Healthcare

15 pages, 491 KiB

Open AccessArticle

In the Shadow of the Pandemic: Examining Therapists’ Perceptions of Work-Related Stress in the Late Stages of the COVID-19 Pandemic in Germany

by Smilla Johann, Megan Evans, Rike Böttcher, Nadine Muller, Barbara Buchberger, Charbel El Bcheraoui and Heide Weishaar

Healthcare 2024, 12(19), 1933; https://doi.org/10.3390/healthcare12191933 - 26 Sep 2024

Abstract

Background/Objectives: The previous literature has identified increased work-related stress among healthcare workers (HCWs) during the COVID-19 pandemic. This study analyzes work-related perceived stress experienced by therapists during the COVID-19 pandemic in Germany to identify potential for supporting this crucial group of HCWs in [...] Read more.

Background/Objectives: The previous literature has identified increased work-related stress among healthcare workers (HCWs) during the COVID-19 pandemic. This study analyzes work-related perceived stress experienced by therapists during the COVID-19 pandemic in Germany to identify potential for supporting this crucial group of HCWs in future health crises. Methods: Survey data on stress, measured through the Perceived Stress Scale 4, among HCWs (therapists n = 612, nurses n = 501, and doctors n = 461) were analyzed using descriptive statistics, and data from four semi-structured interviews and seven focus group discussions with therapists were analyzed using thematic content analysis. Data were collected from March to September 2022. Results: Therapists reported similar stress levels to other HCWs, with the reporting of perceived stress differing between work contexts. Eight stressors were identified through the thematic analysis: (1) concerns about maintaining the quality of care, (2) uncertainty about the future, (3) workload, (4) interactions with colleagues and patients, (5) PPE, (6) the risk of infection, (7) insufficient information flow, and (8) the lack of public and political recognition. Conclusions: This study emphasizes the distinct challenges that therapists experienced during the COVID-19 pandemic. By identifying the factors that contributed to the stress experienced, the study can inform targeted support strategies which can enhance therapists’ work, ultimately contributing to sustaining essential healthcare services during public health crises. Full article

(This article belongs to the Special Issue Emotional Stress of Healthcare Professionals in Work)

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11 pages, 385 KiB

Open AccessArticle

Eating Habits Related to Pregnancy, Body Perception, Attractiveness and Self-Confidence

by Wioleta Faruga-Lewicka, Wiktoria Staśkiewicz-Bartecka, Patrycja Janiszewska, Martina Grot and Marek Kardas

Healthcare 2024, 12(19), 1932; https://doi.org/10.3390/healthcare12191932 - 26 Sep 2024

Abstract

Background: Pregnancy is a period of many changes in a woman’s life, including those related to eating habits, taking care of health and fitness, as well as esthetic and psychological considerations. Methods: The study was conducted between January 2021 and December 2022. A [...] Read more.

Background: Pregnancy is a period of many changes in a woman’s life, including those related to eating habits, taking care of health and fitness, as well as esthetic and psychological considerations. Methods: The study was conducted between January 2021 and December 2022. A questionnaire was used to conduct the study, the questions of which concerned eating habits, as well as perceptions of one’s body and changes in appearance during pregnancy. Respondents filled out the questionnaire twice. The first survey was in the first two weeks after the doctor’s confirmation of pregnancy and after the end of pregnancy, up to a maximum of 2 months after delivery. The purpose of the study was to evaluate changes in women’s eating habits during pregnancy compared to before pregnancy to analyze the impact of pregnancy on women’s body perception and attractiveness and self-confidence; furthermore, the study aimed to analyze the body mass index (BMI) of women before pregnancy and to compare weight gain during pregnancy depending on the initial BMI, taking into account different age groups. The values of measurable parameters were presented using the arithmetic mean, median, dominant and standard deviation. Non-measurable parameters were presented using percentages. The Chi2 test of homogeneity was used to examine differences between groups. Results: During pregnancy, respondents mostly ate five meals a day, increased the amount of vegetables and fruits in their diets, and ate their meals without rushing (defined as slowly, calmly and without measuring the time left until the end of the meal break). Respondents reduced their coffee intake during pregnancy, while they increased their water intake to about 2 L a day. In the survey, about 2% of respondents followed a weight-loss diet during pregnancy. Respondents who were more likely to take body circumference measurements equally often monitored their daily energy intake. Conclusion: Women changed their eating habits during pregnancy to healthier ones compared to before pregnancy. The women’s eating habits and well-being were also not affected by their age. Also, there was no significant relationship between eating habits and well-being in pregnant women, regardless of their age. The study may assist medical staff in promoting healthier eating habits and tailoring psychological support, which is crucial for the well-being of pregnant women. Full article

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12 pages, 270 KiB

Open AccessArticle

Dietary Habits, Awareness, and Knowledge among Polish Healthcare Providers and Healthcare Students

by Magdalena Kurnik-Łucka, Dominika Grońska, Iga Salwa, Julia Niedbałowska, Kamil Paweł Skowron, Katarzyna Anna Dyląg, Elżbieta Rząsa-Duran, Marcin Wojnarski, Agnieszka Pac and Krzysztof Gil

Healthcare 2024, 12(19), 1931; https://doi.org/10.3390/healthcare12191931 - 26 Sep 2024

Abstract

Background/Objectives: Nutrition plays a significant role in preventive medicine, as up to 80% of chronic diseases could be avoided by adhering to healthy dietary principles. The aim of our study was to identify dietary habits, awareness, and nutrition knowledge in a random [...] Read more.

Background/Objectives: Nutrition plays a significant role in preventive medicine, as up to 80% of chronic diseases could be avoided by adhering to healthy dietary principles. The aim of our study was to identify dietary habits, awareness, and nutrition knowledge in a random sample of Polish healthcare students and professionals. Methods: Initially, a total screened sample consisted of 1287 respondents, yet the actual response/participation rate was 634/1287. A validated questionnaire for the Polish population, the Dietary Habits and Nutrition Beliefs Questionnaire (KomPAN), was used for the assessment. Results: The majority of respondents were females (84.2% of medical students and 87.2% of healthcare professionals), current non-smokers (79.6% of medical students and 85.2% of healthcare professionals), and had a normal waist circumference (76.3% of medical students and 63.1% of healthcare professionals). Both clinical dieticians and students studying clinical dietetics received significantly different scores of dietary indexes (pro-healthy pHDI-10 and non-healthy nHDI-14) vs. respective groups of respondents. Both healthcare students and professionals who self-reported better nutritional knowledge indeed yielded significantly better results in the dietary indexes as well as nutritional knowledge scores. The nutrition knowledge score was positively correlated with pHDI-10 and negatively correlated with nHDI-14, BMI, age, and waist circumference. Conclusions: Our results illustrate lifestyle trends among Polish healthcare students and professionals, and such results should encourage the development of evidence-based dietary policies targeting healthcare providers. High-quality continuing nutrition education should be obligatorily provided to all healthcare providers to enhance their dietary awareness as well as ensure high quality of care and outcomes achieved by the Polish healthcare system. Full article

10 pages, 618 KiB

Open AccessArticle

Comparative Study of Physical Activity, Leisure Preferences, and Sedentary Behavior among Portuguese, Italian, and Spanish University Students

by Rui Paulo, André Ramalho, Isabella Scursatone, Maria Caire, Nicolás Bores Calle, Daniel Bores-García, María Espada, Miguel Rebelo and Pedro Duarte-Mendes

Healthcare 2024, 12(19), 1930; https://doi.org/10.3390/healthcare12191930 - 26 Sep 2024

Abstract

Objective: The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity, and the frequency of non-sedentary behaviors of Portuguese, Italian, and Spanish students attending higher education. Methods: A total of 1354 students (21.2 [...] Read more.

Objective: The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity, and the frequency of non-sedentary behaviors of Portuguese, Italian, and Spanish students attending higher education. Methods: A total of 1354 students (21.2 ± 2.9 years) participated in the study, with data collected through an online questionnaire for 6 months. Results: The highest levels of sedentary behavior are found among Spanish students, followed by the Portuguese, and lastly the Italians. In relation to physical activity levels, Spanish students perform more low and moderate physical activity, while Italian students perform more vigorous activities and naturally have a lower level of sedentary behavior. Conclusions: However, it is worth highlighting that students from all three countries reach the minimum levels of physical activity recommended by the WHO. Full article

(This article belongs to the Special Issue Physical Activity, Healthy Lifestyle and Well-Being across the Lifespan)

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14 pages, 809 KiB

Open AccessArticle

Assessing Patient Use of and Attitudes toward eHealth Services for Communication with Primary Care Centers in Saudi Arabia and Factors Affecting Usage

by Tourkiah Alessa, Khalid Alhussaini and Luc de Witte

Healthcare 2024, 12(19), 1929; https://doi.org/10.3390/healthcare12191929 - 26 Sep 2024

Abstract

Background: This study investigates patients’ use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. Methods: A cross-sectional [...] Read more.

Background: This study investigates patients’ use of eHealth services, their awareness of the availability of these services, and their intention to use them in primary care. It also examines patient characteristics and factors that influence the use of these services. Methods: A cross-sectional design using questionnaires was conducted. Based on the unified theory of acceptance and use of technology (UTAUT), the participants rated the two most common services. Descriptive analyses and linear correlation analyses were performed. A simple linear regression was conducted to identify factors influencing the participants’ intention to use eHealth services. Results: In total, 1203 participants with an average age of 43.7 years were surveyed. The participants’ usage rates varied, with the lowest at 2.4%, for measuring vital signs, and the highest at 47.4%, for booking appointments. The intentions to use the services ranged from 22.5%, for video consultations, to 46.6%, for prescription refill requests. Approximately 20% of the respondents were unaware of each service’s availability. Positive associations were found between all the constructs and the intention to use online services, with a younger age being the most significant factor. Conclusions: The use of and intention to use eHealth services varied greatly. The participants were often unaware of the availability of these services. Promoting the availability and benefits of eHealth services could enhance patient engagement in primary care settings. Full article

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17 pages, 624 KiB

Open AccessArticle

Associations between the Number of Children, Depressive Symptoms, and Cognition in Middle-Aged and Older Adults: Evidence from the China Health and Retirement Longitudinal Study

by Yongze Zhao, Huaxin Mai and Ying Bian

Healthcare 2024, 12(19), 1928; https://doi.org/10.3390/healthcare12191928 - 26 Sep 2024

Abstract

Background: China’s rapidly aging population presents challenges for cognitive health and mental well-being among the older adults. This study examines how the number of children affects cognitive function in middle-aged and older adults and whether depressive symptoms mediate this relationship. Methods: [...] Read more.

Background: China’s rapidly aging population presents challenges for cognitive health and mental well-being among the older adults. This study examines how the number of children affects cognitive function in middle-aged and older adults and whether depressive symptoms mediate this relationship. Methods: This study analyzed data from waves 1 to 5 (2011–2020) of the China Health and Retirement Longitudinal Study (CHARLS), involving 5932 participants aged 45 and older. Participants were grouped by the number of children: childless, only child and multiple children. We used Logarithmic Generalized Linear Models (LGLMs) to explore the relationships among the number of children, depressive symptoms, and cognitive function. Indirect effect coefficients and 95% bias-corrected and accelerated confidence intervals (BCaCI) were estimated using Simultaneous Equation Models (SEM) with three-stage least squares (3SLS) and the bootstrap method to assess the mediating effect of depressive symptoms. Results: In middle-aged and older adults, a negative association was observed between the number of children and overall cognitive functioning (all p < 0.01). This association remained significant even after adjusting for covariates in groups with three (β = −0.023, p < 0.05) and four or more children (β = −0.043, p < 0.001). Conversely, the positive association between the number of children and depression also persisted after adjusting for covariates, although it weakened as the number of children increased (all p < 0.01). Depressive symptoms consistently correlated negatively with overall cognitive function (p < 0.001) and partially mediated the relationship between the number of children and cognitive function (pMe = 20.36%, p < 0.05). The proportion of the mediating effect attributed to depression was more pronounced in middle-aged and older adults who had experienced the loss of children (pMe = 24.31%) or had two children (pMe = 25.39%), with stronger mediating effects observed in males (pMe = 48.84%) and urban residents (pMe = 64.58%). Conclusions: The findings indicate that depressive symptoms partially mediate the relationship between the number of children and cognitive function in middle-aged and older adults in China. These results highlight the significance of considering mental health factors when studying cognitive function in this demographic. Notably, in families without children and those with two children, depressive symptoms play a crucial role in explaining the decline in cognitive function. Full article

(This article belongs to the Special Issue Depression: Recognizing and Addressing Mental Health Challenges)

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11 pages, 226 KiB

Open AccessArticle

Exploring the Relationship between Health Literacy and Depression among Individuals with Chronic Conditions: Insights from the KCHS

by Eungyeong Kim

Healthcare 2024, 12(19), 1927; https://doi.org/10.3390/healthcare12191927 - 26 Sep 2024

Viewed by 114

Abstract

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a [...] Read more.

Objectives: This study, utilizing data from the 2021 Korean Community Health Survey (KCHS), aimed to investigate the role of health literacy in mitigating depression among individuals with chronic diseases, particularly focusing on how sociodemographic and subjective factors influence this relationship. Methods: With a sample of 77,133 subjects primarily dealing with hypertension and diabetes, the study employed various analytical tools to identify factors associated with an increased risk of depression. Results: These factors included marital status (OR 1.47, 95% CI 1.40–1.54), residential district (OR 1.43, 95% CI 1.39–1.50), unemployment (OR 1.47, 95% CI 1.41–1.54), enrollment in the national basic living security program (OR 1.50, 95% CI 1.40–1.62), unmet healthcare needs (OR 2.32, 95% CI 2.14–2.51), fair subjective health status (OR 1.74, 95% CI 1.63–1.90), poor subjective health status (OR 4.33, 95% CI 4.05–4.63), and stress (OR 4.56, 95% CI 4.36–4.77). Notably, individuals with higher health literacy showed a significantly lower susceptibility to depression (OR 0.74, 95% CI 0.68–0.75), underscoring the importance of health literacy as a critical factor in mental health outcomes. Conclusions: Such initiatives could serve as effective preventive measures against depression in this vulnerable population. Full article

(This article belongs to the Special Issue Mental Health at a Personal, Communal, and Social Level)

19 pages, 5886 KiB

Open AccessArticle

Innovative Chair and System Designs to Enhance Resistance Training Outcomes for the Elderly

by Teng Qi, Miyuki Iwamoto, Dongeun Choi, Siriaraya Panote and Noriaki Kuwahara

Healthcare 2024, 12(19), 1926; https://doi.org/10.3390/healthcare12191926 - 26 Sep 2024

Viewed by 127

Abstract

Introduction: This study aims to provide a safe, effective, and sustainable resistance training environment for the elderly by modifying chairs and movement systems used during training, particularly under unsupervised conditions. Materials and Methods: The research focused on investigating the effect of modified chair [...] Read more.

Introduction: This study aims to provide a safe, effective, and sustainable resistance training environment for the elderly by modifying chairs and movement systems used during training, particularly under unsupervised conditions. Materials and Methods: The research focused on investigating the effect of modified chair designs on enhancing physical stability during resistance training by involving 19 elderly participants (mean 72.1, SD 4.7). The study measured changes in the body’s acceleration during movements to compare the effectiveness of the modified chairs with those commonly used in chair-based exercise (CBE) training in maintaining physical stability. A system was developed based on experimental video data, which leverages MediaPipe to analyze the videos and compute joint angles, identifying whether the actions are executed correctly. Results and Conclusions: Comparisons revealed that modified chairs offered better stability during sitting (p < 0.001) and stand-up (p < 0.001) resistance training. According to the questionnaire survey results, compared to the regular chair without an armrest, the modified chair provided a greater sense of security and a better user experience for the elderly. Video observations indicated that the correct completion rate for most exercises, except stand-up resistance training, was only 59.75%, highlighting the insufficiency of modified chairs alone in ensuring accurate movement execution. Consequently, the introduction of an automatic system to verify proper exercise performance is essential. The model developed in this study for recognizing the correctness of movements achieved an accuracy rate of 97.68%. This study proposes a new chair design that enhances physical stability during resistance training and opens new avenues for utilizing advanced technology to assist the elderly in their training. Full article

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15 pages, 269 KiB

Open AccessArticle

A Phenomenological Approach to Medication Adherence in Elderly Patients: A Qualitative Study

by Gloria Liquori, Nicolò Panattoni, Aurora De Leo, Sara Dionisi, Noemi Giannetta, Beatrice Gasperi, Giovanni Battista Orsi, Flavio Di Muzio, Marco Di Muzio and Emanuele Di Simone

Healthcare 2024, 12(19), 1925; https://doi.org/10.3390/healthcare12191925 - 25 Sep 2024

Viewed by 164

Abstract

Background: Patient adherence to drug treatment is crucial to the success of any prescribed therapy, especially in chronic conditions. The present phenomenological qualitative study aims to explore the elderly experience in managing their medication therapy and their perception of medication adherence. Methods: Based [...] Read more.

Background: Patient adherence to drug treatment is crucial to the success of any prescribed therapy, especially in chronic conditions. The present phenomenological qualitative study aims to explore the elderly experience in managing their medication therapy and their perception of medication adherence. Methods: Based on Husserl’s perspective, a qualitative descriptive study was conducted utilizing the phenomenological approach, specifically Interpretative Phenomenological Analysis (IPA). The data analysis followed Giorgi’s phenomenological approach and the inductive content analysis method. Approval for the study was obtained from the relevant Ethics Committee. Results: Themes emerged when participants described experiences about their own adherence to therapy. The following general theme emerged from the interviews and the phenomenological analysis: Generating awareness: taking therapy saves your life. It was followed by three other themes: (1) Drug therapy awareness; (2) Drug therapy in daily life; and (3) Drug therapy as a life partner. Conclusions: Elderly patients undergoing polypharmacological treatment emphasize the key factors for improving medication adherence, highlighting the influence of individual, motivational, and relational aspects. They express a strong desire for information and value the support of family doctors and nurses in managing therapy. Patient interviews indicate general support among elderly patients for using mobile health in pharmacological treatment, recognizing its potential and limitations. Full article

(This article belongs to the Section Medication Management)

14 pages, 458 KiB

Open AccessArticle

Individual Characteristics Associated with Fears and Prevention Behaviors Related to Respiratory Infectious Disease among South Korean Adults Using Complex Sample Design

by Gunsoo Han and Jae-Ahm Park

Healthcare 2024, 12(19), 1924; https://doi.org/10.3390/healthcare12191924 - 25 Sep 2024

Viewed by 166

Abstract

Objectives: This study aimed to identify the relationships among individual characteristics, COVID-19-related fears, and infection-prevention behaviors using data from 228,932 adults (weighted to 43,583,798.71) aged 19 and older who participated in the 2021 Community Health Survey conducted by the Korea Disease Control and [...] Read more.

Objectives: This study aimed to identify the relationships among individual characteristics, COVID-19-related fears, and infection-prevention behaviors using data from 228,932 adults (weighted to 43,583,798.71) aged 19 and older who participated in the 2021 Community Health Survey conducted by the Korea Disease Control and Prevention Agency. Methods: The complex sample design analysis using SPSS 20.0 revealed the following. Results: Women had statistically significantly higher COVID-19-related fears and a higher level of preventive behaviors compared to men. During the COVID-19 pandemic, the level of physical activity among men was higher than that of women. Compared to the period before COVID-19, the frequency of smoking and drinking decreased for both men and women, with the reduction being more pronounced in men than in women. The high-exercise group had a lower level of COVID-19-related fears. Self-perceived health status was inversely and significantly related to COVID-19-related fears. The low-exercise group had a lower score for self-perceived health status than the high-exercise group. Conclusions: This study demonstrated that maintaining sufficient physical activity positively influences self-perceived health and reduces anxieties related to COVID-19 infection and fatalities. The results highlight the importance of physical activity and the need to identify strategies that effectively maintain regular exercise while adhering to infection-prevention measures during pandemics. Full article

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13 pages, 1496 KiB

Open AccessArticle

Risks Associated with the Use of Intranasal Corticosteroids: An Analysis of Adverse Reactions Reported to EudraVigilance

by Luís Martins, Samuel Silvestre and Cristina Monteiro

Healthcare 2024, 12(19), 1923; https://doi.org/10.3390/healthcare12191923 - 25 Sep 2024

Viewed by 140

Abstract

Background: Intranasal corticosteroids (INCS) are used for several conditions, including allergic rhinitis and sinusitis. Consequently, their safety profile needs continuous monitoring. This study aimed to analyse the adverse drug reactions (ADRs) of the INCS with market authorisation in Europe. Methods: A retrospective analysis [...] Read more.

Background: Intranasal corticosteroids (INCS) are used for several conditions, including allergic rhinitis and sinusitis. Consequently, their safety profile needs continuous monitoring. This study aimed to analyse the adverse drug reactions (ADRs) of the INCS with market authorisation in Europe. Methods: A retrospective analysis of the ADR data from EudraVigilance in the period between the 1 January 2011 and 12 June 2023 was performed, with 2641 reports selected for analysis. ADRs were categorised by seriousness and evolution, with a focus on the most prevalent ADRs and their alignment with the Summary of Product Characteristics (SmPC). Results: The 18–64 age group, particularly females, was most affected. Mometasone was the most reported INCS, with predominantly non-serious ADRs, evolving towards resolution, which often were not listed in the SmPC. From the reported ADRs that were not described in the SmPC of the INCS studied, “Anosmia” and “Ageusia” were highlighted. Regarding the ADRs described in the SmPC, the most frequently reported were “Epistaxis” and “Headache”. The ADRs belonging to the Designated Medical Event list were also analysed, with “Angioedema” as the most reported ADR, which was mainly associated with budesonide. Conclusions: These findings underscore the importance of continuous INCS monitoring to mitigate ADRs and safeguard public health. Further research is warranted to explore potential novel signs for safety arising from previously unreported ADRs. Full article

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11 pages, 1589 KiB

Open AccessArticle

Health Attitudes of Women Living in Religious Communities—A Preliminary Study

by Paulina Teodorczyk, Paweł Najechalski, Maciej Walędziak and Anna Różańska-Walędziak

Healthcare 2024, 12(19), 1922; https://doi.org/10.3390/healthcare12191922 - 25 Sep 2024

Viewed by 171

Abstract

Introduction: Members of consecrated life communities exhibit homogeneity with regard to factors that are relevant to health, including diet, daily activities, religiosity, and housing. This may be indicative of the manner in which the community influences the formation of the health-seeking attitudes of [...] Read more.

Introduction: Members of consecrated life communities exhibit homogeneity with regard to factors that are relevant to health, including diet, daily activities, religiosity, and housing. This may be indicative of the manner in which the community influences the formation of the health-seeking attitudes of its members. Purpose of the study: The objective of this study was to validate a survey about health awareness and health-seeking attitudes among consecrated people and to identify potential issues to be improved. In addition, the study aspires to provide insights into the lifestyles of consecrated persons in Poland, based on the results of the survey and available data. Materials and Methods: The study group included 27 female participants, members of societies of apostolic life and non-habitual apostolic religious congregations of the Roman Catholic Church. The participants were invited to express their comments and suggestions on the survey, with the purpose of validating the survey before using it as a tool for a larger study. Results: All participants agreed that nutrition, rest, and physical activity had a significant impact on health. A total of 89% of participants considered their lifestyle as healthy and a similar proportion indicated that living in a consecrated community had a positive impact on their health, with the most positive influence of factors related to spiritual exercise, rhythm of the day, and sense of interpersonal connection within the community. Approximately 44% of participants indicated that their attitude was based on a healthy diet and adequate sleep quality. However, they identified an existing need to improve the balance between work and rest. Additionally, 4% of respondents admitted irregular eating habits, ignoring quality of alimentary products, non-satisfactory rest time, and insufficient sleep. Conclusions: Even though the purpose of this study was only to validate a survey predestined for a larger study, it already gives an insight into the level of awareness of health behavior and lifestyle of residents of religious communities. Full article

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13 pages, 578 KiB

Open AccessArticle

Predictors of Poor Mental Health Outcomes in Healthcare Workers during COVID-19: A Two Waves Study

by Emanuela Saveria Gritti, Giulia Bassi, Arianna Schiano Lomoriello, Alessandra Simonelli, Silvia Salcuni, Tommaso Boldrini and Paolo Girardi

Healthcare 2024, 12(19), 1921; https://doi.org/10.3390/healthcare12191921 - 25 Sep 2024

Viewed by 296

Abstract

Objective: This cross-sectional study aimed to identify potential predictors of poor mental health outcomes among healthcare workers in two different waves of the COVID-19 emergency in Italy. Methods: An online survey collected data from N = 557 healthcare workers (21–77 years). The study [...] Read more.

Objective: This cross-sectional study aimed to identify potential predictors of poor mental health outcomes among healthcare workers in two different waves of the COVID-19 emergency in Italy. Methods: An online survey collected data from N = 557 healthcare workers (21–77 years). The study predictors were sociodemographic characteristics, occupational status, factors related to the work environment, COVID-19-related adverse events, and lifetime traumatic events. The poor mental health outcomes that were considered were depersonalization/derealization, anxiety, depression, and somatization symptoms. Results: The main predictors of poor mental health outcomes were sleeping less than six hours per night, inadequate protective equipment measures, female gender, personal and familiar infection, living alone, working as a nurse, and working in a COVID-19 ward. Healthcare workers in 2021 reported experiencing more serious accidents and stressful events than those of the first wave. Depressive symptoms and COVID-19-related adverse events were higher in the second pandemic outbreak than in the first. Conclusions: Preventive strategies against poor mental health outcomes should be particularly focused on female nurses who live alone, work in areas with high infection rates, and have experienced the COVID-19 infection personally or who are close to people that have experienced the infection. Full article

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15 pages, 241 KiB

Open AccessReview

Streamlining Acute Stroke Processes and Data Collection: A Narrative Review

by Adam Forward, Aymane Sahli and Noreen Kamal

Healthcare 2024, 12(19), 1920; https://doi.org/10.3390/healthcare12191920 - 25 Sep 2024

Viewed by 201

Abstract

(1) Background: Acute ischemic stroke treatment has been thoroughly studied to identify strategies to reduce treatment times. However, many centers still struggle to achieve fast treatment times. Additionally, studies primarily focus on larger, more advanced centers; yet, smaller centers often face longer treatment [...] Read more.

(1) Background: Acute ischemic stroke treatment has been thoroughly studied to identify strategies to reduce treatment times. However, many centers still struggle to achieve fast treatment times. Additionally, studies primarily focus on larger, more advanced centers; yet, smaller centers often face longer treatment times. (2) Objectives: The aim of this study is to analyze the existing literature reviewing stroke treatment processes in primary and comprehensive stroke centers that investigated or reduced treatment times. The articles identified were categorized based on the focus areas and approaches used. (3) Results: Three main categories of improvements were identified in the literature: (1) standardization of processes, (2) resource management, and (3) data collection. Both primary and comprehensive stroke centers were able to reduce treatment times through standardization of the processes. However, challenges such as variations in hospital resources and difficulties incorporating data collection software into workflow were highlighted. Additionally, many strategies to optimize resources and data collection that can benefit primary stroke centers were only conducted in comprehensive stroke centers. (4) Conclusions: Many existing strategies to improve stroke treatment times, such as pre-notification and mass stroke team alerts, have been implemented in both primary and comprehensive stroke centers. However, tools such as simulation training are understudied in primary stroke centers and should be analyzed. Additionally, while data collection and feedback are recognized as crucial for process improvement, challenges persist in integrating consistent data collection methods into clinical workflow. Further development of easy-to-use software tailored to clinician needs can help improve stroke center capabilities to provide feedback and improve treatment processes. Full article

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

13 pages, 1236 KiB

Open AccessArticle

Effects of Water Immersion Versus Epidural as Analgesic Methods during Labor among Low-Risk Women: A 10-Year Retrospective Cohort Study

by Carmen Herrero-Orenga, Laura Galiana, Noemí Sansó, Myriam Molas Martín, Araceli Castro Romero and Juan Carlos Fernández-Domínguez

Healthcare 2024, 12(19), 1919; https://doi.org/10.3390/healthcare12191919 - 25 Sep 2024

Viewed by 611

Abstract

Background: Adequate pain relief during childbirth is a very important issue for women and healthcare providers. This study investigates the effects on maternal and neonatal outcomes of two analgesic methods during labor: water immersion and epidural analgesia. Methods: In this retrospective observational cohort [...] Read more.

Background: Adequate pain relief during childbirth is a very important issue for women and healthcare providers. This study investigates the effects on maternal and neonatal outcomes of two analgesic methods during labor: water immersion and epidural analgesia. Methods: In this retrospective observational cohort study at a first-level hospital, in Spain, from 2009 to 2019, 1134 women, low-risk singleton and at term pregnancy, were selected. Among them, 567 women used water immersion; 567 women used epidural analgesia for pain control. Maternal outcomes included mode of birth and perineum condition. Neonatal outcomes included 5 min Apgar score, umbilical cord arterial pH, and Neonatal Intensive Care Unit admissions. Chi-square tests and Mann–Whitney U tests, together with their effect sizes (Cramer’s V, odds ratio, and Cohen’s d) were used to test the main hypotheses. Results: Spontaneous vaginal birth was almost 17 times more likely in the water immersion group (OR = 16.866 [6.540, 43.480], p < 0.001), whereas the odds of having a cesarean birth were almost 40 times higher in the epidural group (OR = 39.346 [3.610, 429.120], p < 0.001). The odds of having an intact perineum were more than two times higher for the water immersion group (OR = 2.606 [1.290, 5.250], p = 0.007), whereas having an episiotomy was more than eight times more likely for the epidural group (OR = 8.307 [2.800, 24.610], p < 0.001). Newborns in the water immersion group showed a better 5 min Apgar score and umbilical cord arterial pH and lower rates in admissions at the Neonatal Intensive Care Unit. Conclusions: Women choosing water immersion as an analgesic method were no more likely to experience adverse outcomes and presented better results than women choosing epidural analgesia. Full article

(This article belongs to the Section Women's Health Care)

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14 pages, 4489 KiB

Open AccessArticle

Cost and Cost-Effectiveness of Distributing HIV Self-Tests within Assisted Partner Services in Western Kenya

by Victor Mudhune, Monisha Sharma, Sarah Masyuko, Kenneth Ngure, George Otieno, Unmesha Roy Paladhi, David A. Katz, Edward Kariithi, Carey Farquhar and Rose Bosire

Healthcare 2024, 12(19), 1918; https://doi.org/10.3390/healthcare12191918 - 25 Sep 2024

Viewed by 201

Abstract

Background: Assisted partner services (APS) is a recommended public health approach to promote HIV testing for sexual partners of individuals diagnosed with HIV. We evaluated the cost and cost-effectiveness of integrating oral HIV self-testing (HIVST) into existing APS programs. Methods: Within the APS-HIVST [...] Read more.

Background: Assisted partner services (APS) is a recommended public health approach to promote HIV testing for sexual partners of individuals diagnosed with HIV. We evaluated the cost and cost-effectiveness of integrating oral HIV self-testing (HIVST) into existing APS programs. Methods: Within the APS-HIVST study conducted in western Kenya (2021–2022), we conducted micro-costing, time-and-motion, and provider surveys to determine incremental HIVST distribution cost (2022 USD). Using a decision tree model, we estimated the incremental cost per new diagnosis (ICND) for HIVST incorporated into APS, compared to APS with provider-delivered testing only. Scenario, parameter and probabilistic sensitivity analyses were conducted to explore influential assumptions. Results: The cost per HIVST distributed within APS was USD 8.97, largest component costs were testing supplies (38%) and personnel (30%). Under conditions of a facility-based testing uptake of <91%, or HIVST utilization rates of <27%, HIVST integration into APS is potentially cost-effective. At a willing-to-pay threshold of USD 1000, the net monetary benefit was sensitive to the effectiveness of HIVST in increasing testing rates, phone call rates, HIVST sensitivity, HIV prevalence, cost of HIVST, space allocation at facilities, and personnel time during facility-based testing. In a best-case scenario, the HIVST option was cheaper by USD 3037 and diagnosed 11 more cases (ICND = 265.82). Conclusions: Implementers and policy makers should ensure that HIVST programs are implemented under conditions that guarantee efficiency by focusing on facilities with low uptake for provider-delivered facility-based testing, while deliberately targeting HIVST utilization among the few likely to benefit from remote testing. Additional measures should focus on minimizing costs relating to personnel and testing supplies. Full article

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15 pages, 652 KiB

Open AccessArticle

Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors

by Alba Marcos-Delgado, Vicente Martín-Sánchez, Ana Molina-Barceló, Jessica Alonso-Molero, Beatriz Pérez-Gómez, Marina Pollán, Nuria Aragonés, María Ederra-Sanza, Guillermo Fernández-Tardón, Gemma Binefa, Victor Moreno, Rocío Barrios-Rodríguez, Pilar Amiano, José María Huerta, Enrique Pastor Teso, Juan Alguacil, Gemma Castaño-Vinyals, Manolis Kogevinas and Antonio José Molina de la Torre

Healthcare 2024, 12(19), 1917; https://doi.org/10.3390/healthcare12191917 - 25 Sep 2024

Viewed by 192

Abstract

The aim of our study is to evaluate the relationship between sociodemographic and clinical characteristics of individuals with Colorectal Cancer (CRC), tumour-intrinsic characteristics and treatment received with health-related quality of life (HRQoL). Methods: Cross-sectional analysis of data from 805 survivors from the MCC [...] Read more.

The aim of our study is to evaluate the relationship between sociodemographic and clinical characteristics of individuals with Colorectal Cancer (CRC), tumour-intrinsic characteristics and treatment received with health-related quality of life (HRQoL). Methods: Cross-sectional analysis of data from 805 survivors from the MCC study was conducted. HRQoL was assessed through a general and specific questionnaire, SF-12 and FCSI (Colorectal Symptom Index). Statistical analyses were performed with linear regression with adjustment for sociodemographic variables, stage at diagnosis and histological grade. Results: Participants had survived a median of 7.9 years from diagnosis (IQR 7.1–8.5 years). Age at diagnosis, sex and area showed a clear association with HRQoL in both physical and mental dimensions of the SF-12 questionnaire. A direct association between CRC recurrence was also found in the PCS-12 and MCS-12 dimensions and radical surgery in the PCS-12. Regarding the scores in FCSI questionnaire, statistically significant differences were observed by sex, age and area, with older women being the most impaired (p < 0.001). Conclusions: Age, sex and area was associated with lower scores of HRQoL among CRC survivors. Knowing the determinants related to HRQoL would allow us to lay the groundwork to develop strategies that help reduce morbidity and mortality, relapses and increase HRQoL. Full article

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19 pages, 262 KiB

Open AccessArticle

Factors Affecting Glycemic Control in Patients with Type 2 Diabetes in Kalasin Province, Thailand: An Analytical Cross-Sectional Study

by Patcharin Phuwilert, Santisith Khiewkhern, Teerasak Phajan, Kasama Wongprachum, Jindawan Wibuloutai, Chitkamon Srichomphoo, Le Ke Nghiep and Kukiat Tudpor

Healthcare 2024, 12(19), 1916; https://doi.org/10.3390/healthcare12191916 - 25 Sep 2024

Viewed by 300

Abstract

Background: Optimal glycemic management is critical since it can predict all associated essential causes of death, even after accounting for other risk factors. Objectives: This study investigated the factors associated with glycemic control in patients with type 2 diabetes mellitus (T2DM), particularly self-care [...] Read more.

Background: Optimal glycemic management is critical since it can predict all associated essential causes of death, even after accounting for other risk factors. Objectives: This study investigated the factors associated with glycemic control in patients with type 2 diabetes mellitus (T2DM), particularly self-care behaviors. Methods: An analytical cross-sectional study examined 385 patients with T2DM in 1 general and 17 community hospitals in Kalasin Province. The samples were collected using mixed-method sampling. Data were collected using a validated questionnaire with six parts and laboratory examination records between September 2021 and December 2022. Descriptive statistics (e.g., percentages and means ± SD) were used to analyze the data. The relationship between relevant factors and lack of glycemic control was analyzed by multivariate logistic regression using SPSS version 25. Results: Results showed that most patients were female (78.18%), and the mean age was 59.84 ± 9.05 years. Additionally, a significant proportion of the patients (79.74%) had poor glycemic control. Several factors are significantly associated with poor glycemic control in patients with T2DM. These factors included subjects under the age of 60 years (OR = 2.95, 95% CI: 1.57 to 5.54; p-value < 0.001), a diabetes duration of over 10 years (OR = 3.95, 95% CI: 1.90 to 8.22; p-value < 0.001), poor knowledge about diabetes (OR = 3.92, 95% CI: 1.59 to 9.67; p-value < 0.003), and inadequate self-care behaviors (OR = 6.12, 95% CI: 3.20 to 11.68; p-value < 0.001). Conclusions: In conclusion, proper interventions for controlling glycemic level behaviors are necessary to improve proper self-care behaviors in patients who have a low knowledge level of T2DM, have had diabetes for over ten years, and are aged < 60 years. This approach can reduce the likelihood of experiencing disabilities and economic hardship. Full article

(This article belongs to the Special Issue Primary and Community Care: Opportunities and Challenges)

18 pages, 293 KiB

Open AccessArticle

Preparedness for Caregiving Role and Telehealth Use to Provide Informal Palliative Home Care in Portugal: A Qualitative Study

by Paula Caetano, Ana Querido and Carlos Laranjeira

Healthcare 2024, 12(19), 1915; https://doi.org/10.3390/healthcare12191915 - 25 Sep 2024

Viewed by 280

Abstract

Background/Objectives: Given the increasing occurrence of long-term illnesses, it is imperative to focus on adequately preparing and assisting those who assume the responsibility of caregiving. Our study aims to explore whether caregivers feel prepared to provide informal palliative home care, their experiences, and [...] Read more.

Background/Objectives: Given the increasing occurrence of long-term illnesses, it is imperative to focus on adequately preparing and assisting those who assume the responsibility of caregiving. Our study aims to explore whether caregivers feel prepared to provide informal palliative home care, their experiences, and the usefulness of telehealth in managing daily activities. Methods: Using a descriptive qualitative research design and a purposeful sampling technique, thirteen primary family caregivers who provide informal palliative home care were recruited. Data collection was conducted through face-to-face individual interviews conducted from May 2023 to July 2023. Data were analyzed using Braun and Clarke’s reflexive thematic analysis. Results: Caregivers were mainly female (n = 8) with a mean age of 59.5 years (SD = 9.42). Based on our findings, three overarching themes emerged: (1) becoming a caregiver, (2) support-from-home palliative care team, and (3) telehealth in palliative home care. The reasons that influence the preparedness of family caregivers include their own desires, health conditions, their range of responsibilities, and the consequences that arise from the situation’s complexity. Telehealth helps fulfill the patient’s wishes to be at home in EoL and provides caregivers with access to professional guidance and support. Conclusions: Specialized home-based palliative care teams must be aware of caregivers’ self-assurance, knowledge, skills, and aptitudes in carrying out daily responsibilities and in managing emotions to improve preparedness for caregiving, loss, and its aftermath. The provision of professional PC services in the home along with a robust support system for informal caregivers is invaluable. Full article

(This article belongs to the Special Issue New Advances in Palliative Care)

15 pages, 2465 KiB

Open AccessArticle

A Study on Internet News for Patient Safety Campaigns: Focusing on Text Network Analysis and Topic Modeling

by Sun-Hwa Shin and On-Jeon Baek

Healthcare 2024, 12(19), 1914; https://doi.org/10.3390/healthcare12191914 - 24 Sep 2024

Viewed by 403

Abstract

Background/Objectives: This study aimed to identify the main issues related to public patient safety campaigns reflected in Korean online news. This study utilized a text-mining method to identify keywords and topics related to patient safety campaigns. Methods: The data collection period was from [...] Read more.

Background/Objectives: This study aimed to identify the main issues related to public patient safety campaigns reflected in Korean online news. This study utilized a text-mining method to identify keywords and topics related to patient safety campaigns. Methods: The data collection period was from 1 January 2022 to 31 December 2023, and 4110 news articles were extracted. Through data preprocessing, 2661 duplicated news and 1213 unrelated news were removed, and 236 news were selected. Using the NetMiner program, keyword co-occurrence frequency calculation, keyword centrality analysis, and topic modeling analysis were performed. Results: The results showed that the most frequently mentioned keywords with high degree centrality, betweenness centrality, and closeness centrality in online news were “hospital”, “medical”, “medicine”, “project”, and “treatment”. The topics of online news related to the patient safety campaign were “patient-centered care for medical safety”, “health promotion projects at a regional institution”, “hand hygiene education to prevent infection”, “healthcare quality improvement through the Mint Festival”, and “safe use of medicines”. Conclusions: This study analyzed patient safety campaign news topics using text network analysis and topic modeling. It was confirmed that patient safety campaigns are essential for fostering a patient safety culture, improving medical quality, and encouraging patient participation in hospitals. Therefore, to build a safe medical environment, it is necessary to establish an effective patient safety campaign for not only medical staff providing medical care, but also patients and their caregivers, and for this, cooperation and participation from various professional occupations are necessary. Full article

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17 pages, 324 KiB

Open AccessArticle

Impact of Mobile Health Literacy, Stroke-Related Health Knowledge, Health Beliefs, and Self-Efficacy on the Self-Care Behavior of Patients with Stroke

by Hana Kim, Aro Han, Hyunjung Lee, Jiwoo Choi, Hyohjung Lee and Mi-Kyoung Cho

Healthcare 2024, 12(19), 1913; https://doi.org/10.3390/healthcare12191913 - 24 Sep 2024

Viewed by 142

Abstract

Background: The recent substantial increase in the incidence of stroke cases has resulted in high medical expenses. Stroke necessitates ongoing care, emphasizing the importance of consistent self-management. The occurrence of stroke impacts healthcare costs and has far-reaching effects on social services, encompassing disability, [...] Read more.

Background: The recent substantial increase in the incidence of stroke cases has resulted in high medical expenses. Stroke necessitates ongoing care, emphasizing the importance of consistent self-management. The occurrence of stroke impacts healthcare costs and has far-reaching effects on social services, encompassing disability, unemployment, and other related concerns beyond individuals and families. This study aimed to assess the impact of mobile health literacy, stroke-related health knowledge, health beliefs, and self-efficacy on self-care behaviors of patients with stroke to plan tailored self-care interventions for this patient population. Methods: This descriptive survey included 99 stroke patients from three hospitals, which provided treatment equivalent to or better than general hospitals, in City C and was conducted between 7 July 2023 and 30 May 2024. The data collected from hospitalized stroke patients were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, and multiple linear regression. Results: The self-care behavior of patients with stroke who participated in the study was 73.01 ± 12.24 points. Stroke self-efficacy was identified as a significant factor influencing stroke self-care behaviors and eating habits. Mobile health literacy and stroke self-efficacy also influenced medication and self-care behavior, whereas hypertension and stroke self-efficacy affected lifestyle self-care behaviors. Conclusions: Strengthening stroke self-efficacy, improving mobile health literacy, and addressing comorbidities such as hypertension are important for promoting self-care behavior in stroke patients. Full article

(This article belongs to the Special Issue Integrated Care in Chronic Diseases)

31 pages, 1216 KiB

Open AccessReview

Quantifying Physical Activity and Sedentary Behavior in Adults with Intellectual Disability: A Scoping Review of Assessment Methodologies

by Cora J. Firkin, Iva Obrusnikova and Laura C. Koch

Healthcare 2024, 12(19), 1912; https://doi.org/10.3390/healthcare12191912 - 24 Sep 2024

Viewed by 521

Abstract

Background/Objectives: Methodologies for assessing behavior form the foundation of health promotion and disease prevention. Physical activity (PA) and sedentary behavior (SB) assessment methodologies have predominantly been developed for adults without an intellectual disability (ID), raising credibility concerns for adults with ID. The [...] Read more.

Background/Objectives: Methodologies for assessing behavior form the foundation of health promotion and disease prevention. Physical activity (PA) and sedentary behavior (SB) assessment methodologies have predominantly been developed for adults without an intellectual disability (ID), raising credibility concerns for adults with ID. The purpose was to synthesize the current state of assessment methodologies for quantifying PA and SB volume in the free-living setting for adults with an ID. Methods: Following PRISMA guidelines, eleven databases were searched through December 2023, yielding 8174 records. Data were extracted in Covidence (v.2.0), obtaining quantified PA and SB volume and assessment methodology characteristics across data collection and analysis, including tool(s) and technique(s) used, preparatory actions taken, instructions provided, and behavioral strategies employed during data collection. Results: Of the 8174 articles screened, 91 met the inclusion criteria. Common metrics included minutes/hours per day/week and steps per day/week. Despite 80% of the studies using objective techniques, substantial variation existed across studies regarding wearable models, sampling frequency and epoch length settings, calibration protocols, wearable placements, and data processing techniques. Limited studies provided instructions that did not exclusively rely on spoken language. Behavioral strategies varied, including self-monitoring, providing assistance or supervision, administering questionnaires verbally, issuing reminders, and offering monetary incentives. Conclusions: This review underscores the need for greater consistency and accessibility in PA and SB assessment methodology for adults with ID. Tailored preparation, instruction, and behavioral strategies may enhance assessment viability and suitability for adults with ID, with or without caregiver or researcher involvement in the free-living setting. Full article

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21 pages, 1539 KiB

Open AccessArticle

Characteristics and Trends of Workplace Violence towards Frontline Health Workers under Comprehensive Interventions in a Chinese Infectious Disease Hospital

by Yiming Huang, Min Zhang, Chuning He, Fuyuan Wang, Yujie Liu, Jing Wu, Qianqian Luo, Na Chen and Yuting Tang

Healthcare 2024, 12(19), 1911; https://doi.org/10.3390/healthcare12191911 - 24 Sep 2024

Viewed by 303

Abstract

Objectives: This study investigated workplace violence (WPV) toward frontline health workers under comprehensive interventions to improve the occupational safety and health management system in a Chinese infectious disease hospital. Methods: The risk assessment of WPV using an international questionnaire was conducted in 2018 [...] Read more.

Objectives: This study investigated workplace violence (WPV) toward frontline health workers under comprehensive interventions to improve the occupational safety and health management system in a Chinese infectious disease hospital. Methods: The risk assessment of WPV using an international questionnaire was conducted in 2018 and 2021 to compare the perceived levels of exposure to WPV and intervention measures before and after the intensification of anti-violence measures in the hospital context. Additionally, qualitative data were collected in 2021 through semi-structured and unstructured interviews, providing complementary information about WPV toward frontline health workers (HWs). Results: After establishing the occupational safety and health management system (OSHMS), the total incidence rate of WPV decreased from 60.90% in 2018 to 34.44% in 2021. Psychological violence declined significantly from 60.90% in 2018 to 33.89% in 2021. The endorsement of precautionary measures increased significantly from 2018 to 2021, including patient screening recognition, patient protocol, shift or rota changes, etc. A thematic analysis of several subthemes shows that HWs had an in-depth understanding of WPV, recognizing its multifaceted consequences in the context of complex risk factors. Conclusions: This study demonstrates a significant decrease in WPV, psychological violence, verbal abuse, bullying/mobbing, and ethnic discrimination after implementing the comprehensive OSHMS. Full article

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17 pages, 3794 KiB

Open AccessArticle

Multi-Regional Pelvic Floor Muscle Function Diagnosis System Based on Inflatable Stretchable Electrode Array

by Hailu Chen, Siming Wu, Yinfeng Wang, Yinjuan Chang, Mingjie Li, Zhenwei Xie and Shengming Wang

Healthcare 2024, 12(19), 1910; https://doi.org/10.3390/healthcare12191910 - 24 Sep 2024

Viewed by 283

Abstract

Background: Effective prevention and treatment of pelvic floor dysfunction (PFD) necessitates the identification of lesions within the complex pelvic floor muscle (PFM) groups associated with various symptoms. Here, we developed a multi-region pelvic floor muscle functional diagnosis system (MPDS) based on an inflatable [...] Read more.

Background: Effective prevention and treatment of pelvic floor dysfunction (PFD) necessitates the identification of lesions within the complex pelvic floor muscle (PFM) groups associated with various symptoms. Here, we developed a multi-region pelvic floor muscle functional diagnosis system (MPDS) based on an inflatable stretchable electrode array, which aids in accurately locating areas related to PFD. Methods: Clinical diagnostic experiments were conducted on 56 patients with postpartum stress urinary incontinence (PSUI) and 73 postpartum asymptomatic controls. MPDS collects pelvic floor electromyography from all participants. By assessing EMG parameters such as activation time differences (ATD) and using Jensen–Shannon (JS) divergence to verify, with the aim of locating target muscle groups with functional abnormalities. Results: Clinical test results showed that by observing the AT sequence of the PSUI group and the control group, muscle groups with functional abnormalities in the Pubococcygeus muscle (PC) and Puborectalis muscle (PR) regions could be preliminarily diagnosed. In the assessment of regional muscle contribution values based on JS divergence, it was verified that the contribution values of rapid contraction in the PC and PR regions of the PSUI group were relatively lower compared to those of the control group, which correlated with urinary control dysfunction. Conclusions: These experiments demonstrate that the MPDS helps in accurately locating target muscle groups with functional abnormalities, showcasing its potential in precise assessment of complex muscle groups such as PFM, which may improve diagnostic precision and reliability. Full article

(This article belongs to the Special Issue Pelvic Floor Health and Care)

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14 pages, 5186 KiB

Open AccessArticle

The Impact of Smoking on Arterial Stiffness in Young Adults: A Prospective Analysis

by Suzana Maria Guberna, Cosmina Elena Jercălău, Andreea Catană, Eleonora Drăgan, Anamaria-Georgiana Avram, Irina Cuciureanu, Maria Mirabela Manea and Cătălina Liliana Andrei

Healthcare 2024, 12(19), 1909; https://doi.org/10.3390/healthcare12191909 - 24 Sep 2024

Viewed by 216

Abstract

Background: Arterial stiffness is a crucial factor in the pathogenesis of cardiovascular disease, often associated with aging. However, the impact of smoking on arterial stiffness is frequently underestimated. This study aims to investigate the intricate relationship between smoking and arterial stiffness to advance [...] Read more.

Background: Arterial stiffness is a crucial factor in the pathogenesis of cardiovascular disease, often associated with aging. However, the impact of smoking on arterial stiffness is frequently underestimated. This study aims to investigate the intricate relationship between smoking and arterial stiffness to advance our understanding of and therapeutic approaches to cardiovascular health. Methods: A prospective analysis was conducted from January to July 2024, focusing on arterial stiffness parameters in a cohort of students from the Carol Davila University of Medicine and Pharmacy. Participants were categorized as smokers or non-smokers based on self-reported smoking status. The study endpoints included correlations between high pulse wave velocity, elevated peripheral and central systolic blood pressure, increased peripheral and central pulse pressure, and smoking status. These markers were assessed using an arteriograph device measuring the time difference between the initial forward pulse wave and the reflected pulse wave in the brachial artery to indirectly estimate the PWV using oscillometric pulsations. Results: Our investigation, involving 102 young individuals aged 20 to 26 (69 females, 33 males), revealed that smokers exhibited significantly higher average values of arterial stiffness indicators compared to non-smokers. Current smokers had higher mean systolic blood pressure (130.65 vs. 123.05 mmHg), higher mean peripheral pulse pressure (53.19 vs. 45.64 mmHg), higher mean central pulse pressure (33.66 vs. 29.69 mmHg), and higher mean pulse wave velocity (5.27 vs. 5.03 m/s). Conclusions: The utilization of arterial stiffness markers as predictive tools offers opportunities for personalized treatment strategies, potentially enhancing cardiovascular health outcomes. Full article

(This article belongs to the Special Issue Preventive Potential of Modifiable Risk Factors)

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12 pages, 1445 KiB

Open AccessArticle

Regulation of Cerebral Blood Flow Velocity by Transcutaneous Electrical Nerve Stimulation: A Preliminary Study

by Eun-Seon Yang, Ju-Yeon Jung and Chang-Ki Kang

Healthcare 2024, 12(19), 1908; https://doi.org/10.3390/healthcare12191908 - 24 Sep 2024

Viewed by 248

Abstract

Objectives: An excessive and abrupt increase in cerebral blood flow may cause blood vessel damage, leading to stroke. Therefore, appropriate methods to immediately regulate blood flow velocity are important. Through an analysis of 31 healthy adults, we therefore investigated whether stimulating the common [...] Read more.

Objectives: An excessive and abrupt increase in cerebral blood flow may cause blood vessel damage, leading to stroke. Therefore, appropriate methods to immediately regulate blood flow velocity are important. Through an analysis of 31 healthy adults, we therefore investigated whether stimulating the common carotid artery (CCA) using transcutaneous electrical nerve stimulation (TENS) could modulate blood flow velocity in the CCA. Methods: Three stimulation intensities (below-threshold, threshold, and above-threshold) were applied in a random order. Blood velocity changes were examined by the measurement of peak systolic velocity (PSV) with Doppler ultrasound before, during, and after TENS stimulation. To evaluate arterial stiffness, pulse wave velocity (PWV) was calculated using CCA diameter, and blood pressure was measured before and after stimulation. Results: PSV changes in the below-threshold level were significant (p = 0.028). The PSV after below-threshold stimulation was significantly decreased by 2.23% compared to that before stimulation (p = 0.031). PWV showed no significant differences; however, a nonsignificant increase was observed immediately after stimulation only in the above-threshold condition. Above-threshold stimulation can increase vascular tone by activating the sympathetic nerve, possibly triggering vasoconstriction. Conclusions: A decrease in blood flow velocity may not be expected upon the above-threshold stimulation. In contrast, the below-threshold stimulation immediately reduces blood flow velocity, without significantly affecting hemodynamic function, such as arterial flexibility. Therefore, this short-term and low electrical stimulation technique can help to lower vascular resistance and prevent vascular damage from rapid blood flow velocity. Full article

(This article belongs to the Special Issue From Heart to Brain: Innovations in Cardiovascular and Stroke Research)

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12 pages, 602 KiB

Open AccessArticle

Influence of Academic Training and Professional Experience on the Management of Deep Caries Lesions

by Sebastiana Arroyo-Bote, David Ribas-Perez, Catalina Bennasar Verges, Diego Rodriguez Menacho, Paloma Villalva Hernandez-Franch, Ignacio Barbero Navarro and Antonio Castaño Séiquer

Healthcare 2024, 12(19), 1907; https://doi.org/10.3390/healthcare12191907 - 24 Sep 2024

Viewed by 398

Abstract

Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating [...] Read more.

Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. Methods: This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. Results: A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor’s degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master’s degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16–30 years. Conclusions: Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions. Full article

(This article belongs to the Special Issue Oral Healthcare: Diagnosis, Prevention and Treatment—2nd Edition)

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19 pages, 2799 KiB

Open AccessArticle

Enhancing Operating Room Efficiency: The Impact of Computational Algorithms on Surgical Scheduling and Team Dynamics

by Adriana Vladu, Timea Claudia Ghitea, Lucia Georgeta Daina, Dorel Petru Țîrț and Mădălina Diana Daina

Healthcare 2024, 12(19), 1906; https://doi.org/10.3390/healthcare12191906 - 24 Sep 2024

Viewed by 317

Abstract

Background/Objectives: Operating room (OR) efficiency is a critical factor in healthcare delivery, influenced by various components including surgical duration, room turnover, staff availability, and equipment preparation. Optimizing surgical start times through systematic strategies such as computational algorithms can significantly enhance OR utilization and [...] Read more.

Background/Objectives: Operating room (OR) efficiency is a critical factor in healthcare delivery, influenced by various components including surgical duration, room turnover, staff availability, and equipment preparation. Optimizing surgical start times through systematic strategies such as computational algorithms can significantly enhance OR utilization and management. This study aimed to improve OR efficiency by effectively managing and optimizing surgical start times using a computational algorithm designed to allocate resources more efficiently. Methods: A comparative analysis was conducted over two six-month periods from January to June 2023 and January to June 2024, with an improvement phase implemented between July and December 2023. Results: These measures encompassed training surgical personnel, strengthening the medical team, revising work procedures and hospital regulations, and the integration of a computational algorithm to better schedule and manage surgical interventions. Following the implementation of these comprehensive measures, enhanced management of surgical start times was observed. A statistically significant increase in surgical interventions between 8 and 10 a.m. was noted for the entire OR, rising from 28.65% to 32.13%. While OR occupancy between 8 and 12 a.m. increased from 63.91% to 73.30%, this difference was not statistically significant. However, a notable improvement in average occupancy between 9 and 11 a.m. was observed, rising from 87.53% to 98.07%. Conclusions: The introduction of computational algorithms significantly improved operating room efficiency, particularly in managing surgical start times. Additionally, team coordination improved as a result of more structured scheduling processes. The results indicate that effective management of surgical start times, especially when enhanced by computational algorithms, can positively impact OR utilization, particularly within specific time blocks. Full article

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9 pages, 242 KiB

Open AccessArticle

Gestational Outcomes Related to the Occurrence of Gestational Diabetes Mellitus: A Cohort Study

by Samara Souza Stork, Claudia Meurer Souza, Josiane Somariva Prophiro, Elizabeth Ann Brownell and Betine Pinto Moehlecke Iser

Healthcare 2024, 12(19), 1905; https://doi.org/10.3390/healthcare12191905 - 24 Sep 2024

Viewed by 343

Abstract

Background: Gestational diabetes mellitus (GDM) is the main cause of hyperglycemia in pregnancy and is related to complications throughout the gestational and post-partum period. Objectives: To analyze the pregnancy outcomes related to the occurrence of GDM in women and their offspring. Methods: Third-trimester [...] Read more.

Background: Gestational diabetes mellitus (GDM) is the main cause of hyperglycemia in pregnancy and is related to complications throughout the gestational and post-partum period. Objectives: To analyze the pregnancy outcomes related to the occurrence of GDM in women and their offspring. Methods: Third-trimester pregnant women were interviewed and monitored until childbirth. The diagnosis of GDM, blood glucose ≥ 92 mg/dL, was defined by the criteria of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG). Results: A total of 138 women participated, and there were 136 births (due to 2 fetal losses); 23 (16.7%) were diagnosed with GDM. The risk of complications during childbirth was higher among pregnant women with GDM (RR 3.40; 95%CI 1.65–7.00), as was the occurrence of cesarean birth (RR 1.9; 95%CI 1.46–2.59). The occurrence of preterm birth did not show a significant difference between GDM/non-GDM groups. There was a non-significant association in adjusted analyses of macrosomia (birth weight ≥ 4000 g) among newborns born to mothers with GDM (RR 1.27; 95%CI 0.67–2.38). For newborns born to pregnant women with GDM, there was a higher risk for the following outcomes: large for gestational age (LGA) (3.29 95%CI 1.62–6.64), low Apgar (4.98 95%CI 2.32–10.69), and birth asphyxia (9.51 95%CI 3.42–26.48). Conclusions: The findings reinforce that GDM is an important risk factor for adverse pregnancy outcomes for women and their offspring. Full article

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

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Healthcare, Volume 12, Issue 19 (October-1 2024) – 29 articles

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