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Feature Papers in Healthcare in 2019

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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (15 September 2019) | Viewed by 75156

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Prof. Dr. Sampath Parthasarathy

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Guest Editor

Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 8829 Kastler street, Orlando, FL 32727, USA
Interests: atherosclerosis; heart failure mechanisms; cardiovascular pharmacology; cardiovascular nutrition; fatty acids; lipids and lipoproteins; oxidative stress and antioxidants; endometriosis; macrophages
* Deceased, 1 December 2020.
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In order to acknowledge of reviewers and excellent authors in /Healthcare/, we provide a waiver to some excellent referees and authors. The excellent referees reviewed papers and provided valuable review reports for Healthcare. The excellent authors brought bright scientific edge and published popular papers. All those candidates can publish a paper free of charge in 2019. The scope of this Special Issue includes, but not limit to:

Chronic care

Health assessment
Laboratory and diagnostic procedures
Medication management
Disease prevention
Early diagnosis
Treatment and comprehensive strategies
Morbidity and mortality
Long term outcomes
Scoring systems and outcome prediction
Socio-economic burden of chronic care

Critical care *

Emergency, perioperative and intensive care
Pediatric/neonates care
Medical imaging, monitoring, support

Advanced inpatients care

Advanced medical investigation and treatment
Experimental medicine
Uncommon diagnostic or surgical procedures

Health informatics (electronic and online based clinical studies and medical research)

Health care materials

Mental health

Nursing

* Treatment for a short period of time for a brief but serious illness, injury or other health condition.

Prof. Dr. Sampath Parthasarathy
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (11 papers)

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Research

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9 pages, 883 KiB

Open AccessArticle

An Exercise Program Designed for Children with Attention Deficit/Hyperactivity Disorder for Use in School Physical Education: Feasibility and Utility

by Alyx Taylor, Dario Novo and David Foreman

Healthcare 2019, 7(3), 102; https://doi.org/10.3390/healthcare7030102 - 04 Sep 2019

Cited by 9 | Viewed by 9347

Abstract

Moderate to high intensity exercise can improve cognitive function and behavior in children including those with attention-deficit/hyperactivity disorder (ADHD). However, exercise with long periods of the same activity, or inactivity can fail to engage or maintain their attention. This study examined the effect of exercise sessions developed to engage children with ADHD. Twelve children (10–11 years), six with a diagnosis of ADHD and six with no diagnosis, undertook 40-min sessions of short-duration, mixed activities bi-weekly for eleven weeks. ADHD symptoms and exercise enjoyment were recorded before six and eleven weeks of intervention. Teacher-reported data showed ADHD symptoms were significantly decreased in the children with ADHD, with a moderate to large effect size. There were no changes in the control group. All children indicated equal enjoyment of the exercise sessions. Specially designed exercise sessions stimulate and maintain engagement by children with ADHD and may reduce ADHD symptom levels in the school environment. The method that supports inclusive practice in physical education (PE) was successfully transferred to the study school and led by the usual class teacher. Children evaluated the exercises as acceptable and enjoyable for those with and without ADHD. This inclusive exercise method might help children manage ADHD symptoms. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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12 pages, 246 KiB

Open AccessArticle

Family Economic Burden of Elderly Chronic Diseases: Evidence from China

by Xiaocang Xu, Xiuquan Huang, Xiaolu Zhang and Linhong Chen

Healthcare 2019, 7(3), 99; https://doi.org/10.3390/healthcare7030099 - 21 Aug 2019

Cited by 26 | Viewed by 5351

Abstract

Chronic diseases among the elderly and their huge economic burden on family have caught much attention from economists and sociologists over the past decade in China. This study measured the economic burden of elderly chronic disease (ECD) in families using the China Health and Retirement Longitudinal Study (CHARLS) data set from Peking University (China). We studied some aspects of this burden, including health-service utilization, out-of-pocket expenditure on inpatient and outpatient, total family expenditures on items, and labor force participation rates of family members, etc. Some interesting things were found, for example, the additional annual expenditure on inpatient care (per member) in ECD-families was 37 to 45 percent of the annual expenditure in the control group; the labor-force participation rate in ECD-families was 2.4 to 3.3 percent of points lower than in the control group. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

12 pages, 527 KiB

Open AccessArticle

Learning in Practice: Collaboration Is the Way to Improve Health System Outcomes

by Pieter J. Van Dam, Phoebe Griffin, Nicole S. Reeves, Sarah J. Prior, Bronwyn Paton, Raj Verma, Amelia Giles, Lea Kirkwood and Gregory M. Peterson

Healthcare 2019, 7(3), 90; https://doi.org/10.3390/healthcare7030090 - 09 Jul 2019

Cited by 4 | Viewed by 5885

Abstract

Evidence suggests that it is challenging for universities to develop workplace-relevant content and curricula by themselves, and this can lead to suboptimal educational outcomes. This paper examines the development, implementation, and evaluation of Australia’s first tertiary graduate course in healthcare redesign, a partnership initiative between industry and university. The course not only provides students with an understanding of person-centered sustainable healthcare but also the skills and confidence to design, implement, and evaluate interventions to improve health service delivery. Increasing students’ application of new knowledge has been through work-integrated learning, a pedagogy that essentially integrates theory with the practice of workplace application within a purposely designed curriculum. The specific aim of this study was to examine the outcomes of the course after two years, utilizing an anonymous online survey of graduates. Sixty-two graduates (48%) completed the survey. Kirkpatrick’s four-level evaluation model was used to analyze the data. The analysis revealed high satisfaction levels in relation to the course content and delivery. Through successful completion of the innovative course, students had increased their knowledge of health system redesign methods and, importantly, the ability to translate that knowledge into everyday practice. Graduates of the clinical redesign course reported that they had been able to transfer their skills and knowledge to others in the workplace and lead further improvement projects. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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8 pages, 351 KiB

Open AccessArticle

Assessing the Penetrance of Dementia Services

by Michael Rozsa and Leon Flicker

Healthcare 2019, 7(3), 81; https://doi.org/10.3390/healthcare7030081 - 27 Jun 2019

Viewed by 3245

Abstract

Introduction: This scoping review aims to identify studies that assess dementia case finding programs (such as memory clinics) on a population basis and specifically assess the impacts that these services have on the diagnosis and management of dementia within a specific population. Methods: We conducted a literature review using the PubMed database, Ovid search engine, and records identified from external sources. This review assessed studies that contained data on patients diagnosed with dementia within a set population, reviewed the impact of specialty services on the diagnosis and management of such patients, and evaluated how this compared to data estimates for that population catchment. Results: The literature review yielded 1106 unique studies, of which only five were determined to be relevant based on the inclusion criteria. There was considerable variation between the primary outcome measures of the five studies included, and a quantitative meta-analysis could not be performed. Discussion: There are currently limited data on the fraction of the total population of people with dementia that are diagnosed and managed by specialised dementia assessment services within a set population. Further studies investigating how these services impact the incidence and prevalence of dementia diagnosis and ongoing management are required. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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10 pages, 1306 KiB

Open AccessArticle

Self-Assessment of Preparedness among Critical Care Trainees Transitioning from Fellowship to Practice

by Laura Watkins, Matthew DiMeglio and Krzysztof Laudanski

Healthcare 2019, 7(2), 74; https://doi.org/10.3390/healthcare7020074 - 30 May 2019

Cited by 4 | Viewed by 3750

Abstract

This study evaluated the subjective assessment of preparedness needs of critical care trainees and recent graduates between 2013 and 2014. A questionnaire was developed and validated by the subcommittee of the In-Training Section of Society of Critical Care Medicine (SCCM). The survey was deployed twice between December 2013 and January 2014 via email to any trainee or individual graduated from a critical care fellowship within the previous three years. Six percent (180) of all individuals completed the survey, and 67% of respondents had recently interviewed for a job. Northeast was the preferred location for a job (47%), and academia was favored over private practice (80% vs. 15%). Of the respondents that secured an interview, 55% felt prepared for the interview, 67% felt prepared to build an adequate job portfolio, 33% received formal guidance from their mentor/training program. 89% of total respondents agreed it is important to participate in a formal training course in job search, portfolio development, and interviewing process. The preferred sources of training were equally distributed between their home institution, webinars, and SCCM. There is an ongoing need in education regarding the transition period from fellowship to practice. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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9 pages, 361 KiB

Open AccessArticle

Among Trauma Patients, Younger Men with Ventilator-Associated Pneumonia Have Worse Outcomes Compared to Older Men—An Exploratory Study

by Duraid Younan, Sarah J. Delozier, Nathaniel McQuay, John Adamski, Aisha Violette, Andrew Loudon, Jeffrey Ustin, Regan Berg, Glen Tinkoff, Matthew L. Moorman and UHRISES Research Consortium

Healthcare 2019, 7(2), 67; https://doi.org/10.3390/healthcare7020067 - 30 Apr 2019

Cited by 2 | Viewed by 3782

Abstract

Background: Ventilator-associated pneumonia is associated with significant morbidity. Although the association of gender with outcomes in trauma patients has been debated for years, recently, certain authors have demonstrated a difference. We sought to compare the outcomes of younger men and women to older men and women, among critically ill trauma patients with ventilator-associated pneumonia (VAP). Methods: We reviewed our trauma data base for trauma patients with ventilator-associated pneumonia admitted to our trauma intensive care unit between January 2016 and June 2018. Data collected included demographics, injury mechanism and severity (ISS), admission vital signs and laboratory data and outcome measures including hospital length of stay, ICU stay and survival. Patients were also divided into younger (<50) and older (≥50) to account for hormonal status. Linear regression and binary logistic regression models were performed to compare younger men to older men and younger women to older women, and to examine the association between gender and hospital length of stay (LOS), ICU stay (ICUS), and survival. Results: Forty-five trauma patients admitted to our trauma intensive care unit during the study period (January 2016 to August 2018) had ventilator-associated pneumonia. The average age was 58.9 ± 19.6 years with mean ISS of 18.2 ± 9.8. There were 32 (71.1%) men, 27 (60.0%) White, and 41 (91.1%) had blunt trauma. Mean ICU stay was 14.9 ± 11.4 days and mean total hospital length of stay (LOS) was 21.5 ± 14.6 days. Younger men with VAP had longer hospital LOS 28.6 ± 17.1 days compared to older men 16.7 ± 6.6 days, (p < 0.001) and longer intensive care unit stay 21.6 ± 15.6 days compared to older men 11.9 ± 7.3 days (p = 0.02), there was no significant difference in injury severity (ISS was 22.2 ± 8.4 vs. 17 ± 8, p = 0.09). Conclusions: Among trauma patients with VAP, younger men had longer hospital length of stay and a trend towards longer ICU stay. Further research should focus on the mechanisms behind this difference in outcome using a larger database. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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14 pages, 1117 KiB

Open AccessArticle

A Supervised Pattern Analysis of the Length of Stay for Hip Replacement Admissions

by Dimitrios Zikos, Ashara Shrestha, Taylor Colotti and Leonidas Fegaras

Healthcare 2019, 7(2), 58; https://doi.org/10.3390/healthcare7020058 - 06 Apr 2019

Cited by 3 | Viewed by 4160

Abstract

Hip replacement is the most common surgical procedure among Medicare patients in the US and worldwide. The hospital length of stay (LOS) for hip replacement admissions is therefore important to be controlled, contributing to savings for hospitals. This study combined medical claims and hospital structure and service data to examine LOS fluctuations and trends, and admission distribution patterns, during weekdays, for hip replacement cases. The study furthermore examined associations of these patterns with the LOS performance. Most hospitals were found to admit hip replacement cases at the start of the week (Monday through Wednesday). There is an upward LOS trend as we approach late weekday admissions. Multiple linear regression analysis showed that LOS weekday inconsistencies, a large proportion of hip replacement admissions on Thursday and Friday, the government ownership status, the bed size, and the critical access status are associated with an increased LOS. On the other hand, the rate of hip replacement admissions over total ones, and the hospital being accredited, are associated with a lower LOS. Findings stress out the need for hospitals to maintain an effective and balanced distribution of hip replacement admissions, evenly during the week, and the need for standardized case management, to avoid practice variability and, therefore, LOS fluctuations for their hip replacement cases. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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Review

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20 pages, 647 KiB

Open AccessReview

The Mediterranean Diet and Breast Cancer: A Personalised Approach

by Amani Al Shaikh, Andrea J. Braakhuis and Karen S. Bishop

Healthcare 2019, 7(3), 104; https://doi.org/10.3390/healthcare7030104 - 09 Sep 2019

Cited by 18 | Viewed by 8343

Abstract

There have been many original and review articles summarizing the impact of nutrition and diet on breast cancer risk. However, very few consider the implication of genetic background and the effect of personalised nutrition on the risk and prognosis of breast cancer. A literature search was performed using the following databases: MEDLINE (Ovid), PubMed, Scopus and EMBASE (Ovid). The ensuing search terms were selected: genomics, nutrigenomics, breast cancer, breast neoplasms, cancer, nutrigenetics, diet–gene interaction, and Mediterranean, nutrition, polyphenols and diet. In this review, we discuss the Mediterranean-style diet and associated nutrients, evidence of benefit, impact on gene expression and evidence of interactions with genotype and how this interaction can modify breast cancer risk and progression. In addition, the impact of nutrients commonly associated with a Mediterranean-style diet, on breast cancer treatment, and synergistic effects are mentioned when modified by genotype. Some evidence exists around the benefit of a gene-based personalised diet based on a Mediterranean-style dietary pattern, but further evidence in the form of clinical trials is required before such an approach can be comprehensively implemented. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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19 pages, 688 KiB

Open AccessReview

Pancreatic Cancer Cachexia: The Role of Nutritional Interventions

by Toni Mitchell, Lewis Clarke, Alexandra Goldberg and Karen S. Bishop

Healthcare 2019, 7(3), 89; https://doi.org/10.3390/healthcare7030089 - 09 Jul 2019

Cited by 32 | Viewed by 9207

Abstract

Pancreatic cancer is a cancer with one of the highest mortality rates and many pancreatic cancer patients present with cachexia at diagnosis. The definition of cancer cachexia is not consistently applied in the clinic or across studies. In general, it is “defined as a multifactorial syndrome characterised by an ongoing loss of skeletal muscle mass with or without loss of fat mass that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment.” Many regard cancer cachexia as being resistant to dietary interventions. Cachexia is associated with a negative impact on survival and quality of life. In this article, we outline some of the mechanisms of pancreatic cancer cachexia and discuss nutritional interventions to support the management of pancreatic cancer cachexia. Cachexia is driven by a combination of reduced appetite leading to reduced calorie intake, increased metabolism, and systemic inflammation driven by a combination of host cytokines and tumour derived factors. The ketogenic diet showed promising results, but these are yet to be confirmed in human clinical trials over the long-term. L-carnitine supplementation showed improved quality of life and an increase in lean body mass. As a first step towards preventing and managing pancreatic cancer cachexia, nutritional support should be provided through counselling and the provision of oral nutritional supplements to prevent and minimise loss of lean body mass. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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12 pages, 239 KiB

Open AccessReview

A Review of the Complex Role of Family Caregivers as Health Team Members and Second-Order Patients

by Deborah Witt Sherman

Healthcare 2019, 7(2), 63; https://doi.org/10.3390/healthcare7020063 - 24 Apr 2019

Cited by 38 | Viewed by 6858

Abstract

In Palliative Care, the unit of care is the patient and their family. Although members of the health care team often address the family caregiver’s opinions and concerns, the focus of care remains on the needs of the patient. The readiness and willingness of the family caregiver is often overlooked as they are expected to assume a complex caregiving role. When family caregivers are not intellectually or emotionally prepared or physically capable, the caregiver is at high risk for serious health issues and cognitive, emotional, and physical decline particularly as caregiving extends over time. Family caregivers are often a neglected and at-risk population. Illustrated through the use of a case study, this article addresses the complex role of family caregivers, as both health team members and second-order patients. It emphasizes the importance of family assessment and interventions to balance the burdens and benefits of family caregiving and protect caregivers’ health and well-being. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

Other

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8 pages, 859 KiB

Open AccessCommentary

Community Empowerment and Community Partnerships in Nursing Decision-Making

by Pedro Melo and Odete Alves

Healthcare 2019, 7(2), 76; https://doi.org/10.3390/healthcare7020076 - 12 Jun 2019

Cited by 14 | Viewed by 14378

Abstract

Community empowerment has been studied as a process and result phenomenon throughout the last 40 years. Community partnership, which has been studied during the last 20 years, has been identified as a key process to promote intervention and research within communities. In this paper, we introduce the relation between these two concepts, from the research that is being developed at the Centre for Interdisciplinary Health Research (CIIS) in Universidade Católica Portuguesa. We comment on the available evidence regarding community partnership and community empowerment within the Nursing Decision-Making process. There is a particular focus on Community Health Nursing Specialists (CHNS) and the aim to promote the identification of CHNS as potential community partnership developers within society. It is also important to analyze how community partnership processes are intentionally integrated as a nursing intervention within the nursing process. This analysis should occur from the nursing diagnosis to the evaluation of health gains in communities sensitive to CHNS care in a Nursing Theoretical Model developed from a Nursing PhD process—the Community Assessment, Intervention, and Empowerment Model. Full article

(This article belongs to the Special Issue Feature Papers in Healthcare in 2019)

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