Integrated Health Information Research Articles

The use of artificial intelligence, numerical algorithms and expert approach in selected nephrology problems

Background: The integration of AI, numerical algorithms, and expert approaches in nephrology shows promise for enhancing patient care. Traditionally, nephrology relied on clinician expertise, but the growing volume of data requires innovative methods. AI, fueled by vast datasets, can uncover patterns and improve diagnostic accuracy and treatment optimization. Numerical algorithms enable computational modeling of renal physiology and disease progression, aiding in treatment prediction and optimization. Expert systems codify nephrologists' knowledge into decision support tools, aiding in diagnosis and treatment selection. Embracing these technologies can revolutionize nephrological practice, improving patient outcomes.Aim of the study: The aim of the research is to review scientific works on the use of artificial intelligence (AI), numerical algorithms, and expert algorithms in diagnosis, decision support and prediction of selected disease states and issues related to nephrology.Material and methods: The study rigorously retrieved relevant publications from esteemed academic databases, Scopus and PubMed, and screened them based on predefined criteria. Through keyword-based searches, it analyzed the intersection of nephrology and artificial intelligence, offering insights into emerging trends and advancements. This approach facilitated a comprehensive exploration of the integration of artificial intelligence in nephrology research, paving the way for future developments in the field.Results: Artificial intelligence in nephrology and medicine uses various technologies such as machine learning, deep learning and natural language processing to improve diagnosis, treatment and patient care. Analyzes clinical, laboratory, imaging and genetic data to accelerate the identification of kidney diseases. By integrating health information systems and research data, artificial intelligence enables pattern recognition, outcome prediction and treatment optimization, ultimately having the potential to permanently improve patient care.Conclusions: Numerical algorithms, artificial intelligence, and expert algorithms show promise in nephrology, improving patient care and research.

System interoperability and data linkage in the era of health information management: A bibliometric analysis.

Background: Across the world, health data generation is growing exponentially. The continuous rise of new and diversified technology to obtain and handle health data places health information management and governance under pressure. Lack of data linkage and interoperability between systems undermines best efforts to optimise integrated health information technology solutions. Objective: This research aimed to provide a bibliometric overview of the role of interoperability and linkage in health data management and governance. Method: Data were acquired by entering selected search queries into Google Scholar, PubMed, and Web of Science databases and bibliometric data obtained were then imported to Endnote and checked for duplicates. The refined data were exported to Excel, where several levels of filtration were applied to obtain the final sample. These sample data were analysed using Microsoft Excel (Microsoft Corporation, Washington, USA), WORDSTAT (Provalis Research, Montreal, Canada) and VOSviewer software (Leiden University, Leiden, Netherlands). Results: The literature sample was retrieved from 3799 unique results and consisted of 63 articles, present in 45 different publications, both evaluated by two specific in-house global impact rankings. Through VOSviewer, three main clusters were identified: (i) e-health information stakeholder needs; (ii) e-health information quality assessment; and (iii) e-health information technological governance trends. A residual correlation between interoperability and linkage studies in the sample was also found. Conclusion: Assessing stakeholders' needs is crucial for establishing an efficient and effective health information system. Further and diversified research is needed to assess the integrated placement of interoperability and linkage in health information management and governance. Implications: This research has provided valuable managerial and theoretical contributions to optimise system interoperability and data linkage within health information research and information technology solutions.

Integrating Health and Disability Data Into Academic Information Systems: Workflow Optimization Study.

Integrating health information into university information systems holds significant potential for enhancing student support and well-being. Despite the growing body of research highlighting issues faced by university students, including stress, depression, and disability, little has been done in the informatics field to incorporate health technologies at the institutional level. This study aims to investigate the current state of health information integration within university systems and provide design recommendations to address existing gaps and opportunities. We used a user-centered approach to conduct interviews and focus group sessions with stakeholders to gather comprehensive insights and requirements for the system. The methodology involved data collection, analysis, and the development of a suggested workflow. The findings of this study revealed the shortcomings in the current process of handling health and disability data within university information systems. In our results, we discuss some requirements identified for integrating health-related information into student information systems, such as privacy and confidentiality, timely communication, task automation, and disability resources. We propose a workflow that separates the process into 2 distinct components: a health and disability system and measures of quality of life and wellness. The proposed workflow highlights the vital role of academic advisors in facilitating support and enhancing coordination among stakeholders. To streamline the workflow, it is vital to have effective coordination among stakeholders and redesign the university information system. However, implementing the new system will require significant capital and resources. We strongly emphasize the importance of increased standardization and regulation to support the information system requirements for health and disability. Through the adoption of standardized practices and regulations, we can ensure the smooth and effective implementation of the required support system.

Use of an electronic wellness instrument in the integrated health and social care of older adults: a group concept mapping study

BackgroundHealth system fragmentation directly contributes to poor health and social outcomes for older adults with multiple chronic conditions and their care partners. Older adults often require support from primary care, multiple specialists, home care, community support services, and other health-care sectors and communication between these providers is unstructured and not standardized. Integrated and interprofessional team-based models of care are a recommended strategy to improve health service delivery to older adults with complex needs. Standardized assessment instruments deployed on digital platforms are considered a necessary component of integrated care. The aim of this study was to develop strategies to leverage an electronic wellness instrument, interRAI Check Up Self Report, to support integrated health and social care for older adults and their care partners in a community in Southern Ontario, Canada.MethodsGroup concept mapping, a participatory mixed-methods approach, was conducted. Participants included older adults, care partners, and representatives from: home care, community support services, specialized geriatric services, primary care, and health informatics. In a series of virtual meetings, participants generated ideas to implement the interRAI Check Up and rated the relative importance of these ideas. Hierarchical cluster analysis was used to map the ideas into clusters of similar statements. Participants reviewed the map to co-create an action plan.ResultsForty-one participants contributed to a cluster map of ten action areas (e.g., engagement of older adults and care partners, instrument’s ease of use, accessibility of the assessment process, person-centred process, training and education for providers, provider coordination, health information integration, health system decision support and quality improvement, and privacy and confidentiality). The health system decision support cluster was rated as the lowest relative importance and the health information integration was cluster rated as the highest relative importance.ConclusionsMany person-, provider-, and system-level factors need to be considered when implementing and using an electronic wellness instrument across health- and social-care providers. These factors are highly relevant to the integration of other standardized instruments into interprofessional team care to ensure a compassionate care approach as technology is introduced.

Evaluation of Outbreak Preparedness to Prevent the Reintroduction of Malaria in Ramanagara District: A Descriptive Epidemiological Study.

Background Malaria is a vector-borne disease transmitted by female anopheline mosquitoes. It is also a multidimensional disease influenced by social factors such as poor environmental conditions and awareness gaps. India has witnessed a substantial reduction in malaria cases and has declared three regions as malaria-free, with Karnataka being one of the states. However, Karnataka witnesses significant population movement and migration, which influences the spread of malaria. Ramanagara, a district in Karnataka, reported zero indigenous cases over the past three years. Hence, we selected this district to evaluate outbreak preparedness to prevent the reintroduction of malaria. This choice underscores the district's significance as a valuable model for preventing the reintroduction of malaria. Methodology Baseline survey data on malaria cases and vector survey data were evaluated for the period spanning 2018 to 2022. The data were gathered from both the regional office and the Ramanagara district health office. In addition to the documenting system, because there was no regular submission of Form-P and Form-L of the Integrated Disease Surveillance Project and Integrated Health Information Platform from the private sector, to complete the missing data, across-sectional study was conducted among private sector practitioners and pharmacies in Ramanagara from April 2023 to June 2023. Data was collected via interviews using a malaria surveillance assessment toolkit sourced from the National Centre for Vector Borne Diseases Control and World Health Organization protocols to assess six core areas of malaria elimination. Data collected via interviews were compiled in MS Excel and analyzed using SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). Results Malaria control measures in the selected district achieved >80% coverage with notable improvements in the National Health Mission-National Vector Borne Disease Control Programme fund utilization, logistics availability, and physical performance over the past five years. The Annual Parasite Index was <1 at 0.0061 in 2018 and 0.0017 in 2022. The annual blood examination rate was consistently >10 from 22.05 in 2018 to 24.36 in 2022. The primary vectors identified were Anopheles culicifacies and Anopheles stephensi. In 2018, there were six cases of Plasmodium vivax and one case of Plasmodium falciparum reported as imported cases. In 2021 and 2022, two cases of P. vivax were reported. Notably, there were no instances of mixed infections or indigenous cases documented from 2018 to 2022 Conclusions Although the level of outbreak preparedness in the region is satisfactory, the effectiveness of vector control measures appears to be lacking. Increased government funding is needed along with comprehensive training and workshops for healthcare workers. Adequate financial resources and enhanced skills among healthcare workers are crucial to reinforce the existing efforts to control vectors and prevent potential outbreaks effectively.

COVID-19 genome surveillance: A geographical landscape and mutational mapping of SARS-CoV-2 variants in central India over two years

Reading the viral genome through whole genome sequencing (WGS) enables the detection of changes in the viral genome. The rapid changes in the SARS-CoV-2 viral genome may cause immune escape leading to an increase in the pathogenicity or infectivity. Monitoring mutations through genomic surveillance helps understand the amino acid changes resulting from the mutation. These amino acid changes, especially in the spike glycoprotein, may have implications on the pathogenicity of the virus by rendering it immune-escape. The region of Vidarbha in Maharashtra represents 31.6 % of the state's total area. It holds 21.3 % of the total population. In total, 7457 SARS-CoV-2 positive samples belonging to 16 Indian States were included in the study, out of which 3002 samples passed the sequencing quality control criteria. The metadata of 7457 SARS-CoV-2 positive samples included in the study was sourced from the Integrated Health Information Platform (IHIP). The metadata of 3002 sequenced samples, including the FASTA sequence, was submitted to the Global Initiative on Sharing Avian Influenza Data (GISAID) and the Indian biological data centre (IBDC). This study identified 104 different SARS-CoV-2 pango-lineages classified into 19 clades. We have also analysed the mutation profiles of the variants found in the study, which showed eight mutations of interest, including L18F, K417N, K417T, L452R, S477N, N501Y, P681H, P681R, and mutation of concern E484K in the spike glycoprotein region. The study was from November 2020 to December 2022, making this study the most comprehensive genomic surveillance of SARS-CoV-2 conducted for the region.

Barriers and strategies for primary health care workforce development: synthesis of evidence

BackgroundHaving a sufficient and well-functioning health workforce is crucial for reducing the burden of disease and premature death. Health workforce development, focusing on availability, recruitment, retention, and education, is inseparable from acceptability, motivation, burnout, role and responsibility, and performance. Each aspect of workforce development may face several challenges, requiring specific strategies. However, there was little evidence on barriers and strategies towards comprehensive health workforce development. Therefore, this review explored barriers and strategies for health workforce development at the primary health care level around the world.MethodsA scoping review of reviews was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews. The article search was performed in Google Scholar, PubMed, Web of Science, and EMBASE. We used EndNote x9 for managing the collected articles, screening processes, and citation purpose. The scoping review included any kind of review articles on the application of health workforce development concepts, such as availability, recruitment, retention, role and responsibility, education and training, motivation, and burnout, with primary health care and published in English anywhere in the world. Based on the concepts above, barriers and strategies for health workforce development were identified. The findings were synthesized qualitatively based on the building blocks of the health system framework. The analysis involved specific activities such as familiarization, construction of the thematic framework, indexing, charting, and interpretation. The results were presented in texts, tables, and figures.ResultsThe search strategies yielded 7,276 papers were found. Of which, 69 were included in the scoping review. The most frequently cited barriers were financial challenges and issues related to health care delivery, such as workloads. Barriers affecting healthcare providers directly, including lack of training and ineffective teamwork, were also prominent. Other health system and governance barriers include lack of support, unclear responsibility, and inequity. Another notable barrier was the shortage of health care technology, which pertains to both health care supplies and information technology. The most common cited effective strategies were ongoing support and supervision, engaging with communities, establishing appropriate primary care settings, financial incentives, fostering teamwork, and promoting autonomous health care practice.ConclusionsEffective leadership/governance, a robust health financing system, integration of health information and technology, such as mobile health and ensuring a consistent supply of adequate resources are also vital components of primary health care workforce development. The findings highlight the importance of continuous professional development, which includes training new cadres, implementing effective recruitment and retention mechanisms, optimising the skill mix, and promoting workplace wellness. These elements are essential in fostering a well-trained and resilient primary health care workforce.

Cloud-based secure data storage and access control for internet of medical things using federated learning

PurposeThe purpose of this paper Computing is a recent emerging cloud model that affords clients limitless facilities, lowers the rate of customer storing and computation and progresses the ease of use, leading to a surge in the number of enterprises and individuals storing data in the cloud. Cloud services are used by various organizations (education, medical and commercial) to store their data. In the health-care industry, for example, patient medical data is outsourced to a cloud server. Instead of relying onmedical service providers, clients can access theirmedical data over the cloud.Design/methodology/approachThis section explains the proposed cloud-based health-care system for secure data storage and access control called hash-based ciphertext policy attribute-based encryption with signature (hCP-ABES). It provides access control with finer granularity, security, authentication and user confidentiality of medical data. It enhances ciphertext-policy attribute-based encryption (CP-ABE) with hashing, encryption and signature. The proposed architecture includes protection mechanisms to guarantee that health-care and medical information can be securely exchanged between health systems via the cloud. Figure 2 depicts the proposed work's architectural design.FindingsFor health-care-related applications, safe contact with common documents hosted on a cloud server is becoming increasingly important. However, there are numerous constraints to designing an effective and safe data access method, including cloud server performance, a high number of data users and various security requirements. This work adds hashing and signature to the classic CP-ABE technique. It protects the confidentiality of health-care data while also allowing for fine-grained access control. According to an analysis of security needs, this work fulfills the privacy and integrity of health information using federated learning.Originality/valueThe Internet of Things (IoT) technology and smart diagnostic implants have enhanced health-care systems by allowing for remote access and screening of patients’ health issues at any time and from any location. Medical IoT devices monitor patients’ health status and combine this information into medical records, which are then transferred to the cloud and viewed by health providers for decision-making. However, when it comes to information transfer, the security and secrecy of electronic health records become a major concern. This work offers effective data storage and access control for a smart healthcare system to protect confidentiality. CP-ABE ensures data confidentiality and also allows control on data access at a finer level. Furthermore, it allows owners to set up a dynamic patients health data sharing policy under the cloud layer. hCP-ABES proposed fine-grained data access, security, authentication and user privacy of medical data. This paper enhances CP-ABE with hashing, encryption and signature. The proposed method has been evaluated, and the results signify that the proposed hCP-ABES is feasible compared to other access control schemes using federated learning.

Technology Readiness And Technology Acceptance: Exploring Healthcare Professionals' Intention To Use Telemedicine In Malaysia

Malaysia is among the countries that have undergone significant transformations as part of integrating health information into its healthcare system. Healthcare professionals' tasks and responsibilities have changed due to the digitalization of the industry. Telemedicine is an interactive technology-driven platform designed to facilitate medical interactions between two healthcare entities, healthcare providers, healthcare professionals, and patients. This interaction occurs remotely, overcoming geographical barriers. Through technology, telemedicine combines the accessibility, affordability, and convenience of health-related information and communication. The knowledge, competence, attitudes, and working environment of experts in the health organization are only a few variables that affect how well new technology works. There has not been much study done recently using TRAM to look at the choices made by medical practitioners regarding telemedicine. In order to gain a more profound understanding of the factors influencing the adoption of telemedicine among healthcare professionals in Malaysia, this research seeks to examine their readiness and acceptance of adopting technology. The study will delve into the correlation between Technology Readiness (TR) and the Technology Acceptance Model (TAM), with the inclusion of Perceived Digital Competence (PDC) as an additional variable. Moreover, the study will investigate the potential moderating role of demographic factors, including age, gender, and education, in these relationships. The theoretical significance of this research allows the researchers to bridge existing gaps in the literature, offering a more profound insight into the characteristics displayed by healthcare professionals and their inclinations toward adopting telemedicine. In the current pandemic and fiercely competitive business environment, the study's practical significance may help healthcare professionals better understand their lived experiences with digital health competence and increase their intention to use telemedicine to provide limitless and borderless teleconsultations.

Impact of the COVID-19 vaccination campaigns in Argentina during 2021: An observational quantification of the death probability for confirmed cases in Buenos Aires province

BackgroundA SARS-CoV-2 (COVID-19) vaccination campaign was launched in Argentina in January 2021. The vaccines then available were administered to the population in several different schemes. This observational study presents a quantification of the impact of the different schemes on the probability of death for confirmed COVID-19 cases in Argentina's Buenos Aires Province. The results provide a local measure of the schemes' effectiveness that heretofore has been lacking. MethodsThe study's main source of information is the Integrated Health Information System database, which contains 1,538,113 records of confirmed SARS-CoV-2 (COVID-19) cases reported in 2021 in the Province. To assess the real-world effectiveness of the vaccination campaign, two categorical variables representing vaccination status were defined. Probability of death was formulated as a generalized linear model with a logistic link and includes variables for geography, a socio-economic level index, symptom onset, sex, and vaccination status. The effectiveness level was derived from the death probability estimates. FindingsThe study's findings indicated that the most effective vaccine was rAd26-rAd5 (Sputnik), with ChAdOx1-S (AZ/Covishield) and BBIBP-CorV (Sinopharm) following in efficacy, for both single and multiple doses. The effectiveness of a single dose was consistently below 50%, while it ranged from 50% to 90% for two or more doses. Notably, the analysis of variables such as the municipality of residence of the infected persons and the season of symptom onset yielded particularly intriguing insights. The socioeconomic level of a municipality emerged as a moderately strong predictor of the probability of death, which was marginally higher in municipalities with lower-income populations. Additionally, the data revealed an increased probability of death during the winter season. InterpretationThe vaccination campaigns carried out in Buenos Aires Province in 2021 significantly contributed to reducing the number of deaths due to SARS-CoV-2 (COVID-19) among its population. However, the extent of this impact varied considerably depending on individual characteristics such as age, health status, and vaccination schedule adherence.

Key elements and contextual factors that influence successful implementation of large-system transformation initiatives in the New Zealand health system: a realist evaluation

BackgroundDespite three decades of policy initiatives to improve integration of health care, delivery of health care in New Zealand remains fragmented, and health inequities persist for Māori and other high priority populations. An evidence base is needed to increase the chances of success with implementation of large-system transformation (LST) initiatives in a complex adaptive system.MethodsThis research aimed to identify key elements that support implementation of LST initiatives, and to investigate contextual factors that influence these initiatives. The realist logic of enquiry, nested within the macro framing of complex adaptive systems, formed the overall methodology for this research and involved five phases: theory gleaning from a local LST initiative, literature review, interviews, workshop, and online survey. NVivo software programme was used for thematic analysis of the interview, workshop, and the survey data. We identified key elements and explained variations in success (outcomes) by identifying mechanisms triggered by various contexts in which LST initiatives are implemented.ResultsThe research found that a set of 10 key elements need to be present in the New Zealand health system to increase chances of success with implementation of LST initiatives. These are: (i) an alliancing way of working; (ii) a commitment to te Tiriti o Waitangi; (iii) an understanding of equity; (iv) clinical leadership and involvement; (v) involved people, whānau, and community; (vi) intelligent commissioning; (vii) continuous improvement; (viii) integrated health information; (ix) analytic capability; and (x) dedicated resources and time. The research identified five contextual factors that influenced implementation of LST initiatives: a history of working together, distributed leadership from funders, the maturity of Alliances, capacity and capability for improvement, and a continuous improvement culture. The research found that the key mechanism of trust is built and nurtured over time through sharing of power by senior health leaders by practising distributed leadership, which then creates a positive history of working together and increases the maturity of Alliances.DiscussionTwo authors (KMS and PBJ) led the development and implementation of the local LST initiative. This prior knowledge and experience provided a unique perspective to the research but also created a conflict of interest and introduced potential bias, these were managed through a wide range of data collection methods and informed consent from participants. The evidence-base for successful implementation of LST initiatives produced in this research contains knowledge and experience of senior system leaders who are often in charge of leading these initiatives. This evidence base enables decision makers to make sense of complex processes involved in the successful implementation of LST initiatives.ConclusionsUse of informal trust-based networks provided a critical platform for successful implementation of LST initiatives in the New Zealand health system. Maturity of these networks relies on building and sustaining high-trust relationships among the network members. The role of local and central agencies and the government is to provide the policy settings and conditions in which trust-based networks can flourish.OtherThis study was approved by the Victoria University of Wellington Human Ethics Committee (Ethics Approval Number 27,356). The research was supported by the Victoria University of Wellington research grant (222,809) and from the University of Auckland Department of Medicine research fund (H10779).

Integrated health information system in the Republic of Serbia

The Republic of Serbia's integrated health information system (IHIS) serves as a central electronic repository for storing and processing various medical and health-related data. It encompasses patient records, institutional information, details of health interventions and services, electronic prescriptions, appointment scheduling for specialist consultations, diagnostic procedures, and surgical operations. The implementation of this system promises several benefits, including improved access to patient information, expedited diagnostics, enhanced medication selection processes, heightened patient safety measures, more comprehensive health-statistical reporting, and accelerated dissemination of biomedical knowledge. This paper aims to explore the advantages of employing information technologies in healthcare delivery within health institutions, contrasting it with traditional methods of data collection, analysis, and interpretation, specifically focusing on primary healthcare institutions. Drawing upon current professional and societal perspectives, the paper discusses the conceptual framework and objectives of IHIS, emphasizing the significance of leveraging information technologies in healthcare.

Factors Influencing Electronic Health Record Workflow Integration Among Nurses in Saudi Arabia: Cross-Sectional Study.

Globally, healthcare organizations have transitioned from paper-based documentation to electronic health records (EHR), including in Saudi Arabia. However, the adoption of EHR at the national level in Saudi Arabia needs more attention. Thus, this study aimed to determine the workflow integration of EHR and associated factors. The specific aims were to examine the level of EHR use and workflow integration among nurses, to determine the differences in EHR use and workflow integration based on nurses' demographic characteristics, and to determine the association between the predictive factors and EHR workflow integration. This is a cross-sectional, correlational descriptive study. The data were collected from 293 nurses using the convenience sampling method. The participating nurses completed a questionnaire that included two measures: the Information System Use Survey and the Workflow Integration Survey (WIS). The data were analyzed using descriptive and multivariate statistics with SPSS software. The nurses had a positive perception of EHR use and workflow. The EHR use scores differed based on workplace (P < .01), education level (P < .05), and area of practice (P < .001). Similarly, the EHR workflow integration scores varied according to workplace (P < .05), education level (P < .05), and area of practice (P < .001). Education level and workplace significantly predicted information system use. Furthermore, education level and information system use significantly predicted the EHR integration into nurses' workflow. The nurses expressed a greater perceived use of EHR regarding the integrated health information system, which was a predictor of EHR integration into nurses' workflow.

A Data-Driven Paradigm for a Resilient and Sustainable Integrated Health Information Systems for Health Care Applications.

Many transformations and uncertainties, such as the fourth industrial revolution and pandemics, have propelled healthcare acceptance and deployment of health information systems (HIS). External and internal determinants aligning with the global course influence their deployments. At the epic is digitalization, which generates endless data that has permeated healthcare. The continuous proliferation of complex and dynamic healthcare data is the digitalization frontier in healthcare that necessitates attention. This study explores the existing body of information on HIS for healthcare through the data lens to present a data-driven paradigm for healthcare augmentation paramount to attaining a sustainable and resilient HIS. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: PRISMA-compliant in-depth literature review was conducted systematically to synthesize and analyze the literature content to ascertain the value disposition of HIS data in healthcare delivery. This study details the aspects of a data-driven paradigm for robust and sustainable HIS for health care applications. Data source, data action and decisions, data sciences techniques, serialization of data sciences techniques in the HIS, and data insight implementation and application are data-driven features expounded. These are essential data-driven paradigm building blocks that need iteration to succeed. Existing literature considers insurgent data in healthcare challenging, disruptive, and potentially revolutionary. This view echoes the current healthcare quandary of good and bad data availability. Thus, data-driven insights are essential for building a resilient and sustainable HIS. People, technology, and tasks dominated prior HIS frameworks, with few data-centric facets. Improving healthcare and the HIS requires identifying and integrating crucial data elements. The paper presented a data-driven paradigm for a resilient and sustainable HIS. The findings show that data-driven track and components are essential to improve healthcare using data analytics insights. It provides an integrated footing for data analytics to support and effectively assist health care delivery.

Impact of Various Risk Factors on the Positive Fecal Immunochemical Test for Colorectal Cancer in the Iranian Population.

Background: Colorectal cancer (CRC) is the most prevalent cancer with high mortality worldwide. We aimed to evaluate the incidence of CRC based on the positive fecal immunochemical test (FIT) result in the Iranian population. Methods: The present study was conducted on the health assessment data recorded in the SINA (Integrated Health Information System) in 2018 and 2019 from individuals who had participated in the national program, including asymptomatic people aged 50-69 years or had risk factors of CRC such as family or past personal history of CRC as well as symptomatic individuals, for the early detection and prevention of CRC in Mashhad, Iran. Results: The study participants included 140,463 eligible individuals, of whom 8258 (5.88%) and 145 (2.21%) were positive for FIT and diagnosed with colon cancer, respectively. Unfortunately, only 654 people had undergone colonoscopy. Our results indicated that age, fast food intake (≥two units per day), family history of CRC in first or second-degree relatives, some gastrointestinal diseases such as inflammatory bowel disease (IBD) and CRC, as well as bleeding per anus, constipation, abdominal cramp, and losing body weight were associated with increased risk of positive FIT. However, some other factors, including having a hard job, physical activity, and Iranian nationality (compared to non-Iranians), were associated with a low risk of positive FIT screening tests for CRC. Conclusion: A high number of high-risk persons in Mashhad were positive for the FIT test in 2018-2019, and many of them were diagnosed with CRC, according to the colonoscopy results. Therefore, screening is highly recommended as the first step in the early detection of CRC.

Is the education of the parents differently associated with their children health literacy?

Abstract Background Parents with higher levels of education tend to have better abilities in searching and integrating health information, which can ultimately benefit their childreńs health literacy. We aim to analyse the associations between childreńs health literacy and parents’ education in families with school-age children. Methods A total of 735 children (51.7% boys) with a mean of age (SD) of 7.7 (1.2) years old, participated in this study. Childreńs health literacy was measured with the HLS-Child-Q15, which contained 15 items assessing the child's perceived ease or difficulty in finding, understanding, appraising, and applying health information (α = 0.7). A mean of all items was conducted along with a median split (limited and sufficient health literacy). Parents self-reported their education (e.g., primary school, secondary schools and higher education) and family income. Binary regression models were used, adjusting for age and income. Results Boys whose mothers had a higher education degree had lower odds of achieving sufficient health literacy (adjusted odds ratio (aOR)= 0.4, 95% confidence interval (CI)=0.1; 0.9). In contrast, boys whose fathers had a secondary or higher education degree had a significantly higher odds of achieving sufficient health literacy (aOR=2.3 (1.1; 4.7) and 2.9 (1.2; 6.9, respectively), irrespective of their age and income. Conclusions The indirect association between mothers’ education levels and their sons’ health literacy, and the direct association of fathers’ education levels on their sons’ health literacy, could be explained by previous research that has linked a motheŕs education level to the quality of everyday childcare and a fatheŕs education level to the access of higher social positions and resources, that ultimately can be invested in the child's health literacy. Future intervention studies should take into account the important role of fathers in improving childreńs health literacy, mainly in boys. Key messages • Parents with higher levels of education tend to have children with better health literacy. • There are significant associations between parentśeducation and childreńs health literacy, mainly in boys.

The Primary Health Care Approach: Rhetoric or Policy? - A Review of National Health Policies in 8 Countries in Southern Africa

INTRODUCTION: The Primary Health Care approach (PHC) can contribute towards universal health coverage (UHC). However, implementing the PHC approach in Africa remains suboptimal. One way to ascertain political commitment to the PHC approach is its reflection in the national health policies (NHP). Several PHC initiatives have helped define and guide the PHC definition, implementation, and evaluation. These include the Alma Ata PHC conference, the Ouagadougou Declaration on PHC in Africa, and the Astana conference. The aim of this paper is to explore to what extent the guidance and characteristics of the PHC approach have been reflected and integrated into the National Health Policies (NHPs) in countries in the Southern African Development Community (SADC). &#x0D; &#x0D; METHODS: The READ approach was undertaken to analyze eight publicly available NHPs. A 12-point checklist was developed to extract relevant data from the policy documents.&amp;nbsp; The WHO Health Systems building blocks are used as the analytical framework to understand the key features of the PHC approach mentioned in the policies.&#x0D; &#x0D; RESULTS: All the NHPs were developed after the Alma Ata conference in 1978. Six of the eight NHPs reviewed were updated after the Ouagadougou declaration on PHC in Africa in 2008. None of the NHPs were updated after the 2018 Astana PHC conference. Based on the checklist, Lesotho had the most integrated PHC elements (n=12), while Eswatini had the least (n=4). Based on the policy review, there seems to be commitment and priority placed on leadership, governance, and access to essential medicines. However, more still needs to be done to improve service delivery in terms of integrated patient centered care (only included in 3 out of the 8), health financing for primary care, integrated health information systems and the community health workers as part of the health workforce. &#x0D; &#x0D; CONCLUSION: In conclusion, NHPs should guide implementation, and the NHP is a reference document for many organizations wishing to partner with the government in improving health care services. As such, it should be updated in line with the new evidence and learning and reflect the country&amp;rsquo;s priorities to help align development actors.

Colorectal Cancer Classification from Protein Sequences Using Several RNN Pre-Trained Models

Bioinformatics is one field that can integrate health information with data mining applications in order to predict or analyze the patient’s information. One among the several diseases is colorectal cancer,which is horrible and rated the third leading disease in the area of cancer which leads to death in both men and women.In general, there are several intelligent methods to identify several kinds of problems in gene selection for predicting cancer,but there is no method to give a solution for patients who are diagnosed in the advanced stage.This motivated me to design theproposed approach in which we try to identify all the homo protein sequences and then train these sequences corresponding to one which causes colorectal cancer.InBioinformatics,a protein acts as one of the main agent or source to perform a biological function by interacting with molecules like Deoxyribonucleic acid (DNA), Ribonucleic acid (RNA). The function of a protein determines the healthy or diseased states of an organism. Protein interaction with other proteins can be visualized through a network called Protein-Protein Interaction Network (PPIN).In general classification of protein sequences is a very complex task. Deep learning techniques like CNN and RNN can be used to solve the problem.In computational bioinformatics,the classification of protein sequence plays an important role in determining accuracy.To improve the accuracy of our current model, the suggested method incorporates GRU, LSTM, RNN, and Customized LSTM into an RNN based architecture by optimizing the parameters in a two-way direction.Here we try to test all the models on sample protein sequences that are collected from TCGA and then determine the correctness of testing data and training data.

Health chain-block chain based electronic healthcare record system with access and permission management

An electronic health record (EHR) is a technology that allows you to keep track of your health information. It keeps computerized records of several healthcare organizations. Records are exchanged via enterprise-wide data systems as well as other networking technologies and exchanges. Patients nowadays expect immediate access to their health information. However, the health sector comes with immediate access to data, and there are worries about the privacy and security of medical records of patients. As a result, a blockchain-based solution can assist in resolving this issue. The blockchain has the potential to beat the conventional centralized system, which suffers from a severe lack of accessibility. The current healthcare system is often seen as being both costly and convoluted. However, with improved health data management and insurance providers, this may be reduced via the use of Blockchain Technology (BT). It is the goal of the developers of BT to make it possible to keep track of financial transactions without having to rely on a central authority or a bank. Innovations in BT have allowed for better health records, insurance billing, and smart contract transactions, and it also enable a decentralized data structure of activities, as well as eternal availability and security over health information. Access to medical records, instrument tracking, prescription databases, hospital facilities, and property lifetime all inside a blockchain architecture is made possible by BT that also greatly improves the seamless integration of health information. The use of BT in the medical field has this advantage as one of its primary advantages. Access to a patient's medical history is crucial for prescribing the right treatment, and BT has the potential to greatly enhance the current state of public healthcare delivery. This paper offers a block chain-based scheme called “Health Chain” as a solution for maintaining medical records. Health Chain is made to be better than the existing systems since it gives patients, health professionals, and other external stakeholders safe, efficient, and ubiquitous medical information available while maintaining the patients' confidentiality. To regulate operations and restrict access to digital health records, Health Chain uses timed-based smart contracts. In addition, it uses cutting-edge encryption methods to boost security. This study suggests a new reward system that uses healthcare professionals to track patients' medical information and construct additional units. Numerous tests are run to assess the proposed Health Chain model's performance, and the findings demonstrate that the proposed suggestion effectively manages a huge dataset called (nCOV19) from the Covid-19 study with little delay. Maximum efficiency will be expected to be attained by 98%, transaction latency by 95%, overall system execution time by 96%, data security by 92%, and data scalability by 95%, according to the suggested research.

A Narrative Review of the Frameworks, Challenges, and Applications of Interoperability in E -Health

Introduction: Integrated Health Information Systems (HIS) are necessary to achieve national and international goals in health and development, which are facing cooperation problems due to diversity and heterogeneity. Interoperability as a key characteristic of data sharing and the main prerequisite of integration enables healthcare providers to make timely decisions for diagnosis, treatment, action, and patient care. Therefore, this research aimed to provide a category of interoperability concepts in electronic health ( E -Health). Method: This research is a narrative review to categorize the interoperability concepts in E - Health. For this purpose, Scopus, Google Scholar, PubMed, Science Direct, and IEEE databases were searched using the keywords "Interoperability framework" and "Integration" with the combination of AND along with "E -Health". Therefore, all the articles referring to the concepts of interoperability were selected. Results: The result of the search in the aforementioned databases was 304 articles. By removing duplicate, out -of-reach, and unrelated articles, only 40 articles were examined, and topics related to the concepts of interoperability were classified based on six axes (dimensions, levels, obstacles, integration, architecture, and measurement). Finally, its applications and challenges were described in a narrative review. Conclusion: Due to the nature of the health system, integrity and intelligence are very important in this area. Therefore, to facilitate the exchange of information and the use of health information systems from each other’s services, paying attention to the presented classification has an undeniable effect, and also, an important role in the integrity and intelligence of the environment, and increases the efficiency and effectiveness in the quality of providing health care services.