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The Department of Business Management and Analytics in Arcada University of Applied Sciences arranged a Workshop on Analytics in June 8, 2016. Five Working Papers presented in this workshop are published in this report.

COVID-19 had led to severe clinical manifestations. In the current scenario, 98 794 942 people are infected, and it has responsible for 2 124 193 deaths around the world as reported by World Health Organization on 25 January 2021. Telemedicine has become a critical technology for providing medical care to patients by trying to reduce transmission of the virus among patients, families, and doctors. The economic consequences of coronavirus have affected the entire world and disrupted daily life in many countries. The development of telemedicine applications and eHealth services can significantly help to manage pandemic worldwide better. Consequently, the main objective of this paper is to present a systematic review of the implementation of telemedicine and e-health systems in the combat to COVID-19. The main contribution is to present a comprehensive description of the state of the art considering the domain areas, organizations, funding agencies, researcher units and authors involved. The results show that the United States and China have the most significant number of studies representing 42.11% and 31.58%, respectively. Furthermore, 35 different research units and 9 funding agencies are involved in the application of telemedicine systems to combat COVID-19.

Key summary points Aim To investigate the extent to which Dutch older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic. Findings One third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. Message Delay of routine care during the pandemic may impact morbidity and related adverse outcomes in the long term, which should be monitored in future research., Purpose Delay of routine medical care during the COVID-19 pandemic may have serious consequences for the health and functioning of older adults. The aim of this study was to investigate whether older adults reported cancellation or avoidance of medical care during the first months of the COVID-19 pandemic, and to explore associations with health and socio-demographic characteristics. Methods Cross-sectional data of 880 older adults aged ≥ 62 years (mean age 73.4 years, 50.3% female) were used from the COVID-19 questionnaire of the Longitudinal Aging Study Amsterdam, a cohort study among community-dwelling older adults in the Netherlands. Cancellation and avoidance of care were assessed by self-report, and covered questions on cancellation of primary care (general practitioner), cancellation of hospital outpatient care, and postponed help-seeking. Respondent characteristics included age, sex, educational level, loneliness, depression, anxiety, frailty, multimorbidity and information on quarantine. Results 35% of the sample reported cancellations due to the COVID-19 situation, either initiated by the respondent (12%) or by healthcare professionals (29%). Postponed help-seeking was reported by 8% of the sample. Multimorbidity was associated with healthcare-initiated cancellations (primary care OR = 1.92, 95% CI = 1.09–3.50; hospital OR = 1.86, 95% CI = 1.28–2.74) and respondent-initiated hospital outpatient cancellations (OR = 2.02, 95% CI = 1.04–4.12). Depressive symptoms were associated with postponed help-seeking (OR = 1.15, 95% CI = 1.06–1.24). Conclusion About one third of the study sample reported cancellation or avoidance of medical care during the first months of the pandemic, and this was more common among those with multiple chronic conditions. How this impacts outcomes in the long term should be investigated in future research.

Coordinated medical care offered in Poland for patients suffering from neurofibromatosis type 1 and related RASopathies combines complex multispecialty consultation with permanent supervision and the patient’s oriented longitudinal care. Neurofibromatosis type 1 is one of the most common single gene disorders in the global population, observed in 1 out of 2500–3000 live births. It is a primary neoplasia disease with 100% penetration of the gene mutation but remarkable age-dependent onset of different disease signs and symptoms, outstanding clinical heterogeneity between patients even in one family and lack of genotype-phenotype correlation, a high rate of spontaneous mutation exceeding 50%, and multiple comorbidities among which increased risk of malignancy is the most important. Medical practice proved that not only patient-oriented complex but also coordinated care provided in centers of competence is indispensable for patients and the families and provides a sense of medical security to them in conjunction with public health costs rationalization.

SARS‐COV‐2 is a highly virulent positive‐sense single stranded RNA virus that spreads rapidly via respiratory droplets, causing severe acute respiratory syndromes with significant mortality and morbidity. Currently 210 countries and territories are affected around the world with a reported 2.6 million confirmed cases.1 The COVID 19 pandemic has changed the way patients attend their specialist appointments and receive medical care. Whilst some specialist clinics have closed we have implemented strategies and restructured our academic practice in Australia to minimize the spread of disease whilst treating patients who need urgent care. We hope to share these strategies in the hope they may be useful to the dermatology community. This article is protected by copyright. All rights reserved.

Background The number of patients with neurological diseases is currently increasing annually, which presents tremendous challenges for both patients and doctors. With the advent of advanced information technology, digital medical care is gradually changing the medical ecology. Numerous people are exploring new ways to receive a consultation, track their diseases, and receive rehabilitation training in more convenient and efficient ways. In this paper, we explore the use of facial expression recognition via artificial intelligence to diagnose a typical neurological system disease, Parkinson disease (PD). Objective This study proposes methods to diagnose PD through facial expression recognition. Methods We collected videos of facial expressions of people with PD and matched controls. We used relative coordinates and positional jitter to extract facial expression features (facial expression amplitude and shaking of small facial muscle groups) from the key points returned by Face++. Algorithms from traditional machine learning and advanced deep learning were utilized to diagnose PD. Results The experimental results showed our models can achieve outstanding facial expression recognition ability for PD diagnosis. Applying a long short-term model neural network to the positions of the key features, precision and F1 values of 86% and 75%, respectively, can be reached. Further, utilizing a support vector machine algorithm for the facial expression amplitude features and shaking of the small facial muscle groups, an F1 value of 99% can be achieved. Conclusions This study contributes to the digital diagnosis of PD based on facial expression recognition. The disease diagnosis model was validated through our experiment. The results can help doctors understand the real-time dynamics of the disease and even conduct remote diagnosis.

We scrutinize the evolution of COVID-19 in Madagascar by comparing results from three approaches (cubic polynomial, semi-gaussian and gaussian-like models) which we use to provide an analytical form of the spread of the pandemic. In so doing, we introduce (for the first time) the ratio ℜI/Tc,d of the cumulative and daily numbers of infected persons over the corresponding one of tests which are expected to be less sensitive to the number of the tests because the credibility of the results based only on the absolute numbers often raises some criticisms. We also give and compare the effective reproduction number Reff from different approaches and with the ones of some European countries with a small number of population (Greece, Switzerland) and some other African countries. Finally, we show and comment the evolution of the total number of deaths and of the per cent number of cured persons and discuss the performance of the medical care., Highlights • Attempt to study the COVID-19 spread in Madagascar. • First use of the ratio of the number of infected over the one of the tests. • Comparison of the predictions of different approaches. • Comments on the performance of the medical care in Madagascar.

Background: The coronavirus disease 2019 (COVID-19) pandemic raises the concern that other non-COVID conditions will be affected by a decline in care. Therefore, we aimed to investigate the decline in ambulatory presentations for vascular events (stroke, transient ischemic attack [TIA], and myocardial infarction [MI]) during the COVID-19 pandemic. Methods: Patients with a diagnosis of ischemic stroke, TIA, or MI documented anonymously in 1,262 general practices in Germany were included. We studied the differences between 2019 and 2020 (between April and June) in terms of rates and baseline characteristics by comparing monthly absolute frequencies. Results: A total of 3,496 patients with stroke (mean age: 72.2 years), 1,608 patients with TIA (mean age: 71.5 years), and 2,385 patients with MI (mean age: 66.8 years) were identified between April and June 2020, indicating a decrease of 10% (stroke), 16% (TIA), and 9% (MI) compared to 2019. For patients with stroke, the decrease in men was 13% (women: −6%) but reached 17% in the age category 51–60 years. For MI, the decrease was only obvious in males (14%). The largest decrease in stroke (−17%) and MI (−19%) was noted in April, while that for TIA occurred in May (−22%). In June for all 3 conditions, the previous year’s level was achieved. Only in TIA, the age differs between 2019 and 2020 (mean age: 69.9 vs. 71.5 years; p < 0.05). In patients with stroke and MI, the proportions of men were lower in 2019 than in 2020 (stroke: 54.8–50.5%, p < 0.05 and MI: 64–60.2%, p < 0.05). Conclusion: Although the decline in the number of patients presenting with stroke, TIA, and MI was not as noticeable in the ambulatory sector as it was in the area of emergency hospital-based care, our data indicate that the COVID-19 pandemic affected all sectors within the medical care system.

Background Sudden death accounts for up to 15% of all deaths among working age adults. A better understanding of victims’ medical care and symptoms reported at their last medical encounter may identify opportunities for interventions to prevent sudden deaths. Methods From 2013−15, all out-of-hospital deaths, ages 18–64 reported by Emergency Medical Services (EMS) in Wake County, North Carolina were screened and adjudicated to identify 399 victims of sudden death, 264 of whom had available medical records. Demographic and clinical characteristics and prescribed medications were compared between victims with versus without a medical encounter within one month preceding death with chi-square tests and t-tests, as appropriate. Symptoms reported in medical encounters within one month preceding death were analyzed. Results Among the 264 victims with available medical records, 73 (27.7%) had at least one encounter within a month preceding death. These victims were older and more likely to have multiple chronic illnesses, yet most were not prescribed evidence-based medicines. Of these 73 victims, 30 (41.1%) reported cardiac symptoms including dyspnea, edema, and chest pain. Conclusions Many victims seek medical care and report cardiac symptoms in the month prior to sudden death. However, medications that might prevent sudden death are under prescribed. These findings suggest that there are opportunities for intervention to prevent sudden death.

Background In the face of an aging society, an immediate and preventive medical system urgently needs to be established, and the application of wearable devices is essential. However, the application of smart medical care in Taiwan is still not widespread, and few studies have explored the related issues of wearable medical device usage. Thus, determining the success of a wearable medical device mainly depends on the degree of user adoption and use. Objective The purpose of this study was to examine the factors that influence the intention to use wearable medical devices. Methods This study applied the unified theory of acceptance and use of technology (UTAUT) to build a comprehensive model that explains intentions to use wearable medical devices. Results The research findings showed that health consciousness and trust were the strongest predictors of intentions to use wearable medical devices. Conclusions The results reveal the magnitudes of the impacts of the variables in a well-accepted revised UTAUT model in the context of the medical industry, particularly in the setting of wearable medical devices. Several important implications for academics and industry decision-makers can be formulated from these results.

Background High-quality medical resources are in high demand worldwide, and the application of artificial intelligence (AI) in medical care may help alleviate the crisis related to this shortage. The development of the medical AI industry depends to a certain extent on whether industry experts have a comprehensive understanding of the public’s views on medical AI. Currently, the opinions of the general public on this matter remain unclear. Objective The purpose of this study is to explore the public perception of AI in medical care through a content analysis of social media data, including specific topics that the public is concerned about; public attitudes toward AI in medical care and the reasons for them; and public opinion on whether AI can replace human doctors. Methods Through an application programming interface, we collected a data set from the Sina Weibo platform comprising more than 16 million users throughout China by crawling all public posts from January to December 2017. Based on this data set, we identified 2315 posts related to AI in medical care and classified them through content analysis. Results Among the 2315 identified posts, we found three types of AI topics discussed on the platform: (1) technology and application (n=987, 42.63%), (2) industry development (n=706, 30.50%), and (3) impact on society (n=622, 26.87%). Out of 956 posts where public attitudes were expressed, 59.4% (n=568), 34.4% (n=329), and 6.2% (n=59) of the posts expressed positive, neutral, and negative attitudes, respectively. The immaturity of AI technology (27/59, 46%) and a distrust of related companies (n=15, 25%) were the two main reasons for the negative attitudes. Across 200 posts that mentioned public attitudes toward replacing human doctors with AI, 47.5% (n=95) and 32.5% (n=65) of the posts expressed that AI would completely or partially replace human doctors, respectively. In comparison, 20.0% (n=40) of the posts expressed that AI would not replace human doctors. Conclusions Our findings indicate that people are most concerned about AI technology and applications. Generally, the majority of people held positive attitudes and believed that AI doctors would completely or partially replace human ones. Compared with previous studies on medical doctors, the general public has a more positive attitude toward medical AI. Lack of trust in AI and the absence of the humanistic care factor are essential reasons why some people still have a negative attitude toward medical AI. We suggest that practitioners may need to pay more attention to promoting the credibility of technology companies and meeting patients’ emotional needs instead of focusing merely on technical issues.

Background Surveys suggest that a large proportion of people use the internet to search for information on medical symptoms they experience and that around one-third of the people in the United States self-diagnose using online information. However, surveys are known to be biased, and the true rates at which people search for information on their medical symptoms before receiving a formal medical diagnosis are unknown. Objective This study aimed to estimate the rate at which people search for information on their medical symptoms before receiving a formal medical diagnosis by a health professional. Methods We collected queries made on a general-purpose internet search engine by people in the United States who self-identified their diagnosis from 1 of 20 medical conditions. We focused on conditions that have evident symptoms and are neither screened systematically nor a part of usual medical care. Thus, they are generally diagnosed after the investigation of specific symptoms. We evaluated how many of these people queried for symptoms associated with their medical condition before their formal diagnosis. In addition, we used a survey questionnaire to assess the familiarity of laypeople with the symptoms associated with these conditions. Results On average, 15.49% (1792/12,367, SD 8.4%) of people queried about symptoms associated with their medical condition before receiving a medical diagnosis. A longer duration between the first query for a symptom and the corresponding diagnosis was correlated with an increased likelihood of people querying about those symptoms (rho=0.6; P=.005); similarly, unfamiliarity with the association between a condition and its symptom was correlated with an increased likelihood of people querying about those symptoms (rho=−0.47; P=.08). In addition, worrying symptoms were 14% more likely to be queried about. Conclusions Our results indicate that there is large variability in the percentage of people who query the internet for their symptoms before a formal medical diagnosis is made. This finding has important implications for systems that attempt to screen for medical conditions.

Introduction: Advanced care planning (ACP) is a voluntary process of discussion about future care between an individual and their care provider. ACP is a key focus of national policy as a means to improve patient centered care at the end-of-life. Despite wide held belief that ACP is beneficial, uptake is sporadic with considerable variation depending on age, ethnicity, location and disease group. Methods: This study looked to establish the prevalence of ACP on initial presentation to hospital with a medical emergency within The Society of Acute Medicine Benchmarking Audit (SAMBA'18). 123 acute hospitals from across the UK collected data during a day of care survey. The presence of ACP and the presence of 'Do Not Attempt Cardiopulmonary Resuscitation' orders were recorded separately. Results: Among 6072 patients presenting with an acute medical emergency, 290 patients (4.8%) had an ACP that was available for the admitting medical team. The prevalence of ACP was higher at 12.6% for patients over 90 years old. Comparing the effect of location for older patients showed that for patients over 90 years old, 25.3% of patients in institutional care had ACP whereas 8.7% of patients admitted from home had ACP. However, in patients above the age of 90 who were being re-admitted after a hospital admission within the previous 30 days, just 15.3% had evidence of ACP. Conclusion: Very few patients have an ACP that is available to admitting medical teams during an unscheduled hospital admission. Even among patients with advanced age, and who have recently been in hospital, the prevalence of available ACP remains low, in spite of national guidance. Further interventions are needed to ensure that patients' wishes for care are known by providers of acute medical care. Funding Statement: The authors stated that: This study was unfunded." Declaration of Interests: No conflicts of interest declared by the authors. Ethics Approval Statement: The authors declared that ethics committee approval was not required for this study.

Background: The Extracorporeal Life Support Organization (ELSO) Maastricht Treaty for Nomenclature in Extracorporeal Life Support (ECLS) established consensus nomenclature and abbreviations for ECLS to ensure accurate, concise communication. Methods: We build on this consensus nomenclature by layering a framework of precise and efficient abbreviations for cannula configuration that describe flow direction, number of cannulae used, any additional ECLS-related catheters, and cannulation sites. This work is a consensus of international representatives of the ELSO, including those from the North American, Latin American, European, South and West Asian, and Asian-Pacific chapters of ELSO. Results: The classification increases in descriptive capability by introducing a third (cannula tip position) and fourth (cannula dimension) level to those provided in the previous consensus on ECLS cannulation configuration nomenclature. This expansion offers the simplest level needed to convey cannulation information yet allows for more details when required. Conclusions: A complete nomenclature for ECLS cannulation configurations accommodating future revisions was developed to facilitate ability to compare practices and results, to promote efficient communication, and to improve quality of registry data., SCOPUS: ar.j, info:eu-repo/semantics/published

A prospective observational study was performed in canine clinical medicine to evaluate the emetic action and adverse effects of tranexamic acid. Veterinarians treated 137 dogs with a single dose of tranexamic acid (50 mg/kg, IV) after accidental ingestion of foreign substances. If needed, a second (median, 50 mg/kg; range, 20-50 mg/kg, IV) or third dose (median, 50 mg/kg; range, 25-50 mg/kg, IV) was administered. Tranexamic acid induced emesis in 116 of 137 (84.7%) dogs. Median time to onset of emesis was 116.5 sec (range, 26-370 sec), median duration of emesis was 151.5 sec (range, 30-780 sec), and median number of emesis episodes was 2 (range, 1-8). Second and third administrations of tranexamic acid induced emesis in 64.7 and 66.7% of dogs, respectively. In total, IV administration of tranexamic acid successfully induced emesis in 129 of 137 (94.2%) dogs. Adverse effects included a tonic-clonic convulsion and hemostatic disorder in two different dogs, both of which recovered after receiving medical care. Tranexamic acid induced emesis in most dogs following a single-dose. When a single dose was not sufficient, an additional dosage effectively induced emesis. Overall, adverse effects were considered low and self-limiting.

Background The Centers for Disease Control and Prevention (CDC) tracks influenza-like illness (ILI) using information on patient visits to health care providers through the Outpatient Influenza-like Illness Surveillance Network (ILINet). As participation in this system is voluntary, the composition, coverage, and consistency of health care reports vary from state to state, leading to different measures of ILI activity between regions. The degree to which these measures reflect actual differences in influenza activity or systematic differences in the methods used to collect and aggregate the data is unclear. Objective The objective of our study was to qualitatively and quantitatively compare national and region-specific ILI activity in the United States across 4 surveillance data sources—CDC ILINet, Flu Near You (FNY), athenahealth, and HealthTweets.org—to determine whether these data sources, commonly used as input in influenza modeling efforts, show geographical patterns that are similar to those observed in CDC ILINet’s data. We also compared the yearly percentage of FNY participants who sought health care for ILI symptoms across geographical areas. Methods We compared the national and regional 2018-2019 ILI activity baselines, calculated using noninfluenza weeks from previous years, for each surveillance data source. We also compared measures of ILI activity across geographical areas during 3 influenza seasons, 2015-2016, 2016-2017, and 2017-2018. Geographical differences in weekly ILI activity within each data source were also assessed using relative mean differences and time series heatmaps. National and regional age-adjusted health care–seeking percentages were calculated for each influenza season by dividing the number of FNY participants who sought medical care for ILI symptoms by the total number of ILI reports within an influenza season. Pearson correlations were used to assess the association between the health care–seeking percentages and baselines for each surveillance data source. Results We observed consistent differences in ILI activity across geographical areas for CDC ILINet and athenahealth data. ILI activity for FNY displayed little variation across geographical areas, whereas differences in ILI activity for HealthTweets.org were associated with the total number of tweets within a geographical area. The percentage of FNY participants who sought health care for ILI symptoms differed slightly across geographical areas, and these percentages were positively correlated with CDC ILINet and athenahealth baselines. Conclusions Our findings suggest that differences in ILI activity across geographical areas as reported by a given surveillance system may not accurately reflect true differences in the prevalence of ILI. Instead, these differences may reflect systematic collection and aggregation biases that are particular to each system and consistent across influenza seasons. These findings are potentially relevant in the real-time analysis of the influenza season and in the definition of unbiased forecast models.

Historically, infectious diseases have caused more casualties than battle. The French military health service therefore developed a range of research on vector-borne diseases such as malaria and arboviruses, antibiotic resistance, infectious agents that can be used as biological weapons and vaccines. The main objective is to control naturally acquired or provoked infectious diseases and limit their impact on armed forces as well as on civilian populations in France or abroad, particularly in Africa and anywhere French armies may be deployed. The expertise of the military health service teams in manipulating agents requiring high level of biosafety precautions and in organizing and providing medical care in unnatural conditions, including the battlefield, associated with complementarity staff experience (physicians, biologists, epidemiologists, researchers, pharmacists, logisticians), has been used in the management of the Ebola outbreak in Guinea. Keywords: Africa, arbovirus, drug resistance, Ebola, malaria, Plasmodium falciparum, vaccine, vector-borne diseases

Introduction: Rheumatic diseases are becoming more and more common in Poland with the ageing of the population. Nearly 18% of the total hospital admissions in Poland result from rheumatic diseases, which was equivalent to 350 thousand cases in the year 2008. These diseases tend to last for many decades, decreasing both the quality of life and income of the patients as well as increasing the medical institutions’ workload and society’s financial burden. The aim of the study was to determine whether the medical care parameters in a rheumatic disease hospital ward show any significant differences among different patient age groups – especially such that would support taking them into account as a basis for adjusting the financial coverage level of medical services. Material and methods: Data on hospitalizations at the Rheumatic Diseases Ward of Wroclaw University Hospital in Wroclaw in the years 2009–2015 were analyzed, taking into account the age groups, number of hospital admissions, their duration and causes. Relevant statistical data analysis was performed. Discussion: The study revealed that the number of old patients hospitalized at the rheumatic diseases ward increased over the last 6 years and that such statistically significant differences do exist: on average the old patients not only tend to stay much longer at the hospital, but also suffer from a different and more diverse spectrum of diseases in comparison to their younger counterparts. Conclusions: The detected differences in medical care parameters support the need for more individualized medical care and increased cost of the hospital stay in the case of older patients. Consequently, those factors justify the necessity to increase the value of medical services in the case of old patients, possibly also taking into account the variation between age subgroups.

The scientific literature is full of numerous reports dealing with the quality of life of patients suffering from different diseases. The aim of the study is to present a set of questionnaires, which are used to study the quality of the patient's life, the questionnaires, which are the most popular in Poland and all over the world as well as those which concern the children's allergy. Increasingly, the research deals with the objective and subjective feelings of patients about their condition. Currently, the European Union's priority is to improve the quality of life of patients suffering from chronic non-communicable diseases. The studies on the quality of life are an interdisciplinary area, combining the clinical significance and the psychological aspects of medical care.

Background: Administrative records from insurance and hospital discharge data sources are important public health tools to conduct passive surveillance of disease in populations. Identifying rare but catastrophic conditions is a challenge since approaches for maximizing valid case detection are not firmly established. Objective: The purpose of our study was to explore a number of algorithms in which International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and other administrative variables could be used to identify cases of muscular dystrophy (MD). Methods: We used active surveillance to identify possible cases of MD in medical practices in neurology, genetics, and orthopedics in 5 urban South Carolina counties and to identify the cases that had diagnostic support (ie, true cases). We then developed an algorithm to identify cases based on a combination of ICD-9-CM codes and administrative variables from a public (Medicaid) and private insurer claims-based system and a statewide hospital discharge dataset (passive surveillance). Cases of all types of MD and those with Duchenne or Becker MD (DBMD) that were common to both surveillance systems were examined to identify the most specific administrative variables for ascertainment of true cases. Results: Passive statewide surveillance identified 3235 possible cases with MD in the state, and active surveillance identified 2057 possible cases in 5 actively surveilled counties that included 2 large metropolitan areas where many people seek medical care. There were 537 common cases found in both the active and passive systems, and 260 (48.4%) were confirmed by active surveillance to be true cases. Of the 260 confirmed cases, 70 (26.9%) were recorded as DBMD. Conclusions: Accuracy of finding a true case in a passive surveillance system was improved substantially when specific diagnosis codes, number of times a code was used, age of the patient, and specialty provider variables were used. [JMIR Public Health Surveill 2017;3(1):e2]

This paper defines economic inclusion as the ability of all people, including the disadvantaged, to share in economic gains, that is, the conditions that allow for broadly shared prosperity. Beyond the “right” to access consumption in cities, and beyond relatively standardized safety net policies that support economic security, inclusion demands intentional, flexible, context-appropriate strategies aimed at shifting the dynamics of local land and labor markets, public education, and other institutions. The paper analyzes the varied contexts for designing and supporting such strategies in a rapidly changing society, where urban regions have long been critical to incorporating a broad cross-section of people, including immigrant newcomers. Four dimensions are particularly crucial: an urban area’s level of economic growth, the quality of its jobs, its demographic profile, and its geography of opportunity (degree and form of spatial inequality). Economic inclusion is particularly urgent in America’s strongest local markets, which are pricing out the lowest-wage workers and showing a disturbing tendency to import rather than grow the talent needed for the emerging, innovation-driven economy. But weak-market regions face important challenges—and a range of options for leveraging demographic and other changes—as well. And for now, in all types of cities, innovative and promising strategies remain small in scale, in part because they are competing for support with entrenched, underperforming systems.

Background: There is preliminary evidence that mobile health (mHealth) apps are feasible, attractive, and an effective platform for the creation of self-management tools for persons living with HIV (PLWH). As a foundation for the current study, we conducted formative research using focus groups, participatory design sessions, and usability evaluation methods to inform the development of a health management app for PLWH. The formative research resulted in identification of the following functional requirements of a mHealth app for self-management: (1) communication between providers and peers, (2) medication reminders, (3) medication log, (4) lab reports, (5) pharmacy information, (6) nutrition and fitness, (7) resources (eg, social services, substance use, video testimonials), (8) settings, and (9) search function. Objective: The purpose of this study was to conduct an ecological review of the existing apps for PLWH and to compare the functionality of existing apps with the app specifications identified in our formative work. Methods: We searched two mobile app stores (Google Play and iTunes) and found a total of 5606 apps. We reviewed the apps, narrowed our search terms, and found a total of 112 apps. Of these, we excluded 97 (86.6%) apps that were either not in English (10/112, 8.9%), not HIV focused (32/112, 28.9%), or focused only on HIV prevention (2/112, 7.8%); targeted health care providers (26/112, 23.2%); provided information only on conference schedules and events (7/112, 6.3%), fundraisers (7/112, 6.3%), specific clinics (7/112, 6.3%), international or narrow local resources (3/112, 2.7%); or were identified in the first search but were no longer on the market at the next review (4/112, 3.6%). The 15 apps meeting inclusion criteria were then evaluated for inclusion of the nine functionalities identified in our earlier work. Results: Of the 15 apps that we included in our final review, none had all of the functionalities that were identified in our formative work. The apps that we identified included the following functionalities: communication with providers and/or peers (4/15, 27%), medication reminders (6/15, 40%), medication logs (7/15, 47%), lab reports (5/15, 33%), pharmacy information (4/15, 27%), resources (7/15, 47%), settings (11/15, 73%), and search function (6/15, 40%). No apps included nutrition or fitness information. Conclusions: Currently, there are only a small number of apps that have been designed for PLWH to manage their health. Of the apps that are currently available, none have all of the desired functionalities identified by PLWH and experts in our formative research. Findings from this work elucidate the need to develop and evaluate mobile apps that meet PLWH’s desired functional specifications. [JMIR Mhealth Uhealth 2015;3(3):e91]

We complement the empirical evidence on the sustainability of weight loss achieved through cash rewards and, for the first time, rigorously examine the potential of cash rewards to prevent weight cycling. In a three period randomized controlled trial, about 700 obese persons were first assigned to two treatment groups, which were promised cash contingent on the achievement of an individually assigned target weight, and to a control group. Successful participants were subsequently allocated to two treatment groups offered cash rewards for confirming the previously achieved target weight and to a control group. This is the first experiment of this kind that finds effects of weight loss rewards up to 18 months after they were removed. Additional rewards only significantly improve the sustainability of weight loss while they are in place. Die empirische Analyse untersucht zum einen die Nachhaltigkeit einer Gewichtsreduktion, die mittels Geldanreizen erzielt wurde, und zum anderen die Wirksamkeit von Geldanreizen zur Verhinderung des Jo-Jo-Effekts nach einer erfolgreichen Gewichtsreduktion. In einem drei-phasigen Feldexperiment wurden ca. 700 fettleibige Teilnehmer zunächst zufällig auf zwei Anreizgruppen und einer Kontrollgruppe verteilt. Unabhängig von der Gruppenzugehörigkeit sollten ein individuelles Gewichtsreduktionziel erreicht werden, wobei nur Mitglieder der Anreizgruppen eine Geldprämie für das Erreichen des Zieles erhalten konnten. Erfolgreiche Teilnehmer wurden danach erneut zufällig einer Kontrollgruppe und zwei Anreizgruppen zugewiesen, wobei das Halten des Zielgewichts nur für letztere durch eine Geldprämie inzentiviert wurde. Anders als in früheren Experimenten, können Effekt der Abnehmprämie selbst 18 Monate nach ihrem Auslaufen nachgewiesen werden. Monetäre Anreize zur Verhinderung des Jo-Jo-Effekt wirken hingegen nicht über ihr Auslaufen hinaus.

The paper aims to provide the basis for an estimation equation and will focus on the relation between transport emissions and air quality in an urban environment. This is directly related to the fact that most health impacts are related to local air quality levels. The aim of the paper is to create an understanding of the factors that play a role in the causal relation between transport emissions and health effects and provides approximations from existing studies that can be used to assess these health impacts and related costs. The paper focuses on the translation of air pollution levels into health impacts and health costs. The overall structure of the paper follows the two key steps and elaborates on the inherent challenges: (1) identify and measure the health effects of air pollution, and (2) to estimate the costs of the health effects. The paper is divided into four chapters: chapter one is introduction- outlining the goals and background to the project; chapter two gives impacts of air pollution from transport on health; chapter three presents valuation of health impacts- reviews the literature on how to value the impacts on health associated with air pollution; and chapter four gives guidelines for calculating the health effects of air pollution from traffic.

Background: The consistency of treatment recommendations of evidence-based medical textbooks with more recently published evidence has not been investigated to date. Inconsistencies could affect the quality of medical care. Objective: To determine the frequency with which topics in leading online evidence-based medical textbooks report treatment recommendations consistent with more recently published research evidence. Methods: Summarized treatment recommendations in 200 clinical topics (ie, disease states) covered in four evidence-based textbooks–UpToDate, Physicians’ Information Education Resource (PIER), DynaMed, and Best Practice–were compared with articles identified in an evidence rating service (McMaster Premium Literature Service, PLUS) since the date of the most recent topic updates in each textbook. Textbook treatment recommendations were compared with article results to determine if the articles provided different, new conclusions. From these findings, the proportion of topics which potentially require updating in each textbook was calculated. Results: 478 clinical topics were assessed for inclusion to find 200 topics that were addressed by all four textbooks. The proportion of topics for which there was 1 or more recently published articles found in PLUS with evidence that differed from the textbooks’ treatment recommendations was 23% (95% CI 17-29%) for DynaMed, 52% (95% CI 45-59%) for UpToDate, 55% (95% CI 48-61%) for PIER, and 60% (95% CI 53-66%) for Best Practice ( χ 2 3 =65.3, P

Background Death with a functioning kidney graft (DWFG) is now a major cause of graft loss after renal transplantation, occurring in up to 40% of cases. Its occurrence provides insight into the medical care of subjects with a functioning kidney transplant. In this study, we used the time to DWFG as an endpoint, to test whether improved medical care has contributed to better kidney transplant outcomes. Methods We used single-center data from the Milwaukee Regional Medical Center and Froedtert Hospital, on kidney-only transplants from 1969 through 2005. A total of 3,157 kidney transplants were done at our center during this time. There were 714 deaths with functioning kidney. We also recorded the major causes of DWFG over the time period from 1969 through 2005 divided into 3 epochs. The data were analyzed as a serial collection of yearly obituaries. Results The time to DWFG has increased to 10 years despite a 20-year increase in the mean age of transplant recipients over the same time period. Conclusions Better pre-transplant evaluation, improved treatments for hypertension and hyperlipidemia, improved management of acute myocardial infarction, superior immunosuppressive protocols and better prophylaxis and treatment of infectious diseases have all likely contributed to this trend.

SUMMARYNational studies determining the burden of gastroenteritis have defined gastroenteritis by its clinical picture, using symptoms to classify cases and non-cases. The use of different case definitions has complicated inter-country comparisons. We selected four case definitions from the literature, applied these to population data from Australia, Canada, Ireland, Malta and the United States, and evaluated how the epidemiology of illness varied. Based on the results, we developed a standard case definition. The choice of case definition impacted on the observed incidence of gastroenteritis, with a 1·5–2·1 times difference between definitions in a given country. The proportion of cases with bloody diarrhoea, fever, and the proportion who sought medical care and submitted a stool sample also varied. The mean age of cases varied by

Primarily a disease of young adults, Acquired Immuno Deficiency Syndrome (AIDS) imposes economic costs that could be devastatingly high in the long run by undermining the transmission of human capital the main driver of long-run economic growth across generations. AIDS makes it harder for victims' children to obtain an education and deprives them of the love, nurturing, and life skills that parents provide. These children will in turn find it difficult to educate their children, and so on. An overlapping generations model is used to show that an otherwise growing economy could decline to a low level subsistence equilibrium if hit with an AIDS type increase in premature adult mortality. Calibrating the model for South Africa, where the HIV prevalence rate is over 20 percent, simulations reveal that the economy could shrink to half its current size in about four generations in the absence of intervention. Programs to combat the disease and to support needy families could avert such a collapse, but they imply a fiscal burden of about 4 percent of Gross domestic product (GDP).

Introduction: There is a body of literature that indicates that physical exercise interventions, with a primary focus on improvement of functioning instead of pain relief, might be effective to stimulate return to work and improve function in workers who are absent from work due to low back pain (LBP). Successful application and implementation of these interventions however, depends on multiple factors that need to be addressed carefully in clinical practice as well as research. Methods: Descriptive literature review, to identify an overview of current knowledge with respect to the safety, content- and context-related aspects of physical exercise interventions, issues relating to timing, the influence of treatment confidence and patient expectations, and the process of changing provider and employer behavior. Results: Physical exercises are not associated with an increased risk for recurrences. The effects of interventions may vary depending on content-related factors (i.e., type of exercises, dosage, frequency, skills of the healthcare providers, etc.) and contextual factors (i.e., treatment setting, compensation system, etc.). Treatment confidence and patients' expectations also significantly influence outcomes of physical exercise interventions. Timing is also important; interventions targeting return to work, applied during the acute phase of work absenteeism, compete with a high rate of spontaneous recovery and may therefore be inefficient. Conclusions: Despite numerous studies, more quantitative and qualitative investigations are needed to further clarify the requirements for a successful application and implementation of physical exercise interventions for disabled workers with low back pain. © 2005 Springer Science + Business Media, Inc.

Aims: Dentistry and medicine have been treated as separate entities by healthcare professionals as well as the populace since a long time. Although dentistry as a standalone entity has achieved considerable progress, there is a significant inequity in the accessibility, affordability, and acceptability of dental care among various socioeconomic strata in the community. Moreover, it is becoming increasingly evident that oral diseases and systemic diseases often share multiple risk factors. Management of oral and systemic diseases as distinct units often results in duplication of care and wastage of resources. This paper gives information on the models of medical-dental integration and possible methods for integrating the same into Indian healthcare scenario. Materials and Methods: A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for articles pertaining to medical-dental integration. The data obtained were collated. Results: Literatures show that different modalities for medical-dental integration are in practice. However, there is a paucity in conceptual models that may be applied to bring about such an integration into the Indian healthcare system. Conclusion: Integration of medical and dental care would pave the way for equity in health care for everyone. Conceptual models for integrating oral disease surveillance into systemic disease have been proposed in this paper.

Introduction : The volume and quality of biomedical research publications from an institution are considered adequate indicators of the quality of medical care in that institute. King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia (KSA), is one of the oldest and most distinguished medical centers in the country. Methods: In this study, we analyzed the number of publications from the Critical Care Unit of the hospital in the past two decades, from 1996 to 2016. The research publications were evaluated on various parameters. Moreover, the impact of their study on global medicine was determined. Results: Our results indicate a steady progression in the number of publications from the institute in the past two decades. An average of 17.3 papers was published each year during this time. Out of the 283 publications from KAMC included in this study, the majority of the publications were original articles, 61 were review articles, 66 were multicenter trial studies and 28 were randomized control trials. The citation profile of the publications was good indicating global impact of the studies. Conclusion: The global impact of research as evaluated through published manuscripts in KAMC is overall good. This was deduced from both the increase in the number of publications each year and also the quality of papers as evidenced by the citation index of the papers published between 1996 and 2016.

With the acceleration of population ageing, the achieving of healthy ageing is becoming a global imperative and social protection policies and social security systems have an important role to play in this endeavour. Through a life-cycle approach, social protection systems can support the prevention of disability in old age (i.e. by addressing social determinants of health), effective access to long term-care without hardship for those in need of it and decent work in the care economy. In order to make this contribution effectively, the adoption of a gender-transformative approach will be required; for, women are disproportionately represented among both older persons and long-term care (LTC) providers in all their diversity. Furthermore, to adequately contribute to the achieving of healthy ageing and effective access to LTC without hardship as a rights-based entitlement, social protection systems will need to build strong coordination among health care, social care and other social and employment policies. This paper highlights the key entry points for social protection systems to contribute to the Decade on Healthy Ageing, building on a rights-based approach achored in human rights and international social security standards. This working paper draws from the article "Long-term care in the context of population ageing: What role for social protection policies?" by the same authors published in the special edition of the International Social Security Review "The human right to long-term care for the elderly: Extending the role of social security programmes (Tessier et al., 2022).

Purpose: Process optimization in healthcare using artificial intelligence (AI) is still in its infancy. In this study, we address the research question “To what extent can an AI-driven chatbot help to optimize the diagnostic process?” Design / Method / Approach: First, we developed a mathematical model for the utility (i.e., total satisfaction received from consuming a good or service) resulting from the diagnostic process in primary healthcare. We calculated this model using MS Excel. Second, after identifying the main pain points for optimization (e.g., waiting time in the queue), we ran a small experiment (n = 25) in which we looked at time to diagnosis, average waiting time, and their standard deviations. In addition, we used a questionnaire to examine patient perceptions of the interaction with an AI-driven chatbot. Findings: Our results show that scheduling is the main factor causing issues in a physician’s work. An AI-driven chatbot may help to optimize waiting time as well as provide data for faster and more accurate diagnosis. We found that patients trust AI-driven solutions primarily when a real (not virtual) physician is also involved in the diagnostic process. Practical Implications: AI-driven chatbots may indeed help to optimize diagnostic processes. Nevertheless, physicians need to remain involved in the process in order to establish patient trust in the diagnosis. Originality / Value: We analyze the utility to physicians and patients of a diagnostic process and show that, while scheduling may reduce the overall process utility, AI-based solutions may increase the overall process utility. Research Limitations / Future Research: First, our simulation includes a number of assumptions with regard to the distribution of mean times for encounter and treatment. Second, the data we used for our model were obtained from different papers, and thus from different healthcare systems. Third, our experimental study has a very small sample size and only one test-physician. Paper type: Empirical

Glycine monitoring is gaining importance as a biomarker in clinical analysis due to its involvement in multiple physiological functions, which results in glycine being one of the most analyzed biomolecules for diagnostics. This growing demand requires faster and more reliable, while affordable, analytical methods that can replace the current gold standard for glycine detection, which is based on sample extraction with subsequent use of liquid chromatography or fluorometric kits for its quantification in centralized laboratories. This work discusses electrochemical sensors and biosensors as an alternative option, focusing on their potential application for glycine determination in blood, urine, and cerebrospinal fluid, the three most widely used matrices for glycine analysis with clinical meaning. For electrochemical sensors, voltammetry/amperometry is the preferred readout (10 of the 13 papers collected in this review) and metal-based redox mediator modification is the predominant approach for electrode fabrication (11 of the 13 papers). However, none of the reported electrochemical sensors fulfill the requirements for direct analysis of biological fluids, most of them lacking appropriate selectivity, linear range of response, and/or capability of measuring at physiological conditions. Enhanced selectivity has been recently reported using biosensors (with an enzyme element in the electrode design), although this is still a very incipient approach. Currently, despite the benefits of electrochemistry, only optical biosensors have been successfully reported for glycine detection and, from all the inspected works, it is clear that bioengineering efforts will play a key role in the embellishment of selectivity and storage stability of the sensing element in the sensor.

Global governance has become an increasingly popular concept among international relations scholars for analyzing how non-state actors participate in the governance of various issues of global common interest. HIV/AIDS policy is one of the key fields in which the prominent features of global governance are found. This paper discusses how the global governance of HIV/AIDS intersects with state sovereignty issues by examining the case of South Africa, a country seriously affected by the disease and one of the principal loci of contestation over the direction of HIV/AIDS policy.

Aim To investigate the magnitude of executive function deficits and their dependency on gestational age, sex, age at assessment, and year of birth for children born preterm and/or at low birthweight. Method PubMed, PsychINFO, Web of Science, and ERIC were searched for studies reporting on executive functions in children born preterm/low birthweight and term controls born in 1990 and later, assessed at a mean age of 4 years or higher. Studies were included if five or more studies reported on the same executive function measures. Results Thirty‐five studies (3360 children born preterm/low birthweight, 2812 controls) were included. Children born preterm/low birthweight performed 0.5 standardized mean difference (SMD) lower on working memory and cognitive flexibility and 0.4 SMD lower on inhibition. SMDs for these executive functions did not significantly differ from each other. Meta‐regression showed that heterogeneity in SMDs for working memory and inhibition could not be explained by study differences in gestational age, sex, age at assessment, or year of birth. Interpretation Children born preterm/low birthweight since 1990 perform half a SMD below term‐born peers on executive function, which does not seem to improve with more recent advances in medical care or with increasing age. What this paper adds Children born preterm/low birthweight perform below term‐born children on core executive functions.Lower gestational age or male sex are not risk factors for poorer executive functions.Executive function difficulties in children born preterm/low birthweight remain stable across childhood.Executive function difficulties are similar for children born recently and children born in earlier eras., What this paper adds Children born preterm/low birthweight perform below term‐born children on core executive functions.Lower gestational age or male sex are not risk factors for poorer executive functions.Executive function difficulties in children born preterm/low birthweight remain stable across childhood.Executive function difficulties are similar for children born recently and children born in earlier eras. This article's abstract has been translated into Spanish and Portuguese. Follow the links from the http://onlinelibrary.wiley.com/doi/10.1111/dmcn.14213/abstract to view the translations.

Patients are increasingly being asked to complete standardized, validated questionnaires with regard to their symptoms, functioning, and well-being [ie, patient-reported outcomes (PROs)] as part of routine care. These PROs can be used to inform patients' care and management, which we refer to as "PRO-cision Medicine." For PRO-cision Medicine to be most effective, clinicians and patients need to be able to understand what the PRO scores mean and how to act on the PRO results. The papers in this supplement to Medical Care describe various methods that have been used to address these issues. Specifically, the supplement includes 14 papers: 6 describe different methods for interpreting PROs and 8 describe how different PRO systems have addressed interpreting PRO scores and/or acting on PRO results. As such, this "Methods Toolkit" can inform clinicians and researchers aiming to implement routine PRO reporting into clinical practice by providing methodological fundamentals and real-world examples to promote personalized patient care.

International audience; AbstractIn the frame of “precision medicine”, the scandium radionuclides have recently received considerable interest, providing personalised adjustment of radiation characteristics to optimize the efficiency of medical care or therapeutic benefit for particular groups of patients. Radionuclides of scandium, namely scandium-43 and scandium-44 (43/44Sc) as positron emitters and scandium-47 (47Sc), beta-radiation emitter, seem to fit ideally into the concept of theranostic pair. This paper aims to review the work on scandium isotopes production, coordination chemistry, radiolabeling, preclinical studies and the very first clinical studies. Finally, standardized procedures for scandium-based radiopharmaceuticals have been proposed as a basis to pave the way for elaboration of the Ph.Eur. monographs for perspective scandium radionuclides.

Global pandemics pose unprecedented challenges to healthcare. In the current situation, telemedicine appears to be a sustainable and effective solution in the implementation of precautions, prevention and treatment in order to discontinue the spreading of the coronavirus infection (COVID-19). The aim of this paper was to research and analyze the role of telemedicine in assistance to healthcare in the COVID-19 pandemic. Methods: The PubMed Database, Google Scholar, SpringerLink, ScienceDirect (Elsevier) and sites of public authorities have been accessed and reviewed. Results: Advantages, restrictions, policy and application of telemedicine in the conditions of COVID-19 pandemic have been studied and analyzed. Conclusion: Healthcare systems are put under an extreme test during global pandemics. Telemedicine is crucial during the COVID-19 pandemic because it guarantees that patients have access to medical care.

Chumak Z. V., Shapoval M. V., Andrievskiy O. G. Hif-1α and IGF Expression in Endometrial Hyperplasia. Journal of Education, Health and Sport. 2020;10(11):61-68. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.11.006 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.11.006 https://zenodo.org/record/268459 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 16.10.2020. Revised: 30.10.2020. Accepted: 11.11.2020. Hif-1α and IGF Expression in Endometrial Hyperplasia Z. V. Chumak1,2, M. V. Shapoval1, O. G. Andrievskiy1 1Odessa National Medical University; 2Сity Center for Menopause, Odessa, Ukraine Abstract The objective: to assess the effect of insulin resistance and hypoxia on the risk of endometrial hyperplasia development. The research was conducted on the base of Municipal Maternity House №5 (Odessa, Ukraine). The data obtained from the sample of 417 reproductive, perimenopausal, and postmenopausal age women who referred for medical care to the gynecological department, were analyzed. All the women under examination were carried out medical and diagnostic scraping of the uterine cavity. Results. The intensity of hypoxia increases with age and closely correlates (r=0,78) with the level of insulin resistance. IGF demonstrates reverse dynamics – its rates has been diminished with age (r=-0,63). Conclusion. It was demonstrated that insulin resistance and hypoxia play significant role in the pathogenesis of endometrial hyperplasia. Indices of IGF and HIF could be recommended as valuable biomarkers of prognosis in the case of endometrial hyperplasia. Key words: endometrial hyperplasia; IGF; Hif-1α; malignancy

This article reviews the mechanism, symptoms, causes, severity, diagnosis, prevention and present recommendations for surgical as well as non-surgical management of pressure ulcers. Particular focus has been placed on the current understandings and the newer modalities for the treatment of pressure ulcers. The paper also covers the role of nutrition and pressure-release devices such as cushions and mattresses as a part of the treatment algorithm for preventing and quick healing process of these wounds. Pressure ulcers develop primarily from pressure and shear; are progressive in nature and most frequently found in bedridden, chair bound or immobile people. They often develop in people who have been hospitalised for a long time generally for a different problem and increase the overall time as well as cost of hospitalisation that have detrimental effects on patient’s quality of life. Loss of sensation compounds the problem manifold, and failure of reactive hyperaemia cycle of the pressure prone area remains the most important aetiopathology. Pressure ulcers are largely preventable in nature, and their management depends on their severity. The available literature about severity of pressure ulcers, their classification and medical care protocols have been described in this paper. The present treatment options include various approaches of cleaning the wound, debridement, optimised dressings, role of antibiotics and reconstructive surgery. The newer treatment options such as negative pressure wound therapy, hyperbaric oxygen therapy, cell therapy have been discussed, and the advantages and disadvantages of current and newer methods have also been described.

The global crisis over the Covid-19 virus pandemic has raised some questions that are relevant to criminal law as well. Disturbing news are coming from several countries about the deaths of many people because of the inability of healthcare professionals to provide them with adequate medical care due to a lack of mechanical ventilation devices. In this regard, the question arises as to what are the criteria by which to decide who will be connected to the ventilator and how the decision-making of doctors in these tragic life and death issues can be facilitated. The paper deals with the institute of the so-called collision of duties, which in some legal systems constitutes an independent cause for the exclusion of unlawfulness and, in some cases, a type of necessity. In comparative law, a number of different criteria are met by which patients should be triaged in disaster situations. The author concludes that the adoption of appropriate guidelines can establish a standard of due diligence that would to some extent remove the burden of decision making from physicians.

Our paper analyses the technical efficiency and the change in the efficiency of the healthcare systems in 23 European Union (EU) countries between 2008 and 2016 based on the data published by OECD. We apply Dynamic Network Data Envelopment Analysis (DNDEA) to assess the efficiency of the medical care system and public health system, together with overall healthcare system efficiency. The findings suggest that the efficiency of public health systems in 2016 were higher than the efficiency of medical care systems in the same year only in Denmark. In the case of France, Hungary, Ireland, Lithuania, Poland, Portugal, Spain and the United Kingdom, the medical systems were more efficient. The model marked Austria, Czech Republic, Estonia, Finland, Germany, Greece, Italy, Latvia, Luxembourg, Netherlands, Slovak Republic, Slovenia and Sweden as efficient in terms of the medical care system as well as the public health system in 2016.

Mykhalchuk Vasyl Mykolayovych, Pishchikov Valeriy Anatoliyovych. The peculiarities of medical care organizing forpatients with viral hepatitis in Ukraine. Journal of Education, Health and Sport. 2020;10(1):279-288. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.01.031 https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.01.031 http://dx.doi.org/10.5281/zenodo.4252033 The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019. © The Authors 2020; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.12.2019. Revised: 25.12.2019. Accepted: 31.01.2020. THE PECULIARITIES OF MEDICAL CARE ORGANIZING FOR PATIENTS WITH VIRAL HEPATITIS IN UKRAINE Vasyl Mykolayovych Mykhalchuk, Doctor of Medicine, Professor, Head of the Health Care Management Department, NMAPE named after P L Shupik; Valeriy Anatoliyovych Pishchikov, Doctor of Medicine, Professor, Chief Researcher of the Scientific Department of Medical Care Organization, Deputy Head of the Department of Health Care and Sanatoriums of the State Administration Abstract The problem of chronic viral hepatitis is gaining relevance. Many authors consider the issues of epidemiology as well as medical and diagnostic problems. Revising the structure of health care facilities (HCFs), a lack of specialized medical care units was defined. The purpose of the Program is to ensure access of the general population to the prevention, diagnosis and treatment of viral hepatitis B and C in Ukraine in order to stabilize the epidemic situation, reduce morbidity, disability and mortality, increase the duration and quality of patients life. Keywords: hepatitis B and C; epidemiology; revention; diagnosis; treatment

The impact of the epidemic on the global economy has exposed the fragility and complexity of the internal and external economic system, and the global economic situation is not optimistic. Taking the epidemic as an example, this paper analyzed the impact of emergencies on the global economy from multiple perspectives. The outbreak of the epidemic has made most offline businesses shut down overnight. At the same time, it has also led to the rapid development of online economy, such as online education, home office software, video entertainment and so on. The outbreak and spread of the epidemic has promoted the digital upgrading of all walks of life, including online government affairs, commerce, science, education, culture and health organization, operation and maintenance. The era of digital economy has come, and digitization is the general trend.

[Background]: In recent years, aging has become a global social problem. Intelligent health management technology (IHMT) provides solutions for the elderly to deal with various health risks. However, the elderly are facing many difficulties in using IHMT. Studying the application types of IHMT and the influencing factors of the elderly’s acceptance of it will help to improve the use behavior of the elderly. [Methods]: This paper summarizes the application types of IHMT, identifies the influencing factors of the elderly’s adaption of IHMT, and makes a systematic comment on the influencing factors. [Results]: We divide the different functions of IHMT for the elderly into four types: self-monitoring, medical care, remote monitoring, and health education. The influencing factors are divided into three types: individual, social, and technology. [Conclusions]: This study finds that IHMT’s application covers all aspects of the health services of the elderly. Among these applications, self-monitoring is the most used. We divided the influencing factors of the elderly’s acceptance of IHMT into three categories and nine subcategories, having 25 variables.

Management of combat casualties has always been a challenging task. Armed Forces world over have developed effective casualty air evacuation mechanisms. The history of casualty evacuation dates back to 1870s. The first evacuation of casualty by air was during the First World War. The paper highlights the background and evolution of air evacuation in the world and discusses the Indian Scenario of casualty air evacuation. The casualty evacuation capabilities of the aircrafts in the Indian Air Force (IAF) are highlighted. To ensure prompt casualty evacuation, the Armed Forces have a chain of casualty air evacuation, thus ensuring that the injured reach the health care center in the least possible time. An indigenously developed patient transfer unit (PTU) comprising of a trauma care recovery trolley with a complement of a portable ventilator, multipara monitor, infusion pumps and oxygen system is also discussed. In addition, the paper discusses the aeromedical considerations while evacuating casualties by air and contraindications for air evacuation. The advancements in the field of medical technology and medical care has ensured safe air evacuation of casualties and has reduced the morbidity and mortality of casualties, thus boosting the morale of the troops.

This paper innovatively constructs a panel extended linear expenditure system (ELES) model including the theory of internal and external habit formation and analyzes the time effect of consumption habits and the regional differences of the comparison effects on rural residents in a variety of consumption expenditures from a temporal and spatial perspective. This research demonstrates the following. Firstly, overall, rural residents have least internal habits in terms of subsistence spending, followed by developmental spending and the most in enjoyment spending. Secondly, China’s rural residents consider the “actual use value” of commodities in “introverted” consumption expenditures, but in “export-oriented” consumption expenditures, besides the “actual use value” of the goods, they also seek to fulfill their “emotional demands”. Thirdly, there is the largest comparison effect on food and housing consumption expenditures for rural residents in coastal economic developed regions, and the smallest comparison effect on clothing, transportation, cultural and educational expenditures. It is the largest comparison effect on clothing and medical care expenditures for rural residents in underdeveloped regions of the central and western, and the smallest comparison effect on food and housing consumption expenditures.

“Continuity of Care” is the main prerequisite for the unhindered movement of people across borders within the European Union (EU). The COntinuity of care in MEtabolic diseases through modern TECHnology (COMETECH) project aims to address the problem of inadequate access to health system services to people who live in isolated communities in Greece and North Macedonia cross-border areas. As the project is almost completed, 4 e-health units—2 in each country—have been established in isolated and deprived communities, aiming at introducing “Continuity of Care” for patients with diabetes in the border region between those countries. The establishment of the e-health units allows affordable access to medical services within Greece-North Macedonia cross-border area. These units (equipped with state-of-the-art medical devices, supported by an advanced software application and medical staff) record data of local people and offer valuable and high-quality medical care services. The records of the EU citizens using the COMETECH services are safely and easily accessible by their physicians. This paper presents the user requirements of e-health units and the medical devices that are set up for the COMETECH Project for helping people with diabetes in the targeted countries.

Traumatic Brain Injury (TBI) is a leading cause of morbidity and moribundity in the United States (Bruns and Hauser, 2003; Corrigan et al., 2010). A number of factors including sex influence TBI clinical outcome. Both clinical and lab studies show a clear influence of sex on TBI outcome. However, whether this is mediated by hormones, genes, or both is still under debate (Gupte et al., 2019; Ma et al., 2019; Mikolic et al., 2020). The majority of research focuses on factors of endogenous hormone signaling (release and reception) in natal males (Slewa-Younan et al., 2004; Dubal et al., 2006; Herson et al., 2009; Griesbach et al., 2015; Clevenger et al., 2018; Mollayeva et al., 2018; Spani et al., 2018; Ma et al., 2019). This excludes natal females and both males and females taking exogenous hormones for hormone replacement (HRT) or cross sex hormone therapy (CSHT) as part of a gender confirming therapy (Mollayeva et al., 2018; Spani et al., 2018; Ma et al., 2019; Giordano et al., 2020; Biegon, 2021). While transgender and gender non-conforming (TGNC) individuals make up 0.3–0.5% of the global population, they are affected by violence at higher rates compared to cisgender individuals (Jauk, 2013). Despite these higher rates of violence and increased risk of TBI, the TGNC population remains understudied in the TBI field (Safer et al., 2016). This bias extends to healthcare settings where many TGNC individuals face significant barriers to obtaining high-quality, compassionate medical care at primary care facilities, especially in emergency rooms, where most TBIs are diagnosed (Sanchez et al., 2009; Porter et al., 2016; Reisner et al., 2016; Safer et al., 2016; Dickey and Singh, 2017). Research regarding transgender health has dramatically increased, yet there is still significant room for improvement as TGNC individuals are at an increased risk for several health issues (Reisner et al., 2016; Ackerley et al., 2019; Neblett and Hipp, 2019; Yeung et al., 2019; Wiepjes et al., 2020). A gender inclusive approach in biomedical research is vital to our understanding and treatment of TBI. The aim of this paper is to call upon lab-based investigators to approach the study of TBI and also biomedical research in a gender inclusive manner.