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Healthcare, Volume 11, Issue 2 (January-2 2023) – 131 articles

Cover Story (view full-size image): Nursing work environments change constantly and grow in complexity. Previous literature explored nursing work environments evaluating predominantly structure and outcome aspects rather than work processes. With the intention to expand present knowledge regarding nursing workload, this research explored nurses’ work processes to identify antecedents of nurses’ work organization and observe the effects on physical, mental, and emotional dimensions of nursing workload. This is a cross-sectional study. Nurses working in nine medical-surgical wards across three hospitals in Italy self-reported on work organization and workloads connected to specific shifts. Patient, nurse, and workflow aspects influence nurses’ work organization, which in turn affects all dimensions of workload. Some recommendations for improvement are suggested. View this paper
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15 pages, 2356 KiB  
Article
Factors That Influence, Exacerbate, Contribute or Promote Violence in Couples
by Claudia Sánchez, Cecilia Mota, Jorge Carreño and María Eugenia Gómez
Healthcare 2023, 11(2), 281; https://doi.org/10.3390/healthcare11020281 - 16 Jan 2023
Viewed by 1590
Abstract
Life as a couple, and their ability to solve problems or not, can result in the relationship being satisfactory and functional or unsatisfactory and dysfunctional, which increases the risk of violence with serious implications. For that reason, it is important to isolate the [...] Read more.
Life as a couple, and their ability to solve problems or not, can result in the relationship being satisfactory and functional or unsatisfactory and dysfunctional, which increases the risk of violence with serious implications. For that reason, it is important to isolate the risk factors to prevent and treat unsatisfactory and dysfunctional relationships. The qualitative interpretive exploratory method was used, analysing 50 sessions of group psychotherapy with patients from a reproductive health institution whose relationships faced violent problems. The identified factors were the lack of autonomy in one of the partners, unresolved internal factors, a combination of external factors and factors caused by their interaction; symmetrical and asymmetrical violence, subjugation of one before the other, intergenerational violence, family violence during childhood and normalisation of violence. Isolating factors to understand relationship problems at risk of manifesting violence opens the possibility of effective, specific and preventive treatments of family and intimate partner violence. Full article
(This article belongs to the Special Issue Perinatal Mental Health and Care)
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13 pages, 585 KiB  
Article
“It’s All about Calculations—But There Are No Definite Results”—Parental Adaptation and Coping during the First Month following Their Child’s Diabetes Diagnosis
by Louise Norman Jespersen, Kristine Zoega Mikkelsen and Dan Grabowski
Healthcare 2023, 11(2), 280; https://doi.org/10.3390/healthcare11020280 - 16 Jan 2023
Cited by 1 | Viewed by 1709
Abstract
Diabetes-related habits established during the first few years after diagnosis are difficult to change. Therefore, the initial period after a child has been diagnosed with diabetes holds a unique potential for early interventions to adjust adverse patterns of diabetes self-management before they become [...] Read more.
Diabetes-related habits established during the first few years after diagnosis are difficult to change. Therefore, the initial period after a child has been diagnosed with diabetes holds a unique potential for early interventions to adjust adverse patterns of diabetes self-management before they become firmly established. Family functioning is strongly related to glycemic levels, and attending to parents’ needs at the time of diagnosis could therefore reduce psychological distress and improve glycemic levels in their children. This study aims to investigate parental adaptation to and coping with their child’s diabetes diagnosis during the first month post-diagnosis. Twenty interviews with parents of children (0–18 years) with newly diagnosed type 1 diabetes were conducted and analyzed using systematic text condensation. Four themes were identified: (1) Removal of the safety net, when families experience that they are now on their own; (2) Hit by the realities, when parents realize the impact of living with diabetes; (3) Hang in there, when families mobilize resources to get them through a tough period; and (4) Toward a new normal, when parents begin to reestablish their life with diabetes in mind. This study generated unique insights into early parental adaptation and coping after their child was diagnosed with diabetes. Full article
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11 pages, 1932 KiB  
Article
Effectiveness of the Pelvic Clock and Static Bicycle Exercises on Wisconsin Gait Scale and Trunk Impairment Scale in Chronic Ambulatory Hemiplegic Patients: A Single Group Pre-Post Design
by Thamer Altaim, Venkatesan Ramakrishnan, Shenbaga Sundaram Subramanian, Sugasri Sureshkumar, Makesh Babu Subramanian, Vijayamurugan Eswaramoorthi, Riziq Allah Gaowgzeh, Saad Alfawaz, Ziyad Neamatallah, Umar Alabasi and Majed Albadi
Healthcare 2023, 11(2), 279; https://doi.org/10.3390/healthcare11020279 - 16 Jan 2023
Viewed by 2087
Abstract
Background: Most Hemiplegic patients achieve ambulatory function during the sub-acute stage of stroke. Though ambulatory, they still perform an unpleasant awkward gait with remarkable compensations requiring more energy expenditure. Fatigue arises at an early duration as a result of increased energy expenditure. The [...] Read more.
Background: Most Hemiplegic patients achieve ambulatory function during the sub-acute stage of stroke. Though ambulatory, they still perform an unpleasant awkward gait with remarkable compensations requiring more energy expenditure. Fatigue arises at an early duration as a result of increased energy expenditure. The walking pattern becomes circumduction, featured by asymmetry with an extensor synergy of the lower limb. Each step is rotated away from the body then towards the body, forming a semicircle. This leads to changes in various parameters of gait (spatiotemporal, kinematic, and kinetic) in hemiparetic patients. Purpose: Many studies reveal the effectiveness of various therapeutic techniques in managing hemiplegic circumduction gait. Pelvic clock exercises aid in improving pelvic rotation components and cause dissociation in impaired pelvic mobility due to spasticity. A static bicycle helps in enhancing proper control between the hamstrings and quadriceps. It also helps in improving knee flexion range. As the patient places the foot in the cycle’s petals, it helps to enhance dorsiflexion and eversion functions as well. As the lower body is exercised, there could be relative changes in the upper body, i.e., the trunk. Thus, this study aimed to determine the changes in gait functions and trunk performance of chronic ambulatory hemiplegic patients in response to the above therapies for four weeks. Method: Twenty-five subjects (post-stroke duration (2.8 ± 0.6) years) who could walk 10 m independently without assistance or support of aid participated in a pelvic clock and static bicycle exercise intervention. The session duration was 30 min a day, and therapy was delivered six days a week and continued for four weeks. The entire program was carried out in an outpatient neurorehabilitation center. Results: After the intervention with pelvic clock and static bicycle exercises, there was a remarkable change in gait and trunk functions in chronic hemiplegic patients. Conclusion: The exercises comprising pelvic clock and static bicycle showed positive differences in gait and trunk functions in chronic stage hemiplegic patients. Later, randomized controlled studies involving larger sample sizes, advanced activation techniques, and increased intervention duration will explore in-depth information on their effectiveness and clinical significance. Full article
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12 pages, 7965 KiB  
Article
Demonstration of Accuracy and Feasibility of Remotely Delivered Oximetry: A Blinded, Controlled, Real-World Study of Regional/Rural Children with Obstructive Sleep Apnoea
by Ryan Begley, Yogesan Kanagasingam, Chun Chan, Chandrashan Perera, Moya Vandeleur and Paul Paddle
Healthcare 2023, 11(2), 278; https://doi.org/10.3390/healthcare11020278 - 16 Jan 2023
Viewed by 1185
Abstract
Objectives: Evaluate diagnostic accuracy and feasibility of a mail-out home oximetry kit. Design: Patients were referred for both the tertiary/quaternary-centre hospital-delivered oximetry (HDO) and for the mail-out remotely-delivered oximetry (RDO). Quantitative and qualitative data were collected. The COVID-19 pandemic began during this study; [...] Read more.
Objectives: Evaluate diagnostic accuracy and feasibility of a mail-out home oximetry kit. Design: Patients were referred for both the tertiary/quaternary-centre hospital-delivered oximetry (HDO) and for the mail-out remotely-delivered oximetry (RDO). Quantitative and qualitative data were collected. The COVID-19 pandemic began during this study; therefore, necessary methodological adjustments were implemented. Setting: Patients were first evaluated in Swan Hill, Victoria. RDO kits were sent to home addresses. For the HDO, patients travelled to the Melbourne city area, received the kit, stayed overnight, and returned the kit the following morning. Participants: All consecutive paediatric patients (aged 2–18), diagnosed by a specialist in Swan Hill with obstructive sleep apnoea (OSA) on history/examination, and booked for tonsillectomy +/− adenoidectomy, were recruited. Main outcome measures: Diagnostic accuracy (i.e., comparison of RDO to HDO results) and test delivery time (i.e., days from consent signature to oximetry delivery) were recorded. Patient travel distances for HDO collection were calculated using home/delivery address postcodes and Google® Maps data. Qualitative data were collected with two digital follow-up surveys. Results: All 32 patients that had both the HDO and RDO had identical oximetry results. The HDO mean delivery time was 87.7 days, while the RDO mean delivery time was 23.6 days (p value: <0.001). Qualitatively, 3/28 preferred the HDO, while 25/28 preferred the RDO (n = 28). Conclusions: The remote option is as accurate as the hospital option, strongly preferred by patients, more rapidly completed, and also an ideal investigation delivery method during certain emergencies, such as the COVID-19 pandemic. Full article
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10 pages, 764 KiB  
Article
Assessment of Saudi Society’s Knowledge Regarding Hypothyroidism and Its Neuropsychiatric Clinical Manifestations
by Hayat Saleh Alzahrani, Rand Abdalla Alshabnan, Fatmah Mamdooh Mokhtar, Aljoharah Ibrahim Aleisa, Nora Abdulrahman AlHedaithi, Ghadah Khalid Alotaibi, Tif Meshref Alamri, Wejdan Dia Aluthaim, Jana Mahmoud Alyousef, Reem Saeed AlSarhan, Maha Mohammed AlHussein, Bader A. Almehmadi, Mansour Alzahrani and Fahad Mohammad Alfhaid
Healthcare 2023, 11(2), 277; https://doi.org/10.3390/healthcare11020277 - 16 Jan 2023
Cited by 1 | Viewed by 1641
Abstract
Background: This study was conducted to assess the level of knowledge and awareness of hypothyroidism and its neuropsychiatric clinical manifestations among the Saudi population. Methods: This was a cross-sectional study employing a convenient sampling technique, conducted between February and May 2022. A questionnaire [...] Read more.
Background: This study was conducted to assess the level of knowledge and awareness of hypothyroidism and its neuropsychiatric clinical manifestations among the Saudi population. Methods: This was a cross-sectional study employing a convenient sampling technique, conducted between February and May 2022. A questionnaire was distributed online to all participants in all five regions. Results: In this survey, a total of 2016 Saudi citizens participated. When asked about depression, more than half of the participants (59.6%) correctly identified depression as one of the neuropsychiatric clinical symptoms of hypothyroidism. Nearly half of the participants (47.5%) were unaware that anxiety was not a neuropsychiatric manifestation of hypothyroidism. With a percentage of 91.0%, the majority of participants exhibited poor knowledge. The regression analysis showed that males have significantly reduced knowledge about hypothyroidism than females (coefficient −3.686, p-value < 0.0001). Similarly, those who have “enough income and can save” were more knowledgeable than others (coefficient 0.731, p-value < 0.02). Regarding the source of information, journals provide three times more information (p-value 0.0001), and healthcare practitioners provides four times more information as compared to family and friends (p-value 0.0001). Conclusion: Due to a lack of knowledge about hypothyroidism and its complications, symptoms, risk factors, and treatment, the most viable solution to these misconceptions would be to implement a variety of educational programs to increase public awareness of this issue. Full article
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16 pages, 656 KiB  
Article
Effect of the Active Aging-in-Place–Rehabilitation Nursing Program: A Randomized Controlled Trial
by Ana da Conceição Alves Faria, Maria Manuela F. P. S. Martins, Olga Maria Pimenta Lopes Ribeiro, João Miguel Almeida Ventura-Silva, Esmeralda Faria Fonseca, Luciano José Moreira Ferreira and José Alberto Laredo-Aguilera
Healthcare 2023, 11(2), 276; https://doi.org/10.3390/healthcare11020276 - 16 Jan 2023
Cited by 4 | Viewed by 2432
Abstract
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program (AAP-RNP) [...] Read more.
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program (AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks, and the sessions took place at the participants’ homes. We used as instruments the Tilburg Frailty Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip strength measurement; Tinetti Index; Individual lifestyle profile; and Borg’s perception of effort. (3) Results: Post-program, there was an improvement in multidimensional and physical frailty, functional capacity, balance, and perceived exertion (p < 0.05) in the experimental group. Among the older adults’ lifestyles, we observed significant improvements in physical activity habits, relational behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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17 pages, 2004 KiB  
Review
Prevalence of Spontaneous Bacterial Peritonitis (SBP) in Hepatitis B (HBV), and Hepatitis C (HCV) Liver Cirrhosis: A Systematic Review and Meta-Analysis
by Kizito Eneye Bello, Ahmad Adebayo Irekeola, Sameer Badri Al-Mhanna, Okolo Martin-Luther Oseni, Adejo Patience Omebije, Rafidah Hanim Shueb and Nazri Mustaffa
Healthcare 2023, 11(2), 275; https://doi.org/10.3390/healthcare11020275 - 16 Jan 2023
Cited by 2 | Viewed by 1937
Abstract
Background and Aim: Spontaneous bacterial peritonitis (SBP) is a common infection in liver cirrhosis. This systematic review and meta-analysis provide detailed information on the prevalence of SBP among hepatitis B virus (HBV) and hepatitis C virus (HCV)-related liver cirrhosis globally. Methods: A systematic [...] Read more.
Background and Aim: Spontaneous bacterial peritonitis (SBP) is a common infection in liver cirrhosis. This systematic review and meta-analysis provide detailed information on the prevalence of SBP among hepatitis B virus (HBV) and hepatitis C virus (HCV)-related liver cirrhosis globally. Methods: A systematic search for articles describing the prevalence of SBP in HBV and HCV-related cirrhosis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Our search returned ten (10) eligible articles involving 1713 viral cirrhosis cases representing eight (8) countries. A meta-analysis was performed on our eligible studies using the random effect model. A protocol was registered with PROSPERO (CRD42022321790). Results: The pooled prevalence of SBP in HBV-associated cirrhosis had the highest estimate [8.0% (95% CI, 2.7–21.0%; I2 = 96.13%; p < 0.001)], followed by SBP in HCV-associated liver cirrhosis [4.0% (95% CI, 1.3%–11.5%; I2 = 88.99%; p < 0.001)]. China (61.8%, CI: 57.1–66.3%), the USA (50.0%, CI: 34.6–65.4%), and Holland (31.1%, CI: 21.6–42.5%) had the highest estimate for SBP in HBV associated liver cirrhosis, SBP in HCV associated liver cirrhosis and SBP in HBV + HCV associated liver cirrhosis respectively. There was a significant difference in the prevalence of SBP in viral hepatitis-associated liver cirrhosis with the year of sampling and method of SBP detection at P < 0.001. There was an increase in SBP incidence at the beginning of 2016 across the liver cirrhosis in this study. Conclusion: The findings of this review revealed a rise in the incidence of SBP in viral hepatitis over the last decade. The latter indicates a possible future rise in the global prevalence of SBP among HBV and HCV-related liver cirrhosis. Full article
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13 pages, 642 KiB  
Article
Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the Lifespan
by Marcelo de Maio Nascimento, Élvio Rúbio Gouveia, Bruna R. Gouveia, Adilson Marques, Cíntia França, Pedro Campos, Francisco Martins, Jesús García-Mayor and Andreas Ihle
Healthcare 2023, 11(2), 274; https://doi.org/10.3390/healthcare11020274 - 16 Jan 2023
Cited by 1 | Viewed by 1875
Abstract
This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 [...] Read more.
This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports. Full article
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22 pages, 17195 KiB  
Article
AI-Assisted Assessment of Wound Tissue with Automatic Color and Measurement Calibration on Images Taken with a Smartphone
by Sawrawit Chairat, Sitthichok Chaichulee, Tulaya Dissaneewate, Piyanun Wangkulangkul and Laliphat Kongpanichakul
Healthcare 2023, 11(2), 273; https://doi.org/10.3390/healthcare11020273 - 16 Jan 2023
Cited by 4 | Viewed by 5665
Abstract
Wound assessment is essential for evaluating wound healing. One cornerstone of wound care practice is the use of clinical guidelines that mandate regular documentation, including wound size and wound tissue composition, to determine the rate of wound healing. The traditional method requires wound [...] Read more.
Wound assessment is essential for evaluating wound healing. One cornerstone of wound care practice is the use of clinical guidelines that mandate regular documentation, including wound size and wound tissue composition, to determine the rate of wound healing. The traditional method requires wound care professionals to manually measure the wound area and tissue composition, which is time-consuming, costly, and difficult to reproduce. In this work, we propose an approach for automatic wound assessment that incorporates automatic color and measurement calibration and artificial intelligence algorithms. Our approach enables the comparison of images taken at different times, even if they were taken under different lighting conditions, distances, lenses, and camera sensors. We designed a calibration chart and developed automatic algorithms for color and measurement calibration. The wound area and wound composition on the images were annotated by three physicians with more than ten years of experience. Deep learning models were then developed to mimic what the physicians did on the images. We examined two network variants, U-Net with EfficientNet and U-Net with MobileNetV2, on wound images with a size of 1024 × 1024 pixels. Our best-performing algorithm achieved a mean intersection over union (IoU) of 0.6964, 0.3957, 0.6421, and 0.1552 for segmenting a wound area, epithelialization area, granulation tissue, and necrotic tissue, respectively. Our approach was able to accurately segment the wound area and granulation tissue but was inconsistent with respect to the epithelialization area and necrotic tissue. The calibration chart, which helps calibrate colors and scales, improved the performance of the algorithm. The approach could provide a thorough assessment of the wound, which could help clinicians tailor treatment to the patient’s condition. Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
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11 pages, 444 KiB  
Review
Analysis of Mobile App-Based Mental Health Solutions for College Students: A Rapid Review
by Avishek Choudhury, Annabella Kuehn, Hamid Shamszare and Yeganeh Shahsavar
Healthcare 2023, 11(2), 272; https://doi.org/10.3390/healthcare11020272 - 16 Jan 2023
Cited by 2 | Viewed by 3880
Abstract
Background: College students are one of the most susceptible age groups to mental health problems. With the growing popularity of mobile health (mHealth), there is an increasing need to investigate its implications for mental health solutions. This review evaluates mHealth interventions for addressing [...] Read more.
Background: College students are one of the most susceptible age groups to mental health problems. With the growing popularity of mobile health (mHealth), there is an increasing need to investigate its implications for mental health solutions. This review evaluates mHealth interventions for addressing mental health problems among college students. Methods: An online database search was conducted. Articles were required to focus on the impact of mHealth intervention on student mental health. Fifteen of the 487 articles, initially pulled from the search query, were included in the review. Results: The review identified three primary aspects of mental health: depression, anxiety, and stress. Research that found statistically significant improvements following mHealth intervention involved study durations between four and eight weeks, daily app use, guided lessons using cognitive behavioral therapy, acceptance and commitment therapy, and meditation. The review’s findings show that future work must address the concern of digital divide, gender and sex differences, and have larger sample sizes. Conclusions: There is potential to improve depressive symptoms and other similar mental health problems among college students via mobile app interventions. However, actions must be taken to improve barriers to communication and better reach the younger generations. Full article
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9 pages, 272 KiB  
Article
Knowledge of Oral Cancer Risk Factors among International Medical and Dental Students at the Lithuanian University of Health Sciences: A Cross-Sectional Study
by Sandra Petrauskienė, Dominika Kopczynska, Gintarė Žemgulytė and Kristina Saldūnaitė-Mikučionienė
Healthcare 2023, 11(2), 271; https://doi.org/10.3390/healthcare11020271 - 15 Jan 2023
Cited by 1 | Viewed by 1569
Abstract
The aim of this study was to evaluate knowledge of oral cancer risk factors among international dental and medical students at the Lithuanian University of Health Sciences (LSMU). A cross-sectional study was conducted among international medical and dental students at the LSMU in [...] Read more.
The aim of this study was to evaluate knowledge of oral cancer risk factors among international dental and medical students at the Lithuanian University of Health Sciences (LSMU). A cross-sectional study was conducted among international medical and dental students at the LSMU in 2018–2019. In total, 253 students participated, for a response rate of 76.2%. An anonymous self-administered English questionnaire, consisting of 18 items, covered background information (gender, faculty and academic study year), and statements about risk factors for oral cancer and attitudes towards the prevention and treatment of oral cancer. The fifteen statements had the following answer options: yes, no and I don’t know. The statistical data analysis was performed using SPSS version 22. Overall, a good, fair and poor knowledge of oral risk factors was reported by 15.02%, 56.92% and 28.06% of the participants, respectively. The mean score for knowledge of oral cancer risk factors was 10.01 (SD = 2.56), which was defined as fair knowledge. Cronbach’s alpha was found to be 0.78 (a good value). Bartlett’s sphericity test and the KMO index were adequate (χ2 = 677.563, p < 0.001; KMO = 0.788). This study demonstrates a lack of knowledge of oral cancer risk factors among international medical and dental students. Full article
(This article belongs to the Topic State-of-the-Art Dentistry and Oral Health)
14 pages, 1075 KiB  
Article
Prevalence and Causes of Elective Surgical Cancellations: Findings from a Rural Tertiary Hospital in the Eastern Cape, South Africa
by Abongile Sukwana, Busisiwe Mrara and Olanrewaju Oladimeji
Healthcare 2023, 11(2), 270; https://doi.org/10.3390/healthcare11020270 - 15 Jan 2023
Cited by 2 | Viewed by 2200
Abstract
Background: Cancellations of elective surgeries adversely affect the patient, hospital staff, facility, and health system. Cancellations potentially result in hospital financial losses, theatre inefficiency, and substandard patient care. A common benchmark for the cancellation rate of elective surgeries is less than five percent, [...] Read more.
Background: Cancellations of elective surgeries adversely affect the patient, hospital staff, facility, and health system. Cancellations potentially result in hospital financial losses, theatre inefficiency, and substandard patient care. A common benchmark for the cancellation rate of elective surgeries is less than five percent, and most operating rooms fall short of this standard. There is a paucity of data on the rates and causes of elective surgical cancellations in rural, resource-limited settings. This study aimed to determine the prevalence of elective surgery cancellations, the causes for such cancellations, and the surgical disciplines most affected at Nelson Mandela Academic Hospital (NMAH). Methodology: This was an observational, descriptive, cross-sectional review of operating theatre records from January 2019 to July 2019. The prevalence and main causes of elective case cancellations were determined. The causes were classified, and the most affected surgical departments and patient characteristics were identified. Results: The prevalence of elective surgical case cancellations was 14.4% in our hospital, higher than the international benchmark of 5%. Patient-, facility-, and surgical-related factors were the leading causes of cancellations, and avoidable cancellations were mostly surgical- and anaesthetic-related. Ophthalmology was the most affected, followed by gynaecology and general surgery, with plastic surgery being the least affected. The most common patient-related factors were nonattendance and uncontrolled medical conditions, while overbooking was the most common surgical reason. Abnormal investigatory results and unfit status were the most common anaesthetic reasons. Facility-related issues included the lack of theatre time, equipment scarcity or malfunction, and staff unavailability. Most cancellations were unavoidable, but with careful planning, could be avoided. Conclusion and recommendations: This study identified challenges with theatre efficiency in a rural, resource-limited setting that call for the cooperation of multidisciplinary teams of surgeons, anaesthetists, nursing staff, and health care policymakers. Full article
(This article belongs to the Section Perioperative Care)
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15 pages, 955 KiB  
Article
The Effectiveness of Family Medicine-Driven Interprofessional Collaboration on the Readmission Rate of Older Patients
by Ryuichi Ohta and Chiaki Sano
Healthcare 2023, 11(2), 269; https://doi.org/10.3390/healthcare11020269 - 15 Jan 2023
Cited by 13 | Viewed by 1934
Abstract
Interprofessional collaboration (IPC) for older patient care among family physicians, dentists, therapists, nutritionists, nurses, and pharmacists in the rural hospital care of older patients could improve the hospital readmission rate. However, there is a lack of interventional studies on IPC for improving the [...] Read more.
Interprofessional collaboration (IPC) for older patient care among family physicians, dentists, therapists, nutritionists, nurses, and pharmacists in the rural hospital care of older patients could improve the hospital readmission rate. However, there is a lack of interventional studies on IPC for improving the readmission rate among Japanese older patients in rural hospitals. This quasi-experimental study was performed on patients >65 years who were discharged from a rural community hospital. The intervention was IPC implementation with effective information sharing and comprehensive management of older patients’ conditions for effective discharge and readmission prevention; implementation started on 1 April 2021. The study lasted 2 years, from 1 April 2021 to 31 March 2022 for the intervention group and from 1 April 2020 to 31 March 2021 for the comparison group. The average participant age was 79.86 (standard deviation = 15.38) years and the proportion of men was 45.0%. The Cox hazard model revealed that IPC intervention could reduce the readmission rate after adjustment for sex, serum albumin, polypharmacy, dependent condition, and Charlson Comorbidity Index score (hazard ratio = 0.66, 95% confidence interval: 0.54–0.81). Rural IPC intervention can improve inpatient care for older patients and decrease readmission rates. Thus, for effective rural IPC interventions, family physicians in hospitals should proactively collaborate with various medical professionals to improve inpatient health outcomes. Full article
(This article belongs to the Section Preventive Medicine)
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8 pages, 924 KiB  
Article
Effects of High-Intensity Exercise on Physiological Indicators of Recovery Period by Wearing Face Masks of Elite Athletes
by Hyeong-Tae Kwon and Daeho Kim
Healthcare 2023, 11(2), 268; https://doi.org/10.3390/healthcare11020268 - 15 Jan 2023
Cited by 1 | Viewed by 1849
Abstract
Athletes need to maintain the necessary physical conditioning for sports performance while wearing face masks to reduce the risk of virus transmission during training and competition during the COVID-19 situation. The quantitative and physiological effects of face masks on exercise capacity needs to [...] Read more.
Athletes need to maintain the necessary physical conditioning for sports performance while wearing face masks to reduce the risk of virus transmission during training and competition during the COVID-19 situation. The quantitative and physiological effects of face masks on exercise capacity needs to be reported. The purpose of this study was to evaluate elite athletes to quantify, in detail, the effect of a KF94 face mask on changes in lactic acid during recovery after high-intensity aerobic exercise. Thirteen elite soft tennis athletes were recruited. A crossover design was used to examine the effects of using a disposable KF94 face mask compared with not masking during exercise. The participants completed a shuttle run test experiment two times during a 3-day period, including 5–10 min of warmup according to their personal preferences. The lactic acid concentration at 20 min of recovery after maximum exercise was 5.98 ± 1.53 mM/L without a mask and 7.61 ± 1.85 mM/L with a KF94 mask (p < 0.001). The maximum laps of shuttle run tests were 101.5 ± 22.5 laps without a mask and 94.2 ± 20.2 laps with a KF94 mask (p < 0.001). Intense exercise after wearing quarantine masks reduces the maximum aerobic exercise ability and decreases the ability to recover lactic acid. Full article
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15 pages, 1318 KiB  
Article
Understanding the Families’ Perceptions of Adapted Physical Activity for Individuals with Autism Spectrum Disorder through Metaphors
by Bekir Erhan Orhan, Aydın Karaçam, Ali Selman Özdemir, Eda Gökçelik, Alpar Aser Sabuncu and Laurențiu-Gabriel Talaghir
Healthcare 2023, 11(2), 267; https://doi.org/10.3390/healthcare11020267 - 15 Jan 2023
Cited by 3 | Viewed by 2104
Abstract
The aim of this study was to understand the perceptions, understanding and experiences of the families of individuals with autism spectrum disorder (ASD) related to adapted physical activity (APA), and their educators, through their use of metaphors. The research was based on systematic [...] Read more.
The aim of this study was to understand the perceptions, understanding and experiences of the families of individuals with autism spectrum disorder (ASD) related to adapted physical activity (APA), and their educators, through their use of metaphors. The research was based on systematic content analysis in the qualitative research model. The data were collected based on metaphors. The participants included 85 families of individuals with ASD attending private institutions operating in Istanbul and Ankara. The metaphors used by the families were examined under two headings: adapted physical activities, and educators. When the metaphors used to describe APA were examined, four themes emerged, education, emotion, support and development, and these themes were divided into the categories of guidance, skill, affection, and care. When the metaphorical perceptions of educators were examined, three themes emerged: education, emotion, and social adaptation. These were further categorized as experience, knowledge, entertainment, independence, happiness, and treatment. The metaphors showed that experiences in APA support increased self-confidence for individuals with autism spectrum disorder and support the social adaptation of individuals who have the opportunity to apply knowledge and experience. This research shows that families have positive perceptions of APA educators and their lessons. Full article
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11 pages, 256 KiB  
Article
Informational Needs for Dental-Oriented Electronic Health Records from Dentists’ Perspectives
by Abdullah Alanazi, Ghada Alghamdi and Bakheet Aldosari
Healthcare 2023, 11(2), 266; https://doi.org/10.3390/healthcare11020266 - 14 Jan 2023
Viewed by 3303
Abstract
Introduction: Information technology is vital to support dental care services and is yet to be thoroughly investigated. This study aims to assess the dentists’ needs and requirements for health records from dental care providers’ perspectives. Methods: In-depth interviews were conducted with dentists during [...] Read more.
Introduction: Information technology is vital to support dental care services and is yet to be thoroughly investigated. This study aims to assess the dentists’ needs and requirements for health records from dental care providers’ perspectives. Methods: In-depth interviews were conducted with dentists during clinic practices. This qualitative research method involves exploring the information and functions dentists use to obtain information from EHR. The target population is the dental staff interacting with the patients and accessing the electronic health records in the government and private sectors. Results: Thirty-five dentists were interviewed directly after the treatment session and asked four pre-defined questions, the dentists’ needs were collected, and the met and unmet needs were presented. The interview results revealed 42 needs (15 were met and 27 were unmet), with an average of 1.17 needs per session. The information needs were categorized into foreground and background information needs and reported in nine main themes. Discussion: The interviews were analyzed, and as a result, nine themes were generated: chief complaints and symptoms, medical and health history, medications, visual representations of the problem, treatment procedures, X-ray services, needs related to advanced features, needs related to insurance coverage, and finally, information needs related to the treatment environment. The required information and functions mentioned by dentists in the study emphasize the need for integrated modules for oral and medical care services. Generally, it is evident that dentists have substantial unmet needs, and the desired EHR should have functions that cover all dentists’ needs. Conclusion: The study’s findings demonstrate gaps between current and desired EHR to serve dentists’ needs. Dentists need better access to patient history and medical information, progress notes, and X-rays to provide visualization tools for problems and patient charts. Moreover, essential needs were related to messaging capability, educational tools, availability of tutorial videos, and accessing external resources. Information needs were described and should be considered when designing EHR to meet all dentists’ needs. Full article
(This article belongs to the Section Health Informatics and Big Data)
16 pages, 733 KiB  
Systematic Review
Systematic Review of Penetrating Cardiac Injury by a Firearm: Forensic Implications
by Francesco Sessa, Giuseppe Cocimano, Massimiliano Esposito, Pietro Zuccarello, Edmondo Scoto, Pietro Mazzeo and Monica Salerno
Healthcare 2023, 11(2), 265; https://doi.org/10.3390/healthcare11020265 - 14 Jan 2023
Cited by 2 | Viewed by 2625
Abstract
Penetrating injuries of the heart, named penetrating cardiac injury (PCI), may cause hemorrhagic shock as well as cardiac tamponade, leading to death if not treated immediately. This systematic review aims to highlight the main aspects of penetrating cardiac injuries after firearm wounds. The [...] Read more.
Penetrating injuries of the heart, named penetrating cardiac injury (PCI), may cause hemorrhagic shock as well as cardiac tamponade, leading to death if not treated immediately. This systematic review aims to highlight the main aspects of penetrating cardiac injuries after firearm wounds. The cases of 39 subjects (age 37.05 + 15.4) were selected (6 fatal cases). Specifically, 4/39 cases involved subjects under 18 y.o.; analyzing the entrance wound, in 30/39 cases it was located in the anterior chest, 4/39 in the posterior chest, 3/39 in the shoulder/axilla area, 1/39 in the neck, and 1/39 in the pelvis (gluteus). The exit wound was found in only 3/39 cases. Several factors may influence the prognosis: firstly, prompt intervention represents a crucial point, then considering the complications related to PCI, the most important are myocardial infarction, and projectile migration with embolization. The mortality rate is related to: (1) area and severity of the heart injury; (2) duration of transport and intervention; (3) contemporary lesion to other organ/s; (4) the quantity of blood lost; (5) and presence/absence of cardiac tamponade. Based on these findings, a correct approach in the management of PCI may be considered important from a forensic point of view, both as regards to medical liability and from the trial perspective. Full article
(This article belongs to the Special Issue Forensic Science and Legal Medicine: A Multidisciplinary Puzzle 2.0)
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14 pages, 691 KiB  
Article
Development of a Scale of Nurses’ Competency in Anticipatory Grief Counseling for Caregivers of Patients with Terminal Cancer
by Chia-Chi Hsiao, Suh-Ing Hsieh, Chen-Yi Kao and Tsui-Ping Chu
Healthcare 2023, 11(2), 264; https://doi.org/10.3390/healthcare11020264 - 14 Jan 2023
Viewed by 1859
Abstract
Anticipatory grief leads to a highly stressful and conflicting experience among caregivers of patients with terminal cancer. Nurses lack the competency to assess and manage the caregivers’ psychological problems, which in turn affects the caregivers’ quality of life. A scale assessing the anticipatory [...] Read more.
Anticipatory grief leads to a highly stressful and conflicting experience among caregivers of patients with terminal cancer. Nurses lack the competency to assess and manage the caregivers’ psychological problems, which in turn affects the caregivers’ quality of life. A scale assessing the anticipatory grief counseling competency among nurses is unavailable. In this study, an Anticipatory Grief Counseling Competency Scale (AGCCS) was developed for nurses. The Scale (AGCCS) was translated into Chinese and then revised. Psychometric testing of the scale was conducted on 252 nurses who participated in the care of patients with terminal cancer at a regional teaching hospital in Southern Taiwan. The data were analyzed using descriptive statistics, reliability, and Pearson’s correlation, and principal component analysis and analysis of variance were performed. Item- and scale-content validity indexes were 0.99 and 0.93, respectively. The Cronbach α of internal consistency was 0.981. The final 53-item AGCCS had five factors, which accounted for 70.81% of the total variance. The Pearson correlation coefficients of these factors ranged between 0.406 and 0.880 (p < 0.001). The AGCCS can be used to evaluate the aforementioned competency for improving caregivers’ quality of care. It can also facilitate in-service education planning and evaluation. Full article
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12 pages, 559 KiB  
Review
In Situ Simulation: A Strategy to Restore Patient Safety in Intensive Care Units after the COVID-19 Pandemic? Systematic Review
by Vanesa Gómez-Pérez, Dolores Escrivá Peiró, David Sancho-Cantus and Jorge Casaña Mohedo
Healthcare 2023, 11(2), 263; https://doi.org/10.3390/healthcare11020263 - 14 Jan 2023
Cited by 1 | Viewed by 2065
Abstract
Background: Patient safety is a public health problem worldwide. In situ simulation (ISS) arises as a learning strategy that allows health professionals to immerse themselves in a real environment without endangering the patients until they have learned the skills needed, thus increasing the [...] Read more.
Background: Patient safety is a public health problem worldwide. In situ simulation (ISS) arises as a learning strategy that allows health professionals to immerse themselves in a real environment without endangering the patients until they have learned the skills needed, thus increasing the quality of care. This systematic review aimed to verify the efficacy of the use of “in situ simulation” as a method that will allow health professionals to increase patient safety in Intensive Care Units after the situation experienced during the pandemic caused by the COVID-19 virus. Methods: Seven studies were reviewed using the PRISMA methodology for systematic reviews. The CASPe guide was used to assess the quality of the manuscripts. Results: The main topics that emerged from this review in relation to in situ simulation were as follows: looking at aspects such as patient self-perception of safety, adverse events, interprofessional communication and health system organization in relation to in situ simulation. Conclusions: The adequate implementation of in situ simulation after the COVID-19 pandemic in ICU services is shown to be an efficient and effective strategy to promote improvement in the attitudes on a culture of safety and teamwork of professionals. Full article
(This article belongs to the Section Prehospital Care)
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13 pages, 1070 KiB  
Article
Does Inspiratory Muscle Training Affect Static Balance in Soccer Players? A Pilot Randomized Controlled Clinical Trial
by Silvana Loana de Oliveira-Sousa, Martha Cecilia León-Garzón, Mariano Gacto-Sánchez, Alfonso Javier Ibáñez-Vera, Luis Espejo-Antúnez and Felipe León-Morillas
Healthcare 2023, 11(2), 262; https://doi.org/10.3390/healthcare11020262 - 14 Jan 2023
Cited by 2 | Viewed by 2116
Abstract
Inspiratory muscle training (IMT) is effective in improving postural stability and balance in different clinical populations. However, there is no evidence of these effects in soccer players. A single-blind, two-arm (1:1), randomized, placebo-controlled pilot study on 14 soccer players was performed with the [...] Read more.
Inspiratory muscle training (IMT) is effective in improving postural stability and balance in different clinical populations. However, there is no evidence of these effects in soccer players. A single-blind, two-arm (1:1), randomized, placebo-controlled pilot study on 14 soccer players was performed with the main aim of assessing the effect of IMT on static balance, and secondarily, of examining changes in the respiratory muscle function. The experimental group (EG) received an IMT program with progressive intensity, from 20% to 80%, of the maximal inspiratory pressure (MIP). The sham group (SG) performed the same program with a fixed load of 20% of the MIP. Static balance and respiratory muscle function variables were assessed. A two-factor analysis of variance for repeated measures was used to assess differences after training. Statistical significance was set at p < 0.05. Significant increases were observed in the EG on length of sway under eyes open (from 2904.8 ± 640.0 to 3522.4 ± 509.0 mm, p = 0.012) and eyes closed (from 3166.2 ± 641.3 to 4173.3 ± 390.8 mm, p = 0.004). A significant increase in the maximal voluntary ventilation was observed for both groups (EG p = 0.005; SG p = 0.000). No significant differences existed between the groups. IMT did not improve the static balance in a sample of soccer players. Conducting a high-scale study is feasible and could refine the results and conclusions stemming from the current pilot study. Full article
(This article belongs to the Special Issue Improving Athletes’ Performance and Avoiding Health Issues)
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11 pages, 517 KiB  
Article
Evolution of Physical Training in Police Academies: Comparing Fitness Variables
by Bridget Melton, Gregory Ryan, Victor Zuege, Haresh Rochani, Derick Anglin and Joseph Dulla
Healthcare 2023, 11(2), 261; https://doi.org/10.3390/healthcare11020261 - 14 Jan 2023
Viewed by 1987
Abstract
The purpose of this study was to evaluate the effectiveness of three different physical training approaches to improving cadets’ fitness variables. Retrospective data for male and female land management law enforcement officers attending a 15-week training program at three separate time points were [...] Read more.
The purpose of this study was to evaluate the effectiveness of three different physical training approaches to improving cadets’ fitness variables. Retrospective data for male and female land management law enforcement officers attending a 15-week training program at three separate time points were provided for analysis. The time points reflected the three different training approaches, including calisthenic training (CT) = 83, functional fitness training (FT) = 90, and strength training (ST) = 110. Inferential data analysis was used to find which mode of exercise had the greatest impact on body composition, cardiovascular endurance, muscular strength, agility, and flexibility. All groups displayed decreases in body fat percentage, with weight loss being more significant within the CT and FT groups, while the ST group increased in body weight. The CT group had the greatest flexibility increases compared to the FT and ST groups. ST training elicited significantly smaller changes in cardiovascular endurance than the FT and CT groups. ST training showed greater improvements in lean mass, while CT and FT showed greater increases in flexibility and endurance. These results suggest that training protocols can increase performance and optimize the abilities to perform job tasks in tactical athletes. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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21 pages, 3538 KiB  
Article
Modeling Consequences of COVID-19 and Assessing Its Epidemiological Parameters: A System Dynamics Approach
by Ateekh Ur Rehman, Syed Hammad Mian, Yusuf Siraj Usmani, Mustufa Haider Abidi and Muneer Khan Mohammed
Healthcare 2023, 11(2), 260; https://doi.org/10.3390/healthcare11020260 - 13 Jan 2023
Cited by 2 | Viewed by 2593
Abstract
In 2020, coronavirus (COVID-19) was declared a global pandemic and it remains prevalent today. A necessity to model the transmission of the virus has emerged as a result of COVID-19’s exceedingly contagious characteristics and its rapid propagation throughout the world. Assessing the incidence [...] Read more.
In 2020, coronavirus (COVID-19) was declared a global pandemic and it remains prevalent today. A necessity to model the transmission of the virus has emerged as a result of COVID-19’s exceedingly contagious characteristics and its rapid propagation throughout the world. Assessing the incidence of infection could enable policymakers to identify measures to halt the pandemic and gauge the required capacity of healthcare centers. Therefore, modeling the susceptibility, exposure, infection, and recovery in relation to the COVID-19 pandemic is crucial for the adoption of interventions by regulatory authorities. Fundamental factors, such as the infection rate, mortality rate, and recovery rate, must be considered in order to accurately represent the behavior of the pandemic using mathematical models. The difficulty in creating a mathematical model is in identifying the real model variables. Parameters might vary significantly across models, which can result in variations in the simulation results because projections primarily rely on a particular dataset. The purpose of this work was to establish a susceptible–exposed–infected–recovered (SEIR) model describing the propagation of the COVID-19 outbreak throughout the Kingdom of Saudi Arabia (KSA). The goal of this study was to derive the essential COVID-19 epidemiological factors from actual data. System dynamics modeling and design of experiment approaches were used to determine the most appropriate combination of epidemiological parameters and the influence of COVID-19. This study investigates how epidemiological variables such as seasonal amplitude, social awareness impact, and waning time can be adapted to correctly estimate COVID-19 scenarios such as the number of infected persons on a daily basis in KSA. This model can also be utilized to ascertain how stress (or hospital capacity) affects the percentage of hospitalizations and the number of deaths. Additionally, the results of this study can be used to establish policies or strategies for monitoring or restricting COVID-19 in Saudi Arabia. Full article
(This article belongs to the Special Issue End of the COVID-19 Era: Models, Predictions and Projections)
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15 pages, 9876 KiB  
Article
Psychological Skills Training for Athletes in Sports: Web of Science Bibliometric Analysis
by Inchon Park and Jonghwan Jeon
Healthcare 2023, 11(2), 259; https://doi.org/10.3390/healthcare11020259 - 13 Jan 2023
Cited by 12 | Viewed by 5121
Abstract
Psychological Skill Training (PST) for optimal performance in sports has received extensive attention from athletes, coaches, and experts, and numerous studies have been conducted, but despite this interest, it has not been the subject of any bibliographic analysis. The analysis covered 405 articles [...] Read more.
Psychological Skill Training (PST) for optimal performance in sports has received extensive attention from athletes, coaches, and experts, and numerous studies have been conducted, but despite this interest, it has not been the subject of any bibliographic analysis. The analysis covered 405 articles and reviews that were located in the Thomson Reuters Web of Science (Core CollectionTM) between 1992 and 2021. These papers were published by 1048 authors from 543 different universities across 54 countries in 107 different journals. The fundamental bibliometric calculations and co-word networks were completed. As a result, the following thematic elements were grouped into four clusters: (1) PST for stress, mental toughness, and coping, (2) PST for anxiety, motivation, self-confidence, and self-efficacy, (3) PST for flow and mindfulness, and (4) PST for emotions. From the results of this study, it was confirmed that the topic of PST is converging toward the best performance, with various approaches, such as stress management, anxiety control, and coping as techniques for PST. Furthermore, mindfulness and positive psychology studies emphasize athletes’ quality of life, so coaches and experts should pay more attention to improving athletes’ quality of life in future research. Full article
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9 pages, 247 KiB  
Article
Prevalence and Risk Factors of Neuropsychiatric Symptoms in Institutionalized Patients with Parkinson’s Disease in Taiwan: A Nationwide Observational Study
by Yang-Pei Chang, Ching-Fang Chien, Sun-Wung Hsieh, Ling-Chun Huang, Chung-Fen Lin, Chih-Cheng Hsu and Yuan-Han Yang
Healthcare 2023, 11(2), 258; https://doi.org/10.3390/healthcare11020258 - 13 Jan 2023
Viewed by 1686
Abstract
Neuropsychiatric symptoms (NPSs) are known to be frequent in Parkinson’s disease (PD) with great impacts on the quality of life, but reports about the prevalence in institutions are few. Our aim was to investigate the prevalence of and risk factors for NPSs in [...] Read more.
Neuropsychiatric symptoms (NPSs) are known to be frequent in Parkinson’s disease (PD) with great impacts on the quality of life, but reports about the prevalence in institutions are few. Our aim was to investigate the prevalence of and risk factors for NPSs in institutionalized patients with PD in Taiwan. The National Health Research Institute executed a cross-sectional, community-based, observational study on residential long-term care service institutions. The diagnosis of PD was determined by physicians with the estimated Hoehn and Yahr stage of PD according to the EQ-5D-5L questionnaire. A total of 370 patients with PD (80.1 ± 9.94 years old, 55.1% females) were included, and 139 (37.6%) had more than one NPS in the prior 3 months. The top three NPSs were nighttime behavior (65 (17.6%)), depression (53 (14.3%)), and fear/anxiety (49 (13.2%)). There were no differences between those with NPS and those without NPS in terms of age, gender, education, Mini-Mental State Examination, or Hoehn and Yahr stage. However, multivariate logistic regression analysis showed that genitourinary disease (odds ratio (OR) = 3.13; 95% confidence interval (95%CI) = 1.77–5.51) and psychiatric disorders (OR = 5.18; 95%CI = 3.09–8.69) may be associated with increased risk of NPSs. Increased physical restraint was observed in residents with advanced PD. Genitourinary disease and psychiatric disorders appear to increase the risk of NPSs in institutionalized residents with PD. Full article
8 pages, 2273 KiB  
Case Report
Epidermoid Cyst of the Uterine Cervix, an Unusual Location: Literature Review and Case Report
by Camelia Liana Buhas, Andrei Pascalau, Claudia Teodora Judea-Pusta, Ovidiu Laurean Pop, Adrian Sorin Judea, Bianca-Maria Negrutiu, Lavinia Marcut, Bogdan Adrian Buhas, Daniela Gheorghita and Alin Danut Bodog
Healthcare 2023, 11(2), 257; https://doi.org/10.3390/healthcare11020257 - 13 Jan 2023
Viewed by 1843
Abstract
Epidermoid cysts are most often benign cystic lesions, with uterine cervical localisation being very unusual. We present the case of a 52-year-old female patient diagnosed with an epidermoid cyst at the level of the uterine cervix. A bioptic and haemostatic uterine curettage was [...] Read more.
Epidermoid cysts are most often benign cystic lesions, with uterine cervical localisation being very unusual. We present the case of a 52-year-old female patient diagnosed with an epidermoid cyst at the level of the uterine cervix. A bioptic and haemostatic uterine curettage was performed, followed by total hysterectomy with bilateral adnexectomy. The histopathologic analysis and immunohistochemical essay of the resection specimens confirmed the cervical epidermoid cyst. The presence of high-risk HPV (human papillomavirus) was only seen in the cervical mucosa. The exact etiopathogenesis is unknown, but postpartum cell implantation of reminiscent embryonic tissue can be involved in the development of these lesions. Full article
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15 pages, 2055 KiB  
Article
Selection of an Efficient Classification Algorithm for Ambient Assisted Living: Supportive Care for Elderly People
by Reyadh Alluhaibi, Nawaf Alharbe, Abeer Aljohani and Rabia Emhmed Al Mamlook
Healthcare 2023, 11(2), 256; https://doi.org/10.3390/healthcare11020256 - 13 Jan 2023
Cited by 1 | Viewed by 1445
Abstract
Ambient Assisted Living (AAL) is a medical surveillance system comprised of connected devices, healthcare sensor systems, wireless communications, computer hardware, and software implementations. AAL could be used for an extensive variety of purposes, comprising preventing, healing, as well as improving the health and [...] Read more.
Ambient Assisted Living (AAL) is a medical surveillance system comprised of connected devices, healthcare sensor systems, wireless communications, computer hardware, and software implementations. AAL could be used for an extensive variety of purposes, comprising preventing, healing, as well as improving the health and wellness of elderly individuals. AAL intends to ensure the wellbeing of elderly persons while also spanning the number of years seniors can remain independent in their preferred surroundings. It also decreases the quantity of family caregivers by giving patients control over their health situations. To avert huge costs as well as possible adverse effects on standard of living, classifiers must be used to distinguish between adopters as well as nonadopters of such innovations. With the development of numerous classification algorithms, selecting the best classifier became a vital and challenging step in technology acceptance. Decision makers must consider several criteria from different domains when selecting the best classifier. Furthermore, it is critical to define the best multicriteria decision-making strategy for modelling technology acceptance. Considering the foregoing, this research reports the incorporation of the multicriteria decision-making (MCDM) method which is founded on the fuzzy method for order of preference by similarity to ideal solution (TOPSIS) to identify the top classifier for continuing toward supporting AAL implementation research. The results indicate that the classification algorithm KNN is the preferred technique among the collection of different classification algorithms for the ambient assisted living system. Full article
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17 pages, 1003 KiB  
Article
Assessment of Knowledge, Perception, Experience and Phobia toward Corticosteroids Use among the General Public in the Era of COVID-19: A Multinational Study
by Muna Barakat, Mohamed Hassan Elnaem, Amani Al-Rawashdeh, Bayan Othman, Sarah Ibrahim, Doaa H. Abdelaziz, Anas O. Alshweiki, Zelal Kharaba, Diana Malaeb, Nabeel Kashan Syed, Abdulqadir J. Nashwan, Mohammed Fathelrahman Adam, Reem Alzayer, Mohammad Saleh Albarbandi, Rana K. Abu-Farha, Malik Sallam, Yasmeen Barakat and Noha O. Mansour
Healthcare 2023, 11(2), 255; https://doi.org/10.3390/healthcare11020255 - 13 Jan 2023
Cited by 6 | Viewed by 3715
Abstract
Background: Corticosteroids play a significant role in managing the vast majority of inflammatory and immunologic conditions. To date, population-based studies on knowledge and attitudes concerning corticosteroids are scarce. This study aims to comprehensively assess knowledge, perception, experience and phobia toward corticosteroid use among [...] Read more.
Background: Corticosteroids play a significant role in managing the vast majority of inflammatory and immunologic conditions. To date, population-based studies on knowledge and attitudes concerning corticosteroids are scarce. This study aims to comprehensively assess knowledge, perception, experience and phobia toward corticosteroid use among the general population in the era of COVID-19. Methods: A cross-sectional self-administrated questionnaire was used to collect the data from 6 countries. Knowledge and corticophobia scores, descriptive statistics and logistic regression were computed. Results: A total of 2354 participants were enrolled in this study; the majority were females (61.6%) with an average age of 30. Around 61.9% had been infected previously with COVID-19, and about one-third of the participants had experience with corticosteroid use. The mean knowledge score was relatively satisfactory (8.7 ± 4.5 out of 14), and Corticophobia ranked a high score in all countries. Age, female gender, and history of COVID-19 were positively correlated with developing corticophobia. Conclusion: Our study highlights that the general knowledge about steroids was satisfactory. However, the phobia toward its use upon indication is high. Therefore, enhancing awareness and providing essential counseling regarding the rational use of corticosteroids may reduce corticophobia. Full article
(This article belongs to the Special Issue Health Priorities and COVID-19)
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8 pages, 728 KiB  
Article
Acquisition Status of Basic Clinical Skills in Japanese Novice Rehabilitation Therapists: A Preliminary Single-Center Study
by Kenta Fujimura, Hiroaki Sakurai, Soichiro Koyama, Kazuya Takeda, Takuma Ii, Shota Suzumura, Shigeo Tanabe and Yoshikiyo Kanada
Healthcare 2023, 11(2), 254; https://doi.org/10.3390/healthcare11020254 - 13 Jan 2023
Viewed by 1491
Abstract
The number of post-graduate rehabilitation therapists (novice therapists) is increasing due to the growing demand for rehabilitation services in Japan. This study investigated the acquisition status of Japanese novice therapists’ basic clinical skills to clarify their quality and characteristics. Eleven participants’ basic clinical [...] Read more.
The number of post-graduate rehabilitation therapists (novice therapists) is increasing due to the growing demand for rehabilitation services in Japan. This study investigated the acquisition status of Japanese novice therapists’ basic clinical skills to clarify their quality and characteristics. Eleven participants’ basic clinical skills (eight physical and three occupational therapists) were assessed using an Objective Structured Clinical Examination. Tasks included exercises of joint range of motion, muscle strengthening, getting up, standing up and sitting down, and transferring between wheelchair and bed. Assessment items were subdivided into categories: attitude, preparation, intervention, safety management, and feedback. One-way ANOVA and Friedman test were used for statistical analysis to compare the data between tasks and categories. The scores for each task’s achievement rate were not statistically significant. However, the achievement rate of each category including tasks was 92.6% (SD 4.0%) for attitude, 81.4% (SD 11.1%) for preparation, 77.9% (SD 14.7%) for intervention, 87.6% (SD 17.3%) for safety management, and 64.0% (SD 14.2%) for feedback. There were significant differences between attitude and feedback (p < 0.001), and between safety management and feedback (p = 0.012). Post-graduate training programs should focus on improving the quality of clinical skills, especially in skills related to feedback. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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12 pages, 866 KiB  
Article
Effectiveness of Spironolactone in Terms of Galectin-3 Levels in Patients with Heart Failure with a Reduced Ejection Fraction in the Vietnamese Population
by Son Kim Tran, Toan Hoang Ngo, Tin Trung Lai, Giang Khanh Truong, Khoa Dang Dang Tran, Phuong Minh Vo, Phi The Nguyen, Phi Hoang Nguyen, Thuan Tuan Nguyen, Oanh Thi Kim Nguyen, Thang Nguyen, Kien Trung Nguyen and Hung Do Tran
Healthcare 2023, 11(2), 253; https://doi.org/10.3390/healthcare11020253 - 13 Jan 2023
Cited by 3 | Viewed by 1622
Abstract
Background: Galectin-3 is a biomarker that has been demonstrated to play a significant role in myocardial fibrosis and remodeling in the pathogenesis of heart failure. Furthermore, spironolactone has the ability to control galectin-3 levels in heart failure patients. Objectives: The aim of our [...] Read more.
Background: Galectin-3 is a biomarker that has been demonstrated to play a significant role in myocardial fibrosis and remodeling in the pathogenesis of heart failure. Furthermore, spironolactone has the ability to control galectin-3 levels in heart failure patients. Objectives: The aim of our study was to determine the factors associated with the increase in galectin-3 and the alteration of galectin-3 concentration in patients with heart failure with a reduced ejection fraction after 12 weeks of treatment with spironolactone. Materials and methods: A cross-sectional descriptive study was conducted on 122 patients with heart failure with a reduced ejection fraction. Those patients were nonusers of spironolactone and presented for examination or had been hospitalized at the Can Tho Cardiovascular Hospital in Vietnam. The demographic and cardiovascular risk factor details were obtained at baseline, and galectin-3 levels were measured at baseline and also 12 weeks after taking spironolactone 25 mg once daily vs. 50 mg once daily. Results: The median baseline galectin-3 was 54.82 ± 26.06. Galectin-3 levels were positively correlated with age, NT-proBNP, and negatively correlated between EF and galectin-3 levels (p < 0.05). After 12 weeks of treatment with spironolactone, the galectin-3 concentration decreased from 54.82 ± 26.06 to 44.20 ± 24.36 (p < 0.05). According to the subgroup analysis, the average concentration of galectin-3 decreased the most in the group of patients with grade 3 hypertension and NYHA class III heart failure. The 50 mg once-daily dose of spironolactone significantly improved galectin-3 concentrations compared with the 25 mg once-daily group, at 17.11 ± 20.81 (p < 0.05) (reduced 29.05%) and 3.46 ± 6.81 ng/mL (p < 0.05) (reduced 6.87%), respectively. Conclusion: Treatment with spironolactone played an essential role in reducing galectin-3 concentrations, especially spironolactone 50 mg once daily, which showed a significant effect on reducing galectin-3 compared with a 25 mg once-daily dose. Full article
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14 pages, 900 KiB  
Article
Effectiveness of Non-Contact Dietary Coaching in Adults with Diabetes or Prediabetes Using a Continuous Glucose Monitoring Device: A Randomized Controlled Trial
by Yeh-Chan Ahn, Yang Seok Kim, Bukyung Kim, Jung Mi Ryu, Myoung Soo Kim, Minkyeong Kang and Jiwon Park
Healthcare 2023, 11(2), 252; https://doi.org/10.3390/healthcare11020252 - 13 Jan 2023
Cited by 2 | Viewed by 2434
Abstract
We aimed to evaluate the effectiveness of dietary coaching and continuous glucose monitoring (CGM) in patients with diabetes or prediabetes to improve their behavioral skills and health outcomes. A randomized controlled study with pre- and post-testing was conducted. Data were collected between November [...] Read more.
We aimed to evaluate the effectiveness of dietary coaching and continuous glucose monitoring (CGM) in patients with diabetes or prediabetes to improve their behavioral skills and health outcomes. A randomized controlled study with pre- and post-testing was conducted. Data were collected between November 2020 and April 2021. Forty-five patients with diabetes or prediabetes who used a CGM device were enrolled and analyzed. Dietary education, individual coaching and group coaching were provided to participants in the experimental group for 4 weeks. After the intervention, the thigh circumference in men significantly differed between the two groups (z = −2.02, p = 0.044). For women, participants in the experimental group showed greater improvement in eating self-efficacy compared with those in the control group (z = −2.66, p = 0.008). Insomnia was negatively related to the change in eating self-efficacy (r = −0.35, p = 0.018) and increase in thigh circumference (r = −0.35, p = 0.017). Even if used within a short intervention period, non-contact dietary coaching programs can help enhance behavioral skills, such as eating self-efficacy and health outcomes, such as thigh circumference. Moreover, the changed variables can indirectly improve other health outcomes in patients with diabetes or prediabetes. Full article
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