Perspective Chapter: Telehealth Technologies for the Elderly People

Home telehealth technology delivers a telemedicine tool for elder adults to take an active role in the management of their chronic diseases. This study aimed to determine the requirements and applications of home telehealth systems to monitor health parameters of the elderly. Electronic databases including PubMed, Scopus, Web of Science complemented by Google Scholar were searched. This systematic review was conducted based on preferred reporting items for systematic reviews and meta-analyses. In this study, 21 articles met the inclusion criteria and were included in the final review. There were 80 different requirements and 15 types of applications to create a home telehealth system specifically for the elderly. The highest frequency of applications element was related to the “blood pressure” (18%) and the lowest frequency related to items such as blood coagulation (1%) monitoring. Other systems` elements were “alert system” (12%), “information analysis” (12%), smartphone (20%), and internet (23%). Recognizing all used requirements and achieved capabilities may assist in designing more effective systems. They might be expanded at national level to meet the elderly’s needs at a greater scale

Monkeypox: a systematic review of epidemiology, pathogenesis, manifestations, and outcomes

Introduction. Since May 2022, an unusually large number of new monkeypox infections-a previously rare viral zoonotic disease, mainly reported from central and western Africa has been reported globally, and the World Health Organization (WHO) declared a global health emergency in July 2022. We aimed to systematically review the monkeypox virus epidemiology, pathogenesis, transmission, presentations, and outcomes. Materials and methods. Our aim is to systematically review the epidemiology, pathogenesis, manifestations, and outcomes of Monkeypox disease. We searched the keywords in the online databases of PubMed, Embase, Scopus, and Web of Science and investigated all English articles until December 2022. In order to ascertain the findings, this study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. In order to optimize the quality, this review study benefits from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. To minimize any probable bias risk, we utilized the Newcastle-Ottawa Scale (NOS) risk assessment tool. Results. The most prevalent symptoms were rash and fever. The infection was accompanied by different complications such as, but not limited to, encephalitis (mainly in children), septicemia, bacterial cellulitis, retropharyngeal and parapharyngeal abscesses, etc. A wide range of hospitalization from 3.7% to 100% has been reported. The mortality rate ranged from 0% to 23%, which mainly occurred in infants and children. High mortality of the monkeypox rate was reported among pregnant women. The mortality rate of monkeypox is lower among women and those who received the smallpox vaccine compared to men and those who did not receive the vaccine. A wide range of the overall second-rate attack was reported, which is more pronounced in unvaccinated patients. Conclusion. In our systematic review of 35 studies on monkeypox, we cast light on the existing evidence on its epidemiology, pathogenesis, manifestation, and outcomes. Further studies are needed to elucidate the natural history of the disease in various patients’ population, as well as detailing the monkeypox attack rate

Virtual clinic in pregnancy and postpartum healthcare: A systematic review

Abstract Background and Aims To monitor the health status of pregnant women moment by moment, new technologies in the field of telemedicine can be used, such as virtual visits and virtual clinics. During the COVID‐19 pandemic, by using these technologies, useful and satisfactory services have been provided to pregnant mothers. The aim of this study is to specify the applications, features, and infrastructure of a comprehensive virtual clinic in the field of gynecological and pregnancy care. Methods A systematic review search was conducted through the scientific databases from February 2013 to February 2022 using Scopus, Web of Science, and PubMed. Furthermore, manual searches in Google Scholar and the reference lists of included studies were carried out. Results In this systematic review we included 16 articles that reported experiences in virtual clinics in pregnancy and postpartum healthcare. The involved studies were experimental, cohort, and cross‐sectional studies. The target group users were pregnant or women who gave birth and families of neonatal. The application of virtual clinics was for the visit, consultation, monitoring, follow‐up, and home care virtually. Highly satisfaction scores of caregivers after virtual visits and consultation were reported. There were some challenges during virtual visits and consultation; the most important challenge was a poor internet connection. Conclusion The reviewed studies show promising outcomes according to patient and provider satisfaction. We predict that telehealth will become a growingly significant part of gynecological care in the future

Public acceptability of COVID-19 vaccines and its predictors in Middle ‎Eastern/North African (MENA) countries: a systematic review‎

Introduction COVID-19 vaccines emerged as a worldwide hope to contain the pandemic. However, many people ‎are still hesitant to receive these vaccines. We aimed to systematically review the public knowledge, perception, and acceptability of COVID-19 vaccines in the Middle East and North Africa (MENA) countries and the predictors of vaccine acceptability in this region. Methods We systematically searched databases of PubMed, Scopus, Web of Science, and Cochrane and retrieved ‎all relevant studies by 5 August 2021. Results There was a considerable variation in the COVID-19 vaccine acceptance ‎rates, from 12% in a study from Israel to 83.3% in Kuwait, although two other studies from Israel mentioned 75% ‎and 82.2% acceptability rates. Concerns about the side effects and safety of the vaccine were the main reasons for ‎the lack of acceptability of taking the vaccine, which was reported in 19 studies. ‎ Conclusion Several factors, such as age, gender, education level, and comorbidities, ‎are worthy of attention as they could expand vaccine coverage in the target population.

Prevalence of sexually transmitted infections and associated risk behaviors in prisoners: A systematic review

Abstract Background and Aims Sexually transmitted infections (STIs) are one of the major health concerns globally. Generally, prisoners are at higher risks for STIs due to risk factors including; drug‐use, high‐risk sexual behaviors, densely populated prisons, and poor living conditions. Therefore, we aimed to conduct a systematic review to evaluate the existing data on STI prevalence, and its associated risk factors among prisoners. Methods We conducted a systematic search of the literature using the keywords in Scopus, PubMed, Web of Science, and Google Scholar online databases. We selected all the relevant original studies in English through title/abstract and full‐text screening process.‎ Results Based on the inclusion and exclusion criteria, we selected and reviewed 32 studies out of 96 identified papers. The most important STI‐associated risk factors among prisoners were drug use, low educational levels, and unsafe sex. The prevalence of STIs was heterogenous in selected studies and was reported as follows; Human Immunodeficiency Virus (HIV) (0%−14.5%), hepatitis B viruses (HBV) (0.04%−27.23%), hepatitis C viruses (HCV) (0.17%−49.7%), Syphilis (0.2%−22.1%), Chlamydia Trachomatis (CT) (1.02%−6.7%), Gonorrhea (0.6%−7.8%), and herpes simplex virus‐2 (HSV‐2) 22.4%. Conclusion This systematic review indicates that the prevalence of STIs (HIV, HBV, HCV, Syphilis, Chlamydia Trachomatis, Gonorrhea, and HSV‐2) among prisoners appears to be higher than the general population, with drug abuse, low educational levels, and unsafe sex as major risk factors

Changes in sexual activities, function, and satisfaction during the COVID-19 pandemic era: a systematic review and meta-analysis

Introduction: Little is known about the impact of the coronavirus on sexual behavior, function, and satisfaction. Aim: The aim of the present study was to systematically review people’s sexual function and behaviors and their changes in sexual activities during the COVID-19 pandemic. Methods: Comprehensive searches in PubMed, Web of Science, and Scopus were conducted with keywords in accordance with MeSH terms: COVID-19, SARS-CoV-2, coronavirus, sexual health, sexual function, sexual dysfunctions, sexuality, sexual orientation, sexual activities, and premarital sex. Two reviewers independently assessed full-text articles according to predefined criteria: original design, English studies, and investigating either the general population or sexual minorities. Results: Risk of bias in the studies was assessed by the Newcastle-Ottawa Scale, and data were pooled via random effects meta-analyses. We utilized the standardized mean difference to evaluate the effects of the COVID-19 pandemic on sexual activity, functioning, and satisfaction. We included 19 studies in the analysis and 11 studies in the meta-analysis, with a sample size of 12 350. To investigate sexual activity changes, a sample size of 8838 was entered into the subgroup analysis, which showed a significant decrease in both genders (5821 women, P < .033; 3017 men, P < .008). A subgroup meta-analysis showed that the sexual function of men and women during the COVID-19 pandemic significantly declined (3974 women, P < .001; 1427 men, P < .001). Sexual desire and arousal decreased in both genders, though mainly in women. In investigating sexual satisfaction changes during the COVID-19 pandemic, a meta-analysis with a sample size of 2711 showed a significant decrease (P < .001). The most indicative changes in sexual behaviors during the pandemic were the increase in masturbating and usage of sex toys. Greater COVID-19 knowledge was associated with lower masturbation, oral sex, and vaginal sex. The more protective behaviors were associated with less hugging, kissing, cuddling, genital touching, watching porn with a partner, and vaginal sex. Conclusion: The COVID-19 pandemic led to increased challenges and changes for individuals’ sexual behaviors. Efforts for preventive strategies should therefore be concentrated between pandemics, while ensuring that there is information available to the population during a pandemic for help in times of psychological distress or crisis

COVID-19 mortality and its predictors in the elderly: A systematic review

Background and Aims Older people have higher rates of comorbidities and may experience more severe inflammatory responses; therefore, are at higher risk of death. Herein, we aimed to systematically review the mortality in coronavirus disease 2019 (COVID-19) patients and its predictors in this age group. Methods We searched PubMed, Web of Science, and Science Direct using relevant keywords. Retrieved records underwent a two-step screening process consisting of title/abstract and full-text screenings to identify the eligible studies. Results Summarizing findings of 35 studies demonstrated that older patients have higher mortality rates compared to the younger population. A review of articles revealed that increasing age, body mass index, a male gender, dementia, impairment or dependency in daily activities, presence of consolidations on chest X-ray, hypoxemic respiratory failure, and lower oxygen saturation at admission were risk factors for death. High d-dimer levels, 25-hydroxy vitamin D serum deficiencies, high C-reactive protein (≥5 mg/L) levels plus any other abnormalities of lymphocyte, higher blood urea nitrogen or lactate dehydrogenase, and higher platelet count were predictors of poor prognosis and mortality in the elderly. Studies have also shown that previous treatment with renin–angiotensin–aldosterone system inhibitors, pharmacological treatments of respiratory disorders, antibiotics, corticosteroids, vitamin K antagonist, antihistamines, azithromycin, Itolizumab (an anti-CD6 monoclonal antibody) in combination with other antivirals reduces COVID-19 worsening and mortality. Vaccination against seasonal influenza might also reduce COVID-19 mortality. Conclusion Overall, a critical consideration is necessary for the care and management of COVID-19 in the aged population considering the drastic contrasts in manifestation and prognosis compared to other age groups. Mortality from COVID-19 is independently associated with the patient's age. Elderly patients with COVID-19 are more vulnerable to poor outcomes. Thus, strict preventive measures, timely diagnosis, and aggressive therapeutic/nontherapeutic care are of great importance to reduce acute respiratory distress syndrome and severe complications in older people.publishedVersio

Design, development, and evaluation of a registry system for hyperbaric oxygen therapy: A methodological study

Abstract Background and Aims Hyperbaric oxygen therapy (HBOT), utilizes 100% oxygen at pressures greater than sea‐level atmospheric pressure, for the treatment of conditions in which the tissues starve for oxygen. The Undersea and Hyperbaric Medical Society (UHMS) has granted HBOT approval for the treatment of various conditions. On the other hand, applying informatics registry systems can improve care delivery, ameliorate outcomes, and reduce the costs and medical errors for the patients receiving HBOT treatment. Therefore, we aimed to design, develop, and evaluate a registry system for patients undergoing HBOT. Methods In the first phase, the conceptual and logical models were designed after conducting symposiums with experts and having other experts review the models. In the second phase, the system was developed on the web using ASP.NET  and C# programming languages frameworks. The last phase involved Nielsen's heuristic evaluation method for the system's usability. Five experts evaluated the system, including three health information management specialists and two medical informatics specialists. Results The hyperbaric patient information registry system (HPIRS) interacts with three types of users—a specialist physician, a nurse, and a system administrator. A scenario for each predefined activity was designed, and all the information was stored in the SQL servers. The five experts independently found 152 issues, of which 84 were duplicates. The 68 distinct issues of the system were then resolved. Conclusions The design and development of such registry systems can make data available and stored carefully to improve clinical care and medical research and decrease costs and errors. These registries can provide the healthcare systems with E‐health applications, improved data management, more secure data transfer, and support for statistical reporting. The implemented heuristic evaluation method can also provide a low‐cost and readily available system to fix the issues of the designed systems

Impact of COVID ‐19 pandemic on routine vaccination coverage of children and adolescents: A systematic review

International audienceScientists and healthcare workers have expressed their concerns on the impacts of the COVID-19 pandemic on vaccination coverage in children and adolescents. Therefore, we aimed to systematically review the studies addressing this issue worldwide

Supplemental material - Telemedicine technologies and applications in the era of COVID-19 pandemic: A systematic review

Supplemental material for Telemedicine technologies and applications in the era of COVID-19 pandemic: A systematic review by Esmaeil Mehraeen, Seyed Ahmad Seyed Alinaghi, Mohammad Heydari, Amirali Karimi, Abdollah Mahdavi, Mehrnaz Mashoufi, Arezoo Sarmad, Peyman Mirghaderi, Ahmadreza Shamsabadi, Kowsar Qaderi, Pegah Mirzapour, Amirata Fakhfouri, Hadiseh Azadi Cheshmekabodi, Kimia Azad, Seyed Ali Bagheri Zargande, Shahram Oliaei, Parisa Yousefi Konjdar, Farzin Vahedi, Tayebeh Noori in Health Informatics Journal</p