Healthcare最新文献

Objectives: Arterial hypertension (AH) is one of the most common disorders affecting the human population. The diet of patients with AH can influence the course of the disease and prognosis. The aim of this study was to investigate the differences in nutrition in hospitalised and non-hospitalised hypertensive patients, compared to control groups of non-hypertensive patients from the same medical centres. Methods: Patients from nine centres-six hospitals and three ambulatory care centres-were surveyed. The Questionnaire for the Assessment of Dietary Habits, Lifestyle, and Nutrition Knowledge (KomPAN) was administered by interviewers. Results: Complete results were obtained from 172 hospitalised and 63 non-hospitalised patients. A significantly higher mean body mass index was found for the hypertensive patients (p < 0.001), and a higher unhealthy diet index score was also shown for the hypertensive patients (p = 0.003). Over and above this, a lower mean health-promoting diet index score was found in the hospitalised group (who were on a hospital diet) for the hypertensive patients (p = 0.018). Summary: The study highlights a strong positive correlation between body mass index (BMI) and arterial hypertension (AH), with patients exhibiting higher BMI levels compared to a control group. A BMI of over 25 significantly increases the likelihood of developing AH, and obesity is associated with a higher risk in both men and women. Conclusions: The study indicates that a hospital diet may not be suitable for people with AH. Further research should be conducted to obtain reliable results. Clinical implications: The study showed which factors should be considered when composing a diet for people with hypertension, the relevance of which was demonstrated in the discussion. The study shows that the problem that clinicians have been struggling with for years is still present and inadequately remedied.

Objectives: This cross-sectional observational study examines the relationship between chronic cervico-cranio-mandibular pain, a significant health concern associated with temporomandibular disorders, and adverse childhood experiences (ACEs). Given the high prevalence of cervical pain and the gap in adequate treatment for temporomandibular disorders, this research highlights the interplay between psychological, social factors, and musculoskeletal health.

Methods: The study, conducted from January to June 2023, included 114 participants (mean age = 31 ± 12 years, 69.3% female) experiencing chronic cervico-cranio-mandibular pain. Pain severity and dysfunction were assessed, and exposure to ACEs was measured using validated questionnaires. Statistical analysis, performed using Jamovi (v 2.23.28) software.

Results: Data revealed a significant correlation between the number of ACEs and both pain intensity (r = 0.254, p = 0.006, η² = 0.062) and disability (r = 0.262, p = 0.005, η² = 0.068). However, no significant association was found between ACEs and mandibular functional limitation (p = 0.222). These findings suggest that while early life stressors impact overall health, their specific influence on cervico-cranio-mandibular pain is limited.

Conclusion: The study emphasizes the importance of integrated early intervention strategies to mitigate the long-term musculoskeletal repercussions of adverse events, advocating for comprehensive mental health support and preventive measures. This research contributes valuable insights into the necessity of a multifaceted approach to understanding, diagnosing, and treating musculoskeletal disorders, highlighting the complexity of their causes and effects.

Background/Objectives: The external environment constantly influences human health through many factors, including air quality, access to green spaces, exposure to pollutants, and climate change. Contamination poses a substantial threat to human well-being; conversely, environmental factors also positively impact health. The purpose of this study is to provide a comprehensive review of the complex relationship between various environmental factors and human health. While individual studies have explored specific aspects, a broader integrative understanding is lacking. Methods: Through databases (PubMed, Cochrane, Copernicus), 4888 papers were identified, with 166 selected for detailed analysis. Results: We summarized recent research, identifying multiple associations between environmental factors such as air pollution, climate change, solar radiation, and meteorological conditions and their impact on various health outcomes, including respiratory, cardiovascular, metabolic and gastrointestinal, renal and urogenital, neurological and psychological health, infectious and skin diseases, and major cancers. We use chord diagrams to illustrate these links. We also show the interaction between different environmental factors. Findings begin with exploring the direct impact of environmental factors on human health; then, the interplay and combined effects of environmental factors, elucidating their (often indirect) interaction and collective contribution to human health; and finally, the implications of climate change on human health. Conclusions: Researchers and policymakers need to consider that individuals are exposed to multiple pollutants simultaneously, the "multipollutant exposure phenomenon". It is important to study and regulate environmental factors by considering the combined impact of various pollutants rather than looking at each pollutant separately. We emphasize actionable recommendations and solutions.

Background: The aging global population presents significant challenges for healthcare systems. Technology-assisted interventions have emerged as promising tools to enhance independence and well-being among elderly individuals.

Objective: The aim of this study was to evaluate the effectiveness of technology-assisted interventions in promoting independence among elderly patients and identify key barriers and facilitators to their implementation.

Methods: A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, IEEE Xplore, ACM Digital Library, Cochrane Library, and Scopus. Studies evaluating technology-assisted interventions for promoting independence in elderly patients were included. Data were synthesized through narrative and thematic analysis.

Results: Fourteen studies met inclusion criteria. Technology-assisted interventions demonstrated positive impacts on physical and cognitive functioning, health management, quality of life, and technological engagement among elderly patients. Improvements were observed in areas such as mobility, chronic disease management, mental health, and daily living activities. High usability and adherence rates were reported for well-designed interventions. However, challenges in user-centered design, personalization, and integration with existing healthcare systems were identified.

Conclusions: Technology-assisted interventions show promise in promoting independence among elderly patients. Future research should focus on addressing identified challenges and conducting larger, long-term studies to confirm effectiveness and sustainability.

Contact lens (CL) wear is a safe method for the correction of refractive errors. However, rare, severe ocular complications may occur which may lead to visual loss. As most of these complications are related to poor patient compliance with care and maintenance instructions, resulting in the contamination of hands, CLs and accessories, it was the purpose of this study to assess hand-washing habits in a sample of Spanish soft CL wearers. Hand hygiene was explored through a self-reported online survey and via an in-office practical demonstration in a subset of those users answering the survey. A total of 198 surveys were analyzed, and 18 CL users participated in the practical demonstration. Overall, hand-washing habits were not adequate, with 35 (17.8%) and 103 (52.2%) participants reporting not always washing their hands prior to CL or storage case manipulation, respectively. While 161 (81.3%) participants dried their hands after washing, 132 of these (82.1%) used non-disposable cloth towels. Participants receiving specific hand-washing information from their practitioners (141, or 71.1%) had better hand hygiene (p < 0.05). During the practical demonstration, 13 (72.2%) participants used water and soap to wash their hands, but only 3 (16.7%) displayed correct hand washing routines. Complete patient education, as well as practical reminders at all follow-up visits, are essential to ensure better hand hygiene in order to reduce the probability of ocular complications and to guarantee safe and satisfactory CL use.

Background: Chronic, end-stage renal disease significantly impacts patients' daily activities and sleep quality, particularly those undergoing hemodialysis. However, there is limited research on the extent of these challenges and their correlation with this population.

Aim: This study aims to assess the level of activity of daily living and the prevalence of sleep disturbances in patients with end-stage renal disease undergoing hemodialysis.

Method: A cross-sectional study involved 130 patients receiving hemodialysis in two public General Hospitals in Greece. The Barthel Index was used to measure daily living activity, while the Athens Insomnia Scale assessed sleep disorders. The data were analyzed using SPSSV25.0.

Results: Of the 210 questionnaires, 130 were returned fully completed (response rate 62%). Most of the sample participants suffered from comorbidities (76.9%). The total Barthel Index score showed moderate dependence for patients, significantly related to the years and hours of dialysis (p = 0.007 and p = 0.000, respectively). The total score of the Athens Insomnia Scale was also significantly associated with age (p = 0.029), marital status (p = 0.015) and the years and hours of hemodialysis (p = 0.004 and p = 0.001, respectively). A statistically significant difference was recorded between the daily activity of patients with end-stage renal failure and their sleep quality (p = 0.000) Finally, the physical activity level of the participants was related to the existence of another physical health (p = 0.000) or mental health problem (p = 0.000).

Conclusions: Hemodialysis patients with chronic, end-stage renal disease experience significant challenges in maintaining daily activities and are prone to sleep disorders. These findings suggest a need for integrated care strategies that address both physical function and sleep quality to improve the overall well-being of this population.

Background/Objectives: Individuals with spinal cord injuries have a higher incidence of chronic conditions such as hypertension and cardiovascular diseases due to a sedentary lifestyle and low levels of physical activity caused by their disability. Additionally, their physical fitness levels are lower compared to those without disabilities. This cross-sectional study aimed to investigate the relationship between hypertension and the fitness of individuals with spinal cord injuries in South Korea while considering differences across sexes and spinal cord injury levels. Methods: This study used data for 835 individuals with spinal cord injuries aged 20-64 years who visited the Korea Paralympic Committee fitness standard test centers from 2018 to 2022, obtained from the Korea Culture Information Sports Association's big data market. The data were analyzed using a series of t-tests, a one-way analysis of variance, a logistic regression analysis, and the four-quartile method. Results: The prevalence of hypertension was 24.4%, and it was different according to the spinal cord injury impairment level. A lower grip strength, a lower arm curl, and a higher body mass index were associated with increased blood pressure. Conclusions: Therefore, a high level of physical strength in people with spinal cord injuries is thought to contribute to lowering blood pressure.

Background: Renal and liver transplantation influences the quality of life of the patients who undergo these procedures. Therefore, the aim of the present study was to analyze possible differences in liver and kidney transplantation in relation to the patient's sex and to determine their impact on quality of life.

Methodology: An observational study was carried out with 147 patients with liver (n = 70) and kidney (n = 77) failure on the transplantation waiting list. The possible influence of sex on clinical, sociodemographic, and psychological aspects of the patients' quality of life before and 6 months after transplantation was analyzed. Questionnaires on health-related quality of life (SF-36), the perception of social and family support (EASP), and coping strategies (CEA), the depression and anxiety scale (HAD), and the Eysenck personality inventory (EPI) were used. A univariate analysis was performed according to sex using statistical tools including the Chi-square test, the t-test, and a univariate linear analysis of variance.

Results: In patients on the waiting list for liver transplantation, we found sex differences in terms of age (p = 0.040), time of evolution of end-stage liver disease (p = 0.013), etiology (p = 0.07), and associated complications, as well as in the consumption of tobacco and other psychotropic substances (p = 0.022), while patients on the waiting list for renal transplantation showed sex-related differences in terms of etiology (p = 0.012) and alcohol consumption (p = 0.005). The results showed significant sex-related differences in sociodemographic and psychological aspects, but no significant sex-related differences were observed in global quality of life in either of the two assessments in both groups.

Discussion: The findings suggest that improvement in quality of life after liver or kidney transplantation is not influenced by the patient's sex.

Background/Objective: Although there are many reports on the association between cognitive and physical functions in older adults, little information is available on those aged ≥75 years. Therefore, this study aimed to determine whether mild cognitive impairment (MCI) in older adults over 75 years who live in independent senior housing is associated with physical function. Methods: In this study, 271 participants (174 women and 97 men) with a mean age of 85.4 ± 4.7 years were included. Cognitive function was assessed using the Japanese version of the Montreal Cognitive Assessment; a score < 26 confirmed MCI. MCI was an objective variable in univariate and multivariable logistic regression analyses. Physical function was measured using hand grip strength, normal and maximum gait speeds, and the 30 s chair stand test. Physical function was an explanatory variable adjusted for age and divided into tertiles (high, middle, and low) based on sex. The significance level was set at 5%. Results: There were 170 participants (63%) with MCI. Compared to the non-MCI group, the MCI group had significantly higher age and significantly lower normal and maximum gait speeds and 30 s chair stand test values Age-adjusted univariate analyses in women showed higher MCI rates in the low-fitness group than in the high-fitness group for maximum gait speed and 30 s chair stand test values. No variables were associated with MCI in men. Conclusions: MCI may be associated with physical function in women and older adults over 75 years who live in independent senior housing.

Background: There are high documented rates of exposure to traumatic events and mental health disorders among youths yet existing disparities in access to care for racial and ethnic minority youths and youths in rural communities. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an evidence-based behavioral health therapy for children. The delivery of TF-CBT via telehealth can decrease access to care barriers. An interdisciplinary clinical team developed a training program to guide clinicians to effectively provide TF-CBT via telehealth. The goal of this study was to describe variation in implementation processes of the telehealth TF-CBT program and identify barriers and facilitators to program implementation post-training, which were utilized to develop implementation strategies for intervention sustainability.

Methods: Using a mixed-methods approach, data were collected on telehealth implementation processes and facilitators and barriers to the delivery of telehealth TF-CBT. This study was guided by an adapted implementation science framework, namely the Exploration, Preparation, Implementation, Sustainment model. Interviews and surveys were completed with clinical site leaders who had participated in the telehealth TF-CBT training.

Results: Throughout clinical sites, there was varied adoption and penetration of the telehealth TF-CBT program. Facilitators to implementation included leadership and site staff buy in, community needs, and training resources, while barriers included funding, available logistical resources, and child and family involvement.

Conclusions: The feedback gained from this project assisted in the development of implementation strategies for increased adoption and sustainment of TF-CBT delivered via telehealth. Strategies include ongoing interactive assistance and resource support, enhanced training for stakeholders, and program adaptations, with the goal to increase access to quality mental health care for underserved populations.