Average Visit Duration Research Articles

69 Connecting with the next generation of shepherds – an online sheep-based webpage serves as an additional tool in Extension education

Abstract Cooperative Extension education continues to maintain a strong foothold in educating people in the agricultural industry. To connect with the next generation of agriculturalists, Extension needs to investigate alternative methods to disseminate educational material. Developing and maintaining a webpage that provides relevant and scientific based sheep production information is critical as interest in the small ruminant industry continues to rise. The Ohio State University Extension Sheep Team webpage provides shepherds across the nation with the latest information regarding sheep production from daily management to industry outreach. In addition, a unique highlight of the webpage includes research summaries of sheep research conducted at Ohio State that are simplified to illustrate real-world application to improve on-farm production efficiencies. Over the past year alone, the OSU Extension Sheep Team webpage has recorded over 90,000 page views with an average visit duration time of approximately two minutes. Of these page views, approximately 9,000 originate from locations beyond the United States including Canada, United Kingdom, Australia, and New Zealand. According to the web servers’ descriptive statistic analysis, the top referral search engine is Google, representing 58% of all page visits. Interestingly, due the OSU Extension Sheep Team’s presence on social media, Facebook accounts for approximately 18% of all page visits whereas direct subscription of the weekly newsletter only accounts for 15% of all page visits. Furthermore, top article topics include those that relate to basic sheep management practices, health and disease, parasite control methods, and common poisonous plants. Due to the unusual weather patterns of 2019, an article related to poisonous plants accounted for 16% of the webpage’s total visits, which surpassed the number of homepage visits. In order to continue providing relevant Extension information, universities should consider utilizing web-based articles to efficiently reach a larger audience and provide timely articles based upon viewer interest.

Case Study on Recording Pigs’ Daily Activity Patterns with a UHF-RFID System

The main objective of this paper is the monitoring of daily activity patterns of fattening pigs at different locations in the housing environment using UHF-RFID. Four hundred fattening pigs were equipped with UHF-RFID ear tags and monitored during the fattening period for about four months. The RFID antennas were installed at the feeding troughs, playing devices and drinkers. A validation phase for each of these locations was carried out prior to the first data collection. The sensitivity (true positive rate) of the UHF-RFID system was about 80% at the feeding trough and the playing device and about 60% at the drinkers. The mean of the daily visiting time of all pigs at the trough was about 55 min. The mean visiting duration at the playing device was about 38 min and at the drinkers about 9 min. The visiting times of the pigs showed a high intra- and inter-variability. It was observed that the average visit duration at the feeding trough decreases over the course of a fattening period but increases at the playing device. A documentation of visiting times of animals is possible utilizing RFID systems, allowing a higher data density than video or direct observations.

Evaluating the Telehealth Experience of Patients With COVID-19 Symptoms: Recommendations on Best Practices.

Positive patient experiences are associated with illness recovery and adherence to medication. To evaluate the virtual care experience for patients with COVID-19 symptoms as their chief complaints. We conducted a cross-sectional study of the first cohort of patients with COVID-19 symptoms in a virtual clinic. The main end points of this study were visit volume, wait times, visit duration, patient diagnosis, prescriptions received, and satisfaction. Of the 1139 total virtual visits, 212 (24.6%) patients had COVID-19 symptoms. The average wait time (SD) for all visits was 75.5 (121.6) minutes. The average visit duration for visits was 10.5 (4.9) minutes. The highest volume of virtual visits was on Saturdays (39), and the lowest volume was on Friday (19). Patients experienced shorter wait times (SD) on the weekdays 67.1 (106.8) minutes compared to 90.3 (142.6) minutes on the weekends. The most common diagnoses for patients with COVID-19 symptoms were upper respiratory infection. Patient wait times for a telehealth visit varied depending on the time and day of appointment. Long wait times were a major drawback in the patient experience. Based on patient-reported experience, we proposed a list of general, provider, and patient telehealth best practices.

Facilitating hikers’ mobility in protected areas through smartphone app: a case of the Hoge Kempen National Park, Belgium

Visitor mobility in protected areas is often a challenge as manual map reading and finding a route consume the time. This paper presents a digital tool that provides valuable information for both the visitors and the managers of protected areas. The app provides assistance to users to generate, access, and record hiking routes within the protected area. A route planner was created to generate user-specific alternative routes taking into account the user’s preferences in terms of distance, preferred landscape, level of accessibility, etc. The app also provides the users with basic information on the park, including captivating points, typical flora, and fauna. Moreover, visitors and park management can communicate with each other through exchanging messages and suggestions. The pilot validation test performed with 20 participants and real-time test from 68 park visitors revealed that all the functionality of the app is in order and the app enhances the mobility experience of the user within Hoge Kempen National Park. Furthermore, regular use of the app from users will generate rich data that is valuable for visitor management purposes, for example, the number of trips per day, the average duration of visits and popular segments.

Effect of Medical Scribes on Outpatient Oncology Visits at a Multidisciplinary Cancer Center.

The use of medical scribes has emerged as a strategy to increase clinic workflow efficiency and reduce physician burnout. While oncology clinics may be ideally suited to scribe integration because of the high burden of documentation, oncology-specific scribe research has been limited. The objective of this study was to determine the effect of scribe integration on clinic workflow efficiency and physician satisfaction and quality of life in outpatient oncology clinics. We conducted a retrospective, concurrent qualitative and quantitative analysis of patient visit durations and survey data for 129 attending physicians affiliated with an academic hospital's cancer center between January 2017 and January 2019. Thirty-three physicians were paired with scribes in each physician's individual clinic or clinics. In terms of clinic efficiency, physicians with scribes had a 12.1% decrease in their overall average patient visit duration compared with their own time before receiving a scribe (P < .0001) and spent significantly less time completing charts at the end of the day (P = .04). Compared with their peers, oncologists with scribes showed a 10%-20% decrease in the duration of all patient visits. Scribes also contributed to patient care, as shown by 90% of physicians surveyed who strongly agreed that they spent less time at the computer and more time with patients; 100% of physicians surveyed strongly agreed that scribes improved their quality of life. The integration of medical scribes into oncology clinics across several oncologic disciplines has the potential to reduce burnout through increasing physician satisfaction and quality of life, improving patient care, and streamlining clinic workflow.

The home visit communication skills inventory: Piloting a tool to measure community health worker fidelity to training in rural South Africa.

Community-based home visiting programs using community health workers (CHWs) have become popular modes of delivering health care services, especially in settings where health workers are overburdened and resources are limited. Yet, little is known about the processes that shape effective implementation in low-resource settings, and whether these processes adhere to home visitors' training. This study used the newly-developed Home Visit Communication Skills Inventory (HCSI) to explore the delivery of a CHW program in rural South Africa. Routine home visits from CHWs to their maternal care clients were audio-recorded with consent, and later transcribed and translated into English. The HCSI, devised and piloted using existing frameworks and program-specific training components, consisted of 21 items covering domains related to active listening, active delivery, and active connecting, and was used to score English transcripts of the home visits. The HCSI was used to generate general frequencies and aggregate scores for each CHW. Eighty-four home visits by 14 CHWs showed a diverse application of communication skills. Active listening and active delivery were common, with fewer instances of active connecting observed. Practices disaggregated by CHW showcased varying strengths by an individual. In reviewing visit characteristics, longer average visit duration was significantly correlated with the presence of multiple types of active connecting skills. While technical skills were widely observed, fewer CHWs engaged in more complex "connecting" skills. The HCSI is a feasible, low-cost, and practical way to describe home visit fidelity among CHWs. Audio-based checklists can be used to describe fidelity to a model in the absence of additional supervisory resources.

PCV16 MANAGEMENT OF GASTROINTESTINAL AND UROGENITAL BLEEDING EVENTS IN PATIENTS WITH NON VALVULAR ATRIAL FIBRILLATION TREATED WITH DABIGATRAN ETEXILATE EARLY AFTER APPROVAL

In the RE-LY trial, dabigatran showed a favourable safety and efficacy profile compared to vitamin K antagonists (VKA). This study described under real-world practice the management of patients with non-valvular atrial fibrillation (NVAF) treated with dabigatran presenting to the emergency department/room (ED) with GIB and urogenital bleeding (UGB) prior to the availability of idarucizumab. Observational chart abstraction study collecting data from 44 sites in the United States (US) and Canada, enrolling NVAF patients presenting to the ED between October 28, 2010 and August 1, 2013 with acute GIB or UGB and evidence of dabigatran use within 5 days before the bleeding event. Patients were followed until discharge. The study included 220 patients (66%, n=145, from the US). Mean age was 76.1 years (standard deviation: 10.3), 108 (49%) were female and 84 (38%) were taking concomitant medications known to increase the risk of bleeding. GIB was observed in 161 (73%) and UGB in 63 (29%, 4 with concomitant GIB). At least one intervention was recorded for 170 patients (77%), discontinuation of dabigatran being the most common (n=157, 71%), followed by transfusion/infusion (n=81, 36.8%). The majority received packed red blood cell transfusions (60/81, 74.1%). Average duration of ED visit was 7.6 ± 8.5 hours and 148 (67%) patients were admitted to the hospital. At discharge, 169 (77%) patients had their bleeding event resolved, 42 (19%) still had some symptoms and 9 (4%, n=8 GIB, 1 UGB) had died. Bleeding incidence is low for patients treated with dabigatran, limiting the number of patients that can be assessed. Real world outcomes of GIB and UGB were favorable in this time period early after approval of dabigatran, with mortality rates similar to those previously reported. Availability of idarucizumab adds to the available bleeding management options for patients taking dabigatran.

Real Time Visualization of DSpace Usage: An Integrated Framework for Libraries

Web analytics is also known as cloud analytics which helps to display the information regarding site metrics from massive data. This can be achieved in two ways via the user’s web browser such as statistical and visualization of a particular digital web based interface. This paper explores high level digital archiving software by integration of DSpace with web analytics popular tool Piwik. The paper discusses to create a single window web analytic interface to represent the user log and present the DSpace Usage. For this the researchers select DSpace, an open source software as it is free and popular. They integrate DSpace software with Piwik web analytic tool. Piwik, a web analytic interface tool has been chosen due to its successful integration with DSpace and it is also a free web analytics tool. The whole integration is being performed in Ubuntu operating system due to its reliability and good rate of performance. After successful integration of DSpace with Piwik in Ubuntu Operating System, researchers found that there are multiple colourful link icons showing the different community, sub-community, collection and metadata. It will also display statistical visual graph showing unique visitors, average visit duration, page views, downloads, average generation time page views, unique page views total searches on your website, unique keywords downloads, etc. Through this web analytic interface, DSpace usage may be measured easily and the users’ trend at present will be displayed to rectify any demerits behind this.

Eating behavior, milk production, rumination, and digestibility characteristics of high- and low-efficiency lactating cows fed a low-roughage diet

This study aimed to identify individual characteristics differing among high-efficiency (HEf; upper 20%, n = 31), low-efficiency (LEf; lower 20%, n = 31), and mid-efficiency (MEf, 60% n = 93) lactating cows. Primiparous (37) and multiparous (118) high-producing milking cows at 30 to 180 d in milk were fed individually a low-roughage diet [31.6% of dry matter (DM)] for 4 wk. Daily average DM intake, rate of eating, visit duration, meal size, and daily rumination time were higher in LEf compared with HEf cows. On the other hand, HEf cows exhibited higher digestibility of DM, crude protein, and neutral detergent fiber than the LEf cows. Daily eating time was similar in the HEf and LEf groups and higher than that of the MEf cows. Visit and meal frequency, average visit and meal duration, daily lying time, and pedometer activity were similar in the HEf, LEf, and MEf groups. The HEf cows produced 1.75% more milk, but similar energy-corrected milk compared with the LEf cows. Milk fat and protein content were lower by 1.8 and 3.8%, respectively, in the HEf cows than in the LEf group. Body weight (BW) and BW gain were similar in the 3 efficiency groups. Diurnal distribution of DM intake showed 6 distinct major meals, each composed of 1.1 to 1.6 visits. Higher intake peaks (greater meal size) were found in the LEf cows compared with the HEf group. Daily DM intake was highly correlated (affected) with energy-corrected milk production (r = 0.61), BW (r = 0.4), eating rate (r = 0.57), and visit size (r = 0.54). Energy balance showed that the lower efficiency of the LEf cows was attributed to their excess heat production and energy loss.

Visual attention on a respiratory function monitor during simulated neonatal resuscitation: an eye-tracking study

ObjectiveA respiratory function monitor (RFM) may improve positive pressure ventilation (PPV) technique, but many providers do not use RFM data appropriately during delivery room resuscitation. We sought to use eye-tracking...

Park use and physical activity among adolescent girls at two time points

ABSTRACTThis longitudinal study described park usage and assessed the contribution of parks to moderate to vigorous physical activity (MVPA) among adolescent girls. High school girls from California (n = 131) and Minnesota (n = 134) wore a global positioning system (GPS) monitor and accelerometer for 6 consecutive days at two time points, one year apart. Park visits were classified by linking the GPS, accelerometer, and park and built environment data around home and school locations into a geographic information system. At baseline, 20% of girls visited a park at least once (mean 0.1 times/day), which was similar one year later (19%, mean 0.1 times/day). Girls lived a mean Euclidean distance of 0.2 miles to the nearest park at both times. Among all park visits, the mean Euclidean distance of the park visited was 4.1 (baseline) and 3.9 miles (follow-up). The average duration of park visits was higher at baseline (63.9 minutes) compared to follow-up (38.4 minutes). On days when a park was visited, MVPA was higher than on days when a park was not visited. On average, 1.9% (baseline) and 2.8% (follow-up) of MVPA occurred in parks. In this study, parks were an under-used resource for adolescent girls, particularly for MVPA.

Doctor-couple communication during assisted reproductive technology visits.

What are the characteristics of doctor-couple communication content during actual ART visits? Physicians were mainly focused on providing biomedical information, while communication content from couples had a 2-fold focus on providing biomedical information and on positive talk. Communication aspects in ART seem crucial for clinical decision-making, retention in care and critical conversations with couples due to low treatment success rates. However, no studies have been carried out on the actual interaction between the doctor and the couple in this context. This observational study involved 28 clinicians and 160 patients referred to eight Italian ART clinics during a one-year recruitment period. ART visits at eight Italian clinics were videotaped. The visits were coded using the Roter Interaction Analysis System (RIAS), particularly focusing on RIAS composite categories, verbal dominance and patient-centeredness score. A total of 85 visits were eligible for analysis (62% acceptance rate), involving 28 clinicians and 160 patients (including 75 couples). The average visit duration was 37 ± 17.7 min. The mean verbal dominance was 1.9 ± 0.86 (range: 0.72-5.74). Physicians mainly focused on providing biomedical information. Communication content from couples had a 2-fold focus on providing biomedical information and on positive talk. The mean of patient centeredness index (PCI) was 0.51 (SD = 0.28; range 0.08-1.77); visits in which the doctor was a woman or the treatment indication was for heterologous fertilization showed higher PCI scores. Overall, females accounted for 67% of all patient talk. Taking this imbalance into account as expected frequencies for each composite category, males reported significantly more utterances in almost all of the socioemotional categories. These results are preliminary and observational and only regard Italy. Communication during visits may have been biased since the professionals who agreed to participate showed an interest in communication issues. Another limitation is a possible Hawthorne effect due to the fact that participants were aware of being videotaped. Our study showed that ART physicians mainly adopted an informative model of communication and a more disease-oriented approach. Findings revealed the complexity of communication content during ART consultations, given its triadic characteristic in which the third party is also a patient; clinicians should be aware of this complex aspect and of the specific male and female perspectives to be taken into account. The results could be useful for training ART professionals. This study was possible thanks to an unconditional grant from Ferring Spa to the Department of Health Sciences, University of Milan. There are no competing interests to declare. N/A.

Transport properties and size exclusion effects in wide-pore superficially porous particles

The effects of hydrodynamic radius on the transport of solute molecules in packed beds of wide-pore superficially porous particles (SPP) are studied using pore-scale simulation. The free molecular diffusion rate varies with radius through the Stokes-Einstein relation. Lattice Boltzmann and Langevin methods are used to model fluid motion and the transport of an ensemble of solute molecules in the fluid, providing statistics on solute concentration, flux, molecule age and residence time, as a function of depth in the SPP. Intraparticle effective diffusion and bed dispersion coefficients are calculated and correlated with the hydrodynamic radius and accessible porosity.The relative importance of convection and diffusion are found to depend on the molecule (tracer) size through the diffusion rate, and convection effects are more significant for larger, slower-diffusing molecules. When larger molecules are utilized, the intraparticle concentration is reduced in proportion to the local particle porosity, leading to a natural definition of the accessible porosity used in size exclusion chromatography (SEC). Although the pore shape is complex, the SEC constant K can be calculated directly from simulation. Simulation demonstrates that the effective diffusion coefficient is elevated near the particle hull, which is largely open to interstitial flow, and decreases with depth into the particle. All molecules studied here have transport access to the entire particle depth, although the accessible volume at a given depth depends on their size. The first passage time into the particle is well predicted by the diffusion rate, but residence time is influenced by convection, shortening the average visit duration. These results are of interest in “perfusion” chromatography where convection is thought to increase separation efficiency for large biomolecules.

3:00 PM Abstract No. 71 Large medical center experience with moving outpatient paracentesis from hospital-based interventional radiology suite to outpatient clinic

Ultrasound (US)-guided paracentesis uses sophisticated IR procedure rooms for long periods of time. We moved outpatients to a separate outpatient (OP) clinic and quantified our experience performing clinic-based US-guided large volume paracentesis. A retrospective chart review of US-guided paracentesis procedures per month was conducted from May 2014 to August 2017. Data was analyzed using t-test. Institutional hourly IR suite rate was previously found to be $539/hr. July 2017 was chosen as a representative sample for the calculation of volume drained and time in the clinic. A total of 50 patients were scheduled for appointments in July 2017, 25 female and 25 male. Four patients were excluded, three with lack of fluid, and one no-show. Procedural technique was constant in both settings. Albumin was administered based on volume drained. A total of 723 paracentesis procedures (60.25/month) were performed last year in the OP clinic, Sept 2016-Aug 2017. The average fluid obtained from paracentesis in July was 4660 cc, and average duration of clinic visit was 104 minutes. Since opening, 1184 paracentesis procedures have been performed in the OP clinic. A significant increase was found in the total number of paracentesis procedures performed in the ten months prior to clinic opening (May 2014-Feb 2015) as compared to the current state (Nov 2016-Aug 2017). The average number of paracentesis procedures per month increased from 72.1 to 92.5, p = 0.0023. Moving procedures to the OP clinic decreased IR suite usage by 372 patients thereby decreasing IR suite time by 644 hours and shifting $349,184 of cost to the OP setting with potential savings. During the course of the study period, two of the 1184 patients in OP clinic required hospitalization, one for hypovolemia and one for syncope prior to the procedure. By moving OP large-volume paracentesis patients from a hospital based IR suite to an OP clinic setting, we increased the total number of paracentesis procedures that we were able to perform while potentially decreasing cost.

Telemedicine pharmacy services implementation in organ transplantation at a metropolitan academic medical center.

Transplant patients represent a complex patient population for which telemedicine may allow enhanced access to the healthcare team and promote active engagement in health improvement. This retrospective study summarizes a multi-pronged approach that was instituted to implement a pharmacy telemedicine practice at our institution. Telemedicine visits included the provision of six key elements for our patients: (1) medication reconciliation, (2) vaccination history, (3) medication teaching, (4) pharmacotherapy review, (5) medication adherence, and (6) triage to other providers. From January through June 2017, 46 patients were registered for a visit (recipients n = 32 and living donors n = 14). Three-fourths of the patients who completed a visit connected using a mobile device. Time from discharge to the visit was 5.4 days. The average visit duration was 11.6 ± 8 minutes. Medication reconciliation was performed for 24 patients where 6 (25%) required medication list adjustments. An average of 1.2 ± 0.4 medication changes were updated in the medical record. During visits, patients were asked questions to assess adherence to their regimen, all patients responded favorably indicating that they were following instructions provided by the healthcare team. Telemedicine has the potential to improve the healthcare delivery model by providing increased patient-to-healthcare team interactions and access, which optimize engagement and outcomes.

Caracterização dos usuários e do padrão de uso das academias ao ar livre

Objective: To verify the characteristics of the users and the usage pattern of outdoor fitness equipment (OFE). Methods: Descriptive, exploratory and quantitative research, conducted in 2015, with 308 users of 22 OFE of Teresina, Piaui. Data collection was carried out by filling out a form which contained questions related to sociodemographic, behavioral and health aspects, nutritional profile, equipment and space usage, distance from the residence, and company for practices. Each site was visited four times, with an average visit duration of one hour. The variables were analyzed with use of measures of central tendency and dispersion. Results: The findings show an average period of OFE use of 22.2 + 17.7 months, users’ mean age of 53.8 + 12.4 years, prevalence of women (78.2%, n=241), complete secondary education (42.2%, n=130), brown race/color (55.5%, n=171), and mean BMI of 25.85 + 3.981 kg/m². It was found that 63% (n=194) of the users take up to 10 minutes to reach the outdoor gym, 87% (n=268) attend it from three to five times a week, 54.2% (n=167) remain there for 20 to 40 minutes, and 49.4% (n=152) of the subjects do not use at least one piece of equipment because of some pain (39.2%, n=60). Despite the availability of a physical education professional in a majority (70.8%, n=218) of OFE, having a follow-up conducted by this professional was considered the most urgent need (36.7%; n=113). Conclusion: In the investigated outdoor gyms there was the prevalence of brown female users, with a complete secondary education, who live near the gym and make use of it three to five times a week, remaining in the location for 20 to 40 minutes.

Economic Evaluation of A Patient Support Programme Abbvie Care 2.0 Immunology

To assess the impact on resources consumption and health outcomes of the patient support programme (PSP) Abbvie Care 2.0 Immunology in Spain. A cost-consequence analysis was designed in Excel to estimate differences following the implementation of Abbvie Care 2.0 in patients with immune-mediated chronic diseases along a 1-year time horizon. The hospital perspective was used to collect inputs related to health outcomes and resource consumption in 2 different situations: without and with PSP implementation, for each patient group; rheumatic (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis), dermatologic (psoriasis, hidradenitis suppurativa) and gastrointestinal (ulcerative colitis, Crohn’s disease) The collected resources included annual number of hospital professional visits (clinician, nurse and pharmacist) and average visit duration, annual number of emergency visits and disease-related hospital admissions. Health outcomes comprised adherence, persistence, activation (measured with PAM-10 questionnaire) and programme satisfaction for patients and professionals. An expert panel of pharmacists from 6 public hospitals validated and collected data. Unitary costs (€, 2017) for resources derived from local databases. For an hypothetical cohort of patients (41.7% rheumatic, 24.0% dermatologic and 34.4% gastrointestinal immunologic diseases), the PSP implementation was associated to reduction in routine visits to physician (-13.1%), hospital pharmacy (-33.4%) and specialized nursery (-9.4%) as well as visit duration (-5.6%, -6.4% and -10.9%, respectively) Additional incidence-related visits decreased also in annual number -5.3% (physician), -12.1% (pharmacy), -14.5% (nurse), and duration, which joined to reduction in emergency visits (-59.1%) and hospital admissions (-84.5%) were associated to average cost-savings of €3,578.25 patient/year. Abbvie Care 2.0 implementation increased drug adherence (1.6%) and 6-months persistence (10.3%) and patient activation (2.8% of PAM-10-Total score improvement). The average PSP-satisfaction reported-scores reached 9.66/10 for patients and 8/10 for professionals. Abbvie Care 2.0 contributes to reduce burden of hospital visits, being associated to cost-savings and improvement in health outcomes with high satisfaction-levels scores.

Exploiting social media information toward a context-aware recommendation system

The rise of the social networks during the last few years has provided a vast amount of knowledge in several domains. Among them, route planning and point-of-interest recommendation have significantly benefited. Seen from the side of a tourist, they consist two challenging and time-consuming tasks since they may rely on many parameters and are limited by several constraints, such as time and budget available, user preferences, etc. In this paper we present Xenia, a context-aware system that works toward solving the aforementioned problems. More specifically, it aims to automatically construct travel routes, i.e., ordered visits to various places-of-interest. The user (tourist) indicates an initial and an ending point and her/his available time budget and the system proposes travel routes that maximize her/his travel experience, while adhering to the aforementioned limitations. This particular route planning problem is widely known as the “Tourist Trip Design Problem,” having several variations. In this work we solve this problem by modeling it through the “Orienteering Problem.” We harvest geo-tagged photos from the well-known social network Flickr and using the user-generated textual metadata that accompany them we extract areas-of-interest within a given city along with their underlying semantics. Moreover, by utilizing both the timestamps and the geo-tags of the photos we are able to identify the trajectory patterns of tourists, to detect popular places-of-interest and finally to estimate the average visit duration. Using this historical data we propose travel routes for four of the most popular Greek cities. The effectiveness of our approach is validated upon a twofold validation consisting by (a) a comparison versus the most typical baselines that have adopted by state-of-the-art works and (b) an empirical evaluation by real-life users.

A new marker of primary care utilization - annual accumulated duration of time of visits

BackgroundMost of the research on primary care workload has focused on the number of visits or the average duration of visits to a primary care physician (PCP) and their effect on the quality of medical care. However, the accumulated annual visit duration has yet to be examined. This measure could also have implications for the allocation of resources among health plans and across regions. In this study we aimed to define and characterize the concept of "Accumulated Annual Duration of Time" (AADT) spent with a PCP. MethodA cross-sectional study based on a national random sample of 77,247 adults aged 20 and over. The study’s variables included annual number of visits and AADT with a PCP, demographic characteristics and chronic diseases. The time period was the entire year of 2012.ResultsFor patients older than 20 years, the average annual number of visits to a PCP was 8.8 ± 9.1, and the median 6 ± 10 IQR (Interquartile Range). The mean AADT was 65.8 ± 75.7 min, and the median AADT was 43 ± 75 IQR minutes. The main characteristics of patients with a higher annual number of visits and a higher AADT with a PCP were: female, older in age, a higher Charlson index and a low socio-economic status. Chronic diseases were also found to increase the number of annual visits to a PCP as well as the AADT, patients with chronic heart failure had highest AADT in comparison to others (23.1 ± 15.5 vs. 8.6 ± 8.9 visits; and 165.3 ± 128.8 vs. 64.5 ± 74 min). It was also found that the relationship between AADT and age was very similar to the relationship between visits and age.ConclusionWhile facing the ongoing increase in a PCP’s work load and shortening of visit length, the concept of AADT provides a new measure to compare between different healthcare systems that allocate different time frames for a single primary care visit. For Israel, the analysis of the AADT data provides support for continued use of the number of visits in the capitation formula, as a reliable and readily-accessible indicator of primary care usage.

Abstracts from The 34(th) Annual National Neurotrauma Symposium June 26-29, 2016 Lexington, Kentucky.

Abstracts from The 34(th) Annual National Neurotrauma Symposium June 26-29, 2016 Lexington, Kentucky.