Healthcare, Volume 12, Issue 3 (February-1 2024) – 129 articles

Background: Research consistently shows that abuse during childhood is related to adult psychopathology. Information regarding childhood abuse is frequently collected from either previous documentation or from participants’ self-reports. Objective: In the current study, we combined information on reports of childhood abuse from several informants (patients, treating clinicians, and independent interviewer), as well as diagnostic assessments of adult patients based on independent interviewer assessments based on structured diagnostic interviews (SCID) and clinician judgments, to better examine the association between exposure to abuse during childhood and adult psychopathology. Participants and Setting: A convenience sample of patients in community mental health and hospital-based clinics (N = 170) and their clinicians (N = 80) participated in the study. Methods: Patients and clinicians completed the Clinical Data Form. Patients also completed the Childhood Trauma Questionnaire. Independent interviewer-assessed patients and completed the Familial Experiences Interview. Clinicians completed a diagnostic assessment of their patients based on clinical judgment. Independent interviewers completed the Structured Clinical Interview (SCID). Results: Reports of exposure to physical, emotional, and sexual abuse during childhood from all informants correlated with the treating clinician’s diagnosis of borderline personality disorder (BPD; r range 0.23–0.37, p < 0.05), but not with SCID diagnosis of BPD. Clinician and SCID diagnosis of post-traumatic stress disorder (PTSD) correlated with patient and interviewer reports of childhood sexual abuse (r range 0.23–0.30, p < 0.05), but there were no correlations with treating clinician’s reports of sexual abuse. Conclusions: The association between BPD and childhood abuse is consistent across different ratings and measurements. The study raises questions of the ability of a structured interview to accurately capture BPD and highlights the connection between sexual abuse and PTSD, and the importance of treating clinicians’ examination of childhood sexual abuse among their patients. Full article

In recent years, music has been regarded as a promising non-pharmacological intervention for a number of physical and mental conditions. Five-elements music therapy—based on the five-element theory—is a unique non-pharmacological therapy of East Asian traditional medicine. It has the potential to effectively provide individualized music therapy to individuals with illness. However, one limitation of this music therapy is that the classification of the five elements and its application is mainly based on subjective judgment. The development of artificial intelligence (AI) has enabled the acoustic analysis of multi-factor sound sources. This can develop five-element music therapy. Here, we discussed the challenges proposed by the future combination of five-element music therapy and AI. Further, we hypothesized that AI may promote its use in the medical field. Full article

Background—There is no validated dementia screening tool for multi-ethnic Asian populations comprising Chinese, Malays, and Indians. This study aimed to establish the psychometric properties of the Community Screening Instrument for Dementia (CSI-D), Chinese Mini Mental State Examination (CMMSE), and Elderly Cognitive Assessment Questionnaire (ECAQ) in multi-ethnic Singapore. Methods—Participants were randomly drawn from a community-based neurological diseases study of older adults conducted in Singapore, with oversampling to allow similar subject numbers from the three major ethnicities: Chinese, Malay, and Indian. The CSI-D, CMMSE, and ECAQ were administered by trained research nurses using a standardised translated questionnaire in a language the participant was most conversant in. Participants were independently diagnosed as a case/non-case of dementia using the DSM-IV. Results—There were 259 participants (85 Chinese, 85 Malays, and 89 Indians, mean age 70.15 years, 65.4% female, 58.8% had no/minimal formal education); 22.8% (n = 59) had dementia. Correlations between the measures were substantial. All the measures had acceptable overall discriminative abilities. Diagnostic accuracies of the instruments did not differ across the ethnic groups. Effects of education were present in the cognitive screening measures. Conclusions—The CSI-D, CMMSE, and ECAQ are valid dementia instruments in this multi-ethnic Asian setting. Full article

The LYMQOL Leg questionnaire is the most widely used, evidence-based tool for the assessment of health-related quality of life (HRQoL) in patients with lower limb lymphedema (LLL). It has been translated into several languages, but a German version is currently lacking. The aim of our study was to validate a German translation of LYMQOL Leg. Translation and cross-cultural adaptation were performed in accordance with ISPOR principles. A total of 103 patients with LLL from Germany, Austria, and Switzerland were interviewed twice. The content and face validity assessments indicated that the German LYMQOL Leg questionnaire was acceptable for interviewing patients with lymphedema. Comparing the LYMQOL Leg with the SF-36 demonstrated good construct validity. Reliability determined by the test–retest procedure was good (intra-class-correlation coefficients 0.68–0.92). Cronbach’s alpha values ranged from 0.76 to 0.90 in both interviews, showing an acceptable internal consistency. The four domains of the questionnaire reached a cumulative variance of 52.7% in the factor analysis. The association between the lymphedema stages and the LYMQOL Leg domain scores was not significant. In conclusion, the validity of the German version of LYMQOL Leg, called LYMQOL Bein, was confirmed and thus represents a suitable tool for measuring HRQoL in German-speaking patients with LLL. Full article

Background: The widespread adoption of mobile devices by adolescents underscores the potential to harness these tools to instill healthy habits into their daily lives. An exemplary manifestation of this initiative is the Healthy Jeart app, crafted with the explicit goal of fostering well-being. Methodology: This study, framed within an applied investigation, adopts an exploratory and descriptive approach, specifically delving into the realm of user experience analysis. The focus of this research is a preliminary examination aimed at understanding users’ perceived usability of the application. To glean insights, a comprehensive questionnaire was administered to 101 teenagers, seeking their evaluations on various usability attributes. The study took place during 2022. Results: The findings reveal a considerable consensus among users regarding the evaluated usability aspects. However, the areas for improvement predominantly revolve around managing the information density, particularly for a subset of end users grappling with overwhelming content. Additionally, recommendations are put forth to streamline the confirmation process for user suggestions and comments. Conclusion: This analysis illuminates both the strengths of the app and areas ripe for refinement, paving the way for a more user-centric and efficacious Healthy Jeart application. Full article

The COVID-19 pandemic caused a global health crisis directly impacting the healthcare system. Healthcare leaders influence and shape the ability of an organization to cope with and recover from a crisis such as the COVID-19 pandemic. Their actions serve to guide and support nurses’ actions through unpredictable health service demands. The purpose of this paper was to examine frontline managers’ experiences and organizational leadership responses that activated organizational resilience during the COVID-19 pandemic, and to learn for ongoing and future responses to healthcare crises. Fourteen managers participated in semi-structured interviews. We found that: (1) leadership challenges (physical resources and emotional burden), (2) the influence of senior leader decision-making on managers (constant change, shortage of human resources, adapting care delivery, and cooperation and collaboration), and (3) lessons learned (managerial caring behaviours and role modelling, adaptive leadership, education and training, culture of care for self, and others) were evidence of managers’ responses to the crisis. Overall, the study provides evidence of managers experiences during the early waves of the pandemic in supporting nurses and fostering organizational resilience. Knowing manager’s experiences can facilitate planning, preparing, and strengthening their leadership strategies to improve work conditions is a high priority to manage and sustain nurses’ mental health and wellbeing. Full article

Background: Data on breastfeeding rates and targeted interventions in women with pre-gestational diabetes mellitus are inconclusive. The aim of the study was to evaluate breastfeeding rates up to one year postpartum and whether targeted counseling towards the end of pregnancy can impact breastfeeding rates and duration. An additional goal was to evaluate whether counseling affected women’s perceptions regarding breastfeeding. Methods: Women with pre-gestational diabetes mellitus were cluster-randomized between 32 and 36 weeks of gestation, either to face-to-face instruction with a certified lactation consultant or to receive written information on breastfeeding. Thirty-eight women without diabetes served as controls and were given written information on breastfeeding. All women filled out a questionnaire regarding intended breastfeeding duration, exclusivity, and perceptions, before intervention and at three, six, and twelve months post-partum. Results: Fifty-two women with pre-gestational diabetes mellitus consented to participate. All completed the questionnaires, 26 in each group. At three, six, and twelve months postpartum, rates of any breastfeeding were around 60%, 50%, and 30%, respectively. Approximately one-third breastfed exclusively in each group at three and six months. No significant difference in breastfeeding rates was noted between face-to-face instruction, written information, and controls. End-of-pregnancy counseling improved confidence in breastfeeding knowledge and confidence in being able to manage blood glucose. Conclusions: Breastfeeding rates in pre-gestational diabetes mellitus were comparable to those of women without diabetes and were unchanged by mode of instruction at the end of pregnancy. However, targeted diabetes-oriented breastfeeding instruction at the end of pregnancy improved knowledge and confidence among women with pre-gestational diabetes mellitus. Full article

The provision of efficient healthcare services is essential, driven by the increasing demand for healthcare resources and the need to optimize hospital operations. In this context, the motivation to innovate and improve services while addressing urgent concerns is critical. Hospitals face challenges in managing internal dispatch services efficiently. Outsourcing such services can alleviate the burden on hospital staff, reduce costs, and introduce professional expertise. However, the pressing motivation lies in enhancing service quality, minimizing costs, and exploring innovative approaches. With the rising demand for healthcare services, there is an immediate need to streamline hospital operations. Delays in internal transportation services can have far-reaching implications for patient care, necessitating a prompt and effective solution. Drawing upon dispatch data from a healthcare center in Taiwan, this study constructed a decision-making model to optimize the allocation of hospital service resources. Employing simulation techniques, we closely examine how hospital services are currently organized and how they work. In our research, we utilized dispatch data gathered from a healthcare center in Taichung, Taiwan, spanning from January 2020 to December 2020. Our findings underscore the potential of an intelligent dispatch strategy combined with deployment restricted to the nearest available workers. Our study demonstrates that for cases requiring urgent attention, delay rates that previously ranged from 5% to 34% can be notably reduced to a much-improved 3% to 18%. However, it is important to recognize that the realm of worker dispatch remains subject to a multifaceted array of influencing factors. It becomes evident that a comprehensive dispatching mechanism must be established as part of a broader drive to enhance the efficiency of hospital service operations. Full article

Background: The utilization of anti-tumor necrosis factor-α (anti-TNF-α) biosimilars in inflammatory bowel disease (IBD) is constantly increasing. However, pediatric data are limited. This study aimed to assess the effectiveness and safety of adalimumab biosimilar (ADL-BioS) in pediatric IBD patients. Methods: All consecutive pediatric IBD patients from the Sicilian Network for Inflammatory Bowel Disease cohort treated with ADL-BioS from 2019 to 2021 were recruited. Remission at weeks 14 and 52, treatment persistence, and adverse events were the endpoints of this study. Factors associated with clinical remission and treatment persistence were examined. Results: There were 41 patients in total. Nine (22%) patients were switched from the reference product to ADL-BioS. Two patients had multiple switches. Eleven months was the median follow-up period. Clinical remission was attained by 70.7% and 72.0% of patients on weeks 14 and 52, respectively. Four (9.8%) adverse events occurred (10.1/100 person-year). Treatment persistence was 85.4% at 1 and 2 years. Patients with a longer duration of disease had a higher probability of stopping their treatment (p = 0.036). Conclusions: This is the first real-world study that particularly addresses the use of ADL-BioS in pediatric IBD. With high rates of treatment persistence and a low frequency of non-serious side effects, ADL-BioS seems to be effective. Full article

Cancer-related pain (C-RP) is a prevalent and debilitating concern among patients with cancer, with conventional treatments limited in their ability to provide adequate relief, and by the adverse effects associated with their use. Complementary and integrative medicine (CIM) modalities have been shown to be potentially effective and safe for the treatment of pain and related symptoms, when used in conjunction with conventional medications and under medical supervision. An increasing number of oncology centers provide CIM within their conventional supportive and palliative care service, in an “Integrative Oncology” (IO) setting. A large body of clinical research, including systematic reviews and guidelines such as those published in 2022 by the Society for Integrative Oncology (SIO), in collaboration with the American Society for Clinical Oncology (ASCO), support the use of some CIM modalities for C-RP and related concerns. These include acupuncture for general and peri-operative/procedural pain, as well as aromatase inhibitor-associated arthralgia (AIA); reflexology or acupressure for pain during systemic therapy for cancer; hypnosis for procedural pain or pain due to diagnostic workup; and massage for pain experienced by patients during palliative and hospice care. Further research is needed, within both randomized control trials and pragmatic non-controlled studies which are more reflective of the real-life IO setting. This review summarizes the evidence supporting the use of CIM for C-RP; the analgesic mechanism of the modalities presented; and the challenges facing IO researchers, as well as the implementation of the 2022 SIO-ASCO guideline recommendations. Full article

Repatterning is a term that can be used in different fields, including genetics, molecular biology, neurology, psychology, or rehabilitation. Our aim is to identify the key concept of neuromuscular repatterning in somatic training programmes for dancers. A systematic search of eight databases was conducted using the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. The Quality Assessment Tool for Quantitative Studies and the Oxford Levels of Evidence scales were used. The search yielded 1218 results, of which 5 met the inclusion criteria. Five studies (n = 5) were related to psychosomatic health (n = 5), two studies highlighted integration and inter-articular connectivity in movement (n = 2), four studies investigated the neurological component of alignment and efficiency in dance practice (n = 4), and two studies investigated self-confidence (n = 2). Five studies (n = 5) used imagery based on the anatomical and physiological experience of body systems as the main analytical method. Four studies (n = 4) used developmental movement through Bartenieff fundamentals as the main technique for this methodology. Developmental movement and imagery are two methodologies strongly connected to the concept of neuromuscular repatterning in somatic training programmes for dancers. The acquisition of further quantitative experimental or quasi-experimental studies is warranted to better define the level of improvement or impact of neuromuscular repatterning in dancers. Full article

Premature birth can increase the level of parenting stress (PS), especially in the case of parents of high-risk infants (extremely low birth weight (ELBW) and very low birth weight (VLBW)). Though published research has explored how maternal PS influences early dyadic interactions, limited research has focused on infant-directed speech (IDS), and no studies have investigated the link between prematurity severity based on birth weight and maternal IDS. This study, involving 100 mother–infant dyads, categorized into 30 ELBW premature infants, 30 VLBW premature infants, and 40 full-term (FT) ones, examined the impact of preterm birth weight and maternal parenting stress on IDS features during early interactions at 3 and 9 months postpartum. Maternal input was assessed using the CHILDES system, while parenting stress was evaluated using the Parenting Stress Index-Short Form. The results revealed that high-risk conditions (ELBW preterm birth and high parenting stress) at 3 months were associated with reduced affect-salient speech and increased questioning. IDS functional patterns, specifically the proportion of affect-salient speech and questions, were influenced by both birth weight groups and parenting stress levels at 3 months but not at 9 months. These findings highlight the need to assess, within the context of prematurity, both birth weight and parenting stress in clinical practice, offering insights for developing interventions supporting positive parent–infant interactions and facilitating infant development. Full article

Background: Resilience is an important aspect of mental health in young people, which has become more relevant after the COVID-19 pandemic. It is therefore of paramount importance to have valid and reliable instruments that measure the globality of this aspect. One of the instruments that has been shown to have good psychometric properties and which has been widely adapted in several languages is the Connor–Davidson resilience scale, composed of 10 elements (10-item CD-RISC). Aim: The aim of this study was to evaluate the validity and reliability of the Portuguese version of the 10-item CD-RISC among young university students. Methods: a cross-sectional observational study of psychometric validation was conducted with a sample of 206 university students. Results: Good and adequate fit indices were obtained for the confirmatory factor analysis (CFA): Standardized Root-Mean-Square Residual [SRMR] = 0. 056; comparative fit index [CFI] = 0.958; and the Tucker–Lewis index [TLI] = 0.946. It also showed an average degree of convergent validity with the Depression, Anxiety and Stress Scale (DASS-21) and the General Health Scale (SF-36), and its internal consistency was good (Cronbach’s alpha = 0.842) with a range of factor loadings between 0.42 and 0.77. Conclusions: the results show that the 10-item CD-RISC is a valid, reliable scale to measure resilience among young Portuguese university students. Full article

The present work aims to map the available scientific evidence on the benefits of using the ISBAR tool in the nursing care of acutely ill adult patients’ handover in an emergency department context. To this end, a scoping review was conducted, according to the guidelines proposed by the Joanna Briggs Institute (JBI), to answer the following research question: “What are the benefits of using the ISBAR tool in the nursing care of acutely ill adult patients’ handover in an emergency department context?” The bibliographic search was carried out during August and September 2023 in the following electronic databases: CINAHL Complete; MEDLINE Complete; Cochrane Central Register of Controlled Trials; Cochrane Database of Systematic Reviews; and Cochrane Methodology Register. Only works published between 2013 and 2023 were deemed fit for inclusion. All the included studies (9) show that ISBAR methodology, as a standardized tool for transferring nursing care in the emergency service, allows for a safe, clear, and concise transition of nursing care. The benefits relate to patient and professional safety, continuity, and quality of care, as well as patient and professional comfort, with health gains. Full article

Social and healthcare professionals often feel ill equipped to effectively engage in difficult conversations with patients, and poor proficiency negatively affects the quality of patient care. Printed educational resources (PERs) that provide guidance on sustaining complex clinical communication may be a source of support if thoughtfully designed. This study aimed to describe the key features of PERs in order to improve the quality of clinical communication according to the perspective of meaningful stakeholders. This was a descriptive secondary analysis of data collected by three remote focus group discussions that involved 15 stakeholders in the context of developing an educational booklet to support professionals in complex communication scenarios. Focus groups were audio-recorded and transcribed verbatim, and an inductive thematic analysis was performed. Three key features of PERs that aim toward quality improvement in clinical communication were identified: (1) having the potential to provide benefits in clinical practice; (2) facilitating, encouraging, and enticing reading; and (3) meeting the need of professionals to improve or update their knowledge. These findings suggest that PERs relevant to professionals’ clinical priorities and learning needs may make their efforts to apply learning in practice more likely and consequently result in improved healthcare quality. Full article

Acute lower back pain (ALBP) is an extremely common musculoskeletal problem. ALBP consists of a sudden onset of short-duration pain in the lower back. However, repeated attacks can make the pain chronic. It can be measured through a self-report scale as well as through physical and physiological evaluations. Heart Rate Variability (HRV) has been used to evaluate the body’s response to pain. However, to the best of our knowledge, no clear consensus has been reached regarding the relationship between both variables and on an optimal protocol for ALBP evaluation based on HRV. The objective of this review is to analyze the relationship and effectiveness of HRV as an instrument for measuring ALBP. Furthermore, we consider the influence of different types of interventions in this relationship. The protocol of this review was previously recorded in the International Prospective Register of Systematic Reviews (number CRD42023437160). The PRISMA guidelines for systematic reviews and PubMed, WOS and Scopus databases are employed. Studies with samples of adults with ALBP are included. This study sets out a systematic review protocol to help identify the relationship between HRV and ALBP. Understanding this relationship could help in designing early detection or action protocols that alleviate ALBP. Full article

Stress shielding (SS) around press-fit radial head arthroplasty (RHA) was recently reported as a cause of a new type of proximal radial neck resorption (PRNR). Very few studies have analyzed this phenomenon. No comprehensive classification is currently available. We thus decided to clinically and radiographically analyze 97 patients who underwent a press-fit RHA and who were followed up for a mean period of 72 months (range: 2–14 years). PRNR in the four quadrants of the radial neck was assessed. We designed a novel SS classification based on (1) the degree of resorption of the length of the radial neck and (2) the number of neck quadrants involved on the axial plane. The mean PRNR (mPRNR) was calculated as the mean resorption in the four quadrants. mPRNR was classified as mild (<3 mm), moderate (3 to 6 mm), and severe (>6 mm). Eighty-four percent of the patients presented PRNR. mPRNR was mild in 33% of the patients, moderate in 54%, and severe in 13%. In total, 6% of the patients with mild mPRNR displayed resorption in one quadrant, 18% displayed resorption in two quadrants, 4% displayed resorption in three quadrants, and 72% displayed resorption in four quadrants. All four quadrants were always involved in moderate or severe mPRNR, with no significant differences being detected between quadrants (p = 0.568). mPRNR has no apparent effect on the clinical results, complications, or RHA survival in the medium term. However, longer-term studies are needed to determine the effects of varying degrees of PRNR on implant failure. Full article

Stigma negatively impacts individuals, families, and communities, affecting relationships, education, and employment and leading to an additional burden on mental health. Assessing public attitudes towards people with mental health conditions is crucial, especially in terms of public health. Therefore, the Attitudes to Mental Illness Questionnaire (AMIQ) was validated and adapted to the Italian cultural context. Translation followed four phases, involving bilingual speakers, comparison, back-translation, and expert review. In the pre-test phase, the questionnaire was administered to 21 participants anonymously. The validation test involved 213 subjects. Statistical analyses included exploratory and confirmatory factor analysis, and McDonald’s Omega and Cronbach’s alpha to assess the internal consistency. The results indicate good internal consistency (Omega = 0.71; Alpha = 0.72), and confirmatory factor analysis (CFI = 0.971) validated the questionnaire’s construct. The study’s findings align with the original validation, underscoring the questionnaire’s robustness. Overall, understanding public attitudes is crucial for public health interventions combating stigma and fostering positive attitudes. Full article

This study aimed to develop and validate a scale for measuring the therapeutic communication of nursing students. The scale development and evaluation study was conducted based on the scale development guidelines of DeVellis. A 47-item instrument was developed based on a review of the literature and interviews with 16 experts. Content validity was evaluated by ten nursing scholars, and the number of items was reduced to 35. The scale was administered to 352 nursing students from three regions in South Korea in 2022. Exploratory factor analysis and confirmatory factor analysis were performed on the scale items. Convergent validity, discriminant validity, and internal consistency reliability of the scale were evaluated. The factor analysis resulted in 15 items and two factors: relationship building and problem solving. Confirmatory factor analysis and evaluation of convergent and discriminant validity provided support for the validity of the two-factor Therapeutic Communication Scale in nursing students. The total scale demonstrated good internal consistency, with a McDonald’s omega (ω) of 0.89. The Therapeutic Communication Scale is a reliable and valid measure that can be used to assess nursing students’ therapeutic communication competence related to patient-centered nursing and provide foundational data to improve such skills. Full article

In this study, we examined the effects of memory training on cognitive function and depressive symptoms in a cohort of 794 healthy adults aged 50 years or older. Participants were divided into an active intervention group and a passive intervention group, with various cognitive measures assessed over a one-year period. Univariate analysis revealed that the active intervention group consistently outperformed the passive group in measures of memory self-perception (Memory Complaint Questionnaire—MACQ), depressive symptoms (Geriatric Depression Scale—GDS-4), verbal memory and recall ability (A3LP), and verbal fluency (VF). Significant differences in MACQ scores were observed between the two groups at all time points, indicating enhanced memory self-perception in the active group. GDS-4 scores consistently favored the active group, suggesting a reduction in depressive symptoms. A3LP scores demonstrated that the active group had better verbal memory and recall abilities. VF scores consistently favored the active group, indicating superior language skills and cognitive flexibility. Linear regression model and mixed linear regression model reinforced these findings, with highly significant interaction effects observed between the active/passive group, gender, age, education, and time. These effects were particularly pronounced for MACQ and A3LP scores, indicating the combined impact of these factors on memory self-perception and verbal memory. This study highlights the positive impact of memory training intervention on cognitive function and depressive symptoms in older adults and underscores the importance of considering gender, age, and education in cognitive interventions. Notably, these benefits persist for up to six months from the end of the program. The results provide valuable insights into cognitive changes in aging populations and suggest that tailored memory training programs can yield significant improvements. Full article

Juvenile idiopathic arthritis can be influenced by pain, medication adherence, and physical activity. A new digital health intervention, InteractiveClinics, aims to monitor these modifiable risk factors. Twelve children, aged 10 to 18 years, received daily notifications on a smartwatch to record their pain levels and take their medications, using a customised mobile app synchronised to a secure web-based platform. Daily physical activity levels were automatically recorded by wearing a smartwatch. Using a quantitative descriptive research design, feasibility and user adoption were evaluated. The web-based data revealed the following: Pain: mean app usage: 68% (SD 30, range: 28.6% to 100%); pain score: 2.9 out of 10 (SD 1.8, range: 0.3 to 6.2 out of 10). Medication adherence: mean app usage: 20.7% (SD, range: 0% to 71.4%), recording 39% (71/182) of the expected daily and 37.5% (3/8) of the weekly medications. Pro-re-nata (PRN) medication monitoring: 33.3% (4/12), one to six additional medications (mean 3.5, SD 2.4) for 2–6 days. Physical activity: watch wearing behaviour: 69.7% (439/630), recording low levels of moderate-to-vigorous physical activity (mean: 11.8, SD: 13.5 min, range: 0–47 min). To conclude, remote monitoring of real-time data is feasible. However, further research is needed to increase adoption rates among children. Full article

This cross-sectional epidemiological study aimed to describe dental caries and oral hygiene conditions among visually impaired students in Hong Kong. Students aged 6–21 years from two specialised schools for those with vision impairment were invited. Information on sociodemographic background and oral health-related behaviours was collected through an online parent-reported questionnaire. Dental caries and oral hygiene were assessed using the Decayed, Missing and Filled Teeth (DMFT) index and the Visible Plaque Index (VPI), respectively. Chi-square, Mann–Whitney U and Kruskal–Wallis H tests were conducted to analyse the association between students’ background and oral health status. A total of 73 participants were recruited, of whom 57.5% were male. Their mean (SD) age was 12.9 (4.7) years. Their mean DMFT score (SD) was 1.0 (1.8), and 43.8% had caries experience. The mean VPI (SD) was 0.76 (0.30). Their caries experience was significantly associated with their snacking habits (p = 0.013). Male participants had poorer oral hygiene than females (p = 0.048). In summary, dental caries is prevalent among visually impaired students in Hong Kong and their oral hygiene condition is unsatisfactory. Caries experience is significantly associated with snacking frequency, whereas oral hygiene is associated with gender. More specially designed preventive oral health measures should be provided for visually impaired students and their caretakers. Full article

Objectives: Our study aimed to investigate the prevalence of female pelvic floor dysfunction (PFD) in Israeli women who experienced vaginal delivery and are in their reproductive years (premenopausal), as well as to understand their attitudes and health-seeking behavior and barriers towards treating this problem. Methods: In this cross-sectional study, we conducted a questionnaire-based Internet survey. The surveys were sent to Israeli women in their fertile years (18–50 years old). We asked the women about their PFD symptoms, attitudes, and help-seeking behaviors. We used two validated questionnaires, including the USIQ and the PFDI-20. The combined questionnaire was submitted in both Hebrew and Arabic. We assessed the prevalence of PFD symptoms in the study population. Symptomatic women were asked about their help-seeking behaviors and their beliefs, desires, and barriers regarding the clinical management of symptoms. Results: Between July and September 2020, 524 women completed the questionnaire (response rate 44%). In total, 95% reported at least one symptom (mostly urinary-related) at any grade of severeness in at least one category, and 66.8% suffered from at least one moderate to severe symptom in at least one category. Most women (93.7%) reported that they wanted to be asked and offered voluntary information about PFD from physicians and nurses; however, only 16.6% reported receiving such information. Barriers to seeking treatment were mainly related to low awareness. The study’s main limitation was selection bias due to the questionnaire’s design. Conclusions: These findings show the importance of raising awareness of the different therapeutic solutions to PFD symptoms and designing more available services for this common problem. Full article

In committed intimate relationships, motivations for engaging in or avoiding sexual relations can indicate partners’ perceptions, needs, and attitudes toward sexual intimacy, and reflect sexual functioning. Sexual motivations can be positive, reflecting and advancing relational goals, such as establishing and maintaining closeness between partners and pleasure, or negative, stemming out of fear of one’s partner, pleasing them, or depriving sexual contact to punish the partner or establish relational power. In this study, we extended the current conceptualization and assessment of negative sexual motivations to explore the associations between women’s history of sexual abuse, their mental health, and their negative sexual motivations. Structural equation modeling results from 236 adult Israeli women who were in committed intimate relationships indicated that a woman’s history of sexual abuse negatively predicted her mental health which, in turn, negatively predicted her negative sexual motivations. Mental health mediated the association between a woman’s history of sexual abuse and her negative sexual motivations. These findings have theoretical and empirical contributions to research in terms of the short- and long-term effects of sexual abuse on women, mental health, and women’s sexuality. Their clinical implications for mental health professionals, sexual therapists, and clinicians working with women who experience sexual abuse are also discussed. Full article

Objective. To analyze the epidemiological shifts in the incidence of ascending and arch aortic aneurysms (AA) treated with open surgery in the context of evolving endovascular options on a national basis. Methods. Between 1 January 2009 and 31 December 2018, 4388 cases were admitted to the hospital with either ruptured (r)AA or non-ruptured (nr)AA as the primary or secondary diagnosis. Patients were classified as having AA based on inclusion and exclusion criteria. Results. The age-standardized hospital incidence rates for treatment of nrAA were 7.8 (95% confidence interval (CI): 6.9 to 8.7) in 100,000 men and 2.9 (2.4 to 3.4) in 100,000 women and were stable over time. The overall raw in-hospital mortality rate was 2.0% and was significantly lower in males compared to women (1.6% vs. 2.8%, p = 0.015). Higher van Walraven scores (OR: 1.08 per point; 95%CI: 1.06 to 1.11; p = 0.001) and higher age (OR 1.05 per year; (95%CI: 1.02 to 1.07, p = 0.045) were significantly associated with hospital mortality. Conclusions. Endovascular surgery seems to have no influence on hospital incidence in patients treated with conventional surgery for AA in Switzerland. There was a significant reduction in in-hospital mortality in both men and women, with age and the von Walraven score being independent factors for worse outcomes. Full article

The COVID-19 pandemic disrupted healthcare and support services, creating challenges for disabled people. New Zealand implemented a range of policies to prevent and limit viral transmission of COVID-19. This study investigates disabled people’s experiences accessing healthcare and disability support services during the COVID-19 pandemic, and based on this analysis, the implications of public health policy decisions on disabled people’s experiences during the pandemic in New Zealand are explicated. A qualitative design underpinned by interpretive description methodology guided this study. A total of 64 disabled people or parents of disabled children participated in semi-structured interviews. The team of health services and disability researchers then engaged in an iterative thematic approach to analysis, which led to three key themes: (1) protective personal factors, which assisted disabled people to access healthcare and support services, (2) immediate pandemic policy impacts, including policy and legislative changes, which created additional access barriers for disabled people, and (3) exacerbating factors, including compounding vulnerabilities, overstretched systems, and the impact of the vaccine mandate, which worsened the already limited access to healthcare and disability services for disabled people. The pandemic overwhelmed an already stretched healthcare and disability support system, resulting in service disruptions with negative consequences for disabled people’s health and wellbeing. Future policy development needs to be disability-centred in its inclusion of people with lived experience and consideration of the support needs of disabled populations. A first step in this process could include pandemic planning and policy co-design to ensure a continuum of healthcare services and support availability for individuals when services are disrupted. In addition, access to formal and informal support for disabled people should be recognised as a fundamental human right when accessing healthcare and disability support services. Full article

Background: Intravenous nutrient therapies (IVNTs) have gained popularity on the commercial market. Targeted at people with a variety of ailments and needs, the procedures allegedly offer numerous benefits and quick results, widely advertised on the websites of drip bars and health clinics as well as in the available literature. What is less often presented is the point of view of the customers of such services and the opinions of health personnel. Although the latter perspective seems to be crucial, little is known about it. Therefore, the purpose of this study was to present the opinions and experiences of health professionals (n = 188) on commercially available IVNTs dedicated to adults. Methods: The study was conducted between April 2019 and March 2020 by means of a survey using an ad hoc questionnaire made available mainly to health professionals attending public health postgraduate courses at the Poznan University of Medical Sciences, Poland. Results: As many as 91.5% of the respondents had heard of commercially available IVNTs (mostly from the media), and 47.3% knew of a facility offering such services. Among the possible situations where the use of IVNTs would be justified, the most commonly mentioned was a diagnosed nutrient deficiency (37.8%), while the least common ones were libido problems (1.1%) and the need to speed up metabolism (2.1%). For 25.5% of the respondents, there was no good rationale for using IVNTs. As many as 15.4% had no opinion on the subject. Health risks of IVNTs were recognised by 95.2% of professionals, with the biggest concerns being the lack of full information on patients’ health status and medical contraindications (84%), the risk of overdose and interactions (77.1%), and hypersensitivity or allergic reactions (75.5%). Among the reasons for IVNTs’ popularity, the respondents listed not only fads spread by celebrities and social media (89.4%) and the need for quick, effortless remedies (77.1%), but also reasons inherent in the Polish healthcare system. As many as 80.3% of the respondents stressed the need for public health institutions to take a stand on commercial IVNTs. Knowing of an IVNT facility was not significantly associated with the opinions of professionals in key areas. Conclusion: Postgraduate public health courses are a good opportunity to engage health professionals in discussions about the current challenges, trends, and needs in the area of health promotion and healthcare. This study’s findings shed some light on the opinions about IVNTs held by health professionals, who are important stakeholders of the healthcare system. Thus, these findings may help to better understand the popularity of IVNTs and incorporate health professionals’ perspectives in future efforts aiming to increase the awareness of IVNT-related health risks among both professionals and patients. Full article

Suicide is a significant public health concern, with one million lives lost to it every year. Suicidal ideation and attempts are markers of high risk. The COVID-19 pandemic has had a negative psychological impact on the population. This study aims to describe and analyze the clinical and sociodemographic characteristics of patients who have received medical attention for self-harm attempts in a hospital emergency department, comparing the period before and after the COVID-19 pandemic. This is a descriptive, retrospective study that collected data from medical records of patients who received care for self-harm attempts in the emergency department. The data included cases from 1 January 2018 to 31 December 2022. In total, 529 cases of self-harm attempts were identified, of which 62.8% were female. The number of post-pandemic self-harm attempts significantly increased compared to the period before the pandemic. The most used method for self-harm was medication ingestion. This study revealed that over one-third of the participants had previously attempted suicide. Most self-harm attempts were made by women in the 10–20 or 41–50 age groups, with a history of psychiatric illness and multiple medications. The study results also highlighted an increase in self-harm attempts during the COVID-19 pandemic. Full article

(1) Background: The most common musculoskeletal pathology among healthcare professionals is neck and/or shoulder pain. The aim of this study was to determine the dominant upper limb functionality concerning the ability to replicate a given movement pattern among employees reporting neck or upper limb pain while using a computer during the COVID-19 pandemic. (2) Methods: The study was conducted from March to April 2021 on a group of 45 medical employees who used a computer workstation for 4 to 6 h of their working time. In the design of this study, three study groups were created: a group of patients with pain syndrome of segment C5/C7 of the spine, a group of patients with shoulder pain syndrome, and a control group of healthy volunteers. (3) Results: The examined groups significantly differed in the correctness of performing the given movement (p = 0.001) and the minimum value of inclination during the exercise session (p = 0.026), as well as the maximum lowering (p = 0.03) in relation to the control group. (4) Conclusions: The VECTIS device can be used to assess the accuracy of reflecting the prescribed movement of the upper limb in rehabilitation programs for patients with cervical spine pain syndrome and shoulder pain syndrome. Full article

Background: During the COVID-19 pandemic, reduced access to care services and fear of infection prompted families to increase home care for their older relatives with long-term care needs. This had negative effects on both members of the caring dyad, impacting their quality of life (QoL) and mental well-being. This study investigated the factors that influenced the mental well-being and QoL of 239 dyads, before and after the first pandemic wave in Italy. Methods: Data were collected through a survey on the use of health and social care services and interventions by older care recipients living in the community and their family caregivers. Factors associated with deterioration of mental well-being and QoL in older care recipients (mean age 86.1 years old) and their family caregivers after the pandemic were studied. Results: The importance attached by family caregivers to the skills and training of healthcare professionals was a protective factor against the deterioration in the well-being of older care recipients. Similarly, the importance associated by family caregivers to the help received from healthcare professionals was a protective factor for QoL. Financial hardship of older care recipients was a risk factor for deterioration in caregivers’ mental well-being, while support from other family members was a protective factor for QoL. Conclusions: The presence of attentive healthcare professionals, a supportive family environment, and economic support can reduce the burden on both the caregiver and the older care recipient. These aspects need to be considered in any future emergency situation and when planning care services for community-dwelling older people. Full article