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Healthcare, Volume 11, Issue 10 (May-2 2023) – 162 articles

Cover Story (view full-size image): Increased usage of biologic inhibitors or targeted synthetic disease-modifying antirheumatic agents has improved outcomes but tripled the costs of healthcare in patients with inflammatory joint diseases. Evidence suggests that diet and physical activity are effective interventions for reducing levels of inflammation in those patients. The current study provides new data of combined diet and physical activity interventions, showing an improvement in the Health Assessment Questionnaire score; however, no firm conclusions can be made regarding the biological inflammatory indices. The results of this study can only be used as a means of highlighting the low-quality evidence in this field of investigation and the need for further and better-quality research, while a personalized medicine data collection and analysis approach is needed. View this paper
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14 pages, 669 KiB  
Article
Functional Status of Patients over 65 Years Old Intervened on for a Hip Fracture One Year after the Operation
by Pablo A. Marrero-Morales, Enrique González-Dávila, María Fernanda Hernández-Gutiérrez, Eva M. Gallego-González, Martina Jiménez-Hernández, Emilio J. Sanz-Álvarez, Natalia Rodríguez-Novo and Yurena M. Rodríguez-Novo
Healthcare 2023, 11(10), 1520; https://doi.org/10.3390/healthcare11101520 - 22 May 2023
Cited by 2 | Viewed by 3707
Abstract
Objectives: Evaluation of the functional status one year after a hip fracture surgery and the influence of sarcopenia and other clinical factors at the time of admission. Method: Prospective observational study with 135 patients over 65 years of age. Functional status of basic [...] Read more.
Objectives: Evaluation of the functional status one year after a hip fracture surgery and the influence of sarcopenia and other clinical factors at the time of admission. Method: Prospective observational study with 135 patients over 65 years of age. Functional status of basic (modified Katz) and instrumental activities (Lawton and Brody) and walking ability (Functional Ambulation Classification, FAC) was measured on admission, at discharge, and telephonically one year later. The risk or positive screening of sarcopenia (SARC-F) and cognitive status (Pfeiffer), as well as clinical variables, were evaluated. Results: 72% of patients are women; 36% have a risk of sarcopenia (Sarc-F ≥ 4), and 43% have moderate–severe cognitive impairment (Pfeiffer ≥ 5). Walking capacity at one year was closer to the values at admission more often in women than in men (0.2 ± 1.3 points vs. 0.9 ± 1.6; p = 0.001), as well as in patients without risk of sarcopenia versus sarcopenic patients (0.3 ± 1.2 points vs. 0.7 ± 1.7; p = 0.001), although their evolution did not show significant differences (p = 0.183). Instrumental activities after one year have not been recovered (1.7 ± 2.5 points; p = 0.032), and patients at risk of sarcopenia showed worse values (1.7 ± 1.9 points vs. 3.7 ± 2.7; p < 0.001) and worse evolution (p = 0.012). The evolution of basic activities varied according to the risk of sarcopenia (0.6 ± 1.4 points vs. 1.4 ± 2.1; p = 0.008). Conclusions: Functional status at one year is related to the functional status at admission, the positive screening of sarcopenia, sex, and cognitive impairment of the patient. Knowing at the time of admission an estimate of the functional status at one year will help to reinforce the individual treatment of patients with a worse prognosis. Full article
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9 pages, 261 KiB  
Article
Perceived Eye-Related Symptoms and Influencing Factors in Hospital Nurses
by Ok-Hee Cho, Haemin Cho and Hyekyung Kim
Healthcare 2023, 11(10), 1519; https://doi.org/10.3390/healthcare11101519 - 22 May 2023
Viewed by 1017
Abstract
Nurses are at risk of eye discomfort due to the increasing use of visual display terminals and wearing masks, which may worsen eye-related symptoms. This study was conducted in South Korea to identify the factors influencing eye-related symptoms among hospital nurses on/off duty. [...] Read more.
Nurses are at risk of eye discomfort due to the increasing use of visual display terminals and wearing masks, which may worsen eye-related symptoms. This study was conducted in South Korea to identify the factors influencing eye-related symptoms among hospital nurses on/off duty. The study included 154 nurses who completed a self-reported questionnaire that assessed demographic characteristics, perceived health status, dry-eye symptoms, occupational stress, and eye-related symptoms. The results showed that nurses complained of more eye-related symptoms on duty than off duty, with female sex and dry-eye symptoms being the factors influencing eye-related symptoms on duty. On the other hand, computer use time (≥4 h) and dry-eye symptoms were the factors influencing eye-related symptoms off duty. The study suggests that assessing dry-eye symptoms can facilitate early interventions to relieve eye-related symptoms in hospital nurses, and they should pay attention to eye health during working hours as well as off hours. Full article
(This article belongs to the Special Issue Clinical Nursing in Healthcare)
17 pages, 4511 KiB  
Article
An Evaluation Study of a New Designed Oscillating Hydraulic Trainer of Neck
by Hongchun Yang, Yawei Lv, Sisi Chen, Baixi Xing and Jianfeng Wu
Healthcare 2023, 11(10), 1518; https://doi.org/10.3390/healthcare11101518 - 22 May 2023
Viewed by 928
Abstract
In view of the importance of neck strength training and the lack of adequate training equipment, this study designed a new oscillating hydraulic trainer (OHT) of neck based on oscillating hydraulic damper. We used surface electromyography (sEMG) and subjective ratings to evaluate the [...] Read more.
In view of the importance of neck strength training and the lack of adequate training equipment, this study designed a new oscillating hydraulic trainer (OHT) of neck based on oscillating hydraulic damper. We used surface electromyography (sEMG) and subjective ratings to evaluate the neck OHT and compared the results with a simple hat trainer (HATT) and traditional weight trainer (TWT) to verify the feasibility and validity of the OHT. Under similar exercise conditions, 12 subjects performed a set of neck flexion and extension exercise with these 3 trainers. The sEMG signals of targeted muscles were collected in real time, and subjects were asked to complete subjective evaluations of product usability after exercise. The results showed that the root mean square (RMS%) of sEMG indicated that the OHT could provide two-way resistance and train the flexors and extensors simultaneously. The overall degree of muscle activation with OHT was higher than that with the other two trainers in one movement cycle. In terms of resistance characteristics exhibited by the sEMG waveform, duration (D) with OHT was significantly longer than HATT and TWT when exercising at a high speed, while Peak Timing (PT) was later. The ratings of product usability and performing usability of OHT were remarkably higher than that of HATT and TWT. Based on the above results, the OHT was proved to be more suitable for strength training, such as neck muscles, which were getting more attention gradually, but lacked mature and special training equipment. Full article
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10 pages, 279 KiB  
Article
Loneliness and Social Isolation among Transgender and Gender Diverse People
by André Hajek, Hans-Helmut König, Marco Blessmann and Katharina Grupp
Healthcare 2023, 11(10), 1517; https://doi.org/10.3390/healthcare11101517 - 22 May 2023
Cited by 2 | Viewed by 2552
Abstract
Here, we report the prevalence of loneliness and social isolation and investigate the levels of loneliness and social isolation among transgender and gender diverse people using cross-sectional data from the HH-TPCHIGV study. Using the De Jong Gierveld tool, we assess loneliness, using the [...] Read more.
Here, we report the prevalence of loneliness and social isolation and investigate the levels of loneliness and social isolation among transgender and gender diverse people using cross-sectional data from the HH-TPCHIGV study. Using the De Jong Gierveld tool, we assess loneliness, using the Bude and Lantermann tool, we assess perceived social isolation and using the Lubben Social Network Scale, we assess objective social isolation. The prevalence rate of loneliness was 83.3% (perceived social isolation: 77.7%; objective social isolation: 34.4%). Regressions revealed that favorable outcomes (i.e., lower loneliness levels, lower perceived social isolation, and lower objective social isolation) were consistently associated with higher school education. Beyond that, we identify an association between particularly poor health-related factors and higher loneliness and objective social isolation levels. We also report that unemployment was significantly associated with higher levels of perceived social isolation. In conclusion, we show high prevalence rates of loneliness and social isolation among transgender and gender diverse people. Additionally, important correlates (e.g., education, health-related factors, or unemployment) were identified. Such knowledge may provide help to address transgender and gender diverse people at risk for loneliness and social isolation. Full article
20 pages, 837 KiB  
Article
Impact of Stress on Periodontal Health: Literature Revision
by Denise Corridore, Matteo Saccucci, Giulia Zumbo, Erika Fontana, Luca Lamazza, Claudio Stamegna, Gabriele Di Carlo, Iole Vozza and Fabrizio Guerra
Healthcare 2023, 11(10), 1516; https://doi.org/10.3390/healthcare11101516 - 22 May 2023
Cited by 5 | Viewed by 1878
Abstract
Stress is a physiological response of the body to stressful life events but may not be when the individual is persistently exposed to the stress trigger, and it negatively affects certain physiological functions, thus triggering psychosomatic diseases. In literature, chronic stress and inadequate [...] Read more.
Stress is a physiological response of the body to stressful life events but may not be when the individual is persistently exposed to the stress trigger, and it negatively affects certain physiological functions, thus triggering psychosomatic diseases. In literature, chronic stress and inadequate coping strategies are found to mediate the risk and development of periodontitis; mechanisms have therefore been proposed to explain the effects of stress on the periodontium. Since stress is a prevalent problem in modern life and given the importance of maintaining oral health, the present literature review aimed to estimate the association between stress and periodontal disease. The research question adopted is the following: “Are psychological stress and periodontal disease related?” The search was conducted in August 2022 and limited to articles in electronic databases from 2017 to 2022 in English, excluding reviews and literature reviews. From the electronic databases, a total of 532 articles were identified and became 306 after reviews and duplicates were removed. An additional bibliographic search was conducted through the same electronic databases, controlled terms and keywords including only systematic reviews, which were previously excluded. Through the bibliography cited in the systematic reviews, an additional 18 articles were identified, with a new total of 324. As a result of reading the title and abstract of these 324 articles, an additional 295 were excluded. Reading the full text of the remaining 29 studies, 2 articles were excluded due to non-adherence to the eligibility criteria. The remaining 27 results were included in our literature review. It has been suggested in the literature that adverse socioeconomic conditions elicit a stress response, which can trigger periodontal inflammation. Most of the 27 articles included in the study confirm and demonstrate a positive association between psychological stress and periodontal disease. Numerous studies have shown the mechanisms through which chronic stress negatively affects periodontal tissues. Therefore, in the light of the results obtained from this review, it is important that oral health professionals, also for general health purposes, consider stress factors among the risk factors of periodontal disease, its severity and decreased efficacy of treatments. It is therefore advisable to act preventively through the interception of chronic stress. Full article
(This article belongs to the Special Issue 2nd Edition of Healthcare and Special Needs Patients)
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12 pages, 3803 KiB  
Article
Real World Evidence on the Effectiveness of Nusinersen within the National Program to Treat Spinal Muscular Atrophy in Poland
by Dominika Krupa, Marcin Czech, Ewa Chudzyńska, Beata Koń and Anna Kostera-Pruszczyk
Healthcare 2023, 11(10), 1515; https://doi.org/10.3390/healthcare11101515 - 22 May 2023
Cited by 1 | Viewed by 1676
Abstract
Background: Spinal muscular atrophy (SMA) is a debilitating neuromuscular disease resulting in children’s mortality and disability. Nusinersen is available to all SMA patients in Poland since 2019. Aim: To compare mortality or disease progression to mechanical ventilation in two patient cohorts before and [...] Read more.
Background: Spinal muscular atrophy (SMA) is a debilitating neuromuscular disease resulting in children’s mortality and disability. Nusinersen is available to all SMA patients in Poland since 2019. Aim: To compare mortality or disease progression to mechanical ventilation in two patient cohorts before and after the program’s introduction. Additionally, to describe the patient population treated with nusinersen and costs incurred by the public payer. Methods: We used the National Health Fund (NHF) database to identify patients born in either 2014 or 2019, who received at least two health services with an ICD10 G12 diagnosis. Outcomes were time to event: death or first mechanical ventilation. We identified all benefits received by nusinersen-treated patients, between 1 January 2019 and 31 May 2022. Results: Children with SMA born in 2019 had significantly lower mortality in the first years of their lives than children born in 2014. Approximately 875 patients (all age groups) were treated with nusinersen in the analysis period. The cost of causal drugs in this period amounted to €51.4 million. The cost of healthcare benefits amounted to €14.9 million. Conclusions: The drug program to treat SMA improved patient care in Poland. The NHF database was a reliable source to monitor resource-intensive therapies’ costs, demography, and selected patient outcomes. Full article
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16 pages, 1033 KiB  
Article
Regional Differences in Self-Reported Health, Physical Activity and Physical Fitness of Urban Senior Citizens in Austria
by Sonja Jungreitmayr, Verena Venek and Susanne Ring-Dimitriou
Healthcare 2023, 11(10), 1514; https://doi.org/10.3390/healthcare11101514 - 22 May 2023
Viewed by 1051
Abstract
The aim of this study is to compare data on the health status, self-reported exercise and non-exercise physical activity as well as fitness parameters, such as grip strength, of people in retirement in two cities that are both considered urban centres according to [...] Read more.
The aim of this study is to compare data on the health status, self-reported exercise and non-exercise physical activity as well as fitness parameters, such as grip strength, of people in retirement in two cities that are both considered urban centres according to the statistical office of the European Union (EUROSTAT), but differ by geographic location. Self-reported physical activity questionnaires and objective assessments of physical fitness indicators collected by sports scientists were used and examined for differences. A total of 210 people (66.3 years ± 2.3) in Salzburg (n = 90) and Vienna (n = 120) was analysed. While no differences were found in self-reported health, there were differences in self-reported exposure to self-reported exercise and non-exercise physical activity, with the Viennese population being more inactive than their more western comparison group. In addition, the objective indicators for muscle strength, balance and flexibility of the lower extremities differed significantly in favour of the more western Austrian population. We recommend assessing the situation of older people in Austria regarding their physical activity and fitness on a regional basis, even if they live in cities of the same category. Future projects should therefore aim to consider specific regional needs during development and incorporate both subjective and objective indicators when monitoring the success of such programs. Full article
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10 pages, 507 KiB  
Review
Pelvic Organ Prolapse Syndrome and Lower Urinary Tract Symptom Update: What’s New?
by Gaetano Maria Munno, Marco La Verde, Davide Lettieri, Roberta Nicoletti, Maria Nunziata, Diego Domenico Fasulo, Maria Giovanna Vastarella, Marika Pennacchio, Gaetano Scalzone, Gorizio Pieretti, Nicola Fortunato, Fulvio De Simone, Gaetano Riemma and Marco Torella
Healthcare 2023, 11(10), 1513; https://doi.org/10.3390/healthcare11101513 - 22 May 2023
Cited by 2 | Viewed by 1343
Abstract
(1) Background: This narrative review aimed to analyze the epidemiological, clinical, surgical, prognostic, and instrumental aspects of the link between pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), collecting the most recent evidence from the scientific literature. (2) Methods: We matched [...] Read more.
(1) Background: This narrative review aimed to analyze the epidemiological, clinical, surgical, prognostic, and instrumental aspects of the link between pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), collecting the most recent evidence from the scientific literature. (2) Methods: We matched the terms “pelvic organ prolapse” (POP) and “lower urinary tract symptoms” (LUTS) on the following databases: Pubmed, Embase, Scopus, Google scholar, and Cochrane. We excluded case reports, systematic reviews, articles published in a language other than English, and studies focusing only on a surgical technique. (3) Results: There is a link between POP and LUTS. Bladder outlet obstruction (BOO) would increase variation in bladder structure and function, which could lead to an overactive bladder (OAB). There is no connection between the POP stage and LUTS. Prolapse surgery could modify the symptoms of OAB with improvement or healing. Post-surgical predictive factors of non-improvement of OAB or de novo onset include high BMI, neurological pathologies, age > 65 years, and the severity of symptoms; predictors of emptying disorders are neurological pathologies, BOO, perineal dysfunctions, severity of pre-surgery symptoms, and severe anterior prolapse. Urodynamics should be performed on a specific subset of patients (i.e., stress urinary incontinence, correct surgery planning), (4) Conclusions: Correction of prolapse is the primary treatment for detrusor underactivity and for patients with both POP and OAB. Full article
(This article belongs to the Special Issue Urinary Tract Health and Care)
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20 pages, 1798 KiB  
Review
How Were Return-of-Service Schemes Developed and Implemented in Botswana, Eswatini and Lesotho?
by Sikhumbuzo A. Mabunda, Andrea Durbach, Wezile W. Chitha, Oduetse Moaletsane, Blake Angell and Rohina Joshi
Healthcare 2023, 11(10), 1512; https://doi.org/10.3390/healthcare11101512 - 22 May 2023
Cited by 3 | Viewed by 1151
Abstract
Botswana, Eswatini and Lesotho are three Southern African countries that make use of return-of-service (RoS) schemes to increase human resources for health in their countries. These initiatives bind beneficiaries to a pre-defined period of service upon the completion of their studies based on [...] Read more.
Botswana, Eswatini and Lesotho are three Southern African countries that make use of return-of-service (RoS) schemes to increase human resources for health in their countries. These initiatives bind beneficiaries to a pre-defined period of service upon the completion of their studies based on the length of funding support received. We aimed to review the history of these policies to understand the conceptualisation, intent and implementation of these schemes. We used a multi-methods research design which consisted of a literature review, a policy review and semi-structured interviews with policymakers and implementors. All three governments have a combination of grant-loan schemes and full bursaries or scholarships. The policies have all been operating for over 20 years, with Eswatini’s pre-service policy being the oldest since it was introduced in 1977, followed by Lesotho’s 1978 policy and Botswana’s 1995 pre-service policy. These policies have never been reviewed or updated. RoS schemes in these countries were introduced to address critical skills shortages, to improve employability prospects for citizens, to have competent public sector employees by global standards and to aid the career progress of government employees. Ministries of Health are passive role players. However, these schemes can only be efficient if there is clear cooperation and coordination between all stakeholders. Full article
(This article belongs to the Section Health Policy)
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13 pages, 1655 KiB  
Article
Preconception Expanded Carrier Screening: A Discourse Analysis of Dutch Webpages
by Sofia Morberg Jämterud and Anke Snoek
Healthcare 2023, 11(10), 1511; https://doi.org/10.3390/healthcare11101511 - 22 May 2023
Viewed by 1216
Abstract
Preconception expanded carrier screening (PECS) informs prospective parents about the risk of conceiving a child with a heritable genetic condition. PECS will also, for many, become an important screening test, and websites will likely play a vital role in providing information on this [...] Read more.
Preconception expanded carrier screening (PECS) informs prospective parents about the risk of conceiving a child with a heritable genetic condition. PECS will also, for many, become an important screening test, and websites will likely play a vital role in providing information on this practice. The aim of this article is to examine rationalities in the information on PECS on Dutch websites. The method used is multimodal critical discourse analysis. This method allows an examination of norms and assumptions in the descriptions, as well as of the positions that are discursively made available. The data consist of publicly available material on websites from two genetics departments in the Netherlands. In the results, we present the three main discourses and subject positions that were identified: risk and the couple as possible mediators of severe conditions; the focus on scientific facts and rational conceivers; and severity of the conditions and the responsible couple. In this study, we highlight the importance of acknowledging the interrelation between epistemology and ethics in the discourse on PECS. Finally, it is claimed that the focus on scientific facts in information on PECS risks making existential and ethical dilemmas and choices invisible. Full article
(This article belongs to the Section Chronic Care)
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11 pages, 700 KiB  
Article
Acupuncture Decreases Risk of Hypertension in Patients with Chronic Spontaneous Urticaria in Taiwan: A Nationwide Study
by Heng-Wei Chang, Wei-De Lin, Pai-Jun Shih, Shin-Lei Peng, Chung-Y. Hsu, Cheng-Li Lin, Wen-Ling Liao and Mao-Feng Sun
Healthcare 2023, 11(10), 1510; https://doi.org/10.3390/healthcare11101510 - 22 May 2023
Cited by 1 | Viewed by 1687
Abstract
Patients with chronic spontaneous urticaria (CSU) have a higher risk of developing hypertension. This study aimed to determine whether acupuncture could decrease the risk of hypertension in patients with CSU. We enrolled patients newly diagnosed with CSU between 1 January 2008, and 31 [...] Read more.
Patients with chronic spontaneous urticaria (CSU) have a higher risk of developing hypertension. This study aimed to determine whether acupuncture could decrease the risk of hypertension in patients with CSU. We enrolled patients newly diagnosed with CSU between 1 January 2008, and 31 December 2018, from the Taiwanese National Health Insurance Research Database. The claims data were assessed from the index date to 31 December 2019. A Cox regression model was used to compare the hazard ratios (HRs) of the two cohorts. The cumulative incidence of hypertension was estimated using the Kaplan–Meier method. After propensity score matching with a 1:1 ratio, 43,547 patients with CSU who received acupuncture were matched with 43,547 patients with CSU who did not receive acupuncture in this study. After considering potential confounding factors, patients who received acupuncture had a significantly lower risk of hypertension than those in the control group (adjusted hazard ratio = 0.56, 95% confidence interval = 0.54–0.58). Patients who received medications combined with acupuncture tended to have the lowest risk of hypertension. This study revealed that acupuncture decreases the risk of hypertension in patients with CSU in Taiwan. The detailed mechanisms can be further clarified through prospective studies. Full article
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20 pages, 1406 KiB  
Article
A Study of Reasons for Self-Disclosure on Social Media among Chinese COVID-19 Patients: Based on the Theory of Planned Behavior Model
by Yi Wang, Tianrui Qiao and Chao Liu
Healthcare 2023, 11(10), 1509; https://doi.org/10.3390/healthcare11101509 - 22 May 2023
Cited by 2 | Viewed by 1332
Abstract
Background: With a massive population of internet users, China has witnessed a shift in the behavior of social media users towards the COVID-19 pandemic, transitioning from reticence to frequent sharing of information in response to changing circumstances and policy adjustments of the disease. [...] Read more.
Background: With a massive population of internet users, China has witnessed a shift in the behavior of social media users towards the COVID-19 pandemic, transitioning from reticence to frequent sharing of information in response to changing circumstances and policy adjustments of the disease. This study aims to explore how perceived benefits, perceived risks, subjective norms, and self-efficacy influence the intentions of Chinese COVID-19 patients to disclose their medical history on social media, and thus to examine their actual disclosure behaviors. Methods: Based on the Theory of Planned Behavior (TPB) and Privacy Calculus Theory (PCT), a structural equation model was constructed to analyze the influence paths among perceived benefits, perceived risks, subjective norms, self-efficacy, and behavioral intentions to disclose medical history on social media among Chinese COVID-19 patients. A total of 593 valid surveys were collected via a randomized internet-based survey, which constituted a representative sample. Firstly, we used SPSS 26.0 to conduct reliability and validity analyses of the questionnaire, as well as the tests of demographic differences and correlations between variables. Next, Amos 26.0 was employed to construct and test the model fit degree, identify the relationships among latent variables, and conduct path tests. Results: Our findings revealed the following: (1) There were significant gender differences in the self-disclosure behaviors of medical history on social media among Chinese COVID-19 patients. (2) Perceived benefits had a positive effect on self-disclosure behavioral intentions (β = 0.412, p < 0.001); perceived risks had a positive effect on self-disclosure behavioral intentions (β = 0.097, p < 0.05); subjective norms had a positive effect on self-disclosure behavioral intentions (β = 0.218, p < 0.001); self-efficacy had a positive effect on self-disclosure behavioral intentions (β = 0.136, p < 0.001). (3) Self-disclosure behavioral intentions had a positive effect on disclosure behaviors (β = 0.356, p < 0.001). Conclusions: Our study, by integrating TPB and PCT to examine the influencing factors of the self-disclosure behaviors among Chinese COVID-19 patients on social media, found that perceived risks, perceived benefits, subjective norms, and self-efficacy had a positive influence on the self-disclosure intentions of Chinese COVID-19 patients. We also found that self-disclosure intentions, in turn, positively influenced disclosure behaviors. However, we did not observe a direct influence of self-efficacy on disclosure behaviors. Our study provides a sample of the application of TPB in the context of social media self-disclosure behavior among patients. It also introduces a novel perspective and potential approach for individuals to address the feelings of fear and shame related to illness, particularly within the context of collectivist cultural values. Full article
(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)
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11 pages, 606 KiB  
Study Protocol
Interprofessional Needs Analysis and User-Centred Prototype Evaluation as a Foundation for Building Individualized Digital Education in Dementia Healthcare Supported by Artificial Intelligence: A Study Protocol
by Manuela Malek, Julia Nitsche, Claudia Dinand, Jan Ehlers, Vanessa Lissek, Patricia Böhm, Eva-Maria Derksen and Margareta Halek
Healthcare 2023, 11(10), 1508; https://doi.org/10.3390/healthcare11101508 - 22 May 2023
Viewed by 1115
Abstract
Continuous profession-specific training is necessary to provide high-quality care for people with dementia. Research shows the need for more educational programmes that are personalized and responsive to the learning needs and preferences of staff. Digital solutions supported by artificial intelligence (AI) may be [...] Read more.
Continuous profession-specific training is necessary to provide high-quality care for people with dementia. Research shows the need for more educational programmes that are personalized and responsive to the learning needs and preferences of staff. Digital solutions supported by artificial intelligence (AI) may be a means of making these improvements. There is a lack of formats that support learners in selecting the right content according to their learning needs and preferences. The project “My INdividual Digital EDucation.RUHR” (MINDED.RUHR) addresses this problem and seeks to develop an automatized delivery system for individual learning content using AI. The sub-project presented here aims to achieve the following: (a) explore learning needs and preferences regarding behavioural changes in people with dementia, (b) develop learning nuggets, (c) evaluate the feasibility of the digital learning platform, and (d) identify optimization criteria. Following the first phase of the framework for the design and evaluation of digital health interventions (DEDHI), we use a qualitative approach with focus group interviews for exploration and development, and co-design workshops and expert audits to evaluate the developed learning nuggets. The developed e-learning tool is the first step in supporting the digital training of healthcare professionals in the context of caring for people with dementia, individualized through AI. Full article
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15 pages, 1549 KiB  
Article
Partial Contribution of Socioeconomic Factors to the Mortality Rate of the Working-Age Population in Russia
by Mihajlo Jakovljevic, Olga Kozlova, Maria Makarova, Natalia Neklyudova and Olga Pyshmintseva
Healthcare 2023, 11(10), 1507; https://doi.org/10.3390/healthcare11101507 - 22 May 2023
Cited by 2 | Viewed by 1062
Abstract
This study’s relevance lies in the need to assess the role of socioeconomic, medical, and demographic factors on working-age population mortality in Russia. The purpose of this study is to substantiate the methodological tools for the assessment of the partial contribution of the [...] Read more.
This study’s relevance lies in the need to assess the role of socioeconomic, medical, and demographic factors on working-age population mortality in Russia. The purpose of this study is to substantiate the methodological tools for the assessment of the partial contribution of the most important factors that determine the dynamics of the mortality of the working-age population. Our hypothesis is that the factors determining the socioeconomic situation in the country affect the level and dynamics of mortality of the working-age population, but to a different extent in each separate period. To analyse the impact of the factors, we used official Rosstat data for the period from 2005 to 2021. We used the data that reflect the dynamics of socioeconomic and demographic indicators, including the dynamics of mortality of the working-age population in Russia as a whole and in its 85 regions. First, we selected 52 indicators of socioeconomic development and then grouped them into four factor blocks (working conditions, health care, life security, living standards). To reduce the level of statistical noise, we carried out a correlation analysis, which allowed us to narrow down the list to 15 key indicators with the strongest association with the mortality rate of the working-age population. The total period of 2005–2021 was divided into five segments of 3–4 years each, characterising the picture of the socioeconomic state of the country during the period under consideration. The socioeconomic approach used in the study made it possible to assess the extent to which the mortality rate was influenced by the indicators adopted for analysis. The results of this study show that over the whole period, life security (48%) and working conditions (29%) contributed most to the level and dynamics of mortality in the working-age population, while factors determining living standards and the state of the healthcare system accounted for much smaller shares (14% and 9%, respectively). The methodological apparatus of this study is based on the application of methods of machine learning and intelligent data analysis, which allowed us to identify the main factors and their share in the total influence on the mortality rate of the working-age population. The results of this study show the need to monitor the impact of socioeconomic factors on the dynamics and mortality rate of the working-age population in order to improve the effectiveness of social programme. When developing and adjusting government programmes to reduce mortality in the working-age population, the degree of influence of these factors should be taken into account. Full article
(This article belongs to the Section Health Policy)
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15 pages, 11658 KiB  
Article
Resource Support for “Mobilization–Participation” in Public Health Emergencies Based on a Complex Network Evolutionary Game
by Chenxi Lian, Jida Liu and Jian Wang
Healthcare 2023, 11(10), 1506; https://doi.org/10.3390/healthcare11101506 - 22 May 2023
Viewed by 1108
Abstract
The organized system of emergency resources with the participation of social subjects features a network, which puts forward new requirements for mobilization policies for public health emergencies. Considering the “mobilization–participation” action of the relationship between the government and social resource subjects and revealing [...] Read more.
The organized system of emergency resources with the participation of social subjects features a network, which puts forward new requirements for mobilization policies for public health emergencies. Considering the “mobilization–participation” action of the relationship between the government and social resource subjects and revealing the mechanism of governance measures represent the foundation of developing effective mobilization strategies. To analyze the behavior of subjects in an emergency resource network, this study proposes a framework for the emergency actions of government and social resource subjects, as well as clarifies the functions of relational mechanisms and interorganizational learning in decision making. The game model and its rules of evolution in the network were developed by considering the interventions of rewards and penalties. An emergency resource network was constructed on the basis of a response to the COVID-19 epidemic in a city in China, and a simulation of the “mobilization–participation” game was designed and conducted. We propose a path to promote emergency resource actions by analyzing the initial situations and the interventions’ effects. This article suggests that guiding and improving the initial selection of subjects under a certain reward system would be an effective path to facilitate resource support actions during public health emergencies. Full article
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13 pages, 460 KiB  
Article
Health Service Protection vis-à-vis the Detection of Psychosocial Risks of Suicide during the Years 2019–2021
by Ismael Puig-Amores, Isabel Cuadrado-Gordillo and Guadalupe Martín-Mora-Parra
Healthcare 2023, 11(10), 1505; https://doi.org/10.3390/healthcare11101505 - 22 May 2023
Cited by 2 | Viewed by 999
Abstract
Health services are especially relevant in suicide prevention and intervention, representing a favourable environment in which to implement specific strategies to detect and address suicidal behaviours. Indeed, a significant proportion of people who die by suicide (DBS) present at primary care and mental [...] Read more.
Health services are especially relevant in suicide prevention and intervention, representing a favourable environment in which to implement specific strategies to detect and address suicidal behaviours. Indeed, a significant proportion of people who die by suicide (DBS) present at primary care and mental health services during the last year, month, or even days before committing suicide. The objective of this descriptive and cross-sectional study of all registered cases of death by suicide (N = 265) in Extremadura (Spain) was to determine which of those people who died by suicide had mental health problems (MHP) and what type of assistance they had requested. Diagnoses, previous suicide attempts, type of health service, and last visit before death were explored with univariate analyses and logistic regressions. The proportion of people without MHP was found to be high, and these people had hardly visited the health services at all in their last year. People with MHP, between the ages of 40 and 69, and with previous suicide attempts were more likely to have visited the mental health service in the three months prior to their death. It is, thus, necessary to provide health professionals with tools and training in the prevention of and approach to suicide. Efforts must be directed towards effectively assessing mental health and the risk of suicide since a large proportion of people who die by suicide may go unnoticed. Full article
(This article belongs to the Special Issue Primary Mental Health Care in a New Era: Second Edition)
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21 pages, 6175 KiB  
Systematic Review
Effects of Exercise Intervention (with and without Joint Mobilization) in Patients with Adhesive Capsulitis: A Systematic Review and Meta-Analysis
by Jong Hyeon Lee, Hyung Gyu Jeon and Yong Jin Yoon
Healthcare 2023, 11(10), 1504; https://doi.org/10.3390/healthcare11101504 - 22 May 2023
Viewed by 3070
Abstract
This review aimed to investigate the effects of exercise and exercise with joint mobilization on shoulder range of motion (ROM) and subjective symptom recovery in patients with adhesive capsulitis (AC). Related Studies published from 2000 to 2021 that were peer-reviewed and for which [...] Read more.
This review aimed to investigate the effects of exercise and exercise with joint mobilization on shoulder range of motion (ROM) and subjective symptom recovery in patients with adhesive capsulitis (AC). Related Studies published from 2000 to 2021 that were peer-reviewed and for which pre-and post-values could be calculated were extracted from PubMed, CINAHL, SPORTDiscus, and Web of Science. Nine studies met our inclusion criteria. As a result of calculating the standard mean difference (SMD) and 95% confidence intervals (CI), both exercise and exercise with joint mobilization showed a large effect on shoulder ROM and subjective outcomes. The combination showed a more significant effect than exercise alone on shoulder flexion (SMD = −1.59 [−2.34, −0.65]), extension (SMD = −1.47 [−2.05, −0.89]), internal rotation (SMD = −1.77 [−2.17, −1.36], external rotation (SMD = −2.18 [−2.92, −1.44]), and abduction ROM (SMD = −1.99 [CI −3.86, −0.12]). Patients who performed exercise alone showed a higher effect of improvement in subjective function (SMD = 3.15 [2.06, 4.24]) and pain (SMD = 4.13 [1.86, 6.41]). Based on these results, an AC rehabilitation exercise program should be developed by adjusting the amount of exercise and joint mobilization by identifying the patient’s needs, subjective symptoms, and ROM. Full article
(This article belongs to the Special Issue Musculoskeletal Disorders, Physical Therapy and Rehabilitation)
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13 pages, 559 KiB  
Article
The Relationship between Nomophobia, Insomnia, Chronotype, Phone in Proximity, Screen Time, and Sleep Duration in Adults: A Mobile Phone App-Assisted Cross-Sectional Study
by Haitham Jahrami
Healthcare 2023, 11(10), 1503; https://doi.org/10.3390/healthcare11101503 - 22 May 2023
Cited by 5 | Viewed by 3135
Abstract
Earlier studies that have investigated the association between nomophobia and insomnia revealed that a strong relationship exists between both variables. This study aimed to explore possible associations between these variables and their impact on physical and mental health outcomes using a cross-sectional study [...] Read more.
Earlier studies that have investigated the association between nomophobia and insomnia revealed that a strong relationship exists between both variables. This study aimed to explore possible associations between these variables and their impact on physical and mental health outcomes using a cross-sectional study design and mobile phone apps to collect data. Using a survey approach, data were collected from 444 participants (52% female, mean age 34 ± 12) using the Nomophobia Questionnaire (NMP-Q), the Insomnia Severity Index (ISI), the Morningness–Eveningness Questionnaire (MEQ) and three Android mobile phone apps. The Plees Tracker, screen time, and pedometer apps aided in collecting data on sleep duration, time spent on screen per day, and how close the phone was to the person. A statistically significant association was noted between nomophobia and insomnia, nomophobia and the eveningness chronotype, and nomophobia and screen time. The eveningness chronotype was also associated with an increased screen time use. The results show that NMP-Q, ISI, and screen time increase according to the chronotype. No statistically significant differences were noted in daily steps or sleep duration according to chronotype. The findings suggest that interventions targeting nomophobia may be beneficial in addressing insomnia among adults, particularly those with an evening chronotype. Future studies should consider exploring the causal relationship between them. Full article
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9 pages, 271 KiB  
Article
Sex Differences in Maximal Oxygen Uptake Adjusted for Skeletal Muscle Mass in Amateur Endurance Athletes: A Cross Sectional Study
by Higgor Amadeus Martins, José Geraldo Barbosa, Aldo Seffrin, Lavínia Vivan, Vinicius Ribeiro dos Anjos Souza, Claudio Andre Barbosa De Lira, Katja Weiss, Beat Knechtle and Marilia Santos Andrade
Healthcare 2023, 11(10), 1502; https://doi.org/10.3390/healthcare11101502 - 22 May 2023
Cited by 1 | Viewed by 2969
Abstract
Male athletes tend to outperform female athletes in several endurance sports. Maximum cardiac output can be estimated by maximal oxygen consumption (V˙O2max), and it has been established that men present [...] Read more.
Male athletes tend to outperform female athletes in several endurance sports. Maximum cardiac output can be estimated by maximal oxygen consumption (V˙O2max), and it has been established that men present V˙O2max values about 20% higher than women. Although sex differences in V˙O2max have already been well studied, few studies have assessed sex differences with regard to muscle oxidative capacity. The aim of this study was to compare aerobic muscle quality, accessed by V˙O2max and adjusted by lower limb lean mass, between male and female amateur triathletes. The study also aimed to compare sex differences according to V˙O2 submaximal values assessed at ventilatory thresholds. A total of 57 participants (23 women and 34 men), who had been training for Olympic-distance triathlon races, underwent body composition evaluation by dual-energy X-ray absorptiometry and performed a cardiorespiratory maximal test on a treadmill. Male athletes had significantly higher V˙O2max, both absolutely and when adjusted to body mass. Conversely, when V˙O2max was adjusted for lean mass, there was no significant difference between sexes. The same was observed at submaximal exercise intensities. In conclusion, differences in V˙O2max adjusted to body mass but not lean mass may explain, at least in part, sex differences in performance in triathlons, marathons, cycling, and other endurance sports. Full article
10 pages, 921 KiB  
Article
Translation and Validation of the Arabic Version of the Athlete Sleep Screening Questionnaire
by Ahmed S. Alhowimel, Aqeel M. Alenazi, Mohammed M. Alshehri, Bader A. Alqahtani, Abdulaziz Al-Jamaan, Faris Alodaibi, Yasir S. Alshehri and Jonathan Charest
Healthcare 2023, 11(10), 1501; https://doi.org/10.3390/healthcare11101501 - 22 May 2023
Cited by 1 | Viewed by 1346
Abstract
Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. [...] Read more.
Sleep improves the cognitive and physical performance of athletes. A detailed questionnaire that detects sleep disruptions is required to identify sleep-deprived athletes. This study evaluates the translated Athlete Sleep Screening Questionnaire (ASSQ), a tool suggested by the International Olympic Committee, among Arabic-speaking athletes. The ASSQ was translated into Arabic and examined for floor or ceiling effects, internal consistency, and validity among Arabic-speaking athletes. The Arabic Pittsburgh Sleep Quality Index (PSQI) was employed to assess convergent validity. Ninety athletes (28.9% women) participated and completed this study’s questionnaires. The Cronbach’s alpha for the ASSQ-Sleep Difficulty Score (SDS) was 0.435, and that of the ASSQ-chronotype was 0.632. The SDS and chronotype subset of the ASSQ demonstrated excellent test-retest reliability, with intraclass correlation coefficients of 0.84 and 0.938, respectively. The ASSQ-SDS correlated positively with the PSQI (0.734, p = 0.001). The ASSQ-chronotype was inversely associated with the PSQI (p = 0.001). This study’s findings can assist clinicians in assessing sleep disorders in sports. The Arabic version of the ASSQ has satisfactory psychometric qualities and can identify clinically relevant sleep problems in athletes. Full article
(This article belongs to the Collection Sport and Exercise Medicine)
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11 pages, 290 KiB  
Article
Factors Associated with Job Stress and Their Effects on Mental Health among Nurses in COVID-19 Wards in Four Hospitals in Korea
by Insu Kim and Hae Ran Kim
Healthcare 2023, 11(10), 1500; https://doi.org/10.3390/healthcare11101500 - 22 May 2023
Viewed by 1514
Abstract
Increased workload during the COVID-19 pandemic has threatened nurses’ mental health. This study aimed to identify factors associated with job stress in COVID-19 nurses compared to other nurses. Nurses were recruited from four hospitals in Republic of Korea in November 2020. The general [...] Read more.
Increased workload during the COVID-19 pandemic has threatened nurses’ mental health. This study aimed to identify factors associated with job stress in COVID-19 nurses compared to other nurses. Nurses were recruited from four hospitals in Republic of Korea in November 2020. The general sociodemographic questionnaire, job stress, anxiety (GAD-7), and depression (PHQ-9) were used to conduct an online survey. Stepwise multiple regression analysis was used to identify the factors associated with job stress. A total of 290 participants were analyzed: 122 in the dedicated ward and 168 in the nondedicated ward nurse groups. Job stress, anxiety, and depression were higher in nurses dedicated to COVID-19 (4.19 ± 0.59, 5.98 ± 3.92, and 6.97 ± 4.47, respectively) than in the nondedicated group (3.92 ± 0.72 (p = 0.001), 4.98 ± 4.20 (p = 0.042), and 5.92 ± 4.36 (p = 0.047), respectively). Among COVID-19 nurses, job stress levels were higher in 30–39 year olds than in 20–29 year olds (3.71 ± 0.43 vs. 4.04 ± 0.54, p = 0.006) and in non-smokers compared with smokers (3.85 ± 0.49 vs. 3.38 ± 0.53, p = 0.24). Anxiety (β = 0.34, standard error (SE) = 0.01, p < 0.001) and clinical experience of 5–10 years (β = 0.23, SE = 0.10, p = 0.004) were associated with job stress. These findings can be applied when devising response strategies for infectious diseases and developing psychological and organizational intervention programs for alleviating job stress in nurses. Full article
11 pages, 1535 KiB  
Article
Chronic Low Back Pain and Incident Transient Ischemic Attack and Stroke in General Practices in Germany
by Louis Jacob, Lee Smith, Ai Koyanagi, Josep Maria Haro, Jae Il Shin, Christian Tanislav, Alexis Schnitzler and Karel Kostev
Healthcare 2023, 11(10), 1499; https://doi.org/10.3390/healthcare11101499 - 21 May 2023
Cited by 1 | Viewed by 1722
Abstract
The aim was to investigate the association between chronic low back pain (CLBP) and incident transient ischemic attack (TIA) and stroke in Germany. The present retrospective cohort study included adults aged ≥18 years who were diagnosed for the first time with CLBP in [...] Read more.
The aim was to investigate the association between chronic low back pain (CLBP) and incident transient ischemic attack (TIA) and stroke in Germany. The present retrospective cohort study included adults aged ≥18 years who were diagnosed for the first time with CLBP in one of 1198 general practices in Germany in 2005–2019 (index date). Patients without CLBP were matched to those with CLBP (1:1) using a propensity score based on age, sex, the index year, the number of medical consultations per year during the follow-up, and the number of years of follow-up. In patients without CLBP, the index date was a randomly selected visit date. Both groups were followed for up to 10 years. There were 159,440 patients included in the study (mean (SD) age: 52.1 (16.5) years; 51.5% women). Within 10 years of the index date, 6.5% and 5.9% of patients with and without CLBP were diagnosed with TIA or stroke, respectively (log-rank p-value < 0.001). The Cox regression analysis corroborated these results, as there was a significant association between CLBP and incident TIA or stroke (HR = 1.28, 95% CI = 1.22–1.35). CLBP was positively and significantly associated with incident TIA and stroke in Germany. More research is warranted to better understand this relationship. Full article
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18 pages, 1626 KiB  
Article
Virtual Reality for Upper Extremity Rehabilitation—A Prospective Pilot Study
by Pinar Tokgöz, Dirk Wähnert, Andreas Elsner, Thomas Schack, Miguel Angel Cienfuegos Tellez, Jens Conrad, Thomas Vordemvenne and Christoph Dockweiler
Healthcare 2023, 11(10), 1498; https://doi.org/10.3390/healthcare11101498 - 21 May 2023
Cited by 3 | Viewed by 1904
Abstract
Applications related to virtual reality are a rapidly growing area. Thus, these technologies are also increasingly used in the field of medicine and rehabilitation. The primary objective of this prospective pilot study was to investigate the feasibility, user experience and acceptance of a [...] Read more.
Applications related to virtual reality are a rapidly growing area. Thus, these technologies are also increasingly used in the field of medicine and rehabilitation. The primary objective of this prospective pilot study was to investigate the feasibility, user experience and acceptance of a virtual-reality-based system for upper extremity rehabilitation. The study was conducted as a single-center trial over 16 weeks. The eligibility criteria included rehabilitants with upper extremity injuries of at least 18 years of age who were fluent in spoken and written German. After detailed instruction, each participant was asked to complete daily 30 min exercises over 15 training sessions with the virtual reality system consisting of three different training modules. Outcomes were assessed pre-study and post-study using standardized clinical measures. In addition, qualitative interviews with rehabilitants as well as therapists regarding user experience and acceptance were conducted. Six participants were recruited for the pilot study, of which five underwent virtual-reality-based rehabilitation. Overall, the clinical measures showed a positive tendency over the course of the study, even if the results were not significant. Furthermore, the virtual-reality-based training was well accepted by the participants as well as therapists. Given these findings, it will be beneficial to evaluate virtual reality for rehabilitation in further research. Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
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13 pages, 1563 KiB  
Article
Cost-Effectiveness of Cerebrolysin after Ischemic Stroke: Secondary Analysis of the CARS Study
by Stefan Strilciuc, Constantin Radu, Diana-Alecsandra Grad, Adina Dora Stan, Cristian Vladescu, Anca Dana Buzoianu and Dafin Muresanu
Healthcare 2023, 11(10), 1497; https://doi.org/10.3390/healthcare11101497 - 21 May 2023
Cited by 1 | Viewed by 1909
Abstract
The cost-effectiveness of Cerebrolysin as an add-on therapy for moderate–severe acute ischemic stroke is a topic that remains understudied. This study aims to address this gap by performing a comprehensive cost-utility analysis using both deterministic and probabilistic methods from a payer perspective and [...] Read more.
The cost-effectiveness of Cerebrolysin as an add-on therapy for moderate–severe acute ischemic stroke is a topic that remains understudied. This study aims to address this gap by performing a comprehensive cost-utility analysis using both deterministic and probabilistic methods from a payer perspective and within the Romanian inpatient care setting. Quality-adjusted life years (QALYs) were calculated using partial individual patient data from the 2016 Cerebrolysin and Recovery After Stroke (CARS) trial, utilizing three different health state valuation models. Cost data was extracted from actual acute care costs reported by Romanian public hospitals for reimbursement purposes for patients included in the CARS study. Incremental cost-effectiveness ratios were calculated for each treatment arm for the duration of the clinical trial. Deterministic analysis based on sample mean values indicates Cerebrolysin would be cost-effective at a threshold between roughly 18.8 and 29.9 thousand EUR, depending on valuation techniques. Probabilistic sensitivity analysis results indicate an 80% chance probability of cost-effectiveness of Cerebrolysin as an add-on therapy for acute ischemic stroke, considering a willingness-to-pay threshold of 50,000 EUR in a 90-day timeframe after stroke. Further economic evaluations of Cerebrolysin are needed to strengthen these findings, covering a timeframe of at least 12 months after the acute incident, which would account for treatment effects spanning beyond the first 90 days after ischemic stroke. These should be conducted to determine its cost-effectiveness under various care settings and patient pathways. Most importantly, modelling techniques are needed to answer important questions such as the estimates of population gain in QALYs after acute administration of Cerebrolysin and the potential offsetting of direct medical costs as a result of administering the intervention. Full article
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9 pages, 482 KiB  
Article
Predictive Factors of the Fatality of Motor Vehicle Passengers Involved in Far-Side Lateral Collisions: A National Crash Database Study
by Akane Masumitsu, Masahito Hitosugi, Mineko Baba, Mami Nakamura, Kaoru Koike, Hitoshi Ida and Masashi Aoki
Healthcare 2023, 11(10), 1496; https://doi.org/10.3390/healthcare11101496 - 21 May 2023
Cited by 2 | Viewed by 1052
Abstract
Although the risks faced by passengers in near-side lateral collisions are understood, and despite the presence of side airbags for injury prevention, passengers involved in far-side lateral collisions also suffer serious and fatal injuries. The objective of this study was to determine the [...] Read more.
Although the risks faced by passengers in near-side lateral collisions are understood, and despite the presence of side airbags for injury prevention, passengers involved in far-side lateral collisions also suffer serious and fatal injuries. The objective of this study was to determine the independent predictive factors of fatality of motor vehicle passengers involved in far-side lateral collisions. Using 2010 records from the National Automotive Sampling System/Crashworthiness Data System (NASS/CDS), we selected 86 fatal and 325 non-fatal passengers with an Abbreviated Injury Scale (AIS) score of 2 or more. The background and injury severity of the passengers and collision characteristics were compared between the two groups. In a multivariable logistic regression analysis, variables independently associated with fatalities were female sex (Ref, male) (odds ratio [OR], 0.396), age (OR, 1.029), body mass index (OR, 1.057), total delta-V (OR, 1.031), head AIS score (OR, 1.679), chest AIS score (OR, 1.330), and abdomen AIS score (OR, 1.294). This is the first report to determine factors affecting fatality in passengers involved in far-side lateral collisions. Improving the safety of the vehicle interior, such as by including additional seatbelt systems or a side airbag that deploys between seats, might help to avoid fatalities, and reduce injury severity. Full article
(This article belongs to the Section Forensic Medicine)
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18 pages, 644 KiB  
Article
Barriers and Facilitators of Communication in the Medication Reconciliation Process during Hospital Discharge: Primary Healthcare Professionals’ Perspectives
by María Jesús Rojas-Ocaña, Cristina Teresa-Morales, Juan Diego Ramos-Pichardo and Miriam Araujo-Hernández
Healthcare 2023, 11(10), 1495; https://doi.org/10.3390/healthcare11101495 - 21 May 2023
Cited by 2 | Viewed by 2031
Abstract
The WHO established that medication errors are the most common and preventable errors and represent an expenditure of 42 billion U.S. dollars annually. The risk of medication errors increases in transitions between levels of care, mainly from hospital care to primary healthcare after [...] Read more.
The WHO established that medication errors are the most common and preventable errors and represent an expenditure of 42 billion U.S. dollars annually. The risk of medication errors increases in transitions between levels of care, mainly from hospital care to primary healthcare after hospital discharge. In this context, communication is a key element in the safety of the medication reconciliation process. The aim of this paper was to describe the barriers to, and facilitators of, effective communication during the medication reconciliation process at hospital discharge in people over 65 years of age, from the perspective of primary healthcare professionals. A qualitative descriptive study was designed, and in-depth interviews were conducted with 21 individuals, of whom 13 were nurses and 8 were physicians. This study was carried out with healthcare professionals belonging to primary healthcare centres in Huelva (Spain). Following content analysis of the discourses we identified 19 categories, grouped into three areas: interlevel communication, communication between primary healthcare professionals, and communication between healthcare professionals and patients/caregivers. The barriers found mainly relate to the adequacy and use of technological tools, time available, workload and the level of collaboration of patients/caregivers. Facilitating elements for communication in medication reconciliation included technologies, such as computerized medical history, protocolization of clinical sessions, the presence of case management nurse and interdisciplinary teamwork. Full article
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11 pages, 752 KiB  
Article
What Are The Core Symptoms of Antenatal Depression? A Study Using Patient Health Questionnaire-9 among Japanese Pregnant Women in the First Trimester
by Toshinori Kitamura, Yuriko Usui, Mikiyo Wakamatsu, Mariko Minatani and Ayako Hada
Healthcare 2023, 11(10), 1494; https://doi.org/10.3390/healthcare11101494 - 20 May 2023
Cited by 1 | Viewed by 1834
Abstract
Background: Depression is frequently seen among pregnant women. This is called antenatal depression (AND). Aim: Our aim was to identify clusters of AND and its core symptoms. Methods: The Patient Health Questionnaire-9 (PHQ-9), Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24), and Nausea and [...] Read more.
Background: Depression is frequently seen among pregnant women. This is called antenatal depression (AND). Aim: Our aim was to identify clusters of AND and its core symptoms. Methods: The Patient Health Questionnaire-9 (PHQ-9), Pregnancy-Unique Quantification of Emesis and Nausea (PUQE-24), and Nausea and Vomiting of Pregnancy Quality of Life Questionnaire (NVP-QOL) were distributed to 382 pregnant women with a gestational age of 10 to 13 weeks who were attending antenatal clinics. The two PHQ-9 subscale scores were entered into a 2-step cluster analysis. The PHQ-9 items’ capacity to identify AND were examined in terms of the area under curve (AUC) of a receiver operating characteristic (ROC) analysis. The selected symptom items were examined for their diagnostic capability in terms of the graded response model (GRM) in the item response theory (IRT) analysis. Results: Three clusters emerged. Cluster 3 scored highly in the scores of the two PHQ-9 subscales and the two emesis scales. In the ROC, five items showed an AUC > 0.80. The GRM identified four items with high information: ‘loss of interest’, ‘depressed mood’, ‘self-esteem’, and ‘poor concentration’. Conclusions: The core symptoms of antenatal depression were four non-somatic symptoms; particularly, ‘depressed mood’ and ‘loss of interest’. AND did not exist alone, but was accompanied by nausea and vomiting. Hence, we propose a new category: emesis–depression complex among pregnant women. Full article
(This article belongs to the Special Issue Perinatal Mental Health and Care)
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22 pages, 9505 KiB  
Article
Automated Uterine Fibroids Detection in Ultrasound Images Using Deep Convolutional Neural Networks
by Ahsan Shahzad, Abid Mushtaq, Abdul Quddoos Sabeeh, Yazeed Yasin Ghadi, Zohaib Mushtaq, Saad Arif, Muhammad Zia ur Rehman, Muhammad Farrukh Qureshi and Faisal Jamil
Healthcare 2023, 11(10), 1493; https://doi.org/10.3390/healthcare11101493 - 20 May 2023
Cited by 8 | Viewed by 4018
Abstract
Fibroids of the uterus are a common benign tumor affecting women of childbearing age. Uterine fibroids (UF) can be effectively treated with earlier identification and diagnosis. Its automated diagnosis from medical images is an area where deep learning (DL)-based algorithms have demonstrated promising [...] Read more.
Fibroids of the uterus are a common benign tumor affecting women of childbearing age. Uterine fibroids (UF) can be effectively treated with earlier identification and diagnosis. Its automated diagnosis from medical images is an area where deep learning (DL)-based algorithms have demonstrated promising results. In this research, we evaluated state-of-the-art DL architectures VGG16, ResNet50, InceptionV3, and our proposed innovative dual-path deep convolutional neural network (DPCNN) architecture for UF detection tasks. Using preprocessing methods including scaling, normalization, and data augmentation, an ultrasound image dataset from Kaggle is prepared for use. After the images are used to train and validate the DL models, the model performance is evaluated using different measures. When compared to existing DL models, our suggested DPCNN architecture achieved the highest accuracy of 99.8 percent. Findings show that pre-trained deep-learning model performance for UF diagnosis from medical images may significantly improve with the application of fine-tuning strategies. In particular, the InceptionV3 model achieved 90% accuracy, with the ResNet50 model achieving 89% accuracy. It should be noted that the VGG16 model was found to have a lower accuracy level of 85%. Our findings show that DL-based methods can be effectively utilized to facilitate automated UF detection from medical images. Further research in this area holds great potential and could lead to the creation of cutting-edge computer-aided diagnosis systems. To further advance the state-of-the-art in medical imaging analysis, the DL community is invited to investigate these lines of research. Although our proposed innovative DPCNN architecture performed best, fine-tuned versions of pre-trained models like InceptionV3 and ResNet50 also delivered strong results. This work lays the foundation for future studies and has the potential to enhance the precision and suitability with which UF is detected. Full article
(This article belongs to the Special Issue Digital Transformation in Healthcare: Second Edition)
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11 pages, 849 KiB  
Article
Sleep Quality in Women with Premenstrual Syndrome Is Associated with Metabolic Syndrome-Related Variables
by Hyejin Chun and Miae Doo
Healthcare 2023, 11(10), 1492; https://doi.org/10.3390/healthcare11101492 - 20 May 2023
Viewed by 1404
Abstract
In this study, we examined whether metabolic syndrome (MetS)-related variables are simultaneously affected by sleep quality, premenstrual syndrome (PMS) and dietary consumption. In this cross-sectional study, data for 307 premenopausal women were available. The results showed that women experiencing PMS had significantly lower [...] Read more.
In this study, we examined whether metabolic syndrome (MetS)-related variables are simultaneously affected by sleep quality, premenstrual syndrome (PMS) and dietary consumption. In this cross-sectional study, data for 307 premenopausal women were available. The results showed that women experiencing PMS had significantly lower sleep quality and were more depressed and anxious (p < 0.001 for all). After the subjects were divided into groups according to PMS, the effect of sleep quality on MetS-related variables or MetS components significantly differed; only among women who experienced PMS were poor sleepers significantly higher in waist circumference (p = 0.018) and diastolic blood pressure (p = 0.012) than good sleepers. Among the MetS components, abdominal obesity in women with poor sleep quality was approximately three (16.9% vs. 3.0%, p= 0.020) times more common than in those with good sleep quality. However, these findings were not observed among those who did not experience PMS. Poor sleepers among women experiencing PMS consumed 2.8 times more alcoholic drinks than good sleepers (p = 0.006). The MetS-related variables in Korean women experiencing PMS are associated with sleep quality, and these associations may be modified by dietary habits. Full article
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15 pages, 1377 KiB  
Article
Effectiveness of the Boston Brace in the Treatment of Paediatric Scoliosis: A Longitudinal Study from 2010–2020 in a National Spinal Centre
by Athanasios I. Tsirikos, Rachel Adam, Kirsty Sutters, Maureen Fernandes and Silvia García-Martínez
Healthcare 2023, 11(10), 1491; https://doi.org/10.3390/healthcare11101491 - 20 May 2023
Cited by 1 | Viewed by 1535
Abstract
Bracing can reduce curve progression in order to prevent or delay scoliosis surgery in growing children. Brace treatment is effective in adolescent idiopathic scoliosis (AIS), but there is less evidence of its efficacy in early-onset or non-idiopathic scoliosis. We assessed the outcome of [...] Read more.
Bracing can reduce curve progression in order to prevent or delay scoliosis surgery in growing children. Brace treatment is effective in adolescent idiopathic scoliosis (AIS), but there is less evidence of its efficacy in early-onset or non-idiopathic scoliosis. We assessed the outcome of bracing at the end point of treatment, including the patients’ perception of clinical results. We reviewed 480 patients treated using Boston brace from 2010–2020 (70% female); 249 patients completed bracing (52%) and 118 patients (47.4%) did not require surgery, with 83% having idiopathic scoliosis. Brace success was considered scoliosis below 50° at the end of bracing, with the patient skeletally mature. A total of 131 patients required scoliosis surgery after bracing (64% had idiopathic scoliosis; adolescents 57% and juveniles 43%). All patients had a minimum two-year follow-up after bracing or after scoliosis correction, with the quality of life assessment questionnaires. A total of 98 out of 182 patients with idiopathic scoliosis did not require surgery (54%). Thoracic scoliosis improved with bracing by a mean of 3.4° and thoracolumbar/lumbar scoliosis by a mean of 6.8°. A total of 85 patients with AIS (64%) but only 9 patients with JIS (20%) did not need surgery. In the AIS group, 97 patients had scoliosis of 20–40°; 71 of these patients (73.2%) did not require scoliosis correction at the end of bracing. In total, 84 patients with idiopathic scoliosis had surgery at a mean of 14 years (surgery was delayed by a mean of 3.2 years). In total, 20 of 67 patients with non-idiopathic scoliosis did not need surgery (30%). Thoracic scoliosis improved with bracing by a mean of 8.4° and thoracolumbar/lumbar scoliosis by a mean of 0.8°. A total of 47 patients with non-idiopathic scoliosis required surgery at a mean of 13.1 years (surgery was delayed by a mean of 5.2 years). Multivariate regression analysis showed that idiopathic scoliosis, AIS, closed triradiate cartilage, post-menarche status, higher Risser grade and smaller scoliosis angle at initial presentation predicted brace success. Patients reported good function and self-image, reduced pain and high satisfaction after treatment in both the bracing-only and the bracing followed by surgery groups. Full article
(This article belongs to the Special Issue Paediatric Spinal Deformity)
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