Healthcare

10 pages, 251 KiB

Open AccessArticle

Association between Chronic Pain and Sarcopenia in Greek Community-Dwelling Older Adults: A Cross-Sectional Study

by Maria Tsekoura, Evdokia Billis, Charalampos Matzaroglou, Elias Tsepis and John Gliatis

Healthcare 2024, 12(13), 1303; https://doi.org/10.3390/healthcare12131303 (registering DOI) - 29 Jun 2024

(1) Background: Sarcopenia and chronic pain are prevalent syndromes among older adults that negatively affect their quality of life. The present study aimed to investigate the relationship between chronic pain and sarcopenia among Greek community-dwelling older adults. (2) Methods: Older adults >60 years [...] Read more.

(1) Background: Sarcopenia and chronic pain are prevalent syndromes among older adults that negatively affect their quality of life. The present study aimed to investigate the relationship between chronic pain and sarcopenia among Greek community-dwelling older adults. (2) Methods: Older adults >60 years of age were enrolled in this descriptive, cross-sectional study. Sarcopenia status was assessed according to the EWGSOP2 2019 algorithm. This assessment included the evaluation of muscle strength, body composition and gait speed. Pain location and pain characteristics were assessed using a self-reported questionnaire. Pain severity was assessed via the visual analog scale. The participants were also asked to fill out the SARC-F, the Hospital Anxiety and Depression Scale (HADS) and the Falls Efficacy Scale-International (FES-I) questionnaire. (3) Results: This study included 314 participants with a mean age of 71.3 ± 7.4 years. The prevalence of sarcopenia was 19.4 (n = 61), and 44.26% of the sarcopenic participants recorded chronic pain. Chronic pain was associated with sarcopenia, comorbidities, the number of drugs and HADS. (4) Conclusions: The results demonstrated a high percentage of chronic pain in the sarcopenic population. The results also highlight the importance of the detection of chronic pain in older patients with sarcopenia in order to develop effective preventive and therapeutic strategies. Full article

(This article belongs to the Special Issue New Advances in the Treatment of Chronic Musculoskeletal Pain)

16 pages, 645 KiB

Open AccessReview

Alternative Treatments for Emotional Experiencing and Processing in People with Migraine or Tension-Type Headache: A Scoping Review

by Alessandra Marelli, Licia Grazzi, Marina Angela Visco, Pietro Crescenzo, Alessandra Bavagnoli, Cristal Sirotich and Venusia Covelli

Healthcare 2024, 12(13), 1302; https://doi.org/10.3390/healthcare12131302 (registering DOI) - 29 Jun 2024

Abstract

This narrative review aims to summarize the use of alternative treatments (e.g., relaxation training, meditation, written intervention) for emotional expression, processing, control, or management in patients with migraine and tension-type headaches, which the previous literature has shown to be related to migraine pain [...] Read more.

This narrative review aims to summarize the use of alternative treatments (e.g., relaxation training, meditation, written intervention) for emotional expression, processing, control, or management in patients with migraine and tension-type headaches, which the previous literature has shown to be related to migraine pain perception and headache symptoms. Online databases including PubMed, Scopus, Web of Science, PsycINFO, and Medline were searched to identify studies published between 2000 and 2023. A descriptive synthesis of the included studies was conducted. We included seven articles after screening 1.173 records. A total of 610 patients with a diagnosis of migraine or tension-type headache, and an average age of 19–45.5 years (68–90.4% females) were recruited in the selected studies. Overall, the results show that alternative approaches to headache treatment contribute to the management, reduction, or control of negative emotions and at the same time have a positive impact on pain perception and headache symptoms. However, in some cases, the effects are more promising than others, depending on the peculiarities or limitations of each approach considered. This review provides useful insights from a methodological point of view for future studies on the management or control of negative emotions in patients with migraine and tension-type headache. Full article

(This article belongs to the Special Issue Narrative in Health and Social Care: 2nd Edition)

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14 pages, 258 KiB

Open AccessArticle

Mental Health, Sleep Quality, and Psychological Well-Being during the Holy Month of Ramadan

by Danny Jandali, Abdullah Alwaleedi, Michele W. Marenus, Sarah R. Liener, Amine Sheik, Malak Elayyan and Weiyun Chen

Healthcare 2024, 12(13), 1301; https://doi.org/10.3390/healthcare12131301 (registering DOI) - 29 Jun 2024

Abstract

Objectives: Ramadan, a significant month for Muslims, presents unique challenges, particularly in the context of the USA. This study aimed to explore the relationship between mental health factors (depression, anxiety, and stress), sleep quality, and psychological well-being (subjective happiness and life satisfaction) during [...] Read more.

Objectives: Ramadan, a significant month for Muslims, presents unique challenges, particularly in the context of the USA. This study aimed to explore the relationship between mental health factors (depression, anxiety, and stress), sleep quality, and psychological well-being (subjective happiness and life satisfaction) during the month of Ramadan among participants and by gender. Methods: This study enlisted 163 participants (74% female, 25.7% male), with an average age of 36.8 years (SD = 13.1), mostly of Middle Eastern descent. Recruitment was conducted via flyers at local community mosques, social media, and outreach through local religious leaders. Data collection took place in the last three weeks of Ramadan, utilizing a Qualtrics survey that included the Depression Anxiety and Stress Scale (DASS-21), the Subjective Happiness Scale (SHS), Satisfaction with Life Scale (SWLS), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by means of descriptive statistics and multiple linear regression models using SPSS version 28. Results: The study indicates that while mental health and psychological well-being remained within normal levels during Ramadan, sleep scores indicated significant sleep disturbance among participants. Multiple linear regression models revealed that subjective happiness, sleep duration, and the global PSQI score were significant predictors of stress for the total sample (F = 9.816, p = 0.001). Life satisfaction was the only significant predictor of anxiety (F = 7.258, p = 0.001), and it, alongside subjective happiness, significantly predicted depression (F = 12.317, p = 0.001). For men, subjective happiness alone predicted stress, while life satisfaction was a predictor for both anxiety and depression (F = 4.637, p = 0.001). In women, sleep duration and medication usage were linked to stress but not anxiety. Life satisfaction and subjective happiness were, however, predictors of depression (F = 6.380, p = 0.001). Conclusion: Fostering positive affective states can serve as a protective mechanism against the potential psychological distress associated with altered sleep patterns and lifestyle changes that accompany Ramadan. This study highlights that Ramadan is a tool for bolstering happiness and life satisfaction, thereby lowering levels of stress, anxiety, and depression. In non-Muslim majority contexts like the USA, there is a need for accommodations to safeguard against potential psychological distress. Full article

11 pages, 1194 KiB

Open AccessArticle

A Culture of Early Mobilization in Adult Intensive Care Units: Perspective and Competency of Physicians

by Ali Albarrati, Monira I. Aldhahi, Turki Almuhaid, Ali Alnahdi, Ahmed S. Alanazi, Abdulfattah S. Alqahtani and Rakan I. Nazer

Healthcare 2024, 12(13), 1300; https://doi.org/10.3390/healthcare12131300 (registering DOI) - 28 Jun 2024

Abstract

Background: Early mobility (EM) is vital in the intensive care unit (ICU) to counteract immobility-related effects. A multidisciplinary approach is key, as it requires precise initiation knowledge. However, physicians’ understanding of EM in adult ICU settings remains unexplored. This study was conducted to [...] Read more.

Background: Early mobility (EM) is vital in the intensive care unit (ICU) to counteract immobility-related effects. A multidisciplinary approach is key, as it requires precise initiation knowledge. However, physicians’ understanding of EM in adult ICU settings remains unexplored. This study was conducted to investigate the knowledge and clinical competency of physicians working in adult ICUs toward EM. Methods: This cross-sectional study enrolled 236 physicians to assess their knowledge of EM. A rigorously designed survey comprising 30 questions across the demographic, theoretical, and clinical domains was employed. The criteria for knowledge and competency were aligned with the minimum passing score (70%) stipulated for physician licensure by the medical regulatory authority in Saudi Arabia. Results: Nearly 40% of the respondents had more than 5 years of experience. One-third of the respondents received theoretical knowledge about EM as part of their residency training, and only 4% of the respondents attended formal courses to enhance their knowledge. Almost all the respondents (95%) stated their awareness of EM benefits and its indications and contraindications and considered it safe to mobilize patients on mechanical ventilators. However, 62.3% of the respondents did not support EM for critically ill patients on mechanical ventilators until weaning. In contrast, 51.7% of respondents advised EM for agitated patients with RASS > 2. Only 113 (47.9%) physicians were competent in determining the suitability of ICU patients for EM. For critically ill patients who should be mobilized, nearly 60% of physicians refused to initiate EM. Conclusions: This study underscores insufficient practical knowledge of ICU physicians about EM criteria, which leads to suboptimal decisions, particularly in complex ICU cases. These findings emphasize the need for enhanced training and education of physicians working in adult ICU settings to optimize patient care and outcomes in critical care settings. Full article

(This article belongs to the Section Critical Care)

25 pages, 693 KiB

Open AccessArticle

Help or Hurt? The Impact of Digital Finance on the Physical Health of the Elderly in China

by Yaling Luo, Lei Zhou and Weike Zhang

Healthcare 2024, 12(13), 1299; https://doi.org/10.3390/healthcare12131299 (registering DOI) - 28 Jun 2024

Abstract

Under the backdrop of global aging, the escalating number of elderly individuals in poor health poses a growing social burden and impacts economic development and social stability. A fundamental question arises as to whether the advancements of digital finance (DF) can effectively enhance [...] Read more.

Under the backdrop of global aging, the escalating number of elderly individuals in poor health poses a growing social burden and impacts economic development and social stability. A fundamental question arises as to whether the advancements of digital finance (DF) can effectively enhance the physical health of the elderly. This study aims to investigate the impact of DF on the physical health of the elderly by utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. The results reveal a significant positive impact of DF on enhancing the physical health of the elderly. Furthermore, the study demonstrates that this impact is particularly pronounced among the elderly with higher educational attainment, stronger intergenerational links, and those residing in central cities. A mechanism analysis further reveals that DF contributes to improving the physical health of the elderly by augmenting household disposable income, alleviating liquidity constraints, and enhancing the utilization of medical services. These findings offer valuable insights for the future development of DF and the implementation of policies promoting healthy aging and active aging. Full article

(This article belongs to the Section Health Policy)

10 pages, 398 KiB

Open AccessArticle

Factors Associated with Mental Illness in a Primary Healthcare Setting in the Kingdom of Saudi Arabia: A Case–Control Study

by Abdulaziz S. Alangari, Faris Fatani, Nouf Binhowaimel, Hanan M. Al Kadri, Awad Alshahrani, Badr F. Al Khateeb, Aljohrah I. Aldubikhi, Mona I. Bin Amer, Afrah Alsaif and Ashraf El-Metwally

Healthcare 2024, 12(13), 1298; https://doi.org/10.3390/healthcare12131298 (registering DOI) - 28 Jun 2024

Abstract

Background/Objectives: Mental health conditions are a leading cause of morbidity and mortality worldwide, with a 13% rise within the last decade. This study aimed to investigate the factors associated with mental illness in patients presenting to a primary healthcare center in the Kingdom [...] Read more.

Background/Objectives: Mental health conditions are a leading cause of morbidity and mortality worldwide, with a 13% rise within the last decade. This study aimed to investigate the factors associated with mental illness in patients presenting to a primary healthcare center in the Kingdom of Saudi Arabia (KSA). Methods: Data were extracted from the electronic health records of 46 primary care centers in Riyadh, Saudi Arabia from March 2022 to March 2023. A total of 2418 age-matched mental health cases and controls were evaluated. Descriptive and logistic regression analyses were performed to examine the distribution and association of relevant risk factors. A total of 1209 cases were age-matched to 1209 controls presenting to a primary clinic. Results: The odds of mental illness in females were 2.2 times that of males. Clinical conditions associated with mental illness were stroke, diabetes, and obesity. Neurodegenerative disorders were also associated with mental illness. Conclusions: Primary clinics in the KSA can serve as focal points in removing the barriers to mental healthcare. There is an urgent need to spread awareness, remove the stigma, and provide appropriate care and referrals for mental health conditions in the KSA. Full article

17 pages, 2045 KiB

Open AccessArticle

What Chinese Women Seek in Mental Health Apps: Insights from Analyzing Xiaohongshu User Posts during the COVID-19 Pandemic

by Zhenzhen Qin, Sandy Ng, Wenqing Wu and Suxin Zhang

Healthcare 2024, 12(13), 1297; https://doi.org/10.3390/healthcare12131297 (registering DOI) - 28 Jun 2024

Viewed by 40

Abstract

Gender disparity poses a prominent obstacle to achieving effective mental health outcomes in digital healthcare. Despite women being more inclined to use mental health apps and seeking designs tailored to their specific needs, there is limited research on the factors influencing female users’ [...] Read more.

Gender disparity poses a prominent obstacle to achieving effective mental health outcomes in digital healthcare. Despite women being more inclined to use mental health apps and seeking designs tailored to their specific needs, there is limited research on the factors influencing female users’ engagement with these apps. The COVID-19 pandemic has further exacerbated its disproportionate impact on women’s mental health. This study investigates female users’ posts (n = 5538) about mental health apps during the pandemic, using data collected via a Python web crawler from Xiaohongshu, a popular female-centric social media platform in China. A mixed-methods approach used qualitative thematic analysis and quantitative descriptive statistics. Among these posts, therapeutic functionality emerged as the highest priority, followed by credibility and user experience, with specific design elements highlighted as particularly significant. These findings provide valuable insights for mental health researchers and developers, including you, aiming to create gender-tailored mobile solutions to address the mental health challenges faced by women, especially during future pandemics. Full article

(This article belongs to the Special Issue The Impact of COVID-19 on Mental Health across Diverse Populations)

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8 pages, 406 KiB

Open AccessArticle

Malnutrition Prevalence in Australian Residential Aged Care Facilities: A Cross-Sectional Study

by Marie-Claire O’Shea, Judy Bauer, Clare Barrett, Katina Corones-Watkins, Ursula Kellett, Stephen Maloney, Lauren T. Williams, Christian Osadnik and Jonathan Foo

Healthcare 2024, 12(13), 1296; https://doi.org/10.3390/healthcare12131296 - 28 Jun 2024

Viewed by 136

Abstract

Long-term or residential services are designed to support older people who experience challenges to their physical and mental health. These services play an important role in the health and well-being of older adults who are more susceptible to problems such as malnutrition. Estimates [...] Read more.

Long-term or residential services are designed to support older people who experience challenges to their physical and mental health. These services play an important role in the health and well-being of older adults who are more susceptible to problems such as malnutrition. Estimates of the significance of malnutrition require up-to-date prevalence data to inform government strategies and regulation, but these data are not currently available in Australia. The aim of this study was to collect malnutrition prevalence data on a large sample of people living in residential aged care facilities in Australia. A secondary aim was to examine the relationship between malnutrition and anthropometry (body mass index (BMI) and weight loss). This prevalence study utilised baseline data collected as part of a longitudinal study of malnutrition in 10 Residential Aged Care facilities across three states in Australia (New South Wales, South Australia, and Queensland). The malnutrition status of eligible residents was assessed by dietitians and trained student dietitians using the Subjective Global Assessment (SGA) with residents categorised into SGA-A = well nourished, SGA-B = mildly/moderately malnourished, and SGA-C = severely malnourished. Other data were extracted from the electronic record. Of the 833 listed residents, 711 residents were eligible and had sufficient data to be included in the analysis. Residents were predominantly female (63%) with a mean (SD) age of 84 (8.36) years and a mean (SD) BMI of 26.74 (6.59) kg/m². A total of 40% of residents were categorised as malnourished with 34% (n = 241) categorised as SGA-B, and 6% (n = 42) SGA-C. Compared to the SGA, BMI and weight loss categorisation of malnutrition demonstrated low sensitivity and high specificity. These findings provide recent, valid data on malnutrition prevalence and highlight the limitations of current Australian practices that rely on anthropometric measures that under-detect malnutrition. There is an urgent need to implement a feasible aged care resident screening program to address the highly prevalent condition of malnutrition in Australia. Full article

(This article belongs to the Special Issue Clinical Nutrition Management in Healthcare)

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12 pages, 2388 KiB

Open AccessArticle

Evaluating the Validity of International Standards of Height, Weight, and Body Mass Index on Jordanian Children and Adolescents

by Walid Al-Qerem, Ruba Zumot, Anan Jarab, Judith Eberhardt, Fawaz Alasmari and Alaa Hammad

Healthcare 2024, 12(13), 1295; https://doi.org/10.3390/healthcare12131295 - 28 Jun 2024

Viewed by 174

Abstract

Background: the variations in a child’s overall body shape and figure among different countries are attributable to differences in genetics, environmental factors, and the interaction between these elements. This study aims to evaluate the validity, reliability, and appropriateness of applying international growth standards [...] Read more.

Background: the variations in a child’s overall body shape and figure among different countries are attributable to differences in genetics, environmental factors, and the interaction between these elements. This study aims to evaluate the validity, reliability, and appropriateness of applying international growth standards to Jordanian children and adolescents aged 2–19 years old. Methods: 65,828 Jordanian children and adolescents (43% males; 57% females) aged 2–19 years old were selected from the Hakeem Program database and various private schools across Jordan. Height-for-age, weight-for-age, and body mass index (BMI)-for-age were analyzed comparatively for Jordanian children and adolescents against international growth standards. The z-score for each record was computed based on international equations. Results: Mean z-scores for height-for-age, weight-for-age, and BMI-for-age for both genders showed significant deviation from international standards across most age intervals. It was found that in most age groups, Jordanian children and adolescents were shorter and lighter than CDC and WHO standards, except for females at ages ≥ 16 years, who were heavier with higher BMI-for-age values than CDC standards based on weight-for-age and BMI-for-age equations. Moreover, Jordanian males at ages ≥ 12 years had lower BMI-for-age values than CDC standards. Conclusions: Jordanian children and adolescents showed significant deviations in their measurements from international standards and growth reference values. The development of a population-specific growth chart is highly recommended to enhance the accuracy of evaluating children’s and adolescents’ wellness. Full article

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10 pages, 653 KiB

Open AccessArticle

Diagnostic Accuracy of the Recognizing Acute Delirium as Part of Your Routine (RADAR) Scale for Delirium Assessment in Hospitalized Older Adults: A Cross-Sectional Study

by Diletta Fabrizi, Paola Rebora, Valentina Spedale, Giulia Locatelli, Giuseppe Bellelli, Stefania Di Mauro, Davide Ausili and Michela Luciani

Healthcare 2024, 12(13), 1294; https://doi.org/10.3390/healthcare12131294 - 28 Jun 2024

Viewed by 154

Abstract

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving [...] Read more.

Delirium is highly prevalent among hospitalized older adults and is associated with unfavorable outcomes. However, delirium often remains undiagnosed in the hospital context. Having a valid, simple, and fast screening tool could help in limiting the additional workload for healthcare professionals, without leaving delirium undetected. The aim of this study was to estimate the sensitivity and specificity of the Recognizing Acute Delirium As part of your Routine (RADAR) scale in an Italian hospital. An observational cross-sectional study was conducted. A total of 150 patients aged ≥70 years were enrolled. Receiver operating characteristic (ROC) curves using the Confusion Assessment Method (CAM) criterion-defined delirium as the gold standard were plotted to evaluate the performance of the RADAR scale. The cut-off suggested by previous research was used to estimate the sensitivity, specificity, and positive and negative predictive values of the RADAR scale. The involved patients were mostly females (60%; n = 90), with a median age of 84 years (I–III quartiles: 80–88). According to the CAM and the RADAR scale, 37 (25%) and 58 (39%) patients were classified as experiencing delirium, respectively. The area under the ROC curve of the RADAR scale was 0.916. Furthermore, the RADAR scale showed robust sensitivity (95%), specificity (80%), and positive (60%) and negative predictive values (98%). The RADAR scale is thus suggested to be a valid tool for screening assessment of delirium in hospitalized older adults. Full article

(This article belongs to the Special Issue Research, Education, Workforce, and Regulation to Transforming Nursing Practice and Leadership: The Future of Nursing)

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10 pages, 626 KiB

Open AccessArticle

Oral Hygiene Profile of Schoolchildren from Bucharest, Romania—How It Can Be Used and Improved for Better Prevention of Oral Diseases

by Cristian Funieru, Mihnea Ioan Nicolescu, Cristian Băicuş, Oana Slușanschi, Clara Ilinca Bica, Andreea Moldoveanu, Anca Cristina Perpelea and Adrian Teodor Țandără

Healthcare 2024, 12(13), 1293; https://doi.org/10.3390/healthcare12131293 - 28 Jun 2024

Viewed by 163

Abstract

Background: Oral hygiene is essential for low caries or gingivitis prevalence in children. This study aimed to determine the oral hygiene profile of children from secondary schools (10–17 years) in Bucharest, Romania, and to explore options for preventing their future oral diseases. Methods: [...] Read more.

Background: Oral hygiene is essential for low caries or gingivitis prevalence in children. This study aimed to determine the oral hygiene profile of children from secondary schools (10–17 years) in Bucharest, Romania, and to explore options for preventing their future oral diseases. Methods: The study was cross-sectional, with a sample of n = 1595 pupils. The sample was stratified by clusters in city areas, grades, and the criterion of the presence/absence of in-school dental service. Dental check-ups were performed by using a commune dental examination kit. The oral hygiene simplified index (OHI; Silness and Löe) was used to assess the children’s oral hygiene status. Five questions were used to determine oral hygiene habits. Results: The mean value of the OHI was 1.04. Some differences in oral hygiene scores were found for different socioeconomic variables, such as parents’ education (p < 0.05): parents with vs. without a university degree—0.95/0.94 (male/female) vs. 1.06. Most of the children used manual toothbrushes (88%). Conclusions: The analysis of objective data (OHI) revealed a good level of oral hygiene, with many socioeconomic disparities. Full article

(This article belongs to the Special Issue Contemporary Oral and Dental Health Care: Issues and Challenges)

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13 pages, 699 KiB

Open AccessReview

Cognitive Restructuring during Depressive Symptoms: A Scoping Review

by Bruno Santos, Lara Pinho, Maria José Nogueira, Regina Pires, Carlos Sequeira and Pilar Montesó-Curto

Healthcare 2024, 12(13), 1292; https://doi.org/10.3390/healthcare12131292 - 28 Jun 2024

Viewed by 172

Abstract

Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the [...] Read more.

Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the analysis of their thoughts. CR for people with depression has positive effects, although there is little research on how it should be structured and applied. CR is a thought modification technique presented in the Nursing Interventions Classification (NIC), but is not organized in a sequential approach, and there is no procedure for applying it in practice. This scoping review aims to identify the structure, contents and assessment instruments used in CR for people with depressive symptoms and to analyze the health outcomes of applying the CR technique in this population. Out of 515 articles, seven studies were included in the review, up to 2021 and without any time limitation. The studies were not guided by a consistent and sound framework of the CR technique and each study used its own framework, although they used similar techniques. We grouped CR into six steps. No specific studies were found regarding intervention by nurses. CR is effective in reducing depressive symptoms, so it is an important therapeutic tool that should be used on people with depression. With this scoping review, mental health nurses will have a more comprehensive idea of the techniques that can be used in the application of CR to patients with depressive symptoms. Full article

(This article belongs to the Section Healthcare Quality and Patient Safety)

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11 pages, 658 KiB

Open AccessSystematic Review

Revision Surgery for Shoulder Infection after Arthroscopic Rotator Cuff Repair: Functional Outcomes and Eradication Rate—A Systematic Review

by Michele Mercurio, Giorgio Gasparini, Erminia Cofano, Stefano Colace and Olimpio Galasso

Healthcare 2024, 12(13), 1291; https://doi.org/10.3390/healthcare12131291 - 28 Jun 2024

Viewed by 267

Abstract

The outcomes after arthroscopic rotator cuff repair (RCR) have been reported to be successful. The incidence of deep infections (defined as an infection involving any part of the anatomy other than the skin and subcutaneous tissue) after surgery ranges between 0.03% and 3.4%. [...] Read more.

The outcomes after arthroscopic rotator cuff repair (RCR) have been reported to be successful. The incidence of deep infections (defined as an infection involving any part of the anatomy other than the skin and subcutaneous tissue) after surgery ranges between 0.03% and 3.4%. This systematic review aims to investigate the outcomes of revision surgery for infection following arthroscopic RCR. Clinical outcomes and eradication rates among patients treated with different surgical and antibiotic therapies are analyzed. A total of five studies were eligible for systematic review. A total of 146 patients were treated and evaluated, of whom 71 (48%) and 75 (52%) underwent arthroscopic and open surgery to manage the infection, respectively. The most common causative bacterium was Cutibacterium acnes (50.4%). Two studies reported the pre-and postoperative ASES score and Constant–Murley score (CMS), and a statistically significant improvement was found after surgery (p < 0.001 for both). Eradication was observed in a total of 138 patients (94.5%); no difference was found between arthroscopic and open revision surgery (92.8% and 96%, respectively, p = 0.90). The frequency-weighted mean duration of the intravenous antibiotic therapy was 6.6 ± 5.4 days, while the overall mean duration of antibiotic therapy, considering intravenous and oral administration, was 43.5 ± 40 days. Patients with infection following arthroscopic RCR undergoing revision surgery experienced a high rate of eradication. A significant improvement in shoulder functionality and less residual pain can be expected. Full article

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13 pages, 702 KiB

Open AccessSystematic Review

The Effect of Dragon Boating on the Quality of Life for Breast Cancer Survivors: A Systematic Review

by Igor Herrero-Zapirain, Sergio Álvarez-Pardo, Arkaitz Castañeda-Babarro, Adrian Moreno-Villanueva and Juan Francisco Mielgo-Ayuso

Healthcare 2024, 12(13), 1290; https://doi.org/10.3390/healthcare12131290 - 27 Jun 2024

Viewed by 193

Abstract

Physical activity improves breast cancer-related symptoms in women and decreases cancer-related mortality. The main objective of this systematic review is to synthesize and analyze the evidence of the effect of dragon boating on the quality of life of female breast cancer survivors. A [...] Read more.

Physical activity improves breast cancer-related symptoms in women and decreases cancer-related mortality. The main objective of this systematic review is to synthesize and analyze the evidence of the effect of dragon boating on the quality of life of female breast cancer survivors. A systematic review based on the PRISMA method was conducted using four databases (Web of Science, Scopus, Cochrane and Pubmed). The search phrase used was “Breast Cancer” AND “Dragon Boat” AND “Quality of Life”. The search was conducted in June 2024. The PEDro method was used to ensure the quality of the publications. A total of 77 articles published until 2024 were selected, of which 10 met the inclusion criteria of assessing the application of dragon boating and that used a validated instrument to assess quality of life. There is no homogeneity in terms of the instrument used to measure QOL. The SF-36 was the most commonly used, followed by the FACT-B and the EORTC QLQ-C30. Five out of ten articles compared the improvement in quality of life between dragon boating and other physical activities, while 6 out of 10 analyzed the pre–post effect of dragon boat use. Dragon boating is a physical activity alternative that improves the quality of life of breast cancer survivors and reduces the symptomatology caused by the disease and its treatments. As dragon boat programs are applied over a longer period of time, the improvements in quality of life are greater. When compared with other types of physical activity, dragon boating does not show significant differences that position it as a better option for this population. Full article

(This article belongs to the Special Issue Non-pharmacological Approaches and Their Impact on Noncommunicable Diseases)

11 pages, 334 KiB

Open AccessArticle

Assessing the Dependence and Perceptions of the Harm and Addictiveness of Electronic Cigarettes among Saudi University Students: A Cross-Sectional Study

by Abdulwahab Aqeeli, Abdullah A. Alsabaani, Hassan Alshaiban, Ahmad Y. Alqassim, Anwar S. Alahmar, Abdullah Sabai and Saud Alwadani

Healthcare 2024, 12(13), 1289; https://doi.org/10.3390/healthcare12131289 - 27 Jun 2024

Viewed by 156

Abstract

(1) Background: The rising prevalence of e-cigarette use among university students necessitates a comprehensive understanding of dependence levels and associated factors. This study investigates e-cigarette dependence among Jazan University students in Saudi Arabia. (2) Methods: With the use of a cross-sectional design, data [...] Read more.

(1) Background: The rising prevalence of e-cigarette use among university students necessitates a comprehensive understanding of dependence levels and associated factors. This study investigates e-cigarette dependence among Jazan University students in Saudi Arabia. (2) Methods: With the use of a cross-sectional design, data were collected from 1187 students through an online survey from January to April 2024. Dependence levels were assessed using the Penn State Electronic Cigarette Dependence Index (PS-ECDI), and the Arabic version of the questionnaire was validated through pilot testing. Multivariable logistic regression analysis was employed to identify factors associated with e-cigarette dependence. (3) Results: The results indicated that among current e-cigarette users, 37.4% had low dependence, 34.4% had medium dependence, and 13.8% had high dependence. A significant proportion of current and ever users regarded e-cigarettes to be less harmful (50.6% and 44.4%, respectively) and less addictive (37.9% and 32.3%, respectively) than cigarettes. Significant factors influencing dependence included gender, with males showing higher odds of medium (AOR = 12.8, 95% CI: 3.4–47.6) and low dependence (AOR = 9.7, 95% CI: 2.5–37.3) compared to females. Longer duration of e-cigarette use (>2 years) was strongly associated with high dependence (AOR = 50, 95% CI: 7.7–324). Daily use and multiple quit attempts were also significant predictors of higher dependence levels. (4) Conclusions: These findings highlight the substantial e-cigarette dependence among university students and underscore the need for targeted interventions to address this growing public health concern. Full article

14 pages, 576 KiB

Open AccessArticle

Perception of Periodontitis Patients about Treatment Outcomes: A Cross-Sectional Study in Saudi Arabia

by Khalid Saad Alkhurayji, Hessah Al Suwaidan, Farah Kalagi, Mohamed Al Essa, Mohammed Alsubaie, Saja Alrayes and Arwa Althumairi

Healthcare 2024, 12(13), 1288; https://doi.org/10.3390/healthcare12131288 - 27 Jun 2024

Viewed by 156

Abstract

Patient compliance following periodontal therapy is extremely important in predicting the prognosis of the disease and maintaining treatment outcomes. Therefore, this study aimed to investigate the perception of periodontitis patients about treatment outcomes. A cross-sectional study was conducted among periodontitis patients in a [...] Read more.

Patient compliance following periodontal therapy is extremely important in predicting the prognosis of the disease and maintaining treatment outcomes. Therefore, this study aimed to investigate the perception of periodontitis patients about treatment outcomes. A cross-sectional study was conducted among periodontitis patients in a single dental center through a pre-validated questionnaire that was distributed to each participant in the waiting area of periodontal clinics by utilizing a convenience sampling technique. Median and interquartile ranges were used in addition to frequency and percentages. Bivariate analyses were performed using the Mann–Whitney U and Kruskal–Wallis test. Among the 300 male and female participants, the median score (interquartile range) of the current level of pain revealed that males experienced more pain than females, with a median score of 5 (0–7) for males and 4 (0–6) for women. However, the median (interquartile range) for desired and expected pain levels in both genders was 0 (0–1), 0 (0–4). There were significant differences in median score ratings between males and females for expected, distress, success, and importance levels (p-value < 0.05). Patients with periodontitis provided valuable insights into the experiences of individuals undergoing treatment for periodontal disease, indicating overall patient satisfaction with the expected levels of periodontal outcomes. Full article

23 pages, 1202 KiB

Open AccessArticle

An Exploratory Study of the Potential of Online Counseling for University Students by a Human-Operated Avatar Counselor

by Keita Kiuchi, Hidehiro Umehara, Koushi Irizawa, Xin Kang, Masahito Nakataki, Minoru Yoshida, Shusuke Numata and Kazuyuki Matsumoto

Healthcare 2024, 12(13), 1287; https://doi.org/10.3390/healthcare12131287 - 27 Jun 2024

Viewed by 201

Abstract

Recently, the use of digital technologies, such as avatars and virtual reality, has been increasingly explored to address university students’ mental health issues. However, there is limited research on the advantages and disadvantages of counselors using avatars in online video counseling. Herein, 25 [...] Read more.

Recently, the use of digital technologies, such as avatars and virtual reality, has been increasingly explored to address university students’ mental health issues. However, there is limited research on the advantages and disadvantages of counselors using avatars in online video counseling. Herein, 25 university students were enrolled in a pilot online counseling session with a human counselor-controlled avatar, and asked about their emotional experiences and impressions of the avatar and to provide qualitative feedback on their communication experience. Positive emotions during the session were associated with impressions of the avatar’s intelligence and likeability. The anthropomorphism, animacy, likeability, and intelligent impressions of the avatar were interrelated, indicating that the avatar’s smile and the counselor’s expertise in empathy and approval may have contributed to these impressions. However, no associations were observed between participant experiences and their prior communication with avatars, or between participant experiences and their gender or the perceived gender of the avatar. Accordingly, recommendations for future practice and research are provided. Accumulating practical and empirical findings on the effectiveness of human-operated avatar counselors is crucial for addressing university students’ mental health issues. Full article

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26 pages, 1741 KiB

Open AccessArticle

Evaluation of Community Involvement and Development in an Orthopedic Hospital

by Flaviu Moldovan and Liviu Moldovan

Healthcare 2024, 12(13), 1286; https://doi.org/10.3390/healthcare12131286 - 27 Jun 2024

Viewed by 190

Abstract

Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the [...] Read more.

Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the sustainability of healthcare organizations, which includes the area of community involvement and expansion. It is made up of nine indicators. These were designed using the most representative activities reported by hospitals around the world. Their testing was conducted in an orthopedic emergency hospital. The designed indicators are community engagement actions; the interventions’ content adapted to the community; partnership and networking; the involvement of volunteers and training networks; the involvement and participation of professional associations; community-involved local opinion leaders; satisfaction with partnerships; initiatives together with the community; and educational visits. The testing and validation of health practices of the indicators highlighted their adequacy with the proposed purpose of the research and the promotion of sustainable development. We have also verified their compatibility with the requirements of national hospital accreditation legislation and the European framework for quality assurance in hospitals. Full article

(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims: 2nd Edition)

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11 pages, 213 KiB

Open AccessArticle

Reflexive Views of Virtual Communities of Practice among Informal and Formal Caregivers of People with a Dementia Disease

by Sandra Lukic, Connie Lethin, Jonas Christensen and Agneta Malmgren Fänge

Healthcare 2024, 12(13), 1285; https://doi.org/10.3390/healthcare12131285 - 27 Jun 2024

Viewed by 183

Abstract

Knowledge seems to mitigate the consequences of dementia and new educational strategies are required. This study aimed to qualitatively explore the reflexive views and experiences of virtual Communities of Practice (vCoP) among informal and formal caregivers of people with dementia and explore vCoP [...] Read more.

Knowledge seems to mitigate the consequences of dementia and new educational strategies are required. This study aimed to qualitatively explore the reflexive views and experiences of virtual Communities of Practice (vCoP) among informal and formal caregivers of people with dementia and explore vCoP as a tool for learning and knowledge development. Data were collected in a sequence of virtual workshops and analyzed and synthesized using thematic analysis. For the informal caregivers, one main theme emerged: Learning and support, comprising three subthemes: Strategies for learning; Creating emotional support; and in need of professional support. Among formal caregivers, one main theme emerged: Professional development, comprising two subthemes: Sharing and gaining knowledge and Knowledge as a professional tool. vCoP and collaborative learning using an educational platform seem to support learning and professional development among informal and formal caregivers, respectively. As a collaborative, virtual activities seem to provide practical and emotional support and promote professional development; vCoP seem to have the potential to promote the resilience and sustainability of care. Further research is necessary to gain an understanding of the effects of Communities of Practice (CoP) and vCoP and their successful implementation in care practices as well as the potential of using CoP in continuing professional development, CPD. Full article

(This article belongs to the Special Issue Healthcare Practice in Community)

15 pages, 835 KiB

Open AccessArticle

Evaluating the Perceived Health-Related Effectiveness of ‘The Daily Mile’ Initiative in Irish Primary Schools

by Luke Hanna, Con Burns, Cian O’Neill and Edward Coughlan

Healthcare 2024, 12(13), 1284; https://doi.org/10.3390/healthcare12131284 - 27 Jun 2024

Viewed by 156

Abstract

Many Irish primary school children do not meet recommended physical activity (PA) guidelines. The Daily Mile (TDM) is a primary school initiative designed to increase children’s PA output. This study evaluates TDM’s perceived effect on Irish primary school children’s health-related metrics. A mixed-methods [...] Read more.

Many Irish primary school children do not meet recommended physical activity (PA) guidelines. The Daily Mile (TDM) is a primary school initiative designed to increase children’s PA output. This study evaluates TDM’s perceived effect on Irish primary school children’s health-related metrics. A mixed-methods study, comprising two data collection phases, used the RE-AIM framework to evaluate TDM. Phase One involved teachers, principals and classroom assistants (n = 191) from TDM-registered schools completing a questionnaire. Two TDM-registered schools participated in Phase Two, where (i) interviews were conducted with each principal, (ii) a teacher sub-sample (n = 4) participated in a focus group, and (iii) a child sub-sample (n = 14) participated in separate focus groups. TDM was perceived to positively impact the markers of children’s health, including their PA behaviour, physical fitness and social well-being. Inclement weather (66.5%) and a lack of time (56.5%) were reported as the top-ranked implementation barriers. Moreover, TDM’s repetitive nature often left children feeling disinterested and resulted in some teachers modifying the initiative to maintain engagement levels. Maintaining the long-term implementation of TDM and its health benefits in primary schools may require bespoke amendments to the original format to preserve children’s engagement. Full article

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15 pages, 526 KiB

Open AccessSystematic Review

Characteristics and Epidemiology of Megaprostheses Infections: A Systematic Review

by Luigi Cianni, Francesco Taccari, Maria Beatrice Bocchi, Giulia Micheli, Flavio Sangiorgi, Antonio Ziranu, Massimo Fantoni, Giulio Maccauro and Raffaele Vitiello

Healthcare 2024, 12(13), 1283; https://doi.org/10.3390/healthcare12131283 - 27 Jun 2024

Viewed by 238

Abstract

Background: Megaprostheses were first employed in oncological orthopedic surgery, but more recently, additional applications have arisen. These implants are not without any risks and device failure is quite frequent. The most feared complication is undoubtedly the implants’ infection; however, the exact incidence is [...] Read more.

Background: Megaprostheses were first employed in oncological orthopedic surgery, but more recently, additional applications have arisen. These implants are not without any risks and device failure is quite frequent. The most feared complication is undoubtedly the implants’ infection; however, the exact incidence is still unknown. This systematic review aims to estimate in the current literature the overall incidence of megaprosthesis infections and to investigate possible risk/protective factors. Methods: We conducted a systematic search for studies published from July 1971 to December 2023 using specific keywords. To be included, studies needed to report either the megaprosthesis anatomical site, and/or whether the megaprosthesis was coated, and/or the surgical indication as oncological or non-oncological reasons. Results: The initial literature search resulted in 1281 studies. We evaluated 10,456 patients and the overall infection rate was 12%. In cancer patients, the infection rate was 22%, while in non-oncological patients, this was 16% (trauma 12%, mechanical failure 17%, prosthetic joint infections 26%). The overall infection rates comparing coated and uncoated implants were 10% and 12.5%, respectively. Conclusions: The number of megaprosthesis implants is increasing considerably. In traumatological patients, the infection rate is lower compared to all the other subgroups, while the infection rate remains higher in the cancer patient group. As these devices become more common, focused studies exploring epidemiological data, clinical outcomes, and long-term complications are needed to address the uncertainties in prevention and management. Full article

(This article belongs to the Special Issue Orthopedic Implant-Associated Infections: Unlocking the Secrets of Prevention and Treatment)

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14 pages, 1490 KiB

Open AccessArticle

The Development and Content Validation of a Clinical Screening Scale to Identify Attention-Deficit Hyperactivity Disorder Cases Based on the Gender Perspective: An e-Delphi Study

by Meritxell Perez-Beltran, Juan Roldán-Merino, Maria Eugenia Russi, Maria Garau Rolandi, Roser Colome Roura, Francisco Sampaio, Marta Domínguez Del Campo, Mariona Farres-Tarafa, Barbara Hurtado Pardos and José Ángel Alda Díez

Healthcare 2024, 12(13), 1282; https://doi.org/10.3390/healthcare12131282 - 27 Jun 2024

Viewed by 211

Abstract

Background: Although many studies analyse gender differences in the clinical expression of Attention-Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls with ADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls with ADHD. Objective: The objective [...] Read more.

Background: Although many studies analyse gender differences in the clinical expression of Attention-Deficit Hyperactivity Disorder (ADHD) and prevalence studies show that girls with ADHD are underdiagnosed, there are no instruments that are sensitive to the detection of girls with ADHD. Objective: The objective of this study is to develop a self-report early detection instrument for boys and girls with ADHD aged 7 to 16, which includes the gender perspective and is sensitive to the detection of girls with ADHD. Methods: The scale was developed and the items that comprised it were created from the thematic analysis of ADHD and its evaluation in children based on the diagnostic criteria of the DSM-5-TR. A modified e-Delphi method involving a three-round web survey was used to establish a consensus on the content of the scale. Ten experts were recruited to form a professional panel. The panel members were asked to assess the differential symptomatology of ADHD in boys and girls, the dimensions to be evaluated, and the importance of scale items to evaluate the content. Results: A consensus was reached regarding 13 total items distributed in three dimensions: inattention; hyperactivity/impulsivity; and, a third dimension, internalisation, which includes symptoms most present in the expression of ADHD in girls. Conclusions: To the best of our knowledge, the development of this scale using the Delphi method is the first specific scale used for identifying ADHD that also addresses the gender perspective and the differential symptomatology between boys and girls. However, we must proceed to the analysis of psychometric properties, as the scale requires an exhaustive study of its reliability and validity. We can anticipate that this scale will provide relevant and reliable information that can be used for the identification of ADHD in both boys and girls. Full article

(This article belongs to the Section Healthcare Quality and Patient Safety)

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12 pages, 509 KiB

Open AccessArticle

Obesity in Saudi Medical Students and Alignment with Eating Disorders: A Stratified Random Cross-Sectional Investigation

by Abdullah A. Alrasheed, Nasser M. AbuDujain, Samar Almohammedi, Rahaf Alrayes, Fahad Alajlan, Osama Abdulqader, Majd Albarrak, Khalid H. Alharbi, Turky H. Almigbal and Mohammed A. Batais

Healthcare 2024, 12(13), 1281; https://doi.org/10.3390/healthcare12131281 - 27 Jun 2024

Viewed by 330

Abstract

As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for [...] Read more.

As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for these students. We conducted a quantitative analytical cross-sectional study at the College of Medicine at King Saud University between November 2023 and February 2024. A stratified random sampling technique was utilized, enrolling a net number of 415 participants. Participants were asked several questions, including demographic information, weight, height, and past medical history, and were given a validated screening tool for EDs. Participants’ mean age was 21.4 ± 1.67 years, and 17.6% were considered obese. The prevalence of positive screening for EDs was 27.7%; it was more common in females (p = 0.013) and those who earned more than 1000 SAR per month (p = 0.011). Female students also exhibited almost twice the odds of having EDs than males (AOR = 1.957; 95% CI = 1.218–3.146; p = 0.006). Furthermore, non-obese students showed decreased odds of having EDs compared with obese students by at least 48% (AOR = 0.517; 95% CI = 0.287–0.929; p = 0.027). Our study revealed a concerning prevalence of ED symptoms and obesity among medical students, suggesting profound implications. Therefore, multicenter studies are needed to assess the generalizability of the results and apply the findings to targeted national campaigns and interventions tailored specifically to medical students. Full article

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16 pages, 525 KiB

Open AccessReview

A Preliminary Scoping Review of the Impact of e-Prescribing on Pharmacists in Community Pharmacies

by Amr A. Farghali and Elizabeth M. Borycki

Healthcare 2024, 12(13), 1280; https://doi.org/10.3390/healthcare12131280 - 26 Jun 2024

Viewed by 273

Abstract

Objective: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow. Methods: The literature search was conducted using PubMed^®, Web of Science [...] Read more.

Objective: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow. Methods: The literature search was conducted using PubMed^®, Web of Science^®, and the Cochrane Database of Systematic Reviews^®, as well as grey literature reports, using the search terms and related components of “pharmacists”, “electronic prescribing”, “medication errors”, and “efficiency”. The search included all articles that were published from January 2011 to September 2023. Twenty-two relevant articles were identified and fully reviewed, ten of which were included in this review. Results: Electronic prescribing (e-prescribing) provides a solution for some of the challenges that are associated with handwritten and paper prescriptions. However, the implementation of e-prescribing systems has been recognized as a source of new unforeseen medication errors in all the reviewed articles. Productivity in community pharmacies has been affected with receiving electronic prescriptions (e-prescriptions) and having to deal with the issues that arise from them. The pharmacists’ interventions were not eliminated with e-prescriptions compared to other prescription formats. The most frequently reported reason for intervention was related to incomplete instructions in the field of directions of use. Other common challenges with e-prescriptions were related to missing information, quantity, inappropriate dose, dosage form, and drug. Discussion: This review demonstrates the scarcity of research about the impact of electronic prescribing on medication error and efficiency in community pharmacies. In the literature, most of the studies had mainly focused on hospital pharmacies. The literature search demonstrated that there are still some barriers to overcome with e-prescribing systems and that medication errors were not fully eliminated with e-prescriptions. New errors have been identified with e-prescriptions, all of which caused delays in processing, which affected the productivity of the pharmacy staff, and could have negatively impacted patients’ safety if not properly resolved. Conclusion: e-Prescribing solved some of the challenges associated with illegibility of handwritten prescriptions. However, more time is required to allow e-prescribing systems to mature. Further training for prescribers and pharmacists is also recommended before and after the implementation. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Medication Management)

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14 pages, 758 KiB

Open AccessArticle

Laser Acupuncture versus Liraglutide in Treatment of Obesity: A Multi-Institutional Retrospective Cohort Study

by Wen-Lin Yu, Yu-Ning Liao, Tsung-Hsien Yang, Ching-Wei Yang, Ting-I Kao, Pai-Wei Lee, Chiu-Yi Hsu, Jhen-Ling Huang, Yu-Tung Huang and Hsing-Yu Chen

Healthcare 2024, 12(13), 1279; https://doi.org/10.3390/healthcare12131279 - 26 Jun 2024

Viewed by 223

Abstract

Background: Obesity is a global concern, driving the search for alternative treatments beyond lifestyle changes and medications. Laser acupuncture (LA) shows promise in obesity management, yet few studies compare it with FDA-approved medications. This study aimed to assess and compare LA’s impact with [...] Read more.

Background: Obesity is a global concern, driving the search for alternative treatments beyond lifestyle changes and medications. Laser acupuncture (LA) shows promise in obesity management, yet few studies compare it with FDA-approved medications. This study aimed to assess and compare LA’s impact with liraglutide on weight reduction in obese individuals. Methods: Data from the Chang Gung Research Database (CGRD) (2013–2018) were analyzed. Primary outcomes included changes in body weight and BMI within 180 days, with secondary outcomes measuring the proportion achieving 5%, 10%, and 15% weight loss. Adverse events were also assessed. Results: Of 745 subjects (173 LA users, 572 liraglutide users), LA users lost more weight by day 180 (5.82 ± 4.39 vs. 2.38 ± 5.75 kg; p < 0.001) and had a greater BMI reduction (−2.27 ± 1.73 vs. −0.93 ± 2.25 kg/m²; p < 0.001). More LA users achieved 5% and 10% weight loss compared to liraglutide users (64.2% vs. 22.7%, 26.6% vs. 4.2%; all p < 0.001). After balancing baseline differences, LA’s benefits remained significant. No adverse events were reported with LA. Conclusions: LA may offer superior weight reduction compared to liraglutide. Future studies should explore LA alone or in combination with liraglutide for obesity management. Full article

(This article belongs to the Special Issue Emerging Developments in Integrative and Complementary Medicine: Advancements in Research and Clinical Applications)

16 pages, 368 KiB

Open AccessArticle

Exploring the Relationship between Co-Sleeping, Maternal Mental Health and Expression of Complaints during Infancy, and Breastfeeding

by Marilena Vogiatzoglou, Maria Iliadou, Evangelia Antoniou, Ewa Andersson, Irina Mrvoljak-Theodoropoulou, Calliope Dagla, Dimitra Sotiropoulou, Eleni Tsolaridou, Eirini Orovou, Eirini Tomara and Maria Dagla

Healthcare 2024, 12(13), 1278; https://doi.org/10.3390/healthcare12131278 - 26 Jun 2024

Viewed by 246

Abstract

Background: This study explores whether the implementation of co-sleeping in infants aged 6–12 months (a) is associated with maternal complaints and mothers’ difficulties regarding their infant’s sleep, (b) is associated with maternal mental health, (c) affects infant sleep characteristics and maternal sleep quality, [...] Read more.

Background: This study explores whether the implementation of co-sleeping in infants aged 6–12 months (a) is associated with maternal complaints and mothers’ difficulties regarding their infant’s sleep, (b) is associated with maternal mental health, (c) affects infant sleep characteristics and maternal sleep quality, and (d) is associated with breastfeeding. Methods: This study is a cross-sectional study conducted from July to November 2021. A total of 151 new mothers of infants aged 6–12 months participated. All participants were divided into two different groups, the group of mothers who adopted the co-sleeping method from birth up to the time of the survey and the group of those who did not adopt co-sleeping at that time. The Brief Infant Sleep Questionnaire—Revised Short Form (BISQ-R SF), the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI), and a questionnaire on mothers’ demographics were administered. Results: Regarding the mothers’ complaints, mothers who co-sleep with their children have lower sleep quality than those who do not co-sleep. In respect of the mothers’ mental health, there did not seem to be a statistically significant difference in the two groups. Regarding the difficulties during the sleep process, children who sleep with their parents seem to have more difficulties compared to the others (p = 0.008). It was also shown that co-sleeping children seem to have more disturbed sleep compared to those who sleep alone (p = 0.018), and a general trend obtained of a significantly higher number of awakenings for co-sleeping children (p < 0.001). Finally, breastfeeding appeared to be more related to the children of the present sample sleeping with their parents (p < 0.001). Conclusions: This study showed that co-sleeping is associated with more difficulties in infant and maternal sleep, but no direct correlation with maternal mental health was found. In addition, it showed a positive correlation of co-sleeping with breastfeeding. Full article

13 pages, 357 KiB

Open AccessArticle

Predictors of Perceived Healthcare Professionals’ Well-Being in Work Design: A Cross-Sectional Study with Multigroup PLS Structural Equation Modeling

by Danijela Nesic, Marko Slavkovic, Nebojsa Zdravkovic and Nikola Jerkan

Healthcare 2024, 12(13), 1277; https://doi.org/10.3390/healthcare12131277 - 26 Jun 2024

Viewed by 248

Abstract

The growing attention paid to employee well-being in the healthcare system, along with the reinforcement of factors that drive change in the work environment, provides a strong foundation for studying the relationship between work design and its related outcomes. The aim of this [...] Read more.

The growing attention paid to employee well-being in the healthcare system, along with the reinforcement of factors that drive change in the work environment, provides a strong foundation for studying the relationship between work design and its related outcomes. The aim of this study was to examine the relationship between the elements of work design and the overall well-being of healthcare professionals, particularly the differences across multiple groups of various genders and age brackets. A cross-sectional study design was employed, and a convenience sampling method was used. The study participants were healthcare professionals, and a total of 427 valid surveys were collected. The partial least squares structural equation modeling (PLS-SEM) approach was deployed to test the relationship between the determinants of work design and the perceived well-being of healthcare professionals. The results indicate a strong positive relationship between the social characteristics of work and overall well-being, as well as a positive contribution of the work context to the perceived well-being of healthcare professionals. The findings validated that knowledge characteristics had no beneficial impacts on overall well-being; nor did the task characteristics of work design. Although the mentioned associations failed to demonstrate statistical significance, the results nonetheless have significant practical consequences that are comparable to those of the relationships that demonstrated statistical significance. Full article

14 pages, 859 KiB

Open AccessArticle

The Potential Benefits of Acute Aronia Juice Supplementation on Physical Activity Induced Alterations of the Serum Protein Profiles in Recreational Runners: A Pilot Study

by Tamara Uzelac, Marija Takić, Vuk Stevanović, Nevena Vidović, Ana Pantović, Petar Jovanović and Vesna Jovanović

Healthcare 2024, 12(13), 1276; https://doi.org/10.3390/healthcare12131276 - 26 Jun 2024

Viewed by 224

Abstract

Intensive physical activity (PA) can lead to proteinuria and, consequently, serum protein profiles in athletes. Therefore, the aim of this study was to investigate the effects of acute aronia juice consumption before a simulated half-marathon race on serum protein profiles in recreational runners. [...] Read more.

Intensive physical activity (PA) can lead to proteinuria and, consequently, serum protein profiles in athletes. Therefore, the aim of this study was to investigate the effects of acute aronia juice consumption before a simulated half-marathon race on serum protein profiles in recreational runners. The pilot study was designed as a single-blind, placebo-controlled, crossover study, with 10 male participants who consumed aronia juice (containing 1.3 g polyphenols) or placebo before the race. The blood levels of total proteins, albumin, the non-albumin fractions gamma, beta, alpha2 and alpha1, as well as renal function parameters, were determined before and 15 min, 1 h and 24 h after the race. The significant changes in urea, creatinine and uric acid levels were noticed at selected time points in both groups. In the placebo group, a significant decrease in total proteins (p < 0.05) was observed 24 h after the race, along with an increase in gamma fraction abundance (p < 0.05). In addition, urea and uric acid levels returned to baseline only in the aronia group 24 h after the race. Thus, according to the results obtained, acute aronia juice supplementation before intensive PA could influence the transient change in renal function and PA-induced protein loss in recreational runners. Full article

(This article belongs to the Special Issue Nutrition and Supplementation for Human Performance)

13 pages, 310 KiB

Open AccessArticle

Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults

by Amanda Andrade, Tânia Nascimento, Catarina Cabrita, Helena Leitão and Ezequiel Pinto

Healthcare 2024, 12(13), 1275; https://doi.org/10.3390/healthcare12131275 - 26 Jun 2024

Viewed by 213

Abstract

Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This [...] Read more.

Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population. Full article

(This article belongs to the Section Medication Management)

9 pages, 227 KiB

Open AccessArticle

Exploring Stroke Patients’ Needs: A Cultural Adaptation and Validation of the Modified Needs Assessment Questionnaire in a Greek Context

by Katerina Paschalidou, Efi Tsitskari, Anna Tsiakiri, Evangelia Makri, Pinelopi Vlotinou, Konstantinos Vadikolias and Nikolaos Aggelousis

Healthcare 2024, 12(13), 1274; https://doi.org/10.3390/healthcare12131274 - 26 Jun 2024

Viewed by 213

Abstract

Stroke survivors often face diverse unmet needs highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for [...] Read more.

Stroke survivors often face diverse unmet needs highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally the research sought to identify potential differences in the assessment of stroke patients’ needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors adhering to World Health Organization guidelines and providing autonomous consent participated in the study. The mNAQ comprising 141 items across 12 domains was utilized to evaluate stroke patients’ needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory factor analysis, exploratory factor analysis and Cronbach’s reliability analysis to establish construct validity and internal consistency. Concurrent and known-groups validity analyses were conducted; and Spearman’s rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications guided by confirmatory and exploratory factor analyses resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively differentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for comprehensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care improving functional outcomes and ultimately enhancing the overall well-being and quality of life for stroke survivors. Full article

(This article belongs to the Section Healthcare Quality and Patient Safety)

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Healthcare, Volume 12, Issue 13 (July-1 2024) – 66 articles

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