 65,601 patients, researchers have concluded that oral isotretinoin is the most effective treatment for acne. Following closely behind, triple therapies incorporating a topical retinoid, benzoyl peroxide (BPO) and an antibiotic have shown significant efficacy. For monotherapies, both oral/topical antibiotics and topical retinoids demonstrate comparable effectiveness for inflammatory lesions. However, it is important to note that oral/topical antibiotics exhibit limited efficacy for non-inflammatory lesions and should not be utilized as stand-alone treatments due to the risk of bacterial resistance.

Comparative Efficacy of Pharmacological Treatments for Acne Vulgaris: A Network Meta-Analysis of 221 Randomized Controlled Trials

Chien-Chang Lee, MD, ScD, et al
Department of Emergency Medicine, National Taiwan University Hospital, and Center for Intelligent Healthcare, National Taiwan University Hospital, Taipei, Taiwan
Permanent link

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JOURNAL

The Annals of Family Medicine

FRANCE 

Survey suggests geographic inequalities in patient registration versus primary care physician density can exclude patients from comprehensive care access

Presence of primary care physicians and patients’ ability to register: a simulated-patient survey in the Paris region

Peer-Reviewed Publication

AMERICAN ACADEMY OF FAMILY PHYSICIANS

French researchers conducted a large, simulated study to examine the relationship between the presence of primary care physicians (PCPs) and the ability of patients to register with a PCP. The study aimed to analyze local PCP supply based on various indicators, including PCP presence, patient registration availability for office visits, and patient registration availability for home visits. Out of 5,188 census blocks, 55.4% had at least one PCP, with 38.6% of those blocks allowing registration for office visits and 19.46% allowing registration for home visits. The research revealed that geographic inequalities in patient registration were more significant than those related to PCP density, challenging the assumption that patients could easily find and register with a PCP. They found that doctors were less likely to accept new patients who required time-consuming procedures including home visits and complicated services. Additionally, they were also less likely to accept new patients if they worked in areas that required them to take on the highest work loads (lowest PCP density in the most disadvantaged areas). The authors argue that policy decisions mandating patient registration with a PCP to access health care may unintentionally exclude individuals who are unable to register with a PCP, preventing them from benefiting completely  from the health care system.

What We Know: Finding a PCP with whom to register in France is a prerequisite for benefiting fully from the health care system, access to which can be undermined by substantial PCP refusal to register new patients. PCPs can also refuse appointments to unregistered patients.

What This Study Adds: The findings from the study suggest that the number of primary care doctors in a specific area does not correlate with a patient’s ability to register for care from any of those doctors. Patients who requested more complex services or were located in more disadvantaged areas were more likely to be denied registration for a PCP. The researchers contend that the inability of patients to register with a PCP may result in the exclusion of certain patient groups from accessing health care services that require PCP registration. These observations highlight the need for a more nuanced approach in developing policies to ensure equitable health care access for all individuals.

Presence of Primary Care Physicians and Patients’ Ability to Register: A Simulated-Patient Survey in the Paris Region

Raphaëlle Delpech, MD, et al
Department of General Practice, University of Paris-Saclay and CESP (Centre for Research in Epidemiology and Population Health), Inserm U1018, University of Paris-Saclay, UVSQ, Gender, Sexual and Reproductive Health Team, Paris, France
Permanent link

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JOURNAL

The Annals of Family Medicine

 

Primary care clinics that improved patient access, identified at-risk patients and expanded services experienced reductions in acute hospitalizations

Reducing acute hospitalizations at high performing CPC+ primary care practice sites: strategies, activities, and facilitators

Peer-Reviewed Publication

AMERICAN ACADEMY OF FAMILY PHYSICIANS

Researchers from Mathematica studied high-performing Comprehensive Primary Care Plus (CPC+) sites to identify key strategies that contributed to significant reductions in acute hospitalization rates. Researchers identified CPC+ practice sites with the highest likelihood of achieving substantial reductions in Medicare acute hospitalization rates between 2016 and 2018, and referred to them as "Acute Hospitalization Rate (AHR) high-performers." Afterwards, they conducted telephone interviews and within- and cross-case comparative analyses of 14 of these primary care practice sites, with the help of physicians, practice administrators, care managers, and other practice staff including nurses and pharmacists.

AHR high-performers credited various care delivery activities that aligned with three key strategies: (1) improving and promoting timely access to primary care, (2) identifying high-risk patients and providing enhanced care management tailored to their needs, and (3) expanding the range of services offered at the practice site. The AHR high-performers also recognized several factors that facilitated the implementation of these strategies, such as receiving enhanced payments through CPC+, prior experience in transforming primary care practices, utilizing data to identify valuable activities for specific patient subgroups, fostering teamwork, and benefiting from organizational support for innovation. Based on their findings, the researchers concluded that strengthening the local primary care infrastructure through practice-driven and targeted changes in access, care management, and comprehensiveness can support efforts to reduce  incidence of acute hospitalizations. They encourage other primary care clinics to emulate these strategies, tailoring specific activities to fit their context, personnel, patient population and available resources.

What We Know: Access to timely primary care has been linked to reduced hospitalizations among patients. However, the existing health care system often lacks the necessary resources to enable primary care doctors to reach patients before their conditions worsen and require hospitalization. Notably, clinics enrolled in CMS’ Comprehensive Primary Care Plus (CPC+) program receive both financial and technical support to proactively engage with patients prior to hospitalization. However, researchers aren’t certain what high-performing clinics are doing to reduce acute hospitalization rates. Petersen, et al’s study strives to explain those specific activities.

What This Study Adds: Clinics that successfully reduced acute hospitalization rates implemented several effective strategies. They focused on improving access to primary care, proactively identifying high-risk patients and providing them with enhanced care management. These clinics also expanded the range of services available to patients. Additional contributing factors to their success included receiving enhanced payments through CPC+, prior experience with clinic transformations, utilizing data to identify high-value services for specific patient groups, receiving organizational support for change, and fostering teamwork among health care professionals.

Reducing Acute Hospitalizations at High Performing CPC+ Primary Care Practice Sites: Strategies, Activities, and Facilitators

Dana M. Petersen, MA, MPH, PhD, et al
Mathematica, Oakland, California
Permanent link

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JOURNAL

The Annals of Family Medicine

U$A 

Researchers examine the impact of loan repayment program enrollment on physician workforce equity and patient care access

Impact of service-based student loan repayment program on the primary care workforce

Peer-Reviewed Publication

AMERICAN ACADEMY OF FAMILY PHYSICIANS

Researchers from the American Board of Family Medicine and the University of Minnesota Medical School investigated whether participation in medical school repayment programs impacted the care family physicians provided to patients post graduation. By analyzing data from over 10,000 American Board of Family Medicine National Graduate Survey respondents, the authors examined differences in program participation, participant demographics, scope of practice, and the likelihood of serving medically underserved or rural populations.

The study revealed a significant increase in participation in the Public Service Loan Forgiveness (PSLF) program between 2016 and 2020, while participation in the National Health Service Corps (NHSC) program remained unchanged. Physicians enrolled in the NHSC program were more likely to come from underrepresented groups; exhibited a wider scope of practice; and were more inclined to practice in rural areas (23.29% compared to 10.84% in PSLF). They also were more likely to practice in areas designated as Health Professional Shortage Areas (12.5% compared to 3.70% in PSLF), serving medically underserved populations (82.17% compared to 24.22% in PSLF). In contrast, PSLF primarily supported physicians intending to work in public service.

What We Know: With average medical school debt soaring to $200,000 over the last few decades, the escalating financial burden is driving concerns that students may opt out of low-pay but high-value public service careers in Federally Qualified Health Centers (FQHCs), rural health clinics, and the Indian Health Service. Loan repayment programs – like the Public Service Loan Forgiveness program and the National Health Service Corps (NHSC) – play a vital role in making primary care a viable career option by alleviating the burden of high educational costs.

What This Study Adds: The analysis conducted in this study suggests that PSLF may be less effective in supporting family physicians from underrepresented backgrounds, promoting a broader scope of practice, and directing physicians to underserved settings compared to service-based loan repayment programs like NHSC.

Impact of Service-Based Student Loan Repayment Program  on the Primary Care Workforce 
 

Caitlin S. Davis, MD, MSc, et al
Fairfax Family Medicine Program, Fairfax, Virginia
Permanent link

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JOURNAL

The Annals of Family Medicine

 

Calling for cancer centers to lead on climate disaster preparedness

Sylvester researchers, collaborators advocate for NCI-designated centers to take steps to protect vulnerable patients, bolster community resilience

Peer-Reviewed Publication

UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE

MIAMI, FLORIDA (JULY 25, 2023) – Cancer centers are uniquely positioned to protect communities and their most vulnerable residents – cancer patients – from climate-driven disasters by bolstering emergency preparedness, noted researchers with Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, the American Cancer Society (ACS) and collaborating organizations. 

Writing in a commentary in the Journal of the National Cancer Institute (NCI), the researchers noted that all 71* of the country’s NCI-designated cancer centers have been impacted by one or more climate-related disasters during the past decade. 

Wildfires. Floods. Hurricanes and tropical storms. Severe ice and snowstorms. Extreme heat events. Cancer centers have gained experience dealing with all types of climate hazards, according to the researchers. 

Additionally, the centers already have emergency preparedness plans in place as required by the Centers for Medicare and Medicaid Services (CMS), the agency overseeing these federal health programs.  

“During the COVID-19 pandemic, it became clear that cancer centers can adapt quickly to challenging circumstances and develop best practices to prioritize patient and public safety,” said Leticia Nogueira, PhD, ACS’s scientific director for Health Services Research and the paper’s corresponding author, “the same type of prioritization and collaboration between institutions and professionals from different backgrounds is urgently needed to better prepare and response to climate-driven disasters”. 

Gaps in Emergency Preparedness  

However, while cancer centers adapted quickly to the challenges posed by the pandemic, the researchers identified some significant shortcomings in emergency preparedness among the cancer centers when it came to climate-related disasters, especially when it came to protecting the health and safety of cancer patients.  

For the analysis, the researchers conducted an extensive audit of the centers’ websites to identify and categorize current preparedness information, guidance and practices. Their review revealed some glaring information gaps and deficiencies, including:  

• Only half of the centers posted preparedness information specifically for cancer patients. 

• Less than 25% contained emergency information for climate disasters, despite their increasing frequency and severity. 

• Less than 10% of centers provided cancer-specific emergency preparedness material related to climate-driven disasters.  

• Only one center’s website included information on maintaining psychological health and well-being during climate disasters. 

Although some websites outlined steps that individuals can take to boost personal preparedness, including making disaster kits and evacuation plans and ensuring pet safety, very few -- about 5% -- included cancer-specific recommendations such as: pre-registering for special-needs shelters, requesting additional medical supplies before disasters, creating portable medical cards containing vital personal health information and stocking medical items in disaster kits.  

“As a psychiatrist, I know firsthand that the diagnosis and treatment of cancer brings about a multitude of stressors related to the physical, psychological and socioeconomic consequences of the disease,” explained Zelde Espinel, M.D., Sylvester clinician and researcher and lead author of the paper. “Patients living with cancer – and their caregivers and care providers – have distinctive needs and vulnerabilities that are further amplified when faced with the risks posed by climate-driven extreme weather events.”  

Roadmap for Cancer-Specific Future Preparedness 

“ NCI-designated cancer centers are well-positioned to advance knowledge and expertise about “climate-proofing” healthcare operations for cancer patients and others,” said Tracy Crane, PhD, RDN, co-lead of Cancer Control and director of Lifestyle Medicine, Prevention and Digital Health at Sylvester, and one of the paper’s authors. “They have greater access to resources through accreditation, established relationships with other healthcare organizations and are trusted entities within their communities.” 

Additionally, the centers already have CMS-compliant emergency-preparedness plans that should be evaluated and revised, as needed, to better protect medically vulnerable populations during climate disasters. 

Moreover, the centers can build on existing resources for centralized information sharing, such as the NCI’s “Emergency Resources for the Cancer Community,” ACS’s “Guide to Getting Ready for a Natural Disaster” and the Department of Health and Human Services’ website with hazard-specific content for actions before, during and after disasters. Other federal and local resources are readily available and should be utilized as appropriate. 

The researchers also recommended structured information sharing among cancer centers to share lessons learned from previous climate disasters and coordinated research efforts that promote collaboration in evidence-gathering, data analysis, implementation strategies and communication methods that can result in best practices. 

“Our research takes on even greater significance during the expansive heatwaves and climate disasters of 2023 as we encourage national cancer centers to pursue innovative strategies for enhancing emergency preparedness for their patients, providers, other staff and care systems in this current era of compounding disasters,” said co-author James M. Shultz, Ph.D., Sylvester researcher and associate professor of public health at UM Miller School of Medicine. His Protect and Promote Population Health in Complex Crises research program focuses on safeguarding medically high-risk patients, particularly cancer patients, from disaster threats. 

“Climate-related disasters are only expected to increase in the coming decade,” added Crane. “Cancer centers have a responsibility and an opportunity to partner with their communities and ensure they are prepared to protect medically vulnerable populations, especially cancer patients.”    

  

# # # 

*With the recent addition of the University of Florida, there are now 72 NCI-designated cancer centers in the United States. When the cancer centers were reviewed UF had not yet received designation. 

DOI: 10.1093/jnci/djad139 

# # # 

MEDIA CONTACT: 
Sandy Van 
sandy.van@miami.edu  
808.206.4576 

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JOURNAL

JNCI Journal of the National Cancer Institute

DOI

10.1093/jnci/djad139 

ARTICLE TITLE

Protecting Vulnerable Patient Populations from Climate Hazards: The Role of the Nations’ Cancer Centers

ARTICLE PUBLICATION DATE

25-Jul-2023

 

Canadian patients report high levels of satisfaction from an integrated model of virtual and in-person care

Investigating patient experience, satisfaction, and trust in an integrated virtual care (IVC) model: a cross-sectional survey

Peer-Reviewed Publication

AMERICAN ACADEMY OF FAMILY PHYSICIANS

 

IMAGE: INVESTIGATING PATIENT EXPERIENCE, SATISFACTION, AND TRUST IN AN INTEGRATED VIRTUAL CARE (IVC) MODEL: A CROSS-SECTIONAL SURVEY view more 

CREDIT: ANNALS OF FAMILY MEDICINE

In an effort to increase access to care in underserved communities, researchers from the University of Ottawa evaluated the implementation of an integrated virtual care (IVC) model. Their study evaluated the overall experience and satisfaction of patients receiving care through a combination of virtual and in-person visits. A secondary aim was to compare the experiences of patients who had been previously seen in person by a family physician before transitioning to the IVC clinics with those who met their family physician virtually for the first time in their virtual appointment at participating clinics.

The IVC model helps alleviate the burden on overwhelmed primary care clinicians by leveraging telemedicine technology, allowing family doctors located outside the community to provide care to patients remotely. By utilizing secure messaging, telephone consultations, and video appointments, the IVC model expands the pool of available family doctors, ensuring patients can access care even when local clinicians are overburdened.  In-person care is provided by physicians, nurse practitioners and other allied health professionals including community paramedics within the local family health team.

Using a cross-sectional online survey administered to 121 patients, the researchers determined that across all groups, 90% of patients were very satisfied or satisfied with care from their family physician, and 89% with care from their allied health team. When comparing previous healthcare experiences, 75% of respondents believe that their encounters with IVC were better than or the same as any prior, in-person healthcare encounters. There was no difference in satisfaction or trust between patients who had a previously established in-person relationship with their doctor and those whose first visit was virtual.

What We Know: Health care systems, both in Canada and globally, have long faced challenges in delivering timely and continuous primary care to their populations. The COVID-19 pandemic further exacerbated these difficulties, prompting health care organizations to establish virtual care networks to address the evolving needs of patients and ensure access to health care services.

What This Study Adds: Researchers found across all groups, 90% of patients were very satisfied or satisfied with care from their family physician, and 89% with care from their allied health team. When comparing previous healthcare experiences, 75% of respondents believe that their encounters with IVC were better than or the same as any prior, in-person healthcare encounters. Those levels were comparable to traditional in-person models of primary care.

Investigating Patient Experience, Satisfaction, and Trust in an Integrated Virtual Care (IVC) Model: A Cross-Sectional Survey

Jonathan Fitzsimon, MD, et al
Faculty of Medicine and Department of Family Medicine, University of Ottawa, Ontario, Canada
Permanent link

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JOURNAL

The Annals of Family Medicine