Subjects -> HEALTH AND SAFETY (Total: 1478 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (87 journals)
    - HEALTH AND SAFETY (700 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (358 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (112 journals)
    - PHYSICAL FITNESS AND HYGIENE (117 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (700 journals)            First | 1 2 3 4     

Showing 201 - 203 of 203 Journals sorted alphabetically
Health Policy OPEN     Open Access  
Health Promotion International     Hybrid Journal   (Followers: 23)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 7)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access  
Health Psychology     Full-text available via subscription   (Followers: 59)
Health Psychology Bulletin     Open Access   (Followers: 1)
Health Psychology Research     Open Access   (Followers: 21)
Health Psychology Review     Hybrid Journal   (Followers: 46)
Health Research Policy and Systems     Open Access   (Followers: 15)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access   (Followers: 1)
Health Sciences and Disease     Open Access   (Followers: 1)
Health Security     Hybrid Journal   (Followers: 1)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 6)
Health Systems & Reform     Open Access   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 13)
Health, Risk & Society     Hybrid Journal   (Followers: 11)
Health, Safety and Environment     Open Access   (Followers: 34)
Healthcare     Open Access   (Followers: 2)
Healthcare Quarterly     Full-text available via subscription   (Followers: 9)
Healthcare Technology Letters     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription   (Followers: 1)
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
Histoire, médecine et santé     Open Access   (Followers: 1)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 3)
Horizonte Medico     Open Access  
Horizonte Sanitario     Open Access  
Hua Hin Sook Jai Klai Kangwon Journal     Open Access  
Human Nutrition & Metabolism     Open Access   (Followers: 1)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 5)
IISE Transactions on Occupational Ergonomics and Human Factors     Hybrid Journal  
IJS Global Health     Open Access  
Implementation Science     Open Access   (Followers: 22)
Implementation Science Communications     Open Access   (Followers: 4)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 2)
Indian Journal of Youth and Adolescent Health     Open Access  
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Public Health     Open Access  
Infodir : Revista de Información científica para la Dirección en Salud     Open Access  
interactive Journal of Medical Research     Open Access  
International Archives of Health Sciences     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Health Trends and Perspectives     Open Access  
International Journal for Equity in Health     Open Access   (Followers: 10)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 39)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 1)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 8)
International Journal of Child Development and Mental Health     Open Access   (Followers: 2)
International Journal of Circumpolar Health     Open Access   (Followers: 2)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 3)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 22)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 20)
International Journal of Growth and Development     Open Access   (Followers: 1)
International Journal of Health & Allied Sciences     Open Access   (Followers: 3)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 13)
International Journal of Health Economics and Management     Hybrid Journal   (Followers: 10)
International Journal of Health Geographics     Open Access   (Followers: 7)
International Journal of Health Policy and Management     Open Access   (Followers: 11)
International Journal of Health Professions     Open Access   (Followers: 3)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 11)
International Journal of Health Research     Open Access   (Followers: 4)
International Journal of Health Sciences     Open Access  
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 7)
International Journal of Health System and Disaster Management     Open Access   (Followers: 4)
International Journal of Healthcare     Open Access  
International Journal of Healthcare Delivery Reform Initiatives     Full-text available via subscription   (Followers: 1)
International Journal of Healthcare Information Systems and Informatics     Hybrid Journal   (Followers: 6)
International Journal of Healthcare Management     Hybrid Journal   (Followers: 14)
International Journal of Healthcare Policy     Hybrid Journal   (Followers: 1)
International Journal of Hygiene and Environmental Health     Hybrid Journal   (Followers: 7)
International Journal of Indigenous Health     Open Access   (Followers: 5)
International Journal of Kinesiology in Higher Education     Hybrid Journal  
International Journal of MCH and AIDS     Open Access  
International Journal of Medicine and Health Development     Open Access   (Followers: 4)
International Journal of Mens Social and Community Health     Open Access  
International Journal of Mental Health     Full-text available via subscription   (Followers: 24)
International Journal of Practice-based Learning in Health and Social Care     Open Access   (Followers: 1)
International Journal of Prevention and Treatment     Open Access   (Followers: 1)
International Journal of Public Health Research and Management     Hybrid Journal   (Followers: 5)
International Journal of Public Health Science     Open Access   (Followers: 6)
International Journal of Scientific Reports     Open Access   (Followers: 3)
International Journal of Sexual Health     Hybrid Journal   (Followers: 3)
International Journal of Social Welfare     Hybrid Journal   (Followers: 18)
International Journal of Spa and Wellness     Hybrid Journal  
International Journal of Telerehabilitation     Open Access   (Followers: 1)
International Journal of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
International Research in Children's Literature     Hybrid Journal   (Followers: 4)
Internationale Revue Fur Soziale Sicherheit     Hybrid Journal   (Followers: 1)
InterScientia     Open Access  
Investigaciones Andina     Open Access  
Iranian Journal of Health and Environment     Open Access  
Iranian Journal of Public Health     Open Access  
Israel Journal of Health Policy Research     Open Access  
İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi     Open Access  
JAMA Health Forum     Open Access  
JBI Evidence Implementation     Full-text available via subscription   (Followers: 4)
JBI Evidence Synthesis     Hybrid Journal   (Followers: 5)
Jeugd en Co     Hybrid Journal  
JGZ Tijdschrift voor jeugdgezondheidszorg     Hybrid Journal   (Followers: 2)
JMIR Human Factors     Open Access   (Followers: 4)
JMIR Public Health and Surveillance     Open Access  
JMIR Serious Games     Open Access   (Followers: 8)
Jornal Brasileiro de TeleSSaúde     Open Access  
Jornal de Ciências da Saúde do Hospital Universitário da Universidade Federal do Piauí     Open Access   (Followers: 3)
Journal Health NPEPS     Open Access  
Journal of Advances in Environmental Health Research     Open Access   (Followers: 2)
Journal Of Allied Health     Full-text available via subscription   (Followers: 7)
Journal of Behavior, Health & Social Issues     Open Access   (Followers: 8)
Journal of Behavioral Addictions     Open Access   (Followers: 5)
Journal of Behavioral Health Services & Research     Hybrid Journal   (Followers: 15)
Journal of Biology, Agriculture and Healthcare     Open Access   (Followers: 2)
Journal of Charoenkrung Pracharak Hospital     Open Access  
Journal of Child Sexual Abuse     Hybrid Journal   (Followers: 61)
Journal of Communication in Healthcare     Hybrid Journal   (Followers: 3)
Journal of Community Health     Hybrid Journal   (Followers: 9)
Journal of Community Medicine and Primary Health Care     Open Access   (Followers: 4)
Journal of Consumer Health on the Internet     Hybrid Journal   (Followers: 4)
Journal of Creativity in Mental Health     Hybrid Journal   (Followers: 13)
Journal of Developing Areas     Full-text available via subscription   (Followers: 5)
Journal of Development Effectiveness     Hybrid Journal   (Followers: 5)
Journal of Dr. NTR University of Health Sciences     Open Access  
Journal of Earth, Environment and Health Sciences     Open Access   (Followers: 2)
Journal of Eating Disorders     Open Access   (Followers: 14)
Journal of Education and Health Promotion     Open Access   (Followers: 4)
Journal of Environment Pollution and Human Health     Open Access   (Followers: 3)
Journal of Epidemiology & Community Health     Hybrid Journal   (Followers: 64)
Journal of Epidemiology and Public Health     Open Access   (Followers: 4)
Journal of Ergonomics     Open Access   (Followers: 8)
Journal of Evolution and Health : An Ancestral Health Society Publication     Open Access  
Journal of Exercise & Organ Cross Talk     Open Access   (Followers: 4)
Journal of Exercise Science & Fitness     Open Access   (Followers: 24)
Journal of Family & Consumer Sciences     Full-text available via subscription  
Journal of Family Medicine and Primary Care     Open Access   (Followers: 11)
Journal of Family Social Work     Hybrid Journal   (Followers: 12)
Journal of Family Strengths     Open Access   (Followers: 3)
Journal of Fasting and Health     Open Access   (Followers: 1)
Journal of Global Health     Open Access   (Followers: 2)
Journal of Health and Social Behavior     Hybrid Journal   (Followers: 27)
Journal of Health Care Chaplaincy     Hybrid Journal   (Followers: 3)
Journal of Health Design     Open Access   (Followers: 1)
Journal of Health Disparities Research and Practice     Open Access   (Followers: 2)
Journal of Health Economics and Outcomes Research     Open Access   (Followers: 2)
Journal of Health Policy and Management     Open Access   (Followers: 2)
Journal of Health Promotion     Open Access   (Followers: 1)
Journal of Health Psychology     Hybrid Journal   (Followers: 57)
Journal of Health Research     Open Access  
Journal of Health Research and Reviews     Open Access  
Journal of Health Science     Open Access   (Followers: 3)
Journal of Health Science and Alternative Medicine     Open Access   (Followers: 1)
Journal of Health Science and Community Public Health     Open Access  
Journal of Health Science and Medical Research     Open Access  
Journal of Health Science and Prevention     Open Access  
Journal of Health Science Research     Open Access  
Journal of health sciences     Open Access  
Journal of Health Sciences     Open Access  
Journal of Health Sciences and Medicine     Open Access  
Journal of Health Sciences and Surveillance System     Open Access  
Journal of Health Sciences Scholarship     Open Access  
Journal of Health Service Psychology     Full-text available via subscription   (Followers: 1)
Journal of Health Services and Education     Open Access  
Journal of Health, Population and Nutrition     Open Access   (Followers: 13)
Journal of Healthcare Informatics Research     Hybrid Journal   (Followers: 2)
Journal of Healthcare Risk Management     Hybrid Journal   (Followers: 10)
Journal of Human Health     Open Access   (Followers: 1)
Journal of Human Trafficking     Open Access   (Followers: 29)
Journal of Ideas in Health     Open Access   (Followers: 1)
Journal of Immigrant and Minority Health     Hybrid Journal   (Followers: 8)
Journal of Industrial Safety Engineering     Full-text available via subscription   (Followers: 6)
Journal of Infection and Public Health     Open Access   (Followers: 4)
Journal of Integrated Care     Hybrid Journal   (Followers: 18)
Journal of Integrated Health Sciences     Open Access   (Followers: 4)
Journal of Interprofessional Education & Practice     Full-text available via subscription   (Followers: 5)
Journal of Law and Health     Open Access   (Followers: 8)
Journal of Manmohan Memorial Institute of Health Sciences     Open Access  
Journal of Medical and Health Studies     Open Access   (Followers: 2)
Journal of Mental Health Counseling     Full-text available via subscription   (Followers: 8)
Journal of Multidisciplinary Healthcare     Open Access   (Followers: 6)
Journal of Multidisciplinary Research in Healthcare     Open Access   (Followers: 2)
Journal of Muslim Mental Health     Open Access   (Followers: 6)
Journal of Nanotheranostics     Open Access  
Journal of Nursing & Interprofessional Leadership in Quality & Safety     Open Access   (Followers: 5)
Journal of Occupational Health     Open Access   (Followers: 1)
Journal of Occupational Health Psychology     Full-text available via subscription   (Followers: 39)
Journal of Occupational Science     Hybrid Journal   (Followers: 27)
Journal of Oral Health and Craniofacial Science     Open Access  
Journal of Patan Academy of Health Sciences     Open Access  
Journal of Prevention and Health Promotion     Full-text available via subscription  
Journal of Preventive Medicine and Public Health     Open Access   (Followers: 1)
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Journal of Psychosexual Health     Open Access  
Journal of Public Child Welfare     Hybrid Journal   (Followers: 8)

  First | 1 2 3 4     

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Healthcare
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2227-9032
Published by MDPI Homepage  [84 journals]
  • Healthcare, Vol. 10, Pages 1043: Positive Psychology: Supervisor
           Leadership in Organizational Citizenship Behaviors in Nurses

    • Authors: Nieves López-Ibort, Ana I. Gil-Lacruz, Luis Navarro-Elola, Ana C. Pastor-Tejedor, Jesús Pastor-Tejedor
      First page: 1043
      Abstract: Introduction: In nursing, identifying factors encouraging positive work attitudes is extremely important since a nurse’s performance directly impacts the quality of the care they provide, and, therefore, their patients’ health. Objective: The main objective of this research is to analyze whether the supervisor–nurse relationship is positively correlated with a nurse’s organizational citizenship behaviors. Thus, we established a main hypothesis as follows: the quality of the supervisor–nurse interpersonal relationship is positively related to the job satisfaction of the nurse, controlled by moderating the effects of psychological empowerment, the perceived organizational support, and leader–leader exchange. Methodology: This is a cross-sectional descriptive study with individuals as the units of analysis. The population studied comprised all the nurses and supervisors working in nine public hospitals in the autonomous community of Aragon (Spain). The sample consisted of 2541 nurses, 192 supervisors, and 2500 paired dyads. Self-report questionnaires were used to ensure workers’ anonymity. The dependent variable was the nurse’s organizational citizenship behaviors; the main independent variable was the supervisor’s leadership; the moderating variables were the nurse’s empowerment, the organizational support the nurse perceived, and the quality of the supervisor–superior relationship. Results: Empirical evidence demonstrates that the quality of the supervisor–nurse relationship is positively correlated with organizational citizenship behaviors. The results also confirm the moderating effect of nurses’ empowerment and of the organizational support they perceive. Discussion: Our research shows how important it is for organizations to establish management practices promoting high-quality nurse–supervisor relationships; thus, hospital management should monitor both the supervisors’ performance and leadership. Conclusions: The quality of the relationship the supervisor establishes with their nurses is vitally important since it is a necessary requirement for beneficial results for the organization as a result of citizenship behavior practice.
      Citation: Healthcare
      PubDate: 2022-06-03
      DOI: 10.3390/healthcare10061043
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1044: Impact of a Maternal Motivational
           Interviewing on Oral Health in the Mother-Child Dyad

    • Authors: M. Á. Ramírez-Trujillo, M. C. Villanueva-Vilchis, L. A. Gaitán-Cepeda, F. C. Aguilar-Díaz, M. E. Rojas-Russell, J. Fuente-Hernández
      First page: 1044
      Abstract: Motivational Interviewing (MI) has been included in dentistry programs. There exists a need for interventions in the mother-child dyad. The aim of this paper was to compare the effects of a MI-based educational program on oral care knowledge, attitudes, and practices (KAP) in the mother-child dyad to a Traditional Education-based program (TE). A community intervention trial was carried out. The experimental and control groups were made up of women between 18 and 45 years of age in the sixth month of gestation. Both groups were provided with TE. The experimental group additionally received a session based on the principles of the MI. Socio-demographic data, children’s oral health KAP (COHKAP), that of the mother (MOHKAP), and maternal self-efficacy (MSE) in relation to children’s oral health (COHMSE) were recorded. A baseline measurement was made, as well as a six-month follow up. The participants included 135 women with an average age of 24.88 ± 6.00. After intervention, the experimental group’s COHKAP, MOHKAP, and COHMSE all increased (p < 0.001). When MI-based interventions are combined with TE, MSE and dental care KAP for the mother-child dyad in pregnant women can be improved.
      Citation: Healthcare
      PubDate: 2022-06-03
      DOI: 10.3390/healthcare10061044
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1045: Do General Practitioners in a Visiting
           Medical Officer Arrangement Improve the Perceived Quality of Care of Rural
           and Remote Patients' A Qualitative Study in Australia

    • Authors: I Nyoman Sutarsa, Rosny Kasim, Ben Steward, Suzanne Bain-Donohue, Claudia Slimings, Sally Hall Dykgraaf, Amanda Barnard
      First page: 1045
      Abstract: Background: In rural and remote Australia, general practitioners (GPs) provide care across the continuum from primary to secondary care, often in Visiting Medical Officer (VMO) arrangements with a local hospital. However, little is known about the role of GP-VMOs in improving the perceived quality of care and health outcomes for rural and remote communities. Methods: We collected qualitative data from three GP-VMOs (all aged >55 years) and 10 patients (all aged over 65 years) in three local health districts of New South Wales, Australia. Thirteen in-depth interviews were conducted between October 2020 and February 2021. We employed thematic analysis to identify key roles of GP-VMOs in improving the perceived quality of care and health outcomes of rural and remote patients. Results: Our study advances the current understanding regarding the role of GP-VMOs in improving the perceived quality of services and health outcomes of rural and remote patients. Key roles of GP-VMOs in improving the perceived quality of care include promoting the continuity of care and integrated health services, cultivating trust from local communities, and enhancing the satisfaction of patients. Conclusions: GP-VMOs work across primary and secondary care creating better linkages and promoting the continuity of care for rural and remote communities. Employing GP-VMOs in rural hospitals enables the knowledge and sensitivity gained from their ongoing interactions with patients in primary care to be effectively utilised in the delivery of hospital care.
      Citation: Healthcare
      PubDate: 2022-06-04
      DOI: 10.3390/healthcare10061045
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1046: Evaluation of the Relationship between
           the BMI and the Sequence and Chronology of Eruption in Permanent Dentition
           in Spanish Population

    • Authors: Marta Macarena Paz-Cortés, Laura Muñoz-Cano, Montserrat Diéguez-Pérez
      First page: 1046
      Abstract: The aim was to analyze the relationship between BMI (body mass index) and the sequence and chronology of the eruption of permanent teeth in a sample of Spanish children. Methods: The study design was descriptive, cross-sectional, observational, and epidemiological. Patients of pediatric age were included. Emerged teeth, and patient’s age, race, and sex were recorded. The nutritional status of the child was assessed by calculating the BMI, according to the WHO parameters. Statistical analysis was carried out with a confidence interval of 95%. A prediction model with logistic regression models was obtained. Results: A total of 725 pediatric patients between 4 and 14 years old were analyzed. BMI acts as a predictor variable for eruption symmetry, as it was most frequent in overweight children (p < 0.001). The probability of symmetry in dental eruption increases for South American children, for an extra month of age, and each meter of height. BMI had an influence in the first tooth to appear only in the fourth quadrant. BMI did not seem to influence present teeth, and the sequence of permanent dental eruption was not influenced by the BMI category. Conclusions: Age, weight, height, and BMI act as significant predictors for eruption symmetry. BMI does not produce alterations in the eruption sequence of the permanent dentition.
      Citation: Healthcare
      PubDate: 2022-06-04
      DOI: 10.3390/healthcare10061046
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1047: The Relationship between Emotional
           Intelligence and Pain Management Awareness among Nurses

    • Authors: Marwan Rasmi Issa, Noor Awanis Muslim, Raed Hussam Alzoubi, Mu’taman Jarrar, Modhi A. Alkahtani, Mohammad Al-Bsheish, Arwa Alumran, Ammar K. Alomran
      First page: 1047
      Abstract: Pain management, a crucial part of nursing care, is considered one of the most basic patient rights. To properly treat patients’ pain, nurses need a high degree of pain management awareness (PMA). The researchers hypothesized that nurses’ pain management awareness is affected by their emotional intelligence (EI). Purpose: Because there is a dearth of studies on this topic, the purpose of this study was to describe the relationship between emotional intelligence and pain management awareness in a sample of nurses. Methods: The study employed a descriptive design with a quantitative approach to analyze data from a survey designed with the simple random sample technique. The questionnaires were completed by 330 nurses working at six governmental hospitals in Saudi Arabia. The Statistical Package for the Social Sciences (V23) and Analysis of Moment Structures (V23) were used to determine the reliability and validity of the questionnaires and analyze the causal relationships among the variables. Results: The results revealed a significant positive relationship between nurses’ emotional intelligence and their pain management awareness. Conclusions: These findings suggest that having emotional intelligence is an important nurse characteristic for effective pain management awareness and possibly the provision of pain management care. Clinical Implications: Hospital and nurse managers as well as administration should consider using the emotional intelligence variables utilized in this study to develop ways to improve pain management awareness among nurses. Such efforts may help improve hospital and patient outcomes related to pain management.
      Citation: Healthcare
      PubDate: 2022-06-04
      DOI: 10.3390/healthcare10061047
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1048: Association of Depression, Anxiety,
           Stress and Stress-Coping Strategies with Somatization and Number of
           Diseases According to Sex in the Mexican General Population

    • Authors: Aniel Jessica Leticia Brambila-Tapia, Fabiola Macías-Espinoza, Yesica Arlae Reyes-Domínguez, María Luisa Ramírez-García, Aris Judit Miranda-Lavastida, Blanca Estela Ríos-González, Ana Miriam Saldaña-Cruz, Yussef Esparza-Guerrero, Francisco Fabián Mora-Moreno, Ingrid Patricia Dávalos-Rodríguez
      First page: 1048
      Abstract: Somatization and number of diseases are interrelated variables, whose association with stress-coping strategies, according to sex, has not been investigated. Therefore, the aim of this study was to investigate such association in a sample of the Mexican general population. The general population was invited to answer an electronic questionnaire via the social networks—e-mail, WhatsApp and Facebook—by the research team. A sample of 1008 adults was obtained, of which 62.2% were women, in whom we detected higher levels of negative psychological variables, somatization and number of diseases and lower levels of sleep quality. Positive moderate correlations were found between depresion, anxiety and stress with somatization, on one hand, and with the number of diseases, on the other, and negative moderate correlations were found between sleep quality and the two dependent variables. As for the coping strategies, self-blame, behavioral disengagement, denial, self-distraction and substance use were positively correlated with somatization. Of these, self-blame, substance use, and self-distraction also showed a positive correlation with number of diseases in both sexes. Negative correlations were detected for active coping and the two dependent variables in men and for religion and planning with somatization in women. In conclusion, the coping strategies showed significant correlations with somatization and number of diseases in both sexes.
      Citation: Healthcare
      PubDate: 2022-06-05
      DOI: 10.3390/healthcare10061048
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1049: The Psychological Impact of Coronavirus
           Disease 2019 on Patients Attending a Tertiary Healthcare Facility in
           Pakistan: A Cross-Sectional Study

    • Authors: Umar Abdul Ali, Nadia Iftikhar, Hafsa Amat-ur-Rasool, Mehboob Ahmed, Javeria Hafeez, Wayne G. Carter
      First page: 1049
      Abstract: The COVID-19 pandemic has had a damaging impact on global health. Post-infection, patients may experience mental health difficulties and therefore require suitable psychological treatment and support. The objective of this study was to identify the psychological impact of COVID-19 on patients who were recovering from the physical effects of the disease, and to examine socio-demographic correlates within one month of treatment at a tertiary healthcare facility in Pakistan. A cross-sectional study was employed that utilized the Depression Anxiety Stress Scale-21 and Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5. A questionnaire was administered to 250 patients, with data collected over three months. Mild to extremely severe scores of depression, anxiety and stress were reported by approximately 43%, 52% and 42% of participants, respectively, and 8% developed PTSD. The incidence of depression, anxiety, stress or PTSD was not significantly associated with gender, age or previous interaction with COVID-19 patients. Depression was significantly associated with levels of education, severity of COVID-19 disease and a patient’s current condition. Anxiety was associated with healthcare worker status. The severity of disease and a patient’s current condition were also linked to the levels of anxiety, stress and the presence of PTSD. Collectively, these results indicate that a high percentage of patients recovering from COVID-19 experience psychological distress.
      Citation: Healthcare
      PubDate: 2022-06-05
      DOI: 10.3390/healthcare10061049
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1050: Factors Associated with the Level of
           Physical Activity in Middle-Aged Colombian People during Lockdown in
           Response to COVID-19: A Cross-Sectional Study

    • Authors: Patricia Alexandra García-Garro, Agustín Aibar-Almazán, Yulieth Rivas-Campo, Gloria Cecilia Vega-Ávila, Diego Fernando Afanador-Restrepo, Antonio Martínez-Amat, María Isabel Afanador-Rodríguez, Fidel Hita-Contreras
      First page: 1050
      Abstract: (1) Background: Due to the pandemic caused by COVID-19, mandatory confinement was declared, which generated a decrease in the practice of physical activity (PA). Based on this problem, it was proposed to study the associations between PA in relation to depressive symptoms, quality of sleep, and the quality of life of middle-aged people who work in the university context during compulsory confinement as a result of COVID-19. (2) Methods: A total of 336 middle-aged people (48 ± 6.67) participated in this analytical cross-sectional study. The variable levels of PA, quality of sleep, symptoms of depression, and quality of life were measured with the International Physical Activity Questionary (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scale (ZSDS), and the SF-12v2 questionnaire, respectively. (3) Results: A logistic regression model was used to analyze the relationships between the level of PA and depressive symptoms (OR = 2.053), total sleep duration (OR = 0.495), sleep disturbances (OR = 2.414), quality of sleep (OR = 2.471), use of sleep medication (OR = 0.348), daytime dysfunction (OR = 1.809), general health (OR = 0.949), and physical functioning (OR = 0.987). (4) Conclusions: In middle-aged people, during compulsory confinement, being insufficiently active is a risk for depressive symptoms and disturbances in sleep quality.
      Citation: Healthcare
      PubDate: 2022-06-05
      DOI: 10.3390/healthcare10061050
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1051: “Peculiar” Snoring in a
           40-Year-Old Patient: A Case Report and Review of Literature

    • Authors: Nicholas-Tiberio Economou, Kyriaki Cholidou, Anastasios Kallianos, Katja Weiss, Beat Knechtle, Pantelis T. Nikolaidis, Georgia Trakada
      First page: 1051
      Abstract: This is a case description of a patient with previously diagnosed rapid eye movement sleep behavior disorder (RBD) and nocturnal enuresis, who complained about a “peculiar sound” while sleeping and, occasionally, while awake during intensive exercise, for the last three months. A home audio recording, which his wife obtained while he was sleeping, showed a high-pitched sound identified as stridor. Full video polysomnography revealed no apneas or hypopneas. The flow-volume loop yielded an inspiratory plateau, indicating variable extrathoracic obstruction. The upper and lower respiratory system computed tomography did not show any anomalies or mechanical lesions (e.g., masses and scars). Fiberoptic laryngoscopy revealed an abnormal activity of the vocal cord abductor during quiet breathing and inspiration in a supine position, leading to partial obstruction. A positive dopamine transporter scan and the coexistence of stridor, RBD, and nocturnal enuresis were diagnostic for multiple system atrophy. The patient was treated with continuous positive airway pressure as a symptomatic therapy for stridor and levodopa.
      Citation: Healthcare
      PubDate: 2022-06-06
      DOI: 10.3390/healthcare10061051
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1052: Evidence of the Association between Nurse
           Staffing Levels and Patient and Nurses’ Outcomes in Acute Care
           Hospitals across Japan: A Scoping Review

    • Authors: Noriko Morioka, Suguru Okubo, Mutsuko Moriwaki, Kenshi Hayashida
      First page: 1052
      Abstract: We aimed to summarize the evidence of an association between nurse staffing and nursing sensitivity outcomes in Japanese hospitals. A scoping review was conducted and reported following the PRISMA-SR 2020 statement. The ICHUSHI and CiNii databases were searched for published articles written in Japanese and PubMed and CINAHL for those written in English. Out of the 15 included studies, all observational studies, 3 were written in Japanese and the others in English. The nurse staffing level measures were grouped into three categories: patient-to-nurse ratio, nursing hours per patient day, and nurse-to-bed ratio. The outcome measures were grouped into three categories: patient outcome, nursing care quality reported by nurses, and nurse outcome/nursing care quality. Some studies reported that the nursing staff increasingly favored positive patient outcome. Conversely, the findings regarding failure to rescue, in-hospital fracture, and post-operative complications were inconsistent. Although some studies indicated that more nurse staffing was favored toward better patient and nurse outcomes, due to the sparse accumulation of studies and heterogeneity among the findings, it is difficult to draw robust conclusions between nurse staffing level and outcomes in Japanese acute care hospitals.
      Citation: Healthcare
      PubDate: 2022-06-06
      DOI: 10.3390/healthcare10061052
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1053: WHODAS Assessment Feasibility and Mental
           Health Impact on Functional Disability in Systemic Lupus Erythematosus

    • Authors: Liliana Duca, Nadinne Alexandra Roman, Aliana Miron, Andreea Teodorescu, Lorena Dima, Petru Ifteni
      First page: 1053
      Abstract: Systemic lupus erythematosus (SLE), besides rheumatological dysfunction, manifests in neuropsychiatric disorders like depression and anxiety. Mental health illnesses in SLE patients have a high prevalence and a profound impact on quality of life, generating an increased disability and premature mortality. This study aimed to establish the degree of disability in patients with SLE and the impact of depression and anxiety on patients’ functioning. Additionally, the study aimed to verify whether World Health Organization-Disability Assessment Schedule (WHODAS) 2.0 is suitable for the evaluation of patients with SLE associating depression and/or anxiety symptoms. Cross-sectional research was performed, including adult patients, diagnosed with SLE. To evaluate depression, anxiety, and functioning, approved questionnaires Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and, World Health Organization-Disability Assessment Schedule (WHODAS) were applied. Confirmatory factor analysis was performed on WHODAS subscales. Sixty-two patients were included in the research, with a mean of SLE diagnosis of 12.48 years; 53 patients (85%) had depression (p < 0.001). Anxiety was found in 38 patients (61.29%, p < 0.05). WHODAS assessment results depicted that 39 patients (62.90%, p < 0.05) manifested disability, from which 26 (66.66%, p < 0.05) presented moderate and severe disability. A strong correlation between the severity of anxiety and the degree of disability (r > 0.6, p < 0.001) was found. The WHODAS scale assessment proved to be a valuable tool for SLE patient’s functioning assessment. This study suggests that depression and anxiety negatively impact WHODAS disability scores, decreasing the quality of life in SLE patients.
      Citation: Healthcare
      PubDate: 2022-06-06
      DOI: 10.3390/healthcare10061053
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1054: Development and Validation of Filial
           Piety Representations at Parents’ End of Life Scale

    • Authors: Sok-Leng Che, Wai-I Ng, Xiang Li, Mingxia Zhu
      First page: 1054
      Abstract: Filial piety has a long historical standing in Chinese communities. However, the filial piety practices of adult children at the end of a parent’s life are under-explored. This study aims to develop a measurement for filial piety representations of the adult children of Macao Chinese, whose parents are at the stage of end of life. By adopting a scale development and validation framework, a 19-item Filial Piety Representations at Parents’ End of Life Scale (FPR-EoL) was formulated based on a Dual Filial Piety Model and literature, through procedures of item identification, panel review, cognitive interviews, and pre-test. The FPR-EoL was examined on 274 individuals. Factor analysis showed four factors in the scale; respect and comfort, acceptance of death, spending final days, and disclosing bad news. The Cronbach’s alpha of FPR-EoL was 0.73, and the four factors were 0.73, 0.66, 0.58 and 0.77, respectively. Discriminant validity was examined between FPR-EoL, the Good Death Inventory (GDI) and the Filial Piety Scale (FPS). The results suggested that there were differences between the three scales. FPR-EoL is found to be a reliable, valid and novel measure of filial piety representations among Macao Chinese. It may be a potential tool to probe and achieve good death among older persons of Chinese ethnicity in clinical settings.
      Citation: Healthcare
      PubDate: 2022-06-06
      DOI: 10.3390/healthcare10061054
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1055: Association between Obesity and Anemia in
           a Nationally Representative Sample of South Korean Adolescents: A
           Cross-Sectional Study

    • Authors: Jaehoon Jeong, Younghoon Cho, In-Young Cho, Joonho Ahn
      First page: 1055
      Abstract: Anemia is associated with physical, cognitive, and developmental problems. Given that there are limited studies on anemia prevalence among obese Asian adolescents and that past evidence is controversial, this study investigated the relationship between obesity and anemia in a nationally representative sample of South Korean adolescents. Data were obtained from the 2007–2019 Korea National Health and Nutrition Examination Survey. Overall, 10,231 subjects were included in the analysis. Multiple logistic regression was performed to determine the relationship between obesity and anemia. Compared with the non-obesity group, the adjusted odds ratio (OR; 95% confidence interval [CI]) of anemia was 1.00 (0.66–1.50) in the obesity group. However, in the early adolescent subgroup of 10–13 years (adjusted OR, 2.88; 95% CI, 1.20–6.95), the risk of anemia was significantly higher in the obese group than in the non-obese group. Obesity was associated with an increased risk of anemia in early adolescents. Obese adolescents aged 10–13 require special care, especially through regular examination and management for anemia.
      Citation: Healthcare
      PubDate: 2022-06-06
      DOI: 10.3390/healthcare10061055
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1056: “We Are Having a Huge Problem with
           Compliance”: Exploring Preconception Care Utilization in South
           Africa

    • Authors: Winifred Chinyere Ukoha, Ntombifikile Gloria Mtshali
      First page: 1056
      Abstract: Background: Preconception care (PCC), a policy directive from the World Health Organisation (WHO), comprises all the health interventions offered to women and couples before conception and is intended to improve their overall health status and the pregnancy outcomes. Although PCC should be an essential part of maternal and child health services in most African countries, its provision and utilization are not widely documented. Hence, this study aimed to explore the factors influencing preconception care utilization among high-risk women in South Africa. Methods: A descriptive qualitative study of 29 purposively selected women and healthcare workers was conducted through individual in-depth interviews using a semi-structured interview guide. The interviews were transcribed verbatim, and the analyses were performed using Nvivo version 12. The Social-Ecological Model (SEM) guided the data analysis. Four levels of factors (the individual, the interpersonal, the community and social, and the policy and institutional) were used to assess what can influence PCC utilization. Findings: The availability of PCC services, the intrahospital referral of women, the referral practices of other healthcare workers, the underutilization of the PCC facility, and resources emerged at the institutional levels, while compliance with PCC appointments, socioeconomic factors, pregnancy planning, assumptions, and knowledge was at the individual levels. Conclusion: The utilization of the preconception care services was inadequate. The primary influencer of preconception care utilization was at the individual, policy, and institutional levels. The availability of preconception care services and the intrahospital referral of women at high risk of adverse pregnancy outcomes positively influenced the women’s PCC utilization, while poor pregnancy planning, and unavailability of PCC policies and guidelines negatively influenced preconception care utilization. Therefore, interventions to improve PCC utilization should focus on the four SEM levels for effectiveness. There is a need to raise PCC awareness and develop policy and guidelines to ensure consistent, standardized practice among healthcare workers.
      Citation: Healthcare
      PubDate: 2022-06-06
      DOI: 10.3390/healthcare10061056
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1057: Assessment of Parental Knowledge towards
           Space Maintainer as an Essential Intervention after Premature Extraction
           of Primary Teeth

    • Authors: Amel Ali, Mamata Hebbal, Nada Aldakheel, Norah Al Ghamdi, Elzahraa Eldwakhly
      First page: 1057
      Abstract: This study assessed parents’ knowledge about space maintainers as an interceptive strategy after premature loss of primary teeth. Methods and Material: A cross-sectional questionnaire-based descriptive study was conducted on a sample of 600 parents; 456 (76%) were females, and 144 (24%) were males, recruited from an outpatient dental clinic at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. The questionnaire consisted of two sections; the first section collected sociodemographic data of participants, and the second section gathered parental knowledge of space maintainers. The research ethics committee granted ethical approval, and informed consent was obtained before participation. Results: 600 parents participated in this study. The total mean knowledge score regarding space maintainers was 7.97 ± 3.38. The mean knowledge score was 7.06 ± 2.99 for male parents and 8.26 ± 3.45 for female parents. The difference in the mean knowledge score between female and male parents was statistically significant (p < 0.001). Additionally, there was a statistically significant difference in the knowledge score and parents’ age groups, with parents having the highest knowledge in the 30–40 age group (p = 0.0197). There was a positive correlation between knowledge scores and the number of children. Parents with one child showed less knowledge than those with two to four children (p = 0.0121). Conclusions: Participants’ knowledge regarding space maintainers was 49.8%, which is considered inadequate. It was deemed essential to increase knowledge among parents about space maintainers as an interceptive approach after premature loss of primary teeth.
      Citation: Healthcare
      PubDate: 2022-06-07
      DOI: 10.3390/healthcare10061057
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1058: A Transfer Learning Approach with a
           Convolutional Neural Network for the Classification of Lung Carcinoma

    • Authors: Mamoona Humayun, R. Sujatha, Saleh Naif Almuayqil, N. Z. Jhanjhi
      First page: 1058
      Abstract: Lung cancer is among the most hazardous types of cancer in humans. The correct diagnosis of pathogenic lung disease is critical for medication. Traditionally, determining the pathological form of lung cancer involves an expensive and time-consuming process investigation. Lung cancer is a leading cause of mortality worldwide, with lung tissue nodules being the most prevalent way for doctors to identify it. The proposed model is based on robust deep-learning-based lung cancer detection and recognition. This study uses a deep neural network as an extraction of features approach in a computer-aided diagnosing (CAD) system to assist in detecting lung illnesses at high definition. The proposed model is categorized into three phases: first, data augmentation is performed, classification is then performed using the pretrained CNN model, and lastly, localization is completed. The amount of obtained data in medical image assessment is occasionally inadequate to train the learning network. We train the classifier using a technique known as transfer learning (TL) to solve the issue introduced into the process. The proposed methodology offers a non-invasive diagnostic tool for use in the clinical assessment that is effective. The proposed model has a lower number of parameters that are much smaller compared to the state-of-the-art models. We also examined the desired dataset’s robustness depending on its size. The standard performance metrics are used to assess the effectiveness of the proposed architecture. In this dataset, all TL techniques perform well, and VGG 16, VGG 19, and Xception for 20 epoch structure are compared. Preprocessing functions as a wonderful bridge to build a dependable model and eventually helps to forecast future scenarios by including the interface at a faster phase for any model. At the 20th epoch, the accuracy of VGG 16, VGG 19, and Xception is 98.83 percent, 98.05 percent, and 97.4 percent.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061058
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1059: How Little Do We Know about HIV and STIs
           Prevention' Results from a Web-Based Survey among the General
           Population

    • Authors: Andrea De Vito, Agnese Colpani, Beatrice Zauli, Maria Chiara Meloni, Marco Fois, Vito Fiore, Giovanni Antonio Pintus, Vincenzo Gesualdo Nardi, Sergio Babudieri, Giordano Madeddu
      First page: 1059
      Abstract: Background: Prevention campaigns have led to a significant decrease in new HIV diagnoses in Western Europe, while other sexual transmitted infections (STIs) have shown an opposite trend. Several educational programs are promoted among young students, whereas informational campaigns addressing the general population are scarce. We aimed to investigate the level of awareness regarding STIs among the general population. Methods: We proposed a questionnaire regarding STIs and HIV to the general population in Italy. We assigned 1 point to correct, 0.5 point to partially correct, and 0 point to wrong answers. We collected data about age, sex, region of origin, level of education and whether they were health workers. Results: Overall, 2183 people answered the questionnaire, of which 555 aged over 50 years old. Being male, older than 50 years old, retired or unemployed, not educated, and no regular use of condoms were associated with lower scores. Only 16% of participants knew the Undetectable = Untransmittable (U = U) campaign. Overall, 2131 (97.6%) people think more educational campaigns should be offered. Of interest, 80% said the questionnaire led them to learn more about HIV and STIs. Conclusion: Our study reveals several gaps in general population awareness about HIV and STIs, especially among people aged over 50 years old. Most participants stated that the questionnaire was a learning opportunity. These data suggest that improvement of knowledge could start from easy-to-dispose medium, such as surveys and questionnaires delivered through social media. Furthermore, particular attention should be paid to population segmentation and campaign tailoring to enhance interventions effectiveness. Our data reinforce the need for more informational and educational campaigns tailored to the specific segments of the population.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061059
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1060: Ectopic Intrauterine Device Revealed by
           Ureteral Colic in a 37-Week Pregnant Woman: Case Report

    • Authors: Alexandra Matei, Mihai Cornel Traian Dimitriu, Irina Pacu, Crîngu Ionescu
      First page: 1060
      Abstract: Copper T intrauterine devices (IUDs) are a popular long-acting reversible contraceptive method. The most common reasons for contraceptive failure are expulsion and extrauterine migration. We report a case of a 28-year-old female, G13P3, 37 weeks pregnant, who presented to the hospital for left abdominal flank pain. The patient was admitted for treatment of left ureteral colic. The woman went into labour, and Caesarean Section was performed due to foetal distress. During the surgery, an inspection of the peritoneal cavity revealed a copper IUD embedded in the granulous tissue located in the left lateral abdominal region, which was extracted. No uterine scar tissue could be identified macroscopically. The migration of an IUD in the abdominal cavity is a rare finding, and coexistence with third-trimester pregnancy is an infrequent but serious event due to potential visceral complications. Higher gravidity can be associated with an increased risk of IUD migration in women with a non-scarred uterus.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061060
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1061: Treatment of Knee Osteochondral Fractures

    • Authors: Mihai Alexandru Cordunianu, Iulian Antoniac, Marius Niculescu, Gheorghe Paltanea, Anca Daniela Raiciu, Horatiu Dura, Norin Forna, Ioana Dana Carstoc, Mihai Bogdan Cristea
      First page: 1061
      Abstract: Osteochondral lesions (OCLs) that are frequently encountered in skeletally immature and adult patients are more common than once thought, and their incidence rate is rising. These lesions can appear in many synovial joints of the body, such as the shoulder, elbow, hip, and ankle, occurring most often in the knee. The term osteochondral lesion includes a vast spectrum of pathologies such as osteochondritis dissecans, osteochondral defects, osteochondral fractures, and osteonecrosis of the subchondral bone. When considering this, the term osteochondral fracture is preserved only for an osteochondral defect that combines disruption of the articular cartilage and subchondral bone. These fractures commonly occur after sports practice and are associated with acute lateral patellar dislocations. Many of these lesions are initially diagnosed by plain radiographs; however, a computed tomography (CT) scan or magnetic resonance imaging (MRI) can add significant value to the diagnosis and treatment. Treatment methods may vary depending on the location and size of the fracture, fragment instability, and skeletal maturity. The paper reports a 14-year-old boy case with an osteochondral fracture due to sports trauma. The medical approach involved an arthrotomy of the knee, drainage of the hematoma, two Kirschner wires (K-wires) for temporary fixation to restructure anatomic alignment, and a titanium Herbert screw fixing the fracture permanently. The patient had a favorable postoperative outcome with no residual pain, adequate knee stability, and a normal range of motion. The mobility of the knee was fully recovered.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061061
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1062: Effect of Aging on Educational
           Differences in the Risk of Cognitive Impairment: A Gender-Specific
           Analysis Using Korean Longitudinal Study of Aging (2006–2016)

    • Authors: Roeul Kim, Woojin Chung
      First page: 1062
      Abstract: This study examined the effect of aging on gender-specific educational differences in the risk of cognitive impairment using a nationally representative sample of 4278 men and 5495 women aged 45 years and older from the dataset of the Korean Longitudinal Study of Aging. Sociodemographics, lifestyle, and medical conditions were included as covariates in the mixed logistic regression analysis models. The prevalence of cognitive impairment was higher in women than in men at baseline. The risk of cognitive impairment in each age group decreased with education in both men and women. The risk by educational rank was worse at lower levels and increased with age, more so for women than men. Aging appears to widen the impact of educational differences on the risk of cognitive impairment and is more unfavorable for women than for men. Public health policies regarding population aging need to consider this and identify the target population to reduce both the level of and the difference in the risk of cognitive impairment.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061062
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1063: The Early Dynamic Change in Cardiac
           Enzymes and Renal Function Is Associated with Mortality in Patients with
           Fulminant Myocarditis on Extracorporeal Membrane Oxygenation: Analysis of
           a Single Center’s Experience

    • Authors: Ching-Lin Ho, Teressa Reanne Ju, Chi Chan Lee, Hsin-Ti Lin, Alexander-Lee Wang, Robert Jeenchen Chen, You-Cian Lin
      First page: 1063
      Abstract: (1) Background: Fulminant myocarditis (FM) could result in hemodynamic derangement and fatal arrhythmia. Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is used to maintain organ perfusion in FM patients complicating cardiogenic shock. The present study aims to assess the static and dynamic factors in association with mortality in FM patients on V-A ECMO (2) Methods: Twenty-eight patients were enrolled between 2013 to 2019 for analysis (3) Results: In-hospital survival rate was 78.5%. There was no statistical difference in demographics and baseline laboratory data between survivors and non-survivors. However, within 24 h after ECMO support, CK-MB increased by 96.8% among non-survivors, but decreased by 23.7% among survivors (p = 0.022). Troponin I increased by 378% among non-survivors and 1.7% among survivors (p = 0.032). Serum creatinine increased by 108% among non-survivors, but decreased by 8.5% among survivors (p = 0.005). The receiver operating characteristic curve suggested an increase in serum creatinine by 68% within 24 h after ECMO support was associated with increased mortality with an area under the curve of 0.91. (4) Conclusions: V-A ECMO is an excellent tool to support FM patients with cardiogenic shock. The early dynamic change of renal function and cardiac enzymes may be useful for outcome assessment.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061063
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1064: Prevalence and Correlates of Vitamin D
           Deficiency in Children Aged Less than Two Years: A Cross-Sectional Study
           from Aseer Region, Southwestern Saudi Arabia

    • Authors: Saleh M. Al-Qahtani, Ayed A. Shati, Youssef A. Alqahtani, Samy A. Dawood, Aesha F. Siddiqui, Mohamed Samir A. Zaki, Shamsun N. Khalil
      First page: 1064
      Abstract: Background: Vitamin D is an essential nutrient for bone growth, mineralization, and other metabolic processes in the human body. Hence, insufficiency or deficiency of this vitamin can have long-term effects, particularly for children. Objectives: The aims of this study were to determine the prevalence of vitamin D deficiency in children up to 2 years of age and investigate the independent predictors of vitamin D deficiency. Methodology: This cross-sectional study was conducted among 484 children aged up to two years who were admitted to the hospital for the treatment of any acute condition from January to November 2021. Serum 25(OH)D was used to determine the level of vitamin D. The serum 25(OH)D was categorized into 3 groups: Sufficiency (>30 ng/mL), insufficiency (20–30 ng/mL), and the deficiency (<20 ng/mL). Results: Overall, vitamin D deficiency was observed in 70.5% of the children, of whom 45.9% had insufficient levels, and one-fourth (24.6%) showed deficiency. The children aged 2–12 months (infants) were more likely to be vitamin deficient compared to children aged 12 months and above. The children who lived in urban areas had a threefold increased risk of vitamin D deficiency (aOR = 3.0, 95% CI 1.78–5.08). The children who were exposed to sunlight for less than 3 days per week experienced a higher risk of developing vitamin D deficiency (aOR = 4.17, 95% CI 2.04–10.88). Children who had received only breast milk were more than two times more likely to experience vitamin D deficiency (aOR = 2.42, 95% CI 1.12–5.23) compared to their counterparts. Conclusion: Our study reveals a high prevalence of vitamin D deficiency among children aged up to two years. Infants, urban dwellers, only breastfed, and exposure to sunlight for less than three days per week were identified to be the independent risk factors for vitamin D deficiency. The results of this work call for enhancing awareness to ensure adequate levels of vitamin D for better health of the children in this region of Saudi Arabia.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061064
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1065: The Impact of Telemedicine on
           Parkinson’s Care during the COVID-19 Pandemic: An Italian Online
           Survey

    • Authors: Fabiana Ruggiero, Linda Lombi, Maria Takeko Molisso, Giorgio Fiore, Eleonora Zirone, Roberta Ferrucci, Elena Pirola, Marco Locatelli, Sergio Barbieri, Francesca Mameli
      First page: 1065
      Abstract: Traditionally, medical care and research in Parkinson’s disease (PD) have been conducted through in-person visit. The recent Coronavirus Disease 2019 (COVID-19) pandemic has profoundly impacted the delivery of in-person clinical care. We conducted an online survey to investigate the impact of COVID-19 on access to telehealth care, interviewing both PD patients and neurologists. Survey responses were collected from 1 March to 31 May 2021 through an anonymous, self-reported questionnaire, on the ‘Qualtrics’ platform. In total, 197 patients and 42 neurologists completed the survey. In our sample, 37.56% of PD patients and 88.10% of neurologists reported having used alternatives to in-person visits, while 13.70% of PD patients and 40.48% of neurologists used telemedicine. Data showed that respondents were generally satisfied with the use of telemedicine during the COVID-19 pandemic. The relational dimension between patient and neurologist seems to be the factor that most positively affected the telemedicine experience, contributing greatly to a more patient-centred care. Current findings suggest the need to improve the access to telehealth services for patients with PD. The technology has the potential to improve the care of frail patients, especially when availability of face-to-face visits is limited.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061065
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1066: Medicaid Expansions: Probing
           Medicaid’s Filling of the Cancer Genetic Testing and Screening Space
           

    • Authors: Stephen M. Modell, Lisa Schlager, Caitlin G. Allen, Gail Marcus
      First page: 1066
      Abstract: Cancer is the third largest source of spending for Medicaid in the United States. A working group of the American Public Health Association Genomics Forum Policy Committee reviewed 133/149 pieces of literature addressing the impact of Medicaid expansion on cancer screening and genetic testing in underserved groups and the general population. Breast and colorectal cancer screening rates improved during very early Medicaid expansion but displayed mixed improvement thereafter. Breast cancer screening rates have remained steady for Latina Medicaid enrollees; colorectal cancer screening rates have improved for African Americans. Urban areas have benefited more than rural. State programs increasingly cover BRCA1/2 and Lynch syndrome genetic testing, though testing remains underutilized in racial and ethnic groups. While increased federal matching could incentivize more states to engage in Medicaid expansion, steps need to be taken to ensure that they have an adequate distribution of resources to increase screening and testing utilization.
      Citation: Healthcare
      PubDate: 2022-06-08
      DOI: 10.3390/healthcare10061066
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1067: Hypothetical Model of How a Clinical
           Remount Procedure Benefits Patients with Existing Dentures: A Narrative
           Literature Review

    • Authors: Chi-Hsiang Cheng, Ikiru Atsuta, Kiyoshi Koyano, Yasunori Ayukawa
      First page: 1067
      Abstract: The clinical remount procedure, which involves remounting the dentures on an articulator with interocclusal records, can effectively reduce occlusal discrepancies. This procedure can be applied not only to new dentures but also to those already in service; however, research in this field is still scarce. This narrative review aims to establish a hypothetical mechanism and possible indications and contraindications for this technique as a basis for further research. Current studies have revealed a high prevalence of malocclusion in delivered dentures. Performing a clinical remount on these existing dentures would enhance the oral function of the denture wearer and would enable effective and accurate correction of the accumulated errors in the jaw relationship in a stable working environment. This technique should be performed if a patient has poor masticatory function or occlusion-related complaints. However, performing a clinical remount on dentures with an excessive anterior–posterior discrepancy between the centric relation and the maximal intercuspal position or on dentures with extremely low occlusal vertical dimension, is considered less effective. The clinical remount procedure remains an essential skill both for fabricating quality dentures and maintaining those already in service.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061067
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1068: Factors Contributing to Burnout among
           Healthcare Workers during COVID-19 in Sabah (East Malaysia)

    • Authors: Nicholas Tze Ping Pang, Noor Melissa Nor Hadi, Mohd Iqbal Mohaini, Assis Kamu, Chong Mun Ho, Eugene Boon Yau Koh, Jiann Lin Loo, Debbie Quah Lye Theng, Walton Wider
      First page: 1068
      Abstract: The third wave of COVID-19 in Malaysia has significantly strained the healthcare system of the country and increased the level of burnout among the healthcare workers (HCWs) in the country. Therefore, this study aimed to identify the various factors associated with burnout among HCWs. A cross-sectional study was conducted among 150 HWCs in Kota Kinabalu, Sabah, Malaysia. An online survey was administered using the Copenhagen Burnout Inventory, Multidimensional Scale of Perceived Social Support, Brief COPE, and Fear of COVID-19 scales. Pearson correlations were assessed amongst all variables. Subsequently, a multiple linear regression analysis was performed using burnout dimensions as dependent variables. Multiple linear regression results showed: (a) lower work-related burnout (β = −0.217, p < 0.01) among married HCWs; (b) higher personal-related burnout (β = 0.228, p < 0.01), work-related burnout (β = 0.425, p < 0.01), and client-related burnout (β = 0.359, p < 0.01) among doctors; (c) fear towards COVID-19 was significantly associated with client-related burnout (β = 0.243, p < 0.01); (d) an avoidant coping strategy was significantly associated with personal-related burnout (β = 0.322, p < 0.01); (e) social support from family was significantly associated with personal-related burnout (β = −0.264, p < 0.01), work-related burnout (β = −0.186, p < 0.05), and client-related burnout (β = −0.326, p < 0.01);(f) and social support from friends was significantly associated with work-related burnout (β = −0.202, p < 0.05). This study demonstrated significant theoretical contributions and clinical implications in the healthcare system in Sabah by addressing the impact of various factors on burnout among HWCs.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061068
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1069: Encouraging People with Spinal Cord
           Injury to Take Part in Physical Activity in the COVID-19 Epidemic through
           the mHealth ParaSportAPP

    • Authors: Adrià Marco-Ahulló, Lluïsa Montesinos-Magraner, Luís-Millan González, Teresa Crespo-Rivero, Patricia Launois-Obregón, Xavier García-Massó
      First page: 1069
      Abstract: Background: Although mHealth tools have great potential for health interventions, few experimental studies report on their use by people with spinal cord injuries in physical activity. Objective: The main objective of this study was to analyze the effect of the ParaSportAPP on different physical and psychological variables in people with paraplegia. Methods: Fourteen of these subjects made up the final sample. All the participants performed two pre-tests (control period) and a post-test with 8 months between the evaluations (COVID-19 broke out between pre-test 2 and the post-test). The ParaSportAPP was installed on their smartphones when they performed pre-test 2. The same tests were performed in the same order in all the evaluations: (i) the questionnaires PASIPD, HADS, RS-25; SCIM III and AQoL-8D, (ii) respiratory muscle strength, (iii) spirometry and (iv) cardiopulmonary exercise test. Results: The results showed no differences in any of the variables studied between the measurement times. Conclusions: Although none of the variables experienced improvements, the ParaSportAPP mobile application was able to lessen the impact of the pandemic on the variables studied.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061069
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1070: Changes in Maximum Mandibular Mobility
           Due to Splint Therapy in Patients with Temporomandibular Disorders

    • Authors: Bernhard Wiechens, Svea Paschereit, Tristan Hampe, Torsten Wassmann, Nikolaus Gersdorff, Ralf Bürgers
      First page: 1070
      Abstract: Splint therapy is widely used in the treatment of myofascial pain, but valid studies on the efficacy of this therapy are rare. The purpose of the present study was to investigate which qualifiable and quantifiable effects of splint therapy are detectable. For this purpose, 29 patients (21 women, mean age 44.6 ± 16 years) diagnosed with myofascial pain (RDC/TMD) were investigated in this prospective clinical trial (10/6/14An). Patients were treated with Michigan splints applied overnight for three months. Before (T1) and after three months of treatment (T2), patients were registered with an electronic ultrasound device with qualitative and quantitative evaluation of the registrations and a qualitative assessment of pain symptoms using a verbal analog scale. Significant differences were found between maximum mouth opening (MMP) (p < 0.001) and right condylar movement (CM) at MMP (p = 0.045). Qualitative assessment revealed that 24 of 29 patients experienced an improvement in pain symptoms, 17 of whom experienced complete remission. The results of the qualitative and quantitative analysis provide indications of the effectiveness of the splint therapy. In addition to quantitative measurements, the ultrasound facebow technique was also able to provide qualitative information.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061070
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1071: The Current Contexts of Newly Graduated
           Nurses’ Competence: A Content Analysis

    • Authors: Areum Hyun, Marion Tower, Catherine Turner
      First page: 1071
      Abstract: Producing and sustaining a competent nursing workforce is imperative to protect the public. Identifying current issues and trends in nursing competence can strengthen insights and provide direction for the future nursing workforce. A summative content analysis was performed; PubMed, CINAHL, and Scopus were searched for content from the last ten years. A total of 3225 titles and abstracts regarding nursing competence were identified and analysed using the big-data analysis software Leximancer. Five themes were discovered from the analysis: (1) standardisation of nursing competencies with emerging competencies, (2) assessment competency levels, (3) graduates’ expectations and achievement, (4) safe and quality practice with teamwork, and (5) competency curriculum development. This found standardised nursing competencies, which suggests prioritising which core competencies should be focused on during education to produce competent generalist professional nurses, and employers could help nursing graduates improve their competence in specialised areas. This review also suggests that further education strategies should be developed to better prepare graduates for culturally safe practice to meet the needs of diverse minority populations and for informatics competency during the COVID-19 pandemic. Competence assessment methods must be extensively investigated to measure nursing competencies both longitudinally and cross-sectionally.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061071
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1072: An Investigation into the Pressures
           Experienced by Medical Masters Students during the COVID-19 Pandemic Based
           on the Perceived Stress Scale-14 and Its Alleviation Methods

    • Authors: Heyu Meng, Jianjun Ruan, Yanqiu Chen, Zhaohan Yan, Xiangdong Li, Fanbo Meng
      First page: 1072
      Abstract: The COVID-19 pandemic can be seen as a traumatic event during which time medical students have been required to perform dual roles both as students and as medical workers. In this study, we aimed to use the Perceived Stress Scale (PSS-14) to judge the pressures on medical students and to identify effective ways to relieve these pressures. In this cross-sectional study, the subjects were recruited under informed consent according to the Declaration of Helsinki. Students undertaking Masters degrees at the China-Japan Union Hospital of Jilin University were randomly selected and data were collected through questionnaire surveys. Our data showed significant differences in the levels of pressure experienced by Masters students (p < 0.05). In the student population that showed increased pressure, females were significantly more stressed than males (p < 0.05). In addition, the pressures persisted after a holiday period (p < 0.05) but were reduced by undertaking recreational activities. The psychological pressures resulting from the COVID-19 pandemic were higher in female medical students compared to males. We showed that recreational activities including chatting with friends reduced psychological pressures in female medical students.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061072
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1073: Oral Care Awareness and Factors Related
           to the Burden of Nurses at a Community Hospital in Japan

    • Authors: Takashi Koike, Ryuichi Ohta, Yuhei Matsuda, Chiaki Sano, Takahiro Kanno
      First page: 1073
      Abstract: Objective: This cross-sectional study investigated the oral care knowledge, awareness, and challenges of 159 nurses and identified the factors related to the burden of oral care in Unnan City Hospital, Japan. Materials and Methods: This study included outpatient, ward, and operating room nurses who answered a questionnaire comprising 19 questions regarding awareness, actual implementation status of oral care provided, burden and learning experiences of oral care, and participants’ characteristics. A univariate regression model was used to assess whether catheterization was associated with the independent variables. Results: The number and rate of valid questionnaires were 134 and 87.6%, respectively. The mean years of clinical experience were 18.71 ± 12.02 years; 95.5% of the nurses were women. There were significant differences in the Oral Health-related Caregiver Burden Index among “interest in oral care” (p = 0.006), “priority of oral care” (p = 0.005), and “burden of oral care”. Conclusions: This study shows that nurses who are highly interested in oral care, prioritize oral care, and do not perceive oral care as a burden. Educational interventions, such as training sessions and direct guidance to solve challenges, are needed and can lead to improvements in the quality of life and advancement of health.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061073
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1074: Association of Hypertension and
           Organ-Specific Cancer: A Meta-Analysis

    • Authors: Morgan Connaughton, Mahsa Dabagh
      First page: 1074
      Abstract: Hypertension and cancer are two of the leading global causes of death. Hypertension, known as chronic high blood pressure, affects approximately 45% of the American population and is a growing condition in other parts of the world, particularly in Asia and Europe. On the other hand, cancer resulted in approximately 10 million deaths in 2020 worldwide. Several studies indicate a coexistence of these two conditions, specifically that hypertension, independently, is associated with an increased risk of cancer. In the present study, we conducted a meta-analysis initially to reveal the prevalence of hypertension and cancer comorbidity and then to assess which organ-specific cancers were associated with hypertension by calculating the summary relative risks (RRs) and 95% confidence intervals (CIs). Our analysis shows that hypertension plays a role in cancer initiation. Our extended analysis on how the hypertension-associated angiogenesis factors are linked to cancer demonstrated that matrix metalloproteinases 2 and 9 appear to be two key factors facilitating cancer in hypertensive patients. This work serves as an important step in the current assessment of hypertension-promoted increased risk of 19 different cancers, particularly kidney, renal cell carcinoma, breast, colorectal, endometrial, and bladder. These findings provide new insight into how to treat and prevent cancer in hypertensive patients.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061074
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1075: Validation Testing of the European
           Portuguese Critical-Care Pain Observation Tool

    • Authors: Rita Marques, Filipa Araújo, Marisa Fernandes, José Freitas, Maria Anjos Dixe, Céline Gélinas
      First page: 1075
      Abstract: Aim. The study aim was to validate the Portuguese version of the Critical-Care Pain Observation Tool (CPOT) in the critically ill adult population of Portugal. Methods. A prospective, observational cohort study was conducted to evaluate the CPOT in mechanically ventilated patients who were admitted to an intensive care unit. A consecutive sample of 110 patients was observed at rest pre-procedure, during a nociceptive procedure (NP) which includes turning/positioning and endotracheal or tracheal suctioning and 20 min post-procedure. Two raters participated in the data collection. The discriminative validity, criterion validity, convergent validity and inter-rater reliability of the CPOT were examined. Results. The inter-rater reliability was excellent (0.93 ≤ α ≤ 1.00) at rest and fair to moderate (0.39 ≤ α ≤ 0.60) during the NP. The CPOT could discriminate between conditions with higher scores during the NP when compared to CPOT scores at rest (p < 0.001). The optimal CPOT cut-off score was >2, with a sensitivity of 71% and a specificity of 80%, and self-reported pain was the gold standard criterion. Significant correlations (<0.40) were found between CPOT scores, the heart rate and the respiratory rate during the nociceptive procedure. Conclusions. The CPOT appears to be a valid alternative for both ventilated and non-ventilated patients who are unable to communicate.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061075
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1076: Affect and Cognitive Closure in
           Students—A Step to Personalised Education of Clinical Assessment in
           Psychology with the Use of Simulated and Virtual Patients

    • Authors: Maciej Walkiewicz, Bartosz Zalewski, Mateusz Guziak
      First page: 1076
      Abstract: Introduction: Since there was no general model of competencies to determine a successful clinical assessment, we based our study on the many skills that are needed to perform one. We analysed students’ learning performance based on inner determinants, such as affect and cognitive closure, with the use of two teaching methods (i.e., simulated patient (SP) or virtual patient (VP)). Methods: The sample comprised 56 fifth-year clinical psychology students. The need for closure (NFC) and efficacy in fulfilling the need for closure (EFNC) were measured using standardised questionnaires. The authors’ VP and SP tools were used to teach and measure the effectiveness of learning psychological interview techniques and clinical reasoning. Clinical interview skills included building contact with the patient, gathering important information and making mistakes. Clinical reasoning skills were divided into eight dimensions for the assessment of mental health. Results: Affect and cognitive closure are important psychological variables in anticipating and developing interview and clinical reasoning skills for psychology students. The simulated patient was more effective for interview skills, while the virtual patient was a beneficial teaching tool for most clinical reasoning skills. Virtual patient training was a useful teaching method for students with a low EFNC, probably because it provided a stable and strong structure. Simulated patient training was effective for people with a high EFNC, presumably because it allowed them to build on their advanced structuring skills. Conclusions: Affect and cognitive closure can be used to identify students’ learning abilities to provide a more personalised education. The results of the present study may be useful for evaluating different teaching methods, monitoring their effectiveness and enhancing students’ performance.
      Citation: Healthcare
      PubDate: 2022-06-09
      DOI: 10.3390/healthcare10061076
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1077: Exploring Healthcare Professionals’
           Practices and Attitudes towards Monitoring and Reporting of Severe Adverse
           Drug Reactions

    • Authors: Warisara Srisuriyachanchai, Anthony R. Cox, Narumol Jarernsiripornkul
      First page: 1077
      Abstract: Healthcare professionals (HCPs) play a key role in the monitoring of severe adverse drug reactions (ADRs). The present study aims to explore practices and barriers of HCPs in severe ADR monitoring and reporting, to evaluate their attitudes towards the monitoring and to assess the related factors. Self-administered questionnaires produced in hard copy and Google form were sent to 510 HCPs by stratified random sampling. Of the 350 HCPs that responded (68.6%), 44.9% had ever monitored ADRs. The most common practices were the observation of abnormal symptoms for ADR identification (88.5%), discontinuation of the suspected drug for ADR management (88.5%) and advice on recurrent drug allergy for ADR prevention (88.5%). Most HCPs (93.0%) obtained further patient history to identify severe ADRs. The uncertainty of the causal relationship was a major barrier to ADR reporting (60.0%). Pharmacists were more involved with practices in ADR monitoring and reporting (OR 20.405; p < 0.001), whereas longer work experience (>20 years) was negatively related to the practices (OR 0.271; p = 0.024). Over one-third (37.6%) of HCPs had a positive attitude towards severe ADR monitoring. In conclusion, the practices in severe ADR monitoring varied among different professions. However, the barriers to the reporting of ADRs still exist; hence, improving knowledge and cooperation among HCPs should be promoted.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061077
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1078: Aggression, Alexithymia and Sense of
           Coherence in a Sample of Schizophrenic Outpatients

    • Authors: Argyro Pachi, Athanasios Tselebis, Ioannis Ilias, Effrosyni Tsomaka, Styliani Maria Papageorgiou, Spyros Baras, Evgenia Kavouria, Konstantinos Giotakis
      First page: 1078
      Abstract: Schizophrenia elevates the risk for aggressive behavior, and there is a need to better understand the associated variables predicting aggression for treatment and prevention purposes. The aim of the present study is to determine the relationship between alexithymia, sense of coherence and aggressive behavior in a sample of schizophrenic outpatients. Using a correlational research design, standardized self-report questionnaires assessed aggression (brief aggression questionnaire—BAQ), alexithymia (Toronto Alexithymia Scale—TAS) and sense of coherence (sense of coherence questionnaire—SOC) in a sample of 100 schizophrenic outpatients in clinical remission. Participants reported high levels of aggression and alexithymia along with reduced sense of coherence. Significant negative correlations were evidenced among scores on the SOC scale (p < 0.001) with both the TAS as well as with the BAQ scales. However, a positive correlation (p < 0.001) was observed between the TAS and BAQ scales. Regression indicated that 27% of the variation in the BAQ rating was explained by the TAS, while an additional 17.8% was explained by the sense of coherence. The difficulty identifying feelings of alexithymia and the comprehensibility and manageability components of sense of coherence significantly predicted anger, hostility and physical aggression. Sense of coherence mediated the relationship between alexithymia and aggression. From the path analysis, comprehensibility emerged as the key factor counterbalancing alexithymic traits and aggressive behaviors, and manageability effectuated higher anger control. The findings hold practical implications for the treatment and rehabilitation of schizophrenic patients.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061078
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1079: Healthcare Utilization and Smoking among
           South Carolina’s Long-Term Uninsured

    • Authors: Caitlin Torrence, Khoa Truong, Laksika B. M. Sivaraj
      First page: 1079
      Abstract: Cigarette smoking and tobacco-related health conditions have continued to rise among persons of low social economic status. This study explored the association between healthcare utilization and smoking among the long-term uninsured (LTU). The sample consisted of South Carolina residents who had been without healthcare insurance for at least 24 months. Multivariable logistic regression was used to estimate differences in the likelihood of delaying healthcare due to cost and/or not filling a needed prescription between smokers and non-smokers. Among LTU, smoking was a significant predictor of delaying healthcare at the 10% level (AOR = 1.36, 95% CI = 0.99–1.86); the sensitivity analysis strengthened this association at the 5% level (AOR = 1.43, 95% CI = 1.06–1.93). Smoking was a significant predictor of not filling needed prescriptions (AOR = 1.44, 95% CI = 1.06–1.96). While neglected healthcare utilization was common among the LTU, this problem was more severe among smokers. The wider gap in access to healthcare services among the LTU, especially LTU who smoke, warrants further attention from the research community and policy makers.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061079
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1080: Assistive Technologies, Robotics,
           Automatic Machines: Perspectives of Integration in the Health Domain

    • Authors: Daniele Giansanti
      First page: 1080
      Abstract: Assistive technologies, robotics, and automatic machines are becoming important elements of the human health domain [...]
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061080
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1081: A Comparative Study on the Cultural
           Dimensions and Health Perception of the COVID-19 Pandemic between China
           and the United States

    • Authors: Yahan Zhang, Shanshan Liu, JongWoo Jun
      First page: 1081
      Abstract: When a public crisis such as COVID-19 occurs, factors that affect health-related behaviors, such as compliance with safety precautions, health professionals, and directives from government agencies will become more obvious. This research explores the differences between the people of the United States and China regarding preventive behavioral intentions, perceptions of personal and social risks, seriousness, and other cultural characteristics in the context of the COVID-19 health crisis. The purpose is to provide insights that can be used when global public health events occur in the future. A total of 536 people who lived in the US and China from 12 July to 7 September 2020 were recruited in the survey. Through a web-based survey, differences in the attitudes and perceptions of COVID-19 between the two countries were identified. Overall, the people of China scored higher than Americans on several measures regarding personal risk perception, social risk perception, and seriousness. Chinese citizens also had higher preventive behavioral intentions than their US counterparts. In addition, the relationships between cultural dimensions and health-related variables were also different.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061081
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1082: An Exploratory Case Study of the Types of
           Resources Black Boys Use to Support Their Mental Health

    • Authors: Brittany Ribeiro Brown, Ed-Dee G. Williams, Jamie M. Abelson, Arushi Chandrakapure, Daphne C. Watkins
      First page: 1082
      Abstract: Black adolescent boys experience mental health challenges because of their exposure to a greater frequency and severity of psychosocial stressors. This study used a sample of Black boys at a high school in southeastern Michigan as a case study to understand the types of resources Black boys might use to support their mental health. After conducting a rigorous analysis of the study data using a rapid and an accelerated data reduction technique, four themes helped us answer the question: What kinds of mental health support resources are Black boys using' Four themes emerged from our analysis: online resources, community and trusted individuals, self-reliance, and additional needs. This case study is a springboard for further work to tailor a mental health education and support intervention, such as the YBMen Project, for Black boys and for building additional support amid the multiple crises occurring that impact their mental health and safety. Findings have implications for future research, practice, and policy to improve the mental health of Black boys in high school.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061082
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1083: Subjective Wellbeing and Its Associated
           Factors among University Community during the COVID-19 Pandemic in
           Northern Malaysia

    • Authors: Syaheedatul Iman Dinsuhaimi, Asrenee Ab Razak, Liza Sharmini Ahmad Tajudin, Wan Mohd Zahiruddin Wan Mohammad, Azhany Yaakub, Azizah Othman, Aziah Daud, Kamarul Imran Musa, Nani Draman, Alwi Besari
      First page: 1083
      Abstract: Lockdown implementation during COVID-19 pandemic has caused many negative impacts in various aspect of life, including in the academic world. Routine disruption to teaching and learning environment has raised concerns to the wellbeing of university staff and students. This study aimed to examine the subjective wellbeing of the university community in Northern Malaysia during lockdown due to COVID-19 pandemic and the factors affecting it. An online cross-sectional survey involving 1148 university staff and students was conducted between March and April 2020. The research tools include the Personal Wellbeing Index (PWI) to assess subjective wellbeing and the Depression, Anxiety and Stress 21 (DASS-21) scale for psychological distress. While we found the subjective wellbeing score in our study population was stable at 7.67 (1.38), there was high prevalence of anxiety, depression, and stress with 27.4%, 18.4%, and 11.5%, respectively. The students reported higher levels of psychological distress compared to staff. The PWI score was seen to be inversely affected by the depression and stress score with a reduction in the PWI score by 0.022 (95% CI −0.037 to −0.007) and 0.046 (95% CI −0.062 to −0.030) with every one-unit increment for each subscale, respectively. Those who perceived to have more difficulty due to the lockdown also reported low subjective wellbeing. Thus, it is crucial to ensure policies and preventative measures are in place to provide conducive teaching and learning environment. Additionally, the detrimental psychological effects especially among students should be addressed proactively.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061083
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1084: Human Activity Recognition Based on
           Embedded Sensor Data Fusion for the Internet of Healthcare Things

    • Authors: Mohamed E. Issa, Ahmed M. Helmi, Mohammed A. A. Al-Qaness, Abdelghani Dahou, Mohamed Abd Elaziz, Robertas Damaševičius
      First page: 1084
      Abstract: Nowadays, the emerging information technologies in smart handheld devices are motivating the research community to make use of embedded sensors in such devices for healthcare purposes. In particular, inertial measurement sensors such as accelerometers and gyroscopes embedded in smartphones and smartwatches can provide sensory data fusion for human activities and gestures. Thus, the concepts of the Internet of Healthcare Things (IoHT) paradigm can be applied to handle such sensory data and maximize the benefits of collecting and analyzing them. The application areas contain but are not restricted to the rehabilitation of elderly people, fall detection, smoking control, sportive exercises, and monitoring of daily life activities. In this work, a public dataset collected using two smartphones (in pocket and wrist positions) is considered for IoHT applications. Three-dimensional inertia signals of thirteen timestamped human activities such as Walking, Walking Upstairs, Walking Downstairs, Writing, Smoking, and others are registered. Here, an efficient human activity recognition (HAR) model is presented based on efficient handcrafted features and Random Forest as a classifier. Simulation results ensure the superiority of the applied model over others introduced in the literature for the same dataset. Moreover, different approaches to evaluating such models are considered, as well as implementation issues. The accuracy of the current model reaches 98.7% on average. The current model performance is also verified using the WISDM v1 dataset.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061084
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1085: Risk of SARS-CoV-2 Infection Breakthrough
           among the Non-Vaccinated and Vaccinated Population in Italy: A Real-World
           Evidence Study Based on Big Data

    • Authors: Alessandro Perrella, Massimo Bisogno, Angelo D’Argenzio, Ugo Trama, Enrico Coscioni, Valentina Orlando, COVID CaRe Group
      First page: 1085
      Abstract: SARS-CoV-2 infection after vaccination can occur because COVID-19 vaccines do not offer 100% protection. The study aim was to assess duration of vaccination coverage, disease symptoms and type of hospitalization among non-vaccinated and vaccinated subjects to evaluate the vaccination trend over time. A retrospective cohort study was carried out among people testing COVID-19 positive in Campania Region using information from the Health Information System of Campania Region (Sinfonia). Vaccination status was assessed considering: no vaccination, partial vaccination and effective vaccination. Univariate and multivariate logistic regression models were constructed to evaluate the association between ICU admissions caused by COVID-19 and gender, age groups and vaccine type. Vaccine coverage duration trends were investigated using segmented linear regression and breakpoint estimations. Vaccination coverage was assessed by analyzing COVID-19 positive subjects in the 9 months after an effective dose vaccination. A significant risk of hospitalization in the ICU was caused by vaccination status: subjects non-vaccinated (OR:7·14) and partially vaccinated (OR:3·68) were 3 and 7 times more at risk of hospitalization, respectively, than subjects effectively vaccinated. Regarding subjects with an effective vaccination, the vaccine’s ability to protect against infection in the months following vaccination decreased. The risk of contracting COVID-19 after vaccination was higher 5 months (β = 1441, p < 0.001) and 7 months (β = 3110, p < 0.001) after administration of an effective dose. COVID-19 vaccines were demonstrated to protect from symptomatic infection by significantly reducing hospitalization risk, and their full protection against SARS-CoV-2 was demonstrated to decrease after 5 months regardless of age, gender or vaccine type.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061085
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1086: Systematic Analysis of Literature on the
           Healthcare Financial Models to Follow in Russia and Romania

    • Authors: Vladimir Bulatnikov, Cristinel Petrişor Constantin
      First page: 1086
      Abstract: This paper aims at finding the suitable healthcare financial model, focusing on their pros and cons, as debated by several scholars. The focus is on the potential benefits for both Romanian and Russian healthcare systems. To reach this goal, a systematic review of the literature was conducted, and various competitive advantages and disadvantages of the financial models were extracted. We reviewed 77 papers published during the last 21 years that were found in famous scientific databases. The main findings of the research point out that the financing of healthcare systems should be based on hybrid sources, and the funds raised should be better invested in order to create added value. By assuring a proper financing, the population’s quality of life will improve and life expectancy will increase. This paper provides a new viewpoint to the problem because it reviews certain papers from Russian literature which are not usually included in the review articles. The research results have implications for the government, medical community, and academia, which should work together to strengthen the healthcare system.
      Citation: Healthcare
      PubDate: 2022-06-10
      DOI: 10.3390/healthcare10061086
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1087: Predicting the Mortality of ICU Patients
           by Topic Model with Machine-Learning Techniques

    • Authors: Chih-Chou Chiu, Chung-Min Wu, Te-Nien Chien, Ling-Jing Kao, Jiantai Timothy Qiu
      First page: 1087
      Abstract: Predicting clinical patients’ vital signs is a leading critical issue in intensive care units (ICUs) related studies. Early prediction of the mortality of ICU patients can reduce the overall mortality and cost of complication treatment. Some studies have predicted mortality based on electronic health record (EHR) data by using machine learning models. However, the semi-structured data (i.e., patients’ diagnosis data and inspection reports) is rarely used in these models. This study utilized data from the Medical Information Mart for Intensive Care III. We used a Latent Dirichlet Allocation (LDA) model to classify text in the semi-structured data of some particular topics and established and compared the classification and regression trees (CART), logistic regression (LR), multivariate adaptive regression splines (MARS), random forest (RF), and gradient boosting (GB). A total of 46,520 ICU Patients were included, with 11.5% mortality in the Medical Information Mart for Intensive Care III group. Our results revealed that the semi-structured data (diagnosis data and inspection reports) of ICU patients contain useful information that can assist clinical doctors in making critical clinical decisions. In addition, in our comparison of five machine learning models (CART, LR, MARS, RF, and GB), the GB model showed the best performance with the highest area under the receiver operating characteristic curve (AUROC) (0.9280), specificity (93.16%), and sensitivity (83.25%). The RF, LR, and MARS models showed better performance (AUROC are 0.9096, 0.8987, and 0.8935, respectively) than the CART (0.8511). The GB model showed better performance than other machine learning models (CART, LR, MARS, and RF) in predicting the mortality of patients in the intensive care unit. The analysis results could be used to develop a clinically useful decision support system.
      Citation: Healthcare
      PubDate: 2022-06-11
      DOI: 10.3390/healthcare10061087
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1088: Development of a General Health Score
           Based on 12 Objective Metabolic and Lifestyle Items: The Lifestyle and
           Well-Being Index

    • Authors: Octavio Pano, Carmen Sayón-Orea, María Soledad Hershey, Maira Bes-Rastrollo, Miguel A. Martínez-González, J. Alfredo Martínez
      First page: 1088
      Abstract: Healthy and unhealthy lifestyles are tightly linked to general health and well-being. However, measurements of well-being have failed to include elements of health and easy to interpret information for patients seeking to improve lifestyles. Therefore, this study aimed to create an index for the assessment of general health and well-being along with two cut-off points: the lifestyle and well-being index (LWB-I). This was a cross-sectional analysis of 15,168 individuals. Internally valid multivariate linear models were constructed using key lifestyle features predicting a modified Short Form 36 questionnaire (SF-36) and used to score the LWB-I. Categorization of the LWB-I was based on self-perceived health (SPH) and analyzed using receiver operating characteristic curve analysis. Optimal cut-points identified individuals with poor and excellent SPH. Lifestyle and well-being were adequately accounted for using 12 lifestyle items. SPH groups had increasingly healthier lifestyle features and LWB-I scores; optimal cut-point for poor SPH were scores below 80 points (AUC: 0.80 (0.79, 0.82); sensitivity 75.7%, specificity 72.3%)) and above 86 points for excellent SPH (AUC: 0.67 (0.66, 0.69); sensitivity 61.4%, specificity 63.3%). Lifestyle and well-being were quantitatively scored based on their associations with a general health measure in order to create the LWB-I along with two cut points.
      Citation: Healthcare
      PubDate: 2022-06-11
      DOI: 10.3390/healthcare10061088
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1089: Post-Work Recovery from Fatigue and Sleep
           Episodes among Nurses Who Are Engaged in 16-Hour Night Shifts: A
           Prospective Observational Study

    • Authors: Issei Konya, Kazuhiro Watanabe, Inaho Shishido, Naotaka Sugimura, Yuta Matsushita, Shinya Yamaguchi, Rika Yano
      First page: 1089
      Abstract: Poor recovery from fatigue among shift-working nurses can cause a transition from acute to chronic fatigue. We aimed to clarify the relationship between nurses’ recovery from fatigue and sleep episodes after 16 h night shifts while considering age. This prospective study included 62 nurses who worked 16 h night shifts. Fatigue was assessed by a questionnaire before, during, and after the night shift, and the morning following the night shift. Sleep episodes were continuously measured using a wearable device. We performed a hierarchical cluster analysis of multivariate sleep parameters in first and main sleep episodes after night shifts. A linear mixed model was used to estimate the difference between clusters in recovery from fatigue after the night shift, considering age. The participants were classified into a high sleep quality group (HSQG) and low sleep quality group (LSQG) in sleep episodes after the night shift. There was a significant main effect of clusters, and HSQG was significantly more effective than LSQG in recovering from fatigue. However, no main effects of age or interaction were observed. The quality of first and main sleep episodes at home was associated with recovery from the night shift to the next day, regardless of age.
      Citation: Healthcare
      PubDate: 2022-06-11
      DOI: 10.3390/healthcare10061089
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1090: Effects of Aquatic Training and Bicycling
           Training on Leg Function and Range of Motion in Amateur Athletes with
           Meniscal Allograft Transplantation during Intermediate-Stage
           Rehabilitation

    • Authors: Yake Chen, Yonghwan Kim, Moonyoung Choi
      First page: 1090
      Abstract: Meniscal allograft transplantation (MAT) is a treatment modality for restoring knee function in patients with irreversible meniscal injury. Strengthening programs to promote functional recovery are treated with caution during the intermediate rehabilitation phase following MAT. This study analyzed the effects of aquatic training (AQT) and bicycling training (BCT) during the intermediate stage of rehabilitation in amateur athletes that underwent MAT. Participants (n = 60) were divided into AQT (n = 30) and BCT (n = 30) groups. Both groups performed training three times per week from 6 to 24 weeks following surgery. International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC) score, knee joint range of motion (ROM), isokinetic knee strength, and Y-balance test (YBT) performance were evaluated. All measured variables for the AQT and BCT groups improved significantly after training compared with pre-training values. The IKDC score and YBT were significantly higher for AQT than for BCT. The knee flexion ROM and isokinetic muscle strength were significantly improved in the BCT group compared to those in the AQT group. The AQT group exhibited greater improvement in dynamic balance, whereas BCT provided greater improvement in isokinetic muscle strength. AQT and BCT were effective in reducing discomfort and improving knee symptoms and functions during intermediate-stage rehabilitation following MAT in amateur athletes.
      Citation: Healthcare
      PubDate: 2022-06-11
      DOI: 10.3390/healthcare10061090
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1091: The Moderated Mediating Effect of Hope,
           Self-Efficacy and Resilience in the Relationship between Post-Traumatic
           Growth and Mental Health during the COVID-19 Pandemic

    • Authors: Donatella Di Corrado, Benedetta Muzii, Paola Magnano, Marinella Coco, Rosamaria La Paglia, Nelson Mauro Maldonato
      First page: 1091
      Abstract: As a major life trauma, COVID-19 had negative impacts on psychological well-being. The aim of this study was to test and verify the mediation of resilience, hope and self-efficacy and to analyze the moderating effect of gender and COVID-19 contagion on the association between symptoms of anxiety, stress and depression, and post-traumatic growth among adults during COVID-19. A cross-sectional study was conducted via an online survey with self-administered questionnaires. The Depression, Anxiety, and Stress Scale, the Post-traumatic Growth Inventory, the Resilience Scale, the General Self-Efficacy Scale, and the Comprehensive State Hope Scale were used. A total of 493 (n = 262 female and n = 231 male) participated in the survey (Mage = 33.40 years, SD = 13.41, range = 20 to 60). A multiple mediation model was used to verify the mediating effect of resilience, hope and self-efficacy on the relationship between symptoms of anxiety, stress and depression, and PTG. A moderated mediation model was examined to find and test the moderated effects of gender and COVID-19 contagion on the mediation model. Results showed the indirect effects of anxiety (β = 0.340 (0.120); 95% CI [from 0.128 to 0.587]) and depression (β = 0.222 (0.095); 95% CI [0.048, 0.429]) on PTG trough resilience and hope. Symptoms of anxiety, stress and depression, and self-efficacy were significantly highest in females. Moreover, males and participants with COVID-19 contagion had significantly higher levels of resilience and post-traumatic growth. These findings suggest that hope and resilience, as protective factors, could be an important key to developing an intervention strategy to enhance and improve psychological health during a crisis.
      Citation: Healthcare
      PubDate: 2022-06-12
      DOI: 10.3390/healthcare10061091
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1092: An Enactive–Ecological Model to
           Guide Patient-Centered Osteopathic Care

    • Authors: Francesco Cerritelli, Jorge E. Esteves
      First page: 1092
      Abstract: Osteopaths commonly face complexity and clinical uncertainty in their daily professional practice as primary contact practitioners. In order to effectively deal with complex clinical presentations, osteopaths need to possess well-developed clinical reasoning to understand the individual patient’s lived experience of pain and other symptoms and how their problem impacts their personhood and ability to engage with their world. We have recently proposed (En)active inference as an integrative framework for osteopathic care. The enactivist and active inference frameworks underpin our integrative hypothesis. Here, we present a clinically based interpretation of our integrative hypothesis by considering the ecological niche in which osteopathic care occurs. Active inference enables patients and practitioners to disambiguate each other’s mental states. The patients’ mental states are unobservable and must be inferred based on perceptual cues such as posture, body language, gaze direction and response to touch and hands-on care. A robust therapeutic alliance centred on cooperative communication and shared narratives and the appropriate and effective use of touch and hands-on care enable patients to contextualize their lived experiences. Touch and hands-on care enhance the therapeutic alliance, mental state alignment, and biobehavioural synchrony between patient and practitioner. Therefore, the osteopath–patient dyad provides mental state alignment and opportunities for ecological niche construction. Arguably, this can produce therapeutic experiences which reduce the prominence given to high-level prediction errors—and consequently, the top-down attentional focus on bottom-up sensory prediction errors, thus minimizing free energy. This commentary paper primarily aims to enable osteopaths to critically consider the value of this proposed framework in appreciating the complexities of delivering person-centred care.
      Citation: Healthcare
      PubDate: 2022-06-12
      DOI: 10.3390/healthcare10061092
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1093: Content Analysis of YouTube Videos That
           Demonstrate Panoramic Radiography

    • Authors: Marlene Grillon, Andy Wai Kan Yeung
      First page: 1093
      Abstract: In this digital era, dental students often search for online resources for self-directed learning. YouTube is one of the most commonly sought online platforms for educational or instructional videos. No prior study has examined the validity of panoramic radiography videos available on YouTube. This study provides a content analysis of these YouTube videos. A search for relevant YouTube videos was conducted in April 2022. The search string was: (panoramic OR pan OR OPG) AND (dental OR dentistry OR X-ray). The first 100 videos that resulted from the search and their related videos were screened. Exclusion criteria included irrelevance (e.g., no demonstration of panoramic radiography procedures) and non-English videos. For each included video, the following parameters were recorded: image receptor type, patient age, patient type (real patient, animation, or phantom head), patient preparation procedures, machine preparation, patient positioning, and operator safety. The number of views, comments, likes, and channel subscribers were recorded, as well as the video duration and the age of the video. Forty videos were included and analyzed. Most of the videos demonstrated digital panoramic radiography with an adult patient. Procedures on the patient and machine preparations as well as patient positioning were generally explained well. However, most videos did not well-demonstrate operator safety details concerning the use of adequate personal protective equipment. View count, comment count, and channel subscriber count positively correlated with the like count. Clinicians and students should carefully critique the content of such instructional videos and refer to the contents from other sources such as user manuals and latest recommendations from local authorities.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061093
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1094: Differential Screening of Herniated
           Lumbar Discs Based on Bag of Visual Words Image Classification Using
           Digital Infrared Thermographic Images

    • Authors: Gi Nam Kim, Ho Yeol Zhang, Yong Eun Cho, Seung Jun Ryu
      First page: 1094
      Abstract: Doctors in primary hospitals can obtain the impression of lumbosacral radiculopathy with a physical exam and need to acquire medical images, such as an expensive MRI, for diagnosis. Then, doctors will perform a foraminal root block to the target root for pain control. However, there was insufficient screening medical image examination for precise L5 and S1 lumbosacral radiculopathy, which is most prevalent in the clinical field. Therefore, to perform differential screening of L5 and S1 lumbosacral radiculopathy, the authors applied digital infrared thermographic images (DITI) to the machine learning (ML) algorithm, which is the bag of visual words method. DITI dataset included data from the healthy population and radiculopathy patients with herniated lumbar discs (HLDs) L4/5 and L5/S1. A total of 842 patients were enrolled and the dataset was split into a 7:3 ratio as the training algorithm and test dataset to evaluate model performance. The average accuracy was 0.72 and 0.67, the average precision was 0.71 and 0.77, the average recall was 0.69 and 0.74, and the F1 score was 0.70 and 0.75 for the training and test datasets. Application of the bag of visual words algorithm to DITI classification will aid in the differential screening of lumbosacral radiculopathy and increase the therapeutic effect of primary pain interventions with economical cost.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061094
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1095: Treatment, Diagnostic Criteria and
           Variability of Terminology for Lateral Elbow Pain: Findings from an
           Overview of Systematic Reviews

    • Authors: Luigi Di Filippo, Simone Vincenzi, Denis Pennella, Filippo Maselli
      First page: 1095
      Abstract: Background: Lateral elbow pain (LEP) represents a musculoskeletal disorder affecting the epicondyloid region of the elbow. The terminological framework of this problem in literature, to date, is confusing. This systematic review (SR) aims to analyse the panorama of the scientific literature concerning the pathogenetic framework, treatment, and clinical diagnosis of LEP. Methods: We conducted an SR according to the guidelines of the PRISMA statement. We performed research using the electronic Medline, Epistemonikos, and Cochrane Library databases. The research started on 12 January 2022 and finished on 30 April 2022. We included all systematic reviews and meta-analyses published, in English, between 1989 and 2022. The articles’ selection was based on critical appraisal using Amstar 2. In the selected reviews we obtained the etiopathogenic terminology used to describe the symptoms, treatment, and diagnostic criteria of LEP. Results: Twenty-five SRs met the eligibility criteria and were included in the study. From these SRs, 227 RCT articles were analysed and different treatments proposals were extracted, such as exercise, manipulation corticosteroid injection, and surgery. In the selected articles, 10 different terms emerged to describe LEP and 12 different clinical tests. The most common treatments detected in this SR were a conservative multimodal approach (e.g., eccentric exercises, manual therapy, acupuncture, ultrasound), then surgery or other invasive treatments (e.g., corticosteroid injection, tenotomy). The most common term detected in this SR was “lateral epicondylitis” (n = 95, 51.6%), followed by “tennis elbow” (n = 51, 28.1%) and “lateral epicondylalgia” (n = 18, 9.4%). Among the diagnostic tests were painful palpation (n = 101, 46.8%), the Cozen test (n = 91, 42.1%), the pain-free grip-strength test (n = 41, 19.0%), and the Maudsley test (n = 48, 22.2%). A total of 43.1% of RCTs (n = 96) included subjects with LEP > 3 months, 40.2% (n = 85) included patients with LEP < 3 months, and 16.7% of the items (n = 35) were not specified by the inclusion criteria on the onset of symptoms. Conclusions: In this SR, a considerable terminological heterogeneity emerged in the description of LEP, associated with the lack of clear and recognised diagnostic criteria in evaluating and treating patients with lateral elbow pain.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061095
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1096: Prognosis of the Ipsilesional
           Corticospinal Tracts with Preserved Integrities at the Early Stage of
           Cerebral Infarction: Follow Up Diffusion Tensor Tractography Study

    • Authors: Sung Ho Jang, Hye Rin Seo, Dong Hyun Byun
      First page: 1096
      Abstract: This study examined the prognosis of the ipsilesional corticospinal tracts (CSTs) with preserved integrities at the early stage of cerebral infarction using follow-up diffusion tensor tractography (DTT). Thirty-one patients with a supratentorial infarction were recruited. DTT, Motricity Index (MI), modified Brunnstrom classification (MBC), and functional ambulation category (FAC) were performed twice at the early and chronic stages. The patients were classified into two groups based on the integrity of the ipsilesional CST on the second DTT: Group A (24 patients; 77.4%)—preserved integrity and Group B (7 patients; 22.6%)—disrupted integrity. No significant differences in MI, MBC, and FAC were observed between groups A and B at the first and second evaluations, except for FAC at the first evaluation (p > 0.05). MI, MBC, and FAC at the second evaluation were significantly higher than at the first evaluation in both groups A and B (p < 0.05). On the second DTT, one patient (4.2%) in group A showed a false-positive result, whereas five patients (71.4%) in group B had false-negative results. Approximately 20% of patients showed disruption of the ipsilesional CST at the chronic stage. However, the clinical outcomes in hand and gait functions were generally good. Careful interpretation considering the somatotopy of the ipsilesional CST is needed because of the high false-negative results on DTT at the chronic stage.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061096
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1097: Access to Digital Information and
           Protective Awareness and Practices towards COVID-19 in Urban Marginalized
           Communities

    • Authors: Siwarat Pattanasri, Thi Phuoc Lai Nguyen, Thanh Bien Vu, Ekbordin Winijkul, Mokbul Morshed Ahmad
      First page: 1097
      Abstract: Due to digital inequality, poor living, and health care conditions, marginalized people are the most vulnerable group to the COVID-19 pandemic. This study examined how digital information influences knowledge, practices, threat appraisals, and motivation behaviors of urban marginalized communities. It examined slum people’s digital competencies, their access to COVID-19 online information, and their trust in COVID-19 information provided by both online and offline media. A total of 453 slum people in Bangkok city, Thailand were surveyed, and multiple regression was performed to examine whether socio-demographic factors influence the access to online communication of slum people. We hypothesized that access to online information might affect marginalized people’s awareness of COVID-19 and resulted in greater levels of their practices and protective behaviors. The finding showed that slum people who had access to online information tended to have a better awareness of self-protection against COVID-19, while elderly, female, and foreign migrant workers faced a number of constraints in accessing COVID-19 online information. Such results are important considering the pandemic is compelling societies to turn toward digital technologies to confront the COVID-19 pandemic and address pandemic-related issues. We also discuss how to enhance the role of digital communication in helping urban marginalized communities during and after the pandemic.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061097
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1098: Comparison of the Effect of Endurance,
           Strength, and Endurance-Strength Training on Inflammatory Markers and
           Adipokines Levels in Overweight and Obese Adults: Systematic Review and
           Meta-Analysis of Randomised Trials

    • Authors: Aleksandra Makarewicz, Małgorzata Jamka, Jakub Geltz, Angelika Śmidowicz, Marta Kokot, Nina Kaczmarek, Edyta Mądry, Jarosław Walkowiak
      First page: 1098
      Abstract: The aim of this meta-analysis was to compare the effects of endurance, strength, and combined training on inflammatory markers and adipokine concentrations in overweight and obese adults. We performed a literature search of the Cochrane Library, PubMed, Scopus, and Web of Science databases and identified 24 randomised control trials published prior to June 2021. Our findings indicate that endurance training was significantly more beneficial than strength training in reducing C-reactive protein (CRP) (standard mean difference (SMD): −1.317, 95% confidence intervals (CI): −2.565, −0.070, p = 0.0385), interleukin 6 (IL-6) (SMD: −0.363, 95% CI: −0.648, −0.078, p = 0.0126), and visfatin (SMD: −0.618, 95% CI: −1.015, −0.222, p = 0.0023) concentrations. Moreover, combined training was more beneficial than strength training alone in lowering tumour necrosis factor-alpha (TNF-α) levels (SMD: 0.890, 95% CI: −0.301, 1.478, p = 0.0030). There were no differences between the effects of different types of training programmes on adiponectin and leptin concentrations. In conclusion, compared with strength training, endurance training is more effective in lowering CRP, IL-6, and visfatin concentrations, while combined training is more beneficial in reducing TNF-α levels in overweight and obese adults. Further studies are needed to determine which type of training has a better effect on adiponectin and leptin concentrations in this population.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061098
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1099: The Impact of Instant Reimbursement of
           Cross-Regional Medical Services on Hospitalization Costs Incurred by the
           Floating Population—Evidence from China

    • Authors: Xiaodong Zhang, Lei Zhang
      First page: 1099
      Abstract: Background: The medical cost reimbursement function of medical insurance can reduce the medical burden of individuals and thus improve their medical service utilization level. This study aimed to explore the impact of different cross-regional reimbursement types of medical insurance (instant reimbursement and manual reimbursement) on the hospitalization costs incurred by the floating population. Methods: The data used in this study was from the 2018 China Migrants Dynamic Survey (CMDS) conducted by the National Health Commission of China. The multiple linear regression model and Propensity Score Matching method (PSM) were used to analyze the impact of instant and manual reimbursement on hospitalization costs. Results: (1) Instant reimbursement and manual reimbursement could significantly reduce the floating population’s out-of-pocket proportion of hospitalization costs by 33.2% and 26.9%, respectively; (2) the average proportion and amounts of out-of-pocket hospital costs of instant reimbursement for the floating population were lower than those of manual reimbursement by 6.35% and 19.6%, respectively, and this impact would gradually increase as the flow distance expanded; (3) there was no significant impact of instant reimbursement on the total hospitalization costs relative to manual reimbursement. Conclusions: Our study suggests that instant reimbursement can effectively reduce the out-of-pocket medical burden of the floating population at the individual level, but it will not have an obvious impact on the total hospitalization costs at the social level.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061099
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1100: Intestinal Permeability Associated with
           the Loss of Skeletal Muscle Strength in Middle-Aged and Older Adults in
           Rural Area of Beijing, China

    • Authors: Cheng Li, Yaru Li, Nan Wang, Zhiwen Ge, Zhengli Shi, Jia Wang, Bingjie Ding, Yanxia Bi, Yuxia Wang, Zhongxin Hong
      First page: 1100
      Abstract: The association between intestinal permeability and sarcopenia remains unclear, and few studies have mentioned the relationship between intestinal permeability and skeletal muscle strength. The present cross-sectional community study was conducted in a rural area of Beijing to explore the association between intestinal permeability and handgrip strength (HGS) in middle-aged and older adults. Serum lipopolysaccharide (LPS), diamine oxidase (DAO) and D-lactate were detected to evaluate intestinal permeability. Gut microbiota (GM) and its potential interaction were also analyzed in the decision tree model. HGS was negatively correlated with DAO (r = −0.396, p < 0.01) in males. The negative association between HGS and DAO remained significant with the adjustment of covariates (β = −1.401, p < 0.05). Serum DAO and LPS were both negatively associated with HGS in middle-aged and older males, with the significant interactions of GM in the decision tree model, and D-lactate showed a negative association with HGS in females. Therefore, intestinal permeability was associated with the loss of skeletal muscle strength in middle-aged and older adults, and serum DAO may be a novel predictor for the loss of skeletal muscle strength in middle-aged and older males.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061100
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1101: The Veterans Choice Act and Technical
           Efficiency of Veterans Affairs (VA) Hospitals

    • Authors: Dongjin Oh, Keon-Hyung Lee, Jongsun Park
      First page: 1101
      Abstract: The Veterans Health Administration (VHA), responsible for providing 9 million veterans with quality healthcare, is not insulated from concerns about efficiency. In the aftermath of the Veterans Affairs (VA) hospital scandal in 2014, Congress passed the Veterans Choice Act of 2014, which allows eligible veterans to use non-VA hospitals instead of VA hospitals. After analyzing 118 or 119 VA hospitals each year from 2012 through 2017 in the U.S, this paper evaluates the efficiency scores of VA hospitals and examines how the 2014 Act has influenced their technical efficiency over time. Slack analysis shows that inefficient VA hospitals can improve efficiency by reallocating input resources, and regression analysis demonstrates that the overall technical efficiency of VA hospitals decreased by 0.164 after the implementation of the Act. This means that as more veterans used non-VA hospitals under the 2014 Act, the technical efficiency of VA hospitals decreased considerably. Given that a substantial portion of veterans’ demands for healthcare transferred out to non-VA hospitals, the VHA should evaluate whether the current capacity of VA hospitals is appropriate and try to reduce wasted input resources to improve efficiency.
      Citation: Healthcare
      PubDate: 2022-06-13
      DOI: 10.3390/healthcare10061101
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1102: Primary and Secondary Caregivers of
           People with Dementia (PwD): Differential Patterns and Implications for
           Psychological Support

    • Authors: Arantxa Gorostiaga, Igone Etxeberria, Karmele Salaberria, Iñigo Kortabitarte
      First page: 1102
      Abstract: Very little attention has been paid to identifying the differential characteristics of primary and secondary dementia caregivers. The aims of this study were: to determine whether differences exist between primary and secondary caregivers of people with dementia (PwD) and to explore the profile of primary and secondary caregivers reporting symptoms of anxiety and/or depression. The participants were 146 caregivers of PwD, 73 primary caregivers and 73 secondary caregivers. The results revealed different patterns for each type of caregiver. Primary caregivers showed a more negative profile in terms of poorer self-rated health and higher levels of anxiety and depression: 61.6% of primary and 42.5% of secondary caregivers reported symptoms of anxiety, and 24.7% and 11% reported depression, respectively. The frequency of problem behavior, subjective burden, health, and the comorbidity between anxiety and depression were associated with depression and anxiety among primary caregivers, whereas gender (being a woman), subjective burden, health, and the comorbidity between anxiety and depression were associated among secondary caregivers. These findings may help to guide professionals in targeting psychological support programs and customizing the strategies and skills that need to be provided in accordance with the type of caregiver in question: primary or secondary. The practical implications of the findings are discussed.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061102
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1103: Therapeutic Effects of Intradialytic
           Exercise on Life Quality of Patients with End-Stage Renal Disease: Study
           Protocol for a Randomized Control Trial

    • Authors: Hsiang-Chi Chang, Cheng-Hsu Chen, Yuan-Yang Cheng
      First page: 1103
      Abstract: Background: Exercise training has positive effects on physical functions and could reduce a sedentary lifestyle for hemodialysis (HD) patients. Given that low-level physical activity increases morbidity and mortality, here, we aimed to determine the effects of an intradialytic exercise program delivered at different frequencies on HD patients in Taiwan. Methods: This study is a prospective, randomized control trial. An intradialytic exercise program will be arranged for patients after receiving their informed consent. Patients will be segregated at random into three groups as follows: (a) three times/week of intradialytic exercise training plus standard care maintenance of HD, (b) two times/week of intradialytic exercise training plus standard care maintenance of HD, or (c) standard care maintenance of HD. Subjects will be followed for 24 weeks. At three time points, 0, 12, and 24 weeks, the primary outcome, the Short-Form 36 score, will be measured. Additional secondary outcomes to be measured are the Beck depression inventory, 6 min walking test, sit-to-stand test, and anthropometric measures such as the body mass index, thigh circumference, and the proportion of fat in the body composition. Conclusions: There is emerging evidence in support of intradialytic exercise improving health-related quality of life for patients on HD. However, the difference in the therapeutic effects between three times per week and twice per week has never been determined. With this study, we anticipate to fill the knowledge gap in the exercise prescription among HD patients.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061103
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1104: Conditions for Feasibility of a
           Multicomponent Intervention to Reduce Social Isolation and Loneliness in
           Noninstitutionalized Older Adults

    • Authors: Jose Hernández-Ascanio, Pedro Emilio Ventura-Puertos, Manuel Rich-Ruiz, Vanesa Cantón-Habas, Ana María Roldán-Villalobos, Luis Ángel Pérula-de Torres
      First page: 1104
      Abstract: Aims: To identify the factors conditioning the feasibility of an intervention to reduce social isolation and loneliness in noninstitutionalized older adults from the perspective of the intervention agents. Design: A Dimensional Grounded Theory study conducted from December 2019 to January 2020. Methods: Twelve participants were recruited from an experimental study developed in a health district of a southern Spanish city. Data were collected through focus group meetings, individual interviews, biograms, anecdote notebooks, and the field diaries of two participants not included in the other techniques. Transcripts were analyzed using thematic analysis. Findings: Findings were divided into three themes: (a) the elderly between the walls of loneliness, economic difficulties, losses, and the past; (b) intervention agents/volunteers between the walls of inexperience in the management of psychological/emotional processes, lack of moral authority, and difficulty in planning results adapted to the (elderly) person; and (c) intervention between the walls of (interest in) company and assistance at home, lack of involvement (“waiting for you to save them”), and withdrawal/“abandonment”. Conclusion: A profile of the specialized intervention agent, professionalized (or at least a mentored agent), with both technical and relational competencies; a clear understanding of the purposes of the intervention (empowerment, as opposed to having company or being helped with household chores) and the commitment to active participation by the elder; or adequate management of the completion of the intervention (flexibility, attachment management) are some of the main factors contributing to the feasibility of these approaches. Impact: The findings have potential implications in the field of primary healthcare because primary and community healthcare services can implement corrections to the proposed intervention and ensure its effectiveness under feasible conditions. The nurse is shown as the most appropriate profile to conduct this intervention, although more research is needed to analyze the feasibility of this type of intervention in the daily practice of community nurses.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061104
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1105: Video-Assisted Stylet Intubation with a
           Plastic Sheet Barrier, a Safe and Simple Technique for Tracheal Intubation
           of COVID-19 Patients

    • Authors: Ching-Hsuan Huang, I-Min Su, Bo-Jyun Jhuang, Hsiang-Ning Luk, Jason Zhensheng Qu, Alan Shikani
      First page: 1105
      Abstract: As the COVID-19 pandemic evolves, infection with the Omicron variants has become a serious risk to global public health. Anesthesia providers are often called upon for endotracheal intubations for COVID patients. Expedite and safe intubation can save patient’s life, while minimizing the virus exposure to the anesthesia provider and personnel involved during airway intervention is very important to protect healthcare workers and conserve the medical work force. In this paper, we share clinical experience of using a video-assisted intubating stylet technique combined with a simple plastic sheet barrier placed over the patients’ mouth for tracheal intubation during the Omicron crisis in Taiwan. We demonstrated that the use of an intubating stylet combined with plastic sheet barrier is swift, safe, and accurate in securing the airway in patients with COVID-19.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061105
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1106: Strengthening Breast Cancer Screening
           Mammography Services in Pakistan Using Islamabad Capital Territory as a
           Pilot Public Health Intervention

    • Authors: Ayesha Isani Majeed, Assad Hafeez, Shahzad Ali Khan
      First page: 1106
      Abstract: Late diagnosis of treatable breast cancer is the reason for higher breast cancer mortality. Until now, no public breast cancer facility has been established in the Islamabad Capital Territory. First, a Federal Breast Screening Center (FBSC) was established. Afterward, awareness campaigns about breast cancer were organized among the public. Subsequently, women above 40 years of age were provided with mammography screenings. Data were analyzed in SPSS version 22.0. An intervention was performed using a six tier approach to strengthening the health system. Utilizing the offices of the FBSC and the national breast cancer screening campaign, breast cancer awareness has become a national cause and is being advocated by the highest offices of the country. The number of females undergoing mammography has increased each year, starting from 39 in 2015 to 1403 in 2019. Most of the cases were BI-RAD I (n = 2201, 50.74%) followed by BI-RAD II (n = 864, 19.92%), BI-RAD III (n = 516, 11.89%), BI-RAD IV (n = 384, 8.85%), BI-RAD V (n = 161, 3.71%), and BI-RVAD VI (n = 60, 1.38%). The current study has theoretical and practical implications for the contemplation of policymakers. The FBSC can serve as a model center for the establishment of centers in other parts of the country, thereby promoting nationwide screening coverage.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061106
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1107: Osteoporosis Pre-Screening Using Ensemble
           Machine Learning in Postmenopausal Korean Women

    • Authors: Youngihn Kwon, Juyeon Lee, Joo Hee Park, Yoo Mee Kim, Se Hwa Kim, Young Jun Won, Hyung-Yong Kim
      First page: 1107
      Abstract: As osteoporosis is a degenerative disease related to postmenopausal aging, early diagnosis is vital. This study used data from the Korea National Health and Nutrition Examination Surveys to predict a patient’s risk of osteoporosis using machine learning algorithms. Data from 1431 postmenopausal women aged 40–69 years were used, including 20 features affecting osteoporosis, chosen by feature importance and recursive feature elimination. Random Forest (RF), AdaBoost, and Gradient Boosting (GBM) machine learning algorithms were each used to train three models: A, checkup features; B, survey features; and C, both checkup and survey features, respectively. Of the three models, Model C generated the best outcomes with an accuracy of 0.832 for RF, 0.849 for AdaBoost, and 0.829 for GBM. Its area under the receiver operating characteristic curve (AUROC) was 0.919 for RF, 0.921 for AdaBoost, and 0.908 for GBM. By utilizing multiple feature selection methods, the ensemble models of this study achieved excellent results with an AUROC score of 0.921 with AdaBoost, which is 0.1–0.2 higher than those of the best performing models from recent studies. Our model can be further improved as a practical medical tool for the early diagnosis of osteoporosis after menopause.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061107
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1108: Utility of Teleorthodontics in
           

    • Authors: Sabina Saccomanno, Vincenzo Quinzi, Arianna Albani, Nicola D’Andrea, Giuseppe Marzo, Guido Macchiarelli
      First page: 1108
      Abstract: Background. Coronavirus disease has subjected the whole of humanity to two years of social isolation and a series of restrictions. These circumstances have led to the use of information technology in an increasingly widespread manner. Even in the dental field, telematic means have been used to respond to emergencies. The aim of this systematic review of the literature is to evaluate the types of orthodontic emergency that occurred most often and how they were managed by teleorthodontics during the COVID-19 pandemic. The secondary aim is that clinicians will use teleorthodontics not only during pandemics but as an additional tool to manage orthodontics. Materials and Methods. Out of 1695 articles available on PubMed, Science Direct, Cochrane and SciELO, eight articles were selected for this systematic literature review. Google Scholar was used as a secondary source to confirm that there were no additional articles. The screened papers comprised editorials, clinical studies, cross-sectional studies and retrospective studies in Italian, English or Spanish language. Results. The articles showed that the means by which patients most often communicated with their orthodontists were voice calls and smartphone applications such as WhatsApp® Messenger. Through these media, patients communicated their orthodontic emergencies. These mainly involved fixed multibracket appliances and the most common issues were discomfort and pain, fracture or loss of the appliance, protruding distal ends of archwires, brackets, tubes and bands or retainer detachment. Through teleorthodontics, patients could solve these issues by using orthodontic relief wax, cutting the protruding distal ends of the archwire with a nail clipper or a stronger cutter and removing or replacing detached bands, brackets, tubes or metallic ligature with a clean tweezer. Conclusions. In situations where personal contact is limited, teleorthodontics represents a valuable aid for professionals and patients facing orthodontic emergencies. The hope is that it may continue to represent a valuable aid for patients with difficulties in planning an in-office visit.
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061108
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1109: Vertebral Related Diseases in Healthcare:
           The Role of Pain Management and Rehabilitation

    • Authors: Alessandro de Sire, Nicola Marotta, Antonio Ammendolia
      First page: 1109
      Abstract: The increase in the life expectancy of the general population implied for vertebral diseases an impacting role for the medical condition of the person, not only in the clinical context, but also from a social and economic point of view, due to the underestimation of primary prevention and complex secondary prevention rehabilitation frameworks [...]
      Citation: Healthcare
      PubDate: 2022-06-14
      DOI: 10.3390/healthcare10061109
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1110: FIDChain: Federated Intrusion Detection
           System for Blockchain-Enabled IoT Healthcare Applications

    • Authors: Eman Ashraf, Nihal F. F. Areed, Hanaa Salem, Ehab H. Abdelhay, Ahmed Farouk
      First page: 1110
      Abstract: Recently, there has been considerable growth in the internet of things (IoT)-based healthcare applications; however, they suffer from a lack of intrusion detection systems (IDS). Leveraging recent technologies, such as machine learning (ML), edge computing, and blockchain, can provide suitable and strong security solutions for preserving the privacy of medical data. In this paper, FIDChain IDS is proposed using lightweight artificial neural networks (ANN) in a federated learning (FL) way to ensure healthcare data privacy preservation with the advances of blockchain technology that provides a distributed ledger for aggregating the local weights and then broadcasting the updated global weights after averaging, which prevents poisoning attacks and provides full transparency and immutability over the distributed system with negligible overhead. Applying the detection model at the edge protects the cloud if an attack happens, as it blocks the data from its gateway with smaller detection time and lesser computing and processing capacity as FL deals with smaller sets of data. The ANN and eXtreme Gradient Boosting (XGBoost) models were evaluated using the BoT-IoT dataset. The results show that ANN models have higher accuracy and better performance with the heterogeneity of data in IoT devices, such as intensive care unit (ICU) in healthcare systems. Testing the FIDChain with different datasets (CSE-CIC-IDS2018, Bot Net IoT, and KDD Cup 99) reveals that the BoT-IoT dataset has the most stable and accurate results for testing IoT applications, such as those used in healthcare systems.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061110
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1111: Severe Ground Fall Injury Associated with
           Alcohol Consumption in Geriatric Patients

    • Authors: Jung Sung Hwang, Sun Hyu Kim
      First page: 1111
      Abstract: This study investigated characteristics of geriatric patients sustaining ground fall injury related to alcohol consumption and analyzed factors associated with the severity of such injuries in both alcohol- and non-alcohol-related cases. We retrospectively reviewed geriatric patients sustaining ground falls who were admitted to six university hospitals from 2011 to 2018. Patients were classified into alcohol and non-alcohol groups. Their general characteristics, clinical characteristics, and factors of injury severity were analyzed. A total of 31,177 patients were reviewed. Factors significantly associated with alcohol-related ground-fall injuries were: male, 65~84 years old, injury time other than 06:00~11:59, transportation to emergency department (ED) by ambulance and from other hospitals, injured in residential facilities, transportation areas, public or commercial facilities, activities other than paid or unpaid, non-slippery floor, obstacles, concrete floor, and absence of lights. Factors associated with severe injury after ground fall in alcohol-related cases were: male, injury time at between 06:00 and 17:59, transportation to the ED via ambulance from other hospitals, injured in residential facility, and slippery floor. Risk factors for severity in alcohol-related geriatric fall injury included: male sex, daytime injury, transportation by ambulance, injury in a residential facility, and slippery floor condition. Prophylactic measures and therapeutic interventions by ED teams are needed for the management of such cases.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061111
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1112: Screening for Mild Cognitive Impairment
           in the Preoperative Setting: A Narrative Review

    • Authors: Mariska te Pas, Marcel Olde Rikkert, Arthur Bouwman, Roy Kessels, Marc Buise
      First page: 1112
      Abstract: Cognitive impairment predisposes patients to the development of delirium and postoperative cognitive dysfunction. In particular, in older patients, the adverse sequelae of cognitive decline in the perioperative period may contribute to adverse outcomes after surgical procedures. Subtle signs of cognitive impairment are often not previously diagnosed. Therefore, the aim of this review is to describe the available cognitive screeners suitable for preoperative screening and their psychometric properties for identifying mild cognitive impairment, as preoperative workup may improve perioperative care for patients at risk for postoperative cognitive dysfunction. Electronic systematic and snowball searches of PubMed, PsycInfo, ClinicalKey, and ScienceDirect were conducted for the period 2015–2020. Major inclusion criteria for articles included those that discussed a screener that included the cognitive domain ‘memory’, that had a duration time of less than 15 min, and that reported sensitivity and specificity to detect mild cognitive impairment. Studies about informant-based screeners were excluded. We provided an overview of the characteristics of the cognitive screener, such as interrater and test-retest reliability correlations, sensitivity and specificity for mild cognitive impairment and cognitive impairment, and duration of the screener and cutoff points. Of the 4775 identified titles, 3222 were excluded from further analysis because they were published prior to 2015. One thousand four hundred and forty-eight titles did not fulfill the inclusion criteria. All abstracts of 52 studies on 45 screeners were examined of which 10 met the inclusion criteria. For these 10 screeners, a further snowball search was performed to obtain related studies, resulting in 20 articles. Screeners included in this review were the Mini-Cog, MoCA, O3DY, AD8, SAGE, SLUMS, TICS(-M), QMCI, MMSE2, and Mini-ACE. The sensitivity and specificity range to detect MCI in an older population is the highest for the MoCA, with a sensitivity range of 81–93% and a specificity range of 74–89%. The MoCA, with the highest combination of sensitivity and specificity, is a feasible and valid routine screening of pre-surgical cognitive function. This warrants further implementation and validation studies in surgical pathways with a large proportion of older patients.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061112
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1113: How Can We Help Healthcare Workers during
           a Catastrophic Event Such as the COVID-19 Pandemic'

    • Authors: Hannah Wozniak, Lamyae Benzakour, Christophe Larpin, Sebastian Sgardello, Grégory Moullec, Sandrine Corbaz, Pauline Roos, Laure Vieux, Typhaine M. Juvet, Jean-Claude Suard, Rafaël Weissbrodt, Jérôme Pugin, Jacques A. Pralong, Sara Cereghetti
      First page: 1113
      Abstract: Healthcare workers (HCWs) have significantly suffered during the COVID-19 pandemic, reporting a high prevalence of anxiety, depression and post-traumatic stress disorder (PTSD). We investigated with this survey whether HCWs benefitted from supportive measures put in place by hospitals and how these measures were perceived. This cross-sectional survey, which was conducted during the first wave of COVID-19 at the Geneva University Hospitals, Switzerland, between May and July 2021, collected information on the use and perception of practical and mental health support measures provided by the hospital. In total, 3461 HCWs participated in the study. Regarding the practical support measures, 2896 (84%) participants found them useful, and 2650 (76%) used them. Regarding the mental health support measures, 3149 (90%) participants found useful to have the possibility of attending hypnosis sessions, 3163 (91%) to have a psychologist within hospital units, 3202 (93%) to have a medical nursing psychiatric permanence available seven days a week, and 3171 (92%) to have a hotline available seven days a week. In total, 436 (13%) HCWs used at least one of the available mental health support measures. During the COVID-19 pandemic, the support measures were valued by HCWs. Given the high prevalence of psychiatric issues among HCWs, these measures seem necessary and are likely to have alleviated the suffering of HCWs.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061113
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1114: A Design Approach to Optimise Secure
           Remote Three-Dimensional (3D) Printing: A Proof-of-Concept Study towards
           Advancement in Telemedicine

    • Authors: Xiao Wen Kok, Anisha Singh, Bahijja Tolulope Raimi-Abraham
      First page: 1114
      Abstract: Telemedicine is defined as the delivery of healthcare services at a distance using electronic means. The incorporation of 3D printing in the telemedicine cycle could result in pharmacists designing and manufacturing personalised medicines based on the electronic prescription received. Even with the advantages of telemedicine, numerous barriers to the uptake hinder the wider uptake. Of particular concern is the cyber risk associated with the remote digital transfer of the computer-aided design (CAD) file (acting as the electronic prescription) to the 3D printer and the reproducibility of the resultant printed medicinal products. This proof-of-concept study aimed to explore the application of secure remote 3D printing of model solid dosage forms using the patented technology, DEFEND3D, which is designed to enhance cybersecurity and intellectual property (IP) protection. The size, shape, and colour of the remote 3D-printed model medicinal products were also evaluated to ensure the end-product quality was user-focused. Thermoplastic polyurethane (TPU) and poly(lactic) acid (PLA) were chosen as model polymers due to their flexibility in preventing breakage printing and ease of printing with fused deposition modelling (FDM). Our work confirmed the potential of secure remote 3D (FDM) printing of prototype solid dosage forms resulting in products with good reproducibility, resolution, and quality towards advancements in telemedicine and digital pharmacies. The limitation of the work presented here was the use of model polymers and not pharmaceutically relevant polymers. Further work could be conducted using the same designs chosen in this study with pharmaceutically relevant polymers used in hot-melt extrusion (HME) with shown suitability for FDM 3D printing. However, it should be noted that any challenges that may occur with pharmaceutically relevant polymers are likely to be related to the polymer’s printability and printer choice as opposed to the ability of the CAD file to be transferred to the printer remotely.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061114
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1115: Moving toward Appropriate Motor
           Assessment Tools in People Affected by Severe Acquired Brain Injury: A
           Scoping Review with Clinical Advices

    • Authors: Mirjam Bonanno, Rosaria De Luca, William Torregrossa, Paolo Tonin, Rocco Salvatore Calabrò
      First page: 1115
      Abstract: Severe acquired brain injury (SABI) is among the leading causes of death and disability worldwide. Patients following SABI may develop motor, sensory and cognitive disorders, alone or in combination. This review aims to point out the most used scales to assess motor function in SABI patients, also attempting to give some indications on their applicability in clinical practice. Studies were identified by searching on PubMed, Web of Science, PeDro and Cochrane databases between January and March 2022. We found that motor assessment tools are currently used by researchers/clinicians either in the acute/post-acute phase (for prognosis and rehabilitation purposes) or in the chronic phase (when functional items may also be considered). Moreover, specific scales exist only for patients with disorders of consciousness, whereas regarding motor function, SABI is mainly assessed by adapting the tools commonly used for stroke. Although some doubts remain about the validity of some of these assessment tools in SABI, to investigate motor outcomes is fundamental to establish a correct prognosis and plan a tailored rehabilitation training in these very frail and vulnerable patients.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061115
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1116: Comparison of Measurements of External
           Load between Professional Soccer Players

    • Authors: Roghayyeh Gholizadeh, Hadi Nobari, Lotfali Bolboli, Marefat Siahkouhian, João Paulo Brito
      First page: 1116
      Abstract: Background: The excessive and rapid increases in training load (TL) may be responsible for most non-contact injuries in soccer. This study’s aims were to describe, week(w)-by-week, the acute (AW), chronic (CW), acute:chronic workload ratio (wACWR), total distance (wTD), duration training (wDT), sprint total distance (wSTD), repeat sprint (wRS), and maximum speed (wMS) between starter and non-starter professional soccer players based on different periods (i.e., pre-, early-, mid-, and end-season) of a full-season (Persian Gulf Pro League, 2019–2020). Methods: Nineteen players were divided according to their starting status: starters (n = 10) or non-starters (n = 9). External workload was monitored for 43 weeks: pre- from w1–w4; early- from w5–w17; mid- from w18–w30, and end-season from w31–w43. Results: In starters, AW, CW, and wACWR were greater than non-starters (p < 0.05) throughout the periods of early- (CW, p ≤ 0.0001), mid- (AW, p = 0.008; CW, p ≤ 0.0001; wACWR, p = 0.043), or end-season (AW, p = 0.035; CW, p = 0.017; wACWR, p = 0.010). Starters had a greater wTD (p ≤ 0.0001), wSTD (p ≤ 0.0001 to 0.003), wDT (p ≤ 0.0001 to 0.023), wRS (p ≤ 0.0001 to 0.018), and wMS (p ≤ 0.0001) than non-starters during early-, mid-, and end-season. Conclusion: Starters experienced more CW and AW during the season than non-starters, which underlines the need to design tailored training programs accounting for the differences between playing status.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061116
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1117: The Users’ Intention to Participate
           in a VR/AR Sports Experience by Applying the Extended Technology
           Acceptance Model (ETAM)

    • Authors: Kyongmin Lee, Seungwook Oh
      First page: 1117
      Abstract: Since the basic model of technology acceptance model (TAM) was introduced, studies in various fields have been conducted to improve the explanatory power of the TAM. These studies show that there are limitations in explaining the intention to use a new technology with just two variables (perceived usefulness and perceived ease of use), and that the intention to use a new technology can be affected by many external variables, in addition to the two variables. Accordingly, the purpose of this study is to identify factors affecting users’ intention to participate in a virtual/augmented reality (VR/AR) sports experience based on the extended technology acceptance model (ETAM). To this end, this study analyzed the results of a survey conducted on 300 university students who are sports majors in Korea, who have experienced VR/AR sports. First, among experience economy factors, education experience, escape experience, and esthetic experience had a positive effect on presence. Second, presence had a positive effect on perceived usefulness and flow. Third, perceived usefulness and flow had a positive effect on the intention to participate. This study has significance in empirically investigating the relationship among variables affecting users’ intention to participate in a VR/AR sports experience using the ETAM. The results can be used as basic data for establishing strategies necessary in vitalizing VR/AR sports in the future.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061117
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1118: Polycystic Ovary Syndrome (PCOS) and
           Non-Suicidal Self-Injury (NSSI): A Community-Based Study

    • Authors: Sophie Williams, Dean Fido, David Sheffield
      First page: 1118
      Abstract: Polycystic Ovary Syndrome (PCOS) is an endocrine condition that has been associated with atypical emotional regulation strategy use as well as elevated levels of depression, anxiety, self-harm and suicidal ideation. Despite the existence of clinical screening guidance for this population, there is still little to no understanding of how non-suicidal self-injury and suicidal ideation and intention manifest in women with PCOS and how this might differ from women without PCOS. Within this cross-sectional investigation, women with and without a diagnosis of PCOS (n = 418) completed validated metrics of emotion dysregulation, rumination and non-suicidal self-injury (NSSI), as well as self-reported indices of previous suicidal ideation and future suicidal intention. Group comparisons indicated that women with, relative to those without, PCOS reported significantly greater metrics across all variables. Moreover, serial mediation analyses were conducted to test the ideation-to-action framework of suicide in women with PCOS, with the positive relationship between a PCOS diagnosis and future suicidal intention being explained through the indirect pathway of increased emotion dysregulation, recent suicidal ideation and NSSI. Our findings call to action the need for international screening for suicide intention and self-harm in women with PCOS.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061118
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1119: A Comparative Study of Natural Language
           Processing Algorithms Based on Cities Changing Diabetes Vulnerability Data
           

    • Authors: Siting Wang, Fuman Song, Qinqun Qiao, Yuanyuan Liu, Jiageng Chen, Jun Ma
      First page: 1119
      Abstract: (1) Background: Poor adherence to management behaviors in Chinese Type 2 diabetes mellitus (T2DM) patients leads to an uncontrolled prognosis of diabetes, which results in significant economic costs for China. It is imperative to quickly locate vulnerability factors in the management behavior of patients with T2DM. (2) Methods: In this study, a thematic analysis of the collected interview materials was conducted to construct the themes of T2DM management vulnerability. We explored the applicability of the pre-trained models based on the evaluation metrics in text classification. (3) Results: We constructed 12 themes of vulnerability related to the health and well-being of people with T2DM in Tianjin. We considered that Bidirectional Encoder Representation from Transformers (BERT) performed better in this Natural Language Processing (NLP) task with a shorter completion time. With the splitting ratio of 6:3:1 and batch size of 64 for BERT, the test accuracy was 97.71%, the completion time was 10 min 24 s, and the macro-F1 score was 0.9752. (4) Conclusions: Our results proved the applicability of NLP techniques in this specific Chinese-language medical environment. We filled the knowledge gap in the application of NLP technologies in diabetes management. Our study provided strong support for using NLP techniques to rapidly locate vulnerability factors in T2DM management.
      Citation: Healthcare
      PubDate: 2022-06-15
      DOI: 10.3390/healthcare10061119
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1120: A Comparison of Univariate and
           Multivariate Forecasting Models Predicting Emergency Department Patient
           Arrivals during the COVID-19 Pandemic

    • Authors: Egbe-Etu Etu, Leslie Monplaisir, Sara Masoud, Suzan Arslanturk, Joshua Emakhu, Imokhai Tenebe, Joseph B. Miller, Tom Hagerman, Daniel Jourdan, Seth Krupp
      First page: 1120
      Abstract: The COVID-19 pandemic has heightened the existing concern about the uncertainty surrounding patient arrival and the overutilization of resources in emergency departments (EDs). The prediction of variations in patient arrivals is vital for managing limited healthcare resources and facilitating data-driven resource planning. The objective of this study was to forecast ED patient arrivals during a pandemic over different time horizons. A secondary objective was to compare the performance of different forecasting models in predicting ED patient arrivals. We included all ED patient encounters at an urban teaching hospital between January 2019 and December 2020. We divided the data into training and testing datasets and applied univariate and multivariable forecasting models to predict daily ED visits. The influence of COVID-19 lockdown and climatic factors were included in the multivariable models. The model evaluation consisted of the root mean square error (RMSE) and mean absolute error (MAE) over different forecasting horizons. Our exploratory analysis illustrated that monthly and weekly patterns impact daily demand for care. The Holt–Winters approach outperformed all other univariate and multivariable forecasting models for short-term predictions, while the Long Short-Term Memory approach performed best in extended predictions. The developed forecasting models are able to accurately predict ED patient arrivals and peaks during a surge when tested on two years of data from a high-volume urban ED. These short- and long-term prediction models can potentially enhance ED and hospital resource planning.
      Citation: Healthcare
      PubDate: 2022-06-16
      DOI: 10.3390/healthcare10061120
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1121: Antibiotic Resistance of Helicobacter
           pylori in Children with Gastritis and Peptic Ulcers in Mekong Delta,
           Vietnam

    • Authors: Loan Thi Thuy Le, Tuan Anh Nguyen, Nghia An Nguyen, Yen Thi Hai Nguyen, Hai Thi Be Nguyen, Liem Thanh Nguyen, Mai Tuyet Vi, Thang Nguyen
      First page: 1121
      Abstract: Background: Helicobacter pylori (H. pylori) infection causes gastritis, duodenal and gastric ulcers, and gastric cancer. H. pylori eradication efficacy is low worldwide, and antibiotic resistance is the leading cause of therapy failure; therefore, this study was performed to determine the characteristics of antibiotic resistance of H. pylori in children with gastritis, duodenal and gastric ulcer. Methods: A cross-sectional study was conducted on 237 pediatric patients diagnosed with gastroduodenal inflammation and ulcer at two hospitals in Vietnam from March 2019 to April 2022. Pediatric patients with positive H. pylori tests continued to do E-tests to measure the minimum inhibitory concentration of the antibiotic so that we could prescribe effective antibiotics based on the sensitivity. Results: In 237 pediatric patients (51.1% males) with a median age of 10.3 years (range 5–16 years), endoscopic images showed that inflammatory lesions and peptic ulcers accounted for 69.2% and 30.8%, respectively. Resistance rates of H. pylori were 80.6% to clarithromycin (CLR), 71.7% to amoxicillin (AMX), 49.4% to metronidazole (MTZ), 45.1% to levofloxacin (LEV), and 11.4% to tetracycline (TET); dual resistance to AMX + CLR was 64.2%, AMX + LEV 35%, AMX + MTZ 33.3%, CLR + MTZ 32.5%, and TET + MTZ 7.2%. The frequency of clarithromycin resistance was significantly increased, particularly in pediatric patients who had received prior H. pylori treatment. The percentage of amoxicillin resistance increased with age; amoxicillin resistance of H. pylori was more prevalent among pediatric patients with peptic ulcers than those with gastroduodenal inflammation and higher in males than females. Conclusions: The proportions of resistance to CLR, AMX, MTZ, and LEV were extremely high, in contrast to TET, which was lower in pediatric patients. Our study suggests that the standard triple therapy with CLR should be limited as the empiric therapy for pediatric patients, and we should consider using eradication regimens with TET for children over 8 years of age if the medical facility is not qualified to perform antibiotic susceptibility tests of H. pylori in the Mekong Delta.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061121
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1122: Factors Affecting Turnover Intention
           among New Graduate Nurses: Focusing on Job Stress and Sleep Disturbance

    • Authors: Minjeong An, Seongkum Heo, Yoon Young Hwang, Jin Shil Kim, Yeonhu Lee
      First page: 1122
      Abstract: Despite the high prevalence of nurses’ turnover and the turnover intention of new nurses, there are insufficient studies examining turnover intention at the time when job orientation is completed and independent nursing commences. Thus, this study examined turnover intention levels and identified the factors affecting turnover intention of new Generation Z nurses, focusing on job stress and sleep disturbance, at the eighth week after completing job orientation. This was a cross-sectional descriptive correlational study. Using a convenient sampling method, 133 new nurses were recruited. Data were collected using a structured questionnaire consisting of demographic and occupational characteristics, job stress, sleep disturbance, and turnover intention. Descriptive statistics were computed to describe the sample and interest variables. Logistic regression analysis was performed to examine the association of job stress and sleep disturbance with turnover intention. Most nurses were women (91.7%) and approximately two-thirds worked in the surgical ward (n = 61, 45.9%). Turnover intention was 12.8%, average job stress was 40.11 ± 90.7, and average sleep disturbance was 42.39 ± 15.27. New graduate nurses’ turnover intention was associated with job stress (OR = 1.07, 95% CI = 1.02–1.12) and sleep disturbance (OR = 1.19, 95% CI = 1.05–1.35), and this model explained 47.7% of the variance. Study findings determine that job stress and sleep disturbance were significant predictors of turnover intention in new nurses at the eighth week after joining the hospital. Therefore, nursing administrators should focus on new nurses’ job stress and sleep disturbance, and provide them with timely assessment and management to reduce turnover intention.
      Citation: Healthcare
      PubDate: 2022-06-16
      DOI: 10.3390/healthcare10061122
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1123: Level of Depression during the COVID-19
           Pandemic in Poland—A Cross-Sectional Study

    • Authors: Anna Zalewska, Monika Gałczyk, Katarzyna Van Damme-Ostapowicz
      First page: 1123
      Abstract: Objectives: The aim of this study was to assess the level of depression during the COVID-19 pandemic in Poland. Methods: The online survey was conducted among Polish adult citizens (204 respondents) with a positive SARS-CoV-2 test result. The level of depression was assessed by the Beck Depression Inventory in Polish. Results: Depressive symptoms of moderate or severe degree appeared in about every fourth person. Women were characterised with higher mean depression scores. In the group of men, significant correlations were found between mental condition and age—the higher the age, the higher the values of depression measures. Those who were asymptomatic with SARS-CoV-2 had the best results—a lack of depression, while those who were fully symptomatic had the worst results—major depressive disorder. Conclusions: There is a need for further research and monitoring of mental health in specific population groups. It is necessary to plan preventive measures to prevent the negative effects of the pandemic, especially in women. Specialist support should be implemented during and after the pandemic.
      Citation: Healthcare
      PubDate: 2022-06-16
      DOI: 10.3390/healthcare10061123
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1124: Virtual Reality in the Rehabilitation of
           Patients with Injuries and Diseases of Upper Extremities

    • Authors: Pinar Tokgöz, Susanne Stampa, Dirk Wähnert, Thomas Vordemvenne, Christoph Dockweiler
      First page: 1124
      Abstract: Upper-extremity injuries and diseases rarely have life-threatening consequences, but failure to manage them properly can result in severe dysfunction. This article presents the current state of using virtual reality to support the rehabilitation process of patients with injuries and diseases of the upper extremities and points out their effects on upper-extremity functions. A scoping review was conducted to provide a comprehensive overview of the field of virtual reality for upper-extremity rehabilitation. PubMed, Web of Science, and the Cochrane Library were searched by two independent researchers between April and May 2021 to identify relevant publications and were examined according to inclusion and exclusion criteria. As a result of the literature review, 11 studies of various target groups were identified. Virtual-reality technologies were categorized into multisensory high-end systems and game-based systems. With respect to functional recovery, technologies based on virtual reality were not inferior to traditional rehabilitation. In addition, the users were highly motivated and satisfied. The results emphasize the need for stronger evidence-based virtual-reality technologies for rehabilitation of injuries and diseases of upper extremities.
      Citation: Healthcare
      PubDate: 2022-06-16
      DOI: 10.3390/healthcare10061124
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1125: Association between the Development of
           Hospice and Palliative Care and Government-Funded Research Priority:
           Taiwan-Based Example

    • Authors: Ming-Chieh Cho, Po-Chin Yang, Yueh-Hsin Wang, Hsiao-Ting Chang, Ming-Hwai Lin
      First page: 1125
      Abstract: In recent years, hospice and palliative care (HPC) has grown, developed, and changed in response to the humanistic and social needs for supporting those with incurable illnesses. As a relatively new discipline, research is needed in HPC, and the priority setting of research is essential to help direct finite resources to support research. To promote creative research in different fields including HPC, the Taiwan government subsidized institutions to conduct research. In this study, we obtained data from the Government Research Bulletin, an open-source online system containing complete information about government subsidized studies since 1993 to investigate the development of research priority in HPC in Taiwan. In total, 552 studies were recorded during 1993–2021, with a continued upward trend. An association was found between research priority and the promulgation of new HPC regulations. The type of diseases in research extended from cancer to all advanced chronic conditions. The increased diversity in out-of-hospital settings of palliative research was also observed. Numerous studies have focused on education, and the theme gradually shifted from “training and education for healthcare professionals” to “public education”. Here, the results may serve as a basis to understand the commonalities of research and enhance dialog in HPC research.
      Citation: Healthcare
      PubDate: 2022-06-16
      DOI: 10.3390/healthcare10061125
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1126: Child Gender and Married Women’s
           Overwork: Evidence from Rural–Urban Migrants in China

    • Authors: Yanjiao Song, Ruojing Wang
      First page: 1126
      Abstract: Overwork is one of the risk factors for the work-related burden of disease. In China, nearly a quarter of migrant women are overworked. Working long hours can significantly increase the possibility of migrant women suffering from hypertension and hyperglycemia. The phenomenon of overtime work of migrant women and their health conditions deserves attention. Based on the China Migrants Dynamic Survey in 2016, this study indicates that giving birth to a boy may exacerbate overtime work among migrant women and having more boys in a family increases the probability of women’s overwork. Empirical results confirmed the existence of son preferences in China. Compared with women who gave birth to boys, women who gave birth to girls have a lower probability of being a workaholic due to a future fertility plan. Furthermore, the overwork of women is also due to the great economic burden on families to buy a wedding house, brought on by the birth of boys. To overcome the endogenous problem caused by this omitted explanatory variable, this study uses each province’s relative sex ratio at birth in 2010 as the instrumental variable of the firstborn’s gender. The IV results illustrate that the birth of boys still significantly exacerbates women’s overwork. Furthermore, considering age heterogeneity, the influence of son preference on women’s overtime work exists throughout their labor life cycle. This paper provides a new perspective for understanding migrant women’s overtime work and their health issues in urban China.
      Citation: Healthcare
      PubDate: 2022-06-16
      DOI: 10.3390/healthcare10061126
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1127: Adverse Childhood Events, Post-Traumatic
           Stress Disorder, Infectious Encephalopathies and Immune-Mediated Disease

    • Authors: Robert C. Bransfield
      First page: 1127
      Abstract: Adverse Childhood Events (ACE), Post-Traumatic Stress Disorder (PTSD), and infectious encephalopathies are associated with immune-mediated diseases. Data supporting this are reviewed, and an integrated hypothesis is provided. All three can be associated with intrusive symptoms and temporal lobe pathology. ACE and PTSD are accompanied by an impaired mental capacity to differentiate external danger vs. safety. Infectious encephalopathies are accompanied by a failure of adaptive immunity and an impaired immune capacity to differentiate internal danger vs. safety. All three conditions are associated with impairments to differentiate danger vs. safety and adapt effectively. There are reciprocal interactions between ACE, PTSD, and infectious encephalopathies with accompanying persistent immune activation. This is associated with immune dysregulation, chronic hyperarousal, activation of the stress response, and impairments of the fear recognition and response neural circuits, hypothalamic–pituitary–adrenal axis, amygdala, and hippocampus. The pathophysiological processes can result in a broad spectrum of chronic neuropsychiatric and somatic symptoms and diseases. Understanding the psychodynamic, neurological, neuroimmune, inflammatory and autoimmune components of this interactive process expands the effective treatment opportunities.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061127
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1128: Hospital Length of Stay in Patients with
           and without Serious and Persistent Mental Illness: Evidence of Racial and
           Ethnic Differences

    • Authors: Omolola E. Adepoju, Lyoung H. Kim, Steven M. Starks
      First page: 1128
      Abstract: Background: Prior studies have documented racial and ethnic differences in mental healthcare utilization, and extensively in outpatient treatment and prescription medication usage for mental health disorders. However, limited studies have investigated racial and ethnic differences in length of inpatient stay (LOS) in patients with and without Serious and Persistent Mental Illness. Understanding racial and ethnic differences in LOS is necessary given that longer stays in hospital are associated with adverse health outcomes, which in turn contribute to health inequities. Objective: To examine racial and ethnic differences in length of stay among patients with and without serious and persistent mental illness (SPMI) and how these differences vary in two age cohorts: patients aged 18 to 64 and patients aged 65+. Methods: This study employed a retrospective cohort design to address the research objective, using the 2018 Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample. After merging the 2018 National Inpatient Sample’s Core and Hospital files, Generalized Linear Model (GLM), adjusting for covariates, was applied to examine associations between race and ethnicity, and length of stay for patients with and without SPMI. Results: Overall, patients from racialized groups were likely to stay longer than White patients regardless of severe mental health status. Of all races and ethnicities examined, Asian patients had the most extended stays in both age cohorts: 8.69 days for patients with SPMI and 5.73 days for patients without SPMI in patients aged 18 to 64 years and 8.89 days for patients with SPMI and 6.05 days for patients without SPMI in the 65+ cohort. For individuals aged 18 to 64, differences in length of stay were significantly pronounced in Asian patients (1.6 days), Black patients (0.27 days), and Native American patients/patients from other races (0.76 days) if they had SPMI. For individuals aged 65 and older, Asian patients (1.09 days) and Native American patients/patients from other races (0.45 days) had longer inpatient stays if they had SPMI. Conclusion: Racial and ethnic differences in inpatient length of stay were most pronounced in Asian patients with and without SPMI. Further studies are needed to understand the mechanism(s) for these differences.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061128
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1129: The Effect of Resistance Training on Bone
           Mineral Density in Older Adults: A Systematic Review and Meta-Analysis

    • Authors: Danilo A. Massini, Flávio H. Nedog, Thiago P. de Oliveira, Tiago A. F. Almeida, Caroline A. A. Santana, Cassiano M. Neiva, Anderson G. Macedo, Eliane A. Castro, Mário C. Espada, Fernando J. Santos, Dalton M. Pessôa Filho
      First page: 1129
      Abstract: Resistance training (RT) has been considered an intervention with effective stimulus on bone mineral formation and is, therefore, recommended to decrease the rate of bone morpho-functional proprieties loss with aging. Thus, this meta-analysis aimed to analyze the effectiveness of RT protocols in promoting changes in bone mineral density (BMD) in older adults. The systematic reviews and meta-analysis followed the PRISMA guidelines (PROSPERO CRD42020170859). The searches were performed in the electronic databases using descriptors according to the PICO strategy. The methodological quality and risk of bias were assessed with the PEDro scale, and the magnitude of the results was determined by Hedges’ g. Seven studies involving 370 elderlies, with the RT planned as a unique exercise mode of intervention, showed designs with four to five exercises for upper- and lower-limbs musculature, two to three sets per exercise, eight to twelve repetitions to failure at 70–90% 1 RM, 60–120 s of rest between sets, and executed three times per week for 12–52 weeks. The RT protocols were classified between good and excellent and evidenced a positive effect on the BMD at the hip (0.64%) and spine (0.62%) but not in the femoral neck (−0.22%) regardless of the intervention length. The narrow range of either positive or negative changes in the BMD after the RT intervention support, at best, a preventive effect against the increasing risk of bone frailty in an older population, which is evident beyond 12 weeks of RT practice engagement.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061129
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1130: Understanding the Needs and Priorities of
           People Living with Persistent Pain and Long-Term Musculoskeletal
           Conditions during the COVID-19 Pandemic—A Public Involvement Project
           

    • Authors: Sally Fowler Davis, Helen Humphreys, Tom Maden-Wilkinson, Sarah Withers, Anna Lowe, Robert J. Copeland
      First page: 1130
      Abstract: Background: Critiques of public involvement (PI) are associated with failing to be inclusive of under-represented groups, and this leads to research that fails to include a diversity of perspectives. Aim: The aim of this PI project was to understand the experiences and priorities of people from three seldom-heard groups whose musculoskeletal pain may have been exacerbated or treatment delayed due to COVID-19. Engaging representatives to report diverse experiences was important, given the goal of developing further research into personalised and integrated care and addressing population health concerns about access and self-management for people with musculoskeletal pain. Methods: The project was approved via Sheffield Hallam University Ethics but was exempt from further HRA approval. A literature review was conducted, followed by informal individual and group discussions involving professionals and people with lived experience of (a) fibromyalgia pain, (b) those waiting for elective surgery and (c) experts associated with the care home sector. Findings from the literature review were combined with the insights from the public involvement. Resulting narratives were developed to highlight the challenges associated with persistent pain and informed the creation of consensus statements on the priorities for service improvement and future research. The consensus statements were shared and refined with input from an expert steering group. Results: The narratives describe pain as a uniformly difficult experience to share with professionals; it is described as exhausting, frustrating and socially limiting. Pain leads to exclusion from routine daily activities and often resigns people to feeling and being unwell. In all cases, there are concerns about accessing and improving services and critical issues associated with optimising physical activity, functional wellbeing and managing polypharmacy. Exercise and/or mobilisation are important and commonly used self-management strategies, but opportunity and advice about safe methods are variable. Services should focus on personalised care, including self-management support and medication management, so that people’s views and needs are heard and validated by health professionals. Conclusions: More research is needed to explore the most effective pain management strategies, and public involvement is important to shape the most relevant research questions. Health and care systems evaluation is also needed to address the scale of the population health need. The pandemic appears to have highlighted pre-existing shortcomings in holistic pain management.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061130
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1131: Telehome Monitoring of Symptoms and Lung
           Function in Children with Asthma

    • Authors: Audrey Fossati, Caroline Challier, Aman Allah Dalhoumi, Javier Rose, Annick Robinson, Caroline Perisson, François Galode, Baptiste Luaces, Michael Fayon
      First page: 1131
      Abstract: Background: The ability to perceive bronchial obstruction is variable in asthma. This is one of the main causes of inaccurate asthma control assessment, on which therapeutic strategies are based. Objective: Primary: To evaluate the ability of physicians to characterize the bronchial obstruction perception profile in asthmatic children using a clinical and spiro-metric telemonitoring device. Secondary: To evaluate its impact on asthma management (control, treatment, respiratory function variability) and the acceptability of this telemonitoring system. Methods: 26 asthmatic children aged 6–18 years equipped with a portable spirometer and a smartphone application were home-monitored remotely for 3 months. Clinical and spiro-metric data were automatically transmitted to a secure internet platform. By analyzing these data, three physicians blindly and independently classified the patients according to their perception profile. The impact of telemonitoring on the quantitative data was assessed at the beginning (T0) and end (T3 months) of telemonitoring, using matched statistical tests. Results: Patients could initially be classified according to their perception profile, with a concordance between the three observers of 64% (kappa coefficient: 0.55, 95%CI [0.39; 0.71]). After discussion among the observers, consensus was reached for all patients but one. There was a significant >40% decrease in FEV1 and PEF variability, with good acceptance of the device. Conclusions: Clinical and spiro-metric tele-home monitoring is applicable and can help define the perception profile of bronchial obstruction in asthmatic children. The device was generally well accepted.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061131
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1132: A Competition-Based Problem-Posing
           Approach for Nursing Training

    • Authors: Han-Yu Sung
      First page: 1132
      Abstract: Conventional nursing teaching usually adopts one-way teaching approaches. As such, students cannot think deeply and engage in learning, which results in lower learning motivation and learning achievement. Several studies have indicated that problem-posing is a learning process that has students think about problems and actively construct knowledge, which helps their in-depth thinking and promotes their learning achievement. However, problem-posing is a task with a higher difficulty level; in particular, with insufficient learning motivation, it is not easy for students to pose in-depth questions. Therefore, the present study introduced competition to a problem-posing activity to facilitate students’ motivation. This study adopted a quasi-experimental design and conducted an experiment in the unit of Care of Critically Ill Patients. The results showed that the proposed competition-based problem-posing mobile learning approach could significantly enhance students’ learning achievement and learning motivation and would not cause an excessive cognitive load. Moreover, competition increased students’ learning motivation, and fostered them to actively reflect on and revise their questions, thereby increasing their problem-posing quality and learning achievement. This study can serve as a reference for future clinical practice to enhance the quality and sustainability of apprenticeships.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061132
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1133: Acute Supplementation with Cannabidiol
           Does Not Attenuate Inflammation or Improve Measures of Performance
           following Strenuous Exercise

    • Authors: Brett W. Crossland, B. Rhett Rigby, Anthony A. Duplanty, George A. King, Shanil Juma, Nicholas A. Levine, Cayla E. Clark, Kyndall P. Ramirez, Nicole L. Varone
      First page: 1133
      Abstract: Supplementation with cannabidiol (CBD) may expedite recovery when consumed after exercise. The purpose of this study was to determine if supplementation with CBD reduces inflammation and enhances performance following strenuous eccentric exercise in collegiate athletes. Twenty-four well-trained females (age = 21.2 ± 1.8 years, height = 166.4 ± 8 cm, weight = 64.9 ± 9.1 kg) completed 100 repetitions of unilateral eccentric leg extension to induce muscle damage. In this crossover design, participants were randomized to receive 5 mg/kg of CBD in pill form or a placebo 2 h prior to, immediately following, and 10 h following muscle damage. Blood was collected, and performance and fatigue were measured prior to, and 4 h, 24 h, and 48 h following the muscle damage. Approximately 28 days separated treatment administration to control for the menstrual cycle. No significant differences were observed between the treatments for inflammation, muscle damage, or subjective fatigue. Peak torque at 60°/s (p = 0.001) and peak isometric torque (p = 0.02) were significantly lower 24 h following muscle damage, but no difference in performance was observed between treatments at any timepoint. Cannabidiol supplementation was unable to reduce fatigue, limit inflammation, or restore performance in well-trained female athletes.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061133
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1134: Medical–Legal and Psychosocial
           Considerations on Parental Alienation as a Form of Child Abuse: A Brief
           Review

    • Authors: Oana-Maria Isailă, Sorin Hostiuc
      First page: 1134
      Abstract: Parental alienation, an entity situated at the limit of psychiatry, sociology, and justice, still represents a controversial concept despite the legal dispositions that take it into account. The scope of this paper is to consider the relationship between parent and child, and child abuse from a psychosocial perspective, as well as to depict parental alienation, considered a form of child abuse, without omitting contradictory arguments which are also based on prudence in the minor’s interest, turning the attention to parental estrangement. Although parental alienation is not a psychiatric diagnosis per se and neither is parental estrangement, recognizing the difference between them is vital to adequately manage the situation at the time of establishing custody.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061134
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1135: Impact of an Educational Program on
           Improving Nurses’ Management of Fever: An Experimental Study

    • Authors: Bi-Hung Hsiao, Ya-Ling Tzeng, Kwo-Chen Lee, Shu-Hua Lu, Yun-Ping Lin
      First page: 1135
      Abstract: Background: Despite a public information campaign “To Break the Myth of Fever”, nurses continued to overtreat fever. This study hypothesized that the campaign lacked the detailed rationale essential to alter nurses’ attitudes and behaviors. Aim: To evaluate the effect of the educational program on nurses’ knowledge, attitudes, and behaviors related to fever management. Design: A randomized experimental design using a time series analysis. Methods: A random sample of 58 medical/surgical nurses was evenly divided into an intervention and a control group. The intervention group received an educational program on fever and fever management. Both groups completed a pretest and four posttests using investigator-developed instruments: a questionnaire on knowledge and attitudes about fever management and a fever treatment checklist to audit charts. Results: The intervention group had markedly higher knowledge scores and reduced use of ice pillows at all four posttests, as well as lower use of antipyretics overall, except for the first posttest, despite no sustained change in attitude. Conclusions: An educational program for fever management can effectively improve clinical nurses’ knowledge and attitudes about fever management.
      Citation: Healthcare
      PubDate: 2022-06-17
      DOI: 10.3390/healthcare10061135
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1136: Assessment of Diagnostic Imaging Sector
           in Public Hospitals in Northern Jordan

    • Authors: Ammar A. Oglat
      First page: 1136
      Abstract: The most effective diagnostic methods in the medical field are diagnostic imaging techniques such as radiography, computed tomography (CT), magnetic resonance imaging (MRI), and nuclear medicine, which are used to visualize internal body to diagnose it, determine potential treatment, and evaluate and forecast care results. Therefore, the purpose of this research is to assess the diagnostic imaging sector, at three major public hospitals in the northern part of Jordan, according to regional and global requirements. The assessment approach was based on knowledge of the accessibility of diagnostic imaging equipment and its quality assurance and performance, the quantity and efficiency of radiological technologists, and the design of radiology units and medical imaging chambers in many aspects based on the use of two tools, a questionnaire and checklists, to accomplish a comprehensive evaluation. The response rate of radiological technologists was 66%. The assessment reveals a noticeable increase in the number of radiological technologists in general with high academic qualification level. Additionally, the number of diagnostic imaging equipment in Jordan revealed a large deficiency in the population–device balance, and through checklists that evaluated both CT and MRI units, it was revealed that the rate of following global requirements and occupational health and safety (OHS) standards was high. The basic supplies available in both the CT and MRI units alike were high, which indicates the high quality of healthcare provided in Jordan.
      Citation: Healthcare
      PubDate: 2022-06-18
      DOI: 10.3390/healthcare10061136
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1137: The Efficacy of
           Machine-Learning-Supported Smart System for Heart Disease Prediction

    • Authors: Nurul Absar, Emon Kumar Das, Shamsun Nahar Shoma, Mayeen Uddin Khandaker, Mahadi Hasan Miraz, M. R. I. Faruque, Nissren Tamam, Abdelmoneim Sulieman, Refat Khan Pathan
      First page: 1137
      Abstract: The disease may be an explicit status that negatively affects human health. Cardiopathy is one of the common deadly diseases that is attributed to unhealthy human habits compared to alternative diseases. With the help of machine learning (ML) algorithms, heart disease can be noticed in a short time as well as at a low cost. This study adopted four machine learning models, such as random forest (RF), decision tree (DT), AdaBoost (AB), and K-nearest neighbor (KNN), to detect heart disease. A generalized algorithm was constructed to analyze the strength of the relevant factors that contribute to heart disease prediction. The models were evaluated using the datasets Cleveland, Hungary, Switzerland, and Long Beach (CHSLB), and all were collected from Kaggle. Based on the CHSLB dataset, RF, DT, AB, and KNN models predicted an accuracy of 99.03%, 96.10%, 100%, and 100%, respectively. In the case of a single (Cleveland) dataset, only two models, namely RF and KNN, show good accuracy of 93.437% and 97.83%, respectively. Finally, the study used Streamlit, an internet-based cloud hosting platform, to develop a computer-aided smart system for disease prediction. It is expected that the proposed tool together with the ML algorithm will play a key role in diagnosing heart diseases in a very convenient manner. Above all, the study has made a substantial contribution to the computation of strength scores with significant predictors in the prognosis of heart disease.
      Citation: Healthcare
      PubDate: 2022-06-18
      DOI: 10.3390/healthcare10061137
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1138: Religiosity, Emotions and Health: The
           Role of Trust/Mistrust in God in People Affected by Cancer

    • Authors: David Almaraz, Jesús Saiz, Florentino Moreno Martín, Iván Sánchez-Iglesias, Antonio J. Molina, Tamara L. Goldsby, David H. Rosmarin
      First page: 1138
      Abstract: Trust in God implies the conviction that God looks after a person’s own interests. The first evidence of a relationship between this construct and people’s psychological and emotional health dates back several centuries. However, the literature on this is limited, especially for people with physical health conditions, such as cancer. Therefore, the purpose of this study is to test the relationships between trust/mistrust in God, social support and emotions in people affected by cancer. The sample consisted of 177 women and men in Spain diagnosed with cancer. The instruments used were the Trust/Mistrust in God Scale, the Positive and Negative Affect Schedule and the Multidimensional Scale of Perceived Social Support. Correlation analysis and hierarchical regression analysis were performed to compare several explanatory models for the dependent variables: positive and negative emotions. The results show significant relationships between all variables. It was observed that, when trust/mistrust in God is included in the model, only mistrust in God predicts both types of emotions. In addition, both social support and some sociodemographic variables help to predict the dependent variables. This study shows that valuing the religiosity and spirituality of oncology patients in healthcare settings can have a significant positive impact on the health of these individuals. Moreover, it represents an important approach to the study of trust/mistrust in God in the context of a traditionally Catholic country.
      Citation: Healthcare
      PubDate: 2022-06-18
      DOI: 10.3390/healthcare10061138
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1139: Association between Fear of Falling and
           Seven Performance-Based Physical Function Measures in Older Adults: A
           Cross-Sectional Study

    • Authors: Wen-Ni Wennie Huang, Hui-Fen Mao, Hsin-Min Lee, Wen-Chou Chi
      First page: 1139
      Abstract: Fear of falling (FOF), a common phenomenon among older adults, may result in adverse health consequences. The strength of the association between FOF and physical function among older adults has not been well compared in previous studies. Therefore, a cross-sectional study was performed on 105 older adults to determine and compare the strength of the association between FOF and seven common physical function measures. After controlling for age, logistic regression models were fitted for each physical function measure. According to odds ratios, the Berg Balance Scale (BBS), Short Physical Performance Battery, gait speed, and Timed Up & Go Test were associated with the identification of FOF. Based on a c-statistic value of 0.76, the BBS, a common and quick assessment of functional balance tasks, was found to be able to distinguish between fearful and non-fearful older adults. Interventions targeted to improve lower-extremity physical functions, especially functional balance ability, may help prevent or delay the adverse consequences of FOF.
      Citation: Healthcare
      PubDate: 2022-06-19
      DOI: 10.3390/healthcare10061139
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1140: Knowledge and Use of Cervical Cancer
           Prevention Services among Social Work and Nursing University Students

    • Authors: Maria Moudatsou, Panayiota Vouyiouka, Eleni Karagianni-Hatziskou, Michael Rovithis, Areti Stavropoulou, Sofia Koukouli
      First page: 1140
      Abstract: The present study examines: (a) the knowledge of healthcare students on cervical cancer (CC) issues and the use of related preventive services, as well as their association with the field of study and other sociodemographic characteristics; (b) the possible effect of social capital and its parameters. A cross-sectional study was conducted, using a convenience non-probability sampling technique. The final sample consisted of forty-nine social work and fifty-one nursing students. The two groups were similar regarding their sociodemographic characteristics and the knowledge and use of gynecological preventive services. However, the nursing students undertook a PAP smear check-up to a lesser extent (48.6%) compared to social work students (51.4%) (p = 0.026). The social capital scores were high for both groups, but social work students were significantly more ‘Tolerant to diversity’. For the total sample, only the ‘Family and friends connections’ subscale correlated with knowledge about the existing gynecological preventive services. Among the main reasons explaining university students’ avoidance of preventive testing were the feelings of fear and embarrassment associated with the PAP smear test. Given the significance of the future professional roles of healthcare students as information sources and leaders in women’s CC preventive behavior, understanding the individual factors contributing to their own adherence is essential. It is equally important to increase their scientific knowledge through the improvement of academic curricula regarding these issues.
      Citation: Healthcare
      PubDate: 2022-06-19
      DOI: 10.3390/healthcare10061140
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1141: Use of the Nursing Interventions
           Classification and Nurses’ Workloads: A Scoping Review

    • Authors: Claudio-Alberto Rodríguez-Suárez, Martín Rodríguez-Álvaro, Alfonso-Miguel García-Hernández, Domingo-Ángel Fernández-Gutiérrez, Carlos-Enrique Martínez-Alberto, Pedro-Ruymán Brito-Brito
      First page: 1141
      Abstract: Background: The Nursing Interventions Classification allows the systematic organisation of care treatments performed by nurses, and an estimation of the time taken to carry out the intervention is included in its characteristics. The aim of this study is to explore the evidence related to the use of the Nursing Interventions Classification in identifying and measure nurses’ workloads. Methods: A scoping review was conducted through a search of the databases Ovid Medline, PubMed, Web of Science, CINAHL, Scopus, LILACS and Cuiden. The DeCS/MeSH descriptors were: “Standardized Nursing terminology” and “Workload”. The search was limited to articles in Spanish, English and Portuguese. No limits were established regarding year of publication or type of study. Results: Few reports were identified (n = 8) and these had methodological designs that contributed low levels of evidence. Research was focused on identifying specific interventions, types of activities, the prevalence of interventions and the time required to perform them. Conclusions: The evidence found on determination of nurses’ workloads using the Nursing Interventions Classification was inconclusive. It is essential to increase the number of reports, as well as the settings and clinical context in which the Nursing Interventions Classification is used, with greater quality and methodological rigour.
      Citation: Healthcare
      PubDate: 2022-06-19
      DOI: 10.3390/healthcare10061141
      Issue No: Vol. 10, No. 6 (2022)
       
  • Healthcare, Vol. 10, Pages 1142: Knowledge and Prevalence of Risk Factors
           for Coronary Artery Disease in Patients after Percutaneous Coronary
           Intervention and Coronary Artery Bypass Grafting

    • Authors: Mikołaj Matysek, Krzysztof Wójcicki, Tomasz Tokarek, Artur Dziewierz, Tomasz Rakowski, Stanisław Bartuś, Dariusz Dudek
      First page: 1142
      Abstract: Background: Percutaneous coronary intervention (PCI) is associated with a short hospital stay and fast recovery. However, it might be related to insufficient implementation of lifestyle changes after the procedure. Conversely, coronary artery bypass grafting (CABG) is a highly invasive technique that requires a prolonged hospital stay and long rehabilitation with more opportunities for education. This study aimed to evaluate the impact of CABG on adherence to lifestyle modifications and knowledge about coronary artery disease (CAD) in comparison with PCI. We also evaluated the level of education and tried to define groups of patients that might require targeted education. Methods: Data was collected using a self-designed 56-item questionnaire. Questions assessed the knowledge of CAD risk factors and the level of their control. Results: The study group consisted of 155 consecutive patients admitted to the Cardiology Department. Patients with a history of PCI (68%) (at least 8 weeks before) were included in the prior-PCI group, and patients with previous surgical revascularization (also at least 8 weeks before) were assigned to the prior-CABG group (32%). The knowledge score was higher in the prior-CABG group. The median (IQR) results in the prior-PCI vs. prior-CABG group were, respectively: 20 (12–24) vs. 22 (19–25) [points, per 31 max.]; p = 0.01. Similar results were obtained in the level of risk control (prior-PCI vs. prior-CABG, respectively: 6 (4–7) vs. 7 (6–8) [points, per 15 max.]; p = 0.002). Conclusions: The method of treatment of CAD might impact the implementation of lifestyle modifications after the procedure. More effort is required to improve secondary prevention, especially in PCI patients.
      Citation: Healthcare
      PubDate: 2022-06-20
      DOI: 10.3390/healthcare10061142
      Issue No: Vol. 10, No. 6 (2022)
       
 
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