Management Of Health Conditions Research Articles

Voice-Based Conversational Agents for the Prevention and Management of Chronic and Mental Health Conditions: Systematic Literature Review.

BackgroundChronic and mental health conditions are increasingly prevalent worldwide. As devices in our everyday lives offer more and more voice-based self-service, voice-based conversational agents (VCAs) have the potential to support the prevention and management of these conditions in a scalable manner. However, evidence on VCAs dedicated to the prevention and management of chronic and mental health conditions is unclear.ObjectiveThis study provides a better understanding of the current methods used in the evaluation of health interventions for the prevention and management of chronic and mental health conditions delivered through VCAs.MethodsWe conducted a systematic literature review using PubMed MEDLINE, Embase, PsycINFO, Scopus, and Web of Science databases. We included primary research involving the prevention or management of chronic or mental health conditions through a VCA and reporting an empirical evaluation of the system either in terms of system accuracy, technology acceptance, or both. A total of 2 independent reviewers conducted the screening and data extraction, and agreement between them was measured using Cohen kappa. A narrative approach was used to synthesize the selected records.ResultsOf 7170 prescreened papers, 12 met the inclusion criteria. All studies were nonexperimental. The VCAs provided behavioral support (n=5), health monitoring services (n=3), or both (n=4). The interventions were delivered via smartphones (n=5), tablets (n=2), or smart speakers (n=3). In 2 cases, no device was specified. A total of 3 VCAs targeted cancer, whereas 2 VCAs targeted diabetes and heart failure. The other VCAs targeted hearing impairment, asthma, Parkinson disease, dementia, autism, intellectual disability, and depression. The majority of the studies (n=7) assessed technology acceptance, but only few studies (n=3) used validated instruments. Half of the studies (n=6) reported either performance measures on speech recognition or on the ability of VCAs to respond to health-related queries. Only a minority of the studies (n=2) reported behavioral measures or a measure of attitudes toward intervention-targeted health behavior. Moreover, only a minority of studies (n=4) reported controlling for participants’ previous experience with technology. Finally, risk bias varied markedly.ConclusionsThe heterogeneity in the methods, the limited number of studies identified, and the high risk of bias show that research on VCAs for chronic and mental health conditions is still in its infancy. Although the results of system accuracy and technology acceptance are encouraging, there is still a need to establish more conclusive evidence on the efficacy of VCAs for the prevention and management of chronic and mental health conditions, both in absolute terms and in comparison with standard health care.

Disruptions in the management and care of university students with preexisting mental health conditions during the COVID-19 pandemic.

Students with preexisting mental health conditions or disabilities may fair worse due to virus mitigation strategies during the COVID-19 pandemic. This study was conducted to understand the experiences of students with preexisting mental health conditions or disabilities at a public university during COVID-19. We examined disruptions in the management of preexisting mental health conditions or disabilities and its impact on psychological well-being. Students were surveyed about their health care experiences during the COVID-19 pandemic between June and September 2020. Linear regressions and mediation analyses were conducted to examine the relationships between disruption to care, mental health self-efficacy, and four psychological well-being outcomes (stress, anxiety, depression, and overall distress). Of the total (N = 1,082) study participants, 258 (24%) reported having a preexisting mental health condition(s) or disabilities (81% female; Mage = 23.47). Of those, 155 (61%) reported that COVID-19 disrupted health care delivery and management of their conditions or disabilities. Of those who reported this disruption, 51% (n = 109) of participants reported a disruption in their ability to see a health care professional and 58% (n = 69) reported either that they lost care or that the quality of the new telemedicine care was not sufficient. A series of linear regressions revealed significant relationships between disruption to care and the four psychological outcomes. Mediation analyses revealed that depression, stress, anxiety, and overall distress were mediated by self-efficacy in managing mental health. University administrators and health care providers should evaluate the scope of mental health care and telemedicine services for students to help long-term psychological effects of COVID-19.

Determinants of Longitudinal Adherence in Smartphone-Based Self-Tracking for Chronic Health Conditions

The use of interactive mobile and wearable technologies for understanding and managing health conditions is a growing area of interest for patients, health professionals and researchers. Self-tracking technologies such as smartphone apps and wearable devices for measuring symptoms and behaviours generate a wealth of patient-centric data with the potential to support clinical decision making. However, the utility of self-tracking technologies for providing insight into patients' conditions is impacted by poor adherence with data logging. This paper explores factors associated with adherence in smartphone-based tracking, drawing on two studies of patients living with axial spondyloarthritis (axSpA), a chronic rheumatological condition. In Study 1, 184 axSpA patients used the uMotif health tracking smartphone app for a period of up to 593 days. In Study 2, 108 axSpA patients completed a survey about their experience of using self-tracking technologies. We identify six significant correlates of self-tracking adherence, providing insight into the determinants of tracking behaviour. Specifically, our data provides evidence that adherence correlates with the age of the user, the types of tracking devices that are being used (smartphone OS and physical activity tracker), preferences for types of data to record, the timing of interactions with a self-tracking app, and the reported symptom severity of the user. We discuss how these factors may have implications for those designing, deploying or using mobile and wearable tracking technologies to support monitoring and management of chronic diseases.

Prevention and management of physical health conditions in adults with severe mental disorders: WHO recommendations

BackgroundPeople with severe mental disorders (SMD) experience premature mortality mostly from preventable physical causes. The World Health Organization (WHO) have recently produced guidelines on the prevention and management of physical health conditions in SMD. This paper presents the evidence which led to the recommendations presented in the guidelines.MethodsThe work followed the methodological principles for WHO guideline development. Systematic reviews in relation to the treatment of seven key priority physical health conditions and associated risk factors in persons with SMD were systematically sourced. The quality of this evidence was assessed, and compiled into evidence profiles. Existing guidelines and treatment recommendations were also considered. Based on this information, specific recommendations were developed on the prevention and management of physical health conditions and their risk factors amongst people with SMD.ResultsNineteen recommendations were made in relation to the seven key priority physical health conditions and risk factors, alongside best practice statements for each condition. A mixture of conditional and strong recommendations were made, the quality of evidence underpinning these was generally low or very low. This is owing to the dearth of direct evidence relating to people living with SMD and comorbidities.ConclusionsThis paper presents evidence-based recommendations to prevent and manage physical health conditions in people with SMD. The recommendations are designed to inform policy makers, healthcare providers as well as other stakeholders about what they can do to improve the management of physical health conditions in adults with SMD and support the promotion of individual health behaviors to reduce the risk factors for these conditions. If implemented, these recommendations can improve the care that people with SMD receive for their physical health conditions in an equitable and person-centered manner, so that in future in relation to premature mortality ‘no-one is left behind’.

Hearing Loss and Home Health: An Unmet Need and an Opportunity for Action.

The purpose of this study was to identify unmet hearing care needs among older adults receiving home healthcare as a potential method to reach a population unserved by clinic-based care. Cross-sectional analyses were used to identify hearing loss and hearing aid use among beneficiaries enrolled in home care, using data from the nationally representative 2017 Medicare Current Beneficiary Survey (MCBS). Survey participants who reported enrollment in home healthcare services in 2017 (n = 3,183,693) were included for the purposes of analyses. Home health and hearing status were assessed through MCBS questionnaires, reported by Medicare beneficiaries or an appointed proxy, along with hearing status evaluated at initial home care intake. Among older Medicare beneficiaries receiving home healthcare, 51.8% self-reported hearing concerns. Of this population, only 16.1% reported hearing aid use. Recipients with hearing difficulty received an average of 30 visits per year, totaling to $5,208.25 in expenditure. By self-report, 44% of older home care recipients with hearing difficulty were misclassified as having "adequate" hearing on initial assessment and 31% of initial assessments identified hearing loss among those who self-reported no difficulty hearing. Effective management of chronic health conditions is core to healthy aging, including sensory health. Hearing loss represents a largely unaddressed need among home care recipients and frequently goes unidentified. Home-based hearing services that integrate into existing assessments and practices may be an avenue in identifying hearing loss and extending care to older adults who have traditionally gone without access to hearing intervention.

Venous thrombosis in neonates.

The incidence of thrombotic disorders in neonates and children is increasing with advances in diagnostic modalities, supportive care, and management of many health conditions. The developing coagulation system, need for intensive care, including catheterization, and co-morbid conditions are responsible for the relatively high risk of thrombosis in neonates compared to older children. This review addresses the advances over the last 3 years in neonatal thrombosis, with a focus on epidemiology, cerebral sinovenous thrombosis (CSVT), renal vein thrombosis (RVT), and portal vein thrombosis (PVT). The incidence of neonatal thrombosis in the contemporary era is reported to be 6.9–15 per 1,000 neonatal intensive care unit (NICU) admissions, compared to 2.4 per 1,000 NICU admissions reported in older registry data. The majority of recently published studies are small, retrospective, and from single centers, albeit they emphasize the need for definitive data to support the efficacy and safety of anticoagulation therapy (ACT) in the management of CSVT, RVT, and PVT. We highlight two important international initiatives geared towards improving the evidence base for these conditions. The International Pediatric Thrombosis Network (IPTN) is a collaboration of 74 centers across 27 countries (as of January 2021) which has started important projects like the international neonatal RVT registry, while the International Pediatric Stroke Study (IPSS) group is in the planning stages of a randomized controlled trial to evaluate the utility of ACT in the management of neonatal CSVT.

Burden and determinants of multimorbidity among women in reproductive age group: a cross-sectional study based in India.

Background: India's government is currently running several programs with a sole focus on women's health during their child-bearing years. However, none of these programs incorporate the management of chronic health conditions during the reproductive span. This issue is an emerging public health concern; therefore, the present study aims to identify the patterns and correlates of multimorbidity among women in reproductive age groups in India. Methods: The study utilizes nationally-representative cross-sectional data from the Demographic and Health Survey on 661,811 women in the reproductive age group of 15-49 years. The study uses information on seven chronic morbidities, namely asthma, cancers, heart disease, diabetes, tuberculosis, hypertension, and thyroid disorder. Descriptive, bivariate, and multivariable techniques were utilized to accomplish the study objective. Results: The findings show that 17.4 and 3.5 per 100 women of reproductive age suffered from any one morbidity and multimorbidity, respectively. Hypertension, diabetes, and thyroid disorders were commonly occurring morbidities. The prevalence of having any one morbidity or multimorbidity increased with age. Variables like religion, wealth, parity, menopause, consumption of tobacco and alcohol, body mass index, and type of diet were found to be significantly related to the burden of multimorbidity. The prevalence of multimorbidity was found to be higher for women who belong to the Southern, Eastern, and North-Eastern regions of India. Conclusions: Findings suggest the importance of multimorbidity in the context of women of reproductive age. Inclusion of chronic disease management strategies with maternal and child health services needs to be taken into consideration by the program and policymakers. The annexation of social marketing approaches at the primary level of healthcare would assist policy-makers in educating women about the importance of leading a healthy lifestyle. Practicing dietary diversity can help in maintaining optimal estrogen levels, which would further help in decreasing multimorbidity rates among women in India.

Application of the National Institute for Health and Care Excellence Evidence Standards Framework for Digital Health Technologies in Assessing Mobile-Delivered Technologies for the Self-Management of Type 2 Diabetes Mellitus: Scoping Review.

BackgroundThere is a growing role of digital health technologies (DHTs) in the management of chronic health conditions, specifically type 2 diabetes. It is increasingly important that health technologies meet the evidence standards for health care settings. In 2019, the National Institute for Health and Care Excellence (NICE) published the NICE Evidence Standards Framework for DHTs. This provides guidance for evaluating the effectiveness and economic value of DHTs in health care settings in the United Kingdom.ObjectiveThe aim of this study is to assess whether scientific articles on DHTs for the self-management of type 2 diabetes mellitus report the evidence suggested for implementation in clinical practice, as described in the NICE Evidence Standards Framework for DHTs.MethodsWe performed a scoping review of published articles and searched 5 databases to identify systematic reviews and primary studies of mobile device–delivered DHTs that provide self-management support for adults with type 2 diabetes mellitus. The evidence reported within articles was assessed against standards described in the NICE framework.ResultsThe database search yielded 715 systematic reviews, of which, 45 were relevant and together included 59 eligible primary studies. Within these, there were 39 unique technologies. Using the NICE framework, 13 technologies met best practice standards, 3 met minimum standards only, and 23 technologies did not meet minimum standards.ConclusionsOn the assessment of peer-reviewed publications, over half of the identified DHTs did not appear to meet the minimum evidence standards recommended by the NICE framework. The most common reasons for studies of DHTs not meeting these evidence standards included the absence of a comparator group, no previous justification of sample size, no measurable improvement in condition-related outcomes, and a lack of statistical data analysis. This report provides information that will enable researchers and digital health developers to address these limitations when designing, delivering, and reporting digital health technology research in the future.

Current status of annual health check-ups for part-time employees in Japan

The number of part-time staff is increasing every year, and they are becoming very essential in completing the workforce. Healthcare and assurance for part-timers will be an important issue in the future. The purpose of our study was to collect recent data and examine the status of health management for part-time employees in workplaces. We administered a questionnaire to part-time staff at 14,000 workplaces that were randomly selected from a nationwide list of workplaces. Of the 4,718 respondents, 4,652 valid cases were analyzed. Part-timers were classified as those working more than 3/4 (Category 1), more than 1/2 and less than 3/4 (Category 2), and less than 1/2 (Category 3) of the routine working hours of full-time employees. A total of 97.2% of workplaces conducted regular medical health check-ups (medical check-ups) for full-time employees. The percentage of workplaces conducting medical check-ups for part-timers was lower as their working hours were fewer; only 32.2% of workplaces conducted medical check-ups for Category 3 part-timers. The percentages were lower for smaller workplaces, and workplaces with 29 or fewer employees had the lowest percentage for Category 3 part-timers (27.9%). The percentage of employers bearing the full cost of medical check-ups was lower for Category 1 (90.5%), 2 (87.7%), and 3 (85.0%) part-timers than that for full-time employees (93.7%). The rate of regular medical check-ups in workplaces was lower for part-timers, as their working hours were shorter, and workplaces were smaller. Expanding health management in workplaces may be necessary owing to the diversity in working styles.

Perception and Acceptance of Herbal Medicines among Residents of Port Harcourt, Nigeria

Background: The use of herbal medicines and medicinal plants available in a locality in the treatment and control of human diseases, promotion of health and management of health conditions will continue to play a significant role in the healthcare system of the people, especially in developing countries. This cross-sectional study was carried out to assess the perception and knowledge of usage of herbal medicines among the residents of Port Harcourt, Nigeria. Methodology: Multi-stage sampling technique was used for this study.
 Results: The results indicated that out of the 273 questionnaires returned, 118 (44.9%) of the respondents were male while 144 (55.1%) were female. The average age of the respondents was 36±10 years. The prevalence of usage of herbal medicine from this study was 80.9%. The major source of information about herbal medicines was home (family and friends).The results also indicate that 180 (68.6%) of the respondents did not experience unpleasant effects such as headaches, vomiting, nausea and diarrhea, with the use of herbal medicines. Similarly, on the reasons for using herbal medicine, 134 (51.1%) of the respondents indicated that they used herbal medicines because they are effective, 66 (25.3%) said herbal medicines are always available mostly as locally sourced herbs, while 46 (17.7%) said herbal medicines are not costly. On the perception of herbal medicines, 206 (78.6%) indicated that herbal medicines are efficacious, 197 (75.3%) supported the integration of herbal medicines into the conventional health system, 243 (92.6%) supported the establishment of a Board to regulate the practice of herbal medicine in order to prevent indiscriminate use of herbal medicines while 234 (89.9%) of the respondents supported the establishment of a formal training institution for herbal medicine practitioners.
 Conclusion: It is concluded that herbal medicines have wide acceptability and perception among the study population. It is recommended that herbal medical practice be properly regulated and integrated into the conventional health system.

Educational Intervention to Improve Citizen's Healthcare Participation Perception in Rural Japanese Communities: A Pilot Study.

In this mixed-methods study, we hypothesized that social cognitive theory (SCT)-based educational interventions for healthcare participation can improve the self-efficacy of older rural citizens in participating in their health management without any difficulties. Quasi-experimental study before and after SCT-based educational interventions and semi-structured interviews were conducted. Participants were Japanese elderly (>65 years) from rural communities. Propensity score matching was performed to estimate the effectiveness of educational interventions on participants’ perception (intervention: n = 156; control: n = 121). Interview contents were transcribed verbatim and analyzed based on thematic analysis. The intervention group scored significantly higher than the control group for participation in planning and managing self-care. Interviews revealed three themes: ability to manage health conditions, relationship with medical professionals, and relationship among citizens. Participants reported difficulties in judging symptoms and communicating with medical professionals. Hierarchy and low motivation to participate in healthcare hindered collaboration. The findings suggest that SCT-based educational interventions can positively impact rural citizens’ self-efficacy in healthcare participation.

Berbagi dengan Panti Wreda: Pemeriksaan Kesehatan untuk Menilik Kondisi Kesehatan Lansia

The shifting of population demography to older people groups encourage Indonesia government create integrative care’s policy. Unfortunately, the nursing home as long term care failed to bring integrative care. This aim of community services is to build integrative care for older people groups in nursing home. The first step to establish integrative care is older people’s mapping regarding their health condition and food management through medical check-up. The activities consist of two steps, which are medical check-up and nutrition education. The result shows older peoples have hypertension, normal blood sugar, mild cognitive condition, and average physical activity. The condition motivate nursing home to organize integrative care with other institutions. In addition, the community services also bring opportunity to regular services, especially to nutrition management and medical check-up.

Flexible organic thin-film transistor immunosensor printed on a one-micron-thick film

Flexible and printed biosensor devices can be used in wearable and disposable sensing systems for the daily management of health conditions. Organic thin-film transistors (OTFTs) are promising candidates for constructing such systems. Moreover, the integration of organic electronic materials and biosensors is of extreme interest owing to their mechanical and chemical features. To this end, the molecular recognition chemistry-based design for the interface between sensor devices and analyte solution is crucial to obtain accurate and reproducible sensing signals of targets, though little consideration has been given to this standpoint in the field of device engineering. Here, we report a printed OTFT on a 1 μm-thick film functionalized with a sensing material. Importantly, the fabricated device quantitatively responds to the addition of a protein immunological marker. These results provide guidelines for the development of effective healthcare tools.

Social support buffers the impacts of Diabetes distress on health-related quality of life among type 2 diabetic patients.

Diabetes patients experience significant distress. Improving health-related quality of life (HRQoL) is cardinal in the management of all chronic health conditions. We investigated the moderating role of social support (SS) in the relationship between diabetes distress (DD) and HRQoL. Three hundred and ninety-six type 2 diabetes mellitus (T2DM) patients (M age = 57.71 years) completed measures of relevant variables. Results showed that SS moderated DD-HRQoL association. Our findings provided a guide on extent of support for T2DM management behaviors that may be helpful in ameliorating impacts of stress on patients' health.

Impact and outcome evaluation of HealthPathways: a scoping review of published methodologies.

INTRODUCTION The HealthPathways programme is an online health information system used mainly in primary health care to promote a consistent and integrated approach to patient care. AIM The aim of this study is to perform a scoping review of the methodologies used in published impact and outcomes evaluations of HealthPathways programmes. METHODS The review included qualitative, quantitative or mixed-methods evaluations of the impact or outcome of HealthPathways. MEDLINE, Embase, CINAHL and Web of Science databases were searched. Seven programme aims were identified in the impact and outcome evaluation: (1) increased awareness and use of HealthPathways; (2) general practitioners are supported to adopt best practice, patient-centred care; (3) increased appropriate use of resources and services; (4) improved quality of referrals; (5) enhanced consistent care and management of health conditions; (6) improved patient journeys through the local health system; and (7) reduction in health-care cost and increased value for money. RESULTS Twenty-one studies were included in the final review; 15 were research papers and six were reports. 'Increased awareness and use of HealthPathways' was the most frequent programme aim evaluated (n = 12). Quantitative and qualitative research methodologies, as well as prospective and retrospective data collections, have been adopted to evaluate the impact and outcome of HealthPathways. DISCUSSION Assessing the impacts and outcomes of HealthPathways may be challenging due to limitations in primary data and the interconnectedness of change across the measured aims. Each aim may therefore require specific methodologies sensitive enough to capture the impact that HealthPathways are making over time.

Design and Implementation of Home Health System Based on ID Card Identification and Multidevice Access

With the development of society and the gradual arrival of an ageing society, various diseases threaten human health. If you use the software that comes with your medical device to understand and analyze your health, not only the user is in trouble but also a variety of health data can not be linked, giving users a more three‐dimensional health analysis. In this case, this article will design and implement a mobile client for a home health system. The user’s information is hosted by the remote data center. It is necessary to collect the user’s information to facilitate management and analysis of health conditions. The manual input method is easy to input errors due to the long address and ID number, so the system will collect user information based on ID card identification. Train ID information to achieve accurate identification. For the multidevice access function, the key parts of the IEEE 11073 standard are used for communication. The mobile phone client that implements the home health system runs on the Android platform. According to the user information management, the user physiological data management, the user physiological data collection, and the user information synchronization are divided into four modules. The ID card identification module is called in the user management module, and the IEEE11073 communication plug‐in is called by JNI in the health data measurement module. The health data can be presented intuitively to the user, or the information can be synchronized to the remote data center for further analysis.

Care for Breast Cancer Survivors.

The number of cancer survivors is increasing globally. More than 15.5 million Americans in 2016 and 1.3 million Koreans in 2013 were living with cancer history. This growing population is expected to increase due to marked development of cancer treatment and early detection. Especially, breast cancer is the second most common cancer in Korean women with relatively favorable 5-year survival rate. Cancer survivors generally face various physical, psychological, and social problems including late-effect or long-term effect after cancer treatment and high risk for second primary cancer and comorbid chronic diseases such as cardiovascular disease and bone health. Breast cancer survivors also encounter wide range of health problems. To satisfy their complex needs, comprehensive supports are required. We categorized the strategy of comprehensive care for breast cancer survivors into (1) Surveillance for primary cancer, (2) Screening of second primary cancer, (3) Management of comorbid health condition, (4) Promoting healthy lifestyle behaviors, and (5) Preventive care. In the future, studies for providing best comprehensive care for breast cancer survivors are needed according to the individuals' demand.

Evaluation framework for selecting wearable activity monitors for research.

Wearable devices that support activity tracking and other measurements hold great potential to increase awareness of health behaviors and support the management of chronic health conditions. There is a scarcity of guidance for researchers of all disciplines when planning new studies to evaluate and select technologies appropriate for study purpose, population, and overall context. The aim of this study was to develop and test an evaluation framework to rapidly and systematically evaluate and select consumer-grade wearable devices that serve individual study needs in preparation for evaluations with target populations. The wearable evaluation framework was defined based on published literature and past research experiences of the research team. We tested the framework with example case studies to select devices for two different research projects focused on aging-in-place and gestational diabetes. We show how knowledge of target population and research goals help prioritize application of the criteria to inform device selection and how project requirements inform sequence of criteria application. The framework for wearable device evaluation includes 27 distinct evaluation criteria: 12 for everyday use by users, 6 on device functionality, and 9 on infrastructure for developing the research infrastructure required to obtain the data. We evaluated 10 devices from four vendors. After prioritizing the framework criteria based on the two example case studies, we selected the Withings Steele HR, Garmin Vivosmart HR+ and Garmin Forerunner 35 for further evaluation through user studies with the target populations. The aim of this paper was to develop and test a framework for researchers to rapidly evaluate suitability of consumer grade wearable devices for specific research projects. The use of this evaluation framework is not intended to identify a definitive single best device, but to systematically narrow the field of potential device candidates for testing with target study populations. Future work will include application of the framework within different research projects for further refinement.

DPO2 Project: telehealth to enhance the social role of physical activity in people living with COPD

Telehealth has been referred has an innovative solution for COPD patient treatment, minimizing the costs related with medical assistance while improving the patient care support and health outcomes. We have designed an innovative telehealth program of pulmonary rehabilitation (PR) that aims to increase long term adherence of patient to physical activity (PA), self-care management of health condition and facilitation of social participation following an approach of community-based intervention, taking account the patient preferences. Therefore, our telehealth program combine education sessions, exercise training and follow up of health outcomes using a mobile application and a wrist oximeter, through bluetooth technology, for facilitating outdoor exercise and social participation of people living with COPD.

基于“互联网+”糖尿病患者在阳泉地区健康管理现状

基于“互联网+”糖尿病患者在阳泉地区健康管理现状