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Siblings of children with chronic disorders are at a heightened risk for internalizing and externalizing problems. Studies on sibling mental health typically use parent report, and sometimes sibling self-report, but do not include the perspectives of teachers. We investigated how teachers and parents in Norway rated sibling mental health to gain a more coherent picture of siblings' well-being and functioning across the home and school contexts. We compared how siblings aged 8–16 years (45% boys, 54% girls) were scored on the strengths and difficulties questionnaire by teachers (n = 125), mothers (n = 115), and fathers (n = 81) with population norms and clinical cutoffs. For boys, the mean teacher scores did not indicate problems for total difficulties or any subscale except hyperactivity–inattention, but mean parent scores were higher for total difficulties and most subscales (d =.44 to.96). For girls, teachers indicated higher than norm scores for total difficulties, emotional problems, hyperactivity–inattention and peer problems (d =.26 to.46), while parents indicated higher total difficulties and problems across most subscales (d =.31 to.54). Prosocial behavior was as a relative strength of siblings across all raters. Siblings may not display the same level of mental health problems in school as at home, and teachers can offer an important perspective on siblings' mental health and functioning. [ABSTRACT FROM AUTHOR]

The SIBS intervention aims to prevent mental health problems for siblings of children with chronic disorders and has shown promising results. The mechanisms behind these changes have not been examined. Parent-child relationship quality is a predictor of mental health in siblings. Our first objective was to investigate whether sibling-perceived relationship quality between siblings and parents changes over time after participating in SIBS. Second, as the intervention requires participation of only one parent, we examined with a dual scale (anxiety and avoidance attachment style) whether relationship quality was associated with which parent participated. Third, as SIBS aims to promote parents' communication skills, we examined whether sibling-perceived communication quality with parents predicted relationship quality over time. The sample comprised 99 siblings (M = 11.5 years, SD = 2.0; range 8–16; 54% girls, 46% boys) of children with chronic disorders and one parent per sibling (63% mothers). We administered the questionnaires at pre-intervention, at three- and 6-months post-intervention. We applied growth curve models for relationship quality over time with communication quality as a predictor, controlling for parent gender. We found significant improvement in sibling-perceived relationship quality with the participating and the non-participating parent on the relationship anxiety scale over time, with small to medium effect sizes. Higher communication quality significantly predicted improvement of relationship quality in all four relationship outcomes. We conclude that change in relationship quality may be part of the positive outcomes of the SIBS intervention and is mainly explained by communication enhancement. Controlled trials of the SIBS intervention are indicated. Highlights: We investigated change in sibling perceived relationship quality between siblings and parents after participation in the SIBS intervention. The anxiety dimension of the sibling perceived relationship quality between siblings and both parents improved over time after the intervention. Communication improvement was a significant predictor of relationship quality over time. The SIBS intervention may enhance communication and relationship quality between siblings and their parents. [ABSTRACT FROM AUTHOR]

Introduction: Dioxins represent a category of enduring environmental contaminants that possess the capability to elicit endocrine disruptions and a spectrum of ailments, most notably encompassing malignancies, immunological impairments, and nervous system impairments. These chemical compounds incite the generation of Reactive Oxygen Species (ROS), consequently instigating cellular toxicity through the activation of the Aryl Hydrocarbon Receptor (AHR). Given the significant noxiousness associated with dioxins, it is imperative to implement decisive actions aimed at mitigating ongoing ambient exposure. In spite of advancements in comprehending the origin and fundamental mechanisms of persistent environmental pollutants, the development of efficacious interventions has remained an elusive endeavor. Objectives: This investigation focuses on the distinct pharmacological mechanisms inherent in polyphenolic constituents that have been hitherto explored in relation to various dioxin-induced toxicities, both in in vivo and in vitro models. Materials and Methods: Preclinical studies were identified through systematic searches of PubMed, Embase, and the Cochrane Library, while clinical trials were retrieved from ClinicalTrials.gov and PubMed databases. Results: Preclinical research unveils the significant efficacy of phytochemicals in mitigating dioxin toxicity. Conversely, clinical findings exhibit a mixed spectrum of outcomes, but hold promise for the use of phytochemicals as adjuncts to conventional therapies for diverse dioxin-induced toxicities. These outcomes suggest that polyphenols may exert substantial influence on disease-related mechanisms such as oxidative stress, inflammation, apoptosis, and gene regulation. Conclusion: In our assessment, this represents the inaugural comprehensive review encompassing in vitro and in vivo investigations concerning the molecular-level interactions between various environmental contaminants and polyphenols. Furthermore, additional clinical investigations are warranted, with a focus on the appropriate patient populations, identification of relevant toxicity biomarkers, and elucidation of the impact of phytochemicals on these parameters. [ABSTRACT FROM AUTHOR]

The study explored challenges experienced by siblings of children with chronic disorders, as expressed by siblings in parent-child dialogues. Seventy-three parent-child dialogues (M duration = 28.6 min) were analyzed using qualitative thematic analysis. The dialogues took place within the SIBS group intervention for siblings and parents of children with chronic disorders. The siblings (aged 8 to 14 years) had brothers and sisters with autism spectrum disorders, ADHD, rare disorders, cerebral palsy, or severe mental health disorders. The data are from session 5 in the SIBS intervention, in which the siblings are to express their wishes about family-related challenges (e.g., desired changes) to their parents. The parents are encouraged to listen, explore, and validate the child's perspective before discussing solutions. Most of the family-oriented challenges the siblings expressed were related to the diagnosis of the brother or sister with a disorder. Four main themes were identified: (1) Family life (e.g., limitations in family activities); (2) The diagnosis (e.g., concerns about the future); (3) Violence; and (4) Important relationships. The siblings experienced challenges and difficult emotions in interactional processes in which the diagnosis affected family life and relationships. The study adds a new dimension to the field by identifying siblings' expressed challenges based on parent-child dialogues. Identified themes can guide how parents should meet and address siblings' needs, how health care providers inform and support parents in doing so, and emphasize the relevance of interventions targeting family-level risk and resilience factors. [ABSTRACT FROM AUTHOR]

Our objective was to examine the factor structure of the Experiences in Close Relationships-Relationships Structures (ECR-RS), an attachment-theory based relationship measure, in at-risk sample comprising siblings of children with chronic disorders. Psychometric studies with general populations have demonstrated that the ECR-RS comprises two factors, representing anxiety and avoidance in close relationships. The sample comprised 103 siblings (M age = 11.5 years, SD = 2.2, range 8 to 16 years) of children with chronic disorders and their parents. The siblings completed a 9-item version of the Experiences in Close Relationships-Relationships Structures (ECR-RS) about their relations with mothers and fathers that was analyzed with confirmatory factor analysis. We examined construct validity using correlations between sibling social functioning, measured with the Strengths and Difficulties Questionnaire, and parent mental health, measured with the Hopkins Symptom Checklist-90-Revised. The ECR-RS comprised two factors, anxiety and avoidance, in line with previous studies. Both factors demonstrated significant overlap with sibling social functioning, but not with parental mental health. We conclude that the ECR-RS comprises two factors, anxiety and avoidance, that are related to siblings' social functioning. The ECR-RS can be used as a psychometrically sound measure of relationship anxiety and avoidance in families of children with chronic disorders. [ABSTRACT FROM AUTHOR]

Abstract Background A population-based follow-up study assessing the risk of developing hypertension and diabetes associated with alcohol use disorder (AUD) is crucial. We investigated this relationship by using insurance claims data from Taiwan. Methods From the claims data, an AUD cohort (N = 60,590) diagnosed between 2000 and 2006 and a non-AUD comparison cohort (N = 60,590) without the diagnosis of hypertension or diabetes at baseline were established and matched by propensity scores estimated by baseline demographic status and the Charlson comorbidity index (CCI). We assessed the incidence rates of hypertension and/or diabetes at the end of 2016 and used Cox’s method to estimate the related hazard ratios (HRs) and 95% confidence intervals (CIs). Results Relative to the comparison cohort, the AUD cohort had an approximately 1.70-fold higher incidence of hypertension (35.1 vs. 20.7 per 1,000 person-years), with an adjusted HR (aHR) of 1.72 (95% CI: 1.68–1.76), 2.16-fold higher incidence of diabetes (20.2 vs. 9.36 per 1,000 person-years), with an aHR of 2.18 (95% CI: 2.11–2.24), and 1.91-fold higher incidence of both diabetes and hypertension (10.3 vs. 5.38 per 1,000 person-years) with an aHR of 2.02 (95% CI: 1.94–2.10). The incidence rates of all outcomes were greater in men than in women, whereas the HRs were greater for AUD in women than for AUD in men relative to the respective comparison patients. The risk increased further for subjects with CCI ≥ 1, which was higher in the AUD cohort. Conclusions The increased risk of developing diabetes and hypertension in patients with AUD, especially the differences noted according to gender, indicates that clinicians should address potential comorbidities in these patients.

Therapeutic innovation is expected to change if not disrupt present care models for several chronic diseases in the coming years, as suggested by recent clinical trials. New drugs that anticipate and possibly delay the full expression of a disease will likely face some common challenges, such as the need of designing and implementing large scale interventions; the necessary engagement of multiple specialties for both diagnosis and treatment; the shift from specialist to non-specialist interventions and secondary prevention. Building on the case of HCV and other innovation in hepatology, we discuss common challenges caused by disruptive change that other chronic conditions faced in the past. The recent history of hepatology shows interesting examples of disruptive innovations that completely reverted traditional treatment approaches. As we learned from the slow early diffusion of antiviral drugs, without a clear information and a prompt design of the appropriate delivery modalities, the effectiveness of new treatments is undermined and care risk to be postponed for long time. This implies the definition of (i) new service models diversified by care phases and patients' target; (ii) horizontal integration: to go beyond the professional boundaries to build solid alliances; (iii) vertical integration between primary and secondary care. [ABSTRACT FROM AUTHOR]

Depressive symptoms are common in South African primary care patients with chronic medical conditions, but are usually unrecognised and untreated. This study evaluated an integrated, task-sharing collaborative approach to management of depression comorbid with chronic diseases in primary health care (PHC) patients in a real-world setting. Existing HIV clinic counsellors provided a manualised depression counselling intervention with stepped-up referral pathways to PHC doctors for initiation of anti-depressant medication and/ or referral to specialist mental health services. Using a comparative group cohort design, adult PHC patients in 10 PHC facilities were screened with the Patient Health Questionnaire-9 with those scoring above the validated cut-off enrolled. PHC nurses independently assessed, diagnosed and referred patients. Referral for treatment was independently associated with substantial improvements in depression symptoms three months later. The study confirms the viability of task-shared stepped-up collaborative care for depression treatment using co-located counselling in underserved real-world PHC settings. [ABSTRACT FROM AUTHOR]

To identify profiles of aging by combining psychological distress, cognition and functional disability, and their associated factors. Data were drawn from the Étude sur la Santé des Aînés-Services study and included 1585 older adults. Sociodemographic, psychosocial, lifestyle and health factors were informed from structured interviews. Group-based multi-trajectory modeling and multinomial logistic regression were used to identify aging profiles and correlates. Sampling weights were applied to account for the sampling plan. The weighted sample size was 1591. Three trajectories were identified: a favorable (79.0%), intermediate (14.5%), and severe scenario (6.5%). Factors associated with the severe scenario were older age, male gender, lower education, the presence of anxiety disorders, low physical activity, and smoking. Membership in the intermediate scenario was associated with daily hassles, physical disorders, anxiety and depression, antidepressant/psychotherapy use, low physical activity, and no alcohol use. High social support was protective against less favorable profiles. Symptoms of anxiety and depression and high burden of physical disorders were associated with less favorable trajectories. Modifiable lifestyle factors have a significant effect on healthy aging. Assessment and management of anxio-depressive symptoms are important in older adults. Clinical interventions including access to psychotherapy and promotion of healthier lifestyles should be considered. [ABSTRACT FROM AUTHOR]

Our objective was to examine the factor structure of the Experiences in Close Relationships-Relationships Structures (ECR-RS), an attachment-theory based relationship measure, in at-risk sample comprising siblings of children with chronic disorders. Psychometric studies with general populations have demonstrated that the ECR-RS comprises two factors, representing anxiety and avoidance in close relationships. The sample comprised 103 siblings (M age = 11.5 years, SD = 2.2, range 8 to 16 years) of children with chronic disorders and their parents. The siblings completed a 9-item version of the Experiences in Close Relationships-Relationships Structures (ECR-RS) about their relations with mothers and fathers that was analyzed with confirmatory factor analysis. We examined construct validity using correlations between sibling social functioning, measured with the Strengths and Difficulties Questionnaire, and parent mental health, measured with the Hopkins Symptom Checklist-90-Revised. The ECR-RS comprised two factors, anxiety and avoidance, in line with previous studies. Both factors demonstrated significant overlap with sibling social functioning, but not with parental mental health. We conclude that the ECR-RS comprises two factors, anxiety and avoidance, that are related to siblings’ social functioning. The ECR-RS can be used as a psychometrically sound measure of relationship anxiety and avoidance in families of children with chronic disorders.

MXenes are recently advanced two-dimensional layered nanomaterials that have various characteristic properties for developing electrochemical sensors for bioanalytical applications, such as hydrophilicity, good biocompatibility, electrical conductivity, heightened ion transportation, and ease of functionalization. MXenes are revealed to be having applications in various other fields including energy storage, and catalysis. The combination of a layered structure, biocompatibility, and high surface functionalities makes MXene a highly versatile material for electrochemical sensing applications. The effect of various synthesis and functionalization strategies on tuning the properties of MXenes toward improving sensing abilities has been comprehensively discussed. This review article also discusses the relevance of early diagnosis of various biomarkers of chronic diseases via MXene modified electrochemical sensor for gaining a better understanding of their early diagnosis, disease progression, and risk assessment. Modification with MXenes improves the electrocatalytic functionality of the electrodes thereby improving their applicability in health and biomedical fields. [ABSTRACT FROM AUTHOR]

There is an acute issue of patients recovering with chronic disorders in medicine of critical conditions — they are a vegetative and minimally consciousness state. Such states develop in patients after coma and are characterized by the presence of wakefulness with complete or almost complete absence of signs of purposeful behavior. Capturing small reflexes and body signs allows observing changes in the physiological state of the patient, the effectiveness of the treatment course and requires a continuous process, which is not always possible considering to the high workload of medical staff. In this regard, visual display and data transmission systems for patients are more efficient. The display device should be safe, mobile and not restrict the patient’s movement, should not have a negative impact on the patient. The display method should be intuitively understandable and clear for prompt decision-making. The main parts of the visual system are sensors of physiological signs on the patient’s body, a control module, a visual display object, and a data transmission module. RGB Arlight 5060 LED strips with pixel addressing on a textile substrate are used as display elements. The object of the visual display consists of three layers: a duvet cover on the underside, a wool blanket, a cotton backing with LED strips. The paper presents an assessment of the heating of the proposed visual display system for patients with chronic disorders and a comparison of the results with the maximum permissible heating of human skin. The heating estimation was performed by COMSOL Multiphysics cross-platform finite element analysis, solver, and multiphysics simulation. The simulation results are compared with an experimental study using a contact temperature meter Centre 304 and an infrared camera Optris PI 640i. The security of the system has been confirmed. Scenarios for the indicators to reduce the thermal impact are proposed. The proposed visual display system may be relevant when monitoring the physiological state of patients in Intensive Care Units. The implementation of the system will help to see changes in the physiological state and increase the chances of getting out of a chronic condition in the future.

BackgroundChronic disorders are highly prevalent and are a major contributor to death and disability worldwide. Evidence has shown that therapeutic patient education (TPE) interventions are effective in improving a range of biomedical and psychological outcomes for a variety of chronic disorders. This has been demonstrated in scores of randomized controlled and evidence-synthesis studies. However, no quantitative evidence has been published so far on the content and effective teaching strategies in TPE programs. The present systematic review and meta-analysis aim to bridge this gap by answering the who, what, and how of TPE programs.MethodsUsing a pretested search strategy, we searched the Web of Science, MEDLINE, CINAHL, PsycINFO, and the COCHRANE databases, from inception to August 2019. The search strategy was based on four comprehensive search concepts (patient education, chronic diseases, study design, and outcomes). After a careful screening for eligible studies, two reviewers extracted qualitative and quantitative data from the randomized controlled trials on the TPE interventions. We also developed a taxonomy of curriculum skills and intervention delivery techniques to aid the extraction of data in these domains.ResultsWe found that these interventions were effective in improving biological outcomes (SMD = 0.48; 95% CI: 0.38–0.57), adherence to the treatment regimen (SMD = 0.73; 95% CI: 0.46–1.002), knowledge (SMD = 1.22; 95% CI: 0.79–1.65), self-efficacy (SMD = 0.43; 95% CI: 0.30–0.56), and psychological health (SMD = −0.41; 95% CI: −0.53 to −0.29). This effectiveness was consistent across different delivery formats (individual, group, and electronic) and delivery agents (non-specialists vs. specialists).ConclusionThe flexibility in the choice of mode of delivery and curriculum development gives stakeholders an opportunity to scale up TPE interventions in healthcare settings.Systematic review registrationIdentifier: CRD42019141294.

Background: During the COVID-19 pandemic telemedicine became essential in maintaining diagnostic procedures and treatment in psychiatry. However, it is still an open question if telemedicine is a feasible treatment option for all groups of psychiatric patients alike. This prospective monocentric observational trial was conducted to assess the general applicability of telemedical treatment in a naturalistic psychiatric outpatient cohort and to identify groups of disorders and clusters of psychopathology that respond particularly well to telemedical treatment considering sociodemographic characteristics and patients' perspectives. Methods: Patients were recruited April 2020-April 2021 and asked to fill out the WHO-5 and the SCL-90R at baseline, after 4-6 and 8-12 weeks and a feedback-survey. Additionally, medical records, psychopathology, psychosocial functioning, and socio-demographic data were analyzed. Primary outcomes were well-being, psychopathology and functioning during treatment. Secondly, diagnostic groups and psychopathology linked to a superior treatment-response were determined with respect to patients' subjective experiences. Results: Out of 1.385 patients, 254--mostly with hyperkinetic (35.3%) and depressive disorders (24.6%)--took part. Well-being and SCL-90R total scores improved substantially (both p < 0.001). CGI and GAF scores were worse in depressed subjects (both p < 0.05). Improvement was mainly seen in depressed patients; chronic disorders experienced a decline in well-being. Sociodemographic characteristics could not explain this difference. Particularly female (r = 0.413) patients found telepsychiatry equivalent to conventional treatment. The more virtual sessions participants attended themore likely they were to find telepsychiatry equal to conventional treatment (r = 0.231) Conclusion: Telemedicine is an effective treatment for patients with depression under naturalistic conditions. Telemedical consultations are a simple and reliable way of monitoring symptom severity and directing treatment choices during the treatment of depressive disorders. Patients with depression benefited more from telemedical treatment compared to participants with chronic non-episodic psychiatric disorders. Future research needs to concentrate on improving telemedical treatment options suited for the latter conditions. Psychiatric telemedicine yielded overall high degrees of satisfaction among users. [ABSTRACT FROM AUTHOR]

Background: Obesity is currently one of the most prevalent health issues, with nearly 30% of the global population being obese or overweight. Obesity is also a leading cause of many noncommunicable diseases (NCDs), which account for 60-70% of all deaths worldwide. Pakistan, ninth most obese country in the globe, is currently experiencing from an obesity epidemic that affects all age groups, particularly females as compared to men, and the ratio will be doubled in the coming years (2050) due to high carbohydrate intake, physical inactivity, and other environmental factors. Aside from exercise and physical activity, a fiber-rich diet may be the most effective way to overcome obesity. Material and methods: A cross-sectional study was conducted in three medical colleges of Pakistan from March 2021-March 2022. Total 600 medical students (300 males and 300 females) of 1st to 4th year level students were participants in this study. Data were collected by distributing a questionnaire containing few questions related to informations about obesity and dietary habits. Results: The students belonged to 1st year 143 (18.33%), 2nd year 153 (23.88%), 3rd year 156 (26.00%) and 4th year 191 (31.88%). The majority of these students 218 (36.33%), had an obese body mass index (BMI) while 118 (19.66%) and 79 (13.16%), had an overweight and underweight body mass index, respectively. 50.46%, 49.49%, and 50.27%, low, moderate and high levels of physical activity, respectively, were recorded in males, while 49.53%, 50.01%, and 49.72%, respectively recorded in females. Prevalence of obesity in males and females was found 33.66 and 39.00%, respectively. In comparison to the level of physical activity, batches (first, second, third, and fourth years) and gender (males, females) were signiicant at p<0.05, but body mass index was not.Conclusion: It is concluded that the level of physical activity is not highly linked with body mass index. [ABSTRACT FROM AUTHOR]

The therapeutic benefit of antagonists at the strychnine-insensitive glycineB site is under investigation for acute and chronic disorders of the CNS, e.g., stroke, trauma, epilepsy, Alzheimer's disease, ALS, Parkinson's disease, Huntington's chorea, anxiety disorders, depressions, chronic pain. This great interest is underlined by the better therapeutic index, e.g., lack of vacuolization, learning impairment or psychotomimetic effects. As mentioned earlier Glycine is a major neurochemical component in seizure inhibition and 1PB7 (strychnine-in-sensitive glycine site), an important target site for the development of anticonvulsants. In fact, about one quarter of epileptic patients worldwide (about 12 million people) do not respond to any marketed anticonvulsant drugs. Therefore, the need for new anticonvulsant is great. The present study contributed molecular insight in to the binding process, which is of great pivotal importance for designing new ligands interfering with NMDA and showed that new wave of flexible ligand docking program like Auto-Dock can produce unbiased docking. There is still significant room for improvement especially for the empirical binding free energy force field and inhibition constant prediction. Designing and synthesis followed by anticonvulsant screening provided us a few novel Glycine analogues. Acid hydrazones analogs were found more potent anticonvulsants as compared to Imines. Introduction of halogen atoms (electron withdrawing groups) especially bromo and chloro significantly improved the activity. [ABSTRACT FROM AUTHOR]

BackgroundDuring the COVID-19 pandemic telemedicine became essential in maintaining diagnostic procedures and treatment in psychiatry. However, it is still an open question if telemedicine is a feasible treatment option for all groups of psychiatric patients alike. This prospective monocentric observational trial was conducted to assess the general applicability of telemedical treatment in a naturalistic psychiatric outpatient cohort and to identify groups of disorders and clusters of psychopathology that respond particularly well to telemedical treatment considering sociodemographic characteristics and patients' perspectives.MethodsPatients were recruited April 2020–April 2021 and asked to fill out the WHO-5 and the SCL-90R at baseline, after 4–6 and 8–12 weeks and a feedback-survey. Additionally, medical records, psychopathology, psychosocial functioning, and socio-demographic data were analyzed. Primary outcomes were well-being, psychopathology and functioning during treatment. Secondly, diagnostic groups and psychopathology linked to a superior treatment-response were determined with respect to patients' subjective experiences.ResultsOut of 1.385 patients, 254—mostly with hyperkinetic (35.3%) and depressive disorders (24.6%)—took part. Well-being and SCL-90R total scores improved substantially (both p < 0.001). CGI and GAF scores were worse in depressed subjects (both p < 0.05). Improvement was mainly seen in depressed patients; chronic disorders experienced a decline in well-being. Sociodemographic characteristics could not explain this difference. Particularly female (r = 0.413) patients found telepsychiatry equivalent to conventional treatment. The more virtual sessions participants attended the more likely they were to find telepsychiatry equal to conventional treatment (r = 0.231).ConclusionTelemedicine is an effective treatment for patients with depression under naturalistic conditions. Telemedical consultations are a simple and reliable way of monitoring symptom severity and directing treatment choices during the treatment of depressive disorders. Patients with depression benefited more from telemedical treatment compared to participants with chronic non-episodic psychiatric disorders. Future research needs to concentrate on improving telemedical treatment options suited for the latter conditions. Psychiatric telemedicine yielded overall high degrees of satisfaction among users.

Quality of parent-child communication is associated with adjustment in siblings of children with chronic disorders. SIBS is an intervention aiming to increase parental listening, exploring, and validating behaviors while talking with siblings about their experiences. We examined parent-sibling communication during SIBS by describing: 1) Sibling-selected dialogue topics; 2) Parental responses to siblings' emotional expressions, and 3) Associations between responses and demographics and parental psychological distress. Forty dialogues (M duration = 23 minutes) between siblings (10–16 years; Mage = 12.2 years; 52.5% boys) and one parent (62.5% mothers) were coded with the Verona Coding System for Emotional Sequences. Parents mostly provided space for further disclosure of siblings' experiences (M = 66.9%). In average, 41.9% of parental responses were exploring, 16.4% were listening, and 8.5% were validating. Few associations between parental responses and background variables were found. Parental validation should be given more focus in further development and implementation of the SIBS intervention. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has highlighted the need to modernize healthcare systems to the reality of the 21st century. The first world-wide Strategic Committee to launch Collaborative Value-Based Healthcare (C-VBHC) anchored on populational Real World Data and structured collaboration, took place in Montreal, via TOWWERS showcase project. The meeting covered a broad range of topics from the perspective of each of the various Real-World healthcare actors, the 5P+: Patient, Prescriber, Producer, Policymaker, Payer, including Data and Research stakeholders. Attended by approximately 20 participants from North America and Europe, the meeting provided a valuable opportunity to unit the 5P+ around common goals and exchanging on solutions. TOWWERS Strategic committee identified key elements required to continue the transformation. [ABSTRACT FROM AUTHOR]

Oxidative stress is one of the major contributors to the aetiology of chronic disorders. The modern lifestyle was seen to contribute significantly to the development of oxidative stress. The use of medicinal plants with antioxidant properties has been exploited to treat or prevent several human pathologies, of which oxidative stress seems to be one of the causes. These natural antioxidants, particularly polyphenols, have a variety of biological effects, including those that are anti-inflammatory, anti-ageing, anti-diabetic, anti-atherosclerotic, and anti-cancer. However, beneficial, and detrimental effects of antioxidant molecules used to reduce oxidative stress in several human conditions are apparent, especially in pre-clinical studies. Hence, natural antioxidants can also act as pro-oxidants. [ABSTRACT FROM AUTHOR]

Currently Covid-19 pandemic is a leading challenge across the globe. It is mandatory to attain and maintain good nutritional status to fight against virus. Nutritional status of individual is affected by several factors such as age, sex, health status, life style and medications. Nutritional status of individuals has been used as resilience towards destabilization during this COVID-19 pandemic. Optimal nutrition and dietary nutrient intake impact the immune system, therefore the only sustainable way to survive in current context is to strengthen the immune system. There is no evidence found that supplement can cure the immune system except Vit C, which is one of the best way to improve immune system. A proper diet can ensure that the body is in proper state to defeat the virus. However along with the dietary management guidelines the food safety management and good food practices is compulsory. This article explores the importance of nutrition to boost immunity and gives some professional and authentic dietary guidelines about nutrition and food safety to withstand COVID-19. The aim of the study – to analyze and systematize the literature data about the influence of nutrition on the manifestation of COVID-19 infection. Materials and Methods. The study uses publications of the world scientific literature on COVID-19 infection, in particular the causes and mechanisms of its development, treatment, complications and its consequences as well as the influence of different nutrients and nutrasuticals on the course of COVID-19. This review highlights the nutritional interventions to increase the immune response in the body during viral infections, especially considering the novel coronavirus pandemic. Due to their beneficial effects on general healthcare and disease prophylaxis, nutraceuticals have been gaining more and more importance lately. Results. During the COVID-19 pandemic, the nutritional status of individuals has been used as a measure of resilience toward destabilization. Optimal nutrition and dietary nutrient intake impact the immune system through gene expression, cell activation, and signaling molecules modification. In addition, various dietary ingredients are determinants of gut microbial composition and subsequently shape the immune responses in the body. Therefore the existing evidence suggests that the only sustainable way to survive in the current situation is to strengthen the immune system. An adequate intake of zinc, iron, and vitamins A, B 12, B6, C, and E is essential for the maintenance of immune function. In the current scenario, COVID-19 has imposed a new set of challenges for the individual to maintain a healthy diet. The state of self-isolation, lockdown, and social distancing are important measures to flattening the curve of the disease, although these measures have severe repercussions on an individual’s life. The act of confining to one’s home has significant impacts on one’s health, including changes in eating patterns, sleeping habits, and physical activity. It would promote sedentary behaviors that affect mental and physical health and lead to an increased risk of obesity. Fear and anxiety may also cause changes in dietary habits leading to unhealthy dietary patterns and less desire to eat or with lessened enjoyment during eating. Micronutrients are dietary components that may contribute substantially to a robust immune system. Essential micronutrients like vitamins A, D, E, C, B6, B12, and folate and trace elements such as iron, zinc, and selenium, available in a variety of fresh animal- and plant-based foods, aid the body’s ability to fight infections. Conclusions. COVID-19 became the most challenging pandemic influencing all countries worldwide. A proper and healthy diet can ensure a robust immune system that can resist any onslaught by the virus. A certain amount of particular nutrient saturates into cells and prevents any kind of nutritional deficiency. Individuals consuming well-balanced diets appear to be safer with better immune systems and lower incidence of chronic diseases and infections

The first known case of infection from the novel coronavirus was recorded almost one year ago, in China’s Hubei province. The city of Wuhan was infamous the world over as the original virus epicenter, seeing more than half of China’s reported cases and deaths. The outbreak of COVID-19 virus, as sickened more than 14.7 million people. At least 610.200 people have died. The aim of the study – to analyze and systematize the literature data about the influence of chronic diseases on the manifestation of COVID-19 infection. Materials and Methods. The study uses publications of the world scientific literature on COVID-19 infection, in particular the causes and mechanisms of its development, treatment, complications and its consequences as well as the influence of different chronic disorders on the course of COVID-19. Results. A sample of patients hospitalized with COVID-19 across 14 states of the USA in March was analyzed by The Centers for Disease Control and Prevention. It was found that many (89 %) had underlying health problem and 94 % of patients were at the age 65 and older. The case fatality rate for those under age 60 was 1.4 percent. For those over age 60, the fatality rate jumps to 4.5 percent. The older the population, the higher the fatality rate. For those 80 and over, Covid-19 appears to have a 13.4 percent fatality rate. Moreover, it was recognized, that older adults don't present in a typical way of the course of different disorders, and we're seeing that with Covid-19 as well. Conclusions. Chronic diseases and conditions are on the rise worldwide. COVID-19 became the most challenging pandemic influencing all countries worldwide. Chronic diseases are suggested to be one of the main causes of different life-threatening complications of COVID-19 infection and one of the main factors of poor prognosis for the patients

Background: Having a high quality primary health-care (PHC) system leads to a more efficient health-care system, which lower rates of hospitalization and leads to better health outcomes. One of the main criteria for assessing the quality of PHC services is the assessment of patient satisfaction, so the study aims to assess the chronic disease patients' satisfaction with PHC services provided by centers. Methods: A descriptive cross-sectional study conducted on patients with chronic diseases who follow-up in PHC centers within the Second Health Cluster in Riyadh using a questionnaire to assess their satisfaction level. A total 210 patients with different chronic diseases from the seven PHC centers (30 patients from each PHC center) who agreed to participate were included in the study. Results: In the study, 126 (60%) participants were females and 96 (45.7%) participants were in the age group more than 50 years. The survey showed that patients were satisfied with services offered by physicians, nurses, laboratory, and pharmacy with weighted means (3.81, 3.54, 3.59, and 3.88, respectively), while they were not satisfied with waiting time and services offered by receptionists with weighted means (3.22 and 3.27, respectively). The patient satisfaction showed a significant association with gender and level of education (P = 0.003 and 0.005, respectively). Conclusions: The survey showed that patients with chronic diseases were satisfied with services provided by PHC centers of the Second Health Cluster in Riyadh except receptionists' services, appointments, and waiting time. This survey will guide the policymakers for improving the services provided at the PHC centers.

Objective: To examine the associations between BMI categories and subsequent 3-year cognitive decline among older adults, and to test whether physical activity modifies the associations. Methods: Study sample included n = 1028 cognitively unimpaired older adults participating in the Étude sur la Santé des Aînés (ESA)-Services longitudinal study and followed 3 years later. Cognitive decline was defined as a decrease of > 3 points in MMSE scores between baseline and follow-up. BMI categories (normal weight (reference), underweight, overweight, obese) were derived from self-reported weight and height. Moderate to vigorous physical activity of ≥20 min (# of times per week) was self-reported. The presence of chronic disorders was ascertained from administrative and self-reported data. Logistic regression analyses were used to study the risk of cognitive decline associated with BMI categories stratified by weekly physical activity (≥140 min), the presence of metabolic, cardiovascular and anxio-depressive disorders. Results: In the overall sample, there was no evidence that underweight, overweight, or obesity, as compared to normal weight, was associated with cognitive decline, after adjusting for sociodemographic, lifestyle factors, and comorbidities. Individuals with overweight reporting high physical activity had lower odds of cognitive decline (OR = 0.25, 95% CI = 0.07–0.89), whereas no association was observed in individuals with overweight reporting low physical activity (OR = 0.85, 95% CI = 0.41–1.75). Among participants with metabolic and cardiovascular disorders, individuals with overweight reporting high physical activity had lower odds of cognitive decline (OR = 0.09, 95% CI = 0.01–0.59 and OR = 0.03, 95% CI = 0.01–0.92 respectively), whereas no association was observed in those with low physical activity. Conclusion: Physical activity modifies the association between overweight and cognitive decline in older adults overall, as in those with metabolic and cardiovascular disorders. Results highlight the importance of promoting and encouraging regular physical activity in older adults with overweight as prevention against cognitive decline. [ABSTRACT FROM AUTHOR]

Background and purpose: The European Federation of Neurological Associations (EFNA), in partnership with the NeuroCOVID‐19 taskforce of the European Academy of Neurology (EAN), has investigated the impact of the first wave of the COVID‐19 pandemic on individuals with neurological diseases, as well as the hopes and fears of these patients about the post‐pandemic phase. Methods: An EFNA‐EAN survey was available online to any person living with a neurological disorder in Europe. It consisted of 18 items concerning the impact of the first wave of the COVID‐19 pandemic on the medical care of people with neurological disorders, and the hopes and fears of these individuals regarding the post‐pandemic phase. Results: For 44.4% of the 443 survey participants, the overall care of their neurological disease during the pandemic was inappropriate. This perception was mainly due to significant delays in accessing medical care (25.7%), insufficiently reliable information received about the potential impact of COVID‐19 on their neurological disease (49.6%), and a substantial lack of involvement in their disease management decisions (54.3%). Participants indicated that their major concerns for the post‐pandemic phase were experiencing longer waiting times to see a specialist (24.1%), suffering from social isolation and deteriorating mental well‐being (23.1%), and facing delays in clinical trials with disinvestment in neuroscience research (13.1%). Conclusions: Despite the great efforts of health services to cope with the first wave of the COVID‐19 pandemic, individuals with neurological conditions feel they have been left behind. These findings provide invaluable insights for improving the care of patients with neurological disorders in the further course of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Based on their chemical composition, salus per aquam (spa) mineral waters (or medical mineral waters) can be classified as sulphurous, sulphate, bicarbonate etc. Sulphate mineral waters where the predominant element is sulphate anion SO42−, are frequently used in clinical therapy. In this review, we describe and analyze the current scientific knowledge concerning the therapeutic effect of sulphate mineral waters in the treatment of several disorders.Moreover, we underline how important is to integrate spa treatments with other therapeutic approaches to meet the various needs that can arise during a specific pathological state.

Noncommunicable chronic disorders (NCDs) are multifactorial disorders that share a state of chronic, low-grade inflammation together with an imbalance of gut microbiota. NCDs are becoming increasingly prevalent worldwide, and mainly in Western countries, with a significant impact on global health. Societal changes, together with the widespread diffusion of modern agricultural methods and food processing, have led to a significant shift in dietary habits over the past century, with an increased diffusion of the Western diet (WD). WD includes foods high in saturated fat, refined sugars, salt, sweeteners, and low in fiber, and is characterized by overeating, frequent snacking, and a prolonged postprandial state. An increasing body of evidence supports the association between the diffusion of WD and the rising prevalence of NCDs. WD also negatively affects both gut microbiota and the immune system by driving to microbial alterations, gut barrier dysfunction, increased intestinal permeability, and leakage of harmful bacterial metabolites into the bloodstream, with consequent contribution to the development of systemic low-grade inflammation. In this review article we aim to dissect the role of gut microbiota imbalance and gut barrier impairment in mediating the detrimental effects of WD on the development of NCDs, and to identify potential therapeutic strategies., Competing Interests: Declaration of competing interest AG reports personal fees for consultancy for Eisai S.r.l., 3PSolutions, Real Time Meeting, Fondazione Istituto Danone, Sinergie S.r.l. Board MRGE and Sanofi S.p.A; personal fees for acting as a speaker for Takeda S.p.A, AbbVie and Sandoz S.p.A; and personal fees for acting on advisory boards for VSL3 and Eisai. GI has received personal fees for acting as speaker for Alfa Sigma, Biocodex, Illumina, Malesci, Sofar and Tillotts Pharma, and for acting as consultant/advisor for Biocodex, Malesci, and Tillots Pharma., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Having a high quality primary health-care (PHC) system leads to a more efficient health-care system, which lower rates of hospitalization and leads to better health outcomes. One of the main criteria for assessing the quality of PHC services is the assessment of patient satisfaction, so the study aims to assess the chronic disease patients' satisfaction with PHC services provided by centers. Methods: A descriptive cross-sectional study conducted on patients with chronic diseases who follow-up in PHC centers within the Second Health Cluster in Riyadh using a questionnaire to assess their satisfaction level. A total 210 patients with different chronic diseases from the seven PHC centers (30 patients from each PHC center) who agreed to participate were included in the study. Results: In the study, 126 (60%) participants were females and 96 (45.7%) participants were in the age group more than 50 years. The survey showed that patients were satisfied with services offered by physicians, nurses, laboratory, and pharmacy with weighted means (3.81, 3.54, 3.59, and 3.88, respectively), while they were not satisfied with waiting time and services offered by receptionists with weighted means (3.22 and 3.27, respectively). The patient satisfaction showed a significant association with gender and level of education (P = 0.003 and 0.005, respectively). Conclusions: The survey showed that patients with chronic diseases were satisfied with services provided by PHC centers of the Second Health Cluster in Riyadh except receptionists' services, appointments, and waiting time. This survey will guide the policymakers for improving the services provided at the PHC centers. [ABSTRACT FROM AUTHOR]

Abstract Discovery of deoxyribonucleic acid (DNA) solved out the mystery of cellular functioning and abnormality in cellular metabolism. Understanding the coding of DNA resulted in enormous medical growth and helps the researchers in finding the genes which trigger major chronic diseases in humans. Further, the structural and sequential analysis brought humans into a new era of medical industry. The advancement in understanding of DNA could be a boon for agricultural sector as it allowed the farmers/breeders to choose better varieties with disease resistant features. In developing nations where the staple foods suffers with micronutrient deficiencies and stress conditions, DNA modifications and repair mechanism could solve out their problems. The role of DNA damaging factors and repair mechanism plays a crucial role in occurrence of certain disorders. Extracts prepared from various natural resources could either stop or slow down the process of DNA damage. This will help to eradicate major disorders related to DNA from human race. Further on the basis of type and dose of natural extracts, it would ease the planning of diets for patients suffering from chronic disorders.

Introduction: Substance abuse is currently a crippling problem worldwide. The hindering effect it has upon the development and prosperity of each society has turned it into a serious threat. Due to the importance of the problem the current study was aimed to investigate the effect of health promotion programs on the smoking cessation of the adolescent and youth in Iran. Methods: The current study was a quasi-experimental study. The target population consisted of the teenagers and the youth people of district 12 of Tehran City. The understudied cases were divided into intervention and control groups. Each groups included 20 participants. The researcher-constructed questionnaire was used for data collection. Data analysis was conducted using SPSS version 20. Results: Analysis of Cognitive-Therapy Co-Variance and its Effect on Health Promotion Scores show that Mean Square in Pre-Intervention sample and follow-up was 7854.365 and 5632.845 respectively. Also in Post-Intervention and follow-up was 4785.123 and 2865.563 that show a significant relationship between the pre and post-intervention and follow-up scores. Mean Square in Post-Intervention and follow-up for Effectiveness of Health Promotion Programs on Smoke cessation with 39 degrees of freedom was 730.58 and 746.420. The Ancova results showed that the improvement in wrong beliefs is permanent. Conclusion: Research findings revealed that onetime and recurrent health promotion programs have significant impacts upon smoking cessation of the teenagers and the youth. Since drug abuse is a motivational disorder, educational programs and improving the living condition for treating drug abuse is highly recommended.

The increasing prevalence of smart mobile devices (e.g., smartphones) enables the combined use of mobile crowdsensing (MCS) and ecological momentary assessments (EMA) in the healthcare domain. By correlating qualitative longitudinal and ecologically valid EMA assessment data sets with sensor measurements in mobile apps, new valuable insights about patients (e.g., humans who suffer from chronic diseases) can be gained. However, there are numerous conceptual, architectural and technical, as well as legal challenges when implementing a respective software solution. Therefore, the work at hand (1) identifies these challenges, (2) derives respective recommendations, and (3) proposes a reference architecture for a MCS-EMA-platform addressing the defined recommendations. The required insights to propose the reference architecture were gained in several large-scale mHealth crowdsensing studies running for many years and different healthcare questions. To mention only two examples, we are running crowdsensing studies on questions for the tinnitus chronic disorder or psychological stress. We consider the proposed reference architecture and the identified challenges and recommendations as a contribution in two respects. First, they enable other researchers to align our practical studies with a baseline setting that can satisfy the variously revealed insights. Second, they are a proper basis to better compare data that was gathered using MCS and EMA. In addition, the combined use of MCS and EMA increasingly requires suitable architectures and associated digital solutions for the healthcare domain.

Abstract Background Chronic diseases are generating a major health and societal burden worldwide. Healthy lifestyles, including physical activity (PA), have proven efficacy in the prevention and treatment of many chronic conditions. But, so far, national PA surveillance systems, as well as strategies for promotion of PA, have shown low impact. We hypothesize that personalized modular PA services, aligned with healthcare, addressing the needs of a broad spectrum of individual profiles may show cost-effectiveness and sustainability. Methods The current manuscript describes the protocol for regional implementation of collaborative self-management services to promote PA in Catalonia (7.5 M habitants) during the period 2017–2019. The protocols of three implementation studies encompassing a broad spectrum of individual needs are reported. They have a quasi-experimental design. That is, a non-randomized intervention group is compared to a control group (usual care) using propensity score methods wherein age, gender and population-based health risk assessment are main matching variables. The principal innovations of the PA program are: i) Implementation of well-structured modular interventions promoting PA; ii) Information and communication technologies (ICT) to facilitate patient accessibility, support collaborative management of individual care plans and reduce costs; and iii) Assessment strategies based on the Triple Aim approach during and beyond the program deployment. Discussion The manuscript reports a precise roadmap for large scale deployment of community-based ICT-supported integrated care services to promote healthy lifestyles with high potential for comparability and transferability to other sites. Trial registration This study protocol has been registered at ClinicalTrials.org (NCT02976064). Registered November 24th, 2016.

Siblings of children with chronic disorders are at increased risk of experiencing family communication problems and poorer mental health. We assessed initial feasibility, acceptability, and outcomes of SIBS; a manual-based group intervention for siblings and parents of children with chronic disorders, aiming to improve parent-sibling communication and sibling mental health. Ninety-nine siblings aged 8–16 years (M = 11.5 years, SD = 2.0; 54.5% girls) and parents (63.6% mothers) of children with chronic disorders participated in three separate group sessions for siblings and parents and two joint sessions with integrated sibling-parent dialogues. We assessed participant satisfaction post-intervention and checked for group leader manual adherence. We measured the following outcomes at baseline, three, and six months post-intervention in an open trial: (1) parent-sibling communication quality; (2) sibling emotional and behavioral problems; (3) sibling adaptation to the disorder; and (4) sibling disorder knowledge. Using growth curve modeling, we found significant improvement in parent-sibling communication quality (p = 0.001), emotional and behavioral problems (p = 0.009), adaptation to the disorder (p = 0.003), and disorder knowledge (p = 0.000) from baseline to follow-up (effect sizes d = 0.22 to 0.64). Improvement in sibling-reported emotional and behavioral problems and adaptation to the disorder was partly explained by communication quality. User satisfaction was high and manual adherence was good. Our evaluation yields support for the SIBS intervention, with initial evidence of acceptability, feasibility, and beneficial outcomes. Our study suggests targeting parent-sibling communication may be a beneficial way of improving siblings' mental health. Highlights: SIBS is a novel five-session intervention for siblings as next of kin. An open trial showed beneficial sibling outcomes after participating in SIBS. Both siblings and parents reported high satisfaction with SIBS. Involving parents actively may be key to sibling interventions. Targeting parent-child communication may represent useful sibling support. [ABSTRACT FROM AUTHOR]

The increasing prevalence of smart mobile devices (e.g., smartphones) enables the combined use of mobile crowdsensing (MCS) and ecological momentary assessments (EMA) in the healthcare domain. By correlating qualitative longitudinal and ecologically valid EMA assessment data sets with sensor measurements in mobile apps, new valuable insights about patients (e.g., humans who suffer from chronic diseases) can be gained. However, there are numerous conceptual, architectural and technical, as well as legal challenges when implementing a respective software solution. Therefore, the work at hand (1) identifies these challenges, (2) derives respective recommendations, and (3) proposes a reference architecture for a MCS-EMA-platform addressing the defined recommendations. The required insights to propose the reference architecture were gained in several large-scale mHealth crowdsensing studies running for many years and different healthcare questions. To mention only two examples, we are running crowdsensing studies on questions for the tinnitus chronic disorder or psychological stress. We consider the proposed reference architecture and the identified challenges and recommendations as a contribution in two respects. First, they enable other researchers to align our practical studies with a baseline setting that can satisfy the variously revealed insights. Second, they are a proper basis to better compare data that was gathered using MCS and EMA. In addition, the combined use of MCS and EMA increasingly requires suitable architectures and associated digital solutions for the healthcare domain. [ABSTRACT FROM AUTHOR]

Plants and their corresponding botanical preparations have been used for centuries due to their remarkable potential in both the treatment and prevention of oxidative stress-related disorders. Aging and aging-related diseases, like cardiovascular disease, cancer, diabetes, and neurodegenerative disorders, which have increased exponentially, are intrinsically related with redox imbalance and oxidative stress. Hundreds of biologically active constituents are present in each whole plant matrix, providing promissory bioactive effects for human beings. Indeed, the worldwide population has devoted increased attention and preference for the use of medicinal plants for healthy aging and longevity promotion. In fact, plant-derived bioactives present a broad spectrum of biological effects, and their antioxidant, anti-inflammatory, and, more recently, anti-aging effects, are considered to be a hot topic among the medical and scientific communities. Nonetheless, despite the numerous biological effects, it should not be forgotten that some bioactive molecules are prone to oxidation and can even exert pro-oxidant effects. In this sense, the objective of the present review is to provide a detailed overview of plant-derived bioactives in age-related disorders. Specifically, the role of phytochemicals as antioxidants and pro-oxidant agents is carefully addressed, as is their therapeutic relevance in longevity, aging-related disorders, and healthy-aging promotion. Finally, an eye-opening look into the overall evidence of plant compounds related to longevity is presented. [ABSTRACT FROM AUTHOR]

Microbiome First Medicine is a suggested 21st century healthcare paradigm that prioritizes the entire human, the human superorganism, beginning with the microbiome. To date, much of medicine has protected and treated patients as if they were a single species. This has resulted in unintended damage to the microbiome and an epidemic of chronic disorders [e.g., noncommunicable diseases and conditions (NCDs)]. Along with NCDs came loss of colonization resistance, increased susceptibility to infectious diseases, and increasing multimorbidity and polypharmacy over the life course. To move toward sustainable healthcare, the human microbiome needs to be front and center. This paper presents microbiome-human physiology from the view of systems biology regulation. It also details the ongoing NCD epidemic including the role of existing drugs and other factors that damage the human microbiome. Examples are provided for two entryway NCDs, asthma and obesity, regarding their extensive network of comorbid NCDs. Finally, the challenges of ensuring safety for the microbiome are detailed. Under Microbiome-First Medicine and considering the importance of keystone bacteria and critical windows of development, changes in even a few microbiota-prioritized medical decisions could make a significant difference in health across the life course.

Knowledge about the experiences of children with chronic disorders (CCD) is often based on parent-report. Obtaining self-report from CCD may be challenging due to cognitive impairments associated with many disorders. We explored siblings' perspectives on the experiences of their brothers and sisters with CCD, which represent a unique intragenerational and peer-based viewpoint. Siblings of children with various genetic disorders involving physical and/or intellectual disabilities were recruited from family courses at a specialist center for rare disorders. Participants (N = 58; M age= 11.4 years, SD = 2.4; range 7 to 17 years; 69.0% girls) attended group sessions focused on siblings' diagnostic knowledge and emotional experiences. We conducted a thematic analysis following guidelines for consensual qualitative research of 20 videotaped and transcribed group sessions for 58 siblings of CCD. We interpreted siblings' perspectives as indicating considerable efforts to understand and reflect upon the state of mind of the CCD along the following main themes: Abilities; Intensions; Insight; Emotions; Personality, preferences and desires; and Normality versus difference. Siblings emphasized CCD's physical, cognitive, and social abilities, focusing more on strengths than limitations. A desire to be normal and lack of insight were common inferred reasons for problematic behavior displayed by the CCD. Siblings expressed fears of bullying of the CCD. In conclusion, siblings show psychologically complex insights into the experiences and mindsets of CCD and should be considered as informants in research and in informing practice interventions for CCD, alongside their parents. [ABSTRACT FROM AUTHOR]

Aim of the study: The aim of the study was to investigate whether there are differences in the various dimensions of the health locus of control between oncological and non-oncological patients and to determine whether there is a relationship between the level of health locus of control and the type, duration of disease and gender. Material and methods: The study was conducted at the Department of Hematology and the 1st Department of Cardiology of the University Hospital in Krakow. 204 patients were enrolled. Our own questionnaire developed for this purpose and the Multidimensional Health Locus of Control scale were used. The US normalization group and the Polish standardization groups of the chronically ill patients were used for comparative analysis. Results: Analysis showed significant differences between women and men in the Internal control scale (p < 0.02). The respondents from both groups showed lower scores in the Internal locus of control and much higher scores in the dimension Powerful Others. In the group of oncological patients, a negative correlation was found between the Internal scale of health locus of control and the duration of the disease (p = 0.007). There was a significant difference between oncological and non-oncological patients in the Powerful Others scale (p < 0.004). Conclusions: The results suggest that oncologically ill patients could be more convinced that others are responsible for their health when compared to non-oncological patients. The longer the disease persists in oncological patients, the weaker is their internal motivation to achieve good treatment results. [ABSTRACT FROM AUTHOR]

Previous research has indicated that, reflecting East Asians' holistic attentional style, they are likely to emphasize more somatic symptoms and perceive their internal visceral states less accurately as compared with Westerners. Based on these findings, comparing representative samples of Americans and Japanese participants, this research examined whether somatosensory amplification would vary across cultures. Moreover, by controlling confounding factors, including neuroticism and chronic disorders, the possibility that the association between somatosensory amplification and negative affective states differs across cultures also was tested. The results showed that Japanese exhibit higher somatosensory amplification than do Americans. In both cultures, as neuroticism and the number of chronic disorders increased, negative affective states also increased, leading to higher somatosensory amplification. Whereas negative affective states completely mediated the paths of neuroticism and chronic disorders to somatosensory amplification in the United States, such mediation was partial in Japan. Moreover, the association between somatosensory amplification and negative affective states was weaker in Japanese than in Americans. [ABSTRACT FROM AUTHOR]

The gut microbiome plays a key role in influencing several pathways and functions involved in human health, including metabolism, protection against infection, and immune regulation. Perturbation of the gut microbiome is recognised as a pathogenic factor in several gastrointestinal and extraintestinal disorders, and is increasingly considered as a therapeutic target in these conditions. Faecal microbiota transplantation (FMT) is the transfer of the microbiota from healthy screened stool donors into the gut of affected patients, and is a well-established and highly effective treatment for recurrent Clostridioides difficile infection. Despite the mechanisms of efficacy of FMT not being fully understood, it has been investigated in several chronic noncommunicable disorders, with variable results. This review aims to give an overview of mechanisms of efficacy of FMT in chronic noncommunicable disorders, and to paint the current landscape of its investigation in these medical conditions, including inflammatory bowel disease (IBD), chronic liver disorders, and also extraintestinal autoimmune conditions. • Gut microbiome perturbations are associated with a wide range of chronic noncommunicable conditions • Faecal microbiota transplantation (FMT) is a therapeutic approach to restore gut microbiome. • FMT is a well-established treatment for recurrent Clostridioides difficile infection, but there is growing interest for its application in a range of chronic non-communicable diseases. • FMT alters host-microbiome interactions to impact upon host phenotype, including via changes in microbial metabolites and immune responses. • Barriers to more widespread application of FMT relate to regulatory and logistical factors. Industry and pharmaceutical companies are aiming to develop 'microbiome therapeutics. [ABSTRACT FROM AUTHOR]

Gerardo González-Saldivar,1 René Rodríguez-Gutiérrez,2 José Luis Viramontes-Madrid,3 Alejandro Salcido-Montenegro,2 Kevin Erick Gabriel Carlos-Reyna,2 Andrés Marcelo Treviño-Alvarez,2 Neri Alejandro Álvarez-Villalobos,4 José Gerardo González-González2 1Ophthalmology Department, 2Endocrinology Division, Hospital Universitario “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, 3Instituto Nacional de Salud Pública, Cuernavaca, Morelos, 4Medical Statistics Department, Hospital Universitario “Dr. José E. González”, Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico Background: There is scarce scientific information assessing participants’ perception of pharmaceutical research in developed and developing countries concerning the risks, safety, and purpose of clinical trials.Methods: To assess the perception that 604 trial participants (cases) and 604 nonparticipants (controls) of pharmaceutical clinical trials have about pharmaceutical clinical research, we surveyed participants with one of four chronic diseases from 12 research sites throughout Mexico.Results: Participation in clinical trials positively influences the perception of pharmaceutical clinical research. More cases (65.4%) than controls (50.7%) perceived that the main purpose of pharmaceutical research is to cure more diseases and to do so more effectively. In addition, more cases considered that there are significant benefits when participating in a research study, such as excellent medical care and extra free services, with this being the most important motivation to participate for both groups (cases 52%, controls 54.5%). We also found a sense of trust in their physicians to deal with adverse events, and the perception that clinical research is a benefit to their health, rather than a risk. More controls believed that clinical trial participants’ health is put at risk (57% vs 33.3%). More cases (99.2%) than controls (77.5%) would recommend participating in a clinical trial, and 90% of cases would enroll in a clinical trial again.Conclusion: Participation in clinical trials positively influences the perception that participants have about pharmaceutical clinical research when compared to nonparticipants. This information needs to be conveyed to clinicians, public health authorities, and general population to overcome misconceptions. Keywords: perceptions, clinical trials, chronic disorders, participants’ perception, pharmaceutical industry, developing countries