Healthcare

16 pages, 1458 KiB

Open AccessArticle

Investigating the Effectiveness of a Workplace Musculoskeletal Disorders Management Program

by Eleni Grana, Petros Galanis, Emmanuel Velonakis, Styliani Tziaferi and Panayota Sourtzi

Healthcare 2024, 12(18), 1815; https://doi.org/10.3390/healthcare12181815 - 10 Sep 2024

Musculoskeletal disorders (MSDs) present a major occupational health challenge, especially among office workers. Objective: To evaluate the effectiveness of a workplace intervention program for managing MSDs and measure its impact on presenteeism/absenteeism and health status. Methods: This semi-experimental study was conducted [...] Read more.

Musculoskeletal disorders (MSDs) present a major occupational health challenge, especially among office workers. Objective: To evaluate the effectiveness of a workplace intervention program for managing MSDs and measure its impact on presenteeism/absenteeism and health status. Methods: This semi-experimental study was conducted between May 2019 and October 2022 in Greece and involved 247 office workers randomly assigned to early and late intervention groups. The intervention included a seminar on ergonomics and proper workstation practices with a demonstration of exercises. Data were collected by the SF-36, the Standardised Nordic, and the Work Productivity and Activity Impairment Questionnaires. Results: In the early intervention group (n = 143), presenteeism significantly decreased (p = 0.045), from a mean value of 0.11 to 0.07, but not absenteeism. Significant improvements were observed in physical (p = 0.007) and mental health (p = 0.012). Reductions in pain were recorded for the neck (p = 0.032), shoulders (p = 0.015), wrists (p = 0.014), upper back, lower back, hips, and knees (p = 0.044 for each). In the late intervention group (n=104), there were no significant changes in absenteeism or presenteeism. Mental health improved significantly (p = 0.008), and reductions in pain were noted for the neck (p = 0.001), wrist (p = 0.0005), and upper back (p = 0.001). Conclusions: This workplace intervention program proved effective both in reducing pain in various body areas and reducing presenteeism, and improved physical and mental health were observed in the intervention groups while absenteeism remained unchanged. Full article

(This article belongs to the Special Issue Health Risks in the Work Environment: Assessment and Improvement)

► Show Figures

Figure 1

21 pages, 988 KiB

Open AccessSystematic Review

Navigation Support during Transitions in Care for Persons with Complex Care Needs: A Systematic Review

by Lyndsay Howitt, Greeshma Jacob, Giulia Zucal, Judy Smith, Rhonda Crocker Ellacott and Shirlee Sharkey

Healthcare 2024, 12(18), 1814; https://doi.org/10.3390/healthcare12181814 - 10 Sep 2024

Abstract

Persons with complex care needs that arise due to chronic health conditions, serious illness, or social vulnerability are at increased risk of adverse health outcomes during transitions in care. To inform the development of a best practice guideline, a systematic review was conducted [...] Read more.

Persons with complex care needs that arise due to chronic health conditions, serious illness, or social vulnerability are at increased risk of adverse health outcomes during transitions in care. To inform the development of a best practice guideline, a systematic review was conducted to examine the effect that navigation support has during transitions in care on quality of life, emergency department visits, follow-up visits, patient satisfaction, and readmission rates for persons with complex care needs. Eight databases were searched from 2016 to 2023. Studies were appraised using validated tools and data were extracted and presented narratively. The GRADE approach was used to assess the certainty of the evidence. Seventeen studies were included and the majority focused on transitions from hospital to home. Navigation support was provided for one month to one year following a transition. Results weakly indicate that providing navigation support during transitions in care may increase follow-up visits, reduce readmissions within 30 days, and increase patient satisfaction for persons with complex care needs. There were no important differences for quality of life and emergency department visits within 30 days of a transition. The certainty of the evidence was very low. Providing navigation support during transitions in care may improve outcomes for persons with complex needs; however, there remains uncertainty regarding the effectiveness of this intervention and more high-quality research is needed. Full article

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

► Show Figures

Figure 1

13 pages, 859 KiB

Open AccessArticle

Explain Breathlessness: Could ‘Usual’ Explanations Contribute to Maladaptive Beliefs of People Living with Breathlessness?

by Marie T. Williams, Hayley Lewthwaite, Dina Brooks and Kylie N. Johnston

Healthcare 2024, 12(18), 1813; https://doi.org/10.3390/healthcare12181813 - 10 Sep 2024

Abstract

Background: Explanations provided by healthcare professionals contribute to patient beliefs. Little is known about how healthcare professionals explain chronic breathlessness to people living with this adverse sensation. Methods: A purpose-designed survey disseminated via newsletters of Australian professional associations (physiotherapy, respiratory medicine, palliative care). [...] Read more.

Background: Explanations provided by healthcare professionals contribute to patient beliefs. Little is known about how healthcare professionals explain chronic breathlessness to people living with this adverse sensation. Methods: A purpose-designed survey disseminated via newsletters of Australian professional associations (physiotherapy, respiratory medicine, palliative care). Respondents provided free-text responses for their usual explanation and concepts important to include, avoid, or perceived as difficult to understand by recipients. Content analysis coded free text into mutually exclusive categories with the proportion of respondents in each category reported. Results: Respondents (n = 61) were predominantly clinicians (93%) who frequently (80% daily/weekly) conversed with patients about breathlessness. Frequent phrases included within usual explanations reflected breathlessness resulting from medical conditions (70% of respondents) and physiological mechanisms (44%) with foci ranging from multifactorial to single-mechanism origins. Management principles were important to include and phrases encouraging maladaptive beliefs were important to avoid. The most frequent difficult concept identified concerned inconsistent relationships between oxygenation and breathlessness. Where explanations included the term ’oxygen’, a form of cognitive shortcut (heuristic) may contribute to erroneous beliefs. Conclusions: This study presents examples of health professional explanations for chronic breathlessness as a starting point for considering whether and how explanations could contribute to adaptive or maladaptive breathlessness beliefs of recipients. Full article

► Show Figures

Figure 1

26 pages, 1559 KiB

Open AccessReview

Impact of Natural Disasters on Mental Health: Evidence and Implications

by Eamin Z. Heanoy and Norman R. Brown

Healthcare 2024, 12(18), 1812; https://doi.org/10.3390/healthcare12181812 - 10 Sep 2024

Abstract

Natural disasters are large-scale catastrophic events, and they are increasing in frequency and severity. Converging evidence indicates that the mental health consequences of disasters are extensive and are often associated with trauma and the disruption of personal and socioeconomic factors in people’s lives. [...] Read more.

Natural disasters are large-scale catastrophic events, and they are increasing in frequency and severity. Converging evidence indicates that the mental health consequences of disasters are extensive and are often associated with trauma and the disruption of personal and socioeconomic factors in people’s lives. Although most individuals experiencing disaster-related traumatic events do not develop mental illnesses, some experience adverse psychological effects of disasters. These mental health effects begin immediately following a disaster and may persist for extended periods. In this article, we summarize the literature findings to provide a narrative review that focuses on the mental health consequences of natural disasters. An overview of the disaster mental health research field is provided, and the findings are ordered into theoretical frameworks. Then, the development and course of psychopathology regarding disaster aftermath are described in a methodological context. Next, understanding a disaster as an event of transition is highlighted, and the impact of this disaster-specific transition is discussed. Lastly, a potential relationship between the transitional impact of a disaster and mental health consequences is speculated on, and the implications are discussed. The impact of disasters on mental health can be direct or indirect, short-term or long-term, and to some extent depends on the recovery process of the affected community. Also, we propose the possible merits of using the Transitional Impact Scale in the context of disaster mental health research by assessing the features of disaster-related transition and its effects on mental health. We conclude by suggesting a direction for future research in terms of measuring the disaster mental health effects in community settings (affected vs. non-affected) and also considering cross-cultural and cross-regional differences. In recent decades, a large amount of knowledge has been gathered from disaster mental health research, but, still, more research is needed to resolve some irregular findings through refining the methodological variations. Full article

► Show Figures

Figure 1

11 pages, 249 KiB

Open AccessArticle

Evaluation of Evidence-Based Practice Competency among Greek Undergraduate Nursing Students

by Eleni Miliara, Athena Kalokairinou, Stefania Schetaki, Evridiki Patelarou and Athina Patelarou

Healthcare 2024, 12(18), 1811; https://doi.org/10.3390/healthcare12181811 - 10 Sep 2024

Abstract

For several years, the global scientific community has accepted and recognized the importance of evidence-based practice for nursing science. The main factor for the implementation of evidence-based practice is the competence of undergraduate nursing students towards evidence-based practice, so that they as active [...] Read more.

For several years, the global scientific community has accepted and recognized the importance of evidence-based practice for nursing science. The main factor for the implementation of evidence-based practice is the competence of undergraduate nursing students towards evidence-based practice, so that they as active nurses are ready for its application in their clinical practice, in order to provide better care for their patients. The aim of the present study is to examine the level of evidence-based practice competency evaluated with the self-reported Evidence-Based Practice Competence Questionnaire. It is important to mention that such a study has not been conducted on nursing students in Greece, but only on registered nurses. A quantitative study based on cross-sectional design was conducted from February to June 2022 in a convenience sample of Greek undergraduate nursing students. The SPSS 26.0 program was used to perform descriptive, bivariate, and multivariate analyses. A total of 175 undergraduate students participated at the Hellenic Mediterranean University Department of Nursing (Greece), specifically from the 2nd and 3rd academic years. The mean score of the Evidence-Based Practice Competence Questionnaire for nursing undergraduate students was 3.03 ± 0.26, indicating moderate evidence-based practice. Among the Evidence-Based Practice Competence Questionnaire dimensions, mean scores of 3.03 ± 0.32 for attitude toward evidence-based practice, 3.01 ± 0.49 for skills in evidence-based practice, and 3.03 ± 0.49 for knowledge in evidence-based practice were obtained. Significant differences among participants’ mean Evidence-Based Practice Competence Questionnaire scores regarding gender (p = 0.766), age (p = 0.400), academic year (p = 0.153), and training in the field of research methodology (p = 0.538) were not found. It appears that the level of readiness towards evidence-based practice is mediocre among undergraduate nursing students at a university in Greece. Therefore, it is necessary to carry out new studies in the future, so that there is a correct approach of all the elements that contribute to the readiness of nursing undergraduate students regarding evidence-based practice. Full article

17 pages, 638 KiB

Open AccessArticle

Effect of Comprehensive Educational Program on Preeclamptic Women’s Risk Perception of Cardiovascular Disease, Self-Efficacy, and Adherence to Healthy Lifestyle Behaviors

by Nahed Ahmed Hussien, Hend Ali Mohamed Abd El-fatah, Zhenxiang Zhang, Hassanat Ramadan Abdel-Aziz, Ahmad Mahmoud Saleh, Kamala Dhakal, Yongxia Mei and Asmaa Morgan Farahat Khatap

Healthcare 2024, 12(18), 1810; https://doi.org/10.3390/healthcare12181810 - 10 Sep 2024

Abstract

Purpose: To evaluate the effect of a comprehensive educational program on preeclamptic women’s knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. Patients and methods: This study employed a pretest-posttest design. One hundred and two women who previously had [...] Read more.

Purpose: To evaluate the effect of a comprehensive educational program on preeclamptic women’s knowledge, risk perception of cardiovascular disease, self-efficacy, and adherence to healthy lifestyle behaviors. Patients and methods: This study employed a pretest-posttest design. One hundred and two women who previously had preeclampsia were enrolled from July 2022 to December 2022 from outpatient obstetric, gynecological, and family planning clinics. The primary and secondary outcomes were measured at baseline, after eight weeks, and after three months of the educational intervention. The data were analyzed using SPSS version 23, descriptive and inferential statistics, specifically the Chi-square test, independent t-tests, and repeated measures ANOVA. Results: A statistically significant difference was found between the two groups immediately post-intervention and the three-month follow-up, with a significant improvement among the intervention group than control group regarding cardiovascular disease knowledge (p < 0.001), risk perception (p < 0.001), self-efficacy (p < 0.001), and healthy lifestyle behaviors (p < 0.001). There was a statistically significant interaction between group and time regarding total cardiovascular disease risk perception (F = 203.67, p < 0.001, η2 = 0.673), self-efficacy (F = 70.06, p < 0.001, η2 = 0.405), and adherence to healthy lifestyle behaviors (F = 145.08, p < 0.001, η2 = 0.597). Conclusion: This study concluded that the comprehensive educational program had a positive effect on improving preeclamptic women’s knowledge and risk perception of CVD, self-efficacy, and adherence to healthy lifestyle behaviors following preeclampsia. Full article

(This article belongs to the Special Issue Focus on Maternal, Pregnancy and Child Health)

► Show Figures

Figure 1

11 pages, 7988 KiB

Open AccessArticle

Temporal Mortality Trends Attributable to Stroke in South Asia: An Age–Period–Cohort Analysis

by Ruhai Bai, Minmin Li, Ashok Bhurtyal, Wenxuan Zhu, Wanyue Dong, Di Dong, Jing Sun, Yanfang Su and Yan Li

Healthcare 2024, 12(18), 1809; https://doi.org/10.3390/healthcare12181809 - 10 Sep 2024

Abstract

South Asia contributes the most to stroke mortality worldwide. This study aimed to determine the long-term trends in stroke mortality across four South Asian countries and its associations with age, period, and birth cohort. In 2019, nearly one million stroke deaths occurred across [...] Read more.

South Asia contributes the most to stroke mortality worldwide. This study aimed to determine the long-term trends in stroke mortality across four South Asian countries and its associations with age, period, and birth cohort. In 2019, nearly one million stroke deaths occurred across South Asia, and the associated age-standardized mortality rate (ASMR) was 80.2 per 100,000. Between 1990 and 2019, India had the largest decrease in the ASMR (−35.8%) across the four South Asian countries. While Pakistan had the smallest decrease in the ASMR (−7.6%), an increase was detected among males aged 15 to 34 years and females aged 15 to 19 years. Despite a 22.8% decrease in the ASMR, Bangladesh had the highest ASMR across the four South Asian countries. Nepal reported a witness increase in the stroke ASMR after 2006. Improved period and cohort effects on stroke mortality were generally indicated across the analyzed countries, except for recent-period effects in males from Nepal and cohort effects from those born after the 1970s in Pakistan. Stroke mortality has decreased in the four South Asian countries over the past 30 years, but potentially unfavorable period and cohort effects have emerged in males in Nepal and both sexes in Pakistan. Governmental and societal efforts are needed to maintain decreasing trends in stroke mortality. Full article

► Show Figures

Figure 1

12 pages, 415 KiB

Open AccessArticle

Association between Motoric Cognitive Risk Syndrome and Indicators of Reflecting Independent Living among Community-Dwelling Older Adults in Japan: A Cross-Sectional Study

by Koji Takimoto, Hideaki Takebayashi, Yoshiyuki Yoshikawa, Hiromi Sasano, Soma Tsujishita and Koji Ikeda

Healthcare 2024, 12(18), 1808; https://doi.org/10.3390/healthcare12181808 - 10 Sep 2024

Abstract

The purpose of this study was to examine whether motoric cognitive risk syndrome (MCR) is associated with various indicators of independent living among community-dwelling older adults in Japan. The study design was a cross-sectional study, and the participants were 107 community-dwelling older adults [...] Read more.

The purpose of this study was to examine whether motoric cognitive risk syndrome (MCR) is associated with various indicators of independent living among community-dwelling older adults in Japan. The study design was a cross-sectional study, and the participants were 107 community-dwelling older adults (mean age 79 ± 7 years) who were living independently. The participants were administered the Questionnaire for Medical Checkup of Old-Old (QMCOO) as an indicator of health status and the Japan Science and Technology Agency Index of Competence (JST-IC) as an indicator of higher levels of functioning capacity, among others. In addition, we assessed physical frailty (J-CHS), sarcopenia (AWGS2019), and MCR (slow gait + subjective memory complaints), which are predictors of adverse events in the elderly. Multiple regression analysis with QMCOO as the response variable showed that MCR (p = 0.01, β: 0.25) and physical frailty (p < 0.01, β: 0.43) were significantly associated. In addition, analysis with JST-IC as the response variable showed that MCR (p = 0.03, β: −0.20), physical frailty (p = 0.01, β: −0.24) and age (p = 0.02, β: −0.21) were significantly associated. In conclusion, MCR was found to be similarly associated with QMCOO and JST-IC as physical frailty. It is expected that the MCR will be used as an initial screening tool to identify signs of risk in community-dwelling older people, as it is easy to diagnose. Full article

► Show Figures

Figure 1

12 pages, 246 KiB

Open AccessArticle

Oral Health Knowledge, Attitudes, and Learned Clinical Skills in Pediatric Medicine Residents and Nurse Practitioner Students: A Pre-Post Design

by Laurie Love, Francisco Ramos-Gomez, Janni J. Kinsler, Cristina Cabrera-Mino, Cambria Garell and Nancy A. Pike

Healthcare 2024, 12(18), 1807; https://doi.org/10.3390/healthcare12181807 - 10 Sep 2024

Abstract

(1) Background/Objective: California has one of the highest rates of pediatric dental caries in the nation. One way to combat this problem is through non-dental provider training programs that focus on prevention. However, there are limited data on healthcare provider training program integration [...] Read more.

(1) Background/Objective: California has one of the highest rates of pediatric dental caries in the nation. One way to combat this problem is through non-dental provider training programs that focus on prevention. However, there are limited data on healthcare provider training program integration and evaluation of oral health curricula focused on prevention of early childhood caries. This study will assess the change in healthcare providers’ attitudes, knowledge, and skills by implementing an interprofessional educational (IPE) oral health curriculum in medicine and nurse practitioner programs at one university in Southern California. (2) Methods: A mixed method design was employed using a pre- and post-educational survey, and end-of-program focus group interviews. Descriptive statistics and paired t-tests were used to assess group differences and thematic analyses for the focus groups. (3) Results: A total of 81 students (14 pediatric medicine residents, 18 pediatric, and 49 family nurse practitioners) completed the curriculum and surveys. Attitudes related to oral hygiene remained unchanged, with the nurse practitioner group showing improved clinical skills (all questions; p < 0.021). Knowledge scores significantly improved across all groups (paired t-test; p < 0.001). All focus groups expressed the helpfulness of the educational modules, the usefulness of the skills learned, and the benefits of IPE activities. (4) Conclusion: Healthcare providers showed improved oral health knowledge and clinical skills acquired through the oral health program and can serve as a model to educate across disciplines on the prevention of early childhood caries. Full article

(This article belongs to the Special Issue Prevention and Management of Oral Diseases among Children)

11 pages, 511 KiB

Open AccessArticle

Knowledge and Perception of Pharmacy Students toward Telepharmacy Education in Saudi Arabia

by Mohammed M. Alsultan, Mohamed A. Baraka, Abdullah K. Alahmari, Mahmoud E. Elrggal, Mansour A. Mahmoud, Marwan A. Alrasheed, Shahad O. Alkahlah, Arjwan M. Alqarni, Manar M. Alghamdi, Abdulaziz H. Al Khzem, Bashayer M. Alshehail and Mansour M. Alotaibi

Healthcare 2024, 12(18), 1806; https://doi.org/10.3390/healthcare12181806 - 10 Sep 2024

Abstract

Telepharmacy education should be incorporated into the curricula due to its beneficial effects on students, providing pharmacy services during their practice. Therefore, this study aims to explore the knowledge and perceptions of pharmacy students regarding the integration of telepharmacy services into their education [...] Read more.

Telepharmacy education should be incorporated into the curricula due to its beneficial effects on students, providing pharmacy services during their practice. Therefore, this study aims to explore the knowledge and perceptions of pharmacy students regarding the integration of telepharmacy services into their education curriculum in Saudi Arabia. A cross-sectional study was conducted using an online survey from 1 June to 30 September 2023, among pharmacy students from five universities in Saudi Arabia. The questionnaire was divided into three sections, and descriptive statistics and a generalized linear model were used for analysis. A total of 523 pharmacy students participated. Approximately half of the students were aware of telepharmacy, and only one-quarter had studied it as part of their curriculum. Students believed that telepharmacy education should cover communication, reimbursement, and training for virtual patient interactions. There was a significant positive correlation (p < 0.0001) between the knowledge and perception scores. In addition, students who had heard about telepharmacy before and those with a “somewhat” confidence level showed a significantly positive correlation with knowledge scores (p = 0.01). In conclusion, perception scores, students who had heard of telepharmacy, and those with a “somewhat” confidence level were all positively correlated with pharmacy students’ understanding of telepharmacy. This study underscores the importance of integrating telepharmacy education and practical training into pharmacy curricula to prepare future pharmacists for the evolving healthcare landscape. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

► Show Figures

Figure 1

18 pages, 1186 KiB

Open AccessArticle

Exploring the Impact of a Structured Educational Approach on Peristomal Skin Complications: An Interim Analysis

by Francesco Carlo Denti, Eliana Guerra, Francesca Caroppo, Pietro Abruzzese, Fabrizio Alessi, Filippo Barone, Pasqualina Bernardino, Massimiliano Bergamini, Cristina Bernardo, Gloria Bosio, Paula Carp, Manuela Cecconello, Annalinda Cerchier, Francesca Croci, Rita Detti, Cristina Di Pasquale, Maria Rosaria D’Ippolito, Simona Ditta, Erica Ducci, Anna Belloni Fortina, Stefano Frascarelli, Marianna Galante, Rita Guarino, Nicola Leggio, Elisabetta Livio, Alessandra Marchetti, Francesca Marelli, Rita Mastropaolo, Viviana Melis, Nicola Palmiero, Arianna Panarelli, Anna Lea Pascali, Francesco Pizzarelli, Laura Precisi, Cinzia Rastello, Silvia Regaglia, Rossana Elvira Rinaldi, Nadia Rumbolo, Claudio Sansone, Angela Santelli, Giovanni Sarritzu, Stefano Sfondrini, Sara Stanzani, Mattia Stella, Margherita Walterova and Rosario Caruso Show full author list Hide full author list

Healthcare 2024, 12(18), 1805; https://doi.org/10.3390/healthcare12181805 - 10 Sep 2024

Abstract

This study, employing an interim analysis, investigates the effects of the Dermamecum protocol, a structured educational and tailored approach that stratifies ostomy patients into risk paths (green, yellow, red) based on pre-operative and post-operative characteristics. The green path indicates a low risk of [...] Read more.

This study, employing an interim analysis, investigates the effects of the Dermamecum protocol, a structured educational and tailored approach that stratifies ostomy patients into risk paths (green, yellow, red) based on pre-operative and post-operative characteristics. The green path indicates a low risk of peristomal skin complications (PSCs), focusing on sustaining healthy behaviours and basic stoma care. The yellow path represents a moderate risk, emphasizing the need for patients to self-monitor and recognize early signs of complications. The red path corresponds to high risk, requiring stringent monitoring and immediate access to healthcare support. The study aims to reduce PSCs and improve patient outcomes. Methods include the stratification of 226 patients, with significant differences in gender distribution, BMI categories, and stoma types across the paths. Results show an occurrence rate of PSCs of 5.9% in all risk paths (5.7% green path, 4.7% yellow path, and 7.9% red path, p = 0.685), significantly lower than the median rate of 35% reported in the literature. Multiple correspondence analysis validated the stratification, with distinct clusters for each path. Poisson regression models in the exploratory framework of an interim analysis identified male gender as the only significant predictor of PSCs, indicating the need for gender-specific interventions. The findings suggest that the Dermamecum protocol effectively reduces early PSCs, providing a foundation for further research. Full article

► Show Figures

Figure 1

10 pages, 241 KiB

Open AccessBrief Report

The Association of Dietary Micronutrient Intake and Systemic Inflammation among Patients with Type 2 Diabetes: A Cross-Sectional Study

by Kenneth Izuora, Amalie Alver, Arpita Basu, Kavita Batra, Shelley J. Williams and Jeffrey L. Ebersole

Healthcare 2024, 12(18), 1804; https://doi.org/10.3390/healthcare12181804 - 10 Sep 2024

Abstract

Inflammation contributes to the pathogenesis of type 2 diabetes (T2DM). This study sought to document how the systemic biomarkers of inflammation varied based on food choices among patients with T2DM. This cross-sectional study enrolled ambulatory patients with T2DM. Demographic and clinical information was [...] Read more.

Inflammation contributes to the pathogenesis of type 2 diabetes (T2DM). This study sought to document how the systemic biomarkers of inflammation varied based on food choices among patients with T2DM. This cross-sectional study enrolled ambulatory patients with T2DM. Demographic and clinical information was collected. Five drops of fingerstick blood were collected using an absorbent paper device (HemaSpot HFR). C-reactive protein (CRP), serum amyloid A protein (SAA), and fibrinogen were measured using a Luminex assay. Patient-generated 7-day food diaries were analyzed using a validated food processor software. Data were analyzed by Pearson’s correlation tests, linear regression and logistic regression with the significance level set at 0.05. Among the 71 participants, 43 (60.6%) were females. The average age and duration of T2DM were 64.1 ± 10.3 and 15.8 ± 9.1 years, respectively. In a simple linear regression run with selected micronutrients, iron [F (1, 53) = 5.319, p < 0.05, adj. R² = 0.074] significantly predicted plasma CRP. This significance was lost with multiple linear regressions including age, gender, BMI, T2DM duration, T2DM complications, glycohemoglobin A1c (HbA1c) and other micronutrients. The average intake of most micronutrients by the participants was below the recommended daily intake. A higher intake of iron-rich foods was associated with higher levels of systemic inflammation in a simple linear regression model, but the association was not present after adjusting for patient factors like age, gender, BMI and T2DM-related variables. This relationship needs to be explored further given the key role of inflammation in the pathogenesis of T2DM and its associated complications. Full article

10 pages, 1781 KiB

Open AccessArticle

An Observational Study on the Management of Medico-Legal Maxillofacial Trauma Cases by General Practitioners

by Constantin Răzvan Giuvara, Victor Vlad Costan, Otilia Boisteanu, Adina Armencia, Mihai Ciofu, Eduard Radu Cernei, Carina Balcos, Bulgaru Iliescu, Gabriela Calin and Loredana Liliana Hurjui

Healthcare 2024, 12(18), 1803; https://doi.org/10.3390/healthcare12181803 - 10 Sep 2024

Abstract

Maxillofacial trauma, as seen from a medico-legal point of view, is an integral part of medical practice in emergency departments. Therefore, general practitioners should have sufficient knowledge about their roles and responsibilities in managing these cases. This study aimed to assess general practitioners’ [...] Read more.

Maxillofacial trauma, as seen from a medico-legal point of view, is an integral part of medical practice in emergency departments. Therefore, general practitioners should have sufficient knowledge about their roles and responsibilities in managing these cases. This study aimed to assess general practitioners’ knowledge, practices, and attitudes regarding managing medico-legal cases (MLCs). Material and method: This study included 113 general practitioners from St. Spiridon Hospital in Iasi, Romania. Participants completed a self-administered structured questionnaire assessing the knowledge, attitudes, and practices of general practitioners regarding the handling of medico-legal cases. Results: The scores obtained for the level of knowledge, attitudes, and practices indicate a good level of knowledge on the part of the responding doctors, with the average value being 38, in a range from 0 to 49 (min. value 28–max wave. 47). The score regarding the attitudes of doctors related to the management of medico-legal cases is modest, with the average value being 37 points out of a maximum of 60 points (min. 14–max. 51). The same situation is recorded in the case of practices regarding the management of medico-legal cases, with the average value being 68 out of a maximum value of 90 (min. 38–max. 84). Conclusion: This study’s results revealed the absence of a well-defined protocol for the recognition and handling of medico-legal cases among general practitioners from Iasi and the need to improve the level of attitudes and practices regarding the management of medico-legal cases. The limitations of this study included the relatively small sample from a single hospital and the use of a methodology based on self-administered questionnaires, which may be subjective. Accordingly, future studies should involve larger and more diverse samples to monitor changes in knowledge and practices over time and qualitative methodologies to gain deeper physician-related insights into medical case management. Full article

(This article belongs to the Special Issue Innovations in Forensic Medicine)

► Show Figures

Figure 1

14 pages, 1462 KiB

Open AccessArticle

Depression and Anxiety among Migrant Older Adults during the COVID-19 Pandemic in China: Network Analysis of Continuous Cross-Sectional Data

by Chi Zhang, Yuefan Zhao, Lei Wei, Qian Tang, Ruyue Deng, Shiyuan Yan and Jun Yao

Healthcare 2024, 12(18), 1802; https://doi.org/10.3390/healthcare12181802 - 10 Sep 2024

Abstract

Many Chinese migrant older adults are more prone to mental health problems due to their “migrant” status. During the COVID-19 pandemic, restrictions on their mobility exacerbated these conditions. Mental health is a crucial dimension of healthy aging. Network analysis offers a novel method [...] Read more.

Many Chinese migrant older adults are more prone to mental health problems due to their “migrant” status. During the COVID-19 pandemic, restrictions on their mobility exacerbated these conditions. Mental health is a crucial dimension of healthy aging. Network analysis offers a novel method for exploring interactions between mental health problems at the symptom level. This study employs network analysis to examine the interactions between comorbid depressive and anxiety symptoms across different stages of the COVID-19 pandemic. Surveys were conducted from September 2019 to January 2020 (T1), September 2020 to January 2021 (T2), and September 2021 onwards (T3). Depression and anxiety symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9) and the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Expected Influence (EI) and Bridge Expected Influence (Bridge EI) were used to identify central and bridge symptoms in the network. Network stability and accuracy tests were performed. Among the Chinese migrant older adults, the anxiety prevalence was 18.50% at T1, 21.11% at T2, and 9.38% at T3. The prevalence of depression was 26.95% at T1, 55.44% at T2, and 60.24% at T3. The primary central symptoms included ‘Afraid something will happen’ (A2), ‘Irritability’ (A6), ‘Panic’ (A7), ‘Feeling of worthlessness’ (D6), ‘Anhedonia’ (D1), and ‘Feeling of fear’ (A5). The major bridge symptoms included ‘Feeling of fear’ (A5), ‘Panic’ (A7), ‘Irritability’ (A6), ‘Fatigue’ (D4), ‘Anhedonia’ (D1), and ‘Depressed or sad mood’ (D2). Differences in network structure were observed across the periods. The network analysis further revealed the evolving relationships between central and bridge symptoms over time, highlighting the importance of targeted intervention strategies for central and bridge symptoms of comorbid depression and anxiety at different periods. Full article

► Show Figures

Figure 1

25 pages, 1769 KiB

Open AccessArticle

Qualitative Evaluation of a Quality Improvement Collaborative Implementation to Improve Acute Ischemic Stroke Treatment in Nova Scotia, Canada

by Shadi Aljendi, Kelly J. Mrklas and Noreen Kamal

Healthcare 2024, 12(18), 1801; https://doi.org/10.3390/healthcare12181801 - 10 Sep 2024

Abstract

The Atlantic Canada Together Enhancing Acute Stroke Treatment (ACTEAST) project is a modified quality improvement collaborative (mQIC) designed to improve ischemic stroke treatment rates and efficiency in Atlantic Canada. This study evaluated the implementation of the mQIC in Nova Scotia using qualitative methods. [...] Read more.

The Atlantic Canada Together Enhancing Acute Stroke Treatment (ACTEAST) project is a modified quality improvement collaborative (mQIC) designed to improve ischemic stroke treatment rates and efficiency in Atlantic Canada. This study evaluated the implementation of the mQIC in Nova Scotia using qualitative methods. The mQIC spanned 6 months, including two learning sessions, webinars, and a per-site virtual visit. The learning sessions featured presentations about the project and the improvement efforts at some sites. Each session included an action planning period where the participants planned for the implementation efforts over the following 2 to 4 months, called “action periods”. Eleven hospitals and Emergency Health Services (EHS) of Nova Scotia participated. The Consolidated Framework for Implementation Research (CFIR) was utilized to develop a semi-structured interview guide to uncover barriers and facilitators to mQIC’s implementation. Interviews were conducted with 14 healthcare professionals from 10 entities, generating 458 references coded into 28 CFIR constructs. The interviews started on 17 June 2021, 2 months after the intervention period, and ended on 7 October 2021. Notably, 84% of these references were positively framed as facilitators., highlighting the various aspects of the mQIC and its context that supported successful implementation. These facilitators encompassed factors such as networks and communications, strong leadership engagement, and a collaborative culture. Significant barriers included resource availability, relative priorities, communication challenges, and engaging key stakeholders. Some barriers were prominent during specific phases. The study provides insights into quality improvement initiatives in stroke care, reflecting the generally positive opinions of the interviewees regarding the mQIC. While the quantitative analysis is still ongoing, this study highlights the importance of addressing context-specific barriers and leveraging the identified facilitators for successful implementation. Full article

► Show Figures

Figure 1

Journal Menu

Journal Browser

Healthcare, Volume 12, Issue 18 (September-2 2024) – 15 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI