Healthcare

11 pages, 284 KiB

Open AccessArticle

Direct and Indirect Costs Related to Physical Activity Levels in Patients with Diabetes Mellitus in Spain: A Cross-Sectional Study

by Antonio Sarria-Santamera, Zhanna Alexeyeva, Mei Yen Chan, Miguel A. Ortega, Angel Asunsolo-del-Barco and Carlos Navarro-García

Healthcare 2022, 10(4), 752; https://doi.org/10.3390/healthcare10040752 - 18 Apr 2022

Cited by 4 | Viewed by 2592

Abstract

Diabetes mellitus (DM) is a global public health concern. DM is importantly linked to the modern lifestyle. Lifestyle-based interventions currently represent a critical preventive and therapeutic approach for patients with DM. Increasing physical activity has proven multiple benefits to prevent this condition; however, [...] Read more.

Diabetes mellitus (DM) is a global public health concern. DM is importantly linked to the modern lifestyle. Lifestyle-based interventions currently represent a critical preventive and therapeutic approach for patients with DM. Increasing physical activity has proven multiple benefits to prevent this condition; however, there is still room for further progress in this field, especially in terms of the effect of exercise in patients with already established DM. This study intends to examine the economic relationship between physical activity and direct/indirect costs in patients with DM. We analyze a national representative sample (n = 1496) of the general population of Spain, using available data from the National Health Survey of 2017 (NHS 2017). Our results show that 63.7% of the sample engaged in some degree of physical activity, being more frequent in men (67.5%), younger individuals (80.0%), and those with higher educational levels (69.7%). Conversely, lower levels of physical activity were associated with female sex, older subjects, and various comorbidities. Our study estimates that 2151 € per (51% in direct costs) patient may be saved if a minimum level of physical activity is implemented, primarily, due to a decrease in indirect costs (absenteeism and presenteeism). This study shows that physical activity will bring notable savings in terms of direct and indirect costs in patients with DM, particularly in some vulnerable groups. Full article

(This article belongs to the Collection Health Economics & Finance and Global Public Health)

11 pages, 258 KiB

Open AccessArticle

Effect of Pharmacist-Led Interventions on Physicians’ Prescribing for Pediatric Outpatients

by Kien Trung Nguyen, Vy Tran Thanh Le, Thao Huong Nguyen, Suol Thanh Pham, Phuong Minh Nguyen, Katja Taxis, Mai Tuyet Vi, Thang Nguyen and Hung Do Tran

Healthcare 2022, 10(4), 751; https://doi.org/10.3390/healthcare10040751 - 18 Apr 2022

Cited by 2 | Viewed by 2256

Abstract

Background: Children are at high risk of drug-related problems, increased risk of treatment failures, and high treatment costs. We aimed to evaluate the effect of pharmacist-led interventions on physicians’ prescribing for pediatric outpatients. Methods: A prospective study with pre- and post-intervention measurement assessment [...] Read more.

Background: Children are at high risk of drug-related problems, increased risk of treatment failures, and high treatment costs. We aimed to evaluate the effect of pharmacist-led interventions on physicians’ prescribing for pediatric outpatients. Methods: A prospective study with pre- and post-intervention measurement assessment was conducted to collect pediatric outpatients’ prescriptions during the pre-intervention period (January 2020) and post-intervention (August 2020) at a children’s hospital in Vietnam. Drug-related problems were identified and categorized according to Pharmaceutical Care Network Europe (PCNE), version 9.1. The intervention program was developed based on the results of pre-intervention observations. After the intervention, prescriptions were evaluated. Statistical tests were used to compare the proportions of drug-related problems before and after the intervention and to identify factors related to drug-related problems. Results: There were 2788 out of 4218 (66.1%) prescriptions with at least one drug-related problem before the intervention. Of these drug-related problems, the most common was inappropriate timing of administration and incorrect dosage (36.1% and 35.6%, respectively). After the intervention, the percentage of prescriptions with at least one drug-related problem was 45.5% (p < 0.001). Most of the drug-related problem types decreased significantly (p < 0.05). The binary logistic regression analysis results showed that in addition to pharmacists’ intervention, patients’ gender, primary disease, comorbidity status, and the total number of drugs prescribed were also factors related to drug-related problems. Conclusions: Drug-related problems in pediatric outpatients were quite common. Pharmacists’ intervention helped to improve the prevalence and types of drug-related problems. Full article

9 pages, 254 KiB

Open AccessArticle

Public Health Financing and Responses to COVID-19: Lessons from South Korea

by Hyeki Park, Boram Sim, Bo Zhao and Eun Woo Nam

Healthcare 2022, 10(4), 750; https://doi.org/10.3390/healthcare10040750 - 18 Apr 2022

Cited by 5 | Viewed by 3163

Abstract

Health financing strategies contribute significantly to containing the outbreak of the Coronavirus disease 2019 (COVID-19). This study aims to reassess Korea’s financing strategies in response to COVID-19 in 2020, to ascertain its effects and sustainability. The Joint External Evaluation tool was adopted to [...] Read more.

Health financing strategies contribute significantly to containing the outbreak of the Coronavirus disease 2019 (COVID-19). This study aims to reassess Korea’s financing strategies in response to COVID-19 in 2020, to ascertain its effects and sustainability. The Joint External Evaluation tool was adopted to analyze the data collected from government reports, official statistics, and other sources. Findings show that Korea could maintain a low incidence and fatality rate compared with other countries, at low costs. It was a result of rapidly procured healthcare resources based on laws and policies established after the 2015 epidemic, and the National Health Insurance. However, to achieve long-term sustainability, it is important to enhance the financial stability of the national health insurance and increase the proportion of the public sector in healthcare resources. Full article

(This article belongs to the Collection Health Economics & Finance and Global Public Health)

11 pages, 568 KiB

Open AccessArticle

Physical Activity and Its Diurnal Fluctuations Vary by Non-Motor Symptoms in Patients with Parkinson’s Disease: An Exploratory Study

by Koichi Nagaki, Shinsuke Fujioka, Hiroyuki Sasai, Yumiko Yamaguchi and Yoshio Tsuboi

Healthcare 2022, 10(4), 749; https://doi.org/10.3390/healthcare10040749 - 18 Apr 2022

Cited by 3 | Viewed by 2575

Abstract

Background: This exploratory study investigated the association between non-motor symptoms (NMS) and both physical activity and diurnal activity patterns in patients with Parkinson’s disease (PwPD). Methods: Participants included PwPD with modified Hoehn and Yahr stages 1–3. The presence of NMS was assessed with [...] Read more.

Background: This exploratory study investigated the association between non-motor symptoms (NMS) and both physical activity and diurnal activity patterns in patients with Parkinson’s disease (PwPD). Methods: Participants included PwPD with modified Hoehn and Yahr stages 1–3. The presence of NMS was assessed with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part I. Physical activity was measured using a waist-mounted triaxial accelerometer. Logistic regression analyses evaluated associations between NMS and physical activity; furthermore, diurnal fluctuation in physical activity due to NMS was examined by ANCOVA. Results: Forty-five PwPD were included in the study. Among the domains of NMS, pain and other sensations (OR, 8.36; 95% CI, 1.59–43.94) and fatigue (OR, 14.26; 95% CI, 1.85–109.90) were associated with low daily step count (<4200 steps/day). Analysis by time of day showed no characteristic variability in physical activity but had constant effect sizes for pain and other sensations (p = 0.20, ES = 0.36) and fatigue (p = 0.08, ES = 0.38). Conclusion: Our exploratory study suggested that PwPD with pain and other sensations and fatigue recorded lower step counts than their asymptomatic counterparts. Therefore, PwPD with pain and fatigue may need more support in promoting physical activity. Full article

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

► Show Figures

Figure 1

14 pages, 965 KiB

Open AccessArticle

Socio-Economic, Demographic and Health Determinants of the COVID-19 Outbreak

by Ayfer Ozyilmaz, Yuksel Bayraktar, Metin Toprak, Esme Isik, Tuncay Guloglu, Serdar Aydin, Mehmet Firat Olgun and Mustafa Younis

Healthcare 2022, 10(4), 748; https://doi.org/10.3390/healthcare10040748 - 18 Apr 2022

Cited by 8 | Viewed by 2756

Abstract

Objective: In this study, the effects of social and health indicators affecting the number of cases and deaths of the COVID-19 pandemic were examined. For the determinants of the number of cases and deaths, four models consisting of social and health indicators were [...] Read more.

Objective: In this study, the effects of social and health indicators affecting the number of cases and deaths of the COVID-19 pandemic were examined. For the determinants of the number of cases and deaths, four models consisting of social and health indicators were created. Methods: In this quantitative research, 93 countries in the model were used to obtain determinants of the confirmed cases and determinants of the COVID-19 fatalities. Results: The results obtained from Model I, in which the number of cases was examined with social indicators, showed that the number of tourists, the population between the ages of 15 and 64, and institutionalization had a positive effect on the number of cases. The results obtained from the health indicators of the number of cases show that cigarette consumption affects the number of cases positively in the 50th quantile, the death rate under the age of five affects the number of cases negatively in all quantiles, and vaccination positively affects the number of cases in 25th and 75th quantile values. Findings from social indicators of the number of COVID-19 deaths show that life expectancy negatively affects the number of deaths in the 25th and 50th quantiles. The population over the age of 65 and CO₂ positively affect the number of deaths at the 25th, 50th, and 75th quantiles. There is a non-linear relationship between the number of cases and the number of deaths at the 50th and 75th quantile values. An increase in the number of cases increases the number of deaths to the turning point; after the turning point, an increase in the number of cases decreases the death rate. Herd immunity has an important role in obtaining this finding. As a health indicator, it was seen that the number of cases positively affected the number of deaths in the 50th and 75th quantile values and the vaccination rate in the 25th and 75th quantile values. Diabetes affects the number of deaths positively in the 75th quantile. Conclusion: The population aged 15–64 has a strong impact on COVID-19 cases, but in COVID-19 deaths, life expectancy is a strong variable. On the other hand, it has been found that vaccination and the number of cases interaction term has an effect on the mortality rate. The number of cases has a non-linear effect on the number of deaths. Full article

(This article belongs to the Collection Health Economics & Finance and Global Public Health)

► Show Figures

Figure 1

10 pages, 459 KiB

Open AccessArticle

Usefulness of Novel Atherogenic Lipid Indices for the Evaluation of Metabolic Status Leading to Coronary Heart Disease in a Real-World Survey of the Japanese Population

by Isamu Matsunaga, Miyuki Ando, Yuki Tsubakimoto, Miyuki Nagasawa and Yoshimasa Kurumi

Healthcare 2022, 10(4), 747; https://doi.org/10.3390/healthcare10040747 - 17 Apr 2022

Viewed by 1941

Abstract

We evaluated the usefulness of two novel cholesterol-triglyceride subgroup (CTS) indices, CTS_qlt and CTS_qnt, that potentially reflect the metabolic status regarding risk of coronary heart disease (CHD) using a retrospective longitudinal study of the Japanese general population. We recruited 12,373 [...] Read more.

We evaluated the usefulness of two novel cholesterol-triglyceride subgroup (CTS) indices, CTS_qlt and CTS_qnt, that potentially reflect the metabolic status regarding risk of coronary heart disease (CHD) using a retrospective longitudinal study of the Japanese general population. We recruited 12,373 individuals from the annual users of our healthcare center. Among them, the first onset of CHD was recorded in 131 individuals between April 2014 and March 2020. The multivariate Cox proportional hazards regression analyses for all normalized lipid indices revealed that the CTS_qnt index showed a comparable hazard ratio for the CHD outcome to non-high-density lipoprotein cholesterol (nonHDL-c) and triglycerides. The HR of the CTS_qlt index was significantly lower than for CTS_qnt, but still comparable to that for low-density lipoprotein cholesterol (LDL-c). In comparison with the other indices, CTS_qlt is more sensitive to risk increment while the index value increases. Linear regression analyses for the CTS indices and previously known lipid indices suggest that the CTS_qnt and CTS_qlt indices reflect the quantity of atherogenic lipoproteins and particle size (quality) of smaller and denser LDLs, respectively. Furthermore, the CTS_qnt/HDL-c index can be used as a comprehensive risk indicator that may represent the status of lipid metabolism determined by the CTS_qlt and CTS_qnt indices and thus may be useful for screening. The CTS indices can be used to evaluate the metabolic status of individuals, which may increase the risk of future CHD. Full article

(This article belongs to the Section Preventive Medicine)

► Show Figures

Figure 1

15 pages, 263 KiB

Open AccessArticle

The Prevalence and Psychosocial Correlates of Ketum (Mitragyna speciosa) Use among Individuals on Methadone Maintenance Therapy Programme in Hospital Taiping, Malaysia

by Ling Ling Choo, Muhammad Muhsin Ahmad Zahari, Seng Kit Choy, Naemah Abdul Rahim and Rusdi Abd Rashid

Healthcare 2022, 10(4), 746; https://doi.org/10.3390/healthcare10040746 - 17 Apr 2022

Cited by 2 | Viewed by 2650

Abstract

Ketum use is significantly prevalent amongst individuals in the northern states of Peninsular Malaysia. This study aims to investigate the prevalence and psychosocial correlates of Ketum use in individuals who are in the Methadone Maintenance Therapy (MMT) Programme at the Hospital Taiping. This [...] Read more.

Ketum use is significantly prevalent amongst individuals in the northern states of Peninsular Malaysia. This study aims to investigate the prevalence and psychosocial correlates of Ketum use in individuals who are in the Methadone Maintenance Therapy (MMT) Programme at the Hospital Taiping. This is a cross-sectional study conducted in the methadone clinic at the Hospital Taiping. The study instruments used were Subjective Opiate Withdrawal Scale (SOWS), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) questionnaire, and Kratom Dependence Scale (KDS). A total of 215 subjects were recruited for this study. The prevalence of ketum users was 49.3% (n = 106). Chinese and Indian ethnicity had a lower tendency to use ketum compared to Malay ethnicity, with OR = 0.386 (95% CI 0.134, 1.113) and 0.119 (95% CI 0.035, 0.408), respectively. Individuals who used other illicit drugs had a higher tendency to use ketum with the adjusted OR = 9.914 (95% CI: 1.109, 88.602). Every one unit increase in SOWS increased the odds of being a ketum user by 1.340 (95% CI: 1.070, 1.677), whereas every one unit increase in duration in the MMT programme reduced the odds of being a ketum user by 0.990 (95% CI: 0.982, 0.998). Ketum use is prevalent amongst those in the MMT programme in this study. The high prevalence of ketum use is of concern and further interventions should be carried out to address this. Full article

13 pages, 1003 KiB

Open AccessArticle

The Use of Virtual Therapy in Cardiac Rehabilitation of Male Patients with Coronary Heart Disease: A Randomized Pilot Study

by Sandra Jóźwik, Adam Wrzeciono, Błażej Cieślik, Paweł Kiper, Joanna Szczepańska-Gieracha and Robert Gajda

Healthcare 2022, 10(4), 745; https://doi.org/10.3390/healthcare10040745 - 16 Apr 2022

Cited by 7 | Viewed by 2537

Abstract

The study aimed to evaluate the effectiveness of virtual reality therapy (VRT) in the treatment of anxiety–depressive disorders and in reducing stress levels in a group of men with coronary heart disease (CHD) participating in cardiac rehabilitation (CR). The study included 34 men [...] Read more.

The study aimed to evaluate the effectiveness of virtual reality therapy (VRT) in the treatment of anxiety–depressive disorders and in reducing stress levels in a group of men with coronary heart disease (CHD) participating in cardiac rehabilitation (CR). The study included 34 men with CHD who were assigned to the experimental group (EG) or the control group (CG). CR in the EG was supported by 8 VRT sessions, while CR in the CG was supplemented with 8 SAT sessions. Anxiety–depressive disorders were assessed using the Hospital Anxiety and Depression Scale (HADS). Perceived stress was assessed using the Perception of Stress Questionnaire (PSQ). In the EG, all measured parameters improved after the intervention. Significant reductions in HADS total score, the HADS-A, general stress score, emotional tension, and the external stress were obtained. In the CG, a deterioration in all measured parameters was observed. Significant changes were obtained in the general stress score and intrapsychic stress. The analysis between groups showed that the effectiveness of psychological interventions significantly differed between groups. The study results confirmed that supplementing standard CR with VRT leads to an improvement in the mental state of the patients and thus has a positive effect on the course of CR. However, the small sample size and high withdrawal rate prompt cautious interpretation of the results. Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

► Show Figures

Figure 1

14 pages, 250 KiB

Open AccessArticle

Nursing Experience of New Nurses Caring for COVID-19 Patients in Military Hospitals: A Qualitative Study

by Young-Hoon Kwon, Hye-Ju Han and Eunyoung Park

Healthcare 2022, 10(4), 744; https://doi.org/10.3390/healthcare10040744 - 16 Apr 2022

Cited by 3 | Viewed by 2536

Abstract

This qualitative study explored the experiences of new nurses with less than one year of clinical experience in caring for COVID-19 patients in a military hospital. In-depth interviews were conducted with six new nurses working in a negative-pressure isolation unit of the Armed [...] Read more.

This qualitative study explored the experiences of new nurses with less than one year of clinical experience in caring for COVID-19 patients in a military hospital. In-depth interviews were conducted with six new nurses working in a negative-pressure isolation unit of the Armed Forces Capital Hospital. Data were analyzed using the phenomenological method proposed by Colaizzi, and 12 themes were derived and classified into four clusters: burden of nursing in isolation units; hardship of nursing critically ill patients; efforts to perform nursing tasks; positive changes through patient care. The participants were anxious while caring for COVID-19 patients with severe illness due to a lack of clinical experience. Furthermore, the wearing of heavy personal protective equipment impeded communication with patients, leading to physical and psychological exhaustion. However, they tried to utilize their own know-how and provide the best nursing care, resulting in them gaining confidence. Participants were able to think critically and took pride in being military nursing professionals. This study is meaningful as it provides insight into the experiences of new military nurses who were rapidly dispatched during a national medical crisis. The results can be applied to develop future strategies aimed at improving new nurses’ competency in military hospitals. Full article

(This article belongs to the Section Nursing)

11 pages, 265 KiB

Open AccessArticle

An Exploration of the Use and Impact of Preventive Measures on Skin Cancer

by Man Hung, Isaac Rex Beazer, Sharon Su, Jerry Bounsanga, Eric S. Hon and Martin S. Lipsky

Healthcare 2022, 10(4), 743; https://doi.org/10.3390/healthcare10040743 - 15 Apr 2022

Cited by 16 | Viewed by 7524

Abstract

Background: Skin cancer is the most common form of cancer, and both clinical and epidemiological data link cumulative solar dosages and the number of sunburns to skin cancer. Each year, more than 5.4 million new cases of skin cancer are diagnosed, incurring a [...] Read more.

Background: Skin cancer is the most common form of cancer, and both clinical and epidemiological data link cumulative solar dosages and the number of sunburns to skin cancer. Each year, more than 5.4 million new cases of skin cancer are diagnosed, incurring a significant health and financial burden. Recommended preventive measures for skin cancer include the use of sunscreen, sun avoidance, and protective clothing. This study used a national database to examine the association of preventive measures with the prevalence of skin cancer, specifically analyzing the preventive measures of sunscreen use, staying in the shade, and wearing long-sleeved shirts. The second aim was to determine which characteristics, if any, correlated with using prevention measures. Methods: This study analyzed data from the National Health and Nutritional Examination Survey 2015–2016 cycle to examine the association of three preventive measures (using sunscreen, staying in the shade, and wearing long-sleeved shirts) with skin cancer. Logistic regression and chi-square tests were utilized to examine the relationship between skin cancer and these prevention methods. Results: Sunscreen use (OR = 3.752; p < 0.05) was statistically associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts (OR = 6.911; p = 0.064) and staying in the shade (OR = 0.646; p = 0.481) did not emerge as factors significantly associated with a lower prevalence after controlling for gender, race/ethnicity, marital status, income, health insurance, and general health. Additionally, men and individuals of color were less likely to use sunscreen. Conclusion: Sunscreen use was associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts and staying in the shade was not significantly linked to lower rates of skin cancer, suggesting that these measures may not be as effective as sunscreen for preventing skin cancer. Men and individuals of color were significantly less likely to use sunscreen. These findings can help guide future education efforts and research regarding skin cancer prevention and suggest the need to develop male-oriented programs to mitigate the gender disparity in employing sun-protection measures. Full article

10 pages, 464 KiB

Open AccessArticle

Effects of Changes in Multiple Chronic Conditions on Medical Costs among Older Adults in South Korea

by Soojin Park and Jin Young Nam

Healthcare 2022, 10(4), 742; https://doi.org/10.3390/healthcare10040742 - 15 Apr 2022

Cited by 3 | Viewed by 2250

Abstract

This study aims to analyze the relationship between cognitive function and out-of-pocket cost of the state change of multiple chronic conditions in individuals aged 60 or older. Data from the 2014 to 2018 Korean Longitudinal Study of Aging were used for 2202 older [...] Read more.

This study aims to analyze the relationship between cognitive function and out-of-pocket cost of the state change of multiple chronic conditions in individuals aged 60 or older. Data from the 2014 to 2018 Korean Longitudinal Study of Aging were used for 2202 older adults who were cognitively “normal” at the start of the survey. Four status change groups were established (“Good → Good,” “Good → Bad,” “Bad → Good,” and “Bad → Bad”) according to the change in the number of chronic diseases. Generalized estimating equation modeling analyzed the association between these changes and out-of-pocket medical cost. Out-of-pocket cost was significantly higher among older adults with multiple chronic conditions (p < 0.0001). Total out-of-pocket medical cost and out-of-pocket cost for outpatient care and prescription drugs were significantly higher for Bad→ Bad or Good → Bad changes. Older adults with cognitive decline had significantly higher total out-of-pocket medical cost and out-of-pocket cost for prescription drugs. This study demonstrates the need to improve the multiple chronic conditions management construction model to enhance the health of older adults in Korea and secure national health care finances long-term. It provides a foundation for related medical and medical expenses-related systems. Full article

(This article belongs to the Collection Aging and Chronic Disease: Experiences, Holisitic Care and Quality of Life)

► Show Figures

Figure 1

11 pages, 6046 KiB

Open AccessCase Report

Video-Assisted Intubating Stylet Technique for Difficult Intubation: A Case Series Report

by Pei-Jiuan Tsay, Chih-Pin Yang, Hsiang-Ning Luk, Jason Zhensheng Qu and Alan Shikani

Healthcare 2022, 10(4), 741; https://doi.org/10.3390/healthcare10040741 - 15 Apr 2022

Cited by 8 | Viewed by 3353

Abstract

Induction of anesthesia can be challenging for patients with difficult airways and head or neck tumors. Factors that could complicate airway management include poor dentition, limited mouth opening, restricted neck motility, narrowing of oral airway space, restricted laryngeal and pharyngeal space, and obstruction [...] Read more.

Induction of anesthesia can be challenging for patients with difficult airways and head or neck tumors. Factors that could complicate airway management include poor dentition, limited mouth opening, restricted neck motility, narrowing of oral airway space, restricted laryngeal and pharyngeal space, and obstruction of glottic regions from the tumor. Current difficult airway management guidelines include awake tracheal intubation, anesthetized tracheal intubation, or combined awake and anesthetized intubation. Video laryngoscopy is often chosen over direct laryngoscopy in patients with difficult airways because of an improved laryngeal view, higher frequency of successful intubations, higher frequency of first-attempt intubation, and fewer intubation attempts. In this case series report, we describe the video-assisted intubating stylet technique in five patients with difficult airways. We believe that the intubating stylet is a feasible and safe airway technique for anesthetized tracheal intubation in patients with an anticipated difficult airway. Full article

(This article belongs to the Special Issue All-Time Paradigm Shift of Anesthesia Management and Pain Medicine)

► Show Figures

Figure 1

17 pages, 1006 KiB

Open AccessArticle

Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic

by Klara Saczuk, Barbara Lapinska, Adam Wawrzynkiewicz, Alicja Witkowska, Heber Isac Arbildo-Vega, Monika Domarecka and Monika Lukomska-Szymanska

Healthcare 2022, 10(4), 740; https://doi.org/10.3390/healthcare10040740 - 15 Apr 2022

Cited by 12 | Viewed by 4491

Abstract

The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. [...] Read more.

The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. Temporomandibular disorders (TMD) are of multifactorial etiology, and manifest with jaw dysfunction, masticatory muscle tension or pain, as well as headache. Though bruxism can act as an exacerbating factor for TMD, stress can also play crucial role in the onset. The study aimed to measure occurrence of TMD and bruxism symptoms in the medical student population, asses the stress level, and evaluate adopted stress-coping strategies during the COVID-19 pandemic outbreak. A survey study was performed among 1018 students at Medical University of Lodz during April 2020. A self-designed questionnaire for screening TMD and bruxism symptoms, Perceived Stress Scale (PSS-10), and Brief-COPE questionnaires were applied. TMD and bruxism symptoms were observed in the majority of subjects during social isolation. The perceived stress levels were significantly higher in those experiencing TMD and bruxism symptoms. Mostly maladaptive, emotion-focused coping strategies were chosen by study subjects experiencing high levels of stress. Choosing Self-Blaming as a coping strategy is the strongest predictor of perceived stress. Full article

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

► Show Figures

Figure 1

13 pages, 692 KiB

Open AccessSystematic Review

Effects of Occlusal Splints on Spinal Posture in Patients with Temporomandibular Disorders: A Systematic Review

by Martina Ferrillo, Nicola Marotta, Amerigo Giudice, Dario Calafiore, Claudio Curci, Leonzio Fortunato, Antonio Ammendolia and Alessandro de Sire

Healthcare 2022, 10(4), 739; https://doi.org/10.3390/healthcare10040739 - 15 Apr 2022

Cited by 38 | Viewed by 4824

Abstract

There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web [...] Read more.

There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture. Full article

(This article belongs to the Special Issue Vertebral Related Diseases in Healthcare: The Role of Pain Management and Rehabilitation)

► Show Figures

Figure 1

17 pages, 288 KiB

Open AccessArticle

Exploring Adoption and Satisfaction with Self-Service Health Technology in Older Age: Perspectives of Healthcare Professionals and Older People

by Lesley Pek Wee Land, Lynn Chenoweth and Yukun Grant Zhang

Healthcare 2022, 10(4), 738; https://doi.org/10.3390/healthcare10040738 - 15 Apr 2022

Cited by 2 | Viewed by 2880

Abstract

(1) Background. A range of self-service technologies (SST) have been adapted to support the health of older people. Factors involved in older people’s and health professionals’ perceptions of SST in older age were investigated. (2) Methods. Customer Dominant Logic guided this prospective mixed-methods [...] Read more.

(1) Background. A range of self-service technologies (SST) have been adapted to support the health of older people. Factors involved in older people’s and health professionals’ perceptions of SST in older age were investigated. (2) Methods. Customer Dominant Logic guided this prospective mixed-methods study, including surveys with people 70 years and over and health professionals and individual semi-structured interviews in a sample of survey respondents. Survey data were descriptively analysed, while interview themes were derived inductively. (3) Results. Surveyed (n = 12) people 70 years and over placed higher value, expressed more positive user experience, were more satisfied and had greater recognition of the benefits of SST, compared with (n = 10) health professionals (p = 0.001), who considered them to be inferior to traditional healthcare. All seven interviewees agreed that despite accessibility issues and complexity, they valued SST support of older people’s health, thereby confirming the relevance of Customer Dominant Logic in SST offerings. (4) Conclusions. Since older participants were positive and satisfied in using SSTs that are health-supporting, health professionals have a role in encouraging and assisting older people in their use. This requires targeted SST education for health professionals, and more accessible, user-friendly SST and technological support for older people. Full article

12 pages, 749 KiB

Open AccessArticle

Effects of Leisure-Time Physical Activity on Cognitive Reserve Biomarkers and Leisure Motivation in the Pre-Diabetes Elderly

by Bo-Ram Kim and Seung-Taek Lim

Healthcare 2022, 10(4), 737; https://doi.org/10.3390/healthcare10040737 - 15 Apr 2022

Cited by 6 | Viewed by 2559

Abstract

The purpose of this study was to investigate the change in cognitive reserve biomarkers of the pre-diabetic individual according to the types of leisure-time physical activity (aerobic or resistance physical activity). The research subjects (n = 184) who participated in the survey [...] Read more.

The purpose of this study was to investigate the change in cognitive reserve biomarkers of the pre-diabetic individual according to the types of leisure-time physical activity (aerobic or resistance physical activity). The research subjects (n = 184) who participated in the survey were pre-diabetic and diabetic patients who were visiting university hospitals and welfare centers. The intervention subjects (n = 36) who were elderly females with pre-diabetes volunteered to participate in the study by performing regular physical exercise (aerobic or resistance exercise). The study participants were 65 years of age or older with pre-diabetes defined by a glycated hemoglobin (HbA1c) level of (5.7–6.4)%. All research subjects performed motivation and stress questionnaire survey. All intervention subjects participated in leisure-time physical activity (LTPA) for 12 weeks. Body composition, HbA1c, and cognitive reserve biomarkers were measured at baseline, and at 6 and 12 weeks. LTPA motivation confirmed that the LTPA participants had a high level of motivation. Stress confirmed that the stress level of LTPA participants was low. Two-way within-factor ANOVA revealed significant group × time interaction for weight (p < 0.05), BMI (p < 0.01), % fat (p < 0.001), SBP (p < 0.05), HbA1c (p < 0.001), BDNF (p < 0.001), and Beta-Amyloid 1–42 (p < 0.001). In both physical activity groups, HbA1c (p < 0.001), NGF (p < 0.05), BDNF (p < 0.05), and Cathepsin B (p < 0.05) improved significantly at 12 weeks, compared to baseline and 6 weeks. In the resistance physical activity group, Beta-Amyloid 1–42 (p < 0.01) and Homocysteine (p < 0.05) significantly decreased at 12 weeks, compared to baseline and at 6 weeks. The LTPA showed high levels of integrated and identified regulation among leisure motive types, and the level of stress was found to be low. The LTPA is effective in reducing the HbA1c levels of the pre-diabetes elderly. In addition, the pre-diabetes elderly were found to have increased NGF, BDNF, and cathepsin B, and decreased Beta-Amyloid 1–42 and homocysteine. Regular leisure-time physical activity has a positive effect on cognitive reserve biomarkers through improving glycemic control by reducing weight and % fat in the pre-diabetes elderly. Full article

(This article belongs to the Special Issue Strategies to Manage Obesity in Older Adults)

► Show Figures

Figure 1

11 pages, 858 KiB

Open AccessArticle

Decline of Lung Function in Knee and Spine Osteoarthritis in the Korean Population: Cross-Sectional Analysis of Data from the Korea National Health and Nutrition Examination Survey

by Seong-Kyu Kim, Sang Gyu Kwak and Jung-Yoon Choe

Healthcare 2022, 10(4), 736; https://doi.org/10.3390/healthcare10040736 - 15 Apr 2022

Cited by 1 | Viewed by 1904

Abstract

Background: Evidence on the close association between osteoarthritis (OA) and lung diseases is supported by the shared pathogenesis of the two diseases. We assessed the association between knee and spine OA and chronic obstructive pulmonary disease (COPD) in the Korean population. Methods: Using [...] Read more.

Background: Evidence on the close association between osteoarthritis (OA) and lung diseases is supported by the shared pathogenesis of the two diseases. We assessed the association between knee and spine OA and chronic obstructive pulmonary disease (COPD) in the Korean population. Methods: Using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2012, a total of 2006 subjects who underwent both plain radiography for assessment of knee and lumbar spine and spirometry analysis for lung function were analyzed. Radiographic severity grade for OA was assessed using the Kellgren–Lawrence (K-L) grading scale. COPD was defined as a ratio of forced expiratory volume in one second (FEV₁) to forced vital capacity (FVC) less than 0.7. Results: Subjects with spine OA had higher prevalence of COPD than controls (p < 0.001), but not knee OA (p = 0.990). FVC (L), FEV₁ (L), and FVC/FEV1 (%) were significantly decreased in spine OA compared to in controls (p = 0.003, p < 0.001, and p < 0.001, respectively). FVC (L), FVC (%), FEV₁ (L), and FEV₁ (%) were significantly different between knee OA and controls. Univariate regression analysis showed that spine OA was significantly associated with COPD (OR 1.581, 95% CI 1.204–2.076, p = 0.001), but not knee OA. Multivariate analysis revealed that spine OA lost statistical significance for COPD. Conclusion: This study found that subjects with knee OA and spine OA had a decline of lung function compared to subjects without OA, although OA was not associated with COPD. Full article

► Show Figures

Figure 1

2 pages, 162 KiB

Open AccessReply

Reply to Giansanti, D. Comment on “Patel, B.; Makaryus, A.N. Artificial Intelligence Advances in the World of Cardiovascular Imaging. Healthcare 2022, 10, 154”

by Bhakti Patel and Amgad N. Makaryus

Healthcare 2022, 10(4), 735; https://doi.org/10.3390/healthcare10040735 - 15 Apr 2022

Cited by 2 | Viewed by 1194

Abstract

Thank you for your interest and comment [...] Full article

(This article belongs to the Special Issue The Artificial Intelligence in Digital Pathology and Digital Radiology: Where Are We?)

17 pages, 2639 KiB

Open AccessArticle

The Impact of the Main Negative Socio-Economic Factors on Female Fertility

by Viorel Țarcă, Elena Țarcă and Florin-Alexandru Luca

Healthcare 2022, 10(4), 734; https://doi.org/10.3390/healthcare10040734 - 14 Apr 2022

Cited by 13 | Viewed by 3261

Abstract

The negative relationship between fertility and income is well known to economists and demographers. Developed countries have experienced a remarkable decline in their fertility rate as they have become richer. Lifestyle choices can affect a woman’s ability to conceive. Tobacco use and heavy [...] Read more.

The negative relationship between fertility and income is well known to economists and demographers. Developed countries have experienced a remarkable decline in their fertility rate as they have become richer. Lifestyle choices can affect a woman’s ability to conceive. Tobacco use and heavy drinking is associated with an increased risk of ovulation disorders, and being overweight or significantly underweight can inhibit normal ovulation. Our research is focused on evaluating the main risk factors that influence female fertility. We assembled a country-specific dataset on birth rate and socio-economic factors for 171 countries, using data integrated from publicly available data sources. The regression model shows that the negative factor with the greatest impact on female fertility is represented by the level of income per capita. The negative effects of smoking, alcohol consumption, and body weight on female fertility are also demonstrated, but with a lower impact compared to the average income per capita. Full article

► Show Figures

Figure 1

13 pages, 494 KiB

Open AccessArticle

Determinants and Factors Associated with the Maintenance of Exclusive Breastfeeding after Hospital Discharge after Birth

by Sergio Martínez-Vázquez, Antonio Hernández-Martínez, Julián Rodríguez-Almagro, Rocío Adriana Peinado-Molina and Juan Miguel Martínez-Galiano

Healthcare 2022, 10(4), 733; https://doi.org/10.3390/healthcare10040733 - 14 Apr 2022

Cited by 9 | Viewed by 2890

Abstract

The benefits of exclusive breastfeeding are well known for both mother and baby. Despite this, rates of exclusive breastfeeding remain low. The present study aimed to determine the factors associated with the maintenance of this type of feeding after being discharged from the [...] Read more.

The benefits of exclusive breastfeeding are well known for both mother and baby. Despite this, rates of exclusive breastfeeding remain low. The present study aimed to determine the factors associated with the maintenance of this type of feeding after being discharged from the hospital after childbirth. A cross-sectional study was carried out with 1200 postpartum women in Spain. Sociodemographic, obstetric, and neonatal data were collected. Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were calculated. Early breastfeeding initiation was identified as a factor that favors breastfeeding after hospital discharge (aOR: 2.47; 95%CI: 1.77, 3.45). Other factors that favor breastfeeding after discharge included the woman feeling very supported by her partner during pregnancy, childbirth, and the puerperium (aOR: 2.54; 95%CI:1.30, 5.00) and having previously breastfed other children (aOR: 1.97; 95%CI: 1.40, 2.76). Among the factors that hindered exclusive breastfeeding after discharge were multiple or twin pregnancies (aOR: 0.31; 95%CI 0.12, 0.83), induction of labor (aOR: 0.73; 95%CI: 0.53, 0.99), admission of the newborn to the neonatal intensive care unit (NICU) (aOR: 0.31; 95%CI 0.19, 0.52), using epidural pain relief during labor (aOR: 0.41; 95%CI: 0.27, 0.64), or a preterm newborn (aOR: 0.38; 95%CI: 0.21, 0.69). For all these reasons, it is essential to promote certain practices such as the early start of breastfeeding or the induced onset of labor, among others, in order to promote the maintenance of exclusive breastfeeding beyond hospital discharge after childbirth. Full article

► Show Figures

Figure 1

15 pages, 306 KiB

Open AccessReview

COVID-19 and the Infodemic: An Overview of the Role and Impact of Social Media, the Evolution of Medical Knowledge, and Emerging Problems

by Francesca Corinti, Daniela Pontillo and Daniele Giansanti

Healthcare 2022, 10(4), 732; https://doi.org/10.3390/healthcare10040732 - 14 Apr 2022

Cited by 12 | Viewed by 2962

Abstract

The infodemic is an important component of the cyber-risk in regard to the poor and uncontrolled dissemination of information related to the COVID-19 pandemic. The purpose of this study was to perform a narrative review based on three points of view to allow [...] Read more.

The infodemic is an important component of the cyber-risk in regard to the poor and uncontrolled dissemination of information related to the COVID-19 pandemic. The purpose of this study was to perform a narrative review based on three points of view to allow for an overall picture of this issue. The points of view focused on: (a) the volume of use of social media (a key element of the infodemic) and the position of international health domain bodies; (b) the evolution of scientific production in the life sciences; (c) emerging issues. The research methodology was based on Google and PubMed searches and a qualification process based on a standard checklist and an evaluation of eligibility based on parameters with five score levels applied by two experts (plus one in case of discrepancy). The three points of view stressed the key role of social media as a dissemination tool of the infodemic among citizens. The impact on citizens depends on various social factors and involves indirect (e.g., vaccine avoidance) and direct risks such as mental problems and the risk of suicide. The widespread diffusion of social media, conveyed by mobile technologies, also suggests their use as countermeasures, calibrated based on citizens’ level of both technological and health literacy. Effective and promising countermeasures in this direction are based both on initiatives of contact by apps or SMS and the collection of data based on surveys and finalized to the particular intervention. The review also suggests as further areas of in-depth research: (a) to combat high-level infodemic produced by scientific publications that are not yet official (preprint) or that have undergone peer review with bias/distortion; (b) focusing on the impact of the infodemic considering its spread in different languages. Full article

(This article belongs to the Special Issue The Impact of Mobile Technology in the Battle against COVID-19: Successes and Failures)

9 pages, 1639 KiB

Open AccessArticle

Relationship of the Nigrostriatal Tract with the Motor Function and the Corticospinal Tract in Chronic Hemiparetic Stroke Patients: A Diffusion Tensor Imaging Study

by Sung Ho Jang and Min Jye Cho

Healthcare 2022, 10(4), 731; https://doi.org/10.3390/healthcare10040731 - 14 Apr 2022

Cited by 1 | Viewed by 2292

Abstract

This study investigated the relationship of the nigrostriatal tract (NST) with motor function and the corticospinal tract (CST) using diffusion tensor tractography in chronic hemiparetic stroke patients. Forty-three consecutive patients with putaminal hemorrhage in the chronic stage were recruited. The Motricity Index was [...] Read more.

This study investigated the relationship of the nigrostriatal tract (NST) with motor function and the corticospinal tract (CST) using diffusion tensor tractography in chronic hemiparetic stroke patients. Forty-three consecutive patients with putaminal hemorrhage in the chronic stage were recruited. The Motricity Index was used to evaluate the motor function of affected hemiparetic extremities. The fractional anisotropy and the tract volume of ipsilesional NST and ipsilesional CST were acquired. The tract volume (Rho = 0.824) of ipsilesional NST and fractional anisotropy (r = 0.682) and the tract volume (Rho = 0.886) of ipsilesional CST showed a strong positive correlation with the Motricity Index score. The fractional anisotropy of ipsilesional NST showed moderate positive correlations with the fractional anisotropy (r = 0.449) and tract volume (Rho = 0.353) of ipsilesional CST. The tract volume of ipsilesional NST showed strong positive correlations with the fractional anisotropy (Rho = 0.716) and the tract volume (Rho = 0.799) of ipsilesional CST. The regression model showed that the tract volumes of ipsilesional NST and ipsilesional CST were positively associated with the Motricity Index score (Adjusted R² = 0.763, F = 45.998). Mediation analysis showed that the tract volume of ipsilesional CST partially mediated the effects of the tract volume of ipsilesional NST on the Motricity Index score (z = 3.34). A close relationship was found between ipsilesional NST and the motor function of affected extremities in chronic hemiparetic patients with putaminal hemorrhage. Moreover, ipsilesional NST influenced the motor function of affected extremities indirectly through ipsilesional CST. Full article

► Show Figures

Figure 1

10 pages, 243 KiB

Open AccessArticle

Gender-Based Differences in the Consumption of Food Rich in Fibre and Its Relationship with Perceived Mood Status: A Cross-Sectional Study

by Mudi H. Alharbi and Sehad N. Alarifi

Healthcare 2022, 10(4), 730; https://doi.org/10.3390/healthcare10040730 - 14 Apr 2022

Cited by 6 | Viewed by 1762

Abstract

It is unclear whether gender-based differences in dietary fibre intake exist in the relationship between daily fibre consumption and the prevalence of mood disorders. This study aims to examine the effects of dietary fibre consumption on mood status between genders in Saudi Arabia. [...] Read more.

It is unclear whether gender-based differences in dietary fibre intake exist in the relationship between daily fibre consumption and the prevalence of mood disorders. This study aims to examine the effects of dietary fibre consumption on mood status between genders in Saudi Arabia. A total of 359 Saudi participants completed the survey. The data showed that women consumed 14 g fibre/day and had a mild depression score, while men consumed 12 g/day and had very severe stress. The consumption of low-to-moderate servings of fruit or very low servings of nuts and seeds was associated with stress in men. Moderate levels of depression among women were likely to occur with low-to-moderate servings of nuts and seeds. Moderate-to-high stress levels among women appeared to be associated with low-to-moderate servings of vegetables, while depressed men consumed vegetables in low-to-moderate servings. However, anxious women who experienced mild levels consumed low-to-moderate servings of vegetables, and those with a mild-to-moderate level of anxiety consumed low-to-moderate servings of bread, whole grains, and cereals. The preliminary results showed that the consumption of 12 g fibre/day is not enough to relieve stress among men, while 14 g/day reduces the level of depression to mild among women. Fibre-rich foods, e.g., vegetables, nuts and seeds, fruit, bread, cereals and legumes, lower the degree of negative moods, but this is not only attributed to fibre, as there are other influential nutrients. Full article

(This article belongs to the Section Nutrition and Public Health)

16 pages, 1786 KiB

Open AccessReview

BUSIS: A Benchmark for Breast Ultrasound Image Segmentation

by Yingtao Zhang, Min Xian, Heng-Da Cheng, Bryar Shareef, Jianrui Ding, Fei Xu, Kuan Huang, Boyu Zhang, Chunping Ning and Ying Wang

Healthcare 2022, 10(4), 729; https://doi.org/10.3390/healthcare10040729 - 14 Apr 2022

Cited by 38 | Viewed by 5069

Abstract

Breast ultrasound (BUS) image segmentation is challenging and critical for BUS computer-aided diagnosis (CAD) systems. Many BUS segmentation approaches have been studied in the last two decades, but the performances of most approaches have been assessed using relatively small private datasets with different [...] Read more.

Breast ultrasound (BUS) image segmentation is challenging and critical for BUS computer-aided diagnosis (CAD) systems. Many BUS segmentation approaches have been studied in the last two decades, but the performances of most approaches have been assessed using relatively small private datasets with different quantitative metrics, which results in a discrepancy in performance comparison. Therefore, there is a pressing need for building a benchmark to compare existing methods using a public dataset objectively, to determine the performance of the best breast tumor segmentation algorithm available today, and to investigate what segmentation strategies are valuable in clinical practice and theoretical study. In this work, a benchmark for B-mode breast ultrasound image segmentation is presented. In the benchmark, (1) we collected 562 breast ultrasound images and proposed standardized procedures to obtain accurate annotations using four radiologists; (2) we extensively compared the performance of 16 state-of-the-art segmentation methods and demonstrated that most deep learning-based approaches achieved high dice similarity coefficient values (DSC ≥ 0.90) and outperformed conventional approaches; (3) we proposed the losses-based approach to evaluate the sensitivity of semi-automatic segmentation to user interactions; and (4) the successful segmentation strategies and possible future improvements were discussed in details. Full article

► Show Figures

Figure 1

12 pages, 292 KiB

Open AccessArticle

Relationship between Associated Neuropsychological Factors and Fall Risk Factors in Community-Dwelling Elderly

by DongHyun Yi, SeungJun Jang and JongEun Yim

Healthcare 2022, 10(4), 728; https://doi.org/10.3390/healthcare10040728 - 14 Apr 2022

Cited by 3 | Viewed by 2235

Abstract

This study examined whether neuropsychological factors could affect fall risk factors in the community-dwelling elderly via correlation analysis. A total of 393 older adults (76.69 ± 6.01) participated in this study. Cognitive function, depression, fall efficacy, balance confidence, balance, gait, and muscle strength [...] Read more.

This study examined whether neuropsychological factors could affect fall risk factors in the community-dwelling elderly via correlation analysis. A total of 393 older adults (76.69 ± 6.01) participated in this study. Cognitive function, depression, fall efficacy, balance confidence, balance, gait, and muscle strength were evaluated, and the correlation between psychological factors and fall risk factors was analyzed. Additionally, a multiple regression analysis was conducted to determine whether or not there was a significant effect between psychological factors and fall risk factors. Analysis showed that the psychological factors examined were all significantly correlated with the fall risk factors. A correlation analysis between cognitive function and fall risk factors showed that the correlation coefficient of the 6-Meter Walk Test was highest; for depression and fall risk factors, the correlation coefficient of gait speed was highest; for fall efficacy and fall risk factors, the correlation coefficient of the 6-Meter Walk Test was highest; and for confidence in balancing and fall risk factors, the correlation coefficient of the 6-Meter Walk Test was highest. This study suggests that psychological factors affect fall risk factors in the community-dwelling elderly, and a multifaceted approach that includes psychological factors would be helpful in providing interventions for falls. Full article

3 pages, 195 KiB

Open AccessComment

Comment on Patel, B.; Makaryus, A.N. Artificial Intelligence Advances in the World of Cardiovascular Imaging. Healthcare 2022, 10, 154

by Daniele Giansanti

Healthcare 2022, 10(4), 727; https://doi.org/10.3390/healthcare10040727 - 14 Apr 2022

Cited by 1 | Viewed by 1415

Abstract

Regarding Dr. Makaryus’s interesting review study [...] Full article

(This article belongs to the Special Issue The Artificial Intelligence in Digital Pathology and Digital Radiology: Where Are We?)

11 pages, 231 KiB

Open AccessArticle

Factors Associated with Major Errors on Death Certificates

by Sangyup Chung, Sun-Hyu Kim, Byeong-Ju Park and Soobeom Park

Healthcare 2022, 10(4), 726; https://doi.org/10.3390/healthcare10040726 - 13 Apr 2022

Cited by 6 | Viewed by 1832

Abstract

The objective of this study was to investigate errors on death certificates and factors associated with the occurrence of major errors. A retrospective analysis was conducted for six months in 2020 at a university training hospital. Errors were judged as major and minor [...] Read more.

The objective of this study was to investigate errors on death certificates and factors associated with the occurrence of major errors. A retrospective analysis was conducted for six months in 2020 at a university training hospital. Errors were judged as major and minor errors according to the contribution to the process of determining the cause of death. Death certificates were classified into two groups with major errors (ME group) and without major errors (non-ME group). General characteristics of the death certificates, the main cause of death (cancer, cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, genitourinary disease, intentional self-harm, external causes, and other causes), the number of causes of deaths written on the death certificate, and major and minor errors were investigated. The ME group had 127 cases out of 548 death certificates. The number of causes of deaths written on the death certificates and the total number of errors were higher in the ME group than in the non-ME group. Cardiovascular disease, cerebrovascular disease, digestive disease, respiratory disease, external causes, and other diseases as causes of deaths had higher risks of major errors on death certificates than cancer as a cause of death. The group with cancer as a cause of death had the lowest incidence of major errors and fewer causes of deaths. To reduce major errors, continuous education and feedback are needed for those who are qualified to issue a death certificate. Full article

(This article belongs to the Section Healthcare Quality and Patient Safety)

9 pages, 263 KiB

Open AccessArticle

Satisfaction with the Care Received and the Childbirth and Puerperium Experience in Christian and Muslim Pregnant Women

by Francisco Javier Fernández-Carrasco, Gustavo Adolfo Silva-Muñoz, Juana María Vázquez-Lara, Juan Gómez-Salgado, Juan Jesús García-Iglesias and Luciano Rodríguez-Díaz

Healthcare 2022, 10(4), 725; https://doi.org/10.3390/healthcare10040725 - 13 Apr 2022

Cited by 2 | Viewed by 2580

Abstract

Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth [...] Read more.

Over the last three decades, there has been an increase in the population as a result of the migratory flow due to the arrival of migrants to Spain, including young women of childbearing age and with reproductive capacity. This phenomenon has made childbirth assistance an extremely important priority in recent years. The aim of this study was to assess the satisfaction and experience during childbirth and the postpartum period in pregnant women according to their religion after assistance in a tertiary hospital. A descriptive cross-sectional study was conducted on a sample of 242 women using the validated Spanish version of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) to measure satisfaction with the childbirth experience during the months of January to April 2021. Statistically significant differences were found in the domains of birth satisfaction (p < 0.01), satisfaction with the obstetrician (p < 0.01), and perception of pain during labour (p < 0.01). The Christian group of women scored higher in these three domains as compared to the Muslim group. The rate of breastfeeding at birth was 5.26 times higher among the Muslim group compared to the Christian group (p = 0.02). The experience of childbirth and the puerperium significantly influenced the levels of satisfaction of pregnant women with the process of childbirth in a different way according to the religious culture of the patient. Full article

(This article belongs to the Topic Impact of Globalization on Healthcare)

12 pages, 1803 KiB

Open AccessArticle

Patient Profile and Management of Delirium in Older Adults Hospitalized Due to COVID-19

by Pablo Jorge-Samitier, Raúl Juárez-Vela, Iván Santolalla-Arnedo, Isabel Antón-Solanas, Vicente Gea-Caballero, Juan Luis Sánchez-González and María Teresa Fernández-Rodrigo

Healthcare 2022, 10(4), 724; https://doi.org/10.3390/healthcare10040724 - 13 Apr 2022

Cited by 5 | Viewed by 1879

Abstract

SARS-CoV-2 can cause neurologic symptoms, as well as respiratory ones. Older adults are at risk of developing acute delirium in older persons (ADOP). The combination of experiencing respiratory isolation due to COVID-19, as well as other associated risk factors for older adults, may [...] Read more.

SARS-CoV-2 can cause neurologic symptoms, as well as respiratory ones. Older adults are at risk of developing acute delirium in older persons (ADOP). The combination of experiencing respiratory isolation due to COVID-19, as well as other associated risk factors for older adults, may have had an impact on ADOP and ADOP management in the acute hospital setting. This study aimed to analyze the characteristics of ADOP in patients admitted to a COVID-19 unit. An observational prospective study on a sample of 108 patients was carried out between November 2020 and May 2021. The following data were collected: sociodemographic characteristics, risk factors for ADOP, management of ADOP, and impact on ADOP on both functional and cognitive deterioration. A 29.6% proportion of older adults admitted to an acute COVID-19 unit presented hyperactive ADOP, mainly during the night. Management of ADOP in our sample involved mainly pharmacological treatment and had a serious impact on hospital stay and both functional and cognitive deterioration. Preventive strategies and being accompanied by a relative or a carer may be useful to manage ADOP during hospital admission due to COVID-19. Full article

► Show Figures

Figure 1

14 pages, 818 KiB

Open AccessArticle

Medical Students’ Perceptions towards Digitization and Artificial Intelligence: A Mixed-Methods Study

by Adrian Gillissen, Tonja Kochanek, Michaela Zupanic and Jan Ehlers

Healthcare 2022, 10(4), 723; https://doi.org/10.3390/healthcare10040723 - 13 Apr 2022

Cited by 27 | Viewed by 5367

Abstract

Digital technologies in health care, including artificial intelligence (AI) and robotics, constantly increase. The aim of this study was to explore attitudes of 2020 medical students’ generation towards various aspects of eHealth technologies with the focus on AI using an exploratory sequential mixed-method [...] Read more.

Digital technologies in health care, including artificial intelligence (AI) and robotics, constantly increase. The aim of this study was to explore attitudes of 2020 medical students’ generation towards various aspects of eHealth technologies with the focus on AI using an exploratory sequential mixed-method analysis. Data from semi-structured interviews with 28 students from five medical faculties were used to construct an online survey send to about 80,000 medical students in Germany. Most students expressed positive attitudes towards digital applications in medicine. Students with a problem-based curriculum (PBC) in contrast to those with a science-based curriculum (SBC) and male undergraduate students think that AI solutions result in better diagnosis than those from physicians (p < 0.001). Male undergraduate students had the most positive view of AI (p < 0.002). Around 38% of the students felt ill-prepared and could not answer AI-related questions because digitization in medicine and AI are not a formal part of the medical curriculum. AI rating regarding the usefulness in diagnostics differed significantly between groups. Higher emphasis in medical curriculum of digital solutions in patient care is postulated. Full article

(This article belongs to the Special Issue The Artificial Intelligence in Digital Pathology and Digital Radiology: Where Are We?)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Healthcare, Volume 10, Issue 4 (April 2022) – 161 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI