Offer Health Care Research Articles

Predictive Analytics for Identifying High-Risk Medicare Patients: Enhancing Preventive Care

The intended purpose of this paper is to carry out an analysis of the use of predictive modeling for the early identification of high-risk Medicare patients with the aim of enhancing preventative measures. MEDI-CARE, a vital policy in the United States of America, which focuses on offering health care services to the old and people with disabilities, has been criticized over such factors as Shortcoming of Medicare hence can be attributed to factors such as the growing costs of health care and the emerging cases of chronic diseases. A new type of risk stratification: The use of predictive analytics, which incorporates ML-AI, is also in the early warning system and to monitor or follow up on the patient’s adverse health event, subsequent to which care coordination plans can be formulated. The abstract, hence, is an explanation of the roles of preventive and predictive analytics, especially in health care, with such a thing as the identification of early high-risk patients and management. They are that there is a rise in the dependence on methodologies that are data-driven for the purpose of attaining enhanced healthcare outcomes, reduction in the hospitalization quotient and the effective management of diseases which occur chronically. A few such points comprise data and information from electronic health records and other digital healthcare databases, model construction, and model application. It also addresses the various ethical pitfalls likely to arise when using the concept of predictive analytics, and these include the privacy of the patient’s data, how the collected data will be protected and filtered, as well as the prejudice that might be experienced when developing the algorithm. Current and earlier models of prediction, as well as their application in Medicare and research limitations, are described in the literature review of the article. Whereas in the methodology section, the procedures used in data collection, modeling, and validation are described, the results and discussion section put into perspective the effectiveness of the work done in enhancing Preventive care through predictive analytics. Finally, the discussion in the conclusion shall be based on the findings of the study and recommend future research directions for policy making.

Health-related challenges faced by men who had sex with other men amid the COVID-19 pandemic in the context of sexualized drug use (chemsex): A literature review

The COVID-19 pandemic has had widespread effects, impacting various aspects of human life, including sexual behaviors and substance use activities. This article aims to review and synthesize findings from existing published and unpublished research regarding health-related issues related to sexualized drug use (chemsex) among men who had sex with men (MSM) during the COVID-19 pandemic. The information was gathered from various databases, and 21 articles were included in this review. The results focused on the following seven health-related aspects: (i) Trends in chemsex practices among MSM during the pandemic; (ii) sexual behaviors and drug usage issues among MSM during the pandemic; (iii) mental and psychological health issues among MSM participating in chemsex during the pandemic; (iv) challenges and obstacles regarding health-care service access for MSM during the pandemic; (v) health disparity issues among MSM during the pandemic; (vi) digital health technology offering health care to MSM during the pandemic; and (vii) health-care interventions related to MSM engaging in chemsex during the pandemic. During the pandemic, targeted interventions were required that not only focused on mitigating physical health risks but also on addressing the mental health and socioeconomic challenges faced by MSM participating in chemsex. Moreover, digital health technologies and telemedicine offered promising avenues to provide necessary services remotely during the COVID-19.

Current German Recommendations and International Research on the Use of COVID-19 Boosters among Health Care Providers in 2024: A Narrative Review.

While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide on COVID-19 boosters in 2024. The review outlines key recommendations from the German Robert Koch Institute. HCPs should receive COVID-19 boosters at least 12 months after their last vaccination or COVID-19 infection, contingent on the prevalent viral variant(s) in the region. However, excessive doses and/or frequent boosters, especially with mRNA vaccines, may lead to immune imprinting, T-cell exhaustion, and immunoglobulin (Ig) switching. Notably, this review highlights the significance of Ig, particularly IgA and IgG subclasses, in influencing infection risk and disease progression. Furthermore, it explores the implications of mRNA vaccine technology and potential adverse effects related to excessive dosing. In conclusion, this article provides a comprehensive analysis of COVID-19 vaccine boosters for HCPs, synthesising current recommendations, scientific debates, and considerations for optimising protection against SARS-CoV-2 in the evolving landscape of the post-pandemic era.

Digital Health Literacy and Social Determinants of Health Affecting Telehealth Use by Athletic Trainers.

While increasing telehealth use throughout sports medicine has improved patients' access to health care, some communities may not have the same opportunities to connect with a provider. Barriers to telehealth implementation can be influenced by internal (eg,provider's digital health literacy and resources) and external (eg,community's social determinants of health or "SDOH") factors. This study aimed to assess the impact of internal and external factors on telehealth use by athletic trainers (ATs). Cross-sectional survey. In total, 767 ATs participated in the study. Participants (age = 39 [13]y) completed a survey containing the electronic health literacy scale and digital health literacy instrument, reported professional use of telehealth as a provider (yes/no), provided resources at their clinical site, and provided the zip code for the community they served. After data collection, the researchers extracted SDOH information using the zip code data from 2 US databases, including population density, median household income, poverty index, education level, and technology access. Chi-square or independent samples t tests were conducted to compare telehealth use by each SDOH factor. In total, 62.3% (n = 478/767) of ATs reported using telehealth, and 81.6% of ATs (n = 626) had a dedicated facility to offer health care services. We identified a significant difference in digital health literacy scores between users and nonusers of telehealth (P = .013). We did not identify any significant differences between telehealth users by community type (P = .957), population density (P = .053), income (P = .462), poverty index (P = .073), and computer (P = .211) or broadband internet access (P = .295). Our data suggest that internal factors such as digital health literacy and clinical site resources may have contributed to an AT's previous telehealth use in clinical practice. However, the SDOH data extracted from the community zip code where the AT provided clinical services were similar for those with and without previous telehealth use.

Pathways for Diagnosing and Treating CKD-Associated Pruritus: A Narrative Review.

Chronic kidney disease (CKD)-associated pruritus is a common, persistent, and distressing itch experienced by patients across the CKD spectrum. Although the disorder is associated with adverse outcomes and poor health-related quality of life, it remains underdiagnosed and undertreated. The purpose of this narrative review is to offer health care providers guidance on how to effectively identify, assess, and treat patients with CKD-associated pruritus, with the goal of reducing symptom burden and improving patient-important outcomes, such as quality of life (QoL). A panel of nephrologists and researchers from across Canada and the United States was assembled to develop this narrative review based on the best available data, current treatment guidelines, and their clinical experiences. A panel of nephrologists who actively care for patients with pruritus receiving dialysis from across Canada was assembled. Two researchers from the United States were also included based on their expertise in the diagnosis and management of CKD-associated pruritus. Throughout Spring 2023, the panel met to discuss key topics in the identification, assessment, and management of CKD-associated pruritus. Panel members subsequently developed summaries of the pertinent information based on the best available data, current treatment guidelines, and added information on their own clinical experiences. In all cases, approval of the article was sought and achieved through discussion. This narrative review provides pragmatic guidance addressing: (1) methods for screening CKD-associated pruritus, (2) assessing severity, (3) management of CKD-associated pruritus, and (4) suggested areas for future research. The panel developed a 3-pillar framework for proactive assessment and severity scoring in CKD-aP: systematic screening for CKD-associated pruritus (pillar 1), assessment of pruritus intensity (pillar 2), and understanding the impact of CKD-associated pruritus on the patient's QoL (pillar 3). Management of CKD-associated pruritus can include ensuring optimization of dialysis adequacy, achieving mineral metabolism targets (ie, calcium, phosphate, and parathyroid hormone). However, treatment of CKD-associated pruritus usually requires additional interventions. Patients, regardless of CKD-associated pruritus severity, should be counseled on adequate skin hydration and other non-pharmacological strategies to reduce pruritus. Antihistamines should be avoided in favor of evidence-based treatments, such as difelikefalin and gabapentin. A formal systematic review (SR) of the literature was not undertaken, although published SRs were reviewed. The possibility for bias based on the experts' own clinical experiences may have occurred. Key takeaways are based on the current available evidence, of which head-to-head clinical trials are lacking. This work was funded by an arm's length grant from Otsuka Canada Pharmaceutical Inc. (the importer and distributer of difelikefalin in Canada). LiV Medical Education Agency Inc. provided logistical and editorial support.

Writing the History of Legal Abortion.

Writing the History of Legal Abortion Johanna Schoen (bio) I started to research the history of legal abortion in the early 2000s, when the papers of a North Carolina abortion provider, Dr. Takey Crist, fell into my lap. Crist had wanted to donate his papers to an archive, and I volunteered to help him. Indeed, I ended up organizing his entire collection and, following that, the collections of a number of other abortion providers.1 When I began this work, I could not conceive of a world in which the U.S. Supreme Court might overturn Roe v. Wade. The providers I met, by that time all in their sixties and seventies, were full of passion and fervor about the 1970s, when they had taken the political moment to open the first legal abortion clinics. They were strong believers in a woman’s right to choose, to control her body, to determine her future. In addition, politics looked different twenty years ago. One of the first abortion providers Crist introduced me to was his friend Susan Hill, who owned the National Women’s Health Organization (NWHO), the largest group of free-standing abortion clinics after Planned Parenthood. As a twenty-four-year-old social worker, Susan had helped to open an abortion clinic in Florida two weeks after the Roe decision. Even the judges appointed by Republican presidents, she told me in the early 2000s, tended to be fair when she met them in court. By the late 1970s, she had founded the NWHO and was opening clinics in some of the most under-served areas in this country, including, in the early 1990s, the “Pink Clinic” in Jackson, Mississippi, which became the defendant in the Dobbs case.2 To open her clinics and to keep them open and services unobstructed, she had spent her life in court.3 I could not imagine a Republican Party interested in alienating a large voting block and losing abortion as the easy political rallying point [End Page 22] it had been since the 1980s. Clearly, I was wrong—which just shows that you should never ask a historian to predict the future. By the time the U.S. Supreme Court did overturn Roe with its decision in Dobbs v. Jackson Women’s Health, I was no longer surprised. I was also twenty years older and more cynical. When I first began to research legal abortion, I was fascinated with the stories of young feminists who, in the early 1970s, had had no doubt about their ability to open abortion clinics and offer health care to women across the country. Their political commitment and compassion were deeply moving; they believed that their actions could change the world. Of course, sometimes their political convictions were also didactic and funny. For a few years, while I taught at the University of Iowa, I sat on the board of the Emma Goldman Clinic in Iowa City, the longest running feminist health collective in the country. When I confessed to one of the directors that I had never seen my cervix—in the world of women’s health clinics this was seen as a prerequisite on the path to a feminist consciousness—she assured me that I could call on their services any time. I never took her up on this offer. As a historian, I was interested in the fault lines that existed in the world of abortion care. I wanted to tell the heroic stories of young women activists who had overcome sexism and patriarchy to establish women’s health clinics and the stories of young male doctors committed to legal abortion care who had dared their colleagues to integrate abortion into their OB-GYN clinics. I also wanted to know what decades of harassment had done to the abortion provider community and how members coped with it. Had the relentless antiabortion propaganda changed their feelings about their work? And if so, how had they responded to these changes? Learning about antiabortion politics and harassment was easy. The papers of Takey Crist and Susan Hill were full of antiabortion materials—pamphlets and leaflets handed out on picket lines, letters by antiabortion activists to convert or threaten...

Prevalence of neuroinfectious diseases and outcomes in Africa

Prevalence of neuroinfectious diseases and outcomes in Africa

Invest the time to build trust among marginalized research participants.

Gaining access to Indigenous communities and offering health care in a decolonizing way can take years of respectful collaboration. Gaining access to Indigenous communities and offering health care in a decolonizing way can take years of respectful collaboration.

The Relationship Between Life Satisfaction and Functional Ego States for Elders in Nursing Homes

The purpose of this study was to examine the relationship between life satisfaction and functional ego states of elderly people in a nursing home. This cross-sectional study sample was composed of 126 elders living in a nursing home who were not diagnosed with dementia. Data were collected using the Introduction Form, the Satisfaction with Life Scale, and the Ego States Scale. Data were analyzed using one-way analysis of variance and post hoc tests. The mean Satisfaction With Life Scale score of elderly participants was estimated to be 21.84 ± 5.30 (range 9–33). The possible range of scores is 5–35, with a score of 20 representing a neutral point on the scale. This result indicates that elderly people in nursing home show a higher than average level of life satisfaction. The dominant functional ego state of the participants was found to be Critical Parent (34.1%). There were significant differences in the Satisfaction With Life Scale means between groups in terms of dominant functional ego states (F = 47.304, p < 0.05). Post-hoc comparisons demonstrated that elderly people with a tendency to show more Critical Parent behaviors and communication patterns had lower levels of life satisfaction, and elderly people showing more Natural Child energy had higher levels of life satisfaction (p < 0.05). According to the research findings, the elders in Turkey have adopted a more critical stance over the years and shifted from the concerned, natural, but rational agedness defined in prior studies to a criticizing, demanding, and more rule-making agedness. Having an attitude more spontaneously and authentically like a child can increase life satisfaction in the elderly living in nursing homes. The research devoted to the functional ego states of the elderly needs to be completed with cultural analysis. Determining the dominant functional ego states of individuals while offering health care to the elderly experiencing problems in their personal and interpersonal relationships, and promoting convenient ego states, might render the care more effective and increase the life satisfaction of elderly people.

Digital Transformation of the Health Sector During the Covid-19 Pandemic in Saudi Arabia

Background: In March 2020, the first case of COVID-19 in Saudi Arabia was confirmed. In reaction to the outbreak, Saudi Arabia ordered the closure of the majority of governmental and private services. Technology and digital solutions have made it possible to provide essential services after the implementation of these severe protection requirements. Objective: This study aims to show how Saudi Arabia used digital technology during the COVID-19 epidemic in the fields of public health and health care services, and shedding insight on the efficacy of digital transformation in Saudi Arabia for preventing the spread of Covid-19. Methods: Using public announcements, press briefings and releases, news clips, published statistics, peerreviewed literature, and professional debates, we documented Saudi Arabia's usage of digital technologies throughout the epidemic. Results: The government and business sectors of Saudi Arabia jointly created and released around 19 applications and platforms that support public health duties and offer health care. Detailed descriptions of each are given. Companies in the telecommunications industry collaborated well and took steps to assist continuing efforts. Using social media, websites, and SMS text messages, risk communication initiatives adhered to best practice guidelines. Conclusions: An important step toward digital transformation has been taken by Saudi Arabia's Vision 2030 framework. This shift was made possible by COVID-19. For future epidemics in Saudi Arabia, artificial intelligence might be used to integrate data from several sources. Reducing the number of applications and combining their operations may also boost and make it easier for people to utilize them.

A review of guidelines, recommendations, and framework of men’s preconception care

The focus of men’s health is within the context of preconception health and primary care, which involves a new method of engaging men’s attention to their preconception and general health. The aim of this review research is to offer health care practitioners a complete framework for men’s preconception care. From 2000 to October 2021, researchers examined electronic databases such as Web of Science, PubMed, Scopus, ScienceDirect, ProQuest, Cochrane, SAGE, Springer, UpToDate, and Google Scholar for published papers on men’s preconception care. Two independent authors assessed the quality of the included studies using techniques suitable for this type of investigation. Only 14 of the 835 studies that were found in the original search matched the inclusion criteria. Individual responsibility across the life span (evaluation of reproductive life plan, acquiring information about contraception) and risk assessment (age, medical and surgical history, medications, family history and genetic risks, social history, sexual health assessment, physical examination, laboratory testing, mental health, and intimate partner violence) are the two main topics of preconception care in men according to a review of studies. Our findings clearly demonstrated the critical components of a comprehensive preconception care approach for men. Therefore, preconception care for men remains a developing concept. Further research is required to develop standards for evaluating males during the preconception period.

The impact of referral letter quality on timely access to specialised mental health care: a quantitative study of the reliability of patient triage

BackgroundPatients referred to specialised mental health care are usually triaged based on referral information provided by general practitioners. However, knowledge about this system’s ability to ensure timely access to and equity in specialised mental health care is limited. We aimed to investigate to the degree to which patient triage, based on referral letter information, corresponds to triage based on a hospital specialist’s consultation with the patient, and whether the degree of correspondence is affected by the quality of the referral letter.MethodsWe gathered information from three specialised mental health centres in Norway regarding patients that were referred and offered health care (N = 264). Data consisted of triage decisions for each patient (i.e., the hospital specialist’s assessment of maximum acceptable waiting time), which were determined on the basis of a) referral information and b) meeting the patient. Referral letter quality was evaluated using the Quality of Referral information-Mental Health checklist. The reliability of priority setting and the impact of referral letter quality on this measure were investigated using descriptive analyses, binary logistic regression and Nadaraya-Watson kernel regression.ResultsIn 143 (54%) cases, the triage decision based on referral information corresponded with the decision based on patient consultation. In 70 (27%) cases, the urgency of need for treatment was underestimated when based on referral information compared with that based on information from patient consultation. Referral letter quality could not explain the differences between the two triage decisions. However, when a cut-off value of 7 on the Quality of Referral information-Mental Health scale was used, low-quality letters were found more frequently among patients whose urgency of need was underestimated, compared with those whose need was overestimated.ConclusionsDeciding the urgency of patient need for specialised mental health care based on referral information is a reliable system in many situations. However, the possibility of under- and overestimation is present, implying risks to patient safety and inappropriate use of resources. Improving the content of referral letters does not appear to reduce this risk when the letters are of acceptable quality.Trial registrationNCT01374035.

Actualizing Cultural Humility: An Exploratory Study of Veterinary Students' Participation in a Northern Community Health Rotation.

Rotations in diverse, marginalized communities may offer health care students opportunities to develop cultural humility through different clinical experiences and activities. Through the actualization of cultural humility, veterinarians may offer accessible, affordable, culturally proficient, high-quality care to all their patients with a better understanding of how cultural differences affect the animal patient's health, well-being, and care. The purpose of this study was to explore whether participation in a community rotation in remote northern Indigenous communities promotes cultural humility among final-year veterinary students. Small groups of University of Calgary veterinary students travel annually to the Sahtu Settlement Area of the Northwest Territories, Canada, to participate in the Northern Community Health Rotation (NCHR). During the 4-week rotation, students spend 2.5 weeks providing veterinary services to domestic animals in five communities in the Sahtu. Eleven veterinary students who attended the NCHR between 2015 and 2020 answered exploratory open-ended questions in an online survey. Responses highlight areas of learning that contributed to their development of cultural humility. The rotation appears successful in increasing students' confidence working with people from diverse cultures, offering students opportunities to implement a client-centered approach, and advancing their capacity to recognize and challenge their preconceived biases about Indigenous cultures and animal ownership. These experiences are important to the acquisition of cultural humility for veterinary care providers.

Successful Same-Day Discharge for Robot-Assisted Radical Prostatectomy: A Systematic Review and Meta-Analysis.

Same-day discharge (SDD) following robot-assisted radical prostatectomy (RARP) is emerging as the standard of care. We conducted a systematic review and meta-analysis to evaluate the differences in perioperative characteristics, complication/readmissions rates and satisfaction/cost data between inpatient (IP) RARP and SDD RARP. This study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was prospectively registered with PROSPERO (CRD42021258848). A comprehensive search of PubMed®, Embase®, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and conference abstract publications was performed. A leave-one-out sensitivity analysis was performed to control for heterogeneity and risk of bias. A total of 14 studies were included with a pooled population of 3,795 patients, including 2,348 (61.9%) IP RARPs and 1,447 (38.1%) SDD RARPs. SDD pathways varied, though many commonalities were present in patient selection, perioperative recommendations and postoperative management. When compared to IP RARP, SDD RARP had no differences in ≥grade 3 Clavien-Dindo complications (RR: 0.4, 95% CI 0.2, 1.1, p=0.07), 90-day readmission rates (RR: 0.6, 95% CI 0.3, 1.1, p=0.10) or unscheduled emergency department visits (RR: 1.0, 95% CI 0.3, 3.1, p=0.97). Cost savings per patient ranged between $367 and $2,109, and overall satisfaction was high at 87.5%-100%. SDD following RARP is both feasible and safe, while potentially offering health care cost savings with high patient satisfaction rates. Data from this study will inform the uptake and development of future SDD pathways in contemporary urological care such that it may be offered to a broader patient population.

Barriers to the provision of non-communicable disease care in Zimbabwe: a qualitative study of primary health care nurses

BackgroundNon-communicable diseases (NCDs) contribute significantly to the global disease burden, with low-and middle-income (LMICs) countries disproportionately affected. A significant knowledge gap in NCDs exacerbates the high burden, worsened by perennial health system challenges, including human and financial resources constraints. Primary health care workers play a crucial role in offering health care to most people in LMICs, and their views on the barriers to the provision of quality care for NCDs are critical. This study explored perceived barriers to providing NCDs care in primary health care facilities in Zimbabwe.MethodsIn-depth, individual semi-structured interviews were conducted with general nurses in primary care facilities until data saturation was reached. We focused on diabetes, hypertension, and depression, the three most common conditions in primary care in Zimbabwe. We used thematic content analysis based on an interview guide developed following a situational analysis of NCDs care in Zimbabwe and views from patients with lived experiences.ResultsSaturation was reached after interviewing 10 participants from five busy urban clinics. For all three NCDs, we identified four cross-cutting barriers, a) poor access to medication and functional equipment such as blood pressure machines, urinalysis strips; b) high cost of private care; c)poor working conditions; and d) poor awareness from both patients and the community which often resulted in the use of alternative potentially harmful remedies. Participants indicated that empowering communities could be an effective and low-cost approach to positive lifestyle changes and health-seeking behaviours. Participants indicated that the Friendship bench, a task-shifting programme working with trained community grandmothers, could provide a platform to introduce NCDs care at the community level. Also, creating community awareness and initiating screening at a community level through community health workers (CHWs) could reduce the workload on the clinic nursing staff.ConclusionOur findings reflect those from other LMICs, with poor work conditions and resources shortages being salient barriers to optimal NCDs care at the facility level. Zimbabwe's primary health care system faces several challenges that call for exploring ways to alleviate worker fatigue through strengthened community-led care for NCDs. Empowering communities could improve awareness and positive lifestyle changes, thus optimising NCD care. Further, there is a need to optimise NCD care in urban Zimbabwe through a holistic and multisectoral approach to improve working conditions, basic clinical supplies and essential drugs, which are the significant challenges facing the country's health care sector. The Friendship Bench could be an ideal entry point for providing an integrated NCD care package for diabetes, hypertension and depression.

Development and Validation of the Anaphylaxis Quality of Life Scale for Adults

Anaphylaxis is a severe and potentially life-threatening allergic reaction that can have a detrimental impact on quality of life (QoL). There are no validated scales to measure the impact of anaphylaxis on QoL of adults. The aim of this study was to develop and assess the reliability and validity of a QoL scale for adults with anaphylaxis (Anaphylaxis Quality of Life Scale for Adults [A-QoL-Adults]). All participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis (as per the World Allergy Organization diagnostic criteria) to food, drugs, venom, or latex or had spontaneous anaphylaxis. Interviews were conducted with 13 adults; data were analyzed using thematic analysis to extract items for a QoL scale. A prototype QoL scale was then completed by 115 participants alongside validated scales to measure generic QoL (World Health Organization Quality of Life Scale [Brief Version] [WHOQoL BREF]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), and stress (Perceived Stress Scale [PSS]). The A-QoL-Adults scale has 21 items demonstrating excellent internal reliability (Cronbach α= 0.96). Factor analysis produced 3 subscales: Emotional Impact; Social Impact; and Limitations on Life. Each has excellent internal reliability (0.92, 0.92, and 0.91, respectively). Poorer anaphylaxis-related QoL (total A-QoL-Adults score and subscale scores) correlated significantly with poorer general QoL and greater anxiety, depression, and stress (all P < .01 with medium-to-large effect sizes). The A-QoL-Adults scale is a reliable measure of QoL in adults with anaphylaxis and shows good construct validity. It will offer health care professionals a means to further understand the impact of anaphylaxis on adult patients and could help direct and monitor allergy management and the need for further psychological intervention.

Nature-based Pathways to Health Promotion: The Value of Parks and Greenspace.

The built environment is a key social determinant of health. Exposure to parks and greenspace can improve physical and mental health and provide other benefits that enhance well-being. Programs and initiatives that capitalize on nature-based opportunities offer health care providers with a cost-effective alternative for upstream health promotion.

Factors influencing high school students’ decision in applying to Medical School

Background: Many factors influence high school students’ future profession choices, which differ by culture and other variables such as the students’ background, social differences, and financial status, all of which culminate in a student pursuing their higher education in a single field. As a result, the factors that influenced that choice must be addressed in order to achieve better outcomes for both the educational programs and the health system. Methods: A cross-sectional study was conducted in Riyadh city among high school students. Sociodemographic characteristics, preferred study specialties, GPA, and performances were obtained using a self-administered questionnaire. Results: The age of the students was between 16-19 years old. Most selected specialties were medicine, followed by engineering, information technology and Nursing, however, Pharmacy was in the least selected specialty. Findings showed that the top perceived barrier was the high aptitude score required for entry into medicine (23.3%); another group of the students (23.1%) indicated that the English Language competency test/skills were the second obstacle. Offering health care and motivation were the most important factor for the majority of students. The majority had remarkably agreed or strongly agreed to the humanitarian context about studying medicine (90.4%). Conclusion: A higher percentage of high school students choose to attend medical school, with the primary obstacles to admission being the high aptitude score required for admission, followed by English language competency examinations. Finally, there is a considerable disparity between genders when it comes to medical school preferences and reasons. Keywords: Medicine, medical student, Saudi Arabia, healthcare, medical schools

Telehealth during COVID-19 pandemic era: a systematic review

&lt;abstract&gt;&lt;sec&gt; &lt;title&gt;Background&lt;/title&gt; &lt;p&gt;Across the globe, the coronavirus (COVID-19) pandemic has altered the delivery of healthcare services as patients must maintain their distance from caregivers, and still receive medical treatment. This has triggered a necessity for exploring means which minimizes the physical gap between patients and healthcare givers while offering health care and ensuring high medical protection at a reduced risk of exposure. Even though telehealth services are no replacement for conventional healthcare, its' usefulness in the coronavirus (COVID-19) pandemic is immense.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Objective&lt;/title&gt; &lt;p&gt;This research reviews the ardent utilization, barriers and recommendations with telehealth services for healthcare delivery during the COVID-19 pandemic.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Methods&lt;/title&gt; &lt;p&gt;An assessment of literature in five large digital databases; PubMed, Science Direct, Sage Pub, ProQuest, and Google Scholar was conducted. Inclusion criteria included studies defining telehealth/telemedicine, utilization, barriers and recommendations during the COVID-19 pandemic from January 2020 to July 2021, written in English and published in peer-reviewed journals. Two reviewers independently assessed search results, extracted data, and assessed the quality of the included studies. Narrative synthesis was undertaken to summarize and report the findings.&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Results&lt;/title&gt; &lt;p&gt;Overall, the study discoveries which are most commonly stated as impediments for telehealth services' full utilization between patients and physicians beyond the scope of typical medical confinement are: infrastructure and internet access (20.00%), data privacy and security (13.33%), digital literacy (13.33%), reimbursement and liability (10.00%), and clinician and patient's unwillingness (6.67%).&lt;/p&gt; &lt;/sec&gt;&lt;sec&gt; &lt;title&gt;Conclusions&lt;/title&gt; &lt;p&gt;The intrusion of coronavirus has accelerated the transition to telehealth services in healthcare delivery, but it has also provided a unique chance to demonstrate the critical role that telehealth can play in ensuring that people of all races, ethnicities, and communities receive high-quality treatment (justice). Healthcare professionals should emphasize the effectiveness of telehealth services as an alternate healthcare delivery method in promoting healthcare to all populace.&lt;/p&gt; &lt;/sec&gt;&lt;/abstract&gt;

Virtual reality-based rehabilitation in patients following total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials.

Background:Physical therapy is regarded as an essential aspect in achieving optimal outcomes following total knee arthroplasty (TKA). The coronavirus disease 2019 (COVID-19) pandemic has made face-to-face rehabilitation inaccessible. Virtual reality (VR) is increasingly regarded as a potentially effective option for offering health care interventions. This systematic review and meta-analysis investigate VR-based rehabilitation's effectiveness on outcomes following TKA.Methods:From inception to May 22, 2021, PubMed/Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Scopus, PsycINFO, Physiotherapy Evidence Database, China National Knowledge Infrastructure, and Wanfang were comprehensively searched to identify randomized controlled trials (RCTs) evaluating the effect of VR-based rehabilitation on patients following TKA according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook for Systematic Reviews of Interventions.Results:Eight studies were included in the systematic review, and seven studies were included in the meta-analysis. VR-based rehabilitation significantly improved visual analog scale (VAS) scores within 1 month (standardized mean difference [SMD]: −0.44; 95% confidence interval [CI]: −0.79 to −0.08, P = 0.02), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) within 1 month (SMD: −0.71; 95% CI: −1.03 to −0.40, P < 0.01), and the Hospital for Special Surgery Knee Score (HSS) within 1 month and between 2 months and 3 months (MD: 7.62; 95% CI: 5.77 to 9.47, P < 0.01; MD: 10.15; 95% CI: 8.03 to 12.27, P < 0.01; respectively) following TKA compared to conventional rehabilitation. No significant difference was found in terms of the Timed Up and Go (TUG) test.Conclusions:VR-based rehabilitation improved pain and function but not postural control following TKA compared to conventional rehabilitation. More high-quality RCTs are needed to prove the advantage of VR-based rehabilitation. As the COVID-19 pandemic continues, it is necessary to promote this rehabilitation model.