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Chronic or refractory breathlessness adversely affects quality of life. Current treatment strategies for managing breathlessness are often inadequate in providing complete relief. Kinesiology taping is generally used in musculoskeletal practice for preventive and rehabilitative purposes. Recently, our attention was drawn to the plausible mechanism(s) and indication for use of kinesiology taping for managing chronic breathlessness. We present a brief review of the scientific rationale and efficacy of kinesiology taping for respiratory function-related outcomes. Through this publication, we hope to catalyse discussions amongst palliative care professionals and researchers on the potential use of kinesiology taping in the management of chronic breathlessness. [ABSTRACT FROM AUTHOR]

This special issue brings together five original research papers on chronic conditions in South Asian contexts with a view to rethink dominant discourses of risk, evidence and control surrounding the category of chronic conditions. Focusing on the multiple and contradictory (re)definitions of what counts as illness, specifically in the context of the rising burden of chronic illness, the papers in this issue deal with a range of health care practices from individual patients negotiating with 'healthy diet', to policy questions about the etiology of emerging disease burden and appropriateness of pharmaceutical interventions in 'traditional' sites of healing. While some of the chronic illnesses addressed in this special issue have received considerable attention from anthropologists (e.g. mental illness, diabetes), others, like leucorrhea have rarely been studied by anthropologists, despite the growing literature on 'chronic illnesses'. [ABSTRACT FROM AUTHOR]

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

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

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

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

Slippery slope argumentation features prominently in debates over assisted suicide. The jurisdiction of Oregon features prominently too, especially as regards parliamentary scrutiny of assisted suicide proposals. This paper examines Oregon's public data (including certain official pronouncements) on assisted suicide in light of the two basic versions of the slippery slope argument, the empirical and moral-logical versions. Oregon's data evidences some normatively interesting shifts in its assisted suicide practice which in turn prompts consideration of two elements of moral-logical slippage that are not widely discussed. One is slippage from an initial autonomy-based public justification for assisted suicide which does not include burden-based concerns within its operative account of voluntariness to an evolved public justification that does. The other is an expansion of a terminal illness ground to include chronic illnesses effectively rendered terminal via a refusal of treatment. [ABSTRACT FROM AUTHOR]

Inclusive education communities and systems are based on how teachers can use their knowledge, skills, and social awareness to meet the increasingly diverse needs of the learners within their classrooms. International research suggests that teachers often feel underprepared to meet the needs of all learners and are largely ill-prepared to know how best to teach and include children living with a chronic illness. The findings from a mixed-methods study involving 55 New Zealand primary school teachers are reported here. Drawing on this study, this paper presents teachers' experiences on how they got to know these children as individuals. Teachers reflected on how they sought the children's own voices to better understand the implications of their illnesses for living and learning. The paper presents teachers' experiences on how they embraced the opportunity for their own professional learning and development, and for some teachers, the joys of working with these inspirational children. The themes 'don't stress', 'learn everything you can', and 'work as a team' are presented. This paper argues that teaching a child living with a chronic illness is a privilege. It is an opportunity for teachers to develop knowledge and skills that will benefit their practice with all children. [ABSTRACT FROM AUTHOR]

Unhealthy lifestyle behaviors such as spending too many hours sitting and inadequate physical activity (PA) can contribute to different chronic diseases. Research has revealed the capabilities of digital technology interventions such as persuasive technologies (PTs) for providing health support and encouraging healthy behavior changes to assist people in preventing chronic diseases and having healthier lifestyles. Thus, the use of mobile technology to deliver PT interventions has dramatically increased, especially for promoting PA and reducing sedentary behavior (SB) by employing various persuasive strategies (PSs). This paper provides a systematic review of 16 years of research from 2006 to 2021. The review aims to (1) explore the various ways each strategy is implemented on mobile-based PTs for PA and SB, (2) evaluate the effectiveness of different ways of implementing the PSs on mobile-based PT interventions for PA and SB, (3) provide a comparison of the different ways of implementing each PS, (4) show the weaknesses and strengths of the interventions based on the strategies and implementations, (5) highlight the limitations and pitfalls of the existing research, and (6) give recommendations and directions for future research. [ABSTRACT FROM AUTHOR]

Patient engagement is currently considered the cornerstone of a revolution in healthcare for its positive impact on health outcomes, health behaviors and healthcare costs. Patient engagement is focused on personalized care to consumers through providing knowledge, skills and confidence. Mobile health (mHealth) applications are an innovative means to facilitate patient engagement. Nevertheless, the extent to which the current mHealth applications are designed to engage patients in managing their chronic diseases is unclear. This paper aims to identify the Persuasive System Design (PSD) features present in current mHealth applications that increased the engagement of patients with chronic diseases. This review also aims to identify patient engagement-related outcomes of these features. This paper conducted a systematic literature review and meta-analysis to find relevant studies published from all years up to 2020 through six databases: PubMed, Scopus, Web of Science, Cinahl plus with full text, MEDLINE with full text, and Cochrane Library (Central register of controlled trials). The database search returned 4939 articles; after applying the inclusion and exclusion criteria, the number of included articles for the final review was 13. A qualitative content analysis was performed to identify PSD model features and their patient engagement-related outcomes. The quality assessment has been done through the Cochrane Risk of Bias tool for RCTs. The systematic literature review and meta-analysis identified eleven PSD features that can increase patient engagement through using mHealth applications. The identified PSD features have been shown to have various patient engagement-related outcomes. Behavior Change Techniques (BCTs) were combined with the identified PSD features. This paper identified persuasive features of mHealth application design that influence the engagement of patients with chronic diseases toward changing their behavior. The impact of these features is also analyzed in this review. The results show that an mHealth technology-mediated patient engagement model is needed. [ABSTRACT FROM AUTHOR]

This paper focuses on the (in)direct tools of governmental bureaucracy used to control journalistic work in the Kurdistan Region of Iraq (KRI). It calls for understanding media capture not only through structural-level consequences, but also through the methods used to create an environment of instability and unsafety. To make sense of these processes, and how they are experienced and negotiated by journalists, this paper combines scholarship on the emotional labor of journalism with scholarship on processes of media capture in deeply restrictive environments. The mixed-methods approach aims first to uncover structural conditions of media capture in the KRI through a document analysis of 21 public reports published by the Kurdistan Journalists' Syndicate (KJS) and the Metro Center for Journalists' Rights and Advocacy (MC) between 2014 and 2020. Second, it aims to reveal how journalists and editors-in-chief from diverse media organizations manage and negotiate these chronic conditions of precarity and instability, through 15 semi-structured in-depth interviews. The results show multiple strategies that have been developed by journalists and editors to mitigate or acclimate direct and indirect bureaucratic violence (e.g., editorial support, socialization skills and networks, understanding of unspoken and unwritten rules, etc.) [ABSTRACT FROM AUTHOR]

Follow-up policies following treatment are indispensable and effective in reducing the number of complications of chronic diseases, and hence the cost of treating complications, but bring additional follow-up cost inevitably. This paper introduces the virtual age method to measure the effect of follow-up on the patient's risk of developing a complication, and further proposes a mixed integer nonlinear programming model to develop the optimal periodic follow-up policies from a cost perspective. By means of the proposed model, the optimal timing and type of follow-up checkups for heterogeneous patients can be derived, achieving a tradeoff between costs of treating complications and follow-up. A case study of pediatric type 1 diabetes mellitus patients is presented to illustrate the applicability of the proposed method and analyse the impacts of significant input parameters on the optimal model solutions. The findings form the basis to design flexible and effective follow-up policies for monitoring patients with chronic diseases. [ABSTRACT FROM AUTHOR]

A call for papers is presented for a special issue to be published on preschool children suffering from chronic illnesses.

This paper examines the effect of national health insurance on the choice of healthcare facility among diabetic and hypertensive patients in Ghana. The data for this paper came from a secondary source, and the conditional mixed processing approach was utilised to investigate the influence of health insurance status on healthcare facility choice among diabetic and hypertension patients. The study reveals that when compared with uninsured individuals suffering from hypertension/diabetes, insured individuals are more likely to attend formal healthcare facilities and herbal clinics/hospitals and less likely to attend traditional/spiritual healing centres instead of chemical shop/self-care. This work addresses the problem of unobserved heterogeneity (selection bias) by employing the conditional mixed processing approach to account for the potential that health insurance is endogenous to the choice of healthcare facility, which if not accounted for might lead to biased estimates. [ABSTRACT FROM AUTHOR]

Advances in detection and treatment mean that over 50% of people diagnosed with colorectal cancer can expect to live for more than ten years following treatment. Studies show that colorectal cancer patients can experience numerous physical and psychological late effects. The aim of this study was to conduct a systematic review and qualitative synthesis on the experiences of living with colorectal cancer as a chronic illness. Electronic searches of online databases were undertaken of peer reviewed and grey literature. Forty-seven papers were eligible for inclusion in the review, capturing the experiences of over 700 participants, the findings from which were analysed using thematic synthesis. Three higher order concepts were identified which were prevalent across studies and countries and which related to the supportive care needs of patients; common physical and psychological late effects of cancer; and methods of psychosocial adjustment to living with and beyond colorectal cancer. The results are considered in the context of existing theoretical approaches to chronic illness and the need to develop a theoretical approach which fully encapsulates the experience of living with colorectal cancer as a chronic illness in order to inform interventions to support patient adjustment. [ABSTRACT FROM AUTHOR]

Introduction: Demographic and epidemiological challenges are demanding deep transformation within health systems. The Basque Health System has introduced innovative initiatives to deal with this reality, particularly focused on patients with multiple chronic conditions. This review intends to identify and summarize the existing evidence on the effectiveness and cost-effectiveness of these innovations developed in the Basque Country focused on complex chronic, frail, and end-of-life patients. Methods: A scoping review of literature was undertaken in PubMed database and gray literature for data published from 2009 to 2016 on clinical management innovative approaches related to complex chronic, frail, and end-of-life patients in the Basque Country. Selected papers were analyzed by study population, reported outcomes, study period, and setting. Results: 12 studies corresponding to 9 initiatives have been included and analyzed in the review. Results show that interventions had been effective in the achievement of their objectives and therefore, care for these targeted patients has improved. Only 3 out of 12 papers report results on cost-effectiveness, 2 presenting it as cost-effective and one not. Conclusions: There is a consistent pattern on the benefits of implementing specific care management programs targeting these complex chronic, frail, or end-of-life patients. [ABSTRACT FROM AUTHOR]

Vitiligo is a chronic pigmentary condition and severely impacts patient quality of life (QoL). It is an underrecognized burden for patients, healthcare systems, and society in Latin America (LA). This paper examines the journey of a vitiligo patient in LA and assesses the disease landscape. Americas Health Foundation (AHF) assembled a panel of six Argentine, Brazilian, Colombian, and Mexican vitiligo experts. On 10–12 May 2022, they met in a virtual meeting. Each panelist wrote a short paper on barriers to vitiligo diagnosis and treatment in LA before the meeting. AHF staff moderated as the panel reviewed and modified each paper over three days. The panel approved the recommendations based on research, professional opinion, and personal experience. The panel agreed that lack of disease awareness and research, social ostracization, and limited therapeutic options hinder patients in their quest for diagnosis and treatment. In addition to the medical and psychological difficulties associated with vitiligo, problems connected to the Latin American healthcare system may negatively impact diagnosis, prognosis, and treatment. Access to timely diagnosis and treatment is crucial for improving outcomes. Governments, medical societies, academics, patient organizations, industry, and the public must unite to eliminate these challenges. [ABSTRACT FROM AUTHOR]

American colonization of the Philippines restyled local civilization's character. One notable transition prompted by American colonial rule was the adoption of new public health conventions. In spite of these practices being introduced to elevate the well-being and life expectancy of the Filipinos their implementation was met with resistance. Accordingly, this paper focuses upon the creation of the Philippines' first crematory facility, namely the San Lazaro Crematorium (opened in 1903, in Manila). The work, thus, grants an overview of how Filipinos responded to a societal modernization project initiated by the American colonial regime. The paper discusses three matters: first, what American colonial policymakers sought, with reference to public health, to accomplish; second, how the American colonial framework directly challenged Filipino culture with regard to disease prevention and death management; and, third, why the construction of the San Lazaro Crematorium offers a unique entry point to grasp the nature of America's initial governance of the Philippines. Such clarification has twofold value: it helps to deepen comprehension of the administration's operation and, in association, native opposition to it; plus, given that the crematorium is presently derelict this paper can underscore its value as a dark heritage object worthy of preservation. [ABSTRACT FROM AUTHOR]

The article announces the deadline for submission of the manuscripts about the research examining any aspect of the use of clinical assessment devices in relation to medical illnesses. The topics of interest which include the assessment of psychopathology in primary care settings, use of personality assessment in medical settings, assessment of psychological factors involved in biological variables or chronic disease and problems in the assessment of psychotropic drug effects are also presented.

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]

This paper centers on Isabella, a Candomblé follower who struggled with severe rheumatoid arthritis from an early age, arguing that care and self-care practices in Candomblé are intertwined to such extent that they challenge the dichotomy of caring and being cared for. In contrast to a linear model of care that positions care-giver and care-receiver at opposite ends of care relationships, the concept of 'circular care' describes forms of care that are directed at others and simultaneously at oneself. Exploring the religious kinship in a Candomblé house - with Candomblé deities (orixás) and between humans - this paper shows how circular care blurs the distinction between self and other. The emic concept of 'the double mirror' illustrates the 'constitutive alterity' of humans and orixás who relate to each other through kinship building and collective care practices. Since circular care frames one's care for the orixás and the religious family as healing self-care, failing to provide the correct care may in turn be experienced as detrimental self-neglect. The concept of circular care thus enables a deeper understanding of complex dynamics of care and self-care in the contexts of chronic illness, religion, kinship, and beyond. [ABSTRACT FROM AUTHOR]

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

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]

As Jungian analysts, we rarely discuss our medical conditions, especially chronic illness and disability and their effects on our work and lives. The sense of being judged by our colleagues and being forced to give up our practices by prevailing cultural and societal norms can create fear and apprehension in a disabled analyst, who may not feel able to discuss the depths that can also emerge from serious physical conditions. These apprehensions may also be connected to the overused and often misused concept of psychosomatic illness, a reductive and causal approach that may stifle a more creative experience emerging from illness and disability. C. A. Meier brings a different understanding and approach to the links between soma and psyche, connecting the two at the psychoid level, where synchronistic experiences may emerge. Furthermore, through the myth of Inanna's journey to the death world of Ereshkigal, this paper includes a personal account of illness and disability, connecting it to a wider conversation concerning the Jungian approach to ourselves as analysts, to our colleagues, and to our clients. [ABSTRACT FROM AUTHOR]

An editorial is presented on ongoing COVID-19 pandemic in transforming society's approach to the health, wellbeing, and healthcare services. Topics include people living longer with increasing multiple chronic conditions and rising costs of healthcare; presenting new opportunities for designers in the development of the systems as well as the design of new products; and patients and caregivers experiencing challenges such as disruption in care plans and lack of communication.

Objective: This paper aimed to examine the longitudinal validity of self-rated health (SRH) and whether it would be affected by possible changes in evaluation standards (i.e., response shift) over time. Design: Data are from a longitudinal survey of a nationally representative sample in China. Analytical sample was restricted to respondents aged 45 and above (n = 15,893). Individual fixed effects models were used to analyze changes in ratings on health anchoring vignettes and self-rated health over time. Main outcome measures: SRH at two time points with a -two-year span. Results: Both SRH and anchoring vignettes ratings displayed changes over a two-year span for all the studied age groups. Compared with the self-assessed change in health ("How would you rate your health as compared to that of last year?"), changes in SRH reported over time displayed a more stable and optimistic pattern. SRH responded to doctor diagnosed chronic disease and changes in functional limitation, before and after adjusting for evaluation standards. Conclusion: SRH is responsive to the newly diagnosed chronic disease and functional limitation, regardless of whether we consider response shift within the same respondents over time. [ABSTRACT FROM AUTHOR]

The complexity of the current healthcare ecosystem justifies the convenience of targeting patients' companions in health communication strategies. Designing successful interventions requires taking into account which keys should be pressed in companions in order to generate positive outcomes in the accompanied patients. In particular, this paper explores how companion health empowerment and companion health literacy affect the well-being of chronically-ill elderly patients. Data for this research come from a cross-sectional quantitative study including 1,814 individuals (907 chronically-ill elderly patients and their 907 companions). Data were collected through two online questionnaires, one for patients and one for companions. The findings suggest that companion health empowerment is defined by the dimensions information search empowerment and knowledge development and decision participation empowerment. Furthermore, the distinction between functional, interactive and critical health literacy has revealed to be useful for comprehending companion health literacy. A structural equation model shows that critical health literacy sets the threshold above which companion health literacy improves accompanied patient well-being, even more so when it is backed up by companion information search empowerment and by companion knowledge development and decision participation empowerment. [ABSTRACT FROM AUTHOR]

This paper focuses on the particular situation of an advanced cancer patient whose condition has taken a chronic turn. We argue that chronicity of this kind sometimes falls at the frontier of Evidence Based Medicine because the uncertainty about the patient's condition can lead physicians to resort to clinical trials or non-licensed drugs to prevent the disease from progressing. This situation leaves plenty of scope for individual adjustments between patients and their doctors. Advanced cancer is regarded here not just as a biological event but as a chronic illness and a 'negotiated reality'. We argue that the chronicity of advanced cancer patients' situation broadens the patients' scope for 'work', and we have called this specific type of patient's work 'decision-making work'. This paper is based on a case study focusing on Patrick, a middle-aged Frenchman with metastatic lung cancer who underwent oncological treatment for seven years and was strongly determined to find new therapeutic options even if this meant having to go abroad. He actively orchestrated his therapeutic itinerary by reorganising his relationships with the medical world and coordinating the physicians' work. His particular social position enabled Patrick to bypass some of the current medical rules and to reorganise the usual pattern of distribution of medical responsibilities. The chronicity of his condition placed him at the very frontier of the health care system. [ABSTRACT FROM AUTHOR]

According to the World Health Organization, cardiovascular disease (CVD) has become a major cause of chronic illness around the globe. It has been reported that soy-based fermented food (SFF) is very effective in preventing thrombus (one of the most important contributing factors to CVD), which are mainly attributed to the bioactive substances, especially the fibrinolytic enzymes (FE) generated by microorganisms during the fermentation process of soybean food. This paper therefore mainly reviewed the microbial fibrinolytic enzymes (MFE) from SFF. We first discuss the use of microbial fermentation to produce FE, with an emphasis on the strains involved. The production, purification, physicochemical properties, structure-functional attributes, functional properties and possible application of MFE from SFF are then discussed. Finally, current limitations and future perspectives for the production, purification, and the practical application of MFE are discussed. MFE from SFF pose multiple health benefits, including thrombolysis, antihypertension, anti-inflammatory, anti-hyperlipidemia, anticancer, neuroprotective, antiviral and other activities. Therefore, they exhibit great potential for functional foods and nutraceutical applications, especially foods with CVDs prevention potential. [ABSTRACT FROM AUTHOR]

Current attempts to understand unusually high rates of psychiatric illness in complex, chronic illnesses can be guilty of operating within an explanatory framework whereby there are two options. Either (a) that the psychiatric predicaments are secondary to the bodily condition, and (b) that they are primary. In this paper, I draw upon philosophical work on affect, contemporary empirical work, and qualitative first-person patient data to illustrate a much messier reality. I argue that affective experience is generally more complex in such conditions, and that a variety of pre- and post-morbid causal factors dynamically interact such that the resultant psychiatric predicaments do not permit to classification as strictly primary or secondary to the bodily condition. Affective scaffolding, in my view, provides an apt theoretical framework for capturing this nuance. [ABSTRACT FROM AUTHOR]

This paper introduces a contemporary psychodynamic attachment approach for managing chronic illnesses with a focus on the role of impairments in mentalizing, attachment, and epistemic trust. This approach emphasizes the significance of relational dynamics in healthcare settings and may thus provide a complementary approach in health psychology which currently primarily targets individual and behavioral aspects of chronic illness by addressing the relational dynamics that are typically involved in chronic illness management. We review empirical evidence highlighting the roles of mentalizing, attachment, and epistemic trust in chronic illness. We propose an attachment and mentalizing-based healthcare paradigm that prioritizes relational dynamics that aligns with emerging health psychology trends, offering a holistic approach to patient care. Finally, we present some practical implications of this approach, underscoring the importance of psychologists working in health in fostering secure attachment, epistemic trust and mentalizing within patient-provider relationships. This involves tailoring patient interactions and psychoeducation to individual needs and narratives, enhancing treatment adherence and well-being. [ABSTRACT FROM AUTHOR]

Evidence indicates that pediatric chronic health conditions (CHCs) often impair executive functioning (EF) and impaired EF undermines pediatric CHC management. This bidirectional relationship likely occurs due to biobehavioural and social-structural factors that serve to maintain this feedback loop. Specifically, biobehavioural research suggests that inflammation may sustain a feedback loop that links together increased CHC severity, challenges with EF, and lower engagement in health promoting behaviours. Experiencing social and environmental inequity also maintains pressure on this feedback loop as experiencing inequities is associated with greater inflammation, increased CHC severity, as well as challenges with EF and engagement in health promoting behaviours. Amidst this growing body of research, a model of biobehavioural and social-structural factors that centres inflammation and EF is warranted to better identify individual and structural targets to ameliorate the effects of CHCs on children, families, and society at large. This paper proposes this model, reviews relevant literature, and delineates actionable research and clinical implications. [ABSTRACT FROM AUTHOR]

Use of mobile health applications (mHealth apps) is becoming increasingly popular for the management of chronic illnesses, but mHealth-based intervention studies often have limitations associated with subject recruitment and retention. In this synopsis, we focus on targeted aspects of mHealth-based intervention studies, specifically: (i) subject recruitment, (ii) cohort sizes, and (iii) retention rates. We used the Google Scholar (meta-search) and Galileo search engines to identify sample articles focusing on mHealth apps and interventions published between 2010 and 2020 and selected 21 papers for detailed review. Most studies recruited relatively small cohorts (minimum: 20, maximum: 510). Retention rates had high variance with only five studies managing >80% subject retention throughout the study duration, 10.4% being the lowest. Eighty-five percent of the studies expressed concerns regarding study duration, app usage, and lack of proper implementation. The use of mHealth interventions generally yielded positive outcomes, but most studies discussed facing challenges associated with recruitment and retention. There is a clear need to identify strategies for recruiting larger cohorts and improving retention rates, and ultimately increasing the reliability of mHealth app-based intervention studies. We advise that potential underutilized opportunities lie at the intersection of mHealth and social media to address the limitations identified in the synopsis. [ABSTRACT FROM AUTHOR]

During the ongoing Covid-19 pandemic, telemedicine has provided people with a technical solution to alleviate chronic disease management without the fear of cross-contamination of Covid-19. This research adopted semi-structured interviews to understand Wuhan senior citizens' intentions to use digital devices for chronic disease management during and after the lockdown. The research illustrated how citizens in Wuhan managed their medical requirements by the 'grid-managed' online community. This paper also revealed different emphases on telemedicine between middle-aged and senior citizens. In addition, the findings suggested that cultural background, medical literacy, and socio-economic infrastructures play a pivotal role in influencing senior citizens' perceptions and use of telemedicine and telecare services. The findings also identified the key role of social networks which we term as a new form of acquaintance society. [ABSTRACT FROM AUTHOR]

Background:There is a lack of evidence-based knowledge about the effectiveness of home-based OT for older adults aimed at improving occupational performance by practicing activities and tasks. Aim:This review synthesizes and discusses evidence for the effectiveness of occupation-focused and occupation-based OT for older adults at home. Material and methods:Peer-reviewed quantitative papers were included. Participants: ≥ 60-year-old adults with functional limitations. Intervention: OT aiming at improving occupational performance, primarily through the practice of activities and tasks. Outcome: Occupational performance. Context: Home. Three reviewers critically appraised 13 of 995 detected papers. Extracted data were presented and summarized descriptively. Results:Eight high-quality papers showed that occupation-focused and occupation-based OT using cognitive, behavioral and environmental strategies may significantly improve occupational performance in older, home-dwelling adults with physical health problems. Maintaining achieved improvements was a consistent challenge. Conclusions and significance:Evidence suggests that older adults’ occupational performance can be significantly improved through low-intensity occupation-focused and occupation-based intervention. It is recommended to develop and test high-intensity OT programs and maintenance programs. [ABSTRACT FROM PUBLISHER]

Objective: To evaluate beliefs, and attitudes about health of refugees with chronic conditions such as diabetes mellitus type 2, hypertension, chronic obstructive pulmonary disease, and posttraumatic stress disorder and the consequent effects on self-care in comparison to resident populations. Design: A systematic review methodology was used. PubMed, Embase, PsycINFO and CINAHL databases were searched for relevant articles. The main terms analysed were health beliefs, chronic conditions and refugee populations. From 844 articles, 45 were retained for further assessment, and finally 5 met the inclusion criteria. Results: Differences in the health beliefs, attitudes and self-care management approaches of refugees compared to resident populations were identified in two studies. The remaining three papers did not make comparisons between the refugees and the resident population, nor did they specifically explore the refugees' health beliefs. Of the five studies, three were carried out in Sweden and two in the US. Refugees who have poorer mental and physical health as well as higher prevalence of chronic diseases than the populations among which they resettle seem to lack the knowledge about their illness, symptoms and self-management and thus are less able to control their chronic conditions. Conclusion: The findings highlighted the deficiency in the literature of studies which examine health beliefs and attitudes of minority groups such as refugees who have chronic conditions. The findings also gave insight to the need for a distinctive understanding of refugee health and the management of chronic conditions in comparison to other non-refugee migrant groups. Further research is needed to fully understand the differences between refugees and local populations in terms health beliefs, chronic disease and self-management. [ABSTRACT FROM AUTHOR]

This paper explores the experiences of students with chronic illnesses in UK universities. Sixty-seven students with chronic illnesses completed an online survey with open-ended questions about their experiences in higher education. Questions covered four main topics: academic work; university staff; social and extracurricular activities; and participants' miscellaneous opinions. Using thematic analysis, the data were analysed with references to the social model of disability and social representations of chronic illness. Participants wrote of misconceptions surrounding chronic illnesses, a sense of inequality, and feeling undervalued. Many staff members seemed to lack understanding and so 'policed' academic regulations rather than accommodating for their chronic illnesses. However, some participants wrote of social and academic 'allies' who offered understanding and proactive support. The findings add substance to the chronic illness literature with the focus on students at university, and we offer recommendations to universities for improving inclusivity for students with chronic illnesses. Disabled students with energy-limiting chronic illnesses are frustrated by a lack of support and feel that they have fewer opportunities than non-disabled students. Some university staff may hold negative views of disabled individuals, and so provide inadequate support. This can lead to students' reluctance to disclose chronic illnesses. Students with chronic illnesses felt that some staff and peers did not class chronic illnesses as 'real' disabilities and felt that they were perceived lesser than those with visible disabilities. Some students proudly owned the label of 'disabled' to educate others, including staff, who sometimes used university regulations inappropriately to excuse not adjusting support for disabled students. Some staff and students were perceived as supportive allies. Universities must listen to disabled students and those with chronic illnesses to ensure they fulfil their legal and moral obligations of providing equality of opportunity, enabling all students to succeed. [ABSTRACT FROM AUTHOR]

Place and health are intricately bound. COVID has amplified system burdens and health risks within the housing care continuum, in which older adults with chronic illnesses are disproportionately represented. The paper identifies the health experiences of older adults with severe conditions living in and moving through temporary avoidance hotels during the COVID-19 pandemic. An interpretive descriptive approach was taken with qualitative chart data and provider observation to represent the experiences of 14 older avoidance hotel residents living with serious illnesses. Through provider documentation, we illustrate trends pre-pandemic, in the first nine months of the pandemic, and the second nine months. Such trends include strengths and opportunities such as the health-affirming nature of avoidance hotels, their potential in generating continuity of care and permanent housing, and synergy between harm reduction approaches and palliative care. Challenges were also identified in catering to the diverse medical, behavioral, and psychosocial-spiritual needs of older and seriously ill residents and the consequences of geographic dispersion on health care, health behaviors, and informal care networks. Through these strengths and challenges, avoidance hotels present essential lessons in considering future housing and healthcare intervention and implementation that addresses the needs of older seriously ill people facing homelessness and housing precarity. [ABSTRACT FROM AUTHOR]

While experience often affords important knowledge and insight that is difficult to garner through observation or testimony alone, it also has the potential to generate conflicts of interest and unrepresentative perspectives. We call this tension the paradox of experience. In this paper, we first outline appeals to experience made in debates about access to unproven medical products and disability bioethics, as examples of how experience claims arise in bioethics and some of the challenges raised by these claims. We then motivate the idea that experience can be an asset by appealing to themes in feminist and moral epistemology, distinguishing between epistemic and justice-based appeals. Next, we explain the concern that experience may be a liability by appealing to empirical work on cognitive biases and theoretical work about the problem of partial representation. We conclude with preliminary recommendations for addressing the paradox and offer several questions for future discussion. [ABSTRACT FROM AUTHOR]

Cystic fibrosis (CF) is an inherited, life-limiting chronic health condition that impacts many organ systems including the lungs, pancreas, liver, intestines, and reproductive organs. Given the various organ systems impacted, treatments can be complex, burdensome, and time consuming. In addition, the stress and emotional impact of CF on caregivers as well as patients is significant. This paper describes delivery of psychosocial care across developmental stages in the largest pediatric CF center in the country. The focus will be on goals of care as well as assessment and intervention strategies. Furthermore, clinical informatics and next steps also will be discussed. [ABSTRACT FROM AUTHOR]

This paper examines the impact of chronic illnesses on labor force participation using labor market surveys data for Egypt and Tunisia. The study also investigates the reverse effect of labor force participation on the incidence of chronic diseases. We adopted the simultaneous equations modeling technique to address the potential endogeneity of chronic illnesses in the labor participation equation. The results reveal that chronically ill people are less likely to participate in the labor force in both Egypt and Tunisia. However, the sub-samples analysis indicates some variations across gender and age groups. Specifically, the effect of chronic illnesses is found to be larger and significant for the male group compared to female counterparts. Likewise, the feedback effect shows that labor force participation exerts negative impact on chronic illness, particularly for the total sample. Moreover, the impact of labor force participation on chronic diseases in elder group is larger compared to its effect in the younger group. The study recommends that policymakers in the Arab countries should endeavor to reduce chronic health conditions in order to boost labor force participation and productivity. [ABSTRACT FROM AUTHOR]

A person trapped in a building engulfed in a raging fire, a person dealing with severe chronic disease, people dealing with a virus pandemic, and people fighting in a protracted war may appear dissimilar but are fundamentally in a similar situation and their behaviors follow a predictable and similar pattern. In this paper, the behaviors of rational people dealing with a significant persistent unpleasant, or dangerous stimulus that is inescapable are elucidated. The unique modulatory effects of stimulus persistence on human behavior as well as the role of means and interest are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Integrated care is becoming very crucial in healthcare management due to the increase of chronic non-communicable diseases (NCD) globally. Therefore, this paper aimed to review and examine how applicable and transferable quality referral factors were to the Saudi health system. Methods: Two searches were completed to (1) identify quality referral factors and (2) to identify the Saudi literature relevant to the referral system. This paper employed a knowledge-to-action framework, and assessed quality factors of referrals for their applicability and transferability in the Saudi context using Wang's literature-based method. Results: The quality referral factors introduced were safe, timely, effective, efficient, equitable, patient centred, structured referral letter, dissemination of referral guidelines, central computerised system, and inclusion criteria. These factors could be applicable and transferrable to the Saudi setting with a consideration of 13 factors. The 13 factors include organizational structure, social acceptability/norms, availability of resources and skills, magnitude of health issues, and characteristics of the target population. Conclusion: Although deficits are present in the current Saudi referral system, the applicability and transferability of the quality referral factors are attainable in Saudi Arabia. From an international perspective, this review shows 10 quality factors that are significant in the process of referral system for chronic NCD. [ABSTRACT FROM AUTHOR]

Both scholarly and popular accounts of Canada's relatively non-conflictual immigration politics have attributed substantial power to the selectivity of the country's immigration policy. In this paper, we use new measures of knowledge of the fiscally selective elements of the immigration system to demonstrate that individuals who know more about the system are, in fact, more supportive of immigration, and that this impact is strongest among those who consider themselves on the left. We argue that this is evidence of the progressive's dilemma, showing in particular that knowledge of welfare state-relevant selection criteria such as the Canadian system's discrimination against those with chronic illnesses or those who are older is much more important in determining the attitudes of respondents on the left than those on the right. [ABSTRACT FROM AUTHOR]

Tamarind is a fruit with a wide variety of uses, and the presence of enzyme inhibitors in Tamarind seeds gives the fruit bioactive activities. Protease inhibitors have been recognized as molecules that can potentially contribute to health. Trypsin inhibitors present different physiological effects, such as anti-inflammatory and satietogenic effects, which make them potent candidates for the treatment and prevention of chronic diseases, despite the challenging methodologies in characterizing these new molecules. This paper aims to address the activities and health application perspectives of Tamarind enzyme inhibitors using a systematic integrative literature review. [ABSTRACT FROM AUTHOR]

Bronchial asthma (abbreviated as asthma), is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness. The main characteristics of asthma include variable reversible airflow limitation and airway remodeling. The pathogenesis of asthma is still unclear. Th1/Th2 imbalance, Th1 deficiency and Th2 hyperfunction are classic pathophysiological mechanisms of asthma. Some studies have shown that the imbalance of the Th1/Th2 cellular immune model and Th17/Treg imbalance play a key role in the occurrence and development of asthma; however, these imbalances do not fully explain the disease. In recent years, studies have shown that γδT and γδT17 cells are involved in the pathogenesis of asthma. γδTreg has a potential immunosuppressive function, but its regulatory mechanisms have not been fully elucidated. In this paper, we reviewed the role of γδT17/γδTreg cells in bronchial asthma, including the mechanisms of their development and activation. Here we propose that γδT17/Treg cell subsets contribute to the occurrence and development of asthma, constituting a novel potential target for asthma treatment. [ABSTRACT FROM AUTHOR]

Chronic health conditions represent a key challenge for contemporary public healthcare. Current policy promotes self-management support to reduce demands on health services and improve patients' health and wellbeing. Though there is emerging recognition that self-management is achieved in collaboration between health professionals and patients, how chronicity is managed in interaction remains relatively underexplored in research. In this paper we report on research examining how people are supported to self-manage their conditions through their healthcare encounters. We draw on observational data from consultations between people with multiple chronic health conditions and their healthcare professionals, and semi-structured interviews with both patients and professionals about these consultations. We illuminate points of disconnect between patients and health professionals and demonstrate how these disconnects unfold in self-management support interactions. We argue that self-management is temporally and socially situated, incorporating past, present and (anticipated) future experiences. However, there is a disjuncture between the temporal logics of self-management enacted by health professionals and the subjective temporalities of people's lived experience of chronicity. Health professionals focus on patients progressing toward optimistic futures but give less attention to the complexities of patient life histories that render self-management more difficult. For self-management support to be effective, we argue that health professionals need to consider the complexities of people's life histories and how these shape imagined futures. Policy guidelines, we argue, should attend to how relations between patients and professionals shape self-management support, and the historical and social factors that shape experiences of living with chronic conditions. [ABSTRACT FROM AUTHOR]

The landscape of cancer is changing, with earlier detection and the emergence of new treatment options signalling the potential reconfiguration of cancer (for some) as a chronic condition. Cancer is increasingly experienced in terms of chronicity, incorporating both ongoing episodes of acute treatment alongside the long-term management of disease, symptoms, and side effects. This emphasis refocuses attention toward living-with, as well as beyond, cancer. Yet, how cancer chronicity is understood and experienced by both patients and healthcare professionals remains underexplored. While sociological scholarship has critically analysed how chronic illness has been positioned as a problem of/for the person and/or the healthcare system, less attention has been paid to instances like cancer, where chronicity might be viewed as reflective of forms of success (e.g. through the deferral of mortality even in the absence of 'cure'). In this paper we draw on qualitative interview data from a large study of cancer survivorship including patients, their family carers and health professionals, across two Australian hospitals. We critically analyse the dimensions of chronicity in the cancer sphere, understanding cancer-as-chronicity as producing a particular form of subjectivity, shaped by the everyday management and experience of treatment, impairment, symptoms, and side-effects. We posit that constructions of cancer as chronic, and associated imperatives linked to longevity, commitment, and resilience, are placing new demands on patients, family carers, and professionals alike. [ABSTRACT FROM AUTHOR]