Healthcare

21 pages, 5981 KiB

Open AccessSystematic Review

Respiratory Function Analysis in Patients with Chronic Pain: An Umbrella Review and Meta-Analysis of Pooled Findings

by Ferran Cuenca-Martínez, Núria Sempere-Rubio, Elena Muñoz-Gómez, Sara Mollà-Casanova, Enrique Carrasco-González and Francisco M. Martínez-Arnau

Healthcare 2023, 11(9), 1358; https://doi.org/10.3390/healthcare11091358 - 08 May 2023

Cited by 1 | Viewed by 1378

Abstract

Background: The main aim of this umbrella review was to assess the respiratory function in patients with chronic pain (CP), including patients with chronic neck pain (CNP), chronic low back pain (CLBP), and fibromyalgia syndrome (FMS). Methods: We searched in PubMed, PEDro, EMBASE, [...] Read more.

Background: The main aim of this umbrella review was to assess the respiratory function in patients with chronic pain (CP), including patients with chronic neck pain (CNP), chronic low back pain (CLBP), and fibromyalgia syndrome (FMS). Methods: We searched in PubMed, PEDro, EMBASE, CINAHL, and Google Scholar (4 February 2023). The outcome measures were respiratory muscle strength (MIP/MEP) and pulmonary function (VC, MVV, FVC, FEV₁, FEV₁/FVC ratio, FEV_25–75, and PEF). This review was previously registered in the international prospective register of systematic reviews, PROSPERO (CRD42023396722). The methodological quality was analyzed using AMSTAR and ROBIS scales, and the strength of the evidence was established according to the guidelines advisory committee grading criteria. To compare the outcomes reported by the studies, we calculated the standardized mean differences and the corresponding 95% confidence interval for the continuous variables. Results: Four systematic reviews with and without meta-analysis were included, from which a total of 15 primary studies were extracted. Five meta-analyses were carried out, using analyses by subgroup according to the type of CP. The meta-analyzing variables were MIP, MEP, MVV, FEV₁, and FVC. Conclusions: Overall, patients with CP have decreased respiratory muscle strength with a moderate quality of evidence. Regarding the pulmonary function, patients with CNP showed a diminished VC, PEF, MVV, FEV₁, and FVC, while FEV_25–75 and the FEV₁/FVC ratio were conserved with a limited to moderate quality of evidence. Finally, patients with FMS and CLBP only showed a decrease in MVV with a limited quality of evidence. Full article

(This article belongs to the Topic Clinical Features and Intervention of Patients with Chronic Non-Oncologic Pain)

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11 pages, 258 KiB

Open AccessArticle

Predictors of Parental Recall of Newborn Hearing Screening Program in Saudi Arabia

by Mohammed A. Almatrafi, Nouf Alsahaf, Abdulrahman Kabli, Lama Maksood, Khawlah Alharbi, Alhanouf Alsharif, Revan A. Mujahed, Abdallah Y. Naser, Hamza M. Assaggaf, Rafat Mosalli, Shahd Alshareef and Emad Salawati

Healthcare 2023, 11(9), 1357; https://doi.org/10.3390/healthcare11091357 - 08 May 2023

Viewed by 1110

Abstract

Hearing impairment is a prevalent disabling condition among children; all newborns should undergo a universal newborn hearing screening (UNHS). Unfortunately, many newborns who fail the screening test are lost to follow-up. Our study aims to evaluate parents’ perceptions of UNHS and to identify [...] Read more.

Hearing impairment is a prevalent disabling condition among children; all newborns should undergo a universal newborn hearing screening (UNHS). Unfortunately, many newborns who fail the screening test are lost to follow-up. Our study aims to evaluate parents’ perceptions of UNHS and to identify predictors for newborn hearing screening recall in Saudi Arabia. A cross-sectional study involving Saudi parents with 0-to-18-year-old children born in Saudi Arabia was conducted. Descriptive statistics and binary logistic regression were used to describe the participants’ characteristics and to identify UNHS recall predictors. A total of 1533 parents were surveyed. Overall, 29.9% of them recalled a hearing screening at birth, while 22.2% reported no hearing screening, and 47.8% were unable to remember. Only (6.9%) participants reported a failed hearing screening, of which 75.9% recalled a follow-up recommendation. Females, parents aged 30–34 years, consanguineous parents, and parents of newborns who were treated with antibiotics were more likely to recall hearing screening compared to others. This study highlights inadequate awareness of UNHS among parents. Our findings support the need to improve the reporting system of UNHS results and implement educational programs to increase parents’ recall of hearing test results and ensure early follow-ups for neonates with failed test results. Full article

15 pages, 1036 KiB

Open AccessArticle

Evaluation of an Advanced Care Planning Training Program Incorporating Online Skills in Shared Decision Making: A Preintervention and Postintervention Comparative Study

by Yuko Goto and Hisayuki Miura

Healthcare 2023, 11(9), 1356; https://doi.org/10.3390/healthcare11091356 - 08 May 2023

Cited by 3 | Viewed by 995 | Correction

Abstract

Aim: This study evaluated an advanced care planning (ACP) training program incorporating online skills in shared decision making (SDM). Method: The New World Kirkpatrick Model was employed to assess the efficacy of the training program at four levels: reaction, learning, behavior, and results. [...] Read more.

Aim: This study evaluated an advanced care planning (ACP) training program incorporating online skills in shared decision making (SDM). Method: The New World Kirkpatrick Model was employed to assess the efficacy of the training program at four levels: reaction, learning, behavior, and results. Reaction measured the participants’ satisfaction and difficulty with the training program alongside the status of support received from workplaces engaging in ACP. Learning evaluated the changes in SDM skills. Behavior assessed the changes in the relationship between patients and healthcare professionals when the latter were involved in the SDM process. Results evaluated whether the participants were willing to participate in ACP educational programs as a facilitator and whether their motivation for continuous learning changed through throughout the training program. The relationships among patients, healthcare providers, and third-party roles were analyzed in SDM role-playing via structural equation modeling (SEM). Results: Between September 2020 and June 2022, 145 multidisciplinary participants completed the entirety of the training program. The most common responses to the training were “satisfied”, “slightly difficult”, and “I received some support from my workplace”. The SDM skills significantly improved from the first to the third workshop, evaluated using the Wilcoxon rank-sum test. In the first workshop, SDM was primarily performed by healthcare providers; however, in the third workshop, patient-centered SDM was adopted. Of the participants who completed the program, 63% intended to participate in future ACP educational programs as ACP education facilitators. Conclusion: This study ascertained the validity of this training. Full article

(This article belongs to the Special Issue Perspectives in Family Medicine and Primary Care of Older People)

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16 pages, 996 KiB

Open AccessArticle

Effectiveness of Acupuncture on Health-Related Quality of Life in Patients Receiving Maintenance Hemodialysis

by Marta Correia de Carvalho, José Nunes de Azevedo, Pedro Azevedo, Carlos Pires, Jorge Pereira Machado and Manuel Laranjeira

Healthcare 2023, 11(9), 1355; https://doi.org/10.3390/healthcare11091355 - 08 May 2023

Cited by 3 | Viewed by 1389

Abstract

Patients with kidney failure (KF) receiving maintenance hemodialysis (HD) experience numerous symptoms that impair their health-related quality of life (HRQOL) and contribute to high mortality rates. Acupuncture is often used for symptom enhancement and HRQOL. This blinded, randomized, controlled patient-assessor trial evaluated the [...] Read more.

Patients with kidney failure (KF) receiving maintenance hemodialysis (HD) experience numerous symptoms that impair their health-related quality of life (HRQOL) and contribute to high mortality rates. Acupuncture is often used for symptom enhancement and HRQOL. This blinded, randomized, controlled patient-assessor trial evaluated the effectiveness of acupuncture compared with sham acupuncture on patients’ HRQOL receiving maintenance HD as a secondary analysis. Seventy-two participants were randomly assigned to verum acupuncture (VA), sham acupuncture (SA), or waiting-list (WL) groups. The outcome was an improvement in HRQOL, assessed using the Kidney Disease Quality of Life—Short Form, version 1.3 (KDQOL-SF™ v1.3) at baseline, after treatment, and at 12-week follow-up. Non-parametric tests were used for statistical analysis. Of the 72 randomized patients, 67 were included in the complete analysis set. As for the changes between baseline and after treatment, the VA group showed significantly increased scores on most of the KDQOL-SF™ v1.3 scales compared to SA or WL groups (p < 0.05). No statistically significant differences between groups were observed in the changes from baseline to follow-up (p > 0.05). Compared to the sham treatment, acupuncture improved the HRQOL in patients receiving maintenance HD after treatment but not at follow-up. Full article

(This article belongs to the Collection Advances in Integrative Medicine: Complementary Approaches and Therapies in Global Healthcare)

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10 pages, 243 KiB

Open AccessArticle

by Hyeok Gyu Park, Sunkyung Jeong and Myoungjin Kwon

Healthcare 2023, 11(9), 1354; https://doi.org/10.3390/healthcare11091354 - 08 May 2023

Cited by 1 | Viewed by 1085

Abstract

This study attempted to identify factors affecting depression in relation to loneliness among adolescents. The study participants were 2668 adolescents aged 12 to 18 years who felt stressed and lonely. The variables in this study were classified into sociodemographic and psychological characteristics based [...] Read more.

This study attempted to identify factors affecting depression in relation to loneliness among adolescents. The study participants were 2668 adolescents aged 12 to 18 years who felt stressed and lonely. The variables in this study were classified into sociodemographic and psychological characteristics based on the 16th Korea Youth Risk Behavior Web-Based Survey items. Results revealed that sex, smoking, suicidal ideation, suicide planning, and anxiety were significantly related to depression (p < 0.05) in the group that reported less loneliness. Economic level, alcohol consumption, suicidal ideation, suicide planning, subjective body type, and anxiety were significantly related factors (p < 0.05) in the group that reported feeling very lonely. This study is significant in providing basic data for developing evidence-based strategies to ameliorate depression in adolescents. Full article

12 pages, 241 KiB

Open AccessArticle

Symptom Clusters, Psychological Distress, and Quality of Life in Patients with Atrial Fibrillation

by Chohee Bang and Sookyung Park

Healthcare 2023, 11(9), 1353; https://doi.org/10.3390/healthcare11091353 - 08 May 2023

Viewed by 1104

Abstract

Background: Patients with atrial fibrillation (AF) experience diverse symptoms such as palpitations, dizziness, and fainting that lead to depression, anxiety, and poor quality of life. Management of symptoms is fundamental for AF, and with the increasing prevalence of AF, studies on management of [...] Read more.

Background: Patients with atrial fibrillation (AF) experience diverse symptoms such as palpitations, dizziness, and fainting that lead to depression, anxiety, and poor quality of life. Management of symptoms is fundamental for AF, and with the increasing prevalence of AF, studies on management of symptoms in patients with AF are needed. Objectives: This study aimed to assess symptom clusters according to symptom severity in patients with atrial fibrillation and evaluate the relationships between symptom cluster groups and the psychological distress and quality of life of these patients. Design: A descriptive survey was used in this study. Methods: A total of 175 patients were included in this study. Data regarding symptoms, psychological distress, and quality of life were obtained using structured questionnaires and analyzed using frequency and percentage, mean and standard deviation, cluster analysis, t-testing, Chi-square testing, Pearson’s correlation coefficient, and multiple regression analysis. The Euclidean distance square of the hierarchical cluster was used to form symptom cluster groups. Results: Two groups of symptom clusters were formed based on the seven most common symptoms (i.e., chest palpitations, fatigue/tiredness, dizziness, lack of energy, pulse skipping, insomnia, and heavy breathing) of atrial fibrillation patients. Psychological distress and quality of life showed significant correlations with the symptom cluster groups (p < 0.001). Conclusion: Symptoms of atrial fibrillation increased patients’ depression and anxiety, and further affected their quality of life. Therefore, management of symptoms is critical to maintaining a high quality of life. Nursing interventions based on the characteristics of symptom cluster groups must be developed and attempted. Full article

(This article belongs to the Special Issue Clinical Nursing in Healthcare)

12 pages, 283 KiB

Open AccessArticle

“Crying on the Bus”: First Time Fathers’ Experiences of Distress on Their Return to Work

by Suzanne Hodgson, Jon Painter, Laura Kilby and Julia Hirst

Healthcare 2023, 11(9), 1352; https://doi.org/10.3390/healthcare11091352 - 08 May 2023

Viewed by 1562

Abstract

There is increasing research interest in the experiences of new fathers taking paternity leave, but less insight into men’s experiences of returning to work after the birth of their first baby. For many men in the UK context, this could take place immediately [...] Read more.

There is increasing research interest in the experiences of new fathers taking paternity leave, but less insight into men’s experiences of returning to work after the birth of their first baby. For many men in the UK context, this could take place immediately after the birth or after one or two weeks of paternity leave. This paper utilizes data from a UK-based study whilst also drawing on international literature and policy contexts. A constructivist grounded theory method was adopted to generate theory from the data gathered. Twelve new fathers shared their experiences in this study by participating in audio-recorded, semi-structured interviews. This paper focuses on fathers’ experiences of negotiating the workplace as part of an overall theoretical framework related to broader transitions to fatherhood and sheds light on the distress, guilt and psychological challenges that the participants experienced when they initially returned to work. Whether fathers did or did not explicitly describe distress at this time, they all described a change in their worker identity, which for some participants led to uncertainty in the workplace. Men returning to work at this time in the postnatal period are vulnerable to experiencing distress. Flexibility and support in the workplace could be protective of their mental health. Finally, policy and practice developments are offered to support men’s transitions to fatherhood in the workplace context. Full article

(This article belongs to the Special Issue Mental Health Matters: From Cross-Cultural Perspectives)

3 pages, 213 KiB

Open AccessEditorial

Pregnancy, Childbirth, Puerperium, Breastfeeding, and Sexuality in the World of Rare Diseases

by Raquel Rodríguez-Blanque, Juan Carlos Sánchez-García and Jonathan Cortés-Martín

Healthcare 2023, 11(9), 1351; https://doi.org/10.3390/healthcare11091351 - 08 May 2023

Viewed by 789

Abstract

Rare diseases, also known as orphan diseases, are medical conditions that affect a small percentage of the population [...] Full article

(This article belongs to the Special Issue Pregnancy, Childbirth, Puerperium, Breastfeeding and Sexuality in the World of Rare Diseases)

10 pages, 913 KiB

Open AccessArticle

Combined Programmed Intermittent Bolus and Patient-Controlled Bolus Is a More Favorable Setting for Epidural Pain Relief Than Continuous Infusion

by Shih-Kai Liu, Shao-Chun Wu, Shao-Chi Hung, Kuen-Bao Chen, Amina M. Illias and Yung-Fong Tsai

Healthcare 2023, 11(9), 1350; https://doi.org/10.3390/healthcare11091350 - 08 May 2023

Viewed by 1345

Abstract

Epidural analgesia is a suitable and effective treatment for labor pain. However, the preferable modality setting for delivery remains debatable. This study adopted a programmed intermittent epidural bolus (PIEB) setting in conjunction with a patient-controlled epidural analgesia (PCEA) setting to improve the quality [...] Read more.

Epidural analgesia is a suitable and effective treatment for labor pain. However, the preferable modality setting for delivery remains debatable. This study adopted a programmed intermittent epidural bolus (PIEB) setting in conjunction with a patient-controlled epidural analgesia (PCEA) setting to improve the quality of labor analgesia and reduce the number of medical staff. We conducted a prospective observational analysis of primigravida parturients scheduled for spontaneous labor, which required epidural analgesia for painless labor. A total of 483 healthy primigravida parturients with singleton pregnancies were included in this cohort; 135 nulliparous patients were assigned to the continuous infusion setting (CEI) group and 348 to the PIEB + PCEA group. Compared to the CEI setting, the PIEB + PCEA setting significantly reduced the manual rescue by the clinician, extended the time required for the first manual rescue dose, and acclaimed good maternal satisfaction. The use of the CEI mode increased for poor performance requiring more than two rescues with an odds ratio of 2.635 by a binary logistic regression analysis. Using the PIEB + PCEA setting as the maintenance infusion had a longer duration for the first requested manual rescue, fewer manual rescue boluses, excellent satisfaction, and no significant increase in adverse events compared to the CEI setting. Full article

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11 pages, 843 KiB

Open AccessArticle

Exercise-Induced Bronchoconstriction in Children: A Comparison between Athletes and Non-Athletes

by Kamila Malewska-Kaczmarek, Daniela Podlecka, Tymoteusz Mańkowski, Joanna Jerzyńska and Iwona Stelmach

Healthcare 2023, 11(9), 1349; https://doi.org/10.3390/healthcare11091349 - 08 May 2023

Cited by 2 | Viewed by 1461

Abstract

Exercise-induced bronchoconstriction (EIB) is a dysfunction of the respiratory tract consisting of transient airflow obstruction. This study is a retrospective analysis of two prospective studies concerning EIB symptoms in two adolescent populations. Our study group included 400 non-athletes and 101 athletes. Due to [...] Read more.

Exercise-induced bronchoconstriction (EIB) is a dysfunction of the respiratory tract consisting of transient airflow obstruction. This study is a retrospective analysis of two prospective studies concerning EIB symptoms in two adolescent populations. Our study group included 400 non-athletes and 101 athletes. Due to the similarity of indoor exercise conditions, an analysis was performed on the basis of where training took place. The study aims to assess the EIB prevalence in the following groups of adolescent children: non-athletes and athletes. In “indoor” athletes, the EIB prevalence was 22.4%. Among non-athletes, EIB was diagnosed in 10.2% (p = 0.007). A history of asthma was found in 6.5% of non-athletes and 29.3% of indoor athletes (p < 0.001). The incidence of EIB without asthma was higher in indoor athletes (14.6%) than in non-athletes (9.9%). Athletes achieved higher mean values in forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), peak expiratory flow (PEF), and maximum expiratory flow rate at 25% (MEF₂₅) parameters. In the group of non-athletes, higher results were observed in forced expiratory volume in one second % of vital capacity (FEV₁%VC), MEF₅₀, and MEF₇₅. The findings of the study present the complexity of the EIB diagnosis among children training in an indoor environment. Full article

(This article belongs to the Collection Sport and Exercise Medicine)

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13 pages, 1113 KiB

Open AccessArticle

Evaluation of Knowledge and Practice of Resident Dentists in Iasi, Romania in the Management of Traumatic Dental Injuries: A Cross-Sectional Study

by Alice Murariu, Elena-Raluca Baciu, Livia Bobu, Simona Stoleriu, Roxana-Ionela Vasluianu, Monica Silvia Tatarciuc, Diana Diaconu-Popa, Petruța Huțanu and Gabriela Luminița Gelețu

Healthcare 2023, 11(9), 1348; https://doi.org/10.3390/healthcare11091348 - 08 May 2023

Viewed by 1095

Abstract

Dentists play an essential role in the treatment of dental and periodontal traumatic injuries by providing early and correct treatment. The purpose of the present study was to assess the level of knowledge of dental residents regarding dental trauma. The cross-sectional study was [...] Read more.

Dentists play an essential role in the treatment of dental and periodontal traumatic injuries by providing early and correct treatment. The purpose of the present study was to assess the level of knowledge of dental residents regarding dental trauma. The cross-sectional study was conducted at the Faculty of Dental Medicine within the “Grigore T. Popa” University of Medicine and Pharmacy in Iasi, Romania on a sample of 366 residents in General Dentistry, Pediatric Dentistry and Periodontology. To assess their knowledge, a questionnaire was created containing 18 questions about the clinical signs and therapy of dental trauma, with a focus on tooth avulsion. A very low level of knowledge (<25%) was found only for the type of splinting required to maintain an avulsed tooth on the arch. The highest number of correct answers was provided by the residents in Periodontology. Physiological serum as storage medium was recognized by a percentage of 75.9–80% of the subjects, and 60–77% of them recognized pulp necrosis as complication of dental avulsion. The study underlines the need to introduce in the curriculum of all categories of residents additional information, not only in the already existent theoretical form, but also as possible scenarios of various clinical situations. Full article

(This article belongs to the Special Issue Oral Healthcare: Diagnosis, Prevention and Treatment)

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11 pages, 457 KiB

Open AccessArticle

Collective Catering Activities and Official Controls: Dietary Promotion, Sustainability and Future Perspectives

by Vincenzo Marcotrigiano, Giacomo Domenico Stingi, Prudenza Tiziana Nugnes, Sabrina Mancano, Vita Maria Lagreca, Teresa Tarricone, Gerardo Salerno, Pietro Pasquale, Paola Marchet, Giovanni Andrea Sava, Alessandro Citiulo, Monica Tissi, Stefania Oliva, Sandro Cinquetti and Christian Napoli

Healthcare 2023, 11(9), 1347; https://doi.org/10.3390/healthcare11091347 - 07 May 2023

Cited by 2 | Viewed by 1382

Abstract

Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where [...] Read more.

Ensuring safe meals with suitable hygienic-sanitary and nutritional features is an essential requirement to guarantee health in different settings. This study aims to evaluate the compliance of collective catering menus adopted in both school canteens and healthcare facilities in a regional area where specific guidelines have been issued, assessing many matters from food weight to single courses and from the use of wholegrain pasta and bread to the rotation of seasonal fruit and vegetables. Overall, 85 menus, edited by freelance professionals and endorsed by the Food Hygiene and Nutrition Service staff of the Local Health Authority, were assessed from 2018 to 2022, highlighting critical issues potentially attributable at a local level to the lack of complete knowledge of the existence of guidelines and official reference documents among nutrition professionals. Since the preliminary outcomes show non-compliance in both sectors investigated, it is essential to continue to strengthen the role of prevention departments entrusted with services dedicated to food and nutritional safety and promote joint official controls performed by healthcare workers and other professionals with different backgrounds in order to ensure safe food for the target population that use collective catering services. In school canteens and healthcare facilities, providing and administering food is an opportunity to promote health through a balanced diet and safe food and offers opportunities for the development of community well-being and the local economy in a sustainable manner, understood in economic, environmental and social terms. Full article

(This article belongs to the Special Issue Primary Healthcare Services and Innovative Models during COVID-19)

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11 pages, 1520 KiB

Open AccessArticle

Musculoskeletal Injuries and Risk Factors in Spanish CrossFit^® Practitioners

by Lucas Lastra-Rodríguez, Inés Llamas-Ramos, Vicente Rodríguez-Pérez, Rocío Llamas-Ramos and Ana F. López-Rodríguez

Healthcare 2023, 11(9), 1346; https://doi.org/10.3390/healthcare11091346 - 07 May 2023

Cited by 1 | Viewed by 1581

Abstract

CrossFit^® Training is a physical and sports-conditioning system based on constantly varied functional movements performed at high intensity. CrossFit^® has been shown to significantly improve general physical performance and body composition. Although there seems to be an association between the practice [...] Read more.

CrossFit^® Training is a physical and sports-conditioning system based on constantly varied functional movements performed at high intensity. CrossFit^® has been shown to significantly improve general physical performance and body composition. Although there seems to be an association between the practice of CrossFit^® and musculoskeletal injuries, the relationship between CrossFit^® and injury risks has been poorly studied. The main objective of this study was to establish the relationship between CrossFit^® and musculoskeletal injuries. Secondary objectives were the analysis of various risk factors and injury and the comparison of the incidence of CrossFit^® injuries to that of other sports. An online questionnaire was distributed to gyms affiliated with CrossFit^®, Inc. in the Principality of Asturias, Spain in order to carry out a retrospective transversal descriptive study. The frequency of injuries in CrossFit^® is similar to most sports. Injuries are often minor and of short duration, with the shoulder being the most affected joint complex. Full article

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18 pages, 381 KiB

Open AccessReview

Trends in Molecular Diagnosis of Nosocomial Pneumonia Classic PCR vs. Point-of-Care PCR: A Narrative Review

by Andrei-Mihai Bălan, Constantin Bodolea, Sebastian Daniel Trancă and Natalia Hagău

Healthcare 2023, 11(9), 1345; https://doi.org/10.3390/healthcare11091345 - 07 May 2023

Cited by 2 | Viewed by 2357

Abstract

Nosocomial pneumonia is one of the most frequent hospital-acquired infections. One of the types of nosocomial pneumonia is ventilator-associated pneumonia, which occurs in endotracheally intubated patients in intensive care units (ICU). Ventilator-associated pneumonia may be caused by multidrug-resistant pathogens, which increase the risk [...] Read more.

Nosocomial pneumonia is one of the most frequent hospital-acquired infections. One of the types of nosocomial pneumonia is ventilator-associated pneumonia, which occurs in endotracheally intubated patients in intensive care units (ICU). Ventilator-associated pneumonia may be caused by multidrug-resistant pathogens, which increase the risk of complications due to the difficulty in treating them. Pneumonia is a respiratory disease that requires targeted antimicrobial treatment initiated as early as possible to have a good outcome. For the therapy to be as specific and started sooner, diagnostic methods have evolved rapidly, becoming quicker and simpler to perform. Polymerase chain reaction (PCR) is a rapid diagnostic technique with numerous advantages compared to classic plate culture-based techniques. Researchers continue to improve diagnostic methods; thus, the newest types of PCR can be performed at the bedside, in the ICU, so-called point of care testing—PCR (POC-PCR). The purpose of this review is to highlight the benefits and drawbacks of PCR-based techniques in managing nosocomial pneumonia. Full article

11 pages, 751 KiB

Open AccessArticle

Pilot Study: The Effectiveness of Hyperbaric Oxygen Therapy in the Treatment of Periodontitis in Patients with Type 2 Diabetes

by Katarzyna Latusek, Adrianna Słotwińska-Pawlaczyk, Aleksandra Warakomska, Magdalena Kubicka-Musiał, Rafał Wiench and Bogusława Orzechowska-Wylęgała

Healthcare 2023, 11(9), 1344; https://doi.org/10.3390/healthcare11091344 - 07 May 2023

Viewed by 1447

Abstract

Periodontitis is a chronic inflammatory disease with multifactorial aetiology. The relationship between periodontal disease and systemic diseases such as diabetes, obesity, metabolic syndrome, atherosclerotic, cardiovascular disease, and cognitive disorders has been the subject of many studies. The purpose of this study was to [...] Read more.

Periodontitis is a chronic inflammatory disease with multifactorial aetiology. The relationship between periodontal disease and systemic diseases such as diabetes, obesity, metabolic syndrome, atherosclerotic, cardiovascular disease, and cognitive disorders has been the subject of many studies. The purpose of this study was to evaluate the effectiveness of hyperbaric oxygen therapy on periodontal health in patients suffering from periodontitis and type 2 diabetes. The study was conducted with 14 patients. A total of 369 periodontal pockets in the study group and 431 in the control group were examined. For further analysis, the pockets were classified as moderately deep (4–5 mm) and deep (≥6 mm). All patients received standard non-surgical treatment: scaling and root planing (SRP). Additionally, a series of 30 hyperbaric chamber sessions was carried out in the study group. The following parameters were compared between groups: PD (probing depth), CAL (clinical attachment level), and BOP (bleeding on probing). The results of the study showed significantly better results in terms of PD reduction and CAL gain in the study group in comparison to the control group. Both groups showed a reduction in BOP (bleeding on probing) after treatment. The use of hyperbaric oxygen therapy seems to have considerable benefits in patients with type 2 diabetes. Full article

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

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38 pages, 791 KiB

Open AccessArticle

Wealth Status and Health Insurance Enrollment in India: An Empirical Analysis

by Preshit Nemdas Ambade, Joe Gerald and Tauhidur Rahman

Healthcare 2023, 11(9), 1343; https://doi.org/10.3390/healthcare11091343 - 07 May 2023

Viewed by 1785

Abstract

Since 2005, health insurance (HI) coverage in India has significantly increased, largely because of the introduction of government-funded pro-poor insurance programs. As a result, the determinants of HI enrollment and their relative importance may have changed. Using National Family Health Survey (NFHS)-4 data, [...] Read more.

Since 2005, health insurance (HI) coverage in India has significantly increased, largely because of the introduction of government-funded pro-poor insurance programs. As a result, the determinants of HI enrollment and their relative importance may have changed. Using National Family Health Survey (NFHS)-4 data, collected in 2015–2016, and employing a Probit regression model, we re-examine the determinants of household HI enrollment. Then, using a multinomial logistic regression model, we estimate the relative risk ratio for enrollment in different HI schemes. In comparison to the results on the determinants of HI enrollment using the NFHS data collected in 2005–2006, we find a decrease in the wealth gap in public HI enrollment. Nonetheless, disparities in enrollment remain, with some changes in those patterns. Households with low assets have lower enrollments in private and community-based health insurance (CBHI) programs. Households with a higher number of dependents have a higher likelihood of HI enrollment, especially in rural areas. In rural areas, poor Scheduled Caste and Scheduled Tribe households are more likely to be enrolled in public HI than the general Caste households. In urban areas, Muslim households have a lower likelihood of enrollment in any HI. The educational attainment of household heads is positively associated with enrollment in private HI, but it is negatively associated with enrollment in public HI. Since 2005–2006, while HI coverage has improved, disparities across social groups remain. Full article

(This article belongs to the Special Issue Social, Economic and Political Determinants of Health and Health Equity)

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13 pages, 1099 KiB

Open AccessCase Report

Recognition of Prodromal Hypoglossal Nerve Palsy Presenting with Neck Pain as Primary Complaint: Findings from a Rare Case Report in Direct Access Physiotherapy during the COVID-19 Pandemic

by Firas Mourad, Claudia Milella, Graziana Lullo, Francesco Zangari, Roberto Meroni, Alan Taylor, Roger Kerry, Nathan Hutting and Filippo Maselli

Healthcare 2023, 11(9), 1342; https://doi.org/10.3390/healthcare11091342 - 07 May 2023

Viewed by 2374

Abstract

Neck pain (NP) is the second most common musculoskeletal disorder. Spinal cysts (SCs) are cystic dilatations of the synovial sheaths in joints and tendons. SCs are extremely rare in the cervical spine. Typically, patients are unaware of having an SC due to its [...] Read more.

Neck pain (NP) is the second most common musculoskeletal disorder. Spinal cysts (SCs) are cystic dilatations of the synovial sheaths in joints and tendons. SCs are extremely rare in the cervical spine. Typically, patients are unaware of having an SC due to its asymptomatic nature; however, when cervical SC extends, its volume could compress the surrounding structures, such as the hypoglossal nerve. Isolated hypoglossal nerve palsy (HNP) is very rare and typically presents with unilateral atrophy of the musculature of the tongue and contralateral tongue deviation. Often, patients with HNP also report occipital/neck pain. A 75-year-old man with occipital/neck pain as a primary complaint. Although difficult to observe because of the filtering facepiece two mask, difficulties in articulation and sialorrhea during the interview were noticed. These latter were cues to consider CN examination that revealed CN XII palsy. This prompted a referral for further examination that revealed an SC compressing the right hypoglossal canal. The patient was not considered a surgical candidate and was managed conservatively. This case report outlines the relevant findings relating to the triage of a rare isolated hypoglossal nerve palsy from the physiotherapist’s perspective within a complex setting because of the COVID-19 pandemic. Although referred with a diagnosis of cervical radiculopathy, our case highlights that skilled physiotherapists may play a fundamental role in both the recognition and, when applicable, subsequent novel management of a non-musculoskeletal presentation. Full article

(This article belongs to the Special Issue Outcome Measures and Assessment Tools in Rehabilitation)

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13 pages, 5932 KiB

Open AccessArticle

Intraindividual Left–Right Side Differences of Sagittal Condylar Inclination (SCI) in Different Skeletal Classes

by Andi Ciprian Dragus, Augustin Mihai, Gabriela Tanase, Mihai Burlibasa and Corina Marilena Cristache

Healthcare 2023, 11(9), 1341; https://doi.org/10.3390/healthcare11091341 - 07 May 2023

Cited by 4 | Viewed by 1224

Abstract

(1) Background: The temporomandibular joint (TMJ) is the most complex and one of the most important joints in the human body due to its essential roles in mastication, swallowing, breathing and speech. Several instruments have been used to track mandibular movements and register [...] Read more.

(1) Background: The temporomandibular joint (TMJ) is the most complex and one of the most important joints in the human body due to its essential roles in mastication, swallowing, breathing and speech. Several instruments have been used to track mandibular movements and register the characteristic parameters of the TMJ, among which condylography instruments are validated for the accurate clinical registration of the condylar path. Sagittal condylar inclination (SCI) is one of the most important parameters, together with the Bennett angle and the immediate side shift, used for articular settings in the process of oral rehabilitation. The aim of the present study was to evaluate the differences between the left and right SCI and to assess whether the differences were statistically significant for skeletal class, age, gender, dentate status, TMJ pathology or parafunctional habits. (2) Methods: One hundred and forty consecutive patients, fully dentate or partially edentulous, and with angle class I, II and II, were recruited. Their left and right SCIs were determined with an ultrasonic jaw tracking device. Each subject had to make three protrusive movements and three right and left laterotrusive movements. The software calculated the SCI from the mean of the protrusive movements. (3) Results: The mean values obtained for the right and left SCI were 34.68° (±12.44°) and 34.94° (±13.23°), respectively, with no statistically significant differences between the left and right values for gender, dentate status, TMJ disorders or parafunctional habits. Skeletal class III subjects registered lower SCI means, which were statistically significant for the left SCI. (4) Conclusions: For an optimal functionalization of prosthetic restorations and for an ideal treatment plan, the registration of both the left and right paths of the condyles and the articular disc should be taken into consideration. Full article

(This article belongs to the Special Issue Second Edition of Innovative Solutions for Oral Healthcare)

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19 pages, 767 KiB

Open AccessSystematic Review

Impact of Clear Aligners versus Fixed Appliances on Periodontal Status of Patients Undergoing Orthodontic Treatment: A Systematic Review of Systematic Reviews

by Federica Di Spirito, Francesco D’Ambrosio, Davide Cannatà, Vincenzo D’Antò, Francesco Giordano and Stefano Martina

Healthcare 2023, 11(9), 1340; https://doi.org/10.3390/healthcare11091340 - 06 May 2023

Cited by 5 | Viewed by 2566

Abstract

The present umbrella review of four systematic reviews with meta-analysis aimed to assess whether clear aligners are associated with better periodontal conditions compared with fixed appliances in patients undergoing orthodontic treatment. The present study protocol was developed in accordance with the PRISMA statement [...] Read more.

The present umbrella review of four systematic reviews with meta-analysis aimed to assess whether clear aligners are associated with better periodontal conditions compared with fixed appliances in patients undergoing orthodontic treatment. The present study protocol was developed in accordance with the PRISMA statement before the literature search, data extraction, and analysis and was registered on PROSPERO (CRD42023401808). The question formulation, search, and study selection strategies were developed according to the PICO model. Systematic reviews with a meta-analysis published in English without date restriction were electronically searched across the Cochrane Library, Web of Science (Core Collection), Scopus, EMBASE, and MEDLINE/PubMed databases until 10 February 2023. An assessment of study quality was performed using the AMSTAR 2 tool. Differences in the PI, GI, and BOP in the short- and medium-term follow-ups, in the PPD in long-term follow-up, and the gingival recessions in the short-term follow-up were found between subjects with clear aligners and fixed appliances, revealing a slight tendency for clear aligners to be associated with healthier periodontal conditions. However, even if statistically significant, such differences would be negligible in a clinical environment. Therefore, the impact of orthodontic treatment with clear aligners and fixed appliances on periodontal health status should be considered comparable. Full article

(This article belongs to the Special Issue Oral Healthcare: Diagnosis, Prevention and Treatment)

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19 pages, 507 KiB

Open AccessArticle

Undermine Sufferers’ Testimonies to Avoid Social Impacts of Pain

by Mª Isabel García-Rodríguez, Lourdes Biedma-Velázquez and Rafael Serrano-del-Rosal

Healthcare 2023, 11(9), 1339; https://doi.org/10.3390/healthcare11091339 - 06 May 2023

Viewed by 1174

Abstract

Pain is a subjective experience that is mediated by the social structure and by the contextual aspects of people in pain. From the point of view of those affected, a sociological analysis has been carried out of why society doubts pain and the [...] Read more.

Pain is a subjective experience that is mediated by the social structure and by the contextual aspects of people in pain. From the point of view of those affected, a sociological analysis has been carried out of why society doubts pain and the impact that the lack of credibility has on people in pain. Qualitative methodology is used. In total, 19 semi-structured interviews have been conducted with men and women in pain. Research has shown that pain produces discredit in all dimensions of individual’s social life, from the most intimate to that related to healthcare and production. The lack of credibility takes the form of epistemic injustice, being a reaction produced from the social structure to avoid the impacts that pain could produce on the social system. Epistemic injustice affects anyone in pain, but the form it takes will be related to sufferer’s circumstances. Studying this topic is important because it shows the rigidity of expert systems to deal with some old and new situations related to pain. It also shows the frequent lack of fit between the systems and the sufferers. Finally, the article shows that to deal unfairly with the testimony of people in pain has negative consequences on the treatment of pain. A better understanding of these issues could improve the sufferers’ living conditions. Full article

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13 pages, 869 KiB

Open AccessArticle

Validation of the Barthel Index as a Predictor of In-Hospital Mortality among COVID-19 Patients

by Julio Alberto Mateos-Arroyo, Ignacio Zaragoza-García, Rubén Sánchez-Gómez, Paloma Posada-Moreno and Ismael Ortuño-Soriano

Healthcare 2023, 11(9), 1338; https://doi.org/10.3390/healthcare11091338 - 06 May 2023

Viewed by 1424

Abstract

In order to predict the high mortality due to COVID-19, simple, useful and remote instruments are required. To assess the validity of the baseline Barthel Index score as a predictor of in-hospital mortality among COVID-19 patients, a validation study of a clinical prediction [...] Read more.

In order to predict the high mortality due to COVID-19, simple, useful and remote instruments are required. To assess the validity of the baseline Barthel Index score as a predictor of in-hospital mortality among COVID-19 patients, a validation study of a clinical prediction tool in a cohort of patients with COVID-19 was conducted. The primary variable was mortality and the Barthel Index was the main explanatory variable. Demographic, clinical and laboratory variables were collected. Other mortality predictor scores were also assessed: Pneumonia Severity Index, CURB-65 and A-DROP. The Receiver Operating Characteristic Area under the Curve (ROC AUC), sensitivity and specificity were calculated for both the Barthel Index and the other predictor scores. An analysis of the association between the main variables was conducted, adjusting by means of three multivariate models. Three hundred and twelve patients were studied. Mortality was 16.4%. A mortality Odds Ratio (OR) of 5.95 was associated with patients with a Barthel Index ≤ 90. The model number 3 was developed to predict in-hospital mortality before COVID-19 infection occurs. It exhibits an OR of 3.44, a ROC AUC of 0.792, a sensitivity of 74.5% and a specificity of 73.9%. The Baseline Barthel Index proved useful in our population as a predictor of in-hospital mortality due to COVID-19. Full article

(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)

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12 pages, 542 KiB

Open AccessArticle

Understanding Cognitive Deficits in People with Arthritis

by Weixi Kang, Edward Whelan and Antonio Malvaso

Healthcare 2023, 11(9), 1337; https://doi.org/10.3390/healthcare11091337 - 06 May 2023

Viewed by 1039

Abstract

Cognitive deficits are commonly seen in people with arthritis. However, previous studies focused primarily on small-sized clinical samples. There is a need for cohort-based studies, which are characterized by high generalizability. In addition, these studies mainly focused on attention, memory, and executive function. [...] Read more.

Cognitive deficits are commonly seen in people with arthritis. However, previous studies focused primarily on small-sized clinical samples. There is a need for cohort-based studies, which are characterized by high generalizability. In addition, these studies mainly focused on attention, memory, and executive function. However, cognition is not a single concept, but includes other cognitive domains, such as verbal fluency and arithmetic abilities. Thus, we aim to explore how arthritis can affect cognitive abilities, including episodic memory, semantic verbal fluency, fluid reasoning, and numerical ability by using a large cohort from the United Kingdom. The main findings were that people with arthritis have significantly lower immediate word recall (t(2257) = −6.40, p < 0.001, Cohen’s d = −0.12, 95% C.I. = [−0.16, −0.08]), delayed word recall (t(2257) = −5.60, p < 0.001, Cohen’s d = −0.11, 95% C.I. = [−0.14, −0.07]), semantic verbal fluency (t(2257) = −3.03, p < 0.01, Cohen’s d = −0.06, 95% C.I. = [−0.10, −0.02]), fluid reasoning (t(2257) = −3.96, p < 0.001, Cohen’s d = −0.07, 95% C.I. = [−0.11, −0.04]), and numerical ability (t(2257) = −3.85, p < 0.001, Cohen’s d = −0.07, 95% C.I. = [−0.10, −0.03]) compared to what they would expect given their demographics. Interventions are needed to improve cognitive abilities in people with arthritis. Full article

(This article belongs to the Special Issue Psychological and Cognitive Well-Being: Prevention, Risk Factors and Planned Intervention throughout the Lifespan)

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16 pages, 691 KiB

Open AccessArticle

Antecedents of Nurse Managers’ Work Engagement: A Cross-Sectional Study

by Andrea Forster and Clemens Koob

Healthcare 2023, 11(9), 1336; https://doi.org/10.3390/healthcare11091336 - 06 May 2023

Viewed by 2214

Abstract

The responsibilities of nurse managers are complex. Their actions are crucial to providing the best possible care to patients and to the success of health care organizations. Thus, nurse managers’ work engagement is essential. However, understanding of the antecedents of nurse managers’ work [...] Read more.

The responsibilities of nurse managers are complex. Their actions are crucial to providing the best possible care to patients and to the success of health care organizations. Thus, nurse managers’ work engagement is essential. However, understanding of the antecedents of nurse managers’ work engagement is lacking. The job demands–resources theory posits that work engagement is contingent upon job resources and demands. Therefore, the aim of this study was to explore which job demands and resources exert a major influence on nurse managers’ work engagement. Considering the literature, job resources and demands potentially relevant to nurse managers’ work engagement were identified. To investigate the associations between these potential antecedents and nurse managers’ work engagement, the study employed a cross-sectional survey. The dataset for analyses comprised 408 nurse managers in Germany and was analyzed by multiple linear regression. The study variables accounted for 26% of the variance in nurse managers’ work engagement. Positive associations were detected between the job resource of empowering leadership and nurse managers’ work engagement. Regarding job demands, lack of formal rewards and work–life interferences had negative effects on work engagement. The findings suggest that the job demands–resources theory can explain nurse managers’ work engagement. However, not all job resources and demands considered were determined to be influential. In conclusion, empowering leadership should be promoted in the work environment of nurse managers. Nurse managers should be provided engaging financial and nonfinancial rewards. Work–life interferences should be systematically mitigated. Full article

(This article belongs to the Section Nursing)

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13 pages, 1341 KiB

Open AccessProtocol

Effect of Physiotherapy Treatment with Immersive Virtual Reality in Subjects with Stroke: A Protocol for a Randomized Controlled Trial

by Aitor Garay-Sánchez, Yolanda Marcén-Román, Mercedes Ferrando-Margelí, M. Ángeles Franco-Sierra and Carmen Suarez-Serrano

Healthcare 2023, 11(9), 1335; https://doi.org/10.3390/healthcare11091335 - 05 May 2023

Viewed by 1973

Abstract

Background: Many stroke survivors suffer from sensorimotor deficits, especially balance impairments. The purpose of this trial is to investigate whether the designed Immersive Virtual Reality training program is better in the short term (15 sessions) and in the medium term (30 sessions) than [...] Read more.

Background: Many stroke survivors suffer from sensorimotor deficits, especially balance impairments. The purpose of this trial is to investigate whether the designed Immersive Virtual Reality training program is better in the short term (15 sessions) and in the medium term (30 sessions) than physiotherapy training with Bayouk, Boucher and Leroux exercises, with respect to static balance in sitting and standing, dynamic balance and quality of life in patients with balance impairment in stroke survivors. Methods: This study is a randomized controlled trial with two treatment arms and evaluators blinded, and a functionality treatment group in combination with specific balance exercise training according to Bayouk, Boucher and Leroux (control group) or a balanced treatment using Immersive VR. The primary outcome will be static, Dynamic balance and gait measured by Bestest Assessment Score (BESTest), Berg Scale (BBS), Pass Scale (PASS) and Time Up and Go test (TUG). The secondary outcome will be the stroke-associated quality of life using the Stroke Quality of Life Scale (ECVI-38). Conclusions: The results of this study may add new insights into how to address balance using Immersive Virtual Reality after a stroke. If the new training approach proves effective, the results may provide insight into how to design more comprehensive protocols in the future for people with balance impairments after stroke. Full article

(This article belongs to the Topic Applications of Virtual Reality Technology in Rehabilitation)

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24 pages, 838 KiB

Open AccessArticle

Sarcopenia Prediction for Elderly People Using Machine Learning: A Case Study on Physical Activity

by Minje Seok and Wooseong Kim

Healthcare 2023, 11(9), 1334; https://doi.org/10.3390/healthcare11091334 - 05 May 2023

Cited by 6 | Viewed by 16174

Abstract

Sarcopenia is a well-known age-related disease that can lead to musculoskeletal disorders and chronic metabolic syndromes, such as sarcopenic obesity. Numerous studies have researched the relationship between sarcopenia and various risk factors, leading to the development of predictive models based on these factors. [...] Read more.

Sarcopenia is a well-known age-related disease that can lead to musculoskeletal disorders and chronic metabolic syndromes, such as sarcopenic obesity. Numerous studies have researched the relationship between sarcopenia and various risk factors, leading to the development of predictive models based on these factors. In this study, we explored the impact of physical activity (PA) in daily life and obesity on sarcopenia prediction. PA is easier to measure using personal devices, such as smartphones and watches, or lifelogs, than using other factors that require medical equipment and examination. To demonstrate the feasibility of sarcopenia prediction using PA, we trained various machine learning models, including gradient boosting machine (GBM), xgboost (XGB), lightgbm (LGB), catboost (CAT), logistic regression, support vector classifier, k-nearest neighbors, random forest (RF), multi-layer perceptron, and deep neural network (DNN), using data samples from the Korea National Health and Nutrition Examination Survey. Among the models, the DNN achieved the most precise accuracy on average, 81%, with PA features across all data combinations, and the accuracy increased up to 90% with the addition of obesity information, such as total fat mass and fat percentage. Considering the difficulty of measuring the obesity feature, when adding waist circumference to the PA features, the DNN recorded the highest accuracy of 84%. This model accuracy could be improved by using separate training sets according to gender. As a result of measurement with various metrics for accurate evaluation of models, GBM, XGB, LGB, CAT, RF, and DNN demonstrated significant predictive performance using only PA features including waist circumference, with AUC values at least around 0.85 and often approaching or exceeding 0.9. We also found the key features for a highly performing model such as the quantified PA value and metabolic equivalent score in addition to a simple obesity measure such as body mass index (BMI) and waist circumference using SHAP analysis. Full article

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11 pages, 1021 KiB

Open AccessArticle

Multifaceted Analysis of the Environmental Factors in Severely Injured Trauma: A 30-Day Survival Analysis

by Sung Woo Jang, Hae Rim Kim, Pil Young Jung and Jae Sik Chung

Healthcare 2023, 11(9), 1333; https://doi.org/10.3390/healthcare11091333 - 05 May 2023

Cited by 1 | Viewed by 877

Abstract

(1) Background: Most factors that predict the in-hospital survival rate in patients with severe trauma are patient-related factors; environmental factors are not currently considered important. Predicting the severity of trauma using environmental factors could be a reliable and easy-to-use method. Therefore, the purpose [...] Read more.

(1) Background: Most factors that predict the in-hospital survival rate in patients with severe trauma are patient-related factors; environmental factors are not currently considered important. Predicting the severity of trauma using environmental factors could be a reliable and easy-to-use method. Therefore, the purpose of this study was to determine whether environmental factors affect the survival in patients with severe trauma. (2) Methods: Medical records of patients who activated trauma team in the single regional trauma center, from 2016 to 2020, were retrospectively analyzed. After exclusion of young patients (<19 years old), cases of mild trauma (ISS < 16), and non-preventable deaths (trauma and injury severity score <25%), a total of 1706 patients were included in the study. (3) Results: In the Cox proportional hazard regression analysis, older age, night compared with day, and high rainfall were identified as statistically significant environmental predictors of mortality due to severe trauma. The relationship between mortality and precipitation showed a linear relationship, while that between mortality and temperature showed an inverted U-shaped relationship. (4) Conclusions: Various environmental factors of trauma affect mortality in patients with severe trauma. In predicting the survival of patients with severe trauma, environmental factors are considered relatively less important, though they can be used effectively. Full article

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11 pages, 1313 KiB

Open AccessArticle

Parental Stress Scale: Psychometric Properties in Parents of Preschool Children with Developmental Language Disorder

by Konstantinos Kotsis, Maria Boukouvala, Aspasia Serdari, Iouliani Koullourou, Vassiliki Siafaka and Thomas Hyphantis

Healthcare 2023, 11(9), 1332; https://doi.org/10.3390/healthcare11091332 - 05 May 2023

Viewed by 2062

Abstract

Parents of children with developmental disabilities experience more stress compared to those of typically developing children; therefore, measuring parental stress may help clinicians to address it. The Parental Stress Scale (PSS) is a self-rceport measure in the public domain that assesses stress related [...] Read more.

Parents of children with developmental disabilities experience more stress compared to those of typically developing children; therefore, measuring parental stress may help clinicians to address it. The Parental Stress Scale (PSS) is a self-rceport measure in the public domain that assesses stress related to child rearing. The present study tested the psychometric properties of the Greek version of the PSS in 204 parents (mean age: 39.4 ± 5.7, 124 mothers and 80 fathers) of kindergarten children diagnosed with Developmental Language Disorder (DLD) after a clinical assessment. Confirmatory factor analysis (CFA) was used to confirm the original four-factor structure. The results showed that the original four-factor structure (parental rewards, parental stressors, lack of control and parental satisfaction) is valid in this specific Greek population. The reliability was high (ω = 0.78) and there were weak correlations (r = −0.372, r = −0.337, r = −0.236), yet of statistical significance (p < 0.001), with similar psychological constructs (quality of life, emotional functioning and worries). Our data confirmed that the PSS is a reliable and valid tool to measure parental stress in parents of children with DLD. Greek clinicians (mental health professionals, speech-language pathologists) can evaluate parental stress and design early interventions targeting specific stress aspects, along with core language interventions for the children. Full article

(This article belongs to the Section Healthcare Quality and Patient Safety)

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11 pages, 1529 KiB

Open AccessArticle

Medical Professional Liability in Obstetrics and Gynecology: A Pilot Study of Criminal Proceedings in the Public Prosecutor’s Office at the Court of Rome

by Eva Bergamin, Annamaria Fiorillo, Vincenzo M. Grassi, Maria Lodise, Giuseppe Vetrugno and Fabio De-Giorgio

Healthcare 2023, 11(9), 1331; https://doi.org/10.3390/healthcare11091331 - 05 May 2023

Cited by 2 | Viewed by 1092

Abstract

Criminal trials and claims against physicians for malpractice-related damages have increased dramatically in recent years, and, with Obstetrics and Gynecology being one of the medical specialties that is at the highest risk, we carried out a retrospective analysis aimed at examining all Obstetrics- [...] Read more.

Criminal trials and claims against physicians for malpractice-related damages have increased dramatically in recent years, and, with Obstetrics and Gynecology being one of the medical specialties that is at the highest risk, we carried out a retrospective analysis aimed at examining all Obstetrics- and Gynecology-related medical professional liability prosecutions within the General Register of Criminal Records of the Rome Public Prosecutor’s Office between the years 2000 and 2014. The number of prosecutions increased steadily in the years 2000–2005, with varying trends in the following years. A total of 727 healthcare professionals were involved in criminal charges, and most prosecuted crimes were related to Articles 590 and 589 of the Italian Penal Code, followed by violations of Article 17 of Law 194/78. In most cases, filing was requested and granted without opposition. In 95 cases, an expert witness was appointed by the Court, and in 68 cases, the technical consultants of the State Prosecutor found culpable conduct. Public hospitals, private nursing homes and outpatient clinics, or private practices were mostly involved; in 45% of the cases, the physicians were hospital employees. In this setting, Italy is prepared to introduce new measures and regulations to address the issues posed by defensive medicine and charges of professional liability for healthcare providers. Full article

(This article belongs to the Special Issue Old Issues and New Challenges in Forensic and Legal Medicine)

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14 pages, 1301 KiB

Open AccessArticle

A Cross-Sectional Assessment of Parental Concerns in the Pediatric Surgery Department during the COVID-19 Pandemic

by Ada Claudia Silvana Gruescu, Calin Popoiu, Mihaela Codrina Levai, Raluca Tudor, Roxana Manuela Fericean and Mircea Rivis

Healthcare 2023, 11(9), 1330; https://doi.org/10.3390/healthcare11091330 - 05 May 2023

Viewed by 1158

Abstract

The COVID-19 pandemic has impacted various aspects of healthcare, including pediatric surgery. This study aimed to assess parental concerns and stress levels in pediatric surgery during the COVID-19 pandemic, identify factors associated with increased parental anxiety or concern, and provide recommendations for healthcare [...] Read more.

The COVID-19 pandemic has impacted various aspects of healthcare, including pediatric surgery. This study aimed to assess parental concerns and stress levels in pediatric surgery during the COVID-19 pandemic, identify factors associated with increased parental anxiety or concern, and provide recommendations for healthcare providers. A cross-sectional study was conducted in a tertiary pediatric hospital in Timisoara, Romania, involving 174 parents of pediatric patients requiring elective or emergency surgery, with a mean age of 37.6 (25–47) years, out of which 89.1% of respondents were women. Parental concerns were assessed using the Parental Concerns Questionnaire (PCQ), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS-10). Parents of children undergoing emergency surgery (n = 108) reported higher levels on the practical impact domain of the PCQ scale (3.4 vs. 2.2, p < 0.001), emotional impact (2.7 vs. 2.2, p = 0.002), and total PCQ score (9.5 vs. 7.7, p < 0.001) compared to parents of children undergoing elective surgery (n = 66). Parents in the emergent surgery group also reported higher anxiety scores on the HADS questionnaire (7.9 vs. 6.5, p = 0.009) and higher perceived stress and total score on the PSS-10 survey (7.8 vs. 5.6, p = 0.046) (10.5 vs. 9.1, p = 0.047), respectively. A significantly higher proportion of parents in the emergent surgery group were concerned about restricted visitation policies (p = 0.013) and reported delaying or considering delaying their child’s surgery due to the pandemic (p = 0.036). The results demonstrate heightened concerns, anxiety, and stress among parents of children undergoing emergency surgery during the COVID-19 pandemic. Healthcare providers should address parental concerns, provide clear communication, and ensure adequate support for families. Recommendations include enhancing information about COVID-19 precautions, reassuring parents about personal protective equipment availability, and facilitating family support within visitation restrictions. Full article

(This article belongs to the Special Issue The Impact of the COVID-19 Pandemic on Health: Time to Take a Longer-Term Perspective)

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15 pages, 1170 KiB

Open AccessArticle

Effects of Resilience Training on Resilient Functioning in Chronic Stress Situations among Cadets of the Swiss Armed Forces

by Madlaina Niederhauser, Regula Zueger, Hubert Annen, Nejla Gültekin, Zeno Stanga, Serge Brand and Dena Sadeghi-Bahmani

Healthcare 2023, 11(9), 1329; https://doi.org/10.3390/healthcare11091329 - 05 May 2023

Cited by 2 | Viewed by 1371

Abstract

Research on resilient functioning has gained increasing interest, and some recent studies interpreted resilience in the sense of resilient functioning to stress. In the present study, we investigated the associations between resilient functioning and coping strategies, stress reactivity, self-efficacy, and well-being, and we [...] Read more.

Research on resilient functioning has gained increasing interest, and some recent studies interpreted resilience in the sense of resilient functioning to stress. In the present study, we investigated the associations between resilient functioning and coping strategies, stress reactivity, self-efficacy, and well-being, and we examined whether resilient functioning could be improved through a training intervention. The participants were 110 male cadets from two infantry officers’ schools of the Swiss Armed Forces. The schools were divided into an intervention and control group. The participants in the intervention group took part in the resilience training intervention, whereas the participants in the control group performed military training as usual. Data were assessed before and after the intervention period. Results showed that resilient functioning was positively associated with task-oriented coping and well-being and negatively associated with emotion-oriented coping and stress reactivity. Furthermore, resilient functioning significantly improved in the intervention group from pre- to post-intervention. The results suggested that specific interventions have the power to increase resilient functioning. Full article

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Healthcare, Volume 11, Issue 9 (May-1 2023) – 156 articles

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