Medical Treatment Process Research Articles

Effectiveness of Cognitive-behavioral Therapy on Depression in Infertile Women

Background:Infertility is an individual and social problem that affects people’s life quality and has been addressed in several scientific fields. Nevertheless, the psychosocial needs of infertile couples during the medical treatment process are discussed to a lesser degree. Objectives:This study aimed to investigate the efficacy of cognitive-behavioral therapy on depression in infertile women referring to the infertility clinic of Birjand University of Medical Sciences.
 Methods:This randomized controlled trial (RCT), with two groups of control and experiment, is performed on infertile women referring to the university clinic in 2019. Beck Depression Inventory was used for data collection. The cognitive-behavioral intervention was conducted during 10 sessions. Data analysis was administered by SPSS version 19 using statistical tests like t-test and repeated measures ANOVA.
 Results:The mean age of women in the experimental and control group was 28 ± 4.1 and 28.04 ± 3.64 years, respectively. There was a significant difference between experimental and control groups in the mean score of depression (P < 0.05). Also, the post hoc test showed the stable effect of cognitive-behavioral training on reducing depression in infertile women after the intervention and during the follow-up period.
 Conclusions:Given the positive impact of cognitive-behavioral therapy on reducing depression in infertile women, it is suggested to consider the psychological needs of couples during medical treatment.

A Review on Wire-Driven Flexible Robot Manipulators

Background: At present, with the rapid development of technology in medical treatment and rescue, how to reduce the operation complexity caused by limited space has become one of the hot topics. For example, in search and rescue, it is difficult for people to enter these high-risk areas due to various restricted geographic environments. During some medical treatment processes, minimally invasive surgery is difficult to operate because of its small incision. In order to solve these problems, a kind of Wire-Driven Flexible Robot Manipulator (WDFRM) has been developed. The WDFRMs have better flexibility and greater degrees of freedom (DOF) than the traditional rigid manipulators, and play an important role in these extreme operation fields. Objective: The paper aims to report the latest progress in the studies of the WDFRMs, and provides a reference for readers in this field. Method: By summarizing various productions and patents related to the WDFRMs, the structural characteristics, differentiations, applications of the WDFRMs are proposed. Results: Different types of WDFRMs are compared, analyzed, and classified according to their structural characteristics and supporting mode. The technical problems of the WDFRMs are pointed out, and the future development direction of this research field is predicted. Conclusion: According to their structural characteristics, the research shows that WDFRMs can be divided into Wire-Driven Serpentine Flexible Robot Manipulators (WDSFRMs) and Wire-Driven Continuum Flexible Robot Manipulators (WDCFRMs). WDFRMs will have more applications in medical treatment, rescue, and military affairs. The structure, stiffness and accuracy of the WDFRMs still need to be improved continuously.

Low-Carbon Action in Full Swing: A Study on Satisfaction with Wise Medical Development.

The development of “wise medical” is crucial to global carbon reduction. The medical sector not only has the moral obligation to reduce carbon emissions, but also has the responsibility to provide high-quality services to patients. Existing research mostly focuses on the relationship between low-carbon and wise medical, while ignoring the transformation of wise medical and patients’ opinions in the context of low-carbon transition. The paper crawls the text data of comments on the Zhihu platform (a Chinese platform similar to Quora), explores the focus of patients on wise medical through the co-occurrence analysis of high-frequency words, with a focus directly related to the role of wise medical treatment in carbon reduction, and designed a questionnaire accordingly. Using 837 valid questionnaires collected in Zhejiang Province, an XGBoost model was constructed to discuss the main factors affecting patient satisfaction, and the regional heterogeneity among the coastal area of eastern Zhejiang, the plain area of northern Zhejiang and the mountainous area of southwestern Zhejiang is discussed. The results show that patients’ focus on wise medical lies mainly in the convenience brought by digitalization and the actual medical effect, and the main factors affecting satisfaction with medical treatment are the flow of people in hospitals, optimization of the medical treatment process, the application of digital platforms, the quality of telemedicine services and the appropriate quality of treatment. In terms of regional differences in Zhejiang Province, wise medical is more developed in the plain area of northern Zhejiang, with better simplified medical treatment processes and the construction of a digital platform, while the mountainous areas of southwestern Zhejiang have better quality in telemedicine services despite the geographical environment. Eastern Zhejiang is somewhere in between.

Research on the design of serious illness insurance scheme in Shanghai based on micro-simulation

BackgroundUrban and rural residents’ basic medical insurance (URRBMI) is an institutional arrangement for rural residents and unemployed urban residents in China. The serious illness medical insurance system (SIMIS) was established to provide additional medical cover. At present, the SIMIS payment method in China is based on large expenses, and only a few areas, such as Shanghai, pay according to the treatment of serious diseases. This study aims to simulate and analyse the effect of the two payment methods on SIMIS in Shanghai.MethodsWe developed a micro-simulation model to predict the number and characteristics of SIMIS participants among urban and rural residents in Shanghai and to simulate the process of medical treatment, medical consumption, and medical insurance payments for each insured person from 2020 to 2025. We then summarised and analysed the payment compensation effect, and compared it with Shanghai’s current policies.ResultsThe payment of SIMIS according to high expenses, the total medical expenses of seriously ill patients show an increasing trend, with an average annual growth rate of 3.56%. The URRBMI fund payment covers 56%–58% of total medical expenses, and the SIMIS fund covers 5%–7% of the total medical expenses. Both cover 62%–63% of total medical expenses. Self-payment under SIMIS covers 22%–23% of the total medical expenses, total self-payment covers 14%–15% of the total medical expenses, and the medical expenses borne by individuals cover 36%–38% of the total medical expenses.The fund expenditure is 213 million yuan and average annual cost borne by individual patients ranges from 40 000 to 60 000 yuan.ConclusionsThe policy of designing SIMIS according to national guidelines does not meet the development needs of Shanghai. Shanghai should take the current policy of paying compensation according to the treatment of serious illness as the policy basis, consider the security needs of patients with large medical expenses outside the scope of protection, and adjust policies appropriately to prevent poverty caused by illness.

Bioinformatics Application in Precision Medicine

Bioinformatics is a computer science-based field that helps to improve the medical treatment process. Along with that, this research article has discussed the importance of bioinformatics in precision medicine. In this regard, this research study has selected secondary thematic analysis to represent the effectiveness of bioinformatics in the healthcare sector. In the present time, bioinformatics has provided advanced gene therapy to patients that help to reduce the mortality rate in India. Along with that, the healthcare sector increases efficiency to provide medical treatment facilities to the people. Keyword :Gene therapy, molecular biology, cystic fibrosis, personalized medicine

MRI Brain Tumor Image Classification Using a Combined Feature and Image-Based Classifier.

Brain tumor classification plays a niche role in medical prognosis and effective treatment process. We have proposed a combined feature and image-based classifier (CFIC) for brain tumor image classification in this study. Carious deep neural network and deep convolutional neural networks (DCNN)-based architectures are proposed for image classification, namely, actual image feature-based classifier (AIFC), segmented image feature-based classifier (SIFC), actual and segmented image feature-based classifier (ASIFC), actual image-based classifier (AIC), segmented image-based classifier (SIC), actual and segmented image-based classifier (ASIC), and finally, CFIC. The Kaggle Brain Tumor Detection 2020 dataset has been used to train and test the proposed classifiers. Among the various classifiers proposed, the CFIC performs better than all other proposed methods. The proposed CFIC method gives significantly better results in terms of sensitivity, specificity, and accuracy with 98.86, 97.14, and 98.97%, respectively, compared with the existing classification methods.

Use of Fast-Acting Insulin Analog for Preparing a Pharmaceutical Composition for Preventing, Treating, or Alleviating Diabetes

Diabetes is the most common disease in India that mostly affects adult people and reduces physical strength. Diabetes decreases insulin production in the human body that creates various physical disturbances such as damage to the heart, stroke, and others. In the past decades, medical treatments have followed long-acting insulin that reduces life expectancy rate and increases mortality rate in India. Along with that, in the present time, India's medical treatment has adopted the pharmaceutical composition of insulin to prevent diabetes and manage blood sugar in the human body. In this regard, this research study has selected some previous research papers to understand the importance of fast-acting insulin analogue to prevent diabetes. According to the secondary information, most of the medical treatment process in India has adopted fast-acting insulin analogue to prevent diabetes. Moreover, though fast-acting insulin analogue India reduces mortality rate and increases the life expectancy of adult people in India. Keyword : Metabolic disturbances, E-bacteria, amino acids, Regular Human Insulin (RHI).

Chất lượng dịch vụ khám bệnh, chữa bệnh và một số yếu tố ảnh hưởng tại khoa khám bệnh, bệnh viện đa khoa quận Gò Vấp, thành phố Hồ Chí Minh năm 2021

Objective: The aim of study is assessing the healthcare service quality through patient’s perception and analyzing several effects on the quality of healthcare services. Methods: The descriptive cross-sectional study, using quantitactive and qualitative method was conducted at the Outpatient Department, Go Vap district General Hospital. 250 selected patients filled the original SERVPERF questionaire which consists 22 questions about 5 dimensions of service quality including Reliability, Responsiveness, Assurance, Empathy and Tangible. Results: The main finding showed that the mean score of all the domains is 3.94. The positive inuencies on healthcare service included: training and development of human resources, modern facilities and equipment, convenient one-stop medical examination and treatment process. The negative remarkable factor is the waiting in the drug dispensing process and the medical staff's communication is sometimes inappropriate. Conclusions: The hospital’s service quality has not been evaluated well, the department needs to calculate and determine the appropriate number of human resources, improve the drug taking stage as well as develop sanctions in handling violations to improve quality and serve the increasing needs of patients. Keywords: Healthcare service quality, outpatient department, SERVPERF.

Considerations on the Design Strategy of Professional Big Data Cloud Platform for Chest Pain Center

The establishment of a professional big data cloud platform with the chest pain center as the core can not only collect, process and analyze various types of rapidly changing mass data in the clinical work of the chest pain center in real time, but also provide personalized services to individuals and connect individuals, hospitals and health management institutions through the mobile Internet channel. This paper summarizes and proposes matters that should be noted in building this platform: The design should focus on the actual business operation and management requirements and meet the infrastructure requirements of the big data cloud platform. It should be considered as a whole from the regional level to the hospital level, and the architecture design and standards should be considered vertically and horizontally; It is recommended to unify patient identification numbers and to be compatible with existing data systems. At the initial stage of the construction of the cloud platform, a tertiary hospital should be the core, and all kinds of medical resources such as hospitals, nursing institutions, nursing homes and pharmacies at all levels should be gradually opened. The functional integration design strategy of the chest pain center workstation should be integrated with the electronic medical record system as the core, making full use of the original PACS system and equipment of the hospital to automatically collect time trajectory and examination data of the whole process of patient's medical treatment. Meet the hospital's quality control and management needs of the platform. The ultimate goal is to reduce the mortality of patients with chest pain.

DSAS: A Secure Data Sharing and Authorized Searchable Framework for e-Healthcare System

In e-healthcare system, an increasing number of patients enjoy high-quality medical services by sharing encrypted personal healthcare records (PHRs) with doctors or medical research institutions. However, one of the important issues is that the encrypted PHRs prevent effective search of information, resulting in the decrease of data usage. Another issue is that medical treatment process requires the doctor to be online all the time, which may be unaffordable for all doctors (e.g., to be absent under certain circumstances). In this paper, we design a new secure and practical proxy searchable re-encryption scheme, allowing medical service providers to achieve remote PHRs monitoring and research safely and efficiently. Through our scheme DSAS, (1) patients’ healthcare records collected by the devices are encrypted before uploading to the cloud server ensuring privacy and confidentiality of PHRs; (2) only authorized doctors or research institutions have access to the PHRs; (3) Alice (doctor-in-charge) is able to delegate medical research and utilization to Bob (doctor-in-agent) or certain research institution through the cloud server, supporting minimizing information exposure to the cloud server. We formalize the security definition and prove the security of our scheme. Finally, performance evaluation shows the efficiency of our scheme.

BIO-MEDICAL WASTE MANAGEMENT PRACTICES AMONG HEALTH CARE PROFESSIONALS: A CASE STUDY IN DISTRICT FAISALABAD, PUNJAB PAKISTAN

Biomedical waste (BMW) is produced during surgical, and medical treatment, vaccination, and diagnostic processes. Owing to its hazardous nature BMW must be carefully segregated, handle and discard. As the healthcare professionals are significant and influential part of any healthcare system so their practices for handling this waste are imperative. Purpose: This study was conducted in public sector hospitals of Faisalabad, Punjab, Pakistan to assess the Bio-medical waste management practices among healthcare professionals. Design/Methodology/Approach: In this cross-sectional quantitative study, 500 respondents was conveniently recruited in which 280 were MBBS doctors and 220 staff nurses serving in different departments of the hospital. A self-designed questionnaire comprises of different statements about practices of healthcare waste management was used for data collection. The collected data was analyzed through SPSS version 24. Findings: The researchers found that although “Hospital Waste Management Rule Pakistan 2005” exists and there are Bio Medical Waste Management (BMWM) committees in the hospitals, the healthcare waste management practices were not up to the mark. Moreover, no proper trainings of the healthcare professionals were conducted. Keywords: Bio Medical Waste Management, Healthcare

Sử dụng bảo hiểm y tế của bệnh nhân HIV/AIDS tại phòng khám ngoại trú tỉnh Lào Cai năm 2020

Objective: This article aims to describe the current situation of using health insurance of HIV / AIDS patients at the Outpatient Clinic (OPC) of Lao Cai General Hospital in 2020. Methods: The article uses quantitative data from a study using cross-sectional design. There were 313 HIV/AIDS infected patients participating in the study and were treated at the hospital outpatient clinic in Lao Cai province from January to September 2020. Descriptive statistical analysis was applied using SPSS 16.0 software. Results: The percentage of patients using health insurance cards for medical examination and treatment related to HIV in the past 12 months was high, accounting for 91.37%; using health insurance card in all visits is 97.23%. The highest age group that does not use health insurance card was from 35 to 50 years old, accounting for 59.26%, and all patients who were more than 50 years old reported using health insurance. The reasons for not using health insurance cards for medical examination and treatment are mainly due to fear of disclosing HIV/AIDS status and stigma and discrimination, and lack of information about health insurance; offline health insurance; time for medical examination and treatment under health insurance is long. Recommendation: The rate of use of health insurance cards related to HIV is generally high but still low in the age group 35-50. Hospitals need to improve the medical examination and treatment process of health insurance; develop and implement a communication plan on health insurance; reduce against stigma and discrimination of health workers, assure confidentiality in the process of medical examination and use of health insurance cards, people aged 35-50 years old should get more attention. Keywords: HIV/AIDS, health insurance, hospital, outpatient clinic, HIV/AIDS, patients

Человек в современной медицине – от восстановления здоровья к улучшению

The article analyzes the dynamics of the development of medical models of treatment of deviations from the health norm, discusses the issue of changing ideas about the human health in medicine. It is shown that as a result of changes in the conceptual understanding of health and the process of its restoration, the principle of achieving a commercially profitable, fast and controlled result is introduced into modern medicine, as a result of that the process of medical treatment is standardized and regulated. But the preservation of object optics of views in the medical industry, as shown in the article, becomes ineffective, moreover, risky in a situation of moving boundaries of the human health norm. To overcome the existing risks, new institutes and practices of ethical examination of health standards are being introduced into medicine. It is shown that the accepted deliberative practices of ethical expertise only introduce a procedure for taking into account the patient’s position regarding the boundaries of their health standards and the limits of medical intervention. At the same time, the patient’s position is considered as something ready, initially given, in other words, the classic “human project” continues to be defended in medicine.

Medical treatment process modeling based on process mining and treatment patterns

Clinical practice guidelines (CPGs) are statements relating to evidence-based and economically reasonable medical treatment processes (MTPs) for certain clinical circumstances. The executable MTPs in healthcare information systems can assist the clinical processes. In our previous work, several treatment patterns and their modeling proposals were proposed to reduce the effort spent in modeling MTPs. However, given a CPG document, all the process elements are modeled manually. Besides, business process mining can extract MTP models automatically from execution logs. However, the existing process mining algorithms focus on the control-flow of structured processes. This paper proposes an integrated framework for modeling executable MTPs based on process mining and treatment patterns, taking both the efficiency of mining and the quality of modeling into account. In this framework, an execution log processing approach is presented to identify the subsequences and decision points conforming to the treatment patterns and represent them with abstract activities. Experiments on a synthetic log of the non-secondary hypertension MTP and empirical findings demonstrate the effectiveness of our approach. The results show that the process mining in our approach framework can automatically generate more accurate MTP models, and the subprocess models based on treatment patterns make the models easy to understand.

How to Dispose of Medical Waste Caused by COVID-19? A Case Study of China.

The rapid increase in novel coronavirus (COVID-19) patients also means a rapid increase in medical waste that could carry the novel coronavirus (SARS-CoV-2). How to safely dispose of medical waste caused by COVID-19 is a huge challenge that needs to be solved urgently. The outbreak of the COVID-19 has led to a significant increase in the daily generation of medical waste in China and has placed a severe test on the Chinese medical waste disposal system. Unlike ordinary wastes and garbage, medical waste that is untreated or incompletely treated will not only cause environmental pollution, but also directly or indirectly cause infections and endanger people’s health. Faced with difficulties, the Chinese government formulated a policy for medical waste management and a response plan for the epidemic, which provides policy guarantee for the standardized disposal of epidemic medical waste. In addition, the government and medical institutions at all levels formed a comprehensive, refined, and standardized medical treatment process system during research and practice. China has increased the capacity of medical waste disposal in various places by constructing new centralized disposal centers and adding mobile disposal facilities. China has achieved good results in the fight against COVID-19, and the pressure on medical waste disposal has been relieved to a certain extent. However, the global epidemic situation is severe. How to ensure the proper and safe disposal of medical waste is related to the prevention and control of the epidemic situation. This study summarizes China’s experience in the disposal of medical waste in the special case of COVID-19 and hopes to provide some reference for other countries in the disposal of medical waste.

On treatment patterns for modeling medical treatment processes in clinical practice guidelines

Clinical practice guidelines (CPGs) contain evidence-based and economically reasonable medical treatment processes. Executable medical treatment processes in healthcare information systems can assist the treatment processes. To this end, business process modeling technologies have been exploited to model medical treatment processes. However, medical treatment processes are usually flexible and knowledge-intensive. To reduce the effort in modeling, we summarize several treatment patterns (i.e., frequent behaviors in medical treatment processes in CPGs), and represent them by three process modeling languages (i.e., BPMN, DMN, and CMMN). Based on the summarized treatment patterns, we propose a pattern-based integrated framework for modeling medical treatment processes. A modeling platform is implemented to support the use of treatment patterns, by which the feasibility of our approach is validated. An empirical analysis is discussed based on the coverage rates of treatment patterns. Feedback from interviewed physicians in a Chinese hospital shows that executable medical treatment processes of CPGs provide a convenient way to obtain guidance, thus assisting daily work for medical workers.

Thực trạng sử dụng kháng sinh trên bệnh nhân hệ Ngoại Bệnh viện đa khoa tỉnh Thái Bình năm 2020

Objective: This article aims to describe the current situation of using health insurance of HIV / AIDS patients at the Outpatient Clinic (OPC) of Lao Cai General Hospital in 2020. Methods: The article uses quantitative data from a study using cross-sectional design. There were 313 HIV/AIDS infected patients participating in the study and were treated at the hospital outpatient clinic in Lao Cai province from January to September 2020. Descriptive statistical analysis was applied using SPSS 16.0 software. Results: The percentage of patients using health insurance cards for medical examination and treatment related to HIV in the past 12 months was high, accounting for 91.37%; using health insurance card in all visits is 97.23%. The highest age group that does not use health insurance card was from 35 to 50 years old, accounting for 59.26%, and all patients who were more than 50 years old reported using health insurance. The reasons for not using health insurance cards for medical examination and treatment are mainly due to fear of disclosing HIV/AIDS status and stigma and discrimination, and lack of information about health insurance; offline health insurance; time for medical examination and treatment under health insurance is long. Recommendation: The rate of use of health insurance cards related to HIV is generally high but still low in the age group 35-50. Hospitals need to improve the medical examination and treatment process of health insurance; develop and implement a communication plan on health insurance; reduce against stigma and discrimination of health workers, assure confidentiality in the process of medical examination and use of health insurance cards, people aged 35-50 years old should get more attention. Keywords: HIV/AIDS, health insurance, hospital, outpatient clinic, HIV/AIDS, patients

Chất lượng dịch vụ điều trị nội trú và một số yếu tố ảnh hưởng tại trung tâm chẩn đoán và điều trị ung bướu, bệnh viện Quân Y 175, thành phố Hồ Chí Minh năm 2021

Objectives: This study aims to estimate the quality of inpatient treatment services at the Center Oncology its influencing factors. Research Methods: A cross-sectional study, with a combination of quantative and qualitative approaches. Quantitative study to measure the quality of inpatient treatment services through the perceptions of 214 patients who came for medical examination and treatment at the Center for Oncology Diagnosis and Treatment, Military Hospital 175. Research results: The main findings showed that the average score of SERVPERF model was at 4.36/5. Human resources and human resource training and development; facilities and equipment; medical examination and treatment process, branding and advertising; salary and bonus; The supervision and inspection of medical examination and treatment service provision are important factors affecting the quality of inpatient treatment services. Conclusion: In order to improve the quality of healthcare services, the Center needs to promote the management of medical human resources, to supplement and well-equip, as well as maintain the salary and bonus regime, current supervision and inspection. Keywords: Healthcare services, patients, customers, SERVPERF,…

Users’ Satisfaction to Medical Examination and Treatment Services with Health Insurance Cards In NINH BINH Province, Vietnam

Health insurance is an important social policy with humanitarian meaning and profound community sharing, which is highly valued and promoted by the Vietnamese Government in the social security policy system. Therefore, it is necessary to study users’ satisfaction to medical examination and treatment services with health insurance cards. Based on the questionnaire surveys, the research team conducted Cronbach's Alpha analysis of each factor, assessed the scale reliability. Multivariate regression and ANOVA test showed that all four components: health services, human resources, medical examination and treatment costs, medical information and medical products positively affected users’ satisfaction to medical examination and treatment services with health insurance cards in Ninh Binh province, Vietnam. Based on the survey results and the information exchanged directly with people who came for medical examination and treatment, the research team drew out shortcomings in medical examination and treatment for users of health insurance card sin Ninh Binh province. Shortcomings in medical examination and treatment with health insurance cards were pointed out as an important basis for proposals to improve the medical examination and treatment quality for insured subjects including: Health insurance costs and response levels; Medical examination and treatment process with health insurance and doctor’s responsibility. Reasonable waiting time and hospital environment; Health insurance-based drug delivery.

Improving Patient Health Literacy in Hospitals - A Challenge for Hospital Health Education Programs.

BackgroundThe health literacy of hospital patients has become a very important issue, especially in the face of emerging infectious diseases. The design of and measures used by hospitals, however, have not yet taken into account whether patients can develop their health literacy through the process of medical treatment. Hospitals should take on this role as part of health education programs.MethodsA cross-sectional survey was conducted at pre-admission testing center patients waiting to be hospitalized in a regional teaching hospital. A purposive sampling method was used to recruit 406 patients via self-administered questionnaires.ResultsAmong the 406 participants, 36.1% had adequate health literacy. There were significant differences in age, education attainment, and history of chronic diseases for health literacy. The ability to find and judge information on health was lower. Watching health-related TV programs was positively correlated with health literacy. Health literacy, health promotion literacy, and understanding information on health were positively correlated to self-care and management. 65.8% of patients did not understand the treatment for which they were being admitted. Health literacy, healthcare health literacy, the ability to judge health information were positively related to understanding the treatment.ConclusionHealth literacy is a critical facilitating factor in improving self-care and management and understanding treatment on admission. Health education programs cannot, however, be one-size-fits-all. To help patients change their behavior, the change must be made easy. To this end, health information in the form of entertainment programs and simplified materials may be useful and even necessary.