Healthcare doi: 10.3390/healthcare12060688
Authors: Nayeon Lee Ya-Ke Wu
Law enforcement is a stressful occupation that places significant psychological demands on those serving in this role. However, little is known about the severity of work-related stress and psychological distress among law enforcement officers (LEOs) in North Carolina (NC). This cross-sectional study examined the severity of work-related stress and psychological distress among 283 LEOs in NC. The Maslach Burnout Inventory, the Operational Police Stress Questionnaire, the Depression, Anxiety, and Stress Scale, and the Post-Traumatic Stress Disorder (PTSD) Checklist were used to assess burnout, operational police stress, depression, anxiety, stress, and PTSD among LEOs. Descriptive statistics, independent t-tests, Mann–Whitney U tests, one-way ANOVA, and Kruskal–Wallis tests were performed. Rural and male LEOs reported higher burnout levels related to depersonalization (i.e., increased mental distance from one’s job) compared with their urban and female counterparts. LEOs exposed to toxic materials or performing patrol duties exhibited higher operational police stress levels than those who did not. Caucasian LEOs exhibited higher depression, anxiety, and stress than their African American counterparts. Rural LEOs and LEOs who were exposed to toxic materials displayed higher levels of PTSD than their counterparts. Our findings highlight the need for increased mental health support and better working environments for LEOs.
]]>Healthcare doi: 10.3390/healthcare12060685
Authors: Sunyoung Lee Eunyoung Park Hyun-E Yeom
This qualitative study explored the experiences of nursing students whose clinical practice in mental health nursing had been substituted with virtual simulation programs due to the COVID-19 pandemic. The participants were ten nursing students who had undergone a virtual simulation program-centered practice, replacing the traditional clinical practice in mental health nursing and previous clinical practice in mental health nursing. The data were collected through in-depth individual interviews from January to February 2021. Following Braun and Clarke’s method, the thematic analysis identified five themes and ten sub-themes. The five themes included the following: (1) lack of vibrancy in the actual clinical setting, (2) limited direct and indirect practical experience, (3) performing diverse roles in a virtual setting, (4) learner-directed practicum, and (5) sense of relief due to a safe virtual practicum environment. The participants recognized the limitations of the practice, particularly regarding communication with patients with mental disorders in the virtual simulation program. However, their perception of nursing underwent a positive change through the indirect clinical practice experience. Accordingly, it is necessary to develop a platform for the mental health nursing practicum that can easily interact with clients and to establish a hybrid practice that combines the clinical practice and virtual simulation practice.
]]>Healthcare doi: 10.3390/healthcare12060687
Authors: Patryk Rzońca Sławomir Butkiewicz Paula Dobosz Artur Zaczyński Marcin Podgórski Robert Gałązkowski Waldemar Wierzba Katarzyna Życińska
COVID-19 disease is characterised by a wide range of symptoms that in most cases resemble flu or cold. Early detection of infections, monitoring of patients’ conditions, and identification of patients with worsening symptoms became crucial during the peak of pandemic. The aim of this study was to assess and compare the performance of common early warning scores at the time of admission to an emergency department in predicting in-hospital mortality in patients with COVID-19. The study was based on a retrospective analysis of patients with SARS-CoV-2 infection admitted to an emergency department between March 2020 and April 2022. The prognostic value of early warning scores in predicting in-hospital mortality was assessed using the receiver operating characteristic (ROC) curve. Patients’ median age was 59 years, and 52.33% were male. Among all the EWS we assessed, REMS had the highest overall accuracy (AUC 0.84 (0.83–0.85)) and the highest NPV (97.4%). REMS was the most accurate scoring system, characterised by the highest discriminative power and negative predictive value compared to the other analysed scoring systems. Incorporating these tools into clinical practice in a hospital emergency department could provide more effective assessment of mortality and, consequently, avoid delayed medical assistance.
]]>Healthcare doi: 10.3390/healthcare12060686
Authors: Farrah Jacquez Lisa M. Vaughn Jamie Hardy-Besaw
Social connection is a core dimension of health and wellness among all populations, yet the experience of moving to and living in a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Using hybrid (inductive/deductive) qualitative analysis, we identified seven domains of social connection from the perspective of the interviewed participants: (1) lens of the individual; (2) immigrant experience; (3) interpersonal support; (4) community belonging; (5) community capital; (6) community navigation; and (7) social acceptance. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of social connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. Additionally, these results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess the social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.
]]>Healthcare doi: 10.3390/healthcare12060684
Authors: Roberto Montón-Martínez Juan Arturo Ballester-Ferrer Sabina Baladzhaeva Noemí Sempere-Ruiz Antonio Casanova-Lizón Alba Roldan Diego Pastor José Manuel Sarabia Alejandro Javaloyes Iván Peña-González Manuel Moya-Ramón
Background: Substance use disorders pose unique challenges, affecting individuals physiologically and socially. This study addresses the fundamental question of how adherence to exercise programs impacts those with substance use disorders, examining both in-person and online interventions. Methods: A 12-week analysis involving 26 participants assessed physical fitness, strength, and quality of life. Participants were categorized into in-person and online exercise groups, with their adherence tracked through attendance and a dedicated app. Results: The in-person group exhibited higher adherence rates and significant improvements, in contrast to the challenges encountered by the online groups, particularly in substance use disorder cohorts. Statistical analyses highlighted these differences, emphasizing the pivotal role of the exercise program delivery format. Conclusions: This research advocates for hybrid models, blending professional supervision with online flexibility, recognizing the distinct challenges of substance use disorders. Insights from this study will contribute to shaping more effective, personalized interventions in the complex landscape of substance use disorders, offering guidance for advancing treatment strategies.
]]>Healthcare doi: 10.3390/healthcare12060683
Authors: Santiago Berrezueta-Guzman Mohanad Kandil María-Luisa Martín-Ruiz Iván Pau de la Cruz Stephan Krusche
This study explores the integration of large language models (LLMs), like ChatGPT, to improve attention deficit hyperactivity disorder (ADHD) treatments. Utilizing the Delphi method for its systematic forecasting capabilities, we gathered a panel of child ADHD therapy experts. These experts interacted with our custom ChatGPT through a specialized interface, thus engaging in simulated therapy scenarios with behavioral prompts and commands. Using empirical tests and expert feedback, we aimed to rigorously evaluate ChatGPT’s effectiveness in therapy settings to integrate AI into healthcare responsibly. We sought to ensure that AI contributes positively and ethically to therapy and patient care, thus filling a gap in ADHD treatment methods. Findings show ChatGPT’s empathy, adaptability, and communication strengths, thereby highlighting its potential to significantly improve ADHD care. The study points to ChatGPT’s capacity to transform therapy practices through personalized and responsive patient care. However, it also notes the need for enhancements in privacy, cultural sensitivity, and interpreting nonverbal cues for ChatGPT’s effective healthcare integration. Our research advocates for merging technological innovation with a comprehensive understanding of patient needs and ethical considerations, thereby aiming to pioneer a new era of AI-assisted therapy. We emphasize the ongoing refinement of AI tools like ChatGPT to meet ADHD therapy and patient care requirements more effectively.
]]>Healthcare doi: 10.3390/healthcare12060682
Authors: Maria Shuk Yu Hung Winnie Wing Man Ng Edward Kwok Yiu Choi
Background: Healthcare students’ health and wellbeing have been seriously affected worldwide. Research studies highlighted the need to establish health promotion strategies to improve them. Methods: A mixed method feasibility with a randomized controlled trial study followed by qualitative focus-group interviews to evaluate the effect of a 24 h online health promotion program improving healthcare students’ health and wellbeing was performed in mid-2022. The study also illustrated the program’s effect, contents, and activity arrangements. Healthcare students from two large tertiary institutions were randomly assigned to intervention and waitlist-control groups. Outcomes were measured by self-completed online questionnaires at three-time points (baseline, week four, and week eight), and in-depth focus-group interviews followed. Results: Among 70 enrolled and 60 eligible students, 54 completed the study, with a 10% attrition rate. Results demonstrated a significant difference between groups at week eight. Within the intervention group, there were significant differences were found from baseline to week eight for depression (p = 0.001), anxiety (p = 0.004), and stress (p < 0.001). The program also improved certain domains of personal wellbeing and quality of life. Qualitative findings further illustrated the program contents and activities’ feasibility, acceptability, and suitability. Most participants welcomed the online mode’s flexibility and convenience. They enjoyed diversified and complementary content and activities. They had increased self-awareness of health and wellbeing. Besides, mental health knowledge enables them to ‘self-care’ and help those in need in the future. Conclusions: The results indicate the feasibility of performing full-scale research in the future and may provide more support for the students of higher education institutions.
]]>Healthcare doi: 10.3390/healthcare12060681
Authors: Stijn R. J. M. Deckers Yvonne van Zaalen
Background: Shared decision-making is one key element of interprofessional collaboration. Communication is often considered to be the main reason for inefficient or ineffective collaboration. Little is known about group dynamics in the process of shared decision-making in a team with professionals, including the patient or their parent. This study aimed to evaluate just that. Methods: Simulation-based training was provided for groups of medical and allied health profession students from universities across the globe. In an overt ethnographic research design, passive observations were made to ensure careful observations and accurate reporting. The training offered the context to directly experience the behaviors and interactions of a group of people. Results: Overall, 39 different goals were defined in different orders of prioritizing and with different time frames or intervention ideas. Shared decision-making was lacking, and groups chose to convince the parents when a conflict arose. Group dynamics made parents verbally agree with professionals, although their non-verbal communication was not in congruence with that. Conclusions: The outcome and goalsetting of an interprofessional meeting are highly influenced by group dynamics. The vision, structure, process, and results of the meeting are affected by multiple inter- or intrapersonal factors.
]]>Healthcare doi: 10.3390/healthcare12060680
Authors: Raphaël Serreau Yasmine Terbeche Virginie Rigourd
Perinatal exposure to pollutants, including persistent organic pollutants (POPs) and heavy metals, poses significant risks to both mothers and children, marking this period as highly vulnerable. Despite the well-acknowledged benefits of breastfeeding, there exists a gap in comprehensive understanding regarding the impact of environmental pollutants on breast milk, underscoring the critical need for this study. Our research addresses this gap by exploring the intersection of environmental health and lactation, situated within the broader ‘One Health’ concept, thus contributing a novel perspective to the existing body of knowledge. This scoping review aims to examine recent research on the persistent presence of organic pollutants (POPs) and heavy metals in breast milk, thereby elucidating the environmental setting’s impact on milk quality. We seek to highlight the innovative angle of our study by emphasizing the ‘One Health’ concept, which has not been thoroughly explored in the context of lactation and environmental pollutants. We performed a scoping review, consulting two online databases to identify articles published from 1995 to 2023 that reported on pollutants in breast milk, using the PRISMA checklist. This methodological approach underlines the comprehensive and up-to-date nature of our literature review, ensuring the relevance and timeliness of our findings. From a total of 54 relevant articles, findings indicate that POPs are present in higher concentrations in breast milk the longer the lactation period. These findings highlight the persistent and bioaccumulative nature of such contaminants, offering new insights into their long-term implications for maternal and infant health. This exposure does not appear time-sensitive, suggesting pollutants accumulated in maternal fat compartments can be excreted into human milk years after exposure, a novel finding that underscores the importance of considering long-term environmental exposures in lactation research. The presence of POPs and heavy metals in both infant formula and maternal milk underscores a critical need for further comparative studies to understand the health implications better. Our discussion extends the current dialogue on the safety of breastfeeding in polluted environments, providing a new framework for assessing risks and benefits. While breastfeeding remains the WHO-recommended nutrition for optimal infant growth, the findings emphasize the importance of continued risk reduction policies to protect mothers and infants from environmental contaminants in breast milk. Our conclusion calls for an integrated approach, combining public health, environmental science, and clinical practice to develop effective strategies for reducing exposure to environmental pollutants. This multidisciplinary perspective is a significant contribution to the field, paving the way for future research and policy development.
]]>Healthcare doi: 10.3390/healthcare12060679
Authors: Luis Ceballos-Laita Edzard Ernst Andoni Carrasco-Uribarren Sara Cabanillas-Barea Jaime Esteban-Pérez Sandra Jiménez-del-Barrio
Objectives: The aim of this study was to evaluate the clinical effectiveness of craniosacral therapy (CST) in the management of any conditions. Methods: Two independent reviewers searched the PubMed, Physiotherapy Evidence Database, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases in August 2023, and extracted data from randomized controlled trials (RCT) evaluating the clinical effectiveness of CST. The PEDro scale and Cochrane Risk of Bias 2 tool were used to assess the potential risk of bias in the included studies. The certainty of the evidence of each outcome variable was determined using GRADEpro. Quantitative synthesis was carried out with RevMan 5.4 software using random effect models. Data Synthesis: Fifteen RCTs were included in the qualitative and seven in the quantitative synthesis. For musculoskeletal disorders, the qualitative and quantitative synthesis suggested that CST produces no statistically significant or clinically relevant changes in pain and/or disability/impact in patients with headache disorders, neck pain, low back pain, pelvic girdle pain, or fibromyalgia. For non-musculoskeletal disorders, the qualitative and quantitative synthesis showed that CST was not effective for managing infant colic, preterm infants, cerebral palsy, or visual function deficits. Conclusions: The qualitative and quantitative synthesis of the evidence suggest that CST produces no benefits in any of the musculoskeletal or non-musculoskeletal conditions assessed. Two RCTs suggested statistically significant benefits of CST in children. However, both studies are seriously flawed, and their findings are thus likely to be false positive.
]]>Healthcare doi: 10.3390/healthcare12060677
Authors: Mohammed A. Aljunaid Lojain Nasser Alruwaili Hamzah Yahya Alhajuj Mohammed Talal Musslem Hussain Hasan Jamal
Women’s knowledge about perimenopause plays a crucial role in shaping their perception of related illnesses, influencing coping strategies, treatment adherence, and the overall management of this life stage. This cross-sectional study assessed the awareness, knowledge, attitudes, and practices regarding perimenopause among 409 Saudi women attending primary healthcare centers. Participants completed a structured questionnaire addressing demographic data, awareness, knowledge, attitudes, and practices related to perimenopause. While 75.3% of the participants were aware of perimenopause, only 17.4% could identify more than 10 out of 20 perimenopause symptoms. Commonly recognized symptoms included menstrual irregularity (67.7%), mood swings (66.0%), and mood fluctuations (50.4%). Only 23.0% had optimal knowledge about perimenopause complications. Additionally, 73.3% had not consulted a doctor for perimenopause-related issues. An analysis of the overall knowledge score showed a mean (SD) = 14.82 (5.64) out of 34. The level of knowledge was independently associated with a higher educational level, more frequent perimenopause symptoms, and regular doctor visits. This study reveals high awareness but insufficient knowledge among Saudi women regarding perimenopause symptoms and complications associated with higher perimenopause morbidity and a lack of engagement with healthcare professionals. It underscores the need for early and continued education on perimenopause, improved doctor–patient communication, and specific interventions to boost knowledge and attitudes toward perimenopause.
]]>Healthcare doi: 10.3390/healthcare12060678
Authors: Chad Yixian Han Georgia Middleton Jersyn Doh Alison Yaxley Yogesh Sharma Claire Baldwin Michelle Miller
Introduction: Self-managed exercise and nutrition interventions can alleviate pre-frailty and frailty but understanding of adherence to them is lacking. This study aimed to explore the experiences of, and barriers and enablers to, a hospital-to-home self-managed combined exercise and nutrition program for hospitalised older adults living with pre-frailty and frailty. Methods: A hybrid approach to data- and theory-driven descriptive thematic analysis identified experiences, barriers, and enablers to participation in a 3-month, self-managed, exercise–nutrition, hospital-to-home frailty-support program. Pre-frail and frail older adult patients ≥ 65 years admitted to the acute medical unit at a South Australian tertiary hospital were recruited. Individual semi-structured interviews were audio-recorded, transcribed verbatim, and analysed descriptively, using the Theoretical Domains Framework. Results: The nutrition component of the program found 11 common barriers and 18 common enablers. The exercise component included 14 barriers and 24 enablers. Intentions, Social influences, Environmental context/resource and Emotions served as primary barriers towards adherence to both components. Common enablers for both components included Knowledge, Social identity, Environmental context/resource, Social influences, and Emotions. Conclusions: this research revealed important factors affecting adherence to a self-managed exercise–nutrition program in pre-frail and frail older adults within the environment, resources, and emotion domains that should be considered when designing other intervention programs in this population group.
]]>Healthcare doi: 10.3390/healthcare12060676
Authors: Elizabeth Chun Annie Crete Christopher Neal Richard Joseph Rachele Pojednic
Wellness-centric proactive healthcare is increasingly sought after, with individuals frequently embracing complementary modalities to achieve this goal. In this six-month study, healthy adult participants (n = 25) received specific therapies, including whole-body cryotherapy, infrared sauna, and photobiomodulation, along with guidance on physical activity, diet, and alcohol intake. Serum biomarkers were measured for all participants, while a subset also received biometric assessments for body composition (n = 10) and heart rate variability (n = 7). Over the course of the study (mean (SD) follow-up days = 174 (130)), participants exhibited significant improvements in health. LDL cholesterol (−9.77 (15.43) md/dL) and hsCRP (−1.75 (2.66) mg/L) decreased significantly (p < 0.05). HbA1c increased slightly (p < 0.05), but the effect size was small (0.12 (0.13)%). The body composition subset lost overall body weight (−3.29 (3.75) kg), primarily body fat, while preserving lean muscle mass (p < 0.05). Heart rate variability increased for those with existing cardiovascular risk factors (p < 0.05). In conclusion, participation in the multimodal Healthspan protocol is associated with substantial improvements in health-related biomarkers and biometrics.
]]>Healthcare doi: 10.3390/healthcare12060675
Authors: Codruța Alina Popescu Veronica Junjan Anca Dana Buzoianu Mugur Daniel Ciumăgeanu Șoimița Mihaela Suciu
Background: This article investigates the determinants of the intention to migrate of nursing students at a major medical university in Romania and relates them to major international developments, specifically the Brexit referendum and the COVID-19 pandemic. Methods: An online survey about the intention to migrate was made available to nursing students at the University of Medicine and Pharmacy “Iuliu Hațieganu”, Cluj-Napoca, Romania, in 2016 (before Brexit) and again in 2016 (after Brexit), 2017, 2018, and 2021 and 2022 (during the pandemic). A total of 549 students responded (response rate: 84.6%). Results: Before the Brexit referendum, 62.6% of the respondents had a plan to seek employment abroad, whereas after the Brexit referendum, only 34.7% indicated that they had such a plan after graduation. Before the pandemic, 43.6% of the students expressed an intention to work abroad, while during the pandemic, only 19.8% had such plans. Conclusions: This study documented the effect of significant international developments—such as the Brexit referendum and the COVID-19 pandemic—on decreasing the intention to migrate. As expected, the change in preference for the UK as a destination country changed dramatically. Additionally, the study provides both theoretical and empirical insights into the types of and the consistency of preparation for migration of nursing students.
]]>Healthcare doi: 10.3390/healthcare12060674
Authors: Tobias Schiffler Eva Reiter Ali Kapan Gottfried Kranz Stefan Thomas Kotzian Sandra Haider
Background: Therapeutic climbing (TC) has emerged as a prospective rehabilitation approach for individuals with multiple sclerosis (MS). The existing literature primarily focuses on the physical and psychological benefits of TC across diverse populations but is limited concerning its application and efficacy for patients with MS. Objectives: This study aimed to delineate the experiences, subjective effects, and perceptions of both individuals with MS and therapists regarding TC, highlighting the potential benefits and challenges of this therapeutic approach. Methods: Using a qualitative design, semi-structured interviews were conducted with patients living with MS (N = 5) and therapists (N = 7) involved in TC sessions at a rehabilitation facility. The interviews were recorded, transcribed verbatim, and subjected to thematic qualitative text analysis. Results: Our analysis resulted in the identification of five main categories: (1) motivational factors, (2) training conditions, (3) training content, (4) observed effects, and (5) safety protocol. Our findings primarily centred around the motivational aspects of TC. Participants consistently reported experiencing feelings of accomplishment, success, enjoyment, and increased self-confidence. Furthermore, TC was often perceived as a comprehensive intervention, addressing endurance, strength, flexibility, neuromotor functions, cognition, and mental health while having a low-risk profile. However, due to the demanding nature of TC, careful fatigue management is crucial. This entails personalised intensity adjustments during sessions and coordinating TC with other physically demanding therapies when implementing TC within a rehabilitation environment. Conclusions: TC shows promise within MS rehabilitation and can be considered safe under certain framework conditions. This research sheds light on its potential benefits, facilitators, and barriers and provides insights for practical integration into rehabilitation programs.
]]>Healthcare doi: 10.3390/healthcare12060673
Authors: Angelika Bogusz Magdalena Górnicka
Endometriosis is a chronic gynecological disease characterized by ectopic endometrial tissue outside the uterus that can cause chronic pain, dysmenorrhea, fatigue, and infertility. The aim of this study was to assess diet quality and nutritional knowledge of women with endometriosis. A questionnaire was used to collect data on lifestyle, dietary habits and nutritional knowledge from 90 women. More than 80% of women with endometriosis (82.2%) confirmed that diet and lifestyle are related to the progression of endometriosis. After being diagnosed with endometriosis, 77.3% of respondents reported a change in their dietary habits and made various changes to their diet by increasing or eliminating the consumption of certain foods. The majority declared reducing pro-inflammatory products, increasing anti-inflammatory foods, including the consumption of vegetables and fruits, avoiding white/or red/or processed meat, and avoiding sweets. Nevertheless, diet quality as assessed by the pro-healthy diet index (pHDI-10) and the Mediterranean Diet Score (MDS) showed a low intensity of consumption of pro-healthy food (average pHDI-10 value 31.4%; MDS 7.55/14 points, p = 0.0001). Women with endometriosis reported lower than recommended consumption of fruits, vegetables, dairy products and whole grains. A higher percentage of healthy controls had a “good” level of nutritional knowledge than women with endometriosis. The results of our study highlight the need to improve diet quality and nutritional knowledge among women with endometriosis as well as developing targeted dietary recommendations to help improve well-being and reduce the pain symptoms of endometriosis.
]]>Healthcare doi: 10.3390/healthcare12060671
Authors: Marja van Vliet Miriam de Kleijn Karolien van den Brekel-Dijkstra Tim Huijts Sandra van Hogen-Koster Hans Peter Jung Machteld Huber
Positive health (PH) has been described as a promising transformative innovation to address the challenges of promoting well-being and reducing the burden of disease. For this study, we conducted a scientific literature review of the current state of knowledge about PH as introduced by Huber and colleagues, following the Cochrane Rapid Review recommendations. Three databases were searched (PubMed, Google Scholar, and CINAHL). Data were extracted and synthesised using a narrative approach. A total of 55 articles were included. The initial evaluation revealed promising results at both the individual and collective levels. However, several articles gave reason for further refinement of the conceptualisation of PH and of ways to measure the effects of PH interventions in greater detail. Professionals also expressed a desire for a more informed application and elaboration of the PH method, in various settings and populations, to increase its effectiveness in practice. The results from the rapid review highlight the transformative potential of PH in shifting from a disease-oriented to a health-oriented paradigm of healthcare. This underlines the need for continued research regarding further development of the concept and its practical method, along with the necessity for methodological innovation.
]]>Healthcare doi: 10.3390/healthcare12060672
Authors: Melissa Helen Zegarra-Ramos Cristina García-Bravo Elisabet Huertas-Hoyas Gemma Fernández-Gómez Mª Pilar Rodríguez-Pérez Jorge Pérez-Corrales Sara García-Bravo
(1) Background: Healthy aging is the process of developing and maintaining functional capacity and optimizing involvement in order to improve one’s quality of life as people age. This study aimed to encourage healthy aging in people with cognitive impairment, as well as a control group, via the use of the Nintendo Switch combined with occupational therapy sessions, aiming to improve gross and fine motor skills, functionality, quality of life, and cognitive status. (2) Methods: A randomized clinical trial was undertaken. The sample was randomized using the OxMar software program Attribution 4.0 International, facilitating the division into a control group (CG), who received conventional occupational therapy sessions, and an experimental group (EG), who received therapy incorporating the Nintendo Switch, in addition to conventional occupational therapy sessions. The intervention period with the Nintendo Switch lasted for 8 weeks. (3) Results: Thirty-two participants were included in the study. Significant differences were found in the vast majority of the variables analyzed, which shows an improvement following the intervention; these improvements were mainly observed in measures of skill and the perception of quality of life. (4) Conclusions: An eight-week intervention with the Nintendo Switch alongside conventional occupational therapy helps to maintain cognitive status and functional independence. Following 8 weeks of intervention with the Nintendo Switch, improvements in gross motor dexterity, fine motor dexterity, and quality of life were observed in older people with cognitive impairment.
]]>Healthcare doi: 10.3390/healthcare12060670
Authors: Carmela Protano Andrea De Giorgi Federica Valeriani Elisa Mazzeo Stefano Zanni Luigi Cofone Gabriele D’Ancona Anis Hasnaoui Ivano Pindinello Marise Sabato Francesca Ubaldi Veronica Volpini Vincenzo Romano Spica Matteo Vitali Francesca Gallè
Digital technologies have greatly developed and impacted several aspects of life, including health and lifestyle. Activity tracking, mobile applications, and devices may also provide messages and goals to motivate adopting healthy behaviors, namely physical activity and dietary changes. This review aimed to assess the effectiveness of digital resources in supporting behavior changes, and thus influencing weight loss, in people with overweight or obesity. A systematic review was conducted according to the PRISMA guidelines. The protocol was registered in PROSPERO (CRD42023403364). Randomized Controlled Trials published from the database’s inception to 8 November 2023 and focused on digital-based technologies aimed at increasing physical activity for the purpose of weight loss, with or without changes in diet, were considered eligible. In total, 1762 studies were retrieved and 31 met the inclusion criteria. Although they differed in the type of technology used and in their design, two-thirds of the studies reported significantly greater weight loss among electronic device users than controls. Many of these studies reported tailored or specialist-guided interventions. The use of digital technologies may be useful to support weight-loss interventions for people with overweight or obesity. Personalized feedback can increase the effectiveness of new technologies in motivating behavior changes.
]]>Healthcare doi: 10.3390/healthcare12060669
Authors: Lucia Gozzo
This Special Issue collects updated evidence about pharmacovigilance and regulatory actions which can be translated into the change and control of prescribing behaviour [...]
]]>Healthcare doi: 10.3390/healthcare12060668
Authors: Rocío Molina-Barea Mahmoud Slim Elena P. Calandre
Pelvic floor dysfunction comprises various disorders, including urinary incontinence, fecal incontinence, pelvic organ prolapse, and chronic pelvic pain. This study aimed to evaluate health-related quality of life (HRQoL), anxiety, depression, sleep disturbance, and sexual functioning in women with pelvic floor dysfunction of colorectal etiology compared with control women. Patients were recruited from a specialized colorectal unit and controls were selected from among the patients’ friends and relatives. Sociodemographic and clinical data were collected. Pelvic floor dysfunction distress and impact, HRQoL, depression, anxiety, insomnia, and sexual functioning were assessed using the following validated questionnaires: Short-Form Pelvic Floor Distress Inventory (PFDI-20), Short Form Pelvic Floor Impact Questionnaire (PFIQ-7), 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), and Changes in Sexual Functioning Scale (CSFQ). Statistical analyses included Welch’s t-test, Fisher’s exact test, and Spearman’s correlation coefficients. Eighty-four patients and 57 controls were included. Compared with controls, patients were more likely to be obese or overweight, have had higher numbers of deliveries, more vaginal deliveries, more frequent use of forceps, and have had more associated comorbidities, mainly in the urinary, neurological, and psychiatric domains. As expected, patients scored significantly higher than controls on both the PFDI-20 and PFIQ-7 and their respective sub-scales, with the highest mean values in the patient group on the sub-scales related to the colorectal–anal domain. QoL, depression, anxiety, insomnia, and sexual functioning were significantly worse in patients than in controls (p < 0.0001 in every case). In patients, PFIQ-7 scores correlated significantly with HRQoL (p < 0.001 for the physical component and p < 0.01 for the mental component), depression (p < 0.001), anxiety (p < 0.001), insomnia (p < 0.05), and sexual functioning scores (p < 0.05). Colorectal pelvic floor dysfunction had a markedly deleterious impact on the HRQoL, depression, anxiety, sleep disturbance, and sexual functioning of patients. It is concluded that colorectal pelvic floor dysfunction exerts a considerable burden on patients’ lives. Addressing these issues in clinical settings could significantly improve patients’ well-being.
]]>Healthcare doi: 10.3390/healthcare12060667
Authors: Thomas Mayers Ayaka Sakamoto Ryota Inokuchi Kyoko Hanari Huijun Z. Ring Nanako Tamiya
The COVID-19 pandemic highlighted the need for advance care planning (ACP) as a way to help mitigate the various care concerns that accompanied the healthcare crisis. However, unique obstacles to typical ACP practice necessitated the need for guidance and innovation to help facilitate these vital conversations. The aim of this systematic review was to identify the various ACP barriers and facilitators that arose during the pandemic and determine how ACP practice was affected across different contexts and among different populations. This systematic review (PROSPERO registration number: CRD42022359092), which adheres to the PRISMA guidelines for reporting systematic reviews, examined studies on ACP in the context of the COVID-19 pandemic. The review involved searches of five databases, including MEDLINE and Embase. Of the 843 identified studies, 115 met the inclusion criteria. The extracted ACP barriers and facilitators were codified and quantified. The most frequently occurring ACP barrier codes were: Social distancing measures and visitation restrictions, Uncertainty surrounding the COVID-19 prognosis, and Technological/Telehealth barriers. The most frequently occurring ACP facilitator codes were the following: Telehealth/virtual ACP platforms, Training for clinicians, and Care team collaboration. Identifying the ACP barriers and facilitators is essential for developing effective, resilient ACP promotion strategies and improving its delivery, accessibility, and acceptability.
]]>Healthcare doi: 10.3390/healthcare12060666
Authors: Ludovico Lucenti Gianluca Testa Alessia Caldaci Fabio Sammartino Calogero Cicio Martina Ilardo Marco Sapienza Vito Pavone
Periprosthetic joint infection (PJI) poses a challenging complication for many patients undergoing arthroplasty, and the literature identifies numerous risk factors. A comprehensive understanding of the primary risk and protective factors for PJI is valuable for surgeons. This article aims to compile and summarize the key risk factors for PJI documented in the literature. Some risk factors are related to the nutritional status of patients, with obesity, weight loss, hypovitaminosis, and malnutrition being frequently reported. Pathologies affecting patients also contribute to PJI risk, including septic arthritis, hepatitis, diabetes, urinary tract infections, anemia, hypothyroidism, osteoporosis, and dental pathologies. Unhealthy habits, such as tobacco and drug abuse, are significant factors. Previous corticosteroid injections may also play a role in infection development. A few protective factors are also reported in the literature (use of statins, preoperative decolonization, and preadmission skin preparation). The identification of risk factors and the implementation of evidence-based preoperative protocols are essential steps in reducing the incidence of PJI.
]]>Healthcare doi: 10.3390/healthcare12060665
Authors: Melvin Omone Ogbolu Miklós Kozlovszky
In Nigeria, statistics reveal that there is a high rate of cervical cancer among women and a significant lack of awareness surrounding Human Papillomavirus (HPV), which poses a substantial risk of HPV infection. This cross-sectional survey, conducted at Ibrahim Badamasi Babangida (IBB) University, focuses on adapting and exploring the factors that influence a 20-item scale to measure HPV knowledge, evaluating knowledge-associated patterns and HPV-associated risk factors. We examined HPV vaccination rates, infection awareness, vaccine awareness, and the impact of ethnicity on HPV knowledge. Various validated forms were adapted to measure HPV awareness and knowledge. Non-parametric tests addressed non-normality. Data were presented using median and IQR and categorical data were frequency-based. Bivariate tests (Mann–Witney, Kruskal Wallis) explored knowledge-associated factors, while quantile regression (75th percentile) examined HPV knowledge factors. Variables were considered statistically significant at p < 0.05. The adapted 20-item knowledge scale revealed strong reliability (Cronbach’s alpha = 0.913), ensuring internal consistency. The median knowledge score was 0, with an interquartile range (IQR) of 0–5. Our findings revealed a significant lack of awareness and knowledge about HPV; only 34.8% of the population were aware of HPV infection and 25.0% were familiar with HPV vaccination. Furthermore, ethnicity was found to be significantly associated with knowledge of HPV. This study emphasizes the necessity for targeted interventions to enhance HPV awareness, especially within specific ethnic groups. Despite a robust knowledge scale, educational initiatives such as seminars/conferences about HPV and cervical cancer remain crucial in addressing this gap, ultimately reducing HPV infection and cervical cancer risks in Nigeria.
]]>Healthcare doi: 10.3390/healthcare12060664
Authors: Jeonga Kwon Jusun Jang
This study aimed to explore the factors that affect the severity and number of sports injuries among Korean sports participants in their 20s and 30s. The data of 5118 lifestyle and professional athletes in their 20s and 30s were collected from a sports safety survey conducted by the Korea Sports Safety Foundation in 2019. The characteristics of the study population were analyzed using descriptive analysis. Determinants of injury severity and frequency based on participants’ sex were identified using multivariate logistic regression analyses. The results show that among male sports participants, the type of athlete, knowledge of first aids, the physical condition, completing safety education, the skill level, and checking environmental factors were associated with injury severity. Among female sports participants, the type of athlete, the physical condition, performing finishing exercises, completing safety education, and the skill level were associated with injury severity. Additionally, among male sports participants, physical condition, completing safety education, skill level, participating in exercises according to one’s fitness level, and having an awareness of accident prevention methods were associated with injury frequency. Lastly, among female sports participants, drinking water during scheduled breaks, carrying water to stay hydrated, physical condition, completing safety education, and skill level were associated with injury frequency. Furthermore, being a lifestyle athlete, being in good physical condition, and having beginner or intermediate skills in one’s sport reduced injury severity among Korean sports participants in their 20s and 30s. Being in good physical condition, not completing safety education, and having beginner skills in one’s sport reduced the injury frequency among Korean sports participants in their 20s and 30s. These findings suggest that lifestyle and professional athletes should be aware of these factors and participate in sports activities in a manner that reduces injury severity and frequency. Moreover, these factors should be considered when developing strategies to prevent sport injuries in lifestyle and professional athletes and allow them to participate in sports activities safely.
]]>Healthcare doi: 10.3390/healthcare12060663
Authors: Milena Santric-Milicevic Kristina Pavlekic Zoran Bukumiric Aleksandar Stevanovic Dejan Nikolic Bojana Matejic Dragana Matanovic Dusan Backovic Goran Tulic Relja Lukic Dubravka Zivanovic Sofija Radosavljevic Vladimir Milovanovic Marija Zdujic Sanja Stankovic Milika Asanin Marija Zdravkovic Ratko Tomasevic
The mental health of healthcare workers, especially the nursing staff in intensive care units, is crucial for the optimal functioning of healthcare systems during medical emergencies. This study implements a cross-sectional design to investigate the associations between nurses’ personal characteristics, workplace challenges, and job satisfaction with the increased perception of tension, stress, and pressure at the workplace (TSPW) before and during the COVID-19 pandemic. In 2021, we surveyed 4210 nurses from 19 intensive healthcare facilities in the capital of Serbia, Belgrade, and, at that time, collected data about their perceived TSPW before and during the COVID-19 pandemic. Our study identified six predictors of the increase in TSPW, as perceived by nurses: their work in COVID-19 infectious zones (OR = 1.446), exhaustion due to work under protective equipment (OR = 1.413), uncertainty and fear of infection (OR = 1.481), a high degree of superiors’ appreciation and respect (OR = 1.147), a high degree of patients’ attitudes (OR = 1.111), and a low degree of work autonomy (OR = 0.889). The study’s findings suggest that a solution to this issue is necessary to ensure that nurses are safe and able to alleviate the physical and mental strain that comes with prolonged use of protective equipment. Nurses on the frontline of the pandemic require better health protection, better conditions, and respect for their role. Strategies to promote mental health would help reduce nurses’ stress and increase job satisfaction.
]]>Healthcare doi: 10.3390/healthcare12060662
Authors: Jiyun Kim Yuna Paik
Abdominal obesity (AO) and dynapenia (DP) are associated with cognitive decline, and the relationship between dynapenic abdominal obesity (DAO), a combination of DP and AO, and mild cognitive impairment (MCI) has been confirmed. This study aims to determine whether this relationship exhibits potential sex differences. The relationship between MCI and DAO was confirmed in 1309 community elderly individuals aged 65 years or older who were not diagnosed with dementia. The MCI was defined as a Korean mini-mental state examination (K-MMSE) score of 18–23 points. Multiple logistic regression analyses were conducted, categorizing participants into groups: a control group without AO or DP, an AO group, a DP group, and a DAO group. The study results showed that in women, both DP and DAO were significantly associated with MCI not only in the unadjusted Model 1 but also in Model 2, which adjusted for general characteristics and health behaviors, and Model 3, which additionally adjusted for chronic diseases and disease-related characteristics. In men, DP was associated with MCI in the unadjusted Model 1. The findings highlight sex differences in the impact of the DAO on MCI. These differences should be considered when studying the factors related to MCI in old age.
]]>Healthcare doi: 10.3390/healthcare12060661
Authors: Susanne Wehrli Andrew A. Dwyer Markus A. Landolt
Access to healthcare is multifaceted and poses significant challenges for individuals with chronic and rare diseases (RDs). This study aimed to conduct a psychometric evaluation of the German version of the Perception of Access to Healthcare Questionnaire (PAHQ) among individuals with RDs. We conducted an evaluation of the PAHQ using a sample of 271 adults with an RD diagnosis. The 31-item instrument underwent evaluation including a comparison of three different confirmatory factor models (CFA). Subsequent steps involved item removal, reliability analysis (computation of Cronbach’s alpha), and analysis of criterion-related validity. The six-factor model showed the best fit to the data and was selected for further examination. Subsequently, six items were removed. Fit indices for the final model were acceptable. Cronbach’s alpha ranged from 0.75 to 0.91 for the six subscales, except for the availability subscale which exhibited the lowest value (0.64). In terms of criterion-related validity, different skills relating to the navigation of access dimensions were significantly correlated with corresponding PAHQ subscales, thus confirming validity. The capacity of the PAHQ to guide targeted interventions and facilitate cross-population comparisons positions it as a valuable instrument for advancing healthcare access research and promoting equitable access to care, particularly for individuals with rare and chronic diseases.
]]>Healthcare doi: 10.3390/healthcare12060660
Authors: Yi-Ju Pan Sheng-Hsuan Chang Wei-Chen Lee Yu-Chun Chen
Increasing insomnia signals a public health problem, alongside rising zolpidem use. This study investigates the factors behind the disproportionate rise in zolpidem prescriptions in Taiwan. It aims to identify the determinants of high-dose zolpidem users in Taiwan’s Yilan County and employ an innovative approach to outline their medication-seeking patterns, using Taiwan’s healthcare database. The associations between sociodemographic and clinical factors and low-dose and high-dose users were analyzed using multiple logistic regression. Social network analysis was employed to explore medication-seeking behavior among these user groups across different healthcare institutions. Of our 5290 participants, 22.82% are high-dose users. This study found that males face a 1.33-fold higher risk and that having chronic diseases is a major risk factor, contributing to a more than four-times higher risk (adjusted OR = 4.27, 95% CI 1.55–11.70) of being a high-dose user of zolpidem. A social network analysis showed a higher density (0.52) for high-dose users, revealing their frequent visits, for zolpidem, to different healthcare institutions. Psychiatrists have a central role in both low-dose and high-dose user networks, with a greater influence on low-dose users (64.4) than high-dose users (32.2). In sum, patients seeking high doses of zolpidem are driven by personal factors. Future efforts should include regulated dispensing, public health education, and specialized training for healthcare professionals on drug addiction.
]]>Healthcare doi: 10.3390/healthcare12060657
Authors: Theresia A. Ottaru Gideon P. Kwesigabo Zeeshan Butt Matthew Caputo Pilly Chillo Hellen Siril Lisa R. Hirschhorn Claudia Hawkins
With improved survival, adults living with HIV (ALHIV) are increasingly likely to experience age-related and HIV-related comorbidities, including renal insufficiency. Other risk factors for renal insufficiency (high blood pressure (BP), obesity, diabetes, and dyslipidemia) are also growing more common among ALHIV. To determine the prevalence of renal insufficiency (defined as an eGFR < 60 mL/min/1.73 m2) and factors associated with reduced eGFR, we conducted a cross-sectional study at six HIV clinics in Dar-es-Salaam, Tanzania. We applied multivariable (MV) ordinal logistic regression models to identify factors associated with reduced eGFR and examined the interaction of age with BP levels. Among the 450 ALHIV on ART analyzed [26% males; median age 43 (IQR: 18–72) years; 89% on tenofovir-containing ART; 88% HIV viral load ≤50 copies/mL], 34 (7.5%) had renal insufficiency. Prevalence was higher among males (12%) vs. females (6%), p = 0.03; ALHIV ≥50 (21%) vs. <50 years (2.5%), p < 0.001; those with high [≥130/80 mmHg (15%)] vs. normal [<120/80 mmHg (4%)] BP, p < 0.01 and those with dyslipidemia (10%) vs. those without (4.5%), p < 0.03. After adjusting for covariates, age (in years) was the only covariate with a statistically significant association with reduced eGFR (OR = 1.09 (1.07–1.12), p < 0.001). No significant interaction between age and BP was found. Interventions to increase routine screening for renal insufficiency, especially among older ALHIV, and improve BP control are critical to reducing kidney disease-related morbidity and mortality.
]]>Healthcare doi: 10.3390/healthcare12060654
Authors: Susana Diz Miguel Jacinto Aldo M. Costa Diogo Monteiro Rui Matos Raul Antunes
The practice of physical activity, exercise and sport has many benefits for the general population, but studies on the population with intellectual and developmental disabilities (IDD) are scarce and inconclusive. The aim of this systematic review is to analyze the state of the art on the role of physical activity, exercise and sport in the quality of life and well-being of people with IDD, seeking to understand the current panorama in this area and provide answers to these questions. The research was carried out between July and October 2023 using three databases: PubMed, Web of Science and Scopus. Fifteen articles met the eligibility criteria for this study, and these were methodologically assessed using the Downs and Black scale (1998). Higher values were identified in the total quality of life score and some domains of this variable (e.g., personal development, physical well-being and emotional well-being), in satisfaction with life and in the perception of well-being in individuals with IDD who have enjoyed or are involved in physical activity, physical exercise and/or sports programs. Thus, according to the studies included in this systematic review, we can conclude that the practice of physical activity, physical exercise and sport seems to contribute to improving the quality of life and well-being of people with IDD. Despite the growing research interest in this area, there is still a notable lack of studies exploring the impact of these programs, especially sports-based programs, on quality of life and well-being variables in the population under study.
]]>Healthcare doi: 10.3390/healthcare12060659
Authors: Almudena Marco-Ibáñez Carlos Aibar-Remón Adriana Gamba-Cabezas Lina Maldonado Isabel Aguilar-Palacio
Virtual consultation has been implemented as a tool to improve the cooperation and coordination between primary care and other specialties. However, in its use in dermatology, inequities have been described. The aim of this study was to identify individual and geographical factors affecting the likelihood of accessing this resource. We conducted a cross-sectional study. The study population was individuals living in Aragón, a region in the north-east of Spain, who were users of the Aragon Health Service in 2021. To explore the differences in individual and area characteristics, between patients with virtual and non-virtual dermatology consultation, we performed bivariate analyses. To analyse the use of virtual consultation in dermatology, a multilevel methodology stratified by sex was developed. We analysed 39,174 dermatology visits, with 16,910 being virtual (43.17%). The rates of virtual consultation were higher in urban areas and the most affluent areas, for older persons, chronic complex patients and people with more advantageous socioeconomic positions. The best multilevel model conducted showed inequalities by socioeconomic position and area of residence. There are individual and area inequalities in the use of teledermatology. As this tool should improve equity of access, teledermatology interventions must address and adapt to the needs of the local patient population.
]]>Healthcare doi: 10.3390/healthcare12060658
Authors: Dimitris Charalambos Karaferis Dimitris A. Niakas
Introduction: The aim of this study was to identify and evaluate patient-relevant experiences that fulfill the expectations and demands of society in Greece and those that could be improved by offering a better quality of care. The satisfaction of health service recipients is one of the key elements of the success of a health system. Methods: A cross-sectional survey was conducted to obtain data on satisfaction with hospitalization from patients admitted to 10 public hospitals in Athens between June 2019 and December 2021. Statistical analysis was applied to 57 items and 7 dimensions of patient satisfaction, namely waiting–arrival–admission, nursing staff, medical staff, other staff, service and quality of food, interior environment, and procedures. Results: A total of 3724 patients, aged ≥ 18 years, who had experienced hospitalization and agreed to participate in the study were included, the response rate of which was 93%. Patient satisfaction and experience with healthcare services provided by hospitals is moderate, with almost two-thirds of patients (67.38%) satisfied with the care they received. The encounter with the medical–nursing personnel (3.75/5) and other staff (4/5) were factors that positively affected patients’ overall satisfaction with hospitalization. However, there were some causes of dissatisfaction, mainly associated with waiting hours, easy access to medical services or services received in emergencies, delays of planned procedures (3.50/5), or problems with old facilities and equipment (3.56/5). Conclusion: Based on the patients’ judgment, the performance of hospitals was rated at a ‘tolerable’ level. Professionalism and the education of personnel led to a positive treatment outcome and improved the experience of patients to a good level. However, public hospitals continued to be underfunded and lacked strong support, which affected staff communication and responsiveness to patients’ requirements, while smart technologies and the simplification of procedures were not adopted to help staff provide a better quality of healthcare. The results suggest that there is plenty of room for improvement.
]]>Healthcare doi: 10.3390/healthcare12060656
Authors: Mansour M. Alasiri Abdullah Almalki Saud Alotaibi Abdullah Alshehri Alhanouf A. Alkhuraiji Julie Toby Thomas
This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full mouth bleeding score (FMBS), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), keratinized tissue width (KTW), transgingival probing, and gingival biotype assessment, were recorded at baseline and 6 months into treatment for both orthodontic groups and a control group. Statistical analysis evaluated differences in parameters between groups and across time points. In the thick phenotype, both Invisalign and FOT groups showed a significant mean reduction in FMPS (baseline to 6 months) by −24.8707 and −12.3489, respectively (p < 0.05). The gingival index decreased significantly for both groups, with Invisalign and FOT showing reductions of −0.83355 and −1.10409, respectively (p < 0.05). FMBS (baseline to 6 months) decreased significantly for Invisalign and FOT, with mean differences of −9.10298 and −12.6579 (p < 0.05). Probing pocket depth (baseline to 6 months) was also significantly reduced for both Invisalign and FOT groups while CAL showed non-significant differences in both groups (p > 0.05). Similar changes were seen in the thin phenotype too. This study highlights the positive influence of both Invisalign and fixed orthodontic therapy on periodontal health, particularly in patients with thin and thick gingival biotypes. These findings, with significant reductions in key periodontal parameters, offer valuable insights to guide orthodontic treatment decisions and enhance patient outcomes.
]]>Healthcare doi: 10.3390/healthcare12060655
Authors: Michele Antonelli Davide Donelli Filippo Luca Gurgoglione Davide Lazzeroni Geza Halasz Giampaolo Niccoli
This review aims to delineate the potential impact of static meditation practice on cholesterol and triglyceride levels. PubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar were systematically screened up until December 2023 to identify pertinent studies. After searching the scientific literature, 16 clinical studies (11 trials and 5 observational experiments) met the criteria for inclusion, involving a total of 1147 participants. In general, Ayurvedic-based meditation techniques were predominantly associated with lower total cholesterol levels, mindfulness-based techniques demonstrated benefits in both total cholesterol and triglyceride levels, and Eastern meditation techniques with spiritual origins were primarily linked to improved serum concentrations of HDL cholesterol. Study participants mostly engaged in meditation on a daily basis, often practicing it once or even twice a day, spanning a duration ranging from a few weeks to several months. The meta-analysis shows an association between meditation practice in healthy or sub-healthy adults and reduced cholesterol levels, with an average decrease of approximately −14 mg/dL (MD = −13.91 [−23.35; −4.47] mg/dL; p = 0.02), alongside favorable and even more pronounced impacts on triglyceride levels (MD = −32.56 [−48.44; −16.68] mg/dL; p < 0.01). In summary, regular engagement in static meditation practices can be associated with lower triglyceride and, to a lesser extent, cholesterol levels. Further studies on the topic are recommended to better investigate the relationship between meditation practice and physiological parameters.
]]>Healthcare doi: 10.3390/healthcare12060653
Authors: Belkis Aracena-Genao René Leyva-Flores Rene Santos-Luna Saul Lara-Diaz Angel Argenis Mejía-Avilez
The objective of this study was to evaluate the technical efficiency of Mexico’s public health system in the delivery of obstetric care from 2012 to 2018. A multi-stage quantitative study of the public health institutions responsible for 95% of the system’s obstetric services was conducted using data envelopment analysis. The efficiency of state-level productive units (decision-making units, or DMUs) was calculated and juxtaposed with the DMUs’ maximum (0.82) and minimum (0.22) scores. Using the outcomes of the initial stage, the average technical efficiency of each institution at the national level was estimated and compared. The results were also utilized to estimate and compare the average efficiency of each state-level health system based on economic characteristics (state GDP per capita). Outputs included prenatal visits and deliveries, while inputs comprised gynecologists, exam rooms, and delivery rooms. Institutional efficiency ranged from 0.16 to 0.82, with an average of 0.417. The Ministry of Health (0.82) and the Mexican Social Security Institute (0.747) exhibited the highest efficiency scores, while the remaining institutions (Institute for Social Security and Services for State Workers [ISSSTE]; Mexican Petroleum [PEMEX]; the Secretary of National Defense [SEDENA]; and the Navy [SEMAR]) scored below the health system average. Of the 153 DMUs, 20% surpassed the maximum (0.82) and 40.6% fell below the minimum (0.22). These findings indicate that 80% of DMUs have unused operational capacity that could be utilized to enhance technical efficiency. No relationship was found between efficiency and the GDP of Mexico’s 32 politico-administrative divisions. The efficiency gap between institutions (0.66) shows that while some DMUs are saturated (exhibiting high efficiency scores), the majority have unused operational capacity. Leveraging this untapped capacity could address the needs of vulnerable populations facing restricted access due to health system fragmentation.
]]>Healthcare doi: 10.3390/healthcare12060652
Authors: Miguel Mayo-Yáñez Alejandro Klein-Rodríguez Aldán López-Eiroa Irma Cabo-Varela Raquel Rivera-Rivera Pablo Parente-Arias
Head and neck cancer, the seventh most common cancer worldwide, often affects the larynx, with a higher incidence in men. Total laryngectomy, a common treatment, results in the loss of phonation, and tracheoesophageal voice rehabilitation is the current rehabilitation method of choice. Despite ongoing debates regarding the timing of tracheoesophageal puncture (TEP), a crucial procedure for voice prosthesis placement, the secondary puncture continues to be the preferred choice in the majority of cases. This underscores the persistent controversy and the absence of consensus in this field. The aim of this manuscript was to define evidence-based recommendations regarding the procedure of primary TEP with voice prosthesis placement, establish the conditions and requirements for performing primary TEP, determine the indications and contraindications of primary TEP, as well as to define the complications and management of primary TEP. A total of 19 statements were formulated, with 78.95% of them having a Level of Evidence 4 and a Grade of Recommendation C. There is not sufficient evidence comparing the outcomes of primary TEP versus secondary TEP. Future studies with robust methodologies are needed to clarify the role of primary and secondary TEP in the rehabilitation of patients undergoing total laryngectomy.
]]>Healthcare doi: 10.3390/healthcare12060651
Authors: Mehmet Koca Serdar Deniz Feyza İnceoğlu Ali Kılıç
Examining the workload and working conditions of healthcare workers is crucial regarding the quality of the work life of employees and the quality of services provided. This study aims to determine the effects of the perceptions of workload on the quality of work life of health personnel working in two different tertiary hospitals affiliated with the Ministry of Health and the Higher Education Institution in Türkiye with structural equation modeling. This study was conducted in two hospitals in Malatya province: İnönü University Turgut Özal Medical Center affiliated with the Higher Education Institution and Malatya Training and Research Hospital affiliated with the Ministry of Health. The mean score of the Individual Workload Perception Scale was 106.18 ± 16.5, and the mean score of the Work-related Quality of Life Scale was 66.39 ± 15.33. Total workload scores had a statistically significant positive effect on total quality of work life scores (β1 = 0.98; p = 0.001). It was concluded that there was a statistically significant relationship between workload and quality of work life and age, unit of employment, working time in the profession, and hospital type.
]]>Healthcare doi: 10.3390/healthcare12060650
Authors: Marwa Alhaj Ahmad Shamsa Al Awar Gehan Sayed Sallam Meera Alkaabi Darya Smetanina Yauhen Statsenko Kornelia Zaręba
During the postpartum period, psychological disorders may emerge. Aims and objectives: With the current study, we aim to explore the biological determinants that act on women during labor and incur the risk for postpartum depression (PPD). To reach the aim, we will perform the following tasks: (i) identify biological peripartum risk factors and calculate pooled prevalence of PPD for each of them; (ii) explore the strength of the relationship between peripartum risk factors and PPD; (iii) rank the predictors by their prevalence and magnitude of association with PPD. The knowledge obtained will support the development and implementation of early diagnostic and preventive strategies. Methods and analysis: We will systematically go through peer-reviewed publications available in the PubMed search engine and online databases: Scopus, Web of Science, EMBASE. The scope of the review will include articles published any time in English, Arabic, or Polish. We will deduplicate literature sources with the Covidence software, evaluate heterogeneity between the study results, and critically assess credibility of selected articles with the Joanna Briggs Institute’s bias evaluation tool. The information to extract is the incidence rate, prevalence, and odds ratio between each risk factor and PPD. A comprehensive analysis of the extracted data will allow us to achieve the objectives. The study findings will contribute to risk stratification and more effective management of PPD in women.
]]>Healthcare doi: 10.3390/healthcare12060649
Authors: Hollie Roberts Kelly Lambert Karen Walton
Dysphagia commonly affects older adults, making them nutritionally vulnerable. There is significant variation in the reported prevalence of dysphagia in aged care. The aim of this systematic review and meta-analysis was to determine the prevalence of dysphagia in individuals living in residential aged care facilities using appropriate assessment methods, and in four subgroups at higher risk: individuals with nervous system diseases, dementia, malnutrition, and poor dentition. Scopus, Web of Science, Medline, and CINAHL Plus were searched, and study selection was conducted in Covidence. Meta-analysis using a random effects model was used to obtain the pooled prevalence of dysphagia. Seven studies were eligible for inclusion. Dysphagia prevalence ranged from 16 to 69.6%. The pooled prevalence of dysphagia was 56.11% (95% CI 39.363–72.172, p < 0.0001, I2 = 98.61%). Sensitivity analysis examining the prevalence of dysphagia using only the CSE indicated a pooled prevalence of 60.90% (95% CI 57.557–64.211, p = 0.9994, I2 = 0%). Only one study each reported on dysphagia prevalence in individuals with nervous system diseases (31%), poor dentition (92%), and dementia (68.4%), meaning that meta-analysis could not be completed. No studies reported on the prevalence of dysphagia in individuals with malnutrition. The prevalence of dysphagia is high amongst residents of aged care facilities. This evidence should be used to guide improvements in the health outcomes and quality of life of aged care residents. Future research should explore the prevalence in the subgroups at higher risk.
]]>Healthcare doi: 10.3390/healthcare12060648
Authors: Ivan Borjan Ivna Pleština-Borjan Silvia N. W. Hertzberg Alen Siničić Ljubo Znaor Beáta Éva Petrovski Goran Petrovski
Purpose: The goal of this research is to investigate the characteristics and surgical techniques for repairing rhegmatogenous retinal detachment (RRD) and their influence on anatomical and functional success of the treatment with a special emphasis on the economic costs and outcome quality-adjusted life years (QALYs) of the procedures. Methods: This retrospective study analyzed data from 151 patients with RRD treated at the Department of Ophthalmology, Clinical Hospital Centre Split, Croatia, in a 3-year period, using one of three surgical techniques: pneumoretinopexy (PR), scleral buckling (SB) or pars plana vitrectomy (PPV), followed-up for at least 6 months. Demographic, pre- and post-operative ophthalmic exam parameters and surgical technique used were collected accordingly. Statistical analysis of the influence of the studied parameters upon anatomical and functional outcomes was performed, as well as health economic analysis on costs and derived utilities/QALYs of these surgical methods. Results: Of all patients, 130 (86%) were successfully operated on, and 21 patients (14%) required another surgical procedure. No statistically significant differences in the anatomical success between the 3 surgical techniques were found. However, the functional outcome (based on the final best corrected visual acuity (BCVA)) differed significantly. Despite improvement in the final BCVA, BCVA ≥ 0.5 was achieved in only 52 (34.4%) patients. The final BCVA showed significant association with the time elapsed from the onset of RRD to the surgical intervention, pre-operative BCVA, macular- and preoperative lens- status and type of surgery. The estimated diagnosis-related group (DRG) cost for day and inpatient surgery was based upon existing DRG cost for PPV, which for PR and SB was calculated accordingly. Based upon the success of the procedure and visual outcome, the overall calculated QALYs for PR and SB appeared to be similar, while the QALYs were lower for PPV. Conclusions: The success rate of treating RRD mostly depends on performing an early surgical procedure (especially in the case of attached macula), identification of all retina tears and, most importantly, choosing the appropriate surgical technique. Decisions on treatment for RRD should also be based upon cost-effective and QALYs-assessed procedures, especially in countries like Croatia, where limited healthcare resources exist. This study shows PR to be efficient and most cost-effective for RRD repairment in appropriate cases.
]]>Healthcare doi: 10.3390/healthcare12060647
Authors: Marilena Anastasaki Agapi Angelaki Philippos Paganis Elena Olga Christidi Nancy Papathanasiou Eleni Panagiota Stoupa Evika Karamagioli Emmanouil Pikoulis Christos Lionis
Trans people face substantial barriers to care worldwide. In Greece, limited evidence regarding trans health and actions to improve accessibility in healthcare services is available. This study aims to identify barriers to care for transgender populations in order to discuss the potential gaps in healthcare providers’ training in this direction. A scoping review was conducted in PubMed. Study eligibility criteria included: (a) reporting on at least one barrier to care for trans individuals or at least one educational need for healthcare providers; (b) free full text availability; and (c) publishing from 2015 and afterwards. Discrepancies in study inclusion were discussed between the research team until consensus was reached. Out of 560 identified references, 69 were included in this study, with only three reporting empirical research from Greece. Several individual-, interpersonal-, and institutional-level barriers to healthcare for trans individuals were identified. These included discriminatory treatment by healthcare providers, a lack of knowledgeable providers trained on trans-specific healthcare issues, lack of trusted and safe healthcare environments, health coverage-related issues, and healthcare systems that do not take into account particular transgender health issues during care provision. Improving access to care for transgender people is a multidimensional issue that should be addressed at the societal, healthcare, and research levels. Actions for future professional education initiatives should focus on respecting transgender identity, protecting confidentiality, creating trusted provider–patient relationships, and providing sufficient competency on trans-specific healthcare issues.
]]>Healthcare doi: 10.3390/healthcare12060646
Authors: Magdalena Metzger Stefan Manhartseder Leonie Krausgruber Carina Wagner Sara Frank Rosmarie Reisner Monika Ehling-Schulz Johannes Grillari Roswitha Hosemann Peter Dungel
Background: To prevent occupational skin diseases, employees are instructed to periodically apply hand protection products as a barrier to protect their hands from water, cleaning agents or other irritants. The aim of this work was to investigate whether bacteria present on the skin at the time of protection product application are enclosed underneath this protective layer, if they can be transferred to other surfaces and if a standard isopropanol-based skin disinfectant can nonetheless reduce the bacterial burden. Methods: This prospective study was conducted in human volunteers based on the European Standard (EN 1500) to assess the burden of microorganisms before and after the application of various protection product formulations and subsequent hand disinfection. Results: All protection products, with the exception of alcohol-based gels, enclosed bacteria underneath a lipid layer which could be transferred onto other surfaces. Still, the hand disinfectant efficiently reduced the bacteria burden. Discussion: In occupations where proper hand hygiene is vital, alcohol-based gels might be the best option for the protection of the skin barrier as well as for reducing the contamination risk. Conclusion: An alcohol-based disinfection agent can dissolve the lipid film of protection products following the standard protocol for hygienic hand disinfection.
]]>Healthcare doi: 10.3390/healthcare12060645
Authors: Joungsue Kim Jiyoung Yoon Inah Kim Jeehee Min
This study aimed to investigate the mental health of new police trainees during the coronavirus disease 2019 (COVID-19) pandemic in Korea. Two groups of police trainees were surveyed considering the distribution of gender, age, and education level: those who joined the school before COVID-19 and those who joined during the outbreak. Mental health indicators, including insomnia, depression, and anxiety, were compared between the two groups. The prevalence of insomnia, depression, and anxiety significantly varied in the group that joined during COVID-19 compared with the group that joined before. Specifically, insomnia showed a significant change in women, with a higher rate of 2.6%. Although the prevalence of depression was initially low, it increased from 0.4% to 1.3% during the pandemic. Anxiety rates also showed notable differences, particularly among women, with a higher rate of 4.7%. The highest differences in prevalence were observed in the low-income group, with a rate of 7.7% for anxiety. The findings highlight the vulnerability of police officers to psychosocial effects during disasters such as pandemics. Disaster preparedness programs or education can be integrated into new police officer training institutions to help manage mental health changes and promote overall well-being.
]]>Healthcare doi: 10.3390/healthcare12060644
Authors: Richard Chiu Eric Tatara Mary Ellen Mackesy-Amiti Kimberly Page Jonathan Ozik Basmattee Boodram Harel Dahari Alexander Gutfraind
Despite the availability of direct-acting antivirals that cure individuals infected with the hepatitis C virus (HCV), developing a vaccine is critically needed in achieving HCV elimination. HCV vaccine trials have been performed in populations with high incidence of new HCV infection such as people who inject drugs (PWID). Developing strategies of optimal recruitment of PWID for HCV vaccine trials could reduce sample size, follow-up costs and disparities in enrollment. We investigate trial recruitment informed by machine learning and evaluate a strategy for HCV vaccine trials termed PREDICTEE—Predictive Recruitment and Enrichment method balancing Demographics and Incidence for Clinical Trial Equity and Efficiency. PREDICTEE utilizes a survival analysis model applied to trial candidates, considering their demographic and injection characteristics to predict the candidate’s probability of HCV infection during the trial. The decision to recruit considers both the candidate’s predicted incidence and demographic characteristics such as age, sex, and race. We evaluated PREDICTEE using in silico methods, in which we first generated a synthetic candidate pool and their respective HCV infection events using HepCEP, a validated agent-based simulation model of HCV transmission among PWID in metropolitan Chicago. We then compared PREDICTEE to conventional recruitment of high-risk PWID who share drugs or injection equipment in terms of sample size and recruitment equity, with the latter measured by participation-to-prevalence ratio (PPR) across age, sex, and race. Comparing conventional recruitment to PREDICTEE found a reduction in sample size from 802 (95%: 642–1010) to 278 (95%: 264–294) with PREDICTEE, while also reducing screening requirements by 30%. Simultaneously, PPR increased from 0.475 (95%: 0.356–0.568) to 0.754 (95%: 0.685–0.834). Even when targeting a dissimilar maximally balanced population in which achieving recruitment equity would be more difficult, PREDICTEE is able to reduce sample size from 802 (95%: 642–1010) to 304 (95%: 288–322) while improving PPR to 0.807 (95%: 0.792–0.821). PREDICTEE presents a promising strategy for HCV clinical trial recruitment, achieving sample size reduction while improving recruitment equity.
]]>Healthcare doi: 10.3390/healthcare12060641
Authors: Luz Myriam Reynales-Shigematsu Leonor Rivera-Rivera Marina Séris-Martínez Belen Saenz-de-Miera
Depression, suicidal behavior, excessive alcohol intake, and tobacco use are the main mental health problems in adolescents. To address these problems, it is necessary to understand the many factors associated with them, including parental factors. The aim of this study was to assess the associations between parental behavior and mental health problems in adolescents in Mexico. Data from the National Health and Nutrition Survey (ENSANUT) 2018–2019, representative for Mexico, were used. Households in which a parent–adolescent child pairing was identified (regardless of family type) were selected; n = 8758 households. The four outcomes of interest that were measured in the adolescents were: excessive alcohol intake, tobacco use, suicidal behavior, and depressive symptomatology. Logistic regression models using the adjusted odds ratio (AOR) and 95% confidence interval (95% CI) were estimated. Adolescents whose parents used alcohol or tobacco and reported depressive symptoms and suicidal behavior were more likely to present these behaviors themselves (AOR = 1.47, 95% CI: 1.17–1.85; AOR = 2.26, 95% CI: 1.51–3.39; AOR = 2.61, 95% CI: 1.88–3.61; AOR = 1.74, 95% CI: 1.16–2.61, respectively). Child sexual abuse was also strongly associated with the four outcomes of interest in adolescents (AOR = 1.89, 95% CI: 1.06–3.36 for excessive alcohol intake; AOR = 2.97, 95% CI: 1.49–5.91 for tobacco use; AOR = 5.15, 95% CI: 3.27–8.09 for depressive symptoms; AOR = 6.71, 95% CI: 4.25–10.59 for suicidal behavior). The family constitutes the central nucleus of care for children and adolescents; therefore, any effort to promote adolescent mental health must necessarily involve their parents and family.
]]>Healthcare doi: 10.3390/healthcare12060643
Authors: Melanie Davis Brian Neelon John L. Pearce Danira Medunjanin Elizabeth Bast Robert Neal Axon Hermes Florez Kelly J. Hunt
While telemedicine infrastructure was in place within the Veterans Health Administration (VHA) healthcare system before the onset of the COVID-19 pandemic, geographically varying ordinances/closures disrupted vital care for chronic disease patients such as those with type 2 diabetes. We created a national cohort of 1,647,158 non-Hispanic White, non-Hispanic Black, and Hispanic veterans with diabetes including patients with at least one primary care visit and HbA1c lab result between 3.5% and 20% in the fiscal year (FY) 2018 or 2019. For each VAMC, the proportion of telehealth visits in FY 2019 was calculated. Two logistic Bayesian spatial models were employed for in-person primary care or telehealth primary care in the fourth quarter of the FY 2020, with spatial random effects incorporated at the VA medical center (MC) catchment area level. Finally, we computed and mapped the posterior probability of receipt of primary care for an “average” patient within each catchment area. Non-Hispanic Black veterans and Hispanic veterans were less likely to receive in-person primary care but more likely to receive tele-primary care than non-Hispanic white veterans during the study period. Veterans living in the most socially vulnerable areas were more likely to receive telehealth primary care in the fourth quarter of FY 2020 compared to the least socially vulnerable group but were less likely to receive in-person care. In summary, racial minorities and those in the most socially vulnerable areas were less likely to receive in-person primary care but more likely to receive telehealth primary care, potentially indicating a disparity in the impact of the pandemic across these groups.
]]>Healthcare doi: 10.3390/healthcare12060642
Authors: Kuntal Chowdhary Zachary Crockett Jason Chua Jennifer Soo Hoo
In recent years, the surge in sport and exercise participation, particularly in running, has coincided with the widespread adoption of running-related technology, such as fitness trackers. This study investigates the correlation between the use of running-related technology and running-related injuries among recreational and elite long-distance runners. We conducted a quantitative, cross-sectional online survey of 282 adult runners. Data were analyzed using descriptive statistics and a multivariable logistic regression analysis. Participants, with an average age of 37.4 years, reported varied running experience, with 90.07% utilizing running-related technology during their runs to some degree, primarily smartwatches like Garmin and Apple Watch. Running-related technology users showed a higher likelihood of experiencing running-related injuries compared to non-users (OR = 0.31, p < 0.001). However, those who utilized the metrics obtained from running-related technology to guide their training decisions did not exhibit a higher risk of injury. This nuanced relationship highlights the importance of considering individual training behaviors and the potential psychological impacts of technology on running practices. The study underscores the need for future research integrating biomechanical and psychosocial factors into running-related technology to enhance injury prevention strategies.
]]>Healthcare doi: 10.3390/healthcare12060640
Authors: Abdullah M. Alshahrani Mohammad S. Al-Shahrani Elhadi Miskeen Muffarah Hamid Alharthi Mohannad Mohammad S. Alamri Mohammed A. Alqahtani Mutasim E. Ibrahim
Background: Identifying the potential factors of depression among medical students is the first step towards academic excellence and future safe medical practice. Methods: A cross-sectional study was conducted from December 2019 to February 2020 at the University of Bisha, College of Medicine (UBCOM), Bisha Province, Saudi Arabia. Male medical students from year one to year six were involved. A self-administered questionnaire was used to collect data about students’ socio-demographic and academic characteristics. The Arabic version of the PHQ-9 scale with a score of ≥10 was used to identify depression. Logistic regression analysis was used to assess the prevalence and correlates of depression. Results: Of the 190 male students enrolled, 26.8% had depressive symptoms, of whom 45.1% were experiencing moderate to severe symptoms. The significantly highest depression rate was found among the second-year students, at 43.8% (OR = 2.544; 95% CI 1.178–5.714; p = 0.018), and the lowest rate was found among year one students, at 8.9% (OR = 0.203; 95% CI 0.075–0.560; p = 0.002). Univariate regression revealed a significant correlation between depression and dissatisfaction with family income, loss of family members, having psychological illness, difficulties in personal relationships, regretting studying medicine, failure in an academic year, a lower grade than expected, conflict with tutors, lack of college facilities and heavy academic load. In multivariate analysis, loss of family members (AOR = 3.69; 95% CI 1.86–7.413), difficulties in personal relationships (AOR = 2.371; 95% CI 1.009–5.575), regretting studying medicine (AOR = 3.764; 95% CI 1.657–8.550), and failing an academic year (AOR = 2.559; 95% CI 1.112–5.887) were independently correlated with depression. Conclusions: The study concluded that medical students at UBCOM experience depressive symptoms associated with various risk indicators. Optimizing the educational and social environment and infrastructure facilities at UBCOM might promote students’ mental health and well-being.
]]>Healthcare doi: 10.3390/healthcare12060639
Authors: Nawal Alissa Mawaddah Alshareef
Background: Exclusive breastfeeding is defined as the practice of providing infants with breast milk as their sole source of nourishment for the first six months of life. This study investigated the factors influencing exclusive breastfeeding practices in Makkah, Saudi Arabia. Methods: The study employed a descriptive cross-sectional study design. Data gathered from 340 mothers attending the Maternity and Childhood Hospital in Makkah provided insights into the demographic profiles and postpartum practices of participants. Results: The study revealed the significance of early breastfeeding initiation and the provision of pre-birth breastfeeding information in extending the duration of exclusive breastfeeding. There was a statistically significant difference between mothers who had Cesarean section deliveries and those who had natural deliveries in terms of exclusive breastfeeding duration. Conclusions: These findings have essential implications for healthcare professionals, policymakers, and future research endeavors, emphasizing the importance of healthcare education and timely support in promoting extended exclusive breastfeeding practices.
]]>Healthcare doi: 10.3390/healthcare12060638
Authors: Sofia Pavanello Decaro Antonio Prunas
This study investigates the relationship between sexual quality of life (SQoL) and internalized homonegativity among Italian lesbian and bisexual cisgender women, drawing on the minority stress model. The aim of this study is to compare levels of internalized homonegativity and SQoL between the two groups, exploring the association between these variables. We used a quantitative methodology based on a questionnaire. The data were collected through an online questionnaire from 686 women, including 217 lesbians and 469 bisexuals, using the Lesbian Internalized Homophobia Scale and the Female-Sexual Quality of Life Questionnaire. Statistical analyses, including t-tests and linear regression, were performed to assess group differences and predictors of SQoL. The findings support the hypothesis that bisexual women may experience higher levels of internalized homonegativity. Additionally, the study reveals disparities in SQoL, with lesbian women reporting better outcomes. The linear regression model confirmed a significant negative association between internalized homonegativity and SQoL. The results highlight the need for further research on factors influencing sexual well-being in sexual minority women, and the need to give thorough attention to specific sexual identities in clinical and research practice.
]]>Healthcare doi: 10.3390/healthcare12060635
Authors: Anthony Montgomery Olga Lainidi Katerina Georganta
Healthcare management faces significant challenges related to upward communication. Sharing information in healthcare is crucial to the improvement of person-centered, safe, and effective patient care. An adverse event (AE) is an unintended or unexpected incident that causes harm to a patient and may lead to temporary or permanent disability. Learning from adverse events in healthcare is crucial to the improvement of patient safety and quality of care. Informal communication channels represent an untapped resource with regard to gathering data about the development of AEs. In this viewpoint paper, we start by identifying how informal communication played a key factor in some high-profile adverse events. Then, we present three Critical Challenge points that examine the role of informal communication in adverse events by (1) understanding how the prevailing trends in healthcare will make informal communication more important, (2) explaining how informal communication is part of the group-level sensemaking process, and (3) highlighting the potential role of informal communication in “breaking the silence” around critical and adverse events. Gossip, as one of the most important sources of informal communication, was examined in depth. Delineating the role of informal communication and adverse events within the healthcare context is pivotal to understanding and improving team and upward communication in healthcare organizations. For clinical leaders, the challenge is to cultivate a climate of communication safety, whereby informal communication channels can be used to collect soft intelligence that are paths to improving the quality of care and patient safety.
]]>Healthcare doi: 10.3390/healthcare12060637
Authors: Verena Fuhrmann Bettina Wandl Anton N. Laggner Dominik Roth
This study compared the treatment outcomes of acute exacerbation of COPD (AECOPD) at an academic tertiary care emergency department before and during the COVID-19 pandemic. Analyzing data from 976 patients, our study showed a significant surge in overall respiratory therapy interventions amidst the noticeable decline in the total number of AECOPD cases during the pandemic. The marked increase in the utilization of non-invasive ventilation (NIV) was particularly important, soaring from 12% to 18% during the pandemic. Interestingly, this heightened reliance on NIV stood in contrast to the stability observed in other therapeutic modalities, including oxygen insufflation alone, high-flow nasal cannulas, and invasive ventilation. This distinctive treatment pattern underscores the adaptability of healthcare providers in the face of novel challenges, with a discernible emphasis on the strategic utilization of NIV. The shift in patient acuity during the pandemic became evident as the data showed a cohort of individuals presenting with AECOPD who were more severely ill. This was reflected in the increased use of NIV and, notably, a statistically significant rise in one-year mortality rates—from 32% before the pandemic to 38% during the pandemic (p = 0.046). These findings underscore the intricate balance healthcare providers must strike in navigating the complexities of patient care during a public health crisis. A closer examination of the longitudinal trajectory revealed a subtle decrease in re-admission rates from 65% to 60%. The increased reliance on NIV, a key finding of this investigation, reflects a strategic response to the unique demands of the pandemic, potentially influenced by both medical considerations and non-medical factors, such as the prevalent “fear of aerosols” and the imperative to navigate transmission risks within the healthcare setting. These insights contribute to understanding the evolving dynamics of AECOPD management during public health crises.
]]>Healthcare doi: 10.3390/healthcare12060636
Authors: Ahmad H. Almadani Maha S. Algazlan Abdulaziz F. Alfraiji Nawaf Y. Almalki
Hypothyroidism is a common side effect of lithium use and is associated with a slower response to treatment and poorer long-term remission in patients with bipolar disorder. No studies have examined the prevalence of lithium-associated hypothyroidism or its associated factors in Saudi Arabia. We aimed to estimate the prevalence of lithium-associated hypothyroidism among psychiatric patients in a specialized lithium clinic at a tertiary care hospital in Saudi Arabia and to examine the possible risk factors for its development. This retrospective observational study included 117 participants. The prevalence of secondary hypothyroidism was 15%. The median duration between the start of lithium therapy and the first abnormal thyroid test result was 341 days. The multiple logistic regression showed that none of the studied variables, namely, sex, current age, age of lithium initiation, continuity on lithium, lithium level (≤0.5 mmol/L or >0.5 mmol/L), and prescription of as-needed medications, was significantly associated with secondary hypothyroidism. Our study also shed light on the possible clinical significance of baseline TSH levels in developing hypothyroidism secondary to lithium. Further multicenter studies with larger sample sizes are warranted to examine the generalizability of these results.
]]>Healthcare doi: 10.3390/healthcare12060634
Authors: Sergio Hidalgo-Fuentes Isabel Martínez-Álvarez María Josefa Sospedra-Baeza Manuel Martí-Vilar César Merino-Soto Filiberto Toledano-Toledano
The well-being of people is a key aspect of the field of psychology. Hence, it is important to analyse the variables that are related to life satisfaction and happiness as perceived by individuals and that, therefore, increase their overall well-being. The main objective of this study was to analyse the predictive capacity of emotional intelligence and perceived social support on both the level of life satisfaction and perceived happiness. A total of 380 psychology students completed the Trait Meta Mood Scale, the Multidimensional Scale of Perceived Social Support, the Satisfaction with Life Scale, and the Subjective Happiness Scale. The results show that both emotional intelligence and social support are related to and predictive of subjective happiness and life satisfaction. The importance of developing the components of emotional intelligence and promoting an adequate social network in young people is highlighted.
]]>Healthcare doi: 10.3390/healthcare12060633
Authors: Philip A. Arnone Andrew E. McCanse Derek S. Farmen Mark V. Alano Nicholas J. Weber Shawn P. Thomas Austin H. Webster
While some research supports utilizing plain radiography for measuring biomechanical alignment of the spine for prognosis and treatment, there are contrasting viewpoints regarding both the value and utilization of these procedures in conservative care. Evaluation of both conservative and non-conservative approaches to spinal care revealed vast differences in radiographic utilization and interpretation between orthopedic surgeons, primary care physicians, chiropractic physicians, and physical therapists, which may account for the different viewpoints and rationales in the literature. A research summary is provided to explore any unique biomechanical parameters identified with plain radiography of the spine (PROTS) and how these measurements may relate to patient health. Understanding any unique value provided through biomechanical assessment utilizing PROTS may help chiropractic physicians determine the appropriate use of radiographic procedures in clinical practice and how to coordinate efforts with other conservative and non-conservative spinal healthcare professions to improve patient health.
]]>Healthcare doi: 10.3390/healthcare12060631
Authors: Simona Pajaujiene Luca Petrigna
Background: In recent years, new technologies such as the introduction of the smartphone and the tablet in everyday life and habits have often made adolescents sedentary. It is becoming a serious problem in society. It is important to propose, as soon as possible, proper and feasible programs to modify this trend. A solution should be to increase physical activity, reducing sedentary behaviors. Adopting dogs and walking and playing with them could be a solution, and the population should be sensitized about this aspect. Consequently, the objective of this scoping revision of the literature is to analyze the association between physical activity in adolescents and the presence of a dog in the family. Methods: Three electronic databases were screened until 21 February 2024. The detected articles were screened against the eligibility criteria. The results were narratively discussed. Results: After the screening process, a total of four studies were included. The studies presented heterogeneity in the physical activity assessment. This made it hard to synthesize the results. Indicatively, there is a positive association between physical activity and dog ownership. Conclusions: walking and playing with the dog increase the physical activity level of adolescents. Therefore, a sensibilization campaign should highlight the importance of having dogs in families, especially in adolescence. It is fundamental to daily walk and play with them.
]]>Healthcare doi: 10.3390/healthcare12060632
Authors: Palanikumar Balasundaram Mohamed Sakr
Background: Mechanical ventilation in preterm neonates aims for synchrony, preventing complications such as lung injury. Neurally Adjusted Ventilatory Assist (NAVA) is a unique mode relying on diaphragmatic electrical signals for synchronization. We conducted a review focusing on the long-term consequences of using invasive NAVA in neonates with a focus on bronchopulmonary dysplasia (BPD). Methods: A systematic review following PRISMA explored invasive NAVA in preterm neonates. Primary objectives compared NAVA to conventional ventilation, assessing BPD incidence, ventilation duration, length of stay, and adverse events. Secondary objectives analyzed ventilator parameters. Results: After screening 282 records, the review incorporated two randomized controlled trials for primary outcomes and seven trials for secondary outcomes, including two randomized crossovers, four prospective crossovers, and one retrospective study. NAVA showed reduced oxygen requirement at 28 days but no significant differences in oxygen need at 36 weeks postmenstrual age, total length of stay, or ventilator days. Substantial variations were not observed in adverse events. Ventilator variables favored NAVA, indicating decreased peak inspiratory pressure, tidal volume, work of breathing, and respiratory severity score. Conclusion: Our study found no significant reduction in BPD with NAVA despite short-term benefits. Future large-scale trials are essential to assess NAVA’s impact on long-term outcomes comprehensively.
]]>Healthcare doi: 10.3390/healthcare12060630
Authors: Fahad Alzahrani Reem A. Alhusayni Nosaiba B. Khairi Ammar A. Bahauddin Shadi Tamur
Background: In Saudi Arabia, cardiovascular diseases (CVDs) establish a significant health challenge, with a high prevalence and substantial impact on mortality and disability burden. Evaluating the knowledge, attitude, and practices (KAPs) of hospital pharmacy professionals towards CVDs prevention and management is crucial for effective healthcare strategies. Methods: A cross-sectional, multicenter study was conducted using a self-administered survey targeting hospital pharmacists and pharmacy technicians in the Madinah region of Saudi Arabia. The survey assessed their KAPs towards CVDs prevention and management, incorporating demographic variables and perceived barriers. Results: Out of 177 contacted pharmacy professionals, 159 (89.8%) completed the survey. The study results revealed inadequate knowledge levels with an average score of 3.87 out of 7, indicating significant gaps in comprehending drug interactions, managing lipid levels, and addressing resistant hypertension. Attitudes were generally positive towards CVDs prevention. Practices in CVDs prevention were satisfactory but varied, with notable gaps in providing educational materials and collaboration with other healthcare professionals. Major barriers included time constraints, lack of private counseling areas, and low patient expectations regarding pharmacy professionals’ roles. Conclusion: The study has uncovered notable deficiencies in cardiovascular care, especially within the realm of hospital pharmacy professionals in Saudi Arabia’s Madinah region. This finding underscores the importance of implementing specialized educational initiatives and ongoing professional development programs for these healthcare workers. By focusing on these areas and overcoming the challenges identified, we can significantly improve the contribution of hospital pharmacy professionals in Saudi Arabia toward the prevention and management of cardiovascular diseases.
]]>Healthcare doi: 10.3390/healthcare12060629
Authors: Daniela Rappold Stefan Stättner Elisabeth Nöhammer
Background: ERAS® (Enhanced Recovery after Surgery) is an evidence-based multidisciplinary approach focusing on optimizing outcomes after surgery through structured clinical pathways. This study aimed to assess patient-reported outcome and experience measures (PROM/PREM), which are not routinely assessed after liver surgery within an ERAS® protocol. Methods: Routine outcome parameters were extracted from clinical documentation. Using qualitative content analysis, PROM and PREM were retrospectively identified in 13 case records. In a prospective survey of 10 participants, PROM was assessed at three timepoints using the EQ-5D-5L questionnaire. PREM were collected at discharge. Results: The following PROM categories occurred in the retrospective content analysis: appetite (84.6%), pain/discomfort (76.9%), mobility (69.2%), wound condition (69.2%), and weight (61.5%). The categories of continuity of care (92.0%) and information, communication, education (69.0%) emerged as PREM. Descriptive changes in health state were shown for all EQ-5D-5L dimensions and timepoints. At discharge, mobility, selfcare, usual activities, and pain/discomfort tended to be worse, whereas anxiety/depression decreased gradually from preoperatively to the 4 week follow-up. There was high satisfaction with interprofessional care services and experienced cooperation between professionals. Conclusions: PROM and PREM are helpful to incorporate patients’ perspectives after liver surgery within an ERAS® pathway and should be collected routinely in clinical practice.
]]>Healthcare doi: 10.3390/healthcare12060628
Authors: Lene Lauge Berring Eugenie Georgaca Sophie Hirsch Hülya Bilgin Burcu Kömürcü Akik Merve Aydin Evi Verbeke Gian Maria Galeazzi Stijn Vanheule Davide Bertani
Background: Being subjected to or witnessing coercive measures in mental health services can have a negative impact on service users, carers and professionals, as they most often are experienced as dehumanising and traumatic. Coercion should be avoided, but when it does happen, it is important to understand how the experience can be processed so that its consequences are managed. Method: A systematic review and meta-ethnography was used to synthesise findings from qualitative studies that examined service users’, staff’s and relatives’ experiences of recovery from being exposed to coercive measures in mental health care settings. We identified, extracted and synthesised, across 23 studies, the processes and factors that were interpreted as significant to process the experience. Results: Recovery from coercion is dependent on a complex set of conditions that support a sense of dignity and respect, a feeling of safety and empowerment. Being in a facilitating environment, receiving appropriate information and having consistent reciprocal communication with staff are the means through which these conditions can be achieved. People employ strategies to achieve recovery, both during and after coercion, to minimise its impact and process the experience. Conclusions: The findings point to the importance of mental health care settings offering recovery-oriented environments and mental health professionals employing recovery-oriented practices, that would empower service users to develop strategies for managing their mental distress as well as their experiences in mental health care in a way that minimises traumatisation and fosters recovery.
]]>Healthcare doi: 10.3390/healthcare12060627
Authors: Ozana Brito Guilherme Fregonezi Karen Pondofe Rayane Grayce da Silva Vieira Tatiana Ribeiro Mário Emílio Dourado Júnior Emanuela Coriolano Fidelix Danilo Nagem Ricardo Valentim Antonio Sarmento Vanessa Resqueti
This study aimed to monitor the clinical and functional progression of patients with amyotrophic lateral sclerosis (ALS) and adjust ventilatory support during the COVID-19 pandemic in Brazil using telemedicine. This longitudinal case series included five evaluations from January 2019 to June 2021. The first and second assessments were performed in person and consisted of pulmonary function, respiratory muscle strength, functionality (ALS Functional Rating Scale—Revised [ALSFRS-R]) and disease staging (King’s College criteria). The use of non-invasive ventilation (NIV), ALSFRS-R, and disease staging were assessed in the third, fourth, and fifth assessments during the COVID-19 pandemic, using telemedicine. The rate of functional decline was calculated by the difference in the total score of ALSFRS-R between evaluations. A cutoff of 0.77 in the ALSFRS-R was used to characterize the speed of functional decline. Eleven patients (mean age of 51 years, eight males) were assessed. The total score of the ALSFRS-R (p < 0.01) and its motor domain (p < 0.01) reduced significantly during the pandemic. NIV prescription increased from 54.4% to 83.3%. Telemedicine helped with the clinical and functional follow-up of patients with ALS.
]]>Healthcare doi: 10.3390/healthcare12060626
Authors: Benedikt Bachmetjev Artur Airapetian Rolandas Zablockis
Euthanasia and assisted suicide, involving the intentional termination of a patient’s life, are subjects of global debate influenced by cultural, ethical, and religious beliefs. This study explored the attitudes of the general public toward euthanasia, finding varying levels of support. A cross-sectional study was conducted. This research specifically evaluated the perspectives of 5804 Lithuanian residents using a survey distributed through social media, which presented medical scenarios on life-preserving interventions. Analysis indicated that gender, religion, experience in caring for patients in a terminal condition, education, and age significantly influenced the attitudes of the respondents toward end-of-life decisions. Specifically, factors like being non-religious or having less experience in caring for the terminally ill correlated with a more positive opinion regarding euthanasia and other forms of medical assistance in dying.
]]>Healthcare doi: 10.3390/healthcare12060625
Authors: Wai Lim Ku Hua Min
Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) pose significant burdens on individuals and society, necessitating accurate prediction methods. Machine learning (ML) algorithms utilizing electronic health records and survey data offer promising tools for forecasting these conditions. However, potential bias and inaccuracies inherent in subjective survey responses can undermine the precision of such predictions. This research investigates the reliability of five prominent ML algorithms—a Convolutional Neural Network (CNN), Random Forest, XGBoost, Logistic Regression, and Naive Bayes—in predicting MDD and GAD. A dataset rich in biomedical, demographic, and self-reported survey information is used to assess the algorithms’ performance under different levels of subjective response inaccuracies. These inaccuracies simulate scenarios with potential memory recall bias and subjective interpretations. While all algorithms demonstrate commendable accuracy with high-quality survey data, their performance diverges significantly when encountering erroneous or biased responses. Notably, the CNN exhibits superior resilience in this context, maintaining performance and even achieving enhanced accuracy, Cohen’s kappa score, and positive precision for both MDD and GAD. This highlights the CNN’s superior ability to handle data unreliability, making it a potentially advantageous choice for predicting mental health conditions based on self-reported data. These findings underscore the critical importance of algorithmic resilience in mental health prediction, particularly when relying on subjective data. They emphasize the need for careful algorithm selection in such contexts, with the CNN emerging as a promising candidate due to its robustness and improved performance under data uncertainties.
]]>Healthcare doi: 10.3390/healthcare12060624
Authors: Cristina González-Sánchez José Jiménez-Cabello Sonia Rodríguez-Ruíz José Luis Mata-Martín
Nowadays, obesity (OB) is one of the most important health problems in population-wide health. In addition to its physical consequences, it is a risk factor for the development of psychological problems, including body dissatisfaction (BD). This is why the treatment of BD is essential for its prevention. However, this has mostly been studied from a quantitative perspective, without focusing on the discomfort experienced by the person and the accompanying thoughts and emotions. In this study, 26 women with obesity (BMI > 30 kg/m2) participated, of whom 16 had high BD and 10 had low BD, as measured by the BSQ questionnaire. The women with high BD underwent six sessions of exposure to their own body in front of a mirror, recording the discomfort experienced with this vision during the session. In addition, all participants recorded positive and negative thoughts towards their body before and after these sessions. After the exposure treatment sessions, a reduction in symptomatology (BD, discomfort when visualizing one’s own body) was observed, as well as a change in the thoughts expressed by the participants, both in quantity (fewer negative thoughts) and in quality (a more positive self-perception and/or in more respectful terms used towards themselves). In conclusion, such treatments prove to be effective in reducing subjective discomfort and body-related thoughts in women with obesity.
]]>Healthcare doi: 10.3390/healthcare12060623
Authors: Petros Galanis Ioannis Moisoglou Aglaia Katsiroumpa Maria Mastrogianni
Workplace bullying affects workers’ lives, causing several mental and physical health problems and job-related issues. Therefore, a summary of the evidence on the consequences of workplace bullying on workers’ lives is essential to improve working conditions. The literature lacks systematic reviews and meta-analyses on the association between workplace bullying and job stress and the professional quality of life of nurses. Thus, we aimed to quantitatively summarize the data on the association between workplace bullying, job stress, and professional quality of life. We performed our study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The review protocol was registered with PROSPERO (CRD42024495948). We searched PubMed, Medline, Scopus, Cinahl, and Web of Science up to 4 January 2024. We calculated pooled correlation coefficients and 95% confidence intervals [CI]. We identified nine studies with a total of 3730 nurses. We found a moderate positive correlation between workplace bullying and job stress (pooled correlation coefficient = 0.34, 95% CI = 0.29 to 0.39). Moreover, a small negative correlation between workplace bullying and compassion satisfaction (pooled correlation coefficient = −0.28, 95% CI = −0.41 to −0.15) was identified. Additionally, our findings suggested a moderate positive correlation between workplace bullying and job burnout (pooled correlation coefficient = 0.43, 95% CI = 0.32 to 0.53) and secondary traumatic stress (pooled correlation coefficient = 0.36, 95% CI = 0.11 to 0.57). Our findings can help nursing managers and policy-makers to draw attention to workplace bullying by implementing effective interventions, so as to reduce the bullying of nurses.
]]>Healthcare doi: 10.3390/healthcare12060622
Authors: Ricardo Fandiño Juan Basanta Francisca Fariña Ramón Arce
Aim: Child-to-parent offenders (CPOs) are commonly specialist offenders and with high rates of recidivism. Thus, a field study was designed to estimate the prevalence of recidivism in the reference measures of recidivism i.e., dangerousness, risk factors and psychopathy, and compare CPOs with non-child-to-parent juvenile offenders (non-CPOs). Method: A total of 136 juvenile offenders (76.5% boys), 76 CPOs and 60 non-CPOs, aged from 14 to 18 years old, were measured in terms of dangerousness, risk factors and psychopathic traits. Results: For CPOs, the results show a more than common prevalence (>0.50), 75.0%, 95% CI [0.653, 0.847]) of dangerousness (caseness); a significant prevalence (>0.05) of diagnostic psychopathy (25.0%, 95% CI [0.150, 0.350]); and a common prevalence (=0.50), 55.3%, 95% CI [0.441, 0.665]) of classifications of high- and very high-risk factors. Comparatively, no significant differences were observed between CPOs and non-CPOs in terms of mental health problems (dangerousness); meanwhile CPOs exhibited significantly more interpersonal and affective psychopathic traits and significantly higher risks in family circumstances/parenting, and personality and behavior risk factors. Conclusions: The implications for prevention and intervention programs with CPOs are discussed.
]]>Healthcare doi: 10.3390/healthcare12060621
Authors: Maura Crepaldi Jessica Giannì Agostino Brugnera Andrea Greco Angelo Compare Maria Luisa Rusconi Barbara Poletti Stefano Omboni Giorgio Angelo Tasca Gianfranco Parati
Previous research has highlighted the positive impact of greater health-related quality of life (Hr-QoL) and subjective well-being (SWB) on chronic diseases’ severity and progression. There is a paucity of studies investigating the long-term trajectories of these variables among hypertensive patients. The present study aims to investigate the relationships between psychological variables (Type A and D personality, locus of control—LoC, self-esteem, and trait anxiety) with SWB and Hr-QoL in patients with hypertension and comorbid metabolic syndrome. A total of 185 volunteer patients (130 males, 70.3%; mean age 54 ± 10.93) were enrolled. Patients filled out measures of Hr-QoL and SWB, LoC, and self-esteem at three time points—Type A and D behaviors and anxiety measures only at baseline. Analyses were run through two-level hierarchical mixed models with repeated measures (Level 1) nested within participants (Level 2), controlling for sociodemographic and clinical confounders. Neither Hr-QoL nor SWB changed over time. Patients with greater self-esteem and internal LoC (and lower external LoC) increased their SWB and Hr-QoL up to 1-year follow-up. A greater Type A behavior and trait anxiety at baseline predicted a longitudinal increase in most of the dependent variables. Results suggest that it could be useful to tailor interventions targeting specific variables to increase Hr-QoL and SWB among hypertensive patients.
]]>Healthcare doi: 10.3390/healthcare12060620
Authors: Lotte Bock Madiha Rana Lara Westemeyer Majeed Rana
The diagnosis of a chronic disease, such as multiple sclerosis, has both psychological and physical effects. Living with the disease and its uncertain consequences requires a great deal of psychological resilience in order to employ more comprehensive coping strategies in stressful situations. This study investigated the effect of a four-week online self-directed resilience training program on the perception of psychological resilience among multiple sclerosis patients. A total of 94 MS patients were recruited for a randomised controlled trial. The experimental group underwent a 28-day online self-directed training program consisting of daily exercises aimed at strengthening a resilient mindset. Psychological resilience was measured through self-assessment immediately before, immediately after, and three months after the training. A repeated measures ANOVA revealed a statistically significant improvement in the perception of four factors related to stress: perceived worries, tension, joy, and demands. Two resilience coping strategies were measured, of which one, a resilient orientation, improved significantly in the short and long term. The study suggests that online self-directed resilience training might provide an easily accessible, low-cost option for patients with MS to improve their psychological resilience. This is a pilot study to assess the general applicability to people with MS. Future studies should examine the transferability of results in relation to disease stage and co-morbidities.
]]>Healthcare doi: 10.3390/healthcare12060619
Authors: Susanne Stampa Christine Thienel Pinar Tokgöz Oliver Razum Christoph Dockweiler
Due to the coronavirus pandemic, telerehabilitation has become increasingly important worldwide. While the effectiveness of telerehabilitation is considered proven for many indications, there is comparatively little knowledge about the implementation conditions. Therefore, this scoping review summarises the current state of facilitating and inhibiting factors that may influence the uptake of telerehabilitation. The review follows the JBI methodology for scoping reviews. The article search was carried out in five databases (MEDLINE, EMBASE, Web of Science, Cochrane and Psyndex) in May 2022, with an update in October 2023. Two independent researchers identified relevant studies according to the inclusion and exclusion criteria. The Consolidated Framework for Implementation Research served as the theoretical basis for the categorisation of the facilitating and inhibiting criteria in the organisational context. A total of 28 studies (timespan 2012 to 2023) have been included. The most relevant barriers identified are technical issues and a lack of technical skills. The factors considered most favourable for implementation are patients’ motivation and the involvement of high-level leaders. The results provide clear indications of factors that inhibit and facilitate implementation, but also show that further research is needed.
]]>Healthcare doi: 10.3390/healthcare12060618
Authors: Doreen Mainza Shempela Jay Sikalima Jim Mwandia Ernest Mwila Rodgers Chilyabanyama Mike Masona Cynthia Banda Kasonde Andrew Mwandila Hector Kamalamba Maisa Kasanga Imukusi Mutanekelwa Steward Mudenda Franco Jordan Kandama Fatim Cham Michael Njuguna Paul McCarrick Linden Morrison Victor Daka Karen Sichinga
Zambia’s adult HIV prevalence is high at 11% and faces challenges in achieving UNAIDS 95-95-95 targets for HIV, with a national viral load suppression of 86.2% falling short of the required 95%. North-Western Province has the lowest viral load suppression at 77.5%. Our study investigated the role of an integrated sample referral system in optimizing HIV viral load coverage and Early Infant Diagnosis turnaround time in the province. Using electronic data from the DISA Laboratory Information System and Smartcare, a retrospective cross-sectional analysis was conducted, involving 160,922 viral load and Early Infant Diagnosis results. The chi-square test and multiple linear regression were used for analysis. Following the implementation of the integrated sample referral system, viral load coverage consistently increased monthly (p < 0.001), Early Infant Diagnosis turnaround time improved by 47.7%, and sample volume increased by 25%. The study identifies associations between various factors and testing outcomes. These findings demonstrate improvements in viral load coverage and the Early Infant Diagnosis turnaround time and suggest targeting modifiable factors to further optimize the referral system. We recommend continued strengthening of the referral system and more deliberate demand-creation implementation strategies.
]]>Healthcare doi: 10.3390/healthcare12060617
Authors: Blanca Gonzalo de Diego Alexandra González Aguña Marta Fernández Batalla Sara Herrero Jaén Andrea Sierra Ortega Roberto Barchino Plata María Lourdes Jiménez Rodríguez José María Santamaría García
In parallel with the development and design of different technological advances, competencies in nursing have advanced. With the development of robotics, it is expected that nursing robotic competencies will also increase. The aim of this study is to review the competencies in nursing robotics. A review was conducted between January 2017 and December 2023. The search strategy was carried out in the MEDLINE database (through PubMed). This review explores the developmental competencies in nursing robotics and informatics. The data extraction in this review included an intentional search for competencies and learning outcomes in engineering and robotic programs. A total of 340 competencies and program outcomes were reviewed. The synthesis of the data established a total of 17 developmental competencies in nursing robotics based on this knowledge extraction, which we organized into five categories: assessment, diagnosis, planning, intervention (implementation) and evaluation. This review suggests that nursing robotic competencies for the development of care robotics are still scarce, and there is an opportunity for the development of competencies and the definition of new roles in the area of nursing informatics in order to adapt to the new health care demands of society.
]]>Healthcare doi: 10.3390/healthcare12060616
Authors: Laura Fernández-Gamero Andrés Reinoso-Cobo María del Carmen Ruiz-González Jonathan Cortés-Martín Inmaculada Muñóz Sánchez Elena Mellado-García Beatriz Piqueras-Sola
In recent times, research has been conducted on the use of hypnosis during childbirth preparation and its effects on pain, fear, and overall childbirth experience. The main objective of this study was to analyze the published scientific literature on the use of hypnotherapy during childbirth preparation and the outcomes achieved during labor. A systematic literature review was conducted following the PRISMA 2020 protocol, with a search performed on the PubMed, Cinahl, Scopus, and WOS databases. Studies meeting inclusion criteria, including randomized controlled trials (RCTs), were evaluated for methodological quality using the PEDro scale. The searches yielded a total of 84 results, from which 7 RCTs of high scientific quality were selected. Each article examined the impact of a hypnosis intervention during pregnancy and the results obtained during labor. The analysis covered the use of epidural anesthesia, pharmacological analgesia during labor, self-reported pain, labor duration, type of delivery, fear of childbirth, and childbirth experience. The results demonstrated benefits in reducing fear and pain during labor, along with an enhancement in the overall childbirth experience. Hypnotherapy can be a valuable resource for reducing fear and pain during labor and improving the lived childbirth experience.
]]>Healthcare doi: 10.3390/healthcare12060615
Authors: Sandra Morelli Giuseppe D’Avenio Carla Daniele Mauro Grigioni Daniele Giansanti
The expanding role of technology assessment in telemedicine is the focus of this study. An umbrella review has been proposed to delve into emerging themes within telemedicine technology assessment by scrutinizing systematic reviews gathered from PubMed and Scopus. The proposed approach was based on a standard narrative checklist and a qualification process. The selection process identified 20 systematic reviews. The main findings underscore the transformative potential of telemedicine, emphasizing technology assessments focused on systematic evaluations, stakeholder engagement, societal impact recognition, targeted interventions, and structured frameworks. While offering valuable insights, the current studies highlight certain limitations that require attention. There is a need for the following: (I) First of all, a more focused approach, primarily centered on a process-centric, multidomain, and generalizable technology assessment (TA). (II) A deeper analysis in specific healthcare areas, including a comprehensive examination of the cost–benefit ratio, peer-to-peer interactions, and a broader inclusion of diagnostic technologies. (III) Greater emphasis on the involved stakeholders, ranging from patients to stakeholders. In conclusion, this study contributes to a comprehensive and nuanced understanding of the continually evolving landscape in telemedicine technology assessment, offering valuable insights for practitioners, researchers, and policymakers alike. Researchers are encouraged to further explore both the established and emerging themes identified in this study.
]]>Healthcare doi: 10.3390/healthcare12060614
Authors: Martim Santos Ana Ferraz Maria Garcia M. Graça Pereira
Pediatric burn injuries are a critical medical condition that triggers a series of ongoing multifactorial stressors that affect both children and their families. To inform healthcare research and clinical practice, this study aimed to understand and describe the perceptions and experiences of the parents of burn-injured children during hospital stay. Forty-six parents (thirty-eight mothers) of forty-six children (eighteen girls) with a mean age of 2.28 years (SD = 1.52) answered ten open-ended questions. This qualitative study was conducted in a referral hospital in the northern region of Portugal. Qualitative data were analyzed using an inductive content analysis. Five key themes emerged from the data analysis: diving into the crisis of the child burn injury, being together and in good hands, becoming aware of an uncertain future, enhancing supportive care and environment, and finding ways to guide parents. Qualitative findings underlined the pressing need for integrated care within this context. Parents were significantly burdened and distressed during the inpatient phase. These parents should be included in the integrated care plan starting from admission. Understanding and addressing parents’ healthcare needs and psychosocial adjustment difficulties is paramount to the development of future intervention programs and the delivery of suitable integrated healthcare.
]]>Healthcare doi: 10.3390/healthcare12060613
Authors: Silmara Meneguin Camila Fernandes Pollo Amanda Vitória Zorzi Segalla Fary Jaqueline Fortaleza Generoso Aniele de Leo Cesar de Oliveira
Objective: To investigate the effects of sociodemographic and working condition variables, as well as the coping strategies used by nurses, on their occupational stress during the COVID-19 pandemic. Methods: A cross-sectional study was conducted with 104 nurses who worked in intensive and emergency care at a public hospital in the state of São Paulo, Brazil. Data collection was performed in person and online using a questionnaire assessing sociodemographic and occupational characteristics, the Nursing Stress Inventory, and the Occupational Coping Scale. Results: The participants had a high level of stress (median = 132), especially in the ‘interpersonal relations’ domain (median = 63), and made little use of occupational coping strategies (median = 87). Income (p = 0.027), work shift (p = 0.028), being on leave from work (p = 0.020), number of hospitals with employment ties (p = 0.001), and relationship with management were independently associated with the levels of stress among the nurses. Conclusion: In the present study, the high levels of stress among nurses were influenced by financial and work-related factors as well as interpersonal relationships. No significant association was found between stress among the nurses and the use of occupational coping strategies.
]]>Healthcare doi: 10.3390/healthcare12060612
Authors: Jamaji C. Nwanaji-Enwerem Tori F. Ehrhardt Brittney Gordon Hannah Meyer Annemarie Cardell Maurice Selby Bradley A. Wallace Matthew Gittinger Jeffrey N. Siegelman
Few studies explore emergency medicine (EM) residency shift scheduling software as a mechanism to reduce administrative demands and broader resident burnout. A local needs assessment demonstrated a learning curve for chief resident schedulers and several areas for improvement. In an institutional quality improvement project, we utilized an external online cross-sectional convenience sampling pilot survey of United States EM residency programs to collect information on manual versus software-based resident shift scheduling practices and associated scheduler and scheduler-perceived resident satisfaction. Our external survey response rate was 19/253 (8%), with all United States regions (i.e., northeast, southeast, midwest, west, and southwest) represented. Two programs (11%) reported manual scheduling without any software. ShiftAdmin was the most popularly reported scheduling software (53%). Although not statistically significant, manual scheduling had the lowest satisfaction score and programs with ≤30 residents reported the highest levels of satisfaction. Our data suggest that improvements in existing software-based technologies are needed. Artificial intelligence technologies may prove useful for reducing administrative scheduling demands and optimizing resident scheduling satisfaction.
]]>Healthcare doi: 10.3390/healthcare12060611
Authors: Pejman Peykani Mir Saman Pishvaee
In the context of healthcare systems, the performance evaluation of hospitals plays a crucial role in assessing the quality of healthcare systems and facilitating informed decision-making processes. However, the presence of data uncertainty poses significant challenges to accurate performance measurement. This paper presents a novel uncertain common-weights data envelopment analysis (UCWDEA) approach for evaluating the performance of hospitals under uncertain environments. The proposed UCWDEA approach addresses the limitations of traditional data envelopment analysis (DEA) models by incorporating the uncertainty theory (UT) to model the inherent uncertainty in input and output data. Also, by utilizing a common set of weights (CSW) technique, the UCWDEA method provides a more robust and reliable assessment of hospital performance. The main advantages of the proposed UCWDEA approach can be succinctly summarized as follows. Firstly, it allows for the comparison of all hospitals on a consistent basis to calculate a realistic efficiency score, rather than an overly optimistic efficiency score. Secondly, the uncertain common-weights DEA approach exhibits linearity, enhancing its applicability. Thirdly, it possesses the capability to extend its utility under various other prevalent uncertainty distributions. Moreover, it enhances the discriminatory power of results, facilitates the ranking of hospitals in the presence of data uncertainty, and aids in identifying the sensitivity and stability levels of hospitals towards data uncertainty. Notably, in order to showcase the pragmatic application and efficacy of the uncertain common-weights DEA model, a genuine dataset has been utilized to evaluate the efficiency of 20 public hospitals in Tehran, all of which are affiliated with the Iran University of Medical Sciences. The results of the experiment demonstrate the efficacy of the UCWDEA approach in assessing and ranking hospitals amidst uncertain conditions. In summary, the research outcomes can offer policymakers valuable insights regarding hospital performance amidst data uncertainty. Additionally, it can provide practical recommendations on optimizing resource allocation, benchmarking performance, and formulating effective policies to augment the overall efficiency and effectiveness of healthcare services.
]]>Healthcare doi: 10.3390/healthcare12060610
Authors: Adelina Tanevski Bogdan Mihnea Ciuntu Oana Viola Badulescu David Ovidiu Buescu Mihai Marius Zuzu Valerii Lutenco Raul Mihailov Ciprian Cirdeiu Dan Vintila Lili Gabriela Lozneanu Dan Andronic Stefan Octavian Georgescu
Surgical emergencies in patients with hemophilia A represent a major risk of mortality without proper multidisciplinary management and require prompt and effective treatment to prevent complications and improve patient outcomes. We present a short number of cases that were hospitalized in the I–II Surgery Clinic of the Emergency County Hospital “St. Spiridon” from Iasi, Romania, with hemophilia A requiring surgical emergencies. The timing of surgical intervention is very important, so the indication for surgical intervention must be made judiciously and without delay. Consequently, it is vital to ensure access to hemostatic support so surgery can be performed on these patients, ultimately saving their lives.
]]>Healthcare doi: 10.3390/healthcare12060609
Authors: Yolanda Mayman Talitha Crowley Brian van Wyk
Adolescents living with HIV (ALHIVs) are considered a priority population in the fight against HIV, requiring dedicated services. The COVID-19 pandemic and subsequent disruptions deprived ALHIVs on antiretroviral therapy (ART) of the care and social support essential for treatment adherence and positive treatment outcomes. This study describes health managers’ and healthcare workers’ responses to the impact of COVID-19 on service delivery to ALHIVs in HIV treatment in the Cape Town Metropole. A descriptive qualitative design was employed, where semi-structured individual interviews (n = 13) were conducted with senior and programme managers as well as healthcare workers between April and October 2023. Inductive thematic analysis was performed using Atlas.ti version 23. Two main themes emerged from these interviews: “HIV service delivery to adolescents during the COVID-19 pandemic” and “Lessons learnt—the way forward”. The de-escalation of health services at primary health facilities and the disruption of HIV services resulted in disengagement from care by ALHIVs, increasing mental health and treatment challenges. This warrants the restoration of psychosocial support services and the re-engagement of ALHIVs. The findings from this study can function as a guide for health systems and healthcare providers to navigate future pandemics to ensure that vulnerable populations such as ALHIVs continue to receive care and treatment.
]]>Healthcare doi: 10.3390/healthcare12060608
Authors: Katarzyna Krefft-Trzciniecka Hanna Cisoń Alicja Pakiet Danuta Nowicka Jacek C. Szepietowski
Background: The study aimed to examine the impact of stem cell treatment on quality of life (QoL) and sexual functioning in women with androgenetic alopecia (AGA). Methods: Twenty-three women underwent a single session of autologous cellular micrografts (ACMs). The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) and Female Sexual Function Index (FSFI) were used before and after 6 months. Results: The AGA severity decreased by an average of 1 point on the Ludwig scale (p = 0.004) after treatment. FSFI scores indicated sexual dysfunction in over half of the women at baseline, but they improved significantly post-treatment for arousal [median (IQR): 4.8 (1.5) vs. 5.10 (0.9); p = 0.035] and satisfaction [4.4 (1.4) vs. 4.8 (1.8); p = 0.025]. QoL scores improved after treatment in psychological health (57.96 ± 19.0 vs. 69.35 ± 14.0; p = 0.031) and environment (72.96 ± 13.4 vs. 81.09 ± 12.6; p = 0.007), but not in physical health and social relationships. No associations were found between the WHOQOL-BREF or FSFI domains versus age and AGA severity. Conclusions: AGA reduces QoL and impacts sexual functioning in women with AGA. The high treatment burden arises from the chronic and progressive nature of AGA, coupled with limited treatment effectiveness. Effective treatments for AGA, like ACM, are urgently needed to enhance patient-reported outcomes along with clinical results.
]]>Healthcare doi: 10.3390/healthcare12060607
Authors: Magde Mohamed Nour Adnan Kisa
This scoping review maps communication strategies employed by political leaders in countries that experienced high infection rates during the COVID-19 pandemic. Using the Arksey and O’Malley scoping review framework, this study systematically explored the literature from 2019 to October 2023. The process involved identifying and selecting relevant studies, charting them, and summarizing the data from the 40 articles that met the inclusion criteria. This review identified a diverse array of communication strategies, which highlight the complex nature of crisis communication. These strategies featured the use of social media, science-based policy communication, strategic narrative control, empathy, ideological influences, and storytelling. These six approaches underscore the importance of adaptability and context-specific strategies in political leadership during a health crisis. The findings demonstrate that political communication during the pandemic varied significantly and was influenced by factors such as media platform, political ideology, gender, and non-verbal cues. This review enriches our understanding of crisis communication in political contexts. It emphasizes the necessity of combining traditional and digital media and considering various sociopolitical factors. The insights gained are crucial for enhancing crisis management and public trust, and they set the stage for further research and practical application in crisis communication.
]]>Healthcare doi: 10.3390/healthcare12060605
Authors: Jessica Morales-Sanhueza Guadalupe Martín-Mora-Parra Isabel Cuadrado-Gordillo
Violence in intimate partner relationships among young adults has become a global health problem given its prevalence and its negative effects on physical and psychological well-being. The severity of the problem has given rise to a large body of research that has attempted to find the variables associated with victimization in young couples (for example, attachment style, emotional regulation skills or empathy, among others). Moreover, traditionally, many of these investigations have only considered the point of view of female victims within a gender violence approach. However, in recent times, more and more evidence of the existence of mutual violence in young relationships has been found. These findings, combined with simplistic explanations of the phenomenon, have proven to be insufficient to prevent it. In this context, the main objective of this study was to investigate how some variables linked to dating violence interact with each other, modifying the mutual violence young people suffer and exercise. Considering this, different instruments were administered (the Experience in Close Relationships Scale (ECR-R); Difficulties in Emotional Regulation Scale (DERS-E); Basic Empathy Scale (BES); and Multidimensional Couple Violence Scale (EMVN)) to a sample of 557 young Chileans. The analysis of the results, based on the construction of a moderated mediation model, reveals that difficulties in emotional regulation are a predictor of violence in intimate partner relationships, whose direct and indirect effects on the violence exercised can be moderated by that partner’s attachment style. The findings also reveal that there is no association between empathy and violence, and they highlight that both men and women are victims and aggressors at the same time. This demonstrate the need to consider prevention and intervention strategies aimed at both sexes, since intimate partner violence is mutual and reciprocal.
]]>Healthcare doi: 10.3390/healthcare12060606
Authors: María del Carmen Celdrán-Navarro Ismael Jiménez-Ruiz A. Myriam Seva-Llor James R. Moore Cesar Leal-Costa
How can we know the reality of the context of bullying in the field of primary health care? The aim of this study is to obtain a validated and reliable tool that allows measurement of the involvement of primary care professionals in addressing bullying through a systematic content validation process. A cross-cultural validation of the Healthcare Provider’s Practices, Attitudes, Self-Confidence, and Knowledge Regarding Bullying Questionnaire was conducted for the Spanish perspective. This involved linguistic adaptation through translation–back-translation, content validity index (CVI) analysis, construct validity using confirmatory factor analysis (CFA), and internal consistency (Cronbach’s α). The total CVI was 0.95, with individual item scores ≥ 0.78. CFA revealed a good fit for the three subscales, with discrimination indices (item–total correlation within the dimension) > 0.30. Cronbach’s α for each dimension indicated a high level of reliability, with values of 0.735 for attitudes, 0.940 for self-confidence, and 0.895 for knowledge. The questionnaire is valid and reliable for evaluating the knowledge, attitudes, and self-confidence of primary care professionals in Spain regarding bullying. Its validity and reliability guarantee its potential use in other health settings and may lead to better training of professionals and school biopsychosocial health.
]]>Healthcare doi: 10.3390/healthcare12060604
Authors: Rey Gutiérrez Tolentino Irina Lazarevich Manuel Abraham Gómez Martínez Jorge Armando Barriguete Meléndez Beatriz Schettino Bermúdez José Jesús Pérez González Rubén del Muro Delgado Claudia Cecilia Radilla Vázquez
Overweight and obesity in adolescents has become a serious public health problem worldwide and Mexico City is no exception. Therefore, the objective of this study was to investigate the epidemiological panorama of overweight and obesity related to eating habits, physical activity and the concurrent presence of depression and anxiety in adolescents from high schools in Mexico City. Anthropometric measurements were taken from 2710 adolescents from 33 participating high schools. Likewise, a previously validated eating habit and physical activity questionnaire was administered, which consisted of four different sections, where each of the sections focused on key aspects of the participants’ lifestyle: (1) eating habits, (2) intake of non-recommended foods, (3) food and company environment, and (4) physical activity. Moreover, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression was applied. In this study, a high prevalence of overweight and obesity (26.5% overweight and 20.0% obese) was found in adolescents from high schools in Mexico City. Only 13.14% of participants had adequate eating habits and 18.19% physical activity habits. An association was found between having inadequate eating habits and obesity in adolescent women (OR = 1.95; CI 1.009–3.76). Additionally, associations were observed between depression symptoms and obesity (OR = 5.68, CI 1.36–32.81; p = 0.01), while anxiety was associated with underweight and obesity adjusted by other dietary habits and psychological factors. Therefore, it is important to identify adolescents with overweight or obesity and establish prevention strategies for weight control in this age group, promoting healthy eating, physical activity and education in mental health.
]]>Healthcare doi: 10.3390/healthcare12060603
Authors: Reisa Hiramatsu Etsuko Ozaki Satomi Tomida Teruhide Koyama
Background: Eating speed has been implicated as a leading cause of metabolic syndrome (MetS). However, it is difficult to break the habit of eating fast. Since coffee consumption is associated with a lower risk of MetS, we investigated the association between eating speed and the amount of coffee consumed with MetS. Methods: This study included data from 3881 participants (2498 females and 1383 males). We used a self-administered questionnaire to collect information on participants’ coffee consumption (<1 cup/day and ≥1 cup/day) and eating speed (slow, normal, or fast). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analyses to investigate the relationship between the prevalence of MetS due to eating speed and the amount of coffee consumed. Results: The group that consumed ≥1 cup/day of coffee (filtered or instant) had a lower OR for MetS compared to the group that consumed <1 cup/day (OR: 0.695; 95% Cl: 0.570–0.847). The eating fast group, compared to the eating slow group, had a higher OR for MetS (OR: 1.689; 95% Cl: 1.227–2.324). When the data were stratified by coffee consumption and eating speed groups, the slow-eating group among those who consumed <1 cup/day of coffee (filtered or instant) had a lower OR for MetS (OR: 0.502; 95% CI: 0.296–0.851) compared to the fast-eating group. In contrast, the groups who consumed ≥1 cup/day of coffee were associated with lower OR for MetS, regardless of their eating speed. Conclusions: This suggests that drinking ≥1 cup/day of coffee may help prevent MetS induced by eating fast.
]]>Healthcare doi: 10.3390/healthcare12060602
Authors: Daniel Schwarzkopf Frank Bloos Winfried Meißner Hendrik Rüddel Daniel O. Thomas-Rüddel Ulrich Wedding
This study assessed differences in interprofessional collaboration, perception of nonbeneficial care, and staff well-being between critical care and palliative care teams. In six German hospitals, a staff survey was conducted between December 2013 and March 2015 among nurses and physicians in intensive and palliative care units. To allow comparability between unit types, a matching was performed for demographic characteristics of staff. N = 313 critical care and 79 palliative care staff participated, of which 72 each were successfully matched. Critical care nurses perceived the poorest overall quality of collaboration compared with critical care physicians and palliative care physicians and nurses. They also reported less inclusive leadership from attendings and head nurses, and the least collaboration on care decisions with physicians. They were most likely to perceive nonbeneficial care, and they reported the lowest levels of job satisfaction and the highest intention to leave the job. In partial correlations, aspects of high-quality collaboration were associated with less perceived nonbeneficial care and higher staff well-being for both critical care and palliative care staff. Our findings indicate that critical care teams could improve collaboration and enhance well-being, particularly among nurses, by adopting principles of collaborative work culture as established in palliative care.
]]>Healthcare doi: 10.3390/healthcare12060601
Authors: Natasa Kusic Vesna Tomic Spiric Snezana Arandjelovic Aleksandra Peric Popadic Ivana Bozic Antic Milan Dimitrijevic Rada Miskovic Ljiljana Stefanovic Aleksandra Plavsic
Background: Drug desensitization allows for safe administration of a drug to a patient with a previous hypersensitivity reaction. Successful desensitization protocols have been described for different medications, including protocols for oncology patients. Few cases of desensitization to sorafenib and imatinib have been described in the literature so far. Objective: The objective of this paper is to describe the process of the sorafenib and imatinib drug hypersensitivity diagnosis and desensitization process in two patients. Methods: Two oncology patients who experienced non-immediate hypersensitivity reactions to sorafenib and imatinib underwent desensitization to these drugs. We designed a protocol for the first patient and used a modified protocol from the literature for the second patient. Results: By using a slow desensitization technique and gradual tapering of corticosteroids and antihistamines, both patients reached the target dose of the incriminated drug. Conclusions: Desensitization to sorafenib and imatinib can be an effective therapeutic option in patients with hypersensitivity to those medications, without alternative treatment options.
]]>Healthcare doi: 10.3390/healthcare12060600
Authors: Doris Mayerhofer Katja Haider Manuela Amon Afsaneh Gächter Teresa O’Rourke Rachel Dale Elke Humer Thomas Probst Christoph Pieh
Although problematic smartphone use (PSU) is prevalent and associated with mental health and physical activity, there are no studies on its prevalence and associations in Austria. The aim of this study was to evaluate the prevalence of PSU and its associations with mental health in adolescents and young adults. A cross-sectional online survey was performed from 19 April to 27 July 2023, and the data of N = 913 respondents (14.1% male, 82.4% female, 3.5% diverse; median age: 17 [IQR: 15–18]; range: 14–20 years) were included in the analyses. Overall, 38.1% (females: 39.0%, males: 33.3%) of those surveyed were above the cut-off for PSU measured with the Smartphone Addiction Scale (SAS-SV). In addition to screen time, PSU is also associated with depressive symptoms (aOR = 1.46), anxiety symptoms (aOR = 1.86), disordered eating (aOR = 1.55), and alcohol abuse (aOR = 1.71), but not physical inactivity. On the other hand, physical inactivity was associated with depressive symptoms (aOR = 2.48), anxiety symptoms (aOR = 1.74), distress (aOR = 2.02), and low well-being (aOR = 3.25). A total of 37.7% respondents reported being strongly lonely, as measured with the De Jong Gierveld Loneliness Scale. The amount of screen time, but not PSU, was associated with loneliness. In sum, PSU affects more than one-third of adolescents and young adults in Austria and is associated with increased mental health symptoms. However, intensive screen time seems to be more strongly associated with increased mental health symptoms than PSU itself. The study confirms once again that smartphone use is associated with negative effects and that they should be used responsibly.
]]>Healthcare doi: 10.3390/healthcare12050599
Authors: Ito Taro Toshimichi Onuma Tetsuji Kurokawa Yoko Chino Akiko Shinagawa Yoshio Yoshida
Cervical cancer incidence is increasing among Japanese women, which is partly attributed to low screening rates. This study examined the implementation of opt-in human papillomavirus (HPV) self-sampling among Japanese women aged 30–39 years who had not undergone cervical cancer screening, focusing on those requiring preconception care. The responses to the opt-in approach and effectiveness in detecting cervical squamous intraepithelial neoplasia 2 or worse (CIN2+) were evaluated. Participants used the Evalyn® Brush for self-sampling, with HPV testing conducted using the Cobas 4800 system (version 2.2.0). Out of 3489 eligible, unscreened women from four municipalities in Fukui Prefecture, only 10.6% (370/3489) requested the self-sampling kit. Of these, 77.3% (286/370) returned the kit (HPV testing rate: 8.2% (286/3489)). The HPV positivity rate was 13.7% (39/285), yet only 61.5% (24/39) of those with positive HPV results proceeded to cytology testing. Subsequently, three cases of CIN2+ were detected (10.5/1000). While this study demonstrated a reasonable kit return rate and indicated the capability of opt-in HPV self-sampling to detect CIN2+ cases in unscreened women, the low ordering rate of kits and suboptimal compliance for follow-up cytology testing highlight significant challenges. The findings suggest the need for more effective strategies to enhance participation in cervical cancer screening programs.
]]>Healthcare doi: 10.3390/healthcare12050598
Authors: Ana María Antolí-Jover María Adelaida Álvarez-Serrano María Gázquez-López Adelina Martín-Salvador María Ángeles Pérez-Morente Encarnación Martínez-García Inmaculada García-García
This study addresses the health-related quality of life (HRQoL) of Spanish nurses during the sixth wave of the COVID-19 pandemic, assessed through the EQ-5D and EQ-VAS indices. Methods: This cross-sectional 334 study used online surveys, recruiting 305 Spanish nurses. Results: Nurses generally perceived a good HRQoL. “Negative work–family interaction” is adversely associated with the EQ-VAS (β = −0.337, 95% CI [−1.733, −0.723]) and EQ-5D (β = −0.399, 95% CI [−0.021, −0.01]) indices, while “positive work–family interaction” shows a positive relationship with the EQ-VAS (β = 0.218, 95% CI [0.381, 1.759]). The presence of a “paid supportive caregiver” is positively associated with the EQ-VAS (β = 0.18, 95% CI [1.47, 12.3]) and EQ-5D (β = 0.149, 95% CI [0.004, 0.117]) indices, but a higher “number of children” is negatively linked with the EQ-5D index (β = −0.146, 95% CI [−0.061, −0.002]). In addition, living with a partner (EQ-VAS β = 0.16, 95% CI [1.094, 14.67] and EQ-5D index β = 0.174, 95% CI [0.018, 0.163]) and working a “rotating shift” (EQ-5D index β = 0.158, 95% CI [0.005, 0.098]) are positively associated. Conclusions: These findings highlight the need to comprehensively address nurses’ well-being, considering both their working conditions and their home environment, especially in crisis contexts such as the current pandemic.
]]>Healthcare doi: 10.3390/healthcare12050597
Authors: Dulaney A. Wilson Julio Mateus Emily Ash Tanya N. Turan Kelly J. Hunt Angela M. Malek
Gestational hypertension, preeclampsia, eclampsia, and chronic hypertension (CHTN) are associated with adverse infant outcomes and disproportionately affect minoritized race/ethnicity groups. We evaluated the relationships between hypertensive disorders of pregnancy (HDP) and/or CHTN with infant mortality, preterm delivery (PTD), and small for gestational age (SGA) in a statewide cohort with a diverse racial/ethnic population. All live, singleton deliveries in South Carolina (2004–2016) to mothers aged 12–49 were evaluated for adverse outcomes: infant mortality, PTD (20 to less than <37 weeks) and SGA (<10th birthweight-for-gestational-age percentile). Logistic regression models adjusted for sociodemographic, behavioral, and clinical characteristics. In 666,905 deliveries, mothers had superimposed preeclampsia (HDP + CHTN; 1.0%), HDP alone (8.0%), CHTN alone (1.8%), or no hypertension (89.1%). Infant mortality risk was significantly higher in deliveries to women with superimposed preeclampsia, HDP, and CHTN compared with no hypertension (relative risk [RR] = 1.79, 1.39, and 1.48, respectively). After accounting for differing risk by race/ethnicity, deliveries to women with HDP and/or CHTN were more likely to result in PTD (RRs ranged from 3.14 to 5.25) or SGA (RRs ranged from 1.67 to 3.64). As CHTN, HDP and superimposed preeclampsia confer higher risk of adverse outcomes, prevention efforts should involve encouraging and supporting mothers in mitigating modifiable cardiovascular risk factors.
]]>Healthcare doi: 10.3390/healthcare12050596
Authors: Pablo Rodríguez-Prieto Ian Craig Simpson Diego Gomez-Baya Claudia García de la Cadena Desirée Ruiz-Aranda Joaquín A. Ibáñez-Alfonso
Background: Guatemala remains one of the poorest countries in Central America and suffers from high rates of social inequality and violence. In addition to the negative impact that two years without attending school has had on Guatemalan children due to the consequences of the COVID-19 pandemic, this unfavourable socioeconomic context poses a risk to children’s emotional and cognitive development. This work presents a protocol for implementing a cognitive and emotional stimulation program aimed at increasing the academic performance of these children and consequently improving their quality of life. Methods: The protocol proposes the implementation of a randomized controlled trial to assess the efficacy of a 24-session-long stimulation program. It targets the cognitive functions of attention, language, executive functions, and social cognition, using the digital neurorehabilitation platform NeuronUP. The participants (n = 480) will be randomly assigned to an Experimental or Control group. Pre- and post-intervention assessments will be carried out, together with a follow-up in the next academic year, in which both groups will change roles. Results will be compared for the first and second years, looking for differences in academic and cognitive performance between groups. Discussion: Mid- and long-term outcomes are still unknown, but effective interventions based on this protocol are expected to facilitate the following benefits for participants: (1) improved cognitive and emotional development; (2) improved academic performance; (3) improved well-being. We expect to create a validated neuropsychological stimulation program that could be applied in similar socioeconomically disadvantaged contexts around the world to help these children improve their life chances.
]]>Healthcare doi: 10.3390/healthcare12050595
Authors: Kristy Robson Rodney Pope Robin Orr
Damage to the articular cartilage resulting in an acute tear can lead to functional changes within the joint and increase the risk of osteoarthritis developing. There is limited understanding of the association between occupational risk factors and sustaining an acute articular cartilage tear in the military and other physically demanding occupations. Therefore, the aim of this systematic review was to identify and evaluate original research reporting on occupational risk factors associated with sustaining acute articular cartilage tears. Methods: A systematic review following the Preferred Reporting Items for Systematic review and Meta-Analysis—Protocols was conducted and registered with the Open Science Framework. Key academic databases were searched using terms from the following concepts: risk or cause, paid occupations, and acute articular cartilage tears. Results: Of an initial 941 studies, 2 studies met the eligibility criteria, both reporting data from military contexts; only one evaluated acute articular cartilage tears in both males and females. One paper focused on articular cartilage injury within the knee and the other within the ankle joint with incidence rates being 0.2 and 0.3 per 1000 person-years, respectively. People in more physically active occupations and individuals with an above-normal body mass index were reported as being at higher risk of sustaining an acute articular cartilage tear. Conclusion: Physically demanding occupations, such as the military, may increase the risk for acute tears of the articular cartilage. However, the findings of this review indicate there is a paucity of research to underpin understanding of the injury mechanisms and occupational risk factors for acute articular cartilage tears.
]]>Healthcare doi: 10.3390/healthcare12050594
Authors: Jiyoung Park Dongheon Kang Seon-Deok Eun
The Republic of Korea has established an institutional framework to expedite the provision of rehabilitation sports public services to individuals with disabilities post-hospital discharge (Act on Guarantee of Right to Health and Access to Health Services for People with Disabilities in December 2017). Regrettably, this service remains non-operational to date. This study employs a service design approach to identify and develop essential elements for the effective implementation of public rehabilitation sports services in Korea. Adopting the service design method, including the empathize–define–ideate–prototype phases, co-creation activities were conducted with three teams comprising people with disabilities, caregivers, rehabilitation physicians, specialized sports instructors, facility managers, and government officials, emphasizing equitable distribution. By leveraging the experiences of people with disabilities, these teams collaboratively engaged in creative activities to formulate strategies for delivering prompt and user-friendly rehabilitation sports public services post-hospital discharge. Contributions from each team were meticulously collected and organized, incorporating diverse perspectives into the development of the Korean Rehabilitation Sports Public Service Information System (KRSPSIS). Additionally, we presented a scenario illustrating the practical application of the KRSPSIS. Through this system, we anticipate providing more efficient and convenient rehabilitation sports public services to individuals with disabilities during the critical early stages following hospital discharge.
]]>Healthcare doi: 10.3390/healthcare12050593
Authors: Shu-Mei Chao Chao-Kuei Pan Ming-Ling Wang Yu-Wen Fang Shu-Fen Chen
mHealth has been utilized in the care of patients with chronic kidney disease, allowing the collection of patient health-related data, offering disease-related information, enabling the tracking and recording of biochemical parameters, and enabling communication with healthcare providers in real time through applications. mHealth may improve the health outcomes in patients with peritoneal dialysis. This systematic review aimed to summarize evidence regarding the functionality and usability of mHealth apps in patients with peritoneal dialysis. We conducted a comprehensive literature review, searching in five databases, including CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science, to retrieve titles and abstracts related to peritoneal dialysis and mHealth applications for PRISMA recommendations from January 2013 to December 2023. Overall, 11 studies met all the inclusion criteria. The functionality of mHealth apps included inform, instruct, record, display, guide, remind/alert, and communicate. Most of the apps have multifunctionality. The usability was categorized into three aspects: efficiency (self-efficacy and usability), satisfaction, and effectiveness (underwent kidney transplantation and switched to hemodialysis, rehospitalization, peritonitis rate, infection rates at exit sites, mortality, fluid overload, inadequate solute clearance, biochemical values, quality of life, consumer quality index, and technology readiness). Generally, outcomes in the intervention group had better effects compared to those in the control group. Multifunctional mHealth apps show a good potential in improving the efficiency, satisfaction, and effectiveness for patients compared to traditional care. Future research should include more studies and participants to explore and verify the long-term effectiveness of mHealth apps.
]]>Healthcare doi: 10.3390/healthcare12050591
Authors: Maha Hoteit Myriam Dagher Nikolaos Tzenios Najat Al Kaaki Ghadir Rkein Abdul Rahman Chahine Yonna Sacre Samer Hotayt Rami Matar Mahmoud Hallal Micheal Maitar Bilal Hotayt
Chronic liver diseases are a major global health concern. Aims: this study investigated the links between medical, clinical, anthropometric, and dietary factors with dysfunction-associated steatotic liver disease (MASLD) in the Lebanese population using a case-control approach to uncover factors influencing visceral obesity, sarcopenia, and sarcopenic obesity. Methods and Materials: a total of 120 participants (20–70 years old) were divided into case and control groups based on liver disease diagnosis. Patient information was gathered through a questionnaire encompassing demographics, medical history, and beverage consumption. Anthropometric and body composition data were collected in a clinical setting. Results: our findings indicated a clear association between the presence of MASLD and obesity, hypertension, and diabetes. The positive association with higher body mass index and all three conditions remained consistent even when data was stratified by case and control groups. A greater proportion of MASLD patients exhibited sarcopenic obesity. Furthermore, MASLD cases showed higher consumption of sugary beverages and a reduced intake of milk and water in their diets. Conclusions: this study shed light on the health attributes and diets of the Lebanese population with liver diseases and suggested more research in this area and in a more ethnically diverse population.
]]>Healthcare doi: 10.3390/healthcare12050592
Authors: Kimberly E. Smith Rosa Acevedo-Duran Jennifer L. Lovell Aliyah V. Castillo Valeria Cardenas Pacheco
Adolescent mental health is an urgent global public health issue. Youth participatory action research is an effective strategy to amplify youth voices and can serve as a catalyst for evidence-based action addressing the mental health crisis. To illustrate the benefits of youth participatory action research for informing community health, we describe an ongoing collaboration with a youth council located in the central coast of California, USA. Research methods included an anonymous online self-report survey to gather information about the mental health of high school students in 2020 (n = 176) and 2022 (n = 234), 93% Latinx/Mexican American. Both surveys included a four-item patient health questionnaire to screen for depression and anxiety risk, in addition to scaled and open-ended survey questions selected by the youth leaders based on their research questions. Quantitative and qualitative results indicated a significant but small decrease in mental health risk, and a continued need for resources to access mental health support. Results led to community-based action aimed at improving local youth mental health. The interdisciplinary research team (psychology and public health) and youth leaders share reflections highlighting the innovative, empowering, and transformative impact of youth participatory action research as a tool for improving community health.
]]>Healthcare doi: 10.3390/healthcare12050590
Authors: Leah Macaden Kevin Muirhead
Dementia education and training for workforce development is becoming increasingly important in bridging knowledge gaps among health and social care practitioners in the UK and internationally. Dementia Education for Workforce Excellence (DEWE) was developed during the COVID-19 pandemic, blending both synchronous and asynchronous instruction and delivered across three different contexts: care homes, home care, and nurse education within the UK and India. This study aimed to evaluate DEWE using mixed methods with online survey data analyzed descriptively and interview data analyzed thematically. Integration of survey and interview data aimed toward a comprehensive evaluation of this novel approach for dementia workforce development. Thirty-four social care practitioners and nurse educators completed the online survey demonstrating high-level learner satisfaction, learning gains, behavioral change, and motivation to share new knowledge. Four key themes developed from the analysis of interviews (n = 9) around participants’ pursuit of new knowledge; delivery modes in DEWE; learning gains and impact of DEWE; and adaptations for future program implementation. Findings suggest DEWE is an innovative resource that promotes person- and relationship-centered dementia care across all stages of one’s dementia journey. Cultural adaptations are recommended for international delivery to ensure contextual alignment and maximum impact.
]]>Healthcare doi: 10.3390/healthcare12050589
Authors: Eilat Shinar Eli Jaffe Zvika Orr Beth G. Zalcman Joseph Offenbacher Maxim Quint Evan Avraham Alpert Boaz Zadok Weiss Baruch Berzon
Demands for whole blood (WB) and COVID-19 convalescent plasma (CCP) donations during the SARS-CoV-2 (COVID-19) pandemic presented unprecedented challenges for blood services throughout the world. This study aims to understand the motivating factors that drive WB and CCP donations in the context of the pandemic. This cross-sectional study is based on data extracted from surveys of the two volunteer donor cohorts. The findings reveal that when compared to CCP donors, WB donors were more likely to view donation as a form of social engagement (97.7% vs. 87.1%, p < 0.01), advantageous in the workplace (46.4% vs. 28.6%, p < 0.01), advantageous in their social network (58.6% vs. 47.0%, p = 0.01), and view their donation in the context of positive self-satisfaction (99% vs. 95.1%, p = 0.01). The average age of CCP donors was 7.1 years younger than those who donated WB (p < 0.01). Motivational factors were also analyzed by sex and religiosity. In conclusion, whereas both donor groups showed a high motivation to partake in these life-saving commitments, WB donors were more likely to be motivated by factors that, when better-understood and implemented in policies concerning plasma donations, may help to increase these donations.
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