[The Childhood Decade in Russia: legal securing of health care applying information technologies].

In conditions of impetuous development of national digital technologies and necessity for their legal regulation, significance and possibilities of their implementation in protecting health of rising generation during childhood decade in Russia are demonstrated. The conceptual apparatus related to discussed problem is considered. The emphasis is made on preventive aspect of intersectoral state protection of health care and rights of children and adolescents aged 0-17 years. The scale of problem is especially impressive considering number of contingent over 30 million people and interests of about 24 million of family members with children. The purpose of the study is applying analytical method, content analysis and SWOT analysis to monitor main problems of intersectoral health care and rights of rising generation in Russia in conditions of implementation of information technologies; to evaluate application of legislation in force in context of their role and effect during the Decade of Children (2018-2027); to demonstrate significance of the institution of the Commissioner for rights of child under the President of the Russian Federation.

Improvement of Cancer Prevention and Control: Reflection on the Role of Emerging Information Technologies.

Cancer has become an important public health problem affecting the health of Chinese residents, as well as residents all over the world. With the improvement of cancer prevention and treatment, the growth of the mortality rate of cancers has slowed down gradually, but the incidence rate is still increasing rapidly, and cancers still impose heavy disease and economic burdens. Cancer screening and early cancer diagnosis and treatment are important ways to reduce the burden of cancer-related diseases. At present, various projects for early cancer diagnosis and treatment have been implemented in China. With the expansion of the coverage of these projects, the problems related to project implementation, operation, and management have emerged gradually. In recent years, emerging information technologies have been applied in the field of health and have facilitated health management and clinical decision-making. Meanwhile, China announced multiple policies to encourage and promote the application of information technologies in the field of health. Therefore, combined with the analysis of major problems in cancer prevention and control projects, this paper probes into how to apply information technologies such as biological information mining, artificial intelligence, and electronic information collection technology to various stages of cancer prevention and control. Information technologies realize the integrated management of prevention and control processes, for example, mobilization and preliminary identification, high-risk assessment, clinical screening, clinical diagnosis and treatment, tracking and follow-up, and biological sample management of high-risk groups, and promote the efficient implementation of cancer prevention and control projects in China.

An economic evaluation of the expansion of electronic case reporting in an academic healthcare setting.

Objectives: Determine the economic cost or benefit of expanding electronic case reporting (eCR) for 29 reportable conditions beyond the initial eCR implementation for COVID-19 at an academic health center. Materials and methods: The return on investment (ROI) framework was used to quantify the economic impact of the expansion of eCR from the perspective of an academic health system over a 5-year time horizon. Sensitivity analyses were performed to assess key factors such as personnel cost, inflation, and number of expanded conditions. Results: The total implementation costs for the implementation year were estimated to be $5031.46. The 5-year ROI for the expansion of eCR for the 29 conditions is expected to be 142% (net present value of savings: $7166). Based on the annual ROI, estimates suggest that the savings from the expansion of eCR will cover implementation costs in approximately 4.8 years. All sensitivity analyses yielded a strong ROI for the expansion of eCR. Discussion and conclusion: Our findings suggest a strong ROI for the expansion of eCR at UHealth, with the most significant cost savings observed implementing eCR for all reportable conditions. An early effort to ensure data quality is recommended to expedite the transition from parallel reporting to production to improve the ROI for healthcare organizations. This study demonstrates a positive ROI for the expansion of eCR to additional reportable conditions beyond COVID-19 in an academic health setting, such as UHealth. While this evaluation focuses on the 5-year time horizon, the potential benefit could extend further.

[Risk factors, treatment organization and quality indicators for chronic obstructive pulmonary disease in primary care settings: Dutch experience].

INTRODUCTION: Chronic obstructive pulmonary disease (COPD), usually in advanced stages, is associated with high mortality, being the third leading cause of death worldwide. In the Netherlands, care delivery to patients with COPD has become a focus of the regional medical community, since the COPD death rates in this country are higher than the European Union average. However, between 2011 and 2021, the number of people with COPD (under follow-u by general practitioners) decreased. The experience of this country is interesting, as a large set of measures to improve the situation has been developed and implemented in this region. The purpose of the study was to analyze the experience of the Netherlands in organizing medical care for COPD in primary care settings. MATERIAL AND METHODS: The search for scientific literature sources was carried out using the PubMed database and Google system. The search time horizon equaled to 5 years. RESULTS: In the Netherlands, in the system of care delivery to patients with COPD, primary care settings are heavily burdened. The article summarizes approaches to identify COPD risk factors, summarizes current clinical recommendations as of December 2022, and highlights findings of the study on medical digital platforms with the potential to organize continuous monitoring of patients. The paper exemplifies criteria for assessing the treatment quality in specialized care settings, including primary care. DISCUSSION: It is assumed that the most effective measure to further improve efficacy of COPD treatment is the introduction of remote digital medical devices. A possible integration of the updated standards and quality indicators into digital services will further strengthen the concept of continuous automated remote monitoring of COPD patients. Evidence-based selection and introduction of effective digital solutions into current practice will improve quality of care delivery to patients.

Evidence-based clinical engineering: Health information technology adverse events identification and classification with natural language processing.

The primary goal of this project is to create a framework to extract Real-World Evidence to support Health Technology Assessment, Health Technology Management, Evidence-Based Maintenance, and Post Market Surveillance (as outlined in the EU Medical Device Regulation 2017/745) of medical devices using Natural Language Processing (NLP) and Artificial Intelligence. An initial literature review on Spontaneous Reporting System databases, Health Information Technologies (HIT) fault classification, and Natural Language Processing has been conducted, from which it clearly emerges that adverse events related to HIT are increasing over time. The proposed framework uses NLP techniques and Explainable Artificial Intelligence models to automatically identify HIT-related adverse event reports. The designed model employs a pre-trained version of ClinicalBERT that has been fine-tuned and tested on 3,075 adverse event reports extracted from the FDA MAUDE database and manually labelled by experts.

The impact of digital presence and use of information technology on business performance of veterinary practices: a case study of Bosnia and Herzegovina.

Introduction: The veterinary profession is facing various challenges in the 21st century, such as livestock production intensification, shifting distribution of infectious diseases, growing focus on food safety alongside growing demand for companion animals' veterinary services. Information technologies and digitalization trends had driven changes in many business sectors, including providing veterinary services thus opening new avenues to overcome the existing challenges this profession is facing. Methods: A study was conducted among 244 veterinary practices in Bosnia and Herzegovina. The gathered information related to subjects involving digital presence, the utilization of information technologies, and the business performance. To obtain this information, a personalized questionnaire was utilized as the means for collecting data. Results: The study revealed that only 10.2% had a business-associated website, and 54.9% were present on at least one social media platform. The study suggests that a positive impact on annual profit can be achieved through the implementation of effective digital marketing strategies such as web presence, search engine optimization, Google business account existence, website Google advertisement, continuous administration of social media, and social media advertisement. The statistical analysis indicates that Google advertisements, website search engine optimization, and social media advertisements greatly affect annual profit. Discussion: Improving digital presence of veterinary businesses with professionally managed websites, use of social media platforms, investment in online marketing strategies, and adopting telehealth services and online access to patient records positively affects business performance and better fits the growing needs of clients and society.

Predicting future onset of depression among middle-aged adults with no psychiatric history.

BACKGROUND: Depression is a major cause of disability worldwide. Recent data suggest that, in industrialised countries, the prevalence of depression peaks in middle age. Identifying factors predictive of future depressive episodes is crucial for developing prevention strategies for this age group. AIMS: We aimed to identify future depression in middle-aged adults with no previous psychiatric history. METHOD: To predict a diagnosis of depression 1 year or more following a comprehensive baseline assessment, we used a data-driven, machine-learning methodology. Our data-set was the UK Biobank of middle-aged participants (N = 245 036) with no psychiatric history. RESULTS: Overall, 2.18% of the study population developed a depressive episode at least 1 year following baseline. Basing predictions on a single mental health questionnaire led to an area under the curve of the receiver operating characteristic of 0.66, and a predictive model leveraging the combined results of 100 UK Biobank questionnaires and measurements improved this to 0.79. Our findings were robust to demographic variations (place of birth, gender) and variations in methods of depression assessment. Thus, machine-learning-based models best predict diagnoses of depression when allowing the inclusion of multiple features. CONCLUSIONS: Machine-learning approaches show potential for being beneficial for the identification of clinically relevant predictors of depression. Specifically, we can identify, with moderate success, people with no recorded psychiatric history as at risk for depression by using a relatively small number of features. More work is required to improve these models and evaluate their cost-effectiveness before integrating them into the clinical workflow.

[Primary care pathways and locations during the pandemic in a rural area of Alicante]. / Vías y lugares de atención primaria durante la pandemia en una zona rural de Alicante.

This paper describes the means of health care used in a primary health care centre (PHCC) in a rural area to care for patients during the COVID-19 pandemic. After conducting a cross-sectional study using health questionnaire with 243 patients (100 COVID-19 and 143 other pathologies), we observed that general medical care was 100% by telephone, and little use was made of the portal for citizen information and appointment requests of the Conselleria de Sanitat de la Comunidad Valenciana. Nursing attended 100% by telephone, as did the PHCC doctors and the PHCC emergencies; in the case of taking samples, blood samples and wound care it was face-to-face (men 91%, women 88%), and at home (9% and 12%). In conclusion, different care patterns are observed according to the PHCC professionals, and the need to improve the online pathway with care management.

Healthcare Information Technology: A Systematic Mapping Study.

OBJECTIVES: This paper presents a systematic mapping of studies related to information systems and technology in the field of healthcare, enabling a visual mapping of the different lines of knowledge that can provide an overview of the scientific literature in this field. This map can help to clarify critical aspects of healthcare informatics, such as the main types of information systems, the ways in which they integrate with each other, and the technological trends in this field. METHODS: Systematic mapping refers to a process of classifying information in a given area of knowledge. It provides an overview of the state of the art in a particular discipline or area of knowledge, establishing a map that describes how knowledge is structured in that particular area. In this study, we proposed and carried out a specific implementation of the methodology for mapping. In total, 1,619 studies that combine knowledge related to information systems, computer science, and healthcare were selected and compiled from prestigious publications. RESULTS: The results established a distribution of the available literature and identified papers related to certain research questions, thereby providing a map of knowledge that structures the different trends and main areas of research, making it possible to address the research questions and serving as a guide to deepen specific aspects of the field of study. CONCLUSIONS: We project and propose future research for the trends that stand out because of their interest and the possibility of exploring these topics in greater depth.

Simulated medical information system: education for aspiring healthcare information technologists.

Objectives: To determine if a simulated medical information system can improve the level of understanding of healthcare information technology students. Methods: The study involved 40 healthcare information technology students. All the students took the healthcare information technology course using the simulated medical information system. The primary outcome was a measure of their level of understanding assessed with a questionnaire using a five-point Likert-type scale. The questions were all included in the required knowledge for the Specific Behavioral Objectives for Healthcare Information Technologists (2016) and Senior Healthcare Information Technologists (ver. 1.1, 2017). To measure the level of understanding, median with 10th-90th percentile CI values for both sets of questionnaires were calculated for all the students. The Wilcoxon signed-rank test was used to compare level of understanding before and after the training. Results: Some students were excluded because they failed to complete the questionnaires. For both Healthcare Information Technologists (n=37) and Senior Health Information Technologists (n=34), the level of understanding was significantly different before (median [10th-90th percentile]: 1175 [935-1271], 416 [302-513]) and after (1200 [1016-1472], 469.5 [351-527]) the training (p<0.05). Conclusions: A simulated medical information system may be an effective tool for students to learn about healthcare information technology.

Self-management programs to ensure sustainable return to work following long-term sick leave due to low back pain: A sequential qualitative study.

BACKGROUND: Low back pain (LBP) is a prevalent condition frequently leading to disability. Research suggests that self-management (SM) programs for chronic LBP should include strategies to promote sustainable return to work. OBJECTIVES: This study aimed to 1) validate and prioritize the essential content elements of a SM program in light of the needs of workplace representatives, and 2) identify the main facilitators and barriers to be considered when developing and implementing a SM program delivered via information and communication technologies (ICT). METHODS: A sequential qualitative design was used. We recruited workplace representatives and potential future users of SM programs (union representatives and employers) and collected data through focus groups and nominal group techniques to validate the relevance of the different elements included into 3 broad categories (Understand, Learn, Apply), as well as to highlight potential barriers and facilitators. RESULTS: Eleven participants took part in this study. The content elements proposed in the scientific literature for SM programs were found to align with potential future users' needs, with participants ranking the same elements as those proposed in the literature as the most important across all categories. Although some barriers were identified, workplace representatives believed that ICT offer an appropriate strategy for delivering individualized SM programs to injured workers who have returned to work. CONCLUSION: Our study suggests that the elements identified in the scientific literature as essential components of SM programs designed to ensure a sustainable return to work for people with LBP are in line with the needs of future users.

Inclusão Digital de idosos: as (TICs) e o uso do celular / Digital inclusion of seniors: the (ICTs) and the use of the smartphone

O envelhecimento humano é um fenômeno que vem crescendo em escala global e se constitui como um acontecimento que chama a atenção de alguns anos para cá. Outro fator de muita relevância na contemporaneidade são as Tecnologias da Informação e Comunicação (TICs) que nos possibilitam questionar quais são os significados atribuídos pelos idosos a essas tecnologias, levando em consideração o uso do smartphone. O presente estudo tem como objetivo conhecer de que forma os idosos utilizam e como se relacionam com este aparelho. Trata-se de um estudo quantitativo, em que a coleta de dados foi realizada por meio da aplicação de questionários a 100 pessoas com mais de sessenta anos, participantes de grupos de convivência em uma cidade do interior do Rio Grande do Sul. Os dados foram analisados pelo programa Statistical Package for the Social Sciences (SPSS) versão 25, possibilitando a análise por meio de uma estatística descritiva. A pesquisa possibilitou a compreensão de como os idosos se relacionam com esta tecnologia, as dificuldades de inserção em um mundo conectado e as limitações que estes apresentam ao manusear seu smartphone. Também foram listados os aplicativos mais utilizados pela categoria pesquisada, contemplando durante a discussão os benefícios de utilizarem as TICs e os sentimentos que acometem esses idosos.(AU)

Human aging is a phenomenon that has been growing on a global scale and constitutes an event that has drawn attention in recent years. Another very relevant factor in contemporaneity are the Information and Communication Technologies (ICTs) that allow us to question what are the meanings attributed by the elderly to these technologies, considering the use of smartphones. The present study aims to understand how the elderly use and relate to this device. This is a quantitative study, in which data collection was carried out by applying questionnaires to 100 people over sixty years old, participants of socialization groups in a city in the countryside of Rio Grande do Sul. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25, enabling analysis by using descriptive statistics. The research made it possible to understand how the elderly relate to this technology, the difficulties of insertion in a connected world, and the limitations they present when handling their smartphone. The applications most used by this researched category were also listed, contemplating during the discussion the benefits of using ICTs and the feelings that affect these elderly people.(AU)

The effectiveness of telepsychiatry: thematic review.

AIMS AND METHOD: This review aims to clarify the evidence on the effectiveness of telepsychiatry following the COVID-19 pandemic. We conducted a literature review of three databases (Cochrane Library, PubMed and PsycINFO), using the terms virtual consultation/telepsychiatry/video consultation AND psychiatry/mental illness. RESULTS: We identified 325 eligible papers and conducted a thematic analysis resulting in five themes: patient and clinical satisfaction, diagnostic reliability, outcomes, technology and professional guidance. The most significant factors linked to effectiveness of telepsychiatry were patient and clinician satisfaction and adequate technology to facilitate examination of the patient. CLINICAL IMPLICATIONS: The consistent diagnostic reliability, satisfactory clinical outcomes and patient satisfaction linked to telepsychiatry favour its continued use once the pandemic ends. The main barrier is reluctance among clinicians and lack of professional guidance. We recommend education on the uses of telepsychiatry among clinicians, and the provision of professional guidance for its use from medical bodies and organisations.

On the role of artificial intelligence in psychiatry.

Recently, there has been growing interest in artificial intelligence (AI) to improve efficiency and personalisation of mental health services. So far, the progress has been slow, however, advancements in deep learning may change this. This paper discusses the role for AI in psychiatry, in particular (a) diagnosis tools, (b) monitoring of symptoms, and (c) delivering personalised treatment recommendations. Finally, I discuss ethical concerns and technological limitations.

The virtual Clinical Assessment of Skills and Competence: the impact and challenges of a digitised final examination.

The COVID-19 pandemic has affected how clinical examinations are conducted, resulting in the Royal College of Psychiatrists delivering the Clinical Assessment of Skills and Competence virtually. Although this pragmatic step has allowed for progression of training, it has come at the cost of a significantly altered examination experience. This article aims to explore the fairness of such an examination, the difference in trainee experience, and the use of telemedicine to consider what might be lost as well as gained at a time when medical education and delivery of healthcare are moving toward the digitised frontier.

Simulated virtual on-call training programme for improving non-specialised junior doctors' confidence in out-of-hours psychiatry: quantitative assessment.

AIMS AND METHOD: To investigate whether a psychiatry-specific virtual on-call training programme improved confidence of junior trainees in key areas of psychiatry practice. The programme comprised one 90 min lecture and a 2 h simulated on-call shift where participants were bleeped to complete a series of common on-call tasks, delivered via Microsoft Teams. RESULTS: Thirty-eight trainees attended the lecture, with a significant improvement in confidence in performing seclusion reviews (P = 0.001), prescribing psychiatric medications for acute presentations (P < 0.001), working in section 136 suites (places of safety) (P = 0.001) and feeling prepared for psychiatric on-call shifts (P = 0.002). Respondents reported that a virtual on-call practical session would be useful for their training (median score of 7, interquartile range 5-7.75). Eighteen participants completed the virtual on-call session, with significant improvement in 9 out of the 10 tested domains (P < 0.001). CLINICAL IMPLICATIONS: The programme can be conducted virtually, with low resource requirements. We believe it can improve trainee well-being, patient safety, the delivery of training and induction of rotating junior doctors during the COVID-19 pandemic and it supports the development and delivery of practical training in psychiatry.

Multicentre, England-wide randomised controlled trial of the 'Foundations' smartphone application in improving mental health and well-being in a healthcare worker population.

BACKGROUND: Healthcare workers (HCWs) have faced considerable pressures during the COVID-19 pandemic. For some, this has resulted in mental health distress and disorder. Although interventions have sought to support HCWs, few have been evaluated. AIMS: We aimed to determine the effectiveness of the 'Foundations' application (app) on general (non-psychotic) psychiatric morbidity. METHOD: We conducted a multicentre randomised controlled trial of HCWs at 16 NHS trusts (trial registration number: EudraCT: 2021-001279-18). Participants were randomly assigned to the app or wait-list control group. Measures were assessed at baseline, after 4 and 8 weeks. The primary outcome was general psychiatric morbidity (using the General Health Questionnaire). Secondary outcomes included: well-being; presenteeism; anxiety; depression and insomnia. The primary analysis used mixed-effects multivariable regression, presented as adjusted mean differences (aMD). RESULTS: Between 22 March and 3 June 2021, 1002 participants were randomised (500:502), and 894 (89.2%) followed-up. The sample was predominately women (754/894, 84.3%), with a mean age of 44⋅3 years (interquartile range (IQR) 34-53). Participants randomised to the app had a reduction in psychiatric morbidity symptoms (aMD = -1.39, 95% CI -2.05 to -0.74), improvement in well-being (aMD = 0⋅54, 95% CI 0⋅20 to 0⋅89) and reduction in insomnia (adjusted odds ratio (aOR) = 0⋅36, 95% CI 0⋅21 to 0⋅60). No other significant findings were found, or adverse events reported. CONCLUSIONS: The app had an effect in reducing psychiatric morbidity symptoms in a sample of HCWs. Given it is scalable with no adverse effects, the app may be used as part of an organisation's tiered staff support package. Further evidence is needed on long-term effectiveness and cost-effectiveness.

Community social work in Hong Kong during COVID-19: Intervention strategies to address social injustices.

In Hong Kong, professional social workers made their presence felt when they delivered a variety of services at the height of the pandemic. Social workers who were working in community development projects or who had adopted community work approaches have become the major service providers when the availability and accessibility of other types of social services have been seriously impeded. This article reports on a qualitative research study conducted to examine (1) how community social workers have planned and implemented services, (2) their use of information and communication technologies (ICTs), and (3) ideas for addressing injustices in disaster management work.

Adicciones a las tecnologías de la información y la comunicación en la Comunitat Valenciana, 2018-2020 / Addictions to information and communication technologies in Comunitat Valenciana (Spain), 2018-2020

Objetivo: Describir el perfil sociodemográfico de las personas atendidas por adicción a las tecnologías de la información y la comunicación (TIC) en las unidades de conductas adictivas (UCA) de la Comunitat Valenciana, en 2018-2020. Método: Análisis anual y para el total del periodo según la información recogida en los registros de las UCA. Resultados: Se registraron 219 casos, mayoritariamente varones (87%), menores de 30 años (53%), con estudios primarios o inferiores (51%), y convivientes con padres (57%). En el periodo analizado se observaron cambios significativos en la edad (aumento) y la situación laboral (más trabajadores activos). El año de la pandemia de COVID-19 (2020) acentuó o mantuvo las tendencias previas. Conclusiones: El perfil de las personas atendidas por adicción a las TIC en la Comunitat Valenciana es mayoritariamente el de un varón, menor de 30 años y con estudios primarios o inferiores; se observa una tendencia a un aumento en la edad y en la proporción de personas trabajadoras activas. La prevención debería centrarse en estos colectivos con mayor riesgo. (AU)

Objective: To describe the sociodemographic profile of the people treated for addiction to information and communication technologies (ICTs) in the addictive behavior units (ABU) of Comunitat Valenciana, Spain, in 2018-2020. Method: Annual analysis and for the global period according to information collected in the ABU records. Results: 219 registered cases, mostly men (87%), under 30 years of age (53%), with primary education or less (51%), and living with parents (57%). In the study period significant changes were observed in age (increase) and employment situation (more active workers). The COVID-19 pandemic's year (2020) accentuated or maintained previous trends. Conclusions: The person treated for addiction to ICTs in Comunitat Valenciana is mostly male, under 30 years of age and with a primary education level or less, with a trend to increase in age and in proportion of active workers. Prevention should focus on these groups at higher risk. (AU)

Vías y lugares de atención primaria durante la pandemia en una zona rural de Alicante / Primary care pathways and locations during the pandemic in a rural area of Alicante

Este trabajo describe las vías de asistencia sanitaria utilizadas en un centro de atención primaria de salud (CAPS) de una zona rural para la atención a sus pacientes durante la pandemia de COVID-19. Tras realizar un estudio transversal mediante un cuestionario de salud a 243 pacientes (100 con COVID-19 y 143 con otras patologías), observamos que la atención de medicina general fue el 100% telefónica y hubo escaso uso del portal de información a la ciudadanía y solicitud de cita previa de la Conselleria de Sanitat de la Comunidad Valenciana. En urgencias médicas, la atención a pacientes de COVID-19 fue también telefónica, pero presencial para otras patologías (63%). Enfermería atendió el 100% por vía telefónica, al igual que los/las médicos/as de CAPS y de urgencias de CAPS; en toma de muestras, constantes y cuidados de heridas fue presencial (hombres 91%, mujeres 88%) y en domicilio (9% y 12%). En conclusión, se observan distintos patrones asistenciales según los/las profesionales del CAPS y una necesidad de mejorar la vía online en la gestión asistencial. (AU)

This paper describes the means of health care used in a primary health care centre (PHCC) in a rural area to care for patients during the COVID-19 pandemic. After conducting a cross-sectional study using health questionnaire with 243 patients (100 COVID-19 and 143 other pathologies), we observed that general medical care was 100% by telephone, and little use was made of the portal for citizen information and appointment requests of the Conselleria de Sanitat de la Comunidad Valenciana. Nursing attended 100% by telephone, as did the PHCC doctors and the PHCC emergencies; in the case of taking samples, blood samples and wound care it was face-to-face (men 91%, women 88%), and at home (9% and 12%). In conclusion, different care patterns are observed according to the PHCC professionals, and the need to improve the online pathway with care management. (AU)