Healthcare

Editorial

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2 pages, 180 KiB

Open AccessEditorial

Management of Emerging Health Conditions to Improve Resilience and Mental Health

by Yi-Chih Lee and Wei-Li Wu

Healthcare 2022, 10(10), 1908; https://doi.org/10.3390/healthcare10101908 - 29 Sep 2022

Cited by 1 | Viewed by 1213

Abstract

Good health is when a person is in a complete, optimal physical, mental, and social condition [...] Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

Research

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12 pages, 1548 KiB

Open AccessArticle

Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic

by Alexandra-Simona Zamfir, Tudor-Andrei Cernomaz, Bogdan Mihnea Ciuntu, Doina Azoicăi, Carmen Lăcrămioara Zamfir, Raluca Ozana Chistol and Anca Sava

Healthcare 2024, 12(11), 1091; https://doi.org/10.3390/healthcare12111091 - 26 May 2024

Cited by 1 | Viewed by 934 | Correction

Abstract

Background: In the wake of the coronavirus disease 19 (COVID-19) pandemic, affecting healthcare systems globally, urgent research is needed to understand its potential repercussions on the diagnosis and management of cardiovascular disorders. This emphasises the importance of detecting coronary artery anomalies (CAAs), rare [...] Read more.

Background: In the wake of the coronavirus disease 19 (COVID-19) pandemic, affecting healthcare systems globally, urgent research is needed to understand its potential repercussions on the diagnosis and management of cardiovascular disorders. This emphasises the importance of detecting coronary artery anomalies (CAAs), rare conditions that can range from benign to potentially life-threatening manifestations. We aimed to retrospectively assess the impact of the COVID-19 pandemic on the detection of various coronary anomalies using Coronary Computed Tomography Angiography (CCTA) within a regional tertiary cardiology unit in north-eastern Romania, focusing on perceived occurrence in the population under study, types, and related demographic and clinical factors. Methods: We analysed CCTA scans and investigated the trends in CAA detection among cardiology patients over a decade. We compared pre-COVID-19 and pandemic-era data to assess the impact of healthcare utilisation, patient behaviour, and diagnostic approaches on anomaly detection. Results: Our analysis revealed a higher detection rate of CAAs during the pandemic (3.9% versus 2.2%), possibly highlighting differences in patient clinical profile and addressability changes presentation compared to the previous period. Origination and course anomalies, often linked to severe symptoms, were significantly higher pre-COVID-19 (64.1% versus 51.3%). Conversely, intrinsic CAAs, typically asymptomatic or manifesting later in life, notably increased during the pandemic (49.0% versus 61.4%; p = 0.020). Conclusions: Our study underscores a significant rise in CAA detection during the COVID-19 era, potentially linked to changes in cardiovascular and respiratory clinical patterns, with advanced imaging modalities like CCTA offering accuracy in identification. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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12 pages, 1068 KiB

Open AccessArticle

Changes in Challenging Behaviors Accompanying Transition to a New Facility in Individuals with Intellectual Disabilities

by Mizuho Kawanaka, Yuto Iwanaga, Akiko Tokunaga, Toshio Higashi, Goro Tanaka, Akira Imamura and Ryoichiro Iwanaga

Healthcare 2024, 12(3), 288; https://doi.org/10.3390/healthcare12030288 - 23 Jan 2024

Viewed by 1214

Abstract

Challenging behavior (CB), the most common example being extreme self-injurious or aggressive/destructive behavior, is often observed as a major behavior issue in individuals with severe intellectual disabilities. This study investigated how CB changed among residents of a facility for people with disabilities before [...] Read more.

Challenging behavior (CB), the most common example being extreme self-injurious or aggressive/destructive behavior, is often observed as a major behavior issue in individuals with severe intellectual disabilities. This study investigated how CB changed among residents of a facility for people with disabilities before and after it was restructured from a traditional format single room shared by two to three individuals with approximately 20 residents lived together to a format featuring private areas with two rooms per resident and a unitcare system. Twenty-one residents of Care Home A, which was rebuilt in the new care format, were selected. Care staff completed a questionnaire one month before, one month after, and six months after residents moved to the new facility. Scores were compared among each time point. The results revealed significant reductions in residents’ aggressive, stereotyped, and targeted behaviors, such as hitting their own head and fecal smearing. The major features of the restructured facility were a living space consisting of two private rooms per resident and a shift to unit care for the entire ward. These new features enabled residents to reduce destructive stimuli and made it easier to understand what to do in each private room. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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12 pages, 1387 KiB

Open AccessArticle

Human Error Analysis and Modeling of Medication-Related Adverse Events in Taiwan Using the Human Factors Analysis and Classification System and Logistic Regression

by Shu-Huan Ko, Min-Chih Hsieh and Run-Feng Huang

Healthcare 2023, 11(14), 2063; https://doi.org/10.3390/healthcare11142063 - 19 Jul 2023

Cited by 2 | Viewed by 1893

Abstract

Medical institutions worldwide strive to avoid adverse medical events, including adverse medication-related events. However, studies on the comprehensive analysis of medication-related adverse events are limited. Therefore, we aimed to identify the error factors contributing to medication-related adverse events using the Human Factors Analysis [...] Read more.

Medical institutions worldwide strive to avoid adverse medical events, including adverse medication-related events. However, studies on the comprehensive analysis of medication-related adverse events are limited. Therefore, we aimed to identify the error factors contributing to medication-related adverse events using the Human Factors Analysis and Classification System (HFACS) and to develop error models through logistic regression. These models calculate the probability of a medication-related adverse event when a healthcare system defect occurs. Seven experts with at least 12 years of work experience (four nurses and three pharmacists) were recruited to analyze thirty-seven medication-related adverse events. The findings indicate that decision errors, physical/mental limitations, failure to correct problems, and organizational processes were the four factors that most frequently contributed to errors at the four levels of the HFACS. Seven error models of two types (error occurrence and error analysis pathways) were established using logistic regression models, and the relative probabilities of failure factor occurrences were calculated. Based on our results, medical staff can use the error models as a new analytical approach to improve and prevent adverse medication events, thereby improving patient safety. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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17 pages, 3258 KiB

Open AccessArticle

Application of SHAP for Explainable Machine Learning on Age-Based Subgrouping Mammography Questionnaire Data for Positive Mammography Prediction and Risk Factor Identification

by Jeffrey Sun, Cheuk-Kay Sun, Yun-Xuan Tang, Tzu-Chi Liu and Chi-Jie Lu

Healthcare 2023, 11(14), 2000; https://doi.org/10.3390/healthcare11142000 - 11 Jul 2023

Cited by 7 | Viewed by 2062

Abstract

Mammography is considered the gold standard for breast cancer screening. Multiple risk factors that affect breast cancer development have been identified; however, there is an ongoing debate regarding the significance of these factors. Machine learning (ML) models and Shapley Additive Explanation (SHAP) methodology [...] Read more.

Mammography is considered the gold standard for breast cancer screening. Multiple risk factors that affect breast cancer development have been identified; however, there is an ongoing debate regarding the significance of these factors. Machine learning (ML) models and Shapley Additive Explanation (SHAP) methodology can rank risk factors and provide explanatory model results. This study used ML algorithms with SHAP to analyze the risk factors between two different age groups and evaluate the impact of each factor in predicting positive mammography. The ML model was built using data from the risk factor questionnaires of women participating in a breast cancer screening program from 2017 to 2021. Three ML models, least absolute shrinkage and selection operator (lasso) logistic regression, extreme gradient boosting (XGBoost), and random forest (RF), were applied. RF generated the best performance. The SHAP values were then applied to the RF model for further analysis. The model identified age at menarche, education level, parity, breast self-examination, and BMI as the top five significant risk factors affecting mammography outcomes. The differences between age groups ranked by reproductive lifespan and BMI were higher in the younger and older age groups, respectively. The use of SHAP frameworks allows us to understand the relationships between risk factors and generate individualized risk factor rankings. This study provides avenues for further research and individualized medicine. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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9 pages, 245 KiB

Open AccessArticle

Key Drivers of COVID-19 Vaccine Hesitancy: A Perspective of Collectivism

by Yi-Chih Lee and Wei-Li Wu

Healthcare 2023, 11(2), 176; https://doi.org/10.3390/healthcare11020176 - 6 Jan 2023

Cited by 1 | Viewed by 1682

Abstract

Vaccination against the COVID-19 pandemic remains a major part of global immunization policy. The aim of this study was to explore young people’s willingness to continue to receive vaccination against COVID-19 in a collectivist culture. In this study, an online questionnaire was used [...] Read more.

Vaccination against the COVID-19 pandemic remains a major part of global immunization policy. The aim of this study was to explore young people’s willingness to continue to receive vaccination against COVID-19 in a collectivist culture. In this study, an online questionnaire was used to measure willingness to continue vaccination, the tendency towards collectivism, the degree of disease anxiety, vaccine brand loyalty, and perceived infectability in 2022. The results showed that women were more willing to be vaccinated than men (70.1% vs. 29.9%). Young people who were willing to receive continuous vaccination had a relatively higher tendency towards collectivism (p < 0.001), a relatively higher degree of disease anxiety (p < 0.001), and lower vaccine brand loyalty (p = 0.034). The COVID-19 pandemic is still ongoing and, since young people are the most active in group activities, policy-makers should weigh the factors influencing vaccination among the young to create effective policy measures. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

10 pages, 541 KiB

Open AccessArticle

An Analysis of Health Perceptions and Performance in Elementary Students in Korea during the ongoing COVID-19 Pandemic

by Yongsuk Seo, Chul-min Kim, Min-jun Kim, Eui-jae Lee and Hyun-su Youn

Healthcare 2023, 11(1), 83; https://doi.org/10.3390/healthcare11010083 - 27 Dec 2022

Cited by 3 | Viewed by 2491

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, social distancing guidelines changed lifestyles, including increased sedentary time, physical inactivity, and disrupted sleep patterns among children. The purpose of the present study is to analyze the health awareness (mental health, disease, physical activity, sleep, eating [...] Read more.

During the coronavirus disease 2019 (COVID-19) pandemic, social distancing guidelines changed lifestyles, including increased sedentary time, physical inactivity, and disrupted sleep patterns among children. The purpose of the present study is to analyze the health awareness (mental health, disease, physical activity, sleep, eating habit, and hygiene health management) of elementary school students during the COVID-19 pandemic, and use the importance-performance analysis (IPA) technique to identify gender differences in health perceptions. We collected data on 1006 students, which was analyzed using frequency analysis, reliability testing, independent sample t-tests, and importance-performance analysis (IPA). A median importance value of 0.163 and a median performance value of 4.048 were selected as cross points to distribute the IPA matrix into four quadrants. The highest performance was given for wearing a mask and sanitary practice; the IPA matrix indicated that the sense of belonging, happiness, trust, and movement activity were located in quadrant I. Children’s regular physical activity and level of physical activity were low, especially that of girls. Children’s sleep management was poor. Their physical activity and sleep-related factors must be improved under the facilitation of the national government, public education institutions, and families. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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17 pages, 5779 KiB

Open AccessArticle

Efficacy of Different Dosing Regimens of IgE Targeted Biologic Omalizumab for Chronic Spontaneous Urticaria in Adult and Pediatric Populations: A Meta-Analysis

by Humayun Manzoor, Foha Razi, Amina Rasheed, Zouina Sarfraz, Azza Sarfraz, Karla Robles-Velasco, Miguel Felix and Ivan Cherrez-Ojeda

Healthcare 2022, 10(12), 2579; https://doi.org/10.3390/healthcare10122579 - 19 Dec 2022

Cited by 5 | Viewed by 2519

Abstract

Chronic urticaria is a debilitating skin condition that is defined as itchy hives at least twice a week and lasting for six or more weeks, with or without angioedema. Chronic spontaneous urticaria (CSU) is a form of disease that is witnessed in two-thirds [...] Read more.

Chronic urticaria is a debilitating skin condition that is defined as itchy hives at least twice a week and lasting for six or more weeks, with or without angioedema. Chronic spontaneous urticaria (CSU) is a form of disease that is witnessed in two-thirds of those with chronic urticaria. This meta-analysis explores the efficacy of differential dosages of omalizumab for outcomes of weekly itching scores, weekly wheal scores, urticarial assessment score 7 (UAS7), and responder rates. Adhering to PRISMA Statement 2020 guidelines, a systematic search of PubMed/MEDLINE, Scopus, Embase, and Web of Science was conducted until 15 September 2022. A combination of the following keywords was used: omalizumab and chronic urticaria. Data comprising clinical trial ID, name, author/year, country, dosage and time of intervention, inclusion criteria, mean age, female gender, and racial grouping information were obtained. The meta-analytical outcomes were analyzed in RevMan 5.4. The risk-of-bias assessment was conducted using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). A total of 10 trials comprising 1705 patients with CSU were included. Notably, 1162 belonged to the intervention group, while 543 were controls. A total of 70.4% of the participants were female in the intervention group, while 65.6% of them were female in the control group. The overall mean age was 38.64 ± 10.66 years. Weekly itch score outcomes were most notable with 150 mg dosage (Cohen’s d = −2.6, 95% CI = −4.75, −0.46, p = 0.02). The weekly wheal score outcomes had the largest effect size with 300 mg dosage (Cohen’s d = −1.45, 95% CI = −2.2, −0.69, p = 0.0002). For UAS7 outcomes, the largest effect size was yielded with 150 mg dosage (Cohen’s d = −6.92, 95% CI: −10.38, −3.47, p < 0.0001). The response rate to omalizumab had a likelihood of being higher with 300 mg of intervention compared to placebo (OR = 8.65, 95% CI = 4.42, 16.93, p < 0.0001). Well-rounded urticarial symptom resolution was observed with 150 mg and 300 mg dosages of omalizumab. Improvement of UAS7 was more comparable with 150 mg dosage, whereas the chance of response to treatment was higher with 300 mg dosage. Our findings support omalizumab as an effective intervention for adult and pediatric populations that are resistant to many therapies, including high-dose H1-antihistamines. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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7 pages, 582 KiB

Open AccessArticle

Evaluating Post-Market Adverse Events of The New Hepatitis C Therapies Using FEARS Data

by Majed A. Algarni

Healthcare 2022, 10(8), 1400; https://doi.org/10.3390/healthcare10081400 - 27 Jul 2022

Cited by 3 | Viewed by 1808

Abstract

Background: Little is known regarding the safety of direct-acting antivirals (DAA), even though they are widely used. This study aims to evaluate the adverse events of DAA using post-market data. Methods: FDA Adverse Events Reporting System (FAERS) data from January 2019 through December [...] Read more.

Background: Little is known regarding the safety of direct-acting antivirals (DAA), even though they are widely used. This study aims to evaluate the adverse events of DAA using post-market data. Methods: FDA Adverse Events Reporting System (FAERS) data from January 2019 through December 2019 were analyzed. FERAS reports in which the suspected drug contained the DAA drugs were extracted and included in the analysis. Univariable and bivariable analyses were performed in this study. Results: Most of the reported side effects were non-serious (62%). The number of times the drug was reported as ineffective was significantly higher while using Harvoni vs. Mavyret (32.14% vs. 1.05%) (p-value < 0.0001). On the other hand, hospitalization was significantly more reported while using Mavyret compared to Harvoni (52.02% vs. 22.45%) (p-value < 0.0001). Liver cancer was significantly more reported while using Harvoni vs. Mavyret (7.65% vs. 1.20%) (p-value < 0.0001). No significant difference in death cases was reported while using both drugs. Conclusion: Depending on the FDA Adverse Events Reporting System (FAERS) database, most of the non-serious adverse effects were headache and fatigue. There was no significant difference in cases of death reported while using both drugs. Liver cancer was more reported while using Harvoni. Hospitalization was more reported while using Mavyret. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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Review

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14 pages, 1803 KiB

Open AccessReview

The Evaluation of Inflammatory Biomarkers in Predicting Progression of Acute Pancreatitis to Pancreatic Necrosis: A Diagnostic Test Accuracy Review

by Hafiz Muhammad Asim Riaz, Zara Islam, Lubna Rasheed, Zouina Sarfraz, Azza Sarfraz, Karla Robles-Velasco, Muzna Sarfraz and Ivan Cherrez-Ojeda

Healthcare 2023, 11(1), 27; https://doi.org/10.3390/healthcare11010027 - 22 Dec 2022

Cited by 4 | Viewed by 2665

Abstract

Acute pancreatitis is the acute inflammation of the pancreas; 30% of cases may progress to pancreatic necrosis. The aim of this study was to assess the diagnostic accuracy of inflammatory biomarkers (C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH)) in detecting pancreatic [...] Read more.

Acute pancreatitis is the acute inflammation of the pancreas; 30% of cases may progress to pancreatic necrosis. The aim of this study was to assess the diagnostic accuracy of inflammatory biomarkers (C-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH)) in detecting pancreatic necrosis in adults with confirmed acute pancreatitis within 14 days of symptom onset and without organ failure. A systematic search was conducted across the Cumulative Index of Nursing and Allied Health (CINAHL), Cochrane, Embase, PubMed, and Web of Science until May 30, 2022, with the following keywords: acute disease, biomarkers, C-reactive protein, calcitonin, differential, diagnosis, lactate dehydrogenase, pancreatitis, acute necrotizing, necrosis, sensitivity, specificity. Statistical analysis was conducted in RevMan 5.4.1 (Cochrane). Five studies pooling 645 participants were included of which 59.8% were males, with a mean age of 49 years. CRP was the best cutoff at 279 mg/L (χ2 = 47.43, p < 0.001), followed by 200 mg/L (χ2 = 36.54, p < 0.001). LDH was cut off at 290 units/L (χ2 = 51.6, p < 0.001), whereas PCT did not display the most reliable results at 0.05 ng/mL. Inflammatory biomarkers are scalable diagnostic tools that may confer clinical value by decreasing the mortality of acute pancreatitis sequelae. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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12 pages, 1517 KiB

Open AccessReview

Palliative Care Landscape in the COVID-19 Era: Bibliometric Analysis of Global Research

by Hammoda Abu-Odah, Jingjing Su, Mian Wang, Sin-Yi (Rose) Lin, Jonathan Bayuo, Salihu Sabiu Musa and Alex Molassiotis

Healthcare 2022, 10(7), 1344; https://doi.org/10.3390/healthcare10071344 - 20 Jul 2022

Cited by 5 | Viewed by 2588

Abstract

Despite the increasing number of publications globally, the COVID-19 pandemic has underscored significant research gaps that should be resolved, including within PC-related research. This study aimed to map and understand the global trends in palliative care (PC)-related COVID-19 research and provide quantitative evidence [...] Read more.

Despite the increasing number of publications globally, the COVID-19 pandemic has underscored significant research gaps that should be resolved, including within PC-related research. This study aimed to map and understand the global trends in palliative care (PC)-related COVID-19 research and provide quantitative evidence to guide future studies. We systematically searched four databases between 1st January 2020 and 25th April 2022. The VOSviewer, Gephi, and R software were utilized for data analysis and results visualization. A total of 673 articles were identified from the databases between 1st January 2020 and 25th April 2022. Canada (6.2%), Australia (5.4%), and the United Kingdom (3.8%) were the most productive countries regarding articles published per million confirmed COVID-19 cases. A lack of international collaborations and an uneven research focus on PC across countries with different pandemic trajectories was observed. The PC research in question focused on cancer, telehealth, death and dying, and bereavement. This study’s conclusions support the recommendation for international collaboration to facilitate knowledge and practice transformation to support countries with unmet PC needs during the pandemic. Further studies are required on the grief and bereavement support of families, healthcare professionals and patients with other life-threatening illnesses. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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2 pages, 175 KiB

Open AccessCorrection

Correction: Zamfir et al. Trends in Coronary Artery Anomalies Detection by Coronary Computed Tomography Angiography (CCTA): A Real-Life Comparative Study before and during the COVID-19 Pandemic. Healthcare 2024, 12, 1091

by Alexandra-Simona Zamfir, Tudor-Andrei Cernomaz, Bogdan Mihnea Ciuntu, Doina Azoicăi, Carmen Lăcrămioara Zamfir, Raluca Ozana Chistol and Anca Sava

Healthcare 2024, 12(16), 1561; https://doi.org/10.3390/healthcare12161561 - 7 Aug 2024

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In the original publication [...] Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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