Healthcare

18 pages, 846 KiB

Open AccessArticle

Priority Criteria for Community-Based Care Resource Allocation for Health Equity: Socioeconomic Status and Demographic Characteristics in the Multicriteria Decision-Making Method

by Hui-Ching Wu

Healthcare 2022, 10(7), 1358; https://doi.org/10.3390/healthcare10071358 - 21 Jul 2022

Cited by 2 | Viewed by 1873

Abstract

SDG 10 stipulates that inequality within and between countries can be reduced by governmental policies that focus on the allocation of fiscal resources and social protection strategies to improve equity. The sustainability of community-based care stations is a crucial support network for achieving [...] Read more.

SDG 10 stipulates that inequality within and between countries can be reduced by governmental policies that focus on the allocation of fiscal resources and social protection strategies to improve equity. The sustainability of community-based care stations is a crucial support network for achieving the goal of active aging. Unequal allocation would occur only if the populations of administrative districts are considered. Comprehensive policies, in accordance with data and sustainable goals, must consider multiple factors. Hence, this study used multicriteria decision making (MCDM) to investigate how nine criteria-related socioeconomic statuses (SES) and demographic characteristics are prioritized in community resource and funding allocation. Thirty-four community care and aging experts were invited to complete a questionnaire based on the modified Delphi method and the analytical hierarchy process (AHP) method. The assessment criteria for the allocation of community resources are prioritized in the following order: disability level, age, household composition, identity of social welfare, family income, ethnicity, marital status, educational attainment, and gender. Quantitative indices can be used to determine the importance of resource allocation policymaking. The benefit of this study lies in decision makers’ application of ranking and weighting values in public funding allocation ratios for community-based care resources for health equity in Taiwan. Full article

(This article belongs to the Special Issue Policy Interventions to Promote Health and Prevent Disease)

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18 pages, 2294 KiB

Open AccessArticle

New Method to Implement and Analysis of Medical System in Real Time

by Yahia Zakria Abd Elgawad, Mohamed I. Youssef, Tarek Mahmoud Nasser, Amir Almslmany, Ahmed S. I. Amar, Abdelrhman Adel Mohamed, Naser Ojaroudi Parchin, Raed A. Abd-Alhameed, Heba G. Mohamed and Karim H. Moussa

Healthcare 2022, 10(7), 1357; https://doi.org/10.3390/healthcare10071357 - 21 Jul 2022

Cited by 2 | Viewed by 1515

Abstract

The use of information technology and technological medical devices has contributed significantly to the transformation of healthcare. Despite that, many problems have arisen in diagnosing or predicting diseases, either as a result of human errors or lack of accuracy of measurements. Therefore, this [...] Read more.

The use of information technology and technological medical devices has contributed significantly to the transformation of healthcare. Despite that, many problems have arisen in diagnosing or predicting diseases, either as a result of human errors or lack of accuracy of measurements. Therefore, this paper aims to provide an integrated health monitoring system to measure vital parameters and diagnose or predict disease. Through this work, the percentage of various gases in the blood through breathing is determined, vital parameters are measured and their effect on feelings is analyzed. A supervised learning model is configured to predict and diagnose based on biometric measurements. All results were compared with the results of the Omron device as a reference device. The results proved that the proposed design overcame many problems as it contributed to expanding the database of vital parameters and providing analysis on the effect of emotions on vital indicators. The accuracy of the measurements also reached 98.8% and the accuracy of diagnosing COVID-19 was 64%. The work also presents a user interface model for clinicians as well as for smartphones using the Internet of things. Full article

(This article belongs to the Special Issue Artificial Intelligence Applications in Medicine)

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0 pages, 888 KiB

Open AccessBrief Report

Analysis of Retinal Blood Vessel Diameters in Pregnant Women Practicing Yoga: A Feasibility Study

by Dejan Dinevski, Miha Lučovnik, Ivan Žebeljan, Domen Guzelj, Izidora Vesenjak Dinevski, Adam Saloň, Patrick De Boever and Nandu Goswami

Healthcare 2022, 10(7), 1356; https://doi.org/10.3390/healthcare10071356 - 21 Jul 2022

Viewed by 1308

Abstract

Studies have shown that practicing yoga during pregnancy beneficially affects maternal and neonatal outcomes. The objective of this study was to determine the effect of prenatal yoga on the microvascular circulatory system via non-invasive measurements of retinal blood vessels. We included 29 women [...] Read more.

Studies have shown that practicing yoga during pregnancy beneficially affects maternal and neonatal outcomes. The objective of this study was to determine the effect of prenatal yoga on the microvascular circulatory system via non-invasive measurements of retinal blood vessels. We included 29 women who practiced prenatal yoga in the study. There were no statistically significant differences in arteriolar and venular diameters pre- vs. post-90 min yoga practice (150.5 ± 11.4 μm pre- vs. 151.2 ± 10.2 μm post-yoga; p = 0.53 for arteriolar and 221.8 ± 16.1 μm pre- vs. 223.2 ± 15.7 μm post-yoga; p = 0.51 for venular diameters). The current study demonstrated the feasibility of the setup. More extensive studies are needed to determine the potential microvascular effects of practicing yoga throughout pregnancy. Full article

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14 pages, 643 KiB

Open AccessArticle

The Age Factor in the Analysis of Occupational Risks in the Wood Industry

by Noelia Araújo-Vila, Diego R. Toubes and Jose Antonio Fraiz-Brea

Healthcare 2022, 10(7), 1355; https://doi.org/10.3390/healthcare10071355 - 21 Jul 2022

Viewed by 1573

Abstract

Workers in the wood industry are continually exposed to a wide range of risks. Some risks are potentially high and may lead to serious work-related accidents or occupational diseases. It is a sector where physical work is predominant and where high-risk machinery is [...] Read more.

Workers in the wood industry are continually exposed to a wide range of risks. Some risks are potentially high and may lead to serious work-related accidents or occupational diseases. It is a sector where physical work is predominant and where high-risk machinery is used. There is also the age factor, as the age of the workforce increases the risks of loss of skills, particularly physical skills. This study analyses the impact of age on the occupational safety and health management in the wood industry. To this end, a qualitative analysis was carried out through semi-structured in-depth interviews. A total of 52 interviews were conducted with wood-based entrepreneurs, occupational safety technicians and experts from Galicia (Spain). The results show that there is a growing concern to integrate the older group in occupational safety and health management due to the increasing work life. The older group is not the one with the greatest number of occupational accidents (8.3%), but rather the one that needs better working conditions in the face of physical deterioration, considering that a large proportion of senior workers is transferred to administrative tasks. Consequently, the proportion of older workers performing physical tasks, which are the tasks with the highest associated risk, is lower. Full article

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12 pages, 257 KiB

Open AccessArticle

The Incident Feedback Committee (IFC): A Useful Tool to Investigate Errors in Clinical Research

by Sandra David-Tchouda, Alison Foote and Jean-Luc Bosson

Healthcare 2022, 10(7), 1354; https://doi.org/10.3390/healthcare10071354 - 21 Jul 2022

Viewed by 1067

Abstract

In clinical practice, an objective of safety management is to identify preventable causes of adverse events to avoid the incidents from recurring. Likewise, in the field of clinical research adequate methods to investigate incidents that impair the quality of a clinical trial are [...] Read more.

In clinical practice, an objective of safety management is to identify preventable causes of adverse events to avoid the incidents from recurring. Likewise, in the field of clinical research adequate methods to investigate incidents that impair the quality of a clinical trial are needed. Understanding the causes of errors and undesirable incidents can help guarantee participant safety, improve the practices of research coordinators, investigators, and clinical research assistants and help to minimize research costs. Here, we present the main features of our Incident Feedback Committees (IFC) in clinical research, with outcomes over 5 years. Methods: The IFC has adapted the ALARM and ORION post-event methods with investigations focused on ‘the incidents’ occurring during research studies. It sought the root causes contributing to these incidents and proposed corrective actions. Results: Since our IFC was set up in 2015 it has examined 52 incidents from nine studies. The most frequent causes mainly concerned the working environment (54%). Most incidents had two or more causes. Some corrective actions were planned for ongoing or future studies. Conclusion: IFCs provide a useful and much-appreciated method of analysing incidents in the performance of clinical research. A multicentre study is needed to evaluate the effect of IFCs on the quality of an establishment’s clinical research, at the individual level (patient safety) and also at the system level (changes in the organization of tasks). Full article

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

18 pages, 321 KiB

Open AccessArticle

Caring for Daughters with Anorexia Nervosa: A Qualitative Study on Parents’ Representation of the Problem and Management of the Disorder

by Luna Carpinelli, Tiziana Marinaci and Giulia Savarese

Healthcare 2022, 10(7), 1353; https://doi.org/10.3390/healthcare10071353 - 21 Jul 2022

Cited by 2 | Viewed by 1780

Abstract

Background: This study explores the implicit theories by which primary caregivers (PC) of patients diagnosed with anorexia nervosa (AN) understand the eating disorder and interpret their role in treating and managing the problem. Methodology: In-depth, semi-structured, and open interview questions were used to [...] Read more.

Background: This study explores the implicit theories by which primary caregivers (PC) of patients diagnosed with anorexia nervosa (AN) understand the eating disorder and interpret their role in treating and managing the problem. Methodology: In-depth, semi-structured, and open interview questions were used to achieve the study’s goals. In total, 19 caregivers, 16 mothers, and three fathers (mean age: 50.74; SD: 5.248) from a public service for the treatment of behavioral disorders in southern Italy were interviewed. A lexical correspondence analysis (LCA) was applied to the verbatim transcripts to identify the main factorial dimensions, which organize similarity and dissimilarity in the collected discourses. Results: The first dimension represents the dialectic between two different models of explanation of the problem, and the second dimension represents the dialectic between two different perspectives on the attribution of responsibility. Overall, the analyses show the difficulties of PC in exploring the emotional dynamics of the problem and the tendency to take out of the family context every possible representation of the role that it can play in the maintenance and evolution of the disorder. Conclusions: The strategies to prevent and treat AN may benefit from knowledge of the meaning’s lenses adopted by the primary caregivers to explain and cope with their daughters’ illness. Full article

10 pages, 478 KiB

Open AccessStudy Protocol

Factors Associated with Anxiety and Depression in Infertile Couples—Study Protocol

by Tong Yang, Nahathai Wongpakaran, Tinakon Wongpakaran, Ubol Saeng-Anan, Charuk Singhapreecha, Rewadee Jenraumjit and Carmelle Peisah

Healthcare 2022, 10(7), 1352; https://doi.org/10.3390/healthcare10071352 - 21 Jul 2022

Cited by 3 | Viewed by 2287

Abstract

(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of [...] Read more.

(1) Background: Infertility refers to the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility is an important medical and social problem that causes individual distress, family conflict and emotional impact experienced by about 15% of couples worldwide. Anxiety and depression are the main psychological problems associated with infertility with many potential contributing factors which are yet to be fully elucidated. This study aims to investigate factors related to anxiety and depression among infertile couples. (2) Methods/Design: This study will employ an analytical cross-sectional survey. Sociodemographic information will be collected. Validated tools will be used to assess anxiety and depression (Outcome Inventory-21(OI-21), marital satisfaction (ENRICH Marital Satisfaction Scale, sufficiency economy (Sufficiency Economy Scale (SES) and personality traits (Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ). The Actor-Partner Interdependence Model estimated by multilevel modeling will be used for dyadic analysis. (3) Discussion: This study will provide evidence about factors associated with anxiety and depression in infertile couples. Outcomes will raise awareness about mental health problems among infertile couples and guide future research for interventions. Full article

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11 pages, 288 KiB

Open AccessArticle

by Julien Ancel, Claire Launois, Jeanne-Marie Perotin, Bruno Ravoninjatovo, Pauline Mulette, Jean Hagenburg, Julie Malet, Muriel Griffon, Sophie Carré, François Lebargy, Gaëtan Deslée and Sandra Dury

Healthcare 2022, 10(7), 1351; https://doi.org/10.3390/healthcare10071351 - 21 Jul 2022

Cited by 6 | Viewed by 1558

Abstract

Background: Cystic Fibrosis (CF) adult patients experience daily physical symptoms and disabilities that may impact their quality of life and mental health. Methods: This prospective study aimed to evaluate the relative contribution of the familial, occupational, and social environment, besides that of the [...] Read more.

Background: Cystic Fibrosis (CF) adult patients experience daily physical symptoms and disabilities that may impact their quality of life and mental health. Methods: This prospective study aimed to evaluate the relative contribution of the familial, occupational, and social environment, besides that of the main physical and mental health factors, to the quality of life of CF adult patients using the Cystic Fibrosis Questionnaire-Revised (CFQ-R) in a multivariate model. Results: Fifty patients were analyzed (70% of men; median age of 25 years; median body mass index of 21 kg/m²; median FEV1 of 57%). Anxiety and depression scores were negatively associated with 9 of the 12 CFQ-R domains. When controlling for anxiety and depression, FEV1% and BMI were significant positive predictors of several domains of the CFQ-R. All the familial, occupational, and social components analyzed but one (professional training) were predictors of at least one domain of the CFQ-R. Conclusion: Anxiety and depression explained a greater proportion of the variance than physical variables (age, sex, BMI, FEV1%, and exacerbation in the last year) in CF HRQoL. Many familial, occupational, and social components were also specifically and independently predictors of some HRQoL domains. Their screening might help identifying CF patients eligible for specific interventions, focusing on the impaired QoL dimensions. Full article

(This article belongs to the Section Environmental Factors and Global Health)

9 pages, 253 KiB

Open AccessArticle

Relationship between Edinburg Postnatal Depression Scale (EPDS) Scores in the Early Postpartum Period and Related Stress Coping Characteristics

by Shoichi Magawa, Sachiko Yanase, Tsutako Miyazaki, Kazumasa Igura, Shintaro Maki, Shota Nii, Masafumi Nii, Hiroaki Tanaka, Eiji Kondo, Tomoaki Ikeda and Takayuki Kageyama

Healthcare 2022, 10(7), 1350; https://doi.org/10.3390/healthcare10071350 - 21 Jul 2022

Cited by 2 | Viewed by 2119

Abstract

Despite postpartum depression being a common mental health problem, there is no screening method for it. The only risk assessment used is the Edinburgh Postnatal Depression Scale (EPDS). We investigated the relationship between Brief Scale for Coping Profile (BSCP) subscales performed during pregnancy [...] Read more.

Despite postpartum depression being a common mental health problem, there is no screening method for it. The only risk assessment used is the Edinburgh Postnatal Depression Scale (EPDS). We investigated the relationship between Brief Scale for Coping Profile (BSCP) subscales performed during pregnancy and EPDS scores. We recruited 353 women with normal pregnancies (160 primiparas, and 193 multiparas) and performed BSCP at 26 weeks of gestation. The EPDS was first performed within one week after delivery (T1), and then after one month (T2). Spearman’s correlation coefficients were calculated for the BSCP and EPDS for the whole and primi/multipara groups. Multiple regression analysis was performed with the EPDS T2 scores as the dependent variable. The EPDS scores were higher in the primipara group compared to the multipara (p < 0.001), and the EPDS T1 scores were higher than the overall T2 score (p < 0.001). In the multiple regression analysis, EPDS T1 and the “seeking help for solution” subscale were selected as significant explanatory variables when analyzed in the whole group; EPDS T1 and “active solution” for the primiparas; and EPDS T1, “changing mood”, and “seeking help for solution” for the multiparas. The BSCP can be used as a screening tool for postpartum depression during pregnancy. Full article

(This article belongs to the Special Issue Diagnosis, Prevention, Treatment and Medical Care for Gynecologic and Perinatal Diseases)

10 pages, 960 KiB

Open AccessArticle

Fetal Fibronectin and Cervical Length as Predictors of Spontaneous Onset of Labour and Delivery in Term Pregnancies

by Delia Grab, Bogdan Doroftei, Mihaela Grigore, Ovidiu Sebastian Nicolaiciuc, Sorana Caterina Anton, Gabriela Simionescu, Radu Maftei, Maria Bolota, Ciprian Ilea, Gabriel Costachescu and Emil Anton

Healthcare 2022, 10(7), 1349; https://doi.org/10.3390/healthcare10071349 - 20 Jul 2022

Cited by 3 | Viewed by 1659

Abstract

(1) Objective: This study aimed to determine whether qualitative fetal fibronectin and transvaginal sonographic measurement of cervical length are effective in predicting delivery in term pregnancies within 5 days of the test. (2) Methods: We examined 268 women with singleton pregnancies presenting themselves [...] Read more.

(1) Objective: This study aimed to determine whether qualitative fetal fibronectin and transvaginal sonographic measurement of cervical length are effective in predicting delivery in term pregnancies within 5 days of the test. (2) Methods: We examined 268 women with singleton pregnancies presenting themselves at 37⁺⁰–40⁺⁴ weeks (median 38 weeks + 1 day) of gestation with irregular and painful uterine contractions, intact membranes and cervical dilatation less than 2 cm. All women were admitted to hospital up to 72 h after birth. On admission, a qualitative fetal fibronectin test was performed in cervicovaginal secretions and transvaginal sonographic measurement of cervical length was carried out. The primary outcome measure was delivery within 5 days of presentation. RESULTS: Among the women who delivered within 5 days after admission, 65.2% had positive fFN assessment, 43.5% had cervical length below 26 mm, 52.2% had the age > 32.5 years, 34.8% were nulliparous and 56.5% had gestational age ≥ 275 days. Logistic regression analysis demonstrated that significant contributors to the prediction of delivery within 5 days were fibronectin positivity, cervical length ≤ 26 mm, maternal age > 32.5 years and gestational age ≥ 275 days, with no significant contribution from parity. (3) Conclusions: Qualitative fetal fibronectin test and transvaginal cervical length measurement in term pregnancies are useful tests for predicting spontaneous onset of labour within 5 days. It helps women and healthcare providers to determine the optimum time for hospital admission. Full article

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

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8 pages, 241 KiB

Open AccessArticle

The Effectiveness of Pre-Operative Screening Tests in Determining Viral Infections in Patients Undergoing Oral and Maxillofacial Surgery

by Shintaro Sukegawa, Yuka Sukegawa, Kazuaki Hasegawa, Sawako Ono, Tomoya Nakamura, Ai Fujimura, Ayaka Fujisawa, Keisuke Nakano, Kiyofumi Takabatake, Hotaka Kawai, Yumika Mukainaka, Hitoshi Nagatsuka and Yoshihiko Furuki

Healthcare 2022, 10(7), 1348; https://doi.org/10.3390/healthcare10071348 - 20 Jul 2022

Viewed by 1389

Abstract

We analyzed the rate of patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection diagnosed by pre-operative screening and estimated its cost. We retrospectively analyzed patients who underwent elective surgery at our maxillofacial surgery department between [...] Read more.

We analyzed the rate of patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infection diagnosed by pre-operative screening and estimated its cost. We retrospectively analyzed patients who underwent elective surgery at our maxillofacial surgery department between April 2014 and March 2022. We compared the number of patients with each infection identified by pre-operative screening and a pre-operative questionnaire. We also compared the prevalence of infections with varying age, sex, and oral diseases, and calculated the cost of screening per positive result. The prevalence of HBV, HCV, and HIV was 0.39% (62/15,842), 0.76% (153/15,839), and 0.07% (10/12,745), respectively. The self-reported rates were as follows: HBV, 63.4% (26/41); HCV, 50.4% (62/123); HIV, 87.5% (7/8). Differences in sex were statistically significant for all infectious diseases; age significantly affected HBV and HCV rates. There was no association between the odds ratio of oral disease and viral infections. The cost per positive result was $1873.8, $905.8, and $11,895.3 for HBV, HCV, and HIV, respectively. Although self-assessment using questionnaires is partially effective, it has inadequate screening accuracy. Formulating an auxiliary diagnosis of infectious diseases with oral diseases was challenging. The cost determined was useful for hepatitis, but not HIV. Full article

(This article belongs to the Special Issue 2nd Edition of Healthcare and Special Needs Patients)

19 pages, 1513 KiB

Open AccessReview

Sense of Coherence and Work Stress or Well-Being in Care Professionals: A Systematic Review

by Pablo González-Siles, Manuel Martí-Vilar, Francisco González-Sala, César Merino-Soto and Filiberto Toledano-Toledano

Healthcare 2022, 10(7), 1347; https://doi.org/10.3390/healthcare10071347 - 20 Jul 2022

Cited by 5 | Viewed by 2492

Abstract

Job-related stress affects the physical and psychological health of professionals dedicated to care. This work is a systematic review that aims to determine the relationships between a sense of coherence (SOC) and work stress and well-being perceived by care professionals. The review was [...] Read more.

Job-related stress affects the physical and psychological health of professionals dedicated to care. This work is a systematic review that aims to determine the relationships between a sense of coherence (SOC) and work stress and well-being perceived by care professionals. The review was carried out following the PRISMA guidelines, and the search was carried out using the Web of Science (WoS), PubMed, and Scopus databases, obtaining a final selection of 41 articles. The results indicate that stress, depression, burnout, and posttraumatic stress disorder (PTSD) negatively correlate with SOC; in contrast, job satisfaction, well-being, and quality of life positively correlate with SOC. It is concluded that SOC could act as a mediating variable and as a predictor variable of these health problems. Full article

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21 pages, 10785 KiB

Open AccessEditor’s ChoiceArticle

Clinical and Biological Adaptations in Obese Older Adults Following 12-Weeks of High-Intensity Interval Training or Moderate-Intensity Continuous Training

by Layale Youssef, Jordan Granet, Vincent Marcangeli, Maude Dulac, Guy Hajj-Boutros, Olivier Reynaud, Fanny Buckinx, Pierrette Gaudreau, José A. Morais, Pascale Mauriège, Gilles Gouspillou, Philippe Noirez and Mylène Aubertin-Leheudre

Healthcare 2022, 10(7), 1346; https://doi.org/10.3390/healthcare10071346 - 20 Jul 2022

Cited by 8 | Viewed by 3326

Abstract

Sarcopenia and obesity are considered a double health burden. Therefore, the implementation of effective strategies is needed to improve the quality of life of older obese individuals. The aim of this study was to compare the impact of high-intensity interval training (HIIT) and [...] Read more.

Sarcopenia and obesity are considered a double health burden. Therefore, the implementation of effective strategies is needed to improve the quality of life of older obese individuals. The aim of this study was to compare the impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on functional capacities, muscle function, body composition and blood biomarkers in obese older adults. Adipose tissue gene expression and markers of muscle mitochondrial content and quality control involved in exercise adaptations were also investigated. Sixty-eight participants performed either HIIT (n = 34) on an elliptical trainer or MICT (n = 34) on a treadmill, three times per week for 12 weeks. HIIT produced significantly higher benefits on some physical parameters (six-minute walking test (HIIT: +12.4% vs. MICT: +5.2%); step test (HIIT: +17.02% vs. MICT: +5.9%); ten-repetition chair test (HIIT: −17.04% vs. MICT: −4.7%)). Although both HIIT and MICT led to an improvement in lower limb power (HIIT: +25.2% vs. MICT: +20.4%), only MICT led to higher improvement in lower limb muscle strength (HIIT: +4.3% vs. MICT: +23.2%). HIIT was more beneficial for increasing total lean body mass (HIIT: +1.58% vs. MICT: −0.81%), while MICT was more effective for decreasing relative gynoid fat mass (HIIT: −1.09% vs. MICT: −4.20%). Regarding adipose tissue gene expression, a significant change was observed for cell death-inducing DFFA (DNA fragmentation factor-alpha)-like effector A (CIDEA) in the HIIT group (A.U; HIIT at T0: 32.10 ± 39.37 vs. HIIT at T12: 48.2 ± 59.2). Mitochondrial transcription factor A (TFAM) content, a marker of mitochondrial biogenesis, increased significantly following HIIT (+36.2%) and MICT (+57.2%). A significant increase was observed in the HIIT group for Translocase of Outer Membrane 20 (TOM20; +54.1%; marker of mitochondrial content), Mitofusin-2 (MFN2; +71.6%; marker of mitochondrial fusion) and Parkin RBR E3 Ubiquitin Protein Ligase (PARKIN; +42.3%; marker of mitophagy). Overall, our results indicate that even though MICT (walking on treadmill) and HIIT (on an elliptical) are effective intervention strategies in obese older adults, HIIT appears to have slightly more beneficial effects. More specifically, HIIT led to higher improvements than MICT on functional capacities, lean mass and skeletal muscle markers of mitochondrial content, fusion, and mitophagy. Thus, MICT but also HIIT (time-efficient training) could be recommended as exercise modalities for obese older adults to maintain or improve mobility, health and quality of life. Full article

(This article belongs to the Special Issue Strategies to Manage Obesity in Older Adults)

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8 pages, 417 KiB

Open AccessReview

Ethical Challenges Regarding Cosmetic Surgery in Patients with Body Dysmorphic Disorder

by Sorin Hostiuc, Oana-Maria Isailă, Mugurel Constantin Rusu and Ionut Negoi

Healthcare 2022, 10(7), 1345; https://doi.org/10.3390/healthcare10071345 - 20 Jul 2022

Cited by 3 | Viewed by 3501

Abstract

Body dysmorphic disorder (BDD) is an obsessive-compulsive disease, associated with increased addressability to plastic surgeons; however, as patients perceive body defects due to decreased insight, they are often unsatisfied with their appearance after cosmetic surgery. The purpose of this study is to evaluate [...] Read more.

Body dysmorphic disorder (BDD) is an obsessive-compulsive disease, associated with increased addressability to plastic surgeons; however, as patients perceive body defects due to decreased insight, they are often unsatisfied with their appearance after cosmetic surgery. The purpose of this study is to evaluate the ethical reasoning that should be performed before accepting these patients as cosmetic surgery candidates. We will focus our analysis on three main areas of interest: autonomy, which in these patients is significantly decreased, beneficence as satisfaction, which in these particular patients does not justify performing the intervention, and loyalty, which should render cosmetic procedures immoral in patients with body dysmorphic disorder. Full article

(This article belongs to the Special Issue Patient Care Assessment)

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12 pages, 1517 KiB

Open AccessReview

Palliative Care Landscape in the COVID-19 Era: Bibliometric Analysis of Global Research

by Hammoda Abu-Odah, Jingjing Su, Mian Wang, Sin-Yi (Rose) Lin, Jonathan Bayuo, Salihu Sabiu Musa and Alex Molassiotis

Healthcare 2022, 10(7), 1344; https://doi.org/10.3390/healthcare10071344 - 20 Jul 2022

Cited by 4 | Viewed by 2163

Abstract

Despite the increasing number of publications globally, the COVID-19 pandemic has underscored significant research gaps that should be resolved, including within PC-related research. This study aimed to map and understand the global trends in palliative care (PC)-related COVID-19 research and provide quantitative evidence [...] Read more.

Despite the increasing number of publications globally, the COVID-19 pandemic has underscored significant research gaps that should be resolved, including within PC-related research. This study aimed to map and understand the global trends in palliative care (PC)-related COVID-19 research and provide quantitative evidence to guide future studies. We systematically searched four databases between 1st January 2020 and 25th April 2022. The VOSviewer, Gephi, and R software were utilized for data analysis and results visualization. A total of 673 articles were identified from the databases between 1st January 2020 and 25th April 2022. Canada (6.2%), Australia (5.4%), and the United Kingdom (3.8%) were the most productive countries regarding articles published per million confirmed COVID-19 cases. A lack of international collaborations and an uneven research focus on PC across countries with different pandemic trajectories was observed. The PC research in question focused on cancer, telehealth, death and dying, and bereavement. This study’s conclusions support the recommendation for international collaboration to facilitate knowledge and practice transformation to support countries with unmet PC needs during the pandemic. Further studies are required on the grief and bereavement support of families, healthcare professionals and patients with other life-threatening illnesses. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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10 pages, 254 KiB

Open AccessArticle

Cervical Cancer Screening among Female Refugees in Jordan: A Cross-Sectional Study

by Nadia Muhaidat, Mohammad A. Alshrouf, Roaa N. Alshajrawi, Zeina R. Miqdadi, Raghad Amro, Abedalaziz O. Rabab’ah, Serena A. Qatawneh, Alaa M. Albandi and Kamil Fram

Healthcare 2022, 10(7), 1343; https://doi.org/10.3390/healthcare10071343 - 20 Jul 2022

Cited by 1 | Viewed by 2671

Abstract

Background: Cervical cancer (CC) is mainly linked to infection with a high-risk oncogenic human papillomavirus (HPV), with 85% of deaths occurring in developing countries. Refugees are less likely to be aware of screening methods and to have routine gynecological examinations. Methods: This is [...] Read more.

Background: Cervical cancer (CC) is mainly linked to infection with a high-risk oncogenic human papillomavirus (HPV), with 85% of deaths occurring in developing countries. Refugees are less likely to be aware of screening methods and to have routine gynecological examinations. Methods: This is a cross-sectional study involving a total of 359 women aged 19–64 living in the Jerash camp in Jordan. Data were collected using a carefully developed and validated questionnaire. Results: A total of 359 participants were included in the study, with a mean age of 38.99 ± 10.53. Participants demonstrated fair knowledge of CC risk factors (4.77 ± 2.85 out of 11). Among the participants, 73.5% had heard of the cervical smear test; however, only 12.8% had actually undergone the test, with a mean total number of smear tests performed of 1.48 ± 0.79 and the mean age at the time of the first test was 32.5 ± 7.89. Conclusions: Refugee women have a fair level of knowledge of CC risk factors but are unmotivated to have a Pap smear test to screen for CC. Efforts should be made to raise awareness about the issue and promote testing for underrepresented women in refugee camps. Full article

(This article belongs to the Special Issue Access and Healthcare for Disadvantaged Populations)

13 pages, 1481 KiB

Open AccessArticle

Trends and Geographic Variabilities in Benzodiazepines Prescription in Primary Care to Older Adults: A 3-Year Population-Based Ecological Study in Portugal

by Ana Bárbara Tavares, Ana Isabel Placido, Daniela Almeida Rodrigues, Manuel Morgado, Adolfo Figueiras, Maria Teresa Herdeiro and Fátima Roque

Healthcare 2022, 10(7), 1342; https://doi.org/10.3390/healthcare10071342 - 19 Jul 2022

Cited by 1 | Viewed by 2490

Abstract

(1) Background: According to the World Health Organization (WHO), benzodiazepines (BZD) are considered essential medicines for the treatment of several mental disorders in older adults over 65 years old. However, the long-term use of BZD could present a harmful impact on this population, [...] Read more.

(1) Background: According to the World Health Organization (WHO), benzodiazepines (BZD) are considered essential medicines for the treatment of several mental disorders in older adults over 65 years old. However, the long-term use of BZD could present a harmful impact on this population, leading to cognitive deficits, drug dependence, falls, and fractures. This study aims to analyze trends of BZD prescription to Portuguese older adults in the primary care setting, and to analyze the change in the prescription rate of BZD over time, assessing the geographical variability in mainland Portugal. (2) Methods: A nationwide, retrospective ecological study was performed between January 2019 and December 2021 for BZD prescribing data reported in a national public database for all persons aged 65 and older in mainland Portugal (about 2.4 million). Trends of BZD by defined daily doses (DDD) and per 1000 older adults’ inhabitants per day (DID) were analyzed. (3) Results: A total of 19 BZD were included in this study and more than 1 million BZD prescriptions were recorded in each year of this study period. BZD prescriptions were three times higher in females than in males. Alprazolam, lorazepam, diazepam, ethyl loflazepate, and bromazepam were the most prescribed BZD over the years, presenting the higher DDD and DID values. (4) Conclusions: Despite the DID value growth of several BZD, Portugal is now showing stable BZD prescriptions in older adults, between the years 2019 to 2021. More studies are needed to access if these results are a consequence of successful health programs or just a consequence of the pandemic context that we are facing, which limited older adults’ clinical appointments. Full article

(This article belongs to the Special Issue Potentially Inappropriate Medications and the Risk of Adverse Drug Events in Older Patients)

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26 pages, 671 KiB

Open AccessArticle

The Importance of Behavioral and Native Factors on COVID-19 Infection and Severity: Insights from a Preliminary Cross-Sectional Study

by Hani Amir Aouissi, Mohamed Seif Allah Kechebar, Mostefa Ababsa, Rabih Roufayel, Bilel Neji, Alexandru-Ionut Petrisor, Ahmed Hamimes, Loïc Epelboin and Norio Ohmagari

Healthcare 2022, 10(7), 1341; https://doi.org/10.3390/healthcare10071341 - 19 Jul 2022

Cited by 22 | Viewed by 3510

Abstract

The COVID-19 pandemic has had a major impact on a global scale. Understanding the innate and lifestyle-related factors influencing the rate and severity of COVID-19 is important for making evidence-based recommendations. This cross-sectional study aims at establishing a potential relationship between human characteristics [...] Read more.

The COVID-19 pandemic has had a major impact on a global scale. Understanding the innate and lifestyle-related factors influencing the rate and severity of COVID-19 is important for making evidence-based recommendations. This cross-sectional study aims at establishing a potential relationship between human characteristics and vulnerability/resistance to SARS-CoV-2. We hypothesize that the impact of the virus is not the same due to cultural and ethnic differences. A cross-sectional study was performed using an online questionnaire. The methodology included the development of a multi-language survey, expert evaluation, and data analysis. Data were collected using a 13-item pre-tested questionnaire based on a literature review between 9 December 2020 and 21 July 2021. Data were statistically analyzed using logistic regression. For a total of 1125 respondents, 332 (29.5%) were COVID-19 positive; among them, 130 (11.5%) required home-based treatment, and 14 (1.2%) intensive care. The significant and most influential factors on infection included age, physical activity, and health status (p < 0.05), i.e., better physical activity and better health status significantly reduced the possibility of infection, while older age significantly increased it. The severity of infection was negatively associated with the acceptance (adherence and respect) of preventive measures and positively associated with tobacco (p < 0.05), i.e., smoking regularly significantly increases the severity of COVID-19 infection. This suggests the importance of behavioral factors compared to innate ones. Apparently, individual behavior is mainly responsible for the spread of the virus. Therefore, adopting a healthy lifestyle and scrupulously observing preventive measures, including vaccination, would greatly limit the probability of infection and prevent the development of severe COVID-19. Full article

(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)

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11 pages, 1094 KiB

Open AccessReview

Mild Cognitive Impairment in Rural Areas: Research Advances and Implications for Clinical Practice and Healthcare Policy

by Vaios Peritogiannis, Aglaia Roganaki, Eleftheria Siarava and Maria Samakouri

Healthcare 2022, 10(7), 1340; https://doi.org/10.3390/healthcare10071340 - 19 Jul 2022

Cited by 2 | Viewed by 1875

Abstract

Mild cognitive or neurocognitive impairment (MCI) may be more prevalent in rural areas. Differences between rural and urban MCI patients in terms of risk factors, course and prognosis are rarely reported. The present review aims to summarize the latest research on MCI in [...] Read more.

Mild cognitive or neurocognitive impairment (MCI) may be more prevalent in rural areas. Differences between rural and urban MCI patients in terms of risk factors, course and prognosis are rarely reported. The present review aims to summarize the latest research on MCI in rural areas. A literature search was performed in the databases of PubMed, Scopus and ScienceDirect for articles published over the last decade. Eleven articles were included in this review, reporting on the differences between rural and urban MCI patients. Several risk factors, such as older age, lack of activities and food insecurity have been associated with MCI in both rural and urban areas, whereas others, such as obesity, adverse childhood experiences and plasma chemokine C-C motif ligand 11 (considered as a potential negative regulator of neurogenesis), differed according to the place of residence. No specific protective factor for rural women has been reported. There is some evidence that MCI may present earlier in rural residents, but that progression to dementia may be more rapid in urban residents. It seems that there may be clinically relevant differences in the onset, course and prognosis of MCI with regards to the place of residence (urban vs rural). Those differences should be taken into account for the design of health policies and service delivery across different settings. Full article

(This article belongs to the Section Health Policy)

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16 pages, 4735 KiB

Open AccessArticle

Enhanced Gravitational Search Optimization with Hybrid Deep Learning Model for COVID-19 Diagnosis on Epidemiology Data

by Mahmoud Ragab, Hani Choudhry, Amer H. Asseri, Sami Saeed Binyamin and Mohammed W. Al-Rabia

Healthcare 2022, 10(7), 1339; https://doi.org/10.3390/healthcare10071339 - 19 Jul 2022

Cited by 2 | Viewed by 1888

Abstract

Effective screening provides efficient and quick diagnoses of COVID-19 and could alleviate related problems in the health care system. A prediction model that combines multiple features to assess contamination risks was established in the hope of supporting healthcare workers worldwide in triaging patients, [...] Read more.

Effective screening provides efficient and quick diagnoses of COVID-19 and could alleviate related problems in the health care system. A prediction model that combines multiple features to assess contamination risks was established in the hope of supporting healthcare workers worldwide in triaging patients, particularly in situations with limited health care resources. Furthermore, a lack of diagnosis kits and asymptomatic cases can lead to missed or delayed diagnoses, exposing visitors, medical staff, and patients to 2019-nCoV contamination. Non-clinical techniques including data mining, expert systems, machine learning, and other artificial intelligence technologies have a crucial role to play in containment and diagnosis in the COVID-19 outbreak. This study developed Enhanced Gravitational Search Optimization with a Hybrid Deep Learning Model (EGSO-HDLM) for COVID-19 diagnoses using epidemiology data. The major aim of designing the EGSO-HDLM model was the identification and classification of COVID-19 using epidemiology data. In order to examine the epidemiology data, the EGSO-HDLM model employed a hybrid convolutional neural network with a gated recurrent unit based fusion (HCNN-GRUF) model. In addition, the hyperparameter optimization of the HCNN-GRUF model was improved by the use of the EGSO algorithm, which was derived by including the concepts of cat map and the traditional GSO algorithm. The design of the EGSO algorithm helps in reducing the ergodic problem, avoiding premature convergence, and enhancing algorithm efficiency. To demonstrate the better performance of the EGSO-HDLM model, experimental validation on a benchmark dataset was performed. The simulation results ensured the enhanced performance of the EGSO-HDLM model over recent approaches. Full article

(This article belongs to the Special Issue Clinical Decision-Making Processes in COVID-19 Pandemic: Changes and Effects)

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15 pages, 303 KiB

Open AccessArticle

Health System- and Patient-Related Factors Associated with COVID-19 Mortality among Hospitalized Patients in Limpopo Province of South Africa’s Public Hospitals

by Musa E. Sono-Setati, Peter M. Mphekgwana, Linneth N. Mabila, Masenyani O. Mbombi, Livhuwani Muthelo, Sogo F. Matlala, Takalani G. Tshitangano and Naledzani J. Ramalivhana

Healthcare 2022, 10(7), 1338; https://doi.org/10.3390/healthcare10071338 - 19 Jul 2022

Cited by 6 | Viewed by 2050

Abstract

South Africa has recorded the highest COVID-19 morbidity and mortality compared to other African regions. Several authors have linked the least amount of death in African countries with under-reporting due to poor health systems and patients’ health-seeking behaviors, making the use of clinical [...] Read more.

South Africa has recorded the highest COVID-19 morbidity and mortality compared to other African regions. Several authors have linked the least amount of death in African countries with under-reporting due to poor health systems and patients’ health-seeking behaviors, making the use of clinical audits more relevant for establishing the root causes of health problems, and improving quality patient care outcomes. Clinical audits, such as mortality audits, have a significant role in improving quality health care services, but very little is documented about the outcomes of the audits. Therefore, the study sought to determine the health care system and patient-related factors associated with COVID-19 mortality by reviewing the COVID-19 inpatient mortality audit narration reports. This was a retrospective qualitative research approach of all hospitalized COVID-19 patients, resulting in death between the first and second COVID-19 pandemic waves. Thematic analysis employed inductive coding to identify themes from mortality audits from all 41 public hospitals in Limpopo Province, South Africa. Four themes with seventeen sub-themes emerged: sub-standard emergency medical care provided, referral system inefficiencies contributed to delays in access to health care services, the advanced age of patients with known and unknown comorbidities, and poor management of medical supplies and equipment, as a health system and patient-related factors that contributed to the high mortality of COVID-19 patients. There is a need to routinely conduct clinical audits to identify clinical challenges and make recommendations for health promotion, risk communication, and community engagement. We recommend reviewing and expanding the scope of practice for health-care providers during epidemics and pandemics that include aspects such as task-shifting. Full article

14 pages, 484 KiB

Open AccessArticle

Mental Health Support for Hospital Staff during the COVID-19 Pandemic: Characteristics of the Services and Feedback from the Providers

by Mélanie Loiseau, Fiona Ecarnot, Nicolas Meunier-Beillard, Alexandra Laurent, Alicia Fournier, Irene François-Purssell, Christine Binquet and Jean-Pierre Quenot

Healthcare 2022, 10(7), 1337; https://doi.org/10.3390/healthcare10071337 - 18 Jul 2022

Cited by 4 | Viewed by 1314

Abstract

French authorities created mental health support services to accompany HCWs during the pandemic. We aimed to obtain feedback from staff providing these mental health support services within French hospitals to identify positive and negative features and avenues for improvement. A mixed-methods study was [...] Read more.

French authorities created mental health support services to accompany HCWs during the pandemic. We aimed to obtain feedback from staff providing these mental health support services within French hospitals to identify positive and negative features and avenues for improvement. A mixed-methods study was performed between 1 April and 30 June 2020. We contacted 77 centres to identify those providing mental health support services. We developed a questionnaire containing questions about the staff providing the service (quantitative part), with open questions to enable feedback from service providers (qualitative part). Of the 77 centres, 36 had mental health support services; 77.8% were created specifically for the epidemic. Services were staffed principally by psychologists, mainly used a telephone platform, and had a median opening time of 8 h/day. Thirty-seven professionals provided feedback, most aged 35–49 years. For 86.5%, it was their first time providing such support. Median self-reported comfort level was 8 (interquartiles 3–10), and 95% would do it again. Respondents reported (i) difficulties with work organisation, clinical situations, and lack of recognition and (ii) a desire for training. This study suggests that mental health support needs to be adapted to the needs of HCWs, both in terms of the content of the service and the timing of delivery. Full article

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11 pages, 2076 KiB

Open AccessArticle

Medico-Legal Aspects of Hospital-Acquired Infections: 5-Years of Judgements of the Civil Court of Rome

by Michele Treglia, Margherita Pallocci, Pierluigi Passalacqua, Giuseppe Sabatelli, Lucilla De Luca, Claudia Zanovello, Agostino Messineo, Giuseppe Quintavalle, Alberto Michele Cisterna and Luigi Tonino Marsella

Healthcare 2022, 10(7), 1336; https://doi.org/10.3390/healthcare10071336 - 18 Jul 2022

Cited by 13 | Viewed by 2026

Abstract

Introduction: Healthcare-associated infections (HAIs) represent a risk to patients’ health, as well as being an issue of worldwide relevance in terms of public health and increased healthcare costs. The occurrence of a complication causally related to the development of an infection contracted during [...] Read more.

Introduction: Healthcare-associated infections (HAIs) represent a risk to patients’ health, as well as being an issue of worldwide relevance in terms of public health and increased healthcare costs. The occurrence of a complication causally related to the development of an infection contracted during a hospital stay, or in any event during a healthcare activity, may represent a source of liability for the healthcare facility itself and, therefore, lead to compensation for the injured patient. The aim of this research is to analyze the phenomenon of professional liability related to HAIs, to emphasize its economic and juridical aspects and, at the same time, highlight the clinical-managerial issues deserving attention, in order to guarantee the safety of care for patients. Methods: The retrospective review concerned all the judgments regarding HAIs drawn up by the Judges of the Civil Court of Rome, published between January 2016 and December 2020. Results: In the five-year period considered, 140 verdicts were issued in which the liability for which compensation was sought was related to the occurrence of healthcare-related infections. Convictions were recognized in 62.8%. The most involved branches were those related to the surgical areas: orthopedics, heart surgery, and general surgery. The three most frequently isolated organisms were Staphylococcus aureus, Pseudomonas aeruginosa, and Klebsiella pneumoniae. The total amount of compensation paid was EUR 21.243.184,43. Conclusions: The study showed how the analysis of the juridical and medico legal aspects of HAIs may represent not only a helpful tool for healthcare performance assessment, but also a data source usable in clinical risk management and in the implementation of patient safety. Full article

(This article belongs to the Special Issue Old Issues and New Challenges in Forensic and Legal Medicine)

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9 pages, 568 KiB

Open AccessCase Report

Intervention of Coordination by Liaison Nurse Where Ward Staff Struggled to Establish a Therapeutic Relationship with a Patient Because of Failure to Recognize Delirium: A Case Study

by Yuri Nakai, Yusuke Nitta and Reiko Hashimoto

Healthcare 2022, 10(7), 1335; https://doi.org/10.3390/healthcare10071335 - 18 Jul 2022

Cited by 1 | Viewed by 1757

Abstract

In this case study, ward staff found it difficult to establish a therapeutic relationship with a patient with advanced gastric cancer because they misdiagnosed delirium as a psychogenic reaction to the cancer diagnosis. This article reports on the process and effects of intervention [...] Read more.

In this case study, ward staff found it difficult to establish a therapeutic relationship with a patient with advanced gastric cancer because they misdiagnosed delirium as a psychogenic reaction to the cancer diagnosis. This article reports on the process and effects of intervention by a liaison nurse. The liaison nurse recognized the misdiagnosis and approached the ward staff via a psychiatrist-led team. This enabled rapid revision of the treatment policy. The liaison nurse contributed to the continuation of treatment by enabling the ward staff and patient to understand each other better and to collaborate to build a relationship and control the patient’s mental health symptoms, including attention disorder and excessive demands. The patient and family had different views on discharge because of the patient’s mental health issues. The liaison nurse encouraged the ward staff to inform the family caregiver about the patient’s medical condition, the expected future course of the disease, and likely symptoms, and provide appropriate professional services. This enabled the patient to be discharged in line with their wishes. This case highlights the role of the liaison nurse in coordinating care and helping ward staff to recognize symptoms and provide appropriate care and support for patients and their families. Full article

(This article belongs to the Special Issue Mental Health and Nursing Care of Individuals with Cancer and Their Families)

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14 pages, 922 KiB

Open AccessArticle

School Students’ Concerns and Support after One Year of COVID-19 in Austria: A Qualitative Study Using Content Analysis

by Andrea Jesser, Yvonne Schaffler, Afsaneh Gächter, Rachel Dale, Elke Humer and Christoph Pieh

Healthcare 2022, 10(7), 1334; https://doi.org/10.3390/healthcare10071334 - 18 Jul 2022

Cited by 10 | Viewed by 1942

Abstract

Adolescents suffer severely from the psychological consequences of the COVID-19 pandemic. Using qualitative content analysis, this study examined open-ended responses to a survey on the mental health of school students in Austria in February 2021. A representative sample (n = 214) was [...] Read more.

Adolescents suffer severely from the psychological consequences of the COVID-19 pandemic. Using qualitative content analysis, this study examined open-ended responses to a survey on the mental health of school students in Austria in February 2021. A representative sample (n = 214) was drawn from a total survey sample of 3052 adolescents aged 14–20. The analysis revealed several areas of concern, including school-related concerns, concerns about restrictions, self-related concerns, and interpersonal problems. School-related concerns associated with distance learning were mentioned most frequently. Compared with research conducted at the beginning of the pandemic, it appeared that concerns about educational and professional futures increased. The analysis also indicated young people’s most important sources of support, such as social contacts, recreational activities, attitudes and abilities, distraction, and escape. Of concern is the proportion of young people citing maladaptive coping strategies and the reluctance to seek professional support. Ideas for practice-oriented measures were developed from the study results, such as embedding youth-led peer interventions in traditional mental health services. Full article

(This article belongs to the Special Issue Psychological Well-Being for Adolescents and Youths)

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10 pages, 705 KiB

Open AccessArticle

Decision of Anticoagulation in Nonvalvular Atrial Fibrillation in the Real World in the Non-Antivitamin K Anticoagulants Era

by Gabriela Silvia Gheorghe, Andreea Simona Hodorogea, Andrei Cristian Dan Gheorghe, Dragoș Emanuel Popa, Simona Vulpe, Cristina Georgescu, Ruxandra Bănică, Andrei Gorgian Florescu, Elena Cristiana Trușcă, Omer Eden, Ana Ciobanu and Irina Pârvu

Healthcare 2022, 10(7), 1333; https://doi.org/10.3390/healthcare10071333 - 18 Jul 2022

Cited by 1 | Viewed by 1515

Abstract

Background. Patients with nonvalvular atrial fibrillation (NVAF) have five times higher risk of stroke than the general population. Anticoagulation (ACO) in NVAF is a class I indication after assessing the CHA2DS2-VASc and HAS-BLED scores. However, in the real world, NVAF patients receive less [...] Read more.

Background. Patients with nonvalvular atrial fibrillation (NVAF) have five times higher risk of stroke than the general population. Anticoagulation (ACO) in NVAF is a class I indication after assessing the CHA2DS2-VASc and HAS-BLED scores. However, in the real world, NVAF patients receive less ACO than needed due to patients’ comorbidities that can be assessed by the Charlson comorbidity index (CCI). The use of non-antivitamin K anticoagulants (NOAC) has improved the decision to anticoagulate. Objective. We analyzed the factors influencing the ACO prescribing decision in NVAF patients in the real world and the changes induced by the introduction of NOAC. Method. We carried out an observational retrospective cross-sectional study that included consecutive patients with permanent NVAF and CHA2DS2-VASc ≥ 2, admitted to a community hospital between 2010–2011 (group 1, 286 patients), when only vitamin K antagonists (VKA) were used, and 2018–2019 (group 2, 433 patients), respectively. We calculated CHA2DS2-VASc, HAS-BLED, and CCI and recorded the ACO decision and the use of VKA or NOAC in group 2. We compared the calculated scores between ACO and non-anticoagulated (nonACO) patients in both groups and between groups. Results. A 31.5% share of patients in group 1 and 12.9% in group 2 did not receive ACO despite a CHA2DS2-VASc score ≥ 2. In group 1, nonACO patients had higher HAS-BLED and CCI scores than the ACO patients, but their CHA2DS2-VASc scores were not significantly different. Old age, dementia, severe chronic kidney disease, neoplasia, and anemia were the most frequent reasons not to prescribe anticoagulants. In group 2, more nonACO patients had dementia, diabetes mellitus, and higher HAS-BLED than ACO patients. Moderate-severe CKD, neoplasia with metastasis, liver disease, anemia, and diabetes mellitus were statistically significantly more frequent in nonACO patients from group 1 than those from group 2. In group 2, 55.7% of ACO patients received NOAC. Conclusions. In real-world clinical practice, the decision for anticoagulation in NVAF is influenced by patient age, comorbidities, and risk of bleeding, and many patients do not receive anticoagulants despite a high CHA2DS2-VASc score. The use of NOAC in the past few years has improved treatment decisions. At the same time, the correct diagnosis, treatment, and surveillance of comorbidities have cut down the risk of bleeding and allowed anticoagulant use according to guidelines. Full article

(This article belongs to the Section Community Care)

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8 pages, 528 KiB

Open AccessArticle

Incidence and Risk of Anti-Resorptive Agent-Related Osteonecrosis of the Jaw after Tooth Extraction: A Retrospective Study

by Rieko Shimizu, Shintaro Sukegawa, Yuka Sukegawa, Kazuaki Hasegawa, Sawako Ono, Tomoya Nakamura, Ai Fujimura, Ayaka Fujisawa, Keisuke Nakano, Kiyofumi Takabatake, Hotaka Kawai, Hitoshi Nagatsuka and Yoshihiko Furuki

Healthcare 2022, 10(7), 1332; https://doi.org/10.3390/healthcare10071332 - 18 Jul 2022

Cited by 1 | Viewed by 1515

Abstract

Bone-modifying agents (BMA) such as bisphosphonates and denosumab are frequently used for the treatment of bone metastases, osteoporosis, and multiple myeloma. BMA may lead to anti-resorptive agent-related osteonecrosis of the jaw (ARONJ). This study aimed to clarify the risk factors for and probabilities [...] Read more.

Bone-modifying agents (BMA) such as bisphosphonates and denosumab are frequently used for the treatment of bone metastases, osteoporosis, and multiple myeloma. BMA may lead to anti-resorptive agent-related osteonecrosis of the jaw (ARONJ). This study aimed to clarify the risk factors for and probabilities of developing ARONJ after tooth extraction in patients undergoing BMA therapy. In this study, the records of 505 target sites of 302 patients undergoing BMA who presented with mandibular fractures at the Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, from March 2014 to January 2022, were retrospectively analyzed for the onset of ARONJ after tooth extraction. The following variables were investigated as attributes: anatomy, health status, and dental treatment. The correlation coefficient was calculated for the success or failure of endodontic surgery for each variable, the odds ratio was calculated for the upper variable, and the factors related to the onset of ARONJ were identified. The incidence rate of ARONJ was found to be 3.2%. Hypoparathyroidism was an important factor associated with ARONJ development. Thus, systemic factors are more strongly related to the onset of ARONJ after tooth extraction than local factors. Full article

(This article belongs to the Collection Dentistry, Oral Health and Maxillofacial Surgery)

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15 pages, 1764 KiB

Open AccessArticle

Evaluation of Ibuprofen Use on the Immune System Indicators and Force in Disabled Paralympic Powerlifters of Different Sport Levels

by Felipe J. Aidar, Guacira S. Fraga, Márcio Getirana-Mota, Anderson Carlos Marçal, Jymmys L. Santos, Raphael Fabricio de Souza, Lucio Marques Vieira-Souza, Alexandre Reis Pires Ferreira, Dihogo Gama de Matos, Paulo Francisco de Almeida-Neto, Nuno Domingos Garrido, Alfonso López Díaz-de-Durana, Beat Knechtle, Breno Guilherme de Araújo Tinoco Cabral, Eugenia Murawska-Ciałowicz, Hadi Nobari, Ana Filipa Silva, Filipe Manuel Clemente and Georgian Badicu

Healthcare 2022, 10(7), 1331; https://doi.org/10.3390/healthcare10071331 - 18 Jul 2022

Cited by 4 | Viewed by 2137

Abstract

Background: Paralympic powerlifting (PP) training is typically intense and causes fatigue and alterations in the immune system. Objective: To analyze whether IBU would affect performance and the immune system after training in PP. Methodology: 10 athletes at the national level (NL) and 10 [...] Read more.

Background: Paralympic powerlifting (PP) training is typically intense and causes fatigue and alterations in the immune system. Objective: To analyze whether IBU would affect performance and the immune system after training in PP. Methodology: 10 athletes at the national level (NL) and 10 at the regional level (RL) participated in the study, where force and blood indicators were evaluated after training. The study took place over three weeks: (1) familiarization and (2 and 3) comparison between recovery methods, with ibuprofen or placebo (IBU vs. PLA), 800 mg. In the evaluation of the force, the peak torque (PT), fatigue index (FI), and blood immune system biomarkers were analyzed. The training consisted of five sets of five repetitions with 80% of one maximum repetition (5 × 5, 80% 1RM) on the bench press. Results: The PT at the national level using IBU was higher than with PLA (p = 0.007, η2p = 0.347), and the FI in the NL was lower with IBU than with PLA (p = 0.002, η2p = 0.635), and when comparing the use of IBU, the NL showed less fatigue than the regional level (p = 0.004, η2p = 0.414). Leukocytes, with the use of IBU in the NL group, were greater than in the RL (p = 0.001, η2p = 0.329). Neutrophils, in the NL with IBU, were greater than in the RL with IBU and PLA (p = 0.025, η2p = 0.444). Lymphocytes, in NL with IBU were lower than in RL with IBU and PLA (p = 0.001, η2p = 0.491). Monocytes, in the NL with IBU and PLA, were lower than in the RL with IBU (p = 0.049, η2p = 0.344). For hemoglobin, hematocrit, and erythrocyte, the NL with IBU and PLA were higher than the RL with IBU and PLA (p < 0.05). Ammonia, with the use of IBU in the NL, obtained values higher than in the RL (p = 0.007), and with the use of PLA, the NL was higher than the RL (p = 0.038, η2p = 0.570). Conclusion: The training level tends to influence the immune system and, combined with the use of the IBU, it tends to improve recovery and the immune system. Full article

(This article belongs to the Collection Sport and Exercise Medicine)

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12 pages, 297 KiB

Open AccessArticle

Work Engagement, Work Environment, and Psychological Distress during the COVID-19 Pandemic: A Cross-Sectional Study in Ecuador

by Carlos Ruiz-Frutos, Ingrid Adanaqué-Bravo, Mónica Ortega-Moreno, Javier Fagundo-Rivera, Kenny Escobar-Segovia, Cristian Arturo Arias-Ulloa and Juan Gómez-Salgado

Healthcare 2022, 10(7), 1330; https://doi.org/10.3390/healthcare10071330 - 18 Jul 2022

Cited by 5 | Viewed by 2514

Abstract

Work environments can interfere with the mental health of workers as generators or reducers of psychological distress. Work engagement is a concept related to quality of life and efficiency at work. The aim of this study was to find the relationship between work [...] Read more.

Work environments can interfere with the mental health of workers as generators or reducers of psychological distress. Work engagement is a concept related to quality of life and efficiency at work. The aim of this study was to find the relationship between work environment factors and work engagement among the Ecuadorian general population during the first phase of the COVID-19 pandemic to assess their levels of psychological distress. For this purpose, a cross-sectional, descriptive study using a set of questionnaires was performed. Sociodemographic and work environment data, work engagement (UWES-9 scale) scores, and General Health Questionnaire (GHQ-12) scores were collected. The variables that predicted 70.2% of psychological distress during the first phase of the pandemic were being female, with a low level of vigour (work engagement dimension), being stressed at work, and low job satisfaction. The sample showed an intermediate level of engagement in both the global assessment and the three dimensions, being higher in those without psychological distress. With effective actions on work environment factors, mental health effects may be efficiently prevented, and work engagement may be benefited. Companies can reduce workers’ psychological distress by providing safe and effective means to prevent the risk of contagion; reducing the levels of work conflict, work stress, or workload; and supporting their employees with psychological measures in order to maintain ideal working conditions. Full article

(This article belongs to the Special Issue Direct and Indirect Effects of the Ongoing COVID-19 Pandemic on Physical and Mental Health: Second Edition)

25 pages, 969 KiB

Open AccessReview

The Use of Mobile-Based Ecological Momentary Assessment (mEMA) Methodology to Assess Dietary Intake, Food Consumption Behaviours and Context in Young People: A Systematic Review

by Brigitte Battaglia, Lydia Lee, Si Si Jia, Stephanie Ruth Partridge and Margaret Allman-Farinelli

Healthcare 2022, 10(7), 1329; https://doi.org/10.3390/healthcare10071329 - 18 Jul 2022

Cited by 5 | Viewed by 2663

Abstract

Mobile-based ecological momentary assessment (mEMA) offers a novel method for dietary assessment and may reduce recall bias and participant burden. This review evaluated mEMA methodology and the feasibility, acceptability and validity as a dietary assessment method in young people. Five databases were searched [...] Read more.

Mobile-based ecological momentary assessment (mEMA) offers a novel method for dietary assessment and may reduce recall bias and participant burden. This review evaluated mEMA methodology and the feasibility, acceptability and validity as a dietary assessment method in young people. Five databases were searched from January 2008 to September 2021 for studies including healthy young people aged 16–30 years and used mEMA for obtaining dietary intake data, food consumption behaviours and/or contextual factors. Data on the method used to administer mEMA, compliance with recording and validation were extracted. A total of 46 articles from 39 independent studies were included, demonstrating a wide variation in mEMA methods. Signal-contingent prompting (timed notification to record throughout the day) was used in 26 studies, 9 used event-contingent (food consumption triggered recordings), while 4 used both. Monitoring periods varied and most studies reported a compliance rate of 80% or more. Two studies found mEMA to be burdensome and six reported mEMA as easy to use. Most studies (31/39) reported using previously validated questions. mEMA appears to be a feasible and acceptable methodology to assess dietary intake and food consumption in near real time. Full article

(This article belongs to the Section Nutrition and Public Health)

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