Community Medicine Research Articles

“Community-based intervention to dengue prevention: Insights from urban residents in Pune, using the health belief model"

BackgroundDengue infection is increasingly recognized as one of the world's emerging infectious diseases. The present study was carried out with the aim of assessing knowledge and health beliefs regarding Dengue fever among community in an urban slum area of Pune. This cross-sectional study was undertaken in an urban slum area of Urban Health Centre, Pashan, which is a field practice area of Department of Community Medicine. Aim & objectivesThis study is aimed at understanding the perception towards the Dengue Prevention using the Health Belief Model (HBM) approach, prevention measures adopted, their knowledge, opinion and confidence towards various control measures. MethodsA Cross-Sectional Study using a pre-tested, semi-structured questionnaire was conducted for assessing on knowledge, health beliefs and practice of dengue control. ResultsAbout 26.1 % knew the causes of dengue, 56.2 % had poor knowledge on the severity of dengue. The knowledge on causes (69.9 %), signs and symptoms (77.1 %), treatment (51.2 %) and carriers (86.3 %) of dengue was poor. The knowledge regarding insects breeding spots, potential breeding spots inside (26.1 %) and outside (38.1 %) and prevention was almost poor. The data was collected from the questionnaire, entered and analysed using Statistical Package for Social Sciences (SPSS) version 21.0. ConclusionMost people living across the community behaved in a similar manner, irrespective of age, education and socio-economic status. Perceptions of the community as explained by Health Belief Model was greatly influenced by their approach to the available health care services and for the subsequent behavioural change.

Medical and Social Characteristics of Toxicological Patients

Background: Acute poisoning of chemical etiology is currently a significant socio-economic and medical problem. It is a leading cause of high morbidity and premature mortality among the economically active population. Objectives: This study aimed to analyze the medical and social characteristics of toxicological patients. Methods: The study was conducted on 100 patients with acute chemical poisoning treated at the Specialized Toxicology Centre in Saint Petersburg. Data were collected by copying material from medical records and conducting a survey among patients. The data were then assessed using statistical methods. Results: In the studied group of toxicological patients, the majority (62.0%) were men. Age distribution showed that most patients (62.0%) were between 20 - 40 years old. More than half (55.0%) were unemployed, and only 25.0% were married. Analysis of the patient distribution by diagnosis showed that a large proportion (44.0%) had been poisoned with drugs, 26.0% with medications, 17.0% with ethanol, 11.0% with psychotropic drugs, and 2.0% with other substances. The main causes of poisoning were drug overdose (44.0%), self-medication (26.0%), and intoxication (21.0%). One-third of the patients (33.0%) had a concomitant viral infection. Additionally, 37.0% of patients consumed alcohol more than once a week, and half of the patients (50.0%) associated drinking alcohol with relaxation and pleasure. The largest proportion of patients (56.0%) did not engage in sports or other forms of physical activity at home. Conclusions: Analysis of the medical and social characteristics of toxicological patients indicates a need for public hygiene education measures to promote social competence and cultivate a negative attitude towards harmful factors affecting health.

The Impact of Public Health on Disease Prevention

Public health plays an important role in preventing diseases by supporting measures that prioritise the well-being of entire populations over individuals. This study investigates the history of public health, the approaches used in illness prevention, and the difficulties encountered in executing these tactics. Public health strategies, such as immunisation programs and lifestyle modifications, are critical in combating communicable and non-communicable diseases. Case studies like the Diabetes Prevention Program and REACH U.S. demonstrate the effectiveness of public health efforts. The paper also discusses current difficulties, such as limited resources, misinformation, and increasing dangers, as well as possible future strategies for improving public health systems through innovation, research, and community participation. Keywords: Public Health, Disease Prevention, Vaccination, Health Promotion, Preventive Healthcare.

The Impact of Public Health on Health Education

Public health and health education are interconnected professions, with public health providing the framework for effective health education. This study examines the historical history of public health, important principles that characterize the relationship between public health and health education, and the role public health plays in developing educational programs. By evaluating previous and present public health initiatives, the report emphasizes the importance of health education in improving community well-being. Furthermore, this analysis uses case studies to highlight how public health policies can influence and improve the effectiveness of health education methods. Finally, this study emphasizes that the effectiveness of health education initiatives is dependant on their alignment with public health principles, which allows for the development of evidence-based programs that target specific community needs. Keywords: Public health, health education, community well-being, health promotion, disease prevention

Pylore Krishnaier Rajagopalan: Pioneer in Kyasanur Forest Disease Research and His Contributions to Zoonotic Disease Studies.

Pylore Krishnaier Rajagopalan was a distinguished public health expert who made significant breakthroughs in the research of Kyasanur forest disease (KFD), a prevalent tick-borne viral ailment in South India. His extensive research on KFD provided vital insights into the impact of the disease on public health and considerably advanced our knowledge of it. Rajagopalan's work also encompasses the study of zoonotic diseases, where he made substantial contributions to our understanding of their epidemiology and control. His research on KFD was instrumental in comprehending the disease transmission dynamics, clinical manifestations, and control strategies, resulting in improved management practices in regions where the disease is endemic. Rajagopalan's contributions have had a long-lasting impact on public health practices, as his work has influenced both scientific research and public health policies. The enduring effects of his work can be observed in the enhanced disease surveillance, outbreak response, and comprehension of zoonotic disease dynamics, which will continue to inform contemporary public health practices.

Spatial-temporal distribution of neglected tropical diseases burdens in China from 2005 to 2020

BackgroundOut of the 21 neglected tropical diseases (NTDs) listed by the World Health Organization, 15 affect the People’s Republic of China. Despite significant achievements in controlling NTDs, comprehensive assessments of the disease burden based on actual case data and detailed information on spatial and temporal dynamics are still lacking. This study aims to assess the disease burden and spatial–temporal distribution of NTDs in China from 2005 to 2020, to provide a reference for the formulation of national health agendas in line with the global health agenda, and guide resource allocation.MethodsThe number of cases and deaths of major NTDs in China from 2005 to 2020 were downloaded from the China Public Health Science Data Center (https://www.phsciencedata.cn/Share/index.jsp) of the Chinese Center for Disease Control and Prevention and relevant literatures. Simplified formulas for disability-adjusted life years (DALYs) helped estimate the years of life lost (YLLs), years lived with disability (YLDs), and total DALYs. Spatial autocorrelation analysis of the average NTDs burden data for the years 2005 to 2020 was evaluated using Moran's I statistic.ResultsChina's overall NTDs burden decreased significantly, from 245,444.53 DALYs in 2005 to 18,984.34 DALYs in 2020, marking a reduction of 92.27%. In 2005, the DALYs caused by schistosomiasis and rabies represent a substantial proportion of the total disease burden, accounting for 65.37% and 34.43% respectively. In 2015, Hunan and Sichuan provinces had the highest diversity of NTDs, with 9 and 8 number of different NTDs reported respectively. And the highest disease burden was observed in Sichuan (242,683.46 DALYs), Xizang Zizhiqu (178,318.99 DALYs) and Guangdong (154,228.31 DALYs). The “high-high” clustering areas of NTDs were mainly in China's central and southern regions, as identified by spatial autocorrelation analysis.ConclusionsChina has made unremitting efforts in the prevention and control of NTDs, and the disease burden of major NTDs in China has decreased significantly. Using the One Health concept to guide disease prevention and control in the field to effectively save medical resources and achieve precise intervention.Graphical abstract

The Association of Dietary Diversity with Hyperuricemia among Community Inhabitants in Shanghai, China: A Prospective Research.

Hyperuricemia, a major worldwide burden on public hygiene, is closely connected with dietary habits. However, few studies have evaluated the association of dietary diversity with hyperuricemia. To preliminarily reveal the status of a diversified diet in preventing hyperuricemia based on a neighborhood-based, massive-scale cohort in China, a total of 43,493 participants aged 20-74 years old, with no history of hyperuricemia at baseline, were enrolled in the research from April 2016 to December 2019. The Dietary Diversity Score (DDS) was utilized to evaluate the dietary variety and split the participants into the low-, medium-, and high-DDS groups. Information on participants was connected to regional health information systems that acquired data on hyperuricemia instances up to 28 February 2023. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed by Cox proportional hazards models. Restricted cubic splines (RCS) were implemented to analyze dose-response correlation. A total of 1460 individuals with newly diagnosed hyperuricemia were observed over a median follow-up period of 5.59 years. Compared to the low-DDS group, HRs for the medium- and high-DDS groups were 0.87 (95% CI 0.76-0.99) and 0.80 (95% CI 0.70-0.91) in the fully adjusted model, respectively. The risk of hyperuricemia incidence was reduced by 5% for each 1 unit of DDS increase. A linear correlation of DDS with hyperuricemia emerged and further revealed that the intake of 8-10 broad categories of food could decrease the incidence of hyperuricemia. Our results validate the dietary principle of "food diversification" recommended in guidelines. Conclusions should be applied with caution considering the paucity of related evidence in additional nations.

Large-Scale Genomics Applications in Public Health and Precision Medicine Using Big Data and Predictive Analytics

After gaining experience from large population sequencing projects, there is a significant gap between the promise of genomics in Precision Medicine (PM) and the existing state of affairs. To fully exploit this potential, Public Healthcare (PH) must adopt procedures, regulations, and technology that are unfamiliar to them. The development needs to be improved by several historical procedures and regulatory hurdles. In the future, PM will include making genetic big data easily accessible at the point of treatment and implementing tools to govern its use effectively. Significant modifications need to be made in billing, payment, and monitoring to accomplish this goal. New systemic and technological structures must also be developed inside the healthcare sector. The responsibilities of clinical geneticists will expand to include overseeing PM systems. Genetic counselors will guide and assist PM by establishing and upholding PM structures. The trajectory of the research is now hindered by several impediments, resulting in avoidable fatalities. Revamping medical facilities to accommodate genomics has the potential to influence the treatment of patients significantly and enable the achievement of long-awaited advancements in PM.

Modeling Population Dynamics in the Indian Context: A Differential Difference Equation Approach

The study of population dynamics is of paramount importance in comprehending the evolving demographics and socioeconomic structure of a country. The task of modelling population dynamics in the Indian context poses distinct challenges and opportunities owing to the extensive and heterogeneous nature of the country's population. This research paper utilises a differential difference equation (DDE) methodology to comprehensively model population dynamics in India. The study seeks to enhance comprehension of population dynamics by considering various factors, including birth rates, death rates, migration patterns, and seasonal variations. The study employs Delay Differential Equations (DDEs) as a mathematical framework to effectively model the dynamic characteristics of population systems. These equations account for time delays, historical events, and discrete factors that play a significant role in shaping population dynamics, whether it be growth or decline. Numerical techniques, such as Euler's method and the Runge-Kutta method, are utilised in order to solve Delay Differential Equation (DDE) models and effectively simulate the dynamics of populations over a given time period. The evaluation of each method involves a comparative analysis of its accuracy, smoothness, convergence properties, and computational efficiency. The research findings presented in this study enhance our comprehension of population dynamics in India and offer significant insights that can be utilised by policymakers, urban planners, and researchers in the fields of demography, public health, and social sciences. The results have the potential to provide valuable insights for evidence-based decision-making and the development of effective policies aimed at addressing the various challenges and opportunities related to population dynamics in the Indian context.

Awareness of Zika virus Disease Effects on Children, and Attitude towards Infected Unborn Babies, among Caregivers that Visit Immunization Clinic of a Teaching Hospital, Enugu, Nigeria

Aims: To assess caregivers’ awareness of Zika virus disease effects on children, infected by their mother during pregnancy; and attitude towards infected unborn babies. Study Design: This quantitative study, was of observational, descriptive, and cross-sectional design. Place and Duration of Study: The study was conducted in the Immunization unit, Enugu State University Teaching Hospital, Enugu, Nigeria; between November 2016 and February 2017. Methodology: A trained Resident doctor in the department of Community Medicine, interviewed 10 randomly selected female caregivers that brought children to the hospital for immunization. Thirty respondents were interviewed each week for eight weeks, since immunization activity was conducted three days in a week. Sixteen were interviewed on the ninth week; making a total of 256 respondents. Results: A total of 256 women participated in the study, with 89.5% of them being married, and 86.0% falling within the age range of 20 – 39 years. Overall awareness on Zika virus infection effect on children such as failure to thrive, involuntary muscle contractions, learning handicap, visual and hearing impairment, and less functional individual with reduced societal value were poor. None of the total scores were up to 50.0%. In situation where Zika virus is detected in an unborn baby, praying and leaving the outcome to God was the highest selected option (48.8%), while abandoning the baby in the hospital was the least selected option (6.6%). Other options were accepting and caring for the baby (41.8%), and terminating the pregnancy (14.8%). Conclusion: Though the declaration of Zika virus infection by the World Health Organization, as a Public Health Emergency of International Concern was lifted since November 2016; the infection could still be going on undetected, in many low- and middle-income countries. Efforts should be made to improve on the level of awareness on Zika virus, and effects on children.

O42 USABILITY AND EFFECT OF A HYPERTENSION MOBILE APPLICATION IN KNOWLEDGE AND GUIDELINES ADHERENCE OF FAMILY AND COMMUNITY MEDICINE RESIDENTS

Background: Mobile health (mHealth) applications have become integral in medical education and information access, yet effectiveness varies, and barriers to engagement persist. OBJECTIVE: This study aimed to assess the usability and effectiveness of the mHealth application entitled Hypertension Now in increasing knowledge and guideline adherence among residents. Methods: A before-and-after educational intervention study was conducted among residents of the Department of Family and Community Medicine (DFCM), Philippines General Hospital from January to August 2023. The intervention was a newly developed medical reference app for managing hypertension based on the latest local and international hypertension guidelines. Usability, knowledge score, and adherence rate were measured using a questionnaire, pre- and post-intervention examinations, and medical chart audits. Results: All 32 DFCM residents participated in the study. The app was rated high on ease of use and usefulness for practice by the residents. It was also rated high on interface and overall satisfaction. It significantly increased the knowledge scores of the residents by 1.6 points (p=0.001). The proportion of those who passed the exam significantly increased post-intervention (37.5% vs. 59.4%, p=0.035). Moreover, the app increased the adherence of the residents to proper physical examination (82% vs. 91%, p=0.024), diagnosis (80% vs. 90%, p=0.012), and pharmacologic treatment (53% vs. 83%, p=0.001). There was no increase in adherence to proper risk assessment (83% vs. 78%, p=0.371), laboratory examination (35% vs. 40%, p=0.329), and non-pharmacologic treatment (77% vs. 81%, p=0.470). Conclusion: The mHealth app for hypertension management was usable and effective in increasing the knowledge of family and community medicine residents in managing hypertension. While the app increased guideline adherence to physical examinations, diagnostics, and pharmacological treatments for hypertension, it did not increase adherence to risk assessment, laboratory examination, and non-pharmacologic treatment.

Assessment of sexual function and quality of life in breast cancer patients before and after the occurrence of therapy-related skin changes

Background Patients with breast cancer (BC) who receive adjuvant chemotherapy or other treatment modalities may potentially benefit from an enhanced prognosis of survival. Physical or aesthetic complications may, nevertheless, result in significant distress as a consequence of adverse dermatologic responses. There has been a heightened focus on matters related to quality of life (QoL) as the number of BC survivors has risen. Sexual disorders are reported by as many as 75% of women who undergo treatment for BC. Despite this, the majority of oncologists lack the necessary training to identify patients who are particularly susceptible to developing sexual disorders. Patients diagnosed with BC frequently experience female sexual dysfunction. Objective To compare and evaluate the impact of skin changes induced by different treatment modalities in BC patients on their sexual function and QoL. Patients and methods This is a prospective cohort research on 58 cases diagnosed with BC, which was conducted in the outpatient clinic of the Clinical Oncology department, Faculty of Medicine, Menoufia University from April 2022 to February 2023. The calculated sample size for the current study using Epi info 7 programs was 56 women. The power of the study is 80% with a confidence level of 95% as determined by the Public Health and Community Medicine Department, Faculty of Medicine, Menoufia University. Both sexual function and QoL were assessed before and 3–6 months after the occurrence of skin changes related to different treatment modalities using validated questionnaires irrespective of their tumor stage. Results Of the 58 patients, there was statistically significant variance regarding dermatological life quality index (DLQI) (P<0.001), with 8.6% of patients experiencing a very large influence on their QoL, which increased to 19%. However, the number of patients having an extremely large influence on their quality of life changed from 0 to 5.2%. There was statistically significant variance (P<0.001) regarding female sexual function index values among the six domains of female sexual function index before and after the occurrence of skin changes. There is a negative correlation between DLQI score and desire, arousal, lubrication, orgasm, and satisfaction scores, while there is a positive correlation between DLQI score and pain score. QoL was negatively affected by the occurrence of such skin lesions. Conclusion There was a significant negative impact of skin changes induced by different treatment modalities in BC patients on their sexual function and QoL.

Epidemiological Profile and Awareness Regarding Animal Bite Management in an Urban Area.

The most common way for people to contract the deadly zoonotic disease rabies is through animal bites. This study was designed because there is a shortage of community-based data to determine the true extent of rabies infection and a lack of understanding regarding patient misconceptions in urban areas. The objective was to determine the scope of the issue and the epidemiological features of animal bite incidents. This was a facility-based cross-sectional study conducted at the field practice area (Urban Health Training Centre) under the Department of Community Medicine, Government Medical College. The study duration was one year (May 2023 to April 2024). Consecutive patients (accompanied by an attendant) attending the Urban Health Training Centre were included in the study. A purposive sampling technique was used, and around 400 animal bite cases were recorded in one year at the Urban Health Training Centre. Out of 1503 male cases at the Urban Health Training Centre, around 255 were dog bite cases (50.6%), whereas out of 1302 females visiting the Urban Health Training Centre, around 145 were dog bite cases (48%). The majority (35%) belonged to the age group of 11 to 20 years for both males and females. The mean age of the cases was 19.4 ± 3.4 years. The study found a male preponderance (64%), with females constituting 36%. The right lower limb (49.5%), left lower limb (39%), and upper limb were the most frequently bitten sites. Fifty-one percent of the cases fell into Category II. According to local data, the most popular home management practices were ghee oil and cold treatments. Although Category III is the most severe bite, only 35% had taken the anti-rabies vaccine (ARV), and 8.75% had received rabies immunoglobulin. The public and medical community need to be made aware of the importance of wound care and the prudent use of the anti-rabies vaccine.

Raising the Academic Authority of Clinical Experience: The Department of Internal Medicine at Keijo Imperial University and Its Periodical Imsangnaegwahak.

This paper examines the periodical Clinical Internal Medicine published by the Department of Internal Medicine at Keijo Imperial University in colonial Korea. Previous studies on medical research at Keijo Imperial University have primarily focused on preclinical departments such as anatomy, hygiene, pharmacology, and microbiology which produced knowledge that supported Japan's imperialistic expansion. This approach has overlooked the research contributions of clinical departments, often viewing the roles of preclinical and clinical departments through a dichotomy between research versus clinician training. However, Clinical Internal Medicine demonstrates that the Department of Internal Medicine at Keijo Imperial University was actively engaged in research. By analyzing the purpose and content of Clinical Internal Medicine, this paper reveals that its publication was an effort by the Department of Internal Medicine to address the demand for practical knowledge among clinicians practicing outside the university. At the same time, it reflects a commitment to enhancing the academic value of clinical experience and critiques the blind pursuit of experimental medicine in the Japanese medical community in the 1920s and 1930s. The case of the Department of Internal Medicine at Keijo Imperial University illustrates the transformation of clinical experience into "worthy" academic knowledge in colonial Korea. Based on these findings, this paper provides insights into the role of clinical departments at Keijo Imperial University in research and post-graduation education.

Immunization Status of Children in Urban Slums of Rawalpindi and Barriers to Immunization

Objective: To determine immunization status of children residing in urban slums of Rawalpindi and identify the barriers to immunization. Study Design: Cross sectional study. Place and Duration of Study: Slums of Takht Pari, Rawalpindi Pakistan, from Jan to Mar 2020. Methodology: Children, aged 12-23 months, residing at Takht Pari were enrolled. Two sessions of a free medical camp were arranged at Takht Pari by Department of Community Medicine, Foundation University, Islamabad. Data was collected from parents visiting the medical camp with the mother labelled as the primary respondent. Immunization cards and mother’s recall were used to assess the immunization status of children. Results: Two hundred ninety-one (72.9%) children were completely immunized, partially immunized were 106(26.6%) while 2(0.5%) were unimmunized. Three hundred eighty-eight (97.2%) children were vaccinated through government centers while those who received vaccination through private clinics were 9(2.3%). Factors associated with incomplete immunization were education of parents (p<0.001), number of children (p<0.001), gender of child (p=0.001), access to TV or Radio (p<0.001), and site of immunization (government/private) (p<0.001). Conclusion: Immunization status of 73% shows that unremitting efforts are essential for attaining universal coverage of immunization with extra attention to underprivileged areas. Planning and placement of public facilities for preventive services needs to be an urgent priority improving service utilization and enhancing coverage as people tend to follow ease of accessibility for using immunization services.

Motivators and Barriers to Career Choices in Community Medicine Among Medical Students in South Punjab, Pakistan: A Cross-Sectional Survey.

Background Community medicine plays a vital role in public health, yet research on medical students' career choices in this field is limited, especially in underserved areas like South Punjab, Pakistan. This study explores the factors that influence undergraduate medical students' interest in pursuing a career in community medicine. Methodology A cross-sectional survey was conducted with 305 fourth- and final-year undergraduate medical students from various colleges in South Punjab. Data were collected via a structured online questionnaire, focusing on students' interests, motivations, barriers, and perceptions related to community medicine. Results The survey found that 40% of students showed interest in community medicine, with higher interest among females. Key motivators included preventive healthcare and public health initiatives, while financial constraints and unclear career progression were significant barriers. A gap was noted between students' interest and their perceived preparedness to address public health challenges. Conclusion Female students showed greater interest in community medicine and were more likely to recommend it. Bridging the gap between interest and perceived preparedness requires enhancing practical experiences, increasing the visibility of community medicine successes, and addressing financial and career progression concerns. Implementing these strategies can help attract and retain students in community medicine and improve public health outcomes.

Space-Time Trend of Arboviruses in Health Regions of Bahia: Na Ecological Study During the Covid-19 Pandemic

Objective: To analyze the temporal trend of Dengue, Zika and Chikungunya rates in the Health Regions of the State of Bahia (RSEBA) from March 2020 to June 2021. Theoretical reference: Arboviruses are considered a group of emerging and re-emerging zoonoses that cause serious consequences for the health of the population, generating concern for health authorities. With the impacts generated by the Covid-19 pandemic, it was postponed, requiring efforts for this health emergency. Therefore, studying the spatio-temporal trend of arboviruses becomes necessary to analyze the dynamics of the number of arbovirus cases registered in the health regions of the state of Bahia. Method: The spatial distribution of average rates by Health Region (RS) in Bahia will be investigated and trend analysis will be carried out using simple linear regression with PraisWinsten correction. Results and discussion: The possible findings raise the hypothesis that the fluctuations in the time series evaluated are associated with the Covid-19 pandemic and the consequent underreporting of cases Implications of the research: As there is a lack of research in the literature that evaluates the rates of arbovirus cases in time and space, considering them as health regions, it is possible to affirm that our findings can offer the scientific community and/or public health investors subsidies to direct public policies that optimize actions on the part of these agents, taking into account the health region most affected by these diseases.

Conditions affecting the tourism development of a destination through visitors’ evaluation: The case of Sapa Town, Lao CAI Province, Vietnam

The research aims to determine the conditions that affect the tourism development of a destination through the evaluation of tourists (in the case of Sapa town, Lao Cai province, Vietnam). Using quantitative methods, the article uses SPSS software to process interview results from 400 tourists according to four groups of factors: (i) accessibility to public communication services, hotel amenities and hygiene, level of convenience and comfort of sightseeing transportation; (ii) the adequacy, capacity, and hygiene of the parking lot, the diversity and specificity of souvenirs, the attractiveness and diversity of entertainment activities, (iii) security issues, order, and safety and (iv) the quality of tourism human resources. The research results show a group of conditions, such as the adequacy, capacity, and hygiene of the parking lot, the diversity and specificity of souvenirs, and the attractiveness and diversity of entertainment activities. Location and natural landscape have the strongest impact on the development of a tourist destination. While factors in groups I, iii, and iV have a lower level of influence. From there, this study proposes policy implications for improving the service quality of the destination, such as: the issue of human resource training, the quality of infrastructure; renewing products and services, and diversifying local cultural experiences. In particular, the quality of human resources is an issue that needs improvement not only in Sapa but also for many tourist destinations in mountainous regions of Vietnam.

Optimizing Integration with the Italian EHR: The Use of LOINC Codes.

According to the regulation "Decreto del Presidente del Consiglio dei Ministri" (DPCM) of September 29, 2015, n.178, the Logical Observation Identifiers Names and Codes (LOINC) system is included among the coding systems adopted in the Italian Electronic Health Record (EHR). As part of the Digital Health Solutions in Community Medicine (DHEAL-COM) project, one key goal is to categorize parameters using international classification systems. This enables the identification of appropriate Information and Communication Technology (ICT) solutions tailored to support people's health needs. Our objective is to incorporate LOINC codes for parameter categorization, thus anticipating the future use of EHR.

Medicine distribution pattern detection in pharmaceutical supply chains: a new Kth-proximity density-distance-based method

Purpose Medicine distribution logistics pattern in pharmaceutical supply chains is a hot topic, which aims to predict applicable and efficient medicine distribution patterns so that the medicine can be distributed effectively. This research aims to propose a new method, named density-distance method, that works based on Kth proximity using patient features (including age, gender, education, inherent diseases, systemic diseases and disorders); geographical features (city, state, population, density, land area) and supply chain features (destination and transportation system). Design/methodology/approach The proposed method of this research consists of two main phases where in the first phase, quantitative data analytics will be carried out to find out the significant factors and their impacts on medicine distribution. Then, in the next phase, a new Kth-proximity density-distance-based method is proposed to determine the best locations for the wholesalers while designing a supply chain. Findings The findings show that the proposed method can effectively design a supply chain network using realistic features. In addition, it is found that while the distance-density aggregate index is applied, the wholesalers' locations will be different compared to classic supply chain designs. The results show that age, public hygiene level and density are the most influential during designing new supply chains. Practical implications The outcomes of this research can be used in the medicine supply chains to predict appropriate medicine distribution logistics patterns. Originality/value In this research, the machine learning method based on the nearest neighbor has been used for the first time in the design of the supply chain network.