Need For Preventive Health Care Research Articles

Application of Industry 4.0 and digital twin in the field of smart healthcare

There is an increasing need for preventive health care as well as precise diagnosis and tailored treatment of different diseases in recent years. Providing customized treatment for each patient and maximizing accuracy and efficiency are main goals of a good healthcare system. This thesis explores the integration of digital twin technology with Industry 4.0 in healthcare. Digital twins create virtual representations of physical systems, enabling real-time monitoring and tailored treatments. Key elements include the living human body, IoT, digital twin, cloud computing, and simulation. The architecture comprises data acquisition, data munging, data storage, data simulation with analytics, and user access layers. Creating a digital twin involves precise 3D modeling, representing the entire body or specific organs. A case study demonstrates real-time monitoring using wearable sensors for blood pressure, blood sugar, and heart rate. Data is transmitted, integrated with the digital twin, and accessible via a website with alarms for abnormal readings. While Industry 4.0 and digital twin adoption in healthcare is evolving, the architecture serves as a reference. It offers real-time data for diagnosis and treatment, with potential for advanced simulations. Challenges include automated data systems and privacy concerns. Despite limitations, this integration holds promise for precision medicine and personalized healthcare.

Chinese Immigrant Women's Experiences as Community Health Workers in Korea: A Focus Group Study.

The number of immigrant women in Korea is rapidly increasing. Immigrant women in Korea experience a host of health problems associated with living in a new country. Community health workers (CHWs) may be effective at delivering health promotion programs to vulnerable groups such as recent immigrants. Qualitative analysis was performed to identify the main themes characterizing the experiences of CHWs in recommending and guiding preventive screening tests for immigrant women. This focus-group study was designed to investigate the experiences and perceptions of CHWs. We conducted interviews with 15 Chinese immigrant women who served as CHWs in a cancer screening program. We asked questions about the attitudes and perceptions that CHWs had from their research experiences. Each interview was audio-recorded and transcribed verbatim. Three main themes emerged: (a) recognizing the need for preventive healthcare, (b) becoming the CHWs who help people to be healthy, and (c) challenges to overcome to make CHWs more active. The CHWs in this study were willing to help other Chinese immigrant women and to improve their competency to help more effectively. However, they recognized limitations on their ability to address problems when delivering a breast and cervical cancer screening program. When training CHWs for immigrants in Korea, frequent opportunities for consultation should be provided during program delivery to facilitate troubleshooting and help CHWs overcome challenges. A program that utilizes CHWs for various minority groups is needed.

Recent Patterns of Multimorbidity Among Older Adults in High-Income Countries.

Population aging along with the rising burden of chronic medical conditions (CMCs) is challenging the sustainability of health care systems globally. The authors sought to characterize contemporary patterns of multimorbidity among older adults (aged ≥65 years) in high-income countries (HICs). Medline, EMBASE, CINAHL, PsycINFO, and Web of Science were searched in January 2018 for English-language articles that reported the prevalence of multimorbidity (defined as co-occurrence of ≥2 CMCs in an individual without defining an index disease) among older adults in HICs, or the proportions with ≥3 or ≥5 CMCs. Only studies that utilized data collected during January 2007-December 2017 were included. A total of 52 articles (45 studies) that reported data among >60 million older adults in 30 HICs were included. The overall prevalence of multimorbidity was 66.1% (interquartile range [IQR] 54.4-76.6). The multimorbidity prevalence increased with age as well as with the number of CMCs included in the assessment. The prevalence of ≥3 or ≥5 CMCs was 44.2% (IQR 34.0-70.3) and 12.3% (IQR 8.7-19.1), respectively. The multimorbidity prevalence was also higher among females as well as among studies using care-based data rather than self-reported data. The prevalence of hypertension, dyslipidemia, diabetes, pain disorders, depression, heart failure, cancer, and dementia among the older adults was 60.6%, 51.2%, 25.2%, 34.0%, 12.0%, 14.0%, 8.6%, and 8.4%, respectively. The available data suggest a high prevalence of multimorbidity among older adults. There is a need for increased research into understanding the causal mechanisms that underlie multimorbidity toward supporting the development of cost-effective interventions. In addition, the study results reiterate the need for preventive health care to move beyond targeting single diseases in favor of directing efforts toward reducing overall morbidity among this population.

77-OR

Objectives Women with a preterm birth in a preeclamptic pregnancy have excess cardiovascular (CVD) mortality. Based on complete reproductive experience of 836.147 women, we evaluate the effects of the size of the fetus in preeclamptic pregnancies on risk for early death in mothers. Methods We use data from the population-based Medical Birth Registry of Norway, covering births in 1967 to 2009. Women with 1st births in 1967 to 2002 were followed for total reproduction and/or death until 2009. There were 23,000 maternal deaths, 3891 were due to CVD. We used birth weight-by-gestational-age to assess size of the fetus. Analyses were adjusted for period, maternal age and education. Results Women with preterm preeclampsia and a small fetus (lowest quartile), had 2.5-fold increase (95%C.I 1.6–3.8) in CVD death, while a large fetus (highest quartile), had 12.3-fold (7.3–21) increased risk. Similarly strong HR-values were found both for 22–34 and 35–36 weeks (HR = 11.4, and 13.0). Excluding diabetes moderately reduced these high risks. For women with one lifetime pregnancy, risks were largely increased. Conclusions Previous studies show that women with small fetuses have higher risk for an early CVD death; however we find that in preterm preeclampsia, a large fetus provides the greatest hazard. Diabetes, or undiagnosed diabetes, may play a strong role in the relation between preeclampsia and the excess risk for long term maternal death. For women with two or more births and preterm preeclampsia, cardiovascular death is increased (3-fold), but for these mothers the overall death hazard is not affected , especially when the fetus is small. Having only one pregnancy may reflect underlying maternal morbidity, which could decrease fertility or reduce the woman’s interest in additional children. One child mothers with preterm preeclampsia are in special need for preventive health care. Disclosures R. Skjaerven: None. L. deRoo: None. K. Klungsoyr: None. N.H. Morken: None. J. Rich-Edwards: None. A.J. Wilcox: None.

Exploring Determinants of Health Seeking Behaviour and Perceptions of Need for Preventive Health Care among Rural and Urban Women of Shimla

This paper examines the factors that mostly affect the health seeking behaviour of rural and urban women of Shimla and their awareness, knowledge and opinion regarding the preventive health services. With the help of Chi square (2) tests the independent variables like age, marital status, education, income and occupation were analyzed for their independent predictive power on dependent variables comprising the perception of need for preventive health care and its utilization which included going/not going for voluntary health check up and reasons for non utilization of voluntary health care services in rural and urban areas. Education variable decided the perception of health needs as well as the capacity to acquire the health services (p < 0.01), thereby playing a vital role in determining the utilization pattern of health services.

Understandings of influenza and influenza vaccination among high-risk urban dwelling Thai adults: a qualitative study

The 2004 outbreak of influenza A H5N1 and the WHO's recommendation for national pandemic plans has led the Thai Ministry of Public Health to develop an influenza vaccination programme for high-risk adults. To date there is no available information to guide this intervention, and how to maximize the uptake of the vaccine by the Thai population. To address this knowledge gap, this study explored factors influencing urban-dwelling Thai adults' decisions whether or not to have the vaccine. It explored their beliefs about influenza and influenza vaccination, and other influences on their decisions. In-depth interviews were conducted among 20 high-risk individuals who were aged 65 and over or under 65 years with chronic diseases requiring influenza vaccination. Interviews were tape recorded and analysed following using grounded theory. Most participants had insufficient knowledge about influenza and influenza vaccination. Their decisions in relation to vaccination were based on a number of factors, including salience of risk, influence of others, perception of the need for preventive health care and the availability of influenza vaccine. These findings underscore the need to consider and understand factors underlying people's vaccination decisions to create an effective influenza vaccination programme.

Clinical neuropsychiatric correlates and EEG findings among children with developmental disorders in Lagos, Nigeria

Developmental disorders with or without associated neuropsychiatric complications continue to be one of the major health problems in Africa. The grossly inadequate management/ rehabilitative facilities further worsen this. A prospective study aimed at finding the types of developmental disorders and associated neuropsychiatric complications among children aged </=15 years that presented with developmental disorder in the study centers over 36 month study duration. The study was carried out in the paediatric and child psychiatric clinics as well as the Electroencephalographic (EEG) unit of two major health facilities in Lagos, Nigeria: Lagos University Teaching Hospital (LUTH) and Psychiatric Hospital, Yaba, Lagos. For each subject, socio-demographic data was obtained and appropriate clinical evaluation was carried out to obtain the necessary data and clinical diagnoses. Furthermore, each of the subjects had waking EEG recording using 20-channel computerized Medelec(R)EEG machine. The EEG interpretation was blinded to the clinical history of the subjects. Overall, one hundred and eleven (111) subjects were evaluated over the 36 month study period. The cohort was made up of 63 (56.8%) males and 48 (43.2%) females. The mean age was 4.8 (+/-3.9) years, with most subjects falling in the age group of 0-5 years(69.4%). Mixed specific developmental disorders were most common (55%) followed by that of specific developmental disorders of speech and language (34.2%). Forty-one (36.9%) subjects suffered from one or more types of complications, with seizure, 22(19.8%) being the most common. The waking EEG recording was normal in 22 (19.8%) subjects; while abnormal epileptiform activities were found in 85 (76.6%) of recordings. No statistically significant relationship existed between EEG abnormalities and the factors of age and clinical diagnoses (i.e developmental abnormalities). The small number of subjects in this study is a major hindrance to drawing a general conclusion. However, it has been shown that a number of the cohort in addition to their developmental disorders suffered from such complications as seizures, hyperactivity etc. Furthermore, a significant proportion had EEG abnormalities of the epileptiform types possibly reinforcing the previously known fact of prevalent subtle brain damage among African children. The need for preventive health care is therefore emphasized.

Addressing at-risk pregnant women's issues through community, individual and corporate grassroots efforts.

Prenatal care is crucial to the health and well-being of our youngest children. Yet millions of children are coming into the world without the benefit of this care, and their numbers are increasing. About one-fourth of pregnant women do not receive the recommended level of prenatal care. The percentage of pregnant women who receive virtually no prenatal care (no more than a visit or two in the last few weeks of pregnancy) has increased in recent years. Mothers are less likely to obtain adequate or prompt prenatal care if they are young, poor, unmarried, relatively uneducated, uninsured, or living in inner cities or rural areas (Carnegie Task Force on Meeting the Needs of Young Children, 1994). Pregnant women, new mothers, and families are often ill informed or misinformed about the need for preventive health care and the process of actually getting care. Even if people have the necessary information, they may lack the motivation, friendly guidance, ability to pay, or means of transportation necessary to get to care. Services are provided in different places, and eligibility forms are varied, complex, and designed to frustrate (National Commission to Prevent Infant Mortality, 1989). Mothers who do not receive prenatal care are more likely to have low-birthweight infants (2,500 grams or less). These babies are significantly more likely to have neurodevelopmental handicaps, congenital anomalies, and more frequent respiratory tract infections. Over 40 percent of these infants are rehospitalized more than once in their first year of life (Carnegie Task Force on Meeting the Needs of Young Children, 1994). Consequently, pregnant women who do not receive prenatal care and thus have less chance of delivering healthy, full-term, normal-weight babies are referred to in this article as risk. In spite of considerable investment of resources and the highly skilled and well-equipped medical system, by most measures the overall health status of Americans lags behind that of many other nations' citizens. Among the nations of the world, the United States ranks 19th in infant mortality, 21st in deaths of children under five, and 29th in the percentage of low-birthweight babies. The low childhood immunization rates in the United States are a national disgrace (Children's Defense Fund, cited in Hartman, 1992). Zuravin (1989) defined refusal or delay in providing health care as one subtype of parent behavior resulting in child neglect. Social work studies provide overwhelming evidence that extreme poverty is significant in the etiology of neglect, especially chronic neglect. At the micro level, the multiplicity of problems facing chronically neglecting caregivers requires interventions that are comprehensive, in-home, and longer term. Social services agencies have long been unable to provide the concrete and paraprofessional services necessary to increase household management and parenting skills (Nelson, Saunders, & Landsman, 1993). The crises in health care - the new demands and the need for answers - clearly point to the need for a redefinition of services. Although social work emphasizes the importance of family involvement, research indicates that the actual number of encounters with families is a relatively small percentage of the many interventions provided by social workers in health care settings (Bergman et al., 1993), Society cannot afford to ignore the increasing blight of child maltreatment perpetuated by economic inequities and by the failure of the human services system to adequately meet the needs of families and children (Nelson et al., 1993). Shared Beginnings was established in 1994 to address the needs of high-risk pregnant women in Denver, specifically women enrolled for health care at Provenant Family Medicine Centers. The program involved the collaboration of the medical, social services, and business communities; philanthropic sectors; and community members. This article describes the nature of this program and the steps taken to initiate and maintain such a grassroots program. …

Group Health Supervision Visits More Effective Than Individual Visits in Delivering Health Care Information

Preventive health care consumes a substantial amount of pediatricians' time and has been promoted as one of the most important medical functions physicians perform.1-4 The American Academy of Pediatrics (AAP) has emphasized the need for preventive health care. To assist in the delivery of child health supervision, the AAP Committee on Psychosocial Aspects of Child and Family Health has recently published guidelines recommending specific topics to be covered at each of the routine health maintenance visits.5 Despite the acceptance of recommendations for preventive child health care, the efficacy of office-based prevention strategies has not yet been proven.6 However, assessment of the literature addressing the effectiveness and costs of strategies for promoting and maintaining child health has been noted to be "more remarkable for its limitations than its findings."6

Education and integration of midlevel health-care practitioners in obstetrics and gynecology: Experience of a training program in Washington State

The impetus for the development of the Gynecorps Training Program was the identification of medically underserved populations of women in Washington State and their need for preventive health care, the maldistribution of physicians, and the success of a pilot program for training midlevel personnel conducted in 1972 by the Department of Obstetrics and Gynecology, University of Washington School of Medicine. The program trains community-based and -sponsored Registered Nurses and Physician's Assistants as women's health-care specialists, with the goal of delivering preventive care in obstetrics and gynecology to populations of high-risk, low-income, and/or underserved women. A summary of the training program, its curriculum, and the integration of its graduates into community health teams is presented and discussed.