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Healthcare, Volume 11, Issue 22 (November-2 2023) – 95 articles

Cover Story (view full-size image): Work coordination is considered a central aspect in the management of organizations and in crisis and disaster management. There is clear evidence of the critical role of dialogue in the process of knowledge transformation and integration, the relevant role of informal coordination practices in contexts of high uncertainty and the alternation between formal and informal coordination practices in rapid response organizations, such as health organizations. The availability of a tool to identify and measure these practices and their impact on the organization’s results will make these practices visible and enhance their deployment throughout the organization as a key factor in improving the quality of teamwork and care outcomes. View this paper
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14 pages, 596 KiB  
Article
“You Need to Set a Daily Schedule”: Understanding Successful Aging via Three-Sided Viewpoints
Healthcare 2023, 11(22), 3005; https://doi.org/10.3390/healthcare11223005 - 20 Nov 2023
Viewed by 594
Abstract
This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 [...] Read more.
This study aimed to identify the constructs related to successful aging in the context of engagement in social and productive activities. A qualitative design was used to explore three viewpoints on the aging period with 9 focus groups (3 each for adults 65 years or older, older adults’ family members, and health professionals) and 18 interviews with older adults (older adults Mage = 71.7 years, Standard Deviation = 4.62). The transcripts were analyzed using constructivist grounded theory principles. Three categories were identified for successful aging: (a) engagement with life, including social participation, fixed/flexible schedule, time, and meaningful occupation; (b) self-management abilities, including producing daily schedules, independence, and initiation/striving toward goals; and (c) diversity among older adults, including their views on retirement, being active or not, and their dreams/values/goals. Considering the diverse nature of older adults, recognizing the importance of life engagement and self-management abilities emphasizes the necessity for an occupation-based, self-tailored approach to enable successful aging. Full article
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13 pages, 1000 KiB  
Article
Segmental Rib Index and Spinal Deformity: Scoliogenic Implications
Healthcare 2023, 11(22), 3004; https://doi.org/10.3390/healthcare11223004 - 20 Nov 2023
Viewed by 619
Abstract
The aim of this report is to evaluate the segmental rib index (RI) from the T1 to T12 spinal levels in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the [...] Read more.
The aim of this report is to evaluate the segmental rib index (RI) from the T1 to T12 spinal levels in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the frontal plane radiological deformity presented as the Cobb angle and to the posterior truncal surface deformity presented as the scoliometric readings of Angle of Trunk Rotation (ATR) in these patients is also assessed. Any statistically significant relationship between these parameters would be very important for biomechanical relations in rib cage (RC) deformity presented as rib hump deformity (RHD) and deformity in the spine, and would thus provide valuable information about scoliogeny. The segmental rib index (RI) is presented in 83 boys and girls with mild and moderate IS. The measurements include the scoliometric readings for truncal asymmetry (TA), the Cobb angle assessment and the segmental RI from T1-T12. The statistical package SPSS 23 was used for statistical analysis. The TA was documented and the Cobb angle is presented by gender and curve type. The segmental RI of thoracic, thoracolumbar and lumbar curves are presented for the first time. The correlations of the segmental RI to surface deformity presented as rib hump deformity (RHD) in all IS patients, and particularly in thoracic curves, to Cobb angle by gender and age and the comparison of the segmental RI index of asymmetric but not scoliotic children to the scoliotic peers by curve (in thoracic, thoracolumbar, lumbar curves) in boys and girls are presented. The findings emphasize the significant protagonistic role of thoracic asymmetry in relation to the spinal deformity, mainly in girls for the thoracic and in boys for the thoracolumbar curves. The cut-off point of age of the examined scoliotics was 14 years, which is when the RI shows a stronger correlation with spinal deformity, namely when thoracic deformity is decisively effective in the development of thoracic spinal deformity, in terms of Cobb angle. In summary, the results of this study may provide scoliogenic implications for IS, as far as the role of the thorax is concerned. Full article
(This article belongs to the Special Issue Paediatric Spinal Deformity)
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24 pages, 4285 KiB  
Article
Patent and Bibliometric Analysis of the Scientific Landscape of the Use of Pulse Oximeters and Their Prospects in the Field of Digital Medicine
Healthcare 2023, 11(22), 3003; https://doi.org/10.3390/healthcare11223003 - 20 Nov 2023
Viewed by 934
Abstract
This study conducted a comprehensive patent and bibliometric analysis to elucidate the evolving scientific landscape surrounding the development and application of pulse oximeters, including in the field of digital medicine. Utilizing data from the Lens database for the period of 2000–2023, we identified [...] Read more.
This study conducted a comprehensive patent and bibliometric analysis to elucidate the evolving scientific landscape surrounding the development and application of pulse oximeters, including in the field of digital medicine. Utilizing data from the Lens database for the period of 2000–2023, we identified the United States, China, the Republic of Korea, Japan, Canada, Australia, Taiwan, and the United Kingdom as the predominant countries in patent issuance for pulse oximeter technology. Our bibliometric analysis revealed a consistent temporal trend in both the volume of publications and citations, underscoring the growing importance of pulse oximeters in digitally-enabled medical practice. Using the VOSviewer software(version 1.6.18), we discerned six primary research clusters: (1) measurement accuracy; (2) integration with the Internet of Things; (3) applicability across diverse pathologies; (4) telemedicine and mobile applications; (5) artificial intelligence and deep learning; and (6) utilization in anesthesiology, resuscitation, and intensive care departments. The findings of this study indicate the prospects for leveraging digital technologies in the use of pulse oximetry in various fields of medicine, with implications for advancing the understanding, diagnosis, prevention, and treatment of cardio-respiratory pathologies. The conducted patent and bibliometric analysis allowed the identification of technical solutions to reduce the risks associated with pulse oximetry: improving precision and validity, technically improved clinical diagnostic use, and the use of machine learning. Full article
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11 pages, 1019 KiB  
Article
Comparison of Elicitation Approaches in Early Stage HTA Applied on Artificial Thymus for Patients with DiGeorge Syndrome
Healthcare 2023, 11(22), 3002; https://doi.org/10.3390/healthcare11223002 - 20 Nov 2023
Viewed by 714
Abstract
This paper focuses on research in expert elicitation as a part of the early stage health technology assessment (eHTA). The current state of affairs is analysed and two elicitation approaches are compared—the four fixed intervals method and the histogram method—as applied to an [...] Read more.
This paper focuses on research in expert elicitation as a part of the early stage health technology assessment (eHTA). The current state of affairs is analysed and two elicitation approaches are compared—the four fixed intervals method and the histogram method—as applied to an example of early assessment of clinical effectiveness of artificial thymus for patients with DiGeorge syndrome. A survey was carried out consisting of four questions concerning the topic, with the aim to apply the elicitation methods. Eight experts answered the questions using both elicitation methods. Based on their answers, the methods were compared visually and by means of statistical tests. In order to compare the perception of the two elicitation methods, the survey also included questions regarding the experts’ subjective preferences. The results of the comparison of the two elicitation approaches did not clearly confirm which method was more beneficial and better; however, it was possible to indicate which of the two methods is better suited for different types of experts. Before selecting an elicitation method as a part of eHTA, it is advisable to effectively consider the technology to be assessed and the type of experts to be invited to share their opinion. Full article
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13 pages, 849 KiB  
Article
Dietary Intake of Capsaicin and Its Association with Markers of Body Adiposity and Fatty Liver in a Mexican Adult Population of Tijuana
Healthcare 2023, 11(22), 3001; https://doi.org/10.3390/healthcare11223001 - 20 Nov 2023
Viewed by 581
Abstract
Background: Capsaicin (CAP) is the main chemical component responsible for the pungency (burning pain) of the chili plant (capsicum spp.), whose metabolic functions include energy balance and fatty acid oxidation. The aim of this study is to analyze the association of dietary [...] Read more.
Background: Capsaicin (CAP) is the main chemical component responsible for the pungency (burning pain) of the chili plant (capsicum spp.), whose metabolic functions include energy balance and fatty acid oxidation. The aim of this study is to analyze the association of dietary capsaicin consumption with markers of adiposity and fatty liver in a Mexican adult population. Methods: This cross-sectional/analytical study recruited 221 subjects aged 18 to 65 years who were resident in the city of Tijuana, Baja California, Mexico. The daily CAP intake was analyzed through a validated chili/CAP consumption questionnaire. Anthropometric and biochemical measurements were performed following standardized protocols. Adjusted Pearson’s correlations were applied to analyze the association of CAP with adiposity and fatty liver markers. Results: In this study, the daily average consumption of CAP was 152.44 mg. The dietary CAP consumption positively correlated with BMI (r = 0.179, p = 0.003), hip circumference (r = 0.176, p = 0.004) and body adiposity index (r = 0.181, p = 0.001. Likewise, the daily CAP intake positively correlated with hepatic steatosis index (r = 0.158, p = 0.004), fatty liver index (r = 0.141, p = 0.003) and lactate dehydrogenase (r = 0.194, p = 0.016) after statistical settings. Conclusions: The results of this study suggest positive associations between dietary CAP consumption and the markers of body adiposity and fatty liver in a Mexican adult population. Full article
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16 pages, 1323 KiB  
Review
The Internet, Apps, and the Anesthesiologist
Healthcare 2023, 11(22), 3000; https://doi.org/10.3390/healthcare11223000 - 20 Nov 2023
Viewed by 609
Abstract
Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that the uptake of apps into anesthetic practice [...] Read more.
Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that the uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus on how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist. Full article
(This article belongs to the Special Issue Reviews on Critical Care)
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10 pages, 15426 KiB  
Case Report
One-Stage Tricompartmental Hypoallergenic UKA for Tricompartmental Osteoarthritis: A Case Report
Healthcare 2023, 11(22), 2999; https://doi.org/10.3390/healthcare11222999 - 20 Nov 2023
Viewed by 739
Abstract
Osteoarthritis (OA) is a degenerative and progressive joint disease. When all three compartments are involved, end-stage OA is treated with a total knee arthroplasty (TKA). Unicompartmental knee arthroplasty (UKA) is a primary treatment for isolated osteoarthritis. UKA has a quicker recovery time than [...] Read more.
Osteoarthritis (OA) is a degenerative and progressive joint disease. When all three compartments are involved, end-stage OA is treated with a total knee arthroplasty (TKA). Unicompartmental knee arthroplasty (UKA) is a primary treatment for isolated osteoarthritis. UKA has a quicker recovery time than TKA, as well as less morbidity and more tissue sparing. At the time of surgery, 17% of patients have a tricompartmental disease and most patients with a Kellegren–Lawrence grade >3 have an intact anterior cruciate ligament (ACL). Conventional TKA sacrifices the ACL. Patients with concurrent medial and lateral osteoarthritis and a functional ACL may receive a primary bi-unicondylar arthroplasty. Combined partial knee arthroplasty (CPKA) is an established practice either in bicompartmental femoro-tibial OA or in OA progression after UKA, with the addition of another UKA. A conversion of a lateral UKA to a tricompartmental joint replacement has been reported in the literature. In our case report, we describe a one-stage hypoallergenic tricompartmental UKA, with improved clinical score and no sign of early failure at the last follow-up. Full article
(This article belongs to the Special Issue New Advances in Joint Osteoarthritis)
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12 pages, 933 KiB  
Article
Knowledge, Attitude, and Practice of E-Cigarettes of Adolescents and Adults in Saudi Arabia: A Cross-Sectional Study
Healthcare 2023, 11(22), 2998; https://doi.org/10.3390/healthcare11222998 - 20 Nov 2023
Viewed by 1012
Abstract
E-cigarettes have gained enormous popularity, and their use has increased drastically worldwide. However, little is known regarding adolescents’ and adults’ knowledge, attitudes, and practices in Saudi Arabia. We conducted a cross-sectional study using a self-administered online-modified WHO GATS questionnaire on a convenience sample [...] Read more.
E-cigarettes have gained enormous popularity, and their use has increased drastically worldwide. However, little is known regarding adolescents’ and adults’ knowledge, attitudes, and practices in Saudi Arabia. We conducted a cross-sectional study using a self-administered online-modified WHO GATS questionnaire on a convenience sample approach. Data were collected between January and March 2021 after the alleviation of COVID-19 lockdown measures in Saudi Arabia. Univariate and multivariate regression models were developed to identify independent factors associated with knowledge, attitude, and practice. Our sample (1335) had a mean age of 26.45 ± 10.5 years; nearly half of the participants had poor knowledge about e-cigarettes. The usage and positive attitude were reported by 18.6% and 19.4%, respectively. Around 43.5% of e-cigarette users reported starting or increased use during the COVID-19 pandemic, while 9.5% of participants would recommend it to others. Logistic regressions showed that older participants were more likely to have poor knowledge (OR = 1.02, 95% C.I. = 1.01–1.03) and positive attitudes (OR = 0.98, 95% C.I. = 0.91–0.96). Male participants and smokers (OR = 3.0, 95% C.I. = 2.3–3.8) were more likely to have a positive attitude. However, younger participants were less likely to go for e-cigarettes (OR = 0.95, 95% C.I. = 0.93–0.97), while males (OR = 2.53, 95% C.I. = 1.65–3.86) and smokers (OR = 4.63, 95% C.I. = 3.47–6.18) were more likely to use them. This study indicated a high level of poor knowledge about e-cigarettes. A considerable proportion of participants reported usage and a positive attitude towards them. Older age, male gender, and being a smoker were the main elicited predictors for e-cigarette use. Full article
(This article belongs to the Section Preventive Medicine)
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11 pages, 537 KiB  
Article
The Longitudinal Mediating Effect of Smartphone Dependency on the Relationship between Exercise Time and Subjective Happiness in Adolescents
Healthcare 2023, 11(22), 2997; https://doi.org/10.3390/healthcare11222997 - 20 Nov 2023
Viewed by 609
Abstract
The phenomenon of adolescents engaging in less physical activity as they age raises several concerns. Among these, we hypothesized that this trend may negatively impact their mental health and smartphone dependency. Thus, the aim of this study was to longitudinally examine the mediating [...] Read more.
The phenomenon of adolescents engaging in less physical activity as they age raises several concerns. Among these, we hypothesized that this trend may negatively impact their mental health and smartphone dependency. Thus, the aim of this study was to longitudinally examine the mediating effect of smartphone dependency in the relationship between adolescents’ exercise time and subjective well-being. For analysis, publicly available data from the 2018 Korean Children and Youth Panel Survey were utilized, with a total of 2,242 participants’ data included in the analysis. Latent growth modeling results revealed a significant linear decrease in adolescents’ exercise time and subjective well-being each year, while smartphone dependency exhibited an increasing trend. Furthermore, the significance tests of indirect effects indicated that the mediating effect of the changing trend in smartphone dependency between the changing trends in exercise time and subjective happiness in adolescents was statistically significant. These findings suggest that as grade levels increase, reducing exercise time can lead to higher smartphone dependency among adolescents, ultimately resulting in decreased subjective well-being. Full article
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11 pages, 693 KiB  
Article
Effects of Using Sitting Position versus Lithotomy Position during the Second Stage of Labour on Maternal and Neonatal Outcomes and the Childbirth Experience of Chinese Women: A Prospective Cohort Study
Healthcare 2023, 11(22), 2996; https://doi.org/10.3390/healthcare11222996 - 20 Nov 2023
Viewed by 838
Abstract
Existing research concerning the effects of the sitting birth position during the second stage of labour on maternal and neonatal outcomes remains controversial, and there is a lack of studies to explore its effect on the childbirth experience. The objective of this study [...] Read more.
Existing research concerning the effects of the sitting birth position during the second stage of labour on maternal and neonatal outcomes remains controversial, and there is a lack of studies to explore its effect on the childbirth experience. The objective of this study is to explore whether the sitting birth position would influence maternal and neonatal outcomes, as well as the childbirth experience. The prospective cohort design was conducted in the study from February to June 2023, a total of 222 women (including primiparous women and multiparous women) were enrolled in our study, and they were divided into the sitting position cohort (n = 106) or the lithotomy position cohort (n = 116). The pre-designed questionnaire and Childbirth Experience Questionnaire (CEQ) were used for data collection during hospitalisation. Chi-square, Fisher’s exact test, t-tests, or the Mann–Whitney U test were utilised to assess differences between groups. Multivariate linear regression and logistic regression were employed to control possible confounders. The study found that primiparous women in the sitting position cohort had a shorter duration of the second stage of labour, higher spontaneous vaginal birth rates, lower episiotomy rates, and a better childbirth experience (p < 0.01). After adjusting for confounding factors through multiple linear and logistic regression analyses, the results remained consistent with those reported above. No neonate in each cohort had Apgar scores at 1 min and 5 min postpartum less than 7 or a Cord artery pH less than 7.00, regardless of parity. Based on the findings, we recommend that women could take the sitting birth position into account when giving birth for a positive childbirth experience, especially for primiparous women. The study could also serve as a reference for healthcare providers in the management of childbirth positions and the development of high-quality maternal care. Full article
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11 pages, 1665 KiB  
Case Report
Microfracture- and Xeno-Matrix-Induced Chondrogenesis for Treatment of Focal Traumatic Cartilage Defects of the Knee: Age-Based Mid-Term Results
Healthcare 2023, 11(22), 2995; https://doi.org/10.3390/healthcare11222995 - 20 Nov 2023
Viewed by 556
Abstract
The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) [...] Read more.
The aim of this study was to investigate clinical and instrumental outcomes of the autologous matrix-induced chondrogenesis (AMIC) technique for the treatment of isolated traumatic condyle and femoropatellar cartilage lesions. A total of 25 patients (12 males, 13 females, mean age 47.3 years) treated between 2018 and 2021 were retrospectively reviewed and subdivided into two groups based on age (Group A, age < 45 years; Group B, age > 45 years). A clinical evaluation was performed using the International Knee Documentation Committee (IKDC), Lysholm score and Visual Analogue Score (VAS). Cartilage regeneration was evaluated via magnetic resonance (1.5 Tesla) and classified according to a Magnetic resonance Observation of CArtilage Repair Tissue (MOCART) scoring system. At a minimum follow-up of 2 years, Group A patients obtained greater instrumental results in comparison to group B: in fact, the MOCART score was statistically significantly correlated with IKDC (r = 0.223) (p < 0.001) exclusively in group A. Nevertheless, a significant improvement in clinical functionality was shown in Group B (p < 0.001), demonstrating that this technique is safe, reproducible and capable of offering satisfactory clinical results regardless of age. Full article
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12 pages, 830 KiB  
Article
Relationship between Subjective Health, the Engel Coefficient, Employment, Personal Assets, and Quality of Life for Korean People with Disabilities
Healthcare 2023, 11(22), 2994; https://doi.org/10.3390/healthcare11222994 - 19 Nov 2023
Viewed by 693
Abstract
The aim of this research is to examine the effect of subjective health on the quality of life of Korean people with disabilities. The second goal of this study is to examine the effect of the Engel coefficient on quality of life. Additionally, [...] Read more.
The aim of this research is to examine the effect of subjective health on the quality of life of Korean people with disabilities. The second goal of this study is to examine the effect of the Engel coefficient on quality of life. Additionally, this study is conducted to inspect the effect of employment and personal assets on quality of life. Further, in this work, the moderating effect of personal assets on the association between employment and quality of life for people with a disability is explored. The Panel Survey of Employment for the Disabled served as the source of data. The study period ranges from 2016 to 2018. To test the research hypotheses, this study adopted econometric analyses, namely, ordinary least squares, fixed effect, and random effect models. The results revealed that the quality of life for people with disabilities is positively influenced by subjective health, employment, and personal assets. In contrast, the Engel coefficient exerts a negative impact on quality of life. Plus, the finding indicates that personal assets negatively moderate the relationship between employment and quality of life for people with disabilities. This research is aimed at presenting policy implications for the welfare of people with disabilities. Full article
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13 pages, 281 KiB  
Perspective
Strengthening Primary Healthcare in Jordan for Achieving Universal Health Coverage: A Need for Family Health Team Approach
Healthcare 2023, 11(22), 2993; https://doi.org/10.3390/healthcare11222993 - 19 Nov 2023
Viewed by 956
Abstract
Achieving Universal Health Coverage (UHC) is a strategic objective of the Jordanian government and has been prioritized in its strategies and plans. However, there are several challenges affecting primary healthcare in Jordan and the health system in general that prevent Jordan from achieving [...] Read more.
Achieving Universal Health Coverage (UHC) is a strategic objective of the Jordanian government and has been prioritized in its strategies and plans. However, there are several challenges affecting primary healthcare in Jordan and the health system in general that prevent Jordan from achieving UHC. This paper highlights the importance of team-based care in the form of Family Health Teams (FHTs) to realize Jordan’s goal of achieving UHC. FHTs are a team-based approach that brings together diverse professionals to provide a comprehensive, efficient, patient-centered primary care system that meets the changing needs of Jordan’s population and refugees. However, the implementation of FHT may encounter obstacles, including individual, organizational, institutional, and external barriers. To overcome such obstacles, several actions and processes need to be taken, including political commitment and leadership, implementing good governance and policy frameworks, allocating resources and funding, multisectoral collaboration, and engagement of communities and stakeholders. The successful implementation of FHTs requires participation from government officials, parliamentarians, civil society, and influential community, religious, and business leaders. A strategic policy framework, effective oversight, coalition building, regulation, attention to system design, and accountability are also essential. In conclusion, adopting the FHT approach in Jordan’s Primary Healthcare system offers a promising path towards achieving UHC, improving healthcare access, quality, and efficiency while addressing the unique challenges faced by the country’s healthcare system. Full article
(This article belongs to the Section Family Medicine)
8 pages, 254 KiB  
Brief Report
Rubella Vaccine Uptake among Women of Childbearing Age in Healthcare Settings
Healthcare 2023, 11(22), 2992; https://doi.org/10.3390/healthcare11222992 - 19 Nov 2023
Cited by 1 | Viewed by 730
Abstract
Background: Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There [...] Read more.
Background: Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment for rubella, but the disease is preventable by vaccination with an efficacy of over 95%. Vaccination coverage is still below the recommended levels and many cases have occurred worldwide. The COVID-19 pandemic has had a negative impact on the immunization programs and the quality of disease surveillance worldwide. Operators of the healthcare setting are at increased risk of infection due to their work duties and should receive preventive vaccination or serologic protection to work in a healthcare setting. Aims: To evaluate the serological evidence of rubella IgG antibodies in female healthcare operators of childbearing age, to assess the risk of a breakthrough infection and the need for an additional dose of vaccine. Methods: We collected age and antibody titers from 449 young female operators aged <50 years who underwent the periodic surveillance at the Occupational Medicine Unit of the Policlinico Tor Vergata, Rome, from January to July 2022. Subjects were considered immune if the anti-rubella IgG titer was >11.00 IU/mL. Results: The rate of serologically unprotected subjects was 9.13% (41/449). The mean age of protected subjects was 26.93 years, while the mean age of unprotected subjects was 28.24 years. Age did not correlate with mean titer on statistical analysis (p = 0.10). The acceptance rate among unprotected operators was 31.7%. A positive attitude towards vaccination was found in 11/28 (39.3%) of the unvaccinated subjects, while a negative tendency was found in 2/28 (7.1%) of these subjects; most of the unvaccinated operators 15/28 (53.6%) prefer to postpone the administration of the vaccine. When compared with a similar population from the pre-pandemic period, the actual proportion of immune female subjects was not significantly different from that found in 2019 (90.87% vs. 90.3%). Conclusions: Protection against rubella was suboptimal among female healthcare workers of childbearing age. Acceptance of the rubella vaccine among these operators was low. Most of those who were hesitant intended to postpone the vaccination, while a minority had negative attitudes toward vaccination. A policy of mandatory vaccination policy should overcome the reluctance of operators. Full article
23 pages, 333 KiB  
Article
The Learning Transfer of Dementia Training Program Participants: Its Antecedents and Mediating Effect on the Job Competency of Geriatric Caregivers
Healthcare 2023, 11(22), 2991; https://doi.org/10.3390/healthcare11222991 - 19 Nov 2023
Viewed by 670
Abstract
This study examined how learning transfer and its antecedents impacted job competency among geriatric caregivers who underwent dementia training. The dementia training program of the National Health Insurance Service of South Korea was selected for this study. The participants included caregivers who provided [...] Read more.
This study examined how learning transfer and its antecedents impacted job competency among geriatric caregivers who underwent dementia training. The dementia training program of the National Health Insurance Service of South Korea was selected for this study. The participants included caregivers who provided care to patients with dementia at 3–12 months post-training. A hierarchical regression analysis was used to verify the research model. The results are summarized as follows: First, transfer opportunity and transfer intention were antecedent variables with a statistically significant positive effect on the near transfer of learning. Second, self-efficacy, the instructor’s role, and transfer intention were antecedent variables with a statistically significant positive effect on the far transfer of learning. Third, the near transfer of learning had a statistically significant effect on all six competency variables (communication, problem solving, interpersonal relationships, skills, self-development, and work ethics). Fourth, the far transfer of learning had a statistically significant static effect on all six competency variables, although the size of the influence on competency enhancement was relatively small compared with the near transfer of learning. This study confirmed the effects of various transfer climate-related variables in a training program on job competency, suggesting that the learning transfer of caregivers who underwent dementia training is a significant mediating variable. The limitations of this study and directions for future research are also discussed. The learning transfer of caregivers who underwent this training enhanced their job competencies. Full article
(This article belongs to the Special Issue Dementia Caregivers’ Wellbeing—Challenges and Opportunities)
16 pages, 310 KiB  
Article
Impact of the COVID-19 Pandemic on Contraception Awareness and Mental Well-Being in Teenagers and Young Adult Women: A Three-Year Cross-Sectional Analysis
Healthcare 2023, 11(22), 2990; https://doi.org/10.3390/healthcare11222990 - 19 Nov 2023
Viewed by 675
Abstract
During the COVID-19 pandemic, significant shifts occurred in reproductive health, especially among teenagers and young adult women in Romania. This study, conducted from 2020 to 2022, aimed to longitudinally assess contraceptive awareness and its correlation with mental well-being in this demographic. A cohort [...] Read more.
During the COVID-19 pandemic, significant shifts occurred in reproductive health, especially among teenagers and young adult women in Romania. This study, conducted from 2020 to 2022, aimed to longitudinally assess contraceptive awareness and its correlation with mental well-being in this demographic. A cohort of 210 participants aged 15–25, with a history of wanted or unwanted pregnancy, was studied. The research involved collaborations with Romanian educational institutions and strict adherence to ethical standards. Participants’ data on contraceptive knowledge and practices were analyzed, considering factors like substance use and prior sexual education. Mental well-being was evaluated using the SF-36, WHOQOL-BREF, GAD-7, and PHQ-9 scales. The study revealed a positive correlation between increased contraceptive knowledge and improved mental health scores. In 2022, 68% of participants displayed proficient contraceptive awareness, up from 52% in 2020. Those with good contraceptive knowledge had an average SF-36 score of 72, indicating a better quality of life, compared to a score of 58 among those with limited knowledge. Furthermore, there was a notable decrease in GAD-7 and PHQ-9 scores among individuals with better contraceptive awareness, suggesting reduced anxiety and depression levels. The SF-36 survey results showed significant improvements across the years: the physical score increased from 52.1 (±6.3) in 2020 to 56.5 (±6.8) in 2022, the mental score from 51.4 (±7.2) to 55.0 (±6.9), and the total score from 53.6 (±7.9) to 57.5 (±8.0). WHOQOL-BREF results showed a substantial increase in the social domain score from 53.6 (±18.2) in 2020 to 63.0 (±20.5) in 2022. GAD-7 scores declined from 7.9 (±2.6) in 2020 to 6.5 (±3.3) in 2022, indicating a decrease in anxiety symptoms. PHQ-9 scores, measuring depression, also showed a downward trend, from 4.8 (±2.2) in 2020 to 3.9 (±2.8) in 2022. These findings highlight the intertwined nature of contraceptive awareness and mental well-being. The improvements in contraceptive awareness positively impacted mental health outcomes, emphasizing the need for targeted educational interventions in this demographic, particularly during global crises like the pandemic. Full article
(This article belongs to the Special Issue New Waves of Sexual and Reproductive Health)
11 pages, 252 KiB  
Article
Etiology of Exercise Injuries in Firefighters: A Healthcare Practitioners’ Perspective
Healthcare 2023, 11(22), 2989; https://doi.org/10.3390/healthcare11222989 - 19 Nov 2023
Viewed by 665
Abstract
The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters’ musculoskeletal injuries [...] Read more.
The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters’ musculoskeletal injuries due to exercise. Semi-structured interviews were conducted with 14 HCPs. Two interviews were pilot-tested with HCPs to ensure reliability and validity. Interviews were transcribed and uploaded to a qualitative analysis software program. Although the study inquired about injuries incurred by any exercise modality (e.g., endurance and resistance training), injuries induced during resistance training were prominent among HCPs as resistance training emerged as a primary exercise injury mechanism. HCPs indicated that the back and shoulder were prevalent anatomical exercise injury locations. Risk factors for exercise injuries included age, immobility, movement proficiency, and factors associated with fatigue. Exercise injury mechanisms included poor resistance training technique and overexertion. These findings could guide exercise program design, use of movement assessments, and the identification of other countermeasures to decrease the risk of resistance training exercise injuries among firefighters. Full article
(This article belongs to the Special Issue Health, Safety, and Readiness of Tactical Populations)
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10 pages, 249 KiB  
Review
Psychosocial Occupational Health—A Priority for Middle-Income Countries?
Healthcare 2023, 11(22), 2988; https://doi.org/10.3390/healthcare11222988 - 19 Nov 2023
Viewed by 700
Abstract
In response to new developments of work and employment in high-income countries (HICs), psychosocial aspects of work and health have received increased attention. In contrast, middle-income countries (MICs) are mainly concerned with severe challenges of noxious- and dangerous-material work environments, poor employment conditions, [...] Read more.
In response to new developments of work and employment in high-income countries (HICs), psychosocial aspects of work and health have received increased attention. In contrast, middle-income countries (MICs) are mainly concerned with severe challenges of noxious- and dangerous-material work environments, poor employment conditions, and deficient social policies, which leaves the psychosocial aspects with a marginal role, at best, in occupational health. More recently, differences between these two worlds were even aggravated by the COVID-19 pandemic. Yet, with economic globalisation and the growing worldwide interconnectivity, the world of work in MICs is being rapidly transformed, starting to share several concerns with the modern Western societies. In this process, psychosocial occupational health will become an increasingly pressing issue. This contribution explores the extent to which psychosocial aspects of work and health are already addressed in research originating from MICs. Using a narrative review approach, a selective focus on recent findings from two regions, Asia Pacific and Latin America, revealed an increasing interest in work stress-related problems, but a restricted impact of the respective research findings. It is hoped that future scientific developments in MICs will enrich the international state of the art in this field. Full article
10 pages, 246 KiB  
Article
Benefits of Being Teamed with a Service Dog for Individuals Living with Visible and Invisible Disabilities
Healthcare 2023, 11(22), 2987; https://doi.org/10.3390/healthcare11222987 - 19 Nov 2023
Viewed by 604
Abstract
Over 61 million people in the United States are living with disabilities. Less than one percent are teamed with service dogs. A service dog is a type of assistance dog specifically trained to perform a disability-related task(s) to assist the person and support [...] Read more.
Over 61 million people in the United States are living with disabilities. Less than one percent are teamed with service dogs. A service dog is a type of assistance dog specifically trained to perform a disability-related task(s) to assist the person and support their independence. Service dogs may also provide valuable secondary benefits. The aim of this survey research is to add empiric data on benefits of being teamed with a service dog. Two hundred and four individuals teamed with service dogs responded to demographic and survey questions that included the benefits they experience from being teamed with a service dog. Overwhelmingly, respondents agreed or strongly agreed to benefits of emotional connection (96%), community participation (97%), physical activity (96%), psychological wellbeing (98%), quality of life (97%), a reduction in prescribed medications (78%), and a decrease in paid or unpaid assistance hours (83%), which extend beyond their primary disability need. It is clear that many others may benefit from being teamed with a service dog. Greater evidence is needed to increase tangible support for those who desire to be teamed with a service dog and can meet the Americans with Disabilities requirements. Additionally, to support individuals with service dogs now and in the future, healthcare professionals need to be knowledgeable about and culturally competent in caring for patients teamed with service dogs. Service dogs, when indicated, may benefit individuals living with disabilities by meeting primary and secondary needs that support independence. Full article
13 pages, 277 KiB  
Case Report
The Long-Term Adaptations of a Combined Swimming and Aquatic Therapy Intervention in an Adult Person with High-Functioning Autism (Asperger’s Syndrome): A Case Study
Healthcare 2023, 11(22), 2986; https://doi.org/10.3390/healthcare11222986 - 19 Nov 2023
Viewed by 918
Abstract
Individuals with High-Functioning Autism present impairments in communication, social interaction, and motor development. A low level of motor skills, namely difficulties in gross and fine mobility, and in motor control, discourage individuals with High-Functioning Autism from being involved in physical activities, resulting in [...] Read more.
Individuals with High-Functioning Autism present impairments in communication, social interaction, and motor development. A low level of motor skills, namely difficulties in gross and fine mobility, and in motor control, discourage individuals with High-Functioning Autism from being involved in physical activities, resulting in fewer opportunities for social interaction. There is not much evidence available about the effects of regular swimming exercise and/or aquatic therapy on health promotion in adults with High-Functioning Autism. An adult male (22 yrs) diagnosed with High-Functioning Autism participated in a combined 6-month swimming and aquatic therapy program (two sessions/week, 60 min each). The pre- and post-intervention assessments consisted of physical fitness, balance, functional ability, and psychomotor tests. The post-intervention assessments showed improvements in the standing long jump (+100%), hand grip force (+71.7%), bend arm hang test (+123.1%), and the physiological parameters in the 6 min walk test (+10.2%). On the opposite, decrements in the sit-up (−12%) and sit-and-reach test (−6.3%) were observed. It was noted that the participant frequently lost interest and focus quickly, resulting in the abandonment of the exercise. Conclusively, there is a great need for further research on this topic examining a larger adult population. Full article
21 pages, 755 KiB  
Article
The RODI mHealth app Insight: Machine-Learning-Driven Identification of Digital Indicators for Neurodegenerative Disorder Detection
Healthcare 2023, 11(22), 2985; https://doi.org/10.3390/healthcare11222985 - 19 Nov 2023
Viewed by 705
Abstract
Neurocognitive Disorders (NCDs) pose a significant global health concern, and early detection is crucial for optimizing therapeutic outcomes. In parallel, mobile health apps (mHealth apps) have emerged as a promising avenue for assisting individuals with cognitive deficits. Under this perspective, we pioneered the [...] Read more.
Neurocognitive Disorders (NCDs) pose a significant global health concern, and early detection is crucial for optimizing therapeutic outcomes. In parallel, mobile health apps (mHealth apps) have emerged as a promising avenue for assisting individuals with cognitive deficits. Under this perspective, we pioneered the development of the RODI mHealth app, a unique method for detecting aligned with the criteria for NCDs using a series of brief tasks. Utilizing the RODI app, we conducted a study from July to October 2022 involving 182 individuals with NCDs and healthy participants. The study aimed to assess performance differences between healthy older adults and NCD patients, identify significant performance disparities during the initial administration of the RODI app, and determine critical features for outcome prediction. Subsequently, the results underwent machine learning processes to unveil underlying patterns associated with NCDs. We prioritize the tasks within RODI based on their alignment with the criteria for NCDs, thus acting as key digital indicators for the disorder. We achieve this by employing an ensemble strategy that leverages the feature importance mechanism from three contemporary classification algorithms. Our analysis revealed that tasks related to visual working memory were the most significant in distinguishing between healthy individuals and those with an NCD. On the other hand, processes involving mental calculations, executive working memory, and recall were less influential in the detection process. Our study serves as a blueprint for future mHealth apps, offering a guide for enhancing the detection of digital indicators for disorders and related conditions. Full article
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11 pages, 916 KiB  
Article
Distal Femur Megaprostheses in Orthopedic Oncology: Evaluation of a Standardized Post-Operative Rehabilitation Protocol
Healthcare 2023, 11(22), 2984; https://doi.org/10.3390/healthcare11222984 - 19 Nov 2023
Viewed by 606
Abstract
Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment [...] Read more.
Background and Objectives: Megaprostheses are the most used reconstructive approach for patients who have undergone massive resection of their distal femurs due to bone tumors. Although the literature about their outcomes has flourished in recent decades, to date, a consensus on rehabilitative treatment is yet to be established. In this study, we report on our experience with our latest standardized rehabilitation program, evaluating our results in a mid-to-long-term scenario. Materials and Methods: We evaluated the functional results of all our oncologic patients treated between 2016 and 2022 who could follow our standardized post-operative rehabilitative approach, consisting of progressive knee mobilization and early weight-bearing. Results: Sixteen cases were included in our study. The average duration of the patients’ hospitalization was 12.2 days. A standing position was reached on average 4.1 days after surgery, while assisted walking was started 4.5 days after surgery. After a mean post-operative follow-up of 46.7 months, our patients’ mean MSTS score was 23.2 (10–30). Our data suggest that the sooner patients could achieve a standing position (R = −0.609; p = 0.012) and start walking (R = −0.623; p = 0.010), the better their final functional outcomes regarding their MSTS scores. Conclusions: Rehabilitation should be considered a pivotal factor in decreeing the success of distal femur megaprosthetic implants in long-surviving oncologic patients. Correct rehabilitation, focused on early mobilization and progressive weight-bearing, is crucial to maximizing the post-operative functional outcomes of these patients. Full article
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19 pages, 1310 KiB  
Review
Healthcare Cybersecurity Ethical Concerns during the COVID-19 Global Pandemic: A Rapid Review
Healthcare 2023, 11(22), 2983; https://doi.org/10.3390/healthcare11222983 - 18 Nov 2023
Viewed by 1208
Abstract
Background and objectives: Healthcare organizations have endured significant challenges and relied upon telehealth and related technological advances during the COVID-19 pandemic to allow for the sustainment of care. The purpose of this study was to systematically identify healthcare cybersecurity ethical concerns experienced during [...] Read more.
Background and objectives: Healthcare organizations have endured significant challenges and relied upon telehealth and related technological advances during the COVID-19 pandemic to allow for the sustainment of care. The purpose of this study was to systematically identify healthcare cybersecurity ethical concerns experienced during the pandemic to assist with the sustainability of the delivery of care going forward. Methods: This study was guided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocols for systematic reviews and focused on cybersecurity in healthcare organizations that published articles during the COVID-19 pandemic (March 2020 through October 2022). The articles were accessed using the EBSCOhost and Pub-Med (which queries MEDLINE) platforms, through which the Academic Search Complete, MEDLINE Complete, and Complementary Index databases were accessed. Follow-on supplementary topic modeling allowed for the additional application of ethical principles to the review findings. Results: Among the 22 articles that met the inclusion criteria, three ethical concerns were identified by the rapid review: smart and medical technology concerns (73% of occurrences), at-risk population cybersecurity (55% of occurrences), and legal challenges in data protection (73% of occurrences). The research team also conducted a latent Dirichlet allocation (LDA) analysis, identifying three topics from the review corpus: robotic and biomedical/clinical care outcomes, diagnostic applications, and public health data usage. These were then mapped to primary ethical healthcare principles. Conclusions: The sustainment of healthcare technology interoperability and related telehealth initiatives involves the ongoing assessment of cybersecurity threats and adequate knowledge of related ethical stakeholder concerns to promote ongoing care delivery. Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
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12 pages, 282 KiB  
Article
Physicians’ Words, Patients’ Response: The Role of Healthcare Counselling in Enhancing Beneficial Lifestyle Modifications for Patients with Cardiometabolic Disorders: The IACT Cross-Sectional Study
Healthcare 2023, 11(22), 2982; https://doi.org/10.3390/healthcare11222982 - 18 Nov 2023
Viewed by 694
Abstract
Background: Preventive cardiology aims to educate patients about risk factors and the importance of mitigating them through lifestyle adjustments and medications. However, long-term adherence to recommended interventions remains a significant challenge. This study explores how physician counselling contributes to successful behavior changes [...] Read more.
Background: Preventive cardiology aims to educate patients about risk factors and the importance of mitigating them through lifestyle adjustments and medications. However, long-term adherence to recommended interventions remains a significant challenge. This study explores how physician counselling contributes to successful behavior changes in various aspects of lifestyle. Methods: A cross-sectional study conducted in Greece in 2022–2023 included 1988 participants. Validated questionnaires assessed patients’ characteristics, dietary habits, and lifestyle choices. Results: The findings revealed that patients who received lifestyle advice from physicians demonstrated increased compliance with the Mediterranean diet and a higher involvement in physical activity. Notably, they were also less likely to be non-smokers. Importantly, physicians’ recommendations had a more pronounced association with adherence level to the Mediterranean diet compared to other lifestyle behaviors. Additionally, specific dietary components like cereal, legume, and red meat consumption were significantly associated with physicians’ guidance. Conclusions: This study highlights the complex relationship between patients’ cardiometabolic health, lifestyle decisions, and healthcare professionals’ guidance. The substantial influence of physicians on Mediterranean diet adherence underscores the necessity for a multidisciplinary healthcare approach. Collaborative efforts involving physicians, dietitians, and fitness experts can offer comprehensive support to patients in navigating the intricate landscape of cardiometabolic health. Full article
10 pages, 281 KiB  
Article
A Machine Learning Approach Unveils the Relationships between Sickness Behavior and Interoception after Vaccination: Suggestions for Psychometric Indices of Higher Vulnerability
Healthcare 2023, 11(22), 2981; https://doi.org/10.3390/healthcare11222981 - 18 Nov 2023
Viewed by 719
Abstract
Objective: Prior research has suggested a possible connection between vaccination and manifestations of Sickness Behavior; however, a need remains to first delve deeper into this association and second examine how Interoceptive Awareness and emotional factors may modulate individuals’ perceptions of their health status [...] Read more.
Objective: Prior research has suggested a possible connection between vaccination and manifestations of Sickness Behavior; however, a need remains to first delve deeper into this association and second examine how Interoceptive Awareness and emotional factors may modulate individuals’ perceptions of their health status post vaccination. Method: An online retrospective cross-sectional survey of 647 individuals who received a COVID-19 vaccination was conducted. Together with vaccination side effects, socio-demographic characteristics, health status, level of concern about vaccination, and Interoceptive Awareness were collected at the baseline level. Mood, sleep, and Sickness Behavior were assessed at baseline and after vaccination. Data were analyzed using inferential statistics and machine learning techniques. Results: After vaccination, there was a significant increase in Sickness Behavior levels (mean (±SD) SicknessQ T0 = 1.57 (±2.72), mean (±SD) SicknessQ T1 = 5.54 (±5.51); p-value = 0.001; ES = 0.77). A Machine Learning analysis revealed specific patterns of individual dispositions (sex and age), baseline emotional characteristics (levels of depression, anxiety, stress, and concern about adverse reactions), as well as some components of Interoceptive Awareness (Noticing, Body Listening, and Attention Regulation), as predictors of high levels of Sickness Behavior, both in terms of overall scores (JRIP: 72.65% accuracy, AUC = 0.692, d = 0.709; F1 = 0.726) and individual items (JRIP: 75.77% accuracy, AUC = 0.694; d = 0.717; F1 = 0.754). Conclusions: Our results provide new insight into post-immune reactions by highlighting the contribution of Interoceptive Awareness in modulating the severity of Sickness Behavior. This sheds light on the role of awareness of bodily sensations in modulating perceptions of health status, helping to identify the characteristics that make individuals more prone to feeling sick. Full article
16 pages, 319 KiB  
Article
Correlation between Health and eHealth Literacy and a Healthy Lifestyle: A Cross-Sectional Study of Spanish Primary Healthcare Patients
Healthcare 2023, 11(22), 2980; https://doi.org/10.3390/healthcare11222980 - 18 Nov 2023
Viewed by 771
Abstract
Background: Health literacy and eHealth literacy play a crucial role in improving a community’s ability to take care of themselves, ultimately leading to a reduction in disparities in health. Embracing a healthy way of living is vital in lessening the impact of illnesses [...] Read more.
Background: Health literacy and eHealth literacy play a crucial role in improving a community’s ability to take care of themselves, ultimately leading to a reduction in disparities in health. Embracing a healthy way of living is vital in lessening the impact of illnesses and extending one’s lifespan. This research delves into the link between the health and eHealth literacy levels of individuals accessing primary healthcare services and investigates how this relates to adopting a health-conscious lifestyle. Methods: The approach involves a cross-sectional examination carried out at a healthcare facility in the Madrid region of Spain, focusing on adult patients who are in need of primary care nursing services. Health and eHealth literacy and a healthy lifestyle were measured using the Health Literacy Questionnaire (HLQ), the eHealth Literacy Questionnaire (eHLQ), and the “PA100” questionnaire, respectively. Results: Only some of the dimensions of the HLQ and eHLQ were significantly related to a healthy lifestyle, predominantly with a very low or low relationship. Dimension three of the HLQ and dimension five of the eHLQ acquired more importance and were positioned as positive predictors of a healthy lifestyle. Conclusions: This study helps comprehend the relationship between health and eHealth literacy and a healthy lifestyle, which provides information that contributes to understanding the factors that might have a higher impact on lifestyles. Full article
(This article belongs to the Special Issue Advances in Primary Health Care and Community Health)
8 pages, 692 KiB  
Brief Report
The Impact of Non-Adherence to Antihypertensive Drug Therapy
Healthcare 2023, 11(22), 2979; https://doi.org/10.3390/healthcare11222979 - 18 Nov 2023
Viewed by 909
Abstract
Medication non-adherence is a major healthcare barrier, especially among diseases that are largely asymptomatic, such as hypertension. The impact of poor medication adherence ranges from patient-specific adverse health outcomes to broader strains on health care system resources. The Centers for Disease Control (CDC) [...] Read more.
Medication non-adherence is a major healthcare barrier, especially among diseases that are largely asymptomatic, such as hypertension. The impact of poor medication adherence ranges from patient-specific adverse health outcomes to broader strains on health care system resources. The Centers for Disease Control (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) database was used to retrieve Centers for Medicare and Medicaid Services’ data pertaining to blood pressure (BP) medication adherence, socio-economic variables, and cardiovascular (CV) outcomes across the United States. Multivariable linear regression models were used to estimate the change in total CV deaths as a function of non-adherence to BP medications. For every percent increase in the non-adherence rate, the total number of CV deaths increased by 7.13 deaths per 100,000 adults (95% CI: 6.34–7.92), even after controlling for the percentage of residents with access to insurance, the percentage of residents who were eligible for Medicaid, the percentage of residents without a college education, median home value, income inequality, and the poverty rate (p < 0.001). There is a significant association between non-adherence to BP medications and total CV deaths. Even a one percent increase in the adherence rate in the United States could result in tens of thousands of preventable CV deaths. Based on recently published CDC data, this could also have a tremendous impact on health care costs. This provides compelling evidence for increased efforts to improve adherence. Full article
(This article belongs to the Special Issue Progress in Prevention and Care for Cardiovascular Diseases)
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12 pages, 556 KiB  
Systematic Review
Anxiety-Reducing Effects of Lavender Essential Oil Inhalation: A Systematic Review
Healthcare 2023, 11(22), 2978; https://doi.org/10.3390/healthcare11222978 - 17 Nov 2023
Viewed by 1608
Abstract
Anxiety disorders are the most prevalent and disabling mental disorders, causing health-related burdens. With the increasing demand for and interest in safe and acceptable anxiolytics, several studies report the anxiolytic effects of lavender aromatherapy, providing evidence of its physiological and psychological effects. However, [...] Read more.
Anxiety disorders are the most prevalent and disabling mental disorders, causing health-related burdens. With the increasing demand for and interest in safe and acceptable anxiolytics, several studies report the anxiolytic effects of lavender aromatherapy, providing evidence of its physiological and psychological effects. However, existing reviews comprehensively cover the effects of different modes of delivering aromatherapy. Therefore, this review assesses the efficacy of lavender essential oil inhalation in reducing anxiety. The titles and abstracts of relevant articles published over the last five years were searched in PubMed, Web of Science, and Scopus databases. This review only included clinical trials that utilized lavender inhalation for anxiety treatment. Eleven studies comprising 972 participants were included. Of these, 10 reported significantly decreased anxiety levels after lavender oil inhalation. The physiological measures of vital signs, including blood pressure, heart rate, respiratory rate, pulse, and saturation, were conducted in three trials, showing that lavender oil inhalation could physiologically affect anxiety levels. Lavender oil inhalation is a safe and feasible anxiolytic intervention for treating people with diverse types of anxiety. Data from further studies with a high-quality design and accurate information are necessary to confirm the validity of these findings and elucidate the anxiety-reducing mechanisms of lavender inhalation. Full article
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10 pages, 669 KiB  
Article
Outcome of Involuntary Mental Health Assessment in a Psychiatric Department in Greece
Healthcare 2023, 11(22), 2977; https://doi.org/10.3390/healthcare11222977 - 17 Nov 2023
Viewed by 572
Abstract
Despite their controversiality, involuntary admissions in psychiatric departments remain a central issue in mental health care. The present study aims to identify demographic and clinical factors possibly associated with emergency involuntary psychiatric assessment and its outcome in Greece. This study was carried out [...] Read more.
Despite their controversiality, involuntary admissions in psychiatric departments remain a central issue in mental health care. The present study aims to identify demographic and clinical factors possibly associated with emergency involuntary psychiatric assessment and its outcome in Greece. This study was carried out in the psychiatric department of the University General Hospital of Alexandroupolis (UGHA) from 1 March 2018 to 28 February 2019. The sample included 191 individuals who had been psychiatrically assessed without their consent following a prosecutorial order. The majority of the involuntary assessments resulted in hospitalization (71%), with 51% of them resulting in involuntary hospitalization. Almost all patients diagnosed with “F20–29 schizophrenia, schizotypal and delusional disorders” were subsequently admitted to the psychiatric department of the UGHA (77 of 81, 66 of them involuntarily). Higher admission rates were recorded among those who had been referred from the Prosecutor’s Office of regions that are located far from the psychiatric department of UGHA (Fisher’s exact test, p-value = 0.045). In multivariate logistic regression, prior contact with psychiatric services and having an “F20–29 schizophrenia, schizotypal and delusional disorders” diagnosis was statistically significant with admission to the hospital as an outcome variable. Our study suggests an increased risk of involuntary admission among patients with psychosis, patients who had visited a psychiatric service prior to their assessment as well as those living further away from the main psychiatric services of the hospital. Better organization of community psychiatric services in remote places from hospital central services may lead to fewer prosecutorial referrals and coercive measures. Full article
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11 pages, 952 KiB  
Article
Association between Chronic Kidney Disease and Dynapenia in Elderly Koreans
Healthcare 2023, 11(22), 2976; https://doi.org/10.3390/healthcare11222976 - 17 Nov 2023
Viewed by 754
Abstract
Chronic kidney disease (CKD) is caused by various factors such as chronic inflammation, oxidative stress, and obesity. Loss of muscle strength and mass is a negative prognostic factor for CKD. Therefore, in this study, we aimed to investigate the association between CKD and [...] Read more.
Chronic kidney disease (CKD) is caused by various factors such as chronic inflammation, oxidative stress, and obesity. Loss of muscle strength and mass is a negative prognostic factor for CKD. Therefore, in this study, we aimed to investigate the association between CKD and dynapenia in the Korean elderly. To this end, we analyzed 7029 participants from the 2014–2019 Korean National Health and Nutrition Examination Survey (KNHANES) aged ≥65 years. After adjusting for all of the covariates that could affect the results, such as physical examinations, lifestyle factors, and exercise, the association between CKD and dynapenia was found to be significant, at 1.207 (95% CI: 1.056–1.379) in CKD stage 2 and 1.790 (95% CI: 1.427–2.246) in CKD stage 3a–5. However, when sexes were analyzed separately, women were significant in both CKD stage 2 and stage 3–5 compared to normal, but only in stage 3–5 for men. Additionally, the prevalence of dynapenia increased significantly as the stage of CKD increased (normal, stage 2, and stage 3–5: 18.5%, 20.8%, and 32.3% in men and 27.5%, 34.4%, and 46.1% in women, respectively). Thus, CKD is significantly related to dynapenia, especially in women, when stratified by sex. Full article
(This article belongs to the Section Chronic Care)
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