Healing Environment Research Articles

Principles of Instrumentation in Periodontics

Instrumentation in periodontics plays a crucial role in the effective management of periodontal diseases. This article explores the fundamental principles guiding instrumentation techniques used in periodontal therapy. The primary objectives include achieving optimal biofilm removal, root surface detoxification, and creating a conducive environment for tissue healing. Various instruments, such as scalers, curettes, and ultrasonic devices, are discussed in terms of their indications, advantages, and limitations. Additionally, the importance of ergonomic considerations and operator proficiency in enhancing treatment outcomes is emphasized. Understanding these principles is essential for dental practitioners to deliver comprehensive periodontal care that promotes long-term oral health and patient satisfaction.

The Healing Environment Approach in Elderly-Friendly Resort Design Based on Nvivo Analysis

The aging process in the elderly results in physical, psychological, and social declines that can lead to various health issues. Many elderly individuals engage in travel activities, such as visiting new places or spending time abroad, as a means of psychological satisfaction and self-actualization, improving their overall quality of life. However, a significant concern is whether resort areas provide adequate comfort and safety for elderly tourists, as many destinations are not elderly-friendly. This research aims to explore the concept of healing, the specific needs of the elderly in tourism for comfort and security, and how to design an ideal resort for the elderly. This research employs a mixed-methods approach, using both quantitative and qualitative data. Quantitative data were processed using SPSS/SmartPLS, while qualitative data were analyzed using NVivo. The research's findings highlight the importance of a "healing environment" in resort design for the elderly, with considerations for accessibility, psychological well-being, and integration with nature. The results provide insights into how a resort can be designed to meet the physical and emotional needs of elderly tourists. The research's implications suggest that applying the "healing environment" approach can significantly enhance the safety, comfort, and overall experience for elderly visitors in tourism settings.

Multiple-Layer Chitosan-Based Patches Medicated With LTX-109 Antimicrobial Peptide for Modulated Local Therapy in the Management of Chronic Wounds.

In response to the critical issue of chronic wound management, this research explores the development of a multiple-layer biomaterial loaded with LTX-109 a novel broad-spectrum topical antimicrobial peptide currently investigated for the treatment of bacterial skin infections. The novel patch is conceived to load and preserve the function of LTX-109, release it on site in a progressive manner, and therefore make available a device for simultaneous wounds disinfection and tissues healing. Chitosan, tannic acid and glycerol along with the solvent casting process are selected for the development of a multilayer structure in which each single layer is designed by choosing a specific composition and stability to tune its behavior and function. On the top, a protective layer to protect the wound from external contaminations, in the middle a medicated layer loaded with LTX-109 and at the bottom a multifunctional layer to modulate the release of LTX-109. Extensive characterizations show that the patch meets the essential requirements for creating an effective wound healing environment, such as absorption of exudate, maintenance of good oxygen and moisture permeability, biodegradability, biocompatibility, and sustained release of LTX-109 with fully retained antibacterial activity as demonstrated by MIC values obtained against reference bacteria.

Accelerating Oral Wound Healing Using Bilayer Biomaterial Delivery of FTY720 Immunotherapy.

Orofacial clefts are the most common congenital craniofacial anomaly. Adverse healing following cleft palate repair can lead to oronasal fistula (ONF), a persistent connection between the oral and nasal cavities. Although human allograft tissues are currently the gold standard for ONF repair, these methods carry risks of infection and rejection, often requiring surgical revision. Immunoregenerative therapies present a novel alternative approach to harness the body's immune response and enhance the wound healing environment. An FDA-approved immunomodulatory drug, FTY720, is repurposed to reduce lymphocyte egress and induce immune cell fate switching toward pro-regenerative phenotypes. In this study, a bilayer biomaterial system is engineered using Tegaderm to secure and control the delivery of FTY720-nanofiber scaffolds (FTY720-NF). The release kinetics of the bilayer FTY720-NF is optimized to maintain drug release for up to 7 days, ensuring safe transdermal absorption and tissue biodistribution. The comprehensive immunophenotyping results demonstrate a regenerative state transition in hybrid immune cells recruited to the wound site. Further, histological evaluations reveal a significant ONF closure in mice by day 7 following bilayer FTY720-NF implantation. These findings demonstrate the utility of immunomodulatory strategies for oral wound healing, better positing the field to develop more efficacious treatment options in pediatric patients.

Preparing the soil: Adjusting the metabolic health of patients with chronic wounds and musculoskeletal diseases.

In recent years, systemic inflammation has emerged as a pivotal player in the development and progression of various degenerative diseases. This complex, chronic inflammatory state, often undetected, can have far-reaching consequences for the body's physiology. At the molecular level, markers such as C-reactive protein, cytokines and other inflammatory mediators serve as indicators of systemic inflammation and often act as predictors of numerous musculoskeletal diseases and even certain forms of cancer. The concept of 'meta-inflammation', specifically referring to metabolically triggered inflammation, allows healthcare professionals to understand inflammatory responses in patients with metabolic syndrome. Driven by nutrient excess and the expansion of adipose tissue, meta-inflammation is closely associated with insulin resistance, further propagating the metabolic dysfunction observed in many Western societies. Wound persistence, on the other hand, exacerbates the detrimental effects of prolonged inflammation at the local level. Acute inflammation is a beneficial and essential process for wound healing and infection control. However, when inflammation fails to resolve, it can impede the healing process, leading to chronic wounds, excessive scarring and even the activation of fibrotic pathways. This approach significantly reduces the efficacy of regenerative biological therapies. Our review focuses on the vital role of proteins, vitamins and minerals in collagen synthesis and cell proliferation for tissue healing. We also examine hormonal influences on regeneration, noting the negative effects of imbalances, and emphasize glucose regulation's importance in creating a stable environment for chronic wound healing.

High strength “breathable” glycosilicone/Aloe vera polysaccharide-based gel dressing for efficient wound repair

Medical wound dressings are effective in protecting wounds, maintaining moisture, creating an optimal healing environment and accelerating wound healing. However, their deficiencies in mechanical properties, adhesion and prevention of adhesion to the wound bed have been identified as limiting factors for their therapeutic efficacy in wound healing. To address these issues, we prepared glycosilicone gel dressings consisting of hydrophobic polysiloxanes and highly hydrophilic polysaccharides via ester exchange and silicone hydrogen addition reactions. Silicone gel dressings exhibit skin-like “respiratory” properties, with good permeability to O2 and CO2. Additionally, elongation and other important parameters are similar to those of the skin, which provides a foundation for the application of silicone gels in the field of wound dressings. The introduction of Aloe vera polysaccharide (AP) results in the glycosilicone gel exhibiting certain mechanical properties, including a tensile strength of 0.35 MPa and an adhesion force of 10 N/m. Furthermore, a mouse model of total skin defect demonstrated that the wound healing rate of the mice on the 12th day was 98 %, which effectively promotes wound healing. Consequently, the glycosilicone gel is anticipated to be an optimal wound dressing.

“Give me the reigns of taking care of myself with a home”: Healing environments in an Indigenous-led alcohol harm reduction program

BackgroundDistinct from western Managed Alcohol Programs (MAPs), Indigenous-led alcohol harm reduction programs can be defined by both ‘culture as healing’ and decolonized harm reduction philosophies. We sought to explore experiences of Indigenous ‘family members’ (participants) in an Indigenous-led alcohol harm reduction program and culturally supportive housing to identify appropriate supports according to family member perspectives, and to inform delivery of the program.MethodsSituated within an Indigenous-western research partnership, we completed semi-structured interviews with seven family members of an Indigenous-led alcohol harm reduction and culturally supportive housing program. Community-guided protocols informed relational knowledge gathering practices including semi-structured in-depth interviews, qualitative thematic analysis, collaborative interpretation of findings, and development of knowledge products.ResultsFamily members highlighted the importance of tailored Indigenous-led alcohol harm reduction in shifting their relationships to alcohol from survival to having choice and control of their drinking (It’s a choice I’m making right now). The provision of varied and incremental culture-based opportunities (Multiple pathways for connecting to culture) facilitated engagement with culture as healing. Policies that honour respect and autonomy were identified as supportive to healing and harm reduction, countering family members’ experiences in western spaces (Give me the reigns of taking care of myself with a home).ConclusionsAn Indigenous-led alcohol harm reduction program within a model of culture as healing facilitated shifts in relationships to alcohol, providing a space where family members could explore long term goals of healing and connection to culture. Family members’ experiences and recommendations offer key considerations for the design of Indigenous-led harm reduction and culture as healing models. Recommendations emphasize the provision of tailored alcohol harm reduction plans in parallel to multiple and accessible opportunities for connection to culture as healing in order to meet diverse participant goals and relationships to alcohol and culture.

Novel 3D printed bioactive SiC orthopedic screw promotes bone growth associated activities by macrophages, neurons, and osteoblasts.

Ceramic additive manufacturing currently relies on binders or high-energy lasers, each with limitations affecting final product quality and suitability for medical applications. To address these challenges, our laboratory has devised a surface activation technique for ceramic particles that eliminates the necessity for polymer binders or high-energy lasers in ceramic additive manufacturing. We utilized this method to 3D print bioactive SiC orthopedic screws and evaluated their properties. The study's findings reveal that chemical oxidation of SiC activated its surface, enabling 3D printing of orthopedic screws in a binder jet printer. Post-processing impregnation with NaOH and/or NH4OH strengthened the scaffold by promoting silica crystallization or partial conversion of silicon oxide into silicon nitride. The silica surface of the SiC 3D printed orthopedic screws facilitated osteoblast and neuron adhesion and extensive axon synthesis. The silicate ions released from the 3D printed SiC screws favorably modulated macrophage immune responses toward an M1 phenotype as indicated by the inhibition of TNFα secretions and of reactive oxygen species (ROS) expression along with the promotion of IL6R shedding. In contrast, under the same experimental conditions, Ti ions released from Ti6Al4V discs promoted macrophage TNFα secretion and ROS expression. In vivo tests demonstrated direct bone deposition on the SiC scaffold and a strong interfacial bond between the implanted SiC and bone. Immunostaining showed innervation, mineralization, and vascularization of the newly formed bone at the interface with SiC. Taken altogether, the 3D printed SiC orthopedic screws foster a favorable environment for wound healing and bone regeneration. The novel 3D printing method, based on ceramic surface activation represents a significant advancement in ceramic additive manufacturing and is applicable to a wide variety of materials.

Psychosocial well-being needs of alcohol/drug sufferers and therapeutic architectural solutions in rehabilitation centre, Nigeria: a cross-sectional study

Background In a rehabilitation centre designed for drug and alcohol recovery, the therapeutic environment may enhance the psychosocial well-being of sufferers and facilitate a speedy recovery. This study aims to investigate the psychosocial well-being needs (PWNs) of users in an alcohol and drug rehabilitation centre (ADRC) and how therapeutic architectural solutions (TASs) can promote a healing environment through design. Methods The study employed a mixed research method (qualitative and quantitative). The research strategy was a case study of four rehabilitation centres in Nigeria’s busiest cities; Lagos, Abuja, Port Harcourt, and Enugu. Data were collected via survey questionnaires, an in-depth interview guide, an observation guide, and a checklist of TACs in a healthcare facility. We first investigated what the PWNs of alcohol and drug sufferers (ADSs) are, then identified the therapeutic architectural components (TACs) of an ADRC, before determining what effect TACs have on the recovery process of substance abuse patients. Results The findings identify eight PWNs and nine TACs essential in an ADRC. The result indicates that TACs have a significant effect on the recovery process of ADSs. However, based on the study results, a framework (framework here refers to using an intelligent and sensitive conceptual design structure as a standard guide for the building archetype rehabilitation facility, which supports mental health service delivery) may be recommended for rehabilitation facilities with TASs for Substance Abuse Disorder (SUD). Conclusion The study result presents a correlation between ADSs’ recovery rates and a well-designed therapeutic environment. So, there is a need for evidence-based design (EBD) of rehabilitation centres with full compliments of a therapeutic architectural environment and integration of mental health services into routine care in sub-Saharan Africa. Limitations include that analyses were cross-sectional and thus may not deduce causal directions, and the authors based the result on self-report.

Perspectives of Families and Healthcare Staff on the Design of Inpatient Hospital Rooms in Saudi Arabia.

Aim: This study aims to explore the relationship between the perspectives of both family members and healthcare staff regarding the design of hospital inpatient rooms. It investigates the impact of family presence on the healing environment and examines the influence of specific design elements within inpatient rooms on the extent of family presence. Background: The positive impact of family presence in healthcare settings is rooted in the notion that patients and their families are significant stakeholders in the care process. However, little is known about the influence of inpatient room design elements on family presence in healthcare settings in the Middle East. Methods: A questionnaire survey was conducted among 359 participants, encompassing patients, family visitors, and healthcare professionals from three hospitals in Saudi Arabia. The questionnaire items sought insights into the influence of design elements within inpatient rooms on family presence and the overall healing environment. Results: The results indicate a strong preference for single-patient rooms (74.5%), natural light (77.6%), comfortable seating (85.8%), and a family zone positioned by the window for unobstructed views of nature (50.5%). Furthermore, the study reveals that family presence is perceived to have positive effects on the healing environment (84.0%), patient safety (81.3%), and satisfaction with the care process (88.0%). Conclusion: This study proposes a design model for inpatient rooms that can effectively cater to the needs of patients and their families, thereby contributing to the overall improvement of healthcare building design.

A dual-layer nano dressing with enhanced antimicrobial and healing properties via sesame nanoemulgel with efficient levofloxacin delivery for wound management

Creating suitable wound dressings is considered a promising approach for treating severe skin injuries, as they can provide the environment for healing and protection against infection. The optimum wound dressing should possess biocompatibility, high absorbency, antimicrobial activity, breathability, and mechanical strength. So, in this study, we created a two-layer dressing that includes a surface layer composed of xanthan, polyvinyl alcohol, and sesame oil, as well as a nanofibrous sublayer that contains polyvinyl alcohol, collagen, levofloxacin, and sesame oil nanoemulsion (Video 1). This dual structure is designed to offer antimicrobial properties and facilitate wound healing while having suitable physical stability. The films showed desirable morphological features and significantly increased flexibility (less than 1000). These features were respectively proven through scanning electron microscopy and tensile strength. Laboratory investigations were conducted to examine the precise compatibility and anti-inflammatory features. According to the obtained results, the nanosystems showed compatibility with hemolysis below 5 percent and by adding sesame oil to the films, their anti-inflammatory properties (88 ± 0.19 %) and blood compatibility (1.3507 ± 0.20) increased. In-vivo studies using the rat skin defect model showed that the dressings significantly accelerate the closure of skin wounds and enhance the reconstruction of skin appendage structures. The therapeutic effect resulted from reducing inflammatory factors, and the film's antimicrobial properties effectively prevent the growth of harmful microorganisms. In conclusion, the study suggests that the new nano-biocomposite films suit wound management.

Improved Wound Healing: The Healing Power of Blood Transfusions for Individuals with HIV

Wound healing in individuals with HIV is often compromised due to impaired immune function, chronic inflammation, and common comorbidities like anemia. Blood transfusions, traditionally used to manage anemia, have shown promise in enhancing wound healing through multiple mechanisms. This review explores the role of blood transfusions in improving wound healing for HIV-positive patients, focusing on their impact on oxygen delivery, immune modulation, inflammation reduction, and tissue repair. By restoring adequate hemoglobin levels, blood transfusions can improve oxygenation, support cellular metabolism, and promote collagen synthesis and angiogenesis, all crucial for effective wound healing. In addition to addressing anemia, blood transfusions may offer broader benefits, including the modulation of immune responses and the reduction of systemic inflammation. These effects can create a more favorable environment for wound healing, helping to mitigate prolonged inflammation and tissue damage commonly seen in HIV-positive individuals. Clinical studies and case reports have highlighted significant improvements in wound healing outcomes following transfusion therapy, underscoring its potential as a complementary intervention in HIV care. Keywords: anemia, blood transfusions, HIV, immune response, wound healing,

The Effect of Immobilization Methods of P9-4 Antimicrobial Peptide Onto Gelatin Methacrylate on Multidrug-Resistant Bacteria: A Comparative Study.

Wound dressings play a crucial role in wound management by providing a protective barrier and creating an optimal environment for healing. Photocrosslinkable hydrogels, such as gelatin methacrylate (GelMA), have gained attention for their unique properties but often lack antimicrobial activity. To enhance their effectiveness, researchers are exploring methods to incorporate antimicrobial agents into photocrosslinkable hydrogel dressings. Immobilization of antimicrobial peptides (AMPs) onto hydrogel matrices may be achieved through physical or chemical methods. Although, chemical immobilization, using techniques like EDC/NHS chemistry, has shown promise in enhancing antimicrobial properties of hydrogels, the capacity for immobilization may be limited by the structure of hydrogel. Physical methods, such as immersing, offer alternatives but may have different efficacy and biocompatibility. The study aims to chemically immobilize GelMA with P9-4 AMP by photoinduced conjugation and EDC/NHS chemistry and compare its antimicrobial efficacy with a physical immobilization method. Chemical immobilization by EDC/NHS chemistry significantly enhances the antimicrobial effect of GelMA hydrogels against multi-drug resistant Psuedomonas aeruginosa (MDR P. aeruginosa) and methicillin-resistant Staphylococcus aureus (MRSA) while maintaining favorable biocompatibility. Study highlights the potential of AMP-functionalized GelMA as advanced wound dressings for reducing infections caused by antibiotic-resistant bacteria and offers a promising approach for future research in wound management.

Biologics in rotator cuff repair.

Rotator cuff tears are common in middle-aged and elderly patients. Despite advances in the surgical repair of rotator cuff tears, the rates of recurrent tear remain high. This may be due to the complexity of the tendons of the rotator cuff, which contributes to an inherently hostile healing environment. During the past 20 years, there has been an increased interest in the use of biologics to complement the healing environment in the shoulder, in order to improve rotator cuff healing and reduce the rate of recurrent tears. The aim of this review is to provide a summary of the current evidence for the use of forms of biological augmentation when repairing rotator cuff tears.

A Living Microecological Hydrogel with Microbiota Remodeling and Immune Reinstatement for Diabetic Wound Healing.

Dysregulated skin microbiota and compromised immune responses are the major etiological factors for non-healing diabetic wounds. Current antibacterial strategies fail to orchestrate immune responses and indiscriminately eradicate bacteria at the wound site, exacerbating the imbalance of microbiota. Drawing inspiration from the beneficial impacts that probiotics possess on microbiota, a living microecological hydrogel containing Lactobacillus plantarum and fructooligosaccharide (LP/FOS@Gel) is formulated to remodel dysregulated skin microbiota and reinstate compromised immune responses, cultivating a conducive environment for optimal wound healing. LP/FOS@Gel acts as an "evocator," skillfully integrating the skin microecology, promoting the proliferation of Lactobacillus, Ralstonia, Muribaculum, Bacillus, and Allobaculum, while eradicating colonized pathogenic bacteria. Concurrently, LP/FOS@Gel continuously generates lactic acid to elicit a reparative macrophage response and impede the activation of the nuclear factor kappa-B pathway, effectively alleviating inflammation. As an intelligent microecological system, LP/FOS@Gel reinstates the skin's sovereignty during the healing process and effectively orchestrates the harmonious dialogue between the host immune system and microorganisms, thereby fostering the healing of diabetic infectious wounds. These remarkable attributes render LP/FOS@Gel highly advantageous for pragmatic clinical applications.

Observation of the Therapeutic Effect of Hydrogel Combined with Alginate Dressings for a Patient with Grade 4 Acute Radiation Dermatitis: A Case Report.

In this case report, the authors summarize their experience of using hydrogel combined with alginate dressings in the wound care of a patient with grade 4 acute radiation dermatitis. With the combination of hydrogel and alginate dressings, the authors achieved autolytic debridement of the wound and created a moist healing environment to facilitate wound closure. Hydrogel helps the dressing adhere better to the wound bed, ensuring that it does not easily detach during the wound healing process. It also eliminates the need for traditional adhesive tapes for fixation, thus avoiding damage to the fragile skin in the radiation field.The wound gradually decreased in size from an area of 10 × 12 cm, and exudate decreased continuously. The wound completely healed in 20 days with a total of 17 dressing changes. As the wound gradually healed, the patient's psychological burden decreased and comfort level increased. The patient expressed satisfaction and hope for the gradual healing of the wound.Thus, the treatment of severe acute radiation dermatitis with hydrogel combined with alginate dressings yields remarkable results, aligning the noninvasive, low-adhesive, absorbent, conformable, and comfortable attributes of optimized wound care. This experience provides a practical foundation for wound management in acute radiation dermatitis and supports clinical application and promotion of the approach.

Fracture Non-Union in Osteoporotic Bones: Current Practice and Future Directions.

Given the compromised bone quality and altered healing environment, fracture non-union in osteoporotic bones presents a complex challenge in orthopedics. As global populations age, the incidence of osteoporotic fractures rises, leading to increased delayed healing and non-union cases. The pathophysiology underlying non-union in osteoporotic patients involves impaired bone regeneration, reduced osteoblast function, and poor vascularity. Traditional management strategies - ranging from pharmacological interventions like bisphosphonates and teriparatides to surgical approaches such as bone grafting and mechanical fixation - often yield limited success due to the weakened bone structure. Recent advances, however, have introduced novel therapies such as growth factors, stem cell applications, gene therapy, and bioactive scaffolds that offer more targeted and biologically driven solutions. Emerging technologies like three-dimensional printing and nanotechnology further contribute to customized treatment strategies that hold promise for improved outcomes. Diagnostic approaches have also evolved, integrating radiological assessments and biomarkers to identify patients at risk for non-union better. Despite these advancements, challenges remain, including the high costs, technical complexities, and the need for more robust clinical evidence. Future directions involve optimizing these innovative treatments, validating their effectiveness in more extensive clinical trials, and integrating personalized medicine approaches to cater to the individual needs of osteoporotic patients. Overall, integrating these emerging therapeutic strategies alongside traditional practices represents a significant shift towards more effective and personalized management of fracture non-union in osteoporotic bones.

Racism, Identity-Based Discrimination, and Intersectionality in Adolescence

Adolescence is a critical developmental stage for young people as they transition into adulthood. Several important developmental tasks that must be completed during this transition include exploring one’s identity, developing and applying abstract thinking, adjusting to a new physical sense of self, and fostering stable and productive peer relationships while striving for autonomy and independence from parents. Young people begin to adopt a personal value system and form their racial and ethnic, social, sexual, and moral identity within a society that may provide conflicting and nonaffirming messages. Adolescent development strives toward an affirmed sense of self and self-esteem, which is best accomplished within a nurturing psychosocial context that fosters positive youth development. Youth-focused interventions should intentionally promote affirmation of ancestry and cultural identity, intersections with other historically marginalized identities, and critical consciousness. Fostering healing environments that affirm and address the radical need for change, coaching parents and guardians as critical agents in the creation of affirmative environments for development, and conducting research using anti-oppressive approaches are additional strategies to promote positive youth development. Simultaneously, structural transformations that address underlying social inequities are needed. Health care systems should continue to diversify the workforce and train staff and clinicians in integrative, identity-based, and healing-centered approaches. Organizations should consider training in diversity and competencies related to belonging while safeguarding inclusion with policies, procedures, and practices. Public health and policymakers can embed intersectional approaches within structural and systemic processes, particularly in all policies.

Nursing Home in Medan City Using a Healing Environment Approach

Nursing Home in Medan City Using a Healing Environment Approach

Supporting Aging-in-Place: Drivers and Desired Outcomes of a Healing Environment for Older Adults in Block Spaces of High-Density Cities.

Aim: The objective of this study was to develop a comprehensive multidimensional framework by identifying the key drivers and components associated with the health of older people in healing environments, and to apply this framework in high-density city block spaces, creating opportunities for aging in place. Background: Effective theoretical and practical research frameworks are necessary to determine how to best support older adults in high-density city areas as they face aging-related challenges. Methods: The methodological approach involved bibliometric analysis (SciMAT) and systematic literature review of approximately 4446 articles related to rehabilitation settings and older adults. The review focused on literature that developed concepts and research frameworks and provided an empirical foundation. Results: The review identified four types of drivers for a healing environment for older individuals in high-density city blocks (HEOI-HCBs): self-environment, interpersonal, physical, and informational environments. These drivers were linked to eight desirable outcomes: initiative acquisition, shared vision, trust, empathy, integrity, systematicity, networking, and perceived usefulness. Conclusion: The drivers and outcomes formed the HEOI-HCBs framework, each representing a distinct dimension of the HEOI-HCBs concept. This study and the resulting framework facilitate the application and understanding of healing environments.