Healthcare最新文献

Background: Autologous blood donation for placental malposition is common in Japan, but no studies have scientifically evaluated its usefulness. The purpose of this study was to evaluate the necessity for autologous blood donation for placental malposition.

Methods: A retrospective study was conducted of patients who underwent autologous blood donation for placental malposition at Kindai University Hospital from 2012 to 2022. The primary outcome was the proportion of patients who were able to avoid allogeneic blood transfusion by autologous blood transfusion; secondary outcomes were autologous blood disposal rate, allogeneic blood transfusion rate, and complications of autologous blood donation and allogeneic blood transfusion. A systematic review of studies on autologous blood transfusion for placental malposition was conducted on PubMed.

Results: Fifty-two patients (total placenta previa 16; marginal placenta previa 20; low-lying placenta 16) were included. Eight (15%) had complications at the time of autologous blood donation, including non-reassuring fetal heart rate, but no sequelae. Allogeneic blood transfusion was avoided by autologous blood transfusion in only five cases (9.6%). Autologous blood was discarded in nine cases (17%), seven of which had a low-lying placenta positioned normally at delivery. Allogeneic blood transfusion was performed in eight cases (15%) with no complications. In the systematic review, seven articles that met the inclusion criteria were selected for further evaluation. The results showed that there were no publications that scientifically demonstrated the benefit of autologous blood transfusion.

Conclusions: The results of this study indicate that autologous blood donation for placental malposition has little benefit.

Background/objectives: Local intralesional corticosteroid injections into the periungual fold are used to treat patients with onychocryptosis, but their short- or medium-term effects are unknown. The goal was to compare the efficacy of this treatment in stages IIa, IIb, and III of the condition with a common conservative method such as gauze bandaging.

Methods: A two-arm randomized trial with 40 patients with stage IIa, IIb, and III onychocryptosis equally assigned into two treatment groups-control (spiculotomy and application of gauze bandaging) and experimental group (spiculotomy and infiltration of corticosteroid)-was performed. Anthropometric data, initial clinical status, pain, and inflammatory measures were collected before and at least one month after the intervention.

Results: Pain reduction was higher in the experimental group (5.5 vs. 4.8 points) but with no significant differences (p = 0.306).Corticosteroids significantly reduced inflammation over gauze bandaging (1.9 vs. 1) with significant differences between them (p = 0.029).

Conclusions: Corticosteroid infiltration was more effective than gauze bandaging application in reducing inflammation in patients with onychocryptosis, with similar effects on pain. These findings support the clinical importance of corticosteroid treatment for this condition, although a single infiltration may not be sufficient to prevent relapses.

Background/objectives: With population aging, disability and chronic conditions are increasingly prevalent among middle-aged and older adults in China. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, this paper explores the effects of Activities of Daily Living limitations, Instrumental Activities of Daily Living limitations, and chronic conditions on Out-of-Pocket Expenditures (OOPEs) among middle-aged and older adults in China.

Methods: A first-difference model and a system-generalized method of moment model (GMM) are used.

Results: The system-GMM model for the first time addresses unobserved heterogeneity and produces unbiased estimates of the effects of health and OOPEs. Additionally, this paper assesses the heterogeneity of the results across the demographic and socioeconomic groups.

Conclusions: These findings can be used to inform policymakers on improving medical resource allocation and ensure better financial protection for those living with a disability and chronic diseases.

Objectives: The Republic of Korea is progressively becoming a super-aged society, emphasizing the need for regular physical activity among older adults because it has physical, psychological, and social benefits. Recently, increasing depression and suicide rates have been reported among older adults living alone. However, research that considers older adults' living situations is limited. Therefore, this study aimed to analyze the relationship between health-promoting behaviors (HPB), physical self-efficacy (PSE), exercise adherence, and sports commitment among older adults aged ≥ 65 years who participated in sports activities and investigate the influence of their living situation.

Methods: The participants were 452 individuals aged ≥ 65 who lived in the metropolitan areas of Chungcheong-do, Jeolla-do, and Gwangju Provinces, Republic of Korea, and who regularly participated in sports activities (men = 283, women = 169). This study was conducted from January to May 2024. Data were collected using a structured and validated questionnaire, and the collected data were analyzed using descriptive statistics, correlation analysis, structural equation modeling, and multi-group analysis.

Results: Structural equation modeling showed that the research model was appropriate, and all five paths showed statistical significance. The identity of the model was verified in the multi-group analysis, but path coefficients differed between older adults living alone and those living with family members. HPB significantly affected PSE, exercise adherence, and sports commitment among both groups of older adults. However, the impact of PSE on exercise adherence and sports commitment was not statistically significant among older adults living alone.

Conclusions: The results highlight the need to consider older adults' living situations when establishing regular physical activity. Efforts should also be made to promote regular exercise participation among older adults living alone.

Background: Sedentary behavior is associated with various adverse health outcomes. Medical students often experience high academic demands, leading to increased sedentary time. This study aimed to evaluate the effectiveness of a mobile app providing real-time feedback in reducing total sedentary time and prolonged sedentary bouts and in promoting physical activity among medical students. Methods: Seventy-seven medical students from Jazan University (mean age: 21.4 years; range: 20-25 years) participated in this study. Participants were assigned to either the control group (n = 40) or the intervention group (n = 37). The intervention group received real-time vibration feedback via a mobile app, prompting movement every 30 min of sedentary time, while the control group received no intervention. Sedentary behavior and physical activity levels were assessed using the Activities Completed Over Time in 24 h. Paired t-tests were conducted to examine within-group changes, and a two-way ANOVA was used to assess the interaction effect of time and group on sedentary time and physical activity. Results: After six weeks, the intervention group showed significant within-group reductions in their total sedentary time of 1.82 h (p = 0.01) and prolonged sedentary bouts of 1.91 h (p = 0.001), while the control group had no significant changes. Physical activity levels did not significantly change within either group. The two-way ANOVA revealed that there was no significant change over time between the two groups in their total sedentary time F (1, 75) = 1.590, p = 0.21, prolonged sedentary bouts F (1, 75) = 3.499, p = 0.06, or physical activity F (1, 75) = 0.565, p = 0.45. Conclusions: Real-time feedback from mobile apps resulted in significant within-group reductions in total and prolonged sedentary time among medical students in the intervention group. Low-cost mobile apps providing real-time feedback may be an effective intervention for reducing sedentary behavior among medical students, potentially improving their health and well-being.

Background/objectives: Most of the research in assisted reproduction has focused on the stressful situation experienced by women or couples looking for a desired pregnancy; however, the stress experienced by assisted reproduction professional teams is seldom studied. The present study aims to evaluate burnout and its relationship with workplace stressors among assisted reproduction professionals.

Methods: A cross-sectional design was used to conduct an online self-assessment national survey, sent to all members of the Spanish Association for Fertility. The questionnaire contained sociodemographic and occupational questions about stressors in the workplace and the Maslach Burnout Inventory (MBI-HSS) to assess the three subscales of burnout: emotional exhaustion, depersonalization and personal accomplishment.

Results: The percentages showing high emotional exhaustion and depersonalization in the whole sample were 41.8% and 43.2%, respectively. Additionally, low personal accomplishment was displayed in 42.6% of the respondents. Embryologists stand out for presenting the highest percentages of burnout (emotional exhaustion = 72.1%; depersonalization = 48.1%; low personal accomplishment = 48.1%), whilst psychologists showed the lowest percentages in high emotional exhaustion (32.3%) and depersonalization (24%), and gynecologists in low personal accomplishment (28.5%). Working under pressure was the stressor most experienced by the sample (76.6%) and the one that better predicted the three subscales of burnout.

Conclusions: This study highlights the close relationship between high levels of burnout and workplace stressors and shows the need to reduce workplace stressors to improve the well-being of professionals working in assisted reproduction, and, consequently, that of the patients they look after.

Background/objectives: This quasi-experimental study examined the effectiveness of an intensive, group-based pediatric constraint-induced movement therapy (pCIMT) program for young children.

Methods: Thirty-five children aged 21 months to 6 years, with unilateral hemiparesis (HP), or weakness on one side of the body from varying etiologies, participated in a 4-week intensive, interprofessional, theme- and group-based pCIMT clinic program in the Midwest, United States. The program ran for 4 weeks with 3 h of therapy per day, 5 days per week with 3 weeks of 24 h casting for the unaffected arm, followed by 1 week of bimanual focus. Outcome measures included the Quality Upper Extremity Skills Test (QUEST), Assisting Hand Assessment (AHA), Canadian Occupational Performance Measure (COPM), and Pediatric Evaluation of Disability Inventory (PEDI).

Results: The participants statistically significantly improved the unilateral function of the HP arm in four of five QUEST variables (p < 0.009), bimanual coordination as measured by the AHA (p < 0.001), and some areas of occupational performance as measured by the COPM (p < 0.001) and PEDI (p < 0.05).

Conclusions: This study revealed the intensive, group-based pCIMT clinic model was effective and feasible to implement with the support from various stakeholders.

Background: Medication errors in neonatal intensive care units (NICUs) are prevalent, with dosage and prescription errors being the most common. Aims: To identify the common medication errors reported over twelve years using a voluntary, nonanonymous incident reporting system (RiskMan clinical incident reporting information system) at an Australian tertiary NICU. Methods: This was a single-centre cohort study conducted at a tertiary NICU. All medication-related incidents (errors) reported prospectively through the RiskMan online voluntary reporting database from January 2010 to December 2021 were included. The medication incidents were grouped into administration, prescription, pharmacy-related, and others, which included the remaining uncommon incidents. Results: Over the study period, 583 medication errors were reported, including administration-related (41.3%), prescription-related (24.5%), pharmacy-related (10.1%), and other errors (24%). Most incidents were reported by nursing and midwifery staff (77%) and pharmacists (17.5%). Most outcomes were minor or insignificant (98%), with only a few resulting in major or significant harm. There was one extreme incident that may have contributed to the death of a neonate and nine moderate incidents. Conclusions: Our results demonstrate that medication errors are common and highlight the need to support improvement initiatives and implement existing evidence-based interventions in routine practice to minimise medication errors in the NICU.

Background: Pregnancy termination (PT) is a major public health concern in low-and middle-income countries like Bangladesh. This cross-sectional study aimed to determine the prevalence and factors of PT using the nationally representative Bangladesh Demographic and Health Survey data 2017-2018.

Materials and methods: A weighted population-based sample of 8759 ever-married reproductive-aged women (15-49 years) was included in the study. The outcome variable was PT in any of the following forms: miscarriage, induced abortion, and stillbirth. A univariate analysis for mean, frequency, and percentage and multiple logistical regression were used to determine the factors associated with PT.

Results: Around 18% of the women were found to have PT. The mean age of the women in the study was 25.79 years; 65.1% lived in the rural areas, and the majority of them were Muslims. Advanced age of the women (AOR:3.49, p = 0.004), residence in the countryside (AOR:0.81, p = 0.002), higher education (AOR:0.72, p = 0.027), not being a Muslim (AOR:0.74, p = 0.010), higher socio-economic status (AOR:1.28, p = 0.027), having a job (AOR:1.15, p = 0.041), being married at the age of >22 years (AOR:0.71, p = 0.036), and using a mobile phone (AOR:1.22, p = 0.002) were significant factors of PT. This study did not find any association between PT and contraceptive use.

Conclusions: Age, living region, education, religion, wealth index, working status, marital age, and mobile phone use are the determinants of PT. Interventions including these factors need to be made to reduce PT in Bangladeshi women. These findings could be helpful in undertaking further epidemiological studies to understand the actual causes of PT in various rural and urban settings among different socio-demographic groups in Bangladesh.

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