Healthcare

13 pages, 902 KiB

Open AccessArticle

Sparing Is Caring: Hormonal Retreatment in Women with Recurrent Endometrial Cancer after Fertility Preservation Management—A Single Centre Retrospective Study

by Ida Pino, Maria Di Giminiani, Davide Radice, Ailyn Mariela Vidal Urbinati, Anna Daniela Iacobone, Maria Elena Guerrieri, Eleonora Petra Preti, Silvia Martella and Dorella Franchi

Healthcare 2023, 11(7), 1058; https://doi.org/10.3390/healthcare11071058 - 06 Apr 2023

Cited by 1 | Viewed by 1410

Abstract

Fertility-sparing treatment (FTS) of endometrial cancer (EC) has a high rate of remission but also a high rate of relapse (10–88%). Many women still wish to conceive at the time of relapse, but results regarding retreatment are still lacking. This study aims to [...] Read more.

Fertility-sparing treatment (FTS) of endometrial cancer (EC) has a high rate of remission but also a high rate of relapse (10–88%). Many women still wish to conceive at the time of relapse, but results regarding retreatment are still lacking. This study aims to evaluate the safety, oncological and pregnancy outcomes of repeated FST in women with recurrent EC. This is a retrospective single-center study that recruited patients who had uterine recurrence after achieving a complete response (CR) with FST for FIGO stage IA, well-differentiated (G1), endometrioid EC. All eligible women underwent a second FST. Among 26 patients with recurrence, 6 decided to receive a hysterectomy and 20 received fertility-sparing retreatment. In total, 17 out of 20 women (85%) achieved a CR in a median time of 6 months. A total of 2/20 women showed a stable disease and continued the treatment for a further 6 months and finally achieved a CR. In total, 1/20 women showed disease progression and underwent demolitive surgery. After relapse and a CR, 14 patients attempted to become pregnant, among whom 7 became pregnant (pregnancy rate 50%—life birth rate 29%). Secondary FST is a safe and effective option for women who desire to preserve fertility after the recurrence of early-stage EC. Full article

(This article belongs to the Special Issue Fertility Sparing Gynaecological Surgery)

► Show Figures

Figure 1

18 pages, 2712 KiB

Open AccessArticle

Detection of Depression-Related Tweets in Mexico Using Crosslingual Schemes and Knowledge Distillation

by Jorge Pool-Cen, Hugo Carlos-Martínez, Gandhi Hernández-Chan and Oscar Sánchez-Siordia

Healthcare 2023, 11(7), 1057; https://doi.org/10.3390/healthcare11071057 - 06 Apr 2023

Cited by 2 | Viewed by 1788

Abstract

Mental health problems are one of the various ills that afflict the world’s population. Early diagnosis and medical care are public health problems addressed from various perspectives. Among the mental illnesses that most afflict the population is depression; its early diagnosis is vitally [...] Read more.

Mental health problems are one of the various ills that afflict the world’s population. Early diagnosis and medical care are public health problems addressed from various perspectives. Among the mental illnesses that most afflict the population is depression; its early diagnosis is vitally important, as it can trigger more severe illnesses, such as suicidal ideation. Due to the lack of homogeneity in current diagnostic tools, the community has focused on using AI tools for opportune diagnosis. Unfortunately, there is a lack of data that allows the use of IA tools for the Spanish language. Our work has a cross-lingual scheme to address this issue, allowing us to identify Spanish and English texts. The experiments demonstrated the methodology’s effectiveness with an F1-score of 0.95. With this methodology, we propose a method to solve a classification problem for depression tweets (or short texts) by reusing English language databases with insufficient data to generate a classification model, such as in the Spanish language. We also validated the information obtained with public data to analyze the behavior of depression in Mexico during the COVID-19 pandemic. Our results show that the use of these methodologies can serve as support, not only in the diagnosis of depression, but also in the construction of different language databases that allow the creation of more efficient diagnostic tools. Full article

(This article belongs to the Special Issue Information Technologies Applied on Healthcare)

► Show Figures

Figure 1

10 pages, 282 KiB

Open AccessArticle

Prediction of Lung Function Status Using Handgrip Strength and Anthropometry among the Healthy Malay Population in Malaysia

by Mohd Hasni Ja’afar, Rosnah Ismail, Noor Hassim Ismail, Zaleha Md Isa, Azmi Mohd Tamil, Nafiza Mat Nasir, Tengku Saifudin Tengku Ismail, Nurul Hafiza Ab Razak, Najihah Zainol Abidin, MyLinh Duong and Khairul Hazdi Yusof

Healthcare 2023, 11(7), 1056; https://doi.org/10.3390/healthcare11071056 - 06 Apr 2023

Viewed by 1221

Abstract

Lung function depends primarily on the strength of the intercostal muscles and the diaphragm, which is indirectly related to handgrip strength (HGS). This study aims to determine the predictability of lung functions using HGS among healthy adults of Malay ethnicity in Malaysia. This [...] Read more.

Lung function depends primarily on the strength of the intercostal muscles and the diaphragm, which is indirectly related to handgrip strength (HGS). This study aims to determine the predictability of lung functions using HGS among healthy adults of Malay ethnicity in Malaysia. This study also aims to compare the equation using HGS with equations without HGS, such as the Global Lung Initiative (GLI). This study was carried out among adults between 35 to 70 years of age residing in urban and rural Malaysia. A series of standardized questionnaires were used to collect socio-demographic information. Lung functions were measured using a portable spirometer and HGS was measured using a Jamar dynamometer. The predictability of lung function indices (FEV₁ and FVC) using HGS, age, and height was determined using multiple linear regression (MLR). Prediction of lung function indices was also generated using models without HGS for comparison with the equation that used HGS from this study. Pearson correlation analysis showed that both dominant (r = 0.49; p < 0.001) and non-dominant (r = 0.58; p < 0.001) HGS had a moderate significant correlation with lung function. In the MLR model, HGS was a significant (p < 0.001) predictor of lung function indices (FEV₁ and FVC). The correlation of the predicted and measured lung indices using the equation generated in this study, which includes HGS, was higher compared with other lung function test equations that do not include HGS. The equations from MLR could be used to predict lung function indices among healthy Malay adults. The measurement of HGS may be used as a screening tool for lung function status when spirometry is unavailable. Full article

15 pages, 285 KiB

Open AccessArticle

Role of Dentistry in Humanitarian Projects: Knowledge and Perspective of Future Professionals on the World of Volunteering in Spain

by Matías Ferrán Escobedo Martínez, Enrique Barbeito Castro, Sonsoles Olay, Brezo Suárez-Solis Rodríguez, Juan Suárez-Solis Rodríguez, Luis Junquera, Mario Mauvezín Quevedo and Sonsoles Junquera

Healthcare 2023, 11(7), 1055; https://doi.org/10.3390/healthcare11071055 - 06 Apr 2023

Viewed by 1150

Abstract

Non-governmental organizations (NGOs) in dentistry seek to promote the improvement on oral health in the most disadvantaged regions. The objective of this study is to identify the level of knowledge, expectations, and motivations that dental school students have about volunteering in dentistry, as [...] Read more.

Non-governmental organizations (NGOs) in dentistry seek to promote the improvement on oral health in the most disadvantaged regions. The objective of this study is to identify the level of knowledge, expectations, and motivations that dental school students have about volunteering in dentistry, as well as to evaluate possible differences in these variables depending on their level of dental training. During the month of September 2022, a voluntary and anonymous online survey was carried out among all the students at the Dentistry School of Oviedo University. There were 5 questions to judge knowledge about global oral health course. 12 additional questions were included to assess the willingness to volunteer in international setting, the volunteer profile, as well as the most effective means to improve oral health in host communities. None of the students from our center had participated as a volunteer in dental NGOs, but up to 64.4% of them had considered their collaboration. The level of knowledge about global oral health obtained was low, with the percentage of correct answers ranging between 14.4% (in the question about the ideal patient/dentist ratio) and 57.8% (in the question about the fluoride concentration in drinking water). Majority of dental students (98.9%) were not aware that basic package of oral care was created by WHO. Significantly, the students of the clinical courses showed a greater motivation to volunteer. Full article

15 pages, 2017 KiB

Open AccessSystematic Review

Analgesic Efficacy of COX-2 Inhibitors in Periodontal Surgery: A Systematic Review and Meta-Analysis

by Mario Alberto Isiordia-Espinoza, Eduardo Gómez-Sánchez, Itzel Joselyn Mora-Falcón, Iván Agustín Amador-Beas, Adriana Hernández-Gómez, Nicolás Addiel Serafín-Higuera and Lorenzo Franco-de la Torre

Healthcare 2023, 11(7), 1054; https://doi.org/10.3390/healthcare11071054 - 06 Apr 2023

Cited by 1 | Viewed by 1762

Abstract

The objective of this systematic review and meta-analysis was to evaluate the analgesic efficacy of COX-2 inhibitors versus other drugs in periodontal surgery. Two researchers searched PubMed, Google Scholar, ACM Digital, BASE, EBSCOhost, Scopus, or Web of Science for clinical trials using various [...] Read more.

The objective of this systematic review and meta-analysis was to evaluate the analgesic efficacy of COX-2 inhibitors versus other drugs in periodontal surgery. Two researchers searched PubMed, Google Scholar, ACM Digital, BASE, EBSCOhost, Scopus, or Web of Science for clinical trials using various combinations of words. All articles that met the selection criteria were assessed using the Cochrane Collaboration’s risk of bias tool. For data analysis, the inverse variance and mean difference statistical method was used with Review Manager 5.3 software for Windows. According to the conclusion of each study (qualitative evaluation), only one clinical trial had results in favor of a COX-2 inhibitor when compared to placebo, one clinical study informed that a COX-2 was better that an active control, four studies showed similar analgesic efficacy to active controls, and one clinical study informed the analgesic effect of one celecoxib-caffeine combination in comparison with celecoxib alone and placebo (n = 337). The COX-2 inhibitors showed a decrease in the rescue analgesic consumption (n = 138; I² = 15%; mean difference = −0.31; 95%CIs = −0.6 to −0.01), and lower pain intensity at four hours (n = 178; I2 = 0%; mean difference = −2.25; 95%CIs = −2.94 to −1.55; p = 0.00001) when compared to active controls after periodontal surgery. In conclusion, the data indicate that COX-2 agents produce better pain relief in comparison to placebo and other drugs after periodontal surgery. Full article

(This article belongs to the Special Issue Periodontal Diseases and Oral Health)

► Show Figures

Figure 1

12 pages, 595 KiB

Open AccessArticle

The Effect of Ramadan Fasting on the Coping Strategies Used by Male Footballers Affiliated with the Tunisian First Professional League

by Jamel Hajji, Aiche Sabah, Musheer A. Aljaberi, Chung-Ying Lin and Lin-Yi Huang

Healthcare 2023, 11(7), 1053; https://doi.org/10.3390/healthcare11071053 - 06 Apr 2023

Cited by 3 | Viewed by 1787

Abstract

This study aimed to discover coping strategies among professional male Tunisian footballers during the Ramadan 2021 fast. One hundred and eighty footballers who belong to twelve Tunisian professional clubs (age: 25.54 ± 4.41 years, weight: 77.19 ± 5.99 kg; height: 180.54 ± 7.28 [...] Read more.

This study aimed to discover coping strategies among professional male Tunisian footballers during the Ramadan 2021 fast. One hundred and eighty footballers who belong to twelve Tunisian professional clubs (age: 25.54 ± 4.41 years, weight: 77.19 ± 5.99 kg; height: 180.54 ± 7.28 cm; BMI: 23.67 ± 0.58) were tested during three sessions: one week before Ramadan, during the last week of Ramadan, and one week after Ramadan 2021. The footballers completed the Arabic version of the Inventory of Coping Strategies for Competitive Sport (ICSCS) scale in each session. Responses were recorded retrospectively one hour after a competition. The analysis of variance revealed a significant effect of Ramadan fasting on the adaptation profile of footballers (F = 3.51; p-value = 0.0001). Before and after Ramadan fasting, active coping dominates the adaptation profile of Tunisian professional footballers. During Ramadan, footballers use an irregular and unbalanced coping profile. The lifestyle change induced by the Ramadan fast significantly and negatively affected the adaptation profile of Tunisian professional footballers. Under the effect of the month of Ramadan, footballers developed a different coping profile from that of normal months. Full article

(This article belongs to the Special Issue Improving Athletes’ Performance and Avoiding Health Issues)

► Show Figures

Figure 1

11 pages, 560 KiB

Open AccessArticle

Validity and Consistency of the Arabic Version of the Eating Disorder Examination Questionnaire (EDE-Q) among Saudi Adults

by Khalid Aldubayan, Khloud Ghafouri, Hiba Mutwalli, Hebah A. Kutbi and Walaa A. Mumena

Healthcare 2023, 11(7), 1052; https://doi.org/10.3390/healthcare11071052 - 06 Apr 2023

Viewed by 1862

Abstract

The prevalence of eating disorders (EDs) is growing, and early screening is important to prevent related health complications. The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a diagnostic tool to identify cases of EDs; however, a validated Arabic version of [...] Read more.

The prevalence of eating disorders (EDs) is growing, and early screening is important to prevent related health complications. The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a diagnostic tool to identify cases of EDs; however, a validated Arabic version of the tool is needed to help in the screening process of EDs. The aim of this study was to validate the Arabic version of EDE-Q. A cross-sectional study included a sample of 549 adults, who were recruited mainly from the four major provinces in Saudi Arabia. A forward–backward translation method was conducted, and then the tool was validated using the confirmatory factor analysis (CFA). The dataset was split for further convergent analysis using exploratory factor analysis (EFA) and CFA. The results of CFA from the main dataset did not support the four-factor original EDE-Q. The results of EFA from the first data-split suggested a three-factor EDE-Q-14 Arabic version. This was supported by the results of CFA of the second data-split. A total of five items were allocated in each shape and weight concern, and restraint component, with correlations ranging from 0.969 and 0.462 and from 0.847 to 0.437, respectively. A total of four items were allocated in eating concern, with correlations ranging from 0.748 to 0.556. The internal consistency of the global and the three subscales were high, with Cronbach’s α ranging from 0.762 to 0.900. Findings of the current study suggest that the Arabic version of the EDE-Q-14 is a valid and reliable tool to screen for EDs among adults in Saudi Arabia. Full article

► Show Figures

Figure 1

21 pages, 502 KiB

Open AccessArticle

An Integrated Model for Evaluating the Sustainability of Gamified Mobile Health Apps: An Instrument Development and Validation

by Abdulsalam Salihu Mustafa, Nor’ashikin Ali, Jaspaljeet Singh Dhillon and Darshana Sedera

Healthcare 2023, 11(7), 1051; https://doi.org/10.3390/healthcare11071051 - 06 Apr 2023

Cited by 2 | Viewed by 2080

Abstract

Mobile health (mHealth) apps are designed to support health behavior outcomes and improve well-being. The existing body of literature confirms mHealth’s overall efficacy in promoting physical activity; however, more research on its utility in sustaining user engagement is needed. Understanding the determinants of [...] Read more.

Mobile health (mHealth) apps are designed to support health behavior outcomes and improve well-being. The existing body of literature confirms mHealth’s overall efficacy in promoting physical activity; however, more research on its utility in sustaining user engagement is needed. Understanding the determinants of an individual’s willingness to continue using mHealth is vital to improving the intervention’s success. This study developed a unified model and survey instrument adapted from extant literature while introducing new constructs to predict the sustained use of gamified mHealth. A pilot study was conducted to validate the survey instrument using 48 gamified fitness app users in Malaysia. The survey instrument was tested following rigorous guidelines for quantitative research in the information system context. According to the findings, the reliabilities of most measurement items met the criterion, and those items were retained. Overall, this paper contributes by integrating social comparison theory and the self-determination theory for sustaining user engagement with gamified mHealth through an extrinsic and intrinsic motivation perspective. Full article

(This article belongs to the Section Health Informatics and Big Data)

► Show Figures

Figure 1

14 pages, 296 KiB

Open AccessArticle

Prevalence and Associated Factors of Malocclusion among Preschool Children in Huizhou, China: A Cross-Sectional Study

by Lude Lin, Wanting Chen, Dejun Zhong, Xiayuan Cai, Jieyi Chen and Fang Huang

Healthcare 2023, 11(7), 1050; https://doi.org/10.3390/healthcare11071050 - 06 Apr 2023

Cited by 2 | Viewed by 1439

Abstract

This survey examined the prevalence of malocclusion and its associated factors in 3- to 5-year-old children in Huizhou, China. Children were recruited from 21 kindergartens using a multistage sampling method. Two examiners performed oral examinations on the children, assessing occlusal traits, including primary [...] Read more.

This survey examined the prevalence of malocclusion and its associated factors in 3- to 5-year-old children in Huizhou, China. Children were recruited from 21 kindergartens using a multistage sampling method. Two examiners performed oral examinations on the children, assessing occlusal traits, including primary molar and canine relationship, overjet, crossbite, overbite, anterior open bite, scissor bite, midline deviation, crowding, and spacing. Caries experience was recorded. Self-administered questionnaires were distributed to collect background information and oral health-related habits. Chi-square test, Mann–Whitney U test, and binary logistic regression were conducted. The study invited 1485 children and eventually recruited 1454 (52.9% boys; response rate: 97.9%). The prevalence of malocclusion was 68.3%, and deep overbite was found in 48.6% of the children. Children who had lip-biting habits had a higher prevalence of deep overbite than those who did not (OR = 2.36, p < 0.05). Children who had digit-sucking habits and dental caries in anterior maxillary teeth had a lower prevalence of deep overbite than those who did not (OR = 0.73 and 0.70, respectively, p < 0.05). In conclusion, over half of the children in Huizhou who participated in the study had malocclusion. Dental caries in anterior maxillary teeth, digit-sucking, and lip-biting were the associated factors of deep overbite. Full article

(This article belongs to the Special Issue Oral Health Status of Children and Adolescents)

14 pages, 951 KiB

Open AccessArticle

Validation of the Opening Minds Scale for Health Care Providers (OMS-HC): Factor Structure and Psychometric Properties of the Brazilian Version

by Bruna Sordi Carrara, Marcos Sanches, Sireesha Jennifer Bobbili, Simone de Godoy Costa, Álvaro Francisco Lopes de Sousa, Jacqueline de Souza and Carla Aparecida Arena Ventura

Healthcare 2023, 11(7), 1049; https://doi.org/10.3390/healthcare11071049 - 06 Apr 2023

Cited by 1 | Viewed by 1144

Abstract

Stigma towards people with mental illness is also present among health professionals. The study validated and estimated the reliability, dimensionality and structure of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) scale in Brazil. In this methodological study, health professionals (n [...] Read more.

Stigma towards people with mental illness is also present among health professionals. The study validated and estimated the reliability, dimensionality and structure of the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) scale in Brazil. In this methodological study, health professionals (n = 199) from Family Health Units in Brazil were recruited by convenience sampling. The EFA conducted with 16 items resulted in four factors. The Cronbach’s Alpha for the OMS scale was 0.74, which is considered to reflect reasonable reliability. The data presented contribute to the use of the scale in studies that investigate the level of stigma among health professionals towards people with mental illness, as well as in the development of anti-stigma interventions in this context. Full article

► Show Figures

Figure A1

14 pages, 1021 KiB

Open AccessArticle

“Breastfeeding at Night Is Awesome” Mothers’ Intentions of Continuation of Breastfeeding Extreme and Very Preterm Babies upon Discharge from a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

by Sphiwe Madiba, Perpetua Modjadji and Busisiwe Ntuli

Healthcare 2023, 11(7), 1048; https://doi.org/10.3390/healthcare11071048 - 06 Apr 2023

Cited by 2 | Viewed by 1645

Abstract

Kangaroo mother care (KMC) is effective in increasing mothers’ initiation and maintenance of breastfeeding (BF) for extreme and very preterm (VLBW) infants. Although South Africa has implemented KMC for more than two decades, little is known about mothers’ perspectives on KMC. The purpose [...] Read more.

Kangaroo mother care (KMC) is effective in increasing mothers’ initiation and maintenance of breastfeeding (BF) for extreme and very preterm (VLBW) infants. Although South Africa has implemented KMC for more than two decades, little is known about mothers’ perspectives on KMC. The purpose of this study was to describe the BF intentions and practices of mothers of VLBW infants at home following discharge and assess the role long stay in KMC has on their decision to BF beyond discharge. This qualitative study was conducted at the KMC unit of a tertiary hospital in Pretoria, South Africa. Focus group interviews were conducted with 38 mothers of VLBW infants who had transitioned from neonatal intensive care (NICU) to KMC. We analysed transcripts following the five steps for qualitative thematic data analysis. Mothers were knowledgeable of the importance and value of BF preterm infants and conceded that breast milk has advantages over formula. Mothers had positive feelings toward BF their preterm infants. The stay in KMC increased the direct BF of their preterm infants, mothers’ BF efficacy, and had a positive influence on mothers’ intentions to continue BF following discharge and to exclusively breastfeed for six months. Their BF intentions, efficacy, and practices were influenced by the skilful BF counselling, training, and support they received from the nursing staff. High intention to BF among these mothers is suggestive of their knowledge and confidence in BF for their VLBW infants. It is important that nursing staff in NICU and KMC appreciate the significant role they play in mothers’ readiness and confidence to breastfeed beyond discharge. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

► Show Figures

Figure 1

13 pages, 2206 KiB

Open AccessArticle

Effects of Visual Communication Design Accessibility (VCDA) Guidelines for Low Vision on Public and Open Government Health Data

by Jongho Lim, Woojin Kim, Ilkon Kim and Eunjoo Lee

Healthcare 2023, 11(7), 1047; https://doi.org/10.3390/healthcare11071047 - 06 Apr 2023

Cited by 1 | Viewed by 1270

Abstract

Since 2019, the Korean government’s investments in making data more accessible to the public have grown by 337%. However, open government data, which should be accessible to everyone, are not entirely accessible to people with low vision, who represent an information-vulnerable class. Emergencies, [...] Read more.

Since 2019, the Korean government’s investments in making data more accessible to the public have grown by 337%. However, open government data, which should be accessible to everyone, are not entirely accessible to people with low vision, who represent an information-vulnerable class. Emergencies, such as the COVID-19 pandemic, decrease face-to-face encounters and inevitably increase untact encounters. Thus, the information gap experienced by low-vision people, who are underprivileged in terms of information, will be further widened, and they may consequently face various disadvantages. This study proposed visual communication design accessibility (VCDA) guidelines for people with low vision. Introduced screens enhanced by accessibility guidelines were presented to 16 people with low vision and 16 people with normal vision and the speed of visual information recognition was analyzed. No statistically significant difference (p > 0.05) was found due to the small sample size; however, this study’s results approached significance with improved visual recognition speed for people with low vision after adopting VCDA. As a result of the intervention, the visual information recognition speed of both normal and low-vision people improved. Thus, our results can help improve information recognition speed among people with normal and low vision. Full article

► Show Figures

Figure 1

17 pages, 1718 KiB

Open AccessReview

Pharmacological Modulation of Temporal Discounting: A Systematic Review

by Luis Felipe Sarmiento, Jorge Alexander Ríos-Flórez, Hector Andres Paez-Ardila, Pêssi Socorro Lima de Sousa, Antonio Olivera-La Rosa, Anderson Manoel Herculano Oliveira da Silva and Amauri Gouveia, Jr.

Healthcare 2023, 11(7), 1046; https://doi.org/10.3390/healthcare11071046 - 06 Apr 2023

Cited by 1 | Viewed by 1846

Abstract

Temporal discounting is a phenomenon where a reward loses its value as a function of time (e.g., a reward is more valuable immediately than when it delays in time). This is a type of intertemporal decision-making that has an association with impulsivity and [...] Read more.

Temporal discounting is a phenomenon where a reward loses its value as a function of time (e.g., a reward is more valuable immediately than when it delays in time). This is a type of intertemporal decision-making that has an association with impulsivity and self-control. Many pathologies exhibit higher discounting rates, meaning they discount more the values of rewards, such as addictive behaviors, bipolar disorder, attention-deficit/hyperactivity disorders, social anxiety disorders, and major depressive disorder, among others; thus, many studies look for the mechanism and neuromodulators of these decisions. This systematic review aims to investigate the association between pharmacological administration and changes in temporal discounting. A search was conducted in PubMed, Scopus, Web of Science, Science Direct and Cochrane. We used the PICO strategy: healthy humans (P-Participants) that received a pharmacological administration (I-Intervention) and the absence of a pharmacological administration or placebo (C-Comparison) to analyze the relationship between the pharmacological administration and the temporal discounting (O-outcome). Nineteen studies fulfilled the inclusion criteria. The most important findings were the involvement of dopamine modulation in a U-shape for choosing the delayed outcome (metoclopradime, haloperidol, and amisulpride). Furthermore, administration of tolcapone and high doses of d-amphetamine produced a preference for the delayed option. There was a time-dependent hydrocortisone effect in the preference for the immediate reward. Thus, it can be concluded that dopamine is a crucial modulator for temporal discounting, especially the D2 receptor, and cortisol also has an important time-dependent role in this type of decision. One of the limitations of this systematic review is the heterogeneity of the drugs used to assess the effect of temporal discounting. Full article

► Show Figures

Figure 1

12 pages, 868 KiB

Open AccessArticle

Engaging Leadership and Psychological Safety as Moderators of the Relationship between Strain and Work Recovery: A Cross-Sectional Study of HSS Employees

by Kirsikka Selander, Eveliina Korkiakangas, Minna Toivanen, Kirsi Yli-Kaitala, Hilpi Kangas, Nina Nevanperä and Jaana Laitinen

Healthcare 2023, 11(7), 1045; https://doi.org/10.3390/healthcare11071045 - 05 Apr 2023

Cited by 1 | Viewed by 1527

Abstract

Work in the health and social sector (HSS) is highly straining and therefore recovery from work needs to be promoted. Less is known on how job resources can be used to alleviate job strain and increase recovery from work. Thus, we analyzed the [...] Read more.

Work in the health and social sector (HSS) is highly straining and therefore recovery from work needs to be promoted. Less is known on how job resources can be used to alleviate job strain and increase recovery from work. Thus, we analyzed the following: the association between job demands and work recovery; the connections of engaging leadership and psychological safety to recovery from work; and the moderating effects of engaging leadership and psychological safety on the relationship between strain and recovery from work. This cross-sectional study of 18,155 HSS and 4347 eldercare employees in 2020 using linear regression analysis showed that job strain (p < 0.001) and moral distress (p < 0.001) were associated with decreased recovery from work. Engaging leadership (p < 0.001) and psychologically safe work community (p < 0.001) enhanced recovery from work independently. Engaging leadership mitigated the harmful effect of job strain (p < 0.01) and moral distress (p < 0.05), and psychological safety mitigated the effect of job strain (p < 0.001), but not moral distress (p > 0.05). Thus, it is important to reduce job strain so that employees recover from work. Further job resources such as engaging leadership and psychological safety are important in themselves as they support recovery from work and employees’ well-being, but also as they alleviate job demands. Full article

(This article belongs to the Special Issue Job Satisfaction and Mental Health of Workers)

► Show Figures

Figure 1

11 pages, 596 KiB

Open AccessArticle

Infant and Young Child Feeding Knowledge among Caregivers of Children Aged between 0 and 24 Months in Seshego Township, Limpopo Province, South Africa

by Ndivhudzannyi Muleka, Baatseba Maanaso, Mafiwa Phoku, Mabitsela Hezekiel Mphasha and Maishataba Makwela

Healthcare 2023, 11(7), 1044; https://doi.org/10.3390/healthcare11071044 - 05 Apr 2023

Cited by 1 | Viewed by 1787

Abstract

Background: Appropriate infant and young child feeding (IYCF) involves the initiation of breastfeeding within an hour of delivery, exclusive breastfeeding for 6 months, introduction of complementary feeding at 6 months while continuing breastfeeding for 2 years or beyond. Adequate IYCF knowledge among caregivers [...] Read more.

Background: Appropriate infant and young child feeding (IYCF) involves the initiation of breastfeeding within an hour of delivery, exclusive breastfeeding for 6 months, introduction of complementary feeding at 6 months while continuing breastfeeding for 2 years or beyond. Adequate IYCF knowledge among caregivers is associated with improved practices, lowers risk of kids developing malnutrition, infection, morbidity, and mortality. Early introduction of solid foods, mixed feeding, inadequate breastfeeding, and complementary feeding are all prevalent in South Africa. These are related to caregivers’ lack of IYCF knowledge. Hence, this study aims to determine the IYCF knowledge level of caregivers of children under 24 months in the semiurban Seshego Township, South Africa. Methodology: Quantitative and cross-sectional design was applied. A total of 86 caregivers were selected using simple random sampling, which is representative of a target population of 110. Structured questionnaire was utilised to gather data, and analysed through statistical software, using descriptive and inferential statistics. Chi-square test was used to calculate associations at 95% confidence interval, where a p-value of < 0.05 was considered statistically significant. Results: Findings show that 67% of participants had good IYCF knowledge (a score of 81 to 100%) and there was a significant relationship between knowledge and education (p = 0.001). Moreover, 40.7% did not know that exclusive breastfeeding should be up to 6 months, and 90% mentioned that breastmilk protects the child against diseases. Most participants (82.6%) know that complementary feeding should be introduced at 6 months with continuation of breastfeeding. Conclusions: Caregivers know that breastfeeding should begin immediately after birth, and that it protects against diseases. Moreover, they know that solid food should be introduced at 6 months. However, there is still a need to strengthen IYCF education, particularly on exclusive breastfeeding. Interventions to improve IYCF knowledge should be intertwined with improving educational and health literacy on breastfeeding and complementary feeding. Full article

► Show Figures

Figure 1

37 pages, 781 KiB

Open AccessSystematic Review

Appraisal and Evaluation of the Learning Environment Instruments of the Student Nurse: A Systematic Review Using COSMIN Methodology

by Marzia Lommi, Anna De Benedictis, Simona Ricci, Luca Guarente, Roberto Latina, Giuliana Covelli, Gianluca Pozzuoli, Maddalena De Maria, Dominique Giovanniello, Gennaro Rocco, Alessandro Stievano, Laura Sabatino, Ippolito Notarnicola, Raffaella Gualandi, Daniela Tartaglini and Dhurata Ivziku

Healthcare 2023, 11(7), 1043; https://doi.org/10.3390/healthcare11071043 - 05 Apr 2023

Viewed by 1979

Abstract

Background: Nursing education consists of theory and practice, and student nurses’ perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently [...] Read more.

Background: Nursing education consists of theory and practice, and student nurses’ perception of the learning environment, both educational and clinical, is one of the elements that determines the success or failure of their university study path. This study aimed to identify the currently available tools for measuring the clinical and educational learning environments of student nurses and to evaluate their measurement properties in order to provide solid evidence for researchers, educators, and clinical tutors to use in the selection of tools. Methods: We conducted a systematic review to evaluate the psychometric properties of self-reported learning environment tools in accordance with the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) Guidelines of 2018. The research was conducted on the following databases: PubMed, CINAHL, APA PsycInfo, and ERIC. Results: In the literature, 14 instruments were found that evaluate both the traditional and simulated clinical learning environments and the educational learning environments of student nurses. These tools can be ideally divided into first-generation tools developed from different learning theories and second-generation tools developed by mixing, reviewing, and integrating different already-validated tools. Conclusion: Not all the relevant psychometric properties of the instruments were evaluated, and the methodological approaches used were often doubtful or inadequate, thus threatening the instruments’ external validity. Further research is needed to complete the validation processes undertaken for both new and already developed instruments, using higher-quality methods and evaluating all psychometric properties. Full article

(This article belongs to the Section Nursing)

► Show Figures

Figure 1

11 pages, 897 KiB

Open AccessArticle

A Machine Learning Approach for Predicting Capsular Contracture after Postmastectomy Radiotherapy in Breast Cancer Patients

by Domenica Antonia Bavaro, Annarita Fanizzi, Serena Iacovelli, Samantha Bove, Maria Colomba Comes, Cristian Cristofaro, Daniela Cutrignelli, Valerio De Santis, Annalisa Nardone, Fulvia Lagattolla, Alessandro Rizzo, Cosmo Maurizio Ressa and Raffaella Massafra

Healthcare 2023, 11(7), 1042; https://doi.org/10.3390/healthcare11071042 - 05 Apr 2023

Cited by 1 | Viewed by 1679

Abstract

In recent years, immediate breast reconstruction after mastectomy surgery has steadily increased in the treatment pathway of breast cancer (BC) patients due to its potential impact on both the morpho-functional and aesthetic type of the breast and the quality of life. Although recent [...] Read more.

In recent years, immediate breast reconstruction after mastectomy surgery has steadily increased in the treatment pathway of breast cancer (BC) patients due to its potential impact on both the morpho-functional and aesthetic type of the breast and the quality of life. Although recent studies have demonstrated how recent radiotherapy techniques have allowed a reduction of adverse events related to breast reconstruction, capsular contracture (CC) remains the main complication after post-mastectomy radio-therapy (PMRT). In this study, we evaluated the association of the occurrence of CC with some clinical, histological and therapeutic parameters related to BC patients. We firstly performed bivariate statistical tests and we then evaluated the prognostic predictive power of the collected data by using machine learning techniques. Out of a sample of 59 patients referred to our institute, 28 patients (i.e., 47%) showed contracture after PMRT. As a result, only estrogen receptor status (ER) and molecular subtypes were significantly associated with the occurrence of CC after PMRT. Different machine learning models were trained on a subset of clinical features selected by a feature importance approach. Experimental results have shown that collected features have a non-negligible predictive power. The extreme gradient boosting classifier achieved an area under the curve (AUC) value of 68% and accuracy, sensitivity, and specificity values of 68%, 64%, and 74%, respectively. Such a support tool, after further suitable optimization and validation, would allow clinicians to identify the best therapeutic strategy and reconstructive timing. Full article

(This article belongs to the Special Issue Artificial Intelligence Applications in Medicine)

► Show Figures

Figure 1

28 pages, 2199 KiB

Open AccessArticle

“Sex Should Not Be Part of the Lives of Persons with Disabilities, but They Are Human Beings Too”: Perceptions of Healthcare Providers and Factors Affecting Service Delivery in Ghana

by Abdul-Aziz Seidu, Bunmi S. Malau-Aduli, Kristin McBain-Rigg, Aduli E. O. Malau-Aduli and Theophilus I. Emeto

Healthcare 2023, 11(7), 1041; https://doi.org/10.3390/healthcare11071041 - 04 Apr 2023

Cited by 3 | Viewed by 3175

Abstract

Persons with disabilities (PwDs) constitute about 16% of the global population and face many challenges in every society, including access to sexual and reproductive healthcare. The attitudes of healthcare providers (HPs) exert a major influence on PwDs accessing sexual and reproductive healthcare (SRH). [...] Read more.

Persons with disabilities (PwDs) constitute about 16% of the global population and face many challenges in every society, including access to sexual and reproductive healthcare. The attitudes of healthcare providers (HPs) exert a major influence on PwDs accessing sexual and reproductive healthcare (SRH). A sequential explanatory mixed methods design was used to investigate the attitudes and perceptions of HPs towards PwDs and SRH delivery in Ghana’s Ashanti region. Quantitative data analysis indicated that overall, 82% of HPs had received information on disability-related issues and had relatively positive attitude towards PwDs, which varied across sub-scales of the Attitude Towards Disability score and associated with their sociodemographic characteristics. HPs faced several challenges in SRH services delivery to PwDs, which included a lack of funding and training, and inadequate staff. Inductive thematic analysis of the qualitative data revealed eight overarching themes. The findings revealed that HPs had prejudice about the mental and sexual health abilities of PwDs. Inadequate skill set, inadequate resources, and limited funding were major challenges identified. Nonetheless, compassion and benevolence towards PwDs, improvision, economic and educational support, awareness creation, and referrals were strategies adopted to overcome these challenges. Mandatory training of HPs is recommended to ensure improved SRH service delivery to PwDs. Future research could explore the perceptions and coping strategies of PwDs. Full article

(This article belongs to the Special Issue Social Inequalities, Health Behaviours and Health-Related Well-Being across Populations)

► Show Figures

Figure 1

7 pages, 235 KiB

Open AccessCommunication

Self-Reported Questionnaire to Evaluate Functional Abilities in Middle Age: A Call for Delphi Expert Panel

by Roee Hayek, Odelyah Saad and Shmuel Springer

Healthcare 2023, 11(7), 1040; https://doi.org/10.3390/healthcare11071040 - 04 Apr 2023

Cited by 1 | Viewed by 1217

Abstract

Early detection of functional decline is important for promoting optimal aging. Self-reported questionnaires can efficiently assess functional abilities. Therefore, we aimed to highlight the lack of functional ability assessment questionnaires for the middle-aged population (MA, 45–65 years) and the need to develop such [...] Read more.

Early detection of functional decline is important for promoting optimal aging. Self-reported questionnaires can efficiently assess functional abilities. Therefore, we aimed to highlight the lack of functional ability assessment questionnaires for the middle-aged population (MA, 45–65 years) and the need to develop such a questionnaire. An online search was performed to find questionnaires quantifying self-reported performance and functional abilities at MA. We also conducted an online survey of a group of the MA population and interviewed individuals who reported age-related functional decline. Eight potentially relevant questionnaires were found, and one hundred and twenty-three individuals responded to our survey, five of whom were interviewed. None of the questionnaires were specifically designed to assess functional capacity at MA, and most of the questionnaires are likely to have a ceiling effect in assessing the MA population. Furthermore, the questionnaires do not capture functions related to dynamic balance, flexibility, and maximum strength, which are reported as difficult by our respondents, making them less appropriate for assessing function at MA. There is a need to engage a Delphi expert panel of several relevant healthcare professionals to develop a functional capacity assessment questionnaire for MA. Full article

(This article belongs to the Section Health Assessments)

17 pages, 584 KiB

Open AccessArticle

Identifying the Barriers to Universal Cervical Length Screening for Preterm Birth Prevention at a Tertiary Hospital in Thailand (Physician Perspectives): Implementation Research

by Saifon Chawanpaiboon, Vitaya Titapant, Sanitra Anuwutnavin, Attapol Kanjanapongporn and Julaporn Pooliam

Healthcare 2023, 11(7), 1039; https://doi.org/10.3390/healthcare11071039 - 04 Apr 2023

Viewed by 1214

Abstract

Objective: To identify physicians’ views on the barriers to measuring cervical length for preventing preterm deliveries. Materials and methods: This prospective, descriptive implementation study had three phases. In Phase I, 20 physicians were interviewed. Phase II comprised questionnaire development and data validation. The [...] Read more.

Objective: To identify physicians’ views on the barriers to measuring cervical length for preventing preterm deliveries. Materials and methods: This prospective, descriptive implementation study had three phases. In Phase I, 20 physicians were interviewed. Phase II comprised questionnaire development and data validation. The questionnaire was distributed to 120 Phase III participants. Results and discussion: All 120 participants responded. In 44 cases, the physicians received support from their local Maternal and Child Health Boards for preterm-birth-prevention programs; the other 76 physicians did not. The doctors tended to believe that cervical length screening plays no role in preventing preterm births (4/44 (9.1%) and 24/76 (31.6%); OR, 4.615; 95% CI, 1.482–14.373; p = 0.005). They were unsure about the correct measurement procedures (13/44 (29.5%) and 37/76 (48.7%); OR, 2.262; 95% CI, 1.028–4.977; p = 0.040). A lack of cost-free drug support (progesterone) for women with short cervices was identified as a barrier to preventing preterm births (30/44 (68.2%) and 32/76 (42.1%); OR, 0.339; 95% CI, 0.155–0.741; p = 0.006). Conclusions: Many physicians are unconvinced that measuring cervical length prevents premature births, and are unsure about the correct measurement procedures. There is a lack of government funding for hormone-usage programs. Full article

(This article belongs to the Section Health Policy)

► Show Figures

Figure 1

14 pages, 273 KiB

Open AccessArticle

Efforts of a Mobile Geriatric Team from a Next-of-Kin Perspective: A Phenomenographic Study

by Kjerstin Larsson, Veronika Wallroth and Agneta Schröder

Healthcare 2023, 11(7), 1038; https://doi.org/10.3390/healthcare11071038 - 04 Apr 2023

Viewed by 1134

Abstract

Many older adults with complex illnesses are today cared for by their next of kin in their own homes and are often sent between different caregivers in public healthcare. Mobile Geriatric Teams (MGTs) are a healthcare initiative for older adults with extensive care [...] Read more.

Many older adults with complex illnesses are today cared for by their next of kin in their own homes and are often sent between different caregivers in public healthcare. Mobile Geriatric Teams (MGTs) are a healthcare initiative for older adults with extensive care needs living at home, coordinated between hospital, primary, and municipal care. The study aims to describe how next of kin experience care efforts from an MGT for their older adult family members. The study has a descriptive qualitative design and uses a phenomenographic approach. Fourteen next of kin to older adult family members who receive efforts from an MGT were interviewed. Two descriptive categories reflecting their experiences emerged: Professional care and No longer having the main responsibility. The study shows that the participants valued that the staff was very competent, that the physician made home visits and could make quick decisions, and that treatments were given at home. They feel that they receive support and experience security and that a burden is lifted from them. Our study shows that through the MGT, next of kin become involved in the care and are relieved of the burden of responsibility of caring for their older family member. Full article

(This article belongs to the Section Community Care)

11 pages, 287 KiB

Open AccessArticle

Asthma, COPD, Respiratory, and Allergic Health Effects in an Adult Population Living near an Italian Refinery: A Cross-Sectional Study

by Mariangela Valentina Puci, Ottavia Eleonora Ferraro, Maria Cristina Monti, Marco Gnesi, Paola Borrelli, Ennio Cadum, Pietro Perotti, Simona Migliazza, Simona Dalle Carbonare, Cristina Montomoli and Simona Villani

Healthcare 2023, 11(7), 1037; https://doi.org/10.3390/healthcare11071037 - 04 Apr 2023

Cited by 1 | Viewed by 1511

Abstract

Background and aim. Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Globally, 545 million people suffer from chronic respiratory diseases with a wide geographical variability. Risk factors for asthma are both genetic and related to several [...] Read more.

Background and aim. Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Globally, 545 million people suffer from chronic respiratory diseases with a wide geographical variability. Risk factors for asthma are both genetic and related to several environmental factors (internal and external pollutants); these also have an important role in the occurrence of COPD. The aim of this study was to describe the prevalence of asthma, COPD, and asthma/COPD overlap (ACO) in an adult population living in two municipalities located in the Po Valley. Methods. A standardized questionnaire on respiratory symptoms and sociodemographic characteristics was self-administered to a random sample of the adult population aged 20–64 years, living near a refinery in Northern Italy during the period between 2016 and 2019. Logistic and multinomial regression were implemented to explore factors associated with asthma, COPD, and ACO. Results. In total, 1108 subjects filled out the questionnaire, the mean age was 48.02 ± 12.34 years (range 21–68), and 53% of the respondents/participants were female. Half of the responders were non-smokers, but the frequency of current and former smokers was significantly greater in men than in women (p < 0.001). The likelihood of being a probable case of asthma decreased with increasing age and increased for smokers. Tobacco smoke was associated with the presence of COPD and ACO. Conclusion. Respiratory diseases such as asthma and COPD are common in the general population, with differences among countries worldwide. Our findings show, on the basis of the main confirmed risk factor, namely smoking, that it is useful to plan target programs and actions in order to reduce smoking, thus improving the quality of life in public health. Full article

(This article belongs to the Special Issue Clinical Epidemiology and Biostatistics for Health Sciences)

11 pages, 582 KiB

Open AccessArticle

Cross-Cultural Validity of a Dietary Questionnaire for Studying Dental Caries in Japanese Children

by Yukie Nakai and Yukako Mori-Suzuki

Healthcare 2023, 11(7), 1036; https://doi.org/10.3390/healthcare11071036 - 04 Apr 2023

Viewed by 1271

Abstract

This study examines the cross-cultural validity of the Japanese version of the Food Frequency Questionnaire (FFQ), designed for studies on dental caries to assess dietary intake in Japanese children. Parent-reported dietary data were collected (274 children, 3–6 years old) using the 38-item FFQ, [...] Read more.

This study examines the cross-cultural validity of the Japanese version of the Food Frequency Questionnaire (FFQ), designed for studies on dental caries to assess dietary intake in Japanese children. Parent-reported dietary data were collected (274 children, 3–6 years old) using the 38-item FFQ, whose reliability and validity have been demonstrated in adults. Factor analysis was used to determine dimensionality. Dietary cariogenicity scores were compared with the levels of plaque mutans streptococci, and the decayed, missing, and filled teeth (dmft) index to evaluate the criterion validity using Pearson’s correlation coefficient (r) and the Kruskal–Wallis test. The FFQ showed good criterion validity, assessed through its relationship with the dmft index (r = 0.119; p = 0.05) and Dentocult SM score (r = 0.124; p = 0.04). Factor analysis revealed six questionnaire subscales. Internal consistency was from low to acceptable (Cronbach’s alpha = 0.64 for the total scale, 0.39–0.53 for each subscale). Children with a higher SM score were more likely to have higher dietary cariogenicity scores (p = 0.01; Kruskal–Wallis test). These results confirm the validity of the Japanese version of the FFQ for children, which can be used to track dietary structure dynamics regarding cariogenicity from childhood to adulthood. Full article

(This article belongs to the Special Issue Oral Health and Dental Care in Pediatric Dentistry: Second Edition)

► Show Figures

Figure 1

8 pages, 240 KiB

Open AccessCommunication

Association between Clinical Periodontal Features and Glycated Hemoglobin in Patients with Diabetes and Controlled Periodontitis: A Cross-Sectional Study

by Masayuki Tooi, Yuhei Matsuda, Hui Zhong and Shinichi Arakawa

Healthcare 2023, 11(7), 1035; https://doi.org/10.3390/healthcare11071035 - 04 Apr 2023

Viewed by 995

Abstract

Diabetes and periodontitis are the most prevalent chronic diseases, and they influence each other’s progression. Only a few studies have shown the association between diabetes and mild periodontitis. We aimed to investigate the relationship between well-controlled periodontitis and glycated hemoglobin (HbA1c) in patients [...] Read more.

Diabetes and periodontitis are the most prevalent chronic diseases, and they influence each other’s progression. Only a few studies have shown the association between diabetes and mild periodontitis. We aimed to investigate the relationship between well-controlled periodontitis and glycated hemoglobin (HbA1c) in patients with diabetes. This retrospective study investigated 150 Japanese patients with type 2 diabetes treated with supportive periodontal therapy (SPT). Medical histories of diabetes and periodontal therapy were collected, and a multiple linear regression analysis was performed to determine their association. The patients included 67 (44.7%) males and 83 (55.3%) females, with a mean age of 68.1 (standard deviation = 10.5) years. Forty-four (29.3%) patients were treated for diabetes, and the mean HbA1c was 6.7% (0.7). Oral status was 23.3 (5.1) for the number of teeth, 2.5 mm (0.4) for mean probing pocket depth (PPD), and 163.9 mm² (181.3) for the periodontal inflamed surface area (PISA). The multiple regression analysis showed a significant association between mean PPD (β = 0.38, p = 0.03) and HbA1c in patients with mild diabetes but not in severe cases. These results suggest that the diagnostic indices for periodontitis used to assess the association between periodontitis and HbA1c would be determined based on the severity of periodontitis and type 2 diabetes. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Health Care: Volume III)

19 pages, 456 KiB

Open AccessReview

Addressing Health Disparities through Community Participation: A Scoping Review of Co-Creation in Public Health

by Sergio Morales-Garzón, Lucy Anne Parker, Ildefonso Hernández-Aguado, Manuel González-Moro Tolosana, María Pastor-Valero and Elisa Chilet-Rosell

Healthcare 2023, 11(7), 1034; https://doi.org/10.3390/healthcare11071034 - 04 Apr 2023

Cited by 1 | Viewed by 3808

Abstract

Background: There is general agreement regarding the relevance of community involvement in public health policy, practice, and research to reduce health inequities. Objective: This review aims to analyse the experiences of community engagement in public health actions, with particular attention to methodologies used [...] Read more.

Background: There is general agreement regarding the relevance of community involvement in public health policy, practice, and research to reduce health inequities. Objective: This review aims to analyse the experiences of community engagement in public health actions, with particular attention to methodologies used and how community participation is articulated. Method and Analysis: We searched the Web of Science, EBSCO, and ProQuest for scientific articles published in peer-reviewed journals. We recorded methodological aspects, the approach to equity, actors that participated in the actions, and participation of the community in different phases (agenda setting, design, implementation, and evaluation). Results: Of 4331 records, we finally included 31 studies published between 1995 and 2021. Twelve studies referred to Community-Based Participatory Research as the framework used. The actions addressed equity, mainly by tackling economic vulnerability (n = 20, 64%) and racial discrimination (n = 18, 58%). Workshops were the most used method. Participation was frequently observed in the design and implementation phases of the action, but it was reduced to community feedback in the evaluation. Conclusions: Co-created public health actions offer the opportunity to reduce health inequity and promote social change; yet, further effort is needed to involve communities in the entire cycle of decision making. Full article

► Show Figures

Figure 1

10 pages, 528 KiB

Open AccessArticle

Does Personality, Trait Emotion Regulation, and Trait Attentional Control Contribute toward the Experience and Impact of an Alcohol Hangover?

by Felicity Hudson and Craig Gunn

Healthcare 2023, 11(7), 1033; https://doi.org/10.3390/healthcare11071033 - 04 Apr 2023

Viewed by 1185

Abstract

Mixed results have been reported for the relationship between personality and hangover, but recent findings have indicated that regulatory and attentional control processes may relate to hangover severity and the impact of a hangover on completing daily activities. This study aimed to explore [...] Read more.

Mixed results have been reported for the relationship between personality and hangover, but recent findings have indicated that regulatory and attentional control processes may relate to hangover severity and the impact of a hangover on completing daily activities. This study aimed to explore how these factors relate to hangover severity, hangover impact, and to unhealthy alcohol use. In total, 108 participants completed a survey, rating the severity and impact of their last-experienced hangover and completing measures of the above factors. Separate multiple linear regressions were conducted to analyse each outcome (severity, impact, unhealthy drinking). For severity, the overall regression was significant (Adj. R² = 0.46, p < 0.001), with the attentional control factor ‘Focusing’ (B = −0.096, p = 0.011), and personality factor ‘Agreeableness’ (B = 0.072, p = 0.005) predicting severity. For impact, the overall regression was significant (Adj. R² = 0.41, p < 0.001) with the attentional control factor ‘Shifting’ (B = −0.252, p = 0.021), personality factors ‘Extraversion’ (B = 0.225, p = 0.009) and ‘Agreeableness’ (B = −0.156, p = 0.042), and hangover severity (B = 1.603, p < 0.001) predicting impact. For unhealthy drinking, the overall regression model was significant (Adj. R² = 0.45, p < 0.001) with emotion dysregulation factors ‘Awareness’ (B = 0.301, p = 0.044) and ‘Impulse Control’ (B = 0.381, p = 0.011) predicting unhealthy drinking. These findings add to our understanding of the heterogeneity of hangover experience and highlight that attentional control, emotion regulation, and personality play important roles in the experience and impact of a hangover. Full article

(This article belongs to the Special Issue Alcohol Use and Hangover)

► Show Figures

Figure 1

9 pages, 276 KiB

Open AccessArticle

Comparison of Acute Arterial Responses Following a Rescue Simulation and Maximal Exercise in Professional Firefighters

by Vanessa Santos, Luís Miguel Massuça, Luís Monteiro, Vítor Angarten, Mark G. Abel, Bo Fernhall and Helena Santa-Clara

Healthcare 2023, 11(7), 1032; https://doi.org/10.3390/healthcare11071032 - 04 Apr 2023

Cited by 1 | Viewed by 1282

Abstract

Cardiovascular events are the leading cause of on-duty deaths among firefighters. Screening firefighters for risk of sudden cardiac event is a critical element of a comprehensive medical program. Although intense physical exertion has been shown to trigger sudden cardiac events in the general [...] Read more.

Cardiovascular events are the leading cause of on-duty deaths among firefighters. Screening firefighters for risk of sudden cardiac event is a critical element of a comprehensive medical program. Although intense physical exertion has been shown to trigger sudden cardiac events in the general population, it is unclear how hemodynamic responses following clinical exercise testing compare to that of performing firefighting tasks in personal protective equipment. Therefore, the purpose of this study was to compare hemodynamic responses following rescue simulation (RS) and maximal exercise in firefighters. This was a cross-over repeated measures study. Thirty-eight professional firefighters (31.8 ± 5.2 yr; VO_2peak: 57.9 mL/kg/min) completed a maximal aerobic exercise test (MAET) and an RS. Pulse wave velocity (PWV), pulse pressure (PP), and brachial and central mean arterial pressure (MAP) were measured before and 5 and 15 min post-exercise. The findings indicated that femoral PWV decreased after MAET and RS at both time points (p < 0.005). No significant differences were found in aortic and carotid PWV over time or between conditions (p ≥ 0.05). Significant increases in brachial and central PP and MAP were noted 5 min post-MAET and RS (p = 0.004). In conclusion, the present study demonstrated that peripheral arterial stiffness (AS) decreased in firefighters following both conditions, with no differences in central AS. Our findings provide valuable information on hemodynamic responses similar between RS and MAET, and are important for controlling CVD risk and the AS response. Full article

(This article belongs to the Special Issue Occupational Health and Physical Fitness of Tactical Population)

21 pages, 2333 KiB

Open AccessReview

Disease Prediction Using Graph Machine Learning Based on Electronic Health Data: A Review of Approaches and Trends

by Haohui Lu and Shahadat Uddin

Healthcare 2023, 11(7), 1031; https://doi.org/10.3390/healthcare11071031 - 04 Apr 2023

Cited by 10 | Viewed by 5005

Abstract

Graph machine-learning (ML) methods have recently attracted great attention and have made significant progress in graph applications. To date, most graph ML approaches have been evaluated on social networks, but they have not been comprehensively reviewed in the health informatics domain. Herein, a [...] Read more.

Graph machine-learning (ML) methods have recently attracted great attention and have made significant progress in graph applications. To date, most graph ML approaches have been evaluated on social networks, but they have not been comprehensively reviewed in the health informatics domain. Herein, a review of graph ML methods and their applications in the disease prediction domain based on electronic health data is presented in this study from two levels: node classification and link prediction. Commonly used graph ML approaches for these two levels are shallow embedding and graph neural networks (GNN). This study performs comprehensive research to identify articles that applied or proposed graph ML models on disease prediction using electronic health data. We considered journals and conferences from four digital library databases (i.e., PubMed, Scopus, ACM digital library, and IEEEXplore). Based on the identified articles, we review the present status of and trends in graph ML approaches for disease prediction using electronic health data. Even though GNN-based models have achieved outstanding results compared with the traditional ML methods in a wide range of disease prediction tasks, they still confront interpretability and dynamic graph challenges. Though the disease prediction field using ML techniques is still emerging, GNN-based models have the potential to be an excellent approach for disease prediction, which can be used in medical diagnosis, treatment, and the prognosis of diseases. Full article

(This article belongs to the Section Health Informatics and Big Data)

► Show Figures

Figure 1

9 pages, 644 KiB

Open AccessArticle

Effectiveness of a Program Based on Action-Observation Training (AOT) on Motor, Functional and Cognitive Aspects in Patients with Cognitive Impairment: A Non-Randomized Controlled Trial

by Cecilia Estrada-Barranco, Maria de los Ángeles Martinez-Javaloyes, Isabel Rodriguez-Costa, Ismael Sanz-Esteban, Alberto Bermejo-Franco, Araceli Aranda-Ruiperez and Maria de los Ángeles Gallegos-Martínez

Healthcare 2023, 11(7), 1030; https://doi.org/10.3390/healthcare11071030 - 04 Apr 2023

Cited by 1 | Viewed by 1751

Abstract

Cognitive impairment is frequent in elderly subjects. It is associated with motor impairment, a limitation in quality of life and frequently, institutionalization. The aim of this work is to test the efficacy of a therapeutic group program based on action-observation learning. Methods: a [...] Read more.

Cognitive impairment is frequent in elderly subjects. It is associated with motor impairment, a limitation in quality of life and frequently, institutionalization. The aim of this work is to test the efficacy of a therapeutic group program based on action-observation learning. Methods: a non-randomized controlled trial study was conducted. We included 40 patients with cognitive impairment from a nursing home who were categorized into mild and moderate cognitive impairment and divided separately into a control and experimental group. Experimental group performed a 4-week group work, in which each patient with mild cognitive impairment was paired with a patient with moderate cognitive impairment. Thus, patients with mild cognitive impairment observed a series of functional exercises performed by their peers and replicated them. Simultaneously, the patients with moderate cognitive impairment replicated the movement after observing it performed by a patient with mild cognitive impairment. The control group continued to receive their usual care at the center. The upper limb function, cognitive level and function in basic activities of human daily life were measured before and after the intervention and compared with the control group. Results: statistically significant differences were found in the functionality of basic activities of daily living, in the functionality of the upper limb and in the cognitive level in all patients in the experimental group regardless of the initial cognitive level. No statistically significant differences were found in the control group. Conclusions: the implementation of a group, peer-based, action-observation learning therapeutic program is effective in improving the basic activities of human daily life, cognitive level and upper limb functionality in patients with mild and moderate dementia. Full article

(This article belongs to the Special Issue Prevention, Intervention, and Care of Dementia)

► Show Figures

Figure 1

11 pages, 270 KiB

Open AccessArticle

The Masticatory Structure and Function in Children with Cerebral Palsy—A Pilot Study

by Karolina Szuflak, Roksana Malak, Brittany Fechner, Dorota Sikorska, Włodzimierz Samborski, Ewa Mojs and Karolina Gerreth

Healthcare 2023, 11(7), 1029; https://doi.org/10.3390/healthcare11071029 - 04 Apr 2023

Cited by 2 | Viewed by 1403

Abstract

(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related [...] Read more.

(1) Background: Muscle tension around the head and neck influences orofacial functions. The data exist concerning head posture during increased salivation; however, little is known about muscle tightness during this process. This study aims to investigate whether or not any muscles are related to problems with eating, such as drooling in individuals with cerebral palsy; (2) Methods: Nineteen patients between the ages of 1 and 14 were examined prior to the physiotherapy intervention. This intervention lasted three months and consisted of: relaxing muscles via the strain-counterstrain technique, functional exercises based on the NeuroDevelopmental Treatment-Bobath method, and functional exercises for eating; (3) Results: the tone of rectus capitis posterior minor muscle on the left side (p = 0.027) and temporalis muscle on the right side (p = 0.048) before the therapy, and scalene muscle on the right side after the therapy (p = 0.024) were correlated with drooling behavior and were considered statistically significant. Gross motor function was not considered statistically significant with the occurrence of drooling behavior (p ≤ 0.05). Following the therapeutic intervention, the frequency of drooling during feeding decreased from 63.16% to 38.89% of the total sample of examined patients; (4) Conclusions: The tightness of the muscles in the head area can cause drooling during feeding. Full article

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

Journal Menu

Journal Browser

Healthcare, Volume 11, Issue 7 (April-1 2023) – 133 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI