Way For Healthcare Professionals Research Articles

Artificial daylight photodynamic therapy using methyl aminolevulinate in a real-world setting in Germany - Results from the non-interventional study ArtLight.

Artificial daylight photodynamic therapy (ADL-PDT) is an alternative, all-year applicable, nearly painless treatment approach for actinic keratoses (AK) with comparable effectiveness to daylight or conventional PDT. At the time this study was initiated, methyl aminolevulinate (MAL) was the only photosensitizer approved for ADL-PDT in Germany. To gain comprehensive insights into the practicability of MAL-ADL-PDT in patients with AK using different artificial daylight sources under real-world conditions. This prospective, non-interventional, multicenter study (ArtLight, NCT05725213) enrolled patients with Olsen grade 1 or 2 AK on the face and scalp in Germany. Patients were treated with MAL-ADL-PDT (160mg/g MAL cream). The primary outcome measure was the practicability of MAL-ADL-PDT assessed as rate of resolved AK lesions in the focus area (10x10 cm area within the treatment area). Secondary outcomes included treatment-associated pain (numeric rating scale, NRS-11), Actinic Keratosis Area and Severity Index (AKASI), total lesion count over time, skin preparation, safety, overall assessment of effectiveness, tolerability, adherence, and patient satisfaction. In total, 224 patients (median age: 75.0 years (range 50-91), 85.3% male, 62.5% AK Olsen grade 2, 55.4% treatment-naïve) were included and treated with MAL-ADL-PDT. Three months after treatment, lesion counts were reduced in the focus area by 71% (p<0.001) indicating practicability of the treatment. Nearly all patients (93.3%) experienced none or mild pain during PDT (NRS score 0-3). Median AKASI decreased from 6.2 at baseline to 3.4 at month 3 (95% CI 2.4-3.0; p<0.001). The majority of investigators (82.8%) and patients (80.0%) were satisfied with the treatment. No new safety signals were reported. The clinical practicability of MAL-ADL-PDT was demonstrated under real-world conditions by effective lesion reduction and predominantly none to mild procedural pain. Thus, MAL-ADL-PDT is a convenient way for healthcare professionals to deliver PDT treatment to patients with AK located on the face and scalp.

Innovative approach towards early prediction of ovarian cancer: Machine learning- enabled XAI techniques

Globally, ovarian cancer affects women disproportionately, causing significant morbidity and mortality rates. The early diagnosis of ovarian cancer is necessary for enhancing patient health and survival rates. This research article explores the utilization of Machine Learning (ML) techniques alongside eXplainable Artificial Intelligence (XAI) methodologies to aid in the early detection of ovarian cancer. ML techniques have recently gained popularity in developing predictive models to detect early-stage ovarian cancer. These predictions are made using XAI in a transparent and understandable way for healthcare professionals and patients. The primary aim of this study is to evaluate the effectiveness of various ovarian cancer prediction methodologies. This includes assessing K Nearest Neighbors, Support Vector Machines, Decision trees, and ensemble learning techniques such as Max Voting, Boosting, Bagging, and Stacking. A dataset of 349 patients with known ovarian cancer status was collected from Kaggle. The dataset included a comprehensive range of clinical features such as age, family history, tumor markers, and imaging characteristics. Preprocessing techniques were applied to enhance input data, including feature scaling and dimensionality reduction. A Minimum Redundancy Maximum Relevance (MRMR) algorithm was used to select the features in the model. Our experimental results demonstrate that in Support Vector Machines, we found 85 % base model accuracy and 89 % accuracy after stacking several ensemble learning techniques. With the help of XAI, complex ML algorithms can be given more profound insights into their decision-making, improving their applicability. This paper aims to introduce the best practices for integrating ML and artificial intelligence in biomarker evaluation. Building and evaluating Shapley values-based classifiers and visualizing results were the focus of our investigation. The study contributes to the field of oncology and women's health by offering a promising approach to the early diagnosis of ovarian cancer.

Effectiveness of simulation-based medical education perceptions and attitudes

Simulation is a highly effective method often used in medical training. Simulation-based medical education (SBME) provides a way for healthcare professionals and patients to experience medical scenarios without actual risk to health or safety. This study focuses on comparing the views and opinions about SBME and traditional medical education (TME) among students from various levels and programs within medical colleges at Majmaah University in Saudi Arabia. A survey was used to gather information on students' perceptions and attitudes towards SBME and TME. The study analyzed responses from 472 healthcare students using Statistical Analysis System software. Of these participants, 52.33% were male and 47.67% were female. Most of the students, 80.30%, were pursuing bachelor's degrees, while 19.70% were in master's programs. The breakdown of their fields of study was as follows: 17.80% in medicine, 71.82% in applied medical sciences, and 10.38% in dentistry. A large majority, 93.43%, were familiar with SBME in general, and 90.89% knew about SBME in their specific field, indicating high awareness. Despite the challenges in using and maintaining SBME, the study found overall positive perceptions and attitudes towards it among healthcare students. Additionally, most participants believed that SBME offers a better learning environment, helps in reducing future medical mistakes, and supports every student's right to access SBME training.

A Web Portal for Communicating Polygenic Risk Score Results for Health Care Use-The P5 Study.

We present a method for communicating personalized genetic risk information to citizens and their physicians using a secure web portal. We apply the method for 3,177 Finnish individuals in the P5 Study where estimates of genetic and absolute risk, based on genetic and clinical risk factors, of future disease are reported to study participants, allowing individuals to participate in managing their own health. Our method facilitates using polygenic risk score as a personalized tool to estimate a person’s future disease risk while offering a way for health care professionals to utilize the polygenic risk scores as a preventive tool in patient care.

A systematic review of interventions using health behavioral theories to improve medication adherence among patients with hypertension.

Medication adherence is a major problem in the treatment of hypertension. Approximately half of the patients who use antihypertensive medications are not adherent. Several interventions have endeavored to improve medication adherence among patients with hypertension, and some have used health behavioral models/theories. However, the quality and effectiveness of using health behavioral models/theories in improving medication adherence among patients with hypertension remain unknown. The main aim of this systematic review was to describe study characteristics and types of health behavioral models/theories used in interventions for improving medication adherence among adults with hypertension. PubMed, Scopus, Ovid MEDLINE, CINAHL, and PsycINFO databases were searched for randomized clinical trial interventions using any health behavioral models/theories published in English from 1979 to 2019. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two independent reviewers searched, screened abstracts and articles, extracted data, and assessed the risk of bias and the use of the model/theory using the Theory Coding Scheme. A total of 11 articles were included in this systematic review. Two studies reported significant improvement in medication adherence. The Self-Regulation Model and Social Cognitive Theory were the most common types of models/theories. Nine studies used a single model/theory, and four studies measured the constructs of a model/theory. Risk of bias was good (n = 4) and fair (n = 5) in interventions. Using health behavioral models/theories may be an efficient way for health care professionals to improve adherence to medications among patients with hypertension. More interventions with rigorous designs are needed that appropriately utilize health behavioral models/theories for improving medication adherence among adults with hypertension.

Maternal morbidity: how to reduce it.

Internationally there has been increased interest in maternal morbidity; both as a strategy to reduce maternal deaths and also because of the significant impact on a woman's life as a result of suffering from maternal morbidity. The present review will evaluate the current knowledge of, and strategies to reduce maternal morbidity. The study of maternal morbidity and how to reduce it has been hampered for many years by the lack of a standard approach to measurement and evaluation. The World Health Organization has attempted to standardize the approach to maternal morbidity with the development of a new definition that recognizes the multiple dimensions of maternal morbidity, including external factors such as socioeconomic factors. This approach will assist with a more accurate evaluation of maternal morbidity. Maternal morbidity arises from many and varied causes. Many of these are amenable to quality improvement with an associated reduction in maternal morbidity. There have been significant advances in the understanding of maternal morbidity: incidence causes and management. Future research should aim to establish accurate rates for maternal morbidity and further develop ways for healthcare professionals, including anaesthesia care providers, to reduce it.

To Tweet or Not to Tweet-a Review of the Viral Power of Twitter for Infectious Diseases.

Purpose of ReviewWith real-time communication crucial to both healthcare professionals (HCPs) and the public in infectious diseases (ID), social media networking sites has become even more important. Twitter is the most popular form of social media used for ID communication. We will review the power of Twitter in ID.Recent FindingsTwitter allows for real-time sharing of educational resources at ID scientific conferences, enabling individuals that are not able to attend conferences to follow conferences anytime anywhere and stimulate discussion around topics of interest with experts from across the globe. Further, Twitter chats are a valuable tool for stewardship, with different accounts periodically hosting chats on various stewardship topics. Several studies have also demonstrated the strong relationship between dissemination and citation impact of publications with the help of Twitter. There is great value in engaging with non-ID people on Twitter via dissemination of ID knowledge to other disciplines. Lastly, when used appropriately, Twitter is a useful site for distributing vaccine information, whether informally (by advocates and physicians) or formally (by government entities) and allows one to keep up with ongoing ID outbreaks in real time.SummaryTwitter has transformed how we communicate in healthcare. Particularly in ID, where bacteria and viruses can enter/exit borders anytime anywhere, global real-time information about outbreaks and antimicrobial resistance for clinicians and the public is critical. Twitter has no hierarchy or barriers, is a conduit for global collaboration, and is a way for HCPs and the public to “social”ize on healthcare topics, if used appropriately.

User testing of the psychometric properties of pictorial-based disability assessment Longshi Scale by healthcare professionals and non-professionals: a Chinese study in Shenzhen

Objective: The aim of this study was to validate a novel pictorial-based Longshi Scale for evaluating a patient’s disability by healthcare professionals and non-professionals. Design: Prospective study. Setting: Rehabilitation departments from a grade A, class 3 public hospital, a grade B, class 2 public hospital, and a private hospital and seven community rehabilitation centers. Subjects: A total of 618 patients and 251 patients with functional disabilities were recruited in a two-phase study, respectively. Main measures: Outcome measure: pictorial scale of activities of daily living (ADLs, Longshi Scale). Reference measure: Barthel Index. The Spearman correlation coefficient was used to analyze the validity of Longshi Scale against Barthel Index. Results: In phase 1 study, from March 2016 to August 2016, the results demonstrated that the Longshi Scale was both reliable and valid (intraclass correlation coefficient based on two-way random effect (ICC2,1) = 0.877–0.974 for intra-rater reliability; ICC2,1 = 0.928–0.979; κ = 0.679–1.000 for inter-rater reliability; intraclass correlation coefficient based on one-way random effect (ICC1,1) = 0.921–0.984 for test–retest reliability and Spearman correlation coefficient = 0.836–0.899). In the second phase, in March 2018, results further demonstrated that the Longshi Scale had good inter-rater and intra-rater reliability among healthcare professionals and non-professionals including therapists, interns, and personal care aids (ICC1,1 = 0.822–0.882 on Day 1; ICC1,1 = 0.842–0.899 on Day 7 for inter-rater reliability). In addition, the Longshi Scale decreased assessment time significantly, compared with the Barthel Index assessment (P < 0.01). Conclusion: The Longshi Scale could potentially provide an efficient way for healthcare professionals and non-professionals who may have minimal training to assess the ADLs of functionally disabled patients.

Having Therapeutic Conversations With Fathers Grieving the Death of a Child.

A child's death is a traumatic life experience for parents. Health-care professionals (HCPs) have sought guidance on how to intervene with grieving parents, particularly with fathers. Having therapeutic conversations is an effective way for HCPs to support grieving fathers. In our previous study, fathers identified core beliefs that influenced their experience of grief and coping. In this article, the Illness Beliefs Model was integrated with the findings to provide a framework for interventions to create open conversations, ease fathers' suffering, and thereby help their spouse and family suffering as well. This article will guide HCPs to engage in therapeutic conversations to support bereaved fathers.

Cultural barriers lead to inequitable healthcare access for aboriginal Australians and Torres Strait Islanders

Abstract Aims This article seeks to address some of the factors, particularly cultural barriers, contributing to inequity in healthcare service provisions for indigenous Australians. Furthermore, this article presents ways for healthcare professionals to take action on culture-related health equity issues. Finally, this article addresses what nurses can do to support more operational interventions and enhance the quality of services for indigenous Australians and Torres Strait Islanders. Background Recently, scholarly literature in Australia has focused on the issue of ensuring equitable access to healthcare for aboriginal Australians and Torres Strait Islanders, who are regarded as economically, socially, politically and culturally disadvantaged (Larkins et al, 2016; Lowell, 2013). 1 , 2 However, in spite of significant efforts on the part of the Australian government, scholars, policy makers and communities to provide fair and equitable healthcare, this challenging and longstanding issue remains unresolved and needs to be addressed immediately (Australian Institute of Health and Welfare, 2015; Australian Bureau of Statistics (ABS), 2011). 3 , 4 Data sources Using the Population, Intervention and Outcome framework, several databases (PUBMED, MEDLINE, and SCOPUS) and government web-based literature resources were searched to identify original research articles published from 2000 to 2016. Discussion Health inequity exists among aboriginal Australians and Torres Strait Islanders, and the cultural barriers are vital factors in addressing aboriginals' health inequity. Healthcare professionals could be part of an effective solution for diminishing racial/ethnic disparities in healthcare. Different types of nurses could play different roles in addressing aboriginal cultural barriers among aboriginal Australians and Torres Strait Islanders. Nurses are uniquely positioned to initiate and sustain contact with aboriginal Australians and Torres Strait Islanders in healthcare workplaces, as they can intervene at the points of greatest need in the community to address socially significant healthcare and social issues. Conclusions The different roles of nurses in providing health and social care interventions to aboriginal Australians and Torres Strait Islanders could be utilized to increase equity in access to healthcare and help aboriginals attain better levels of health.

Happy Feet in a Rural Clinic: A Diabetic Foot Education Intervention

The prevalence of Type 2 Diabetes is higher in rural areas than in urban areas and this population have more barriers to health care (Rural Healthy People, 2010). Many diabetic patients in disparate population in rural communities do not receive the established diabetes standards of care such as foot screenings and diabetic foot prevention education which contribute to incidence in foot ulcer formation and amputations (Agency for Healthcare Research and Quality, 2008). The complexity of Diabetes requires a multidisciplinary approach which in most cases may not be available in many rural health care settings (Abu Qamar, 2012). Fragmented diabetic patient education leads to non-compliance, diabetic foot ulcer development and subsequent rise in lower limb amputations. Under usage of the diabetes standards of care among disparate population can be addressed by implementation of an evidenced based diabetic foot education intervention. Purpose: The purpose of this study was to determine the effectiveness of a patient-centered diabetes foot education intervention in a rural clinic, designed to improve patients’ knowledge, as evidenced by an increase in the Patient Interpretation of Neuropathy (PIN) scores from pre-intervention to post-intervention. Methods: The participants were clinically diagnosed with type 2 diabetes for at least six months and were less than 70 years of age. Patients were excluded if they were more than 70 years of age, had active foot ulcers, with previous minor or major amputations, or Charcot's joints. The Patient Interpretation of Neuropathy (PIN) questionnaire was used. It is a 73item reliable and valid measurement tool that evaluated type 2 diabetic patients’ level of understanding of the link between foot ulceration, self-care deficit, cognitive and emotional understanding of peripheral neuropathy. A single group pretestposttest quasi-experimental design was used with paired samples t-test which compared mean scores for the same group of participants in two different occasions. To estimate the sample size, a priori, G*Power was used to determine the appropriate number of participants needed to detect a difference between pre and posttest PIN total scores with 95% confidence that the difference was real. Estimated sample size needed for power was N=34. A total of 25 participants completed the education intervention with (n=25) pre-test and (n=25) post-test. Results: There was a significant increase on T2DM patient’s knowledge scores from Pre-educational intervention (M = 261.64, SD = 30.0) to Post educational intervention (M = 327.96, SD = 22.0), t value = 7.952, p = .000 (two-tailed). The Mean difference of the two scores was -66.32, with a 95 percent confidence interval stretching from a lower bound of -83.53334 to an upper bound of -49.10666. The eta squared statistic (.7) indicated an extremely large effect size. Majority of the participants were women which may have increased the probability of female to male ratio. The hypothesis and question posed in this study were both answered YES. The use of the HPM theoretical framework and the selected educational material demonstrated significant changes in knowledge and behavior as evidenced by the statistically significant improvement in diabetic patients’ PIN scores from pre to post implementation of diabetic foot care education intervention. Conclusion: The use of a scientific approach, such as evidence-based practice, plays a crucial role in the provision of appropriate care to patients. The move towards evidenced based practice paves the way for healthcare professionals to move away from long-established style of care delivery to the new paradigm where decisions are driven according to the best evidence available. The hypothesis and question posed in this study were both answered yes. The use of Pender’s health promotion model as theoretical framework and the selected standardized educational materials demonstrated significant changes in the knowledge and behavior of the participants in this study as evidenced by improvement in diabetic patients’ PIN scores from pre to post implementation of a diabetic foot care prevention education. The findings indicated increased knowledge, willingness and motivation, which are important elements that contribute to behavior change in this patient population. Diabetic foot education and prevention among diabetic patients in this rural clinic is essential because the knowledge and skills acquired as a result of the education intervention will have a significant impact in therapeutic outcomes among this patient population.

Asthma in intellectual disability: are we managing our patients appropriately?

People with intellectual disability are a vulnerable group of people with asthma that has, to date, largely been ignored in the medical literature. Although guidelines for medication management for people with intellectual disability suggest asthma is treated as for other populations, there are special considerations that should be taken into account when managing asthma in this group. Due to their cognitive impairment as well as comorbidities, they are likely to require support with asthma self-management, including inhaler use. Their varying degrees of autonomy mean that there is often a need to provide education and information to both the person and their caregivers.Educational aimsTo understand general principles of health of people with intellectual disability and how this affects the healthcare professional’s approach to asthma management.To understand how intellectual disability affects cognition, autonomy and communication, and therefore the ability of a person to self-manage asthma.To recognise ways of mitigating respiratory disease risk in people with intellectual disability.To describe ways for healthcare professionals to support people with intellectual disability and their caregivers in asthma management.

A debate on the proposition that self-report is the gold standard in assessment of pediatric pain intensity.

Self-report is often represented as "the gold standard" in assessment of pain intensity in children. We evaluate arguments for and against this claim and consider its implications for pain management. Those in the support of the proposition argue that, when children are able to self-report, treatment decisions should be made based on these scores in line with current evidence-based recommendations. Pain is a subjective phenomenon and can be assessed only via self-report. Treating self-report scores as the gold standard is the only valid way for health care professionals to decide on appropriate treatment.Those against the proposition contend that reliance on self-reported pain scores for analgesic treatment decisions is inappropriate as they oversimplify the pain experience, yield only marginal information on which to base treatment decisions, and potentially place children at significant risk for adverse events. Self-reports of pain intensity sometimes contradict well-founded estimates based on other evidence. Wide variation between children in the meaning of pain scores precludes easy interpretation. We conclude that self-report, when available, can be considered a primary source of evidence about pain intensity. However, it cannot be treated as an unquestioned gold standard. Instead, hierarchical or bundled approaches should be used, taking into account self-report as well as the many individual and contextual factors that influence pain including clinical history, patient preferences, and response to previous treatments. Alternate models are presented to guide further practice and research.

The experience of patients with fear-avoidance belief hospitalised for low back pain – a qualitative study

Purpose: Severe pain, anxiety, depression, and fear-avoidance belief (FAB) are widespread among patients hospitalised for acute low back pain (LBP). Research shows that these psychological factors impact negatively on rehabilitation. This study aimed to investigate and develop an understanding of pain in patients with fear avoidance belief hospitalised for LBP. Method: Semi-structured interviews were conducted with nine patients selected by an FAB questionnaire: averaged FAB – physical activity score was 21 and FAB – work score was 30. All participants were recruited from a rheumatology ward. Analyses were based on the content analysis. Results: The analysis revealed two main categories: (1) back history until the pain became dominant, demonstrating the importance of the LBP histories before admission to hospital. (2) Being in a universe of pain verified, the severe pain expressed through metaphors and a need to be involved in the rehabilitation. During interviews, the participants did not indicate high FAB behaviour. Conclusions: Despite high scores, the FAB questionnaire might not be sufficient to detect FAB in patients hospitalised for acute LBP. It is important to include the deeper meaning of metaphors and the personal story behind the expression of pain as a way of understanding each individual with LBP.Implications for RehabilitationFAB questionnaire is not sufficient either to detect fear avoidance in LBP patients hospitalised with acute conditions or to catch the complexities of individual pain experiences.It seems essential for health care professionals (HCP) to involve the patient in their treatment and development of a rehabilitation plan based on their individual histories and concerns about the future.The metaphors expressed are a way for HCPs to gain insight into the psychological aspect of pain for the individual patient.

On the Need for Precise, Concise Communication during Resuscitation: A Proposed Solution

On the Need for Precise, Concise Communication during Resuscitation: A Proposed Solution

A pilot study on record reviewing with a priori patient selection

ObjectivesTo investigate whether a priori selection of patient records using unexpectedly long length of stay (UL-LOS) leads to detection of more records with adverse events (AEs) compared to non-UL-LOS.DesignTo investigate...

Context-based and Rule-based Adaptation of Mobile User Interfaces in mHealth

Mobile technology is an integral part of the modern health care environment. In mHealth, the mobile user interface (MUI) serves as the bridge between the application and the health care professional. It is important that the doctor be able to easily express his needs on the MUI and correctly interpret the information displayed. New techniques for adapting MUIs offer new opportunities for the MUI designer to maximize the benefits of mHealth technology by providing the best possible way for health care professionals to perform their tasks efficiently and effectively. For the designer, the hope is that new technologies will be developed, such as mobile devices adaptable to different environments, so as to enable customization of the application to the user's context. In this paper, we propose context-based and rule-based approach for designing adaptable MUIs in mHealth. The MUI features adapted to the needs of health care professionals have been implemented on the iPhone and evaluated with an empirical study.

Writing for publication: A case study

AbstractWriting for publication is an important part of professional practice in the health care professions. It is one way of reflecting on and improving practice, and writing skills developed through the publication process may enhance practitioners' ability to communicate more broadly. This article describes a method of teaching writing for publication skills to a multidisciplinary group of health care professionals. It outlines a step‐by‐step process for writing and illustrates three ways for health care professionals to work towards achieving publication: (i) adopting new writing behaviours, (ii) developing support networks for writers and (iii) overcoming external barriers to writing. This article concludes by suggesting that, in what is an increasingly important area for health care professionals, managers should incorporate writing for publication in their planning of staff development and in clinical time allocation. Copyright © 2008 John Wiley &amp; Sons, Ltd.

Family meetings in palliative care: Multidisciplinary clinical practice guidelines

BackgroundSupport for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers. Yet it seems there is insufficient research to demonstrate the utlility of family meetings or the best way to conduct them. This study sought to develop multidisciplinary clinical practice guidelines for conducting family meetings in the specialist palliative care setting based on available evidence and consensus based expert opinion.MethodsThe guidelines were developed via the following methods: (1) A literature review; (2) Conceptual framework; (3) Refinement of the guidelines based on feedback from an expert panel and focus groups with multidisciplinary specialists from three palliative care units and three major teaching hospitals in Melbourne, Australia.ResultsThe literature review revealed that no comprehensive exploration of the conduct and utility of family meetings in the specialist palliative care setting has occurred. Preliminary clinical guidelines were developed by the research team, based on relevant literature and a conceptual framework informed by: single session therapy, principles of therapeutic communication and models of coping and family consultation. A multidisciplinary expert panel refined the content of the guidelines and the applicability of the guidelines was then assessed via two focus groups of multidisciplinary palliative care specialists. The complete version of the guidelines is presented.ConclusionFamily meetings provide an opportunity to enhance the quality of care provided to palliative care patients and their family carers. The clinical guidelines developed from this study offer a framework for preparing, conducting and evaluating family meetings. Future research and clinical implications are outlined.

Roles and responsibilities of health care professionals in combating environmental degradation and social injustice: education and activism

This article describes the causes and health consequences of environmental degradation and social injustice. These issues, which impact primarily on the poor and underserved (both in the United States and internationally) are rarely or inadequately covered in the curriculums of traditional health care professions. The discussion offers ways for health care professionals to promote equality and justice and uses the example of Rudolph Virchow's social activism to illustrate how one physician can lead society toward major public health gains. There is also an examination of the roles of institutions and organisations in enhancing environmental preservation and promoting social justice. Specific curricular suggestions from history and the humanities are offered for those teaching and mentoring new health professionals.