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Frontiers in Medicine 2024The rapid spread of COVID-19 pandemic across the world has not only disturbed the global economy but also raised the demand for accurate disease detection models....
The rapid spread of COVID-19 pandemic across the world has not only disturbed the global economy but also raised the demand for accurate disease detection models. Although many studies have proposed effective solutions for the early detection and prediction of COVID-19 with Machine Learning (ML) and Deep learning (DL) based techniques, but these models remain vulnerable to data privacy and security breaches. To overcome the challenges of existing systems, we introduced Adaptive Differential Privacy-based Federated Learning (DPFL) model for predicting COVID-19 disease from chest X-ray images which introduces an innovative adaptive mechanism that dynamically adjusts privacy levels based on real-time data sensitivity analysis, improving the practical applicability of Federated Learning (FL) in diverse healthcare environments. We compared and analyzed the performance of this distributed learning model with a traditional centralized model. Moreover, we enhance the model by integrating a FL approach with an early stopping mechanism to achieve efficient COVID-19 prediction with minimal communication overhead. To ensure privacy without compromising model utility and accuracy, we evaluated the proposed model under various noise scales. Finally, we discussed strategies for increasing the model's accuracy while maintaining robustness as well as privacy.
PubMed: 38912338
DOI: 10.3389/fmed.2024.1409314 -
Cureus May 2024Globally, mental disorders have become a significant burden, affecting a substantial number of individuals. Accessing mental health services is crucial for effective... (Review)
Review
Globally, mental disorders have become a significant burden, affecting a substantial number of individuals. Accessing mental health services is crucial for effective treatment and improving outcomes. However, significant barriers to seeking health services can impede access and contribute to the treatment gap. This systematic review aims to identify and analyze the perceived barriers to seeking mental health services in Saudi Arabia. A comprehensive search was conducted among four databases (PubMed, Web of Science, ProQuest, and Science Direct) to identify relevant studies published between 2018 and 2023. Studies that investigated barriers that could prevent psychiatric patients from seeking mental health services in Saudi Arabia were included. Data extraction and synthesis were performed to identify common themes and barriers. The review included a total of six studies that examined barriers to seeking mental health services in Saudi Arabia. The identified barriers encompassed a range of factors, including stigma, lack of awareness, concerns about confidentiality, limited availability of services, negative attitudes toward professional help, and cultural and religious beliefs. The lack of knowledge, as well as the negative attitude toward mental health care, was a perceived barrier to help-seeking in most studies. Furthermore, stigma was consistently reported as a predominant barrier, preventing individuals from seeking mental health care. This systematic review highlights the barriers to seeking mental health services in Saudi Arabia. Addressing these barriers is essential for improving access to mental healthcare and reducing the treatment gap. Strategies should focus on destigmatization efforts, increasing awareness, ensuring confidentiality and privacy, providing culturally appropriate care, and addressing structural limitations. By implementing these strategies, healthcare systems can improve access to mental health care and the overall well-being of individuals experiencing mental disorders in Saudi Arabia.
PubMed: 38883041
DOI: 10.7759/cureus.60363 -
The Australian and New Zealand Journal... Jun 2024Emergency departments the world over have seen substantial increases in the number of individuals presenting for mental health reasons. However, we have a limited... (Review)
Review
OBJECTIVE
Emergency departments the world over have seen substantial increases in the number of individuals presenting for mental health reasons. However, we have a limited understanding of their experiences of care. The aim of this review was to systematically examine and synthesise literature relating to the experiences of individuals presenting to emergency department for mental health reasons.
METHODS
We followed Pluye and Hong's seven-step approach to conducting a systematic mixed studies review. Studies were included if they investigated adult mental health experiences in emergency department from the users' perspective. Studies describing proxy, carer/family or care provider experiences were excluded.
RESULTS
Sixteen studies were included. Thematic synthesis identified three themes and associated subthemes. Theme 1 - - comprised: Feeling understood and heard; Engaging in judgement-free interactions; Receiving therapeutic support; Being actively and passively invalidated for presenting to the ED; and Once a psych patient, always a psych patient. Theme 2 - - comprised: Waiting for an 'extremely' long time; and Lacking privacy. Theme 3 was .
CONCLUSIONS
The experiences described by individuals presenting to emergency department for mental health reasons were mostly poor. The results illustrate a need for increased mental health education and training for all emergency department staff. Employment of specialist and lived experience workers should also be prioritised to support more therapeutic relationships and emergency department environments. In addition, greater investment in mental health systems is required to manage the current crisis and ensure future sustainability.
PubMed: 38880783
DOI: 10.1177/00048674241259918 -
Revista Da Escola de Enfermagem Da U S P 2024To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults.
OBJECTIVE
To identify and analyze the features and quality of self-management support of mobile applications available in Brazil for chronic low back pain in adults.
METHOD
A systematic review on the Apple Store® and Google Play® digital platforms. The Self-Management Support Assessment Tool scale was used to assess self-management support and the Institute for Healthcare Informatics Functionality Score scale was used to assess functionality.
RESULTS
Seventeen applications were selected, which included around seven self-management skills. The applications that met the majority of self-management support skills were Pathways, Branch, Pancea, Pain Navigator, and Curable. The Curable, Branch and MoovButh applications had the highest scores, with ten features on the functionality scale.
CONCLUSION
Some applications have the potential to complement in-person treatment in terms of validity, acceptability and clinical usefulness in pain management. However, barriers such as lack of partnership between healthcare providers and patients, limited evidence-based content, social support, cultural relevance, cost, language, security and privacy can limit their sustained use. PROSPERO Registration: CRD42022382686.
Topics: Low Back Pain; Humans; Self-Management; Mobile Applications; Brazil; Adult; Chronic Pain
PubMed: 38875500
DOI: 10.1590/1980-220X-REEUSP-2023-0326en -
F1000Research 2024Fiscal decentralization offers potential for stimulating local economic development in Africa, empowering subnational governments to control revenue and spending....
BACKGROUND
Fiscal decentralization offers potential for stimulating local economic development in Africa, empowering subnational governments to control revenue and spending. However, challenges such as urbanization, poverty, inequality, insufficient infrastructure, and governance issues hinder the successful implementation of the core tenets of fiscal decentralization. This paper explores the role of digital technologies in promoting greater fiscal decentralization and revenue enhancement, as a strategic response to these local economic development challenges in Africa.
METHOD
Through a systematic literature review, this study explores the role of fiscal decentralization in driving local economic development, with a focus on leveraging digital technologies to boost revenue generation and strengthen governance and institutional capacity at the subnational level.
RESULTS
The research underscores the importance of investing in digital infrastructure, skill development, and regulatory frameworks, while addressing data privacy and security concerns.
CONCLUSION
By emphasizing the transformative impact of digital technologies fiscal decentralization and property taxation, this paper contributes to the existing literature and highlights avenues for promoting local economic development across Africa.
Topics: Africa; Humans; Digital Technology; Economic Development; Politics
PubMed: 38872736
DOI: 10.12688/f1000research.143922.1 -
BMC Women's Health Jun 2024Although women face a wide range of contraceptive options, globally, young women are at risk of unintended pregnancies. Our umbrella review aimed to determine the... (Review)
Review
BACKGROUND
Although women face a wide range of contraceptive options, globally, young women are at risk of unintended pregnancies. Our umbrella review aimed to determine the decisional needs of nulligravida women aged 11 to 30 considering contraceptive options and identify effective interventions to support their involvement in making decisions about contraceptive use.
METHODS
We followed Joanna Briggs Institute methods for umbrella reviews, theoretically guided by the Ottawa Decision Support Framework. We searched six electronic databases. Two reviewers independently screened citations, extracted data, and appraised quality using AMSTAR2. We analysed findings descriptively.
RESULTS
Of 124 citations, we identified 11 reviews of variable quality (critically low to moderate quality): Six reported decisional needs and 5 reported on interventions. Decisional needs of young women were: (a) information needs about contraceptive options (e.g., mechanism of actions, eligibility, administration, side effects); (b) unclear values (concerns about hormone use) and features of different options (based on their religious values); and (c) need for support and resources (support from society and need for privacy). Compared to controls, decision support interventions including patient decision aids and patient education material increased knowledge and improved discussion of options with their clinicians.
CONCLUSION
Young women making contraceptive decisions experience unmet decisional needs. Effective interventions such as patient decision aids and general patient education materials may address their decisional needs and enhance their level of participation in making contraception decisions. Implications and contribution to the field: Young women's decisional needs when considering contraceptive use are informational needs, unclear values (including religious influences), need for support and resources when facing this decision. Interventions, such as patient decision aid and patient education material can, address decisional needs by improving young women's knowledge about contraceptive options.
Topics: Humans; Female; Decision Making; Adolescent; Young Adult; Adult; Contraception; Contraception Behavior; Child; Health Knowledge, Attitudes, Practice; Decision Support Techniques
PubMed: 38851748
DOI: 10.1186/s12905-024-03172-2 -
Journal of Health Services Research &... Jun 2024To explore the technology-based tools available for supporting the identification of victims of domestic abuse and modern slavery in remote services and consider the... (Review)
Review
OBJECTIVE
To explore the technology-based tools available for supporting the identification of victims of domestic abuse and modern slavery in remote services and consider the benefits and challenges posed by the existing tools.
METHODS
We searched six academic databases. Studies were considered for inclusion if they were published in English between 2000 and 2023. The QuADS quality appraisal tool was used to assess the methodological quality of included studies. A narrative synthesis was conducted using the convergent integrated approach.
RESULTS
Twenty-four studies were included, of which two were professional guidelines; each reported on a distinct technology-based tool for remote services. All tools related to domestic abuse and 21 focused on screening for intimate partner violence among young and mid-life women (18-65) in high-income countries. The review did not identify tools that support the identification of victims of modern slavery. We identified eight common themes of tool strengths, highlighting that the remote approach to screening was practical, acceptable to victims, and, in some circumstances, elicited better outcomes than face-to-face approaches. Five themes pointed to tool challenges, such as concerns around privacy and safety, and the inability of computerised tools to provide empathy and emotional support.
CONCLUSIONS
Available technology-based tools may support the identification of victims of domestic abuse by health and social care practitioners in remote services. However, it is important to be mindful of the limitations of such tools and the effects individuals' screening preferences can have on outcomes. Future research should focus on developing tools to support the identification of victims of modern slavery, as well as empirically validating tools for screening during remote consultations.
PubMed: 38849123
DOI: 10.1177/13558196241257864 -
Advances in Ophthalmology Practice and... 2024The convergence of smartphone technology and artificial intelligence (AI) has revolutionized the landscape of ophthalmic care, offering unprecedented opportunities for... (Review)
Review
BACKGROUND
The convergence of smartphone technology and artificial intelligence (AI) has revolutionized the landscape of ophthalmic care, offering unprecedented opportunities for diagnosis, monitoring, and management of ocular conditions. Nevertheless, there is a lack of systematic studies on discussing the integration of smartphone and AI in this field.
MAIN TEXT
This review includes 52 studies, and explores the integration of smartphones and AI in ophthalmology, delineating its collective impact on screening methodologies, disease detection, telemedicine initiatives, and patient management. The collective findings from the curated studies indicate promising performance of the smartphone-based AI screening for various ocular diseases which encompass major retinal diseases, glaucoma, cataract, visual impairment in children and ocular surface diseases. Moreover, the utilization of smartphone-based imaging modalities, coupled with AI algorithms, is able to provide timely, efficient and cost-effective screening for ocular pathologies. This modality can also facilitate patient self-monitoring, remote patient monitoring and enhancing accessibility to eye care services, particularly in underserved regions. Challenges involving data privacy, algorithm validation, regulatory frameworks and issues of trust are still need to be addressed. Furthermore, evaluation on real-world implementation is imperative as well, and real-world prospective studies are currently lacking.
CONCLUSIONS
Smartphone ocular imaging merged with AI enables earlier, precise diagnoses, personalized treatments, and enhanced service accessibility in eye care. Collaboration is crucial to navigate ethical and data security challenges while responsibly leveraging these innovations, promising a potential revolution in care access and global eye health equity.
PubMed: 38846624
DOI: 10.1016/j.aopr.2024.03.003 -
Journal of Medical Internet Research May 2024Mobile health (mHealth) uses mobile technologies to promote wellness and help disease management. Although mHealth solutions used in the clinical setting have typically... (Review)
Review
BACKGROUND
Mobile health (mHealth) uses mobile technologies to promote wellness and help disease management. Although mHealth solutions used in the clinical setting have typically been medical-grade devices, passive and active sensing capabilities of consumer-grade devices like smartphones and activity trackers have the potential to bridge information gaps regarding patients' behaviors, environment, lifestyle, and other ubiquitous data. Individuals are increasingly adopting mHealth solutions, which facilitate the collection of patient-generated health data (PGHD). Health care professionals (HCPs) could potentially use these data to support care of chronic conditions. However, there is limited research on real-life experiences of HPCs using PGHD from consumer-grade mHealth solutions in the clinical context.
OBJECTIVE
This systematic review aims to analyze existing literature to identify how HCPs have used PGHD from consumer-grade mobile devices in the clinical setting. The objectives are to determine the types of PGHD used by HCPs, in which health conditions they use them, and to understand the motivations behind their willingness to use them.
METHODS
A systematic literature review was the main research method to synthesize prior research. Eligible studies were identified through comprehensive searches in health, biomedicine, and computer science databases, and a complementary hand search was performed. The search strategy was constructed iteratively based on key topics related to PGHD, HCPs, and mobile technologies. The screening process involved 2 stages. Data extraction was performed using a predefined form. The extracted data were summarized using a combination of descriptive and narrative syntheses.
RESULTS
The review included 16 studies. The studies spanned from 2015 to 2021, with a majority published in 2019 or later. Studies showed that HCPs have been reviewing PGHD through various channels, including solutions portals and patients' devices. PGHD about patients' behavior seem particularly useful for HCPs. Our findings suggest that PGHD are more commonly used by HCPs to treat conditions related to lifestyle, such as diabetes and obesity. Physicians were the most frequently reported users of PGHD, participating in more than 80% of the studies.
CONCLUSIONS
PGHD collection through mHealth solutions has proven beneficial for patients and can also support HCPs. PGHD have been particularly useful to treat conditions related to lifestyle, such as diabetes, cardiovascular diseases, and obesity, or in domains with high levels of uncertainty, such as infertility. Integrating PGHD into clinical care poses challenges related to privacy and accessibility. Some HCPs have identified that though PGHD from consumer devices might not be perfect or completely accurate, their perceived clinical value outweighs the alternative of having no data. Despite their perceived value, our findings reveal their use in clinical practice is still scarce.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/39389.
Topics: Humans; Telemedicine; Health Personnel; Patient Generated Health Data; Smartphone
PubMed: 38820580
DOI: 10.2196/49320 -
Journal of Medical Internet Research May 2024Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause... (Review)
Review
BACKGROUND
Health care organizations worldwide are faced with an increasing number of cyberattacks and threats to their critical infrastructure. These cyberattacks cause significant data breaches in digital health information systems, which threaten patient safety and privacy.
OBJECTIVE
From a sociotechnical perspective, this paper explores why digital health care systems are vulnerable to cyberattacks and provides sociotechnical solutions through a systematic literature review (SLR).
METHODS
An SLR using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted by searching 6 databases (PubMed, Web of Science, ScienceDirect, Scopus, Institute of Electrical and Electronics Engineers, and Springer) and a journal (Management Information Systems Quarterly) for articles published between 2012 and 2022 and indexed using the following keywords: "(cybersecurity OR cybercrime OR ransomware) AND (healthcare) OR (cybersecurity in healthcare)." Reports, review articles, and industry white papers that focused on cybersecurity and health care challenges and solutions were included. Only articles published in English were selected for the review.
RESULTS
In total, 5 themes were identified: human error, lack of investment, complex network-connected end-point devices, old legacy systems, and technology advancement (digitalization). We also found that knowledge applications for solving vulnerabilities in health care systems between 2012 to 2022 were inconsistent.
CONCLUSIONS
This SLR provides a clear understanding of why health care systems are vulnerable to cyberattacks and proposes interventions from a new sociotechnical perspective. These solutions can serve as a guide for health care organizations in their efforts to prevent breaches and address vulnerabilities. To bridge the gap, we recommend that health care organizations, in partnership with educational institutions, develop and implement a cybersecurity curriculum for health care and intelligence information sharing through collaborations; training; awareness campaigns; and knowledge application areas such as secure design processes, phase-out of legacy systems, and improved investment. Additional studies are needed to create a sociotechnical framework that will support cybersecurity in health care systems and connect technology, people, and processes in an integrated manner.
Topics: Computer Security; Humans; Delivery of Health Care; Patient Safety
PubMed: 38820579
DOI: 10.2196/46904