Prenatal PFAS exposures and cardiometabolic health in middle childhood in the MIREC cohort.

Studies on prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and cardiometabolic health in childhood have produced inconsistent results. In this study, we evaluated associations between prenatal PFAS exposures, individually and as a mixture, and cardiometabolic outcomes including insulin resistance, beta cell function, blood lipids, blood pressure and central adiposity during middle childhood (7-9 years of age) in a Canadian maternal-child cohort (n = 281). We also explored effect measure modification based on child sex and physical activity.

Different types of greenspace within urban parks and depressive symptoms among older U.S. adults living in urban areas.

Access to greenspace in the form of urban parks is frequently used to study the mental health benefits of nature and may alleviate depression. However, there is a lack of research that considers the different types of vegetated and non-vegetated spaces that parks can provide. Our aim was to investigate whether different types of accessible park area, grassy; tree covered; and non-vegetated, were associated with depressive symptoms among older (≥50 years) urban US adults.

A randomized controlled trial of a housing intervention to reduce endocrine disrupting chemical exposures in children.

Few studies have considered household interventions for reducing endocrine disrupting chemical (EDC) exposures. We conducted a secondary analysis of a randomized controlled trial, originally designed to reduce lead exposure, to evaluate if the intervention lowered EDC exposures in young children. Study participants were children from the Cincinnati, Ohio area (n = 250, HOME Study).

Firearm-Related Lead Exposure and Child Lead Levels in the United States, 2012-2018.

Objective: To determine if firearm ownership is positively related to elevated child lead levels at a state-level, even when accounting for other sources of lead.

Study Design: For this cross-sectional ecological study, we investigated whether household firearm ownership rates (a proxy for firearm-related lead exposure) was associated with the prevalence of elevated child blood lead levels in 44 US States between 2012 and 2018. To account for potential confounding, we adjusted for other known lead exposures, poverty rate, population density, race, and calendar year.

Residential greenspace and major depression among older adults living in urban and suburban areas with different climates across the United States.

Background And Aim: Residential greenspace could alleviate depression - a leading cause of disability. Fewer studies of depression and greenspace have considered major depression, and, to our knowledge, none have considered how climate, which determines vegetation abundance and type, may change the impacts of greenspace. Our aim was to investigate whether residential greenspace is associated with major depression among older adults and explore effect modification by climate.

Analysis of patient preferences on patient-provider interactions through the OpenNotes online portal in dermatology.

Many medical centers are beginning to use OpenNotes (ON) to empower patients. However, there is a lack of literature reviewing the ON system in dermatology and any differences in attitudes between men and women. If so, it is uncertain what concerns are more important to female patients.

Care partners reading patients' visit notes via patient portals: Characteristics and perceptions.

Background: Care partners are key members of patients' health care teams, yet little is known about their experiences accessing patient information via electronic portals.

Objective: To better understand the characteristics and perceptions of care partners who read patients' electronic visit notes.

Patient Involvement: Focus groups with diverse patients from a community health center provided input into survey development.

Words Matter: What Do Patients Find Judgmental or Offensive in Outpatient Notes?

Background: Sharing outpatient notes with patients may bring clinically important benefits, but notes may sometimes cause patients to feel judged or offended, and thereby reduce trust.

Objective: As part of a larger survey examining the effects of open notes, we sought to understand how many patients feel judged or offended due to something they read in outpatient notes, and why.

Design: We analyzed responses from a large Internet survey of adult patients who used secure patient portals and had at least 1 visit note available in a 12-month period at 2 large academic medical systems in Boston and Seattle, and in a rural integrated health system in Pennsylvania.

Validation of a brief scale to assess ambulatory patients' perceptions of reading visit notes: a scale development study.

Objectives: To develop and evaluate the validity of a scale to assess patients' perceived benefits and risks of reading ambulatory visit notes online (open notes).

Design: Four studies were used to evaluate the construct validity of a benefits and risks scale. Study 1 refined the items; study 2 evaluated underlying factor structure and identified the items; study 3 evaluated study 2 results in a separate sample; and study 4 examined factorial invariance of the developed scale across educational subsamples.

Frequency and Types of Patient-Reported Errors in Electronic Health Record Ambulatory Care Notes.

Importance: As health information transparency increases, patients more often seek their health data. More than 44 million patients in the US can now readily access their ambulatory visit notes online, and the practice is increasing abroad. Few studies have assessed documentation errors that patients identify in their notes and how these may inform patient engagement and safety strategies.

Correction: OpenNotes After 7 Years: Patient Experiences With Ongoing Access to Their Clinicians' Outpatient Visit Notes.

[This corrects the article DOI: 10.2196/13876.].

Later emergency provider shift hour is associated with increased risk of admission: a retrospective cohort study.

Background: Understanding factors that drive admissions is critical to containing cost and optimising hospital operations. We hypothesised that, due to multiple factors, emergency physicians would be more likely to admit a patient seen later in their shift.

Methods: Retrospective study examining all patient visits at a large academic hospital from July 2010 to July 2016.

A patient and family reporting system for perceived ambulatory note mistakes: experience at 3 U.S. healthcare centers.

Objective: The study sought to test a patient and family online reporting system for perceived ambulatory visit note inaccuracies.

Materials And Methods: We implemented a patient and family electronic reporting system at 3 U.S.

An Opportunity to Engage Obstetrics and Gynecology Patients Through Shared Visit Notes.

Objective: To assess obstetrics and gynecology patients' interest in reading their ambulatory visit notes, identification of documentation errors, and perceptions of sensitive language through a quality improvement (QI) initiative.

Methods: Beginning April 2016, as part of a QI project all obstetrics and gynecology patients (except family planning) were invited to read their ambulatory visit notes and provide feedback using a patient reporting tool codeveloped with patients. Two physicians with safety expertise reviewed all patient-reported errors over the first 16 months.

OpenNotes After 7 Years: Patient Experiences With Ongoing Access to Their Clinicians' Outpatient Visit Notes.

Background: Following a 2010-2011 pilot intervention in which a limited sample of primary care doctors offered their patients secure Web-based portal access to their office visit notes, the participating sites expanded OpenNotes to nearly all clinicians in primary care, medical, and surgical specialty practices.

Objective: The aim of this study was to examine the ongoing experiences and perceptions of patients who read ambulatory visit notes written by a broad range of doctors, nurses, and other clinicians.

Methods: A total of 3 large US health systems in Boston, Seattle, and rural Pennsylvania conducted a Web-based survey of adult patients who used portal accounts and had at least 1 visit note available in a recent 12-month period.

Ambient Pollutants and Spontaneous Intracerebral Hemorrhage in Greater Boston.

Background and Purpose- Associations between exposures to ambient air pollution and spontaneous intracerebral hemorrhage (ICH) have been inconsistent, and data on stroke subtypes are currently limited. Methods- We obtained information on all cases of deep or lobar hematomas from ICH patients who were admitted to the Massachusetts General Hospital in Boston, MA, between 2006 and 2011. We linked the date of admission with 1- to 7-day moving averages of fine particulate matter (PM), black carbon, nitrogen dioxide, and ozone from area monitors.

Housing Quality and Mental Health: the Association between Pest Infestation and Depressive Symptoms among Public Housing Residents.

Housing quality, which includes structural and environmental risks, has been associated with multiple physical health outcomes including injury and asthma. Cockroach and mouse infestations can be prime manifestations of diminished housing quality. While the respiratory health effects of pest infestation are well documented, little is known about the association between infestation and mental health outcomes.

OpenNotes and shared decision making: a growing practice in clinical transparency and how it can support patient-centered care.

Objective: Prior studies suggest inviting patients to read their visit notes (OpenNotes) has important benefits for patient engagement. We utilized survey data to investigate our hypothesis that patients who read more notes would report greater shared decision making (SDM).

Materials And Methods: Our survey focused on the safety and quality implications of OpenNotes.

Open Notes in Teaching Clinics: A Multisite Survey of Residents to Identify Anticipated Attitudes and Guidance for Programs.

Background: Clinicians are increasingly sharing outpatient visit notes with patients through electronic portals. These open notes may bring about new educational opportunities as well as concerns to physicians-in-training and residency programs.

Objective: We assessed anticipatory attitudes about open notes and explored factors influencing residents' propensity toward note transparency.

The Importance of Visit Notes on Patient Portals for Engaging Less Educated or Nonwhite Patients: Survey Study.

Background: OpenNotes, a national initiative to share clinicians' visit notes with patients, can improve patient engagement, but effects on vulnerable populations are not known very well.

Objective: Our aim is to examine the importance of visit notes to nonwhite and less educated patients.

Methods: Patients at an urban academic medical center with an active patient portal account and ≥1 available ambulatory visit note over the prior year were surveyed during June 2016 until September 2016.

Tackling Ambulatory Safety Risks Through Patient Engagement: What 10,000 Patients and Families Say About Safety-Related Knowledge, Behaviors, and Attitudes After Reading Visit Notes.

Background: Ambulatory safety risks including delayed diagnoses or missed abnormal test results are difficult for clinicians to see, because they often occur in the space between visits. Experts advocate greater patient engagement to improve safety, but strategies are limited. Patient access to clinical notes ("OpenNotes") may help close the safety gap between visits.

Empowering Informal Caregivers with Health Information: OpenNotes as a Safety Strategy.

Background: Enabling family/friend caregivers with access to visit notes may help avoid errors, delayed diagnoses, or other ambulatory safety risks. Patient, parent, and caregiver perceptions of how shared notes affect safety behaviors and attitudes were studied in an exploratory study.

Methods: To assess the impact of OpenNotes on safety, 24,722 patients with active portal accounts and ≥ 1 available visit notes during the prior year at an urban hospital were surveyed between June and September 2016.

What Patients Value About Reading Visit Notes: A Qualitative Inquiry of Patient Experiences With Their Health Information.

Background: Patients are increasingly asking for their health data. Yet, little is known about what motivates patients to engage with the electronic health record (EHR). Furthermore, quality-focused mechanisms for patients to comment about their records are lacking.

A patient feedback reporting tool for OpenNotes: implications for patient-clinician safety and quality partnerships.

Background: OpenNotes, a national movement inviting patients to read their clinicians' notes online, may enhance safety through patient-reported documentation errors.

Objective: To test an OpenNotes patient reporting tool focused on safety concerns.

Methods: We invited 6225 patients through a patient portal to provide note feedback in a quality improvement pilot between August 2014 and 2015.