Health Care Task Research Articles

Revisiting Drug Compliance: The Need for a Holistic Approach in the Treatment of Severe Mental Disorders.

The limited practice of depot antipsychotics and psychoeducation use, recommended for overcoming the noncompliance of patients with severe mental disorders, is linked to a high incidence of treatment violation. Therefore, the development of personalized mental healthcare approaches is a crucial healthcare task. To describe and differentiate the role of clinical, social and psychological factors that lead to different level of treatment engagement of psychiatric inpatients. Secondary analysis of findings from 91 inpatients, based on the Treatment Motivation Assessment Questionnaire and Medication Compliance Scale, as well as the Scale of Internalized Stigma of Mental Illness and Perceived Discrimination and Devaluation Scale. Factorial analysis, cluster analysis and analysis of variance with p-level=0.05 and the calculation of the effect size (ES) according to Cohen's d and Cramer's V were used. The nature of therapy compliance in various categories of patients is mediated differentially, including: the severity of negative symptoms (ES=0.29), the global level of functioning and work maladjustment (ES=0.23-0.26), various motivational and behavioral styles (ES≥0.74) and the intensity of psychiatric stigmatization (ES≥0.88). Consideration of the clinical, social and psychological factors should empirically determine the strategies for the personalized use of prolonged antipsychotics and socio-psychotherapeutic interventions when developing an individual treatment plan for psychiatric in-patients.

Multi-Agent Systems in Fog-Cloud Computing for Critical Healthcare Task Management Model (CHTM) Used for ECG Monitoring.

In the last decade, the developments in healthcare technologies have been increasing progressively in practice. Healthcare applications such as ECG monitoring, heartbeat analysis, and blood pressure control connect with external servers in a manner called cloud computing. The emerging cloud paradigm offers different models, such as fog computing and edge computing, to enhance the performances of healthcare applications with minimum end-to-end delay in the network. However, many research challenges exist in the fog-cloud enabled network for healthcare applications. Therefore, in this paper, a Critical Healthcare Task Management (CHTM) model is proposed and implemented using an ECG dataset. We design a resource scheduling model among fog nodes at the fog level. A multi-agent system is proposed to provide the complete management of the network from the edge to the cloud. The proposed model overcomes the limitations of providing interoperability, resource sharing, scheduling, and dynamic task allocation to manage critical tasks significantly. The simulation results show that our model, in comparison with the cloud, significantly reduces the network usage by 79%, the response time by 90%, the network delay by 65%, the energy consumption by 81%, and the instance cost by 80%.

Diversity of International High-Risk Clones of Acinetobacter baumannii Revealed in a Russian Multidisciplinary Medical Center during 2017–2019

Acinetobacter baumannii is a dangerous bacterial pathogen possessing the ability to persist on various surfaces, especially in clinical settings, and to rapidly acquire the resistance to a broad spectrum of antibiotics. Thus, the epidemiological surveillance of A. baumannii within a particular hospital, region, and across the world is an important healthcare task that currently usually includes performing whole-genome sequencing (WGS) of representative isolates. During the past years, the dissemination of A. baumannii across the world was mainly driven by the strains belonging to two major groups called the global clones or international clones (ICs) of high risk (IC1 and IC2). However, currently nine ICs are already considered. Although some clones were previously thought to spread in particular regions of the world, in recent years this is usually not the case. In this study, we determined five ICs, as well as three isolates not belonging to the major ICs, in one multidisciplinary medical center within the period 2017–2019. We performed WGS using both short- and long-read sequencing technologies of nine representative clinical A. baumannii isolates, which allowed us to determine the antibiotic resistance and virulence genomic determinants, reveal the CRISPR/Cas systems, and obtain the plasmid structures. The phenotypic and genotypic antibiotic resistance profiles are compared, and the possible ways of isolate and resistance spreading are discussed. We believe that the data obtained will provide a better understanding of the spreading and resistance acquisition of the ICs of A. baumannii and further stress the necessity for continuous genomic epidemiology surveillance of this problem-causing bacterial species.

A Scheduling Mechanism Based on Optimization Using IoT-Tasks Orchestration for Efficient Patient Health Monitoring.

Over the past years, numerous Internet of Things (IoT)-based healthcare systems have been developed to monitor patient health conditions, but these traditional systems do not adapt to constraints imposed by revolutionized IoT technology. IoT-based healthcare systems are considered mission-critical applications whose missing deadlines cause critical situations. For example, in patients with chronic diseases or other fatal diseases, a missed task could lead to fatalities. This study presents a smart patient health monitoring system (PHMS) based on an optimized scheduling mechanism using IoT-tasks orchestration architecture to monitor vital signs data of remote patients. The proposed smart PHMS consists of two core modules: a healthcare task scheduling based on optimization and optimization of healthcare services using a real-time IoT-based task orchestration architecture. First, an optimized time-constraint-aware scheduling mechanism using a real-time IoT-based task orchestration architecture is developed to generate autonomous healthcare tasks and effectively handle the deployment of emergent healthcare tasks. Second, an optimization module is developed to optimize the services of the e-Health industry based on objective functions. Furthermore, our study uses Libelium e-Health toolkit to monitors the physiological data of remote patients continuously. The experimental results reveal that an optimized scheduling mechanism reduces the tasks starvation by 14% and tasks failure by 17% compared to a conventional fair emergency first (FEF) scheduling mechanism. The performance analysis results demonstrate the effectiveness of the proposed system, and it suggests that the proposed solution can be an effective and sustainable solution towards monitoring patient’s vital signs data in the IoT-based e-Health domain.

Vigilance in Cardiac Telemetry Monitoring: Performance Outcomes and Effects on Operators’ Cognitive and Affective States

Healthcare represents an industry where any errors have the potential to lead to significant consequences such as unintended patient injury or death. Teams of healthcare professionals work together to complete patient care activities across several hospital environments including operating rooms, trauma centers, and care floors. While most healthcare tasks are patient-facing, some tasks such as cardiac telemetry monitoring occur without much patient interaction. Even so, cardiac telemetry monitoring represents a task where errors result in patient harm or death. The purpose of this study was to investigate the vigilance decrement using a healthcare visual search task based on cardiac telemetry monitoring. Results of this study were viewed through the lens of resource theory of vigilance. Findings from this study include a decrease in correct detections and false alarms with increased workload which supports previous vigilance decrement research as well providing directions for future research.

Policy Throughout The Pandemic

Policy Throughout The Pandemic

Towards an AI Coach to Infer Team Mental Model Alignment in Healthcare.

Shared mental models are critical to team success; however, in practice, team members may have misaligned models due to a variety of factors. In safety-critical domains (e.g., aviation, healthcare), lack of shared mental models can lead to preventable errors and harm. Towards the goal of mitigating such preventable errors, here, we present a Bayesian approach to infer misalignment in team members' mental models during complex healthcare task execution. As an exemplary application, we demonstrate our approach using two simulated team-based scenarios, derived from actual teamwork in cardiac surgery. In these simulated experiments, our approach inferred model misalignment with over 75% recall, thereby providing a building block for enabling computer-assisted interventions to augment human cognition in the operating room and improve teamwork.

Disparities in Health Care Task Participation and Provider Communication by Family Caregiver Race.

Disparities in Health Care Task Participation and Provider Communication by Family Caregiver Race.

Enhancing patient participation in healthcare operations through patient training and education using the theoretical lens of media synchronicity

AbstractThe article proposes and tests a model that examines the type of communication media (personal meetings, group classes, and written materials) that is most effective to train and educate patients how to perform two critical self‐management tasks in the treatment of diabetes. The model is based on media synchronicity theory (MST), a media selection theory. The model was tested by surveying 326 patients diagnosed with diabetes. We found that patients best mastered coproduction tasks that required conveying large amounts of information when written documents were provided. However, when coproduction tasks required comprehension of information that had multiple interpretations, patients increased their coproduction task behaviors when the training was face‐to‐face. Also, as predicted by MST, when learning the healthcare task required conveying little new information that patients could comprehend without struggling, patients trained with face‐to‐face media performed this task better. Finally, as expected, when patients increased the number of task behaviors they performed, their health outcomes improved. We discuss how these findings apply not only to healthcare operations, but also to other services that require extensive customer coproduction.

Healthcare career intervention with youth in a predominantly Latinx rural community: a pilot study of a creative approach.

The present study discusses a pilot intervention for youth in a predominantly Latinx rural community in the U.S. The intervention incorporated multimodal creative activities into the social cognitive career theory-based healthcare career program. Participants (N = 75) were assessed for healthcare career self-efficacy, outcome expectations, and interests (pre-/post-intervention). Their healthcare career task self-efficacy and interests scores significantly increased overall. By race/ethnicity groups, however, only White students reported an increase in healthcare interests, and only students of color an increase in healthcare career task self-efficacy. This provides preliminary evidence for the effectiveness of the proposed intervention. Implications for services and research are discussed.

The effects of compassion-based feedback on wellbeing ratings during a professional assessment healthcare task

BackgroundThere is a need for higher education policy to consider how student nurses might be supported to help them to develop the resilience and mental wellbeing needed to cope with stressful environments. Reviews and qualitative research in this area suggest that compassion can improve wellbeing, however, compassion-based feedback is yet to be explored as a pedagogical intervention using quantitative methods. PurposeTo explore the effect of different feedback types on subjective wellbeing. MethodsIn this experimental design, nursing students were presented with three feedback types, ‘compassion-based feedback, simple descriptive feedback, and utilitarian feedback’ and were asked to provide post-trial ratings of subjective wellbeing, in relation to each type, whilst undertaking a nursing-related task. Participants also rated the helpfulness of ‘Type of Feedback’. ResultsWe report a significant difference of ‘Type of Feedback’ with higher ratings of wellbeing when participants were presented with compassion-based feedback. ConclusionCompassion-based feedback could lead to higher wellbeing in educational tasks related to nursing.

Comparing the different viewpoints on overseas transplantation demands between genders and roles.

This study examined the different demands for overseas liver transplantation between genders and roles from the perspective of overseas liver transplant recipients and primary caregivers.An exploratory qualitative method was employed using a purposive sample of individuals who had received overseas liver transplantation. We recruited 28 recipients and 29 family members from a leading hospital in Taiwan. Face-to-face semi-structured interviews were conducted with each participant, and data were analyzed using qualitative content analysis.Three demands were identified across gender and roles: (a)sufficient information related to overseas liver transplantation,(b)domestic availability of the liver source, and(c)supportive policy for receiving continuous treatment and health insurance cover.Different patterns and meanings related to gender and roles were discussed. Male recipients were less enthusiastic about receiving the overseas liver transplantation. Rather, they complained about losing the economic and decision-making power due to body deterioration after overseas liver transplantation. Their primary need was to increase their dignity and significant position in the family. Female recipients were apprehensive for overseas liver transplantation and required more psychological support and positive experiences from other transplant recipients. Most male primary caregivers required a nursing aide quickly. Most female primary caregivers would engage in the health care task but needed more medical personnel, assistance, and high emotional support from relatives.This study revealed the common and urgent demands of overseas liver transplant recipients and primary caregivers. The unique demands of recipients and primary caregivers based on their gender and roles were rooted in the potential influences of traditional cultures and modern medicine in an ethnic-Chinese society.

Animal Welfare and Livestock Supply Chain Sustainability Under the COVID-19 Outbreak: An Overview.

The COVID-19 pandemic, caused by the emergence of a new strain of coronavirus (SARS-CoV-2) around the end of December 2019, has caused a worldwide public health emergency and a socioeconomic crisis during 2020. The lockdown imposed to cope with the health issues caused by the outbreak of the disease has dramatically challenged and negatively affected all the economic sectors of the modern global economy. Specifically, the livestock sector and its related industries are among the most impacted sectors. This is mainly ascribed to the limitations of animal movement and the decrease of production inputs' availability. Other factors negatively affecting the sustainability of the livestock sector have been the shortage of workers due to the lockdown/curfew, the strong decrease in the purchasing power of the consumer, and the intensification of health care tasks. Such an impact is not only highly relevant because of their economic consequences, but also because of the effects of the lockdown and sanitary rules on animal care and welfare. The current review aims to offer: (a) a comprehensive overview of the impact of COVID-19 on the welfare of farm animals and on the performance of livestock farming systems, on food chain sustainability, and finally, on the global economy and food security; and (b) a prospective outline of alleviation actions.

Determining best practices for manual pill crushing through evaluation of upper extremity muscle exposures

Nurses in long-term care homes often crush pills into a fine powder using a manual pill crushing device. This study provides novel quantitative data on muscle loading experienced during pill crushing. The influence of surface height, number of pills and device orientation were studied in twelve muscles of the upper extremity. Variations in the work surface height and number of pills crushed resulted in static shoulder and forearm muscle activations that exceeded recommended static limits. In most cases, working at approximately a 50th percentile female's hip height (87 cm) reduced the level of muscle activity, often to below the EMG-based exposure limit, compared to higher heights. A perpendicularly oriented device required substantially lower muscle activity in some shoulder muscles, with marginal differences occurring in muscles of the elbow and wrist. These data can inform practical design and work practice recommendations to reduce muscular activity while performing this important healthcare task.

Inpatient dermatology consultations in a tertiary care hospital in Spain: A retrospective study of 750 patients

ObjectiveMedical interconsultations are a healthcare task that is generally undervalued and understudied. The main objective of this study was to describe and analyse the interconsultations requested of dermatology departments and the aspects that are involve in resolving the interconsultations. Patients and methodsWe conducted an observational retrospective study that collected the interconsultations for patients hospitalised over a period of 36 months. We analysed variables related to the management of patients and the quality of the care. ResultsThe study included 750 patients with a mean age of 64.85 (±20.23) years. The medical departments requested the most consultations, mainly internal medicine departments (37.9 %). The most common topic for the consultations was inflammatory dermatoses (36.2 %). The most common individual diagnosis was drug rash (8.1 %). ConclusionsConsultation activities have a significant impact on the management of hospitalised patients, resulting in improved quality of care and reduced healthcare costs. These activities are also of training value for resident physicians.

Interconsultas dermatológicas en pacientes hospitalizados en un hospital terciario en España: un estudio retrospectivo de 750 pacientes

ObjectiveMedical consultations are a healthcare task that is generally undervalued and understudied. The main objective of this study was to describe and analyse the consultations requested of dermatology departments and the aspects that are involve in resolving the consultations. Patients and methodsWe conducted an observational retrospective study that collected the consultations for patients hospitalised over a period of 36 months. We analysed variables related to the management of patients and the quality of the care. ResultsThe study included 750 patients with a mean age of 64.85 (±20.23) years. The medical departments requested the most consultations, mainly internal medicine departments (37.9%). The most common topic for the consultations was inflammatory dermatoses (36.2%). The most common individual diagnosis was drug rash (8.1%). ConclusionsConsultation activities have a significant impact on the management of hospitalised patients, resulting in improved quality of care and reduced healthcare costs. These activities are also of training value for resident physicians.

Using Simulation Modeling to Inform Policy Makers for Planning Physician Workforce in Healthcare System in Croatia.

The objective of this paper is to show how a simple but powerful simulation model can be build up using standard spreadsheet program and used to simulate future, needs and supply of physicians in order to inform policy makers at national level when deciding on enrollment to medical schools and immigration quotas for physicians. The Republic of Croatia is facing a serious shortage of physicians in the healthcare system and simulation results have shown that the gap between needs and supply will even increase if current enrollment qoutas to medical schools would persist. Increasing enrollment quotas, adjusting immigration policy, re-directing physicians from other professions to the healthcare system, task shift and skill mix options are just some of the measures needed to be taken promptly in order to prevent a huge deficit of physicians in the future. Simulation modeling is certainly a method for predicting changes within healthcare systems with a possibility to examine multiple different scenarios and suggest interventions.

Measuring caregiver activation to identify coaching and support needs: Extending MYLOH to advanced chronic illness.

IntroductionFamily and friends of seriously ill patients are key partners in providing support and health care at home, managing relationships with clinicians, and navigating complex health care systems. Becoming a knowledgeable, confident, and effective caregiver is a developmental process we term 'caregiver activation' and could be facilitated by clinicians equipped with suitable tools. Managing Your Loved One’s Health (MYLOH) is a new tool to identify gaps in caregivers' knowledge, skills, and access to clinical and personal support. Created in partnership with caregivers and clinicians, MYLOH items reflect the essential dimensions of caregiving and can be used to tailor caregiver coaching to domains of greatest need. In this study, we extend MYLOH's initial focus on dementia care to caregivers of patients with other chronic life-limiting illnesses.MethodsMYLOH was completed by primary caregivers (n = 190) of people with a range of advanced chronic illnesses enrolled in the LifeCourse study, an innovative, whole-person approach to health management. Item relevance and responses were compared by group across MYLOH items and domains using z-tests for equality of proportions.ResultsAll MYLOH items were relevant to caregiving for all types of chronic illness; only 13% of caregivers answered “not my responsibility” to any question. MYLOH identified caregiving struggles across patient diagnosis groups with a few, disease-specific ‘hotspots’. Overall, 64% of caregivers scored low in activation on at least one healthcare management task, especially getting enough help with caregiving, managing everyday caregiving tasks, understanding/managing medications, and knowing how to respond to rapid changes in care recipients' health status. No difficulty was unique to a specific type of care recipient illness.ConclusionsMYLOH has potential as a tool for identifying caregiver coaching and support needs in managing a range of serious chronic illnesses. Caregiving difficulties endorsed by over 20% of caregivers should be core components of chronic illness management programs regardless of disease focus, with disease-specific tailoring as required. MYLOH may be useful in evaluating caregiver interventions and health systems’ performance in integrating caregivers into the care management of patients with complex life-limiting illness.

Task Shifting on Provision of Contraceptives and Abortion Services in Maternal and Reproductive Health in Sub-Saharan Africa to achieve Universal Health Coverage: A Narrative Review

Introduction: Improving maternal and reproductive health is a target for Sustainable Development Goals 3. Accessibility to contraceptives and abortion services is important in improving maternal and reproductive health. In 2014 in sub-Saharan Africa, over 40% of women aged 15-49 years wanted to avoid pregnancy but only 50% or 55 million of these could access contraceptives. Shortage of skilled health workers, which is worse in Africa, has been associated with these challenges. Universal Health Coverage (UHC) is a target for world nations. To achieve UHC adequate skilled healthcare workers is one key factor needed. In 2013, globally, this shortage was 7.2 million and projected to be 12.9 million by 2035. Task shifting has been thought as a possible solution to this shortage. Therefore, the objective of this review is to establish the outcome of task shifting in the provision of contraceptives and abortion services in sub-Saharan Africa. Methods: A systematic approach was adopted. Medline, PsycINFO, EBM Reviews databases were searched. Google scholar and hand searching bibliographies of retrieved studies were also done. A quality appraisal using Mixed Method Appraisal Tool was done. Data were extracted using a customized form and themes identified. A narrative synthesis of the results was reported. Results: A total of 319 records were retrieved and a set inclusion and exclusion criteria eleven studies were included in the final analysis. The quality of studies was poor as only one random control trial was retrieved limiting the quality of the evidence. Results suggest that task shifting may be a safe and effective method inimproving contraceptives and abortion service accessibility in sub-Saharan Africa. Conclusion: To cover healthcare staff shortages task shifting of contraceptive and abortion services can be considered in healthcare practices and included national human resource policies. Further research is required to cover gaps in long-term outcome these services.

An Exploratory Study of the Knowledge and Practices of Family Caregivers in the Care of the Elderly at Home in the Buea Health District, Cameroon

Background: Family members in Cameroon care for older relatives with little or no education on this role and no support from health care workers. Aim: To explore the knowledge and practices of family caregivers of older adults, in order to design a health education program that can assist them in their caregiving role. Methods: A cross-sectional community-based study design was employed, with a structured questionnaire administered to 126 primary family caregivers from 21 communities in the Buea Health District. Data was analysed using descriptive and inferential statistics. Results: Most participants had knowledge of common problems of the elderly like joint pains (95.2%) and difficulty walking (95.2%), but a good number did not know about complex problems like bowel (33.1%) and urinary (31%) incontinence as well as elderly care resources within their communities (88.1%). Regarding their practices, they mostly reported assisting older relatives with activities of daily living. However, a few of these relatives also reported engaging in the practice of some highly skilled healthcare task like providing their elderly relatives with automedications (14.3%). Conclusion: The knowledge and practices of family caregivers in the care of older relatives is generally poor and demands that training programs to enhance their care giving skills be developed. Centres that supports elderly care should create more awareness in the population about their existence and service provision.