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Healthcare, Volume 11, Issue 14 (July-2 2023) – 139 articles

Cover Story (view full-size image): Medical students are a population at an increased risk of developing mental illness. International studies estimate that one in three students suffers from depression, anxiety, or burnout. To gain a better understanding of the situation in Portugal, we conducted the first-ever nation-wide study exploring the mental health of medical students, which led us to three main conclusions: approximately half of the students experience depressive symptoms, about a third experience anxiety symptoms, and belonging to a sexual or ethnic minority is a predictor for the development of psychological distress. These results are concerning and need to be addressed. To support our students, it is crucial to provide them with tools known to prevent distress, such as daily organization techniques and the prioritization of a strong social network. View this paper
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16 pages, 1988 KiB  
Article
Are All Societies Ready for Digital Tools? Feasibility Study on the Use of Mobile Application in Polish Early Breast Cancer Patients Treated with Perioperative Chemotherapy
by Grażyna Suchodolska, Anna Koelmer, Monika Puchowska and Elżbieta Senkus
Healthcare 2023, 11(14), 2114; https://doi.org/10.3390/healthcare11142114 - 24 Jul 2023
Cited by 2 | Viewed by 1453
Abstract
Background: The population of individuals affected by breast cancer is growing, and with advances in cancer treatment implemented into usual care, there is an urgent need to improve the recognition, monitoring and treatment of therapy-induced adverse effects. This study aims to explore the [...] Read more.
Background: The population of individuals affected by breast cancer is growing, and with advances in cancer treatment implemented into usual care, there is an urgent need to improve the recognition, monitoring and treatment of therapy-induced adverse effects. This study aims to explore the use of an in-app electronic questionnaire to assess and monitor chemotherapy-related symptoms in early breast cancer patients treated with perioperative chemotherapy. Method: Between December 2019 and June 2021, 72 female study participants used the mobile app Centrum Chorób Piersi UCK and completed an in-app questionnaire about the 14 most common chemotherapy-related symptoms. Replies including symptoms with a critical value triggered automatic email alerts to the nursing team. Results: Acceptance of the study was higher among younger women and patients originating from rural areas, while possible digital exclusion among patients >60 years was observed during the enrolment process. A total of 55 participants completed the electronic questionnaire at least once and generated 553 responses with 1808 specific problems reported. Fatigue (n = 428) was the most common problem, and fever (n = 5) the least reported problem. A total of 21 participants triggered alerts with responses containing symptoms with critical value assessment (n = 89). Significant negative correlation was observed between the number of responses and time from the first chemotherapy administration; however, the number of responses was not determined by any sociodemographic or medical factors. Significant positive correlations were identified between the number of communicated problems and participants’ age. The usage of our electronic symptom assessment questionnaire decreased substantially after the period of active encouragement during the study enrolment. Conclusions: Not all societies are ready for innovative eHealth solutions. Patients’ age should be carefully considered when app-based interventions are introduced to usual cancer care. Additional support is suggested for older patients to improve their awareness and participation in eHealth interventions. More research involving older participants is needed to explore and address their particular needs and perspectives on eHealth solutions. Full article
(This article belongs to the Special Issue Digital Health for Equity)
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12 pages, 690 KiB  
Study Protocol
Effects of a 4-Week After-School Physical Literacy Program on Health-Related Quality of Life and Symptomatology in Schoolchildren with ADHD: A Study Protocol
by José Ignacio Calzada-Rodríguez, María Mendoza-Muñoz, Raquel Pastor-Cisneros, Sabina Barrios-Fernandez, Jorge Carlos-Vivas, Rafael Gómez-Galán and Laura Muñoz-Bermejo
Healthcare 2023, 11(14), 2113; https://doi.org/10.3390/healthcare11142113 - 24 Jul 2023
Viewed by 1128
Abstract
Research has shown that physical activity programs led to improvements in children with Attention Deficit Hyperactivity Disorder (ADHD). However, no study evaluating the impact of a physical literacy (PL) program has been conducted. This study aims to examine PL and the effects of [...] Read more.
Research has shown that physical activity programs led to improvements in children with Attention Deficit Hyperactivity Disorder (ADHD). However, no study evaluating the impact of a physical literacy (PL) program has been conducted. This study aims to examine PL and the effects of an after-school PL program on Health-related quality of life (HRQoL) and ADHD symptomatology including quality and sustained attention. A parallel-group randomised controlled trial will be conducted assessing PL, HRQoL and ADHD symptomatology, both at the beginning and the end of the PL after-school program implementation. The program will last 4 weeks, including two sessions per week lasting 55 min. Sessions will be divided into several parts: greeting (5 min), block I (20 min), block II (20 min) and relaxation and feedback (10 min). Block I will focus on the acquisition of content that contributes to the development of the domains of knowledge and understanding and daily activity; and block II, in addition to favouring physical competence, will seek to improve motivation. If this program proves its effectiveness, it could be an alternative to be included in educational systems, representing a scientific breakthrough regarding physical activity adherence and inactivity-related disease prevention, HRQoL and management of ADHD-associated symptomatology. Full article
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22 pages, 1794 KiB  
Article
COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?
by Preshit Nemdas Ambade, Kednapa Thavorn and Smita Pakhale
Healthcare 2023, 11(14), 2112; https://doi.org/10.3390/healthcare11142112 - 24 Jul 2023
Cited by 1 | Viewed by 1207
Abstract
Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown’s impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 [...] Read more.
Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown’s impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 March–31 May 2020), we modeled the epidemic’s trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. Results: The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, −15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, –204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Conclusion: Maharashtra’s early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India. Full article
(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
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10 pages, 621 KiB  
Protocol
Effects of Acupressure on Maternal and Neonatal Obstetric Outcomes during Labor: Study Protocol
by Miguel Ángel Carmona-Rodríguez, Salvador Martínez-Flores, Rubén Morilla-Romero-de-la-Osa and Manuel Luque-Oliveros
Healthcare 2023, 11(14), 2111; https://doi.org/10.3390/healthcare11142111 - 24 Jul 2023
Viewed by 2192
Abstract
Background. A Cochrane review found that there is insufficient evidence to determine the effectiveness of acupressure for pain relief. One of the problems detected is the methodological variability reported. Objective. To assess the impact of the application of acupressure on obstetric and neonatal [...] Read more.
Background. A Cochrane review found that there is insufficient evidence to determine the effectiveness of acupressure for pain relief. One of the problems detected is the methodological variability reported. Objective. To assess the impact of the application of acupressure on obstetric and neonatal outcomes of labor, pain experience, and mother’s satisfaction with the experience. Method. Design of a protocol to carry out a two-arm multicenter single-blinded randomized controlled trial. Intervention (pressure on LI4 of the left hand, B6 of the left leg, GB21 of the left shoulder, and then the same sequence on the right side) and placebo (application of the technique on points not identified by acupuncture as key points) will be performed by a single researcher. Results. The recruitment began in April 2021 and, to date, there has been the participation of 40 women, divided into 17 included in the experimental group and 23 in the control. Communication of future results will be made in accordance with the CONSORT checklist. Conclusions. The designed protocol could methodologically improve some aspects of previous studies while maintaining adequate statistical power. The effectiveness of acupressure for one or more outcomes proposed (time and pain in labor) could support the inclusion of a new therapeutic tool in the clinical practice of midwives that would allow them to assist pregnant women, improving their experience both physically and psycho-emotionally Full article
(This article belongs to the Section Nursing)
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12 pages, 1396 KiB  
Article
Framework Development of Non-Face-to-Face Training of Basic Life Support for Laypersons: A Multi-Method Study
by Sangsoo Han, Choung Ah Lee, Won Jung Jeong, JuOk Park and Hang A Park
Healthcare 2023, 11(14), 2110; https://doi.org/10.3390/healthcare11142110 - 24 Jul 2023
Viewed by 938
Abstract
The spread of infectious diseases has accelerated the transition from face-to-face (F2F) to non-F2F (NF2F) education. To maintain the effect of successful NF2F education in cardiopulmonary resuscitation, reorganizing the curriculum to suit the NF2F educational environment is necessary. We propose an appropriate learning [...] Read more.
The spread of infectious diseases has accelerated the transition from face-to-face (F2F) to non-F2F (NF2F) education. To maintain the effect of successful NF2F education in cardiopulmonary resuscitation, reorganizing the curriculum to suit the NF2F educational environment is necessary. We propose an appropriate learning curriculum for NF2F basic life support (BLS) training for laypersons based on expert surveys and learners’ performance outcomes. This study included three stages and used multiple methods. A draft curriculum was created through a literature review and three-round Delphi approach, and then applied as a test for actual education. After the training, the final curriculum of the NF2F BLS training for laypersons was proposed by reflecting on the performance outcomes of learners and expert opinions. NF2F theoretical education was simplified into five content items: concept of chain of survival, legal protection for first aiders, importance of bystander cardiopulmonary resuscitation, how to recognize a patient in cardiac arrest and activate the emergency medical services system, and reduced training time. In the hands-on skills session, it was recommended to practice chest compressions using a simple intuitive feedback device and to use automated external defibrillators step-by-step more than in F2F training. In conclusion, NF2F training is a suitable option for BLS training methods in situations where F2F training is difficult. Full article
(This article belongs to the Special Issue Innovation in Healthcare Education)
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15 pages, 306 KiB  
Review
Facing HCV as a Major Public Healthcare Threat in Italy: Epidemiology and Micro-Elimination Pathways among Underserved Populations
by Vito Fiore, Valentina Manca, Agnese Colpani, Andrea De Vito, Ivana Maida, Giordano Madeddu and Sergio Babudieri
Healthcare 2023, 11(14), 2109; https://doi.org/10.3390/healthcare11142109 - 24 Jul 2023
Cited by 1 | Viewed by 829
Abstract
Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated [...] Read more.
Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated people, patients with psychiatric disorders, and migrants. A narrative review of literature was performed using key electronic databases (Scopus, Pubmed—MEDLINE) and search engines (Google Scholar). Peer-reviewed publications, grey literature on HCV, and recent models proposed for micro-elimination in underserved populations were included. An insight into the COVID-19 pandemic and its influence on HCV micro-elimination pathways will be also provided. Regarding prison settings, a progressive reduction in HCV epidemiology among incarcerated people in the last years was found (one-third of the level it had been before). People suffering from psychiatric disorders have a high anti-HCV prevalence, but there is a lack of data on active infections. A bidirectional relationship between HCV and psychiatric disorders was found. Migrants showed a very inconsistent assessment of HCV. Furthermore, available studies recorded data from populations with high heterogeneity of anti-HCV prevalence, Therefore, the reported results need caution in their evaluation. Full article
15 pages, 9250 KiB  
Review
A Bibliometric Analysis of Research on Temporomandibular Joint Disc Displacement from 1992 to 2022
by Qiuhao Wang, Jin Jia, Changhan Zhou, Wang Ye and Ruiye Bi
Healthcare 2023, 11(14), 2108; https://doi.org/10.3390/healthcare11142108 - 24 Jul 2023
Viewed by 1267
Abstract
The temporomandibular joint (TMJ) disc displacement is the most common temporomandibular disorders (TMD) condition. It causes clicking, pain, limited mandibular movements, and even masticatory difficulties in many people. The aim of this study is showcasing hotspots and frontiers in the field and providing [...] Read more.
The temporomandibular joint (TMJ) disc displacement is the most common temporomandibular disorders (TMD) condition. It causes clicking, pain, limited mandibular movements, and even masticatory difficulties in many people. The aim of this study is showcasing hotspots and frontiers in the field and providing a reference for the future research by a bibliometric analysis. Studies published from 1992 to 2022 were retrieved from Web of Science Core Collection on 23 April 2023. A total of 1882 studies (1739 articles and 143 reviews) were included in the bibliometric analysis. From 1992 to 2022, the annual number of publications and citations greatly increased. The United States of America (USA) contributed the most publications about TMJ disc displacement. Shanghai Jiao Tong University was the most productive institution; meanwhile, Yang, C. from this institution was the most prolific author. The University of Washington was the most influential institution, and Brooks, S. was the most influential author. Diagnostic criteria and management of TMJ disc displacement, as well as TMJ disc displacement-associated conditions, might be a hotspot for current global research. We provided an objective and valuable reference for future research on TMJ disc displacement. Full article
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14 pages, 587 KiB  
Article
Advanced Activities of Daily Living in Community-Dwelling Older Adults: A Cross-Sectional Study of the Mexican Health and Aging Study (MHAS 2018)
by Martha A. Sánchez-Rodríguez, Mariano Zacarías-Flores, Elsa Correa-Muñoz and Víctor Manuel Mendoza-Núñez
Healthcare 2023, 11(14), 2107; https://doi.org/10.3390/healthcare11142107 - 24 Jul 2023
Viewed by 1703
Abstract
Background: The advanced activities of daily living (AADLs) in old age is a key indicator of the mobility domain for the intrinsic capacity of older adults living in the community; for this reason, it is relevant to know the prevalence and risk factors [...] Read more.
Background: The advanced activities of daily living (AADLs) in old age is a key indicator of the mobility domain for the intrinsic capacity of older adults living in the community; for this reason, it is relevant to know the prevalence and risk factors related to performing fewer AADLs in different populations. Aim: To determine the prevalence and factors associated with the ability to perform AADLs in older adults reported in the Mexican Study of Health and Aging (MSHA 2018). Methods: A secondary cross-sectional analysis of the MSHA 2018 data was carried out, including a convenience sample of 6474 subjects ≥ 60 years of age, for both sexes, without cognitive deficits. Nine questions related to AADLs were selected from the database. Multiple logistic regression analysis was performed to determine factors associated with <3 AADLs, including sociodemographic, lifestyle, and health status factors. Results: The prevalence of the ability to perform <3 AADLs was 63%. Age is the most important risk factor for <3 AADLs, which increases by the decade, followed by sedentary lifestyle (OR = 2.15, 95% CI: 1.91–2.42, p < 0.0001). Conclusions. Our findings suggest that age, schooling, urban residence, sedentary lifestyle, and comorbidity are the main risk factors for <3 AADLs in older Mexican adults. Full article
(This article belongs to the Special Issue Intrinsic Capacity and Healthy Aging)
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27 pages, 634 KiB  
Systematic Review
Prescription and Effects of Cardiorespiratory Training in Individuals with Intellectual Disability: A Systematic Review
by Miguel Jacinto, Rafael Oliveira, Alexandre D. Martins, João Paulo Brito, Rui Matos and José Pedro Ferreira
Healthcare 2023, 11(14), 2106; https://doi.org/10.3390/healthcare11142106 - 24 Jul 2023
Cited by 1 | Viewed by 1182
Abstract
This study aims to systematize effects of cardiorespiratory training (CT) programs in individuals with intellectual disability (ID) and identifying the fundamental and structuring aspects for the prescription of CT. This systematic review was carried out through four databases (Pubmed, Web of Science, Scopus, [...] Read more.
This study aims to systematize effects of cardiorespiratory training (CT) programs in individuals with intellectual disability (ID) and identifying the fundamental and structuring aspects for the prescription of CT. This systematic review was carried out through four databases (Pubmed, Web of Science, Scopus, and SPORTDiscus), considering data from the period between 2013 and 2022. From 257 studies, 12 studies were included in this systematic review. Three studies used interval CT, while seven used continuous CT. Seven were carried out in the population with Down syndrome, while only three were carried out with participants with ID. The CT programs had the following characteristics: duration of 8 to 12 weeks, weekly frequency of three sessions, for 20 to 60 min, the intensity of 50% to 80% of maximal heart rate or 70% to 80% of peak oxygen consumption, using an ergometer cycle or an outdoor walking. The studies reported improvements in cardiorespiratory function, lipid, hemodynamic and metabolic profile, body composition, and neuromuscular and cognitive capacity. This review presents characteristics and recommendations that technicians can follow when structuring, prescribing, and implementing CT programs to individuals with ID. Full article
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12 pages, 396 KiB  
Article
Effects of Community Environment, Leisure, and Social Activities on Health Status of Older Adults with Diabetes in South Korea
by Jiyoun Kim, Yoonho Ra and Eunsurk Yi
Healthcare 2023, 11(14), 2105; https://doi.org/10.3390/healthcare11142105 - 24 Jul 2023
Cited by 2 | Viewed by 1137
Abstract
This study investigates the effects of community environment, leisure, and social activities on the health status of older adults with diabetes, a serious disease in modern society. Data from the 2020 National Survey of Older Koreans were analyzed. Descriptive statistics were used to [...] Read more.
This study investigates the effects of community environment, leisure, and social activities on the health status of older adults with diabetes, a serious disease in modern society. Data from the 2020 National Survey of Older Koreans were analyzed. Descriptive statistics were used to assess participants’ characteristics, and regression analyses were conducted to assess the effects of community environment, leisure, and social activities. Mediating effects were tested using hierarchical regression analysis and bootstrapping. The key results are as follows. (a) Community environmental satisfaction affected participation in leisure and social activities. (b) Community accessibility had a negative effect on subjective health, while community environmental satisfaction had a positive effect on subjective health, cognitive function, and chronic diseases. (c) Leisure activities had a positive effect on cognitive health, while social activities influenced subjective health, cognitive function, and chronic diseases. (d) Analysis of the mediating effect of leisure and social activities on the relationship between the community environment and health status of older adults with diabetes confirmed a partial mediating effect. To improve older adults’ mental and physical health, mere quantitative increases in the community environment will not be sufficient. It is necessary to cultivate and manage professionals to increase opportunities for participation by increasing social exchanges and systematically managing older adults’ health. Full article
(This article belongs to the Special Issue The Effects of Social Relationships on Health in Old Age)
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17 pages, 2005 KiB  
Article
Implications in Halotherapy of Aerosols from the Salt Mine Targu Ocna—Structural-Functional Characteristics
by Mihaela Orlanda Antonovici (Munteanu), Ioan Gabriel Sandu, Viorica Vasilache, Andrei Victor Sandu, Stefanita Arcana, Raluca Ioana Arcana and Ion Sandu
Healthcare 2023, 11(14), 2104; https://doi.org/10.3390/healthcare11142104 - 24 Jul 2023
Viewed by 959
Abstract
The paper presents the evolution of the concentration level for four particle size groups of microaerosols (1.0, 2.5, 4.0 and 10.0 µm) in correlation with the microclimatic characteristics (temperature, humidity, lighting, pressure and concentration in CO2 and O2) in three [...] Read more.
The paper presents the evolution of the concentration level for four particle size groups of microaerosols (1.0, 2.5, 4.0 and 10.0 µm) in correlation with the microclimatic characteristics (temperature, humidity, lighting, pressure and concentration in CO2 and O2) in three active areas of the Targu Ocna Saltworks, currently used in treatments with solions (hydrated aerosols): in the vicinity of the walls of the old mining salt room, where there is a semi-wet static regime (SSR); in the transition area between the old rooms of exploitation with the semi-wet dynamic regime (DSR); and in the area of the waterfall and the marshy lake with the dynamic wet regime (DWR). The first and last halochamber are the ones recommended for cardio–respiratory, immuno–thyroid and osteo–muscular conditions, as well as in psycho–motor disorders. Based on questionnaires carried out over the course of a year, between 1 September 2021–31 August 2022, in two periods of stationing/treatment: a cold one (15 September 2021–15 December 2021) and a warm one (1 May 2022–30 July 2022), correlated with the data from the Salina medical office, achieved the profile of the improvement rate of the patients’ ailments depending on the type of treatment (working regime in halochambers). These studies have allowed the optimization of the treatment conditions in the artificial surface halochambers in order to reduce the stationary period and optimize the treatment cycles. Full article
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23 pages, 1288 KiB  
Article
Exploring the Interrelationships between Public Health, Fiscal Decentralization, and Local Government Debt in China
by Mingyao Cao, Keyi Duan, Mingyu Cao and Haslindar Ibrahim
Healthcare 2023, 11(14), 2103; https://doi.org/10.3390/healthcare11142103 - 24 Jul 2023
Viewed by 953
Abstract
This paper investigates the interrelationships among local government debt, fiscal decentralization, and public health. The investigation begins by constructing a theoretical model to analyze the inherent connections between these variables. Subsequently, an empirical analysis is conducted using data from China between 2015 and [...] Read more.
This paper investigates the interrelationships among local government debt, fiscal decentralization, and public health. The investigation begins by constructing a theoretical model to analyze the inherent connections between these variables. Subsequently, an empirical analysis is conducted using data from China between 2015 and 2021. The findings demonstrate a bidirectional relationship between fiscal decentralization, local government debt, and public health. Specifically, it is observed that an increase in local government debt has adverse effects on both fiscal decentralization and public health, while fiscal decentralization has a positive impact on public health. These insights are consistently validated through rigorous regression methodologies, affirming the robustness and significance of these relationships. Full article
(This article belongs to the Section Health Policy)
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15 pages, 517 KiB  
Article
Evaluating Standardized Job Competencies for Managing Students at Risk for Anaphylaxis in Elementary School Nurses
by Yeon-Ha Kim and Aee Lee Kim
Healthcare 2023, 11(14), 2102; https://doi.org/10.3390/healthcare11142102 - 24 Jul 2023
Viewed by 783
Abstract
This study aimed to evaluate standardized job competencies of elementary school nurses in managing the health of students at risk for anaphylaxis (SRAs). A total of 166 elementary school nurses from across Korea participated in this study. The tool utilized was a list [...] Read more.
This study aimed to evaluate standardized job competencies of elementary school nurses in managing the health of students at risk for anaphylaxis (SRAs). A total of 166 elementary school nurses from across Korea participated in this study. The tool utilized was a list of standardized job tasks of elementary school nurses in managing SRAs’ health. Seven factors were obtained from the factor analysis, with a cumulative variance explained of 68.6%. The importance–performance analysis method was employed to suggest priority areas for training. The factors placed in quadrant II included: (1) “offering psychological support”, among elementary school nurses who have been provided with clinical information on anaphylaxis, (2) “providing emergency care”, among those who have not been provided with clinical information on anaphylaxis, (3) the factors “utilizing individualized healthcare plans”, “conducting health education and staff training”, and “evaluating the student”, among those who agreed that schools need legal protection to purchase epinephrine auto-injectors, and (4) the factor “preparing a school emergency system”, among those with less than five years of experience as a school nurse. When planning continuing education strategies to improve elementary school nurses’ management of SRAs, factors such as career experience, access to clinical information, and beliefs regarding legal protection for schools to purchase epinephrine auto-injectors should be considered. Full article
(This article belongs to the Section School Health)
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12 pages, 296 KiB  
Article
Assessing the Impact of COVID-19 Prevention Measures on Adolescent Growth in Italy
by Luciana Zaccagni, Natascia Rinaldo, Gianni Mazzoni, Simona Mandini, Sabrina Masotti, Stefania Toselli, Federica De Luca and Emanuela Gualdi-Russo
Healthcare 2023, 11(14), 2101; https://doi.org/10.3390/healthcare11142101 - 24 Jul 2023
Cited by 2 | Viewed by 998
Abstract
COVID-19 infection has caused increased morbidity and mortality worldwide. Several strategies have been adopted around the world to prevent its spread. Italy underwent a long lockdown for face-to-face educational activities, which were replaced with online classes. This longitudinal study aimed to analyze the [...] Read more.
COVID-19 infection has caused increased morbidity and mortality worldwide. Several strategies have been adopted around the world to prevent its spread. Italy underwent a long lockdown for face-to-face educational activities, which were replaced with online classes. This longitudinal study aimed to analyze the effects of COVID-19 prevention measures on physical growth and body image perception in a sample of Italian adolescents who experienced the pandemic-induced lockdown in 2020. In particular, we wished to ascertain how lifestyle changes had affected their growth rates and health. Special attention was paid to increases in adiposity indicators (BMI, waist circumference, waist-to-height ratio) and weight caused by reduced physical activity, and consequent possible dissatisfaction with body image. We assessed the impact of school closures by comparing the annual growth rate and body image perception changes of adolescents (n = 60; age = 11.3 ± 0.4 years) who experienced this isolation with those in the following years who did not experience these restrictions (n = 68; age = 11.4 ± 0.3 years). As a consequence of the lockdown, our results indicate a greater annual growth rate in weight and other indices of adiposity (p < 0.05). As the virus is continuing to evolve and propagate, larger population studies can verify and confirm our findings. In promoting health policy to prevent the ongoing prevalence of obesity in adolescents, an accurate assessment of whether the increase in obesity rates during the pandemic is to be considered a temporary trend is highly recommended. Full article
10 pages, 491 KiB  
Article
Persistent Pain as an Early Indicator for Operative Carpal Tunnel Revision after Primary Release: A Retrospective Analysis of Recurrent and Persistent Carpal Tunnel Syndrome
by Daniel Georg Gmainer, Andrzej Hecker, Petra Brinskelle, Alexander Draschl, Patrick Reinbacher, Lars-Peter Kamolz and David Benjamin Lumenta
Healthcare 2023, 11(14), 2100; https://doi.org/10.3390/healthcare11142100 - 24 Jul 2023
Viewed by 1051
Abstract
Background: Prolonged symptoms of carpal tunnel syndrome (CTS) after primary carpal tunnel release (CTR) can reduce the quality of life and lead to multiple referrals across specialties. The following study aimed to identify differences in symptoms, signs, and intraoperative findings between recurrent and [...] Read more.
Background: Prolonged symptoms of carpal tunnel syndrome (CTS) after primary carpal tunnel release (CTR) can reduce the quality of life and lead to multiple referrals across specialties. The following study aimed to identify differences in symptoms, signs, and intraoperative findings between recurrent and persistent CTS cases to avoid undesired outcomes after primary CTR. Methods: A retrospective analysis was conducted on revision CTRs performed between 2005 and 2015 using literature-based definitions for recurrent (a relapse of symptoms occurs following a symptom-free period of ≥3 months) and persistent (symptoms persisting longer than three months after surgical release) CTS. The parameters assessed were symptoms, clinical signs, and intraoperative findings. Results: Out of 53 cases, 85% (n = 45) were external referrals, whereby our own revision rate was 0.67% (n = 8/1199). Paresthesia and numbness were frequent in both groups; however, abnormal postoperative pain was reported more often in persistent cases (86%; n = 30/35) in comparison to recurrent cases (50%; n = 9/18; p = 0.009). Scarring around the median nerve was observed in almost all recurrent cases (94%; n = 17/18) and in 40% (n = 14/35) of persistent cases (p < 0.001). Incomplete division of the palmar ligament was the primary cause for revision in the persistent cohort (49%; n = 17/35). Conclusions: For patients experiencing symptoms for more than three months after CTR, primarily presenting as pain, it is advisable to consider referring the patient to a certified hand clinic for additional evaluation. Full article
(This article belongs to the Special Issue Perspectives on Plastic, Reconstructive and Hand Surgery)
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15 pages, 280 KiB  
Article
Predictors of Nursing Faculty Job and Career Satisfaction, Turnover Intentions, and Professional Outlook: A National Survey
by Sheila A. Boamah, Michael E. Kalu, Farinaz Havaei, Kimberly McMillan and Emily Belita
Healthcare 2023, 11(14), 2099; https://doi.org/10.3390/healthcare11142099 - 24 Jul 2023
Cited by 4 | Viewed by 2274
Abstract
Background: Retaining talented and experienced nurses in clinical practice and academia is crucial for maintaining continuity, ensuring high-quality care and education, and fostering a positive work environment. Although factors influencing nursing staff retention are well documented, little is known about how workplace factors [...] Read more.
Background: Retaining talented and experienced nurses in clinical practice and academia is crucial for maintaining continuity, ensuring high-quality care and education, and fostering a positive work environment. Although factors influencing nursing staff retention are well documented, little is known about how workplace factors impact nursing faculty retention outcomes. Methods: A national survey involving 645 nursing faculty across Canada was undertaken. Multivariate regression analysis with interaction effects was conducted to determine the association between work-related factors (i.e., workplace culture and work–life imbalance) and faculty job and career satisfaction, turnover intentions, and professional outlook. Results: Supportive workplace culture positively influenced faculty job and career satisfaction and professional outlook, while it negatively impacted turnover intentions. Conversely, work–life imbalance decreased faculty job and career satisfaction and professional outlook (i.e., confidence in nursing program, profession), and it increased intentions to leave the job. Conclusion: Our results offer insights into the work–life experiences of Canadian faculty members and shed light on key factors that impact their job-related outcomes. In the context of competing resources, every effort must be made to improve modifiable workplace factors such as the academic work environment and create targeted interventions and policies to promote faculty retention. Full article
(This article belongs to the Special Issue Job Satisfaction and Mental Health of Workers)
14 pages, 1482 KiB  
Systematic Review
Between Resilience and Agency: A Systematic Review of Protective Factors and Positive Experiences of LGBTQ+ Students
by Telmo Fernandes, Beatriz Alves and Jorge Gato
Healthcare 2023, 11(14), 2098; https://doi.org/10.3390/healthcare11142098 - 23 Jul 2023
Cited by 3 | Viewed by 2289
Abstract
A negative school climate resulting from homophobic and transphobic bias and discrimination is associated with poor well-being and mental health among LGBTQ+ youth. However, protective factors and mechanisms may buffer against the impact of stigmatization. Drawing on the socio-ecological model, minority stress theory, [...] Read more.
A negative school climate resulting from homophobic and transphobic bias and discrimination is associated with poor well-being and mental health among LGBTQ+ youth. However, protective factors and mechanisms may buffer against the impact of stigmatization. Drawing on the socio-ecological model, minority stress theory, and positive youth development and agency perspectives, we carried out a systematic review of research focusing on factors that can promote the well-being of LGBTQ+ students in educational settings, outlining the primary outcomes from studies published between 2012 and 2022. The PRISMA protocol was used for this review, and 64 articles were scrutinized. The results of the thematic analysis revealed that both external factors (school-inclusive policies and extracurricular activities; social support from school, family, and the community; and school connectedness) and internal factors (psychosocial characteristics and personal agency) promote positive school experiences, such as the exploration of sexual and gender identities in a safe environment. The present findings highlight the need for inclusive school policies and strategies and individual-level interventions that target the well-being and positive mental health outcomes of sexual and gender minority students. Full article
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16 pages, 1111 KiB  
Article
Impact of Vitamin D Deficiency on Mental Health in University Students: A Cross-Sectional Study
by Mansour Almuqbil, Moneer E. Almadani, Salem Ahmad Albraiki, Ali Musharraf Alamri, Ahmed Alshehri, Adel Alghamdi, Sultan Alshehri and Syed Mohammed Basheeruddin Asdaq
Healthcare 2023, 11(14), 2097; https://doi.org/10.3390/healthcare11142097 - 23 Jul 2023
Cited by 1 | Viewed by 4477
Abstract
Students pursuing a university education are vulnerable to psychological burdens such as depression, anxiety, and stress. The frequency of vitamin D deficiency, on the other hand, is extensively recognized worldwide, and vitamin D regulates various neurological pathways in the brain that control psychological [...] Read more.
Students pursuing a university education are vulnerable to psychological burdens such as depression, anxiety, and stress. The frequency of vitamin D deficiency, on the other hand, is extensively recognized worldwide, and vitamin D regulates various neurological pathways in the brain that control psychological function. Therefore, the goal of this cross-sectional study was to determine the relationship between vitamin D deficiency and psychological burden among university students in Riyadh, Saudi Arabia. During March–May 2021 in Riyadh, a cross-sectional comparative study survey was delivered to university students. The DASS-21 scale was used to determine the severity of the psychological burden. Both univariate and binomial regression analyses were conducted to analyze the level of significance and influence of several factors on the development of psychological burden. The data were analyzed with SPSS-IBM, and a p value of <0.05 was considered significant. Of the 480 students recruited for the study, 287 (59.79%) had a vitamin D deficiency. Significantly (p = 0.048), a high proportion of the vitamin D-deficient students attained a low or moderate GPA compared to the control cohort. The prevalence of depression, anxiety, and stress among the vitamin D-deficient students was 60.35%, 6.31%, and 75.08%, respectively, which was significantly (p < 0.05) different from the control group. The odds of developing depression (OR = 4.96; CI 2.22–6.78; p < 0.001), anxiety (OR = 3.87; CI 2.55–6.59; p < 0.001), and stress (OR = 4.77; CI 3.21–9.33; p < 0.001) were significantly higher in the vitamin D-deficient group. The research shows a strong association between psychological stress and vitamin D deficiency. To promote the mental health and psychological wellbeing of university students, it is critical to create awareness about the adequate consumption of vitamin D. Additionally, university students should be made aware of the likelihood of a loss in academic achievement owing to vitamin D deficiency, as well as the cascade effect of psychological burden. Full article
(This article belongs to the Special Issue The Role of Nutrition in Healthcare)
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11 pages, 273 KiB  
Article
Characteristics of Stress and Burnout among Lithuanian University Coaches: A Pre-Pandemic Coronavirus and Post-Pandemic Period Comparison
by Romualdas Malinauskas and Vilija Malinauskiene
Healthcare 2023, 11(14), 2096; https://doi.org/10.3390/healthcare11142096 - 23 Jul 2023
Cited by 1 | Viewed by 1013
Abstract
(1) Background: The majority of studies analyzing associations between burnout, gender, and perceived stress have utilized a cross-sectional design. This present longitudinal study investigated associations between burnout, perceived stress, and gender compared during the pre-pandemic Coronavirus and post-pandemic period among Lithuanian university coaches. [...] Read more.
(1) Background: The majority of studies analyzing associations between burnout, gender, and perceived stress have utilized a cross-sectional design. This present longitudinal study investigated associations between burnout, perceived stress, and gender compared during the pre-pandemic Coronavirus and post-pandemic period among Lithuanian university coaches. (2) Methods: 214 university coaches were randomly selected for the study. Study participants completed two measurements: one pre-pandemic and the second post-pandemic. (3) Results: Gender differences were identified on all burnout elements but not on perceived stress. Repeated measures (RM) multivariate analysis of variance (MANOVA) results did not show a significant effect for the interaction between gender and time. Results of hierarchical (stepwise) regression analyses revealed that perceived stress after the pandemic predicted burnout levels for all three burnout components (exhaustion, depersonalization, and reduced accomplishment) after the pandemic. (4) Conclusions: The current study contributes to the understanding of burnout components in relation to perceived stress through a longitudinal approach using a representative sample of Lithuanian university coaches. Full article
14 pages, 275 KiB  
Article
Effects of an Orff Music Activity Intervention Program on the Ego-Resilience, Peer Relationships, Happiness, Interpersonal Care Awareness, Anxiety, and Stress of Children from Multicultural Families in Republic of Korea
by Su-Hee Kim and Sook Lee
Healthcare 2023, 11(14), 2095; https://doi.org/10.3390/healthcare11142095 - 23 Jul 2023
Cited by 1 | Viewed by 1364
Abstract
This study developed an interpersonal care-based Orff music activity program for children from multicultural families in Republic of Korea. We measured its effects on ego-resilience, peer relationships, happiness, interpersonal care awareness, anxiety, and stress. The participants were 74 children from third to sixth [...] Read more.
This study developed an interpersonal care-based Orff music activity program for children from multicultural families in Republic of Korea. We measured its effects on ego-resilience, peer relationships, happiness, interpersonal care awareness, anxiety, and stress. The participants were 74 children from third to sixth grade attending 10 regional children’s centers in Cheonan-si, Chungcheongnam-do Province, Republic of Korea. They were randomly assigned to 36 experimental groups and 38 control groups. The experimental program was developed based on investigations of human care theory, expressions of care, and Orff music activities. The experiment was conducted twice a week for five weeks in 45 min sessions. Data were collected from June to September 2020. We used questionnaires on ego-resilience, peer relationships, happiness, and interpersonal care awareness to measure the effects, which were analyzed through frequency and descriptive statistics. Anxiety, physiological anxiety, acculturation stress, and physiological stress were measured using Behavior Detection VibraImage System Version 8.1 PRO (VIBRASYSTEM Ltd., Co., Seoul, Republic of Korea). The homogeneity of the variables across groups was examined using the χ² test, t-test, and Fisher’s exact test. The effects were examined using repeated measures variance analysis and independent t-tests. The results showed that the program had significant effects on ego-resilience, peer relationships, happiness, interpersonal care awareness, physiological anxiety, and physiological stress. The findings suggest that interpersonal care nursing can be effective for children from multicultural families, and the program can be used for intervention to improve children’s mental health. Full article
13 pages, 1181 KiB  
Article
Reliability and Accuracy of YouTube Peri-Implantitis Videos as an Educational Source for Patients in Population-Based Prevention Strategies
by Federica Di Spirito, Francesco Giordano, Maria Pia Di Palo, Davide Cannatà, Marco Orio, Nicoletta Coppola and Rossella Santoro
Healthcare 2023, 11(14), 2094; https://doi.org/10.3390/healthcare11142094 - 23 Jul 2023
Cited by 3 | Viewed by 999
Abstract
Considering the need to improve patient knowledge, awareness, and compliance for peri-implantitis prevention, and patients’ demand for better, quick, and convenient access to medical information, the present study primarily assessed the reliability and accuracy of YouTube videos on peri-implantitis and secondarily evaluated their [...] Read more.
Considering the need to improve patient knowledge, awareness, and compliance for peri-implantitis prevention, and patients’ demand for better, quick, and convenient access to medical information, the present study primarily assessed the reliability and accuracy of YouTube videos on peri-implantitis and secondarily evaluated their educational value for the patients, and the related suitability, as part of population-based preventive strategies, to deliver valid information, potentially capable of improving patient knowledge and educational skills. This study’s protocol was developed in advance, and computer history and cookies were cleared to avoid limitations based on preferred user histories. The search term “peri-implantitis” was defined using the Google Trends website, and videos were searched on YouTube on 5 December 2022. Video inclusion and data collection were conducted by independent pre-calibrated investigators. Descriptive statistics were performed on the videos’ characteristics, source, category, target audience, popularity, source reliability, video information and quality (VIQI), content, and educational value. Pearson’s correlation between educational value and all parameters was calculated. Videos with very low/low and medium/good/excellent educational value were compared using the Mann–Whitney U test. A total of 44 videos with medium values for popularity, VIQI, content, and educational value were analyzed. Most videos covered peri-implantitis treatment rather than etiology and prevention, about half were uploaded by dentists/specialists, and only 10% specifically targeted patients. Only 2% of YouTube videos about peri-implantitis had excellent educational value, and 5% had good educational value. Video educational value was correlated with VIQI and content beyond video length and source reliability. When comparing the very low/low and medium/good/excellent educational value YouTube videos on peri-implantitis, a significant difference was found in the Video Information and Quality Index, VIQI, and video content. Full article
(This article belongs to the Special Issue Innovation in Healthcare Education)
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13 pages, 902 KiB  
Article
Experiences of Telenursing in Overcoming Challenges and Applaying Strategies by COVID-19 Patients in Home Isolation: Qualitative Study in Primary Care
by Glòria Tort-Nasarre, Anna Espart, Paola Galbany-Estragués, Bruna Álvarez, Martí Subias-Miquel and Maria Romeu-Labayen
Healthcare 2023, 11(14), 2093; https://doi.org/10.3390/healthcare11142093 - 22 Jul 2023
Viewed by 1965
Abstract
During the first wave of the COVID-19 pandemic, there was a significant increase in the use of telenursing to provide care for patients at home. However, the quality of the patient experience when nurses rely on technology instead of personal contact has not [...] Read more.
During the first wave of the COVID-19 pandemic, there was a significant increase in the use of telenursing to provide care for patients at home. However, the quality of the patient experience when nurses rely on technology instead of personal contact has not been thoroughly investigated. This study aimed to understand the perspectives of COVID-19 patients in home isolation who received telenursing from primary care nurses during the initial phase of the pandemic. A qualitative study was conducted that employed purposive sampling and involved semi-structured interviews via videoconference with fourteen COVID-19 patients from two primary health centers in Catalonia (Spain). Thematic analysis was used, and the study adhered to the COREQ checklist. The findings revealed three themes related to the challenges faced by COVID-19 patients in home isolation: physical symptoms, emotional and social difficulties, and a lack of information. Three themes emerged regarding the strategies patients employed to overcome these challenges and the role of nurses: self-care, emotional support, and personal commitment. The patients reported having achieved strategies to improve their physical, psychological, and situational well-being despite the unprecedented situation. The study highlights that telenursing is a valuable resource for delivering patient-centered care, which could lead to changes in organisational policies and the development of best clinical practices. Full article
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19 pages, 605 KiB  
Article
Association of Socioeconomic Factors and Physical Activity with Health-Related Quality of Life in Italian Middle School Children: An Exploratory Cross-Sectional Study
by Francesco Sanmarchi, Lawrence M. Scheier, Laura Dallolio, Matteo Ricci, Giulia Longo, Andrea Ceciliani and Alice Masini
Healthcare 2023, 11(14), 2092; https://doi.org/10.3390/healthcare11142092 - 22 Jul 2023
Viewed by 869
Abstract
Health-related quality of life (HRQoL) provides a broad assessment of an individual’s well-being and can serve as a good prognosticator of life’s outcomes later for children and adolescents. Understanding the factors associated with HRQoL is crucial for promoting better health and life satisfaction. [...] Read more.
Health-related quality of life (HRQoL) provides a broad assessment of an individual’s well-being and can serve as a good prognosticator of life’s outcomes later for children and adolescents. Understanding the factors associated with HRQoL is crucial for promoting better health and life satisfaction. This study investigated the cross-sectional association of socioeconomic status, cardio fitness, and physical activity levels with HRQoL in 224 Italian early adolescents attending secondary school in the Emilia-Romagna region located in Northern Italy. In a multivariate path regression model, younger students and females reported a higher quality of life (β = −0.139, p = 0.015, 95% CI: −0.254–−0.023 and β = 0.142, p = 0.019, 95% CI: 0.011–0.273, respectively). Having both parents employed and having a higher familiar educational status were also associated with a higher quality of life (β = 0.142, p = 0.013, 95% CI 0.027–0.257 and β = 0.133, p = 0.017, 95% CI 0.022–0.244, respectively). Greater engagement in routine physical activity levels from moderate to vigorous intensity was positively associated with quality of life (β = 0.429, p < 0.001, 95% CI: 0.304–0.554). Endurance (speed) was positively associated with quality of life (β = 0.221, p = 0.001, 95% CI: 0.087–0.355), and students with longer times on the shuttle run reported less quality of life (β = −0.207, p = 0.002, 95% CI: −0.337–−0.077). These relations remained intact even when controlling for socioeconomic factors. The current findings reinforce the importance of promoting regular physical activity among younger children and also addressing socioeconomic status disparities to improve children’s well-being. Future studies may want to consider expanding the array of measures used to assess physical activity and include additional measures assessing nutrition, cultural factors, and family functioning, all of which can influence a child’s willingness to engage in physical activity and their well-being. The emphasis on fitness and physical activity and their contribution to a child’s well-being should be the prime focus for stakeholders who work in the education, public health, and health policy sectors. Full article
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15 pages, 3589 KiB  
Review
Human Skin Pigmentation: From a Biological Feature to a Social Determinant
by Sarah Mosca and Aldo Morrone
Healthcare 2023, 11(14), 2091; https://doi.org/10.3390/healthcare11142091 - 22 Jul 2023
Cited by 3 | Viewed by 3954
Abstract
Skin pigmentation is the most variable human characteristic that can be observed and has been used throughout history to classify humans into distinct groups. Many factors influence skin colour, but the melanin pigment is considered the most important because its type and quantity [...] Read more.
Skin pigmentation is the most variable human characteristic that can be observed and has been used throughout history to classify humans into distinct groups. Many factors influence skin colour, but the melanin pigment is considered the most important because its type and quantity can determine variations in pigmentation shades. The evolution of skin pigmentation started around 1.6–2 million years ago. As a result of migratory phenomena to places with less ultraviolet radiation (UVR) and other seasonal regimes, the selection of depigmented skin and different tanning capabilities occurred over time. Thus, genetic adaptation to new environmental conditions gradually led to changes in skin pigmentation. Despite the biological importance of pigmentation, variation in skin colour has led to social and health inequalities. Since Linnaeus, skin colour classifications have been used to describe different human groups, encouraging the misuse of a biological characteristic. This review examines the characterisation of pigmentation and its evolution through history and society. The unequal perception of pigmentation diversity has led to an incomplete state of dermatological training and issues in medical approach in dermatology. The consciousness of all these aspects increases the need to address and overcome dermatologic and social health disparities related to skin pigmentation. Full article
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15 pages, 1164 KiB  
Review
Sleep Profiles in Eating Disorders: A Scientometric Study on 50 Years of Clinical Research
by Alessandro Carollo, Pengyue Zhang, Peiying Yin, Aisha Jawed, Dagmara Dimitriou, Gianluca Esposito and Stephen Mangar
Healthcare 2023, 11(14), 2090; https://doi.org/10.3390/healthcare11142090 - 21 Jul 2023
Cited by 1 | Viewed by 1785
Abstract
Sleep and diet are essential for maintaining physical and mental health. These two factors are closely intertwined and affect each other in both timing and quality. Eating disorders, including anorexia nervosa and bulimia nervosa, are often accompanied by different sleep problems. In modern [...] Read more.
Sleep and diet are essential for maintaining physical and mental health. These two factors are closely intertwined and affect each other in both timing and quality. Eating disorders, including anorexia nervosa and bulimia nervosa, are often accompanied by different sleep problems. In modern society, an increasing number of studies are being conducted on the relationship between eating disorders and sleep. To gain a more comprehensive understanding of this field and highlight influential papers as well as the main research domains in this area, a scientometric approach was used to review 727 publications from 1971 to 2023. All documents were retrieved from Scopus through the following string “TITLE-ABS ((“sleep” OR “insomnia”) AND (“anorexia nervosa” OR “bulimia nervosa” OR “binge eating” OR “eating disorder*”) AND NOT “obes*”) AND (LIMIT-TO (LANGUAGE, “English”))”. A document co-citation analysis was applied to map the relationship between relevant articles and their cited references as well as the gaps in the literature. Nine publications on sleep and eating disorders were frequently cited, with an article by Vetrugno and colleagues on nocturnal eating being the most impactful in the network. The results also indicated a total of seven major thematic research clusters. The qualitative inspection of clusters strongly highlights the reciprocal influence of disordered eating and sleeping patterns. Researchers have modelled this reciprocal influence by taking into account the role played by pharmacological (e.g., zolpidem, topiramate), hormonal (e.g., ghrelin), and psychological (e.g., anxiety, depression) factors, pharmacological triggers, and treatments for eating disorders and sleep problems. The use of scientometric perspectives provides valuable insights into the field related to sleep and eating disorders, which can guide future research directions and foster a more comprehensive understanding of this important area. Full article
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14 pages, 248 KiB  
Article
Perception of Women’s Knowledge of and Attitudes towards Cervical Cancer and Papanicolaou Smear Screenings: A Qualitative Study in South Africa
by Zintle Gwavu, Daphne Murray and Uchenna Benedine Okafor
Healthcare 2023, 11(14), 2089; https://doi.org/10.3390/healthcare11142089 - 21 Jul 2023
Cited by 2 | Viewed by 1698
Abstract
Background: Cervical cancer is the most common form of cancer worldwide. Consequently, it is crucial that women are encouraged to undergo interventions early via Papanicolaou (Pap) smear screenings to improve their health. In light of this, this study explored the knowledge of and [...] Read more.
Background: Cervical cancer is the most common form of cancer worldwide. Consequently, it is crucial that women are encouraged to undergo interventions early via Papanicolaou (Pap) smear screenings to improve their health. In light of this, this study explored the knowledge of and attitudes towards cervical cancer and Papanicolaou (Pap) smear screenings among women in the Caleb Motshabi district, South Africa. Four focus group discussions were carried out among 19 women. The interviews/discussion were audio-recorded and transcribed verbatim and then analysed thematically. In this regard, seven main themes emerged that provided insight into the perceptions of the participants regarding their knowledge of and attitudes towards cervical cancer and Papanicolaou (Pap) smear screenings. While the majority of participants were aware of cervical cancer and Pap smears, they lacked more specific knowledge of what this cancer is or its related causes. Although some participants had had a Pap smear done, they neither knew how the procedure was done nor the reasons for it. In addition, most mentioned receiving information about this procedure from their peers rather than healthcare workers. Notably, those with previous experience indicated that they had regular screenings. Furthermore, they better understood exactly how it is done. The findings emphasised women’s limited knowledge of cervical cancer and Pap smears. It further highlighted the need for sustainable education programmes and mobile clinics to encourage an awareness of and accessibility to this particular type of screening within South African communities. Therefore, intervention strategies that make people aware of this specific cancer and encourage the uptake of Papanicolaou (Pap) smear screenings are crucial, as is the continued advocacy for sustained educational programmes and accessible healthcare services. Full article
(This article belongs to the Special Issue Cancer Healthcare Disparities)
11 pages, 315 KiB  
Article
Predicting Quality of Life in Women with Breast Cancer Who Engage in Physical Exercise: The Role of Psychological Variables
by Santiago Fresno-Alba, Marta Leyton-Román, Sara Mesquita da Silva and Ruth Jiménez-Castuera
Healthcare 2023, 11(14), 2088; https://doi.org/10.3390/healthcare11142088 - 21 Jul 2023
Cited by 5 | Viewed by 1478
Abstract
In this study, we aimed to conduct a descriptive analysis of the primary physiological and psychological factors influencing the quality of life in women with breast cancer who engage in physical exercise. The study examined the key psychological variables predicting patients’ quality of [...] Read more.
In this study, we aimed to conduct a descriptive analysis of the primary physiological and psychological factors influencing the quality of life in women with breast cancer who engage in physical exercise. The study examined the key psychological variables predicting patients’ quality of life, perceived support from family and friends, and the perception of physical condition. The sample consisted of 46 women from Cáceres (Spain) aged between 30 and 75 years undergoing breast cancer treatment. The Functional Evaluation Scale in Cancer Therapy (FACT-B+4) was used to measure quality of life; the Basic Psychological Needs Satisfaction Scale was used to measure autonomy, competence, and social relationships; the Behavior Regulation Questionnaire in Exercise (BREQ-3) was used to measure the types of self-determined motivation for sports participation; the General Evaluation of Self-Esteem Scale was used to measure self-esteem; the International Fitness Scale (IFIS) was used to measure perceived physical condition; and the Perceived Autonomy Support Scale for Exercise Settings (PASSES) was used to measure the perceived autonomy support from family and friends. A multiple regression analysis revealed that perceived physical condition and self-esteem were significant positive predictors of a variance in quality of life, while intrinsic motivation did not significantly predict it. The findings underscore the importance of promoting autonomous motivation in patients to enhance their physical and psychological well-being through physical activity. Full article
10 pages, 2639 KiB  
Brief Report
Evaluation of Atlas-Based Mobile Application in Undergraduate Teaching in Oral Histopathology
by Shuangshan Deng, Zucen Li, Xinyu Ma, Yali Wei, Ping Lyu and Yi Fan
Healthcare 2023, 11(14), 2087; https://doi.org/10.3390/healthcare11142087 - 21 Jul 2023
Viewed by 786
Abstract
The utilization of mobile devices in education is a growing trend in various subjects. We developed the Dental and Maxillofacial Development Teaching Atlas App, and applied it to the learning process of oral histopathology. The aim of the current study was to investigate [...] Read more.
The utilization of mobile devices in education is a growing trend in various subjects. We developed the Dental and Maxillofacial Development Teaching Atlas App, and applied it to the learning process of oral histopathology. The aim of the current study was to investigate the educational effects of atlas-based mobile-assisted teaching in the field of dental medicine, and to suggest relevant improvements. The Dental and Maxillofacial Development Teaching Atlas App encompasses a wide range of atlases. It harbors various features, such as terminology definitions, student communications, and teacher–student interactions. By conducting questionnaires (70 students) and a quiz (68 students), we obtained students’ feedback, to evaluate the effects and application prospects of the WeChat applet. The questionnaire results indicate that students experienced a high level of satisfaction and support. Additionally, students participated in the quiz, with the experimental group exhibiting significantly higher average scores than the control group. The fill-in-the-blank questions, image recognition questions, and the total score all demonstrated statistically significant differences, while the terminology definition questions did not. The Dental and Maxillofacial Development Teaching Atlas App facilitates students’ utilization of fragmented time for learning, and demonstrates positive effects in enhancing students’ learning interests and proactiveness. It also holds promising potential for applications in other disciplines in the field of dental education. Full article
(This article belongs to the Special Issue Detection, Prevention and Management of Oral Health Issues)
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12 pages, 657 KiB  
Article
Epidemiological Study of Oral Health among Children and Adolescent Schoolchildren in Melilla (Spain)
by Marta Hernandez-Donadeu, David Ribas-Pérez, Diego Rodriguez Menacho, Paloma Villalva Hernandez-Franch, Ignacio Barbero Navarro and Antonio Castaño-Séiquer
Healthcare 2023, 11(14), 2086; https://doi.org/10.3390/healthcare11142086 - 21 Jul 2023
Cited by 1 | Viewed by 866
Abstract
Dental epidemiological studies are essential for analysing and evaluating the population’s health state and dental treatments provided, as well as for planning future oral health programme activities and interventions based on their findings. In order to determine the health condition of children and [...] Read more.
Dental epidemiological studies are essential for analysing and evaluating the population’s health state and dental treatments provided, as well as for planning future oral health programme activities and interventions based on their findings. In order to determine the health condition of children and adolescents in connection to the prevalence of caries, caries indices (decayed and filled teeth (dft) for primary teeth and decayed, missing and filled teeth (DMFT) in permanent teeth) and periodontal indices (community periodontal index (CPI)), oral exams of children and adolescents aged 6, 12 and 15 from selected schools were conducted. To assess the achievement of the oral health objectives set for Spain in 2020, these data were compared with those acquired at the national level. At 6 years of age, 278 children were examined, the prevalence of caries was 55.6%, the dft index was 2.77 (±3.44), the DMFT was 0.19 (±0.16), the restorative index (RI) was 4.62%, and the significant caries (SiC) index was 8.40 (±2.07). At 12 years of age, 208 students were examined, the prevalence of caries found was 65.86%, the DMFT index was 1.85 (±2.22), the RI was 36.63%, the SiC index was 5.43 (±2.07), and children without the presence of periodontal pathology was 59.13%. At 15 years of age, 165 students were examined, the prevalence of caries was 70.06%, the DMFT was 3.08 (±3.39), the RI was 42.42%, the SiC index was 8.10 (±2.55), and adolescents without periodontal disease was 47.90%. Conclusions: Melilla-born children and adolescents had higher caries indicators and indices than the corresponding national averages for Spain. Teenagers under the age of 15 have a particularly high frequency of dental caries. The investigation of the children’s origin is where there is the most disparity. Children of Berber descent have much higher values than children of European heritage. Full article
(This article belongs to the Special Issue Oral Health Status of Children and Adolescents)
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23 pages, 649 KiB  
Systematic Review
Systematic Review of Lung Cancer Screening: Advancements and Strategies for Implementation
by Daniela Amicizia, Maria Francesca Piazza, Francesca Marchini, Matteo Astengo, Federico Grammatico, Alberto Battaglini, Irene Schenone, Camilla Sticchi, Rosa Lavieri, Bruno Di Silverio, Giovanni Battista Andreoli and Filippo Ansaldi
Healthcare 2023, 11(14), 2085; https://doi.org/10.3390/healthcare11142085 - 21 Jul 2023
Cited by 8 | Viewed by 3768
Abstract
Lung cancer is the leading cause of cancer-related deaths in Europe, with low survival rates primarily due to late-stage diagnosis. Early detection can significantly improve survival rates, but lung cancer screening is not currently implemented in Italy. Many countries have implemented lung cancer [...] Read more.
Lung cancer is the leading cause of cancer-related deaths in Europe, with low survival rates primarily due to late-stage diagnosis. Early detection can significantly improve survival rates, but lung cancer screening is not currently implemented in Italy. Many countries have implemented lung cancer screening programs for high-risk populations, with studies showing a reduction in mortality. This review aimed to identify key areas for establishing a lung cancer screening program in Italy. A literature search was conducted in October 2022, using the PubMed and Scopus databases. Items of interest included updated evidence, approaches used in other countries, enrollment and eligibility criteria, models, cost-effectiveness studies, and smoking cessation programs. A literature search yielded 61 scientific papers, highlighting the effectiveness of low-dose computed tomography (LDCT) screening in reducing mortality among high-risk populations. The National Lung Screening Trial (NLST) in the United States demonstrated a 20% reduction in lung cancer mortality with LDCT, and other trials confirmed its potential to reduce mortality by up to 39% and detect early-stage cancers. However, false-positive results and associated harm were concerns. Economic evaluations generally supported the cost-effectiveness of LDCT screening, especially when combined with smoking cessation interventions for individuals aged 55 to 75 with a significant smoking history. Implementing a screening program in Italy requires the careful consideration of optimal strategies, population selection, result management, and the integration of smoking cessation. Resource limitations and tailored interventions for subpopulations with low-risk perception and non-adherence rates should be addressed with multidisciplinary expertise. Full article
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