Healthcare Paradigm Research Articles

Challenges in oral health research for older adults.

The high burden of chronic disease in older adults presents significant organisational and funding challenges to healthcare policymakers. However, it is a matter of debate whether research is informing oral healthcare policy at scale. The objective of the study was to identify barriers to translation of research into oral healthcare policy and practice for older adults and suggest strategies to address these barriers. The effectiveness of current models of oral health care, particularly for vulnerable older adults with special needs, is not well established. Researchers need to engage more proactively with stakeholders such as policymakers and end-users from the study design phase. This is particularly relevant for research in residential care settings. Building a rapport and developing trust with these groups will enable researchers to align their research with the priorities of policymakers. The evidence-based care paradigm, which is underpinned by randomised clinical trials (RCTs), may not be practical in population oral health research involving older adults. Alternative methods should be considered to develop an evidence-informed paradigm for oral health care in older adults. Since the pandemic, there are opportunities to use electronic health record data and digital technology. Further research is needed to evaluate the effectiveness of tele-health in oral health of older adults. Use of a wider range of co-designed studies rooted in the practicalities of "real world" health service delivery is recommended. This may address issues of concern to policymakers and stakeholders regarding oral health and increase the likelihood of translation of geriatric oral health research into oral healthcare policy and practice.

Quantum Computing for Healthcare: A Review

In recent years, the interdisciplinary field of quantum computing has rapidly developed and garnered substantial interest from both academia and industry due to its ability to process information in fundamentally different ways, leading to hitherto unattainable computational capabilities. However, despite its potential, the full extent of quantum computing’s impact on healthcare remains largely unexplored. This survey paper presents the first systematic analysis of the various capabilities of quantum computing in enhancing healthcare systems, with a focus on its potential to revolutionize compute-intensive healthcare tasks such as drug discovery, personalized medicine, DNA sequencing, medical imaging, and operational optimization. Through a comprehensive analysis of existing literature, we have developed taxonomies across different dimensions, including background and enabling technologies, applications, requirements, architectures, security, open issues, and future research directions, providing a panoramic view of the quantum computing paradigm for healthcare. Our survey aims to aid both new and experienced researchers in quantum computing and healthcare by helping them understand the current research landscape, identifying potential opportunities and challenges, and making informed decisions when designing new architectures and applications for quantum computing in healthcare.

Quality in Psychiatric Care in the Community Mental Health Setting from the Perspective of Patients and Staff.

The current paradigm of mental health care focuses on care provided in the community, increasingly moving away from hospital care models that involve considerable economic burden. Patient and staff perspectives on the quality of psychiatric care can highlight strengths and areas for improvement to ensure better care provision. The aim of this study was to describe and compare perceptions of quality of care among patients and staff in community mental health services and to determine possible relationships between these perceptions and other study variables. A comparative cross-sectional descriptive study was conducted in a sample of 200 patients and 260 staff from community psychiatric care services in the area of Barcelona (Spain). The results showed high overall levels of quality of care from patient (m = 104.35 ± 13.57) and staff (m =102.06 ± 8.80) perspectives. Patients and staff both gave high scores to Encounter and Support factors, while factors concerning patient Participation and Environment received the lowest scores. Continuous assessment of the quality of psychiatric care in the community setting is essential to ensure the highest quality of care, taking the perspectives of those involved into account.

Evidence-Based Medicine: History, Review, Criticisms, and Pitfalls.

Evidence-based medicine (EBM) is the use of high-quality clinical research in making decisions about the care of patients. Its formal origin dates back to the mid-nineteenth century, and since then, it has continued to evolve. The best research evidence, clinical expertise, and patient values are described as the foundations of EBM. However, several tools and skills have been developed and added over time. EBM has faced a lot of criticism, and the pitfalls are widely discussed and published in the medical literature. The biggest challenge is the changing paradigm of healthcare, cost-effectiveness, and changing evidence which has led to controversies and challenges in the rapid adaptation of the EBM. This review article discusses the history, conception, and evolution of modern-day EBM. In addition, we discuss why EBM has been criticized and highlight the pitfalls.

Informed Consent in Dental Practice: A Qualitative Analysis of Awareness and Apprehensions Among Practitioners in South India

Context: The push for autonomy and liberalization has transformed the practice of medicine and dentistry from paternalism to a patient cantered model. Patient’s choice to accept or reject the proposed treatment is central to this new paradigm of health care. Informed consent is an essential tool for an ethical dental practice. Aim: The objective of the present study was to explore the knowledge, attitudes, perceptions and prevailing practices among dentists regarding the informed consent process. Materials and methods: A phenomenological approach was undertaken. A semi structured telephonic interview was conducted based on a flexible topic guide and continued until data saturation. Statistical analysis: The data was transcribed verbatim. Coding and categorisation done. Anonymity was ensured in all steps. The data was subjected to a thematic analysis. Results: Participants were apprehensive about the influence of social media on the new paradigm of doctor patient relationship and the increasing utility of specialists as a protection from litigation. Lack of clarity regarding the consent method has prevented its routine application. Conclusions: It can be concluded that a comprehensive understanding regarding informed consent process was lacking among the participants.

Culinary cultural immersion: A qualitative analysis of resident knowledge, attitudes, and behavioral changes following a brief Somali cultural immersion experience.

Teaching cultural humility is required by the Accreditation Council for Graduate Medical Education and can improve patient satisfaction and health care outcomes. Because one-third of the 150,000 Somali immigrants and refugees in the United States live in Minnesota, we aimed to determine whether a brief cultural immersion experience, where small groups of residents share a meal with Somali interpreters at a Somali restaurant, would affect resident knowledge, attitudes, and behaviors when caring for Somali patients in a Minnesota emergency department. From October 2017 to September 2018, emergency medicine residents were invited to dinners held outside of regular clinical/academic hours. Dinners took place at a Somali restaurant and were facilitated by a Somali interpreter and a faculty physician. While they were designed as learner-driven sessions, facilitators were encouraged to discuss specific themes. In addition to an evaluation survey, participants underwent semistructured interviews after the experiences, and a qualitative analysis of derived themes is reported. Six dinners were hosted for a total of 20 residents, with 17 (85%) completing the evaluation survey and interview. Residents strongly agreed that this experience was worth their time and would recommend the program. Residents reported an increase in their knowledge of Somali culture, health care paradigms, and diet. Behavioral changes were described, including how residents greet patients, tailor clinical visits to patient expectations, and use interpreters as cultural brokers. Attitudinal changes were reported to a lesser degree but included an increased acceptance of cultural differences and an increased sense of connectedness to this population. Finally, residents reported that the benefits of this program were due to the authenticity of the experience, the informal small-group setting, and their sense of being in the minority during the dinners. A brief immersion experience at a Somali restaurant was sufficient to result in increased knowledge, attitudinal, and behavioral changes when caring for Somali patients.

Opportunities and Obstacles for Using Remote Monitoring and AI to Enable Sustained Integrated Telehealth PPT

Telehealth has seen a rapid growth period in the last a couple of years globally, partly propelled by the pandemic. Now many patients and healthcare providers have seen the potential benefits of telehealth, many people are in the process to drive sustained growth of this new paradigm of healthcare. The panel will be focused on two key enabling factors of the future growth of integrated telehealth, i.e., remote monitoring and AI. They will use specific cases to discuss the Opportunities and Obstacles in the development, deployment, and commercialization of these technologies.

Gender and Sex in Medical Practice: An Exploratory Study on Knowledge, Behavior, and Attitude among Sicilian Physicians

Personalized medicine is a new paradigm in health care, and the concept of socio-cultural gender, as opposed to biological sex, emerged in several medical approaches. This exploratory study aimed to investigate the knowledge of sex and gender in clinical medicine among Sicilian physicians. Data collection was based on an online survey sent to the members of the Medical Councils of Sicily (Italy). The questionnaire included nine specific items about awareness and attitudes regarding gender medicine and its importance in clinical practice. 8023 Sicilian physicians received the solicitation e-mail and only 496 responded. Regarding the knowledge of gender medicine, 71.1% of participants stated that they know it, while 88.5% believe that gender medicine should be included in training programs. Similarly, a high percentage (77.6%) would like to keep up to date on this topic. Physicians sampled seem to understand the importance of gender medicine principles, although their experience of some gender issues (i.e., sex disparities in acute cardiovascular care and smoking cessation strategies) is low (55.44% and 21.57%, respectively). The results of this exploratory study should encourage facing the gender medicine gap in the current curricula of health professionals and should implement the transitional value of sex and gender principles in the clinical setting.

Performance Medicine: a novel and needed paradigm for proactive health care.

Performance Medicine is an emerging clinical practice that holds immense promise for advancing preventive health. To date, however, the concept remains imprecise, disorganized, and commercialized. The purpose of this perspective article is to define characteristics, core tenets, and practice standards to help build a common framework. We define performance broadly as "one's capacity to bring energy and attention to what matters most in a given moment". Performance Medicine, therefore, is predicated on the thesis that the critical practices that enhance one's daily wellbeing simultaneously increase both lifespan and healthspan. As a clinical practice, Performance Medicine is proactive and preventive. It focuses on the immediate and actionable strategies to address one's physical, mental, and emotional capabilities every day. The practice employs a values-centered approach that begins with a discovery process to elucidate the client's deeply held beliefs about their health status, life mission and goals, vision for optimal wellbeing, and motivations for change. Subsequent diagnostics and therapies combine evidence-based practices from multiple medical specialties including internal medicine, sports medicine, obesity medicine, integrative medicine, and others. This is complemented by the most recent scientific advancements in nutrition, exercise physiology, sleep, and recovery. The Performance Medicine prescription incorporates a personalized combination of lifestyle-based behavior change practices, evidence-based diagnostics and risk reduction therapies, ongoing monitoring, and community support. Finally, the iterative and incremental process towards enhanced and sustained health is guided and supported by a trusted partnership between the client and a team of expert practitioners and coaches.

Health 2050: faster cure via bioinformatics and quantified self; a design analysis

Four areas make up 75% of our healthcare costs: cardio-, onco-, neuro- and metabolic diseases. These are largely preventable, even reversible. Instead, they are currently often 'managed' and made chronic, not cured. This is too costly. Research is showing new opportunities for enhancing our body's self-repair in a matter of hours or days. Our research question: what could be an intervention- and bio-feedback portfolio to promote health self-repair within hours or days? There are large cross-domain differences regarding: intervention aims, (self-)measurement options, focus on symptoms vs. causes, plus degree of attention for health self-management. Given recent research into rapid cure, we advise advanced daily bioinformatics feedback, using molecular biomarkers. This creates a quantified self 'endoself', showing key biological opportunities for cure and self-repair. Thus, we shift from the current 'antibiotics/external fix' paradigm of healthcare to a 'wound healing' paradigm, improving use of resources in health.

Revolutionizing Healthcare Paradigms: The Integral Role of Artificial Intelligence in Advancing Diagnostic and Treatment Modalities

Revolutionizing Healthcare Paradigms: The Integral Role of Artificial Intelligence in Advancing Diagnostic and Treatment Modalities

Towards wearable sensing-based precise and rapid responding system for the early detection of future pandemic

During the past three years, tremendous efforts have been made to tackle the Coronavirus Disease 2019 (COVID-19) crisis, including centralized quarantine, compulsory testing, and sweeping lockdowns. The measures have taken effect, but have caused a huge burden on healthcare systems and significant disruption to global economies on an unprecedented scale. Recently, some countries and regions have observed signs of the pandemic resurgence. To better handle the resurgence in the post-COVID era and future pandemics, an immediate revolution of the precise and rapid responding system capable of early detection is needed. Based on a comprehensive review, this article summarizes the enabling wearable devices in physiological monitoring and biomolecular diagnosis, highlights their potential contributions to the detection and management of COVID-19, as well as its long-term effects, and suggests a wearable sensing-based system to avoid future pandemics. Wearable devices, in conjunction with mobile health (mHealth) technologies, provide a novel way to track and monitor diseases through continuous physiological, physical, and biomolecular sensing. Augmented by artificial intelligence (AI), especially the emerging Generative Pre-trained Transformer (GPT) algorithms, patients could potentially be identified before they become symptomatic. By combining contact tracing and effective quarantine, it is possible to arrest the spread of the disease and control its emergence at an early stage. Furthermore, with minor refinements, the proposed response system holds the potential for extended use beyond COVID-19, particularly in addressing cardiovascular diseases (CVDs) during both outbreaks and non-pandemic scenarios. By implementing this groundbreaking approach, there exist valuable prospects to transform the current healthcare paradigm and drive significant advancements in disease prevention, detection, and management.

Graceful User Following for Mobile Balance Assistive Robot in Daily Activities Assistance

Numerous diseases and aging can cause degeneration of people's balance ability resulting in limited mobility and even high risks of fall. Robotic technologies can provide more intensive rehabilitation exercises or be used as assistive devices to compensate for balance ability. However, With the new healthcare paradigm shifting from hospital care to home care, there is a gap in robotic systems that can provide care at home. This paper introduces Mobile Robotic Balance Assistant (MRBA), a compact and cost-effective balance assistive robot that can provide both rehabilitation training and activities of daily living (ADLs) assistance at home. A three degrees of freedom (3-DoF) robotic arm was designed to mimic the therapist arm function to provide balance assistance to the user. To minimize the interference to users’ natural pelvis movements and gait patterns, the robot must have a Human-Robot Interface(HRI) that can detect user intention accurately and follow the user's movement smoothly and timely. Thus, a graceful user following control rule was proposed. The overall control architecture consists of two parts: an observer for human inputs estimation and an LQR-based controller with disturbance rejection. The proposed controller is validated in high-fidelity simulation with actual human trajectories, and the results successfully show the effectiveness of the method in different walking modes.

Gov➔Value: How to combine reported quality experiences and patient-reported outcome measures. First results on vulvar cancer patients in an Italian Research Hospital.

Vulvar cancer (VC) accounts for <1% of cancers affecting the female gender. Clinical Pathways (CP) and Clinical Outcomes Monitoring are useful for providing high-quality care to these patients. However, it is essential to integrate them with the patient's perspective according to Value-Based Healthcare paradigms. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are tools for assessing outcomes and experiences with health care from the patient's perspective. The aim of this paper is to collect and synthesize PROMs and main stakeholders' experience on the VC CP, according to a value-based approach. To select the most appropriate instrument, a review was conducted on the main databases and official websites of specific institutions and organizations. In the second phase, a 2-round Delphi survey was conducted to assess the Reported Experience Measures (REMs) tool. Questions were evaluated according to four criteria (general relevance, evidence-based, measurability, actionability) and included if strong agreement was reached. A Principal Component Analysis (PCA) was executed. Cronbach's alpha and McDonald's omega were computed. Fisher's exact test and Wilcoxon rank sum test were used to compare ratings between groups. Descriptive statistics were performed for both PROMs and REMs instruments. For PROMs assessment, EORTC QLQ-C30 questionnaire was selected and administered to 28 patients. Global Health Status/Quality of Life and Functional Scales Scores were high or very high, while symptoms scale reported low or medium scores. The final REMs consists of 22 questions for professionals and 16 for patients and caregivers. It was administered to 22 patients, 11 caregivers, 5 physicians, 2 nurses and 1 clinical senior manager. PCA identified 4 components. Scale reliability was acceptable (α = 0.75 95% CI: 0.61-0.85; ω = 0.69; 95% CI: 0.54, 0.82). A statistically significant difference between the patient/caregiver group and the professionals was found for items 8 (follow-up), 10 (perceived quality), 12 (safety), and 16 (climate) (p = 0.02; p = 0.03; p < 0.001; p < 0.001, respectively). PROMs could provide new ways of intercepting patients' needs and feedback, thus acting on them. The proposed REMs tool would allow to detect information not available elsewhere, which, through Audit and feedback strategies, could lead to enhancement of healthcare experience, according to a value-based approach.

CHANGING THE PARADIGM OF HEALTHCARE AFTER COVID-19- A NARRATIVE REVIEW

&#x0D; &#x0D; &#x0D; The COVID-19 pandemic have changed the worldview of healthcare paradigm; we need to Review the measures taken by multiple healthcare fields in response to this Virus, for this Studies and guidelines related to the Changing the Paradigm of healthcare post COVID-19 setting were reviewed. There are total 134 research papers from databases such as PubMed, WHO NCBI, Springer, Google Scholar, clinical related data set, Field Epidemiology and Disease Surveillance Division (FEDSD), National Institute of Health (NIH), were review and it is concluded that Healthcare paradigm has is required to be transformed after COVID-19 by adding new technological advancement in all branches of medicinal services, for this local healthcare system must be powerful to 'paddle' an emergency relief. This paper looks at the latest evidence and provides recommendations for improvements to the health care system to minimize the effects of the COVID-19 epidemic and improve Public health.&#x0D; &#x0D; &#x0D;

IFlick: Smartphone-based anemia screening in rural healthcare paradigm

Anemia is the most prominent and severe disease, the prevalence of low red blood cells. Identifying and continuously monitoring hemoglobin in the human body is a challenge. Anemia detection involves various invasive and non-invasive solutions. However, both solutions have limitations such as cost, time-consuming, resource dependencies, and not being implemented in smartphones. Therefore, anemia identification with limited resources, low cost, more reliable, and edge intelligence is required. This paper proposes a non-invasive and edge-based point-of-care solution (iFlick). The solution estimates hemoglobin level by performing automatic region of interest segmentation and histogram calculation of RGB colors from the eye images. While the solution is tested in the primary health centers, a person is anemic if the hemoglobin level ranges < 11.5 gdL −1 . The proposed application reported an accuracy of ± 0 . 057 gdL −1 with 94% sensitivity for 157 participants. The experiment found that iFlick takes 10 - 15 s to estimate the hemoglobin value. The proposed solution helps the rural healthcare system determine hemoglobin values with the iFlick smart mobile application.

A conceptual model of the data ecosystem formation in the health 4.0

Digitalization of health and medicine has become a global trend in recent years. The development of this trend is manifested in improving the quality of medical care, increasing access to medical services, and ensuring more effective health decisions. The global health trend is characterized by the transition from e-health to digital health, which is closely related to the formation and development of Industry 4.0. The projection of innovative approaches of Industry 4.0 into the health sector opens up great opportunities for creating a new healthcare paradigm (Health 4.0) by integrating modern technologies, analytical tools and smart medical devices.&#x0D; This article highlights Industry 4.0 technologies, the integration of which into healthcare has led to the generation of a huge amount of various data. Data collected through new technologies on the Health 4.0 platform, their types, structure, sources and capabilities are examined. It is shown that for the collection, transmission, storage, processing of heterogeneous data of a large volume, the introduction of new approaches and methods is required. In the environment of technological transformation, the evolution of the healthcare system at the data level and the conceptual model of the chain of formation of the Healthcare 4.0 ecosystem are proposed. The content of the components included in the Healthcare 4.0 data ecosystem is determined. Some problems arising in the formation of the data ecosystem on the Healthcare 4.0 platform and the processing of large health data are studied

Pengaruh Bauran Pemasaran terhadap Pengalaman Pasien Rawat Inap di Rumah Sakit Permata Hati Kecamatan Mandau Tahun 2022

Hospitals have a very strategic role in an effort to accelerate the improvement of public health status. The new paradigm of health care requires hospitals to provide quality services according to the needs and desires of patients. The marketing mix can be used as a marketing tool that makes it easier for hospitals to achieve their marketing goals. The purpose of this study was to determine the effect of the marketing mix on the experience of inpatients at Permata Hati Hospital, Mandau District in 2022. This type of research was descriptive quantitative using a cross sectional design. This study reveals that the marketing mix affects patient practice with the most dominant variable affecting patient experience is the process variable.

How Digital Therapeutics Are Urging the Need for a Paradigm Shift: From Evidence-Based Health Care to Evidence-Based Well-being.

A scientific paradigm consists of a set of shared rules, beliefs, values, methods, and instruments for addressing scientific problems. Currently, health care embraces the paradigm of evidence-based health care (EBH). This paradigm prompts health care institutions to base decisions on the best available evidence, which is commonly generated in large-scale randomized controlled trials. We illustrate the application of EBH via the evaluation of drugs. We show how EBH is challenged when it is applied to the evaluation of digital therapeutics, which refers to technology and data to prevent, manage, or treat a medical disorder or disease. We conclude that amid the growing application of digital therapeutics, the paradigm of EBH is challenged in four domains: population, intervention, comparison, outcome. In the second part of this viewpoint, we argue for a paradigm shift in health care so we can optimally evaluate and implement digital therapeutics, and we sketch out the contours of this novel paradigm. We address the need for considering design in health care and evaluation processes, studying user values so that health care can move from a focus on health to well-being, focusing on individual experiences rather than the average, addressing the need for evaluation in authentic use contexts, and stressing the need for continuous evaluation of the dynamic relations between users, context, and digital therapeutics. We conclude that the transition from EBH toward evidence-based well-being would improve the successful implementation of digital technologies in health care.

The paradigm and future value of the metaverse for the intervention of cognitive decline.

Cognitive decline is a gradual neurodegenerative process that is affected by genetic and environmental factors. The doctor-patient relationship in the healthcare for cognitive decline is in a "shallow" medical world. With the development of data science, virtual reality, artificial intelligence, and digital twin, the introduction of the concept of the metaverse in medicine has brought alternative and complementary strategies in the intervention of cognitive decline. This article technically analyzes the application scenarios and paradigms of the metaverse in medicine in the field of mental health, such as hospital management, diagnosis, prediction, prevention, rehabilitation, progression delay, assisting life, companionship, and supervision. The metaverse in medicine has made primary progress in education, immersive consultation, dental disease, and Parkinson's disease, bringing revolutionary prospects for non-pharmacological complementary treatment of cognitive decline and other mental problems. In particular, with the demand for non-face-to-face communication generated by the global COVID-19 epidemic, the needs for uncontactable healthcare service for the elderly have increased. The paradigm of self-monitoring, self-healing, and healthcare experienced by the elderly through the metaverse in medicine, especially from meta-platform, meta-community, and meta-hospital, will be generated, which will reconstruct the service modes for the elderly people. The future map of the metaverse in medicine is huge, which depends on the co-construction of community partners.