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For the prevention and cure of disease, patient use various types of chemical and drug agents. Along with their curative effect, almost all drugs have some destructive effects and side-effects. Due to the minimal and/or none of unwanted side-effect, recently, the use of herbal remedy as the drug of choice becomes the preference choice. The mangosteen, Garcinia mangostana, contains various types of polyphenols. It has been used as a traditional medicine from the ancient times till present days. The purpose of this paper is to investigate the biological properties of mangosteen in relation to health promotion effects.

Several research papers from well-known database (such as PubMed, Google scholar, Scopus and Sciencedirect) were reviewed without considering publication-times to understand the biological properties of mangosteen.

Mangosteen and its xanthone exerted diverse biological activities such as anti-oxidant, anti-inflammatory, anti-allergy, anti-bacteria, anti-fungal, anti-malaria, anticancer and anti-diabetes.

Based on these studies, mangosteen is beneficial dietary supplement of overall human health.

This study aims to test the effects of Celliant armbands on grip strength in subjects with chronic wrist and elbow pain. Celliant® is a functional textile fabric containing minerals that emit infrared radiation (IR) in response to body heat. IR-emitting fabrics have biological effects including the reduction of pain and inflammation and the stimulation of muscle function.

A randomized placebo-controlled trial recruited 80 subjects (40 per group) with a six-month history of chronic wrist or elbow pain (carpal tunnel syndrome, epicondylitis or arthritis) to wear an armband (real Celliant or placebo fabric) on the affected wrist or elbow for two weeks. Grip strength was measured by a dynamometer before and after the two-week study.

For the placebo group, the mean grip strength increased from 47.95 ± 25.14 (baseline) to 51.69 ± 27.35 (final), whereas for the Celliant group, it increased from 46.3 ± 22.02 to 54.1 ± 25.97. The mean per cent increase over the two weeks was +7.8% for placebo and +16.8% for Celliant (p = 0.0372). No adverse effects was observed.

Limitations include the wide variation in grip strength in the participants at baseline measurement, which meant that only the percentage increase between baseline and final measurements showed a significant difference. Moreover, no subjective measurements of pain or objective neurophysiology testes was done.

Celliant armbands are easy to wear and have not been shown to produce any adverse effects. Therefore, there appears to be no barrier to prevent widespread uptake.

IR-emitting textiles have been studied for their beneficial effects, both in patients diagnosed with various disorders and also in healthy volunteers for health and wellness purposes. Although there are many types of textile technology that might be used to produce IR-emitting fabrics, including coating of the fabric with a printed layer of ceramic material, incorporating discs of mineral into the garment, the authors feel that incorporating ceramic particles into the polymer fibers from which the fabric is woven is likely to be the most efficient way of achieving the goal.

Celliant armbands appear to be effective in painful upper limb inflammatory disorders, and further studies are warranted. The mechanism of action is not completely understood, but the hypothesis that the emitted IR radiation is absorbed by nanostructured intracellular water provides some theoretical justification.

This paper aims to investigate the eHealth ecosystem’s evolution during the coronavirus disease 2019 (COVID-19) pandemic and its effects on the progression of care for patients with chronic cardiovascular disease.

To attain the aim of the study, this study chose to adopt a qualitative method that matches the complexity of the issue. The study was conducted in a real context through 44 face-to-face semi-structured interviews of key informants at different levels of the Italian eHealth service ecosystem, via Microsoft Teams. The interviews were carried out from June 2020 to January 2021. In this research, we adopted an abductive approach that enabled a process where the theoretical framework and the data analysis evolved at the same time.

The study results were used to develop a conceptual framework that considers the key factors enabling and constraining the evolutionary process of the eHealth service ecosystem. In particular, the drivers that emerged from the study were actor role empowerment, actor–network engagement and resource reconfiguration while the inhibitors were inter- and intra-actor misalignment, resource myopia and the platformisation gap. The findings also revealed the pivotal role of the meso level in the development of the eHealth service ecosystem, boosted by the COVID-19 pandemic.

By adopting a service ecosystem perspective, this paper contributes, at both a theoretical and a managerial level, to a better understanding of the dynamics related to the diffusion of eHealth. The study identifies the main issues that researchers, managers and policymakers should address to support the evolution of the eHealth service ecosystem, with particular regard to chronic cardiovascular disease.

People with severe persistent mental illness pose a significant challenge to managed care organizations and society in general. The financial costs are staggering as is the community impact including homelessness and incarceration. This population also has a high incident of chronic comorbid disorders that not only drives up healthcare costs but also significantly shortens longevity. Traditional case management approaches are not always able to provide the intense and direct interventions required to adequately address the psychiatric, medical and social needs of this unique population. This article describes a Medicare Advantage Chronic Special Needs Program that provides a Medical Home, Active Community Treatment, and Integrated Care. A comparison of utilization and patient outcome measures of this program with fee for service Medicare found significant reduction in utilization and costs, as well as increased adherence to the management of chronic medical conditions and preventative services.

The purpose of this study was to examine adverse outcomes associated with cesarean deliveries and to assess potential confounding factors.

A hospital-based cross-sectional study was conducted from September 1−30, 2019 using mixed methods of data collection. Multistage sampling was used to draw the eligible study participants. The sample size was calculated using the single population proportion formula. A systematic random sampling technique was used to draw the sample size. 180 original medical records were excluded because of having missed information, leaving 1,618 women as the study population. We used the questionnaire adapted from the Ethiopian Demographic and Health Survey to collect quantitative data and analyzed using SPSS version 22, while thematic analysis for qualitative measures was used to generate themes regarding associated perspectives of participants from a community.

More than 383 women delivered by cesarean section. 20% of the mothers with the mean age at birth of 26.1 ± 4.8 experienced adverse outcomes. Adjusted odds ratio (AOR) was used to measure the association of determinants and was 2.95 (95% CI 1.19–7.29) for nonuse of antenatal care, 3.18 (95% CI 1.43–6.94) for nonuse of prophylaxis, 4.28 (95% CI 1.58−11.61) for history of medical illness and 7.09 (95% CI 1.19−45.59) for use of substandard operation set up compared with their counterparts.

Strengths of the study include the finding of the study are reliably reported in mixed study methods examining hospital-based institutional and personal risk factors and exploring the whole community's perspectives. However, the important limitations of the study indicate that the study poses a number of challenges related to studying design, therefore there was not sufficient evidence of causality to draw conclusions from the findings. In addition, the study was conducted at a single hospital so that it is not convenient to generalize the findings of the study for setting different in social and economic status.

Based on the findings, attention has been drawn to healthcare personnel to provide training and consultation services for pregnant women and for health care administration to ensure standard set up for operation.

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.

Social spending is at the forefront of the tools used to repair the damage caused by the global epidemic. However, one of the most critical questions in recent days is as follows: what are the effects of social expenditures in eliminating unemployment? The primary purpose of this article is to provide empirical evidence on the impact of social spending on chronic unemployment in the selected organization for economic co-operation and development (OECD) countries.

In this study, the data of 30 selected OECD countries between 1991 and 2018 have been compiled. First, countries have been divided into four categories according to their spending intensity to determine the effects of social spending on the long-term unemployment rate. Then, the auto-regressive distributed lag (ARDL) approach and the error correction models (ECM) examine the variables' short- and long-term interactions.

The author found that the change in the share of social expenditures in GDP affects chronic unemployment similarly. This finding is consistent with the results of studies in the literature dealing with the relationship between public sector size and unemployment. However, the research findings are specifically about the effects of social expenditures on chronic unemployment. In this respect, the results reflect that expenditures with passive characteristics have an expansionary effect on long-term unemployment. In addition, the progressive effect of social expenditures on chronic unemployment is increasing in countries with high expenditure intensity. In countries with relatively low spending intensity, the impact of social spending is limited to the short run and is lower.

Multiple studies have reported that public policies developed in line with the incentives of active employment and public or private sector investments reduce the unemployment rate by positively affecting the output/employment level. This study, unlike other studies, focuses on the effects of social expenditures on chronic unemployment. It also compares the effects of social spending on the long-term unemployment rate for countries with varying spending intensities. Therefore, this article tests the impact of social expenditures used against a concrete socioeconomic problem in the OECD sample. In this respect, the findings contribute to the literature by addressing the relationship between social spending and chronic unemployment.

The purpose of this paper is to review the causes of long waiting time in Hong Kong public hospitals and to suggest solutions in the service, organisational, systems, financial and policy perspectives.

The paper is a review of waiting time of public hospital services. Total joint replacement, which is one of the elective surgeries in public hospitals, is presented as a case study.

The average waiting time of semi-urgent and non-urgent patients in the accident and emergency departments of public hospitals is two hours, and that of specialist outpatient (SOP) clinics is from 1 to 144 weeks. For total joint replacement, it is from 36 to 110 months. Measures like Government subsidisation programme for the replacement surgery and employing adequate physiotherapists, Chinese medicine practitioners, clinical psychologists and nurses to reduce the waiting time are suggested. Issues concerning the healthcare system of Hong Kong, such as structural reform, service delivery model, primary care, quality and process management, and policy reviews, are also discussed.

The ‬over-reliance of public services has resulted in long waiting time in public hospitals in Hong Kong, particularly in the emergency services and SOP clinics. However, the consequences of long waiting period for surgical operations, though much less discussed by the media and public, can be potentially detrimental to the patients and families, and may result in more burdens to the already stretched public hospitals‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬.

A global trend of type 2 diabetes prevalence is rising. Preventing and managing of systemic and dental complications is crucial to decrease negative effects on glycemic control. The purpose of this paper is to estimate the efficacy of Brief Lifestyle Change in conjunction with Dental Care (Brief-LCDC) Programs to decrease glycemic level and improve periodontal status in patients with type 2 diabetes.

Health Center 54 conducted randomized controlled trial among 192 patients (96 intervention and 96 control) from February to August 2018. Group education for lifestyle modification, individual oral hygiene instruction and lifestyle counseling by motivational interviewing was provided to the intervention group at baseline. Motivation of lifestyle modification every month by multimedia was also provided to the intervention group. The usual program was provided to the control group. At baseline and a six-month follow-up, glycemic level and periodontal status were assessed from participants. Data were analyzed by descriptive statistic, t-test, χ² test, Fisher’s exact test, Repeated measure ANOVA and multiple linear regression.

Glycemic level and periodontal status were lower in the intervention group than the control group at the sixth-month followed up with statistical significances. Glycemic level and periodontal status had negatively correlated to intervention group with statistically significant.

Brief-LCDC Program which incorporated lifestyle modification and oral health care had efficacious to decrease glycemic level and improve periodontal status in patients with type 2 diabetes. Early prevention program by Brief-LCDC Program is crucial to prevent dental complications.

The reduction of costs has a more and more relevant role in the healthcare context, therefore, a large effort is done by health providers to this aim, for example, by reducing the length of hospital stay (LOS) of patients undergoing surgery. Fast track surgery fits perfectly this issue and was applied to patients undergoing knee replacement surgery due to Osteoarthritis, one of the most common diseases of aged population. The paper aims to discuss these issues.

Lean six sigma was applied to analyze the implementation of fast track surgery through the define, measure, analyze, improve, control roadmap, used as a typical problem-solving approach. It is characterized by five operational phases, which make possible the achievement of fixed goals through a rigorous process of defining, measuring, analyzing, improving and controlling business problems.

The corrective action, consisting in the application of fast track surgery, improved both effectiveness and efficiency of the process of care. The average length of hospital stay (LOS) was reduced from 8.34 to 6.68 days (–19.9 percent) and its standard deviation from 2.41 to 1.99 days (–17.1 percent). The statistical significance of this decrease was verified by means of proper tests. Moreover, some variables influencing the LOS were identified.

The follow up and the satisfaction of patients were not analyzed and could be a future development of this study.

Patients will experience a faster recovery while the hospital will benefit from a rise of available beds. The effect is a general improvement of hospital management.

The introduction of fast track surgery for patients undergoing knee replacement surgery made significantly reduce LOS and, consequently, costs’ with a money saving of more than 50,000 euro per year.