Pembuatan Alat Monitoring Infus Berbasis NodeMCU ESP8266

The problem of late replacement of infusion mattresses for patients in a medical institution is still common today. It still helps him closely with the nurses' negligence in monitoring the patient's infusion condition. This condition is very dangerous for the patient's health. Therefore the making of infusion monitoring equipment based on NodeMCU esp8266. This tool works by relying on the results of sensor readings that are inserted into the microcontroller which will be processed by NodeMCU. The sensor used in making this system is the sensor module, the sensor reading sensor is the intended emission sensor - in this case, means the drip drops, the sensor will count the number of drops. From the number of drops, it can be used to count the drip infusion. In this study, it can be concluded that the NodeMCU ESP 8266-based infusion monitoring tool using the IR Obstacle sensor component has been successfully made through the functionality test process.

Does Internet Use Affect Medical Decisions among Older Adults in China? Evidence from CHARLS

Background: The rapid growth of the elderly population poses a huge challenge for people to access medical services. The key to get rid of the dilemma is for patients to go firstly to primary medical institutions. Existing studies have identified numerous factors that can affect patients’ health institution choice. However, we currently know little about the role of Internet use in the patients’ medical decisions. The objective of this study is to explore health-seeking behavior and institution choice under the background of the Internet era from the perspective of older adults, and to analyze whether the Internet could guide patients to the appropriate medical institution so as to accomplish hierarchical treatment. Methods: The dataset comprises 9416 people aged 45 or above from the China Health and Retirement Longitudinal Survey (CHARLS), which, through multistage cluster sampling, was conducted in 2011, 2013, and 2015. Logistic regression, PSM, and FE model are used to estimate the influence of Internet use on the health care decision-making behavior. Results: Internet use has a significant positive impact on the self-treatment of common diseases (β = 0.05, p < 0.05). In terms of medical institution choices, those who use Internet are more inclined to choose top-level hospitals than community health service institutions to treat common diseases (β = 0.06, p < 0.01). Conclusions: The Internet has lowered the obstacles to learning about common ailments, resulting in a substitution impact of self-treatment for hospital care. However, Internet use may aggravate older adults’ perception of the risk of disease, which exacerbates the tendency of going to higher-level medical institutions for medical treatment. The finding of the study is useful for further rational planning and utilization of the Internet in order to guide patients to appropriate medical institution, which helps to improve the efficiency of the overall medical and health services.

КЛІНІЧНИЙ ВИПАДОК ГОСПІТАЛЬНОЇ ПНЕВМОНІЇ, ВИКЛИКАНОЇ KLEBSIELLA PNEUMONIA, ВНАСЛІДОК КОНТАКТУ ІЗ ЧЛЕНОМ РОДИНИ

The problem of morbidity and mortality due to infectious lesions of the respiratory tract, in particular nosocomial pneumonia, remain one of the most pressing problems of modern medicine. Nosocomial pneumonia ranks 3rd among all infectious diseases that a patient can contract at a medical institution after urinary and wound inflammation and it is characterized by high mortality. Nosocomial pneumonia is provoked by antibiotic-resistant microorganisms; in the intensive care patients, it is complicated by the re-aspiration of bacteria that accumulate above the cuff of the intubation tube. Identification of nosocomial and community-acquired pneumonia involves a particular flora of pathogens and, accordingly, involves empiric therapy. Routine analysis of sputum according to Gram gives approximate data, which is a clarification for empiric treatment. We present a clinical case, which demonstrates that infection is also possible due to contact of a family member with another one, working at a medical institution. Therefore, in our clinical case, we emphasize that it is very important to collect a thorough history. Careful collection of medical history can provide additional information: working in a team, being a medical professional, relatives working at a medical institution. It should be noted that in this category of patients, the causative agent of infection, including nosocomial pneumonia, may be the strains of nosocomial microorganisms. Regardless of age, we recommend the use of preventive measures (lifestyle modification, acclimatization training, sports, etc.) to increase the non-specific resistance of the body. As a preventive measure, medical personnel should follow the regimes of ventilation and wet cleaning in the premises, wash their hands and rinse their nasal passages as often as possible with saline solutions, use a mask to protect the respiratory organs, disinfect hands with alcohol.

Decision Tool of Medical Endoscope Maintenance Service in Chinese Hospitals: A Conjoint Analysis

Background: Quality and cost of medical device maintenance are dominant factors influencing hospitals’ decision in choosing medical endoscope products. Effective and efficient medical device maintenance are also paramount for providing cost-effective and high quality of medical care. This research aims to facilitate decision-making at hospitals in choosing the suitable endoscope device and the associated maintenance service; it also aims to facilitate decision-making at suppliers to develop the right products and services to fulfill customer demands.Methods: A cross-sectional survey was undertaken in 50 Chinese hospitals, including primary and tertiary hospitals. Moreover, 65 medical staff and 56 medical engineers were recruited from 50 Chinese hospitals. A comprehensive set of attributes were defined and investigated. Conjoint analysis and orthogonal design were used for survey design and statistical analysis. Results: Attribute importance and utility values of decision-making factors were analyzed at the aggregate, occupation, and medical institution levels. (1) At the aggregate level, the most critical factor is "maintenance response" and the least important one is "maintenance efficiency". (2) At the occupation level, medical staff paid more attention to "maintenance response" and medical engineers paid more attention to "maintenance quality". (3) At the medical institution level, Primary hospitals paid more attention to "maintenance price", while tertiary hospitals paid more attention to "maintenance quality". Conclusions: In general, this study provides a more scientific decision-making tool to both hospitals in choosing maintenance service of medical equipment such as endoscopy, and it also helps manufacturers and suppliers improve the after-sales service.

ANALYSIS OF THE DEVELOPMENT OF A MEDICAL INFORMATION SYSTEM

Охрана здоровья граждан – одна из ключевых тем развития государства. О необходимости выстроить систему здравоохранения на новой технологической базе заявил в Послании Федеральному Собранию 21.04.2021 Президент РФ Владимир Путин. Здравоохранение представляет собой достаточно сложную и динамическую систему, которая требует постоянной оценки ситуации и быстрого принятия решений. Непрерывная оценка эпидемиологической ситуации и мониторинг здоровья конкретного гражданина невозможен без качественно организованного обмена информацией и единой системы данных, внедренных в повседневную работу медицинских учреждений. На данный момент существует большое количество медицинских информационных систем (МИС), однако, многие из них содержат избыточный функционал и специфичный формат хранения данных. Адаптировать существующие МИС под нужды конкретных регионов довольно проблематично как в трудо- и времязатратах, так и финансовом плане. Была поставлена задача разработать медицинскую информационную систему Астрал.Мед, направленную на решение актуальных задач в сфере оказания первичной медико-санитарной помощи. Одной из задач разработки является возможность передачи и приема различной медицинской информации в уже существующие МИС с целью, в конечном итоге, отправки этих данных в Единую государственную информационную систему в сфере здравоохранения. В данном случае должно реализовываться единое хранилище всех данных пациентов внезависимости от медицинского учреждения, в котором они обслуживаются, и от информационной системы в данном учреждении. Реализация системы Астрал.Мед состоит из: разработки модуля интерфейсной части; разработки базы данных и способа взаимодействия с ней; модуля обработки запросов от специалистов медицинского учреждения и модуля интеграции со сторонними МИС (что является одной из самых основных и сложных задач из-за возможной несовместимости форматов хранения данных в различных информационных системах). Protection of the health of citizens is one of the key topics in the development of the state. The need to build a health care system on a new technological base was announced by the President of the Russian Federation Vladimir Putin in his Address to the Federal Assembly on April 21, 2021. Health care is a rather complex and dynamic system that requires constant assessment of the situation and quick decision-making. A continuous assessment of the epidemiological situation and monitoring of the health of a particular citizen is impossible without a well-organized exchange of information and a unified data system introduced into the daily work of medical institutions. At the moment, there are a large number of medical information systems (MIS), however, many of them contain redundant functionality and a specific data storage format. It is quite problematic to adapt existing IIAs to the needs of specific regions, both in terms of labor and time costs, and financially. The task was to develop a medical information system Astral.Med, aimed at solving urgent problems in the field of primary health care. One of the development tasks is the possibility of transferring and receiving various medical information to the already existing MIS with the aim, ultimately, of sending this data to the Unified State Information System in the field of health care. In this case, a single repository of all patient data should be implemented, regardless of the medical institution in which they are served and the information system in this institution. Implementation of the Ast-Ral.Med system consists of: development of the interface module; developing a database and a way to interact with it; a module for processing requests from specialists of a medical institution and a module for integration with third-party MIS (which is one of the most basic and complex tasks due to the possible incompatibility of data storage formats in various information systems).

Hardware and software complex for remote monitoring and control of a pregnant woman's health state

Introduction: The problem of remote monitoring of people's health has become especially urgent nowadays due to the rapid spread of dangerous infectious and viral diseases, such as COVID-19. This period was especially difficult for pregnant women. According to Rosstat statistics, in 2020, maternal mortality in Russia increased by 24.4% compared to 2019 and reached 11.2 per 100,000 newborns. This is the worst level since 2013. In the current conditions, there is a necessity for developing remote monitoring systems which allow you to check the health status of a pregnant woman remotely using tools outside a medical institution. Purpose: To develop the structure and validate the choice of elements for a hardware and software complex which would perform remote monitoring outside a medical institution and assess the condition of pregnant women during their active life. Results: An automated questionnaire for pregnant women has been developed in accordance with the methodological recommendations of the Ministry of Health of the Russian Federation, providing a quantitative assessment of the current state of a pregnant woman in order to study the dynamics of her health. Based on the results of instrumental studies, according to 30 factors of patient's body functioning and the questionnaire data, a set of diagnostically significant indicators was developed. For each of them, a range of values was specified (norm, alarm, pathology). We have developed an experimental sample of the hardware and software complex and tested its functioning, particularly the modes of taking biomedical data by urine tests. The algorithms for processing and analysis of biomedical data have been experimentally studied in order to confirm the validity of the proposed solutions. Practical relevance: The results of the studies allow us to affirmatively answer the question about the possibility of remote monitoring outside a medical institution and assessing the health state of a pregnant woman in order to predict pregnancy complications, as well as to validate the choice of measuring channels for recording a complex of biomedical signals and data, and the choice of algorithms for information processing and analysis.

Rates of overweight and obesity in children and adolescents in St. Petersburg: assessment of the risks of developing metabolic syndrome

Background. It is known that the earlier a persons body weight exceeds the normal range, the metabolic disorders associated with obesity will form at an earlier age. The progressive increase in the prevalence of obesity and metabolic syndrome in different countries is primarily associated with the so-called human risk factors, which include: physical inactivity, excessive consumption of food rich in fats and carbohydrates, stress, smoking. In this regard, it is extremely important to regularly monitor the body weight of children and adolescents in order to early identify a tendency to increase body weight for the making recommendations for maintaining weight within the normal range. Aim. To evaluate the frequency of obesity and overweight in children, adolescents and adults from among the residents of St. Petersburg, to conduct a comparative assessment of the data obtained. Materials and methods. The work was attended by students of St. Petersburg schools (children and adolescents) and patients (adults) who are being treated in St. Petersburg State Medical Institution Elizavetinskaya Hospital. The sample was random: when collecting data from children and adolescents, data from one of the classes in each parallel from 4th to 11th grade were taken into account, when collecting data from adults 2 people from each ward of the gastroenterology department of the St. Petersburg State Medical Institution Elizavetinskaya Hospital. Data collection was carried out in the period: AugustDecember 2020. Statistical processing was performed out using the computer software package SPSS 8.0. Estimation of anthropometric parameters (age, body weight, height) and calculation of body mass index (BMI) were performed in 74 children (age 912 years), 137 adolescents (age 1318 years) and 55 adults (mean age 49.12 17.03). Results. An increase in body weight was detected in 6.8% of children (5.4% overweight and 1.4% obese of the 1st degree), 14.6 % of adolescents (11.7% overweight and 2.9% obese of the 1st degree) and 62% of adults (36% overweight, 13% obese of the 1st degree, 7% obese of the 2nd degree, 6% obese of the 3rd degree). During the correlation analysis, it was observed that the proportion of overweight people in the observed age categories increased with age (p 0.05). Conclusions. Overweight and obesity begin to be detected already in children, in a fairly large percentage of cases already occur in adolescents and are observed in more than half of the adults surveyed in St. Petersburg. Therefore, it is necessary to carry out activities among parents of preschoolers and schoolchildren, as well as, if possible, the children themselves, to form motivation to maintain a healthy lifestyle in order to prevent the early development of overweight.

Personal data protection in medical institutions. Part II

The problem of protecting personal data in medical institutions is currently extremely urgent. The article discusses the main issues of personal data protection in a medical institution.

Disposal of the person’s hospitalization in the medical insitution for conducting forensic examinations in the criminal procceedings

Individual freedom is one of the fundamental values protected by the European Convention on Human Rights, due to its importance, requiring a rigorous review by the European Court of Human Rights of any measure that could infringe this value. At the same time, this fundamental right is protected by the Constitution of the Republic of Moldova and the Code of Criminal Procedure, due to which individual freedom is inviolable, and its coercion is allowed only in cases and with the procedure strictly regulated by law. The hospitalization of the person in the medical institution is a form of de privation of liberty and, respectively, it is going to take place only on the basis of a court authorization. At the same time, the person’s hospitalization can affect the right to privacy. It is therefore strictly necessary that the whole procedure be followed imperatively and without exception. The disposition of the forced internment of the person in a medical institution for the performance of judicial expertise in the criminal process is within the competence of the investigating judge. Therefore, this article is dedicated to the procedure regarding the hospitalization of the person in the medical institution, on the basis of grounds and reasons on which the hospitalization can take place, the attribution of the criminal investigation body and the prosecutor in cases when there is a need to hospitalize the person.