Health Care Consumers Research Articles

Special Section: Consumer Healthcare Technologies in Smart Cities

This Special Issue takes an in-depth look into the recent developments in consumer technology that blend into everyone's health and safety in a smart city environment. Smart wearables, such as watches and wristbands, have been widely used in health monitoring in recent years. These connected consumer electronics devices not only provide indicative information for consumers' health management, but also play a vital role in communicable disease management and prevention. In the context of consumer technology as part of a smart city infrastructure, wireless communication and sensing technologies have evolved substantially over the past decade and have seen an accelerating trend of technical advances, particularly in the consumer healthcare sector. Optimization techniques have been developed significantly and smart devices have become more efficiently designed and implemented both for the betterment of individual consumers and health service providers.

Memristor-Based Hierarchical Attention Network for Multimodal Affective Computing in Mental Health Monitoring

We present a circuit design of the hierarchical attention network for multimodal affective computing, which can be used in mental health monitoring. Specifically, a kind of cost-effective memristor is fabricated using the albumen protein, and the corresponding testing performance is conducted to ensure its efficiency and stability. Then, considering the hierarchical mechanism inspired by the human limbic system, the nanoscale memristors arranged in a crossbar array configuration are further applied to construct a compact hierarchical attention network that can perform the multimodal affective computing. Furthermore, based on the wearable technology and flexible electronics technology, a mental health monitoring system with low privacy invasiveness, low energy consumption, and low fabrication cost can be designed. Based on the mapping relationship between the multimodal affective computing and mental health, the mental health state of the current user can be monitored. This study is expected to help achieving the deep integration of neuromorphic electronics and mental health monitoring system, further promoting the development of next-generation consumer healthcare technology in smart city.

Preparation and evaluation of anti-arthritic activity of Moringa oleifera leaves extract loaded silver nanoparticles

Silver Nanoparticles (Ag-NPs) are increasingly used in various fields including medical, food, healthcare consumer and industrial purposes due to their unique physical and chemical properties. The conventional physical and chemical methods of synthesis of Ag-NPs seem to be very expensive and hazardous. Interestingly, biologically prepared Ag-NPs show high yield, solubility and high stability. The biologically Ag-NPs was characterized by UV-visible spectroscopy and SEM with EDAX. The appearance of specific absorbance peak at 440 nm indicates the presence of Ag-NPs. The development of Ag-NPs as anti-arthritic molecules is one of the most interesting approaches for arthritic treatment as it can overcome poor delivery and the problem of drug resistance. The anti-arthritic activity of developed MO-AgNPs was determined by albumin denaturation assay. MO-AgNPs (Moringa Olifera leaves extract loaded silver nanoparticles) exhibit 25% higher anti-arthritic activity when compared with standard Aspirin drug.

Formulation and Evaluation of Herbal Gargle against Throat Irritation, Inflammation and Infection

Abstract: Herbal gargles have gained significant attention as potential alternatives to conventional oral care products due to their perceived natural composition and reported therapeutic benefits. This review aims to provide a comprehensive overview of the efficacy of herbal gargles in promoting oral health and preventing various oral ailments. Our oral cavity is a sweet able place to grow different types of bacterial species either harmless or harmful for human. From ancient age medicinal plants are considered as a store room of different types of biological activity in Ayurveda, Unani and Siddha, and have important role to cleanse tooth and prevent different human pathogens are responsible for unpleasant odour, inflammation of teeth root, dental plaque. The study evaluates a wide range of herbal ingredients commonly found in mouth gargles, including essential oils, plant extracts, and traditional herbal remedies. It explores their antimicrobial properties, antioxidant activity, and potential for reducing plaque formation, gingivitis, and bad breath. Aqueous extract of Tulsi, Turmeric, Clove, Fennel, Betel leaves, Pudina, Ginger, Liquorice shows effective antimicrobial, antifungal activity, anti-inflammatory and anti-plaque properties. In this research work herbal gargle was evaluated depends on various parameter like color, pH, Phase separation , Homogeneity and antibacterial properties. Herbal gargles show potential as adjuncts to conventional oral care, Herbal gargle is suitable for any age group due to less side effect. Healthcare professionals and consumers should approach herbal gargles with caution, taking into consideration individual oral health needs and consulting oral healthcare providers for personalized recommendations.

Teaching and Learning Interventions Designed to Improve Cultural Competence in Health Profession Students: A Systematic Review

Purpose: Developing healthcare profession students’ cultural competency knowledge, skills and attributes is critical to meet the needs of culturally and linguistically diverse healthcare service consumers. The purpose of this systematic review was to identify effective cultural competence interventions for healthcare profession students. Methods: A systematic review of peer reviewed articles published from 2010-2021 using PRISMA guidelines was conducted by searching CINAHL, EMBASE, ERIC, PubMed, and Psych INFO databases. Article quality was assessed using the Evaluation Tool for Quantitative Research and Mixed Method Appraisal Tool. Results: The initial search identified 2,261 potentially relevant studies, 41 studies met the inclusion criteria in which intervention effectiveness was evaluated using a validated outcome measure pre- and post- intervention. Only one study used a non-self-report outcome measure. Out of the 41 studies, only eight studies employed randomisation in the method. Conclusion/Recommendations: This review evaluated effectiveness of cultural competence interventions and evaluation of the intervention using either self-report or non-self-report validated outcome measures at pre- and post-intervention exposure. Combining cultural competence teaching methods such as lectures with simulations, role-playing and community engagement with diverse populations enhanced cultural competence. Further studies are required to compare effective cultural competence teaching models and identify reliable non-self-report outcome measures to assess the effectiveness of interventions post-exposure. Comparing effective cultural competence teaching models that utilise reliable non-self-report outcome measures will be valuable for guiding the design of teaching and learning interventions directed towards cultural competence. Further research is also required to examine the duration of intervention efficacy and how to maintain efficacy post-intervention exposure. Findings from this review are important for designing and structuring of cultural competence curriculum for healthcare profession students and informing future research on cultural competence teaching. This review has identified that most evaluation tools and studies have been designed for the nursing discipline. There is need to design more cultural competence evaluation tools and studies for other healthcare disciplines such as pharmacy and physical therapy.

Consumer compliments about nursing and midwifery care: A 12-month retrospective analysis.

To analyse the compliments received from patients' and companions and to describe the characteristics of high-quality nursing and midwifery care from the perspective of healthcare consumers. Retrospective analysis of health service compliments data. All compliments specific to nursing and midwifery care received between July 2020 and June 2021 were extracted from the reporting database for six hospital sites of a large public health service in Victoria, Australia. Inductive coding captured the characteristics and qualities of nurses and midwives elicited from the compliments. Deductive coding used two frameworks: an adapted health complaints assessment tool, and 10 dimensions of nursing and midwifery care used in the health service. Descriptive statistics were used for analysis of coded data. Of the 2833 records identified, 433 nursing and midwifery-specific compliments were identified; of these 225 consumer or care partner compliments were identified for analysis. Most compliments (80.4%, n = 181) were from the smaller hospital sites compared to 19.6% (n = 44) received at the largest hospital site; and from care programmes that typically care for older patients (42.7%, n = 113). Only 39% (n = 89) of compliments related to quality and safety of clinical care, 9% (n = 21) related to management and 17% (n = 38) to relationships. Forty-nine percent (n = 113) related to dimensions of fundamental nursing and midwifery care, with psychological care best represented (39.8%, n = 89). Most often, compliments related to characteristics or attributes of nurses. Analysis of compliments reveals characteristics of nursing and midwifery care valued by healthcare consumers. Surprisingly, few compliments related to clinical dimensions of nursing and midwifery practice. Comments related to psychological aspects of nursing and midwifery care were most common. Understanding consumer perceptions of high-quality care provided by nurses and midwives provide guidance about care delivery that meets or exceed consumer expectations. The findings suggest low consumer awareness about professional and clinical aspects of nursing and midwifery work. Compliments provide a unique insight into consumer perspectives of high-quality nursing and midwifery care. When making compliments, consumers most often commented about the attributes and characteristics of nurses and midwives, rather than clinical aspects of care. Compliments specific to nursing and midwifery care provide guidance to enhance care delivery to meet or exceed consumer expectations. No patient or public contribution.

International Spinal Cord Injury Community Survey: Socioeconomic and Healthcare Satisfaction in Spain.

Survey study. People living with spinal cord injury (SCI) are major healthcare and rehabilitation services consumers and have unmet healthcare needs. This study aimed to describe the socioeconomic characteristics of people living with SCI in Spain and to determine the level of use and satisfaction with the public healthcare system. We conducted a survey (the Spanish version of the International Spinal Cord Injury Community Survey) consisting of 134 questions. We analyzed the age, sex, neurological classification of the injury on the American Spinal Injury Association Impairment Scale, time of injury, socio-occupational and socioeconomic status, and level of use and satisfaction with the public health system. 472 people responded to the survey [68.9% male; mean age 51.2years (standard deviation: 13.9years); 61.7% with paraplegia and 38.3% with tetraplegia]. 89.2% of those surveyed were unemployed and 77.1% received a disability pension. The number of medical visits was 2.3/year, and 19.8% of the patients required at least 1 hospital admission during the previous year. 94.7% of the people with SCI considered the health care received as good or very good. Respondents with SCI in Spain considered they had good access to primary and specialized care and were satisfied with the healthcare system. Notably, we observed a high average of annual visits to medical professionals but a low rate of hospitalizations. Technical aids and state services related to disability should be the most important elements to be improved.

Single Packet, Single Channel, Switched Antenna Array for RF Localization

Cost-effective and accurate means of localizing radio transmitters has the potential to enable a wide range of applications in the consumer electronics, IoT, and healthcare domains. However, existing multi-antenna localization methods require high-cost synchronized receivers, long integration times, and/or specialized packet structures. This paper proposes using a high-speed RF mux that sequentially connects antennas to a single 2MHz radio receiver and sub-packet switching to determine the Angle of Arrival of individual packets. Importantly, this approach does not need synchronization between the mux and the receiver, reducing cost and system complexity. Our signal processing pipeline recovers both switch timing and the antenna number from the received RF signal. The sub-packet waveforms are used to generate a synthetic reference packet, and our customized Multi-Resolution Beaming and MUSIC algorithms are used to determine the Angle of Arrival. Results show that our real-time system is highly accurate even when the target is moving, with a mean AoA accuracy of 3.4 degrees and a 2D localization accuracy of 36.4 cm. Furthermore, the system is capable of tracking multiple users carrying smartphones in either their hands or pockets. Ultimately this approach enables a single low-cost, low bandwidth commodity RF receiver to be used to create an N-element phased array receiver.

Consumers' Needs for Laboratory Results Portals: Questionnaire Study.

Over the last decade, there has been an increase in the number of health care consumers (ie, patients, citizens, and laypeople) with access to their laboratory results through portals. However, many portals are not designed with the consumer in mind, which can limit communication effectiveness and consumer empowerment. We aimed to study design facilitators and barriers affecting consumer use of a laboratory results portal. We sought to identify modifiable design attributes to inform future interface specifications and improve patient safety. A web-based questionnaire with open- and closed-ended items was distributed to consumers in British Columbia, Canada. Open-ended items with affinity diagramming and closed-ended questions with descriptive statistics were analyzed. Participants (N=30) preferred reviewing their laboratory results through portals rather than waiting to see their provider. However, respondents were critical of the interface design (ie, interface usability, information completeness, and display clarity). Scores suggest there are display issues impacting communication that require urgent attention. There are modifiable usability, content, and display issues associated with laboratory results portals that, if addressed, could arguably improve communication effectiveness, patient empowerment, and health care safety.

Liver Injury Following Isoniazid Preventive Therapy in HIV Patients Attending Halibet National Referral Hospital, Eritrea: A Prospective Cohort Study.

A 6-month course of isoniazid, 300mg daily, was programmatically introduced in Eritrea in 2014 as tuberculosis preventive therapy in people living with human immunodeficiency virus (PLHIV). The rollout of isoniazid preventive therapy (IPT) in PLHIV was successful in the first 2-3years. After 2016, rumours based on rare but real incidents of liver injuries following use of IPT spread widely across the country and created concerns amongst healthcare professionals and consumers, that ultimately caused dramatic decline in the rollout of the intervention. Decision makers have been demanding better evidence as previously conducted local studies had inherent methodological limitations. This real-world observational study was conducted to evaluate the risk of liver injury associated with IPT among PLHIV attending Halibet national referral hospital, Asmara, Eritrea. A prospective cohort study, that consecutively enrolled PLHIV attending Halibet hospital, was conducted between 1 March and 30 October 2021. Those exposed to anti-retroviral therapy (ART) plus IPT were considered as exposed and those taking only ART were considered as unexposed. Both groups were prospectively followed up for 4-5months with monthly liver function tests (LFTs). A Cox proportional hazard model was used to explore whether there was increased risk of drug-induced liver injury (DILI) associated with IPT. Probability of survival without DILI was also estimated using Kaplan-Meier curves. A total of 552 patients, 284 exposed and 268 unexposed, completed the study, with a mean follow-up time of 3.97 (SD 0.675) months for the exposed and 4.06 (SD 0.675) months for the unexposed. Twelve patients developed drug-induced liver injury (DILI), with a median time-to-onset of 35days (interquartile range: 26.8, 60days). All cases were from the exposed group and all except two cases were asymptomatic. The incidence rate of DILI in the exposed group was 10.6 cases per 1000 person-months and zero for the unexposed group (p=0.002). DILI in PLHIV taking IPT was common; therefore, liver function should be closely monitored to safely administer the product. Despite high levels of deranged liver enzymes, the majority had no symptoms of DILI, emphasising the importance of close laboratory monitoring, especially during the first 3months of treatment.

High-Performance transparent and flexible Zinc-Ion Solid-State batteries based on nanotube network and hydrogel electrolyte

Transparent and flexible electronics research is a lively and promising domain that holds immense potential for a plethora of innovative applications in consumer electronics, healthcare, and renewable energy sectors. It would be extremely beneficial to develop internal energy sources that are transparent and do not alter the visual appearance would. In this study, we introduce the design of a transparent and flexible zinc-ion solid-state battery (TFZSB), all of whose component elements, such as the electrode, electrolyte/diaphragm, and packaging, are made of transparent and soft materials. The electrodes have been constructed with a framework of nanotube (NT) networks, while the electrolyte is built from a polyacrylamide (PAM) hydrogel material. The suggested electrode design effectively leverages the outstanding optical properties and flexibility of the NT network, while the construction assimilates the PAM hydrogel for providing electrical protection and fabricate the electrolyte, culminating in a resilient interface, which confers exceptional electrochemical stability under varying mechanical strains. With a strong visible-light spectrum transmittance of >80 % and a retention Coulombic efficiency of >92 % under large-scale strains, the TFZSB demonstrates a mass specific capacity of 122.6mAh/g. This TFZSB constitutes a breakthrough in the realm of wearable and smart electronics, and holds the potential to unlock a multitude of opportunities in the future by bridging the domains of energy storage and flexibility/transparency.

An Empirical Analysis of the Influence of Different Types of Metadata on the Usefulness of Online Reviews for Healthcare Businesses

This study aims to identify factors that influence the usefulness of online healthcare reviews and to develop a predictive model for review usefulness. A sample of 4,351 online reviews posted between October 2014 and October 2022 was analyzed using negative binomial regression and support vector regression algorithms. The results reveal that user metadata attributes related to reviewer reputation, readability, subjectivity, and containing more sentences have a significant positive influence on review helpfulness. However, reviews assigning higher star ratings to a business are perceived as less useful by healthcare consumers. The study recommends that healthcare businesses should encourage consumers to post reviews, pay attention to the opinions and concerns of high-reputation and cool patients, and use review, business, and user metadata to build effective models for predicting review usefulness. By using a predictive model like the one developed in this study, online review platforms can estimate the helpfulness of new reviews instantly.

Twilight Talks: engaging health consumers with public lectures

Issue Addressed: Climbing rates of chronic disease allied with rising demand for public health services highlight a present need for honest conversations and information sharing around health behavior. The authors speculated that the Darling Downs community would benefit from public lectures on general health topics delivered by local clinicians. Health information delivered concisely, conversationally, and with authority could serve as an important intervention in reducing disease burden and enhancing patients’ abilities to act as partners in their healthcare. Such lectures would also contribute to achieving strategic goals and national standards around engaging health care consumers.
 Methods: A pilot lecture was held in October 2014. The success of this lecture led to a regular schedule of public lectures programmed for subsequent years, branded as “Twilight Talks”. These lectures have focused on health themes of broad interest to a general audience.
 Results: Twelve Twilight Talks have been delivered so far. Community response has exceeded expectations, with an average of 50 attendees to each event, and a range of 25 to 115. Audience reception and knowledge transfer measured through qualitative feedback has been equally positive.
 Conclusions: A program of public health lectures is a novel initiative for the Darling Downs, prompting several hundred members of the community to think seriously about aspects of their health and learn about practical ways of making positive change.

Outpatient apheresis billing: A photopheresis model shows that hospital price transparency data remain difficult to interpret.

The US health care payment system is complex and difficult to interpret. Although federal regulations require that more data, in the form of charges and negotiated rates, be made available, compliance remains variable. We review chargemaster and negotiated rate values for extracorporeal photopheresis (ECP) to assess this variability. We sought to determine the availability of chargemaster and negotiated rates for health care consumers and to assess compliance and pricing among institutions using ECP as a model for apheresis billing. We obtained ECP chargemaster data and negotiated rates from 20 institutions. We analyzed the availability of ECP chargemaster data and compared values with a previously published historic cohort. We evaluated the availability of negotiated rates and determined relative reimbursement using charge to reimbursement ratios. We determined calculated fines for hospitals based on bed size. Chargemaster availability increased from 2019 to 2022, though only 65% (13/20) of hospitals had both chargemaster and negotiated rate data. Chargemaster prices increased significantly from 2019 to 2022 (range, $3,586.83-$34,043.00). We reviewed 1,191 negotiated rates, with institutions averaging 93.6 different rates (SD, 189.5). Negotiated rates were variable, ranging from $3,586.83 to $34,043.00 per procedure. Reimbursement was higher among private insurers compared with reported Centers for Medicare & Medicaid Services negotiated rates. Of the 35% (7/20) that lacked chargemaster and negotiated rates, institutions faced an average annual fine of $1,430,800. Despite recent financial penalties, ECP pricing data are often unavailable or inadequate. Current available resources are unlikely to benefit the average health care consumer who requires ECP.

Attitudes Toward Organ Transplant Research

The shortage of organs for transplant may be addressed by increasing the rate of organ donation, but additionally by increasing the rate of transplantation from registered donors. In 2019, approximately one in three hearts from Australian donors were transplanted. Despite the potential utility and benefit of donated organ research, there is scant literature describing the attitudes of healthcare workers and consumers regarding this.

Deprescription in Palliative Care.

Individuals with limited life expectancy represent a significant proportion of healthcare consumers and are usually patients with multiple diseases and high levels of frailty. Polypharmacy and the prescription of long lists of drugs are frequent in patients with reduced life expectancy and often, as the patient's health status deteriorates, the list of drugs increases substantially as new medications are introduced to address new symptoms or complications. A key priority for healthcare professionals managing the care of these patients should be balancing the pharmacological approach to chronic diseases with the palliation of acute symptoms and complications. An important element of this process is to ensure that the benefit of any prescription decision outweighs potential risks. We reviewed the pros and cons of deprescribing drugs in individuals with limited life expectancy, how to identify the expected disease trajectory, which drugs are to be discontinued, identified some models trying to achieve rigorous deprescribing criteria, and the psychosocial effects of deprescribing in late phases of life. Deprescribing is not a one-time event but rather a continuous process that requires ongoing evaluation and monitoring. It is vital to continuously monitor and evaluate the pharmacological and non-pharmacological prescriptions for patients with chronic illnesses to align them with their goals of care and life expectancy.

Healthcare Consumers’ Perceptions of Specialty Hospitals through a Focus Group Interview

Healthcare Consumers’ Perceptions of Specialty Hospitals through a Focus Group Interview

In-Depth Co-Design of Mental Health Monitoring Technologies by People with Lived Experience

Advancements in digital monitoring solutions collaborate closely with electronic medical records. These fine-grained monitoring capacities can generate and process extensive electronic record data. Such capacities promise to enhance mental health care but also risk contributing to further stigmatization, prejudicial decision-making, and fears of disempowerment. This article discusses the problems and solutions identified by nine people with lived experience of being mental health care consumers or informal carers. Over the course of ten facilitated focus group format sessions (two hours) between October 2019 and April 2021, the participants shared their lived experience of mental health challenges, care, and recovery within the Australian context. To support the development, design, and implementation of monitoring technologies, problems, and solutions were outlined in the following areas—access, agency, interactions with medical practitioners, medication management, and self-monitoring. Emergent design insights include recommendations for strengthened consent procedures, flexible service access options, and humanized consumer interactions. While consumers and carers saw value in digital monitoring technologies that could enable them to take on a more proactive involvement in their personal wellness, they had questions about their level of access to such services and expressed concerns about the changes to interactions with health professionals that might emerge from these digitally enabled processes.

Jordanians' knowledge, attitude and practice regarding adverse drug reactions reporting

ObjectivesThe purpose of the current study was to evaluate the general public knowledge, attitudes, and practice regarding Adverse Drug Reactions (ADRs) reporting and pharmacovigilance in Jordan. MethodsA cross‐sectional study was conducted between July 16, 2022, and July 30, 2022, in Jordan. During the study period, an electronic survey consisting of 4 sections was administered to a convenience sample of Jordanians (aged 18 or above) using 2 social media platforms (Facebook and WhatsApp). Logistic regression analysis was used to screen the predictors of ADRs reporting by the participants. ResultsA total of 441 participants completed the survey. The majority of the participants (67.6%) were females, 53.1% between 26 and 45 years old. Almost all participants (96.3%) were always aware of the indication of the medications they take, the time and frequency (87.8%), and the duration of medications (84.4%). Nearly one-third of the participants (37.4%) asked about their medications' ADRs. However, the drug information leaflet was the most frequently used source of ADR information (33.3%). The majority of responders believed that both healthcare providers and consumers should report ADRs (93.4% and 80.3%, respectively). Only one-quarter of respondents (27.2%) believed that consumers could directly report ADRs through the Jordan pharmacovigilance program. The majority of patients who had experienced ADRs (70.3%) were aware that ADRs should be reported, and among them, 91.9% had reported the ADRs to healthcare providers. Furthermore, few participants (8.1%) reported it to the Jordan National Pharmacovigilance Centre (JNCP). Linear regression revealed that none of the demographic characteristics (age, gender, education, job, and social status) were affecting public reporting practice of the ADRs (P > 0.05 for all). ConclusionRespondents showed fair knowledge about adverse drug reactions and their reporting. However, there is a need to initiate educational activities and intervention programs to raise awareness about the JNPC, which will have a positive impact on public health and ensure safe medication use in Jordan.

Association of the Extent of Internet Use by Patients With Cancer With Social Support Among Patients and Change in Patient-Reported Treatment Outcomes During Inpatient Rehabilitation: Cross-sectional and Longitudinal Study.

Given the increasing number of cancer survivors and their rising survival rates, rehabilitation plays an increasingly important role. Social support among patients is an essential element of inpatient and day care rehabilitation. The internet can empower patients with cancer to become more active health care consumers and facilitate information and supportive care needs. By contrast, therapists suspect that high internet use during rehabilitation may severely limit social interactions between patients, thus interfering with the patients' rehabilitation program and jeopardizing treatment success. We hypothesized that the extent of internet use would be negatively related to social support among patients with cancer during their clinical stay as well as fewer improvements in patient-reported treatment outcomes from the first to the last day of their clinical stay. Patients with cancer participated during their inpatient rehabilitation. Cross-sectional data, such as the extent of participants' internet use and perceived social support among patients, were collected during the last week of their clinic stay. The treatment outcomes, that is, participants' levels of distress, fatigue, and pain, were collected on the first and last day of the clinic stay. We used multiple linear regression analysis to study the association between the extent of internet use and social support among patients with cancer. We used linear mixed model analyses to study the association between the extent of internet use by patients with cancer and the change in patient-reported treatment outcomes. Of the 323 participants, 279 (86.4%) participants reported that they used the internet. The extent of the internet use (t315=0.78; P=.43) was not significantly associated with the perceived social support among the participants during their clinical stay. In addition, the extent of participants' internet use during their clinical stay was not associated with changes in participants' levels of distress (F1,299=0.12; P=.73), fatigue (F1,299=0.19; P=.67), and pain (F1,303=0.92; P=.34) from the first to the last day of their clinical stay. The extent of internet use does not seem to be negatively associated with the perceived social support among patients with cancer or with the change in patients' levels of distress, fatigue, or pain from the first to the last day of their clinical stay.