Professional Healthcare Personnel Research Articles

Predisposing and enabling factors influencing the utilisation of maternal healthcare services at fishing landing sites in Buikwe district, Uganda

Background: Studies have demonstrated that women who get professional healthcare personnel's prenatal, delivery, and postnatal care have better pregnancy outcomes, which lowers the incidence of both neonatal and mother deaths. Uganda is among the sub-Saharan African countries with the highest percentages of maternal deaths of which the majority of the deaths take place in remote, resource-constrained areas, such as fishing landing sites. We investigated the factors influencing the use of maternity healthcare services by women from remote Lake Victoria islands fishing settlements in the Buikwe district of Uganda. Methods: A cross-sectional study design with a quantitative approach was used. One hundred and four mothers were recruited in the study carried out at Ssenyi, Kiyindi and Nkombwe landing site in Buikwe district. Questionnaires were used to obtain information from mothers about predisposing factors, and enabling factors. Multinomial logistic regression was used to determine which factors influenced the use of maternal healthcare services. Results: Marital status (p=0.045, aOR=0.582; 95% CI=0.163-2.082) and paternal occupation (p=0.017, aOR=1.335; 95% CI=0.059-8.348) were the factors influencing maternal healthcare service utilisation among the respondents. Conclusions: Increasing the amount of actions meant to raise socioeconomic standing and involving the men in maternal health seeking might aid in enhancing maternal healthcare services use by women at the landing sites in Uganda.

Enhancing Self-Care Prediction in Children with Impairments: A Novel Framework for Addressing Imbalance and High Dimensionality

Addressing the challenges in diagnosing and classifying self-care difficulties in exceptional children’s healthcare systems is crucial. The conventional diagnostic process, reliant on professional healthcare personnel, is time-consuming and costly. This study introduces an intelligent approach employing expert systems built on artificial intelligence technologies, specifically random forest, decision tree, support vector machine, and bagging classifier. The focus is on binary and multi-label SCADI datasets. To enhance model performance, we implemented resampling and data shuffling methods to tackle data imbalance and generalization issues, respectively. Additionally, a hyper framework feature selection strategy was applied, using mutual-information statistics and random forest recursive feature elimination (RF-RFE) based on a forward elimination method. Prediction performance and feature significance experiments, employing Shapley value explanation (SHAP), demonstrated the effectiveness of the proposed model. The framework achieved a remarkable overall accuracy of 99% for both datasets used with the fewest number of unique features reported in contemporary literature. The use of hyperparameter tuning for RF modeling further contributed to this significant improvement, suggesting its potential utility in diagnosing self-care issues within the medical industry.

ZAMBIA’S MENTAL HEALTH PATIENTS: VICTIMS OF UNSPEAKABLE INFRASTRUCTURE CHALLENGE IN ZAMBIA’S HEALTH SYSTEM

Purpose: This article attempts to examine the critical role that physical health infrastructure and associated facilities play in the delivery of effective integrated primary health care services for mental patients in Zambia. The working definition for ‘physical infrastructure’ in the paper relates to wider capacities in form of hospital buildings, bed spaces, medical equipment, and professional healthcare personnel, among other elements that facilitate effective operations of a health facility.
 Methodology: This study has used both quantitative and qualitative data from various sources to map the debate on the impact of inadequate infrastructure on mental health patients in Zambia’s health system. 
 Findings: Inadequate health infrastructure has had a negative impact on the well-being of mental health patients and other sectors of the Zambian society. The entire country has only one ill-resourced main hospital, offering mental health services and has been overwhelmed by a combination of insufficient infrastructure and effects of COVID-19 pandemic.
 Unique contributions to theory, practice, and policy: For the health reforms to be effective, it is recommended that the conceptual integrated health system in Zambia be anchored on universal allocation of adequate resources and operationalization of mental health policies that genuinely connect with social determinants of mental health issues within communities. The involvement of non-governmental organizations providing an interface between communities and governments should be supported by organizational and multi-institution capacity and coordination. A systems theory informed this study and has been elaboratively discussed in the second chapter of this paper

TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

Equine Discomfort Ethogram.

Simple SummaryPain and discomfort behavior in horses tends to be especially subtle, and not readily or widely appreciated even by equine professionals, including many long-time horse keepers, trainers, and even by veterinarians, veterinary technicians, and care staff. Based on decades of evaluating the behavior of normal and physically uncomfortable horses in a referral hospital, as well as research context, we describe and illustrate a catalog of behaviors (ethogram) associated with equine physical discomfort. Our objective is to promote an unambiguous universal understanding of equine discomfort behaviors associated with various body systems and anatomic sources.In recent years, there has been a growing interest in and need for a comprehensive ethogram of discomfort behavior of horses, particularly for use in recognizing physical discomfort in domestically managed horses. A clear understanding of the physical discomfort behavior of horses among caretakers, trainers, and professional health care personnel is important to animal welfare and caretaker safety. This is particularly relevant to pain management for hospitalized equine patients. Various pain scale rubrics have been published, typically incorporating only a few classically cited pain behaviors that, in many cases, are specific to a particular body system, anatomic location, or disease condition. A consistent challenge in using these rubrics in practice, and especially in research, is difficulty interpreting behaviors listed in various rubrics. The objective of this equine discomfort ethogram is to describe a relatively comprehensive catalog of behaviors associated with discomfort of various degrees and sources, with the goal of improving understanding and clarity of communication regarding equine discomfort and pain. An inventory of discomfort-related behaviors observed in horses has been compiled over 35 years of equine behavior research and clinical consulting to medical and surgical services at the University of Pennsylvania School of Veterinary Medicine’s equine hospital. This research and clinical work included systematic evaluation of thousands of hours of video-recordings, including many hundreds of normal, healthy horses, as well as hospitalized patients with various complaints and/or known medical, neurologic, or orthopedic conditions. Each of 73 ethogram entries is named, defined, and accompanied by a line drawing illustration. Links to online video recorded examples are provided, illustrating each behavior in one or more hospitalized equine patients. This ethogram, unambiguously describing equine discomfort behaviors, should advance welfare of horses by improving recognition of physical discomfort, whether for pain management of hospitalized horses or in routine husbandry.

Pain revised - learning from anomalies.

As professional health care personnel we are well educated in anatomy, physiology, clinical medicine and so forth. Our patients present with various symptoms and signs that we use this knowledge to diagnose and treat. But sometimes the patient case contradicts our knowledge. Since the patient is the terrain and our knowledge is the map, these patient cases are anomalies that give us the opportunity to update our maps. One such anomaly is how time restricted amnesia can improve or even eradicate an underlying chronic pain condition and eliminate the patient's dependence on daily opioid consumption. In this short communication I will use amnesia as a starting point to briefly review chronic pain from a learning and memory perspective. I will introduce, for many readers, new concepts like degeneracy and criticality, and together with more familiar concepts like habits and brain network activity, we will end with overarching principles for how chronic pain treatment in general can be crafted and individualized almost independently of the chronic pain condition at hand. This introductory article is followed by a review series that elaborates on the fundamental biological principles for chronic pain, treatment options, and testing the theory with real world data.

War and Regeneration: The Great War and Eugenics in Eastern Europe

How were healthcare practices altered by massive violent deaths and the epidemics that decimated European societies between 1914 and 1918? How did states, professional healthcare personnel, and other caretakers choose to learn from this trauma? How have historians reflected on these complex shifts? The centenary of the Great War presents an opportunity to reconsider the legacies of this event that reshaped Europe from a variety of perspectives, among them the changes brought about in the field of social medicine. Using my own research on the history of eugenics in eastern Europe as a starting point, I will focus on several departures in historical research that have taken place over the past decade in relation to this theme and suggest a few other directions for future research.