Search results

The burden of mental illness is profound and growing. Each year, almost one in three adults in the non-institutionalized community has a diagnosable mental or addictive disorder, and this figure climbs to approximately 40% among emergency departments patients. We described the principal cardiovascular acute disease and their emotional and behavioral consequences where psychological intervention could improve the care pathway and clinical outcome. Peer-reviewed articles from Medline, Psycinfo, Web of Science, Scopus, and Cochrane library, about psychological and psychopathological sequelae in cardiovascular acute disease were searched. The psychological and psychopathological sequelae associated to stroke include emotional and behavioral changes and cognitive impairment. Fear, symptoms of depression, anxiety or specific post-traumatic symptoms like intrusions, hyper-arousal and/or cognitive avoidance are common in people suffering of cardiovascular acute disease treated at emergency departments. In emergency departments, health personnel must recognize psychological and psychopatho-logical sequelae in cardiovascular acute disease in order to develop effective interventions for these patients. Identify factors that are associated with both psychological distress and physical distress and promote interventions aimed at reducing psychological distress and improving psychological health empowerment is an important element to consider in order to offer the best care to vulnerable population as that suffering of cardiovascular acute disease.

The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic.

A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed.

Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered.

To the best of the authors’ knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.

The substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.

A systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.

Chronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.

The present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.

Given the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

This chapter aims to provide suggestive evidence on how the Lombardy region dealt with the COVID-19 pandemic in 2020 and discuss future challenges for the Lombardy healthcare system. After an introduction to the wide spread of the virus inside the region, we describe the Lombardy health system so the reader may understand the context in which the virus has taken hold so quickly. The pandemic has heavily stressed the system, mainly because Lombardy experienced an excess of hospital admissions. We have considered the increased mortality rate as a proxy of the proper managing of the COVID-19 pandemic. In addition, we describe the process of treating non-COVID patients, such as those affected by acute myocardial infarction (AMI), stroke and oncological diseases. Despite the pandemic, hospitals have been able to guarantee a high level of performance. A discussion of the future evolution of the healthcare system concludes this chapter.

This study specifically seeks to investigate the strategic implementation of machine learning (ML) algorithms and techniques in healthcare institutions to enhance innovation management in healthcare settings.

The papers from 2011 to 2021 were considered following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. First, relevant keywords were identified, and screening was performed. Bibliometric analysis was performed. One hundred twenty-three relevant documents that passed the eligibility criteria were finalized.

Overall, the annual scientific production section results reveal that ML in the healthcare sector is growing significantly. Performing bibliometric analysis has helped find unexplored areas; understand the trend of scientific publication; and categorize topics based on emerging, trending and essential. The paper discovers the influential authors, sources, countries and ML and healthcare management keywords.

The study helps understand various applications of ML in healthcare institutions, such as the use of Internet of Things in healthcare, the prediction of disease, finding the seriousness of a case, natural language processing, speech and language-based classification, etc. This analysis would help future researchers and developers target the healthcare sector areas that are likely to grow in the coming future.

The study highlights the potential for ML to enhance medical support within healthcare institutions. It suggests that regression algorithms are particularly promising for this purpose. Hospital management can leverage time series ML algorithms to estimate the number of incoming patients, thus increasing hospital availability and optimizing resource allocation. ML has been instrumental in the development of these systems. By embracing telemedicine and remote monitoring, healthcare management can facilitate the creation of online patient surveillance and monitoring systems, allowing for early medical intervention and ultimately improving the efficiency and effectiveness of medical services.

By offering a comprehensive panorama of ML's integration within healthcare institutions, this study underscores the pivotal role of innovation management in healthcare. The findings contribute to a holistic understanding of ML's applications in healthcare and emphasize their potential to transform and optimize healthcare delivery.

We study changes in age-specific diabetes-related mortality and annual health care utilization. We find that half of the estimated 16% increase of diabetic mortality falls within employable age groups. We estimate that disease combination-specific increase in case fatality has resulted in premature diabetic mortality costing $3.2 billion annually. The estimated annual direct cost of treating high-risk diabetics reaches $36 billion, of which Medicare and Other Federal Programs compensate 54%. Respiratory conditions among diabetics comprise the same proportion of high-risk diabetics as do the disease combinations including coronary heart diseases. Treating of general diabetic conditions has become more efficient as indicated by the estimated declines in per unit health care costs.

Discusses environmental factors which may have harmful effects on the cardiovascular system and cause acute or chronic disease. Classifies these factors as chemical, physical, biological and psychosocial. Concentrates on describing the chemical, physical and biological elements which directly cause cardiovascular diseases, such as nicotine and carbon monoxide (chemical); temperatue and electricity (physical) and viral infections such as maternal coxsackie (biological). Concludes by stressing the need for more intensive studies on this subject.

This study aims to determine the relationship between body mass index (BMI) and Global Registry of Acute Coronary Events (GRACE) risk score in patients diagnosed with acute coronary syndrome (ACS) and to evaluate the results in this context.

This was a prospective cohort study of ACS patients admitted to a cardiac care unit in high specialization hospital's cardiology service. The study included 140 men aged >35 years who were diagnosed with ACS.

The mean age of the individuals participating in the study was 61.4 ± 10.9 years old. The mean BMI of the individuals was 25.3 ± 6.6 kg/m², and the mean value of the waist/hip ratio was 0.85 ± 0.01. Individuals were divided into four quarters according to the GRACE score. It was determined that individuals with the highest GRACE score were very underweight or morbidly obese according to their BMI values (p = 0.04).

It has been observed that there is a U-shaped relationship between the GRACE score and the BMI in individuals diagnosed with ACS. The risk of death of ACS patients with very high or very low BMI values was found to be close to each other. Although there is a relationship between BMI and GRACE score, it is concluded that it is insufficient to determine the risk in coronary disease alone, and body fat distribution should be examined together with BMI.

Cardiovascular diseases are the leading cause of death worldwide. In Italy, acute myocardial infarction (AMI) is a major cause of hospitalization and healthcare costs. AMI is a myocardial necrosis event caused by an unstable ischemic syndrome. The Italian government has defined an indicator called “AMI: 30-day mortality” to assess the quality of the overall care pathway of the heart attacked patient. In order to guarantee high standards, all hospitals had to implement techniques to increase the quality of care pathway. The aim of the paper is to identify the root cause and understand the mortality rate for AMI and redesign the patient management process in order to improve it.

A Lean Six Sigma (LSS) approach was used in this study to analyze the patient flow in order to reduce 30-days mortality rate from AMI registered by Complex Operative Unit (COU) of Cardiology of an Italian hospital. Value stream mapping (VSM) and Ishikawa diagrams were implemented as tools of analysis.

Process improvement using LSS methodology made it possible to reduce the overall times from 115 minutes to 75 minutes, with a reduction of 35%. In addition, the corrective actions such as the activation of a post-discharge outpatient clinic and telephone contacts allowed the 30-day mortality rate to be lowered from 16% before the project to 8% after the project. In this way, the limit value set by the Italian government was reached.

The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

The LSS approach has brought significant benefits to the process of managing patients with AMI. Corrective actions such as the activation of an effective shared protocol or telephone interview with checklist can become the gold standard in reducing mortality. The limitation of the study is that it is single-centered and was applied to a facility with a limited number of cases.

LSS, applied for the first time to the management of cardiovascular diseases in Italy, is a methodology which has proved to be strategic for the improvement of healthcare process. The simple solutions implemented could serve as a guide for other hospitals to pursue the national AMI mortality target.