ABSTRACT
Background: Despite the incentives and provisions created for hospitals by the US Affordable Care Act related to value-based payment and community health needs assessments, concerns remain regarding the adequacy and distribution of hospital efforts to address SDOH. This scoping review of the peer-reviewed literature identifies the key characteristics of hospital/health system initiatives to address SDOH in the US, to gain insight into the progress and gaps. Methods: PRISMA-ScR criteria were used to inform a scoping review of the literature. The article search was guided by an integrated framework of Healthy People SDOH domains and industry recommended SDOH types for hospitals. Three academic databases were searched for eligible articles from 1 January 2018 to 30 June 2023. Database searches yielded 3,027 articles, of which 70 peer-reviewed articles met the eligibility criteria for the review. Results: Most articles (73%) were published during or after 2020 and 37% were based in Northeast US. More initiatives were undertaken by academic health centers (34%) compared to safety-net facilities (16%). Most (79%) were research initiatives, including clinical trials (40%). Only 34% of all initiatives used the EHR to collect SDOH data. Most initiatives (73%) addressed two or more types of SDOH, e.g., food and housing. A majority (74%) were downstream initiatives to address individual health-related social needs (HRSNs). Only 9% were upstream efforts to address community-level structural SDOH, e.g., housing investments. Most initiatives (74%) involved hot spotting to target HRSNs of high-risk patients, while 26% relied on screening and referral. Most initiatives (60%) relied on internal capacity vs. community partnerships (4%). Health disparities received limited attention (11%). Challenges included implementation issues and limited evidence on the systemic impact and cost savings from interventions. Conclusion: Hospital/health system initiatives have predominantly taken the form of downstream initiatives to address HRSNs through hot-spotting or screening-and-referral. The emphasis on clinical trials coupled with lower use of EHR to collect SDOH data, limits transferability to safety-net facilities. Policymakers must create incentives for hospitals to invest in integrating SDOH data into EHR systems and harnessing community partnerships to address SDOH. Future research is needed on the systemic impact of hospital initiatives to address SDOH.
Subject(s)
Social Determinants of Health , Humans , United States , Hospitals/statistics & numerical data , Patient Protection and Affordable Care Act , Delivery of Health CareABSTRACT
Three new species of Laccaria infundibuliformis, L. pallidus, and L. darjeelingensis, collected from Darjeeling, India, are described based on morphological and molecular evidence. Laccaria infundibuliformis is characterized by its small infundibuliform basidiocarps, and echinulate basidiospores with spines up to 1.36 µm long. Laccaria pallidus is characterized by medium-sized greyish-red basidiocarps, and echinulate basidiospores with spines up to 1.9 µm long. Laccaria darjeelingensis is characterized by dull red basidiocarps, and echinulate basidiospores with spines up to 1.27 µm long. Altogether, the study shows that these three Laccaria species are previously unknown to science.
Subject(s)
Agaricales , Basidiomycota , Laccaria , Fruiting Bodies, Fungal , Spores, Fungal , IndiaABSTRACT
INTRODUCTION: Childhood obesity, caused due to excessive fat accumulation, is one of the leading causes of preventable deaths associated with several non-communicable diseases. In Nepal, there is limited data available on the status of overweight and obesity among school children. The objective of this study was to find out the prevalence of childhood overnutrition among school going children in a municipality. METHODS: A descriptive cross-sectional study was conducted from June 2019 to July 2019, in four schools of a municipality selected by simple random sampling. Ethical approval was obtained from Nepal Health Research Council (Registration number 380/2019). Data was collected using census sampling from children aged 5-18 years through self-administered questionnaires to the children's parents. The data was entered into the Statistical Package for Social Sciences for analysis. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 379 school children, the prevalence of overnutrition was found to be 38 (10.03%) (95% Confidence Interval= 7.01-13.05). Prevalence of overnutrition was highest in children of age group 10-13 years 23 (60.5%), in females 27 (71.1%), those consuming junk food 4-6 times weekly 14 (36.8%) and those performing daily physical activity less than 60 minutes 24 (63.2%). CONCLUSIONS: The prevalence of childhood overnutrition is similar in comparison to other studies done in similar settings.
Subject(s)
Pediatric Obesity , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Overweight/epidemiology , Pediatric Obesity/epidemiology , Prevalence , SchoolsABSTRACT
INTRODUCTION: Body image is the person's perceptions, thoughts and feelings about his/her body which is a multi-dimensional concept. Body Image Dissatisfaction can be measured using a Body Shape Questionnaire. The main aim of this study was to find out the prevalence of body image dissatisfaction among adolescent girls of a municipality in Kathmandu. METHODS: A cross-sectional survey was done from July 2019 to December 2019 among the female students from grade eight to twelve of the selected private schools of Budhanilkantha municipality. Stratified random sampling was done. Body Shape Questionnaire short version was used to measure the prevalence of body dissatisfaction. Data were analyzed using Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was done, frequency and percentage were calculated. RESULTS: One hundred ninety seven (75.2%) at 95% Confidence Interval (69.97-80.43) students were found to have body image dissatisfaction, among which Positive Body Image Dissatisfaction was found to be in 85 (42%) respondents which indicates that 112 (58%) respondents with healthy Body Mass Index were dissatisfied with their body shape. CONCLUSIONS: Prevalence of body image dissatisfaction was found to be high in adolescent girls though most of the girls had normal body weight and a healthy Body Mass Index.