Background:As people age, their physical functions decline, and changes in social roles and life experiences put older adults at a higher risk of social isolation.Methods:In this study, we employed both snowball and purposive sampling techniques to collect valid data [...] Read more.

Background:As people age, their physical functions decline, and changes in social roles and life experiences put older adults at a higher risk of social isolation.Methods:In this study, we employed both snowball and purposive sampling techniques to collect valid data from 237 seniors aged 60 to 75 residing in Hunan Province. Using structural equation modeling (SEM) with the partial least squares (PLS) method, we examined the relationship between physical activity and social isolation among this elderly population.Result:Findings from this study indicate a positive association between physical activity and regulatory emotional self-efficacy, while revealing a negative association with the perception of being a burden to others. Moreover, a higher regulatory emotional self-efficacy is linked to reduced social isolation, whereas an increased sense of self-perceived burden is associated with greater social isolation. This study also uncovers that the link between physical activity and reduced social isolation is influenced by both regulatory emotional self-efficacy and the perception of self-burden.Conclusion:It is imperative for a collaborative effort involving government entities, societal groups, family units, and individuals to meticulously address and cater to the diverse requirements of senior citizens.Full article

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Background:Volume-based drug procurement is regarded as a pharmaceutical cost-containment measure in healthcare provision globally. The Centralized Volume-Based Drug Procurement (CVBDP) launched in March 2019 in China, also known as the ‘4+7’ policy. 11 cities, including Xi’an city in Shaanxi Province, were set [...] Read more.

Background:Volume-based drug procurement is regarded as a pharmaceutical cost-containment measure in healthcare provision globally. The Centralized Volume-Based Drug Procurement (CVBDP) launched in March 2019 in China, also known as the ‘4+7’ policy. 11 cities, including Xi’an city in Shaanxi Province, were set up as pilots. This study aims to examine the intended and unintended impacts of the ‘4+7’ policy on the use of original and generic drugs in city-level and county-level hospitals in Shaanxi, China.Methods: The data used in this study came from the Shaanxi Drug and Apparatus Centralized Procurement Platform (SDACPP). In total, 111,999 drug procurement order records of 118 policy-related drugs (including 25 ‘4+7’ policy-list drugs and 93 alternative drugs by generic name) from April 2017 to November 2019 were included in analyses. Policy-list drugs were divided into bid-winning and non-winning drug products. The volume and the expenditure of the drugs served as the outcome variables, measured by Defined Daily Doses (DDDs) and Chinese yuan (CNY), respectively. A difference-in-differences (DID) approach was used to estimate the policy’s net effect.Results: After the ‘4+7’ policy, the volume of bid-winning, policy-list, and policy-related drugs increased. An unexpected increase in volume was observed among alternative drugs, especially original drugs in city-level hospitals. The expenditure of policy-list and non-winning drugs declined, whereas that of alternative drugs unanticipatedly increased. Changes in volume and expenditure were both greater in generic drugs and in city-level hospitals, compared to their original and county-level hospital counterparts.Conclusions: Our findings highlight the positive effects of the ‘4+7’ policy on generic drug substitution and pharmaceutical expenditure containment, which are greater in city-level hospitals. The unanticipatedly incremental volume of original drugs in city-level hospitals suggests the potential risk of the poor quality of bid-winning drugs, lower compliance with bid-winning drugs among patients, or physicians’ profit-seeking behaviors in urban areas. More regulations and supervisions for the prescription and financial incentives of physicians are needed to address these concerns.Full article

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Background: Adherence to drug prescriptions is often suboptimal among heart failure (HF) patients. Informed decision-making may improve patients’ adherence to HF drug prescriptions.Aims of the study: We aimed to test whether a self-study-based informed decision-making tool could improve adherence to drug prescriptions [...] Read more.

Background: Adherence to drug prescriptions is often suboptimal among heart failure (HF) patients. Informed decision-making may improve patients’ adherence to HF drug prescriptions.Aims of the study: We aimed to test whether a self-study-based informed decision-making tool could improve adherence to drug prescriptions among ambulatory HF patients.Methods: A tool and a statement-based questionnaire were developed to evaluate drug adherence willingness based on COMPAR-EU recommendations. The test group (n = 40) was exposed to the tool + questionnaire; controls (n = 40) answered the questionnaire only. Agreement with statements of the questionnaire was graded on a scale of 0 to 4 points, reflecting no to full agreement.Results: The median age of controls was younger (56 vs. 61 years;p = 0.04); test and control group patients did not differ across other parameters (alwaysp > 0.05). Patients in both groups agreed that “HF is a life-long disease” (3.5 vs. 4;p = 0.19) and that “only life-long drug treatment provides benefit” (4 vs. 4;p = 0.22). More test group patients confirmed improved comprehension of HF disease (3 vs. 2;p = 0.03) and greater acceptance that “achievement of benefit asks for a combination of HF drugs” (4 vs. 3;p = 0.009) and “daily intake” (4 vs. 3;p = 0.004). In test group patients, questions remained, resulting in less agreement that “all aspects of my heart disease” are understood (1 vs. 3;p < 0.001). Willingness to adhere to HF-drug treatment was not different between the groups (3 vs. 3.5;p = 0.28).Conclusions: The self-study-based informed decision-making tool improved the comprehension of HF and the need for HF treatment, but did not improve willingness to adhere since questions remained unanswered.Full article

Aim: The aim of this study was to analyze service-related musculoskeletal injuries of professional firefighters in 2021–2023.Material and methods: Analysis was completed on the basis of annual reports on the injury status of the State Fire Service (SFS) obtained from the Office [...] Read more.

Aim: The aim of this study was to analyze service-related musculoskeletal injuries of professional firefighters in 2021–2023.Material and methods: Analysis was completed on the basis of annual reports on the injury status of the State Fire Service (SFS) obtained from the Office of Occupational Safety and Health (OOSH) at General Headquarters. The report databases were searched using keywords typical of bone injuries and including anatomical names: “sprain”, “fracture”, “dislocation”, “bone injury”, “bone”, “joint”, “spine”, “skull and “musculoskeletal injury”.Results: Events matching the analysis target of N = 1944 (2021—n = 707; 2022—n = 589; 2023—n = 648) accounted for 49.4% from all accidents in the State Fire Service in Poland in the analyzed period. A significant increase in the analyzed period 2021–2023 was observed in events where the cause of injury was sports activities (45% vs. 49% vs. 63%,p < 0.001). A significant decrease was observed in events where the cause of injury was interventions (26% vs. 27% vs. 17%,p < 0.001), technical and maintenance (TM) work (8% vs. 6% vs. 5%,p = 0.008) and category “other” (15% vs. 14% vs. 11%,p = 0.034). Statistically significant differences were found between cause and the type of injury (p = 0.002), season (p < 0.001) and the location of injury (p < 0.001).Conclusions: A large number of musculoskeletal injuries are associated with sports activities, which is inherent in the risks of the activities. The lower extremities are most affected by injuries during sports activities The spring period dominates in the season category, which may be related to the difficulty of the terrain and return to increased sports activity after the winter period.Full article

Background: This study explores the multifaceted inequalities faced by informal waste pickers in Hong Kong, focusing on the impacts of gender and socioeconomic status in shaping their working environment, income, and psychological health. Recognizing that social stratification encompasses a series of structural [...] Read more.

Background: This study explores the multifaceted inequalities faced by informal waste pickers in Hong Kong, focusing on the impacts of gender and socioeconomic status in shaping their working environment, income, and psychological health. Recognizing that social stratification encompasses a series of structural factors, i.e., gender, race, and socioeconomic status, we aim to fill the gap in existing literature regarding the precarious employment of this population.Methods: Utilizing a comprehensive, territory-wide survey, we analyzed the experiences of male and female waste pickers across different socioeconomic backgrounds. Differences between genders for continuous variables were assessed using the independent samplest-test. Differences across categories defined by gender and socioeconomic status were analyzed using one-way ANOVA, followed by post hoc comparisons with the least significant difference (LSD) method.Results: Our findings indicate that both gender and socioeconomic status significantly influence working environment, occupational income, and psychological health outcomes. Specifically, female waste pickers from lower socioeconomic backgrounds face more adverse working environments, lower income levels, and heightened psychological health risks compared to their higher-status counterparts.Conclusions: These results underscore the urgent need for targeted outreach and tailored healthcare services for vulnerable female waste pickers, as well as social support systems that empower them to negotiate with intermediaries and recycling shop owners. By recognizing their essential role in Hong Kong’s urban recycling ecosystem, this study advocates for policies that address these disparities and promote psychological health and social well-being among this marginalized group.Full article

Parkinson’s disease (PD) and multiple sclerosis (MS) are two chronic neurological diseases (CNDs) that have a high demand for early and continuous rehabilitation. However, accessing professional care remains a challenge, making it a key priority to identify sustainable solutions for ensuring early rehabilitation [...] Read more.

Parkinson’s disease (PD) and multiple sclerosis (MS) are two chronic neurological diseases (CNDs) that have a high demand for early and continuous rehabilitation. However, accessing professional care remains a challenge, making it a key priority to identify sustainable solutions for ensuring early rehabilitation availability.Objective: The FIT4TeleNEURO pragmatic trial proposes to investigate, in real-life care settings, the superiority in terms of the effectiveness of early rehabilitation intervention with harmonized, mix-model telerehabilitation (TR) protocols (TR single approach, task-oriented—TRsA; TR combined approach, task-oriented and impairment-oriented—TRcA) compared to conventional management (control treatment, CeT) in people with PD and MS.Design, and Methods: This multicenter, randomized, three-treatment arm pragmatic trial will involve 300 patients with CNDs (PD, N = 150; MS, N = 150). Each participant will be randomized (1:1:1) to the experimental groups (20 sessions of TRsA or TRcA according to a mix-model—3 asynchronous + 1 synchronous session/week) or the control group (20 sessions of CeT). Primary and secondary outcome measures will be obtained at the baseline (T0), post-intervention (T1, 5 weeks after baseline), and follow-up (T2, 3 months after the end of the treatment). A multidimensional evaluation (cognitive, motor, and quality of life domains) will be conducted at each time point of assessment (T0; T1; T2). The primary outcome measures will be the assessment of change (T0 vs. T1 vs. T2) in static and dynamic balance, measured using the Mini-Balance Evaluation Systems Test. Usability and acceptability assessment will be also investigated.Expected Results: Implementing TR protocols will enable a more targeted and efficient response to the growing demand for rehabilitation in the early stages of CNDs. Both the TRsA and TRcA approaches are expected to be more effective than CeT, with the combined approach likely providing greater benefits in secondary outcome measures. Finally, the acceptability of the asynchronous modality could open the door to scalable solutions, such as digital therapeutics.Full article

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Background: Health inequalities between citizens of different European countries and between socially advantaged and disadvantaged groups are seen as challenges to the EU’s commitment to solidarity, social and economic cohesion, human rights, and equality of opportunity. This study aimed to assess inequity in [...] Read more.

Background: Health inequalities between citizens of different European countries and between socially advantaged and disadvantaged groups are seen as challenges to the EU’s commitment to solidarity, social and economic cohesion, human rights, and equality of opportunity. This study aimed to assess inequity in the distribution of specific communicable and non-communicable diseases among the adult population of Pécs City, Hungary.Methods: This is an ecological study combined with health inequity analysis. The study population comprised adult patients living in the city of Pécs who were treated for circulatory, neoplasm, or respiratory diseases in 2019. Hospitalization and local socioeconomic data by zip codes were obtained from the National Health Insurance Fund of Hungary and the Hungarian Central Statistical Office. Diseases were classified according to the International Classification of Diseases, 10th revision (ICD-10). The differences and ratios of the proportions of treated diseases were calculated, along with the concentration index (C). Zip codes were ranked into categories 1 to 5 based on socio-demographic variables: education, employment status, and apartment ownership. Ap-value of less than 0.05 was used as the cut-off point for statistical significance. IBM SPSS version 25 and STATA version 14.0 software were used for data analysis.Results: All 36 zip codes in the city of Pécs were included in this study. Analysis based on employment status showed a higher prevalence of neoplasms in areas with higher unemployment (C = −0.0528; 95% CI = −0.0975, −0.0080). In terms of apartment ownership, neoplasms (C = −0.0742; 95% CI = −0.1102, −0.0382) and circulatory diseases (C = −0.0280; 95% CI = −0.0520, −0.0039) were more prevalent in zip codes with fewer apartment owners.Conclusions: This study identified significant inequity in the distribution of neoplasms and circulatory diseases among the adult population of Pécs, especially in areas where the low socioeconomic segment of the population lives. Efforts should be made to establish tailored interventions such as targeted healthcare funding and employment programs for the unemployed and National Housing Trust Fund for those who do not own houses through multisectoral collaboration among healthcare providers, employers, governors, and policymakers.Full article

Background: Hiking is a physical activity recommended for people of all ages. In an era of increased incidence of cardiovascular and psychiatric diseases, directing individuals to hiking can be very important from both public health and socioeconomic perspectives. Since the health status of [...] Read more.

Background: Hiking is a physical activity recommended for people of all ages. In an era of increased incidence of cardiovascular and psychiatric diseases, directing individuals to hiking can be very important from both public health and socioeconomic perspectives. Since the health status of recreational hikers and the general population in the Republic of Serbia has not been compared yet, our objectives are to compare the health-related characteristics of those two groups, including the prevalence of comorbidities, pharmacotherapy, and drug consumption.Methods: A descriptive epidemiological study was conducted. Research questions were asked via two specially prepared questionnaires distributed through the Google Forms platform. The means of the two groups were tested by a two-sample Studentt-test for independent variables.Results: The sample consisted of 259 hikers and 292 people from the general population. A total of 199 hikers (76.8%) and 218 people from the general population group (74.7%) were declared as healthy. The statistically significant differences between the groups included age, sex, education level, and body mass index. In both groups, the majority of those with pre-existing medical conditions had at least one cardiovascular disease (23.5% of the hikers and 19.5% of the individuals in the general group). Pre-existing psychiatric diseases were noted in 6% of the hikers and in 12% of those in the general group. The average durations of the disease in the hiker and general population were 11.9 and 8.4 years, respectively (p < 0.05), whereas, there were no differences in drug consumption.Conclusions: This pilot study represents the comparison of the cardiovascular and mental health among hikers and the general population in the Republic of Serbia. Although psychiatric diseases were clearly less prevalent among hikers, the prevalence and burden of cardiovascular diseases must be interpreted with caution, due to big age difference between the respondents from both groups. However, our future studies will employ objective measurements and clinical parameters rather than self-reported surveys, so that the health benefits of hiking appear more clearly.Full article

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Background: Workplace violence (WPV) in healthcare, particularly in emergency departments (EDs), is a growing and complex issue that significantly impacts healthcare providers (HCPs). Following the COVID-19 pandemic, the rates of WPV have increased globally, contributing to increased burnout, reduced morale, and heightened challenges [...] Read more.

Background: Workplace violence (WPV) in healthcare, particularly in emergency departments (EDs), is a growing and complex issue that significantly impacts healthcare providers (HCPs). Following the COVID-19 pandemic, the rates of WPV have increased globally, contributing to increased burnout, reduced morale, and heightened challenges in staff retention within EDs.Objective: This study aimed to explore HCPs’ perspectives on WPV in EDs. The insights gathered were intended to inform targeted interventions in a quality improvement initiative focused on addressing WPV in our healthcare institutions.Methods: A qualitative study involving semi-structured interviews was conducted with 52 HCPs across two urban EDs at a multi-site academic health center. Participants from various roles and shifts shared experiences related to safety, leadership, training, and security. Interviews were recorded, transcribed, anonymized, and thematically analyzed to identify key themes surrounding WPV in EDs.Results: The thematic analysis identified four main themes, including (1) Violence is Part of the Job, (2) Leadership Dynamics regarding WPV, (3) Disconnect Among ED Staff During WPV Response, and (4) Enhancing Systems and Culture for Effective WPV Management. These themes provide a comprehensive view of HCPs’ experiences and offer actionable recommendations for healthcare organizations seeking to address WPV.Conclusions: The study provides valuable qualitative insights into WPV in EDs, emphasizing the importance of addressing cultural, structural, and procedural gaps. These findings can guide the development of more supportive and effective strategies to create a safer environment for ED staff. Further rounds of interviews are planned post-intervention to assess changes in HCPs’ perceptions and experiences.Full article

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Background: Dyslipidemia increases cardiometabolic risk, but the impact of sleep quality on lipid levels remains uncertain. This study aims to assess the prevalence of poor sleep quality in patients with dyslipidemia and its association with lipid levels.Methods: A cross-sectional and prospective study [...] Read more.

Background: Dyslipidemia increases cardiometabolic risk, but the impact of sleep quality on lipid levels remains uncertain. This study aims to assess the prevalence of poor sleep quality in patients with dyslipidemia and its association with lipid levels.Methods: A cross-sectional and prospective study was conducted among patients aged 20 years and older who were diagnosed with dyslipidemia at the Family Medicine Outpatient Clinic in Thailand from July to December 2023. Data were collected through interviews and a review of electronic health records. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Blood levels of triglycerides, HDL-C, and LDL-C were measured. The association between sleep quality and lipid levels was analyzed using multivariable regression, adjusting for age, sex, body mass index, diabetes mellitus, hypertension, alcohol use, exercise, statins, fibrates, and ezetimibe.Results: Of the 257 participants, 183 (71.21%) were female, with a mean age of 69.31 ± 7.48 years. Overall, 86 participants (33.64%) reported poor sleep quality. A higher sum score of PSQI was significantly associated with elevated triglyceride levels (adjusted mean difference [AMD] 2.59, 95% CI 0.07–5.11,p = 0.044), particularly in the sleep latency domain (AMD 8.58, 95% CI 0.00–17.16,p = 0.050). Additionally, higher scores in the subjective sleep quality domain were significantly associated with increased LDL-C levels (AMD 8.08, 95% CI 1.70–14.60,p = 0.013).Conclusions: This study highlights a significant association between poor sleep quality and elevated triglyceride and LDL-C levels. These findings underscore the importance of integrated healthcare strategies that address both sleep quality and lipid management to mitigate cardiovascular risks.Full article

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Background/Objectives: Low back pain (LBP) is a leading cause of disability worldwide. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), and thiocolchicoside, a muscle relaxant, are commonly combined to target inflammation and muscle spasm. However, the efficacy and safety of their combination remain under [...] Read more.

Background/Objectives: Low back pain (LBP) is a leading cause of disability worldwide. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), and thiocolchicoside, a muscle relaxant, are commonly combined to target inflammation and muscle spasm. However, the efficacy and safety of their combination remain under discussion. This systematic review evaluates the efficacy and safety of diclofenac-thiocolchicoside therapy for LBP and other musculoskeletal conditions.Methods: A systematic review was conducted following PRISMA guidelines. Eligible studies included randomized controlled trials (RCTs) and observational studies comparing diclofenac-thiocolchicoside combination with placebo, monotherapy, or alternative treatments. A search was performed in PubMed, Scopus, and relevant websites, identifying articles published up to 30 September 2024. Studies from trial registries were excluded. Risk of bias was assessed using Revised Cochrane Risk of Bias for randomized trials (RoB 2) for RCTs and the Newcastle-Ottawa Scale (NOS) for observational studies. Evidence certainty was evaluated with the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework. Results were visualized using Robvis, tables, and graphs.Results: Of 393 identified records, 9 studies (1097 patients) met the inclusion criteria. Seven RCTs reported significant pain reduction and functional improvement with combination therapy compared to placebo or active controls. However, study heterogeneity, dosage variations, and risk of bias limited comparability. Adverse events (AEs) included gastrointestinal (GI) discomfort and drowsiness, though no severe complications were consistently reported.Conclusions: Despite methodological limitations, the diclofenac-thiocolchicoside combination demonstrates promising efficacy for acute LBP and musculoskeletal pain management. However, there is no clear evidence of its clinical superiority over other available treatments, due to study heterogeneity and potential biases. Rigorous, standardized research with larger sample sizes and consistent methodologies is essential to definitively establish the efficacy and safety of diclofenac-thiocolchicoside, providing clearer guidance for clinical decision-making.Full article

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Objectives: To clarify the latent profile of depressive symptoms in Chinese older adults living alone and to explore the relationship between this profile and self-neglect.Methods: Data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) were utilized to conduct a [...] Read more.

Objectives: To clarify the latent profile of depressive symptoms in Chinese older adults living alone and to explore the relationship between this profile and self-neglect.Methods: Data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) were utilized to conduct a latent profile analysis for the identification of depressive symptoms. Logistic regression was employed to analyze the related factors. Generalized linear modeling was used to assess the impact of different profiles of depressive symptoms on self-neglect.Results: A total of 1822 older adults living alone, with a mean age of (83.60 ± 9.15) years, were included in the study. Three categories of depression were identified: the C1 mild depression–sleep disturbance group (29.36%), the C2 moderate depression–forcefulness group (55.22%), and the C3 major depression–loneliness loss group (15.42%). Logistic regression analysis indicated that gender, place of residence, annual household income, educational level, reason for living alone, self-rated health status, cognitive function, and emotional support were significant influencing factors (p < 0.05). The risk of experiencing higher levels of self-neglect in the C2 was 1.264 times greater than in the C1. Furthermore, the risk of higher levels of self-neglect in the C3 was 2.040 times greater than in the C1.Conclusions: Heterogeneity in depressive symptoms is evident among Chinese older adults living alone, with variations in self-neglect across different potential categories of these individuals. The focus should be on older adults in the C2 and C3 profiles. This study proposes targeted intervention strategies from family, community, and policy development perspectives to help improve self-neglect in older adults.Full article

Background/Objectives: Poor sleep quality, depression, and anxiety are associated with subjective cognitive decline (SCD) and greater risk for developing cognitive impairment and Alzheimer’s disease. The COVID-19 pandemic negatively impacted sleep habits and psychological well-being in many individuals, yet their relationship to SCD in [...] Read more.

Background/Objectives: Poor sleep quality, depression, and anxiety are associated with subjective cognitive decline (SCD) and greater risk for developing cognitive impairment and Alzheimer’s disease. The COVID-19 pandemic negatively impacted sleep habits and psychological well-being in many individuals, yet their relationship to SCD in this context remains understudied. We examined sociodemographic characteristics, depression, anxiety, and sleep changes during the pandemic (i.e., increased problems/poorer quality) and SCD in older individuals living in the US. Methods: In total, 288 older adults (M_age = 67.4 [7.4]) completed an online survey including a sociodemographic questionnaire, the Center for Epidemiologic Studies Depression Scale (Revised) (CES-D-10; depression), General Anxiety Disorder-7 (GAD-7; anxiety), the Everyday Cognition scale (ECog; SCD), and a question about increased sleep problems/worsened sleep quality during the pandemic. Hierarchical and logistic regression analyses were used to assess relations among sociodemographic factors, depression, anxiety, changes in sleep quality, and SCD. Results: Self-reported pandemic-related impairments in sleep were associated with greater SCD (β = 0.16,p = 0.01). Depression (β = 0.46,p < 0.001) and anxiety (β = 0.29,p < 0.001) were also associated with greater SCD. Depression (OR = 1.17,p < 0.001) and anxiety (OR = 1.15,p = 0.017) predicted reported poorer sleep during the pandemic. Conclusions: Depression, anxiety, and poorer sleep quality during the COVID-19 pandemic were associated with greater SCD concerns. Greater depression and anxiety were also associated with the reported sleep problems/worsened sleep quality. Prevention and management of anxiety and depressive symptoms may help maintain sleep quality and reduce risk of cognitive decline.Full article

Background: Orthostatic hypotension (OH) is a chronic, debilitating condition common in older adults. This study examined the effects of daily lifestyle habits on non-neurogenic OH in older adults in South Korea. We further compared the effects of daily lifestyle habits on OH to [...] Read more.

Background: Orthostatic hypotension (OH) is a chronic, debilitating condition common in older adults. This study examined the effects of daily lifestyle habits on non-neurogenic OH in older adults in South Korea. We further compared the effects of daily lifestyle habits on OH to those of the autonomic nervous system (ANS) function.Methods: In a cross-sectional study, 217 community-dwelling older adults aged ≥65 years were recruited using the convenience sampling method. Data were collected using two questionnaires to assess OH and daily lifestyle habits: OH was measured by Orthostatic Grading Scale (OGS) and lifestyle habits included nutrition, sleep, physical activity, and psychological status (stress and depression levels). Plasma catecholamines (epinephrine and norepinephrine) were measured to indicate the ANS function. The data were analyzed usingt-tests, Pearson’s correlation coefficients, and multiple linear regression analysis.Results: Significant factors related to OGA score included nutritional status (B = −0.20,p ≤ 0.040), poorer sleep quality (B = 0.15,p = 0.005), physical activity (B = −0.01,p = 0.032), stress (B = 0.04,p = 0.001), and depression (B = 0.23,p = 0.001). These together explained 40.5% of the variance in OH. However, no significant association was found between catecholamines and OGS score.Conclusions: These results suggest that lifestyle habits are important factors, while ANS function may be less associated with non-neurogenic OH. Thus, preventive and non-pharmacological interventions for decreasing OH symptoms should focus on maintaining healthy lifestyle habits in older adults.Full article

Background/Objectives: Heart failure assistance is strictly correlated with the concept of palliative care. Supportive treatment should be part of the heart failure patient pathway from the beginning. Palliative care with interprofessional effective collaboration could be an important resource used to reduce heart failure [...] Read more.

Background/Objectives: Heart failure assistance is strictly correlated with the concept of palliative care. Supportive treatment should be part of the heart failure patient pathway from the beginning. Palliative care with interprofessional effective collaboration could be an important resource used to reduce heart failure distressing symptoms and improve quality of life. Nurses, as professionals with a holistic vision of care, play a crucial role in palliative care introduction and implementation. The aim was to explore nurses’ attitudes and perceptions of heart failure palliative care, updating and adding knowledge to the current evidence.Methods: A systematic mixed-method review following the Joanna Briggs Institute methodology was undertaken. The screening of articles, data extraction and quality appraisal were performed by more than one author. The search was undertaken in May 2024 and applied to PubMed, Cinahl, Embase, Web of science, PsycInfo, Cochrane library and Scopus. A convergent integrated approach allowed us to combine qualitative and quantitative data. The analysis and synthesis of results was guided by the Theoretical Domain Framework.Results: Of the 1048 records identified, 26 met the inclusion criteria. Twelve framework domains were completed with data extracted. A flow chart was elaborated to offer an overview of the main concepts included.Conclusions: Numerous behaviors and elements influenced heart failure palliative care implementations. Analysis has shown that each analyzed element was strictly correlated one with another. When implementation was possible, outcome improvement sustained palliative care benefits with the direct involvement of nurses as educators and coordinators.Full article

Background/Objectives: It is established that both birth and infant feeding experiences can impact maternal mental health, but little is known about how the two might interact. Potentially, a positive breastfeeding experience might help to mitigate feelings associated with birth trauma, but conversely, a [...] Read more.

Background/Objectives: It is established that both birth and infant feeding experiences can impact maternal mental health, but little is known about how the two might interact. Potentially, a positive breastfeeding experience might help to mitigate feelings associated with birth trauma, but conversely, a difficult feeding experience might further compound birth trauma. The aim of this study was therefore to explore how mothers’ experiences of breastfeeding following birth trauma might impact their mental health. Methods: To explore this, mothers were invited to complete an online survey about their experiences of birth and breastfeeding and how they felt these affected their wellbeing. There were 501 responses, with 159 (32%) describing their birth experience as traumatic and therefore included in this analysis. A thematic analysis approach was used to explore themes around breastfeeding experiences and the impact on wellbeing. Results: Mothers who described positive breastfeeding experiences felt that breastfeeding helped them to bond with their baby post birth trauma and that this protected their mental health. Conversely, mothers who had a difficult experience described how pain, exhaustion, and low milk supply further negatively impacted their wellbeing. Conclusions: The findings show the importance of enhanced support for breastfeeding mothers who have experienced birth trauma, as feeding experiences can potentially help heal or compound challenging memories, thoughts, and emotions around birth.Full article

New graduate nurse (NGN) turnover is emerging as one of the foremost issues in healthcare systems, primarily due to the implications for patient care and the need to secure the human resource future of the nursing profession. The initial months of transitioning into [...] Read more.

New graduate nurse (NGN) turnover is emerging as one of the foremost issues in healthcare systems, primarily due to the implications for patient care and the need to secure the human resource future of the nursing profession. The initial months of transitioning into the professional role are crucial for cultivating and developing clinical practice patterns, professional values and a connection to the profession. However, the initial transition period for new nurses is associated with numerous challenges that can interrupt a healthy introduction into practice, justifying the critical prioritization of these issues. In light of these challenges to NGN entry to practice, this paper aims to conceptualize the contemporary professional role transition experiences of new graduate nurses and highlight the potential leverage that transition theories offer in managing this experience. Eleven transition theories relevant to this discourse were identified to enhance the understanding and comprehension of the new graduate nurses to inform future initiatives, directives, interventions and policies.Full article

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Background: Workers in healthcare facilities can encourage and serve as role models for the general population regarding vaccination. The information source preferences of employees in healthcare facilities can play an important role in their decisions to receive COVID-19 and seasonal influenza vaccinations [...] Read more.

Background: Workers in healthcare facilities can encourage and serve as role models for the general population regarding vaccination. The information source preferences of employees in healthcare facilities can play an important role in their decisions to receive COVID-19 and seasonal influenza vaccinations (SIVs). A study of specific channels of information and their impact on vaccine acceptance could provide valuable insights.Methods: A cross-sectional questionnaire-based survey was conducted during the first semester of 2021 among 2592 staff members in healthcare facilities (primary, secondary and tertiary).Results: Higher odds of seasonal influenza vaccination (SIV) acceptance were found among staff who were informed by the National Public Health Organization (NPHO) (adjusted Odds Ratio (aOR): 1.47, 95% confidence intervals (CI): 1.13–1.90), the Hellenic Ministry of Health (HMH) (aOR: 1.50, 95% CI: 1.16–1.94) and the Healthcare Facilities Infection Control Committees (ICC) (aOR: 1.35, 95% CI: 1.06–1.73). Professionals who were more willing to accept a COVID-19 vaccine were more likely to obtain information from television (aOR: 1.43, 95% CI: 1.08–1.92), the ICC (aOR: 1.36, 95% CI: 1.03–1.81), the NPHO (aOR: 1.71, 95% CI: 1.28–2.28) and the HMH (aOR: 1.68, 95% CI: 1.26–2.26). Social media presented no statistically significant association with either COVID-19 vaccine acceptance or SIV.Conclusions: Workers in healthcare facilities who received information from highly credible organizations were more likely to accept vaccines. Television was effective in disseminating COVID-19 vaccine campaigns.Full article

Background/Objectives: There is a lack of research examining healthcare professionals’ perspectives regarding the potential of non-pharmacological solutions such as immersive virtual reality (VR). The aim of this study was to investigate opportunities and challenges related to the application of immersive virtual reality (VR) [...] Read more.

Background/Objectives: There is a lack of research examining healthcare professionals’ perspectives regarding the potential of non-pharmacological solutions such as immersive virtual reality (VR). The aim of this study was to investigate opportunities and challenges related to the application of immersive virtual reality (VR) technology in patients aged 65 and older undergoing surgery with regional anesthesia and sedation.Method: A qualitative, multicenter study was conducted in the spring of 2024, involving semi-structured interviews with 17 healthcare professionals.Result: A qualitative content analysis of the interviews identified the main theme “Healthcare professionals’ openness to opportunities for this technology for elderly patients”, with the subthemes and themes “elderly patients”, which included the participants’ attitudes towards elderly patients; “virtual reality”, which concerned opportunities, barriers, and risks; and “sustainable healthcare”, which comprised the participants’ thoughts about its impact on sustainable development.Conclusions: The participants suggested potential areas of use for VR during the perioperative period but also identified limitations and risks. They suggested VR was likely to have a positive impact on sustainable healthcare, as well as economic advantages. For its successful implementation, the equipment must be safe. There also needs to be a clear division of responsibilities for it to be functional and suitable for its users. Strategies such as nudging can be used to facilitate its implementation.Full article