Search results

This review aims to describe the effectiveness of education with the transtheoretical model (TTM)-based on the self-care behavior of hypertension patients.

A systematic literature search was carried out on four databases: PubMed, Science Direct, Cochrane and Grey literature to identify studies reported in English which were published in the last ten years. The literature search was conducted from November 13 to December 10, 2020.

Based on the six studies that have been analyzed, TTM is effective in changing the stage of change and behavior of hypertension patients. These behavioral changes have an impact on the patient's controlled blood pressure. Various types of TTM-based educational interventions can be used, but the tailored behavior intervention is the most appropriate one with a minimum intervention duration of six months. Educational intervention is carried out through combine counseling and education using electronic media.

This review presents the effectiveness of transtheoretical-based health education in changing the self-care behavior of hypertension patients accompanied by evidence-based on its implementation. There is a high and unclear risk of bias on several items influence this systematic outcome. Nevertheless, this review can still provide an overview of the effectiveness of education based on the TTM in hypertension patients about the quality results of the reviewed studies.

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.

A hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.

Patient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.

The article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.

Background: Compliance of patients with self-care practices is the mainstay of measures to manage diabetes. This study explored self-care practices of type 2 diabetes patients receiving insulin treatment in North-East Ethiopia.

Methods: The study employed an interpretive phenomenological approach using purposive sampling. The data were collected from 24 (11 males and 13 females) participants (July 2019 to January 2020) using in-depth interviews till theoretical saturation. The data were analyzed thematically and organized using QDA Miner Lite v2.0.8.

Results: The findings were categorized into: labeling diabetes, self-care maintenance experiences, recognition of symptoms, and mitigating mechanisms. The self-care maintenance practice of patients was linked with diet input preferences and the effectiveness level of insulin. What guides the self-care behavior was the patients’ preferentiality of strictly adhering to their preferred dietary inputs. Barley and wheat were the most common preferential and non-preferential inputs, respectively. The patients strictly adhered to insulin treatment because they found it effective. The most common hyperglycemia symptoms to be managed by taking an additional dose of insulin, were frequent urination, increased thirst, and their consequence (dehydration). Excessive sweating (initial), shivering (middle), and falling (final), respectively in severity, were the most common symptoms of hypoglycemia which were perceived to be treated with sweet snacks.

Originality: To our knowledge, this is the first research in Ethiopia to investigate the self-care experiences of type 2 diabetes patients receiving insulin using an interpretive phenomenological approach.

Breast cancer is a global public health dilemma and the most prevalent cancer in the world. Effective treatment plans improve patient survival rates and well-being. The five-year survival rate is often used to develop treatment selection and survival prediction models. However, unlike other types of cancer, breast cancer patients can have long survival rates. Therefore, the authors propose a novel two-level framework to provide clinical decision support for treatment selection contingent on survival prediction.

The first level classifies patients into different survival periods using machine learning algorithms. The second level has two models with different survival rates (five-year and ten-year). Thus, based on the classification results of the first level, the authors employed Bayesian networks (BNs) to infer the effect of treatment on survival in the second level.

The authors validated the proposed approach with electronic health record data from the TriNetX Research Network. For the first level, the authors obtained 85% accuracy in survival classification. For the second level, the authors found that the topology of BNs using Causal Minimum Message Length had the highest accuracy and area under the ROC curve for both models. Notably, treatment selection substantially impacted survival rates, implying the two-level approach better aided clinical decision support on treatment selection.

The authors have developed a reference tool for medical practitioners that supports treatment decisions and patient education to identify patient treatment preferences and to enhance patient healthcare.

This study aims to provide a systematic review about the Internet of Things (IoT) and its impacts on happiness. It intends to serve as a platform for further research as it is sparse in in-depth analysis.

This systematic review initially observed 2,501 literary articles through the ScienceDirect and WorldCat search engines before narrowing it down to 72 articles based on subject matter relevance in the abstract and keywords. Accounting for duplicates between search engines, the count was reduced to 66 articles. To finally narrow down all the literature used in this systematic review, 66 articles were given a critical readthrough. The count was finally reduced to 53 total articles used in this systematic review.

This paper necessitates the claim that IoT will likely impact many aspects of our everyday lives. Through the literature observed, it was found that IoT will have some significant and positive impacts on people's welfare and lives. The unprecedented nature of IoTs impacts on society should warrant further research moving forward.

While the literature presented in this systematic review shows that IoT can positively impact the perceived or explicit happiness of people, the amount of literature found to supplement this argument is still on the lower end. They also necessitate the need for both greater depth and variety in this field of research.

Since technology is already a pervasive element of most people’s contemporary lives, it stands to reason that the most important factors to consider will be in how we might benefit from IoT or, more notably, how IoT can enhance our levels of happiness. A significant implication is its ability to reduce the gap in happiness levels between urban and rural areas.

Currently, the literature directly tackling the quantification of IoTs perceived influence on happiness has yet to be truly discussed broadly. This systematic review serves as a starting point for further discussion in the subject matter. In addition, this paper may lead to a better understanding of the IoT technology and how we can best advance and adapt it to the benefits of the society.

Ireland’s ageing population has resulted in an increasing number of older adults living with frailty. Despite growing attention towards older adults’ and health professionals’ perspectives of frailty, occupational therapy research is limited. This study aims to explore occupational therapists’ perceptions of frailty and how their perceptions impact their approach to the assessment and management of frailty.

Using qualitative descriptive design, 19 occupational therapists working with older adults participated in online focus groups. Data were analysed using thematic analysis.

Perceptions of occupational therapists were constructed into three main themes: conceptualising frailty; management of frailty; and advancing frailty practice. Findings indicate that occupational therapists perceived frailty as a multidimensional concept but highlight a reluctance to use frailty terminology with patients. Findings also suggest that although occupational therapists are involved in provision of care for older adults living with frailty, the profession’s scope is not optimised in the assessment and management of frailty.

Findings provide insight into occupational therapists’ perceptions of frailty. Development of a shared understanding of frailty between clinicians and patients and enhancement of undergraduate frailty education are recommended to progress occupational therapy’s role in frailty management.

Information is scarce on healthcare managers' understanding of simulation educators' impact on clinical work. Therefore, the aim of this study was to explore healthcare managers' perceptions of the significance of clinically active simulation educators for the organisation.

Healthcare managers were invited to be interviewed in a semi-structured manner. Inductive thematic analysis was used to identify and analyse patterns of notions describing the managers' perceptions of simulation educators' impact as co-workers on their healthcare organisations.

The identified relevant themes for the healthcare unit were: (1) value for the manager, (2) value for the community and (3) boundaries. Simulation educators were perceived to be valuable gatekeepers of evidence-based knowledge and partners in leadership for educational issues. Their most prominent value for the community was establishing a reflective climate, facilitating open communication and thereby improving the efficacy of teamwork. Local tradition, economy, logistics and staffing of the unit during simulation training were suggested to have possible negative impacts on simulation educators' work.

The findings might have implications for the implementation and support of simulation training programs.

Healthcare managers appreciated both the personal value of simulation educators and the effect of their work for their own unit. Local values were prioritised versus global. Simulation training was valued as an educational tool for continual professional development, although during the interviews, the managers did not indicate the importance of employment of pedagogically competent and experienced staff.

The study provided new insights about how simulation educators as team members affect clinical practice.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

The rapid rise of large language models (LLMs) has propelled them to the forefront of applications in natural language processing (NLP). This paper aims to present a comprehensive examination of the research landscape in LLMs, providing an overview of the prevailing themes and topics within this dynamic domain.

Drawing from an extensive corpus of 198 records published between 1996 to 2023 from the relevant academic database encompassing journal articles, books, book chapters, conference papers and selected working papers, this study delves deep into the multifaceted world of LLM research. In this study, the authors employed the BERTopic algorithm, a recent advancement in topic modeling, to conduct a comprehensive analysis of the data after it had been meticulously cleaned and preprocessed. BERTopic leverages the power of transformer-based language models like bidirectional encoder representations from transformers (BERT) to generate more meaningful and coherent topics. This approach facilitates the identification of hidden patterns within the data, enabling authors to uncover valuable insights that might otherwise have remained obscure. The analysis revealed four distinct clusters of topics in LLM research: “language and NLP”, “education and teaching”, “clinical and medical applications” and “speech and recognition techniques”. Each cluster embodies a unique aspect of LLM application and showcases the breadth of possibilities that LLM technology has to offer. In addition to presenting the research findings, this paper identifies key challenges and opportunities in the realm of LLMs. It underscores the necessity for further investigation in specific areas, including the paramount importance of addressing potential biases, transparency and explainability, data privacy and security, and responsible deployment of LLM technology.

The analysis revealed four distinct clusters of topics in LLM research: “language and NLP”, “education and teaching”, “clinical and medical applications” and “speech and recognition techniques”. Each cluster embodies a unique aspect of LLM application and showcases the breadth of possibilities that LLM technology has to offer. In addition to presenting the research findings, this paper identifies key challenges and opportunities in the realm of LLMs. It underscores the necessity for further investigation in specific areas, including the paramount importance of addressing potential biases, transparency and explainability, data privacy and security, and responsible deployment of LLM technology.

This classification offers practical guidance for researchers, developers, educators, and policymakers to focus efforts and resources. The study underscores the importance of addressing challenges in LLMs, including potential biases, transparency, data privacy, and responsible deployment. Policymakers can utilize this information to shape regulations, while developers can tailor technology development based on the diverse applications identified. The findings also emphasize the need for interdisciplinary collaboration and highlight ethical considerations, providing a roadmap for navigating the complex landscape of LLM research and applications.

This study stands out as the first to examine the evolution of LLMs across such a long time frame and across such diversified disciplines. It provides a unique perspective on the key areas of LLM research, highlighting the breadth and depth of LLM’s evolution.

The purpose of this paper is to explore and describe the perspectives and reasoning of senior development leaders in healthcare organizations, when reflecting on design as theory and practice in relation to more traditional methods and tools for improving quality and support innovation.

The paper is based on a qualitative interview design with five development and innovation leaders from separate healthcare regions in Sweden. They have, to varying degrees, applied design theory and practice for quality improvement and innovation in their organizations. The interview transcript was analysed using a content analysis together with an interpretive approach.

The major findings are to be found in the balancing act for leadership and organizations in healthcare when it comes to introducing and combining different theories and practices for improving quality and support innovation. The balance is between the change in power dynamics and pushing traditional boundaries in a complex healthcare world.

The narratives from the leaders' experience of applying design theory and practice for improving healthcare quality can help us create readiness and knowledge about how we prevent and/or facilitate planning and implementing design theories, practices, methods and tools in a healthcare context.

The study provides a unique insight when it captures and illustrates five different organizations' experiences when applying design for developing healthcare quality.