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Farewell CV, Schmiege SJ, Leiferman J. Racial Differences in Psychosocial Resources and Mental and Physical Health Outcomes during Pregnancy: A structural equation modeling approach. RESEARCH SQUARE 2024:rs.3.rs-4617998. [PMID: 39070611 PMCID: PMC11276014 DOI: 10.21203/rs.3.rs-4617998/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Objectives Poor prenatal health is of particular concern among minoritized individuals who may experience adverse social determinants of health contributing to the intergenerational transmission of health disparities. The purpose of this study was to investigate associations between psychosocial resources, and mental and physical health among a prenatal sample, and to explore if these relationships vary by race. Methods English-speaking pregnant individuals living in the United States were recruited using Centiment (n=340). Participants completed a 121-item cross-sectional survey. We conducted a single- and multi-group structural equation model to test hypothesized relationships, and then investigated differences by pregnant White individuals versus Black, Indigenous, and People of Color (BIPOC). Results Our final single-group model exhibited good model fit (χ2 (43) = 99.07, p<.01, CFI = 0.97, SRMR = 0.04, and RMSEA = 0. 06 (0.05 - 0.08)). After controlling for demographic characteristics and social determinants of health, higher levels of mindfulness were statistically significantly related to lower anxiety and depression scores (both p<.01). Higher levels of social supports were statistically significantly related to lower anxiety scores. Scale measurement invariance was confirmed for the multi-group model and the structural model was statistically significantly different between pregnant White individuals and BIPOC in this sample (Δ χ2 (27) = 116.71, p <.01). Conclusions Identification of core components of psychosocial resource interventions, consideration of upstream structural determinants, mindfulness and valued-living (MVL)-based strategies, cultural adaptation, and an emphasis on resilience rather than psychopathology may result in improved prenatal health among pregnant individuals traditionally underrepresented in research.
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Srinivasan R, McVoy M, Neudecker M, Divan MK, Wu A, Cascio ME, Dusek JA, Miller DW. Mind-Body Interventions for Youth with Chronic Medical Conditions: A Scoping Review of the Literature. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:620-644. [PMID: 38498029 DOI: 10.1089/jicm.2023.0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Background and purpose: Little is known about the applicability, utilization, and effectiveness of mind-body interventions (MBIs) for conditions that are not predominantly pain, neoplastic, or psychiatric, particularly in pediatric patients. This scoping review describes research pertaining to such interventions in youth with nonpain, noncancer, and nonpsychiatric predominant chronic medical conditions. Methods: Searches of EBSCO CINAHL, Elsevier Scopus, Ovid for MEDLINE, and Ovid PsycInfo were conducted to investigate MBIs in youth under 18 years of age with nonpain, noncancer, and nonpsychiatric predominant chronic medical conditions. Articles published between 2010 and 2020 were included. Abstracts were screened by three authors for inclusion, and disagreements were resolved by a designated author. Selected full-text articles were divided among all authors for review of study quality, intervention feasibility and acceptability, and effectiveness. Results: The search yielded 1010 titles with 15 meeting the final inclusion criteria, studying a total of 641 youth. Participants ranged in age from 6 to 19 years (included studies had data on participants <18 years reported separately); 61.5% were female (n = 394) and 38.5% were male (n = 247). The two most common conditions studied were asthma and irritable bowel syndrome, with yoga being the most popular intervention. Overall, MBIs showed promising preliminary evidence for improving symptoms and quality of life in youth with chronic medical conditions. Conclusion: MBIs have been successfully delivered and show promise in symptom palliation and quality of life improvement for youth with a variety of chronic medical conditions. More data from high-quality randomized controlled trials are needed to further characterize the effectiveness of specific modalities for specific conditions.
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Affiliation(s)
- Roshini Srinivasan
- Duke University School of Medicine, Durham, North Carolina, USA
- University Hospitals Connor Whole Health, Cleveland, Ohio, USA
| | - Molly McVoy
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Mandy Neudecker
- University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
| | - Mina Kumari Divan
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Amy Wu
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Jeffery A Dusek
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - David W Miller
- University Hospitals Connor Whole Health, Cleveland, Ohio, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
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Bowman-Busato J, Schreurs L, Halford JCG, Yumuk V, O'Malley G, Woodward E, De Cock D, Baker JL. Providing a common language for obesity: the European Association for the Study of Obesity obesity taxonomy. Int J Obes (Lond) 2024:10.1038/s41366-024-01565-9. [PMID: 38902385 DOI: 10.1038/s41366-024-01565-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/30/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The basis for a high-performing and resilient healthcare system is having a common, precise, and scientifically accurate language used across all stakeholder groups. However, such a common language is lacking for obesity. Therefore, the European Association for the Study of Obesity undertook a taxonomy initiative to provide standardised language for obesity as commonly used from policy to practice for other major policy-prioritised non-communicable diseases (NCDs). METHODS An online Delphi consensus study was conducted, involving a panel of experts representing stakeholder groups of policymakers, healthcare professionals, people with lived experience, and researchers. Based on the understanding of obesity as an adiposity-based chronic disease, 54 statements demarcated into definition, scope and contextual usage were developed across six themes: Definition of obesity, Causes, onset and progression, Obesity prevention, Screening and early diagnosis, Treatment and management, Obesity consequences. RESULTS Of the 194 invited experts, 70 (36%), 63 (33%), and 58 (30%) experts participated in rounds one, two, and three, respectively. Consensus was achieved on 70% of the proposed definitions, scope, and contextual usage after round one, 94% after round two and 100% after round three. The Definition of Obesity theme included distinctions between population-level indicators and individual-level signs of obesity, and how pre-obesity was defined. The Causes, Onset and Progression theme characterised the timing of obesity development. The Obesity Prevention theme explicitly differentiated between health promotion and primary prevention. Both the Screening and Early Diagnosis, and the Treatment and Management themes defined concepts supporting a continuum of care model. The Consequences of Obesity theme encompassed health and socio-economic outcomes. CONCLUSION The taxonomy provides a contemporary evidence-based language about obesity that aligns with language used for policy-prioritised NCDs. The taxonomy is useful for education, advocacy, and communication and can be used by policymakers, healthcare professionals, people living with obesity, researchers, and health system users.
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Affiliation(s)
| | - Lucas Schreurs
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium.
| | - Jason C G Halford
- European Association for the Study of Obesity, Teddington, United Kingdom
- Department of Psychology, University of Liverpool, Liverpool, UK
- School of Psychology, University of Leeds, Leeds, UK
| | - Volkan Yumuk
- European Association for the Study of Obesity, Teddington, United Kingdom
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Grace O'Malley
- European Association for the Study of Obesity, Teddington, United Kingdom
- Obesity Research and Care Group, School of Physiotherapy, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Euan Woodward
- European Association for the Study of Obesity, Teddington, United Kingdom
| | - Diederik De Cock
- Biostatistics and Medical Informatics Research Group, Department of Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), 1090, Brussels, Belgium
| | - Jennifer L Baker
- European Association for the Study of Obesity, Teddington, United Kingdom
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Frederiksberg, Denmark
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Ngwenya N, Smith T, Shahmanesh M, Psaros C, Munikwa C, Nkosi K, Seeley J. Social Categorisation and Social Identification: The Mediating Role of Social Isolation and Loneliness in Adolescents Living with HIV. Int J Behav Med 2024; 31:459-467. [PMID: 37524973 PMCID: PMC11106135 DOI: 10.1007/s12529-023-10205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Social isolation and loneliness are associated with living with a chronic condition particularly where stigma is a factor. Our study aimed to examine the lived experience of adolescents living with HIV in relation to isolation because of their diagnosis and consequences of disclosure. Giddens' structuration theory was used as an analytic framework to identify the potential mechanisms underlying adolescents living with HIV's experiences. METHOD Longitudinal in-depth interviews were conducted with 20 adolescents living with HIV aged 15-24 years with each participant taking part in three interviews (total 60) between September 2020 and October 2021. Thematic analysis was performed using Braun and Clarke's steps for coding and analysing qualitative data and informed by the structuration theory framework. RESULTS The findings indicated that adolescents living with HIV have agency and make conscious choices about sharing their status. However, these choices are influenced by their experiences in their community. The discrimination and negative judgements they often experience prevent them from disclosing their status. Stigma, discrimination, and psychological distress contribute to the isolation that adolescents and young adults living with HIV experience. The limited disclosure itself can lead to them becoming isolated and lonely. CONCLUSION The negative experiences which adolescents living with HIV face can have an impact not only on their psychological wellbeing but also on their decision to disclose and seek support. These experiences may lead to social isolation and loneliness, an unintended consequence of their action in protecting themselves from the conditions created by the structures/environment in which they live.
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Affiliation(s)
- Nothando Ngwenya
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
- University of KwaZulu-Natal, Durban, South Africa.
| | - Thandeka Smith
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Maryam Shahmanesh
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
- Institute for Global Health, University College London, London, UK
| | - Christina Psaros
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, USA
| | | | - Khethokuhle Nkosi
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
- University of KwaZulu-Natal, Durban, South Africa
- London School of Hygiene and Tropical Medicine, London, UK
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Lee YM, Kim Y. Is Curcumin Intake Really Effective for Chronic Inflammatory Metabolic Disease? A Review of Meta-Analyses of Randomized Controlled Trials. Nutrients 2024; 16:1728. [PMID: 38892660 PMCID: PMC11174746 DOI: 10.3390/nu16111728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
This review aimed to examine the effects of curcumin on chronic inflammatory metabolic disease by extensively evaluating meta-analyses of randomized controlled trials (RCTs). We performed a literature search of meta-analyses of RCTs published in English in PubMed®/MEDLINE up to 31 July 2023. We identified 54 meta-analyses of curcumin RCTs for inflammation, antioxidant, glucose control, lipids, anthropometric parameters, blood pressure, endothelial function, depression, and cognitive function. A reduction in C-reactive protein (CRP) levels was observed in seven of ten meta-analyses of RCTs. In five of eight meta-analyses, curcumin intake significantly lowered interleukin 6 (IL-6) levels. In six of nine meta-analyses, curcumin intake significantly lowered tumor necrosis factor α (TNF-α) levels. In five of six meta-analyses, curcumin intake significantly lowered malondialdehyde (MDA) levels. In 14 of 15 meta-analyses, curcumin intake significantly reduced fasting blood glucose (FBG) levels. In 12 of 12 meta-analyses, curcumin intake significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR). In seven of eight meta-analyses, curcumin intake significantly reduced glycated hemoglobin (HbA1c) levels. In eight of ten meta-analyses, curcumin intake significantly reduced insulin levels. In 14 of 19 meta-analyses, curcumin intake significantly reduced total cholesterol (TC) levels. Curcumin intake plays a protective effect on chronic inflammatory metabolic disease, possibly via improved levels of glucose homeostasis, MDA, TC, and inflammation (CRP, IL-6, TNF-α, and adiponectin). The safety and efficacy of curcumin as a natural product support the potential for the prevention and treatment of chronic inflammatory metabolic diseases.
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Affiliation(s)
- Young-Min Lee
- Department of Practical Science Education, Gyeongin National University of Education, Gyesan-ro 62, Gyeyang-gu, Incheon 21044, Republic of Korea;
| | - Yoona Kim
- Department of Food and Nutrition, Institute of Agriculture and Life Science, Gyeongsang National University, Jinju 52828, Republic of Korea
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Kassaw AT, Sendekie AK, Minyihun A, Gebresillassie BM. Medication regimen complexity and its impact on medication adherence in patients with multimorbidity at a comprehensive specialized hospital in Ethiopia. Front Med (Lausanne) 2024; 11:1369569. [PMID: 38860203 PMCID: PMC11163062 DOI: 10.3389/fmed.2024.1369569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/10/2024] [Indexed: 06/12/2024] Open
Abstract
Background Medication regimen complexity (MRC) is suspected to hinder medication adherence in patients with multiple illnesses. Despite this, the specific impact on Ethiopian patients with multimorbidity is unclear. This study assessed MRC and its impact on medication adherence in patients with multimorbidity. Methods A hospital-based cross-sectional study was conducted on patients with multimorbidity who had been followed at the University of Gondar Comprehensive and Specialized Hospital (UoGCSH), Ethiopia, from May to July 2021. Medication complexity was measured using the validated Medication Regimen Complexity Index (MRCI) tool, and the Adherence in Chronic Diseases Scale (ACDS) was used to measure medication adherence. Pearson's chi-square test was used to examine associations between MRCI levels and medication adherence. Ordinal logistic regression analysis was used to determine the impact of MRC and other associated variables on medication adherence. Statistical significance was determined using the adjusted odds ratio (AOR) at p-value <0.05 and its 95% confidence range. Results Out of 422 eligible patients, 416 (98.6%) were included in the study. The majority of participants (57.2%) were classified as having a high MRCI score with a mean (±SD) score of 9.7 (±3.4). Nearly half of the patients (49.3%) had low medication adherence. Patients with medium (AOR = 0.43, 95% CI: 0.04, 0.72) and higher (AOR = 0.31, 95% CI: 0.07, 0.79) MRCI levels had lower odds of medication adherence. In addition, monthly income (AOR = 4.59, 95% CI: 2.14, 9.83), follow-up durations (AOR = 2.31, 95% CI: 1.09, 4.86), number of medications (AOR = 0.63, 95% CI: 0.41, 0.97), and Charlson comorbidity index (CCI) (AOR = 0.36, 95% CI: 0.16, 0.83) were significantly associated with medication adherence. Conclusion Medication regimen complexity in patients with multimorbidity was found to be high and negatively impacted the levels of medication adherence. Healthcare providers and other stakeholders should seek interventions aimed at simplifying drug regimen complexity and improving adherence.
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Affiliation(s)
- Abebe Tarekegn Kassaw
- Department of Pharmacy, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Minyihun
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Begashaw Melaku Gebresillassie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
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Silva CC, Presseau J, van Allen Z, Schenk PM, Moreto M, Dinsmore J, Marques MM. Effectiveness of Interventions for Changing More Than One Behavior at a Time to Manage Chronic Conditions: A Systematic Review and Meta-analysis. Ann Behav Med 2024; 58:432-444. [PMID: 38721982 PMCID: PMC11112274 DOI: 10.1093/abm/kaae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Health behaviors play a significant role in chronic disease management. Rather than being independent of one another, health behaviors often co-occur, suggesting that targeting more than one health behavior in an intervention has the potential to be more effective in promoting better health outcomes. PURPOSE We aimed to conduct a systematic review and meta-analysis of randomized trials of interventions that target more than one behavior to examine the effectiveness of multiple health behavior change interventions in patients with chronic conditions. METHODS Five electronic databases (Web of Science, PubMed, CINAHL, EMBASE, and Cochrane) were systematically searched in November 2023, and studies included in previous reviews were also consulted. We included randomized trials of interventions aiming to change more than one health behavior in individuals with chronic conditions. Two independent reviewers screened and extracted data, and used Cochrane's Risk of Bias 2 tool. Meta-analyses were conducted to estimate the effects of interventions on change in health behaviors. Results were presented as Cohen's d for continuous data, and risk ratio for dichotomous data. RESULTS Sixty-one studies were included spanning a range of chronic diseases: cardiovascular (k = 25), type 2 diabetes (k = 15), hypertension (k = 10), cancer (k = 7), one or more chronic conditions (k = 3), and multiple conditions (k = 1). Most interventions aimed to change more than one behavior simultaneously (rather than in sequence) and most targeted three particular behaviors at once: "physical activity, diet and smoking" (k = 20). Meta-analysis of 43 eligible studies showed for continuous data (k = 29) a small to substantial positive effect on behavior change for all health behaviors (d = 0.081-2.003) except for smoking (d = -0.019). For dichotomous data (k = 23) all analyses showed positive effects of targeting more than one behavior on all behaviors (RR = 1.026-2.247). CONCLUSIONS Targeting more than one behavior at a time is effective in chronic disease management and more research should be directed into developing the science of multiple behavior change.
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Affiliation(s)
- Carolina C Silva
- Trinity Centre for Practice and Healthcare Innovation (TCPHI), School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Zack van Allen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Paulina M Schenk
- Centre for Behaviour Change, University College London, London, England, UK
| | | | - John Dinsmore
- Trinity Centre for Practice and Healthcare Innovation (TCPHI), School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Marta M Marques
- NOVA National School of Public Health, Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, Lisbon, Portugal
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Al Ramahi R, Tumeh D. The prevalence and severity of upper gastrointestinal complications among patients with chronic diseases: a cross-sectional study from Palestine. BMC Gastroenterol 2024; 24:175. [PMID: 38773426 PMCID: PMC11106898 DOI: 10.1186/s12876-024-03267-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/15/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Many old people have at least one chronic disease. As a result, multiple drugs should be used. Gastrointestinal complications may occur because of the harmful effects of these chronic drugs on the stomach. The study aimed to assess the prevalence of upper gastrointestinal complications in patients taking chronic medications, the severity of these symptoms, and whether they take any gastro-protective drugs or not. METHODOLOGY This was a cross-sectional study through face-to-face questionnaires from internal outpatient clinics at a specialized hospital. Patients with chronic diseases who were taking at least one chronic medication were included in the study. Data Collection Form was used to gather information. The Short-Form Leeds Dyspepsia Questionnaire (SF-LDQ) was used to evaluate the severity of the upper gastrointestinal symptoms. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. RESULTS A total of 400 patients with chronic diseases and using multiple medications were included. Among them, 53.8% were females and 56% were married, 58.5% were unemployed, 70% were not smokers, the mean age was 54.7 ± 17.5 years. The most common comorbid diseases among the patients were diabetes, hypertension, and arthritis, with percentages of 44.3%, 38%, and 27.3%, respectively. The mean number of chronic medications used was 3.36 ± 1.6 with a range of 1 to 9. The most commonly used was aspirin with a percentage of 50%, followed by atorvastatin, bisoprolol, and insulin with percentages of 29.5%, 25%, and 20.3%, respectively. Among the 400 participants, 362 (90.5%) suffered from upper gastrointestinal side effects like indigestion (65.8%), heartburn (78.3%), nausea (48.8%), and regurgitation (52.0%). Based on SF-LDQ scoring, of the 400 respondents, 235(58.8%), 109(27.3%) and 18(4.5%) suffered from mild, moderate and severe dyspepsia, respectively. A high percentage 325 (81.3%) of participants were prescribed gastro-protective medications. Proton pump inhibitors were the most prescribed group in 209 (52.3%) patients. Dyspepsia was significantly associated with older age (p-value = 0.001), being educated (p-value = 0.031), not being single (p-value < 0.001), having health insurance (p-value = 0.021), being a smoker (p-value = 0.003), and using ≥ 5 medications (p-value < 0.001). CONCLUSION Upper gastrointestinal complications among patients with chronic diseases were very common. Fortunately, the symptoms were mild in most cases. The risk increased with age and using a higher number of medications. It is important to review patients' medications and avoid overuse of them, in addition to use gastro-protective agents when needed.
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Affiliation(s)
- Rowa Al Ramahi
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O.Box 7, Nablus, Palestine.
| | - Deema Tumeh
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, P.O.Box 7, Nablus, Palestine
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Wiggins M, Painter S, Burant C, Juratovac E, Alto K. Understanding Ohio X-Waivered Advanced Practice Registered Nurses' Rate of Naltrexone Prescription for Alcohol Use Disordered Patients. J Am Psychiatr Nurses Assoc 2024; 30:613-623. [PMID: 36694460 DOI: 10.1177/10783903221151062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Alcohol use disorder (AUD) is overrepresented within the United States. Naltrexone, a recommended treatment for AUD, is underutilized. However, the prescribing behaviors of advanced practice registered nurses (APRNs) regarding naltrexone for AUD patients have not been studied. The purpose of our study was to explore the prescriptive practices of a sample of APRNs. AIMS To describe and analyze survey responses of a sample of Ohio APRNs with training in medication for addiction treatment (MAT) for substance use disorders (as evidenced by DEA x-waiver receipt) regarding prescribing practices of naltrexone for AUD patients. METHOD Public information collected from the first author's Nursing Board (list of APRNs in Ohio) was checked against the public information of x-waivered providers nationally from the Substance Abuse and Mental Health Services Administration's (SAMHSA) website. This generated a potential sample size of 824 APRNs, all of whom were sent email solicitations to complete a Qualtrics survey. After 3 weeks, 55 surveys were completed, and the data were analyzed. Descriptive statistics were generated as well as a logistic regression with five potential predictor variables against the outcome variable (defined as use of naltrexone for AUD patients). RESULTS Years practicing as an APRN was found to negatively predict naltrexone prescribing behavior for AUD patients. Practice setting and work experience with an addiction specialist physician were not found to predict naltrexone prescribing behavior for AUD patients. CONCLUSION Implications for further study were discussed, with emphasis on regulatory variance between states.
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Affiliation(s)
- Morgan Wiggins
- Morgan Wiggins, MSN, APRN, PMHNP-BC, Case Western Reserve University, Cleveland, OH, USA; DNP, APRN, PMHNP-BC, The Ohio State University College of Nursing, Columbus, OH, USA
| | - Susan Painter
- Susan Painter, DNP, APRN, C-CNS, PMHCNS-BC, Case Western Reserve University, Cleveland, OH, USA
| | - Christopher Burant
- Christopher Burant, PhD, MACTM, FGSA, Case Western Reserve University, Cleveland, OH, USA
| | - Evanne Juratovac
- Evanne Juratovac, PhD, APRN, GCNS-BC, Case Western Reserve University, Cleveland, OH, USA
| | - Kathleen Alto
- Kathleen Alto, PhD, MetroHealth Medical Center Cleveland, OH, USA
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Ali Y, Wright N, Charnock D, Henshaw H, Morris H, Hoare DJ. Applications of Grounded Theory Methodology to Investigate Hearing Loss: A Methodological Qualitative Systematic Review With Developed Guidelines. Ear Hear 2024; 45:550-562. [PMID: 38608196 PMCID: PMC11008453 DOI: 10.1097/aud.0000000000001459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 11/23/2023] [Indexed: 04/14/2024]
Abstract
OBJECTIVES Qualitative methodologies are commonly adopted in hearing loss research. Grounded theory methodology is increasingly used to establish novel theories explaining experiences related to hearing loss. Establishing and improving the quality of grounded theory studies has been emphasized as critical to ensuring theoretical trustworthiness. Thus, the primary aim of the present study was to systematically review hearing loss research studies that have applied grounded theory methodology and assess the methodological quality of those grounded theory applications. Secondarily aims were to (i) explore how grounded theory methodology has been applied to investigate hearing loss, and (ii) use the findings of the review to develop a set of guidelines to aid the future high-quality application of grounded theory methodology to hearing loss research. DESIGN Original peer-reviewed studies applying grounded theory methodology and published in English were identified through systematic searches in 10 databases; Applied Social Sciences Index and Abstracts, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, EBSCO, Global Health, MEDLINE (OvidSP), PsycINFO, PubMed, Scopus, and Web of Science. The quality of studies was assessed according to 12 grounded theory principles using the Guideline for Reporting, Evaluating, and applying the core principles of Grounded Theory studies (GUREGT) tool. Data were analyzed using qualitative inductive thematic analysis. RESULTS After the removal of duplicates, 155 articles were retrieved. Of those, 39 met the criteria for inclusion in the systematic review. An increase in the adoption of grounded theory methodology to investigate hearing loss was identified with the number of published studies tripling in the last 5 years. Critical appraisal using the GUREGT tool identified four studies as high-quality. Most included studies were of moderate study quality (n = 25), and 10 were classified as being of low study quality. Using inductive thematic analysis, the included studies investigated one of four areas relating to hearing loss: (a) Living with hearing loss, (b) Identity and hearing loss, (c) Coping strategies for hearing loss, and (d) Audiological counseling and rehabilitation. Analysis also identified four main grounded theory factors frequently overlooked in hearing loss research: the different schools of grounded theory, sampling strategy, sample size, and the depth of grounded theory application. CONCLUSIONS Use of grounded theory methodology is increasing at a rapid rate in hearing loss research. Despite this, studies conducted in the field to date do not meet and apply the full spectrum of grounded theory principles, as outlined by the GUREGT tool. To improve methodological rigor in future studies using grounded theory, we propose a set of guidelines that address the most commonly overlooked methodological considerations in hearing loss studies to date. The guidelines are designed to aid researchers to achieve high methodological quality in any field, improve qualitative rigor, and promote theoretical credibility.
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Affiliation(s)
- Yasmin Ali
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Nicola Wright
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - David Charnock
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Helen Henshaw
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Haley Morris
- Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, United Kingdom
| | - Derek J Hoare
- National Institute for Health and Care Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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11
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Mossburg S, Kilany M, Jinnett K, Nguyen C, Soles E, Wood-Palmer D, Aly M. A Rapid Review of Interventions to Improve Care for People Who Are Medically Underserved with Multiple Sclerosis, Diabetic Retinopathy, and Lung Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:529. [PMID: 38791744 PMCID: PMC11121396 DOI: 10.3390/ijerph21050529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/26/2024]
Abstract
In the United States, patients with chronic conditions experience disparities in health outcomes across the care continuum. Among patients with multiple sclerosis, diabetic retinopathy, and lung cancer, there is a lack of evidence summarizing interventions to improve care and decrease these disparities. The aim of this rapid literature review was to identify interventions among patients with these chronic conditions to improve health and reduce disparities in screening, diagnosis, access to treatment and specialists, adherence, and retention in care. Using structured search terms in PubMed and Web of Science, we completed a rapid review of studies published in the prior five years conducted in the United States on our subject of focus. We screened the retrieved articles for inclusion and extracted data using a standard spreadsheet. The data were synthesized across clinical conditions and summarized. Screening was the most common point in the care continuum with documented interventions. Most studies we identified addressed interventions for patients with lung cancer, with half as many studies identified for patients with diabetic retinopathy, and few studies identified for patients with multiple sclerosis. Almost two-thirds of the studies focused on patients who identify as Black, Indigenous, or people of color. Interventions with evidence evaluating implementation in multiple conditions included telemedicine, mobile clinics, and insurance subsidies, or expansion. Despite documented disparities and a focus on health equity, a paucity of evidence exists on interventions that improve health outcomes among patients who are medically underserved with multiple sclerosis, diabetic retinopathy, and lung cancer.
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Affiliation(s)
- Sarah Mossburg
- American Institutes for Research, Arlington, VA 22202, USA
| | - Mona Kilany
- American Institutes for Research, Arlington, VA 22202, USA
| | - Kimberly Jinnett
- Department of Social and Behavioral Sciences, UCSF Institute for Health and Aging, San Francisco, CA 94158, USA
| | | | - Elena Soles
- American Institutes for Research, Arlington, VA 22202, USA
| | | | - Marwa Aly
- Department of Applied Health Sciences, School of Public Health, Indiana University Bloomington, Bloomington, IN 47405, USA
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Buzzanca-Fried KE, Snyder AR, Bauer RM, Morgan-Daniel J, de Corcho CP, Addeo R, Lahey SM, Houck Z, Beneciuk JM. Psychological Constructs From the Fear Avoidance Model and Beyond as Predictors for Persisting Symptoms After Concussion: An Integrative Review. Arch Phys Med Rehabil 2024:S0003-9993(24)00949-3. [PMID: 38663576 DOI: 10.1016/j.apmr.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES To identify the range of evidence for relationships between psychological factors using the Fear Avoidance Model (FAM) as a guiding framework and relevant clinical outcomes in adult patients with persisting symptoms after concussion (PSaC), develop a comprehensive understanding of psychological factors that have been identified as predictors of clinical outcomes for PSaC, and contribute to the theoretical framework of the FAM for PSaC. DATA SOURCES Six databases (CINAHL, Embase, PsycINFO, PubMed, SportDiscus, and Web of Science) were searched by a librarian for empirical and theoretical publications and experimental and quasi-experimental study designs. The literature search was not limited by publication date restrictions. Gray literature, with the exception of doctoral dissertations, was excluded. STUDY SELECTION We included studies in the English language consisting of human participants aged ≥18 years. Articles must have included both outcomes pertaining to PSaC (≥3mo after injury) and psychological constructs. DATA EXTRACTION One reviewer extracted data from the resulting studies using a standardized data extraction form designed for this review. Two reviewers independently assessed risk of bias using the Quality in Prognosis Studies tool. DATA SYNTHESIS This review found numerous psychological constructs, some directly linked to the FAM, that have potential prognostic relationships with PSaC. However, research remains limited and some psychological factors central to FAM were only identified in a small number of studies (catastrophizing, cogniphobia, and avoidance), whereas other psychological factors were studied more extensively (anxiety and depression). CONCLUSIONS There is the need for additional evidence, and this integrative review provides an adaptation of the FAM for PSaC to be used as a guiding preliminary framework for future research. Future research should aim to include psychological factors proposed in this modified FAM to fully understand PSaC.
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Affiliation(s)
- Katherine E Buzzanca-Fried
- Department of Rehabilitation Science, University of Florida, Gainesville, FL; Brooks Rehabilitation, Jacksonville, FL; Brooks Rehabilitation Clinical Research Center, Brooks Rehabilitation, Jacksonville, FL.
| | - Aliyah R Snyder
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Russell M Bauer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | | | - Christopher Perez de Corcho
- Brooks Rehabilitation, Jacksonville, FL; Brooks Rehabilitation Clinical Research Center, Brooks Rehabilitation, Jacksonville, FL
| | - Russell Addeo
- Department of Behavioral Medicine, Brooks Rehabilitation, Jacksonville, FL
| | - Sarah M Lahey
- Department of Behavioral Medicine, Brooks Rehabilitation, Jacksonville, FL
| | - Zachary Houck
- Department of Behavioral Medicine, Brooks Rehabilitation, Jacksonville, FL
| | - Jason M Beneciuk
- Brooks Rehabilitation, Jacksonville, FL; Brooks Rehabilitation Clinical Research Center, Brooks Rehabilitation, Jacksonville, FL; Department of Physical Therapy, University of Florida, Gainesville, FL, United States
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Toniolo J, Ngoungou EB, Preux PM, Beloni P. Role and knowledge of nurses in the management of non-communicable diseases in Africa: A scoping review. PLoS One 2024; 19:e0297165. [PMID: 38635822 PMCID: PMC11025970 DOI: 10.1371/journal.pone.0297165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 12/30/2023] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND 31.4 million people in low- and middle-income countries die from chronic diseases annually, particularly in Africa. To address this, strategies such as task-shifting from doctors to nurses have been proposed and have been endorsed by the World Health Organization as a potential solution; however, no comprehensive review exists describing the extent of nurse-led chronic disease management in Africa. AIMS This study aimed to provide a thorough description of the current roles of nurses in managing chronic diseases in Africa, identify their levels of knowledge, the challenges, and gaps they encounter in this endeavor. METHODS We performed a scoping review following the key points of the Cochrane Handbook, and two researchers independently realized each step. Searches were conducted using five databases: MEDLINE, PyscINFO, CINAHL, Web of Science, and Embase, between October 2021 and April 2023. A descriptive analysis of the included studies was conducted, and the quality of the studies was assessed using the Downs and Black Scale. RESULTS Our scoping review included 111 studies from 20 African countries, with South Africa, Nigeria, and Ghana being the most represented. Findings from the included studies revealed varying levels of knowledge. Nurses were found to be actively involved in managing common chronic diseases from diagnosis to treatment. Facilitating factors included comprehensive training, close supervision by physicians, utilization of decision trees, and mentorship. However, several barriers were identified, such as a shortage of nurses, lack of essential materials, and inadequate initial training. CONCLUSION There is significant potential for nurses to enhance the screening, diagnosis, and treatment of chronic diseases in Africa. Achieving this requires a combination of rigorous training and effective supervision, supported by robust policies. To address varying levels of knowledge, tailored training programs should be devised. Further research is warranted to establish the effectiveness of nurse-led interventions on population health outcomes.
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Affiliation(s)
- Jean Toniolo
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Département d’Epidémiologie Biostatistiques et Informatique Médicale (DEBIM)/ Unité de Recherche en Epidémiologie des Maladies Chroniques et Santé Environnement (UREMCSE), Faculté de Médecine, Université des Sciences de la Santé, Owendo, Gabon
- Département Universitaire de Sciences Infirmières, Faculté de Médecine et Pharmacie, Université de Limoges, Limoges, France
| | - Edgard Brice Ngoungou
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Département d’Epidémiologie Biostatistiques et Informatique Médicale (DEBIM)/ Unité de Recherche en Epidémiologie des Maladies Chroniques et Santé Environnement (UREMCSE), Faculté de Médecine, Université des Sciences de la Santé, Owendo, Gabon
- Centre d’Epidémiologie, de Biostatistique, et de Méthodologie de la Recherche-Gabon (CEBIMER-Gabon), Institut Supérieur de Biologie Médicale (ISBM), Université des Sciences de la Santé, Owendo, Gabon
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pascale Beloni
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Département Universitaire de Sciences Infirmières, Faculté de Médecine et Pharmacie, Université de Limoges, Limoges, France
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Pomey MP, Jutras-Aswad D, Paquette J, Saadi K, Taguemout M, Ikene DL, Arbour N, Zertal A, Fréjeau N, Morin D, Ouellette JS, Alami Marrouni K, Duquette P. Perceptions and engagement of patients with chronic conditions on the use of medical cannabis: a scoping review. Eur J Med Res 2024; 29:211. [PMID: 38561859 PMCID: PMC10983766 DOI: 10.1186/s40001-024-01803-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
CONTEXT Studies generally focus on one type of chronic condition and the effect of medical cannabis (MC) on symptoms; little is known about the perceptions and engagement of patients living with chronic conditions regarding the use of MC. OBJECTIVES This scoping review aims to explore: (1) what are the dimensions addressed in studies on MC that deal with patients' perceptions of MC? and (2) how have patients been engaged in developing these studies and their methodologies? Through these objectives, we have identified areas for improving future research. METHODS We searched five databases and applied exclusion criteria to select relevant articles. A thematic analysis approach was used to identify the main themes: (1) reasons to use, to stop using or not to use MC, (2) effects of MC on patients themselves and empowerment, (3) perspective and knowledge about MC, and (4) discussion with relatives and healthcare professionals. RESULTS Of 53 articles, the main interest when assessing the perceptions of MC is to identify the reasons to use MC (n = 39), while few articles focused on the reasons leading to stop using MC (n = 13). The majority (85%) appraise the effects of MC as perceived by patients. Less than one third assessed patients' sense of empowerment. Articles determining the beliefs surrounding and knowledge of MC (n = 41) generally addressed the concerns about or the comfort level with respect to using MC. Only six articles assessed patients' stereotypes regarding cannabis. Concerns about stigma constituted the main topic while assessing relationships with relatives. Some articles included patients in the research, but none of them had co-created the data collection tool with patients. CONCLUSIONS Our review outlined that few studies considered chronic diseases as a whole and that few patients are involved in the co-construction of data collection tools as well. There is an evidence gap concerning the results in terms of methodological quality when engaging patients in their design. Future research should evaluate why cannabis' effectiveness varies between patients, and how access affects the decision to use or not to use MC, particularly regarding the relationship between patients and healthcare providers. Future research should consider age and gender while assessing perceptions and should take into consideration the legislation status of cannabis as these factors could in fact shape perception. To reduce stigma and stereotypes about MC users, better quality and accessible information on MC should be disseminated.
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Affiliation(s)
- Marie-Pascale Pomey
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada.
- School of Public Health, Department of Health Management, Evaluation of Policy, Université de Montréal, 7101 Du Parc Avenue 3rd Floor, Montréal, QC, H3N 1X9, Canada.
- Centre of Excellence on Partnership with Patients and the Public, Montréal, QC, Canada.
| | - Didier Jutras-Aswad
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, QC, Canada
| | - Jesseca Paquette
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
| | - Kamilla Saadi
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Anthropology, Université de Montréal, Montréal, QC, Canada
| | - Mélissa Taguemout
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Dina-Liza Ikene
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Nathalie Arbour
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Amel Zertal
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Nathalie Fréjeau
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
| | - Danielle Morin
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
| | - Jean-Sylvain Ouellette
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Multiple Sclerosis Society of Canada, Toronto, ON, Canada
| | - Kanza Alami Marrouni
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Pierre Duquette
- University of Montreal Hospital Research Centre (CRCHUM), Montréal, QC, Canada
- Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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15
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Beaney T. Is consensus attainable on the definition of multiple long term conditions? BMJ 2024; 384:q230. [PMID: 38453185 DOI: 10.1136/bmj.q230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
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16
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McGhee WRG, Doherty CJ, Graham-Wisener L, Fallis R, Stone C, Axiaq A, Dempster M. Immersive virtual reality and psychological well-being in adult chronic physical illness: systematic review. BMJ Support Palliat Care 2024; 14:14-24. [PMID: 37848219 DOI: 10.1136/spcare-2023-004502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/11/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION Individuals with chronic physical illness are at increased risk of negative psychological sequelae. Immersive virtual reality (VR) is an emerging treatment that might reduce these negative effects and increase quality of life in individuals with chronic physical illness. OBJECTIVE To systematically review literature examining the use of immersive VR in adult populations with chronic physical illness to understand: (1) how immersive VR is used to improve psychological well-being of adults with chronic physical illness (2) what effect this immersive VR has on the psychological well-being of adults with chronic physical illness. DESIGN Systematic literature review and meta-analysis. Searches of Ovid Medline/PubMed, PsycINFO, Embase, Web of Science and Scopus between July 1993 and March 2023 inclusive. RESULTS 12 811 texts were identified; 31 met the inclusion criteria. Relaxing and engaging immersive VR interventions were shown to be acceptable and feasible among adults with cancer, dementia, cardiovascular disease, kidney disease and multiple sclerosis. Many of the studies reviewed were feasibility or pilot studies and so the evidence about effectiveness is more limited. The evidence, mostly from studies of people with cancer, suggests that immersive VR can have a positive effects on anticipatory anxiety symptoms and pain. CONCLUSIONS Environment-based and game-based relaxing immersive VR offer novel interventions, with beneficial effects among people with cancer and, potentially, beneficial effects in those with other long-term physical illness.
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Affiliation(s)
| | | | | | | | | | - Ariana Axiaq
- Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, Belfast, UK
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Beaney T, Clarke J, Woodcock T, Majeed A, Barahona M, Aylin P. Effect of timeframes to define long term conditions and sociodemographic factors on prevalence of multimorbidity using disease code frequency in primary care electronic health records: retrospective study. BMJ MEDICINE 2024; 3:e000474. [PMID: 38361663 PMCID: PMC10868275 DOI: 10.1136/bmjmed-2022-000474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 12/12/2023] [Indexed: 02/17/2024]
Abstract
Objective To determine the extent to which the choice of timeframe used to define a long term condition affects the prevalence of multimorbidity and whether this varies with sociodemographic factors. Design Retrospective study of disease code frequency in primary care electronic health records. Data sources Routinely collected, general practice, electronic health record data from the Clinical Practice Research Datalink Aurum were used. Main outcome measures Adults (≥18 years) in England who were registered in the database on 1 January 2020 were included. Multimorbidity was defined as the presence of two or more conditions from a set of 212 long term conditions. Multimorbidity prevalence was compared using five definitions. Any disease code recorded in the electronic health records for 212 conditions was used as the reference definition. Additionally, alternative definitions for 41 conditions requiring multiple codes (where a single disease code could indicate an acute condition) or a single code for the remaining 171 conditions were as follows: two codes at least three months apart; two codes at least 12 months apart; three codes within any 12 month period; and any code in the past 12 months. Mixed effects regression was used to calculate the expected change in multimorbidity status and number of long term conditions according to each definition and associations with patient age, gender, ethnic group, and socioeconomic deprivation. Results 9 718 573 people were included in the study, of whom 7 183 662 (73.9%) met the definition of multimorbidity where a single code was sufficient to define a long term condition. Variation was substantial in the prevalence according to timeframe used, ranging from 41.4% (n=4 023 023) for three codes in any 12 month period, to 55.2% (n=5 366 285) for two codes at least three months apart. Younger people (eg, 50-75% probability for 18-29 years v 1-10% for ≥80 years), people of some minority ethnic groups (eg, people in the Other ethnic group had higher probability than the South Asian ethnic group), and people living in areas of lower socioeconomic deprivation were more likely to be re-classified as not multimorbid when using definitions requiring multiple codes. Conclusions Choice of timeframe to define long term conditions has a substantial effect on the prevalence of multimorbidity in this nationally representative sample. Different timeframes affect prevalence for some people more than others, highlighting the need to consider the impact of bias in the choice of method when defining multimorbidity.
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Affiliation(s)
- Thomas Beaney
- Department of Primary Care and Public Health, Imperial College London, London, UK
- Department of Mathematics, Imperial College London, London, UK
| | - Jonathan Clarke
- Department of Mathematics, Imperial College London, London, UK
| | - Thomas Woodcock
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Azeem Majeed
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | | | - Paul Aylin
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Riecke F, Bauer L, Polzer H, Baumbach SF, Neuerburg C, Böcker W, Grill E, Saller MM. Effects of medical interventions on health-related quality of life in chronic disease - systematic review and meta-analysis of the 19 most common diagnoses. Front Public Health 2024; 12:1313685. [PMID: 38379671 PMCID: PMC10878130 DOI: 10.3389/fpubh.2024.1313685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
Introduction The demographic shift leads to a tremendous increase in age-related diseases, which are often chronic. Therefore, a focus of chronic disease management should be set on the maintenance or even improvement of the patients' quality of life (QoL). One indicator to objectively measure QoL is the EQ-5D questionnaire, which was validated in a disease- and world region-specific manner. The aim of this study was to conduct a systematic literature review and meta-analysis on the QoL across the most frequent chronic diseases that utilized the EQ-5D and performed a disease-specific meta-analysis for treatment-dependent QoL improvement. Materials and methods The most common chronic disease in Germany were identified by their ICD-10 codes, followed by a systematic literature review of these ICD-10 codes and the EQ-5D index values. Finally, out of 10,016 independently -screened studies by two persons, 538 studies were included in the systematic review and 216 studies in the meta-analysis, respectively. Results We found significant medium to large effect sizes of treatment effects, i.e., effect size >0.5, in musculoskeletal conditions with the exception of fractures, for chronic depression and for stroke. The effect size did not differ significantly from zero for breast and lung cancer and were significantly negative for fractures. Conclusion Our analysis showed a large variation between baseline and post-treatment scores on the EQ-5D health index, depending on the health condition. We found large gains in health-related quality of life mainly for interventions for musculoskeletal disease. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020150936, PROSPERO identifier CRD42020150936.
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Affiliation(s)
- Franziska Riecke
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
| | - Leandra Bauer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
- Department of Orthopaedics, University Hospital Jena, Campus Eisenberg, Waldkliniken Eisenberg, Eisenberg, Germany
| | - Hans Polzer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
| | - Sebastian Felix Baumbach
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
| | - Carl Neuerburg
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
| | - Wolfgang Böcker
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
| | - Eva Grill
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU, Munich, Germany
| | - Maximilian Michael Saller
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Ludwig-Maximilians-University (LMU) Hospital, Munich, Germany
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Spencer BKC, Hugh-Jones S, Cottrell D, Pini S. The INSCHOOL project: Young people with long-term physical health conditions: An in-depth qualitative study of their needs at school. J Adolesc 2024; 96:337-349. [PMID: 38013246 DOI: 10.1002/jad.12278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION The INSCHOOL project aimed to understand the school experiences and unmet needs of young people across a diversity of long-term physical health conditions. METHODS Young people aged 11-18 years, in mainstream secondary school in the United Kingdom, with one of 11 physical health conditions were invited to unique participant-driven interviews, focus groups, or written activities. Creative preparation activities were provided to give participants increased control over the data collection and prioritize their voices. A needs analysis, in combination with participatory analysis sessions with young people, identified the common needs of participants in relation to their school lives. RESULTS Eighty-nine young people participated from April 2022 to 2023. Analysis of their transcripts defined six common needs across all the health conditions: Need to safely manage my health at school; need for a flexible education pathway; need to be acknowledged and listened to in the right way; need to be included in and supported by the school community; need to build toward my future; need to develop attitudes and approaches to help me cope in school. CONCLUSIONS This study has generated new, actionable knowledge by identifying six major needs that young people have in relation to the intersection of their health condition and their school life. This paper shows that a commonalities approach to research and policy development is warranted given the similarities in experiences and needs. The common needs identified in the INSCHOOL project highlight six areas where future interventions could be targeted to begin making meaningful changes for all young people with long-term health conditions.
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Affiliation(s)
| | | | - David Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Simon Pini
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Ge Y, Zheng C, Wang X, Liu T. Psychometric properties of the Chinese version of the health behavior motivation scale: a translation and validation study. Front Psychol 2024; 15:1279816. [PMID: 38298519 PMCID: PMC10827909 DOI: 10.3389/fpsyg.2024.1279816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
Objective This study's objectives were to translate the Health Behavior Motivation Scale (HBMS) into Chinese and verify the scale's validity and reliability among Chinese healthy adults. Method The HBMS scales were translated into Chinese based on Brislin's principles. The Chinese version of HBMS is created through translation, back translation, and cross-cultural adaptation. This investigation implemented the convenience sampling method to conduct a survey on 781 healthy respondents, utilizing the Chinese version of the HBMS and a general demographic questionnaire. We used AMOS (v28.0) and SPSS (v26.0) for statistical analysis. We employed test-retest reliability, split-half reliability, and internal consistency to assess the reliability of the translation questionnaire. Structure validity and content validity were used to assess validity. Results The Chinese version of the Health Behavior Motivation Scale (HBMS) had a Cronbach's alpha coefficient of 0.885, and the range of Cronbach's alpha values for each dimension was 0.820-0.885. The scale's test-retest reliability was 0.824, and its split-half reliability was 0.906. Five public factors with a cumulative variance contribution of 56.527% were retrieved from the exploratory factor analysis. Moreover, the factor loading value for each item exceeded 0.4.In confirmatory factor analysis, the indicators were reported as follows: χ2/df = 1.567, GFI = 0.900, CFI = 0.952, IFI = 0.952, TLI = 0.946, AGFI = 0.881, PGFI = 0.757, PNFI = 0.789, RMSEA = 0.039, and the results of the model fit metrics were within the reference range. Conclusion The Chinese version of the HBMS exhibits strong discrimination, validity, and reliability. The tool effectively identifies the motivation of healthy people to engage in healthy behaviors. It can be used by healthcare practitioners to assist in the development of follow-up interventions to reduce the prevalence of chronic disease in older people and the incidence of chronic disease in populations of young and middle-aged people.
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Affiliation(s)
- Yuanhui Ge
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Chen Zheng
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
| | - Xin Wang
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
- Nursing Department of Huaian Hospital of Huaian City, Huaian, China
| | - Tao Liu
- Department of Nursing, Jinzhou Medical University, Jinzhou, China
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21
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Huang CH, Yu S, Yu HS, Tu HP, Yeh YT, Yu HS. Chronic blue light-emitting diode exposure harvests gut dysbiosis related to cholesterol dysregulation. Front Cell Infect Microbiol 2024; 13:1320713. [PMID: 38259967 PMCID: PMC10800827 DOI: 10.3389/fcimb.2023.1320713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Night shift workers have been associated with circadian dysregulation and metabolic disorders, which are tightly coevolved with gut microbiota. The chronic impacts of light-emitting diode (LED) lighting at night on gut microbiota and serum lipids were investigated. Male C57BL/6 mice were exposed to blue or white LED lighting at Zeitgeber time 13.5-14 (ZT; ZT0 is the onset of "lights on" and ZT12 is the "lights off" onset under 12-hour light, 12-hour dark schedule). After 33 weeks, only the high irradiance (7.2 J/cm2) of blue LED light reduced the alpha diversity of gut microbiota. The high irradiance of white LED light and the low irradiance (3.6 J/cm2) of both lights did not change microbial alpha diversity. However, the low irradiance, but not the high one, of both blue and white LED illuminations significantly increased serum total cholesterol (TCHO), but not triglyceride (TG). There was no significant difference of microbial abundance between two lights. The ratio of beneficial to harmful bacteria decreased at a low irradiance but increased at a high irradiance of blue light. Notably, this ratio was negatively correlated with serum TCHO but positively correlated with bile acid biosynthesis pathway. Therefore, chronic blue LED lighting at a high irradiance may harvest gut dysbiosis in association with decreased alpha diversity and the ratio of beneficial to harmful bacteria to specifically dysregulates TCHO metabolism in mice. Night shift workers are recommended to be avoid of blue LED lighting for a long and lasting time.
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Affiliation(s)
- Cheng-Hsieh Huang
- Ph. D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Kaohsiung, Taiwan
- Aging and Disease Prevention Research Center, Fooyin University, Kaohsiung, Taiwan
| | - Sebastian Yu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsu-Sheng Yu
- Department of Food Science, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Tsung Yeh
- Aging and Disease Prevention Research Center, Fooyin University, Kaohsiung, Taiwan
- Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, Taiwan
| | - Hsin-Su Yu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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22
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Altieri M, Sergi MR, Tommasi M, Santangelo G, Saggino A. The efficacy of telephone-delivered cognitive behavioral therapy in people with chronic illnesses and mental diseases: A meta-analysis. J Clin Psychol 2024; 80:223-254. [PMID: 37428900 DOI: 10.1002/jclp.23563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 03/20/2023] [Accepted: 06/10/2023] [Indexed: 07/12/2023]
Abstract
COVID-19 pandemic led to an increase of remote treatments, such as telephone-delivery cognitive behavioral therapy (T-CBT). To our knowledge, no meta-analyses studied the effect of T-CBT in chronic and/or mental illnesses on multiple psychological outcomes. Therefore, our study aims to evaluating the efficacy of T-CBT compared to other interventions (treatment as usual, TAU, or face-to-face CBT). Each effect size (ES) was calculated in Hedges' g and pooled together to produce a mean ES for each outcome (depression, anxiety, mental and physical QoL, worry, coping, and sleep disturbances). The meta-analysis included 33 studies with a randomized controlled trial design. A large ES was found when comparing the efficacy of T-CBT against TAU on depression (g = 0.84, p < 0.001), whereas a moderate ES was found on anxiety (g = 0.57; p < 0.001), and a small effect on mental quality of life (g = 0.33, p < 0.001), sleep disturbances (g = 0.37, p = 0.042), coping (g = 0.20, p = 0.016) and worry (g = 0.43, p = 0.001). The meta-analysis comparing the efficacy of T-CBT and CBT on depression revealed a not significant pooled ES (g = 0.06, p = 0.466). The results provided evidence that T-CBT could be to be more effective than TAU conditions in multiple psychological outcomes, and as efficient as face-to-face CBT in treating depression.
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Affiliation(s)
- Manuela Altieri
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Maria R Sergi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Marco Tommasi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Aristide Saggino
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
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23
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Popa AE, Bejenaru A, Mitrea EC, Morândău F, Pogan L. Return to work after chronic disease: A theoretical framework for understanding the worker-employer dynamic. Chronic Illn 2023; 19:704-718. [PMID: 35912437 DOI: 10.1177/17423953221117852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Return to work after chronic disease is important for workers, employers and society. The process, however, is challenging. This article provides an analytical and theoretical framework for explaining this process informed by the person-environment fit theory. METHODS This article uses a narrative method to (1) review the key concepts, benefits and influencing factors in the literature on return to work after chronic diseases, (2) analyse and critique the most important theoretical models used for explaining return to work after chronic diseases, and (3) review the person-environment fit theory and how it has been used so far. RESULTS The existing models highlight different aspects, but they overlook the relationship between the worker and the employer. An analytical and theoretical framework is proposed to comprehensively explain the worker-employer dynamic. The framework also considers the role of broader factors (policy, labour market) and other stakeholders (health professionals, civil society actors) emphasising the idea that return to work is a phased and cyclical process. DISCUSSION The framework can be used to guide future qualitative and quantitative studies, or as a map for identifying problematic areas related to the worker or the work environment. The model should be empirically tested in future studies.
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Affiliation(s)
- Adela Elena Popa
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Anca Bejenaru
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Elena Cristina Mitrea
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Felicia Morândău
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Livia Pogan
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
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24
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Rydland HT, Bentsen HL, Ervik R, Grønning K, Islam K, Kjerstad E, Skogedal Lindén T. Promoting labour market inclusion of the chronically ill: a scoping review of Scandinavian countries' efforts. Scand J Public Health 2023; 51:1097-1107. [PMID: 35535443 PMCID: PMC10642227 DOI: 10.1177/14034948221096005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This article is a scoping review of efforts in labour market inclusion of the chronically ill in the Scandinavian countries, a research area that has received much political as well as research attention in recent years. The aim of the review was to identify promising strategies and the need for further research. METHODS Six electronic databases were searched for literature published between 2015 and 2020. We included peer-reviewed articles that studied the effect of measures, aimed at the workplace or at the individual, that are intended to increase participation. Our search resulted in 2718 articles; our screening procedures resulted in 47 included articles. RESULTS Among the included studies, musculoskeletal problems (17 articles) and mental health problems (29 articles) were the most frequent chronic conditions. Multimodal occupational rehabilitation programmes directed towards the individual employee were the most frequent interventions (30 articles). Return to work (24 articles) and sickness absence (12 articles) were the most common outcomes. About half (25 articles) of the included studies reported a positive impact of the intervention on work inclusion of the chronically ill. CONCLUSIONS Our review found little evidence of how government programmes directed towards the supply side of the labour market succeed in including the chronically ill. Our review further indicated that multidisciplinary workplace interventions have a substantial effect. We also identified a significant lack of research on the effect of various governmental policies and programmes, including local health, work and welfare services, and limited coordination and cooperation between health and work services professions.
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Affiliation(s)
| | | | - Rune Ervik
- NORCE Norwegian Research Centre AS, Bergen, Norway
| | - Kjersti Grønning
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kamrul Islam
- NORCE Norwegian Research Centre AS, Bergen, Norway
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25
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Thomas S, Byrne LK, Ryan NP, Hendrieckx C, White V. Unmet supportive care needs in families of children with chronic health conditions: an Australian cross-sectional study. World J Pediatr 2023; 19:1181-1191. [PMID: 37246167 PMCID: PMC10225288 DOI: 10.1007/s12519-023-00730-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/01/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The aim of this study was to identify similarities and differences in the unmet supportive care needs (USCN) of families of children with major chronic health conditions (CHCs) using a universal need assessment tool. METHODS A cross-sectional online survey involving parents of children with congenital heart disease (CHD), type 1 diabetes mellitus (T1D), cancer, and asthma diagnosed within the last 5 years recruited via social media and support organizations. Thirty-four items assessing the USCN across six domains (care needs, physical and social needs, informational needs, support needs, financial needs, child-related emotional needs) were responded to on a 4-point Likert scale [no need (1) to high need (4)]. Descriptive statistics identified the level of need, and linear regressions identified factors associated with higher need domain scores. Due to small numbers, the asthma group was excluded from comparisons across CHCs. RESULTS One hundred and ninety-four parents completed the survey (CHD: n = 97, T1D: n = 50, cancer: n = 39, and asthma: n = 8). Parents of children with cancer were most likely to report at least one USCN (92%), followed by parents of children with T1D (62%). The five most commonly reported USCN across CHCs were drawn from four domains: child-related emotional, support, care, and financial. Three need items were included in the top five needs for all conditions. A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support. CONCLUSIONS Using a universal need assessment tool, this is one of the first studies to characterize USCN in families of children diagnosed with common CHCs. While proportions endorsing different needs varied across conditions, the most endorsed needs were similar across the illness groups. This suggests that support programs or services could be shared across different CHCs. Video Abstract.
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Affiliation(s)
- Sangeetha Thomas
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, 3125, Australia.
| | - Linda K Byrne
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, 3125, Australia
| | - Nicholas P Ryan
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, 3125, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Christel Hendrieckx
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, 3125, Australia
- Australian Centre for Behavioural Research in Diabetes, Melbourne, VIC, Australia
- Institute of Health Transformation, Deakin University, Melbourne, VIC, Australia
| | - Victoria White
- School of Psychology, Faculty of Health, Deakin University, Melbourne, VIC, 3125, Australia.
- Cancer Council Victoria, Melbourne, VIC, Australia.
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26
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Badour B, Bull A, Gupta AA, Mirza RM, Klinger CA. Parental Involvement in the Transition from Paediatric to Adult Care for Youth with Chronic Illness: A Scoping Review of the North American Literature. Int J Pediatr 2023; 2023:9392040. [PMID: 38045800 PMCID: PMC10691897 DOI: 10.1155/2023/9392040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 10/23/2023] [Accepted: 11/11/2023] [Indexed: 12/05/2023] Open
Abstract
With medical advancements and improvements in medical technology, an increasing number of children with chronic conditions survive into adulthood. There is accordant growing interest toward supporting adolescents throughout the transition from paediatric to adult care. However, there is currently a paucity of research focusing on the role that these patients' parents should play during and after the transition to adult care and if maintained parental involvement is beneficial during this transition within a North American context. Accordingly, this scoping review utilized Arksey and O'Malley's five-step framework to consider parental roles during chronically ill children's transition to adult care. APA PsycInfo, CINAHL, EMBASE, MEDLINE, ProQuest, and Scopus were searched alongside advanced Google searches. Thematic content analysis was conducted on 30 articles meeting the following inclusion criteria: (1) published in English between 2010 and 2022, (2) conducted in Canada or the United States, (3) considered adolescents with chronic conditions transitioning to adult care, (4) family being noted in the title or abstract, and (5) patient populations of study not being defined by delays in cognitive development, nor mental illness. Three themes emerged from the literature: the impacts of maintaining parental involvement during transition to adult care for patients, parents experiencing feeling loss of stability and support surrounding the transition of their child's care, and significant nonmedical life events occurring for youths at the time of transition of care. Parents assuming supportive roles which change alongside their maturing child's needs were reported as being beneficial to young peoples' transition processes, while parents who hover over or micromanage their children during this time were found to hinder successful transitions. Ultimately, the majority of reviewed articles emphasized maintained parental involvement as having a net positive impact on adolescents' transitions to adult care. As such, practice and policies should be structured to engage parents throughout the transition process to best support their chronically ill children during this time of change.
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Affiliation(s)
- Bryn Badour
- Faculty of Arts and Science: Health Studies Program, University of Toronto, Toronto, Ontario, Canada M5S 3G3
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada M5S 1V4
| | - Amanda Bull
- Faculty of Arts and Science: Health Studies Program, University of Toronto, Toronto, Ontario, Canada M5S 3G3
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada M5S 1V4
| | - Abha A. Gupta
- Temerty Faculty of Medicine: Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada M5S 1A8
- Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8
- Division of Medical Oncology, University Health Network: Princess Margaret Cancer Centre, Toronto, Ontario, Canada M5G 2C1
| | - Raza M. Mirza
- Faculty of Arts and Science: Health Studies Program, University of Toronto, Toronto, Ontario, Canada M5S 3G3
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada M5S 1V4
- Temerty Faculty of Medicine: Translational Research Program, University of Toronto, Toronto, Ontario, Canada M5S 1A8
- Factor-Inwentash Faculty of Social Work: Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada M5S 1V4
| | - Christopher A. Klinger
- Faculty of Arts and Science: Health Studies Program, University of Toronto, Toronto, Ontario, Canada M5S 3G3
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada M5S 1V4
- Temerty Faculty of Medicine: Translational Research Program, University of Toronto, Toronto, Ontario, Canada M5S 1A8
- Factor-Inwentash Faculty of Social Work: Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada M5S 1V4
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27
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Cáceres C, Heusser B, Garnham A, Moczko E. The Major Hypotheses of Alzheimer's Disease: Related Nanotechnology-Based Approaches for Its Diagnosis and Treatment. Cells 2023; 12:2669. [PMID: 38067098 PMCID: PMC10705786 DOI: 10.3390/cells12232669] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 09/19/2023] [Indexed: 12/18/2023] Open
Abstract
Alzheimer's disease (AD) is a well-known chronic neurodegenerative disorder that leads to the progressive death of brain cells, resulting in memory loss and the loss of other critical body functions. In March 2019, one of the major pharmaceutical companies and its partners announced that currently, there is no drug to cure AD, and all clinical trials of the new ones have been cancelled, leaving many people without hope. However, despite the clear message and startling reality, the research continued. Finally, in the last two years, the Food and Drug Administration (FDA) approved the first-ever medications to treat Alzheimer's, aducanumab and lecanemab. Despite researchers' support of this decision, there are serious concerns about their effectiveness and safety. The validation of aducanumab by the Centers for Medicare and Medicaid Services is still pending, and lecanemab was authorized without considering data from the phase III trials. Furthermore, numerous reports suggest that patients have died when undergoing extended treatment. While there is evidence that aducanumab and lecanemab may provide some relief to those suffering from AD, their impact remains a topic of ongoing research and debate within the medical community. The fact is that even though there are considerable efforts regarding pharmacological treatment, no definitive cure for AD has been found yet. Nevertheless, it is strongly believed that modern nanotechnology holds promising solutions and effective clinical strategies for the development of diagnostic tools and treatments for AD. This review summarizes the major hallmarks of AD, its etiological mechanisms, and challenges. It explores existing diagnostic and therapeutic methods and the potential of nanotechnology-based approaches for recognizing and monitoring patients at risk of irreversible neuronal degeneration. Overall, it provides a broad overview for those interested in the evolving areas of clinical neuroscience, AD, and related nanotechnology. With further research and development, nanotechnology-based approaches may offer new solutions and hope for millions of people affected by this devastating disease.
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Affiliation(s)
| | | | | | - Ewa Moczko
- Facultad de Ingeniería y Ciencias, Universidad Adolfo Ibáñez, Viña del Mar 2562307, Chile; (C.C.)
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Bunæs-Næss H, Kvæl LAH, Nilsson BB, Heywood S, Heiberg KE. Aquatic high-intensity interval training (HIIT) may be similarly effective to land-based HIIT in improving exercise capacity in people with chronic conditions: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2023; 9:e001639. [PMID: 38022764 PMCID: PMC10649609 DOI: 10.1136/bmjsem-2023-001639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 11/19/2023] Open
Abstract
Objective To investigate the effect of aquatic high-intensity interval training (AHIIT) on exercise capacity in people with chronic conditions. Design Systematic review and meta-analysis. Participants Adults (age ≥18 years) with any chronic conditions (long duration, continuing health problems). Data sources The databases Medline, EMBASE, CINAHL, SPORTSDiscus, PEDro and The Cochrane Library were searched from inception to 11 August 2023. Eligibility criteria Randomised or non-randomised controlled trials of adults reporting one or more chronic conditions were included, comparing the effect of AHIIT with a non-exercising control group, land-based high-intensity interval training (LBHIIT) or aquatic moderate-intensity continuous training (AMICT). Results Eighteen trials with 868 participants with chronic musculoskeletal, respiratory, cardiovascular, metabolic or neurological conditions were included. Adherence to AHIIT was high, ranging from 84% to 100%. There was moderate certainty in evidence according to the Grading of Recommendations Assessment, Development and Evaluation system for a moderate beneficial effect on exercise capacity standardised mean differences (SMD) 0.78 (95% CI 0.48 to 1.08), p<0.00001) of AHIIT compared with a non-exercising control group. There was moderate certainty in evidence for no difference of effects on exercise capacity (SMD 0.28 (95% CI -0.04 to 0.60), p=0.08) of AHIIT compared with LBHIIT. There was moderate certainty in evidence for small effect on exercise capacity (SMD 0.45 (95% CI 0.10 to 0.80), p=0.01) of AHIIT compared with AMICT. Conclusion There are beneficial effects of AHIIT on exercise capacity in people with a range of chronic conditions. AHIIT has similar effects on exercise capacity as LBHIIT and may represent an alternative for people unable to perform LBHIIT. PROSPERO registration number CRD42022289001.
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Affiliation(s)
- Heidi Bunæs-Næss
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Linda Aimée Hartford Kvæl
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Centre for Welfare and Labour Research, Norwegian Social Research, Oslo Metropolitan University, Oslo, Norway
| | - Birgitta Blakstad Nilsson
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
- Division of Medicine, Department of Clinical Services, Oslo University Hospital, Oslo, Norway
| | - Sophie Heywood
- Department of Physiotherapy, St Vincent's Hospital, St Vincent's Health Australia Ltd Fitzroy, Fitzroy, Victoria, Australia
- Department of Physiotherapy, University of Melbourne VCCC, Parkville, Victoria, Australia
| | - Kristi Elisabeth Heiberg
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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29
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Paltzat K, Scott S, Dhaliwal KK, Saunders-Smith T, Manns BJ, Campbell T, Ivers N, Pannu R, Campbell DJ. Patient Perspectives on a Tailored Self-Management Education and Support Intervention for Low-Income Seniors With Chronic Health Conditions. CJC Open 2023; 5:808-815. [PMID: 38020328 PMCID: PMC10679452 DOI: 10.1016/j.cjco.2023.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/07/2023] [Indexed: 12/01/2023] Open
Abstract
Background The Assessing Outcomes of Enhanced Chronic Disease Care Through Patient Education and a Value-based Formulary Study (ACCESS) was a 2 x 2 factorial randomized trial that tested the impact of a tailored self-management education support (SMES) program, which demonstrated a 22% reduction in adverse clinical events. We sought to qualitatively explore participants' perspectives on the SMES intervention, and the ways in which it may have improved self-management skills. Methods We used a qualitative descriptive approach and conducted individual semistructured interviews. We conducted inductive and deductive thematic analysis using NVivo 12 (QSR International, Burlington, MA). Results We interviewed 20 participants who had recently completed the 3-year SMES intervention. The following 3 main themes emerged from the data: (i) empowerment; (ii) intervention acceptability; and (iii) suggestions for improvement. Regarding empowerment, we identified subthemes of health literacy, self-efficacy, self-management, and active role in health. Several participants reported that empowerment promoted health behaviour change or improved confidence in self-management. Regarding acceptability, we identified subthemes of ease of use and presentation style. Most participants expressed positive feelings toward the intervention and felt that it was easy to understand. Finally, we identified subthemes of learning style, content, and engagement strategies, within the theme of suggestions for improvement. Some participants said that the messages were too general and did not fully address the complex health concerns they had. Conclusions Our results highlighted key strategies to promote patient engagement and self-management behaviours and demonstrated how they may have been used to improve clinical endpoints. Additionally, we demonstrated the novel use of marketing principles in SMES interventions.
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Affiliation(s)
- Kaitlyn Paltzat
- Global Studies Institute, Université de Genève, Geneva, Switzerland
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sara Scott
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kirnvir K. Dhaliwal
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Terry Saunders-Smith
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Braden J. Manns
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tavis Campbell
- Department of Psychology, Faculty of Science, University of Calgary, Calgary, Alberta, Canada
| | - Noah Ivers
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Raj Pannu
- Emergence Creative, New York, New York, USA
| | - David J.T. Campbell
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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30
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Wee J, Tan XR, Gunther SH, Ihsan M, Leow MKS, Tan DSY, Eriksson JG, Lee JKW. Effects of Medications on Heat Loss Capacity in Chronic Disease Patients: Health Implications Amidst Global Warming. Pharmacol Rev 2023; 75:1140-1166. [PMID: 37328294 DOI: 10.1124/pharmrev.122.000782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/20/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
Pharmacological agents used to treat or manage diseases can modify the level of heat strain experienced by chronically ill and elderly patients via different mechanistic pathways. Human thermoregulation is a crucial homeostatic process that maintains body temperature within a narrow range during heat stress through dry (i.e., increasing skin blood flow) and evaporative (i.e., sweating) heat loss, as well as active inhibition of thermogenesis, which is crucial to avoid overheating. Medications can independently and synergistically interact with aging and chronic disease to alter homeostatic responses to rising body temperature during heat stress. This review focuses on the physiologic changes, with specific emphasis on thermolytic processes, associated with medication use during heat stress. The review begins by providing readers with a background of the global chronic disease burden. Human thermoregulation and aging effects are then summarized to give an understanding of the unique physiologic changes faced by older adults. The effects of common chronic diseases on temperature regulation are outlined in the main sections. Physiologic impacts of common medications used to treat these diseases are reviewed in detail, with emphasis on the mechanisms by which these medications alter thermolysis during heat stress. The review concludes by providing perspectives on the need to understand the effects of medication use in hot environments, as well as a summary table of all clinical considerations and research needs of the medications included in this review. SIGNIFICANCE STATEMENT: Long-term medications modulate thermoregulatory function, resulting in excess physiological strain and predisposing patients to adverse health outcomes during prolonged exposures to extreme heat during rest and physical work (e.g., exercise). Understanding the medication-specific mechanisms of altered thermoregulation has importance in both clinical and research settings, paving the way for work toward refining current medication prescription recommendations and formulating mitigation strategies for adverse drug effects in the heat in chronically ill patients.
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Affiliation(s)
- Jericho Wee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Xiang Ren Tan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Samuel H Gunther
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Mohammed Ihsan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Melvin Khee Shing Leow
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Doreen Su-Yin Tan
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Johan G Eriksson
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine (J.W., X.R.T., S.H.G., M.I., M.K.S.L., J.G.E., J.K.W.L.), Department of Pharmacy, Faculty of Science, (D.S.-Y.T), Department of Physiology, Yong Loo Lin School of Medicine (J.K.W.L.), Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine (J.K.W.L.), National University of Singapore, Singapore; Health and Social Sciences, Singapore Institute of Technology, Singapore (X.R.T.); Campus for Research Excellence and Technological Enterprise, Singapore (S.H.G., J.K.W.L.); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (M.K.S.L.); Duke-National University of Singapore Medical School, Singapore (M.K.S.L.); Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital, Singapore (M.K.S.L.); Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore (M.K.S.L., J.G.E.); Folkhalsan Research Center, Helsinki, Finland (J.G.E.); Department of General Practice and Primary Health Care, University of Helsinki, and Helsinki University Hospital, University of Helsinki, Helsinki, Finland (J.G.E.); and Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore (J.G.E.)
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Thomas S, Ryan NP, Byrne LK, Hendrieckx C, White V. Unmet supportive care needs of families of children with chronic illness: A systematic review. J Clin Nurs 2023; 32:7101-7124. [PMID: 37353963 DOI: 10.1111/jocn.16806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 05/12/2023] [Accepted: 06/08/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND AND AIMS Unmet supportive care needs (SCN) refer to perceived gaps in the support parents want to manage caregiving activities for children with chronic health conditions (CHC) and the support received. This review aims to systematically identify the unmet SCN of families with children living with five common paediatric CHC and characterise the assessment tools used to measure SCN. DESIGN Systematic review methodology with narrative synthesis of data. Reporting followed the PRISMA statement guidelines. METHOD Literature searches were conducted in electronic databases Medline complete, PsycINFO, CINHAL and EMBASE to retrieve relevant articles published between 1990 and July 2022. Eligible studies involved (i) children aged 0-18 years diagnosed with either of cancer, congenital heart disease (CHD), diabetes, asthma, renal disease and (ii) assessment of unmet SCN. Studies involving children with genetic or developmental conditions were excluded. The methodological quality of studies was assessed using JBI assessment tool. RESULTS Of 6223 articles screened, 34 papers were included (25 quantitative, 5 qualitative and 4 mixed design). Most papers explored unmet needs of families with cancer (n = 26). The remaining articles concerned CHD (n = 5), asthma (n = 2) and mixed CHC (n = 1, renal failure, and diabetes). Information (e.g. treatment, lifestyle, etc.) and health care (e.g. emotional support, practical services, etc.) were the most common unmet need domains across health conditions. A variety of methods and need assessments hampered comparisons between studies both across and within CHC. CONCLUSION Irrespective of illness, addressing unmet informational or health care needs may help to optimise outcomes and care for children and families living with common CHC. There was considerable variation in reporting styles, study design and need assessments both within and across conditions. RELEVANCE TO CLINICAL PRACTICE Health care professionals must routinely evaluate the type, quality and quantity of psychoeducation and support that families of children with CHC want and receive. Providing nurses with more effective strategies to assess child and family needs across a broad range of domains may help to increase understanding of where further support for families is required. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution to this study as it involved a systematic review of existing literature.
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Affiliation(s)
- Sangeetha Thomas
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Nicholas P Ryan
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Linda K Byrne
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Christel Hendrieckx
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Melbourne, Victoria, Australia
- Institute of Health Transformation, Deakin University, Burwood, Victoria, Australia
| | - Victoria White
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Lattimer TA, Tenzek KE, Ophir Y. Shouts from the Void: A Mixed-Method Analysis Surrounding the Online Chronic Illness Community, NEISVoid. HEALTH COMMUNICATION 2023:1-12. [PMID: 37691142 DOI: 10.1080/10410236.2023.2250939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Chronic illness affects millions worldwide, rendering the life of those affected complex to manage. Extant research points to the need for effective and supportive care for the successful treatment, yet health care encounters for this population are often filled with negative experiences, ranging from discontinuity of care to disenfranchisement from providers. One such group dedicated to sharing struggles is the NEISVoid (No End In Sight) community on Twitter. Through the use of the hashtag, #NEISVoid, they come together to share what experiences living with chronic illness look like, in vulnerable and potentially unfiltered ways. The present study analyzes the discourse surrounding the hashtag #NEISVoid in tweets published from January 1 2020, until September 1 2022 (N = 450,914 tweets) using the mixed-method analysis of topic model network (ANTMN) approach. We identify and discuss four broad discursive themes: community experiences, symptom management, efficacy solutions, and biomedical health. We analyze this discourse through the chronic care model (CCM) and in light of research on hashtag activism. We discuss practical and theoretical implications for health communicators.
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Affiliation(s)
| | | | - Yotam Ophir
- Department of Communication, University at Buffalo
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Paul B, Kirubakaran R, Isaac R, Dozier M, Grant L, Weller D. A systematic review of the theory of planned behaviour interventions for chronic diseases in low health-literacy settings. J Glob Health 2023; 13:04079. [PMID: 37681679 PMCID: PMC10506128 DOI: 10.7189/jogh.13.04079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
Background Due to their chronicity, prolonged morbidity, and high mortality, chronic respiratory diseases (CRDs) pose a huge burden of disease globally, primarily among low- and middle-income countries. Most of these diseases can be controlled by early diagnosis and treatment, correct practice of medications, regular follow-up, and avoidance of risk factors, which involves a change in health behaviour among patients. The theory of planned behaviour (TPB) has been proven to be effective and has been used increasingly as a behavioural framework for designing and evaluating behaviour change interventions, although most such studies were on affluent populations and from the global north. We aimed to collate evidence of TPB-based behavioural interventions in low health literacy settings for its effectiveness and feasibility by conducting a systematic review (SR). Methods We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines in conducting and reporting this study. We selected interventional studies using at least two constructs of TPB for behaviour change in chronic disease patients and conducted in LMICs, used the PICO framework, and exported the retrieved studies through the Endnote software. We evaluated the studies using the Risk of Bias (RoB) 2 and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tools. Results We retrieved and reviewed the titles and abstracts 4281 titles and abstracts, identifying 186 articles for further detailed screening. Eleven studies met the criteria for a standardised independent full-text screening by two authors and four were selected for narrative synthesis. All studies were from urban settings, with established feasibility and fidelity; all interventions were effective in changing health behaviour and TPB constructs and provided structured education to participants in the intervention group (either face-to-face and through group education). Three studies had some concerns/moderate risk of bias and one had high risk of bias. Conclusions All studies demonstrated effectiveness, feasibility, and fidelity of TPB interventions in LMIC settings, although most were of moderate quality. Further studies should gather definitive evidence and prove their feasibility and utility in LMICs. Registration PROSPERO CRD42018104890.
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Affiliation(s)
- Biswajit Paul
- Christian Medical College Vellore, India
- University of Edinburgh, UK
| | | | - Rita Isaac
- Christian Medical College Vellore, India
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Nonaka K, Takubo K, Aida J, Watai Y, Komatsu A, Gomi F, Shichi Y, Yamazaki Y, Ishiwata T, Sasano H, Arai T. Accelerated telomere shortening in adrenal zona reticularis in patients with prolonged critical illness. Front Endocrinol (Lausanne) 2023; 14:1244553. [PMID: 37745694 PMCID: PMC10512174 DOI: 10.3389/fendo.2023.1244553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Background The number of patients with prolonged critical illness (PCI) has been increasing in many countries, and the adrenal gland plays an important role in maintaining homeostasis during PCI. Chronic disease burden is reportedly associated with shorter telomere lengths in human tissues. Telomere shortening in human somatic cells is largely dependent on cell divisions, and critically short telomeres lead to cellular dysfunction and aging. However, the association between PCI and telomere lengths in human adrenal cells is poorly understood. In this study, we investigated this association to assess whether the burden of PCI could accelerate the aging process in adrenal cells. Methods Adrenocortical tissues from patients who died after PCI usually show a diffuse pattern of intracellular cholesterol ester depletion (i.e., lipid depletion). This study examined near-normal adrenal glands obtained from autopsied patients who died suddenly (control group) and lipid-depleted adrenal glands obtained from autopsied patients who died after PCI (PCI group). The control group included 7 men aged 80 to 94 years (mean age: 85.3 years) and 7 women aged 84 to 94 years (mean age: 87.7 years). The PCI group included 10 men aged 71 to 88 years (mean age: 78.8 years) and 8 women aged 77 to 95 years (mean age: 85.6 years). By using quantitative fluorescence in situ hybridization, relative telomere lengths (RTLs) were determined in the parenchymal cells of the three adrenocortical zones (zona glomerulosa, zona fasciculata, and zona reticularis [ZR]) and in the chromaffin cells of the medulla. The number of adrenal parenchymal cells was determined by immunohistochemistry and digital image analysis. Results RTLs in ZR cells were significantly shorter in the PCI group than in the control group for both men and women (P = 0.0001 for men and P = 0.0012 for women). However, RTLs in the remaining three types of adrenal cells did not differ between the control and PCI groups for both men and women. The number of ZR cells was higher in the PCI group than in the control group for both men and women (P < 0.0001 for both men and women). The proportion of the number of ZR cells to the total number of adrenocortical parenchymal cells was also higher in the PCI group than in the control group (P < 0.0001 for both men and women). The Ki-67 proliferation index in ZR cells was higher in the PCI group than in the control group (P = 0.0039 for men and P = 0.0063 for women). Conclusions This study demonstrated ZR cell-specific telomere shortening in patients with adrenal lipid depletion who died after PCI. Our results suggest that the reactive proliferation of ZR cells accelerates the telomere shortening and aging process in ZR cells in these patients. The results of our study may contribute to the understanding of adrenal aging during PCI.
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Affiliation(s)
- Keisuke Nonaka
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Kaiyo Takubo
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Junko Aida
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yoriko Watai
- Department of Drug Discovery Support Business, Summit Pharmaceuticals International, Tokyo, Japan
| | - Akiko Komatsu
- Department of Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Fujiya Gomi
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuuki Shichi
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuto Yamazaki
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toshiyuki Ishiwata
- Division of Aging and Carcinogenesis, Research Team for Geriatric Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Hironobu Sasano
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
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Rohwer A, Toews I, Uwimana-Nicol J, Nyirenda JLZ, Niyibizi JB, Akiteng AR, Meerpohl JJ, Bavuma CM, Kredo T, Young T. Models of integrated care for multi-morbidity assessed in systematic reviews: a scoping review. BMC Health Serv Res 2023; 23:894. [PMID: 37612604 PMCID: PMC10463690 DOI: 10.1186/s12913-023-09894-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 08/10/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The prevalence of multi-morbidity is increasing globally. Integrated models of care present a potential intervention to improve patient and health system outcomes. However, the intervention components and concepts within different models of care vary widely and their effectiveness remains unclear. We aimed to describe and map the definitions, characteristics, components, and reported effects of integrated models of care in systematic reviews (SRs). METHODS We conducted a scoping review of SRs according to pre-specified methods (PROSPERO 2019 CRD42019119265). Eligible SRs assessed integrated models of care at primary health care level for adults and children with multi-morbidity. We searched in PubMed (MEDLINE), Embase, Cochrane Database of Systematic Reviews, Epistemonikos, and Health Systems Evidence up to 3 May 2022. Two authors independently assessed eligibility of SRs and extracted data. We identified and described common components of integrated care across SRs. We extracted findings of the SRs as presented in the conclusions and reported on these verbatim. RESULTS We included 22 SRs, examining data from randomised controlled trials and observational studies conducted across the world. Definitions and descriptions of models of integrated care varied considerably. However, across SRs, we identified and described six common components of integrated care: (1) chronic conditions addressed, (2) where services were provided, (3) the type of services provided, (4) healthcare professionals involved in care, (5) coordination and organisation of care and (6) patient involvement in care. We observed differences in the components of integrated care according to the income setting of the included studies. Some SRs reported that integrated care was beneficial for health and process outcomes, while others found no difference in effect when comparing integrated care to other models of care. CONCLUSIONS Integrated models of care were heterogeneous within and across SRs. Information that allows the identification of effective components of integrated care was lacking. Detailed, standardised and transparent reporting of the intervention components and their effectiveness on health and process outcomes is needed.
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Affiliation(s)
- Anke Rohwer
- Centre for Evidence-based Health Care, Division Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - Ingrid Toews
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | - Jeannine Uwimana-Nicol
- Centre for Evidence-based Health Care, Division Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - John L Z Nyirenda
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
| | | | - Ann R Akiteng
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Faculty of Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Charlotte M Bavuma
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Kigali University Teaching Hospital, Kigali, Rwanda
| | - Tamara Kredo
- South African Medical Research Council, Cochrane South Africa, Cape Town, South Africa
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Taryn Young
- Centre for Evidence-based Health Care, Division Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Mugo MG. The impact of health insurance enrollment on health outcomes in Kenya. HEALTH ECONOMICS REVIEW 2023; 13:42. [PMID: 37584819 PMCID: PMC10428604 DOI: 10.1186/s13561-023-00454-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 07/31/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND The achievement of the global agenda on universal health coverage (UHC) is pivotal in ensuring healthy lives and promoting the well-being of all. However, achieving healthy lives and wellbeing of all has been hampered by the challenge of health care financing. As such, healthcare financing, through health insurance is gaining popularity in developing countries such as Kenya, in their pursuit to achieve universal health coverage. The primary purpose of health insurance and delivery is to improve health. However, there is a paucity of evidence on the effectiveness of health insurance in improving the health outcomes and health status of the Kenyan population. Therefore, this study aimed to analyze the impact of health insurance on health outcomes in Kenya. METHODS The study utilized the most recent nationally representative Kenya Integrated Household Budget Survey (KIHBS) 2015/16 dataset in order to analyze the impact of health insurance on health outcomes. The instrumental variable 2-stage least squares (IV 2SLS) and control function approach (CFA) estimation techniques were used to cater for potential endogeneity and heterogeneity biases present in ordinary least squares (OLS) estimators. RESULTS Health insurance enrolment leads to a reduction in mortality, thereby improving the health status of the Kenyan population, despite low levels of insurance uptake. However, the insured population experienced higher chronic illnesses and out-of-pocket (OOP) expenditures raising concerns about financial risk protection. The fact that health insurance is linked to chronic illnesses not only reinforces the reverse causality of health insurance and health status, but also that the effects of potential adverse selection strongly drive the strength and direction of this impact. CONCLUSIONS We conclude that health insurance enrolment reduces mortality and hence has a beneficial impact in promoting health. Health insurance coverage therefore, should be promoted through the restructuring of the National Hospital Insurance Fund (NHIF) fragmented schemes and by consolidating the different insurance schemes to serve different population groups more effectively and equitably. The government should revisit the implementation of a universal social health insurance scheme, as a necessary step towards UHC, while continuing to offer subsidies in the form of health insurance to the marginalized, vulnerable and poor populations.
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Affiliation(s)
- Mercy G Mugo
- Department of Economics & Development Studies, University of Nairobi, P.O. Box 30197, 00100, Nairobi, Kenya.
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Belachew EA, Getachew D, Netere AK, Gizachew E, Sendekie AK. Perception, willingness, and practices of telemedicine in patients with chronic diseases: implication of digital health in patients' perspective at a tertiary care hospital in Ethiopia. Front Public Health 2023; 11:1234436. [PMID: 37608985 PMCID: PMC10440689 DOI: 10.3389/fpubh.2023.1234436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
Background Technology-based healthcare services have important implications for the diagnosis, prevention, and treatment of diseases, as well as providing access to high-quality care that both the patient and the healthcare practitioner can benefit from. To access medical information, patients have also searched for methods of technology-based healthcare services like telemedicine (TM). However, little is known regarding the perceptions, willingness, and practices of TM among Ethiopian patients, especially in the study setting. Objective This study assessed the perceptions, willingness, and practice of TM among patients with chronic disease at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methods A cross-sectional study was conducted from June 1 to July 30, 2022, among patients with chronic diseases who were on follow-up at the UoGCSH. Eligible participants were included in the study using a systematic random sampling technique. A structured questionnaire was used and recorded in the Kobo data collection tool. The collected data were managed and analyzed using the Statistical Package for Social Science (SPSS) version 26. Results Out of 422 patients approached, 384 (91% response rate) were included in the final analysis. The mean (±SD) age of the participants was 48.07 ± 16.17 years. The overall perceptions mean (±SD) score of the respondents was 3.92 ± 1.06. Generally, near to three-fourths (71.1%) of the participants had a positive perception of TM services, and around two-thirds (63.3%) had a willingness to be involved in the TM service. However, only around one-fourth (24.5%) of the participants were perceived to have a high level of TM practice currently. Conclusion The findings suggest that although the level of perception and willingness of TM services among patients with chronic diseases was positive, their level of practice was low. Therefore, creating awareness and suitable conditions to improve their utilization of TM could be important.
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Affiliation(s)
- Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demis Getachew
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adeladlew Kassie Netere
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eshetie Gizachew
- Department of Information System, College of Informatics, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Husson M, Dechartres A, Ramdjee B, Diverres M, Zejli T, L'Hénaff M, Jehanno E, Tubach F, Caille A. Patient and public involvement is suboptimal in randomized controlled trials addressing a chronic condition. J Clin Epidemiol 2023; 160:71-82. [PMID: 37356637 DOI: 10.1016/j.jclinepi.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVES To describe patient and public involvement (PPI) in randomized controlled trials (RCTs) addressing a chronic condition and to analyze whether PPI is associated with trial characteristics. STUDY DESIGN AND SETTING We used PubMed search to identify RCTs addressing a chronic condition and published in journals with a mandatory PPI statement. RESULTS Across 101 RCTs; 40 (40%) reported PPI at any stage of the research process. PPI contribution occurred mostly at the design stage of RCTs (n = 36), especially for assessing the burden of the intervention (n = 24), and at the conduct stage (n = 21), with the elaboration of communication materials (n = 14). Less than one-third (13/40) of RCTs included PPI in the development or choice of outcome measures. As compared with non-PPI RCTs, PPI RCTs more frequently were published in The BMJ, had a corresponding author from the United Kingdom, reported a public funding source, had a higher inclusion rate, used usual care as a control and evaluated a digital intervention. PPI RCTs were associated with less frequent use of placebo as a control group. CONCLUSION Our results underline that PPI is not uncommon in RCTs of chronic conditions but infrequently occurred at a key stage. Yet, the engagement of patients as a real partner in RCTs of chronic conditions should be enhanced.
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Affiliation(s)
- Mathilde Husson
- Département de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris 75013, France
| | - Agnès Dechartres
- Département de Santé Publique, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris 75013, France
| | - Bruno Ramdjee
- Département de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris 75013, France
| | - Maëlle Diverres
- Département de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Paris 75013, France
| | - Tarik Zejli
- INSERM, SPHERE U1246, Université de Tours, Université de Nantes, Tours, France; INSERM CIC 1415, CHRU de Tours, Tours Cedex 9 37044, France
| | - Marianne L'Hénaff
- Association de Recherche, de Communication et d'Action pour l'accès aux Traitements, Paris, France
| | - Eric Jehanno
- Association Nationale de Défense contre la Polyarthrite Rhumatoïde, Paris, France
| | - Florence Tubach
- Département de Santé Publique, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris 75013, France
| | - Agnès Caille
- Département de Santé Publique, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris 75013, France; INSERM, SPHERE U1246, Université de Tours, Université de Nantes, Tours, France; INSERM CIC 1415, CHRU de Tours, Tours Cedex 9 37044, France.
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Basnet R, Mendez DR, Lugo-González I, O'Hagan E, O'Keeffe M, Sharma S, Pate JW, Kennedy DS. Online information on chronic pain in 3 countries: an assessment of readability, credibility, and accuracy. Pain Rep 2023; 8:e1078. [PMID: 37342519 PMCID: PMC10278708 DOI: 10.1097/pr9.0000000000001078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives To assess the readability, credibility, and accuracy of online information on chronic pain in Australia, Mexico, and Nepal. Methods We assessed Google-based websites and government health websites about chronic pain for readability (using the Flesch Kincaid Readability Ease tool), credibility (using the Journal of American Medical Association [JAMA] benchmark criteria and Health on the Net Code [HONcode]), and accuracy (using 3 core concepts of pain science education: (1) pain does not mean my body is damaged; (2) thoughts, emotions, and experiences affect pain; and (3) I can retrain my overactive pain system). Results We assessed 71 Google-based websites and 15 government websites. There were no significant between-country differences in chronic pain information retrieved through Google for readability, credibility, or accuracy. Based on readability scores, the websites were "fairly difficult to read," suitable for ages 15 to 17 years or grades 10 to 12 years. For credibility, less than 30% of all websites met the full JAMA criteria, and more than 60% were not HONcode certified. For accuracy, all 3 core concepts were present in less than 30% of websites. Moreover, we found that the Australian government websites have low readability but are credible, and the majority provided all 3 core concepts in pain science education. A single Mexican government website had low readability without any core concepts but was credible. Conclusion The readability, credibility, and accuracy of online information on chronic pain should be improved internationally to support facilitating better management of chronic pain.
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Affiliation(s)
- Ritu Basnet
- Scheer Memorial Adventist Hospital, Benepa, Nepal
| | - David Ruiz Mendez
- Iztacala Faculty of Superior Studies, National Autonomous University of México, Tlalnepantla de Baz, Mexico
| | - Isaías Lugo-González
- Iztacala Faculty of Superior Studies, National Autonomous University of México, Tlalnepantla de Baz, Mexico
| | - Edel O'Hagan
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Mary O'Keeffe
- School of Public Health, Institute for Musculoskeletal Health, University of Sydney, Sydney, Australia
| | - Saurab Sharma
- Department of Exercise Physiology, School of Health Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, Australia
| | - Joshua W. Pate
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - David S. Kennedy
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
- Motion and Mobility Research Laboratory, University of Victoria, Victoria, BC, Canada
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Alizadeh N, Packer T, Chen YT, Alnasery Y. What we know about fatigue self-management programs for people living with chronic conditions: A scoping review. PATIENT EDUCATION AND COUNSELING 2023; 114:107866. [PMID: 37364380 DOI: 10.1016/j.pec.2023.107866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 06/08/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE The significant impact of fatigue on the lives of patients with chronic conditions has demanded a response. One response has been the development and testing of self-management programs. Little is known about what these programs have in common or how they differ. This scoping review compared the key components of fatigue self-management programs. METHODS Scoping review methodology was employed. Databases of CINAHL, Academic Search Premier, PsycINFO, Cochrane and Medline were searched to identify relevant sources. RESULTS Included fatigue programs were compared using a three-component framework: 1) self-management strategies; 2) active patient participation; and 3) self-management support. Although all programs included some aspects of these components, the extent varied with only a few domains of these components found across all programs. CONCLUSION The three self-management components employed in this study showed potential benefits in identifying similarities and differences across fatigue programs with comparable and distinct underlying theories. This three-component framework could facilitate identification of domains associated with positive outcomes. PRACTICE IMPLICATIONS It is essential that authors of programs provide detailed descriptions to enable inter-program comparison. The three-component framework chosen for this review was capable of describing and comparing fatigue self-management programs, paving the way for more effective interventions.
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Affiliation(s)
- Neda Alizadeh
- School of Occupational Therapy, Dalhousie University, Halifax, Canada
| | - Tanya Packer
- School of Health Administration, Dalhousie University, Halifax, Canada; Department of Nursing, Umea University, Umea, Sweden.
| | - Yu-Ting Chen
- Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Yaser Alnasery
- School of Occupational Therapy, Dalhousie University, Halifax, Canada; College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Ongenda ION, Mengistu Z, Tincello D, Williams C, Pitchforth E. Opinion: pelvic floor disorders: learning from chronicity & chronic care models. Front Glob Womens Health 2023; 4:1006693. [PMID: 37404229 PMCID: PMC10315837 DOI: 10.3389/fgwh.2023.1006693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 05/31/2023] [Indexed: 07/06/2023] Open
Affiliation(s)
- Inès Osenge-Nyoyi Ongenda
- Primary Care Research Group, Department of Health and Community Sciences and Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Zelalem Mengistu
- Obstetrics and Gynecology Department, University of Gondar, Gondar, Ethiopia
| | - Douglas Tincello
- Women's and Children's CBU, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, United Kingdom
| | - Christopher Williams
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester, United Kingdom
| | - Emma Pitchforth
- Primary Care Research Group, Department of Health and Community Sciences and Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
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Prescott TAK, Hill R, Mas-Claret E, Gaya E, Burns E. Fungal Drug Discovery for Chronic Disease: History, New Discoveries and New Approaches. Biomolecules 2023; 13:986. [PMID: 37371566 DOI: 10.3390/biom13060986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Fungal-derived drugs include some of the most important medicines ever discovered, and have proved pivotal in treating chronic diseases. Not only have they saved millions of lives, but they have in some cases changed perceptions of what is medically possible. However, now the low-hanging fruit have been discovered it has become much harder to make the kind of discoveries that have characterised past eras of fungal drug discovery. This may be about to change with new commercial players entering the market aiming to apply novel genomic tools to streamline the discovery process. This review examines the discovery history of approved fungal-derived drugs, and those currently in clinical trials for chronic diseases. For key molecules, we discuss their possible ecological functions in nature and how this relates to their use in human medicine. We show how the conservation of drug receptors between fungi and humans means that metabolites intended to inhibit competitor fungi often interact with human drug receptors, sometimes with unintended benefits. We also plot the distribution of drugs, antimicrobial compounds and psychoactive mushrooms onto a fungal tree and compare their distribution to those of all fungal metabolites. Finally, we examine the phenomenon of self-resistance and how this can be used to help predict metabolite mechanism of action and aid the drug discovery process.
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Affiliation(s)
| | - Rowena Hill
- Earlham Institute, Norwich NR4 7UZ, Norfolk, UK
| | | | - Ester Gaya
- Royal Botanic Gardens, Kew, Richmond TW9 3AB, Surrey, UK
| | - Edie Burns
- Royal Botanic Gardens, Kew, Richmond TW9 3AB, Surrey, UK
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Robinault L, Niazi IK, Kumari N, Amjad I, Menard V, Haavik H. Non-Specific Low Back Pain: An Inductive Exploratory Analysis through Factor Analysis and Deep Learning for Better Clustering. Brain Sci 2023; 13:946. [PMID: 37371424 DOI: 10.3390/brainsci13060946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Non-specific low back pain (NSLBP) is a significant and pervasive public health issue in contemporary society. Despite the widespread prevalence of NSLBP, our understanding of its underlying causes, as well as our capacity to provide effective treatments, remains limited due to the high diversity in the population that does not respond to generic treatments. Clustering the NSLBP population based on shared characteristics offers a potential solution for developing personalized interventions. However, the complexity of NSLBP and the reliance on subjective categorical data in previous attempts present challenges in achieving reliable and clinically meaningful clusters. This study aims to explore the influence and importance of objective, continuous variables related to NSLBP and how to use these variables effectively to facilitate the clustering of NSLBP patients into meaningful subgroups. Data were acquired from 46 subjects who performed six simple movement tasks (back extension, back flexion, lateral trunk flexion right, lateral trunk flexion left, trunk rotation right, and trunk rotation left) at two different speeds (maximum and preferred). High-density electromyography (HD EMG) data from the lower back region were acquired, jointly with motion capture data, using passive reflective markers on the subject's body and clusters of markers on the subject's spine. An exploratory analysis was conducted using a deep neural network and factor analysis. Based on selected variables, various models were trained to classify individuals as healthy or having NSLBP in order to assess the importance of different variables. The models were trained using different subsets of data, including all variables, only anthropometric data (e.g., age, BMI, height, weight, and sex), only biomechanical data (e.g., shoulder and lower back movement), only neuromuscular data (e.g., HD EMG activity), or only balance-related data. The models achieved high accuracy in categorizing individuals as healthy or having NSLBP (full model: 93.30%, anthropometric model: 94.40%, biomechanical model: 84.47%, neuromuscular model: 88.07%, and balance model: 74.73%). Factor analysis revealed that individuals with NSLBP exhibited different movement patterns to healthy individuals, characterized by slower and more rigid movements. Anthropometric variables (age, sex, and BMI) were significantly correlated with NSLBP components. In conclusion, different data types, such as body measurements, movement patterns, and neuromuscular activity, can provide valuable information for identifying individuals with NSLBP. To gain a comprehensive understanding of NSLBP, it is crucial to investigate the main domains influencing its prognosis as a cohesive unit rather than studying them in isolation. Simplifying the conditions for acquiring dynamic data is recommended to reduce data complexity, and using back flexion and trunk rotation as effective options should be further explored.
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Affiliation(s)
- Lucien Robinault
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Nitika Kumari
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Amjad
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Rehabilitation and Allied Health Sciences and Department of Biomedical Engineering, Riphah International University, Islamabad 46000, Pakistan
| | - Vincent Menard
- M2S Laboratory, ENS Rennes, University of Rennes 2, 35065 Rennes, France
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
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Stenner P, De Luca Picione R. A Theoretically Informed Critical Review of Research Applying the Concept of Liminality to Understand Experiences with Cancer: Implications for a New Oncological Agenda in Health Psychology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5982. [PMID: 37297586 PMCID: PMC10253067 DOI: 10.3390/ijerph20115982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/24/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
Liminality was described more than 20 years ago as a major category explaining how cancer is experienced. Since then, it has been widely used in the field of oncology research, particularly by those using qualitative methods to study patient experience. This body of work has great potential to illuminate the subjective dimensions of life and death with cancer. However, the review also reveals a tendency for sporadic and opportunistic applications of the concept of liminality. Rather than being developed in a systematic way, liminality theory is being recurrently 're-discovered' in relatively isolated studies, mostly within the realm of qualitative studies of 'patient experience'. This limits the capacity of this approach to influence oncological theory and practice. In providing a theoretically informed critical review of liminality literature in the field of oncology, this paper proposes ways of systematizing liminality research in line with a processual ontology. In so doing, it argues for a closer engagement with the source theory and data, and with more recent liminality theory, and it sketches the broad epistemological consequences and applications.
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Affiliation(s)
- Paul Stenner
- School of Psychology and Counselling, The Open University, Walton Hall, Milton Keynes MK7 6AA, UK;
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Khattab R, Abdelmaksoud IR, Abdelrazek S. Deep Convolutional Neural Networks for Detecting COVID-19 Using Medical Images: A Survey. NEW GENERATION COMPUTING 2023; 41:343-400. [PMID: 37229176 PMCID: PMC10071474 DOI: 10.1007/s00354-023-00213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 02/23/2023] [Indexed: 05/27/2023]
Abstract
Coronavirus Disease 2019 (COVID-19), which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2), surprised the world in December 2019 and has threatened the lives of millions of people. Countries all over the world closed worship places and shops, prevented gatherings, and implemented curfews to stand against the spread of COVID-19. Deep Learning (DL) and Artificial Intelligence (AI) can have a great role in detecting and fighting this disease. Deep learning can be used to detect COVID-19 symptoms and signs from different imaging modalities, such as X-Ray, Computed Tomography (CT), and Ultrasound Images (US). This could help in identifying COVID-19 cases as a first step to curing them. In this paper, we reviewed the research studies conducted from January 2020 to September 2022 about deep learning models that were used in COVID-19 detection. This paper clarified the three most common imaging modalities (X-Ray, CT, and US) in addition to the DL approaches that are used in this detection and compared these approaches. This paper also provided the future directions of this field to fight COVID-19 disease.
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Affiliation(s)
- Rana Khattab
- Information Systems Department, Faculty of Computers and Information, Mansoura University, Mansoura, Egypt
| | - Islam R. Abdelmaksoud
- Information Systems Department, Faculty of Computers and Information, Mansoura University, Mansoura, Egypt
| | - Samir Abdelrazek
- Information Systems Department, Faculty of Computers and Information, Mansoura University, Mansoura, Egypt
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Alzahrani MS, Alharthi YS, Aljamal JK, Alarfaj AA, Vennu V, Noweir MD. National and Regional Rates of Chronic Diseases and All-Cause Mortality in Saudi Arabia-Analysis of the 2018 Household Health Survey Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5254. [PMID: 37047870 PMCID: PMC10093916 DOI: 10.3390/ijerph20075254] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
The disease burden and mortality were estimated in Saudi Arabia between 2010 and 2017 but were unknown in 2018. This study aims to assess the 2018 national and regional rates of chronic diseases and all-cause mortality among the total and Saudi populations. In this descriptive cross-sectional study, we obtained data from 24,012 households from the 2018 household health survey. We included doctor-diagnosed chronic conditions such as diabetes mellitus (DM), hypertension (HTN), cardiovascular diseases (CAD), and cancer (CN). A secondary analysis was performed by the total and Saudi populations. Both citizens and residents comprised the total population. Makkah and Al-Medina had greater rates among the total population; however, Al-Baha and Ha'il had high rates of chronic diseases and related mortality in the Saudi population. Age-adjusted mortality rates were 286 per 100,000 population-year. The age-adjusted mortality rate among those aged 65 and above was 3428 per 100,000 population in the same age group. Men had a rate of 1779 per 100,000 men, which was higher than the rate of 1649 for women. In 2018, most citizens in Ha'il had DM, most Al-Baha had HTN and CAD, and most Al-Qassim had CN. People aged 65 and older had the highest death rate.
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Affiliation(s)
- Majed S. Alzahrani
- Department of Preventive Medicine, Second Health Cluster, Ministry of Health, Riyadh 12231, Saudi Arabia
| | - Yaser S. Alharthi
- Department of Pediatric Emergency Medicine, Maternity & Children Hospital, Ministry of Health, Makkah 24269, Saudi Arabia
| | - Jamal K. Aljamal
- Department of Family Medicine, King Abdulaziz Hospital, Ministry of National Guard, Al-Ahsa 31982, Saudi Arabia
| | - Abdulrahman A. Alarfaj
- Department of Family Medicine, King Abdulaziz Hospital, Ministry of National Guard, Al-Ahsa 31982, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia
| | - Mohammed D. Noweir
- Department of Preventive Medicine, Prince Mansour Military Hospital, Taif 26526, Saudi Arabia
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Pazuki D, Ghosh R, Howlader MMR. Nanomaterials-Based Electrochemical Δ 9-THC and CBD Sensors for Chronic Pain. BIOSENSORS 2023; 13:384. [PMID: 36979596 PMCID: PMC10046734 DOI: 10.3390/bios13030384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
Chronic pain is now included in the designation of chronic diseases, such as cancer, diabetes, and cardiovascular disease, which can impair quality of life and are major causes of death and disability worldwide. Pain can be treated using cannabinoids such as Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) due to their wide range of therapeutic benefits, particularly as sedatives, analgesics, neuroprotective agents, or anti-cancer medicines. While little is known about the pharmacokinetics of these compounds, there is increasing interest in the scientific understanding of the benefits and clinical applications of cannabinoids. In this review, we study the use of nanomaterial-based electrochemical sensing for detecting Δ9-THC and CBD. We investigate how nanomaterials can be functionalized to obtain highly sensitive and selective electrochemical sensors for detecting Δ9-THC and CBD. Additionally, we discuss the impacts of sensor pretreatment at fixed potentials and physiochemical parameters of the sensing medium, such as pH, on the electrochemical performance of Δ9-THC and CBD sensors. We believe this review will serve as a guideline for developing Δ9-THC and CBD electrochemical sensors for point-of-care applications.
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Affiliation(s)
- Dadbeh Pazuki
- Department of Electrical and Computer Engineering, McMaster University, 1280 Main Street, Hamilton, ON L8S 4K1, Canada;
| | - Raja Ghosh
- Department of Chemical Engineering, McMaster University, 1280 Main Street, Hamilton, ON L8S 4LS, Canada;
| | - Matiar M. R. Howlader
- Department of Electrical and Computer Engineering, McMaster University, 1280 Main Street, Hamilton, ON L8S 4K1, Canada;
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Naidoo J, Murphy C, Atkins MB, Brahmer JR, Champiat S, Feltquate D, Krug LM, Moslehi J, Pietanza MC, Riemer J, Robert C, Sharon E, Suarez-Almazor ME, Suresh K, Turner M, Weber J, Cappelli LC. Society for Immunotherapy of Cancer (SITC) consensus definitions for immune checkpoint inhibitor-associated immune-related adverse events (irAEs) terminology. J Immunother Cancer 2023; 11:jitc-2022-006398. [PMID: 37001909 PMCID: PMC10069596 DOI: 10.1136/jitc-2022-006398] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
Immune-related adverse events (irAEs) associated with immune checkpoint inhibitor (ICI) therapy may vary substantially in their clinical presentation, including natural history, outcomes to treatment, and patterns. The application of clinical guidelines for irAE management can be challenging for practitioners due to a lack of common or consistently applied terminology. Furthermore, given the growing body of clinical experience and published data on irAEs, there is a greater appreciation for the heterogeneous natural histories, responses to treatment, and patterns of these toxicities, which is not currently reflected in irAE guidelines. Furthermore, there are no prospective trial data to inform the management of the distinct presentations of irAEs. Recognizing a need for uniform terminology for the natural history, response to treatment, and patterns of irAEs, the Society for Immunotherapy of Cancer (SITC) convened a consensus panel composed of leading international experts from academic medicine, industry, and regulatory agencies. Using a modified Delphi consensus process, the expert panel developed clinical definitions for irAE terminology used in the literature, encompassing terms related to irAE natural history (ie, re-emergent, chronic active, chronic inactive, delayed/late onset), response to treatment (ie, steroid unresponsive, steroid dependent), and patterns (ie, multisystem irAEs). SITC developed these definitions to support the adoption of a standardized vocabulary for irAEs, which will have implications for the uniform application of irAE clinical practice guidelines and to enable future irAE clinical trials.
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Affiliation(s)
- Jarushka Naidoo
- Oncology, Beaumont RCSI Cancer Centre, Dublin, Ireland
- RCSI university of Health Sciences, Beaumont RSCI Cancer Centre, Dublin, Ireland
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, USA
| | - Catherine Murphy
- Department of Oncology, St Vincents University Hospital, Dublin, Ireland
- Department of Oncology, Beaumont Hospital, Beaumont RCSI Cancer Centre, Dublin, Ireland
| | - Michael B Atkins
- Oncology, Georgetown University, Washington, District of Columbia, USA
| | - Julie R Brahmer
- Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | | | | | | | | | | | - Joanne Riemer
- Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Caroline Robert
- Institut Gustave-Roussy, Villejuif, France
- Paris-Saclay University, Gif-sur-Yvette, France
| | - Elad Sharon
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Karthik Suresh
- Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Michelle Turner
- Department of Oncology and the Thoracic Oncology, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, Maryland, USA
| | - Jeffrey Weber
- Perlmutter Cancer Center, NYU Langone Health, New York, New York, USA
| | - Laura C Cappelli
- Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
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49
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Spencer BKC, Wright J, Flemming K, Cottrell D, Pini S. School lives of adolescent school students living with chronic physical health conditions: a qualitative evidence synthesis. Arch Dis Child 2023; 108:225-229. [PMID: 36460338 PMCID: PMC9985755 DOI: 10.1136/archdischild-2022-324874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/11/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE Assess the existing evidence base in order to synthesise the current qualitative findings for the impact of chronic health conditions on the school lives of young people. DESIGN Qualitative evidence synthesis using thematic synthesis. PATIENTS Young people aged 11-18 years with a chronic health condition from one of the following groups: oncology, cystic fibrosis, diabetes, asthma, rheumatology, neuromuscular, colorectal, chronic pain, allergies and dermatology. OUTCOME MEASURE Qualitative findings and discussions present in included studies formed the data for the thematic synthesis. RESULTS From a search identifying 19 311 records, a sample of 35 papers were included. The included papers represented 15 countries and primarily employed interviews as part of data collection. Thematic synthesis resulted in six themes: 'keeping up/catching up/missing out/looking forward'; 'identity'; 'relationship with peers'; 'normality and difference'; 'autonomy'; 'relationships with staff'. CONCLUSIONS Thematic synthesis highlighted the commonalities, rather than divergence, of issues for young people across different chronic conditions. Policies need to be based on the experiences of the people they aim to provide for, and while attendance and attainment remain important, there is clearly more that needs to be considered when gathering data, designing interventions and developing policies to support this population. It may also be advisable for clinical professionals to include the broader psychosocial aspects of school life in discussions and plans to support young people with long-term conditions. PROSPERO REGISTRATION NUMBER CRD42021278153.
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Affiliation(s)
- Bethan K C Spencer
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Kate Flemming
- Department of Health Sciences, University of York, York, North Yorkshire, UK
| | - David Cottrell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
| | - Simon Pini
- Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire, UK
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50
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Broad-Spectrum Antimicrobial Activity of Oftasecur and Visuprime Ophthalmic Solutions. Microorganisms 2023; 11:microorganisms11020503. [PMID: 36838468 PMCID: PMC9959165 DOI: 10.3390/microorganisms11020503] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/04/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
Due to the wide etiology of conjunctivitis, the expensive and time-consuming diagnosis requires new therapeutic strategies with broad-spectrum antimicrobial activity and nonselective mechanisms of action. In this context, eye drops could provide an alternative to conventional antimicrobial therapies. Here, we compare the antibacterial and antiviral activity of Oftasecur and Visuprime, commercially available ophthalmic solutions. Cytotoxicity assay was performed on Vero CCL-81 cells by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide (MTT) test. Antibacterial efficacy was evaluated on Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae by disk diffusion, broth microdilution methods, and time-killing tests. Furthermore, the antiviral activity against HSV-1 was estimated by co-treatment, cell and viral pretreatment and post-treatment, via plaque reduction assay, fluorescence assessment (GFP-engineered HSV-1), and real-time PCR. After 24 h of exposure, Oftasecur and Visuprime showed a volume-inducing 50% of cytotoxicity of 125 and 15.8 μL, respectively Oftasecur and Visuprime induced 90% antibacterial activity in response to mean volume of 10.0 and 4.4 µL for Gram-positive and Gram-negative strains, respectively. Oftasecur exerted bactericidal action on both bacterial populations, while Visuprime was bacteriostatic on Gram-negative strains and slightly bactericidal on Gram-positive bacteria. A major impact on infectivity occurred by exposure of viral particles to the ophthalmic solutions. In detail, 50% of inhibition was verified by exposing the viral particles to 3.12 and 0.84 μL of Oftasecur and Visuprime, respectively, for 1 h. The reduction of the fluorescence and the expression of the viral genes confirmed the recorded antiviral activity. Due to their high antimicrobial efficiency, Oftasecur and Visuprime could represent a valid empirical strategy for the treatment of conjunctivitis.
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