Journal Description
Healthcare
Healthcare
is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published semimonthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and its members receive discounts on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and other databases.
- Journal Rank: JCR - Q2 (Health Care Sciences and Services) / CiteScore - Q2 (Leadership and Management)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.5 days after submission; acceptance to publication is undertaken in 2.7 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for Healthcare include: Trauma Care and European Burn Journal.
Impact Factor:
2.4 (2023);
5-Year Impact Factor:
2.5 (2023)
Latest Articles
Differences in Workloads of Maximal Tasks in Active-Duty Firefighters
Healthcare 2024, 12(15), 1495; https://doi.org/10.3390/healthcare12151495 (registering DOI) - 27 Jul 2024
Abstract
The purpose of this study was to compare the workload of a maximal treadmill test (TREAD) and a fire suppression task (BURN) in firefighters and to examine their relationships to fitness as measured by body mass index (BMI), percent body fat (BF%), and
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The purpose of this study was to compare the workload of a maximal treadmill test (TREAD) and a fire suppression task (BURN) in firefighters and to examine their relationships to fitness as measured by body mass index (BMI), percent body fat (BF%), and peak aerobic capacity (VO2PEAK). The amount of time spent in the heart rate (HR) intensity ranges of 50–59% HRMAX (ZONE1), 60–69% HRMAX (ZONE2), 70–79% HRMAX (ZONE3), 80–89% HRMAX (ZONE4), and ≥90% HRMAX (ZONE5) quantified the workload as the Edward’s Training Impulse for TREAD (ETRIMPTREAD) and BURN (ETRIMPBURN). The ETRIMPTREAD was significantly less than ETRIMPBURN. For TREAD, ZONE5 > ZONE2 and ZONE3. For BURN, ZONE4 > ZONE1, ZONE2, and ZONE5 > ZONE1, ZONE2, and ZONE3. A lower BF% and greater VO2PEAK were related to a greater ETRIMPTREAD and unrelated to ETRIMPBURN. For BURN only, a lower BF% and greater VO2PEAK were related to less time in ZONE5. BMI was unrelated to all workload measures. Laboratory-based maximal exercise testing does not adequately reflect the workload of simulated fire suppression and therefore may not be indicative of firefighter readiness to meet job demands. Less-fit firefighters rely on higher cardiovascular intensities to complete the same workload, and practitioners should consider this when selecting strategies to reduce job-associated cardiovascular risk.
Full article
(This article belongs to the Special Issue Health and Readiness of Tactical Populations)
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Open AccessSystematic Review
Effectiveness of Internet-Based or Mobile App Interventions for Family Caregivers of Older Adults with Dementia: A Systematic Review
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Fabiane Elizabetha de-Moraes-Ribeiro, Sara Moreno-Cámara, Henrique da-Silva-Domingues, Pedro Ángel Palomino-Moral and Rafael del-Pino-Casado
Healthcare 2024, 12(15), 1494; https://doi.org/10.3390/healthcare12151494 (registering DOI) - 27 Jul 2024
Abstract
Introduction: Global aging presents socioeconomic and health challenges. Dementia, a growing concern, affects millions of older adults, intensifying the burden on family caregivers. E-health interventions offer hope through technological solutions, although current research is limited. This study evaluated the effectiveness of internet-based or
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Introduction: Global aging presents socioeconomic and health challenges. Dementia, a growing concern, affects millions of older adults, intensifying the burden on family caregivers. E-health interventions offer hope through technological solutions, although current research is limited. This study evaluated the effectiveness of internet-based or mobile app interventions for family caregivers of older adults with dementia. Methodology: A systematic review with a narrative synthesis was conducted using databases (PubMed, CINAHL, Scopus, LILACS, and PsycInfo) and the bibliographies of retrieved articles, with no restrictions on time or language. Results: The search yielded 2092 results, of which 22 studies met the inclusion criteria, encompassing a total of 2761 family caregivers. Twenty-one different outcomes were evaluated and classified into three main types of interventions: psychoeducational, psychotherapeutic, and multicomponent. Conclusions: The study highlights the importance of internet-based and mobile app interventions in supporting family caregivers of older adults with dementia. These interventions positively affect many aspects of caregiver well-being, suggesting their utility in addressing this group’s emotional, social, and self-care needs.
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(This article belongs to the Section Community Care)
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Open AccessArticle
Trends in Multicomponent Training Research in the Aged Population: A Bibliometric Analysis
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Damián Pereira-Payo, Ángel Denche-Zamorano, María Mendoza-Muñoz, Juan Manuel Franco-García, Jorge Carlos-Vivas and Jorge Pérez-Gómez
Healthcare 2024, 12(15), 1493; https://doi.org/10.3390/healthcare12151493 (registering DOI) - 27 Jul 2024
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The proportion of aged populations is increasing worldwide. Exercise has a palliating effect on some adverse implications of aging. Multicomponent training (MCT) is a recommended form of exercise for the aged population. The aims of this research were to (1) study the number
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The proportion of aged populations is increasing worldwide. Exercise has a palliating effect on some adverse implications of aging. Multicomponent training (MCT) is a recommended form of exercise for the aged population. The aims of this research were to (1) study the number of publications regarding MCT in the aged population following an exponential growth rate; (2) identify the journals, authors, and countries that stand out the most in this area; and (3) describe the most common themes and used keywords in this field. The analysis was performed through the traditional laws of bibliometrics, including, Price’s, Lotka’s, Bradford’s, and Zipf’s law. All documents published in journals indexed in the Web of Science (WoS) Core Collection from 2001 to November 2023 that met the inclusion criteria were included. The 485 documents included in this review revealed that the number of annual publications experienced an exponential growth phase, 15 journals with six or more publications formed the core journals on this topic, and the author Mikel Izquierdo and his collaborative network topped the lists of prominent and prolific co-authors. Spain was the leading country in number of publications. Various thematic lines and keywords regarding strength, sarcopenia, quality of life, falls, balance, dual-task exercise, and cognitive and physical functioning were identified. In conclusion, this work confirmed that research on this topic is going through an exponential growth phase and provided detailed information about the journals, authors, and countries involved in the subject, as well as the keywords most frequently used in the subject matter.
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Open AccessArticle
Students’ Well-Being and Academic Engagement: A Multivariate Analysis of the Influencing Factors
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Silvia Puiu, Mihaela Tinca Udriștioiu, Iulian Petrișor, Sıdıka Ece Yılmaz, Miriam Spodniaková Pfefferová, Zhelyazka Raykova, Hasan Yildizhan and Elisaveta Marekova
Healthcare 2024, 12(15), 1492; https://doi.org/10.3390/healthcare12151492 (registering DOI) - 27 Jul 2024
Abstract
This paper aims to identify the factors that are positively or negatively impacting students’ well-being and their academic engagement. We used partial least-squares structural equation modeling (PLS-SEM) using the data collected through a questionnaire from four countries: Romania, Turkey, Slovakia, and Bulgaria. The
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This paper aims to identify the factors that are positively or negatively impacting students’ well-being and their academic engagement. We used partial least-squares structural equation modeling (PLS-SEM) using the data collected through a questionnaire from four countries: Romania, Turkey, Slovakia, and Bulgaria. The model includes seven factors that influence the well-being of students and indirectly their academic engagement: stressors in the students’ lives; professors’ support; social support from family and friends; the students’ perceived satisfaction in their lives; engaging in activities during their leisure time; self-exploration regarding their careers; and environmental exploration regarding their careers. The results show that all factors, except for stressors and environmental exploration regarding their careers, positively influence the students’ well-being and thus their academic engagement. These findings are useful for universities professors and managers in better organizing activities to increase academic performance.
Full article
(This article belongs to the Special Issue Evaluating Health and Wellness in Schools: Assessment, Predictors, and Interventions)
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Open AccessArticle
The Role of Emotion Regulation and Awareness in Psychosocial Stress: An EEG-Psychometric Correlational Study
by
Roberta A. Allegretta, Katia Rovelli and Michela Balconi
Healthcare 2024, 12(15), 1491; https://doi.org/10.3390/healthcare12151491 (registering DOI) - 27 Jul 2024
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Background: In stressful situations, to overcome unpleasant emotions, individuals try to manage stress through emotion regulation strategies such as cognitive reappraisal, interoception, and mindfulness. Method: 26 healthy adults underwent a modified version of the Trier Social Stress Test (named the Social Stress Test,
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Background: In stressful situations, to overcome unpleasant emotions, individuals try to manage stress through emotion regulation strategies such as cognitive reappraisal, interoception, and mindfulness. Method: 26 healthy adults underwent a modified version of the Trier Social Stress Test (named the Social Stress Test, SST) while their electrophysiological (EEG) activity was monitored. Participants also completed self-report questionnaires prior to this, including the Five-Facet Mindfulness Questionnaire (FFMQ), Multidimensional Assessment of Interoceptive Awareness (MAIA), Emotional Regulation of Others and Self (EROS), and the Interpersonal Reactivity Index (IRI). Three brain regions of interest (ROIs) were considered in the EEG data processing: frontal, temporo-central, and parieto-occipital. Correlational analyses were performed between psychometric scales and EEG band power spectral values for each ROI. Results: The results showed positive correlations between interoceptive awareness, mindfulness, and high-frequency EEG bands (beta, alpha, gamma) over frontal ROI, indicating enhanced cognitive processing and emotional regulation. Conversely, emotion regulation and empathy measures correlated positively with low-frequency EEG bands (delta, theta), associated with improved social cognition and top-down regulatory processes. Conclusions: These findings suggest that EEG correlations of the stress response are connected to emotion regulation mechanisms, emphasizing the importance of body state awareness in managing stress and emotions for overall well-being and quality of life.
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Open AccessReview
The Experiences and Perspectives of Persons with Prostate Cancer and Their Partners: A Qualitative Evidence Synthesis Using Meta-Ethnography
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Seidu Mumuni, Claire O’Donnell and Owen Doody
Healthcare 2024, 12(15), 1490; https://doi.org/10.3390/healthcare12151490 (registering DOI) - 27 Jul 2024
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Prostate cancer affects one in nine men, so understanding patients’ and their partners experiences is crucial for developing effective treatments. The purpose of this review was to synthesis and report the experiences and views of persons with prostate cancer and their partners. Methods:
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Prostate cancer affects one in nine men, so understanding patients’ and their partners experiences is crucial for developing effective treatments. The purpose of this review was to synthesis and report the experiences and views of persons with prostate cancer and their partners. Methods: A qualitative evidence synthesis (QES) was conducted following the eMERGe reporting guideline. Six databases were searched for the relevant literature, and the Critical Appraisal Skills Program (CASP) tool was used for quality appraisal. Results: A total of 1372 papers were identified, and 36 met the inclusion criteria. Four themes emerged: quality of life, relationships and dynamics, treatment journey and survivorship and aftercare. Conclusions: Prostate cancer’s impact on patients and partners is significant, requiring comprehensive support, holistic care, tailored assistance, and research into therapies to minimize adverse effects and address emotional distress and relationship strain. Prostate cancer treatment causes physical changes, triggering feelings of loss and grief, and affects coping mechanisms. Drawing on emotional support and education is vital for boosting confidence and resilience, as many patients and partners face fears of recurrence and lifestyle changes, highlighting the need for tailored information and presurgery support.
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Open AccessArticle
Management of Stress Urinary Incontinence by Obstetricians and Gynecologists in Jordan: A Nationwide Survey Study
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Ayman Qatawneh, Fatemah N. Lari, Wedad A. Sawas, Fatemah A. Alsabree, Mariam Kh. Alowaisheer, Marah A. Aldarawsheh and Renad A. Alshareef
Healthcare 2024, 12(15), 1489; https://doi.org/10.3390/healthcare12151489 (registering DOI) - 27 Jul 2024
Abstract
Background: Stress urinary incontinence (SUI) is a common condition that can significantly impact a patient’s quality of life. Although multiple diagnostic and treatment options exist, significant variability in SUI management exists between countries. Since women’s SUI prevalence in Jordan is high, and Jordan
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Background: Stress urinary incontinence (SUI) is a common condition that can significantly impact a patient’s quality of life. Although multiple diagnostic and treatment options exist, significant variability in SUI management exists between countries. Since women’s SUI prevalence in Jordan is high, and Jordan is a lower-middle-income country, this study aimed to investigate how obstetricians and gynecologists (OBGYNs) across Jordan manage and treat women with SUI. Method: A Google Forms survey was prepared and sent out to Jordanian OBGYNs via WhatsApp. The results were collected and arranged in Microsoft Excel and then transferred to SPSS for statistical analysis. Results: Out of the 804 Jordanian registered OBGYNs, 497 could be reached, 240 conduct gynecological surgeries, and 94 completed the survey, providing a response rate of 39.2%. Most of the respondents were females between 41 and 55 years old. More than 70% of the OBGYNs worked in the private sector, and 88.3% operated in the capital of Jordan. Most of the respondents favored lifestyle and behavior therapy (43.6%) or pelvic floor physiotherapy (40.4%) as the first-line management for SUI. The transobturator mid-urethral sling (MUS) was the most common initial surgical treatment option. The physicians preferred two-staged procedures for the repair of pelvic organ prolapse alongside concomitant SUI. In the case of recurrent SUI following surgery, 77% of the respondents chose to refer to a urologist or urogynecologist. Conclusions: The Jordanian OBGYNs preferred using lifestyle/behavioral therapy and pelvic floor muscle physiotherapy as the first-line treatment to manage SUI. Secondly, the MUS would be the most frequently preferred surgical choice. To effectively manage SUI, adequate training in urogynecology and referral resources are essential in lower-middle-income countries.
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(This article belongs to the Special Issue Urinary Tract Health and Care)
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Open AccessArticle
Randomized Controlled Trial on the Effects of Home-Based Breathing Exercises on Respiratory Function and Fatigue in COVID-19-Cured Young Patients
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Cheol-Hyeon Jeong, Min-Woo Nam, Dong-Yeop Lee, Ji-Heon Hong, Jae-Ho Yu, Jin-Seop Kim, Seong-Gil Kim and Yeon-Gyo Nam
Healthcare 2024, 12(15), 1488; https://doi.org/10.3390/healthcare12151488 (registering DOI) - 26 Jul 2024
Abstract
This study investigates the effects of home-based Kakao Healthcare breathing exercises and stretching on respiratory function and fatigue in COVID-19-cured patients. A total of 35 participants performed four movements of home-based breathing exercises and five respiratory muscle stretching exercises four times a week
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This study investigates the effects of home-based Kakao Healthcare breathing exercises and stretching on respiratory function and fatigue in COVID-19-cured patients. A total of 35 participants performed four movements of home-based breathing exercises and five respiratory muscle stretching exercises four times a week for four weeks. Respiratory function was measured using forced vital capacity(FVC), forced expiratory volume in one second(FEV1), FEV1/FVC ratio, and peak expiratory flow(PEF). Fatigue was assessed using the Fatigue Severity Scale (FSS). Data analysis was performed using independent-sample and paired-sample t-tests in SPSS 24, with the significance level set at p < 0.05. After four weeks of home-based Kakao Healthcare breathing exercises, there were significant increases in respiratory FVC, FEV1, FEV1/FVC, and PEF function values observed in the training group (T.G.) after the exercise intervention (p < 0.05). Such an increase was observed when comparing these values with their corresponding pre-exercise measurements. In contrast, there were no statistically significant differences in respiratory function outcomes before and after exercise in the control group (C.G.) (p > 0.05). The FSS scores were statistically significant within the training group (T.G.) (p >0.05). The 4-week Kakao Healthcare breathing exercise scheme was found to be capable of improving some respiratory functions in COVID-19-recovered patients, but it showed no significant improvement in fatigue levels.
Full article
Open AccessReview
Lotilaner Ophthalmic Solution, 0.25%, for the Treatment of Demodex Blepharitis
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Pinakin Gunvant Davey, Marjan Farid, Paul Karpecki, Ian Benjamin Gaddie, Arthur Chan, James Mun, Sesha Neervannan and Elizabeth Yeu
Healthcare 2024, 12(15), 1487; https://doi.org/10.3390/healthcare12151487 - 26 Jul 2024
Abstract
Demodex blepharitis, a chronic lid margin disease, is caused by an infestation of Demodex mites, the most common ectoparasites in human skin and eyelids. Lotilaner ophthalmic solution, 0.25% (Xdemvy, Tarsus Pharmaceuticals), is the first therapy approved to treat Demodex blepharitis. This narrative review
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Demodex blepharitis, a chronic lid margin disease, is caused by an infestation of Demodex mites, the most common ectoparasites in human skin and eyelids. Lotilaner ophthalmic solution, 0.25% (Xdemvy, Tarsus Pharmaceuticals), is the first therapy approved to treat Demodex blepharitis. This narrative review characterizes lotilaner ophthalmic solution, 0.25%, and describes its efficacy, safety, and tolerability. The safety and efficacy of lotilaner ophthalmic solution, 0.25%, for treating Demodex blepharitis was evaluated in four phase 2 and two phase 3 trials. The data of 980 patients included in these phase 2 and 3 clinical trials revealed that the proportion of eyes with a clinically meaningful reduction to 10 or fewer collarettes (the cylindrical, waxy debris found at the base of the eyelashes) ranged from 81 to 93%. The mite eradication rate confirmed by a microscopy of epilated lashes ranged from 52 to 78%. No serious treatment-related adverse events were reported in any of these clinical studies. As high as 92% of the patients receiving lotilaner eyedrops in the phase 3 trials found it to be neutral to very comfortable. Given the positive safety and efficacy outcomes, the drug is likely to become the standard of care in the treatment of Demodex blepharitis.
Full article
Open AccessArticle
Exploring the Mediating Role of Self-Regulation in Bullying Victimization and Depressive Symptoms among Adolescents: A Cross-Regional and Gender Analysis
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Qi-Lu Huang, Wing-Shan Ho and Ho-Nam Cheung
Healthcare 2024, 12(15), 1486; https://doi.org/10.3390/healthcare12151486 - 26 Jul 2024
Abstract
This study explores the mediating role of self-regulation in the relationship between bullying victimization and depressive symptoms among adolescents, considering the moderating effects of gender and region. A cross-sectional analysis was conducted with 3984 adolescents aged 12–18 from the United Kingdom, Hong Kong,
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This study explores the mediating role of self-regulation in the relationship between bullying victimization and depressive symptoms among adolescents, considering the moderating effects of gender and region. A cross-sectional analysis was conducted with 3984 adolescents aged 12–18 from the United Kingdom, Hong Kong, Taiwan, and the Netherlands. Data were collected via an online survey administered through Qualtrics. The survey included validated measures such as the Illinois Bullying Scale (IBS) to measure bullying victimization, the Adolescent Self-Regulatory Inventory (ASRI) to measure self-regulation, and the Patient Health Questionnaire (PHQ) to measure depression. The SPSS macro PROCESS was employed for data analysis, with model 4 used for testing the mediating effects of self-regulation and model 1 for assessing the moderating effects of gender and region. The results demonstrated significant associations between bullying victimization, self-regulation, and depressive symptoms. Self-regulation mediated the positive association between bullying victimization and depression, with notable variations across genders and regions. Specifically, male students in Hong Kong exhibited an increased susceptibility to depression when subjected to bullying. These findings underscore the protective role of self-regulation in mitigating the adverse effects of bullying victimization on adolescent mental health. Implications for interventions and prevention strategies targeting adolescent depression are discussed.
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Open AccessReview
Exploring Novel Treatment Modalities for Type 1 Diabetes Mellitus: Potential and Prospects
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Rasha Aziz Attia Salama, MohamedAnas MohamedFaruk Patni, Shadha Nasser Mohammed Ba-Hutair, Nihal Amir Wadid and Mushirabanu Sharifmiyan Akikwala
Healthcare 2024, 12(15), 1485; https://doi.org/10.3390/healthcare12151485 - 26 Jul 2024
Abstract
Despite the effectiveness of insulin injections in managing hyperglycemia in type 1 diabetes mellitus (T1DM), they fall short in addressing autoimmunity and regenerating damaged islets. This review aims to explore the potential and prospects of emerging treatment modalities for T1DM, including mesenchymal stem
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Despite the effectiveness of insulin injections in managing hyperglycemia in type 1 diabetes mellitus (T1DM), they fall short in addressing autoimmunity and regenerating damaged islets. This review aims to explore the potential and prospects of emerging treatment modalities for T1DM, including mesenchymal stem cells (MSCs), MSC-derived exosomes, gene therapy, islet allotransplantation, pancreatic islet cell transplantation, and teplizumab. We review emerging treatment modalities for T1DM, highlighting several promising strategies with varied mechanisms and outcomes. Mesenchymal stem cells demonstrate potential in modulating the immune response and preserving or restoring beta-cell function, although variability in sources and administration routes necessitates further standardization. Similarly, MSC-derived exosomes show promise in promoting beta-cell regeneration and immune regulation, supported by early-stage studies showing improved glucose homeostasis in animal models, albeit with limited clinical data. Gene therapy, utilizing techniques like CRISPR-Cas9, offers targeted correction of genetic defects and immune modulation; however, challenges in precise delivery and ensuring long-term safety persist. Islet allotransplantation and pancreatic islet cell transplantation have achieved some success in restoring insulin independence, yet challenges such as donor scarcity and immunosuppression-related complications remain significant. Teplizumab, an anti-CD3 monoclonal antibody, has demonstrated potential in delaying T1DM onset by modulating immune responses and preserving beta-cell function, with clinical trials indicating prolonged insulin production capability. Despite significant progress, standardization, long-term efficacy, and safety continue to pose challenges across these modalities. Conclusion: While these therapies demonstrate significant potential, challenges persist. Future research should prioritize optimizing these treatments and validating them through extensive clinical trials to enhance T1DM management and improve patient outcomes.
Full article
(This article belongs to the Section Medication Management)
Open AccessArticle
Spatial Analysis of Health System Factors in Infectious Disease Management: Lessons Learned from the COVID-19 Pandemic in Korea
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Jeongwook Lee and SangA Lee
Healthcare 2024, 12(15), 1484; https://doi.org/10.3390/healthcare12151484 - 26 Jul 2024
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Infectious disease outbreaks present ongoing and substantial challenges to health systems at local, national, and global levels, testing their preparedness, response capabilities, and resilience. This study aimed to identify and analyze critical health system-level factors that influence infection outbreaks, focusing on the experience
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Infectious disease outbreaks present ongoing and substantial challenges to health systems at local, national, and global levels, testing their preparedness, response capabilities, and resilience. This study aimed to identify and analyze critical health system-level factors that influence infection outbreaks, focusing on the experience of the COVID-19 pandemic in Korea. Conducted as a secondary data analysis, this study utilized national datasets from Korea. Given the inherent spatial dependencies in the spread of infectious diseases, we employed a spatial lag model to analyze data. While city-specific characteristics did not emerge as significant factors, health system variables, particularly the number of community health centers and health budgets, showed significant influence on the course of the COVID-19 outbreak, along with spatial autocorrelation coefficients. Our findings underscore the importance of enhancing public healthcare infrastructure, considering regional specificities, and promoting collaboration among local governments to bolster preparedness for future outbreaks. These insights are crucial for policymakers and healthcare professionals in formulating effective strategies to prevent, manage, and mitigate the impact of infectious disease outbreaks.
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Open AccessReview
An Evaluation of a Women’s Clinic: The Healthcare and Learning Project of the Functional Unit for Women with Schizophrenia
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Alexandre González-Rodríguez, Mentxu Natividad, Bruma Palacios-Hernández, Rosa Ayesa-Arriola, Jesús Cobo and José A. Monreal
Healthcare 2024, 12(15), 1483; https://doi.org/10.3390/healthcare12151483 - 26 Jul 2024
Abstract
Gender differences exist in mental and physical health in schizophrenia, and healthcare education is part of the associated clinical approach. The main goal of the present paper is to describe a women’s clinic for schizophrenia and carry out a narrative review about innovative
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Gender differences exist in mental and physical health in schizophrenia, and healthcare education is part of the associated clinical approach. The main goal of the present paper is to describe a women’s clinic for schizophrenia and carry out a narrative review about innovative healthcare and learning strategies in the context of women who suffer from schizophrenia, and to discuss innovative strategies for both healthcare and learning projects to be applied in this context. Observing the development of our unit, four clear innovation phases can be distinguished: the generation of new ideas (clinical and social needs), strategic planning (five observatories), the execution of these strategies (observatories/teams/interventions) and feedback, iteration and scaling. We found that the observatory for morbi-mortality adopted a retroactive proactive approach, and the observatory for hyperprolactinemia was proactive and deliberate. We describe the innovation aspects, both clinical and educational, as incremental. There was one exception, the introduction of a social exclusion and discrimination observatory, that from our perspective, was not gradual, but transformative. Future learning projects should include the role of social sciences and humanities and new technologies. Our pilot project gave us the opportunity to apply new learning methods to a relatively neglected field of care.
Full article
(This article belongs to the Special Issue Biological and Clinical Aspects of the Treatment of Schizophrenia and Related Disorders: Second Edition)
Open AccessArticle
Emotional and Behavioural Problems in Spanish University Students: Association with Lifestyle Habits and Mental Well-Being
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Gloria Tomás-Gallego, Raúl Jiménez Boraita, Javier Ortuño Sierra, Esther Gargallo Ibort and Josep María Dalmau Torres
Healthcare 2024, 12(15), 1482; https://doi.org/10.3390/healthcare12151482 - 26 Jul 2024
Abstract
Emotional health represents a significant burden on the mental health of university students. Adapting to a new learning environment and facing increased academic pressure make this period particularly vulnerable for their emotional health and well-being. The objective of the study was to analyse
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Emotional health represents a significant burden on the mental health of university students. Adapting to a new learning environment and facing increased academic pressure make this period particularly vulnerable for their emotional health and well-being. The objective of the study was to analyse the prevalence of emotional and behavioural problems in university students and their association with lifestyle habits, and mental and physical health indicators. A cross-sectional study was conducted on a sample of 1268 students (23.65 ± 7.84 years) from a university in northern Spain during November 2020 and March 2021. An online questionnaire was administered, comprising the self-report Strengths and Difficulties questionnaire, the Trait Meta-Mood Scale, the Rosenberg Self-Esteem Scale, the Satisfaction with Life Scale, the Perceived Stress Scale, the SENTIA-Brief Scale, the KIDMED questionnaire, the International Physical Activity Questionnaire-Short Form, the Alcohol Use Disorders Identification Test, and the Compulsive Internet Use Scale. 27.60% of students exhibited some form of emotional and behavioural problem. Students who did not present emotional and behavioural problems showed lower perceived stress, reduced suicidal behaviour and emotional intelligence deficits, as well as lower alcohol consumption and compulsive internet use (p < 0.001). Additionally, they reported higher engagement in physical activity and greater adherence to the Mediterranean diet (p < 0.001). The study shows that emotional and behavioural problems are recurring among university students, and given that modifiable psychosocial and lifestyle factors are associated with these issues, it underscores the need to develop multidisciplinary intervention strategies.
Full article
Open AccessArticle
“Mind the Gap”—Differences between Documentation and Reality on Intensive Care Units: A Quantitative Observational Study
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Florian Jürgen Raimann, Cornelius Johannes König, Vanessa Neef and Armin Niklas Flinspach
Healthcare 2024, 12(15), 1481; https://doi.org/10.3390/healthcare12151481 - 26 Jul 2024
Abstract
Introduction: Digitalization in medicine is steadily increasing. Complex treatments, scarce personnel resources and a high level of documentation are a constant burden on healthcare systems. The balancing between correct manual documentation in the digital records and limited staff resources is rarely successful. The
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Introduction: Digitalization in medicine is steadily increasing. Complex treatments, scarce personnel resources and a high level of documentation are a constant burden on healthcare systems. The balancing between correct manual documentation in the digital records and limited staff resources is rarely successful. The aim of this study is to evaluate the adherence between documentation and lack of documentation in the treatment of critical care patients. Material and Methods: For the evaluation, data from the hospital information system (HIS) of several intensive care units (ICU) were examined in conjunction with data collected from a checklist. All boluses of sedatives, analgesics and catecholamines were documented paper based across all shifts and all weekdays and compared with corresponding digital data from the HIS (2019–2022) of previous years. Results: 939 complete digital patient records revealed a massive under-documentation of the medication administration compared to that applied according to the checklist. Only 12% of all administered catecholamines, 11% of α2-agonists, 33% of propofol, 92% of midazolam and 46% of opioids were found in the digital recordings. In comparison, the effect was more pronounced on weekdays compared to weekends. In addition, the highest documentation gap was found in the comparison of early shifts. Comparing neurosurgical vs. internal vs. anesthesiologic ICUs there was a highly significant difference between anesthesiologic ICUs compared with other disciplines (p < 0.0001). Discussion: Our data shows that there is a remarkable documentation gap and incongruence in the area of applied boli. Automated documentation by connecting syringe pumps that enter data directly into the HIS can not only reduce the workload, but also lead to comprehensive and legally required documentation of all administered medication.
Full article
(This article belongs to the Special Issue Assessment and Analysis of Healthcare Systems)
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Open AccessArticle
Investigating Obstetric Violence in Ecuador: A Cross-Sectional Study Spanning the Last Several Years
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Martha Fors, Kirsten Falcón, Thais Brandao, Maria López and Desirée Mena-Tudela
Healthcare 2024, 12(15), 1480; https://doi.org/10.3390/healthcare12151480 - 26 Jul 2024
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This pilot cross-sectional study was designed to determine the profile of obstetric violence in Ecuador in recent years. An online survey was conducted between March 2022 and April 2022, including women over 18 years who granted their informed consent to participate (n =
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This pilot cross-sectional study was designed to determine the profile of obstetric violence in Ecuador in recent years. An online survey was conducted between March 2022 and April 2022, including women over 18 years who granted their informed consent to participate (n = 1598). We used non-probabilistic sampling to obtain our sample. Fisher’s exact test was performed to assess the association between violence and type of birth, healthcare facility, and education level. Out of the women who participated in the study, 89.2% (n = 1426) identified themselves as Mestiza. Additionally, 88.3% (n = 1411) had completed university-level education. The majority of the participants, specifically 63.6% (n = 1017), received their care in public institutions, and 98.2% (n = 1569) reported structural negligence, while 74.5% (n = 1190) reported violation of their right to information. The entire sample affirmed to have experienced violation of the right of presence. This report shows that obstetric violence is present in Ecuador in different ways and that women experience negligence and violation of their right to receive ethical healthcare during childbirth.
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Open AccessArticle
Comparison of Four Tests for the Diagnosis of Helicobacter pylori Infection
by
Lior Charach, Tsachi Tsadok Perets, Rachel Gingold-Belfer, Yair Huta, Olga Ashorov, Zohar Levi, Ram Dickman and Doron Boltin
Healthcare 2024, 12(15), 1479; https://doi.org/10.3390/healthcare12151479 - 25 Jul 2024
Abstract
Background: Due to lower operational costs, health maintenance organizations (HMOs) may prioritize Helicobacter pylori stool antigen testing (HpStAg) for the non-invasive diagnosis of H. pylori infection over 13C-urea breath tests (13C-UBTs). The aim of our study was to compare the accuracy of the
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Background: Due to lower operational costs, health maintenance organizations (HMOs) may prioritize Helicobacter pylori stool antigen testing (HpStAg) for the non-invasive diagnosis of H. pylori infection over 13C-urea breath tests (13C-UBTs). The aim of our study was to compare the accuracy of the diagnostic tests for H. pylori. Methods: We performed histology, rapid urease test (RUT), 13C-UBT and HpStAg on consecutive patients referred for gastroscopy. Monoclonal stool antigen test was performed using the LIAISON Meridian chemiluminescent immunoassay. Histology was examined with hematoxylin and eosin, and additional stains were performed at the pathologist’s discretion. For the assessment of 13C-UBT, we compared concordant histology and RUT. HpStAg was compared to the concordant results of two of the three remaining tests. Results: 103 patients were included (36 males (35.0%), age 50.1 ± 18.4 years). The indication for gastroscopy was dyspepsia in 63 (61.2%). Agreement between RUT and histology was 95.9%. For 13C-UBT and HpStAg, respectively, H. pylori positivity was 30% (30/100) and 27.16% (22/81); sensitivity was 97% and 70%; specificity was 100% and 94.4%; accuracy was 98% and 86%; positive predictive value (PPV) was 100% and 86.4%; negative predictive value (NPV) was 93% and 86%. No demographic, clinical, or endoscopic predictors of HpStAg accuracy were identified using logistic regression. Conclusions: 13C-UBT performs better than HpStAg at our institution. When interpreting results, clinicians should consider test limitations.
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Open AccessArticle
Manifestation and Progression of Metabolic Dysfunction-Associated Steatotic Liver Disease in a Predominately African American Population at a Multi-Specialty Healthcare Organization
by
Astha Saini, Brian Rutledge, Anirudh R. Damughatla, Mina Rasheed, Paul Naylor and Milton Mutchnick
Healthcare 2024, 12(15), 1478; https://doi.org/10.3390/healthcare12151478 - 25 Jul 2024
Abstract
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African Americans (AA) have a high incidence of risk factors associated with MASLD (metabolic dysfunction-associated steatotic liver disease); the AA population has a lower incidence of MASLD and MASH (metabolic-associated steatotic hepatitis) than Caucasian and Hispanic Americans (non-AA). We investigated if underlying risk
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African Americans (AA) have a high incidence of risk factors associated with MASLD (metabolic dysfunction-associated steatotic liver disease); the AA population has a lower incidence of MASLD and MASH (metabolic-associated steatotic hepatitis) than Caucasian and Hispanic Americans (non-AA). We investigated if underlying risk factor variation between AA and non-AA individuals could provide a rationale for the racial diversity seen in MASLD/MASH. Using ICD-10 codes, patients from 2017 to 2020 with MASLD/MASH were identified and confirmed to have either MASLD or MASH. Despite the large (>80%) AA population in our clinics, only 54% of the MASLD/MASH patients were African American. When the non-invasive NAFLD Fibrosis Scores (NFS) evaluated at early diagnosis were compared to the most recent values, the only increase in fibrosis score by NFS over time was in non-AA MASH patients. The increase in fibrosis only in non-AA MASLD patients is consistent with racial disparity in the disease progression in non-AA as compared to AA patients. Even with the large proportion of AA patients in our study, there was no significant racial disparity in the earliest assessment of either risk factors, laboratory values, or fibrosis scores that would account for racial disparity in the development and progression of MASLD.
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Open AccessSystematic Review
Community-Based Interventions in People with Palliative Care Needs: An Integrative Review of Studies from 2017 to 2022
by
Antonia Vélez-López, Juan Manuel Carmona-Torres, Ángel López-González, José Alberto Laredo-Aguilera, David Callado-Pérez and Joseba Rabanales-Sotos
Healthcare 2024, 12(15), 1477; https://doi.org/10.3390/healthcare12151477 - 25 Jul 2024
Abstract
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Aim: To describe the latest scientific evidence regarding community-based interventions performed on patients in need of palliative care worldwide. Introduction and background: Given the rise of chronic diseases, their complexities and the fragility of patients, we are facing around 56.8 million people in
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Aim: To describe the latest scientific evidence regarding community-based interventions performed on patients in need of palliative care worldwide. Introduction and background: Given the rise of chronic diseases, their complexities and the fragility of patients, we are facing around 56.8 million people in need of palliative care. Community-based healthcare, particularly palliative care, can address social inequalities and improve the biopsychosocial health of disadvantaged populations. Therefore, primary care, as the main health referent in the community, has a central role in the care of these patients. Methods: This is an integrative review from January 2017 to June 2022 that follows the PRISMA statement and has been registered in PROSPERO. PubMed, Cuiden, the Web of Science (WoS), Cochrane and LILACS were the five databases searched. The scientific quality assessment of the articles was carried out following the CASPe methodology. Study selection was carried out by two researchers, A.V.L. and J.M.C.T., using the inclusion and exclusion criteria mentioned below. In cases of doubt or discrepancy, a third author (J.R.S.) was consulted. Results: The interventions mentioned in the 16 articles analysed were classified under the following categories: music therapy, laughter therapy, spiritual and cognitive interventions, aromatherapy, interdisciplinary and community-based teams, advance care planning and community, volunteering, telemedicine and care mapping. Example: Educating people to talk about different ethical issues could improve their quality of life and help develop more compassionate cities. Conclusions: We have identified interventions that are easily accessible (laughter therapy, telemedicine or music therapy), simple enough to be carried out at the community level and do not incur high costs. This is why they are recommended for people with palliative care needs in order to improve their quality of life.
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Open AccessArticle
Unmasking Elder Abuse: Depression and Dependency in the Post-Pandemic Era
by
Isabel Iborra-Marmolejo, Cristina Aded-Aniceto, Carmen Moret-Tatay, Gloria Bernabé-Valero, María José Jorques-Infante and María José Beneyto-Arrojo
Healthcare 2024, 12(15), 1476; https://doi.org/10.3390/healthcare12151476 - 25 Jul 2024
Abstract
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The aim of this study was to analyze elder abuse in people over 65 years of age and its relationship with some risk factors—depression symptoms, dependency, gender and age—in the Spanish population. Methods: A battery of questionnaires was administered to a sample of
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The aim of this study was to analyze elder abuse in people over 65 years of age and its relationship with some risk factors—depression symptoms, dependency, gender and age—in the Spanish population. Methods: A battery of questionnaires was administered to a sample of 167 participants electronically (M = 72.42; SD = 6.46), including the Abbreviated Yesavage Scale to assess depression, the Katz Index for Basic Activities of Daily Living to assess dependency, and the American Medical Association and the Canadian Task Force Questionnaire to assess suspicion of abuse. Results: A prevalence of 40.72% of suspected abuse, of 5.99% of established depression, and of 1.20% of severe dependence was obtained. The prevalence of abuse was higher in the population with dependency (75%) than without dependency (37%). In the case of depression, the prevalence of abuse was 70% for people with established depression and 35.4% for people without depression. Conclusion: Women have higher rates of abuse than men, although this difference is not statistically significant. The same occurs with age. Nevertheless, having established depression and dependency are confirmed risk factors for suffering abuse.
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