Healthcare最新文献

Background: With increasing demand for ambulatory catheter angiography, interest in the transradial approach for diagnostic cerebral procedures has grown markedly. This study aimed to evaluate the effect of the transradial approach for catheter-based diagnostic cerebral procedures on wrist function. Methods: Wrist function was quantified by the Patient-Rated Wrist Evaluation (PRWE) questionnaire. The PRWE score ranged from 0 to 100, with 0 indicating no functional impairment. Association analyses with demographic and clinical parameters were performed using univariate logistic regression models. Results: A total of 88 patients underwent ambulatory diagnostic cerebral angiography during the 15-month observation period; of these, 40 (45%) participated in a telephone interview. Overall, 47.5% (n = 19) of patients reported no wrist impairment (PRWE = 0) after the transradial approach. The remaining 52.5% (n= 21) showed a mean PRWE score of 21.3 ± 22.5 (standard deviation), with a median value of 11.0 and a range from 1.0 to 87.0. Interestingly, univariate logistic regression models revealed a trend towards association between the dichotomized PRWE score and body mass index (p = 0.051). No associations were found with age, sex, prior neurosurgical status, total procedure duration, dose area product, fluoroscopy time, or dominant hand (p > 0.05). Conclusions: Following transradial cerebral catheter angiography, 52.5% of patients reported some degree of wrist impairment at follow-up; whether this represents procedure-related deterioration cannot be determined without baseline values.

Background/Objectives: People suffering from mental illnesses are more likely to experience adverse social and health outcomes. Various interventions have been shown to help people with mental illness achieve better results in terms of symptom reduction, functional status, and quality of life. Psychiatric rehabilitation interventions integrate evidence-based practices, promising approaches, and emerging methods that can be effectively implemented to enhance health outcomes in this population. This study aims to examine whether the rehabilitative treatment provided to a group of patients with mental illness leads to improvements in health outcomes and psychiatric symptomatology. Methods: This study employed a retrospective quasi-experimental design. Data were collected between 2023 and 2025 within the Partial Hospitalization Program of the Psychiatry and Mental Health Service of Soria (Spain). The sample consisted of 58 participants who received rehabilitative treatment in this setting. Data were collected at the time of patients' admission and at discharge. Gender, age, psychiatric diagnosis according to ICD-10, and the average length of stay in the rehabilitation program were assessed. The questionnaires administered were psychometrically validated scales related to heteroaggressiveness, perceived quality of life, global functioning, attitudes toward medication, and the risk of suicide. Results: A significant improvement was observed in the Global Assessment of Functioning (GAF) Scale (t = -7.1, p < 0.001), with mean scores increasing from 42.17 at admission to 69.13 at discharge. Additionally, reductions in suicidal risk and hetero-aggressive behavior were noted, alongside improvements in quality of life and treatment adherence. Conclusions: The findings highlight the effectiveness of implementing activities and programs focused on psychiatric rehabilitation processes to promote positive health outcomes. Future research directions and practical implications are discussed to support the continued development and optimization of psychiatric rehabilitation programs.

From an interbehavioral and contingential perspective, family dialogues about sexuality are understood as patterns of verbal interaction regulated by social, gender, and caregiving contingencies rather than as individual attitudes or intentions. Background: This study analyzes the functional conditions under which family dialogues about sexuality occur between mothers and their adolescent sons and daughters, considering caregiving roles and gender norms that regulate these interactions. The research aimed to identify the functional relations between communicative practices and the social contingencies that maintain or inhibit them. Methods: A qualitative approach grounded in interbehavioral psychology was employed, using semistructured interviews with 40 mothers of students from a public middle school in Puebla, Mexico. Data were analyzed through contingency analysis, distinguishing micro- and macrocontingential systems related to family sexual education. Results: Results show that, although patterns of avoidance and discourse displacement toward schools or peers persist, families exhibit increasing openness toward comprehensive sexuality education and recognize its preventive value against violence, adolescent pregnancy, and misinformation. Functional delegation and adolescent mediation of dialogue were identified, along with emerging inclusive macrocontingencies linked to the acceptance of diverse families and LGBTIQ+ themes. Conclusions: It is concluded that households function as self-regulated interbehavioral systems in which historical and gender contingencies restrict sexual dialogue, yet gradual functional changes toward respect, inclusion, and shared educational responsibility are observed.

Background/objectives: Lower limb amputation (LLA) negatively affects the physical and psychological health of individuals, leading to a lower quality of life and sedentary lifestyle. The objective of this scoping review is to search for evidence regarding physical activity interventions in individuals with LLA, investigating improvements in specific outcomes related to quality of life and performance.

Methods: PRISMA guidelines-extension for scoping reviews-were used to structure the study. The research was conducted between 26 July 2023 and 30 September 2023; it was structured by defining two PICO questions (P = amputation, I = physical exercise, O1 = quality of life, and O2 = performance) through Pubmed, Cochrane, and Pedro databases. The study included subjects with LLA of any etiology, in prosthetic or pre-prosthetic phase, practicing non-competitive physical activity. The results were then subjected to both qualitative and quantitative analysis.

Results: Of the 615 studies identified, 18 were included in the review. They consisted of 6 systematic reviews (SR), 5 RCTs, 4 case-control studies, 1 case report (CR), and 2 cross-sectional (CS). Physical activity (PA) interventions were extremely heterogeneous and were, therefore, categorized into 6 modalities: surveys were the most reported strategies (57%), followed by personalized training (23%), strength training (13%), endurance training (13%), combined training (2%), and gait training (5%). Due to the heterogeneity of the studies, the variety of interventions proposed and the different outcomes registered, there is no evidence that one approach is more effective than another, while each group showed benefits on different specific outcomes. In total, five outcome categories were identified: quality of life was the most frequently analysed (42%), followed by cardiovascular fitness (20%), muscular fitness (14%), gait parameters (13%), functionality and disability (11%).

Conclusions: PA represents a valuable strategy for improving performance and quality of life in individuals with LLA, offering a variety of interventions. Although there is no evidence that one strategy is better than the others, each activity has proven to be effective on specific outcomes, therefore, the choice must depend on the patient's necessities. The preferred option should be the personalization of the training according to individual needs, coupled with long-term planning and remote monitoring. Creating meeting places and supporting occasions for sports activities could be a valid option. Further research could help to clarify the benefits of such interventions and enhance the understanding of how to optimize the management of LLA patients.

Background/Objectives: Meaningful social connections are critical for well-being in later life, yet older adults living with HIV frequently experience social isolation and loneliness, compounded by stigma, mental health conditions, and systemic inequities. This study aimed to explore how older adults living with HIV and a concurrent mental health diagnosis experience social isolation and cultivate meaningful relationships, situating these experiences within Social Convoy Theory. Methods: Using a Heideggerian phenomenological approach, we conducted in-depth, semi-structured interviews with 33 adults aged 50 and older in Ontario, Canada, who self-identified as living with HIV and a diagnosed mental health condition. Participants were recruited through community-engaged strategies and snowball sampling. Data were analyzed iteratively, combining descriptive and interpretive coding to identify patterns in social isolation, relational meaning, and the influence of intersecting social, structural, and health determinants. Results: Participants described social isolation as both a physical and existential experience, influenced by stigma, mental health challenges, and contextual factors such as urban versus rural settings. Meaningful relationships were characterized by authenticity, trust, emotional safety, and reciprocity, often formed within peer networks sharing similar lived experiences. Community engagement and virtual platforms facilitated connection, while rural or suburban environments often intensified isolation. Relationships providing validation, agency, and continuity of experience were particularly impactful on participants' well-being. Conclusions: Social isolation among older adults living with HIV and mental health conditions extends beyond objective network measures to include emotional and identity-related dimensions. Interventions should prioritize affirming, context-sensitive spaces that support disclosure, trust, and reciprocal relationships, recognizing the nuanced needs of this population for both social and existential connectedness.

Background: Age-related declines in respiratory muscle strength and ventilatory efficiency can impair functional capacity and metabolic health in older adults. Inspiratory muscle training (IMT) has been proposed as a practical intervention to counteract these changes, yet its systemic effects remain unclear. This study aimed to examine the effects of short-term IMT on functional capacity, diaphragm thickness, and liver tissue characteristics in healthy elderly men. Methods: Thirty community-dwelling men aged 60-80 years were randomly assigned to an IMT or control group. The IMT group performed four weeks of breathing exercises using a POWERbreathe^® device at 40% of maximal inspiratory pressure, with a weekly 10% increase in pressure. Pre- and post-intervention assessments included the six-minute walk test (6MWT), diaphragm thickness and liver density via computed tomography, and quality of life (QoL; SF-12). Results: Four weeks of inspiratory muscle training significantly improved diaphragm thickness (11.7%), fatty liver density (FLD) (+16.7%), and six-minute walk performance (+5.3%), with large time × group effects favoring the IMT group. While the physical quality of life showed modest, comparable improvements, mental health outcomes demonstrated a moderate, time-dependent improvement without a significant group-by-time interaction. Conclusions: Short-term IMT improved diaphragmatic function and functional capacity in older men and was associated with favorable changes in a liver-related biomarker; however, given that only a single liver-related metric was assessed, these findings should not be interpreted as evidence of overall improvements in liver health.

Background/Objectives: Smartphone-based leisure reservation platforms increasingly shape how individuals participate in leisure, yet little is known about how such technology-mediated engagement influences users' awareness of multidimensional health benefits. The purpose of this study is to investigate how regular users of smartphone-based leisure reservation platforms perceive multidimensional health benefits associated with their leisure activities. Methods: Based on a constructivist/interpretivist approach, this study applied Interpretative Phenomenological Analysis (IPA). Ten participants with at least one year of platform use completed semi-structured interviews. Data were analyzed through iterative coding and theme development, with trustworthiness ensured through member checking, peer debriefing, and triangulation. Results: Participants reported three dimensions of health awareness. (1) App-enabled accessibility as a catalyst for physical health awareness (i.e., physical health benefits) included improved vitality and increased motivation to maintain exercise routines. (2) App-based planning and anticipation in supporting mental well-being (i.e., mental health benefits) involved stress reduction, emotional recovery, enjoyment, and heightened self-care awareness. (3) Platform-mediated social encounters and the construction of social health (i.e., social health benefits) reflected expanded social networks, strengthened interpersonal relationships, and a greater sense of belonging fostered through shared leisure experiences. Conclusions: Smartphone-based leisure platforms play a meaningful role in enhancing users' awareness of multidimensional health benefits. By improving accessibility, diversifying leisure options, and facilitating social interaction, these platforms support holistic well-being. The findings contribute to understanding technology-mediated leisure and offer practical implications for designing digital leisure services that promote physical, mental, and social health.

Background and Objectives: Quality of life (QoL) among healthcare professionals (HCPs) is a critical determinant of workforce performance and patient care. Therefore, the present study aimed to assess QoL and its determinants among HCPs in the Hail region, Saudi Arabia. Methods: In this cross-sectional study, data were collected from 388 HCPs from multiple healthcare facilities using the WHOQOL-BREF questionnaire. The survey was conducted from August 2025 to October 2025. Convenience sampling was used, and QoL domain scores were calculated according to WHO guidelines. We applied Spearman's correlation test to assess correlations across domains and logistic regression to identify factors associated with individual and overall QoL. Results: Among the HCPs studied, overall QoL had a median score of 80, while the physical, psychological, social, and environmental domains showed moderate scores with considerable variability. We found a significant positive correlation between the various QoL domains (p = 0.001). Non-Saudi nationals (p = 0.010) and participants with chronic diseases (p = 0.032) reported significantly lower overall QoL. Furthermore, age group, work experience, HCPs category, work setting, nationality, and the presence of chronic disease were significant predictors across multiple QoL domains. Conclusions: The findings highlight the need for targeted workplace and health support interventions to manage the mental and physical health of HCPs, particularly for non-Saudi HCPs and those with chronic conditions, through tailored training, education, and lifestyle-based support programs.

Background/Objectives: Arboviral diseases share common vectors, geographic distribution, and symptoms. Developing Machine Learning diagnostic tools for co-circulating arboviral diseases faces data-scarcity challenges. This study aimed to demonstrate that proof of concept using synthetic data can establish computational feasibility and guide future real-world validation efforts. Methods: We assembled a synthetic dataset of 28,000 records, with 7000 for each disease-Dengue, Zika, and Chikungunya-plus Influenza as a negative control. These records were obtained from the existing literature. A binary matrix with 67 symptoms was created for detailed statistical analysis using Odds Ratios, Chi-Square, and symptom-specific conditional prevalence to validate the clinical relevance of the simulated data. This dataset was used to train and evaluate various algorithms, including Multi-Layer Perceptron (MLP), Narrow Neural Network (NN), Quadratic Support Vector Machine (QSVM), and Bagged Tree (BT), employing multiple performance metrics: accuracy, precision, sensitivity, specificity, F1-score, AUC-ROC, and Cohen's kappa coefficient. Results: The dataset aligns with the PAHO guidelines. Similar findings are observed in other arboviral databases, confirming the validity of the synthetic dataset. A notable performance across all evaluated metrics was observed. The NN model achieved an overall accuracy of 0.92 and an AUC above 0.98, with precision, sensitivity, and specificity values exceeding 0.85, and an average Uniform Cohen's Kappa of 0.89, highlighting its ability to reliably distinguish between Dengue and Influenza, with a slight decrease between Zika and Chikungunya. Conclusions: These models could accelerate early diagnosis of arboviral diseases by leveraging encoded symptom features for Machine Learning and Deep Learning approaches, serving as a support tool in regions with limited healthcare access without replacing clinical medical expertise.

Background/Objectives: Vast amounts of textual data are generated by healthcare organizations every year. Traditional content analysis is time-intensive, error-prone, and potentially biased. This study demonstrates how freely available large language model (LLM) artificial intelligence (AI) tools can efficiently and effectively analyze qualitative healthcare data and uncover insights missed by traditional manual analysis. Interview data from chief nursing officers (CNOs) at top-performing academic medical centers were analyzed to identify factors contributing to their operational and patient quality success. Methods: Semi-structured interviews were conducted with CNOs from top-performing academic medical centers that achieved top-decile quality measures while using resources most efficiently. Interview transcripts were analyzed using a mix of traditional text mining in LSA and Gemini 2.5. The capability of four freely available AI platforms-Gemini 2.5, Scholar AI 5.1, Copilot's Chat, and Claude's Sonnet 4.5-was also reviewed. Results: LLM AI analysis identified ten primary factors, comprising twenty-four subtopics, that characterized successful hospital performance. Notably, AI analysis identified a theoretical connection that manual analysis had missed, revealing how the identified framework aligned with Donabedian's seminal structure, process, outcomes quality model. The AI analysis reduced the required time from weeks to nearly instantaneous. Conclusions: LLM AI tools offer a transformative approach to unlocking insight from the analysis of qualitative textual data in healthcare settings. These tools can provide rapid insight that is accessible to personnel with minimal text-mining expertise and offer a practical solution for healthcare organizations to unlock insight hidden in the vast amounts of textual data they hold.