Healthcare

16 pages, 289 KiB

Open AccessArticle

Consumers’ Channel Preference for Fresh Foods and Its Determinants during COVID-19—Evidence from China

by Xujin Pu, Jingyi Chai and Rongtao Qi

Healthcare 2022, 10(12), 2581; https://doi.org/10.3390/healthcare10122581 - 19 Dec 2022

Cited by 3 | Viewed by 2292

The public has been experiencing unprecedented challenges during the COVID-19 pandemic for the past two years. Government measures, such as improvements in offline markets and the encouragement of contactless e-commerce use, have been taken to abate the spread of infection. This study explored [...] Read more.

The public has been experiencing unprecedented challenges during the COVID-19 pandemic for the past two years. Government measures, such as improvements in offline markets and the encouragement of contactless e-commerce use, have been taken to abate the spread of infection. This study explored whether public channel preferences for fresh foods have changed and aimed to identify potential determinants. Data from 10,708 consumers were obtained by issuing questionnaires, and the binary logic measurement model was used for the empirical analysis to study the core factors that determine consumers’ choice of online and offline purchase channels for fresh food. The results show that, from the perspective of consumers’ personal behavior, consumers who do not pay attention to online evaluations and consumers who do not buy products based on their purchase experience have increased the frequency of online fresh food purchases during the epidemic. Food safety also significantly affects consumers’ choices of purchase channels. Consumers who believe that online fresh foods are safer prefer to purchase fresh food online. Among the factors affecting the performance of online fresh food, consumers concerned about food safety increased the frequency of online purchases, while consumers concerned about the reputation of the platform decreased the frequency of online purchases. These findings can help online and offline retailers better understand consumer needs and then determine their marketing strategies. Full article

(This article belongs to the Special Issue Food Safety and Its Impact on Health and Healthcare in the Age of COVID-19)

15 pages, 1455 KiB

Open AccessArticle

Cataract Surgery in Low-Income Countries: A Good Deal!

by Steffen Flessa

Healthcare 2022, 10(12), 2580; https://doi.org/10.3390/healthcare10122580 - 19 Dec 2022

Cited by 6 | Viewed by 2298

Abstract

Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to [...] Read more.

Cataract is a major cause of blindness worldwide. In particular, in low-income countries, the burden of disease as well as its direct and indirect economic cost are a major challenge for the population and economy. In many cases, it would be possible to prevent or cure blindness with a comparably simple cataract surgery, but many countries lack the resources to strengthen healthcare systems and implement broad cataract surgery programs reaching, in particular, the rural poor. In this paper, we analyse whether such an intervention could be cost-effective or even cost-saving for the respective health systems. We calculate the net value of the lifelong costs of cataract with and without surgery. This calculation includes direct costs (e.g., treatment, glasses, surgery) as well as indirect cost of the caregiver and the patient. We total all costs from the year of onset of cataract until death and discount the respective values to the year of onset. We define the surgery as cost-saving if the net-value of costs with surgery is lower than without surgery. If the cost per quality adjusted life year is lower than one gross national product per capita, we define the intervention as highly cost-effective. We find that the cost-effectiveness of cataract surgery depends on the age of onset of the disease and the age of surgery. If the surgery is performed with the beginning of severe impairment, even surgery of a 78-year-old patient is still cost-saving. Almost all possible constellations are highly cost-effective, only for the very old it is questionable whether the surgery should be performed. The simulations show that cataract surgery is one of the most cost-effective interventions. However, millions of people in low-income countries still have no chance to prevent or cure blindness due to limited resources. The findings of this paper clearly call for a stronger effort to reach poor and rural populations with this cost-effective service. Full article

(This article belongs to the Special Issue Healthcare Management and Health Economics)

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17 pages, 5779 KiB

Open AccessArticle

Efficacy of Different Dosing Regimens of IgE Targeted Biologic Omalizumab for Chronic Spontaneous Urticaria in Adult and Pediatric Populations: A Meta-Analysis

by Humayun Manzoor, Foha Razi, Amina Rasheed, Zouina Sarfraz, Azza Sarfraz, Karla Robles-Velasco, Miguel Felix and Ivan Cherrez-Ojeda

Healthcare 2022, 10(12), 2579; https://doi.org/10.3390/healthcare10122579 - 19 Dec 2022

Cited by 6 | Viewed by 2577

Abstract

Chronic urticaria is a debilitating skin condition that is defined as itchy hives at least twice a week and lasting for six or more weeks, with or without angioedema. Chronic spontaneous urticaria (CSU) is a form of disease that is witnessed in two-thirds [...] Read more.

Chronic urticaria is a debilitating skin condition that is defined as itchy hives at least twice a week and lasting for six or more weeks, with or without angioedema. Chronic spontaneous urticaria (CSU) is a form of disease that is witnessed in two-thirds of those with chronic urticaria. This meta-analysis explores the efficacy of differential dosages of omalizumab for outcomes of weekly itching scores, weekly wheal scores, urticarial assessment score 7 (UAS7), and responder rates. Adhering to PRISMA Statement 2020 guidelines, a systematic search of PubMed/MEDLINE, Scopus, Embase, and Web of Science was conducted until 15 September 2022. A combination of the following keywords was used: omalizumab and chronic urticaria. Data comprising clinical trial ID, name, author/year, country, dosage and time of intervention, inclusion criteria, mean age, female gender, and racial grouping information were obtained. The meta-analytical outcomes were analyzed in RevMan 5.4. The risk-of-bias assessment was conducted using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). A total of 10 trials comprising 1705 patients with CSU were included. Notably, 1162 belonged to the intervention group, while 543 were controls. A total of 70.4% of the participants were female in the intervention group, while 65.6% of them were female in the control group. The overall mean age was 38.64 ± 10.66 years. Weekly itch score outcomes were most notable with 150 mg dosage (Cohen’s d = −2.6, 95% CI = −4.75, −0.46, p = 0.02). The weekly wheal score outcomes had the largest effect size with 300 mg dosage (Cohen’s d = −1.45, 95% CI = −2.2, −0.69, p = 0.0002). For UAS7 outcomes, the largest effect size was yielded with 150 mg dosage (Cohen’s d = −6.92, 95% CI: −10.38, −3.47, p < 0.0001). The response rate to omalizumab had a likelihood of being higher with 300 mg of intervention compared to placebo (OR = 8.65, 95% CI = 4.42, 16.93, p < 0.0001). Well-rounded urticarial symptom resolution was observed with 150 mg and 300 mg dosages of omalizumab. Improvement of UAS7 was more comparable with 150 mg dosage, whereas the chance of response to treatment was higher with 300 mg dosage. Our findings support omalizumab as an effective intervention for adult and pediatric populations that are resistant to many therapies, including high-dose H1-antihistamines. Full article

(This article belongs to the Special Issue Management in Different Health Conditions)

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9 pages, 267 KiB

Open AccessArticle

The Analysis of Blood Inflammation Markers as Prognostic Factors in Parkinson’s Disease

by Iulia-Diana Stanca, Oana Criciotoiu, Simona-Daniela Neamtu, Ramona-Constantina Vasile, Nicoleta-Madalina Berceanu-Bora, Teodora-Nicoleta Minca, Ionica Pirici, Gabriela-Camelia Rosu and Simona Bondari

Healthcare 2022, 10(12), 2578; https://doi.org/10.3390/healthcare10122578 - 19 Dec 2022

Cited by 4 | Viewed by 2255

Abstract

Parkinson’s disease is a chronic, progressive, and neurodegenerative disease, and yet with an imprecise etiopathogenesis. Although neuroinflammation was initially thought to be a secondary condition, it is now believed that microglia-induced inflammation could also contribute to the degeneration of the nigrostriatal pathway. Here, [...] Read more.

Parkinson’s disease is a chronic, progressive, and neurodegenerative disease, and yet with an imprecise etiopathogenesis. Although neuroinflammation was initially thought to be a secondary condition, it is now believed that microglia-induced inflammation could also contribute to the degeneration of the nigrostriatal pathway. Here, we aimed to establish the feasibility of basic inflammatory biomarkers as prognostic factors in PD. The study was based on retrospective analyses of blood samples taken from patients diagnosed with PD, as well as from healthy subjects. Complete medical records, total leukocyte count with subpopulations, and erythrocyte sedimentation rate (ESR) were analyzed. We calculated the serum neutrophils-to-lymphocytes ratio (NLR) and platelet-to lymphocytes ratio (PLR), and also compared the laboratory data between the PD group and the control group. Only PLR and NLR showed statistically significant differences (p < 0.001 and 0.04, respectively). In our study, ESR did not show statistically significant correlations with motor score or with disability. In our research, ESR was correlated with the disease duration (p = 0.04), and PLR showed a significant correlation with disease stage (p = 0.027) and disease duration (p = 0.001), but not with motor state. These biomarkers could prove to be effective tools for a primary evaluation of inflammation in PD, but further tests are required to properly investigate the neuroinflammatory status of these patients. Full article

17 pages, 1458 KiB

Open AccessSystematic Review

Most Common Long COVID Physical Symptoms in Working Age Adults Who Experienced Mild COVID-19 Infection: A Scoping Review

by Zoe Mass Kokolevich, Melissa Crowe, Diana Mendez, Erik Biros and Jacqueline Elise Reznik

Healthcare 2022, 10(12), 2577; https://doi.org/10.3390/healthcare10122577 - 19 Dec 2022

Cited by 14 | Viewed by 3402

Abstract

Background: One-third of patients who recover from COVID-19 present with long COVID. Their symptoms are broad, affecting their physical functioning and, ultimately, their quality of life. Many of those individuals who develop long COVID, possibly from a mild COVID-19 infection, are in the [...] Read more.

Background: One-third of patients who recover from COVID-19 present with long COVID. Their symptoms are broad, affecting their physical functioning and, ultimately, their quality of life. Many of those individuals who develop long COVID, possibly from a mild COVID-19 infection, are in the 18–65 age group. This prolongation of malaise directly influences national workforce economies. Objectives: To summarise the commonly reported physical symptoms of long COVID in order to inform potential adjustments in healthcare for the employable population. Methods: The Embase, CINAHL, Medline, SCOPUS, and WHO COVID-19 databases were searched. The study selection process was based on the PRISMA guidelines. The extracted data were synthesised and presented narratively. Results: 7403 studies were accessed, comprising 60 cohort studies and 10 case series/studies, representing 289,213 patients who met our criteria. The most frequently reported physical symptoms were fatigue (92%), shortness of breath (SOB) (81.8%), muscle pain (43.6%), and joint pain (34.5%). Conclusions: The range of reported physical symptoms was broad and varied; the main ones being fatigue, breathlessness/SOB, and pain. Similarities observed between long COVID and other post-acute infection syndromes may help formulate protocols to manage and promote recovery for long COVID patients. Inconsistencies were evident, particularly with a lack of adherence to the standardised definitions of long COVID. Full article

(This article belongs to the Section Health Policy)

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13 pages, 807 KiB

Open AccessArticle

Competency in ECG Interpretation and Arrhythmias Management among Critical Care Nurses in Saudi Arabia: A Cross Sectional Study

by Mohammed Saeed Aljohani

Healthcare 2022, 10(12), 2576; https://doi.org/10.3390/healthcare10122576 - 19 Dec 2022

Cited by 5 | Viewed by 4050

Abstract

Background: Electrographic interpretation skills are important for healthcare practitioners caring for patients in need of cardiac assessment. Competency in ECG interpretation skills is critical to determine any abnormalities and initiate the appropriate care required. The purpose of the study was to determine the [...] Read more.

Background: Electrographic interpretation skills are important for healthcare practitioners caring for patients in need of cardiac assessment. Competency in ECG interpretation skills is critical to determine any abnormalities and initiate the appropriate care required. The purpose of the study was to determine the level of competence in electrocardiographic interpretation and knowledge in arrhythmia management of nurses in critical care settings. Methods: A descriptive cross-sectional design was used. A convenience sample of 255 critical care nurses from 4 hospitals in the Al-Madinah Region in Saudi Arabia was used. A questionnaire was designed containing a participant’s characteristics and 10 questions with electrocardiographic strips. A pilot test was carried out to evaluate the validity and reliability of the questionnaire. Descriptive and bivariate analyses were conducted using an independent t-test, one-way ANOVA, or bi-variate correlation tests, as appropriate. A statistical significance of p < 0.05 was assumed. Results: Females comprised 87.5% of the sample, and the mean age of the sample was 32.1 (SD = 5.37) years. The majority of the participants (94.9%) had taken electrocardiographic interpretation training courses. The mean total score of correct answers of all 10 ECG strips was 6.45 (±2.54) for ECG interpretation and 4.76 (±2.52) for arrhythmia management. No significant differences were observed between ECG competency level and nursing experience or previous training. Nurses working in the ICU and CCU scored significantly higher than those working in ED. Conclusions: The electrocardiographic knowledge in ECG interpretation and arrhythmia management of critical care nurses is low. Therefore, improving critical care nurses’ knowledge of ECGs, identification, and management of cardiac arrhythmias is essential. Full article

(This article belongs to the Special Issue Nursing Care in the ICU)

18 pages, 4837 KiB

Open AccessArticle

Body Mass Index and Clinical Outcomes in Adult COVID-19 Patients of Diverse Ethnicities

by Wael Hafez, Mahmoud Abdelshakor, Samy Kishk, Amr Gebril, Muneir Gador, Sana Osman, Hesham Mohamed Abuelsaoud and Ahmed Abdelrahman

Healthcare 2022, 10(12), 2575; https://doi.org/10.3390/healthcare10122575 - 19 Dec 2022

Cited by 3 | Viewed by 12251

Abstract

(1) Background: Body mass index (BMI) was observed to affect COVID-19 outcomes; however, the complete spectrum of clinical outcomes concerning BMI remains unexplored. The current study aimed to investigate the correlation between BMI and the severity and mortality of COVID-19, as well as [...] Read more.

(1) Background: Body mass index (BMI) was observed to affect COVID-19 outcomes; however, the complete spectrum of clinical outcomes concerning BMI remains unexplored. The current study aimed to investigate the correlation between BMI and the severity and mortality of COVID-19, as well as ICU admission, radiological findings, clinical presentation, and time to viral clearance. (2) Methods: This retrospective study included 1796 multiethnic patients with COVID-19 treated at NMC Royal Hospital, Abu Dhabi, UAE. (3) Results: COVID-19’s adjusted odds of severity increased by 3.7- and 21.5-fold in classes I and III, respectively (p = 0.001). The odds of mortality were not significantly different after adjustment for age, sex, and race. The adjusted odds of ICU admission increased significantly by 3-fold and non-significantly by 4-fold in obesity classes I and II, respectively. Pneumonia was significantly higher in patients who were overweight and class I, II, and III obese. Furthermore, class III obese patients had a greater risk of presenting with combined respiratory and gastrointestinal manifestations (p < 0.001). The median time to viral clearance with a BMI > 40 kg/m² was moderately higher than that with a BMI < 40 kg/m². (4) Conclusions: High BMI was associated with pneumonia, ICU admission, severity, and mortality due to COVID-19. Full article

(This article belongs to the Topic One Health Approach in Global Health and Clinical Medicine)

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11 pages, 239 KiB

Open AccessArticle

The Effects of Cancer Beliefs and Sociodemographic Factors on Colorectal Cancer Screening Behaviours in Newfoundland and Labrador

by Yujia Kong, Lance Garrett Shaver, Fuyan Shi, Huaxia Mu, Weixiao Bu, Holly Etchegary, Kris Aubrey-Bassler, Shabnam Asghari, Yanqing Yi and Peizhong Peter Wang

Healthcare 2022, 10(12), 2574; https://doi.org/10.3390/healthcare10122574 - 19 Dec 2022

Cited by 3 | Viewed by 1613

Abstract

Objectives: This study investigated the beliefs about cancer treatment, outcomes, and screening among adults aged 50–74 in Newfoundland and Labrador and whether these beliefs or sociodemographic factors were associated with differences in colorectal cancer (CRC) screening behaviours. Methods: This analysis uses data collected [...] Read more.

Objectives: This study investigated the beliefs about cancer treatment, outcomes, and screening among adults aged 50–74 in Newfoundland and Labrador and whether these beliefs or sociodemographic factors were associated with differences in colorectal cancer (CRC) screening behaviours. Methods: This analysis uses data collected from an online survey of adults on cancer awareness and prevention in NL. Chi-square tests were used to assess differences in distributions of beliefs based on CRC screening behaviour. Logistic regression was used to identify sociodemographic factors independently associated with CRC screening behaviour. Results: A total of 724 participants were included in the analysis, 57.4% of which had ever had CRC screening. Most held positive beliefs about cancer outcomes and treatment. Only beliefs about screening affected CRC screening behaviour. People who never had CRC screening were more likely to believe their worries about what might be found would prevent them from screening (χ² = 9.380, p = 0.009); screening is only necessary if they have symptoms (χ² = 15.680, p < 0.001); and screening has a high risk of leading to unnecessary surgery (χ² = 6.824, p = 0.032). Regression identified that men had higher likelihood of having had CRC screening than women in our study (OR = 1.689, 95%CI = 1.135–2.515), as did all age groups compared to ages 50–54. No associations were found with the other sociodemographic factors studied. Conclusion: Beliefs about cancer screening appear to play some role in CRC screening behaviour, but the absolute effect was small. The relatively few sociodemographic associations with screening behaviour suggest that NL’s CRC screening program is equitably reaching people from different socioeconomic backgrounds. Full article

12 pages, 561 KiB

Open AccessArticle

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic

by Chrysoula Dafogianni, Despoina Pappa, Polyxeni Mangoulia, Freideriki Eleni Kourti, Ioannis Koutelekos, Evangelos Dousis, Nikoletta Margari, Eftychia Ferentinou, Areti Stavropoulou, Georgia Gerogianni, Evangelos Fradelos and Afroditi Zartaloudi

Healthcare 2022, 10(12), 2573; https://doi.org/10.3390/healthcare10122573 - 19 Dec 2022

Cited by 10 | Viewed by 3314

Abstract

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The [...] Read more.

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators. Full article

(This article belongs to the Special Issue Direct and Indirect Effects of the Ongoing COVID-19 Pandemic on Physical and Mental Health: Second Edition)

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11 pages, 659 KiB

Open AccessArticle

Implementation of the Flipped Classroom Combined with Problem-Based Learning in a Medical Nursing Course: A Quasi-Experimental Design

by Meixuan Chi, Naijuan Wang, Qing Wu, Ming Cheng, Chenya Zhu, Xiaohua Wang and Yunying Hou

Healthcare 2022, 10(12), 2572; https://doi.org/10.3390/healthcare10122572 - 19 Dec 2022

Cited by 8 | Viewed by 2963

Abstract

Background: Medical Nursing is one of the most important core courses in nursing education, and the emergence of the flipped classroom has made up for the shortcomings of traditional teaching and improved the effectiveness of teaching. However, it is worth exploring how to [...] Read more.

Background: Medical Nursing is one of the most important core courses in nursing education, and the emergence of the flipped classroom has made up for the shortcomings of traditional teaching and improved the effectiveness of teaching. However, it is worth exploring how to maximize the effect of students’ self-study before class while making full use of classroom teaching to promote the cultivation of students’ abilities, so that the flipped classroom can have a maximal teaching effect. Therefore, this study explored the effect of a flipped-classroom teaching mode based on a small private online course (SPOC) combined with problem-based learning (PBL) in a course of Medical Nursing. Methods: Nursing undergraduates from the years 2018 (control group) and 2019 (experimental group), respectively, used the traditional lecture method and the flipped-classroom teaching mode based on a SPOC combined with PBL. The teaching effect was evaluated by teaching-mode-recognition evaluation, critical thinking measurement, and academic achievement. Results: The scores of teaching-mode recognition evaluated by the students in the experimental group were higher than those in the control group in the following five aspects: “helping to improve learning interest” (p = 0.003), “helping to improve autonomous learning ability” (p = 0.002), “helping to improve communication and cooperation ability” (p < 0.001), “helping to cultivate clinical thinking” (p = 0.012), and “helping to promote self-perfection and sense of achievement” (p = 0.001). Compared with the control group, the score on the “analytical ability” dimension of the Critical Thinking Disposition Inventory in the experimental group was higher (p = 0.030). The excellent rates of the final theoretical examination (p = 0.046) and comprehensive case analysis (p = 0.046) in the experimental group were higher than those in the control group. Conclusions: The flipped-classroom teaching mode based on a SPOC combined with PBL can promote students’ abilities of autonomous learning, communication and cooperation, and clinical and critical thinking; improves their academic performance; and is recognized and welcomed by them. However, to extend the flipped-classroom teaching model of a SPOC combined with PBL to other nursing education courses, more optimization and evaluation are required. Full article

(This article belongs to the Section Nursing)

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14 pages, 294 KiB

Open AccessArticle

Evaluation of 34 Cytokines and Vitamin D Status Reveal A Sexually-Dimorphic Active Immune Response to SARS-CoV-2

by Osama E. Amer, Shaun Sabico, Eman Sheshah, Naif H Alotaibi, Dara A. Aldisi, Mushira A. Enani, Naji J. Aljohani, Naemah Alshingetti, Suliman Y. Alomar, Syed D. Hussain, Abdullah M. Alnaami, Mohamed A. Elsaid and Nasser M. Al-Daghri

Healthcare 2022, 10(12), 2571; https://doi.org/10.3390/healthcare10122571 - 19 Dec 2022

Cited by 5 | Viewed by 2030

Abstract

Background: Several observational studies have inconsistently demonstrated that vitamin D deficiency is a risk factor for coronavirus disease-19 (COVID-19) infection and severity. Discrepancies in results may partially be explained by the individuals’ immune profiles, which are modulated, in varying degrees, by vitamin D [...] Read more.

Background: Several observational studies have inconsistently demonstrated that vitamin D deficiency is a risk factor for coronavirus disease-19 (COVID-19) infection and severity. Discrepancies in results may partially be explained by the individuals’ immune profiles, which are modulated, in varying degrees, by vitamin D status and sex hormones. Methods: In this study we evaluated the differences and associations of serum levels of 25(OH)D with 34 cytokines in 220 adults (82 controls (41 males; 41 females) and 138 SARS-CoV-2 patients (79 males and 59 females)) with and without COVID-19. Results: Serum 25(OH)D levels were significantly lower in the SARS-CoV-2 group than in the controls. Serum IP-10, MCP-1, CRP, IFNγ, IL-10, IL-13, IL-17α, IL-23, and IL-6 were significantly higher in COVID-19 patients compared to controls. Serum levels of VEGF, IFNγ, IL-13, and IL-5 were significantly higher in male patients than in females. 25(OH)D was significantly correlated with EFG (R = 0.39, p < 0.05) and IL-15 (R = 0.39, p < 0.05) in male patients, while it was inversely correlated with CRP (R = −0.51, p < 0.05) in female patients. Conclusions: Altered levels of cytokines, chemokines, and vitamin D were observed in SARS-CoV-2 adult patients. These expressions were sexually dimorphic and thus highlight the sex-specific nature of the active immune response following SARS-CoV-2 infection. Full article

(This article belongs to the Special Issue New Insights into COVID-19: Epidemiology, Prevention, Diagnosis, and Treatment of SARS-CoV-2, and New Variants)

6 pages, 749 KiB

Open AccessBrief Report

Prevalence of Spirometry Testing among Patients with Asthma and COPD in German General Practices

by Annika Härtel, Maximilian Peters and Karel Kostev

Healthcare 2022, 10(12), 2570; https://doi.org/10.3390/healthcare10122570 - 18 Dec 2022

Cited by 2 | Viewed by 2141

Abstract

The goal of this study was to estimate the prevalence of spirometry testing among patients with asthma and chronic obstructive pulmonary disease (COPD) in general practices (GPs) in Germany. This retrospective cross-sectional study was based on data from the Disease Analyzer database (IQVIA), [...] Read more.

The goal of this study was to estimate the prevalence of spirometry testing among patients with asthma and chronic obstructive pulmonary disease (COPD) in general practices (GPs) in Germany. This retrospective cross-sectional study was based on data from the Disease Analyzer database (IQVIA), This retrospective cross-sectional study included all patients with at least one confirmed asthma or COPD diagnosis in one of those 50 general practices in Germany between January 2020, and January 2021, as well as at least one visit to these general practices between January 2021, and January 2022. The main outcomes of the study aimed to ascertain the proportion of spirometry testing among asthma and COPD patients between January 2021, and January 2022, overall, and separately, in men, women, six age groups (≤30, 31–40, 41–50, 51–60, 61, 70, >70), and patients who received at least one prescription of anti-asthma or anti-COPD drugs. This study included 8835 patients with asthma only, 5597 with COPD only, and 1897 with both asthma and COPD diagnoses. Of these, 27.2% of COPD patients, 7% of asthma patients, and 54.7% of asthma + COPD patients, received spirometry testing during the study period. Among COPD and asthma + COPD patients, the prevalence of spirometry testing was much higher in women than in men (COPD: 31.6% vs. 23.2%; asthma + COPD: 59.6% vs. 46.3%) and much higher in treated than in non-treated patients (COPD: 31.7% vs. 15.0%; asthma + COPD: 57.5% vs. 27.8%). The prevalence of spirometry testing was relatively low among COPD and asthma patients followed in GP practices, but usually higher in female patients, treated patients, and patients suffering from both asthma and COPD. Full article

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10 pages, 762 KiB

Open AccessEditor’s ChoiceArticle

Fetal Movement Counting in Prolonged Pregnancies: The COMPTAMAF Prospective Randomized Trial

by Louise Moniod, Agathe Hovine, Béatrice Trombert, Florence Rancon, Paul Zufferey, Laura Chauveau, Céline Chauleur and Tiphaine Raia-Barjat

Healthcare 2022, 10(12), 2569; https://doi.org/10.3390/healthcare10122569 - 18 Dec 2022

Cited by 2 | Viewed by 2421

Abstract

In prolonged pregnancies, the risks of neonatal morbidity and mortality are increased. The aim of this trial was to assess the benefits of maternal information about fetal movement (FM) counting on neonatal outcomes in prolonged pregnancy. It was a prospective, single center, randomized, [...] Read more.

In prolonged pregnancies, the risks of neonatal morbidity and mortality are increased. The aim of this trial was to assess the benefits of maternal information about fetal movement (FM) counting on neonatal outcomes in prolonged pregnancy. It was a prospective, single center, randomized, open-label study conducted from October 2019 to March 2022. Intention-to-treat analyses were performed on 278 patients randomized into two 1:1 groups (control group and FM counting group). The primary outcome was a composite score of neonatal morbidity (presence of two of the following items: fetal heart rate abnormality at delivery, Apgar score of <7 at 5 min, umbilical cord arterial pH of <7.20, and acute respiratory distress with mutation in neonatal intensive care unit). There was no significant difference between the two groups in the rate of neonatal morbidity (14.0% in the FM counting group versus 22.9% in the standard information group; p = 0.063; OR 0.55, 95% CI 0.29–1.0). In this study, fetal movement counting for women in prolonged pregnancy failed to demonstrate a significant reduction in adverse neonatal outcomes. Full article

(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)

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9 pages, 802 KiB

Open AccessArticle

Cumulative Burden of Being Underweight Increases the Risk of Hip Fracture: A Nationwide Population-Based Cohort Study

by Han-Dong Lee, Sangsoo Han, Hae-Dong Jang, Kyungdo Han, Nam-Su Chung, Hee-Woong Chung, Ki-Hoon Park, Ha-Seung Yoon and Jae-Young Hong

Healthcare 2022, 10(12), 2568; https://doi.org/10.3390/healthcare10122568 - 17 Dec 2022

Cited by 1 | Viewed by 1452

Abstract

(1) Background: Being underweight is a known risk factor for hip fractures. However, it is unclear whether the cumulative underweight burden affects the incidence of hip fractures. Therefore, we explored the effect of the cumulative underweight burden on the development of hip fractures; [...] Read more.

(1) Background: Being underweight is a known risk factor for hip fractures. However, it is unclear whether the cumulative underweight burden affects the incidence of hip fractures. Therefore, we explored the effect of the cumulative underweight burden on the development of hip fractures; (2) Methods: In a cohort of adults aged 40 years and older, 561,779 participants who were not underweight and had no hip fractures from 2007 to 2009 were identified. The risk of hip fracture from the time of the last examination to December 2018 according to the cumulative burden of being underweight (based on 0 to 3 examinations) was prospectively analyzed; (3) Results: During follow-up (mean 8.3 ± 0.8 years), the prevalence of newly diagnosed hip fractures was 0.2%, 0.4%, 0.5%, and 0.9% among those with 0, 1, 2, and 3 cumulative underweight, respectively. The adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of groups meeting the diagnostic criteria for underweight 1, 2, and 3 compared to 0 were 2.3 (1.6–3.3), 2.9 (1.8–4.5), and 4.5 (3.4–6.1), respectively (p for trend < 0.01); (4) Conclusions: The risk of hip fracture increased as the burden of underweight accumulated. Full article

(This article belongs to the Section Health Informatics and Big Data)

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12 pages, 1324 KiB

Open AccessEditor’s ChoiceArticle

Persistence to Medications for Benign Prostatic Hyperplasia/Benign Prostatic Obstruction-Associated Lower Urinary Tract Symptoms in the ASL TO4 Regione Piemonte (Italy)

by Lucrezia Greta Armando, Raffaella Baroetto Parisi, Elisa Remani, Mariangela Esiliato, Cristina Rolando, Valeria Vinciguerra, Abdoulaye Diarassouba, Clara Cena and Gianluca Miglio

Healthcare 2022, 10(12), 2567; https://doi.org/10.3390/healthcare10122567 - 17 Dec 2022

Cited by 2 | Viewed by 1938

Abstract

Background: Pharmacological treatment of benign prostatic hyperplasia (BPH)/benign prostatic obstruction (BPO)-associated lower urinary tract symptoms (LUTS) aims at improving patients’ quality of life by managing urinary symptoms and preventing complications and disease progression. However, continuous use of drugs to treat BPH/BPO-associated LUTS decreases [...] Read more.

Background: Pharmacological treatment of benign prostatic hyperplasia (BPH)/benign prostatic obstruction (BPO)-associated lower urinary tract symptoms (LUTS) aims at improving patients’ quality of life by managing urinary symptoms and preventing complications and disease progression. However, continuous use of drugs to treat BPH/BPO-associated LUTS decreases over time. The aim of this retrospective observational study was to describe use of α1-adrenoceptor antagonists (ABs) and steroid 5α-reductase inhibitors (5ARIs) by adult (age ≥ 40 years) men in the ASL TO4, a Local Health Authority in the northern area of the city of Turin (Italy). Methods: Persistence measures were adopted as a robust, informative, and feasible way to understand medication-taking behavior and to assess patient compliance. Results: A total of 4309 men (median age 71 years) were enrolled. Monotherapy was the treatment option prescribed to the largest part of the study population. However, ≥two drugs were prescribed to a substantial proportion of men (23%). Men prescribed alfuzosin or dutasteride had significantly greater persistence, which decreased over time. Conclusions: Unmet needs and areas of intervention for healthcare systems aimed at improving the use of drugs for BHP/BPO-associated LUTS in the ASL TO4 Regione Piemonte were identified. Full article

(This article belongs to the Special Issue Medication Adherence and Beliefs About Medication: Second Edition)

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10 pages, 646 KiB

Open AccessArticle

Oral Anticoagulation in Patients with Chronic Kidney Disease and Non-Valvular Atrial Fibrillation: The FAERC Study

by Marco Montomoli, Lourdes Roca, Mariana Rivera, Raul Fernandez-Prado, Beatriz Redondo, Rosa Camacho, Cayetana Moyano, Saul Pampa, Angela Gonzalez, Juan Casas, Maria Kislikova, Ana Sanchez Horrillo, Alicia Cabrera Cárdena, Borja Quiroga, Cristina Rabasco, Sara Piqueras, Andrea Suso, Javier Reque, Juan Villa, Raquel Ojeda and David Arroyo Show full author list Hide full author list

Healthcare 2022, 10(12), 2566; https://doi.org/10.3390/healthcare10122566 - 17 Dec 2022

Cited by 3 | Viewed by 2314

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and its presence is associated with a higher risk of stroke and mortality. Material and Methods: The FAERC study performed a retrospective multicentre analysis of historical cohorts in [...] Read more.

Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and its presence is associated with a higher risk of stroke and mortality. Material and Methods: The FAERC study performed a retrospective multicentre analysis of historical cohorts in which data were collected from arrhythmia diagnosis onwards. Results: We analysed a Spanish cohort of 4749 patients with CKD (mean eGFR 33.9 mL/min) followed up in the nephrology clinic, observing a 12.2% prevalence of non-valvular AF. In total, 98.6% of these patients were receiving anticoagulant treatment, mainly with coumarins (79.7%). Using direct-acting oral anticoagulants (DOACs) was associated with fewer cerebrovascular events than using acenocoumarol, but in contrast with other studies, we could not corroborate the association of risk of bleeding, coronary events, or death with a type of anticoagulant prescribed. Conclusions: Atrial fibrillation is highly prevalent in renal patients. Direct-acting anticoagulants seem to be associated with fewer ischemic-embolic complications, with no differences in bleeding, coronary events, or mortality rates. Full article

(This article belongs to the Special Issue Exploring the Link between Cardiorenal and Metabolic Diseases)

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7 pages, 261 KiB

Open AccessReview

A Narrative Review of Current Striae Treatments

by Nuno Mendes, Paulo Jorge Alves, Mafalda Barros, Jorge Magalhães Rodrigues and Jorge Machado

Healthcare 2022, 10(12), 2565; https://doi.org/10.3390/healthcare10122565 - 17 Dec 2022

Cited by 5 | Viewed by 5487

Abstract

Striae (striae cutis distensae) are a common disfiguring skin condition, characterised by the appearance of linear bands on the skin, with an atrophic look. The striae development is still unknown, being more common in women than in men. The prevalence of [...] Read more.

Striae (striae cutis distensae) are a common disfiguring skin condition, characterised by the appearance of linear bands on the skin, with an atrophic look. The striae development is still unknown, being more common in women than in men. The prevalence of this condition ranges from 50% to 90%. Regarding treatment, there are various treatment strategies currently available for stretch marks, including topical preparations such as tretinoin and glycolic acid, and also laser. The goal of this work is to discover the main treatments available for striae management. For that, a search was performed based on the definition of specific scientific keywords, by exploring PubMed, ScienceDirect and Biblioteca Virtual em Saúde (BVS). MeSH thesaurus (Medical Subject Headings) descriptors were used. The results indicate that, to date, no treatment is fully effective. More clinical trials are needed to validate the efficacy of these therapies and their long-term use in this type of skin lesion. Full article

(This article belongs to the Collection Advances in Integrative Medicine: Complementary Approaches and Therapies in Global Healthcare)

6 pages, 734 KiB

Open AccessArticle

Competencies in Basic Life Support after a Course with or without Rescue Ventilation: Historical Cohort Study

by Jordi Castillo, Adrián González-Marrón, Anna Llongueras, Laia Camós, Mireia Montané and Encarnación Rodríguez-Higueras

Healthcare 2022, 10(12), 2564; https://doi.org/10.3390/healthcare10122564 - 17 Dec 2022

Cited by 1 | Viewed by 1556

Abstract

Background: Simplifying the international guidelines to improve skills after training and their retention over time has been one of the top priorities in recent years. The objective of our study was to compare the results of the practical skills learned during training in [...] Read more.

Background: Simplifying the international guidelines to improve skills after training and their retention over time has been one of the top priorities in recent years. The objective of our study was to compare the results of the practical skills learned during training in basic life support with and without pulmonary ventilation. Methods: This was a comparative study of historical cohorts consisting of undergraduate students in health sciences. In one cohort, rescue breathing was performed, and in the other, it was not. The same data collection instruments were used for both cohorts: a test type examination of knowledge, data from a smart mannequin and an instructor observation grid. The means of knowledge and practical skills scores collected by the mannequin were compared using independent sample t-tests. Results: 497 students were recruited without significant differences between the two cohorts. The mean scores for knowledge and skills determined by the instructor and the mannequin were statistically higher in the cohort that did not perform rescue breathing. Conclusion: Students who participated in basic life support training that did not include rescue breathing scored better than those who participated in training that included this skill. Training with only compressions simplifies the guidelines and increases learning and content retention. Full article

(This article belongs to the Collection Clinical Simulation in Health Sciences)

11 pages, 879 KiB

Open AccessArticle

Translation, Cross-Cultural Adaptation, and Validation of the Galician Version of the Nurse Prescribing Self-Efficacy Scale

by Andrea Franco-Rodríguez, Eva María Domínguez-Martís, Diego Gabriel Mosteiro-Miguéns, David López-Ares, Belén Cotón-Sánchez, Marta Domínguez-Varela and Silvia Novío

Healthcare 2022, 10(12), 2563; https://doi.org/10.3390/healthcare10122563 - 17 Dec 2022

Cited by 1 | Viewed by 1814

Abstract

Low self-efficacy has been identified as one of the factors that could hinder the prescribing competence of nurses. No valid and reliable existing instruments assess Galician nurses’ confidence to prescribe. The aim of this study was to determine the reliability and validity of [...] Read more.

Low self-efficacy has been identified as one of the factors that could hinder the prescribing competence of nurses. No valid and reliable existing instruments assess Galician nurses’ confidence to prescribe. The aim of this study was to determine the reliability and validity of the Galician version of the Nurse Prescribing Self-Efficacy Scale (G-NP-SES, 19 items). The study was conducted in two phases: the translation and adaptation to the Galician version of the NP-SES, and the assessment of its psychometric properties. G-NP-SES was sent to nurses working in primary healthcare centers in Galicia (Spain) between March and June of 2022. Its content, construct and discriminant validity, and internal consistency reliability were examined. A total of 193 people participated in the study. As the original scale, G-NP-SES also had three dimensions (% of cumulative variance = 80.82%). It showed good internal consistency (Cronbach’s alpha coefficient (α) = 0.90, with each factor ranging from 0.86 to 0.89), high content validity (scale’s content validity index = 0.92, with item-content validity index ranged from 0.87 to 1), and good discriminant validity. G-NP-SES is an instrument with good psychometric properties which could be used to accurately assess Galician nurses’ self-efficacy to prescribe and consequently to improve their job performance. Full article

(This article belongs to the Special Issue Global Perspectives on Nursing and Midwifery Workforce Development)

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12 pages, 4032 KiB

Open AccessArticle

Rubella Virus Infections: A Bibliometric Analysis of the Scientific Literature from 2000 to 2021

by Hasan Ejaz, Hafiz Muhammad Zeeshan, Abid Iqbal, Shakil Ahmad, Fahad Ahmad, Abualgasim Elgaili Abdalla, Naeem Anwar, Kashaf Junaid, Sonia Younas, Ashina Sadiq, Muhammad Atif and Syed Nasir Abbas Bukhari

Healthcare 2022, 10(12), 2562; https://doi.org/10.3390/healthcare10122562 - 17 Dec 2022

Cited by 4 | Viewed by 2035

Abstract

Rubella virus (RuV) generally causes a mild infection, but it can sometimes lead to systemic abnormalities. This study aimed to conduct a bibliometric analysis of over two decades of RuV research. Medical studies published from 2000 to 2021 were analyzed to gain insights [...] Read more.

Rubella virus (RuV) generally causes a mild infection, but it can sometimes lead to systemic abnormalities. This study aimed to conduct a bibliometric analysis of over two decades of RuV research. Medical studies published from 2000 to 2021 were analyzed to gain insights into and identify research trends and outputs in RuV. R and VOSviewer were used to conduct a bibliometric investigation to determine the globally indexed RuV research output. The Dimensions database was searched with RuV selected as the subject, and 2500 published documents from the preceding two decades were reviewed. The number of publications on RuV has increased since 2003, reaching its peak in 2020. There were 12,072 authors and 16,769 author appearances; 88 publications were single-authored and 11,984 were multi-authored. The United States was the most influential contributor to RuV research, in terms of publications and author numbers. The number of RuV-related articles has continued to increase over the past few years due to the significant rubella burden in low-income nations. This study will aid in formulating plans and policies to control and prevent RuV infections. Full article

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13 pages, 1176 KiB

Open AccessArticle

Evaluation of the Impact of Catheter Ablation Procedure on Outcomes and Economic Burden in Patients with Atrial Fibrillation: Real-World Data from Italian Administrative Databases

by Luca Degli Esposti, Melania Dovizio, Melania Leogrande, Valentina Perrone and Roberto De Ponti

Healthcare 2022, 10(12), 2561; https://doi.org/10.3390/healthcare10122561 - 17 Dec 2022

Cited by 3 | Viewed by 2314

Abstract

A real-world analysis among the Italian population has been carried out to estimate the number of atrial fibrillation (AF) patients undergoing catheter ablation and to evaluate their clinical outcome and economic burden. A retrospective analysis on administrative Italian databases has been performed. Between [...] Read more.

A real-world analysis among the Italian population has been carried out to estimate the number of atrial fibrillation (AF) patients undergoing catheter ablation and to evaluate their clinical outcome and economic burden. A retrospective analysis on administrative Italian databases has been performed. Between January 2011 and December 2019, all patients diagnosed with AF were considered and those undergoing catheter ablation were identified. Overall, 3084 (3.54%) of AF patients with at least one catheter ablation were included (mean age 63.2, 67.3% males). A significant decrease in the use of AF-related medications and in hospitalizations, mainly related to AF and heart failure, was observed during the 3-year post-ablation period. The average total cost per patient during the 1-year before ablation period was significantly higher compared to the 1-year post-ablation cost (EUR 5248 vs. 4008, respectively; p < 0.001). After propensity score matching, the overall mortality of patients who underwent ablation was significantly lower compared to that assessed in patients not treated with the procedure (9.386/1000 vs. 23.032/1000 person-year, respectively; p < 0.001). Moreover, the mean total costs were significantly higher in patients who did not undergo ablation compared to those who received ablation (EUR 5516 vs. 4008, respectively; p < 0.001). This real-world data analysis shows that in Italy, although catheter ablation is performed in a minority of AF patients, it is associated with significantly better post-procedure clinical outcomes and a significant reduction in healthcare-related costs. Full article

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19 pages, 388 KiB

Open AccessArticle

Preventive Medicine via Lifestyle Medicine Implementation Practices Should Consider Individuals’ Complex Psychosocial Profile

by Zacharias Papadakis, Andreas Stamatis, Matthew Manierre and Ali Boolani

Healthcare 2022, 10(12), 2560; https://doi.org/10.3390/healthcare10122560 - 17 Dec 2022

Cited by 4 | Viewed by 2171

Abstract

Noncommunicable chronic diseases are associated with lifestyle behaviors. Psychological and social factors may influence the adoption of such behaviors. Being mentally and physically energized or fatigued may influence the intention–behavior gap of healthy lifestyle adoption accordingly. We investigated the associations of age, sex, [...] Read more.

Noncommunicable chronic diseases are associated with lifestyle behaviors. Psychological and social factors may influence the adoption of such behaviors. Being mentally and physically energized or fatigued may influence the intention–behavior gap of healthy lifestyle adoption accordingly. We investigated the associations of age, sex, lifestyle behaviors, mood, and mental and physical energy and fatigue at both the trait and state levels. The participants (N = 670) completed questionnaires assessing their sleep, mood, mental and physical state energy and fatigue, physical activity, mental workload, and diet. The ordinary least squares regression models revealed an overlap between the mental state and trait energy levels for males who consume polyphenols, have a high mental workload, and sleep well. Being younger, having a high stress level, bad sleep habits, and being confused and depressed were associated with high mental fatigue. Physical energy and fatigue shared the same commonalities with the previous results, with greater discrepancies observed between the state and trait indicators compared to that between mental energy and fatigue. Diet and stress management seem to be predictors of high physical energy, and females report higher physical fatigue levels. Health care professionals should consider this psychosocial complex profiling in their differential diagnosis and when one is implementing lifestyle behavioral changes to address the facets of preventive medicine, wellness, and health promotion. Full article

(This article belongs to the Special Issue Non-pharmacological Approaches and Their Impact on Noncommunicable Diseases)

14 pages, 274 KiB

Open AccessEditor’s ChoiceArticle

Through Thick and Thin: The Meaning of Dementia for the Intimacy of Ageing Couples

by Päivi Eskola, Outi Jolanki and Mari Aaltonen

Healthcare 2022, 10(12), 2559; https://doi.org/10.3390/healthcare10122559 - 17 Dec 2022

Cited by 8 | Viewed by 2652

Abstract

As the population ages, the number of people with dementia increases. An emerging body of research is focusing on living with dementia and understanding the experience of caring and the care burden. There is much less research on the meaning of dementia from [...] Read more.

As the population ages, the number of people with dementia increases. An emerging body of research is focusing on living with dementia and understanding the experience of caring and the care burden. There is much less research on the meaning of dementia from the perspective of an older couple’s spousal relationship and related intimacy. This qualitative study explores the meanings of emotional and physical intimacy and the changes brought by dementia in the couplehood of persons with dementia and their spousal carers. The data comprise semi-structured interviews with 35 persons. The interviews were analysed using inductive qualitative content analysis. Four themes describing the meanings of relational intimacy were identified: intimacy as a striving force, intimacy turning into worrisome behaviour, intimacy as physical and emotional dependency, and intimacy turning into one-sided caring for a partner. Dementia changes the intimate relationship in many ways, but shared affection and long-term partnership help maintain the spousal relationship. While dementia may bring about conflicts and behavioural challenges in an intimate relationship, the couple’s shared intimacy and a sense of responsibility for one another may serve as a resource and support the continuity of couplehood. Full article

(This article belongs to the Special Issue Dementia and Care)

16 pages, 259 KiB

Open AccessArticle

Patients’ Experience of Medication Brand Changes during Hormone Therapy for Breast Cancer—An Interpretative Phenomenological Analysis

by Yolanda Eraso, Zoe Moon and Ieva Steinberga

Healthcare 2022, 10(12), 2558; https://doi.org/10.3390/healthcare10122558 - 16 Dec 2022

Cited by 2 | Viewed by 2028

Abstract

Medication adherence to hormone therapy (HT) in breast cancer survivors is often suboptimal and is affected by a range of factors. Patients are usually prescribed different generic formulations of HT drugs and their impact on side effects and on adherence and persistence is [...] Read more.

Medication adherence to hormone therapy (HT) in breast cancer survivors is often suboptimal and is affected by a range of factors. Patients are usually prescribed different generic formulations of HT drugs and their impact on side effects and on adherence and persistence is poorly understood. This study aimed to explore women’s lived experience of HT medication brand changes (generic substitution) and its impact on side effects, quality of life and medication-taking behaviors, as well as on adherence and persistence. Nine female breast cancer survivors who had previous experience of HT medication brand changes participated in the study. Individual, online, semi-structured interviews were conducted and analyzed using interpretative phenomenological analysis. The findings identified three superordinate themes and nine subordinate themes that influenced the lived experience of medication brand changes for these patients: (i) experiencing brand changes, (ii) responsiveness of health care providers and (iii) future expectations. Women reported negative physical and emotional experiences of brand changes, which is often compounded by healthcare professionals’ lack of information and reassurances, disbelief in the worsening of side effects and inconsistent advice regarding generics. These have implications for women’s self-efficacy for medication-taking behaviors, ability to manage side effects and HT adherence and persistence. Full article

12 pages, 3149 KiB

Open AccessArticle

Exercised-Induced Hypoalgesia following An Elbow Flexion Low-Load Resistance Exercise with Blood Flow Restriction: A Sham-Controlled Randomized Trial in Healthy Adults

by Stefanos Karanasios, Alexia Sozeri, George A. Koumantakis and George Gioftsos

Healthcare 2022, 10(12), 2557; https://doi.org/10.3390/healthcare10122557 - 16 Dec 2022

Cited by 7 | Viewed by 2359

Abstract

We aimed to evaluate the hypoalgesic effect of an elbow flexion low-load resistance exercise with blood flow restriction (LLRE–BFR) when compared to high-load resistance exercise (HLRE) with sham-BFR in healthy individuals. Forty healthy young adults (17 women), with a mean age ± SD: [...] Read more.

We aimed to evaluate the hypoalgesic effect of an elbow flexion low-load resistance exercise with blood flow restriction (LLRE–BFR) when compared to high-load resistance exercise (HLRE) with sham-BFR in healthy individuals. Forty healthy young adults (17 women), with a mean age ± SD: 26.6 ± 6.8 years, and mean body mass index ± SD: 23.6 ± 2.7 were randomly assigned to either an LLRE–BFR (30% 1 repetition maximum, RM) or an HLRE with sham-BFR group (70% of 1 RM). Blood pressure and pressure pain thresholds (PPTs) were measured pre- and post-exercise intervention. The rating of perceived exertion (RPE) was recorded after each set. There were non-significant between-group changes in PPT at the dominant biceps (−0.61, 95%CI: −1.92 to 0.68) with statistically significant reductions between pre- and post-exercise in LLRE–BFR (effect size, d = 0.88) and HLRE-BFR (effect size, d = 0.52). No within- or between-group differences were recorded in PPT at non-exercising sites of measurement. No mediating effects of changes in blood pressure or RPE on the changes in pressure pain threshold were observed. LLRE–BFR produced a similar hypoalgesic effect locally compared to HLRE and can be used as an alternative intervention to decrease pain sensitivity when HLRE is contraindicated or should be avoided. Full article

(This article belongs to the Special Issue The Role of Physical Therapy in Pain Management and Pain Relief)

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14 pages, 2529 KiB

Open AccessArticle

The Effect of Single Bout Treatment of Heat or Cold Intervention on Delayed Onset Muscle Soreness Induced by Eccentric Contraction

by Riku Yoshida, Masatoshi Nakamura and Ryo Ikegami

Healthcare 2022, 10(12), 2556; https://doi.org/10.3390/healthcare10122556 - 16 Dec 2022

Cited by 3 | Viewed by 2327

Abstract

We studied the preventive effects of heat or cold therapy after repeated eccentric contraction against torque reduction, muscle soreness, and range of motion (ROM) due to delayed-onset muscle soreness (DOMS). A total of 42 healthy male subjects were randomly allocated into three groups: [...] Read more.

We studied the preventive effects of heat or cold therapy after repeated eccentric contraction against torque reduction, muscle soreness, and range of motion (ROM) due to delayed-onset muscle soreness (DOMS). A total of 42 healthy male subjects were randomly allocated into three groups: the HEAT group received heat therapy using an ultra-short-wave device; the ICE group received ice therapy using an ice pack; the Control group received no intervention. The measurements included maximal voluntary isometric, concentric, and eccentric elbow flexion torque, elbow extension ROM, pressure pain threshold, and muscle soreness with stretching muscle thickness and echo intensity. The measurements were taken before (pre), after (post), after (t-post), one–four days after, and seven days after the muscle damage protocol. The results showed the main effect of time on all measurements, but no significant interactions were observed. The results of this study suggest that heat or cold therapy in the first 30 min after intense eccentric exercise is insufficient to exert a preventive effect against DOMS. Full article

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12 pages, 4027 KiB

Open AccessArticle

Neck and Shoulder Morbidity in Patients with Oral Cancer and Clinically Negative Node Neck Status: A Comparison between the Elective Neck Dissection and Sentinel Lymph Node Biopsy Strategies

by Gerben van Hinte, Koen P. A. Withagen, Remco de Bree and Caroline M. Speksnijder

Healthcare 2022, 10(12), 2555; https://doi.org/10.3390/healthcare10122555 - 16 Dec 2022

Cited by 2 | Viewed by 1612

Abstract

The choice for the most optimal strategy for patients with a cT_1-2N₀ carcinoma of the oral cavity, sentinel lymph node biopsy (SLNB) or elective neck dissection (END), is still open for debate in many head and neck cancer (HNC) treatment [...] Read more.

The choice for the most optimal strategy for patients with a cT_1-2N₀ carcinoma of the oral cavity, sentinel lymph node biopsy (SLNB) or elective neck dissection (END), is still open for debate in many head and neck cancer (HNC) treatment centers. One of the possible benefits of the less invasive SLNB could be reduced neck and shoulder morbidity. Recent studies have shown a benefit in favor of SLNB the first year after intervention, but the long-term consequences and differences in neck morbidity remain unclear. This cross-sectional study aimed to research differences in neck and shoulder morbidity and Health-Related Quality of Life (HR-QoL) in patients with a cT_1-2N₀ carcinoma of the oral cavity, treated with either END or SLNB. Neck and shoulder morbidity and HR-QOL were measured with patient-reported questionnaires (SDQ, SPADI, NDI, NDII, EORTC-QLQ-C30, EORTC-QLQ-HN35) and active range of motion (AROM) measurements. In total 18 patients with END and 20 patients with SLNB were included. We found no differences between END and SLNB for long-term neck morbidity, shoulder morbidity, and HR-QOL. The significant differences found in the rotation of the neck are small and not clinically relevant. Full article

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15 pages, 1179 KiB

Open AccessArticle

A Multisite Assessment of Saudi Bachelor Nursing Students’ Perceptions of Clinical Competence and Learning Environments: A Multivariate Conceptual Model Testing

by Mohammad Hamdi Abuadas

Healthcare 2022, 10(12), 2554; https://doi.org/10.3390/healthcare10122554 - 16 Dec 2022

Cited by 3 | Viewed by 2184

Abstract

Background: It is thought that students’ perceptions of educational and clinical learning environments improve the effectiveness of curricula and professional standards. It is essential to examine the educational and clinical learning environments in which nursing students learn, as well as how nursing students [...] Read more.

Background: It is thought that students’ perceptions of educational and clinical learning environments improve the effectiveness of curricula and professional standards. It is essential to examine the educational and clinical learning environments in which nursing students learn, as well as how nursing students evaluate particular factors of these environments. Objectives: The objectives of this study were to (1) identify nursing students’ perceptions on professional competence and learning environments in the classroom and clinical settings and (2) test a hypothetical model of variables that influence and predict students’ perceptions of learning environments and professional competencies. Methods: The study employed a descriptive cross-sectional methodological design. Five hundred and eighteen undergraduate nursing students were recruited from three Saudi Arabian universities using a convenient sampling technique. Using valid and reliable self-reported questionnaires, including the Dundee Ready Educational Environment Measure (DREEM), the modified Clinical Learning Environment Inventory (CLEI), and the Nurse Professional Competence Scale-Short (NPCS-SF), data were collected. Results: Perceptions of professional competence and learning environments were positive among nursing students. With satisfactory fit indices, the final model found that students’ perceptions of clinical competence were significantly predicted by their perceptions of the clinical environment (B = 0.43, p < 0.001), students’ perceptions of university environments (B = 0.29, p < 0.001), ward type (B = 0.12, p < 0.001), and students’ year of study (B = 0.11, p < 0.001). The students’ perceptions of clinical environments were significantly predicted by their perceptions of the university environment (B = 0.31, p < 0.001), gender (B = 0.13, p < 0.001), students’ year of study (B = 0.12, p < 0.001), and ward type (B = 0.11, p < 0.001). Moreover, the students’ perceptions of the university environment were significantly predicted by gender (B = 0.11, p < 0.001) and length of training (B = 0.12, p < 0.001). Conclusions: A range of factors might influence students’ perceptions of their professional competence and learning environments. Improving the learning environments and clinical experiences of students could enhance their clinical competence. This study’s findings provide evidence for how to enhance the learning environments in the classroom and clinical settings in order to improve students’ clinical competence, which will ultimately result in better patient outcomes. It is a top priority for nursing educators all around the world to improve classroom and clinical learning settings that foster students’ learning and professional competencies. Full article

(This article belongs to the Topic Teaching Social Sciences and Humanities in Medicine, Allied Health and Social Care)

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7 pages, 247 KiB

Open AccessArticle

Physical Function of Japanese Preadolescents during the COVID-19 Pandemic

by Sho Narahara, Tadashi Ito, Yuji Ito, Hideshi Sugiura, Koji Noritake and Nobuhiko Ochi

Healthcare 2022, 10(12), 2553; https://doi.org/10.3390/healthcare10122553 - 16 Dec 2022

Cited by 2 | Viewed by 1419

Abstract

Children’s exercise habits have changed during the COVID-19 pandemic. This study aimed to examine the physical function and physical activity of preadolescent children before and during the COVID-19 pandemic. This cross-sectional study compared time spent in moderate-to-vigorous physical activity (MVPA), grip strength, single-leg [...] Read more.

Children’s exercise habits have changed during the COVID-19 pandemic. This study aimed to examine the physical function and physical activity of preadolescent children before and during the COVID-19 pandemic. This cross-sectional study compared time spent in moderate-to-vigorous physical activity (MVPA), grip strength, single-leg standing time, and two-step tests of healthy children aged 10 to 12 years, enrolled from January 2018 to January 2020 (pre-COVID-19 group, n = 177) and from January 2021 to September 2022 (during-COVID-19 group, n = 69). The during-COVID-19 group had weaker grip strength (median: 14.4 vs. 15.8 kg; p = 0.012), worse performance on the two-step test (mean: 1.56 vs. 1.60; p = 0.013), and less MVPA (median: 4 vs. 7 h per week; p = 0.004). Logistic regression showed that the during-COVID-19 group was significantly related to weaker grip strength (odds ratio: 0.904, 95% CI: 0.829–0.986; p = 0.022) and worse performance in the two-step test (odds ratio: 0.976, 95% CI: 0.955–0.997; p = 0.028). The COVID-19 pandemic decreased exercise opportunities for preadolescent children, which may have had a negative impact on muscle strength and balance. It is essential to increase the amount of MVPA among preadolescent children. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

9 pages, 255 KiB

Open AccessArticle

Effects of Debriefing on Motivation and Reflective Thinking of Nursing Students during In-School Practicum Using a Flipped Learning Model

by Sisook Kim and Yedong Son

Healthcare 2022, 10(12), 2552; https://doi.org/10.3390/healthcare10122552 - 16 Dec 2022

Cited by 3 | Viewed by 1887

Abstract

Debriefing and flipped learning have been determined to be useful strategies for nursing education. Recently, it has been reported that applying debriefing and flipped learning together was helpful for educational outcomes. The objective of this study was to compare learning motivation and reflective [...] Read more.

Debriefing and flipped learning have been determined to be useful strategies for nursing education. Recently, it has been reported that applying debriefing and flipped learning together was helpful for educational outcomes. The objective of this study was to compare learning motivation and reflective thinking before and after debriefing during nursing practicums that applied flipped learning. We implemented a quasi-experimental procedure in the form of a pretest-posttest non-equivalent control group design (1 September to 22 October 2021). The participants comprised 63 nursing students in South Korea (33 in the experimental group and 30 in the control group). Each group took part in a nursing practice class, wherein the experimental group engaged in debriefing using flipped learning, while the control group engaged only in flipped learning. We then examined academic motivation and reflective thinking in both the groups, and found that reflective thinking was significantly higher in the experimental group (53.67 ± 5.71) versus the control group (50.80 ± 4.69) (t = 2.165, p = 0.034). However, there were no differences in learning motivation between the two groups (t = 1.864, p = 0.067). In sum, this study confirmed the benefits of this new teaching approach, in which debriefing and flipped learning were integrated and incorporated into a nursing practice class. Given our promising results, this approach can be applied in various cases to strengthen the clinical practice skills of nursing students. Full article

(This article belongs to the Section Nursing)

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