Editor’s Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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8 pages, 864 KiB  
Brief Report
Improving the Therapeutic Relationship When Prescribing Antidepressants: A Pilot Study
by Konrad Michel, Daniela Lutz-Beck and Sylva Engeroff
Healthcare 2023, 11(21), 2825; https://doi.org/10.3390/healthcare11212825 - 25 Oct 2023
Viewed by 837
Abstract
Studies indicate that the quality of the doctor–patient relationship moderates the effect of pharmacotherapy. To enhance the quality of the therapeutic relationship in the pharmacotherapy of depression, we developed a brief manual with interactive materials for residents in psychiatry and their patients. In [...] Read more.
Studies indicate that the quality of the doctor–patient relationship moderates the effect of pharmacotherapy. To enhance the quality of the therapeutic relationship in the pharmacotherapy of depression, we developed a brief manual with interactive materials for residents in psychiatry and their patients. In a pilot study at a psychiatric university hospital’s outpatient department, we compared patient-centered treatment parameters of a first patient group treated as usual and a second patient group treated using the manual. The study had no influence on the choice of medication. In the manual group, patient satisfaction with the doctor–patient relationship increased significantly at the three-month follow-up. Depression parameters declined in both groups, without group differences. Continuation of antidepressant medication at six months was higher in the manual group. In conclusion, a simple intervention using written materials for doctors prescribing antidepressants improved doctors’ and patients’ satisfaction with treatment. Full article
(This article belongs to the Section Medication Management)
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15 pages, 647 KiB  
Review
The Risk Factors and Screening Uptake for Prostate Cancer: A Scoping Review
by Seidu Mumuni, Claire O’Donnell and Owen Doody
Healthcare 2023, 11(20), 2780; https://doi.org/10.3390/healthcare11202780 - 20 Oct 2023
Cited by 2 | Viewed by 2673
Abstract
Objectives: The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer. Design: Scoping review. Methods: Arksey and O’Malley’s framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, [...] Read more.
Objectives: The purpose of this scoping review was to identify the risk factors and screening uptake for prostate cancer. Design: Scoping review. Methods: Arksey and O’Malley’s framework guided this review; five databases (Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, Academic Search Complete and Cochrane Library) and grey literature were searched. Screening was undertaken against predetermined inclusion criteria for articles published before July 2023 and written in English. This review is reported in line with PRISMA-Sc. Results: 10,899 database results were identified; 3676 papers were removed as duplicates and 7115 papers were excluded at title and abstract review. A total of 108 papers were full-text reviewed and 67 were included in the review. Grey literature searching yielded no results. Age, family history/genetics, hormones, race/ethnicity, exposure to hazards, geographical location and diet were identified as risk factors. Prostatic antigen test (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS), magnetic resonance imaging (MRI), magnetic resonance spectroscopic imaging (MRSI) and prostate biopsy were identified as screening/diagnostic methods. The evidence reviewed highlights moderate knowledge and screening uptake of prostate cancer with less than half of men reporting for PSA screening. On the other hand, there is a year-to-year increase in PSA and DRE screening, but factors such as poverty, religion, culture, communication barriers, language and costs affect men’s uptake of prostate cancer screening. Conclusion: As prostate cancer rates increase globally, there is a need for greater uptake of prostate cancer screening and improved health literacy among men and health workers. There is a need to develop a comprehensive prostate cancer awareness and screening programme that targets men and addresses uptake issues so as to provide safe, quality care. Strengths and limitations of this study: (1) A broad search strategy was utilised incorporating both databases and grey literature. (2) The PRISMA reporting guidelines were utilised. (3) Only English language papers were included, and this may have resulted in relevant articles being omitted. Full article
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14 pages, 276 KiB  
Article
Opinion of Polish Patients with Epilepsy on Generic Medications
by Katarzyna Swakowska, Urszula Religioni and Anna Staniszewska
Healthcare 2023, 11(20), 2717; https://doi.org/10.3390/healthcare11202717 - 12 Oct 2023
Viewed by 626
Abstract
Aim: The majority of medicines used in Poland are generic drugs and substitutions of the originals. The objective of this study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The conducted study [...] Read more.
Aim: The majority of medicines used in Poland are generic drugs and substitutions of the originals. The objective of this study was to obtain information on the current knowledge about generic medicines among Polish patients with epilepsy. Material and Methods: The conducted study was based on a self-developed questionnaire. The questionnaire consisted of 26 questions, including the questions regarding the respondents’ knowledge about generics, their previous experience, and the factors behind these choices. Results: Overall, 1220 questionnaires were analyzed. Among all patients, 66.4% reportedly had heard about generics. Of these, 61.5% of patients had used generic drugs in the past. A significant proportion of participants had never been recommended to switch to a generic medicine by their healthcare professional (23% physicians and 13.9% pharmacists). Statistically, relevant differences were observed regarding the respondents’ kind and level of education, place of residence, and net income per household. Conclusions: Significant gaps were identified in the knowledge and perceptions among patients regarding generic medicines, especially in relation to their efficacy and safety. Efforts must be directed towards increasing public awareness of generic medicines and there should also be a focus on educating patients about generic medicines. Full article
20 pages, 1867 KiB  
Article
Awareness, Attitudes and Willingness to Donate Biological Samples to a Biobank: A Survey of a Representative Sample of Polish Citizens
by Łukasz Pronicki, Marcin Czech, Mariusz Gujski and Natalia D. Boguszewska
Healthcare 2023, 11(20), 2714; https://doi.org/10.3390/healthcare11202714 - 11 Oct 2023
Cited by 1 | Viewed by 844
Abstract
Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, [...] Read more.
Biotechnology is developing at an ever-increasing pace, and the progressive computerization of health care and research is making it increasingly easy to share data. One of the fastest growing areas is biobanking. However, even with the best equipment and the best trained staff, a biobank will be useless without donors. For this reason, we have decided to gauge Polish citizens’ awareness and attitudes towards biobanking and their willingness to donate biological samples. For this purpose the survey was conducted among a nationwide group of 1052 Poles aged 18 and over where the totals for gender, age and place of residence were selected according to their representation in the total population of adult Poles. The survey was conducted using the Computer Assisted Web Interview (CAWI) technique. Approximately two thirds of respondents N = 701 (66.6%) indicated that they had heard of scientific studies in which samples of biological material such as blood, saliva or urine are collected. More than half of respondents (N = 613, 58.3%) had a positive opinion regarding scientific research in which samples of biological material are taken. Only N = 220 (20.9%) of respondents had previously encountered the term biobanking. More than a half N = 687 (65.3%) of respondents would participate in a scientific study that biobanked biological material and health information. Almost half of the respondents (48.0%) would like specific consent to be used in biobanking. In our study we observed a negligible correlation between socio-demographic factors and a willingness to donate biological material to a biobank. Considering the results presented above, the level of knowledge and awareness of biobanks, and their role in scientific research and the health care system, among Polish citizens is low and requires education and information activities. Full article
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10 pages, 285 KiB  
Opinion
Oral Health Strategies: Surveying the Present to Plan the Future of Community-Based Learning
by Nélio Jorge Veiga, Patrícia Couto, Patrícia Correia, Anna Carolina Volpi Mello-Moura, Pedro Campos Lopes and Maria José Correia
Healthcare 2023, 11(19), 2646; https://doi.org/10.3390/healthcare11192646 - 28 Sep 2023
Viewed by 784
Abstract
Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review’s main goal is to analyze the strategies that improve oral health literacy within the [...] Read more.
Introduction: Oral health literacy relates to the capacity of individuals to acquire, understand and to act upon oral health information to make appropriate health decisions. This scientific review’s main goal is to analyze the strategies that improve oral health literacy within the community, specifically oriented to a community-based learning model focused on the most vulnerable risk groups in society. Materials and Methods: The current review is based on the literature on oral health literacy within community-based learning strategies. The present review selected scientific studies by searching MEDLINE and related databases, such as Web of Science and PUBMED, and by consulting existing bibliographies. Results: Based on the application of the inclusion criteria to the abstracts, 45 publications were retrieved which explicitly dealt with the definitions of oral health literacy, community-based learning, and service learning. Several studies have demonstrated that health consumers with low health literacy fail to understand the available health information. Therefore, innovative oral health literacy strategies should be undertaken. Service learning is an example of an educational approach where the student learns specific soft skills in the classroom and collaborates directly with an agency or institution and engages in reflection activities to deepen their understanding of what is being taught. Conclusions: One of the main strategies used to incorporate the oral health professional in social responsibility and direct contact in the community is through experiencing community-based learning projects. The future graduate must be an educator capable of educating patients in order to themselves acquire high-level skills in oral health literacy. Full article
(This article belongs to the Section Community Care)
13 pages, 1056 KiB  
Article
Pharmacologic Stewardship in a Rural Community Pharmacy
by Chrysanthi Sardeli, Theodoros Athanasiadis, Eleni Stamoula and Dimitrios Kouvelas
Healthcare 2023, 11(19), 2619; https://doi.org/10.3390/healthcare11192619 - 25 Sep 2023
Viewed by 870
Abstract
Background: Pharmacotherapy is an essential part of patient care. In order to achieve optimal health outcomes, safe and effective prescribing and administering of medications is crucial, especially since the process of pharmacotherapy can cause serious problems, mainly adverse events and/or interactions, that often [...] Read more.
Background: Pharmacotherapy is an essential part of patient care. In order to achieve optimal health outcomes, safe and effective prescribing and administering of medications is crucial, especially since the process of pharmacotherapy can cause serious problems, mainly adverse events and/or interactions, that often pass undetected. Objective(s): To investigate the feasibility of using community pharmacies as checkpoints to detect errors and failures in prescribing, as well as patients’ compliance with pharmacotherapy. To this end, analysis and recording of the prescribing process was carried out and error-prone points were identified. Methods: Patients and caregivers filling prescriptions during the first 4 weeks of November 2017 and February 2018 answered questions in order to evaluate their attendance of regular checkups and their compliance with prescribing instructions. All prescriptions filled at the pharmacy were examined for detection of prescription errors and drug–drug interactions. Statistical analyses, including calculations of the correlation coefficient phi (φ), chi-square, and confidence intervals, were carried out. Detected errors and failures were evaluated by application of the Health Failure Mode Effect Analysis (HFMEA) quality tool. Results: A significant number of patients (16.7%) failed to regularly attend checkups regarding known health problems (95% CI: 10.6–22.7%), a corresponding percentage (16%, 95% CI: 10.1–21.9%) did not comply with prescribed pharmacotherapy, and a significant proportion of patients self-medicated regularly (32%, 95% CI: 24.5–39.5%). A total of 8.6% of prescriptions included medication combinations with a potential for severe drug–drug interactions (95% CI: 7.1–10.2%) while 58.7% of the prescriptions included combinations that could lead to moderate ones (95% CI: 56.1–61.4). The HFMEA indicated that all problems recorded required immediate interventions, except for prescribing errors. Conclusions: Community pharmacies can be potential checkpoints for the detection and evaluation of prescribing errors and pharmacotherapy failures. Full article
(This article belongs to the Special Issue Pharmacovigilance and Appropriate Drug Use)
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13 pages, 258 KiB  
Article
Views about Euthanasia and Dementia: Exploring Perceptions Utilising Evidence from the Mass Observation Archive
by Janet Blain, Dean Stevens, Louise Taylor, Paul Kingston and Geoffrey Watts
Healthcare 2023, 11(18), 2552; https://doi.org/10.3390/healthcare11182552 - 15 Sep 2023
Viewed by 1124
Abstract
This paper contributes to the ongoing discussion in the United Kingdom regarding euthanasia and assisted dying, using data specifically related to individuals with dementia. A qualitative approach was taken with data captured via a set of written questions in the form of a [...] Read more.
This paper contributes to the ongoing discussion in the United Kingdom regarding euthanasia and assisted dying, using data specifically related to individuals with dementia. A qualitative approach was taken with data captured via a set of written questions in the form of a Mass Observation Archive Directive. The respondents, known as Observers, provided written responses; there was no limit to the length of the responses and the Observers were able to provide as much or as little detail as they chose. The data were analysed thematically utilising NVivo software. One-hundred and seven responses were received, representing a range of beliefs, and with opinions regarding euthanasia and dementia with pro, anti, and uncertain views being expressed. Five main themes emerged during our data analysis: capacity, legislation, agency and personal philosophies, disquietude, and incumbrance. Consistent with previous research capturing public views regarding euthanasia and assisted dying for people with dementia, the findings suggest policy makers may wish to consult the British public regarding legislation regarding euthanasia and dementia. Full article
(This article belongs to the Special Issue Dementia and Care)
14 pages, 275 KiB  
Article
Navigating the Impacts of Dementia: The Experience of Male Spousal Carers
by Edward Tolhurst and Bernhard Weicht
Healthcare 2023, 11(18), 2492; https://doi.org/10.3390/healthcare11182492 - 08 Sep 2023
Viewed by 854
Abstract
This article investigates the experience of male spousal carers for women living with dementia. While cultural discourses on care are highly gendered, social scientific research often addresses care relationships in gender-neutral terms. Setting out to address this matter, this qualitative research study incorporated [...] Read more.
This article investigates the experience of male spousal carers for women living with dementia. While cultural discourses on care are highly gendered, social scientific research often addresses care relationships in gender-neutral terms. Setting out to address this matter, this qualitative research study incorporated semi-structured joint interviews with 10 couples in which a male spouse cared for a woman with dementia. The aim was to explore how couples negotiate relationships and care following a diagnosis of dementia. The focus of this paper is on the perspectives expressed in these joint interviews by the male carers. A thematic analysis was undertaken to establish the key content of the men’s accounts. Three principal themes were identified: making sense of the condition; treating dementia as a problem to be solved; and engaging with professionals and support. The gendered basis of experience for male carers is explored within these themes, demonstrating how societal norms of masculinity intersect with caring roles. The paper concludes that a nuanced research approach to dementia care must continue to be developed, accounting for how gender shapes personal responses to the navigation of care relationships. Practitioners and policymakers must also consider how gendered experience shapes the identities and strategies of male carers. Full article
(This article belongs to the Special Issue Dementia and Care)
17 pages, 944 KiB  
Article
Impact of Voluntary, Community and Social Enterprise (VCSE) Organisations Working with Underserved Communities with Type 2 Diabetes Mellitus in England
by Lucie Nield, Sadiq Bhanbhro, Helen Steers, Anna Young and Sally Fowler Davis
Healthcare 2023, 11(18), 2499; https://doi.org/10.3390/healthcare11182499 - 08 Sep 2023
Viewed by 988
Abstract
The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those [...] Read more.
The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those living with type 2 diabetes mellitus (T2DM) and to develop a theory of change (TofC) through understanding the impact of VCSE organisations on diabetes management. An appreciative inquiry (AI) was carried out and co-delivered using qualitative interviews and an embedded analysis with VCSE partners. A voluntary service coordinated seven VCSE organisations who assisted with recruiting their service users and undertook interviews to identify the impact of existing activities and programmes. People living with T2DM were interviewed about services. Themes were as follows: (a) individual and group activities; (b) trusted services and relationships across the community; (c) long-term engagement; (d) sociocultural context of diet and nutritional choices; (e) experience of adaptation; and (f) culturally appropriate advice and independent VCSE organisations. The structured educational approach (DESMOND) for T2DM was accessed variably, despite these services being recommended by NICE guidelines as a standard intervention. The VCSE offered continuity and culturally appropriate services to more marginalised groups. This evaluation highlights the importance of targeted engagement with underserved communities, particularly where primary care services are more limited. The TofC is a unique insight into the impact of VCSE services, offering bespoke support to manage T2DM, suggesting areas for improvements in capacity and offering the capability to sustain the VCSE sector as an essential element of the T2DM care pathway in England. Full article
(This article belongs to the Special Issue Ageing and Healthcare Utilisation)
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19 pages, 2004 KiB  
Systematic Review
Effectiveness of Osteopathic Manipulative Treatment in Adults with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
by Francesca Buffone, Andrea Gianmaria Tarantino, Federico Belloni, Andrea Spadafora, Giorgio Bolzoni, Irene Bruini, Andrea Bergna and Luca Vismara
Healthcare 2023, 11(17), 2442; https://doi.org/10.3390/healthcare11172442 - 31 Aug 2023
Cited by 1 | Viewed by 2052
Abstract
The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and [...] Read more.
The aim of this systematic review and meta-analysis was to evaluate the effectiveness of the osteopathic manipulative treatment (OMT) in adults with irritable bowel syndrome (IBS). A literature resview was carried out on the following databases: PubMed, Embase, Cochrane, Cinahl, Scopus, PEDro and ClinicalTrials.gov. 350 articles were recovered. Eligibility criteria were evaluated by two independent reviewers, including randomized controlled trials (RCTs), quasi-RCTs, or ongoing RCTs with OMT compared to any kind of control in patients diagnosed with IBS. Six studies (five RCTs and one ongoing RCT) were considered eligible. Four RCTs were classified as some concerns and one as high risk of bias. In the meta-analysis, OMT compared to sham/no intervention showed statistically significant results for abdominal pain (effect size ES = −1.14 [−1.66, −0.62]; p < 0.0001) and constipation (ES = −0.66 [−1.12, −0.20]; p = 0.005). Instead, OMT was not superior to the control for the IBS symptoms measured with the IBS Severity Score and the Likert scale (ES = −0.34 [−0.83, 0.16]; p = 0.19), and diarrhea (ES = −1.20 [−2.84, 0.43]; p = 0.15). The quality of evidence was “low” for IBS symptoms in general for abdominal pain and constipation, while it was judged as “very low” for diarrhea. OMT turns out to be safe in the treatment of IBS without major adverse effects. OMT may be effective in IBS patients, however the results must be interpreted carefully due to the low methodological quality of the studies. Full article
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10 pages, 232 KiB  
Article
The Experiences of Community Health Workers in Preventing Noncommunicable Diseases in an Urban Area, the Philippines: A Qualitative Study
by Yuko Yamaguchi, Lia M. Palileo-Villanueva, Leonor Sanchez Tubon, Eunice Mallari and Hiroya Matsuo
Healthcare 2023, 11(17), 2424; https://doi.org/10.3390/healthcare11172424 - 30 Aug 2023
Viewed by 5118
Abstract
(1) Background: Barangay health workers (BHWs) play important roles as community health workers in preventing noncommunicable diseases (NCDs), where the shortage of health professionals is felt more acutely in the Philippines. However, there is little research on the experiences of BHWs as community [...] Read more.
(1) Background: Barangay health workers (BHWs) play important roles as community health workers in preventing noncommunicable diseases (NCDs), where the shortage of health professionals is felt more acutely in the Philippines. However, there is little research on the experiences of BHWs as community health workers in preventing NCDs. This study aimed to clarify the roles and difficulties of BHWs in conducting activities for the prevention of NCDs. (2) Methods: Qualitative data were collected from 25 BHWs. (3) Results: The mean age of the participants was 50.4 ± 9.5 years, 23 were women, and the mean length of time as a BHW was 9.1 ± 7.7 years. Three major themes about the role of BHWs in preventing NCDs—“screening for NCDs”, “assisting patients with management of their conditions”, and “promoting healthy behaviors”—and four major themes about the difficulties—“insufficient awareness of preventative behaviors”, “economic burdens”, “lack of resources for managing NCDs”, and “difficulty of access to medical care facilities”—were identified. (4) Conclusions: Through the findings of this study, focusing interventions aimed at addressing the difficulties for the prevention of NCDs among BHWs may help reduce health inequities. Full article
(This article belongs to the Special Issue Health Education and Promotion in the Community)
15 pages, 664 KiB  
Systematic Review
Digital Health for Patients Undergoing Cardiac Surgery: A Systematic Review
by Kevin A. Wu, Sameer Kunte, Shashank Rajkumar, Vishal Venkatraman, Grace Kim, Samantha Kaplan, Syed Omar Anwar-Hashmi, Julie Doberne, Tom C. Nguyen and Shivanand P. Lad
Healthcare 2023, 11(17), 2411; https://doi.org/10.3390/healthcare11172411 - 28 Aug 2023
Cited by 1 | Viewed by 1318
Abstract
Digital health interventions have shown promise in improving patient outcomes and experiences in various healthcare settings. However, their effectiveness in the context of cardiac surgery remains uncertain. This systematic review aims to evaluate the existing evidence on the use of digital health interventions [...] Read more.
Digital health interventions have shown promise in improving patient outcomes and experiences in various healthcare settings. However, their effectiveness in the context of cardiac surgery remains uncertain. This systematic review aims to evaluate the existing evidence on the use of digital health interventions for patients undergoing cardiac surgery. A comprehensive search of PubMed MEDLINE, Elsevier EMBASE, Elsevier Scopus databases, and ClinicalTrials.gov was conducted to identify relevant studies published up to the present. Studies that examined the effects of digital health interventions, including mobile applications and web-based interventions, on perioperative care and patient outcomes in cardiac surgery were included. The data were extracted and synthesized to provide a comprehensive overview of the findings. The search yielded 15 studies composed of 4041 patients, analyzing the feasibility and implementation of mobile or internet applications for patients undergoing cardiac surgery. The studies included the use of mobile applications (ManageMySurgery, SeamlessMD, mHeart, Telediaglog, ExSed, Soulage Tavie, Heart Health application, and Mayo Clinic Health Connection) and web-based interventions (Heartnet and Active Heart). The findings indicated that these digital health interventions were associated with improved patient engagement, satisfaction, and reduced healthcare utilization. Patients reported finding the interventions helpful in their recovery process, and there was evidence of enhanced symptom monitoring and timely intervention. The completion rates of modules varied depending on the phase of care, with higher engagement observed during the acute phase. Interest in using digital health applications was expressed by patients, regardless of age, gender, or complexity of the cardiac defect. The results demonstrated that web-based interventions resulted in improvements in mental health, quality of life, and eHealth literacy. This systematic review highlights the potential benefits of digital health interventions in the context of cardiac surgery. Further research, including randomized controlled trials, is needed to establish the effectiveness, feasibility, and generalizability of digital health interventions in cardiac surgery. Full article
(This article belongs to the Special Issue Digital Therapeutics in Healthcare)
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15 pages, 1478 KiB  
Systematic Review
Virtual Reality-Based Exercise Therapy for Patients with Chronic Musculoskeletal Pain: A Scoping Review
by Paraskevi Bilika, Natalia Karampatsou, Giorgos Stavrakakis, Achilleas Paliouras, Yannis Theodorakis, Nikolaos Strimpakos and Eleni Kapreli
Healthcare 2023, 11(17), 2412; https://doi.org/10.3390/healthcare11172412 - 28 Aug 2023
Cited by 2 | Viewed by 2691
Abstract
This scoping review aimed to identify interventions utilizing virtual-reality-based exercise therapy in patients with chronic musculoskeletal pain. Searches were conducted in four databases using descriptors related to virtual reality, exercise, and chronic musculoskeletal pain. Two reviewers screened the titles and abstracts of the [...] Read more.
This scoping review aimed to identify interventions utilizing virtual-reality-based exercise therapy in patients with chronic musculoskeletal pain. Searches were conducted in four databases using descriptors related to virtual reality, exercise, and chronic musculoskeletal pain. Two reviewers screened the titles and abstracts of the studies to assess eligibility, with a third author resolving any discrepancies. Data were extracted and summarized in a narrative format by three independent raters. Clinical trials were evaluated using the PEDro scale to assess the effectiveness of virtual-reality-based exercise therapy in chronic musculoskeletal pain patients. A total of 162 articles were identified from the databases. After applying the inclusion criteria, nine articles were considered suitable for analysis, including six randomized clinical trials. The selected articles were categorized based on study characteristics, virtual-reality-based exercise therapy interventions (including technologies and equipment used), exercise interventions, outcome measures, and effectiveness. The findings indicate that virtual-reality-based exercise therapy shows promising results in reducing pain, improving disability, enhancing range of motion, and increasing treatment satisfaction in patients with chronic musculoskeletal pain. However, it is not possible to conclude that virtual-reality-based exercise therapy is superior to other treatments due to the limited number of available studies, heterogeneity in application protocols, and varying methodological quality. Further research is needed to draw more definitive conclusions. Full article
(This article belongs to the Special Issue New Advances in the Treatment of Chronic Musculoskeletal Pain)
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19 pages, 1053 KiB  
Article
Young People and the Future: School Students’ Concerns and Hopes for the Future after One Year of COVID-19 in Austria—Findings of a Mixed-Methods Pilot Study
by Sonja Fehkührer, Elke Humer, Stefan Kaltschik, Christoph Pieh, Thomas Probst, Gertraud Diestler and Andrea Jesser
Healthcare 2023, 11(16), 2242; https://doi.org/10.3390/healthcare11162242 - 09 Aug 2023
Cited by 1 | Viewed by 896
Abstract
The COVID-19 pandemic resulted in enormous changes in everyday life and numerous burdens for adolescents. This pilot study focused on how young people look to the future in the face of these burdens. Responses to two open-ended questions on concerns and hopes for [...] Read more.
The COVID-19 pandemic resulted in enormous changes in everyday life and numerous burdens for adolescents. This pilot study focused on how young people look to the future in the face of these burdens. Responses to two open-ended questions on concerns and hopes for the future that were part of a larger online survey on the mental health of school students in Austria were analyzed using qualitative content analysis. Subsequently, differences in the experiences of boys and girls, young people with and without a migration background and psychologically stressed and non-stressed young people were examined by applying a mixed-methods approach. Data collection took place from 3 February to 28 February 2021. From a total survey sample of 3052 adolescents aged 14–20, a representative sample according to gender and migration background (N = 500) was drawn. Qualitative content analysis revealed several areas of concern about the future, including school-related concerns, concerns about the further development of the pandemic and the associated restrictions, concerns related to a lack of locus of control, health-related concerns and concerns about social relationships. The analysis also indicated young people’s greatest hopes for the future, such as hopes related to further pandemic development, hopes regarding major life goals, school, social relationships and health. Young people’s experiences differ according to gender, migration background and the extent of psychological distress. This study contributes to research on the psychological well-being of adolescents during the pandemic and provides important insights into the subjective experience of young people. It aims to gain a more comprehensive understanding of the concerns and hopes for the future of young people in a time marked by various challenges. The results of the study should be used to develop ideas for measures, such as the expansion of school psychological services and low-threshold support services for students, such as school social work and counseling. Full article
(This article belongs to the Special Issue Research and Survey on Mental Health of Children and Adolescents)
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31 pages, 1330 KiB  
Review
The Quiet Epidemic: An Overview of Emerging Qualitative Research Trends on Sedentary Behavior in Aging Populations
by André Ramalho and João Petrica
Healthcare 2023, 11(15), 2215; https://doi.org/10.3390/healthcare11152215 - 06 Aug 2023
Cited by 4 | Viewed by 2459
Abstract
Sedentary behavior poses a significant health risk to older adults. The purpose of this scoping review is to summarize key findings from qualitative research (since 2012), with a focus on explaining prevailing research trends and patterns within the field. This review included 25 [...] Read more.
Sedentary behavior poses a significant health risk to older adults. The purpose of this scoping review is to summarize key findings from qualitative research (since 2012), with a focus on explaining prevailing research trends and patterns within the field. This review included 25 studies that met the strict inclusion criteria. Five key research themes have emerged: (1) defining and shaping perspectives of sedentary behavior, (2) understanding the dynamics of daily routines and contexts, (3) raising awareness of older adults’ perceived advantages and disadvantages of sedentary behavior, (4) identifying its determinants and discouraging factors, and (5) exploring interventions to promote active behaviors and reduce sedentary behavior. These themes highlight the multifaceted nature of SB and underscore the importance of tailoring interventions to address individual, social, and environmental issues. A comprehensive understanding of SB is critical to developing effective strategies to promote active lifestyles and reduce SB in older adults. Further qualitative research is needed to deepen our understanding and develop targeted interventions and strategies. Full article
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13 pages, 281 KiB  
Article
The Spousal Unit and Dementia: Investigating the Relational Basis of the Couplehood Concept
by Bernhard Weicht and Edward Tolhurst
Healthcare 2023, 11(15), 2191; https://doi.org/10.3390/healthcare11152191 - 03 Aug 2023
Cited by 1 | Viewed by 734
Abstract
A strong emphasis is consistently placed upon the relational basis of experience within social scientific dementia research. Within this research corpus, the concept of couplehood is increasingly employed, albeit in rather undefined and loosely theorised ways. Moreover, the evaluation highlights that couplehood is [...] Read more.
A strong emphasis is consistently placed upon the relational basis of experience within social scientific dementia research. Within this research corpus, the concept of couplehood is increasingly employed, albeit in rather undefined and loosely theorised ways. Moreover, the evaluation highlights that couplehood is often defined by a normative position that seeks to convey an affirmative perspective on dementia and spousal relationships. The lack of theoretical foundation, however, weakens the explanatory potential of the concept, both for theorising dementia, as well as for empirical research. This article critically evaluates the utility of the couplehood concept by delineating three underlying theoretical conceptions: phenomenological, interactional and relational perspectives. It will be argued that those theoretical threads offer different analytical angles and research opportunities. More thorough ontological development, however, can guide understandings of the complexities that underpin the relational experience of dementia. This will promote a conceptual starting point that offers a more balanced and multifaceted accommodation of two persons and their relationship. Full article
(This article belongs to the Special Issue Dementia and Care)
11 pages, 284 KiB  
Review
Perspectives on Aging and Quality of Life
by Shinichi Noto
Healthcare 2023, 11(15), 2131; https://doi.org/10.3390/healthcare11152131 - 26 Jul 2023
Cited by 4 | Viewed by 1424
Abstract
The aging of the world’s population and the health problems accompanying it are becoming increasingly severe. Healthcare policies in developed countries focus on how to prevent and treat diseases associated with aging and how to maintain quality of life. Typical age-related diseases include [...] Read more.
The aging of the world’s population and the health problems accompanying it are becoming increasingly severe. Healthcare policies in developed countries focus on how to prevent and treat diseases associated with aging and how to maintain quality of life. Typical age-related diseases include deafness, cataracts, osteoarthritis, chronic obstructive pulmonary disease, diabetes mellitus, and dementia. Although the mechanisms by which these diseases develop differ, they are all caused by the accumulation of molecular and cellular damage over time. In addition, age-related diseases can cause a decline in physical and mental functions and the ability to perform activities of daily living, as well as the loss of roles in society and a sense of fulfillment in life. Therefore, there is a need for treatment and measures to accurately grasp and maintain quality of life. This review aims to introduce areas and representative papers expected to be contributed to the special issue of “Aging and Quality of Life”. Full article
(This article belongs to the Special Issue Aging and Quality of Life)
16 pages, 293 KiB  
Article
Essential Skills for Health Communication, Barriers, Facilitators and the Need for Training: Perceptions of Healthcare Professionals from Seven European Countries
by Dina Zota, Dimitrios V. Diamantis, Konstantinos Katsas, Pania Karnaki, Thomas Tsiampalis, Piotr Sakowski, Costas A. Christophi, Eleni Ioannidou, Sara Darias-Curvo, Victoria-Luise Batury, Hendrik Berth, Anja Zscheppang, Maike Linke, Sotiris Themistokleous, Afroditi Veloudaki and Athena Linos
Healthcare 2023, 11(14), 2058; https://doi.org/10.3390/healthcare11142058 - 18 Jul 2023
Cited by 2 | Viewed by 2221
Abstract
Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional’s perception regarding health communication training’s necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey [...] Read more.
Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional’s perception regarding health communication training’s necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey in the framework of the H-Com project were utilized. The study included 691 healthcare professionals (physicians, nurses, students and allied health professionals) from seven European countries. Only 57% of participants had participated in health communication training, while 88.1% of them indicated a willingness to be trained in health communication. Nurses were more likely (OR = 1.84; 95% CI 1.16, 2.91) to have received such training, compared to physicians. Most examined communication skills, barriers and facilitators of effective communication, and perceived outcomes of successful communication were considered crucial for most participants, although physicians overall seemed to be less concerned. Most agreed perceived outcomes were improved professional–patient relations, patient and professional satisfaction, physical and psychological health amelioration and patients’ trust. Nurses evaluated the importance of these communication skills and communication barriers, facilitators and outcomes higher than physicians. Physicians may underestimate the importance of communication skills more than nurses. Health communication should become an integral part of training for all health professionals. Full article
13 pages, 293 KiB  
Article
Infant-Directed Speech to 3-Month-Old Severe Preterm Infants: The Influence of Birth Weight and Maternal Depressive Symptoms
by Alessandra Provera, Erica Neri and Francesca Agostini
Healthcare 2023, 11(12), 1807; https://doi.org/10.3390/healthcare11121807 - 20 Jun 2023
Cited by 1 | Viewed by 1000
Abstract
Severe premature birth (<32 weeks) is a risk factor for the development of maternal perinatal depression, while also affecting dyadic interactions and child outcomes. Although several studies have examined the impacts of prematurity and depression on early interactions, only a few studies have [...] Read more.
Severe premature birth (<32 weeks) is a risk factor for the development of maternal perinatal depression, while also affecting dyadic interactions and child outcomes. Although several studies have examined the impacts of prematurity and depression on early interactions, only a few studies have investigated the features of maternal verbal input. Furthermore, no study has investigated the relationship between the effect of severity of prematurity according to birth weight and maternal input. This study aimed to explore the effects of the severity of preterm birth and postnatal depression on maternal input during early interactions. The study included 64 mother–infant dyads, classified into three groups: 17 extremely low birth weight (ELBW) preterm infants, 17 very low birth weight (VLBW) preterm infants, and 30 full-term (FT) infants. At 3 months postpartum (corrected age for preterm infants), the dyads participated in a 5-min free interaction session. Maternal input was analyzed using the CHILDES system in terms of lexical and syntactic complexity (i.e., word types, word tokens, mean length of the utterance) and functional features. Maternal postnatal depression (MPD) was assessed using the Edinburgh Postnatal Depression Scale. The results showed that in high-risk conditions (i.e., ELBW preterm birth and maternal postnatal depression), maternal input was characterized by a lower frequency of affect-salient speech and a higher proportion of information-salient speech, specifically as directives and questions, suggesting that mothers in these conditions may experience more difficulty in conveying affective content to their infants. Moreover, the more frequent use of questions may reflect an interactive style characterized by a higher level of intrusiveness. These findings provide preliminary evidence of the impacts of prematurity severity and maternal depression on maternal verbal input, highlighting the importance of assessing both factors in clinical practice. Understanding the mechanisms underlying the impacts of prematurity and depression on early interactions may inform the development of tailored interventions aimed at promoting positive parent–infant interactions and child development. Full article
(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)
19 pages, 941 KiB  
Review
Effectiveness of Workplace Interventions to Improve Health and Well-Being of Health and Social Service Workers: A Narrative Review of Randomised Controlled Trials
by Rahman Shiri, Risto Nikunlaakso and Jaana Laitinen
Healthcare 2023, 11(12), 1792; https://doi.org/10.3390/healthcare11121792 - 17 Jun 2023
Cited by 4 | Viewed by 4532
Abstract
Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review [...] Read more.
Health and social service workers face high levels of workload and job stressors, which can affect their health and well-being. Therefore, it is important to evaluate the effectiveness of workplace interventions that aim to improve their mental and physical health outcomes. This review summarizes the findings of randomized controlled trials (RCTs) that examined the impact of different types of workplace interventions on various health indicators among health and social service workers. The review searched the PubMed database from its inception to December 2022 and included RCTs that reported on the effectiveness of organizational-level interventions and qualitative studies that explored barriers and facilitators to participation in such interventions. A total of 108 RCTs were included in the review, covering job burnout (N = 56 RCTs), happiness or job satisfaction (N = 35), sickness absence (N = 18), psychosocial work stressors (N = 14), well-being (N = 13), work ability (N = 12), job performance or work engagement (N = 12), perceived general health (N = 9), and occupational injuries (N = 3). The review found that several workplace interventions were effective in improving work ability, well-being, perceived general health, work performance, and job satisfaction and in reducing psychosocial stressors, burnout, and sickness absence among healthcare workers. However, the effects were generally modest and short-lived. Some of the common barriers to participation in workplace interventions among healthcare workers were inadequate staff, high workload, time pressures, work constraints, lack of manager support, scheduling health programs outside work hours, and lack of motivation. This review suggests that workplace interventions have small short-term positive effects on health and well-being of healthcare workers. Workplace interventions should be implemented as routine programs with free work hours to encourage participation or integrate intervention activities into daily work routines. Full article
(This article belongs to the Collection Featured Review Papers on Chronic Diseases)
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14 pages, 485 KiB  
Systematic Review
Causes for Medical Errors in Obstetrics and Gynaecology
by Désirée Klemann, Maud Rijkx, Helen Mertens, Frits van Merode and Dorthe Klein
Healthcare 2023, 11(11), 1636; https://doi.org/10.3390/healthcare11111636 - 02 Jun 2023
Cited by 2 | Viewed by 1788
Abstract
Background: Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events. To understand the main causes of [...] Read more.
Background: Quality strategies, interventions, and frameworks have been developed to facilitate a better understanding of healthcare systems. Reporting adverse events is one of these strategies. Gynaecology and obstetrics are one of the specialties with many adverse events. To understand the main causes of medical errors in gynaecology and obstetrics and how they could be prevented, we conducted this systematic review. Methods: This systematic review was performed in compliance with the Prisma 2020 guidelines. We searched several databases for relevant studies (Jan 2010–May 2023). Studies were included if they indicated the presence of any potential risk factor at the hospital level for medical errors or adverse events in gynaecology or obstetrics. Results: We included 26 articles in the quantitative analysis of this review. Most of these (n = 12) are cross-sectional studies; eight are case–control studies, and six are cohort studies. One of the most frequently reported contributing factors is delay in healthcare. In addition, the availability of products and trained staff, team training, and communication are often reported to contribute to near-misses/maternal deaths. Conclusions: All risk factors that were found in our review imply several categories of contributing factors regarding: (1) delay of care, (2) coordination and management of care, and (3) scarcity of supply, personnel, and knowledge. Full article
(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)
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11 pages, 577 KiB  
Article
Examining the Public Messaging on ‘Loneliness’ over Social Media: An Unsupervised Machine Learning Analysis of Twitter Posts over the Past Decade
by Qin Xiang Ng, Dawn Yi Xin Lee, Chun En Yau, Yu Liang Lim, Clara Xinyi Ng and Tau Ming Liew
Healthcare 2023, 11(10), 1485; https://doi.org/10.3390/healthcare11101485 - 19 May 2023
Cited by 4 | Viewed by 1463
Abstract
Loneliness is an issue of public health significance. Longitudinal studies indicate that feelings of loneliness are prevalent and were exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. With the advent of new media, more people are turning to social media platforms such as [...] Read more.
Loneliness is an issue of public health significance. Longitudinal studies indicate that feelings of loneliness are prevalent and were exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. With the advent of new media, more people are turning to social media platforms such as Twitter and Reddit as well as online forums, e.g., loneliness forums, to seek advice and solace regarding their health and well-being. The present study therefore aimed to investigate the public messaging on loneliness via an unsupervised machine learning analysis of posts made by organisations on Twitter. We specifically examined tweets put out by organisations (companies, agencies or common interest groups) as the public may view them as more credible information as opposed to individual opinions. A total of 68,345 unique tweets in English were posted by organisations on Twitter from 1 January 2012 to 1 September 2022. These tweets were extracted and analysed using unsupervised machine learning approaches. BERTopic, a topic modelling technique that leverages state-of-the-art natural language processing, was applied to generate interpretable topics around the public messaging of loneliness and highlight the key words in the topic descriptions. The topics and topic labels were then reviewed independently by all study investigators for thematic analysis. Four key themes were uncovered, namely, the experience of loneliness, people who experience loneliness, what exacerbates loneliness and what could alleviate loneliness. Notably, a significant proportion of the tweets centred on the impact of the COVID-19 pandemic on loneliness. While current online interactions are largely descriptive of the complex and multifaceted problem of loneliness, more targeted prosocial messaging appears to be lacking to combat the causes of loneliness brought up in public messaging. Full article
(This article belongs to the Special Issue Social Media for Health Information Management)
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13 pages, 1507 KiB  
Review
Imaging Methods to Quantify the Chest and Trunk Deformation in Adolescent Idiopathic Scoliosis: A Literature Review
by Ana San Román Gaitero, Andrej Shoykhet, Iraklis Spyrou, Martijn Stoorvogel, Lars Vermeer and Tom P. C. Schlösser
Healthcare 2023, 11(10), 1489; https://doi.org/10.3390/healthcare11101489 - 19 May 2023
Cited by 1 | Viewed by 2598
Abstract
Background context: Scoliosis is a three-dimensional deformity of the spine with the most prevalent type being adolescent idiopathic scoliosis (AIS). The rotational spinal deformation leads to displacement and deformation of the ribs, resulting in a deformity of the entire chest. Routine diagnostic [...] Read more.
Background context: Scoliosis is a three-dimensional deformity of the spine with the most prevalent type being adolescent idiopathic scoliosis (AIS). The rotational spinal deformation leads to displacement and deformation of the ribs, resulting in a deformity of the entire chest. Routine diagnostic imaging is performed in order to define its etiology, measure curve severity and progression during growth, and for treatment planning. To date, all treatment recommendations are based on spinal parameters, while the esthetic concerns and cardiopulmonary symptoms of patients are mostly related to the trunk deformation. For this reason, there is a need for diagnostic imaging of the patho-anatomical changes of the chest and trunk in AIS. Aim: The aim of this review is to provide an overview, as complete as possible, of imaging modalities, methods and image processing techniques for assessment of chest and trunk deformation in AIS. Methods: Here, we present a narrative literature review of (1) image acquisition techniques used in clinical practice, (2) a description of various relevant methods to measure the deformity of the thorax in patients with AIS, and (3) different image processing techniques useful for quantifying 3D chest wall deformity. Results: Various ionizing and non-ionizing imaging modalities are available, but radiography is most widely used for AIS follow-up. A disadvantage is that these images are only acquired in 2D and are not effective for acquiring detailed information on complex 3D chest deformities. While CT is the gold standard 3D imaging technique for assessment of in vivo morphology of osseous structures, it is rarely obtained for surgical planning because of concerns about radiation exposure and increased risk of cancer during later life. Therefore, different modalities with less or without radiation, such as biplanar radiography and MRI are usually preferred. Recently, there have been advances in the field of image processing for measurements of the chest: Anatomical segmentations have become fully automatic and deep learning has been shown to be able to automatically perform measurements and even outperform experts in terms of accuracy. Conclusions: Recent advancements in imaging modalities and image processing techniques make complex 3D evaluation of chest deformation possible. Before introduction into daily clinical practice, however, there is a need for studies correlating image-based chest deformation parameters to patient-reported outcomes, and for technological advancements to make the workflow cost-effective. Full article
(This article belongs to the Special Issue Paediatric Spinal Deformity)
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12 pages, 806 KiB  
Communication
Severe Gastrointestinal Toxicity Following the Use of Gilteritinib: A Case Series and Analysis of Postmarketing Surveillance Data
by Lucia Gozzo, Antonella Nardo, Serena Brancati, Antongiulio Judica, Andrea Duminuco, Cinzia Maugeri, Marina Parisi, Laura Longo, Daniela Cristina Vitale, Rosy Ruscica, Giovanni Luca Romano, Elisa Mauro, Paolo Fabio Fiumara, Giuseppe Alberto Maria Palumbo, Francesco Di Raimondo, Calogero Vetro and Filippo Drago
Healthcare 2023, 11(10), 1479; https://doi.org/10.3390/healthcare11101479 - 18 May 2023
Cited by 1 | Viewed by 1136
Abstract
Gilteritinib has been approved as monotherapy in adults with acute myeloid leukemia (AML) FLT3 mutated with relapsed or refractory disease, in light of its advantages in terms of survival and the favorable safety profile. Hepatobiliary disorders and musculoskeletal and connective tissue disorders represent [...] Read more.
Gilteritinib has been approved as monotherapy in adults with acute myeloid leukemia (AML) FLT3 mutated with relapsed or refractory disease, in light of its advantages in terms of survival and the favorable safety profile. Hepatobiliary disorders and musculoskeletal and connective tissue disorders represent the most frequent adverse reactions associated with gilteritinib, whereas the most frequent serious adverse reaction is acute kidney injury. In the summary of product characteristics, gastrointestinal (GI) events are indicated as very common, in particular diarrhea, nausea and stypsis. Furthermore, serious GI disorders have been observed with gilteritinib in clinical trials, including GI hemorrhage, GI perforation and GI obstruction. However, the association with the FLT3 inhibitor has not been confirmed. Nevertheless, serious GI AEs have been recognized as an important potential risk to be monitored in postmarketing surveillance. We present three cases of serious self-limiting GI events observed in patients on gilteritinib treatment for AML, and an analysis of relevant available postmarketing surveillance data. Full article
(This article belongs to the Special Issue Pharmacovigilance and Appropriate Drug Use)
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20 pages, 1854 KiB  
Article
ALTAI Tool for Assessing AI-Based Technologies: Lessons Learned and Recommendations from SHAPES Pilots
by Jyri Rajamäki, Fotios Gioulekas, Pedro Alfonso Lebre Rocha, Xavier del Toro Garcia, Paulinus Ofem and Jaakko Tyni
Healthcare 2023, 11(10), 1454; https://doi.org/10.3390/healthcare11101454 - 17 May 2023
Viewed by 1084
Abstract
Across European countries, the SHAPES Project is piloting AI-based technologies that could improve healthcare delivery for older people over 60 years old. This article aims to present a study developed inside the SHAPES Project to find a theoretical framework focused on AI-assisted technology [...] Read more.
Across European countries, the SHAPES Project is piloting AI-based technologies that could improve healthcare delivery for older people over 60 years old. This article aims to present a study developed inside the SHAPES Project to find a theoretical framework focused on AI-assisted technology in healthcare for older people living in the home, to assess the SHAPES AI-based technologies using the ALTAI tool, and to derive ethical recommendations regarding AI-based technologies for ageing and healthcare. The study has highlighted concerns and reservations about AI-based technologies, namely dealing with living at home, mobility, accessibility, data exchange procedures in cross-board cases, interoperability, and security. A list of recommendations is built not only for the healthcare sector, but also for other pilot studies. Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
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12 pages, 1117 KiB  
Article
The Effects of Neurodevelopmental Treatment-Based Trunk Control Exercise on Gross Motor Function and Trunk Control in Children with Developmental Disabilities
by Miho Park, Jeongseon Kim, Changseon Yu and Hyoungwon Lim
Healthcare 2023, 11(10), 1446; https://doi.org/10.3390/healthcare11101446 - 16 May 2023
Cited by 2 | Viewed by 3056
Abstract
Background: Good trunk control is essential for higher developmental stages as the trunk is activated first when movement occurs, providing stability for the head and extremities. Purpose: To determine if neurodevelopmental treatment-based trunk control exercise (NDT-TCE) is effective in improving gross motor function [...] Read more.
Background: Good trunk control is essential for higher developmental stages as the trunk is activated first when movement occurs, providing stability for the head and extremities. Purpose: To determine if neurodevelopmental treatment-based trunk control exercise (NDT-TCE) is effective in improving gross motor function and trunk control in children with developmental disabilities (DD). Materials and Methods: Twenty children with developmental disabilities were randomly assigned to the NDT-TCE (12 children) and control (8 children) groups. Results: After the intervention; the NDT-TCE group showed improvement in GMFM (Gross Motor Function Measure; except for the GMFM-E dimension) and SATCo scores. The control group showed improvement in GMFM-A; B; C; and total scores; as well as static and active control of SATCo. The NDT-TCE group had a significant improvement in the GMFM B dimension and total score compared to the control group. The NDT-TCE group showed a significant improvement in static and active control of SATCo compared to the control group, but there was no significant difference in reactive control. Conclusions: The NDT-TCE intervention specifically improved GMFM-B and trunk control scores. Therefore, NDT-TCE can be applied as a trunk-focused intervention for children with DD who have difficulty controlling their trunk. Full article
(This article belongs to the Section Chronic Care)
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10 pages, 502 KiB  
Article
Health-Related Quality of Life in Pregnant Women during the First Trimester in Northern Spain: A Descriptive Cross-Sectional Study
by Cristian Martín-Vázquez, Rubén García-Fernández, Natalia Calvo-Ayuso, María Cristina Martínez-Fernández, Cristina Liébana-Presa and José David Urchaga-Litago
Healthcare 2023, 11(10), 1424; https://doi.org/10.3390/healthcare11101424 - 14 May 2023
Viewed by 1410
Abstract
Background: Achieving the optimal quality of life is currently a health challenge for the world’s population. Pregnancy is a stressful period of life that affects women’s quality of life. Aims: This study aimed to describe and analyse the health-related quality of life in [...] Read more.
Background: Achieving the optimal quality of life is currently a health challenge for the world’s population. Pregnancy is a stressful period of life that affects women’s quality of life. Aims: This study aimed to describe and analyse the health-related quality of life in pregnant women during their first trimester in a health area in the north of Spain. Methods: A cross-sectional descriptive study was carried out. A total of 359 women completed the 36-Item Short-Form Health Survey. Results: The sample consisted of 57.9% primiparous women, 30% had experienced a previous abortion, and 7.2% were foreign women. The mean age was 33.53 years. The sum of the physical and mental component values was below 50 points. Notably, 4.17% of women reported a worsening of their health in the last year, and 28.69% had an increased depression risk. Conclusion: Being a foreigner, prenatal abortion, previous caesarean section, previous children, or assisted reproduction techniques are the variables that have a negative association with some dimensions of quality of life in pregnant women. Full article
(This article belongs to the Section Women's Health Care)
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11 pages, 271 KiB  
Article
Cervical Cancer Prevention Knowledge (Cckp-64) among Female Students in Novi Sad, Serbia during COVID-19 Pandemic
by Sanja D Tomić, Andrijana Ćorić, Slobodan Tomić, Ermina Mujičić, Jelena Malenković, Armin Šljivo and Goran Malenković
Healthcare 2023, 11(10), 1400; https://doi.org/10.3390/healthcare11101400 - 12 May 2023
Cited by 1 | Viewed by 1603
Abstract
Cervical cancer is a significant global health concern affecting young women, with over 500,000 new cases reported annually. This questionnaire-based study aimed to evaluate the knowledge of cervical cancer prevention among female students at the University of Novi Sad during the COVID-19 pandemic [...] Read more.
Cervical cancer is a significant global health concern affecting young women, with over 500,000 new cases reported annually. This questionnaire-based study aimed to evaluate the knowledge of cervical cancer prevention among female students at the University of Novi Sad during the COVID-19 pandemic using the Cervical Cancer Knowledge Prevention-64 (CCKP-64) tool. The study sample consisted of 402 predominantly 20–22-year-old female students from either social or technical science faculties in urban environments. Results revealed that out of the 402 female students involved in the study, most had a good general knowledge of primary prevention of cervical cancer, with a correct answer rate ranging from 29.9 to 80.6%. On the contrary, only 63.4% of female students have heard about the vaccine against cervical cancer; 52.0% know that the vaccine exists in Serbia; and 31.8% know where to get vaccinated. Only a small proportion of students (9.7%) have encountered cervical cancer among their relatives/friends and think that the disease could affect them in the future (25.4%). Older students (>26 years) generally (p < 0.05) had better knowledge regarding distressing symptoms of cervical cancer, cytological examination and secondary prevention; however, it was also noted that a significant percentage of this age group reported not having received vaccinations (53.0%, p = 0.001). This study underscores the need for increased awareness and education about the HPV vaccine and secondary prevention among young women in Serbia. Future research should investigate knowledge and attitudes toward cervical cancer prevention in diverse populations to develop effective interventions and strategies. These findings have implications for public health policies in Serbia to promote cervical cancer prevention among young women. Full article
13 pages, 478 KiB  
Article
Significance of Post-Traumatic Growth and Mental Health for Coping in Multiple Sclerosis Caregivers
by Irene Gil-González, María Ángeles Pérez-San-Gregorio, Jesús Funuyet-Salas, Rupert Conrad and Agustín Martín-Rodríguez
Healthcare 2023, 11(10), 1390; https://doi.org/10.3390/healthcare11101390 - 11 May 2023
Viewed by 1311
Abstract
We investigated the influence of post-traumatic growth (PTG) and mental health (MH) on multiple sclerosis (MS) caregivers’ uses of coping strategies and identified biopsychosocial predictors of proactive or reactive coping. The Short Form Health Survey (SF-12), General Health Questionnaire (GHQ-28), Post-Traumatic Growth Inventory [...] Read more.
We investigated the influence of post-traumatic growth (PTG) and mental health (MH) on multiple sclerosis (MS) caregivers’ uses of coping strategies and identified biopsychosocial predictors of proactive or reactive coping. The Short Form Health Survey (SF-12), General Health Questionnaire (GHQ-28), Post-Traumatic Growth Inventory (PGI-21), Brief COPE Questionnaire (COPE-28), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to evaluate 209 caregivers. Higher PTG was related to greater use of emotional support, positive reframing, religion, active coping, instrumental support, planning, denial, self-distraction, self-blaming, and venting. Better MH was associated with greater use of acceptance, while behavioral disengagement and self-distraction were associated with poorer MH. The PTG dimensions relating to others and new possibilities, SF-12 dimensions of physical and emotional roles as well as partnership, not living with the patient, and significant others’ social support were predictors of proactive coping. Reactive coping was positively predicted by the PTG dimension relating to others, depression, vitality, other than partner relation, and physical role, and negatively predicted by mental health level and emotional role. In summary, higher MH was associated with proactive coping strategies, whereas post-traumatic growth was related to the use of a wide range of proactive coping as well as reactive coping strategies. Full article
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17 pages, 590 KiB  
Systematic Review
Spiritual Needs of Older Adults Living with Dementia: An Integrative Review
by Katherine Carroll Britt, Augustine C. O. Boateng, Hui Zhao, Francesca C. Ezeokonkwo, Chad Federwitz and Fayron Epps
Healthcare 2023, 11(9), 1319; https://doi.org/10.3390/healthcare11091319 - 04 May 2023
Cited by 7 | Viewed by 3361
Abstract
Older adults living with dementia experience progressive decline, prompting reliance on others for spiritual care and support. Despite a growing interest in studying persons living with dementia (PLwDs), empirical evidence on the spiritual needs of PLwDs has not been synthesized. Using the Whittemore [...] Read more.
Older adults living with dementia experience progressive decline, prompting reliance on others for spiritual care and support. Despite a growing interest in studying persons living with dementia (PLwDs), empirical evidence on the spiritual needs of PLwDs has not been synthesized. Using the Whittemore and Knafl method, this integrative review examined the literature from 2000 to 2022 on the spiritual care needs of PLwDs. We sought to identify characteristics of the spiritual needs of PLwDs and ways to address them. The ATLA Religion, CINAHL, PsycINFO, PubMed, and Socindex databases were used to search the literature, and 12 peer-reviewed articles met the inclusion criteria. Spiritual care needs varied across studies. Overall, findings support the importance of identifying PLwDs’ religious and spiritual backgrounds to inform person-centered care. Spiritual needs were identified as verbal and non-verbal expressions related to past meaning and religious and spiritual background and were not consistently addressed in care. Providers reported observing spiritual distress in the mild stage prompting the need for spiritual care. There is a great need for dementia-specific spiritual assessment tools and spiritual care interventions to support spiritual well-being in dementia care. Spiritual care involves facilitating religious rituals and providing spiritual group therapy and religious and spiritual activities. Full article
(This article belongs to the Special Issue Dementia and Care)
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21 pages, 1525 KiB  
Article
Predicting Disability Using a Nomogram of the Tilburg Frailty Indicator (TFI)
by Robbert J. Gobbens, Livia M. Santiago, Izabella Uchmanowicz and Tjeerd van der Ploeg
Healthcare 2023, 11(8), 1150; https://doi.org/10.3390/healthcare11081150 - 17 Apr 2023
Cited by 3 | Viewed by 1006
Abstract
Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop [...] Read more.
Disability is associated with lower quality of life and premature death in older people. Therefore, prevention and intervention targeting older people living with a disability is important. Frailty can be considered a major predictor of disability. In this study, we aimed to develop nomograms with items of the Tilburg Frailty Indicator (TFI) as predictors by using cross-sectional and longitudinal data (follow-up of five and nine years), focusing on the prediction of total disability, disability in activities of daily living (ADL), and disability in instrumental activities of daily living (IADL). At baseline, 479 Dutch community-dwelling people aged ≥75 years participated. They completed a questionnaire that included the TFI and the Groningen Activity Restriction Scale to assess the three disability variables. We showed that the TFI items scored different points, especially over time. Therefore, not every item was equally important in predicting disability. ‘Difficulty in walking’ and ‘unexplained weight loss’ appeared to be important predictors of disability. Healthcare professionals need to focus on these two items to prevent disability. We also conclude that the points given to frailty items differed between total, ADL, and IADL disability and also differed regarding years of follow-up. Creating one monogram that does justice to this seems impossible. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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11 pages, 1336 KiB  
Article
Quality of Life and Family Support in Critically Ill Patients following ICU Discharge
by Konstantina Avgeri, Epaminondas Zakynthinos, Vasiliki Tsolaki, Markos Sgantzos, George Fotakopoulos and Demosthenes Makris
Healthcare 2023, 11(8), 1106; https://doi.org/10.3390/healthcare11081106 - 12 Apr 2023
Cited by 2 | Viewed by 1304
Abstract
Background: Following discharge from the intensive care unit (ICU), critically ill patients may present cognitive dysfunction and physical disability. Objectives: To investigate the quality of life (QoL) of patients following discharge from ICU, physical performance and lung function and to assess the role [...] Read more.
Background: Following discharge from the intensive care unit (ICU), critically ill patients may present cognitive dysfunction and physical disability. Objectives: To investigate the quality of life (QoL) of patients following discharge from ICU, physical performance and lung function and to assess the role of support by family members and friends. Methods: This prospective study was conducted in the University Hospital of Larissa Greece between 2020 and 2021. Patients hospitalized at the ICU for at least 48 h were included and assessed at hospital discharge, at 3 and at 12 months later. The research implements of the study were a dedicated questionnaire and the SF-36 health questionnaire for the appraisal of the QoL. Lung function changes were assessed by spirometry and physical performance by the 6-min walking test (6MWT). Results: One hundred and forty-three participants were included in the study. The mean (SD) of the physical and mental health SF-36 scores at hospital discharge, 3 and 12 months were 27.32 (19.59), 40.97 (26.34) and 50.78 (28.26) (p < 0.0001) and 42.93 (17.00), 55.19 (23.04) and 62.24 (23.66), (p < 0.0001), respectively. The forced expiratory volume in one second and 6MWT significantly improved over 12 months. Patients who were supported by two or more family members or patients who were visited by their friends >3 times/week presented better scores in the physical and mental SF36 domains at 12 months. Conclusion: This study shows that the quality of life of Greek patients who were discharged from the ICU can be positively affected both by the support they receive from their family environment and friends. Full article
(This article belongs to the Special Issue Nursing Care in the ICU)
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11 pages, 543 KiB  
Review
Pain in Ehlers–Danlos Syndrome: A Non-Diagnostic Disabling Symptom?
by Viviana Guerrieri, Alberto Polizzi, Laura Caliogna, Alice Maria Brancato, Alessandra Bassotti, Camilla Torriani, Eugenio Jannelli, Mario Mosconi, Federico Alberto Grassi and Gianluigi Pasta
Healthcare 2023, 11(7), 936; https://doi.org/10.3390/healthcare11070936 - 24 Mar 2023
Cited by 2 | Viewed by 2517
Abstract
Background: Ehlers–Danlos syndrome (EDS) is a phenotypically and genetically heterogeneous group of connective tissue disorders. Currently, diagnosis of EDS is based on a series of clinical and genetic tools. On the other hand, the hypermobile form has not yet been characterized from a [...] Read more.
Background: Ehlers–Danlos syndrome (EDS) is a phenotypically and genetically heterogeneous group of connective tissue disorders. Currently, diagnosis of EDS is based on a series of clinical and genetic tools. On the other hand, the hypermobile form has not yet been characterized from a genetic point of view: it is considered a part of a continuous spectrum of phenotypes, ranging from isolated non syndromic joint hypermobility, through to the recently defined hypermobility spectrum disorders (HSD). The aim of this study is to characterize the pain symptom that is not considered among the diagnostic criteria but is relevant to what concerns the quality of life of patients with EDS. (2) Methods: A review of the literature was performed on two medical electronic databases (PubMed and Embase) on 20 December 2022. Study selection and data extraction were achieved independently by two authors and the following inclusion criteria were determined a priori: published in the English language and published between 2000 and 2022. (3) Results: There were fifty eligible studies obtained at the end of the search and screen process. Pain is one of the most common symptoms found in Ehlers–Danlos (ED) patients. Different causes seem to be recognized in different phases of the syndrome. (4) Conclusions: Pain is a nonspecific symptom and cannot be considered among the diagnostic criteria, but it is a negative predictive factor in the quality of life of patients with EDS. Therefore, proper evaluation and treatment is mandatory. Full article
(This article belongs to the Special Issue Musculoskeletal Pain Care and Management in Rare Diseases)
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16 pages, 335 KiB  
Article
Solitary Sexual Desire: Its Relation to Subjective Orgasm Experience and Sexual Arousal in the Masturbation Context within a Spanish Population
by Oscar Cervilla, Eva Jiménez-Antón, Ana Álvarez-Muelas, Pablo Mangas, Reina Granados and Juan Carlos Sierra
Healthcare 2023, 11(6), 805; https://doi.org/10.3390/healthcare11060805 - 09 Mar 2023
Cited by 4 | Viewed by 3445
Abstract
The tridimensional sexual desire proposal (i.e., dyadic to partner, dyadic to attractive other and solitary) has been empirically supported. However, solitary sexual desire and its relationship to other dimensions of sexual functioning has received less attention. Hence, we examined the capacity of solitary [...] Read more.
The tridimensional sexual desire proposal (i.e., dyadic to partner, dyadic to attractive other and solitary) has been empirically supported. However, solitary sexual desire and its relationship to other dimensions of sexual functioning has received less attention. Hence, we examined the capacity of solitary sexual desire to explain the subjective orgasm experience (Study 1) and sexual arousal (Study 2) in the context of solitary masturbation. Study 1, composed of 2406 heterosexual adults (M age = 39.72, SD = 11.81), assessed for solitary sexual desire, dyadic sexual desire, and the intensity of the subjective orgasm experience obtained through solitary masturbation, along with other associated parameters. Study 2, consisting of 41 heterosexual young people (M age = 22.49, SD = 3.17), evaluated the genital response (penile circumference/vaginal pulse amplitude) and subjective arousal to sexually explicit films related to solitary masturbation. In both men and women, solitary sexual desire accounted for a significant percentage of the subjective orgasm experience obtained through solitary masturbation. In addition, in women, the propensity for sexual arousal was explained by solitary sexual desire. It is concluded that solitary sexual desire -as opposed to dyadic- is important to explain sexual arousal and orgasm in the solitary masturbation context. These results highlight the importance of addressing sexual desire in the solitary context, given its implications with other dimensions of sexual functioning. Full article
17 pages, 1883 KiB  
Article
Development and Validation of a Risk Scoring Tool for Bronchopulmonary Dysplasia in Preterm Infants Based on a Systematic Review and Meta-Analysis
by Zhumei Yu, Lili Wang, Yang Wang, Min Zhang, Yanqin Xu and Annuo Liu
Healthcare 2023, 11(5), 778; https://doi.org/10.3390/healthcare11050778 - 06 Mar 2023
Cited by 3 | Viewed by 1747
Abstract
Background: Bronchopulmonary dysplasia (BPD) is the most common serious pulmonary morbidity in preterm infants with high disability and mortality rates. Early identification and treatment of BPD is critical. Objective: This study aimed to develop and validate a risk scoring tool for early identification [...] Read more.
Background: Bronchopulmonary dysplasia (BPD) is the most common serious pulmonary morbidity in preterm infants with high disability and mortality rates. Early identification and treatment of BPD is critical. Objective: This study aimed to develop and validate a risk scoring tool for early identification of preterm infants that are at high-risk for developing BPD. Methods: The derivation cohort was derived from a systematic review and meta-analysis of risk factors for BPD. The statistically significant risk factors with their corresponding odds ratios were utilized to construct a logistic regression risk prediction model. By scoring the weights of each risk factor, a risk scoring tool was established and the risk stratification was divided. External verification was carried out by a validation cohort from China. Results: Approximately 83,034 preterm infants with gestational age < 32 weeks and/or birth weight < 1500 g were screened in this meta-analysis, and the cumulative incidence of BPD was about 30.37%. The nine predictors of this model were Chorioamnionitis, Gestational age, Birth weight, Sex, Small for gestational age, 5 min Apgar score, Delivery room intubation, and Surfactant and Respiratory distress syndrome. Based on the weight of each risk factor, we translated it into a simple clinical scoring tool with a total score ranging from 0 to 64. External validation showed that the tool had good discrimination, the area under the curve was 0.907, and that the Hosmer–Lemeshow test showed a good fit (p = 0.3572). In addition, the results of the calibration curve and decision curve analysis suggested that the tool showed significant conformity and net benefit. When the optimal cut-off value was 25.5, the sensitivity and specificity were 0.897 and 0.873, respectively. The resulting risk scoring tool classified the population of preterm infants into low-risk, low-intermediate, high-intermediate, and high-risk groups. This BPD risk scoring tool is suitable for preterm infants with gestational age < 32 weeks and/or birth weight < 1500 g. Conclusions: An effective risk prediction scoring tool based on a systematic review and meta-analysis was developed and validated. This simple tool may play an important role in establishing a screening strategy for BPD in preterm infants and potentially guide early intervention. Full article
(This article belongs to the Special Issue Maternal, Fetal and Neonatal Health)
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13 pages, 249 KiB  
Article
Tokophobia: Case Reports and Narratives of Ten Japanese Women
by Mizuki Takegata, Yuriko Usui, Satoshi Sohda, Satoru Takeda, Jun Takeda, Tomomi Saito, Yasuyo Kasai, Hideki Watanabe, Megumi Haruna, Yukiko Ohashi and Toshinori Kitamura
Healthcare 2023, 11(5), 696; https://doi.org/10.3390/healthcare11050696 - 26 Feb 2023
Cited by 1 | Viewed by 1557
Abstract
Intense fear of childbirth by expectant women is called tokophobia. Because there are no qualitative studies targeting women with an intense fear of childbirth in Japan, it is unknown whether there is any link between the type of fear of objects/situations among tokophobic [...] Read more.
Intense fear of childbirth by expectant women is called tokophobia. Because there are no qualitative studies targeting women with an intense fear of childbirth in Japan, it is unknown whether there is any link between the type of fear of objects/situations among tokophobic women and their psychological/demographic background. Furthermore, there is no available summary of the lived experience of Japanese women with tokophobia. This study aims to identify the intensity patterns of various types of fear among the participants and summarize the lived experience of having intense fear of childbirth. A qualitative descriptive study was conducted using a semi-structured interview. Pregnant women with an intense fear of childbirth participated in individual interviews facilitated by a psychiatrist and a midwife. Audio recordings of the interviews were transcribed and analyzed using a content analysis approach. The number of participants was ten. The types of feared objects varied individually and these were categorized as being related to either prospective or retrospective fear. The participants’ experiences were grouped into three categories: difficulty in daily life, preoccupied negative expectation towards childbirth, and psychological adaptation to the upcoming childbirth. The results imply that women with tokophobia continuously suffer from fear in their daily life; hence, a special approach is needed to detect and reduce their fear. Full article
(This article belongs to the Special Issue Perinatal Mental Health and Care)
14 pages, 2070 KiB  
Article
Long-Term Evolution of Activities of Daily Life (ADLs) in Critically Ill COVID-19 Patients, a Case Series
by Samuele Ceruti, Andrea Glotta, Maira Biggiogero, Martino Marzano, Giovanni Bona, Marco Previsdomini, Andrea Saporito and Xavier Capdevila
Healthcare 2023, 11(5), 650; https://doi.org/10.3390/healthcare11050650 - 23 Feb 2023
Viewed by 1788
Abstract
Background: The most common long-term symptoms of critically ill COVID-19 patients are fatigue, dyspnea and mental confusion. Adequate monitoring of long-term morbidity, mainly analyzing the activities of daily life (ADLs), allows better patient management after hospital discharge. The aim was to report long-term [...] Read more.
Background: The most common long-term symptoms of critically ill COVID-19 patients are fatigue, dyspnea and mental confusion. Adequate monitoring of long-term morbidity, mainly analyzing the activities of daily life (ADLs), allows better patient management after hospital discharge. The aim was to report long-term ADL evolution in critically ill COVID-19 patients admitted to a COVID-19 center in Lugano (Switzerland). Methods: A retrospective analysis on consecutive patients discharged alive from ICU with COVID-19 ARDS was performed based on a follow-up one year after hospital discharge; ADLs were assessed through the Barthel index (BI) and the Karnofsky Performance Status (KPS) scale. The primary objective was to assess differences in ADLs at hospital discharge (acute ADLs) and one-year follow-up (chronic ADLs). The secondary objective was to explore any correlations between ADLs and multiple measures at admission and during the ICU stay. Results: A total of 38 consecutive patients were admitted to the ICU; a t-test analysis between acute and chronic ADLs through BI showed a significant improvement at one year post discharge (t = −5.211, p < 0.0001); similarly, every single task of BI showed the same results (p < 0.0001 for each task of BI). The mean KPS was 86.47 (SD 20.9) at hospital discharge and 99.6 at 1 year post discharge (p = 0.02). Thirteen (34%) patients deceased during the first 28 days in the ICU; no patient died after hospital discharge. Conclusions: Based on BI and KPS, patients reached complete functional recovery of ADLs one year after critical COVID-19. Full article
(This article belongs to the Section Critical Care)
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13 pages, 624 KiB  
Article
Health-Related Quality of Life and Healthcare Events in Patients with Monotherapy of Anti-Diabetes Medications
by Tadesse Melaku Abegaz and Askal Ayalew Ali
Healthcare 2023, 11(4), 541; https://doi.org/10.3390/healthcare11040541 - 12 Feb 2023
Cited by 1 | Viewed by 1590
Abstract
This study aimed to examine the difference in health-related quality of life (HRQOL) and diabetes-related healthcare events (HCEs) among adults with diabetes who were on metformin, sulfonylurea, insulin, or thiazolidinedione (TZD) monotherapy. The data were sourced from the Medical Expenditure Panel Survey (MEPS). [...] Read more.
This study aimed to examine the difference in health-related quality of life (HRQOL) and diabetes-related healthcare events (HCEs) among adults with diabetes who were on metformin, sulfonylurea, insulin, or thiazolidinedione (TZD) monotherapy. The data were sourced from the Medical Expenditure Panel Survey (MEPS). Diabetes patients ≥18 years old who had a complete record of physical component score and mental component scores in round 2 and round 4 of the survey were included. The primary outcome was HRQOL of diabetes patients as measured by the Medical Outcome Study short-form (SF-12v2TM). Multinomial logistic regression and negative binomial regression were conducted to determine associated factors of HRQOL and HCE, respectively. Overall, 5387 patients were included for analysis. Nearly 60% of patients had unchanged HRQOL after the follow-up, whereas almost 15% to 20% of patients showed improvement in HRQOL. The relative risk of declined mental HRQOL was 1.5 times higher relative to unchanged mental HRQOL in patients who were on sulfonylurea 1.55 [1.1–2.17, p = 0.01] than metformin users. The rate of HCE decreased by a factor of 0.79, [95% CI: 0.63–0.99] in patients with no history of hypertension. Patients on sulfonylurea 1.53 [1.20–1.95, <0.01], insulin 2.00 [1.55–2.70, <0.01], and TZD 1.78 [1.23–2.58, <0.01] had increased risk of HCE compared to patients who were on metformin. In general, antidiabetic medications modestly improved HRQOL in patients with diabetes during the follow-up period. Metformin had a lower rate of HCE as compared to other medications. The selection of anti-diabetes medications should focus on HRQOL in addition to controlling glucose level. Full article
(This article belongs to the Special Issue Pharmacy Practice and Administration 2.0)
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13 pages, 276 KiB  
Article
Changes in Physical Activity and Depression among Korean Adolescents Due to COVID-19: Using Data from the 17th (2021) Korea Youth Risk Behavior Survey
by Yong-Sook Eo and Myo-Sung Kim
Healthcare 2023, 11(4), 517; https://doi.org/10.3390/healthcare11040517 - 09 Feb 2023
Cited by 1 | Viewed by 1578
Abstract
This study aimed to identify changes in the health behavior and mental health of adolescents due to coronavirus disease 2019 (COVID-19) and the characteristics related to changes in physical activity and depression among health behavior changes. Data were extracted from the 17th Korea [...] Read more.
This study aimed to identify changes in the health behavior and mental health of adolescents due to coronavirus disease 2019 (COVID-19) and the characteristics related to changes in physical activity and depression among health behavior changes. Data were extracted from the 17th Korea Youth Risk Behavior Web-based Survey of 54,835 adolescents. We classified the adolescents into three groups according to changes in physical activity and depression: no change, increased, or decreased. Independent variables included changes in health behavior due to COVID-19, demographic characteristics, health-related behavior, and mental health. Data were analyzed using the χ2-test and multiple logistic regressions using the SPSS Statistics 27 program. Changes in physical activity and depression showing negative changes due to the pandemic were related to factors such as having breakfast, current smoking, current drinking, stress, loneliness, despair, suicidal ideation, suicide plans, and suicide attempts. The related factors differed between the increased and decreased groups. The results of this study confirm that it is necessary to develop programs to promote the health of youth by considering the factors that affect physical activity and depression, which in turn influences the status of their health. Full article
(This article belongs to the Special Issue Research and Survey on Mental Health of Children and Adolescents)
18 pages, 7003 KiB  
Article
A Low-Cost System Using a Big-Data Deep-Learning Framework for Assessing Physical Telerehabilitation: A Proof-of-Concept
by José Miguel Ramírez-Sanz, José Luis Garrido-Labrador, Alicia Olivares-Gil, Álvaro García-Bustillo, Álvar Arnaiz-González, José-Francisco Díez-Pastor, Maha Jahouh, Josefa González-Santos, Jerónimo J. González-Bernal, Marta Allende-Río, Florita Valiñas-Sieiro, Jose M. Trejo-Gabriel-Galan and Esther Cubo
Healthcare 2023, 11(4), 507; https://doi.org/10.3390/healthcare11040507 - 09 Feb 2023
Cited by 1 | Viewed by 1900
Abstract
The consolidation of telerehabilitation for the treatment of many diseases over the last decades is a consequence of its cost-effective results and its ability to offer access to rehabilitation in remote areas. Telerehabilitation operates over a distance, so vulnerable patients are never exposed [...] Read more.
The consolidation of telerehabilitation for the treatment of many diseases over the last decades is a consequence of its cost-effective results and its ability to offer access to rehabilitation in remote areas. Telerehabilitation operates over a distance, so vulnerable patients are never exposed to unnecessary risks. Despite its low cost, the need for a professional to assess therapeutic exercises and proper corporal movements online should also be mentioned. The focus of this paper is on a telerehabilitation system for patients suffering from Parkinson’s disease in remote villages and other less accessible locations. A full-stack is presented using big data frameworks that facilitate communication between the patient and the occupational therapist, the recording of each session, and real-time skeleton identification using artificial intelligence techniques. Big data technologies are used to process the numerous videos that are generated during the course of treating simultaneous patients. Moreover, the skeleton of each patient can be estimated using deep neural networks for automated evaluation of corporal exercises, which is of immense help to the therapists in charge of the treatment programs. Full article
(This article belongs to the Special Issue Analysis of Healthcare Big Data and Health Informatics)
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25 pages, 566 KiB  
Systematic Review
Prevalence of Potentially Inappropriate Prescriptions According to the New STOPP/START Criteria in Nursing Homes: A Systematic Review
by Isabel Díaz Planelles, Elisabet Navarro-Tapia, Óscar García-Algar and Vicente Andreu-Fernández
Healthcare 2023, 11(3), 422; https://doi.org/10.3390/healthcare11030422 - 01 Feb 2023
Cited by 5 | Viewed by 2929
Abstract
The demand for long-term care is expected to increase due to the rising life expectancy and the increased prevalence of long-term illnesses. Nursing home residents are at an increased risk of suffering adverse drug events due to inadequate prescriptions. The main objective of [...] Read more.
The demand for long-term care is expected to increase due to the rising life expectancy and the increased prevalence of long-term illnesses. Nursing home residents are at an increased risk of suffering adverse drug events due to inadequate prescriptions. The main objective of this systematic review is to collect and analyze the prevalence of potentially inadequate prescriptions based on the new version of STOPP/START criteria in this specific population. Databases (PubMed, Web of Science and Cochrane) were searched for inappropriate prescription use in nursing homes according to the second version of STOPP/START criteria. The risk of bias was assessed with the STROBE checklist. A total of 35 articles were assessed for eligibility. One hundred and forty nursing homes and more than 6900 residents were evaluated through the analysis of 13 studies of the last eight years. The reviewed literature returned prevalence ranges between 67.8% and 87.7% according to the STOPP criteria, according to START criteria prevalence ranged from 39.5% to 99.7%. The main factors associated with the presence of inappropriate prescriptions were age, comorbidities, and polypharmacy. These data highlight that, although the STOPP/START criteria were initially developed for community-dwelling older adults, its use in nursing homes may be a starting point to help detect more efficiently inappropriate prescriptions in institutionalized patients. We hope that this review will help to draw attention to the need for medication monitoring systems in this vulnerable population. Full article
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11 pages, 1410 KiB  
Article
Preferred Place of End-of-Life Care Based on Clinical Scenario: A Cross-Sectional Study of a General Japanese Population
by Kyoko Hanari, Sandra Y. Moody, Takehiro Sugiyama and Nanako Tamiya
Healthcare 2023, 11(3), 406; https://doi.org/10.3390/healthcare11030406 - 31 Jan 2023
Cited by 1 | Viewed by 1372
Abstract
In Japan, which has an aging society with many deaths, it is important that people discuss preferred place for end-of-life care in advance. This study aims to investigate whether the preferred place of end-of-life care differs by the assumed clinical scenario. This clinical [...] Read more.
In Japan, which has an aging society with many deaths, it is important that people discuss preferred place for end-of-life care in advance. This study aims to investigate whether the preferred place of end-of-life care differs by the assumed clinical scenario. This clinical scenario-based survey used data from a nationwide survey conducted in Japan in December 2017. Participants aged 20 years and older were randomly selected from the general population. The survey contained questions based on three scenarios: cancer, end-stage heart disease, and dementia. For each scenario, respondents were asked to choose the preferred place of end-of-life care among three options: home, nursing home, and medical facility. Eight hundred eighty-nine individuals participated in this study (effective response rate: 14.8%). The proportions of respondents choosing home, nursing home, and medical facility for the cancer scenario were 49.6%, 10.9%, and 39.5%, respectively; for the end-stage heart disease scenario, 30.5%, 18.9%, and 50.6%; and for the dementia scenario, 15.2%, 54.5%, and 30.3% (p < 0.0001, chi-square test). The preferred place of end-of-life care differed by the assumed clinical scenario. In clinical practice, concrete information about diseases and their status should be provided during discussions about preferred place for end-of-life care to reveal people’s preferences more accurately. Full article
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9 pages, 576 KiB  
Article
Evaluation of Midwives’ Practises on Herpetic Infections during Pregnancy: A French Vignette-Based Study
by Adrian Mrozik, Yann Sellier, Déborah Lemaitre and Laurent Gaucher
Healthcare 2023, 11(3), 364; https://doi.org/10.3390/healthcare11030364 - 28 Jan 2023
Cited by 1 | Viewed by 1393
Abstract
(1) Background: One out of two pregnant women has a history of herpes infection. Initial infections have a high risk of neonatal transmission. Our objective was to analyse the professional practises of midwives regarding the management of herpes infections during pregnancy in France; [...] Read more.
(1) Background: One out of two pregnant women has a history of herpes infection. Initial infections have a high risk of neonatal transmission. Our objective was to analyse the professional practises of midwives regarding the management of herpes infections during pregnancy in France; (2) Methods: A national survey conducted via an online self-questionnaire, including clinical vignettes for which the midwives proposed a diagnosis, a drug treatment, a mode of birth, and a prognosis. These responses were used to evaluate the conformity of the responses to the guidelines, as well as the influence of certain criteria, such as mode of practise and experience; (3) Results: Of 728 responses, only 26.1% of the midwives reported being aware of the 2017 clinical practise guidelines. The midwives proposed taking the appropriate actions in 56.1% of the responses in the case of a recurrence, and in 95.1% of the responses in the case of a primary infection. For the specific, high-risk case of a nonprimary initial infection at 38 weeks of gestation, reporting knowledge of the recommendations improved the compliance of the proposed care by 40% (p = 0.02). However, 33.8% of the midwives underestimated the neonatal risk at term after a primary initial infection, and 43% underestimated the risk after a primary initial infection at term; (4) Conclusions: The majority of reported practises were compliant despite a low level of knowledge of the guidelines. The dissemination of guidelines may be important to improve information and adherence to appropriate therapeutic practise. Full article
(This article belongs to the Special Issue Maternal, Fetal and Neonatal Health)
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14 pages, 1212 KiB  
Article
Interprofessional Collaboration in Complex Patient Care Transition: A Qualitative Multi-Perspective Analysis
by Franziska Geese and Kai-Uwe Schmitt
Healthcare 2023, 11(3), 359; https://doi.org/10.3390/healthcare11030359 - 27 Jan 2023
Cited by 5 | Viewed by 15273
Abstract
Healthcare professionals often feel challenged by complex patients and the associated care needs during care transition. Interprofessional collaboration (IPC) is considered an effective approach in such situations. However, a fragmented healthcare system can limit IPC. This study explored experiences of Swiss healthcare professionals [...] Read more.
Healthcare professionals often feel challenged by complex patients and the associated care needs during care transition. Interprofessional collaboration (IPC) is considered an effective approach in such situations. However, a fragmented healthcare system can limit IPC. This study explored experiences of Swiss healthcare professionals regarding complex patient care transition and the potential of IPC. Professionals from nursing, medicine, psychology, physiotherapy, dietetics and nutrition, social service, occupational therapy, and speech therapy were included. A qualitative between-method triangulation design was applied, with two focus group discussions and ten individual interviews. The combination of different data-collection methods allowed us to explore complex patient care transition and to systematically add perspectives of healthcare professionals from different care settings. Three main themes were identified: (1) Participants described their vision of an ideal complex patient care transition, i.e., the status they would like to see implemented; (2) participants reported challenges in complex patient care transition as experienced today; and (3) participants suggested ways to improve complex patient care transition by IPC. This study highlighted that healthcare professionals regarded IPC as an effective intervention to improve complex patient care transition. It emerged that sustainable implementation of IPC across care organizations is currently limited in Switzerland. In the absence of strong and direct promotion of IPC by the healthcare system, professionals in clinical practice can further promote IPC by finding hands-on solutions to overcome organizational boundaries. Full article
(This article belongs to the Section Chronic Care)
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16 pages, 656 KiB  
Article
Effect of the Active Aging-in-Place–Rehabilitation Nursing Program: A Randomized Controlled Trial
by Ana da Conceição Alves Faria, Maria Manuela F. P. S. Martins, Olga Maria Pimenta Lopes Ribeiro, João Miguel Almeida Ventura-Silva, Esmeralda Faria Fonseca, Luciano José Moreira Ferreira and José Alberto Laredo-Aguilera
Healthcare 2023, 11(2), 276; https://doi.org/10.3390/healthcare11020276 - 16 Jan 2023
Cited by 4 | Viewed by 2429
Abstract
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program (AAP-RNP) [...] Read more.
(1) Background: It is of great importance to promote functional capacity and positive lifestyles, since they contribute to preventing the progression of frailty among the older adults. The aim of this study was to evaluate the effect of active aging-in-place–rehabilitation nursing program (AAP-RNP) on the functional capacity and lifestyles of frail older adults. (2) Methods: This was a single-blinded, two-group, randomized, controlled trial of 30 frail older people enrolled at a Health-care unit in Portugal between 2021 and 2022. The duration of the program was 12 weeks, and the sessions took place at the participants’ homes. We used as instruments the Tilburg Frailty Indicator; Fried frailty phenotype; Senior Fitness Test battery; Barthel Index; Lawton Index; handgrip strength measurement; Tinetti Index; Individual lifestyle profile; and Borg’s perception of effort. (3) Results: Post-program, there was an improvement in multidimensional and physical frailty, functional capacity, balance, and perceived exertion (p < 0.05) in the experimental group. Among the older adults’ lifestyles, we observed significant improvements in physical activity habits, relational behavior, and stress management. (4) Conclusions: Rehabilitation nurses have a relevant role, and the AAP-RNP seems to be effective in improving functional capacity and lifestyles in frail older adults. Full article
(This article belongs to the Special Issue Frailty in Community-Dwelling Older People)
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15 pages, 2356 KiB  
Article
Factors That Influence, Exacerbate, Contribute or Promote Violence in Couples
by Claudia Sánchez, Cecilia Mota, Jorge Carreño and María Eugenia Gómez
Healthcare 2023, 11(2), 281; https://doi.org/10.3390/healthcare11020281 - 16 Jan 2023
Viewed by 1588
Abstract
Life as a couple, and their ability to solve problems or not, can result in the relationship being satisfactory and functional or unsatisfactory and dysfunctional, which increases the risk of violence with serious implications. For that reason, it is important to isolate the [...] Read more.
Life as a couple, and their ability to solve problems or not, can result in the relationship being satisfactory and functional or unsatisfactory and dysfunctional, which increases the risk of violence with serious implications. For that reason, it is important to isolate the risk factors to prevent and treat unsatisfactory and dysfunctional relationships. The qualitative interpretive exploratory method was used, analysing 50 sessions of group psychotherapy with patients from a reproductive health institution whose relationships faced violent problems. The identified factors were the lack of autonomy in one of the partners, unresolved internal factors, a combination of external factors and factors caused by their interaction; symmetrical and asymmetrical violence, subjugation of one before the other, intergenerational violence, family violence during childhood and normalisation of violence. Isolating factors to understand relationship problems at risk of manifesting violence opens the possibility of effective, specific and preventive treatments of family and intimate partner violence. Full article
(This article belongs to the Special Issue Perinatal Mental Health and Care)
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24 pages, 1504 KiB  
Article
The Association between Physical Activity, Self-Compassion, and Mental Well-Being after COVID-19: In the Exercise and Self-Esteem Model Revised with Self-Compassion (EXSEM-SC) Perspective
by Ming-Yu Claudia Wong, Hong-Wang Fung and Guangzhe Frank Yuan
Healthcare 2023, 11(2), 233; https://doi.org/10.3390/healthcare11020233 - 12 Jan 2023
Cited by 5 | Viewed by 2905
Abstract
During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students’ negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated [...] Read more.
During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students’ negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated Measures Panel Analysis Framework (RMPAF) to examine the stability of the model in revealing the relationship between physical activity, self-compassion, and mental well-being among Hong Kong adolescents. It is also aimed at examining the changes in physical activity, self-compassion, and mental well-being among Hong Kong adolescents between, before, and after the peak of COVID-19 using the EXSEM-SC Model. The RMPAF has involved 572 (60% Female, Mage = 13.63, SD =1.31) Hong Kong secondary school students. Furthermore, using the abductive qualitative approach, a total of 25 (Mage = 14.84, SD = 1.40) students were involved in the in-depth interviews to further investigate the relationships within the EXSEM-SC. The quantitative results showed that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs, as well as satisfying model construct consistency. Moreover, it showed no significant differences in the level of physical activity, self-compassion, and mental well-being during and after the peak of COVID-19. The qualitative results demonstrated two new categories within the EXSEM-SC variables, which are personality traits and injuries experiences. With the stability of the EXSEM-SC model among adolescents, it is expected that the physical activity intervention, which is based on the EXSEM-SC model, could also aim at easing Hong Kong adolescent’s mental health issues. In addition, in terms of generating a long-term impact among students, the physical activity and self-compassionate intervention should be promoted among schools. However, the quantitative properties of the two new categories in the qualitative outcomes should be involved in future investigation. Full article
(This article belongs to the Special Issue Research and Survey on Mental Health of Children and Adolescents)
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19 pages, 674 KiB  
Review
Fibromyalgia Syndrome Pain in Men and Women: A Scoping Review
by Ilga Ruschak, Pilar Montesó-Curto, Lluís Rosselló, Carina Aguilar Martín, Laura Sánchez-Montesó and Loren Toussaint
Healthcare 2023, 11(2), 223; https://doi.org/10.3390/healthcare11020223 - 11 Jan 2023
Cited by 10 | Viewed by 2982
Abstract
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disorder of unknown etiology that affects up to 5.0% of the world population. It has a high female predominance, between 80 and 96%. Due to the low number of diagnosed men, research work has focused mainly [...] Read more.
Fibromyalgia syndrome (FMS) is a chronic musculoskeletal disorder of unknown etiology that affects up to 5.0% of the world population. It has a high female predominance, between 80 and 96%. Due to the low number of diagnosed men, research work has focused mainly on women. The extensive body of literature on sex differences in pain in the general population suggests that men and women differ in their responses to pain, with greater sensitivity to pain and a higher risk of clinical pain commonly observed among women. This review aims to: (1) determine how pain is assessed or what types of questionnaires are used, (2) examine whether there are differences in pain characteristics between men and women with FMS and (3) describe how pain is conceptualized or manifested in patients at a qualitative level. In this study, the scoping review method of articles published in the last 5 years (2016–2022) was used. Ten articles were included. The most used questionnaires and scales to assess pain were the PVAS (Pain Visual Analogue Scale) and the FIQ (Fibromyalgia Impact Questionnaire). On the other hand, five categories were obtained: (1) qualities of pain, (2) uncertainty and chaos, (3) pain as an aggravating factor, (4) adaptation to the new reality and (5) the communication of pain. It has been observed that both subjective perception and widespread pain are higher in women. Men, on the other hand, have a worse impact of the pathology, more painful experiences and more catastrophic thoughts about pain. An updated knowledge of pain in FMS and whether it differs according to sex would be beneficial for clinicians to make an earlier diagnosis and treatment and, in turn, benefit patients suffering from this chronic disease. Full article
(This article belongs to the Section Pain Management)
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22 pages, 4797 KiB  
Article
Adverse Effects of COVID-19 Vaccination: Machine Learning and Statistical Approach to Identify and Classify Incidences of Morbidity and Postvaccination Reactogenicity
by Md. Martuza Ahamad, Sakifa Aktar, Md. Jamal Uddin, Md. Rashed-Al-Mahfuz, A. K. M. Azad, Shahadat Uddin, Salem A. Alyami, Iqbal H. Sarker, Asaduzzaman Khan, Pietro Liò, Julian M. W. Quinn and Mohammad Ali Moni
Healthcare 2023, 11(1), 31; https://doi.org/10.3390/healthcare11010031 - 22 Dec 2022
Cited by 14 | Viewed by 2742
Abstract
Good vaccine safety and reliability are essential for successfully countering infectious disease spread. A small but significant number of adverse reactions to COVID-19 vaccines have been reported. Here, we aim to identify possible common factors in such adverse reactions to enable strategies that [...] Read more.
Good vaccine safety and reliability are essential for successfully countering infectious disease spread. A small but significant number of adverse reactions to COVID-19 vaccines have been reported. Here, we aim to identify possible common factors in such adverse reactions to enable strategies that reduce the incidence of such reactions by using patient data to classify and characterise those at risk. We examined patient medical histories and data documenting postvaccination effects and outcomes. The data analyses were conducted using a range of statistical approaches followed by a series of machine learning classification algorithms. In most cases, a group of similar features was significantly associated with poor patient reactions. These included patient prior illnesses, admission to hospitals and SARS-CoV-2 reinfection. The analyses indicated that patient age, gender, taking other medications, type-2 diabetes, hypertension, allergic history and heart disease are the most significant pre-existing factors associated with the risk of poor outcome. In addition, long duration of hospital treatments, dyspnoea, various kinds of pain, headache, cough, asthenia, and physical disability were the most significant clinical predictors. The machine learning classifiers that are trained with medical history were also able to predict patients with complication-free vaccination and have an accuracy score above 90%. Our study identifies profiles of individuals that may need extra monitoring and care (e.g., vaccination at a location with access to comprehensive clinical support) to reduce negative outcomes through classification approaches. Full article
(This article belongs to the Special Issue Graph Machine Learning in Healthcare)
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10 pages, 762 KiB  
Hypothesis
The Ecological-Dynamics Framework for Medical Skills
by Kersi Taraporewalla, André van Zundert, Marcus O. Watson and Ian Renshaw
Healthcare 2023, 11(1), 38; https://doi.org/10.3390/healthcare11010038 - 22 Dec 2022
Viewed by 1471
Abstract
Physicians are required to move and manipulate equipment to achieve motor tasks such as surgical operations, endotracheal intubations, and intravenous cannulation. Understanding how movements are generated allows for the analysis of performance, skill development, and methods of teaching. Ecological-Dynamics (ECD) is a theoretical [...] Read more.
Physicians are required to move and manipulate equipment to achieve motor tasks such as surgical operations, endotracheal intubations, and intravenous cannulation. Understanding how movements are generated allows for the analysis of performance, skill development, and methods of teaching. Ecological-Dynamics (ECD) is a theoretical framework successfully utilized in sports to explain goal-directed actions and guide coaching and performance analysis via a Constraint-Led Approach (CLA). Its principles have been adopted by other domains including learning music and mathematics. Healthcare is yet to utilize ECD for analyzing and teaching practical skills. This article presents ECD theory and considers it as the approach to understand skilled behavior and developing training in medical skills. Full article
(This article belongs to the Section Critical Care)
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