Impact of Globalization on Healthcare

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Topic Information

Dear Colleagues,

Globalization has a dramatic impact on healthcare systems and health outcomes. The effect of globalization on health systems and individuals is complex. The impact of globalization has dual effects, both positive and negative. and the impacts need to be well valued. Globalization has shown potential positive impacts by minimizing the gaps in health inequalities between rich and poor people, between the Global South and North, and by improving healthcare for all. However, there are also downsides to global health, such as the spread of infectious diseases due to rapid mobility, which is emerging as the greatest threat to all. Under the umbrella of globalization and its impact, other systems beyond human health should not be neglected, such as the impact on animal health and/or ecosystem health and their impact on human health.

Nevertheless, globalization is neither inherently good nor bad, but rather an inexorable force that needs to be understood and channeled for the ecosystem's wellbeing. As we have understood globalization beyond economic development, such as institutional, sociocultural, and environmental transitions, this would be the right time to value its understanding of healthcare impacts. Thus, this Topic invites innovative articles on diverse aspects of globalization and its impact on health, which are not restricted to the below thematic areas:

Theme 1: Globalizing healthcare leadership;
Theme 2: Decolonizing healthcare and health services;
Theme 3: Governing universal health coverage;
Theme 4: Promoting human–animal–environment wellbeing and ecosystem sustainability;
Theme 5: Globalizing policies for healthcare.

The themes mentioned above are framed with reference to any diseases of concern (non-communicable and/or infectious, including COVID-19); however. manuscripts which are pushing inter- and/or transdisciplinary science by applying new conceptual thinking to theoretical models, current methods, and policy efforts are preferred. In addition, innovations on Sustainable Development Goals and interlinkages to Goal 3 with potential impacts due to globalization are of particular interest, as long as they showcase national or regional efforts and identify current gaps in the health impacts of globalization and identify strategies on how to address them. We are interested in full-length manuscripts based on original research, systematic reviews, methodological advances, or policy analyses.

Prof. Dr. Joachim G. Voss
Dr. Sandul Yasobant
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
International Journal of Environmental Research and Public Health ijerph	-	5.4	2004	29.6 Days	CHF 2500
Healthcare healthcare	2.8	2.7	2013	19.5 Days	CHF 2700
Medicina medicina	2.6	3.6	1920	19.6 Days	CHF 1800

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Published Papers (37 papers)

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12 pages, 1544 KiB  

Open AccessSystematic Review

Effect of the Helping Babies Breathe Program on Newborn Outcomes: Systematic Review and Meta-Analysis

by Sergio Agudelo-Pérez, Annie Cifuentes-Serrano, Paula Ávila-Celis and Henry Oliveros

Medicina 2022, 58(11), 1567; https://doi.org/10.3390/medicina58111567 - 31 Oct 2022

Cited by 2 | Viewed by 1859

Abstract

Background and objectives: In low- and middle-income countries, the leading cause of neonatal mortality is perinatal asphyxia. Training in neonatal resuscitation has been shown to decrease this cause of mortality. The program “Helping Babies Breathe” (HBB) is a program to teach basic neonatal [...] Read more.

Background and objectives: In low- and middle-income countries, the leading cause of neonatal mortality is perinatal asphyxia. Training in neonatal resuscitation has been shown to decrease this cause of mortality. The program “Helping Babies Breathe” (HBB) is a program to teach basic neonatal resuscitation focused on countries and areas with limited economic resources. The aim of the study was to determine the effect of the implementation of the HBB program on newborn outcomes: mortality and morbidity. Material and Methods: A systematic review was carried out on observational studies and clinical trials that reported the effect of the implementation in low- and middle-income countries of the HBB program on neonatal mortality and morbidity. We carried out a meta-analysis of the extracted data. Random-effect models were used to evaluate heterogeneity, using the Cochrane Q and I2 tests, and stratified analyses were performed by age and type of outcome to determine the sources of heterogeneity. Results: Eleven studies were identified. The implementation of the program includes educational strategies focused on the training of doctors, nurses, midwives, and students of health professions. The poled results showed a decrease in overall mortality (OR 0.67; 95% CI 0.57, 0.80), intrapartum stillbirth mortality (OR 0.62; 95% CI 0.51, 0.75), and first-day mortality (OR 0.70; 95% IC 0.64, 0.77). High heterogeneity was found, which was partly explained by differences in the gestational age of the participants. Conclusions: The implementation of the program HBB in low- and medium-income countries has a significant impact on reducing early neonatal mortality. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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5 pages, 1290 KiB  

Open AccessCase Report

Successful Interventional Management of Life-Threatening Bleeding after Oocyte Retrieval: A Case Report and Review of the Literature

by Hiroyuki Tokue, Azusa Tokue and Yoshito Tsushima

Medicina 2022, 58(11), 1534; https://doi.org/10.3390/medicina58111534 - 27 Oct 2022

Viewed by 1287

Abstract

Life-threatening bleeding after oocyte retrieval is unusual. We report a case of massive vaginal bleeding requiring transcatheter arterial embolization (TAE) after transvaginal US-directed follicle aspiration for oocyte retrieval and provide a brief review of cases in which the pseudoaneurysm of the injured artery [...] Read more.

Life-threatening bleeding after oocyte retrieval is unusual. We report a case of massive vaginal bleeding requiring transcatheter arterial embolization (TAE) after transvaginal US-directed follicle aspiration for oocyte retrieval and provide a brief review of cases in which the pseudoaneurysm of the injured artery was managed with a TAE approach. A 40-year-old woman presented massive vaginal bleeding after transvaginal ultrasonography-directed follicle aspiration for oocyte retrieval. Contrast-enhanced computed tomography revealed active bleeding from the uterine ostium. Transcatheter arterial embolization was performed for a pseudoaneurysm of the right pudendal artery to manage the hemorrhage. Potentially life-threatening bleeding should be recognized as a rare complication after oocyte retrieval to promptly establish the diagnosis and preserve the uterus. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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15 pages, 1170 KiB  

Open AccessArticle

Illness Perceptions and Self-Management among People with Chronic Lung Disease and Healthcare Professionals: A Mixed-Method Study Identifying the Local Context

by Xiaoyue Song, Cynthia Hallensleben, Bo Li, Weihong Zhang, Zongliang Jiang, Hongxia Shen, Robbert J. J. Gobbens, Niels H. Chavannes and Anke Versluis

Healthcare 2022, 10(9), 1657; https://doi.org/10.3390/healthcare10091657 - 30 Aug 2022

Cited by 1 | Viewed by 2210

Abstract

Self-management interventions (SMIs) may fail if they misalign with the local context. To optimize the implementation of SMIs in Chinese people with chronic lung disease (CLD), the local context was identified in Chinese primary care (PC) and secondary care (SC). A mixed-method study [...] Read more.

Self-management interventions (SMIs) may fail if they misalign with the local context. To optimize the implementation of SMIs in Chinese people with chronic lung disease (CLD), the local context was identified in Chinese primary care (PC) and secondary care (SC). A mixed-method study using semi-structured interviews and quantitative surveys was conducted on people with CLD and healthcare professionals (HCPs). The qualitative data was collected until data saturation was reached, and participants were invited to complete the survey after the interview. The qualitative data—analyzed with the framework approach—was triangulated with the quantitative data. A total of 52 participants completed the interviews, and 48 also finished the survey. Four themes were identified; (a) illness perceptions (e.g., patients had poor CLD knowledge and SM, inadequate resources lead to suboptimal disease control in PC); (b) self-management skills (e.g., most patients delayed exacerbation recognition and action, and some were admitted at the crisis point); (c) factors influencing self-management skills (e.g., (in)adequate disease knowledge and medical expenditure affordability); and (d) needs for self-management (e.g., increased disease knowledge, individualized self-management plan, eHealth, (healthcare insurance) policy support). Identified themes were dependent on each other and should be leveraged when implementing SMIs. Ultimately, such SMIs can optimize patient health outcomes. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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14 pages, 283 KiB  

Open AccessArticle

Socio-Economic and Demographic Factors Associated with Knowledge and Attitude of HIV/AIDS among Women Aged 15–49 Years Old in Indonesia

by Feny Deya Virdausi, Ferry Efendi, Tiyas Kusumaningrum, Qorinah Estiningtyas Sakilah Adnani, Lisa McKenna, Kadar Ramadhan and Ika Adelia Susanti

Healthcare 2022, 10(8), 1545; https://doi.org/10.3390/healthcare10081545 - 15 Aug 2022

Cited by 6 | Viewed by 2171

Abstract

Women’s susceptibility to HIV/AIDS infection is related to socio-economic and demographic factors. This study sought to analyze socio-economic and demographic factors related to knowledge and attitude of HIV/AIDS among women aged 15–49 years old in Indonesia. We conducted a secondary data analysis using [...] Read more.

Women’s susceptibility to HIV/AIDS infection is related to socio-economic and demographic factors. This study sought to analyze socio-economic and demographic factors related to knowledge and attitude of HIV/AIDS among women aged 15–49 years old in Indonesia. We conducted a secondary data analysis using the 2017 Indonesian Demographic and Health Survey (IDHS). Among 49,627 women, our study analyzed 25,895 women aged 15–49 years familiar with HIV terminology. Multiple logistic regression was utilized to analyze associations between socio-economic and demographic factors with knowledge and attitudes toward HIV/AIDS. Women’s age, education level, wealth quintile, residential area and region, access to information, owning cell phones and autonomy were significantly associated with positive knowledge and attitudes toward HIV/AIDS. These findings revealed that several demographical and social factors contribute to knowledge and attitudes toward HIV/AIDS among women aged 15–49 years in Indonesia. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

15 pages, 1126 KiB  

Open AccessArticle

From Health Campaign to Interpersonal Communication: Does Traditional Diet Culture Hinder the Communication of the Chinese Gongkuai Campaign?

by Jing Yan, Jing Ji and Lan Gao

Int. J. Environ. Res. Public Health 2022, 19(16), 9992; https://doi.org/10.3390/ijerph19169992 - 13 Aug 2022

Cited by 4 | Viewed by 1804

Abstract

Interpersonal communication is beneficial in promoting individuals’ tendency to accept health-campaign-targeted behavior. Based on the protective action decision model, this study investigated the key factors underlying individual’s interpersonal communication on the Gongkuai campaign, which was carried out during Coronavirus disease 2019 (COVID-19). The [...] Read more.

Interpersonal communication is beneficial in promoting individuals’ tendency to accept health-campaign-targeted behavior. Based on the protective action decision model, this study investigated the key factors underlying individual’s interpersonal communication on the Gongkuai campaign, which was carried out during Coronavirus disease 2019 (COVID-19). The main goal of the Gongkuai campaign was to change traditional communal eating habits and reduce public health risks. An online questionnaire survey involving 618 respondents was conducted in China after the 2020 Gongkuai campaign propagated, and the data were analyzed by using the structural equation modeling technique. The results indicated that health campaign exposure is a critical determinant of perceived campaign-related knowledge and health risk perception, which are significant predictors of interpersonal communication. Meanwhile, campaign-related knowledge can elicit risk perception. Furthermore, campaign exposure influenced interpersonal communication in ways that traditional diet culture did not predict. Risk perception was also unaffected by traditional diet culture. It is worth noting that individuals’ agreement with traditional diet culture does not hinder health campaign-generated interpersonal communication in the context of public health crisis. Based on the findings, theoretical and policy implications for motivating interpersonal communication were discussed, and research limitations were pointed out. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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12 pages, 378 KiB  

Open AccessArticle

How Do Health Teams Perceive International Migrant Users of Primary Care?

by Consuelo Cruz-Riveros, Alfonso Urzúa, Gustavo Macaya-Aguirre and Báltica Cabieses

Int. J. Environ. Res. Public Health 2022, 19(16), 9940; https://doi.org/10.3390/ijerph19169940 - 12 Aug 2022

Cited by 2 | Viewed by 1591

Abstract

The following study aims to describe the perception of international migrants who use the primary level of care by health personnel and to explore how this perception can affect the care process in the commune of Antofagasta, north of Chile. Methodology: The methodology [...] Read more.

The following study aims to describe the perception of international migrants who use the primary level of care by health personnel and to explore how this perception can affect the care process in the commune of Antofagasta, north of Chile. Methodology: The methodology was qualitative using a phenomenological descriptive design, through which the discourses of the health personnel of three primary health care centers (n = 14) were explored. Results: The participants presented two thematic categories. The first one related to experiences during delivery of care to migrants and included perceptions and beliefs, factors associated with using services, and reasons for consultation. The second category related to stereotypes towards migrants, including prejudices, beliefs about their lives and reasons for migration. Conclusions: The therapeutic relationship with migrants in primary care depends on the health care personnel’s acceptability of this population, hence, allowing the delivery of care based on respect for their culture and rights. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

20 pages, 1275 KiB  

Open AccessArticle

Validation of the Spanish Version of the Questionnaire on Environmental Awareness in Nursing (NEAT)

by Olga María Luque-Alcaraz, Antonio Gomera, África Ruíz, Pilar Aparicio-Martinez and Manuel Vaquero-Abellan

Healthcare 2022, 10(8), 1420; https://doi.org/10.3390/healthcare10081420 - 29 Jul 2022

Cited by 2 | Viewed by 2132

Abstract

Environmental awareness of the ecological problems caused by this climate crisis and its impact on global health has been growing globally. Nurses are health care agents that usually hurt the environment and contribute to the unsustainability of the care system. Such behavior is [...] Read more.

Environmental awareness of the ecological problems caused by this climate crisis and its impact on global health has been growing globally. Nurses are health care agents that usually hurt the environment and contribute to the unsustainability of the care system. Such behavior is perpetuated without the nurses’ awareness and is even magnified by the current pandemic, jeopardizing the health systems and the Sustainable Development Goals. However, there is no Spanish version of any survey that measures the awareness of these agents, only the Nurses Environmental Awareness Tool (NEAT) is available. The current research presents a unique investigation based on a mixed method, using the Spanish version of the NEAT, also called NEAT-es. The results of the mixed analysis (N = 376), a cognitive interview, and descriptive analysis indicated perfect consistency (Cronbach’s alpha > 0.80), better than the original. The survey validation achieved higher values and can be used to measure environmental awareness in Spain and Spanish-speaking countries. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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11 pages, 572 KiB  

Open AccessArticle

Development and Psychometric Testing of a Taiwanese Team Interactions and Team Creativity Instrument (TITC-T) for Nursing Students

by Hsing-Yuan Liu, Su-Ching Sung, Chun-Yen Chao, Nai-Hung Chen, Hsiu-Fang Chen and Sheau-Ming Wu

Int. J. Environ. Res. Public Health 2022, 19(13), 7958; https://doi.org/10.3390/ijerph19137958 - 29 Jun 2022

Cited by 3 | Viewed by 1495

Abstract

Background: How well team members work together can be affected by team interactions and creativity. There is no single instrument for measuring both variables in healthcare education settings in Taiwan. The purpose of this study is to develop an instrument to measure team [...] Read more.

Background: How well team members work together can be affected by team interactions and creativity. There is no single instrument for measuring both variables in healthcare education settings in Taiwan. The purpose of this study is to develop an instrument to measure team interactions and team creativity for Taiwanese nursing students. Methods: A 34-item team interactions and team creativity self-report instrument was developed for nursing students in Taiwan (TITC-T). Items consisted of statements about how a participant perceived their team members’ constructive controversy, helping behaviors, communication, and creativity. Nursing students (n = 275) were recruited from two campuses of a science and technology university to examine the psychometric properties of the TITC-T. The reliability and psychometric properties were evaluated. Results: The Cronbach’s alpha was 0.98. The confirmatory factor analysis resulted in a one-dimensional factor structure that fit well with the model (Comparative Fit Index = 0.995, Tucker Lewis Index = 0.908, Root Mean Square Error of Approximation = 0.098). Conclusions: The TITC-T is a valid and reliable tool for evaluating team interactions and team creativity for students enrolled in nursing programs in Taiwan. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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15 pages, 1382 KiB  

Open AccessArticle

Association of Hospital Characteristics and Previous Hospitalization-Related Experiences with Patients’ Perceptions of Hospital Care in China

by Yufan Wang, Beizhu Ye, Yimei Zhu, Xiaoyu Wang and Yuan Liang

Int. J. Environ. Res. Public Health 2022, 19(13), 7856; https://doi.org/10.3390/ijerph19137856 - 27 Jun 2022

Viewed by 1569

Abstract

Patients’ perceptions of healthcare vary over time and by setting, and previous studies have rarely focused on these factors. We aimed to measure patients’ perceptions of hospital care in China and to examine how patients’ perceptions of hospital care vary by hospital characteristics [...] Read more.

Patients’ perceptions of healthcare vary over time and by setting, and previous studies have rarely focused on these factors. We aimed to measure patients’ perceptions of hospital care in China and to examine how patients’ perceptions of hospital care vary by hospital characteristics (differences in setting) and previous hospitalization-related experiences (changes with time). We conducted a national cross-sectional survey of 7267 inpatients between July 2014 and April 2015 in China. Hospital characteristics measured were hospital technical level, hospital type, teaching status, and the ratio of doctors/nurses to ward beds. Previous hospitalization-related experiences measured were current admission length, number of previous admissions, and hospital selection (hospital advertisements or personal recommendations). Patients’ perceptions of hospital care included perceptions of doctors, nurses, and hospital organization. Scores were highest for perceptions of nurses, followed by perceptions of doctors, and hospital organization. Of the five hospital characteristics rated, the technical level was most strongly associated with patient perceptions of healthcare. The effect of hospital admission length and frequency of hospitalization on patients’ perceptions was represented by a √-shaped dose–response curve (scores were initially high, then decreased, then rebounded to higher than the initial scores). Patients who selected a hospital with hospital advertisements gave lower scores than those without hospital advertisements, and patients who selected a hospital with personal recommendations gave higher scores than those without If the observed √-shaped dose–response curves indicate a causal relationship between patients’ perceptions and hospital admission length or frequency of hospitalization, this may help to guide the timing of patient satisfaction assessments. The negative association between patient perception and advertising, and the positive association with personal recommendations (word-of-mouth) and hospital technical level, could provide important information for clinicians and hospital administrators. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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14 pages, 1201 KiB  

Open AccessArticle

Tuberculosis among People Living on the Street and Using Alcohol, Tobacco, and Illegal Drugs: Analysis of Territories in Extreme Vulnerability and Trends in Southern Brazil

by Alessandro Rolim Scholze, Josilene Dália Alves, Thaís Zamboni Berra, Antônio Carlos Vieira Ramos, Flávia Meneguetti Pieri, Sandra Cristina Pillon, Júlia Trevisan Martins, Maria José Quina Galdino, Emiliana Cristina Melo, Felipe Mendes Delpino, Ariela Fehr Tártaro, Inês Fronteira and Ricardo Alexandre Arcêncio

Int. J. Environ. Res. Public Health 2022, 19(13), 7721; https://doi.org/10.3390/ijerph19137721 - 23 Jun 2022

Cited by 4 | Viewed by 1850

Abstract

(1) Background: Tuberculosis presents an epidemiological trend toward inequality, especially among people in social exclusion and situations of vulnerability. This study aimed to analyze territories with a concentration of people diagnosed with tuberculosis in a street situation and who partake in chronic use [...] Read more.

(1) Background: Tuberculosis presents an epidemiological trend toward inequality, especially among people in social exclusion and situations of vulnerability. This study aimed to analyze territories with a concentration of people diagnosed with tuberculosis in a street situation and who partake in chronic use of alcohol, tobacco, and illicit drugs. We also analyzed trends in this health condition in southern Brazil. (2) Methods: Ecological study, developed in the 399 municipalities of Paraná, southern Brazil, with all tuberculosis cases in the homeless population registered in the Information System of Notifiable Diseases between 2014 and 2018. For data analysis, we used descriptive statistics, the Prais–Winsten autoregression method for the time series, and the Getis-Ord Gi technique* for spatial analysis. (3) Results: in total, 560 cases were reported. We found a predominance of alcohol, smoking, and illicit drug users, with an increasing trend in the state and clusters of spatial risk in the East health macro-region. (4) Conclusions: We observed territories with critical levels of highly vulnerable people who use psychoactive substances and are in a street situation. The results highlight the importance of incorporating public policies of social protection for these individuals and resolutive health services that receive these cases and assist in eradicating TB. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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12 pages, 278 KiB  

Open AccessArticle

Exploring Healthcare Professionals’ Practices and Attitudes towards Monitoring and Reporting of Severe Adverse Drug Reactions

by Warisara Srisuriyachanchai, Anthony R. Cox and Narumol Jarernsiripornkul

Healthcare 2022, 10(6), 1077; https://doi.org/10.3390/healthcare10061077 - 10 Jun 2022

Cited by 7 | Viewed by 1905

Abstract

Healthcare professionals (HCPs) play a key role in the monitoring of severe adverse drug reactions (ADRs). The present study aims to explore practices and barriers of HCPs in severe ADR monitoring and reporting, to evaluate their attitudes towards the monitoring and to assess [...] Read more.

Healthcare professionals (HCPs) play a key role in the monitoring of severe adverse drug reactions (ADRs). The present study aims to explore practices and barriers of HCPs in severe ADR monitoring and reporting, to evaluate their attitudes towards the monitoring and to assess the related factors. Self-administered questionnaires produced in hard copy and Google form were sent to 510 HCPs by stratified random sampling. Of the 350 HCPs that responded (68.6%), 44.9% had ever monitored ADRs. The most common practices were the observation of abnormal symptoms for ADR identification (88.5%), discontinuation of the suspected drug for ADR management (88.5%) and advice on recurrent drug allergy for ADR prevention (88.5%). Most HCPs (93.0%) obtained further patient history to identify severe ADRs. The uncertainty of the causal relationship was a major barrier to ADR reporting (60.0%). Pharmacists were more involved with practices in ADR monitoring and reporting (OR 20.405; p < 0.001), whereas longer work experience (>20 years) was negatively related to the practices (OR 0.271; p = 0.024). Over one-third (37.6%) of HCPs had a positive attitude towards severe ADR monitoring. In conclusion, the practices in severe ADR monitoring varied among different professions. However, the barriers to the reporting of ADRs still exist; hence, improving knowledge and cooperation among HCPs should be promoted. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

14 pages, 2917 KiB  

Open AccessArticle

Study on Associating Emotions in Verbal Reactions to Facial Expressions in Dementia

by SungHo Hwang, JiWon Hwang and HyeonCheol Jeong

Healthcare 2022, 10(6), 1022; https://doi.org/10.3390/healthcare10061022 - 01 Jun 2022

Cited by 1 | Viewed by 1795

Abstract

The purpose of this study was to provide basic data on cognitive therapy and to improve social support programs for the elderly with dementia by identifying the difficulties they experienced in emotional communication by identifying how they recognized emotions in verbal reactions to [...] Read more.

The purpose of this study was to provide basic data on cognitive therapy and to improve social support programs for the elderly with dementia by identifying the difficulties they experienced in emotional communication by identifying how they recognized emotions in verbal reactions to facial expressions using Ekman’s photographs of facial expressions and comparing their responses with the general elderly population. There were 141 participants in this study. Data collection was conducted from 3 April 2019 to 30 June 2019 in Seoul, in the Gyeonggi-do and Gangwon-do provinces of South Korea. This study performed descriptive research in which subjects made participative decisions with their guardian through recruitment. The tools used in this study included a general characteristic questionnaire and the Ekman 6 facial expressions photographs tool, which underwent intensive validity studies. The collected data were analyzed using the R version 3.5.1 statistic computing platform. The ability of the elderly with dementia to associate verbal expressions with facial expressions differed from that of the general elderly population. The rates of correct associations of verbal expressions to facial expressions were similar across dementia grades. There was a significant difference in the proportion of correct associations between positive and negative emotions in the elderly with dementia compared to the general elderly population. In the elderly with dementia, pictures showing fear, anger, and disgust had higher wrong rates of incorrect answers than correct answers. The average score of elderly with dementia in associating verbal expressions with six facial expressions was 2.69, which was even lower when they were asked to associate verbal expressions with pictures showing facial expressions of anger or disgust. This study shows that elderly persons with dementia have difficulties identifying two negative emotions (anger, disgust) and find it much easier to identify a positive emotion of happiness represented by a smiling face. Since the ability of the elderly with dementia to interpret verbal expressions to facial expressions was different from that of the general elderly population, careful attention and consideration are needed to support and communicate emotions to the elderly with dementia. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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11 pages, 397 KiB  

Open AccessArticle

Development of Leisure Valuation Assessment Tool for the Elderly

by Da Sol Park and Hae Yean Park

Int. J. Environ. Res. Public Health 2022, 19(11), 6678; https://doi.org/10.3390/ijerph19116678 - 30 May 2022

Cited by 2 | Viewed by 1841

Abstract

This study aimed to develop a leisure valuation assessment tool to revitalize leisure activities for the elderly living in the community. The research method, literature review, and Delphi survey were conducted for the expert panel. Then, the leisure value and participatory leisure activity [...] Read more.

This study aimed to develop a leisure valuation assessment tool to revitalize leisure activities for the elderly living in the community. The research method, literature review, and Delphi survey were conducted for the expert panel. Then, the leisure value and participatory leisure activity items were derived to form the assessment items. The two Delphi surveys revealed 38 leisure value assessment items and 41 participating leisure activity items. We attempted to verify the model suitability and validity of the leisure value assessment items through confirmatory factor analysis. The verification showed a good fit. Based on the intensive validity test result, AVE (average variance extracted) values were 66 for physical leisure activities, 65 for emotional leisure activities, and 65 for social leisure activities. The conceptual reliability was 0.96 for physical leisure activities, 0.95 for emotional leisure activities, and 0.96 for social leisure activities. Regarding the internal consistency for reliability verification, Cronbach’s alpha values for physical leisure, emotional leisure, and social leisure activities were 0.909, 0.925, and 0.955, respectively. Hence, the items were highly interrelated and homogeneous tests that measured the same characteristics. The assessment tool can be used to identify useful information on the leisure activities of the elderly and to activate leisure activities for the elderly. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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13 pages, 774 KiB  

Open AccessArticle

Utilization of Postnatal Care Services among Thai Women during the COVID-19 Pandemic: Results of a Web-Based Survey

by Yin Min Aye, Soo Jung Kim, Wichukorn Suriyawongpaisal, Seo Ah Hong and Yan-Shing Chang

Int. J. Environ. Res. Public Health 2022, 19(11), 6536; https://doi.org/10.3390/ijerph19116536 - 27 May 2022

Viewed by 2788

Abstract

The postnatal period is an underserved aspect of maternity care, potentially worsened by the COVID-19 pandemic. This study aims to identify postnatal care (PNC) use by health personnel within the 42 days of childbirth among postpartum mothers in Thailand. This web-based, cross-sectional study [...] Read more.

The postnatal period is an underserved aspect of maternity care, potentially worsened by the COVID-19 pandemic. This study aims to identify postnatal care (PNC) use by health personnel within the 42 days of childbirth among postpartum mothers in Thailand. This web-based, cross-sectional study was conducted from July to October 2021 (n = 840). Multiple binary and ordinal logistic regressions were conducted to predict three outcome variables (≥2 times, ≥3 times, or level of PNC use). Women who received PNC were in low numbers (≥2: 30.7% and (≥3: 12.9%), while 54.4% of women reported no barriers to access PNC, and 31.9% reported barriers, including worries over COVID-19 infection, followed by movement restrictions imposed by the government (11.7%) and the closure of healthcare centers (10%). Women working in a self-employed capacity, living in urban areas, and undergoing a Caesarean section with no/less worry about COVID-19 infection were more likely to utilize postnatal care (≥2 or number of PNC). This study provides timely information, revealing that a relatively low percentage of postpartum women received PNC, particularly among the socially deprived group. Since the fear of COVID infection is listed as a major barrier, the provision of PNC services, including a telehealth program should be considered. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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11 pages, 371 KiB  

Open AccessArticle

Quality of Work Life and Work Process of Assistance Nurses

by Denisse Parra-Giordano, Denisse Quijada Sánchez, Patricia Grau Mascayano and Daniela Pinto-Galleguillos

Int. J. Environ. Res. Public Health 2022, 19(11), 6415; https://doi.org/10.3390/ijerph19116415 - 25 May 2022

Cited by 5 | Viewed by 2068

Abstract

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL [...] Read more.

Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. The work process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

12 pages, 325 KiB  

Open AccessArticle

Competency and Related Factors in Preventing Emerging Infectious Diseases among Nurses in Long-Term Care Facilities in Taiwan

by Po-Jen Kung and Ching-Min Chen

Healthcare 2022, 10(5), 894; https://doi.org/10.3390/healthcare10050894 - 12 May 2022

Cited by 2 | Viewed by 1485

Abstract

Emerging infectious diseases (EIDs) are a considerable threat to health, particularly in long-term care facilities (LTCFs), where residents are especially vulnerable. Nurses’ competency in EID prevention is crucial to minimize the adverse effects of EIDs in LTCFs. This study investigated nurses’ competency and [...] Read more.

Emerging infectious diseases (EIDs) are a considerable threat to health, particularly in long-term care facilities (LTCFs), where residents are especially vulnerable. Nurses’ competency in EID prevention is crucial to minimize the adverse effects of EIDs in LTCFs. This study investigated nurses’ competency and related factors in EID prevention in LTCFs in Tainan, Taiwan. A cross-sectional design was employed, and nurses were recruited to complete an online survey examining the knowledge, attitude, and skills required to prevent EIDs in LTCFs. A total of 235 nurses completed the survey. The equivalent score index (SI) for knowledge regarding EID prevention was 68, indicating that the nurses did not have adequate knowledge regarding EID prevention. In contrast, the equivalent SI for the subscale of attitudes toward EID prevention was 78, indicating that the nurses exhibited moderately to highly positive attitudes toward EID prevention. However, they rated themselves as being highly skilled in EID prevention, corresponding to an equivalent SI of 91. Perceived supervisors’ approval, marital status, attitudes toward EID prevention, EID prevention skills, knowledge regarding EIDs, and being in charge of infectious disease prevention were significant predictors of the nurses’ competency. LTCF nurses, especially those working in nursing homes, should enhance their knowledge regarding EID prevention. These findings may help improve nurses’ competency in preventing EIDs by encouraging the integration of practice strategies, education, research, and policy recommendations to eliminate EIDs in LTCFs. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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12 pages, 1110 KiB  

Open AccessArticle

The Relationship between Korean Parents’ Smartphone Addiction and That of Their Children: The Mediating Effects of Children’s Depression and Social Withdrawal

by Shin-Il Lim and Sookyung Jeong

Int. J. Environ. Res. Public Health 2022, 19(9), 5593; https://doi.org/10.3390/ijerph19095593 - 05 May 2022

Cited by 7 | Viewed by 3069

Abstract

With the number of smartphone users growing around the world, children are using smartphones from an increasingly early age. Consequently, a significant number of children are being exposed to the risk of smartphone addiction, which is emerging as a serious social problem. Smartphone [...] Read more.

With the number of smartphone users growing around the world, children are using smartphones from an increasingly early age. Consequently, a significant number of children are being exposed to the risk of smartphone addiction, which is emerging as a serious social problem. Smartphone addiction can negatively impact children’s physical, cognitive, and social development. Previous studies have demonstrated that parental smartphone addiction influences that of their children. Therefore, this study explores the relationship between parental smartphone addiction and children’s smartphone addiction and the mediating effects of children’s depression and social withdrawal. Data are drawn from National Youth Policy Institute’s 2018 Korean Children and Youth Panel Survey. Respondents comprise 2011 fourth-grade elementary school students and their parents. Data were analyzed using SPSS version 21.0 and AMOS 21.0 software. Results show that the relationship between parental smartphone addiction and that of their children has a significantly positive mediating effect on children’s social withdrawal, but no such effect on children’s depression and there were no serial effects of children’s depression and social withdrawal. Consequently, educational programs that control parents’ smartphone usage, improve the parent–child relationship, and engender social sensitivity should be developed to reduce and prevent smartphone addiction among children. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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9 pages, 263 KiB  

Open AccessArticle

Satisfaction with the Care Received and the Childbirth and Puerperium Experience in Christian and Muslim Pregnant Women

by Francisco Javier Fernández-Carrasco, Gustavo Adolfo Silva-Muñoz, Juana María Vázquez-Lara, Juan Gómez-Salgado, Juan Jesús García-Iglesias and Luciano Rodríguez-Díaz

Healthcare 2022, 10(4), 725; https://doi.org/10.3390/healthcare10040725 - 13 Apr 2022

Cited by 2 | Viewed by 1986

Abstract

Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth [...] Read more.

Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth assistance an extremely important priority in recent years. The aim of this study was to assess the satisfaction and experience during childbirth and the postpartum period in pregnant women according to their religion after assistance in a tertiary hospital. A descriptive cross-sectional study was conducted on a sample of 242 women using the validated Spanish version of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) to measure satisfaction with the childbirth experience during the months of January to April 2021. Statistically significant differences were found in the domains of birth satisfaction (p < 0.01), satisfaction with the obstetrician (p < 0.01), and perception of pain during labour (p < 0.01). The Christian group of women scored higher in these three domains as compared to the Muslim group. The rate of breastfeeding at birth was 5.26 times higher among the Muslim group compared to the Christian group (p = 0.02). The experience of childbirth and the puerperium significantly influenced the levels of satisfaction of pregnant women with the process of childbirth in a different way according to the religious culture of the patient. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

10 pages, 323 KiB  

Open AccessArticle

Development of the Psychological Capital Scale for Male Nursing Students in Taiwan and Testing Its Measurement Invariance between Genders

by Jiunnhorng Lou, Renhau Li and Shuling Chen

Int. J. Environ. Res. Public Health 2022, 19(6), 3620; https://doi.org/10.3390/ijerph19063620 - 18 Mar 2022

Cited by 8 | Viewed by 1946

Abstract

The aims of this study were to develop a psychological capital (PsyCap) scale for male nursing students and to compare the scores with those of female nursing students. Few past studies have focused on male nursing students to understand their PsyCap relative to [...] Read more.

The aims of this study were to develop a psychological capital (PsyCap) scale for male nursing students and to compare the scores with those of female nursing students. Few past studies have focused on male nursing students to understand their PsyCap relative to female nursing students. We recruited 384 male nursing students in Taiwan to construct the PsyCap Scale with 16 items and four factors based on the relevant literature: hope, optimism, resiliency, and self-efficacy. The scale showed good model fit in confirmatory factor analysis with factor loadings from 0.62 to 0.78. Cronbach’s alpha coefficients ranged from 0.75 to 0.83 for the four subscales and 0.91 for the total scale. We also conducted measurement invariance tests with data from 402 female nursing student volunteers in Taiwan. The invariance of factor loadings and intercepts of the established scale (i.e., with the same unit and origin between genders) indicated that the male nursing students had higher PsyCap in optimism and resiliency than the females. We developed a 16-item-scale to make administration rapid and convenient and applied advanced statistical methods for reliable and valid comparisons between sexes. The results may help the government to create education programmes or policies supporting male nursing students. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

13 pages, 769 KiB  

Open AccessArticle

Political Populism, Institutional Distrust and Vaccination Uptake: A Mediation Analysis

by Almudena Recio-Román, Manuel Recio-Menéndez and María Victoria Román-González

Int. J. Environ. Res. Public Health 2022, 19(6), 3265; https://doi.org/10.3390/ijerph19063265 - 10 Mar 2022

Cited by 14 | Viewed by 3191

Abstract

Politics is ubiquitous in public health, but vaccines had never been weaponized to instill distrust to gain political advantage. In pandemic and post-pandemic scenarios, populist political parties could use vaccine-related issues to generate distrust in evidence-based knowledge. Therefore, some questions arise. What impact [...] Read more.

Politics is ubiquitous in public health, but vaccines had never been weaponized to instill distrust to gain political advantage. In pandemic and post-pandemic scenarios, populist political parties could use vaccine-related issues to generate distrust in evidence-based knowledge. Therefore, some questions arise. What impact could populist political parties impinge on vaccination uptake rates through sowing political discontent? What could the medical institutions do to avoid the adverse effects that these political strategies could infringe? For answering these research questions, we first hypothesized that vaccine uptake was negatively associated with distrust in the institutions. Furthermore, we analyzed whether populism mediates this relationship. In doing so, we hypothesized a positive association between distrust and populism, because populists, mainly fueled by politically discontent citizens, offer hope of a better future, blaming their misfortune on the actions of the elite. Additionally, we hypothesized that those citizens with a higher level of political dissatisfaction, following the claims of the populist political parties, will have lower vaccine uptake results, because they will be discouraged from making the efforts to counter the pandemic. Based on a survey carried out by the European Commission that covered 27 E.U. + U.K. countries (totaling 27,524 respondents), this paper proves that an individual’s political discontent fully mediates the relationship between distrust in institutions and vaccine uptake. Targeting the vaccine-hesitant population is quite convenient for populists because they only need to convince a minority of citizens not to be vaccinated to achieve their destabilizing goals. New outbreaks will appear if the minimum herd immunity coverage is not reached, reinforcing a vicious circle of distrust in elites, in consequence. For tackling this matter, recommendations are given to institutional managers from a social marketing standpoint. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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16 pages, 639 KiB  

Open AccessArticle

The Spirit of Adventure: A Driver of Attractiveness of the Hospitality Industry for Young People during a Pandemic Crisis

by Adriana Burlea-Schiopoiu, Mara Del Baldo and Samuel O. Idowu

Int. J. Environ. Res. Public Health 2022, 19(4), 1913; https://doi.org/10.3390/ijerph19041913 - 09 Feb 2022

Cited by 4 | Viewed by 3038

Abstract

The COVID-19 pandemic has strongly affected tourism and leisure activities worldwide, especially in the hospitality and tourism sectors. Within this context, this study aimed to evaluate the impact of the pandemic on the future attractiveness of the hospitality industry (HI) to young people. [...] Read more.

The COVID-19 pandemic has strongly affected tourism and leisure activities worldwide, especially in the hospitality and tourism sectors. Within this context, this study aimed to evaluate the impact of the pandemic on the future attractiveness of the hospitality industry (HI) to young people. The conceptual model underpinning the empirical research proposes a direct relationship between job attractiveness and the spirit of youth adventure. Findings prove that young people are enthusiastic about working in the HI because they can easily practice their creative ideas. Communicating with other people and dealing with clients’ complaints is challenging for them in the pandemic crisis created by COVID-19. The results are of interest to policymakers in terms of suggestions on how to transform the challenges into opportunities by using the constraints imposed by the pandemic crisis that have limited the socialisation between people, enhancing the creativity of young people, and motivating them to work in the HI. Moreover, our research provides managers and other decisionmakers with some motivational factors to increase the attractiveness of their companies to young people and suggestions helpful to scholars involved in HI research to cultivate resilience capabilities by giving them inherent skills. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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17 pages, 3662 KiB  

Open AccessArticle

Comparison of Metabolites and Gut Microbes between Patients with Parkinson’s Disease and Healthy Individuals—A Pilot Clinical Observational Study (STROBE Compliant)

by Cheol-Hyun Kim, Jeeyoun Jung, Young-ung Lee, Kwang-ho Kim, Sunny Kang, Geon-hui Kang, Hongmin Chu, Se-Young Kim and Sangkwan Lee

Healthcare 2022, 10(2), 302; https://doi.org/10.3390/healthcare10020302 - 04 Feb 2022

Cited by 7 | Viewed by 1799

Abstract

Introduction: Even if levodopa, dopamine agonists, and others are used for patients with Parkinson’s disease, the effect is not sustained, and side effects such as motor fluctuation and dyskinesia are more likely to appear as the dose increases. Thus, new approaches for managing [...] Read more.

Introduction: Even if levodopa, dopamine agonists, and others are used for patients with Parkinson’s disease, the effect is not sustained, and side effects such as motor fluctuation and dyskinesia are more likely to appear as the dose increases. Thus, new approaches for managing Parkinson’s disease are needed. This study aimed to compare the metabolites and gut microbes between patients with Parkinson’s disease and healthy individuals. Methods: This was an observational study with a case-control design. Metabolite and gut microbial analyses were performed using blood and stool samples collected from the subjects. Results: Among the metabolites, the acetate, citrate, methionine, and trimethylamine levels were significantly different between the two groups. In the gut microbes, abundance of Bacteroidetes, Prevotella, Phascolarctobacterium, Pseudoflavonifractor, Eisenbergiella, and Gemella were also significantly different between the two groups. Discussion: Metabolites are the products of gut microbes. Therefore, when the gut microbes change, the metabolites change accordingly. Metabolites and gut microbes that were significantly different between the two groups were mostly those involved in lipid and glucose metabolism. Our data may be helpful for the development of new drugs targeting metabolites and gut microbes through large-scale studies in the future. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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10 pages, 241 KiB  

Open AccessArticle

Adolescents’ Sexual and Reproductive Healthcare-Seeking Behaviour and Service Utilisation in Plateau State, Nigeria

by Esther Awazzi Envuladu, Karlijn Massar and John de Wit

Healthcare 2022, 10(2), 301; https://doi.org/10.3390/healthcare10020301 - 04 Feb 2022

Cited by 2 | Viewed by 2869

Abstract

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services [...] Read more.

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one-third of the participating adolescents were currently sexually active, slightly more than three-quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non-use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01–0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50–6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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12 pages, 631 KiB  

Open AccessArticle

Incidence and Sociodemographic Correlates of Psychological Health Problems among Residents of the West Pomeranian Voivodeship during the COVID-19 Outbreak

by Anna Maria Cybulska, Kamila Rachubińska, Małgorzata Starczewska, Labib Zair and Mariusz Panczyk

Medicina 2022, 58(2), 196; https://doi.org/10.3390/medicina58020196 - 27 Jan 2022

Cited by 2 | Viewed by 2421

Abstract

Background and Objectives: Psychological health problems have become an important topic of consideration for many scientists, because the epidemiology of these disorders is strongly influenced by stressful events such as the SARS-CoV-2 coronavirus pandemic. The aim of this study was to evaluate [...] Read more.

Background and Objectives: Psychological health problems have become an important topic of consideration for many scientists, because the epidemiology of these disorders is strongly influenced by stressful events such as the SARS-CoV-2 coronavirus pandemic. The aim of this study was to evaluate selected parameters of psychosocial functioning as well as socio-demographic correlates of depression, anxiety, sleep disorders and perceived stress among the residents of the West Pomeranian Voivodeship. Materials and Methods: An online questionnaire was completed by 323 participants, in whom the parameters of psychosocial functioning were assessed (symptoms of depression, anxiety, severity of sleep disorders and perceived stress). Results: The majority of the respondents (75.2%) scored high on the Perceived Stress Scale, and almost half of the respondents (47.1%) had sleep disorders. A total of 26% of the participants had no depressive symptoms. Age was significantly correlated with the severity of depressive symptoms and sleep disorders. There was a strong correlation between the severity of depression and anxiety (r = 0.76; p < 0.0001), a moderate correlation between depression and perceived stress (r = 0.47; p < 0.0001) and a strong correlation between depression and sleep disorders (r = 0.651; p < 0.0001). Conclusions: Age contributed to the severity of depressive symptoms and the occurrence of sleep disorders among the residents of the West Pomeranian Voivodeship during the SARS-CoV-2 pandemic. Some residents of the West Pomeranian Voivodeship showed moderate to severe depressive and anxiety symptoms, as well as high levels of stress and insomnia. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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8 pages, 311 KiB  

Open AccessArticle

Factors Affecting Delayed Hospital Arrival of Patients with Acute Myocardial Infarction in Kinmen

by Yu-Han Huang, Chorng-Kuang How and Ching-Sung Ho

Int. J. Environ. Res. Public Health 2022, 19(3), 1323; https://doi.org/10.3390/ijerph19031323 - 25 Jan 2022

Viewed by 2382

Abstract

This study explores factors related to delayed emergency medical treatment for acute myocardial infarction patients on Kinmen Island. A cross-sectional study was performed in the only hospital in Kinmen Island. The study group consisted of 116 patients diagnosed with acute myocardial infarction (AMI, [...] Read more.

This study explores factors related to delayed emergency medical treatment for acute myocardial infarction patients on Kinmen Island. A cross-sectional study was performed in the only hospital in Kinmen Island. The study group consisted of 116 patients diagnosed with acute myocardial infarction (AMI, ICD-10 codes: I21.9) from November 2015 to May 2019. The binary logistic regression analyses were performed for the inferential statistical analysis. The mean age of the study group was 63.0 ± 14.5 years, 39.7% of the patients arrived at the emergency medicine longer than 6 h after the onset of symptoms. The related factors for delayed arrival the hospital emergency medicine department were female sex, age over 65 years, less than nine years’ education, and Killip Class, but only Killip Class reached the significant difference of statistics (OR = 3.616, 95% C.I. = 1.574 to 8.310, p = 0.002), and patients with delayed arrival times (>6 h) were found to have a higher percentage of Killip Class ≥ II. Therefore, it is essential to remind the physicians to proceed with risk stratification for acute coronary syndrome patients. In addition, health authorities should provide effective programs to increase awareness of the symptoms and timely treatment of acute myocardial infraction to the general public, especially the elderly. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

11 pages, 526 KiB  

Open AccessProtocol

Construction of Progress Prediction Model of Urinary Incontinence in Elderly Women: Protocol for a Multi-Center, Prospective Cohort Study

by Di Zhang, Lei Gao, Yuanyuan Jia, Shiyan Wang, Haibo Wang, Xiuli Sun and Jianliu Wang

Int. J. Environ. Res. Public Health 2022, 19(2), 734; https://doi.org/10.3390/ijerph19020734 - 10 Jan 2022

Cited by 4 | Viewed by 1986

Abstract

Background: Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to [...] Read more.

Background: Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to establish an effective UI progress prediction model for elderly women with UI for earlier detection and better treatment. Methods: This study is conducted as a prospective, multi-center, cohort study, and recruits 800 women aged ≥60 with mild or moderate UI in China. Participants are divided into three groups: stress urinary incontinence group (SUI), urgency urinary incontinence group (UUI), and mixed urinary incontinence group (MUI). This study will investigate the general conditions of patients, after complete relevant pelvic floor function assessment, as well as after follow up at 6 months, 12 months, and 18 months by telephone. The primary endpoint is UI disease progress. Single factor and multi-factor Cox regression model analyses are undertaken to evaluate the associated risk factors affecting the progress of UI to establish a progress prediction model for elderly women. Discussion: This study will provide more predictive information for elderly women with UI, and new clinical references for the intervention and the treatment of UI for medical staff. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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11 pages, 606 KiB  

Open AccessArticle

Effect of Home-Based Tele-Pilates Intervention on Pregnant Women: A Pilot Study

by Ah-Hyun Hyun, Joon-Yong Cho and Jung-Hoon Koo

Healthcare 2022, 10(1), 125; https://doi.org/10.3390/healthcare10010125 - 08 Jan 2022

Cited by 7 | Viewed by 3957

Abstract

Pilates is effective for training the core muscles and stabilizing the hip joints, which provides relief from pelvic pain and low back pain during pregnancy. However, there are no specific guidelines on appropriate physical exercises for pregnant women due to the current pandemic. [...] Read more.

Pilates is effective for training the core muscles and stabilizing the hip joints, which provides relief from pelvic pain and low back pain during pregnancy. However, there are no specific guidelines on appropriate physical exercises for pregnant women due to the current pandemic. We aimed to apply the exercise standard proposed by the American College of Obstetricians and Gynecologists to home-based tele-Pilates exercise (HTPE), to determine its effect on the physical and mental health of pregnant women. We randomly divided the subjects into the following two groups who completed 8 weeks of HTPE (50 min/day, 2 days/week): (a) Pilates exercise (PE, n = 7) and (B) non-Pilates exercise (CON, n = 7). HTPE was performed by adjusting the program every 3 weeks, based on pain and physical fitness levels. We measured body composition, muscles of the hip joint, pelvic tilt, Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI), before and after HTPE. Following HTPE, while the percentage of body fat and body mass index had significantly decreased, the body fat mass did not change in the PE group (p < 0.05). The PE group showed an increase in strength of the left and right hip flexion and hip abduction, compared to the CON group (p < 0.01). The ODI and PSQI were significantly decreased in the PE group (p < 0.05). Therefore, the 8-week HTPE program is an effective exercise for pregnant woman that reduces body fat metabolism and strengthens muscles of the hip joint, thus alleviating pregnancy-induced low back pain and insomnia. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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11 pages, 806 KiB  

Open AccessArticle

Risk of Glaucoma Associated with Components of Metabolic Disease in Taiwan: A Nationwide Population-Based Study

by Ya-Wen Chang, Fung-Chang Sung, Ya-Ling Tzeng, Chih-Hsin Mou, Peng-Tai Tien, Cheng-Wen Su and Yu-Kuei Teng

Int. J. Environ. Res. Public Health 2022, 19(1), 305; https://doi.org/10.3390/ijerph19010305 - 28 Dec 2021

Viewed by 1838

Abstract

Purpose: This retrospective cohort study was conducted to determine the glaucoma risk associated with metabolic disease (MetD) using insurance claims data of Taiwan. Methods: From the database, we identified patients with newly diagnosed hypertension, diabetes and/or hyperlipidemia from the years 2000 to 2002 [...] Read more.

Purpose: This retrospective cohort study was conducted to determine the glaucoma risk associated with metabolic disease (MetD) using insurance claims data of Taiwan. Methods: From the database, we identified patients with newly diagnosed hypertension, diabetes and/or hyperlipidemia from the years 2000 to 2002 as the MetD cohort (N = 42,036) and an age-gender-diagnosis-date matched control cohort without MetD with a two-fold sample size than that of the MetD cohort. Both cohorts were followed until the development of glaucoma, death, or withdrawal, until 31 December 2013. The incidence of glaucoma, and the Cox method estimated hazard ratio (HR) of glaucoma were calculated. Results showed that the incidence of glaucoma was two-fold higher in the MetD cohort than in the controls (1.99 versus 0.99 per 1000 person-years), with an adjusted HR of 1.66 (95% CI: 1.50–1.85). The glaucoma incidence was higher in patients with diabetes than those with hypertension and hyperlipidemia (2.38 versus 1.95 and 1.72 per 1000 person-years, respectively). The incidence increased to 5.67 per 1000 person-years in patients with all three comorbidities, with an aHR of 4.95 (95% CI: 2.35–10.40). We also found higher incidence rates of primary open-angle glaucoma and primary angle-closure glaucoma with aHRs of 2.03 and 1.44, respectively. It was concluded that glaucoma risk increased with the number of MetD. Health providers need to monitor patients with MetD to prevent glaucoma. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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11 pages, 337 KiB  

Open AccessArticle

Increased Anxiety and Depression Symptoms in Post-Acute Care Patients with Stroke during the COVID-19 Pandemic

by Hsiang-Yun Chou, Yu-Chun Lo, Ya-Wen Tsai, Chia-Li Shih and Chieh-Ting Yeh

Int. J. Environ. Res. Public Health 2022, 19(1), 162; https://doi.org/10.3390/ijerph19010162 - 24 Dec 2021

Cited by 10 | Viewed by 3159

Abstract

This study aimed to explore the quality and stability of post-acute care for patients with stroke, including their functional outcomes, mental health and medical care in Taiwan during the COVID-19 pandemic. In this retrospective case–control study—based on propensity score matching—we assessed 11 patients [...] Read more.

This study aimed to explore the quality and stability of post-acute care for patients with stroke, including their functional outcomes, mental health and medical care in Taiwan during the COVID-19 pandemic. In this retrospective case–control study—based on propensity score matching—we assessed 11 patients admitted during the pandemic period (in 2021) and 11 patients admitted during the non-pandemic period (in 2020). Functional outcomes, including the scores of the modified Rankin Scale, Barthel Index, EuroQoL-5 Dimension, Lawton–Brody instrumental activities of daily living, Berg Balance Scale, 5-metre walking speed and 6-min walking distance, were determined. Data on the length of acute care, length of post-acute care, destination after discharge and 14-days readmission were used to evaluate the quality of medical care. The Wilcoxon signed-rank test was used to compare functional performance before and after rehabilitation. The pandemic group showed no significant improvement in the scores of EuroQoL-5 Dimension, a self-reported health status assessment (p = 0.13), with the anxiety or depression dimension showing a negative effect (r = 0.21). Post-acute care programmes can efficiently improve the functional performance of patients with stroke during the COVID-19 pandemic in Taiwan. Mental health should therefore be simultaneously maintained while rehabilitating physical function. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

13 pages, 963 KiB  

Open AccessArticle

Cervical Cancer Mortality in Romania: Trends, Regional and Rural–Urban Inequalities, and Policy Implications

by Florentina Furtunescu, Roxana Elena Bohiltea, Adrian Neacsu, Corina Grigoriu, Corina Silvia Pop, Nicolae Bacalbasa, Ionita Ducu, Ana-Maria Iordache and Radu Virgil Costea

Medicina 2022, 58(1), 18; https://doi.org/10.3390/medicina58010018 - 23 Dec 2021

Cited by 8 | Viewed by 2905

Abstract

Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by [...] Read more.

Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by the countries remain very heterogeneous. This study aimed to investigate the differences in cervix cancer mortality between Romania and EU and within Romania over the last two decades and to reveal the major sources of inequalities and the policy implications. Materials and Methods: We analyzed the number of deaths and the mortality rates by cervical cancer, standardized using the direct method, over two decades (2001–2016 for the EU, and 2001–2019 for the national and sub-national analyses). Trends, mortality reduction over the years, and mortality differences at the beginning and end of the time interval have been calculated for the EU and Romania, at national and sub-national levels (rural–urban and regions). Results: Our results revealed differences in cervical cancer mortality between Romania and EU and within Romania (among regions and rural–urban areas). These differences used to be very high in the past and are still persisting. Conclusions: The country should revisit its national cervical cancer screening program, which has been implemented for many years, but with a very limited participation rate. Due to the similar problems existing in Central-Eastern Europe, targeted support from the EU for the members from this geographical area could contribute to the minimization of differences in cervical cancer mortality among the EU members. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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13 pages, 350 KiB  

Open AccessArticle

Impact of Internet Use on Mental Health among Elderly Individuals: A Difference-in-Differences Study Based on 2016–2018 CFPS Data

by Huan Zhang, Hongyang Wang, Huiyu Yan and Xiaoyu Wang

Int. J. Environ. Res. Public Health 2022, 19(1), 101; https://doi.org/10.3390/ijerph19010101 - 23 Dec 2021

Cited by 27 | Viewed by 6095

Abstract

The number of elderly Internet users has increased significantly in the past few years. However, the impact of Internet use on mental health remains unclear. In this study, we performed a difference-in-differences analysis using data from the 2016 and 2018 waves of the [...] Read more.

The number of elderly Internet users has increased significantly in the past few years. However, the impact of Internet use on mental health remains unclear. In this study, we performed a difference-in-differences analysis using data from the 2016 and 2018 waves of the China Family Panel Studies (CFPS) to evaluate the impact of Internet usage on mental health among elderly individuals. A total of 5031 validated respondents were included to explore the relationship between Internet use and reduced levels of depression as well as improved life satisfaction among elderly individuals. The results showed that Internet use significantly reduced depression levels. Unexpectedly, Internet use was not found to improve life satisfaction. Moreover, discontinuing Internet use was not significantly associated with improvements in depression or life satisfaction. More research is needed to fully elucidate the relationship between Internet use and depression levels, as well as life satisfaction among elderly individuals. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

11 pages, 349 KiB  

Open AccessArticle

Decreased Physical Activity during Pregnancy Is Associated with Excessive Gestational Weight Gain

by Jia-Jing Sun and Li-Yin Chien

Int. J. Environ. Res. Public Health 2021, 18(23), 12597; https://doi.org/10.3390/ijerph182312597 - 29 Nov 2021

Cited by 6 | Viewed by 2040

Abstract

The majority of pregnant women in Taiwan are not considered physically active. During pregnancy, many women decrease their physical activity levels when compared to pre-pregnancy. The purpose of this study was to examine the association between decreased physical activity from pre-pregnancy to pregnancy [...] Read more.

The majority of pregnant women in Taiwan are not considered physically active. During pregnancy, many women decrease their physical activity levels when compared to pre-pregnancy. The purpose of this study was to examine the association between decreased physical activity from pre-pregnancy to pregnancy and excessive gestational weight gain (GWG). This study applied a prospective panel design. Recruitment was conducted at six medical facilities in Taiwan and lasted from August 2016 to April 2017. Physical activity levels were determined both before and during pregnancy using the International Physical Activity Questionnaire—Short Form, with data subsequently being transformed into METs-min/week. Excessive GWG was determined based on the body mass index (BMI) specific GWG range. We recruited 747 pregnant women in their second trimester and followed them through to one-month postpartum. About 40% of participants (41.2%) exhibited excessive GWG. Physical activity decreased from an average of 2261 (SD = 3999) to 1252 (SD = 2258) METs-min/week from pre-pregnancy to pregnancy (p < 0.0001). Controlling for age and pre-pregnancy BMI, a logistic regression model revealed that a decline in physical activity of > 4000 METs-min/week from pre-pregnancy to pregnancy was associated with an increased risk for excessive GWG (OR = 2.83, 95% CI: 1.27–4.43). A substantial decrease in physical activity from pre-pregnancy to pregnancy was a risk factor for excessive GWG. Although most women decreased their physical activity during pregnancy, only those pregnant women who were physically active pre-pregnancy could show the kind of large decrease that resulted in excessive GWG. Health professionals should continue to develop strategies for counteracting the problematic trend of decreasing PA during pregnancy among low-risk pregnant women. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

16 pages, 3329 KiB  

Open AccessArticle

Scientometric Analysis of Global Scientific Literature on Aging in Place

by Olugbenga Oladinrin, Kasun Gomis, Wadu Mesthrige Jayantha, Lovelin Obi and Muhammad Qasim Rana

Int. J. Environ. Res. Public Health 2021, 18(23), 12468; https://doi.org/10.3390/ijerph182312468 - 26 Nov 2021

Cited by 7 | Viewed by 2722

Abstract

The amount of literature reporting “aging-in-place” studies has increased sharply in recent decades. However, the studies have taken a global view of the range and scope of the research that has taken place. This study presents a bibliometric analysis of the current status [...] Read more.

The amount of literature reporting “aging-in-place” studies has increased sharply in recent decades. However, the studies have taken a global view of the range and scope of the research that has taken place. This study presents a bibliometric analysis of the current status of the aging in place research themes published as scientific articles between 1970 and 2021, using the Web of Science database. VOSviewer software was employed to map and visualize the 1331 items of bibliographic data retrieved. The findings reveal a continuous growing trend in the publication of aging in place research. Most productive institutions derive from the USA. The International Journal of Environmental Research and Public Health is the most preferred Journal. The most popular research hotspots or areas include; older adults, aging, housing, dementia, long-term care, and technology, and their associations with the field of “aging in place” field were elucidated. This study offers several valuable insights to scholars, research institutions, and policymakers, enabling a better understanding of the developments in the aging in place research domain. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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14 pages, 1549 KiB  

Open AccessArticle

Can the School Fruit and Vegetable Scheme Be an Effective Strategy Leading to Positive Changes in Children’s Eating Behaviours? Polish Evaluation Results

by Katarzyna Wolnicka, Anna Małgorzata Taraszewska and Joanna Jaczewska-Schuetz

Int. J. Environ. Res. Public Health 2021, 18(23), 12331; https://doi.org/10.3390/ijerph182312331 - 24 Nov 2021

Cited by 5 | Viewed by 2247

Abstract

Background: The School Fruit and Vegetable Scheme (SFVS) was developed to form the habit of eating fruit and vegetables (F&V) among children. The survey aimed to identify both the strengths of the scheme and areas that required support and strengthening in the further [...] Read more.

Background: The School Fruit and Vegetable Scheme (SFVS) was developed to form the habit of eating fruit and vegetables (F&V) among children. The survey aimed to identify both the strengths of the scheme and areas that required support and strengthening in the further implementation of school schemes. Methods: The study was conducted from 2012 to 2015 among students of randomly selected 85 primary schools that participated in the programme (intervention group) or did not participate therein (control group). The F&V consumption among the students was evaluated based on the 3 day food record method. Other behaviours were evaluated via frequency and preference questionnaires. Results: Over the three years of implementing SFVS, fruit consumption significantly increased by approximately 30 g/day, i.e., by 18%. In the control group, it increased only by approximately 4%. At the same time, no increase in vegetable consumption was observed. A number of other positive effects of SFVS were also found. These concerned students’ nutritional attitudes and behaviours, such as a further increase in the children’s knowledge on the health aspects of F&V consumption, the levels of their consumption and an increased preference for fruit in general. Conclusions: The results indicate that providing F&V in schools free of charge can be an effective strategy for enhancing F&V consumption among children, in particular by raising the awareness of the health importance of F&V consumption and gradually influencing children’s eating habits, especially when it comes to the habit of fruit consumption. The issue of vegetable consumption is an area for intervention enhancement. There is also a need for further, in-depth analyses, taking into account the impact of potential confounding factors. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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37 pages, 1015 KiB  

Open AccessReview

Oral Health Status among Migrants from Middle- and Low-Income Countries to Europe: A Systematic Review

by Dorina Lauritano, Giulia Moreo, Francesco Carinci, Vincenzo Campanella, Fedora Della Vella and Massimo Petruzzi

Int. J. Environ. Res. Public Health 2021, 18(22), 12203; https://doi.org/10.3390/ijerph182212203 - 20 Nov 2021

Cited by 47 | Viewed by 3110

Abstract

Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. [...] Read more.

Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. Objectives. The objective of this study was to conduct a systematic review of studies analyzing the oral health condition among migrants from middle- and low-income countries to Europe and assessing the eventual association between their sociodemographic and socioeconomic characteristics and oral health status. Materials and Methods. A systematic review was conducted in PubMed, Cochrane Library, Scopus and Science Direct databases. After titles, abstracts and full-text examination, only 27 articles were selected on the basis of inclusion criteria and consequently included for quality assessments and data extraction. Results. Most of the studies reported a higher prevalence of caries experience, a poorer periodontal health and more difficulties in accessing dentalcare services among migrant groups compared with the non-migrant population. Inequalities were mostly associated with ethnic background, economic condition and social grade. Conclusion. Our review demonstrates the lack of dental health among migrants, underlining that their cultural beliefs and their social and economic living conditions could influence their oral health. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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10 pages, 326 KiB  

Open AccessArticle

Evaluation of Stress Levels of Trainee Cardiac Surgery Residents during Training Interventions Using Physiological Stress Parameters

by George Awad, Robert Pohl, Sabine Darius, Beatrice Thielmann, Boris Kuzmin, Ingo Slottosch, Jens Wippermann, Hendrik Schmidt, Maximilian Philipp Scherner and Irina Böckelmann

Int. J. Environ. Res. Public Health 2021, 18(22), 11953; https://doi.org/10.3390/ijerph182211953 - 14 Nov 2021

Cited by 5 | Viewed by 1829

Abstract

Background: This study analysed the psychological and psycho-emotional stress in cardiac surgery. Using heart rate variability (HRV) analysis, it is possible to record intraoperative objective stress responses in surgeons. The aim of the study was to assess with the help of HRV parameters [...] Read more.

Background: This study analysed the psychological and psycho-emotional stress in cardiac surgery. Using heart rate variability (HRV) analysis, it is possible to record intraoperative objective stress responses in surgeons. The aim of the study was to assess with the help of HRV parameters the postulated increased stress levels of cardiac surgeons in training compared to experienced senior cardiothoracic surgeons in exactly the same work situation in order to make qualification-differentiated statements about physiological stress during surgical interventions. Methods: During surgical teaching procedures, long-term ECG data (n = 15 each) for two operating residents and their assisting senior physicians were recorded. Time and frequency domain HRV parameters were analysed. Results: The time-related parasympathetic-dominated HRV parameters RMSSD (19.5 ms vs. 28.1 ms), NN50 (297.67 vs. 693.40), and cardiac interval mean RR (692.8 ms vs. 737.3 ms) indicate a higher stress level in the operating residents compared to the experienced surgeons. The higher stress index (11.61 vs. 8.86) confirms this. Conclusion: Compared to experienced surgeons, operating residents showed lower parasympathetic activity and higher stress levels during cardiac surgery training procedures. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

15 pages, 1405 KiB  

Open AccessReview

European Educational Programmes in Health Emergency and Disaster Management: An Integrative Review

by Juana Perpiñá-Galvañ, Rocío Juliá-Sanchis, Érika Olmos-Castelló, Salvador Mollá-Pérez and Ángela Sanjuan-Quiles

Int. J. Environ. Res. Public Health 2021, 18(21), 11455; https://doi.org/10.3390/ijerph182111455 - 30 Oct 2021

Cited by 3 | Viewed by 3420

Abstract

There is a need for trained health professionals who can swiftly respond to disasters occurring worldwide. Little is known about whether the currently available programmes in disaster management are in line with the recommendations of expert researchers. Our objective was to qualitatively review [...] Read more.

There is a need for trained health professionals who can swiftly respond to disasters occurring worldwide. Little is known about whether the currently available programmes in disaster management are in line with the recommendations of expert researchers. Our objective was to qualitatively review the characteristics of European educational programmes in health emergency and disaster management and to provide guidance to help improve their curricula. We carried out an integrative review to extract the main characteristics of the 2020/21 programmes available. We identified 34 programmes, the majority located in Spain, the UK or France. The primary qualification types awarded were master’s degrees, half of them lasting one year, and the most common teaching method was in person. Almost all of the programmes used a virtual university classroom, a third offered multidisciplinary disaster management content and teachers, and half of them employed situational simulations. The quality of European educational programmes in health emergency and disaster management has improved, especially in terms of using more practical and interactive teaching methodologies and in the inclusion of relevant topics such as communication, psychological approaches and evaluation of the interventions. However, generally, the educational programmes in disaster management have not yet incorporated the skills related to the intercultural and interprofessional awareness aspects. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

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