Health Care Benefits Research Articles

Securing the Internet of Health Things: Embedded Federated Learning-Driven Long Short-Term Memory for Cyberattack Detection

The proliferation of the Internet of Health Things (IoHT) introduces significant benefits for healthcare through enhanced connectivity and data-driven insights, but it also presents substantial cybersecurity challenges. Protecting sensitive health data from cyberattacks is critical. This paper proposes a novel approach for detecting cyberattacks in IoHT environments using a Federated Learning (FL) framework integrated with Long Short-Term Memory (LSTM) networks. The FL paradigm ensures data privacy by allowing individual IoHT devices to collaboratively train a global model without sharing local data, thereby maintaining patient confidentiality. LSTM networks, known for their effectiveness in handling time-series data, are employed to capture and analyze temporal patterns indicative of cyberthreats. Our proposed system uses an embedded feature selection technique that minimizes the computational complexity of the cyberattack detection model and leverages the decentralized nature of FL to create a robust and scalable cyberattack detection mechanism. We refer to the proposed approach as Embedded Federated Learning-Driven Long Short-Term Memory (EFL-LSTM). Extensive experiments using real-world ECU-IoHT data demonstrate that our proposed model outperforms traditional models regarding accuracy (97.16%) and data privacy. The outcomes highlight the feasibility and advantages of integrating Federated Learning with LSTM networks to enhance the cybersecurity posture of IoHT infrastructures. This research paves the way for future developments in secure and privacy-preserving IoHT systems, ensuring reliable protection against evolving cyberthreats.

Acceptability of the National Health Insurance scheme and preferred benefit package among civil servants in Rivers State, Nigeria

Health-care insurance is one of the financial risk protection tools available to clients in the health-care industry. In most developing countries, citizens are in favor of paying for their health-care expenses out of pocket, a payment mode that potentially tips these people into poverty. This study aims to determine the level of acceptance of and the preferred benefit package available in the National Health Insurance Scheme (NHIS) among civil servants in Rivers State, Nigeria. In this descriptive cross-sectional study, respondents were selected through simple random sampling. The collected data were cleaned and analyzed with Statistical Product and Service Solution version 23. Out of the 351 respondents, male subjects accounted for the big majority of the sample (n = 208; 59.3%); only 30 (8.5%) had any form of health insurance; and about two-thirds of the respondents, at around 223 (63.5%), expressed acceptance of using NHIS as a strategy for payment. The most preferred benefits package was the one that covers all services 178 (50.7%). The poor and the poorest showed a preference for the health-care benefits package that covers all expenses, whereas the rich showed a preference for services covering basic diseases. The overall acceptability of the NHIS was statistically associated with socio-economic status (p ≤ 0.05). Thus, the opinions of the consumers and their health needs must be taken into consideration when planning a health insurance benefits package.

Mechanisms of slow-release antibacterial properties in chitosan‑titanium dioxide stabilized perilla essential oil Pickering emulsions: Focusing on oil-water interfacial behaviors

Perilla essential oil (PLEO) offers benefits for food preservation and healthcare, yet its instability restricts its applications. In this study, chitosan (CS) and TiO2 used to prepare composite particles. TiO2, after being modified with sodium laurate (SL), was successfully introduced at 0.1 %–3 % into the CS matrix. The resulting CS-SL-TiO2 composite particles can be formed by intertwining and rearranging through intramolecular and intermolecular interactions, and form an O/W interface with stability and viscoelasticity. The Pickering emulsions stabilized by these particles exhibit non-Newtonian pseudoplastic behavior, shear-thinning properties, and slow-release characteristics, along with antibacterial activity. Emulsions with 0.5 % and 1 % CS-SL-TiO2 composites demonstrated superior antibacterial effects against Escherichia coli and Staphylococcus aureus. The study revealed that all emulsions undergo Fickian diffusion and a sustained release of PLEO, with the Ritger-Peppas model best describing this release mechanism. The slow-release behaviors positively correlates with interfacial pressure, composite particle size, composite particle potential, composite contact angle, emulsion particle size and emulsion potential, but negatively correlates with diffusion rate, penetration rate, release kinetics and release rate. The findings lay groundwork for developing slow-release antimicrobial emulsions within polysaccharide matrices, showcasing promise for antimicrobial packaging solutions and enhanced food preservation techniques.

Demystifying Artificial Intelligence for Health Care Professionals: Continuing Professional Development as an Agent of Transformation Leading to Artificial Intelligence-Augmented Practice.

The rapid rise of artificial intelligence (AI) is transforming society; yet, the education of health care providers in this field is lagging. In health care, where AI promises to facilitate diagnostic accuracy, and allow for personalized treatment, bridging the knowledge and skill gaps for providers becomes vital. This article explores the challenges of AI education, such as the emergence of self-proclaimed experts during the pandemic, and the need for comprehensive training in AI language, mechanics, and ethics. It advocates for a new breed of health care professionals who are both practitioners and informaticians, who are capable through initial training or through continuing professional development of harnessing AI's potential. Interdisciplinary collaboration, ongoing education, and incentives are proposed to ensure health care benefits from AI's trajectory. This perspective article explores the hurdles and the imperative of creating educational programming designed specifically to help health care professionals augment their practice with AI.

Insights from a COVID-era health needs assessment of rural Midwestern Latinos

ABSTRACT Latino health and well-being are crucial to the growth and vibrancy of rural areas across the United States, particularly at a time when the demographics of many rural communities are transitioning from minority Latino to majority Latino populations. This manuscript details the findings of a study that explored the health and healthcare benefit status of 524 Latino households in rural Indiana during the COVID-19 pandemic. Via 20-minute, door-to-door interviews conducted by bilingual researchers, survey participants answered questions about access to healthcare services and benefits, dietary and safety habits, medical issues, and vaccination status. The study found that slightly more than half of those surveyed were enrolled in healthcare benefit plans; approximately a third were unsatisfied with their health/health status; almost two-thirds had not received a flu shot and were eating fast food/processed food on a daily basis. Top health concerns reported included: stress (52%), vision problems (34%), neck and back pain (30%), headaches/migraines (28%), anxiety and depression (28%) and weight problems (26%). The study also discovered that half of the respondents could not identify a primary healthcare provider (PCP) by name and that pregnant women faced a lack of resources for maternal health in the county where the study was conducted. The results indicate that Latinos in rural communities continue to endure significant health issues and barriers to healthcare. The study provides an excellent model of how a rural community can monitor the health of its residents, which can inform health interventions for underserved populations.

Utilization of Artificial Intelligence (AI) in Healthcare Decision-Making Processes: Perceptions of Caregivers in Saudi Arabia.

Background In the evolving landscape of healthcare, artificial intelligence (AI) has emerged as a transformative force, revolutionizing decision-making processes. Through advanced machine learning and data analytics, AI promises precision and personalized treatments, particularly impactful in diagnostics and personalized medicine. Aim and objectives This study aims to investigate the utilization and effectiveness of AI algorithms among healthcare caregivers, focusing on decision-making processes. Objectives include assessing AI adoption prevalence, understanding demographic factors influencing utilization, and evaluating its impact on decision-making dynamics, diagnostics, and personalized medicine. Methods Employing a quantitative cross-sectional approach, an online questionnaire was distributed to 224 healthcare professionals. The survey covered AI familiarity, perceived effectiveness, and potential barriers. Data analysis utilized descriptive statistics and bivariate analyses. Results Seventy-five percent of caregivers reported that they used AI in the decision-making process, with nurses representing a significant majority (50.4%). Bivariate analyses identified correlations between AI utilization and demographic variables, emphasizing its diverse adoption across specialties. Conclusion This study reveals substantial AI adoption, notably among nurses, indicating a transformative shift in decision-making processes. The findings underscore AI's potential in diagnostics and personalized medicine, highlighting the need for targeted interventions and collaborative efforts to address challenges and maximize AI benefits in healthcare.

Ocimum Tenuiflorum Linne: A Narrative Review

Indonesia's diverse flora offers significant potential for medicinal plant production, yet reliance on anecdotal experiences prompts a deeper examination. This study focuses on Ruku-ruku (Ocimum Tenuiflorum Linne), traditionally a culinary herb in West Sumatra. Despite its local culinary use, Ruku-ruku remains largely unexplored for medicinal properties, emphasizing the importance of phytochemical screening to uncover its therapeutic potential. Ocimum Sanctum, known as Holy Basil or Tulsi, holds sacred status in India and boasts a rich history documented in ancient medical texts. This study aimed to review the evidence for therapeutic efficacy and botanical and chemical aspects. The research methodology, employing a narrative literature review, assesses 40 studies (2015-2023). Results underscore Tulsi's holistic benefits, covering metabolic disorders, cardiovascular and cognitive health, infections, cancer prevention, oral health, wound healing, and weight management. Diverse formulations, from essential oils to capsules and gels, highlight the extensive applications of Ocimum Tenuiflorum Linne. The study explores botanical and chemical aspects, including shoot induction and essential oil extraction. Ocimum Sanctum's adaptogenic and antimicrobial properties are discussed, showcasing its potential under stress conditions and against various infections. In conclusion, this review stresses the vast therapeutic potential of Ocimum Tenuiflorum Linne, urging further research to unlock its full medicinal benefits. Integrating traditional wisdom with modern science positions these plants as valuable subjects for pharmaceutical and medicinal applications, potentially addressing contemporary health challenges, including the COVID-19 pandemic. This research contributes to providing information about Ocimum Tenuiflorum Linne and its benefits for health care as therapeutic properties.

Impacts of COVID-19 shelter in place across key life domains among immigrant farmworker Latina mothers and young adults

ObjectiveIndividuals and families from racial and ethnic groups experience social and economic disadvantage making them vulnerable to the disproportionate impact of the COVID-19 pandemic. This study sought to capture the impacts of Shelter in Place (SIP) across key life domains including family life, education, work, mental health, and coping strategies among a sample of Mexican-origin mothers who were currently engaged in agricultural work, or whose spouses were engaged in agricultural work, and young adults who had a parent working in agriculture.MethodDuring the summer of 2020, while California was under SIP orders, we conducted three virtual focus groups using Zoom(r). We recruited focus group participants from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), an ongoing, 20-year, longitudinal cohort study of Mexican-origin families in a predominantly agricultural area of California. Three focus groups were conducted with mothers (n = 9), mean age = 48 years, young adult women (n = 8) and young adult men (n = 5), mean age = 18 years, respectively.ResultsMothers reported high levels of stress stemming from fear of Covid-19 infection, work instability and financial concerns, children’s schooling, anxiety about an uncertain future, and the demands of caretaking for dependents. Adverse mental health impacts were particularly pronounced among participants experiencing multiple adversities pre-dating the pandemic, including unemployment, single motherhood, and having undocumented family members. For young adults, work instability and varying work hours were also a source of stress because they made it difficult to make decisions about the future, such as whether to attend college or how many classes to take. Families used coping strategies including expressing gratitude, focusing on what’s under one’s control, familismo, and community engagement to manage mental health challenges during SIP.ConclusionIn the event of future pandemics or disasters, particular attention is needed to those who experience unemployment, are undocumented and/or have undocumented family members, and/or are single parents facing economic adversity. During public health emergencies, action at the local, state, and national level is needed to support farmworkers and other vulnerable groups’ secondary major stressors stemming from inequities in access to affordable housing, childcare, living wages, healthcare, and other benefits.

Artificial Intelligence Applications in Healthcare

Nowadays, the employment of artificial intelligence (AI) technologies in healthcare has provided useful outcomes related to decision-making, early diagnosis of diseases, and optimization of patient care services. AI technologies apply to a variety of data sources. The present paper has discussed the latest developments on Artificial Intelligence healthcare applications, AI technologies, benefits, challenges, and ethical considerations. It also has underlined the role of AI in the improvement of diagnosis, prediction, and personalized treatment. On the basis of the present research, it is claimed that the regulation of AI in healthcare is going to decide the fate of AI-ethics in healthcare for at least the coming decade. The ethical agoras on the regulation of AI-healthcare should instead stamp and remain as the imprint on possible and permissible moral and ethical philosophy of AI in healthcare shaped over the years.

TAPS-tool reveals severe under detection of substance use problems in patients with severe mental illness.

Substance use disorders (SUD) and associated problems are highly prevalent but often undetected in patients with Severe Mental Illness (SMI). This study investigates the prevalence, under-detection, and variables associated with a high risk of SUD in a Dutch sample of adult outpatient SMI patients (N = 83). Substance use (The Tobacco, Alcohol, Prescription medication, and other Substance use -TAPS-tool), quality of life (Manchester Short Assessment of Quality of Life-MANSA), general functioning (Health of the Nation Outcome Scale-HoNOS), DSM-5 classifications and patient characteristics (age, education, marital status) were assessed. Detection of SUD was determined by calculating % agreement of DSM-5 classification to TAPS outcome. A logistic regression analysis was performed to determine the association of patient characteristics, quality of life and general functioning to an increased risk of SUD as determined by the TAPS. Concerning prevalence, 89% of the patients used tobacco, above guideline-recommended daily limits of alcohol, illicit drugs or prescription medications for nonmedical purposes. Almost all smokers, half of the alcohol users and three-quarter of the patients that use marihuana or stimulant drugs had a high risk of SUD. All patients with high risk of SUD associated with alcohol, drugs or medications also had SUD associated with tobacco use. Concerning under detection less than half of the patients with a high risk of SUD according the TAPS had a SUD in their DSM-5 classification. Gender, partner, age and satisfaction about the relationship with family had a significant association with a high risk of SUD. Screening for addiction in an SMI sample with the TAPS-tool revealed a high prevalence of substance use and a high risk of SUD. TAPS outcomes compared to the clinically obtained DSM-5 classification revealed a high degree of under-detection of substance use problems. Smoking seems to pose a specific additional risk of addiction and deserves more attention in treatment to achieve greater health care benefits.

Employee benefit availability, use, and subjective evaluation: A meta-analysis of relationships with perceived organizational support, affective organizational commitment, withdrawal, job satisfaction, and well-being.

Employee benefits constitute 38.1% of compensation costs, representing a sizeable investment in the workforce. Unlike other forms of support that depend on the actions of individuals throughout the organization, benefits can be changed through decisions at the highest level and influence employees throughout the company. Yet, the literature on benefits has been largely disjointed, resulting in theoretical ambiguity and practical questions about the role of employee benefit experiences in individual employee outcomes. To inform theory and practice, we organized the benefits literature using social exchange theory as a framework and conducted a meta-analysis on the relationships of employee benefit availability, use, and subjective evaluation with perceived organizational support, employee attitudes, and well-being. Our review (k = 134, N = 260,604) found unique relationships between the availability and subjective evaluation of employee benefits and affective organizational commitment, withdrawal intentions, job satisfaction, and well-being, with these relationships partially mediated by perceived organizational support. Benefit use contributed little to these outcomes beyond benefit availability and subjective evaluation. Benefit subjective evaluation was also more strongly related to most outcomes than were benefits availability and use. These relationships varied across types of benefits, with training benefits more strongly related to job satisfaction and health care and retirement benefits more strongly related to turnover intentions. Altogether, this meta-analysis integrates the empirical literature on employee benefits and highlights the implications of benefit experiences and types for the employee-organization relationship and employee well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Security Risk Assessment of IoT for Remote Patient Monitoring System

Remote Patient Monitoring (RPM), an essential component of telehealth, is among the biggest changes marked in healthcare. It facilitates patients’ treatment, remotely at home or in some distant location, without traditional clinical settings. The RPM plays a key role in data acquisition, data analysis and insights, and improved healthcare management. It collects real-time data using wearable sensors and mobile apps, and furnish crucial health metrics. Advanced algorithms and prognostic modelling than process the data, pattern and likely health risks to predict any disease more precisely and accurately for early action. RPM provides real-time watch and remote consultation that help in improved disease control and better patients’ care. Improved accuracy, reduced cost, real time interaction, and refined patient well-being are the significant healthcare benefits of RPM. Prognosis Health & Management (PHM) system is used for predicting the remaining useful life (RUL) of healthcare assets such as sensors, pacemakers, defibrillators and other medical equipment. The PHM leads to pre-emptive maintenance, lowers downtime, and tracks the life span of such healthcare equipment. The IoT enables PHM to monitor remote assets and gather instant data to foresee the RUL of such equipment. Providing the facilitations, PHM also creates potential vulnerabilities of exposure of device, network and data, and poses data security and privacy challenges. Therefore, strong security controls are required to keep patients’ data confidential and safe from uneven approaches to technology and data breaches. This paper evaluates risk associated with RPM using OCTAVE ALLGERO, a risk assessment framework, to mitigate the data security concerns.

The perceived controllability of negatively-valenced episodic future thinking modulates delay discounting

ABSTRACT Intertemporal decision-making is important for both economy and physical health. Nevertheless, in daily life, individuals tend to prefer immediate and smaller rewards to delayed and larger rewards, which is known as delay discounting (DD). Episodic future thinking (EFT) has been proven to influence DD. However, there is still no inconsistent conclusion on the effect of negative EFT on DD. Considering the perceived controllability of negative EFT may address the issue (Controllability refers to the extent to which progress and result of an event could be controlled by ourselves). In the current study, we manipulated EFT conditions (baseline, neutral EFT, negative-controllable EFT and negative-uncontrollable EFT), delayed time (i.e. 1 week, 1 month, 3 months, 6 months, 1 year and 3 years) and reward magnitude (small, large). We mainly found that when experiencing negative-uncontrollable EFT compared to negative-controllable EFT in the delayed time of 6 months with large rewards, individuals chose more delayed rewards, suggesting that negative-uncontrollable EFT effectively reduced DD under conditions of both large-magnitude reward and longer delayed time. The current study provides new insight for healthy groups on optimising EFT. In that case, individuals are able to gain long-term benefits in financial management and healthcare.

Navigating Disease Management: A Comprehensive Review of the De Ritis Ratio in Clinical Medicine.

The De Ritis ratio, defined as the serum aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, is a widely recognized biochemical marker with significant applications in diagnosing and managing various diseases, particularly liver disorders. This comprehensive review synthesizes current knowledge surrounding the clinical relevance of the De Ritis ratio, examining its historical development, diagnostic utility, and prognostic significance across various medical conditions, including liver diseases, cardiovascular disorders, and muscular pathologies. Through an in-depth analysis of literature spanning several decades, this review highlights the role of the De Ritis ratio not only in differential diagnosis but also as a prognostic indicator for disease progression and patient outcomes. The ratio's ability to distinguish between different types of liver pathology, aid in early disease detection, and its potential use in monitoring treatment response are discussed. Additionally, the review addresses the methodological considerations, such as confounding factors and interpretation challenges, that impact the clinical utility of the De Ritis ratio. Given the evolving landscape of clinical diagnostics and the push toward more personalized medicine, the review concludes with recommendations for further research. These include longitudinal studies to explore the ratio's changes over time, comparative research across diverse populations, and technological integration to enhance diagnostic accuracy and patient care. This review aims to reaffirm the importance of the De Ritis ratio in modern clinical practice and encourages continued exploration into its potential applications and benefits in healthcare.

Workshop on s-claim application system for BPJS claim officers at Grandmed Lubuk Pakam Hospital

BPJS Health is a public legal entity that is directly responsible to the President and functions to organize health insurance programs for all Indonesian residents, including foreigners who work for a minimum of six months in Indonesia. The BPJS Health claim procedure can be quite complicated and requires a lot of supporting documents. Unclearness in the guidance or instructions provided can make participants confused and not prepare the complete documents required, one of which is incomplete data files. This is a problem that slows down the claim process. This activity aims to provide health education on the application of the S-National Health Insurance (JKN) system, namely health protection program in Indonesia designed to provide basic health care and protection benefits for all Indonesian citizens. The main goal of JKN is to ensure that everyone in Indonesia has access to adequate basic health services, either through contributions paid by participants themselves or contributions paid by the government for certain groups. With the existence of JKN, it is hoped that the entire population of Indonesia can feel the benefits of equitable and quality health services, thereby improving the health status of the community as a whole. Claims to BPJS officers. The method of implementing activities is using observation sheets and questionnaires regarding the application of the S-Claim system to BPJS officers. Through this activity, it is hoped that the knowledge of BPJS claims officers can increase and change attitudes so that they can apply the BPJS E-Claim system correctly. Socialization to BPJS claims officers can be concluded that the knowledge of BPJS claims officers at Grandmed Lubuk Pakam Hospital has increased by 60% after conducting socialization using discussion, lecture and question and answer methods as well as holding quizzes or tests to evaluate participants' understanding of the S application.

Economic evaluation of the effect of needle and syringe programs on skin, soft tissue, and vascular infections in people who inject drugs: a microsimulation modelling approach

BackgroundNeedle and syringe programs (NSP) are effective harm-reduction strategies against HIV and hepatitis C. Although skin, soft tissue, and vascular infections (SSTVI) are the most common morbidities in people who inject drugs (PWID), the extent to which NSP are clinically and cost-effective in relation to SSTVI in PWID remains unclear. The objective of this study was to model the clinical- and cost-effectiveness of NSP with respect to treatment of SSTVI in PWID.MethodsWe performed a model-based, economic evaluation comparing a scenario with NSP to a scenario without NSP. We developed a microsimulation model to generate two cohorts of 100,000 individuals corresponding to each NSP scenario and estimated quality-adjusted life-years (QALY) and cost (in 2022 Canadian dollars) over a 5-year time horizon (1.5% per annum for costs and outcomes). To assess the clinical effectiveness of NSP, we conducted survival analysis that accounted for the recurrent use of health care services for treating SSTVI and SSTVI mortality in the presence of competing risks.ResultsThe incremental cost-effectiveness ratio associated with NSP was $70,278 per QALY, with incremental cost and QALY gains corresponding to $1207 and 0.017 QALY, respectively. Under the scenario with NSP, there were 788 fewer SSTVI deaths per 100,000 PWID, corresponding to 24% lower relative hazard of mortality from SSTVI (hazard ratio [HR] = 0.76; 95% confidence interval [CI] = 0.72–0.80). Health service utilization over the 5-year period remained lower under the scenario with NSP (outpatient: 66,511 vs. 86,879; emergency department: 9920 vs. 12,922; inpatient: 4282 vs. 5596). Relatedly, having NSP was associated with a modest reduction in the relative hazard of recurrent outpatient visits (HR = 0.96; 95% CI = 0.95–0.97) for purulent SSTVI as well as outpatient (HR = 0.88; 95% CI = 0.87–0.88) and emergency department visits (HR = 0.98; 95% CI = 0.97–0.99) for non-purulent SSTVI.ConclusionsBoth the individuals and the healthcare system benefit from NSP through lower risk of SSTVI mortality and prevention of recurrent outpatient and emergency department visits to treat SSTVI. The microsimulation framework provides insights into clinical and economic implications of NSP, which can serve as valuable evidence that can aid decision-making in expansion of NSP services.

High-fidelity synthetic patient data applications and privacy considerations

This paper explores the potential applications of high-fidelity synthetic patient data in the context of healthcare research, including challenges and benefits. The paper starts by defining synthetic data, types of synthetic data and approaches to generating synthetic data. It then discusses the potential applications of synthetic data in addition to as a privacy enhancing technology and current debates around whether synthetic data should be considered personal data and,therefore, should be subjected to privacy controls to minimise reidentification risks. This will be followed by a discussion of privacy preservation approaches and privacy metrics that can be applied in the context of synthetic data. The paper includes a case study based on synthetic electronic healthcare record data from the Clinical Practice Research Datalink on how privacy concerns due to reidentification have been addressed in order to make this data available for research purposes. The authors conclude that synthetic data, particularly high-fidelity synthetic patient data, has the potential to add value over and above real data for public health and that it is possible to address privacy concerns to make synthetic data available via a combination of privacy measures applied during the synthetic data generation process and post-generation reidentification risk assessments as part of data protection impact assessments.

From the “backburner” to the forefront: Qualitative analysis of medical and physician assistant students’ reflections on Crip Camp

BackgroundDisability-focused health professions education must evolve to portray the lives of disabled patients, lived experiences of ableism, and disability history more accurately and authentically. Methods of education that utilize first-person perspectives of disabled people to deliver authentic representations are limited in the current literature. ObjectiveTo explore first-year medical and physician assistant students' reflections on healthcare access, healthcare providers’ roles, and barriers to health equity for patients with disabilities after watching an exemplar, first-person perspective documentary titled Crip Camp: A Disability Revolution. MethodsA three-part, student-created disability curriculum “Introduction to Disability and Anti-Ableist Healthcare” was offered as an elective for first-year medical students during the 2021–2022 and 2022–2023 academic years. The disability curriculum was required for first-year physician assistant students during the 2023–2024 academic year. One curricular component was watching Crip Camp: A Disability Revolution and completing a 500-750-word reflective essay. Qualitative thematic analysis was used to organize essay responses. ResultsSeven major themes emerged in the students’ essays highlighting the importance of disability-focused education, the necessity of understanding the historical context and mistreatment of people with disabilities, limitations of health policies and health systems, the role of trainees and providers, and intersectionality. Themes were aligned with the socioecological model and disability consciousness to reflect healthcare delivery and education benefit, respectively. ConclusionCrip Camp: A Disability Revolution was an effective educational intervention to provide and apply knowledge in reflecting on healthcare experiences of people with disabilities. The themes have implications for health professions education and health care delivery.

Cost-effectiveness of enoxaparin versus aspirin in the prevention of venous thromboembolism after total hip or knee arthroplasty: an analysis from the CRISTAL cluster-randomized trial.

The aim of this study was to evaluate the healthcare costs and benefits of enoxaparin compared to aspirin in the prevention of symptomatic venous thromboembolism (VTE) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) using data from the CRISTAL trial. This trial-based economic analysis reports value for money as incremental cost per quality-adjusted life-year (QALY) gained in 2022 Australian dollars, compared to a single threshold value of AUD$70,000 per QALY. Event costs were estimated based on occurrence of VTEs and bleeds, and on published guidelines for treatment. Unit costs were taken from Australian sources. QALYs were estimated using CRISTAL six-month follow-up data. Sensitivity analyses are presented that vary the cost of VTE treatment, and extend the analyses to two years. The CRISTAL trial found that enoxaparin was more effective than aspirin in preventing symptomatic VTE within 90 days of THA or TKA (risk difference 1.97% (95% confidence interval (CI) 0.54% to 3.41%; p = 0.007)). The additional cost after a THA or TKA was AUD$83 (95% CI 68 to 97) for enoxaparin, and enoxaparin resulted in an additional 0.002 QALYs (95% CI -0.002 to 0.005). Incremental cost per QALY gained was AUD$50,567 (95% CI 15,513, dominated) for enoxaparin. We can be 60% confident that the incremental cost per QALY does not exceed the willingness-to-pay threshold of AUD$70,000. Increasing the cost of VTE treatment and extension of costs and consequences to two years suggested greater confidence that enoxaparin is good value for money (70% and 63% confidence, respectively). This analysis provides strong evidence that enoxaparin thromboprophylaxis following THA or TKA reduced VTEs, but weak evidence of net economic benefits over aspirin. If the value of avoiding VTEs is high, and there is a strong likelihood of VTE-related health impairments, we can be more confident that enoxaparin is cost-effective compared to aspirin.

Efektivitas Senam Ergonomik terhadap Tekanan Darah Lansia dengan Hipertensi

Movement in ergonomic exercise contains tremendous benefits in disease prevention and health care, including hypertension. The purpose of this study was to determine the effectiveness of ergonomic exercise on blood pressure in the elderly in the work area of the Tandebura Health Center, Kolaka Regency. The type of research used is quantitative research with the one group pretest-posttest design method which was carried out at the Bahteramas General Hospital in June-July 2022 involving a sample of 27 people. Sampling using simple random sampling technique. Data were analyzed using the Wilcoxon test. The results showed that before treatment (pre test) showed that the min-max value of systolic blood pressure was 120-150 mmHg with a mean±SD value of 138.52±6.767 while the min-max value of diastolic blood pressure was 80-90 mmHg. with a mean±SD value of 82.59±4.466. After being given treatment (post test), the min-max value of systolic blood pressure is 120-145 mmHg with a mean±SD value of 133.15±6.672 while the min-max value of diastolic blood pressure is 70-90 mmHg with a mean value of ± SD is 80±2.774 and there is an effect of ergonomic exercise on reducing blood pressure in the elderly with hypertension in the work area of the Tandebura Health Center, Kolaka Regency. It is recommended that the elderly often do ergonomic exercises independently.