Chronic Illness Research Articles

Addressing Cardiovascular Disease Disparities Among Medicare Beneficiaries: Insights from the Indian Health Service

Background: Chronic illnesses, especially cardiovascular diseases (CVD), disproportionately affect populations served by the Indian Health Service (IHS), contributing to significantly higher morbidity and mortality rates. This study aimed to assess the prevalence and incidence of Coronary Artery Disease (CAD), Heart Failure (HF), Atrial Fibrillation (AF), and cerebrovascular diseases among Medicare beneficiaries (MBs) within these communities. Methods: Utilizing data from IHS electronic records spanning fiscal years 2021-2023, this study analyzed a cohort of 9,844 adults diagnosed with CVD. Demographic, health status, and healthcare utilization data were collected. Statistical analyses included multivariable logistic regression and propensity score matching to evaluate the relationship between healthcare utilization and cardiovascular outcomes. Results: The findings revealed that 49.9% of the participants experienced at least one severe cardiovascular condition, with CAD incidence slightly decreasing from 37.9% in 2021 to 38.2% in 2024 (P < .001). Conversely, the overall mortality rate was 20.1%, with CAD and HF being leading contributors. Socioeconomic factors significantly influenced healthcare access and outcomes, as 34.7% of the participants qualified for both Medicare and Medicaid. Conclusion: The study underscores the urgent need for targeted interventions to improve cardiovascular health outcomes in high-risk populations. Engaging with Indigenous communities and enhancing healthcare access through integrated care models are vital for addressing disparities and fostering better health equity. Future research should explore innovative strategies to optimize care delivery for these vulnerable populations.

Moderating effect for illness uncertainty on the relationship of depressive and anxiety symptoms among patients with type 1 diabetes in Taif region, Saudi Arabia.

Illness uncertainty was found to be associated with the development of depressive and anxiety symptoms among patients with type 1 diabetes and chronic illness in general. However, the moderating effect of illness uncertainty was not examined in sufficient depth. The current study evaluates how the path from diabetes distress to depression and anxiety is mediated by illness uncertainty, ambiguity, symptoms and course predictability, and illness complexity. Descriptive cross-sectional survey of a large-scale sample of patients living with type one diabetes in Saudi Arabia. We utilized structural equation modelling mediation analysis to examine the effect of illness uncertainty and its subcategories (illness-related ambiguity, symptoms and course predictability, and illness complexity) on depressive and anxiety symptoms. The current survey analyzed data pertaining to (n = 536) type one diabetes patients. Mean Mishel Uncertainty of Illness Scale score was 80.8 points (Cronbach's α = 0.91) signifying moderate uncertainty among our patients. Diabetes-related uncertainty was associated with marriage (t = 3.337, P = 0.0009937), diabetes complications (t = 5.257, P < 0.00001), pain (r = 0.2247, P < 0.00001), and children count (correlation coefficient r = 0.195, P < 0.00001). The prevalence of depression was (n = 367, 68.5%) and for anxiety was (n = 173, 30.3%). Illness uncertainty correlated with depressive (r = 0.2484, P < 0.00001) and anxiety (r = 0.2548, P < 0.00001) symptoms' scores. Illness uncertainty exerted a partial moderating effect on both anxiety (β = 0.060, P < 0.001) and depressive symptoms (β =0.056, P < 0.001). We observed a partial moderating effect for diabetes-related ambiguity and diabetes-related symptom unpredictability in terms of depressive and anxiety symptoms. However, for diabetes-related course unpredictability, the moderating effect was significant only for anxiety. Diabetes-related complexity did not exert a significant moderating effect on either depressive or anxiety symptoms. We confirmed high levels of depression and anxiety among patients with type one diabetes in Saudi Arabia. Our findings suggest that illness uncertainty affects both diabetes-related distress and depression constructs and is likely to be affected by them.

Primary care physicians' knowledge and attitudes about obesity, adherence to treatment guidelines and its' association with confidence to treat obesity at the Saudi Ministry of Interior primary health care centers.

Many primary care physicians (PCPs) believed that managing overweight and obesity is essential to their jobs, however, many believe that they were doing it ineffectively, unsatisfying, and had negative attitudes. We conducted this study to explore the knowledge, attitudes and adherence to obesity management guidelines, identify potential barriers that may prevent adherence of PCPs to obesity treatment guidelines. We conducted this cross-sectional study and conducted a questionnaire sent via email to all PCPs in the Ministry of Interior centers in Riyadh, Al-Kharj, AlQassim, Wadi Ad Dawasir, Hail and Tabuk in Saudi Arabia. A total of 119 PCPs participated in the survey, 61 (51.3%) males and 58 (48.7%) females. All respondents (n = 119, 100%) answered correctly that obesity is a disease. Of PCPs surveyed, genetics accounted for 75.6% of the responses as the cause of obesity. 79.8% believed that the best way for patients with obesity to lose weight was to engage in regular physical activity. The majority of PCPs (87.4%) thought that treating obesity should be a top priority, and 88.2% would typically recommend obesity therapy to their patients. Around 68.9% of PCPs thought that it's their patients' responsibility to lose weight. The majority will recommend obesity treatment and 75.6% would talk to their patients about weight concerns, while 60.5% would refer their patients to obesity surgery. There was a positive significant association between higher knowledge and better attitude and better adherence to treatment guidelines. More experienced PCPs were more confident. The most common perceived barrier was the patients' lack of desire to follow obesity treatment. Primary care clinics and PCPs play a crucial role in diagnosing and treating patients with obesity, according to Ministry of Health guidelines on the prevention and management of obesity. PCPs must not only acknowledge obesity as a chronic illness and the possible long-term consequences it may cause, but also provide comprehensive, multi-component interventions that include lifestyle changes, medication, and appropriate referrals for bariatric surgery when needed. Healthcare professionals must form a cooperative relationship with obese patients to ensure that the patients follow treatment protocols.

The iPeer2Peer mentorship program for adolescent thoracic transplant recipients: An implementation-effectiveness evaluation

BackgroundAn increase in self-management skills for adolescent thoracic transplant recipients may improve health outcomes and facilitate a successful transition to adulthood. The iPeer2Peer© program is an online peer mentorship program that has been successfully implemented as a self-management intervention in multiple chronic disease populations. This study aimed to determine the implementation and effectiveness outcomes of the iPeer2Peer program for adolescent thoracic transplant recipients. MethodsA type III, hybrid implementation-effectiveness pilot study that comprised a quasi-experimental single-arm pre-post design was used to evaluate the iPeer2Peer program. Participant mentees, ages 12 to 17, were recruited from two large Canadian transplant centres. Peer mentors, ages 18 to 25, were thoracic transplant recipients who had successfully transitioned to adult care and self-manage their condition. A mixed methods approach for data collection was used, including interviews, focus groups, and standardized questionnaires. ResultsTwenty mentees (median 15.0 years, IQR 3.3 years; 65% female) completed the iPeer2Peer program with nine young adult mentors (median 21.0 years, IQR 3.0 years; 78% female). Implementation outcomes indicated that the iPeer2Peer intervention was perceived as feasible, adoptable, acceptable, and appropriate for adolescent thoracic transplant recipients. Significant findings were noted in mentees for increased self-management and a decrease in overall depression and anxiety symptoms. ConclusionsThe successful implementation of the pilot iPeer2Peer program offers support to evaluate the scalability, sustainability, and cost-effectiveness of the program for adolescents with chronic illness, specifically thoracic transplant recipients. Changes to the iPeer2Peer program that facilitate a flexible delivery may help implementation and acceptance.

Posttraumatic growth and spirituality among adults with chronic illness.

Posttraumatic growth and spirituality among adults with chronic illness.

An Overview of Diabetes Types, Management of Type 1 Diabetes, and its Impact

Diabetes mellitus, a complex, and growing global health challenge, manifests in various forms, each with distinct causes, progression, and management strategies. This review provides a comprehensive overview of diabetes types, with a particular focus on the management of Type 1 Diabetes (T1D) and its profound impact on individuals’ lives. T1D, an autoimmune disorder that typically arises in childhood or adolescence, necessitates lifelong insulin therapy due to the destruction of insulin-producing beta cells in the pancreas. The review explores the classification of diabetes, highlighting the differences in etiology, pathophysiology, and management across the major types: Type 1 Diabetes, Type 2 Diabetes, Gestational Diabetes Mellitus, and other specific forms of diabetes. The management of T1D involves a multifaceted approach, including advanced insulin delivery systems, continuous glucose monitoring technologies, and lifestyle modifications. Despite advancements in diabetes care, T1D significantly impacts individuals’ physical health, psychological well-being, and social life. The relentless demands of managing T1D, coupled with the risk of acute complications such as hypoglycemia and diabetic ketoacidosis, contribute to physical and emotional strain. Additionally, the disease’s social and lifestyle implications, including the stigma associated with chronic illness, further complicate the lived experience of those with T1D. This review underscores the importance of integrated care approaches that address both the physical and psychological aspects of T1D, aiming to enhance the quality of life for affected individuals. Keywords: Diabetes, Type 1 Diabetes, Impact, Individuals’ Lives

Screening for mental disorders in health workers

Introduction: mental health is presented as an essential element in work capacity and productivity, and, similarly, psychosocial risks at work can generate detrimental effects on mental health. Objective: To determine the prevalence of depression, anxiety, and panic disorders among healthcare professionals at the Regional Hospital of Culiacán, Sinaloa, Mexico. Methods: quantitative, observational, descriptive, cross-sectional and analytical study, with stratified probabilistic sampling. Sample of 299 health workers. For data collection, the instrument for detecting anxiety, depression and panic disorders, Patient Health Questionnaire (PHQ-4+PHQ-TP), was used; and for the analysis the statistical program SPSS version 27.Results: it is shown that 59,5 % of the participants are women, 76,3 % work in the morning shift, and 51.8% are single. With 66.9% the nursing job category predominates, 76,6 % have an academic level greater than a bachelor's degree. A quarter of them work two jobs and suffer from chronic illnesses. 25,8 % have been diagnosed with depression, anxiety and/or panic, predominating in the morning shift and in the female gender. Most are assigned to emergency services. The risk of panic predominates at 39,5 % and 53,4 % correspond to nursing staff. Cases of anxiety and depression occur in 47,8 % and 55,7 % respectively in resident doctors. Conclusion: the study shows a high prevalence of mental disorders in health workers in Culiacán, Sinaloa, with significant differences depending on the shift and job category. These findings are consistent with international literature, highlighting the urgent need to implement psychological support programs and improve working conditions.

A Comprehensive Review on Understanding Magnesium Disorders: Pathophysiology, Clinical Manifestations, and Management Strategies.

Magnesium is vital in a broad spectrum of physiological processes, including enzyme activity, energy production, and neuromuscular function. Despite its crucial role, magnesium disorders - comprising both deficiency (hypomagnesemia) and excess (hypermagnesemia) - are frequently underrecognized and inadequately managed in clinical practice. Magnesium deficiency is widespread, particularly among populations with chronic illnesses, the elderly, and those experiencing malnutrition, often leading to significant neuromuscular, cardiovascular, and metabolic complications. Conversely, hypermagnesemia, though less common, poses serious risks, especially in individuals with impaired renal function or those receiving high doses of magnesium supplements or medications. This review comprehensively examines magnesium disorders, detailing their pathophysiology, clinical manifestations, and management strategies. It highlights the essential functions of magnesium in maintaining cellular integrity, cardiovascular health, and bone structure and discusses the global prevalence and risk factors associated with magnesium imbalances. By offering insights into the current understanding of magnesium homeostasis and its disruptions, this review aims to enhance the awareness and treatment of magnesium-related conditions, ultimately improving patient outcomes across diverse clinical settings.

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

COVID-19 Vaccination Recommendations: Challenges and Strategies for High-Risk Populations

&lt;p&gt;COVID-19（新冠併發重症）大流行對全球，尤其是有潛在醫療狀況的易感染之高風險族群，造成深遠的影響。為因應全球不斷演變的疫情趨勢以及台灣持續增加病例的疫苗防治需求，台灣家庭醫學醫學會建立了針對易感染之高風險族群的COVID-19疫苗接種建議。本研究進行全面性的文獻回顧並經由專家小組討論後，擬定具證據力的建議以作為防疫策略參考。總計提出25項建議，說明糖尿病、肥胖症、慢性腎臟疾病、心血管疾病和呼吸系統疾病病友感染COVID-19後的重症風險為高，因此強調COVID-19 mRNA（訊息核糖核酸）疫苗在這些易感染之高風險族群中的安全性和有效性以及家庭醫師在COVID-19疫情的關鍵作用，包括常規篩檢、衛教、疫苗接種服務的提供和持續的研究。此建議為醫界與政府相關單位在為易感染高風險族群制定疫苗接種計畫時，提供了兼具客觀實證依據與符合臨床實務需求的具體指引，同時強化家庭醫師在防疫工作中的核心角色，透過持續的監測與積極推動疫苗施打，在不斷變化的COVID-19疫情趨勢中發揮重要作用。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;The COVID-19 pandemic has had a profound global impact, particularly on high-risk populations, such as those with underlying medical conditions. In response to the evolving pandemic landscape and the constant surge in the need to vaccinate among vulnerable cases in Taiwan, the Taiwan Association of Family Medicine (TAFM) has developed recommendations on COVID-19 vaccination for high-risk groups. Based on a comprehensive literature review and expert panel discussions, a total of 25 evidence-based recommendations have been developed to serve as a reference for vaccination strategies, highlighting the increased risk of severe COVID-19 outcomes among individuals with complications such as diabetes, obesity, chronic kidney disease, cardiovascular disease, and respiratory illnesses. The recommendations emphasize the safety and effectiveness of COVID-19 vaccines, particularly mRNA vaccines, for the aforementioned high-risk populations and underscore the critical roles of family physicians in response to severe COVID-19 outcomes, including routine screening, health education, vaccine administration, and continuous research to optimize strategies. The TAFM recommendations provide a robust, evidence-based framework that meets clinical practice requirements and provides effective guidelines for physicians, healthcare institutions, and governments in tailoring vaccination efforts to address the unique needs of high-risk groups in Taiwan. Ongoing monitoring and proactive vaccination drives are essential for ensuring the effectiveness of these recommendations in the evolving COVID-19 landscape, while also accentuating the continuous efforts of family physicians in preventing endemic diseases.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Mexican Delphi Consensus For Use Immunotherapy With MV130 Vaccine In Patients With Recurrent Respiratory Infectious Diseases (Expert Panel)

Background and objectives: recurrent respiratory infections are currently a public health problem due to their high costs and resistance to treatments as well increase morbidity and mortality. An imbalance in the homeostasis of progressive cellular and humoral immunity the application of immunotherapy with trained immunity vaccines (ivie) is currently a therapeutic option in all patients with recurrent respiratory infections by training innate and adaptive immunity by reducing episodes of respiratory exacerbations and improving the quality of life of patients. Methods: using delphi method and a panel of experts, a questionnaire was developed that included questions regarding the benefit and non-benefit of the treatment of patients with persistence of recurrent respiratory infections by specific criteria, from diagnosis, identification of risk factors and comorbidities, ideal candidate by consensus to receive the therapy, follow-up, and presentation of clinical data for reduction of recurrence of the conditions. There was a consensus on determining the use of immunotherapy mv130 vaccine in patients with specific criteria as long- and short-term use. Conclusion: immunotherapy with trained immunity vaccines (ivie) is currently a therapeutic option in all patients with recurrent respiratory infections and associated comorbidities in patients with chronic respiratory illnesses, autoimmune diseases, hematological malignancies for improvement clinical infections and improvement quality of life.

Self-reported immune status and COVID-19 associated subjective cognitive functioning in post-COVID-19 syndrome: Examination of an Irish cohort.

Cognitive changes are very frequently reported by people with post-COVID-19 syndrome (PCS), but there is limited understanding of the underpinning mechanisms leading to these difficulties. It is possible that cognitive difficulties are related to immune status and/or low mood. The aim of the present study was to examine the relationship between immune status and cognitive functioning in PCS, while considering whether depression symptoms also influence this association. Participants were recruited in an online study of cognitive and psychological consequences of PCS, involving individuals attending a post-COVID clinic in an acute general hospital in Ireland, and a comparison sample of age- and sex-matched community controls who had also been infected with COVID-19 but had not experienced PCS. Participants with PCS (n=71) and community controls (n=50) completed the immune status questionnaire, Cognitive Failures Questionnaire (CFQ), Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F). Significant differences were observed between groups in terms of perceived immune status, perceived cognitive function, depression scores, and fatigue, with the "PCS" group reporting lower immune status, more cognitive difficulties, and higher levels of depression and fatigue. Regression analysis in the PCS group indicated that immune status and depression significantly contributed to variance in subjective cognitive functioning, with immune status remaining a significant predictor of cognitive functioning scores even when accounting for depression, fatigue, and other covariates related to PCS, such as Body Mass Index(BMI). Our findings suggest that subjective cognitive functioning is influenced by self-reported immune status in PCS, emphasising the importance of immune status, cognitive, and mood screening as part of routine clinical care in PCS.

Validation of a Primary Biliary Cholangitis-Specific Version of Chronic Liver Disease Questionnaire: CLDQ-PBC.

Primary biliary cholangitis (PBC) is a chronic liver disease, leading to cirrhosis and impairment of patient-reported outcomes. We aimed to develop a PBC-specific version of the Chronic Liver Disease Questionnaire (CLDQ) instrument to assess health-related quality of life of patients with PBC. From our Liver Database, we included patients with PBC who had CLDQ, clinicolaboratory data, and completed Short Form-36 and The Functional Assessment of Chronic Illness Therapy-Fatigue. The 29 items of CLDQ were subjected to item reduction, exploratory factor analysis, and fed into a standard instrument validation pipeline. Data were available for 108 patients with PBC: 57 ± 11 years, 7% male, 58% cirrhosis, and 24% decompensated cirrhosis (Child B and C). Of 29 CLDQ items, none met the exclusion criteria. Exploratory factor analysis (95% of variance) returned 7 factors. Based on evaluation of factor loadings and face validity, those factors yielded 7 domains (Diet, Emotion, Fatigue, Itch, Symptoms, Sleep, and Worry). Good to excellent internal consistency (Cronbach's α 0.85-0.93) was observed for 5/7 domains. For the remaining 2 domains (Diet and Itch), additional items obtained from patients, experts, and review of the literature were included. For 5 domains, known-group validity tests discriminated between patients with PBC with and without cirrhosis, advanced cirrhosis, and depression ( P < 0.05 for 3-5 domains). The CLDQ-PBC domains were correlated with relevant domains of Short Form-36, CLDQ-PBC Fatigue correlated with Fatigue Scale of Functional Assessment of Chronic Illness Therapy-Fatigue (rho = +0.85), and CLDQ-PBC Worry domain negatively correlated with alkaline phosphatase (rho = -0.38, P = 0.0082). The CLDQ-PBC has been developed based on the original CLDQ. The new instrument has evidence for internal consistency and validity and is being fully validated using an external cohort.

Illuminating insights: Exploring the effect of 16/8 intermittent fasting on serum cytokine levels in overweight adults.

The immune system's pivotal role extends to numerous diseases, and maintaining a balance between dietary and consumed energy is vital for preventing chronic illnesses and increasing life expectancy. Intermittent fasting (IF), a dietary approach typically implemented through time restrictions, exerts positive effects on the immune system and shows promising outcomes in managing various diseases. To evaluate the effectiveness of IF on the immune system with a wide cytokine panel. A total of 21 volunteers with body mass index (BMI) between 25 and 30 were included in the study. Fasting was applied for 16 h in a day to the volunteers, and they were free to consume food for the rest of the day. The weight, BMI, interleukin (IL)-1β, interferon (IFN)-α2, IFN-γ, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-18, IL-23, and IL-33 values were measured using flow cytometry and compared before and after 21 days follow-up. The mean age of study participants was 37.76 ±8.06 years and weight loss of the volunteers was 3.35 percentile compared to the values obtained before fasting. The pro-inflammatory cytokines decreased, while anti-inflammatory cytokines increased after fasting; there was a significant difference in TNF-α, MCP-1, IL-6, IL-8, and IL-33 values. Also, IL-1β, IL-8 and IL-12p70 had moderately positive, IL-33 had strongly negative, and IL-10 had moderately negative correlation with the BMI change over time. Intermittent fasting has positive effects on obesity-induced inflammation and promotes decrease in proinflammatory cytokines and increase in IL-33 values, which is known to have a protective effect on fat-associated inflammation.

151 The Impact of a community based exercise rehabilitation program (ExWell Medical) on people with diverse chronic illnesses

151 The Impact of a community based exercise rehabilitation program (ExWell Medical) on people with diverse chronic illnesses

Compassion-Facilitating Interventions Among Patients With Life-Limiting Chronic Illnesses: A Scoping Review

Compassion-Facilitating Interventions Among Patients With Life-Limiting Chronic Illnesses: A Scoping Review

Healthcare workers' perceptions and acceptance for COVID-19 vaccine for their children aged

The coronavirus disease 2019 (COVID-19) vaccination program among adults in India is one of the highly successful vaccination drives globally, but the acceptance of the COVID-19 vaccine among parents for their children is largely unknown. As parents are primary decision-makers for their children, we aimed to assess parents' perceptions and acceptance for COVID-19 vaccination for children in India. To assess parental perceptions and acceptance for COVID-19 vaccination for their children (aged <18 years). A cross-sectional anonymous web-based survey was designed and conducted from November 1 to December 15, 2022. All the healthcare workers of a tertiary care institute in eastern Uttar Pradesh, having a child aged <18 years, constituted the study population and were invited. They were recruited through snowball sampling and were sent the study questionnaire in Google form through email and WhatsApp. Bivariate analysis was performed to determine the predictors of child vaccination acceptance among the parents. A total of 388 healthcare worker parents (HCWPs) having a child <18 years of age completed the survey. The mean age of the parents was 40.28 ± 11.34 years. The majority (96.9%) of them had already received the recommended two doses of the COVID-19 vaccine. Around 91% of the parents agreed that COVID-19 vaccines are important for children's health, whereas 89% agreed that COVID-19 vaccines are effective. A total of 356 (91.7%) parents were willing to vaccinate their children with a COVID-19 vaccine, of which 91.3% intended to do so as soon as possible. The factors significantly associated with the stated willingness for child vaccination among the participants were younger age (P = 0.008), female gender (P = 0000), currently married status (P = 0.00001), urban residence (P = 0.01), lower monthly income (P = 0.03), absence of any chronic illness (P = 0.0003), history of COVID-19 in the child (P = 0.004), and the child being up-to-date with the routine childhood vaccines (P = 0.01). The HCWPs from eastern Uttar Pradesh, India, have a positive attitude and low vaccine hesitancy toward COVID-19 vaccination for children, with around 92% currently willing to vaccinate their children with COVID vaccine. Further longitudinal studies are required to assess the trend of parental acceptance of COVID vaccine.

Heterogeneity in trajectories of traumatic distress at the start of the COVID-19 pandemic.

The COVID-19 outbreak has led to an increase in posttraumatic stress symptoms (PTSSs; Prout et al., 2020) for some individuals, whereas others appeared to be more resilient. It remains relatively unclear what characterizes these potentially different response trajectories ( Chen & Bonanno, 2020). This study sought to (a) assess individuals' PTSS levels at the start of the pandemic and at two subsequent timepoints 3 and 6 months later, (b) identify different trajectories of PTSSs over time, and (c) describe which individual characteristics influenced the likelihood of each of these different trajectories to occur. A community sample (n = 317) responded to an online survey during the first weeks of the pandemic, 3 and 6 months later. Among those who reported acute levels of PTSSs, latent class growth analyses identified three different resilience trajectories-resilient (low baseline PTSSs and a slight decrease over time), chronic (severe PTSSs at baseline and no change over time), and recovered (severe PTSSs at baseline but a sharp improvement over time). Baseline childhood adversity, depression, anxiety, defensive functioning, and somatization predicted trajectories. Demographics (age, gender, preexisting chronic illness) and COVID-related factors (knowing someone diagnosed with or who died of COVID-19) were unrelated to trajectories. Results suggest that although high PTSS levels decreased over time on average, heterogenous change trajectories can be identified based on baseline psychological characteristics. This implies that mental health, including past and present experiences, as well as adaptational mechanisms may shape individuals' experiences with pandemic-related ongoing stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of Recreational Therapy on Anxiety Levels in Patients with Chronic Illness

Purpose: The aim of the study was to assess the effects of recreational therapy on anxiety levels in patients with chronic illness. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: The study indicated that engaging in recreational activities, such as art, music, and physical exercise, can significantly alleviate anxiety symptoms. These activities provide a distraction from pain and discomfort, enhance mood, and promote relaxation. For instance, studies have demonstrated that music therapy can lead to decreased levels of cortisol, the stress hormone, and increased production of endorphins, which are natural mood elevators. Similarly, physical activities like yoga and tai chi help in reducing tension and improving overall mental health by fostering a sense of physical well-being and empowerment. Art therapy, through creative expression, allows patients to process their emotions and experiences, leading to reduced feelings of anxiety and depression. Overall, recreational therapy offers a holistic approach to managing anxiety in chronically ill patients, contributing to improved quality of life and better mental health outcomes. Implications to Theory, Practice and Policy: Cognitive-behavioral theory, biopsychosocial model and flow theory may be used to anchor future studies on assessing the effects of recreational therapy on anxiety levels in patients with chronic illness. Practitioners should consider combining different types of recreational therapies to maximize therapeutic benefits. Policymakers should recognize the value of recreational therapy and integrate it into national healthcare guidelines and policies. This integration can promote the widespread adoption of these therapies in various healthcare settings, ensuring that patients with chronic illnesses have access to comprehensive care options.

EMPOWERING PATIENTS WITH AI-DRIVEN PERSONALIZED MEDICINE: A PARADIGM SHIFT IN CHRONIC DISEASE MANAGEMENT

The emergence of artificial intelligence (AI) in healthcare has opened the door to a disruptive approach to chronic illness management, centered on individualized therapy that empowers patients. This research investigates the potential of AI-driven personalized medicine to transform the treatment and management of chronic illnesses by adapting therapeutic tactics to individual patient characteristics. Traditional chronic illness management approaches frequently rely on standardized therapies, which may fail to account for a patients unique genetic, environmental, and lifestyle characteristics. AI, with its capacity to analyze large datasets and discover patterns, provides a more sophisticated approach, allowing for the development of personalized treatment regimens that maximize efficacy while minimizing side effects.The use of AI in healthcare enables real-time monitoring and continual customization of treatment regimens depending on patient reactions, promoting a proactive approach to illness management. Patients are no longer passive beneficiaries of care, but active players in their treatment journey, armed with personalized insights that allow for informed decision-making. This trend toward patient-centered care is especially important in the case of chronic illnesses, where long-term management and adherence to treatment procedures are vital for improving results. Furthermore, AI-powered tailored medicine has the potential to save healthcare costs by eliminating trial-and-error methods and averting consequences through early intervention. However, implementing this paradigm change is not without its problems. Data privacy, ethical concerns, and the need for strong regulatory frameworks must all be addressed to enable the safe and successful use of AI in customized medicine.AI-powered personalized medicine offers a paradigm change in chronic illness treatment, providing a more effective, patient-centered approach that has the potential to enhance clinical results and empower individuals. By leveraging AI, healthcare systems may transition to a future in which therapy is personalized to the individual, improving care quality and, eventually, altering the landscape of chronic illness management.