Healthcare Assistants Research Articles

Can formal home and community-based care substitute informal care? Evidence from Chinese Longitudinal Healthy Longevity Survey

BackgroundFormal home and community-based care are often considered as the preferable option to institutional care, offering older individuals the convenience of receiving care in their homes. Although research has found that these services may alleviate the burden on informal caregivers, there is a lack of research on which specific types of formal home and community-based care influence informal care provision.MethodsEmploying fixed-effects and quantile regression models, this study seeks to explore the effects that various formal home and community-based care services have on reducing the burden of informal care. This study draws data from the Chinese Longitudinal Healthy Longevity Survey 2005, 2008, 2011, 2014, and 2018.ResultsOur findings indicate that two types of formal care substantially influence the provision of informal care. The availability of daily living assistance services correlates with reduced informal caregiving hours, especially for those with extensive care needs. The availability of community-based health care services is linked to a reduction in the direct expenses incurred from informal caregiving, especially for those incurring greater direct caregiving costs. These effects are more prominent among urban residents. Other services, such as mental health support and legal advice services, do not demonstrate significant effects on reducing informal care hours and costs.ConclusionsDaily living assistance and community-based health care services play a crucial role in benefiting informal caregivers. It is important to prioritize the expansion of these services, especially among those with greater care needs.

Fusion of PCA and ICA in Statistical Subset Analysis for Speech Emotion Recognition.

Speech emotion recognition is key to many fields, including human-computer interaction, healthcare, and intelligent assistance. While acoustic features extracted from human speech are essential for this task, not all of them contribute to emotion recognition effectively. Thus, reduced numbers of features are required within successful emotion recognition models. This work aimed to investigate whether splitting the features into two subsets based on their distribution and then applying commonly used feature reduction methods would impact accuracy. Filter reduction was employed using the Kruskal-Wallis test, followed by principal component analysis (PCA) and independent component analysis (ICA). A set of features was investigated to determine whether the indiscriminate use of parametric feature reduction techniques affects the accuracy of emotion recognition. For this investigation, data from three databases-Berlin EmoDB, SAVEE, and RAVDES-were organized into subsets according to their distribution in applying both PCA and ICA. The results showed a reduction from 6373 features to 170 for the Berlin EmoDB database with an accuracy of 84.3%; a final size of 130 features for SAVEE, with a corresponding accuracy of 75.4%; and 150 features for RAVDESS, with an accuracy of 59.9%.

Don't you know that you're toxic? Regression model of a toxic workplace environment identification

The aim of this paper is to identify key relevant characteristics of pathological workplaces and their importance via logistic regression and the creation of the model that would be based on this method. Online questionnaire survey was used for collecting the data. It has been realized in 2023 on the sample of 489 respondents. These respondents were employees of companies that operated in the Slovak Republic. The model itself has been developed using logistic regression. The model has identified relevant characteristics of the pathological workplace: 1) sectoral type of the company; 2) type of corporate culture; 3) type of leadership. Toxic workplaces are present mostly in companies from accommodation and catering services where personal culture and authoritative leadership take place. With the same profile of corporate culture and leadership, also sectors of education, healthcare, and social assistance have been detected as more likely to be endangered by toxicity. However, little is known about the characteristics of pathological workplaces, which could help to prevent unhealthy relationships between managers and employees and lead the company to more effective production and operation on the market. The research abstracts from the generational specifics of subjects who are involved in the pathological working schemes.

BEYOND RHETORIC: CHINA'S PUBLIC DIPLOMACY IN KENYA THROUGH A POLITICAL-ECONOMIC LENS (2013-2020)

This article explores the evolution of China-Kenya relations within the context of China's broader public diplomacy strategy, focusing particularly on the period from 2013 to 2020. The foundation for these bilateral relations was laid as China opened up to developing countries and African nations gained independence. While formal diplomatic relations between China and Kenya were established in 1963, it was during the 2000s that these relations diversified significantly under the leadership of Chinese President Hu Jintao and Kenyan President Mwai Kibaki. This diversification spanned commercial, cultural, and political domains, becoming a notable example of public diplomacy. With the ascension of Chinese President Xi Jinping, China's public diplomacy experienced a strategic shift towards a more assertive and politically oriented approach. This study argues that under Xi Jinping, new initiatives and strategic plans were introduced, enhancing the existing framework of China's public diplomacy. A key element of this transformation was the increased emphasis on foreign aid, which gained momentum through the Belt and Road Initiative (BRI). Between 2013 and 2020, China's foreign aid to Kenya played a pivotal role in reshaping the structure of Chinese public diplomacy. This period saw a continuation and expansion of activities in culture and media, established in earlier phases, alongside a growing focus on infrastructure development, humanitarian aid, healthcare assistance, and educational and cultural projects. The study begins by examining traditional public diplomacy tools such as cultural exchanges, high-level visits, and educational initiatives. It then discusses specific projects implemented between 2013 and 2020, analyzing their contributions to public diplomacy efforts. Finally, the article provides an overview of these projects, as documented in AidData, highlighting their impact on the bilateral relations between China and Kenya.

Registered nurses' perceptions of nursing associates' professional identity.

The nursing associate (NA) role was introduced in 2017 with a pilot programme of trainees, and in 2019 became regulated by the Nursing and Midwifery Council (NMC). The role bridges the gap between the healthcare assistant (HCA) and registered nurse (RN), allowing RNs to focus on complex care. With over 9000 NAs on the NMC register and more in training, it is important to understand RN perceptions of the NA professional identity. The findings of a qualitative survey of RNs (n=23) identified the following themes: NMC standards and scope of practice; The 'cheap nurse'; Skills development and progression; A supportive bridging role. Although valued, the role was perceived as a threat, ambiguous and inconsistently implemented. The implications are that the role ambiguity and lack of standardisation need addressing and a clear understanding of these must be articulated for the professions and public alike.

The implications of healthcare professionals wearing jewelry on patient care biosafety: observational insights and experimental approaches

The use of jewelry among healthcare professionals poses a risk of cross contamination due to potential bacterial accumulation and spread. Through a mixed-method design, this study first analyzed the implications of healthcare professionals wearing jewelry on patient care biosafety as well as on the residual bacterial load of hands and rings after hand hygiene. Firstly, an observational prevalence study to verify whether nursing professionals wear personal accessories during healthcare assistance was carried out. Second, an experimental design involving intentional contamination and hygiene of the hands, with and without a ring, was conducted. The bacterial load of both hands and rings was measured by counting colony forming units. The observational study showed that nursing workers frequently wear jewelry during healthcare assistance. Nonetheless, the experimental study did not indicate differences in bacterial contamination between hands with and without a ring, despite the hand hygiene procedure applied. In conclusion, many nursing workers wear jewelry in the workplace. Although hands with and without a ring exhibited similar microbial load, rings appeared as a potential source of bacterial contamination, reinforcing the need to remove jewelry during working hours. Hand hygiene using alcohol, or soap and water significantly decreased the bacterial load on the participants’ hands, with handwashing proving to be the most efficient method for removing intentional contamination.

"Healthcare Assistance Challenges-Driven Neurosymbolic AI"

"Healthcare Assistance Challenges-Driven Neurosymbolic AI"

2222 Individual telephone calls to frail older adults improve outpatient clinic attendance rates

Abstract Introduction The multidisciplinary assessment clinic (MDAC) is an outpatient service for older people at a district general hospital. Patients are triaged to the MDAC clinic if they have geriatric syndrome (for example falls) plus comorbidity and/or mobility, social or cognitive concerns. The service had a high ‘did not attend’ (DNA) rate compared with other geriatric outpatient clinics. This project aimed to reduce MDAC DNA rates and improve cost effectiveness through implementation of a new pre-appointment telephone service. Method We analysed six months of attendance data prior to establishing the pre-appointment telephone service. The existing system consisted of a standardised trust appointment letter and a text message reminder. For the new system a healthcare assistant (HCA) telephoned patients the day before their appointment to confirm attendance and discuss any concerns. We analysed six months of attendance data following the implementation of the new system and compared DNA rates. Results Prior to implementation of the new pre-appointment telephone service, 29 of 268 patients DNA (11%). From the second data set, following implementation of the new telephone system, 11 of 253 patients DNA (4%). Successful contact was made with 72% of those phoned, allowing confirmation or cancelled appointments to be rebooked. Chi square analysis found a significant difference between the two systems, with a p value of <0.01 indicating an improvement in attendance rates with the new system. Conclusion Telephoning frail older patients prior to an outpatient clinic appointment significantly reduces DNA rates—a similar system could be implemented in other geriatric medicine outpatient settings.

AI-guided DVT diagnosis in primary care: protocol for cohort with qualitative assessment.

Deep vein thrombosis (DVT), a formation of blood clots within deep veins, mostly of the proximal lower limb, has an annual incidence of 1-2 per 1000. Patients who are affected by multiple chronic health conditions and who experience limited mobility are at high risk of developing DVT. Traditional DVT diagnosis involves probabilistic assessment in primary care, followed by specialised ultrasound scans (USS), mainly conducted in hospitals. The emergence of point-of-care ultrasound (POCUS), coupled with artificial intelligence (AI) applications, has the potential to expand primary care diagnostic capabilities. To assess the accuracy and acceptability of AI-guided POCUS for DVT diagnosis when performed by non-specialists in primary care. Diagnostic cross-sectional study coupled with a qualitative evaluation conducted at primary care DVT clinics. First, a diagnostic test accuracy (DTA) study will investigate the accuracy of AI-guided POCUS in 500 individuals with suspected DVT, performed by healthcare assistants (HCAs). The reference standard is the standard of care of USS conducted by sonographers. Second, after receiving both scans, participants will be invited to complete a patient satisfaction survey (PSS). Finally, semi-structured interviews with 20 participants and four HCAs, and three sonographers will explore the acceptability of AI-guided POCUS DVT diagnosis. This study will rigorously evaluate the accuracy and acceptability of AI-guided POCUS DVT diagnosis conducted by non-specialists in primary care.

Ultrasonography for the optimal selection of patients suitable for single session arteriography and endovascular revascularization in severe peripheral artery disease.

Peripheral artery disease (PAD) represents a high burden on the healthcare and social assistance systems. Revascularizationreduces symptoms, amputation rate and increases the chances of social reintegration. Our aim was to evaluate thebenefits of vascular duplex ultrasonography (DUS) for identifying patients suitable for direct percutaneous transluminal angioplasty(PTA) without the need for a prior angiography. We included in the study 251 patients withPAD evaluated by DUS. Depending on the DUS findings the patients were split in two groups: group I, 143 patients (57%), inwhich selective angiography and direct PTA was performed and group 2, 108 patients (43%), in which invasive arteriographywas considered necessary prior to a decision for revascularization.Results: The first group had a similar success rate (92.3% vs. 86.1%; p=0.111), but with a reduction in radioscopy time(minutes) (17.2 vs. 20.8; p=0.013), iodine contrast volume (ml) (190 vs. 227.5; p<0.001), days of hospitalization (4 vs. 7; p<0.001) and by 44.75% (p<0.001) of hospitalization costs when compared to the second group. DUS allows the optimal selection of patients who can benefit from direct PTA. This strategy has a high success rate, with a significant decrease in radioscopy exposure time, volume of iodine contrast needed, duration and hospitalization costs, when compared to arteriography and PTA in two different sessions.

Navigating Uncertainty with Compassion: Healthcare Assistants' Reflections on Balancing COVID-19 and Routine Care through Adversity.

The coronavirus disease 2019 pandemic created unprecedented challenges for healthcare systems around the world. Healthcare assistants played a vital role in the provision of frontline patient care during this crisis. Despite their important contribution, there exists limited research that specifically examines the healthcare assistant's experiences and perspectives of care provision during the COVID-19 pandemic. This study explored healthcare assistants' caring experiences and perspectives on resilience and self-efficacy during the COVID-19 pandemic in Hong Kong. A qualitative descriptive study with semi-structured interviews was conducted with 25 healthcare assistants from public hospitals. Interview recordings were analyzed using thematic analysis. Five main themes emerged from the data: frontline reinforcement: supporting HCAs through resourcing and education amidst the COVID-19 crisis, confronting uncertainty: building personal fortitude in the face of the COVID-19 pandemic, fostering collective resilience through shared support, self-efficacy as a catalyst for adaptive growth, and paving the way for transformation. These findings advocate for the resilience and self-efficacy of healthcare assistants; this may potentially strengthen healthcare system preparedness for navigating unpredictable challenges in the future.

Medicine management: legal and ethical principles

This article explores the legal and ethical issues that impact the safe administration of medicines. A discussion is provided on understanding the role of the healthcare assistant (HCA), assistant practitioner (AP) and informed consent, which is key to ethical and legal care provision. Mental capacity and the practice of covert medication administration is also outlined. By upholding ethical and legal principles, the HCA and AP can ensure that patient-centred care, which respects individuals' rights and promotes their wellbeing, is consistently practiced.

Activities of living, 8: controlling body temperature

This article provides healthcare assistants (HCAs) and assistant practitioners (APs) with an understanding related to the critical activity of controlling body temperature in patients. Recognising the intricate interplay of physiological, psychological, sociocultural, environmental and politicoeconomic factors at play is imperative for the provision of holistic and patient-centred care. The article emphasises the physiological mechanisms involved in temperature regulation, as well as the significance of maintaining a stable body temperature for optimal patient wellbeing. It addresses the various methods of assessing body temperature, including oral, rectal, axillary, tympanic and skin measurements, with a focus on choosing the most appropriate method based on the patient's condition.

Using contact network dynamics to implement efficient interventions against pathogen spread in hospital settings: A modelling study.

Long-term care facilities (LTCFs) are hotspots for pathogen transmission. Infection control interventions are essential, but the high density and heterogeneity of interindividual contacts within LTCF may hinder their efficacy. Here, we explore how the patient-staff contact structure may inform effective intervention implementation. Using an individual-based model (IBM), we reproduced methicillin-resistant Staphylococcus aureus colonisation transmission dynamics over a detailed contact network recorded within a French LTCF of 327 patients and 263 staff over 3 months. Simulated baseline cumulative colonisation incidence was 21 patients (prediction interval: 11, 31) and 35 staff (prediction interval: 19, 54). We examined the potential impact of 3 types of interventions against transmission (reallocation reducing the number of unique contacts per staff, reinforced contact precautions, and hypothetical vaccination protecting against acquisition), targeted towards specific populations. All 3 interventions were effective when applied to all nurses or healthcare assistants (median reduction in MRSA colonisation incidence up to 35%), but the benefit did not exceed 8% when targeting any other single staff category. We identified "supercontactor" individuals with most contacts ("frequency-based," overrepresented among nurses, porters, and rehabilitation staff) or with the longest cumulative time spent in contact ("duration-based," overrepresented among healthcare assistants and patients in elderly care or persistent vegetative state (PVS)). Targeting supercontactors enhanced interventions against pathogen spread in the LTCF. With contact precautions, targeting frequency-based staff supercontactors led to the highest incidence reduction (20%, 95% CI: 19, 21). Vaccinating a mix of frequency- and duration-based staff supercontactors led to a higher reduction (23%, 95% CI: 22, 24) than all other approaches. Although based on data from a single LTCF, when varying epidemiological parameters to extend to other pathogens, our results suggest that targeting supercontactors is always the most effective strategy, indicating this approach could be applied to prevent transmission of other nosocomial pathogens. By characterising the contact structure in hospital settings and identifying the categories of staff and patients more likely to be supercontactors, with either more or longer contacts than others, interventions against nosocomial spread could be more effective. We find that the most efficient implementation strategy depends on the intervention (reallocation, contact precautions, vaccination) and target population (staff, patients, supercontactors). Importantly, both staff and patients may be supercontactors, highlighting the importance of including patients in measures to prevent pathogen transmission in LTCF.

Sharenting: characteristics and awareness of parents publishing sensitive content of their children on online platforms

BackgroundThe term “sharenting” describes the increasingly popular habit of parents to share photos, videos, or other information regarding their children on their social profiles, through online platforms. It is highly likely that many parents are posting content about their underage children online with little knowledge of the risks associated with this practice. This study aims to investigate whether variables such as parents’ age, gender, marital status, occupation and educational level influence the practice of sharing child-related content and the degree of awareness.MethodsWe performed a pilot cross-sectional study, based on an anonymous questionnaire. The questionnaire was administered to parents of underage children attending the pediatric outpatient clinic of the Umberto I Hospital, Sapienza University, in Rome, Italy, by researchers, through the google forms platform; qualitative variables were generated on excel sheets and a statistical analysis was performed on SPSS Ibm-statistics using the chi-square test.ResultsTwo hundred twenty-eight parents of children under 18 years of age completed the questionnaire (82% mothers, 18% fathers); 98% of the respondents used social media and 75% of them published their children’s related content online. Thirty-one percent of the compilers started their practice of sharenting in the first 6 months of life of their child. Our analysis showed that compared to parents who do not post online, parents who usually post online their children are significantly more likely to be partial employees or unemployed (p = 0,002), with lower educational level (p = 0,05), younger (less than 35 years of age (p = 0,01)) and have a higher number of followers (p < 0,001). Finally, 93% of the compilers were not aware of the current legislation and of the risks related to the practice of sharenting.ConclusionsPediatricians, healthcare assistants and preventive healthcare professionals should play a central role in alerting parents and families to the risks of sharenting; the results of our study could draw their attention to the increasing practice of sharenting and make healthcare professionals active part in the protection of children.

Nasogastric tube feeding under physical restraint of children and young people with mental disorders: a comprehensive audit and case series across paediatric wards in England

ObjectiveTo estimate the number of patients on paediatric wards in England who received nasogastric tube (NGT) feeding under physical restraint from April 2022 to March 2023, identify the demographics and...

Transforming experimental radiology: Design and implementation of an innovative ePACS image storage system for AI imaging research environments

Introduction and purpose: We present the needs, design, development, implementation, and accessibility of a crafted experimental PACS (ePACS) system to securely store images, ensuring efficiency and ease of use for AI processing, specifically tailored for research scenarios, including phantoms, animal and human studies and quality assurance (QA) exams. The ePACS system plays a crucial role in any medical imaging departments that handle non-care profile studies, such as protocol adjustments and dummy runs. By effectively segregating non-care profile studies from the healthcare assistance, the ePACS usefully prevents errors both in clinical practice and storage security. Methods and results: The developed ePACS system considers the best practices for management, maintenance, access, long-term storage and backups, regulatory audits, and economic aspects. Moreover, key aspects of the ePACS system include the design of data flows with a focus on incorporating data security and privacy, access control and levels based on user profiles, internal data management policies, standardized architecture, infrastructure and application monitorization and traceability, and periodic backup policies. A new tool called DicomStudiesQA has been developed to standardize the analysis of DICOM studies. The tool automatically identifies, extracts, and renames series using a consistent nomenclature. It also detects corrupted images and merges separated dynamic series that were initially split, allowing for streamlined post-processing. Discussion and conclusions: The developed ePACS system encompasses a successful implementation, both in hospital and research environments, showcasing its transformative nature and the challenging yet crucial transfer of knowledge to industry. This underscores the practicality and real-world applicability of our innovative approach, highlighting the significant impact it has on the field of experimental radiology.

1 - Soft Power Diplomacy

For decades, and despite sanctions and turbulent relations with major international actors since the 1960s, Cuba has managed to assert itself in the international system. A small island with very limited natural resources, Cuba leveraged its international affairs on its provision of healthcare. This article investigates the role and impact of Cuban medical assistance in Africa. It proceeds from the premise that soft power has useful explanatory value in understanding the Cuba–Africa diplomatic intercourse. The article argues that despite its political ideology and limited political freedoms, Cuba established itself as a model and prominent player in the unique and consistent provision of healthcare and humanitarian assistance to the African continent, and in the development of Africa’s healthcare systems, for more than sixty years. It has also offered community-based healthcare training, which most African countries consider to be more relevant and cost-effective than hospital-based training. Furthermore, the Cuban training gave African medical students a shift in perspective and orientation to focus on public service, not profit-making.

Network-integrated medical chatbot for enhanced healthcare services

Technology has a significant role in improving medical care, such as enhancing communication between patients and healthcare virtual assistants. By including artificial intelligence and natural language processing (NLP), the main aim of this research paper is to design a medical chatbot framework, and application design prototype, and use the Dialog Flow tool to build an auto-response system known as a chatbot. The goal is to provide medical services and meet patients' needs. It will communicate with the user in the language they follow. With the help of keywords such as symptoms entered by the patients, it will help to identify the disease. Moreover, the application provides the patients with the ability to record their medicine to remind them to take it. Additionally, it will make it easier for patients to learn more about their disease and motivate them to take the necessary precautions to stay healthy.

Stripped of their professional status: overseas educated nurses working as unregistered practitioners in their host country

Background: Many of the overseas qualified nurses educated work as health care assistants and support workers for a decreased wage without scope for professional advancement. There is an imperative to ease their entry to the nursing register. Aim: To gather and provide evidence to the regulatory bodies regarding the demographics of this cohort of nurses and the challenges they face in attempting to register as a nurse. Design: This study used a mixed-method explanatory sequential design. The survey was completed by 857 unregistered nurses followed by five in-depth interviews. Results from both phases were triangulated. Results: The results signpost to the characteristics and challenges of these nurses working as unqualified grades of staff for a decreased wage without scope for professional advance. Discussion and conclusion: The downward occupational spiral of internationally educated nurses underscores the paradoxical nature of the pedagogical application of transition theory, as these nurses are compelled to revert to a novice status.