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Healthcare, Volume 12, Issue 1 (January-1 2024) – 122 articles

Cover Story (view full-size image): Knowing the (digital) health literacy level of their patients can raise hospital staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools may support healthcare professionals in assessing patients’ (digital) health literacy. Ideally, such assessment tools address multiple domains of health literacy, fit the complex hospital context, and have a short administration time. This literature review gives an overview of available tools for measuring (digital) health literacy used in hospitals. It can guide healthcare professionals in choosing an assessment tool that is feasible in their daily practice and measures the required domains. View this paper
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10 pages, 235 KiB  
Article
Reliability and Mental Health Correlates of a Single-Item Measure of Self-Rated Mental Health (SRMH) in the Chinese Context
by Hong Wang Fung, Stanley Kam Ki Lam, Wai Tong Chien, Henry Wai-Hang Ling, Zi Yi Wu, Colin A. Ross and Anson Kai Chun Chau
Healthcare 2024, 12(1), 122; https://doi.org/10.3390/healthcare12010122 - 4 Jan 2024
Cited by 1 | Viewed by 1351
Abstract
The use of single-item measures of self-rated mental health (SRMH) has been increasingly valued in epidemiologic research. However, little is known about the reliability and mental health correlates of SRMH in Chinese populations. This study examined the reliability and mental health correlates of [...] Read more.
The use of single-item measures of self-rated mental health (SRMH) has been increasingly valued in epidemiologic research. However, little is known about the reliability and mental health correlates of SRMH in Chinese populations. This study examined the reliability and mental health correlates of SRMH in three Chinese samples. We analyzed data collected from two convenience samples of Chinese adults from Hong Kong and/or Taiwan (Sample 1: N = 205; Sample 2: N = 377), and a random sample of Taiwan psychiatric inpatients (Sample 3: N = 100). Our results showed that the single-item measure of SRMH had moderate to good test–retest reliability (intraclass correlation [ICC] = 0.75) in Sample 1 and acceptable reliability between the self-report and interviewer-administered versions (ICC = 0.58) in Sample 3. It had a high positive correlation with self-esteem and a moderately high negative correlation with depression. It also had a consistently negative correlation with borderline personality disorder symptoms and post-traumatic stress disorder symptoms. The SRMH score was also associated with psychiatric service usage. These findings contribute to the body of knowledge regarding the use of a single-item measure of SRMH to assess overall self-perceived mental health in Chinese communities. Full article
16 pages, 842 KiB  
Article
Social Media, Endometriosis, and Evidence-Based Information: An Analysis of Instagram Content
by Hannah Adler, Monique Lewis, Cecilia Hoi Man Ng, Cristy Brooks, Mathew Leonardi, Antonina Mikocka-Walus, Deborah Bush, Alex Semprini, Jessica Wilkinson-Tomey, George Condous, Nikhil Patravali, Jason Abbott and Mike Armour
Healthcare 2024, 12(1), 121; https://doi.org/10.3390/healthcare12010121 - 4 Jan 2024
Cited by 2 | Viewed by 3584
Abstract
Social media platforms are used for support and as resources by people from the endometriosis community who are seeking advice about diagnosis, education, and disease management. However, little is known about the scientific accuracy of information circulated on Instagram about the disease. To [...] Read more.
Social media platforms are used for support and as resources by people from the endometriosis community who are seeking advice about diagnosis, education, and disease management. However, little is known about the scientific accuracy of information circulated on Instagram about the disease. To fill this gap, this study analysed the evidence-based nature of content on Instagram about endometriosis. A total of 515 Instagram posts published between February 2022 and April 2022 were gathered and analysed using a content analysis method, resulting in sixteen main content categories, including “educational”, which comprised eleven subcategories. Claims within educational posts were further analysed for their evidence-based accuracy, guided by a process which included fact-checking all claims against the current scientific evidence and research. Of the eleven educational subcategories, only four categories (cure, scientific article, symptoms, and fertility) comprised claims that were at least 50% or greater evidence-based. More commonly, claims comprised varying degrees of evidence-based, mixed, and non-evidence-based information, and some categories, such as surgery, were dominated by non-evidence-based information about the disease. This is concerning as social media can impact real-life decision-making and management for individuals with endometriosis. Therefore, this study suggests that health communicators, clinicians, scientists, educators, and community groups trying to engage with the endometriosis online community need to be aware of social media discourses about endometriosis, while also ensuring that accurate and translatable information is provided. Full article
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11 pages, 743 KiB  
Article
Mid-Term Results of an Italian Multicentric Experience with the RoadsaverTM Dual-Layer Carotid Stent System
by Olga Silvestri, Giulio Accarino, Davide Turchino, Francesco Squizzato, Michele Piazza, Martina Bastianon, Sara Di Gregorio, Giovanni Pratesi, Michele Antonello, Davide Costa, Raffaele Serra and Umberto Marcello Bracale
Healthcare 2024, 12(1), 120; https://doi.org/10.3390/healthcare12010120 - 4 Jan 2024
Cited by 1 | Viewed by 871
Abstract
Background: Carotid artery stenting (CAS) using first-generation single-layer stents is widely accepted as a good alternative to standard carotid endarterectomy (CEA) but it is associated with worse outcomes in terms of both plaque prolapse and cerebral embolization. Aim: To evaluate the perioperative and [...] Read more.
Background: Carotid artery stenting (CAS) using first-generation single-layer stents is widely accepted as a good alternative to standard carotid endarterectomy (CEA) but it is associated with worse outcomes in terms of both plaque prolapse and cerebral embolization. Aim: To evaluate the perioperative and midterm outcomes of CAS using the new-generation RoadsaverTM dual-layer micromesh-covered carotid stent. Methods: Herein, we present the results of an observational, retrospective, multicentric study on non-consecutive patients who underwent the CAS procedure between January 2017 and December 2022 at three Italian, high-volume vascular surgery centers. The inclusion criteria were the patients’ eligibility for the CAS procedure in accordance with the current Italian guidelines, and the implantation of a Roadsaver stent. Both symptomatic and asymptomatic patients were included in the study. The patients requiring reintervention for carotid restenosis following CEA were also included. Perioperative data regarding procedural success was defined as the successful implantation of the device in the desired position, less than 30% residual stenosis, and the absence of intraoperative neurological complications. The primary outcome was any adverse cerebrovascular event such as stroke or transient ischemic attack (TIA) during the procedure and/or after discharge. The secondary outcomes were the need for further intervention, and all-cause death following procedure. Results: Three-hundred-fifty-three (353) patients were included in our study; the mean age was 74.3 years. A total of 5.9% of the patients were symptomatic on their operated side, while 7.3% had contralateral carotid occlusion. A cerebral embolic protection device (CPD) was employed in all patients. A total of 13.3% of the patients were operated on for restenosis after CEA Technical success was achieved in 96.9% of the cases with an intraoperative report of six TIAs (1.7%) and six ipsilateral strokes (1.7%). The mean hospital stay was 1.8 days. The thirty-day follow up showed one TIA and one more stroke. At the mean 35-month follow-up time, the primary outcome was present in six patients (1.7%), where four TIAs (1.1%) and two strokes (0.5%) were reported. Restenosis occurred in five patients (1.4%). Death for any cause was reported in 11 patients (3.1%). Conclusions: As most recent, high-quality studies show, the CAS procedure with second-generation devices such as the Roadsaver stent is safe and effective in preventing carotid-related cerebrovascular events in both symptomatic and asymptomatic patients. The intraoperative and postoperative cerebrovascular complication rate in high volume centers is very low, ensuring confidence in its employment for the CAS procedure along with a CPD as a valid alternative to CEA. Full article
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11 pages, 807 KiB  
Article
Stakeholder Insights into Czech Performance-Based Managed Entry Agreements: Potential for Transformative Change in Pharmaceutical Access?
by Petra Hospodková, Pavel Karásek and Aleš Tichopád
Healthcare 2024, 12(1), 119; https://doi.org/10.3390/healthcare12010119 - 4 Jan 2024
Viewed by 1228
Abstract
Managed Entry Agreements (MEAs) play a pivotal role in addressing the challenges arising from escalating prices of innovative medical technologies, especially in areas like oncology, immunology, and rare diseases. Among MEAs, Performance-Based MEAs (PB MEAs) and Outcome-Based MEAs (OB MEAs) stand out as [...] Read more.
Managed Entry Agreements (MEAs) play a pivotal role in addressing the challenges arising from escalating prices of innovative medical technologies, especially in areas like oncology, immunology, and rare diseases. Among MEAs, Performance-Based MEAs (PB MEAs) and Outcome-Based MEAs (OB MEAs) stand out as innovative strategies. This study examines the adoption of PB MEAs in the Czech Republic post a 2022 legislative change. Interviews with key stakeholders, including the Ministry of Health, pharmaceutical companies, insurers, and patient groups, were conducted to explore perceptions and challenges. Stakeholders expressed concerns about legislation completeness, data quality, transparency, and methodology. Interestingly, pharmaceutical companies were less concerned about transparency and methodology, likely due to their multinational experience. Despite legislative progress, challenges persist, especially in data infrastructure, risk-sharing perceptions, and stakeholder readiness. Addressing these issues requires collaboration between pharmaceutical companies and payers. Patient involvement, though mandated, remains limited, potentially due to a lack of awareness. This study emphasizes the need for a comprehensive transformation beyond legislation for a successful PB MEA implementation. Trust, technical infrastructure, and data availability are crucial, necessitating a holistic approach. It contributes to the global discourse on PB MEAs, stressing the adjustment of financial frameworks, embracing value-based healthcare principles, and ensuring high-quality health data metrics. A more holistic, value-based MEA approach could reshape pharmaceutical reimbursement in the future. Full article
(This article belongs to the Section Health Policy)
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16 pages, 4618 KiB  
Article
Work-Related Musculoskeletal Disorders Risk Assessment during Manual Lymphatic Drainage with Compressive Bands among Physiotherapists
by Julien Jacquier-Bret and Philippe Gorce
Healthcare 2024, 12(1), 118; https://doi.org/10.3390/healthcare12010118 - 4 Jan 2024
Cited by 1 | Viewed by 909
Abstract
Background: Complete decongestive therapy is the standard treatment for lymphedema. Manual lymphatic drainage and short-stretch multilayer compression bandaging are two daily stages of complete decongestive therapy during which physiotherapists work with patients. Objective: The aim of this study was to assess the risks [...] Read more.
Background: Complete decongestive therapy is the standard treatment for lymphedema. Manual lymphatic drainage and short-stretch multilayer compression bandaging are two daily stages of complete decongestive therapy during which physiotherapists work with patients. Objective: The aim of this study was to assess the risks of musculoskeletal disorders to which physiotherapists are exposed during these two phases. Method: Five physiotherapists performed five 20 min manual lymphatic drainages, followed by the compression bandaging phase. From the video recordings, 8477 postures defined by 13 joint angles were grouped into clusters using hierarchical cluster analysis. The risk of musculoskeletal disorders in physiotherapists’ postures was assessed using ergonomic tools. Results: Seven clusters, called generic postures (GP), were identified and defined throughout the mean joint angle values and standard deviation. Four seated GPs were found for the drainage phase, and three standing GPs were identified for the bandaging phase. This phase corresponded to a quarter of the total duration. The GP’s ergonomic scores ranged from 4.51 to 5.63 and from 5.08 to 7.12, respectively, for the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA). GP1, GP3, and GP4 presented the highest ergonomic scores (RULA scores: 5.27 to 5.63; REBA scores: 6.25 to 7.12). The most affected areas were the neck (flexion > 20° for all GPs), trunk (flexion between 25 and 30° for GP2, and GP7 during the bandaging phase and GP4 during the drainage phase), and shoulder (flexion and abduction >20° for all GPs except GP5). Conclusions: These results highlighted that the two complete decongestive therapy phases could be described as a combination of GP. Ergonomic assessment showed that compression bandaging as well as drainage phases expose physiotherapists to moderate musculoskeletal disorder risks that require “further investigation and change soon”. Full article
(This article belongs to the Special Issue News Trends in Work-Related Musculoskeletal Disorders and Diseases)
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10 pages, 1441 KiB  
Article
Affinity and Usage of Technology in General, and Telehealth in Particular amongst Michigan Older Adults during the COVID-19 Pandemic
by Zeenat Kotval-K and Isha Pithwa
Healthcare 2024, 12(1), 117; https://doi.org/10.3390/healthcare12010117 - 4 Jan 2024
Viewed by 1138
Abstract
The COVID-19 pandemic and the travel restrictions imposed by many states led people to resort to technology for many of their daily needs which put older adults (aged 65 years and over) at a particular disadvantage as it is known that they are [...] Read more.
The COVID-19 pandemic and the travel restrictions imposed by many states led people to resort to technology for many of their daily needs which put older adults (aged 65 years and over) at a particular disadvantage as it is known that they are slow to adopt technology on a wide scale. Increasing the adoption and usage of technology for all purposes, especially healthcare appointments, would particularly benefit this population segment. Primary data was collected through online surveys targeted at older adults, aged 65 and over, living in Michigan, through a Qualtrics panel. Results indicate that, since this survey was an online survey, there is a bias in the use of technology as more than half the respondents had used zoom/skype or a similar medium to connect with friends and family during the period of travel restrictions. However, a substantial portion had not used telehealth services. Barriers to using telehealth services and factors that would encourage them to use them more are discussed. The study points to an emerging need for older adults to take advantage of technology more in order to overcome some of the barriers to accessing telehealth for their healthcare needs. Although technology cannot replace having real contact with people and being able to move about in the community, it helps, to a certain degree, to elevate overall wellbeing. Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
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29 pages, 416 KiB  
Review
Family Caregiver Adaptation during the Transition to Adulthood of Individuals with Intellectual Disabilities: A Scoping Review
by Shivasangarey Kanthasamy, Nazleen Miskon, Joanna Barlas and Nigel V. Marsh
Healthcare 2024, 12(1), 116; https://doi.org/10.3390/healthcare12010116 - 3 Jan 2024
Viewed by 1281
Abstract
During the transition to adulthood, individuals diagnosed with intellectual disability (ID) and their family caregivers have unique experiences. This scoping review studies the sources of the family caregiver’s objective burden, support, coping mechanisms, positive caregiving, and quality of life to understand the caregiver’s [...] Read more.
During the transition to adulthood, individuals diagnosed with intellectual disability (ID) and their family caregivers have unique experiences. This scoping review studies the sources of the family caregiver’s objective burden, support, coping mechanisms, positive caregiving, and quality of life to understand the caregiver’s adaptation process when the individual with ID transits to adulthood, according to Joanna Briggs Institute (JBI) Scoping Review methodology guidelines. The inclusion criteria included studies of family caregivers of any age who provide unpaid care and live with individuals diagnosed with ID who are transitioning to adulthood. Of 2875 articles identified, 12 published studies were included. The main themes included caregivers reporting dissatisfaction with the available adult services and exhaustion from being a caregiver. Overall, a vicious cycle of likely increased demands during the transition, with caregivers not being prepared to cope with these demands while concurrently being dissatisfied with the adult services system, leads the caregivers to develop a pervasive sense of helplessness. Future studies would benefit from recruiting caregivers from sources other than adult-only service centres and using qualitative (to identify the broad aspects of the key factors) and quantitative (to identify the significant differences between the key factors) methodologies. Full article
(This article belongs to the Special Issue Adolescent Mental Health: Current Issues and New Perspectives)
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12 pages, 262 KiB  
Article
Attitudes of Internal Medicine Nurses, Surgical Nurses and Midwives towards Reporting of Clinical Adverse Events
by Anna Majda, Michalina Majkut, Aldona Wróbel, Alicja Kamińska, Anna Kurowska, Agata Wojcieszek, Kinga Kołodziej and Krystian Barzykowski
Healthcare 2024, 12(1), 115; https://doi.org/10.3390/healthcare12010115 - 3 Jan 2024
Cited by 1 | Viewed by 942
Abstract
Understanding the attitudes of medical staff contributes to shaping a culture of safety in health care. The aim of this study was the measurement of attitudes of nurses and midwives towards reporting clinical adverse events. Various research tools were used, including the Reporting [...] Read more.
Understanding the attitudes of medical staff contributes to shaping a culture of safety in health care. The aim of this study was the measurement of attitudes of nurses and midwives towards reporting clinical adverse events. Various research tools were used, including the Reporting of Clinical Adverse Events Scale (RoCAES; Polish: P-RoCAES), the Justice Sensitivity Inventory, the Feelings in Moral Situations Scale, the Perceived Stress at Work Scale and the Author’s Survey Questionnaire. The cross-sectional survey was conducted from October 2022 to April 2023. The study used assessment-based sampling. The study included 745 midwives and nurses working in internal medicine—surgical wards in nine hospitals in a large provincial city in Poland. One-way analysis of variance ANOVA, post hoc test (Fisher’s NIR), and r-Spearman correlation test were used. The level of significance (p) did not exceed 0.05. Respondents did not differ in terms of sensitivity to justice, moral feelings, and perceived stress at work, all of which variables were at moderate levels. Respondents’ attitudes towards reporting clinical adverse events in the P-RoCAES were positive (surgical nurses 71.10; internal medicine nurses 72.04; midwives 71.26; F(2.741) = 1.14, p = 0.319), especially those with a master’s degree, longer work experience and older age. Respondents with a master’s degree were most likely to perceive a benefit from reporting adverse events (P-RoCAES subscale) (F(2.737) = 8.45, p = 0.001). The longer employment tenure (F(3.716) = 4.63, p = 0.003) and having a master’s degree (F(2.737) = 3.10, p = 0.045) were associated with a higher feeling of guilt among the respondents (P-RoCAES subscale). The longer the participants worked, the more positive their attitude became towards the importance of transparency in procedures (F(2.741) = 3.56, p = 0.029), but the more negative their attitude was towards the benefits of reporting adverse events (P-RoCAES subscale) (r(686) = −0.08, p = 0.037). Individual attitudes of nurses and midwives as well as their age, length of service or education can influence the formation of a culture of safety in health care (including the reporting of clinical adverse events). Attitudes can motivate corrective action, can be reinforced and shaped by educational programs, good quality management and monitoring system solutions. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
34 pages, 1897 KiB  
Article
Nurses Response to the Physical and Psycho-Social Care Needs of Patients with COVID-19: A Mixed-Methods Study
by Angela Tolotti, Loris Bonetti, Corina Elena Luca, Michele Villa, Sarah Jayne Liptrott, Laura Maria Steiner, Colette Balice-Bourgois, Annette Biegger and Dario Valcarenghi
Healthcare 2024, 12(1), 114; https://doi.org/10.3390/healthcare12010114 - 3 Jan 2024
Viewed by 1017
Abstract
The COVID-19 pandemic heavily impacted nursing care. This study aimed to understand which nursing interventions were instrumental in responding to COVID-19 patients’ needs by exploring the experiences of patients and nurses. In this mixed-method study with an explanatory sequential design, we involved nurses [...] Read more.
The COVID-19 pandemic heavily impacted nursing care. This study aimed to understand which nursing interventions were instrumental in responding to COVID-19 patients’ needs by exploring the experiences of patients and nurses. In this mixed-method study with an explanatory sequential design, we involved nurses caring for COVID-19 patients in intensive and sub-intensive care units and patients. In the first phase, we collected data through a survey that assessed patients’ needs from the perspective of nurses and patients, as well as patient satisfaction. In the second phase, qualitative data were collected through interviews with patients and nurses. In the third phase, we extracted quantitative data from patients’ records. Our sample included 100 nurses, 59 patients, 15 patient records, and 31 interviews (15 patients, 16 nurses). The results from the first phase showed patients and nurses agreed on the most important difficulties: “breathing”, “sleep/rest”, and “communication”. Nursing care was rated positively by 90% of the patients. In the second phase, four themes were identified through the patients’ interviews: “my problems”, “my emotions”, “helpful factors”, and “nursing care”. Five themes were identified through the nurses’ interviews: “the context”, “nurses’ experiences and emotions”, “facilitators and barriers to patient care”, “nursing care”, and “the professional role”. From the third phase, the analysis of the clinical documentation, it was not possible to understand the nursing care model used by the nurses. In conclusion, nurses adopted a reactive-adaptive approach, based on experience/knowledge, pursuing generalized objectives, and adapting their response to the clinical evolution. In difficult contexts, nursing care requires a constant competent technical-relational presence at the patient’s bedside. Full article
(This article belongs to the Special Issue Mental Health of Health Care Workers in the COVID-19 Era)
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11 pages, 702 KiB  
Article
The Association between Uric Acid and Metabolic Syndrome in a Middle-Aged and Elderly Taiwanese Population: A Community-Based Cross-Sectional Study
by Chun-Ru Lin, Po-An Tsai, Che Wang and Jau-Yuan Chen
Healthcare 2024, 12(1), 113; https://doi.org/10.3390/healthcare12010113 - 3 Jan 2024
Viewed by 901
Abstract
Background: Metabolic syndrome (MetS) is a prevalent health condition in Taiwan that places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. The aim of this study was to investigate the [...] Read more.
Background: Metabolic syndrome (MetS) is a prevalent health condition in Taiwan that places individuals at higher risk of cardiovascular disease, diabetes, and stroke. Therefore, the identification of risk factors associated with MetS is crucial. The aim of this study was to investigate the association of uric acid and MetS in a Taiwanese community with a middle-aged and elderly population. Methods: This cross-sectional study enrolled residents aged 50–90 years living in one community. All of the subjects received a standardized personal interview, including a structured questionnaire, anthropometric measurements, and blood samples were collected for laboratory testing. MetS was defined as excess waist circumference, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Multiple logistic regression models were used to evaluate uric acid tertiles associated with MetS. Results: A total of 400 subjects were enrolled in the analysis. The overall prevalence of MetS was 35.8%. The prevalence of MetS increased gradually with increasing serum uric acid levels (p value < 0.001). A significant association between uric acid and cardiometabolic risk factors was confirmed, with a Pearson’s correlation coefficient for waist circumference of 0.30 (p < 0.001), a coefficient for systolic blood pressure of 0.13 (p = 0.01), a coefficient for triglycerides of 0.33 (p < 0.001), and a coefficient for high-density lipoprotein of −0.30 (p < 0.001). The adjusted odds ratio (OR) of the high uric acid tertile level for MetS was 2.48 (95% CI = 1.31–4.71, p = 0.01). The area under the ROC curve (AUC) for uric acid in predicting MetS was 0.621 (p < 0.001). Conclusions: The prevalence of MetS in our study population is high. High serum uric acid levels are independently associated with the presence of MetS among the middle-aged and elderly Taiwanese population. Full article
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29 pages, 1674 KiB  
Systematic Review
Evidence-Based Implementation of the Family-Centered Model and the Use of Tele-Intervention in Early Childhood Services: A Systematic Review
by Estibaliz Jimenez-Arberas, Yara Casais-Suarez, Alba Fernandez-Mendez, Sara Menendez-Espina, Sergio Rodriguez-Menendez, Jose Antonio Llosa and Jose Antonio Prieto-Saborit
Healthcare 2024, 12(1), 112; https://doi.org/10.3390/healthcare12010112 - 3 Jan 2024
Viewed by 1627
Abstract
Background: The purpose of this review is to explore the evidence and efficacy of two trends in early childhood intervention services: the family-centered model and the use of tele-intervention. Methods: A systematic review was carried out following the PRISMA methodology and using three [...] Read more.
Background: The purpose of this review is to explore the evidence and efficacy of two trends in early childhood intervention services: the family-centered model and the use of tele-intervention. Methods: A systematic review was carried out following the PRISMA methodology and using three databases: Web of Science, PubMed and Scopus. The studies included were those aimed at children from 0 to 6 years of age, focused on early intervention, and which alluded to the family-centered model and/or tele-intervention. Results: a total of 33 studies were included. Five main themes were identified: (1) The participation of children and family is facilitated and improved by the family-centered model of care; (2) the feeling of competence, self-efficacy, satisfaction and empowerment in professionals and families have a positive impact on quality of life; (3) the use of tele-intervention as a tool for prevention and intervention; (4) preparation for telepractice can improve the development of commitment; (5) tele-intervention as a possible solution to contextual barriers. Conclusions: Tele-intervention in pediatrics is presented as a tool inherent to the family-centered model since its implementation involves several common strategies. Future lines of research should explore the use of this tool as a possible solution to contextual barriers. Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
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9 pages, 504 KiB  
Article
German Porphyria Registry (PoReGer)–Background and Setup
by Lea Gerischer, Mona Mainert, Nils Wohmann, Ilja Kubisch, Ulrich Stölzel, Thomas Stauch, Sabine von Wegerer, Fabian Braun, Christina Weiler-Normann, Sabine Blaschke, Jorge Frank, Rajan Somasundaram and Eva Diehl-Wiesenecker
Healthcare 2024, 12(1), 111; https://doi.org/10.3390/healthcare12010111 - 3 Jan 2024
Viewed by 924
Abstract
Porphyrias, as most rare diseases, are characterized by complexity and scarcity of knowledge. A national registry in one of the largest European populations that prospectively collects longitudinal clinical and laboratory data are an important and effective tool to close this gap. The German [...] Read more.
Porphyrias, as most rare diseases, are characterized by complexity and scarcity of knowledge. A national registry in one of the largest European populations that prospectively collects longitudinal clinical and laboratory data are an important and effective tool to close this gap. The German Porphyria Registry (PoReGer) was founded by four centers with longstanding expertise in the field of porphyrias and rare diseases (Charité–Universitätsmedizin Berlin, Porphyria Center Saxony Chemnitz, University Medical Center Hamburg-Eppendorf, University Medical Center Göttingen) and the German reference laboratory for porphyria, and is supported by the largest German porphyria patient organization. A specified data matrix for three subgroups (acute, chronic blistering cutaneous, acute non-blistering cutaneous) includes data on demographics, specific porphyria-related symptoms, clinical course, general medical history, necessary follow-up assessments (including laboratory and imaging results), symptomatic and disease-modifying therapies, and side-effects. Additionally, the registry includes patient-reported outcome measures on quality of life, depression, and fatigue. PoReGer aims to broaden and deepen the understanding on all porphyria-related subjects. We expect these data to significantly improve the management and care of porphyria patients. Additionally, the data can be used for educational purposes to increase awareness, for the planning of healthcare services, and for machine learning algorithms for early detection of porphyrias. Full article
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12 pages, 216 KiB  
Article
Preliminary Psychometric Evaluation of Novel Measures of Therapist Practice Related to LGBTQ+ Clients
by Rodman Turpin, Jessica N. Fish, Evelyn King-Marshall and Bradley Boekeloo
Healthcare 2024, 12(1), 110; https://doi.org/10.3390/healthcare12010110 - 3 Jan 2024
Viewed by 776
Abstract
Background: Culturally competent and equitable mental healthcare for LGBTQ+ people is critical for addressing mental health inequities for this population. Tools to assess therapists’ practice with LGBTQ+ clients are needed for research and clinical efforts related to mental healthcare equity goals. Methods: We [...] Read more.
Background: Culturally competent and equitable mental healthcare for LGBTQ+ people is critical for addressing mental health inequities for this population. Tools to assess therapists’ practice with LGBTQ+ clients are needed for research and clinical efforts related to mental healthcare equity goals. Methods: We conducted a preliminary assessment of the reliability and validity of a novel 28-item self-report measure assessing therapist practice with LGBTQ+ clients. We examined the construct validity using factor analyses, the convergent and criterion validity using intercorrelations with LGBTQ-affirming knowledge, self-efficacy, and attitudes, and the internal consistency using Cronbach alpha. Results: Our overall total LGBTQ+ practice measure demonstrated excellent internal consistency (Cronbach’s alpha = 0.91) and was strongly associated with LGBTQ+ knowledge (rho = 0.377), self-efficacy (rho = 0.633), and LGBTQ+ attitudes (rho = 0.305). We also identified two subscales: “Commitment to Continued Learning” and “Affirmative Practices”, which demonstrated similarly strong internal consistency and tests of validity. Conclusions: Our novel measure of overall LGBTQ+ practice, including two subscales, demonstrated strong reliability and validity. These findings have important implications for practice and research in mental healthcare for LGBTQ+ clients. Future research exploring these measures in relationship to mental healthcare outcomes is recommended. Full article
(This article belongs to the Special Issue Mental Health and Stigma of Sexual Minorities)
17 pages, 2912 KiB  
Article
Occupational Safety and Health for Adult Saudi Arabian Women: Utilizing National Anthropometric Data
by Abdalla Alrashdan
Healthcare 2024, 12(1), 109; https://doi.org/10.3390/healthcare12010109 - 3 Jan 2024
Viewed by 1171
Abstract
In the last five years, the female labor force has increased rapidly in Saudi Arabia. This is due to the new government’s vision to empower women. For many decades, Saudi females were excluded from working in certain fields due to cultural restrictions. Nowadays, [...] Read more.
In the last five years, the female labor force has increased rapidly in Saudi Arabia. This is due to the new government’s vision to empower women. For many decades, Saudi females were excluded from working in certain fields due to cultural restrictions. Nowadays, Saudi women are not only joining the service workforce but are currently employed in more physically demanding careers, such as manufacturing and military jobs, which were previously dominated by males. It becomes necessary to design workplaces, tools, and equipment to safely accommodate the female physical attributes, which include body dimensions. This study presents the anthropometric measurements of Saudi Arabian adult females. In total, 504 female subjects aged 20–70 participated in the study. Thirty-eight body measurements, including weight and triceps skinfold, were taken in sitting and standing postures. The main contribution of this study is to provide a national anthropometric database of Saudi females, which is very limited, especially for females in the age groups under study. The availability of such data will allow foreign and local manufacturers to design usable and safe products and workspaces for a wide range of Saudi adult females. The findings reveal that there are no significant differences in the body dimensions of Saudi females across all age groups, except for stature height, eye height, chest depth, skinfold (mm), sitting height, buttock–knee length, and hip breadth. The study also reveals that Saudi females’ body sizes are different from other Asian, Middle Eastern, and British nations, which invalidates the assumption of using other nations’ body measurements to estimate Saudis’ body measurements. Utilizing the supermarket cashier workstation to assess the appropriateness of commercial station fit for Saudi females’ body dimensions, the results underscore the crucial role of anthropometric measurements in addressing differences between product design and the unique body dimensions of Saudi females. The identified anthropometric mismatch highlights potential risks, emphasizing the threat to the working safety of Saudi females. Moreover, the data can be used by health professionals as a base to evaluate the health of Saudi adult females. Descriptive statistics and extreme values are determined. The data are presented in standard anthropometric tables. Full article
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1 pages, 147 KiB  
Correction
Correction: Kostev, K.; Cai, T. Cystitis and Utipro® Plus: Real-World Evidence. Healthcare 2023, 11, 2564
by Karel Kostev and Tommaso Cai
Healthcare 2024, 12(1), 108; https://doi.org/10.3390/healthcare12010108 - 2 Jan 2024
Viewed by 529
Abstract
In the original publication [...] Full article
12 pages, 994 KiB  
Article
Death Anxiety in Caregivers of Chronic Patients
by Raúl Quevedo-Blasco, Amparo Díaz-Román and Alberto Vega-García
Healthcare 2024, 12(1), 107; https://doi.org/10.3390/healthcare12010107 - 2 Jan 2024
Viewed by 1304
Abstract
This study aimed to determine the extent to which caregivers of patients with chronic illnesses experience death anxiety, and which variables from caregivers and patients might potentially be related to their death anxiety. It also aimed to compare the levels of death anxiety [...] Read more.
This study aimed to determine the extent to which caregivers of patients with chronic illnesses experience death anxiety, and which variables from caregivers and patients might potentially be related to their death anxiety. It also aimed to compare the levels of death anxiety between patients and caregivers. Web of Science, Scopus, PubMed, Psychology Database, Cochrane, and Google Scholar were searched for original studies available until December 2022 that quantitatively addressed death anxiety in family and informal caregivers of individuals with chronic illnesses. The methodological quality of the included studies was assessed, and a meta-analysis was conducted using Hedges’ g as the effect size index and the DerSimonian–Laird method to analyze differences between patients and caregivers in death anxiety. The results of the 11 included studies showed moderate levels of death anxiety in caregivers, and the meta-analysis (k = 7; 614 patients and 586 caregivers) revealed non-significant differences between the death anxiety experienced by patients and caregivers (pooled Hedges’ g = −0.03, 95% CI = −0.29 to 0.25, p = 0.802). Some sociodemographic and psychological factors (e.g., gender, depression, and anxiety) might be related to the death anxiety experienced, but additional research is necessary to validate these findings. Full article
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15 pages, 1698 KiB  
Article
Information and Communication Technology-Based Application for Cognitive Behavioral Therapy among Community-Dwelling Older Adults with Insomnia: Development and Validation Study
by Yeonhee Lee, Inseong Kim, Seonheui Lee and Soyoung Yu
Healthcare 2024, 12(1), 106; https://doi.org/10.3390/healthcare12010106 - 2 Jan 2024
Viewed by 884
Abstract
This study developed an information and communication technology-based mobile application to administer cognitive behavioral therapy to community-dwelling older adults with insomnia. First, the content of the application was determined through a systematic review and preference survey. Preference data on the perception, needs, and [...] Read more.
This study developed an information and communication technology-based mobile application to administer cognitive behavioral therapy to community-dwelling older adults with insomnia. First, the content of the application was determined through a systematic review and preference survey. Preference data on the perception, needs, and preference for non-face-to-face service content were collected from 15 July 2021 to 31 August 2021 from 100 community-dwelling older adults aged 65 years and older. In the design stage, the structure and function of the application were determined, and an interface was designed. The application was developed in conjunction with design experts and programmers using Android Studio software (Android 9). Usability tests were conducted during the implementation stage, followed by an evaluation stage. The evaluation revealed that the application’s structure and functions should comprise sleep information, sleep-habit improvement, sleep assistance, video, real-time counseling, and exercise services. These elements were finalized after receiving the results of a preference analysis and advice from an advisory panel of experts in different fields. The developed application was rated with a score of four or higher in all areas. This study successfully developed, implemented, and evaluated a new mobile application called Smart Sleep for community-dwelling older adults with insomnia. Full article
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14 pages, 271 KiB  
Review
Oral Adverse Events Associated with BRAF and MEK Inhibitors in Melanoma Treatment: A Narrative Literature Review
by Michele Basilicata, Vincenzo Terrano, Alessandro D'Aurelio, Giovanni Bruno, Teresa Troiani, Patrizio Bollero and Stefania Napolitano
Healthcare 2024, 12(1), 105; https://doi.org/10.3390/healthcare12010105 - 2 Jan 2024
Viewed by 1154
Abstract
Background: Melanoma cancer represents the most lethal type of skin cancer originating from the malignant transformation of melanocyte cells. Almost 50% of melanomas show the activation of BRAF mutations. The identification and characterization of BRAF mutations led to the development of specific drugs [...] Read more.
Background: Melanoma cancer represents the most lethal type of skin cancer originating from the malignant transformation of melanocyte cells. Almost 50% of melanomas show the activation of BRAF mutations. The identification and characterization of BRAF mutations led to the development of specific drugs that radically changed the therapeutic approach to melanoma. Methods: We conducted a narrative review of the literature according to a written protocol before conducting the study. This article is based on previously conducted studies. We identified articles by searching electronic databases (Medline, Google Scholar and PubMed). We used a combination of “melanoma”, “Braf-Mek inhibitors”, “ targeted therapy” and “oral side effects”. Results: Eighteen studies were reported in this article showing the relationship between the use of targeted therapy in melanoma cancer and the development of oral side effects, such as mucositis, hyperkeratosis and cellular proliferation. Conclusion: Targeted therapy plays an important role in the treatment of melanoma cancer, showing a notable increase in response rate, prolonged progression-free survival and overall survival in BRAF-mutated melanoma patients. Oral side effects represent a common finding over the course of treatment. However, these adverse effects can be easily managed in a multidisciplinary approach involving collaboration between medical oncologists and dental doctors. Full article
(This article belongs to the Special Issue Oral Healthcare: Diagnosis, Prevention and Treatment)
13 pages, 1137 KiB  
Article
Development and Effectiveness of a Rapid Cycle Deliberate Practice Neonatal Resuscitation Simulation Program: A Quasi-Experimental Study
by Sun-Yi Yang and Yun-Hee Oh
Healthcare 2024, 12(1), 104; https://doi.org/10.3390/healthcare12010104 - 2 Jan 2024
Cited by 1 | Viewed by 868
Abstract
The Rapid Cycle Deliberate Practice (RCDP) simulation during neonatal resuscitation program (NRP) training provides in-event feedback for each simulation step, repeats the simulation from the beginning, and undergoes a continuous improvement process. It also offers after-event debriefing that involves follow-up discussion and reflection [...] Read more.
The Rapid Cycle Deliberate Practice (RCDP) simulation during neonatal resuscitation program (NRP) training provides in-event feedback for each simulation step, repeats the simulation from the beginning, and undergoes a continuous improvement process. It also offers after-event debriefing that involves follow-up discussion and reflection after completing simulations. These two methods differ in the timing and frequency of feedback application, and there may be differences in the effectiveness of neonatal resuscitation training. A quasi-experimental simulation study with a pre- and post-test design was used; the experimental group received RCDP simulation NRP training, based on the self-determination theory, while the control group received an after-event debriefing, following the NRP scenario. The experimental group displayed significantly improved clinical decision-making skills compared with the control group. When responding to emergencies involving high-risk newborns, we found that RCDP simulation during NRP training and better preparation for neonatal resuscitation among nursing students improved outcomes for newborns. Full article
(This article belongs to the Section Perinatal and Neonatal Medicine)
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13 pages, 489 KiB  
Review
Barriers to Oral Health Care for Autistic Individuals—A Scoping Review
by Jayne Jones, Elysa Roberts, Deborah Cockrell, Denise Higgins and Dileep Sharma
Healthcare 2024, 12(1), 103; https://doi.org/10.3390/healthcare12010103 - 2 Jan 2024
Cited by 2 | Viewed by 1428
Abstract
Background: Challenges in providing adequate dental care for individuals with Autism Spectrum Disorder (ASD) are recognised by parents, caregivers, and dental practitioners, leading to a higher prevalence of unaddressed dental needs. This scoping review aims to explore existing research on the obstacles to [...] Read more.
Background: Challenges in providing adequate dental care for individuals with Autism Spectrum Disorder (ASD) are recognised by parents, caregivers, and dental practitioners, leading to a higher prevalence of unaddressed dental needs. This scoping review aims to explore existing research on the obstacles to oral health care as perceived by individuals with ASD, as reported by their parents, caregivers, and dental professionals. Methods: Systematic searches were conducted in DOSS, Medline, and PubMed databases using relevant keywords to identify relevant studies. Barriers identified within these studies were then categorised based on themes identified. Results: The initial search yielded a total of 254 studies. Following the removal of duplicates and screening of titles and abstracts, 47 studies were further assessed against predetermined criteria, ultimately resulting in the inclusion of 16 articles in this scoping review. The identified barriers were grouped into five overarching themes: challenges in accessing appropriate care (n = 8), negative past experiences (n = 5), parental perceptions of the impact of ASD (n = 8), clinician bias (n = 2), and clinician education (n = 7). Conclusions: The findings of this review highlight the obstacles faced by individuals with ASD in obtaining routine oral health care. These results underscore the imperative for the development, testing, and implementation of tailored interventions focused on autism, as well as their integration into educational curricula for dental practitioners at various educational levels. This approach aims to enhance the delivery of equitable oral health care to individuals with ASD, starting from undergraduate through to postgraduate dental education. Full article
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15 pages, 904 KiB  
Article
Dyslipidemia Is Positively Associated with Chronic Low Back Pain in Korean Women: Korean National Health and Nutrition Examination Survey 2010–2012
by Sunmin Kim and Seon-Mi Lee
Healthcare 2024, 12(1), 102; https://doi.org/10.3390/healthcare12010102 - 2 Jan 2024
Viewed by 836
Abstract
Background: This study aimed to evaluate the association between chronic low back pain (CLBP) and chronic diseases, such as hypertension, diabetes, and dyslipidemia. Methods: This study was a retrospective analysis using data from the Korea National Health and Nutrition Examination Survey (KNHANES) between [...] Read more.
Background: This study aimed to evaluate the association between chronic low back pain (CLBP) and chronic diseases, such as hypertension, diabetes, and dyslipidemia. Methods: This study was a retrospective analysis using data from the Korea National Health and Nutrition Examination Survey (KNHANES) between 2010–2012 and included women who answered a questionnaire in the KNHANES asking whether they had low back pain for ≥3 months. Participants were divided into non-CLBP and CLBP groups. For statistical analysis, the Student’s t-test, chi-square test, Fisher’s exact test, and logistic regression analysis were performed using SPSS. Results: Of 5961 participants, the non-CLBP group comprised 4098 women and the CLBP group comprised 1863. Adjusted logistic regression model revealed that dyslipidemia was positively associated with CLBP (odds ratio, 1.32; 95% confidence interval, 1.140, 1.530; p < 0.001). However, hypertension and diabetes were not associated with CLBP. Conclusions: Our results suggest that proper treatment of dyslipidemia may contribute to lowering the risk of CLBP later in life. Full article
(This article belongs to the Topic Women's Health and Aging)
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18 pages, 870 KiB  
Article
Engagement with mHealth Alcohol Interventions: User Perspectives on an App or Chatbot-Delivered Program to Reduce Drinking
by Robyn N. M. Sedotto, Alexandra E. Edwards, Patrick L. Dulin and Diane K. King
Healthcare 2024, 12(1), 101; https://doi.org/10.3390/healthcare12010101 - 2 Jan 2024
Viewed by 1287
Abstract
Research suggests participant engagement is a key mediator of mHealth alcohol interventions’ effectiveness in reducing alcohol consumption among users. Understanding the features that promote engagement is critical to maximizing the effectiveness of mHealth-delivered alcohol interventions. The purpose of this study was to identify [...] Read more.
Research suggests participant engagement is a key mediator of mHealth alcohol interventions’ effectiveness in reducing alcohol consumption among users. Understanding the features that promote engagement is critical to maximizing the effectiveness of mHealth-delivered alcohol interventions. The purpose of this study was to identify facilitators and barriers to mHealth alcohol intervention utilization among hazardous-drinking participants who were randomized to use either an app (Step Away) or Artificial Intelligence (AI) chatbot-based intervention for reducing drinking (the Step Away chatbot). We conducted semi-structured interviews from December 2019 to January 2020 with 20 participants who used the app or chatbot for three months, identifying common facilitators and barriers to use. Participants of both interventions reported that tracking their drinking, receiving feedback about their drinking, feeling held accountable, notifications about high-risk drinking times, and reminders to track their drinking promoted continued engagement. Positivity, personalization, gaining insight into their drinking, and daily tips were stronger facilitator themes among bot users, indicating these may be strengths of the AI chatbot-based intervention when compared to a user-directed app. While tracking drinking was a theme among both groups, it was more salient among app users, potentially due to the option to quickly track drinks in the app that was not present with the conversational chatbot. Notification glitches, technology glitches, and difficulty with tracking drinking data were usage barriers for both groups. Lengthy setup processes were a stronger barrier for app users. Repetitiveness of the bot conversation, receipt of non-tailored daily tips, and inability to self-navigate to desired content were reported as barriers by bot users. To maximize engagement with AI interventions, future developers should include tracking to reinforce behavior change self-monitoring and be mindful of repetitive conversations, lengthy setup, and pathways that limit self-directed navigation. Full article
(This article belongs to the Special Issue Alcohol Use and Hangover)
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13 pages, 281 KiB  
Article
Suicide Risk Screening and Assessment before and after the COVID-19 Pandemic in New Inmates
by Carmen Santoriello, Carmela De Rosa, Chiara Rufo, Francesca Romano, Gaetana Termoli, Giuseppina Fiorillo, Ludovica Caprio, Monica Vitolo and Antonio Maria Pagano
Healthcare 2024, 12(1), 100; https://doi.org/10.3390/healthcare12010100 - 2 Jan 2024
Viewed by 1174
Abstract
(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before [...] Read more.
(1) Background: Suicide is the main cause of death in Italian prisons. The largest number of inmates who killed themselves was recorded during three years of the COVID-19 pandemic. This study aimed to explore psychosocial risk factors for suicide among inmates incarcerated before and after the onset of COVID-19. (2) Methods: At prison reception, inmates underwent clinical interviews and were assessed using the Blaauw Scale and Suicide Assessment Scale. Psychological distress, measured by the Symptom Checklist-90-R, was compared between inmates admitted before and after COVID-19. Regression analyses were run to examine psychosocial vulnerabilities associated with suicidal intent in newly incarcerated individuals at risk of suicide. (3) Results: Among the 2098 newly admitted inmates (93.7% male) aged 18 to 87 years (M = 39.93; SD = 12.04), 1347 met the criteria for suicide risk, and 98 exhibited high suicidal intent. Inmates who entered prison after the onset of COVID-19 were older and had fewer social relationships. They had a higher prevalence of recidivism and substance abuse, along with elevated levels of psychological distress. An increase in perceived loss of control, anergia, obsessive-compulsive symptoms, phobic anxiety, and paranoid ideation emerged as the factors most strongly associated with high suicidal intent. (4) Conclusions: These findings support the value of psychosocial screening in promptly identifying inmates at risk of suicide, enabling the implementation of targeted, multi-professional interventions. Future research should replicate these results, with a focus on longitudinal studies that monitor the same inmates throughout their incarceration period. Full article
9 pages, 265 KiB  
Brief Report
The Influence of Socioeconomic and Educational Factors on the Level of Anxiety and Fear of COVID-19
by Valle Coronado-Vázquez, María del Valle Ramírez-Durán, Jaime Barrio-Cortes, Elena Benito-Alonso, Marina Holgado-Juan, María Silvia Dorado-Rabaneda and Juan Gómez-Salgado
Healthcare 2024, 12(1), 99; https://doi.org/10.3390/healthcare12010099 - 1 Jan 2024
Cited by 1 | Viewed by 1136
Abstract
During the COVID-19 pandemic, there were reports of heightened levels of anxiety and fear of contagion in the general population. Such psychological responses may be influenced by the socio-environmental context in which individuals reside. This study aimed to examine the relationship between socioeconomic [...] Read more.
During the COVID-19 pandemic, there were reports of heightened levels of anxiety and fear of contagion in the general population. Such psychological responses may be influenced by the socio-environmental context in which individuals reside. This study aimed to examine the relationship between socioeconomic and educational factors and the level of anxiety and fear related to COVID-19. A multicenter, cross-sectional design was used, including patients aged 18 years or older who attended primary care physician consultations at various primary health centers in Toledo, Spain, between October 2020 and January 2021. By means of a non-probabilistic sampling, a total of 150 participants were selected for the study, with 146 of them providing responses to the AMICO questionnaire The level of fear and anxiety associated with COVID-19 was assessed using the validated Anxiety and Fear of COVID-19 Assessment Scale (AMICO). A significant linear relationship was revealed between social class, employment status, and anxiety levels. Specifically, as social class decreased (p = 0.001) and employment situation worsened (unemployment) (p = 0.037), the proportion of participants reporting a high level of anxiety increased. During the second phase of the pandemic, more than half of the patients attending family medicine consultations exhibited a high level of fear and anxiety towards COVID-19, which was significantly associated with lower social class and unemployment. Full article
(This article belongs to the Special Issue Primary Health Care: Challenges and Recommendations during a Pandemic)
10 pages, 1238 KiB  
Article
Can Clinical Assessment of Postural Control Explain Locomotive Body Function, Mobility, Self-Care and Participation in Children with Cerebral Palsy?
by Blanka Vlčkova, Jiří Halámka, Markus Müller, Jose Manuel Sanz-Mengibar and Marcela Šafářová
Healthcare 2024, 12(1), 98; https://doi.org/10.3390/healthcare12010098 - 1 Jan 2024
Cited by 1 | Viewed by 1244
Abstract
Trunk control may influence self-care, mobility, and participation, as well as how children living with cerebral palsy (CP) move around. Mobility and Gross Motor performance are described over environmental factors, while locomotion can be understood as the intrinsic ontogenetic automatic postural function of [...] Read more.
Trunk control may influence self-care, mobility, and participation, as well as how children living with cerebral palsy (CP) move around. Mobility and Gross Motor performance are described over environmental factors, while locomotion can be understood as the intrinsic ontogenetic automatic postural function of the central nervous system, and could be the underlying element explaining the relationship between these factors. Our goal is to study the correlation among Trunk Control Measurement Scale (TCMS) and Pediatric Evaluation of Disability Inventory (PEDI) domains, as well as Locomotor Stages (LS). Methods: A feasibility observational analysis was designed including 25 children with CP who were assessed with these scales. Results: The strong correlation confirms higher levels of trunk control in children with better self-care, mobility and participation capacities. Strong correlations indicate also that higher LS show better levels of PEDI and TCMS domains. Conclusions: Our results suggest that more mature LS require higher levels of trunk control, benefitting self-care, mobility and social functions. Full article
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11 pages, 253 KiB  
Article
Understanding Children’s Online Victimization through the Psychosocial Lens: The Roles of Loneliness, Online Social Currency, and Digital Citizenship
by Yi-Ping Hsieh and Bonni Gourneau
Healthcare 2024, 12(1), 97; https://doi.org/10.3390/healthcare12010097 - 31 Dec 2023
Viewed by 1012
Abstract
This study employed a risk and resilience framework to investigate the influence of multidimensional factors, considering psychosocial and behavioral aspects, on online victimization among fifth-grade children (ages 10–11). Loneliness, online social currency disturbance, and digital citizenship were examined as predictors of online victimization. [...] Read more.
This study employed a risk and resilience framework to investigate the influence of multidimensional factors, considering psychosocial and behavioral aspects, on online victimization among fifth-grade children (ages 10–11). Loneliness, online social currency disturbance, and digital citizenship were examined as predictors of online victimization. Data were collected from 196 students through a self-reported online survey conducted on electronic devices provided by the schools. The findings indicated that 78.6% of fifth-graders owned a smartphone, 70.9% had a gaming console, and the most common online activities were playing online gaming (73%), talking with friends (62.8%), and seeking entertainment (62.2%). Online victimization was prevalent, with 30.8% of children reporting they had been called bad names, 24.7% receiving rude comments, 15.9% expressing feelings of worry or threat due to online harassment, and 3.1% experiencing cyberbullying lasting for days. Furthermore, the results revealed a negative association between digital citizenship and online victimization, while loneliness and online social currency disturbance were positively associated with online victimization after accounting for children’s gender and time spent online. In conclusion, this study suggests that efforts to prevent and address online victimization should prioritize promoting digital citizenship and increasing awareness of the roles of loneliness and social currency disturbances in online social dynamics. Full article
20 pages, 1550 KiB  
Systematic Review
Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies
by Nasser A. N. Alzerwi, Musaed Rayzah, Ahmad K. Alnemare and Ahmed M. E. Elkhalifa
Healthcare 2024, 12(1), 96; https://doi.org/10.3390/healthcare12010096 - 31 Dec 2023
Viewed by 1344
Abstract
Background: The coronavirus disease (COVID-19) pandemic significantly disrupted surgical care worldwide, affecting different specialties in various ways. Lockdowns, surges in COVID-19 cases, and changes in hospital policies notably impacted patient attendance, management practices, and access to surgical services. This scoping review examines the [...] Read more.
Background: The coronavirus disease (COVID-19) pandemic significantly disrupted surgical care worldwide, affecting different specialties in various ways. Lockdowns, surges in COVID-19 cases, and changes in hospital policies notably impacted patient attendance, management practices, and access to surgical services. This scoping review examines the adverse impacts of the COVID-19 pandemic on surgical services and the policies adopted to address these care barriers. Methods: We conducted a comprehensive literature review using the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. Our search, spanning 31 December 2019, to 29 January 2023, focused on understanding the multifaceted impacts of COVID-19 on surgical services, particularly across different specialties. Results: An analysis of 75 articles indicated that the pandemic challenged surgeons worldwide to maintain a balance between delivering emergency and elective surgical care, and implementing safety measures against viral transmission. There was a marked decline in the surgical volume, leading to extended waitlists and decreased operating theater usage. Strategies such as prioritizing medically necessary and time-sensitive surgeries and integrating telemedicine have emerged as pivotal for ensuring the continuity of urgent care. Despite the reduced rates, essential surgeries such as appendectomies and cancer-related operations continued, yet faced hurdles, including reduced staffing, limited operating theater capacity, and complications in patient transfers. Conclusions: This review emphasizes the steep reduction in surgical service utilization at the beginning of the pandemic and emergence of new compounded barriers. Policies that designated surgeries as essential, and focused on equitable and timely access, were effective. Incorporating these findings into post-pandemic assessments and future planning is crucial to sustain adequate surgical care during similar health emergencies. Full article
(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)
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14 pages, 423 KiB  
Article
A Real-World Data Derived Pharmacovigilance Assessment on Drug-Induced Nephropathy: Implication on Gaps in Patient Care
by Yujin Kim, Chang-Young Choi, Yongjun Sunwoo, Chaerin Go, Semi Kim, Sae Hyun Eom, Sooyoung Shin and Yeo Jin Choi
Healthcare 2024, 12(1), 95; https://doi.org/10.3390/healthcare12010095 - 31 Dec 2023
Viewed by 1004
Abstract
This retrospective cross-sectional study aims to investigate the prevalence and seriousness of drug-induced nephrotoxicity and to identify clinical predictors intensifying the seriousness of nephrotoxicity. Adverse drug events (ADEs) reported to the Korean Adverse Event Reporting System Database (KAERS DB) from January 2012 to [...] Read more.
This retrospective cross-sectional study aims to investigate the prevalence and seriousness of drug-induced nephrotoxicity and to identify clinical predictors intensifying the seriousness of nephrotoxicity. Adverse drug events (ADEs) reported to the Korean Adverse Event Reporting System Database (KAERS DB) from January 2012 to December 2021 were investigated. The association between the seriousness and the etiologic drug was estimated in reporting odds ratio (ROR) based on disproportionality analysis. Logistic regression was utilized to recognize predictors associated with serious nephrotoxicity. The majority of ADEs were reported in ages 30 to 59, and immunosuppressants were the most etiologic medications. ADEs involving antibiotics, including vancomycin (ROR 0.268; 95% CI 0.129–0.557), were less likely to be serious. More than 93% of cyclosporine-related ADEs were serious nephrotoxicity, whereas tacrolimus was less likely to report serious nephrotoxicity (ROR 0.356; 95% CI 0.187–0.680). The risk of serious nephrotoxicity was decreased with aging (ROR 0.955; 95% CI 0.940–0.972) while increased in women (OR 2.700; 95% CI 1.450–5.008). Polypharmacy was associated with increased risk of interstitial nephritis (OR 1.019; 95% CI 1.001–1.038). However, further studies investigating the impact of clinical practice on ADE incidences as well as clinical prognosis related to nephrotoxicity are obligated. Full article
(This article belongs to the Section Healthcare Quality and Patient Safety)
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15 pages, 234 KiB  
Article
Healthcare Workers’ Knowledge about the Segregation Process of Infectious Medical Waste Management in a Hospital
by Andreas S. Miamiliotis and Michael A. Talias
Healthcare 2024, 12(1), 94; https://doi.org/10.3390/healthcare12010094 - 31 Dec 2023
Cited by 1 | Viewed by 1288
Abstract
Any hospital’s primary goal is to restore human health and save lives through health services provided to patients, but at the same time, hazardous wastes are produced. Inconsistent management of unsafe wastes might cause adverse effects and other issues for workers, the environment, [...] Read more.
Any hospital’s primary goal is to restore human health and save lives through health services provided to patients, but at the same time, hazardous wastes are produced. Inconsistent management of unsafe wastes might cause adverse effects and other issues for workers, the environment, and public health. Segregation is considered the critical stage in successful medical waste management. Mixing hazardous medical waste with non-hazardous medical waste will be avoided by correctly applying practices at the segregation stage. This study aimed to assess personnel’s knowledge about infectious medical waste and segregation practices used at six wards in Nicosia General Hospital. An analytical cross-sectional study was conducted, and data were collected through a structured self-administered questionnaire. The Statistical Package of Social Science (SPPS) version 25 was used with a minimum statistical significance of α = 0.05. The study population was nurses, nurse assistants, ward assistants, and cleaners working at the study wards. Out of 191 questionnaires, 82 were received, with a response rate of 42.93%. Most participants were female (72%) and nurses (85.4%). Participants had moderate knowledge about infectious medical waste management and good knowledge regarding segregation practices applied in their ward. Segregation was not carried out as it should have been, since most participants stated that infectious medical waste was mixed with non-hazardous medical waste. The number of correct answers the participants gave regarding the colour-coding of different medical waste categories was 67.5%, and only four answered correctly to all questions. Although participants knew segregation practices and the colour-coding process applied to medical waste, they did not use them satisfactorily. They applied methods regarding segregation without specific training, knowledge and guidance. Due to the issue’s importance, training programs must be implemented and performed. Full article
15 pages, 270 KiB  
Perspective
Telehealth Competencies: Training Physicians for a New Reality?
by Ilian Cruz-Panesso, Issam Tanoubi and Pierre Drolet
Healthcare 2024, 12(1), 93; https://doi.org/10.3390/healthcare12010093 - 31 Dec 2023
Viewed by 1454
Abstract
In North America, telehealth increased by 40% between 2019 and 2020 and stabilized at 40% in 2021. As telehealth becomes more common, it is essential to ensure that healthcare providers have the required skills to overcome the challenges and barriers of this new [...] Read more.
In North America, telehealth increased by 40% between 2019 and 2020 and stabilized at 40% in 2021. As telehealth becomes more common, it is essential to ensure that healthcare providers have the required skills to overcome the challenges and barriers of this new modality of care. While the COVID-19 pandemic has accelerated the design and implementation of telehealth curricula in healthcare education programs, its general adoption is still a major gap and an important barrier to ensuring scaling up and sustainability of the telesshealth practice. Lack of experienced faculty and limited curricular time are two of the most common barriers to expanding telehealth education. Overcoming the barriers of telehealth curricula implementation may require moving away from the classic expert model of learning in which novices learn from experts. As the adoption of telehealth curricula is still in its early stages, institutions may need to plan for faculty development and trainee education at the same time. Questions regarding the timing and content of telehealth education, the interprofessional development of curricula, and the identification of optimal pedagogical methods remain open and crucial. This article reflects on these questions and presents telesimulation as an ideal instructional method for the training of telehealth competencies. Telesimulation can provide opportunities for practical training across a range of telehealth competencies, fostering not only technical proficiency but also communication skills and interprofessional collaboration. Full article
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