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Background: Puerto Rico, a US territory, faces numerous challenges adversely affecting public health, including poverty, a fragile healthcare system, inadequate infrastructure, a debt crisis, and vulnerability to climate change-related natural disasters. The impact of these factors on the Health-Related Quality of Life (HRQoL) measure has not been comprehensively evaluated. Only two studies have assessed HRQoL, with the latest conducted in 2011, prior to recent events that could affect public health. This study aimed to assess the HRQoL and associated sociodemographic and health risk factors among adults living in Puerto Rico in 2019. Methods: Prevalence and 95% confidence intervals were used to describe HRQoL and its associations with sociodemographic and health-related variables among adults living in Puerto Rico who answered the Behavioral Risk Factor Surveillance System (BRFSS) survey (n = 4,944) in 2019. Multivariable logistic regression models were developed to identify which of these variables were more likely to be associated with each of the four core HRQoL questions (HRQoL-4), expressed as prevalence odds ratios with 95% confidence intervals adjusted for potential confounders. Results: Through a comprehensive multivariable analysis, we uncovered significant risk factors – increasing number of chronic conditions, advanced age, and low income – associated with poor HRQoL among adults living in Puerto Rico. Specifically, our findings suggest that individuals with an increasing number of chronic conditions were more likely to report poor HRQoL across all 4 domains. As the number of reported chronic conditions increases by one, the odds of reporting having: fair/poor general health increased by a factor of 2.24 (POR: 2.24, 95% CI: 2.08–2.41), physical health impairment increased by a factor of 1.93 (POR: 1.93, 95% CI: 1.78–2.08), mental health impairment increased by a factor of 1.90 (POR: 1.90, 95% CI: 1.78–2.02) and activity limitation increased by a factor of 1.27 (POR: 1.27, 95% CI: 1.13–1.42). Advancing age was associated with all domains of poor HRQoL, except for the mental health domain for which we observed higher rates of poor HRQoL among the younger population (POR: 4.76, 95% CI: 2.4–9.1). Conclusion: This paper shows that the prevalence of poor HRQoL has not improved compared to the only previous study of HRQoL of Puerto Rico in the last decade. We also found that poor HRQoL is associated with having multiple chronic conditions in adults living in Puerto Rico. This may be a consequence of a decline in health services after natural disasters and socioeconomic downturns on the island. The study emphasizes the need for targeted interventions and ongoing monitoring of the population's HRQoL over time to reach vulnerable subgroups, especially those with chronic conditions, advanced age, and low income, in order to reduce health disparities in Puerto Rico. [ABSTRACT FROM AUTHOR]

Optometrists play an integral role in primary eyecare services, including prevention, diagnosis, and management of acute and chronic eye conditions. Therefore, it remains essential that the care they provide be timely and appropriate to ensure the best patient outcomes and optimal utilisation of resources. However, optometrists continuously face many challenges that can affect their ability to provide appropriate care (i.e., the care in line with evidence-based clinical practice guidelines). To address any resulting evidence-to-practice gaps, programs are needed that support and enable optometrists to adopt and utilise the best evidence in clinical practice. Implementation science is a field of research that can be applied to improving the adoption and maintenance of evidence-based practices in routine care, through systematic development and application of strategies or interventions to address barriers to evidence-based practice. This paper demonstrates an approach using implementation science to enhance optometric eyecare delivery. A brief overview of the methods used to identify existing gaps in appropriate eyecare delivery is presented. An outline of the process used to understand the behavioural barriers responsible for such gaps follows, involving theoretical models and frameworks. The resulting development of an online program for optometrists to enhance their capability, motivation, and opportunity to provide evidence-based eyecare is described, using the Behaviour Change Model and co-design methods. The importance of and methods used in evaluating such programs are also discussed. Finally, reflections on the experience and key learnings from the project are shared. While the paper focuses on experiences in improving glaucoma and diabetic eyecare in the Australian optometry context, this approach can be adapted to other conditions and contexts. [ABSTRACT FROM AUTHOR]

This paper argues that self-authored depictions of illness, disability, trauma and bodily hurt by marginalised individuals have deep agentic potential, particularly when these experiences are retold within empathetic online spaces on their own terms and in their own words. This is seldom possible in mainstream institutional settings which are structured by hegemonic norms and where the marginalised are often spoken for. Through an analysis of selected writings in Skin Stories, an Indian collective feminist media publication that publishes gendered articulations of disability, illness and healing, this paper explores the potential of marginalised writings in reclaiming control over one's bodily narrative, sharing knowledge and forging spaces of empathy and connection. It analyses ways in which authors through "intimate vulnerable retellings" of everyday as well as traumatic bodily events/processes like ongoing illness, lifelong chronic pain and sudden disability reclaim and own narratives of bodily vulnerability. These retellings are analysed as interconnected, shared experiences that bear deep knowledge and challenge medicalised understandings. By acknowledging "bodies as knowledge" rather than "bodies as data" these retellings could potentially supplement and enrich medical approaches in managing and understanding chronic pain and illness specifically in India, thereby piecing together experience, knowledge(s) and expertise. [ABSTRACT FROM AUTHOR]

Atherosclerosis （AS）, a multifactorial and chronic inflammatory disease, is considered a lifethreatening condition worldwide. As the predominant immunocytes in AS lesions, macrophages are of exceptional interest in exploring the pathogenesis of this disease. The proliferation, aggregation, aging and death of macrophages significantly contribute to the occurrence and development of AS. Iron is an essential microelement that plays a pivotal role in regulating diverse functions of macrophages under physiological conditions. However, abnormal iron metabolism can disrupt iron homeostasis in macrophages, leading to iron overload in macrophages, significantly contributing to the promotion of AS. From the perspective of macrophage iron overload and and its role in AS, this paper provides an extensive exposition on the phenomenon of macrophage iron overload and its underlying pathophysiological mechanism in promoting AS, providing novel insights for the prevention and treatment of AS. [ABSTRACT FROM AUTHOR]

Whereas exercise training, as part of multidisciplinary rehabilitation, is a key component in the management of patients with chronic coronary syndrome (CCS) and/or congestive heart failure (CHF), physicians and exercise professionals disagree among themselves on the type and characteristics of the exercise to be prescribed to these patients, and the exercise prescriptions are not consistent with the international guidelines. This impacts the efficacy and quality of the intervention of rehabilitation. To overcome these barriers, a digital training and decision support system [i.e. EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool], i.e. a stepwise aid to exercise prescription in patients with CCS and/or CHF, affected by concomitant risk factors and comorbidities, in the setting of multidisciplinary rehabilitation, was developed. The EXPERT working group members reviewed the literature and formulated exercise recommendations (exercise training intensity, frequency, volume, type, session and programme duration) and safety precautions for CCS and/or CHF (including heart transplantation). Also, highly prevalent comorbidities (e.g. peripheral arterial disease) or cardiac devices (e.g. pacemaker, implanted cardioverter defibrillator, left-ventricular assist device) were considered, as well as indications for the in-hospital phase (e.g. after coronary revascularisation or hospitalisation for CHF). The contributions of physical fitness, medications and adverse events during exercise testing were also considered. The EXPERT tool was developed on the basis of this evidence. In this paper, the exercise prescriptions for patients with CCS and/or CHF formulated for the EXPERT tool are presented. Finally, to demonstrate how the EXPERT tool proposes exercise prescriptions in patients with CCS and/or CHF with different combinations of CVD risk factors, three patient cases with solutions are presented. [ABSTRACT FROM AUTHOR]

There has been a catastrophic loss of biodiversity in ecosystems across the world. A similar crisis has been observed in the human gut microbiome, which has been linked to "all human diseases affecting westernized countries". This is of great importance because chronic diseases are the leading cause of death worldwide and make up 90% of America's healthcare costs. Disease development is complex and multifactorial, but there is one part of the body's interlinked ecosystem that is often overlooked in discussions about whole-body health, and that is the skin microbiome. This is despite it being a crucial part of the immune, endocrine, and nervous systems and being continuously exposed to environmental stressors. Here we show that a parallel biodiversity loss of 30–84% has occurred on the skin of people in the developed world compared to our ancestors. Research has shown that dysbiosis of the skin microbiome has been linked to many common skin diseases and, more recently, that it could even play an active role in the development of a growing number of whole-body health problems, such as food allergies, asthma, cardiovascular diseases, and Parkinson's, traditionally thought unrelated to the skin. Damaged skin is now known to induce systemic inflammation, which is involved in many chronic diseases. We highlight that biodiversity loss is not only a common finding in dysbiotic ecosystems but also a type of dysbiosis. As a result, we make the case that biodiversity loss in the skin microbiome is a major contributor to the chronic disease epidemic. The link between biodiversity loss and dysbiosis forms the basis of this paper's focus on the subject. The key to understanding why biodiversity loss creates an unhealthy system could be highlighted by complex physics. We introduce entropy to help understand why biodiversity has been linked with ecosystem health and stability. Meanwhile, we also introduce ecosystems as being governed by "non-linear physics" principles—including chaos theory—which suggests that every individual part of any system is intrinsically linked and implies any disruption to a small part of the system (skin) could have a significant and unknown effect on overall system health (whole-body health). Recognizing the link between ecosystem health and human health allows us to understand how crucial it could be to maintain biodiversity across systems everywhere, from the macro-environment we inhabit right down to our body's microbiome. Further, in-depth research is needed so we can aid in the treatment of chronic diseases and potentially change how we think about our health. With millions of people currently suffering, research to help mitigate the crisis is of vital importance. [ABSTRACT FROM AUTHOR]

Background: The SARS-CoV2 pandemic as well as the implementation of public health measures to decrease the spread of the virus re-sparked the call for "virtual" health or "distance" treatments. This paper aimed to assess the use of video consultations, the up-to-dateness of practice websites, and the views of GPs on whether eHealth is a positive aspect for the future of their practices in publicly -funded primary healthcare facilities in Austria. Methods: The cross-sectional online questionnaire, part of the PRICOV-19 study, was conducted from December 2020 until July 2021. We randomly recruited 176 GP practices across Austria. Descriptive statistics as well as binary logistic regression models were applied to examine the associations between telemedicine use and practice factors. Results: Compared with before the pandemic (3.8%), 7.6% of publicly funded GP practices have been using video consultations since the pandemic. In line with this, 93.9% of the practices had no increase in video consultation use. Fewer than half (44.3%) had an up-to-date webpage, and 27.8% assumed that the pandemic might have been a positive driver for eHealth in their practices. Positive associations with video consultation use could be found in practices with fewer patients aged 70 years and over than the average and more patients with chronic diseases than the average. Conclusion: The use of video consultations in general practice and the readiness for other telemedicine approaches are both very low in Austria. Austria has to urgently follow the example of countries with a transparent and comprehensive national digital health strategy that includes video consultation. Without a proper payment system, patient inclusion, and support with regard to administrative and organizational aspects, no substantial change will occur in spite of an increase in need due to the pandemic and changes in the patient population. [ABSTRACT FROM AUTHOR]

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Endometriosis is defined as the presence of endometrial tissue outside of the uterine cavity. It is a chronic disease affecting approximately 10% of women. In addition to producing a vast array of symptoms, including chronic pelvic pain and dysmenorrhea, the condition significantly impacts quality of life. Over the past century, several theories have attempted to explain the pathogenesis of this complex disease. Recent studies have investigated the potential role of human papillomavirus (HPV) infection in the development of endometriotic lesions. The objective of this review was to conduct a search of online databases (Embase, Medline and PubMed) for available literature from June 2013 to June 2023 concerning the association between HPV and endometriosis. After screening 110 articles, 23 studies met the eligibility criteria, and 8 were included in the systematic review. Out of the 8 reviewed papers, 3 described a statistically significant correlation between HPV infection and endometriosis. 3 others only demonstrated a higher incidence of HPV infection in patients with confirmed endometriosis. A difference in the dominant type of HPV serotype among patients diagnosed with endometriosis was also observed. Given these results, it is difficult to propose a viral origin of the disease. Further research is necessary to determine the role of HPV infection in the development of endometriosis. [ABSTRACT FROM AUTHOR]

Introduction: Approximately 20% of people with a long‐term condition (LTC) experience depressive symptoms (subthreshold depression [SUBD]). People with SUBD experience depressive symptoms that do not meet the diagnostic criteria for major depressive disorder. However, there is currently no targeted psychological support for people with LTCs also experiencing SUBD. Online peer support is accessible, inexpensive and scalable, and might offer a way of bridging the gap in psychosocial care for LTC patients. This article explores the psychosocial needs of people living with LTCs and investigates their perspectives on online peer support interventions to inform their future design. Methods: Through a co‐produced participatory approach, online focus groups were completed with people with lived experience of LTCs. Focus groups were audio recorded and transcribed verbatim. Reflexive thematic analysis (TA) was conducted adopting a critical‐realist approach and an inductive analysis methodology that sought to follow participants' priorities and concerns. Results: Ten people with a range of LTCs participated across three online focus groups, lasting an average of 95 (±10.1) min. The mean age was 57 (±11.4) years and 60% of participants identified as female. The three key emerging themes were: (1) relationship between self and outside world; (2) past experiences of peer support; and (3) philosophy and vision of peer support. Adults living with LTCs shared their past experiences of peer support and explored their perspectives on how future online peer support platforms may support their psychosocial needs. Conclusion: Despite the negative impact(s) of having a long‐term physical health condition on mental health, physical and mental healthcare are often treated as separate entities. The need for an integrated approach for people with LTCs was clear. Implementation of online peer support to bridge this gap was supported, but there was a clear consensus that these interventions need to be co‐produced and carefully designed to ensure they feel safe and not commercialised or prescriptive. Shared explorations of the potential benefits and concerns of these online spaces can shape the philosophy and vision of future platforms. Patient or Public Contribution: This work is set within a wider project which is developing an online peer support platform for those living with LTCs. A participatory, co‐produced approach is integral to this work. The initial vision was steered by the experiences of our Patient and Public Involvement (PPI) groups, who emphasised the therapeutic value of peer‐to‐peer interaction. The focus groups confirmed the importance and potential benefit of this project. This paper represents the perspectives of PPI members who collaborate on research and public engagement at the mental–physical interface. A separate, independent Research Advisory Group (RAG), formed of members also living with LTCs, co‐produced study documents, topic guides, and informed key decision‐making processes. Finally, our co‐investigator with lived experience (E. A.F.) undertook the analysis and write‐up alongside colleagues, further strengthening the interpretation and resonance of our work. She shares first joint authorship, and as a core member of the research team, ensures that the conduct of the study is firmly grounded in the experience of people living with LTCs. [ABSTRACT FROM AUTHOR]

Psoriatic arthritis (PsA) is a complex and chronic inflammatory condition in which the achievement of the best possible disease control has been proposed as the treatment target, which includes the possibility of reaching remission in all disease domains. However, due to the complexity of this multidomain disease, some patients may still have high disease activity in one or more domain and a high burden of disease, potentially leading to various treatment changes and to difficulty with the overall management. In this paper, we overview the concept of patients with difficult-to-treat PsA and the concept of patients with refractory-to-treatment PsA by providing a distinction between these two concepts and the possible implication for the management of patients with PsA. [ABSTRACT FROM AUTHOR]

Objetive: Chronic ankle instability is generally associated with ankle sprain. Its consequences can be measured by means of patient-reported outcome measures (PROMs). The aim of this review is to identify the PROMs specifically available for chronic ankle instability and to evaluate their methodological quality and that of the cross-cultural adaptations made. Data Sources: Papers were retrieved from PubMed, Embase, Scopus and Google Scholar databases, with no time limit applied, based on the following inclusion criteria: (1) type of participants: patients with chronic ankle instability, over 18 years of age; (2)type of study: those specifically focused on this pathology, using PROMs specific to chronic ankle instability and published in English; (3) type of outcome: measurement properties based on COSMIN criteria in patient-reported outcomes associated with chronic ankle instability. Methods: This systematic review, following the COSMIN checklist, was conducted to determine the methodological quality of PROMs specific to foot and ankle pathologies, for patients presenting chronic ankle instability. Results: Of the 576 studies identified in the initial search, 34 were included in the final analysis of measurement properties. Four – the Ankle Instability Instrument, the Chronic Ankle Instability Scale, the Cumberland Ankle Instability Tool and the Identification of Functional Ankle Instability – were original questionnaires, and the remaining 30 were cross-cultural adaptations. Conclusion: The Cumberland Ankle Instability Tool and the Identification of Functional Ankle Instability questionnaires can be useful instruments for evaluating chronic ankle instability, both in patients with this condition and also in non-pathological patients. [ABSTRACT FROM AUTHOR]

Background: In combination with non-pharmacological interventions, opioids may safely reduce chronic breathlessness in patients with severe illness. However, implementation in clinical practice varies. Aim: To synthesise the published literature regarding health professionals', patients' and families' views on the use of opioids for chronic breathlessness, identifying issues which influence implementation in clinical practice. Design: Systematic review and synthesis using the five-stage framework synthesis method. Data sources: Three electronic databases (MEDLINE, Embase via OVID, ASSIA via Proquest) were searched (March 2020) using a predefined search strategy. Studies were also citation chained from key papers. Papers were screened against a priori eligibility criteria. Data were extracted from included studies using the framework synthesis method. Qualitative and quantitative data were synthesised using the pillar process. Included studies were critically appraised using the Mixed-Methods Appraisal Tool. Results: After de-duplication, 843 papers were identified. Following screening, 22 studies were included. Five themes were developed: (i) clinician/patient characteristics, (ii) education/knowledge/experience, (iii) relationship between clinician/family, (iv) clinician/patient fear of opioids and (v) regulatory issues. Conclusions: There are significant barriers and enablers to the use of opioids for the symptomatic reduction of chronic breathlessness based on the knowledge, views and attitudes of clinicians, patients and families. Clinicians' interactions with patients and their families strongly influences adherence with opioid treatment regimens for chronic breathlessness. Clinicians', patients' and families' knowledge about the delicate balance between benefits and risks is generally poor. Education for all, but particularly clinicians, is likely to be a necessary (but insufficient) factor for improving implementation in practice. [ABSTRACT FROM AUTHOR]

World statistics declare that aging has direct correlations with more and more health problems with comorbid conditions. As healthcare communities evolve with a massive amount of data at a faster pace, it is essential to predict, assist, and prevent diseases at the right time, especially for elders. Similarly, many researchers have discussed that elders suffer extensively due to chronic health conditions. This work was performed to review literature studies on prediction systems for various chronic illnesses of elderly people. Most of the reviewed papers proposed machine learning prediction models combined with, or without, other related intelligence techniques for chronic disease detection of elderly patients at an early stage to avoid emergency situations. This method provides a promising approach in the analysis of either structured or unstructured datasets to produce very substantial pattern discoveries. By defining the generic architecture for the prediction model, we reviewed various papers involved in similar fields, based on suggested methodologies and their associated outcomes. The study discussed the pros and cons of different prediction models using traditional and modern machine learning techniques. [ABSTRACT FROM AUTHOR]

The relationship between pandemic, or chronic infectious diseases, and the carceral, meaning set‐apart spaces of enforced confinement for 'wrong‐doers,' has a long, tangled history. It features in Foucault's inquiries into disciplinary power and its associated spatial formations, not least in the shape of the modern prison. Drawing lightly from Foucault's claims about disciplinary and biopolitical power, as well as on his anti‐prison activism, this paper explores three possibilities for penal transformation arising during the early months of COVID‐19 in UK prisons (circa March to August 2020). Consulting primary source material, these possibilities are respectively identified as 'retrenching,' 'reworking' or 'reducing' the carceral. A chief finding is that under the press of pandemic 'emergency,' the tilt of emphasis has been towards a retrenched or reworked 'carceral state,' disappointing any promise of abolition, let alone more humble reduction in carceral conditions. The 'biological sub‐citizens' of prisons are hence being left especially vulnerable to the press of pandemic, in part precisely because of how carceral spatialities are being intensified. [ABSTRACT FROM AUTHOR]

Aims: To outline and examine evidence related to the meaning of 'psychosocial vulnerability' among caregivers of persons with chronic illnesses. Background: The number of informal caregivers continues to rise globally. Their risk of psychosocial vulnerability is frequently overlooked, but understanding their psychosocial vulnerability may offer insights into meeting their needs. Design Scoping review following the PRISMA 2020 extension guidelines. Data sources The databases CINAHL, Embase, Medline/Pubmed, Cochrane Library, PsycINFO, Web of Science, Google Scholar, Lenus and ProQuest were systematically searched to identify original research. No date limit was set, and 23 studies were included. Review methods: A five‐step approach using the Arksey and O'Malley framework. Thematic analysis guided data analysis. Results: Carers' psychosocial vulnerability occurs when they experience barriers to resources while access and use of supports reduce risk. Antecedents of psychosocial vulnerability include a carer's age and sex, socioeconomic status and their health and wellbeing. Psychosocial vulnerability affects carers' relationships and causes personal losses. Conclusions: The concept of carers' psychosocial vulnerability is complex. Recognition of carers at risk for psychosocial vulnerability would help nurses direct relevant support and information to carers who need it most. Summary statement: What is already known about this topic? Carers play an increasingly important role in the delivery of holistic care in the community.Barriers and access to relevant support and homecare remain an issue for carers and patients worldwide.Caregivers frequently succumb to vulnerability as a result of their new identification with the role as well as the duty tied to the role. What this paper adds? Findings offer an understanding of factors which may contribute to carers' psychosocial vulnerability.An overview of the impact of caring for individuals with a chronic illness on carers' lives. The implications of this paper Recognition of those at risk for psychosocial vulnerability could enable health care professionals to provide the relevant support and information to carers who need it most.Further qualitative research is needed to increase understanding of carers' experience of caring for someone with a chronic illness.Carers must be seen as essential components of healthcare in order to ensure connection between policy and service delivery. [ABSTRACT FROM AUTHOR]

Environment and climate change have caused a rise in a wide range of diseases and infections. In countries where overpopulation is a problem, many infections spread severely. The main focus of this paper is the detection and identification of blood diseases. An automated system that examines all potential diseases using patient information and data is needed to deal with unpredictable circumstances. Having an automated and intelligent system that evaluates the reports and counsels doctors in any other area or nation is a demand of the time. The same solutions can be identified by the proposed system. To apply the adaptive neuro-fuzzy inference system (ANFIS) and related techniques to predict chronic diseases early, the authors have gone through various existing models and case studies on diabetics and other patients. The proposed approach, called S-ANFIS which is using the hybrid approach, is based on ANFIS and includes content curation and intelligence analysis in addition to comparison with current models. As a result, the suggested model outperforms other approaches in terms of disease prediction accuracy, with a score of 88.6%. [ABSTRACT FROM AUTHOR]

Background: With what has been known as the "triple-win effect", introducing information and communication technologies (ICTs) in the health care of neurodegenerative diseases is beneficial in delaying the need for institutional care, reducing the associated health care costs, reducing the caregiving burden, and improving individuals' quality of life. Nevertheless, the mismatch between the users' expectations and their actual needs remains one of the main challenges that can reduce the usability of technology solutions. Therefore, the European project Personalized Integrated Care Promoting Quality of Life for Older People (PROCare4Life), which aimed to develop an ICT-based platform for all parties involved in the health care of neurodegenerative diseases, adopted a user-centered design approach, where all users are involved from the inception and throughout the platform development and implementation to integrate their needs and requirements in the proposed platform. Objective: This paper presents the results of a study on the needs and requirements of the potential end users (older people with neurodegenerative diseases, caregivers, and health care professionals) and other key stakeholders in the development of the PROCare4Life platform. Methods: A mixed qualitative and quantitative study design was used, including 2 web-based surveys, 40 interviews, and 4 workshops. The study was conducted between April and September 2020 in 5 European countries: Germany, Italy, Portugal, Romania, and Spain. Both data types were analyzed separately and then merged and interpreted, with greater priority placed on qualitative research. Results: A total of 217 participants were recruited; 157 (72.4%) of them completed the web-based surveys (n=85, 54.1% patients and n=72, 45.9% caregivers), and 60 (27.6%) individuals participated in the qualitative research (20/60, 33% health care professionals; 5/60, 8% patients; 5/60, 8% caregivers; and 30/60, 50% key stakeholders). We identified 3 main themes (T): (T1) experiences associated with illness, (T2) thoughts about the platform technology, and (T3) desired properties. Alerts for adverse events, communication tools, reminders, and monitoring are constantly needed functionalities, whereas ease of use, personalization, and user-friendliness are foreseen as necessary features. Conclusions: This paper identified the key personal, social, and health factors that influence the daily lives of the potential end users and reflected on their needs and expectations regarding the design of the proposed PROCare4Life platform. The collected data were useful for the development of the PROCare4Life platform. Although the combination and collection of features for diverse user groups are typical for integrated care platforms, it results in exponential complexity for designers, developers, and users. Contradicting opinions and several concerns in this study demonstrate that an ICT-integrated care platform should not promise too much for too many. Instead, selection, focus, and, sometimes, restriction to essentials are necessary. Users and other stakeholders should be involved in these decisions. [ABSTRACT FROM AUTHOR]

Objectives: Chronic graft-versus-host disease (cGvHD) is the most frequent cause of late non-relapse mortality after allogeneic haematopoietic stem cell transplantation (alloHCT). Nevertheless, established biomarkers of cGvHD are still missing. The National Institutes of Health (NIH) Consensus Development Project on Criteria for Clinical Trials in cGvHD provided recommendations for biomarker research. We evaluated to which extent studies on cellular and soluble biomarkers in cGvHD published in the last 10 years complied with these recommendations. Also, we highlight the most promising biomarker candidates, verified in independent cohorts and/or repeatedly identified by separate studies. Methods: We searched Medline and EMBASE for “cGvHD”, “biomarkers”, “soluble” and “cells” as MeSH terms or emtree subject headings, and their variations on July 28th, 2021, limited to human subjects, English language and last ten years. Reviews, case reports, conference abstracts and single nucleotide polymorphism studies were excluded. Criteria based on the set of recommendations from the NIH group for biomarker research in cGvHD were used for scoring and ranking the references. Results: A total of 91 references encompassing 15,089 participants were included, 54 prospective, 17 retrospective, 18 cross-sectional, and 2 studies included both prospective and retrospective cohorts. Thirty-five papers included time-matched controls without cGvHD and 20 studies did not have any control subjects. Only 9 studies were randomized, and 8 were multicentric. Test and verification cohorts were included in 11 studies. Predominantly, diagnostic biomarkers were explored (n=54). Assigned scores ranged from 5-34. None of the studies fulfilled all 24 criteria (48 points). Nevertheless, the scores improved during the last years. Three cell subsets (CXCR³+CD56bright NK cells, CD19+CD21low and BAFF/CD19+ B cells) and several soluble factors (BAFF, IL 15, CD163, DKK3, CXCL10 and the panel of ST2, CXCL9, MMP3 and OPN) had the highest potential as diagnostic and/or prognostic biomarkers in cGvHD. Conclusion: Despite several limitations of this review (limited applicability for paediatric population, definition of verification, missing data on comorbidities), we identified promising candidate biomarkers for further evaluation in multicentre collaborative studies. This review confirms the importance of the NIH consensus group criteria for improving the quality and reproducibility of cGvHD biomarker research. [ABSTRACT FROM AUTHOR]

Metabolomics, as a new omics technology, has been widely accepted by researchers and has shown great potential in the field of nutrition and health in recent years. This review briefly introduces the process of metabolomics analysis, including sample preparation and extraction, derivatization, separation and detection, and data processing. This paper focuses on the application of metabolomics in food-derived bioactive ingredients. For example, metabolomics techniques are used to analyze metabolites in food to find bioactive substances or new metabolites in food materials. Moreover, bioactive substances have been tested in vitro and in vivo, as well as in humans, to investigate the changes of metabolites and the underlying metabolic pathways, among which metabolomics is used to find potential biomarkers and targets. Metabolomics provides a new approach for the prevention and regulation of chronic diseases and the study of the underlying mechanisms. It also provides strong support for the development of functional food or drugs. Although metabolomics has some limitations such as low sensitivity, poor repeatability, and limited detection range, it is developing rapidly in general, and also in the field of nutrition and health. At the end of this paper, we put forward our own insights on the development prospects of metabolomics in the application of bioactive ingredients in food. [ABSTRACT FROM AUTHOR]

Functional foods play an important role in health care and chronic diseases prevention, particularly cancer. Prenylated flavonoids are presented in many food resources. They are recognized as neutraceuticals due to their diverse health benefits. Up to now, more than 1000 prenylated flavonoids have been identified in plants. Their food resources are reviewed in this paper. Due to the good safety and cancer prevention effect of prenylated flavonoids, this paper reviews the cancer prevention activities and mechanisms reported in last decade. The structure-activity relationship is discussed. Due to the limited availability in nature, the heterologously biosynthetic technique of prenylated flavonoids is discussed in this review. Inclusion of dietary prenylated flavonoids into human diet is highly desirable. This paper combines the up-to-date information and give a clear image regarding prenylated flavonoids as neutraceuticals. [ABSTRACT FROM AUTHOR]

Aim: To investigate the current condition and degree of fear of disease progression and associated factors in patients with mild or common type COVID‐19. Background: At the end of 2019, COVID‐19 spread from Wuhan in Hubei Province throughout China. Confirmed cases and deaths have since been reported in many countries around the world. However, fear of progression in these patients has been poorly explored. Methods: During February 2020, we recruited 114 patients with mild or common type COVID‐19 admitted to a Fangcang shelter hospital. We assessed patients' degree of fear using the simplified Fear of Progression Questionnaire (Chinese version). Multiple regression analysis was applied to explore potential factors. Results: The fear of disease progression scores of patients with mild or common COVID‐19 was at the low‐to‐moderate level. Current unemployment, disease duration of 28 days or more and not having a spouse diagnosed with COVID‐19 were factors potentially associated with fear of progression. Conclusion: With a high prevalence of fear of disease progression in patients with COVID‐19, the risk of psychological effects from the pandemic is significant and fear of progression is one of the manifestations. The need for psychological support services for patients should be included in all pandemic and disaster planning. Summary statement: What is already known about this topic? Fear of progression is a common bio‐socio‐psychological consequence that widespread in cancer patients as well as chronic diseases.Very few studies focus on fear of progression in patients with major infectious disease, not to mention coronavirus disease (COVID‐19). What this paper adds? The present study surveys fear of progression in patients with mild or common type COVID‐19 and revealed a low‐to‐moderate level overall.Being unemployed, having no spouse diagnosed with COVID‐19, and a disease duration of 28 days or more are potential factors associated to patients' fear of the disease progression. The implications of this paper: The COVID‐19 outbreak has been declared as a public health emergency of international concern. Mental health problems such as fear of disease progression might need more attention beyond medical treatment.Future mental health nursing practice and research need to focus on those potential factors or patients with specific characteristics. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and restrictions imposed to eradicate it have affected healthy lifestyle‐related behaviours. Aim: The aim of this study was to determine the effect of COVID‐19 on lifestyle‐related behaviours. Methods: This cross‐sectional web‐based survey research was performed with a convenience sample of 1020 adults residing in Turkey. Data were collected with self‐report data collection tools on 8–28 April 2021: a sociodemographic characteristics form and the impact of COVID‐19 on lifestyle‐related behaviours questionnaire. Results: Eating behaviours, physical activity and sleep patterns of the participants were negatively affected during COVID‐19 pandemic (p < 0.001). More than half of the participants experienced weight gain during the pandemic. Also, stress levels and smoking increased (p < 0.01). The participants reported having changes in their lifestyles most frequently due to the fear of COVID‐19 infection, stress, decreased motivation, closure of the facilities for social and sports activities and increased food prices. Predictors of lifestyle‐related behaviours were found to be education (β =.189), income (β = −.101), residing in a village (β =.113) and the presence of a chronic disease (β =.075) (p < 0.001). Conclusions: During the pandemic, COVID‐19‐related restrictions should be applied whilst taking account of both social distancing measures and maintenance of healthy lifestyle‐related behaviours. Nurses should offer counselling for maintenance of healthy lifestyle‐related behaviours. Summary statement: What is already known about this topic? Studies performed at the beginning and during the course of COVID‐19 pandemic in different countries have shown that lifestyle‐related behaviours are negatively affected.Few studies have used a valid and reliable tool to determine the effect of COVID‐19 on lifestyle‐related behaviours.The effect of COVID‐19 on lifestyle‐related behaviours has not been examined from a nursing perspective. What this paper adds? In the present study, which was performed at a time when night curfews and weekend shutdowns were imposed in Turkey, lifestyles of the participants were found to be negatively affected.More than half of the participants gained weight and had increased stress and smoking and a decreased sleep quality.The negative effect on lifestyle‐related behaviours was more severe in participants with low education and income levels, living in a village and suffering from a chronic disease. The implications of this paper: Restrictions introduced during the pandemic should both take account of social distancing measures and allow healthy lifestyle‐related behaviours.Nurses playing a role in first line health care services should offer education and counselling for maintenance of healthy lifestyle‐related behaviours by utilizing information and communication technology (e.g., video calls). [ABSTRACT FROM AUTHOR]

Aim: This paper highlights a new role of Advanced Practice Nurse/Nurse Practitioner as the clinical planning lead in the development of a unique model of care and service delivery for children living with health complexity, in the context of a LEADS leadership framework and related capabilities. Background: The LEADS in a Caring Environment Framework is an effective tool for leadership development and systems change. An experienced Advanced Practice Nurse/Nurse Practitioner hired into a leadership role contributes to system change for a complex population across a large geographic area. Sources of evidence: World Health Organization, Canadian Nurses Association and other websites, academic databases (PubMed and CINAHL) and relevant books were explored, and the expertise and knowledge of the authors and the redevelopment project team were utilized. Discussion: The Advanced Practice Nurse/Nurse Practitioner (first author) shares and reflects on her own lived experience as a leader in the planning for programmes and services at the new centre utilizing the five LEADS domains and related capabilities. Conclusion: The utilization of the LEADS in a Caring Environment Capabilities Framework showcases the strengths and skills of an Advanced Practice Nurse/Nurse Practitioner shifting from direct clinical care to successfully leading system‐level change. By incorporating the LEADS framework into practice, in any setting or role, Advanced Practice Nurse/Nurse Practitioners can both evaluate and develop their leadership skills while positively effecting system transformation. Implications for nursing practice: The LEADS framework fosters ongoing professional development and can be used to measure the added value of Advanced Practice Nurses within an organization. Implications for nursing policy: Advanced Practice Nurses improve outcomes within the health care system. Leaders must consider this evidence in health workforce planning, ensuring that Advanced Practice Nursing roles become fully integrated and are supported in the context of national and regional health systems. [ABSTRACT FROM AUTHOR]

• Endotrophin is a signaling molecule derived by the post-translational modification of type VI collagen upon collagen formation. • Circulating levels of endotrophin, measured by the PRO- C6 assay, have been associated to an increased risk of mortality in several chronic diseases. • In this meta-analysis, the association of circulating endotrophin with risk of mortality has been assessed in more than 15,000 patients with a plethora of chronic diseases. A doubling in circulating endotrophin presented a hazard ratio for 3-year mortality of 2.1 when adjusted for age, sex and BMI. • Since endotrophin is a product of fibroblast activation, and it has been associated to pro-fibrotic and pro-inflammatory effects in numerous in vitro and in vivo studies, the data suggest that this molecule can be used as a biomarker reflecting an excessive fibroblast activation, which is implicated in the processes of "wound that does not heal" ultimately leading to fibrosis. • Endotrophin is a potential new marker to be employed to risk stratify patients and identify an endotype of patients with overactivation of fibroblasts, which will benefit from anti-fibrotic treatments. Fibrosis, driven by fibroblast activities, is an important contributor to morbidity and mortality in most chronic diseases. Endotrophin, a signaling molecule derived from processing of type VI collagen by highly activated fibroblasts, is involved in fibrotic tissue remodeling. Circulating levels of endotrophin have been associated with an increased risk of mortality in multiple chronic diseases. We conducted a systematic literature review collecting evidence from original papers published between 2012 and January 2023 that reported associations between circulating endotrophin (PRO C6) and mortality. Cohorts with data available to the study authors were included in an Individual Patient Data (IPD) meta-analysis that evaluated the association of PRO C6 with mortality (PROSPERO registration number: CRD42023340215) after adjustment for age, sex and BMI, where available. In the IPD meta-analysis including sixteen cohorts of patients with different non-communicable chronic diseases (NCCDs) (N = 15,205) the estimated summary hazard ratio for 3-years all-cause mortality was 2.10 (95 % CI 1.75—2.52) for a 2-fold increase in PRO C6, with some heterogeneity observed between the studies (I2=70 %). This meta-analysis is the first study documenting that fibroblast activities, as quantified by circulating endotrophin, are independently associated with mortality across a broad range of NCCDs. This indicates that, irrespective of disease, interstitial tissue remodeling, and consequently fibroblast activities, has a central role in adverse clinical outcomes, and should be considered with urgency from drug developers as a target to treat. [ABSTRACT FROM AUTHOR]

Quality of life has become a central value in the provision of healthcare for patients with chronic conditions. This has engendered debates in critical medical sociology on the non-neutral effects that valuing health and illness, medical interventions, and health care delivery in terms of quality of life yields. Focusing on the case of nephrology, this paper presents qualitative data collected in Austria of two dialysis units in which nephrologists initiated projects aimed towards 'the improvement of patients' quality of life'. Whereas the first involved nurses supporting patients in the administration of peritoneal dialysis at home, the second implied the provision of treatment and care exclusively focused on a well-being 'in the here and now' to patients. By conceptualising physicians as actors within networks of relations and values enacted in practices, it analyses how in both dialysis units reference to quality of life enabled nephrologists to problematise the provision of standard haemodialysis treatment to multi-morbid, elderly patients, to develop a new treatment protocol, and to interest and enrol others in the provision of healthcare according this new protocol. Valuing medical interventions in terms of quality of life not only leads to a governmentalization of living and an economisation of health. It also allows physicians to articulate a socio-medico-ethical problem – the availability of life-prolonging technologies for a growing population of elderly, multi-morbid patients – and develop solutions locally. What the solutions consist in may fundamentally differ, however. [ABSTRACT FROM AUTHOR]

Objective To explore the minimum clinically important difference (MCID) of peptic ulcer scale QLICD - PU (V2. 0) among the System of quality of life instruments for chronic diseases. Methods Using convenience samplings the questionnaire was administered from March 2013 to August 2014 using the QLICD - PU (V2. 0) scale, and the MCIDs were calculatedusing the anchor - based and distribution - based methods, respectively, and analyzed to compare the MCIDs developed by taking the mean, taking the minimum, and taking the maximum methods. Results The MCIDs of physical functioning (8.53), psychological functioning (8.45), social functioning (7.61), general module (7. 05), specific module (8. 82), and overall scale (7. 53) obtained by taking the mean method; the MCIDs obtained by taking the minimum method were 5. 25, 5. 78, 6. 16, 4. 19, 7. 18 and 4. 09, respectively; the MCID obtained by taking the maximum method were 11. 99, 12.05, 10.09, 9.48, 10. 99 and 11.04, respectively. Conclusion In this paper, MCID was formulated by using various methods and criteria, which can be chosen by the users according to the situation. MCID can be used to assess the clinical efficacy of patients with peptic ulcers for the application of quality of life. The MCID values formulated can be validated further by clinical practice in subsequent studies. [ABSTRACT FROM AUTHOR]

The relationship between religion and health tends to be framed positively. Religion has been found to act as a coping mechanism and source of support in times of ill health. In this paper, we focus on the disruptive effect of chronic illness on religious practice and cultural engagement. Drawing on interviews with ethnic minority adults with end‐stage kidney disease, who also identify as religious, we introduce the concept ‘cultural disruption’. While religious practice and belief was found to provide strength and comfort we also found that chronic illness had a disruptive impact on religious and cultural practice that participants attempted to manage. To highlight the potential disruptive effect of chronic illness on religious faith and cultural engagement we identify three elements of cultural disruption—disruption to religious practice, disruption to sense of self and identity and disruption to wellbeing. We conclude by suggesting that understanding and accounting for the potential of cultural disruption when diagnosing, treating and supporting people with chronic illness offers an alternative entry point to the life‐worlds of patients who identify as religious and the things that are important to them. [ABSTRACT FROM AUTHOR]

This paper presents an in‐depth analysis of a hybrid mathematical model, the fractional SECIR model, designed to explore the impact of infectious diseases, with particular emphasis on their effect on individuals with chronic conditions. The study delves into the existence and uniqueness of solutions for the proposed model, yielding several stability results based on parameters that adhere to specific conditions to mitigate pandemic occurrences. The model parameters are estimated using data reported by the Algerian health authorities in recent years, facilitating the application of the model to the Algerian context. The findings derived from the application of this mathematical compartmental model indicate that the basic reproduction number for certain infectious diseases in Algeria (Tuberculosis and COVID‐19) is less than one. This observation suggests the potential for disease eradication or effective management through a combination of targeted interventions including vaccination, high‐quality treatment, and precise isolation measures. [ABSTRACT FROM AUTHOR]

Seamless handoff is crucial for wireless body area network (WBAN) data's transmission, it may avoid the death resulted from sudden diseases, especially for the elder people who suffer from chronic diseases. Therefore, a vertical handoff algorithm that conforms to the characteristics of body area network is urgent. Different from the traditional service types in telecommunications, service types in wireless body area network have their own characteristics. How to reasonably divide these service types according to their requirement of the internet is very important. In addition, we need to study the rationality of different weighting and network selection algorithms for body area network users. In view of the lack of vertical handoff algorithms to meet the characteristics of wireless body area networks, this paper first analyzes the service types in body area network, and reasonably divides the service types in body area network into four types. For these four services types, we comprehensively and systematically analyze the weight determination and network selection algorithms suitable for them. In addition, in wireless body area network environment, there may be situations when multiple users need to transmit information at the same time. For these situations, we propose a broadcast mechanism to prevent network congestion caused by group switching. The simulation results show that the combination of using Analytic hierarchy process to determine the weight and using Technique for Order Preference by Similarity to Ideal Solution as the network selection method is most suitable for vertical handoff in WBAN. The proposed broadcast mechanism can solve the network congestion problem caused by group handoff. [ABSTRACT FROM AUTHOR]

Aims Methods and results Conclusions Fibrosis is a common feature of many chronic diseases, including heart failure, which can have deleterious effects on cardiac structure and function that are associated with adverse outcomes. By‐products of collagen synthesis and degradation, such as carboxy‐ and amino‐terminal pro‐ or telo‐peptides of collagen type I and III (PICP, PINP, PIIINP, and CITP) have been extensively investigated as markers of fibrosis. Although the majority of studies report on the reproducibility of their assay results, there is no a comparison of biomarker assays across studies. Therefore, we conducted a systematic review adhering to PRISMA guidelines.The search terms employed in Medline were: ‘collagen AND cardiac’ or ‘collagen AND heart’. This query yielded a total of 1049 articles. Thereafter, specific search criteria were applied: (i) original English‐language papers; (ii) human studies; (iii) in‐vivo investigations; and (iv) blood/serum/plasma samples. Overall, 89 studies were identified (42 on PIIINP, 32 on PICP, 29 on CITP, and 17 on PINP). The range of reported values for PIIINP was between 0.06 to 11 800 μg/l; for PICP 0.006 to 1265 μg/l; for CITP 0.3 to 5450 μg/l; for PINP 0.15 to 80 μg/l. Extreme variations in values for fibrosis biomarkers were observed across studies, especially when different assays were used, but also with the same assays.Our findings show that it is challenging to ascertain normal ranges or compare studies for the measurement of fibrosis biomarkers. Given the potential implications for clinical practice and current lack of awareness of these issues, this subject warrants comprehensive acknowledgement and understanding. [ABSTRACT FROM AUTHOR]

The use of smart locker technology has been beneficial for patients with chronic diseases who require regular medication and face challenges accessing healthcare facilities due to distance, time, or mobility issues. This study aimed to assess preferences for utilizing Smart Lockers in accessing and dispensing chronic disease medication among healthcare workers (HCWs) and patients in Nigeria. A descriptive cross-sectional survey was conducted between November 8th and December 4th, 2021, across secondary healthcare facilities in five states of Adamawa, Akwa Ibom, Cross River, Benue, and Niger. Among 1,133 participants included in the analysis, 405 were HCWs and 728 were patients with chronic illnesses. Descriptive statistics, including frequencies and percentages, were used to summarize the data, while chi-square tests were employed to assess significant differences between healthcare workers (HCWs) and patients. Results indicated a strong preference among both HCWs and patients for one-on-one counseling as the preferred method for orientating patients on using Smart Lockers, with 53.8% of HCWs and 58.1% of patients expressing this preference (p = 0.25). Additionally, there was a shared preference for hospitals or clinics as secure locations for Smart Lockers, with 68.9% of HCWs and 71.6% of patients preferring this option (p < 0.05). The majority of participants favored receiving notification of drug delivery via phone call, with 49.1% of HCWs and 48.8% of patients expressing this preference (p = 0.63). There was a significant difference in preferences for access hours, the majority (HCWs: 65.4% and patients: 52.6%) favored 24-hour access (p < 0.05). Participants identified patients with HIV within the age range of 18–40 as the most suitable population to benefit from using Smart Lockers for medication dispensing. These findings offer insights into healthcare policies aimed at enhancing medication access and adherence among patients with chronic diseases in Nigeria. The development of models for using smart lockers to dispense chronic disease medications to chronically ill persons in Nigeria and other populations is recommended. [ABSTRACT FROM AUTHOR]

Introduction: Systematic reviews are considered the highest level of evidence that can help guide evidence‐informed decisions in nursing practice, education, and even health policy. Systematic review publications have increased from a sporadic few in 1980s to more than 10,000 systematic reviews published every year and around 30,000 registered in prospective registries. Methods: A cross‐sectional design and a variety of data sources were triangulated to identify the journals from which systematic reviews would be evaluated for adherence to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 2020 reporting guidelines and scope. Specifically, this study used the PRISMA 2020 reporting guidelines to assess the reporting of the introduction, methods, information sources and search strategy, study selection process, quality/bias assessments, and results and discussion aspects of the included systematic reviews. Results: Upon review of the 215 systematic reviews published in 10 top‐tier journals in the field of nursing in 2019 and 2020, this study identified several opportunities to improve the reporting of systematic reviews in the context of the 2020 PRISMA statement. Areas of priority for reporting include the following key areas: (1) information sources, (2) search strategies, (3) study selection process, (4) bias reporting, (5) explicit discussion of the implications to policy, and lastly, the need for (6) prospective protocol registration. Discussion: The use of the PRISMA 2020 guidelines by authors, peer reviewers, and editors can help to ensure the transparent and detailed reporting of systematic reviews published in the nursing literature. Clinical Relevance: Systematic reviews are considered strong research evidence that can guide evidence‐based practice and even clinical decision‐making. This paper addresses some common methodological and process issues among systematic reviews that can guide clinicians and practitioners to be more critical in appraising research evidence that can shape nursing practice. [ABSTRACT FROM AUTHOR]

Epidemiological data suggest that the prevalence of autoimmune diseases is increasing. Although evidence implies that people with chronic illnesses experience higher levels of burnout, there are few available insights for developing preventative interventions. This paper builds on the conservation of resources (COR) and the job demands–resources (JD‐R) framework to investigate the association between impaired health, burnout, and work engagement. In two studies, we research the role of health status as a resource, respectively, autoimmune illness symptom severity as a diminished resource, and investigate its variance explanation in burnout and work engagement above and beyond the effects of job demands and resources. Study 1 investigated the hypotheses among 87 employees with inflammatory bowel diseases. Controlling for job demands and resources, symptom severity was positively associated with (exhaustion) burnout and negatively associated with work engagement. In Study 2, we applied mixed model analyses using a sample of 129 employees with multiple sclerosis. We found significant associations of symptom severity on burnout and vigor work engagement above and beyond the effects of job demands and social support. Our studies provide important insights for employees with chronic illnesses and the organizations in which they work and give indications for theory development, future research, and the development of interventions. [ABSTRACT FROM AUTHOR]

This article explores men's experiences of and management strategies for urinary incontinence (UI) following treatment for prostate cancer. Qualitative interviews with 29 men, recruited from two prostate cancer support groups, explored their post-treatment experiences. Drawing on a conceptual toolkit connecting theories of masculinities, embodiment, and chronic illness, this paper identifies older men's experiences and strategies for managing UI and explores how these are shaped by their masculinities. This article identifies interdependence between managing stigma for UI and maintaining masculinity. Men's embodied practices for engaging in activities in public, crucial to masculine identity, were disrupted. In response, they adopted new reflexive body techniques to manage and resolve their UI, and thereby address the threat to their masculine identities, characterised in three strategies: monitoring, planning, and disciplining. The new embodied practices men described suggest three factors as important components for adopting new reflexive body techniques: routine, desire, and unruliness. [ABSTRACT FROM AUTHOR]

In this paper, we present a review of several selected talks presented at the CTTACC conference (Cellular Therapies in Trauma and Critical Care) held in Scottsdale, AZ in May 2023. This conference review highlights the potential for cellular therapies to "reset" the dysregulated immune response and restore physiologic functions to normal. Improvements in medical care systems and technology have increasingly saved lives after major traumatic events. However, many of these patients have complicated post-traumatic sequelae, ranging from short-term multi-organ failure to chronic critical illness. Patients with chronic critical illness have been found to have dysregulated immune responses. These abnormal and harmful immune responses persist for years after the initial insult and can potentially be mitigated by treatment with cellular therapies. The sessions emphasized the need for more research and clinical trials with cellular therapies for the treatment of a multitude of chronic illnesses: post-trauma, radiation injury, COVID-19, burns, traumatic brain injury (TBI) and other chronic infections. [ABSTRACT FROM AUTHOR]

Aims: To synthesise the composition and effectiveness of computer‐based patient decision aid (PDAs) in interventions for patients with chronic diseases. Design: A systematic review with meta‐analysis. Methods: Five databases were searched, and only randomised controlled trials (RCTs)were included. This review was conducted with the PRISMA guidelines. The JBI Appraisal Tools for randomised trials were used to assess the risk of bias. We used the random‐effects model to conduct meta‐analyses. Evidence from RCTs was synthesised using standardised mean differences or mean differences. The GRADE system was employed to assess the certainty of evidence and recommendations. This study was registered on PROSPERO (number: CRD42022369340). Data Sources: PubMed, Embase, Web of Science, CINAHL and Cochrane Library were searched for studies published before October 2022. Results: The review included 22 studies, and most computer‐based PDAs reported information on the disease, treatment options, pros and cons and risk comparison and value clarification. The use of computer‐based PDAs showed a significant effect on decision conflict and knowledge, but not on decision regret, satisfaction, self‐efficacy, anxiety and quality of life. The overall GRADE certainty of evidence was low. Conclusion: Although the quality of evidence was low, however, using computer‐based PDAs could reduce decision conflict and enhance knowledge when making medical decisions. More research is needed to support the contention above. Relevance to Clinical Practice: Computer‐based PDAs could assist health‐care providers and patients in the shared decision‐making process and improving the quality of decision‐making. Reporting Method: This study adhered to PRISMA guidelines. No Patient or Public Contribution: [ABSTRACT FROM AUTHOR]

Aim: This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving. Background: Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources. Design: This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ). Methods: Semi‐structured interviews were conducted with 17 maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2–18 years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience. Results: Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem‐solving skills, enhancing their self‐efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition. Conclusion: This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC. Relevance to clinical practice: Findings from this study provide insight into the experiences of rural maternal caregivers of children with a chronic health condition and identify the strategies they adopt to overcome caregiver challenges. Understanding these strategies allows nurses to improve care and support for rural mothers using a strength‐based approach to build maternal resilience. [ABSTRACT FROM AUTHOR]

Many genetic centers are developing innovative delivery models for services to address the growing need for access to genetics in the setting of a limited genetics‐certified workforce. In the literature review, alternative service delivery models—including telehealth and genetic counselor involvement with nongenetics specialty providers—aim to increase efficiency, patient access, and provider satisfaction. This paper outlines a traditional model of pediatric care, with a workflow involving a geneticist and genetic counselor, from preclinic to follow‐up. We then present a workflow model of a collaborative team consisting of a genetic counselor and nurse practitioner in condition‐specific pediatric clinics. We break down factors influencing the successful implementation of this model, including patient selection, pre‐established and adaptive clinic goals, and differentiation of roles of the providers. Potential barriers to generalization and the ongoing success of this clinic model include provider interest in genetics and the necessity for careful triaging by clinicians. Formalized analysis of these clinics has not been performed, though at the presented institution, this clinic model is recognized as an effective way to decrease wait times for patients referred for specific indications and creates an environment that allows providers to specialize, increasing their expertize and confidence in particular genetic areas. [ABSTRACT FROM AUTHOR]

The purpose of our study is to see how beneficial is tea tree oil (TTO) for treating chronic blepharitis topically, with a focus on the Demodex mite. To discover all possibly relevant published papers, an accurate Pubmed database search analysis of the current literature was undertaken from 2012 to December 2021. Fourteen papers dealing with the use of TTO to treat chronic blepharitis have been found. The effectiveness of TTO treatment was tested in vitro by 4 authors and in vivo by 10 authors. All studied confirmed efficacy of TTO treatment, even cyclic, on Demodex mite blepharitis. TTO can be used for lid scrubs, facial cleanser, eyelid patch, eyelid gel, eyelash shampoo or, more commonly, as TTO impregnated eyelid wipes. The scientific evidence of TTO for chronic blepharitis treatment gives a lot of confidence for the progress that this treatment may have in the future clinical practice. [ABSTRACT FROM AUTHOR]

Medical sensors are implanted within the vital organs of the human body to record and monitor the vital signs of pulse rate, heartbeat, electrocardiogram, body mass index, temperature, blood pressure, etc. to ensure their effective functioning. These are monitored to detect the patient's health from anywhere and at any time. The wireless sensor networks are embedded in the form of body area nets and are capable of sensing and storing the information on a digital device. Later this information could be inspected or even sent to a remotely located storage device specifically (server or any public or private cloud for analysis) so that a medical doctor can diagnose the present medical condition of a person or a patient. Such a facility would be of immense help in the event of an emergency such as a sudden disaster or natural calamity where communication is damaged, and the potential sources become inaccessible. The aim of this paper is to create a mobile platform using mobile ad hoc network to support healthcare connectivity and treatment in emergency situations. [ABSTRACT FROM AUTHOR]

This paper promotes better life quality and lifestyle for patients. We attain this goal by creating a mobile application that analyses patient's medical records, such as diabetes, hypertension, and chronic kidney diseases. Then, we implement the system to diagnose patients with chronic conditions using machine learning techniques. Machine learning classifiers are used in this paper to decide whether a person has any chronic diseases. The investigated diseases are hypertension, diabetes, and chronic kidney disease. Four datasets were used to build the classifying models. Orange3 from Anaconda-Navigator, a data mining tool, was used to test machine learning algorithms. The study findings revealed the superiority of the tree algorithm with 100% accuracy for hypertension; it was the highest outcome for both males and females using Orange3. The highest precision, which is 100%, is observed by SVM, k-NN, decision trees, logistic regression, and CART for hypertension males' data collection. In comparison, the highest precision is 100% in SVM, MLP, decision tree, random forest, logistic regression, and CART for the female dataset. We conclude that the two datasets for the same diseases share mostly the same algorithm accuracy. For kidneys, the Random Forest algorithm produced 100% accuracy, which is the highest value among other algorithms. For diabetes, neural networks have attested the best accuracy. It was 76.3%, yet the accuracy increased slightly as the kNN algorithm showed 83% accuracy. [ABSTRACT FROM AUTHOR]

Background: Vibration therapy (VT), a treatment of musculoskeletal disorders, has been developed for clinical applications in the past decade. However, its effect on relieving chronic low back pain (CLBP) and improving lumbar function is still illusive, lacking sufficient evidence-based medical data. Objective: This systematic review aimed to evaluate the efficacy of vibration therapy on pain and function in people with CLBP. Methods: PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang Date, VIP, and CBM were applied to search for clinical randomized controlled trials (RCTs) on vibration therapy for people with CLBP. The electronic databases were searched from the establishment of the database until July 1, 2023. Two researchers assessed the quality of the included studies and extracted data. The outcome indicators included the pain intensity index, Oswestry dysfunction index (ODI) score, and Roland–Morris dysfunction questionnaire (RMDQ) score. GRADE was used to evaluate the certainty of evidence of each outcome indicator. The meta-analysis was conducted using RevMan 5.3 software. Results: Fourteen papers met the inclusion criteria with 860 subjects (VT group n = 432 and control group n = 428). VT for patients with CLBP reduced the pain intensity index [SMD = − 0.71, 95% CI (− 1.02, − 0.39), I2 = 76%, P < 0.0001], the ODI score value [MD = − 4.24, 95% CI (− 8.10, − 0.38), I2 = 88%, P = 0.03], and the RMDQ score value [MD = − 2.21, 95% CI (− 3.41, − 1.01), I2 = 0%, P = 0.0003]. Subgroup analysis displayed that the pain intensity index was lower in the whole-body vibration (WBV) group than in the control group [SMD = − 0.49, 95% CI (− 0.79, − 0.19), I2 = 58%, P = 0.001] and the local vibration (LV) group [SMD = − 1.07, 95% CI (− 1.60, − 0.53), I2 = 76%, P < 0.0001]. The ODI scores in the WBV group were lower than those in the control group [MD = − 3.30, 95% CI (− 5.76, − 0.83), I2 = 36%, P = 0.009]. There was no statistically significant difference in ODI scores between the LV group and the control group [MD = − 5.78, 95% CI (− 16.23, 4.66), I2 = 97%, P = 0.28]. Conclusion: The data from this study suggest that VT can reduce pain and improve lumbar function in patients with CLBP. However, we still need to carefully interpret the results of this study, as the certainty of evidence was low, and the clinical relevance of the results is questionable. Further RCTs are needed in the future to ascertain this. [ABSTRACT FROM AUTHOR]