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Bruyère O, Demonceau C, Kergoat MJ. Navigating the Health Care Landscape for an Ageing Population: An International Survey of Strategies and Priorities. J Am Med Dir Assoc 2024; 25:105155. [PMID: 39009063 DOI: 10.1016/j.jamda.2024.105155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 07/17/2024]
Abstract
OBJECTIVES The global increase in the older population, which is expected to reach 1.5 billion by 2050, poses significant challenges for publicly funded health care systems. Life expectancy, although positive, is leading to an increase in chronic diseases requiring complex and costly health and social solutions. This study explores key strategies to address these challenges. DESIGN Qualitative interviews followed by a survey. SETTING AND PARTICIPANTS The study involved experts, students, artificial intelligence, and participants at a congress. METHODS We first interviewed 5 experts from different countries representing health care management and psychology from Belgium, health economics from Canada, sociology from France, and geriatrics from Switzerland. In addition, a focus group session with medical students in physical therapy and queries to ChatGPT increased the range of perspectives. A synthesis of all opinions or insights was used to formulate concrete strategies. These strategies were incorporated into an online survey that was distributed to 215 participants of the Geriatric and Gerontologic Congress in Montreal, Canada, in September 2023. RESULTS All 20 potential solutions were duly acknowledged, with particular attention paid to the following 5 priorities: the urgent need to integrate geriatric training into the education of future health professionals, the promotion of home-based care models, the establishment of comprehensive and integrated care systems, the strengthening of primary care services, and the emphasis on primary prevention strategies. CONCLUSION AND IMPLICATIONS This study highlights key priorities for addressing the health needs of the older population. By emphasizing education, home-based care, and integrated services and strengthening primary care and prevention, health systems can respond effectively to the challenges of an ageing population. Although these needs may not be entirely unmet, they indicate areas where existing services are insufficient in providing adequate coverage and support to ensure tailored and sustainable health care solutions for older people.
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Affiliation(s)
- Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium; Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium.
| | - Céline Demonceau
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, Research Unit in Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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Do You Feel Safe at Home? A Qualitative Study among Home-Dwelling Older Adults with Advanced Incurable Cancer. Healthcare (Basel) 2022; 10:healthcare10122384. [PMID: 36553908 PMCID: PMC9778052 DOI: 10.3390/healthcare10122384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/14/2022] [Accepted: 11/20/2022] [Indexed: 11/29/2022] Open
Abstract
Many older adults with cancer prefer to live at home, and home treatment and outpatient care have been recommended for such patients. To improve their mental health, it is important to identify the challenges that are faced by home-dwelling older adults with cancer. This study aimed to examine the impact of the home on older adults with advanced cancer who were receiving treatment and follow-up care. In a cross-sectional design with criterion-based sampling, eight qualitative interviews were transcribed and interpreted thematically. We identified three themes of home-safety management: good home-safety management, uncertain home-safety management, and home-safety management collapse. Moreover, we revealed eight sub-themes important to the participants' home-safety experience. Ensuring that older adults feel safe at home will afford them the opportunity to enjoy living at home, which in turn may alleviate their symptom burden and enhance their mental health.
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Pereira RCA, Moreira MÂL, Costa IPDA, Tenório FM, Barud NA, Fávero LP, Al-Qudah AA, Gomes CFS, dos Santos M. Feasibility of a Hospital Information System for a Military Public Organization in the Light of the Multi-Criteria Analysis. Healthcare (Basel) 2022; 10:2147. [PMID: 36360488 PMCID: PMC9690232 DOI: 10.3390/healthcare10112147] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 07/29/2023] Open
Abstract
The healthcare environment presents a large volume of personal and sensitive patient data that needs to be available and secure. Information and communication technology brings a new reality to healthcare, promoting improvements, agility and integration. Regarding high-level and complex decision-making scenarios, the Brazilian Navy (BN), concerning its healthcare field, is seeking to provide better management of its respective processes in its hospital facilities, allowing accurate control of preventive and curative medicine to members who work or have served there in past years. The study addresses the understanding, structure and clarifying variables related to the feasibility of technological updating and installing of a Hospital Information System (HIS) for BN. In this scenario, through interviews and analysis of military organization business processes, criteria and alternatives were established based on multi-criteria methodology as a decision aid. As methodological support for research and data processing, THOR 2 and PROMETHEE-SAPEVO-M1 methods were approached, both based on the scenarios of outranking alternatives based on the preferences established by the stakeholders in the problem. As a result of the methodological implementation, we compare the two implemented methods in this context, exposing the Commercial Software Purchase and Adoption of Free Software, integrated into Customization by the Marine Studies Foundation, as favorable actions to be adopted concerning HIS feasibility. This finding generates a comprehensive discussion regarding the BN perspective and changes in internal development in the military environment, prospecting alignment to the culture of private organizations in Information Technology for healthcare management. In the end, we present some conclusions concerning the study, exploring the main points of the decision-making analysis and for future research.
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Affiliation(s)
| | - Miguel Ângelo Lellis Moreira
- Production Engineering Department, Federal Fluminense University, Rio de Janeiro 24210-240, Brazil
- Operational Research Department, Naval Systems Analysis Centre, Rio de Janeiro 20091-000, Brazil
| | - Igor Pinheiro de Araújo Costa
- Production Engineering Department, Federal Fluminense University, Rio de Janeiro 24210-240, Brazil
- Operational Research Department, Naval Systems Analysis Centre, Rio de Janeiro 20091-000, Brazil
| | - Fabrício Maione Tenório
- Production Engineering Department, Federal Fluminense University, Rio de Janeiro 24210-240, Brazil
| | - Naia Augusto Barud
- Production Engineering Department, Federal Fluminense University, Rio de Janeiro 24210-240, Brazil
| | - Luiz Paulo Fávero
- School of Economics, Business and Accounting, University of São Paulo, Sao Paulo 05508-010, Brazil
| | - Anas Ali Al-Qudah
- Faculty of Business, Liwa College of Technology, Abu Dhabi 51133, United Arab Emirates
| | | | - Marcos dos Santos
- Production Engineering Department, Federal Fluminense University, Rio de Janeiro 24210-240, Brazil
- Operational Research Department, Naval Systems Analysis Centre, Rio de Janeiro 20091-000, Brazil
- Systems and Computing Department, Military Institute of Engineering, Rio de Janeiro 22290-270, Brazil
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Gandarillas MÁ, Goswami N. Diversity of Hemodynamic Reactive Profiles across Persons—Psychosocial Implications for Personalized Medicine. J Clin Med 2022; 11:jcm11133869. [PMID: 35807154 PMCID: PMC9267141 DOI: 10.3390/jcm11133869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022] Open
Abstract
This study analyzed the individual differences in hemodynamic time patterns and reactivity to cognitive and emotional tasks, and explored the diversity of psycho-physiological profiles that could be used for the personalized prediction of different diseases. An analysis of heart rate (HR)—blood pressure (BP) relationship patterns across time using cross-correlations (CCs) during a logical-mathematical task and a task recalling negative emotions (rumination) was carried out in a laboratory setting on 45 participants. The results showed maximum HR–BP CCs during the mathematical task significantly more positive than the maximum HR–BP CCs during the rumination task. Furthermore, our results showed a large variety of hemodynamic reactivity profiles across the participants, even when carrying out the same tasks. The most frequent type showed positive HR–BP CCs under cognitive activity, and several positive–negative HR–BP CCs cycles under negative emotional activity. In general terms, our results supported the main hypothesis. We observed some distinct time-based “coordination strategies” in the reactivity of the autonomic nervous system under emotional vs. cognitive loading. Overall, large individual, as well as situational, specificities in hemodynamic reactivity time patterns were seen. The possible relationships between this variety of profiles and different psychosocial characteristics, and the potential for integrative predictive health within the provision of highly personalized medicine, are discussed.
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Affiliation(s)
- Miguel Ángel Gandarillas
- Department of Social, Work, and Differential Psychology, School of Psychology, Complutense University of Madrid, Campus de Somosagua, Ctra. de Húmera, s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- Correspondence: ; Tel.: +34-626-125-229
| | - Nandu Goswami
- Physiology Division, Otto Loewi Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, 8036 Graz, Austria;
- Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai P.O. Box 505055, United Arab Emirates
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Global research trends in perioperative care for the elderly: a bibliometric and visualized study. J Anesth 2022; 36:210-220. [PMID: 34994826 DOI: 10.1007/s00540-021-03033-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 12/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Aged surgical patients are at a relatively higher risk of morbidity and mortality than younger surgical patients. The present study aimed to investigate the trends and research status of perioperative care for the elderly in the anesthesiology field. METHODS We screened manuscripts published between May 31, 1991, and May 31, 2020, from the Web of Science Core Collection (WoSCC). A clustered network was derived from all references cited in all of the included manuscripts. The top authors, journals, institutions, countries, keywords, co-cited articles, and trends were identified through bibliometric analysis and visualization using CiteSpace 5.8.R3 and VOSviewer 1.6.15. RESULTS We included a total of 1860 manuscripts published between 1991 and 2020. The number of publications on perioperative care for the elderly sharply increased from 2014 onwards. The United States of America and the University of California, San Francisco were the leading publication country (24.8%, 461/1860) and institution (2.6%, 48/1860), respectively. High-frequency keywords in cluster analysis included the type of anesthesia, postoperative pain management, postoperative cognitive dysfunction, and postoperative delirium, indicating postoperative cognitive dysfunction and postoperative delirium remain the focus areas for research in perioperative care for the elderly. Organ function protection was the new research focus according to the burst detection analysis of top keywords. CONCLUSIONS The number of studies on perioperative care for the elderly has increased apparently worldwide. Postoperative cognitive dysfunction and postoperative delirium remain primary research focus areas. Organ function protection appears to be the second most highly researched topic in the perioperative care for the elderly.
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Bogataj D, Bogataj M, Kavšek M. Development Dynamics of Health and Social Infrastructure for the Long-term Care - the Case of the Posavje Region. Zdr Varst 2021; 60:269-277. [PMID: 34917196 PMCID: PMC8643109 DOI: 10.2478/sjph-2021-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE The populations of rural areas across Europe, especially Slovenia, are ageing rapidly and the areas themselves are becoming depopulated. Therefore, this study aims to contribute to our understanding of the population dynamics and provide a method for forecasting housing and other long-term care needs. METHOD The surveys questioned those responsible for long-term care, the caretakers in institutional care, and current and potential homecare users in rural areas of Slovenia. We wanted to discover what they considered as crucial in the process of long-term care deinstitutionalization. Our 2020-2050 projections are based on the surveys conducted across 38 municipalities in the Eastern Slovenian region and an in-depth empirical study in Posavje. The results are embedded in the demographic projections and the multistate transition model of the declining functional capacities to forecast the needed housing facilities and human resources. RESULTS The results are the time series of required capacities. Around 60% of respondents in Slovenian rural areas believe that even a better organization of homecare would not allow them to stay at home until death due to inadequately built housing and the absence of a continuous presence of caregivers. These findings were included in the projections. Therefore, community care in the network of Smart Silver Villages was proposed. DISCUSSION Investments are needed to renovate the housing stock of older adults and construct sheltered, assisted living housing and specialized households in the community. Moreover, proper education and training of human resources would increase the output. In addition, financial solutions are advised to develop Smart Silver Villages.
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Affiliation(s)
- David Bogataj
- University of Ljubljana, Faculty of Economy, Kardeljeva pološčad 17, 1000Ljubljana, Slovenia
- Institute INRISK, Kidričeva 1, 8210Trebnje, Slovenia
| | - Marija Bogataj
- University of Ljubljana, Faculty of Economy, Kardeljeva pološčad 17, 1000Ljubljana, Slovenia
| | - Marta Kavšek
- Institute INRISK, Kidričeva 1, 8210Trebnje, Slovenia
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Martyushev-Poklad A, Yankevich D. Patent Landscape of Automated Systems for Personalized Health Management (ASHM): Features, Shortcomings, and Implications for Developing an Optimal ASHM. Front Digit Health 2021; 3:579936. [PMID: 34713081 PMCID: PMC8522012 DOI: 10.3389/fdgth.2021.579936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/26/2021] [Indexed: 11/15/2022] Open
Abstract
The current struggle of national health care systems against global epidemic of non-communicable diseases (NCD) is both clinically ineffective and cost ineffective. On the other hand, rapid development of systems biology, P4 medicine and new digital and communication technologies are good prerequisites for creating an affordable and scalable automated system for personalized health management (ASHM). The current practice of ASHM is better represented in patent literature (36 relevant documents found in Google Patents and USPTO) than in scientific papers (17 documents found in PubMed and Google Scholar). However, only a small fraction of publications disclose a complete self-sufficient system. Problems that authors of ASHM aim to address, methodological approaches, and the most important technical solutions are reviewed and discussed along with shortcomings and limitations. Technical solutions for ASHM currently commercialized or described in literature generally fail to enable practicable, scalable and affordable automated and individualized screening, monitoring, prevention and correction of human health conditions. They also fail to provide a decision support system to patients that would help effectively prevent major NCD and their complications, be accessible and cost effective, consider individual lifestyle factors and involve patients in management of their individual health. Based on analysis of the literature, models of health and care, we propose conceptual framework for developing an ASHM that would be free from the mentioned problems.
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Affiliation(s)
- Andrey Martyushev-Poklad
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Dmitry Yankevich
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
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Raja M, Bjerkan J, Kymre IG, Galvin KT, Uhrenfeldt L. Telehealth and digital developments in society that persons 75 years and older in European countries have been part of: a scoping review. BMC Health Serv Res 2021; 21:1157. [PMID: 34696789 PMCID: PMC8546957 DOI: 10.1186/s12913-021-07154-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/11/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Demographic changes are leading to an ageing population in Europe. People are becoming more dependent on digital technologies and health ministries invest increasingly in digitalisation. Societal digital demands impact older people and learning to use new telehealth systems and digital devices are seen as a means of securing their needs. METHODS The present study undertakes a scoping review in order to map relevant evidence about telehealth and digital developments in society involving citizens aged 75 and over in European countries. It focuses on their experiences and the main barriers to, and facilitators of, societal digital demands. A framework proposed by Arksey and O`Malley was used to guide the scoping review process. The studies included in the review covered telehealth, digital technology and digital devices, and the context covered participants` own home or surroundings. A comprehensive search on PubMed/MEDLINE, CINAHL, Scopus, Embase and Open Grey was undertaken. RESULTS Out of 727 identified citations, 13 sources which met the inclusion criteria (9 original study articles, 2 theses, 1 letter about a product and 1 project report). Few of the studies identified have investigated European citizens 75 years and older separately. The studies included varied in their design, location and focus. Older people have experienced both telehealth and digital devices making life easier and the opposite. The outstanding facilitator found was that technology should be easy to use, and difficulty in remembering the instructions was seen as an important barrier. Interestingly, both social support and lack of social support were found as facilitators of using new devices. CONCLUSIONS Telehealth may give a sense of security but learning to use a new device often takes extra effort. Older people were more open to new devices if the possible advantages of the new technology outweighed the effort that would be involved in adopting a new strategy. As technology develops rapidly, and life expectancy in Europe is anticipated to rise continually, there is a need for new and additional research among older European citizens. Future research should cover the technical solutions most relevant to older people today, social support and participants` access to the devices.
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Affiliation(s)
- Moonika Raja
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Jorunn Bjerkan
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Ingjerd G. Kymre
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Kathleen T. Galvin
- School of Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Lisbeth Uhrenfeldt
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
- Danish Centre of Systematic Reviews, a Joanna Briggs Institute Centre of Excellence, Centre of Clinical Guidelines, Aalborg University, Aalborg, Denmark
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Kim H, Kelly S, Lafortune L, Brayne C. A Scoping Review of the Conceptual Differentiation of Technology for Healthy Aging. THE GERONTOLOGIST 2021; 61:e345-e369. [PMID: 32725147 PMCID: PMC8437509 DOI: 10.1093/geront/gnaa051] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES With the emergence of healthy aging as a key societal issue in recent decades, technology has often been proposed as a solution to the challenges faced by aging societies. From a public health perspective, however, aging-related technologies have been inconsistently conceptualized and ill-defined. By examining how relevant concepts in "technology for aging" have been developed to date, we hope to identify gaps and begin clarifying the topic. RESEARCH DESIGN AND METHODS We conducted a scoping review according to PRISMA-ScR, drawing on PubMed and Embase. We selected articles that directly reported concepts of technology for aging, or from which such concepts could be inferred. RESULTS We identified 43 articles, most of which were narrative reviews (n = 31). Concepts of technology for aging were presented in diverse ways with some overlap. Most studies provided some terminology (n = 36), but with little conceptual uniformity. Conceptual discourse was often focused on the aging agenda; while technological aspects were poorly defined. A conceptual framework from a public health perspective was derived from 8 articles-it showed that technology strategies do not take a population approach. DISCUSSION AND IMPLICATIONS While the potential of "technology for aging" is vast, its real capacity to deliver a desirable life for older people remains underdeveloped. Clearer concepts and realistic goals at population level are lacking. Efficient investment must be made throughout the social system, and technology needs to be integrated via macro-level practices.
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Affiliation(s)
- Hansuk Kim
- Cambridge Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK.,Ministry of Health and Welfare, Sejong, Republic of Korea
| | - Sarah Kelly
- Cambridge Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK.,THIS Institute, University of Cambridge, Cambridge, UK
| | - Louise Lafortune
- Cambridge Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Cambridge Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Gibbs JF, Guarnieri E, Chu QD, Murdoch K, Asif A. Value-based chronic care model approach for vulnerable older patients with multiple chronic conditions. J Gastrointest Oncol 2021; 12:S324-S338. [PMID: 34422397 PMCID: PMC8343083 DOI: 10.21037/jgo-20-317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 09/21/2020] [Indexed: 12/30/2022] Open
Abstract
"Old age, itself, is not a disease" (Suborne 2007). The rising rate of the global aging population is predicted to create a health care crisis within the next three decades. Vulnerable older adults suffer from multiple chronic conditions (MCCs) in addition to cognitive and physical decline during the process of aging resulting in an inability to optimally achieve self-management. In terms of resource utilization, complex inpatient, and outpatient care results in higher physician visits, polypharmacy, and higher prescription costs. Health literacy has become known as an important social determinant of health affecting the older population. Both reductions in health literacy and self-management are associated with poorer health outcomes. The patient activation measure (PAM) has been coined "a vital sign" to ascertain a patient activation level throughout the continuum of care with the introduction of an intervention's progress. In this review, we conceptualize a systematic approach of the development of a "tailored" integrated community and care team to develop a partnership in assisting senior adults with MCCs. Through this intervention the value-based chronic care model (CCM) and PAM allows for an adaptable integration between the activated patient, their caregivers, and the community. The Model for Improvement (MFI) serves as a well-recognized technique for developing and executing quality improvement strategies in this "tailored" engaged and activated individual and community care team approach in achieving health outcomes and quality of life among the vulnerable older adult population worldwide.
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Affiliation(s)
- John F. Gibbs
- Department of Surgery, Hackensack Meridian Health School of Medicine at Seton Hall University, Nutley, NJ, USA
| | - Ellen Guarnieri
- Department of Healthcare Quality and Safety, Thomas Jefferson University College of Population Health, Philadelphia, PA, USA
| | - Quyen D. Chu
- Department of Surgery, LSU-Shreveport School of Medicine, Shreveport, LA, USA
| | - Kenneth Murdoch
- Department of Nursing, Jersey Shore University Medical Center, Neptune, NJ, USA
| | - Arif Asif
- Department of Medicine, Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA
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Fernandes BCG, Silva Júnior JNDB, Guedes HCDS, Macedo DBG, Nogueira MF, Barrêto AJR. Use of technologies by nurses in the management of primary health care. ACTA ACUST UNITED AC 2021; 42:e20200197. [PMID: 34037179 DOI: 10.1590/1983-1447.2021.20200197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/22/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyze the management actions of nurses in Primary Health Care services from the perspective of technologies. METHOD Descriptive-exploratory study with a quantitative approach, carried out from February to April 2019. Through the snowball technique, the sample consisted of 42 nurses from Primary Health Care, using an electronic tool for data collection. The data were analyzed using descriptive statistics techniques. RESULTS 54.8% of nurses use technologies through SISREG and PEC electronic systems, care training related to permanent health education, online and face-to-face courses, in addition to care technologies such as telehealth and telemedicine. CONCLUSION Management actions focused on technology showed restricted use. Nurses need to empower themselves with these organizational devices, with the aim of improving the provision and quality of care for users.
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Kalantari AR, Mehrolhassani MH, Shati M, Dehnavieh R. Health service delivery models for elderly people: A systematic review. Med J Islam Repub Iran 2021; 35:21. [PMID: 34169033 PMCID: PMC8214038 DOI: 10.47176/mjiri.35.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Current Health care delivery systems are not effective for the elderly. Countries with high elderly populations are expected to design special models to serve their elderly population. The aim of this study is to investigate the models of health care delivery to the elderly in different countries.
Methods: The present study is a systematic review based on PRISMA standard guidelines. The search for related studies was conducted in electronic databases (Cochran Library, Scopus, PubMed, Embase, Web of Science) and the Google Scholar search engine without time limits until May 2019. Keywords were extracted based on MeSH strategies. At first, 16243 articles were found. After the screening phase (elimination of duplicated articles, title screening, abstract screening, and full-text screening) 19 articles remained. Two articles deleted after text appraisal using the CASP checklist. In the next stage, after reviewing the gray literature and reviewing the references of remaining articles, three new articles were added (Included studies = 20).
Results: Twenty articles (models) corresponding to the study objectives were finally extracted. These models are limited to nine countries and most have local scopes. These models mainly use a case manager, an intra- or inter-disciplinary team, and an elderly assessment tool in their structure. In addition to the use of an information system, these models provide a wide range of services to the elderly.
Conclusion: Most of the models mentioned are local models. Smaller models to become applicable at the national level, they need to be reviewed and evaluated by policymakers and experts. Given the inefficiency of current systems in providing services to the elderly, it is recommended that countries use an integrated model of health care provision for the elderly.
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Affiliation(s)
- Ali Reza Kalantari
- Department of Health Management, Policy and Economics, Faculty of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Hossein Mehrolhassani
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohsen Shati
- Mental Health Research Center, Tehran Institute of Psychiatry-School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Dehnavieh
- Health Foresight and Innovation Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Fabiani E, Herc M, Šimunič B, Brix B, Löffler K, Weidinger L, Ziegl A, Kastner P, Kapel A, Goswami N. Correlation between timed up and go test and skeletal muscle tensiomyography in female nursing home residents. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2021; 21:247-254. [PMID: 34059569 PMCID: PMC8185258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Tensiomyography (TMG) derived contraction time (Tc) and amplitude (Dm) are related to muscle fibre composition and to muscle atrophy/tone, respectively. However, the link between mobility and TMG-derived skeletal muscle contractile properties in older persons is unknown. The aim of the study was to correlate lower limb skeletal muscle contractile properties with balance and mobility measures in senior female residents of retirement homes in Austria. METHODS Twenty-eight female participants (aged from 67-99 years) were included in measurements of contractile properties (TMG) of four skeletal muscles: vastus lateralis, vastus medialis, biceps femoris and gastrocnemius medialis. Their balance and mobility performance was measured using a timed up and go test (TUG). RESULTS Time needed to complete TUG is negatively correlated to biceps femoris (r= -0.490; p= 0.008), vastus lateralis (r= -0.414; p=0.028) and vastus medialis (r= -0.353; p=0.066) Dm and positively correlated to vastus lateralis Tc (r=0.456; p=0.015). Overall, vastus lateralis Tc and vastus medialis Dm explained 37% of TUG time variance. CONCLUSIONS Our study demonstrates that TMG-derived quadriceps muscle contractile parameters are correlated with the balance and mobility function in female nursing home residents.
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Affiliation(s)
- Ester Fabiani
- Alma Mater Europaea ECM, Maribor, Slovenia,Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Boštjan Šimunič
- Alma Mater Europaea ECM, Maribor, Slovenia,Science and Research Centre Koper, Koper, Slovenia,Corresponding authors: Boštjan Šimunič, Science and Research Centre Koper, Garibaldijeva 1, Koper, Slovenia E-mail:
| | - Bianca Brix
- Head of Gravitational Physiology and Medicine Research Unit, Physiology Division, Medical University of Graz, Graz, Austria
| | - Kerstin Löffler
- Geriatrische Gesundheitszentren der Stadt Graz, Graz Austria
| | - Lisa Weidinger
- Geriatrische Gesundheitszentren der Stadt Graz, Graz Austria
| | - Andreas Ziegl
- AIT Austrian Institute of Technology GmbH, Graz, Austria,Institute of Neural Engineering, Graz University of Technology, Graz, Austria
| | - Peter Kastner
- AIT Austrian Institute of Technology GmbH, Graz, Austria
| | - Alen Kapel
- Alma Mater Europaea ECM, Maribor, Slovenia,Modus Medical, Maribor, Slovenia
| | - Nandu Goswami
- Alma Mater Europaea ECM, Maribor, Slovenia,Head of Gravitational Physiology and Medicine Research Unit, Physiology Division, Medical University of Graz, Graz, Austria,Nandu Goswami, Medical University of Graz, Neue Stitftingtalstrasse 6, 5-D, Graz, Austria E-mail:
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14
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Abstract
Background:
Breast cancer is one of the diseases which cause number of deaths ever
year across the globe, early detection and diagnosis of such type of disease is a challenging task in
order to reduce the number of deaths. Now a days various techniques of machine learning and data
mining are used for medical diagnosis which has proven there metal by which prediction can be
done for the chronic diseases like cancer which can save the life’s of the patients suffering from
such type of disease. The major concern of this study is to find the prediction accuracy of the classification
algorithms like Support Vector Machine, J48, Naïve Bayes and Random Forest and to
suggest the best algorithm.
Objective:
The objective of this study is to assess the prediction accuracy of the classification algorithms
in terms of efficiency and effectiveness.
Methods:
This paper provides a detailed analysis of the classification algorithms like Support Vector
Machine, J48, Naïve Bayes and Random Forest in terms of their prediction accuracy by applying
10 fold cross validation technique on the Wisconsin Diagnostic Breast Cancer dataset using
WEKA open source tool.
Results:
The result of this study states that Support Vector Machine has achieved the highest prediction
accuracy of 97.89 % with low error rate of 0.14%.
Conclusion:
This paper provides a clear view over the performance of the classification algorithms
in terms of their predicting ability which provides a helping hand to the medical practitioners
to diagnose the chronic disease like breast cancer effectively.
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Affiliation(s)
- Somil Jain
- Department of Computer Science and Engineering, Mody University of Science and Technology, Lakshmangarh, Rajasthan, India
| | - Puneet Kumar
- Department of Computer Science and Engineering, Mody University of Science and Technology, Lakshmangarh, Rajasthan, India
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15
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Sadek I, Heng TTS, Seet E, Abdulrazak B. A New Approach for Detecting Sleep Apnea Using a Contactless Bed Sensor: Comparison Study. J Med Internet Res 2020; 22:e18297. [PMID: 32945773 PMCID: PMC7532465 DOI: 10.2196/18297] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/10/2020] [Accepted: 07/26/2020] [Indexed: 01/26/2023] Open
Abstract
Background At present, there is an increased demand for accurate and personalized patient monitoring because of the various challenges facing health care systems. For instance, rising costs and lack of physicians are two serious problems affecting the patient’s care. Nonintrusive monitoring of vital signs is a potential solution to close current gaps in patient monitoring. As an example, bed-embedded ballistocardiogram (BCG) sensors can help physicians identify cardiac arrhythmia and obstructive sleep apnea (OSA) nonintrusively without interfering with the patient’s everyday activities. Detecting OSA using BCG sensors is gaining popularity among researchers because of its simple installation and accessibility, that is, their nonwearable nature. In the field of nonintrusive vital sign monitoring, a microbend fiber optic sensor (MFOS), among other sensors, has proven to be suitable. Nevertheless, few studies have examined apnea detection. Objective This study aims to assess the capabilities of an MFOS for nonintrusive vital signs and sleep apnea detection during an in-lab sleep study. Data were collected from patients with sleep apnea in the sleep laboratory at Khoo Teck Puat Hospital. Methods In total, 10 participants underwent full polysomnography (PSG), and the MFOS was placed under the patient’s mattress for BCG data collection. The apneic event detection algorithm was evaluated against the manually scored events obtained from the PSG study on a minute-by-minute basis. Furthermore, normalized mean absolute error (NMAE), normalized root mean square error (NRMSE), and mean absolute percentage error (MAPE) were employed to evaluate the sensor capabilities for vital sign detection, comprising heart rate (HR) and respiratory rate (RR). Vital signs were evaluated based on a 30-second time window, with an overlap of 15 seconds. In this study, electrocardiogram and thoracic effort signals were used as references to estimate the performance of the proposed vital sign detection algorithms. Results For the 10 patients recruited for the study, the proposed system achieved reasonable results compared with PSG for sleep apnea detection, such as an accuracy of 49.96% (SD 6.39), a sensitivity of 57.07% (SD 12.63), and a specificity of 45.26% (SD 9.51). In addition, the system achieved close results for HR and RR estimation, such as an NMAE of 5.42% (SD 0.57), an NRMSE of 6.54% (SD 0.56), and an MAPE of 5.41% (SD 0.58) for HR, whereas an NMAE of 11.42% (SD 2.62), an NRMSE of 13.85% (SD 2.78), and an MAPE of 11.60% (SD 2.84) for RR. Conclusions Overall, the recommended system produced reasonably good results for apneic event detection, considering the fact that we are using a single-channel BCG sensor. Conversely, satisfactory results were obtained for vital sign detection when compared with the PSG outcomes. These results provide preliminary support for the potential use of the MFOS for sleep apnea detection.
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Affiliation(s)
- Ibrahim Sadek
- AMI-Lab, Computer Science Department, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Sherbrooke, QC, Canada.,Biomedical Engineering Dept, Faculty of Engineering, Helwan University, Helwan, Cairo, Egypt
| | - Terry Tan Soon Heng
- Department of Otolaryngology, Woodlands Health Campus and Khoo Teck Puat Hospital, Singapore, Singapore
| | - Edwin Seet
- Department of Anaesthesia, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Bessam Abdulrazak
- AMI-Lab, Computer Science Department, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Sherbrooke, QC, Canada
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16
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Barrett M, Boyne J, Brandts J, Brunner-La Rocca HP, De Maesschalck L, De Wit K, Dixon L, Eurlings C, Fitzsimons D, Golubnitschaja O, Hageman A, Heemskerk F, Hintzen A, Helms TM, Hill L, Hoedemakers T, Marx N, McDonald K, Mertens M, Müller-Wieland D, Palant A, Piesk J, Pomazanskyi A, Ramaekers J, Ruff P, Schütt K, Shekhawat Y, Ski CF, Thompson DR, Tsirkin A, van der Mierden K, Watson C, Zippel-Schultz B. Artificial intelligence supported patient self-care in chronic heart failure: a paradigm shift from reactive to predictive, preventive and personalised care. EPMA J 2019; 10:445-464. [PMID: 31832118 PMCID: PMC6882991 DOI: 10.1007/s13167-019-00188-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/23/2019] [Indexed: 12/23/2022]
Abstract
Heart failure (HF) is one of the most complex chronic disorders with high prevalence, mainly due to the ageing population and better treatment of underlying diseases. Prevalence will continue to rise and is estimated to reach 3% of the population in Western countries by 2025. It is the most important cause of hospitalisation in subjects aged 65 years or more, resulting in high costs and major social impact. The current "one-size-fits-all" approach in the treatment of HF does not result in best outcome for all patients. These facts are an imminent threat to good quality management of patients with HF. An unorthodox approach from a new vision on care is required. We propose a novel predictive, preventive and personalised medicine approach where patients are truly leading their management, supported by an easily accessible online application that takes advantage of artificial intelligence. This strategy paper describes the needs in HF care, the needed paradigm shift and the elements that are required to achieve this shift. Through the inspiring collaboration of clinical and high-tech partners from North-West Europe combining state of the art HF care, artificial intelligence, serious gaming and patient coaching, a virtual doctor is being created. The results are expected to advance and personalise self-care, where standard care tasks are performed by the patients themselves, in principle without involvement of healthcare professionals, the latter being able to focus on complex conditions. This new vision on care will significantly reduce costs per patient while improving outcomes to enable long-term sustainability of top-level HF care.
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Affiliation(s)
- Matthew Barrett
- University College of Dublin, Catherine McAuley Education & Research Centre, Mater Misericordiae University Hospital, Nelson Street, Dublin, 7 Ireland
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, PO Box 5800, 6202AZ Maastricht, The Netherlands
| | - Julia Brandts
- Department of Cardiology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Hans-Peter Brunner-La Rocca
- Department of Cardiology, Maastricht University Medical Center, PO Box 5800, 6202AZ Maastricht, The Netherlands
| | | | - Kurt De Wit
- Thomas More University of Applied Science, Kleinhoefstraat 4, 2240 Geel, Belgium
| | - Lana Dixon
- Belfast Health and Social Care Trust, A Floor, Belfast City Hospital, Lisburn Rd, Belfast, BT9 7AB UK
| | - Casper Eurlings
- Department of Cardiology, Maastricht University Medical Center, PO Box 5800, 6202AZ Maastricht, The Netherlands
| | | | - Olga Golubnitschaja
- Radiological Clinic, Universitätsklinikum Bonn, Excellence University of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Arjan Hageman
- Sananet Care BV, Rijksweg Zuid 37, 6131AL Sittard, Netherlands
| | | | - André Hintzen
- Department of Cardiology, Maastricht University Medical Center, PO Box 5800, 6202AZ Maastricht, The Netherlands
| | - Thomas M. Helms
- German Foundation for the Chronically Ill, Alexanderstrasse 26, 90762 Fürth, Germany
| | - Loreena Hill
- Queen’s University Belfast, 97 Lisburn Rd, Belfast, BY9 7BL UK
| | | | - Nikolaus Marx
- Department of Cardiology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Kenneth McDonald
- University College of Dublin, Catherine McAuley Education & Research Centre, Mater Misericordiae University Hospital, Nelson Street, Dublin, 7 Ireland
| | - Marc Mertens
- Thomas More University of Applied Science, Kleinhoefstraat 4, 2240 Geel, Belgium
| | - Dirk Müller-Wieland
- Department of Cardiology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Alexander Palant
- German Foundation for the Chronically Ill, Alexanderstrasse 26, 90762 Fürth, Germany
| | - Jens Piesk
- Nurogames GmbH, Schaafenstrasse 25, 50676 Cologne, Germany
| | | | - Jan Ramaekers
- Sananet Care BV, Rijksweg Zuid 37, 6131AL Sittard, Netherlands
| | - Peter Ruff
- Exploris AG, Tödistrasse 52, 8002 Zürich, Switzerland
| | - Katharina Schütt
- Department of Cardiology, University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Yash Shekhawat
- Nurogames GmbH, Schaafenstrasse 25, 50676 Cologne, Germany
| | - Chantal F. Ski
- Queen’s University Belfast, 97 Lisburn Rd, Belfast, BY9 7BL UK
| | | | | | | | - Chris Watson
- Queen’s University Belfast, 97 Lisburn Rd, Belfast, BY9 7BL UK
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17
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Marusic U, Kavcic V, Pisot R, Goswami N. The Role of Enhanced Cognition to Counteract Detrimental Effects of Prolonged Bed Rest: Current Evidence and Perspectives. Front Physiol 2019; 9:1864. [PMID: 30728781 PMCID: PMC6351441 DOI: 10.3389/fphys.2018.01864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 12/11/2018] [Indexed: 12/29/2022] Open
Abstract
Prolonged periods of physical inactivity or bed rest can lead to a significant decline of functional and cognitive functions. Different kinds of countermeasures (e.g., centrifugation, nutritional, and aerobic interventions) have been developed to attempt to mitigate negative effects related to bed rest confinement. The aim of this report is to provide an overview of the current evidence related to the effectiveness of computerized cognitive training (CCT) intervention during a period of complete physical inactivity in older adults. CCT, using a virtual maze navigation task, appears to be effective and has long-lasting benefits (up to 1.5 years after the study). Moreover, enhanced cognition (executive control) reduces decline in the ability to perform complex motor-cognitive dual-tasks after prolonged period of bed rest. It has been demonstrated that CCT administration in older adults also prevents bed rest stress-related physiological changes [these groups showed minimal changes in vascular function and an unchanged level of brain-derived neurotrophic factor (BDNF)] while control subjects showed decreased peripheral vascularization and increased plasma level of the neurotrophin BDNF during a 14-day bed rest. In addition, the effects of CCT are evident also from the brain electrocortical findings: CCT group revealed a decreased power in lower delta and theta bands while significant increases in the same EEG spectral bands power were found in control subjects. If we consider an increase of power in delta band as a marker of cortical aging, then the lack of shift of EEG power to lower band indicates a preventive role of CCT on the cortical level during physiological deconditioning induced by 2-week bed rest immobilization. However, replication on a larger sample is required to confirm the observed findings. Applications derived from these findings could be appropriate for implementation of hospital treatment for bed ridden patients as well as for fall prevention programs.
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Affiliation(s)
- Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia
| | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
| | - Rado Pisot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Nandu Goswami
- Department of Health Sciences, Alma Mater Europaea - European Center Maribor, Maribor, Slovenia.,Head of Research Unit: "Gravitational Physiology, Aging and Medicine", Otto Loewi Research Center of Vascular Biology, Immunity and Inflammation, Medical University of Graz, Graz, Austria
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