Health Management Research Articles

Three-Dimensional DNA Hydrogel Mediated Dual-Mode Sensing Method for Quantification of Epithelial Cell Adhesion Molecule in Biological Fluid Samples.

Monitoring changes in the expression of marker proteins in biological fluids is essential for biomarker-based disease diagnosis. Epithelial cell adhesion molecule (EpCAM) has been identified as a broad-spectrum biomarker for various chronic diseases and as a therapeutic target. However, the development of simple and reliable methods for quantifying EpCAM changes in biological fluids faces challenges due to the variability of its expression across different diseases, the presence of soluble forms, and matrix effects. In this paper, a surface-enhanced Raman scattering (SERS)-fluorescence (FL) dual-mode sensing method was established for quantification of trace EpCAM in biological fluids based on bimetallic Au@Ag nanoparticles and nitrogen-doped quantum dots encapsulated DNA hydrogel hybrid with graphene oxide (Au@Ag-NQDs/GO). The DNA hydrogel was constructed based on three-dimensional (3D) structure DNA-mediated strategy using an aptamer DNA (AptDNA) linker. The interaction of the AptDNA with EpCAM triggered the disassembly of the DNA hydrogel. Consequently, the release of Au@Ag nanoparticles induced an "on-off" switch in the SERS signal while the weakened FL quenching effect in Au@Ag-NQDs/GO system achieved "off-on" switch of FL signal, enabling the simultaneous SERS-FL quantification of EpCAM. The established dual-mode method exhibited outstanding sensitivity and stability in quantifying EpCAM in the range of 0.5-60.0 pg/mL, with the limits of detection (LODs) of SERS and FL as 0.17 and 0.35 pg/mL, respectively. When applied for real sample analysis, the method showed satisfactory specificity and recoveries in cancer cells lysate, serum, and urine samples with RSDs of 2.8-6.3%, 4.0-6.3%, and 2.8-5.7%, respectively. The developed SERS-FL sensing method offered a sensitive, reliable, and practical quantification strategy for trace EpCAM in diverse biological fluid samples, which would benefit the early diagnosis of disease and further health management.

Intelligent Diagnosis Method for Typical Co-frequency Vibration Faults of Rotating Machinery Based on SAE and Ensembled ResNet-SVM

Intelligent fault diagnosis is an important method in rotating machinery fault diagnosis and equipment health management. To deal with co-frequency vibration faults, a type of typical fault in rotating machinery, this paper proposes a fault diagnosis method based on the stacked autoencoder (SAE) and ensembled ResNet-SVM. Furthermore, the time- and frequency-domain features of several co-frequency vibration faults are summarized based on the mechanism analysis and calculated using actual vibration data. To realize and validate the high-precision diagnosis method of rotating equipment with co-frequency faults proposed in this study, the following three criteria are required: First, to improve the effectiveness and robustness of the ensembled model and the sliding window using data augmentation, adding noise, autoencoder (AE) and SAE methods are analyzed in terms of principle and practical effects. Second, ResNet is used as the feature extractor for the ensembled ResNet-SVM model. Feature extraction is carried out twice, and the extracted co-frequency fault features are more comprehensive. Finally, the data augmentation method and ensemble ResNet-SVM are combined for fault diagnosis and compared with other methods. The experimental results show that the accuracy of the proposed method can exceed 99.9%.

Diagnostic pattern of mental, neurological and substance use disorders at primary health care facilities in Uganda

Integration of diagnosis and treatment for mental, neurological, and substance use (MNS) disorders into primary health care is a recommended strategy to improve access to services in low-and middle-income countries. Despite numerous initiatives for integration of mental health care in Uganda, there has not been an evaluation of health management information system (HMIS) records to determine whether MNS disorders are routinely diagnosed. We sought to determine diagnostic pattern of MNS disorders at primary health facilities in Wakiso and Kampala districts, the most populous regions of Uganda. Lower-level primary health facilities were visited to obtain records from HMIS registers, to document diagnoses of MNS disorders. Secondary data analysis was conducted and descriptive statistics reported. A total of 40 primary health care facilities were visited representing 58.6% of the health facilities in the study districts. More than half (54.8%) and almost all (87.5%) of the lower-level health facilities in Wakiso district and Kampala district respectively were visited. The proportion of MNS disorders diagnosed at lower-level primary health facilities in Uganda is very low with Epilepsy the most common MNS diagnosis recorded. Reasons for such low numbers of diagnoses at primary health facilities are discussed as are possible solutions.

Biosecurity protocols and fish health management in Kenyan fish hatcheries: a key to sustainable production of quality fish seed

Aquaculture, or aquafarming, is increasingly becoming a vital farming activity globally to meet exponentially high demand for fish and reduce pressure on global capture fisheries. In Kenya, aquaculture growth has led to concerns over the supply of quality fish seed, with farmers often reporting involving fingerling adulteration and mislabelling where frog tadpoles are packed and supplied as Clarias gariepinus fingerlings and mixed-sex Oreochromis niloticus fingerlings are falsely sold to fish farmers as sex-reversed monosex Nile tilapia. This study aims to identify strategies to enhance the quality of fish seed production in the country. Primary data were collected via questionnaires and interviews using the Kobo toolbox. Respondents were selected through purposive and random sampling. The SPSS software was used for the analysis. Findings showed moderate reliance on specific reporting offices for fish disease cases and significant variation in disease types and bio security measures. Fish disease treatment and management practices were more engaged by hatchery operators than disease reporting. No significant differences were found between disease treatment and management, type of fish diseases encountered at the hatchery, and the nature of fingerlings produced (p > 0.05). However, there was a significant difference between the source of broodstock, biosecurity measures, type of fish diseases encountered, and the Disease Case Reporting Office (p < 0.05). No significant difference was found between biosecurity measures and the period when the hatchery was established (p > 0.05). Lack of financial support, inexperienced workforce, and a lack of knowledge in fish disease identification and treatment were the major problems affecting the sustainability of hatchery operations in the country. Aquaculture policymakers should establish financial support for hatcheries, implement disease management training, promote research collaborations for disease surveillance, and incentivize biosecurity measures among hatchery managers and farmers to improve aquaculture sustainability in Kenya. Further research should explore treatment methods and long-term sustainability to mitigate disease risks.

Examining The Interplay of Lifestyle Diseases and Mental Health: Devising a Possible Machine Learning Based System for Diagnosis

In our fast-paced world, we often neglect our lifestyle, leading to increased incidence of lifestyle diseases. Machine Learning (ML) can aid in efficiently diagnosing these conditions by analyzing vast health data, identifying patterns, and providing personalized insights, ultimately promoting better health management and prevention.

Role of the health literacy assessment in healthcare: Content validation of "Health Literacy Behaviour" nursing outcome.

To validate the content of the "Health Literacy Behaviour" nursing outcome (NO). A content validation study was conducted during 2022. Each indicator was included in the NO, and its response levels were operationally defined. The initial version of each indicator and its response levels were refined and validated through the Delphi method. A panel of health literacy (HL) and nursing taxonomies experts evaluated the content through two content validity indicators. The content validity of the NO and each index was determined by calculating the content validity index (CVI). A qualitative analysis of the recommendations provided by the experts was carried out to improve the understanding of the indicators and their levels. A total of 108 experts participated in this study. Mostly females with more than 10 years of professional experience. The results demonstrated a high CVI of the indicators and the NO "Health Literacy Behaviour." All indicators achieved excellent (CVI≥0.80) relevance and clarity. The CVI universal average method (CVI-p) of the NO achieved an excellent result of 0.90. The indicators included in the NO "Health Literacy Behaviour" have content validity. These findings provide evidence-based indicators to measure the patient's actions to obtain, process, and understand information about health and disease, interact with the health system, and make informed health decisions. The validation of this NO would identify populations with low HL, allowing the health of this community to be promoted. Health literacy should be a priority objective of health management and policies.

Salmonella spp. in Domestic Ruminants, Evaluation of Antimicrobial Resistance Based on the One Health Approach—A Systematic Review and Meta-Analysis

Salmonella spp. pose a global threat as a leading cause of foodborne illnesses, particularly prevalent in the European Union (EU), where it remains the second cause of foodborne outbreaks. The emergence of antimicrobial resistance (AMR) in Salmonella spp. has become a critical concern, complicating treatment strategies and escalating the risk of severe infections. The study focuses on large and small ruminants, identifying a prevalence of Salmonella spp. in slaughterhouses and revealing varied AMR rates across antimicrobial families throughout a meta-analysis. Also, comparison with AMR in human medicine was carried out by a systematic review. The results of the present meta-analysis displayed a prevalence of Salmonella spp. in large and small ruminants at slaughterhouses of 8.01% (8.31%, cattle; 7.04%, goats; 6.12%, sheep). According to the AMR of Salmonella spp., 20, 14, and 13 out of 62 antimicrobials studied were classified as low (<5%), high (>5% but <10%), and very high (>10%), respectively. Salmonella spp. did not display AMR against aztreonam, mezlocillin, ertapenem, meropenem, cefoxitin, ceftazidime, levofloxacin, tilmicosin, linezolid, fosfomycin, furazolidone, quinupristin, trimethoprim and spectinomycin. In contrast, a prevalence of 100% of AMR has been described against ofloxacin, lincomycin, and cloxacillin. In the context of the main antibiotics used in the treatment of human salmonellosis, azithromycin was shown to have the highest resistance among Salmonella spp. isolates from humans. Regarding cephalosporins, which are also used for the treatment of salmonellosis in humans, the prevalence of Salmonella spp. resistance to this class of antibiotics was similar in both human and animal samples. Concerning quinolones, despite a heightened resistance profile in Salmonella spp. isolates from ruminant samples, there appears to be no discernible compromise to the efficacy of salmonellosis treatment in humans since lower prevalences of AMR in Salmonella spp. isolated from human specimens were observed. Although the resistance of Salmonella spp. indicates some degree of concern, most antibiotics are not used in veterinary medicine. Thus, the contribution of cattle, sheep and goats to the rise of antibiotic resistance of Salmonella spp. and its potential impact on public health appears to be relatively insignificant, due to their low prevalence in carcasses and organs. Nevertheless, the observed low prevalence of Salmonella spp. in ruminants at slaughterhouse and the correspondingly low AMR rates of Salmonella spp. to key antibiotics employed in human medicine do not indicate that ruminant livestock poses a substantial public health risk concerning the transmission of AMR. Thus, the results observed in both the meta-analysis and systematic review suggests that AMR is not solely attributed to veterinary antibiotic use but is also influenced by factors such as animal health management (i.e., biosecurity measures, prophylactic schemes) and human medicine.

Prognostics and Health Management Based on Next-Generation Technologies: A Literature Review

With the rapid development of science and technology, the integration and complexity of aerospace vehicles, weaponry, and large-scale chemical equipment are becoming higher and higher. PHM plays an important role in realizing reductions in equipment loss due to failures in many fields. In order to systematically sort through the research history of PHM and deeply analyze the development status of AR and DT technologies in the field of PHM, to clarify the current technical challenges and future development directions and to provide valuable references and insights for researchers, engineers, and decision-makers in the related fields, this paper summarizes the development of PHM in the engineering field. This paper summarizes the development of PHM in the field of engineering, from the initial PHM used in aerospace to the current PHM systems supported by various advanced technologies; analyzes the advantages and shortcomings of the digital twin and augmented reality technologies used for PHM; and organizes and summarizes the future directions and future research focuses of PHM research based on the existing technologies (mainly digital twins and augmented reality). After systematic research and study, we found that the integration of augmented reality and digital twin technologies will provide superb simulation capabilities and immersive operation and bring new challenges and opportunities. Therefore, it is also imperative to address the challenges and limitations that hinder the seamless integration of the new technologies.

Worker perspectives on improving occupational health and safety using wearable sensors: a cross-sectional survey.

Workplace exposure is an important source of ill health. The use of wearable sensors and sensing technologies may help improve and maintain worker health, safety, and wellbeing. Input from workers should inform the integration of these sensors into workplaces. We developed an online survey to understand the acceptability of wearable sensor technologies for occupational health and safety (OSH) management. The survey was disseminated to members of OSH-related organizations, mainly in the United Kingdom and the Netherlands. There were 158 respondents, with over half (n = 91, 58%) reporting current use of wearable sensors, including physical hazards (n = 57, 36%), air quality (n = 53, 34%), and location tracking (n = 36, 23%), although this prevalence likely also captures traditional monitoring equipment. There were no clear distinctions in wearable sensor use between the reported demographic and occupational characteristics, with the exception that hygienists were more likely than non-hygienists (e.g. safety professionals) to use wearable sensors (66% versus 34%). Overall, there was an interest in how sensors can help OSH professionals understand patterns of exposure and improve exposure management practices. Some wariness was expressed primarily around environmental and physical constraints, the quality of the data, and privacy concerns. This survey identified a need to better identify occupational situations that would benefit from wearable sensors and to evaluate existing devices that could be used for occupational hygiene. Further, this work underscores the importance of clearly defining "sensor" according to the occupational setting and context.

Integration of Digital Health Technologies in Maternal and Child Health Management: Opportunities and Challenges

Integration of Digital Health Technologies in Maternal and Child Health Management: Opportunities and Challenges

Awareness and adoption of farm biosecurity practices in commercial dairy, pig and poultry farms of Uttar Pradesh (India).

India's livestock sector has been facing significant losses due to episodes of disease outbreaks since time immemorial. Hence, biosecurity measures are very important to maintain and improve animal health along with prevention of disease outbreak. Keeping these facts into consideration, the study was proposed with an objective to assess the existing biosecurity practices adopted by the commercial dairy, pig and poultry farms. The current study was undertaken in the state of Uttar Pradesh as it is the leading state in milk and meat production. A total of 120 farmers were selected randomly including 40 each practicing commercial dairy, pig and poultry farming. An ex-post facto research methodology was used with face-to-face interview and observation to collect data. The biosecurity practices were assessed under seven dimensions such as, location and design of farm, restricted access, isolation and quarantine, cleaning and disinfection, management of feed and water, disposal of carcass, manure and waste, and health management. Results elicited that about 50% of the farmers had medium level of adoption who adopted 18-34 practices out of 51 practices. The average overall adoption score was 34.17 out of 51 (67%) which makes an overall adoption gap of 33%. Maximum adoption gap was seen in case of restricted access (43%) whereas minimum gap in adoption was seen in case of management of feed and water (27%). Pig and poultry farmers showed significantly higher biosecurity measures than dairy farmers (p < 0.05). The more significant contributors to the adoption of biosecurity measures were the level of knowledge of the farmers (p < 0.01). Other factors such as education, income, herd/flock size, Information and Communication Technology utilization, number of trainings also had a significant contribution (p < 0.05) in actual implementation of biosecurity. Hence, better understanding of these measures among the farmers must be ensured by hands on training along with proper demonstration of various procedures involved in maintaining farm biosecurity is need of the hour.

Editorial: Effective occupational health and safety management in advancing global agri-food sustainability

Editorial: Effective occupational health and safety management in advancing global agri-food sustainability

The managers' perspectives on service providing in women's harm reduction centers during the COVID-19 pandemic: mixed method study

BackgroundThe COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic.MethodsThis convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women’s harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic.ResultsDuring the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities."ConclusionsDuring the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises.

Line manager training and organizational approaches to supporting well-being.

Employee mental health and well-being (MH&WB) is critical to the productivity and success of organizations. Training line managers (LMs) in mental health plays an important role in protecting and enhancing employee well-being, but its relationship with other MH&WB practices is under-researched. To determine whether organizations offering LM training in mental health differ in the adoption of workplace- (i.e. primary/prevention-focused) and worker-directed (including both secondary/resiliency-focused and tertiary/remedial-focused) interventions to those organizations not offering LMtraining and to explore changes in the proportions of activities offered over time. Secondary analysis of enterprise data from computer-assisted telephone interview surveys. The analysis included data from organizations in England across 4 years (2020: n = 1900; 2021: n = 1551; 2022: n = 1904; 2023: n = 1902). Offering LM training in mental health was associated with organizations' uptake of primary-, secondary-, and tertiary-level MH&WB activities across all 4 years. The proportion of organizations offering primary-, secondary- and tertiary-level interventions increased over time. On average, tertiary-level activities were most adopted (2020: 80%; 2021: 81%; 2022: 84%; 2023: 84%), followed by primary-level activities (2020: 66%; 2021: 72%; 2022: 72%; 2023: 73%) and secondary-level activities (2020: 62%; 2021: 60%; 2022: 61%; 2023: 67%). Offering LM training in mental health is associated with the adoption of other MH&WB practices by organizations. Suggesting that organizations that are committed to the mental health agenda are more likely to take a holistic approach (including both worker and workplace strategies) to promoting workforce mental health, rather than providing LM training in isolation.

Assessment of Metaverse wearable technologies for smart livestock farming through a neuro quantum spherical fuzzy decision-making model

Livestock wearable technologies are innovations designed to ensure livestock health management. However, the user aspect of these devices from farmers’ perspective is still questionable. Additionally, livestock wearables are still in progress compared to the other wearables. Thus, this research aims to identify key design features regarding wearable smart collars (WSCs) and rank the alternative WSC prototypes within Metaverse, allowing farmers to select the best wearable device. To this end, an integrated neuro quantum spherical fuzzy multi-criteria decision-making (MCDM) framework is introduced via facial expressions to obtain the priority weights of WSC criteria with the improved decision-making trial and evaluation laboratory (DEMATEL) approach and to rank the WSC alternatives in Metaverse through the improved multi-objective optimization based on ratio analysis (MOORA) model. The novelties of this research are: (1) to build and introduce a novel decision support tool based on facial expressions, expert recommendations, and the quantum spherical fuzzy sets, (2) to guide industrial designers about the essential features of WSCs, whereas they are designing these devices, and (3) to help smallholder farmers to decide on the best WSC to enhance animal welfare and efficiency of animal production. Concerning the findings, “sound and stress analyzer” is the most significant feature, followed by “disease detection” and “price.” Moreover, Prototype 3 is the best WSC for farmers to adopt for livestock health management. Some essential implications are further presented.

Healthcare workers’ views on decentralized primary health care management in Lesotho: a qualitative study

BackgroundLesotho experienced high rates of maternal (566/100,000 live births) and under-five mortality (72.9/1000 live births). A 2013 national assessment found centralized healthcare management in Ministry of Health led to fragmented, ineffective district health team management. Launched in 2014 through collaboration between the Ministry of Health and Partners In Health, Lesotho’s Primary Health Care Reform (LPHCR) aimed to improve service quality and quantity by decentralizing healthcare management to the district level. We conducted a qualitative study to explore health workers’ perceptions regarding the effectiveness of LPHCR in enhancing the primary health care system.MethodsWe conducted 21 semi-structured key informant interviews (KII) with healthcare workers and Ministry of Health officials purposively sampled from various levels of Lesotho’s health system, including the central Ministry of Health, district health management teams, health centers, and community health worker programs in four pilot districts of the LPHCR initiative. The World Health Organization’s health systems building blocks framework was used to guide data collection and analysis. Interviews assessed health care workers’ perspectives on the impact of the LPHCR initiative on the six-health system building blocks: service delivery, health information systems, access to essential medicines, health workforce, financing, and leadership/governance. Data were analyzed using directed content analysis.ResultsParticipants described benefits of decentralization, including improved efficiency in service delivery, enhanced accountability and responsiveness, increased community participation, improved data availability, and better resource allocation. Participants highlighted how the reform resulted in more efficient procurement and distribution processes and increased recognition and status in part due to the empowerment of district health management teams. However, participants also identified limited decentralization of financial decision-making and encountered barriers to successful implementation, such as staff shortages, inadequate management of the village health worker program, and a lack of clear communication regarding autonomy in utilizing and mobilizing donor funds.ConclusionOur study findings indicate that the implementation of decentralized primary health care management in Lesotho was associated a positive impact on health system building blocks related to primary health care. However, it is crucial to address the implementation challenges identified by healthcare workers to optimize the benefits of decentralized healthcare management.

Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial

BackgroundEarly intervention for unmet needs is essential to improve health. Clear inequalities in healthcare use and outcomes exist. The Children and Young People’s Health Partnership (CYPHP) model of care uses...

Increasing Productivity Through Strengthening Achievement Motivation and Effectiveness of Occupational Safety and Health Management

This research aims to analyze the impact of occupational safety and health management and achievement motivation on employee productivity at PT. XYZ (Persero). This study employs a mixed-method approach, combining quantitative surveys and qualitative analysis. Data was collected from PT. XYZ (Persero) Transmission Implementation Units (UPT) in Bogor and Karawang over the period from 2017 to 2021. The results indicate that effective occupational safety and health management and achievement motivation have a significant positive impact on employee productivity. Both directly enhance productivity, although achievement motivation as a mediator is less effective than the direct influence of occupational safety and health management. The conclusion of this study is that improving the effectiveness of occupational safety and health management and achievement motivation can significantly boost employee productivity at PT. XYZ (Persero). Recommendations for the company include enhancing occupational safety and health training, monitoring the work environment, and developing reward programs for high-performing employees.

Interpretable and efficient RUL prediction of turbofan engines using EM-enhanced Bi-LSTM with TCN and attention mechanism

Remaining useful life (RUL) prediction for turbofan engines is important in prognostics and health management (PHM) for the maintenance and operation of critical equipment. With continuous innovations in deep learning techniques, the complexity of models continues to increase, but the interpretability and comprehensibility of the prediction results become particularly important in industrial applications. Therefore, in this study, an improved bidirectional long and short-term memory network (Bi-LSTM) based interpretable hybrid deep learning model for RUL prediction of turbofan engines is proposed, which ingeniously integrates time series convolutional networks (TCNs), expectation maximization (EM), Bi-LSTMs, and attention mechanisms. By capturing time-series features at different levels, the model adapts to the complex dynamics of turbofan engine performance evolution in an efficient and cost-effective manner. Experimental validation on the C-MAPSS dataset demonstrated that the model significantly outperforms other methods in terms of RUL prediction performance, especially in improving prediction accuracy and coping with the degradation of complex system dynamics. The largest contribution of key metrics to the model is validated through consistent results from multiple interpretable tools, providing comprehensive and consistent support for understanding and trusting prediction results in industrial applications. This study further enhances the robustness of the model and the reliability of the interpretable results by delving into the dynamic relationships between the properties of the different life stages, which not only reveal the importance of these characteristics in engine life prediction but also provide more comprehensive information about the engine performance variations by observing the dynamic relationships.

Increasing Productivity Through Strengthening Achievement Motivation and Effectiveness of Occupational Safety and Health Management

Increasing Productivity Through Strengthening Achievement Motivation and Effectiveness of Occupational Safety and Health Management