Healthcare Information Research Articles

Obstetric healthcare experiences and information needs of Dutch women in relation to their vegan diet during pregnancy

ObjectivesThe prevalence of a vegan (strict plant-based) diet is increasing. Adequate access to nutritional information for pregnant women on a vegan diet is vital, as optimal maternal nutrition is important in order to prevent maternal and fetal complications. This study evaluated the obstetric healthcare experiences and information needs of pregnant women following a vegan diet in the Netherlands. MethodsAn online survey examined women’s experiences with obstetric healthcare in relation to their vegan diet during pregnancy. In total, 195 women, all of whom followed a vegan diet during their pregnancy and gave birth between January 2018 and April 2020, completed an online survey about their experiences. Descriptive statistics were used to present the data. ResultsIn total, 36.5% of participants reported that an obstetric healthcare provider had inquired about their diet in general during the first prenatal consultation, and an additional 43.1% of participants proactively informed their healthcare provider about their diet. Only 19.0% of all participants received specific information about their vegan diet during pregnancy, and 25.2% reported having had extra checks, mostly blood tests, during their pregnancy. Of all participants, 35.9% would have preferred to receive additional information regarding their diet. ConclusionsOur data shows that only a minority of pregnant women following a vegan diet received information and recommendations about their diet from their healthcare providers. It is our recommendation that healthcare providers inquire about pregnant women’s diets, and refer those following a vegan diet to reliable sources of dietary information or to a specialized dietitian.

Cultural Transformation of the International Statistical Classification of Diseases and Related Health Problems' Guidelines Needed to Effectively Measure Well-Being.

A cultural transformation is underway at the Veterans Health Administration and other health care systems to address the well-being of the whole person and not just their disease states. A part of this evolution is to develop a measurement paradigm because the existing ones are generally disease-specific; however, the International Statistical Classification of Diseases and Related Health Problems (ICD)-10th Revision-Clinical Modification does include codes for social determinants of health (SDOH). The ICD coding system is an internationally recognized system to identify and classify diseases, injuries, health encounters, and inpatient procedures. Medical and social service providers, researchers, health information managers, public health and health care system professionals, policymakers, and coders use these codes to conduct surveillance, such as on the existence of diseases and their outcomes, health care utilization, and health care-associated adverse events, and for billing and claims reimbursement. The ICD coding system has been the backbone of health care systems' clinical documentation and coding practices on an international level since 1909. Clinical documentation and coding have an immense influence on what can be measured in medical records. The current ICD guidance needs to undergo a cultural transformation to have parity between codes for medical and nonmedical conditions, such as supporting the standard use of SDOH as primary diagnoses for outpatient encounters, expanding its list of SDOH codes, and incorporating a wellness perspective. Developing a measurement paradigm that assesses the well-being of the whole person must involve in tandem revising the ICD coding system to include this same perspective.

"Does My Kid Have an Ear Infection?" An Analysis of Pediatric Acute Otitis Media Videos on TikTok.

With the rise of social media, online platforms have become a common way to access healthcare information. This study examines the quality of pediatric acute otitis media (AOM) videos on TikTok, a popular short-form video social media platform. A TikTok search was conducted between 8/18 and 8/19/2023 using pediatric AOM hashtags: #pediatric acute otitis media management, #kid ear infections remedy, #child ear infections treatment, and #kid ear infection. Data collected include number of views/shares per day, uploader type (nonmedical influencer, lay individual, and medical professional), and content categories. The Patient Education Materials Assessment Tool for Audiovisual Material (PEMAT-AV) and DISCERN questionnaire measured understandability, actionability, and quality of videos. Multivariable linear regression models were used (significance set at ≤0.05). Of 166 videos, 38.6% (64) of uploaders were medical professionals, and 32.5% (54) were nonmedical influencers. Nonmedical influencer videos were viewed and shared significantly more than those by medical professionals (p < 0.05). Controlling for covariates, physicians were more likely to produce more beneficial and higher quality videos as compared with nonmedical influencers (β = 2.4 and 1.3, p < 0.01, respectively). However, physicians did not have significantly different ratings for understandability compared with nonmedical influencers (β = 0.45, p > 0.05). AOM content on TikTok is often geared toward caretakers of symptomatic children. Although physician-created AOM content was significantly higher quality, these videos reached a statistically smaller audience than those from nonmedical influencers. Addressing misinformation on social media platforms requires physicians to reach larger audiences by producing more actionable and understandable content. NA Laryngoscope, 134:5184-5192, 2024.

Digital Health Platform for Improving the Effect of the Active Health Management of Chronic Diseases in the Community: Mixed Methods Exploratory Study

Background China is vigorously promoting the health management of chronic diseases and exploring digital active health management. However, as most medical information systems in China have been built separately, there is poor sharing of medical information. It is difficult to achieve interconnectivity among community residents’ self-testing information, community health care information, and hospital health information, and digital chronic disease management has not been widely applied in China. Objective This study aimed to build a digital health platform and improve the effectiveness of full-cycle management for community chronic diseases through digital active health management. Methods This was a single-arm pre-post intervention study involving the development and use of a digital health platform (2-year intervention; 2020 to 2022). The digital health platform included the “i Active Health” applet for residents and the active health information system (cardio-cerebrovascular disease risk management system) for medical teams. The digital active health management of chronic diseases involved creating health streets, providing internet-assisted full-cycle active health services for residents, implementing internet-based community management for hypertension and diabetes, and performing real-time quantitative assessment and hierarchical management of residents’ risks of cardio-cerebrovascular disease. After the 2-year intervention, management effectiveness was evaluated. Results We constructed a digital health platform with interconnected health information and implemented a digital active health management model. After the intervention, the 2-way referral between community health care institutions and hospitals increased. Residents’ health literacy rate increased from 30.6% (3062/10,000) in 2020 to 49.9% (4992/10,000) in 2022, with improvements in health knowledge, health behavior, and health skills. Moreover, the risk of cardio-cerebrovascular disease decreased after the intervention. The community hypertension and diabetes standardized management rates increased from 59.6% (2124/3566) and 55.8% (670/1200) in 2020 to 75.0% (3212/4285) and 69.4% (1686/2430) in 2022, respectively. The control rates of blood pressure in patients with hypertension and blood sugar in patients with diabetes increased from 51.7% (1081/2091) and 42.0% (373/888) in 2020 to 81.2% (1698/2091) and 73.0% (648/888) in 2022, respectively. The intervention improved patients’ BMI, waist circumference, blood uric acid levels, and low-density lipoprotein cholesterol levels. The drug compliance rate of patients with hypertension and diabetes increased from 33.6% (703/2091) and 36.0% (320/888) in 2020 to 73.3% (1532/2091) and 75.8% (673/888) in 2022, respectively. The intervention greatly improved the diet behavior, exercise behavior, and drinking behavior of patients with hypertension and diabetes. Conclusions Our digital health platform can effectively achieve the interconnection and exchange of different health information. The digital active health management carried out with the assistance of this platform improved the effectiveness of community chronic disease management. Thus, the platform is worth promoting and applying in practice.

An Examination of Factors Influencing Physicians' Acceptance and Use of the e-Nabız System

Aim: This study aims to identify the factors influencing physicians' acceptance and use of the e-Nabız system by comparing two models. Methods: Conducted with 388 physicians from university hospitals across Turkey, the study utilized an online survey based on the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. Descriptive analyses, frequency and percentage distributions, reliability analysis, confirmatory factor analysis, and structural equation modelling were applied to the collected data. Results: In Model 1, the behavioral intention was influenced by performance expectancy and social influence, while usage behavior was shaped by social influence, facilitating conditions, and behavioral intention. Model 1 accounted for 75% of the variance in behavioral intention and 69% in usage behavior. In contrast, Model 2 identified performance expectancy, anxiety, habit, personal technology innovativeness, and workflow as significant predictors of behavioral intention. Usage behavior in Model 2 was influenced by habit, facilitating conditions, anxiety, personal technology innovativeness, workflow, and behavioral intention, explaining 84% of the variance in behavioral intention and 85% in usage behavior. Conclusion: The findings indicate that Model 2 provides a more comprehensive explanation of the factors affecting the acceptance and use of the system. To enhance acceptance and usage, the study suggests focusing on anxiety management, emphasizing performance benefits, aligning the system with workflow, educating users about new technologies, and implementing incentives to foster habitual use. Future research should explore other technology acceptance models in various healthcare information systems to deepen understanding.

Unmet Needs of Children and Young Adults With ADHD: Insights From Key Stakeholders on Priorities for Stigma Reduction.

Individuals with ADHD continue to face stigma, which can negatively impact their access to, adherence to, and quality of mental health services, as well as their overall wellbeing. Perspectives of various stakeholders regarding priorities for stigma reduction remain underexplored. This study explores young adult, parent, teacher, and mental health care professional perspectives on unmet needs of children and young adults with ADHD in the Netherlands, in the context of stigma reduction. A total of 24 respondents participated in seven small focus group discussions (FGDs). The FGDs facilitated in-depth discussions exploring stakeholder group perspectives on unmet needs of children and young adults with ADHD in educational, professional, and social settings. Data was analyzed using thematic content analysis. Three thematic categories of unmet needs were identified: (1) a lack of awareness, knowledge, and understanding of ADHD; (2) insufficient personalized approaches in education and health care; and (3) limited accessibility of information and support services. Within theme 1, respondents primarily highlighted the importance of improving education for primary school teachers and mental health care professionals. Theme 2 underscored the need for increased capacity for personalization and attention to the sociopsychological factors of ADHD, alongside recognizing strengths. Theme 3 emphasized the need for easy access to reliable information and mental health care, including peer networks, as well as proper follow-up and continuity of care. Findings highlight the need for improving our understanding of ADHD as a complex biopsychosocial condition, which requires specific adjustments in education and mental health care. Interventions to improve support and disrupt stigmatization should meet diverse needs, incorporate multi-level strategies, and involve key stakeholders.

Bariatric Surgery Reduced Long-Term Mortality in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Cirrhosis.

With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the U.S.A. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery. Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related, and non-liver-related mortality were analyzed. Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; P < 0.0001), liver-related (3.3% vs. 14%; P < 0.0001), and non-liver-related mortality (22.3% vs. 26.9%; P = 0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR] = 0.63; P < 0.0001), liver-related (aHR = 0.24; P < 0.0001), and non-liver-related (aHR = 0.81; P = 0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR = 0.39; P < 0.0001) whereas open surgeries were associated with higher overall mortality (aHR = 1.24; P = 0.022). Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.

Blockchain in Health Information Systems: A Systematic Review

(1) Background: With the increasing digitalization of healthcare systems, data security and privacy have become crucial issues. In parallel, blockchain technology has gradually proven to be an innovative solution to address this challenge, as its ability to provide an immutable and secure record of transactions offers significant promise for healthcare information management. This systematic review aims to explore the applications of blockchain in health information systems, highlighting its advantages and challenges. (2) Methods: The publications chosen to compose this review were collected from six databases, resulting in the initial identification of 4864 studies. Of these, 73 were selected for in-depth analysis. (3) Results: The main results show that blockchain has been used mainly in electronic health records (63%). Furthermore, it was used in the Internet of Medical Things (8.2%) and for data sharing during the COVID-19 pandemic (6.8%). As advantages, greater security, privacy, and data integrity were identified, while the challenges point to the need for standardization and regulatory issues. (4) Conclusions: Despite the difficulties encountered, blockchain has significant potential to improve healthcare data management. However, more research and continued collaboration between those involved are needed to maximize its benefits.

Assessing global and regional public interest in home dialysis modalities from 2004 to 2024

Background and objectivesHome dialysis (peritoneal dialysis and home hemodialysis) is an important renal replacement therapy modality option for patients with end-stage kidney disease. As the Internet has become a primary source for healthcare information, this study aimed to analyze the global and regional interests in home dialysis using Google Trends™ data from January 2004 to March 2024.Design, setting, participants, and measurementsA comprehensive analysis was conducted using Google Trends™ with the search terms “Peritoneal Dialysis” and “Home Hemodialysis.” This study extracted worldwide trends and detailed regional interests within the United States. Interest levels were quantitatively assessed based on Google Trends™ indices, providing insights into temporal patterns and geographical distributions of public interest.ResultsThe study found a fluctuating pattern of global interest in Peritoneal Dialysis, with peak interest in March 2022 and lowest interest in December 2008. The most recent data from March 2024 showed significant interest level of 94, indicating a new upward trend. Mexico exhibited the highest relative interest in Peritoneal Dialysis. Within the United States, Tennessee demonstrated the highest interest. For Home Hemodialysis, the peak interest was in July 2004. The most recent data from March 2024 showed a modest increase in interest. The United States led in highest relative interest for Home Hemodialysis, followed by Australia, Canada, and the United Arab Emirates. Within the United States, Mississippi demonstrated the highest interest.ConclusionsThis study offers crucial insights into the global and regional landscape of interest in home dialysis modalities over time, highlighting the significance of leveraging online platforms to increase public awareness, education, and engagement home dialysis modalities. By understanding the temporal and geographical patterns of interest, healthcare providers, policymakers, and patient advocacy groups can develop targeted strategies to better promote the benefits of home dialysis, address knowledge gaps, and improve access to these life-sustaining treatments.

Perceptions of a South Australian online trans health resource: transnormativity, safety, and professionalism

Background The proliferation of trans-led online health resources constitutes a purposive community response to the limitations that many trans people face globally in accessing healthcare information and services. While such resources are typically community run or administered by individuals, and hence not subject to reporting mandates, it is useful to examine how end-users perceive online health resources for trans people. Aims This paper reports on an evaluation of one trans-led online health resource, focused on South Australia. Methods Interviews were undertaken with 15 trans people who accessed the website Trans Health SA. Participants were invited to view the website alongside the first author, and to share their thoughts about the website design and content. Results Thematic analysis resulted in the development of three themes: (1) transnormativity and the intended viewer, (2) the website as a welcoming community space, and (3) discrepancies between content and design. Conclusions The paper concludes by considering what it means to create inclusive online trans health resources in the context of both ongoing marginalization and community diversity.

Simulated misuse of large language models and clinical credit systems.

In the future, large language models (LLMs) may enhance the delivery of healthcare, but there are risks of misuse. These methods may be trained to allocate resources via unjust criteria involving multimodal data - financial transactions, internet activity, social behaviors, and healthcare information. This study shows that LLMs may be biased in favor of collective/systemic benefit over the protection of individual rights and could facilitate AI-driven social credit systems.

A new trial monitoring plan (TMP) template for clinical trials: output from a Delphi process

BackgroundMonitoring is a crucial part of trial conduct and ensures that participants’ data is fairly represented, and future healthcare information is enhanced. This project aims to improve trial monitoring by creating a trial monitoring plan (TMP) template with input from individuals experienced in monitoring clinical trials.MethodsA review of monitoring plans received from UK Clinical Research Collaboration (UKCRC) registered clinical trials units (CTU)s created the basis for a preliminary TMP template and a Delphi survey. The TMP template was finalised after 2 rounds of a Delphi survey and a two-part consensus meeting including trialists with experience and expertise in monitoring clinical trials.ResultsWe received 31 monitoring plans from UKCRC-registered CTUs and reviewed over 800 monitoring items for inclusion in a TMP template, selecting items based on guidelines such as Good Clinical Practice (GCP) and our monitoring experiences. For certain items, further expert input was required. A total of 66 items were chosen for a Delphi survey involving 47 participants from 25 UK CTUs and industry. After the first round, all 66 items were retained, and six additional items were suggested by Delphi participants. In the second round, 37 items reached consensus for inclusion in the TMP template. The Delphi process was followed by a consensus meeting with 9 participants from 9 UK CTUs and industry. Participants in the consensus meeting voted on the 32 further items that had not reached the definition of consensus within the Delphi, regarding each item’s inclusion in or exclusion from the TMP template. The voting resulted in 18 items being excluded, leaving 14 items to be included in the TMP template. The process overall resulted in a standardised TMP template with input from many individuals with interest, experience, or expertise in monitoring clinical trials.ConclusionA TMP template was developed building on the currently used monitoring plans and with input from those experienced in clinical trial monitoring. Using a centrally developed good quality TMP template should contribute towards maintaining consistency in monitoring standards across all CTUs, resulting in higher research quality and improved quality assurance. Its use should provide reassurance to participants that their participation is carefully monitored to ensure that their data or any samples provided are treated with confidentiality, integrity, and respect and that their rights and well-being are protected.

Rural-Urban Disparities in Mobile Health Application Ownership and Utilization Among Cancer Survivors

Objective: Mobile health applications (mHealth apps) can provide health care and health-promoting information while contributing to improving cancer survivors’ quality of life and health outcomes. However, little is known about the rural-urban distribution of mHealth app ownership and utilization. In this study, we explore the characteristics of cancer survivors who own and use mHealth apps and examine rural-urban disparities in mHealth app ownership and utilization among cancer survivors. Methods: We utilized data from the “Health Information National Trends Survey–Surveillance, Epidemiology, and End Results” pilot study, fielded among cancer survivors from 3 U.S. cancer registries (Iowa, New Mexico, and California) in 2021. Our sample included 942 cancer survivors who reported owning a smart device (a smartphone and/or a tablet computer). The analyses included computing weighted proportions and fitting a multivariable regression model. Results: Overall, 60.3% of cancer survivors reported using mHealth apps, and 16.9% resided in rural areas. Approximately 45.0% of rural cancer survivors reported utilizing mHealth apps (vs 63.5% of urban survivors). Regression analysis revealed that rural cancer survivors had 46.0% lower odds of owning and using mHealth apps compared with their urban counterparts (adjusted odds ratio = 0.54; 95% CI: 0.36, 0.80). Conclusions: Rural cancer survivors were less likely to own and use mHealth apps compared with urban survivors. Rural cancer survivors usually face structural and health care system-related barriers to health care access and affordability. Leveraging mHealth technology as a tool could potentially contribute to improving health care delivery for rural cancer survivors, and help address existing structural and informational barriers to access.

Systematic review of ethics and legislation of a Global Patient co-Owned Cloud (GPOC)

Background The use of cloud-based storage for personal health records (PHRs) has significantly increased globally over the past thirty years. The four recently published GPOC Series articles introduced the concept of a Global Patient co-Owned Cloud (GPOC) for personal health records. The series includes a systematic review and meta-analysis, a summit, a sandbox, and a survey, with 100% participation from UN member states and key international health organisations. GPOC aims to establish patient co-ownership of PHRs, addressing integration and access challenges. Methods This study is built upon the published GPOC systematic review and meta-analysis that focused on examining cloud-based personal health records and elements such as data security, efficiency, performance, privacy and cost-based factors. However, this study selectively reviews the ethical, legislative and potential human rights dimensions of GPOC. Thus, it includes ethical aspects of co-ownership, rights, privacy, policies, and AI integration. The original study was PROSPERO registered with CRD42022342597, which serves as the foundation for the current study. Results This study offers a comprehensive global overview of ethics, legislation and initiatives by states and organisations. We analyse AI integration and future challenges for GPOC implementation. We present principles from ‘Ethics by Design’ and the ‘Principles of Biomedical Ethics’ by Beauchamp and Childress alongside the European General Data Protection Regulation (GDPR). The study presents a global overview of the relevant global latticework of legislation. Conclusions This study suggests that GPOC could potentially establish a new human right to patient co-ownership of personal health information. GPOC aims to facilitate global AI integration in healthcare and address existing challenges in PHR integration. A decentralised GPOC, supported by blockchain consensus, may offer benefits such as enhanced data security, interoperability, and equitable access to healthcare information globally. Thus, GPOC may have a positive impact on global health.

Patient Health Record Protection Beyond the Health Insurance Portability and Accountability Act: Mixed Methods Study

Background The security and privacy of health care information are crucial for maintaining the societal value of health care as a public good. However, governance over electronic health care data has proven inefficient, despite robust enforcement efforts. Both federal (HIPAA [Health Insurance Portability and Accountability Act]) and state regulations, along with the ombudsman rule, have not effectively reduced the frequency or impact of data breaches in the US health care system. While legal frameworks have bolstered data security, recent years have seen a concerning increase in breach incidents. This paper investigates common breach types and proposes best practices derived from the data as potential solutions. Objective The primary aim of this study is to analyze health care and hospital breach data, comparing it against HIPAA compliance levels across states (spatial analysis) and the impact of the Omnibus Rule over time (temporal analysis). The goal is to establish guidelines for best practices in handling sensitive information within hospitals and clinical environments. Methods The study used data from the Department of Health and Human Services on reported breaches, assessing the severity and impact of each breach type. We then analyzed secondary data to examine whether HIPAA’s storage and retention rule amendments have influenced security and privacy incidents across all 50 states. Finally, we conducted a qualitative analysis of textual data from vulnerability and breach reports to identify actionable best practices for health care settings. Results Our findings indicate that hacking or IT incidents have the most significant impact on the number of individuals affected, highlighting this as a primary breach category. The overall difference-in-differences trend reveals no significant reduction in breach rates (P=.50), despite state-level regulations exceeding HIPAA requirements and the introduction of the ombudsman rule. This persistence in breach trends implies that even strengthened protections and additional guidelines have not effectively curbed the rising number of affected individuals. Through qualitative analysis, we identified 15 unique values and associated best practices from industry standards. Conclusions Combining quantitative and qualitative insights, we propose the “SecureSphere framework” to enhance data security in health care institutions. This framework presents key security values structured in concentric circles: core values at the center and peripheral values around them. The core values include employee management, policy, procedures, and IT management. Peripheral values encompass the remaining security attributes that support these core elements. This structured approach provides a comprehensive security strategy for protecting patient health information and is designed to help health care organizations develop sustainable practices for data security.

The Impact of the U.S. Maternal Tdap Vaccination Program on Preventing Pertussis in Infants 2-&amp;lt;6 Months of Age: A Case-control Evaluation

Abstract Background To protect infants aged &amp;lt;2 months against pertussis, the United States recommends Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during each pregnancy. Data are limited on the strategy’s effectiveness against pertussis in infants aged ≥2 months. Methods Pertussis cases aged 2-&amp;lt;6 months with cough onset between 1/1/2011-12/31/2014 were identified in six U.S. states. Controls were 2-&amp;lt;6 months of age, hospital-matched, and selected by birth certificate. Mothers were interviewed to collect demographic and healthcare information. Provider-verified vaccination history was obtained for infants and mothers. Adjusted odds ratios (aORs) were calculated using conditional logistic regression; overall vaccine effectiveness (VE) was estimated as (1 - aOR) x 100. To describe maternal Tdap VE modified by infant DTaP (diphtheria and tetanus toxoids, and acellular pertussis) doses, case-control sets were unmatched and a time-to-event analysis conducted through a Generalized Linear Mixed Model. Results A total of 335 cases and 927 controls were enrolled. The overall adjusted VE estimate for Tdap during pregnancy was 45.6% (95% confidence interval [CI], 5.8% – 68.5%) and increased slightly, but not significantly against infant hospitalization (55.7% (-116.8% – 90.9%)). Although point estimates were not significant, VE was modified by infant DTaP doses (58.8% (-6.0% – 84.0%) for zero DTaP doses, 30.5% (-21.4% – 60.2%) for one DTaP dose, and 3.2% (-170.8% – 65.4%) for two DTaP doses). Conclusions Our study suggests that there is some benefit of maternal Tdap vaccination beyond the first two months of life, however, on-time vaccination of infants remains critical to maintain protection from pertussis.

Deploying a user-friendly GIS mapping tool in post-earthquake Turkey and Syria

Background The February 2023 earthquakes in Turkey and Syria exposed significant gaps in healthcare information systems, which severely hampered communication, coordination, and the overall public health response. These disruptions were primarily due to the lack of real-time, accessible data on healthcare facilities. Methods In response, an interactive Geographic Information System (GIS) tool, coupled with an integrated WhatsApp chatbot, was developed under the platform Afetsaglikharitasi.org. This system enabled real-time mapping and updates on the status of healthcare services, even in areas with limited internet connectivity, facilitating more efficient resource coordination during the disaster response. Results By March 30, 2023, the disaster health map included data from 537 health centers and had reached over 800,000 individuals via social media platforms such as Instagram, Facebook, and Twitter. The platform attracted over 3,500 unique users, with most accessing it via mobile devices to locate healthcare services. Additionally, shortcomings in the Turkey National Disaster Response Plan (Türkiye Afet Müdahale Planı – TAMP) were identified, particularly the lack of integration of digital health technologies, which hindered resource allocation during the earthquake response and underscored the need for their inclusion in disaster management strategies. Conclusions This study demonstrates the effectiveness of digital health tools in enhancing disaster response and underscores the importance of integrating user-centered, deployable technologies to improve healthcare delivery in emergency settings.

The Relationship Between Chronic Cough and Laryngopharyngeal Reflux: A Professional Voice User’s Guide on Diagnosis and Treatment

Abstract: Chronic cough is multifactorial in origin, affects quality of life adversely, including preventing singers from performing, and poses a diagnostic challenge. Laryngopharyngeal reflux (LPR) is one common cause of chronic cough, but there are many causes of which singing teachers should be aware. Recently, research has been completed to investigate the relationship between chronic cough and LPR to help with treatment and management of this complicated disease process, and that new information is summarized; but awareness of other causes is stressed because many physicians are not expert in cough management. Singers and teachers need to be informed health care consumers.

Expansion and evaluation of level II and III recovery residences for people taking medications for an opioid use disorder: project HOMES (Housing for MAR Expanded Services) study protocol

IntroductionAs the US continues to battle the opioid epidemic, recovery residences remain valuable services for people in recovery. While there is a growing body of literature describing positive outcomes experienced...

Architecting Resilience : A Framework for Secure and Compliant Healthcare IT Infrastructures

Healthcare information technology (IT) systems face unique challenges in maintaining data security and regulatory compliance while supporting critical patient care functions. This article provides a comprehensive analysis of the complex interplay between data protection measures and compliance requirements in the healthcare sector. We examine key components of data security, including encryption, data integrity measures, and secure transfer protocols, with a specific focus on their application to sensitive patient information. The impact of regulations such as HIPAA on system design and maintenance is explored, offering insights into the alignment of IT practices with evolving standards. Through a review of current literature and industry best practices, we present strategies for risk management, employee training, and the implementation of technical controls that address both security and compliance needs. Emerging trends, including cloud computing, the Internet of Medical Things (IoMT), and artificial intelligence in healthcare security, are discussed to provide a forward-looking perspective. This article contributes to the ongoing dialogue on balancing innovation with security in healthcare IT, offering practical recommendations for healthcare organizations to enhance their data protection measures while ensuring regulatory compliance.