Sufficient Medical Care Research Articles

A Case Study on Organophosphate Poisoning in Dehradun

Organophosphate compounds are used as commercial insecticides and applied as aerosols or dust. Consuming these compounds intentionally or unintentionally lead to dangerous conditions even to fatality. The most common obstacle in treating organophosphorus poisoning is the availability of sufficient medical care, equipment to provide proper emergency care observed in rural areas where there is a lot of gaps between intensive care and acute care. Atropine use is as an antidote in organophosphorus poisoning. The dose of atropine mainly depends on the organophosphorus toxic doses. Atropine is a competitive antagonist of acetylcholine at the muscarinic postsynaptic membrane. Atropine blocks all the muscarinic effects in the body. The authors present a case of suicidal OP poisoning with an overview of management of the acute intoxication. The early recognition of symptoms and prompt treatment helps in reducing the morbidity and mortality.

A systematic review of intellectual and developmental disability curriculum in international pre-graduate health professional education

BackgroundDespite the increasing global population of individuals with intellectual and developmental disabilities (IDD), this population remains especially vulnerable to health disparities through several factors such as a lack of access to sufficient medical care and poor determinants of health. To add, numerous studies have shown that healthcare professionals are still insufficiently prepared to support this population of patients. This review synthesizes the literature on current pre-graduate IDD training programs across healthcare professions with the goal of informing the creation of evidence-based curricula.MethodsFour major databases were searched for current pre-graduate IDD training interventions for healthcare professionals. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram and the Best Evidence Medical Educations systematic review guide were used to frame our collection and analysis.ResultsOf the 8601 studies screened, 32 studies were identified, with most studies involving medical students (50%). Of note, 35% of studies were interprofessional. Most interventions utilized multiple pedagogical methods with a majority including clinical experiences (63%) followed by theoretical teaching (59%). Kirkpatrick levels showed 9% were level 0, 6% were level 1, 31% were level 2A, 31% were level 2B, 19% were level 3, 3% were level 4A, and none were level 4B.ConclusionsThere is a paucity of formally evaluated studies in pre-graduate health professional IDD education. As well, there are a lack of longitudinal learning opportunities and integration into formal curriculum. Strengths identified were the use of multimodal approaches to teaching, including interprofessional approaches to optimize team competencies.

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Anabolic-androgenic steroids: Considerations for forensic psychiatry, sports psychiatry, and the law

Construction of Healthcare Facilities Using Energy Efficient Technologies

Introduction. According to the Low-Carbon Development Strategy of the Russian Federation 2050, the special attention is allocated to cities, to evaluation of the quality and comfort of population life-activity, taking into account the implementation of energy-saving measures and other technological solutions, as well as to design and construction ensuring zero carbon dioxide emissions. The quality of people’s life is characterized by the availability of social infrastructure and adjacent spaces including: educational and healthcare institutions, as well as sports, recreation and cultural facilities. Planning the optimal development of healthcare institutions network with respect to the energy efficient measures, requires the integral system of urban territory evaluation, which is the main aim of the present study.Materials and methods. A complex task requires a multifaceted approach to systematizing the information about the state of urban territory in the following spheres: energy efficiency, green technologies, healthcare facilities network and its condition, development and character of the urban territory, environmental stability etc. In the context of low-carbon development the optimization of the healthcare network provided the use of energy-saving technologies becomes possible thanks to the use of the geographic information system.Results. As a result of the study held with application of the systemic approach to the phased planning of the healthcare institutions network optimization and using the geographic information system as a tool for territorial and spatial analysis, there were identified the main districts that require expansion and development of social infrastructure, namely healthcare institutions, and the urban territory features — infrastructure indicators (transport) and comfort of living indicators (urban greening evaluation). The basic opportunities and ways to improve energy efficiency of healthcare buildings were determined.Discussion and Conclusions. The long-term development of the healthcare institutions network in the city is fulfilled by means of the phased planning method implicating the differentiated normative-target approach, multi-criteria evaluation, which allows to organise sufficient medical care under conditions of the specific residing system. The implementation of the information modeling technologies, green and energy saving technologies will ensure improvement of the comfort of staying level, reduce energy consumption and ease the load on the municipal infrastructure of the city.

Uncovering the Most and the Least Factors Affecting Elderly Health Using Association Mining

Thailand has entered the aging society since 2005 and is now stepping towards a complete aging society in 2021. The elderly’s health problems are difficult to avoid.The research aims to analyze the most influential and most minor powerful factors on the elderly’s health status. The association analysis approach is applied to discover the relationship between various factors that affect good health. 17,804 Thai elderly data from the National Statistical Office (NSO) of Thailand were employed. One hundred ninety-nine features were taken into the association rules mining modeling. FP-growth algorithm is chosen to find the most and the least factors affecting the health of the elderly. The interesting relationships among those factors are also disclosed. As a result, the feature that demonstrates good health is performing daily activities independently. Additionally, several features that are less likely to appear in healthy seniors are hard work, working at risk, living in an urban society, living with unfamiliar caregivers, having a few children, and lacking sufficient government medical care. The knowledge gained from the findings can be considered for preparing health care for the aging society.

Uncovering the Most and the Least Factors Affecting Elderly Health Using Association Mining

Thailand has entered the aging society since 2005 and is now stepping towards a complete aging society in 2021. The elderly’s health problems are difficult to avoid.The research aims to analyze the most influential and most minor powerful factors on the elderly’s health status. The association analysis approach is applied to discover the relationship between various factors that affect good health. 17,804 Thai elderly data from the National Statistical Office (NSO) of Thailand were employed. One hundred ninety-nine features were taken into the association rules mining modeling. FP-growth algorithm is chosen to find the most and the least factors affecting the health of the elderly. The interesting relationships among those factors are also disclosed. As a result, the feature that demonstrates good health is performing daily activities independently. Additionally, several features that are less likely to appear in healthy seniors are hard work, working at risk, living in an urban society, living with unfamiliar caregivers, having a few children, and lacking sufficient government medical care. The knowledge gained from the findings can be considered for preparing health care for the aging society.

Activities of “flying” medical teams in the Arkhangelsk province (end of XIX century – 1920)

The article presents a historical example of solving the issue of providing public health care in hard-to-reach and sparsely populated territories in the context of a lack of medical personnel and the danger of outbreaks of epidemic diseases. The data concerns mobile medical units, specifically their management experience and recruiting in the Far North of the European part of Russia. Particular attention is paid to little-known facts relating to the last quarter of the XIX century and the First World War. In the Arkhangelsk province, the successful experience of “flying” medical teams, tested in the conditions of warfare, began to be applied in peacetime for temporary workers at the time of fishing and hunting on the remote deserted coasts of the northern seas. Due to the expansion of social infrastructure, the need for “medical units” disappeared, but was again requested in 1916-1920, when, in conditions of war and the mobilisation of medical personnel in the army, the civilian population of remote districts did not receive sufficient medical care, which created the danger of massive epidemics. A feature of this period was the widespread involvement of women doctors in the mobile medical units, even before the officially adopted resolution on their mobilisation in wartime. The activities of mobile medical units allowed reducing the risk of epidemics by localising individual cases and preventing them from spreading among the population, which in war conditions could lead to a quarantine of the Arkhangelsk port and paralyse economic and military relations with allies. Mobile anti-epidemic units became widespread in the following decades (especially during the years of the Civil and Great Patriotic / World War II). They were and continue to be of particular importance for assisting the population of remote northern territories, primarily leading a nomadic lifestyle. The article is based on analysing a large number of original archival sources.

The Impact of the COVID-19 Pandemic on Avoidance of Health Care, Symptom Severity, and Mental Well-Being in Patients With Coronary Artery Disease.

The COVID-19 pandemic affected regular health care for patients with chronic diseases. However, the impact of the pandemic on primary care for patients with coronary artery disease (CAD) who are enrolled in a structured disease management program (DMP) in Germany is not clear. We investigated whether the pandemic affected primary care and health outcomes of DMP-CAD patients (n = 750) by using a questionnaire assessing patients' utilization of medical care, CAD symptoms, as well as health behavior and mental health since March 2020. We found that out of concern about getting infected with COVID-19, 9.1% of the patients did not consult a medical practitioner despite having CAD symptoms. Perceived own influence on infection risk was lower and anxiety was higher in these patients compared to symptomatic CAD patients who consulted a physician. Among the patients who reported chest pain lasting longer than 30 min, one third did not consult a medical practitioner subsequently. These patients were generally more worried about COVID-19. Patients with at least one worsening CAD symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since the pandemic showed more depressive symptoms, higher anxiety scores, and were less likely to consult a doctor despite having CAD symptoms out of fear of infection. Our results provide evidence that the majority of patients received sufficient medical care during the COVID-19 pandemic in Germany. However, one in ten patients could be considered particularly at risk for medical undersupply and adverse health outcomes. The perceived infection risk with COVID-19 might have facilitated the decision not to consult a medical doctor.

Modeling and analysis of COVID-19 in India with treatment function through different phases of lockdown and unlock

India, unlike several other countries, has witnessed a greater challenge in overcoming the pandemic during the second wave crisis. The strategies on lockdown imposition during the first wave of the pandemic were well implemented due to which the year-long wave did not witness uncontrollable surges in the infections. In this study, we present a detailed study on the disease spread during the first and second wave of COVID-19, by performing numerical simulation in a phase-wise manner as per the lockdown and unlock phases implemented in India. The inclusion of a piecewise treatment function in the framed epidemiological model is a noteworthy aspect of the study since this function takes into consideration the availability of medical equipment, based upon the threshold number of infections. This function framed in this model first grows linearly reaching a peak, then it declines due to shortage of medical resources and finally gets saturated. Analysis of the impact of lockdown is presented for each phase of the pandemic in India. Though the data considered for the study is for a period that marked the beginning of the pandemic, major analysis and predictions are presented based on the second wave data in terms of sensitivity analysis and time series behavior. A comparison of deterministic and stochastic differential equations is presented with simulation results on certain parameter set to examine variation in treatment and recovery. The simulations are performed using MATLAB and R softwares. The work is validated with the real data and model fitting is done applying the Maximum Likelihood method. The study implies that, under accurate lockdown strategies and sufficient medical care, the peak in cases would be attained by 16 May 2021, after which a decline in the cases could be observed.

Toward the development of a vibrant, super-aged society: The future of medicine and society in Japan.

Toward the development of a vibrant, super-aged society: The future of medicine and society in Japan.

CASE STUDY: ORGANOPHOSPHATE POISONING – ATROPINE-INDUCED PSYCHOSIS IN INTENSIVE CARE UNIT PATIENT

Organophosphate compounds are used as commercial insecticides and applied as aerosols or dust. Consuming these compounds intentionally or unintentionally lead to dangerous conditions even to fatality. The most common obstacle in treating organophosphorus poisoning is the availability of sufficient medical care, equipment to provide proper emergency care observed in rural areas where there is a lot of gap between intensive care and acute care. Atropine use is as an antidote in organophosphorus poisoning. The dose of atropine mainly depends on the organophosphorus toxic doses. Atropine is a competitive antagonist of acetylcholine at the muscarinic postsynaptic membrane. Atropine blocks all the muscarinic effects in the body. This study presents a case of organophosphorus poisoning treated with atropine leading to atropine psychosis. Patient’s conditions, outcomes, and improvements are studied.

Hematological Parameters Predict Disease Severity and Progression in Patients with COVID-19: a Review Article.

In December 2019, an outbreak of pneumonia of no identifiable cause had been widely spreading in Wuhan, Hubei Province, China. In late December 2019, the pathogen was identified as a new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and its associated disease, named Coronavirus disease-19 (COVID-19). As of July 3, 2020, 10,906,822 cases have been confirmed worldwide, with 522,112 deaths, as reported by the World Health Organization. Given the developing situation with COVID-19, extensive studies are urgently needed that determine indicators of severity to provide evidence for health policymakers. This study aimed to review the currently available data on hematological parameters to predict disease severity in patients of COVID-19. We performed a review using three electronic databases. Fourteen papers are included. In this review, we summarized the latest research highlighting the clinical features, pathogenesis, and diagnosis, with a concentration on hematological parameters that predict severity to help identify patients with severe disease. These indicators will help doctors know earlier which patients may need intensive care unit (ICU) care to manage their patients with an evidence-based protocol. Most reviewed studies report hematological parameters that predict disease severity, including lymphopenia and elevated fibrin fragment D. We recommend using these indicators in addition to others, like respiratory failure, shock, or multiple organs dysfunction syndrome, for disease classification in situations where there are insufficient ventilators or ICU beds to prioritize advanced medical services accordingly and to ensure the maximum provision of sufficient medical care.

Depression, Anxiety and State Guilt in Individuals under Quarantine in an Institution due to COVID-19 and the Related Factors.

This study identifies depression, anxiety and state guilt of Turkish citizens kept in quarantine for 14 days in an institution where they are brought upon their request within the scope of infection control measures and the related affecting risk factors during the coronavirus pandemic. A total of 385 individuals under quarantine for 14 days between the dates of April 20-May 21, 2020 were included in the study. The data were collected using a socio-demographic data form (age, gender, employment status, having sleep disorder, duration of television review and Internet use, etc.), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Guilt Scale (GS) after the participants were informed about the study objective and they signed the informed consent form. A total of 385 participants, 84 of whom were women, with a mean age of 35.32±11.7 were included in the study. According to BAI and BDI, 14.5% of the participants had anxiety and 17.1% had depression symptoms. The regression analysis found that female gender, having sleep disorder, using Internet for 8 hours or more and having chronic illness were risk factors for anxiety; while female gender, being aged 18-30, having sleep disorder, having psychiatric illness, and using Internet for 8 hours or more were risk factors for depression. The state guilt did not show any significant correlation with any socio-demographic factor. Female gender, being young, having a history of psychiatric illness, having chronic illness, having sleep disorder, using Internet for 8 hours or more were found to be risk factors for more anxiety and depression symptoms. It is important to educate people about the methods of how to maintain healthy sleep during quarantine, to effectively fight against the excessive circulation of misinformation and to provide sufficient medical care to those with psychiatric and chronic diseases, being more vulnerable against infections.

The Factors Associated With Daily Life Support for Single Older Adults to Remain at Their Home

Japan aims to enable older adults to remain at home in their familiar environment. However, the factors associated with daily life support for older adults who require medical and nursing care to remain at home are unclear. This study aimed to clarify the factors associated with daily life support for single older adults needing medical and nursing care to remain at home. Our participants were single older adults aged 65-94 years receiving medical and nursing care and their care providers. First, we analyzed records, which were written by care providers, regarding ten older adults who received medical and nursing care from 2014 to 2018. We categorized occurrences which exert single older adults’ life on change into six factors, such as gradual frailty and loss of a loved one. Then, to consider how they experience these factors, we conducted semi-structured interviews with three additional older adults who were single and received home visiting nursing care service in 2020. During this process, four multidisciplinary researchers discussed the factors associated with daily life support for single older adults; finally, three factors were derived. The first one pertained to health conditions: receiving sufficient medical and nursing care maintain older adults’ physical condition. The second related to the environment: maintaining social interactions (neighbors and friends). The third pertained to older adults’ values and meanings to remain at home. This study suggests that care providers focus on these three factors to help older adults who received medical and nursing care to remain at their home.

Feasibility of a Novel Mobile C-Reactive Protein-Testing Device Using Gold-Linked Electrochemical Immunoassay: Clinical Performance Study.

BackgroundHome-based care is one of the most promising solutions to provide sufficient medical care for several older patients in Japan. However, because of insufficient diagnostic devices, it is sometimes difficult to detect early signs of the occurrence or worsening of diseases, such as infections under home-based care settings. C-reactive protein (CRP) is highly sensitive to diagnosing infections, and its elevation can help diagnose acute infection in older patients. Therefore, a CRP-measuring device that can be used in such a specific occasion is needed for home-based care. However, aspects such as its size, weight, and procedure are still challenging with respect to the practical use of mobile devices that quantitatively measure CRP levels easily and quickly under home-based care settings.ObjectiveWe developed a new mobile, rapid CRP measurement device using a gold-linked electrochemical immunoassay (GLEIA) system. The aim of this study was to evaluate the feasibility of this mobile CRP-testing device.MethodsFirst, we assessed the performance of bare GLEIA-based electrode chips as the foundation of the device. After embedding the bare GLEIA-based electrode chips in a special plastic case and developing the mobile CRP-testing device, we further tested the device prototype using clinical blood samples. Finally, we evaluated the intra-assay variability for precision in the same condition and inter-assay variability for reproducibility in different conditions.ResultsBlood samples for analysis were obtained by direct vein puncture from outpatients (N=85; females: 57/85; males: 28/85; age: 19-88 years) at Kanazawa University Hospital in Japan. For performance evaluation of bare GLEIA-based electrode chips, we used 85 clinical blood samples. There was a significant positive correlation between the electrode-predicted CRP levels and the reference CRP concentrations (R2=0.947; P<.001). The assembled device was mobile (size 45×90×2.4 mm; weight 10 g) and disposable. The minimum volume of the sample needed for measuring CRP was 1.4 µL. The estimated preanalytical time was approximately 7 minutes and 40 seconds, and analysis time was approximately 1 minute and 10 seconds. Subsequently, for performance evaluation of the mobile CRP-testing device using GLEIA-based electrode chips, we used 26 clinical blood samples and found a significant positive correlation between the mobile device-predicted CRP levels and the reference CRP concentrations (R2=0.866, P<.001). The intra-assay variabilities were 34.2%, 40.8%, and 24.5% for low, medium, and high CRP concentrations, respectively. The inter-assay variabilities were 46.5%, 38.3%, and 64.1% for low, medium, and high CRP concentrations, respectively.ConclusionsOur findings suggest that this new mobile CRP-testing device might be suitable for use in home-based care settings.

Analysis of pharmacotherapy of patients with acute coronary syndrome at pre-hospital stage

A patient with acute coronary syndrome requires not only urgent hospitalization, continuous medical observation, but also medical and diagnostic measures that meet standard standards.Purpose of the study.Аnalysis of the management of patients with acute coronary syndrome with ST segments elevation in the prehospital phase.Materials and methods.Analysis of emergency medical care patients with acute coronary syndrome with ST-segment elevation in 2017. In the study group, men (126 people) and women (119 people).Results.The average time of arrival of the team is 14 minutes, the total time of patient care is 28.9 minutes (excluding time for delivery to the hospital). The time from the call to the moment of delivery to the emergency department is 53 minutes. Analysis of drug therapy revealed that the frequency of nitrates was 88.8 %, antiplatelet therapy – 88.2 %, narcotic analgesics – 82.3 %, anticoagulants – 67.3 %, β-blockers – 18.7 %, oxygen therapy – 36.3 %, antiarrhythmic drugs – 6.4 %, fibrinolytic therapy was performed in 54.3 % of patients.Conclusions.А patient with acute coronary syndrome with ST elevation segments in the prehospital hospital provided sufficient medical care in accordance with clinical guidelines. A low percentage of thrombolytic therapy is associated with the presence of absolute contraindications for the patient.

The case of Dr Masajiro Miyazaki: Japanese-Canadian healthcare in World War II

The forcible relocation of Japanese-Canadians (Nikkei) during World War II has been widely examined; however, little scholarly attention has been paid to the impact of relocation on the medical services...

Save a Child’s Heart: A Unique Global Health Model

&#x0D; &#x0D; &#x0D; Save a Child’s Heart (SACH) is a UN-sponsored Israeli non-pro t organization that provides free, life-saving cardiac treatment to children from developing countries who would otherwise be unable to receive sufficient medical care in their home country. SACH utilizes a unique model of care involving several areas of focus including a tertiary care centre in Israel, international screening missions, training local healthcare professionals (HCPs), establishing local care facilities in partner countries, and engaging local and international volunteers. Through these efforts, SACH has been successful in providing cardiac care to 4599 children, training 116 HCPs, and establishing four independent surgical centres internationally. This model has proven its efficacy and can be applied to other tertiary surgical endeavors.&#x0D; &#x0D; &#x0D;

SY8-1 - Pregnancy and Congenital Heart Disease

The number of pregnancy with congenital heart disease has been increasing recently along with drastically increased population of adult congenital heart disease (ACHD) patients all over the world. We have the longest history of ACHD services in Japan so that the biggest volume of ACHD patients and their pregnancies. The management of pregnant ACHD patients faces new challenges and experiences from time to time because they are truly “New Population” especially when they have complex congenital heart disease with/without complex cardiac surgeries. It is necessary for the safe and sufficient medical care before and after pregnancy that we understand haemodynamics and problems in long term after various operations such as Senning, Mustard, Rastelli, Fontan, even double switch operation, or ventricular septation. In addition to the repaired Tetralogy of Fallot, those complicated post-operative settings should be assessed clearly before pregnancy in order to predict the changes caused by pregnancy. Since pregnancy and pregnant ACHD patients are moving target, it is very important to notice the early signs for providing the right care during pregnancy. A good guide and advice to the pregnant ACHD patients at any moment contributes not only to the better course throughout pregnancy and delivery but also to the life-long cardiac history of female ACHD patients.

The association between perceived unmet medical need and mental health among the Republic of Korea Armed Forces

IntroductionWe investigated the effect of unmet medical need on the mental health of Republic of Korea (ROK) Armed Forces personnel, as most of the service members work in remote areas...