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Volume 11
Issue 6
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Healthcare, Volume 11, Issue 6 (March-2 2023) – 147 articles

Cover Story (view full-size image): The average life expectancy of the Italian population has increased over the last few decades, with a consequent increase in the demand for healthcare. Hip fractures continue to be associated with a high rate of disability and, unfortunately, also of mortality. Rehabilitation after hip fracture surgery is essential for autonomy, recovery, and reintegration into the social context. The aim of this web-based survey was to determine the level of knowledge and adherence to the recent treatment recommendations of Italian physiotherapists. The results of this survey show a partial integration of the recommendations for rehabilitation after hip fracture surgery by Italian physiotherapists. Adherence seems to be better in the inpatient setting and with physiotherapists with higher levels of education. The road is still long but we are probably on the right one. View this paper
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14 pages, 1189 KiB  
Article
Mortality Evaluation and Life Expectancy Prediction of Patients with Hepatocellular Carcinoma with Data Mining
by Che-Yu Liu, Chen-Yang Cheng, Szu-Ying Yang, Jyh-Wen Chai, Wei-Hao Chen and Pi-Yi Chang
Healthcare 2023, 11(6), 925; https://doi.org/10.3390/healthcare11060925 - 22 Mar 2023
Cited by 6 | Viewed by 2548
Abstract
Background: The complexity of systemic variables and comorbidities makes it difficult to determine the best treatment for patients with hepatocellular carcinoma (HCC). It is impossible to perform a multidimensional evaluation of every patient, but the development of guidelines based on analyses of said [...] Read more.
Background: The complexity of systemic variables and comorbidities makes it difficult to determine the best treatment for patients with hepatocellular carcinoma (HCC). It is impossible to perform a multidimensional evaluation of every patient, but the development of guidelines based on analyses of said complexities would be the next best option. Whereas conventional statistics are often inadequate for developing multivariate predictive models, data mining has proven more capable. Patients, methods and findings: Clinical profiles and treatment responses of 537 patients diagnosed with Barcelona Clinic Liver Cancer stages B and C from 2009 to 2019 were retrospectively analyzed using 4 decision tree algorithms. A combination of 19 treatments, 7 biomarkers, and 4 states of hepatitis was tested to determine which combinations would result in survival times greater than a year in duration. Just 2 of the algorithms produced complete models through single trees, which made them only the ones suitable for clinical judgement. A combination of alpha fetoprotein ≤210.5 mcg/L, glutamic oxaloacetic transaminase ≤1.13 µkat/L, and total bilirubin ≤ 0.0283 mmol/L was shown to be a good predictor of survival >1 year, and the most effective treatments for such patients were radio-frequency ablation (RFA) and transarterial chemoembolization (TACE) with radiation therapy (RT). In patients without this combination, the best treatments were RFA, TACE with RT and targeted drug therapy, and TACE with targeted drug therapy and immunotherapy. The main limitation of this study was its small sample. With a small sample size, we may have developed a less reliable model system, failing to produce any clinically important results or outcomes. Conclusion: Data mining can produce models to help clinicians predict survival time at the time of initial HCC diagnosis and then choose the most suitable treatment. Full article
(This article belongs to the Special Issue Computing and Artificial Intelligence Techniques for Healthcare Applications: Second Edition)
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9 pages, 1756 KiB  
Case Report
A Case Series on Pain Accompanying Photoimmunotherapy for Head and Neck Cancer
by Yuma Shibutani, Haruna Sato, Shinya Suzuki, Takeshi Shinozaki, Hayato Kamata, Kazuki Sugisaki, Atushi Kawanobe, Shinya Uozumi, Toshikatsu Kawasaki and Ryuichi Hayashi
Healthcare 2023, 11(6), 924; https://doi.org/10.3390/healthcare11060924 - 22 Mar 2023
Cited by 6 | Viewed by 2017
Abstract
One of the most severe side effects of photoimmunotherapy (PIT) for head and neck cancer is pain. As there are presently no detailed reports on pain and pain management in PIT, we conducted a retrospective case series study. We conducted a retrospective study [...] Read more.
One of the most severe side effects of photoimmunotherapy (PIT) for head and neck cancer is pain. As there are presently no detailed reports on pain and pain management in PIT, we conducted a retrospective case series study. We conducted a retrospective study of five patients who had received PIT at the National Cancer Center Hospital East between January 2021 and June 2022 using medical chart data. All patients experienced pain, evidenced by an increased numerical rating scale (NRS) after PIT, regardless of the illumination method. The daily change in mean NRS rating shows that the pain was highest on the day of PIT, with ratings of 6.8 and 7.8 for the frontal and cylindrical diffuser methods, respectively; it dropped the following day quickly. Four of the five patients received fentanyl injections for postoperative pain management beginning on postoperative day (POD) 0. All patients who underwent therapy using a cylindrical diffuser required postoperative pain management with opioid drugs. Pain after PIT tended to be most intense immediately after or one hour after illumination and declined the following day, suggesting the need to have a pain relief plan in place in advance. Full article
(This article belongs to the Special Issue Surgical Operation and Preoperative and Postoperative Care)
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12 pages, 1374 KiB  
Article
Comparison of Hemodynamic and Cerebral Oxygenation Responses during Exercise between Normal-Weight and Overweight Men
by Szu-Hui Wang, Hui-Ling Lin, Chung-Chi Huang and Yen-Huey Chen
Healthcare 2023, 11(6), 923; https://doi.org/10.3390/healthcare11060923 - 22 Mar 2023
Viewed by 1554
Abstract
Obesity has negative impacts on cardiovascular function and may increase cerebrovascular complications during exercise. We compared hemodynamic and cerebral oxygen changes during high-intensity exercise between overweight (OW) and normal-weight (NW) individuals. Eighteen NW and fourteen OW male individuals performed high-intensity (70% of peak [...] Read more.
Obesity has negative impacts on cardiovascular function and may increase cerebrovascular complications during exercise. We compared hemodynamic and cerebral oxygen changes during high-intensity exercise between overweight (OW) and normal-weight (NW) individuals. Eighteen NW and fourteen OW male individuals performed high-intensity (70% of peak oxygen uptake, VO2peak) cycling exercises for 30 min. Hemodynamics were measured using a bioelectrical impedance device, and cerebral oxygenation status was measured using a near-infrared spectrophotometer during and after exercise. The VO2peak of NW individuals was significantly higher than that of OW individuals (41.3 ± 5.7 vs. 30.0 ± 5.0 mL/min/kg, respectively; p < 0.05). During the 30 min exercise, both groups exhibited an increase in oxygenated hemoglobin (O2Hb) (p < 0.001), deoxygenated hemoglobin (p < 0.001), and cardiac output with increasing time. Post-exercise, cardiac output and systemic vascular resistance were significantly higher in the OW group than in the NW group (p < 0.05). The O2Hb in the NW group was significantly higher at post-exercise times of 20 min (13.9 ± 7.0 μmol/L) and 30 min (12.3 ± 8.7 μmol/L) than that in the OW group (1.0 ± 13.1 μmol/L and 0.6 ± 10.0 μmol/L, respectively; p = 0.024 vs. 0.023, respectively). OW participants demonstrated lower cerebral oxygenation and higher vascular resistance in the post-exercise phase than non-OW subjects. These physiological responses should be considered while engaging OW and obese individuals in vigorous exercise. Full article
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11 pages, 1712 KiB  
Article
Effect of Pulsed Electromagnetic Fields (PEMFs) on Muscular Activation during Cycling: A Single-Blind Controlled Pilot Study
by Aurelio Trofè, Alessandro Piras, David Muehsam, Andrea Meoni, Francesco Campa, Stefania Toselli and Milena Raffi
Healthcare 2023, 11(6), 922; https://doi.org/10.3390/healthcare11060922 - 22 Mar 2023
Cited by 6 | Viewed by 2538
Abstract
Purpose: PEMF stimulation results in a higher O2 muscle supply during exercise through increased O2 release and uptake. Given the importance of oxygen uptake in sport activity, especially in aerobic disciplines such as cycling, we sought to investigate the influence of [...] Read more.
Purpose: PEMF stimulation results in a higher O2 muscle supply during exercise through increased O2 release and uptake. Given the importance of oxygen uptake in sport activity, especially in aerobic disciplines such as cycling, we sought to investigate the influence of PEMF on muscle activity when subjects cycled at an intensity between low and severe. Methods: Twenty semi-professional cyclists performed a constant-load exercise with randomized active (ON) or inactive (OFF) PEMF stimulation. Each subject started the recording session with 1 min of cycling without load (warm-up), followed by an instantaneous increase in power, as the individualized workload (constant-load physical effort). PEMF loops were applied on the vastus medialis and biceps femoris of the right leg. We recorded the electromyographic activity from each muscle and measured blood lactate prior the exercise and during the constant-load physical effort. Results: PEMF stimulation caused a significant increase in muscle activity in the warm-up condition when subjects cycled without load (p < 0.001). The blood lactate concentration was higher during PEMF stimulation (p < 0.001), a possible consequence of PEMF’s influence on glycolytic metabolism. Conclusion: PEMF stimulation augmented the activity and the metabolism of muscular fibers during the execution of physical exercise. PEMF stimulation could be used to raise the amplitude of muscular responses to physical activity, especially during low-intensity exercise. Full article
(This article belongs to the Collection Sport and Exercise Medicine)
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13 pages, 2242 KiB  
Article
Depression in Central and Eastern Europe: How Much It Costs? Cost of Depression in Romania
by Miorita Melina Iordache, Costin Octavian Sorici, Kamer Ainur Aivaz, Elena Carmen Lupu, Andrei Dumitru, Cristina Tocia and Eugen Dumitru
Healthcare 2023, 11(6), 921; https://doi.org/10.3390/healthcare11060921 - 22 Mar 2023
Cited by 4 | Viewed by 2665
Abstract
Objective: The present study aims to estimate the public cost of depression in Romania during a seven-year time span to complement existing papers with data from Central and Eastern Europe and to identify and propose measures that allow efficient use of funds. Methods: [...] Read more.
Objective: The present study aims to estimate the public cost of depression in Romania during a seven-year time span to complement existing papers with data from Central and Eastern Europe and to identify and propose measures that allow efficient use of funds. Methods: We used data collected from the National Health Insurance System to analyze the main components of the cost. Findings: Indirect costs exceed direct costs. Within the direct costs, hospitalization and medicines still have an important share but are decreasing due to the intervention of outpatient services such as psychiatrists and psychotherapists. Conclusion: Since the goal is mental health, it is necessary to act early and quickly to decrease the burden in the long run. Annually, the mean direct cost of depression per patient is EUR 143 (part of it is represented by hospitalization, i.e., EUR 67, and psychotherapy, i.e., EUR 5), the mean cost of sick leaves per patient is EUR 273, and the total cost per patient is EUR 5553. Indirect costs (cost of disability and lost productive years) represent 97.17% of the total cost. An integrated approach to early diagnosis, effective treatment, monitoring, and prevention as well as included economic and social programs are needed to optimize indirect costs. Full article
(This article belongs to the Special Issue Healthcare Management and Health Economics)
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13 pages, 289 KiB  
Article
Long-Term Effects of Subthalamic Stimulation on Motor Symptoms and Quality of Life in Patients with Parkinson’s Disease
by Jiin-Ling Jiang, Shin-Yuan Chen, Sheng-Tzung Tsai, Yu-Chin Ma and Jen-Hung Wang
Healthcare 2023, 11(6), 920; https://doi.org/10.3390/healthcare11060920 - 22 Mar 2023
Cited by 1 | Viewed by 1746
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disorder affecting both motor functions and quality of life (QoL). This study compared motor symptoms and QoL in patients with PD before and at 1 and 5 years after subthalamic nucleus deep brain stimulation (STN-DBS) surgery [...] Read more.
Parkinson’s disease (PD) is a progressive neurodegenerative disorder affecting both motor functions and quality of life (QoL). This study compared motor symptoms and QoL in patients with PD before and at 1 and 5 years after subthalamic nucleus deep brain stimulation (STN-DBS) surgery in Taiwan. This study included 53 patients with PD undergoing STN-DBS. The motor symptoms improved by 39.71 ± 26.52% and 18.83 ± 37.15% in the Unified Parkinson’s Disease Rating Scale (UPDRS) part II and by 36.83 ± 22.51% and 22.75 ± 36.32% in the UPDRS part III at 1 and 5 years after STN-DBS in the off-medication/on-stimulation state, respectively. The Hoehn and Yahr stage significantly improved at the 1-year follow-up but declined progressively and returned to the baseline stage 5 years post-surgery. The Schwab and England Activities of Daily Living improved and sustained for 5 years following STN-DBS. Levodopa equivalent daily dose decreased by 35.32 ± 35.87% and 15.26 ± 65.76% at 1 and 5 years post-surgery, respectively. The QoL revealed significant improvement at 1 year post-surgery; however, patients regressed to near baseline levels 5 years post-surgery. The long-term effects of STN-DBS on motor symptoms were maintained over 5 years after STN-DBS surgery. At the same time, STN-DBS had no long-lasting effect on QoL. The study findings will enable clinicians to become more aware of visible and invisible manifestations of PD. Full article
(This article belongs to the Section Nursing)
22 pages, 1104 KiB  
Study Protocol
Developmental Strategy and Validation of the Midwifery Interventions Classification (MIC): A Delphi Study Protocol and Results from the Developmental Phase
by Giulia Maga, Cristina Arrigoni, Lia Brigante, Rosaria Cappadona, Rosario Caruso, Marina Alice Sylvia Daniele, Elsa Del Bo, Chiara Ogliari and Arianna Magon
Healthcare 2023, 11(6), 919; https://doi.org/10.3390/healthcare11060919 - 22 Mar 2023
Viewed by 1674
Abstract
This study protocol aims to describe the rationale and developmental strategy of the first study in the Italian context which aimed to define a Midwifery Interventions Classification, an evidence-based, standardized taxonomy and classification of midwifery interventions. Midwifery interventions require a specific definition, developed [...] Read more.
This study protocol aims to describe the rationale and developmental strategy of the first study in the Italian context which aimed to define a Midwifery Interventions Classification, an evidence-based, standardized taxonomy and classification of midwifery interventions. Midwifery interventions require a specific definition, developed through a consensus-building process by stakeholders to develop the Italian taxonomy of the Midwifery Interventions Classification with the potential for international transferability, implementation, and scaling up. A multi-round Delphi study was designed between June and September 2022, and data collection is planned between February 2023 and February 2024. The developmental phase of the study is based on a literature review to select meaningful midwifery interventions from the international literature, aiming to identify an evidence-based list of midwifery interventions. This phase led to including 16 articles derived from a systematic search performed on PubMed, CINAHL, and Scopus; 164 midwifery interventions were selected from the data extraction performed on the 16 included articles. Healthcare professionals, researchers, and service users will be eligible panelists for the Delphi surveys. The protocol designed a dynamic number of consultation rounds based on the ratings and interim analysis. A nine-point Likert scoring system is designed to evaluate midwifery interventions. Attrition and attrition bias will be evaluated. The results from the study designed in this protocol will inform the development of the Italian taxonomy of the Midwifery Interventions Classification. A shared classification of midwifery interventions will support audit and quality improvement, education, and comparable data collections for research, sustaining public recognition of midwifery interventions to promote optimal maternal and newborn health. Full article
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20 pages, 759 KiB  
Review
Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review
by Irene Moutsou, Eugenie Georgaca and Theofilos Varaklis
Healthcare 2023, 11(6), 918; https://doi.org/10.3390/healthcare11060918 - 22 Mar 2023
Cited by 1 | Viewed by 2819
Abstract
Unaccompanied minors (UAMs) are considered a particularly vulnerable population, facing severe threats regarding their physical and mental health. As their number has increased in recent years worldwide, research on mental health interventions has become necessary. The implementation of psychotherapeutic interventions has been documented, [...] Read more.
Unaccompanied minors (UAMs) are considered a particularly vulnerable population, facing severe threats regarding their physical and mental health. As their number has increased in recent years worldwide, research on mental health interventions has become necessary. The implementation of psychotherapeutic interventions has been documented, but psychosocial interventions seem to not have been consistently studied. In this review, we summarize the psychotherapeutic and psychosocial interventions with UAMs that have been studied up to now. Following the PRISMA guidelines for scoping reviews, we searched four databases and included studies and practice papers; there were no restrictions on publication date, geographical region, language, or method. We identified 46 studies on psychotherapeutic interventions and 16 studies on psychosocial interventions that met the inclusion criteria. Psychotherapeutic interventions were mainly based on cognitive behavioural, psychodynamic, narrative, art and transcultural approaches and aimed at improving UAMs’ trauma, mental health and wellbeing, as well as professionals’ skills and therapeutic protocols. Several studies showed promising results, with the cognitive behavioural approaches being the most researched. However, more research is needed in order to draw conclusions in terms of effectiveness. Psychosocial interventions followed various approaches and aimed at UAMs’ empowerment, wellbeing, support and integration, as well as at improving caregivers’ skills. Nonetheless, they seem not only very heterogeneous but also understudied, and we believe that a focus on them would be very useful. Methodological limitations and their implications for future research are discussed. Full article
(This article belongs to the Special Issue Mental Health in Times of Crisis: New Trends in Diagnosis and Treatment)
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8 pages, 1912 KiB  
Case Report
Fatal Case of a Child Harboring Enterobius vermicularis
by Samia T. Al-Shouli, Mazin Barry, Khalifa Binkhamis, Nourah AlHogail, Nouf Omar Alafaleq, Osman Adamu Dufailu and Khaldoon Aljerian
Healthcare 2023, 11(6), 917; https://doi.org/10.3390/healthcare11060917 - 22 Mar 2023
Cited by 3 | Viewed by 4197
Abstract
Enterobius vermicularis is a threadlike parasite also known as “pinworms”. It is the most common helminth infection, affecting the gastrointestinal tracts of children worldwide, although it seldom causes any fatalities. Enterobius vermicularis infections are usually asymptomatic and may only cause anal pruritis, with [...] Read more.
Enterobius vermicularis is a threadlike parasite also known as “pinworms”. It is the most common helminth infection, affecting the gastrointestinal tracts of children worldwide, although it seldom causes any fatalities. Enterobius vermicularis infections are usually asymptomatic and may only cause anal pruritis, with occasional reported cases of ectopic migration into the appendix or the female genital tract by adult pinworms. Here, we report a case of a 15-year-old girl who presented to the emergency department with high-grade fever, vomiting, and vague abdominal pain for three days. She was diagnosed with acute abdominal pain and underwent emergency ileocecectomy, but died the following day. Pathological examination of ileocecal junction showed intraluminal and intramural Enterobius vermicularis, which were attributed as the cause of her death in the absence of any other pathologies. Death due to Enterobius vermicularis is rare; this case calls for clinicians to be vigilant in exploring Enterobius vermicularis infections in patients with undiagnosed acute abdominal pain, since it could be a potential cause of death. Full article
(This article belongs to the Section Critical Care)
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13 pages, 1074 KiB  
Article
Effect of Load Distribution on Trunk Muscle Activity with Lunge Exercises in Amateur Athletes: Cross-Sectional Study
by Carlos López-de-Celis, Noé Labata-Lezaun, Sergi Romaní-Sánchez, Sergi Gassó-Villarejo, Erik Garcia-Ribell, Jacobo Rodríguez-Sanz and Albert Pérez-Bellmunt
Healthcare 2023, 11(6), 916; https://doi.org/10.3390/healthcare11060916 - 22 Mar 2023
Cited by 2 | Viewed by 2740
Abstract
Background: The effect of load distribution applied to the trunk musculature with lunge exercises has yet to be determined. The aim of this study was to evaluate the effect of load placement using dumbbells on the activation of the latissimus dorsi, erector spinae, [...] Read more.
Background: The effect of load distribution applied to the trunk musculature with lunge exercises has yet to be determined. The aim of this study was to evaluate the effect of load placement using dumbbells on the activation of the latissimus dorsi, erector spinae, external oblique, and rectus abdominis muscles during the lunge. Methods: Forty-two amateur athletes (21 men and 21 women) were recruited. Three lunge exercises were performed with different loading arrangements (ipsilateral, contralateral, and bilateral). The principal variable recorded for muscle activity was mean “root mean square” expressed as the percentage of the maximal voluntary isometric contraction. Results: There are statistically significant differences in the erector spinae (p < 0.001; p < 0.003) and external oblique muscles (p < 0.009; p < 0.001) compared with the contralateral side. The muscle on the opposite side of the load achieved higher activation for these muscles. The erector spinae and latissimus dorsi muscle did not reach a statistically significant difference with the contralateral side in any exercise (p > 0.05). The higher activation of the latissimus dorsi occurred on the same side on which the load was placed. Conclusions: There was higher activation of the erector spinae, external oblique, and rectus abdominis muscles contralateral to the side of load placement during lunge exercise by amateur athletes. Full article
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11 pages, 283 KiB  
Article
Association between Personality Traits and Phubbing: The Co-Moderating Roles of Boredom and Loneliness
by Carla Abi Doumit, Diana Malaeb, Marwan Akel, Pascale Salameh, Sahar Obeid and Souheil Hallit
Healthcare 2023, 11(6), 915; https://doi.org/10.3390/healthcare11060915 - 22 Mar 2023
Cited by 7 | Viewed by 3477
Abstract
Phubbing is defined as the use of one’s phone while in a conversation, leading to a disconnection from interpersonal communications. This topic has become more interesting lately due to the increased use of smartphones worldwide and in Lebanon, where 86% of the population [...] Read more.
Phubbing is defined as the use of one’s phone while in a conversation, leading to a disconnection from interpersonal communications. This topic has become more interesting lately due to the increased use of smartphones worldwide and in Lebanon, where 86% of the population owns a smartphone. This study aims to assess the association between phubbing and personality traits with the moderating effects of loneliness and boredom proneness. This cross-sectional study was conducted between August–September 2020. 461 participants (18–29 years) filled out the survey. Higher open-mindedness was associated with less phubbing. Being married compared to single and higher open-mindedness were significantly associated with less phubbing. More boredom was significantly associated with more phubbing. The interaction extraversion by boredom was significantly associated with phubbing; this was significant at low levels of loneliness and boredom where extraversion was significantly associated with more phubbing. At moderate loneliness and high boredom and at high loneliness and boredom, extraversion was significantly associated with less phubbing. The interactions between boredom and loneliness and the other four personality traits did not show any significant association with phubbing. The current study highlights the importance of personality traits in influencing phubbing and might contribute to the preliminary assessment of phubbing. Healthcare professionals might be able to use the data of this study to implement appropriate smartphone use habits, as this would help patients improve their social relationships. Full article
15 pages, 311 KiB  
Article
Association between Compliance with COVID-19 Restrictions and the Risk of SARS-CoV-2 Infection in Poland
by Karolina Hoffmann, Michał Michalak, Aleksandra Bońka, Wiesław Bryl, Wojciech Myśliński, Magdalena Kostrzewska, Dorota Kopciuch, Tomasz Zaprutko, Piotr Ratajczak, Elżbieta Nowakowska, Krzysztof Kus and Anna Paczkowska
Healthcare 2023, 11(6), 914; https://doi.org/10.3390/healthcare11060914 - 22 Mar 2023
Cited by 1 | Viewed by 1985
Abstract
During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study [...] Read more.
During the coronavirus disease 19 (COVID-19) pandemic it has become very important to comply with preventive measures. We aimed to assess compliance with applicable restrictions and to explore the links between the level of compliance and the risk of COVID-19. This cross-sectional study included Polish adults who were asked to complete a validated questionnaire. The study period was from 1 November 2020 to 31 January 2021 and a computer-assisted web interview method was chosen to perform the survey. The study involved 562 women and 539 men. COVID-19 was reported in 11.26% of participants. A good level of compliance with the sanitary restrictions was reported for 38.87% of participants, an average level of compliance for 47.96%, and a low level of compliance for 13.17%. A reduced risk of COVID-19 was associated with the following preventive measures: regular use of protective masks, social and physical distancing in public places, regular use of hand sanitizers with high ethanol content, and the use of disposable gloves in public places. Our survey revealed satisfactory public compliance with the pandemic restrictions. Sanitary and epidemiologic measures to prevent the pandemic were shown to be adequate and effective. Full article
(This article belongs to the Special Issue Cost, Economics and Databases of Pharmaceutical Drugs in Public Health)
11 pages, 515 KiB  
Article
Diagnostic Yield of Neuroimaging for Headache in a Pediatric Emergency Department: A Single Tertiary Centre Experience
by Mohammed Almuqbil, Saud Abdulaziz Alsayed, Amer Mohammed Almutairi, Khalid Mohammed Aladhadh, Abdullah Omar Alghannami and Mohammed Almutairi
Healthcare 2023, 11(6), 913; https://doi.org/10.3390/healthcare11060913 - 22 Mar 2023
Viewed by 1786
Abstract
Objectives: This study aimed to examine headache neuroimaging findings among the pediatric population visiting the emergency department in Saudi Arabia. Methods: This was a cross-sectional retrospective study of pediatric patients who presented to the emergency department with a headache as their primary complaint. [...] Read more.
Objectives: This study aimed to examine headache neuroimaging findings among the pediatric population visiting the emergency department in Saudi Arabia. Methods: This was a cross-sectional retrospective study of pediatric patients who presented to the emergency department with a headache as their primary complaint. Data were extracted from the electronic medical files of the patients at King Abdullah Specialized Children Hospital (KASCH) between 2015 and 2020. The diagnosis of headache was confirmed using a computerized tomography (CT) scan or magnetic resonance imaging (MRI) upon the patients’ presentation. Results: A total of 263 patients met the inclusion criteria, and their data were extracted. The CT scans were abnormal in 50% of the patients. The MRI showed abnormal findings for 26% of the patients. CT scans and MRI identified that abnormalities were predominantly among patients with the secondary type of headache. The most common abnormal findings on CT were sinusitis (16%), masses (7%), and hydrocephalus (7%). The most common abnormal findings on MRI were masses (8%), cysts (5%), and hydrocephalus (3%). Of all patients with headaches, 10% had a prior diagnosis of headache, and 12% had a family history of headache. A significantly higher percentage of patients with secondary headache were prescribed NSAID and required admission compared to patients with primary headache (p ≤ 0.05). There was no statistically significant differences in the proportion of patients diagnosed with primary and secondary headache in terms of their neurological examination and headache types (p = 0.43). Conclusions: Neuroimaging is essential for diagnosing headaches in children. Headaches were associated with sinusitis in children. The secondary type was more likely to have abnormal CT and MRI results. Primary type headaches were more common in those with a family history. CT scans and MRIs are needed when a headache is accompanied by an abnormal clinical evaluation. Neuroimaging and mild CT usage may be explored if there are clinical abnormalities or family history. Full article
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12 pages, 906 KiB  
Article
Spanish Cross-Cultural Adaptation and Validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in Handball Players
by Jesús Martínez-Cal, Guadalupe Molina-Torres, Elio Carrasco-Vega, Luca Barni, María Isabel Ventura-Miranda and Manuel Gonzalez-Sanchez
Healthcare 2023, 11(6), 912; https://doi.org/10.3390/healthcare11060912 - 21 Mar 2023
Viewed by 1847
Abstract
Objectives: The aim of this study was the cultural adaptation, Spanish translation and validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in an adult population. Design: In this study, a cross-sectional design was used. Methods: This study was divided [...] Read more.
Objectives: The aim of this study was the cultural adaptation, Spanish translation and validation of the Oslo Sports Trauma Research Centre (OSTRC) Overuse Injury Questionnaire in an adult population. Design: In this study, a cross-sectional design was used. Methods: This study was divided into two phases: (1) cross-cultural adaptation of the original version of the OSTRC to a Spanish version (OSTRC-Sp) and (2) analysis of the psychometric properties of the OSTRC-Sp. A total of 427 handball players of both sexes and over 18 years of age participated in the study. Results: The translated version of the questionnaire showed a very high internal consistency (Cronbach’s α = 0.954), while the subscales showed an internal consistency between 0.832 and 0.961, with the endmost values being for shoulder and low back pain, respectively. On the other hand, when analysing item responses, the OSTRC-Sp showed ICC values ranging from 0.844 to 0.956, the former being for the first back question (back_1), and the latter for the fourth shoulder question (shoulder_4), in line with most published versions. Conclusion: The Spanish version of the OSTRC is a reliable and valid tool that can be used by researchers and clinicians in a Spanish-speaking population with musculoskeletal disorders. Full article
(This article belongs to the Special Issue Advances in Musculoskeletal Rehabilitation and Therapy)
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24 pages, 352 KiB  
Article
Regulation of Digital Healthcare in India: Ethical and Legal Challenges
by Dipika Jain
Healthcare 2023, 11(6), 911; https://doi.org/10.3390/healthcare11060911 - 21 Mar 2023
Cited by 18 | Viewed by 9098
Abstract
In the wake of the COVID-19 pandemic, digital healthcare has gained an influx of interest and global investment. The WHO has published guidelines and recommendations for countries to successfully implement telemedicine on a large, nationwide scale. This is not only helpful for patients [...] Read more.
In the wake of the COVID-19 pandemic, digital healthcare has gained an influx of interest and global investment. The WHO has published guidelines and recommendations for countries to successfully implement telemedicine on a large, nationwide scale. This is not only helpful for patients who wish to protect themselves from COVID-19 and related illnesses that they may be vulnerable to, but it also has great potential to increase access to healthcare. In India, a country without universal healthcare grappling with a high level of distrust in the public health system, there are several implementation challenges for digital healthcare across the country. The current laws in India that regulate technology do not explicitly address telehealth, nor are there adequate data protection laws in place that could manage the significant amount of data that would be generated by digital healthcare if applied on a large scale. Further, there are concerns at the level of patient privacy, which could be compromised through digital healthcare. In addition to the legal concerns surrounding privacy, there is no framework in place to ensure informed consent in a digital healthcare context. In this paper, I analyze the legal, structural, and ethical concerns around digital health and provide an understanding of the problems these shortcomings pose, as well as policy recommendations for overcoming these problems. Full article
(This article belongs to the Special Issue Global Health in the Time of COVID-19: Law, Policy and Governance)
13 pages, 3399 KiB  
Article
Explainable Machine Learning to Predict Successful Weaning of Mechanical Ventilation in Critically Ill Patients Requiring Hemodialysis
by Ming-Yen Lin, Yuan-Ming Chang, Chi-Chun Li and Wen-Cheng Chao
Healthcare 2023, 11(6), 910; https://doi.org/10.3390/healthcare11060910 - 21 Mar 2023
Cited by 1 | Viewed by 1839
Abstract
Lungs and kidneys are two vital and frequently injured organs among critically ill patients. In this study, we attempt to develop a weaning prediction model for patients with both respiratory and renal failure using an explainable machine learning (XML) approach. We used the [...] Read more.
Lungs and kidneys are two vital and frequently injured organs among critically ill patients. In this study, we attempt to develop a weaning prediction model for patients with both respiratory and renal failure using an explainable machine learning (XML) approach. We used the eICU collaborative research database, which contained data from 335 ICUs across the United States. Four ML models, including XGBoost, GBM, AdaBoost, and RF, were used, with weaning prediction and feature windows, both at 48 h. The model’s explanations were presented at the domain, feature, and individual levels by leveraging various techniques, including cumulative feature importance, the partial dependence plot (PDP), the Shapley additive explanations (SHAP) plot, and local explanation with the local interpretable model-agnostic explanations (LIME). We enrolled 1789 critically ill ventilated patients requiring hemodialysis, and 42.8% (765/1789) of them were weaned successfully from mechanical ventilation. The accuracies in XGBoost and GBM were better than those in the other models. The discriminative characteristics of six key features used to predict weaning were demonstrated through the application of the SHAP and PDP plots. By utilizing LIME, we were able to provide an explanation of the predicted probabilities and the associated reasoning for successful weaning on an individual level. In conclusion, we used an XML approach to establish a weaning prediction model in critically ill ventilated patients requiring hemodialysis. Full article
(This article belongs to the Special Issue Advances of Decision-Making Medical System in Healthcare)
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15 pages, 467 KiB  
Article
The Relationship between Neighborhood Social Capital and the Health of Chinese Urban Elderly: An Analysis Based on CHARLS2018 Data
by Ziqi Huang, Cuihong Long and Chengzhi Yi
Healthcare 2023, 11(6), 909; https://doi.org/10.3390/healthcare11060909 - 21 Mar 2023
Cited by 3 | Viewed by 1768
Abstract
There is growing interest in the relationship between neighborhood social capital and the health of urban older people, but existing research still falls short in exploring the relationship between the two. Based on 2018 CHARLS data, this paper quantitatively examines the association between [...] Read more.
There is growing interest in the relationship between neighborhood social capital and the health of urban older people, but existing research still falls short in exploring the relationship between the two. Based on 2018 CHARLS data, this paper quantitatively examines the association between neighborhood social capital and the self-rated health of urban older people. The study found that, after controlling for a series of variables, both increased social interaction and increased frequency of social interaction significantly improved urban older people’s self-rated health. To implement the Health China strategy and improve the health of urban older people, further attention should be paid to the role of neighborhood social capital, creating a harmonious environment for neighborhood interaction and promoting the cultivation of neighborhood social capital. Full article
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12 pages, 1480 KiB  
Article
Implementation of the Robson Classification in Greece: A Retrospective Cross-Sectional Study
by Paraskevi Giaxi, Kleanthi Gourounti, Victoria Vivilaki, Panagiotis Zdanis, Antonis Galanos, Aris Antsaklis and Aikaterini Lykeridou
Healthcare 2023, 11(6), 908; https://doi.org/10.3390/healthcare11060908 - 21 Mar 2023
Cited by 5 | Viewed by 2254
Abstract
Cesarean sections have become the most commonly performed operations around the world. The World Health Organization recommended the use of the Robson classification system as a universal standard to establish a joint control system in healthcare facilities. The aim of this study was [...] Read more.
Cesarean sections have become the most commonly performed operations around the world. The World Health Organization recommended the use of the Robson classification system as a universal standard to establish a joint control system in healthcare facilities. The aim of this study was to implement the Robson classification for the first time in Greece to identify trends in cesarean births and examine the groups of women who are the main contributors to the increasing rates. Moreover, the indicators for cesarean sections will be evaluated as per the Robson classification. In the sample analysis, we included the records of 8572 women giving birth in one private health facility in Greece. A total of 8572 women gave birth during the study period, of which 5224 (60.9%) were cesarean section births and 3348 (39.1%) were vaginal births. In our study, according to the Robson classification, the largest contributors to the overall CS rate were as follows: (a) nulliparous women with a single cephalic term pregnancy, who were either labor induced or delivered by cesarean section before labor—Group 2 (34.6%); (b) multiparous women with a single cephalic term pregnancy and at least one previous cesarean section—Group 5 (30.7%); (c) women with a single cephalic preterm pregnancy—Group 10 (11.7%); (d) women with multiple pregnancies—Group 8 (7.0%). Our study is expected to assist policymakers in Greece in planning further interventions for each subgroup of women in order to reduce the overall CS rate and unnecessary CSs. Full article
(This article belongs to the Section Women's Health Care)
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14 pages, 509 KiB  
Article
A Psychometric Study of the Perinatal Assessment of Maternal Affectivity (PAMA) for the Screening of Perinatal Affective Disorders in Mothers
by Franco Baldoni, Francesca Agostini, Grazia Terrone, Giulia Casu and Michele Giannotti
Healthcare 2023, 11(6), 907; https://doi.org/10.3390/healthcare11060907 - 21 Mar 2023
Cited by 2 | Viewed by 1849
Abstract
Recently, empirical evidence from perinatal studies has led researchers to pay more attention to fathers. The need to evaluate male suffering led at first to using the same screening tools developed for mothers. However, these instruments present validity concerns with fathers, and today [...] Read more.
Recently, empirical evidence from perinatal studies has led researchers to pay more attention to fathers. The need to evaluate male suffering led at first to using the same screening tools developed for mothers. However, these instruments present validity concerns with fathers, and today the need to assume a gender-based perspective is clear. The Perinatal Assessment of Paternal Affectivity (PAPA) is a self-reported questionnaire for the screening of a variety of psychological and behavioral dimensions related to affectivity as experienced by fathers during the perinatal period. In the present study, the psychometric properties of the maternal version of the scale (Perinatal Assessment of Maternal Affectivity; PAMA) were examined. The study, based on 225 mothers and their partners (n = 215), used a cross-sectional design with a single assessment at the third trimester of pregnancy. Results indicated a one-factor structure for a seven-item version of the PAMA, which showed adequate internal consistency reliability and was associated in the expected direction with other clinically relevant variables (depression, psychological distress, perceived stress and dyadic adjustment). The findings suggest the usefulness of developing gender sensitive screening tools for the detection of perinatal affective disorders. Full article
(This article belongs to the Special Issue Safety and Quality in Maternal and Neonatal Care)
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11 pages, 598 KiB  
Article
Serious Long-Term Effects of Head and Neck Cancer from the Survivors’ Point of View
by Katherine J. Taylor, Cecilie D. Amdal, Kristin Bjordal, Guro L. Astrup, Bente B. Herlofson, Fréderic Duprez, Ricardo R. Gama, Alexandre Jacinto, Eva Hammerlid, Melissa Scricciolo, Femke Jansen, Irma M. Verdonck-de Leeuw, Giuseppe Fanetti, Orlando Guntinas-Lichius, Johanna Inhestern, Tatiana Dragan, Alexander Fabian, Andreas Boehm, Ulrike Wöhner, Naomi Kiyota, Maximilian Krüger, Pierluigi Bonomo, Monica Pinto, Sandra Nuyts, Joaquim C. Silva, Carmen Stromberger, Francesco Tramacere, Ayman Bushnak, Pietro Perotti, Michaela Plath, Alberto Paderno, Noa Stempler, Maria Kouri and Susanne Singeradd Show full author list remove Hide full author list
Healthcare 2023, 11(6), 906; https://doi.org/10.3390/healthcare11060906 - 21 Mar 2023
Cited by 9 | Viewed by 2722
Abstract
The long-term problems of head and neck cancer survivors (HNCS) are not well known. In a cross-sectional international study aimed at exploring the long-term quality of life in this population, 1114 HNCS were asked to state their two most serious long-term effects. A [...] Read more.
The long-term problems of head and neck cancer survivors (HNCS) are not well known. In a cross-sectional international study aimed at exploring the long-term quality of life in this population, 1114 HNCS were asked to state their two most serious long-term effects. A clinician recorded the responses during face-to-face appointments. A list of 15 example problems was provided, but a free text field was also available. A total of 1033 survivors responded to the question. The most frequent problems were ‘dry mouth’ (DM) (n = 476; 46%), ‘difficulty swallowing/eating’ (DSE) (n = 408; 40%), ‘hoarseness/difficulty speaking’ (HDS) (n = 169; 16%), and ‘pain in the head and neck’ (PHN) (n = 142; 14%). A total of 5% reported no problems. Logistic regression adjusted for age, gender, treatment, and tumor stage and site showed increased odds of reporting DM and DSE for chemo-radiotherapy (CRT) alone compared to surgery alone (odds ratio (OR): 4.7, 95% confidence interval (CI): 2.5–9.0; OR: 2.1, CI: 1.1–3.9), but decreased odds for HDS and PHN (OR: 0.3, CI: 0.1–0.6; OR: 0.2, CI: 0.1–0.5). Survivors with UICC stage IV at diagnosis compared to stage I had increased odds of reporting HDS (OR: 1.9, CI: 1.2–3.0). Laryngeal cancer survivors had reduced odds compared to oropharynx cancer survivors of reporting DM (OR: 0.4, CI: 0.3–0.6) but increased odds of HDS (OR: 7.2, CI: 4.3–12.3). This study provides evidence of the serious long-term problems among HNCS. Full article
(This article belongs to the Special Issue Cancer Patients: How to Improve Quality of Life?)
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14 pages, 979 KiB  
Article
Nature-Based Mindfulness: A Qualitative Study of the Experience of Support for Self-Regulation
by Dorthe Djernis, Cecilie M. Lundsgaard, Helle Rønn-Smidt and Jesper Dahlgaard
Healthcare 2023, 11(6), 905; https://doi.org/10.3390/healthcare11060905 - 21 Mar 2023
Cited by 9 | Viewed by 4405
Abstract
Self-regulation is pivotal for human well-being and mental health. In this qualitative study, we followed a randomized controlled trial (RCT) and explored how a five-day residential mindfulness program in a restorative natural setting supported self-regulation among university students experiencing moderate to severe stress. [...] Read more.
Self-regulation is pivotal for human well-being and mental health. In this qualitative study, we followed a randomized controlled trial (RCT) and explored how a five-day residential mindfulness program in a restorative natural setting supported self-regulation among university students experiencing moderate to severe stress. Six participants were interviewed post intervention and at three months’ follow-up on how they experienced the retreat. Through interpretative phenomenological analysis, four interrelated themes emerged: “supportive conditions”, “attitudes of mindfulness”, “connection” and “physical and psychological balance.” These themes reflected the outcomes of the retreat that participants valued in stressful situations. A progression occurred during the retreat through the themes, with emphasis developing from the supportive conditions of the setting, to cultivating mindful attitudes, over connection to both self, others and nature, to changes and effects on the physical, psychological and even spiritual level. In addition, participants emphasized experiences of positive emotions, energy, calmness, meta-awareness and the feeling of being part of the web of life. In conclusion, participants’ experiences with a five-day nature-based mindfulness intervention revealed a range of qualities of both physical-, psychological-, social- and spiritual nature that are supportive for self-regulation. Full article
(This article belongs to the Special Issue Outdoor and Nature Therapy)
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11 pages, 3784 KiB  
Review
The Use of Robotic Technology in the Healthcare of People above the Age of 65—A Systematic Review
by Ann-Chatrin Linqvist Leonardsen, Camilla Hardeland, Ann Karin Helgesen, Carina Bååth, Lilliana del Busso and Vigdis Abrahamsen Grøndahl
Healthcare 2023, 11(6), 904; https://doi.org/10.3390/healthcare11060904 - 21 Mar 2023
Cited by 4 | Viewed by 3069
Abstract
Aim: The integration of robots can help provide solutions in regards to the need for an increase in resources in healthcare. The aim of this review was to identify how robots are utilized in the healthcare of people who are over the age [...] Read more.
Aim: The integration of robots can help provide solutions in regards to the need for an increase in resources in healthcare. The aim of this review was to identify how robots are utilized in the healthcare of people who are over the age of 65 and how this population experiences interacting with healthcare robots. Design: A systematic literature review with an integrated design was conducted. Methods: A literature search was performed in the electronic databases CINAHL via EBSCO, EMBASE, and Medline via Ovid. Content analysis was performed to assess the studies that were included in this review. Results: A total of 14 articles were included. Participants in the studies included 453 older people ranging from 65 to 108 years of age. Nine of the studies focused on people with dementia or cognitive impairment. Seven studies included different types of socially assistive human-like robots, six of the studies included two different types of animal-like robots, and one study focused on a robotic rollator. The robots mainly served as social assistive- or engagement robots. Full article
(This article belongs to the Topic Healthy, Safe and Active Aging)
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16 pages, 3003 KiB  
Article
Application of Artificial Intelligence in Assessing the Self-Management Practices of Patients with Type 2 Diabetes
by Rashid M. Ansari, Mark F. Harris, Hassan Hosseinzadeh and Nicholas Zwar
Healthcare 2023, 11(6), 903; https://doi.org/10.3390/healthcare11060903 - 21 Mar 2023
Cited by 3 | Viewed by 3804
Abstract
The use of Artificial intelligence in healthcare has evolved substantially in recent years. In medical diagnosis, Artificial intelligence algorithms are used to forecast or diagnose a variety of life-threatening illnesses, including breast cancer, diabetes, heart disease, etc. The main objective of this study [...] Read more.
The use of Artificial intelligence in healthcare has evolved substantially in recent years. In medical diagnosis, Artificial intelligence algorithms are used to forecast or diagnose a variety of life-threatening illnesses, including breast cancer, diabetes, heart disease, etc. The main objective of this study is to assess self-management practices among patients with type 2 diabetes in rural areas of Pakistan using Artificial intelligence and machine learning algorithms. Of particular note is the assessment of the factors associated with poor self-management activities, such as non-adhering to medications, poor eating habits, lack of physical activities, and poor glycemic control (HbA1c %). The sample of 200 participants was purposefully recruited from the medical clinics in rural areas of Pakistan. The artificial neural network algorithm and logistic regression classification algorithms were used to assess diabetes self-management activities. The diabetes dataset was split 80:20 between training and testing; 80% (160) instances were used for training purposes and 20% (40) instances were used for testing purposes, while the algorithms’ overall performance was measured using a confusion matrix. The current study found that self-management efforts and glycemic control were poor among diabetes patients in rural areas of Pakistan. The logistic regression model performance was evaluated based on the confusion matrix. The accuracy of the training set was 98%, while the test set’s accuracy was 97.5%; each set had a recall rate of 79% and 75%, respectively. The output of the confusion matrix showed that only 11 out of 200 patients were correctly assessed/classified as meeting diabetes self-management targets based on the values of HbA1c < 7%. We added a wide range of neurons (32 to 128) in the hidden layers to train the artificial neural network models. The results showed that the model with three hidden layers and Adam’s optimisation function achieved 98% accuracy on the validation set. This study has assessed the factors associated with poor self-management activities among patients with type 2 diabetes in rural areas of Pakistan. The use of a wide range of neurons in the hidden layers to train the artificial neural network models improved outcomes, confirming the model’s effectiveness and efficiency in assessing diabetes self-management activities from the required data attributes. Full article
(This article belongs to the Special Issue Artificial Intelligence Applications in Medicine)
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18 pages, 1173 KiB  
Review
Obesity and Cardiovascular Risk: Systematic Intervention Is the Key for Prevention
by Francesco Perone, Annachiara Pingitore, Edoardo Conte, Geza Halasz, Marco Ambrosetti, Mariangela Peruzzi and Elena Cavarretta
Healthcare 2023, 11(6), 902; https://doi.org/10.3390/healthcare11060902 - 21 Mar 2023
Cited by 25 | Viewed by 6584
Abstract
Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as [...] Read more.
Obesity is a serious public health issue and associated with an increased risk of cardiovascular disease events and mortality. The risk of cardiovascular complications is directly related to excess body fat mass and ectopic fat deposition, but also other obesity-related complications such as pre-type 2 diabetes, obstructive sleep apnoea, and non-alcoholic fatty liver diseases. Body mass index and waist circumference are used to classify a patient as overweight or obese and to stratify cardiovascular risk. Physical activity and diet, despite being key points in preventing adverse events and reducing cardiovascular risk, are not always successful strategies. Pharmacological treatments for weight reduction are promising strategies, but are restricted by possible safety issues and cost. Nonetheless, these treatments are associated with improvements in cardiovascular risk factors, and studies are ongoing to better evaluate cardiovascular outcomes. Bariatric surgery is effective in reducing the incidence of death and cardiovascular events such as myocardial infarction and stroke. Cardiac rehabilitation programs in obese patients improve cardiovascular disease risk factors, quality of life, and exercise capacity. The aim of this review was to critically analyze the current role and future aspects of lifestyle changes, medical and surgical treatments, and cardiac rehabilitation in obese patients, to reduce cardiovascular disease risk and mortality, and to highlight the need for a multidisciplinary approach to improving cardiovascular outcomes. Full article
(This article belongs to the Special Issue Obesity and Its Related Complications—Current Treatments and Future Aspects)
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14 pages, 274 KiB  
Article
Face Mask Use and Social Distancing Attitude of Healthcare Students: A Multi-Disciplinary Study
by Jonas Preposi Cruz, Ejercito Mangawa Balay-Odao, Junel Bryan Bajet, Jennifer Mesde, Khalaf Alotaibi, Ahmed Almogairi, Nahed Alquwez, Mohammed Alqahtani, Ahmed Mansour Almansour, Sharifa Alasiry and Jazi Shaydied Alotaibi
Healthcare 2023, 11(6), 901; https://doi.org/10.3390/healthcare11060901 - 21 Mar 2023
Cited by 1 | Viewed by 1767
Abstract
This multi-disciplinary, cross-sectional, and descriptive study investigated health care students’ face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from [...] Read more.
This multi-disciplinary, cross-sectional, and descriptive study investigated health care students’ face mask use knowledge, attitude, and practices (KAP) and social distancing attitudes. The study was carried out from October to December 2021 and surveyed 543 health care students selected via convenience sampling from the three Shaqra University campuses in Saudi Arabia. Standard multiple linear regressions were conducted on face mask use KAP and social distancing attitude to identify their significant associated factors. The students in this study had poor knowledge and a neutral attitude towards and modest use practices of face masks during the COVID-19 pandemic. Being female, being a nursing student, and having greater self-reported COVID-19-prevention knowledge were related to higher levels of face mask use knowledge. Having higher face mask use knowledge was linked to better attitude and practice. Knowledge of COVID-19 and its prevention and decreased COVID-19 risk perception were associated with better face mask use practices. The students had more positive than negative attitudes toward social distancing. Having known someone who was infected by the virus, lower risk perception, and better face mask use practices were associated with more positive social distancing attitudes. The findings imply the need to ensure that future health care practitioners are knowledgeable, have a positive attitude and good practices concerning face mask use, and have positive attitudes toward social distancing. The study implications are relevant for health care education in Saudi Arabia and elsewhere. Full article
(This article belongs to the Section Nursing)
4 pages, 211 KiB  
Editorial
Exercise Biomechanics for Health: Evaluating Lifelong Activities for Well-Being
by Pedro Forte and José E. Teixeira
Healthcare 2023, 11(6), 900; https://doi.org/10.3390/healthcare11060900 - 21 Mar 2023
Cited by 2 | Viewed by 3670
Abstract
Biomechanics is a multidisciplinary study of the mechanical laws and principles that govern human movement and the functioning of biological systems [...] Full article
(This article belongs to the Special Issue Exercise Biomechanics: Pathways to Improve Health)
9 pages, 518 KiB  
Article
Can a Multidisciplinary Weight Loss Treatment Improve Motor Performance in Children with Obesity? Results from an Observational Study
by Francesca Gallè, Giuliana Valerio, Espedita Muscariello, Ornella Daniele, Valentina Di Mauro, Simone Forte, Teresa Mastantuono, Roberta Ricchiuti, Giorgio Liguori and Pierluigi Pecoraro
Healthcare 2023, 11(6), 899; https://doi.org/10.3390/healthcare11060899 - 21 Mar 2023
Cited by 1 | Viewed by 1656
Abstract
In the last two decades, the relationship between weight status and children’s motor skill competence has been receiving increasing attention, given its possible role in the prevention and treatment of obesity. This study aimed to evaluate the effect of a multidisciplinary obesity treatment [...] Read more.
In the last two decades, the relationship between weight status and children’s motor skill competence has been receiving increasing attention, given its possible role in the prevention and treatment of obesity. This study aimed to evaluate the effect of a multidisciplinary obesity treatment on motor performance in a sample of Italian children and adolescents. Visual and auditory reaction time (VRT and ART), vertical jump elevation (VJE) and power (VJP), body mass index (BMI) and BMI-standard deviation score (BMI-SDS), waist circumference (WC), body composition, dietary habits and physical activity (PA) levels were assessed at baseline and at 6- and 12-month follow-up. Significant improvements were observed in BMI-SDS and FFM, diet and PA levels. Adolescents showed significant improvements in VRT and ART. Jump elevation and power increased in both children and adolescent subgroups. Girls exhibited greater changes than boys in both VRT and ART and VJP but lower changes in VJE. VRT improvement was related to age (OR = 0.285, 95%CI 0.098–0.830, p = 0.021) and FFM (OR = 0.255, 95%CI 0.070–0.933, p = 0.039). An increase in VJE was associated with BMI-SDS (OR = 0.158, 95%CI 0.036–0.695, p = 0.015) and with PA level (OR = 19.102, 95%CI 4.442–82.142, p < 0.001); the increase in VJP was related with the increase in PA (OR = 5.564, 95%CI 1.812–17.081, p = 0.003). These findings suggest the possible effects of a multidisciplinary obesity treatment on children’s motor competence. Since the improvement in motor skills can increase children’s motivation and adherence to weight loss treatment in the long term, these aspects should be further investigated. Full article
(This article belongs to the Special Issue Excess Weight, Dietary Habits and Physical Activity in Children and Adolescents)
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12 pages, 329 KiB  
Article
Influence of Mindfulness on Levels of Impulsiveness, Moods and Pre-Competition Anxiety in Athletes of Different Sports
by Laura C. Sánchez-Sánchez, Clemente Franco, Alberto Amutio, Jaqueline García-Silva and Juan González-Hernández
Healthcare 2023, 11(6), 898; https://doi.org/10.3390/healthcare11060898 - 21 Mar 2023
Cited by 12 | Viewed by 5112
Abstract
Training in emotional regulation skills is one of the most important resources for the adaptation of athletes to contexts of sports pressure, especially during competitions. This study explored the effects of a mindfulness programme (Flow Meditation) on levels of impulsivity, mood and pre-competition [...] Read more.
Training in emotional regulation skills is one of the most important resources for the adaptation of athletes to contexts of sports pressure, especially during competitions. This study explored the effects of a mindfulness programme (Flow Meditation) on levels of impulsivity, mood and pre-competition anxiety-state in a sample of athletes (N = 41, 22.83 ± 5.62 years). Participants were randomly assigned to an intervention group (N = 21; 14 males and 7 females) which received the intervention over 10 weeks (a weekly session) and a control group (wait-list; N = 20; 13 males and 7 females). The variables under study were assessed through different questionnaires at pre- and post-test (T1–T2) in both groups. The mindfulness intervention was effective in reducing impulsivity (cognitive (t = −4.48, p ≤ 0.001, Cohen’s d = 1.40), both motor (t = −4.03, p ≤ 0.001, Cohen’s d = 1.20) and unplanned (t = −5.32, p ≤ 0.001, Cohen’s d = 1.66)), mood (tension (t = −4.40, p ≤ 0.001, Cohen’s d = 1.37), depression (t = −4.56, p ≤ 0.001, Cohen’s d = 1.42), anger (t = −7.80, p ≤ 0.001, Cohen’s d = 2.47), somatic anxiety (t = −5.28, p ≤ 0.001, Cohen’s d = 1.65), and cognitive anxiety (t = −6.62, p ≤ 0.001, Cohen’s d = 2.07) in the intervention group compared to the control group and with large to very large effect sizes. Mindfulness is a factor that enhances athletes’ ability to cope with high sport pressure and the healthy management of competition (e.g., fear of failure), or with their daily life. Full article
(This article belongs to the Special Issue Improving Athletes’ Performance and Avoiding Health Issues)
18 pages, 319 KiB  
Article
Shiver Me Tinders and Ring a Ding for a Fling—Sex Tech Use during COVID-19: Findings from a UK Study
by Hannah R. Marston, Deborah J. Morgan, Sarah Earle and Robin A. Hadley
Healthcare 2023, 11(6), 897; https://doi.org/10.3390/healthcare11060897 - 20 Mar 2023
Cited by 1 | Viewed by 2692
Abstract
Existing research surrounding dating apps has primarily focused on younger people with few studies exploring usage of such apps by middle aged and older adults. The worldwide COVID-19 pandemic challenged social behaviours and forced people to adapt intimacy and wider relationship conduct. The [...] Read more.
Existing research surrounding dating apps has primarily focused on younger people with few studies exploring usage of such apps by middle aged and older adults. The worldwide COVID-19 pandemic challenged social behaviours and forced people to adapt intimacy and wider relationship conduct. The objective of this study was to examine how older adults utilized dating apps during the lockdowns of the UK pandemic (December 2020–May 2021). Findings presented here focus on qualitative data collected from an online survey and eight online, one-to-one interviews with adults aged 40–54 years. The online survey targeted adults across the UK while interviewees were located across England. Employing interpretative phenomenological analysis, findings identified three key themes: 1. Morality, health, and law breaking and COVID-19; 2. Self-surveillance and moral signalling; 3. Loneliness and social isolation. Qualitative findings show engaging with apps was a proxy which alleviated feelings of loneliness and social isolation. Some users used the premise of their social bubble as a way of meeting other people. Using the same premise, others justified breaking the law to engage in physical and sexual intimacy to mitigate their loneliness. The work presented here contributes to the fields of social sciences, gerontology, and human computer interaction. The inter- and multi-disciplinary impact of this study intersects across those fields and offers a cross-sectional insight into behaviours and engagement with technology during one of the most extraordinary global events. Full article
10 pages, 570 KiB  
Article
The Effect of Deep and Slow Breathing on Retention and Cognitive Function in the Elderly Population
by Su-Ha Lee, Dae-Sung Park and Chang-Ho Song
Healthcare 2023, 11(6), 896; https://doi.org/10.3390/healthcare11060896 - 20 Mar 2023
Cited by 3 | Viewed by 3295
Abstract
The purpose of this study was to apply deep and slow breathing to the elderly, who can be classified as potential dementia patients, to confirm changes in the cognitive functions of learning and memory. Forty-five elderly subjects were randomly and evenly divided into [...] Read more.
The purpose of this study was to apply deep and slow breathing to the elderly, who can be classified as potential dementia patients, to confirm changes in the cognitive functions of learning and memory. Forty-five elderly subjects were randomly and evenly divided into a rest group (RG), a before group (BG), and an after group (AG). Measurements of their cognitive abilities were obtained before testing (PT), 30 min after learning (STT), and 24 h after learning (LTT). After PT measurements were obtained from all three groups, the RG and AG conducted new cognitive skills learning, while the BG performed deep and slow breathing (DSB) for 30 min before learning new cognitive skills. After all the three groups underwent 30 min of learning, the STT was performed. Subsequently, the AG performed DSB for 30 min. Finally, 24 h after learning, the LTT was conducted for all three groups. Changes were compared and analyzed by measuring the retention of new cognitive skills and attention, working memory, and spatial perception of cognitive functions. A two-way repeated measure analysis of variance measured the effect of the application of DSB in the three groups. These results demonstrated a significant interaction of time and time*group in all measurements of retention and attention, working memory, and spatial perception. This study confirms the benefit of DSB as part of a dementia prevention training protocol. Full article
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