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A conceptual IoT-based early-warning architecture for remote monitoring of COVID-19 patients in wards and at home
یک معماری مفهومی هشدار اولیه مبتنی بر اینترنت اشیا برای نظارت از راه دور بیماران COVID-19 در بخش ها و در خانه-2022 Due to the COVID-19 pandemic, health services around the globe are struggling. An effective system for monitoring patients can improve healthcare delivery by avoiding in-person
contacts, enabling early-detection of severe cases, and remotely assessing patients’ status.
Internet of Things (IoT) technologies have been used for monitoring patients’ health with
wireless wearable sensors in different scenarios and medical conditions, such as noncommunicable and infectious diseases. Combining IoT-related technologies with early-warning
scores (EWS) commonly utilized in infirmaries has the potential to enhance health services delivery significantly. Specifically, the NEWS-2 has been showing remarkable results
in detecting the health deterioration of COVID-19 patients. Although the literature presents
several approaches for remote monitoring, none of these studies proposes a customized,
complete, and integrated architecture that uses an effective early-detection mechanism for
COVID-19 and that is flexible enough to be used in hospital wards and at home. Therefore,
this article’s objective is to present a comprehensive IoT-based conceptual architecture that
addresses the key requirements of scalability, interoperability, network dynamics, context
discovery, reliability, and privacy in the context of remote health monitoring of COVID-19
patients in hospitals and at home. Since remote monitoring of patients at home (essential
during a pandemic) can engender trust issues regarding secure and ethical data collection,
a consent management module was incorporated into our architecture to provide transparency and ensure data privacy. Further, the article details mechanisms for supporting a
configurable and adaptable scoring system embedded in wearable devices to increase usefulness and flexibility for health care professions working with EWS.
keywords: نظارت از راه دور | کووید-۱۹ | اخبار-2 | معماری | رضایت | اینترنت اشیا | Remote monitoring | COVID-19 | NEWS-2 | Architecture | Consent | IoT |
مقاله انگلیسی |
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Cyber Physical Systems: Analyses, challenges and possible solutions
سیستم های فیزیکی سایبری: تحلیل ها، چالش ها و راه حل های ممکن-2022 It is becoming more difficult to protect the authentication of our data in todays world of smart living. On the one
hand, we are able to live in smart homes and smart cities with ease. Even if we use the most complicated
passwords, we cant be sure that the Internet of Things and the Internet of Everything are safe. One way to make
sure people and things are safe is to use Multi-Factor Authentication. Also, a big and complicated system needs
more efficient and robust solutions for real, and strong, security, so this is important. There are a lot of smart ways
to solve problems today. For this reason, the internet of things is being used in every possible field or application.
This new ecosystem, which is called Cyber Physical Systems, was built by IoTs. Cyber-Physical Systems use
computing, communication, and control to make new technology or the next generation of engineered systems. In
the last decade, there has been a lot of work done on cyber physical systems that we didnt expect. There have
been a lot of threats, challenges, and important issues in the last decade. We have a big problem with the security
of CPS because the basic blocks used to make them are very different. Even if were talking about natural gas
systems or transportation systems or other automated systems, they all have something to do with CPS, no matter
what. These days, CPSs systems are used for energy, transportation, the environment, and health care, among
other things. This article talks about a number of problems that need to be solved by researchers and scientists
(working related to respective area, i.e., CPS). As a result, this article also talks about a partial survey of important
research issues, and an overview of several research projects that have been done in the last decade by a number
of different people to improve CPS.
keywords: سیستم های فیزیکی-سایبری | اینترنت اشیا | اینترنت همه چیز | چالش ها | امنیت و حریم خصوصی | Cyber-physical systems | Internet of things | Internet of everything | Challenges | Security, and privacy |
مقاله انگلیسی |
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Assessment of knowledge regarding tracheostomy care and management of early complications among healthcare professionals
ارزیابی دانش در مورد مراقبت از تراکئوستومی و مدیریت عوارض اولیه در میان متخصصان مراقبت های بهداشتی-2021 Introduction: Tracheostomy is commonly performed surgical procedure in ENT practice. Postoperative care is the most important aspect for achieving good patient outcomes. Unavailability of
standard guidelines on tracheostomy management and inadequate training can make this basic
practice complex. The nursing staff and doctors play a very important role in bedside management, both in the ward and in the intensive care unit (ICU) setup. Therefore, it is crucial that
all healthcare providers directly involved in providing postoperative care to such patients can
do this efficiently.
Objectives: The objective of this study is to assess the knowledge regarding identification and management of tracheostomy-related emergencies and early complications among healthcare professionals so as to improve practice and further standardization. Methods: Cross-sectional observational study included two hundred and fifty-four doctors and nurses from four large tertiary care hospitals. The questions used were simple and straightforward regarding tracheostomy suctioning, cuff care, cuff management, tube blockage, and feeding management in patients with tracheostomy. Results: Based on evidence from our study, knowledge level regarding tracheostomy care ranges from 48% to 52% with knowledge scores above 50% being considered satisfactory. Significant gaps in knowledge exist in various aspects of tracheostomy care and management among healthcare professionals. Conclusion: Our findings demonstrated an adequate knowledge level among health care professionals ranging from 48% to 52% with knowledge scores above 50% being considered satisfactory and revealed that gaps in knowledge still exist in various aspects of tracheostomy care and management. keywords: Tracheostomy | complications | Tracheostomy management | Knowledge | assessment |
مقاله انگلیسی |
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The Impact of Low Fidelity Simulation on Nurse Competence in Active Management of Third Stage of Labor: An Intervention Study in Primary Health Care Settings in Tanzania
تأثیر شبیه سازی وفاداری کم در شایستگی پرستاران در مدیریت فعال مرحله سوم کار: یک مطالعه مداخله در تنظیمات مراقبت های بهداشتی اولیه در تانزانیا-2021 Background: Simulation-based training on obstetric management has demonstrated promising results.
However, its impact has not been well documented particularly in low and middle income countries.
Therefore, this study aimed to test the effectiveness of a low fidelity simulation-based training intervention in improving knowledge and skills of nurses on Active management of third stage of labor
(AMTSL).
Methods: A quasi experimental study including 172 randomly selected nurses using low fidelity simulation-based training was conducted. Baseline, immediate and retention assessments were done. Findings: Overall knowledge and skills on AMTSL were significantly improved after simulation training, skills retained even after six months. Conclusions: A low fidelity simulation intervention showed positive change in knowledge and skills immediately after intervention and skills were highly retained even after six months of training. keywords: Active Management of Third Stage of Labor | Knowledge | Skills | Dodoma | Tanzania |
مقاله انگلیسی |
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Management of Pediatric Atopic Dermatitis by Primary Care Providers: A Systematic Review
مدیریت درماتیت آتوپیک اطفال توسط ارائه دهندگان مراقبت های اولیه: مرور سیستماتیک-2021 BACKGROUND: Primary care providers (PCPs), including
pediatricians and general practitioners, are often the first to see
children with eczema/atopic dermatitis (AD). Little is known
about management of pediatric AD by PCPs and adherence to
national guidelines.
OBJECTIVE: To review existing literature examining management components of pediatric AD (topical corticosteroids
[TCS], topical calcineurin inhibitors [TCIs], antihistamines,
bathing, emollients, and diet) by PCPs.
DATA SOURCES: PubMed/Medline and Embase.
STUDY ELIGIBILITY CRITERIA: English-language articles dated
2015 to 2020 reporting outcomes addressing management of
pediatric AD by PCPs.
STUDY APPRAISAL AND SYNTHESIS METHODS: Two authors
independently screened titles/abstracts, reviewed full-text
articles, extracted relevant data, and evaluated study quality.
Disagreements were resolved by a third author.
RESULTS: Twenty articles were included. Surveys and
national database analyses were the most common methodologies (n = 7 each). PCPs commonly prescribed TCS but had a
preference for low-potency agents, overprescribed nonsedating
antihistamines, and avoided TCIs. PCPs commonly recommended emollients, although this was not universal. Data characterizing nonmedication management were limited.
LIMITATIONS: Most studies did not examine individual patient
encounters, but rather relied on providers reporting their general behaviors. Provider behavior may vary based on country
of practice.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS: Knowledge and management gaps exist among PCPs in treating pediatric AD in key areas including knowledge of TCS safety
profiles and prescribing of TCIs. The current literature is
largely limited to small studies that evaluate prescribing
behaviors with limited data characterizing nonmedication
management, highlighting the need for future research in this
area.
KEYWORDS: atopic dermatitis | eczema | health care delivery | primary care provider | pediatric |
مقاله انگلیسی |
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Factors associated with knowledge towards postoperative nausea and vomiting management among health professionals in referral Hospitals of Northwest Ethiopia: A multi-center cross-sectional study
عوامل مرتبط با دانش به سوی تهوع پس از عمل و مدیریت استفراغ در میان متخصصان بهداشتی در بیمارستان های ارجاع شمال غربی اتیوپی:یک مطالعه چند منظوره مقطعی-2021 Background: Knowledge of health care professionals on postoperative nausea and vomiting (PONV) and anti-
emetic prescription trends affects patient’s outcome after surgery and anesthesia and also patient and family
satisfaction. Hence, knowing the knowledge status of health professionals towards PONV management is vital for
the optimal care of surgical patients. Therefore, the study aimed to assess the knowledge and factors associated
with PONV management among health professionals in referral hospitals of Northwest Ethiopia.
Methods: An institutional based cross-sectional study was conducted on 407 health care professionals from March
1 to 30, 2019. A Simple random sampling technique was used to select the study participants. Both bivariable
and multivariable logistic regression analysis were used to identify factors associated with the knowledge level of
health professionals on PONV management. In the multivariable analysis, variables with a p-value <0.05 were
considered statistically significant.
Results: In this study, about 52.8% (95% CI: 47.9, 57.2) of the participants had good knowledge of PONV
management. Being male (AOR = 1.95; 95% CI: 1.20, 3.17), Physician (AOR = 5.36; 95% CI: 2.20, 13.5),
Anesthetist (AOR = 3.88; 95% CI: 1.66, 9.08), and taking training on PONV management (AOR = 5.32; 95%CI:
1.58, 17.89) were positively associated with good knowledgeable of health professionals about PONV
management.
Conclusion: and recommendation: More than half of health care professionals who are working in the periop-
erative sites of the referral hospitals had good knowledge about the PONV management. Being male, Physician,
Anesthetist and taking in-service training on PONV management were significantly affecting the knowledge level
of health professionals on PONV management. Thus, providing regular in-service training on PONV manage-
ment, especially for physician and anesthetist is highly recommended. keywords: تهوع و استفراغ پس از عمل | دانش | متخصصین سلامت | اتیوپی | Postoperative nausea and vomiting | Knowledge | Health professionals | Ethiopia |
مقاله انگلیسی |
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Knowledge in pre-hospital emergency and risk management among outdoor adventure practitioners in East Africa afro-alpine mountains
دانش در اورژانس قبل از بیمارستان و مدیریت ریسک در میان تمرینکنندگان ماجراجویی در فضای باز در کوه های آفریقای شرقی آفریقا-2021 Introduction: The enjoyment of nature and other benefits of outdoor activities happen amid inherent hazards. This
calls for knowledge and competency in emergency and risk management. Practitioners in outdoor activities, such
as mountaineering, thus need to be knowledgeable on how to manage risks and attend to emergencies in their
practice. The study sought to establish the preparedness of East African mountaineering practitioners in pre-
hospital emergency and risk management. It sought to establish their knowledge on prehospital emergency and
risk management, based on their age, gender, level of education and refresher training.
Methods: The study purposively sampled one hundred and thirty six (N = 136) outdoor adventure practitioners
from the Afro-alpine mountain areas in East Africa. It was hypothesized that there would be no significant
relationship between the outdoor practitioners’ knowledge in prehospital emergency risk management and their
age, gender, level of education, refresher training. Somers’ d was used to test the hypotheses.
Results: It was established that the knowledge scores of prehospital emergency and risk management for the
mountaineering practitioners was low. It was also established that the knowledge scores of outdoor practitioners
were not dependent on their age, gender, and work experience. However, there was a significant relationship
between the outdoor adventure practitioners’ knowledge scores and their highest level of education as well as
refresher training.
Conclusions: The study concluded that there were gaps in the knowledge of prehospital risk management of the
East African Afro-alpine mountaineering practitioners. It recommends frequent and regular training and re-
certification among outdoor adventure practitioners in order to raise the knowledge in prehospital emergency
risk management.
African relevance
• Identifying prehospital emergency care knowledge by African out-
• Prehospital emergency care is not emphasized in the outdoor
• With inaccessible health care in African outdoors, there is need for
door practitioners can guide planning for training.
adventure practice in many African settings.
knowledge in prehospital emergency risk management. keywords: دانش | پیش بیمارستان | اضطراری | کوهنوردی | ماجرا | در فضای باز | Knowledge | Prehospital | Emergency | Mountaineering | Adventure | Outdoor |
مقاله انگلیسی |
8 |
Financial fluency: demystifying accounting and business planning for the reproductive medicine specialist
تسلط مالی: ابهام زدایی از حسابداری و برنامه ریزی تجاری برای متخصص طب تولید مثل-2021 In today’s ever-changing business climate, reproductive health specialists are realizing that financial fluency is key to growing and
maintaining a successful practice. Although financial fundamentals such as accounting may seem complex, both academic and private
practice reproductive specialists who understand these topics can benefit in making business decisions for their practices. We describe
the key financial fundamentals that reproductive health specialists should know, including basic concepts of finance and accounting,
payments and receivables, capital budgeting, and business planning, and interpreting balance sheets, income statements, and cash-flow
statements. (Fertil Steril 2021;115:7–16. 2020 by American Society for Reproductive Medicine.)
KeyWords: Accounting | budgeting | business plan | fertility centers | finance | health care | reproductive medicine |
مقاله انگلیسی |
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Knowledge, attitudes and practices regarding prediabetes among general practitioners in Reunion Island
دانش، نگرش و عملکرد در مورد پیش دیابت در میان پزشکان عمومی در جزیره Reunion-2021 Background: General practitioners (GPs) are among the first health care providers to be
involved in prediabetes care, and their actions can prevent patients’ transition from
prediabetes to diabetes. However, data on knowledge and management of prediabetes in
primary care remain scarce.
Aim: To describe the knowledge, attitudes and practices of GPs towards prediabetes.
Design and setting: This descriptive cross-sectional study included all private GPs working
in Reunion Island.
Method: GPs were sent an electronic questionnaire that specifically sought to establish whether GPs knew the definition of prediabetes and whether their practices were in line with French guidelines for prediabetes screening and management. Results: A total of 121 GPs completed the questionnaire. Of these, 95.0% knew the definition of impaired fasting glucose, but only 66.1% knew that of impaired glucose tolerance. Many GPs reported practices that are not recommended in guidelines. Thus, 59% of respondents declared that they monitored prediabetes with HbA1c and 10% said that they prescribed oral anti-diabetic drugs as prediabetes treatment. The risks factors associated with prediabetes were generally well known. Although 59.5% of respondents reported not having enough time to provide therapeutic education and medical follow up, only 19% referred their patients to a nutritionist or dietician. Lastly, 93.4% of respondents favoured the implementation of a local therapeutic education program targeting prediabetic individuals. Conclusion: Prediabetes management in primary care can be made more effective by improving GPs’ knowledge of prediabetes and official guidelines, facilitating referral of prediabetic patients to lifestyle specialists and implementing local therapeutic education programs. keywords: Prediabetes | Primary Health Care | Secondary Prevention | Health Knowledge | Attitudes | Practice | Diabetes Mellitus. |
مقاله انگلیسی |
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Knowledge of health workers relating to sepsis awareness and management in Lambaréné, Gabon
دانش کارکنان بهداشتی در رابطه با آگاهی و مدیریت سپسیس در لامبارن، گابن-2021 Background In 2016, the third international consensus definitions for sepsis and septic shock (Sepsis-3) task
force provided revised definitions for sepsis and septic shock. This study explores knowledge regarding sepsis
among health workers in Lambarene, Gabon.
Methods We conducted a self-administered questionnaire-based survey about sepsis among health workers from the referral regional hospital, the research center, and primary care health facilities in the Lambar´en´ e region. Participants were from the referral regional hospital, the research center, and primary health care facilities. A score of one was given to each correct answer. The global score out of a possible score of twenty was calculated, and the proportion of correct responses was determined. Results A total of 115 health workers (physicians, nurses and assistant nurses) completed the questionnaire, of which 48.7% (56/115) provided a valid definition of sepsis, but 74% (85/115) had never heard about the quick Sequential Organ Failure Assessment (qSOFA) score. The proportion of correct answers was comparable across the three health profession categories. The median global score across all health workers was 11 [IQR, 9-14.5] out of 20. Physicians attained higher global scores [14 (IQR, 11-15)] than assistant nurses [11 (IQR, 8-13), P=0.007]; their global score was comparable to that of nurses. Conclusion There are considerable knowledge gaps regarding sepsis among health workers in Lambarene, potentially impairing the prompt recognition and management of sepsis. There is a need to establish periodic uptodate training to improve sepsis knowledge. keywords: کارکنان بهداشت | دانش | گابون | Qsofa | سپسیس | Health workers | Knowledge | Gabon | qSOFA | Sepsis |
مقاله انگلیسی |