Healthcare

16 pages, 525 KiB

Open AccessReview

A Preliminary Scoping Review of the Impact of e-Prescribing on Pharmacists in Community Pharmacies

by Amr A. Farghali and Elizabeth M. Borycki

Healthcare 2024, 12(13), 1280; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131280 (registering DOI) - 26 Jun 2024

Abstract

Objective: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow. Methods: The literature search was conducted using PubMed^®, Web of Science [...] Read more.

Objective: This scoping review aims to map the available literature and provide an overview of the published articles discussing the impact of electronic prescribing on medication errors and pharmacy workflow. Methods: The literature search was conducted using PubMed^®, Web of Science^®, and the Cochrane Database of Systematic Reviews^®, as well as grey literature reports, using the search terms and related components of “pharmacists”, “electronic prescribing”, “medication errors”, and “efficiency”. The search included all articles that were published from January 2011 to September 2023. Twenty-two relevant articles were identified and fully reviewed, ten of which were included in this review. Results: Electronic prescribing (e-prescribing) provides a solution for some of the challenges that are associated with handwritten and paper prescriptions. However, the implementation of e-prescribing systems has been recognized as a source of new unforeseen medication errors in all the reviewed articles. Productivity in community pharmacies has been affected with receiving electronic prescriptions (e-prescriptions) and having to deal with the issues that arise from them. The pharmacists’ interventions were not eliminated with e-prescriptions compared to other prescription formats. The most frequently reported reason for intervention was related to incomplete instructions in the field of directions of use. Other common challenges with e-prescriptions were related to missing information, quantity, inappropriate dose, dosage form, and drug. Discussion: This review demonstrates the scarcity of research about the impact of electronic prescribing on medication error and efficiency in community pharmacies. In the literature, most of the studies had mainly focused on hospital pharmacies. The literature search demonstrated that there are still some barriers to overcome with e-prescribing systems and that medication errors were not fully eliminated with e-prescriptions. New errors have been identified with e-prescriptions, all of which caused delays in processing, which affected the productivity of the pharmacy staff, and could have negatively impacted patients’ safety if not properly resolved. Conclusion: e-Prescribing solved some of the challenges associated with illegibility of handwritten prescriptions. However, more time is required to allow e-prescribing systems to mature. Further training for prescribers and pharmacists is also recommended before and after the implementation. Full article

(This article belongs to the Special Issue The 10th Anniversary of Healthcare—Medication Management)

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14 pages, 758 KiB

Open AccessArticle

Laser Acupuncture versus Liraglutide in Treatment of Obesity: A Multi-Institutional Retrospective Cohort Study

by Wen-Lin Yu, Yu-Ning Liao, Tsung-Hsien Yang, Ching-Wei Yang, Ting-I Kao, Pai-Wei Lee, Chiu-Yi Hsu, Jhen-Ling Huang, Yu-Tung Huang and Hsing-Yu Chen

Healthcare 2024, 12(13), 1279; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131279 (registering DOI) - 26 Jun 2024

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Abstract

Background: Obesity is a global concern, driving the search for alternative treatments beyond lifestyle changes and medications. Laser acupuncture (LA) shows promise in obesity management, yet few studies compare it with FDA-approved medications. This study aimed to assess and compare LA’s impact with [...] Read more.

Background: Obesity is a global concern, driving the search for alternative treatments beyond lifestyle changes and medications. Laser acupuncture (LA) shows promise in obesity management, yet few studies compare it with FDA-approved medications. This study aimed to assess and compare LA’s impact with liraglutide on weight reduction in obese individuals. Methods: Data from the Chang Gung Research Database (CGRD) (2013–2018) were analyzed. Primary outcomes included changes in body weight and BMI within 180 days, with secondary outcomes measuring the proportion achieving 5%, 10%, and 15% weight loss. Adverse events were also assessed. Results: Of 745 subjects (173 LA users, 572 liraglutide users), LA users lost more weight by day 180 (5.82 ± 4.39 vs. 2.38 ± 5.75 kg; p < 0.001) and had a greater BMI reduction (−2.27 ± 1.73 vs. −0.93 ± 2.25 kg/m²; p < 0.001). More LA users achieved 5% and 10% weight loss compared to liraglutide users (64.2% vs. 22.7%, 26.6% vs. 4.2%; all p < 0.001). After balancing baseline differences, LA’s benefits remained significant. No adverse events were reported with LA. Conclusions: LA may offer superior weight reduction compared to liraglutide. Future studies should explore LA alone or in combination with liraglutide for obesity management. Full article

(This article belongs to the Special Issue Emerging Developments in Integrative and Complementary Medicine: Advancements in Research and Clinical Applications)

16 pages, 368 KiB

Open AccessArticle

Exploring the Relationship between Co-Sleeping, Maternal Mental Health and Expression of Complaints during Infancy, and Breastfeeding

by Marilena Vogiatzoglou, Maria Iliadou, Evangelia Antoniou, Ewa Andersson, Irina Mrvoljak-Theodoropoulou, Calliope Dagla, Dimitra Sotiropoulou, Eleni Tsolaridou, Eirini Orovou, Eirini Tomara and Maria Dagla

Healthcare 2024, 12(13), 1278; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131278 - 26 Jun 2024

Viewed by 79

Abstract

Background: This study explores whether the implementation of co-sleeping in infants aged 6–12 months (a) is associated with maternal complaints and mothers’ difficulties regarding their infant’s sleep, (b) is associated with maternal mental health, (c) affects infant sleep characteristics and maternal sleep quality, [...] Read more.

Background: This study explores whether the implementation of co-sleeping in infants aged 6–12 months (a) is associated with maternal complaints and mothers’ difficulties regarding their infant’s sleep, (b) is associated with maternal mental health, (c) affects infant sleep characteristics and maternal sleep quality, and (d) is associated with breastfeeding. Methods: This study is a cross-sectional study conducted from July to November 2021. A total of 151 new mothers of infants aged 6–12 months participated. All participants were divided into two different groups, the group of mothers who adopted the co-sleeping method from birth up to the time of the survey and the group of those who did not adopt co-sleeping at that time. The Brief Infant Sleep Questionnaire—Revised Short Form (BISQ-R SF), the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI), and a questionnaire on mothers’ demographics were administered. Results: Regarding the mothers’ complaints, mothers who co-sleep with their children have lower sleep quality than those who do not co-sleep. In respect of the mothers’ mental health, there did not seem to be a statistically significant difference in the two groups. Regarding the difficulties during the sleep process, children who sleep with their parents seem to have more difficulties compared to the others (p = 0.008). It was also shown that co-sleeping children seem to have more disturbed sleep compared to those who sleep alone (p = 0.018), and a general trend obtained of a significantly higher number of awakenings for co-sleeping children (p < 0.001). Finally, breastfeeding appeared to be more related to the children of the present sample sleeping with their parents (p < 0.001). Conclusions: This study showed that co-sleeping is associated with more difficulties in infant and maternal sleep, but no direct correlation with maternal mental health was found. In addition, it showed a positive correlation of co-sleeping with breastfeeding. Full article

13 pages, 357 KiB

Open AccessArticle

Predictors of Perceived Healthcare Professionals’ Well-Being in Work Design: A Cross-Sectional Study with Multigroup PLS Structural Equation Modeling

by Danijela Nesic, Marko Slavkovic, Nebojsa Zdravkovic and Nikola Jerkan

Healthcare 2024, 12(13), 1277; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131277 - 26 Jun 2024

Viewed by 91

Abstract

The growing attention paid to employee well-being in the healthcare system, along with the reinforcement of factors that drive change in the work environment, provides a strong foundation for studying the relationship between work design and its related outcomes. The aim of this [...] Read more.

The growing attention paid to employee well-being in the healthcare system, along with the reinforcement of factors that drive change in the work environment, provides a strong foundation for studying the relationship between work design and its related outcomes. The aim of this study was to examine the relationship between the elements of work design and the overall well-being of healthcare professionals, particularly the differences across multiple groups of various genders and age brackets. A cross-sectional study design was employed, and a convenience sampling method was used. The study participants were healthcare professionals, and a total of 427 valid surveys were collected. The partial least squares structural equation modeling (PLS-SEM) approach was deployed to test the relationship between the determinants of work design and the perceived well-being of healthcare professionals. The results indicate a strong positive relationship between the social characteristics of work and overall well-being, as well as a positive contribution of the work context to the perceived well-being of healthcare professionals. The findings validated that knowledge characteristics had no beneficial impacts on overall well-being; nor did the task characteristics of work design. Although the mentioned associations failed to demonstrate statistical significance, the results nonetheless have significant practical consequences that are comparable to those of the relationships that demonstrated statistical significance. Full article

14 pages, 859 KiB

Open AccessArticle

The Potential Benefits of Acute Aronia Juice Supplementation on Physical Activity Induced Alterations of the Serum Protein Profiles in Recreational Runners: A Pilot Study

by Tamara Uzelac, Marija Takić, Vuk Stevanović, Nevena Vidović, Ana Pantović, Petar Jovanović and Vesna Jovanović

Healthcare 2024, 12(13), 1276; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131276 - 26 Jun 2024

Viewed by 92

Abstract

Intensive physical activity (PA) can lead to proteinuria and, consequently, serum protein profiles in athletes. Therefore, the aim of this study was to investigate the effects of acute aronia juice consumption before a simulated half-marathon race on serum protein profiles in recreational runners. [...] Read more.

Intensive physical activity (PA) can lead to proteinuria and, consequently, serum protein profiles in athletes. Therefore, the aim of this study was to investigate the effects of acute aronia juice consumption before a simulated half-marathon race on serum protein profiles in recreational runners. The pilot study was designed as a single-blind, placebo-controlled, crossover study, with 10 male participants who consumed aronia juice (containing 1.3 g polyphenols) or placebo before the race. The blood levels of total proteins, albumin, the non-albumin fractions gamma, beta, alpha2 and alpha1, as well as renal function parameters, were determined before and 15 min, 1 h and 24 h after the race. The significant changes in urea, creatinine and uric acid levels were noticed at selected time points in both groups. In the placebo group, a significant decrease in total proteins (p < 0.05) was observed 24 h after the race, along with an increase in gamma fraction abundance (p < 0.05). In addition, urea and uric acid levels returned to baseline only in the aronia group 24 h after the race. Thus, according to the results obtained, acute aronia juice supplementation before intensive PA could influence the transient change in renal function and PA-induced protein loss in recreational runners. Full article

(This article belongs to the Special Issue Nutrition and Supplementation for Human Performance)

13 pages, 310 KiB

Open AccessArticle

Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults

by Amanda Andrade, Tânia Nascimento, Catarina Cabrita, Helena Leitão and Ezequiel Pinto

Healthcare 2024, 12(13), 1275; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131275 - 26 Jun 2024

Viewed by 88

Abstract

Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This [...] Read more.

Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population. Full article

(This article belongs to the Section Medication Management)

9 pages, 227 KiB

Open AccessArticle

Exploring Stroke Patients’ Needs: A Cultural Adaptation and Validation of the Modified Needs Assessment Questionnaire in a Greek Context

by Katerina Paschalidou, Efi Tsitskari, Anna Tsiakiri, Evangelia Makri, Pinelopi Vlotinou, Konstantinos Vadikolias and Nikolaos Aggelousis

Healthcare 2024, 12(13), 1274; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131274 - 26 Jun 2024

Viewed by 114

Abstract

Stroke survivors often face diverse unmet needs highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for [...] Read more.

Stroke survivors often face diverse unmet needs highlighting the significance of identifying and addressing these needs to enhance rehabilitation outcomes and overall quality of life. This study aimed to validate the modified Needs Assessment Questionnaire (mNAQ) as a reliable and valid tool for assessing the needs of stroke patients in the Greek context. Additionally the research sought to identify potential differences in the assessment of stroke patients’ needs based on their stroke phase and National Institutes of Health Stroke Scale (NIHSS) scores. A sample of 71 adult stroke survivors adhering to World Health Organization guidelines and providing autonomous consent participated in the study. The mNAQ comprising 141 items across 12 domains was utilized to evaluate stroke patients’ needs. The NIHSS and Barthel Index (BI) were employed for functional independence and mobility assessment. Data analysis incorporated confirmatory factor analysis, exploratory factor analysis and Cronbach’s reliability analysis to establish construct validity and internal consistency. Concurrent and known-groups validity analyses were conducted; and Spearman’s rho correlation explored the relationship between mNAQ and BI scores. Non-parametric analyses were applied to identify differences based on stroke phase and NIHSS scores. The study revealed that the mNAQ initially lacked satisfactory psychometric properties in the Greek context. Subsequent modifications guided by confirmatory and exploratory factor analyses resulted in a refined three-factor scale encompassing 31 items in the domains of communication, mobility, and social functioning needs. This adapted measure effectively differentiated between acute and chronic stroke patients and those with minor and moderate strokes. In conclusion, the validated 31-item Greek mNAQ emerges as a crucial tool for comprehensively assessing the needs of stroke patients. Its application holds promise for optimizing post-stroke care improving functional outcomes and ultimately enhancing the overall well-being and quality of life for stroke survivors. Full article

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

8 pages, 601 KiB

Open AccessArticle

Seasonal Trends in Suicide Attempts-Keywords Related Searches: A Google Trends Analysis

by Krzysztof Bartosz Klimiuk, Dawid Krefta, Michał Krawczyk and Łukasz Balwicki

Healthcare 2024, 12(13), 1273; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131273 - 26 Jun 2024

Viewed by 132

Abstract

Suicide is a significant public health concern globally, with its varying rates influenced by numerous factors, including seasonal changes. Online search behaviors, particularly searches related to suicide and mental health, have been proposed as real-time indicators of suicidal ideation in populations. In this [...] Read more.

Suicide is a significant public health concern globally, with its varying rates influenced by numerous factors, including seasonal changes. Online search behaviors, particularly searches related to suicide and mental health, have been proposed as real-time indicators of suicidal ideation in populations. In this study, a cross-sectional time series analysis was conducted, utilizing data on suicide attempts from the Polish Police Headquarters and online search behavior from Google Trends over a decade. Suicide attempt data were analyzed alongside the frequency of Google searches for suicide-related keywords derived from the Polish Corpus of Suicide Notes. A total of 66 keywords were selected for analysis to identify seasonal trends and patterns in search behavior. The study employed linear regression, Seasonal Mann-Kendall tests, and TBATS models to analyze the data. Suicide rates show seasonal patterns, peaking in warmer months. However, keyword searches did not strongly correlate with peak suicide months. This study enhances our understanding of suicide-related search trends and their potential connection to suicide rates. It suggests avenues for more effective prevention efforts and the potential for future algorithms to predict suicide rates and identify at-risk groups. Full article

(This article belongs to the Section Preventive Medicine)

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21 pages, 4308 KiB

Open AccessArticle

Dynamic Price Application to Prevent Financial Losses to Hospitals Based on Machine Learning Algorithms

by Abdulkadir Atalan and Cem Çağrı Dönmez

Healthcare 2024, 12(13), 1272; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131272 - 26 Jun 2024

Viewed by 142

Abstract

Hospitals that are considered non-profit take into consideration not to make any losses other than seeking profit. A model that ensures that hospital price policies are variable due to hospital revenues depending on patients with appointments is presented in this study. A dynamic [...] Read more.

Hospitals that are considered non-profit take into consideration not to make any losses other than seeking profit. A model that ensures that hospital price policies are variable due to hospital revenues depending on patients with appointments is presented in this study. A dynamic pricing approach is presented to prevent patients who have an appointment but do not show up to the hospital from causing financial loss to the hospital. The research leverages three distinct machine learning (ML) algorithms, namely Random Forest (RF), Gradient Boosting (GB), and AdaBoost (AB), to analyze the appointment status of 1073 patients across nine different departments in a hospital. A mathematical formula has been developed to apply the penalty fee to evaluate the reappointment situations of the same patients in the first 100 days and the gaps in the appointment system, considering the estimated patient appointment statuses. Average penalty cost rates were calculated based on the ML algorithms used to determine the penalty costs patients will face if they do not show up, such as 22.87% for RF, 19.47% for GB, and 14.28% for AB. As a result, this study provides essential criteria that can help hospital management better understand the potential financial impact of patients missing appointments and can be considered when choosing between these algorithms. Full article

(This article belongs to the Section Health Assessments)

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14 pages, 2838 KiB

Open AccessArticle

Optimisation of Remote Monitoring Programmes in Heart Failure: Evaluation of Patient Drop-Out Behaviour and Healthcare Professionals’ Perspectives

by Maria Pagano, Francesco Corallo, Anna Anselmo, Fabio Mauro Giambò, Giuseppe Micali, Antonio Duca, Piercataldo D’Aleo, Alessia Bramanti, Marina Garofano, Placido Bramanti and Irene Cappadona

Healthcare 2024, 12(13), 1271; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131271 - 26 Jun 2024

Viewed by 137

Abstract

Heart failure (HF) is a growing epidemic, affecting millions of people worldwide, and is a major cause of mortality, morbidity, and impaired quality of life. Traditional cardiac rehabilitation is a valuable approach to the physical and quality-of-life recovery of patients with cardiovascular disease. [...] Read more.

Heart failure (HF) is a growing epidemic, affecting millions of people worldwide, and is a major cause of mortality, morbidity, and impaired quality of life. Traditional cardiac rehabilitation is a valuable approach to the physical and quality-of-life recovery of patients with cardiovascular disease. The innovative approach of remote monitoring through telemedicine offers a solution based on modern technologies, enabling continuous collection of health data outside the hospital environment. Remote monitoring devices present challenges that could adversely affect patient adherence, resulting in the risk of dropout. By applying a cognitive-behavioral model, we aim to identify the antecedents of dropout behavior among patients adhering to traditional cardiac rehabilitation programs and remote monitoring in order to improve the latter. Our study was conducted from October 2023 to January 2024. In the first stage, we used data from literature consultation. Subsequently, data were collected from the direct experience of 49 health workers related to both remote monitoring and traditional treatment, recruited from the authors’ workplace. Results indicate that patients with cardiovascular disease tend to abandon remote monitoring programs more frequently than traditional cardiac rehabilitation therapies. It is critical to design approaches that take these barriers into account to improve adherence and patient satisfaction. This analysis identified specific antecedents to address, helping to improve current monitoring models. This is crucial to promote care continuity and to achieve self-management by patients in the future. Full article

(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)

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10 pages, 490 KiB

Open AccessReview

Opioid Medical Detoxification Compared to Opioid Agonist Treatment during Pregnancy: A Scoping Review

by Alice Ordean and Isabella DeVuono

Healthcare 2024, 12(13), 1270; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131270 - 26 Jun 2024

Viewed by 266

Abstract

Opioid use disorder (OUD) is highly prevalent, affecting up to 1% of pregnancies. The current standard of care for the management of OUD during pregnancy has been maintained with opioid agonist treatment (OAT), using either methadone or buprenorphine. OAT use has been associated [...] Read more.

Opioid use disorder (OUD) is highly prevalent, affecting up to 1% of pregnancies. The current standard of care for the management of OUD during pregnancy has been maintained with opioid agonist treatment (OAT), using either methadone or buprenorphine. OAT use has been associated with a risk of neonatal abstinence syndrome (NAS), which requires a longer neonatal length of stay for monitoring and possible pharmacological treatment. As a result, opioid medical detoxification (OMD) was proposed as an alternative strategy to reduce the stigma associated with OAT and to eliminate the risk of NAS by detoxifying or tapering pregnant persons during their pregnancy before delivery; however, the safety and effectiveness of OMD during pregnancy have not been established. This scoping review aims to summarize recent evidence related to maternal, obstetrical, and neonatal outcomes of OMD in comparison to OAT maintenance. This review also provides recommendations for future research initiatives to fill gaps in managing this patient population. Full article

(This article belongs to the Section Perinatal and Neonatal Medicine)

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14 pages, 12687 KiB

Open AccessArticle

Redesigned Electrodes for Improved Intraoperative Nerve Conduction Studies during the Treatment of Peripheral Nerve Injuries

by Nathaniel Riemann, Jack Coursen, Laura Elena Porras, Bryan Sabogal, Xin-Hua Liang, Christian Guaraca, Allan Belzberg, Matthias Ringkamp, Gang Wu, Lily Zhu, Samantha Weed and Constanza Miranda

Healthcare 2024, 12(13), 1269; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131269 - 26 Jun 2024

Viewed by 146

Abstract

Traumatic peripheral nerve injuries (PNI), present with symptoms ranging from pain to loss of motor and sensory function. Difficulties in intraoperative visual assessment of nerve functional status necessitate intraoperative nerve conduction studies (INCSs) by neurosurgeons and neurologists to determine the presence of functioning [...] Read more.

Traumatic peripheral nerve injuries (PNI), present with symptoms ranging from pain to loss of motor and sensory function. Difficulties in intraoperative visual assessment of nerve functional status necessitate intraoperative nerve conduction studies (INCSs) by neurosurgeons and neurologists to determine the presence of functioning axons in the zone of a PNI. This process, also referred to as nerve “inching”, uses a set of stimulating and recording electrode hooks to lift the injured nerve from the surrounding surgical field and to determine whether an electrical stimulus can travel through the zone of injury. However, confounding electrical signal artifacts can arise from the current workflow and electrode design, particularly from the mandatory lifting of the nerve, complicating the definitive assessment of nerve function and neurosurgical treatment decision-making. The objective of this study is to describe the design process and verification testing of our group’s newly designed stimulating and recording electrodes that do not require the lifting or displacement of the injured nerve during INCSs. Ergonomic in vivo analysis of the device within a porcine model demonstrated successful intraoperative manipulation of the device, while quantitative nerve action potential (NAP) signal analysis with an ex vivo simulated “inching” procedure on healthy non-human primate nerve tissue demonstrated excellent reproducible recorded NAP fidelity and the absence of NAP signal artifacts at all points of recording. Lastly, electrode pullout force testing determined maximum forces of 0.43 N, 1.57 N, and 3.61 N required to remove the device from 2 mm, 5 mm, and 1 cm nerve models, respectively, which are well within established thresholds for nerve safety. These results suggest that these new electrodes can safely and successfully perform accurate PNI assessment without the presence of artifacts, with the potential to improve the INCS standard of care while remaining compatible with currently used neurosurgical technology, infrastructure, and clinical workflows. Full article

(This article belongs to the Special Issue Outcome Measures and Innovative Approaches in Rehabilitation)

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15 pages, 5398 KiB

Open AccessArticle

Exploring Opioid Prescription Patterns and Overdose Rates in South Carolina (2017–2021): Insights into Rising Deaths in High-Risk Areas

by Amirreza Sahebi-Fakhrabad, Amir Hossein Sadeghi, Eda Kemahlioglu-Ziya and Robert Handfield

Healthcare 2024, 12(13), 1268; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131268 - 26 Jun 2024

Viewed by 136

Abstract

With opioid overdose rates on the rise, we aimed to develop a county-level risk stratification that specifically focused on access to medications for opioid use disorder (MOUDs) and high overdose rates. We examined over 15 million records from the South Carolina Prescription Tracking [...] Read more.

With opioid overdose rates on the rise, we aimed to develop a county-level risk stratification that specifically focused on access to medications for opioid use disorder (MOUDs) and high overdose rates. We examined over 15 million records from the South Carolina Prescription Tracking System (SCRIPTS) across 46 counties. Additionally, we incorporated data from opioid treatment programs, healthcare professionals prescribing naltrexone, clinicians with buprenorphine waivers, and county-level overdose fatality statistics. To assess the risk of opioid misuse, we classified counties into high-risk and low-risk categories based on their prescription rates, overdose fatalities, and treatment service availability. Statistical methods employed included the two-sample t-test and linear regression. The t-test assessed the differences in per capita prescription rates between high-risk and low-risk counties. Linear regression was used to analyze the trends over time. Our study showed that between 2017 and 2021, opioid prescriptions decreased from 64,223 to 41,214 per 100,000 residents, while fentanyl-related overdose deaths increased by 312%. High-risk counties had significantly higher rates of fentanyl prescriptions and relied more on out-of-state doctors. They also exhibited higher instances of doctor shopping and had fewer medical doctors per capita, with limited access to MOUDs. To effectively combat the opioid crisis, we advocate for improved local healthcare infrastructure, broader treatment access, stricter management of out-of-state prescriptions, and vigilant tracking of prescription patterns. Tailored local strategies are essential for mitigating the opioid epidemic in these communities. Full article

(This article belongs to the Section Health Policy)

9 pages, 588 KiB

Open AccessArticle

Exploring Telemedicine Usage Intention Using Technology Acceptance Model and Social Capital Theory

by Liang-Hsi Kung, Yu-Hua Yan and Chih-Ming Kung

Healthcare 2024, 12(13), 1267; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131267 - 26 Jun 2024

Viewed by 130

Abstract

Telemedicine technology has emerged as a pivotal solution to enhance the accessibility and efficiency of healthcare services. This study investigates the factors influencing the acceptance of telemedicine technology among healthcare professionals in Taiwan. Employing a quantitative research approach, we utilized a survey instrument [...] Read more.

Telemedicine technology has emerged as a pivotal solution to enhance the accessibility and efficiency of healthcare services. This study investigates the factors influencing the acceptance of telemedicine technology among healthcare professionals in Taiwan. Employing a quantitative research approach, we utilized a survey instrument adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Data were collected from 325 healthcare professionals across diverse medical fields. The results indicate that perceived usefulness, ease of use, social influence, and convenience significantly influence intention to use telemedicine. Moreover, age moderates the relationship between perceived usefulness and usage intention. These findings underscore the importance of addressing both technological and social factors in promoting the adoption of telemedicine among healthcare professionals. Policy implications and recommendations for enhancing telemedicine implementation are discussed based on the study findings. Specifically, our findings highlight that perceived usefulness, ease of use, social influence, and convenience significantly impact the intention to use telemedicine technology. Age significantly moderates the relationship between perceived usefulness and usage intention. These results not only theoretically support the UTAUT model but also provide practical strategies to advance the application of telemedicine technology. Full article

(This article belongs to the Topic Advancing the Knowledge and Application of Health Behavior Theories)

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16 pages, 3104 KiB

Open AccessArticle

Unveiling the Evolution of Virtual Reality in Medicine: A Bibliometric Analysis of Research Hotspots and Trends over the Past 12 Years

by Guangxi Zuo, Ruoyu Wang, Cheng Wan, Zhe Zhang, Shaochong Zhang and Weihua Yang

Healthcare 2024, 12(13), 1266; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131266 - 26 Jun 2024

Viewed by 137

Abstract

Background: Virtual reality (VR), widely used in the medical field, may affect future medical training and treatment. Therefore, this study examined VR’s potential uses and research directions in medicine. Methods: Citation data were downloaded from the Web of Science Core Collection database (WoSCC) [...] Read more.

Background: Virtual reality (VR), widely used in the medical field, may affect future medical training and treatment. Therefore, this study examined VR’s potential uses and research directions in medicine. Methods: Citation data were downloaded from the Web of Science Core Collection database (WoSCC) to evaluate VR in medicine in articles published between 1 January 2012 and 31 December 2023. These data were analyzed using CiteSpace 6.2. R2 software. Present limitations and future opportunities were summarized based on the data. Results: A total of 2143 related publications from 86 countries and regions were analyzed. The country with the highest number of publications is the USA, with 461 articles. The University of London has the most publications among institutions, with 43 articles. The burst keywords represent the research frontier from 2020 to 2023, such as “task analysis”, “deep learning”, and “machine learning”. Conclusion: The number of publications on VR applications in the medical field has been steadily increasing year by year. The USA is the leading country in this area, while the University of London stands out as the most published, and most influential institution. Currently, there is a strong focus on integrating VR and AI to address complex issues such as medical education and training, rehabilitation, and surgical navigation. Looking ahead, the future trend involves integrating VR, augmented reality (AR), and mixed reality (MR) with the Internet of Things (IoT), wireless sensor networks (WSNs), big data analysis (BDA), and cloud computing (CC) technologies to develop intelligent healthcare systems within hospitals or medical centers. Full article

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12 pages, 1744 KiB

Open AccessArticle

Health in a Virtual Environment (HIVE): A Novel Continuous Remote Monitoring Service for Inpatient Management

by Tim Bowles, Kevin M. Trentino, Adam Lloyd, Laura Trentino, Kevin Murray, Aleesha Thompson, Frank M. Sanfilippo and Grant Waterer

Healthcare 2024, 12(13), 1265; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131265 - 26 Jun 2024

Viewed by 175

Abstract

The aim of this study was to describe the implementation of a novel 50-bed continuous remote monitoring service for high-risk acute inpatients treated in non-critical wards, known as Health in a Virtual Environment (HIVE). We report the initial results, presenting the number and [...] Read more.

The aim of this study was to describe the implementation of a novel 50-bed continuous remote monitoring service for high-risk acute inpatients treated in non-critical wards, known as Health in a Virtual Environment (HIVE). We report the initial results, presenting the number and type of patients connected to the service, and assess key outcomes from this cohort. This was a prospective, observational study of characteristics and outcomes of patients connected to the HIVE continuous monitoring service at a major tertiary hospital and a smaller public hospital in Western Australia between January 2021 and June 2023. In the first two and a half years following implementation, 7541 patients were connected to HIVE for a total of 331,118 h. Overall, these patients had a median length of stay of 5 days (IQR 2, 10), 11.0% (n = 833) had an intensive care unit admission, 22.4% (n = 1691) had an all-cause emergency readmission within 28 days from hospital discharge, and 2.2% (n = 167) died in hospital. Conclusions: Our initial results show promise, demonstrating that this innovative approach to inpatient care can be successfully implemented to monitor high-risk patients in medical and surgical wards. Future studies will investigate the effectiveness of the program by comparing patients receiving HIVE supported care to comparable patients receiving routine care. Full article

(This article belongs to the Special Issue Innovation in Hospital Management: Strategies and Efforts for Patient and Healthcare Workers Safety and Prevention of Claims)

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12 pages, 270 KiB

Open AccessArticle

The Effectiveness of Mobile Applications in Improving Nursing Students’ Knowledge Related to Pressure Injury Prevention

by Mo`ath Nayef Alkhazali, Burcu Totur Dikmen and Nurhan Bayraktar

Healthcare 2024, 12(13), 1264; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131264 - 26 Jun 2024

Viewed by 142

Abstract

The study’s main goal was to compare the effects of a mobile application versus traditional methods of teaching on nursing students’ acquisition of knowledge about pressure injury prevention. In addition, a secondary aim was to discover nursing students’ viewpoints related to the advantages [...] Read more.

The study’s main goal was to compare the effects of a mobile application versus traditional methods of teaching on nursing students’ acquisition of knowledge about pressure injury prevention. In addition, a secondary aim was to discover nursing students’ viewpoints related to the advantages and disadvantages of using mobile applications as an educational method. A randomized controlled study design was implemented during November and December of 2023 in a nursing faculty with 60 undergraduate students in their second nursing year. A total of 30 students were assigned to the mobile application group, while the other 30 students were assigned to the traditional lecture group. The study was executed in three stages: pre-test, educational intervention, and post-test. The results of the study during the pre-test showed that there were no statistically significant differences in the mean scores of pressure injury themes between the two groups. However, the post-test scores for all PI themes were higher in the mobile application group compared to the traditional lecture group. Furthermore, five advantages of the mobile application were highlighted by students: “improvement of students’ knowledge and skills”, “self-confidence”, “stress reduction”, “enhancement of competence”, and “stimulation of learning motivation”. This study demonstrated the effectiveness of the mobile application method in enhancing nursing students’ knowledge and prophylaxis of pressure injury. Therefore, the mobile application method is recommended as an innovative approach to teaching. Full article

(This article belongs to the Collection Current Nursing Practice and Education)

10 pages, 457 KiB

Open AccessSystematic Review

Is TEVAR an Effective Approach to Prevent Complications after Surgery for Aortic Dissection Type A? A Systematic Review

by Nikolaos Schizas, Georgia Nazou, Ilias Samiotis, Constantine N. Antonopoulos and Dimitrios C. Angouras

Healthcare 2024, 12(13), 1263; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131263 - 25 Jun 2024

Viewed by 262

Abstract

Introduction: A residual false lumen after treatment for Aortic Dissection type A (AD) has been associated with early complications, such as A malperfusion or rupture and mid-term or delayed complications, such as aneurysm formation or dissection expansion. Thoracic Endovascular Aortic Repair (TEVAR) is [...] Read more.

Introduction: A residual false lumen after treatment for Aortic Dissection type A (AD) has been associated with early complications, such as A malperfusion or rupture and mid-term or delayed complications, such as aneurysm formation or dissection expansion. Thoracic Endovascular Aortic Repair (TEVAR) is considered an effective solution by several surgical teams to prevent future complications. In this systematic review, all published data regarding the implementation of TEVAR after previous treatment for AD were collected in order to investigate indications, methods, clinical outcomes and aortic remodeling in these patients. Methods: The aim of this study was to investigate the indications, the methods and the efficacy of TEVAR usage after surgical treatment of AD. Data for this study were collected from four widely used medical databases (MEDLINE, SCIENCE DIRECT, GOOGLE SCHOLAR, OVID). All the results for each database were recorded and were analyzed with a systematic method. Techniques and clinical outcomes were investigated. Aortic remodeling was evaluated based on the following parameters in these studies: aortic diameter, true lumen diameter, false lumen diameter, false lumen thrombosis and false lumen patency. Results: The results obtained from the search among all databases comprised 1410 articles and of these articles 9 were included in the review. The majority of the studies were retrospective (seven out of nine studies), while no study was randomized. The total number of patients was 157 and 133 of them (84.7% of patients) were treated with TEVAR in zone 3 without extension below the diaphragm intraoperatively. Among 142 patients, the calculated mortality rate was 12.7% (18 of 142 patients), with 2.8% (4 of 142 patients) presenting with stroke. The percentage of patients with total or partial thrombosis combined was 65.9% (62 patients in a population of 92). The reintervention rate was 18.7%. Conclusions: TEVAR after AD surgery is an approach usually chosen in clinical practice, but the criteria of its usage are uncertain. This method is safe and enhances aortic remodeling with an acceptable reintervention rate. Definite guidelines in this field should be created in order to delineate whether TEVAR after AD surgery is beneficial as a preventive measure to aorta-related complications and to decide under which criteria this approach should be chosen. Full article

(This article belongs to the Special Issue Current Advances in Cardiovascular Disease)

15 pages, 2230 KiB

Open AccessArticle

Predicting Suicidal Ideation, Planning, and Attempts among the Adolescent Population of the United States

by Hamed Khosravi, Imtiaz Ahmed and Avishek Choudhury

Healthcare 2024, 12(13), 1262; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131262 - 25 Jun 2024

Viewed by 187

Abstract

Suicide is the second leading cause of death among individuals aged 5 to 24 in the United States (US). However, the precursors to suicide often do not surface, making suicide prevention challenging. This study aims to develop a machine learning model for predicting [...] Read more.

Suicide is the second leading cause of death among individuals aged 5 to 24 in the United States (US). However, the precursors to suicide often do not surface, making suicide prevention challenging. This study aims to develop a machine learning model for predicting suicide ideation (SI), suicide planning (SP), and suicide attempts (SA) among adolescents in the US during the coronavirus pandemic. We used the 2021 Adolescent Behaviors and Experiences Survey Data. Class imbalance was addressed using the proposed data augmentation method tailored for binary variables, Modified Synthetic Minority Over-Sampling Technique. Five different ML models were trained and compared. SHapley Additive exPlanations analysis was conducted for explainability. The Logistic Regression model, identified as the most effective, showed superior performance across all targets, achieving high scores in recall: 0.82, accuracy: 0.80, and area under the Receiver Operating Characteristic curve: 0.88. Variables such as sad feelings, hopelessness, sexual behavior, and being overweight were noted as the most important predictors. Our model holds promise in helping health policymakers design effective public health interventions. By identifying vulnerable sub-groups within regions, our model can guide the implementation of tailored interventions that facilitate early identification and referral to medical treatment. Full article

26 pages, 2039 KiB

Open AccessReview

Uncovering Nursing Communication Strategies and Relational Styles to Foster Patient Engagement in Oncology: A Scoping Review

by Andrea Francesco Crivelli, Serena Barello, Marta Acampora and Loris Bonetti

Healthcare 2024, 12(13), 1261; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131261 - 25 Jun 2024

Viewed by 209

Abstract

Nurses play an active role in fostering engagement of oncological patients, and, therefore, adopting effective communication and interpersonal skills is crucial. However, the nurse–patient relationship and communication strategies are frequently undervalued. This scoping review aims to address this gap with a twofold objective: [...] Read more.

Nurses play an active role in fostering engagement of oncological patients, and, therefore, adopting effective communication and interpersonal skills is crucial. However, the nurse–patient relationship and communication strategies are frequently undervalued. This scoping review aims to address this gap with a twofold objective: (1) to explore the existing literature to identify communication strategies and relational styles employed by nurses to promote patient engagement in non-pediatric oncology patients; (2) to assess current knowledge on this topic to determine the need for future research. The search was conducted on different scientific databases and grey literature. The review was conducted following the methodology outlined in the Joanna Briggs Institute guidance for scoping reviews and the updated version of the PRISMA-ScR Checklist. Thirteen articles were included in the study. The studies in total enrolled 863 participants. Four clusters of nursing interventions were identified, encompassing communication strategies and relational styles of varying complexity, along with ten categories of general outcomes emerging from their implementation. This study summarizes the current knowledge regarding nursing communication strategies and relational styles used to promote patient engagement in oncological patients. Further research is needed, to evaluate and integrate the researched techniques, tools, and interventions for future clinical nursing practice. Full article

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12 pages, 620 KiB

Open AccessArticle

Computed Tomography (CT)-Guided Needle Biopsy of Lung Lesions: A Single Center Experience

by Oluebube C. Ezenagu, Gaby E. Gabriel and Sibu P. Saha

Healthcare 2024, 12(13), 1260; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131260 - 25 Jun 2024

Viewed by 174

Abstract

(1) Objective: Lung cancer is one of the leading causes of cancer death among men and women across the globe. The accurate and timely diagnosis of lung lesions is of paramount importance for prognosis. This single-center study is the first to assess [...] Read more.

(1) Objective: Lung cancer is one of the leading causes of cancer death among men and women across the globe. The accurate and timely diagnosis of lung lesions is of paramount importance for prognosis. This single-center study is the first to assess the diagnostic yield and complication rate of a computed tomography (CT)-guided needle biopsy of pulmonary parenchymal and pleural nodules in an academic training center in the United States. (2) Methods: This is a retrospective study approved by IRB. Patients who underwent CT-guided needle biopsy between 2016 and 2020 were reviewed. A CT-guided needle biopsy involving mediastinal lesions was excluded, focusing only on lung parenchymal and pleural lesions. A CT-guided needle biopsy aborted at any point during the procedure was also excluded from this study. (3) Results: 1063 patients were included in this study; 532 were males, and 531 were females. Lesion size ranged from 0.26 cm to 9.2 cm. 1040 patients received diagnoses, among which 772 had a specific diagnosis, and 268 had nonspecific inflammatory or non-malignant diagnoses. Twenty-three cases were non-diagnostic. Among the patients with specific diagnoses, 691 were malignant, 5 were hamartomas, 30 were fungal infections, 6 were acid-fast-positive organisms, and 40 were unspecified atypical cells. Of the patients that had a malignant diagnosis, 317 were adenocarcinoma, 197 were squamous cell carcinoma, 26 were a neuroendocrine tumor, 45 were non-small cell carcinoma (undifferentiated), 17 were small cell carcinoma, and 89 were other metastatic malignancies to the lung. Various common complications, including pneumothorax (337), hemorrhage (128), and hemoptysis (17), were observed, and 42 of the cases required chest tube intervention; others were treated with observation. Other rare complications observed included hemothorax (4) and oxygen desaturation (2), and there was no death in this series. (4) Conclusions: CT-guided needle biopsy is a reliable diagnostic modality for patients with lung parenchymal and pleural nodules, and it can effectively distinguish between benign and cancerous lesions before invasive procedures such as video-assisted thoracoscopy (VATs) or thoracotomy are planned. Our study showed a higher rate of pneumothorax and pulmonary hemorrhage compared to the rates established in guidelines, attributable to the varying experience level in a busy training academic center. Full article

16 pages, 519 KiB

Open AccessProtocol

Effectiveness of an Ecological Model-Based Active Transport Education Program on Physical and Mental Health in High School Students (MOV-ES Project): Study Protocol for a Randomized Controlled Trial

by Eugenio Merellano-Navarro, Andrés Godoy-Cumillaf, Daniel Collado-Mateo, Mirko Aguilar-Valdés, Jorge Torres-Mejías, Alejandro Almonacid-Fierro, Pablo Valdés-Badilla, Frano Giakoni-Ramírez, José Bruneau-Chávez and Pedro R. Olivares

Healthcare 2024, 12(13), 1259; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131259 - 25 Jun 2024

Viewed by 169

Abstract

The United Nations, through its 2030 Agenda and Sustainable Development Goals, advocates for the establishment of conducive environments for physical activity, following the ecological model. In line with this initiative, active transportation emerges as an accessible, cost-effective, and sustainable approach to augmenting daily [...] Read more.

The United Nations, through its 2030 Agenda and Sustainable Development Goals, advocates for the establishment of conducive environments for physical activity, following the ecological model. In line with this initiative, active transportation emerges as an accessible, cost-effective, and sustainable approach to augmenting daily physical activity levels. This study protocol endeavors to assess the impact of an active transportation education program rooted in the ecological model on the physical and mental well-being of high school students. Drawing upon scientific insights, we hypothesize that a 16-week active transportation intervention will lead to a 3% reduction in average body fat percentage and a noteworthy enhancement in executive function (including inhibition, cognitive flexibility, and working memory), physical fitness (comprising cardiorespiratory fitness and muscle strength), and mental health (encompassing mood disorders and cognitive functioning). If this intervention proves effective, it could offer a viable solution for the school community, especially in reducing congestion within the school environment. The study protocol aims to evaluate the impact of an active transportation educational program based on the ecological model on the physical and mental well-being of high school students. Three high schools located in the urban area of Talca, Chile, will be randomly selected (one public, one privately subsidized, and one private non-subsidized). Each high school will be randomly assigned an experimental group (n = 30) and a control group (n = 30; without intervention). The experimental groups will receive an active transportation educational intervention during their physical education classes for four months (60 to 90 min sessions, once a week), while the control group will receive no intervention. The primary outcome will provide information on body composition and executive function. Secondary outcomes will include objective physical activity level, physical fitness, mental well-being, academic achievement, health-related quality of life, perception of environmental urban features, physical activity barriers, and adherence to active transportation. It is expected that the results of the MOV-ES Project will transcend the physical health of schoolchildren and will have an impact on the school community, especially by decongesting the school environment. Full article

(This article belongs to the Special Issue Health, Sport, Physical Activity and Education: Innovations in Improving the Quality of Life of Children and Adolescents)

19 pages, 437 KiB

Open AccessArticle

Assessing the Impact of Multidisciplinary Collaboration on Quality of Life in Older Patients Receiving Primary Care: Cross Sectional Study

by Mohammed Nasser Albarqi

Healthcare 2024, 12(13), 1258; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131258 - 25 Jun 2024

Viewed by 471

Abstract

The growing aging population presents unique challenges in maintaining their quality of life (QoL), which encompasses physical, psychological, and social wellbeing. This study aimed to assess the impact of multidisciplinary collaboration on QoL among older patients receiving primary care. A cross-sectional study was [...] Read more.

The growing aging population presents unique challenges in maintaining their quality of life (QoL), which encompasses physical, psychological, and social wellbeing. This study aimed to assess the impact of multidisciplinary collaboration on QoL among older patients receiving primary care. A cross-sectional study was conducted involving a purposive sampling of 200 participants aged 60 years and above from Primary Healthcare Centers in Al-Ahsa, Saudi Arabia, between March and May 2024. Data were collected using standardized tools: SF-36 for health-related QoL, Multidisciplinary Collaboration Evaluation Tool (MCET), and Lubben Social Network Scale (LSNS). Multivariate regression analyses were performed to examine the associations between multidisciplinary collaboration, social support, and QoL outcomes. Multidisciplinary collaboration exhibited a significant positive association with improvements in physical functioning (β = 2.35, p < 0.001), mental health (β = 3.01, p < 0.001), and general health perceptions (β = 2.12, p < 0.001). Key drivers of effective collaboration included effective communication (β = 0.48, p < 0.001), coordination (β = 0.42, p < 0.001), and patient involvement (β = 0.40, p < 0.001). Social support, particularly from friends (β = 0.33, p < 0.001) and family (β = 0.28, p < 0.001), was also a robust predictor of better QoL. Younger age, female gender, married status, and absence of chronic conditions were associated with greater QoL improvements from multidisciplinary care. Multidisciplinary collaboration and social support networks significantly enhance QoL among older primary care patients. Healthcare systems should prioritize developing collaborative care models, fostering interdisciplinary teamwork, and integrating strategies to promote social connectedness for the aging population. Full article

(This article belongs to the Special Issue Aging and Quality of Life: Second Edition)

7 pages, 1051 KiB

Open AccessCase Report

Transient Neonatal Diabetes Mellitus with an Unknown Cause in a 1-Month-Old Infant: A Case Report

by Mateusz Tarasiewicz, Anna Pietrzykowska, Julia Włodarczyk, Sebastian Seget, Karolina Gadzalska, Paulina Jakiel, Sebastian Skoczylas, Przemysława Jarosz-Chobot and Maciej Borowiec

Healthcare 2024, 12(13), 1257; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131257 - 25 Jun 2024

Viewed by 219

Abstract

Transient neonatal diabetes mellitus (TNDM) is a genetically heterogeneous form of neonatal diabetes characterized by hyperglycemia that remits during infancy with a tendency to recur in later life. This case report presents the history of a male infant with transient neonatal diabetes mellitus. [...] Read more.

Transient neonatal diabetes mellitus (TNDM) is a genetically heterogeneous form of neonatal diabetes characterized by hyperglycemia that remits during infancy with a tendency to recur in later life. This case report presents the history of a male infant with transient neonatal diabetes mellitus. The patient was treated with a continuous subcutaneous insulin infusion (CSII) and a continuous glucose monitoring (CGM) system until the age of 2 months, when the normoglycemia connected with a withdrawal of treatment was noted. The genetic test results excluded the majority of known mutations related to TNDM. This case report focuses on various genetic mutations and the clinical features connected with them that cause TNDM and highlights the difficulties in the diagnostic and therapeutic processes of this disease. CSII and CGM systems seem to be a safe and effective treatment option in TNDM and may be used in the therapy. Full article

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8 pages, 493 KiB

Open AccessBrief Report

Evaluating the Impact of a Virtual Health Coaching Lifestyle Program on Weight Loss after Sleeve Gastrectomy: A Prospective Study

by Kristina Strauss, Rachel Sauls, Michelle K. Alencar and Kelly E. Johnson

Healthcare 2024, 12(13), 1256; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131256 - 24 Jun 2024

Viewed by 301

Abstract

Bariatric surgery (BS) is a leading treatment for obesity; however, adverse side effects (e.g., pain and infection) can deter patients or affect weight maintenance. This study investigates how a post-operative virtual health coaching lifestyle program, monitoring virtual weekly goal progress made by patients, [...] Read more.

Bariatric surgery (BS) is a leading treatment for obesity; however, adverse side effects (e.g., pain and infection) can deter patients or affect weight maintenance. This study investigates how a post-operative virtual health coaching lifestyle program, monitoring virtual weekly goal progress made by patients, affects weight loss after BS, specifically sleeve gastrectomy. Patients recruited for this 6-month study were classified with a BMI > 30 kg/m² 90 days post-operatively. Patients were prescribed lifestyle support delivered by certified health and wellness coaches (InHealth Lifestyle Therapeutics™). Demographic variables (e.g., age, weight, height, and gender) were obtained and compared according to initial, 3-, 6-month, and current weight through repeated measures ANOVA and post hoc comparison. Thirty-eight adult participants were included, with a mean age of 52 years ± 12.9 and with a majority (n = 35; 97%) of them being female. There were significant differences in weight reported across all five time points (p < 0.05), with the greatest weight difference seen between the initial (250.3 ± 45.5 lbs.) and final time points (226.7± 40.4 lbs.). This study suggests post-operative virtual health coaching can enhance weight loss outcomes after sleeve gastrectomy. Further research is needed to assess the long-term effects and cost-effectiveness of such a form of coaching for bariatric surgery patients. Full article

(This article belongs to the Special Issue Telehealth and Remote Patient Monitoring)

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12 pages, 1348 KiB

Open AccessArticle

Evaluation of the “15 Minute Challenge”: A Workplace Health and Wellbeing Program

by Ben Singh, Ty Ferguson, Artem Deev, Anton Deev and Carol A. Maher

Healthcare 2024, 12(13), 1255; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131255 - 24 Jun 2024

Viewed by 252

Abstract

The 15 Minute Challenge is an mHealth workplace wellness initiative, employing gamification to promote physical activity, aiming to enhance health outcomes and overall well-being. This retrospective cohort study evaluated the effectiveness of the program among employees at various Australian, New Zealand, and UK [...] Read more.

The 15 Minute Challenge is an mHealth workplace wellness initiative, employing gamification to promote physical activity, aiming to enhance health outcomes and overall well-being. This retrospective cohort study evaluated the effectiveness of the program among employees at various Australian, New Zealand, and UK workplaces. Real-world data from 11,575 participants across 73 companies were analyzed. The program encouraged daily 15 min physical activity sessions over six weeks. Participants self-reported their physical activity and fitness, energy, overall health, sleep quality, and mood at baseline and 6 weeks. Program satisfaction, engagement rates, and adherence to the program were also assessed. Effectiveness was evaluated using multi-level mixed-effects linear regression analyses. The intervention showed significant increases in physical activity, with 95% of participants meeting or exceeding international physical activity guidelines, up from 57% at baseline (p < 0.05). Self-reported fitness, energy, overall health, sleep quality, and mood significantly improved (between 7.1 and 14.0% improvement; all p < 0.05). High satisfaction was reported, with 92% of participants recommending the program. The 15 Minute Challenge effectively increased physical activity levels and improved self-reported health outcomes among participating employees. The high satisfaction rates and significant health improvements highlight the potential of workplace wellness programs to combat sedentary behavior and promote a healthier, more active lifestyle. Full article

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37 pages, 3781 KiB

Open AccessReview

The Biomechanics of Musculoskeletal Tissues during Activities of Daily Living: Dynamic Assessment Using Quantitative Transmission-Mode Ultrasound Techniques

by Scott C. Wearing, Sue L. Hooper, Christian M. Langton, Michael Keiner, Thomas Horstmann, Nathalie Crevier-Denoix and Philippe Pourcelot

Healthcare 2024, 12(13), 1254; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131254 - 24 Jun 2024

Viewed by 187

Abstract

The measurement of musculoskeletal tissue properties and loading patterns during physical activity is important for understanding the adaptation mechanisms of tissues such as bone, tendon, and muscle tissues, particularly with injury and repair. Although the properties and loading of these connective tissues have [...] Read more.

The measurement of musculoskeletal tissue properties and loading patterns during physical activity is important for understanding the adaptation mechanisms of tissues such as bone, tendon, and muscle tissues, particularly with injury and repair. Although the properties and loading of these connective tissues have been quantified using direct measurement techniques, these methods are highly invasive and often prevent or interfere with normal activity patterns. Indirect biomechanical methods, such as estimates based on electromyography, ultrasound, and inverse dynamics, are used more widely but are known to yield different parameter values than direct measurements. Through a series of literature searches of electronic databases, including Pubmed, Embase, Web of Science, and IEEE Explore, this paper reviews current methods used for the in vivo measurement of human musculoskeletal tissue and describes the operating principals, application, and emerging research findings gained from the use of quantitative transmission-mode ultrasound measurement techniques to non-invasively characterize human bone, tendon, and muscle properties at rest and during activities of daily living. In contrast to standard ultrasound imaging approaches, these techniques assess the interaction between ultrasound compression waves and connective tissues to provide quantifiable parameters associated with the structure, instantaneous elastic modulus, and density of tissues. By taking advantage of the physical relationship between the axial velocity of ultrasound compression waves and the instantaneous modulus of the propagation material, these techniques can also be used to estimate the in vivo loading environment of relatively superficial soft connective tissues during sports and activities of daily living. This paper highlights key findings from clinical studies in which quantitative transmission-mode ultrasound has been used to measure the properties and loading of bone, tendon, and muscle tissue during common physical activities in healthy and pathological populations. Full article

(This article belongs to the Special Issue Biomechanics and Motor Control of Gait and Postural Control)

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19 pages, 1626 KiB

Open AccessArticle

Use of Smart Glasses (Assisted Reality) for Western Australian X-ray Operators’ Continuing Professional Development: A Pilot Study

by Curtise K. C. Ng, Moira Baldock and Steven Newman

Healthcare 2024, 12(13), 1253; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131253 - 24 Jun 2024

Viewed by 247

Abstract

Previous studies have explored use of smart glasses in telemedicine, but no study has investigated its use in teleradiography. The purpose of this study was to implement a six-month pilot program for Western Australian X-ray operators (XROs) to use smart glasses to obtain [...] Read more.

Previous studies have explored use of smart glasses in telemedicine, but no study has investigated its use in teleradiography. The purpose of this study was to implement a six-month pilot program for Western Australian X-ray operators (XROs) to use smart glasses to obtain assisted reality support in their radiography practice from their supervising radiographers, and evaluate its effectiveness in terms of XROs’ competence improvement and equipment usability. Pretest–posttest design with evaluation of the XROs’ competence (including their X-ray image quality) and smart glasses usability by XROs in two remote centers and their supervising radiographers from two sites before and after the program using four questionnaire sets and X-ray image quality review was employed in this experimental study. Paired t-test was used for comparing mean values of the pre- and post-intervention pairs of 11-point scale questionnaire and image quality review items to determine any XROs’ radiography competence improvements. Content analysis was used to analyze open questions about the equipment usability. Our study’s findings based on 13 participants (11 XROs and 2 supervising radiographers) and 2053 X-ray images show that the assisted reality support helped to improve the XROs’ radiography competence (specifically X-ray image quality), with mean post-intervention competence values of 6.16–7.39 (out of 10) and statistical significances (p < 0.001–0.05), and the equipment was considered effective for this purpose but not easy to use. Full article

(This article belongs to the Special Issue Virtual Reality Technologies in Health Care)

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15 pages, 247 KiB

Open AccessArticle

Navigating Cultural Challenges in Transplant Surgery: Insights from Turkish Surgeons

by Hicran Karataş and Şener Balas

Healthcare 2024, 12(13), 1252; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131252 - 24 Jun 2024

Viewed by 226

Abstract

To achieve expertise, transplant surgeons in Turkiye undergo rigorous training, including medical school, residency, compulsory service, and extensive training in transplant surgery. Despite their high academic and clinical knowledge level, success in transplant surgery heavily depends on cultural competency. Through semi-structured interviews with [...] Read more.

To achieve expertise, transplant surgeons in Turkiye undergo rigorous training, including medical school, residency, compulsory service, and extensive training in transplant surgery. Despite their high academic and clinical knowledge level, success in transplant surgery heavily depends on cultural competency. Through semi-structured interviews with 21 transplant surgeons specializing in kidney and liver transplants in Ankara, this study reveals how health illiteracy, culture, and folklore create significant barriers. Surgeons navigate these challenges while enduring harsh working conditions. This research highlights the critical role of cultural competency in transplant surgery, emphasizing the necessity for surgeons to understand and address the diverse cultural needs of their patients. Key findings indicate that surgeons must balance medical expertise with cultural sensitivity to deliver effective care. This study identifies four main cultural barriers: spiritual trust, family politics, health illiteracy, and subcultural incompetency. Effective transplant surgery requires a combination of theoretical proficiency and cultural awareness to meet a patient’s needs and improve surgical outcomes. Full article

(This article belongs to the Topic Communications Challenges in Health and Well-Being)

10 pages, 4868 KiB

Open AccessArticle

Evaluating Accuracy of Rectal Fecal Stool Assessment Using Transgluteal Cleft Approach Ultrasonography

by Yumi Sano, Masaru Matsumoto, Kazuhiro Akiyama, Katsumi Urata, Natsuki Matsuzaka, Nao Tamai, Yuka Miura and Hiromi Sanada

Healthcare 2024, 12(13), 1251; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12131251 - 24 Jun 2024

Viewed by 218

Abstract

Background: Transabdominal ultrasound is used to detect fecal impaction, but the rectum is difficult to visualize without bladder urine or with gastrointestinal gas. Objective: We developed a transgluteal cleft approach that is unaffected by these factors and sought to determine if our ultrasound [...] Read more.

Background: Transabdominal ultrasound is used to detect fecal impaction, but the rectum is difficult to visualize without bladder urine or with gastrointestinal gas. Objective: We developed a transgluteal cleft approach that is unaffected by these factors and sought to determine if our ultrasound method could detect and classify fecal matter in the lower rectum using this approach. Methods: We classified ultrasound images from hospitalized patients into four groups: Group 1 (bowed and rock-like echogenic areas), Group 2 (irregular and cotton candy-like hyperechoic areas), Group 3 (flat and mousse-like hyperechoic areas), and Group 4 (linear echogenic areas in the lumen). Stool characteristics were classified as hard, normal, and muddy/watery. Sensitivity and specificity were determined based on fecal impaction and stool classification accuracy. Results: We obtained 129 ultrasound images of 23 patients. The sensitivity and specificity for fecal retention in the rectum were both 100.0%. The recall rates were 71.8% for Group 1, 93.1% for Group 2, 100.0% for Group 3, and 100.0% for Group 4. The precision rates were 96.6% for Group 1, 71.1% for Group 2, 88.9% for Group 3, and 100.0% for Group 4. Our method was 89.9% accurate overall. Conclusion: Transgluteal cleft approach ultrasound scanning can detect and classify fecal properties with high accuracy. Full article

(This article belongs to the Topic The Use of New Technologies for Health and Clinical Practice)

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