Health Care Agencies Research Articles

Coronary heart disease in old age people

Background; The burden of coronary heart disease (CHD) worldwide is one of great concern to patients and healthcare agencies alike. Exercise‐based cardiac rehabilitation aims to restore patients with heart disease to health. Objective: To determine coronary heart disease in old age people Methods: A cross-sectional study was conducted at First affiliated hospital of Xinjiang Medical University, Urumqi, Xinjiang, China which was performed between October 2022 to May 2024, The total number of patients in our study were 100. The number of Male patients in our study were 70 and female were 30. For all patients, we did diagnostic tests, (coronary angiogram, ECG, Echocaediography) boold test. We also took parameters of BMI (kg/m2). We excluded pregnant women and children in our study. Data was tabulated and analyzed by SPSS version 27. Result: In a current study total 100 patients were enrolled. The minimum age of patients were 53 years and the maximum age of the patients were 81 years. The mean age were 62.35±7.016 years. The minimum BMI were 24 (kg/m2) and the maximum BMI were 39 (kg/m2). The frequency of chest pain symptoms were 75 and its percentage were 75 %. The frequency of shortness of breath symptoms were 25 and its percentage were 25%. P-value were less than < 0.04. The frequency of atherosclerosis were 85 and its percentage were 85%. The frequency of diagnose on coronary angiogram were 10 . the frequency of ECG were diagnosed in 35 patients and the frequency of echocardiogram were in 55 patients and its percentage were 55%. The frequency of treatment angioplasty were done in 85 patients and its percentage were 85%. The frequency of treatment on medication were done in 15 patients. The frequency of major complication chest pain were in 13 patients and heart attack were in 7 patients and the frequency of no major complication were in 80 patients and its percentage were 80 %. In our study P-Value were less than (< 0.05). Conclusion: We concluded that Elderly patients with Coronary heart disease had higher risk of cardiovascular disease. Elderly coronary artery disease (CAD) patients, are similar to younger CAD patients. Patients of coronary heart disease can be diagnosed early and can save many lives. In our study males patients were more as compared to females.

TREINO COGNITIVO MOTOR NO EQUILÍBRIO FUNCIONAL E COGNIÇÃO DE IDOSOS: UMA REVISÃO BIBLIOGRÁFICA

With the aging population, the preservation of cognitive abilities and functional balance in elderly individuals has emerged as a critical issue for maintaining autonomy and quality of life in this population. The practice of activities that combine cognitive and motor stimuli, known as cognitive-motor training, has been suggested as an effective strategy to mitigate the physical and cognitive declines associated with aging. In light of this, the present study aims to analyze the effects of cognitive-motor training on functional balance and cognition in the elderly, based on a literature review. The methodology adopted was a literature review using scientific databases such as Google Scholar and the CAPES Periodicals Platform to select articles addressing the impact of cognitive activities combined with physical exercises on the balance and cognitive abilities of elderly individuals. The main results suggest that cognitive-motor training has positive effects on functional balance, enhancing postural stability and mobility in the elderly. These benefits directly impact the reduction of fall risks, a determining factor for quality of life in older age. Additionally, cognitive-motor training was found to contribute to improvements in memory, attention, and mental processing, highlighting the potential of this intervention for maintaining cognition in elderly individuals. However, the review identified some important limitations, as many of the studies analyzed were conducted in specific contexts, which may limit the generalization of results to different profiles of elderly individuals and environments. Therefore, future research should explore the diversity of approaches and adapt protocols to different realities, seeking to validate the observed effects across a broader range of conditions. It is concluded that cognitive-motor training represents a valuable strategy for promoting balance and cognition in the elderly, potentially contributing to the maintenance of autonomy and quality of life. From this review, the importance of developing personalized interventions and investigating new methodologies that maximize the benefits of cognitive-motor training is emphasized, consolidating it as an effective and safe practice in elderly health care.

A reinforcement learning approach for the online dynamic home health care scheduling problem.

Over recent years, home health care has gained significant attention as an efficient solution to the increasing demand for healthcare services. Home health care scheduling is a challenging problem involving multiple complicated assignments and routing decisions subject to various constraints. The problem becomes even more challenging when considered on a rolling horizon with stochastic patient requests. This paper discusses the Online Dynamic Home Health Care Scheduling Problem (ODHHCSP), in which a home health care agency has to decide whether to accept or reject a patient request and determine the visit schedule and routes in case of acceptance. The objective of the problem is to maximize the number of patients served, given the limited resources. When the agency receives a patient's request, a decision must be made on the spot, which poses many challenges, such as stochastic future requests or a limited time budget for decision-making. In this paper, we model the problem as a Markov decision process and propose a reinforcement learning (RL) approach. The experimental results show that the proposed approach outperforms other algorithms in the literature in terms of solution quality. In addition, a constant runtime of less than 0.001 seconds for each decision makes the approach especially suitable for an online setting like our problem.

Application and effectiveness of adaptive AI in elderly healthcare.

In addressing elderly healthcare issues, cognitive impairment can cause significant disruptions in daily life and may potentially develop into dementia. Thus, finding ways to delay the progression of cognitive impairment is a critical issue. This study aims to develop an adaptive artificial intelligence (AI) mechanism that creates enjoyable and beneficial content to help delay cognitive impairment in the elderly. Utilising virtual reality (VR) and a fishing game, the design enhances reaction time and attention through interactive fishing activities. The AI personalises content based on individual performance to improve cognitive function. Experimental results showed that adaptive AI increased participant satisfaction from 86.84 to 91.05 points and future willingness from 75.26 to 85.68 points. The number of fish caught rose from 98 to 120, with the average per participant increasing from 2.64 to 2.85. This is undoubtedly the trend of the future. VR allows the elderly to have a more impactful and memorable first experience, while AI dynamically adjusts the game's difficulty based on the elderly's performance, addressing the issue of reduced willingness to continue due to inappropriate game difficulty. The VR game developed in this study is designed to be relaxing and incorporates mechanisms to promote the elderly's health. It is not restricted by location or time and, more importantly, meets the health promotion needs of the elderly.

Association between childhood parental literacy and late-life cognitive function: The Guangzhou Biobank Cohort Study

ObjectivesEvidence on the associations of childhood parental education with late-life cognitive function remains inconsistent. Additionally, studies focusing on dimensions of cognitive function are scarce, with none from China. Therefore, we examined the associations of childhood parental education with late-life cognitive function and it's dimensions and investigated potential interactions. Study designA cross-sectional study. MethodsParticipants were included from the third phase of Guangzhou Biobank Cohort Study. Mini-Mental State Examination (MMSE), Delayed 10-Word Recall Test (DWRT), and childhood parental literacy (could read or write) were collected. Multivariate linear and logistic regression were used. ResultsAmong 8891 participants aged ≥50 years, compared with those whose childhood parents could not read/write, those with only the father, only the mother, or both parents able to read/write during childhood had higher scores on the MMSE and its dimensions, and lower odds of mild cognitive impairment (MCI). The coefficients (β) and 95 % confidence intervals (CI) for scores of MMSE were 1.25 (1.10, 1.41), 1.36 (0.86, 1.86), and 2.05 (1.89, 2.21) respectively; the odds ratios and 95 % CIs for MCI were 0.38 (0.33, 0.45), 0.35 (0.18, 0.67), and 0.15 (0.12, 0.19) respectively. More pronounced effects were found in women, those aged ≥60, those with ≤ primary education, and in those whose childhood parents could read/write. Socioeconomic position mediated the association. Cognitive functions of attention and calculation in children of only fathers who could read/write (β = 0.43, 95%CI: 0.35, 0.50) and memory in children of only mothers who could read/write (β = 0.34, 95%CI: 0.16, 0.51) were associated with better outcomes. Consistent results were also found using scores from the DWRT. ConclusionsChildhood parental literacy was associated with late-life cognitive function and it's dimensions, which mediated by socioeconomic position. Specifically, having only a father or only a mother who could read/write during childhood was associated with better cognitive function in attention/calculation and memory, respectively. These results add new evidence to support strategies for elderly cognitive health care.

Elderly Health Care Voucher Scheme in Hong Kong: needs assessment and an evaluation of outcomes

ABSTRACT Elderly Health Care Voucher Scheme represents a form of demand-side subsidy given to the elders to choose a spectrum of medical services in the private medical sector. The current paper aims at (a) conducting a needs assessment of the scheme with an analytical framework of the Four A 's approach (i.e., availability, awareness, accessibility, and acceptance regarding a social program) and (b) evaluating whether the outcome measures of the scheme (i.e., the use of private healthcare services, the use of primary care and the empowerment of the elders in the choice of services) were achieved. The needs assessment concludes that the utilization rate of the elders, awareness and satisfaction rate are high. The positive sides concluded from the needs assessment, however, failed to turn into the fulfillment of outcome measures due to the structural barriers. Recommendations at short-term, medium-term and long-term are made.

Modeling demand responsive service for the elderly healthcare activities considering temporal and spatial variations

ABSTRACT This paper develops a cost-effective demand-responsive transportation (DRT) model aimed at enhancing the accessibility and convenience of clinical visits for the elderly by optimizing two NP-hard problems. First, a set of pick-up stops is optimized based on potential stop locations, spatial and temporal demand, and acceptable walking distance. Next, vehicle routing and scheduling are optimized, considering vehicle capacity, users’ desired arrival times, and travel companions, to minimize total costs. An elite genetic algorithm (EGA) is developed to effectively search for the optimal solution. In the case study, demands are generated from a survey on elderly clinical visits and population census data in Xi’an. The proposed EGA is applied to different clustered demands classified by time interval to identify optimal solutions. Sensitivity analysis is conducted to explore the relationships between model parameters and decision variables for the studied DRT system.

The Pittsburgh Study: A Tiered Model To Support Parents During Early Childhood

ObjectiveTo test the feasibility of implementing The Pittsburgh Study’s (TPS) Early Childhood Collaborative, a population-level, community-partnered initiative to promote relational health by offering accessible preventive parenting program options for families with young children. Study designTPS partnered with healthcare and community agencies serving families in Allegheny County, Pennsylvania, to enroll and screen 878 parents of 1,040 children 4-years-old and under. Participants were assigned to one of four tiered groups based on identified needs: (1) universal, (2) targeted/universal, (3) secondary/tertiary, or (4) tertiary programs. Parents were offered choices in empirically supported parenting programs within group ranging from texting programs to intensive home visiting. Program selection was optional. Chi-square tests were conducted to examine the likelihood of selecting a program by group. ResultsAbout 25% of participants were assigned to each tiered group; 78% of parents chose to enroll in a parenting program. In general, parents with higher levels of adversity were more likely to select a parenting program compared with those reporting less adversity, including secondary/tertiary versus targeted/universal groups (81.4% vs. 72.8%), and tertiary versus universal and targeted/universal groups (83% vs. 74.1% and 72.8%, respectively; p < .001). ConclusionOur high program enrollment rate supports the feasibility of TPS. TPS successfully engaged families in the study by offering choices in, and optimizing accessibility to, parenting programs. TPS is highly aligned with recent recommendations by the American Academy of Pediatrics for tiered approaches as part of a broad public health strategy for supporting early relational health.

Moving the Needle on Measurement of Patient Safety: The Evolving Role of the Agency for Healthcare and Quality (AHRQ) Patient Safety Indicators: Evolving Role of PSIs

Moving the Needle on Measurement of Patient Safety: The Evolving Role of the Agency for Healthcare and Quality (AHRQ) Patient Safety Indicators: Evolving Role of PSIs

MHCNLS-HAR: Multiheaded CNN-LSTM-Based Human Activity Recognition Leveraging a Novel Wearable Edge Device for Elderly Health Care

MHCNLS-HAR: Multiheaded CNN-LSTM-Based Human Activity Recognition Leveraging a Novel Wearable Edge Device for Elderly Health Care

A measurement study of the environmental quality and medical expenditures of elderly individuals: causal inference based on machine learning

BackgroundThe global surge of environmental pollution exacerbates health issues, disease incidence, and economic strain. In China, the increasing healthcare costs of the elderly population necessitate addressing this challenge as part of the “Healthy China” strategy. We explore the impact of environmental quality on elderly healthcare expenses.MethodsThis study devised a comprehensive environmental quality index for 30 Chinese provinces, excluding Tibet, which was correlated with medical expenses for individuals older than 60 years, using China Family Panel Studies (CFPS) data. Because the traditional econometric model cannot solve the endogeneity problem and the selection of instrumental variables is subjective, a new machine learning algorithm is adopted based on the traditional ordinary least squares (OLS) model and the fixed effect model to conduct causal analysis to ensure the reliability of the results. Finally, heterogeneity analysis was conducted based on the generalized random forest algorithm.ResultsSouthern provinces such as Jiangxi and Guangxi exhibited superior environmental qualities. A regional analysis revealed a gradient where environmental quality decreased from west to east and from south to north. Both conventional and machine learning methodologies underscored a pivotal finding: enhanced environmental qualities significantly curtail elderly healthcare expenses. A heterogeneity assessment revealed that such improvements predominantly benefit elderly people in the eastern and central regions, with marginal impacts in the west. For different groups, the improvement of environmental quality can significantly reduce the medical expenditure of people aged 60 to 75, with bedtime hours between 9 and 11 PM and a lower household income.ConclusionsThis study, employing machine learning and traditional models, demonstrates that enhancements in environmental quality significantly reduce medical costs for the elderly in China, especially in the eastern and central regions, and among demographics such as individuals aged 60–75 and low-income households. These findings underscore the potential of environmental policies to lower medical costs within the “Healthy China” initiative framework. However, the study’s scope is limited by the environmental quality index and the extent of data coverage, indicating a need for further research expansion.

Study of fractional order rabies transmission model via Atangana–Baleanu derivative

In this work, we aim at disentangling the theoretical contribution through mathematical modeling approach to advance the understanding of rabies dynamics and control in livestock population. A fractional order model of rabies, using Atangana–Baleanu fractional operator is created. The analysis of suggested system and its application are both conducted. The capacity of proposed model to forecast the disease can help researchers and livestock health care agencies to take preventive actions.

Unveiling the Nexus: Elevating marketing strategies for enhancing satisfaction and loyalty in elderly health care services

The study aimed to examine whether there is an association of marketing mix, and perception with customer’s satisfaction, and loyalty among elderly people. A total of 400 participants were included in the study. The study population comprised individuals aged 65 years and above from Assam, India including both males and females. Participants were primarily selected from residential homes, old age homes, and various common gathering places such as parks, shops, Namghar (a holy place), and community halls. The study indicated a significant correlation between the dimensions of the marketing mix, perception, satisfaction, and loyalty. Moreover, the findings from the linear regression analysis, revealed customer satisfaction towards the marketing of healthcare services can be attributed to product, price, place, process, and physical evidence (7 P’s) and customer perception (R2=.54; .53 respectively). Additionally, customer loyalty towards the marketing of healthcare services is influenced by product and price (7P’s), and customer perception (R2=.54; .2 respectively). This study contributes to understanding the overlooked aspect of marketing to the elderly population, providing valuable insights for healthcare companies to develop improved marketing strategies. Hence, irrespective of the organization's size, type, or location, whether it's a startup or an established entity, privately owned or government-operated, local or global, the role of business managers is vital in making informed decisions and establishing strategic priorities to allocate resources efficiently in order to meet evolving customer demands and achieve business success. As a result, commercial enterprises need to develop tools, concepts, and strategies to effectively navigate the dynamic and unpredictable marketing landscape.

Recommendations for Interchangeability in a Growing Biosimilar Market in Latin America.

Biosimilars offer significant advantages for improving access to biologic treatments in Latin America. However, their uptake has been slow due to misconceptions, regulatory uncertainties, and inadequate pharmacovigilance. To address these issues, Americas Health Foundation convened a multidisciplinary panel of regional experts in biosimilar use and interchangeability from Latin America. The panel assessed the current landscape and recommended steps to enhance access. Key recommendations include strengthening biosimilar regulations, ensuring transparent enforcement, implementing robust pharmacovigilance, and promoting collaboration among stakeholders to educate about the safety, efficacy, and economic advantages of biosimilars and their interchangeability. By embracing biosimilars and interchangeability, Latin American countries can expand patient access, foster competition, diversify treatment sources, and enhance the sustainability of their healthcare systems. However, achieving these goals requires addressing knowledge gaps and biases among healthcare providers, patients, regulators, and government agencies. This can be accomplished through clear communication and the use of real-world evidence.

Posyandu Cadres' Contributions to Elderly Health Improvement

Background: This study investigates the role of community health workers in promoting elderly health through integrated health posts. Specific Background: A qualitative descriptive approach is used to examine the significance of these workers in ensuring regular attendance of the elderly at health services. Knowledge Gap: While previous studies have focused on health post activities, they often overlook the specific strategies employed by community health workers. Aims: The study aims to clarify the contributions of community health workers in facilitating elderly health programs. Results: Findings indicate that these workers adapt activities, such as health consultations and educational sessions, to enhance elderly participation and health outcomes. Novelty: The research provides new insights into innovative service delivery by community health workers amid logistical challenges. Implications: The results highlight the need for ongoing support and training for community health workers, advocating for structured programs to enhance elderly engagement and well-being, with potential applications in similar contexts to improve elderly healthcare. Highlights : Community health workers play a crucial role in facilitating elderly health services. Adaptation of activities enhances elderly engagement and health outcomes. Continuous support and training for health workers are essential for effective program implementation. Keywords: community health workers, elderly health, qualitative study, health post, participation

Undergraduate nursing student's perception toward the nursing profession in Iraqi-Kurdistan. An exploratory study

Nursing students' perception towards the nursing profession is vital and has a positive impact on the successful recruitment, retention, and attrition of staff from the health care agencies. This study aimed to explore the perceptions of undergraduate nursing students toward the nursing profession in Iraq, particularly in the Kurdistan region. The study was conducted at the University of Duhok, a college of nursing in the Kurdistan Region. The researcher of the current study used Nursing Image as a Profession Questionnaire (NIPQ) for the purpose of data collection. Based on the analysis of the participant's responses, the results revealed that in general students have positive perceptions towards the nursing profession. The early twentieth age group students were more satisfied in nursing than the late twentieth age group. High school grades were regarded as the main reason for joining the faculty of nursing. Having a nurse friend or relative and a positive family reaction was perceived as positive influential factors for student enrollment in the nursing program. Few students had a very negative attitude and they attacked the nursing profession when talking with others. The current study concluded that students have positive perceptions towards the nursing profession in the four aspects of the description of the profession, social view perspectives, benefits of the nursing profession, and students' satisfaction in nursing.

It Is Time to Take Complaints Seriously? An Exploratory Analysis of Communications Sent by Users to a Public Healthcare Agency before, during and after the COVID-19 Pandemic

Taking due account of users’ perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. A total of 501 communications sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor–patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor–patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users’ assessment of the quality of care.

What Australia must do to create a climate-responsive health system.

COP-28, the United Nations' Climate Change Conference, hosted by the United Arab Emirates, ended on 12 December 2023. At the convention, Australia released its National Health and Climate Strategy, committing to low-carbon, climate-responsive care. The Strategy will need new policies, projects and investments and a fit-for-purpose health workforce. This is a tall order considering healthcare's challenges. Everyone has a role, including clinicians, healthcare agencies, policymakers, politicians, patients and the providers and manufacturers in the supply chain. Clinicians' groups, policymakers and federal and state departments of health have an opportunity to lead climate change reform by considering climate change impacts across clinical practice and health policy.

Barriers and facilitators experienced by South Korean women undergoing fertility treatment: A qualitative socioecological study

The purpose of this qualitative study was to use interview data to identify and describe the intrapersonal, interpersonal, community, and policy barriers and facilitators experienced by South Korean women undergoing fertility treatment. The researchers conducted one-on-one interviews with 14 women who had undergone fertility treatment and then completed a thematic content analysis on the collected interview data. Guided by the socioecological model, the researchers explored the barriers and facilitators women experienced during fertility treatment. The participants described their struggles and ­emotional distress as well as their coping mechanisms: addressing their physical and emotional stress; soliciting support from their husband, personal network, online peers, and healthcare team; and seeking government financial assistance. The information gained from this study can help healthcare providers and government agencies design effective psychosocial and national policies and interventions for this population.

Customer Awareness of Medical Wearable Health Care Technology and Policy Management in India

Patient and healthcare providers can take preventive actions based on a review of vital signs obtained remotely with wearable medical devices thanks to Internet of Things-based wearable sensors and an integrated cloud platform. Provide essential home care that is as clean and well-manicured as the intensive care unit (ICU), complete with remote vital sign monitoring. In India, there is no governing agency for healthcare. Healthcare professionals are concerned about the dependability of medical devices in the absence of sufficient laws, which makes them prefer to employ conventional medical devices. Based on related dangers, medical gadgets are to be divided into four types. Converging, analysing, and applying massive data collected by wearable medical devices for use in illness diagnosis, mitigation, and preventive therapy is a challenge to the medical business. By exchanging real-time data, the use of wearable medical devices would not only aid to strengthen patient-physician relationships but also decrease the need for human interventions. To uncover consumer awareness difficulties in the adoption of these devices, this paper explores the possibilities of the Internet of Things in the medical wearable business.