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Healthcare, Volume 11, Issue 21 (November-1 2023) – 103 articles

Cover Story (view full-size image): Sexual pleasure is a crucial human right, fundamental to people’s well-being and a key aspect in clinical contexts. This cross-sectional online exploratory qualitative study aimed to expand the understanding of sexual pleasure by examining how 85 LGB+ people (lesbian, gay, bisexual and other minority sexual orientations) with a sexual problem define solitary and partnered sexual pleasure. Summative content analysis was performed. This study reveals a broader range of problems than those proposed as sexual dysfunctions in diagnosis manuals. Nevertheless, the descriptions of sexual pleasure indicated that it may be punctuated by guilt, shame and openness to the experience, and consent has a fundamental role in framing sexual pleasure. View this paper
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11 pages, 323 KiB  
Article
Personality Traits and Risk of Eating Disorders in Men: A Cross-Sectional Study
by Rosendo Berengüí and María A. Castejón
Healthcare 2023, 11(21), 2910; https://doi.org/10.3390/healthcare11212910 - 06 Nov 2023
Viewed by 1260
Abstract
Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for [...] Read more.
Eating disorders (EDs) have been understudied and misunderstood in men. Among the relevant factors in the risk, onset, and maintenance of EDs, personality stands out. Therefore, the aim of the study was to analyze the relationships between personality traits and risk variables for the development of EDs in men. A total of 443 male university students (mean = 22.16 years) who completed the Spanish versions of the Eating Disorder Inventory-3 (EDI-3) and the NEO Five-Factor Inventory (NEO-FFI) participated. Correlation analyses were performed, and in order to determine the predictive role of personality traits on risk scales, a hierarchical multiple regression was performed. The results showed that neuroticism was positively associated with drive for thinness, being its main predictor variable. In bulimia, the main relationships were positively associated with neuroticism and negatively with conscientiousness. As for body dissatisfaction, the main predictor variables were neuroticism and, in a negative sense, extraversion and openness to experience. In conclusion, personality traits are related to the risk of developing EDs in male university students, with neuroticism being the main associated trait. Full article
15 pages, 818 KiB  
Article
New Media Use and Mental Health of Married Women: Mediating Effects of Marital Quality
by Dong Zhou, Yi Xu and Qixuan He
Healthcare 2023, 11(21), 2909; https://doi.org/10.3390/healthcare11212909 - 06 Nov 2023
Viewed by 927
Abstract
While previous studies have investigated the influence of new media on mental health, little is known about its effects on the mental health of married women. This is a crucial research area, given that married women commonly encounter distinct mental health difficulties. Also, [...] Read more.
While previous studies have investigated the influence of new media on mental health, little is known about its effects on the mental health of married women. This is a crucial research area, given that married women commonly encounter distinct mental health difficulties. Also, current research fails to provide comprehensive, population-based studies, with most relying on cross-sectional designs. Therefore, this study aimed to investigate the relationship between new media use and mental health among married women in China, utilizing a nationally representative longitudinal dataset. We utilized a balanced panel dataset from 2016 to 2020 to establish a causal connection between internet use and the mental health of these women. Our findings indicate that internet use has a positive impact on the mental health of married women in China. Additionally, a structural estimation model (SEM) with 2020 wave data was utilized to investigate various new media use effects and explore mediating pathways of marital satisfaction. Consistently, there were negative findings between new media use, marital satisfaction, and depression. Furthermore, it was determined that new media usage had a significant negative impact on married women’s overall satisfaction with their spouses’ housework contribution, which, in turn, negatively affected marital satisfaction as a whole. The pathways that mediate the effect of marital satisfaction on depression differ across general internet use, streaming media use, and WeChat use. Examining various theoretical perspectives, we interpreted the indirect impact of new media use on mental health through marital satisfaction as passive mediation. Full article
(This article belongs to the Topic Women's Health and Aging)
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17 pages, 298 KiB  
Article
The (Mis)use of Psychotropic Drugs and Addiction to Anxiolytics among Older Adults Living at Home or in Retirement Homes: Implications for Quality of Life
by Mirjana Kralj, Krešimir Šolić and Robert Lovrić
Healthcare 2023, 11(21), 2908; https://doi.org/10.3390/healthcare11212908 - 06 Nov 2023
Viewed by 980
Abstract
Nowadays, the growing number of people aged 65+ has become a global phenomenon. At that age, the most common medical problems are multimorbidity and inappropriate polypharmacy, which have a negative impact on the quality of life in older adults. The aim of this [...] Read more.
Nowadays, the growing number of people aged 65+ has become a global phenomenon. At that age, the most common medical problems are multimorbidity and inappropriate polypharmacy, which have a negative impact on the quality of life in older adults. The aim of this cross-sectional study was to examine comorbidity, the use of psychopharmaceuticals, and symptoms of addiction to anxiolytics among older adults living at home or in retirement homes, and to examine the differences in quality of life in relation to the use and misuse of psychotropic drugs. The research included 383 people aged 65+ living in the Republic of Croatia (EU). A standardized questionnaire CAGE was used to collect data about the use of psychotropic drugs. Quality of life was examined using the WHOQOL-BREF scale. The average age of respondents was 83 years. There is a significantly higher prevalence of anxiety disorders (p = 0.001) in respondents who live at home. Psychopharmaceuticals were used by 218 (56.9%) respondents, equally in both groups of respondents. A total of 77 (20.1%) respondents had been using anxiolytics for more than five years, while 26 (6.8%) of them had significant clinical symptoms of addiction to anxiolytics. All domains and the overall quality of life scale were significantly lower (p < 0.001) in respondents who have clinical symptoms of anxiolytic addiction. The results indicate that the use of psychotropic drugs by respondents is inappropriate. Respondents who inappropriately and excessively use psychotropic drugs have a significantly worse quality of life. Full article
(This article belongs to the Special Issue Community Care of Older People with Chronic Diseases)
16 pages, 2499 KiB  
Article
Effectiveness of Palliative Care before Death in Reducing Emergency Care Utilization for Patients with Terminal Cancer and Trends in the Utilization of Palliative Care from 2005–2018
by Yi-Shiun Tsai, Wen-Chen Tsai, Li-Ting Chiu and Pei-Tseng Kung
Healthcare 2023, 11(21), 2907; https://doi.org/10.3390/healthcare11212907 - 06 Nov 2023
Viewed by 815
Abstract
This retrospective cohort study aimed to examine the effect of palliative care for patients with terminal cancer on healthcare utilization. The National Health Insurance (NHI) Research Database and death certificates were utilized to identify patients who died of cancer between 2005 and 2018. [...] Read more.
This retrospective cohort study aimed to examine the effect of palliative care for patients with terminal cancer on healthcare utilization. The National Health Insurance (NHI) Research Database and death certificates were utilized to identify patients who died of cancer between 2005 and 2018. The number of terminal cancer patients between 2005 and 2018 was 605,126. Propensity score matching and conditional logistic regression were performed. The odds ratios (ORs) for “emergency care utilization”, “CPR”, “endotracheal intubation”, and “ICU admission” were significantly lower for enrolled patients regardless of enrollment time compared to unenrolled patients. Compared to unenrolled patients, the OR for “emergency care utilization” increased from 0.34 to 0.68, the OR for “CPR use” increased from 0.13 to 0.26, the OR for “intubation” increased from 0.15 to 0.26, and the OR for “ICU admission” increased from 0.27 to 0.40 in enrolled patients. Between 2005 and 2010, CPR utilization, intubation, and ICU admission in patients enrolled in palliative care declined each year. Since the inclusion of palliative care in NHI (from 2010 onward), its utilization has increased slightly each year. Patients with terminal cancer enrolled in palliative care consume fewer medical resources before death than unenrolled patients; however, the difference decreases with longer times before death. Full article
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10 pages, 242 KiB  
Review
The Role of ChatGPT in the Advancement of Diagnosis, Management, and Prognosis of Cardiovascular and Cerebrovascular Disease
by David-Dimitris Chlorogiannis, Anastasios Apostolos, Anargyros Chlorogiannis, Leonidas Palaiodimos, George Giannakoulas, Sumant Pargaonkar, Sofia Xesfingi and Damianos G. Kokkinidis
Healthcare 2023, 11(21), 2906; https://doi.org/10.3390/healthcare11212906 - 06 Nov 2023
Cited by 1 | Viewed by 1941
Abstract
Cardiovascular and cerebrovascular disease incidence has risen mainly due to poor control of preventable risk factors and still constitutes a significant financial and health burden worldwide. ChatGPT is an artificial intelligence language-based model developed by OpenAI. Due to the model’s unique cognitive capabilities [...] Read more.
Cardiovascular and cerebrovascular disease incidence has risen mainly due to poor control of preventable risk factors and still constitutes a significant financial and health burden worldwide. ChatGPT is an artificial intelligence language-based model developed by OpenAI. Due to the model’s unique cognitive capabilities beyond data processing and the production of high-quality text, there has been a surge of research interest concerning its role in the scientific community and contemporary clinical practice. To fully exploit ChatGPT’s potential benefits and reduce its possible misuse, extreme caution must be taken to ensure its implications ethically and equitably. In this narrative review, we explore the language model’s possible applications and limitations while emphasizing its potential value for diagnosing, managing, and prognosis of cardiovascular and cerebrovascular disease. Full article
(This article belongs to the Special Issue Cardiovascular Health and Stroke)
16 pages, 884 KiB  
Article
Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex
by Pablo del Pozo-Herce, Antonio Martínez-Sabater, Elena Chover-Sierra, Vicente Gea-Caballero, Pedro José Satústegui-Dordá, Carles Saus-Ortega, Clara Isabel Tejada-Garrido, Mercedes Sánchez-Barba, Jesús Pérez, Raúl Juárez-Vela, Iván Santolalla-Arnedo and Enrique Baca-García
Healthcare 2023, 11(21), 2905; https://doi.org/10.3390/healthcare11212905 - 05 Nov 2023
Viewed by 1872
Abstract
Chemsex is understood as “the intentional use of stimulant drugs to have sex for an extended time among gay, bisexual, and other men who have sex with men”. It is a public health problem because of the increased incidence of cases and because [...] Read more.
Chemsex is understood as “the intentional use of stimulant drugs to have sex for an extended time among gay, bisexual, and other men who have sex with men”. It is a public health problem because of the increased incidence of cases and because of the consequences on the physical and mental health of those who practice it. Aim: This study aimed to analyze, with the help of the Delphi method, the content validity of a new instrument to assess the risk of behaviors associated with the chemsex phenomenon. Method: First, a bank of items identified from the literature was elaborated. Secondly, 50 experts with knowledge of the chemsex phenomenon at the national level were contacted. A Delphi group was formed with them to carry out two rounds of item evaluation. The linguistic evaluation (comprehension and appropriateness) was assessed using a Likert scale from 1 to 5 for each item. Items that did not reach a mean score of 4 were eliminated. Content assessment was calculated using each item’s content validity index (CVI) and Aiken’s V (VdA). A minimum CVI and VdA value of 0.6 was established to include the items in the questionnaire. Results: A total of 114 items were identified in the literature. In the first round of Delphi evaluation, 36 experts evaluated the items. A total of 58 items were eliminated for obtaining a CVI or VdA of less than 0.6, leaving 56 items. In a second Delphi round, 30 experts re-evaluated the 56 selected items, where 4 items were eliminated for being similar, and 10 items were also eliminated for not being relevant to the topic even though they had values higher than 0.6, leaving the scale finally composed of 52 items. Conclusion: A questionnaire has been designed to assess the risk of behaviors associated with the chemsex phenomenon. The items that make up the questionnaire have shown adequate content and linguistic validity. The Delphi method proved to be a helpful technique for the proposed objective. Full article
(This article belongs to the Special Issue Chemsex, LGBTIQ+ and Mental Disorders)
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20 pages, 1319 KiB  
Review
Promoting Universal Equitable Accessibility: An Overview on the Impact of Assistive Technology in the UN, UNICEF, and WHO Web Portals
by Rossella Simeoni, Antonia Pirrera, Paola Meli and Daniele Giansanti
Healthcare 2023, 11(21), 2904; https://doi.org/10.3390/healthcare11212904 - 05 Nov 2023
Viewed by 1021
Abstract
The number of people with disabilities and frailties who need support and assistance is increasing. Assistive technologies (ATs) are increasingly playing a central role in supporting people with disabilities and frailties. The study investigated the impact of the ATs on the websites of [...] Read more.
The number of people with disabilities and frailties who need support and assistance is increasing. Assistive technologies (ATs) are increasingly playing a central role in supporting people with disabilities and frailties. The study investigated the impact of the ATs on the websites of the UN, UNICEF, and WHO in terms of proposed activities and actions. The methodology proposed was based on two points of view: (1) A formal process to directly select elements in the institutional webs of the UN, UNICEF, and WHO. (2) A formal process for a complementary literature narrative review based on an umbrella review of Pubmed and Scopus. A standard checklist and a qualification process were applied. The outcome reported 35 documents from the direct search on the web and 19 systematic reviews for the complimentary literature overview. The direct search returned documents related to initiatives focused on the following: The tailoring of the ATs to a person based on international guidelines and specific monitoring initiatives of the AT introduction/access based on surveys both at the population and system/government level with the publication of the data/metadata in an observatory. Dissemination initiatives of both the culture of ATs (e.g., catalog, guidelines, reports, congresses) and of recommendations. The literature overview contributed more specifically to the use and effectiveness of categories of ATs. Both direct research and the literature overview have shown a consistent growth in interest in ATs. The initiatives of the UN, UNICEF, and WHO have been consistent with the institutional role and aimed at improving the diffusion of ATs through capillary monitoring, which is not free from obstacles, and a diffusion of the culture and rational use of ATs. The narrative review shows also the important role of research in monitoring the development, use, and effectiveness of devices, strategies, and support of international institutional initiatives. Important initiatives have been launched internationally on AT in terms of monitoring, dissemination, and improvement in access. However, it is necessary to consider and face the obstacles that limit these initiatives. Full article
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12 pages, 916 KiB  
Article
Incidence and Determinants of Acute Kidney Injury after Prone Positioning in Severe COVID-19 Acute Respiratory Distress Syndrome
by Riccardo La Rosa, Benedetta Grechi, Riccardo Ragazzi, Valentina Alvisi, Giacomo Montanari, Elisabetta Marangoni, Carlo Alberto Volta, Savino Spadaro and Gaetano Scaramuzzo
Healthcare 2023, 11(21), 2903; https://doi.org/10.3390/healthcare11212903 - 04 Nov 2023
Cited by 1 | Viewed by 837
Abstract
(1) Background: Acute kidney injury (AKI) is common among critically ill COVID-19 patients, but its temporal association with prone positioning (PP) is still unknown, and no data exist on the possibility of predicting PP-associated AKI from bedside clinical variables. (2) Methods: We analyzed [...] Read more.
(1) Background: Acute kidney injury (AKI) is common among critically ill COVID-19 patients, but its temporal association with prone positioning (PP) is still unknown, and no data exist on the possibility of predicting PP-associated AKI from bedside clinical variables. (2) Methods: We analyzed data from 93 COVID-19-related ARDS patients who underwent invasive mechanical ventilation (IMV) and at least one PP cycle. We collected hemodynamic variables, respiratory mechanics, and circulating biomarkers before, during, and after the first PP cycle. PP-associated AKI (PP-AKI) was defined as AKI diagnosed any time from the start of PP to 48 h after returning to the supine position. A t-test for independent samples was used to test for the differences between groups, while binomial logistical regression was performed to assess variables independently associated with PP-associated AKI. (3) Results: A total of 48/93 (52%) patients developed PP-AKI, with a median onset at 24 [13.5–44.5] hours after starting PP. No significant differences in demographic characteristics between groups were found. Before starting the first PP cycle, patients who developed PP-AKI had a significantly lower cumulative fluid balance (CFB), even when normalized for body weight (p = 0.006). Central venous pressure (CVP) values, measured before the first PP (OR 0.803, 95% CI [0.684–0.942], p = 0.007), as well as BMI (OR 1.153, 95% CI = [1.013–1.313], p = 0.031), were independently associated with the development of PP-AKI. In the multivariable regression analysis, a lower CVP before the first PP cycle was independently associated with ventilator-free days (OR 0.271, 95% CI [0.123–0.936], p = 0.011) and with ICU mortality (OR:0.831, 95% CI [0.699–0.989], p = 0.037). (4) Conclusions: Acute kidney injury occurs frequently in invasively ventilated severe COVID-19 ARDS patients undergoing their first prone positioning cycle. Higher BMI and lower CVP before PP are independently associated with the occurrence of AKI during prone positioning. Full article
(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)
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21 pages, 2375 KiB  
Review
Education and Training Adaptations for Health Workers during the COVID-19 Pandemic: A Scoping Review of Lessons Learned and Innovations
by Perla Boutros, Nour Kassem, Jessica Nieder, Catalina Jaramillo, Jakob von Petersdorff, Fiona J. Walsh, Till Bärnighausen and Sandra Barteit
Healthcare 2023, 11(21), 2902; https://doi.org/10.3390/healthcare11212902 - 04 Nov 2023
Cited by 1 | Viewed by 3258
Abstract
Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have [...] Read more.
Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have been implemented to mitigate the adverse effects of clinical education. This scoping review aims to assess the impact of COVID-19 on medical education and training, examine the implemented adaptation measures, and evaluate their effectiveness in improving health workers’ education and training during the pandemic. Methods: Employing the PRISMA-ScR framework and Arksey and O’Malley’s methodological guidance, we conducted a scoping review, systematically searching PubMed, medRxiv, Google, and DuckDuckGo databases to account for the grey literature. The search included studies published between 1 December 2019 and 13 October 2021, yielding 10,323 results. Of these, 88 studies focused on health worker education and training during the pandemic. Results: Our review incorporated 31,268 participants, including physicians, medical trainees, nurses, paramedics, students, and health educators. Most studies (71/88, 81%) were conducted in high-income and lower-middle-income countries. The pandemic’s effects on health workers’ clinical skills and abilities have necessitated training period extensions in some cases. We identified several positive outcomes from the implementation of simulation training and e-learning as adaptation strategies, such as enhanced technical and clinical performance, increased confidence and comfort, and an expanded global educational outreach. Conclusions: Despite challenges like insufficient practical experience, limited interpersonal interaction opportunities, and internet connectivity issues, simulation training, e-learning, and virtual training have proven effective in improving clinical education and training during the COVID-19 pandemic. Further research is required to bolster preparedness for future pandemics or similar situations. Full article
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19 pages, 2807 KiB  
Article
Four-Year Training Course for Police Officers (CFOP) and Fitness Outcomes of Police Academy Cadets: A Cohort Study from 2004 to 2020
by Luís Miguel Massuça, Luís Monteiro, Gabriel Coutinho and Vanessa Santos
Healthcare 2023, 11(21), 2901; https://doi.org/10.3390/healthcare11212901 - 03 Nov 2023
Cited by 2 | Viewed by 1404
Abstract
This study examines the effect of gender, age, and a 4-year training course for police officers (CFOP) on the physical fitness attributes of Portuguese police academy cadets. This longitudinal cohort study considered 686 police cadets (female, n = 131; male, n = 555 [...] Read more.
This study examines the effect of gender, age, and a 4-year training course for police officers (CFOP) on the physical fitness attributes of Portuguese police academy cadets. This longitudinal cohort study considered 686 police cadets (female, n = 131; male, n = 555 male), corresponding to 2578 fitness assessments (female, n = 509; male, n = 2069). The database of police cadets’ physical fitness evaluations (from 2004/2005 to 2019/2020) comprises body size, speed, agility, strength, flexibility, and aerobic capacity first assessment (T0) and evaluations at the end of the first four years of the CFOP (T1, T2, T3, T4). Results showed that (i) female cadets are younger (p < 0.05), shorter, lighter, less fast, less agile, less strong, and perform worse in aerobic capacity assessments than male cadets (all, p < 0.001) but perform better in the flexibility assessment (p < 0.001); (ii) female cadets > 29 years are significantly heavier, slower, jump less, perform fewer sit-ups, and perform less on the Cooper test (but they have more handgrip strength), and male cadets > 29 years are significantly heavier, slower, jump less, perform fewer sit-ups, and have less flexibility and aerobic capacity (still, they have superior back and lumbar strength and handgrip strength); and (iii) from T0 to T4 (Δ), female cadets are significantly faster (60 m, −0.32 s; slalom, −0.78 s), jump further (+4 cm), have more abdominal strength endurance (+2.6 repetitions) and more back and lumbar strength (+89.8 kg), and male cadets are significantly heavier (+3.27 kg), faster (60 m, −0.23 s; 30 m, −0.15 s; slalom, −0.91 s), jump further (+8 cm), complete more repetitions in the sit-ups (+4.9 repetitions) and in pull-ups (+2.5 repetitions) and have more back and lumbar strength (+92.1 kg) and handgrip strength (+8.6 kg) but a lower aerobic capacity (Cooper test, −74.8 m; VO2max, −1.3 mL/kg/min) when compared to T0. The study’s findings lead to widely accepted conclusions within the discipline. Nevertheless, this work provides valuable insights into the impact of various factors on the physical fitness of Portuguese police academy cadets, i.e.: (i) it is an essential study with practical implications for recruitment, training, and the ongoing development of Portuguese police academy cadets and police officers; and (ii) these results can also assist in tailoring training programs to different age groups and genders, which is crucial in police training. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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17 pages, 1437 KiB  
Review
The Role of Continuing Professional Training or Development in Maintaining Current Employment: A Systematic Review
by Rahman Shiri, Ashraf El-Metwally, Mikael Sallinen, Marjaana Pöyry, Mikko Härmä and Salla Toppinen-Tanner
Healthcare 2023, 11(21), 2900; https://doi.org/10.3390/healthcare11212900 - 03 Nov 2023
Viewed by 1314
Abstract
The impact of continuing job education and professional development on early exit from the labor market is unclear. This systematic review examined how continuing job education or professional development influences the retention of current employment. We searched the PubMed and Embase databases from [...] Read more.
The impact of continuing job education and professional development on early exit from the labor market is unclear. This systematic review examined how continuing job education or professional development influences the retention of current employment. We searched the PubMed and Embase databases from their start dates to January 2023. Two reviewers screened the full texts of relevant reports and assessed the methodological quality of the included studies using the adapted Effective Public Health Practice Project quality assessment. We qualitatively synthesized the results of the included studies. We screened 7338 publications and included 27 studies consisting of four cohort and 23 cross-sectional studies in the review. The participants of the selected studies were mostly from the health sector (24 studies). There were 19 studies on staying or leaving a current job, six on employee turnover intention, two on job change, one on return to work, one on early retirement, and one on employment. Continuing employee development or training opportunities were associated with increased intention to stay in a current job, decreased intention to leave a current job, decreased employee turnover intention, job change, or early retirement and with faster return to work. One of the two studies that examined the role of age showed that continuing employee development is a more important factor for retaining current employment among younger than older employees. A few studies found that job satisfaction and commitment fully mediated the relationship between employee development and employee intention to leave current employment. This study suggests that participating in professional training/development is related to a lower risk of leaving current employment. Full article
(This article belongs to the Section Chronic Care)
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8 pages, 2665 KiB  
Communication
Contrast-Enhanced Ultrasound Follow-Up for Acute Pyelonephritis Patients
by Andrea Boccatonda, Stefano Venerato, Damiano D’Ardes, Giulio Cocco, Cosima Schiavone and Susanna Vicari
Healthcare 2023, 11(21), 2899; https://doi.org/10.3390/healthcare11212899 - 03 Nov 2023
Viewed by 866
Abstract
Contrast-enhanced ultrasound (CEUS) is increasingly used in clinical practice as the first diagnostic method in patients with suspected pyelonephritis rather than abdominal CT with contrast medium, especially in young subjects. We performed a retrospective analysis on patients in for whom a CEUS examination [...] Read more.
Contrast-enhanced ultrasound (CEUS) is increasingly used in clinical practice as the first diagnostic method in patients with suspected pyelonephritis rather than abdominal CT with contrast medium, especially in young subjects. We performed a retrospective analysis on patients in for whom a CEUS examination was utilized as a follow-up method after acute pyelonephritis as normal clinical practice. Through evaluating all patients, in terms duration between CEUS examination and normalization (healing) of the renal disease, we found that the mean duration is 25.9 days. Our ultrasound findings did not induce any therapeutic modifications, not even in the cases in which the examination was repeated several times. Therefore, setting up a CEUS follow-up examination after 25 days from the first diagnosis can reduce the number of repeated tests, benefitting patients and the healthcare system in terms of reducing costs. Full article
(This article belongs to the Special Issue Adult Critical Care Ultrasound)
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12 pages, 305 KiB  
Article
Differences in Motor Imagery Ability between People with Parkinson’s Disease and Healthy Controls, and Its Relationship with Functionality, Independence and Quality of Life
by María del Rosario Ferreira-Sánchez, Marcos Moreno-Verdú, Ellen Poliakoff, Zacarías Sánchez Milá, David Rodríguez Sanz, Raúl Frutos Llanes, José Manuel Barragán Casas and Jorge Velázquez Saornil
Healthcare 2023, 11(21), 2898; https://doi.org/10.3390/healthcare11212898 - 03 Nov 2023
Viewed by 910
Abstract
Motor imagery (MI) has been shown to be effective for the acquisition of motor skills; however, it is still unknown whether similar benefits can be achieved in neurological patients. Previous findings of differences in MI ability between people with Parkinson’s disease (PwPD) and [...] Read more.
Motor imagery (MI) has been shown to be effective for the acquisition of motor skills; however, it is still unknown whether similar benefits can be achieved in neurological patients. Previous findings of differences in MI ability between people with Parkinson’s disease (PwPD) and healthy controls (HCs) are mixed. This study examined differences in the ability to both create and maintain MI as well as investigating the relationship between the ability to create and maintain MI and motor function, independence and quality of life (QoL). A case–control study was conducted (31 PwPD and 31 HCs), collecting gender, age, dominance, socio-demographic data, duration and impact of the disease. MI intensity (MIQ-RS and KVIQ-34) and temporal accuracy of MI (imagined box and block test [iBBT], imagined timed stand and walk test [iTUG]) were assessed. Functional and clinical assessments included upper limb motor function, balance, gait, independence in activities of daily living and quality of life measures. Statistically significant differences in temporal accuracy were observed and partial and weak relationships were revealed between MI measures and functioning, independence and QoL. PwPD retain the ability to create MI, indicating the suitability of MI in this population. Temporal accuracy might be altered as a reflection of bradykinesia on the mentally simulated actions. Full article
14 pages, 1175 KiB  
Review
Technologies for Managing the Health of Older Adults with Multiple Chronic Conditions: A Systematic Literature Review
by Gabriela Cajamarca, Valentina Proust, Valeria Herskovic, Rodrigo F. Cádiz, Nervo Verdezoto and Francisco J. Fernández
Healthcare 2023, 11(21), 2897; https://doi.org/10.3390/healthcare11212897 - 03 Nov 2023
Viewed by 1534
Abstract
Multimorbidity is defined as the presence of two or more chronic medical conditions in a person, whether physical, mental or long-term infectious diseases. This is especially common in older populations, affecting their quality of life and emotionally impacting their caregivers and family. Technology [...] Read more.
Multimorbidity is defined as the presence of two or more chronic medical conditions in a person, whether physical, mental or long-term infectious diseases. This is especially common in older populations, affecting their quality of life and emotionally impacting their caregivers and family. Technology can allow for monitoring, managing, and motivating older adults in their self-care, as well as supporting their caregivers. However, when several conditions are present at once, it may be necessary to manage several types of technologies, or for technology to manage the interaction between conditions. This work aims to understand and describe the technologies that are used to support the management of multimorbidity for older adults. We conducted a systematic review of ten years of scientific literature from four online databases. We reviewed a corpus of 681 research papers, finally including 25 in our review. The technologies used most frequently by older adults with multimorbidity are mobile applications and websites, and they are mostly focused on communication and connectivity. We then propose opportunities for future research on addressing the challenges in the management of several simultaneous health conditions, potentially creating a better approach than managing each condition as if it were independent. Full article
(This article belongs to the Special Issue New Advances in Digital Health Interventions)
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10 pages, 1134 KiB  
Article
Patients’ Perspective on Termination of Pacemaker Therapy—A Cross-Sectional Anonymous Survey among Patients Carrying a Pacemaker in Germany
by Irene Portig, Elif Karaaslan, Elena Hofacker, Christian Volberg and Carola Seifart
Healthcare 2023, 11(21), 2896; https://doi.org/10.3390/healthcare11212896 - 03 Nov 2023
Viewed by 582
Abstract
Objective: To determine the opinions of patients regarding the withdrawal of pacemaker therapy. Participants and methods: A cross-sectional anonymous questionnaire was administered to patients visiting an outpatient cardiologic clinic for routine follow-up visits of pacemaker therapy or patients carrying a pacemaker admitted to [...] Read more.
Objective: To determine the opinions of patients regarding the withdrawal of pacemaker therapy. Participants and methods: A cross-sectional anonymous questionnaire was administered to patients visiting an outpatient cardiologic clinic for routine follow-up visits of pacemaker therapy or patients carrying a pacemaker admitted to a hospital between 2021 and 2022. Results: Three-hundred and forty patients answered the questionnaire. A total of 56% of the participants were male. The mean age was 81 years. The majority of respondents were very comfortable with their PM and felt well informed, with one exception: more than half of respondents were missing information on withdrawal of pacemaker therapy. Almost two-thirds wanted to decide for themselves if their pacemaker therapy was withdrawn regardless of whether they were ill or healthy. Almost 60% of patients would like the pacemaker to be turned off when dying. Women expressed this wish significantly more often than men. Conclusion: Our survey shows that patients prefer to be informed on issues regarding the withdrawal of pacemakers as early as preimplantation. Also, patients would like to be involved in decisions that have to be made at the end of life, including decisions on withdrawal. Offers of conversations about this important issue should include information on special features of the patient’s pacemaker, e.g., the absence or presence of pacemaker dependency. Knowledge about the pacemaker’s functionality may prevent distress among individuals nearing their end of life when, for example, under the false impression that timely deactivation may allow for a more peaceful death. Full article
(This article belongs to the Special Issue Quality Healthcare at the End of Life)
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10 pages, 722 KiB  
Article
The Impact of Resilience on Post-Traumatic Growth among Nurses in COVID-19-Designated Hospitals: The Mediating Effect of Meaning in Life
by Suk-Jung Han, Young-Ran Yeun and Hyunseung Roh
Healthcare 2023, 11(21), 2895; https://doi.org/10.3390/healthcare11212895 - 03 Nov 2023
Viewed by 950
Abstract
This study aimed to confirm the relationship between resilience, meaning in life, and post-traumatic growth (PTG) among nurses during the COVID-19 pandemic. In particular, the mediating effect of meaning in life on the relationship between resilience and PTG was examined. A cross-sectional descriptive [...] Read more.
This study aimed to confirm the relationship between resilience, meaning in life, and post-traumatic growth (PTG) among nurses during the COVID-19 pandemic. In particular, the mediating effect of meaning in life on the relationship between resilience and PTG was examined. A cross-sectional descriptive research design was used. The participants were 220 nurses at COVID-19-designated hospitals in Seoul. Descriptive statistics, a t-test, ANOVA, Pearson’s correlation coefficient analysis, hierarchical regression, and SPSS PROCESS macro (Model 4) were used for data analyses. As a result of the study, resilience and meaning in life each had a significant positive effect on PTG. In addition, the indirect effect of meaning in life was significant, suggesting that meaning in life partially mediated the relationship between resilience and PTG. The results indicate that nurses’ resilience directly contributes to the improvement of PTG, and this relationship is further strengthened indirectly through the presence of meaning in life. Therefore, it is suggested that strategies should be developed to enhance resilience and promote a sense of meaning in the profession in order to support the mental health and foster growth among nurses. Full article
(This article belongs to the Special Issue Burnout and Mental Health among Health Professionals)
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12 pages, 628 KiB  
Article
Psychological Symptoms in Parents Who Experience Child-to-Parent Violence: The Role of Self-Efficacy Beliefs
by Aitor Jiménez-Granado, Liria Fernández-González, Joana del Hoyo-Bilbao and Esther Calvete
Healthcare 2023, 11(21), 2894; https://doi.org/10.3390/healthcare11212894 - 03 Nov 2023
Cited by 1 | Viewed by 922
Abstract
Previous research suggests that parents involved in child-to-parent violence (CPV) experience shame, judgment, and a lack of social support, often accompanied by feelings of self-blame and helplessness as well as a deterioration in their perception of self-efficacy and their parenting skills. All of [...] Read more.
Previous research suggests that parents involved in child-to-parent violence (CPV) experience shame, judgment, and a lack of social support, often accompanied by feelings of self-blame and helplessness as well as a deterioration in their perception of self-efficacy and their parenting skills. All of these factors may impact parents’ mental health. However, there is a research gap concerning the consequences of CPV among parents. Therefore, the objective of this study was to examine the relationship between CPV and psychological symptoms (i.e., depression, anxiety, hostility, obsessive–compulsive, interpersonal sensitivity, and somatization) in parents based on their perceptions of self-efficacy. The sample was composed of 354 participants: 177 parents (83.1% mothers) and their 177 children (53.4% boys; Mage = 13.27). CPV was reported by both parents and their children. In addition, parents reported their self-efficacy beliefs and psychological symptoms. The results showed that CPV was negatively associated with parents’ psychological symptomatology, except for somatization. Moreover, self-efficacy beliefs explain part of the indirect association between CPV behaviors and psychological symptoms in parents. Overall, our findings provide evidence for the potential impact of CPV on mental health in parents and suggest the relevance of reinforcing their self-efficacy beliefs. Full article
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14 pages, 399 KiB  
Article
Sentiments about Mental Health on Twitter—Before and during the COVID-19 Pandemic
by Felix Beierle, Rüdiger Pryss and Akiko Aizawa
Healthcare 2023, 11(21), 2893; https://doi.org/10.3390/healthcare11212893 - 03 Nov 2023
Viewed by 776
Abstract
During the COVID-19 pandemic, the novel coronavirus had an impact not only on public health but also on the mental health of the population. Public sentiment on mental health and depression is often captured only in small, survey-based studies, while work based on [...] Read more.
During the COVID-19 pandemic, the novel coronavirus had an impact not only on public health but also on the mental health of the population. Public sentiment on mental health and depression is often captured only in small, survey-based studies, while work based on Twitter data often only looks at the period during the pandemic and does not make comparisons with the pre-pandemic situation. We collected tweets that included the hashtags #MentalHealth and #Depression from before and during the pandemic (8.5 months each). We used LDA (Latent Dirichlet Allocation) for topic modeling and LIWC, VADER, and NRC for sentiment analysis. We used three machine-learning classifiers to seek evidence regarding an automatically detectable change in tweets before vs. during the pandemic: (1) based on TF-IDF values, (2) based on the values from the sentiment libraries, (3) based on tweet content (deep-learning BERT classifier). Topic modeling revealed that Twitter users who explicitly used the hashtags #Depression and especially #MentalHealth did so to raise awareness. We observed an overall positive sentiment, and in tough times such as during the COVID-19 pandemic, tweets with #MentalHealth were often associated with gratitude. Among the three classification approaches, the BERT classifier showed the best performance, with an accuracy of 81% for #MentalHealth and 79% for #Depression. Although the data may have come from users familiar with mental health, these findings can help gauge public sentiment on the topic. The combination of (1) sentiment analysis, (2) topic modeling, and (3) tweet classification with machine learning proved useful in gaining comprehensive insight into public sentiment and could be applied to other data sources and topics. Full article
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17 pages, 3302 KiB  
Review
The Use of Prehospital Intensive Care Units in Emergencies—A Scoping Review
by Abdullah Alruwaili, Amir Khorram-Manesh, Amila Ratnayake, Yohan Robinson and Krzysztof Goniewicz
Healthcare 2023, 11(21), 2892; https://doi.org/10.3390/healthcare11212892 - 02 Nov 2023
Viewed by 1353
Abstract
Background: Amidst a rising tide of trauma-related emergencies, emergency departments worldwide grapple with the challenges of overcrowding and prolonged patient wait times. Addressing these challenges, the integration of prehospital intensive care units has appeared as a promising solution, streamlining trauma care and enhancing [...] Read more.
Background: Amidst a rising tide of trauma-related emergencies, emergency departments worldwide grapple with the challenges of overcrowding and prolonged patient wait times. Addressing these challenges, the integration of prehospital intensive care units has appeared as a promising solution, streamlining trauma care and enhancing patient safety. Nevertheless, the feasibility of such an initiative becomes murky when considered globally. This review delves into the intricacies of prehospital intensive care units’ deployment for trauma care, scrutinizing their configurations, operational practices, and the inherent challenges and research priorities. Methods: A scoping review was performed for eligible studies. The result was uploaded to the RAYYAN research platform, facilitating simultaneous evaluation of the studies by all researchers. Results: A total of 42 studies were initially selected. Four studies were duplicates, and 25 studies were unanimously removed as irrelevant. The remaining studies (n = 13) were included in the review, and the outcomes were categorized into diverse subgroups. Conclusions: A country’s emergency medical services must achieve specific milestones in education, competency, resource availability, and performance to effectively harness the potential of a prehospital intensive care unit. While certain nations are equipped, others lag, highlighting a global disparity in readiness for such advanced care modalities. Full article
(This article belongs to the Section Environmental Factors and Global Health)
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11 pages, 582 KiB  
Article
Effect of Smartphone Use on Sleep in Undergraduate Medical Students: A Cross-Sectional Study
by Ashish Goel, Arsalan Moinuddin, Rajesh Tiwari, Yashendra Sethi, Mohammed K. Suhail, Aditi Mohan, Nirja Kaka, Parth Sarthi, Ravi Dutt, Sheikh F. Ahmad, Sabry M. Attia, Talha Bin Emran, Hitesh Chopra and Nigel H. Greig
Healthcare 2023, 11(21), 2891; https://doi.org/10.3390/healthcare11212891 - 02 Nov 2023
Cited by 1 | Viewed by 1818
Abstract
Smartphone use, particularly at night, has been shown to provoke various circadian sleep–wake rhythm disorders such as insomnia and excessive daytime tiredness. This relationship has been mainly scrutinized among patient groups with higher rates of smartphone usage, particularly adolescents and children. However, it [...] Read more.
Smartphone use, particularly at night, has been shown to provoke various circadian sleep–wake rhythm disorders such as insomnia and excessive daytime tiredness. This relationship has been mainly scrutinized among patient groups with higher rates of smartphone usage, particularly adolescents and children. However, it remains obscure how smartphone usage impacts sleep parameters in adults, especially undergraduate college students. This study sought to (1) investigate the association between smartphone use (actual screen time) and four sleep parameters: Pittsburgh sleep quality score (PSQI), self-reported screen time, bedtime, and rise time; (2) compare the seven PSQI components between good and poor sleep quality subjects. In total, 264 undergraduate medical students (aged 17 to 25 years) were recruited from the Government Doon Medical College, Dehradun, India. All participants completed a sleep questionnaire, which was electronically shared via a WhatsApp invitation link. Hierarchical and multinomial regression analyses were performed in relation to (1) and (2). The average PSQI score was 5.03 ± 0.86, with approximately one in two respondents (48.3%) having a poor sleep index. Smartphone use significantly predicted respondents’ PSQI score (β = 0.142, p = 0.040, R2 = 0.027), perceived screen time (β = 0.113, p = 0.043, R2 = 343), bedtime (β = 0.106, p = 0.042, R2 = 045), and rise time (β = 0.174, p = 0.015, R2 = 0.028). When comparing poor-quality sleep (PSQI ≥ 5) to good-quality sleep (PSQI < 5), with good-quality sleep as the reference, except sleep efficiency and sleep medications (p > 0.05), five PSQI components declined significantly: subjective sleep quality (β = −0.096, p < 0.001); sleep latency (β = −0.034, p < 0.001); sleep duration (β = −0.038, p < 0.001); sleep disturbances (β = 1.234, p < 0.001); and sleep dysfunction (β = −0.077, p < 0.001). Consequently, public health policymakers should take this evidence into account when developing guidelines around smartphone use—i.e., the when, where, and how much smartphone use—to promote improved sleep behaviour and reduce the rate of sleep–wake rhythm disorders. Full article
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13 pages, 288 KiB  
Article
‘Fleeing’ as a Strategy for Navigating Resistance in Patient Encounters within Forensic Care
by Lars Hammarström, Ove Hellzén and Siri Andreassen Devik
Healthcare 2023, 11(21), 2890; https://doi.org/10.3390/healthcare11212890 - 02 Nov 2023
Viewed by 969
Abstract
The aim of this study was to describe the phenomenon of “fleeing the encounter when facing resistance” as experienced by carers working in forensic inpatient care. Qualitative analysis, namely reflective lifeworld research, was used to analyze data from open-ended questions with nine carers [...] Read more.
The aim of this study was to describe the phenomenon of “fleeing the encounter when facing resistance” as experienced by carers working in forensic inpatient care. Qualitative analysis, namely reflective lifeworld research, was used to analyze data from open-ended questions with nine carers from a Swedish regional forensic clinic. The data revealed three meaning constituents that describe the phenomenon: shielding oneself from coming to harm or harming the other, finding one’s emotional balance or being exposed, and offering the patient emotional space and finding patience. The carers described their approaches in the encounters with the patients as alternating between primitive instincts and expectant empathy in order to gain control and deal with the interaction for their own part, for that of the patient, and for that of their colleagues. The phenomenon of fleeing the encounter when facing resistance was intertwined with carers’ self-perception as professional carers. Negative encounters with patients evoked feelings of shame and self-blame. A carer is a key person tasked with shaping the care relationship, which requires an attitude on the part of the carer that recognizes not only the patient’s lifeworld but also their own. Full article
(This article belongs to the Topic Ethical, Legal and Forensic Issues regarding Vulnerable Populations)
(This article belongs to the Section Forensic Medicine)
11 pages, 546 KiB  
Article
Sex Differences Associated with Weekend Catch-Up Sleep and Waist-to-Height-Ratio among South Korean Adults Using Korea National Health and Nutrition Examination Survey 2016–2021 Data
by Seungwon Jung and Jin Young Nam
Healthcare 2023, 11(21), 2889; https://doi.org/10.3390/healthcare11212889 - 02 Nov 2023
Viewed by 3376
Abstract
The global surge in obesity rates is closely linked to the rise in sleep deprivation and prevalence of sleep disorders. This study aimed to investigate the association between weekend catch-up sleep (CUS) and obesity among Korean adults. Using multiple logistic regression analysis, we [...] Read more.
The global surge in obesity rates is closely linked to the rise in sleep deprivation and prevalence of sleep disorders. This study aimed to investigate the association between weekend catch-up sleep (CUS) and obesity among Korean adults. Using multiple logistic regression analysis, we analyzed the data of 6790 adults aged >19 years obtained from the Korea National Health and Nutrition Examination Survey 2016–2021. In the subgroup analysis, we conducted multiple logistic regression analysis to determine the association between weekend CUS and obesity, stratified by sex. Women were significantly more likely to be obese than men (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.46–0.61). Obesity was associated with 1 ≤ weekend CUS < 2 (OR = 0.86, 95% CI = 0.75–0.99) but not with weekend CUS ≤ 0. Compared to men, women had a lower obesity risk when engaging in weekend supplementary sleep that was 1 ≤ weekend CUS < 2 (OR = 0.78, 95% CI = 0.63–0.97). Our findings revealed that weekend CUS was associated with obesity. Our findings suggest that weekend CUS may offer a form of biological protection against obesity, and they contribute to a better understanding of this association and may serve as a basis for better obesity management. Full article
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17 pages, 317 KiB  
Review
A Narrative Review of Health Status and Healthcare Delivery in the Oil and Gas Industry: Impacts on Employees, Employers, and Local Communities
by Jordan L. Fox, Tiana Gurney, Srinivas Kondalsamy-Chennakesavan, Thomas A. H. Pols, Haitham Tuffaha, Anton Pak and Matthew McGrail
Healthcare 2023, 11(21), 2888; https://doi.org/10.3390/healthcare11212888 - 02 Nov 2023
Viewed by 1338
Abstract
Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be [...] Read more.
Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be acceptable to multiple stakeholders, including employees, employers, and local communities. The purpose of this review was to broadly explore the health status and needs of workers in the oil and gas industry and healthcare delivery models relating to primary care and emergency responses. Database searches of PubMed, EMBASE, CINAHL, PsycINFO, and Scopus were conducted, as well as grey literature searches of Google, Google Scholar, and the International Association of Oil and Gas Producers website. Resource-sector workers, particularly those in ‘fly-in fly-out’ roles, are susceptible to poor health behaviours and a higher prevalence of mental health concerns than the general population. Evidence is generally supportive of organisation-led behaviour change and mental health-related interventions. Deficiencies in primary care received while on-site may lead workers to inappropriately use local health services. For the provision of emergency medical care, telehealth and telemedicine lead to favourable outcomes by improving patient health status and satisfaction and reducing the frequency of medical evacuations. Full article
16 pages, 2568 KiB  
Review
The Power of Licorice (Radix glycyrrhizae) to Improve Oral Health: A Comprehensive Review of Its Pharmacological Properties and Clinical Implications
by Hebah AlDehlawi and Ahoud Jazzar
Healthcare 2023, 11(21), 2887; https://doi.org/10.3390/healthcare11212887 - 02 Nov 2023
Viewed by 2396
Abstract
Licorice (Radix glycyrrhizae) is a plant root extract widely used in various applications, including cosmetics, food supplements, and traditional medicine. It has a long history of medicinal use in different cultures due to its diverse pharmacological properties. Licorice has traditionally been [...] Read more.
Licorice (Radix glycyrrhizae) is a plant root extract widely used in various applications, including cosmetics, food supplements, and traditional medicine. It has a long history of medicinal use in different cultures due to its diverse pharmacological properties. Licorice has traditionally been used for treating gastrointestinal problems, respiratory infections, cough, bronchitis, arthritis, and skin conditions. In recent years, the potential therapeutic benefits of licorice for oral health have gained significant interest. This paper aims to provide a comprehensive review of the effects of licorice extracts and their bioactive components on common oral diseases such as dental caries, periodontitis, halitosis, candidiasis, and recurrent aphthous ulcers. The chemical composition of licorice has shown the presence of several bioactive compounds such as glycyrrhizin, glabridin, isoliquiritigenin (ISL), and licochalcone exhibiting various pharmacological activities, including anti-inflammatory, antimicrobial, antioxidative, and immunomodulatory effects. Interestingly, in certain patients, licorice has shown a promising potential to inhibit the spread of viruses, prevent biofilm formation, reduce inflammation, boost immune responses, alleviate pain, and exert antioxidative effects. In this review, we provide a brief overview of the current understanding of licorice’s therapeutic benefits in the treatment of oral ailments, emphasising its potential as an alternative treatment option for oral diseases. Further research is warranted to explore its efficacy, safety, and clinical applications using placebo-controlled clinical trials. Full article
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22 pages, 25952 KiB  
Perspective
Functional Neuromyofascial Activity: Interprofessional Assessment to Inform Person-Centered Participative Care—An Osteopathic Perspective
by Francesca Baroni, Robert Schleip, Lorenzo Arcuri, Giacomo Consorti, Giandomenico D’Alessandro, Rafael Zegarra-Parodi, Anna Maria Vitali, Marco Tramontano and Christian Lunghi
Healthcare 2023, 11(21), 2886; https://doi.org/10.3390/healthcare11212886 - 02 Nov 2023
Cited by 1 | Viewed by 3436
Abstract
Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients’ adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive [...] Read more.
Introduction: Health professionals and bodyworkers may be pivotal in promoting prevention programs, providing tailored advice and guidance to patients’ adherence to self-care strategies, such as physical activity. Contemporary evidence encourages manual therapists to involve patients in decision-making and treatment procedures integrating passive and active approaches in treatment planning. This manuscript provides a definition and applications of neuromyofascial movement patterns, discusses the significance of functional assessment, and gives an example of clinical applications in the osteopathic field to highlight how this assessment can promote interdisciplinarity. Methods: The reporting framework used in the current manuscript followed guidelines for writing a commentary. Results: The manuscript highlights the crucial role that the neuromyofascial system plays in human movement and overall well-being and the importance of a functional neuromyofascial activity assessment in the context of person-centered participative care. Conclusions: Understanding individual neuromyofascial patterns could help healthcare practitioners, movement specialists, and bodyworkers in tailoring treatment plans, meeting patients’ unique needs, and promoting a more effective personalized approach to care. The current perspective could spark debates within the professional community and provide a research roadmap for developing an evidence-informed interprofessional framework. Full article
(This article belongs to the Section Chronic Care)
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15 pages, 319 KiB  
Article
Diet-Related Attitudes, Beliefs, and Well-Being in Adolescents with a Vegetarian Lifestyle
by Loredana Benedetto, Ilenia Sabato, Carola Costanza, Antonella Gagliano, Eva Germanò, Luigi Vetri, Michele Roccella, Lucia Parisi, Costanza Scaffidi Abbate and Massimo Ingrassia
Healthcare 2023, 11(21), 2885; https://doi.org/10.3390/healthcare11212885 - 02 Nov 2023
Cited by 1 | Viewed by 1274
Abstract
Vegetarianism can meet healthy, ethical, or ecological values (such as equality and protection of animals or the environment). At the same time, it can represent a response to the need for self-determination in adolescence. Furthermore, some studies show vegetarians have greater depressive risk [...] Read more.
Vegetarianism can meet healthy, ethical, or ecological values (such as equality and protection of animals or the environment). At the same time, it can represent a response to the need for self-determination in adolescence. Furthermore, some studies show vegetarians have greater depressive risk and a lower sense of body satisfaction. Considering the spread of non-meat diets in the Western world, researchers have investigated the benefits and risks to physical and psychological health. Despite this, few studies have been conducted on factors influencing adolescent’s vegetarian diet-related attitudes. Through self-administered loosely structured interviews, this research investigated factors potentially associated with vegetarian choices in adolescence. It checked (a) gender differences in vegetarian choices; (b) religious, familial, ethical, or health factors implied in vegetarian choices; and (c) indicators of well-being among young vegetarians. The findings suggest that for our sample, non-vegetarians have lower scores on health-related questions than others, while for vegetarian adolescents, the benefits of vegetarianism mainly depend on their ethical stances, beliefs, and values. Conversely, it is unrelated to factors such as the desire to lose weight, dissatisfaction about one’s body shape, or depressive feelings. Full article
14 pages, 308 KiB  
Article
Unlocking Happiness: Assessing the Monetary Value of Leisure Activities on Subjective Well-Being
by Yeongbae Choe and Jooa Baek
Healthcare 2023, 11(21), 2884; https://doi.org/10.3390/healthcare11212884 - 02 Nov 2023
Viewed by 823
Abstract
Improving the level of subjective well-being or happiness is often the primary goal for the government and its policy. Thus, knowing the value of leisure activities in improving the subjective well-being would hugely contribute to the policy-making process. This study explores the impact [...] Read more.
Improving the level of subjective well-being or happiness is often the primary goal for the government and its policy. Thus, knowing the value of leisure activities in improving the subjective well-being would hugely contribute to the policy-making process. This study explores the impact of participation in leisure activities on individual subjective happiness by applying the well-being valuation method to the national survey data collected in South Korea. Among the five leisure activities, participation in culture and arts, participation in sports, and tourism activities emerged as significant determinants of subjective happiness at the significant level of 0.05. At the individual level, participation in culture and arts exhibited the highest monetary value, while tourism activities have the highest monetary value at the national level, factoring in the total population and the participation rate across the country. These findings confirm the effect of leisure participation in improving subjective well-being and its corresponding monetary value and suggest that government should be appropriately utilizing the leisure policy to increase the frequency and type of leisure participation, thereby enhancing the level of happiness across the society. Results have significant implications for policy makers, practitioners, and academics in the domains of leisure and tourism. Full article
8 pages, 493 KiB  
Article
FunctionaL Assessment Scale of Hemianopia (FLASH): A New Multidisciplinary Tool to Assess Hemianopia in Patients with Severe Acquired Brain Injury
by Susanna Lucatello, Sara De Angelis, Concetta Di Lorenzo, Marco Iosa, Luisa Magnotti, Marta Di Paolo, Maria De Luca, Maria Gabriella Buzzi and Marco Tramontano
Healthcare 2023, 11(21), 2883; https://doi.org/10.3390/healthcare11212883 - 02 Nov 2023
Viewed by 886
Abstract
Background: Severe acquired brain injury (sABI) encompasses a range of neurological impairments. Visual dysfunction, particularly homonymous visual field defects (HVFDs) and homonymous hemianopia (HH), commonly afflicts sABI survivors, affecting their cognitive and motor rehabilitation. This study presents the FunctionaL Assessment Scale of Hemianopia [...] Read more.
Background: Severe acquired brain injury (sABI) encompasses a range of neurological impairments. Visual dysfunction, particularly homonymous visual field defects (HVFDs) and homonymous hemianopia (HH), commonly afflicts sABI survivors, affecting their cognitive and motor rehabilitation. This study presents the FunctionaL Assessment Scale of Hemianopia (FLASH), developed to analyze the most common postural behaviors exhibited by sABI patients with hemianopia during activities of daily living. A comparison to traditional static automated perimetry for diagnosing visual field deficits (VFDs) to determine the sensitivity and specificity of the FLASH was used. Additionally, this study also aimed to assess its reliability. Methods: Fifty-six patients (25 F, 31 M, mean age 60.59 ± 14.53) with strokes in the sub-acute phase (<6 months from the onset) were assessed with both FLASH and a Humphrey Field Analyzer. Results: After removing two items found to be less reliable than others, FLASH showed high sensitivity (81%) and specificity (77%) when compared to static automated perimetry. Inter-rater reliability was also high, with an intra-class correlation coefficient of 0.954, as well as the internal consistency computed by Cronbach’s alpha, equal to 0.874. Conclusion: FLASH could offer a valuable and cost-effective screening tool for VFD in sABI patients during neurorehabilitation, with potential implications for healthcare cost reduction. Full article
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12 pages, 302 KiB  
Review
Grappling with Issues of Motherhood for Women with Schizophrenia
by Mary V. Seeman
Healthcare 2023, 11(21), 2882; https://doi.org/10.3390/healthcare11212882 - 02 Nov 2023
Viewed by 1063
Abstract
Despite the fact that most persons with schizophrenia find steady employment difficult to sustain, many women with this diagnosis embrace and fulfill the most difficult task of all—motherhood. The aim of this paper is to specify the challenges of motherhood in this population [...] Read more.
Despite the fact that most persons with schizophrenia find steady employment difficult to sustain, many women with this diagnosis embrace and fulfill the most difficult task of all—motherhood. The aim of this paper is to specify the challenges of motherhood in this population and review the treatment strategies needed to keep mothers and children safe, protecting health and fostering growth. The review addresses concerns that had been brought to the author’s earlier attention during her clinical involvement with an outpatient clinic for women with psychosis. It is, thus, a non-systematic, narrative review of topic areas subjectively assessed as essential to “good enough” mothering in the context of schizophrenia. Questions explored are the stigma against motherhood in this population, mothers’ painful choices, issues of contraception, abortion, child custody, foster care and kin placement of children, the effects of antipsychotics, specific perinatal delusional syndromes, and, finally, the availability of parental support. This review is intended for clinicians. Recommendations are that care providers work collaboratively with mothers, take note of their strengths as well as their failings, offer a wide array of family services, monitor households closely for safety and for treatment adherence, appreciating the many challenges women with schizophrenia face daily. Full article
29 pages, 966 KiB  
Article
Machine Learning for Sarcopenia Prediction in the Elderly Using Socioeconomic, Infrastructure, and Quality-of-Life Data
by Minje Seok, Wooseong Kim and Jiyoun Kim
Healthcare 2023, 11(21), 2881; https://doi.org/10.3390/healthcare11212881 - 01 Nov 2023
Cited by 3 | Viewed by 1263
Abstract
Since the WHO’s 2021 aging redefinition emphasizes “healthy aging” by focusing on the elderly’s ability to perform daily activities, sarcopenia, which is defined as the loss of skeletal muscle mass, is now becoming a critical health concern, especially in South Korea with a [...] Read more.
Since the WHO’s 2021 aging redefinition emphasizes “healthy aging” by focusing on the elderly’s ability to perform daily activities, sarcopenia, which is defined as the loss of skeletal muscle mass, is now becoming a critical health concern, especially in South Korea with a rapidly aging population. Therefore, we develop a prediction model for sarcopenia by using machine learning (ML) techniques based on the Korea National Health and Nutrition Examination Survey (KNHANES) data 2008–2011, in which we focus on the role of socioeconomic status (SES), social infrastructure, and quality of life (QoL) in the prevalence of sarcopenia. We successfully identify sarcopenia with approximately 80% accuracy by using random forest (RF) and LightGBM (LGB), CatBoost (CAT), and a deep neural network (DNN). For prediction reliability, we achieve area under curve (AUC) values of 0.831, 0.868, and 0.773 for both genders, males, and females, respectively. Especially when using only male data, all the models consistently exhibit better performance overall. Furthermore, using the SHapley Additive exPlanations (SHAP) analysis, we find several common key features, which mainly contribute to model building. These include SES features, such as monthly household income, housing type, marriage status, and social infrastructure accessibility. Furthermore, the causal relationships of household income, per capita neighborhood sports facility area, and life satisfaction are analyzed to establish an effective prediction model for sarcopenia management in an aging population. Full article
(This article belongs to the Topic Artificial Intelligence in Healthcare - 2nd Volume)
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