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Mlakar-Mastnak D, Blaž Kovač M, Terčelj M, Uhan S, Majdič N, Rotovnik Kozjek N. Effectiveness of Nutritional Intervention Led by Clinical Dietitian in Patients at Risk of Malnutrition at the Primary Healthcare Level in Slovenia - Evaluation Study. Zdr Varst 2024; 63:81-88. [PMID: 38517024 PMCID: PMC10954244 DOI: 10.2478/sjph-2024-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Clinical dietitians play a crucial role in the nutritional support of patients at risk of malnutrition in primary care settings. The study aimed to evaluate the effect of an individualized nutritional intervention on clinically relevant outcomes for patients with chronic disease at nutritional risk. Methods A longitudinal evaluation study was conducted in two Slovenian primary health centres. We used pre-test and post-test design. Patients with chronic disease were screened using the Malnutrition Universal Screening Tool and additional risk factors (≥70 years and BMI <22 kg/m2; lower food intake in the last five days). Patients at nutritional risk were referred to a clinical dietitian for individual nutritional intervention. The effect of the nutritional intervention was assessed six months after the patients' first visit with a clinical dietitian. Results The sample included 94 patients. Nutritional risk was reduced significantly in high-risk and moderate-risk patients. In a subgroup of patients with a MUST score ≥1 (77 patients), body weight, BMI, Fat-Free Mass Index (FFMI), energy intake, and protein intake increased significantly (p<0.001). At the same time, the phase angle significantly increased (p<0.001), but there were no statistically significant changes in the improvement of grip strength. In a subgroup of patients with MUST score 0 (17 patients), we observed an increase in their median daily energy intake (p<0.001) and median protein intake (p=0.003). Conclusion Nutritional intervention delivered by a clinical dietitian improved patients' nutritional intake and nutritional and functional status.
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Affiliation(s)
| | - Milena Blaž Kovač
- University of Ljubljana, Medical Faculty, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Mila Terčelj
- Health Centre Žalec, Prešernova ulica 6, 3310Žalec, Slovenia
| | - Samo Uhan
- Angela Boškin Faculty of Health Care, Spodnji Plavž 3, 4270Jesenice, Slovenija
| | - Neža Majdič
- University Rehabilitation Institute Republic of Slovenia Soča, Clinical Nutrition Team, Linhartova cesta 51, 1000Ljubljana, Slovenia
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Borge CR, Larsen MH, Osborne RH, Aas E, Kolle IT, Reinertsen R, Lein MP, Thörn M, Lind RM, Groth M, Strand O, Andersen MH, Moum T, Engebretsen E, Wahl AK. Impacts of a health literacy-informed intervention in people with chronic obstructive pulmonary disease (COPD) on hospitalization, health literacy, self-management, quality of life, and health costs - A randomized controlled trial. Patient Educ Couns 2024; 123:108220. [PMID: 38458089 DOI: 10.1016/j.pec.2024.108220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To compare the effect of motivational interviewing (MI) and tailored health literacy (HL) follow-up with usual care on hospitalization, costs, HL, self-management, Quality of life (QOL), and psychological stress in people with chronic obstructive pulmonary disease (COPD). METHODS A RCT was undertaken in Norway between March 2018-December 2020 (n = 127). The control group (CG, n = 63) received usual care. The intervention group (IG, n = 64) received tailored HL follow-up from MI-trained COPD nurses with home visits for eight weeks and phone calls for four months after hospitalization. Primary outcomes were hospitalization at eight weeks, six months, and one year from baseline. The trial was registered with ClinicalTrials.gov (NCT03216603) and analysed per protocol. RESULTS Compared with the IG, the CG had 2.8 higher odds (95% CI [1.3 to 5.8]) of hospitalization and higher hospital health costs (MD=€ -6230, 95% CI [-6510 to -5951]) and lower QALYs (MD=0.1, 95% CI [0.10 to 0.11]) that gives an ICER = - 62,300. The IG reported higher QOL, self-management, and HL (p = 0.02- to <0.01). CONCLUSION MI-trained COPD nurses using tailored HL follow-up is cost-effective, reduces hospitalization, and increases QOL, HL, and self-care in COPD. PRACTICE IMPLICATION Tailored HL follow-up is beneficial for individuals with COPD and the healthcare system.
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Affiliation(s)
- Christine R Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal Hospital, Oslo, Norway.
| | - Marie H Larsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Lovisenberg Diaconal University College, Oslo, Norway
| | - Richard H Osborne
- Centre of Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Eline Aas
- Department of Health Management and Health Economics, University of Oslo, Norway; Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | | | | | | | - Oda Strand
- Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Torbjørn Moum
- Department of Behavioral Sciences in Medicine, University of Oslo, Norway
| | - Eivind Engebretsen
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway
| | - Astrid K Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Norway
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Chen P, Yao L, Yuan M, Wang Z, Zhang Q, Jiang Y, Li L. Mitochondrial dysfunction: A promising therapeutic target for liver diseases. Genes Dis 2024; 11:101115. [PMID: 38299199 PMCID: PMC10828599 DOI: 10.1016/j.gendis.2023.101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/15/2023] [Accepted: 08/10/2023] [Indexed: 02/02/2024] Open
Abstract
The liver is an important metabolic and detoxification organ and hence demands a large amount of energy, which is mainly produced by the mitochondria. Liver tissues of patients with alcohol-related or non-alcohol-related liver diseases contain ultrastructural mitochondrial lesions, mitochondrial DNA damage, disturbed mitochondrial dynamics, and compromised ATP production. Overproduction of mitochondrial reactive oxygen species induces oxidative damage to mitochondrial proteins and mitochondrial DNA, decreases mitochondrial membrane potential, triggers hepatocyte inflammation, and promotes programmed cell death, all of which impair liver function. Mitochondrial DNA may be a potential novel non-invasive biomarker of the risk of progression to liver cirrhosis and hepatocellular carcinoma in patients infected with the hepatitis B virus. We herein present a review of the mechanisms of mitochondrial dysfunction in the development of acute liver injury and chronic liver diseases, such as hepatocellular carcinoma, viral hepatitis, drug-induced liver injury, alcoholic liver disease, and non-alcoholic fatty liver disease. This review also discusses mitochondrion-centric therapies for treating liver diseases.
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Affiliation(s)
- Ping Chen
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Lichao Yao
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Mengqin Yuan
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Zheng Wang
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Qiuling Zhang
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Yingan Jiang
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Lanjuan Li
- Department of Infectious Diseases, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
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Jung M, Lee KO, Kim HR, Koh SB, Gim JA. Four modeling approaches to study restrictions on everyday life and social activities due to chronic diseases with consequences of suicidal behavior. J Psychiatr Res 2024; 173:355-362. [PMID: 38581904 DOI: 10.1016/j.jpsychires.2024.03.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/08/2024]
Abstract
The purpose of this study was to discover the association between disability in everyday life and social activities due to chronic diseases and suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) from the Korea National Health and Nutrition Examination Survey (KNHANES), considering the cross-sectional design of this study, 2016-2018 dataset. Variables for finding the associated factors of SI, SP, and SA were confirmed through random forest (RF), decision tree, generalized linear model (GLM), and support vector machine (SVM), and the performance of each model is listed. A total of 17,323 (males: 7,530, females: 9793) responders from the KNHANES from 2016 to 2018 were employed for the study. The relationship between restrictions on daily life, social activities, and three stages of suicidal behaviors due to diseases were analyzed using the R function (R version 4.2.0), randomForest, ctree, glm, and ksvm. The F1-score is a measure used to evaluate the accuracy of the performance of a model, in the binary classification. The score of 1 indicates good performance, whereas a score of 0 signifies poor performance. Due to chronic diseases, disability in everyday life and social activities lead to suicide behaviors. In our study, we examined the impact of limitations in daily living and social activities on suicidal behaviors among participants. Our findings revealed that for those experiencing such limitations, the odds ratios (ORs) for SIs were 6.10 (95% CI: 3.99-9.34) for males and 2.61 (1.79-3.81) for females. SPs were 3.69 (2.36-5.78) for males and 3.94 (2.70-5.75) for females. Similarly, the odds ratios for SAs were 5.04 (2.51-10.13) for males and 2.71 (1.48-4.98) for females, indicating a significant association between these limitations and increased suicidal behaviors, with variances observed between genders. These results underscore the necessity of addressing daily living and social activity restrictions when considering mental health interventions and suicide prevention strategies. In RF, GLM, and SVM, F1-score were 0.8192, 0.6887, and 0.9687 in SA, respectively. Among the patients with chronic disease, those with sequelae, low incomes, and low levels of education had limitations in daily activities and social activities, which increased the likelihood of suicidal thoughts, planning, and attempts.
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Affiliation(s)
- Myoungjee Jung
- Division of Cancer Screening, National Cancer Center, South Korea
| | - Kwang Ok Lee
- Department of Nursing, Sangmyung University, South Korea
| | - Hae-Rim Kim
- Department of Statistics, University of Seoul, South Korea
| | - Sang-Baek Koh
- Institute of Genomic Cohort, Yonsei University Wonju College of Medicine, South Korea.
| | - Jeong-An Gim
- Department of Medical Science, Soonchunhyang University, South Korea.
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Barría-Sandoval C, Ferreira G, Navarrete JP, Farhang M. The impact of COVID-19 on deaths from dementia and Alzheimer's disease in Chile: an analysis of panel data for 16 regions, 2017-2022. Lancet Reg Health Am 2024; 33:100726. [PMID: 38584874 PMCID: PMC10993180 DOI: 10.1016/j.lana.2024.100726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
Background Although several studies have documented the detrimental impacts of global COVID-19 containment measures on individuals with Alzheimer's disease and dementia, a comprehensive analysis of mortality rates for these conditions within the Chilean population is notably lacking. This study aimed to analyze the impact of COVID-19 on mortality rates among individuals with dementia and Alzheimer's disease in Chile. Methods A retrospective longitudinal cross-sectional study was conducted, considering mortality data for specific mental health conditions during the pre-pandemic and pandemic contexts of COVID-19 in Chile. Quantile regression techniques were employed to analyze the existence of differences between the two periods, while non-observable heterogeneity models for panel data methods were used to evaluate the effect of COVID-19 mortality on crude mortality rates. Findings Statistically significant differences were observed in the number of deaths from dementia and Alzheimer's disease between the pre-pandemic and COVID-19 pandemic periods. Specifically, crude mortality rates decreased by 10% (-0.10 [95% CI: -0.16, -0.05]) during the pandemic period. Furthermore, the number of deaths from COVID-19 during the pandemic period has a very weak incidence of deaths from mental health conditions such as dementia and Alzheimer's. Specifically, a unit percentage increase in confirmed cases from COVID-19 would result in a 7% (-0.07 [95% CI: -0.13, -0.001]) decrease in the number of deaths from dementia and Alzheimer's. These findings are supported by the application of panel regression with one-way random effects models. Interpretation The study findings indicate a reduction in mortality rates attributed to dementia and Alzheimer's disease during the COVID-19 pandemic in Chile. This decline could be attributed to the potential underreporting of mental illness as the cause of death during the pandemic period. Several studies have highlighted that approximately 30% of death certificates fail to document the presence of a dementia syndrome. Moreover, the cause of death recorded for individuals with mental health conditions may be influenced by the physician's familiarity with the patient or reflect the prevailing approach to managing end-stage dementia patients. Funding This work received no funding.
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Affiliation(s)
- Claudia Barría-Sandoval
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Concepción, Chile
| | | | - Jean Paul Navarrete
- Department of Statistics, Universidad de Concepción, Concepción, Chile
- Department of Industrial Engineering, Universidad de Concepción, Concepción, Chile
| | - Maryam Farhang
- Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Santiago, Chile
- Millennium Institute for Research in Depression and Personality (MIDAP), Santiago, Chile
- Millennium Institute for Care Research (MICARE), Santiago, Chile
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Vega-Cabello V, Struijk EA, Caballero FF, Yévenes-Briones H, Ortolá R, Calderón-Larrañaga A, Lana A, Rodríguez-Artalejo F, Lopez-Garcia E. Diet Quality and Multimorbidity in Older Adults: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad285. [PMID: 38157322 DOI: 10.1093/gerona/glad285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The role of diet quality in the accumulation of multiple chronic conditions is mostly unknown. This study examined diet quality in association with the number of chronic conditions and the rate of multimorbidity development among community-dwelling older adults. METHODS We used data from 2 784 adults aged ≥65 years from the Seniors-ENRICA 2 cohort. Diet quality was assessed at baseline (2015-17) with the Alternate Healthy Eating Index-2010 (AHEI-2010) and the Mediterranean Diet Adherence Screener (MEDAS). Information on medical diagnoses was obtained from electronic clinical records up to 2021. RESULTS Higher adherence to the AHEI-2010 was associated with a lower number of total chronic conditions (β [95% CI] quartile 4 vs 1: -0.57 [-0.86 to 0.27], p trend < .001] and cardiometabolic conditions (-0.30 [-0.44 to -0.17], p trend < .001) at baseline, while higher adherence to the MEDAS was associated with a lower number of total chronic conditions (-0.30 [-0.58 to -0.02], p trend = .01) and neuropsychiatric and neurodegenerative conditions (-0.09 [-0.17 to -0.01], p trend = .01). After a median follow-up of 5.2 years (range: 0.1-6.1 years) higher adherence to the AHEI-2010 was associated with a lower increase in chronic conditions (β [95% confidence interval] quartile 4 vs 1: -0.16 [-0.30 to -0.01], p trend = .04) and with lower rate of chronic disease accumulation. CONCLUSIONS Higher diet quality, as measured by the AHEI-2010, was associated with a lower number of chronic health conditions and a lower rate of multimorbidity development over time.
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Affiliation(s)
- Veronica Vega-Cabello
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Francisco Felix Caballero
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Humberto Yévenes-Briones
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Alberto Lana
- Department of Medicine, School of Medicine and Health Sciences. Universidad de Oviedo/ISPA; Oviedo, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/CIBERESP (CIBER of Epidemiology and Public Health); Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC; Madrid, Spain
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Molina N, Wehinger S, Marrugat J, Subirana I, Fuentes E, Palomo I. Effect of frailty status on mortality risk among chilean community-dwelling older adults. Geriatr Nurs 2024; 57:154-162. [PMID: 38657397 DOI: 10.1016/j.gerinurse.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/21/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The study of frailty and its effect on the risk of mortality in older people is of utmost importance, but understanding the critical factors is still limited. Our main objective was to analyze the association of frailty with all-cause mortality in a prospective community cohort of older people. METHODS A five-year longitudinal follow-up study was conducted with 1,174 community-dwelling older adults (men and women≥65 years old) from different Family Health Centers and community groups from Chile. We evaluated the functional risk, socioeconomic status, and anthropometric variables. The frailty status was evaluated by modified Fried criteria. RESULTS The diagnosis of frailty was reached in 290 older adult participants, who had significantly increased 5-year all-cause mortality independently of age, sex, cognitive impairment, and socioeconomic status (adjusted HR 1.51, 1.06-2.15). CONCLUSION Frailty is a predictor of increased mortality independently of age, sex, socio-economic and cognitive factors.
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Affiliation(s)
- Nacim Molina
- Thrombosis and Healthy Aging Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Universidad de Talca, Talca 3480094, Chile
| | - Sergio Wehinger
- Thrombosis and Healthy Aging Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Universidad de Talca, Talca 3480094, Chile
| | - Jaume Marrugat
- REGICOR Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERESP de investigación en Epidemiología y Salud Pública, Madrid, Spain; CIBERCV de investigación en Enfermedades Cardiovasculares, Madrid, Spain
| | - Isaac Subirana
- REGICOR Research Group, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; CIBERESP de investigación en Epidemiología y Salud Pública, Madrid, Spain; CIBERCV de investigación en Enfermedades Cardiovasculares, Madrid, Spain
| | - Eduardo Fuentes
- Thrombosis and Healthy Aging Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Universidad de Talca, Talca 3480094, Chile.
| | - Iván Palomo
- Thrombosis and Healthy Aging Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Universidad de Talca, Talca 3480094, Chile
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Bogerd MJ, Slottje P, Bont J, Van Hout HP. Development of a person-centred care approach for persons with chronic multimorbidity in general practice by means of participatory action research. BMC Prim Care 2024; 25:114. [PMID: 38627610 PMCID: PMC11020638 DOI: 10.1186/s12875-024-02364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 04/03/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND The management of persons with multimorbidity challenges healthcare systems tailored to individual diseases. A person-centred care approach is advocated, in particular for persons with multimorbidity. The aim of this study was to describe the co-creation and piloting of a proactive, person-centred chronic care approach for persons with multimorbidity in general practice, including facilitators and challenges for successful implementation. METHODS A participatory action research (PAR) approach was applied in 13 general practices employing four subsequent co-creation cycles between 2019 and 2021. The target population included adults with ≥3 chronic conditions. Participating actors were general practitioners (GPs), practice nurses (PNs), patients (target group), the affiliated care cooperation, representatives of a health insurer and researchers. Each cycle consisted of a try-out period in practice and a reflective evaluation through focus groups with healthcare providers, interviews with patients and analyses of routine care data. In each cycle, facilitators, challenges and follow-up actions for the next cycle were identified. Work satisfaction among GPs and PNs was measured pre and at the end of the final co-creation cycle. RESULTS Identified essential steps in the person-centred chronic care approach include (1) appropriate patient selection for (2) an extended person-centred consultation, and (3) personalised goalsetting and follow-up. Key facilitators included improved therapeutic relationships, enhanced work satisfaction for care providers, and patient appreciation of extended time with their GP. Deliberate task division and collaboration between GPs and PNs based on patient, local setting, and care personnel is required. Challenges and facilitators for implementation encompassed a prioritisation tool to support GPs appropriately who to invite first for extended consultations, appropriate remuneration and time to conduct extended consultations, training in delivering person-centred chronic care available for all general practice care providers and an electronic medical record system accommodating comprehensive information registration. CONCLUSIONS A person-centred chronic care approach targeting patients with multimorbidity in general practice was developed and piloted in co-creation with stakeholders. More consultation time facilitated better understanding of persons' situations, their functioning, priorities and dilemma's, and positively impacted work satisfaction of care providers. Challenges need to be tackled before widespread implementation. Future evaluation on the quadruple aims is recommended.
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Affiliation(s)
- Mieke Jl Bogerd
- Amsterdam UMC, location VUmc, Department of General Practice, Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands.
| | - Pauline Slottje
- Amsterdam UMC, location VUmc, Department of General Practice, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
| | - Jettie Bont
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- Amsterdam UMC, location AMC, Department of General Practice, Meibergdreef 9, Amsterdam, the Netherlands
| | - Hein Pj Van Hout
- Amsterdam UMC, location VUmc, Department of General Practice, Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later life, Amsterdam, the Netherlands
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Xing XY, Wu ZZ, Wang HD, Xu W, Cao D, Liu ZR, Wu GC. The awareness rate of knowledge of chronic diseases and influencing factors among 4790 adults in anhui province: An online survey using WeChat. Heliyon 2024; 10:e28366. [PMID: 38590849 PMCID: PMC10999857 DOI: 10.1016/j.heliyon.2024.e28366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
Objective To investigate public awareness about core information regarding chronic diseases and identify factors influencing that awareness among Anhui Province residents, provide a scientific basis for policy-making, and formulate corresponding intervention measures. Methods From March to April 2021, 12 provincial-level representative counties and districts of Anhui province in the China Adult Chronic Disease and Nutrition Surveillance were selected as survey sites, and 4790 residents were recruited for the survey using stratified multi-stage cluster random sampling. Basic details about the study participants were collected and their awareness of core information about major chronic diseases was measured through an online survey using WeChat. Results In 2021, the awareness rate of core information about chronic diseases among residents of Anhui Province was 54.93%. Multivariate logistic regression analysis showed that a higher awareness rate was associated with the following factors: non-housework occupations (agriculture, forestry, animal husbandry, and fishery: OR = 1.309, commercial services and production and transportation: OR = 1.450, institutions, and professional and technical personnel: OR = 1.461), a high education level (high school/junior high school/technical school OR = 1.357, college and above OR = 2.133), and residence in the southern and northern Anhui areas (southern Anhui OR = 1.282, northern Anhui OR = 1.431); whereas in rural areas (by district and country) (OR = 0.863), the awareness rate was low (all P < 0.05). Conclusions The awareness rate of core information about chronic diseases among residents of Anhui, China, is low. It is necessary to strengthen awareness about chronic disease prevention and management by targeting specific groups of people in this region.
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Affiliation(s)
- Xiu-Ya Xing
- Department of Chronic Non-communicable Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, 230601, China
| | - Zhen-Zhen Wu
- Department of Otorhinolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Hua-Dong Wang
- Department of Chronic Non-communicable Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, 230601, China
| | - Wei Xu
- Department of Chronic Non-communicable Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, 230601, China
| | - Dan Cao
- Department of Chronic Non-communicable Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, 230601, China
| | - Zhi-Rong Liu
- Department of Chronic Non-communicable Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, Anhui, 230601, China
| | - Guo-Cui Wu
- School of Nursing, Anhui Medical University, Hefei, 230032, Anhui, China
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Mete M, Ojha A, Dhar P, Das D. Deciphering Ferroptosis: From Molecular Pathways to Machine Learning-Guided Therapeutic Innovation. Mol Biotechnol 2024:10.1007/s12033-024-01139-0. [PMID: 38613722 DOI: 10.1007/s12033-024-01139-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/11/2024] [Indexed: 04/15/2024]
Abstract
Ferroptosis is a unique form of cell death reliant on iron and lipid peroxidation. It disrupts redox balance, causing cell death by damaging the plasma membrane, with inducers acting through enzymatic pathways or transport systems. In cancer treatment, suppressing ferroptosis or circumventing it holds significant promise. Beyond cancer, ferroptosis affects aging, organs, metabolism, and nervous system. Understanding ferroptosis mechanisms holds promise for uncovering novel therapeutic strategies across a spectrum of diseases. However, detection and regulation of this regulated cell death are still mired with challenges. The dearth of cell, tissue, or organ-specific biomarkers muted the pharmacological use of ferroptosis. This review covers recent studies on ferroptosis, detailing its properties, key genes, metabolic pathways, and regulatory networks, emphasizing the interaction between cellular signaling and ferroptotic cell death. It also summarizes recent findings on ferroptosis inducers, inhibitors, and regulators, highlighting their potential therapeutic applications across diseases. The review addresses challenges in utilizing ferroptosis therapeutically and explores the use of machine learning to uncover complex patterns in ferroptosis-related data, aiding in the discovery of biomarkers, predictive models, and therapeutic targets. Finally, it discusses emerging research areas and the importance of continued investigation to harness the full therapeutic potential of targeting ferroptosis.
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Affiliation(s)
- Megha Mete
- Department of Bioengineering, National Institute of Technology Agartala, Agartala, Tripura, 799046, India
| | - Amiya Ojha
- Department of Bioengineering, National Institute of Technology Agartala, Agartala, Tripura, 799046, India
| | - Priyanka Dhar
- CSIR-Indian Institute of Chemical Biology, Kolkata, 700032, India
| | - Deeplina Das
- Department of Bioengineering, National Institute of Technology Agartala, Agartala, Tripura, 799046, India.
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11
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Lin G, Werner K, Alqunaiebet A, Hamza MM, Alkanhal N, Alsukait RF, Alruwaily A, Rakic S, Cetinkaya V, Herbst CH, Lin TK. The cost-effectiveness of school-based interventions for chronic diseases: a systematic review. Cost Eff Resour Alloc 2024; 22:26. [PMID: 38605333 PMCID: PMC11008027 DOI: 10.1186/s12962-024-00511-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/02/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Chronic diseases, or non-communicable diseases (NCD), are conditions of long duration and often influenced and contributed by complex interactions of several variables, including genetic, physiological, environmental, and behavioral factors. These conditions contribute to death, disability, and subsequent health care costs. Primary and secondary school settings provide an opportunity to deliver relatively low cost and effective interventions to improve public health outcomes. However, there lacks systematic evidence on the cost-effectiveness of these interventions. METHODS We systematically searched four databases (PubMed/Medline, Cochrane, Embase, and Web of Science) for published studies on the cost-effectiveness of chronic-disease interventions in school settings. Studies were eligible for inclusion if they assessed interventions of any chronic or non-communicable disease, were conducted in a school setting, undertook a full cost-effectiveness analysis and were available in English, Spanish, or French. RESULTS Our review identified 1029 articles during our initial search of the databases, and after screening, 33 studies were included in our final analysis. The most used effectiveness outcome measures were summary effectiveness units such as quality-adjusted life years (QALYs) (22 articles; 67%) or disability-adjusted life years (DALYs) (4 articles; 12%). The most common health condition for which an intervention targets is overweight and obesity. Almost all school-based interventions were found to be cost-effective (30 articles; 81%). CONCLUSION Our review found evidence to support a number of cost-effective school-based interventions targeting NCDs focused on vaccination, routine physical activity, and supplement delivery interventions. Conversely, many classroom-based cognitive behavioral therapy for mental health and certain multi-component interventions for obesity were not found to be cost-effective.
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Affiliation(s)
- George Lin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Kalin Werner
- Institute for Health & Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, CA, USA
| | | | - Mariam M Hamza
- Health, Nutrition and Population Global Practice, The World Bank, Washington, DC, USA
| | - Norah Alkanhal
- Saudi Public Health Authority, Riyadh, KSA, Saudi Arabia
| | - Reem F Alsukait
- College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | | | - Severin Rakic
- Health, Nutrition and Population Global Practice, The World Bank, Washington, DC, USA
| | - Volkan Cetinkaya
- Health, Nutrition and Population Global Practice, The World Bank, Washington, DC, USA
| | - Christopher H Herbst
- Health, Nutrition and Population Global Practice, The World Bank, Washington, DC, USA
| | - Tracy Kuo Lin
- Institute for Health & Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, CA, USA.
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12
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Barro Lugo S, Flamarich Gol C, González Martínez MÁ, Sampedro Elvira Á, Saperas Pérez C, Sánchez Collado C. [Chronic communicable and non-communicable pathology and skin pathology of the migrant patient]. Aten Primaria 2024; 56:102922. [PMID: 38583414 PMCID: PMC11002854 DOI: 10.1016/j.aprim.2024.102922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 04/09/2024] Open
Abstract
The care of migrant patients includes initial screening and lifelong monitoring, highlighting the importance of preventing and tracking chronic, communicable and non-communicable diseases. The prevalence of hypertension, diabetes mellitus, dyslipidemia, and obesity varies by ethnicity, influenced by genetic factors, lifestyle, and socio-economic status. Preventive measures, health promotion, and risk factor identification are crucial. Chronic communicable diseases may manifest years after transmission, underscoring the necessity of primary care screening, especially for populations from endemic or high-risk areas. Imported skin lesions are a common reason for consultation among migrant and traveller patients. Their ethiology is varied, ranging from common conditions such as scabies, mycoses, and urticaria to tropical dermatoses like filariasis and leprosy.
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Affiliation(s)
- Silvia Barro Lugo
- Centro de Atención Primaria Larrard, Parc Sanitari Pere Virgili, Barcelona, España; Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria.
| | - Clara Flamarich Gol
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Equipo de Atención Primaria Sant Roc, Institut Català de la Salut, IDIAP Jordi Gol Gorina, Badalona, Barcelona, España
| | - M Ángeles González Martínez
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Trinitat Vella, Institut Català de la Salut, Sant Andreu, Barcelona, España
| | - Ángela Sampedro Elvira
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Gornal, L'Hospitalet de Llobregat, Institut Català de la Salut, L'Hospitalet de Llobregat, Barcelona, España
| | - Carme Saperas Pérez
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Plana Lledó, Mollet del Vallès, Institut Català de la Salut, Metropolitana Nord, Mollet del Vallès, Barcelona, España
| | - Consuelo Sánchez Collado
- Grupo de Trabajo Cooperación y Salud Internacional (COCOOPSI), Sociedad Catalana de Medicina Familiar y Comunitaria; Centro de Atención Primaria Garrotxa-Olot Nord, Institut Català de la Salut, Girona, Olot, Girona, España
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13
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Gaddoury MA, Armenian HK. Epidemiology of Hajj pilgrimage mortality: Analysis for potential intervention. J Infect Public Health 2024; 17 Suppl 1:49-61. [PMID: 37336690 DOI: 10.1016/j.jiph.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/24/2023] [Accepted: 05/18/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND The Saudi Vision 2030 predicts the attendance of 30 million pilgrims each year by 2030. Cost-effective healthcare services during the Hajj are important to manage this increase in the number of pilgrims. Little is known about the impact of the existing chronic diseases on morbidity and mortality during the Hajj. Furthermore, the quality of services provided by Hajj hospitals warrants further study. This study aims to describe patterns of inpatient, all-cause mortality during the Hajj and the relationship between mortality and preexisting chronic diseases as well as the services provided in Hajj hospitals. METHODS The population included pilgrims who were admitted to Hajj hospitals in Makkah and sacred sites between 2012 and 2017, excluding 2015. A retrospective, matched, case-control study design was utilized. 2237 cases of mortality were matched to 4474 control cases based on age and gender. The data were extracted from hospital admissions offices and medical records. Hierarchical, logistic regression models were used to examine the medical services. The effect measure modification of the copresence of more than one chronic disease was also examined. RESULTS The rate of inpatient all-cause mortality was higher in Makkah hospitals compared to sacred site hospitals. Inpatient, all-cause mortality was significantly associated with diabetes, hypertension, and cardiovascular diseases. Effect measure modification was present between diabetes and cardiovascular diseases, hypertension, and cardiovascular diseases, but not between diabetes and hypertension. Patients who received medical services were more likely to die during their hospital stay compared to patients not receiving services. CONCLUSION The current focus on public health issues during the Hajj should be equally distributed between communicable and non-communicable diseases. Although advanced services are provided by Hajj hospitals, interventions to address the increased risks, including mortality, faced by pilgrims with preexisting, chronic diseases should be further investigated and considered.
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Affiliation(s)
- Mahmoud A Gaddoury
- King Abdulaziz University, Faculty of Medicine, Saudi Arabia; University of California, Los Angeles, USA.
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14
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Antonelli Incalzi R, Consoli A, Lopalco P, Maggi S, Sesti G, Veronese N, Volpe M. Influenza vaccination for elderly, vulnerable and high-risk subjects: a narrative review and expert opinion. Intern Emerg Med 2024; 19:619-640. [PMID: 37891453 DOI: 10.1007/s11739-023-03456-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023]
Abstract
Influenza is associated with a substantial health burden, especially in high-risk subjects such as older adults, frail individuals and those with underlying chronic diseases. In this review, we summarized clinical findings regarding the impact of influenza in vulnerable populations, highlighted the benefits of influenza vaccination in preventing severe illness and complications and reviewed the main evidence on the efficacy, effectiveness and safety of the vaccines that are best suited to older adults among those available in Italy. The adverse outcomes associated with influenza infection in elderly and frail subjects and those with underlying chronic diseases are well documented in the literature, as are the benefits of vaccination (mostly in older adults and in patients with cardiovascular diseases, diabetes and chronic lung disease). High-dose and adjuvanted inactivated influenza vaccines were specifically developed to provide enhanced immune responses in older adults, who generally have low responses mainly due to immunosenescence, comorbidities and frailty. These vaccines have been evaluated in clinical studies and systematic reviews by international immunization advisory boards, including the European Centre for Disease Prevention and Control. The high-dose vaccine is the only licensed influenza vaccine to have demonstrated greater efficacy versus a standard-dose vaccine in preventing laboratory-confirmed influenza in a randomized controlled trial. Despite global recommendations, the vaccination coverage in high-risk populations is still suboptimal. All healthcare professionals (including specialists) have an important role in increasing vaccination rates.
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Affiliation(s)
- Raffaele Antonelli Incalzi
- Gerontology Unit, Department of Internal Medicine and Geriatrics, Campus Bio-Medico University and Teaching Hospital, Rome, Italy
| | - Agostino Consoli
- Department of Medicine and Aging Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Pierluigi Lopalco
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - Stefania Maggi
- Institute of Neuroscience-Aging Branch, National Research Council, Padua, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome, Rome, Italy.
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, "La Sapienza" University of Rome and IRCCS San Raffaele, Rome, Italy
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15
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Mustafa YF. Harmful Free Radicals in Aging: A Narrative Review of Their Detrimental Effects on Health. Indian J Clin Biochem 2024; 39:154-167. [PMID: 38577147 PMCID: PMC10987461 DOI: 10.1007/s12291-023-01147-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 07/21/2023] [Indexed: 04/06/2024]
Abstract
The production of harmful free radicals (H-FRs), especially those with oxygen or nitrogen atoms, depends on both internal and environmental causes. The negative effects of H-FRs are greatly alleviated by antioxidant protection. The harmful impact of oxidative stress, or OS, is brought on by a disparity between the defense mechanisms of the body and the creation of H-FRs. Aging is characterized by a slow decline in tissue and organ competence. Age-mediated pathologies start as an aberrant accumulation of H-FRs, which inhibit cells' capacity to divide, repair, and operate, based on the OS theorem of aging. The natural outcome of this situation is apoptosis. These conditions may include skeletal muscle dysfunction, cancer, cardiovascular, chronic hepatitis, chronic renal, and chronic pulmonary disorders. Given the substantial role that OS plays in the progression of many of these illnesses, antioxidant-based therapy may have a favorable impact on how these diseases progress. To ascertain the true efficacy of this therapy strategy, more research is necessary. The aim of this study is to provide an overview of the literature on this challenging issue that is attracting interest.
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Affiliation(s)
- Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul, Iraq
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16
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Le Guern V, Rossignol M, Lepercq J. [Indirect causes of maternal deaths (except stroke, cardiovascular diseases and infections) in France 2016-2018]. Gynecol Obstet Fertil Senol 2024; 52:268-272. [PMID: 38373491 DOI: 10.1016/j.gofs.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Maternal deaths from indirect obstetric cause result from a preexisting condition or a condition that occurred during pregnancy without obstetric causes but was aggravated by the physiological effects of pregnancy. Twenty-nine deaths with an indirect cause related to a preexisting condition, excluding circulatory diseases or infections, were analysed by the expert committee. Pre-pregnancy pathology was documented in 16 women (epilepsy, n=7; amyloid angiopathy, n=1; Dandy-Walker syndrome, n=1; autoimmune diseases, n=3; diffuse infiltrative pneumonitis, n=1; thrombotic thrombocytopenic purpura, n=1; ovarian cancer in fragile X, n=1; major sickle cell disease, n=1). In 13 women, the pathology was unknown before pregnancy (breast cancer, n=9, epilepsy diagnosed during pregnancy, n=1, brain tumours, n=2 meningioma type, macrophagic activation syndrome, n=1). Death was associated with neoplastic or tumour pathology in 13 women (45%). At the same time, epilepsy was responsible for the death of 8 women (27%), making it the most common cause of death. For both neoplasia and epilepsy, about 50% of deaths were preventable, mainly due to undiagnosed and/or delayed treatment in the case of cancer and failure to monitor or adjust treatment in the case of epilepsy. Pre-conception counselling is therefore strongly recommended if a woman has a known chronic medical condition prior to pregnancy. Finally, if there is a family history of breast cancer, a breast examination is strongly recommended from the first visit during pregnancy, and any breast lumps should be investigated as soon as possible to avoid delaying appropriate treatment.
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Affiliation(s)
- Véronique Le Guern
- Médecine interne, centre de référence pour les maladies auto-immunes et systémiques rares d'Île de France, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
| | - Mathias Rossignol
- Département d'anesthésie-réanimation, SMUR, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75465 Paris, France
| | - Jacques Lepercq
- Service de gynécologie obstétrique, maternité Port Royal, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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Nguyen TK, Vu GM, Duong VC, Pham TL, Nguyen NT, Tran TTH, Tran MH, Nguyen DT, Vo NS, Phung HT, Hoang TH. The therapeutic landscape for COVID-19 and post-COVID-19 medications from genetic profiling of the Vietnamese population and a predictive model of drug-drug interaction for comorbid COVID-19 patients. Heliyon 2024; 10:e27043. [PMID: 38509882 PMCID: PMC10950508 DOI: 10.1016/j.heliyon.2024.e27043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 12/13/2023] [Accepted: 02/22/2024] [Indexed: 03/22/2024] Open
Abstract
Despite the raised awareness of the role of pharmacogenomic (PGx) in personalized medicines for COVID-19, data for COVID-19 drugs is extremely scarce and not even a publication on this topic for post-COVID-19 medications to date. In the current study, we investigated the genetic variations associated with COVID-19 and post-COVID-19 therapies by using whole genome sequencing data of the 1000 Vietnamese Genomes Project (1KVG) in comparison with other populations retrieved from the 1000 Genomes Project Phase 3 (1KGP3) and the Genome Aggregation Database (gnomAD). Moreover, we also evaluated the risk of drug interactions in comorbid COVID-19 and post-COVID-19 patients based on pharmacogenomic profiles of drugs using a computational approach. For COVID-19 therapies, variants related to the response of two causal treatment agents (tolicizumab and ritonavir) and antithrombotic drugs are common in the Vietnamese cohort. Regarding post-COVID-19, drugs for mental manipulations possess the highest number of clinical annotated variants carried by Vietnamese individuals. Among the superpopulations, East Asian populations shared the most similar genetic structure with the Vietnamese population, whereas the African population showed the most difference. Comorbid patients are at an increased drug-drug interaction (DDI) risk when suffering from COVID-19 and after recovering as well due to a large number of potential DDIs which have been identified. Our results presented the population-specific understanding of the pharmacogenomic aspect of COVID-19 and post-COVID-19 therapy to optimize therapeutic outcomes and promote personalized medicine strategy. We also partly clarified the higher risk in COVID-19 patients with underlying conditions by assessing the potential drug interactions.
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Affiliation(s)
| | - Giang Minh Vu
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
| | - Vinh Chi Duong
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
| | | | | | - Trang Thi Ha Tran
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
| | - Mai Hoang Tran
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
| | - Duong Thuy Nguyen
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
| | - Nam S. Vo
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
| | - Huong Thanh Phung
- Faculty of Biotechnology, Hanoi University of Pharmacy, Hanoi, Viet Nam
| | - Tham Hong Hoang
- Center for Biomedical Informatics, Vingroup Big Data Institute, Hanoi, Viet Nam
- GeneStory JSC, Hanoi, Viet Nam
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Gu J, Wang Q, Qiu W, Wu C, Qiu X. Chronic diseases and determinants of community health services utilization among adult residents in southern China: a community-based cross-sectional study. BMC Public Health 2024; 24:919. [PMID: 38549080 PMCID: PMC10979594 DOI: 10.1186/s12889-024-18435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The burden of chronic diseases has become a major public health concern, and high-efficiency use of community health services is essential in combating chronic diseases. This study described the status of chronic diseases in southern China and explored the determinants of health service utilization among adult residents. METHODS Data were obtained from one part of community survey data from four counties in Ganzhou City, southern China. A multistage, stratified random sampling method was used to conduct a cross-sectional survey between 2018 and 2020. Overall, 7430 valid questionnaires were collected. A lasso-linear regression analysis was performed to explore the determinants of community health service utilization. RESULTS According to the study, most participants (44.6%) reported having relatively good health, while 42.1% reported having moderate health. Chronic diseases were reported by 66.9% of the respondents. The three most prevalent self-reported chronic diseases were hypertension (22.6%), hyperlipidemia (5.9%), and diabetes (5.9%). Among residents with chronic diseases, 72.1% had one chronic disease, while the rest had multiple. Only 13.9% of residents frequently utilized community health services, while 18.9% never used them. Additionally, among residents who reported having chronic diseases, 14.1% had never attended community health services. Four categories of factors were the key determinants of community health service utilization: (1) personal characteristics, age, and sex; (2) health-related factors, such as family history, self-reported health conditions, and the number of chronic diseases; (3) community health service characteristics, such as satisfaction with and accessibility to community health services; and (4) knowledge of chronic diseases. Specifically, women tend to utilize healthcare services more frequently than men. Additionally, residents who are advanced in age, have a family history of chronic diseases, suffer from multiple chronic conditions, rate their self-reported health condition as poor, have a better knowledge about chronic diseases, have better accessibility to community health services, and have higher the satisfaction with community health services, tend to utilize them more frequently. CONCLUSIONS Given the limited healthcare resources, the government should promote the effective utilization of community health facilities as a critical community-based strategy to combat the growing threat of chronic diseases in southern China. The priority measures involve enhancing residents' access to and satisfaction with community health services and raising awareness of chronic illnesses among older individuals with poor health status.
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Affiliation(s)
- Junwang Gu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, 530021, Nanning, Guangxi, China.
- School of Public Health and Health Management, Gannan Medical University, 341000, Ganzhou, Jiangxi, China.
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, 341000, Ganzhou, Jiangxi, China
| | - Wei Qiu
- School of Public Health and Health Management, Gannan Medical University, 341000, Ganzhou, Jiangxi, China
| | - Chunmei Wu
- School of Public Health and Health Management, Gannan Medical University, 341000, Ganzhou, Jiangxi, China
| | - Xiaoqiang Qiu
- Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, 530021, Nanning, Guangxi, China.
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Tran PB, Nikolaidis GF, Abatih E, Bos P, Berete F, Gorasso V, Van der Heyden J, Kazibwe J, Tomeny EM, Van Hal G, Beutels P, van Olmen J. Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study). Health Res Policy Syst 2024; 22:35. [PMID: 38519938 PMCID: PMC10960468 DOI: 10.1186/s12961-024-01113-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/24/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND The complex management of health needs in multimorbid patients, alongside limited cost data, presents challenges in developing cost-effective patient-care pathways. We estimated the costs of managing 171 dyads and 969 triads in Belgium, taking into account the influence of morbidity interactions on costs. METHODS We followed a retrospective longitudinal study design, using the linked Belgian Health Interview Survey 2018 and the administrative claim database 2017-2020 hosted by the Intermutualistic Agency. We included people aged 15 and older, who had complete profiles (N = 9753). Applying a system costing perspective, the average annual direct cost per person per dyad/triad was presented in 2022 Euro and comprised mainly direct medical costs. We developed mixed models to analyse the impact of single chronic conditions, dyads and triads on healthcare costs, considering two-/three-way interactions within dyads/triads, key cost determinants and clustering at the household level. RESULTS People with multimorbidity constituted nearly half of the study population and their total healthcare cost constituted around three quarters of the healthcare cost of the study population. The most common dyad, arthropathies + dorsopathies, with a 14% prevalence rate, accounted for 11% of the total national health expenditure. The most frequent triad, arthropathies + dorsopathies + hypertension, with a 5% prevalence rate, contributed 5%. The average annual direct costs per person with dyad and triad were €3515 (95% CI 3093-3937) and €4592 (95% CI 3920-5264), respectively. Dyads and triads associated with cancer, diabetes, chronic fatigue, and genitourinary problems incurred the highest costs. In most cases, the cost associated with multimorbidity was lower or not substantially different from the combined cost of the same conditions observed in separate patients. CONCLUSION Prevalent morbidity combinations, rather than high-cost ones, made a greater contribution to total national health expenditure. Our study contributes to the sparse evidence on this topic globally and in Europe, with the aim of improving cost-effective care for patients with diverse needs.
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Affiliation(s)
- Phuong Bich Tran
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.
- Department of Epidemiology and public health, Brussels, Belgium.
| | | | - Emmanuel Abatih
- Department of Applied Mathematics, Computer Sciences and Statistics, Ghent University, Ghent, Belgium
| | - Philippe Bos
- Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Finaba Berete
- Department of Epidemiology and public health, Brussels, Belgium
| | - Vanessa Gorasso
- Department of Epidemiology and public health, Brussels, Belgium
| | | | - Joseph Kazibwe
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ewan Morgan Tomeny
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Guido Van Hal
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economics Research & Modelling Infectious Diseases (CHERMID), University of Antwerp, Antwerp, Belgium
| | - Josefien van Olmen
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
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Sim XR, Hudson J, Parker C, Runacres F, Poon P. Patient and caregiver satisfaction of a palliative care chronic diseases clinic during COVID lockdowns. Chronic Illn 2024:17423953241241757. [PMID: 38504625 DOI: 10.1177/17423953241241757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
OBJECTIVES To assess the quality assurance of a specialist palliative care clinic focused on chronic diseases and explore the satisfaction and acceptability of the telemedicine model amongst patients and caregivers. METHODS A cross-sectional 23-item survey was developed by the clinical team, approved by ethics and distributed to patients and caregivers. Data collection ran between September 2021 and February 2022, and SPSS was used for data analysis. Demographics were collected from hospital records. RESULTS Thirty-five surveys were returned. The cohort had a median age of 82 years, and the most common primary diagnosis was renal failure. Participants rated telemedicine as easier to access than face-to-face appointments due to convenience. Telemedicine was rated highly for future utility, with video consultations being perceived as more useful than telephone consultations. Participants responded overwhelmingly well towards the clinic. DISCUSSION Findings demonstrated high levels of satisfaction with the Supportive Care Clinic model and for telemedicine. However, logistical challenges and the desire for face-to-face appointments were also identified. The study highlights the importance of offering a range of modalities for patient engagement in healthcare services and suggests that telemedicine should complement, rather than replace, face-to-face consultations. Future investigations should explore patient and caregiver sentiment towards telemedicine platforms alongside patient deterioration.
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Affiliation(s)
- Xiang Rong Sim
- School of Clinical Sciences, Monash University, Melbourne, Australia
- Supportive and Palliative Care Unit, Monash Health, Melbourne, Australia
| | - Jade Hudson
- Supportive and Palliative Care Unit, Monash Health, Melbourne, Australia
| | - Catriona Parker
- Supportive and Palliative Care Unit, Monash Health, Melbourne, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Fiona Runacres
- Supportive and Palliative Care Unit, Monash Health, Melbourne, Australia
| | - Peter Poon
- Supportive and Palliative Care Unit, Monash Health, Melbourne, Australia
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Wiedermann CJ, Marino P, Mahlknecht A, Barbieri V, Piccoliori G, Engl A, Gidding-Slok AHM. A cluster-randomized study to evaluate the effectiveness and cost-effectiveness of the Assessment of Burden of Chronic Conditions (ABCC) tool in South Tyrolean primary care for patients with COPD, asthma, type 2 diabetes, and heart failure: the ABCC South Tyrol study. Trials 2024; 25:202. [PMID: 38509576 PMCID: PMC10953192 DOI: 10.1186/s13063-024-08041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Chronic diseases, such as chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes, and heart failure, often coexist and contribute to a significant burden on individuals and health systems. The Assessment of Burden of Chronic Conditions (ABCC) tool, already in routine clinical use in the Netherlands, aims to comprehensively assess and visualize disease burden, stimulate self-management, and encourage shared decision-making. This study aims to validate the German and Italian versions of the ABCC tool and evaluate its effectiveness and cost-effectiveness in the South Tyrolean Primary Care setting. METHODS This is a cluster-randomized study involving approximately 400 patients with COPD, asthma, type 2 diabetes, and heart failure who received care from the South Tyrolean General Practices. Initially, the ABCC tool will be translated into German and Italian and validated. Subsequently, half of the participants will use the validated ABCC tool for patient-reported outcome measurement assessments, while the other half will receive usual care. The primary outcome measure is the change in the patients' perception of the quality of care after 18 months. The secondary outcomes included changes in quality of life, self-management behavior, and healthcare utilization. The missing data will be managed using multiple imputations. Additionally, a cost-effectiveness analysis that considers the direct medical costs reimbursed by the National Health Service will be conducted. DISCUSSION This study provides insights into the application, validation, and efficacy of the ABCC tool in the South Tyrolean healthcare context. The tool's potential to enhance person-centered care, improve the quality of life, and possibly reduce healthcare costs could greatly contribute to sustainable healthcare. The challenges of implementation, such as software integration and the use of an EU data platform, will provide lessons for future international patient care data management. TRIAL REGISTRATION ISRCTN registry, ISRCTN13531607. Registered on August 23, 2023.
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Affiliation(s)
- Christian J Wiedermann
- Institute of General Practice and Public Health, Claudiana-College of Health Professions, Bolzano (BZ), Italy.
| | - Pasqualina Marino
- Institute of General Practice and Public Health, Claudiana-College of Health Professions, Bolzano (BZ), Italy
| | - Angelika Mahlknecht
- Institute of General Practice and Public Health, Claudiana-College of Health Professions, Bolzano (BZ), Italy
| | - Verena Barbieri
- Institute of General Practice and Public Health, Claudiana-College of Health Professions, Bolzano (BZ), Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana-College of Health Professions, Bolzano (BZ), Italy
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana-College of Health Professions, Bolzano (BZ), Italy
| | - Annerika H M Gidding-Slok
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Zhang Y, Gao Y, Liu QS, Zhou Q, Jiang G. Chemical contaminants in blood and their implications in chronic diseases. J Hazard Mater 2024; 466:133511. [PMID: 38262316 DOI: 10.1016/j.jhazmat.2024.133511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/27/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024]
Abstract
Artificial chemical products are widely used and ubiquitous worldwide and pose a threat to the environment and human health. Accumulating epidemiological and toxicological evidence has elucidated the contributions of environmental chemical contaminants to the incidence and development of chronic diseases that have a negative impact on quality of life or may be life-threatening. However, the pathways of exposure to these chemicals and their involvements in chronic diseases remain unclear. We comprehensively reviewed the research progress on the exposure risks of humans to environmental contaminants, their body burden as indicated by blood monitoring, and the correlation of blood chemical contaminants with chronic diseases. After entering the human body through various routes of exposure, environmental contaminants are transported to target organs through blood circulation. The application of the modern analytical techniques based on human plasma or serum specimens is promising for determining the body burden of environmental contaminants, including legacy persistent organic pollutants, emerging pollutants, and inorganic elements. Furthermore, their body burden, as indicated by blood monitoring correlates with the incidence and development of metabolic syndromes, cancers, chronic nervous system diseases, cardiovascular diseases, and reproductive disorders. On this basis, we highlight the urgent need for further research on environmental pollution causing health problems in humans.
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Affiliation(s)
- Yuzhu Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Yurou Gao
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; Sino-Danish College, University of Chinese Academy of Sciences, Beijing 100049, PR China
| | - Qian S Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China.
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, PR China; School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310000, PR China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, PR China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, PR China; School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310000, PR China
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Song A, Koh EJ, Lee WY, Chang S, Lim J, Choi M, Ki M. Suicide risk of chronic diseases and comorbidities: A Korean case-control study. J Affect Disord 2024; 349:431-437. [PMID: 38190857 DOI: 10.1016/j.jad.2024.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Chronic diseases including mental disorders have been associated with suicide. This study broadens the approach by incorporating a comprehensive list of chronic diseases and a context of comorbidities and explored their associations with suicide. METHODS Data-linkage between death registry and Korean National Health Insurance data was conducted. Suicide cases (n = 64,099) between 2009 and 2013 were 1:4 matched for gender and age to an alive control (n = 256,396). A total of 92 individual diseases of 9 broad categories were identified from insurance claims data. Conditional logistic regression was applied to assess the associations, adjusting for mental and behavioral disorders and socioeconomic status. RESULTS Suicide cases frequently experienced chronic diseases (90.0 %) and comorbidities (74.6 %). Chronic diseases greatly increased suicide risk and, among these, mental and behavioral disorders showed the highest suicide risk (OR = 7.53, 95 % CI = 7.32-7.74) followed by cardiovascular (OR = 3.36, 95 % CI = 3.26-3.47). For individual diseases, gastritis and duodenitis were most prevalent (68.1 %) among suicide cases but depressive disorder showed the highest risk (OR = 4.95, 95 % CI = 4.79-5.12). Suicide risk was strong in comorbid status sometimes comparable to odds for mental and behavioral disorder alone (e.g., OR for cardiovascular and eye vision-related diseases = 4.01, 95 % CI = 3.86-4.17). LIMITATIONS Differentiation of comorbidity was limited to pairs between major disease categories, neglecting the heterogeneity within categories. CONCLUSION Chronic diseases, in particular comorbidity, showed strong associations with suicide. This suggests that those with comorbidities feel that they are pushed to the extreme line, supporting comprehensive interventions for them to address wider reasons including psychological and social problems, besides medical problems.
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Affiliation(s)
- Areum Song
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Emily Jiali Koh
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Weon-Young Lee
- Department of Preventive Medicine, Chung-Ang University College of Medicine, 84 Heukseok-Ro, Dongjak-Gu, Seoul 156-756, Republic of Korea
| | - Shusen Chang
- Department of Public Health, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Zhongzheng Dist., Taipei, Taiwan
| | - Jiseun Lim
- Department of Preventive Medicine, Eulji University, 77 Gyeryong-ro 771beon-gil, Yongdu-dong, Jung-gu, Daejeon, Republic of Korea
| | - Minjae Choi
- Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea
| | - Myung Ki
- Program in Public Health, Graduate School, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea; BK21FOUR R&E Center for Learning Health Systems, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul, Republic of Korea.
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24
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Liu LM, Zhuansun MY, Xu TY, Qian YM, Zhang HQ, Zhang QH, Zhang YZ. Measuring the quality of transitional care based on elderly patients' experiences with the partners at care transitions measure: a cross-sectional survey. BMC Nurs 2024; 23:172. [PMID: 38481274 PMCID: PMC10938706 DOI: 10.1186/s12912-024-01847-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The quality of transitional care is closely related to the health outcomes of patients, and understanding the status of transitional care for patients is crucial to improving the health outcomes of patients. Therefore, this study aims to investigate the quality of transitional care in elderly patients with chronic diseases and analyze its influencing factors, to provide a basis for improving transitional care services. METHODS This is a cross-sectional study. We used the Chinese version of the Partners at Care Transitions Measure (PACT-M) to survey patients with chronic diseases aged 60 years and older who were about to be discharged from five tertiary hospitals in Henan and Shanxi provinces. We used the mean ± standard deviation to describe the quality of transitional care, t-test or one-way ANOVA, and regression analysis to explore the factors affecting the quality of transitional care for patients. RESULTS 182 elderly patients with chronic diseases aged ≥ 60 years completed the PACT-M survey. The scores of PACT-M1 and PACT-M2 were (30.69 ± 7.87) and (25.59 ± 7.14) points, respectively. The results of the t-test or one-way ANOVA showed that the patient's marital status, ethnicity, religion, educational level, preretirement occupation, residence, household income per month, and living situation had an impact on the quality of transitional care for elderly patients with chronic diseases (P < 0.05). The results of regression analyses showed that patients' preretirement occupation, social support, and health status were the main influences on the quality of transitional care for elderly patients with chronic diseases (P < 0.05), and they explained 63.1% of the total variance. CONCLUSIONS The quality of transitional care for older patients with chronic illnesses during the transition from hospital to home needs further improvement. Factors affecting the quality of transitional care included patients' pre-retirement occupation, social support, and health status. We can improve the hospital-community-family tertiary linkage service to provide coordinated and continuous transitional care for patients based on their occupation, health status, and social support to enhance the quality of transitional care and the patient's health.
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Affiliation(s)
- La-Mei Liu
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech District, 450000, Zhengzhou City, Henan Province, China.
| | - Meng-Yao Zhuansun
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech District, 450000, Zhengzhou City, Henan Province, China
| | - Tong-Yao Xu
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech District, 450000, Zhengzhou City, Henan Province, China
| | - Yu-Meng Qian
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech District, 450000, Zhengzhou City, Henan Province, China
| | - Hui-Qin Zhang
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech District, 450000, Zhengzhou City, Henan Province, China
| | - Qi-Han Zhang
- School of Nursing and Health, Zhengzhou University, 100 Science Avenue, High-tech District, 450000, Zhengzhou City, Henan Province, China
| | - Yi-Zhen Zhang
- Tongji Shanxi Hospital, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, 030032, Taiyuan City, Shanxi province, China
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Yiğit T, Ata N, Dinçer M, Ülgü MM, Birinci Ş, Ayvalı MO. Insights from Turkey's big data: unraveling the preventability, pathogenesis, and risk management of Alzheimer's disease (AD). Sci Rep 2024; 14:6005. [PMID: 38472452 PMCID: PMC10933367 DOI: 10.1038/s41598-024-56702-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/09/2024] [Indexed: 03/14/2024] Open
Abstract
Extensive research into dementia has more recently honed in on several key areas. These areas include the advancement of techniques such as the accumulation of amyloid-β and tau proteins, the monitoring of cerebral hypometabolism rates etc. The primary objective of this study is to explore the intricate interplay between Alzheimer's disease (AD)-other dementias (D) and various chronic illnesses in terms of time, intensity, and connectivity. In this context, we retrospectively examined data of 149,786 individuals aged 65 and above who received diagnoses of AD and D in the year 2020. At first, logistic regression (LR) analysis has been made with "sex", "age" and "foreigner" (citizenship status) independent variables for AD and D. The LR models shows that while "sex" and "age" variables have a small rate on the risk of developing AD/D, it is detected that being a foreigner increase the risk of AD and D as 69.8% and 88.5% respectively. Besides, the LR models have middle-level success prediction rate for both of the two dependent variables. Additionally, we used the parallel coordinates graphs method within the R Studio to visualize their relationships and connections. The findings of this investigation strongly suggest that AD/D don't stand as isolated conditions, but rather stem from intricate interactions and progressive processes involving diverse chronic diseases over time. Notably, ailments including hypertension, coronary artery disease, diabetes, hyperlipidemia, and psychological disorders, contribute substantially to the emergence of both AD and D. This study highlights that the fight against AD/D can only be possible with next-generation prophylactic interventions that can predict and manage risks. Such an approach holds the potential to potentially lower AD and dementia to levels that are amenable to treatment.
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Affiliation(s)
- Talip Yiğit
- Faculty of Economics and Administrative Sciences, Istanbul 29 Mayıs University, Ümraniye, İstanbul, Turkey.
| | - Naim Ata
- General Directorate of Health Information System, Turkish Ministry of Health, Ankara, Turkey
| | - Murat Dinçer
- Faculty of Economics and Administrative Sciences, Istanbul 29 Mayıs University, Ümraniye, İstanbul, Turkey
| | - M Mahir Ülgü
- General Directorate of Health Information System, Turkish Ministry of Health, Ankara, Turkey
| | | | - M Okan Ayvalı
- General Directorate of Health Information System, Turkish Ministry of Health, Ankara, Turkey
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Lindemann CH, Burst V, Völker LA, Brähler S, Simic D, Becker I, Hellmich M, Kurscheid C, Scholten N, Krauspe R, Leibel K, Stock S, Brinkkoetter PT. Personalized, interdisciplinary patient pathway for cross-sector care of multimorbid patients (eliPfad trial): study protocol for a randomized controlled trial. Trials 2024; 25:177. [PMID: 38468319 PMCID: PMC10926660 DOI: 10.1186/s13063-024-08026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Multimorbid and frail elderly patients often carry a high burden of treatment. Hospitalization due to the onset of an acute illness can disrupt the fragile balance, resulting in further readmissions after hospital discharge. Current models of care in Germany do not meet the needs of this patient group. Rather lack of coordination and integration of care combined with a lack of interdisciplinary approaches result in fragmented and inadequate care and increase the burden of treatment even more. METHODS eliPfad is a randomized controlled trial conducted in 6 hospitals in Germany. Multimorbid elderly patients aged 55 or older are randomly assigned to the intervention or control group. Patients in the intervention group receive the eliPfad intervention additional to standard care. The core components of eliPfad are: Early assessment of patients' individual treatment burden and support through a specially trained case manager Involvement of the patient's general practitioner (GP) right from the beginning of the hospital stay Preparation of an individual, cross-sectoral treatment plan through the interdisciplinary hospital team with the involvement of the patient's GP Establishment of a cross-sectoral electronic patient record (e-ePA) for documentation and cross-sectoral exchange Support/Promote patient adherence Tailored early rehabilitation during the hospital stay, which is continued at home Close-tele-monitoring of medically meaningful vital parameters through the use of tablets, digital devices, and personal contacts in the home environment The intervention period begins in the hospital and continues 6 weeks after discharge. Patients in the control group will be treated according to standard clinical care and discharged according to current discharge management. The primary aim is the prevention/reduction of readmissions in the first 6 months after discharge. In addition, the impact on health-related quality of life, the burden of treatment, survival, self-management, medication prescription, health literacy, patient-centered care, cost-effectiveness, and process evaluation will be examined. Nine hundred forty-eight patients will be randomized 1:1 to intervention and control group. DISCUSSION If eliPfad leads to fewer readmissions, proves (cost-)effective, and lowers the treatment burden, it should be introduced as a new standard of care in the German healthcare system. TRIAL REGISTRATION The trial was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) on 08/14/2023 under the ID DRKS00031500 .
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Affiliation(s)
- Christoph Heinrich Lindemann
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Volker Burst
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Linus Alexander Völker
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Sebastian Brähler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Dusan Simic
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Ingrid Becker
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Hellmich
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Clarissa Kurscheid
- Research Institute for Health and System Development, EUFH University of Applied Sciences, Cologne, Germany
| | - Nadine Scholten
- Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research, and Rehabilitation Science, Chair for Health Services Research, University of Cologne, Cologne, Germany
| | - Ruben Krauspe
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Kerstin Leibel
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Stephanie Stock
- Cologne Institute for Health Economics and Clinical Epidemiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Paul Thomas Brinkkoetter
- Department II of Internal Medicine and Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany.
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Kiani MM, Mostafavi H, Ebrahimi F, Majdzadeh R, Mohamadi E, Kraemer A, Olyaeemanesh A, Takian A. The experiences and perceptions of people with chronic and rare diseases during political-economic sanctions in Iran: a qualitative study. BMC Health Serv Res 2024; 24:276. [PMID: 38444030 PMCID: PMC10913614 DOI: 10.1186/s12913-024-10786-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Economic sanctions aim to exert pressure on political and economic foundations. Hypothesizing that sanctions might affect various aspects of population health, this study, as a component of a broader investigation to ascertain the trend effects of sanctions on selected health outcomes in Iran, seeks to explore the experiences of Iranian citizens associated with the imposed sanctions. METHODS This is a qualitative study. We conducted 31 semi-structured interviews with randomly selected patients diagnosed with at least one chronic and rare disease from diverse backgrounds across four provinces in Iran. We analyzed data using an inductive content analysis approach, facilitated by the MAXQDA10 software. RESULTS We identified three primary themes: direct effects, side effects, and coping strategies. The immediate effects were perceived to be manifested through the restriction of healthcare service availability and affordability for citizens. The side effects included the economic hardships experienced in individuals' lives and the perceived devastation caused by these difficulties. Some coping mechanisms adopted by patients or their families/relatives included prioritizing comorbidities, prioritizing health needs within families with multiple ill members, and readjusting health/illness requirements in light of daily living needs. CONCLUSION In addition to the inherent burden of their illness, patients faced substantial healthcare costs as a result of sanctions, restricted access to medications, and availability of low-quality medications. We advocate considering these challenges within the healthcare system resilience framework as a crucial first step for policymakers, aiming to determine actionable measures and mitigate the adverse effects of sanctions on citizens, particularly the most vulnerable groups.
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Affiliation(s)
- Mohammad Mehdi Kiani
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hakimeh Mostafavi
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Fatemeh Ebrahimi
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Reza Majdzadeh
- School of Health and Social Care, University of Essex, London, UK
- Knowledge Utilization Research Center and Community-Based Participatory-Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Efat Mohamadi
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Alexander Kraemer
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Alireza Olyaeemanesh
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- National Institute for Health Research, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Amirhossein Takian
- Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
- Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Poorsina Ave., Tehran, Iran.
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Abstract
OBJECTIVES To verify the association between early-life nutrition and chronic adult diseases. DATA SOURCES Medline, Embase, Cochrane Database, and Lilacs. SUMMARY OF FINDS The Developmental Origins of Health and Disease (DOHaD) hypothesis postulates that a mismatch between early-life circumstances and later-life situations may have an impact on chronic diseases. In this review, the authors emphasize the research supporting the impact of early nutrition on the origins of adult height, obesity and metabolic syndrome, type 2 diabetes mellitus, cardiovascular diseases, and reproductive outcomes. CONCLUSION Even though this is a new topic and there are still many research questions to be answered, there is strong evidence that both deficiency and excess nutrition in early life can cause epigenetic changes that have effects that last a lifetime and contribute to the development of chronic diseases. Public health efforts to protect adults from getting chronic diseases should focus on nutrition in the first 1000 days of life, from conception to the end of the second year of life.
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Affiliation(s)
| | - Lucas Victor Alves
- Department of Neuropediatrics, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, PE, Brazil
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Nwakasi C, Esiaka D, Staab T, Philip AA, Nweke C. HIV knowledge and information access among women cancer survivors in Nigeria. J Cancer Policy 2024; 39:100456. [PMID: 37989454 DOI: 10.1016/j.jcpo.2023.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/09/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
Women in Nigeria have a high burden of diseases, such as cancer and HIV. Nigerian women also have inadequate access to health information, especially for disease prevention and health promotion. Researchers have indicated that living with HIV can be particularly harmful to the health and survival of cancer survivors. However, there is a dearth of research on Nigerian women cancer survivors' knowledge of cancer and HIV linkage and their access to HIV health information. This knowledge gap may have negative health consequences. Therefore, there is a need to ensure HIV prevention among Nigerian women cancer survivors by improving access to health information. This study used a qualitative descriptive method to examine HIV knowledge and access to health information among women cancer survivors in Nigeria. Semi-structured interviews were conducted with a purposive sample of 30 women cancer survivors from Abuja, Nigeria. We identified three themes from the data, illuminating women's knowledge of the connection between HIV and cancer. The themes include: (a) perception of HIV versus cancer which described views of HIV and cancer as distinct health conditions, (b) perceived effect of HIV on cancer given that HIV can worsen cancer outcomes, and (c) sourcing for HIV health information which highlighted issues of inadequate or inaccessible HIV-cancer information. Our findings showed that targeted health education interventions are required to address the lack of HIV information among cancer survivors.
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Affiliation(s)
- Candidus Nwakasi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
| | - Darlingtina Esiaka
- Department of Behavioral Science, Center for Health Equity Transformation (CHET), The University of Kentucky College of Medicine, Lexington, KY, USA
| | - Theresa Staab
- Department of Health Sciences, Providence College, Providence, RI, USA
| | - Aaron Akpu Philip
- Faculty of Health, School of Public Health, and Social Work, Queensland University of Technology (QUT) Brisbane, Australia
| | - Chizobam Nweke
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
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Hoy SR, Vucetich JA, Vucetich LM, Hindelang M, Huebner JL, Kraus VB, Peterson RO. Links between three chronic and age-related diseases, osteoarthritis, periodontitis, and osteoporosis, in a wild mammal (moose) population. Osteoarthritis Cartilage 2024; 32:281-286. [PMID: 38043856 DOI: 10.1016/j.joca.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/18/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE Osteoarthritis, periodontitis and osteoporosis are chronic, age-related diseases which adversely impact millions of people worldwide. Because these diseases pose a major global public health challenge, there is an urgent need to better understand how these diseases are interrelated. Our objective was to document the age and sex-specific prevalence of each disease and assess interrelationships among the three diseases in a wild mammal (moose, Alces alces) population. METHODS We examined the bones of moose dying from natural causes and recorded the severity of osteoarthritis (typically observed on the hip and lowest vertebrae), osteoporosis (osteoporotic lesions observed on the skull) and periodontitis (observed on maxilla and mandibles). RESULTS Periodontitis was associated with a greater prevalence of both severe osteoarthritis and osteoporotic lesions in moose. We found no evidence to suggest that moose with osteoporotic lesions were more or less likely to exhibit signs of osteoarthritis or severe osteoarthritis. The prevalence of osteoarthritis, periodontitis and osteoporotic lesions was greater among males than for females. CONCLUSIONS Our results were consistent with the hypothesis that bacterial pathogens causing periodontitis are a risk factor for osteoarthritis and osteoporosis. They are also consistent with the hypothesis that the inverse association between osteoarthritis and osteoporosis sometimes observed in humans may be influenced by shared risk factors, such as obesity, smoking or alcohol consumption, which are absent in moose. Together these results provide insights about three diseases which are expected to become more prevalent in the future and that cause substantial socio-economic burdens.
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Affiliation(s)
- Sarah R Hoy
- College of Forest Resources and Environmental Science, Michigan Technological University, Houghton, MI, USA.
| | - John A Vucetich
- College of Forest Resources and Environmental Science, Michigan Technological University, Houghton, MI, USA.
| | - Leah M Vucetich
- College of Forest Resources and Environmental Science, Michigan Technological University, Houghton, MI, USA.
| | - Mary Hindelang
- College of Forest Resources and Environmental Science, Michigan Technological University, Houghton, MI, USA.
| | - Janet L Huebner
- Duke Molecular Physiology Department, Duke University School of Medicine, Durham, NC 27710, USA.
| | - Virginia B Kraus
- Duke Molecular Physiology Department, Duke University School of Medicine, Durham, NC 27710, USA; Department of Medicine, Duke University School of Medicine, Durham, NC 27710, USA.
| | - Rolf O Peterson
- College of Forest Resources and Environmental Science, Michigan Technological University, Houghton, MI, USA.
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31
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Chand S, Dikkatwar MS, Varghese TP, Singh R, Sah SK, Sutar AS, Biswas J, Shandily S. Potential therapies for obesity management: Exploring novel frontiers. Curr Probl Cardiol 2024; 49:102382. [PMID: 38184131 DOI: 10.1016/j.cpcardiol.2024.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 01/08/2024]
Abstract
Humans are becoming less active in the current age of technological advancement, which leads to poor health. Many factors, including unregulated diet, lack of exercise, environmental pollution and genetic factors are contributing to an increase in overweight. Obesity is a chronic condition that disturbs the physical health of a person, resulting in various other complications including cardiac, respiratory, and psychosocial issues. According to WHO, the current trend of obesity has shown a sharp increase in recent years. Methods ranging from as simple as regulating the diet to as complex as surgery are available. There are many approved drugs to treat the obesity majority of them works as suppressing the appetite and making the patient satisfy. Some of other agents works by insulinotropic activity. However, these agents need to be taken for longer period of time thus are associated with significant adverse drug reactions. Thus, the motive of this study is to understand obesity and the various methods available to manage it using the recent pharmacological and non-pharmacological approaches.
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Affiliation(s)
- Sharad Chand
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra 411038, India.
| | - Manoj S Dikkatwar
- DY Patil University School of Pharmacy, DY Patil (Deemed to be University), Nerul, Navi Mumbai, Maharashtra 400706, India.
| | - Treesa P Varghese
- Department of Pharmacy Practice, Yenepoya Pharmacy College & Research Centre (Yenepoya deemed to be University), Naringana, Mangalore, Karnataka, India.
| | - Rohit Singh
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra 411038, India
| | - Sujit Kumar Sah
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra 411038, India
| | - Abhijeet S Sutar
- Department of Pharmaceutical Sciences, School of Health Sciences and Technology, Dr. Vishwanath Karad MIT World Peace University, Pune, Maharashtra 411038, India.
| | - Jeetu Biswas
- Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sector 125, Noida 201313, India.
| | - Shrishti Shandily
- Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sector 125, Noida 201313, India.
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Coucke P. [Get used to digital therapeutics (DTx) : they will take the scene in health care !]. Rev Med Liege 2024; 79:186-190. [PMID: 38487914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Digital therapeutics are making headways in medical treatment at large. They are used alone or in combination with standard medical treatment in various fields, aiming at essentially behavioral changes. As we are facing a growing imbalance between demand and resources, these digital treatments offer a powerful way for patient empowerment.
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Mutambudzi M, Brown MT, Chen NW. Association of Epigenetic Age and Everyday Discrimination With Longitudinal Trajectories of Chronic Health Conditions in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae005. [PMID: 38190429 PMCID: PMC10878241 DOI: 10.1093/gerona/glae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Indexed: 01/10/2024] Open
Abstract
We investigated the strength of the association between baseline epigenetic age, everyday discrimination, and trajectories of chronic health conditions (CHCs) across 3 study waves, among adults 50 years of age and older. We used 2016-2020 data from the Health and Retirement Study (HRS). Data for the PhenoAge and DNAm GrimAge second-generation epigenetic clocks were from the 2016 HRS Venous Blood Study. CHC trajectories were constructed using latent class growth curve models. Multinomial logistic regression models assessed the strength of the association between accelerated epigenetic age, everyday discrimination, and the newly constructed CHC trajectories for participants with complete data (n = 2 893). In the fully adjusted model, accelerated PhenoAge (relative risk ratios [RRR] = 2.53, 95% confidence interval [95% CI] = 1.81, 3.55) and DNAm GrimAge (RRR = 2.79, 95% CI = 1.95, 4.00) were associated with classification into the high CHC trajectory class. Racial disparities were evident, with increased risk of classification into the high trajectory class for Black (PhenoAge: RRR = 1.69, 95% CI = 1.07, 2.68) and reduced risk for Hispanic (PhenoAge: RRR = 0.32, 95% CI = 0.16, 0.64; DNAm GrimAge: RRR = 0.34, 95% CI = 0.17, 0.68), relative to White participants. Everyday discrimination was associated with classification into the medium-high (RRR = 1.28, 95% CI = 1.00, 1.64) and high (RRR = 1.52, 95% CI = 1.07, 2.16) trajectory classes in models assessing DNAm GrimAge. More research is needed to better understand the longitudinal health outcomes of accelerated aging and adverse social exposures. Such research may provide insights into vulnerable adults who may need varied welfare supports earlier than the mandated chronological age for access to federal and state resources.
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Affiliation(s)
- Miriam Mutambudzi
- Department of Public Health, Falk College of Sports and Human Dynamic, Syracuse University, Syracuse, New York, USA
| | - Maria T Brown
- School of Social Work and Aging Studies Institute, Syracuse University, Syracuse, New York, USA
| | - Nai-Wei Chen
- Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, School of Medicine, University of Missouri, Columbia, Missouri, USA
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Mehrabi F, Béland F. The role of frailty in the relationships between social relationships and health outcomes: a longitudinal study. BMC Public Health 2024; 24:602. [PMID: 38402184 PMCID: PMC10894481 DOI: 10.1186/s12889-024-18111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 02/14/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Socially isolated older adults incur increased risks of adverse health outcomes, though the strength of this association is unclear. We examined whether changes in physical frailty moderated the associations between changes in social relationships and changes in health outcomes among older adults. METHODS This longitudinal study is based on three waves of the FRéLE study among 1643 Canadian community-dwelling older adults aged 65 years and older over 2 years. We performed latent growth curve modelling (LGMs) to assess changes with the assumption of missing not at random, adjusting for time-invariant covariates. We used the latent moderated structural equations (LMS) to test the interactions in LGMs. Social relationships were measured by social participation, social networks, and social support from different social ties. Frailty was assessed using the five components of the phenotype of frailty. RESULTS The results revealed that changes in frailty moderated changes in social participation (β = 3.229, 95% CI: 2.212, 4.245), social contact with friends (β = 4.980, 95% CI: 3.285, 6.675), and social support from friends (β = 2.406, 95% CI: 1.894, 2.917), children (β = 2.957, 95% CI: 1.932, 3.982), partner (β = 4.170, 95% CI: 3.036, 5.305) and extended family (β = 6.619, 95% CI: 2.309, 10.923) with changes in cognitive function and depressive symptoms, but not with chronic diseases. These results highlight the beneficial role of social relationships in declining depressive symptoms and improving cognitive health among older adults experiencing increases in frailty. CONCLUSIONS The findings suggest that changes in social support have a protective and compensatory role in decreasing depressive symptoms and enhancing cognitive health among older adults with increasing frailty. Public health policy and strategies should consider the impact of social support on multiple health outcomes among older adults with increasing frailty. Further experimental studies and interventions are warranted to extend findings on the relationships between social relationships and health outcomes, targeting frail older adults. Future studies may also consider other health-related risk factors that may impact the associations between social relationships and health outcomes among older adults.
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Affiliation(s)
- Fereshteh Mehrabi
- School of Public Health, Université de Montréal, Montréal, Québec, Canada.
- Department of Psychology, Concordia University, Montréal, Québec, Canada.
| | - François Béland
- School of Public Health, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada
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Villarreal-Zegarra D, Bellido-Boza L, Erazo A, Pariona-Cárdenas M, Valdivia-Miranda P. Impact of the COVID-19 pandemic on the services provided by the Peruvian health system: an analysis of people with chronic diseases. Sci Rep 2024; 14:3664. [PMID: 38351170 PMCID: PMC10864310 DOI: 10.1038/s41598-024-54275-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/10/2024] [Indexed: 02/16/2024] Open
Abstract
During the pandemic, many individuals with chronic or infectious diseases other than COVID-19 were unable to receive the care they needed due to the high demand for respiratory care. Our study aims to assess the impact of the COVID-19 pandemic on services provided to people with chronic diseases in Peru from 2016 to 2022. We performed a secondary database analysis of data registered by the comprehensive health insurance (SIS), the intangible solidarity health fund (FISSAL), and private healthcare institutions (EPS), using interrupted time series analysis. Our study identified 21,281,128 individual users who received care. The pooled analysis revealed an average decrease of 1,782,446 in the number of users receiving care in the first month of the pandemic compared with the expected values for that month based on pre-pandemic measurements. In addition, during the pandemic months, there was an average increase of 57,911 in the number of new additional single users who received care per month compared with the previous month. According to the time-series analysis of users receiving care per month based on each chronic disease group, the most significant decreases included people with diabetes without complications and chronic lung disease.
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Affiliation(s)
- David Villarreal-Zegarra
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
- Instituto Peruano de Orientación Psicológica, Lima, Peru
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
| | - Luciana Bellido-Boza
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru.
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
| | - Alfonso Erazo
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
| | - Max Pariona-Cárdenas
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
| | - Paul Valdivia-Miranda
- Intendencia de Invetigación y Desarrollo, Superintendencia Nacional de Salud, Lima, Peru
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Kunnath AJ, Sack DE, Wilkins CH. Relative predictive value of sociodemographic factors for chronic diseases among All of Us participants: a descriptive analysis. BMC Public Health 2024; 24:405. [PMID: 38326799 PMCID: PMC10851469 DOI: 10.1186/s12889-024-17834-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Although sociodemographic characteristics are associated with health disparities, the relative predictive value of different social and demographic factors remains largely unknown. This study aimed to describe the sociodemographic characteristics of All of Us participants and evaluate the predictive value of each factor for chronic diseases associated with high morbidity and mortality. METHODS We performed a cross-sectional analysis using de-identified survey data from the All of Us Research Program, which has collected social, demographic, and health information from adults living in the United States since May 2018. Sociodemographic data included self-reported age, sex, gender, sexual orientation, race/ethnicity, income, education, health insurance, primary care provider (PCP) status, and health literacy scores. We analyzed the self-reported prevalence of hypertension, coronary artery disease, any cancer, skin cancer, lung disease, diabetes, obesity, and chronic kidney disease. Finally, we assessed the relative importance of each sociodemographic factor for predicting each chronic disease using the adequacy index for each predictor from logistic regression. RESULTS Among the 372,050 participants in this analysis, the median age was 53 years, 59.8% reported female sex, and the most common racial/ethnic categories were White (54.0%), Black (19.9%), and Hispanic/Latino (16.7%). Participants who identified as Asian, Middle Eastern/North African, and White were the most likely to report annual incomes greater than $200,000, advanced degrees, and employer or union insurance, while participants who identified as Black, Hispanic, and Native Hawaiian/Pacific Islander were the most likely to report annual incomes less than $10,000, less than a high school education, and Medicaid insurance. We found that age was most predictive of hypertension, coronary artery disease, any cancer, skin cancer, diabetes, obesity, and chronic kidney disease. Insurance type was most predictive of lung disease. Notably, no two health conditions had the same order of importance for sociodemographic factors. CONCLUSIONS Age was the best predictor for the assessed chronic diseases, but the relative predictive value of income, education, health insurance, PCP status, race/ethnicity, and sexual orientation was highly variable across health conditions. Identifying the sociodemographic groups with the largest disparities in a specific disease can guide future interventions to promote health equity.
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Affiliation(s)
- Ansley J Kunnath
- Vanderbilt University Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Daniel E Sack
- Vanderbilt University Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Consuelo H Wilkins
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End, Suite 600, Nashville, TN, 37203, USA.
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Sathya T, Selvamani Y, Nagarajan R, Arumai MM. Association between Multimorbidity and Psychological Distress among Older Adults in India: The Moderating Role of Elder Abuse. Clin Gerontol 2024:1-11. [PMID: 38315752 DOI: 10.1080/07317115.2024.2309942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVES In this study, we examine the association between multimorbidity and psychological distress and to what extent elder abuse mediates the association. METHODS We analyzed cross-sectional nationally representative data from the "Building Knowledge Base on Population Ageing in India (BKPAI)." Multivariate logistic regression was used to understand the association between multimorbidity and psychological distress. We used Karlson-Holm- Breen (KHB) method to understand the role of elder abuse in mediating the association between multimorbidity and psychological distress. RESULTS Older adults who ever experienced abuse (OR = 1.92 95%CI = 1.62, 2.26, p < .001) or in last one month (OR = 2.09 95%CI = 1.65, 2.64, p < .001) reported higher odds of psychological distress. Further, older adults with four or more chronic diseases are thrice more likely to report psychological distress (OR = 3.03 95%CI = 2.38, 3.82, p < .001). The results further suggest the mediating role of abuse on the association between multimorbidity and psychological distress. CONCLUSIONS The results suggest the role of elder abuse on the association between multimorbidity and psychological distress among older population in India. CLINICAL IMPLICATIONS Creating an environment to reduce the abuse among older adults who have multimorbidity will be essential to reducing the psychological distress among older adults in India.
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Affiliation(s)
- T Sathya
- School of Public Health, SRM Institute of Science and Technology (SRMIST), University Wellness Program Coordinator, Chennai, India
| | - Y Selvamani
- School of Public Health, SRM Institute of Science and Technology (SRMIST), Chennai, India
| | - R Nagarajan
- International Institute for Population Sciences (IIPS), Govandi Station Road, Mumbai, India
| | - M Mathew Arumai
- Department of Social Work, College of Science & Humanities, SRM Institute of Science and Technology (SRMIST), Chennai, India
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Xiang Z, Wang H, Li H. Comorbidity risk and distribution characteristics of chronic diseases in the elderly population in China. BMC Public Health 2024; 24:360. [PMID: 38310224 PMCID: PMC10837928 DOI: 10.1186/s12889-024-17855-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/23/2024] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The risk of comorbid chronic diseases in elderly people is an important problem affecting their health and quality of life. We analyzed the incidence of chronic diseases for combinations of chronic diseases analyzed. METHODS We used the original data to construct hypothetical cohorts of elderly individuals that evolved with age. The complex network was used to reduce the dimensionality of disease. The multistate transition model is used to calculate the incidence of each chronic disease, exploring comorbidity characteristics and rules. RESULTS (1) By using complex network, seven chronic diseases were screened out in men, including hypertension, diabetes, heart disease, stroke, chronic lung disease, arthritis and dyslipidemia; six chronic diseases in women showed significant comorbidity except chronic lung disease. (2) Incidence show differences in age and sex; incidence of chronic diseases generally increased with age. (3) The marginal risk increases with the number of basic chronic diseases associated with comorbidities. (4) When hypertension is present as a basic disease, its impact on the risk of other chronic diseases is much less than that of other chronic diseases. (5) When diseases occur as basic chronic diseases, hypertension-heart disease and diabetes-dyslipidemia are combinations that have the greatest impact on each other in men; hypertension-heart disease in women. CONCLUSIONS The incidence of chronic diseases in patients who have chronic diseases and will form comorbidities differs from that in healthy states, and the related effects of different chronic diseases also differ. Among these conditions, hypertension is caused by a special mechanism.
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Affiliation(s)
- Zihang Xiang
- School of Systems Science, Beijing Normal University, Beijing, 100875, China
| | - Hao Wang
- China National Health Development Research Center, Beijing, 100044, China
| | - Handong Li
- School of Systems Science, Beijing Normal University, Beijing, 100875, China.
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He ZF, Tan WY, Ma H, Shuai Y, Shan Z, Zhai J, Qiu Y, Zeng H, Chen XL, Wang SB, Liu Y. Prevalence and factors associated with depression and anxiety among older adults: A large-scale cross-sectional study in China. J Affect Disord 2024; 346:135-143. [PMID: 37949242 DOI: 10.1016/j.jad.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND To determine the prevalence of depression and anxiety among older adults in China, and explore the associated factors. METHODS This cross-sectional study recruited participants between October 2022 and December 2022. The sample collection utilized a multi-stage stratified equal probability random sampling method. This study included 8436 older adults who underwent interviews utilizing standardized assessment instruments. The assessment of depressive symptoms employed the Patient Health Questionnaire 9, while the evaluation of anxiety utilized the Generalized Anxiety Disorder 7. Multivariate logistic regression was conducted to determine the odds ratio and 95 % confidence interval (CI). RESULTS The weighted prevalence rates for depression and anxiety were 2.79 % (95 % CI: 2.38 %-3.28 %) and 1.39 % (95 % CI: 1.12 %-1.74 %), respectively. Older adults who were female, widowed, had irregular dietary habits, spent <1 h per day using electronic devices for socializing and entertainment, engaged in >8 h of sedentary behavior per day, and had chronic diseases (cardiovascular disease, cerebrovascular disease, insomnia, and Chronic gastroenteritis) displayed a higher likelihood of encountering symptoms indicative of depression and anxiety. Conversely, older adults living in rural areas and those who walked daily were less prone to experience symptoms of depression and anxiety. CONCLUSIONS This study suggests that the psychological well-being of older adults should be cared for when treating chronic diseases. Moreover, families, communities, and clinics should recognize that supporting regular diets, providing social engagement and recreational activities, encouraging physical activity, and minimizing sedentary behavior can reduce the risk of depression and anxiety.
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Affiliation(s)
- Zhen-Fan He
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China
| | - Huilin Ma
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, China
| | - Yuxing Shuai
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, China
| | - Zejun Shan
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, China
| | - Jiaxiang Zhai
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, China
| | - Yifeng Qiu
- Department of Biostatistics, Southern Medical University, China
| | - Honghao Zeng
- School of Public Health, Sun Yat-sen University, China
| | - Xin-Lin Chen
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, China.
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China.
| | - Yu Liu
- School of Public Health and Management, Guangzhou University of Chinese Medicine, China.
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Gobbens RJJ, Kuiper S, Dijkshoorn H, van Assen MALM. Associations of individual chronic diseases and multimorbidity with multidimensional frailty. Arch Gerontol Geriatr 2024; 117:105259. [PMID: 37952423 DOI: 10.1016/j.archger.2023.105259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/29/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To examine the associations between individual chronic diseases and multidimensional frailty comprising physical, psychological, and social frailty. METHODS Dutch individuals (N = 47,768) age ≥ 65 years completed a general health questionnaire sent by the Public Health Services (response rate of 58.5 %), including data concerning self-reported chronic diseases, multidimensional frailty, and sociodemographic characteristics. Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI). Total frailty and each frailty domain were regressed onto background characteristics and the six most prevalent chronic diseases: diabetes mellitus, cancer, hypertension, arthrosis, urinary incontinence, and severe back disorder. Multimorbidity was defined as the presence of combinations of these six diseases. RESULTS The six chronic diseases had medium and strong associations with total ((f2 = 0.122) and physical frailty (f2 = 0.170), respectively, and weak associations with psychological (f2 = 0.023) and social frailty (f2 = 0.008). The effects of the six diseases on the frailty variables differed strongly across diseases, with urinary incontinence and severe back disorder impairing frailty most. No synergetic effects were found; the effects of a disease on frailty did not get noteworthy stronger in the presence of another disease. CONCLUSIONS Chronic diseases, in particular urinary incontinence and severe back disorder, were associated with frailty. We thus recommend assigning different weights to individual chronic diseases in a measure of multimorbidity that aims to examine effects of multimorbidity on multidimensional frailty. Because there were no synergetic effects of chronic diseases, the measure does not need to include interactions between diseases.
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Affiliation(s)
- Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands; Zonnehuisgroep Amstelland, Amstelveen, the Netherlands; Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Tranzo, Tilburg University, Tilburg, the Netherlands.
| | - Sandra Kuiper
- Tranzo, Tilburg University, Tilburg, the Netherlands; Department of Research, Public Health Service of West-Brabant, Breda, the Netherlands
| | - Henriëtte Dijkshoorn
- Department of Healthy Living, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Marcel A L M van Assen
- Faculty of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands; Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
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Gow K, Rashidi A, Whithead L. Factors Influencing Medication Adherence Among Adults Living with Diabetes and Comorbidities: a Qualitative Systematic Review. Curr Diab Rep 2024; 24:19-25. [PMID: 38112977 PMCID: PMC10798913 DOI: 10.1007/s11892-023-01532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE OF REVIEW Medication adherence plays an important role in improving health outcomes related to diabetes and comorbidity. The potential factors influencing medication adherence and how they contribute to health behaviors have not been synthesized to date. This review synthesized qualitative studies that identified factors influencing medication adherence among adults living with diabetes and comorbidity. RECENT FINDINGS Twenty-eight findings were extracted and synthesized into four themes: perceived support, lack of knowledge, medication issues, and the importance of routine. The findings highlight the factors that support medication adherence and areas that can be targeted to support and promote medication adherence. The findings also support the potential role of healthcare providers in supporting people living with diabetes and comorbidity to adhere to and maintain medication regimes. Several factors were identified that are amenable to intervention within the clinical practice setting and have the potential to enhance medication adherence and improve health outcomes for people living with diabetes and comorbidities. The development of acceptable and effective interventions could have a positive effect on medication adherence and health outcomes.
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Affiliation(s)
- Kendall Gow
- Hollywood Private Hospital, 115 Monash Ave, Nedlands, WA, 6009, Australia
| | - Amineh Rashidi
- School of Nursing and Midwifery, Edith Cowan University Joondalup Campus, Joondalup, WA, 6027, Australia.
| | - Lisa Whithead
- School of Nursing and Midwifery, Edith Cowan University Joondalup Campus, Joondalup, WA, 6027, Australia
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Zivković J, Kumar KA, Rushendran R, Ilango K, Fahmy NM, El-Nashar HAS, El-Shazly M, Ezzat SM, Melgar-Lalanne G, Romero-Montero A, Peña-Corona SI, Leyva-Gomez G, Sharifi-Rad J, Calina D. Pharmacological properties of mangiferin: bioavailability, mechanisms of action and clinical perspectives. Naunyn Schmiedebergs Arch Pharmacol 2024; 397:763-781. [PMID: 37658210 DOI: 10.1007/s00210-023-02682-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 08/20/2023] [Indexed: 09/03/2023]
Abstract
This review aims to provide an in-depth analysis of the pharmacological properties of mangiferin, focusing primarily on its bioavailability and mechanisms of action, and its potential therapeutic applications, especially in the context of chronic diseases. We conducted a comprehensive examination of in vitro and in vivo studies, as well as clinical trials involving mangiferin or plant extracts containing mangiferin. The primary source of mangiferin is Mangifera indica, but it's also found in other plant species from the families Anacardiaceae, Gentianaceae, and Iridaceae. Mangiferin has exhibited a myriad of therapeutic properties, presenting itself as a promising candidate for treating various chronic conditions including neurodegenerative disorders, cardiovascular diseases, renal and pulmonary diseases, diabetes, and obesity. Despite the promising results showcased in many in vitro studies and certain animal studies, the application of mangiferin has been limited due to its poor solubility, absorption, and overall bioavailability. Mangiferin offers significant therapeutic potential in treating a spectrum of chronic diseases, as evidenced by both in vitro and clinical trials. However, the challenges concerning its bioavailability necessitate further research, particularly in optimizing its delivery and absorption, to harness its full medicinal potential. This review serves as a comprehensive update on the health-promoting and therapeutic activities of mangiferin.
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Affiliation(s)
- Jelena Zivković
- Institute for Medicinal Plants Research "Dr. Josif Pančić", Tadeuša Košćuška 1, Belgrade, Serbia.
| | - Kammala Ananth Kumar
- Department of Obstetrics and Gynecology, Division of Basic Sciences and Translational Medicine, University of Texas Medical Branch, Galveston, TX, 77555, USA
| | - Rapuru Rushendran
- Department of Pharmacology, SRM College of Pharmacy, SRM Institute of Science and Technology (SRMIST), Kattankulatur, 603203, Tamil Nadu, India
| | - Kaliappan Ilango
- School of Pharmacy, Hindustan Institute Technology and Science, Padur, Chennai, 603 103, India
| | - Nouran M Fahmy
- Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Abbassia, Cairo, Egypt
- Center of Drug Discovery Research and Development, Ain Shams University, Cairo, Egypt
| | - Heba A S El-Nashar
- Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Abbassia, Cairo, Egypt
- Center of Drug Discovery Research and Development, Ain Shams University, Cairo, Egypt
| | - Mohamed El-Shazly
- Department of Pharmacognosy, Faculty of Pharmacy, Ain Shams University, Abbassia, Cairo, Egypt
- Department of Pharmaceutical Biology, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, 11835, Egypt
| | - Shahira M Ezzat
- Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, 11562, Egypt
- Pharmacognosy, Faculty of Pharmacy, October University for Modern Sciences and Arts (MSA), Giza, 12451, Egypt
| | - Guiomar Melgar-Lalanne
- Instituto de Ciencias Básicas, Universidad Veracruzana, Avda. Castelazo Ayala S/N, 91190, Xalapa, Veracruz, Mexico
| | - Alejandra Romero-Montero
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, 04510, Ciudad de México, Mexico
| | - Sheila I Peña-Corona
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, 04510, Ciudad de México, Mexico
| | - Gerardo Leyva-Gomez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, 04510, Ciudad de México, Mexico
| | | | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
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Alhammad M. Chronic diseases and illness in schools: Teachers' confidence in helping students with intellectual disabilities. J Family Med Prim Care 2024; 13:660-666. [PMID: 38605808 PMCID: PMC11006056 DOI: 10.4103/jfmpc.jfmpc_1328_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 04/13/2024] Open
Abstract
Background With movement to educate students with intellectual disabilities in special and mainstream schools, a considerable number of students with intellectual disabilities have common chronic diseases such as epilepsy and diabetes. In addition, these students may also face common illnesses, which occur in all students, such as fevers and headaches. Teachers are responsible for their students and provide first aid when needed. Therefore, this study aimed to determine whether teachers are confident in their ability to provide help when symptoms related to chronic diseases and illnesses occur. Methods In this cross-sectional study, questionnaires were sent to 300 male and female teachers of students with intellectual disabilities in Riyadh, Saudi Arabia. Results The findings illustrate that, in general, teachers have little confidence in helping students with chronic diseases and illnesses. Although the teachers felt that they were less confident in dealing with some symptoms of illnesses and chronic diseases, there were some symptoms that they showed either strong or low confidence in dealing with. Conclusion The recommendations include increasing teachers' confidence in providing first aid.
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Affiliation(s)
- Mohammed Alhammad
- Department of Special Education, Education Collage, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
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Feng Y, Su M, Liu Y, Peng J, Sun X. Health-related quality of life among cancer survivors: pre-existing chronic conditions are to be given priority. Support Care Cancer 2024; 32:124. [PMID: 38252273 DOI: 10.1007/s00520-024-08315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024]
Abstract
PURPOSE This study aimed to describe the health-related quality of life (HRQoL) of cancer survivors in China by the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire and to explore the impact of the comorbidity of pre-existing chronic conditions on HRQoL in cancer survivors. METHODS Data on cancer survivors were obtained from two cross-sectional surveys conducted in Shandong Province, China. The data of the Chinese general population, the Chinese diabetes population, the Chinese hypertension population, and the Chinese urban population from the published studies were used as the controls. The χ2 test was conducted to compare the incidence of five-dimensional problems between the study and control populations. The non-parametric Mann-Whitney U test and Kruskal-Wallis test were performed to examine the differences in EQ-5D-5L utility scores. Besides, the Tobit regression model was used to examine the variables influencing the EQ-5D-5L utility score. RESULTS One thousand fifty-one adult cancer survivors were included. Cancer survivors had significantly lower EQ-5D-5L utility scores (Z = - 15.939, P < 0.001) and EQ-VAS scores (Z = - 11.156, P < 0.001) than the general adult population. The average EQ-5D-5L utility score of hypertensive cancer survivors was lower than that of the hypertensive population (Z = - 1.610, P = 0.107), but the difference was not statistically significant. CONCLUSION Compared to the general population, the HRQoL of cancer survivors was extremely poor in all dimensions of the EQ-5D-5L. Pre-existing chronic conditions had significant antecedent effects on the HRQoL of cancer survivors. Therefore, more attention should be paid to chronic diseases, and effective interventions should be adopted based on this.
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Affiliation(s)
- Yujia Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Mingzhu Su
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Yanxiu Liu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Jiaqi Peng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Xiaojie Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Wenhuaxi Road 44#, Jinan, China.
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China.
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Cherry-Peppers G, Fryer C, Jackson AD, Ford D, Glascoe A, Smith D, Dunmore-Griffith J, Iris M, Woods D, Robinson-Warner G, Davidson A, McIntosh C, Sonnier J, Slade L, Downer G, Mundey S, Darden-Wilson J, Dawson N, Downes A, Rizkalla A, Bellamy A, Mahone I, Tompkins S, Kiffin G, Mncube-Barnes F, Peppers G, Watkins-Bryant T. A review of the risks and relationships between oral health and chronic diseases. J Natl Med Assoc 2024:S0027-9684(24)00008-7. [PMID: 38326141 DOI: 10.1016/j.jnma.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 09/25/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024]
Abstract
Advances in medical science and in preventive dentistry have changed the context of oral health. The American population is living longer with numerous complex chronic diseases. This paper is to raise awareness about the impact of multiple chronic diseases and their associations with oral diseases. Comorbidities can worsen the course of dental treatment. Inflammation has been the connecting factor in the bidirectional pattern of oral and systemic diseases. High occurrences of chronic diseases generally occur in aging as well as disadvantaged populations. Serious infections, slow healing, prolonged bleeding, and hospitalizations can escalate in patients with uncontrolled chronic diseases. A multidisciplinary team-based approach to patient management can minimize complications and unexpected challenges.
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Affiliation(s)
| | - Cheryl Fryer
- Academic Affairs, Howard University College of Dentistry, USA
| | | | - Debra Ford
- Academic Affairs, Howard University College of Medicine, USA
| | - Alison Glascoe
- Comprehensive Care, Chair, Howard University College of Dentistry, USA
| | - Dawn Smith
- Department of Dental Hygiene, Howard University College of Dentistry, USA
| | | | - Morton Iris
- Comprehensive Care, Howard University College of Dentistry, USA
| | - Dexter Woods
- Comprehensive Care, Howard University College of Dentistry, USA
| | | | | | - Crystal McIntosh
- Department of Periodontics, Howard University College of Dentistry, USA
| | - Jezelle Sonnier
- Department of Restorative Dentistry, Howard University College of Dentistry, USA
| | - Lisa Slade
- Department of Endodontics, Howard University College of Dentistry, USA
| | | | - Shakeya Mundey
- Comprehensive Care, Howard University College of Dentistry, USA
| | | | - Nyree Dawson
- Comprehensive Care, Howard University College of Dentistry, USA
| | - Arielle Downes
- Summer Research Project, Howard University College of Dentistry
| | - Adel Rizkalla
- Comprehensive Care, Howard University College of Dentistry
| | - Ashleigh Bellamy
- Research Summer Project, Howard University College of Dentistry, USA
| | - Ian Mahone
- Research Summer Project, Howard University College of Dentistry, USA
| | - Sydney Tompkins
- Summer Research Project, Howard University College of Dentistry, USA
| | - Gawain Kiffin
- Summer Research Project, Howard University College of Dentistry, USA
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Yu H, Cui Y, Guo F, Zhu Y, Zhang X, Shang D, Dong D, Xiang H. Vanin1 (VNN1) in chronic diseases: Future directions for targeted therapy. Eur J Pharmacol 2024; 962:176220. [PMID: 38042463 DOI: 10.1016/j.ejphar.2023.176220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023]
Abstract
Vanin1 (VNN1) is an exogenous enzyme with pantetheinase activity that mainly exerts physiological functions through enzyme catalysis products, including pantothenic acid and cysteamine. In recent years, the crosstalk between VNN1 and metabolism and oxidative stress has attracted much attention. As a result of the ability of VNN1 to affect multiple metabolic pathways and oxidative stress to exacerbate or alleviate pathological processes, it has become a key component of disease progression. This review discusses the functions of VNN1 in glucolipid metabolism, cysteamine metabolism, and glutathione metabolism to provide perspectives on VNN1-targeted therapy for chronic diseases.
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Affiliation(s)
- Hao Yu
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, 116011, China; College of Pharmacy, Dalian Medical University, 116044, China
| | - Yuying Cui
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China; Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - Fangyue Guo
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China; Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - YuTong Zhu
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China; Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - Xiaonan Zhang
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China; Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China
| | - Dong Shang
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China; Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, China; Department of General Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China
| | - Deshi Dong
- Department of Pharmacy, First Affiliated Hospital of Dalian Medical University, 116011, China.
| | - Hong Xiang
- Laboratory of Integrative Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, China.
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Ramadani RV, Svensson M, Hassler S, Hidayat B, Ng N. Effects of the COVID-19 pandemic on healthcare utilization among older adults with cardiovascular diseases and multimorbidity in Indonesia: an interrupted time-series analysis. BMC Public Health 2024; 24:71. [PMID: 38166721 PMCID: PMC10763491 DOI: 10.1186/s12889-023-17568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has disrupted healthcare utilization globally, but little is known about the effects among patients with cardiovascular diseases (CVDs) and other multimorbidities. This study analyzed the impacts of COVID-19 on healthcare utilization for patients aged 30 years and older with cardiovascular diseases (CVDs) with or without other chronic disease comorbidities in Indonesia. METHODS We designed a retrospective cohort study based on the Indonesian National Health Insurance (NHI) sample data from 2016-2020. We defined healthcare utilization as monthly outpatient and inpatient visits related to chronic diseases at the hospital and primary healthcare levels per 10,000 NHI members. We used interrupted time series analysis to evaluate how the healthcare utilization patterns had changed due to the COVID-19 pandemic. RESULTS Overall, hospital outpatient visits decreased by 39% when the pandemic occurred (95% Confidence Interval (CI): 0.48,0.76), inpatient visits by 28% (95% CI: 0.62,0.83), and primary healthcare visits by 34% (95% CI:0.55, 0.81). For patients with CVDs and multimorbidity, hospital outpatient and inpatient visit rates were reduced by 36% and 38%, respectively and primary healthcare visits by 32%. Some insignificant differences in the reduction of out-and inpatient visits were observed across diagnosis groups and regions. CONCLUSION Healthcare utilization among patients with chronic diseases decreased significantly during COVID-19 and consistently across different chronic diseases and regions. To cope with the unmet needs of healthcare utilization in the context of the pandemic, the healthcare system needs to be strengthened to cater to the needs of the population-at-risk, especially for patients with CVDs and multimorbidity.
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Affiliation(s)
- Royasia Viki Ramadani
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Center for Health Economics and Policy Studies, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia.
| | - Mikael Svensson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, USA
| | - Sven Hassler
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Budi Hidayat
- Center for Health Economics and Policy Studies, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
| | - Nawi Ng
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ji P, Zhang L, Gao Z, Ji Q, Xu J, Chen Y, Song M, Guo L. Relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases: mediating effects of death anxiety. BMC Psychiatry 2024; 24:7. [PMID: 38166844 PMCID: PMC10763298 DOI: 10.1186/s12888-023-05459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Many studies have explored the relationship between self-esteem and quality of life. However, few studies have elucidated the mechanisms underlying the relationship between self-esteem and quality of life in middle-aged and older patients with chronic diseases. The present study aimed to explore the mediating role of death anxiety in this relationship. METHODS Middle-old-aged patients with chronic diseases were selected as the respondents by using a multi-stage sampling method, random number table method from October 2021 to February 2022 in the Second Affiliated Hospital of Zhejiang University School of Medicine. The Cumulative Disease Rating Scale, the Self-Esteem Scale (SES), the Chinese version of the Death Anxiety Scale (CT-DAS), and the Simplified version of the Quality of Life Scale (SF-12) were used as the researching tools to conduct the survey. SPSS26.0 was used to analysis data. AMOS 23.0 software was used to construct structural equation modeling. RESULTS 294 valid questionnaires were collected. There were significant differences in quality of life among middle-aged and elderly patients with chronic diseases who have different physical activities, socialization, and chronic pain (P < 0.01); Self-esteem was positively associated with quality of life (r = 0.330, P < 0.01), self-esteem was negatively associated with death anxiety (r = -0.222, P < 0.01), and death anxiety was negatively associated with quality of life (r = -0.263, P < 0.01); Death anxiety partially mediated the relationship between self-esteem and quality of life, with the mediating effect accounting for 18.40% of the total effect. CONCLUSION Death anxiety partially mediates the relationship between self-esteem and quality of life. Interventions to improve self-esteem and reduce death anxiety should be used to improve the quality of life of middle-aged and senior patients with chronic diseases.
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Affiliation(s)
- Pengjuan Ji
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Lin Zhang
- Department of Internal Medicine Nursing, School of Nursing, Wannan Medical College, 22 Wenchang West Road, Higher Education Park, Wuhu City, An Hui Province, P.R. China
| | - Ziyun Gao
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Qiqi Ji
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Jiashuang Xu
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Yian Chen
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Miaojing Song
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China
| | - Leilei Guo
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China.
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Lin J, Zhang Y, Wang K, Xia H, Hua M, Lu K, Zheng W, Chen R. Long-term impact of PM 2.5 exposure on frailty, chronic diseases, and multimorbidity among middle-aged and older adults: insights from a national population-based longitudinal study. Environ Sci Pollut Res Int 2024; 31:4100-4110. [PMID: 38097844 DOI: 10.1007/s11356-023-31505-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 12/08/2023] [Indexed: 01/19/2024]
Abstract
Particulate Matter 2.5 (PM2.5) is a significant risk factor for frailty and chronic diseases. Studies on the associations between PM2.5 and frailty, chronic diseases, and multimorbidity are scarce, especially from large cohort studies. We aimed to explore the potential association between PM2.5 exposure and the risk of frailty, chronic diseases, and multimorbidity. We collected data from a national cohort (CHARLS) with a follow-up period of 11-18 years, totaling 13,366 participants. We obtained PM2.5 concentration data from the Atmospheric Composition Analysis Group at Dalhousie University. PM2.5 exposure is based on the average annual concentration in the prefecture-level city where residents live. We define frailty as the comprehensive manifestation of declining various body functions, characterized by a frailty index of 0.25 or greater, and multimorbidity as the presence of at least two or more chronic conditions. Cox proportional hazards regression was used to estimate the hazard ratio (HR) with its 95% confidence interval (95%CI). A 10-μg/m3 increase for PM2.5 was significantly associated with an increased risk of frailty (HR = 1.289, 95%CI = 1.257-1.322, P < 0.001). A 10-μg/m3 increase for PM2.5 was significantly associated with the elevated risk for most chronic diseases. Compared to those with no morbidity or only single morbidity, a 10-μg/m3 increase for PM2.5 was significantly associated with the elevated risk for multimorbidity (HR = 1.220, 95%CI = 1.181-1.260, P < 0.001). Ambient PM2.5 exposure is a significant risk factor for frailty, chronic diseases, and multimorbidity, and some measures need to be taken to reduce PM2.5 concentration and prevent frailty and chronic diseases.
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Affiliation(s)
- Junjie Lin
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yu Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Kunyi Wang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Huilin Xia
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Minxia Hua
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Kexin Lu
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Weijun Zheng
- Department of Medical Statistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, 310053, Zhejiang Province, China
| | - Rucheng Chen
- Department of Medical Statistics, School of Public Health, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, 310053, Zhejiang Province, China.
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Althnaibat RM, Bruce HL, Wu J, Gänzle MG. Bioactive peptides in hydrolysates of bovine and camel milk proteins: A review of studies on peptides that reduce blood pressure, improve glucose homeostasis, and inhibit pathogen adhesion. Food Res Int 2024; 175:113748. [PMID: 38129050 DOI: 10.1016/j.foodres.2023.113748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Abstract
The prevalence of diet-related chronic conditions including hypertension and cardiovascular disease, and diabetes mellitus has increased worldwide. Research regarding the use of food-derived bioactive peptides as an alternative strategy to mitigate chronic diseases is on the rise. Milk is recognized as one of the main dietary protein sources for health beneficial bioactive compounds. Hundreds of in vitro studies have suggested that milk-derived bioactive peptides offer multiple biological and physiological benefits, and some but not all were confirmed in vivo with animal models for hypertension, hyperglycemia, and pathogen adhesion. However, only a limited number of health benefits have been confirmed by randomized clinical trials. This review provides an overview of the current clinical studies that target hypertension, postprandial hyperglycemic, and adhesion of enteric pathogen with bioactive peptides derived from bovine and camel milk, with a focus on the factors affecting the efficacy of orally ingested products.
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Affiliation(s)
- Rami M Althnaibat
- University of Alberta, Dept. of Agricultural, Food and Nutritional Science, Edmonton, AB, Canada
| | - Heather L Bruce
- University of Alberta, Dept. of Agricultural, Food and Nutritional Science, Edmonton, AB, Canada
| | - Jianping Wu
- University of Alberta, Dept. of Agricultural, Food and Nutritional Science, Edmonton, AB, Canada
| | - Michael G Gänzle
- University of Alberta, Dept. of Agricultural, Food and Nutritional Science, Edmonton, AB, Canada.
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