Individual Health Characteristics Research Articles

Patients with Osteoporotic Vertebral Fractures in Denmark 2010-2018: A National Registry Analysis.

Register-based cohort study based on linked data from multiple national registries. To describe the sociodemographic and health characteristics of individuals in Denmark with osteoporotic vertebral fractures (OVF) and analyze time trends. The study compares labor market participation and comorbidities between OVF patients and a matched control group without these fractures. The incidence and characteristics of OVF patients in Denmark are not well-documented. Multiple national health and economic registries enable linking of individual patient data, providing new insights. We identified individuals with hospital-diagnosed vertebral compression fractures from 2010 to 2018 using the Danish National Patient Register. A control group was matched by sex, age, and municipality. Work status prior to OVF was categorized as employed, on paid sickness benefit, in early retirement, or on old-age pension. Comorbidities were analyzed based on hospital diagnoses within 10 years prior to the fracture. During 2010 to 2018, 20.262 individuals had a hospital contact with an OVF. Sixty-four percent were women and the mean age was 73.6 (SD 12.4) years. OVF incidence increased from 86 in 2010 to 142 per 100,000 persons in 2018. In 2018, the regional incidence ranged from 120 to 154 per 100,000. More than a fifth of the patients were working prior to the fracture, while 77% were in early retirement or old-age pension. The population with OVF had more comorbidities than the matched comparison group. The incidence of hospital-diagnosed OVFs has risen over the last decade, with regional differences. Notably, over 20% of OVF patients were still employed, highlighting the socioeconomic impact of this condition.

Trend in incidence (2005–2022) and medical and social problems in 15–17 years adolescents

Introduction. The analysis of the incidence in adolescents (15–17 years old inclusive) showed its significant increase during the first two decades of the XXI century. The prevalence of borderline mental disorders among adolescents and cases with deviant behaviour, unhealthy lifestyle, conflict and difficult life situations are increasing. Adolescents and young people need comprehensive medical care, managed with taking into account age-related psychological and social characteristics. The purpose of the study is to analyze the trend in health indicators of older adolescents, social problems affecting the development of their health and education, and scientific substantiation of the main directions and principles of managing medical care and social assistance to adolescents and youth. Materials and methods. According to official statistics, a comparative analysis of the incidence in 0–14 years children and 15–17 years adolescents for the period 2005–2022 was carried out by the main classes of somatic pathology and mental disorders. According to scientific literature, basic information about the medical and social problems in adolescents and 15–25 years youth has been systematized. Results. Analysis of the incidence in adolescents showed its growth and revealed classes of diseases for which the rates of adolescents are higher than in children. This allows determining the main directions of treatment and preventive work. The main medical and social problems of adolescents include: health risks caused by educational factors; unhealthy lifestyle; destructive forms of behaviour; early sexual activity; early employment; professional choice that does not correspond to individual health characteristics. Limitations. The considered medical and social problems are characteristic of older adolescents (15–17 years old inclusive) and young people. Conclusion. Due to the high incidence and unfavourable course of pathologies, psychological characteristics, and the significant prevalence of medical-social problems in adolescence and young people, it is advisable to create medical-social centers for adolescents and youth on the basis of medical institutions in the country.

A Managerial Approach towards Modeling the Different Strains of the COVID-19 Virus Based on the Spatial GeoCity Model.

This study proposes a modification of the GeoCity model previously developed by the authors, detailing the age structure of the population, personal schedule on weekdays and working days, and individual health characteristics of the agents. This made it possible to build a more realistic model of the functioning of the city and its residents. The developed model made it possible to simulate the spread of three types of strain of the COVID-19 virus, and to analyze the adequacy of this model in the case of unhindered spread of the virus among city residents. Calculations based on the proposed model show that SARS-CoV 2 spreads mainly from contacts in workplaces and transport, and schoolchildren and preschool children are the recipients, not the initiators of the epidemic. The simulations showed that fluctuations in the dynamics of various indicators of the spread of SARS-CoV 2 were associated with the difference in the daily schedule on weekdays and weekends. The results of the calculations showed that the daily schedules of people strongly influence the spread of SARS-CoV 2. Under assumptions of the model, the results show that for the more contagious "rapid" strains of SARS-CoV 2 (omicron), immunocompetent people become a significant source of infection. For the less contagious "slow strains" (alpha) of SARS-CoV 2, the most active source of infection is immunocompromised individuals (pregnant women). The more contagious, or "fast" strain of the SARS-CoV 2 virus (omicron), spreads faster in public transport. For less contagious, or "slow" strains of the virus (alpha), the greatest infection occurs due to work and educational contacts.

Prediction and Early Diagnosis of Bronchial Asthma in Workers Specializing in Argon Welding Based on Fuzzy Mathematical Models

The purpose of research is to develop fuzzy mathematical models for predicting and early diagnosis of bronchial asthma developing under the influence of toxic substances released during argon welding providing an acceptable quality of decision-making for practical medicine Methods. The paper uses the method of synthesis of fuzzy mathematical models of forecasting and early diagnosis of occupational diseases provoked by the action of industrial pesticides developed in the South-Eastern Federal University on the basis of the methodology of synthesis of hybrid fuzzy decision rules allowing to take into account the multiplicative nature of the links between the risk of occurrence and development of occupational diseases with the concentration and time of exposure to harmful chemicals. Results. Using the chosen method, fuzzy hybrid models of forecasting and early diagnosis of industrial bronchial asthma in welding workers were obtained in which, in addition to the effects of ozone, dust and fibrogenic risk factors on the human body, unfavorable environmental and ergonomic factors combined with individual health characteristics are taken into account. In the course of modeling and expert evaluation, it was shown that the obtained mathematical model provides confidence in the correct prognosis of the occurrence of industrial bronchial asthma in welding workers at least 0.85, and early diagnosis at least 0.9. Conclusion. Hybrid fuzzy models of forecasting and early diagnosis of industrial bronchial asthma in welding workers caused by the presence of ozone and fibrogenic dust in combination with individual, environmental and ergonomic risk factors were obtained, the quality of which was tested on representative control samples. During the control check, it was shown that the prognostic model provides diagnostic specificity and sensitivity at the level of 0.87, and the early diagnosis model - at the level of 0.92, which is a good result for the class of tasks under consideration.

Ansiedade na Pandemia de COVID-19 no Brasil: Um Estudo Longitudinal

Objective: To measure the prevalence of anxiety longitudinally at two time points during the COVID-19 pandemic, as well as the associated factors. Method: A longitudinal observational study was conducted with 485 participants brazilians through a online questionnaire. Sociodemographic characteristics, individual health characteristics, stress, and anxiety were assessed using Chi-Square tests (to investigate the relationship between categorical variables and the outcome), Student's t-tests (to analyze the relationship between numerical variables and the outcome), and the Mann-Whitney test for the income variable.. Descriptive analysis was performed using means, standard deviation, and prevalence. Results: During the first data collection period (T1), 20.6% of respondents had clinically relevant anxiety, while in the second data collection period, 22.7% of participants had clinically significant anxiety. Among the analyzed periods, 15.6% of participants who did not have anxiety in the first data collection developed clinically significant anxiety in the second period, and 50% of those who were anxious in the first moment did not have clinically significant anxiety in the final period. It was possible to identify significant associations between the incidence of anxiety and being up to 24 years old, lower education level, high levels of fear of COVID-19, low physical activity, high levels of stress, and lower family income. At the same time, significant associations were observed between the incidence of recovery and higher education level, not having lost family members to COVID-19, lower levels of stress, and higher family income. Conclusion: Despite the high prevalence of anxious symptomatology among Brazilians, sociodemographic and behavioral factors could be identified as risk and protective factors for the development of clinically significant anxious symptomatology. Keywords: Pandemics, COVID-19, anxiety, mental health.

Identification of Health Characteristics of People with Physical Disability by Applying the PRECEDE Model.

This study aimed to diagnose the health characteristics of people with grade 1-4 physical disability (but without intellectual disability) by analyzing factors affecting their health through social, epidemiological, behavioral, and ecological diagnoses by partially applying the PRECEDE model. Those registered with physical disability in 2022 and attending a welfare center were selected, with samples extracted from Seoul, Gyeonggi-do, Chungcheong-do, Jeolla-do, and Gyeongsang-do. A total of 1200 people were selected, and the data of 1000 people were finally analyzed. A frequency analysis was performed to identify the participants' characteristics. An independent t-test and one-way analysis of variance were performed to verify the hypotheses. To clarify the relationship between each variable, normality verification, confirmatory factor analysis, and structural equation model analysis were performed. First, the differences in factors influencing health promotion according to personal background variables (gender, age, and income level), including quality of life, showed partial differences according to age and income level. Second, according to disability-related variables (time of onset and disability grade), quality of life and health status showed partial differences. These results can be used as basic data or indicators to build a health promotion system that considers the health characteristics of individuals with a physical disability.

Worsened outcomes of newly diagnosed cancer in patients with recent emergency care visits: A retrospective cohort study of 3699 adults in a safety net health system.

Many patients receive a suspected diagnosis of cancer through an emergency department (ED) visit. Time to treatment for a new diagnosis of cancer is directly associated with improved outcomes with little no describing the ED utilization prior to the diagnosis of cancer. We hypothesize that patients that have an ED visit in proximity to a diagnosis of cancer will have worse outcomes, including mortality. This study is a retrospective cohort study of all patients with cancer diagnosed at Eskenazi Health (Indiana) between 2016 and 2019. Individual health characteristics, ED utilization, cancer types, and mortality were studied. We compared those patients seen in the ED within 6months prior to their diagnosis (cases) to patients not seen in the ED (controls). A total of 3699 patients with cancer were included, with 1239 cases (33.50%). Patients of black race had higher frequencies in the cases vs. controls (46.57% vs. 40.68%). Lung cancer was the most frequently observed cancer among cases vs. controls (11.70% vs. 5.57%). For the cases, 232 patients were deceased (18.72%) compared with 247 patients among the controls (10.04%, p< 0.0001, OR 2.06 95% confidence interval [CI] 1.70-2.51). An ED visit in past 6months (OR=1.73, 95% CI 1.38-2.18) and Medicaid insurance type (versus commercial, OR=4.16, 95% CI 2.45-7.07) were associated with of mortality. Female gender (OR=0.76, 95% CI 0.67-0.88), tobacco use (OR=1.62, 95% CI 138-1.90), and Medicaid insurance type (versus commercial, OR=2.56, 95% CI 2.07-3.47) were associated with prior ED use. Over one third of patients with cancer were seen in the ED within 6months prior to their cancer diagnosis. Higher mortality rates were observed for those seen in the ED. Future studies are needed to investigate the association and impact that the ED has on eventual cancer diagnoses and outcomes.

Improving predictive performance in incident heart failure using machine learning and multi-center data.

To mitigate the burden associated with heart failure (HF), primary prevention is of the utmost importance. To improve early risk stratification, advanced computational methods such as machine learning (ML) capturing complex individual patterns in large data might be necessary. Therefore, we compared the predictive performance of incident HF risk models in terms of (a) flexible ML models and linear models and (b) models trained on a single cohort (single-center) and on multiple heterogeneous cohorts (multi-center). In our analysis, we used the meta-data consisting of 30,354 individuals from 6 cohorts. During a median follow-up of 5.40 years, 1,068 individuals experienced a non-fatal HF event. We evaluated the predictive performance of survival gradient boosting (SGB), CoxNet, the PCP-HF risk score, and a stacking method. Predictions were obtained iteratively, in each iteration one cohort serving as an external test set and either one or all remaining cohorts as a training set (single- or multi-center, respectively). Overall, multi-center models systematically outperformed single-center models. Further, c-index in the pooled population was higher in SGB (0.735) than in CoxNet (0.694). In the precision-recall (PR) analysis for predicting 10-year HF risk, the stacking method, combining the SGB, CoxNet, Gaussian mixture and PCP-HF models, outperformed other models with PR/AUC 0.804, while PCP-HF achieved only 0.551. With a greater number and variety of training cohorts, the model learns a wider range of specific individual health characteristics. Flexible ML algorithms can be used to capture these diverse distributions and produce more precise prediction models.

PREDICTIVE PERFORMANCE OF MACHINE LEARNING MODELS FOR DETECTION OF INCIDENT HEART FAILURE USING MULTI-CENTRE DATA

Objective: To mitigate the health and economic burden associated with heart failure (HF), primary prevention is of utmost importance. To effectively address the diverse range of individual health profiles, prediction models must be trained and validated on a wide range of population-based cohorts. We evaluated the predictive performance of Survival Gradient Boosting (SGB) and Coxnet (CN) for the detection of incident HF. In addition, we compared the models’ performance trained only on a single-centre cohort with those trained on diverse multi-centre cohorts. Design and method: We utilized 6 cohorts from the Heart ‘omics’ in AGEing (HOMAGE) project to evaluate two computational approaches. The dataset consists of 31,382 individuals (mean age 66 ± 10 years old), free of HF at the baseline. During a median follow-up of 5.36 years, 1,130 non-fatal HF events occurred. SGB is a non-linear machine learning method based on training regression trees with the objective of optimizing Cox partial likelihood. Coxnet is a standard linear Cox proportional hazard model, regularized by both L1 and L2 norms. To estimate the predictive accuracy of a single-centre model on a specific test cohort, we averaged the performance of single models trained on remaining cohorts one at a time. To develop models in multi-centre settings, we used 5 cohorts in every iteration as a training set and the remaining 1 cohort as a test set. We used 33 features, including clinical, ECG, and biochemical data. Results: Overall, multi-centre models achieved a higher c-index than those trained on single cohorts (Figure). For example, in the FLEMENGHO cohort, multi-centre SGB achieved 0.819, while only 0.664 in a single-centre setting. Additionally, non-linear SGB achieved a considerably higher c-index than linear CN in all but one cohort, especially in multi-centre settings, for example in the HVC cohort (SGB 0.689, CN 0.614). Conclusions: With a greater number and variety of training cohorts, the model learns a wider range of specific individual health characteristics. Flexible machine learning algorithms such as gradient boosting can be used to capture these diverse distributions and produce more precise, personalized models for the prediction of adverse events.

Motivation to Learn and Multilingualism across the Adult Life Stages in the U.S.

Lifelong learning or continuing education over the life course has become necessary to navigate a rapidly changing technological landscape. Motivation to learn (MtL) is essential for facilitating lifelong learning. In the U.S., most of the educational opportunities are available in English. Moreover, little is known about associations between being multilingual and MtL across the life stages. This study analyzed nationally representative data from the 2012/2014/2017 Program for International Assessment of Adult Competencies (PIAAC) restricted use file (RUF). Using a previously established latent MtL construct, structural equation models were estimated by four age groups --- 25-34 (n = 2,310); 35-44 (n = 1,610); 45-54 (n = 1,670); and 55 and older (n = 2,620). Results showed that being multilingual was associated with greater MtL among younger age groups, including age 25-34 (b = 0.20, p = 0.01) and 35-44 (b = 0.28, p < 0.001), after adjusting for the demographic, socioeconomic and health characteristics of individuals. Multilingualism was not associated with MtL among older age groups, including 45-54 (b = 0.06, p = 0.50) and 55 and older (b = 0.13, p = 0.19). Findings suggest that education policies that target younger multilingual adults are likely to be effective while enhancing MtL of monolingual (i.e., English-speaking only) adults seems to be a necessary first step. Yet, a similar approach may not be effective for older adults, arguably due to more diverse life circumstances, educational needs, and learning style preferences. More detailed interpretations of empirical results and theoretical explanations are needed.

Examining the Relationship Between Community Integration and Mental Health Characteristics of Individuals With Childhood Acquired Neurological Disability.

Background: Many individuals with cerebral palsy (CP) or acquired brain injury (ABI) are at higher risk of lowered psychosocial functioning, poor mental health outcomes and decreased opportunities for community integration (CI) as they transition to adulthood. It is imperative to understand the characteristics of those at highest risk of dysfunction so that targeted interventions can be developed to reduce the impact.Methods: This quantitative, cross-sectional study examines current patients of the Living Independently Fully Engaged [(LIFEspan) Service], a tertiary outpatient hospital-based clinic. The Patient Health Questionnaire-4 (PHQ-4) and the Community Integration Questionnaire (CIQ) were administered to participants. Personal health information was also collected from participants' health charts, and participant interviews. Associations of sex and condition with the outcomes of screening for further assessment of depression, screening for further assessment of anxiety, and CI were calculated using t-tests and Chi-square tests.Results: 285 participants completed standardized screening tools for depression and anxiety (PHQ-4) and 283 completed the Community Integration Questionnaire (CIQ). Mean age was 23.4 (4.2) years; 59% were diagnosed with CP, 41% diagnosed with ABI, and 56% were male. A moderate proportion of the sample screened positive for further assessment of anxiety (28%) and depression (16%), and the overall mean score on the CIQ for the sample was 15.8 (SD 5.1). Participants that screened positive for further assessment of depression and anxiety on the PHQ-4 had lower scores on the Social Integration subscale of the CIQ (p = 0.04 and p = 0.036, respectively). Females were found to have significantly higher community integration than males (p = 0.0011) and those diagnosed with ABI were found to have significantly higher community integration than those with CP (p = 0.009), respectively. A weak negative association was found between age for the total sample and overall PHQ-4 score (p = 0.0417). Presence of an intellectual or learning disability/challenge was associated with a lower CIQ score (p = 0.0026).Conclusions: This current study, highlights the need for further research to explore the unique needs and barriers faced by this population. This study may inform assessments and interventions to support the mental health and community integration of this population.

Greater Risk of Negative Health Outcomes of Older Adults Living Alone in Vietnam: A Community Survey.

In modern Asian societies, there has been a shift in the living arrangements of older adults away from living with others. Knowing the health characteristics of individuals living alone can help identify high-risk groups. This cross-sectional study aimed to describe characteristics of the Vietnamese older adults and to investigate the association between living alone and their reported health outcomes by utilizing survey data of individuals aged ≥60 years in Vietnam in 2018. The community survey included questions about sociodemographic factors, living arrangement, and self-reported physical functional status. Multivariate logistic regression was used to examine whether or not living alone was a predictor of health outcomes. Of 725 study participants, 8.9% lived alone. These participants were more likely to be female, aged 70–79 years, living in rural areas, and currently single or previously married. After adjusting for covariates, older adults who were living alone were more likely to have arthritis (adjusted odds ratio [AOR] = 1.95, 95% confidence interval [CI]: 1.10–3.45), a history of falling (AOR = 2.44, 95% CI: 1.02–5.82), visual difficulties (AOR = 1.89, 95% CI: 1.04–3.41), feelings of loneliness (AOR = 1.95, 95% CI: 1.10–3.47), and high fear of falling (AOR = 1.88, 95% CI: 1.02–3.46). Older adults living alone in Vietnam were at greater risk of negative health consequences than those living with others. Screening and providing adequate social support for this specific population is important in preventing the adverse effects of solitary living among these older adults.

Double jeopardy from the COVID-19 pandemic: risk of exposure and income loss in Portugal

BackgroundIncreasing evidence indicates that the first wave of the COVID-19 pandemic had immediate health and social impact, disproportionately affecting certain socioeconomic groups. Assessing inequalities in risk of exposure and in adversities faced during the pandemic is critical to inform targeted actions that effectively prevent disproportionate spread and reduce social and health inequities. This study examines i) the socioeconomic and mental health characteristics of individuals working in the workplace, thus at increased risk of COVID-19 exposure, and ii) individual income losses resulting from the pandemic across socioeconomic subgroups of a working population, during the first confinement in Portugal.MethodsThis study uses data from ‘COVID-19 Barometer: Social Opinion’, a community-based online survey in Portugal. The sample for analysis comprised n = 129,078 workers. Logistic regressions were performed to estimate the adjusted odds ratios (AOR) of factors associated with working in the workplace during the confinement period and with having lost income due to the pandemic.ResultsOver a third of the participants reported working in the workplace during the first confinement. This was more likely among those with lower income [AOR = 2.93 (2.64-3.25)], lower education [AOR = 3.17 (3.04-3.30)] and working as employee [AOR = 1.09 (1.04-1.15)]. Working in the workplace was positively associated with frequent feelings of agitation, anxiety or sadness [AOR = 1.14 (1.09-1.20)] and perception of high risk of infection [AOR = 11.06 (10.53-11.61)]. About 43% of the respondents reported having lost income due to the pandemic. The economic consequences affected greatly the groups at increased risk of COVID-19 exposure, namely those with lower education [AOR = 1.36 (1.19-1.56)] and lower income [AOR = 3.13 (2.47-3.96)].ConclusionsThe social gradient in risk of exposure and in economic impact of the pandemic can result in an accumulated vulnerability for socioeconomic deprived populations. The COVID-19 pandemic seems to have a double effect in these groups, contributing to heightened disparities and poor health outcomes, including in mental health. Protecting the most vulnerable populations is key to prevent the spread of the disease and mitigate the deepening of social and health disparities. Action is needed to develop policies and more extensive measures for reducing disproportionate experiences of adversity from the COVID-19 pandemic among most vulnerable populations.

Perceived Access to Handguns Among Colorado High School Students.

Access to firearms among youth can increase the risk of suicide or other injury. In this study, we sought to estimate the population prevalence of adolescent perception of firearm access by demographic, geographic, and other individual health characteristics. The 2019 Healthy Kids Colorado Survey was an anonymous survey administered to a representative sample of high school students in Colorado. The survey was used to assess health behaviors and risk and protective factors. Analysis was conducted with weights to the state population of public high school students. In total, 46 537 high school students responded (71% student response rate; 83% school response rate). One in 5 students said it was "sort of easy" (11.1%) or "very easy" (8.8%) to access a handgun, with higher prevalence among male and older-aged youth and differences in racial and/or ethnicity groups. There were geographic differences such that students in schools in more rural areas were more likely to report perceived easy access. Students who had felt sad or hopeless, attempted suicide, or been in a fight were more likely to say they had access to a handgun. A relatively high proportion of youth have easy access to a firearm, with differences across age, sex, race and/or ethnicity, and geography. This highlights the need for efforts to address ways to reduce firearm access for youth, including secure storage at home, for the prevention of youth firearm suicide and other firearm injuries.

Estimating disability prevalence and disability-related inequalities: Does the choice of measure matter?

Different measures for quantifying the percentage of people with a disability in surveys result in diverging estimates of prevalence and disability-related inequalities. Thus understanding the implications of using different disability measures is of vital policy importance. This study is the first to investigate the within-survey variation in disability prevalence based on two internationally recognized measures: the Washington Group Short Set (WGSS) and the Global Activity Limitation Indicator (GALI). It is also the first to examine the disability-related inequality in voter turnout, based on official validated voter records. We use data on 11,308 25-54-year-old respondents from the 2016 wave of the Survey of Health, Impairment and Living Conditions in Denmark (SHILD) to estimate the disability prevalence based on the WGSS and the GALI. Moreover, we investigate health characteristics of individuals with a disability according to the two measures and inequalities in two central social policy success parameters: voter turnout and employment. The WGSS estimates higher disability prevalence (10.6%) than the GALI (5.5%). Only 2.5% of the sample are in both groups, implying that largely, different individuals are defined as having a disability depending on which measure is used. The health profiles of the two groups also differ, as people with a GALI-defined disability are significantly more likely to report a severe mental illness or a major physical health problem. The GALI estimates indicate larger inequalities between people with and without a disability than the WGSS for the probability of being employed, whereas there are no significant differences for voter turnout. The choice of disability measure strongly influences within-survey estimates of disability prevalence, the health profile of the defined groups, and inequalities in outcomes. The WGSS underrepresents the number of people suffering from severe mental illness. Estimated inequalities in employment are larger for the GALI than for the WGSS.

Health Needs and Functional Disability Among Mail-Order Pharmacy Users in the US

This cross-sectional study examines the health characteristics of individuals who use mail-order pharmacies.

Obesity incidence is related to month of birth

Objective: The relationship between the month of birth and obesity status of individuals has been claimed but not proven convincingly. We aim to provide more evidence towards the presumed relationship between month of birth and physical characteristics of individuals. Materials and Methods: We used a Bio-impedance device to determine physical characteristics of 3,000 informed volunteers who attended our clinic. Results: We found that the individuals who were born in the first three months of the year were heavier, taller and older than the applicants who were born in later months of the year. Conclusion: We can conclude that the month of birth was significantly related to obesity incidence. We believe that this information will add to the knowledge on the importance of the relationship between birth month and physical and health characteristics of individuals living in a country with extreme seasonal temperatures.

Domain ontology development of knowledge base in cardiovascular personalized health management

In China, cardiovascular disease has become the leading killer in recent years, and mortality from cardiovascular disease is continuing to rapidly increase. Extant medical research has proven that personal health management (prevention, intervention, and recuperation) of chronic diseases, such as cardiovascular diseases, is the best strategy for their prevention and treatment. Currently, the public can obtain health management knowledge through the Internet, newspapers, books, and other channels. However, with the explosive growth of available information, the public is limited to obtain effective health management guidance due to the characteristics of multiple sources, uneven accuracy (even some contradictory knowledge) and a major paucity of personalization, especially for the general public who lack professional medical knowledge. To address these problems, this paper proposes a knowledge base framework (i.e. domain ontology library) of health management programs based on the cardiovascular disease domain, which can standardize knowledge of health management programs both logically and structurally. In order to satisfy the needs of personalized health management, the core ontology of the domain ontology library is health-management-program ontology. In addition to common ontologies (e.g. disease ontology, drug ontology, etc.), basic ontologies include the ontology of individual health characteristics (e.g. individual-health-characteristics and environmental-characteristics ontology), and ontologies comprising diet and sport (e.g. ingredients, recipes, physical exercise, etc.). We then construct the ontology library through the professional ontology tool, Protégé. With a case study, we translate a piece of text health management knowledge into instances of an ontology library. At the same time, we present a personalized health management program recommendation algorithm based on the ontology library, and a recommendation case is realized according to this algorithm. As a basic research, the results of this paper can also support other health management applications in the future.

Mobile health service adoption in China

Purpose Mobile health service (MHS) can provide users with convenient health services and information to reduce their medical costs from aging or other health issues. Previous studies confirm the underdevelopment of the Chinese MHS. The purpose of this paper is to analyze the factors that affect the intention to use MHS. Design/methodology/approach This paper develops a research model that integrates personal health differences with theory of planned behavior (TPB) and protection motivation theory (PMT). This model is empirically tested using data from 494 valid questionnaires. Structural equation modeling is used to test the hypotheses. Findings Perceived vulnerability to disease, perceived severity of disease, response efficacy and self-efficacy positively affect attitude, thereby exerting a positive influence on the behavioral intention to use MHS. Subjective norms also influence users’ behavioral intention. Personal health status and personal health value have quasi-moderating effects on the relationship between attitude and behavioral intention. Originality/value This paper presents an early attempt to conceptualize and validate a research model of MHS acceptance by integrating TPB and PMT in a complementary manner. The integrated model provides a holistic view of people’s intention to use MHS by considering health threat beliefs, individual role (i.e. attitude and self-efficacy) and social influences (i.e. subjective norms). Furthermore, this research highlights the role of two individual health characteristics (i.e. personal health status and personal health value) in MHS adoption. These new findings are beneficial toward an in-depth understanding of technology adoption in the MHS context.

Selecting, refining and identifying priority Cochrane Reviews in health communication and participation in partnership with consumers and other stakeholders

BackgroundPriority-setting partnerships between researchers and stakeholders (meaning consumers, health professionals and health decision-makers) may improve research relevance and value. The Cochrane Consumers and Communication Group (CCCG) publishes systematic reviews in ‘health communication and participation’, which includes concepts such as shared decision-making, patient-centred care and health literacy. We aimed to select and refine priority topics for systematic reviews in health communication and participation, and use these to identify five priority CCCG Cochrane Reviews.MethodsTwenty-eight participants (14 consumers, 14 health professionals/decision-makers) attended a 1-day workshop in Australia. Using large-group activities and voting, participants discussed, revised and then selected 12 priority topics from a list of 21 previously identified topics. In mixed small groups, participants refined these topics, exploring underlying problems, who they affect and potential solutions. Thematic analysis identified cross-cutting themes, in addition to key populations and potential interventions for future Cochrane Reviews. We mapped these against CCCG’s existing review portfolio to identify five priority reviews.ResultsPriority topics included poor understanding and implementation of patient-centred care by health services, the fact that health information can be a low priority for health professionals, communication and coordination breakdowns in health services, and inadequate consumer involvement in health service design. The four themes underpinning the topics were culture and organisational structures, health professional attitudes and assumptions, inconsistent experiences of care, and lack of shared understanding in the sector. Key populations for future reviews were described in terms of social health characteristics (e.g. people from indigenous or culturally and linguistically diverse backgrounds, elderly people, and people experiencing socioeconomic disadvantage) more than individual health characteristics. Potential interventions included health professional education, interventions to change health service/health professional culture and attitudes, and health service policies and standards. The resulting five priority Cochrane Reviews identified were improving end-of-life care communication, patient/family involvement in patient safety, improving future doctors’ communication skills, consumer engagement strategies, and promoting patient-centred care.ConclusionsStakeholders identified priority topics for systematic reviews associated with structural and cultural challenges underlying health communication and participation, and were concerned that issues of equity be addressed. Priority-setting with stakeholders presents opportunities and challenges for review producers.