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Possible Mechanisms for the Effects of Sound Vibration on Human Health -
Intermittent Energy Restriction, Weight Loss and Cardiometabolic Risk: A Critical Appraisal of Evidence in Humans -
Long-COVID Syndrome? A Study on the Persistence of Neurological, Psychological and Physiological Symptoms -
Behavioral Interventions for Groups at Risk of Rheumatoid Arthritis
Journal Description
Healthcare
Healthcare
is an international, scientific, peer-reviewed, open access journal on health care systems, industry, technology, policy, and regulation, and is published monthly online by MDPI. Ocular Wellness & Nutrition Society (OWNS) is affiliated with Healthcare and the members receive a discount on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE and SSCI (Web of Science), PubMed, PMC, and many other databases.
- Journal Rank: JCR - Q2 (Health Policy & Services)
- Rapid Publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 18.1 days after submission; acceptance to publication is undertaken in 3.6 days (median values for papers published in this journal in the first half of 2021).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.645 (2020)
;
5-Year Impact Factor:
3.044 (2020)
Latest Articles
Association between the Serum Coenzyme Q10 Level and Seizure Control in Patients with Drug-Resistant Epilepsy
Healthcare 2021, 9(9), 1118; https://doi.org/10.3390/healthcare9091118 - 28 Aug 2021
Abstract
Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through
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Drug-resistant epilepsy (DRE) is a chronic neurological disorder with somatic impacts and increased risk of metabolic comorbidities. Oxidative stress might play an important role in metabolic effects and as a regulator of seizure control, while coenzyme Q10 (CoQ10) could improve insulin sensitivity through antioxidant effects. We aimed to investigate the association between CoQ10 level and clinical outcome, represented by the seizure frequency and quality of life, in DRE patients. DRE patients (N = 33) had significantly higher serum insulin levels and lower scores on the physical domain of the World Health Organization Quality of Life questionnaire (WHOQoL) than gender-age matched controls. The serum CoQ10 level (2910.4 ± 1163.7 ng/mL) was much higher in DRE patients than the normal range. Moreover, the serum CoQ10 level was significantly correlated with the seizure frequency (r = −0.412, p = 0.037) and insulin level (r = 0.409, p = 0.038). Based on stratification by insulin resistance (HOMA-IR > 2.4), the subgroup analysis showed that patients with a greater HOMA-IR had higher CoQ10 levels and lower seizure frequency, and had a significantly worse quality of life. In summary, CoQ10 could be a mediator involved in the mechanism of epilepsy and serve as a biomarker of the clinical outcome in DER patients.
Full article
(This article belongs to the Special Issue Unusual Cases in Epilepsy and Epilepsy Surgery)
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Open AccessArticle
The Effect of Physical and Mental Health and Health Behavior on the Self-Rated Health of Pregnant Women
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and
Healthcare 2021, 9(9), 1117; https://doi.org/10.3390/healthcare9091117 - 28 Aug 2021
Abstract
Self-rated health (SRH) is an evaluation tool to assess an individual’s level of health, including both general health and personal experience. There have been existing studies on women’s SRH; however, few studies have been on pregnant women’s SRH and its associated factors. This
[...] Read more.
Self-rated health (SRH) is an evaluation tool to assess an individual’s level of health, including both general health and personal experience. There have been existing studies on women’s SRH; however, few studies have been on pregnant women’s SRH and its associated factors. This study investigated the SRH of pregnant women and their factors using the Korea Community Health Survey. The chi-squared test and multivariable logistic regression were used to investigate the effects of demographic, physical, and mental health and health behaviors on the SRH of pregnant women. As a result of the study, 54.0% out of 1032 pregnant women had good SRH. Their SRH score was good when they were young, economically active, and living in cities. Poor SRH was observed with depression, hypertension, and after experiencing a fall. Good SRH was found when they exercised and slept for more than 8 h a day. This study is the first to observe the SRH of pregnant women and its related factors in South Korea.
Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
Open AccessArticle
Privacy-Preserving Authentication Protocol for Wireless Body Area Networks in Healthcare Applications
by
and
Healthcare 2021, 9(9), 1114; https://doi.org/10.3390/healthcare9091114 - 28 Aug 2021
Abstract
Mobile healthcare service has become increasingly popular thanks to the significant advances in the wireless body area networks (WBANs). It helps medical professionals to collect patient’s healthcare data remotely and provides remote medical diagnosis. Since the health data are privacy-related, they should provide
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Mobile healthcare service has become increasingly popular thanks to the significant advances in the wireless body area networks (WBANs). It helps medical professionals to collect patient’s healthcare data remotely and provides remote medical diagnosis. Since the health data are privacy-related, they should provide services with privacy-preserving, which should consider security and privacy at the same time. Recently, some lightweight patient healthcare authentication protocols were proposed for WBANs. However, we observed that they are vulnerable to tracing attacks because the patient uses the same identifier in each session, which could leak privacy-related information on the patient. To defeat the weakness, this paper proposes a privacy-preserving authentication protocol for WBANs in healthcare service. The proposed protocol is only based on one-way hash function and with exclusive-or operation, which are lightweight operations than asymmetric cryptosystem operations. We performed two rigorous formal security proofs based on BAN logic and ProVerif tool. Furthermore, comparison results with the relevant protocols show that the proposed protocol achieves more privacy and security features than the other protocols and has suitable efficiency in computational and communicational concerns.
Full article
(This article belongs to the Special Issue Cybersecurity and the Digital Health: An Investigation on the State of the Art and the Position of the Actors)
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Open AccessArticle
Comparison of Dietary Behaviors and the Prevalence of Metabolic Syndrome in Single- and Multi-Person Households among Korean Adults
by
and
Healthcare 2021, 9(9), 1116; https://doi.org/10.3390/healthcare9091116 (registering DOI) - 27 Aug 2021
Abstract
Changes in household dynamics in Korea, such as the transition from multi- to single-person households, have led to changes in individuals’ dietary behavior patterns and health status. Thus, this study aimed to compare dietary behaviors and determine the prevalence of metabolic syndrome (MetS)
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Changes in household dynamics in Korea, such as the transition from multi- to single-person households, have led to changes in individuals’ dietary behavior patterns and health status. Thus, this study aimed to compare dietary behaviors and determine the prevalence of metabolic syndrome (MetS) as well as explore factors associated with MetS according to household type among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey 2014–2018, we included 21,944 Korean adults with available health examination and dietary recall data. Based on self-reported information, individuals were divided into two household types: single- and multi-person households. We used multivariable logistic regression to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for MetS and its components after adjusting for potential covariates. Among the study population, 9.19% and 90.81% lived in single-person and multi-person households, respectively. Individuals in single-person households had a higher energy intake overall and a greater percentage of energy from animal protein; total, saturated, and monounsaturated fats; and animal source foods and a lower percentage of energy from carbohydrates, plant protein, and plant source foods than those from multi-person households (all, p < 0.05). Individuals living in single-person rather than multi-person households were more likely to consume milk/dairy products, alcoholic and non-alcoholic beverages, oils/fats, and others but were less likely to consume vegetables/mushrooms, fruits, seaweeds, and fish/shellfish (all, p < 0.05). Living alone was associated with higher energy intake from main meals and foods prepared away from home but a lower dietary variety score and fewer total main meals consumed (all, p < 0.05). Skipping breakfast, frequent eating out, food insecurity, and MetS combination phenotypes significantly differed by household type. Individuals living alone had higher odds of MetS (AOR: 1.14, 95% CI: 1.02–1.29), abdominal obesity (AOR: 1.14, 95% CI: 1.01–1.28), elevated blood pressure (AOR: 1.28, 95% CI: 1.12–1.47), and elevated fasting blood glucose (AOR: 1.18, 95% CI: 1.05–1.33) than those living with others. Compared with those in multi-person households, individuals in single-person households tend to have health and dietary behaviors that increase vulnerability to MetS; therefore, establishing health care strategies and nutrition policies according to household type is necessary.
Full article
(This article belongs to the Special Issue Eating Behaviors and Life Style Study)
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Open AccessFeature PaperArticle
The Evaluation of Preference and Perceived Quality of Health Communication Icons Associated with COVID-19 Prevention Measures
by
, , , , , , , and
Healthcare 2021, 9(9), 1115; https://doi.org/10.3390/healthcare9091115 - 27 Aug 2021
Abstract
Icons have been widely utilized to describe and promote COVID-19 prevention measures. The purpose of this study was to analyze the preference and subjective design features of 133 existing icons associated with COVID-19 prevention measures published by the health and medical organizations of
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Icons have been widely utilized to describe and promote COVID-19 prevention measures. The purpose of this study was to analyze the preference and subjective design features of 133 existing icons associated with COVID-19 prevention measures published by the health and medical organizations of different countries. The 133 icons represent nineteen different function names, such as “Wash Hands” and “Wear Face Mask”. A total of 57 participants were recruited to perform two different tests: ranking test and subjective rating test. The ranking test was conducted to elicit the preference ranking of seven icon designs representing each function name. It was followed by a subjective rating test using 13 semantic scales on the two most preferred icons to analyze their perceived quality. Spearmen correlation was applied to derive the possible correlations between users’ rankings and the semantic scales, and Friedman’s test was also performed to determine the true difference between ranking in terms of each semantic scale to provide a fully meaningful interpretation of the data. Generally, findings from the current study showed that the image presented in the icon is the key point that affects the icons’ perceived quality. Interestingly, Spearman’s correlation analysis between preference ranking and semantic scales showed that vague–clear, weak–strong, incompatible–compatible, and ineffective–effective were the four strongest semantic scales that highly correlated with the preference ranking. Considering the significant relationships between the semantic distances and the functions, images depicted in an icon should be realistic and as close as possible to its respected function to cater to users’ preferences. In addition, the results of Spearman’s correlation and Friedman’s test also inferred that compatibility and clarity of icon elements are the main factors determining a particular icon’s preferability. This study is the first comprehensive study to evaluate the icons associated with the COVID-19 prevention measures. The findings of this study can be utilized as the basis for redesigning icons, particularly for icons related to COVID-19 prevention measures. Furthermore, the approach can also be applied and extended for evaluating other medical icons.
Full article
(This article belongs to the Special Issue Digital Technology to Control the COVID-19 Epidemic Infection: Issues, Successes and Failures)
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Open AccessArticle
Is Time-Driven Activity-Based Costing Coming Out on Top? A Comparison with Activity-Based Costing in the Health Field
Healthcare 2021, 9(9), 1113; https://doi.org/10.3390/healthcare9091113 - 27 Aug 2021
Abstract
The cost of health is a recurrent topic that has generated much research, as it affects all of society. Both public and private agents need to know the real cost of treatments, services, and products for decision-making. This article aims to compare the
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The cost of health is a recurrent topic that has generated much research, as it affects all of society. Both public and private agents need to know the real cost of treatments, services, and products for decision-making. This article aims to compare the use and research impact of two cost systems widely used in health: ABC and TDABC, which is an evolution of ABC. For doing so, a bibliometric review in Scopus and Medline was carried out encompassing the years 2009–2019. The results show a great increase in publications using TDABC, while publications on ABC stabilized. On the other hand, the TDABC articles presented higher research impacts in traditional and alternative metrics. Articles on TDABC are more frequently cited, published in better journals, and more visible in academic social networks. The findings suggest that scholars and practitioners should focus on TDABC rather than ABC for addressing cost in health for its simplicity, projection, and research opportunities.
Full article
(This article belongs to the Special Issue Health Economics & Finance and Global Public Health)
Open AccessArticle
Clinical Findings among Patients with Respiratory Symptoms Related to Moisture Damage Exposure at the Workplace—The SAMDAW Study
by
, , , , , , , and
Healthcare 2021, 9(9), 1112; https://doi.org/10.3390/healthcare9091112 - 27 Aug 2021
Abstract
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Background: Respiratory tract symptoms are associated with workplace moisture damage (MD). The focus of this observational clinical study was patients with workplace MD-associated symptoms, to evaluate the usefulness of different clinical tests in diagnostics in secondary healthcare with a special interest in improving
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Background: Respiratory tract symptoms are associated with workplace moisture damage (MD). The focus of this observational clinical study was patients with workplace MD-associated symptoms, to evaluate the usefulness of different clinical tests in diagnostics in secondary healthcare with a special interest in improving the differential diagnostics between asthma and laryngeal dysfunction. Methods: In patients referred because of workplace MD-associated respiratory tract symptoms, we sought to systematically assess a wide variety of clinical findings. Results: New-onset asthma was diagnosed in 30% of the study patients. Laryngeal dysfunction was found in 28% and organic laryngeal changes in 22% of the patients, and these were common among patients both with and without asthma. Most of the patients (85%) reported a runny or stuffy nose, and 11% of them had chronic rhinosinusitis. Atopy was equally as common as in the general population. Conclusions: As laryngeal changes were rather common, we recommend proper differential diagnostics with lung function testing and investigations of the larynx and its functioning, when necessary, in cases of prolonged workplace MD-associated symptoms. Chronic rhinosinusitis among these patients was not uncommon. Based on this study, allergy testing should not play a major role in the examination of these patients.
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Graphical abstract
Open AccessArticle
Research on the Characteristics and Usefulness of User Reviews of Online Mental Health Consultation Services: A Content Analysis
by
and
Healthcare 2021, 9(9), 1111; https://doi.org/10.3390/healthcare9091111 - 27 Aug 2021
Abstract
Online consultation based on Internet technology is gradually becoming the main way to seek health information and professional assistance. Online user reviews, such as content reviews and star ratings, are an important basis for reflecting users’ views on the effectiveness of health services.
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Online consultation based on Internet technology is gradually becoming the main way to seek health information and professional assistance. Online user reviews, such as content reviews and star ratings, are an important basis for reflecting users’ views on the effectiveness of health services. Here, we used user reviews related to online psychological consultation services for content feature mining and usefulness analyses. We used a professional online psychological counseling service platform in China to collect user reviews that were liked by users as a data sample for a content analysis. An LDA topic model, dictionary-based sentiment analysis, and the NRC Word-Emotion Association Lexicon were used to extract the topic, sentiment, and context features of the content of 4254 useful reviews, and the influence of these features on the usefulness of the reviews was verified by a multiple linear regression analysis. Our results show that the content of online reviews by psychological counseling users presented a positive emotional attitude as a whole and expressed more views on the process, effects, and future expectations of counseling than on other topics. There was a significant correlation between the topic, sentiment, and context features of a user review and its usefulness: reviews giving high scores and containing topics such as “ease emotions” and “consulting expectations” received more user likes. However, the usefulness of a review was significantly reduced if it was in existence for too long. This research provides valuable suggestions for understanding the needs and emotional attitudes of users with mental health problems in terms of online psychological consultation; identifying the factors that affect the number of likes a review receives can help platform users write better consultation evaluations and thereby provide greater usefulness. In addition, the use of online reviews generated by users for content analysis effectively supplements the current research on online psychological counseling in terms of data and methods.
Full article
(This article belongs to the Section Health Assessments)
Open AccessArticle
Public Perceptions of COVID-19 Vaccines: Policy Implications from US Spatiotemporal Sentiment Analytics
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, , , , , and
Healthcare 2021, 9(9), 1110; https://doi.org/10.3390/healthcare9091110 - 27 Aug 2021
Abstract
There is a compelling and pressing need to better understand the temporal dynamics of public sentiment towards COVID-19 vaccines in the US on a national and state-wise level for facilitating appropriate public policy applications. Our analysis of social media data from early February
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There is a compelling and pressing need to better understand the temporal dynamics of public sentiment towards COVID-19 vaccines in the US on a national and state-wise level for facilitating appropriate public policy applications. Our analysis of social media data from early February and late March 2021 shows that, despite the overall strength of positive sentiment and despite the increasing numbers of Americans being fully vaccinated, negative sentiment towards COVID-19 vaccines still persists among segments of people who are hesitant towards the vaccine. In this study, we perform sentiment analytics on vaccine tweets, monitor changes in public sentiment over time, contrast vaccination sentiment scores with actual vaccination data from the US CDC and the Household Pulse Survey (HPS), explore the influence of maturity of Twitter user-accounts and generate geographic mapping of tweet sentiments. We observe that fear sentiment remained unchanged in populous states, whereas trust sentiment declined slightly in these same states. Changes in sentiments were more notable among less populous states in the central sections of the US. Furthermore, we leverage the emotion polarity based Public Sentiment Scenarios (PSS) framework, which was developed for COVID-19 sentiment analytics, to systematically posit implications for public policy processes with the aim of improving the positioning, messaging, and administration of vaccines. These insights are expected to contribute to policies that can expedite the vaccination program and move the nation closer to the cherished herd immunity goal.
Full article
(This article belongs to the Special Issue Social Media and Public Health)
Open AccessArticle
Social Media Behavior and Emotional Evolution during Emergency Events
Healthcare 2021, 9(9), 1109; https://doi.org/10.3390/healthcare9091109 - 27 Aug 2021
Abstract
Online social networks have recently become a vital source for emergency event news and the consequent venting of emotions. However, knowledge on what drives user emotion and behavioral responses to emergency event developments are still limited. Therefore, unlike previous studies that have only
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Online social networks have recently become a vital source for emergency event news and the consequent venting of emotions. However, knowledge on what drives user emotion and behavioral responses to emergency event developments are still limited. Therefore, unlike previous studies that have only explored trending themes and public sentiment in social media, this study sought to develop a holistic framework to assess the impact of emergency developments on emotions and behavior by exploring the evolution of trending themes and public sentiments in social media posts as a focal event developed. By examining the event timelines and the associated hashtags on the popular Chinese social media site Sina-Weibo, the 2019 Wuxi viaduct collapse accident was taken as the research object and the event timeline and the Sina-Weibo tagging function focused on to analyze the behaviors and emotional changes in the social media users and elucidate the correlations. It can conclude that: (i) There were some social media rules being adhered to and that new focused news from the same event impacted user behavior and the popularity of previous thematic discussions. (ii) While the most critical function for users appeared to express their emotions, the user foci changed when recent focus news emerged. (iii) As the news of the collapse deepened, the change in user sentiment was found to be positively correlated with the information released by personal-authentication accounts. This research provides a new perspective on the extraction of information from social media platforms in emergencies and social-emotional transmission rules.
Full article
(This article belongs to the Special Issue Social Media and Public Health)
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Remdesivir in Severe COVID-19 and Non-Invasive Ventilation: A Real-Life Experience
by
, , , , , , and
Healthcare 2021, 9(9), 1108; https://doi.org/10.3390/healthcare9091108 - 27 Aug 2021
Abstract
Background: Antiviral treatment is a hot topic regarding therapy for COVID-19. Several antiviral drugs have been tested in the months since the pandemic began. Yet only Remdesivir obtained approval after first trials. The best time to administer Remdesivir is still a matter for
[...] Read more.
Background: Antiviral treatment is a hot topic regarding therapy for COVID-19. Several antiviral drugs have been tested in the months since the pandemic began. Yet only Remdesivir obtained approval after first trials. The best time to administer Remdesivir is still a matter for discussion and this could also depend upon the severity of lung damage and the staging of the infection. Methods: We performed a real-life study of patients hospitalized forCOVID-19 and receiving non-invasive ventilation (NIV). In this single-center study, a 5 day course of Remdesivir was administered as compassionate use. Further therapeutic supports included antibiotics, low molecular weight heparin and steroids. Data collection included clinical signs and symptoms, gas exchange, laboratory markers of inflammation, and radiological findings. Major outcomes were de-escalation of oxygen-support requirements, clinical improvement defined by weaning from ventilation to oxygen therapy or discharge, and mortality. Adverse drug reactions were also recorded. All data were collected during hospitalization and during a 20-day follow up after treatment. Results: 51 patients were enrolled. A global clinical improvement was recorded in 22 patients (43%) at 12 days, and 36 (71%) at 20 days; in particular, at 12 days, 27 patients (53%) also had a de-escalation of oxygen-support class from a therapeutic point of view. Remdesivir use was associated with a lower hazard ratio for clinical improvement in the elderly (older than 70 years) and in subjects with more extensive lung involvement (total severity score at HRCT of more than 14). The 20-day mortality was 13%. Conclusions: Results demonstrated that Remdesivir is associated with an improvement in clinical, laboratory and radiological parameters in patients with severe COVID-19 and showed an overall mortality of 13%. We conclude that, in this cohort, Remdesivir was a beneficial add-on therapy for severe COVID-19, especially in adults with moderate lung involvement at HRCT.
Full article
(This article belongs to the Special Issue COVID-19 After One Year of Clinical Experience: Unexpected Clinical Presentations or Complications and Post-COVID-19 Clinical Features)
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Open AccessArticle
The Feasibility of Using Machine Learning to Classify Calls to South African Emergency Dispatch Centres According to Prehospital Diagnosis, by Utilising Caller Descriptions of the Incident
Healthcare 2021, 9(9), 1107; https://doi.org/10.3390/healthcare9091107 - 27 Aug 2021
Abstract
This paper presents the application of machine learning for classifying time-critical conditions namely sepsis, myocardial infarction and cardiac arrest, based off transcriptions of emergency calls from emergency services dispatch centers in South Africa. In this study we present results from the application of
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This paper presents the application of machine learning for classifying time-critical conditions namely sepsis, myocardial infarction and cardiac arrest, based off transcriptions of emergency calls from emergency services dispatch centers in South Africa. In this study we present results from the application of four multi-class classification algorithms: Support Vector Machine (SVM), Logistic Regression, Random Forest and K-Nearest Neighbor (kNN). The application of machine learning for classifying time-critical diseases may allow for earlier identification, adequate telephonic triage, and quicker response times of the appropriate cadre of emergency care personnel. The data set consisted of an original data set of 93 examples which was further expanded through the use of data augmentation. Two feature extraction techniques were investigated namely; TF-IDF and handcrafted features. The results were further improved using hyper-parameter tuning and feature selection. In our work, within the limitations of a limited data set, classification results yielded an accuracy of up to 100% when training with 10-fold cross validation, and 95% accuracy when predicted on unseen data. The results are encouraging and show that automated diagnosis based on emergency dispatch centre transcriptions is feasible. When implemented in real time, this can have multiple utilities, e.g. enabling the call-takers to take the right action with the right priority.
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(This article belongs to the Special Issue Innovations in the Emergency Department)
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Open AccessArticle
A Study of the Structure of Japanese University Students’ Awareness of Long-Term Care Socialization
Healthcare 2021, 9(9), 1106; https://doi.org/10.3390/healthcare9091106 - 26 Aug 2021
Abstract
This study aimed to examine the structure of the awareness of long-term care socialization by focusing on the younger generation’s awareness in order to improve a sustainable long-term care system. A questionnaire that assessed personal attributes and awareness of long-term care socialization was
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This study aimed to examine the structure of the awareness of long-term care socialization by focusing on the younger generation’s awareness in order to improve a sustainable long-term care system. A questionnaire that assessed personal attributes and awareness of long-term care socialization was administered. In total, the answers of 209 students (48.4%) were collected for factors related to the awareness of long-term care socialization extracted through exploratory factor analysis. Additionally, the responses 149 students (56.7%) were collected for the construct validity verified through confirmatory factor analysis. According to the exploratory factor analysis, awareness of long-term care socialization included 10 items and three factors: “care burden when caring for family”, “feelings about leaving family care to society”, and “sense of responsibility to care for family as a member of the family”. The goodness-of-fit model in the confirmatory factor analysis proved the awareness of long-term care socialization scale’s construct validity. The structure of the awareness of long-term care socialization included three factors: “care burden when caring for family”, “sense of responsibility to care for family as a member of the family”, and “feelings about leaving family care to society”. This study demonstrated the scale’s good reliability and validity.
Full article
(This article belongs to the Section Health Policy)
Open AccessArticle
Can Ketogenic Diet Therapy Improve Migraine Frequency, Severity and Duration?
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, , , , and
Healthcare 2021, 9(9), 1105; https://doi.org/10.3390/healthcare9091105 (registering DOI) - 26 Aug 2021
Abstract
Migraine is the third most common condition worldwide and is responsible for a major clinical and economic burden. The current pilot trial investigated whether ketogenic diet therapy (KDT) is superior to an evidence-informed healthy “anti-headache” dietary pattern (AHD) in improving migraine frequency, severity
[...] Read more.
Migraine is the third most common condition worldwide and is responsible for a major clinical and economic burden. The current pilot trial investigated whether ketogenic diet therapy (KDT) is superior to an evidence-informed healthy “anti-headache” dietary pattern (AHD) in improving migraine frequency, severity and duration. A 12-week randomised controlled crossover trial consisting of the two dietary intervention periods was undertaken. Eligible participants were those with a history of migraines and who had regularly experienced episodes of moderate or mildly intense headache in the previous 4 weeks. Migraine frequency, duration and severity were assessed via self-report in the Migraine Buddy© app. Participants were asked to measure urinary ketones and side effects throughout the KDT. Twenty-six participants were enrolled, and 16 participants completed all sessions. Eleven participants completed a symptom checklist; all reported side-effects during KDT, with the most frequently reported side effect being fatigue (n = 11). All completers experienced migraine during AHD, with 14/16 experiencing migraine during KDT. Differences in migraine frequency, severity or duration between dietary intervention groups were not statistically significant. However, a clinically important trend toward lower migraine duration on KDT was noted. Further research in this area is warranted, with strategies to lower participant burden and promote adherence and retention.
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(This article belongs to the Section Nutrition and Public Health)
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Open AccessReview
A Review of Monitoring Methods for Cerebral Blood Oxygen Saturation
Healthcare 2021, 9(9), 1104; https://doi.org/10.3390/healthcare9091104 - 26 Aug 2021
Abstract
In recent years, cerebral blood oxygen saturation has become a key indicator during the perioperative period. Cerebral blood oxygen saturation monitoring is conducive to the early diagnosis and treatment of cerebral ischemia and hypoxia. The present study discusses the three most extensively used
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In recent years, cerebral blood oxygen saturation has become a key indicator during the perioperative period. Cerebral blood oxygen saturation monitoring is conducive to the early diagnosis and treatment of cerebral ischemia and hypoxia. The present study discusses the three most extensively used clinical methods for cerebral blood oxygen saturation monitoring from different aspects: working principles, relevant parameters, current situations of research, commonly used equipment, and relative advantages of different methods. Furthermore, through comprehensive comparisons of the methods, we find that near-infrared spectroscopy (NIRS) technology has significant potentials and broad applications prospects in terms of cerebral oxygen saturation monitoring. Despite the current NIRS technology, the only bedside non-invasive cerebral oxygen saturation monitoring technology, still has many defects, it is more in line with the future development trend in the field of medical and health, and will become the main method gradually.
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(This article belongs to the Section Critical Care)
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Open AccessSystematic Review
Related Factors and Treatment of Postoperative Delirium in Old Adult Patients: An Integrative Review
by
, , , , and
Healthcare 2021, 9(9), 1103; https://doi.org/10.3390/healthcare9091103 - 26 Aug 2021
Abstract
“Postoperative delirium” is defined as delirium occurring in the hospital up to one week after a procedure or before discharge (whichever occurs first) that meets the DSM-5 diagnostic criteria. Objectives: To describe the risk factors related to this pathology and identify effective non-pharmacological
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“Postoperative delirium” is defined as delirium occurring in the hospital up to one week after a procedure or before discharge (whichever occurs first) that meets the DSM-5 diagnostic criteria. Objectives: To describe the risk factors related to this pathology and identify effective non-pharmacological forms of treatment. An integrative review of the available literature was performed. The search results considered included all quantitative studies published between 2011 and 2019 in both English and Spanish. A total of 117 studies were selected. Advanced age was identified as the principal risk factor for postoperative delirium. Nursing interventions appear to be the key to preventing or reducing the seriousness of delirium after an anaesthetic episode. The aetiology of postoperative delirium remains unknown, and no treatment exists to eliminate this pathology. The role of nursing staff is fundamental in the prevention, diagnosis, and management of the pathology.
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(This article belongs to the Section Nursing)
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Open AccessArticle
A Feasibility and Efficacy Randomized Controlled Trial of Two Exercise Programs in Severe AECOPD Patients with Resting Hypoxemia
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, , , , and
Healthcare 2021, 9(9), 1102; https://doi.org/10.3390/healthcare9091102 - 25 Aug 2021
Abstract
Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was
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Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was to assess the feasibility and the efficacy of two exercise programs in Acute Exacerbation of COPD (AECOPD) patients with resting hypoxemia. In this randomized clinical trial, patients hospitalized due to an acute exacerbation of COPD with hypoxemia at rest were included. Patients were randomly assigned into three groups. A Control Group (pharmacological treatment), a Global Exercise Group (GEG), and a Functional Electrostimulation Group (FEG). Patients were treated during the hospitalization period. The main outcomes were lower limb strength (assessed by a dynamometer), balance (assessed by the one leg standing balance test), health related quality of life (assessed by the EQ-5D), adverse events and adherence. At the end of the intervention, there were significant differences in all the variables in favour of the experimental groups (p < 0.05). We concluded that conducting an exercise program is feasible and improves lower limb strength, balance, and health related quality of life in AECOPD patients with resting hypoxemia.
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(This article belongs to the Special Issue Sport and Exercise Medicine)
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Open AccessArticle
Personalized Diet in Obesity: A Quasi-Experimental Study on Fat Mass and Fat-Free Mass Changes
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, , and
Healthcare 2021, 9(9), 1101; https://doi.org/10.3390/healthcare9091101 - 25 Aug 2021
Abstract
Considering that the prevalence of overweight and obesity in Southeast of Spain is high, the aim of this work was to analyze the relation between the adherence to a personalized diet and the effectiveness of changes in the body composition in overweight and
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Considering that the prevalence of overweight and obesity in Southeast of Spain is high, the aim of this work was to analyze the relation between the adherence to a personalized diet and the effectiveness of changes in the body composition in overweight and obese adults in this region. This quasi-experimental study presents the following selection criteria: attendance at the consultation between 2006 and 2012, subjects ≥ 19 years of age with overweight or obesity. In total, 591 overweight or obese individuals were involved in this study, attending 4091 clinic consultations in total. Most of the sample consisted of subjects who attended >3 consultations (>1.5 months), and were females aged 19–64 years who obtained clinically significant changes in fat mass (FM, ≥5%) and recommended changes in fat-free mass (FFM, ≥0%). Based on the results obtained and the experience gained from this research, the following recommendations are established: (i) record fat mass and fat-free mass index as a complement to body mass index; (ii) use FM and FFM to evaluate effectiveness of interventions with the aim of obtaining body composition changes; (iii) use personalized diet to achieve significant changes in FM and avoid non-recommended changes in FFM.
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(This article belongs to the Special Issue Obesity—a Hot Topic in Modern Medicine—a Multidisciplinary Challenge)
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Open AccessArticle
Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process
Healthcare 2021, 9(9), 1100; https://doi.org/10.3390/healthcare9091100 - 25 Aug 2021
Abstract
The coronavirus pandemic is a unique collective event which has affected the physical and psychological health of all individuals. Restrictions imposed by governments to counteract this situation have represented risk factors for developing psychopathological symptoms. This study aims to explore the relationship between
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The coronavirus pandemic is a unique collective event which has affected the physical and psychological health of all individuals. Restrictions imposed by governments to counteract this situation have represented risk factors for developing psychopathological symptoms. This study aims to explore the relationship between psychological symptoms and the referential process (RP). Forty-eight healthy participants (25 males, mean age = 39.3; SD = 16.6) completed a demographic questionnaire and the Symptom Checklist-90-Revised (SCL-90-R) through an online platform and wrote about their experience 3 weeks after the imposition of the lockdown. Different linguistic measures of the RP were applied to the narratives. The logical functions expressed through written narratives (The Italian Reflection Dictionary score, IREF) showed significant positive correlations with the SCL-90-R General Score Index (GSI) and different SCL-90-R subscales (depression, anxiety, obsessive-compulsiveness, interpersonal sensitivity, hostility, and paranoid ideation). On the contrary, the reorganization and reflection function related to emotional events (The Italian Weighted Reflection and Reorganization List score, IWRRL) showed significant negative correlations with the SCL-90-R’s GSI and different subscales (obsessive-compulsiveness, depression, anxiety). The results highlight the relationship between psychological symptoms and complex defense mechanisms based on the intellectualization of negative emotions and a positive strategy of reorganization based on emotional elaboration. These results suggest the importance of supporting collective elaborations of citizens in the context of the pandemic.
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(This article belongs to the Special Issue Mental Health and Coping During COVID-19)
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Detection of COVID-19 Patients from CT Scan and Chest X-ray Data Using Modified MobileNetV2 and LIME
Healthcare 2021, 9(9), 1099; https://doi.org/10.3390/healthcare9091099 - 25 Aug 2021
Abstract
The COVID-19 global pandemic caused by the widespread transmission of the novel coronavirus (SARS-CoV-2) has become one of modern history’s most challenging issues from a healthcare perspective. At its dawn, still without a vaccine, contagion containment strategies remained most effective in preventing the
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The COVID-19 global pandemic caused by the widespread transmission of the novel coronavirus (SARS-CoV-2) has become one of modern history’s most challenging issues from a healthcare perspective. At its dawn, still without a vaccine, contagion containment strategies remained most effective in preventing the disease’s spread. Patient isolation has been primarily driven by the results of polymerase chain reaction (PCR) testing, but its initial reach was challenged by low availability and high cost, especially in developing countries. As a means of taking advantage of a preexisting infrastructure for respiratory disease diagnosis, researchers have proposed COVID-19 patient screening based on the results of Chest Computerized Tomography (CT) and Chest Radiographs (X-ray). When paired with artificial-intelligence- and deep-learning-based approaches for analysis, early studies have achieved a comparatively high accuracy in diagnosing the disease. Considering the opportunity to further explore these methods, we implement six different Deep Convolutional Neural Networks (Deep CNN) models—VGG16, MobileNetV2, InceptionResNetV2, ResNet50, ResNet101, and VGG19—and use a mixed dataset of CT and X-ray images to classify COVID-19 patients. Preliminary results showed that a modified MobileNetV2 model performs best with an accuracy of 95 ± 1.12% (AUC = 0.816). Notably, a high performance was also observed for the VGG16 model, outperforming several previously proposed models with an accuracy of 98.5 ± 1.19% on the X-ray dataset. Our findings are supported by recent works in the academic literature, which also uphold the higher performance of MobileNetV2 when X-ray, CT, and their mixed datasets are considered. Lastly, we further explain the process of feature extraction using Local Interpretable Model-Agnostic Explanations (LIME), which contributes to a better understanding of what features in CT/X-ray images characterize the onset of COVID-19.
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(This article belongs to the Special Issue Artificial Intelligence Developments for Medical Diagnosis and Monitoring)
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