Topic Editors

Prof. Dr. Joachim G. Voss
Sarah Cole Hirsh Institute for Evidence-Based Practice, Frances Payne Bolton School of Nursing, Case Western Reserve University, 2120 Cornell Road, Cleveland, OH 44106, USA
Dr. Sandul Yasobant
Indian Institute of Public Health Gandhinagar, Gandhinagar 382042, Gujarat, India

Impacts of the Globalization of Healthcare

Abstract submission deadline
closed (20 March 2022)
Manuscript submission deadline
20 September 2022
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Topic Information

Dear Colleagues,

Globalization has a dramatic impact on healthcare systems and health outcomes. The effect of globalization on health systems and individuals is complex. The impact of globalization has dual effects, both positive and negative. and the impacts need to be well valued. Globalization has shown potential positive impacts by minimizing the gaps in health inequalities between rich and poor people, between the Global South and North, and by improving healthcare for all. However, there are also downsides to global health, such as the spread of infectious diseases due to rapid mobility, which is emerging as the greatest threat to all. Under the umbrella of globalization and its impact, other systems beyond human health should not be neglected, such as the impact on animal health and/or ecosystem health and their impact on human health.

Nevertheless, globalization is neither inherently good nor bad, but rather an inexorable force that needs to be understood and channeled for the ecosystem's wellbeing. As we have understood globalization beyond economic development, such as institutional, sociocultural, and environmental transitions, this would be the right time to value its understanding of healthcare impacts. Thus, this Topic invites innovative articles on diverse aspects of globalization and its impact on health, which are not restricted to the below thematic areas:

Theme 1: Globalizing healthcare leadership;
Theme 2: Decolonizing healthcare and health services;
Theme 3: Governing universal health coverage;
Theme 4: Promoting human–animal–environment wellbeing and ecosystem sustainability;
Theme 5: Globalizing policies for healthcare.

The themes mentioned above are framed with reference to any diseases of concern (non-communicable and/or infectious, including COVID-19); however. manuscripts which are pushing inter- and/or transdisciplinary science by applying new conceptual thinking to theoretical models, current methods, and policy efforts are preferred. In addition, innovations on Sustainable Development Goals and interlinkages to Goal 3 with potential impacts due to globalization are of particular interest, as long as they showcase national or regional efforts and identify current gaps in the health impacts of globalization and identify strategies on how to address them. We are interested in full-length manuscripts based on original research, systematic reviews, methodological advances, or policy analyses.

Prof. Dr. Joachim G. Voss
Dr. Sandul Yasobant
Topic Editors

Keywords

  • development
  • globalization
  • decolonization
  • human-animal-environment wellbeing
  • global health

Participating Journals

Journal Name Impact Factor CiteScore Launched Year First Decision (median) APC
International Journal of Environmental Research and Public Health
ijerph
3.390 3.4 2004 21.4 Days 2500 CHF Submit
Healthcare
healthcare
2.645 - 2013 21.4 Days 1800 CHF Submit
Medicina
medicina
2.430 1.7 1920 22.1 Days 1800 CHF Submit

Published Papers (23 papers)

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Article
Quality of Work Life and Work Process of Assistance Nurses
Int. J. Environ. Res. Public Health 2022, 19(11), 6415; https://doi.org/10.3390/ijerph19116415 - 25 May 2022
Abstract
Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL [...] Read more.
Background: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. Objective: to analyze the Work Process and QWL of assisting nurses in public health. Methods: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. Results: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. The work process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and health problems. Conclusions: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Competency and Related Factors in Preventing Emerging Infectious Diseases among Nurses in Long-Term Care Facilities in Taiwan
Healthcare 2022, 10(5), 894; https://doi.org/10.3390/healthcare10050894 - 12 May 2022
Abstract
Emerging infectious diseases (EIDs) are a considerable threat to health, particularly in long-term care facilities (LTCFs), where residents are especially vulnerable. Nurses’ competency in EID prevention is crucial to minimize the adverse effects of EIDs in LTCFs. This study investigated nurses’ competency and [...] Read more.
Emerging infectious diseases (EIDs) are a considerable threat to health, particularly in long-term care facilities (LTCFs), where residents are especially vulnerable. Nurses’ competency in EID prevention is crucial to minimize the adverse effects of EIDs in LTCFs. This study investigated nurses’ competency and related factors in EID prevention in LTCFs in Tainan, Taiwan. A cross-sectional design was employed, and nurses were recruited to complete an online survey examining the knowledge, attitude, and skills required to prevent EIDs in LTCFs. A total of 235 nurses completed the survey. The equivalent score index (SI) for knowledge regarding EID prevention was 68, indicating that the nurses did not have adequate knowledge regarding EID prevention. In contrast, the equivalent SI for the subscale of attitudes toward EID prevention was 78, indicating that the nurses exhibited moderately to highly positive attitudes toward EID prevention. However, they rated themselves as being highly skilled in EID prevention, corresponding to an equivalent SI of 91. Perceived supervisors’ approval, marital status, attitudes toward EID prevention, EID prevention skills, knowledge regarding EIDs, and being in charge of infectious disease prevention were significant predictors of the nurses’ competency. LTCF nurses, especially those working in nursing homes, should enhance their knowledge regarding EID prevention. These findings may help improve nurses’ competency in preventing EIDs by encouraging the integration of practice strategies, education, research, and policy recommendations to eliminate EIDs in LTCFs. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
The Relationship between Korean Parents’ Smartphone Addiction and That of Their Children: The Mediating Effects of Children’s Depression and Social Withdrawal
Int. J. Environ. Res. Public Health 2022, 19(9), 5593; https://doi.org/10.3390/ijerph19095593 - 05 May 2022
Abstract
With the number of smartphone users growing around the world, children are using smartphones from an increasingly early age. Consequently, a significant number of children are being exposed to the risk of smartphone addiction, which is emerging as a serious social problem. Smartphone [...] Read more.
With the number of smartphone users growing around the world, children are using smartphones from an increasingly early age. Consequently, a significant number of children are being exposed to the risk of smartphone addiction, which is emerging as a serious social problem. Smartphone addiction can negatively impact children’s physical, cognitive, and social development. Previous studies have demonstrated that parental smartphone addiction influences that of their children. Therefore, this study explores the relationship between parental smartphone addiction and children’s smartphone addiction and the mediating effects of children’s depression and social withdrawal. Data are drawn from National Youth Policy Institute’s 2018 Korean Children and Youth Panel Survey. Respondents comprise 2011 fourth-grade elementary school students and their parents. Data were analyzed using SPSS version 21.0 and AMOS 21.0 software. Results show that the relationship between parental smartphone addiction and that of their children has a significantly positive mediating effect on children’s social withdrawal, but no such effect on children’s depression and there were no serial effects of children’s depression and social withdrawal. Consequently, educational programs that control parents’ smartphone usage, improve the parent–child relationship, and engender social sensitivity should be developed to reduce and prevent smartphone addiction among children. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Satisfaction with the Care Received and the Childbirth and Puerperium Experience in Christian and Muslim Pregnant Women
Healthcare 2022, 10(4), 725; https://doi.org/10.3390/healthcare10040725 - 13 Apr 2022
Abstract
Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth [...] Read more.
Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth assistance an extremely important priority in recent years. The aim of this study was to assess the satisfaction and experience during childbirth and the postpartum period in pregnant women according to their religion after assistance in a tertiary hospital. A descriptive cross-sectional study was conducted on a sample of 242 women using the validated Spanish version of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) to measure satisfaction with the childbirth experience during the months of January to April 2021. Statistically significant differences were found in the domains of birth satisfaction (p < 0.01), satisfaction with the obstetrician (p < 0.01), and perception of pain during labour (p < 0.01). The Christian group of women scored higher in these three domains as compared to the Muslim group. The rate of breastfeeding at birth was 5.26 times higher among the Muslim group compared to the Christian group (p = 0.02). The experience of childbirth and the puerperium significantly influenced the levels of satisfaction of pregnant women with the process of childbirth in a different way according to the religious culture of the patient. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Development of the Psychological Capital Scale for Male Nursing Students in Taiwan and Testing Its Measurement Invariance between Genders
Int. J. Environ. Res. Public Health 2022, 19(6), 3620; https://doi.org/10.3390/ijerph19063620 - 18 Mar 2022
Cited by 1
Abstract
The aims of this study were to develop a psychological capital (PsyCap) scale for male nursing students and to compare the scores with those of female nursing students. Few past studies have focused on male nursing students to understand their PsyCap relative to [...] Read more.
The aims of this study were to develop a psychological capital (PsyCap) scale for male nursing students and to compare the scores with those of female nursing students. Few past studies have focused on male nursing students to understand their PsyCap relative to female nursing students. We recruited 384 male nursing students in Taiwan to construct the PsyCap Scale with 16 items and four factors based on the relevant literature: hope, optimism, resiliency, and self-efficacy. The scale showed good model fit in confirmatory factor analysis with factor loadings from 0.62 to 0.78. Cronbach’s alpha coefficients ranged from 0.75 to 0.83 for the four subscales and 0.91 for the total scale. We also conducted measurement invariance tests with data from 402 female nursing student volunteers in Taiwan. The invariance of factor loadings and intercepts of the established scale (i.e., with the same unit and origin between genders) indicated that the male nursing students had higher PsyCap in optimism and resiliency than the females. We developed a 16-item-scale to make administration rapid and convenient and applied advanced statistical methods for reliable and valid comparisons between sexes. The results may help the government to create education programmes or policies supporting male nursing students. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Political Populism, Institutional Distrust and Vaccination Uptake: A Mediation Analysis
Int. J. Environ. Res. Public Health 2022, 19(6), 3265; https://doi.org/10.3390/ijerph19063265 - 10 Mar 2022
Abstract
Politics is ubiquitous in public health, but vaccines had never been weaponized to instill distrust to gain political advantage. In pandemic and post-pandemic scenarios, populist political parties could use vaccine-related issues to generate distrust in evidence-based knowledge. Therefore, some questions arise. What impact [...] Read more.
Politics is ubiquitous in public health, but vaccines had never been weaponized to instill distrust to gain political advantage. In pandemic and post-pandemic scenarios, populist political parties could use vaccine-related issues to generate distrust in evidence-based knowledge. Therefore, some questions arise. What impact could populist political parties impinge on vaccination uptake rates through sowing political discontent? What could the medical institutions do to avoid the adverse effects that these political strategies could infringe? For answering these research questions, we first hypothesized that vaccine uptake was negatively associated with distrust in the institutions. Furthermore, we analyzed whether populism mediates this relationship. In doing so, we hypothesized a positive association between distrust and populism, because populists, mainly fueled by politically discontent citizens, offer hope of a better future, blaming their misfortune on the actions of the elite. Additionally, we hypothesized that those citizens with a higher level of political dissatisfaction, following the claims of the populist political parties, will have lower vaccine uptake results, because they will be discouraged from making the efforts to counter the pandemic. Based on a survey carried out by the European Commission that covered 27 E.U. + U.K. countries (totaling 27,524 respondents), this paper proves that an individual’s political discontent fully mediates the relationship between distrust in institutions and vaccine uptake. Targeting the vaccine-hesitant population is quite convenient for populists because they only need to convince a minority of citizens not to be vaccinated to achieve their destabilizing goals. New outbreaks will appear if the minimum herd immunity coverage is not reached, reinforcing a vicious circle of distrust in elites, in consequence. For tackling this matter, recommendations are given to institutional managers from a social marketing standpoint. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
The Spirit of Adventure: A Driver of Attractiveness of the Hospitality Industry for Young People during a Pandemic Crisis
Int. J. Environ. Res. Public Health 2022, 19(4), 1913; https://doi.org/10.3390/ijerph19041913 - 09 Feb 2022
Abstract
The COVID-19 pandemic has strongly affected tourism and leisure activities worldwide, especially in the hospitality and tourism sectors. Within this context, this study aimed to evaluate the impact of the pandemic on the future attractiveness of the hospitality industry (HI) to young people. [...] Read more.
The COVID-19 pandemic has strongly affected tourism and leisure activities worldwide, especially in the hospitality and tourism sectors. Within this context, this study aimed to evaluate the impact of the pandemic on the future attractiveness of the hospitality industry (HI) to young people. The conceptual model underpinning the empirical research proposes a direct relationship between job attractiveness and the spirit of youth adventure. Findings prove that young people are enthusiastic about working in the HI because they can easily practice their creative ideas. Communicating with other people and dealing with clients’ complaints is challenging for them in the pandemic crisis created by COVID-19. The results are of interest to policymakers in terms of suggestions on how to transform the challenges into opportunities by using the constraints imposed by the pandemic crisis that have limited the socialisation between people, enhancing the creativity of young people, and motivating them to work in the HI. Moreover, our research provides managers and other decisionmakers with some motivational factors to increase the attractiveness of their companies to young people and suggestions helpful to scholars involved in HI research to cultivate resilience capabilities by giving them inherent skills. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Comparison of Metabolites and Gut Microbes between Patients with Parkinson’s Disease and Healthy Individuals—A Pilot Clinical Observational Study (STROBE Compliant)
Healthcare 2022, 10(2), 302; https://doi.org/10.3390/healthcare10020302 - 04 Feb 2022
Abstract
Introduction: Even if levodopa, dopamine agonists, and others are used for patients with Parkinson’s disease, the effect is not sustained, and side effects such as motor fluctuation and dyskinesia are more likely to appear as the dose increases. Thus, new approaches for managing [...] Read more.
Introduction: Even if levodopa, dopamine agonists, and others are used for patients with Parkinson’s disease, the effect is not sustained, and side effects such as motor fluctuation and dyskinesia are more likely to appear as the dose increases. Thus, new approaches for managing Parkinson’s disease are needed. This study aimed to compare the metabolites and gut microbes between patients with Parkinson’s disease and healthy individuals. Methods: This was an observational study with a case-control design. Metabolite and gut microbial analyses were performed using blood and stool samples collected from the subjects. Results: Among the metabolites, the acetate, citrate, methionine, and trimethylamine levels were significantly different between the two groups. In the gut microbes, abundance of Bacteroidetes, Prevotella, Phascolarctobacterium, Pseudoflavonifractor, Eisenbergiella, and Gemella were also significantly different between the two groups. Discussion: Metabolites are the products of gut microbes. Therefore, when the gut microbes change, the metabolites change accordingly. Metabolites and gut microbes that were significantly different between the two groups were mostly those involved in lipid and glucose metabolism. Our data may be helpful for the development of new drugs targeting metabolites and gut microbes through large-scale studies in the future. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Adolescents’ Sexual and Reproductive Healthcare-Seeking Behaviour and Service Utilisation in Plateau State, Nigeria
Healthcare 2022, 10(2), 301; https://doi.org/10.3390/healthcare10020301 - 04 Feb 2022
Abstract
The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services [...] Read more.
The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one-third of the participating adolescents were currently sexually active, slightly more than three-quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non-use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01–0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50–6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Incidence and Sociodemographic Correlates of Psychological Health Problems among Residents of the West Pomeranian Voivodeship during the COVID-19 Outbreak
Medicina 2022, 58(2), 196; https://doi.org/10.3390/medicina58020196 - 27 Jan 2022
Cited by 1
Abstract
Background and Objectives: Psychological health problems have become an important topic of consideration for many scientists, because the epidemiology of these disorders is strongly influenced by stressful events such as the SARS-CoV-2 coronavirus pandemic. The aim of this study was to evaluate [...] Read more.
Background and Objectives: Psychological health problems have become an important topic of consideration for many scientists, because the epidemiology of these disorders is strongly influenced by stressful events such as the SARS-CoV-2 coronavirus pandemic. The aim of this study was to evaluate selected parameters of psychosocial functioning as well as socio-demographic correlates of depression, anxiety, sleep disorders and perceived stress among the residents of the West Pomeranian Voivodeship. Materials and Methods: An online questionnaire was completed by 323 participants, in whom the parameters of psychosocial functioning were assessed (symptoms of depression, anxiety, severity of sleep disorders and perceived stress). Results: The majority of the respondents (75.2%) scored high on the Perceived Stress Scale, and almost half of the respondents (47.1%) had sleep disorders. A total of 26% of the participants had no depressive symptoms. Age was significantly correlated with the severity of depressive symptoms and sleep disorders. There was a strong correlation between the severity of depression and anxiety (r = 0.76; p < 0.0001), a moderate correlation between depression and perceived stress (r = 0.47; p < 0.0001) and a strong correlation between depression and sleep disorders (r = 0.651; p < 0.0001). Conclusions: Age contributed to the severity of depressive symptoms and the occurrence of sleep disorders among the residents of the West Pomeranian Voivodeship during the SARS-CoV-2 pandemic. Some residents of the West Pomeranian Voivodeship showed moderate to severe depressive and anxiety symptoms, as well as high levels of stress and insomnia. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Factors Affecting Delayed Hospital Arrival of Patients with Acute Myocardial Infarction in Kinmen
Int. J. Environ. Res. Public Health 2022, 19(3), 1323; https://doi.org/10.3390/ijerph19031323 - 25 Jan 2022
Abstract
This study explores factors related to delayed emergency medical treatment for acute myocardial infarction patients on Kinmen Island. A cross-sectional study was performed in the only hospital in Kinmen Island. The study group consisted of 116 patients diagnosed with acute myocardial infarction (AMI, [...] Read more.
This study explores factors related to delayed emergency medical treatment for acute myocardial infarction patients on Kinmen Island. A cross-sectional study was performed in the only hospital in Kinmen Island. The study group consisted of 116 patients diagnosed with acute myocardial infarction (AMI, ICD-10 codes: I21.9) from November 2015 to May 2019. The binary logistic regression analyses were performed for the inferential statistical analysis. The mean age of the study group was 63.0 ± 14.5 years, 39.7% of the patients arrived at the emergency medicine longer than 6 h after the onset of symptoms. The related factors for delayed arrival the hospital emergency medicine department were female sex, age over 65 years, less than nine years’ education, and Killip Class, but only Killip Class reached the significant difference of statistics (OR = 3.616, 95% C.I. = 1.574 to 8.310, p = 0.002), and patients with delayed arrival times (>6 h) were found to have a higher percentage of Killip Class ≥ II. Therefore, it is essential to remind the physicians to proceed with risk stratification for acute coronary syndrome patients. In addition, health authorities should provide effective programs to increase awareness of the symptoms and timely treatment of acute myocardial infraction to the general public, especially the elderly. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Protocol
Construction of Progress Prediction Model of Urinary Incontinence in Elderly Women: Protocol for a Multi-Center, Prospective Cohort Study
Int. J. Environ. Res. Public Health 2022, 19(2), 734; https://doi.org/10.3390/ijerph19020734 - 10 Jan 2022
Cited by 1
Abstract
Background: Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to [...] Read more.
Background: Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to establish an effective UI progress prediction model for elderly women with UI for earlier detection and better treatment. Methods: This study is conducted as a prospective, multi-center, cohort study, and recruits 800 women aged ≥60 with mild or moderate UI in China. Participants are divided into three groups: stress urinary incontinence group (SUI), urgency urinary incontinence group (UUI), and mixed urinary incontinence group (MUI). This study will investigate the general conditions of patients, after complete relevant pelvic floor function assessment, as well as after follow up at 6 months, 12 months, and 18 months by telephone. The primary endpoint is UI disease progress. Single factor and multi-factor Cox regression model analyses are undertaken to evaluate the associated risk factors affecting the progress of UI to establish a progress prediction model for elderly women. Discussion: This study will provide more predictive information for elderly women with UI, and new clinical references for the intervention and the treatment of UI for medical staff. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Effect of Home-Based Tele-Pilates Intervention on Pregnant Women: A Pilot Study
Healthcare 2022, 10(1), 125; https://doi.org/10.3390/healthcare10010125 - 08 Jan 2022
Abstract
Pilates is effective for training the core muscles and stabilizing the hip joints, which provides relief from pelvic pain and low back pain during pregnancy. However, there are no specific guidelines on appropriate physical exercises for pregnant women due to the current pandemic. [...] Read more.
Pilates is effective for training the core muscles and stabilizing the hip joints, which provides relief from pelvic pain and low back pain during pregnancy. However, there are no specific guidelines on appropriate physical exercises for pregnant women due to the current pandemic. We aimed to apply the exercise standard proposed by the American College of Obstetricians and Gynecologists to home-based tele-Pilates exercise (HTPE), to determine its effect on the physical and mental health of pregnant women. We randomly divided the subjects into the following two groups who completed 8 weeks of HTPE (50 min/day, 2 days/week): (a) Pilates exercise (PE, n = 7) and (B) non-Pilates exercise (CON, n = 7). HTPE was performed by adjusting the program every 3 weeks, based on pain and physical fitness levels. We measured body composition, muscles of the hip joint, pelvic tilt, Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI), before and after HTPE. Following HTPE, while the percentage of body fat and body mass index had significantly decreased, the body fat mass did not change in the PE group (p < 0.05). The PE group showed an increase in strength of the left and right hip flexion and hip abduction, compared to the CON group (p < 0.01). The ODI and PSQI were significantly decreased in the PE group (p < 0.05). Therefore, the 8-week HTPE program is an effective exercise for pregnant woman that reduces body fat metabolism and strengthens muscles of the hip joint, thus alleviating pregnancy-induced low back pain and insomnia. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Risk of Glaucoma Associated with Components of Metabolic Disease in Taiwan: A Nationwide Population-Based Study
Int. J. Environ. Res. Public Health 2022, 19(1), 305; https://doi.org/10.3390/ijerph19010305 - 28 Dec 2021
Abstract
Purpose: This retrospective cohort study was conducted to determine the glaucoma risk associated with metabolic disease (MetD) using insurance claims data of Taiwan. Methods: From the database, we identified patients with newly diagnosed hypertension, diabetes and/or hyperlipidemia from the years 2000 to 2002 [...] Read more.
Purpose: This retrospective cohort study was conducted to determine the glaucoma risk associated with metabolic disease (MetD) using insurance claims data of Taiwan. Methods: From the database, we identified patients with newly diagnosed hypertension, diabetes and/or hyperlipidemia from the years 2000 to 2002 as the MetD cohort (N = 42,036) and an age-gender-diagnosis-date matched control cohort without MetD with a two-fold sample size than that of the MetD cohort. Both cohorts were followed until the development of glaucoma, death, or withdrawal, until 31 December 2013. The incidence of glaucoma, and the Cox method estimated hazard ratio (HR) of glaucoma were calculated. Results showed that the incidence of glaucoma was two-fold higher in the MetD cohort than in the controls (1.99 versus 0.99 per 1000 person-years), with an adjusted HR of 1.66 (95% CI: 1.50–1.85). The glaucoma incidence was higher in patients with diabetes than those with hypertension and hyperlipidemia (2.38 versus 1.95 and 1.72 per 1000 person-years, respectively). The incidence increased to 5.67 per 1000 person-years in patients with all three comorbidities, with an aHR of 4.95 (95% CI: 2.35–10.40). We also found higher incidence rates of primary open-angle glaucoma and primary angle-closure glaucoma with aHRs of 2.03 and 1.44, respectively. It was concluded that glaucoma risk increased with the number of MetD. Health providers need to monitor patients with MetD to prevent glaucoma. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Increased Anxiety and Depression Symptoms in Post-Acute Care Patients with Stroke during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2022, 19(1), 162; https://doi.org/10.3390/ijerph19010162 - 24 Dec 2021
Abstract
This study aimed to explore the quality and stability of post-acute care for patients with stroke, including their functional outcomes, mental health and medical care in Taiwan during the COVID-19 pandemic. In this retrospective case–control study—based on propensity score matching—we assessed 11 patients [...] Read more.
This study aimed to explore the quality and stability of post-acute care for patients with stroke, including their functional outcomes, mental health and medical care in Taiwan during the COVID-19 pandemic. In this retrospective case–control study—based on propensity score matching—we assessed 11 patients admitted during the pandemic period (in 2021) and 11 patients admitted during the non-pandemic period (in 2020). Functional outcomes, including the scores of the modified Rankin Scale, Barthel Index, EuroQoL-5 Dimension, Lawton–Brody instrumental activities of daily living, Berg Balance Scale, 5-metre walking speed and 6-min walking distance, were determined. Data on the length of acute care, length of post-acute care, destination after discharge and 14-days readmission were used to evaluate the quality of medical care. The Wilcoxon signed-rank test was used to compare functional performance before and after rehabilitation. The pandemic group showed no significant improvement in the scores of EuroQoL-5 Dimension, a self-reported health status assessment (p = 0.13), with the anxiety or depression dimension showing a negative effect (r = 0.21). Post-acute care programmes can efficiently improve the functional performance of patients with stroke during the COVID-19 pandemic in Taiwan. Mental health should therefore be simultaneously maintained while rehabilitating physical function. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Cervical Cancer Mortality in Romania: Trends, Regional and Rural–Urban Inequalities, and Policy Implications
Medicina 2022, 58(1), 18; https://doi.org/10.3390/medicina58010018 - 23 Dec 2021
Abstract
Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by [...] Read more.
Background and Objectives: Despite being largely preventable, cervical cancer mortality still remains an important public health problem globally, in Europe, and in Romania. The European Union member states are urged to implement systematic, population-based screenings for cervical cancer, but the programs developed by the countries remain very heterogeneous. This study aimed to investigate the differences in cervix cancer mortality between Romania and EU and within Romania over the last two decades and to reveal the major sources of inequalities and the policy implications. Materials and Methods: We analyzed the number of deaths and the mortality rates by cervical cancer, standardized using the direct method, over two decades (2001–2016 for the EU, and 2001–2019 for the national and sub-national analyses). Trends, mortality reduction over the years, and mortality differences at the beginning and end of the time interval have been calculated for the EU and Romania, at national and sub-national levels (rural–urban and regions). Results: Our results revealed differences in cervical cancer mortality between Romania and EU and within Romania (among regions and rural–urban areas). These differences used to be very high in the past and are still persisting. Conclusions: The country should revisit its national cervical cancer screening program, which has been implemented for many years, but with a very limited participation rate. Due to the similar problems existing in Central-Eastern Europe, targeted support from the EU for the members from this geographical area could contribute to the minimization of differences in cervical cancer mortality among the EU members. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Impact of Internet Use on Mental Health among Elderly Individuals: A Difference-in-Differences Study Based on 2016–2018 CFPS Data
Int. J. Environ. Res. Public Health 2022, 19(1), 101; https://doi.org/10.3390/ijerph19010101 - 23 Dec 2021
Cited by 2
Abstract
The number of elderly Internet users has increased significantly in the past few years. However, the impact of Internet use on mental health remains unclear. In this study, we performed a difference-in-differences analysis using data from the 2016 and 2018 waves of the [...] Read more.
The number of elderly Internet users has increased significantly in the past few years. However, the impact of Internet use on mental health remains unclear. In this study, we performed a difference-in-differences analysis using data from the 2016 and 2018 waves of the China Family Panel Studies (CFPS) to evaluate the impact of Internet usage on mental health among elderly individuals. A total of 5031 validated respondents were included to explore the relationship between Internet use and reduced levels of depression as well as improved life satisfaction among elderly individuals. The results showed that Internet use significantly reduced depression levels. Unexpectedly, Internet use was not found to improve life satisfaction. Moreover, discontinuing Internet use was not significantly associated with improvements in depression or life satisfaction. More research is needed to fully elucidate the relationship between Internet use and depression levels, as well as life satisfaction among elderly individuals. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Decreased Physical Activity during Pregnancy Is Associated with Excessive Gestational Weight Gain
Int. J. Environ. Res. Public Health 2021, 18(23), 12597; https://doi.org/10.3390/ijerph182312597 - 29 Nov 2021
Abstract
The majority of pregnant women in Taiwan are not considered physically active. During pregnancy, many women decrease their physical activity levels when compared to pre-pregnancy. The purpose of this study was to examine the association between decreased physical activity from pre-pregnancy to pregnancy [...] Read more.
The majority of pregnant women in Taiwan are not considered physically active. During pregnancy, many women decrease their physical activity levels when compared to pre-pregnancy. The purpose of this study was to examine the association between decreased physical activity from pre-pregnancy to pregnancy and excessive gestational weight gain (GWG). This study applied a prospective panel design. Recruitment was conducted at six medical facilities in Taiwan and lasted from August 2016 to April 2017. Physical activity levels were determined both before and during pregnancy using the International Physical Activity Questionnaire—Short Form, with data subsequently being transformed into METs-min/week. Excessive GWG was determined based on the body mass index (BMI) specific GWG range. We recruited 747 pregnant women in their second trimester and followed them through to one-month postpartum. About 40% of participants (41.2%) exhibited excessive GWG. Physical activity decreased from an average of 2261 (SD = 3999) to 1252 (SD = 2258) METs-min/week from pre-pregnancy to pregnancy (p < 0.0001). Controlling for age and pre-pregnancy BMI, a logistic regression model revealed that a decline in physical activity of > 4000 METs-min/week from pre-pregnancy to pregnancy was associated with an increased risk for excessive GWG (OR = 2.83, 95% CI: 1.27–4.43). A substantial decrease in physical activity from pre-pregnancy to pregnancy was a risk factor for excessive GWG. Although most women decreased their physical activity during pregnancy, only those pregnant women who were physically active pre-pregnancy could show the kind of large decrease that resulted in excessive GWG. Health professionals should continue to develop strategies for counteracting the problematic trend of decreasing PA during pregnancy among low-risk pregnant women. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Article
Scientometric Analysis of Global Scientific Literature on Aging in Place
Int. J. Environ. Res. Public Health 2021, 18(23), 12468; https://doi.org/10.3390/ijerph182312468 - 26 Nov 2021
Cited by 1
Abstract
The amount of literature reporting “aging-in-place” studies has increased sharply in recent decades. However, the studies have taken a global view of the range and scope of the research that has taken place. This study presents a bibliometric analysis of the current status [...] Read more.
The amount of literature reporting “aging-in-place” studies has increased sharply in recent decades. However, the studies have taken a global view of the range and scope of the research that has taken place. This study presents a bibliometric analysis of the current status of the aging in place research themes published as scientific articles between 1970 and 2021, using the Web of Science database. VOSviewer software was employed to map and visualize the 1331 items of bibliographic data retrieved. The findings reveal a continuous growing trend in the publication of aging in place research. Most productive institutions derive from the USA. The International Journal of Environmental Research and Public Health is the most preferred Journal. The most popular research hotspots or areas include; older adults, aging, housing, dementia, long-term care, and technology, and their associations with the field of “aging in place” field were elucidated. This study offers several valuable insights to scholars, research institutions, and policymakers, enabling a better understanding of the developments in the aging in place research domain. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Can the School Fruit and Vegetable Scheme Be an Effective Strategy Leading to Positive Changes in Children’s Eating Behaviours? Polish Evaluation Results
Int. J. Environ. Res. Public Health 2021, 18(23), 12331; https://doi.org/10.3390/ijerph182312331 - 24 Nov 2021
Abstract
Background: The School Fruit and Vegetable Scheme (SFVS) was developed to form the habit of eating fruit and vegetables (F&V) among children. The survey aimed to identify both the strengths of the scheme and areas that required support and strengthening in the further [...] Read more.
Background: The School Fruit and Vegetable Scheme (SFVS) was developed to form the habit of eating fruit and vegetables (F&V) among children. The survey aimed to identify both the strengths of the scheme and areas that required support and strengthening in the further implementation of school schemes. Methods: The study was conducted from 2012 to 2015 among students of randomly selected 85 primary schools that participated in the programme (intervention group) or did not participate therein (control group). The F&V consumption among the students was evaluated based on the 3 day food record method. Other behaviours were evaluated via frequency and preference questionnaires. Results: Over the three years of implementing SFVS, fruit consumption significantly increased by approximately 30 g/day, i.e., by 18%. In the control group, it increased only by approximately 4%. At the same time, no increase in vegetable consumption was observed. A number of other positive effects of SFVS were also found. These concerned students’ nutritional attitudes and behaviours, such as a further increase in the children’s knowledge on the health aspects of F&V consumption, the levels of their consumption and an increased preference for fruit in general. Conclusions: The results indicate that providing F&V in schools free of charge can be an effective strategy for enhancing F&V consumption among children, in particular by raising the awareness of the health importance of F&V consumption and gradually influencing children’s eating habits, especially when it comes to the habit of fruit consumption. The issue of vegetable consumption is an area for intervention enhancement. There is also a need for further, in-depth analyses, taking into account the impact of potential confounding factors. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Review
Oral Health Status among Migrants from Middle- and Low-Income Countries to Europe: A Systematic Review
Int. J. Environ. Res. Public Health 2021, 18(22), 12203; https://doi.org/10.3390/ijerph182212203 - 20 Nov 2021
Abstract
Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. [...] Read more.
Introduction. Economic inequality, political instability and globalization have contributed to the constant growth of the migration phenomenon in recent years. In particular, a total of 4.2 million people migrated to Europe during 2019 and most of them settled in Germany, France and Italy. Objectives. The objective of this study was to conduct a systematic review of studies analyzing the oral health condition among migrants from middle- and low-income countries to Europe and assessing the eventual association between their sociodemographic and socioeconomic characteristics and oral health status. Materials and Methods. A systematic review was conducted in PubMed, Cochrane Library, Scopus and Science Direct databases. After titles, abstracts and full-text examination, only 27 articles were selected on the basis of inclusion criteria and consequently included for quality assessments and data extraction. Results. Most of the studies reported a higher prevalence of caries experience, a poorer periodontal health and more difficulties in accessing dentalcare services among migrant groups compared with the non-migrant population. Inequalities were mostly associated with ethnic background, economic condition and social grade. Conclusion. Our review demonstrates the lack of dental health among migrants, underlining that their cultural beliefs and their social and economic living conditions could influence their oral health. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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Article
Evaluation of Stress Levels of Trainee Cardiac Surgery Residents during Training Interventions Using Physiological Stress Parameters
Int. J. Environ. Res. Public Health 2021, 18(22), 11953; https://doi.org/10.3390/ijerph182211953 - 14 Nov 2021
Cited by 1
Abstract
Background: This study analysed the psychological and psycho-emotional stress in cardiac surgery. Using heart rate variability (HRV) analysis, it is possible to record intraoperative objective stress responses in surgeons. The aim of the study was to assess with the help of HRV parameters [...] Read more.
Background: This study analysed the psychological and psycho-emotional stress in cardiac surgery. Using heart rate variability (HRV) analysis, it is possible to record intraoperative objective stress responses in surgeons. The aim of the study was to assess with the help of HRV parameters the postulated increased stress levels of cardiac surgeons in training compared to experienced senior cardiothoracic surgeons in exactly the same work situation in order to make qualification-differentiated statements about physiological stress during surgical interventions. Methods: During surgical teaching procedures, long-term ECG data (n = 15 each) for two operating residents and their assisting senior physicians were recorded. Time and frequency domain HRV parameters were analysed. Results: The time-related parasympathetic-dominated HRV parameters RMSSD (19.5 ms vs. 28.1 ms), NN50 (297.67 vs. 693.40), and cardiac interval mean RR (692.8 ms vs. 737.3 ms) indicate a higher stress level in the operating residents compared to the experienced surgeons. The higher stress index (11.61 vs. 8.86) confirms this. Conclusion: Compared to experienced surgeons, operating residents showed lower parasympathetic activity and higher stress levels during cardiac surgery training procedures. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
Review
European Educational Programmes in Health Emergency and Disaster Management: An Integrative Review
Int. J. Environ. Res. Public Health 2021, 18(21), 11455; https://doi.org/10.3390/ijerph182111455 - 30 Oct 2021
Abstract
There is a need for trained health professionals who can swiftly respond to disasters occurring worldwide. Little is known about whether the currently available programmes in disaster management are in line with the recommendations of expert researchers. Our objective was to qualitatively review [...] Read more.
There is a need for trained health professionals who can swiftly respond to disasters occurring worldwide. Little is known about whether the currently available programmes in disaster management are in line with the recommendations of expert researchers. Our objective was to qualitatively review the characteristics of European educational programmes in health emergency and disaster management and to provide guidance to help improve their curricula. We carried out an integrative review to extract the main characteristics of the 2020/21 programmes available. We identified 34 programmes, the majority located in Spain, the UK or France. The primary qualification types awarded were master’s degrees, half of them lasting one year, and the most common teaching method was in person. Almost all of the programmes used a virtual university classroom, a third offered multidisciplinary disaster management content and teachers, and half of them employed situational simulations. The quality of European educational programmes in health emergency and disaster management has improved, especially in terms of using more practical and interactive teaching methodologies and in the inclusion of relevant topics such as communication, psychological approaches and evaluation of the interventions. However, generally, the educational programmes in disaster management have not yet incorporated the skills related to the intercultural and interprofessional awareness aspects. Full article
(This article belongs to the Topic Impacts of the Globalization of Healthcare)
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