bluuebunny/crossref_metadata_2025 huggingface dataset:
Geriatrik Yaş Grubunda Hukuki İşlemlerde Sağlık Raporu Alınması Zorunlu mu?
Authors: KETEN Hamit Sırrı
Published: May 2020

Dünyada insanların yaşam sürelerinin uzayarak 2019 yılı için 72,6, 2050 yılı için ise 77,1 yıl olması beklenmektedir. Türkiye’de 65 yaş ve üzerindeki nüfusun, toplam nüfus içerisinde oranının 2023'de % 10,2, 2040'da %16,3, 2060'da %22,6 olacağı öngörülmektedir. Bu sebeple 65 yaş ve üzeri gruba yönelik işlemler büyük öneme sahiptir. Altmış beş yaş üstü kişilerden, hukuki işlemler için ilgili dairelerden (noter, tapu) rutin olarak sağlık raporu (akli meleke) istenmektedir. Bu bireyler, bu raporlar için ilk olarak sağlık sisteminin giriş kapısı olan aile sağlığı merkezlerine başvuruda bulunmaktadır. Sağlık raporu düzenleme konusunda hekimlere yetki ve sorumluluklar verilmiştir. Altmış beş yaş üzerindeki bireylerin tümünden hukuki işlemler için sağlık raporu istenmesi, kişinin özerkliğini ihlal eden ve yeterliliğini sorgulamaya açan, olumsuz sonuçlara sebep olabilecek bir uygulamadır. Bu durum iş yükü fazla olan başta aile hekimleri olmak üzere, diğer uzman hekimlerin iş yükünü arttırmakta ve ekonomik olarak devlete külfet doğurmaktadır. Yasal mevzuatta 65 yaş ve üzeri kişilere yönelik hukuki işlem gerçekleştirmede zorunlu bir sağlık raporu düzenlemesi bulunmamaktadır. Buna rağmen hala geriatrik bireylerden rutin olarak bu rapor istenmektedir. Sağlık Bakanlığı ve Adalet Bakanlığı’nın ilgili konuda noterlere ve tapu dairelerine eğitim vermesi, kılavuzlar geliştirmesi ve yaptırımlar uygulaması bu durumun düzelmesi için büyük öneme sahiptir.
Kadınların Kanser Taramalarına Katılımını Etkileyen Faktörler
Authors: ALTUN Yasin
Published: May 2020

Giriş: Kanser, önemli bir halk sağlığı
sorunudur. Kanser tarama birimine başvuran kadınların kanser taramasına
bakışları, tarama yaptırma durumları ve yaptırmalarına katkı sağlayan faktörler
araştırılarak kanser ile mücadelede hedefe yönelik stratejilerin geliştirilmesi
amaçlanmıştır.Yöntem: İlçe
Sağlık Müdürlüğü Kanser Birimi’ne başvuran ve çalışmaya katılmayı kabul eden
200 kadın ile çalışma yürütüldü. Kanser taraması ile ilgili durumlarının
değerlendirilmesi amacıyla 20 soruluk bir anket, onamları alınarak bireylere
uygulandı.Bulgular: Çalışmaya katılanların  %93'ü evli, çoğunluğu ev hanımı (%61) idi.
%40,5'inde en az bir kronik hastalık mevcuttu. 82 kişinin (%41) ailesinde
kanser tanısı alan kişi vardı. Kanser taraması yaptırmayan 86 kişinin %25,6'sı
"Bilmiyordum-Haberim yoktu", %25,6'sı "Yaşım taramaya uygun
değildi", %20,9'u "Fırsatım olmadı", %11,6'sı ise
"Korkuyordum" cevaplarını verdi. Aile hekimine başvurular %74,5 yeni
başlayan-kısa süreli hastalık için, %65 sürekli kullandığı ilaçları yazdırmak
için ve %41 genel muayene amaçlı idi. Kadınların %51,5'i aile hekimi
tarafından, %23'ü ebe/hemşire tarafından, %14'ü ise başka hekimler tarafından
taramalara yönlendirilmiş, %58,5'i taramayı aile hekimi/ebe/hemşire
yönlendirmesi nedeniyle, %31'i ise 
kendisi kontrol amaçlı istediği için yaptırdığını belirtti.

Sonuç: Kişilerin kanser taramaları hakkında
bilgilendirilmesi ve özellikle hekimler tarafından yönlendirilmesi ile tarama
oranları değerli şekilde artacaktır. Aile hekimi ile bireyler arasındaki ilişki
güçlendirilerek taramalara yönelik çekinceler ortadan kaldırılabilir.
Hepatosellüler Kanser Tanılı Hastalarda Trombosit Lenfosit Orani’nin Tümör Morfolojisi ve Alfa Fetoprotein ile İlişkisi
Authors: KARAOĞULLARINDAN Ümit , AKKIZ Hikmet , KURAN Sedef , USKUDAR Oguz , TASKAYNATAN Halil , DELİK Anıl
Published: May 2020

Giriş: Bu çalışmada hepatocellüler karsinom (HCC) tanılı hastalarda platelet lenfosit oranı (PLO) ile tümörün morfolojik ve klinikopatolojik özellikleri arasındaki ilişkinin belirlenmesi amaçlandı.
Yöntem: Görüntüleme yöntemleri (dinamik-trifazik CT ve dinamik-MR) ve/ve ya doku örneklemesi (biyopsi, rezeksiyon veya eksplant) ile HCC tanısı alan hastalar retrospektif olarak incelendi. Hastaların demografik özellikleri, etyolojisi, sirotik veya non-sirotik zeminde gelişmesi, tümörün morfolojik özellikleri (tumor çapı, fokalitesi, vasküler invazyon), tanı anındaki tam kan sayımı, Alfa-fetoprotein, trombosit ve lenfosit değerleri hesaplandı.
Bulgular: Çalışmaya 223 hasta dahil edildi. 223 hastanın 185 (%82,9)’i erkek , 38 (%17,1)’i kadındı. PLO ile AFP arasında pozitif korelasyon (p=0,05) saptanırken, portal ven invazyonu olan hastalarda PLO’nun istatistiksel olarak anlamlı derecede yüksek olduğu görüldü (p=0.001). PLO değeri soliter lezyonu olanlarda infiltratif gruptan anlamlı olarak fazlaydı. PLO değeri infiltratif grupta ise iki veya daha fazla nodulü olan gruptan istatistiksel anlamlı olarak fazlaydı (p=0,001). İnfiltratif tip tümör dışındaki hastalarda maksimal tümör çapı (MTD) arttıkça PLR’nin de istatistiki olarak anlamlı derece arttığı izlendi (p=0,01).
Sonuç: PLO; ucuz ve kolay ulaşılabilir bir belirteç olup; AFP , vasküler invazyon ve MTD gibi kötü prognostik faktörlerle pozitif korele olarak değişmektedir.Tümör agresifliği değerlendirmek için PLO da ek bir prognostik biyomarker olarak kullanılabilir.
Osmaniye İli Verem Savaş Dispanserliğine Başvuran Hastaların Retrospektif Değerlendirilmesi
Authors: ÖZDEMİR Mikail
Published: May 2020

Dünya Sağlık Örgütü (DSÖ) Genel Direktörü Dr. Tedros Adhanom Ghebreyesus’un da belirttiği gibi, TB sınır tanımayan, herkesin tehlike altında olabildiği, yoksulluk, yetersiz beslenme veya çatışmaların olduğu yerlerde büyüyen bir halk sağlığı sorunudur. Ülkemizin komşularının içinde bulunduğu siyasi belirsizlik, savaşlar ve göç dalgası göz önünde bulundurulduğunda, TB’nin hafife alınmaması ve dikey örgütlenme yapısından taviz vermeden hastalıkla mücadele edilmesi gerekmektedir. Bu çalışmada, Suriye’ye yakın komşu ve aynı zamanda sınırları içerisinde bir mülteci kampına ev sahipliği yapan Osmaniye’de 2005 ile 2018 yılları arasında Merkez VSD’ye kayıtlı 1107 hastanın dosyaları retrospektif olarak tanımlayıcı şekilde analiz edilmiştir. Dosyalar detaylı incelenerek yanlış tanı konan ve ‘TB değil’ olarak ayrılanlar çalışma dışı bırakılmıştır (n=50 %4,9). Ayrıca tedavi sonucu ve bir takım hastalık parametrelerine ulaşılamayan ya da hatalı girilen 57 hasta da (%5,1) çalışmaya dahil edilmemiştir. Hastaların tanı anındaki yaşı ortalama 41,3 ±18,2 iken %64’ü erkek ve %36’sı kadındır. Hastaların %94,9’u Türkiye Cumhuriyeti vatandaşı iken %5,1’i yabancı uyrukludur. Yabancı uyruklular kendi içerisinde değerlendirildiğinde %94,1’inin Suriye uyruklu olduğu saptanmıştır. Hastaların kurumumuzdaki tedavi sonucunda halen tedavisi devam eden 32 kişi çıkartıldığında; %65,1’inin tedavisinin tamamlandığı, %32,6’sının kür olduğu ve %5,6’sının ex olduğu saptanmıştır. Tedavi süresi ortalama 8,03 ± 3,60 aydır. Hastaların %53,2’sinde tedavi tamamlama ve %30,1’inde kür gözlenmiştir. Tedaviye başlanan yıl ile tedavi süresi arasında negatif yönde orta düzeyde korelasyon saptanmıştır (r:-0,54 p<0,001). Hastalık yeri %66,6 akciğer iken %28,1 akciğer dışı ve %5,3 her ikisi birlikte gözlenmiştir. Akciğer dışı (extrapulmoner) tutulum en sık %35,4 ile lenf nodu olurken, %34,92 plevra, %8,2 kemik ve %6,34 gastrointestinal sistem tutulumu saptanmıştır. Sonuç olarak, Osmaniye ilinin yıllara göre TB vaka analizi yapıldığında gerek nüfusu gerekse olgu hızı itibariyle paralellik göstermesinden dolayı Türkiye’nin durumunu yansıtan bir örneklem olduğu gözlenmiştir. Yeni tedavi rejimleri ile tedavi süreleri kısalmış ve başarı artmıştır.
Aile Hekimliği Birimi Sağlık Çalışanlarının Hasta Güvenliği Kültürü İle İlgili Algılarının Değerlendirilmesi
Authors: ELBİ Hüseyin , OZCAN Fatih , ÖZYURT Beyhan , ALTAN Selim
Published: May 2020

Amaç: Hasta güvenliği kültürü, hata bildirimlerinde şeffaflık ve tıbbi hataların önlenmesine sistemli yaklaşımdan sağlık çalışanlarının bu kültür içinde nasıl davranacağına, değer yargılarının nasıl olması gerektiğine, inançlarının ve kurallarının düzenlenmesine kadar geniş bir perspektifte değerlendirilmektedir. Bu çalışma, aile hekimliği birimindeki sağlık çalışanlarının hasta güvenliği kültürü ile ilgili algılarını ölçmeyi amaçlamıştır. Yöntem: Tanımlayıcı nitelikte olan bu araştırma Manisa iline bağlı iki ilçe merkezinde bulunan aile sağlığı merkezlerindeki aile hekimliği birimlerinde görev yapan 108 sağlık çalışanı ile yürütülmüştür. Araştırma verileri hasta güvenliği ile ilgili literatür eşliğinde hazırlanmış soru formu ile elde edildi ve SPSS 15 paket programı kullanılarak istatistiksel olarak değerlendirildi. Bulgular: Katılımcıların genel yaş ortalaması ise 41,19±9,27’dir. Katılımcıların 48’i (%44,4) aile hekimi, 60’ı (%55,6) da aile sağlığı elemanıdır. Katılımcıların hasta güvenliği kültürü ile ilgili sorulara verdiği yanıtlar değerlendirildiğinde olumlu puan ortalaması genel olarak %81,47’dir. Tıbbi ofis işleyişi değerlendirmesinde “Bu ofiste birisi gerçekten meşgul ise, diğerleri ona yardım eder” (%90,7), “Bu ofiste gelişen süreçlere paralel olarak personel eğitim alır” (%89,8) soruları en yüksek iki olumlu yüzdeyi, “Bu ofiste iş akışı ile ilgili sorunlar var” (%62,9) sorusu ise en düşük olumlu yüzdeyi alan seçeneklerdir. Ofis içi iletişim ve hasta takibi ile ilgili başlıkta “Bu ofis hastalara koruyucu ya da rutin bakım için randevuları hatırlatıyor.” %94,3 ile en yüksek olumlu yanıta sahip iken, “Bu ofiste anlaşmazlıkları dile getirmek zordur.” %69,9 ile en düşük olumlu yanıt verilen seçenek olmuştur. Sonuç: Bu çalışmada hasta güvenliği kültürü ile ilgili olumlu yanıt oranları önceki çalışmalara göre görece daha yüksek olarak bulunmuştur. Ancak ofis içi iş akışı ve anlaşmazlıkların dile getirilmesi ile ilgili sorulara verilen yanıtlar en düşük olumlu yüzdelere sahiptir. Aile hekimliği sisteminde hasta güvenliği kültürünü değerlendirecek çalışmaların bu sonuçlar ışığında planlama yapması önerilebilir.
Relationship Between Cardiovascular Disease Risk with Depression and Retirement in the Turkish Population
Authors: KIRAĞ Nükhet , ÇALIŞKAN Gizem
Published: May 2020

Objective: The present study identifies the factors that can be linked to coronary artery disease, and evaluates the effect of retirement on the development of cardiovascular diseases in the Turkish population. Methods: This cross-sectional study was carried in the Family Health Centers between March and July 2019. The data was collected using the Beck Depression Inventory and Framingham general cardiovascular disease risk assessment tool, sociodemographic form. Results: The mean Framingham risk score of the respondents was 6.440±7.509. A statistically significant relationship was identified between the Framingham risk score and income perception, monthly net income, occupation, educational status, marital status and employment (p<0.05). When the factors related to the Framingham risk score were evaluated, retirement was found to increase the Framingham risk score 13.991 fold (p<0.05). Conclusion: It is worthy of note that the risk of cardiovascular disease is high in the Turkish population. Retirement was found to be the most influential variable on the risk of developing cardiovascular disease. It is important to organize health training programs on the prevention of heart disease and to develop appropriate health policies.
Examination of level 1.5 earthquake and tsunami in eastern edge of Nankai Trough, Japan
Authors: Kitamura Akihisa
Published: May 2020

Tectonic plates divide the Earth's surfaces and move across the surface of the planet. Their slow but consistent rate of movement causes them to converge, drift apart and rub together. Whilst the speed behind these interactions is extremely low, the sheer mass of these continental plates
means large amounts of energy are associated with the interactions. This energy is the source of the formation of mountain ranges. However, when this energy is suddenly released it is destructive and in the form of earthquakes. There are many different specific causes for earthquakes, but
they typically occur most strongly at sites of plate convergence. These areas where two plates meet face to face and one plate falls beneath the other to be absorbed into the Earth's mantle. Professor Akihisa Kitamura of Department of Geo Science, Faculty of Science, Shizuoka University is
researching to understand more about these processes, specifically what is happening in Japan.
Case study and event analysis for mitigation of unpredictable volcanic hazard
Authors: Ohba Tsukasa
Published: May 2020

Volcanology is an extremely important scientific discipline. Shedding light on how and why volcanoes erupt, how eruptions can be predicted and their impact on humans and the environment is crucial to public safety, economies and businesses. Understanding volcanoes means eruptions can
be anticipated and at-risk communities can be forewarned, enabling them to implement mitigation measures. Professor Tsukasa Ohba is a scientist based at the Graduate School of International Resource Studies, Akita University, Japan, and specialises in volcanology and petrology. Ohba and his
team are focusing on volcanic phenomena including: phreatic eruptions (a steam-driven eruption driven by the heat from magma interacting with water); lahar (volcanic mudflow); and monogenetic basalt eruptions (which consist of a group of small monogenetic volcanoes, each of which erupts only
once). The researchers are working to understand the mechanisms of these phenomena using Petrology. Petrology is one of the traditional methods in volcanology but has not been applied to disastrous eruptions before. The teams research will contribute to volcanic hazard mitigation.
Effects of habitat degradation on fish production in a mangrove estuary
Authors: Nanjo Kusuto
Published: May 2020

The main problems tropical estuaries face are mangrove deforestation and eutrophication that is a result of land development and agriculture fertilization. While these habitat modifications can significantly reduce the fish diversity and production of mangrove ecosystems, the specific
mechanisms are not well understood. It is difficult to quantify the fish production in tropical estuaries, because many fish use estuaries at high tide and migrate to other habitats at low tide. Dr Kusuto Nanjo, based at the Department of Applied Aquabiology, National Fisheries University
in Japan, focused on resident fish, which utilize estuaries for a certain period of their life history without tidal migration and account for a large proportion of the fish assemblages, as good indicators in assessing the secondary production of mangrove ecosystems. It is hoped that by elucidating
this, his team will be able to establish specific conservation measures that protect biodiversity and life within mangrove ecosystems.
United as one: the global R&D community's response to Covid-19
Authors: Sharp Lucy
Published: May 2020

COVID-19 is having a tangible and far-reaching impact on many sectors and industries, including R&D. How is the international research community responding? An unprecedented catastrophe requires unprecedented measures, and this is what is being seen in the scientific community,
with researchers from across the globe pooling their expertise and openly sharing their data. We explore the R&D industry's response to the global pandemic.
Effects of intermittent contact oxidation on microbial population in in-sewer purification
Authors: Satoh Hiroyasu
Published: May 2020

There are multiple branches and approaches necessary to maintaining a healthy population. The provision of medical care, preventative measures and a reliable supply of nutritious food are all important. Also important is public sanitation and the effective cleaning, removal and purification
of waste from human habitation. In particular, creating effective water recycling schemes is essential to reducing the spread of the disease and providing a stable supply of potable water. This process is also important in the context of keeping the environment clean. When sewage waste is
dumped directly into rivers or seas, the results can be catastrophic for local ecosystem. In developed countries, cleaning water is a costly process both in terms of money and energy. Sewage is typically directed to treatment centres that take the dirty water through several cleaning and purification
processes. This generally works effectively, however the process could be further refined. The sewage systems of developing countries, where they exist, are typically used to transport waste directly into rivers and oceans. Understandably, these countries may not be able to build complex and
intensive treatment centres, however low-cost efficient technology could help bridge the gap and create a cleaner environment. There have been multiple attempts to create new sewage sanitation systems in the past. However, many often prove too complex to install in systems that are already
set up and have fallen by the wayside. Professor Hiroyasu Satoh of the Department of Socio-cultural Environmental Studies at The University of Tokyo, his team and several industrial collaborators have been working on designing, testing and implementing a novel in-sewer purification system.
Challenges and Opportunities in Collecting and Modeling Ambulatory Electrodermal Activity Data
Authors: Coffman Donna L , Cai Xizhen , Li Runze , Leonard Noelle R
Published: May 2020

Background

Ambulatory assessment of electrodermal activity (EDA) is an emerging technique for capturing individuals’ autonomic responses to real-life events. There is currently little guidance available for processing and analyzing such data in an ambulatory setting.

Objective

This study aimed to describe and implement several methods for preprocessing and constructing features for use in modeling ambulatory EDA data, particularly for measuring stress.

Methods

We used data from a study examining the effects of stressful tasks on EDA of adolescent mothers (AMs). A biosensor band recorded EDA 4 times per second and was worn during an approximately 2-hour assessment that included a 10-min mother-child videotaped interaction. The initial processing included filtering noise and motion artifacts.

Results

We constructed the features of the EDA data, including the number of peaks and their amplitude as well as EDA reactivity, quantified as the rate at which AMs returned to baseline EDA following an EDA peak. Although the pattern of EDA varied substantially across individuals, various features of EDA may be computed for all individuals enabling within- and between-individual analyses and comparisons.

Conclusions

The algorithms we developed can be used to construct features for dry-electrode ambulatory EDA, which can be used by other researchers to study stress and anxiety.
Enabling Better Use of Person-Generated Health Data in Stroke Rehabilitation Systems: Systematic Development of Design Heuristics
Authors: Dimaguila Gerardo Luis , Gray Kathleen , Merolli Mark
Published: May 2020

Background

An established and well-known method for usability assessment of various human-computer interaction technologies is called heuristic evaluation (HE). HE has been adopted for evaluations in a wide variety of specialized contexts and with objectives that go beyond usability. A set of heuristics to evaluate how health information technologies (HITs) incorporate features that enable effective patient use of person-generated health data (PGHD) is needed in an era where there is a growing demand and variety of PGHD-enabled technologies in health care and where a number of remote patient-monitoring technologies do not yet enable patient use of PGHD. Such a set of heuristics would improve the likelihood of positive effects from patients’ use of PGHD and lower the risk of negative effects.

Objective

This study aims to describe the development of a set of heuristics for the design and evaluation of how well remote patient therapeutic technologies enable patients to use PGHD (PGHD enablement). We used the case of Kinect-based stroke rehabilitation systems (K-SRS) in this study.

Methods

The development of a set of heuristics to enable better use of PGHD was primarily guided by the R3C methodology. Closer inspection of the methodology reveals that neither its development nor its application to a case study were described in detail. Thus, where relevant, each step was grounded through best practice activities in the literature and by using Nielsen’s heuristics as a basis for determining the new set of heuristics. As such, this study builds on the R3C methodology, and the implementation of a mixed process is intended to result in a robust and credible set of heuristics.

Results

A total of 8 new heuristics for PGHD enablement in K-SRS were created. A systematic and detailed process was applied in each step of heuristic development, which bridged the gaps described earlier. It is hoped that this would aid future developers of specialized heuristics, who could apply the detailed process of heuristic development for other domains of technology, and additionally for the case of PGHD enablement for other health conditions. The R3C methodology was also augmented through the use of qualitative studies with target users and domain experts, and it is intended to result in a robust and credible set of heuristics, before validation and refinement.

Conclusions

This study is the first to develop a new set of specialized heuristics to evaluate how HITs incorporate features that enable effective patient use of PGHD, with K-SRS as a key case study. In addition, it is the first to describe how the identification of initial HIT features and concepts to enable PGHD could lead to the development of a specialized set of heuristics.
Use of Eye-Tracking Technology by Medical Students Taking the Objective Structured Clinical Examination: Descriptive Study
Authors: Grima-Murcia M D , Sanchez-Ferrer Francisco , Ramos-Rincón Jose Manuel , Fernández Eduardo
Published: May 2020

Background

The objective structured clinical examination (OSCE) is a test used throughout Spain to evaluate the clinical competencies, decision making, problem solving, and other skills of sixth-year medical students.

Objective

The main goal of this study is to explore the possible applications and utility of portable eye-tracking systems in the setting of the OSCE, particularly questions associated with attention and engagement.

Methods

We used a portable Tobii Glasses 2 eye tracker, which allows real-time monitoring of where the students were looking and records the voice and ambient sounds. We then performed a qualitative and a quantitative analysis of the fields of vision and gaze points attracting attention as well as the visual itinerary.

Results

Eye-tracking technology was used in the OSCE with no major issues. This portable system was of the greatest value in the patient simulators and mannequin stations, where interaction with the simulated patient or areas of interest in the mannequin can be quantified. This technology proved useful to better identify the areas of interest in the medical images provided.

Conclusions

Portable eye trackers offer the opportunity to improve the objective evaluation of candidates and the self-evaluation of the stations used as well as medical simulations by examiners. We suggest that this technology has enough resolution to identify where a student is looking at and could be useful for developing new approaches for evaluating specific aspects of clinical competencies.
Optimizing Health Information Technologies for Symptom Management in Cancer Patients and Survivors: Usability Evaluation
Authors: Lattie Emily G , Bass Michael , Garcia Sofia F , Phillips Siobhan M , Moreno Patricia I , Flores Ann Marie , Smith JD , Scholtens Denise , Barnard Cynthia , Penedo Frank J , Cella David , Yanez Betina
Published: May 2020

Background

Unmanaged cancer symptoms and treatment-related side effects can compromise long-term clinical outcomes and health-related quality of life. Health information technologies such as web-based platforms offer the possibility to supplement existing care and optimize symptom management.

Objective

This paper describes the development and usability of a web-based symptom management platform for cancer patients and survivors that will be implemented within a large health system.

Methods

A web-based symptom management platform was designed and evaluated via one-on-one usability testing sessions. The System Usability Scale (SUS), After Scenario Questionnaire (ASQ), and qualitative analysis of semistructured interviews were used to assess program usability.

Results

Ten cancer survivors and five cancer center staff members participated in usability testing sessions. The mean score on the SUS was 86.6 (SD 14.0), indicating above average usability. The mean score on the ASQ was 2.5 (SD 2.1), indicating relatively high satisfaction with the usability of the program. Qualitative analyses identified valued features of the program and recommendations for further improvements.

Conclusions

Cancer survivors and oncology care providers reported high levels of acceptability and usability in the initial development of a web-based symptom management platform for cancer survivors. Future work will test the effectiveness of this web-based platform.
Privacy Assessment in Mobile Health Apps: Scoping Review
Authors: Benjumea Jaime , Ropero Jorge , Rivera-Romero Octavio , Dorronzoro-Zubiete Enrique , Carrasco Alejandro
Published: May 2020

Background

Privacy has always been a concern, especially in the health domain. The proliferation of mobile health (mHealth) apps has led to a large amount of sensitive data being generated. Some authors have performed privacy assessments of mHealth apps. They have evaluated diverse privacy components; however, different authors have used different criteria for their assessments.

Objective

This scoping review aims to understand how privacy is assessed for mHealth apps, focusing on the components, scales, criteria, and scoring methods used. A simple taxonomy to categorize the privacy assessments of mHealth apps based on component evaluation is also proposed.

Methods

We followed the methodology defined by Arksey and O’Malley to conduct a scoping review. Included studies were categorized based on the privacy component, which was assessed using the proposed taxonomy.

Results

The database searches retrieved a total of 710 citations—24 of them met the defined selection criteria, and data were extracted from them. Even though the inclusion criteria considered articles published since 2009, all the studies that were ultimately included were published from 2014 onward. Although 12 papers out of 24 (50%) analyzed only privacy, 8 (33%) analyzed both privacy and security. Moreover, 4 papers (17%) analyzed full apps, with privacy being just part of the assessment. The evaluation criteria used by authors were heterogeneous and were based on their experience, the literature, and/or existing legal frameworks. Regarding the set of items used for the assessments, each article defined a different one. Items included app permissions, analysis of the destination, analysis of the content of communications, study of the privacy policy, use of remote storage, and existence of a password to access the app, among many others. Most of the included studies provided a scoring method that enables the comparison of privacy among apps.

Conclusions

The privacy assessment of mHealth apps is a complex task, as the criteria used by different authors for their evaluations are very heterogeneous. Although some studies about privacy assessment have been conducted, a very large set of items to evaluate privacy has been used up until now. In-app information and privacy policies are primarily utilized by the scientific community to extract privacy information from mHealth apps. The creation of a scale based on more objective criteria is a desirable step forward for privacy assessment in the future.
Awareness and Preparedness of Field Epidemiology Training Program Graduates to Respond to COVID-19 in the Eastern Mediterranean Region: Cross-Sectional Study
Authors: Al Nsour Mohannad , Khader Yousef , Al Serouri Abdulwahed , Bashier Haitham , Osman Shahd
Published: May 2020

Background

The Field Epidemiology Training Program (FETP) is a 2-year training program in applied epidemiology. FETP graduates have contributed significantly to improvements in surveillance systems, control of infectious diseases, and outbreak investigations in the Eastern Mediterranean Region (EMR).

Objective

Considering the instrumental roles of FETP graduates during the coronavirus disease (COVID-19) crisis, this study aimed to assess their awareness and preparedness to respond to the COVID-19 pandemic in three EMR countries.

Methods

An online survey was sent to FETP graduates in the EMR in March 2020. The FETP graduates were contacted by email and requested to fill out an online survey. Sufficient number of responses were received from only three countries—Jordan, Sudan, and Yemen. A few responses were received from other countries, and therefore, they were excluded from the analysis. The questionnaire comprised a series of questions pertaining to sociodemographic characteristics, knowledge of the epidemiology of COVID-19, and preparedness to respond to COVID-19.

Results

This study included a total of 57 FETP graduates (20 from Jordan, 13 from Sudan, and 24 from Yemen). A total of 31 (54%) graduates had attended training on COVID-19, 29 (51%) were members of a rapid response team against COVID-19, and 54 (95%) had previous experience in response to disease outbreaks or health emergencies. The vast majority were aware of the main symptoms, mode of transmission, high-risk groups, and how to use personal protective equipment. A total of 46 (81%) respondents considered themselves well prepared for the COVID-19 outbreak, and 40 (70%) reported that they currently have a role in supporting the country’s efforts in the management of COVID-19 outbreak.

Conclusions

The FETP graduates in Jordan, Sudan, and Yemen were fully aware of the epidemiology of COVID-19 and the safety measures required, and they are well positioned to investigate and respond to the COVID-19 pandemic. Therefore, they should be properly and efficiently utilized by the Ministries of Health to investigate and respond to the current COVID-19 crisis where the needs are vastly growing and access to outside experts is becoming limited.
COVID-19 Crisis in Jordan: Response, Scenarios, Strategies, and Recommendations
Authors: Alqutob Raeda , Al Nsour Mohannad , Tarawneh Mohammed Rasoul , Ajlouni Musa , Khader Yousef , Aqel Ibrahim , Kharabsheh Saad , Obeidat Nathir
Published: May 2020

As of April 12, 2020, a total of 389 cases of coronavirus disease were confirmed in Jordan. To control this imminent threat, Jordan has enforced public health infection prevention and control measures, called for social distancing, seized all forms of inbound and outbound movement and international travel, and enacted the Defence Law that transferred the authority to the Minister of Defence to work and formulate orders according to the situation. In an effort to support the government in anticipating the requirements of the health system in the upcoming period, an in-depth reflection and examination of different scenarios of the disease spread were developed. This viewpoint suggests different strategies and measures for case detection and contact tracing, clinical management of cases, public health system functioning, and civil society organizations’ contribution. It is necessary to accelerate containment of the disease to protect the economy and to maintain the continuity of some activities to mitigate the subsequent social, economic, and financial impacts. This requires finding a coping mechanism for a period that may be prolonged until laboratories develop a vaccine. Specifically, it is strongly recommended to promote community health awareness toward public health prevention and control measures, increase the efficiency and comprehensiveness of the epidemiological investigation and active and passive surveillance, and employ technology and digital health solutions to track cases and contacts. It is also recommended to increase and expand resources of intensive care units including respirators, increase the capacity and the number of trained health staff in the area of public health and epidemiology, ensure continued provision of essential public health programs, and mobilize the resources of nongovernmental sectors and donors to provide services for refugees and vulnerable populations.
Correlations of Online Search Engine Trends With Coronavirus Disease (COVID-19) Incidence: Infodemiology Study
Authors: Higgins Thomas S , Wu Arthur W , Sharma Dhruv , Illing Elisa A , Rubel Kolin , Ting Jonathan Y ,   Snot Force Alliance
Published: May 2020

Background

The coronavirus disease (COVID-19) is the latest pandemic of the digital age. With the internet harvesting large amounts of data from the general population in real time, public databases such as Google Trends (GT) and the Baidu Index (BI) can be an expedient tool to assist public health efforts.

Objective

The aim of this study is to apply digital epidemiology to the current COVID-19 pandemic to determine the utility of providing adjunctive epidemiologic information on outbreaks of this disease and evaluate this methodology in the case of future pandemics.

Methods

An epidemiologic time series analysis of online search trends relating to the COVID-19 pandemic was performed from January 9, 2020, to April 6, 2020. BI was used to obtain online search data for China, while GT was used for worldwide data, the countries of Italy and Spain, and the US states of New York and Washington. These data were compared to real-world confirmed cases and deaths of COVID-19. Chronologic patterns were assessed in relation to disease patterns, significant events, and media reports.

Results

Worldwide search terms for shortness of breath, anosmia, dysgeusia and ageusia, headache, chest pain, and sneezing had strong correlations (r>0.60, P<.001) to both new daily confirmed cases and deaths from COVID-19. GT COVID-19 (search term) and GT coronavirus (virus) searches predated real-world confirmed cases by 12 days (r=0.85, SD 0.10 and r=0.76, SD 0.09, respectively, P<.001). Searches for symptoms of diarrhea, fever, shortness of breath, cough, nasal obstruction, and rhinorrhea all had a negative lag greater than 1 week compared to new daily cases, while searches for anosmia and dysgeusia peaked worldwide and in China with positive lags of 5 days and 6 weeks, respectively, corresponding with widespread media coverage of these symptoms in COVID-19.

Conclusions

This study demonstrates the utility of digital epidemiology in providing helpful surveillance data of disease outbreaks like COVID-19. Although certain online search trends for this disease were influenced by media coverage, many search terms reflected clinical manifestations of the disease and showed strong correlations with real-world cases and deaths.
Embodied Conversational Agent Appearance for Health Assessment of Older Adults: Explorative Study (Preprint)
Authors: ter Stal Silke , Broekhuis Marijke , van Velsen Lex , Hermens Hermie , Tabak Monique
Published: May 2020

BACKGROUND

Embodied conversational agents (ECAs) have great potential for health apps but are rarely investigated as part of such apps. To promote the uptake of health apps, we need to understand how the design of ECAs can influence the preferences, motivation, and behavior of users.

OBJECTIVE

This is one of the first studies that investigates how the appearance of an ECA implemented within a health app affects users’ likeliness of following agent advice, their perception of agent characteristics, and their feeling of rapport. In addition, we assessed usability and intention to use.

METHODS

The ECA was implemented within a frailty assessment app in which three health questionnaires were translated into agent dialogues. In a within-subject experiment, questionnaire dialogues were randomly offered by a young female agent or an older male agent. Participants were asked to think aloud during interaction. Afterward, they rated the likeliness of following the agent’s advice, agent characteristics, rapport, usability, and intention to use and participated in a semistructured interview.

RESULTS

A total of 20 older adults (72.2 [SD 3.5] years) participated. The older male agent was perceived as more authoritative than the young female agent (P=.03), but no other differences were found. The app scored high on usability (median 6.1) and intention to use (median 6.0). Participants indicated they did not see an added value of the agent to the health app.

CONCLUSIONS

Agent age and gender little influence users’ impressions after short interaction but remain important at first glance to lower the threshold to interact with the agent. Thus, it is important to take the design of ECAs into account when implementing them into health apps.
Evaluation of the Zimbabwe HIV Case Surveillance Pilot Program, 2019 (Preprint)
Authors: Nsubuga Peter , Mabaya Simbarashe , Apollo Tsitsi , Sithole Ngwarai , Komtenza Brian , Matare Takura , Chimwaza Anesu , Takarinda Kudakwashe , Moyo Brian , Mbano Leon , Moyo Thandekile , Lowrance David , Low-Beer Daniel , Mugurungi Owen , Gasasira Alex
Published: May 2020

BACKGROUND

Zimbabwe has a high burden of HIV, with an estimated 1.3 million people living with the virus and an HIV prevalence and incidence of 13.8% and 0.48%, respectively (2017 Spectrum estimates). In 2017, the Zimbabwe Ministry of Health and Child Care (MOHCC) developed and implemented a pilot of HIV case surveillance (CS) based on the 2017 World Health Organisation (WHO) Person-centred HIV patient monitoring (PM) and case surveillance guidelines. As the case surveillance guidelines were new, lessons learned from field implementation experiences were intended to inform the development of HIV case surveillance implementation guidance and tools.

OBJECTIVE

At the end of the pilot phase, the Ministry of Health and Child Care (MOHCC) commissioned an evaluation to inform further steps.

METHODS

Two districts, Umzingwane in Matabeleland South Province and Mutare in Manicaland Province were commissioned to run the CS pilot from August 2017 to December 2018. During this period, 1602 people living with HIV (PLHIV) newly diagnosed with HIV were reported in the CS system, while other HIV sentinel events, including ART initiation and first viral load test, were routinely reported. A mixed-methods cross-sectional study of stakeholders and health facility staff was used to assess the following CS system features: design and operations, performance, usefulness, sustainability and scalability. A total of 13 stakeholders responded to an online questionnaire, while 33 health facility respondents were interviewed in 11 health facilities in the two pilot districts.

RESULTS

The HIV CS system was adequately designed for Zimbabwe’s context, integrated within existing health information systems at the facility level. However, the training was minimal, and an opportunity to train the data entry clerks in data analysis was missed. The system performed well in terms of surveillance and informatics attributes. However, viral load test results return was a significant problem. The system was used at the health facility level to track the HIV positive clients in their catchment area; all facilities that were visited were aware of what is happening to their clients. Almost all respondents believed that the country can roll out the HIV CS system to all facilities with partner support.

CONCLUSIONS

The HIV CS system was found useful at the health facility level and should be rolled out in a phased manner, beginning with all facilities in Manicaland and Matabeleland South provinces. An electronic link needs to be made between the health facilities and the laboratory to reduce viral load test results delays. Lessons learned from the provincial roll out can be used for a nationwide scale-up.
Views on Using Social Robots in Professional Caregiving: Content Analysis of a Scenario Method Workshop (Preprint)
Authors: Busse Theresa Sophie , Kernebeck Sven , Nef Larissa , Rebacz Patrick , Kickbusch Ilona , Ehlers Jan Peter
Published: May 2020

BACKGROUND

Interest in digital technologies in the health care sector is growing and can be a way to reduce the burden on professional caregivers while helping people to become more independent. Social robots are regarded as a special form of technology that can be usefully applied in professional caregiving with the potential to focus on interpersonal contact. While implementation is progressing slowly, a debate on the concepts and applications of social robots in future care is necessary.

OBJECTIVE

In addition to existing studies with a focus on societal attitudes toward social robots, there is a need to understand the views of professional caregivers and patients. This study used desired future scenarios to collate the perspectives of experts and analyze the significance for developing the place of social robots in care.

METHODS

In February 2020, an expert workshop was held with 88 participants (health professionals and educators; [PhD] students of medicine, health care, professional care, and technology; patient advocates; software developers; government representatives; and research fellows) from Austria, Germany, and Switzerland. Using the scenario methodology, the possibilities of analog professional care (Analog Care), fully robotic professional care (Robotic Care), teams of robots and professional caregivers (Deep Care), and professional caregivers supported by robots (Smart Care) were discussed. The scenarios were used as a stimulus for the development of ideas about future professional caregiving. The discussion was evaluated using qualitative content analysis.

RESULTS

The majority of the experts were in favor of care in which people are supported by technology (Deep Care) and developed similar scenarios with a focus on dignity-centeredness. The discussions then focused on the steps necessary for its implementation, highlighting a strong need for the development of eHealth competence in society, a change in the training of professional caregivers, and cross-sectoral concepts. The experts also saw user acceptance as crucial to the use of robotics. This involves the acceptance of both professional caregivers and care recipients.

CONCLUSIONS

The literature review and subsequent workshop revealed how decision-making about the value of social robots depends on personal characteristics related to experience and values. There is therefore a strong need to recognize individual perspectives of care before social robots become an integrated part of care in the future.
The Present and Future Applications of Technology in Adapting Medical Education Amidst the COVID-19 Pandemic (Preprint)
Authors: Remtulla Ridhaa
Published: May 2020

UNSTRUCTURED

The coronavirus disease (COVID-19) pandemic has not only been catastrophic toward patient health but has also proven to be incredibly disruptive to several industries and sectors, including medical education. However, many medical schools have employed various technological solutions in order to minimize the disruption to medical education during this unpredictable time. This viewpoint reviews the various current and potential applications of technology in order to adapt medical education amidst a global pandemic.
Impact of Globalisation on African and Its Implications to Education
Authors: Pacho Titus Ogalo
Published: May 2020

Globalisation is one of the most powerful worldwide forces transforming society. It dominates today’s world as a major driver of change. Globalisation has brought about an agglomeration of cultures, where diverse cultures not only interact but also sometimes clash. It permeates through all spheres of life including the environment, politics, economy, prosperity, culture, religion, education, and human well-being in societies across the globe. The present “villagization” of the world has greatly affected many African countries in almost all aspects of life. It has done so in both positive and negative ways. With the emergence of a global society, social, cultural, economic, political, technological and environmental events in one part of the world quickly come to be significant for people in other parts of the world. This theoretical paper assesses the impact of globalisation for Africa and its implications to education.
ISOLATION OF ACTINOMYCETES FROM THE SEDIMENTS OF PICHAVARAM MANGROVE FOREST, SOUTH INDIA AND ANALYSING THEIR ANTIBACTERIAL EFFICACY
Authors: M AARTHI , D KAMALANATHAN , V BALAKRISHNAN
Published: May 2020

Objective: The aim of the present investigation is to isolate actinomycetes from the sediments of Pichavaram mangrove forest, South India, and to screen for their antibacterial efficiency.

Methods: Actinomycetes were isolated by culturing the samples in Starch Casein Agar medium; they were screened primarily for their antibacterial efficiency against Gram-positive and Gram-negative bacterial organisms. Solvent extraction was done with 50% (percentage) ethyl acetate, crude extracts of actinomycetes were prepared at different concentrations using dimethyl sulfoxide and treated against the bacterial organisms. Antibacterial assay was done in Mueller–Hinton agar medium.

Results: Thirteen actinomycetes were isolated; among them, four actinomycete isolates (Pichavaram mangrove actinomycete 2 [PMA2], PMA6, PMA9, and PMA13) exhibited antibacterial activity.

Conclusion: Isolate PMA2 exhibited very strong antibacterial activity and isolate PMA13 is weakly active against the tested bacterial organisms.
PREVALENCE OF 25-HYDROXY VITAMIN D DEFICIENCY AND SOME BIOCHEMICAL PARAMETERS IN IRAQI PATIENTS WITH RHEUMATOID ARTHRITIS AND THEIR ASSOCIATIONS WITH DISEASE ACTIVITY
Authors: AL-GEBORI ABDULNASSER M , MUNSHED ALOSAMI MOHAMMED HADI , AL-HASHIMI NAWAL HAIDER
Published: May 2020

Objectives: The objectives of the study were to evaluate changes in 25(OH) Vitamin D levels and some biochemical parameters in rheumatoid arthritis (RA) patients compared with healthy controls and assess the correlation of 25-hydroxy Vitamin D, calcium, magnesium, and disease activity. Study the effects of anti-RA drugs on these biochemical parameters and also the role of supplements calcium and 25-OH Vitamin D in RA patients.

Methods: This study conducted between 60 patients for RA and 20 healthy controls according to the American College of Rheumatology standards in 2010. In this study, 25-hydroxy Vitamin D was measured using an enzyme-linked immunosorbent assay, and also some biochemical parameters were measured with a spectrophotometer (Humalyzer 2000).

Results: Serum 25(OH) Vitamin D, calcium, magnesium, and albumin levels were significantly lower in RA patients compared with healthy controls. Serum alanine aminotransferase aspartate aminotransferase levels were significantly increased in RA patients compared with healthy controls. The correlation was non-significantly among 25-hydroxy Vitamin D and clinical disease activity index (CDAI), while the results showed significantly inverse correlation calcium and magnesium concentrations with CDAI.

Conclusion: 25-OH Vitamin D, calcium, albumin, and magnesium deficiency appear to be widespread in patients with RA. Thus, biochemical changes in RA are reflected in the pathogenesis of RA. Furthermore, in these results, there is no relationship between Vitamin D and the disease activity, while there is a relationship between calcium and magnesium with disease activity.