[go: up one dir, main page]
Next Issue
Volume 10, November
Previous Issue
Volume 10, September
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
3.5
2.4
Journals
Healthcare
Volume 10
Issue 10
share announcement

Healthcare, Volume 10, Issue 10 (October 2022) – 308 articles

Cover Story (view full-size image): Aging causes cartilage degeneration, but this natural process may be influenced by various factors, such as the practice of physical activity. The effects of different physical activity interventions on cartilage and a standard operating procedure for an exercise program was proposed. After electronic databases search, a total of 24 studies were included. The most adopted interventions were aerobic, strength, flexibility, postural balance, and mobility interventions and high heterogeneity in the protocols was detected. In conclusion, the practice of physical activity has mainly positive outcomes regarding cartilage structure. The standard operating procedure proposed to help scientific research to move in the same direction consisted of an intervention characterized by 60-minute sessions of aerobic, strength and flexibility training 3 times a week, with gradually increasing intensity. View this paper
  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Reader to open them.
Order results
Result details
Section
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
19 pages, 342 KiB  
Article
Hospital Staffing during the COVID-19 Pandemic in Sweden
by Ritva Rosenbäck, Björn Lantz and Peter Rosén
Healthcare 2022, 10(10), 2116; https://doi.org/10.3390/healthcare10102116 - 21 Oct 2022
Cited by 10 | Viewed by 2101
Abstract
Staff management challenges in the healthcare system are inherently different during pandemic conditions than under normal circumstances. Surge capacity must be rapidly increased, particularly in the intensive care units (ICU), to handle the increased pressure, without depleting the rest of the system. In [...] Read more.
Staff management challenges in the healthcare system are inherently different during pandemic conditions than under normal circumstances. Surge capacity must be rapidly increased, particularly in the intensive care units (ICU), to handle the increased pressure, without depleting the rest of the system. In addition, sickness or fatigue among the staff can become a critical issue. This study explores the lessons learned by first- and second-line managers in Sweden with regard to staff management during the COVID-19 pandemic. A mixed-methods approach was used, with preliminary qualitative interview (n = 38) and principal quantitative questionnaire (n = 272) studies, based on principal component and multiple regression analyses. The results revealed that the pandemic created four types of challenges relating to staff management: staff movement within hospitals; addition of external staff; addition of hours for existing staff through overtime and new shift schedules; and avoidance of lost hours due to sickness or fatigue. Furthermore, the effects of these managerial challenges were different in the first wave than in later waves, and they significantly differed between the ICU and other units. Therefore, a greater proactive focus on staff management would be beneficial in future pandemic situations. Full article
(This article belongs to the Collection The Impact of COVID-19 on Healthcare Services)
17 pages, 4080 KiB  
Article
A New Architecture for Customizable Exergames: User Evaluation for Different Neuromuscular Disorders
by Martina Eckert, Alicia Aglio, María-Luisa Martín-Ruiz and Víctor Osma-Ruiz
Healthcare 2022, 10(10), 2115; https://doi.org/10.3390/healthcare10102115 - 21 Oct 2022
Cited by 3 | Viewed by 1715
Abstract
This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to [...] Read more.
This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to different diseases and states of disease. The game is based on motion capturing and integrates four example exercises that can be configured via our therapeutic web platform “Blexer-med”. To prove the feasibility for a wide range of different users, evaluation tests were performed on 14 patients with various types and degrees of neuromuscular disorders, classified into three groups based on strength and autonomy. The users were free to choose their schedule and frequency. The game scores and three surveys (before, during, and after the intervention) showed similar experiences for all groups, with the most vulnerable having the most fun and satisfaction. The players were motivated by the story and by achieving high scores. The average usage time was 2.5 times per week, 20 min per session. The pure exercise time was about half of the game time. The concept has proven feasible and forms a reasonable basis for further developments. The full 3D exercise needs further fine-tuning to enhance the fun and motivation. Full article
(This article belongs to the Section Health Assessments)
►▼ Show Figures

Figure 1

Figure 1
<p>“Blexer-med” system environment. Left: patient’s side at home; right: clinical web and database.</p> Full article ">Figure 2
<p>Map of the game environment. In each cell, the path can be chosen through one of the four obstacles: tree, lake, river, or trunk.</p> Full article ">Figure 3
<p>Screenshots of two cells on the map. Left: a tree trunk, a wall (no passage), and a lake. The energy is 100% and Phiby gained 7 kg of wood in the previous exercise. Right: Phiby can choose between two different lakes or chopping wood. The energy is 90% and the map shows the explored environment.</p> Full article ">Figure 4
<p>Exercises from left to right, up–down: “Chop the wood”, “Climb the tree”, “Dive and eat”, and “Row the boat”.</p> Full article ">Figure 5
<p>A, B, and C group classification according to strength and autonomy.</p> Full article ">Figure 6
<p>Comparison of median follow-up survey responses for groups A (<span class="html-italic">n</span> = 4), B (<span class="html-italic">n</span> = 4), C (<span class="html-italic">n</span> = 5, one person did not answer).</p> Full article ">Figure 7
<p>Median number of sessions and mini-games played per group.</p> Full article ">Figure 8
<p>Achievements per exercise by groups. “Win” means that the score was reached in the time available, “lost” that the time had run out.</p> Full article ">Figure 9
<p>Achievements per exercise by groups. “Win” means that the score was reached in the time available, “lost” that the time had run out.</p> Full article ">Figure 10
<p>Strength measures before and after intervention.</p> Full article ">
13 pages, 2498 KiB  
Article
Impacts of Internet Use on Chinese Patients’ Trust-Related Primary Healthcare Utilization
by Jiao Lu, Jingyan Bai, Qingqing Guo, Zhongliang Zhou, Xiaowei Yang and Qi Yu
Healthcare 2022, 10(10), 2114; https://doi.org/10.3390/healthcare10102114 - 21 Oct 2022
Cited by 1 | Viewed by 1497
Abstract
Background: The internet has greatly improved the availability of medical knowledge and may be an important avenue to improve patients’ trust in physicians and promote primary healthcare seeking by reducing information asymmetry. However, very few studies have addressed the interactive impacts of both [...] Read more.
Background: The internet has greatly improved the availability of medical knowledge and may be an important avenue to improve patients’ trust in physicians and promote primary healthcare seeking by reducing information asymmetry. However, very few studies have addressed the interactive impacts of both patients’ internet use and trust on primary healthcare-seeking decisions. Objective: To explore the impact of internet use on the relationship between patients’ trust in physicians and primary healthcare seeking among Chinese adults 18 years of age and older to understand the varieties of effects in different cities. Methods: Generalized linear mixed models were applied to investigate the interactive impacts of internet use and patients’ trust in physicians on primary healthcare seeking using pooled data from the China Family Panel Study of 2014 to 2018. We also compared these effects based on different levels of urbanization, ages, and PHC services. Results: Overall, a higher degree of patients’ trust (p < 0.001) was able to directly predict better primary healthcare seeking, and internet use significantly increased the positive effect of patients’ trust on primary healthcare seeking (p < 0.001). However, the marginal effect analysis showed that this effect was related to the level of patients’ trust and that internet use could reduce the positive effect of patients’ trust on primary healthcare seeking when the individual had a low level of trust (≤ 3 units). Further, the heterogeneity analysis indicated that the benefits from internet use were higher in cities with high urbanization, high aging, and high PHC service levels compared to cities with low levels of these factors. Conclusions: The internet use may enhance patients’ trust-related PHC utilization. However, this impact is effective only if patients’ benchmark trust remains at a relatively high level. Comparatively, the role of internet use is more effective in areas with high urbanization, high aging and high PHC level. Thus, with increasing accessibility to the internet, the internet should be regulated to disseminate correct healthcare information. Moreover, in-depth integration of the internet and PHC should be promoted to provide excellent opportunities for patient participation, and different strategies should be set according to each city’s characteristics. Full article
►▼ Show Figures

Figure 1

Figure 1
<p>Generalized linear mixed flow chart of the model.</p> Full article ">Figure 2
<p>Descriptive of control variable. Note: Gender (0 = female; 1= male), residence status (0 = miss; 1 = urban; 2 = rural), education status (1 = illiterate; 2 = primary school or middle school; 3 = high school/secondary school/technical school/junior college; 4 = university or above), health insurance (1 = public medical care; 2 = urban employee medical insurance; 3 = urban resident medical insurance (including one old and one small insurance); 4 = supplementary medical insurance; 5 = new rural cooperative medical insurance; 6 = none of the above urban employees basic medical insurance), marital status (1 = unmarried; 2 = married/living together; 3 = divorced/widowed), location (1 = east; 2 = central; 3 = west), self-reported health status (1 = excellent; 2 = very good; 3 = good; 4 = fair; 5 = poor), diagnosis with a chronic disease, such as hypertension, diabetes, coronary heart disease, or stroke (0 = without chronic disease; 1 = with chronic disease) and whether they have religious belief (0 = no; 1 = yes).</p> Full article ">
42 pages, 1167 KiB  
Review
Blood Pressure Measurement: From Cuff-Based to Contactless Monitoring
by Ping-Kwan Man, Kit-Leong Cheung, Nawapon Sangsiri, Wilfred Jin Shek, Kwan-Long Wong, Jing-Wei Chin, Tsz-Tai Chan and Richard Hau-Yue So
Healthcare 2022, 10(10), 2113; https://doi.org/10.3390/healthcare10102113 - 21 Oct 2022
Cited by 8 | Viewed by 6588
Abstract
Blood pressure (BP) determines whether a person has hypertension and offers implications as to whether he or she could be affected by cardiovascular disease. Cuff-based sphygmomanometers have traditionally provided both accuracy and reliability, but they require bulky equipment and relevant skills to obtain [...] Read more.
Blood pressure (BP) determines whether a person has hypertension and offers implications as to whether he or she could be affected by cardiovascular disease. Cuff-based sphygmomanometers have traditionally provided both accuracy and reliability, but they require bulky equipment and relevant skills to obtain precise measurements. BP measurement from photoplethysmography (PPG) signals has become a promising alternative for convenient and unobtrusive BP monitoring. Moreover, the recent developments in remote photoplethysmography (rPPG) algorithms have enabled new innovations for contactless BP measurement. This paper illustrates the evolution of BP measurement techniques from the biophysical theory, through the development of contact-based BP measurement from PPG signals, and to the modern innovations of contactless BP measurement from rPPG signals. We consolidate knowledge from a diverse background of academic research to highlight the importance of multi-feature analysis for improving measurement accuracy. We conclude with the ongoing challenges, opportunities, and possible future directions in this emerging field of research. Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
►▼ Show Figures

Figure 1

Figure 1
<p>A timeline of PPG-related publications every year from 1990 to 2022. For 2022, the number of publications was recorded up to 26 July 2022.</p> Full article ">Figure 2
<p>This figure shows waveforms from various measurements and the relation between PAT and PTT as in Equation (<a href="#FD1-healthcare-10-02113" class="html-disp-formula">1</a>). ECG = electrocardiography, SCG = seismocardiography, and PPG = photoplethysmography. The letters in the ECG waveforms represent the parts of the waveforms.</p> Full article ">Figure 3
<p>Biological signals from various parts of the body. This figure was modified and enhanced from [<a href="#B52-healthcare-10-02113" class="html-bibr">52</a>]. The abbreviations represent BP measurement signals at various parts on the human body. BCG = ballistocardiography, PPG = photoplethysmography, IPG = impedance photoplethysmography, SBS = strain-based sensor, GCG = gyrocardiography, ECG = electrocardiography, SCG = seismocardiography, ICG = impedance cardiography, ABP = arterial blood pressure (by invasive measurement on the arms), and rPPG = remote photoplethysmography (by cameras).</p> Full article ">Figure 4
<p>A working principle of rPPG. This figure was modified from [<a href="#B53-healthcare-10-02113" class="html-bibr">53</a>]. The specular component gives the information on the skin’s surface, which does not have any physiological signals. The diffused counterpart gives the subtle change in blood flow, which provides physiological information after meticulous signal processing.</p> Full article ">Figure 5
<p>A timeline of rPPG-related publications every year from 1990 to 2022. For 2022, the number of publications was recorded up to 26 July 2022.</p> Full article ">Figure 6
<p>A flowchart showing the research situation in BP measurement. There are 5, 11 and 30 pieces of work using non-ML, ML and DL methods respectively to predict BP from PPG signals, while there are 4, 8 and 7 pieces of work using non-ML, ML and DL methods respectively to predict BP from rPPG signals. ROI preprocessing means preprocessing of data received from some regions of interest on a human face recorded on video. The red dotted line means that there are no research papers talking about the techniques from a video for BP measurement.</p> Full article ">Figure 7
<p>A flowchart showing the organization of this review paper.</p> Full article ">Figure 8
<p>A pipeline of traditional machine learning (TML) methods for PPG signals. Features inside training data are extracted based on various author-preferred criteria (e.g., highest correlation with the ground truth BP) to train their studied TML models and give the predictions for SBP and DBP.</p> Full article ">Figure 9
<p>The flowchart of general PPG waveform-based methods. (upper flowchart) [<a href="#B123-healthcare-10-02113" class="html-bibr">123</a>,<a href="#B125-healthcare-10-02113" class="html-bibr">125</a>,<a href="#B127-healthcare-10-02113" class="html-bibr">127</a>,<a href="#B128-healthcare-10-02113" class="html-bibr">128</a>,<a href="#B136-healthcare-10-02113" class="html-bibr">136</a>]. Features inside training data of raw PPG signals are manually extracted to train their studied models and give the predictions for SBP and DBP. (lower flowchart) [<a href="#B133-healthcare-10-02113" class="html-bibr">133</a>,<a href="#B135-healthcare-10-02113" class="html-bibr">135</a>,<a href="#B137-healthcare-10-02113" class="html-bibr">137</a>,<a href="#B145-healthcare-10-02113" class="html-bibr">145</a>]. The whole waveform profiles of raw PPG signals are put into models, which automatically pick up useful features and give predictions for SBP and DBP.</p> Full article ">Figure 10
<p>The structure of the algorithm in [<a href="#B131-healthcare-10-02113" class="html-bibr">131</a>]. PPG signals are preprocessed by continuous wavelet transform (CWT) to produce two dimensional scalograms for identifying the low-frequency or fast-changing frequency components. These scalograms are converted into RGB images for the convolutional neural network pretrained by GoogLeNet. This model automatically extracts features in the scalograms to predict the BP categories: normotension (NT), prehypertension (PHT), and hypertension (HT).</p> Full article ">Figure 11
<p>The structure of the algorithm in [<a href="#B141-healthcare-10-02113" class="html-bibr">141</a>]. PPG signals are preprocessed by the wavelet transform with the removal of the very low and very high frequency components, the soft Rigrsure thresholding [<a href="#B198-healthcare-10-02113" class="html-bibr">198</a>,<a href="#B199-healthcare-10-02113" class="html-bibr">199</a>], and the normalization. The filtered PPG signals are processed through the approximation network (one-dimensional deep supervised U-net model), which estimates the ABP based on the inputs, and then refined by the refinement network. The maximum and minimum of the refined ABP signals are taken as SBP and DBP, respectively.</p> Full article ">Figure 12
<p>The flowchart of general PTT-based DL methods adopted in [<a href="#B132-healthcare-10-02113" class="html-bibr">132</a>,<a href="#B140-healthcare-10-02113" class="html-bibr">140</a>,<a href="#B142-healthcare-10-02113" class="html-bibr">142</a>,<a href="#B143-healthcare-10-02113" class="html-bibr">143</a>,<a href="#B146-healthcare-10-02113" class="html-bibr">146</a>]. After preprocessing, PPG and ECG signals are fed into the models, which automatically extract the relevant features from the input signals and predict SBP and DBP.</p> Full article ">Figure 13
<p>The structure of the algorithm in [<a href="#B138-healthcare-10-02113" class="html-bibr">138</a>]. The PPG signals are directly put into the CNN part of the model for feature extraction. The model uses the MLP part with the aid of the BMI of the corresponding subjects to predict SBP, DBP, and the hypertension classes. Here, <math display="inline"><semantics> <mrow> <mi>c</mi> <mi>l</mi> <msub> <mi>s</mi> <mrow> <mi>p</mi> <mi>r</mi> <mi>e</mi> <mi>d</mi> </mrow> </msub> </mrow> </semantics></math> is the predicted class from the model, <math display="inline"><semantics> <mrow> <mi>c</mi> <mi>l</mi> <msub> <mi>s</mi> <mrow> <mi>c</mi> <mi>v</mi> <mi>t</mi> </mrow> </msub> </mrow> </semantics></math> is the converted class from the regression result, and <math display="inline"><semantics> <mrow> <mi>c</mi> <mi>l</mi> <msub> <mi>s</mi> <mrow> <mi>o</mi> <mi>u</mi> <mi>t</mi> <mi>p</mi> <mi>u</mi> <mi>t</mi> </mrow> </msub> </mrow> </semantics></math> is the final output class of the algorithm.</p> Full article ">Figure 14
<p>A pipeline of a deep learning model for rPPG singals proposed in [<a href="#B147-healthcare-10-02113" class="html-bibr">147</a>,<a href="#B229-healthcare-10-02113" class="html-bibr">229</a>,<a href="#B230-healthcare-10-02113" class="html-bibr">230</a>]. The pixels of the ROIs of face images are preprocessed and then extracted to form rPPG signals. These rPPG signals are then preprocessed, and those features of preprocessed rPPG signals are extracted to feed the respective models for training to predict SBP and DBP signals.</p> Full article ">Figure 15
<p>A pipeline of traditional machine learning (TML) methods for rPPG signals adopted in [<a href="#B220-healthcare-10-02113" class="html-bibr">220</a>,<a href="#B223-healthcare-10-02113" class="html-bibr">223</a>]. Those rPPG training data are initially preprocessed. Those relevant features of the filtered signals are extracted manually to feed their target models to predict SBP and DBP.</p> Full article ">Figure 16
<p>A pipeline of a deep learning model for rPPG signals proposed in [<a href="#B153-healthcare-10-02113" class="html-bibr">153</a>]. On one hand, pixels from the ROIs of face images are extracted by CHROM as the rPPG signals. On the other hand, age and BMI are fed into another model selector to promote the model training to predict SBP and DBP.</p> Full article ">Figure 17
<p>A pipeline of a deep learning model for rPPG signals proposed in [<a href="#B232-healthcare-10-02113" class="html-bibr">232</a>]. Pixels from RGB face images are extracted to form intensity maps of melanin, hemoglobin (Hem), and shading (residual information). Those extracted signals are used for constructing the pulse contour descriptor, which does not include spatial information, and the spatial pulse contour descriptor, which includes spatial details, in order to preserve spatial phase relationship of the rPPG signals. Both descriptors are used as inputs for the model for prediction of SBP and DBP.</p> Full article ">
6 pages, 1138 KiB  
Article
Development of a Shortened Version of the Nurse Managers’ Empowering Behavioral Scale for Staff Nurses
by Miki Sasaki, Yasuko Ogata, Keiko Fujinami and Yuki Yonekura
Healthcare 2022, 10(10), 2112; https://doi.org/10.3390/healthcare10102112 - 21 Oct 2022
Viewed by 1673
Abstract
The original version of the Nurse Managers’ Empowering Behavioral Scale for Staff Nurses (NMEB-SN) was both unique and comprehensive. However, it was considered lengthy. Hence, the intention of this particular study was to develop a shortened version of the NMEB-SN comprising 15 items [...] Read more.
The original version of the Nurse Managers’ Empowering Behavioral Scale for Staff Nurses (NMEB-SN) was both unique and comprehensive. However, it was considered lengthy. Hence, the intention of this particular study was to develop a shortened version of the NMEB-SN comprising 15 items across five subscales. Responses from 1268 staff nurses working at 10 Japanese hospitals were included in the analysis to confirm the validity and reliability of the scale. The results ensured internal consistency, construct and criterion-related validity, and test–retest reliability. The NMEB-SN short version is applicable in the context of practical and efficient nursing management to attract more nurses to the workplace. Full article
(This article belongs to the Section Nursing)
►▼ Show Figures

Figure 1

Figure 1
<p>Confirmatory factor analysis of the NMEB-SN short version.</p> Full article ">
13 pages, 263 KiB  
Article
A Study on Determinants of COVID-19 Preventive Health Behaviors of Mothers with Young Children in South Korea
by Hye-Gyung An and Chae-Min Yoon
Healthcare 2022, 10(10), 2111; https://doi.org/10.3390/healthcare10102111 - 21 Oct 2022
Viewed by 1186
Abstract
This study is a descriptive research study conducted to identify factors that affect children of Korean mothers the coronavirus disease 2019 (COVID-19) preventive health behavior. It was confirmed that knowledge of COVID-19, maternal confidence, and risk perception of COVID-19 infection were related to [...] Read more.
This study is a descriptive research study conducted to identify factors that affect children of Korean mothers the coronavirus disease 2019 (COVID-19) preventive health behavior. It was confirmed that knowledge of COVID-19, maternal confidence, and risk perception of COVID-19 infection were related to the Preventive health behaviors of COVID-19 of Korean mothers with children. The subjects of this study were 191 mothers residing in Korea and raising children under the age of 5, and data were collected through an online questionnaire. We used the Google platform to fill out a questionnaire and collect data using a network sampling method from mothers who voluntarily participated in a survey at an online community meeting of mothers with young children. The collected data were analyzed using descriptive statistics, factor analysis, t-test, Pearson’s correlation analysis, and multiple regression analysis using IBM SPSS statistics 21.0 program. Preventive health behaviors of COVID-19 factor 1 are positively correlated with: mothers’ COVID-19 knowledge (r = 0.192, p < 0.01), confidence in infant care knowledge(r = 0.179, p < 0.05), and satisfaction with the role of mother(r = 0.351, p < 0.001). Negatively correlated with: unacceptable risk perception(r = −0.222, p< 0.01). Preventive health behaviors of COVID-19 factor 2 are positively correlated with: mothers’ COVID-19 knowledge (r = 0.166, p < 0.05), confidence in infant care knowledge(r = 0.179, p < 0.05), and satisfaction with the role of mother(r = 0.338, p < 0.001). Negatively correlated with: unacceptable risk perception(r = −0.205, p < 0.01). To strengthen COVID-19 preventive health behavior of Korean mothers with young children, it is suggested that education programs should be developed to provide accurate knowledge, increase maternal confidence, and improve the risk perception of COVID-19 infection. Full article
13 pages, 928 KiB  
Systematic Review
The Impact of Depression on the Functional Outcome of the Elderly Stroke Victim from a Gender Perspective: A Systematic Review
by María Salud Franco-Urbano, María del Carmen Rodríguez-Martínez and Patricia García-Pérez
Healthcare 2022, 10(10), 2110; https://doi.org/10.3390/healthcare10102110 - 21 Oct 2022
Cited by 4 | Viewed by 2115
Abstract
(1) Background: The aim of this systematic review focused on analyzing the impact of depression on the functional outcome of the elderly stroke victim and how this disorder affects both the female and the male population. (2) Methods: We conducted a systematic review [...] Read more.
(1) Background: The aim of this systematic review focused on analyzing the impact of depression on the functional outcome of the elderly stroke victim and how this disorder affects both the female and the male population. (2) Methods: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review was registered in PROSPERO (ID 346284). The systematic search for clinical trials was performed in the databases Pubmed, Otseeker, Scopus, Web of Science, Psycinfo, Medline Complete, ScienceDirect, SciELO, and Dialnet. Articles were selected according to the inclusion and exclusion criteria, including those dealing with post-stroke depression in adults whose psychological status had changed. Studies that only assessed the psychological state of caregivers were excluded. (3) Results: In total, 609 articles were identified, of which 11 randomized controlled trials were finally included in the review. The results indicate that post-stroke depression influences the recovery of functionality and quality of life. In addition, the need to detect the mood of the adult population after the stroke and to provide individualized treatment according to the characteristics of the person is highlighted. (4) Conclusions: This systematic review shows how early detection of post-stroke depressive symptoms can improve the degree of disability and quality of life of the person, especially in women. Full article
(This article belongs to the Special Issue Cardiovascular Diseases: Education, Prevention and Treatment)
►▼ Show Figures

Figure 1

Figure 1
<p>PRISMA Flowchart of search.</p> Full article ">Figure 2
<p>Risk of Bias assessment according to the Cochrane Collaboration’s tool (RoB 2.0) for randomised controlled trials. Higgins et al. (2011) [<a href="#B47-healthcare-10-02110" class="html-bibr">47</a>].</p> Full article ">
14 pages, 2089 KiB  
Article
Clothes Make the Man—What Impact Does the Dress of Interprofessional Teams Have on Patients?
by Hans Joachim Roehrens, Jan P. Ehlers and Michaela Zupanic
Healthcare 2022, 10(10), 2109; https://doi.org/10.3390/healthcare10102109 - 21 Oct 2022
Cited by 3 | Viewed by 2483
Abstract
Physicians’ attire seems to play an important role in the success of patient treatment. The classic doctor’s white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor–patient relationship. In a quantitative online questionnaire study [...] Read more.
Physicians’ attire seems to play an important role in the success of patient treatment. The classic doctor’s white coat initiates a strong signal to the patient and can have a determining effect on a successful doctor–patient relationship. In a quantitative online questionnaire study comprising 52 questions, participants were shown four photos of an interprofessional German family medicine team in varying attire. One important study feature relating to the ongoing coronavirus pandemic was that the team was portrayed wearing FFP2 masks in one photo. We measured core values regarding the team’s perception in terms of sympathy, competence, trust, choosing the practice as a personal health care provider, and wanting to participate in the team. The questionnaire was posted online between March and May 2021. It was accessed 1435 times and 906 sheets were qualified for statistical analysis. For the first time in this field of research, a practice team’s attire was investigated. We found a significant influence of different clothing on the perception of sympathy, competence, trust, elective practice, and team participation. Wearing an FFP2 mask promotes feelings of security and competence. The study shows that in times of fast social changes due to rapid digitalization and an ongoing pandemic, we should present ourselves in different ways as a medical team depending on the patient groups we are targeting and the feelings we want to evoke. Full article
►▼ Show Figures

Figure 1

Figure 1
<p>(<b>A</b>) All members of the practice team in white trousers with a blue tunic as a top. (<b>B</b>) Team members either in white trousers, white polo shirt, and white coat, or in whiter trousers and blue polo shirt (<b>C</b>) Team as in the second photo, but with additional FFP2 protective mask. (<b>D</b>) Team in a relaxed mood with #pinksocks as an additional accessory.</p> Full article ">Figure 2
<p>Distribution of the sample according to age groups and gender (<span class="html-italic">n</span> = 906).</p> Full article ">Figure 3
<p>Mean rating of the four photos for likability by the four subgroups (<span class="html-italic">n</span> = 906).</p> Full article ">Figure 4
<p>Mean rating of the four photos for competence by the four subgroups (<span class="html-italic">n</span> = 906).</p> Full article ">Figure 5
<p>Mean rating of the four photos for trust by the four subgroups (<span class="html-italic">n</span> = 906).</p> Full article ">Figure 6
<p>Mean rating of the four photos for choosing a practice by the four subgroups (<span class="html-italic">n</span> = 906).</p> Full article ">Figure 7
<p>Mean rating of the four photos for team participation by the four subgroups (<span class="html-italic">n</span> = 906).</p> Full article ">Figure 8
<p>Mean rating of the four photos for team participation by the two subgroups according to place of residence (<span class="html-italic">n</span> = 906).</p> Full article ">
10 pages, 283 KiB  
Article
Religious Affiliation and Flu Vaccination in Germany: Results of the German Ageing Survey
by Hamzah Shaheen, Hans-Helmut König and André Hajek
Healthcare 2022, 10(10), 2108; https://doi.org/10.3390/healthcare10102108 - 21 Oct 2022
Cited by 1 | Viewed by 1885
Abstract
Our aim was to examine the association between religious affiliation and the likelihood of taking the flu vaccine. Cross-sectional data (year 2014 with n = 7172) were used from the nationally representative German Ageing Survey—covering community-dwelling individuals aged 40 years and over. Multiple [...] Read more.
Our aim was to examine the association between religious affiliation and the likelihood of taking the flu vaccine. Cross-sectional data (year 2014 with n = 7172) were used from the nationally representative German Ageing Survey—covering community-dwelling individuals aged 40 years and over. Multiple logistic regressions showed that compared with individuals without a religious affiliation, individuals with certain religious affiliations had a lower likelihood of taking the flu vaccine. More precisely, the likelihood of taking a flu shot was significantly associated with belonging to the Roman Catholic Church (OR: 0.50, 95% CI: 0.44–0.57), the Protestant Church (OR: 0.68, 0.60–0.77), the Evangelic Free Church (OR: 0.54, 0.35–0.82) and other religious communities (OR: 0.25, 0.14–0.45). The results remained nearly the same when we restricted our analyses to individuals aged 60 years and over (according to existing recommendations for flu vaccination). The association between religious affiliation and the likelihood of taking the flu vaccine was moderated by thoughts about religion and deeds for religion. This knowledge could help to improve the immunization coverage by addressing individuals with certain religious affiliations. Full article
4 pages, 214 KiB  
Editorial
Lifestyle Strategies for the Management of Obesity in Older Adults: From Controversies to Alternative Interventions
by Anthony Villani
Healthcare 2022, 10(10), 2107; https://doi.org/10.3390/healthcare10102107 - 21 Oct 2022
Cited by 3 | Viewed by 2069
Abstract
Improvements in infection control, management of chronic diseases and impressive advancements in modern medicine have all contributed to increases in life expectancy [...] Full article
(This article belongs to the Special Issue Strategies to Manage Obesity in Older Adults)
12 pages, 2347 KiB  
Article
A Non-Randomized Combined Program of Walking and Low-Load Resistance Exercise Improves Cognitive Function and Cardiometabolic Risk Factors in Community-Dwelling Elderly Women
by Jeonghyeon Kim, Seamon Kang, Haeryun Hong, Mingyu Joo and Hyunsik Kang
Healthcare 2022, 10(10), 2106; https://doi.org/10.3390/healthcare10102106 - 21 Oct 2022
Cited by 1 | Viewed by 1839
Abstract
Background: This study examines whether changes in cardiometabolic risk factors, functional fitness, and depressive symptoms following a six-month exercise intervention were associated with cognitive function in Korean women aged 65 years and older. Methods: A non-randomized study design was used to compare post-intervention [...] Read more.
Background: This study examines whether changes in cardiometabolic risk factors, functional fitness, and depressive symptoms following a six-month exercise intervention were associated with cognitive function in Korean women aged 65 years and older. Methods: A non-randomized study design was used to compare post-intervention changes in measured variables between control (n = 30) and exercise (n = 30) groups. The exercise intervention consisted of three days of low-load resistance exercise and two days of walking. Cognitive function and depressive symptoms were assessed with the Korean version of the Mini–Mental State Examination and the Korean version of the Geriatric Depression Scale, respectively. Functional fitness was measured using a senior fitness test battery. Results: The exercise group showed a significant improvement in cognitive function (p < 0.001) in conjunction with significant decreases in blood glucose (p = 0.052), triglycerides (p = 0.011), insulin (p = 0.002), tumor necrosis factor-α (p = 0.043), and depressive symptoms (p = 0.006) and an increase in interleukin-10 (p = 0.037), compared with the control group. Multivariate stepwise regression showed that changes in depressive symptoms (p < 0.001), insulin resistance (p < 0.001), and upper body muscle strength (p = 0.003) were positively associated with cognitive function. Conclusion: A six-month exercise intervention consisting of walking and low-load/high-repetition elastic band resistance exercise has the potential to improve cognitive function, as well as physical function and cardiometabolic risk factors, and to decrease depressive symptoms in older women. Full article
(This article belongs to the Special Issue Metabolic Syndrome and Mental Illness)
►▼ Show Figures

Figure 1

Figure 1
<p>Illustration of overall study design and measurement procedure.</p> Full article ">Figure 2
<p>Time-by-group interactions for cognitive function (<b>left</b>) and depressive symptoms (<b>right</b>). MMSE: Mini–Mental state examination; GDS: geriatric depression scale.</p> Full article ">Figure 3
<p>Illustration of time-by-group interactions for body mass index and physical functional capacity. BMI: body mass index; UBMS: upper body muscle strength; LBMS: lower body muscle strength; LBFLX: lower body flexibility.</p> Full article ">Figure 4
<p>Illustration of time-by-group interactions for metabolic risk factors and serum cytokines.</p> Full article ">Figure 5
<p>The relationships between changes in cognitive function, depressive symptoms, insulin, and upper body muscle strength (UBMS) in the total group.</p> Full article ">
9 pages, 1307 KiB  
Article
Long-Haul COVID Patients: Prevalence of POTS Are Reduced but Cerebral Blood Flow Abnormalities Remain Abnormal with Longer Disease Duration
by C. (Linda) M. C. van Campen and Frans C. Visser
Healthcare 2022, 10(10), 2105; https://doi.org/10.3390/healthcare10102105 - 21 Oct 2022
Cited by 12 | Viewed by 12209
Abstract
Background: Postural orthostatic tachycardia syndrome (POTS) has been described early after the onset of the COVID-19 infection, but also orthostatic hypotension (OH). In the present study, we hypothesized that orthostatic intolerance decreases over time. Methods: In 29 long-haul COVID-19 (LHC) patients, a tilt [...] Read more.
Background: Postural orthostatic tachycardia syndrome (POTS) has been described early after the onset of the COVID-19 infection, but also orthostatic hypotension (OH). In the present study, we hypothesized that orthostatic intolerance decreases over time. Methods: In 29 long-haul COVID-19 (LHC) patients, a tilt test was performed, including measurements of cerebral blood flow (CBF) by extracranial Doppler. The time interval between the onset of infection and the tilt test varied between 3 and 28 months. Results: In the first 12 months after the infection, 71% of the LHC patients showed POTS and after 24 months none of them. In the first 12 months, 29% of patients had a normal heart rate and blood pressure response (normHRBP) and after 24 months 75% (distribution of POTS, OH, and a normHRBP over time: p < 0.0001). Linear regression showed that, over time, there was a decrease in the abnormal CBF during the tilt (p = 0.024) but remained abnormal. Conclusion: In LHC patients, hemodynamic abnormalities of a tilt test change over time. Patients studied early after the onset of the disease mainly exhibit POTS, but patients studied later in the time course mainly show a normHRBP or OH. In addition, the abnormal CBF reduction improves over time, but CBF remains abnormal. Full article
(This article belongs to the Collection Why Some Patients Never Fully Recover: Post Active Phase of Infection Syndromes (PAPIS))
►▼ Show Figures

Figure 1

Figure 1
<p>Frequencies of hemodynamic tilt test results in long-haul COVID-19 patients: relation with disease duration. OH: orthostatic hypotension; normHRBP: normal heart rate and blood pressure response; POTS: postural orthostatic tachycardia syndrome.</p> Full article ">Figure 2
<p>Cerebral blood flow reduction in long-haul COVID-19 patients with POTS, with orthostatic hypotension, and with a normal heart rate and blood pressure during the tilt test. CBF: cerebral blood flow; OH: orthostatic hypotension; normHRBP: normal heart rate and blood pressure response during the tilt test.</p> Full article ">Figure 3
<p>Cerebral blood flow reduction in long-haul COVID-19 patients with POTS, with OH, and with a normal heart rate and blood pressure during the tilt test. CBF: cerebral blood flow; OH: orthostatic hypotension; normHRBP: normal heart rate and blood pressure response during the tilt test.</p> Full article ">
8 pages, 547 KiB  
Article
COVID-19 Depression and Infection Prevention Behavior among College Students: A Health Belief Perspective
by Yeong-Mi Jang, Jong-Uk Park and Nam-Yi Kim
Healthcare 2022, 10(10), 2104; https://doi.org/10.3390/healthcare10102104 - 20 Oct 2022
Cited by 1 | Viewed by 1545
Abstract
The COVID-19 pandemic has resulted in an increase in depression among college students due to anxiety and fear of infection. Nonetheless, COVID-19 infection prevention measures should be actively implemented. In this study, the mediating effect of health belief on the relationship between depression [...] Read more.
The COVID-19 pandemic has resulted in an increase in depression among college students due to anxiety and fear of infection. Nonetheless, COVID-19 infection prevention measures should be actively implemented. In this study, the mediating effect of health belief on the relationship between depression and infection prevention behavior was investigated. A survey of 220 South Korean college students was conducted. Depression was found to be the independent variable, health belief the mediating variable, and infection prevention behavior the dependent variable. The model fit index according to confirmatory factor analysis was found to be suitable. Depression among college students was not directly related to COVID-19 infection prevention behavior; however, depression was confirmed to be related to infection prevention behavior via the mediation of health belief. Arbitration measures, focusing on perceived severity and susceptibility during health belief, are required. Full article
►▼ Show Figures

Figure 1

Figure 1
<p>Path diagram of the model.</p> Full article ">
10 pages, 254 KiB  
Article
Joint Effect of Diabetes Mellitus and Hypertension on COVID-19 in-Hospital Mortality Stratified by Age Group and Other Comorbidities: A Cohort Retrospective Study Using Hospital-Based Data in Sleman, Yogyakarta
by Yampa Eksa Daidella Ghilari, Arik Iskandar, Bayu Satria Wiratama and Anggoro Budi Hartopo
Healthcare 2022, 10(10), 2103; https://doi.org/10.3390/healthcare10102103 - 20 Oct 2022
Cited by 1 | Viewed by 1739
Abstract
The joint effect of diabetes mellitus and hypertension on COVID-19 has rarely been evaluated but had potential as a major risk factor. This study aims to investigate the joint effect between diabetes mellitus and hypertension on in-hospital mortality among COVID-19 patients in Yogyakarta [...] Read more.
The joint effect of diabetes mellitus and hypertension on COVID-19 has rarely been evaluated but had potential as a major risk factor. This study aims to investigate the joint effect between diabetes mellitus and hypertension on in-hospital mortality among COVID-19 patients in Yogyakarta stratified by age groups and other comorbidities status. Methods: This cohort retrospective study collected data from two major hospitals in the Sleman district and a total of 2779 hospitalized COVID-19 patients were included in this study. The study outcome was COVID-19 in-hospital mortality (deceased or discharged alive) and the main risk factors were diabetes mellitus (DM) and hypertension (HT). The multiple logistic regression model was utilized to estimate adjusted odds ratio (AOR) and calculate the joint effect. Results: COVID-19 patients who have both DM and hypertension were three times (AOR: 3.21; 95% CI: 2.45–4.19) more likely to have in-hospital mortality than those without both comorbidities. The highest risk of in-hospital mortality was found in COVID-19 patients without other comorbidities (other than DM and HT) and younger age (age 0–40 years), with AOR equal to 22.40 (95% CI: 6.61–75.99). Conclusions: This study identified a joint effect between diabetes mellitus and hypertension which increases the risk of in-hospital mortality among COVID-19 patients. Targeted public health, clinical, and health education intervention should be carried out on individuals with diabetes mellitus and/or hypertension. Full article
(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
31 pages, 17990 KiB  
Article
Unmanned Aerial Vehicle in the Logistics of Pandemic Vaccination: An Exact Analytical Approach for Any Number of Vaccination Centres
by Adnan Benayad, Olaf Malasse, Hicham Belhadaoui and Noureddine Benayad
Healthcare 2022, 10(10), 2102; https://doi.org/10.3390/healthcare10102102 - 20 Oct 2022
Cited by 1 | Viewed by 1644
Abstract
While the development and manufacture of pandemic vaccines is a daunting task, the greatest challenge lies in how to deliver these vaccines to billions of people around the world. This requires an efficient strategy of deliveries, at constrained costs and deadlines. This paper [...] Read more.
While the development and manufacture of pandemic vaccines is a daunting task, the greatest challenge lies in how to deliver these vaccines to billions of people around the world. This requires an efficient strategy of deliveries, at constrained costs and deadlines. This paper proposes an exact analytical approach and operational strategy to the logistics of any pandemic vaccination efforts, applicable both to sparsely populated areas or deficient infrastructure, and to very dense urban fabrics where mobility is highly constrained. Our strategy consists in dividing the territory concerned into zones and districts in a concentric way. We opt for the use of unmanned aerial vehicles to free ourselves from land constraints. This involves serving, from a logistics centre (central depot), any number n of vaccination centres, while optimizing costs and deadlines. We have determined all equivalent and optimal flight path plans for a fixed and optimal number of drones, which depend on domain D(d); d being the demand of vaccination centers. The analysis of the results led us to define what we will call the “degeneracy of domain D”. All our results are expressed as a function of the parameter n. Full article
(This article belongs to the Topic Multiagency Approach to Disaster Management, Focusing on Triage, Treatment and Transport)
►▼ Show Figures

Figure 1

Figure 1
<p>Localization of all vaccination centres belonging to the concerned territorial area.</p> Full article ">Figure 2
<p>The variation of optimum number N of drones as function of vaccination centre demands, for n = 7, 8, and 9.</p> Full article ">Figure 3
<p>Set of possible graphs corresponding to the various domains of d/C for N = 2, (<b>a</b>) n = 12, (<b>b</b>) n = 13, and (<b>c</b>) n = 15.</p> Full article ">Figure 4
<p>Set of possible graphs corresponding to the various domains of d/C for N = 3, (<b>a</b>) n = 12, (<b>b</b>) n = 13, and (<b>c</b>) n = 15.</p> Full article ">Figure 4 Cont.
<p>Set of possible graphs corresponding to the various domains of d/C for N = 3, (<b>a</b>) n = 12, (<b>b</b>) n = 13, and (<b>c</b>) n = 15.</p> Full article ">Figure 5
<p>A generalization making possible to find the variation of domain degeneracy for any odd number of vaccination centres.</p> Full article ">Figure 5 Cont.
<p>A generalization making possible to find the variation of domain degeneracy for any odd number of vaccination centres.</p> Full article ">Figure 6
<p>A generalization making possible to find the variation of domain degeneracy for any even number of vaccination centres.</p> Full article ">Figure 6 Cont.
<p>A generalization making possible to find the variation of domain degeneracy for any even number of vaccination centres.</p> Full article ">Figure 7
<p>Variation of degree of degeneracy deg(D<sub>0</sub>) and deg(<math display="inline"><semantics> <mover accent="true"> <mi>D</mi> <mo stretchy="false">¯</mo> </mover> </semantics></math><sub>1</sub>) with n.</p> Full article ">Figure 8
<p>Variation of the degrees of degeneracy deg(D<sub>p</sub>) and deg(<math display="inline"><semantics> <mover accent="true"> <mi>D</mi> <mo stretchy="false">¯</mo> </mover> </semantics></math><sub>q</sub>) corresponding to the least degenerate domains.</p> Full article ">Figure 9
<p>Dependence of the number of graphs <span class="html-italic">NG</span> (n, N = 2) as a function of n.</p> Full article ">Figure 10
<p>Dependence of the number of graphs <span class="html-italic">NG</span>(n, N = 3) as a function of odd n. <b>•</b>: (<math display="inline"><semantics> <mrow> <mi mathvariant="normal">n</mi> <mo>∈</mo> <mrow> <mo>{</mo> <mrow> <mn>2</mn> <mi>k</mi> <mo>+</mo> <mn>1</mn> <mo>/</mo> <mo> </mo> <mi>k</mi> <mo>∈</mo> <mi>I</mi> <mi>N</mi> </mrow> <mo>}</mo> </mrow> </mrow> </semantics></math>, odd p); <b>x</b>: (<math display="inline"><semantics> <mrow> <mi mathvariant="normal">n</mi> <mo>∈</mo> <mrow> <mo>{</mo> <mrow> <mn>3</mn> <mo>+</mo> <mn>4</mn> <mi>k</mi> <mo>/</mo> <mo> </mo> <mi>k</mi> <mo>∈</mo> <mi>I</mi> <mi>N</mi> </mrow> <mo>}</mo> </mrow> </mrow> </semantics></math>, even p); <b>*</b>: (n<math display="inline"><semantics> <mrow> <mo>∈</mo> <mrow> <mo>{</mo> <mrow> <mn>5</mn> <mo>+</mo> <mn>4</mn> <mi>k</mi> <mo>/</mo> <mi>k</mi> <mo>∈</mo> <mi>I</mi> <mi>N</mi> </mrow> <mo>}</mo> </mrow> <mo>,</mo> </mrow> </semantics></math> even p).</p> Full article ">Figure 11
<p>Dependence of the number of graphs <span class="html-italic">NG</span>(n, N = 3) as a function of even n. <b>•</b>: (<math display="inline"><semantics> <mrow> <mi mathvariant="normal">n</mi> <mo>∈</mo> <mrow> <mo>{</mo> <mrow> <mn>2</mn> <mi>k</mi> <mo>/</mo> <mo> </mo> <mi>k</mi> <mo>∈</mo> <mi>I</mi> <mi>N</mi> </mrow> <mo>}</mo> </mrow> </mrow> </semantics></math>, even q); <b>x</b>: (<math display="inline"><semantics> <mrow> <mi mathvariant="normal">n</mi> <mo>∈</mo> <mrow> <mo>{</mo> <mrow> <mn>6</mn> <mo>+</mo> <mn>4</mn> <mi>k</mi> <mo>/</mo> <mo> </mo> <mi>k</mi> <mo>∈</mo> <mi>I</mi> <mi>N</mi> </mrow> <mo>}</mo> </mrow> </mrow> </semantics></math>, odd q); <b>*</b>: (n<math display="inline"><semantics> <mrow> <mo> </mo> <mo>∈</mo> <mrow> <mo>{</mo> <mrow> <mn>8</mn> <mo>+</mo> <mn>4</mn> <mi>k</mi> <mo>/</mo> <mi>k</mi> <mo>∈</mo> <mi>I</mi> <mi>N</mi> </mrow> <mo>}</mo> </mrow> <mo>,</mo> </mrow> </semantics></math> odd q).</p> Full article ">Figure A1
<p>The variation of optimum number N of drones as function of vaccination centre demands, for n = 5, and 6.</p> Full article ">Figure A2
<p>The variation of domain degeneracy as a function of vaccination centre demands «site needs» for selected odd values of n.</p> Full article ">Figure A2 Cont.
<p>The variation of domain degeneracy as a function of vaccination centre demands «site needs» for selected odd values of n.</p> Full article ">Figure A2 Cont.
<p>The variation of domain degeneracy as a function of vaccination centre demands «site needs» for selected odd values of n.</p> Full article ">Figure A2 Cont.
<p>The variation of domain degeneracy as a function of vaccination centre demands «site needs» for selected odd values of n.</p> Full article ">Figure A3
<p>The variation of domain degeneracy as a function of the vaccination centres demands for selected even values of n.</p> Full article ">Figure A3 Cont.
<p>The variation of domain degeneracy as a function of the vaccination centres demands for selected even values of n.</p> Full article ">Figure A3 Cont.
<p>The variation of domain degeneracy as a function of the vaccination centres demands for selected even values of n.</p> Full article ">Figure A3 Cont.
<p>The variation of domain degeneracy as a function of the vaccination centres demands for selected even values of n.</p> Full article ">
17 pages, 299 KiB  
Article
Mutual Role Expectations by Patients and General Practitioners—A Mixed Methods Study on Complementarity
by Barbara Plagg, Adolf Engl, Giuliano Piccoliori, Hermann Atz, Ulrich Becker, Johann Kiem, Verena Barbieri, Klaus Eisendle, Christian Josef Wiedermann, Susanne Ursula Elsen and Walter August Lorenz
Healthcare 2022, 10(10), 2101; https://doi.org/10.3390/healthcare10102101 - 20 Oct 2022
Viewed by 1591
Abstract
Background: Changes in public attitudes toward “authorities” in general, as well as shifts in medical practice toward participative models of diagnosis and treatment, imply fundamental transformations in the patient–doctor relationship. However, consistency in reciprocal role expectations cannot be assumed, and this study reveals [...] Read more.
Background: Changes in public attitudes toward “authorities” in general, as well as shifts in medical practice toward participative models of diagnosis and treatment, imply fundamental transformations in the patient–doctor relationship. However, consistency in reciprocal role expectations cannot be assumed, and this study reveals significant discrepancies in attitudes and behaviors in primary health consultations. Methods: We conducted a study in the tri-lingual northeastern Italian region of South Tyrol to determine whether perceptions of the patient’s role were congruent or differed. In a mixed method approach, the quantitative research part consisted of a survey with 34 identical questions for general practitioners (n = 109) and adult primary care patients (n = 506) on verbal communication, self-initiative and health literacy, interpersonal and social qualities of the patient–physician relationship, and formal aspects of the consultation. Patients were interviewed via telephone, and general practitioners responded online. In the qualitative part, 26 semi-structured in-depth interviews were conducted with the patients and analyzed. Results: General practitioners considered patients’ communicative efforts (p < 0.001), self-initiative (p < 0.001), compliance (p = 0.0026), and openness regarding psychosocial issues (p < 0.001) to be significantly more important, whereas patients showed a tendency to give increased importance to formal aspects such as politeness and hygiene (p < 0.001). Perception of the patient’s role differed significantly between the Italian and German linguistic groups. Conclusions: Patients and general practitioners differ in their understanding of patients’ roles. These data suggest that a considerable proportion of the population lacks a clear and tangible idea of the active role they could play in consultations. Targeted information on the identified aspects of patient–provider communication may facilitate participatory behavior and positively impact the longitudinal quality of the patient–general practitioner relationship. Full article
(This article belongs to the Special Issue Expanding Competency of Primary Health Care: Emotional and Bio-Social Meanings for General Practice Consultation)
18 pages, 1837 KiB  
Article
Use Case Evaluation and Digital Workflow of Breast Cancer Care by Artificial Intelligence and Blockchain Technology Application
by Sebastian Griewing, Michael Lingenfelder, Uwe Wagner and Niklas Gremke
Healthcare 2022, 10(10), 2100; https://doi.org/10.3390/healthcare10102100 - 20 Oct 2022
Cited by 4 | Viewed by 1889
Abstract
This study aims at evaluating the use case potential of breast cancer care for artificial intelligence and blockchain technology application based on the patient data analysis at Marburg University Hospital and, thereupon, developing a digital workflow for breast cancer care. It is based [...] Read more.
This study aims at evaluating the use case potential of breast cancer care for artificial intelligence and blockchain technology application based on the patient data analysis at Marburg University Hospital and, thereupon, developing a digital workflow for breast cancer care. It is based on a retrospective descriptive data analysis of all in-patient breast and ovarian cancer patients admitted at the Department of Gynecology of Marburg University Hospital within the five-year observation period of 2017 to 2021. According to the German breast cancer guideline, the care workflow was visualized and, thereon, the digital concept was developed, premised on the literature foundation provided by a Boolean combination open search. Breast cancer cases display a lower average patient case complexity, fewer secondary diagnoses, and performed procedures than ovarian cancer. Moreover, 96% of all breast cancer patients originate from a city with direct geographical proximity. Estimated circumference and total catchment area of ovarian present 28.6% and 40% larger, respectively, than for breast cancer. The data support invasive breast cancer as a preferred use case for digitization. The digital workflow based on combined application of artificial intelligence as well as blockchain or distributed ledger technology demonstrates potential in tackling senological care pain points and leveraging patient data safety and sovereignty. Full article
(This article belongs to the Special Issue Secure and Privacy-Preserving Smart Healthcare)
►▼ Show Figures

Figure 1

Figure 1
<p>C50 and C56 geographical distribution by five-digit zip codes.</p> Full article ">Figure 2
<p>Overview of the breast cancer care workflow based on the German guideline.</p> Full article ">Figure 3
<p>Overview of the technological solution (DGS = German senological center, API = application programming interface).</p> Full article ">
13 pages, 265 KiB  
Article
The Burden of Out-of-Pocket Expenditure Related to Gynaecological Cancer in Malaysia
by Chee Hui Liew, Fatiha Hana Shabaruddin and Maznah Dahlui
Healthcare 2022, 10(10), 2099; https://doi.org/10.3390/healthcare10102099 - 20 Oct 2022
Cited by 5 | Viewed by 2170
Abstract
This study aimed to estimate the economic burden on gynaecological cancer patients and their households, in terms of out-of-pocket expenditure, catastrophic health expenditure (CHE) and poverty impact. A cross-sectional study was conducted at an academic tertiary-care health centre in an upper-middle-income country. Data [...] Read more.
This study aimed to estimate the economic burden on gynaecological cancer patients and their households, in terms of out-of-pocket expenditure, catastrophic health expenditure (CHE) and poverty impact. A cross-sectional study was conducted at an academic tertiary-care health centre in an upper-middle-income country. Data were obtained via structured interviews of 120 gynaecological cancer patients alongside review of medical charts. Mean (SD) and median (IQR) annual household out-of-pocket expenditures were USD 2780 (SD = USD 3926) and USD 1396 (IQR = 3013), respectively. Two thirds (n = 77/120, 64%) of households experienced CHE and 17% (n = 20/120) were impoverished due to out-of-pocket expenditure related to gynaecological cancer. Factors associated with CHE, explored using multivariate logistic regression analysis, estimated that the highest income quintile households, Q5, were 90% less likely to incur CHE compared to the lowest income quintile households, Q1 (adjusted odds ratio = 0.100; p-value < 0.05) and that patients who were not receiving chemotherapy were 88% less likely to incur CHE compared to those receiving chemotherapy (adjusted odds ratio = 0.120; p-value < 0.05). These results indicate the necessity to broaden the coverage of existing financial assistance for patients from low- and middle-income households, such as extending coverage to adult patients of all ages and to those treated in all public hospitals, including academic health centres. Full article
18 pages, 1389 KiB  
Systematic Review
Prospect Theory: A Bibliometric and Systematic Review in the Categories of Psychology in Web of Science
by Júlia Gisbert-Pérez, Manuel Martí-Vilar and Francisco González-Sala
Healthcare 2022, 10(10), 2098; https://doi.org/10.3390/healthcare10102098 - 20 Oct 2022
Cited by 4 | Viewed by 3607
Abstract
Prospect Theory (PT) is an alternative, dynamic explanation of the phenomenon of risky decision making. This research presents an overview of PT’s history in health fields, including advancements, limitations, and bibliometric data. A systematic and bibliometric review of the scientific literature included in [...] Read more.
Prospect Theory (PT) is an alternative, dynamic explanation of the phenomenon of risky decision making. This research presents an overview of PT’s history in health fields, including advancements, limitations, and bibliometric data. A systematic and bibliometric review of the scientific literature included in the psychological categories of Web of Science (WoS) was performed following the PRISMA 2020 statement for systematic reviews. A total of 37 studies (10 non-empirical and 27 empirical) were included in the sample. Bibliometric results showed thematic variability and heterogeneity regarding the production, researchers, and methodologies that are used to study PT. The systematic results highlight three main fields of PT research: preventive and screening behaviors, promotion of healthy habits, and COVID-related decision making. Personal and contextual factors which alter the usual pattern specified by PT are also described. To conclude, PT currently has an interdisciplinary character suitable for health promotion, with recent studies broadening its applicability. Full article
(This article belongs to the Special Issue Primary Mental Health Care in a New Era)
►▼ Show Figures

Figure 1

Figure 1
<p>Flowchart of the selection and screening process of the systematic review articles according to the PRISMA method.</p> Full article ">Figure 2
<p>Annual scientific production.</p> Full article ">Figure 3
<p>Country scientific production.</p> Full article ">Figure 4
<p>Co-occurrence network.</p> Full article ">
16 pages, 342 KiB  
Review
Specialists’ Dual Practice within Public Hospital Setting: Evidence from Malaysia
by Malindawati Mohd Fadzil, Sharifa Ezat Wan Puteh, Azimatun Noor Aizuddin and Zafar Ahmed
Healthcare 2022, 10(10), 2097; https://doi.org/10.3390/healthcare10102097 - 20 Oct 2022
Cited by 3 | Viewed by 3164
Abstract
In line with the commitment of the Malaysian government and Ministry of Health to prevent the brain drain of specialists from public hospitals, they have been permitted to perform dual practice within the public hospital setting (DPH) since 2007. DPH allowed them to [...] Read more.
In line with the commitment of the Malaysian government and Ministry of Health to prevent the brain drain of specialists from public hospitals, they have been permitted to perform dual practice within the public hospital setting (DPH) since 2007. DPH allowed them to hold jobs in both public and private practices within the same public hospitals that they are affiliated to, permitting these specialists to treat public and private patients. Nevertheless, the information regarding DPH in Southeast Asia region is still limited. This narrative review provides insight into the implementation of DPH in Malaysia. It highlights that DPH has been well-governed and regulated by the MOH while serving as a means to retain specialists in the public healthcare system by providing them with opportunities to obtain additional income. Such a policy has also reduced the financial burden of the government in subsidizing healthcare. However, as in other countries with similar policies, multiple challenges have arisen from the implementation of DPH in Malaysia despite its positive achievements and potentials. This paper concludes that proactive governance, monitoring, and regulation are key to ensure the success of DPH. Full article
(This article belongs to the Section Health Policy)
12 pages, 1354 KiB  
Article
Poor Health Conditions among Brazilian Healthcare Workers: The Study Design and Baseline Characteristics of the HEROES Cohort
by Tatiana de Oliveira Sato, Beatriz Suelen Ferreira de Faria, Bianca Biason Albuquerque, Fabio Leandro da Silva, Luiza Salvador Rohwedder, Renata Trivelato de Azevedo, Josiane Sotrate Gonçalves, Ludmilla Maria Souza Mattos de Araújo Vieira, Maria Isabel Triches, Rosângela Aparecida de Sousa, Viviane de Freitas Cardoso and Vivian Aline Mininel
Healthcare 2022, 10(10), 2096; https://doi.org/10.3390/healthcare10102096 - 20 Oct 2022
Cited by 6 | Viewed by 2316
Abstract
This study was conducted to describe the health conditions (the psychosocial aspects, sleep quality, and musculoskeletal symptoms) among Brazilian healthcare workers in the context of the pandemic. Workers answered an online questionnaire, including the short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II), [...] Read more.
This study was conducted to describe the health conditions (the psychosocial aspects, sleep quality, and musculoskeletal symptoms) among Brazilian healthcare workers in the context of the pandemic. Workers answered an online questionnaire, including the short version of the Copenhagen Psychosocial Questionnaire (COPSOQ II), the Pittsburgh Sleep Quality Index (PSQI), the Nordic Musculoskeletal Questionnaire (NMQ), and the Beck Depression Inventory (BDI). The most unfavourable psychosocial factors were work pace (61%; 95% CI: 52–69%), emotional work demands (75%; 95% CI: 67–82%), predictability (47%; 95% CI: 39–56%), work-family conflict (55%; 95% CI: 46–64%), burnout (86%; 95% CI: 78–91%), and stress (81%; 95% CI: 73–87%). Most workers (74%; 95% CI: 66–81%) were classified as poor sleepers. Musculoskeletal symptoms were frequent in the neck (64%; 95% CI: 55–72%), shoulders (62%; 95% CI: 54–70%), upper back (58%; 95% CI: 50–67%), and lower back (61%; 95% CI: 52–69%). Depressive symptoms were also highly prevalent (mild: 22%; 95% CI: 15–30%, moderate: 16%; 95% CI: 11–23%, severe: 8%; 95% CI: 4–14%). Most healthcare workers experience unfavourable psychosocial factors, poor sleep quality, as well as musculoskeletal and depressive symptoms. These findings underscore the urgent need to acknowledge and address psychological and physical distress to improve the personal and professional well-being of this population. Full article
(This article belongs to the Section Coronaviruses (CoV) and COVID-19 Pandemic)
►▼ Show Figures

Figure 1

Figure 1
<p>Flowchart of the participant selection process in accordance with Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).</p> Full article ">Figure 2
<p>Questionnaires applied to each stage of the study.</p> Full article ">Figure 3
<p>Percentage of psychosocial risks according to the dimensions of the COPSOQ II-Br (n = 125). Data are expressed as %.</p> Full article ">
10 pages, 570 KiB  
Case Report
Non-Communicable Diseases and Transitioning Health System in the Democratic People’s Republic of Korea during COVID-19 Lockdown
by Jin-Won Noh, Kyoung-Beom Kim, Ha-Eun Jang, Min-Hee Heo, Young-Jin Kim and Jiho Cha
Healthcare 2022, 10(10), 2095; https://doi.org/10.3390/healthcare10102095 - 20 Oct 2022
Viewed by 2071
Abstract
While there are increasing concerns on COVID-19 situation in Democratic People’s Republic of Korea (DPRK, or North Korea), little is known about North Korea’s health system function for Non-Communicable Diseases. Given the scarcity of available evidence, a scoping review was conducted in peer [...] Read more.
While there are increasing concerns on COVID-19 situation in Democratic People’s Republic of Korea (DPRK, or North Korea), little is known about North Korea’s health system function for Non-Communicable Diseases. Given the scarcity of available evidence, a scoping review was conducted in peer review articles from MEDLINE, SCOPUS, and Web of Science, and policy literatures from Rodongshinmun, state-run media in North Korea to analyze the North Korea health system and COVID-19 pandemic. The transition to a market economy is expected to deepen the gap between the rich and the poor over access to health care, causing a new type of health inequality in North Korea. COVID-19 lockdown intensified the DPRK’s economic predicament exacerbating shortage of health financing on non-communicable diseases. The case study of mixed evidence from scoping review indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. This study indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. The destabilized markets under COVID-19 lockdown intensified the DPRK’s economic predicament and exacerbated the chronic shortage of health financing especially to NCDs. Full article
(This article belongs to the Collection COVID-19: Impact on Public Health and Healthcare)
►▼ Show Figures

Figure 1

Figure 1
<p>Flow Diagram of Study Selection.</p> Full article ">
12 pages, 605 KiB  
Article
Development and Validation of a Scale Measuring Intention toward Participating in Pro Bono of Pre-Service Physical Activity Instructors for the Activation of Physical Activity for the Disabled: Based on the Theory of Planned Behavior
by Kyungjin Kim and Yonghwa Lee
Healthcare 2022, 10(10), 2094; https://doi.org/10.3390/healthcare10102094 - 20 Oct 2022
Cited by 2 | Viewed by 1302
Abstract
The purpose of this study was to develop and validate a scale for predicting the intention of pre-service physical activity instructors for persons with disabilities to participate in pro bono work, based on the Theory of Planned Behavior. This study analyzed 322 university [...] Read more.
The purpose of this study was to develop and validate a scale for predicting the intention of pre-service physical activity instructors for persons with disabilities to participate in pro bono work, based on the Theory of Planned Behavior. This study analyzed 322 university students majoring in adapted physical activity in South Korea. To determine the purpose of the study, the EFA using SPSS 21.0 and CFA using AMOS 21.0 were used to confirm the validity of the measurement tool and the relationship between latent and observed variables. Further, the Cronbach’s alpha was used to identify the internal reliability. As a result, first, the questionnaire used in this study was validated based on the theory. Second, the behavioral belief was influenced by teaching experience about physical activity for the disabled and knowledge about physical activity for the disabled. Third, the normative belief was influenced by the parents of people with disabilities, people with disabilities, family members, friends, and students in my department. Fourth, the control belief was influenced by the state of mind of physical activity instructors for people with disabilities, the ability to create an IEP, and the ability to do physical activity. Full article
(This article belongs to the Special Issue Sports or/and Special Populations: Training Physiology in Health and Sports Performance)
►▼ Show Figures

Figure 1

Figure 1
<p>The diagram of results of the measurement model.</p> Full article ">
10 pages, 1380 KiB  
Article
Examination of the Impact of Strength and Velocity of the Knee and Ankle on Gait Speed in Community-Dwelling Older Adults
by Atsuki Kanayama, Mayuka Minami, Saki Yamamoto, Toshimitsu Ohmine, Minami Fujiwara, Takayuki Murakami, Shuji Okuno, Ryoga Ueba and Akira Iwata
Healthcare 2022, 10(10), 2093; https://doi.org/10.3390/healthcare10102093 - 20 Oct 2022
Cited by 4 | Viewed by 2070
Abstract
The muscle strength of the knee extension and plantarflexion plays a crucial role in determining gait speed. Recent studies have shown that no-load angular velocity of the lower limb joints is essential for determining gait speed. However, no reports have compared the extent [...] Read more.
The muscle strength of the knee extension and plantarflexion plays a crucial role in determining gait speed. Recent studies have shown that no-load angular velocity of the lower limb joints is essential for determining gait speed. However, no reports have compared the extent to which lower limb functions, such as knee extension strength, knee extension velocity, plantarflexion strength, and plantarflexion velocity, impact gait speed in a single study. Therefore, this study aimed to examine the relative importance of maximum strength and no-load angular velocity on gait speed. Overall, 164 community-dwelling older adults (72.9 ± 5.0 years) participated in this study. We measured the gait speed and lower limb function (the strength and velocity of knee extension and plantarflexion). Strength was measured with a hand-held dynamometer, and velocity with a gyroscope. A multiple regression analysis was performed with gait speed as the dependent variable and age, sex, and lower-limb function as independent variables. Plantarflexion velocity (β = 0.25) and plantarflexion strength (β = 0.21) were noted to be significant predictors of gait speed. These findings indicate that no-load plantarflexion velocity is more important than the strength of plantarflexion and knee extensions as a determinant of gait speed, suggesting that improvement in plantarflexion velocity may increase gait speed. Full article
►▼ Show Figures

Figure 1

Figure 1
<p>Measurement of ankle plantarflexion muscle strength. Participants sat on a bed with their backs against the backrest. The backrest was set to tilt backward by 30°. The hand-held dynamometer (HHD) was attached to the sole and the ankle joint was fixed to the neutral position.</p> Full article ">Figure 2
<p>Measurement of ankle plantarflexion angular velocity. Participants sat on a bed with their backs against the backrest. The backrest tilted backward by 30°. The gyroscope (GS) was attached to the dorsum of the feet.</p> Full article ">Figure 3
<p>Flowchart depicting the selection of study participants.</p> Full article ">
11 pages, 569 KiB  
Article
Academic Motivation of Indonesian University Students: Relationship with Self-Compassion and Resilience
by Yasuhiro Kotera, Muhammad Aledeh, Kristian Barnes, Annabel Rushforth, Habib Adam and Riswani Riswani
Healthcare 2022, 10(10), 2092; https://doi.org/10.3390/healthcare10102092 - 20 Oct 2022
Cited by 7 | Viewed by 3188
Abstract
Academic motivation is an important construct for university students, associated with student wellbeing and academic performance. Students who are motivated tend to feel and perform well. Self-compassion, that is kindness and understanding towards oneself in difficult times, and resilience, an ability to bounce [...] Read more.
Academic motivation is an important construct for university students, associated with student wellbeing and academic performance. Students who are motivated tend to feel and perform well. Self-compassion, that is kindness and understanding towards oneself in difficult times, and resilience, an ability to bounce back from difficulties, are also associated with student wellbeing and academic achievement. However, how these variables are related to each other has not been evaluated in Indonesian university students. Indonesian higher education has rapidly developed, focusing on student achievement while their wellbeing suffers. Understanding how academic motivation is linked with self-compassion and resilience can inform an effective way to augment their motivation. Accordingly, this cross-sectional study evaluated the relationship among these three variables. An opportunity sample of 156 students in Indonesia completed measures about those three constructs. Correlation, regression and moderation analyses were used. Intrinsic motivation was positively associated with extrinsic motivation and resilience. Amotivation was negatively associated with self-compassion and resilience. Self-compassion was positively associated with resilience. Both self-compassion and resilience predicted all three types of motivation apart from self-compassion for intrinsic motivation. Lastly, self-compassion nor resilience moderated the pathway from extrinsic motivation to intrinsic motivation. Resilience interventions are recommended for Indonesian students to maintain intrinsic motivation. Our findings will help educators and wellbeing staff to identify helpful ways to support healthful motivation in this student population that is undergoing drastic changes. Full article
(This article belongs to the Special Issue Mental and Behavioral Healthcare)
►▼ Show Figures

Figure 1

Figure 1
<p>Moderation of self-compassion on the pathway from extrinsic motivation to intrinsic motivation: conceptual diagram (<b>Panel A</b>) and statistical diagram (<b>Panel B</b>).</p> Full article ">Figure 2
<p>Moderation of resilience on the pathway from extrinsic motivation to intrinsic motivation: conceptual diagram (<b>Panel A</b>) and statistical diagram (<b>Panel B</b>).</p> Full article ">
9 pages, 276 KiB  
Article
The Effects of Academic Stress and Upward Comparison on Depression in Nursing Students during COVID-19
by Eunju Kwak, Seungmi Park and Ji Woon Ko
Healthcare 2022, 10(10), 2091; https://doi.org/10.3390/healthcare10102091 - 20 Oct 2022
Cited by 5 | Viewed by 2298
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has created a global long-term education crisis, which has negatively affected the psychological well-being of nursing students. This study aims to determine the effect of academic stress and upward comparison on depression among nursing students during the [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic has created a global long-term education crisis, which has negatively affected the psychological well-being of nursing students. This study aims to determine the effect of academic stress and upward comparison on depression among nursing students during the COVID-19 pandemic. A convenience sample of 271 junior and senior nursing students from four universities in South Korea was selected. The SPSS/WIN 28.0 program was employed for the data analysis, and multiple regression analysis was performed to confirm the effect of academic stress and stress from upward comparison on depression. The study results show that the regression model was significant (F = 7.60, p < 0.001). Moreover, age over 25 (β = 0.15, p = 0.006), academic stress (β = 0.31, p < 0.001), and upward comparison (β = 0.18, p = 0.002) explained 19.0% of depression among the participants. Developing and testing the effect of programs that address academic stress and upward comparison may be necessary to control depression in nursing students. Furthermore, in response to COVID-19, efforts must be made to include these interventions in the curriculum for nursing students on a consistent basis. Full article
(This article belongs to the Section Nursing)
16 pages, 1359 KiB  
Article
Barriers and Facilitators to Intradialytic Parenteral Nutrition Implementation Targeting Protein Energy Wasting in Malaysian Hemodialysis Patients
by Birinder Kaur Sadu Singh, Ban-Hock Khor, Sharmela Sahathevan, Abdul Halim Abdul Gafor, Enrico Fiaccadori, Karuthan Chinna, See-Hoe Ng and Tilakavati Karupaiah
Healthcare 2022, 10(10), 2090; https://doi.org/10.3390/healthcare10102090 - 20 Oct 2022
Viewed by 2111
Abstract
The capacity to deliver intradialytic parenteral nutrition (IDPN) for patients on hemodialysis (HD) diagnosed with protein energy wasting (PEW) in low resource settings is unknown. This study aimed to examine the extent of IDPN practice in HD units in Malaysia, and its implementation [...] Read more.
The capacity to deliver intradialytic parenteral nutrition (IDPN) for patients on hemodialysis (HD) diagnosed with protein energy wasting (PEW) in low resource settings is unknown. This study aimed to examine the extent of IDPN practice in HD units in Malaysia, and its implementation to treat PEW. We surveyed pharmacists (n = 56), who are central to parenteral nutrition delivery in Malaysia including IDPN. Seventeen healthcare stakeholders engaging with the Promoting Action on Research Implementation in Health Services (PARIHS) framework used the Likert scale to rate survey outcomes on IDPN implementation to treat PEW, according to the Evidence, Context, and Facilitation elements. IDPN for HD patients was available in 28 of 56 hospitals providing parenteral nutrition services, with only 13 hospitals (23.2%) providing IDPN to outpatients. Outpatient treatment was concentrated to urban locations (12/13) and significantly associated (p < 0.001) with resident nephrologists. The Evidence domain was rated poorly (2.18 ± 0.15) pertaining to IDPN indication when the oral spontaneous intake was ≤20 kcal/kg/day. The Context domain indicated good adherence to international best practice relating to IDPN administration (4.59 ± 0.15) and infusion time (4.59 ± 0.12). Poor adherence was observed in the Facilitation domain on ’Access to pharmacist and dietitian at HD units’ (2.65 ± 0.21) and ’Access to continuous medical education on managing PEW patients on HD’ (2.53 ± 0.15). The IDPN outpatient service was concentrated to urban hospitals with greater manpower resources. The PARIHS evaluation on IDPN implementation to treat PEW revealed facilitators in good practice adherence for prescribing and administration of IDPN but highlighted major barriers relating to IDPN indication and nutrient calculation. Full article
(This article belongs to the Special Issue Clinical Nutrition Management in Healthcare)
►▼ Show Figures

Figure 1

Figure 1
<p>Process Flow from Question to Discussion in the SIS-ER Workshop.</p> Full article ">Figure 2
<p>Mean ± SE Score Ratings from Experts as per Indicators and PARIHS Domains. Abbreviations: HD, Hemodialysis; IDPN, Intradialytic Parenteral Nutrition; IV, Intravenous; PEW, Protein Energy Wasting.</p> Full article ">Figure 3
<p>Outcome Summary of Implementation of IDPN Best Practice Defined by the PARIHS Framework.</p> Full article ">
16 pages, 2785 KiB  
Article
A Tooth Segmentation Method Based on Multiple Geometric Feature Learning
by Tian Ma, Yizhou Yang, Jiechen Zhai, Jiayi Yang and Jiehui Zhang
Healthcare 2022, 10(10), 2089; https://doi.org/10.3390/healthcare10102089 - 20 Oct 2022
Cited by 3 | Viewed by 2134
Abstract
Tooth segmentation is an important aspect of virtual orthodontic systems. In some existing studies using deep learning-based tooth segmentation methods, the feature learning of point coordinate information and normal vector information is not effectively distinguished. This will lead to the feature information of [...] Read more.
Tooth segmentation is an important aspect of virtual orthodontic systems. In some existing studies using deep learning-based tooth segmentation methods, the feature learning of point coordinate information and normal vector information is not effectively distinguished. This will lead to the feature information of these two methods not producing complementary intermingling. To address this problem, a tooth segmentation method based on multiple geometric feature learning is proposed in this paper. First, the spatial transformation (T-Net) module is used to complete the alignment of dental model mesh features. Second, a multiple geometric feature learning module is designed to encode and enhance the centroid coordinates and normal vectors of each triangular mesh to highlight the differences between geometric features of different meshes. Finally, for local to global fusion features, feature downscaling and channel optimization are accomplished layer by layer using multilayer perceptron (MLP) and efficient channel attention (ECA). The experimental results show that our algorithm achieves better accuracy and efficiency of tooth segmentation and can assist dentists in their treatment work. Full article
(This article belongs to the Section Artificial Intelligence in Medicine)
►▼ Show Figures

Figure 1

Figure 1
<p>Creation and preprocessing of dental model datasets.</p> Full article ">Figure 2
<p>Mesh model point clouding segmentation.</p> Full article ">Figure 3
<p>Overall network structure.</p> Full article ">Figure 4
<p>MGFL diagram. MGFL consists of shared MLP, geometric information encoding (GIE) module and geometric feature aggregation (GFA) module.</p> Full article ">Figure 5
<p>ECA diagram. N represents the number of input triangular meshes for the dental model, and C represents the feature dimension of each triangular mesh.</p> Full article ">Figure 6
<p>T-Net structure diagram.</p> Full article ">Figure 7
<p>Comparison of tooth segmentation visualization results of different algorithms.</p> Full article ">
12 pages, 271 KiB  
Article
Factors Related to the Continuity of Care and Self-Management of Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Taiwan
by Hsiao-Mei Chen and Bei-Yi Su
Healthcare 2022, 10(10), 2088; https://doi.org/10.3390/healthcare10102088 - 20 Oct 2022
Cited by 5 | Viewed by 1646
Abstract
Background: Most diabetic patients suffer from chronic diseases affecting their self-management status. This study aims to explore the relationship between the CoC and the self-management of patients with Type 2 Diabetes Mellitus (T2DM) and analyze the predictive factors affecting their self-management. Methods: Structured [...] Read more.
Background: Most diabetic patients suffer from chronic diseases affecting their self-management status. This study aims to explore the relationship between the CoC and the self-management of patients with Type 2 Diabetes Mellitus (T2DM) and analyze the predictive factors affecting their self-management. Methods: Structured questionnaires were used for data collection. Convenient sampling was adopted to recruit inpatients diagnosed with T2DM in the endocrine ward of a medical hospital in central Taiwan. Results: A total of 160 patients were recruited. The average age of the patients is 66.60 ± 14.57 years old. Among the four dimensions of the self-management scale, the average score of the problem-solving dimension was the highest, and that of the self-monitoring of blood glucose was the lowest. The analysis results showed that the overall regression model could explain 20.7% of the total variance in self-management. Conclusions: Healthcare providers should attach importance to the CoC of T2DM patients and encourage patients to maintain good interaction with healthcare providers during their hospitalization. It is recommended to strengthen CoC for patients with diabetes who are single or with low educational levels in clinical practice to enhance their blood glucose control and improve diabetes self-management. Full article
(This article belongs to the Section Chronic Care)
9 pages, 884 KiB  
Review
Fibroid Removal after Myomectomy: An Overview on the Problems of Power Morcellation
by Radmila Sparić, Mladen Andjić, Ottavia D’Oria, Ivana Babović, Zagorka Milovanović, Gaetano Panese, Martina Licchelli, Đina Tomašević, Andrea Morciano and Andrea Tinelli
Healthcare 2022, 10(10), 2087; https://doi.org/10.3390/healthcare10102087 - 19 Oct 2022
Cited by 2 | Viewed by 2621
Abstract
The authors reviewed uterine fibroid (UF) morcellation and its potential consequences, notably a hypothetical spread and dissemination of occult uterine leiomyosarcoma (LMS) tissue, evaluating the effect of laparoscopic versus open myomectomies with and without morcellation on patients’ outcomes, as well as related medical-legal [...] Read more.
The authors reviewed uterine fibroid (UF) morcellation and its potential consequences, notably a hypothetical spread and dissemination of occult uterine leiomyosarcoma (LMS) tissue, evaluating the effect of laparoscopic versus open myomectomies with and without morcellation on patients’ outcomes, as well as related medical-legal issues. MEDLINE and PubMed search was performed for the years 1990–2021, using a combination of keywords on this topic. Relevant articles were identified and included in this narrative review. There is an individual risk, for all patients, for LMS diagnosis after myomectomy. However, the risk for occult LMS diagnosis during a laparoscopic myomectomy is generally reduced when the guidelines of scientific societies are followed, with an overall benefit from the laparoscopic approach with morcellation in appropriate cases. Gynecological societies do not ban morcellation and laparoscopic hysterectomy/myomectomy per se, but recommend their use on the basis of the patients’ clinical characteristics. It is suggested for gynecologists to provide detailed information to patients when obtaining an informed consent for open or laparoscopic hysterectomy/myomectomy. A detailed preoperative assessment of patients and the risk benefit ratio of laparoscopic morcellation of uterine mass could overcome the “a priori” banning of the morcellation technique. Full article
(This article belongs to the Special Issue Gynecological Cancer Diagnosis and Prevention)
►▼ Show Figures

Figure 1

Figure 1
<p>Immunohistochemical preparation of LMS cells (magnification at 10×). It could be seen that the tumor is heterogeneous. The tumor cells frequently express Ki-67 antigen.</p> Full article ">Figure 2
<p>The morcellated uterine fibroid.</p> Full article ">
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-308
Previous Issue
Next Issue
Back to TopTop