Abstract: Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.
Abstract: During COVID-19, the depression rate has increased dramatically. Young adults are most vulnerable to the mental health effects of the pandemic. Lower-income families have a higher ratio to be diagnosed with depression than the general population, but less access to clinics. This research aims to achieve early depression detection at low cost, large scale, and high accuracy with an interdisciplinary approach by incorporating clinical practices defined by American Psychiatric Association (APA) as well as multimodal AI framework. The proposed approach detected the nine depression symptoms with Natural Language Processing sentiment analysis and a symptom-based Lexicon uniquely designed for young adults. The experiments were conducted on the multimedia survey results from adolescents and young adults and unbiased Twitter communications. The result was further aggregated with the facial emotional cues analyzed by the Convolutional Neural Network on the multimedia survey videos. Five experiments each conducted on 10k data entries reached consistent results with an average accuracy of 88.31%, higher than the existing natural language analysis models. This approach can reach 300+ million daily active Twitter users and is highly accessible by low-income populations to promote early depression detection to raise awareness in adolescents and young adults and reveal complementary cues to assist clinical depression diagnosis.
Abstract: Aims: We aimed to assess the efficiency of ‘Attend Anywhere’ orthodontic clinics within a district general hospital during COVID- 19. Our secondary aim was to pilot a questionnaire to assess patient satisfaction with virtual orthodontic appointments. Design: The study design is a service evaluation including pilot questionnaire. Methods: The average number of patients seen per virtual clinic and the number of patients failing to attend was compared to face-to-face clinics. The capability of virtual appointments to be successful in preventing the need for a face-to-face appointment was assessed. Patients were invited to complete a telephone pilot questionnaire focusing on patient satisfaction and accessibility. Results: There was a small increase in the number of patients failing to attend virtual appointments, with a third of the patients who did not attend failing to receive the appointment link. 81.9% of virtual clinic appointments were successful and prevented the need for a face-to-face appointment. Overall patients were very satisfied with their virtual orthodontic appointment and the majority required no assistance to access the service. Conclusions: The use of ‘Attend Anywhere’ clinics in orthodontics offers patients and clinicians an effective and efficient alternative to face-to-face appointments that patients on average find easy to use and completely satisfactory.
Abstract: Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.
Abstract: As far as is known, general nursing care practices do not include specific evidence-based practices related to oral care in children. This study aimed to evaluate the evidence based nursing practice for oral care in children. This article is planned as a review article by searching the literature in this field. According to all age groups and the oral care in various specific situations located evidence in the literature were examined. It has been determined that the methods and frequency used in oral care practices performed by nurses in clinics differ from one hospital to another. In addition, it is seen that different solutions are used in basic oral care, oral care practices to prevent ventilator-associated pneumonia and evidence-based practice in mucositis management in children. As a result, a standard should be established in oral care practices for children and education for children is recommended.
Abstract: Obesity is known to be associated with many clinically important diseases including metabolic syndrome (MetS). Vitamin B12 plays essential roles in fat and protein metabolisms and its cooperation with vitamin B9 is well-known. The aim of this study is to investigate the possible contributions as well as associations of these micronutrients upon obesity and MetS during childhood. A total of 128 children admitted to Namik Kemal University, Medical Faculty, Department of Pediatrics Outpatient Clinics were included into the scope of this study. The mean age±SEM of 92 morbid obese (MO) children and 36 with MetS were 118.3±3.8 months and 129.5±6.4 months, respectively (p > 0.05). The study was approved by Namık Kemal University, Medical Faculty Ethics Committee. Written informed consent forms were obtained from the parents. Demographic features and anthropometric measurements were recorded. WHO BMI-for age percentiles were used. The values above 99 percentile were defined as MO. Components of MetS [waist circumference (WC), fasting blood glucose (FBG), triacylglycerol (TRG), high density lipoprotein cholesterol (HDL-Chol), systolic pressure (SP), diastolic pressure (DP)] were determined. Routine laboratory tests were performed. Serum vitamin B12 concentrations were measured using electrochemiluminescence immunoassay. Vitamin B9 was analyzed by an immunoassay analyzer. Values for vitamin B12 < 148 pmol/L, 148-221 pmol/L, > 221 pmol/L were accepted as low, borderline and normal, respectively. Vitamin B9 levels ≤ 4 mcg/L defined deficiency state. Statistical evaluations were performed by SPSSx Version 16.0. p≤0.05 was accepted as statistical significance level. Statistically higher body mass index (BMI), WC, hip circumference (C) and neck C were calculated in MetS group compared to children with MO. No difference was noted for head C. All MetS components differed between the groups (SP, DP p < 0.001; WC, FBG, TRG p < 0.01; HDL-Chol p < 0.05). Significantly decreased vitamin B9 and vitamin B12 levels were detected (p < 0.05) in children with MetS. In both groups percentage of folate deficiency was 5.5%. No cases were below < 148 pmol/L. However, in MO group 14.3% and in MetS group 22.2% of the cases were of borderline status. In MO group B12 levels were negatively correlated with BMI, WC, hip C and head C, but not with neck C. WC, hip C, head C and neck C were all negatively correlated with HDL-Chol. None of these correlations were observed in the group of children with MetS. Strong positive correlation between FBG and insulin as well as strong negative correlation between TRG and HDL-Chol detected in MO children were lost in MetS group. Deficiency state end-products of both B9 and B12 may interfere with the expected profiles of MetS components. In this study, the alterations in MetS components affected vitamin B12 metabolism and also its associations with anthropometric body measurements. Further increases in vitamin B12 and vitamin B9 deficiency in MetS associated with the increased vitamin B12 as well as vitamin B9 deficiency metabolites may add to MetS parameters.
Abstract: This paper presents the impact of persuasive communication implemented by fertility clinics websites, and how this information influences women at their decision-making for undertaking this procedure. The influential factors for women decisions to do social egg freezing (SEF) are analyzed from a framing theory perspective, with a specific focus on the impact of persuasive information on women’s decision making. This study follows a quantitative approach. A two-phase survey has been conducted to examine the interest rate to undertake SEF. In the first phase, a questionnaire was available during a month (May 2015) to women to answer whether or not they knew enough information of this process, with a total of 230 answers. The second phase took place in the two last weeks of July 2015. All the respondents were invited to a seminars called ‘All about egg freezing’ and afretwards they were requested to answer the second questionnaire. After the seminar, in which they were given an extensive amount of information about egg freezing, a total of 115 women replied the questionnaire. The collected data during this process were analyzed using descriptive statistics. Most of the respondents changed their opinion in the second questionaire which was after receiving information. Although in the first questionnaire their self-evaluation of having knowledge about this process and the implemented technologies was very high, they realized that they still need to access more information from different sources in order to be able to make a decision. The study reached the conclusion that persuasive and framed information by clinics would affect the decisions of these women. Despite the reasons women have to do egg freezing and their motivations behind it, providing people necessary information and unprejudiced data about this process (such as its positive and negative aspects, requirements, suppositions, possibilities and consequences) would help them to make a more precise and reasonable decision about what they are buying.
Abstract: Due to the acquisition of huge amounts of brain tumor magnetic resonance images (MRI) in clinics, it is very difficult for radiologists to manually interpret and segment these images within a reasonable span of time. Computer-aided diagnosis (CAD) systems can enhance the diagnostic capabilities of radiologists and reduce the time required for accurate diagnosis. An intelligent computer-aided technique for automatic detection of a brain tumor through MRI is presented in this paper. The technique uses the following computational methods; the Level Set for segmentation of a brain tumor from other brain parts, extraction of features from this segmented tumor portion using gray level co-occurrence Matrix (GLCM), and the Artificial Neural Network (ANN) to classify brain tumor images according to their respective types. The entire work is carried out on 50 images having five types of brain tumor. The overall classification accuracy using this method is found to be 98% which is significantly good.
Abstract: The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20th week of pregnancy up to 12th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12th and 24th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.
Abstract: This paper is concerned with the ways in which
Assisted Reproductive Technologies (ARTs) affect women’s lives
and perceptions regarding their infertility, contraception and
reproductive health. The paper is based on a qualitative feminist
survey study to explore and analyze issues arising from the use of
ARTs by women in New Delhi, the capital of India. A rapid growth in
the number of fertility clinics has been noticed recently. A critical
analysis of interviews revealed that these technologies are used and
developed for making profits at the cost of women’s lives. In this
way, these technologies are influencing and changing the traditional
patterns of motherhood requiring a rethinking about new ways of
reproduction introduced through the use of ARTs.
Abstract: Hemoglobin (HB) indicates anemia level and by
extension may reflect the nutritional level and perhaps the immunity
of an individual. Some antiretroviral drugs like Zidovudine are
known to cause anemia in people living with HIV/AIDS (PLWHA).
A cross sectional study using demographic data and blood specimen
from 218 female commercial sex workers attending antiretroviral
therapy (ART) clinics was conducted between December, 2009 and
July, 2011 to assess the effect of zidovudine on hematologic, and
RNA viral load of female sex workers receiving antiretroviral
treatment in north western Nigeria. Anemia is a common and serious
complication of both HIV infection and its treatment. In the setting of
HIV infection, anemia has been associated with decreased quality of
life, functional status, and survival. Antiretroviral therapy,
particularly the highly active antiretroviral therapy (HAART), has
been associated with a decrease in the incidence and severity of
anemia in HIV-infected patients who have received a HAART
regimen for at least 1 year. In this study, result has shown that of the
218 patients, 26 with hemoglobin count between 5.1 – 10g/dl were
observed to have the highest viral load count of 300,000 –
350,000copies/ml. It was also observed that most patients (190) with
HB of 10.1 – 15.0g/dl had viral load count of 200,000 – 250,000
copies /ml. An inverse relationship therefore exists i.e. the lower the
hemoglobin level, the higher the viral load count even though the test
statistics did not show any significance between the two (P = 0.206).
This shows that multivariate logistic regression analysis
demonstrated that anemia was associated with a CD4 + cell count
below 50/μL, female sex workers with a viral load above 100,000
copies/mL, who use zidovudine.
Severe anemia was less prevalent in this study population than in
historical comparators; however, mild to moderate anemia rates
remain high. The study therefore recommends that hematological and
virologic parameters be monitored closely in patients receiving first
line ART regimen.
Abstract: This study mainly aims at assessing the level of
microbial pollution of the water used in the chair system in dental
clinics. For this purpose 36 samples have been randomly collected
from a number of dental surgeries in the city of Tripoli in Libya.
However, 32 of the samples have tested positive to microbial
pollution including 13 of the samples, which have tested positives to
Pseudomonas aeruginosa. Based on the results of the test a further
investigation of the biofilms incorporated within the dental chair
system has been conducted. The laboratory tests of biofilms with
similar design to those found in dental chairs have proved that
bacterial pollution takes place through saliva of the patients who use
the chairs, and that this saliva is rich with nutrients which provides a
suitable breeding ground for all types of bacteria.
Abstract: The aim of this research is to propose a Measurement
Scale for Patient Satisfaction (MSPS) in the context of Tunisian
private clinics. This scale is developed using value management
methods and is validated by statistic tools with SPSS.
Abstract: Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement.
Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three
methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.
Abstract: In recent years, rapid advances in software and hardware in the field of information technology along with a digital imaging revolution in the medical domain facilitate the generation and storage of large collections of images by hospitals and clinics. To search these large image collections effectively and efficiently poses significant technical challenges, and it raises the necessity of constructing intelligent retrieval systems. Content-based Image Retrieval (CBIR) consists of retrieving the most visually similar images to a given query image from a database of images[5]. Medical CBIR (content-based image retrieval) applications pose unique challenges but at the same time offer many new opportunities. On one hand, while one can easily understand news or sports videos, a medical image is often completely incomprehensible to untrained eyes.
Abstract: A cross sectional survey design was used to collect
data from 370 diabetic patients. Two instruments were used in
obtaining data; in-depth interview guide and researchers- developed
questionnaire. Fisher's exact test was used to investigate association
between the identified factors and nonadherence. Factors identified
were: socio-demographic factors such as: gender, age, marital status,
educational level and occupation; psychosocial obstacles such as:
non-affordability of prescribed diet, frustration due to the restriction,
limited spousal support, feelings of deprivation, feeling that
temptation is inevitable, difficulty in adhering in social gatherings
and difficulty in revealing to host that one is diabetic; health care
providers obstacles were: poor attitude of health workers, irregular
diabetes education in clinics , limited number of nutrition education
sessions/ inability of the patients to estimate the desired quantity of
food, no reminder post cards or phone calls about upcoming patient
appointments and delayed start of appointment / time wasting in
clinics.
Abstract: Researchers of drug-drug interaction alert systems
have often suggested that there were high overridden rate for alerts and
also too false alerts. However, research about decreasing false alerts is
scant. Therefore, the aim of this article attempts to proactive
identification of false alert for drug-drug interaction and provide
solution to decrease false alerts. This research involved retrospective
analysis prescribing database and calculated false alert rate by using
MYSQL and JAVA. Results of this study showed 17% of false alerts
and the false alert rate in the hospitals (37%) was more than in the
clinics. To conclude, this study described the importance that
drug-drug interaction alert system should not only detect drug name
but also detect frequency or route, as well as in providing solution to
decrease false alerts.