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Healthcare, Volume 12, Issue 21 (November-1 2024) – 101 articles

Cover Story (view full-size image): Peritoneal dialysis (PD) has been shown to confer several advantages over haemodialysis. However, patients undergoing PD typically have complex treatment needs, and the effect of medication regimen complexity on patient outcomes has not been thoroughly evaluated. Thus, this study aims to quantify medication regimen complexity and evaluate patient-centred outcomes, including medication adherence and its determinants in patients undergoing PD. We identified that patients on PD are prescribed complex medication regimens in addition to PD treatments that they perform at home. Our findings on patients on PD, who were adherent to their medications with significantly better outcomes compared to their non-adherent counterparts, reinforces the importance of enhancing patient adherence as one of the main focuses in the practise of daily care for patients with kidney failure. View this paper
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14 pages, 273 KiB  
Article
Evaluation of the Friday Night Live Mentoring Program on Supporting Positive Youth Development Outcomes
by Kathleen P. Tebb and Ketan Tamirisa
Healthcare 2024, 12(21), 2199; https://doi.org/10.3390/healthcare12212199 - 4 Nov 2024
Viewed by 733
Abstract
Introduction: The use of alcohol, tobacco, and other drugs (ATOD) is a leading cause of preventable morbidity and mortality among adolescents. While traditional interventions have targeted specific health-risk behaviors (e.g., substance use, initiation of sexual intercourse, truancy, etc.), the evidence suggests that using [...] Read more.
Introduction: The use of alcohol, tobacco, and other drugs (ATOD) is a leading cause of preventable morbidity and mortality among adolescents. While traditional interventions have targeted specific health-risk behaviors (e.g., substance use, initiation of sexual intercourse, truancy, etc.), the evidence suggests that using a positive youth development (PYD) framework may have positive impacts across a number of domains. Friday Night Live Mentoring (FNLM) is a PYD-based, cross-age peer mentoring program that engages teams of older high school-aged youth to mentor teams of middle school-aged youth in a structured, ongoing, one-on-one relationship. While studies have demonstrated significant but small effect sizes of intergenerational youth mentoring programs in which an adult mentor is paired with the youth mentee, research on cross-age mentoring programs is limited. The purpose of the current study is to evaluate FNLM on its ability to improve participants’ knowledge, attitudes, skills, opportunities to develop caring relationships, school engagement, and academic performance. Methods: A retrospective, pre–post survey was administered online to FNLM participants across 13 California counties. Participants rated their knowledge and attitudes about ATOD, skills, relationships with peers and adults, and academic indicators. Open-ended questions gathered information about participants’ experiences in FNLM. Non-parametric related-samples Wilcoxon signed rank tests (an alternative to paired t-test) were used to compare pre–post differences. Participants were also asked two open-ended questions: “What are the best parts of FNLM?” and “What, if anything, would you change?”. The responses to each question were reviewed, coded, and analyzed according to key themes. Results: A total of 512 participants completed the survey (287 mentors and 225 protégés). There were small but statistically significant improvements across all items for both mentors and protégés. Qualitative analyses showed that most mentors and protégés especially enjoyed getting to know and spend time with one another. Several mentors added that it was rewarding to be a positive influence on or to make a positive difference in the protégé’s life. Many youth stated that the relationships formed, especially with their partner, and the activities were the best part of FNLM. The overwhelming majority would not change anything about the program. Those who provided recommendations for program improvement suggested more activities or more hands-on and engaging activities and more or longer meetings. Conclusion: FNLM actively engages youth and provides them with support and opportunities that promote knowledge, skill development, positive relationships, academic engagement, and success and raise awareness of the harms that the use of alcohol, tobacco, and other drugs (ATOD) can cause. While ATOD use was low prior to program participation, it was significantly lower after participating in the program. Full article
17 pages, 523 KiB  
Article
Determinants of Doctor–Patient Communication in Terms of Patient Rights During the COVID-19 Pandemic
by Kamila Jaroń, Mateusz Grajek and Joanna Kobza
Healthcare 2024, 12(21), 2198; https://doi.org/10.3390/healthcare12212198 - 4 Nov 2024
Viewed by 777
Abstract
Background. Today, the public does not want to be just a passive consumer of health services. Patients often expect to be informed and involved in decisions about their health. With better doctor–patient communication, patients are more likely to follow treatment recommendations. Material and [...] Read more.
Background. Today, the public does not want to be just a passive consumer of health services. Patients often expect to be informed and involved in decisions about their health. With better doctor–patient communication, patients are more likely to follow treatment recommendations. Material and methods. The study was conducted using a face-to-face survey method on a group of 203 adult, independent patients from 2021 to 2022 at a medical facility, i.e., a rehabilitation clinic. Objective. The purpose of this study was to assess the determinants of doctor–patient communication in terms of patient rights. One of patients’ rights is the right to information about their health condition and treatment methods and the right to ask questions when the doctor does not provide details about the treatment or diagnosis or when it is not understandable. Doctors providing information to the patient and the opportunity for the patient to ask questions are key elements in the process of making informed decisions regarding further medical treatment. Therefore, patients were divided into two groups: active (+) and passive in communication (−) with doctors. Results. Patients who were active in communication (33%) wanted to ask questions or had the opportunity to ask the doctor questions, and thus, they were able to take an active part in the discussion with the doctor. In contrast, patients who were passive in communication (67%) did not want to ask questions or did not have the opportunity to ask the doctor questions, and therefore, their active participation in the discussion and thus their right to ask questions may have been limited. The authors’ survey shows that respondents with active communication were significantly more likely than patients with passive communication (almost 100% vs. 86%) to obtain information about their condition (p = 0.002), diagnostic methods (p = 0.003), therapeutic methods (p = 0.00007), treatment results, and prognosis (p = 0.0008). Moreover, almost all respondents with active communication as opposed to respondents with passive communication (95% vs. 52%) rated communication with doctors highest (on a scale from 0 to 5), including credible and professional approach to patients (p < 0.0001), providing information in clear and simple language (p < 0.0001), answering questions asked by patients (p < 0.0001), openness and kindness (p < 0.0001), maintaining professional confidentiality (p < 0.0001), or emotional support (p < 0.0001). Conclusions. Hence, the primary key element of the medical consultation is appropriate amount and content of information given to the patient, providing explanations and answering questions. Also importantly, according to the results, active communication between patients and doctors was significantly influenced by female gender, higher education, and a positive evaluation of communication with doctors. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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10 pages, 442 KiB  
Article
Relationship Between Swallowing Function and Low Serum Albumin Levels in Older Japanese People Aged ≥ 75 Years
by Komei Iwai, Tetsuji Azuma, Takatoshi Yonenaga, Yasuyuki Sasai, Yoshinari Komatsu, Koichiro Tabata, Taketsugu Nomura, Iwane Sugiura, Yujo Inagawa, Yusuke Matsumoto, Seiji Nakashima, Yoshikazu Abe and Takaaki Tomofuji
Healthcare 2024, 12(21), 2197; https://doi.org/10.3390/healthcare12212197 - 4 Nov 2024
Viewed by 613
Abstract
Background/Objectives: This cross-sectional study aimed to investigate the relationship between swallowing function and low serum albumin levels in older Japanese people (aged ≥ 75 years). Methods: A total of 3258 participants (1325 males, 1933 females; mean age, 80.8 years) who had a dental [...] Read more.
Background/Objectives: This cross-sectional study aimed to investigate the relationship between swallowing function and low serum albumin levels in older Japanese people (aged ≥ 75 years). Methods: A total of 3258 participants (1325 males, 1933 females; mean age, 80.8 years) who had a dental checkup in Gifu City, Japan, between April 2020 and March 2021 were recruited. Swallowing function was assessed using the repetitive saliva swallow test, with poor swallowing function defined as swallowing fewer than three times in 30 s. A serum albumin level < 3.6 G/dL was considered low. Results: In total, 78 participants (2%) had a low serum albumin level. Furthermore, after adjusting for age, gender, circulatory disease, support/care-need certification, number of present teeth, and tongue and lip function, a low serum albumin level was positively associated with older (odds ratio [OR]: 1.115; 95% confidence interval [CI]: 1.064–1.169), male (OR: 2.208; 95% CI: 1.360–3.584), circulatory disease (OR: 1.829; 95% CI: 1.079–3.099), support/care-need certification (OR: 2.087; 95% CI: 1.208–3.606), and poor swallowing function (OR: 2.379; CI: 1.377–4.112). Conclusions: These results indicate that poor swallowing function was associated with a low serum albumin level in older Japanese people aged ≥ 75 years. Full article
(This article belongs to the Section Nutrition and Public Health)
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14 pages, 934 KiB  
Review
Treating Cognition in Schizophrenia: A Whole Lifespan Perspective
by Rafael Penadés, Maria Florencia Forte, Gisela Mezquida, Claudia Andrés, Rosa Catalán and Bàrbara Segura
Healthcare 2024, 12(21), 2196; https://doi.org/10.3390/healthcare12212196 - 4 Nov 2024
Viewed by 964
Abstract
Background/Objectives: Cognitive impairment is a core feature of schizophrenia, affecting attention, memory, and executive function and contributing significantly to the burden of the disorder. These deficits often begin before the onset of psychotic symptoms and persist throughout life, making their treatment essential for [...] Read more.
Background/Objectives: Cognitive impairment is a core feature of schizophrenia, affecting attention, memory, and executive function and contributing significantly to the burden of the disorder. These deficits often begin before the onset of psychotic symptoms and persist throughout life, making their treatment essential for improving outcomes and functionality. This work aims to explore the impact of these impairments at different life stages and the interventions that have been developed to mitigate their effects. Methods: This narrative review examined literature searching for different approaches to treat cognitive impairments in schizophrenia across the lifespan. Results: Cognitive alterations appear before psychosis onset, suggesting a window for primary prevention. Then, a period of relative stability with a slight decline gives the period to secondary and eventually tertiary prevention for more than two decades. Finally, another window for tertiary prevention occurs from the third decade of illness until the later stages of the illness, when a progression in cognitive decline could be accelerated in some cases. Cognitive remediation and physical exercise are evidence-based interventions that should be provided to all patients with disabilities. Conclusions: Treating cognition throughout the whole lifespan is crucial for improving functional outcomes. It is necessary to consider the need for personalized, stage-specific strategies to enhance cognitive function and functioning in patients. Full article
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12 pages, 511 KiB  
Article
Changes in Technology Acceptance of Smart Care Beds Among Long-Term Care Workers in Korea
by Young-Sun Kim, Hyeri Shin, Minah Lee, Nam-Hwa Kim, Eui-Hyun Kim, Dukyoung Jung, Minra Choi and Kyeong-Hee Choi
Healthcare 2024, 12(21), 2195; https://doi.org/10.3390/healthcare12212195 - 4 Nov 2024
Viewed by 764
Abstract
Objectives: This study investigates the changing perceptions of Korean care workers regarding a robotic bed designed to assist with repositioning and prevent pressure ulcers. With the primary aim of assessing the technology acceptance among care workers using the robotic bed to solve the [...] Read more.
Objectives: This study investigates the changing perceptions of Korean care workers regarding a robotic bed designed to assist with repositioning and prevent pressure ulcers. With the primary aim of assessing the technology acceptance among care workers using the robotic bed to solve the problem of a shortage of care workers in Korea, we sought to examine the possibility of applying care robots in the field. Methods: A total of 20 long-term care workers participated in the experiment, and their attitudes were measured before and after using the robot. Frequency analysis and paired t-tests were conducted using Stata 17 to analyze the data. Results: The results show significant changes in the perceived ease of use (PEOU), facilitating conditions (FCs), and gerontology anxiety (GA), with the PEOU increasing by 19.87%, FC increasing by 20.63%, and GA decreasing by 17.2%. However, there was no significant change in the perceived usefulness (PU) and intention to use (IU). Conclusions: The results showing that the perception of technology acceptance changed significantly mean that the use of the care robot means that there is a high possibility of positive perceptions in Korean care settings when care robots are distributed in the field in the future, considering that the experimental environment was limited due to the early stage of development of care robots. This study highlights the need for practical demonstrations and thorough training to improve technology acceptance among care workers before the application of care technology in the long-term care environment in South Korea. Full article
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14 pages, 702 KiB  
Article
Analysis of Speech Features in Alzheimer’s Disease with Machine Learning: A Case-Control Study
by Shinichi Noto, Yuichi Sekiyama, Ryo Nagata, Gai Yamamoto and Toshiaki Tamura
Healthcare 2024, 12(21), 2194; https://doi.org/10.3390/healthcare12212194 - 4 Nov 2024
Viewed by 741
Abstract
Background: Changes in the speech and language of patients with Alzheimer’s disease (AD) have been reported. Using machine learning to characterize these irregularities may contribute to the early, non-invasive diagnosis of AD. Methods: We conducted cognitive function assessments, including the Mini-Mental State Examination, [...] Read more.
Background: Changes in the speech and language of patients with Alzheimer’s disease (AD) have been reported. Using machine learning to characterize these irregularities may contribute to the early, non-invasive diagnosis of AD. Methods: We conducted cognitive function assessments, including the Mini-Mental State Examination, with 83 patients with AD and 75 healthy elderly participants, and recorded pre- and post-assessment conversations to evaluate participants’ speech. We analyzed the characteristics of the spectrum, intensity, fundamental frequency, and minute temporal variation (∆) of the intensity and fundamental frequency of the speech and compared them between patients with AD and healthy participants. Additionally, we evaluated the performance of the speech features that differed between the two groups as single explanatory variables. Results: We found significant differences in almost all elements of the speech spectrum between the two groups. Regarding the intensity, we found significant differences in all the factors except for the standard deviation between the two groups. In the performance evaluation, the areas under the curve revealed by logistic regression analysis were higher for the center of gravity (0.908 ± 0.036), mean skewness (0.904 ± 0.023), kurtosis (0.932 ± 0.023), and standard deviation (0.977 ± 0.012) of the spectra. Conclusions: This study used machine learning to reveal speech features of patients diagnosed with AD in comparison with healthy elderly people. Significant differences were found between the two groups in all components of the spectrum, paving the way for early non-invasive diagnosis of AD in the future. Full article
(This article belongs to the Special Issue Aging and Quality of Life: Second Edition)
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10 pages, 260 KiB  
Article
Prevalence of Alexithymia and Associated Factors Among Dental Students in Saudi Arabia: A Cross-Sectional Study
by Hebah M. Hamdan, Ghaida Alislimah, Hessa Alshalawi, Khawlah Alharbi, Mohammed I. Alsaif and Ayman M. Sulimany
Healthcare 2024, 12(21), 2193; https://doi.org/10.3390/healthcare12212193 - 4 Nov 2024
Viewed by 775
Abstract
Background: Mental health challenges among university students are pervasive, with alexithymia posing a particularly significant yet understudied challenge. This condition significantly affects an individual’s ability to cope with stress due to difficulties in recognizing, describing, and processing emotions. Objectives: This study aims to [...] Read more.
Background: Mental health challenges among university students are pervasive, with alexithymia posing a particularly significant yet understudied challenge. This condition significantly affects an individual’s ability to cope with stress due to difficulties in recognizing, describing, and processing emotions. Objectives: This study aims to evaluate alexithymia prevalence and its associated factors among dental undergraduate students and interns enrolled at King Saud University in Riyadh, Saudi Arabia. Methods: Data were collected through a self-administered online survey that assessed alexithymia symptoms (using the Toronto Alexithymia Scale [TAS-20]), sociodemographic profiles, lifestyle-related factors, and health-related factors. The associations between participant factors and alexithymia were assessed using chi-square and multiple logistic regression analyses. Results: Of the 421 eligible participants, 369 completed the survey (87.6% response rate), revealing a significant prevalence of alexithymia (37.9%). Female gender (AOR = 1.7, p = 0.04), depression (AOR = 5.6, p < 0.0001), chronic diseases (AOR = 3.5, p = 0.003), and childhood abuse (AOR = 2.2, p = 0.047) were independent factors significantly associated with alexithymia. Conclusions: These findings highlight the pressing need for mental health support within dental education. Early interventions targeting alexithymia could mitigate its adverse consequences, promoting better student well-being and academic success. Full article
20 pages, 506 KiB  
Article
Innovative Regional Services and Heterogeneous Communication Channels: Results from the Nationwide German egePan Project for Pandemic Management
by Simon Kugai, Benjamin Aretz, Yelda Krumpholtz, Manuela Schmidt, Daniela Süssle, Linda Steyer, Adrienne Henkel, Katrin Bender, Felix Girrbach, Sebastian Stehr, Katrin Balzer and Birgitta Weltermann
Healthcare 2024, 12(21), 2192; https://doi.org/10.3390/healthcare12212192 - 4 Nov 2024
Viewed by 718
Abstract
Background: In the COVID-19 pandemic, novel regional services and communication channels emerged across all sectors of the German healthcare system. To contribute to pandemic preparedness, this study aims to describe newly established services in response to the COVID-19 pandemic from a stakeholder [...] Read more.
Background: In the COVID-19 pandemic, novel regional services and communication channels emerged across all sectors of the German healthcare system. To contribute to pandemic preparedness, this study aims to describe newly established services in response to the COVID-19 pandemic from a stakeholder perspective and to examine the interprofessional communication channels, applying a nationwide cross-sectional approach. Methods: A nationwide sample of German healthcare stakeholders comprising general practitioners, associations of statutory health insurance physicians, hospital medical directors, local health departments, rescue coordination centres, medical directors of emergency services, outpatient nursing services, nursing homes, community care access centres, and hospital nursing managers was surveyed. A web-based questionnaire asked for their level of participation in newly implemented regional COVID-19 services and communication channels. Stakeholders’ level of recommendation was measured using the Net Promotor Score (NPS), a metric that assesses their satisfaction towards the services surveyed. Results: In total, 1312 healthcare stakeholders participated in the survey. Diagnostic centres (23.0–90.9%), COVID-19 wards in hospitals (40.5–92.1%), emergency medical vehicles designated solely for COVID-19 patients (16.5–68.4%), and crisis intervention teams (11.6–30.6%) exhibited the highest rates of engagement. The services receiving the highest recommendation for future use were COVID-19 focus practices (NPS: 33.4–43.7), COVID-19 wards in hospitals (NPS: 47.6–84.4), transportation of COVID-19 patients exclusively by predefined professional groups (NPS: 12.5–36.4), and newly implemented digitally supported nursing services (NPS: 58.3–100.0). Telephones emerged as the most frequently used communication channel (58.0–96.7%), while email was the primary digital channel (23.7–81.5%). Conclusions: During the COVID-19 pandemic, Germany experienced significant variation in the implementation of pandemic-related services across healthcare sectors, with stakeholders prioritising services built on existing healthcare structures. Developing a proactive digital infrastructure to connect healthcare professionals from different sectors is crucial for better future pandemic management. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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11 pages, 3608 KiB  
Article
Spatial Patterns of Emergency Dental Care Utilization: Assessing the Influence of Social Vulnerability and Dental Provider Availability
by Darrell J. Gaskin, Oshin Kanwar, Rachael McCleary, Anna L. Davis, Darien J. Weatherspoon, Eleanor Fleming, Ali Iftikhar, Khushbu Balsara and Hossein Zare
Healthcare 2024, 12(21), 2191; https://doi.org/10.3390/healthcare12212191 - 4 Nov 2024
Viewed by 705
Abstract
Aim: Our aim was to examine the association between emergency dental care use and dental providers’ availability and ZIP code social vulnerability index. Methods: This cross-sectional observational study mapped variations in emergency dental care and analyzed their association with social vulnerability using generalized [...] Read more.
Aim: Our aim was to examine the association between emergency dental care use and dental providers’ availability and ZIP code social vulnerability index. Methods: This cross-sectional observational study mapped variations in emergency dental care and analyzed their association with social vulnerability using generalized spatial two-stage least-squares to address spatial correlation. To perform spatial autoregressive modeling to examine how dental provider capacity and social vulnerability influence emergency care use across neighboring counties, accounting for ZIP Code Tabulation Area (ZCTA) spillover effects, we used secondary data from the Maryland Health Services Cost Review Commission, InfoUSA, and the US Census American Community Survey. We focused on emergency dental care usage in ZIP Code Tabulation Areas, using emergency department visits and inpatient stays per 1000 residents for dental conditions, as the dependent variable. Results: Highly vulnerable ZCTAs saw 5.9× more non-traumatic dental condition (NTDC) ED visits, 5.3× more chronic dental ED visits, 3.3× more NTDC inpatient stays, and 1.3× more chronic dental inpatient stays than less vulnerable areas. For all four measures of emergency dental care use, increased dental provider availability was associated with reductions in use of emergency dental care (ED), while higher social vulnerability was associated with increased use. For example, an increase of one dental provider per 1000 residents was associated with a reduction of 28.2 non-traumatic dental ED visits, while a high social vulnerability index was associated with an increase of 88.6 non-traumatic dental ED visits. Conclusions: There was an association among dental provider availability, social vulnerability, and the use of emergency dental care. Full article
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16 pages, 269 KiB  
Article
The Efficacy of Telehealth Versus In-Person Management Delivery in Adult Patients with Obesity
by Rawan A. Alolayan, Dara A. Aldisi, Danish S. Hussain, Nora Alafif and Mahmoud M. A. Abulmeaty
Healthcare 2024, 12(21), 2190; https://doi.org/10.3390/healthcare12212190 - 4 Nov 2024
Viewed by 655
Abstract
Background: The effectiveness of telehealth in managing obesity in Saudi patients is still under investigation. This study compared the effectiveness of telehealth and in-person obesity management programs for adults. Methods: This clinical trial involved 62 adults, 29 receiving in-person intervention at the clinic [...] Read more.
Background: The effectiveness of telehealth in managing obesity in Saudi patients is still under investigation. This study compared the effectiveness of telehealth and in-person obesity management programs for adults. Methods: This clinical trial involved 62 adults, 29 receiving in-person intervention at the clinic and 33 receiving telehealth via videoconference calls. Anthropometric measurements, biochemical parameters, and dietary and lifestyle habits were assessed at baseline and after 12 weeks. Patients have been educated about goal-setting, healthy eating behaviors, personalized meal plans, and increasing physical activity levels. Results: It showed that 45% and 49% of the in-person and telehealth groups lost more than 5% of their initial body weight. Weight, % body fat, and waist circumference were significantly reduced in the in-person and telehealth groups (p < 0.001). No significant differences between the groups were found in the parameters mentioned above. Within-group analysis showed that light physical activity levels improved in both groups significantly (p < 0.001), and the moderate physical activity level improved significantly among the telehealth group (p < 0.039). No significant differences were observed between the groups regarding physical activity level, blood pressure measurement, and biochemical markers, except for the RBC blood level (p = 0.026). The telehealth group had significantly higher attendance rates for counseling sessions (97% vs. 75% for the in-person group, p < 0.01). Participants’ dropout rates were higher for the in-person group 21%, compared to the telehealth group 13%. Telehealth participants’ satisfaction regarding the benefits of the obesity management program in losing weight was higher at 87% compared to the in-person group at 76%. Conclusions: In conclusion, applying a telehealth obesity management program can support patients struggling with obesity who may have limited access to traditional healthcare services, while ensuring that telehealth care replicates the quality of in-person care. Full article
(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)
11 pages, 276 KiB  
Article
Evaluation of Periodontitis and Fusobacterium nucleatum Among Colorectal Cancer Patients: An Observational Cross-Sectional Study
by Anna Antonacci, Cinzia Bizzoca, Giuseppe Barile, Valeria Andriola, Leonardo Vincenti, Nicola Bartolomeo, Antonia Abbinante, Germano Orrù and Massimo Corsalini
Healthcare 2024, 12(21), 2189; https://doi.org/10.3390/healthcare12212189 - 4 Nov 2024
Viewed by 674
Abstract
Background: Periodontitis has been associated with an increased risk of CRC, as well as a worse prognosis due to increased inflammation mediators and carcinogenic factors. Moreover, direct and indirect virulence factors from periodontal pathogens, such as Fusobacterium nucleatum, could play a pivotal [...] Read more.
Background: Periodontitis has been associated with an increased risk of CRC, as well as a worse prognosis due to increased inflammation mediators and carcinogenic factors. Moreover, direct and indirect virulence factors from periodontal pathogens, such as Fusobacterium nucleatum, could play a pivotal role in malignant transformation and progression. This cross-sectional study aims to evaluate the presence and the stage of periodontitis in a cohort of patients with CRC. The secondary aim is to assess the presence of F. nucleatum and its relationship with patients’ general characteristics, concomitant pathologies, tumor characteristics, and drug therapy. Materials and Methods: Patients affected by CRC underwent dental examination and periodontal charting with the “North Carolina” probe to assess the presence and stage of periodontitis, according to the new classification of periodontal diseases of the World Workshop of the European Federation of Periodontology (EFP) and the American Academy of Periodontology (AAP) 2017. F. nucleatum presence was assessed by a dorsal tongue swab and related to the patient’s general characteristics, concomitant pathologies, tumor characteristics, and drug therapy. Results: Periodontal disease was found in 94.3% of I/II CRC stage patients and 100% of III/IV CRC stage patients. Severe periodontitis was found in 76% of the advanced CRC stage and 87.9% of patients with initial CRC, while initial periodontitis was found in 12.1% of initial CRC and 24% of late CRC stages, respectively, without significant differences. F. nucleatum presence showed no correlation between the patient’s and tumor’s characteristics, comorbidities, and drug assumed. Conclusions: Periodontal disease showed a high prevalence among CRC patients. Moreover, severe periodontitis has a higher prevalence in CRC patients compared to initial periodontitis. F. nucleatum presence was unrelated to CRC stage, site, other comorbidities, and drug therapies. With these data, it is not possible to admit a direct relationship between CRC and periodontal disease, but further case–control studies must be carried out to further prove this aspect. Preventive and operative targeted strategies to maintain a healthy oral status are suggested in CRC patients. Full article
12 pages, 1183 KiB  
Article
Mental Health Status of Patients Recovered from COVID-19 in Macau: A Cross-Sectional Survey
by Ting-Fai Man, Jing-Yu Zhu, Xi-Nan Song and Ying Bian
Healthcare 2024, 12(21), 2188; https://doi.org/10.3390/healthcare12212188 - 4 Nov 2024
Viewed by 822
Abstract
Background/Objectives: The COVID-19 pandemic has led to a global health crisis, impacting physical, and mental well-being, particularly among those who have recovered from the illness. This study aimed to assess the mental health status of patients recovered from COVID-19 in Macau, focusing on [...] Read more.
Background/Objectives: The COVID-19 pandemic has led to a global health crisis, impacting physical, and mental well-being, particularly among those who have recovered from the illness. This study aimed to assess the mental health status of patients recovered from COVID-19 in Macau, focusing on the impact of sequelae of COVID-19, and identifying demographic factors associated with poor mental health. Methods: A cross-sectional online survey was conducted involving 494 adults who had recovered from COVID-19, with 426 participants included in the final analysis. Mental health was evaluated using the 12-item General Health Questionnaire (GHQ-12), with scores ≥3 indicating poor mental health. Results: This study revealed a high prevalence of poor mental health, affecting 71.8% of the respondents. Binary logistic regression identified experiencing COVID-19 sequelae (OR = 5.727, 95% CI: 2.973–11.031), being in the age groups of 26–45 (OR = 4.227, 95% CI: 1.754–10.185), or 61, and above (OR = 18.072, 95% CI: 3.590–90.962), being male (OR = 0.501, 95% CI: 0.257–0.979), being married (OR = 5.714, 95% CI: 1.919–17.016), and dissatisfaction with family relationships (OR = 2.957, 95% CI: 1.228–7.119) as significant risk factors for poor mental health. Conclusions: This study underscores the critical need for targeted psychological support for patients recovered from COVID-19 in Macau, particularly for those with sequelae, and those in vulnerable demographic groups. The findings suggest that specific age groups and individuals with sequelae may face higher mental health risks, indicating the necessity for prioritized interventions. Full article
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14 pages, 294 KiB  
Article
Volunteering and Its Association with Depression, Loneliness, and Lifestyle of Older Adults: Insights from a Japanese Cross-Sectional Study
by Thomas Mayers, Sachie Eto, Naoki Maki, Akihiro Araki and Hitomi Matsuda
Healthcare 2024, 12(21), 2187; https://doi.org/10.3390/healthcare12212187 - 3 Nov 2024
Viewed by 948
Abstract
Background/Objectives: Volunteering has been widely recognized as beneficial to the well-being of older adults, providing health benefits, increased social engagement, and a sense of purpose. This study aimed to explore the associations between volunteering and physical and mental health measures among older adults [...] Read more.
Background/Objectives: Volunteering has been widely recognized as beneficial to the well-being of older adults, providing health benefits, increased social engagement, and a sense of purpose. This study aimed to explore the associations between volunteering and physical and mental health measures among older adults in Japan. Methods: Using an online survey conducted during the COVID-19 pandemic, 500 participants aged 65 and older were divided into volunteer and non-volunteer groups. Demographic, lifestyle, and health characteristics were comprehensively assessed using a series of reliable and validated instruments. Logistic regression analysis was used to explore the associations between volunteering and health outcomes. Results: The findings revealed that while there were no significant differences in physical health indicators and undertreatment of most diseases (with the exception of cataracts), volunteers reported significantly lower levels of depression and loneliness compared to non-volunteers. The volunteer group also showed greater engagement in social activities and hobbies, which may have contributed to their improved mental health outcomes. Conclusions: The results of this study add to the growing body of evidence suggesting that volunteering may be an effective, low-cost intervention for promoting mental health and social engagement among older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People: Second Edition)
14 pages, 249 KiB  
Article
Fairness, Trust, and Well-Being Among Young Adults: Evidence from 2021 Chinese General Social Survey (CGSS)
by Liyun Wu and Gang Wang
Healthcare 2024, 12(21), 2186; https://doi.org/10.3390/healthcare12212186 - 3 Nov 2024
Viewed by 1025
Abstract
Background. As China has undergone tremendous socioeconomic and demographic changes during and after the pandemic, it is crucial to enhance youth well-being and facilitate their transition into the workforce. This study aims to explore the multi-dimensional features of well-being and examine their [...] Read more.
Background. As China has undergone tremendous socioeconomic and demographic changes during and after the pandemic, it is crucial to enhance youth well-being and facilitate their transition into the workforce. This study aims to explore the multi-dimensional features of well-being and examine their relationships with fairness and trust. Methods. Using the nationally representative data from the 2021 Chinese General Social Survey (CGSS), this study analyzes the well-being of 1726 young adults aged 18 to 34 years old living in 19 provinces in China. Results. The research findings generate five latent factors of well-being and reveal the multi-faceted nature of subjective well-being, including physical and mental health challenges, positive outlook, sense of purpose, personal growth, and self-fulfillment. Physical and mental health is the cornerstone for well-being and happiness. Young people with poor physical and mental health conditions are less likely to perceive that society is fair or that people are trustworthy. Additionally, a positive outlook and future orientation are strongly associated with high fairness and/or trust. Discussion and Conclusions. By investigating the differential domains of well-being, this study contributes to the literature with the new conceptualization of well-being sub-measures and their application to youth. Furthermore, this study identifies that well-being is not only an individual-level characteristic but also a group-level attribute that can contribute to fairness and trust at the societal level. As China continues to expand its infrastructure on education, health, and technology, it is expected that sustainable economic growth and development should boost young people’s career development and promote their upward mobility. Full article
11 pages, 397 KiB  
Article
Adaptation of the Taiwan Version of the Supportive and Palliative Care Indicators Tool (SPICT-TW) and Its Association with Six-Month Mortality: A Multi-Center Validation Study in Older People
by Jung-Yu Liao, Hsiao-Ting Chang, Jen-Kuei Peng, Scott A. Murray, Chien-Yi Wu, Hisen-Cheng Chang, Chia-Ming Li, Shao-Yi Cheng, Wei-Zhe Tseng, Chao Agnes Hsiung, Hung-Yi Chiou, Sang-Ju Yu, Kirsty Boyd and Ping-Jen Chen
Healthcare 2024, 12(21), 2185; https://doi.org/10.3390/healthcare12212185 - 1 Nov 2024
Viewed by 1223
Abstract
Background: The Supportive and Palliative Care Indicators Tool (SPICT) was developed for identifying, in a timely manner, patients who may benefit from supportive and palliative care for better treatment review, care-plan discussion, and end-of-life care. Although the SPICT has been validated in different [...] Read more.
Background: The Supportive and Palliative Care Indicators Tool (SPICT) was developed for identifying, in a timely manner, patients who may benefit from supportive and palliative care for better treatment review, care-plan discussion, and end-of-life care. Although the SPICT has been validated in different languages and for patients living in different settings, it has not been validated for patients receiving home-based medical care (HBMC), or in the context of using traditional Chinese characters. Objectives: The present study aimed to validate the Taiwanese version of the SPICT (SPICT-TW) and to measure its ability to predict six-month mortality in patients who received HBMC in Taiwan. Methods: Seven HBMC agents (five clinics and two hospitals) participated in this validation study. We recruited 129 patients aged ≥ 50 years who had been consistently receiving HBMC for >two months. Results: The results revealed that the SPICT-TW demonstrated similar reliability and validity compared to other language versions of the SPICT. It may be an appropriate tool for healthcare professionals to detect, in a timely manner, the needs for palliative care in older people who receive home healthcare. Furthermore, we found that a combination of four general indicators and one clinical indicator in the SPCIT-TW has the best prediction ability at predicting six-month mortality in these HBMC recipients. This multi-center study validated the SPICT-TW among HBMC recipients in Taiwan. Conclusions: The SPICT-TW demonstrated high reliability and validity through the Kuder–Richardson 20, an intraclass correlation coefficient, Cohen’s kappa, and receiver operating characteristic analysis, supporting its potential as a practical tool for identifying older adults at risk of dying within six months who have not yet received palliative care but may benefit from it. Full article
(This article belongs to the Special Issue Healthcare Practice in Community)
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11 pages, 2513 KiB  
Article
Xanthogranulomatous Cholecystitis: A Retrospective Review of Clinical Diagnosis and Treatment from a Single Center
by Mehmet Torun, Cebrail Akyüz, Deniz Kol and Mehmet Ali Özbay
Healthcare 2024, 12(21), 2184; https://doi.org/10.3390/healthcare12212184 - 1 Nov 2024
Viewed by 675
Abstract
The objective of this study was to evaluate and compare the histopathological, clinical, and treatment characteristics of xanthogranulomatous cholecystitis (XGC) in patients undergoing cholecystectomy at a single center. Aim: We aim to enhance the understanding of its presentation and improve its differential [...] Read more.
The objective of this study was to evaluate and compare the histopathological, clinical, and treatment characteristics of xanthogranulomatous cholecystitis (XGC) in patients undergoing cholecystectomy at a single center. Aim: We aim to enhance the understanding of its presentation and improve its differential diagnosis from other gallbladder pathologies. Methods: We retrospectively reviewed 6783 cholecystectomy cases performed between January 2015 and January 2023 at the General Surgery Clinic of Haydarpaşa Numune Training and Research Hospital, and a diagnosis of xanthogranulomatous cholecystitis was histopathologically established in 131 patients. In this retrospective study, we examined the clinicopathological characteristics, preoperative imaging methods and findings, histopathological images, surgical procedure methods, and postoperative complications of 131 patients. Results: The study included 131 patients, with ages ranging from 18 to 88 years, of which 74 (56.5%) were female and 57 (43.5%) were male. Ultrasound imaging was performed on 128 patients. Ultrasound imaging revealed wall thickening in 72.7% of cases, hypoechoic nodules in 13.3%, biliary tract pathologies in 10.9%, and adenomyomatosis in 3.1%. A total of 59 cases had MRI. On MRI, wall thickening was observed in 50.8% of cases, biliary tract pathologies in 33.9%, adenomyomatosis in 10.2%, hypoechoic nodules in 3.4%, and hypoechoic nodules + wall thickening (HN + WT) in 1.7%. Histopathological diagnosis was diffuse in 79.4% of cases and focal in 20.6%. In addition to cholecystectomy, non-surgical interventions were not required in 77.1% of the cases, while 11.5% underwent ERCP, 9.2% underwent percutaneous procedures, 1.5% underwent both ERCP and percutaneous procedures, and 0.8% underwent other non-surgical interventions. Of the surgeries, 93.1% were elective and 6.9% were emergency. Postoperative complications were not observed in 84% of the patients; 5.3% experienced surgical complications, 5.3% had surgical site infection, and 5.3% had other complications (pneumonia and urinary infection). The length of hospital stay ranged from 0 to 26 days, with a mean of 5.27 ± 4.59 days and a median of 4 days. Conclusions: Xanthogranulomatous cholecystitis is a rare disease of the gallbladder with no characteristic radiological or clinical findings and can often be confused with gallbladder cancer. Further studies involving larger populations are needed to improve the preoperative diagnosis. Full article
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10 pages, 1214 KiB  
Article
Multidimensional Benefits of a Tailored Exercise Program in Preventing Frailty: A Community-Based Approach
by Akihiro Kakuda, Yuko Sawada, Rika Okumura, Hiroshi Kinoshita and Tokie Anme
Healthcare 2024, 12(21), 2183; https://doi.org/10.3390/healthcare12212183 - 1 Nov 2024
Viewed by 633
Abstract
Background/Objective: Frailty is a significant health concern in the aging population, particularly in Japan’s super-aging society. Community-based interventions show promise in frailty prevention; however, their effectiveness requires further investigation. This study aimed to evaluate the impact of a continuous municipal rehabilitation program on [...] Read more.
Background/Objective: Frailty is a significant health concern in the aging population, particularly in Japan’s super-aging society. Community-based interventions show promise in frailty prevention; however, their effectiveness requires further investigation. This study aimed to evaluate the impact of a continuous municipal rehabilitation program on frailty status and physical function in older adults living in suburban Japan. Methods: This prospective observational study included 52 participants aged ≥ 65 years (13 males and 39 females) who underwent assessments at baseline and after six months. Participants were divided into Pre-old (65–74 years) and Older (≥75 years) groups. Frailty was assessed using the Kihon checklist (KCL), and physical function was evaluated using the New Physical Fitness Test. Changes in frailty status, physical function, and KCL subcategories were analyzed. Results: Frailty prevalence decreased significantly from baseline to 6 months (21.2% to 7.7%, p = 0.018). In the Pre-old group, significant improvements were observed in the sit-up (p = 0.035) and six-minute walking (p = 0.017) scores. The Older group showed significant improvements in KCL lifestyle (p = 0.023) and physical function (p = 0.018). Seven of ten initially frailty participants transitioned to a non-frailty status after 6 months. Conclusions: The Co-Creative Well-being System was associated with a reduction in frailty prevalence and improvements in physical function, with age-specific benefits observed. This community-based approach presents a promising strategy for addressing frailty in aging populations. Full article
(This article belongs to the Section Preventive Medicine)
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36 pages, 2122 KiB  
Article
Exploring the Challenges and Solutions in Conducting Clinical Trials in Saudi Arabia: A Qualitative Study Perspective
by Basim Alsaywid, Dana Khafagi, Alaa Bashaikh, Abdulaziz Alsada, Reema Bawazir, Rasal Alotaibi, Lina Alharbi, Rama Alqarni, Rana Alhuthayfi, Hana Alhumud, Shadell AlGhamdi, Mohamed Anwar Khan, Wadha Alshali, Eman Al Mutairi and Miltiadis D. Lytras
Healthcare 2024, 12(21), 2182; https://doi.org/10.3390/healthcare12212182 - 1 Nov 2024
Viewed by 1239
Abstract
Introduction: Clinical trials are crucial for advancing medical knowledge and improving healthcare outcomes. Despite an increase in research publications in Saudi Arabia, clinical trial productivity has lagged behind. Understanding the barriers to conducting clinical trials in Saudi Arabia is essential. This study aims [...] Read more.
Introduction: Clinical trials are crucial for advancing medical knowledge and improving healthcare outcomes. Despite an increase in research publications in Saudi Arabia, clinical trial productivity has lagged behind. Understanding the barriers to conducting clinical trials in Saudi Arabia is essential. This study aims to explore the challenges and propose solutions for improving clinical trial capacity in the Kingdom. Specifically, we aim to develop national strategies to enhance clinical trial infrastructure, identify educational needs, and suggest ways to strengthen research education and training in Saudi Arabia. Methods: The study utilized a qualitative research design with a grounded theory approach. Participants were recruited through purposive sampling, including clinical trial professionals from Riyadh, Jeddah, and Al Khobar, who participated in three half-day workshops. Discussions focused on required skillsets, barriers to conducting trials, improvement recommendations, gaps in research education, and strategies for the Saudi National Institute of Health (SNIH) to support clinical trials. Data were collected through pre-workshop surveys and focus group discussions, and thematic analysis was employed to identify common themes. Results: A total of 35 participants, mainly from the government sector (67%), attended the workshops. Physicians represented the largest professional group (31%), with the majority being Saudi nationals (83%) and engaged in clinical practice (65%). The study identified key challenges, including limited resources (82%), inadequate infrastructure (82%), time constraints (80%), and insufficient funding (80%). While satisfaction with educational programs was mixed, a need for improved infrastructure and support for clinical trials in Saudi Arabia was evident. The focus group discussions further highlighted the importance of research competency, identifying 11 essential domains such as research methodology, data management, and project leadership. Nine major challenges were noted, including funding, infrastructure, and collaboration deficits. A total of 38 recommendations were proposed to address these challenges and enhance the national clinical trial ecosystem. Conclusions: This study underscores the importance of addressing the challenges in conducting clinical trials in Saudi Arabia through targeted educational programs, training initiatives, and enhanced support from the SNIH. By implementing strategies that focus on funding, resources, training, and collaboration, Saudi Arabia can significantly advance its clinical trial landscape, improve research quality and efficiency, and position itself as a leader in global health research. Full article
(This article belongs to the Section Health Policy)
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11 pages, 419 KiB  
Article
Resilient Coping Levels and Psychometric Properties of the Brief Resilient Coping Scale Among Nursing Professionals in Saudi Arabia
by Abdulrhman Albougami
Healthcare 2024, 12(21), 2181; https://doi.org/10.3390/healthcare12212181 - 1 Nov 2024
Viewed by 611
Abstract
Objectives: This cross-sectional survey assessed resilient coping levels and their relationship with the sociodemographic characteristics of nursing professionals in Saudi Arabia. Methods: Adult (≥18 years) registered nurses who had been practicing for ≥1 year were included in the study. Resilient coping levels (as [...] Read more.
Objectives: This cross-sectional survey assessed resilient coping levels and their relationship with the sociodemographic characteristics of nursing professionals in Saudi Arabia. Methods: Adult (≥18 years) registered nurses who had been practicing for ≥1 year were included in the study. Resilient coping levels (as assessed via a 4-item Brief Resilience Coping Scale; BRCS) and the data of sociodemographic and other characteristics were collected. Descriptive analysis and ordinal logistic regression were used to analyze the data. Furthermore, the psychometric properties of the BRCS are also reported. Results: Overall, 216 nursing professionals were included. The mean BRCS score was 14.6 (standard deviation = 3.6), with most nursing professionals (62.5%) reporting medium-to-high resilience coping levels. The ordinal logistic regression model demonstrated that nurses with increasing age (p = 0.002), best overall health (p = 0.001), and in the outpatient department (p = 0.049) and intensive care unit (p = 0.032) had significantly high resilient coping levels. The internal consistency of the BRCS was good (Cronbach’s alpha = 0.80). The results of the exploratory factor analysis and confirmatory factor analysis clearly indicate a unidimensional solution with one factor. Conclusions: In summary, most nursing professionals in Saudi Arabia showed medium-to-high resilience coping levels. Moreover, this study suggests that the BRCS was found to be a psychometrically reliable and adequate tool for assessing resilience coping levels and provides valuable insights into the relationship between resilient coping levels and the sociodemographic characteristics of nursing professionals in Saudi Arabia. Full article
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8 pages, 5097 KiB  
Article
Unusual Signal of Lymphadenopathy in Children with Nodular Sclerosing Hodgkin Lymphoma
by Shyam Sunder B. Venkatakrishna, Devyn C. Rigsby, Raisa Amiruddin, Mohamed M. Elsingergy, Jean Henri Nel, Suraj D. Serai, Hansel J. Otero and Savvas Andronikou
Healthcare 2024, 12(21), 2180; https://doi.org/10.3390/healthcare12212180 - 1 Nov 2024
Viewed by 708
Abstract
Purpose: The current guidelines for initial cross-sectional imaging in pediatric lymphomas involve computed tomography (CT) of the chest, abdomen, and pelvis. However, whole-body magnetic resonance imaging (MRI) can be favored over CT for diagnosing and staging the disease, given its lack of ionizing [...] Read more.
Purpose: The current guidelines for initial cross-sectional imaging in pediatric lymphomas involve computed tomography (CT) of the chest, abdomen, and pelvis. However, whole-body magnetic resonance imaging (MRI) can be favored over CT for diagnosing and staging the disease, given its lack of ionizing radiation and its higher tissue contrast. Imaging characteristics of lymphoid tissue on MRI include a high T2/short tau inversion recovery (STIR) signal. A low or intermediate signal of lymphadenopathy on T2 and STIR images is an unexpected finding, noted anecdotally in nodular sclerosing Hodgkin lymphoma. This signal may be characteristic of a histological subtype of the disease and, if confirmed, could potentially be used to avoid biopsy. In this study, we aimed to review signal characteristics of lymphadenopathy in patients with biopsy-confirmed nodular sclerosing Hodgkin lymphoma. Methods: We undertook a retrospective review of relevant MR studies of patients with nodular sclerosing Hodgkin lymphoma. Studies were reviewed by an experienced pediatric radiologist regarding lymph node signal, especially on T2/STIR. Results: Eleven children with nodular sclerosing Hodgkin lymphoma were included. Median age at the time of MRI was 14.3 (IQR: 13.9–16.1) years, and nine were boys. Five patients showed some lymphadenopathy with a low T2/STIR signal, and six showed an intermediate T2/STIR signal. Central gadolinium non-enhancement was observed in four patients. Conclusions: All eleven patients (100%) with a diagnosis of nodular sclerosing Hodgkin lymphoma showed some lymphadenopathy with a low or intermediate T2/STIR signal, and five children (45.5%) showed a frank low signal of some lymphadenopathy, a feature which may prove to be a biomarker for this histology. Full article
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1 pages, 134 KiB  
Correction
Correction: Casamassimo, P.S. Emerging Evidence Supports Broader Definition of Chairside Behavior Guidance and Familial Compliance. Healthcare 2024, 12, 1935
by Paul S. Casamassimo
Healthcare 2024, 12(21), 2179; https://doi.org/10.3390/healthcare12212179 - 1 Nov 2024
Viewed by 401
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue Oral Health Status of Children and Adolescents)
16 pages, 262 KiB  
Article
Exploring the Life Experiences of Living with Cardiac Arrhythmia Developed During Pregnancy
by Kateryna Metersky, Kaveenaa Chandrasekaran, Yoland El-hajj, Suzanne Fredericks and Priyanka Vijay Sonar
Healthcare 2024, 12(21), 2178; https://doi.org/10.3390/healthcare12212178 - 31 Oct 2024
Viewed by 652
Abstract
Background: Approximately half of all women develop palpitations during pregnancy, with a quarter experiencing arrhythmias. While most presentations are benign, some cases can result in sudden cardiac death or serious symptom development. Considering such clinical presentation, healthcare providers must acquire knowledge in this [...] Read more.
Background: Approximately half of all women develop palpitations during pregnancy, with a quarter experiencing arrhythmias. While most presentations are benign, some cases can result in sudden cardiac death or serious symptom development. Considering such clinical presentation, healthcare providers must acquire knowledge in this area to provide comprehensive prenatal, perinatal, and postnatal care. However, no study could be located that focused on women’s life experiences of such complications during or in the post-pregnancy period. Objectives: The study aims to share the results of a study that explored the life experience of one woman who developed non-sustained ventricular tachycardia during her third pregnancy that lasted into the postpartum period. Methods: Using narrative inquiry self-study methodology, a woman’s experiences were explored to uncover the challenges she faced in coping with such complications during a period of transition for herself and her family. This methodology allowed for an in-depth understanding of how these complications could affect all aspects of her life. Results: Four narrative threads were produced: (1) diagnostic challenges and delayed recognition; (2) impact on maternal identity and family dynamics; (3) navigating healthcare systems and treatment decisions; and (4) long-term adaptation and resilience. Conclusions: The intention was to add to this topic area to ensure future researchers, current and future healthcare providers, and patients have literature they can refer to when studying, providing care for, or experiencing similar health complications. Acquiring this knowledge can aid healthcare professionals to ensure appropriate care is provided, risks are minimized, and their recovery is well supported. Full article
17 pages, 2488 KiB  
Article
Deciphering the Physical Characteristics of Ophthalmic Filters Used in Optometric Vision Therapy
by Danjela Ibrahimi, Marcos Aviles, Guillermo Valencia Luna and Juvenal Rodriguez Resendiz
Healthcare 2024, 12(21), 2177; https://doi.org/10.3390/healthcare12212177 - 31 Oct 2024
Viewed by 852
Abstract
Background: This paper aimed to measure and characterize eleven monochromatic filters and twenty-two combinations used empirically to treat patients with visual dysfunctions to propose enhanced protocols based on solid evidence. Their wavelength, transmittance, and relative sensitivity were defined on the retinal cone cells. [...] Read more.
Background: This paper aimed to measure and characterize eleven monochromatic filters and twenty-two combinations used empirically to treat patients with visual dysfunctions to propose enhanced protocols based on solid evidence. Their wavelength, transmittance, and relative sensitivity were defined on the retinal cone cells. Methods: A double-beam UV-VIS-NIR spectrophotometer, VARIAN brand, Cary 5000 model, owned by the National Center of Metrology, with high precision and accuracy, was used to characterize all filters. Filters were purchased from Optomatters Corporation, Belgium. Results: When two or three filters are combined, their transmittance and relative sensitivity on the retinal cone cells decrease regardless of wavelength. As a result, the efficiency of combined filters may decrease during treatments. Additionally, most filters and combinations, regardless of the wavelength, transmit a considerable percentage of light from the red spectrum. A depressant is the best monochromatic filter, and Upsilon–Neurasthenic is the strongest combination to stimulate blue cone cells. In contrast, Stimulant and Delta–Theta are best for red and green cone cells. Mu–Delta and Mu–Theta can be interchangeable, as well as Alpha–Delta and Alpha–Theta. Conclusions: Results suggest that the current phototherapy treatment protocol must be deeply revised, and the number of filters and combinations should be reduced to reduce costs and time and boost efficiency. Full article
(This article belongs to the Special Issue The Latest Advances in Visual Health)
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12 pages, 580 KiB  
Article
The Interrelationship of Benefit Finding, Stigma, and Suicide Risk Among Patients with Schizophrenia and Their Caregivers: A Six-Month Follow-Up Study
by Heng Lee, Pin-Han Peng, Nien-Mu Chiu, Yu-Chi Huang, Pao-Yen Lin, Chi-Fa Hung, Yu Lee and Liang-Jen Wang
Healthcare 2024, 12(21), 2176; https://doi.org/10.3390/healthcare12212176 - 31 Oct 2024
Viewed by 563
Abstract
Objective: This study aimed to assess the dyadic dynamics of benefit finding, stigma, and suicide risk on the depression severity of individuals with schizophrenia and their caregivers. Methods: We prospectively recruited a total of 72 individuals with schizophrenia and 72 caregivers of individuals [...] Read more.
Objective: This study aimed to assess the dyadic dynamics of benefit finding, stigma, and suicide risk on the depression severity of individuals with schizophrenia and their caregivers. Methods: We prospectively recruited a total of 72 individuals with schizophrenia and 72 caregivers of individuals with schizophrenia from a medical center in Taiwan between August 2022 and July 2023. Patients with schizophrenia and their caregivers were assessed using the Taiwanese Depression Questionnaire, Benefit Finding Scale, Explanatory Model Interview Catalogue, Suicide Assessment Scale, and Mini International Neuropsychiatric Interview. Results: The most prevalent psychiatric diagnoses in the caregivers were depressive disorders (29.2%). Using structural equation modeling, we found that patients’ suicidal risk (β = 0.45, p < 0.001) may contribute to the severity of depression in individuals with schizophrenia. We also found that caregivers’ BF degree (β = −0.25, p < 0.01) and suicidal risk (β = 0.64, p < 0.001) may contribute to the severity of depression in the caregivers of individuals with schizophrenia. Furthermore, we found that caregivers’ suicidal risk (β = 0.28, p < 0.05) and caregivers’ stigma (β = −0.31, p < 0.01) level may contribute to the severity of depression in individuals with schizophrenia. Discussion: Clinicians should actively manage caregivers’ stigma and provide positive reinforcement for caregivers’ BF, as this may help reduce depression in both caregivers and individuals with schizophrenia. Additionally, assessing suicide risk in both groups is essential for preventing suicides among individuals with schizophrenia and caregivers alike. Full article
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22 pages, 7006 KiB  
Review
Body Fluid Collection Devices for Ostomy Patients: A Review
by Isaías Barbosa, Pedro Morais, Helena Torres, Jaime C. Fonseca and João L. Vilaça
Healthcare 2024, 12(21), 2175; https://doi.org/10.3390/healthcare12212175 - 31 Oct 2024
Viewed by 997
Abstract
Background/Objectives: Abdominal ostomy surgery has a severe impact on individuals’ daily lives. These procedures are typically indicated for conditions such as cancer, inflammatory bowel disease, or traumatic injuries. They involve creating an artificial opening, denominated the stoma, in the abdominal area to divert [...] Read more.
Background/Objectives: Abdominal ostomy surgery has a severe impact on individuals’ daily lives. These procedures are typically indicated for conditions such as cancer, inflammatory bowel disease, or traumatic injuries. They involve creating an artificial opening, denominated the stoma, in the abdominal area to divert feces or urine, establishing a connection between the affected organs and the body’s exterior. Thus, specialized products to collect the body fluids are required, being effective and tailored products crucial to enhance the quality of life of such patients. Methods: This paper presents a review of fecal fluid collection devices and advanced technologies designed to assist patients with ostomies. The study aims to identify the known bags/devices and evaluate their attributed performance in enhancing the population’s physical and social quality of life. This review is based on a systematic search conducted between 20 February and 2 March 2024, in the PubMed, Scopus, Web of Science, Google Scholar, and Google Patents databases. Articles published within the last eight years from this period were included in the analysis. Results: The devices found in the study were classified as passive, requiring active monitoring by the user, and active, providing automated assistance. Three main categories were identified, reflecting the most significant concerns of patients: (1) devices that control fluid leakage, reducing peristomal dermatological problems; (2) devices that minimize odors and noise, reducing social embarrassment; and (3) devices that monitor fluid volume, helping with electrolyte balance, especially in patients with ileostomies. Conclusions: This study revealed that the existing devices meet primary collection and disposal needs. However, introducing smart devices could offer greater control and confidence to users, providing real-time information on gas pressure, stool texture, and accumulated volume. Thus, overall, the development of advanced technologies can significantly improve patients’ quality of life, restore social confidence, and enable a more effective management of the condition by sharing information with medical teams. Full article
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13 pages, 860 KiB  
Article
Dysmenorrhea and Premenstrual Syndrome in Association with Health Habits in the Mexican Population: A Cross-Sectional Study
by Julia María Alatorre-Cruz, Graciela Catalina Alatorre-Cruz, Vianey Marín-Cevada and Ricardo Carreño-López
Healthcare 2024, 12(21), 2174; https://doi.org/10.3390/healthcare12212174 - 31 Oct 2024
Viewed by 802
Abstract
Background: Dysmenorrhea and premenstrual syndrome (PMS) are common disorders in the Mexican population, but these are usually underdiagnosed and under-treated, impacting women’s quality of life. Adequate health habits have been reported as precursors of decreasing dysmenorrhea symptoms. However, few studies assess their impact [...] Read more.
Background: Dysmenorrhea and premenstrual syndrome (PMS) are common disorders in the Mexican population, but these are usually underdiagnosed and under-treated, impacting women’s quality of life. Adequate health habits have been reported as precursors of decreasing dysmenorrhea symptoms. However, few studies assess their impact on PMS. Aim: This study aims to evaluate dysmenorrhea and premenstrual syndrome in association with health habits in the Mexican population. Methods: To assess the impact of health habits on menstruation symptoms a validated survey was conducted in 1679 adult females aged ≥18 years. The survey collected data on participants’ dysmenorrhea, PMS, and their health habits. Results: The analysis showed that physical activity duration, changes in eating habits (increases in salty or sugary foods) during menstruation, and oversleeping habits predict increases in dysmenorrhea and PMS. In contrast, an active sexual life, relaxing physical activity, and adequate sleep hours during menstruation seem to decrease the symptoms. Conclusions: We conclude that adequate health habits and addressing early gynecological conditions might regulate dysmenorrhea and PMS. Full article
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12 pages, 940 KiB  
Article
The Cross-Sectional and Longitudinal Associations Between Adherence to 24-Hour Movement Behavior Guidelines and Bone Health in Young Children
by Dan Li, Lifang Zhang, Ting Hu, Jiameng Ma, Xianxiong Li, Xiang Zhang and Hyunshik Kim
Healthcare 2024, 12(21), 2173; https://doi.org/10.3390/healthcare12212173 - 31 Oct 2024
Viewed by 553
Abstract
Background: Adherence to the World Health Organization’s 24-hour movement behavior (24-HMB) guidelines is associated with various health outcomes. However, its relationship with bone mineral density (BMD) in young children has not been investigated. This study aimed to examine the cross-sectional and longitudinal associations [...] Read more.
Background: Adherence to the World Health Organization’s 24-hour movement behavior (24-HMB) guidelines is associated with various health outcomes. However, its relationship with bone mineral density (BMD) in young children has not been investigated. This study aimed to examine the cross-sectional and longitudinal associations between adherence to the 24-HMB guidelines and BMD in young children. Methods: A total of 120 children aged 3–5 years were recruited from three kindergartens in Changsha, Hunan, China. Physical activity (PA) was objectively measured using ActiGraph wGT3X-BT accelerometers, and BMD was assessed using the Sunlight Omnisense 7000P ultrasound device. Screen time (ST) and sleep duration (SD) were reported by parents. Logistic regression was used to analyze the associations between guideline adherence and BMD. Results: Only 5.5% of the participants met all three guidelines for PA, ST, and SD, while 16.5% did not meet any. In the cross-sectional analysis, young children who met both ST and SD guidelines (OR = 0.29, 95% CI: 0.09, 0.95) had a lower risk of insufficient BMD compared to those who met none. In the one-year cohort follow-up, young children who met the PA guideline at baseline (OR = 0.22, 95% CI: 0.07, 0.71), as well as those who met both the PA and ST guidelines (OR = 0.18, 95% CI: 0.04, 0.83) or all three (OR = 0.13, 95% CI: 0.03, 0.69), had a lower risk of insufficient BMD at one year. Conclusions: Adherence to the 24-HMB guidelines may promote bone health in young children. Future research should prioritize achievable goals, such as limiting ST and ensuring adequate SD, while gradually increasing MVPA to optimize bone development. Full article
(This article belongs to the Special Issue Promoting Children’s Health Through Movement Behavior)
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11 pages, 269 KiB  
Article
Influences of Digital Literacy and Moral Sensitivity on Artificial Intelligence Ethics Awareness Among Nursing Students
by Yaki Yang
Healthcare 2024, 12(21), 2172; https://doi.org/10.3390/healthcare12212172 - 31 Oct 2024
Viewed by 833
Abstract
Background: As artificial intelligence technology has developed, research on the application of AI in the medical field has increased, and there is a high likelihood that the use of AI technology will expand in nursing education and practice in the future. However, ethical [...] Read more.
Background: As artificial intelligence technology has developed, research on the application of AI in the medical field has increased, and there is a high likelihood that the use of AI technology will expand in nursing education and practice in the future. However, ethical issues arise when utilizing AI, necessitating a high level of ethical awareness before its application. Objectives: This study aimed to identify factors in artificial intelligence ethics awareness among nursing students. Methods: Participants were 140 nursing students attending universities in G City and J Province in South Korea. Data were collected using a self-administered questionnaire from 26 August to 6 September 2024. Factors in artificial intelligence ethics awareness were analyzed by multiple regression analysis. Results: Nursing students’ artificial intelligence ethics awareness is significantly correlated with digital literacy (r = 0.30, p < 0.001) and moral sensitivity (r = 27, p < 0.001). The influencing factor in artificial intelligence ethics awareness among nursing students was moral sensitivity (β = 0.23, p = 0.042). The explanation power of these variables was 14.0% (F = 46.78, p < 0.001). Conclusions: There is a need to provide education and training programs that can improve moral sensitivity to foster artificial intelligence ethics awareness. Full article
14 pages, 753 KiB  
Article
Impact of the Coronavirus Disease 2019 [COVID-19] Pandemic on Post-Acute Care of Patients with Heart Failure and the Effectiveness of Vaccine Prevention
by Lin-Yuan Chang, Chin-Yi Chao, Jin-Long Huang, Yun-Yu Chen, Chi-Yen Wang, Wen-Lieng Lee and Wei-Wen Lin
Healthcare 2024, 12(21), 2171; https://doi.org/10.3390/healthcare12212171 - 31 Oct 2024
Viewed by 665
Abstract
Background: The Heart Failure Post-Acute Care [HF-PAC] program is a specialized healthcare program aimed at providing comprehensive care and support for patients with heart failure [HF] as they transition from acute hospital settings to home. But the impact of the coronavirus disease 2019 [...] Read more.
Background: The Heart Failure Post-Acute Care [HF-PAC] program is a specialized healthcare program aimed at providing comprehensive care and support for patients with heart failure [HF] as they transition from acute hospital settings to home. But the impact of the coronavirus disease 2019 [COVID-19] pandemic on the HF-PAC program remains unknown. Furthermore, the effects of the comprehensive COVID-19 vaccination program on these patients with HF-PAC warrants further investigation. Methods: A total of 265 patients with acute decompensated HF were admitted to the hospital between May 2020 and October 2022. Of these, 159 patients underwent planned HF-PAC follow-up for 6 months, followed by scheduled follow-up visits every 3 months and unscheduled telephone randomized visits for at least another 6 months. Results: The program completion rate was nearly 92%. COVID-19 significantly impacted patients with HF-PAC, leading to an increased mortality [13.3%] compared to before the pandemic [6.5%]. In our patient cohort, 83% had received at least 1 dose of vaccine and 61% had received > 3 doses. Of these patients with HF-PAC, 34% contracted COVID-19 infection post discharge, and 8.8% died owing to the infection. Of the mortality group, 42.9% patients were not vaccinated, and 28.6% received 1 vaccine dose, and their vaccination rate was lower than in the survival group [p = 0.01]. Conclusions: The COVID-19 pandemic had a significant impact on patients enrolled in the HF-PAC program; receiving more than 3 doses of the COVID-19 vaccine was associated with a significant reduction in mortality rates among these patients. Full article
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Article
Machine Learning Analysis of Factors Influencing Pediatric Telehealth Visits During COVID-19: A State-Level Comparison Using 2021–22 National Survey of Children’s Health Data
by Yu-Sheng Lee, Junu Shrestha, Matthew Evan Sprong, Xueli Huang, Sushil Tuladhar and Michael Y. Chuang
Healthcare 2024, 12(21), 2170; https://doi.org/10.3390/healthcare12212170 - 31 Oct 2024
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Abstract
Background/Objectives: The COVID-19 pandemic reduced in-person pediatric visits in the United States by over 50%, while telehealth visits increased significantly. The national use of telehealth for children and the factors influencing their use have been rarely studied. This study aimed to investigate [...] Read more.
Background/Objectives: The COVID-19 pandemic reduced in-person pediatric visits in the United States by over 50%, while telehealth visits increased significantly. The national use of telehealth for children and the factors influencing their use have been rarely studied. This study aimed to investigate the prevalence of telehealth use during the COVID-19 pandemic and explore the potential factors linked to its use at the state level. Methods: A cross-sectional study of the National Survey of Children’s Health (2021–22) sponsored by the federal Maternal and Child Health Bureau was performed. We used the least absolute shrinkage and selection operator (LASSO) regression to predict telehealth use during the pandemic. A bar map showing the significant factors from the multivariable regression was created. Results: Of the 101,136 children, 15.25% reported using telehealth visits due to COVID-19, and 3.67% reported using telehealth visits due to other health reasons. The Northeast states showed the highest telehealth use due to COVID-19. In the Midwest and Southern states, children had a lower prevalence of telehealth visits due to other health reasons. The LASSO regressions demonstrated that telehealth visits were associated with age, insurance type, household income, usual source of pediatric preventive care, perceived child health, blood disorders, allergy, brain injury, seizure, ADHD, anxiety, depression, and special needs. Conclusions: This study demonstrated significant variability in the use of telehealth among states during the COVID-19 pandemic. Understanding who uses telehealth and why, as well as identifying access barriers, helps maximize telehealth potential and improve healthcare outcomes for all. Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
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