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Healthcare, Volume 9, Issue 5 (May 2021) – 129 articles

Cover Story (view full-size image): SHORT INTRODUCTION: Running is one of the most popular sports worldwide and a way to stay in health. However, the literature data report that most recreational runners have at least one running-related Injury each year. Indeed, the repetitive loads given by running can cause multiple concomitant injuries, such as Low Back Pain, and often it is not easy to correctly frame each one in the differential diagnosis process of possible concurrent diseases. Since Haglund’s syndrome is a painful musculoskeletal condition caused by an exostosis of the posterior superior part of the calcaneus, coupled with Achilles tendinopathy and retrocalcaneal bursitis, its diagnosis is a challenge for physical therapist in direct access settings. Therefore, this case report highlights the central role of PTs working in direct access environments that are able to properly manage and refer patients beyond their [...] Read more.
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Article
Connective Tissue Disease-Associated Pulmonary Arterial Hypertension in Southern Taiwan: A Single-Center 10-Year Longitudinal Observation Cohort
Healthcare 2021, 9(5), 615; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050615 - 20 May 2021
Viewed by 521
Abstract
Background: Pulmonary arterial hypertension (PAH) is a life-threatening disease with different etiologies and outcomes. We aimed to explore differences in clinical features and outcomes of idiopathic PAH (iPAH) and connective tissue disease-related PAH (CTD-PAH) in Taiwanese patients and determine risk factors for [...] Read more.
Background: Pulmonary arterial hypertension (PAH) is a life-threatening disease with different etiologies and outcomes. We aimed to explore differences in clinical features and outcomes of idiopathic PAH (iPAH) and connective tissue disease-related PAH (CTD-PAH) in Taiwanese patients and determine risk factors for mortality. Methods: We retrospectively reviewed the medical records of patients with right-sided heart catheterization-diagnosed PAH between January 2005 and December 2015. The iPAH (n = 31) and CTD-PAH (n = 14) patients were enrolled and followed until December 31, 2019. Between-group comparisons were conducted. Potential predictors of the mortality of PAH were determined using the Cox proportional hazard regression model. Results: CTD-PAH patients had higher levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower predicted diffusing capacity of carbon monoxide (DLCO) than iPAH patients. The mortality rates were similar between CTD-PAH and iPAH (21.4% vs. 22.6%, p = 0.99). A mean pulmonary arterial pressure (mPAP) > 46 mmHg was a predictor of PAH-induced mortality (adjusted hazard ratio 21.8, 95% confidence interval 2.32–204.8). Conclusions: A higher mPAP level, but not underlying CTDs, imposed a significantly increased risk of mortality to patients with PAH. Full article
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Article
Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial
Healthcare 2021, 9(5), 614; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050614 - 20 May 2021
Viewed by 440
Abstract
Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function [...] Read more.
Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function in stroke patients. The aim of the current study was to determine the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) acupoints on cortical activity and the motor function of the affected UE in chronic stroke patients. Forty male and female patients diagnosed with stroke agreed to join the study. They were randomly assigned to group 1 (G1) and group 2 (G2). G1 received task-specific training (TST) and sham electrical stimulation while G2 received TST in addition to TENS acupoints. Session duration was 80 min. Both groups received 18 sessions for 6 successive weeks, 3 sessions per week. Evaluation was carried out before and after completion of the treatment program. Outcome measures used were the Fugl-Meyer Assessment of the upper extremity (FMA-UE) and the box and block test (BBT) as measures of the motor function of the affected UE. Brain activity of the motor area (C3) in the ipsilesional hemisphere was measured using a quantitative electroencephalogram (QEEG). The measured parameter was peak frequency. It was noted that the motor function of the affected UE improved significantly post-treatment in both groups, while no significant change was reported in the FMA-UE and BBT scores post-treatment in either G1 or G2. On the other hand, the activity of the motor area C3 improved significantly in G2 only, post-treatment, while G1 showed no significant improvement. There was also significant improvement in the activity of the motor area (C3) in G2 compared to G1 post-treatment. The results of the current study indicate that TST only or combined with TENS acupoints can be considered an effective method for improving motor function of the affected UE in chronic stroke patients, both being equally effective. However, TST combined with TENS acupoints proved better in improving brain plasticity in chronic stroke patients. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Analysis of General Practitioners’ Attitudes and Beliefs about Psychological Intervention and the Medicine-Psychology Relationship in Primary Care: Toward a New Comprehensive Approach to Primary Health Care
Healthcare 2021, 9(5), 613; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050613 - 19 May 2021
Viewed by 474
Abstract
The biopsychosocial paradigm is a model of care that has been proposed in order to improve the effectiveness of health care by promoting collaboration between different professions and disciplines. However, its application still faces several issues. A quantitative-qualitative survey was conducted on a [...] Read more.
The biopsychosocial paradigm is a model of care that has been proposed in order to improve the effectiveness of health care by promoting collaboration between different professions and disciplines. However, its application still faces several issues. A quantitative-qualitative survey was conducted on a sample of general practitioners (GPs) from Milan, Italy, to investigate their attitudes and beliefs regarding the role of the psychologist, the approach adopted to manage psychological diseases, and their experiences of collaboration with psychologists. The results show a partial view of the psychologist’s profession that limits the potential of integration between medicine and psychology in primary care. GPs recognized that many patients (66%) would often benefit from psychological intervention, but only in a few cases (9%) were these patients regularly referred to a psychologist. Furthermore, the referral represents an almost exclusive form of collaboration present in the opinions of GPs. Only 8% of GPs would consider the joint and integrated work of the psychologist and doctor useful within the primary health care setting. This vision of the role of psychologists among GPs represents a constraint in implementing a comprehensive primary health care approach, as advocated by the World Health Organization. Full article
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Review
Burden of Treatment among Elderly Patients with Cancer: A Scoping Review
Healthcare 2021, 9(5), 612; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050612 - 19 May 2021
Viewed by 447
Abstract
Background: The objective of this scoping review is to understand how treatment burden is experienced in elderly patients with cancer and what the most prevalent dimensions of treatment burden are among this population. According to one conceptual model, there are six dimensions of [...] Read more.
Background: The objective of this scoping review is to understand how treatment burden is experienced in elderly patients with cancer and what the most prevalent dimensions of treatment burden are among this population. According to one conceptual model, there are six dimensions of treatment burden, including financial, medication, administrative, time/travel, lifestyle, and healthcare. Methods: A scoping review methodology framework was used to collected data from EMBASE CINAHL (Cumulative Index to Nursing and Allied Health Literature), Medline/PubMed, Scopus, Web of Science, Embase, and Cochrane from 2000 to March 2020. Studies which focused on treatment burden among elderly patients with cancer (+65 years) were selected. Data were extracted using a standardized proforma. Results: The results identified 3319 total papers. Of these, 24 met the inclusion criteria and were included in the scoping review. A significant proportion of these studies was conducted in the United States (n = 10) using self-reported, cross-sectional data. Financial burden was the most prevalent dimension of treatment burden, with 11 studies focusing on the direct and indirect costs associated with cancer treatment. Other but less obvious aspects of treatment burden elderly patients experienced included the length of time taken to access and administer treatment and medication-related burdens. Conclusions: Emerging findings suggest that the financial aspects of cancer treatment are a significant burden for most elderly cancer patients. Personalized healthcare interventions targeting ways to reduce and screen for treatment burden, particularly those related to cost, are urgently needed. Full article
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Review
Prevention and Treatment of Phlebitis Secondary to the Insertion of a Peripheral Venous Catheter: A Scoping Review from a Nursing Perspective
Healthcare 2021, 9(5), 611; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050611 - 19 May 2021
Viewed by 626
Abstract
The objective of this work was to identify available evidence on nursing interventions for the prevention and treatment of phlebitis secondary to the insertion of a peripheral venous catheter. For this, a scoping systematic review was carried out following the guidelines in the [...] Read more.
The objective of this work was to identify available evidence on nursing interventions for the prevention and treatment of phlebitis secondary to the insertion of a peripheral venous catheter. For this, a scoping systematic review was carried out following the guidelines in the PRISMA declaration of documents published between January 2015 and December 2020. The search took place between December 2020 and January 2021. Scielo, Pubmed, Medline, Scopus, WOS, CINHAL, LILACS, and Dialnet databases were consulted, and CASPe, AGREE, and HICPAC tools were used for the critical reading. A total of 52 studies were included to analyze nursing interventions for treatment and prevention. Nursing interventions to prevent phlebitis and ensure a proper catheter use included those related to the maintenance of intravenous therapy, asepsis, and choosing the dressing. With regard to the nursing interventions to treat phlebitis, these were focused on vigilance and caring and also on the use of medical treatment protocols. For the prevention of phlebitis, the highest rated evidence regarding asepsis include the topical use of >0.5% chlorhexidine preparation with 70% alcohol or 2% aqueous chlorhexidine, a proper hygienic hand washing, and the use clean gloves to handle connections and devices. Actions that promote the efficacy and safety of intravenous therapy include maintenance of venous access, infusion volume control, verification of signs of phlebitis during saline solution and medication administration, and constant monitoring. It is recommended to remove any catheter that is not essential. Once discharged from hospital, it will be necessary to warn the patient about signs of phlebitis after PVC removal. Full article
(This article belongs to the Section Nursing)
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Article
Development and Evaluation of Psychometric Properties Regarding the Whole Person Health Scale for Employees of Hospital to Emphasize the Importance of Health Awareness of the Workers in the Hospital
Healthcare 2021, 9(5), 610; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050610 - 19 May 2021
Viewed by 382
Abstract
(1) Background: Whole person health (WPH) is important among employees in hospitals. It will affect their performance and attitude toward patient care and organization. This project was designed to develop and assess the validity and reliability of utilizing the Whole Person Health Scale [...] Read more.
(1) Background: Whole person health (WPH) is important among employees in hospitals. It will affect their performance and attitude toward patient care and organization. This project was designed to develop and assess the validity and reliability of utilizing the Whole Person Health Scale for Employees of a Hospital (WPHS-EH) to determine overall employee health. (2) Methods: A mixed-methods focus group and cross-sectional survey was adopted. Employees held six focus groups, with 62 employees from different departments in medical center in Taiwan. After analyzing the interview content, five experts tested its validity, and the 14-item WPHS-EH scale was analyzed. This was followed by an additional 900 participants questionnaire survey, response rate: 94.9%. Descriptive statistics, Cronbach’s alpha, exploratory factor analysis (EFA), and items analysis were used. Additionally, the scale was implemented to conducted confirmatory factor analysis (CFA) test for validity. (3) Results: Three dimensions were extracted from the questionnaires by EFA: “hospital circumstance and system”, “professional and interpersonal interaction” and “workload and harm”. The Cronbach’s alpha of the WPHS-EH scale was 0.82, while the three sub-dimensions were all significantly correlated with total scores. CFA confirmed the scale construct validity, with a good model fit. (4) Conclusions: The WPHS-EH is a reliable measurement tool to assess the effects of hospitals’ Whole Person Health among employees. The intent of the WPHS-EH was to provide a reliable scale to analyze the work environment for hospital staff and useful information to healthcare administrators interested in improving the staff’s whole person health. Full article
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Review
Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review
Healthcare 2021, 9(5), 609; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050609 - 19 May 2021
Viewed by 444
Abstract
Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on [...] Read more.
Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010–2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings. Full article
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Article
Development of the Readiness for Home-Based Palliative Care Scale (RHBPCS) for Primary Family Caregivers
Healthcare 2021, 9(5), 608; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050608 - 19 May 2021
Viewed by 451
Abstract
In Chinese or Eastern society, most end-of-life (EOL) patients still choose to die at home. However, primary family caregivers usually do not prepare themselves to face the death of patients. Therefore, a measurement of the readiness for home-based palliative care for primary family [...] Read more.
In Chinese or Eastern society, most end-of-life (EOL) patients still choose to die at home. However, primary family caregivers usually do not prepare themselves to face the death of patients. Therefore, a measurement of the readiness for home-based palliative care for primary family caregivers is needed. In this study, the readiness for home-based palliative care scale (RHBPCS) for primary family caregivers was developed to assess the readiness of primary family caregivers. This study recruited 103 participants from five branches of one municipal hospital system. The reliability and validity of the RHBPCS was evaluated using expert validity examination, confirmatory factor analysis (CFA), and item analysis. The results showed that the RHBPCS had strong goodness-of-fit and good reliability and validity. In summary, the RHBPCS is suggested for assessing the readiness for home-based palliative care of primary family caregivers. Full article
(This article belongs to the Section Health Assessments)
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Article
Relationship between Emotional Intelligence, Sleep Quality and Body Mass Index in Emergency Nurses
Healthcare 2021, 9(5), 607; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050607 - 18 May 2021
Viewed by 481
Abstract
Nurses have long working hours with high psychological burdens. In addition, in the emergency department, nurses are required to quickly adapt emotionally. The aim of this study was to describe and relate emotional intelligence (EI) skills of emergency nurses, their body mass index [...] Read more.
Nurses have long working hours with high psychological burdens. In addition, in the emergency department, nurses are required to quickly adapt emotionally. The aim of this study was to describe and relate emotional intelligence (EI) skills of emergency nurses, their body mass index (BMI) and sleep quality. For this purpose, a cross-sectional was carried out in which the perceived emotional intelligence test and the Pittsburgh sleep quality index were applied. Sixty-two emergency nurses (48 women and 14 men) participated. The results indicated that the majority of them present adequate levels of EI, with no differences by gender. Younger nurses showed a better ability to feel, express and understand emotional states than the older ones, while the ability to regulate emotional states occurred in the opposite way. Nurses who have been working for several years showed a better ability to regulate emotions than those with less experience. Those who were overweight grade II and obese type I expressed their feelings better, also the regulation of emotional states decreased as weight increased. Finally, it has been observed that the quality of sleep of emergency nurses is significantly altered, and that this lack of sleep may affect their ability to process emotions. Full article
(This article belongs to the Special Issue Healthcare Strategy and Community Care)
Article
Comparison of Knee and Hip Kinematics during Landing and Cutting between Elite Male Football and Futsal Players
Healthcare 2021, 9(5), 606; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050606 - 18 May 2021
Viewed by 577
Abstract
To design an accurate sport injury prevention program, alterations in the knee and hip kinematic variables involved in injury mechanisms should be known. The main purpose of the current study was to compare knee and hip kinematic variables during landing and cutting among [...] Read more.
To design an accurate sport injury prevention program, alterations in the knee and hip kinematic variables involved in injury mechanisms should be known. The main purpose of the current study was to compare knee and hip kinematic variables during landing and cutting among male football and futsal players, and to discuss them within an injury description frame. Twenty football (20.5 ± 2.1 years., 74.5 ± 6.9 kg and 1.79 ± 0.07 m) and twenty futsal players (20.3 ± 2.0 years., 73.5 ± 7.1 kg and 1.78 ± 0.07 m), with at least three years’ experience of playing in the Kerman Province League, participated in this study. Hip flexion, knee flexion and knee valgus angle during two main movements with risk of injury, such as landing and cutting, were measured using a motion capture system with passive markers at 120-Hz sampling frequency. Landing and cutting maneuvers were administered in as natural way as possible. Results showed significant differences in landing and cutting maneuvers between groups in hip flexion, knee flexion and knee valgus angle. Results indicated that footballers have less extension of hip and knee joints than futsal players in landing maneuvers, which may be due to the higher requirement of jumping−landing maneuvers when playing football. In cutting maneuvers, footballers showed less hip and knee flexion than futsal players, whereas the knee valgus angle in cutting maneuvers was lower in futsal players. More information on the injury mechanisms of landing and cutting in football and futsal are needed to improve the design of injury prevention programs. Full article
(This article belongs to the Special Issue Sport and Exercise Medicine)
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Article
Risk of Dry Eye Syndrome in Patients with Orbital Fracture: A Nationwide Population-Based Cohort Study
Healthcare 2021, 9(5), 605; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050605 - 18 May 2021
Viewed by 433
Abstract
This study aimed to investigate whether orbital fracture increases the risk of dry eye syndrome (DES) and identified the profile of prognostic factors. We studied a cohort from the Taiwan National Health Insurance Research Database (NHIRD). Overall, 46,179 and 184,716 participants were enrolled [...] Read more.
This study aimed to investigate whether orbital fracture increases the risk of dry eye syndrome (DES) and identified the profile of prognostic factors. We studied a cohort from the Taiwan National Health Insurance Research Database (NHIRD). Overall, 46,179 and 184,716 participants were enrolled in the study and control groups, respectively. Each patient in the case group was age- and gender-matched to four individuals without orbital fracture that served as the control group. Cox proportional hazards analysis regression was used to estimate the risks of incident DES. During the follow-up period, the case group was more likely to develop incident DES (0.17%) than the control group (0.11%) (p = 0.001). Multivariate Cox regression analysis demonstrated that the case group had a 4.917-fold increased risk of DES compared to the controls. In the stratified age group, orbital fracture had the highest impact on patients aged 18–29 years. Furthermore, patients with orbital roof fracture have a greater risk of developing DES. Regardless of whether having received surgery or not, the patients with orbital fracture have higher risks of DES. Our study demonstrated that orbital fracture increases the risk of developing subsequent DES. Early recognition by thorough examinations with raised awareness in the clinical setting could preserve visual function and prevent further complications. Full article
(This article belongs to the Special Issue Neuroprotective Strategies for Dry Eye Disease)
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Article
Exploring Health Outcomes for U.S. Veterans Compared to Non-Veterans from 2003 to 2019
Healthcare 2021, 9(5), 604; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050604 - 18 May 2021
Viewed by 916
Abstract
The physical demands on U.S. service members have increased significantly over the past several decades as the number of military operations requiring overseas deployment have expanded in frequency, duration, and intensity. These elevated demands from military operations placed upon a small subset of [...] Read more.
The physical demands on U.S. service members have increased significantly over the past several decades as the number of military operations requiring overseas deployment have expanded in frequency, duration, and intensity. These elevated demands from military operations placed upon a small subset of the population may be resulting in a group of individuals more at-risk for a variety of debilitating health conditions. To better understand how the U.S Veterans health outcomes compared to non-Veterans, this study utilized the U.S. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) dataset to examine 10 different self-reported morbidities. Yearly age-adjusted, population estimates from 2003 to 2019 were used for Veteran vs. non-Veteran. Complex weights were used to evaluate the panel series for each morbidity overweight/obesity, heart disease, stroke, skin cancer, cancer, COPD, arthritis, mental health, kidney disease, and diabetes. General linear models (GLM’s) were created using 2019 data only to investigate any possible explanatory variables associated with these morbidities. The time series analysis showed that Veterans have disproportionately higher self-reported rates of each morbidity with the exception of mental health issues and heart disease. The GLM showed that when taking into account all the variables, Veterans disproportionately self-reported a higher amount of every morbidity with the exception of mental health. These data present an overall poor state of the health of the average U.S. Veteran. Our study findings suggest that when taken as a whole, these morbidities among Veterans could prompt the U.S. Department of Veteran Affairs (VA) to help develop more effective health interventions aimed at improving the overall health of the Veterans. Full article
(This article belongs to the Section Medics)
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Review
Phthalates and Their Impacts on Human Health
Healthcare 2021, 9(5), 603; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050603 - 18 May 2021
Viewed by 464
Abstract
Phthalates are a series of widely used chemicals that demonstrate to be endocrine disruptors and are detrimental to human health. Phthalates can be found in most products that have contact with plastics during producing, packaging, or delivering. Despite the short half-lives in tissues, [...] Read more.
Phthalates are a series of widely used chemicals that demonstrate to be endocrine disruptors and are detrimental to human health. Phthalates can be found in most products that have contact with plastics during producing, packaging, or delivering. Despite the short half-lives in tissues, chronic exposure to phthalates will adversely influence the endocrine system and functioning of multiple organs, which has negative long-term impacts on the success of pregnancy, child growth and development, and reproductive systems in both young children and adolescents. Several countries have established restrictions and regulations on some types of phthalates; however, we think that more countries should establish constraints or substitute measures for phthalates to reduce health risks. This article aims to summarize the adverse impacts of phthalates on human health, analyze the toxicity mechanism, assess the risks, and finally provide feasible strategies to reduce exposure of the public to phthalates. Full article
(This article belongs to the Section Environmental Factors and Global Health)
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Article
Factors beyond Workplace Matter: The Effect of Family Support and Religious Attendance on Sustaining Well-Being of High-Technology Employees
Healthcare 2021, 9(5), 602; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050602 - 18 May 2021
Viewed by 359
Abstract
Background: Apart from the workplace, drawing support from family and religion is critical to maintaining the well-being of high-technology employees. Relying on the job demands-resources model and the positive affective spillover effect, the aim of this study was to investigate the mediated relationship [...] Read more.
Background: Apart from the workplace, drawing support from family and religion is critical to maintaining the well-being of high-technology employees. Relying on the job demands-resources model and the positive affective spillover effect, the aim of this study was to investigate the mediated relationship of family support, work engagement and subjective well-being, and the moderating effect of religious attendance on the mediated relationship. Methods: A cross-sectional research design was adopted. Mediation and moderated mediation were tested using the PROCESS macro v3.5 for the SPSS supplement. Purposive sampling was used for the distribution of questionnaires to high-technology employees in Taiwan. Results: Results from the data of 603 high-technology employees indicated that family support, work engagement, and subjective well-being exhibited a significant mediated relationship, and the mediated relationship was stronger among individuals with religious attendance experience. Conclusions: This study emphasizes the driving effect of family support on high-technology employee well-being and the moderating effect of religious attendance as a situational strength. We recommend closely attending to employee well-being because doing so is conducive to both the personal quality of life of employees and the sustainable development of organizations. Full article
(This article belongs to the Special Issue Psycho-Social Factors of Workplace Health and Safety)
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Case Report
Diagnosis of Synovial Chondromatosis of Temporomandibular Joint: Case Report and Literature Review
Healthcare 2021, 9(5), 601; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050601 - 18 May 2021
Viewed by 360
Abstract
Synovial chondromatosis is a non-cancerous tumor characterized by the formation of multiple nodules of cartilage due to metaplastic development of the synovial membrane. Etiology can be a primary lesion, of which pathogenesis remains unknown, or low-grade trauma or internal disorders. This pathology can [...] Read more.
Synovial chondromatosis is a non-cancerous tumor characterized by the formation of multiple nodules of cartilage due to metaplastic development of the synovial membrane. Etiology can be a primary lesion, of which pathogenesis remains unknown, or low-grade trauma or internal disorders. This pathology can long remain undiagnosed and leads to therapeutic wandering, especially since clinical manifestations are non-specific. Symptoms may mimic temporomandibular disorders and dental orthopantomogram does not always show intra-articular calcified bodies. Cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) are tests of choice for the diagnosis of this pathology. This case report describes the clinical manifestations, diagnosis and management of a case of synovial chondromatosis involving the temporomandibular joint, in a 21-year-old woman who was initially treated for two years for a common temporo-mandibular disorder. The evidence gathered during the medical interview and clinical examination led us to suspect synovial chondromatosis of the temporomandibular joint. Prescription of a CBCT and MRI confirmed the diagnosis of her temporomandibular joint disorder and led to a successful arthroplasty. Full article
(This article belongs to the Section Chronic Care)
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Study Protocol
Benefits of Structured Engagement with Target Audiences of a Health Website: Study Design for a Multi-Case Study
Healthcare 2021, 9(5), 600; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050600 - 18 May 2021
Viewed by 627
Abstract
Access to evidence and practice knowledge precedes use, but availability does not guarantee reach and uptake by intended audiences. The CareSearch project provides online palliative care evidence and information to support health and aged care professionals as well as patients, carers and families [...] Read more.
Access to evidence and practice knowledge precedes use, but availability does not guarantee reach and uptake by intended audiences. The CareSearch project provides online palliative care evidence and information to support health and aged care professionals as well as patients, carers and families to make informed decisions about care at the end of life. Already established in the palliative care sector, CareSearch commenced planning to extend its reach, and ensure website use is maximised for different audiences. This paper reports on the development of the Engagement Framework which will be used to guide and deliver an Engagement Project which will actively seek feedback and insights from intended users in a structured process. The process for developing the Engagement Framework commenced with a literature review of approaches used in knowledge translation, implementation science, and social marketing. The Engagement Framework comprising eight steps was then developed. The Engagement Framework outlines the series of tasks to be undertaken by team members when working with three target groups (Aged Care; Allied Health; and Patients, Carers and Families). A process/formative evaluation collecting data using qualitative methods is also described for use in the subsequent Engagement Project. The evaluation will explore the experiences of project participants as well as staff implementing the engagement activities. The three target groups will enable a cross-case comparison of the strengths and weaknesses of the approach. Planning, implementing and evaluating engagement with intended audiences, offers one mechanism to identify ways to increase interaction and integration with knowledge users. Full article
(This article belongs to the Section TeleHealth and Digital Healthcare)
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Article
Plantar Pressure Variations Induced by Experimental Malocclusion—A Pilot Case Series Study
Healthcare 2021, 9(5), 599; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050599 - 18 May 2021
Viewed by 319
Abstract
Background: All body systems involved in ensuring a healthy posture (musculoskeletal system, oculomotor, oto-vestibular and occluso-cranial-mandibular) are essential in maintaining postural balance. Research Question: Does experimental malocclusion in subjects in static position determine variations in plantar pressure? Methods: Overall, 31 subjects were included [...] Read more.
Background: All body systems involved in ensuring a healthy posture (musculoskeletal system, oculomotor, oto-vestibular and occluso-cranial-mandibular) are essential in maintaining postural balance. Research Question: Does experimental malocclusion in subjects in static position determine variations in plantar pressure? Methods: Overall, 31 subjects were included in the study. The plantar pressure was evaluated in five different points: lateral and medial heel, midfoot, 1st and 5th metatarsal area. Using a specially designed splint, an artificial malocclusion was induced on the right hemimandibular arch. The pressure was measured at 0 (T0), 15 (T1) and 30 min (T2) after splint application. Results: The right external plantar sensors recorded statistically significant differences in pressure values after 15 min of splint wear (5th metatarsal area, p = 0.05; midfoot, p = 0.04). Important pressure values were also recorded by the left internal plantar sensors (1st metatarsal, p = 0.01; medial heel, p = 0.006), after 30 min of splint wear. Conclusions: Asymmetrical experimental malocclusion produces early changes in plantar pressure, a proof of compensatory mechanisms induced by secondary postural imbalance. Full article
(This article belongs to the Collection Healthcare in Dentistry)
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Article
Short-Term Learning Effects of a Cardiopulmonary Resuscitation Program with Focus on the Relationship between Learning Effect and Trainees’ Perceived Competence
Healthcare 2021, 9(5), 598; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050598 - 18 May 2021
Viewed by 360
Abstract
High-quality education and training are essential for effectively improving the quality of cardiopulmonary resuscitation (CPR); however, the relationship between the acquisition of motor skills and learners’ psychological characteristic has not been investigated fully. Therefore, we investigated the relationship between intrinsic motivation for training, [...] Read more.
High-quality education and training are essential for effectively improving the quality of cardiopulmonary resuscitation (CPR); however, the relationship between the acquisition of motor skills and learners’ psychological characteristic has not been investigated fully. Therefore, we investigated the relationship between intrinsic motivation for training, self-efficacy for CPR, and CPR skill acquisition through training. Twenty health sciences undergraduate students participated in a 3-hour basic life support course. Their chest compression skills were assessed before and after the course. The main outcome of this study was the chest compression score, with changes in the score from pretest to posttest regarded as the short-term learning effects from training. The chest compression score was significantly higher after the course (median 53.5%, interquartile range [IQR] 39.8–83.0) than before the course (median 14.0%, IQR 0–43.3, p < 0.001). Furthermore, we found a significant correlation between perceived competence after the training and changes in the chest compression score from pretest to posttest (r = 0.483, p = 0.031), but other psychological indices did not correlate with changes in the chest compression score. A significant correlation was noted between trainees’ perceived competency and the short-term learning effects of CPR training. We suggest instructors focus on psychological components of training, including trainees’ perceived competence. Full article
(This article belongs to the Section Prehospital Care)
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Review
Possible Mechanisms for the Effects of Sound Vibration on Human Health
Healthcare 2021, 9(5), 597; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050597 - 18 May 2021
Viewed by 704
Abstract
This paper presents a narrative review of research literature to “map the landscape” of the mechanisms of the effect of sound vibration on humans including the physiological, neurological, and biochemical. It begins by narrowing music to sound and sound to vibration. The focus [...] Read more.
This paper presents a narrative review of research literature to “map the landscape” of the mechanisms of the effect of sound vibration on humans including the physiological, neurological, and biochemical. It begins by narrowing music to sound and sound to vibration. The focus is on low frequency sound (up to 250 Hz) including infrasound (1–16 Hz). Types of application are described and include whole body vibration, vibroacoustics, and focal applications of vibration. Literature on mechanisms of response to vibration is categorized into hemodynamic, neurological, and musculoskeletal. Basic mechanisms of hemodynamic effects including stimulation of endothelial cells and vibropercussion; of neurological effects including protein kinases activation, nerve stimulation with a specific look at vibratory analgesia, and oscillatory coherence; of musculoskeletal effects including muscle stretch reflex, bone cell progenitor fate, vibration effects on bone ossification and resorption, and anabolic effects on spine and intervertebral discs. In every category research on clinical applications are described. The conclusion points to the complexity of the field of vibrational medicine and calls for specific comparative research on type of vibration delivery, amount of body or surface being stimulated, effect of specific frequencies and intensities to specific mechanisms, and to greater interdisciplinary cooperation and focus. Full article
(This article belongs to the Special Issue The Expanding Scope of Music in Healthcare)
Article
A Validation Study on the Frequency and Natural History of Miscarriages Using the Spanish Primary Care Database BIFAP
Healthcare 2021, 9(5), 596; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050596 - 18 May 2021
Viewed by 411
Abstract
(1) Background: There is a major gap of knowledge towards the natural history of miscarriages in electronic medical records. We aimed to calculate the frequency of miscarriages using data from BIFAP database. (2) Methods: We identified all pregnancy losses and carried out a [...] Read more.
(1) Background: There is a major gap of knowledge towards the natural history of miscarriages in electronic medical records. We aimed to calculate the frequency of miscarriages using data from BIFAP database. (2) Methods: We identified all pregnancy losses and carried out a multistep validation exercise. Potential cases with positive predictive values (PPV) of miscarriage confirmation <85% or those confirming other pregnancy loss were excluded. Kaplan–Meier figures and incidence rates (IRs) of miscarriage with 95% confidence intervals (CIs) expressed by 1000 person-weeks were calculated. Stratifying analysis by age, specific high-risk groups, and drug exposure within the pre-pregnancy period were performed restricted to women with recording last menstrual period (LMP). (3) Results: Women with confirmed miscarriage (N = 18,070), tended to be older, with higher frequency of comorbidities and drug utilization. Restricting to women with LPM recorded, IR of miscarriage was 10.89 (CI 95% 10.68–11.10) per 1000 women-weeks, with a median follow-up of 10 weeks (IQR: 8–12). The IR according to age was: 2.71 (CI 95% 2.59–2.84) in those aged <30 years compared to 9.11 (CI 95% 8.55–9.70) in women aged ≥40 years. Advanced maternal age (Hazard Ratio (HR, 95% confidence interval) CI 95%: 3.34 (3.08–3.62)), use of antihypertensives (1.49 (1.21–1.84), and use of drugs classified as D or X during pregnancy (1.17 (1.07–1.29)) showed to be positive predictors associated with increased risk of miscarriages. (4) Conclusion: BIFAP database can be used to identify women suffering from miscarriages, which will serve to further study risk factors associated with miscarriages with special attention to drug utilization. Full article
(This article belongs to the Special Issue Diagnosis and Treatment for Women's Health)
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Review
Literature Review of the Implications of Exercise Rehabilitation Strategies for SARS Patients on the Recovery of COVID-19 Patients
Healthcare 2021, 9(5), 590; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050590 - 18 May 2021
Viewed by 770
Abstract
As a global pandemic, COVID-19 shows no sign of letting up. With the control of the epidemic in China, the proportion of patients with severe and critical diseases being cured and discharged from hospital has increased, and the recovery of COVID-19 patients has [...] Read more.
As a global pandemic, COVID-19 shows no sign of letting up. With the control of the epidemic in China, the proportion of patients with severe and critical diseases being cured and discharged from hospital has increased, and the recovery of COVID-19 patients has become an important issue that urgently needs attention and solutions. By summarizing the exercise rehabilitation strategies and progress of SARS in 2003, this paper analyzed the differences in clinical indicators and recovery characteristics of severe pneumonia caused by the two viruses, and provided comprehensive exercise guidance and intervention strategies for COVID-19 patients for rehabilitation and nursing by referring to the problems and treatment strategies in the rehabilitation and nursing work of SARS. In the post-epidemic period, China will build a multi-dimensional epidemic prevention system by improving the effectiveness of mass training and strengthening local risk prevention and control. This paper discusses the exercise rehabilitation strategy of SARS patients after recovery, which has guiding significance for exercise intervention and scientific fitness of COVID-19 patients after recovery during epidemic prevention period. Full article
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Article
Chronic Chest Pain Control after Trans-Thoracic Biopsy in Mediastinal Lymphomas
Healthcare 2021, 9(5), 589; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050589 - 18 May 2021
Cited by 1 | Viewed by 368
Abstract
Chest pain following a trans-thoracic biopsy often has multiple etiologies, especially in patients with lymphomas. Pathological neuronal mechanisms integrate with an overproduction of IL-6, TNF-α, IL1-β by macrophages and monocytes, which amplifies inflammation and pain. In consideration of this complex pathogenesis, international guidelines [...] Read more.
Chest pain following a trans-thoracic biopsy often has multiple etiologies, especially in patients with lymphomas. Pathological neuronal mechanisms integrate with an overproduction of IL-6, TNF-α, IL1-β by macrophages and monocytes, which amplifies inflammation and pain. In consideration of this complex pathogenesis, international guidelines recommend diversified analgesia protocols: thoracic epidural, paravertebral block, and systemic administration of opioids. This study reports an attempt to reduce chest pain and prevent chronic pain in 51 patients undergoing trans-thoracic biopsy for mediastinal lymphoma. The entity of pain, measured 72nd hour after biopsy by the Numerical Rating Scale (NRS), was compared with that seen at a 6th month checkpoint in 46 patients. The pain decreased in all cases. At the 6th month checkpoint, among 31 opioid-treated patients, none of the 16 patients with NRS < 6 within the 72nd hour post biopsy had developed chronic chest pain, while 8 of the 15 with higher values did (p < 0.01). Of 10 patients undergoing thoracotomy and treated with opioids, eight had a NRS of no more than 2, of which six had no chronic pain. Of the twenty-one patients who underwent VATS biopsy and were treated with opioids, fifteen had NRS no greater than 2, of which ten had no chronic pain. Subgroups of patients biopsied under mediastinotomy or video-assisted thoracoscopic surgery (VATS) and treated with thoracic epidural analgesia (TEA) or PVB were too small for such analysis. Full article
(This article belongs to the Special Issue Skin Disorders in Hematological Disease)
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Article
Structural Relationship between Physical Self-Concept, Occupational Instability, and Retirement Intention among South Korean Minor League Baseball Players
Healthcare 2021, 9(5), 595; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050595 - 17 May 2021
Viewed by 317
Abstract
This study aimed to verify the structural relationship between physical self-concept, occupational instability, and retirement intention among South Korean minor league baseball players. Snowball sampling was used to recruit 180 minor league players who belonged to the South Korean professional baseball team and [...] Read more.
This study aimed to verify the structural relationship between physical self-concept, occupational instability, and retirement intention among South Korean minor league baseball players. Snowball sampling was used to recruit 180 minor league players who belonged to the South Korean professional baseball team and were active as of December 2020; data were collected through an online survey. Frequency analysis, psychometric validation, descriptive statistical analysis, and path analysis were performed. The results revealed that for these participants, (1) physical self-concept had a significant negative effect on their occupational instability; (2) physical self-concept did not directly affect their retirement intention; and (3) occupational instability had a significant positive effect on their retirement intentions. These results suggest the need to devise a plan addressing the practical difficulties experienced by professional minor league baseball players and improve the physical self-concept of these players to adapt to involuntary retirement. Additionally, a supportive environment should be created to reduce mental health risks. Full article
(This article belongs to the Special Issue Promotion of Health and Exercise)
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Article
Attitude toward Aging Mediates the Relationship between Personality and Mental Health in Older Adults
Healthcare 2021, 9(5), 594; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050594 - 17 May 2021
Viewed by 555
Abstract
This study aimed to examine attitude toward aging as a potential mediator of the relationship between personality factors and mental health in terms of depression and life satisfaction among older adults. A cross-sectional study was conducted with 438 Ethiopian elderly individuals aged 60 [...] Read more.
This study aimed to examine attitude toward aging as a potential mediator of the relationship between personality factors and mental health in terms of depression and life satisfaction among older adults. A cross-sectional study was conducted with 438 Ethiopian elderly individuals aged 60 to 69. The results of the regression-based path analysis showed that after adjusting for demographic data, the relationship between agreeableness and depression in older adults was partially mediated by attitude toward aging. Likewise, attitude toward physical change due to aging and psychological growth subscales jointly mediated the correlation between neuroticism and depression. However, a significant direct path between neuroticism and depression persisted. On the contrary, openness had no significant direct association with depression apart from an indirect through psychosocial loss. The link between life satisfaction and agreeableness as well as openness to experience were partially mediated by psychosocial loss. Therefore, a person’s attitude toward aging and personality characteristics should be taken into consideration while designing interventions for managing mental health issues among older adults. Full article
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Article
The Reciprocal Relationship between Frailty and Depressive Symptoms among Older Adults in Rural China: A Cross-Lag Analysis
Healthcare 2021, 9(5), 593; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050593 - 17 May 2021
Viewed by 360
Abstract
(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, [...] Read more.
(1) Objective: This study aimed to investigate the reciprocal relationship between frailty and depressive symptoms using longitudinal data among older adults in China. (2) Methods: Data derived from 2014 and 2017 waves of a longitudinal study of 1367 older adults aged 70–84 years, living in rural areas of Jiangsu Province, China. Cross-lagged panel model and a multiple group model were used to examine the temporal effect of frailty on depressive symptoms and vice versa. (3) Results: Frailty was associated with subsequent increase in depressive symptoms, such that participants with higher levels of frailty increase the risks of depressive symptoms (b = 0.090, p < 0.01). Depressive symptoms were significant predictors of increased frailty (b = −0.262, p <0.001). However, older men and older women had no significant differences in the reciprocal relationship between frailty and depressive symptoms. (4) Conclusions: In conclusion, we find a significant bi-directional relationship between frailty and depressive symptoms. This finding confirms the dyadic model of frailty and depression. Implications for interventions and policy to help frail and depressive older adults are discussed. Full article
(This article belongs to the Collection Health Care and Services for Elderly Population)
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Article
Perception and Knowledge of Patients from Different Regions in the Kingdom of Saudi Arabia towards Oral Hygiene and Oral Hygiene Aids
Healthcare 2021, 9(5), 592; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050592 - 17 May 2021
Viewed by 423
Abstract
Aim: The present study aims to evaluate the perception and awareness of interdental aids in different regions of Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted, in order to evaluate the perception and knowledge of patients towards oral hygiene products among the [...] Read more.
Aim: The present study aims to evaluate the perception and awareness of interdental aids in different regions of Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted, in order to evaluate the perception and knowledge of patients towards oral hygiene products among the population of the Kingdom of Saudi Arabia. In total, 812 out of 1124 participants responded and completed the survey (response rate 72.2%). The data were collected using a self-administered structured questionnaire in English and Arabic. All statistical analyses were carried out using the SPSS 20 software. p < 0.05 was used to indicate statistical significance. Results: A total of 812 participants responded, of which 486 participants (60%) declared using a toothpaste and toothbrush for cleaning their teeth. The cohort consisted of 274 (34%) females who brushed twice daily, while 96 (33%) males brushed their teeth once a day and 18% of the participants did not even brush once a day. The results indicated that 332 (64%) female participants and 174 (60%) male participants had perception and knowledge of the use of dental floss or any other device to clean between their teeth, while 174 (48.50%) male participants and 174 (49.10%) female participants cleaned their tongue with the same brush, rather than using a tongue scrubber or any other aids. Conclusion: The total awareness of interdental aids in Saudi Arabia is unsatisfactory, as demonstrated by the participants not being conscious or informed about the maintenance of their oral health. A majority of participants did not report adopting basic techniques, such as tongue brushing. This study reveals that no interdental aids were used by 16% of the participants. Thus, it is crucial to develop an effective educational program which emphasizes oral healthcare in this population. Full article
(This article belongs to the Special Issue Food, Nutrition and Health)
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Article
Tobacco Use and Risk Factors for Hypertensive Individuals in Kenya
Healthcare 2021, 9(5), 591; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050591 - 17 May 2021
Viewed by 531
Abstract
This study aimed to examine the association between hypertension and tobacco use as well as other known hypertensive risk factors (BMI, waist–hip ratio, alcohol consumption, physical activity, and socio-economic factors among adults) in Kenya. The study utilized the 2015 Kenya STEPs survey (adults [...] Read more.
This study aimed to examine the association between hypertension and tobacco use as well as other known hypertensive risk factors (BMI, waist–hip ratio, alcohol consumption, physical activity, and socio-economic factors among adults) in Kenya. The study utilized the 2015 Kenya STEPs survey (adults aged 18–69) and investigated the association between tobacco use and hypertension. Descriptive statistics, correlation, frequencies, and regression (linear and logistic) analyses were used to execute the statistical analysis. The study results indicate a high prevalence of hypertension in association with certain risk factors—body mass index (BMI), alcohol, waist–hip ratio (WHR), and tobacco use—that were higher in males than females among the hypertensive group. Moreover, the findings noted an exceptionally low awareness level of hypertension in the general population. BMI, age, WHR, and alcohol use were prevalent risks of all three outcomes: hypertension, systolic blood pressure, and diastolic blood pressure. Healthcare authorities and policymakers can employ these findings to lower the burden of hypertension by developing health promotion and intervention policies. Full article
(This article belongs to the Special Issue Health Economics & Finance and Global Public Health)
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Case Report
Postpartum Psychosis after Traumatic Cesarean Delivery
Healthcare 2021, 9(5), 588; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050588 - 16 May 2021
Viewed by 434
Abstract
An emergency cesarean delivery can be a traumatic childbirth experience for a woman and a risk factor for postpartum psychosis, especially in a patient with a history of bipolar disorder. This article describes the case of a pregnant woman with an unknown history [...] Read more.
An emergency cesarean delivery can be a traumatic childbirth experience for a woman and a risk factor for postpartum psychosis, especially in a patient with a history of bipolar disorder. This article describes the case of a pregnant woman with an unknown history of bipolar disorder who developed an acute psychotic reaction during the procedure of an emergency caesarian section and switched to mania. The purpose of this case study is for perinatal health care professionals to identify suspicious symptoms and promptly refer to psychiatric services so as to ensure the mother’s and the newborn’s safety. This case study highlights the importance of assessing women with bipolar disorder or a previous psychotic episode for the risk of psychiatric complications in pregnancy and after childbirth. Midwifery education on perinatal mental health is crucial for the detection of suspicious symptoms and early referral to a specialist. Full article
(This article belongs to the Special Issue Mental Health Related to Traumatic and Adverse Experiences)
Article
The Empathic Capacity and the Ability to Regulate It: Construction and Validation of the Empathy Management Scale (EMS)
Healthcare 2021, 9(5), 587; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050587 - 15 May 2021
Viewed by 458
Abstract
The aim of this study was to develop a measure to evaluate the management of empathic capacity. To this end, two studies were conducted. Study 1 (N = 277, 172 females) describes the scale creation procedure, factorial validity, and internal consistency. The [...] Read more.
The aim of this study was to develop a measure to evaluate the management of empathic capacity. To this end, two studies were conducted. Study 1 (N = 277, 172 females) describes the scale creation procedure, factorial validity, and internal consistency. The exploratory factor analysis yielded a five-factor model with 18 items (62.4% of the variance explained). The dimensions were as follows: D1: identification, D2: incorporation, D3: reverberation, D4: separation, and D5: projection. The internal consistency was good (alpha values ranging from 0.70 to 0.80). Study 2 (N = 480, 323 females) examined the validity (including convergent validity) of the model and the relationships with sociodemographic variables. The five-factor model showed a robust goodness of fit, χ2 = 240.5, p < 0.001, root mean square residual (RMSR) = 0.05. The fit indices were satisfactory, Non-normed fit index (NNFI) = 0.89, comparative fit index (CFI) = 0.90, mean square error of approximation (RMSEA) = 0.04. The convergent validity analysis showed that, as empathy management increased, so too did the empathy level and emotional intelligence. Some differences by age and sex were found. In conclusion, the Empathy Management Scale is a valid and reliable instrument for analyzing the empathic process that allows vulnerabilities and strengths to be estimated, which could improve professional practice in the healthcare context. Full article
(This article belongs to the Section Nursing)
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Article
Fluctuations in Well-Being Based on Position in Elite Young Soccer Players during a Full Season
Healthcare 2021, 9(5), 586; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9050586 - 14 May 2021
Viewed by 405
Abstract
The current study surveyed weekly and daily variations of well-being ratings relative to the Hooper Index (HI): fatigue (wFatigue), stress (wStress), delayed onset muscle soreness (wDOMS), and sleep quality (wSleep) during a soccer season based on players’ positions. The full-season was divided into [...] Read more.
The current study surveyed weekly and daily variations of well-being ratings relative to the Hooper Index (HI): fatigue (wFatigue), stress (wStress), delayed onset muscle soreness (wDOMS), and sleep quality (wSleep) during a soccer season based on players’ positions. The full-season was divided into three meso-cycles: Early season, week (W)1 to W7; Mid-season, W8 to W13, and End-season, W14 to W20. Twenty-six young players participated in the study (age, 15.5 ± 0.2 years; height, 172.9 ± 4.2 cm; body mass, 61.4 ± 5.6 kg; body fat, 8.6 ± 2.9%; VO2max, 48.4 ± 2.4 mL.kg−1·min−1; maturity offset, 1.9 ± 0.3 years). Participants played in the same team and competed in Iran national under-16 competitions. Well-being status was monitored on training days using the HI questionnaire. The main result was a significant difference between well-being status 5 days before match day (MD) and 4 days before MD, compared to MD for all playing positions (p ≤ 0.001). The highest and lowest records occurred during End-season for wDOMS (strikers = 11.5 ± 8.4 arbitrary units (AU)), Early season (central defenders = 9.5 ± 0.7 AU) and for wFatigue (central midfielders = 11.4 ± 0.9 AU), and Early season (wide defenders = 9.7 ± 0.7 AU), respectively. Overall, the results showed a significant increase in wStress and wSleep for all players’ positions from Early- to End-season. The main application of this study is to make coaches aware of their players’ well-being fluctuations throughout the full season, especially in young elite soccer players, and to avoid injuries, overtraining, and overreaching as much as possible. Full article
(This article belongs to the Special Issue Sport and Exercise Medicine)
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