Healthcare

14 pages, 1384 KiB

Open AccessArticle

Factors Associated with Surgical Smoke Self-Protection Behavior of Operating Room Nurses

by Ching-Lan Yu, Suh-Ing Hsieh, Li-Hung Lin, Shu-Fen Chi, Tzu-Hsin Huang, Shu-Ling Yeh and Chi Wang

Healthcare 2022, 10(5), 965; https://doi.org/10.3390/healthcare10050965 - 23 May 2022

Viewed by 2729

Abstract

Surgical smoke has been proven to be harmful and carcinogenic to humans as well as increasing the risk of acquiring infectious diseases. The operating room nurses’ willingness to use protective equipment against surgical smoke was low. The factors associated with personal protective behavior [...] Read more.

Surgical smoke has been proven to be harmful and carcinogenic to humans as well as increasing the risk of acquiring infectious diseases. The operating room nurses’ willingness to use protective equipment against surgical smoke was low. The factors associated with personal protective behavior in the operating room against surgical smoke were sparsely explored. The purpose of this study is to determine factors associated with surgical smoke self-protection behavior of the operating room nurses. This was a descriptive correlational study using a convenience sample from a medical center in northern Taiwan. The self-designed questionnaires included personal characteristics and perceived attributes. The data were analyzed by descriptive and linear regression. Attendance at in-service education with regard to surgical smoke, the attitude to surgical smoke, and surgical smoke self-protection barriers were significant factors found in multivariate linear regression after controlling the covariates. The overall model was significant and accounted for 14.2% of variances. In summary, attending in-service education, attitude and barriers in executing self-protective behaviors were significant factors. It is important to promote operating room nurses’ health through providing correct surgical smoke knowledge, self-protection strategies to improve attitudes toward surgical smoke, improving the hospital’s environment by adding surgical smoke evacuation equipment, and standardizing the operating procedures. Full article

(This article belongs to the Section Nursing)

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9 pages, 240 KiB

Open AccessArticle

Mediating Effect of Compassion Competence on the Relationship between Caring Behaviors and Quality of Nursing Services in South Korea

by Hyunjin Lee and Kawoun Seo

Healthcare 2022, 10(5), 964; https://doi.org/10.3390/healthcare10050964 - 23 May 2022

Cited by 3 | Viewed by 1889

Abstract

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using [...] Read more.

This study aimed to investigate the mediating effect of compassion competence on the relationship between caring behaviors and the quality of nursing services. Participants included nurses working in South Korean hospitals. Data collected from 1 November to 31 December 2020 were analyzed using a t-test, analysis of variance (ANOVA), Pearson’s correlation coefficients, and hierarchical multiple regression. We found that caring behavior had a positive correlation with the quality of nursing services and compassion competence. Moreover, there was a positive correlation between the quality of nursing services and compassion competence. Compassion competence had a significant mediating effect on the relationship between caring behaviors and quality of nursing services. This suggests that nurses’ caring behaviors can enable high-quality nursing services influenced by compassion. Therefore, in order to improve the quality of nursing services, repeated and continuous implementation of training programs including education that can improve compassion competence is necessary. Full article

(This article belongs to the Section Nursing)

14 pages, 288 KiB

Open AccessArticle

Does Smartphone Addiction, Social Media Addiction, and/or Internet Game Addiction Affect Adolescents’ Interpersonal Interactions?

by Shang-Yu Yang, Yu-Chi Wang, Ya-Chen Lee, Ying-Lien Lin, Pei-Lun Hsieh and Pin-Hsuan Lin

Healthcare 2022, 10(5), 963; https://doi.org/10.3390/healthcare10050963 - 23 May 2022

Cited by 16 | Viewed by 10365

Abstract

The purpose of this study is to investigate the correlations that levels of addiction to smartphones, social media, and online games have with levels of real-life and online interpersonal interactions among adolescents. In this cross-sectional study of adolescents in a college in Taiwan, [...] Read more.

The purpose of this study is to investigate the correlations that levels of addiction to smartphones, social media, and online games have with levels of real-life and online interpersonal interactions among adolescents. In this cross-sectional study of adolescents in a college in Taiwan, structured questionnaire surveys were used to collect information. The questionnaire included the following: demographic background, Real Interpersonal Interaction Scale (RIIS), Internet Interpersonal Interaction Scale (IIIS), Smartphone Application-Based Addiction Scale (SABAS), Bergen Social Media Addiction Scale (BSMAS), and Internet Gaming Disorder Scale—Short Form (IGDS9-SF). Multiple regression analyses were carried out to investigate the correlations between SABAS, BSMAS, IGDS9-SF, and RIIS/IIIS. We recruited 998 students (413 boys). The average age was 17.18 ± 1.46. The study results show that adolescents with higher levels of addiction to smartphones and social media may have greater interpersonal interaction with friends in real life, but adolescents with high levels of addiction to online games may have less interpersonal interactions with friends in real life. Adolescents with high levels of addiction to smartphones, social media, and online games may have greater interpersonal interactions with friends online. Full article

(This article belongs to the Special Issue The Correlates of Technology-Based Addictive Behaviors and Their Impacts on Wellbeing)

14 pages, 2214 KiB

Open AccessArticle

Skin Lesion Analysis for Melanoma Detection Using the Novel Deep Learning Model Fuzzy GC-SCNN

by Usharani Bhimavarapu and Gopi Battineni

Healthcare 2022, 10(5), 962; https://doi.org/10.3390/healthcare10050962 - 23 May 2022

Cited by 23 | Viewed by 3327

Abstract

Melanoma is easily detectable by visual examination since it occurs on the skin’s surface. In melanomas, which are the most severe types of skin cancer, the cells that make melanin are affected. However, the lack of expert opinion increases the processing time and [...] Read more.

Melanoma is easily detectable by visual examination since it occurs on the skin’s surface. In melanomas, which are the most severe types of skin cancer, the cells that make melanin are affected. However, the lack of expert opinion increases the processing time and cost of computer-aided skin cancer detection. As such, we aimed to incorporate deep learning algorithms to conduct automatic melanoma detection from dermoscopic images. The fuzzy-based GrabCut-stacked convolutional neural networks (GC-SCNN) model was applied for image training. The image features extraction and lesion classification were performed on different publicly available datasets. The fuzzy GC-SCNN coupled with the support vector machines (SVM) produced 99.75% classification accuracy and 100% sensitivity and specificity, respectively. Additionally, model performance was compared with existing techniques and outcomes suggesting the proposed model could detect and classify the lesion segments with higher accuracy and lower processing time than other techniques. Full article

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3 pages, 208 KiB

Open AccessViewpoint

The Importance of Acknowledging an Intermediate Category of Airway Management Devices in the Prehospital Setting

by Laurent Suppan, Christophe Alain Fehlmann, Loric Stuby and Mélanie Suppan

Healthcare 2022, 10(5), 961; https://doi.org/10.3390/healthcare10050961 - 23 May 2022

Cited by 2 | Viewed by 1755

Abstract

Prehospital airway devices are often classified as either basic or advanced, with this latter category including both supraglottic airway (SGA) devices and instruments designed to perform endotracheal intubation (ETI). Therefore, many authors analyze the impact of SGA and ETI devices jointly. There are [...] Read more.

Prehospital airway devices are often classified as either basic or advanced, with this latter category including both supraglottic airway (SGA) devices and instruments designed to perform endotracheal intubation (ETI). Therefore, many authors analyze the impact of SGA and ETI devices jointly. There are however fundamental differences between these instruments. Indeed, adequate airway protection can only be achieved through ETI, and SGA devices all have relatively low leak pressures which might compromise both oxygenation and ventilation when lung compliance is decreased. In addition, there is increasing evidence that SGA devices reduce carotid blood flow in case of cardiac arrest. Nevertheless, SGA devices might be particularly useful in the prehospital setting where many providers are not experienced enough to safely perform ETI. Compared to basic airway management (bag-valve-mask) devices, SGA devices enable better oxygenation, decrease the odds of aspiration, and allow for more reliable capnometric measurement by virtue of their enhanced airtightness. For all these reasons, we strongly believe that SGA devices should be categorized as “intermediate airway management devices” and be systematically analyzed separately from devices designed to perform ETI. Full article

(This article belongs to the Section Prehospital Care)

19 pages, 2702 KiB

Open AccessReview

Oral Health Management and Rehabilitation for Patients with Oral Cancer: A Narrative Review

by Yuhei Matsuda, Ruwan D. Jayasinghe, Hui Zhong, Shinichi Arakawa and Takahiro Kanno

Healthcare 2022, 10(5), 960; https://doi.org/10.3390/healthcare10050960 - 23 May 2022

Cited by 4 | Viewed by 4138

Abstract

Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. [...] Read more.

Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. Multidisciplinary team approaches and supportive care in oral cancer treatment reportedly shorten the time to treatment and improve outcomes. Although there is enough evidence confirming the role of oral and maxillofacial surgeons, dentists, and dental hygienists in supportive care in oral cancer treatment, there are very few systematic studies. In particular, oral health management is a concept that encompasses oral function management, oral hygiene management, and oral care during oral cancer treatment. We provide a narrative review focusing on oral health management from a multidisciplinary and supportive care perspective, applicable in oral cancer treatment. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care Ⅱ)

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11 pages, 266 KiB

Open AccessArticle

Factors Affecting Nurses’ Internal Transfer Intentions after the Introduction of COVID-19-Related Family Visiting Restrictions

by Yoshiko Kitamura, Hisao Nakai and Keiko Teranishi

Healthcare 2022, 10(5), 959; https://doi.org/10.3390/healthcare10050959 - 23 May 2022

Cited by 2 | Viewed by 1749

Abstract

Hospitals have established visiting restrictions to block coronavirus disease 2019 (COVID-19) external transmission routes. This study investigated factors associated with nurses’ internal transfer intentions and changes in their workloads, burdens, and daily lives owing to pandemic-related family visiting restrictions. Participants were nurses from [...] Read more.

Hospitals have established visiting restrictions to block coronavirus disease 2019 (COVID-19) external transmission routes. This study investigated factors associated with nurses’ internal transfer intentions and changes in their workloads, burdens, and daily lives owing to pandemic-related family visiting restrictions. Participants were nurses from three medical institutions designated for infectious diseases in Ishikawa Prefecture, Japan. An original self-report questionnaire was developed based on previous studies and a web-based survey conducted. Responses were received from 152 nurses and 84 were included in the analysis. Factors influencing internal transfer intentions were age ≥30 years [odds ratio (OR): 6.54, 95% confidence interval (CI): 1.19–35.83]; ≥11 years of experience (OR: 12.57, 95% CI: 2.32–68.02); and longer working hours (OR: 4.51, 95% CI: 1.48–13.72). The effect of visitation restrictions on daily life and internal transfer intentions was greater in nurses with ≥11 years of experience (OR: 4.31, 95% CI: 1.09–17.04), those with increased night awakening (OR: 3.68, 95% CI: 1.33–10.18), and those who desired to receive counseling (OR: 4.38, 95% CI: 1.07–17.91). In conclusion, excessive working hours may affect nurses’ internal transfer intentions during the COVID-19 pandemic. Nocturnal awakening and desire to receive counseling may predict nurses’ internal transfer intentions. Full article

(This article belongs to the Special Issue Community Care in the Time of COVID-19)

21 pages, 3297 KiB

Open AccessArticle

Ethical Decision Making in Iot Data Driven Research: A Case Study of a Large-Scale Pilot

by Sofia Segkouli, Giuseppe Fico, Cecilia Vera-Muñoz, Mario Lecumberri, Antonis Voulgaridis, Andreas Triantafyllidis, Pilar Sala, Stefano Nunziata, Nadia Campanini, Enrico Montanari, Suzanne Morton, Alexandre Duclos, Francesca Cocchi, Mario Diaz Nava, Trinidad de Lorenzo, Eleni Chalkia, Matina Loukea, Juan Bautista Montalvá Colomer, George E. Dafoulas, Sergio Guillén, María Teresa Arredondo Waldmeyer and Konstantinos Votis Show full author list Hide full author list

Healthcare 2022, 10(5), 957; https://doi.org/10.3390/healthcare10050957 - 23 May 2022

Viewed by 4248

Abstract

IoT technologies generate intelligence and connectivity and develop knowledge to be used in the decision-making process. However, research that uses big data through global interconnected infrastructures, such as the ‘Internet of Things’ (IoT) for Active and Healthy Ageing (AHA), is fraught with several [...] Read more.

IoT technologies generate intelligence and connectivity and develop knowledge to be used in the decision-making process. However, research that uses big data through global interconnected infrastructures, such as the ‘Internet of Things’ (IoT) for Active and Healthy Ageing (AHA), is fraught with several ethical concerns. A large-scale application of IoT operating in diverse piloting contexts and case studies needs to be orchestrated by a robust framework to guide ethical and sustainable decision making in respect to data management of AHA and IoT based solutions. The main objective of the current article is to present the successful completion of a collaborative multiscale research work, which addressed the complicated exercise of ethical decision making in IoT smart ecosystems for older adults. Our results reveal that among the strong enablers of the proposed ethical decision support model were the participatory and deliberative procedures complemented by a set of regulatory and non-regulatory tools to operationalize core ethical values such as transparency, trust, and fairness in real care settings for older adults and their caregivers. Full article

(This article belongs to the Special Issue Smart Home Care)

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8 pages, 252 KiB

Open AccessArticle

Effectiveness of Vitamin D Supplements among Patients Hospitalized for COVID-19: Results from a Monocentric Matched-Cohort Study

by Vito Fiore, Andrea De Vito, Paola Bagella, Elija Princic, Anna Antonella Mariani, Lucia Denti, Alessandro Giuseppe Fois, Giordano Madeddu, Sergio Babudieri and Ivana Maida

Healthcare 2022, 10(5), 956; https://doi.org/10.3390/healthcare10050956 - 22 May 2022

Cited by 6 | Viewed by 2980

Abstract

Objectives: Our study aimed to evaluate the usefulness of Vitamin D3 (VitD3) among patients hospitalized for COVID-19. The primary endpoint was to evaluate the difference in survival rates between patients receiving and not VitD3. The secondary endpoints were to evaluate clinical outcomes, such [...] Read more.

Objectives: Our study aimed to evaluate the usefulness of Vitamin D3 (VitD3) among patients hospitalized for COVID-19. The primary endpoint was to evaluate the difference in survival rates between patients receiving and not VitD3. The secondary endpoints were to evaluate clinical outcomes, such as needing non-invasive ventilation (NIV), ICU transfer, and laboratory findings (inflammatory parameters). Methods: We conducted a retrospective, monocentric matched-cohort study, including patients attending our ward for COVID-19. Patients were divided into two groups depending on VitD3 administration (Group A) or not (Group B) among patients with low VitD levels (defined as blood levels < 30 ng/mL), which depended on physicians’ judgment. Our internal protocol provides VitD3 100,000 UI/daily for two days. Findings: 58 patients were included in Group A, and 58 in Group B. Patients were matched for age, sex, comorbidities, COVID-19-related symptoms, PaO2/FiO2 ratio, blood exams, and medical treatments. Regarding the principal endpoint, there was a statistically significant difference between the two groups in survival rates [Group A vs. Group B = 3 vs. 11 (p = 0.042)]. When considering secondary endpoints, Group A patients were less likely to undergo NIV [Group A vs. Group B = 12 vs. 23 (p = 0.026)] and showed an improvement in almost all inflammatory parameters. Conclusions: The link between VitD3 deficiency and the clinical course of COVID-19 during hospitalization suggests that VitD3 level is a useful prognostic marker. Considering the safety of supplementation and the low cost, VitD3 replacement should be considered among SARS-CoV-2 infected patients needing hospitalization. Full article

(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)

16 pages, 893 KiB

Open AccessArticle

Employment Management Policies for College Graduates under COVID-19 in China: Diffusion Characteristics and Core Issues

by Min Wu, Xinxin Hao and Yihao Tian

Healthcare 2022, 10(5), 955; https://doi.org/10.3390/healthcare10050955 - 22 May 2022

Cited by 7 | Viewed by 3086

Abstract

The outbreak of COVID-19 epidemic has been having a great impact on the job market, so that graduates from all over the world are facing a more complex employment environment. Unemployment of the educated labor force often results in a waste of human [...] Read more.

The outbreak of COVID-19 epidemic has been having a great impact on the job market, so that graduates from all over the world are facing a more complex employment environment. Unemployment of the educated labor force often results in a waste of human capital and leads to serious economic and social problems. In the face of the impact of COVID-19, the Chinese government quickly introduced a series of employment policies for college graduates to relieve their employment pressure and create opportunities of career development. How did these employment policies for college graduates spread rapidly under the unconventional state of the COVID-19 epidemic? What are the diffusion characteristics? What are the core issues and measures? What are the differences between governments at all levels? These problems with rich connotation and research value needed to be further clarified. Based on the 72 employment support policies collected from the Chinese government network, this paper conducted a text analysis of the policies and found that in the process dimension, the employment policies of college graduates accumulated and exploded from bottom to top in the short term, and the policies diffusion followed the gradual model of “east–middle–west”. In the content dimension, there were five core issues: financial subsidies, innovation and entrepreneurship to drive employment, public institutions to absorb, optimizing public services, and lowering the support threshold. Meanwhile, there were obvious differences in the choice of policy tools, policy intensity, and implementation ideas in each region. The findings are of important significance for developed and developing countries to better respond to the impact of various emergency situations. Full article

(This article belongs to the Special Issue Global Health in the Time of COVID-19: Law, Policy and Governance)

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16 pages, 826 KiB

Open AccessSystematic Review

Relation between Burnout and Sleep Problems in Nurses: A Systematic Review with Meta-Analysis

by María José Membrive-Jiménez, José Luis Gómez-Urquiza, Nora Suleiman-Martos, Almudena Velando-Soriano, Tania Ariza, Emilia Inmaculada De la Fuente-Solana and Guillermo A. Cañadas-De la Fuente

Healthcare 2022, 10(5), 954; https://doi.org/10.3390/healthcare10050954 - 21 May 2022

Cited by 25 | Viewed by 5689

Abstract

Burnout can affect nurses’ sleep quality. The aim of this study was to analyze the relationship between burnout syndrome and sleep problems in nurses. A systematic review with meta-analysis was performed. PubMed, CINAHL and Scopus databases were used. Some of the inclusion criteria [...] Read more.

Burnout can affect nurses’ sleep quality. The aim of this study was to analyze the relationship between burnout syndrome and sleep problems in nurses. A systematic review with meta-analysis was performed. PubMed, CINAHL and Scopus databases were used. Some of the inclusion criteria were quantitative studies, in which the levels of burnout and sleep disorders were investigated in a sample of nurses using validated scales. A total of 12 studies were included. Sociodemographic variables did not influence the relation between burnout and sleep problems, except for being female. The environment and workplace violence, together with psychological traits and shifts, affect the probability of developing burnout and insomnia. The meta-analysis sample was n = 1127 nurses. The effect size of the correlation between burnout and sleep disorders was r = 0.39 (95% CI 0.29–0.48) with p < 0.001, indicating that the higher the level of burnout in nurses, the greater the presence of sleep disorders. The positive correlation between burnout and sleep disorders is a problem that must be addressed to improve the health of nurses. Developing turnicity strategies, using warmer lights in hospital units during night shifts and eliminating the fixed night shift could improve nurses’ working conditions. Full article

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13 pages, 1592 KiB

Open AccessArticle

The Effectiveness and Quality of Life Outcomes by Transoral Endoscopic Vestibular Thyroidectomy Using Intraoperative Indocyanin Green Fluorescence Imaging and Neuromonitoring—A Cohort Study

by Fadi Alnehlaoui, Mohammad Nazih Alsarraj, Zuheir Malaki and Salman Yousuf Guraya

Healthcare 2022, 10(5), 953; https://doi.org/10.3390/healthcare10050953 - 21 May 2022

Cited by 5 | Viewed by 3107

Abstract

Background: Transoral endoscopic vestibular thyroidectomy (TOEVT), a variant of natural orifice transluminal endoscopic surgery, offers a scar-less thyroid to young females. However, few studies have compared the effectiveness and quality of life (QoL) outcomes of the TOEVT with open thyroidectomy (OT). This is [...] Read more.

Background: Transoral endoscopic vestibular thyroidectomy (TOEVT), a variant of natural orifice transluminal endoscopic surgery, offers a scar-less thyroid to young females. However, few studies have compared the effectiveness and quality of life (QoL) outcomes of the TOEVT with open thyroidectomy (OT). This is the first study in the Middle East and North Africa region that compares the effectiveness, safety profile and QoL outcomes between TOEVT with OT. Methods: We reviewed the medical records of consecutive patients with TOETV and OT at Zulekha Hospital Sharjah and Dubai United Arab Emirates, between 1 January 2019 and 1 April 2021. The data for demographics, type of surgery, operative time, blood loss, post-operative nodule size, hospital stay and post-operative complications were analyzed. We used an SF-36 questionnaire pre- and postoperatively for the assessment of QoL in both groups. Findings: Out of a total of 41 OT and 32 TOEVT procedures, 59 patients (31 TOEVT and 28 OT) fulfilled the inclusion criteria. There were 45 women and 14 men with an average age of 41 years. The mean operating time was 126 min in TOEVT and 96 min in OT (p = 0.000). The mean thyroid size was 5.55 cm in TOEVT and 8.76 cm in OT (p = 0.000). Lastly, the mean intraoperative blood loss was 39 cc and 95.7 cc in TOEVT and OT, respectively (p = 0.001). There was one temporary hypocalcemia and seroma in TOEVT, four cases of temporary hypocalcemia and one with minor bleeding in OT. The post-operative QoL significantly improved in all patients. However, the QoL improved more significantly in the TOEVT group for bodily pain, vitality, role emotions and cosmetic concerns (p = 0.000). Conclusion: The safety profile and effectiveness of the TOEVT is comparable to the OT procedure. However, TOEVT has an additional advantage of being scarless and offers a better QoL. Full article

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8 pages, 509 KiB

Open AccessOpinion

Artificial Intelligence in NICU and PICU: A Need for Ecological Validity, Accountability, and Human Factors

by Avishek Choudhury and Estefania Urena

Healthcare 2022, 10(5), 952; https://doi.org/10.3390/healthcare10050952 - 21 May 2022

Cited by 6 | Viewed by 2276

Abstract

Pediatric patients, particularly in neonatal and pediatric intensive care units (NICUs and PICUs), are typically at an increased risk of fatal decompensation. That being said, any delay in treatment or minor errors in medication dosage can overcomplicate patient health. Under such an environment, [...] Read more.

Pediatric patients, particularly in neonatal and pediatric intensive care units (NICUs and PICUs), are typically at an increased risk of fatal decompensation. That being said, any delay in treatment or minor errors in medication dosage can overcomplicate patient health. Under such an environment, clinicians are expected to quickly and effectively comprehend large volumes of medical information to diagnose and develop a treatment plan for any baby. The integration of Artificial Intelligence (AI) into the clinical workflow can be a potential solution to safeguard pediatric patients and augment the quality of care. However, before making AI an integral part of pediatric care, it is essential to evaluate the technology from a human factors perspective, ensuring its readiness (technology readiness level) and ecological validity. Addressing AI accountability is also critical to safeguarding clinicians and improving AI acceptance in the clinical workflow. This article summarizes the application of AI in NICU/PICU and consecutively identifies the existing flaws in AI (from clinicians’ standpoint), and proposes related recommendations, which, if addressed, can improve AIs’ readiness for a real clinical environment. Full article

11 pages, 843 KiB

Open AccessArticle

Adaptation and Psychometric Evidence of the ARABIC Version of the Diabetes Self-Management Questionnaire (A-DSMQ)

by Nabil Kaddech, Noomen Guelmami, Tore Bonsaksen, Radhouene Doggui, Chiraz Beji and Jalila El Ati

Healthcare 2022, 10(5), 951; https://doi.org/10.3390/healthcare10050951 - 21 May 2022

Cited by 2 | Viewed by 2436

Abstract

(1) Background: Diabetic patients must engage in self-care practices in order to maintain optimal glycemic control, hence reducing the likelihood of developing complications, and enhance the overall quality of their lives. The Diabetes Self-care Management Questionnaire (DSMQ) is a tool for assessing self-management [...] Read more.

(1) Background: Diabetic patients must engage in self-care practices in order to maintain optimal glycemic control, hence reducing the likelihood of developing complications, and enhance the overall quality of their lives. The Diabetes Self-care Management Questionnaire (DSMQ) is a tool for assessing self-management habits that may be used to predict glycemic control in people with diabetes. However, no Arabic language version of the instrument has been found. Therefore, we adapted an Arabic language version of the instrument in Tunisia. The purpose of the current research aimed to assess the psychometric features of the Tunisian version of the DSMQ in patients with type 2 diabetes. (2) Method: Two samples including both genders, one exploratory (n = 208, mean age 53.2 ± 8.3) and one confirmatory (n = 441, mean age 53.4 ± 7.4), completed an adapted Arabic language version of the DSMQ, a sociodemographic questionnaire and information about their HbA1C levels. (3) Results: The exploratory factor analysis revealed that the 15 items of the A-DSMQ fit well with the data. Likewise, the alpha coefficients for the A-DSMQ factors were above 0.80: for “Glucose Management” (GM), “Dietary Control” (DC), “Physical Activity” (PA), and “Heath-Care Use” (HU). The fit indices for the CFA were good, and the four-factor solution was confirmed. The Average Variance Extracted values and Fornell–Larcker criterion established the convergent and discriminant validity, respectively. The concurrent validity of the tool was established through the statistically significant negative relationships between the A-DSMQ factors and HbA1C, in addition to its positive association with the practice of physical activity measured by the IPAQ. (4) Conclusions: Given the high EFA factor loadings, the CFA fit indices, the correlation matrix, the sensitivity analysis, the convergent validity, and the excellent internal consistency of the A-DSMQ, it can be concluded that the A-DSMQ is an effective psychometric tool for diabetes self-management in Tunisia. Full article

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9 pages, 640 KiB

Open AccessArticle

Diaphragmatic Mobility and Chest Expansion in Patients with Scapulocostal Syndrome: A Cross-Sectional Study

by Thanaporn Srijessadarak, Preeda Arayawichanon, Jaturat Kanpittaya and Yodchai Boonprakob

Healthcare 2022, 10(5), 950; https://doi.org/10.3390/healthcare10050950 - 20 May 2022

Viewed by 3530

Abstract

Scapulocostal syndrome (SCS) is a subset of myofascial pain syndrome affecting the posterior shoulder and upper back area. Some of the affected muscles are attached to the rib cage, which may affect diaphragmatic mobility and chest expansion. The purpose of this study was [...] Read more.

Scapulocostal syndrome (SCS) is a subset of myofascial pain syndrome affecting the posterior shoulder and upper back area. Some of the affected muscles are attached to the rib cage, which may affect diaphragmatic mobility and chest expansion. The purpose of this study was to investigate the characteristics of diaphragmatic mobility and chest expansion in patients with SCS. Twenty-nine patients with SCS and twenty-nine healthy participants of a similar age, gender, weight, and height were included in the study. All participants were evaluated for diaphragmatic mobility (DM) by real-time ultrasound (RTUS) and for chest expansion (CE) using a cloth tape measure. An independent t-test was used to compare the outcome variables between groups. The DM value in the SCS group was 46.24 ± 7.26 mm, whereas in the healthy group it was 54.18 ± 9.74 mm. The DM value was lower in the SCS group compared to in healthy participants (p < 0.05). Chest expansion at the axilla, the fourth intercostal space (4th ICS), and the xiphoid level in the SCS group was 7.26 ± 1.13, 6.83 ± 0.94, and 6.86 ± 1.25, respectively, while chest expansion at the axilla, 4th ICS, and xiphoid level in the healthy group was 7.92 ± 1.39, 7.54 ± 1.43, and 8.13 ± 1.32, respectively. Chest expansion at the 4th ICS and the xiphoid level in the SCS group was significantly lower than in the healthy group (p < 0.05). Patients with SCS presented a decrease in diaphragmatic mobility and chest expansion. Therefore, SCS treatment programs ought to add breathing exercises to improve lung expansion. Full article

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9 pages, 272 KiB

Open AccessArticle

Relationship between Sensitivity Tendency and Psychological Stress Reactivity in Healthy Students

by Syunsaku Ishibashi, Jun Murata, Akiko Tokunaga, Akira Imamura, Kojiro Kawano, Ryoichiro Iwanaga and Goro Tanaka

Healthcare 2022, 10(5), 949; https://doi.org/10.3390/healthcare10050949 - 20 May 2022

Viewed by 1724

Abstract

This study examined the relationship between sensory processing sensitivity and psychological stress reactivity in 69 healthy Japanese university students. The Japanese version of the Highly Sensitive Person Scale and the Japanese version of the Adolescent/Adult Sensory Profile were used for subjective assessment. The [...] Read more.

This study examined the relationship between sensory processing sensitivity and psychological stress reactivity in 69 healthy Japanese university students. The Japanese version of the Highly Sensitive Person Scale and the Japanese version of the Adolescent/Adult Sensory Profile were used for subjective assessment. The Galvanic skin response was measured as an objective measure of stress responses while the participants were completing the Stroop task. The Wilcoxon signed-rank test, the Spearman rank correlation coefficient, and the Mann–Whitney U test were conducted for data analysis. The results demonstrated that there was no significant correlation between the Japanese version of the Highly Sensitive Person Scale and Galvanic skin response. However, there was a marginal trend toward significance between low registration in the Japanese version of the Adolescent/Adult Sensory Profile and Galvanic skin response (r_s = 0.231, p < 0.10; r_s = 0.219, p < 0.10), suggesting that self-rated sensitivity was not necessarily associated with objective measures. These results indicate that sensory processing sensitivity analyses require the consideration of the traits and characteristics of the participants and multifaceted evaluations using a sensitivity assessment scale other than the Japanese version of the Highly Sensitive Person Scale. Full article

(This article belongs to the Section Nursing)

13 pages, 780 KiB

Open AccessArticle

Problematic Use of the Internet Mediates the Association between Reduced Mentalization and Suicidal Ideation: A Cross-Sectional Study in Young Adults

by Francesco Saverio Bersani, Tommaso Accinni, Giuseppe Alessio Carbone, Ornella Corazza, Angelo Panno, Elisabeth Prevete, Laura Bernabei, Chiara Massullo, Julius Burkauskas, Lorenzo Tarsitani, Massimo Pasquini, Massimo Biondi, Benedetto Farina and Claudio Imperatori

Healthcare 2022, 10(5), 948; https://doi.org/10.3390/healthcare10050948 - 20 May 2022

Cited by 7 | Viewed by 2307

Abstract

Suicide is a major public health problem, and it is urgent to investigate its underlying clinical and psychological concomitants. It has been suggested that low mentalization skills and problematic use of the internet (PUI) are factors that can play a role in suicidal [...] Read more.

Suicide is a major public health problem, and it is urgent to investigate its underlying clinical and psychological concomitants. It has been suggested that low mentalization skills and problematic use of the internet (PUI) are factors that can play a role in suicidal behaviors. It is possible that poor mentalization skills contribute to leading to forms of PUI, which, in turn, can represent triggers for suicidal ideation (SI). We tested this hypothesis through a quantitative and cross-sectional study on a sample (n = 623) of young adults (age range: 18–34). Self-report measures investigating symptoms related to Social Media Addiction (SMA), Internet Gaming Disorder (IGD), mentalization capacity, and SI were used. A single mediation analysis with two mediators was carried out to evaluate the direct and indirect effects of mentalization on SI through the mediating role of SMA- and IGD-related symptoms, controlling for potential confounding factors (e.g., socio-demographic and addiction-related variables). The four explored variables were significantly associated with each other (all p < 0.001) across all subjects; the mediational model showed that the total effect of mentalization on SI was significant (B = −0.821, SE = 0.092 (95% CI: −1.001; −0.641)) and that both SMA- (B = −0.073, SE = 0.034 (95% CI: −0.145; −0.008)) and IGD-related symptoms (B = 0.046, SE = 0.027 (95% CI: −0.107; −0.001)) were significant mediators of such association. Our findings support the possibility that PUI severity plays a relevant role in mediating the association between low mentalization skills and levels of SI. Full article

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8 pages, 578 KiB

Open AccessArticle

The Effectiveness of ddPCR for Detection of Point Mutations in Poor-Quality Saliva Samples

by Petra Riedlova, Dagmar Kramna, Silvie Ostrizkova, Hana Tomaskova and Vitezslav Jirik

Healthcare 2022, 10(5), 947; https://doi.org/10.3390/healthcare10050947 - 20 May 2022

Viewed by 1369

Abstract

Background: The noninvasive collection of saliva samples for DNA analyses is simple, and its potential for research and diagnostic purposes is great. However, DNA isolates from such samples are often of inferior quality to those from blood. Aim: The aim of this study [...] Read more.

Background: The noninvasive collection of saliva samples for DNA analyses is simple, and its potential for research and diagnostic purposes is great. However, DNA isolates from such samples are often of inferior quality to those from blood. Aim: The aim of this study was to investigate the robustness and sensitivity of the ddPCR instrument for genetic analyses from saliva samples of poor quality by comparing their results to those obtained using an established method from blood samples. Methods: Blood and saliva were collected from 47 university students, which was followed by manual isolation of DNA and analysis on droplet digital PCR (ddPCR). Results of analyses were supplemented with values of fractional abundances. Results: ddPCR proved to be highly suitable for analysis of even low-quality saliva samples (concentrations as low as 0.79 ng/µL), especially when augmented by fractional abundance data. This combination yielded 100% agreement with results obtained from blood samples. Conclusion: This study verified the applicability of ddPCR as a sensitive and robust method of genetic diagnostic testing even from low-quality saliva isolates. This makes it potentially suitable for a wide range of applications and facilitates the performance of large epidemiological studies, even if sampling or sample processing is suboptimal. Full article

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8 pages, 555 KiB

Open AccessArticle

The Effects of Sternocleidomastoid Muscle Taping on Postural Control in Healthy Young Adults: A Pilot Crossover Study

by Alex Martino Cinnera, Alessandro Antonio Princi, Enza Leone, Serena Marrano, Alessandra Pucello, Stefano Paolucci, Marco Iosa and Giovanni Morone

Healthcare 2022, 10(5), 946; https://doi.org/10.3390/healthcare10050946 - 20 May 2022

Cited by 1 | Viewed by 1600

Abstract

Background: Postural control is a complex ability, also controlled by the somatosensory connection of the neck muscles with the vestibular nuclei. This circuit seems to be interested in maintaining head stabilization during movements. The sternocleidomastoid (SCM) muscle is the dominant source of the [...] Read more.

Background: Postural control is a complex ability, also controlled by the somatosensory connection of the neck muscles with the vestibular nuclei. This circuit seems to be interested in maintaining head stabilization during movements. The sternocleidomastoid (SCM) muscle is the dominant source of the vestibular afferents as confirmed by neurophysiological acquisition. The aim of this study is to evaluate whether the application of kinesio-tape on the SCM muscle can induce a perturbation of the standing postural control by altering the somatosensory system of the neck muscles. Methods: Thirteen healthy participants (age: 24.46 ± 3.04 yrs; 9 female) were enrolled, and the four kinesio-tape (KT) conditions were performed in a random order: without KT application (Ctrl); right KT application (R-SCM); left KT application (L-SCM); and bilateral KT application (B-SCM). All conditions were performed three times with open eyes and closed eyes. Results: There was a significant increase in the length of the centre of pressure (CoP), in the maximal oscillation, and in the anteroposterior root mean square between the three tape application conditions with respect to the Ctrl condition with open eyes. The same parameters were statistically different when the participants were blindfolded in the B-SCM condition with respect to the Ctrl condition. A statistical decrease in the difference in weight distribution between the two feet was observed in the B-SCM group with respect to the Ctrl group in both open and closed eyes conditions. Conclusions: Our results suggest that KT on the SCM muscles may involve some space-time parameters of postural control. Bilateral KT improved the weight distribution between the feet but showed a parallel increase in anteroposterior oscillations and in the length of the CoP with respect to the Ctrl condition. The perturbation seems to be greater in the somatosensory system when it is working coupled with visual afferences during an upright position. Full article

(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)

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9 pages, 268 KiB

Open AccessArticle

Knowledge and Opinions of Healthcare Professionals about Thirdhand Smoke: A Multi-National, Cross-Sectional Study

by Blanca Quispe-Cristóbal, Cristina Lidón-Moyano, Juan Carlos Martín-Sánchez, Hipólito Pérez-Martín, Àurea Cartanyà-Hueso, Íñigo Cabriada-Sáez, Sonia de Paz-Cantos, Jose M. Martínez-Sánchez and Adrián González-Marrón

Healthcare 2022, 10(5), 945; https://doi.org/10.3390/healthcare10050945 - 19 May 2022

Cited by 2 | Viewed by 1777

Abstract

There is scarce evidence on the knowledge and opinions about third-hand smoke (THS) of health care professionals. The main aim of this study was to explore the knowledge and opinions of health care professionals about THS and, secondarily, to explore the factors that [...] Read more.

There is scarce evidence on the knowledge and opinions about third-hand smoke (THS) of health care professionals. The main aim of this study was to explore the knowledge and opinions of health care professionals about THS and, secondarily, to explore the factors that are associated with this knowledge. Cross-sectional study using a snowball sample of multi-national health care professionals (n = 233). Data were obtained from an exploratory, online questionnaire. The health care professionals’ knowledge and opinions on THS were described with absolute frequency and percentage. Chi-square and Fisher-Freeman-Halton exact tests, and simple logistic regression models, were used to explore the bivariate association between the knowledge of the concept THS and sex, continent of birth, educational level, occupation, years of experience, and attitude towards smoking. Finally, a multivariable logistic regression model incorporating all the above variables was fitted. A total of 65.2% of the participants were unaware of the term THS before the study began. In the bivariate analysis, an association was found between prior knowledge of the term THS and continent of birth (p-value = 0.030) and occupation (p-value = 0.014). In the multivariable logistic regression model, a significant association was observed between prior knowledge of the concept THS and sex (p-value = 0.005), continent of birth (p-value = 0.012), and occupation (p-value = 0.001). Almost two out of three health care professionals who participated in our study did not know what THS was. Educational activities on this topic should be implemented. Full article

9 pages, 486 KiB

Open AccessArticle

Personal Protection Equipment and Infection Control Procedures among Health Workers during the COVID-19 Pandemic

by Daniela Carmagnola, Marilisa Toma, Dolaji Henin, Mariachiara Perrotta, Gaia Pellegrini and Claudia Dellavia

Healthcare 2022, 10(5), 944; https://doi.org/10.3390/healthcare10050944 - 19 May 2022

Cited by 4 | Viewed by 1720

Abstract

Health workers have been particularly affected by the COVID-19 pandemic, but it is unclear which healthcare professions are more exposed. We search for information that can help identify health workers who are employed in exposure-prone professions and who, therefore, routinely wear and adopt [...] Read more.

Health workers have been particularly affected by the COVID-19 pandemic, but it is unclear which healthcare professions are more exposed. We search for information that can help identify health workers who are employed in exposure-prone professions and who, therefore, routinely wear and adopt strict infection control equipment and measures from other colleagues. Our purpose is to test the hypothesis that health professionals historically considered less exposure-prone are affected more severely by COVID-19. Taking dentists as an example of exposure-prone healthcare professionals, this study aims to analyze data on COVID-19-related deaths reported by the Italian board of doctors and dentists’ database to evaluate the number of COVID-19-related deaths of doctors and dentists in Italy from the beginning of the pandemic to 31 December 2022. As of 31 December 2021, out of 364 deaths, 38 were dentists, and of the remaining 326 doctors, 140 were general practitioners (GPs). The percentage of deaths among dentists, total doctors and GPs results in 0.06%, 0.09% and 0.33%, respectively, for the whole sample. Excluding subjects over 70 years of age, the corresponding values are 0.05%, 0.06% and 0.25%. Most of the deaths occurred in Lombardia, and the geographical distribution overlaps the trend of the corresponding general Italian population. Considering the outcome of “death”, dentists, despite being at high risk, are not particularly affected by COVID-19. Full article

(This article belongs to the Special Issue Oral Healthcare and Prevention during the Pandemic)

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22 pages, 988 KiB

Open AccessReview

Obstructive Sleep Apnea and Adherence to Continuous Positive Airway Pressure (CPAP) Treatment: Let’s Talk about Partners!

by Debora Rosa, Carla Amigoni, Elisa Rimoldi, Paola Ripa, Antonella Ligorio, Miriam Fracchiolla, Carolina Lombardi, Gianfranco Parati and Elisa Perger

Healthcare 2022, 10(5), 943; https://doi.org/10.3390/healthcare10050943 - 19 May 2022

Cited by 8 | Viewed by 2760

Abstract

Background: Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA). The benefits of this therapy were studied and analyzed over time; patient adherence is often poor, as many factors negatively influence it. A topic that needs clarification [...] Read more.

Background: Continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA). The benefits of this therapy were studied and analyzed over time; patient adherence is often poor, as many factors negatively influence it. A topic that needs clarification is whether adherence to CPAP treatment in a patient with OSA is influenced by the behavior of a partner or spouse. Methods: A scoping review was conducted to evaluate the role of partner involvement in the CPAP treatment management in a patient with OSA. The research project was performed between August and September 2021 by consulting the main biomedical databases: CINHAL, Embase, PsycINFO, and PubMed. Results: Among 21 articles considered valid for our aim, 15 are qualitative studies, 5 are quantitative and 1 presents a mixed method. We identified several thematic areas and “key” elements, which are prevalent in the studies evaluated. Conclusions: The presence of a partner promotes adherence to CPAP therapy in patients with OSA, resulting in ameliorating their overall quality of life. To increase CPAP adherence, a trained nurse could represent a reference figure to technically and emotionally support couples during the adaptation period and in the long term. Full article

(This article belongs to the Section Nursing)

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21 pages, 2805 KiB

Open AccessArticle

Modelling Granular Process Flow Information to Reduce Bottlenecks in the Emergency Department

by Marian Amissah and Sudakshina Lahiri

Healthcare 2022, 10(5), 942; https://doi.org/10.3390/healthcare10050942 - 19 May 2022

Cited by 1 | Viewed by 3075

Abstract

Increasing demand and changing case-mix have resulted in bottlenecks and longer waiting times in emergency departments (ED). However, many process improvement efforts addressing the bottlenecks have limitations, as they lack accurate models of the real system as input accounting for operational complexities. To [...] Read more.

Increasing demand and changing case-mix have resulted in bottlenecks and longer waiting times in emergency departments (ED). However, many process improvement efforts addressing the bottlenecks have limitations, as they lack accurate models of the real system as input accounting for operational complexities. To understand the limitations, this research modelled granular procedural information, to analyse processes in a Level-1 ED of a 1200-bed teaching hospital in the UK. Semi-structured interviews with 21 clinicians and direct observations provided the necessary information. Results identified Majors as the most crowded area, hence, a systems modelling technique, role activity diagram, was used to derive highly granular process maps illustrating care in Majors which were further validated by 6 additional clinicians. Bottlenecks observed in Majors included awaiting specialist input, tests outside the ED, awaiting transportation, bed search, and inpatient handover. Process mapping revealed opportunities for using precedence information to reduce repeat tests; informed alerting; and provisioning for operational complexity into ED processes as steps to potentially alleviate bottlenecks. Another result is that this is the first study to map care processes in Majors, the area within the ED that treats complex patients whose care journeys are susceptible to variations. Findings have implications on the development of improvement approaches for managing bottlenecks. Full article

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8 pages, 942 KiB

Open AccessArticle

Identification of Determinants of Biofeedback Treatment’s Efficacy in Treating Migraine and Oxidative Stress by ARIANNA (ARtificial Intelligent Assistant for Neural Network Analysis)

by Irene Ciancarelli, Giovanni Morone, Maria Giuliana Tozzi Ciancarelli, Stefano Paolucci, Paolo Tonin, Antonio Cerasa and Marco Iosa

Healthcare 2022, 10(5), 941; https://doi.org/10.3390/healthcare10050941 - 19 May 2022

Cited by 4 | Viewed by 1656

Abstract

Migraines are a public health problem that impose severe socioeconomic burdens and causes related disabilities. Among the non-pharmacological therapeutic approaches, behavioral treatments such as biofeedback have proven effective for both adults and children. Oxidative stress is undoubtedly involved in the pathophysiology of migraines. [...] Read more.

Migraines are a public health problem that impose severe socioeconomic burdens and causes related disabilities. Among the non-pharmacological therapeutic approaches, behavioral treatments such as biofeedback have proven effective for both adults and children. Oxidative stress is undoubtedly involved in the pathophysiology of migraines. Evidence shows a complex relationship between nitric oxide (NO) and superoxide anions, and their modification could lead to an effective treatment. Conventional analyses may fail in highlighting the complex, nonlinear relationship among factors and outcomes. The aim of the present study was to verify if an artificial neural network (ANN) named ARIANNA could verify if the serum levels of the decomposition products of NO—nitrite and nitrate (NOx)—the superoxide dismutase (SOD) serum levels, and the Migraine Disability Assessment Scores (MIDAS) could constitute prognostic variables predicting biofeedback’s efficacy in migraine treatment. Twenty women affected by chronic migraine were enrolled and underwent an EMG-biofeedback treatment. The results show an accuracy for the ANN of 75% in predicting the post-treatment MIDAS score, highlighting a statistically significant correlation (R = −0.675, p = 0.011) between NOx (nitrite and nitrate) and MIDAS only when the peroxide levels in the serum were within a specific range. In conclusion, the ANN was proven to be an innovative methodology for interpreting the complex biological phenomena and biofeedback treatment in migraines. Full article

(This article belongs to the Special Issue Neurorehabilitation Outcome Measures and Innovative Approaches in Physiotherapy)

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3 pages, 190 KiB

Open AccessComment

The Newfound Opportunities of Wearable Systems Based on Biofeedback in the Prevention of Falls. Comment on Tanwar et al. Pathway of Trends and Technologies in Fall Detection: A Systematic Review. Healthcare 2022, 10, 172

by Giovanni Morone, Giovanni Maccioni and Daniele Giansanti

Healthcare 2022, 10(5), 940; https://doi.org/10.3390/healthcare10050940 - 19 May 2022

Viewed by 1011

Abstract

We are writing to you as the corresponding authors of the interesting systematic review study “Pathway of Trends and Technologies in Fall Detection: A Systematic Review” [...] Full article

(This article belongs to the Special Issue Cybersecurity and the Digital Health: An Investigation on the State of the Art and the Position of the Actors)

12 pages, 1198 KiB

Open AccessArticle

Morphological Comparison of the Maxillary Arch in Buccal and Palatal Canine Impaction among Asian Population of Gujarati Origin: A Hospital-Based Study

by Falguni Mehta, Mayank Jain, Swati Verma, Sakeenabi Basha, Renuka A. Patel, Rahul Trivedi, Harshik A. Parekh, Valai Kasim Shakeel Ahmed, Mohammad Khursheed Alam, Anil Kumar Nagarajappa and Pratibha Taneja

Healthcare 2022, 10(5), 939; https://doi.org/10.3390/healthcare10050939 - 19 May 2022

Cited by 7 | Viewed by 2930

Abstract

Aim: To estimate the differences in the maxillary arch morphology in buccal and palatal canine impaction in an Asian population of Gujarati origin. Methodology: An institutional ethics committee’s approval was acquired before the commencement of this study. Sixty subjects were enrolled in the [...] Read more.

Aim: To estimate the differences in the maxillary arch morphology in buccal and palatal canine impaction in an Asian population of Gujarati origin. Methodology: An institutional ethics committee’s approval was acquired before the commencement of this study. Sixty subjects were enrolled in the study. Thirty subjects (20 females and 10 males) had a maxillary impacted canine either buccal or palatal and thirty control group participants were selected aged 13 to 18 years who sought orthodontic treatment at the tertiary health care center in Ahmedabad, Gujarat, in western India. Routine pre-treatment radiographs and dental plaster models with good anatomic details were recorded. Measurements of the inter-molar width, palatal depth, arch length, sum of the mesio-distal width of the upper incisors, and available arch space were recorded from prepared orthodontic study models using digital vernier calipers with an accuracy of 0.01 mm and brass wire. The ratio of palatal depth to inter-molar width (Ratio 1), arch length to inter-molar width (Ratio 2), and width of the maxillary incisors to available arch space (Ratio 3) were also secondarily calculated. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21, IBM Inc. The normality of the data was assessed by the Shapiro–Wilk test. As the data was found to be normally distributed, bivariate analyses were also performed (one-way ANOVA test, Bonferroni post hoc correction). The level of statistical significance was set at a p-value less than 0.05. Results: The comparison of the inter-molar width, palatal depth, arch length, sum of the mesio-distal width of the upper incisors, available arch space, Ratio 1, Ratio 2, and Ratio 3 among controls and subjects with buccal and palatal canine impaction showed overall significant differences in the inter-molar width, palatal depth, arch length, sum of the mesio-distal width of the upper incisors, and available arch space when compared using one-way ANOVA as p < 0.05. Ratios 1, 2, and 3 also showed significant differences between the buccal and palatal canine impaction. Conclusion: An inadequate arch length (p < 0.0001) and a higher degree of crowding with reduced available arch space (p < 0.0001) may be considered as early risk factors for buccal maxillary canine impaction. An inadequate inter-molar width (p < 0.0001), and an increased palatal depth (p < 0.0001) with a clinically reduced mesiodistal width of the sum of maxillary incisors may be considered as risk factors for palatal maxillary canine impaction in an Asian population of Gujarati origin. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Pediatric Dentistry)

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12 pages, 415 KiB

Open AccessArticle

Trust-Based Research: Influencing Factors of Patients’ Medical Choice Behavior in the Online Medical Community

by Chutong Qiu, Yuting Zhang, Xiaoyu Wang and Dongxiao Gu

Healthcare 2022, 10(5), 938; https://doi.org/10.3390/healthcare10050938 - 18 May 2022

Cited by 2 | Viewed by 1966

Abstract

The medical service is a special credit commodity, and trust plays a very important role in patients’ online medical choice behavior. By collecting information about the doctors on China’s leading online medical platform (Platform A), a regression analysis model was constructed, based on [...] Read more.

The medical service is a special credit commodity, and trust plays a very important role in patients’ online medical choice behavior. By collecting information about the doctors on China’s leading online medical platform (Platform A), a regression analysis model was constructed, based on the credibility theory model, which has the following three dimensions: ability trust, benevolence trust, and integrity trust. The results showed that the medical title of the doctors, their department’s reputation, the number of gifts given to them, and the number of patients who registered with them after diagnosis, among other factors, had a significant, positive impact on the behavior of choosing doctors. Among these considerations, the number of patients registered after diagnosis had the greatest impact on the behavior of choosing doctors. This factor is the result of each doctor’s personal brand management, which reflects their comprehensive ability, reputation and integrity. Compared with previous studies, this paper creatively analyzed the important influence of departmental reputation and the number of patients registered after diagnosis on medical choice behavior and puts forward that a doctor can use the number of patients registered after diagnosis to manage their personal brand. Based on the results of this study, we will also put forward suggestions from the perspectives of patients, doctors and the online medical community. Full article

(This article belongs to the Special Issue Healthcare Transformation and Innovation in Digital, Aging, and Smart Society)

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10 pages, 564 KiB

Open AccessArticle

The Effect of Early Applied Robot-Assisted Physiotherapy on Functional Independence Measure Score in Post-Myocardial Infarction Patients

by Peter Bartík, Michal Vostrý, Zuzana Hudáková, Peter Šagát, Anna Lesňáková and Andrej Dukát

Healthcare 2022, 10(5), 937; https://doi.org/10.3390/healthcare10050937 - 18 May 2022

Cited by 6 | Viewed by 2228

Abstract

Robot-assisted training has been widely used in rehabilitation programs, but no significant clinical evidence about its use in productive working-age cardiac patients was demonstrated. Thus, we hypothesized that early applied robot-assisted physiotherapy might provide additional treatment benefits in the rehabilitation of post-myocardial infarction [...] Read more.

Robot-assisted training has been widely used in rehabilitation programs, but no significant clinical evidence about its use in productive working-age cardiac patients was demonstrated. Thus, we hypothesized that early applied robot-assisted physiotherapy might provide additional treatment benefits in the rehabilitation of post-myocardial infarction (MI) patients. A total of 92 (50 men, 42 women) hospitalized post-MI patients with the age of 60.9 ± 2.32 participated in the research. An early intensive physiotherapy program (7×/week, 2×/day) was applied for each patient with an average time of 45 min per session. Patients were consecutively assigned to Experimental group (EG) and Control group (CG). Then, 20 min of robot-assisted training by Motomed letto 2 or Thera-Trainer tigo was included in all EG physiotherapy sessions. The Functional Independence Measures (FIM) score at the admission and after 14 days of rehabilitation was used for an assessment. When analyzing time * group effect by repeated-measures ANOVA, we reported that EG showed a higher effect in ADL (p = 0.00), and Motor indicators (p = 0.00). There was no statistically significant effect reported in the Social indicator (p = 0.35). Early rehabilitation programs for post-MI patients might be enhanced by robotic tools, such as THERA-Trainer tigo, and Motomed letto 2. The improvement was particularly noticeable in mobility and ADLs. Full article

(This article belongs to the Special Issue Rehabilitation and Robotics: Are They Working Well Together?)

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12 pages, 251 KiB

Open AccessArticle

Supporting the Delivery of Infection Prevention and Control Training to Healthcare Workers: Insights from the Sector

by Mohammed Qureshi, Abrar Chughtai and Holly Seale

Healthcare 2022, 10(5), 936; https://doi.org/10.3390/healthcare10050936 - 18 May 2022

Cited by 4 | Viewed by 2283

Abstract

Infection prevention and control (IPC) cannot be implemented without healthcare workers (HCWs) being properly trained and competent. The provision of training is essential, yet there is a gap in our understanding of the factors impacting the implementation of IPC training. This paper reports [...] Read more.

Infection prevention and control (IPC) cannot be implemented without healthcare workers (HCWs) being properly trained and competent. The provision of training is essential, yet there is a gap in our understanding of the factors impacting the implementation of IPC training. This paper reports the results from in-depth interviews that explored the current landscape around IPC training delivered across low-, middle-, and high-income countries. Semi-structured interviews were conducted with the key stakeholders involved in policymaking or IPC implementation in Saudi Arabia, Pakistan, India, Indonesia, the Philippines, and Australia. Although the training was mandated for many HCWs, participants indicated that only some training elements were mandatory. Participants spoke about covering various topics, but those in low-resource settings spoke about the challenges of delivering training. Classroom-based training dominated, but online delivery modes were also used in some locations. Whilst HCW’s training was postulated to have improved during the COVID-19 pandemic, the capacity to deliver training did not improve in some settings. More research is needed to establish the essential elements that could underpin the development of training packages. Full article

16 pages, 4897 KiB

Open AccessArticle

Disclosing Critical Voice Features for Discriminating between Depression and Insomnia—A Preliminary Study for Developing a Quantitative Method

by Ray F. Lin, Ting-Kai Leung, Yung-Ping Liu and Kai-Rong Hu

Healthcare 2022, 10(5), 935; https://doi.org/10.3390/healthcare10050935 - 18 May 2022

Cited by 1 | Viewed by 1507

Abstract

Background: Depression and insomnia are highly related—insomnia is a common symptom among depression patients, and insomnia can result in depression. Although depression patients and insomnia patients should be treated with different approaches, the lack of practical biological markers makes it difficult to discriminate [...] Read more.

Background: Depression and insomnia are highly related—insomnia is a common symptom among depression patients, and insomnia can result in depression. Although depression patients and insomnia patients should be treated with different approaches, the lack of practical biological markers makes it difficult to discriminate between depression and insomnia effectively. Purpose: This study aimed to disclose critical vocal features for discriminating between depression and insomnia. Methods: Four groups of patients, comprising six severe-depression patients, four moderate-depression patients, ten insomnia patients, and four patients with chronic pain disorder (CPD) participated in this preliminary study, which aimed to record their speaking voices. An open-source software, openSMILE, was applied to extract 384 voice features. Analysis of variance was used to analyze the effects of the four patient statuses on these voice features. Results: statistical analyses showed significant relationships between patient status and voice features. Patients with severe depression, moderate depression, insomnia, and CPD reacted differently to certain voice features. Critical voice features were reported based on these statistical relationships. Conclusions: This preliminary study shows the potential in developing discriminating models of depression and insomnia using voice features. Future studies should recruit an adequate number of patients to confirm these voice features and increase the number of data for developing a quantitative method. Full article

(This article belongs to the Special Issue Ergonomics Study in Healthcare Assistive Tools and Services)

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