Healthcare

23 pages, 867 KiB

Open AccessEditor’s ChoiceEssay

Historical Osteopathic Principles and Practices in Contemporary Care: An Anthropological Perspective to Foster Evidence-Informed and Culturally Sensitive Patient-Centered Care: A Commentary

by Rafael Zegarra-Parodi, Francesca Baroni, Christian Lunghi and David Dupuis

Healthcare 2023, 11(1), 10; https://doi.org/10.3390/healthcare11010010 - 21 Dec 2022

Cited by 7 | Viewed by 6512

Abstract

Historical osteopathic principles and practices (OPP)—considering the patient as a dynamic interaction of the body, mind, and spirit and incorporating the body’s self-healing ability into care—are inherited from traditional/complementary and alternative (CAM) principles. Both concepts are familiar to contemporary osteopathic practitioners, but their [...] Read more.

Historical osteopathic principles and practices (OPP)—considering the patient as a dynamic interaction of the body, mind, and spirit and incorporating the body’s self-healing ability into care—are inherited from traditional/complementary and alternative (CAM) principles. Both concepts are familiar to contemporary osteopathic practitioners, but their incorporation into healthcare for evidence-informed, patient-centered care (PCC) remains unclear. Further, a polarity exists in the osteopathic profession between a ‘traditional-minded’ group following historical OPP despite evidence against those models and an ‘evidence-minded’ group following the current available evidence for common patient complaints. By shifting professional practices towards evidence-based practices for manual therapy in line with the Western dominant biomedical paradigm, the latter group is challenging the osteopathic professional identity. To alleviate this polarity, we would like to refocus on patient values and expectations, highlighting cultural diversity from an anthropological perspective. Increasing an awareness of diverse sociocultural health assumptions may foster culturally sensitive PCC, especially when including non-Western sociocultural belief systems of health into that person-centered care. Therefore, the current medical anthropological perspective on the legacy of traditional/CAM principles in historical OPP is offered to advance the osteopathic profession by promoting ethical, culturally sensitive, and evidence-informed PCC in a Western secular environment. Such inclusive approaches are likely to meet patients’ values and expectations, whether informed by Western or non-Western sociocultural beliefs, and improve their satisfaction and clinical outcomes. Full article

(This article belongs to the Collection Osteopathic and Manual Therapy Healthcare Reconceptualization: Health Needs and New Evidence)

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12 pages, 1850 KiB

Open AccessEditor’s ChoiceCommentary

Vignette Research Methodology: An Essential Tool for Quality Improvement Collaboratives

by Kurlen S. E. Payton and Jeffrey B. Gould

Healthcare 2023, 11(1), 7; https://doi.org/10.3390/healthcare11010007 - 20 Dec 2022

Cited by 3 | Viewed by 2761

Abstract

Variation in patient outcomes among institutions and within institutions is a major problem in healthcare. Some of this variation is due to differences in practice, termed practice variation. Some practice variation is expected due to appropriately personalized care for a given patient. However, [...] Read more.

Variation in patient outcomes among institutions and within institutions is a major problem in healthcare. Some of this variation is due to differences in practice, termed practice variation. Some practice variation is expected due to appropriately personalized care for a given patient. However, some practice variation is due to the individual preference or style of the clinicians. Quality improvement collaboratives are commonly used to disseminate quality care on a wide scale. Practice variation is a notable barrier to any quality improvement effort. A detailed and accurate understanding of practice variation can help optimize the quality improvement efforts. The traditional survey methods do not capture the complex nuances of practice variation. Vignette methods have been shown to accurately measure the actual practice variation and quality of care delivered by clinicians. Vignette methods are cost-effective relative to other methods of measuring quality of care. This review describes our experience and lessons from implementing vignette research methods in quality improvement collaboratives in California neonatal intensive care units. Vignette methodology is an ideal tool to address practice variation in quality improvement collaboratives, actively engage a large number of participants, and support more evidence-based practice to improve outcomes. Full article

(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)

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10 pages, 762 KiB

Open AccessEditor’s ChoiceArticle

Fetal Movement Counting in Prolonged Pregnancies: The COMPTAMAF Prospective Randomized Trial

by Louise Moniod, Agathe Hovine, Béatrice Trombert, Florence Rancon, Paul Zufferey, Laura Chauveau, Céline Chauleur and Tiphaine Raia-Barjat

Healthcare 2022, 10(12), 2569; https://doi.org/10.3390/healthcare10122569 - 18 Dec 2022

Cited by 2 | Viewed by 1270

Abstract

In prolonged pregnancies, the risks of neonatal morbidity and mortality are increased. The aim of this trial was to assess the benefits of maternal information about fetal movement (FM) counting on neonatal outcomes in prolonged pregnancy. It was a prospective, single center, randomized, [...] Read more.

In prolonged pregnancies, the risks of neonatal morbidity and mortality are increased. The aim of this trial was to assess the benefits of maternal information about fetal movement (FM) counting on neonatal outcomes in prolonged pregnancy. It was a prospective, single center, randomized, open-label study conducted from October 2019 to March 2022. Intention-to-treat analyses were performed on 278 patients randomized into two 1:1 groups (control group and FM counting group). The primary outcome was a composite score of neonatal morbidity (presence of two of the following items: fetal heart rate abnormality at delivery, Apgar score of <7 at 5 min, umbilical cord arterial pH of <7.20, and acute respiratory distress with mutation in neonatal intensive care unit). There was no significant difference between the two groups in the rate of neonatal morbidity (14.0% in the FM counting group versus 22.9% in the standard information group; p = 0.063; OR 0.55, 95% CI 0.29–1.0). In this study, fetal movement counting for women in prolonged pregnancy failed to demonstrate a significant reduction in adverse neonatal outcomes. Full article

(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)

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14 pages, 274 KiB

Open AccessEditor’s ChoiceArticle

Through Thick and Thin: The Meaning of Dementia for the Intimacy of Ageing Couples

by Päivi Eskola, Outi Jolanki and Mari Aaltonen

Healthcare 2022, 10(12), 2559; https://doi.org/10.3390/healthcare10122559 - 17 Dec 2022

Cited by 6 | Viewed by 2089

Abstract

As the population ages, the number of people with dementia increases. An emerging body of research is focusing on living with dementia and understanding the experience of caring and the care burden. There is much less research on the meaning of dementia from [...] Read more.

As the population ages, the number of people with dementia increases. An emerging body of research is focusing on living with dementia and understanding the experience of caring and the care burden. There is much less research on the meaning of dementia from the perspective of an older couple’s spousal relationship and related intimacy. This qualitative study explores the meanings of emotional and physical intimacy and the changes brought by dementia in the couplehood of persons with dementia and their spousal carers. The data comprise semi-structured interviews with 35 persons. The interviews were analysed using inductive qualitative content analysis. Four themes describing the meanings of relational intimacy were identified: intimacy as a striving force, intimacy turning into worrisome behaviour, intimacy as physical and emotional dependency, and intimacy turning into one-sided caring for a partner. Dementia changes the intimate relationship in many ways, but shared affection and long-term partnership help maintain the spousal relationship. While dementia may bring about conflicts and behavioural challenges in an intimate relationship, the couple’s shared intimacy and a sense of responsibility for one another may serve as a resource and support the continuity of couplehood. Full article

(This article belongs to the Special Issue Dementia and Care)

12 pages, 1324 KiB

Open AccessEditor’s ChoiceArticle

Persistence to Medications for Benign Prostatic Hyperplasia/Benign Prostatic Obstruction-Associated Lower Urinary Tract Symptoms in the ASL TO4 Regione Piemonte (Italy)

by Lucrezia Greta Armando, Raffaella Baroetto Parisi, Elisa Remani, Mariangela Esiliato, Cristina Rolando, Valeria Vinciguerra, Abdoulaye Diarassouba, Clara Cena and Gianluca Miglio

Healthcare 2022, 10(12), 2567; https://doi.org/10.3390/healthcare10122567 - 17 Dec 2022

Cited by 2 | Viewed by 1458

Abstract

Background: Pharmacological treatment of benign prostatic hyperplasia (BPH)/benign prostatic obstruction (BPO)-associated lower urinary tract symptoms (LUTS) aims at improving patients’ quality of life by managing urinary symptoms and preventing complications and disease progression. However, continuous use of drugs to treat BPH/BPO-associated LUTS decreases [...] Read more.

Background: Pharmacological treatment of benign prostatic hyperplasia (BPH)/benign prostatic obstruction (BPO)-associated lower urinary tract symptoms (LUTS) aims at improving patients’ quality of life by managing urinary symptoms and preventing complications and disease progression. However, continuous use of drugs to treat BPH/BPO-associated LUTS decreases over time. The aim of this retrospective observational study was to describe use of α1-adrenoceptor antagonists (ABs) and steroid 5α-reductase inhibitors (5ARIs) by adult (age ≥ 40 years) men in the ASL TO4, a Local Health Authority in the northern area of the city of Turin (Italy). Methods: Persistence measures were adopted as a robust, informative, and feasible way to understand medication-taking behavior and to assess patient compliance. Results: A total of 4309 men (median age 71 years) were enrolled. Monotherapy was the treatment option prescribed to the largest part of the study population. However, ≥two drugs were prescribed to a substantial proportion of men (23%). Men prescribed alfuzosin or dutasteride had significantly greater persistence, which decreased over time. Conclusions: Unmet needs and areas of intervention for healthcare systems aimed at improving the use of drugs for BHP/BPO-associated LUTS in the ASL TO4 Regione Piemonte were identified. Full article

(This article belongs to the Special Issue Medication Adherence and Beliefs About Medication: Second Edition)

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13 pages, 521 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

The Association between Bundled Payment Participation and Changes in Medical Episode Outcomes among High-Risk Patients

by Joshua M. Liao, Erkuan Wang, Ulysses Isidro, Jingsan Zhu, Deborah S. Cousins and Amol S. Navathe

Healthcare 2022, 10(12), 2510; https://doi.org/10.3390/healthcare10122510 - 12 Dec 2022

Viewed by 1166

Abstract

Background: Bundled payments for medical conditions are associated with stable quality and savings through shorter skilled nursing facility (SNF) length of stay. However, effects among clinically higher-risk patients remain unknown. Objective: To evaluate whether the association between participation in bundled payments for medical [...] Read more.

Background: Bundled payments for medical conditions are associated with stable quality and savings through shorter skilled nursing facility (SNF) length of stay. However, effects among clinically higher-risk patients remain unknown. Objective: To evaluate whether the association between participation in bundled payments for medical conditions and episode outcomes differed for clinically high-risk versus other patients. Design: Retrospective difference-in-differences analysis; Participants: 471,421 Medicare patients hospitalized at bundled payment and propensity-matched non-participating hospitals. Exposures were 5 measures of clinically high-risk groups: advanced age (>85 years old), high case-mix, disabled, frail, and prior institutional post-acute care provider utilization. Main Measures: Primary outcomes were SNF length of stay and 90-day unplanned readmissions. Secondary outcomes included quality, utilization, and spending measures. Key Results: SNF length of stay was differentially lower among frail patients (aDID −0.4 days versus non-frail patients, 95% CI −0.8 to −0.1 days), patients with advanced age (aDID −0.8 days versus younger patients, 95% CI −1.2 to −0.3 days), and those with prior institutional post-acute care provider utilization (aDID −1.1 days versus patients without prior utilization, 95% CI −1.6 to −0.6 days), compared to non-frail, younger, and patients without prior utilization, respectively. BPCI participation was also associated with differentially greater SNF LOS among disabled patients (aDID 0.8 days versus non-disabled patients, 95% CI 0.4 to 1.2 days, p < 0.001). Bundled payment participation was not associated with differential changes in readmissions in any high-risk group but was associated with changes in secondary outcomes for some groups. Conclusions: Changes under medical bundles affected, but did not indiscriminately apply to, high-risk patient groups. Full article

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6 pages, 2000 KiB

Open AccessEditor’s ChoiceCase Report

Severe Recurrent COVID-Associated Pulmonary Aspergillosis: A Challenging Case

by Luigi Vetrugno, Gian Marco Anzellotti, Regina Frontera, Zoe Parinisi, Barbara Sessa, Cristian Deana and Salvatore Maurizio Maggiore

Healthcare 2022, 10(12), 2483; https://doi.org/10.3390/healthcare10122483 - 08 Dec 2022

Cited by 1 | Viewed by 1102

Abstract

We report a rare case of severe COVID-19-associated pulmonary aspergillosis presenting as invasive pulmonary aspergillosis and subsequently invasive tracheobronchial aspergillosis during hospitalization in a critically ill patient who developed a further Aspergillus infection after home discharge. He needed readmission to the ICU and [...] Read more.

We report a rare case of severe COVID-19-associated pulmonary aspergillosis presenting as invasive pulmonary aspergillosis and subsequently invasive tracheobronchial aspergillosis during hospitalization in a critically ill patient who developed a further Aspergillus infection after home discharge. He needed readmission to the ICU and mechanical ventilation. We therefore strongly encourage a high degree of attention to fungal complications, even after viral recovery and ICU discharge. Full article

(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)

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6 pages, 580 KiB

Open AccessEditor’s ChoiceBrief Report

Safety Evaluation of Remdesivir for COVID-19 Patients with eGFR < 30 mL/min without Renal Replacement Therapy in a Japanese Single-Center Study

by Takumi Umemura, Yoshikazu Mutoh, Takahito Mizuno, Mao Hagihara, Hideo Kato, Tetsuya Yamada, Yoshiaki Ikeda, Hiroshige Mikamo and Toshihiko Ichihara

Healthcare 2022, 10(11), 2299; https://doi.org/10.3390/healthcare10112299 - 17 Nov 2022

Cited by 2 | Viewed by 2090

Abstract

There are limited reports on the safety of remdesivir for patients with severe kidney disease. We investigated the safety of remdesivir administration for COVID-19 patients with estimated glomerular filtration rate (eGFR) <30 mL/min. This single-center retrospective study was conducted between March 2020 and [...] Read more.

There are limited reports on the safety of remdesivir for patients with severe kidney disease. We investigated the safety of remdesivir administration for COVID-19 patients with estimated glomerular filtration rate (eGFR) <30 mL/min. This single-center retrospective study was conducted between March 2020 and April 2022 at Tosei General Hospital, Japan. Propensity score matching was performed between patients with eGFR ≤ 30 mL/min and eGFR >30 mL/min with remdesivir administration. The primary outcome was 30-day mortality after the first administration. Adverse events, including development of acute kidney injury (AKI), liver function disorder, anemia, and thrombocytopenia 48 h after the end of remdesivir administration, were evaluated. After propensity score matching, 23 patients were selected from each group. There were no differences in the 30-day mortality (risk ratio [RR] 1.00; 95% confidence interval [CI] 0.18–5.56). Development of AKI and liver function disorder was not statistically different between the two groups (RR 1.05; 95% CI 0.96–1.14 and RR 0.48; 95% CI 0.04–5.66, respectively). There was no trend toward a significant increase in adverse events in the eGFR < 30 mL/min group and severe renal dysfunction had little effect on the safety of remdesivir treatment. Full article

(This article belongs to the Special Issue Pharmacist-Led Intervention)

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9 pages, 1307 KiB

Open AccessEditor’s ChoiceArticle

Long-Haul COVID Patients: Prevalence of POTS Are Reduced but Cerebral Blood Flow Abnormalities Remain Abnormal with Longer Disease Duration

by C. (Linda) M. C. van Campen and Frans C. Visser

Healthcare 2022, 10(10), 2105; https://doi.org/10.3390/healthcare10102105 - 21 Oct 2022

Cited by 10 | Viewed by 10626

Abstract

Background: Postural orthostatic tachycardia syndrome (POTS) has been described early after the onset of the COVID-19 infection, but also orthostatic hypotension (OH). In the present study, we hypothesized that orthostatic intolerance decreases over time. Methods: In 29 long-haul COVID-19 (LHC) patients, a tilt [...] Read more.

Background: Postural orthostatic tachycardia syndrome (POTS) has been described early after the onset of the COVID-19 infection, but also orthostatic hypotension (OH). In the present study, we hypothesized that orthostatic intolerance decreases over time. Methods: In 29 long-haul COVID-19 (LHC) patients, a tilt test was performed, including measurements of cerebral blood flow (CBF) by extracranial Doppler. The time interval between the onset of infection and the tilt test varied between 3 and 28 months. Results: In the first 12 months after the infection, 71% of the LHC patients showed POTS and after 24 months none of them. In the first 12 months, 29% of patients had a normal heart rate and blood pressure response (normHRBP) and after 24 months 75% (distribution of POTS, OH, and a normHRBP over time: p < 0.0001). Linear regression showed that, over time, there was a decrease in the abnormal CBF during the tilt (p = 0.024) but remained abnormal. Conclusion: In LHC patients, hemodynamic abnormalities of a tilt test change over time. Patients studied early after the onset of the disease mainly exhibit POTS, but patients studied later in the time course mainly show a normHRBP or OH. In addition, the abnormal CBF reduction improves over time, but CBF remains abnormal. Full article

(This article belongs to the Collection Why Some Patients Never Fully Recover: Post Active Phase of Infection Syndromes (PAPIS))

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12 pages, 5569 KiB

Open AccessEditor’s ChoiceArticle

Orthostatic Intolerance in Long-Haul COVID after SARS-CoV-2: A Case-Control Comparison with Post-EBV and Insidious-Onset Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Patients

by C. (Linda) M. C. van Campen and Frans C. Visser

Healthcare 2022, 10(10), 2058; https://doi.org/10.3390/healthcare10102058 - 17 Oct 2022

Cited by 11 | Viewed by 14739

Abstract

Background: As complaints of long-haul COVID patients are similar to those of ME/CFS patients and as orthostatic intolerance (OI) plays an important role in the COVID infection symptomatology, we compared 14 long-haul COVID patients with 14 ME/CFS patients with a post-viral Ebstein-Barr (EBV) [...] Read more.

Background: As complaints of long-haul COVID patients are similar to those of ME/CFS patients and as orthostatic intolerance (OI) plays an important role in the COVID infection symptomatology, we compared 14 long-haul COVID patients with 14 ME/CFS patients with a post-viral Ebstein-Barr (EBV) onset and 14 ME/CFS patients with an insidious onset of the disease. Methods: In all patients, OI analysis by history taking and OI assessed during a tilt test, as well as cerebral blood flow measurements by extracranial Doppler, and cardiac index measurements by suprasternal Doppler during the tilt test were obtained in all patients. Results: Except for disease duration no differences were found in clinical characteristics. The prevalence of POTS was higher in the long-haul patients (100%) than in post-EBV (43%) and in insidious-onset (50%) patients (p = 0.0002). No differences between the three groups were present in the prevalence of OI, heart rate and blood pressure changes, changes in cerebral blood flow or in cardiac index during the tilt test. Conclusion: OI symptomatology and objective abnormalities of OI (abnormal cerebral blood flow and cardiac index reduction during tilt testing) are comparable to those in ME/CFS patients. It indicates that long-haul COVID is essentially the same disease as ME/CFS. Full article

(This article belongs to the Collection Why Some Patients Never Fully Recover: Post Active Phase of Infection Syndromes (PAPIS))

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9 pages, 444 KiB

Open AccessEditor’s ChoiceArticle

Benefits of Cardio-Pulmonary Rehabilitation in Moderate to Severe Forms of COVID-19 Infection

by Clara Douin, Kevin Forton, Michel Lamotte, Alexis Gillet and Philippe Van de Borne

Healthcare 2022, 10(10), 2044; https://doi.org/10.3390/healthcare10102044 - 17 Oct 2022

Cited by 4 | Viewed by 1464

Abstract

Our aim was to evaluate the benefits of cardio-pulmonary rehabilitation on severe to moderate COVID-19 patients. 25 discharged COVID-19 patients underwent a cardio-pulmonary test (CPET), a spirometry test and a measure of carbon monoxide lung diffusion capacity (DLCO) at the beginning of their [...] Read more.

Our aim was to evaluate the benefits of cardio-pulmonary rehabilitation on severe to moderate COVID-19 patients. 25 discharged COVID-19 patients underwent a cardio-pulmonary test (CPET), a spirometry test and a measure of carbon monoxide lung diffusion capacity (DLCO) at the beginning of their rehabilitation program and after 23 ± 5 rehabilitation sessions. This rehabilitation program combined interval training exercises on a bike and resistance exercises for major muscle groups. We then compared their progress in rehabilitation to that obtained with cardiac patients. At the beginning of their rehabilitation program, COVID-19 patients presented a reduced physical capacity with a maximal aerobic capacity (VO₂ max) at 71% of predicted value, a maximal workload at 70% of predicted value and an exercise hyperventilation measured by a higher VE/VCO₂ slope. Exercise was mainly limited by muscle deconditioning. After rehabilitation, the VO₂ max and maximal workload increased in COVID 19 patients by 18% and 26%, respectively. In patients with ischemic heart disease the post-rehabilitation gains in VO2 max and maximal workload were 22% and 25%, respectively. Moreover, exercise hyperventilation decreased by 10% in both groups. On the other hand, the intrinsic pulmonary function of COVID 19 patients improved following natural recovery. In conclusion, even if cardio-pulmonary rehabilitation is probably not the only parameter which explains the partial recovery of moderate to severe COVID-19 patients, it certainly helps to improve their physical capacity and reduce exercise hyperventilation. Full article

(This article belongs to the Special Issue Physiotherapy and Cardiothoracic Care in Acute and Chronic Care)

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8 pages, 249 KiB

Open AccessEditor’s ChoiceArticle

YouTube: Is It a Reliable Source of Nutrition Information on COVID-19 Pandemic?

by Elif Inan-Eroglu and Zehra Buyuktuncer

Healthcare 2022, 10(10), 1911; https://doi.org/10.3390/healthcare10101911 - 29 Sep 2022

Cited by 1 | Viewed by 1355

Abstract

Data on the nutrition-related misinformation about COVID-19 are limited. This study analysed the quality and accuracy of the nutrition information available on YouTube about current COVID-19 pandemic as well as assessed the content of the videos. YouTube was searched using the terms “nutrition [...] Read more.

Data on the nutrition-related misinformation about COVID-19 are limited. This study analysed the quality and accuracy of the nutrition information available on YouTube about current COVID-19 pandemic as well as assessed the content of the videos. YouTube was searched using the terms “nutrition and COVID-19” in Turkish on 1 February 2021. Videos were filtered according to relevancy, and the first 280 videos were analysed. A total of 218 videos were reviewed and classified as “misleading” or “relevant” depending on the information provided. The transparency, utility, reliability, and accuracy of video contents were assessed. The videos attracted a cumulative 6,258,694 views. There were 178 (81.7%) fully relevant and 40 (18.3%) misleading videos. Approximately 80% of the videos shared by health professionals were relevant videos. Government organisations only shared relevant videos. Relevant videos had higher reliability, accuracy, and quality than misleading videos. The nutrition-related content of COVID-19 videos is suboptimal on YouTube. As the COVID-19 pandemic worsens, and nutrition could improve immunity, health professionals and educational and government organisations need to engage more in the spread of nutrition-related COVID-19 information to Internet platforms based on nutrition guidelines and the latest scientific evidence. This will be a practical and immediately implementable public health strategy to effectively spread the right information. Full article

(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)

14 pages, 661 KiB

Open AccessEditor’s ChoiceArticle

An Automated Algorithm for Determining Sleep Using Single-Channel Electroencephalography to Detect Delirium: A Prospective Observational Study in Intensive Care Units

by Kentaro Matsui, Nobuo Sato, Masafumi Idei, Masako Arakida, Yusuke Seino, Jun-ya Ishikawa, Masashi Nakagawa, Rie Akaho, Katsuji Nishimura and Takeshi Nomura

Healthcare 2022, 10(9), 1776; https://doi.org/10.3390/healthcare10091776 - 15 Sep 2022

Cited by 1 | Viewed by 2063

Abstract

The relationship between polysomnography-based objective sleep and delirium in the intensive care unit (ICU) is inconsistent across studies, suggesting limitations in manually determining the sleep stage of critically ill patients. We objectively measured 24-h sleep using a single-channel electroencephalogram (SleepScope [SS]) and an [...] Read more.

The relationship between polysomnography-based objective sleep and delirium in the intensive care unit (ICU) is inconsistent across studies, suggesting limitations in manually determining the sleep stage of critically ill patients. We objectively measured 24-h sleep using a single-channel electroencephalogram (SleepScope [SS]) and an under-mattress sleep monitor (Nemuri SCAN [NSCAN]), both of which have independent algorithms that automatically determine sleep and wakefulness. Eighteen patients (median age, 68 years) admitted to the ICU after valvular surgery or coronary artery bypass grafting were included, and their sleep time was measured one day after extubation. The median total sleep times (TSTs) measured by SS (TST-SS) and NSCAN were 548 (48–1050) and 1024 (462–1257) min, respectively. Two patients with delirium during the 24-h sleep measurement had very short TST-SS of 48 and 125 min, and the percentage of daytime sleep accounted for >80% in both SS and NSCAN. This preliminary case series showed marked sleep deprivation and increased rates of daytime sleeping in ICU patients with delirium. Although data accuracy from under-mattress sleep monitors is contentious, automated algorithmic sleep/wakefulness determination using a single-channel electroencephalogram may be useful in detecting delirium in ICU patients and could even be superior to polysomnography. Full article

(This article belongs to the Special Issue Symptoms and Experiences of Patients after Intensive Care)

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15 pages, 976 KiB

Open AccessEditor’s ChoiceReview

Patient Satisfaction with Telemedicine in Adults with Diabetes: A Systematic Review

by Hidetaka Hamasaki

Healthcare 2022, 10(9), 1677; https://doi.org/10.3390/healthcare10091677 - 02 Sep 2022

Cited by 6 | Viewed by 2503

Abstract

Patient satisfaction assessment is essential for improving the quality of healthcare. Diabetes management using telemedicine technology is promising in the 21st century. However, the number of randomised controlled trials (RCTs) examining the effect of telemedicine on satisfaction in patients with diabetes is limited. [...] Read more.

Patient satisfaction assessment is essential for improving the quality of healthcare. Diabetes management using telemedicine technology is promising in the 21st century. However, the number of randomised controlled trials (RCTs) examining the effect of telemedicine on satisfaction in patients with diabetes is limited. This systematic review aimed to summarise the current evidence on patient satisfaction with telemedicine in adults with diabetes and discuss related issues and future directions of telemedicine in patients with diabetes. The author systematically searched PubMed/MEDLINE, Embase and The Cochrane Library, and a total of six RCTs were eligible for this review. Patient satisfaction with telemedicine was as high as conventional face-to-face care; however, telemedicine appeared not to significantly increase patient satisfaction compared with conventional face-to-face care in the included studies. Significant heterogeneity was noted between the studies, including participants’ age, study duration, the method of assessing patient satisfaction and types of telemedicine. Further studies are required to provide firm evidence to healthcare providers who are willing to use telemedicine in diabetes management. Telemedicine technology has been advancing and is a key tool in providing high-quality healthcare to patients with diabetes in the 21st century. Full article

(This article belongs to the Special Issue Healthcare Strategies for Patients with Chronic Diseases in an Ageing Society)

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16 pages, 1357 KiB

Open AccessEditor’s ChoiceArticle

Digital Care Programs for Chronic Hip Pain: A Prospective Longitudinal Cohort Study

by Dora Janela, Fabíola Costa, Anabela C. Areias, Maria Molinos, Robert G. Moulder, Jorge Lains, Virgílio Bento, Justin K. Scheer, Vijay Yanamadala, Steven P. Cohen and Fernando Dias Correia

Healthcare 2022, 10(8), 1595; https://doi.org/10.3390/healthcare10081595 - 22 Aug 2022

Cited by 4 | Viewed by 2480

Abstract

Chronic hip pain is a cause of disability worldwide. Digital interventions (DI) may promote access while providing proper management. This single-arm interventional study assesses the clinical outcomes and engagement of a completely remote multimodal DI in patients with chronic hip pain. This home-based [...] Read more.

Chronic hip pain is a cause of disability worldwide. Digital interventions (DI) may promote access while providing proper management. This single-arm interventional study assesses the clinical outcomes and engagement of a completely remote multimodal DI in patients with chronic hip pain. This home-based DI consisted of exercise (with real-time biofeedback), education, and cognitive-behavioral therapy. Outcomes were calculated between baseline and program end, using latent growth curve analysis. Primary outcome was the Hip Disability and Osteoarthritis Outcome Score (HOOS). Secondary outcomes were pain, intent to undergo surgery, mental health, productivity, patient engagement (exercise sessions frequency), and satisfaction. Treatment response was assessed using a 30% pain change cut-off. A completion rate of 74.2% (396/534), alongside high patient engagement (2.9 exercise sessions/week, SD 1.1) and satisfaction (8.7/10, SD 1.6) were observed. Significant improvements were observed across all HOOS sub-scales (14.7–26.8%, p < 0.05), with 66.8% treatment responders considering pain. Marked improvements were observed in surgery intent (70.1%), mental health (54%), and productivity impairment (60.5%) (all p < 0.001). The high engagement and satisfaction reported after this DI, alongside the clinical outcome improvement, support the potential of remote care in the management of chronic hip conditions. Full article

(This article belongs to the Special Issue Digital Therapeutics in Healthcare)

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16 pages, 2426 KiB

Open AccessEditor’s ChoiceArticle

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

by Salvatore Corrao, Giuseppe Natoli, Alessandro Nobili, Pier Mannuccio Mannucci, Francesco Perticone, Vincenzo Arcoraci and Christiano Argano

Healthcare 2022, 10(8), 1459; https://doi.org/10.3390/healthcare10081459 - 03 Aug 2022

Cited by 5 | Viewed by 2608

Abstract

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing [...] Read more.

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes. Full article

(This article belongs to the Special Issue Diabetes and Comorbidities)

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21 pages, 14208 KiB

Open AccessEditor’s ChoiceArticle

All Pedicle Screw versus Hybrid Hook–Screw Instrumentation in the Treatment of Thoracic Adolescent Idiopathic Scoliosis (AIS): A Prospective Comparative Cohort Study

by Athanasios I. Tsirikos and Tristan E. McMillan

Healthcare 2022, 10(8), 1455; https://doi.org/10.3390/healthcare10081455 - 03 Aug 2022

Cited by 6 | Viewed by 1790

Abstract

Background: Posterior spinal correction and fusion remains the most common surgical treatment in AIS. Surgeons currently favour all pedicle screw (AS) correction techniques with alternative implants being less utilised. The purpose of this study was to assess whether a hybrid hook–screw (HS) construct [...] Read more.

Background: Posterior spinal correction and fusion remains the most common surgical treatment in AIS. Surgeons currently favour all pedicle screw (AS) correction techniques with alternative implants being less utilised. The purpose of this study was to assess whether a hybrid hook–screw (HS) construct could achieve similar outcomes. Methods: A single centre, prospective cohort study was conducted. Patients with moderate and severe thoracic AIS (Lenke 1) were included. Clinical and radiological results of a standardised hybrid HS technique were compared with those obtained with an AS construct. All patients had a minimum 2-year follow-up. Results: 160 patients were included in this series (80 patients/group). The HS group had significantly reduced surgical time, blood loss and implant density. Both techniques achieved ≥75% scoliosis correction. The HS group was superior in restoring thoracic kyphosis and global sagittal balance with an average 31% increase in kyphosis compared to 10% with the AS group (p < 0.001). There was significant improvement in SRS-22 scores at 2 years postoperative (p < 0.001) in both groups. There were no neurological or visceral complications related to instrumentation, no detected non-union and no reoperations. The HS implant cost was significantly lower than that of AS, with a mean instrumentation saving of almost £2000/patient. Conclusion: A standardised hybrid HS technique achieved excellent correction of thoracic scoliosis, high patient satisfaction and low complication rates in patients with thoracic AIS. These results were comparable to the AS group. The HS technique achieved better correction of thoracic kyphosis and sagittal balance than the AS technique, together with reduced surgical time, blood loss and implant cost. Full article

(This article belongs to the Special Issue Pediatric Spine Health)

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21 pages, 10785 KiB

Open AccessEditor’s ChoiceArticle

Clinical and Biological Adaptations in Obese Older Adults Following 12-Weeks of High-Intensity Interval Training or Moderate-Intensity Continuous Training

by Layale Youssef, Jordan Granet, Vincent Marcangeli, Maude Dulac, Guy Hajj-Boutros, Olivier Reynaud, Fanny Buckinx, Pierrette Gaudreau, José A. Morais, Pascale Mauriège, Gilles Gouspillou, Philippe Noirez and Mylène Aubertin-Leheudre

Healthcare 2022, 10(7), 1346; https://doi.org/10.3390/healthcare10071346 - 20 Jul 2022

Cited by 8 | Viewed by 3361

Abstract

Sarcopenia and obesity are considered a double health burden. Therefore, the implementation of effective strategies is needed to improve the quality of life of older obese individuals. The aim of this study was to compare the impact of high-intensity interval training (HIIT) and [...] Read more.

Sarcopenia and obesity are considered a double health burden. Therefore, the implementation of effective strategies is needed to improve the quality of life of older obese individuals. The aim of this study was to compare the impact of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on functional capacities, muscle function, body composition and blood biomarkers in obese older adults. Adipose tissue gene expression and markers of muscle mitochondrial content and quality control involved in exercise adaptations were also investigated. Sixty-eight participants performed either HIIT (n = 34) on an elliptical trainer or MICT (n = 34) on a treadmill, three times per week for 12 weeks. HIIT produced significantly higher benefits on some physical parameters (six-minute walking test (HIIT: +12.4% vs. MICT: +5.2%); step test (HIIT: +17.02% vs. MICT: +5.9%); ten-repetition chair test (HIIT: −17.04% vs. MICT: −4.7%)). Although both HIIT and MICT led to an improvement in lower limb power (HIIT: +25.2% vs. MICT: +20.4%), only MICT led to higher improvement in lower limb muscle strength (HIIT: +4.3% vs. MICT: +23.2%). HIIT was more beneficial for increasing total lean body mass (HIIT: +1.58% vs. MICT: −0.81%), while MICT was more effective for decreasing relative gynoid fat mass (HIIT: −1.09% vs. MICT: −4.20%). Regarding adipose tissue gene expression, a significant change was observed for cell death-inducing DFFA (DNA fragmentation factor-alpha)-like effector A (CIDEA) in the HIIT group (A.U; HIIT at T0: 32.10 ± 39.37 vs. HIIT at T12: 48.2 ± 59.2). Mitochondrial transcription factor A (TFAM) content, a marker of mitochondrial biogenesis, increased significantly following HIIT (+36.2%) and MICT (+57.2%). A significant increase was observed in the HIIT group for Translocase of Outer Membrane 20 (TOM20; +54.1%; marker of mitochondrial content), Mitofusin-2 (MFN2; +71.6%; marker of mitochondrial fusion) and Parkin RBR E3 Ubiquitin Protein Ligase (PARKIN; +42.3%; marker of mitophagy). Overall, our results indicate that even though MICT (walking on treadmill) and HIIT (on an elliptical) are effective intervention strategies in obese older adults, HIIT appears to have slightly more beneficial effects. More specifically, HIIT led to higher improvements than MICT on functional capacities, lean mass and skeletal muscle markers of mitochondrial content, fusion, and mitophagy. Thus, MICT but also HIIT (time-efficient training) could be recommended as exercise modalities for obese older adults to maintain or improve mobility, health and quality of life. Full article

(This article belongs to the Special Issue Strategies to Manage Obesity in Older Adults)

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9 pages, 1591 KiB

Open AccessEditor’s ChoiceReview

Adverse Childhood Events, Post-Traumatic Stress Disorder, Infectious Encephalopathies and Immune-Mediated Disease

by Robert C. Bransfield

Healthcare 2022, 10(6), 1127; https://doi.org/10.3390/healthcare10061127 - 17 Jun 2022

Cited by 2 | Viewed by 5640

Abstract

Adverse Childhood Events (ACE), Post-Traumatic Stress Disorder (PTSD), and infectious encephalopathies are associated with immune-mediated diseases. Data supporting this are reviewed, and an integrated hypothesis is provided. All three can be associated with intrusive symptoms and temporal lobe pathology. ACE and PTSD are [...] Read more.

Adverse Childhood Events (ACE), Post-Traumatic Stress Disorder (PTSD), and infectious encephalopathies are associated with immune-mediated diseases. Data supporting this are reviewed, and an integrated hypothesis is provided. All three can be associated with intrusive symptoms and temporal lobe pathology. ACE and PTSD are accompanied by an impaired mental capacity to differentiate external danger vs. safety. Infectious encephalopathies are accompanied by a failure of adaptive immunity and an impaired immune capacity to differentiate internal danger vs. safety. All three conditions are associated with impairments to differentiate danger vs. safety and adapt effectively. There are reciprocal interactions between ACE, PTSD, and infectious encephalopathies with accompanying persistent immune activation. This is associated with immune dysregulation, chronic hyperarousal, activation of the stress response, and impairments of the fear recognition and response neural circuits, hypothalamic–pituitary–adrenal axis, amygdala, and hippocampus. The pathophysiological processes can result in a broad spectrum of chronic neuropsychiatric and somatic symptoms and diseases. Understanding the psychodynamic, neurological, neuroimmune, inflammatory and autoimmune components of this interactive process expands the effective treatment opportunities. Full article

(This article belongs to the Collection Why Some Patients Never Fully Recover: Post Active Phase of Infection Syndromes (PAPIS))

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14 pages, 561 KiB

Open AccessEditor’s ChoiceReview

Virtual Reality in the Rehabilitation of Patients with Injuries and Diseases of Upper Extremities

by Pinar Tokgöz, Susanne Stampa, Dirk Wähnert, Thomas Vordemvenne and Christoph Dockweiler

Healthcare 2022, 10(6), 1124; https://doi.org/10.3390/healthcare10061124 - 16 Jun 2022

Cited by 11 | Viewed by 2971

Abstract

Upper-extremity injuries and diseases rarely have life-threatening consequences, but failure to manage them properly can result in severe dysfunction. This article presents the current state of using virtual reality to support the rehabilitation process of patients with injuries and diseases of the upper [...] Read more.

Upper-extremity injuries and diseases rarely have life-threatening consequences, but failure to manage them properly can result in severe dysfunction. This article presents the current state of using virtual reality to support the rehabilitation process of patients with injuries and diseases of the upper extremities and points out their effects on upper-extremity functions. A scoping review was conducted to provide a comprehensive overview of the field of virtual reality for upper-extremity rehabilitation. PubMed, Web of Science, and the Cochrane Library were searched by two independent researchers between April and May 2021 to identify relevant publications and were examined according to inclusion and exclusion criteria. As a result of the literature review, 11 studies of various target groups were identified. Virtual-reality technologies were categorized into multisensory high-end systems and game-based systems. With respect to functional recovery, technologies based on virtual reality were not inferior to traditional rehabilitation. In addition, the users were highly motivated and satisfied. The results emphasize the need for stronger evidence-based virtual-reality technologies for rehabilitation of injuries and diseases of upper extremities. Full article

(This article belongs to the Special Issue Assistive Technologies, Robotics, and Automated Machines in the Health Domain)

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10 pages, 1287 KiB

Open AccessEditor’s ChoiceArticle

Polycystic Ovary Syndrome (PCOS) and Non-Suicidal Self-Injury (NSSI): A Community-Based Study

by Sophie Williams, Dean Fido and David Sheffield

Healthcare 2022, 10(6), 1118; https://doi.org/10.3390/healthcare10061118 - 15 Jun 2022

Cited by 4 | Viewed by 2660

Abstract

Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still [...] Read more.

Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still little to no understanding of how non-suicidal self-injury and suicidal ideation and intention manifest in women with PCOS and how this might differ from women without PCOS. Within this cross-sectional investigation, women with and without a diagnosis of PCOS (n = 418) completed validated metrics of emotion dysregulation, rumination and non-suicidal self-injury (NSSI), as well as self-reported indices of previous suicidal ideation and future suicidal intention. Group comparisons indicated that women with, relative to those without, PCOS reported significantly greater metrics across all variables. Moreover, serial mediation analyses were conducted to test the ideation-to-action framework of suicide in women with PCOS, with the positive relationship between a PCOS diagnosis and future suicidal intention being explained through the indirect pathway of increased emotion dysregulation, recent suicidal ideation and NSSI. Our findings call to action the need for international screening for suicide intention and self-harm in women with PCOS. Full article

(This article belongs to the Special Issue Diagnosis, Prevention, Treatment and Medical Care for Gynecologic and Perinatal Diseases)

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17 pages, 306 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Medicaid Expansions: Probing Medicaid’s Filling of the Cancer Genetic Testing and Screening Space

by Stephen M. Modell, Lisa Schlager, Caitlin G. Allen and Gail Marcus

Healthcare 2022, 10(6), 1066; https://doi.org/10.3390/healthcare10061066 - 08 Jun 2022

Cited by 4 | Viewed by 2069

Abstract

Cancer is the third largest source of spending for Medicaid in the United States. A working group of the American Public Health Association Genomics Forum Policy Committee reviewed 133/149 pieces of literature addressing the impact of Medicaid expansion on cancer screening and genetic [...] Read more.

Cancer is the third largest source of spending for Medicaid in the United States. A working group of the American Public Health Association Genomics Forum Policy Committee reviewed 133/149 pieces of literature addressing the impact of Medicaid expansion on cancer screening and genetic testing in underserved groups and the general population. Breast and colorectal cancer screening rates improved during very early Medicaid expansion but displayed mixed improvement thereafter. Breast cancer screening rates have remained steady for Latina Medicaid enrollees; colorectal cancer screening rates have improved for African Americans. Urban areas have benefited more than rural. State programs increasingly cover BRCA1/2 and Lynch syndrome genetic testing, though testing remains underutilized in racial and ethnic groups. While increased federal matching could incentivize more states to engage in Medicaid expansion, steps need to be taken to ensure that they have an adequate distribution of resources to increase screening and testing utilization. Full article

(This article belongs to the Special Issue Medicaid and Public Health)

10 pages, 252 KiB

Open AccessEditor’s ChoiceArticle

Telemedicine Patient Satisfaction Dimensions Moderated by Patient Demographics

by Andrew N. Mason, Matt Brown and Kevin Mason

Healthcare 2022, 10(6), 1029; https://doi.org/10.3390/healthcare10061029 - 01 Jun 2022

Cited by 13 | Viewed by 2438

Abstract

Background: A multi-dimensional telemedicine patient satisfaction measure is utilized to provide managerial insights into where service improvements are needed and factors that impact patient service perceptions. This research explores the influence of patient demographics on telemedicine satisfaction. Four dimensions of telemedicine patient satisfaction [...] Read more.

Background: A multi-dimensional telemedicine patient satisfaction measure is utilized to provide managerial insights into where service improvements are needed and factors that impact patient service perceptions. This research explores the influence of patient demographics on telemedicine satisfaction. Four dimensions of telemedicine patient satisfaction (health benefits, patient-centered care, monetary costs, and non-monetary costs) were compared across patient gender, income, and education levels. Methods: A survey of 440 US telemedicine patients on patient satisfaction was measured with Likert scale items to create a multi-dimensional construct using the SERVQUAL model. MANOVA, ANOVA, and linear contrasts were used to examine the impact of patient demographics on telemedicine satisfaction dimensions. Results: The findings revealed that patient demographic characteristics moderated various dimensions of their telemedicine experience satisfaction. Satisfaction with telemedicine health benefits was moderated by patient gender and income levels. Patient-centered care was moderated by patient gender, income, and education levels. Satisfaction with the monetary cost of telemedicine was associated with patient gender and education level. Patient education level influenced their satisfaction with telemedicine non-monetary costs. Discussion: Notable trends include generally higher patient satisfaction for women and those with lower education levels. Patient income showed mixed trends regarding the four dimensions of patient satisfaction. Improvements in patient health literacy along with customized services may improve telemedicine patient care satisfaction and health outcomes. Conclusions: Measuring telemedicine patient satisfaction with a multi-dimensional assessment tool provides insights into how patient demographics influence perceptions of services received. The findings highlighted perceptions of telemedicine patient satisfaction dimensions that differed across patient demographics and provided insights into their overall impact on telemedicine patient satisfaction. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

10 pages, 278 KiB

Open AccessEditor’s ChoiceArticle

Does the Quality of Postpartum Hemorrhage Local Protocols Improve the Identification and Management of Blood Loss after Vaginal Deliveries? A Multicenter Cohort Study

by Françoise Vendittelli, Chloé Barasinski, Olivier Rivière, Caroline Da Costa Correia, Catherine Crenn-Hébert, Michel Dreyfus, Anne Legrand and Laurent Gerbaud

Healthcare 2022, 10(6), 992; https://doi.org/10.3390/healthcare10060992 - 27 May 2022

Cited by 5 | Viewed by 1549

Abstract

Substandard care, which can result from a delayed recognition of the severity of blood loss, can increase maternal morbidity. Our objectives were to assess the incidence of postpartum hemorrhage (PPH) and of second-line procedures in maternity units according to the quality of their [...] Read more.

Substandard care, which can result from a delayed recognition of the severity of blood loss, can increase maternal morbidity. Our objectives were to assess the incidence of postpartum hemorrhage (PPH) and of second-line procedures in maternity units according to the quality of their PPH protocol. We used a mixed design, a prospective cohort (3442 women with PPH after vaginal delivery; February–July 2011), and an audit of the written protocols (177 French maternity units; September 2010–June 2011). A quality score was calculated for the protocol of each unit. Maternity units were classified into three categories according to this score: category 1 (total score: 0–8), category 2 (9–12.5), and category 3 (>12.5). The PPH incidence (>500 mL) was 3.2%, 3.3% and 4.6% among maternity units in categories 1, 2 and 3, respectively (p < 0.0001). The incidence of severe maternal morbidity (surgery and/or artery embolization and/or blood transfusion) was higher among maternity units in category 1 (54.8%; 95% CI: 51.9, 57.7) than in either category 2 (50.1%; 95% CI: 47.8, 52.5) or 3 (38.0%; 95% CI: 33.8, 42.4]) (p < 0.0001). The risks of severe maternal morbidity were lower for category 3 than category 1 and 2 (respectively, adjusted RR 0.68, 95% CI 0.60–0.86 and 0.77, 95% CI 0.68–0.87). Finally, maternity units with higher scores identified PPH better and used fewer curative second-line procedures. Full article

(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)

19 pages, 1310 KiB

Open AccessEditor’s ChoiceArticle

Last Aid Training Online: Participants’ and Facilitators’ Perceptions from a Mixed-Methods Study in Rural Scotland

by Leah Macaden, Kirsten Broadfoot, Clare Carolan, Kevin Muirhead, Siobhan Neylon and Jeremy Keen

Healthcare 2022, 10(5), 918; https://doi.org/10.3390/healthcare10050918 - 16 May 2022

Cited by 5 | Viewed by 2784

Abstract

(1) Background: Palliative and end-of-life care services are increasingly gaining centre stage in health and social care contexts in the UK and globally. Death and dying need are relational processes. Building personal and community capacity along with resilience is vital to support families [...] Read more.

(1) Background: Palliative and end-of-life care services are increasingly gaining centre stage in health and social care contexts in the UK and globally. Death and dying need are relational processes. Building personal and community capacity along with resilience is vital to support families and communities to normalise death and dying. Last Aid Training (LAT) is one such innovative educational initiative which teaches the general public about the fundamentals of palliative care and promotes public discussion about death and dying. The Highland Hospice [HH] in Scotland has pioneered delivery of LAT in face-to-face settings since March 2019 and online since March 2020 to accommodate pandemic restrictions. (2) Methods: This study used a mixed-methods approach, combining an online survey with LAT participants followed by individual semi-structured qualitative interviews with both LAT participants and facilitators. The primary aim of this study was to investigate the impacts of LAT for participants at the individual, family, and community levels, as well as explore participant and facilitator experiences and perspectives of LAT in an online environment. (3) Results: Overall, this evaluation demonstrates that provision of foundational death literacy education in social contexts enhances the personal knowledge, skills, and confidence of individual community members and supports the notion that this personal growth could lead to strengthened community action. (4) Conclusions: Findings from this study concluded that there is potential to include LAT as the foundational core training to promote death literacy in communities with further exploration to integrate/align LAT with other national/global end-of-life care frameworks. Full article

(This article belongs to the Special Issue Public Health Palliative Care and Public Palliative Care Education)

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14 pages, 535 KiB

Open AccessEditor’s ChoiceSystematic Review

Prevalence of Frailty among Community-Dwelling Older Adults in Asian Countries: A Systematic Review and Meta-Analysis

by Thi-Lien To, Thanh-Nhan Doan, Wen-Chao Ho and Wen-Chun Liao

Healthcare 2022, 10(5), 895; https://doi.org/10.3390/healthcare10050895 - 12 May 2022

Cited by 20 | Viewed by 2920

Abstract

This study aimed to synthesize frailty prevalence among community-dwelling older adults in Asia and identify factors influencing prevalence estimates. Five electronic databases were searched by 29 April 2022, including representative samples of community-dwelling adults who were aged 60 years and older and lived [...] Read more.

This study aimed to synthesize frailty prevalence among community-dwelling older adults in Asia and identify factors influencing prevalence estimates. Five electronic databases were searched by 29 April 2022, including representative samples of community-dwelling adults who were aged 60 years and older and lived in Asia. Cross-sectional or national longitudinal population-based cohort studies completed with validated instruments were selected. Twenty-one studies with 52,283 participants were included. The pooled prevalence rate of frailty was 20.5% (95% CI = 15.5% to 26.0%). The estimated frailty prevalence was 14.6% (95% CI = 10.9% to 18.8%) while assessed by the Fried frailty phenotype, 28.0% (95% CI = 21.3% to 35.3%) by the Cumulative Frailty Index, 36.4% (95% CI = 33.6% to 39.3%) by the Study of Osteoporotic Fractures (SOF) index, and 46.3% (95% CI = 40.1% to 52.4%) by the Clinical Frailty Scale (p < 0.01). Subgroup analysis in studies using the Fried’s phenotype tool found that frailty prevalence was increased with older age (p = 0.01) and was higher in those who were single (21.5%) than in married participants (9.0%) (p = 0.02). The study results supported a better understanding of frailty prevalence in different geographical distributions and provide references for health policy decision-making regarding preventing frailty progression in older adults. Full article

(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)

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21 pages, 1135 KiB

Open AccessEditor’s ChoiceArticle

A Cluster Analysis of the Acceptance of a Contact Tracing App—The Identification of Profiles for the Italian Immuni Contact Tracing App

by Marcello Sarini, Rossana Actis Grosso, Maria Elena Magrin, Silvia Mari, Nadia Olivero, Giulia Paganin and Silvia Simbula

Healthcare 2022, 10(5), 888; https://doi.org/10.3390/healthcare10050888 - 11 May 2022

Cited by 1 | Viewed by 3622

Abstract

Digital contact tracing apps have been introduced by governments as a strategy to limit the spread of the COVID-19 pandemic. Digital contact tracking is an alternative to traditional contact tracing performed by human tracers who have to reconstruct each contact an infected person [...] Read more.

Digital contact tracing apps have been introduced by governments as a strategy to limit the spread of the COVID-19 pandemic. Digital contact tracking is an alternative to traditional contact tracing performed by human tracers who have to reconstruct each contact an infected person had in the recent past by means of interviews. The Italian government proposed the Immuni digital contact tracking app as a solution. Immuni uses Bluetooth technology to anonymously register all close contacts a person had: if she tests positive for COVID-19 then all registered contacts are notified. The main aim of the paper is to propose a cluster analysis of some factors concerning the possible acceptance of the Immuni app to build behaviour profiles that explain and predict the possible behaviours of the respondents. The factors considered referred to three different pillars: the technological pillar, investigated by considering factors from the technology acceptance models family; the health pillar, where variables of the health belief model were used; and the sociopolitical pillar, where some values of the respondents were considered as possible barriers to or facilitators of the acceptance of this technology. As a result of the cluster analysis, three behavioural profiles were built: the ProApp profile, the Hesitant profile, and the AntiApp profile. The first is the profile grouping the respondents who intend to use the contact tracing app; the second is more about people who are favourable of the use of the app, but some issues such as privacy reduce the strength of their intention; the last profile is about people who are less favourable to use the app. We are confident that the behaviour profiles found would be useful to build more tailored communication campaigns to help promote the use of the app by managing factors that could either be facilitators or barriers. Full article

(This article belongs to the Special Issue Digital Technology to Control the COVID-19 Epidemic Infection: Issues, Successes and Failures)

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29 pages, 694 KiB

Open AccessEditor’s ChoiceReview

Wishes and Needs of Nursing Home Residents: A Scoping Review

by Roxana Schweighart, Julie Lorraine O’Sullivan, Malte Klemmt, Andrea Teti and Silke Neuderth

Healthcare 2022, 10(5), 854; https://doi.org/10.3390/healthcare10050854 - 06 May 2022

Cited by 12 | Viewed by 3391

Abstract

Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where [...] Read more.

Falling birth rates and rising life expectancy are leading to global aging. The proportional increase in older people can be observed in almost all countries and regions worldwide. As a result, more people spend their later years in nursing homes. In homes where person-centered care is implemented, residents report greater satisfaction and quality of life. This approach is based on the wishes and needs of the residents. Therefore, the purpose of this scoping review is to explore the wishes and needs of nursing home residents. A scoping review of the literature was conducted in which 12 databases were systematically searched for relevant articles according to PRISMA-ScR guidelines. Both quantitative and qualitative study designs were considered. A total of 51 articles met the inclusion criteria. Included articles were subjected to thematic analysis and synthesis to categorize findings into themes. The analysis identified 12 themes to which the wishes and needs were assigned: (1) Activities, leisure, and daily routine; (2) Autonomy, independence, choice, and control; (3) Death, dying, and end-of-life; (4) Economics; (5) Environment, structural conditions, meals, and food; (6) Health condition; (7) Medication, care, treatment, and hygiene; (8) Peer relationship, company, and social contact; (9) Privacy; (10) Psychological and emotional aspects, security, and safety; (11) Religion, spirituality; and (12) Sexuality. Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting. Full article

(This article belongs to the Special Issue Long-Term Care for Older Adults)

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25 pages, 1523 KiB

Open AccessEditor’s ChoiceArticle

A Two-Stage De-Identification Process for Privacy-Preserving Medical Image Analysis

by Arsalan Shahid, Mehran H. Bazargani, Paul Banahan, Brian Mac Namee, Tahar Kechadi, Ceara Treacy, Gilbert Regan and Peter MacMahon

Healthcare 2022, 10(5), 755; https://doi.org/10.3390/healthcare10050755 - 19 Apr 2022

Cited by 4 | Viewed by 3986

Abstract

Identification and re-identification are two major security and privacy threats to medical imaging data. De-identification in DICOM medical data is essential to preserve the privacy of patients’ Personally Identifiable Information (PII) and requires a systematic approach. However, there is a lack of sufficient [...] Read more.

Identification and re-identification are two major security and privacy threats to medical imaging data. De-identification in DICOM medical data is essential to preserve the privacy of patients’ Personally Identifiable Information (PII) and requires a systematic approach. However, there is a lack of sufficient detail regarding the de-identification process of DICOM attributes, for example, what needs to be considered before removing a DICOM attribute. In this paper, we first highlight and review the key challenges in the medical image data de-identification process. In this paper, we develop a two-stage de-identification process for CT scan images available in DICOM file format. In the first stage of the de-identification process, the patient’s PII—including name, date of birth, etc., are removed at the hospital facility using the export process available in their Picture Archiving and Communication System (PACS). The second stage employs the proposed DICOM de-identification tool for an exhaustive attribute-level investigation to further de-identify and ensure that all PII has been removed. Finally, we provide a roadmap for future considerations to build a semi-automated or automated tool for the DICOM datasets de-identification. Full article

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

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23 pages, 8131 KiB

Open AccessEditor’s ChoiceReview

Impacts on Context Aware Systems in Evidence-Based Health Informatics: A Review

by Stella C. Christopoulou

Healthcare 2022, 10(4), 685; https://doi.org/10.3390/healthcare10040685 - 05 Apr 2022

Cited by 4 | Viewed by 2486

Abstract

Background: The application of Context Aware Computing (CAC) can be an effective, useful, feasible, and acceptable way to advance medical research and provide health services. Methods: This review was conducted in accordance with the principles of the development of a mixed [...] Read more.

Background: The application of Context Aware Computing (CAC) can be an effective, useful, feasible, and acceptable way to advance medical research and provide health services. Methods: This review was conducted in accordance with the principles of the development of a mixed methods review and existing knowledge in the field via the Synthesis Framework for the Assessment of Health Information Technology to evaluate CAC implemented by Evidence-Based Health Informatics (EBHI). A systematic search of the literature was performed during 18 November 2021–22 January 2022 in Cochrane Library, IEEE Xplore, PUBMED, Scopus and in the clinical registry platform Clinicaltrials.gov. The author included the articles in the review if they were implemented by EBHI and concerned with CAC technologies. Results: 29 articles met the inclusion criteria and refer to 26 trials published between 2011 and 2022. The author noticed improvements in healthcare provision using EBHI in the findings of CAC application. She also confirmed that CAC systems are a valuable and reliable method in health care provision. Conclusions: The use of CAC systems in healthcare is a promising new area of research and development. The author presented that the evaluation of CAC systems in EBHI presents positive effects on the state of health and the management of long-term diseases. These implications are presented in this article in a detailed, clear, and reliable manner. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

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9 pages, 668 KiB

Open AccessEditor’s ChoiceArticle

Can Lung Ultrasound Be the Ideal Monitoring Tool to Predict the Clinical Outcome of Mechanically Ventilated COVID-19 Patients? An Observational Study

by Luigi Vetrugno, Francesco Meroi, Daniele Orso, Natascia D’Andrea, Matteo Marin, Gianmaria Cammarota, Lisa Mattuzzi, Silvia Delrio, Davide Furlan, Jonathan Foschiani, Francesca Valent and Tiziana Bove

Healthcare 2022, 10(3), 568; https://doi.org/10.3390/healthcare10030568 - 18 Mar 2022

Cited by 11 | Viewed by 1533

Abstract

Background: During the COVID-19 pandemic, lung ultrasound (LUS) has been widely used since it can be performed at the patient’s bedside, does not produce ionizing radiation, and is sufficiently accurate. The LUS score allows for quantifying lung involvement; however, its clinical prognostic role [...] Read more.

Background: During the COVID-19 pandemic, lung ultrasound (LUS) has been widely used since it can be performed at the patient’s bedside, does not produce ionizing radiation, and is sufficiently accurate. The LUS score allows for quantifying lung involvement; however, its clinical prognostic role is still controversial. Methods: A retrospective observational study on 103 COVID-19 patients with respiratory failure that were assessed with an LUS score at intensive care unit (ICU) admission and discharge in a tertiary university COVID-19 referral center. Results: The deceased patients had a higher LUS score at admission than the survivors (25.7 vs. 23.5; p-value = 0.02; cut-off value of 25; Odds Ratio (OR) 1.1; Interquartile Range (IQR) 1.0−1.2). The predictive regression model shows that the value of LUSt0 (OR 1.1; IQR 1.0–1.3), age (OR 1.1; IQR 1.0−1.2), sex (OR 0.7; IQR 0.2−3.6), and days in spontaneous breathing (OR 0.2; IQR 0.1–0.5) predict the risk of death for COVID-19 patients (Area under the Curve (AUC) 0.92). Furthermore, the surviving patients showed a significantly lower difference between LUS scores at admission and discharge (mean difference of 1.75, p-value = 0.03). Conclusion: Upon entry into the ICU, the LUS score may play a prognostic role in COVID-19 patients with ARDS. Furthermore, employing the LUS score as a monitoring tool allows for evaluating the patients with a higher probability of survival. Full article

(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)

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9 pages, 450 KiB

Open AccessEditor’s ChoiceReview

Current Practice of High Flow through Nasal Cannula in Exacerbated COPD Patients

by Andrea Bruni, Eugenio Garofalo, Daniela Procopio, Silvia Corrado, Antonio Caroleo, Eugenio Biamonte, Corrado Pelaia and Federico Longhini

Healthcare 2022, 10(3), 536; https://doi.org/10.3390/healthcare10030536 - 15 Mar 2022

Cited by 3 | Viewed by 4014

Abstract

Acute Exacerbation of Chronic Obstructive Pulmonary Disease is a form of severe Acute Respiratory Failure (ARF) requiring Conventional Oxygen Therapy (COT) in the case of absence of acidosis or the application of Non-Invasive Ventilation (NIV) in case of respiratory acidosis. In the last [...] Read more.

Acute Exacerbation of Chronic Obstructive Pulmonary Disease is a form of severe Acute Respiratory Failure (ARF) requiring Conventional Oxygen Therapy (COT) in the case of absence of acidosis or the application of Non-Invasive Ventilation (NIV) in case of respiratory acidosis. In the last decade, High Flow through Nasal Cannula (HFNC) has been increasingly used, mainly in patients with hypoxemic ARF. However, some studies were also published in AECOPD patients, and some evidence emerged. In this review, after describing the mechanism underlying potential clinical benefits, we analyzed the possible clinical application of HFNC to AECOPD patients. In the case of respiratory acidosis, the gold-standard treatment remains NIV, supported by strong evidence in favor. However, HFNC may be considered as an alternative to NIV if the latter fails for intolerance. HFNC should also be considered and preferred to COT at NIV breaks and weaning. Finally, HFNC should also be preferred to COT as first-line oxygen treatment in AECOPD patients without respiratory acidosis. Full article

(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)

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9 pages, 470 KiB

Open AccessEditor’s ChoiceReview

Patient Active Approaches in Osteopathic Practice: A Scoping Review

by Christian Lunghi, Francesca Baroni, Andrea Amodio, Giacomo Consorti, Marco Tramontano and Torsten Liem

Healthcare 2022, 10(3), 524; https://doi.org/10.3390/healthcare10030524 - 14 Mar 2022

Cited by 6 | Viewed by 6059

Abstract

Background: In the field of manual therapies there is a growing interest in moving from passive hands-on approaches to patient active approaches. In the osteopathic field there are both active and passive methods described as integrated in the process of care. However, this [...] Read more.

Background: In the field of manual therapies there is a growing interest in moving from passive hands-on approaches to patient active approaches. In the osteopathic field there are both active and passive methods described as integrated in the process of care. However, this prospective linkage has not been formally explored and is not well shared in the community of practice. The present review aims to appraise the relevant literature on the functioning and principles of Patient active osteopathic approaches (PAOAs) and explore a prospective model for selecting the different types of PAOA, highlighting their integration into patient management strategies. Methods: A scoping review was conducted to analyze the relevant literature on the functioning and the different principles of PAOA and to obtain a comprehensive perspective on the phenomenon. Results: The eligible articles provide insights into the mechanisms of functioning and principles of application of active approaches to be integrated with hands-on approaches. These results provide new insights into the relevance of PAOA to clinical practice. Conclusions: The proposal, emerging from the review, may promote discussions in the community of practice and provide a road map for research towards achieving an evidence-based structure for PAOA. Full article

(This article belongs to the Collection Osteopathic and Manual Therapy Healthcare Reconceptualization: Health Needs and New Evidence)

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14 pages, 4412 KiB

Open AccessEditor’s ChoiceArticle

A Web-Based Application to Monitor and Inform about the COVID-19 Outbreak in Italy: The {COVID-19ita} Initiative

by Corrado Lanera, Danila Azzolina, Francesco Pirotti, Ilaria Prosepe, Giulia Lorenzoni, Paola Berchialla and Dario Gregori

Healthcare 2022, 10(3), 473; https://doi.org/10.3390/healthcare10030473 - 03 Mar 2022

Cited by 5 | Viewed by 2314

Abstract

The pandemic outbreak of COVID-19 has posed several questions about public health emergency risk communication. Due to the effort required for the population to adopt appropriate behaviors in response to the emergency, it is essential to inform the public of the epidemic situation [...] Read more.

The pandemic outbreak of COVID-19 has posed several questions about public health emergency risk communication. Due to the effort required for the population to adopt appropriate behaviors in response to the emergency, it is essential to inform the public of the epidemic situation with transparent data sources. The COVID-19ita project aimed to develop a public open-source tool to provide timely, updated information on the pandemic’s evolution in Italy. It is a web-based application, the front end for the eponymously named R package freely available on GitHub, deployed both in English and Italian. The web application pulls the data from the official repository of the Italian COVID-19 outbreak at the national, regional, and provincial levels. The app allows the user to select information to visualize data in an interactive environment and compare epidemic situations over time and across different Italian regions. At the same time, it provides insights about the outbreak that are explained and commented upon to yield reasoned, focused, timely, and updated information about the outbreak evolution. Full article

(This article belongs to the Special Issue Digital Technology to Control the COVID-19 Epidemic Infection: Issues, Successes and Failures)

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12 pages, 708 KiB

Open AccessEditor’s ChoiceArticle

Self-Service System for the Family Members of ICU Patients: A Pilot Study

by I-Chiu Chang, Ying-Hui Hou, Li-Jung Lu and Yu-Chen Tung

Healthcare 2022, 10(3), 467; https://doi.org/10.3390/healthcare10030467 - 02 Mar 2022

Cited by 2 | Viewed by 2059

Abstract

Family members of intensive care unit patients are often experience high anxiety and require more information about the patients. However, most Taiwanese healthcare institutions currently face manpower shortages due to the COVID-19 pandemic. Therefore, the task of providing additional services to meet family [...] Read more.

Family members of intensive care unit patients are often experience high anxiety and require more information about the patients. However, most Taiwanese healthcare institutions currently face manpower shortages due to the COVID-19 pandemic. Therefore, the task of providing additional services to meet family members’ needs and relieve their stress was deferred by some healthcare institutions. The self-service system, known to be effective and efficient in other industries, was recommended for use in the healthcare industry. This study aims to explore an intensive care unit self-service system (ICU-SSS) designed for the family members of ICU patients. This study investigates the feasibility of the system by following a mixed method approach, including qualitative interviews and a quantitative survey. Firstly, interviews with five family members and five ICU staff members of a case hospital were conducted to identify the need to develop an ICU-SSS for the family member. Secondly, a survey was completed by 30 family members to evaluate the system. The interview results reveal nine categories of family members’ needs and the survey results show that the ICU family members assigned acceptable scores to all the ICU-SSS functions, except the importance of “Logistical information”. Based on these findings, the scientific and practical implications are discussed. Full article

(This article belongs to the Section TeleHealth and Digital Healthcare)

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11 pages, 778 KiB

Open AccessEditor’s ChoiceArticle

Establishing a New ECMO Referral Center Using an ICU-Based Approach: A Feasibility and Safety Study

by Ryszard Gawda, Maciej Piwoda, Maciej Marszalski, Katarzyna Lyp, Jolanta Piwoda, Magdalena Maj, Maciej Gawor, Maciej Molsa, Marek Pietka and Tomasz Czarnik

Healthcare 2022, 10(3), 414; https://doi.org/10.3390/healthcare10030414 - 22 Feb 2022

Cited by 3 | Viewed by 2538

Abstract

Background: A high-volume center with a multidisciplinary team is regarded as the optimal place for providing extracorporeal membrane oxygenation (ECMO). We hypothesize that an ECMO center can also be successfully created and subsequently developed entirely by intensivists in a mid-size mixed intensive care [...] Read more.

Background: A high-volume center with a multidisciplinary team is regarded as the optimal place for providing extracorporeal membrane oxygenation (ECMO). We hypothesize that an ECMO center can also be successfully created and subsequently developed entirely by intensivists in a mid-size mixed intensive care unit (ICU). Methods: A model was created for setting up a new ECMO referral center within the structure of an existing mixed ICU in a tertiary hospital. A retrospective analysis was carried out of the first 33 patients treated in the initial period of the center’s activity, from mid 2018 to the end of 2020. Results: An ECMO center was established and developed entirely based on the resources of an existing mixed ICU. Thirty-three patients were treated. They had an overall survival rate at 90 days of 60.6%. In veno-venous (VV) mode ECMO duration, ICU length of stay, and SOFA score were significantly higher than in veno-arterial mode. No significant differences in clinical characteristics were observed between survivors and non-survivors on VV-ECMO. Conclusions: A regional ECMO center can be set up as an integral part of a mixed ICU in a tertiary hospital. Extracorporeal therapy, such as continuous renal replacement therapy and mechanical ventilation can be managed entirely by intensivists. Further studies are needed to show that the ICU-based approach to setting up a new ECMO center is no less effective than the multidisciplinary approach. Full article

(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)

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8 pages, 364 KiB

Open AccessEditor’s ChoiceArticle

Can Social Media Profiles Be a Reliable Source of Information on Nutrition and Dietetics?

by Paweł Kabata, Dorota Winniczuk-Kabata, Piotr Maciej Kabata, Janusz Jaśkiewicz and Karol Połom

Healthcare 2022, 10(2), 397; https://doi.org/10.3390/healthcare10020397 - 20 Feb 2022

Cited by 9 | Viewed by 3652

Abstract

Background: Social media are growing worldwide platforms for unlimited exchange of various content. Owing to their accessibility and short form, they can be utilized as usable, wide-range communication and information tools for companies, scientific communities, patient advocacy organizations, and special interest groups. This [...] Read more.

Background: Social media are growing worldwide platforms for unlimited exchange of various content. Owing to their accessibility and short form, they can be utilized as usable, wide-range communication and information tools for companies, scientific communities, patient advocacy organizations, and special interest groups. This study aimed to investigate whether Instagram^® profiles can be reliable sources of information and knowledge about nutrition and dietetics. Materials and Methods: Random identification of nutrition-related posts was performed using a built-in website search engine. Posts were searched by five popular hashtags: #nutrition, #nutritionist, #instadiet, #diet, and #dietitian, 250 newest posts of each. Advertisement posts were discarded. Each eligible post was then categorized (dietetics, fitness, motivation, other) and assessed with regard to the quality of nutrition information provided (five levels from none to good quality), popularity (number of followers, likes, and comments), and engagement measures (like, comment, and engagement ratio). Results: A total of 1189 posts were reviewed. The overall quality of the content regarding nutritional knowledge was extremely low (93.9% of all posts), also when divided into categories. Among all posts, 63.8% were categorized as “nutrition and dietetics”, while “fitness”, “motivation”, and “other” categories comprised 8.2%, 4.8%, and 23.2% of the posts, respectively. Posts recognized as dietetics were the most liked (mean n = 116 likes per post) and of the highest quality. However, those motivational raised the greatest degree of engagement (32.7%). Posts with cooking recipes were the most commented. Conclusions: Random post search cannot provide viewers with valuable nutrition information. A dedicated search for high-quality professional profiles is preferred to obtain quality information. Full article

(This article belongs to the Special Issue The Role of Social Media in Innovative Digital Health)

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16 pages, 1351 KiB

Open AccessEditor’s ChoiceArticle

A Preliminary Italian Cross-Sectional Study on the Level of Digital Psychiatry Training, Knowledge, Beliefs and Experiences among Medical Students, Psychiatry Trainees and Professionals

by Laura Orsolini, Silvia Bellagamba, Virginia Marchetti, Giulia Menculini, Silvia Tempia Valenta, Virginio Salvi and Umberto Volpe

Healthcare 2022, 10(2), 390; https://doi.org/10.3390/healthcare10020390 - 18 Feb 2022

Cited by 5 | Viewed by 1775

Abstract

The COVID-19 pandemic led to the implementation of digital psychiatry (DP), resulting in the need for a new skilled healthcare workforce. The purpose of this study was to investigate the level of training, knowledge, beliefs, and experiences of young mental health professionals and [...] Read more.

The COVID-19 pandemic led to the implementation of digital psychiatry (DP), resulting in the need for a new skilled healthcare workforce. The purpose of this study was to investigate the level of training, knowledge, beliefs, and experiences of young mental health professionals and medical students in DP. An ad hoc cross-sectional survey was administered and descriptive analyses, Student’s t and ANOVA tests were conducted, together with an exploratory factor analysis, bivariate correlations and linear regression. Most of the sample (N = 239) declared that DP was never discussed within their academic training (89.1%), mainly revealing an overall lack of knowledge on the issue. Nevertheless, subjects mostly declared that DP represents a valuable therapeutic tool in mental health (80%) and that their training should include this topic (54.4%). Moreover, most subjects declared that digital interventions are less effective than face-to-face ones (73.2%), despite the emerging evidence that being trained in DP is significantly associated with the belief that digital and in-person interventions are comparable in their effectiveness (p ≤ 0.05). Strong positive correlations were found between the knowledge score (KS) and perceived significance index (PSI) (r = 0.148, p < 0.001), and KS and Digital Psychiatry Opinion (DPO) index (r = 0.193, p < 0.001). PSI scores statistically significantly predicted KS total scores (F(1, 237) = 5.283, R² = 0.022, p = 0.022). KS scores statistically significantly predicted DPO total scores (F(1, 237) = 9.136, R² = 0.037, p = 0.003). During the current pandemic, DP represented an ideal response to the forced physical distancing by ensuring the advantage of greater access to care. However, this kind of intervention is still uncommon, and mental health professionals still prove to be skeptical. The lack of formal training on DP during the academic years could be a limiting factor. Full article

(This article belongs to the Collection E-learning and Digital Training in Healthcare Education: Current Trends and New Challenges)

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19 pages, 8856 KiB

Open AccessEditor’s ChoiceArticle

Regression Analysis for COVID-19 Infections and Deaths Based on Food Access and Health Issues

by Abrar Almalki, Balakrishna Gokaraju, Yaa Acquaah and Anish Turlapaty

Healthcare 2022, 10(2), 324; https://doi.org/10.3390/healthcare10020324 - 08 Feb 2022

Cited by 8 | Viewed by 11502

Abstract

COVID-19, or SARS-CoV-2, is considered as one of the greatest pandemics in our modern time. It affected people’s health, education, employment, the economy, tourism, and transportation systems. It will take a long time to recover from these effects and return people’s lives back [...] Read more.

COVID-19, or SARS-CoV-2, is considered as one of the greatest pandemics in our modern time. It affected people’s health, education, employment, the economy, tourism, and transportation systems. It will take a long time to recover from these effects and return people’s lives back to normal. The main objective of this study is to investigate the various factors in health and food access, and their spatial correlation and statistical association with COVID-19 spread. The minor aim is to explore regression models on examining COVID-19 spread with these variables. To address these objectives, we are studying the interrelation of various socio-economic factors that would help all humans to better prepare for the next pandemic. One of these critical factors is food access and food distribution as it could be high-risk population density places that are spreading the virus infections. More variables, such as income and people density, would influence the pandemic spread. In this study, we produced the spatial extent of COVID-19 cases with food outlets by using the spatial analysis method of geographic information systems. The methodology consisted of clustering techniques and overlaying the spatial extent mapping of the clusters of food outlets and the infected cases. Post-mapping, we analyzed these clusters’ proximity for any spatial variability, correlations between them, and their causal relationships. The quantitative analyses of the health issues and food access areas against COVID-19 infections and deaths were performed using machine learning regression techniques to understand the multi-variate factors. The results indicate a correlation between the dependent variables and independent variables with a Pearson correlation R²-score = 0.44% for COVID-19 cases and R² = 60% for COVID-19 deaths. The regression model with an R²-score of 0.60 would be useful to show the goodness of fit for COVID-19 deaths and the health issues and food access factors. Full article

(This article belongs to the Special Issue Socio-Economic Burden of Disease: The COVID-19 Case)

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13 pages, 1126 KiB

Open AccessEditor’s ChoiceArticle

Identifying Cardiovascular Risk Profiles Clusters among Mediterranean Adolescents across Seven Countries

by Riki Tesler, Sharon Barak, Orna Reges, Concepción Moreno-Maldonado, Rotem Maor, Tânia Gaspar, Oya Ercan, Yael Sela, Gizell Green, Avi Zigdon, Adilson Marques, Kwok Ng and Yossi Harel-Fisch

Healthcare 2022, 10(2), 268; https://doi.org/10.3390/healthcare10020268 - 29 Jan 2022

Cited by 6 | Viewed by 3019

Abstract

Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, [...] Read more.

Cardiovascular diseases (CVDs) are the number one cause of death globally and are partially due to the inability to control modifiable lifestyle risk factors. The aim of this study was to analyze the profiles of adolescents from seven Mediterranean countries (Greece, Israel, Italy, Macedonia, Malta, Portugal, Spain) according to their modifiable lifestyle risk factors for CVD (overweight/obesity, physical activity, smoking, alcohol consumption). The sample consisted of 26,110 adolescents (52.3% girls) aged 11, 13, and 15 years who participated in the Health Behavior in School-aged Children (HBSC) survey in 2018 across the seven countries. Sociodemographic characteristics (sex, age, country of residence, socioeconomic status) and CVD modifiable lifestyle risk factors (overweight/obesity, physical activity, smoking, alcohol consumption) were recorded. A two-step cluster analysis, one-way analysis of variance, and chi-square test were performed. Four different cluster groups were identified: two low-risk groups (64.46%), with risk among those with low physical activity levels; moderate-risk group (14.83%), with two risk factors (unhealthy weight and low physical activity level); and a high-risk group (20.7%), which presented risk in all modifiable lifestyle risk factors. Older adolescents reported a higher likelihood of being in the high-risk group. Given that the adolescence period constitutes an important time for interventions aimed at CVD prevention, identifying profiles of moderate- and high-risk adolescents is crucial. Full article

(This article belongs to the Special Issue Child and Adolescent Health: Challenges and Perspectives)

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6 pages, 220 KiB

Open AccessEditor’s ChoiceOpinion

Environment, Environmental Crimes, Environmental Forensic Medicine, Environmental Risk Management and Environmental Criminology

by Michelangelo Bruno Casali, Guido Vittorio Travaini, Carlotta Virginia Di Francesco and Umberto Rosario Genovese

Healthcare 2022, 10(2), 263; https://doi.org/10.3390/healthcare10020263 - 29 Jan 2022

Cited by 1 | Viewed by 2798

Abstract

Forensic medicine has always held the human environment, either seen as a source for pathological agents or the background of judicial events, in great consideration. The concept of the environment has evolved through time, expanding itself to include all the physical and virtual [...] Read more.

Forensic medicine has always held the human environment, either seen as a source for pathological agents or the background of judicial events, in great consideration. The concept of the environment has evolved through time, expanding itself to include all the physical and virtual sub-spaces in which we exist. We can nowadays talk of technoenvironmental reality; virtual spaces exploded because of the COVID-19 pandemic making us come to terms with the fact that those are the places where we work, where we socialize and, even, where we meet our doctors and can be cured. Artificial Intelligence (AI) has contributed to shaping new virtual realities that have got their own rules yet to be discovered, carved and respected. We already fight a daily battle to save our natural environment: along with the danger of green crimes, comes the need for environmental justice and environmental forensic medicine that will probably develop a forensic branch and an experimental branch, to implement our technical culture leading to definition of the real dimension of the risk itself to improve the role of legal medicine in the Environmental Risk Management. While green criminology addresses widespread green crimes, a virtual environment criminology will also develop, maybe with a contribution of AI in the justice field. For a sustainable life, the environmental revolution must rapidly take place, and there is the need for a new justice, a new forensic medicine and a new criminology too. Full article

(This article belongs to the Special Issue New Trends in Forensic and Legal Medicine)

31 pages, 2882 KiB

Open AccessEditor’s ChoiceReview

Current and Future Applications of Artificial Intelligence in Coronary Artery Disease

by Nitesh Gautam, Prachi Saluja, Abdallah Malkawi, Mark G. Rabbat, Mouaz H. Al-Mallah, Gianluca Pontone, Yiye Zhang, Benjamin C. Lee and Subhi J. Al’Aref

Healthcare 2022, 10(2), 232; https://doi.org/10.3390/healthcare10020232 - 26 Jan 2022

Cited by 17 | Viewed by 6708

Abstract

Cardiovascular diseases (CVDs) carry significant morbidity and mortality and are associated with substantial economic burden on healthcare systems around the world. Coronary artery disease, as one disease entity under the CVDs umbrella, had a prevalence of 7.2% among adults in the United States [...] Read more.

Cardiovascular diseases (CVDs) carry significant morbidity and mortality and are associated with substantial economic burden on healthcare systems around the world. Coronary artery disease, as one disease entity under the CVDs umbrella, had a prevalence of 7.2% among adults in the United States and incurred a financial burden of 360 billion US dollars in the years 2016–2017. The introduction of artificial intelligence (AI) and machine learning over the last two decades has unlocked new dimensions in the field of cardiovascular medicine. From automatic interpretations of heart rhythm disorders via smartwatches, to assisting in complex decision-making, AI has quickly expanded its realms in medicine and has demonstrated itself as a promising tool in helping clinicians guide treatment decisions. Understanding complex genetic interactions and developing clinical risk prediction models, advanced cardiac imaging, and improving mortality outcomes are just a few areas where AI has been applied in the domain of coronary artery disease. Through this review, we sought to summarize the advances in AI relating to coronary artery disease, current limitations, and future perspectives. Full article

(This article belongs to the Special Issue Artificial Intelligence (AI) and Machine Learning (ML) in Human Health and Healthcare)

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10 pages, 850 KiB

Open AccessEditor’s ChoiceArticle

Timing to Intubation COVID-19 Patients: Can We Put It Off until Tomorrow?

by Júlio César Garcia de Alencar, Juliana Martes Sternlicht, Alicia Dudy Muller Veiga, Julio Flávio Meirelles Marchini, Juliana Carvalho Ferreira, Carlos Roberto Ribeiro de Carvalho, Izabel Marcilio, Katia Regina da Silva, Vilson Cobello Junior, Marcelo Consorti Felix, Luz Marina Gomez Gomez, Heraldo Possolo de Souza, Denis Deratani Mauá, Emergency USP COVID Group and HCFMUSP COVID-19 Study Group

Healthcare 2022, 10(2), 206; https://doi.org/10.3390/healthcare10020206 - 21 Jan 2022

Cited by 2 | Viewed by 2932

Abstract

Background: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the association between intubation day and [...] Read more.

Background: The decision to intubate COVID-19 patients receiving non-invasive respiratory support is challenging, requiring a fine balance between early intubation and risks of invasive mechanical ventilation versus the adverse effects of delaying intubation. This present study analyzes the association between intubation day and mortality in COVID-19 patients. Methods: We performed a unicentric retrospective cohort study considering all COVID-19 patients consecutively admitted between March 2020 and August 2020 requiring invasive mechanical ventilation. The primary outcome was all-cause mortality within 28 days after intubation, and a Cox model was used to evaluate the effect of time from onset of symptoms to intubation in mortality. Results: A total of 592 (20%) patients of 3020 admitted with COVID-19 were intubated during study period, and 310 patients who were intubated deceased 28 days after intubation. Each additional day between the onset of symptoms and intubation was significantly associated with higher in-hospital death (adjusted hazard ratio, 1.018; 95% CI, 1.005–1.03). Conclusion: Among patients infected with SARS-CoV-2 who were intubated and mechanically ventilated, delaying intubation in the course of symptoms may be associated with higher mortality. Trial registration: The study protocol was approved by the local Ethics Committee (opinion number 3.990.817; CAAE: 30417520.0.0000.0068). Full article

(This article belongs to the Special Issue Pulmonary and Critical Care Medicine)

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10 pages, 957 KiB

Open AccessEditor’s ChoiceConcept Paper

Implementation of Compassionate Communities: The Taipei Experience

by Chia-Jen Liu, Sheng-Jean Huang and Samuel Shih-Chih Wang

Healthcare 2022, 10(1), 177; https://doi.org/10.3390/healthcare10010177 - 17 Jan 2022

Cited by 5 | Viewed by 3214

Abstract

A worldwide movement to empower communities to support their members to care for each other at the end of life (EoL) has emerged since Kellehear published the Compassionate City Charter. This current report discusses the implementation experiences and preliminary outcomes of Compassionate Communities [...] Read more.

A worldwide movement to empower communities to support their members to care for each other at the end of life (EoL) has emerged since Kellehear published the Compassionate City Charter. This current report discusses the implementation experiences and preliminary outcomes of Compassionate Communities (CC) in Taipei City. Using the guidance of the Charter and international experiences, we have developed and multiplied a culturally sensitive, sustainable, and holistic CC program that composes municipal hospital, social, and other services, partnering with community leaders, non-governmental organizations, university students, and volunteers. Innovative campaigns, such as workshops, conferences, and the Life Issue Café, have been delivered to facilitate engagement, public education, and leadership with reverence to folk beliefs and the use of existing social networks. We have identified a model with strong collaborative leadership, high participation rates, and ongoing commitment. The gaps between asking/accepting and providing help were bridged when social connectedness was strengthened. We also integrated home-based medical care, home-based palliative care, and advance care planning to help the vulnerable who live alone, with poor status, or with limited resource access, and continue to support the community throughout the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Public Health Palliative Care and Public Palliative Care Education)

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33 pages, 13277 KiB

Open AccessEditor’s ChoiceArticle

Artificial Intelligence Analysis of Gene Expression Predicted the Overall Survival of Mantle Cell Lymphoma and a Large Pan-Cancer Series

by Joaquim Carreras, Naoya Nakamura and Rifat Hamoudi

Healthcare 2022, 10(1), 155; https://doi.org/10.3390/healthcare10010155 - 14 Jan 2022

Cited by 19 | Viewed by 4128

Abstract

Mantle cell lymphoma (MCL) is a subtype of mature B-cell non-Hodgkin lymphoma characterized by a poor prognosis. First, we analyzed a series of 123 cases (GSE93291). An algorithm using multilayer perceptron artificial neural network, radial basis function, gene set enrichment analysis (GSEA), and [...] Read more.

Mantle cell lymphoma (MCL) is a subtype of mature B-cell non-Hodgkin lymphoma characterized by a poor prognosis. First, we analyzed a series of 123 cases (GSE93291). An algorithm using multilayer perceptron artificial neural network, radial basis function, gene set enrichment analysis (GSEA), and conventional statistics, correlated 20,862 genes with 28 MCL prognostic genes for dimensionality reduction, to predict the patients’ overall survival and highlight new markers. As a result, 58 genes predicted survival with high accuracy (area under the curve = 0.9). Further reduction identified 10 genes: KIF18A, YBX3, PEMT, GCNA, and POGLUT3 that associated with a poor survival; and SELENOP, AMOTL2, IGFBP7, KCTD12, and ADGRG2 with a favorable survival. Correlation with the proliferation index (Ki67) was also made. Interestingly, these genes, which were related to cell cycle, apoptosis, and metabolism, also predicted the survival of diffuse large B-cell lymphoma (GSE10846, n = 414), and a pan-cancer series of The Cancer Genome Atlas (TCGA, n = 7289), which included the most relevant cancers (lung, breast, colorectal, prostate, stomach, liver, etcetera). Secondly, survival was predicted using 10 oncology panels (transcriptome, cancer progression and pathways, metabolic pathways, immuno-oncology, and host response), and TYMS was highlighted. Finally, using machine learning, C5 tree and Bayesian network had the highest accuracy for prediction and correlation with the LLMPP MCL35 proliferation assay and RGS1 was made. In conclusion, artificial intelligence analysis predicted the overall survival of MCL with high accuracy, and highlighted genes that predicted the survival of a large pan-cancer series. Full article

(This article belongs to the Special Issue Artificial Intelligence (AI) and Machine Learning (ML) in Human Health and Healthcare)

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16 pages, 2407 KiB

Open AccessEditor’s ChoiceReview

Effectiveness of Physiotherapy in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

by Luca Pontone Gravaldi, Francesca Bonetti, Simona Lezzerini and Fernando De Maio

Healthcare 2022, 10(1), 132; https://doi.org/10.3390/healthcare10010132 - 10 Jan 2022

Cited by 12 | Viewed by 8321

Abstract

This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were [...] Read more.

This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were searched. Randomised controlled trials (RCTs) on the effectiveness of non-pharmacological interventions supervised by a physiotherapist were compared with usual care or home-based exercise programmes. Two investigators independently screened eligible studies. A total of 12 RCTs satisfied eligible criteria. The risk of bias ranged between medium and high. The meta-analysis results indicated that between supervised physiotherapy and usual care, the former was significantly associated with improvement in disease activity (standardised mean difference = −0.37, 95% CI, −0.64; −0.11; p < 0.001, I² = 71.25%, n = 629), and functional capacity (standardised mean difference = −0.36, 95% CI, −0.61; −0.12, p < 0.05; n = 629). No statistically significant differences emerged when interventions were compared with home-based exercise programmes. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity, and pain in patients with ankylosing spondylitis. No significant improvements emerged when supervised physiotherapy and home-based exercise programmes were compared. Further investigation and RCTs with larger samples are needed. Full article

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

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11 pages, 837 KiB

Open AccessEditor’s ChoiceArticle

Preventable Adverse Events in Obstetrics—Systemic Assessment of Their Incidence and Linked Risk Factors

by Beate Hüner, Christina Derksen, Martina Schmiedhofer, Sonia Lippke, Wolfgang Janni and Christoph Scholz

Healthcare 2022, 10(1), 97; https://doi.org/10.3390/healthcare10010097 - 04 Jan 2022

Cited by 5 | Viewed by 2773

Abstract

(1) Background: Adverse events (AEs) are an inherent part of all medical care. Obstetrics is special: it is characterized by a very high expectation regarding safety and has rare cases of harm, but extremely high individual consequences of harm. However, there is no [...] Read more.

(1) Background: Adverse events (AEs) are an inherent part of all medical care. Obstetrics is special: it is characterized by a very high expectation regarding safety and has rare cases of harm, but extremely high individual consequences of harm. However, there is no standardized identification, documentation, or uniform terminology for the preventability of AEs in obstetrics. In this study, therefore, an obstetrics-specific matrix on the preventable factors of AEs is established based on existing literature to enable standardized reactive risk management in obstetrics. (2) Methods: AEs in obstetrics from one hospital from the year 2018 were retrospectively evaluated according to a criteria matrix regarding preventability. Risk factors for preventable AEs (pAEs) were identified. (3) Results: Out of 2865 births, adverse events were identified in 659 cases (23%). After detailed case analysis, 88 cases (13%) showed at least 1 pAE. A total of 19 risk factors could be identified in 6 categories of pAEs. (4) Conclusion: Preventable categories of error could be identified. Relevant obstetric risk factors related to the error categories were identified and categorized. If these can be modified in the future with targeted measures of proactive risk management, pAEs in obstetrics could also be reduced. Full article

(This article belongs to the Special Issue Pregnancy and Perinatal Health)

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14 pages, 1150 KiB

Open AccessEditor’s ChoiceArticle

Role-Play versus Standardised Patient Simulation for Teaching Interprofessional Communication in Care of the Elderly for Nursing Students

by Alda Elena Cortés-Rodríguez, Pablo Roman, María Mar López-Rodríguez, Isabel María Fernández-Medina, Cayetano Fernández-Sola and José Manuel Hernández-Padilla

Healthcare 2022, 10(1), 46; https://doi.org/10.3390/healthcare10010046 - 27 Dec 2021

Cited by 11 | Viewed by 4675

Abstract

This study aims to describe and compare the effects of standardised patient simulation and role-play in the acquisition and retention of interprofessional communication in elderly care competence amongst nursing students. In this controlled clustered randomised trial, 121 nursing students attended a workshop on [...] Read more.

This study aims to describe and compare the effects of standardised patient simulation and role-play in the acquisition and retention of interprofessional communication in elderly care competence amongst nursing students. In this controlled clustered randomised trial, 121 nursing students attended a workshop on interprofessional communication in elderly care using role-play or standardised patient simulation. The study was conducted between September 2017 and February 2018. Participants’ knowledge, self-efficacy and communication skills were assessed using a simulated scenario at pre-test, post-test and 6-week follow-up points. Between-subject and within-subject differences were measured using counts and proportions of participants who achieved competence. Regardless of the strategy applied, a significant improvement in knowledge, skills, self-efficacy and overall interprofessional communication competence was found between pre-test and post-test. Moreover, there were significant differences between pre-test and follow-up for all the studied variables, but no differences were found between post-test and follow-up. Lastly, when comparing the success rates of both strategies, no significant differences were observed (p > 0.05). In conclusion, standardised patient simulation and role-play have been shown to promote an improvement on knowledge, self-efficacy and interprofessional communication skills in nursing students, although it is not possible to state which strategy is the most adequate for teaching this competency. Full article

(This article belongs to the Collection Aging and Chronic Disease: Experiences, Holisitic Care and Quality of Life)

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9 pages, 587 KiB

Open AccessEditor’s ChoiceArticle

Improving Humanization Skills through Simulation-Based Computers Using Simulated Nursing Video Consultations

by Diana Jiménez-Rodríguez, Mercedes Pérez-Heredia, María del Mar Molero Jurado, María del Carmen Pérez-Fuentes and Oscar Arrogante

Healthcare 2022, 10(1), 37; https://doi.org/10.3390/healthcare10010037 - 26 Dec 2021

Cited by 8 | Viewed by 3033

Abstract

During the COVID-19 confinement, we converted our clinical simulation sessions into simulated video consultations. This study aims to evaluate the effects of virtual simulation-based training on developing and cultivating humanization competencies in undergraduate nursing students. A quasi-experimental study was conducted with 60 undergraduate [...] Read more.

During the COVID-19 confinement, we converted our clinical simulation sessions into simulated video consultations. This study aims to evaluate the effects of virtual simulation-based training on developing and cultivating humanization competencies in undergraduate nursing students. A quasi-experimental study was conducted with 60 undergraduate nursing students. A validated questionnaire was used to evaluate the acquisition of humanization competencies (self-efficacy, sociability, affection, emotional understanding, and optimism). The development of humanization competencies in this group composed of undergraduate nursing students was evaluated using virtual simulation-based training, comparing the levels obtained in these competencies at baseline (pre-test) and after the virtual simulation experience (post-test). After the virtual simulation sessions, students improved their levels in humanization total score and the emotional understanding and self-efficacy competencies, obtaining large effects sizes in all of them (rB = 0.508, rB = 0.713, and rB = 0.505 respectively). This virtual simulation modality enables training in the humanization of care with the collaboration of standardized patients in the form of simulated nursing video consultations and the performance of high-fidelity simulation sessions that comply with the requirements of best practices. Therefore, this methodology could be considered as another choice for virtual simulation. Additionally, this virtual modality could be a way to humanize virtual simulation. Full article

(This article belongs to the Collection E-learning and Digital Training in Healthcare Education: Current Trends and New Challenges)

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13 pages, 1556 KiB

Open AccessEditor’s ChoiceReview

International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review

by Marco Tramontano, Federica Tamburella, Fulvio Dal Farra, Andrea Bergna, Christian Lunghi, Mattia Innocenti, Fabio Cavera, Federica Savini, Vincenzo Manzo and Giandomenico D’Alessandro

Healthcare 2022, 10(1), 28; https://doi.org/10.3390/healthcare10010028 - 24 Dec 2021

Cited by 23 | Viewed by 7718

Abstract

Background: Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person’s self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in [...] Read more.

Background: Osteopathic manipulative treatment (OMT) is a patient-centred, whole-body intervention aimed at enhance the person’s self-regulation. OMT interventions are focused on somatic dysfunctions (SD) that can be defined as an altered regulative function associated with inflammatory signs palpable in the body framework in different body regions. The conceptual model that sustains SD, as well as its usefulness for the osteopathic profession, is still being discussed by the osteopathic community. Understanding the role and the application of SD is the aim of this scoping review. Methods: A literature search was carried out through the main biomedical databases: Pubmed (Medline), Cochrane, Central (Cochrane), Embase, PEDro and Scopus. Grey literature was considered via Google Scholar and the Osteopathic Research Web. The review was prepared by referring to the “Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews” (PRISMA-ScR). Results: A total of 37,279 records were identified through database searching and other sources. After the duplicates were removed, 27,023 titles and abstracts were screened. A total of 1495 full-text articles were assessed for eligibility. The qualitative synthesis included 280 studies. Conclusions: Treating SD is an important part of osteopathic practice that varies from country to country. SD should be considered as a clinical value that assists in the clinical assessment and guides the decision-making process of osteopathic practitioners. Further studies should be designed to better understand why and how to choose the different assessment and intervention modalities to approach SD and to evaluate new osteopathic models. Full article

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

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