Search results for: preventive healthcare

Authors: Naman Jain, Shaun Fernandes

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With the increasing prevalence of online healthcare services, selecting the most suitable doctor has become a complex task, requiring careful consideration of both public sentiment and personal preferences. This paper proposes a sentiment analysis-driven method that integrates public reviews with user-specific criteria and correlated attributes to recommend online doctors. By leveraging Natural Language Processing (NLP) techniques, public sentiment is extracted from online reviews, which is then combined with user-defined preferences such as specialty, years of experience, location, and consultation fees. Additionally, correlated attributes like education and certifications are incorporated to enhance the recommendation accuracy. Experimental results demonstrate that the proposed system significantly improves user satisfaction by providing personalized doctor recommendations that align with both public opinion and individual needs.

Keywords: sentiment analysis, online doctors, personal preferences, correlated attributes, recommendation system, healthcare, natural language processing

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Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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This paper proposes a method to optimize the layout of an emergency department (ED) based on real executions of care processes by considering several planning objectives simultaneously. Recently, demand for healthcare services has been dramatically increased. As the demand for healthcare services increases, so do the need for new healthcare buildings as well as the need for redesign and renovating existing ones. The importance of implementation of a standard set of engineering facilities planning and design techniques has been already proved in both manufacturing and service industry with many significant functional efficiencies. However, high complexity of care processes remains a major challenge to apply these methods in healthcare environments. Process mining techniques applied in this study to tackle the problem of complexity and to enhance care process analysis. Process related information such as clinical pathways extracted from the information system of an ED. A 0-1 goal programming approach is then proposed to find a single layout that simultaneously satisfies several goals. The proposed model solved by optimization software CPLEX 12. The solution reached using the proposed method has 42.2% improvement in terms of walking distance of normal patients and 47.6% improvement in walking distance of critical patients at minimum cost of relocation. It has been observed that lots of patients must unnecessarily walk long distances during their visit to the emergency department because of an inefficient design. A carefully designed layout can significantly decrease patient walking distance and related complications.

Keywords: healthcare operation management, goal programming, facility layout problem, process mining, clinical processes

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Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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Authors: Arash Sepehri bonab

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One of the regions of critical development in medical devices has been the part of the software - as an indispensable component of a therapeutic device, as a standalone device, and more as of late, as applications on portable gadgets. The chance related to a breakdown of the standalone computer program utilized inside healthcare is in itself not a model for its capability or not as a medical device. It is, subsequently, fundamental to clarify a few criteria for the capability of a stand-alone computer program as a medical device. The number of computer program items and therapeutic apps is persistently expanding and so as well is used in wellbeing education (e. g., in clinics and doctors' surgeries) for determination and treatment. Within the last decade, the use of information innovation in healthcare has taken a developing part. In reality, the appropriation of an expanding number of computer devices has driven several benefits related to the method of quiet care and permitted simpler get to social and health care assets. At the same time, this drift gave rise to modern challenges related to the usage of these modern innovations. The program utilized in healthcare can be classified as therapeutic gadgets depending on the way they are utilized and on their useful characteristics. In the event that they are classified as therapeutic gadgets, they must fulfill particular directions. The point of this work is to show a computer program improvement system that can permit the generation of secure and tall, quality restorative gadget computer programs and to highlight the correspondence between each program advancement stage and the fitting standard and/or regulation.

Keywords: medical devices, regulation, software, development, healthcare

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Authors: Eliana Bergamin

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This philosophical inquiry, influenced by the seminal works of Annemarie Mol and Jeannette Pols, critically examines the transformative impact of artificial intelligence (AI) on emotional caregiving practices within virtual healthcare. Rooted in the traditions of philosophy of care, philosophy of emotions, and applied philosophy, this study seeks to unravel nuanced shifts in the moral and emotional fabric of healthcare mediated by AI-powered technologies. Departing from traditional empirical studies, the approach embraces the foundational principles of care ethics and phenomenology, offering a focused exploration of the ethical and existential dimensions of AI-mediated emotional caregiving. At its core, this research addresses the introduction of AI-powered technologies mediating emotional and care practices in the healthcare sector. By drawing on Mol and Pols' insights, the study offers a focused exploration of the ethical and existential dimensions of AI-mediated emotional caregiving. Anchored in ethnographic research within a pioneering private healthcare company in the Netherlands, this critical philosophical inquiry provides a unique lens into the dynamics of AI-mediated emotional practices. The study employs in-depth, semi-structured interviews with virtual caregivers and care receivers alongside ongoing ethnographic observations spanning approximately two and a half months. Delving into the lived experiences of those at the forefront of this technological evolution, the research aims to unravel subtle shifts in the emotional and moral landscape of healthcare, critically examining the implications of AI in reshaping the philosophy of care and human connection in virtual healthcare. Inspired by Mol and Pols' relational approach, the study prioritizes the lived experiences of individuals within the virtual healthcare landscape, offering a deeper understanding of the intertwining of technology, emotions, and the philosophy of care. In the realm of philosophy of care, the research elucidates how virtual tools, particularly those driven by AI, mediate emotions such as empathy, sympathy, and compassion—the bedrock of caregiving. Focusing on emotional nuances, the study contributes to the broader discourse on the ethics of care in the context of technological mediation. In the philosophy of emotions, the investigation examines how the introduction of AI alters the phenomenology of emotional experiences in caregiving. Exploring the interplay between human emotions and machine-mediated interactions, the nuanced analysis discerns implications for both caregivers and caretakers, contributing to the evolving understanding of emotional practices in a technologically mediated healthcare environment. Within applied philosophy, the study transcends empirical observations, positioning itself as a reflective exploration of the moral implications of AI in healthcare. The findings are intended to inform ethical considerations and policy formulations, bridging the gap between technological advancements and the enduring values of caregiving. In conclusion, this focused philosophical inquiry aims to provide a foundational understanding of the evolving landscape of virtual healthcare, drawing on the works of Mol and Pols to illuminate the essence of human connection, care, and empathy amid technological advancements.

Keywords: applied philosophy, artificial intelligence, healthcare, philosophy of care, philosophy of emotions

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Authors: Vandita Mishra

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From the management of patients, reception, record, and assistants in a clinical practice; to the management of ongoing research, clinical cases and department profile in an academic setup, the healthcare provider has to deal with all of it. The victory lies in smooth running of the show in both the above situations with an apt solution of problems encountered and smooth management of crisis faced. Thus this paper amalgamates dental science with health administration by means of introduction of a concept for practice management and problem-solving called 'Quality Circles'. This concept uses various tools for problem solving given by experts from different fields. QC tools can be applied in both clinical and academic settings in dentistry for better productivity and for scientifically approaching the process of continuous improvement in both the categories. When approached through QC, our organization showed better patient outcomes and more patient satisfaction. Introduced in 1962 by Kaoru Ishikawa, this tool has been extensively applied in certain fields outside dentistry and healthcare. By exemplification of some clinical cases and virtual scenarios, the tools of Quality circles will be elaborated and discussed upon.

Keywords: academics, dentistry, healthcare, quality

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Authors: Ananya Gangavarapu

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Convolutional Neural Networks (CNN) based models are providing diagnostic capabilities on par with the medical specialists in many specialty areas. However, collecting the medical data for training purposes is very challenging because of the increased regulations around data collections and privacy concerns around personal health data. The gathering of the data becomes even more difficult if the capture devices are edge-based mobile devices (like smartphones) with feeble wireless connectivity in rural/remote areas. In this paper, I would like to highlight Federated Learning approach to mitigate data privacy and security issues.

Keywords: deep learning in healthcare, data privacy, federated learning, training in distributed environment

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Authors: Seyedeh Zeinab Peighambarzadeh, Mehdi Tavana

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Cataract is the most common cause of blindness worldwide and its incidence will increase as the World’s population ages. Even in modern ophthalmology, there is no effective medical treatment for cataract except surgery. Development of a drug which could prevent or delay the onset of cataract will lessen this burden and reduce the number of blind patients waiting for cataract surgery. This study was undertaken to evaluate the protective effect of vitamin E on Selenite-induced Cataract in Sprague-dawely rats. Cataracts were induced in rats by administration of sodium selenite. On postpartum day ten, in group I, saline was injected subcutaneously. Group II rat pups received subcutaneous injection of vitamin E (60mg/kg B.W.) at day 8 postpartum and every other day thereafter. Group III and IV rat pups received a subcutaneous injection of sodium selenite (13mg/kg B.W.) at day 10 postpartum. Group IV also received subcutaneous injection of vitamin E (60mg/kg B.W.) at day 8 postpartum and every other day thereafter. The development of cataract in rats was assessed clinically by slit-lamp biomicroscope from day 14 up to postpartum day 28. After sacrifice, extricated pup lenses were analyzed for total and soluble protein concentrations and eletrophoretic pattern (SDS-PAGE). There was no opacification of lens in Group I and II. There was mature cataract in 95% of Group III. In group IV, 55% of rats developed sub capsular or cortical cataract. Cataractous and biochemical changes of the crystalline lens proteins due to selenite can be retard or prevented by vitamin E.

Keywords: preventive effect, selenite-induced cataract, vitamin E, rat

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Authors: Rachel M. Lørum, Henrik Eriksson, Frida Smith

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Purpose: In recent years, the use of benchmarks for the improvement of healthcare has become increasingly common. There has been an increasing interest in why improvement initiatives so often fail to eliminate the problems they aspire to solve. Benchmarking comes with its fair share of challenges and problems, such as capturing the dynamics and complexities of the care environments, among others. In this study, we demonstrate how learning-oriented, voluntary benchmarks in the complex environment of public healthcare could be designed. Findings: Our four most important findings were the following: first, important organizational learning (OL) regarding the complexity of the service and implications on how to design a benchmark for learning and improvement occurred during the process. Second, participation by a wide range of professionals and stakeholders was crucial for capturing the complexity of people and organizations and increasing the quality of the template. Third, the continuous dialogue between all organizations involved was an important tool for ongoing organizational learning throughout the process. The last important finding was the impact of the facilitator’s role through supporting progress, coordination, and dialogue. Design: We chose participatory design as the research design. Data were derived from written materials such as e-mails, protocols, observational notes, and reflection notes collected during a period of 1.5 years. Originality: Our main contributions are the identification of important strategies, initiatives, and actors to involve when designing voluntary benchmarks for learning and improvement.

Keywords: organizational learning, quality improvement, learning-oriented benchmark, healthcare, patient safety

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Authors: Petronella Lunda, Catharina Susanna Minnie, Welma Lubbe

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Background This review aimed to provide healthcare professionals with a scientific summary of the best available research evidence on factors influencing respectful perinatal care. The review question was ‘What were the perceptions of midwives and doctors on factors that influence respectful perinatal care?’ Methods A detailed search was done on electronic databases: EBSCOhost: Medline, OAlster, Scopus, SciELO, Science Direct, PubMed, Psych INFO, and SocINDEX. The databases were searched for available literature using a predetermined search strategy. Reference lists of included studies were analysed to identify studies missing from databases. The phenomenon of interest was factors influencing maternity care practices according to midwives and doctors. Pre-determined inclusion and exclusion criteria were used during the selection of potential studies. In total, 13 studies were included in the data analysis and synthesis. Three themes were identified and a total of nine sub-themes. Results Studies conducted in various settings were included in the study. Multiple factors influencing respectful perinatal care were identified. During data synthesis, three themes emerged: healthcare institution, healthcare professionals, and women-related factors. Alongside the themes were sub-themes human resources, medical supplies, norms and practices, physical infrastructure, healthcare professional competencies and attributes, women’s knowledge, and preferences. The three factors influence the provision of respectful perinatal care; addressing them might improve the provision of the care. Conclusion Addressing factors that influence respectful perinatal care is vital towards the prevention of compromised patient care during the perinatal period as these factors have the potential to accelerate or hinder provision of respectful care.

Keywords: doctors, maternity care, midwives, obstetrician, perceptions, perinatal care, respectful care

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma

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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.

Keywords: health information, ICTs, medical professionals, qualitative

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Authors: Grace Iember Anweh, Er Shipp

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Child Sexual Abuse (CSA) has been a contending issue across the globe. The menace of child sexual violence cuts across all continents. From 0 - 13 years, children have been sexually abused – some to the extent that their reproductive organs have been permanently damaged. The research in view is timely, as it will contribute data on CSA and media role to the communication parlance. This study believes that the adverse effects of this menace can hinder children who are potential leaders of tomorrow from harnessing their potentials to contribute to the growth and development of societies due to the psychological, health, and social effects of sex abuse. Where government policies, the law, cultural beliefs, and bottle necks surrounding processes of fighting child sexual abuse have failed, this study assumes that adequate coverage by the mass media, especially the newspapers known for their in-depth coverage and reporting, can help to eradicate or reduce to its barest minimum, the menace of CSA. Therefore, this study aims at assessing the coverage of newspapers – their policies and content towards preventive strategies, and how the public access and receive the messages to the extent they take action to forestall the persistence of sexual violation of children in Nigeria. Methodologically, the study has adopted qualitative and quantitative methods to answer the problem. The study used in-depth interview method to find out from journalists and editors of newspapers the policies that define the production of news content on sexual gender-based violence. In addition, selected National Daily newspapers are content - analysed to determine the focus of media coverage and whether the contents are preventive-based or case-based. In addition, caregivers of the reproductive ages from 16 years and above, ranging from parents, guardians, and school management, will form the study population through a survey using the questionnaire. The aim is to determine their views regarding mass media coverage of sexual violence against children and the effectiveness of the content, to the extent of prompting them to keep the child safe from sexual molesters. Findings from the content analysis so far show that newspapers in Nigeria are not engaged in preventive content of CSA. Their contents are rather case-based.

Keywords: newspaper, coverage, prevention, child, sexual abuse

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Authors: Shaik Asha Begum, S. Joshna Rani, Shaik Abdul Rahaman

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INTRODUCTION: Breast cancer is a disease that creates in breast cells. "KAP" study estimates the Knowledge, Attitude, and Practices of a local area. More than 1.5 million ladies (25% of all ladies with malignancy) are determined to have bosom disease consistently all through the world. Understanding the degrees of Knowledge, Attitude and Practice will empower a more effective cycle of mindfulness creation as it will permit the program to be custom-made all the more properly to the necessities of the local area. OBJECTIVES: The objective of this study is to assess the knowledge on signs and symptoms, risk factors, provide awareness on the practicing of the early detection techniques of breast cancer and provide knowledge on the overall breast cancer including preventive techniques. METHODOLOGY: This is an expressive cross-sectional investigation. This investigation of KAP was done in the Nirmala Educational Institutions from January to April 2021. A total of 300 participants are included from women students in pharmacy graduates & lecturers, and also from graduates other than the pharmacy. The examiners are taken from the BCAM (Breast Cancer Awareness Measure), tool compartment (Version 2). RESULT: According to the findings of the study, the majority of the participants were not well informed about breast cancer. A lump in the breast was the most commonly mentioned sign of breast cancer, followed by pain in the breast or nipple. The percentage of knowledge related to the breast cancer risk factors was also very less. The correct answers for breast cancer risk factors were radiation exposure (58.20 percent), a positive family history (47.6 percent), obesity (46.9 percent), a lack of physical activity (43.6 percent), and smoking (43.2 percent). Breast cancer screening, on the other hand, was uncommon (only 30 and 11.3 percent practiced clinical breast examination and mammography respectively). CONCLUSION: In this study, the knowledge on the signs and symptoms, risk factors of breast cancer - pharmacy graduates have more knowledge than the non-pharmacy graduates but in the preventive techniques and early detective tools of breast cancer -had poor knowledge in the pharmacy and non-pharmacy graduate. After the awareness program, pharmacy and non-pharmacy graduates got supportive knowledge on the preventive techniques and also practiced the early detective techniques of breast cancer.

Keywords: breast cancer, mammography, KAP study, early detection

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Authors: Maximilian Winkens, Matthias Goerke

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The state-oriented maintenance enables the preventive intervention before the failure of a component and guarantees avoidance of expensive breakdowns. Because the timing of the maintenance is defined by the component’s state, the remaining service life can be exhausted to the limit. The basic requirement for the state-oriented maintenance is the ability to define the component’s state. New potential for this is offered by gentelligent components. They are developed at the Corporative Research Centre 653 of the German Research Foundation (DFG). Because of their sensory ability they enable the registration of stresses during the component’s use. The data is gathered and evaluated. The methodology developed determines the current state of the gentelligent component based on the gathered data. This article presents this methodology as well as current research. The main focus of the current scientific work is to improve the quality of the state determination based on the life-cycle data analysis. The methodology developed until now evaluates the data of the usage phase and based on it predicts the timing of the gentelligent component’s failure. The real failure timing though, deviate from the predicted one because the effects from the production phase aren’t considered. The goal of the current research is to develop a methodology for state determination which considers both production and usage data.

Keywords: state-oriented maintenance, life-cycle data, gentelligent component, preventive intervention

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Authors: Sreejith Gopinath, Aspen Olmsted

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This paper is based on our previous work that proposed a risk-transference-based architecture for healthcare systems to store sensitive data outside the system boundary, rendering the system unattractive to would-be bad actors. This architecture also allows a compromised system to be abandoned and a new system instance spun up in place to ensure business continuity without paying a ransom or engaging with a bad actor. This paper delves into the details of various attacks we simulated against the prototype system. In the paper, we discuss at length the time and computational costs associated with storing and retrieving data in the prototype system, abandoning a compromised system, and setting up a new instance with existing data. Lastly, we simulate some analytical workloads over the data stored in our specialized data storage system and discuss the time and computational costs associated with running analytics over data in a specialized storage system outside the system boundary. In summary, this paper discusses the total costs of data storage, access, and analytics incurred with the proposed architecture.

Keywords: cybersecurity, healthcare, ransomware, resilience, risk transference

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Authors: Omid Kalatpour, Mohammadreza Ajdari

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This article studied the possible causes of human error-induced incidents in the petrochemical industry maintenance activities by using Human Factors Analysis and Classification System (HFACS). The purpose of the study was anticipating and identifying these causes and proposing corrective and preventive actions. Maintenance department in a petrochemical company was selected for research. A checklist of human error-induced incidents was developed based on four HFACS main levels and nineteen sub-groups. Hierarchical task analysis (HTA) technique was used to identify maintenance activities and tasks. The main causes of possible incidents were identified by checklist and recorded. Corrective and preventive actions were defined depending on priority. Analyzing the worksheets of 444 activities in four levels of HFACS showed 37.6% of the causes were at the level of unsafe actions, 27.5% at the level of unsafe supervision, 20.9% at the level of preconditions for unsafe acts and 14% of the causes were at the level of organizational effects. The HFACS sub-groups showed errors (24.36%) inadequate supervision (14.89%) and violations (13.26%) with the most frequency. According to findings of this study, increasing the training effectiveness of operators and supervision improvement respectively are the most important measures in decreasing the human error-induced incidents in petrochemical industry maintenance.

Keywords: human error, petrochemical industry, maintenance, HFACS

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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Authors: Sisira Edirippulige

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Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: John Pomerat, Aviv Segev

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Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

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Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Khaled. M.Benelhaj, Moada Elbadary

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The present investigation is carried out to evaluate the effect of aqueous extract of Arbutus Pavarii (Shemari) Libyan medical plant on ethylene glycol(EG) induce lithiasis in adult male albino rats. The lithiasis was induced to rats by oral administration of EG (0.75 w/v%) for 21 days(group 1). Aqueous extract of Shemari (200 mg/kg) was given orally from 1st day for preventive regimen (group 2) and from day 21st up to 42nd day for curative regimen (group 3). The results indicated that the EG elevated the urinary ionic of calcium, oxalates and inorganic phosphate. The Shemari significantly (P<0.01) reduced the levels of these ions. The histopathological findings showed that EG caused marked pathological changes in renal cortex; necrosis of glomerular tufts; mildy thickened bowman’s capsule and coagulative necrosis of large number of convoluted tubules. However, the histological changes in preventive regimen group 2 showed the same changes observed in group 1, but milder in severity and less in frequency. It conclude that Shemari do reduce the urinary ionic levels of calcium, oxalates and inorganic phosphate but failed to prevent complete deterioration effects of EG on kidney structures.

Keywords: EG, shamari, kidney stone, Libyan medical plant, glycol, oxalates

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Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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Authors: Samuel Fekadu A., Esayas Alemayehu B., Bultum Oljira D., Seid Tiku D., Dessalegn Dadi D., Bart Van Der Bruggen A.

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The peroxi-photoelectrocoagulation process was evaluated for the removal of chemical oxygen demand (COD) and color from healthcare wastewater. A 2-level full factorial design with center points was created to investigate the effect of the process parameters, i.e., initial COD, H₂O₂, pH, reaction time and current density. Furthermore, the total energy consumption and average current efficiency in the system were evaluated. Predictive models for % COD, % color removal and energy consumption were obtained. The initial COD and pH were found to be the most significant variables in the reduction of COD and color in peroxi-photoelectrocoagulation process. Hydrogen peroxide only has a significant effect on the treated wastewater when combined with other input variables in the process like pH, reaction time and current density. In the peroxi-photoelectrocoagulation process, current density appears not as a single effect but rather as an interaction effect with H₂O₂ in reducing COD and color. Lower energy expenditure was observed at higher initial COD, shorter reaction time and lower current density. The average current efficiency was found as low as 13 % and as high as 777 %. Overall, the study showed that hybrid electrochemical oxidation can be applied effectively and efficiently for the removal of pollutants from healthcare wastewater.

Keywords: electrochemical oxidation, UV, healthcare pollutants removals, factorial design

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Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

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Authors: Zeynep Sener, Mehtap Dursun

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Supplier evaluation and selection is one of the most important components of an effective supply chain management system. Due to the expanding competition in healthcare, selecting the right medical device suppliers offers great potential for increasing quality while decreasing costs. This paper proposes a fuzzy decision making approach for medical supplier selection. A real-world medical device supplier selection problem is presented to illustrate the application of the proposed decision methodology.

Keywords: fuzzy decision making, fuzzy multiple objective programming, medical supply chain, supplier selection

Procedia PDF Downloads 451