Healthcare

Background: Asbestos is considered one of the major global work-related carcinogens. Some studies suggest a potential causal relationship between asbestos exposure and colorectal cancer (CRC). However, the role of asbestos in CRC carcinogenesis is still controversial. Methods: 35 claims of occupational CRC among asbestos-exposed workers were reviewed. All claims were rejected by the Italian National Institute for Insurance against Accidents (INAIL) due to the “lack of scientific evidence in the causality” between asbestos exposure and CRC; causality was finally assessed in civil trials. All cases were categorized by age, gender, industry type, task, exposure and latency periods, anatomical location, and histopathological characteristics of CRC and concomitant respiratory diseases. Results: Most workers were males aged 60 years or more and employed in occupational activities with extensive use of asbestos for over 20 years. In 31 out of 35 cases, CRC was diagnosed over 39 years after employment. Right-sided colic adenocarcinoma was diagnosed in nine cases; rectum was involved in eight cases. Respiratory comorbidities were observed in 22 workers. Conclusions: Our study provides some interesting points in the assessment of the causal relationship between asbestos exposure and CRC. Full article

The aim of this study was to investigate the effects of different protocols of moderate-intensity intermittent hypoxic training in patients who had recovered from COVID-19 on quality of life (QoL) and mental health. The sample of this clinical trial-controlled double-blind study consisted of 67 participants aged 30–69 years, who were organized randomly according to Normoxia, Hypoxia, Hypoxia Recovery or Control Group. Eight weeks of cycle ergometer training were performed with a frequency of three training sessions per week in normoxic or hypoxic conditions (with or without hypoxic recovery). Health-related QoL and Mental Health Status were evaluated by 12-Item Short Form Survey and Depression Anxiety and Stress Scale instruments, respectively. All training groups improved the QoL’s physical dimensions (Baseline–Post: Normoxia Group 42.1 (11.0)–48.7 (7.0), Hypoxia Group 46.9 (11.8)–53.5 (6.6) and Hypoxia Recovery Group 45.8 (9.2)–51.1 (5.3)) and mental dimensions (Baseline–Post: Normoxia Group 48.8 (7.9)–54.6 (4.6), Hypoxia Group 45.2 (7.7)–53.2 (3.8) and Hypoxia Recovery Group 46.5 (9.7)–52.0 (9.9)). Regarding mental health outcomes, all training groups decreased depressive symptoms (66.7% Normoxia, 31.2% Hypoxia Recovery and 31% Hypoxia groups), anxiety symptoms (46.5% Normoxia, 45.9% Hypoxia Recovery and 39.5% in the Hypoxia groups) and stress symptoms (40.6% Normoxia, 36.3% Hypoxia Recovery and 22.1% Hypoxia groups). Significant statistical difference was not found between groups. Normoxic and hypoxic training showed a similar effect on QoL and the mental health of Brazilian adults who had recovered from COVID-19. Full article

The use of the Internet has several positive functions, but at the same time it also represents a health risk, especially for adolescents. The increased use of the Internet in recent decades has also been linked to an increase in problematic Internet use, which has now become a global social issue. During the COVID-19 pandemic, Internet use increased even more and influenced adolescents’ habits, leading to an increase in sedentary behaviors. The aim of this study was to understand whether Internet addiction differed between sportive and nonsportive adolescents and between males and females. We analyzed two samples of adolescents, with different behaviors regarding sports practice. Internet addiction was assessed by the administration of a validated questionnaire (UADI) via an online survey. Although all the mean values of both the subgroups fell into the “non-pathological” category, differences between sports groups and sexes were found, with different trends for each one of the five dimensions of Internet use. In conclusion, sportive adolescents generally showed less severe Internet addiction; therefore, encouraging sports practice can help to fight wrong habits related to a sedentary lifestyle. The promotion of sports practice in these ages is therefore a priority aspect, especially in females, who showed a general predisposition to escape from reality in comparison to males. Full article

Smartwatches are emerging as effective tools to promote exercise and physical activities in the healthcare industry. However, little is known about how smartwatch attributes facilitate exercise and for whom such attributes are more effective for exercise. Accordingly, the purpose of this study was to explore the structural relationship between smartwatch attributes, flow experience, and continued exercise intentions and to examine the moderating role of exercise involvement in the structural relationship. For this, a total of 600 participants were recruited via a professional survey firm in South Korea based on a multi-stage random sampling method and used for data analyses, including confirmatory factor analysis (CFA), structural equation modeling (SEM), and multi-group SEM. All survey items were adopted from the existing literature on healthcare, flow experience, and wearable device technologies. The results revealed that smartwatch attributes, including interactivity (γ = 0.234, p < 0.001/γ = 0.235, p < 0.001), autonomy (γ = 0.225, p < 0.001/γ = 0.172, p < 0.001), wearability (γ = 0.104, p < 0.05/γ = 0.106, p < 0.05), convenience (γ = 0.209, p < 0.001/γ = 0.214, p < 0.001), and experiential novelty (γ = 0.221, p < 0.001/γ = 0.281, p < 0.001) enhanced flow experience (absorption/enjoyment) during exercise. Furthermore, flow experience (absorption/enjoyment) was found to positively influence exercise intention (β = 0.511, p < 0.001/β = 0.239, p < 0.001). Lastly, exercise involvement was found to modulate the structural relationships among smartwatch attributes, flow experience, and exercise intention (∆χ² = 23.231, ∆df = 12, p < 0.05). By investigating these dynamics, this study contributes to shared knowledge not only in the healthcare literature but also in the wearable-technology literature. The results of the current study also provide useful guidelines for practitioners in the wearable-device and healthcare industries to develop optimal features of smartwatches for exercise and physical activities. Full article

This cross-sectional study investigated the knowledge, attitude and practice (KAP) of community general practice (GP) team members on dysphagia complicated with aspiration pneumonia after stroke in Shanghai between October 2022 and November 2022 using a self-administered questionnaire. A total of 551 questionnaires were collected (mean age: 37.59 ± 8.86 years, 443 (80.40%) females), including 383 (69.51%) physicians. The mean KAP scores were 6.30 ± 1.54 (possible range: 0–12), 40.32 ± 5.11 (possible range: 9–45), and 72.54 ± 13.99 (possible range: 18–90), respectively. Multivariable linear regression analyses suggested that attitude (Coef = 1.29, 95%CI: 1.09–1.50), and holding research funding (Coef = −2.70, 95%CI: −5.00–−0.50) were significantly associated with practice toward dysphagia complicated with aspiration pneumonia after stroke of community GP team members. The structural equation model (SEM) indicated that knowledge had a direct influence on attitude (β = 2.029, p < 0.001) and attitude had a direct impact on practice (β = 0.710, p < 0.001). Additionally, knowledge exerted both direct (β = 0.935, p = 0.016) and indirect effects (β = 1.442, p < 0.001) on practice. In conclusion, this study showed that the community GP team members had poor knowledge, favorable attitudes, and proactive practices. Education and training on the management of dysphagia complicated with aspiration pneumonia after stroke are urgently needed. Full article

Hemodialysis patients undergo hemodialysis two to three times a week and must live together with the dialysis machine. The patient’s self-participation is to combine the patient’s own experience and professional knowledge to influence the care. A successful self-participation experience empowers patients to adapt to living with hemodialysis. However, few studies have been conducted regarding the subjective experiences of such patient participation. There is a lack of a self-participation dialysis life scale for hemodialysis patients. Therefore, this study aims to develop and evaluate a self-participation dialysis life scale for hemodialysis patients. The items for the self-participation dialysis life scale were confirmed through qualitative interviews based on grounded theory. After expert content validity evaluation, 435 hemodialysis patients were purposively sampled from hemodialysis centers in two regional teaching hospitals in Taiwan. Descriptive statistics, principal axis factoring, reliability analysis, Pearson’s correlation, and one-way ANOVA were used for data analysis. The results show that the item- and scale-content validity indices are 0.96 and 0.73, respectively. This scale is divided into two scales. The first part is “Scale of Perceptions of Hemodialysis”, including two factors. The overall can explain 66.34% of the cumulative variances. The second part is the “Scale of Self-Participation in Hemodialysis”, including four factors. The overall can explain 58.91% of the cumulative variances. The Cronbach’s α is 0.812 for “Perceptions of Hemodialysis” and 0.959 for “Self-Participation in Hemodialysis”, respectively. The self-participation dialysis life scale has good reliability and validity and can be used to evaluate the implementation of a patient’s self-participation in their hemodialysis life. Discussing or consulting with patients based on their characteristics, life priorities, and their desired life on dialysis is essential for a high-quality of clinical care among hemodialysis patients. Full article

Assessing knowledge, attitudes and practices towards evidence-based practice (EBP) is a challenge for healthcare professionals. However, the existing literature focuses on nurses working in acute hospital settings, with nurses working in community and primary healthcare settings receiving comparatively less attention. The purpose of the study was to explore factors that related to attitudes, knowledge and practice of community nurses toward EBP. A cross-sectional study was conducted with a sample of community nurses in Greece. Community nurses around the country were invited to complete an online questionnaire during the period of February to April 2022. To measure nurses’ attitudes, practices and knowledge/skills regarding EBP, the Evidence-Based Practice Questionnaire was used. A total of 164 nurses took part in the study. The mean age of nurses was 41.6 years, with 42.7% having either an MSc or a PhD degree. The overall internal consistency for the EBPQ questionnaire was 0.91. The sample demonstrated a high level of knowledge/skills (mean score of 5.5 on a 7-point scale) and positive attitudes (mean score of 5.5 on a 7-point scale) towards EBP, while the level of EBP practice was moderate (mean score of 4.5 on a 7-point scale). A higher educational level showed a positive relationship with the “practice of EBP” subscale (p = 0.005) and the “knowledge/skills about EBP” subscale (p = 0.003). Additionally, an increase in the knowledge/skills score was associated with a more positive attitude towards EBP (p < 0.001) and better practice of EBP (p = 0.003). The identification of educational level as the main factor related to the knowledge/skills and implementation of EBPs in community nurses emphasizes the necessity for educational initiatives in EBP at both undergraduate and postgraduate levels. Informed nurses who are familiar with current guidelines and evidence can effectively train patients about chronic disease management and prevention. Additionally, creating incentives to motivate participation in lifelong learning programs can indeed play a crucial role in enhancing the proficiency of community nurses in evidence-based practice. Full article

In response to the distinctive healthcare requirements of independent, healthy, community-dwelling older adults in Japan and other developed countries with aging populations, the current study examined the differences in factors associated with self-rated health (SRH) between the following two age groups: young–old (65–74) and old–old (75 and above). Age-stratified analysis was used to provide a comprehensive understanding of the unique health challenges faced by these demographic segments and to inform the development of targeted interventions and health policies to improve their well-being. The results of a cross-sectional study of 846 older adults in Yokohama, Japan, who completed self-administered questionnaires, revealed that high SRH was consistently linked with the low prevalence of concurrent medical issues in both age groups (<75 and ≥75) (β: −0.323, p < 0.001 in the <75 group; β: −0.232, p < 0.001 in the ≥75 group) and increased subjective well-being (β: 0.357, p < 0.001 in the <75 group; β: 0.244, p < 0.001 in the ≥75 group). Within the ≥75 age group, higher SRH was associated with more favorable economic status (β: 0.164, p < 0.001) and increased engagement in social activities (β: 0.117, p = 0.008), even after adjusting for age, sex, and economic status. These findings may inform the development of targeted interventions and policies to enhance the well-being of this growing population in Japan and other developed countries. Full article

Background: A literature review reveals that studies on walking and fall occurrences in the context of cancer have predominantly centered on geriatric patients. Nonetheless, cancer patients of all ages are susceptible to such risks. Both cancer and its treatments contribute to significant risk factors for disturbances in walking and falls, encompassing muscle weakness, impaired balance, reduced proprioception, cognitive impairment, and functional limitations. Aim: to assess walking speed and the risk of falls among patients undergoing surgery for the most common malignancies: breast (BU), lung (P), colorectal (DS), and reproductive organs (G). Material and Methods: An observational study was conducted using a cohort design. A total of 176 individuals participated in the study, including 139 cancer patients, who were divided into four groups: BU (N = 30), P (N = 35), DS (N = 35), and G (N = 39), as well as 37 healthy volunteers in the control group (C, N = 37). All participants underwent an assessment of walking speed using BTS G-WALK^® and an evaluation of the number of falls and the risk of falling using a Fall Control Card. Results: There was a significant decrease in walking speed after surgery compared to the time before surgery, from 2.7% in the BU group, through 9.3% in the P group, and 19.2% in the DS group, to 30.0% in the G group. At the same time, for groups G and DS, the average walking speed fell below 1.0 m/s, amounting to 0.84 m/s and 0.97 m/s, respectively, in the measurement after the surgery and 0.95 m/s and 1.0 m/s in the follow-up measurement. Falling occurred in all the groups except for the BU group. The created logistic regression model showed that increasing the walking speed measured after the procedure (study 2) by 1 m/s reduces the risk of falling by approximately 500 times (OR = 0.002). Limitations in daily activity were observed in the follow-up examination (study 3) in 75% of patients. Conclusions: Surgical intervention has an impact on walking speed, and being part of the study group influences the risk of falling. Further research is needed to determine the precise risk of falls in cancer patients. Full article

(1) Background: Sexual satisfaction (SS) is an essential component of quality of life. There is a scarcity of research about sexual satisfaction in Lebanon, a country where discussing sexual issues is still considered a taboo. The present study aimed to assess the reliability and validity of responses to the items in the Arabic version of the Sexual Satisfaction Questionnaire (SSQ), as well as the correlates of sexual satisfaction, among a sample of Lebanese adults. (2) Methods: Two cross-sectional studies were conducted between June and September 2022 with 270 and 359 participants, respectively. (3) Results: The results showed that the Sexual Satisfaction Questionnaire is adequate to be used in Lebanon (McDonald’s ω = 0.90 and 0.86, respectively). Multivariate analysis showed that higher waterpipe dependence (Beta = −0.17) was substantially linked to lower sexual satisfaction, while better emotional intelligence (EI) (Beta = 0.27) and physical activity (Beta = 0.17) were significantly associated with greater sexual satisfaction. (4) Conclusions: The reliability and validity of the responses to the Arabic version of the Sexual Satisfaction Questionnaire were supported by our findings. Also, practical implications for sexual satisfaction enhancement strategies in the Lebanese population might be beneficial since many associated factors are considered to be modifiable. Full article

Objectives: This study examined residents’ attitudes and practices regarding the relevance of spirituality in psychiatry within Saudi residency training programs; their experiences and comfort levels in addressing patients’ spiritual concerns; and their interest and past learning experiences in this area of training and practice. Methods: This cross-sectional study targeted trainees and recent graduates of residency programs across Saudi Arabia. The study materials consisted of an electronic questionnaire that was adapted with permission. Results: The total number of respondents was 71 out of 180 potential participants (39.44%). Most residents (64.8%) felt that it was appropriate to inquire about the spiritual aspects of patients’ lives and that it was essential to address spiritual problems or needs that patients may have within the clinical setting (71.8%). Many participants (40.80%) described themselves as being both religious and spiritual. Most respondents (94.4%) did not receive any training on spirituality and psychiatry, and 80.3% said they would like to learn more about the subject. Conclusions: Our findings indicate that residents have an overall high level of personal spirituality and that they feel it is relevant in clinical practice. However, they have not had much training in this area and are interested in learning more. Educational initiatives would be beneficial for improving the effectiveness of residents and patient care in this untapped area of spirituality in psychiatry. Full article

Sleep monitoring has become a prevalent area of research where body position and physiological data, such as heart rate and respiratory rate, are monitored. Numerous critical health problems are associated with poor sleep, such as pressure sore development, sleep disorders, and low sleep quality, which can lead to an increased risk of falls, cardiovascular diseases, and obesity. Current monitoring systems can be costly, laborious, and taxing on hospital resources. This paper reviews the most recent solutions for contactless textile technology in the form of bed sheets or mats to monitor body positions, vital signs, and sleep, both commercially and in the literature. This paper is organized into four categories: body position and movement monitoring, physiological monitoring, sleep monitoring, and commercial products. A detailed performance evaluation was carried out, considering the detection accuracy as well as the sensor types and algorithms used. The areas that need further research and the challenges for each category are discussed in detail. Full article

Postpartum depression (PPD) affects 10–20% of women. Traditional treatments have raised concerns, but omega-3 fatty acids show potential as an alternative. This thematic review, sourced from databases like PubMed and Scopus between 1 February 2023 and 15 March 2023, seeks to delve into the various perspectives on omega-3 supplementation for PPD. The criteria included studies detailing depressive symptoms, social functioning, and neurobiological variables. The review includes research with women showing PPD symptoms, randomized clinical trials, and articles in Spanish, English, and French. Exclusions were studies lacking proper control comparisons and other interventions besides omega-3. Data extraction was performed independently. Two key studies provide contrasting findings on omega-3’s impact on PPD symptoms. In the study comparing DHA supplementation to a placebo, significant differences were not found in the EPDS scale, but differences were observed in the BDI scale. In contrast, another study recorded a significant decrease in depression scores in all dose groups, with reductions of 51.5% in the EPDS scale and 48.8% in the HRSD scale. Other studies, encompassing both prenatal and postpartum periods, underscore the differentiation between prenatal depression and PPD. Despite shared diagnostic criteria, PPD presents unique symptoms like restlessness, emotional lability, and baby-related concerns. It is crucial to address biases and obtain specific results, recommending exclusive PPD-focused studies. This review emphasizes the need for continuous exploration of omega-3’s relationship with PPD to enhance the life quality of pregnant women and their families. Full article

Background: The COVID-19 pandemic has significantly affected societies worldwide, including the medical healthcare system and trauma care. This study explores the impact of COVID-19 infection on trauma patients in South Korea, a country with effective pandemic management. Methods: A retrospective cohort study of 4206 trauma patients from June 2020 to May 2022 was conducted. Patients were categorized into COVID-19-positive and COVID-19-negative groups. Various clinical parameters, complications, and mortality rates were analyzed. Results: COVID-19-positive patients exhibited higher rates of complications, such as pressure sores (8.8% vs. 2.3%, p < 0.001), surgical site infections (2.4% vs. 0.8%, p = 0.044), and pneumonia (8.8% vs. 4.1%, p = 0.007). There was no significant difference in mortality between COVID-19-positive and -negative groups (4% vs. 5.6%, p = 0.439). Factors influencing mortality included COVID-19 status, age, Glasgow Coma Scale, Injury Severity Score, and transfusion status. Conclusion: COVID-19 positivity may have adverse clinical effects on trauma patients, but the impact varies based on public health factors. Additional studies in different contexts are crucial to elucidate these complexities. Full article

Colorectal cancer (CRC) is a prevalent cancer globally, including in Vietnam where its incidence is rapidly increasing. The aim of this study was to evaluate the awareness of signs, symptoms, and risk factors of colorectal cancer among outpatients at Hoa Hao Medic Company Limited, Ho Chi Minh City, Vietnam. A cross-sectional study was conducted, and a total of 441 people who visited Hoa Hao Medic Company Limited for a general health check-up and voluntarily agreed to participate in this study were recruited through the convenience sampling method. Data were collected through face-to-face structured interviews using the Bowel CAM questionnaire. According to the results, the highest percentage of well-recalled warning signs were “change in bowel habit” (36.7%) followed by abdominal pain (35.4%). Other warning signs such as weight loss and rectal bleeding were reported by 19.0% and 18.1% of participants, respectively. Over 42% of participants stated that they were unaware of any signs or symptoms. The most commonly identified risk factors for CRC were pollution (66.9%), genetics (50.6%), and an unhealthy/poor diet (53.7%) for unprompted questions. The overall awareness score of participants was 3.46/9 (SD ± 2.91) for signs and symptoms of CRC and 5.90/10 (SD ± 1.62) for risk factors. Univariate linear regression identified education level and occupation as predictors of higher CRC awareness. In conclusion, this study highlights that overall awareness of CRC is low among outpatients at Hoa Hao Medic Company Limited. Strategies to increase awareness, knowledge, and education programs are necessary to promote early detection of CRC and reduce its burden in Vietnam. Full article

Background: The purpose of this study was to evaluate the intensity and frequency of low back pain (LBP) in people with multiple sclerosis (PwMS) and patients’ knowledge of physiotherapeutic methods for combating LBP. Methods: This study included all MS patients attending consecutive follow-up visits for treatment related to MS between March and May 2023. Only current pain sensations in the lumbar spine were taken into account. The inclusion criteria were age 18–60 years, a definite diagnosis of MS according to the 2017 McDonald criteria, treatment with disease-modifying drugs (DMTs), and consent to participate in the study. This study was carried out using an original survey questionnaire and a Visual Analogue Scale. PwMS were divided into three age groups: 18–30 years, 31–50 years, and over 50 years. Results: Ninety PwMS (68 women and 22 men) were included in the study. The mean duration of the disease was 9.5 ± 4.9 years, and the mean EDSS was 3.5 ± 1.6. Most patients had a relapsing-remitting form of the disease. Overall, 68.9% of PwMS felt low back pain (n = 62). The relationship tested was statistically significant (p < 0.001), and the strength of the relationship was high (r_c = 0.695). The average level of low back pain among PwMS was 4.7 out of 10 on the VAS. The prevalence of LBP was higher in female patients (p < 0.001), patients with a secondary progressive form of MS (p < 0.001), and patients with a longer duration of disease (p < 0.05). The most widely used methods for treating LBP were kinesitherapy and manual therapy. Conclusions: LBP is common in patients with multiple sclerosis. Female sex, a secondary progressive form of MS, and a longer duration of disease increase the risk of LBP. It is important to implement properly planned physiotherapy activities and educate patients on how to combat LBP. Full article

Second-hand smoke (SHS) has adverse effects for pregnant women and foetuses. This controlled and randomized clinical trial evaluated the efficacy of a comic booklet intervention in promoting SHS avoidance among pregnant women and appropriate smoking behaviours among their male partners. We allocated 140 couples to the experimental group (EG), who received the comic booklet and a reminder sticker, and 146 couples to the control group (CG), who received usual care. The primary outcomes were women’s self-reported SHS exposure and their male partners’ smoking behaviours. Secondary outcomes included knowledge and awareness of SHS. Independent t-tests revealed that three months post-intervention, more male partners in the EG had appropriate self-reported smoking behaviours with a small effect size (Cohen’s d = 0.35, 95% CI [0.08, 0.62], p-value = 0.01). Significantly more pregnant women in the EG recognised their partners’ appropriate smoking behaviours with a nearly middle effect size (Cohen’s d = 0.43, 95% CI [0.16, 0.70], p-value ≤ 0.01). Cues to action showed a significant difference between groups with a small effect size (Cohen’s d = 0.36, 95% CI [0.09, 0.63], p-value = 0.01), as evaluated by male partners. These findings suggest that the comic booklet intervention might be effective against SHS exposure by providing several cues to action through knowledge and awareness of SHS. Full article

Background: The application of enhanced recovery after surgery principles decreases postoperative complications (POCs), length of stay (LOS), and readmissions. Pharmacoprophylaxis decreases morbidity, but the effect of specific regimens on clinical outcomes is unclear. Methods and Materials: Records of 476 randomly selected adult patients who underwent elective colorectal surgeries (ECRS) at 10 US hospitals were abstracted. Primary outcomes were surgical site infection (SSI), venous thromboembolism (VTE), postoperative nausea and vomiting (PONV), pain, and ileus rates. Secondary outcomes included LOS and 7- and 30-day readmission rates. Results: POC rates were SSI (3.4%), VTE (1.5%), PONV (47.9%), pain (58.1%), and ileus (16.1%). Cefazolin 2 g/metronidazole 500 mg and ertapenem 1 g were associated with the shortest LOS; cefotetan 2 g and cefoxitin 2 g with the longest LOS. No SSI occurred with ertapenem and cefotetan. More Caucasians than Blacks received oral antibiotics before intravenous antibiotics without impact. Enoxaparin 40 mg subcutaneously daily was the most common inpatient and discharge VTE prophylaxis. All in-hospital VTEs occurred with unfractionated heparin. Most received rescue rather than around-the-clock antiemetics. Scopolamine patches, spinal opioids, and IV lidocaine continuous infusion were associated with lower PONV. Transversus abdominis plane block with long-acting local anesthetics, celecoxib, non-anesthetic ketamine bolus, ketorolac IV, lidocaine IV, and pregabalin were associated with lower in-hospital pain severity rates. Gabapentinoids and alvimopan were associated with lower ileus rates. Acetaminophen, alvimopan, famotidine, and lidocaine patches were associated with shorter LOS. Conclusions: Significant differences in pharmacotherapy regimens that may improve primary and secondary outcomes in ECRS were identified. In adult ECRS, cefotetan or ertapenem may be better regimens for preventing in-hospital SSI, while ertapenem or C/M may lead to shorter LOS. The value of OA to prevent SSI was not demonstrated. Inpatient enoxaparin, compared to UFH, may reduce VTE rates with a similar LOS. A minority of patients had a documented PONV risk assessment, and a majority used as-needed rather than around-the-clock strategies. Preoperative scopolamine patches continued postoperatively may lower PONV and PDNV severity and shorter LOS. Alvimopan may reduce ileus and shorten LOS. Anesthesia that includes TAP block, ketorolac IV, and pregabalin use may lead to reduced pain rates. Acetaminophen, alvimopan, famotidine, and lidocaine patches may shorten LOS. Given the challenges of pain management and the incidence of PONV/PDNV found in this study, additional studies should be conducted to determine optimal opioid-free anesthesia and the benefit of newer antiemetics on patient outcomes. Moreover, future research should identify latent pharmacotherapy variables that impact patient outcomes, correlate pertinent laboratory results, and examine the impact of order or care sets used for ECRS at study hospitals. Full article

Objectives: The study explores the relationship between social support, self-care ability, and life quality of cured leprosy patients (CLPs), aiming to develop strategies to enhance their overall well-being. Methods: From July to December 2021, we investigated the social support, self-care ability, and life quality of CLPs through three scales and analyzed the correlation between them. In addition, structural estimation modeling (SEM) was employed to analyze their correlation. Results: A total of 9245 CLPs were recruited, with a male-to-female ratio of 2.19:1, and 94.04% of cured patients was 60 years or above, with predominantly home-cured patients. The scores of WHOQOL-BREF, SSRS, and ESCA were (51.39 ± 9.89), (31.87 ± 8.76), and (100.95 ± 19.75), respectively. The results indicate a poorer quality of life and social support for CLPs compared to the general population in China. Furthermore, the home group had higher scores on these scales than the leprosarium group. The correlation analysis showed significant interactions between life quality, social support, self-care ability, and various domains (p < 0.05). SEM results revealed that the direct effect of self-care ability on life quality was 0.13, and the indirect effect on quality of life through social support was 0.08. The mediating effect of social support accounted for 22.86% of the total effect in the home group. In the leprosarium group, the effect of self-care ability on quality of life was 0.14. Conclusions: Most CLPs in Jiangsu Province are concentrated in the central region, with a high disease burden. We found that CLPs have a poorer life quality than the general population, with the leprosarium group being worse than the home group. The government and society should pay more attention to and support these cured patients. Full article