Authors:RuiQi Li, YaLun Dai, YiWen Han, Chi Zhang, Jing Pang, Jian Li, TieMei Zhang, Ping Zeng Abstract: Background and objectivesNationwide data were used to explore factors associated with physical function in order to identify interventions that could improve and maintain physical function in the older people.MethodsThe physical function was assessed by gait speed (GS). We selected 2,677 male and 2,668 female older adults (aged ≥60) who could perform the GS test as study subjects. GS was measured by having subjects walk across and back a 10-m course. A gait speed less than 20% that of a reference population ( PubDate: 2023-11-28T00:00:00Z
Authors:Jiahui Hu, Shudan Zhang, Weibing Ye, Yuanye Zhu, Huiling Zhou, Lihua Lu, Qian Chen, Mallikarjuna Korivi Abstract: PurposeThis study investigated the influence of parenting and grandparenting caregiving styles on fundamental motor skills (FMS) of preschool children.MethodA total of 1,326 preschool children (698 boys, 628 girls) aged 4–6 years were recruited from the kindergartens of Jinhua City, China. Locomotor skills (LM), ball skills (BS), and total fundamental movement skills (TS) of children were assessed by the Test of Gross Motor Development-3rd edition (TGMD-3).ResultsThere were 978 children in parenting and 348 children in grandparenting caregiving styles. The LM, BS and TS scores of children were considerably (p < 0.001) increased with age (irrespective of sex or caregiving style). For the sex comparisons, BS scores of boys were significantly higher than girls (p < 0.001), while LM and TS scores were not different between boys and girls. For the caregiving style comparison, parenting is superior to grandparenting in developing of children's FMS. Parenting boys of 4-, 5-, and 6-years old showed better BS compared to age-matched parenting girls, whereas boys of 5-years old in grandparenting only showed better BS compared to same-age grandparenting girls (p < 0.05). Furthermore, parenting boys of 6-years reported higher LM (p < 0.01), BS (p < 0.001), and TS (p < 0.001) scores compared to grandparenting boys, but girls' FMS at all ages were not significantly different between the caregiving styles.ConclusionParenting caregiving style is positively associated with proper development of FMS among children. Girl children with poor FMS in grandparenting may need a special care or intervention programs to promote their FMS. PubDate: 2023-11-28T00:00:00Z
Authors:Horim A. Hwang, Hyunsuk Jeong, Hyeon Woo Yim Abstract: IntroductionThe number and proportion of older adults living alone is a significant issue. While the number of the oldest old people is also expected to increase, their health characteristics are poorly understood. This study aims to evaluate the health-related quality of life (HRQoL) of the oldest old people according to age, sex, and living arrangements.MethodsThis study is based on the Korea Community Health Survey 2021. Among the survey's 229,242 observations, 73,617 observations aged 65 or higher were used for the analysis. The study participants were divided into 5-year age intervals (from 65–69 to 90+), sex, and living arrangements. The outcome variables are the EuroQol 5 Dimensions (EQ-5D) index score and the problem reporting rates of the five dimensions of EQ-5D.ResultsThe mean EQ-5D index scores were 0.896 at 65–69 and 0.741 at 90+. The mean EQ-5D index score decreased more rapidly as age increased. Women showed consistently lower mean EQ-5D index scores than men in all age intervals. The proportion of older adults living alone increased from 18.1% at 65–69 to 43.6% at 90+. The odds of reporting problems with anxiety/depression among older men living alone were estimated to be significantly higher than older men living with someone (aOR 1.22 95% CI 1.05–1.43). The odds of reporting problems in self-care and usual activity among older women living alone were estimated to be significantly lower than older women living with someone (aOR 0.88 95% CI 0.70–0.83 and aOR 0.88 95% CI 0.82–0.94)ConclusionThis study showed that older adults' HRQoL deteriorates as their age increases. Moreover, living alone may lead to different effects on older adults' HRQoL according to sex. More comprehensive studies and collaborative attention are needed to identify and provide customized care for older adults. PubDate: 2023-11-28T00:00:00Z
Authors:Abu Bakkar Siddique, Sudipto Deb Nath, Mahfuza Mubarak, Amena Akter, Sanjida Mehrin, Mst Jemi Hkatun, Antara Parvine Liza, M. Ziaul Amin Abstract: BackgroundPoor menstrual hygiene practices during menstruation increases the risk of reproductive tract infections, absenteeism, and negative impact on school performance. Despite being a global problem, there is a lack of knowledge and misconceptions about menstrual hygiene among women of all ages, especially in developing countries like Bangladesh. The study aims to assess the knowledge, attitudes, and practices toward menstrual hygiene among early reproductive-aged women in Bangladesh to help policymakers and planners take effective initiatives.MethodologyA cross-sectional survey was conducted between July and December 2022 in Dhaka, Rajshahi, Chittagong, Sylhet, and Barisal regions of Bangladesh. A convenience sampling technique was utilized to recruit a total of 1,214 participants (100% female; mean age: 22.87 ± 2.64 years). A semi-structured questionnaire including informed consent, socio-demographic information, as well as questions regarding knowledge (6-item), attitudes (7-item), and practices (6-item) toward menstruation and menstrual hygiene practices, was used to conduct the survey. All analyses were performed using the STATA (Version 15.0) and Statistical Package for the Social Sciences (SPSS version 25.0).ResultThe mean scores of the knowledge, attitudes, and practices were 4.9 ± 1.51 (out of 6), 12.58 ± 1.58 (out of 14), and 8.80 ± 1.87 (out of 12), respectively. The higher scores of knowledge, attitudes, and practices were significantly associated with several socio-demographic and menstruation-related factors (education, family type, type of menstruation, duration of menstruation, etc.).ConclusionThis study identified several key factors associated with improved knowledge, attitudes, and practices related to menstrual hygiene, including higher education levels, student status, younger age, non-alcohol consumption, and regular menstrual cycles. To enhance menstrual hygiene practices among women, it is crucial to implement targeted interventions that address knowledge disparities and tackle social and environmental influences. PubDate: 2023-11-28T00:00:00Z
Authors:Yasmin Altwaijri, Abdulhameed Al-Habeeb, Abdullah Al-Subaie, Ronny Bruffaerts, Lisa Bilal, Sanaa Hyder, Mohammad Talal Naseem, Abdullah J. Alghanim Abstract: IntroductionComorbidities of mental disorders and chronic physical conditions are a common medical burden reported among Western countries. National estimates of such comorbidities among the general population of Arab countries like Saudi Arabia are unknown. This study examined the prevalence of lifetime chronic physical conditions among the Saudi general population with DSM-IV 12-month mental disorders, and the associations with disability in the Kingdom of Saudi Arabia (KSA).MethodsThe Saudi National Mental Health Survey, a cross-sectional household study – part of the World Mental Health (WMH) Survey Consortium – was conducted between 2013–2016 in the KSA, with 4,001 Saudi citizens aged 15–65 (response rate 61%). The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess prevalence of lifetime chronic physical conditions and 12-month mental disorders; disability was measured in terms of days out of role.ResultsThe prevalence of any comorbid 12-month mental disorder among those with chronic physical conditions was 24%. Major depressive disorder, social phobia, and adult separation anxiety disorder were the most common comorbid mental disorders across all chronic physical conditions. Gender, education, income, urbanicity, region, and employment were associated with the presence of any chronic physical condition. Respondents with mental / physical comorbidities had 2.97 days out of role (on average) in the last 30 days.ConclusionComorbidities of mental disorders and chronic physical conditions are common among Saudis. National efforts are needed to increase awareness of such comorbidities among the general population, and develop prevention and treatment services tailored to the needs of individuals at-risk for comorbidities. PubDate: 2023-11-28T00:00:00Z
Authors:Peter J. Schulz, May O. Lwin, Kalya M. Kee, Wilson W. B. Goh, Thomas Y. T Lam, Joseph J. Y. Sung Abstract: IntroductionThe potential for deployment of Artificial Intelligence (AI) technologies in various fields of medicine is vast, yet acceptance of AI amongst clinicians has been patchy. This research therefore examines the role of antecedents, namely trust, attitude, and beliefs in driving AI acceptance in clinical practice.MethodsWe utilized online surveys to gather data from clinicians in the field of gastroenterology.ResultsA total of 164 participants responded to the survey. Participants had a mean age of 44.49 (SD = 9.65). Most participants were male (n = 116, 70.30%) and specialized in gastroenterology (n = 153, 92.73%). Based on the results collected, we proposed and tested a model of AI acceptance in medical practice. Our findings showed that while the proposed drivers had a positive impact on AI tools’ acceptance, not all effects were direct. Trust and belief were found to fully mediate the effects of attitude on AI acceptance by clinicians.DiscussionThe role of trust and beliefs as primary mediators of the acceptance of AI in medical practice suggest that these should be areas of focus in AI education, engagement and training. This has implications for how AI systems can gain greater clinician acceptance to engender greater trust and adoption amongst public health systems and professional networks which in turn would impact how populations interface with AI. Implications for policy and practice, as well as future research in this nascent field, are discussed. PubDate: 2023-11-28T00:00:00Z
Authors:Young-Ran Lee, Sun-Nam Park, Mi-Ran Lee, Eunjeong Nam Abstract: BackgroundThe risk of disasters and infectious diseases continues to persist in modern times. Children are a vulnerable group in disaster prevention and management due to their limited ability to cope on their own. Hence, the role and disaster preparedness capacity of early childhood teachers (ECTs) is vital for children’s protection.ObjectivesThis study aims to explore how ECTs can improve their personal resilience to adapt to and overcome disasters as part of early childhood education and care (ECEC). To this end, this study examined the effects of ECTs’ self-efficacy, resilience, disaster awareness, COVID-19 stress, and work-related stress on their disaster preparedness.ResultsAccording to the outcomes of disaster preparedness of ECTs based on their general and job characteristics, full-time employees and principals scored significantly higher in work-related disaster preparedness (WrDP) compared to part-time workers and general and assistant teachers, respectively. Resilience and WrDP were identified as influencing factors of general disaster preparedness (GdP), with an explanatory power of 26.4%. GdP and self-efficacy were identified as influencing factors of WrDP, with an explanatory power of 25.7%.DiscussionAccording to the findings, ECTs’ self-efficacy and GdP must be improved, followed by developing strategies to strengthen their resilience and WrDP. Doing so would ensure the safety and disaster preparedness of ECTs and infants who have low self-care capacity. PubDate: 2023-11-28T00:00:00Z
Authors:Stevo Lukić, Jovana Petrović Abstract: Summary of backgroundDementia is among the leading causes of death and disability worldwide, having a major impact not only on the affected person but also on all of society. The Internet is a popular and growing source of health-related information for patients, family members, carriers, and physicians. TikTok, one of the most popular social media platforms, is an important source for knowledge access and adoption. However, the quality of health information on TikTok has not been sufficiently studied.ObjectiveTo evaluate the quality of the information provided in the most popular videos on dementia shared on TikTok.Study designA cross-sectional study.MethodsThe top 100 most popular videos on TikTok obtained by searching the hashtag “dementia” were included in the study and grouped based on their source and content. The popularity of the videos was estimated based on the numbers of likes, comments, and shares. The quality of health-related information was evaluated using the DISCERN score and the Global Quality Score (GQS).ResultsVideos had a median duration of 33.29 s; the median number of likes was 635,100, with a total of 93,698,200 likes, 903,859 comments, and 5,310,912 shares. The source (uploader) of 65% of the videos was family members, while only 4% were uploaded by doctors. The content was lifestyle-related in 62% of the videos, while 12% of the videos were for fun. Videos had a median DISCERN score of 22.5 (IQR 20–27) and a median GQS of 2 (IQR 1–3). The videos uploaded by doctors had the highest quality scores and the lowest popularity.ConclusionThe most popular dementia videos on TikTok are mostly shared by family members and are of poor quality. Given the major public health issues associated with dementia, experts must provide appropriate and active assistance to patients in interpreting the information identified. PubDate: 2023-11-28T00:00:00Z
Authors:Muhammad Hasnain, Fahad R. Albogamy, Saeed S. Alamri, Imran Ghani, Bilal Mehboob Abstract: The Hyperledger Fabric (HF) framework is widely studied for securing electronic health records (EHRs) in the healthcare sector. Despite the various cross-domain blockchain technology (BCT) applications, little is known about the role of the HF framework in healthcare. The purpose of the systematic literature review (SLR) is to review the existing literature on the HF framework and its applications in healthcare. This SLR includes literature published between January 2015 and March 2023 in the ACM digital library, IEEE Xplore, SCOPUS, Springer, PubMed, and Google Scholar databases. Following the inclusion and exclusion criteria, a total of 57 articles emerged as eligible for this SLR. The HF framework was found to be useful in securing health records coming from the Internet of Medical Things (IoMT) and many other devices. The main causes behind using the HF framework were identified as privacy and security, integrity, traceability, and availability of health records. Additionally, storage issues with transactional data over the blockchain are reduced by the use of the HF framework. This SLR also highlights potential future research trends to ensure the high-level security of health records. PubDate: 2023-11-28T00:00:00Z
Authors:Lauren Halsall, Patricia Irizar, Sam Burton, Sara Waring, Susan Giles, Laura Goodwin, Andrew Jones Abstract: BackgroundHealthcare professionals work in high-pressured and demanding environments, which has been linked to the use of alcohol as a coping strategy. This international review aimed (i) to determine the pooled prevalence of hazardous, harmful, dependent, and frequent binge drinking in healthcare professionals, and (ii) to explore factors associated with variation in these outcomes.MethodsScopus, MEDLINE, and PsycINFO were searched from 2003 to 17th November 2022, for studies reporting a prevalence estimate for any outcome among healthcare professionals. Random-effects meta-analyses determined pooled prevalence estimates. Sub-group analyses were conducted, stratifying the meta-analyses by pandemic period vs pre-pandemic period. Meta-regressions explored factors that were associated with variation in the outcomes. PROSPERO (CRD42020173119).ResultsAfter screening 9,108 records, 64 studies were identified as eligible. The pooled prevalence was 19.98% [95% Confidence Intervals [CI]: 16.05–24.23%] for hazardous alcohol use (K = 52), 3.17% [95% CI: 0.95–6.58%] for harmful drinking (K = 8), 14.59% [95% CI: 7.16–25.05%] for dependent drinking (K = 7), and 17.71% [95% CI: 8.34–29.63%] for frequent binge drinking (K = 11). The prevalence of hazardous drinking was greater during the pandemic (28.19%) compared with pre-pandemic estimates (17.95%), though this was not statistically significant (p = 0.049). Studies including all hospital staff (32.04%) showed higher prevalence estimates for hazardous drinking compared with studies of doctors (16.78%) and nurses (27.02%).ConclusionApproximately one fifth of healthcare professionals drink to hazardous levels, with higher prevalence estimates observed during the COVID-19 pandemic. It may be that healthcare professionals used alcohol to cope with the additional trauma and stressors. Further research is needed to investigate whether this is sustained in the post-pandemic period. PubDate: 2023-11-28T00:00:00Z
Authors:Xushu Chen, Mengdan Liu, Qin Ma, Xin Liu, Xueping Peng, Changjiu He Abstract: IntroductionWith the progressive aging of the population, frailty is now a significant challenge in geriatrics research. A growing amount of evidence suggests that sleep disturbance and depression have independent effects on frailty, although the underlying mechanisms are not yet clear. This study aimed to investigate the mediating role of depression in the relationship between sleep disturbance and frailty in older adult patients with type 2 diabetes (T2DM) in the community.MethodPurposive sampling was used to collect face-to-face data from 342 community-dwelling T2DM patients in Chengdu, Sichuan Province, China, between February and May 2023. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate sleep quality, the Simple Geriatric Depression Scale (GDS-15) was used to evaluate depressive symptoms, and the FRAIL Scale (FRAIL) was used to evaluate frailty. Linear regression equation and bootstrap self-sampling were used to verify the mediating role of depressive symptoms in sleep disturbance and frailty.ResultThe study found that sleep disturbance had a direct positive effect with frailty [β = 0.040, 95% CI: (0.013, 0.069)]. Additionally, depression had a direct positive effect on frailty [β = 0.130, 95% CI: (0.087, 0.173)], and depression was found to partially mediate the relationship between sleep disturbance and frailty.ConclusionPoor sleep quality and frailty are common in patients with T2DM. To reduce the frailty of older adult T2DM patients, all levels of society (government, medical institutions, and communities) must pay more attention to mental health. A variety of interventions should be considered to improve sleep quality and depression, which in turn may prevent or control frailty. PubDate: 2023-11-28T00:00:00Z
Authors:Jonathon P. Leider, Sarah Lim, Debra DeBruin, Alexandra T. Waterman, Barbara Smith, Umesh Ghimire, Haley Huhtala, Zachary Zirnhelt, Ruth Lynfield, John L. Hick Abstract: While medical countermeasures in COVID-19 have largely focused on vaccinations, monoclonal antibodies (mAbs) were early outpatient treatment options for COVID-positive patients. In Minnesota, a centralized access platform was developed to offer access to mAbs that linked over 31,000 patients to care during its operation. The website allowed patients, their representative, or providers to screen the patient for mAbs against Emergency Use Authorization (EUA) criteria and connect them with a treatment site if provisionally eligible. A validated clinical risk scoring system was used to prioritize patients during times of scarcity. Both an ethics and a clinical subject matter expert group advised the Minnesota Department of Health on equitable approaches to distribution across a range of situations as the pandemic evolved. This case study outlines the implementation of this online platform and clinical outcomes of its users. We assess the impact of referral for mAbs on hospitalizations and death during a period of scarcity, finding in particular that vaccination conferred a substantially larger protection against hospitalization than a referral for mAbs, but among unvaccinated users that did not get a referral, chances of hospitalization increased by 4.1 percentage points. PubDate: 2023-11-28T00:00:00Z
Authors:Cátia Peixoto, Maria do Carmo Pereira, Simone Morais, Klara Slezakova Abstract: IntroductionExercising on regular basis provides countless health benefits. To ensure the health, well-being and performance of athletes, optimal indoor air quality, regular maintenance and ventilation in sport facilities are essential.MethodsThis study assessed the levels of particulate, down to the ultrafine range (PM10, PM2.5, and particle number concentration in size range of 20–1,000 nm, i.e., – PNC20-1000 nm), gaseous pollutants (total volatile organic compounds – TVOCs, CO2, and O3) and comfort parameters (temperature – T, relative humidity – RH) in different functional spaces of health clubs (n = 8), under specific occupancy and ventilation restrictions.Results and DiscussionIn all HCs human occupancy resulted in elevated particles (up to 2–3 times than those previously reported), considering mass concentrations (PM10: 1.9–988.5 μg/m3 PM2.5: 1.6–479.3 μg/m3) and number (PNC 1.23 × 103 – 9.14 × 104 #/cm3). Coarse and fine PM indicated a common origin (rs = 0.888–0.909), while PNC showed low–moderate associations with particle mass (rs = 0.264–0.629). In addition, up to twice-higher PM and PNC were detected in cardiofitness & bodybuilding (C&B) areas as these spaces were the most frequented, reinforcing the impacts of occupational activities. In all HCs, TVOCs (0.01–39.67 mg/m3) highly exceeded the existent protection thresholds (1.6–8.9 times) due to the frequent use of cleaning products and disinfectants (2–28 times higher than in previous works). On contrary to PM and PNC, TVOCs were higher (1.1–4.2 times) in studios than in C&B areas, due to the limited ventilations combined with the smaller room areas/volumes. The occupancy restrictions also led to reduced CO2 (122–6,914 mg/m3) than previously observed, with the lowest values in HCs with natural airing. Finally, the specific recommendations for RH and T in sport facilities were largely unmet thus emphasizing the need of proper ventilation procedures in these spaces. PubDate: 2023-11-28T00:00:00Z
Authors:Yue Hu, Yuxin Huang, Hua Zhang, Min Fang, Guobang Chen Abstract: BackgroundCOVID-19 has the potential to greatly impact an individual mental well-being. However, an individual’s psychological resilience, combined with support from their community and government disaster relief efforts can aid individuals in confronting crises with a positive mindset. The purpose of this study is to investigate how individuals, across three dimensions of individual resilience perception, community resilience perception, and government trust perception, mitigate individual anxiety during COVID-19.MethodsThis study employed an online survey method that was not restricted by geographical location. Data collection took place from January 2022 to June 2022, and the valid questionnaires covered all 31 provinces, autonomous regions, and municipalities in China. The assessment of community resilience was conducted employing the Conjoint Community Resilience Assessment Measure-10 (CCRAM-10). Structural Equation Modeling (SEM) was also used to examine the relationship between community resilience, government trust, individual psychological resilience, and anxiety.ResultsThe SEM results reveal that individual psychological resilience is significantly negatively correlated with anxiety (b = −0.099, p PubDate: 2023-11-28T00:00:00Z
Authors:Mackenzie Schiff, Ayan Jha, Dawne Walker, Eduardo Gonzalez-Pier Abstract: Despite abundant evidence demonstrating that improvements to health and education are positively correlated, and the importance of school-based platforms to achieve shared impacts, collaboration between ministries of health and education remains limited across low- and middle-income countries. Enhancing this collaboration is essential to realize mutually beneficial results, especially following the COVID-19 pandemic, which severely impacted health and education outcomes globally and highlighted the importance of resilient, domestically funded systems for delivering key social services including primary health care and education. We argue that the lack of an effective joint financing mechanism has hindered adoption of collaborative multisectoral approaches such as the WHO/UNESCO’s Health Promoting Schools (HPS) model. HPS is well-positioned to organize, finance, and deliver primary health care and education services through a school-based platform and strategy. Case studies from several low- and middle-income countries highlight the need to expand limited inter-ministerial collaborations to achieve cross-sectoral benefits and ensure sustainability of HPS beyond the lifecycle of external partners’ support. It is important to identify ways to widen the resource envelope for sector-specific activities and create efficiencies through mutually beneficial outcomes. This paper offers two pragmatic solutions: an inter-ministerial joint financing mechanism that starts with alignment of budgets but matures into a formal system for pooling funds, or a fixed-term co-financing mechanism that uses donor contributions to catalyze inter-ministerial collaborations. Achieving sustainability in these initiatives would require engaging the ministries of health, education, and finance; developing a common administrative, financial, and monitoring mechanism; and securing long-term commitment from all concerned stakeholders. PubDate: 2023-11-28T00:00:00Z
Authors:Jin-Chen Zou, Mao-Yao Wen, Yan Huang, Xin-Zu Chen, Jian-Kun Hu, on behalf of the SIGES Research Group Abstract: ObjectivesThe efficacy of updated health policy in improving the generalization of Helicobacter pylori screening and eradication in southwest China was assessed in a longitudinal analysis of multiple cross-sectional studies from an institution.MethodsIn the periods 2009–2010, 2013–2014, and 2019–2021, 8,365, 16,914, and 18,281 urban observations from health check-ups at West China Hospital were analyzed, respectively. The 14C-urea or 13C-urea breath test was consistently used for H. pylori detection. The protocol has been reported elsewhere (PROSPERO Registration number: CRD42019120764).ResultsThe overall prevalence of H. pylori dramatically decreased from 53.1% to 30.7% over the past decade (OR = 0.39, 95% CI 0.37–0.41), with a similar decline in all sex-specific and age-specific subgroups. The age-specific prevalence consistently increased before 40 years of age and always peaked at 50–59 years. Longitudinal clearance increased along with aging, and prevalence dropped to 22.6%, 25.1%, and 23.6% in the 40–49, 50–59, and 60–69 years initial age groups, respectively.ConclusionThe generalization of H. pylori screening and eradication could greatly contribute to the control of H. pylori infection among urban health check-up populations and lower gastric cancer incidence. PubDate: 2023-11-27T00:00:00Z
Authors:Jaiteg Singh, Noopur Tyagi, Saravjeet Singh, Babar Shah, Farman Ali, Ahmad Ali AlZubi, Abdulrhman Alkhanifer Abstract: The COVID-19 pandemic has greatly affected human behavior, creating a need for individuals to be more cautious about health and safety protocols. People are becoming more aware of their surroundings and the importance of minimizing the risk of exposure to potential sources of infection. This shift in mindset is particularly important in indoor environments, especially hospitals, where there is a greater risk of virus transmission. The implementation of route planning in these areas, aimed at minimizing interaction and exposure, is crucial for positively influencing individual behavior. Accurate maps of buildings help provide location-based services, prepare for emergencies, and manage infrastructural facilities. There aren’t any maps available for most installations, and there are no proven techniques to categorize features within indoor areas to provide location-based services. During a pandemic like COVID-19, the direct connection between the masses is one of the significant preventive steps. Hospitals are the main stakeholders in managing such situations. This study presents a novel method to create an adaptive 3D model of an indoor space to be used for localization and routing purposes. The proposed method infuses LiDAR-based data-driven methodology with a Quantum Geographic Information System (QGIS) model-driven process using game theory. The game theory determines the object localization and optimal path for COVID-19 patients in a real-time scenario using Nash equilibrium. Using the proposed method, comprehensive simulations and model experiments were done using QGIS to identify an optimized route. Dijkstra algorithm is used to determine the path assessment score after obtaining several path plans using dynamic programming. Additionally, Game theory generates path ordering based on the custom scenarios and user preference in the input path. In comparison to other approaches, the suggested way can minimize time and avoid congestion. It is demonstrated that the suggested technique satisfies the actual technical requirements in real-time. As we look forward to the post-COVID era, the tactics and insights gained during the pandemic hold significant value. The techniques used to improve indoor navigation and reduce interpersonal contact within healthcare facilities can be applied to maintain a continued emphasis on safety, hygiene, and effective space management in the long term. The use of three-dimensional (3D) modeling and optimization methodologies in the long-term planning and design of indoor spaces promotes resilience and flexibility, encouraging the adoption of sustainable and safe practices that extend beyond the current pandemic. PubDate: 2023-11-27T00:00:00Z
Authors:Jens Thomsen, Najiba M. Abdulrazzak, Hussain AlRand, The UAE AMR Surveillance Consortium , Godfred Antony Menezes, Carole A. Moubareck, Dean B. Everett, Abiola Senok, Andreas Podbielski Abstract: IntroductionEnterococci are usually low pathogenic, but can cause invasive disease under certain circumstances, including urinary tract infections, bacteremia, endocarditis, and meningitis, and are associated with peritonitis and intra-abdominal abscesses. Increasing resistance of enterococci to glycopeptides and fluoroquinolones, and high-level resistance to aminoglycosides is a concern. National antimicrobial resistance (AMR) surveillance data for enterococci from the Middle East and North Africa (MENA) and the Gulf region is scarce.MethodsA retrospective 12-year analysis of N = 37,909 non-duplicate diagnostic Enterococcus spp. isolates from the United Arab Emirates (UAE) was conducted. Data was generated by routine patient care during 2010–2021, collected by trained personnel and reported by participating surveillance sites to the UAE National AMR Surveillance program. Data analysis was conducted with WHONET.ResultsEnterococcus faecalis was the most commonly reported species (81.5%), followed by Enterococcus faecium (8.5%), and other enterococci species (4.8%). Phenotypically vancomycin-resistant enterococci (VRE) were found in 1.8% of Enterococcus spp. isolates. Prevalence of VRE (%VRE) was highest for E. faecium (8.1%), followed by E. faecalis (0.9%). A significant level of resistance to glycopeptides (%VRE) for these two species has been observed in the majority of observed years [E. faecalis (0–2.2%), 2010: 0%, 2021: 0.6%] and E. faecium (0–14.2%, 2010: 0%, 2021: 5.8%). Resistance to fluoroquinolones was between 17 and 29% (E. faecalis) and was higher for E. faecium (between 42 and 83%). VRE were associated with higher patient mortality (RR: 2.97), admission to intensive care units (RR: 2.25), and increased length of stay (six excess inpatient days per VRE case), as compared to vancomycin-susceptible Enterococcus spp.DiscussionPublished data on Enterococcus infections, in particular VRE-infections, in the UAE and MENA region is scarce. Our data demonstrates that VRE-enterococci are relatively rare in the UAE, however showing an increasing resistance trend for several clinically important antibiotic classes, causing a concern for the treatment of serious infections caused by enterococci. This study also demonstrates that VRE were associated with higher mortality, increased intensive care unit admission rates, and longer hospitalization, thus poorer clinical outcome and higher associated costs in the UAE. We recommend the expansion of current surveillance techniques (e.g., local VRE screening), stricter infection prevention and control strategies, and better stewardship interventions. Further studies on the molecular epidemiology of enterococci are needed. PubDate: 2023-11-27T00:00:00Z
Authors:Jun Mi, Marie Ishida, Kanya Anindya, Barbara McPake, Bernadette Fitzgibbon, Anthony A. Laverty, An Tran-Duy, John Tayu Lee Abstract: BackgroundHealth risk factors, including smoking, excessive alcohol consumption, overweight, obesity, and insufficient physical activity, are major contributors to many poor health conditions. This study aimed to assess the impact of health risk factors on healthcare resource utilization, work-related outcomes and health-related quality of life (HRQoL) in Australia.MethodsWe used two waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) Survey from 2013 and 2017 for the analysis. Healthcare resource utilization included outpatient visits, hospitalisations, and prescribed medication use. Work-related outcomes were assessed through employment status and sick leave. HRQoL was assessed using the SF-6D scores. Generalized estimating equation (GEE) with logit or log link function and random-effects regression models were used to analyse the longitudinal data on the relationship between health risk factors and the outcomes. The models were adjusted for age, sex, marital status, education background, employment status, equilibrium household income, residential area, country of birth, indigenous status, and socio-economic status.ResultsAfter adjusting for all other health risk factors covariates, physical inactivity had the greatest impact on healthcare resource utilization, work-related outcomes, and HRQoL. Physical inactivity increased the likelihood of outpatient visits (AOR = 1.60, 95% CI = 1.45, 1.76 p < 0.001), hospitalization (AOR = 1.83, 95% CI = 1.66–2.01, p < 0.001), and the probability of taking sick leave (AOR = 1.31, 95% CI = 1.21–1.41, p < 0.001), and decreased the odds of having an above population median HRQoL (AOR = 0.48, 95% CI = 0.45–0.51, p < 0.001) after adjusting for all other health risk factors and covariates. Obesity had the greatest impact on medication use (AOR = 2.02, 95% CI = 1.97–2.29, p < 0.001) after adjusting for all other health risk factors and covariates.ConclusionOur study contributed to the growing body of literature on the relative impact of health risk factors for healthcare resource utilization, work-related outcomes and HRQoL. Our results suggested that public health interventions aim at improving these risk factors, particularly physical inactivity and obesity, can offer substantial benefits, not only for healthcare resource utilization but also for productivity. PubDate: 2023-11-27T00:00:00Z
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