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Healthcare, Volume 10, Issue 11 (November 2022) – 221 articles

Cover Story (view full-size image): University students in Czech suffer from poor mental wellbeing. Research reports that students who are motivated to study and are kind toward and less judgmental of themselves tend to have a high level of mental wellbeing. These relationships had not been evaluated in Czech students. This study evaluated the relationships between mental wellbeing, motivation, self-compassion and self-criticism in this student group. Mental wellbeing was positively associated with intrinsic motivation and self-compassion, and negatively associated with amotivation and self-criticism. Self-compassion was the strongest predictor of mental wellbeing. Intrinsic motivation mediated the pathway from self-compassion to mental wellbeing, but not the one from self-criticism to mental wellbeing. Findings can help educators identify effective means to protect students’ mental wellbeing in the Czech Republic. View this paper
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12 pages, 1111 KiB  
Article
Effect of the Sway Bed on Autonomic Response, Emotional Responses, and Muscle Hardness in Children with Severe Motor and Intellectual Disabilities: A Pilot Study
by Mitsuki Ozaki, Jun Murata, Katsuya Sato, Goro Tanaka, Akira Imamura and Ryoichiro Iwanaga
Healthcare 2022, 10(11), 2337; https://doi.org/10.3390/healthcare10112337 - 21 Nov 2022
Viewed by 1752
Abstract
This cross-sectional study aimed to examine the effects of being swayed in a sway bed on children with severe motor and intellectual difficulties by examining potential differences in their autonomic and emotional responses, as well as their muscle hardness, and by comparing them [...] Read more.
This cross-sectional study aimed to examine the effects of being swayed in a sway bed on children with severe motor and intellectual difficulties by examining potential differences in their autonomic and emotional responses, as well as their muscle hardness, and by comparing them with “a control condition without any stimulation”. Children’s heart rate variability, rectus femoris hardness, and passive hip abduction range of motion (ROM) were measured in two experimental conditions, differentiated by the presence of a 5-min sway stimulus. In each condition, the children’s faces were video-recorded and retrospectively rated subjectively by their homeroom teacher concerning the visible expression of eight emotions. Significant intervention-related effects were observed on the heart rate variability and the “Relax” item of the emotional response indicators but not on muscle hardness or hip ROM. Our findings provide evidence that using a motorized sway bed can promote relaxation in children with severe motor and intellectual disabilities by influencing their autonomic response. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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21 pages, 916 KiB  
Article
Stroke-Related Sarcopenia among Two Different Developing Countries with Diverse Ethnic Backgrounds (Cross-National Study in Egypt and China)
by Marwa Mohammed and Jianan Li
Healthcare 2022, 10(11), 2336; https://doi.org/10.3390/healthcare10112336 - 21 Nov 2022
Cited by 7 | Viewed by 2991
Abstract
The prevalence of stroke-related sarcopenia differs according to the diagnostic criteria, the cut-off point for assessment, and ethnicity. Egypt and China are developing countries with different races where no research concerning stroke-related sarcopenia has been performed yet. We aimed to evaluate the prevalence [...] Read more.
The prevalence of stroke-related sarcopenia differs according to the diagnostic criteria, the cut-off point for assessment, and ethnicity. Egypt and China are developing countries with different races where no research concerning stroke-related sarcopenia has been performed yet. We aimed to evaluate the prevalence of possible sarcopenia and confirmed sarcopenia among Egyptian and Chinese stroke survivors using the Asian Working Group of Sarcopenia (AWGS-2019) criteria and to assess the variables associated with the prevalence rate. A prospective cross-sectional study was carried out among 200 Egyptian and 195 Chinese stroke survivors from 2019 to 2021 using a structural health questionnaire. A hand-held dynamometer was used to measure grip strength. Anthropometric measures were used to estimate muscle mass. Data were analyzed using SPSS statistics version 20. p-values < 0.05 were considered statistically significant. The prevalence of possible sarcopenia ranged from 20.0% to 34.4% among Egyptian and Chinese groups, except for the Egyptian females where it was 52.0%. The prevalence of sarcopenia in both populations ranged from 13.6% to 18.6%. Pre-stroke independent variables that accelerated possible sarcopenia were age, history of dyslipidemia, diabetes mellitus, and ischemic heart disease, but stroke severity was a post-stroke risk factor. Age was the only pre-stroke variable for sarcopenia, while quitting smoking and having good nutritional status were variables for the reduction of possible sarcopenia. Quitting smoking, having a good nutritional status, and early rehabilitation reduced sarcopenia development. Controlling vascular risk factors, enhancing rehabilitation, and nutritional therapy are protective measures against sarcopenia. Longitudinal studies are required to identify further risk factors. Full article
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22 pages, 2779 KiB  
Article
Ensemble Technique Coupled with Deep Transfer Learning Framework for Automatic Detection of Tuberculosis from Chest X-ray Radiographs
by Evans Kotei and Ramkumar Thirunavukarasu
Healthcare 2022, 10(11), 2335; https://doi.org/10.3390/healthcare10112335 - 21 Nov 2022
Cited by 18 | Viewed by 4470
Abstract
Tuberculosis (TB) is an infectious disease affecting humans’ lungs and is currently ranked the 13th leading cause of death globally. Due to advancements in technology and the availability of medical datasets, automatic analysis and classification of chest X-rays (CXRs) into TB and non-TB [...] Read more.
Tuberculosis (TB) is an infectious disease affecting humans’ lungs and is currently ranked the 13th leading cause of death globally. Due to advancements in technology and the availability of medical datasets, automatic analysis and classification of chest X-rays (CXRs) into TB and non-TB can be a reliable alternative for early TB screening. We propose an automatic TB detection system using advanced deep learning (DL) models. A substantial part of a CXR image is dark, with no relevant information for diagnosis and potentially confusing DL models. In this work, the U-Net model extracts the region of interest from CXRs and the segmented images are fed to the DL models for feature extraction. Eight different convolutional neural networks (CNN) models are employed in our experiments, and their classification performance is compared based on three publicly available CXR datasets. The U-Net model achieves segmentation accuracy of 98.58%, intersection over union (IoU) of 93.10, and a Dice coefficient score of 96.50. Our proposed stacked ensemble algorithm performed better by achieving accuracy, sensitivity, and specificity values of 98.38%, 98.89%, and 98.70%, respectively. Experimental results confirm that segmented lung CXR images with ensemble learning produce a better result than un-segmented lung CXR images. Full article
(This article belongs to the Special Issue Advances of Decision-Making Medical System in Healthcare)
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21 pages, 2395 KiB  
Systematic Review
Effectiveness of Acupuncture in Parkinson’s Disease Symptoms—A Systematic Review
by Catarina Ramos Pereira, Jorge Machado, Jorge Rodrigues, Natália M. de Oliveira, Maria Begoña Criado and Henri J. Greten
Healthcare 2022, 10(11), 2334; https://doi.org/10.3390/healthcare10112334 - 21 Nov 2022
Cited by 11 | Viewed by 4699
Abstract
Background: Parkinson’s disease (PD) is the second most common neurodegenerative disease. Several pharmacological and surgical therapies have been developed; however, they are accompanied by some adverse effects. As a result, many patients have been resorting to complementary medicine, namely acupuncture, in the hope [...] Read more.
Background: Parkinson’s disease (PD) is the second most common neurodegenerative disease. Several pharmacological and surgical therapies have been developed; however, they are accompanied by some adverse effects. As a result, many patients have been resorting to complementary medicine, namely acupuncture, in the hope of obtaining symptomatic improvements without having disruptive side effects. Therefore, advances in research in this area are very important. This work presents a systematic review of the effectiveness of acupuncture treatments in relieving PD symptoms. Methods: EMBASE, Medline, Pubmed, Science Direct, The Cochrane Library, Cochrane Central Register of Controlled Trials (Central) and Scielo databases, were systematically searched from January 2011 through July 2021. Randomised controlled trials (RCTs) published in English with all types of acupuncture treatment were included. The selection and analysis of the articles was conducted by two blinding authors through Rayyan application. Results: A total of 720 potentially relevant articles were identified; 52 RCTs met our inclusion criteria. After the exclusion of 35 articles, we found 17 eligible. The included RCTs reported positive effects for acupuncture plus conventional treatment compared with conventional treatment alone in the UPDRS score. Conclusions: Although all the studies reviewed pointed out a positive effect of acupuncture on improving motor and non-motor symptoms in Parkinson’s disease, we found great discrepancies regarding the studies’ design and methodology, making difficult any comparison between them. Full article
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12 pages, 969 KiB  
Article
Changes in the Suicide Rate of Older Adults According to Gender, Age, and Region in South Korea from 2010 to 2017
by Kyu-Hyoung Jeong, Ji-Yeon Yoon, Seoyoon Lee, Sunghwan Cho, Hyun-Jae Woo and Sunghee Kim
Healthcare 2022, 10(11), 2333; https://doi.org/10.3390/healthcare10112333 - 21 Nov 2022
Cited by 4 | Viewed by 3180
Abstract
Background: South Korea’s suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. Methods: the statistics on causes of death and resident registration central population (RRCP) provided [...] Read more.
Background: South Korea’s suicide rates are the highest among Organization for Economic Co-operation and Development (OECD) countries, making it one of the most important societal issues in South Korea. Methods: the statistics on causes of death and resident registration central population (RRCP) provided by the National Statistical Office were used to calculate the suicide rate among older adults in Korea. We examined gender (male, female), age (young–old, old–old), and region (urban, rural) by conducting latent growth modeling to estimate changes in the overall older adult suicide rate and verify its relationship. Results: over a period of 8 years, the older adult suicide rate was 104.232 on average in 2010 and it decreased by approximately 10.317 every year, and the rate of decrease gradually slowed down. The initial value of the older adult suicide rate was found to be higher among males, the old–old group, and those living in rural regions. In the quadratic function change rate, only males and the old–old group were statistically significant. Conclusion: in this study, the direction of and the rate of change in the older adult suicide rates and the relationship between gender, age, and region were examined. It is expected that this study will provide basic data to assist in establishing older adult suicide prevention policies, considering the gender, age, and region of the aging population. Full article
(This article belongs to the Topic Healthy, Safe and Active Aging)
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12 pages, 223 KiB  
Article
A Social Emotional Learning Training Programme in a Poor Rural Primary School in Central China: A Pre-Post Intervention Study
by Jiameng Li, Cuiling Ma, Qi Lu and Therese Hesketh
Healthcare 2022, 10(11), 2332; https://doi.org/10.3390/healthcare10112332 - 21 Nov 2022
Viewed by 2109
Abstract
Introduction: Many universal school-based social and emotional learning (SEL) programmes in the U.S. and Europe have been found to improve social skills and reduce emotional distress and behaviour problems. The aim of this study is to determine whether an adapted version of the [...] Read more.
Introduction: Many universal school-based social and emotional learning (SEL) programmes in the U.S. and Europe have been found to improve social skills and reduce emotional distress and behaviour problems. The aim of this study is to determine whether an adapted version of the SEL can reduce social, emotional, and behavioural difficulties in children in mainland China, using a pre-post intervention design. Methods: The study was conducted in a primary school in an economically-disadvantaged rural area in Henan province in central China. The intervention consisted of 16 weekly 90-minunte classroom sessions involving all 190 children in the school. Social and emotional problems were assessed pre- and post- intervention using the Chinese version of the Strengths and Difficulties Questionnaire (SDQ). The results suggest that: (1) the programme can reduce children’s peer relationship problems, and that the reduction was sustainable at the two post-intervention assessments; (2) the intervention effects on emotional symptoms or total difficulties in the overall population are very few, but children identified as high risk in the initial assessment benefited from the programme. Conclusions: This is the first published report on the effectiveness of a school-based SEL programme in mainland China. Although the improvement are limited, the programme does benefit some children. Full article
(This article belongs to the Special Issue Mental Health Matters: From Cross-Cultural Perspectives)
10 pages, 1269 KiB  
Article
The Emergency Performance of the Hungarian Ambulance Service during the COVID-19 Pandemic
by Klára Bíró, Máté Sándor Deák, György Pápai, Attila Nagy, Viktor Dombrádi, Gábor Tamás Szabó, Klára Boruzs, Gábor Bányai and Gábor Csató
Healthcare 2022, 10(11), 2331; https://doi.org/10.3390/healthcare10112331 - 21 Nov 2022
Cited by 4 | Viewed by 2252
Abstract
The COVID-19 pandemic had a considerable impact on the whole health sector, particularly on emergency services. Our aim was to examine the performance of the Hungarian National Ambulance Service during the first four waves of the pandemic. We defined the 2019 performance of [...] Read more.
The COVID-19 pandemic had a considerable impact on the whole health sector, particularly on emergency services. Our aim was to examine the performance of the Hungarian National Ambulance Service during the first four waves of the pandemic. We defined the 2019 performance of the service as the baseline and compared it with the activity during the pandemic years of 2020 and 2021. The data contained deliveries related to acute myocardial infarction, hemorrhagic stroke, ischemic stroke, overall non-COVID-related ambulance deliveries, COVID screenings performed by the ambulance service, and COVID-related ambulance deliveries. The data were aggregated for each week of the investigated time period and stratified by gender and age. Compared with the pre-pandemic era, we found a significant increase in all three medical conditions and overall deliveries (p < 0.001 in all cases). As a result of the increased burden, it is important for emergency services to prepare for the next global epidemic and to improve organizational performance and rescue activities. The Hungarian example highlights that in a pandemic, it can be beneficial to organize the emergency care of a country or a larger region under a single provider with a single decision maker supported by business intelligence. Full article
(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)
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14 pages, 479 KiB  
Article
Nursing Assessment of Pressure Injury Risk with the Braden Scale Validated against Sensor-Based Measurement of Movement
by Susan M. Kennerly, Phoebe D. Sharkey, Susan D. Horn, Jenny Alderden and Tracey L. Yap
Healthcare 2022, 10(11), 2330; https://doi.org/10.3390/healthcare10112330 - 21 Nov 2022
Cited by 11 | Viewed by 7139
Abstract
Nursing staff assessment to accurately identify pressure injury (PrI) risk is a hallmark in PrI prevention care. Risk scores from the Braden Scale for Predicting Pressure Sore Risk© (hereafter Braden), a commonly used tool for assessing PrI risk, signal the need for [...] Read more.
Nursing staff assessment to accurately identify pressure injury (PrI) risk is a hallmark in PrI prevention care. Risk scores from the Braden Scale for Predicting Pressure Sore Risk© (hereafter Braden), a commonly used tool for assessing PrI risk, signal the need for preventative care. Braden Mobility, Activity, and Sensory Perception subscale subgroups associated with repositioning movement features help identify preventative strategies that minimize pressure intensity and duration. Evidence confirming subscale rating accuracy is needed. This study compared assessment score accuracy with movement data collected via accelerometer sensor. Sample included 913 nursing home residents from the Turn Everyone and Move for Pressure Ulcer Prevention (TEAM-UP) cluster randomized trial. Movements and Braden Mobility and Activity subscale scores were evaluated for significant differences and associations. Mobility subgroups explained a small-medium amount of variance in mean lying and upright movement features (0.002 ≤ R2 ≤ 0.195). Activity subgroups explained a small-medium amount of variance in mean lying, upright, and ambulating movements (0.016 ≤ R2 ≤ 0.248). Significant associations occurred among subscale subgroups and most movements. Nursing assessment ratings using Braden scale’s Mobility and Activity subscale scores are accurate indicators of actual repositioning movements and can be relied upon for PrI prevention care planning for older adults. Full article
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8 pages, 537 KiB  
Article
Impact of COVID-19 Pandemic on Oncological Surgery Activities: A Retrospective Study from a Southern Italian Region
by Giuseppe Di Martino, Fabrizio Cedrone, Pamela Di Giovanni, Ferdinando Romano and Tommaso Staniscia
Healthcare 2022, 10(11), 2329; https://doi.org/10.3390/healthcare10112329 - 21 Nov 2022
Cited by 17 | Viewed by 1659
Abstract
(1) Background: The pandemic had a strong impact on healthcare for other diseases, the so-called collateral damage. This situation heavily impacted the health care system, causing a deferment of surgical admissions. This situation had an immediate and long-term impact on millions of patients [...] Read more.
(1) Background: The pandemic had a strong impact on healthcare for other diseases, the so-called collateral damage. This situation heavily impacted the health care system, causing a deferment of surgical admissions. This situation had an immediate and long-term impact on millions of patients with surgical diseases all over the world. The objective of this study was to evaluate the incidence of hospitalizations for colorectal and breast cancers in an Italian region in the year 2020 and compare it with the years 2018–2019. (2) Methods: This retrospective study was performed in the region of Abruzzo, Italy. Monthly number of hospitalizations in the year 2020 was compared with a control period consisting of the average of admissions that occurred in the years 2018–2019 using Poisson regression. (3) Results: A reduction in hospital admissions for all diseases considered was found. In particular, compared with years 2018–2019, admissions for colorectal cancer were 35.71% lower (HRR 0.915; p < 0.001), and admissions for breast cancer were 10.36% lower (HRR 0.895; p < 0.001) (4) Conclusions: The results of this study showed the decrease of admissions for elective oncological surgery during pandemic, suggesting the need of strategic measures to face the burden of future years’ hospitalizations. Full article
(This article belongs to the Collection The Impact of COVID-19 on Healthcare Services)
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8 pages, 3694 KiB  
Article
Dental Prosthetic Rehabilitation Interventions in Elderly Patients Hospitalized in the Nursing Homes of the Lombardy Region: A Retrospective Study
by Saverio Ceraulo, Paolo Caccianiga, Carmelo Casto, Ignazio Ceraulo and Gianluigi Caccianiga
Healthcare 2022, 10(11), 2328; https://doi.org/10.3390/healthcare10112328 - 21 Nov 2022
Cited by 12 | Viewed by 1802
Abstract
Background: The difficulty of frail, non-self-sufficient or non-ambulatory collaborating elderly residents in nursing homes to eat due to a lack of teeth or the absence of a dental prosthesis leads to an increasingly evident increase in the patients’ systemic pathological state, particularly [...] Read more.
Background: The difficulty of frail, non-self-sufficient or non-ambulatory collaborating elderly residents in nursing homes to eat due to a lack of teeth or the absence of a dental prosthesis leads to an increasingly evident increase in the patients’ systemic pathological state, particularly in older patients who take a lot of medications. Total or partial edentulousness that is not filled with dental prostheses or that is filled with inadequate prostheses, associated with socioeconomic factors, depression, impaired motor functions, heart disease and a large number of chronic diseases including excessive use of drugs, often affects elderlies’ feeding. Aim: In this study, prosthetic rehabilitation was performed on some frail elderly residents in 10 nursing homes in the Lombardy district, and, subsequently, meal behavior and social activity were examined in two information questionnaires through compilation. Methods: The research was conducted on only 67 patients, 26 men and 41 women, aged between 75 and 99, who were guests in 10 health facilities (nursing homes) in the Lombard district; only 8 residents did not undergo prosthetic rehabilitation, as they did not cooperate. All the patients who were visited underwent oral prosthetic rehabilitation, and, subsequently, some aspects such as nutrition and socialization were assessed with other residents through the aid of two information dossiers. Results: the results showed that all the residents, despite difficulties in chewing with the new prosthesis, were fed and did not refuse more consistent foods; in addition, there was an improvement in social activity among the residents. Only 19.3% of men and 22% of women continued to eat little; there was an improvement in the participation in social activities among the residents, with a percentage of 73% of men and 88% of women; in particular, during meals 35 residents conversed with the other residents. Discussion: The dental problems of elderly people residing in social welfare homes are increasingly evident when other systemic pathologies are present. It would be desirable to introduce telemedicine in residences for the elderly for the monitoring of dental problems. Conclusions: From the information obtained and from the evaluation of the change in the elderly, it can be concluded that it would be desirable to include specific dental protocols to create a network, including a telematic one, to monitor and perform more dental checks in nursing homes. Full article
(This article belongs to the Special Issue Preventive Oral Health Strategies and Oral Health Status)
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27 pages, 1535 KiB  
Article
Use of Medicinal Plants during Pregnancy, Childbirth and Postpartum in Southern Morocco
by Nadia Kamel, Rachida El Boullani and Yahia Cherrah
Healthcare 2022, 10(11), 2327; https://doi.org/10.3390/healthcare10112327 - 21 Nov 2022
Cited by 4 | Viewed by 4055
Abstract
Southern Morocco, particularly the Guelmim-Oued Noun region, is rich in a wide diversity of plant species. Pregnant women in this region use medicinal plants during pregnancy and childbirth for various purposes; however, the use of these plants has never been documented. The objectives [...] Read more.
Southern Morocco, particularly the Guelmim-Oued Noun region, is rich in a wide diversity of plant species. Pregnant women in this region use medicinal plants during pregnancy and childbirth for various purposes; however, the use of these plants has never been documented. The objectives of this study are threefold: to estimate the prevalence of medicinal plant uses by pregnant women in the province of Guelmim, Morocco, to describe the traditional practices of self-medication and to determine the associated factors. This is a multicenter cross-sectional study with descriptive and analytical approaches. Data were collected using an interview questionnaire, which was administered to pregnant women at health care centers and hospitals in the province of Guelmim. A total of 560 women participated in this study. The prevalence of medicinal plant use was 66.96%. Artemisia herba-alba Asso, Thymus maroccanus Ball., Trigonella foenum-graecum L., Aloysia citriodora Palau, Lepidium sativum L. and Cuminum cyminum L. were the plants with the highest UV. Pain, the induction and facilitation of childbirth, flu syndrome and anemia were the most listed reasons for use. The use of medicinal plants was significantly associated with the level of education (chi-square = 15.651; p = 0.004), and pregnancy monitoring (chi-square = 5.283; p = 0.028). In the province of Guelmim, the prevalence of the use of medicinal plants by women during pregnancy and childbirth is high. Further research is necessary in order to explore potential associated risks and complications. Full article
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11 pages, 292 KiB  
Article
Non-Pathological Psychological Distress among Mainland Chinese in Canada and Its Sociodemographic Risk Factors amidst the Pandemic
by Lixia Yang, Linke Yu, Kesaan Kandasamy, Yiran Wang, Fuyan Shi, Weiguo Zhang and Peizhong Peter Wang
Healthcare 2022, 10(11), 2326; https://doi.org/10.3390/healthcare10112326 - 21 Nov 2022
Cited by 4 | Viewed by 2288
Abstract
The COVID-19 pandemic has exacerbated health inequalities, with a potentially heightened mental health risk for Mainland Chinese in Canada, given the rising anti-Chinese discrimination, and barriers in assessing health services. In this context, this study aimed to assess non-pathological psychological distress towards COVID-19 [...] Read more.
The COVID-19 pandemic has exacerbated health inequalities, with a potentially heightened mental health risk for Mainland Chinese in Canada, given the rising anti-Chinese discrimination, and barriers in assessing health services. In this context, this study aimed to assess non-pathological psychological distress towards COVID-19 and identify its sociodemographic risk factors among Mainland Chinese in Canada at the early stages of the pandemic. Methods: A sample of 731 Mainland Chinese aged 16 or older completed an on-line survey to examine their attitudes, behavioural, and psychological responses towards COVID-19. Non-pathological psychological distress was assessed with a 7-item self-report scale to capture common emotional reactions towards COVID-19. Results: A factor analysis revealed a single-factor structure of the 7-item COVID-19 psychological distress scale (Eigen λ = 3.79). A composite psychological distress index (PDI) score was calculated from these items and used as the outcome variable. Multivariate regression models identified age, financial satisfaction, health status, and perceived/experienced discrimination as significant predictors of psychological distress (ps ≤ 0.05). Conclusions: Mainland Chinese in Canada who were over 25, in poor financial/health status, or with perceived/experienced discrimination were at a higher risk for COVID-19-related psychological distress. The health inequity across these factors would inform the services to mitigate mental health risk in minority groups. Full article
(This article belongs to the Special Issue Mental and Behavioral Healthcare)
11 pages, 2488 KiB  
Article
Formative Usability Evaluation of a Three-Way Digital Healthcare System for the People with Disabilities and Their Caregivers: A Cross-Sectional Study
by Ju Hee Kim, Young-Hyeon Bae, Sung Shin Kim, Minyoung Lee and Seung Hee Ho
Healthcare 2022, 10(11), 2325; https://doi.org/10.3390/healthcare10112325 - 20 Nov 2022
Cited by 4 | Viewed by 1946
Abstract
During the COVID-19 pandemic, there was a growing awareness about the importance of building a health and safety net based on digital healthcare systems, such as ICT-based local community online services and patient monitoring technology. This study was conducted with the aim of [...] Read more.
During the COVID-19 pandemic, there was a growing awareness about the importance of building a health and safety net based on digital healthcare systems, such as ICT-based local community online services and patient monitoring technology. This study was conducted with the aim of evaluating the formative usability of a three-way digital healthcare system, which had been developed to build a health and safety net for people with disabilities and deriving the directions for system improvement in order for them to be used as basic data for further system enhancement. A formative usability evaluation of a three-way digital healthcare system was performed with the participation of 43 healthcare professionals, using the 10-item System Usability Scale (SUS) and five items for satisfaction evaluation. Each item was rated on a five-point Likert scale, with the result converted to a scale of 100. Analysis was performed using the average score and the acceptable system usability level. The overall mean SUS score was 62.4, which corresponds to Grade D according to the SUS grading scale, and the below-average items were complexity (Q2), convenience (Q8), simplicity (Q3), professionalism (technician support, prior learning) (Q4, Q10), and learnability (Q7). The overall mean user satisfaction was 71.2 points, where overall satisfaction, system architecture and understandability, and continuous use intention were marked with below-average scores. The SUS D grade is interpreted as “fair” and the water solubility is “almost acceptable”. For the usability enhancement of the newly developed a three-way digital healthcare system, the overall direction for system architecture improvement was analyzed centering on complexity (Q2), convenience (Q8), professionalism (technician support, prior learning) (Q4, Q10), learnability (Q7), and simplicity (Q3). Efforts need to be directed at enhancing system satisfaction and continuance rate by deriving detailed system improvement strategies and achieving system enhancement to reflect the opinions of not only experts but also users. Full article
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11 pages, 603 KiB  
Article
Association between Sleep Duration and Symptoms of Depression Aged between 18 and 49: The Korea National Health and Nutrition Examination Survey (KNHANES Ⅶ) from 2016 to 2018
by Sung-Yong Choi, Ji-Eun Han, Jiae Choi, Minjung Park, Soo-Hyun Sung and Angela Dong-Min Sung
Healthcare 2022, 10(11), 2324; https://doi.org/10.3390/healthcare10112324 - 20 Nov 2022
Cited by 9 | Viewed by 2386
Abstract
This study aimed to determine the association between symptoms of depression and sleep duration in a representative sample of the Korean population. Using national cross-sectional data from the seventh Korea National Health and Nutrition Examination Surveys (KNHANES-VII), 5461 adults aged 18–49 years were [...] Read more.
This study aimed to determine the association between symptoms of depression and sleep duration in a representative sample of the Korean population. Using national cross-sectional data from the seventh Korea National Health and Nutrition Examination Surveys (KNHANES-VII), 5461 adults aged 18–49 years were analyzed using logistic regression models. The proportions of participants with total daily sleep durations (24 h) of <6 h, 6–8 h, and ≥9 h were 26.2%, 60.6%, and 13.3%, respectively. The proportions of individuals with symptoms of depression in the <6 h, 6–8 h, and ≥9 h sleep duration groups were 37.4%, 46.3%, and 16.3%, respectively. The odds ratios (ORs) were significantly higher in the <6 h and ≥9 h sleep groups than in the 6–8 h sleep group. There was a significant association between short (<6 h/day) and long (≥9 h/day) sleep duration and symptoms of depression among the general Korean population. In particular, our findings suggest that short sleep (<6 h/day) is more associated with symptoms of depression than long sleep (≥9 h/day). Full article
(This article belongs to the Special Issue Sleep Disorders Effect on Human Health)
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9 pages, 275 KiB  
Article
Investigation of the Relationship between the Disease Severity and Quality of Life of Psoriasis Patients and Their Anthropometric Measurements and Diets
by Ali Timucin Atayoglu, Aslı Gizem Çapar, Eda Basmisirlioglu, Yagmur Yasar, Yusuf Aykemat, Ayten Guner Atayoglu and Neriman Inanc
Healthcare 2022, 10(11), 2323; https://doi.org/10.3390/healthcare10112323 - 20 Nov 2022
Cited by 2 | Viewed by 1941
Abstract
Psoriasis is a multifaceted, chronic, inflammatory skin disease that impacts patients’ quality of life. The aim of this study was to investigate the relationship between the disease severity and quality of life of psoriasis patients and their nutritional status. The study included 40 [...] Read more.
Psoriasis is a multifaceted, chronic, inflammatory skin disease that impacts patients’ quality of life. The aim of this study was to investigate the relationship between the disease severity and quality of life of psoriasis patients and their nutritional status. The study included 40 patients in the psoriasis group, compared with 40 healthy individuals in the control group. A questionnaire for determination of socio-demographic characteristics and nutritional intake, anthropometric measurements, psoriasis area and severity index (PASI), and dermatology life quality index (DLQI) were used for the assessments. Daily food consumption details were recorded for three consecutive days to determine daily energy and nutrient intakes. Compared to the control group, the frequencies of single participants, primary school graduates, and housewives were higher in the psoriasis group (p < 0.05). The psoriasis patients weighed more and had an increased waist/hip ratio in comparison with the healthy individuals. The energy intake was lower in the psoriasis group (p < 0.01). There was not a significant statistical difference in the intake of proteins, fiber, vitamin A, vitamin E, vitamin C, Zn, Fe, and Mg supplements between the groups. However, there was an inverse correlation between the daily vitamin E intake and PASI scores (p < 0.05). There was a positive moderate correlation between the DLQI and PASI scores (p < 0.01). Our study indicated that lower daily vitamin E intake levels were associated with the severity of psoriasis. In addition to this, abdominal obesity seems to be another risk factor in psoriasis patients, even if they have a normal body mass index (BMI). An integrated healthcare approach with dermatologists, family physicians, and dietitians is essential to the management of psoriasis. Full article
9 pages, 418 KiB  
Article
A Study on Types of Medication Adherence in Hypertension among Older Patients and Influencing Factors
by Sunmin Lee, Kyu-Hyoung Jeong, Seoyoon Lee and Hayoung Park
Healthcare 2022, 10(11), 2322; https://doi.org/10.3390/healthcare10112322 - 20 Nov 2022
Cited by 3 | Viewed by 3677
Abstract
Background: Hypertension has the characteristic that the risk of complications can be reduced through appropriate medication in daily life. Hence, it is important to consider practical measures to increase medication adherence, particularly among older patients. Methods: This study used the Korea Health Panel [...] Read more.
Background: Hypertension has the characteristic that the risk of complications can be reduced through appropriate medication in daily life. Hence, it is important to consider practical measures to increase medication adherence, particularly among older patients. Methods: This study used the Korea Health Panel 2020 data (Version 2.0.1), jointly conducted by Korea Institute for Health and Social Affairs and National Health Insurance. A total of 2300 patients with high blood pressure over 65 years of age were selected. In order to identify types of medication adherence in older hypertensive patients, and examine factors that influence the types, the Latent Profile Analysis (LPA) and logistic regression were performed. Results: The types of adherence groups were classified into two groups: an ‘adherence group’ (87.1%) and a ‘non-adherence group’ (12.9%). Furthermore, age, living alone, and depressive symptoms were identified as determinants of medication adherence type among older hypertensive patients. Conclusion: The significant impact of sociodemographic status (age, living alone, and depressive symptoms) on medication adherence among older hypertensive patients indicates the need to establish more specific empirical interventions based on each type’s characteristics. It is expected that this study will provide an in-depth understanding of factors associated with medication adherence among older patients with hypertension, which can support interventions tailored to the specific needs of those who are non-adherent. Full article
(This article belongs to the Special Issue Medication Adherence and Beliefs About Medication: Second Edition)
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8 pages, 1330 KiB  
Article
Preparing Children for Their First Dental Visit: A Guide for Parents
by Simone Bagattoni, Francesca Nascimben, Elena Biondi, Raquel Fitzgibbon, Lisa Lardani, Maria Rosaria Gatto, Gabriela Piana and Katia Mattarozzi
Healthcare 2022, 10(11), 2321; https://doi.org/10.3390/healthcare10112321 - 19 Nov 2022
Cited by 3 | Viewed by 2517
Abstract
The aim of the study was to test an information booklet containing suggestions to parents on how to prepare their child for the first dental visit. Forty-five children and one parent per included child took part in the trial. Children were randomized in [...] Read more.
The aim of the study was to test an information booklet containing suggestions to parents on how to prepare their child for the first dental visit. Forty-five children and one parent per included child took part in the trial. Children were randomized in two groups; the information booklet was e-mailed to the parents of the study group. At the end of the visit, the dentist and the parent evaluated the child’s behavior through the Frankl Behavior Rating Scale (FBRS) and the utility of the booklet through a Likert scale. The children evaluated the pleasantness of the visit and the perceived pain through the Wong–Baker FACES® Pain Rating Scale (WBFPRS). Parents evaluated the information booklet as highly understandable and useful. According to the dentist, informed children were more cooperative (FBRS median score: 4; IQR: 3.5–4) than the control group (median score 3; IQR: 2–4) (p = 0.013; Mann–Whitney U test). Children prepared with the booklet reported less pain (WBFPRS: 0.40 ± 0.82 vs. 1.42 ± 1.99; p = 0.034; t-test;) and tended to evaluate the visit as more enjoyable (WBFPRS: 1.1 ± 2.14 vs. 2.75 ± 3.43; p = 0.064; t-test) than unprepared children. The information booklet increases the child’s ability to cooperate during the visit and could represent a useful instrument for the clinical practice. Full article
(This article belongs to the Special Issue Oral Healthcare: Diagnosis, Prevention and Treatment)
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16 pages, 495 KiB  
Article
Deciphering Latent Health Information in Social Media Using a Mixed-Methods Design
by George Shaw, Jr., Margaret Zimmerman, Ligia Vasquez-Huot and Amir Karami
Healthcare 2022, 10(11), 2320; https://doi.org/10.3390/healthcare10112320 - 19 Nov 2022
Cited by 2 | Viewed by 2280
Abstract
Natural language processing techniques have increased the volume and variety of text data that can be analyzed. The aim of this study was to identify the positive and negative topical sentiments among diet, diabetes, exercise, and obesity tweets. Using a sequential explanatory mixed-method [...] Read more.
Natural language processing techniques have increased the volume and variety of text data that can be analyzed. The aim of this study was to identify the positive and negative topical sentiments among diet, diabetes, exercise, and obesity tweets. Using a sequential explanatory mixed-method design for our analytical framework, we analyzed a data corpus of 1.7 million diet, diabetes, exercise, and obesity (DDEO)-related tweets collected over 12 months. Sentiment analysis and topic modeling were used to analyze the data. The results show that overall, 29% of the tweets were positive, and 17% were negative. Using sentiment analysis and latent Dirichlet allocation (LDA) topic modeling, we analyzed 800 positive and negative DDEO topics. From the 800 LDA topics—after the qualitative and computational removal of incoherent topics—473 topics were characterized as coherent. Obesity was the only query health topic with a higher percentage of negative tweets. The use of social media by public health practitioners should focus not only on the dissemination of health information based on the topics discovered but also consider what they can do for the health consumer as a result of the interaction in digital spaces such as social media. Future studies will benefit from using multiclass sentiment analysis methods associated with other novel topic modeling approaches. Full article
(This article belongs to the Special Issue Social Media for Health Information Management)
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26 pages, 1561 KiB  
Review
A Bibliometrics-Enhanced, PAGER-Compliant Scoping Review of the Literature on Paralympic Powerlifting: Insights for Practices and Future Research
by Luca Puce, Khaled Trabelsi, Carlo Trompetto, Laura Mori, Lucio Marinelli, Antonio Currà, Emanuela Faelli, Vittoria Ferrando, Patrick Okwen, Jude Dzevela Kong, Achraf Ammar and Nicola Luigi Bragazzi
Healthcare 2022, 10(11), 2319; https://doi.org/10.3390/healthcare10112319 - 19 Nov 2022
Cited by 10 | Viewed by 2774
Abstract
Paralympic powerlifting (PP), formerly known as “International Paralympic Committee” (IPC) powerlifting, is the format of powerlifting adapted for athletes with disabilities, and it differs from the version for able-bodied athletes in that it consists of bench press only. According to the mandate of [...] Read more.
Paralympic powerlifting (PP), formerly known as “International Paralympic Committee” (IPC) powerlifting, is the format of powerlifting adapted for athletes with disabilities, and it differs from the version for able-bodied athletes in that it consists of bench press only. According to the mandate of the IPC, PP athletes should be enabled to achieve sporting excellence. As such, rigorous evidence is needed. However, to the best of our knowledge, there exists no systematic assessment of the body of scholarly evidence in the field of PP. Therefore, the present study was conducted to fill in this gap of knowledge, by conducting a scoping review of the literature enhanced by a bibliometrics analysis and by mining two major scholarly databases (MEDLINE via PubMed and Scopus). The aim was to provide a review/summary of the findings to date to help practitioners and athletes. Thirty-seven studies were retained in the present study. These covered the following thematic areas: (i) warm-up strategies (n = 2); (ii) aspects of training (n = 2); (iii) physiological aspects and responses (n = 2); (iv) psychological aspects and responses (n = 2); (v) biomechanics of bench press (n = 8); (vi) recovery strategy (n = 5); (vii) impact of the disability and type of disability (n = 4); (viii) epidemiology of PP (n = 6); and (ix) new analytical/statistical approaches for kinematics assessments, internal load monitoring, and predictions of mechanical outputs in strength exercises and in PP (n = 6). Bibliometrics analysis of the PP-related scientific output revealed that, despite having already become a paralympic sports discipline in 1984, only in the last few years, PP has been attracting a lot of interest from the community of researchers, with the first scholarly contribution dating back to 2012, and with more than one-third of the scientific output being published this year (2022). As such, this scholarly discipline is quite recent and young. Moreover, the community dealing with this topic is poorly interconnected, with most authors contributing to just one article, and with one single author being a hub node of the author network. Distributions of the number of articles and the authors/co-authors were found to be highly asymmetrical, indicating that this research is still in its infancy and has great room as well as great potential to grow. Reflecting this, many research topics are also overlooked and underdeveloped, with the currently available evidence being based on a few studies. Full article
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9 pages, 1537 KiB  
Article
Association between Antihypertensive Therapy and Risk of Acute Lower Respiratory Infections (ALRI): A Retrospective Cohort Study
by Jana Heidemann, Marcel Konrad, Christoph Roderburg, Sven H. Loosen and Karel Kostev
Healthcare 2022, 10(11), 2318; https://doi.org/10.3390/healthcare10112318 - 18 Nov 2022
Viewed by 1527
Abstract
Purpose: The aim of this study was to analyze the association between antihypertensive drugs and the incidence of acute lower respiratory infections in patients treated in general practices in Germany. Methods: After propensity score matching of five antihypertensive drug classes, a total of [...] Read more.
Purpose: The aim of this study was to analyze the association between antihypertensive drugs and the incidence of acute lower respiratory infections in patients treated in general practices in Germany. Methods: After propensity score matching of five antihypertensive drug classes, a total of 377,470 patients aged ≥18 years were available for analysis. The association between each antihypertensive drug class and ALRI incidence as compared to all other antihypertensive drug classes (as a group) was studied using conditional Cox regression analyses. Because of multiple comparisons and large patient samples, findings were clinically considered relevant when the hazard ratio was <0.85 or >1.15. Results: The regression analyses applied found no clinically relevant associations between antihypertensive drugs and the incidence of acute lower respiratory infections, as all hazard ratios were between 0.85 and 1.15. Conclusion: In the present study, only slight and not clinically relevant increases or decreases in the ALRI incidence were observed. Additional studies are necessary to further explore the risks associated with antihypertensive agents that are widely embedded in today’s clinical practice. Full article
(This article belongs to the Section Chronic Care)
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11 pages, 471 KiB  
Article
Might Dog Walking Reduce the Impact of COPD on Patients’ Life?
by Ilaria Baiardini, Salvatore Fasola, Chiara Lorenzi, Nicole Colombo, Matteo Bruno, Stefania La Grutta, Carla Scognamillo and Fulvio Braido
Healthcare 2022, 10(11), 2317; https://doi.org/10.3390/healthcare10112317 - 18 Nov 2022
Viewed by 2006
Abstract
Low levels of physical activity (PA) lead to a worsening of physical condition and contributes to multimorbidity in Chronic Obstructive Respiratory Disease (COPD). Unsupervised PA related to dog ownership may contribute to reducing sedentary behavior. We aimed to investigate the relationship between dog [...] Read more.
Low levels of physical activity (PA) lead to a worsening of physical condition and contributes to multimorbidity in Chronic Obstructive Respiratory Disease (COPD). Unsupervised PA related to dog ownership may contribute to reducing sedentary behavior. We aimed to investigate the relationship between dog walking, patient-reported outcomes (PROs) and exacerbations in COPD. A pre-defined sample of 200 COPD patients (dog owners and non-dog owners) with symptomatic COPD was sourced from a database representative of the Italian population. A computer-assisted personal interview was used to assess health status impairment (CAT), fatigue (FACIT), health-related quality of life (HRQoL) (EQ-5D), and PA frequency. In the whole sample, PA was associated with better CAT, EQ-5D, VAS, FACIT scores and reduced number of exacerbation (p < 0.001). Under the same CAT scores, dog-walking duration was associated with a better HRQoL (EQ5D, p = 0.015) and less fatigue (FACIT, p = 0.017). In an adjusted regression model, walking dogs >30 min was associated with lower fatigue (FACIT) than having no dogs and walking dogs <15 min (p = 0.026 and p = 0.009, respectively). Motivation related to dog walking could modify patients’ tendency to focus on symptoms during PA and, therefore, to perceive the fatigue. Dog walking may be effective for increasing and maintaining regular PA, reducing the subjective impact of COPD. Full article
(This article belongs to the Topic Healthy, Safe and Active Aging)
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11 pages, 1236 KiB  
Article
Serostatus and Epidemiological Characteristics for Atypical Pneumonia Causative Bacteria among Healthy Individuals in Medina, Saudi Arabia, a Retrospective Study
by Sari T. Alhoufie, Areej A. Alhhazmi, Waleed H. Mahallawi, Khalid O. Alfarouk and Nadir A. Ibrahim
Healthcare 2022, 10(11), 2316; https://doi.org/10.3390/healthcare10112316 - 18 Nov 2022
Cited by 2 | Viewed by 2650
Abstract
Background: Community-acquired atypical pneumonia is generally a mild and self-limiting infection. Still, it may lead to hospitalization and progressive clinical complications in some cases, particularly among the elderly and individuals with chronic diseases. Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae are the [...] Read more.
Background: Community-acquired atypical pneumonia is generally a mild and self-limiting infection. Still, it may lead to hospitalization and progressive clinical complications in some cases, particularly among the elderly and individuals with chronic diseases. Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae are the community’s main causative agents of atypical pneumonia. However, most published studies evaluated their incidence in the hospital setting, and little is known about their prevalence among healthy individuals. This work aims to assess the seroprevalence of these bacteria among healthy people to determine the status of immunity against these bacteria in the community. Methodology: Two hundred and eighty-three serum samples from a multicenter in Medina, Saudi Arabia, were collected in this study. Serum samples were subjected to indirect enzyme-linked immunosorbent assays (ELISAs) to detect IgG antibodies against C. pneumoniae, L. pneumophila, and M. pneumoniae to investigate the seroprevalence of these bacteria and their distribution among different genders and age groups of healthy people. Results: IgG seropositivity for at least one of the three atypical pneumonia-causative bacteria occurred in 85.8% (n= 243/283) of the sample population. IgG seropositivity for C. pneumoniae occurred in 80.6% (228/283) of the population, followed by 37.5% for L. pneumophila and 23% for M. pneumoniae (66/283). In addition, the IgG seropositivity rates for the three bacteria were observed predominantly among male participants. Furthermore, no significant difference in IgG seropositivity distribution occurred between different age groups of healthy people for C. pneumoniae, L. pneumophila and M. pneumoniae. Conclusions: The current study found that C. pneumoniae, L. pneumophila, and M. pneumoniae tended to be highly prevalent among healthy people and more common among males than females. Additionally, their pattern of distribution among healthy individuals seemed to be predominant among young adults (aged 20–40 years), which differs from their predominant distribution among elderly patients in hospital settings (>50 years). Full article
(This article belongs to the Special Issue Infectious Disease Prevention and Public Health Promotion)
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24 pages, 871 KiB  
Systematic Review
The Role of Pharmacists in Providing Pharmaceutical Care in Primary and Secondary Prevention of Stroke: A Systematic Review and Meta-Analysis
by Saeed Al-Qahtani, Zahraa Jalal, Vibhu Paudyal, Sajid Mahmood and Julie Mason
Healthcare 2022, 10(11), 2315; https://doi.org/10.3390/healthcare10112315 - 18 Nov 2022
Cited by 8 | Viewed by 3749
Abstract
Pharmacists deliver pharmaceutical care in many different healthcare settings and are well-placed to support the prevention of stroke. However, their role and impact in this area is ill-defined. This systematic review aims to explore the pharmacists’ role in stroke prevention. Nine databases were [...] Read more.
Pharmacists deliver pharmaceutical care in many different healthcare settings and are well-placed to support the prevention of stroke. However, their role and impact in this area is ill-defined. This systematic review aims to explore the pharmacists’ role in stroke prevention. Nine databases were searched for studies reporting pharmacist interventions in the management of primary and secondary ischaemic stroke prevention. Study quality was evaluated through Cochrane Risk of Bias and Joanna Briggs Institute (JBI) appraisal tools where possible. A narrative review was conducted and meta-analysis performed for studies with comparable outcomes. Of the 834 initial articles, 31 met inclusion criteria. Study designs were varied and included controlled trials, observational studies, audit reports and conference abstracts. Seven studies addressed the pharmacists’ role in primary prevention and 24 in secondary prevention. Pharmacist interventions reported were diverse and often multifactorial. Overall, 20 studies reported significant improvement in outcomes. Meta-analysis showed pharmacist interventions in emergency care significantly improved the odds of achieving thrombolytic therapy door to needle (DTN) times ≤45 min, odds ratio: 2.69 (95% confidence interval (CI): 1.95–3.72); p < 0.001. The pharmacists’ role is varied and spans the stroke treatment pathway, with the potential for a positive impact on a range of health-related outcomes. Full article
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8 pages, 1276 KiB  
Review
Smart-Card Technology for the Dental Management of Medically Complex Patients
by Mohammed Alshehri, Abdullah Alamri, Mohammed Alghamdi, Rakan Nazer and Omar Kujan
Healthcare 2022, 10(11), 2314; https://doi.org/10.3390/healthcare10112314 - 18 Nov 2022
Cited by 2 | Viewed by 3465
Abstract
Smart-card technology is believed to help healthcare industries in several ways, since it minimizes risks and medical errors, enables accurate patient identification, reduces administrative costs, improves efficiency, and facilitates prompt delivery of care to patients. The present study aims to highlight the adoption [...] Read more.
Smart-card technology is believed to help healthcare industries in several ways, since it minimizes risks and medical errors, enables accurate patient identification, reduces administrative costs, improves efficiency, and facilitates prompt delivery of care to patients. The present study aims to highlight the adoption of a newly designed dental smart card for medically complex patients. The present smart card is an advance in patient identification, using a quick-response (QR) code to automatically report or receive certain types of responses from patients or physicians once illuminated by signals from QR readers. Further, the card provides general information about the patient’s condition and physical details. The card is pocket sized and can be carried easily by the patient anywhere, alongside a digital copy of the card. Full article
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20 pages, 4316 KiB  
Article
AI-Assisted Diagnosis and Decision-Making Method in Developing Countries for Osteosarcoma
by Haojun Tang, Hui Huang, Jun Liu, Jun Zhu, Fangfang Gou and Jia Wu
Healthcare 2022, 10(11), 2313; https://doi.org/10.3390/healthcare10112313 - 18 Nov 2022
Cited by 22 | Viewed by 2934
Abstract
Osteosarcoma is a malignant tumor derived from primitive osteogenic mesenchymal cells, which is extremely harmful to the human body and has a high mortality rate. Early diagnosis and treatment of this disease is necessary to improve the survival rate of patients, and MRI [...] Read more.
Osteosarcoma is a malignant tumor derived from primitive osteogenic mesenchymal cells, which is extremely harmful to the human body and has a high mortality rate. Early diagnosis and treatment of this disease is necessary to improve the survival rate of patients, and MRI is an effective tool for detecting osteosarcoma. However, due to the complex structure and variable location of osteosarcoma, cancer cells are highly heterogeneous and prone to aggregation and overlap, making it easy for doctors to inaccurately predict the area of the lesion. In addition, in developing countries lacking professional medical systems, doctors need to examine mass of osteosarcoma MRI images of patients, which is time-consuming and inefficient, and may result in misjudgment and omission. For the sake of reducing labor cost and improve detection efficiency, this paper proposes an Attention Condenser-based MRI image segmentation system for osteosarcoma (OMSAS), which can help physicians quickly locate the lesion area and achieve accurate segmentation of the osteosarcoma tumor region. Using the idea of AttendSeg, we constructed an Attention Condenser-based residual structure network (ACRNet), which greatly reduces the complexity of the structure and enables smaller hardware requirements while ensuring the accuracy of image segmentation. The model was tested on more than 4000 samples from two hospitals in China. The experimental results demonstrate that our model has higher efficiency, higher accuracy and lighter structure for osteosarcoma MRI image segmentation compared to other existing models. Full article
(This article belongs to the Special Issue Advances of Decision-Making Medical System in Healthcare)
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8 pages, 234 KiB  
Article
Visual Impairment and Blindness among Patients at Nigeria Army Eye Centre, Bonny Cantonment Lagos, Nigeria
by Ngozika Esther Ezinne, Oluwaseun Shittu, Kingsley Kene Ekemiri, Michael Agyemang Kwarteng, Selassie Tagoh, Grace Ogbonna and Khathutshelo Percy Mashige
Healthcare 2022, 10(11), 2312; https://doi.org/10.3390/healthcare10112312 - 18 Nov 2022
Cited by 6 | Viewed by 2268
Abstract
Background: Visual impairment (VI) is a public health problem that can affect an individual’s social wellbeing. The study aims to determine the distribution and causes of vision impairment (VI) and blindness among patients at Nigerian Army Eye Centre Lagos, Nigeria. Method: An institutional [...] Read more.
Background: Visual impairment (VI) is a public health problem that can affect an individual’s social wellbeing. The study aims to determine the distribution and causes of vision impairment (VI) and blindness among patients at Nigerian Army Eye Centre Lagos, Nigeria. Method: An institutional cross-sectional study was conducted, and a systematic random sampling technique was used to enrol study participants from their medical records. Information about their demography, presenting visual acuity (VA), best corrected visual acuity and cause of VI and blindness, were retrieved. Result: A total of five hundred (500) medical records of patients aged from 4 to 96 years, with a mean age of 54.07 ± 21.43 years, were considered for the study. Among the participants, more than half were males (51.2%) and ≥60 years (53.0%). A large (47.2%) proportion of the patients had moderate VI at the time of presentation, followed by blindness (22.0%). The major cause of blindness was cataract, while glaucoma and refractive error were the major causes of VI. Blindness and VI were significantly associated with the type of VI before and after the provision of intervention (p < 0.05) across different age groups (children, youths, adults, elderly) with an adjusted p < 0.003 after an intervention. Conclusions: Cataracts, glaucoma and uncorrected refractive error (URE) were the major causes of VI and blindness in Lagos State. VI was more prevalent in males than females; however, there was no significant difference between the two proportions. The prevalence of VI among age groups was more significant for those 60 years and above. Early screening for the detection and management of cataract, URE and glaucoma is highly advised to reduce the burden of VI. Full article
(This article belongs to the Section Preventive Medicine)
9 pages, 256 KiB  
Article
Factors Influencing Sleep Quality in Open-Heart Patients in the Postoperative Intensive Care Unit
by Ting-Ru Lin, Ching-Hui Cheng, Jeng Wei and Tsae-Jyy Wang
Healthcare 2022, 10(11), 2311; https://doi.org/10.3390/healthcare10112311 - 18 Nov 2022
Cited by 2 | Viewed by 2248
Abstract
Open-heart patients often experience sleep problems postoperatively. This cross-sectional study is aimed to investigate open-heart patients’ sleep quality and its influencing factors during intensive care. A consecutive sample of 117 eligible open-heart patients was recruited from an intensive care unit (ICU) of a [...] Read more.
Open-heart patients often experience sleep problems postoperatively. This cross-sectional study is aimed to investigate open-heart patients’ sleep quality and its influencing factors during intensive care. A consecutive sample of 117 eligible open-heart patients was recruited from an intensive care unit (ICU) of a general hospital. Data were collected using questionnaires. The respondents were 22–88 years, with a median age of 60.25 (13.51). Seventy-nine (67.5%) respondents were male. Most respondents reported a low-to-moderate postoperative pain level (average pain score = 2.02; range: 0–10). The average anxiety score was 4.68 (standard deviation [SD] = 4.2), and the average depression score was 6.91 (SD = 4.52; range: 0–21). The average sleep efficiency index was 70.4% (SD = 10.74%). Most (95.7%) respondents had a sleep efficiency index below 85%, indicating that most patients did not sleep well in the ICU. Linear regression analysis showed that the key predictors of the sleep quality of open-heart patients in the ICU were wound pain (β = −1.9) and noise disturbance (β = −1.86). These results provide information on sleep quality and the factors affecting postoperative patients in the ICU. These findings can be used as a reference for developing relevant interventions. Full article
15 pages, 2514 KiB  
Article
Population Based Average Parotid Gland Volume and Prevalence of Incidental Tumors in T1-MRI
by Tina Brzoska, Till Ittermann, Friedrich Ihler, Carmela Koch, Markus Blaurock, Robin Bülow, Henry Völzke, Chia-Jung Busch and Achim Georg Beule
Healthcare 2022, 10(11), 2310; https://doi.org/10.3390/healthcare10112310 - 18 Nov 2022
Cited by 2 | Viewed by 3545
Abstract
Representative epidemiologic data on the average volume of the parotid gland in a large population-based MRI survey is non-existent. Within the Study of Health in Pomerania (SHIP), we examined the parotid gland in 1725 non-contrast MRI-scans in T1 weighted sequence of axial layers. [...] Read more.
Representative epidemiologic data on the average volume of the parotid gland in a large population-based MRI survey is non-existent. Within the Study of Health in Pomerania (SHIP), we examined the parotid gland in 1725 non-contrast MRI-scans in T1 weighted sequence of axial layers. Thus, a reliable standard operating procedure (Intraclass Correlation Coefficient > 0.8) could be established. In this study, we found an average, single sided parotid gland volume of 27.82 cm3 (95% confidence interval (CI) 27.15 to 28.50) in male and 21.60 cm3 (95% CI 21.16 to 22.05) in female subjects. We observed positive associations for age, body mass index (BMI), as well as male sex with parotid gland size in a multivariate model. The prevalence of incidental tumors within the parotid gland regardless of dignity was 3.94% in the Northeast German population, slightly higher than assumed. Further epidemiologic investigations regarding primary salivary gland diseases are necessary. Full article
(This article belongs to the Collection Radiology-Driven Projects: Science, Networks, and Healthcare)
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11 pages, 834 KiB  
Article
How Vulnerable Are Patients with COPD to Weather Extremities?—A Pilot Study from Hungary
by Gergely Márovics, Éva Pozsgai, Balázs Németh, Szabolcs Czigány, Szilvia Németh-Simon and János Girán
Healthcare 2022, 10(11), 2309; https://doi.org/10.3390/healthcare10112309 - 18 Nov 2022
Cited by 2 | Viewed by 1566
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most common causes of death globally, with increasing prevalence and years lived with disability (YLD). We aimed to investigate how extreme weather conditions were associated with the number of daily COPD-related emergency visits. We [...] Read more.
Chronic obstructive pulmonary disease (COPD) is one of the most common causes of death globally, with increasing prevalence and years lived with disability (YLD). We aimed to investigate how extreme weather conditions were associated with the number of daily COPD-related emergency visits. We collected data regarding the number of daily emergency department (ED) visits made by patients with COPD in 2017, along with all relevant daily meteorological data for the same year. An analysis of the relationship between the number of COPD-related ED visits and extreme meteorological events was carried out. Extremely low temperatures (OR = 1.767) and dew points (OR = 1.795), extremely high atmospheric pressure (OR = 1.626), a high amount of precipitation (OR = 1.270), and light wind speed (OR = 1.560) were identified as possible risk factors for a higher number of COPD-related ED visits. In contrast, extremely high temperatures (OR = 0.572) and dew points (OR = 0.606) were found to be possible protective factors for COPD-related ED visits. By determining the meteorological risk factors for a high number of COPD-related ED visits, our study may help provide invaluable data for identifying vulnerable patient groups based on weather events, thus making more optimal capacity planning at the ED possible. Full article
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10 pages, 1191 KiB  
Article
Risk Analysis and Assessment of Lipid Abnormalities as the Earliest Complication in Newly Diagnosed Diabetic and Non-Diabetic Individuals of a Local Population
by Zunaira Ali Baig, Amir Rashid, Asifa Majeed, Zahra Masood, Asma Faryal, Zahra Arshad Khan and Aden Razaq
Healthcare 2022, 10(11), 2308; https://doi.org/10.3390/healthcare10112308 - 18 Nov 2022
Cited by 1 | Viewed by 1942
Abstract
Lipid variations have been frequently observed in global populations that can affect health status. Mainly studies have been conducted on the type 2 diabetic population, but limited data is available on newly diagnosed ones to unravel complications and risk predictors independent of disease [...] Read more.
Lipid variations have been frequently observed in global populations that can affect health status. Mainly studies have been conducted on the type 2 diabetic population, but limited data is available on newly diagnosed ones to unravel complications and risk predictors independent of disease progression. This study comprising 244 individuals was carried out to assess the lipid abnormalities in newly diagnosed diabetics and non-diabetics. The clinical and socio-demographic data were collected and analyzed using independent samples t-test and linear regression. Serum lipid variations were observed individually and in combination. The individuals in group I (diabetics with dyslipidemia) revealed elevated levels of low-density lipoprotein and serum triglycerides higher than in group II (non-diabetics with dyslipidemia). The frequency of deranged total cholesterol in group I was observed to be higher than in group II. Independent samples t-test showed a significant mean difference in variables between the two groups. Linear regression analysis showed a significant variable outcome for predictors between high-density lipoprotein (HDL) and physical activity (B= −0.043, 95% CI: −0.80, −0.006) and total cholesterol (TC) with family history (B= −0.062, 95% CI: −0.123, −0.001). The findings conclude that lipid levels deranged independently regardless of type 2 diabetes mellitus and present as an early onset in type 2 diabetes instead of later stage complication. These derangements of lipid levels are an independent risk factor for future cardiovascular pathology. Full article
(This article belongs to the Special Issue Patient Care Assessment)
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