Search

Abstract: Many now claim that maintaining or improving the quality of life is the essence of healthcare (i.e. care and/or treatment that improves the patients’ quality of life). Interest in QL, however, stems from increasing recognition that individuals are an integrated whole rather than a series of disconnected parts or disease states. Though this represents a significant change from the past—when the emphasis lay solely on physical or medical condition—it is not, in itself, meaningful unless reliable and valid ways of evaluating the human aspects of the experience can be identified (i.e. quality of life). As quality of life (QL) is seen as a positive state, a desirable outcome of healthcare interventions, it has gained credence as an appropriate outcome measure and has intuitive appeal. Indeed, it is suggested that, because of its close relationship to mortality, self-perceived QL may be the most important outcome of both acute and, particularly, chronic disease. Lack of consensus about its meaning has, however, resulted in ambiguity and, therefore, difficulties in its measurement reflecting, in turn, the difficulty in identifying the components of this multifaceted concept. This paper explores these issues and questions whether we are, in fact, attempting to measure something that cannot truly be measured. [Copyright &y& Elsevier]

This paper examines the psychosocial dimensions of long-term care with reference to the new International Classification of Functioning, Disability and Handicap (ICIDH 2) and to research conducted in Hong Kong. It also draws on selected international literature about older people. It discusses the different ways in which information can be gained about the personal, social and emotional processes of rehabilitation that influence outcomes and raises methodological questions about the study of interventions. Outcomes that are sensitive to psychosocial interventions and that take account of the elderly person's own perspective are identified as important challenges for nurses and other professionals in the multidisciplinary team, in order to respond to an individualized approach to long-term care. It is concluded that gaining a better understanding of the psychosocial dimensions of long-term care will enhance professional practice and benefit older people and their carers. [ABSTRACT FROM AUTHOR]

In January 2013, the international recommendations of the KDIGO (for 'Kidney Disease: Improving Global Outcomes') to define chronic kidney disease (CKD) and classify patients in CKD stages have been published. In this opinion article, we will review and discuss the most important guidelines proposed about CKD staging and glomerular filtration rate (GFR) estimating. In particular, we question the choice of fixed knot values at 60 mL/min/1.73 m² to define CKD. We also question the strategies proposed to measure and use cystatin C results. [ABSTRACT FROM AUTHOR]

Abstract: New evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in protein metabolism, such as high splanchnic extraction and declining anabolic responses to ingested protein. They also need more protein to offset inflammatory and catabolic conditions associated with chronic and acute diseases that occur commonly with aging. With the goal of developing updated, evidence-based recommendations for optimal protein intake by older people, the European Union Geriatric Medicine Society (EUGMS), in cooperation with other scientific organizations, appointed an international study group to review dietary protein needs with aging (PROT-AGE Study Group). To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher protein intake (ie, ≥1.2 g/kg body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or chronic diseases need even more dietary protein (ie, 1.2–1.5 g/kg body weight/d). Older people with severe kidney disease (ie, estimated GFR <30 mL/min/1.73m2), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake. Protein quality, timing of ingestion, and intake of other nutritional supplements may be relevant, but evidence is not yet sufficient to support specific recommendations. Older people are vulnerable to losses in physical function capacity, and such losses predict loss of independence, falls, and even mortality. Thus, future studies aimed at pinpointing optimal protein intake in specific populations of older people need to include measures of physical function. [Copyright &y& Elsevier]

Abstract: Background: In western countries, the yearly incidence of depression is estimated to be 3–5% and the lifetime prevalence is 17%. In patient populations with chronic diseases the point prevalence may be 20%. Depression is associated with increased risk for various conditions such as osteoporoses, cardiovascular diseases, and dementia. WHO stated in 2000 that depression was the fourth leading cause of disease burden in terms of disability. In 2000 the cost of depression in the US was estimated to 83 billion dollars. A predominance of trials suggests that physical exercise has a positive effect on depressive symptoms. However, a meta-analysis from 2001 stated: “The effectiveness of exercise in reducing symptoms of depression cannot be determined because of a lack of good quality research on clinical populations with adequate follow-up.” Objectives: The major objective for this randomized trial is to compare the effect of non-aerobic, aerobic, and relaxation training on depressive symptoms using the blindly assessed Hamilton depression scale (HAM-D17) as primary outcome. The secondary outcome is the effect of the intervention on working status (i.e., lost days from work, employed/unemployed) and the tertiary outcomes consist of biological responses. Design: The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are recruited through general practitioners and psychiatrist and randomized to three different interventions: 1) non-aerobic, — progressive resistance training, 2) aerobic training, — cardio respiratory fitness, and 3) relaxation training with minimal impact on strength or cardio respiratory fitness. Training for all three groups takes place twice a week for 4 months. Evaluation of patients'' symptoms takes place four and 12 months after inclusion. The trial is designed to include 45 patients in each group. Statistical analysis will be done as intention to treat (all randomized patients). Results from the DEMO trial will be reported according to the CONSORT guidelines in 2008–2009. [Copyright &y& Elsevier]

Although the majority of pain complaints, in Australia, are among the elderly population, the focus of treatment is not on this age group. In order to achieve effective management of elderly people's chronic pain, their perspective of pain and coping strategies used needs to be understood. This qualitative study explored the preferred strategies of elderly people and the barriers they encountered in trying to manage their pain. Elderly people (n=72) with chronic pain, over 65 years of age and living in the community, were interviewed for the study. Data were collected using six focus group and 12 in-depth interviews and a biographical questionnaire. Preferred coping strategies were those that could be self-administered and included both physical and cognitive elements. Elderly people wished to be active in their treatment, make informed choices and were willing to try new methods. Least-preferred strategies were the conventional treatments of medications, exercise and physiotherapy. Many barriers have to be overcome to achieve relief for their pain such as cost, access to health care, related disorders, attitudes of health professionals, lack of communication and fear of losing independence. Health professionals need to be aware of elderly people's perspective of pain and their preferred strategies and reasons for these choices. Health services must meet their specific needs. [ABSTRACT FROM AUTHOR]

Background: Access to healthcare is part of every individual's human rights; however, many studies have illustrated that ethnic minority patients seem to be confronted with barriers when using healthcare services. Understanding how healthcare utilities are accessed from the perspective of patients and why healthcare disparities occur with patients from a minority background has the potential to improve health equality and care quality. This qualitative systematic review aims to gain insights into the experiences of people with chronic respiratory diseases (CRDs) from a minority background and explore factors contributing to their experiences in accessing healthcare to inform related health policy makers and healthcare providers. Methods: This systematic review complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, where the Joanna Briggs Institute meta-aggregative instrument facilitated the qualitative synthesis. The study protocol was registered with PROSPERO (CRD42022346055). PubMed, Scopus, Web of Science, and CINAHL were the databases explored. Results: From the papers selected, 47 findings were derived from 10 included studies, and four synthesised findings were generated: (1) the relationship between patients and healthcare professionals affects the usage of healthcare services; (2) patients' perceptions and cultural beliefs affect their compliance with disease management; (3) personal behaviours affect the usage of healthcare services; and (4) health resource inequalities have an impact on accessing healthcare services. Conclusions: This systematic review demonstrates that ethnic minorities with CRDs face inequalities when engaging in healthcare. The relationship between patients and clinicians impacting the use of healthcare is the most pivotal discovery, where not speaking the same language and being of a different race alongside the accompanying criticism and faith in facilities are key contributors to this effect. In addition, the thinking patterns of these marginalised groups may reflect their cultural upbringing and diminish their engagement with therapies. This paper has uncovered ways to attenuate inequalities amongst ethnic minorities in engaging with healthcare providers and provides insight into building effective equity-promoting interventions in healthcare systems. To overcome these disparities, coaching doctors to communicate better with minority cohorts could help such patients to be more comfortable in connecting with medical facilities. [ABSTRACT FROM AUTHOR]

This paper presents a systematic review of bibliometric studies on social wellness published between 2013 and 2022. The review found that most bibliometric studies on social wellness were conducted in the fields of public health, psychology, and sociology, and that the most used indicator was citation count. The findings also show that social wellbeing research frequently focuses on groups of people, like the elderly, people with chronic conditions, and marginalized communities. Furthermore, the paper discusses the potential implications of bibliometric analysis for social wellness research. For example, bibliometric indicators can be used to identify gaps in the literature, highlight key authors and institutions, and track the impact of research on policy and practice. Finally, the paper proposes several future directions for bibliometric research on social wellness, including the need for more interdisciplinary studies, the use of alternative bibliometric indicators, and the incorporation of qualitative approaches to supplement quantitative analyses. [ABSTRACT FROM AUTHOR]

Background: Festivals play an important role in improving death and grief literacy, enabling members of the public to engage with these often-sensitive topics. Good Grief Weston festival was co-designed and delivered with the community in Weston-super-Mare, a coastal town in South-West England with high levels of socioeconomic disadvantage but rich community assets. It was held in person over 8 days in May 2023. Objectives: To evaluate the reach and impact of Good Grief Weston festival and gather data to inform future festivals. Design: Mixed methods evaluation (survey and focus groups). Methods: Online and paper surveys assessing participants' characteristics and experiences were administrated during and after the festival. Survey participants who indicated their willingness to participate were invited to attend a focus group. Focus groups were recorded, transcribed and analysed using thematic analysis. Data were collected by trained community co-researchers. Results: Approximately 3000 people attended the festival. Of 204 completed surveys, 64.5% were from women, age range ⩽15 to ⩾75 years; 88.2% identified as White; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (70.9%), inspired (68.5%), felt part of a like-minded community (54.3%), talked to someone new (49.2%), learnt about grief/bereavement (34.3%), shared or expressed experiences (30.3%) and found out about local support (19.7%). 71.3% reported that they felt more confident talking about grief after attending. Median experience rating was 5 (IQR 0; possible range 1 = poor to 5 = excellent). In free-text comments, participants expressed appreciation for the festival and described benefits in attending. Two focus groups were conducted (n = 8 participants, all women), lasting c.1.5 h. Focus groups added rich descriptions of the festival's value, and data to inform the next festival. Conclusion: Findings suggest festivals of this nature can play a central role in a public health approach. Plain language summary: What was the impact of Good Grief Weston festival? Why was the study done? Previous studies have shown that many people feel unsupported by their community after the death of a loved one. We designed a festival to improve knowledge and support for bereaved people. We did this study to assess how the festival affected the people who attended. What did the researchers do? The team included researchers and people and organisations from the local community. Together, we designed and ran a festival on the topic of death, grief and bereavement in Weston-super-Mare, a coastal town with areas of high deprivation. The festival took place over an eight-day period in May 2023 and included creative, interactive and educational events. The team collected feedback on attendees' experiences of the festival. We did this using online and paper feedback forms, postcards, and focus groups to collect as many opinions as possible. What did the researchers find? We found that a wide range of people attended the festival. Most people who took part in the research rated the festival as 'excellent'. They told us they learnt about grief and bereavement and found out about local support services. Attendees met new people, shared their experiences, and felt that the festival built community spirit. They also made suggestions to improve any future festivals. What do the findings mean? The findings show that in-person festivals can effectively engage the public on the topic of death, grief and bereavement. They can also help develop connections between people and organisations in communities. These connections and learning opportunities may help communities to support their members through bereavement. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the relationship among secondary traumatic stress, compassion fatigue, and meaning in life in nurses during the COVID‐19 pandemic. Background: Changes in working conditions during the pandemic also changed the needs of nurses. In addition to physical health, the COVID‐19 pandemic led to many psychosocial health problems such as sleep disturbances, depression, and traumatic stress. This makes nurses vulnerable to psychological side effects of the pandemic. Design: A cross‐sectional study was conducted. Methods: This study was conducted with 166 nurses. Data were collected online at May–June 2021. A Personal Information Form, the Secondary Traumatic Stress Scale, Compassion Fatigue Scale, and Meaning in Life Scale were used. The STROBE reporting checklist was followed. Results: As secondary traumatic stress levels increase, compassion fatigue increases, meaning in life decreases, and the search for meaning in life increases. Conclusion: Predictors of secondary traumatic stress were shown to be compassion fatigue, change in sleep habits, meaning in life, marital status, and having a chronic illness. This suggested that working during the pandemic posed significant risks in terms of manifesting negative consequences on mental health in the long term. Summary statement: What is already known about this topic? Nurses often face stressful situations such as personal life challenges, the nature of the job that requires focus, and patient care.Nurses are exposed to the detrimental psychological effects of the pandemic because they are among the first medical professionals to meet COVID‐19 infected individuals.The pandemic has created many positive and negative effects on nurses. What this paper adds? This study reports that the mental health of nurses should be protected and strengthened by identifying the psychosocial health problems experienced by nurses due to the COVID‐19 pandemic.Findings inform on choice of effective interventions to protect the mental health of nurses. The implications of this paper: Failure to manage global crisis such as pandemics will cause traumatic stress, compassion fatigue, decreased meaning in life, and burnout in nurses.In order to protect nurses from the long‐term negative effects of pandemics, necessary programmes should be developed to strengthen their mental, physical, and spiritual health, to support their personal life habits and to improve their working conditions.Protective interventions, such as assessment and monitoring of nurses' mental health, can support strengthened crisis management practices. Preventive interventions and programmes based on individual needs should be implemented in order to improve nurses' ability to cope with difficult emotions. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to determine the knowledge, attitudes, and practices of male nurses towards human papillomavirus (HPV) and HPV vaccination and to examine whether knowledge about the HPV vaccine affects attitudes and beliefs about HPV vaccines. Background: HPV is responsible for ≈5% of all cancers worldwide. Therefore, vaccination against HPV is recommended to prevent HPV infections and HPV‐related cancers in men and women. Methods: The study group included 383 male nurses who were asked to complete online questionnaires. The data were collected using the following tools: a sociodeomographical characteristics form, the Human Papillomavirus Knowledge Scale (HPVKS), and The Carolina HPV Immunization Attitudes and Beliefs Scale (CHIAS). Results: It was determined that the general HPV knowledge of the male nurses participating in the study was at a moderate level, but their knowledge of HPV screening test, HPV vaccination, and current HPV vaccination programmes were at a low level. Male nurses' HPV vaccination rates were relatively low, and most of them did not intend to be vaccinated. In addition, CHIAS Attitudes and Beliefs scores of the male nurses were at an average level and HPV knowledge affected the attitudes and beliefs of the nurses. Conclusion: These results demonstrate an opportunity to improve information and awareness about HPV and vaccines by nursing education. Summary statement: What is already known about the topic? Although HPV vaccination is recommended to prevent HPV infections and HPV‐related cancers in men and women, vaccination rates are far behind the target, especially for men. What this paper adds? Findings showed that male nurses' HPV vaccination rates were relatively low.Male nurses' knowledge about HPV and HPV vaccine was not sufficient.HPV knowledge affected the attitudes and beliefs of these male nurses. The implications of this paper: Nurses need to be aware of the HPV vaccine during their undergraduate education. [ABSTRACT FROM AUTHOR]

Simple Summary: Myeloid-derived suppressor cells (MDSCs) are immature cells that expand in the circulation of patients with cancer, sepsis or chronic inflammation, modulate the immune response against cancer (favoring tumor onset and progression) and promote neoangiogenesis. These premises suggest that MDSCs could be involved in the pathogenesis of primary myelofibrosis (PMF) (a myeloproliferative neoplasm characterized by chronic inflammation and extensive neoangiogenesis in bone marrow and spleen). In this paper, we found that (1) MDSCs are increased both in the circulation and in the spleen of PMF patients and strongly correlate with disease progression; and (2) reduced CXCR4 expression on MDSCs along with increased plasmatic SDF-1α can be involved in their mobilization. These findings suggest that circulating MDSCs can be considered a parameter of disease severity and set MDSCs as potential new targets for cancer therapy. Primary myelofibrosis (PMF) is a myeloproliferative neoplasm characterized by a chronic inflammatory state that plays a relevant role in the disease pathogenesis (as proven by high levels of inflammatory cytokines with prognostic significance and by a persistent oxidative stress) and by extensive neoangiogenesis in bone marrow (BM) and spleen. Myeloid-derived suppressor cells (MDSCs) are immature cells that expand in patients with cancer, sepsis or chronic inflammation, favoring tumor onset and progression mainly through the decrease in immune surveillance and the promotion of neoangiogenesis. In this paper, we evaluated the presence of circulating MDSCs in PMF patients, the plasmatic factors involved in their mobilization/expansion and the correlations with laboratory, genetic and clinical parameters. The data indicated that MDSCs could have a relevant role in PMF as a new pathogenic mechanism contributing to explaining the phenotypic diversity observed during the clinical course of the disease, or a potential new target for personalized treatment. [ABSTRACT FROM AUTHOR]

This paper explores the critical role of prognostication tools in identifying high-risk hospitalized older adults who may benefit from palliative care. With an ageing population and increasing prevalence of chronic illnesses, the demand for patient-centered healthcare is paramount. The study evaluates three key tools—the Palliative Performance Scale, CARING criteria, and Palliative Care Rapid Emergency Screening tool. Each tool is analyzed for its psychometric properties, advantages, and limitations. Despite their strengths and limitations, these tools emerge as crucial screening tools for identifying older adults at heightened mortality risk within one year of hospital admission. Our paper calls for ongoing research to adapt and validate existing tools, ensuring their applicability across diverse clinical settings and patient populations. [ABSTRACT FROM AUTHOR]

The article provides insights on the urgent need for transformative responses in health and social care services due to challenges such as aging populations, chronic illnesses, infrastructure underinvestment, and workforce shortages. It presents papers that examine different aspects of these transformations, including the adoption of single-handed care.

Introduction and purpose: Currently, as the frequency of obesity is alarming, the role of many factors that could contribute in preventing and treating this condition are being researched, among them the certain food with beneficial health profiles - one of them is soybeans, specifically the isoflavones it contains. Populations that consume soy are known for lower risk of various disorders - among them obesity. The aim of this paper is to summarize the existing paper about the role of these bioactive components in the treatment of this condition. The search was conducted using PubMed and Google Scholarship databases. Brief description of the state of knowledge: Obesity is one of the leading challenges in today's healthcare as it leads to various chronic diseases that are fraught in consequences. Current knowledge is pointing into the association between composition of the soy isoflavones and the lower risk of obesity. Results of the studies indicate that patients affected with obesity could benefit from introducing soy isoflavones into their diet along with other necessary modifications. Conclusions: Soy isoflavones are potential agents in the holistic obesity treatment. Consumption of isoflavones merits further recognition as foregoing results of conducted studies are pointing to its possibly meaningful role. It is worth mentioning that consumption of soy isoflavones is not only an anti-obese factor, but also presents various other health benefits and when consumed rationally poses no risk to human's well being. We conclude that further studies would enable us to fully reveal the potential of those polyphenols. [ABSTRACT FROM AUTHOR]

In recent decades, there has been significant progress in non-invasive sampling techniques, which serve as effective tools in treating and managing various chronic diseases. Among these techniques, dried saliva spot (DSS) sampling of human saliva has emerged as a prominent alternative to serum for detecting targeted molecules. The diagnostic potential of saliva has been extensively studied, highlighting its applicability across a spectrum of diseases. In addition to DSS, other sampling methods, such as dried plasma spots, dried blood spots, and dried matrix spots, have been explored. Various types of filter papers have been employed in DSS sampling procedures, with notable examples including the utilization of Whatman™ 903 Protein Saver cards for identifying Streptococcus pneumoniae DNA through polymerase chain reaction (PCR) or LC-mass spectrometry analysis. Following sample collection onto the respective filter paper, specialized tools are employed to facilitate subsequent processes such as solvent extraction, evaluation of extraction, and drying times. DSS has found diverse applications, including the analysis of lidocaine in human saliva, serving as a diagnostic tool for diabetes mellitus, detecting antiepileptic, antipsychotic, and antidepressant drugs in oral fluid, identifying spinal muscle atrophy, determining uric acid levels in saliva, analyzing severe acute respiratory syndrome coronavirus 2 antibody levels, and detecting carriage of S. pneumoniae using (PCR). The utilization of DSS sampling represents a novel approach in the management and treatment of various chronic diseases. [ABSTRACT FROM AUTHOR]

Mycoplasma gallisepticum is the primary causative agent of chronic respiratory disease in poultry, and vaccination is the measure most commonly used for its control. Pathological changes caused by M. gallisepticum are mainly observed in the trachea and air sacs, but assessment of air sac lesions is subjective. Standardized parameters for evaluation of pathological changes, and their reproducibility and discrimination in uninfected and infected groups, are critical when assessing the efficacy of M. gallisepticum vaccination. This study reviewed and critically appraised the published literature on evaluation of vaccine efficacy against pathological changes caused by M. gallisepticum in poultry in the trachea and air sacs. A search of four electronic databases, with subsequent manual filtering, identified 23 eligible papers published since 1962 describing the assessment of histopathological changes in the trachea using tracheal lesion scores and/or measurement of tracheal mucosal thicknesses and assessment of gross air sac lesions using lesion scores. Measurement of tracheal lesions proved a more reliable and robust method of assessing disease induced by M. gallisepticum when compared to assessment of air sac lesions, highlighting the importance of including assessment of tracheal lesions as the primary outcome variable in vaccine efficacy studies. In addition, this study also identified the necessity for use of a standardized model for evaluation and reporting on M. gallisepticum vaccines to minimize variations between vaccine efficacy studies and to allow direct comparisons between them. RESEARCH HIGHLIGHTS Tracheal and air sac lesions have been used to assess M. gallisepticum vaccine efficacy. The specific parameters and statistical tests used to compare tracheal and air sac lesions vary greatly. Measures of tracheal lesions are more discriminatory than measures of air sac lesions. A standardized model is needed to evaluate vaccines against infection with M. gallisepticum. [ABSTRACT FROM AUTHOR]

Discusses the management of chronic diseases. Factors that increased the prevalence of chronic diseases; Statistics on the prevalence of chronic diseases.

Background: The term 'Responsibility Sharing', albeit poorly defined, has emerged from the diabetes literature, to describe a distinct mechanism for comprehensively managing the characteristic shift in responsibility that underpins the transition to self-management for adolescents. Methods: A scoping review, following the PRISMA-ScR guidelines, distilled the literature from seven databases to answer the questions: What is responsibility sharing? Who are the key stakeholders? What factors affect responsibility transaction? What are its recognized outcomes? How is responsibility shared? Results: Responsibility sharing is a transactional arrangement between youth and their caregiver/s that functions to repeatedly and flexibly apply ownership to the management of diabetes care tasks, across the course of adolescence. In the main, responsibility sharing was associated with better metabolic and/or psychosocial outcomes. Effective responsibility sharing was seen as being responsive to adolescent capacity and driven by autonomy supportive, sustained communication patterns that enable mutually agreeable responsibility assumption by all stakeholders. Conclusion: Different perspectives on responsibility sharing for adolescents with Type 1 diabetes, and the lack of a universal definition, have led to discordance within the literature about its operationalization and measurement. This paper proposes a definition of responsibility sharing for future researchers to apply. [ABSTRACT FROM AUTHOR]

Wearable sensor technologies are becoming increasingly relevant in health research, particularly in the context of chronic disease management. They generate real-time health data that can be translated into digital biomarkers, which can provide insights into our health and well-being. Scientific methods to collect, interpret, analyze, and translate health data from wearables to digital biomarkers vary, and systematic approaches to guide these processes are currently lacking. This paper is based on an observational, longitudinal cohort study, BarKA-MS, which collected wearable sensor data on the physical rehabilitation of people living with multiple sclerosis (MS). Based on our experience with BarKA-MS, we provide and discuss ten lessons we learned in relation to digital biomarker development across key study phases. We then summarize these lessons into a guiding framework (DACIA) that aims to informs the use of wearable sensor data for digital biomarker development and chronic disease management for future research and teaching. [ABSTRACT FROM AUTHOR]

Background: Potentially inappropriate polypharmacy (PIP) is among the major factors leading to adverse drug reactions, increased healthcare costs, reduced medication adherence, and worsened patient conditions. This study aims to identify existing interventions implemented to monitor and manage polypharmacy in the Italian setting. Methods: A systematic literature review (PROSPERO: CRD42023457049) was carried out according to the PRISMA statement guidelines. PubMed, Embase, ProQuest, and Web of Science were queried without temporal constraints, encompassing all published papers until October 2023. Inclusion criteria followed the PICO model: patients with polypharmacy; interventions to monitor/manage polypharmacy regimen versus no/any intervention; outcomes in terms of intervention effectiveness and cost variation. Results: After duplicate deletion, 153 potentially relevant publications were extracted. Following abstract and full-text screenings, nine articles met the inclusion criteria. Overall, 78% (n = 7) were observational studies, 11% (n = 1) were experimental studies, and 11% (n = 1) were two-phase studies. A total of 44% (n = 4) of the studies involved patients aged ≥ 65 years, while 56% (n = 5) were disease-specific. Monitoring was the most prevalent choice of intervention (67%; n = 6). Outcomes were mainly related to levels of polypharmacy (29%; n = 6) and comorbidities (29%; n = 6), effectiveness rates (14%; n = 3), and avoidable costs (9%; n = 2). Conclusions: This review outlines that Italy is still lacking in interventions to monitor/manage PIP, addressing an unmet need in developing patient-tailored strategies for reducing health-system burden. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to clarify the concept of pediatric hospice and palliative care through conceptual analysis. It also sought to identify the differences between related concepts such as pediatric death care and pediatric spiritual care, in order to provide foundational data for the development of nursing theory and knowledge. Methods: A conceptual analysis of pediatric hospice and palliative care was conducted using Rodgers’ evolutionary method. Out of 5,013 papers identified, 28 were selected for detailed reading and analysis. Results: Pediatric hospice and palliative care encompasses physical, psychological, social, mental, spiritual, and family care for children with acute and chronic diseases with uncertain prognoses ahead of death, as well as their families. Effective pediatric hospice and palliative care will require multidisciplinary team nursing, effective communication, and supportive policies. Conclusion: The findings of this study suggest that providing pediatric hospice and palliative care will lead to improvements in pain relief for children and families, the efficiency of responses to death in children, and the quality of life for children and families. The significance of this study is that it clearly clarifies the concept by analyzing pediatric hospice and palliative care using an evolutionary method. [ABSTRACT FROM AUTHOR]

Introduction: Traditionally, cancer pain has often been viewed as an independent third major category in pain medicine alongside acute pain and chronic non-cancer pain. However, the new chronic pain category MG30 in the eleventh version of International Classification of Diseases (ICD-11) includes cancer-related pain as one of its seven subgroups. In light of this, the aim of the paper is to investigate whether the traditional trichotomy should be replaced by a dichotomy between acute pain and chronic pain, cancer-related pain being part of both groups depending on the duration of pain. Methods: The rationale for viewing cancer pain as a separate category is reviewed. Results: Cancer being a deadly disease, cancer pain has a life-and-death and existential dimension that is different from non-cancer pain. It seems sensible to believe that this is an additional dimension to the suffering caused by cancer pain, and that clinicians should therefore take this existential dimension into consideration when assessing pain. Conclusion: Without challenging the place of chronic cancer-related pain under the MG30 heading, it is concluded that while using ICD-11 in the future, pain clinicians should continue being mindful of the fact that the reality of death shapes the experience of cancer pain. The traditional trichotomy is therefore still valid and mirrors the fact that human beings are vulnerable (acute pain), temporal (chronic pain) and mortal (cancer pain). [ABSTRACT FROM AUTHOR]

Background: During adolescence, adolescents and young adults (AYAs) are expected to transfer their care from the pediatric environment towards an adult-focused setting. To prevent an abrupt transfer of care, it is recommended to provide AYAs with chronic conditions an adequate transition program. The aim of this paper is to describe the study protocol for the development of a transition program for AYAs with common chronic conditions (COCCOS study), using the Experience-Based Co-Design (EBCD) methodology. Methods and analysis: A qualitative, participatory study is conducted in Flanders (Belgium). Study participants are AYAs (n≥15, 14–25 years old, diagnosed with type 1 diabetes, asthma, or obesity), their families, and healthcare providers (n≥15). The study is composed of eight EBCD stages: clinical site observations, in-depth interviews, trigger film, healthcare providers' feedback event, AYAs' feedback event, joint event, co-design workshops, and a celebration event. Photovoice will take place as a starting point of EBCD. Data will be analyzed using thematic analysis. Results: Data collection has started in January 2023 and is expected to be completed in May 2024. As of August 2023, over 15 clinical site observations have been conducted. A total of 18 AYAs, two parents, six healthcare providers have been enrolled and a total of 20 interviews have been conducted. Conclusion: Advancing transitional care is essential for tackling negative health outcomes. Applying the innovative participatory EBCD methodology will reveal key elements of transitional care for AYAs with common chronic conditions in the development of a person-centered transition program. Practice implications: Study findings will apply key elements of transitional care of AYAs with chronic conditions in the development of an adequate transition program. [ABSTRACT FROM AUTHOR]

Introduction: To guide good practices in patient and public involvement (PPI), several calls have been made to share detailed accounts of practical experiences. We describe our collaboration with young people with a chronic condition (YPCC) in the development, testing and implementation of the digital communication tool MyBoT (Map your Burden of Treatment). Methods: MyBoT was developed by a team of academic researchers, some of whom were practising care providers, YPCC and designers. In addition to the two co‐researchers in the research team, various groups of YPCC were involved in decision‐making through participation in a design session, workshops and a dialogue session. The Involvement Matrix was used to reflect on the PPI of all YPCC. Results: Initially, the two co‐researchers were involved in the roles of informer and co‐thinker, but their decision‐making power within the study increased over time. In the final stages of the study, the co‐researchers and researchers became partners. The other YPCC who participated in the different sessions and workshops were co‐thinkers in all stages of the study. Conclusion: The PPI of two YPCCs as co‐researchers within the research team ensured continuous involvement, whereas the PPI of various groups of YPCCs guaranteed a representative and inclusive approach. Researchers play an essential role in bringing all perspectives together, integrating them within the technical and financial constraints and ultimately building a tool that is tailored to its users' needs. Patient or Public Contribution: YPCC played a significant role in the present study. Two YPCC—who are also co‐authors of this paper—were involved in all stages of this project as members of the research team. In addition, various YPCCs were involved in the development, testing and implementation stage of MyBoT by organizing design sessions, workshops and a dialogue session. [ABSTRACT FROM AUTHOR]

Diagnosis of the gallbladder oedema is difficult during the clinical examination because the clinical signs are not specific for this disease. The causes of this pathology are multiple and can be divided into emergencies (such as anaphylactic shock, right-sided hearth failure, pericardial effusion) and chronic pathologies (such cholecystitis, pancreatitis or immune-mediated hemolytic anemia). Imagistics methods complete the information of the clinical exam and ultrasound is considered the golden standard for diagnosing this pathology. Normally, at the ultrasound exam, the gallbladder has a hyperechoic wall, with a diameter of 2-3 mm; while in case of gallbladder oedema, the wall is thick and has a triple stratification, with 2 hyperechoic rows, separated by a hypoechoic line. This pathognomonic description of the gallbladder oedema is also known as the 'Halo Sign' or 'Double Rim Effect'. Making a correct differential for the appearance of the sign is vital for the outcome of the case. The main focus is to exclude every emergency cause in order to start treating the chronic pathologies. This paper presents the pathologies leading to gallbladder oedema, met at the Radiology and Emergencies Departments from the Faculty of Veterinary Medicine Iasi during the period march 2020 - may 2022. The clinical case presented was diagnosed and treated at the Center of Endoscopy and Minimally Invasive Surgery Bucharest. [ABSTRACT FROM AUTHOR]

In seeking to explore the meaning of chronic and chronicity, the association with infertility is neither immediate nor evident. However, this paper explores this relationship by analyzing the idea of infertility in relation to chronicity. In the linkages that come forth the idea of chronic lifestyle emerging from certain ways of being and living, as well the imaginings associated with the chronic body become important nodes of exploring the relationship between infertility and chronicity. Most importantly, the role that time plays in marking the chronic state is seen to be especially potent in the practice of infertility treatment, and the narratives that emerge around its temporal inevitability. The rhetoric that marks the diagnosis and prescription of treatment is often based on the identification of the body as susceptible to reproductive decline and failure, due to the contingencies of modern living. This often translates into a more sustained involvement with ARTs, which may or may not fulfil the required desire for a child. In this paper I seek to analyse the ways in which practitioners of infertility medicine create an image of an affliction that borders on chronicity. In the process, I question the idea of both chronic diseases and chronicity by looking at how illness is imagined in narratives that IVF specialists create in public, and through the idea of a cure for infertility. By analysing data collected through ethnographic fieldwork, this paper aims to build on the idea of the chronic as inevitable within clinical discourse and practice. [ABSTRACT FROM AUTHOR]

Objective: To conduct a systematic review to establish what is known about the relationship between depression and self-evaluation in adolescents with a chronic illness. Methods: A systematic search was conducted using MEDLINE, EMBASE, PsycINFO, Web of Science, The Cochrane Library, and hand-searching. We sought to identify primary research that examined both the cross-sectional and longitudinal associations between depression and self-evaluation in adolescents with chronic illness. The search resulted in 8941 retrieved articles that were screened against an inclusion criteria. A total of 4 papers were included in the review. The MMAT used to assess study methodological quality. Results: A narrative synthesis was conducted, and a summary figure was included. These 4 studies included 236 adolescents aged 9–18 years with depression and either Type 1 Diabetes (T1D), chronic pain, headaches, or Inflammatory Bowel Disease (IBD). The limited existing evidence indicated that that depression was associated with negative self-evaluation in adolescents in some but not all chronic illnesses investigated to date. We also found some evidence that psychological intervention can help to improve self-evaluation, specifically in adolescents with T1D. Conclusions: More robust studies of the association between self-evaluation and depression in adolescents with a chronic illness is needed, with attention to the nuances of differences between chronic illnesses. The existing evidence indicates that there may be a stronger association in some chronic illnesses. Pilot data suggest that specific psychological therapies may improve self-evaluation, although much more extensive evaluation is needed. [ABSTRACT FROM AUTHOR]

Objectives: Subtle syndesmotic instability (SSI) is a difficult albeit important diagnosis to make, as undiagnosed instability frequently leads to posttraumatic ankle arthritis. Stressed conventional radiographs, ultrasonography, bilateral comparative conventional computed tomography (CT) and magnetic resonance imaging (MRI) serve as important diagnostic tools, however, the current diagnostic gold-standard is arthroscopic assessment, an invasive surgical method. The advent of weight-bearing computed tomography (WBCT) is considered to be an important additional diagnostic tool for improved non-invasive SSI diagnosis, particularly by utilizing distal tibiofibular syndesmotic (DTFS) area and volume measurements. However, to date, no studies have assessed WBCT diagnostic accuracy for chronic SSI. The purpose of this study was to prospectively evaluate the diagnostic accuracy of WBCT area and volumetric measurements in patients with suspected chronic SSI, when compared to the gold-standard arthroscopic assessment. Methods: In this IRB-approved prospective comparative study, 11 patients with suspected SSI were enrolled from July 2019 to December 2020. Patients were assessed preoperatively by bilateral standing WBCT. Raw 3D WBCT was automatically segmented by dedicated software. WBCT measurements included semi-automatic DTFS area (1cm proximally to tibial dome apex) and DTFS volumes (1, 3 and 5cm proximally to tibial dome apex). Threshold values for WBCT abnormality were defined based on currently available data (area>105mm2 and volumes>796mm3, >3062 mm3, and >6733 mm3 for 1, 3 and 5cm, respectively). Subjects underwent surgical treatment including DTFS instability arthroscopic assessment, defined as positive when a 3mm diameter sphere could enter the syndesmotic incisura. Confirmed unstable cases were treated with open reduction/internal fixation. WBCT measurements sensitivity, specificity, positive and negative predictive values (PPV/NPV) and accuracy were calculated using confirmed arthroscopic instability as diagnostic gold standard. Paired t-tests/Wilcoxon analysis was used to compare measurements. P-values<0.05 were considered significant. Results: When compared to non-injured sides, DTFS area and volumes were significantly higher in injured ankles at 1cm (667 vs 554mm3) and 3cm (2331 vs 2038mm3). Medial gutter volumes were also increased in injured sides (398 vs 370 mm3). DTFS volumes at 5cm and lateral gutter volumes were not different. Nine of eleven patients had confirmed arthroscopic DTFS instability. Considering WBCT area measurements, 4/11 patients were found to be positive (>105mm2), including 3 true positives (+WBCT/+Arthroscopy), 1 false positive (+WBCT/-Arthroscopy), 6 false negatives (-WBCT/+Arthroscopy), and 1 true negative (-WBCT/-Arthroscopy), leading to a 33.3% sensitivity, 50%, specificity, 75% PPV 75%, 14.3% NPV and 36% accuracy. When analysing WBCT DTFS volumes (1cm), 3/11 patients were found positive (>796mm3), depicting 3 true positives, 0 false positives, 2 true negatives and 6 false negatives, with resultant diagnostic accuracy of: 33.3% sensitivity, 100% specificity, 100% PPV, 25% NPV 25%, and 45% accuracy. Conclusions: This is the first study to prospectively assess the diagnostic accuracy of WBCT area and volume measurements in detecting chronic SSI and to compare it to the arthroscopic diagnostic gold standard. When compared to uninjured side, DTFS area and volumetric measurements were significantly increased in injured sides of patients with suspected SSI, including medial gutter volumes, consistent with associated deltoid ligament instability. However, interestingly, we observed a diagnostic accuracy for WBCT area and volumetric measurements to be lower than initially expected. Further incorporation of additional patients, as well as introduction of an external rotational stress can potentially optimize the WBCT diagnostic accuracy for chronic SSI. [ABSTRACT FROM AUTHOR]

The yips – a phenomenon whereby skilled practitioners suddenly and inexplicably struggle with their performance – has been observed in many sports. With no consensus as to the origins of the yips, it is, for many, a chronic condition bringing an end to careers and hobbies alike. This paper turns its attention to 'target panic', a sport‐specific instantiation of the yips found amongst archers. By bringing empirical encounters with target panic into conversation with geographical literature on skill, this paper seeks to invite reconsideration as to how and where the yips manifest. Rather than focusing on whether the yips is psychological or physical in origin, ecological approaches to skill allow for us to understand the yips as stemming from the disruption of the more‐than‐human communicative links on which skilled ecologies are founded. The concept of disruption is used to understand how this breakdown operates. Disruption is seen to be a boundary creating or boundary affirming process which impedes the ability for different actors to attune to one another. By re‐interpreting the yips as a result of disruption and locating it between actors, rather than within them, this paper contributes to ongoing discussions about what it means to be (de)skilled in a disrupted world and presents new possibilities for methods to prevent and treat the yips. The yips – a phenomenon characterised by sudden loss of skill – occurs in many sports, yet no concrete explanation for it has been established. This paper resists attempts to situate the yips in either mind or body to instead locate it as being distributed across a skilled ecology. In doing so, it draws on negative geographies literatures to argue that the yips are a disruptive phenomenon which impedes the more‐than‐human communication necessary for successful skilled performance. [ABSTRACT FROM AUTHOR]

This paper examines the affective inequalities underpinning the extensive responsibilities of care that are shouldered by chronically ill middle-aged British Pakistani women. In the context of ethnic health inequalities, chronic illness and premature ageing are ubiquitous. Further, mid-life generates gendered pinchpoints in the dynamics of care. The paper draws on extended conversations with women over seven/eight years and tracks their unsettled perspectives on sabar (patient endurance). Middle-aged women described how, over the long haul of living alongside chronic illness, they intuited that they must place some limits on caring for others, and that care required self-care - not in a biomedical sense, but in the sense of attention to their own bodily and relational needs. The paper extends anthropological critiques of Levinas's philosophy of infinite responsibilities to care, tracking how changes at several temporal scales - the life course, intergenerational re-negotiations - affect care. While social transformations of gender, and the proliferation of neoliberal discourses on self-care do affect the traction of normative notions of selfless care for others, the paper locates women's changing perspectives on sabar primarily in the provocations of everyday life. [ABSTRACT FROM AUTHOR]

This literature survey paper provides a comprehensive examination of recent advancements in asthma attack prediction, with a distinct focus on the combination of machine learning (ML) and mobile health technologies. Asthma, as a complex and variable condition, necessitates personalized approaches for effective management, and this survey explores the emerging landscape of predictive tools that leverage diverse data sources. The paper reviews studies that utilize various predictors, including symptoms, physiological measures, and environmental factors, to strengthen the accuracy of predicting asthma attacks. While considerable growth has been made, the survey also highlights existing challenges such as the requirement for external validation, data privacy concerns, and the significance of larger and more representative datasets. Furthermore, the paper discusses the potential implications of these predictive models in real-world clinical practice and the ongoing efforts required to seamlessly integrate the existing asthma management strategies. As the field continues to evolve, this literature survey focuses on providing a greater understanding of the present state, challenges, and future directions in the dynamic intersection of asthma management, ML, and mobile health technologies. [ABSTRACT FROM AUTHOR]

Our comment discusses our experience establishing a youth advisory group focused on chronic disease prevention research. The comment highlights three key learnings: the need for researchers to adapt their working style, the importance of redefining the power dynamics, and disrupting traditional research structures to align with co-researcher engagement models. Plain English Summary: In this comment, we share our insights from working with a youth advisory group in adolescent health research. Our comment supports our research paper on co-designing an online health study, "Health4Me." The youth advisors worked with us for a year, during which we also studied leadership and other outcomes. Adolescent health is gaining worldwide attention. Health researchers see the value of working with young people on issues that affect them. To address this need, we formed the Health Advisory Panel for Youth at the University of Sydney. We motivated young people through building new skills and leadership training, rather than only focusing on improved health outcomes or health knowledge. Here are our key lessons as researchers: Flexibility: We changed our approach to support online teamwork with young people, offered payment and worked around their schedules. Changing power dynamics: We empowered young people by engaging them in decisions and involved them in co-authoring papers and presentations. Challenging traditional structures: To support youth- as co-researchers, we used existing sources of funding and offered mentoring. In conclusion, we highlight practical ways of working with a youth advisory group in health research. Our teamwork led to a youth digital health program, published essays, and future research ideas. It is important for researchers to actively involve and support young people in shaping research that affects them. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To map out the primary research studies relating to how virtual reality (VR) has been used to distract children and young people with long‐term conditions from pain or pruritus. Background: Pharmacologic treatment of chronic pain and pruritus may have side effects; hence, non‐invasive non‐pharmacological treatments are being sought. Design: The scoping review followed the methodology recommended by the Joanna Briggs Institute, PAGER framework and PRISMA‐ScR checklist. The protocol was registered with the Open Science Registration on 14 February 2022 https//doi.org/10.17605/OSF.IO/K2R93. Methods: Five databases (Medline, CINAHL, PsycINFO, Web of Science and Scopus) were searched. Data were extracted from primary research studies published between 2000 and 2022 involving children and adolescent populations (<21 years) with a long‐term condition that had an element of enduring pruritus and/or pain. Results: Of 464 abstracts screened, 35 full‐text papers were assessed with 5 studies meeting the eligibility criteria. Three main themes emerged from the included studies: (1) Improvements in pain and daily functioning; (2) positive perceptions of VR and (3) accessibility and feasibility of VR. No papers were found on the effect of VR on alleviating pruritus. Conclusion: VR is feasible, acceptable, and safe for children and adolescents with chronic pain in a range of long‐term conditions and offers promise as an adjunctive treatment for improving chronic pain and quality of life. No studies were identified that targeted pruritis or measured pruritis outcomes; thus, the effects of VR for pruritis are unknown. There is a need for rigorously designed, randomised controlled trials to test the clinical and cost‐effectiveness of VR interventions for chronic pain and pruritis in children and adolescents. The use of the PAGER (Patterns, Advances, Gaps, Evidence for Practice and Research Recommendations) framework for scoping reviews helped to structure analysis and findings and identify research gaps. Relevance to Clinical Practice: VR interventions offer promise in improving chronic pain related to long‐term conditions. [ABSTRACT FROM AUTHOR]

Context: Burden of Treatment Theory (BOTT) provides a framework to illustrate and explain how interactions between patients, their healthcare systems and their support networks can affect and exacerbate patient ability to manage a chronic illness. Objective: To explore how BOTT has been applied in research and its contribution to the understanding of treatment burden and capacity issues for selfmanagement of chronic illness. Study design and Analysis: A qualitative systematic review of literature was carried out on five electronic databases for original research articles, protocols, or preprints published in the English language which cited the key paper presenting BOTT. Papers which used and engaged with BOTT, for example in their approach to data analysis, data collection, to aid in development of interventions, or to thematise or characterise data were included. DistillerSR software was used to carry out screening and data extraction processes, with 20% of papers double-coded. Quality appraisal was conducted using CASP checklists and the Mixed Methods Review checklist. Setting: Any. Population studied: Any. Results: 564 papers identified, after screening 26 papers met inclusion criteria. BOTT was applied across a range of different study types: 14 qualitative; 3 systematic reviews; 3 protocols; and 3 discussion papers.16 papers originated in UK, 3 from Australia, 2 from Norway and Argentina, and 1 each from the United States and Malawi. BOTT has been applied across a diverse range of settings and research types, with the most common use being to aid in data analysis or data collection for qualitative studies seeking to characterise treatment burden. Another common use was to aid intervention development in research focused on workload alleviation in a diverse range of settings. The constructs of BOTT appear to be stable across different settings, and researcher commentary on theory utility was generally positive. Two papers adapted and extended BOTT to further suit the context of their research focus. Discussion of BOTT constructs revealed appropriate understanding and a high level of critical engagement. Conclusions: BOTT provides a useful conceptual, analytical and sensitising lens in studies focusing on the characterisation and alleviation of treatment burden through healthcare interventions. The constructs are stable and applicable to a wide range of healthcare settings. Future research could examine BoTT utility in different cultural settings. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine which method to triage intensive care patients using chronic comorbidity in a pandemic was perceived to be the fairest by the general public. Secondary objectives were to determine whether the public perceived it fair to provide preferential intensive care triage to vulnerable or disadvantaged people, and frontline healthcare workers. Methods: A postal survey of 2000 registered voters randomly selected from the Australian Electoral Commission electoral roll was performed. The main outcome measures were respondents' fairness rating of four hypothetical intensive care triage methods that assess comorbidity (chronic medical conditions, long-term survival, function and frailty); and respondents' fairness rating of providing preferential triage to vulnerable or disadvantaged people, and frontline healthcare workers. Results: The proportion of respondents who considered it fair to triage based on chronic medical conditions, long-term survival, function and frailty, was 52.1, 56.1, 65.0 and 62.4%, respectively. The proportion of respondents who considered it unfair to triage based on these four comorbidities was 31.9, 30.9, 23.8 and 23.2%, respectively. More respondents considered it unfair to preferentially triage vulnerable or disadvantaged people, than fair (41.8% versus 21.2%). More respondents considered it fair to preferentially triage frontline healthcare workers, than unfair (44.2% versus 30.0%). Conclusion: Respondents in this survey perceived all four hypothetical methods to triage intensive care patients based on comorbidity in a pandemic disaster to be fair. However, the sizable minority who consider this to be unfair indicates that these triage methods could encounter significant opposition if they were to be enacted in health policy. What is known about the topic? Triage systems can be used to prioritise the order in which patients are treated in a pandemic, but the views of the general public on using chronic comorbidity as intensive care unit (ICU) triage criteria are unknown. What does this paper add? This Australian survey, conducted during the coronavirus disease 2019 pandemic, demonstrated that the majority of respondents perceived ICU triage methods based on comorbidity to be fair, but significant ethical issues exist. What are the implications for practitioners? It may be possible to develop an ICU triage protocol for future pandemics in Australia, but further research is required. [ABSTRACT FROM AUTHOR]

Background: Continuing care is needed for the growing number of chronically ill patients who struggle with health problems after discharge. This study aims to elucidate the development process, functionalities, service protocols, and utilization of an Internet Plus Care (IPC) platform devised by our hospital to offer healthcare services to discharged patients. Methods: This was a mixed study. After describing the development process, function and usage of IPC platform, we retrospectively collect data such as the general information of service recipients and service providers, service items, and service prices through the IPC platform from January 2021 to September 2023 to characterize these services. Results: 69 nurses delivered a total of 788 services to 211 patients through the IPC platform. The majority of services (N = 652, 82.7%) were delivered offline, with almost half of the recipients (N = 384, 48.7%) being elderly individuals. 46.4% of nurses provided services ≥ 3 times. Furthermore, 26.5% of patients received services three or more times. Notably, patients' care requirements exhibited variations across age groups, with wound care (n = 243, 63.3%), pressure injuries care (n = 50, 13.0%), and replacement of indwelling nasogastric tubes (n = 20, 5.2%) emerging as the top three services favored by the elderly. Conclusions: The IPC platform demonstrates potential in delivering diverse health services to patients; however, the involvement of nurses and patients needs to be enhanced. It is necessary to implement relevant safeguard policies to promote the effective use of IPC platform for health management of discharged patients in the future. What does this paper contribute to the wider global clinical community?: The prevalence of chronic diseases is on the rise, and patients with chronic diseases continue to struggle with health problems after discharge and require extended treatment and rehabilitation. Our study proves that IPC platform presents a promising avenue for addressing these challenges. It is anticipated that governmental authorities will undertake comprehensive policy, legislative, and medical insurance reforms to facilitate the extensive adoption of IPC platform-based services. [ABSTRACT FROM AUTHOR]

Nutritional therapy, for example through beer, is the best solution to human chronic diseases. In this article, we demonstrate the physiological mechanisms of the functional ingredients in beer with health-promoting effects, based on the PubMed, Google, CNKI, and ISI Web of Science databases, published from 1997 to 2024. Beer, a complex of barley malt and hops, is rich in functional ingredients. The health effects of beer against 26 chronic diseases are highly similar to those of barley due to the physiological mechanisms of polyphenols (phenolic acids, flavonoids), melatonin, minerals, bitter acids, vitamins, and peptides. Functional beer with low purine and high active ingredients made from pure barley malt, as well as an additional functional food, represents an important development direction, specifically, ginger beer, ginseng beer, and coix-lily beer, as consumed by our ancestors ca. 9000 years ago. Low-purine beer can be produced via enzymatic and biological degradation and adsorption of purines, as well as dandelion addition. Therefore, this review paper not only reveals the physiological mechanisms of beer in overcoming chronic human diseases, but also provides a scientific basis for the development of functional beer with health-promoting effects. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is one of the most prevalent chronic diseases in the world and the incidence of diabetes has increased dramatically in developing countries such as India. Health-related quality of life (HRQOL) is an important factor for self-management behaviours of diabetic patients. These behaviours have special importance in preventing complications of diabetes. Health-related quality of life (HRQOL) has become an important measure for evaluating patient treatment with noncurable chronic disease. In the present paper demographic profile of 200 men and women in which 118 were suffering from diabetes in which 68 were men 50 were women from two districts of Uttar Pradesh. The demographic profile of respondents depicted age, gender, religion, educational status, marital status, occupation of respondents. These are the important contributing factors to access the quality of life of diabetic subjects. [ABSTRACT FROM AUTHOR]

Worldwide, the prevalence of chronic (or long-term) conditions in children and young people from birth to 18 years (children) is increasing. Promoting competent and effective self-management skills early in the trajectory is important to improve adherence to treatment and optimise quality of life. Successful self-management, therefore, requires parents and children who are developmentally able to develop a range of complex skills, including the use of digital technologies. This scoping review aimed to identify primary research investigating digital technologies for children and parents sharing self-management in childhood chronic illnesses. A comprehensive search of electronic databases was conducted. Nineteen papers were included, assessed for quality and methodological rigour using the Hawker tool and thematically analysed. Three themes were identified: (i) the feasibility and acceptability of using technology, (ii) the usability of technologies and (iii) the effect of technologies on adherence and self-management skills. The results indicate that technologies such as mobile apps and websites can assist the management of long-term conditions, are an acceptable method of delivering information and can promote the development of effective self-management skills by parents and children. However, future technology design must include children and parents in all stages of development. [ABSTRACT FROM AUTHOR]

Background: The Scottish Government set out its 5-year vision to improve palliative care in its Strategic Framework for Action 2016-2021. This includes a commitment to strengthening research and evidence based knowledge exchange across Scotland. A comprehensive scoping review of Scottish palliative care research was considered an important first step. The aim of the review was to quantify and map palliative care research in Scotland over the ten-year period preceding the new strategy (2006-15). Methods: A systematic scoping review was undertaken. Palliative care research involving at least one co-author from a Scottish institution was eligible for inclusion. Five databases were searched with relevant MeSH terms and keywords; additional papers authored by members of the Scottish Palliative and End of Life Care Research Forum were added. Results: In total, 1919 papers were screened, 496 underwent full text review and 308 were retained in the final set. 73% were descriptive studies and 10% were interventions or feasibility studies. The top three areas of research focus were services and settings; experiences and/or needs; and physical symptoms. 58 papers were concerned with palliative care for people with conditions other than cancer -- nearly one fifth of all papers published. Few studies focused on ehealth, health economics, out-of-hours and public health. Nearly half of all papers described unfunded research or did not acknowledge a funder (46%). Conclusions: There was a steady increase in Scottish palliative care research during the decade under review. Research output was strong compared with that reported in an earlier Scottish review (1990--2005) and a similar review of Irish palliative care research (2002-2012). A large amount of descriptive evidence exists on living and dying with chronic progressive illness in Scotland; intervention studies now need to be prioritised. Areas highlighted for future research include palliative interventions for people with non-malignant illness and multi-morbidity; physical and psychological symptom assessment and management; interventions to support carers; and bereavement support. Knowledge exchange activities are required to disseminate research findings to research users and a follow-up review to examine future research progress is recommended. [ABSTRACT FROM AUTHOR]

Background: Recent years have seen an exponential increase in people with long-term conditions using the Internet for information and support. Prior research has examined support for long-term condition self-management through the provision of illness, everyday, and emotional work in the context of traditional offline communities. However, less is known about how communities hosted in digital spaces contribute through the creation of social ties and the mobilization of an online illness "workforce."Objective: The aim was to understand the negotiation of long-term condition illness work in patient online communities and how such work may assist the self-management of long-term conditions in daily life.Methods: A systematic search of qualitative papers was undertaken using various online databases for articles published since 2004. A total of 21 papers met the inclusion criteria of using qualitative methods and examined the use of peer-led online communities for those with a long-term condition. A qualitative meta-synthesis was undertaken and the review followed a line of argument synthesis.Results: The main themes identified in relation to the negotiation of self-management support were (1) redressing offline experiential information and knowledge deficits, (2) the influence of modeling and learning behaviors from others on self-management, (3) engagement that validates illness and negates offline frustrations, (4) tie formation and community building, (5) narrative expression and cathartic release, and (6) dissociative anonymity and invisibility. These translated into a line of argument synthesis in which four network mechanisms for self-management support in patient online communities were identified. These were (1) collective knowledge and identification through lived experience; (2) support, information, and engagement through readily accessible gifting relationships; (3) sociability that extends beyond illness; and (4) online disinhibition as a facilitator in the negotiation of self-management support.Conclusions: Social ties forged in online spaces provide the basis for performing relevant self-management work that can improve an individual's illness experience, tackling aspects of self-management that are particularly difficult to meet offline. Membership in online groups can provide those living with a long-term condition with ready access to a self-management support illness workforce and illness and emotional support. The substitutability of offline illness work may be particularly important to those whose access to support offline is either limited or absent. Furthermore, such resources require little negotiation online because information and support is seemingly gifted to the community by its members. [ABSTRACT FROM AUTHOR]

Background: Non-communicable diseases (NCDs) are the leading cause of death globally. Eighty-two percent of premature NCD deaths occur within low- and lower middle-income countries (LLMICs). Research to date, largely drawn from high-income countries, suggests that disadvantaged and marginalized groups have a higher NCD burden, but there has been a dearth of research studying this relationship within LLMICs. The purpose of this systematic review is to map the literature on evidence from LLMICs on the socio-economic status (SES) gradient of four particular NCDs: cardiovascular disease, cancer, diabetes, and chronic respiratory diseases.Methods: We conducted a comprehensive literature search for primary research published between 1 January 1990 and 27 April 2015 using six bibliographic databases and web resources. We included studies that reported SES and morbidity or mortality from cardiovascular disease, cancer, diabetes and chronic respiratory diseases within LLMICs.Results: Fifty-seven studies from 17 LLMICs met our inclusion criteria. Fourteen of the 18 papers that reported significant associations between cancer and SES suggested that low SES groups had the highest cancer risk. Eleven of 15 papers reporting significant relationships between CVD and SES suggested that low SES groups have higher risk. In contrast, seven of 12 papers reporting significant findings related to diabetes found that higher SES groups had higher diabetes risk. We identified just three studies on the relationship between chronic respiratory diseases and SES; none of them reported significant findings.Conclusions: Only 17 of the 84 LLMICs were represented, highlighting the need for more research on NCDs within these countries. The majority of studies were medium to high quality cross-sectional studies. When we restricted our analyses to high quality studies only, for both cancer and cardiovascular disease more than half of studies found a significantly higher risk for those of lower SES. The opposite was true for diabetes, whilst there was a paucity of high quality research on chronic respiratory disease. Development programmes must consider health alongside other aims and NCD prevention interventions must target all members of the population.Systematic Review Registration Number: Prospero: CRD42015020169. [ABSTRACT FROM AUTHOR]

In response to the global call to upscale mental health services in low--income countries, mental health non-governmental organisations (MHNGOs) have sprung up in Kerala to address mental health needs by partnering with pre-existing locally grown, bottom-up, community-led pain and palliative clinics (PPCs) to increase access to mental health care through task-shifting. The MHNGOs mandate filtering only patients with 'severe mental disorders' from low socioeconomic backgrounds for their free services. This eligibility criterion mandated by the MHNGO is ruffling feathers within the palliative clinics that oppose such -classifications. They believe that suffering cuts across all divisions and should not be discriminated against based on economic background and severity of illnesses. When chronicity and suffering are held universal by the MHNGO and palliative care, respectively, it brings to the fore the enactment of two perspectives of care. Drawing on observations of clinical interactions between patients, MHNGO staff and mental health professionals and interviews with community volunteers of palliative care clinics in Kerala, this paper demonstrates how chronicity narrative promoted by MHNGOs based on biopsychiatric model gains hegemony, whereas the community care model loses traction progressively. The state, caught between these two narratives, frontstages development by submitting its health machinery to the MHNGOs flouting basic medical safety laws in its services to marginalised people like the tribal population. This paper argues that the rising dominance of chronicity narrative in community mental health clinics as well as in popular media discourses evolves out of power relations between the MHNGOs and the palliative clinics. [ABSTRACT FROM AUTHOR]