Operationalizing a Rideshare Intervention for Colonoscopy Completion: Barriers, Facilitators, and Process Recommendations

IntroductionTransportation is a common barrier to colonoscopy completion for colorectal cancer (CRC) screening. The study aims to identify the barriers, facilitators, and process recommendations to implement a rideshare non-emergency medical transportation (NEMT) intervention following colonoscopy completion within a safety-net healthcare setting.MethodsWe used informal stakeholder engagement, story boards—a novel user-centered design technique, listening sessions and the nominal group technique to identify the barriers, facilitators, and process to implementing a rideshare NEMT program following colonoscopy completion in a large safety-net healthcare system.ResultsBarriers to implementing a rideshare NEMT intervention for colonoscopy completion included: inability to expand an existing NEMT program beyond Medicaid patients and lack of patient chaperones with rideshare NEMT programs. Facilitators included: commercially available rideshare NEMT platforms that were lower cost and had shorter wait times than the alternative of taxis. Operationalizing and implementing a rideshare NEMT intervention in our healthcare system required the following steps: 1) identifying key stakeholders, 2) engaging stakeholder groups in discussion to identify barriers and solutions, 3) obtaining institutional sign-off, 4) developing a process for reviewing and selecting a rideshare NEMT program, 5) executing contracts, 6) developing a standard operating procedure and 7) training clinic staff to use the rideshare platform.DiscussionRideshare NEMT after procedural sedation is administered may improve colonoscopy completion rates and provide one solution to inadequate CRC screening. If successful, our rideshare model could be broadly applicable to other safety-net health systems, populations with high social needs, and settings where procedural sedation is administered.

FAMILY SUPPORT-BASED PSYCHOEDUCATION IN CARING SCHIZOPHRENIC PATIENTS: A LITERATURE REVIEW

Background: The burden of family in caring a schizophrenia impacts on psychological shock and emotional burden; lack of disease knowledge and care skills; poor patient medication adherence; the difficulty of getting along with patients; conflict in the family or at work; financial burden; and need adequate social support. Aim: This study discussed how family support takes care of people with schizophrenia with a psychoeducational approach in mental health service settings. Method: A non-systematic literature review was carried out using the PICO (Population, Intervention, Comparison, Outcome) framework utilizing Scopus, CINAHL, and ProQuest databases in the last 5 years, searching with keywords: Family Support AND Schizophrenia OR Family Psychoeducation. Results: Families with schizophrenia experience the most potent stressors on the burden of care borne, in addition to stigma and the frequency of relapse of sufferers. Community care providers can involve the family in various ways, such as providing psychoeducation, supporting the family's physical, emotional and social needs, and behavioral family assessment or family therapy. Conclusion: Mental health services must develop and imply family psychoeducation training.

Social Dimensions of Roma Marginalization

The paper aims to analyze aspects of Roma marginalization, by identifying and assessing the dimensions of social needs within a compact Roma community, located in a marginalized urban area. The effects of the economic crisis and the COVID-19 pandemic increase inequalities regarding the economic and social situation. The major challenge is to reduce the risk of poverty, especially among families with children, people with disabilities and chronic diseases, but also the social exclusion of people at social risk, based on accurate measurements of social phenomena. The community profile indicates the social status of the inhabitants, which provides a picture of the degree of marginalization and social exclusion of Roma. Thus, the study was conducted by constructing a questionnaire as a research tool, which summarizes the results of the activity of information collection and processing, both based on statistical methods and percentage analysis. The problems faced by marginalized Roma communities are low participation in education, early school leaving, difficult transition to tertiary education, lack of adult skills, low skills among vulnerable people in the labor market, low access to services, poor health and housing. Measures for early detection of situations of social risk and intervention lead to positive effects in preventing marginalization and social exclusion.

Refugee-led socio-spatial organization in Al Baqa’a camp, Jordan

The increase in refugee numbers is an increasingly important concern globally. Many countries in different regions have been accommodating refugees by providing temporary shelters made from ineffective and inadequate materials to provide thermal comfort for refugees. However, the shelters provided are often inadequate solutions for shelter and neglect the social and cultural diversity of the refugees. Socio-cultural norms, practices and values are rarely considered in the design of shelters and this has an adverse impact on how refugees live in these spaces. Using insights from the Al Baqa’a refugee camp in Jordan as a case study, this paper uses a mixed-method approach to explore how the challenges of inadequate shelter has consequently led refugees to self-organize and create new socio-cultural spaces to adapt to the place. The findings suggest that historically, Al Baqa’a camp has reorganized by users due to social needs and climate challenges. When the camp was created in 1967, the inadequacy of the housing and infrastructure to provide comfort influenced refugees to self-organize and create adaptive spaces of comfort. However, over the decades, these spaces have evolved into spaces of enterprise, belonging and memory of their homeland. Therefore, this paper argues that refugee shelter design should have an integrated consideration of the climatic elements and the social and cultural aspects of refugees. The paper concludes with lessons learned drawn from the evidence to act as guideline for the consideration of official humanitarian organizations in other camps and local communities.

THE ROLE OF GIS IN ADDRESSING ENVIRONMENTAL, SOCIAL AND TOURISTIC CHALLENGES IN MOHAMMEDIA CITY, MOROCCO

During the last years, Morocco’s Environmental, Social and Touristic perspectives has improved significantly, but it remains one of the biggest challenges for Mohammedia city. The purpose of this study is to locate an optimal site for the construction of a new Waste Water Treatment Plant (WWTP) in order to help the environment, to select an appropriate site for the construction of a new School that will benefit the social needs of the city and to create a suitable tour plan of touristic sites for tourism. It was carried out by using Geographic Information System (GIS), Remote Sensing (RS), Global Positioning System (GPS) devices, Digital cameras and Multi- criteria Decision Analysis (MCDA).Throughout the process, the used data for both WWTP and School selection include the remote sensing data of multi spectral satellite imageries and the digital elevation model combined with vector data of land use (LU) layers, and for Tour creation the used data include collected photographs and GPS data from the site. According to MCDA, the results presents an optimal site with an area of 48283,02 m2 for a new WWTP, a suitable area with an area of 3200 m² for a new School and a city tour for tourists with a distance of 27 km.

The Development of Spatial Circularity Discourse in Japan: Ecomodernist, Territorialised, or Both? The Story of Onomichi’s Wastescapes

Globally, many national, regional, and urban governments are facilitating circular economy transitions through various pathways. The European Union and China have spearheaded the worldwide shift towards circularity by adopting primarily ecomodernist and technocratic approaches. However, the relevant literature has highlighted the need to integrate conceptualisations of circularity that are more politically and spatially embedded to better suit the local contexts and actual social needs of specific populations. In this paper, we therefore argue that the Japanese approach to circular practices exemplifies a place-bound and just pathway and offers a potential alternative to the European and Chinese methods. Accordingly, we first trace the historical roots of spatial circularity in Japan and then articulate some contemporary circular concepts. Next, we present a detailed analysis of wastescapes in the city of Onomichi to demonstrate through the lived experiences of its citizens that the rather orthodox understandings of circularity that permeate Japanese discourse on circularity coexist with alternative considerations that promote human interactions with nonhuman nature, acknowledge spatial ranges of operations, and value traditional knowledge.

“Retweet for More”: The Serialization of Porn on the Twitter Alter Community

This article examines the notion of seriality in the context of the Filipino alter community, a network of Twitter users producing, distributing, and consuming pornographic images. The alter community is prominent among Filipino gay men who satisfy their need for sexual arousal, collective identity, and validation of their sexuality in the alter community. Seriality is influenced by technological features and affordances of a media platform. In the case of Twitter, the platform’s short form formats and real-time content generation fosters a particular kind of seriality. This essay analyzes data from online observations, content analysis of tweets and profiles, and interviews and is informed by theories on seriality, gay sexuality, and Internet studies. In situating seriality within the context of gay amateur porn economy, this article argues that serial pornography is instrumental in satisfying both present and long-standing affective, sexual, and social needs of gay men. These needs, this essay claims, stem from long history of minoritization of homosexuality. As Twitter renders older tweets ephemeral and quantifies social engagement, seriality enables gay men to satisfy the aforementioned needs longer. Furthermore, this essay proposes that serial porn on Twitter brings new insights to how seriality is conceived. Serial porn images are strategically and carefully constructed narratives of sexual encounters aimed at garnering higher social engagement and validation. Thus, serial narratives can resolve present and urgent affective tensions and needs that unravel within an ongoing life narrative rather than working toward supporting a plausible ending, as seen in other serial forms. This article contributes to an understanding of how pornographic images and serial narratives fit into consumerist culture and how platforms exploit long-standing affective needs of sexual minorities to ensure extended production and consumption of contents.

Investigation of The Sufficiency of Antalya Parks

Urban green spaces are areas established to meet the recreational needs of urban people. Although green spaces vary from country to country and region in terms of plan and design features, they were basically created to allow people to meet with nature. Parks are the basic components of urban landscapes that provide environmental and social functional value. Urban parks, in particular, provide spaces for outdoor physical activities. In order to take advantage of the opportunities of activities in the parks, users must have convenient access to these resources. One of the most important aspects for researching the use and potential benefits of urban green spaces is the assessment of their geographic accessibility. The widespread use of smart city systems and the gradual expansion of their usage areas increase the importance of spatial analysis. Spatial analyses are used in today’s urban management in the processes of determining social needs, identifying current problems, and putting forward solutions. When spatial analyses are used together with GIS, the field of application develops even more, and it supports local governments in responding to the changing demands of the society for a better life. In the study, the adequacy and accessibility of 160 city parks in Konyaaltı District of Antalya Province were examined. In terms of the adequacy of the parks, the area value of 10 m2 per person determined with the Construction Plan numbered 3194 was taken as basis. In terms of accessibility, distance values of 200, 400, 800, 1,200 meters were examined. Neighborhood boundaries and population information were obtained from the relevant units, and Arc-GIS software was used in the analysis. It was determined that the parks in Konyaaltı district were insufficient in terms of adequacy and accessibility. Finally, suggestions were made in terms of increasing the adequacy of the parks and ensuring accessibility.

Linking electronic health records and in-depth interviews to inform efforts to integrate social determinants of health into health care delivery: Protocol for a qualitative research study (Preprint)

BACKGROUND Health systems are attempting to capture social determinants of health (SDoH) in electronic health records (EHR) and use these data to adjust care plans. To date, however, methods for identifying social needs, which are the SDoH prioritized by patients, have been underexplored, and there is little guidance as to how clinicians should act on SDoH data when caring for patients. Moreover, the unintended consequences of collecting and responding to SDoH are poorly understood. OBJECTIVE The objective of this study is to use two data sources, EHR data and patient interviews, to describe divergences between the EHR and patient experiences that could help identify gaps in documentation of SDoH in the EHR; highlight potential missed opportunities for addressing social needs; and identify unintended consequences of efforts to integrate SDoH into clinical care. METHODS We are conducting a qualitative study that merges discrete and free-text data from EHRs with in-depth interviews with women residing in rural, socio-economically deprived communities in the Mid-Atlantic region of the United States. Participants had to confirm that they had at least one visit with the large health system that serves the region. Interviews with the women included questions regarding health, interaction with the health system, and social needs. Next, with consent, for each participant we extracted discrete data (e.g., diagnoses; medication orders) and free-text clinician notes from this health system’s EHRs between 1996 and the year of the interview. We used a standardized protocol to create an EHR narrative, a free-text summary of the EHR data. We used NVivo to identify themes in the interviews and the EHR narratives. RESULTS To date, we have interviewed 88 women, including 51 White women, 19 Black women, 14 Latina women, 2 mixed Black and Latina women, and 2 Asian Pacific women. We have completed the EHR narratives on 66 women. The women range in age from 18 to 90. We found corresponding EHR data on all but 4 of the interview participants. Participants had contact with a wide range of clinical departments (e.g., psychiatry, neurology, infectious disease) and received care in various clinical settings (e.g., primary care clinics, emergency departments, inpatient hospitalizations). A preliminary review of the EHR narratives revealed that the clinician notes were a source of data on a range of SDoH, but did not always reflect the social needs that participants described in the interviews. CONCLUSIONS This study will provide unique insight into the demands and consequences of integrating SDoH into clinical care. This work comes at a pivotal point in time, as health systems, payors, and policy makers accelerate attempts to deliver care within the context of social needs.

Does Journalism Still Matter? The Role of Journalistic and non-Journalistic Sources in Young Peoples’ News Related Practices

In today's hybrid media environment new content creators challenge the status of professionally produced journalism and blur the lines between professional and non-professional content. Growing up in this information landscape, younger generations have developed news-related practices and attitudes that lie in stark contrast to those of previous generations. In addition, discrepancies exist between news definitions and the use practices of young people. We conducted focus groups with German adolescents (15–17 years), young adults (18–24 years) and adults (40–53 years) in August 2020 to uncover young peoples’ orientation toward news and journalism. Our study indicates that the boundaries of what journalism is and what it is not are becoming increasingly indistinct. However, distinctions do emerge between the journalistic and non-journalistic sources that adolescents and young adults use and the functions they associate with them according to their information needs. Differences between the age groups become apparent in their motivations to stay informed which highlights the important role non-journalistic sources play in information behaviour and opinion formation. For teenage participants especially, Social Media Influencers (SMIs) are relevant within these processes, which are linked to a perceived social duty-to-keep-informed. Moreover, findings from the focus groups highlight cohort-specific differences regarding the understanding of journalism and, consequently, differences in the assessment of trust and reliability as well as the verification strategies that are applied. In sum, for young participants journalism is a reliable source of information, especially in the case of current events and for crosschecking online information, while non-journalistic sources fulfil social needs.