Health Care Agencies Research Articles

The effect of post-COVID-19 pandemic on the mental health of Vietnamese populations: A cross-sectional study

COVID-19 is among the tremendous negative pandemics that have been recorded in human history. The study was conducted to give a breakdown of the effect of post-COVID-19 mental health among individuals residing in a developing country. The two scales, namely DASS-21 and IES-R, were employed to collect the essential related data. The findings indicated that anxiety was a typical and common mental issue among the population, including up to 56.75% of the participants having extremely severe anxiety, 13.18% reporting severe anxiety. Notably, no one has anxiety and depression under moderate levels. Additionally, there is 51.92% depression and 43.64% stress ranging from severe to extremely severe levels. Furthermore, there were significant statistical differences among the data on stress, anxiety, and depression according to gender (males and females) and subgroups (students, the elderly, and medical healthcare workers). Besides, the prevalence of post-traumatic stress disorder in the study was relatively high, especially when compared to the figures reported by the World Health Organization. Moreover, stress, anxiety, and depression all displayed positive correlations with post-traumatic stress disorder. This is big data on the mental health of the entire population that helps the country’s government propose policy strategies to support, medical care and social security for the population.

Effect of vagus nerve stimulation (taVNS) on anxiety and sleep disturbances among elderly health care workers in the post COVID-19 pandemic.

Healthcare workers (HCWs) have been significantly impacted by the pandemic. Elderly health care workers carry out a variety of duties at work and have years of clinical expertise. Anxiety and insomnia are among the more commonly encountered problems in senior physicians and other geriatric medical professional populations. The study aims to determine the effect of vagal nerve stimulation on anxiety and sleep disturbances among geriatric medical professionals. 42 participants were enrolled in this study based on the inclusion and exclusion criteria. The participants were divided into two groups using the closed envelope approach, and they took part in therapy sessions lasting 30 minutes, three times per week for a period of four weeks. The Experimental group A received non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) and Control group A received Jacobson's progressive muscle relaxation technique. With a p value of 0.001, taVNS stimulation significantly improved sleep quality and reduced anxiety after 4 weeks. The post-intervention assessment revealed a highly significant improvement in Group A, with a T value of 251 (p < 0.001). The findings suggest that taVNS may be an effective intervention for addressing anxiety and sleep issues in geriatric medical professionals. These results contribute to the exploration of non-invasive strategies to enhance the well-being of healthcare professionals working in demanding environments.

Mobile Application for Improving the Quality of Life and Elderly Health Care

Mobile Application for Improving the Quality of Life and Elderly Health Care

A cost analysis of medications prescribed by vascular surgeons

ObjectiveVarious pharmaceutical cost options have been developed by multiple companies such as GoodRx, Amazon Pharmacy, Mark Cuban Cost Plus Drugs (CPD), Health Warehouse, and local retail pharmacies) to curb the cost of prescription medications prices that patients are having to bear. Vascular surgeons provide long-term continuity of care to patients with vascular disease who often require long-term medical management. This study sought to compare the different pharmaceutical options available for the most prescribed medications by vascular surgeons to their patients and to understand which of them are the most cost-effective. MethodsThe Medicare Part D catalog and vascular surgical literature were evaluated to identify which medications are most prescribed by vascular surgeons. The average price per tablet being paid by patients was identified using the Agency for Healthcare and Research database. The prices per tablet for each of the above pharmaceutical companies were found using online catalogs or coupons. The prices were then compared using analysis of variance and t-tests. ResultsAll four pharmaceutical cost options provide medication cost savings to patients compared with retail pharmacy costs. Analysis of variance showed that there were statistically significant differences among the different pharmaceutical cost options (F 15.44>2.36; P < .001). Mark Cuban CPD provided the most significant cost advantage over the other pharmaceutical options (P < .01). On a national scale, medications prescribed by vascular surgeons through Mark Cuban CPD could provide a 52% cost reduction to patients with vascular disease with a potential annual savings of over $3 billion dollars for the selected medications. ConclusionsCPD shows a strong potential for cost savings for patients commonly prescribed medications by vascular surgeons. As a specialty that provides long-term care and establishes long-term relationships with its patients, vascular surgeons have the unique ability to impact their overall health in a meaningful way by limiting the financial burdens associated with vascular-based medication acquisition and utilization.

Hospital-to-Home-Health Transition Quality (H3TQ) Index: Further Evidence on its Validity and Recommendations for Implementation.

We developed the Hospital-to-Home-Health Transition Quality (H3TQ) Index for skilled home healthcare (HH) agencies to identify threats to safe, high-quality care transitions in real time. Assess the validity of H3TQ in a large sample across diverse communities. A survey of recently hospitalized older adults referred for skilled HH services and their HH provider at two large HH agencies in Baltimore, MD, and New York, NY. There were five hundred eighty-seven participants (309 older adults, 141 informal caregivers, and 137 HH providers). Older adults, caregivers, and HH providers rated 747 unique transitions. Of these, 403 were rated by both the older adult/caregiver and their HH provider, whereas the remaining transitions were rated by either party. Construct, concurrent, and predictive validity were assessed via the overall H3TQ rating, correlation with the care transition measure (CTM), and the Medicare Outcome and Assessment Information Set (OASIS). Proportion of transitions with quality issues as identified by HH providers and older adults/caregivers, respectively; Baltimore 55%, 35%; NYC 43%, 32%. Older adults/caregivers across sites rated their transitions as higher quality than did providers (P<0.05). H3TQ summed scores showed construct validity with the CTM-3 and concurrent validity with OASIS measures. Summed H3TQ scores were not significantly correlated with 30-day ED visits or rehospitalization. The H3TQ identifies care transition quality issues in real-time and demonstrated construct and concurrent validity, but not predictive validity. Findings demonstrate value in collecting multiple perspectives to evaluate care transition quality. Implementing the H3TQ could help identify transition-quality intervention opportunities for HH patients.

The Impact of Value-based Purchasing on Rural and Urban Healthcare Systems in the United States

Since the 2010s, the U.S. government has adopted value-based purchasing, and many states has utilized this program to reduce hospital readmission rates and improve performance of urban hospitals. Nonetheless, the lack of participation in this program among rural hospitals has contributed to the growing urban-rural health disparities. This paper aims to identify policy solutions to improve health outcomes of vulnerable populations who reside in resource-poor at-home healthcare agencies, nursing homes, and hospitals in rural regions. This paper finds that rural health outcomes are significantly worse than urban parts. At the same time, it also shows that African Americans and Hispanics have higher mortality and morbidity rates than that of their White counterparts, demonstrating the need for policymakers to further address the unmet medical needs of vulnerable populations, such as racial minorities and those with chronic conditions. Therefore, this paper proposes that the government allocates more healthcare funding toward resource-poor urban hospitals. Moreover, insurers should not penalize rural hospitals with a higher proportion of high-risk patients for having higher-than-average hospital readmission rates.

On the pathway to health equity: Creating a harm reduction strategy for a large academic acute care hospital.

An urban centre in southwestern Ontario continues to be faced with the extensive impacts of high rates of substance use. To more effectively meet the quintuple aim, in a way that authentically considers patients who use substances, the need for a cohesive, comprehensive organizational harm reduction strategy at the large academic acute care hospital providing community and regional healthcare services was clear. Community-based harm reduction expertise was leveraged to support the development work. Information gathered through literature review and interviews with patients, internal staff and leaders, partner healthcare agencies, and Canadian hospitals leading in harm reduction work provided key insights and supported the formulation of emerging recommendations that will be used to shape the acute care hospital's formal organizational harm reduction strategy.

Enhancing Radar Image Classification with Autoencoder-CNN Hybrid System

The tracking, analysis, and classification of human movements can be crucial, particularly in areas such as elderly care, healthcare, and infant care. Typically, such tracking is done remotely with cameras. However, radar systems have emerged as significant methods and tools for these tasks due to their advantages such as privacy, wireless operation, and the ability to work through walls. By converting reflected radar signals from targets into images, human activities can be classified using powerful classification tools like deep learning. In this study, range-Doppler images of behind-the-wall human movements obtained with a radar system consisting of one transmitter and four receiver antennas were classified. Since the data collected from the four receiver antennas are in different positions, the collected reflection signals also differ. The signals collected with the range-time matrix content were divided into positive and negative parts, resulting in eight images from the four antennas. Instead of using all the data in CNN training, the images were first subjected to a reconstruction process with an autoencoder to reduce differences. As a result, it was observed that reconstructing the images with an autoencoder before classification with CNN increased the classification success. In conclusion, it was observed that the classification success of radar images can be increased by using a hybrid system with an autoencoder to reconstruct the images before classification with CNN.

New nurses’ practice environment, job stress, and patient safety attitudes: a cross-sectional study based on the job demands-resources model

BackgroundPatient safety is paramount for all healthcare agencies. Health professionals' lack of patient safety competencies threaten patients’ lives, and increase patients, families, hospitals, and social burdens. The new nurse-related patient safety issues have particularly attracted much attention. The aim of this study was to examine the impacts of practice environment and job stress on new nurses' patient safety attitudes by employing the job demands–resources model.MethodsThe study used a cross-sectional structural equation modeling (SEM). A convenience sample of 370 new nurses was recruited from seven tertiary hospitals in Anhui province, China, from April 2022 to August 2022. Data were collected using self-report questionnaires including the Chinese version of the Nurse Job Stressors Scale, the Practice Environment Scale, and the Safety Attitudes Questionnaire.ResultsNew nurses' patient safety attitudes scores were moderate (126.99 ± 14.39). Practice environment had a significant direct effect on job stress (β = -0.337, t = 6.120), patient safety attitudes (β = 0.604, t = 13.766), practice environment had an indirect effect on patient safety attitudes through job stress (β = 0.066, t = 3.690), and the indirect effect accounted for 9.9% of the total effect. This model was able to explain 48.3% of patient safety attitudes with moderate prediction accuracy.ConclusionsThis study emphasizes the importance of improving new nurses' attitudes toward patient safety. Hospital administrators should develop policies and strategies to address job characteristics, and establish a favorable work environment to reduce new nurses' job stress as well as to improve patient safety.

Exploring the care coordination experiences of professionals and caregivers of youth with acquired brain injuries in rural areas

Purpose Acquired brain injuries (ABIs) can have devastating effects on children and their families. Families living in rural communities experience unique barriers to receiving and coordinating care for complex medical needs, but little research has examined those barriers for rural youth with ABIs. Materials and Methods This qualitative study explored the experiences of rural adults caring for children with ABIs through interviews with six caregivers, three school staff members, and three medical professionals who had treated at least one child with an ABI. Results Themes in their accounts include difficulty navigating complex situations, support from small communities, isolation and loneliness, the need for more professional education about ABI, and feelings of hope. Barriers to quality care coordination include navigating complex situations, access to transportation, and a lack of communication and education from healthcare agencies. Facilitators of rural care coordination include support from small communities and interagency communication. Conclusions The results support the need for more comprehensive coordination among rural agencies involved in ABI care. Suggestions for care improvement include providing flexibility due to transportation barriers, capitalizing on the benefits of a small and caring community, and providing healthcare and education professionals with more education about ABI interventions.

Molecular sequence classification using efficient kernel based embedding

The alarming spread of diseases across the globe has become a major concern for global healthcare agencies. The research community is actively involved in inventing better and more efficient ways of detecting and treating diseases to solve this global challenge. The abundance of molecular sequence data has eased the path for researchers to develop Machine Learning (ML) based solutions. The performance of the ML models used to classify molecular sequences depends heavily on the type of embedding used to obtain an appropriate numerical representation of the molecular sequences. In recent years, many embedding approaches have been introduced for molecular sequence analysis. However, there is still a need for improvement as far as the efficiency of the methods is concerned (i.e., the ability to capture pairwise relationships and patterns effectively, which could affect the classification performance). To provide a solution to this problem, we propose an efficient kernel-based technique for embedding generation from molecular sequences, which involves computing a kernel matrix using the Sinkhorn-Knopp algorithm and the normalized pairwise distances between k-mers in a manner that satisfies the constraints of a probability distribution. Further, kernel principal component analysis (PCA) is applied to get the top PCs, which are then used as the final embedding. As a result of the experiments, we obtained an ROC-AUC score of 0.657 for our method, which is higher than the scores obtained using baselines. This clearly shows that the low-dimensional embedding obtained through the proposed approach provides an efficient and effective solution for molecular sequence analysis.

Protocol for the development of a core outcome set for clinical trials in primary sclerosing cholangitis

BackgroundPrimary sclerosing cholangitis (PSC) is a progressive immune-mediated liver disease, for which no medical therapy has been shown to slow disease progression. However, the horizon for new therapies is encouraging,...

Quaternary Ammonium Disinfectants: Current Practices and Future Perspective in Infection Control: Review Article

Hospital-acquired infections (HAIs) are one of the most tangled difficulties in advanced clinical practices. These infections lead to financial implications and have a significant impact on morbidity and mortality. It is very difficult to eradicate the HAIs however both disinfection and sterilization account for the best measure to control HAIs. Of all the disinfectants in use, one of the chemical disinfectants which seem to be user-friendly, non-corrosive, and used extensively are Quaternary ammonium compounds (QACs) based disinfectants. To improve the efficacy of these disinfectants and tackle the challenge of antimicrobial resistance (concerning QACs), from time to time newer QACs disinfectants were introduced which are termed as first, second, third, fourth, and fifth-generation QACs disinfectants. Manufacturers of these newer generations QACs disinfectants claim these compounds as high-level, broad-spectrum disinfectants while leading healthcare agencies like the Centre for Disease Control &amp; Prevention (CDC) mention QACs as mild disinfectants and not sporicidal. Sadly, the antimicrobial efficacy of QACs has been largely assessed using old methods like phenol coefficient methods &amp; suspension methods, and not using an internationally standardized method. These loopholes raise a lot of queries about the true efficacies of the QACs and thus, increase the chances of the development of resistant HAIs. Therefore, there is an urgent need for better and standardized methods to study the efficacy of different generation QACs. The present review discusses the status of currently available methods and gaps in the literature that would be useful to highlight the potential use of QACs for infection control and prevention in better ways.

HUBUNGAN KUALITAS PELAYANAN KESEHATAN TERHADAP KEPUASAN PASIEN PESERTA BPJS KESEHATAN DI WILAYAH KERJA PUSKESMAS SUNGAILIAT TAHUN 2023

Introduction: one of the way of developing the healthcare service quality is to give the satisfaction to the patient, which important to do for increasing the function of healthcare service quality to societies by measuring the service quality. Public Health Center (Puskesmas) in Sungailiat has achieving the highest amount. Most of the societies are registered as participants of Healthcare and Social Security Agency (BPJS) which indicates the intensities of visitors of Healthcare and Social Security Agency (BPJS) patients were higher. These variables are related to the service quality such as: tangibles, reliability, responsiveness, empathy, and assurance. The early-results, shows that the the relevant-variables that related to the problem in Sungailiat Public Health Center (Puskesmas) such as: comfortability, human-interaction, and punctuality. Methodology: This research is designed by applying the analytic survey methodology, cross sectional study approach, and Accidental Sampling. There are 110 of Healthcare and Social Security Agency (BPJS) patient samples who taking the treatment in Sungailiat Public Health Center (Puskesmas) area by doing the interview according to the questionnaire. Data are analyzed by using both univariate and bivariate analysis by chi square examination. Results: There were a meaningful-relationship between healthcare service quality in the dimensions of Tangibles, Reliability, Responsiveness, Empathy, and Assurance through Healthcare and Social Security Agency (BPJS) patient satisfaction. Conclusion: Sungailiat Public Health Center (Puskesmas) needs to provide the health brochures and suppliance such as drinking water, also the doctors still need to aware to their punctuality, hospitality, and not to differentiate between Healthcare and Social Security Agency (BPJS) patient and general patience.

HIV seroconversion among female sex workers: retrospective cohort study from a large-scale HIV prevention and sexual and reproductive health program in Tanzania.

In 2016, UNAIDS set ambitious targets to reduce global HIV infections by 75% by 2020 and 90% by 2030, based on the 2.1 million new infections reported in 2010. However, by 2022, new HIV infections had only decreased by 38%, from 2.1 million in 2010 to 1.3 million in 2022, raising concerns about reaching the 2030 goal. Female sex workers (FSWs) in sub-Saharan Africa face a disproportionately high risk of HIV acquisition, contributing 5%-20% of all new infections in several countries in the region. This analysis investigates HIV seroconversion and associated factors among FSWs, offering insights into critical interventions for preventing HIV transmission in this population and advancing the goal of ending the HIV pandemic by 2030. We conducted a retrospective cohort study involving 17,977 FSWs who initially tested HIV negative upon enrollment in the Sauti project between October 2016 and September 2018. HIV incidence rates were calculated by dividing the number of new HIV cases by observed person-time within the cohort. Cox regression analysis identified factors associated with seroconversion. The study revealed an HIV incidence rate of 8.6 per 100 person-years among FSWs [95% confidence interval (CI): 8.1-9.1]. Factors independently associated with HIV seroconversion included age 35 years or older [adjusted hazard ratio (aHR): 2.53; 95% CI: 2.03-3.14], unprotected sex (aHR: 1.27; 95% CI: 1.13-1.42), STI symptoms (aHR: 1.99; 95% CI: 1.67-2.38), and alcohol consumption before sex (aHR: 1.20; 95% CI: 1.07-1.34). Targeted interventions are vital in curbing HIV transmission among FSWs, with a focus on expanding access to primary HIV prevention services, particularly for older FSWs who face heightened risk. Tailored sexual health education programs are imperative to encourage consistent condom use and enable informed decision-making. Accessible and timely STI screening and treatment services are crucial to mitigate HIV transmission risk. Collaborative partnerships between healthcare providers, community organizations, and government agencies are essential in implementing these interventions among FSWs.

Health care prioritization process for the elderly in rural Tanzania under decentralized system: Prospects and challenges.

Beginning the early 1990s, many countries globally adopted the third-generation health sector reforms with a focus of strengthening the primary health care system through community participation. On the contrary, three decades later, primary health care systems in many Low- and Middle-Income countries (LMICs) including Tanzania have remained weak. Specifically, priority setting for the vulnerable groups including the elderly have been weak. We aimed to analyse the prospects and challenges of the priority setting process for the elderly health care services following the 1990s health sector reforms in Tanzania. We conducted an exploratory case study on priority setting process for the elderly healthcare services in Igunga and Nzega Tanzania. We carried out 24 Key Informant Interviews (KIIs) with the positions of District medical officers, social welfare, Medical Officers in-charge (MOI), planning officers and health system information focal person. Additionally, we carried out two focus group discussions (FGDs), one from each district with six participants from each group. Participants for the FGDs were MOI, health secretary, representative members of Health Facility Governing Committee (HFGC) and Council Health Management Team (CHMT). Data were analyzed using the qualitative content analysis. Two categories emerged from the analysis of the transcripts. These were the prospects and challenges in priority setting for the elderly population under the decentralized health sector in rural Tanzania. The prospects included; the capacity of the LGAs on priority setting; existence of strategies used by LGAs; availability of teamwork spirit and the existence of guidelines for priority setting at LGAs. The challenges included difficulties of elderly identification, insufficient resources to implement the planned activities at the LGAs, unintegrated digitalized government health information tools or programs at the LGAs, interference of LGAs by the Central Government and low interest of stakeholders on elderly health care. This study highlights the prospects and challenges facing priority setting for elderly care at the centralized health system in rural Tanzania. From the results the process is well organized but faces some challenges which if not addressed jeopardized and has potential to continue affecting the priority setting. Addressing the challenges highlighted requires joint efforts from both the elderly population in the community, healthcare providers and decision makers across all levels of the health system. This study serves as an eye-opener and calls for a bigger study to get a comprehensive picture of priority setting of the elderly health care in Tanzania.

EP 59 - Evolution of Infection Prevention and Control Policies and Processes in U.S. Home Health Care Agencies

EP 59 - Evolution of Infection Prevention and Control Policies and Processes in U.S. Home Health Care Agencies

Nutritional status as independent prognostic factor of outcome and mortality until five years after hip fracture: a comprehensive prospective study

SummaryWe determined the prognostic value of nutritional status for outcome after hip fracture. Nutritional status was a strong independent prognostic factor for clinical outcome and 5-year mortality. Physical function showed incomplete recovery. Elderly care should focus on prevention already before hip fracture.PurposeTo determine the prognostic value of nutritional status in hip fracture patients for multiple clinical and functional outcomes over 6 months, and for new fractures and survival over 5 years post-fracture.MethodsWe included 152 well-characterized subjects (age 55+ years) with a hip fracture from a previously published randomized controlled trial. Nutritional status was appraised using the Mini Nutritional Assessment (MNA). Multivariable linear, logistic and Cox regression models were fitted, adjusted for age, sex, ASA score, group and additional prognostic covariates identified in backward regression models.ResultsAt baseline, impaired nutritional status was significantly associated with physical disability, depression, impaired cognition and lower quality of life. Prospective analyses showed that impaired baseline nutritional status was an independent prognostic factor for postoperative complications (OR 2.00, 95%CI 1.01–3.98, p = 0.047), discharge location from hospital (home vs. rehabilitation clinic, OR 0.41, 95%CI 0.18–0.98, p = 0.044), hospital readmission (OR 4.59, 95%CI 1.70–12.4, p = 0.003) and total length of hospital stay (HR of being discharged: 0.63, 96%CI 0.44–0.89, p = 0.008), as well as for 5-year mortality (HR 3.94, 95%CI 1.53–10.2, p = 0.005), but not for risk of new fractures (5y-HR 0.87, 95%CI 0.34–2.24, p = 0.769). Curves of physical disability over time showed that the three nutritional status categories followed almost parallel trajectories from baseline until 6 months after hip fracture, without complete recovery and even with further deterioration in malnourished subjects from 3 to 6 months post-fracture.ConclusionAs baselline nutritional status is a strong independent prognostic factor for clinical outcome after hip fracture, affecting even five-year survival, elderly health care should focus on prevention and identification of at-risk individuals already before hip fracture.

Unifying Forces: Harnessing Blockchain and Artificial Intelligence Integration for Enhanced Innovation

Blockchain and artificial intelligence have now become the emerging technologies of our time. However, both strategies induce a change in the market but differ in terms of how creative and complex they are. While block chain is decentralized; distributed ledger technology that the one stores information in multiple locations with no centralized monitoring system, on the other hand, Artificial Intelligence (AI) emulates human problem-solving ability as well as decision-making abilities using software, data or even robots. These two technologies combined together to bring about new opportunities such as productivity gain from both advantages of blockchain and AI security and transparency. Businesses can transform significantly through integration of AI with blockchain technology for data protection, clear data trails and general efficiency. Cyber security is one of the most important concepts linked to these two technologies. The possibility to combine AI’s capabilities with blockchain’s reliable and decentralized nature can be used to manage resources as well as decision making at educational institutes or within healthcare agencies; it may also be employed by society to influence agriculture outputs, planning urban dwellings among others. Artificial intelligence (AI) can help identify risks at an early stage whereas information security and integrity might vanish.

Efektifitas SENADA terhadap Peningkatan Fungsi Kognitif Lansia dengan Demensia: Case Report

Older people in Indonesia are experiencing a significant increase in population, often accompanied by a decline in brain function and the risk of dementia. SENADA (Brain Health Exercise) emerges as a potential approach for enhancing cognitive function in older people through simple movements. Further research and information are needed to support its use in elderly healthcare practices. This study employed a case report approach with nursing care to evaluate the effectiveness of SENADA in older individuals with dementia. Interventions were conducted regularly with structured data collection using MMSE. The aim of this research was to assess the effectiveness of SENADA in improving cognitive function in older people with dementia through a case report approach with nursing care. Interventions were given twice daily for five minutes. Data were collected through interviews, interventions, evaluations, and documentation. Results demonstrated that SENADA therapy in patient Ny. A was effective for enhancing cognitive function in older people, as evidenced by the change in MMSE outputs from moderate to no cognitive impairment.