Healthcare

16 pages, 1357 KiB

Open AccessEditor’s ChoiceArticle

Digital Care Programs for Chronic Hip Pain: A Prospective Longitudinal Cohort Study

by Dora Janela, Fabíola Costa, Anabela C. Areias, Maria Molinos, Robert G. Moulder, Jorge Lains, Virgílio Bento, Justin K. Scheer, Vijay Yanamadala, Steven P. Cohen and Fernando Dias Correia

Healthcare 2022, 10(8), 1595; https://doi.org/10.3390/healthcare10081595 - 22 Aug 2022

Cited by 4 | Viewed by 2455

Abstract

Chronic hip pain is a cause of disability worldwide. Digital interventions (DI) may promote access while providing proper management. This single-arm interventional study assesses the clinical outcomes and engagement of a completely remote multimodal DI in patients with chronic hip pain. This home-based [...] Read more.

Chronic hip pain is a cause of disability worldwide. Digital interventions (DI) may promote access while providing proper management. This single-arm interventional study assesses the clinical outcomes and engagement of a completely remote multimodal DI in patients with chronic hip pain. This home-based DI consisted of exercise (with real-time biofeedback), education, and cognitive-behavioral therapy. Outcomes were calculated between baseline and program end, using latent growth curve analysis. Primary outcome was the Hip Disability and Osteoarthritis Outcome Score (HOOS). Secondary outcomes were pain, intent to undergo surgery, mental health, productivity, patient engagement (exercise sessions frequency), and satisfaction. Treatment response was assessed using a 30% pain change cut-off. A completion rate of 74.2% (396/534), alongside high patient engagement (2.9 exercise sessions/week, SD 1.1) and satisfaction (8.7/10, SD 1.6) were observed. Significant improvements were observed across all HOOS sub-scales (14.7–26.8%, p < 0.05), with 66.8% treatment responders considering pain. Marked improvements were observed in surgery intent (70.1%), mental health (54%), and productivity impairment (60.5%) (all p < 0.001). The high engagement and satisfaction reported after this DI, alongside the clinical outcome improvement, support the potential of remote care in the management of chronic hip conditions. Full article

(This article belongs to the Special Issue Digital Therapeutics in Healthcare)

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17 pages, 492 KiB

Open AccessPerspective

Towards Better Pharmaceutical Provision in Europe—Who Decides the Future?

by Denis Horgan, Tanja Spanic, Kathi Apostolidis, Giuseppe Curigliano, Joanna Chorostowska-Wynimko, Hans-Peter Dauben, Jonathan A. Lal, Rafal Dziadziuszko, Christine Mayer-Nicolai, Marta Kozaric, Bengt Jönsson, Iñaki Gutierrez-Ibarluzea, Marie-Helene Fandel and Ruth Lopert

Healthcare 2022, 10(8), 1594; https://doi.org/10.3390/healthcare10081594 - 22 Aug 2022

Cited by 2 | Viewed by 2460

Abstract

Significant progress has been achieved in human health in the European Union in recent years. New medicines, vaccines, and treatments have been developed to tackle some of the leading causes of disease and life-threatening illnesses. It is clear that investment in research and [...] Read more.

Significant progress has been achieved in human health in the European Union in recent years. New medicines, vaccines, and treatments have been developed to tackle some of the leading causes of disease and life-threatening illnesses. It is clear that investment in research and development (R&D) for innovative medicines and treatments is essential for making progress in preventing and treating diseases. Ahead of the legislative process, which should begin by the end of 2022, discussions focus on how Europe can best promote the huge potential benefits of new science and technology within the regulatory framework. The challenges in European healthcare were spelled out by the panellists at the roundtable organised by European Alliance for Personalised Medicine (EAPM). Outcomes from panellists’ discussions have been summarized and re-arranged in this paper under five headings: innovation, unmet medical need, access, security of supply, adapting to progress, and efficiency. Some of the conclusions that emerged from the panel are a call for a better overall holistic vision of the future of pharmaceuticals and health in Europe and a collaborative effort among all stakeholders, seeing the delivery of medicines as part of a broader picture of healthcare. Full article

(This article belongs to the Special Issue Redefining the Unmet Needs in Healthcare and the Regulatory Challenge)

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10 pages, 254 KiB

Open AccessArticle

Exploring Perceived Stress in Mothers with Singleton and Multiple Preterm Infants: A Cross-Sectional Study in Taiwan

by Yu-Shan Chang, Yi-Chuan Cheng, Tsai-Chung Li and Li-Chi Huang

Healthcare 2022, 10(8), 1593; https://doi.org/10.3390/healthcare10081593 - 22 Aug 2022

Viewed by 1389

Abstract

Objective: The aim of this study was to explore mothers’ perceived level of stress one month after hospital discharge following the birth of singleton and multiple preterm infants. Design: A cross-sectional design was used to compare mother’s perceived stress in two groups of [...] Read more.

Objective: The aim of this study was to explore mothers’ perceived level of stress one month after hospital discharge following the birth of singleton and multiple preterm infants. Design: A cross-sectional design was used to compare mother’s perceived stress in two groups of postpartum mothers and the relationship of the theoretical antecedents and these variables. Setting: A neonatal intensive care unit in a medical center in Taiwan. Participants: Mothers of 52 singletons and 38 multiple premature infants were recruited. One month after the infant was discharged, the participants completed a self-reported questionnaire that included demographic data about the mother and infant, the 21-item Social Support Scale, and the 15-item Perceived Stress Scale. This was returned by email or completed at the outpatient unit. Analysis: Descriptive and inferential analysis. Results: The mean social support scores were 76.6 and 76.5 (out of 105) for mothers with singleton and multiple birth infants, respectively. The most important supporter was the husband. The mean perceived stress scores of 25.8 and 31.0 for mothers with singleton and multiple birth infants, respectively, were significantly different (p = 0.02). Sleep deprivation and social support were predictive indicators of perceived stress in mothers with preterm infants. Conclusions: We suggest that the differences in stress and needs of mothers with singleton and multiple births should be recognized and addressed in clinics. The findings of this study serve as a reference for promoting better preterm infant care. Full article

(This article belongs to the Section Nursing)

18 pages, 332 KiB

Open AccessArticle

A Healthcare Paradigm for Deriving Knowledge Using Online Consumers’ Feedback

by Aftab Nawaz, Yawar Abbas, Tahir Ahmad, Noha F. Mahmoud, Atif Rizwan and Nagwan Abdel Samee

Healthcare 2022, 10(8), 1592; https://doi.org/10.3390/healthcare10081592 - 22 Aug 2022

Cited by 6 | Viewed by 2167

Abstract

Home healthcare agencies (HHCAs) provide clinical care and rehabilitation services to patients in their own homes. The organization’s rules regulate several connected practitioners, doctors, and licensed skilled nurses. Frequently, it monitors a physician or licensed nurse for the facilities and keeps track of [...] Read more.

Home healthcare agencies (HHCAs) provide clinical care and rehabilitation services to patients in their own homes. The organization’s rules regulate several connected practitioners, doctors, and licensed skilled nurses. Frequently, it monitors a physician or licensed nurse for the facilities and keeps track of the health histories of all clients. HHCAs’ quality of care is evaluated using Medicare’s star ratings for in-home healthcare agencies. The advent of technology has extensively evolved our living style. Online businesses’ ratings and reviews are the best representatives of organizations’ trust, services, quality, and ethics. Using data mining techniques to analyze HHCAs’ data can help to develop an effective framework for evaluating the finest home healthcare facilities. As a result, we developed an automated predictive framework for obtaining knowledge from patients’ feedback using a combination of statistical and machine learning techniques. HHCAs’ data contain twelve performance characteristics that we are the first to analyze and depict. After adequate pattern recognition, we applied binary and multi-class approaches on similar data with variations in the target class. Four prominent machine learning models were considered: SVM, Decision Tree, Random Forest, and Deep Neural Networks. In the binary class, the Deep Neural Network model presented promising performance with an accuracy of 97.37%. However, in the case of multiple class, the random forest model showed a significant outcome with an accuracy of 91.87%. Additionally, variable significance is derived from investigating each attribute’s importance in predictive model building. The implications of this study can support various stakeholders, including public agencies, quality measurement, healthcare inspectors, and HHCAs, to boost their performance. Thus, the proposed framework is not only useful for putting valuable insights into action, but it can also help with decision-making. Full article

(This article belongs to the Special Issue Computing and Artificial Intelligence Techniques for Healthcare Applications: Second Edition)

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10 pages, 405 KiB

Open AccessProtocol

Tools for Assessing Knowledge of Back Health in Adolescents: A Systematic Review Protocol

by Adriana Cristina Fiaschi Ramos, Regina Márcia Ferreira Silva, Thailyne Bizinotto, Leonardo Mateus Teixeira de Rezende, Vicente Miñana-Signes, Manuel Monfort-Pañego, Priscilla Rayanne e Silva Noll and Matias Noll

Healthcare 2022, 10(8), 1591; https://doi.org/10.3390/healthcare10081591 - 22 Aug 2022

Cited by 1 | Viewed by 1425

Abstract

Back pain is common in adolescents as a result of their typical daily activities. There is a critical need for developing instruments that can assess the adolescents’ knowledge of proper posture, because adequate postural habits are essential for preventing back pain and facilitating [...] Read more.

Back pain is common in adolescents as a result of their typical daily activities. There is a critical need for developing instruments that can assess the adolescents’ knowledge of proper posture, because adequate postural habits are essential for preventing back pain and facilitating physical well-being. Unfortunately, there is insufficient understanding about appropriate back health in the general public, even though this knowledge is decisive in the development of physical skills and attainment of health literacy. Furthermore, relevant substantive literature is scarce. Therefore, the proposed systematic review aims to identify instruments that are used for assessing knowledge of back health in adolescents. Relevant search terms and descriptors will be combined, and searches will be carried out in a uniform sequence within the PubMed, Embase, CINAHL, and Cochrane Library databases. Eligible articles must present data on the assessment of the adolescents’ knowledge of back health and describe the applied instrumentation. Articles will be selected by two reviewers independently; all disagreements will be resolved by a third reviewer. Mendeley and the Rayyan software will be used for the systematic review, and the checklist proposed by Brink and Louw will be used to verify the methodological quality of the included studies. Our findings may confirm the relevance of constructing and validating back health instruments for use in Brazil and other countries. Full article

(This article belongs to the Special Issue Pediatric Spine Health)

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5 pages, 2795 KiB

Open AccessCase Report

A Case of Advanced Tubal Ectopic Pregnancy after Emergency Contraception

by Stefano Restaino, Matilde Degano, Diana Padovani, Anna Biasioli, Valentina Capodicasa, Giuseppe Vizzielli and Lorenza Driul

Healthcare 2022, 10(8), 1590; https://doi.org/10.3390/healthcare10081590 - 22 Aug 2022

Viewed by 2996

Abstract

Ectopic pregnancy is a relatively common condition and an important cause of morbidity in women of childbearing age. The most frequent implantation site is the fallopian tube. Most cases are diagnosed in an early gestational period. Patients come to the attention of clinicians [...] Read more.

Ectopic pregnancy is a relatively common condition and an important cause of morbidity in women of childbearing age. The most frequent implantation site is the fallopian tube. Most cases are diagnosed in an early gestational period. Patients come to the attention of clinicians for pelvic pain and vaginal blood loss, and consequent diagnosis is made through clinical presentation, laboratory tests, and ultrasound. Other rarer implantation sites such as the abdominal cavity give space for ectopic pregnancy to grow until later gestational ages, delaying diagnosis. This is a rare case of a healthy 41-year-old woman with an advanced ectopic pregnancy after emergency contraception with Ulipristal Acetate. The patient went to visit for amenorrhea after taking a contraceptive. Evaluation with ultrasound demonstrated a 10 + 4 weeks’ unruptured tubal pregnancy with fetal heart rate. The patient underwent laparoscopic salpingectomy without complication. This is the first case of such an advanced ectopic pregnancy in a woman who performed emergency contraception with Ulipristal Acetate. Full article

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

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12 pages, 998 KiB

Open AccessArticle

Predictors of Basic Activity in Daily Living and Length of Hospitalization in Patients with COVID-19

by Ting-Jie I, Yu-Lin Tsai and Yuan-Yang Cheng

Healthcare 2022, 10(8), 1589; https://doi.org/10.3390/healthcare10081589 - 22 Aug 2022

Cited by 1 | Viewed by 1508

Abstract

Background: Patients recovered from COVID-19 often suffer from the sequelae of the disease, which can hinder the patients’ activity in daily living. Early recognition of the patients at risk of prolonged hospitalization and impaired physical functioning is crucial for early intervention. We aim [...] Read more.

Background: Patients recovered from COVID-19 often suffer from the sequelae of the disease, which can hinder the patients’ activity in daily living. Early recognition of the patients at risk of prolonged hospitalization and impaired physical functioning is crucial for early intervention. We aim to identify the predictors of prolonged hospitalization and impaired activity in daily living in this study. Methods: COVID-19 patients hospitalized in a medical center were divided into two groups according to the Barthel index three months after discharge and the median length of hospital stay, respectively. Chi-square test and Mann–Whitney U test were performed to check the differences between the two groups in patient characteristics as well as hematology tests at the emergency department, the intensive care unit mobility scale (ICUMS), and the medical research council sum score (MRCSS). Logistic regression and the receiver operating characteristic curve analysis were further performed for the factors with significant differences between the two groups. Results: Both ICUMS and MRCSS showed significant differences between the groups. The ICUMS had an odds ratio of 0.61 and the MRCSS of 0.93 in predicting a Barthel index score less than 100 three months after discharge. The MRCSS had an odds ratio of 0.82 in predicting a prolonged length of hospital stay. Conclusion: Both ICUMS and MRCSS upon admission are predictive of a Barthel index score of less than 100 three months after discharge. On the other hand, only MRCSS has predictive value of a prolonged hospitalization. Full article

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

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13 pages, 326 KiB

Open AccessArticle

Sleep Quality Worsens While Perceived Stress Improves in Healthcare Workers over Two Years during the COVID-19 Pandemic: Results of a Longitudinal Study

by Haitham Jahrami, Eman A. Haji, Zahra Q. Saif, Noora O. Aljeeran, Aysha I. Aljawder, Faisal N. Shehabdin, Feten Fekih-Romdhane, Khaled Trabelsi, Ahmed S. BaHammam and Michael V. Vitiello

Healthcare 2022, 10(8), 1588; https://doi.org/10.3390/healthcare10081588 - 22 Aug 2022

Cited by 8 | Viewed by 2129

Abstract

The purpose of the study was to measure changes in sleep quality and perceived stress and their interrelationships in a sample of healthcare workers two years post the COVID-19 pandemic. Using a cohort design, data were collected from frontline healthcare workers (FLHCW, n [...] Read more.

The purpose of the study was to measure changes in sleep quality and perceived stress and their interrelationships in a sample of healthcare workers two years post the COVID-19 pandemic. Using a cohort design, data were collected from frontline healthcare workers (FLHCW, n = 70) and non-frontline healthcare workers (NFLHCW, n = 74) in April 2020 (T1) and in February 2022 (T2). The Pittsburgh Sleep Quality Index (PSQI) and the Perceived Stress Scale (PSS-10) were administered at both time points. There were no differences in sleep quality or perceived stress between FLHCW and NFLHCW at either timepoint. For the entire sample, the PSQI scores at T2 were significantly higher than at T1 (7.56 ± 3.26 and 7.25 ± 3.29, respectively) (p = 0.03, Cohen’s d = 0.18). PSS-10 scores at T2 were significantly lower than at T1 (19.85 ± 7.73 and 21.13 ± 7.41, respectively) (p = 0.001, Cohen’s d = 0.78). Baseline sleep quality PSQI (T1) was a significant predictor for changes in sleep quality. During the initial months of the outbreak of the COVID-19 pandemic, poor sleep quality and perceived stress were common for healthcare workers. Two years into the pandemic, the perceived stress was reduced, but sleep quality worsened. Full article

13 pages, 4877 KiB

Open AccessArticle

Periodontal Healing after Lower Third Molars Extraction: A Clinical Evaluation of Different Flap Designs

by Valentina Castagna, Alessia Pardo, Luca Lanaro, Annarita Signoriello and Massimo Albanese

Healthcare 2022, 10(8), 1587; https://doi.org/10.3390/healthcare10081587 - 21 Aug 2022

Cited by 6 | Viewed by 3571

Abstract

Periodontal healing after third molars extraction seems to be influenced by the choice of different flap techniques. The purpose of the present study was to assess the clinical condition of adjacent first and second molar sites, after the extraction of lower third molars, [...] Read more.

Periodontal healing after third molars extraction seems to be influenced by the choice of different flap techniques. The purpose of the present study was to assess the clinical condition of adjacent first and second molar sites, after the extraction of lower third molars, performed through different flap designs. Eighty patients, aged between 14 and 30 years, were analyzed for periodontal parameters of VPI, PPD, and CAL, pre-operatively (T0), after 15 days (T1), after 1 month (T2), and after 2 months (T3) from extraction. Techniques performed were trapezoidal flap (TRAP), marginal flap (MARG), flap with papilla detachment (DETP), and flap with papilla decapitation (DEC). No significant differences were found between the four flaps at each observation time and considering the interval between T0 and T3, for VPI, PPD at first molar site, PPD at second molar site, and CAL at second molar site. Significant variations for CAL were registered, for each flap, between T0 and T3, in all cases for buccal site, in three cases for buccal-distal site. After 2 months of follow-up, no strong evidence can be assumed for or against the use of a particular flap design for the extraction of lower third molars. Full article

(This article belongs to the Special Issue Surgical Operation and Preoperative and Postoperative Care)

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11 pages, 1094 KiB

Open AccessReview

Teledentistry as an Effective Tool for the Communication Improvement between Dentists and Patients: An Overview

by Md Refat Readul Islam, Rafiqul Islam, Sultana Ferdous, Chiharu Watanabe, Monica Yamauti, Mohammad Khursheed Alam and Hidehiko Sano

Healthcare 2022, 10(8), 1586; https://doi.org/10.3390/healthcare10081586 - 21 Aug 2022

Cited by 12 | Viewed by 5972

Abstract

Teledentistry is an online dental care service that allows patients and dentists to meet in real time, safely, without being at the same location. During the COVID-19 pandemic, real-time videoconferencing has gained popularity in the field of teledentistry, with numerous benefits for both [...] Read more.

Teledentistry is an online dental care service that allows patients and dentists to meet in real time, safely, without being at the same location. During the COVID-19 pandemic, real-time videoconferencing has gained popularity in the field of teledentistry, with numerous benefits for both patients and dentists. Online consultations can minimize costs, maximize time, and provide more convenient care options for both patients and dentists. When practicing teledentistry, a dentist must establish a good doctor–patient relationship. Dentists must ensure that the telecommunication solution that they choose meets their clinical requirements and complies with privacy laws. Dentists should provide adequate information to patients about the limitations, advantages, and disadvantages that may occur during online consultation. Dentists must follow guidelines and procedures regarding informed consent, patient details, personal communications, and consultancies’ privacy and confidentiality. The patient should be aware of the limitations of teledentistry, and dentists will provide the best advice possible in the absence of a face-to-face consultation. This article discusses how teledentistry could be an effective tool for dentists and patients. Full article

(This article belongs to the Special Issue Digital Health: Intervention and Monitoring in Oral Health)

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11 pages, 252 KiB

Open AccessArticle

Attitudes towards Antibiotic Prescription and Antimicrobial Resistance Awareness among Italian Dentists: What Are the Milestones?

by Francesco D’Ambrosio, Federica Di Spirito, Alessandra Amato, Mario Caggiano, Roberto Lo Giudice and Stefano Martina

Healthcare 2022, 10(8), 1585; https://doi.org/10.3390/healthcare10081585 - 21 Aug 2022

Cited by 24 | Viewed by 1993

Abstract

Antimicrobial resistance is a growing phenomenon, often associated with the improper prescription of antibiotics, prescribed by those who do not follow the guidelines for antibiotic stewardship. The aim of this study was to evaluate the current attitude towards antibiotic prescribing and antimicrobial resistance [...] Read more.

Antimicrobial resistance is a growing phenomenon, often associated with the improper prescription of antibiotics, prescribed by those who do not follow the guidelines for antibiotic stewardship. The aim of this study was to evaluate the current attitude towards antibiotic prescribing and antimicrobial resistance awareness among Italian dentists. An online questionnaire was distributed to Italian dentists from September to December 2021. The questionnaire was composed of three main sections. The first part was focused on demographic characteristics, the second part on prescription habits, and the third part on the dentists’ knowledge regarding the phenomenon of antimicrobial resistance. A chi-square test was used to find associations between different variables. The level of significance was set at p < 0.05. A total of 382 dentists completed the questionnaire. The main reasons for antibiotic prescribing were for abscesses (39.6%), extractions (24.5%), and pulpitis (14.1%). The majority of participants (85.3%) reported prescribing macrolides in the case of a penicillin allergy. Most dentists (98.9%) were aware of the antimicrobial resistance phenomenon, but only 7.4% of them consulted the guidelines for prescribing antibiotics. This study demonstrates that the same trend exists in Italy as in other countries in terms of the high prevalence of misuse and overuse of antibiotics, and that Italian dentists utilize a range of antibiotic management strategies. Full article

(This article belongs to the Section Medication Management)

10 pages, 253 KiB

Open AccessArticle

Students’ Perception of Quality of Learning Experience (Structure, Process and Outcome): Discipline Versus Problem Based Medical Curriculum and the Mediation Role of Process Quality

by Mu’taman Jarrar, Radwa Bakr Mohamed, Mohammad Al-Bsheish, Waleed Albaker, Arwa Alumran and Ammar K. Alomran

Healthcare 2022, 10(8), 1584; https://doi.org/10.3390/healthcare10081584 - 21 Aug 2022

Cited by 3 | Viewed by 1556

Abstract

Problem-based learning (PBL) is now incorporated into the curricula of most medical schools around the world. In comparison to the traditional curriculum, less is known about the influence of the adoption and implementation of a problem-based curriculum on the perceived structures, processes, and [...] Read more.

Problem-based learning (PBL) is now incorporated into the curricula of most medical schools around the world. In comparison to the traditional curriculum, less is known about the influence of the adoption and implementation of a problem-based curriculum on the perceived structures, processes, and outcomes of learning experiences reported by students. The purpose of this study was twofold: (1) to compare the quality of learning experience of students enrolled in traditional discipline-based and problem-based medical curricula and (2) to explore the mediation effect of the process quality between the relationship of the structural quality and students’ perception of learning experience outcomes. Through the distribution of an electronic survey, all 3rd and 4th year medical students enrolled in the discipline-based curriculum and the problem-based curriculum were invited to participate in the study. The students from both curricula completed the Student Experience Survey (SES), which was developed by the National Center for Academic Accreditation and Evaluation. Descriptive statistics, independent sample t-test and Hayes Macro regression analysis were used. Students enrolled in the problem-based curriculum had higher perceived support and sufficient advice with higher perceived quality of learning experiences compared with students enrolled in the traditional curriculum, however they reported less enjoyment of their university life. The structural factors (t = 19.83, p ≤ 0.001) and process factors (t = 9.21, p ≤ 0.001) were associated with an increase in students’ reported outcomes by 0.67 and 0.49, respectively. These findings explain the mechanism by which the structural factors, such as maintaining adequate facilities and support, may help in enhancing the process quality (e.g., learner-centered learning), which in turn can enhance learning experience outcomes. Full article

(This article belongs to the Special Issue Innovations in Ecological Public Health and Health Education)

7 pages, 219 KiB

Open AccessCase Report

A Unique Glassy Cell Carcinoma (GCC) of the Cervix Diagnosed during Pregnancy—A Case Report

by Marlena Grabowska, Ewa Baum, Małgorzata Lewandowska, Stefan Sajdak, Klaudia Dolińska-Kaczmarek and Monika Englert-Golon

Healthcare 2022, 10(8), 1583; https://doi.org/10.3390/healthcare10081583 - 21 Aug 2022

Cited by 1 | Viewed by 1453

Abstract

Glassy Cell carcinoma (GCC) of the cervix is classified as a unique, aggressive neoplasm, with different sensitivity to chemotherapy and radiotherapy. It is such an extremely rare tumor that it is practically not observed during pregnancy. Information on the coexistence of cervical GCC [...] Read more.

Glassy Cell carcinoma (GCC) of the cervix is classified as a unique, aggressive neoplasm, with different sensitivity to chemotherapy and radiotherapy. It is such an extremely rare tumor that it is practically not observed during pregnancy. Information on the coexistence of cervical GCC with pregnancy is also unique, so it seems extremely important to disseminate it in order to develop the most effective treatment regimen. Additionally, making any decisions regarding therapeutic methods during pregnancy encounters great ethical problems. We present the case of a 26-year-old pregnant woman, 18 weeks gestation, diagnosed with GCC of the cervix, IB3 grade in the International Federation of Gynecology and Obstetrics (FIGO) scale. Despite the unfavorable prognosis, the use of chemotherapy in a pregnant patient brought on a favorable therapeutic effect, without any negative effects on the fetus. The article also presents a literature review on the epidemiology, pathology, immunohistochemistry, treatment and prognosis of this rare disease. Full article

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

21 pages, 469 KiB

Open AccessReview

Piperacillin–Tazobactam Plus Vancomycin-Associated Acute Kidney Injury in Adults: Can Teicoplanin or Other Antipseudomonal Beta-Lactams Be Remedies?

by Abdullah Tarık Aslan and Murat Akova

Healthcare 2022, 10(8), 1582; https://doi.org/10.3390/healthcare10081582 - 20 Aug 2022

Cited by 1 | Viewed by 2293

Abstract

Numerous observational studies and meta-analyses have suggested that combination therapy consisting of piperacillin–tazobactam (TZP) and vancomycin (VAN) augments acute kidney injury (AKI) risk when compared to viable alternatives, such as cefepime–vancomycin (FEP–VAN) and meropenem–VAN. However, the exact pathophysiological mechanisms of this phenomenon are [...] Read more.

Numerous observational studies and meta-analyses have suggested that combination therapy consisting of piperacillin–tazobactam (TZP) and vancomycin (VAN) augments acute kidney injury (AKI) risk when compared to viable alternatives, such as cefepime–vancomycin (FEP–VAN) and meropenem–VAN. However, the exact pathophysiological mechanisms of this phenomenon are still unclear. One major limitation of the existing studies is the utilization of serum creatinine to quantify AKI since serum creatinine is not a sufficiently sensitive and specific biomarker to truly define the causal relationship between TZP–VAN exposure and nephrotoxicity. Even so, some preventive measures can be taken to reduce the risk of AKI when TZP–VAN is preferred. These measures include limiting the administration of TZP–VAN to 72 h, choosing FEP–VAN in place of TZP–VAN in appropriate cases, monitoring the VAN area under the curve level rather than the VAN trough level, avoiding exposure to other nephrotoxic agents, and minimizing the prescription of TZP–VAN for patients with a high risk of AKI. More data are needed to comment on the beneficial impact of the extended-infusion regimen of TZP on nephrotoxicity. Additionally, TZP and teicoplanin can be reasonable alternatives to TZP–VAN for the purpose of lowering AKI risk. However, the data are scarce to advocate this practice convincingly. Full article

(This article belongs to the Special Issue Management of the Patient with Kidney Disease)

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9 pages, 1766 KiB

Open AccessArticle

Plasma Antithrombin Activity during Long-Term Magnesium Sulfate Administration for Preeclampsia without Severe Hypertension

by Kaori Moriuchi, Kaoru Kawasaki, Maako Hayashi, Akihiko Ueda, Yukio Yamanishi, Haruta Mogami, Kohei Fujita, Reona Shiro, Yoshie Yo, Masaki Mandai and Noriomi Matsumura

Healthcare 2022, 10(8), 1581; https://doi.org/10.3390/healthcare10081581 - 19 Aug 2022

Cited by 1 | Viewed by 1577

Abstract

In preeclampsia, plasma antithrombin activity is decreased, which leads to exacerbation of the disorder. We previously showed that long-term magnesium sulfate (MgSO₄) administration prolonged the pregnancy period and may be able to improve pregnancy outcomes for patients with severe preeclampsia. The [...] Read more.

In preeclampsia, plasma antithrombin activity is decreased, which leads to exacerbation of the disorder. We previously showed that long-term magnesium sulfate (MgSO₄) administration prolonged the pregnancy period and may be able to improve pregnancy outcomes for patients with severe preeclampsia. The present study aimed to investigate the changes in plasma antithrombin activity during long-term MgSO₄ administration for patients without severe hypertension. This multicenter retrospective study included patients with preeclampsia and superimposed preeclampsia without severe hypertension at diagnosis. The participants were divided into two groups: MgSO₄ nontreatment group (three institutions) and MgSO₄ treatment group (one institution). Antithrombin activity from time of diagnosis to delivery were compared between the two groups. In the MgSO₄ nontreatment group (n = 16), antithrombin activity prior to delivery was significantly lower than at time of diagnosis (p = 0.015). In three cases, antithrombin activity was less than 60%. On the other hand, in the MgSO₄ treatment group (n = 34), antithrombin activity did not change until just before delivery (p = 0.74). There were no cases in which antithrombin activity was decreased below 60%. Long-term MgSO₄ administration for preeclampsia without severe hypertension may prevent a decrease in antithrombin activity and improve the disease state of preeclampsia. Full article

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

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16 pages, 322 KiB

Open AccessArticle

Comparison of Academic Motivation between Business and Healthcare Students in Online Learning: A Concurrent Nested Mixed-Method Study

by Yasuhiro Kotera, Valentina Gorchakova, Sarah Maybury, Ann-Marie Edwards and Hiromasa Kotera

Healthcare 2022, 10(8), 1580; https://doi.org/10.3390/healthcare10081580 - 19 Aug 2022

Cited by 5 | Viewed by 2514

Abstract

While the demand for online education and the diversity of online students have been increasing worldwide, how online students motivate themselves to continuously engage in learning remains to be appraised. Research in the face-to-face contexts reports that academic motivation is central to student [...] Read more.

While the demand for online education and the diversity of online students have been increasing worldwide, how online students motivate themselves to continuously engage in learning remains to be appraised. Research in the face-to-face contexts reports that academic motivation is central to student success and wellbeing, and the type of motivation can differ by subject. In particular, the motivation of business students and healthcare students can differ considerably. This study aimed to understand the motivation of online students, and compare them between business and healthcare students using a concurrent nested mixed-method design with correlation and thematic analyses. A survey regarding motivation, learning enjoyment, and study willingness was responded to by 120 online students (61 business and 59 healthcare). Business students were associated with extrinsic motivation, whereas healthcare students were associated with intrinsic motivation. While students in both groups enjoyed the pursuit of knowledge, healthcare students valued the process and accomplishment, whereas business students regarded education as steppingstones in their careers. Findings can help educators develop effective motivational support for these student groups. Full article

(This article belongs to the Special Issue Mental Health Matters: From Cross-Cultural Perspectives)

16 pages, 307 KiB

Open AccessArticle

Perspectives and Experiences of Cardiac Rehabilitation after Stroke—A Qualitative Study

by Olive Lennon, Alexandra Crystal, Michelle Kwan, Caoimhe Tierney, Anne Gallagher and Sean Murphy

Healthcare 2022, 10(8), 1579; https://doi.org/10.3390/healthcare10081579 - 19 Aug 2022

Cited by 4 | Viewed by 2123

Abstract

Cardiac rehabilitation (CR) after stroke has been proven to be a safe and feasible secondary prevention intervention. Limited qualitative data capture people’s experiences and perceptions of attending CR following stroke, but with none addressing translational aspects when CR is delivered as routine clinical [...] Read more.

Cardiac rehabilitation (CR) after stroke has been proven to be a safe and feasible secondary prevention intervention. Limited qualitative data capture people’s experiences and perceptions of attending CR following stroke, but with none addressing translational aspects when CR is delivered as routine clinical care. Using a phenomenological, qualitative approach, four semi-structured focus groups were conducted with 15 individuals (60% male) who had completed CR during their stroke care pathway. Our inductive thematic analysis identified five themes. The first centred on recognising stroke as a cardiovascular disease and the applicability of CR post-stroke. The second addressed how peer understanding, camaraderie, and medical supervision created a safe and supportive environment. The third identified how the programme-built confidence supported longer-term healthy lifestyle choices in physical activity, diet, and smoking. The penultimate theme addressed the period from hospital discharge to attending CR as a time of uncertainty where many participants experienced cognitive difficulties, mood disturbances, and mental fatigue without adequate support. Lastly, participants identified unmet needs in their care pathway that included a lack of information about their referral to CR, the programme content, and accessing local supports ahead of CR. Ongoing and unmet needs both during and after CR related to self-management of secondary prevention medications, neurological issues, post-stroke fatigue, and the lack of structured support following CR completion. Full article

(This article belongs to the Special Issue Healthy Living and Risk Reduction after TIA and Stroke)

9 pages, 259 KiB

Open AccessPerspective

Meeting the Need for a Discussion of Unmet Medical Need

by Denis Horgan, Bettina Borisch, Bogi Eliasen, Peter Kapitein, Andrew V. Biankin, Stefan Gijssels, Michael Zaiac, Marie-Helene Fandel, Jonathan A. Lal, Marta Kozaric, Barbara Moss, Ruggero De Maria, Marius Geanta, Frédérique Nowak, Antoni Montserrat-Moliner and Olaf Riess

Healthcare 2022, 10(8), 1578; https://doi.org/10.3390/healthcare10081578 - 19 Aug 2022

Viewed by 2864

Abstract

As Europe and the world continue to battle against COVID, the customary complacency of society over future threats is clearly on display. Just 30 months ago, such a massive disruption to global lives, livelihoods and quality of life seemed unimaginable. Some remedial European [...] Read more.

As Europe and the world continue to battle against COVID, the customary complacency of society over future threats is clearly on display. Just 30 months ago, such a massive disruption to global lives, livelihoods and quality of life seemed unimaginable. Some remedial European Union action is now emerging, and more is proposed, including in relation to tackling “unmet medical need” (UMN). This initiative—directing attention to the future of treating disease and contemplating incentives to stimulate research and development—is welcome in principle. But the current approach being considered by EU officials merits further discussion, because it may prove counter-productive, impeding rather than promoting innovation. This paper aims to feed into these ongoing policy discussions, and rather than presenting research in the classical sense, it discusses the key elements from a multistakeholder perspective. Its central concern is over the risk that the envisaged support will fail to generate valuable new treatments if the legislation is phrased in a rigidly linear manner that does not reflect the serpentine realities of the innovation process, or if the definition placed on unmet medical need is too restrictive. It cautions that such an approach presumes that “unmet need” can be precisely and comprehensively defined in advance on the basis of the past. It cautions that such an approach can reinforce the comfortable delusion that the future is totally predictable—the delusion that left the world as easy prey to COVID. Instead, the paper urges reflection on how the legislation that will shortly enter the pipeline can be phrased so as to allow for the flourishing of a culture capable of rapid adaptation to the unexpected. Full article

(This article belongs to the Special Issue Redefining the Unmet Needs in Healthcare and the Regulatory Challenge)

8 pages, 892 KiB

Open AccessArticle

Clinical Items for Geriatric Patients with Post-Stroke at Discharge or Transfer after Rehabilitation Therapy in a Chronic-Phase Hospital: A Retrospective Pilot Study

by Masatoshi Koumo, Akio Goda, Yoshinori Maki, Kouta Yokoyama, Tetsuya Yamamoto, Tsumugi Hosokawa, Ryota Ishibashi, Junichi Katsura and Ken Yanagibashi

Healthcare 2022, 10(8), 1577; https://doi.org/10.3390/healthcare10081577 - 19 Aug 2022

Viewed by 1280

Abstract

Clinical factors related to destination after rehabilitation therapy for geriatric patients with post-stroke in chronic-phase hospitals have not been elucidated. This study analyzed the clinical characteristics of geriatric patients with post-stroke at discharge/transfer after rehabilitation therapy in a chronic-phase hospital. Fifty-three patients (20 [...] Read more.

Clinical factors related to destination after rehabilitation therapy for geriatric patients with post-stroke in chronic-phase hospitals have not been elucidated. This study analyzed the clinical characteristics of geriatric patients with post-stroke at discharge/transfer after rehabilitation therapy in a chronic-phase hospital. Fifty-three patients (20 men, 33 women; mean age 81.36 ± 8.14 years) were recruited (the period analyzed: October 2013–March 2020). Clinical data were statistically analyzed among patients discharged to homes or facilities for older adults or transferred to another hospital. In addition, we analyzed the clinical items at discharge and transfer after rehabilitation therapy using a decision tree analysis. Twelve patients were discharged, eighteen were discharged to facilities for older adults, and twenty-three were transferred to another hospital. There were significant differences in the modified Rankin Scale, admission dates, functional independence measure (FIM) score, and Barthel Index score in the three groups (p < 0.05). Patients with motor subtotal functional independence scores of ≥14 (chronologically improved ≥5) after rehabilitation therapy for <291 days were more likely to be discharged home. Patients in a chronic-phase hospital who improved within a limited period were discharged to their homes, whereas those who were bedridden tended to be transferred to another hospital. Full article

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

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16 pages, 1548 KiB

Open AccessArticle

Needs Analysis for Non-Face-to-Face Services among Older Adults to Reduce Loneliness

by Hee Kyung Choi and Seon Heui Lee

Healthcare 2022, 10(8), 1576; https://doi.org/10.3390/healthcare10081576 - 19 Aug 2022

Viewed by 1118

Abstract

Background: Considering older adults’ interests and physical abilities, non-face-to-face services precipitated positive acceptance and reduced loneliness. Developing non-face-to-face services designed after investigating older adults’ needs is necessary. Research question: What is the need for non-face-to-face services to reduce loneliness among older adults in [...] Read more.

Background: Considering older adults’ interests and physical abilities, non-face-to-face services precipitated positive acceptance and reduced loneliness. Developing non-face-to-face services designed after investigating older adults’ needs is necessary. Research question: What is the need for non-face-to-face services to reduce loneliness among older adults in the community? Methods: A questionnaire was developed through a content validity evaluation of a group of experts based on a prior systematic review. The survey was administered to 100 community-dwelling older adults between 15 July and 31 August 2021. The need for non-face-to-face services for older adults was analyzed. Results: This study found that non-face-to-face services precipitate positive perceptions and satisfy the needs of older adults in the community. Additionally, the older adults preferred integrated content from non-face-to-face services. Through the analysis of preference differences according to the general characteristics, this study shows the possibility of inducing participation by developing content that attracts older adults’ attention. Conclusion: This study is expected to provide basic data for content development of non-face-to-face services to reduce loneliness among older adults in the community by investigating their needs. Full article

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9 pages, 1538 KiB

Open AccessArticle

uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children

by Cristina Gavrilovici, Cristian Petru Duşa, Cosmin Teodor Mihai, Elena-Lia Spoială, Iuliana Magdalena Stârcea, Codruta Olimpiada Iliescu-Halitchi, Irina Nicoleta Zetu, Lavinia Bodescu-Amancei Ionescu, Roxana Alexandra Bogos, Elena Hanganu and Vasile Lucian Boiculese

Healthcare 2022, 10(8), 1575; https://doi.org/10.3390/healthcare10081575 - 19 Aug 2022

Cited by 1 | Viewed by 1305

Abstract

Acute kidney injury (AKI) occurs frequently in critically ill children, having an incidence of up to 26.9% and is associated with high morbidity and mortality in pediatric intensive care units (PICU). Currently, the decrease in the glomerular filtration rate is calculated using the [...] Read more.

Acute kidney injury (AKI) occurs frequently in critically ill children, having an incidence of up to 26.9% and is associated with high morbidity and mortality in pediatric intensive care units (PICU). Currently, the decrease in the glomerular filtration rate is calculated using the serum creatinine levels. Nevertheless, there may be a 48 h delay between the renal injury and measurable increase in creatinine. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been validated in relation to cardiopulmonary bypass in children, being able to detect AKI before the functional change proven by the rise in serum creatinine. Our aim was to study the utility of using uNGAL in the management of critical pediatric patients admitted to our hospital in a six month period, more specifically, its capacity to predict AKI development, alone and in the association with the renal angina index (RAI). Twenty-eight critically ill children aged from 1 day to 15 years have been included. We found that an increase in uNGAL in day 1 of admission in the PICU was significantly correlated with a decrease in creatinine clearance but not anymore in day 3. However, in our sample uNGAL did not show a significant predictability for AKI development nor the supplementary incorporation of RAI into the prediction model. Therefore, apart from cardiac surgery, the efficacy and utility or uNGAL in the management of critically ill children is still questionable. For the best prediction, we will need to incorporate not only the RAI or other PICU scores, but other biomarkers such as KIM-1, urinary cystatin, and IL 18 in larger samples. Full article

(This article belongs to the Special Issue Anesthesiology and Critical Care)

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7 pages, 244 KiB

Open AccessArticle

Pulmonary Parameters in Adolescents with Severe Thoracic Idiopathic Scoliosis: Comparison Girls versus Boys

by Katarzyna Politarczyk, Wiktoria Popowicz-Mieloch and Tomasz Kotwicki

Healthcare 2022, 10(8), 1574; https://doi.org/10.3390/healthcare10081574 - 19 Aug 2022

Viewed by 1085

Abstract

The study compared pulmonary parameters, registered at the preoperative examination, in adolescent boys versus girls, both with severe thoracic idiopathic scoliosis. Thirty consecutive boys and 30 consecutive girls with Lenke 1 or 3 type, in the age range 14–18 years, with a Cobb [...] Read more.

The study compared pulmonary parameters, registered at the preoperative examination, in adolescent boys versus girls, both with severe thoracic idiopathic scoliosis. Thirty consecutive boys and 30 consecutive girls with Lenke 1 or 3 type, in the age range 14–18 years, with a Cobb angle of >50° and Risser sign ≥ 3 were enrolled. Corrected body height was used to calculate pulmonary parameters according to the Global Lung Function (GLI 2012) reference values. Significantly higher values of the calculated predicted pulmonary parameters and the upper and lower limit of normal (ULN and LLN), as well as significantly higher absolute values of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were observed in boys than girls; however, the registered FVC and FEV1, expressed as percentages of the predicted values, tended to be lower in boys. The FEV1 z-score difference between boys and girls may suggest a need for more intensive preoperative pulmonary rehabilitation in boys. Full article

(This article belongs to the Special Issue Pediatric Spine Health)

15 pages, 815 KiB

Open AccessArticle

The Impact of Postoperative Complications on Survival after Simultaneous Resection of Colorectal Cancer and Liver Metastases

by Sorin Tiberiu Alexandrescu, Narcis Octavian Zarnescu, Andrei Sebastian Diaconescu, Dana Tomescu, Gabriela Droc, Doina Hrehoret, Vladislav Brasoveanu and Irinel Popescu

Healthcare 2022, 10(8), 1573; https://doi.org/10.3390/healthcare10081573 - 19 Aug 2022

Viewed by 1260

Abstract

Background: The aim of this study was to investigate the impact of postoperative complications on the long-term outcomes of patients who had undergone simultaneous resection (SR) of colorectal cancer and synchronous liver metastases (SCLMs). Methods: We conducted a single-institution survival cohort study in [...] Read more.

Background: The aim of this study was to investigate the impact of postoperative complications on the long-term outcomes of patients who had undergone simultaneous resection (SR) of colorectal cancer and synchronous liver metastases (SCLMs). Methods: We conducted a single-institution survival cohort study in patients with SR, collecting clinical, pathological, and postoperative complication data. The impact of these variables on overall survival (OS) and disease-free survival (DFS) was compared by log rank test. Multivariate Cox regression analysis identified independent prognostic factors. Results: Out of 243 patients, 122 (50.2%) developed postoperative complications: 54 (22.2%) major complications (Clavien–Dindo grade III–V), 86 (35.3%) septic complications, 59 (24.2%) hepatic complications. Median comprehensive complication index (CCI) was 8.70. Twelve (4.9%) patients died postoperatively. The 3- and 5-year OS and DFS rates were 60.7%, 39.5% and 28%, 21.5%, respectively. Neither overall postoperative complications nor major and septic complications or CCI had a significant impact on OS or DFS. Multivariate analysis identified the N2 stage as an independent prognostic of poor OS, while N2 stage and four or more SCLMs were independent predictors for poor DFS. Conclusion: N2 stage and four or more SCLMs impacted OS and/or DFS, while CCI, presence, type, or grade of postoperative complications had no significant impact on long-term outcomes. Full article

(This article belongs to the Special Issue Strategies for Surgical Treatment of Colorectal Liver Metastases)

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15 pages, 545 KiB

Open AccessArticle

Effects of Self-Care Education Intervention Program (SCEIP) on Activation Level, Psychological Distress, and Treatment-Related Information

by Nor Aziyan Yahaya, Khatijah Lim Abdullah, Vimala Ramoo, Nor Zuraida Zainal, Li Ping Wong and Mahmoud Danaee

Healthcare 2022, 10(8), 1572; https://doi.org/10.3390/healthcare10081572 - 18 Aug 2022

Cited by 5 | Viewed by 2294

Abstract

Self-care education can direct patients to manage their side effects during treatment, reduce psychological distress, and improve self-care information. In this study, the effectiveness of the Self-Care Education Intervention Program (SCEIP) on patient activation levels, psychological distress, and treatment-related concerns in women with [...] Read more.

Self-care education can direct patients to manage their side effects during treatment, reduce psychological distress, and improve self-care information. In this study, the effectiveness of the Self-Care Education Intervention Program (SCEIP) on patient activation levels, psychological distress, and treatment-related concerns in women with breast cancer was assessed by adopting a longitudinal quasi-experimental pre-test and post-test design. The data for 246 women with breast cancer undergoing adjuvant chemotherapy were collected. Pre- and post-interventional assessments were conducted at baseline (T1) and the second (T2), fourth (T3), and sixth (T4) cycles using the 13-item Patient Activation Measure, 14-item Hospital Anxiety and Depression Scale, and 25-item Cancer Treatment Survey. It was found that the SCEIP significantly improved the activation level (p ≤ 0.001), psychological distress (anxiety level (p ≤ 0.001), the depression level (p ≤ 0.001)), and treatment-related concerns (sensory/psychological concerns (p = 0.05); procedural concerns (p ≤ 0.001)). Therefore, the SCEIP could potentially improve patients’ activation level, psychological distress, and treatment-related concerns regarding symptom management during chemotherapy, specifically for Malaysian women with breast cancer. Full article

(This article belongs to the Special Issue Clinical Nursing in Healthcare)

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11 pages, 269 KiB

Open AccessArticle

Robots and Robotics in Nursing

by Gil P. Soriano, Yuko Yasuhara, Hirokazu Ito, Kazuyuki Matsumoto, Kyoko Osaka, Yoshihiro Kai, Rozzano Locsin, Savina Schoenhofer and Tetsuya Tanioka

Healthcare 2022, 10(8), 1571; https://doi.org/10.3390/healthcare10081571 - 18 Aug 2022

Cited by 15 | Viewed by 7625

Abstract

Technological advancements have led to the use of robots as prospective partners to complement understaffing and deliver effective care to patients. This article discusses relevant concepts on robots from the perspective of nursing theories and robotics in nursing and examines the distinctions between [...] Read more.

Technological advancements have led to the use of robots as prospective partners to complement understaffing and deliver effective care to patients. This article discusses relevant concepts on robots from the perspective of nursing theories and robotics in nursing and examines the distinctions between human beings and healthcare robots as partners and robot development examples and challenges. Robotics in nursing is an interdisciplinary discipline that studies methodologies, technologies, and ethics for developing robots that support and collaborate with physicians, nurses, and other healthcare workers in practice. Robotics in nursing is geared toward learning the knowledge of robots for better nursing care, and for this purpose, it is also to propose the necessary robots and develop them in collaboration with engineers. Two points were highlighted regarding the use of robots in health care practice: issues of replacing humans because of human resource understaffing and concerns about robot capabilities to engage in nursing practice grounded in caring science. This article stresses that technology and artificial intelligence are useful and practical for patients. However, further research is required that considers what robotics in nursing means and the use of robotics in nursing. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

12 pages, 286 KiB

Open AccessArticle

The Impact of the COVID-19 Pandemic on Inpatient Admissions for Psychotic and Affective Disorders: The Experience of a Large Psychiatric Teaching Hospital in Romania

by Vlad Dionisie, Adela Magdalena Ciobanu, Emanuel Moisa, Mihnea Costin Manea and Maria Gabriela Puiu

Healthcare 2022, 10(8), 1570; https://doi.org/10.3390/healthcare10081570 - 18 Aug 2022

Cited by 9 | Viewed by 1596

Abstract

The COVID-19 pandemic resulted in a global sanitary crisis and, in addition, elicited serious mental health consequences. The utilization of psychiatric hospital-based services acts as an indicator of public mental health. Therefore, this research sought to investigate differences in the numbers and characteristics [...] Read more.

The COVID-19 pandemic resulted in a global sanitary crisis and, in addition, elicited serious mental health consequences. The utilization of psychiatric hospital-based services acts as an indicator of public mental health. Therefore, this research sought to investigate differences in the numbers and characteristics of inpatient admissions for psychotic and affective disorders at the largest Romanian psychiatric hospital between the period of lockdown (16 March–15 May 2020) and another three corresponding periods: the same year in the pre-lockdown period (16 January–15 March 2020), the immediate post-lockdown period (16 May–15 July 2020), and two years later (16 March–15 May 2022). A retrospective analysis was performed. The study included a total of 6604 patients. Inpatient admissions decreased during lockdown in comparison with the pre-lockdown period and immediate post-lockdown period for psychotic disorders (p < 0.001 and p < 0.001, respectively) and affective disorders (p < 0.001 and p < 0.001, respectively). For both psychotic and affective disorders, a decrease in the age of the patients admitted during lockdown, as compared with the pre-lockdown period (p < 0.05 and p < 0.001, respectively), was observed. The length of the hospital stay for affective disorders was higher immediately post-lockdown in comparison with the lockdown period (p < 0.001). Collectively, the present findings provide a glimpse of the immediate and long-term consequences of the COVID-19 pandemic and lockdown measures on patients’ access to mental healthcare in the form of hospitalization, and these findings could provide the basis for the development of a different approach to times of crisis. Full article

(This article belongs to the Collection The Impact of COVID-19 on Healthcare Services)

13 pages, 3428 KiB

Open AccessArticle

Neuroendocrine Tumors: An Analysis of Prevalence, Incidence, and Survival in a Hospital-Based Study in Ecuador

by Karime Montes Escobar, Jose Luis Vicente-Villardon, Rosa Elisa Villacís Gonzalez, Paul Humberto Castillo Cordova, Johanna Mabel Sánchez Rodríguez, Melina De la Cruz-Velez and Aline Siteneski

Healthcare 2022, 10(8), 1569; https://doi.org/10.3390/healthcare10081569 - 18 Aug 2022

Cited by 4 | Viewed by 2029

Abstract

Neuroendocrine tumors (NETs) represent a heterogeneous malignancy group of neoplasms, with a limited amount of data from Latin America. Thus, this observational study aimed to provide data about the prevalence, incidence, and survival rates for NET in Ecuadorian hospitals. The study was conducted [...] Read more.

Neuroendocrine tumors (NETs) represent a heterogeneous malignancy group of neoplasms, with a limited amount of data from Latin America. Thus, this observational study aimed to provide data about the prevalence, incidence, and survival rates for NET in Ecuadorian hospitals. The study was conducted using data from the Society for the Fight Against Cancer (SOLCA). We evaluated patients with NETs (2000–2020) using the HJ-Biplot method and Cox proportional hazards. Annual age-adjusted incidence and limited-duration prevalence in multivariable analyses as well as hazard ratios (HRs) for mortality and survival were obtained. In the years 2000–2020, the age-adjusted incidence rate increased by 9-fold in the stomach and by 7-fold in the breast. The incidence rates were 1.38 per 100,000 persons in the lung and at 1.79 per 100,000 persons in gastroenteropancreatic sites (rectum, stomach, and pancreas). The prevalence increased from 0.0027% in 2000 to 0.0736% in 2019 and 0.0245% in 2020. Overall survival was worse for metastatic NETs (HR, 4.061; 95% CI, 1.932–8.540; p < 0.001) and advanced local NETs (HR, 2.348; 95% CI, 1.007–5.475 p < 0.048) than for localized NETs. In conclusion, the NET incidence increased in the last 20 years and survival decreased over time, especially for metastatic tumors in the pancreas and the nostril. Full article

(This article belongs to the Special Issue 2nd Edition of Cancer in Human Health and Healthcare)

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18 pages, 743 KiB

Open AccessArticle

Family Networks, Social Networks, and Life Satisfaction of Older Adults in China

by Weisong Cheng, Wenhao Song, Chunhui Ye and Zhonghan Wang

Healthcare 2022, 10(8), 1568; https://doi.org/10.3390/healthcare10081568 - 18 Aug 2022

Cited by 5 | Viewed by 2203

Abstract

Older adults’ family networks and social networks are important factors that influence life satisfaction, but their transmission mechanisms have not been adequately discussed. The objective of this study was to examine the mechanisms through which family networks and social networks influence the life [...] Read more.

Older adults’ family networks and social networks are important factors that influence life satisfaction, but their transmission mechanisms have not been adequately discussed. The objective of this study was to examine the mechanisms through which family networks and social networks influence the life satisfaction of older adults. We empirically examined the effects and mechanisms of older adults’ family networks and social networks on their life satisfaction using the 2018 China Longitudinal Aging Social Survey with a sample size of 11,418 older adults aged 60 years and older. In the research sample, 6.47% of older adults were subjected to at least one form of mistreatment. The research results indicate that family networks (β = 0.0060, p < 0.05) and social networks (β = 0.0122, p < 0.01) have a significant positive effect on older adults’ life satisfaction. The mechanism-of-action test found that family networks and social networks enhance older adults’ life satisfaction, mainly by reducing the level of physical mistreatment they experience, but these networks cannot improve the life satisfaction of the elderly by reducing their emotional mistreatment. Further research found that community-provided medical escorts, home chores, and meal delivery services can all alleviate the decline in life satisfaction among older adults due to emotional mistreatment. This study deepens our understanding of how older adults’ family and social networks affect their life satisfaction as we examine the mediating role of the physical and emotional mistreatment of older adults and discuss the effects of potential policy interventions. Full article

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13 pages, 265 KiB

Open AccessArticle

Knowledge of and Attitude towards Epilepsy among the Jordanian Community

by Sawsan M. A. Abuhamdah, Abdallah Y. Naser and Mohammed Ahmed R. Abualshaar

Healthcare 2022, 10(8), 1567; https://doi.org/10.3390/healthcare10081567 - 18 Aug 2022

Cited by 6 | Viewed by 1464

Abstract

Background: Epilepsy is a disorder characterized by recurring seizures that do not have an immediate identifiable cause. It is a disorder with complex symptoms and a wide range of risk factors, with age, genetics, and origin being the most prevalent variations. This study [...] Read more.

Background: Epilepsy is a disorder characterized by recurring seizures that do not have an immediate identifiable cause. It is a disorder with complex symptoms and a wide range of risk factors, with age, genetics, and origin being the most prevalent variations. This study aimed to evaluate the knowledge of and attitude towards epilepsy among the Jordanian community. Method: An online cross-sectional study using a self-administered questionnaire was conducted between 29 March and 15 May 2022 in Jordan. In this study, three previously validated questionnaire items were adapted and employed. Binary logistic regression was applied to identify predictors of good knowledge and a positive attitude. Results: A total of 689 participants were involved in this study. A weak level of knowledge about epilepsy was observed among the study participants (35.3%). The participants showed a moderately positive attitude towards epilepsy (63.3%). Being female, holding a bachelor’s degree, knowing anyone who had epilepsy and seeing anyone having an epileptic seizure were factors that positively affected participants’ knowledge about epilepsy. Being aged between 24 and 29 years or being divorced were factors that affected the participants’ attitudes negatively towards epilepsy. Conclusion: The study’s participants had limited knowledge of epilepsy and a favorable attitude toward it. The community’s understanding of epilepsy and attitude toward epilepsy patients should be improved by an informed educational effort on the part of various media platforms. All facets of the community, including parents, should be the focus of these initiatives. Full article

16 pages, 1217 KiB

Open AccessReview

The Role of Osteopathic Care in Gynaecology and Obstetrics: An Updated Systematic Review

by Nuria Ruffini, Giandomenico D’Alessandro, Annalisa Pimpinella, Matteo Galli, Tiziana Galeotti, Francesco Cerritelli and Marco Tramontano

Healthcare 2022, 10(8), 1566; https://doi.org/10.3390/healthcare10081566 - 18 Aug 2022

Cited by 3 | Viewed by 5216

Abstract

Background: Many efforts are made to find safer and more feasible therapeutic strategies to improve gynaecological care. Non-pharmacological treatments, such as osteopathic interventions, could be used as complementary strategies to better manage different gynaecological conditions. This review aims to report the effectiveness of [...] Read more.

Background: Many efforts are made to find safer and more feasible therapeutic strategies to improve gynaecological care. Non-pharmacological treatments, such as osteopathic interventions, could be used as complementary strategies to better manage different gynaecological conditions. This review aims to report the effectiveness of osteopathic treatment in the gynaecology and obstetrics field, updating the previous review published in 2016. The secondary aim was to elucidate the role of somatic dysfunction (SD) in osteopathic assessment and treatment procedures, as well as their health and economic implications. Methods: An electronic search was conducted in the following databases: Embase, MEDLINE (PubMed), and Science direct. All types of clinical studies published between May 2014 and December 2021 have been included: randomised controlled trial (RCT), controlled before/after, interrupted time series quasi RCT, case controls, case reports, case series, observational, clinical studies involving any type of osteopathic treatment, (standardised, semi-standardised or patients’ need-based treatment) performed alone or in combination with other treatments, were included). Results: A total of 76,750 were identified through database searching and other sources. After the removal of duplicates, 47,655 papers were screened based on title and abstract. A total of 131 full-text articles were consequently assessed for eligibility. Twenty-one new articles were included in the synthesis. A total of 2632 participants with a mean age of 28.9 ± 10.5 years were included in the review. Conclusions: Results showed an effectiveness of osteopathic care in gynaecology and obstetrics, but the studies were too heterogeneous to perform quantitative analysis and make clinical recommendations. Nevertheless, osteopathic care could be considered a safe complementary approach to traditional gynaecological care. Full article

(This article belongs to the Collection Osteopathic and Manual Therapy Healthcare Reconceptualization: Health Needs and New Evidence)

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