A telehealth application for adequate hospital visit advice by physicians affected users’ subsequent hospital visit behavior: a historical cohort study with machine learning

IntroductionThe effectiveness of telehealth strategies toward support for adequate hospital visits is vital. We examined whether individuals who received advice from a physician via an online application subsequently visited hospitals. Further, we examined the background factors associated with their hospital visit behavior.MethodsWe used machine learning to examine whether chief complaint, medical advice, and user background characteristics could be used to predict their subsequent hospital visit.ResultsAmong 7,152 participants, those in their 30s were the most frequent users. The proportion of each medical advice was significantly different between the group that did and the one that did not follow physicians’ advice. We further performed supervised machine learning using random forest modeling to categorize those who (1) followed physicians’ advice or (2) did not follow physicians’ advice. The area under the receiver operating characteristic curve was 0.677. Consequently, the aforementioned model soundly categorized whether users followed physicians’ advice. Chief complaint and medical advice were the most important variables to predict whether users followed the advice.DiscussionThe telehealth system to provide support for adequate hospital visits influenced patients’ subsequent hospital visit behavior. Patients’ chief complaint was the most important variable in discriminating whether users followed physicians’ advice

Peak IgG antibody titers against SARS-CoV-2 spike protein following immunization with the Pfizer/BioNTech BNT162b2 vaccine

This study investigated the immune response and outcome of BNT162b2 vaccination among 12 staff at a hospital in Fukushima, Japan. Blood samples were collected from participants before their first vaccination, with subsequent sampling performed during the participants' work days for six weeks thereafter. Antibody titers peaked 6-13 days after the second vaccination (days 27-34 after the first), followed by a steady decrease. Six males had significantly lower peak antibody titers than six females (p = 0.016 with t-test); the older six (median age 53 years) had lower antibody titers than the younger six (median age 35 years) but without statistical significance (p value=0.24 with t-test)

Home-visit rehabilitation in a repopulated village after the Fukushima nuclear disaster

Following the evacuation of areas affected by Japan's 2011 Fukushima Daiichi Nuclear Power Plant (FDNPP) accident, Kawauchi Village was one of the first municipalities repopulated. Although rehabilitation resources were limited, a healthcare facility near the municipality initiated home-visit rehabilitation in 2016. To the best of our knowledge, reports of home-visit rehabilitation in repopulated villages that were evacuated following a nuclear accident are lacking.This article describes a case study of home-visit rehabilitation in Kawauchi Village. The purpose of this study was to explore how users of home-visit rehabilitation services in Kawauchi Village perceive home-visit rehabilitation, and whether it had a positive impact on their daily life. A questionnaire survey was conducted, and their ability to perform activities of daily living was assessed, to understand the living conditions of the visiting-rehabilitation service users.We studied 10 rehabilitation-service users, with a mean age of 86.8 years, who had used the services for an average of 591.4 days. Themes that emerged from the open-ended questionnaire were "established exercise habits and improved physical functions," "the joy of returning to the village," "challenges in the mountainous areas" and "changes in relationships due to the earthquake or evacuation."In conclusion, home-visit rehabilitation was successfully implemented in the repopulated village, and helped maintain the users' physical functions. This may thus be a viable choice for rehabilitation care in repopulated areas after disasters

Factors Affecting the Help-Seeking Behaviours of Patients with Schizophrenia in Rural Cambodia

In low- and middle-income countries in Asia, the use of supernatural, religious, and magical approaches to mental illness is widespread. We aimed to document the help-seeking behaviours and barriers to effective mental healthcare in the case of a psychiatric patient in rural Cambodia. The present case report describes the pathway that a patient with schizophrenia utilised to receive effective treatment in a rural area. First, the patient was taken by his parents to a pagoda. Subsequently, they took him to the home of a Kru Khmer (a Cambodian traditional healer). Nevertheless, his condition did not improve, and after seeing this, a neighbour suggested to his mother that they visit the provincial hospital. The patient received a diagnosis after an assessment by the hospital psychiatrist. Following several months of treatment with medication, the patient no longer exhibited paranoid behaviour. In this case, the patient’s and his family’s beliefs are strongly related to help-seeking behaviour toward medical care among psychiatric patients. To promote timely visits to the hospital, it is crucial to clarify and understand the type of beliefs held by psychiatric patients and their families. Besides, an educational approach to the beliefs is essential for shortening the duration of untreated illness

Cancer information seeking and scanning behavior among Nepalese migrants in Japan and its association with preventive behavior.

BackgroundIncreasing attention is being paid to cancer information seeking (CISE) (active searching for cancer-related health information) and information scanning (CISC) (passive collection of cancer-related health information) among migrants. However, information is lacking with respect to the extent and distribution of CISE and CISC among migrants, particularly in Japan. This study aimed to evaluate the prevalence of both CISE and CISC, to clarify factors associated with CISE and CISC, and to elucidate the association of CISE and CISC with basic cancer knowledge and preventive behavior among Nepalese migrants living in Tokyo, Japan.MethodsNepalese migrants living in Tokyo were recruited from March to August 2019, with snowball sampling. We collected data on CISE, CISC, sociodemographic components, health-related factors, knowledge about risk factors for cancer, and cancer-prevention behavior using a structured questionnaire. We employed several regression approaches to fulfill our study objectives.ResultsOut of the total 200 participants, 53 (27%) were actively involved in CISE and 176 (88%) in CISC. Internet was the most common information source. High education level and Japanese language skills were positively associated with both CISE and CISC. Migrants with low perceived health status were more likely to perform CISC, while those who had been ill last year and who perceived proper access to doctors were more likely to undertake CISE. Migrants with high CISE (B = 0.10, 95% CI: 0.01, 0.19) and high CISC (B = 0.16, 95% CI: 0.08, 0.23) were more likely to have better knowledge on risk factors of cancer. Furthermore, migrants with high CISE were more likely to eat fruits (B = 0.17, 95%CI: 0.01, 0.32), undergo pap smear test (OR = 1.72, 95%CI: 1.12, 2.65), and colonoscopy (OR = 6.02, 95%CI: 1.63, 22.13).ConclusionIn this study, the proportion of Nepalese migrants who deliberately undertook CISE was low, while the practice of CISC was relatively common. Given that the CISE was associated with cancer-prevention behavior, proper strategies should be implemented to alleviate barriers for CISE and improve its impact on providing reliable evidence about cancer to migrants in Japan

Examination of Cluster Groups of Risk Behaviors and Beliefs Associated with Non-Communicable Diseases with Latent Class Analysis: A Cross-Sectional Study in Rural Bangladesh

This cross-sectional observational study examined the cluster groups of risk behaviors and beliefs associated with non-communicable diseases (NCDs) and the demographic factors that influence these cluster groups. The questionnaire survey was conducted in Lohagara Upazila in Narail District, Bangladesh and included basic demographics and items associated with NCDs. The inclusion criteria for the participants in this study included those who were aged between 20 and 80 years and both sexes. The survey items were based on risk behavior, belief, and improvement behavior. To identify the several cluster groups based on NCD-related behavior and belief patterns, a log-likelihood latent class analysis was conducted. Then, a multinomial regression analysis was performed to identify the factor associated with each cluster group. Of the 600 participants, 231 (38.5%) had hypertension, 87 (14.5%) had diabetes, and 209 (34.8%) had a body mass index of 25 or more. Finally, risk behaviors and beliefs associated with NCDs were classified into three cluster groups: (1) very high-risk group (n = 58); (2) high-risk group (n = 270); and (3) moderate-risk group (n = 272). The very high-risk group was significantly associated with female gender, older age, fewer years spent in education, and the absence of daily medication compared to the moderate-risk group. Educational interventions in rural Bangladesh should be immediately implemented to improve the risk behaviors and beliefs associated with NCDs

Community-based intervention for managing hypertension and diabetes in rural Bangladesh

Abstract Background Approximately 80% of non-communicable diseases (NCDs) have been reported in low- and middle-income countries (LMICs). However, studies on the usefulness of educational interventions run by non-healthcare workers in combating NCDs in resource-limited areas in rural parts of LMICs are limited. This study aimed to identify the effectiveness of a community-based simple educational program run by non-healthcare trained staff for several outcomes associated with NCDs in a resource-limited area. Methods Six villages in the Narail district in Bangladesh were selected, two each in the first and second intervention and the control groups, in the Narail district in Bangladesh were selected. Pre- and post-intervention survey data were collected. The first intervention group received the “strong” educational intervention that included a checklist poster on the wall, phone call messages, personalized advice papers, seminar videos, and face-to-face seminars. The second intervention group received a “weak” intervention that included only a checklist poster on the wall in their house. The outcome was the proportion of NCDs and changes in systolic blood pressure and blood sugar level. Confidential fixed-effects logistic regression and multiple linear regression were performed to identify the effectiveness of the intervention. Results Overall, 600 participants completed the baseline survey and the follow-up survey. The mean systolic blood pressure reduced by 7.3 mm Hg (95% confidence interval [CI] 4.6–9.9) in the first intervention group, 1.9 mm Hg (95% CI − 0.5–4.2) in the second intervention group, and 4.7 mm Hg (95% CI 2.4–7.0) in the control group. Multiple linear regression analysis showed that the between-group differences in the decline in systolic blood pressure were significant for the first intervention versus control (p = 0.001), but not for the second intervention versus control (p = 0.21). The between-group differences in the reduction in blood glucose after the intervention, were not significant on multiple linear regression analysis. Conclusions Community-based educational interventions for NCDs provided by non-healthcare staff improved the outcomes of hypertension and risk behaviors. Well-designed community-based educational interventions should be frequently implemented to reduce NCDs in rural areas of low- and middle-income countries. Trial registration UMIN Clinical Trials Registry (UMIN-CTR; UMIN000050171) retrospectively registered on January 29, 2023

Additional file 1 of Community-based intervention for managing hypertension and diabetes in rural Bangladesh

Additional file 1: Figure S1. Lifestyle checklist poster on the wall to prevent noncommunicable diseases. Participants were required to stick the poster on their house wall. The poster was translated in the local language. Some modifications were performed before translation for considering local culture. Figure S2. Semi-advice paper. Grouping was conducted using baseline data by latent class analysis. The advice paper was translated in the local language. Figure S3. Systolic blood pressure and blood sugar level before intervention by group of past medical history. Systolic blood pressure (B) blood sugar. Table S1. Multiple linear regression analysis for the decrease in mean blood pressure between pre- and post-intervention. Table S2. Systolic blood pressure each group of pre-diagnosed and classification. Table S3. Education years and Income by sex. Table S4. Multiple linear regression analysis for the decrease in systolic blood pressure between pre- and post-intervention one considering interaction. Table S5. Blood sugar each group of pre-diagnosed and classification