Effects Of Chronic Health Conditions Research Articles

Mechanisms Underlying Anti-Inflammatory and Anti-Cancer Properties of Stretching-A Review.

Stretching is one of the popular elements in physiotherapy and rehabilitation. When correctly guided, it can help minimize or slow down the disabling effects of chronic health conditions. Most likely, the benefits are associated with reducing inflammation; recent studies demonstrate that this effect from stretching is not just systemic but also local. In this review, we present the current body of knowledge on the anti-inflammatory properties of stretching at a molecular level. A total of 22 papers, focusing on anti-inflammatory and anti-cancer properties of stretching, have been selected and reviewed. We show the regulation of oxidative stress, the expression of pro- and anti-inflammatory genes and mediators, and remodeling of the extracellular matrix, expressed by changes in collagen and matrix metalloproteinases levels, in tissues subjected to stretching. We point out that a better understanding of the anti-inflammatory properties of stretching may result in increasing its importance in treatment and recovery from diseases such as osteoarthritis, systemic sclerosis, and cancer.

Exercise and chronic health conditions in the community: A qualitative Study of Patients and Fitness instructors.

Further information is needed on how community exercise facilities can be effectively utilised to engage people living with chronic health conditions in exercise. The aim of this study was to identify the exercise barriers, facilitators and needs of patients with chronic disease in the community; and to provide recommendations to support the transition from hospital-based to community-based exercise. Using a qualitative approach, four focus groups were conducted with patients who had completed hospital-based exercise programmes (n=11) and fitness instructors (n=10). Data were audio recorded, member checked and transcribed verbatim for thematic analysis using NVivo. The side effects of chronic health conditions, the gym environment and a need for support when joining/attending a gym were perceived as barriers to exercising in the community. In contrast, the presence of supportive staff was perceived by patients as a facilitator to engaging in exercise in the community. A total of three themes emerged from participants views on exercise needs in the community; the referral and induction process in community gyms, fitness instructor training and experience and creating a supportive exercise environment. Themes informed eight key recommendations to support patients to exercise in the community, including supportive gym referral and induction processes for patients with chronic conditions, increased professional training for fitness instructors in the area of chronic disease management and exercise prescription, and exercise support at regular intervals for those with chronic conditions attending community gyms. This study found that there is potential for community gyms to play a key role in promoting health among people with chronic conditions. However, more can be done to foster an inclusive atmosphere in this space. Patients living with chronic conditions need information and advice on exercising in their communities. Community gyms require further support to ensure that facilities meet the exercise needs of people with chronic conditions.

Interactive effects of chronic health conditions and financial hardship on episodic memory among older blacks: Findings from the Health and Retirement Study

AbstractBackgroundPrevious research suggests that chronic health conditions and financial hardship robustly shape cognitive health outcomes, including ADRD risk in older Blacks. However, few studies have explored the moderating effect of financial hardship on chronic disease burden and specific cognitive domains. This study examined whether financial hardship modifies the impact of self‐reported chronic health conditions on episodic memory among a representative sample of older Blacks enrolled in the 2006 Health and Retirement Study (HRS).MethodThe study included 934 older Blacks (50+ years) who completed the psychosocial leave‐behind questionnaire in the 2006 wave of the HRS. Episodic memory included a composite standardized score of immediate and delayed recall. Six chronic health conditions (e.g., hypertension, diabetes, stroke) were summed and dichotomized (0‐1 vs. as ≥2 conditions). Financial hardship was assessed as self‐reported difficulty paying monthly bills (range: not at all=0 to very/completely=3). Weighted OLS regression models tested independent associations between chronic health conditions and episodic memory, controlling for sociodemographic characteristics. An interaction term tested moderation by financial hardship.ResultThe majority of the sample was female (39.34% male) and had less than a high school education (35.89%; Table 1). Financial hardship modified the association between chronic disease burden and episodic memory performance such that individuals who reported very little difficulty paying their monthly bills had significantly lower memory scores at high levels of disease burden compared to those reporting high financial difficulty after controlling for age, gender, education and income (F 2, 49 = 4.97, p= 0.011; see Table 2 and Figure 1).ConclusionThe present study adds to our understanding of cognitive aging among older Black Americans. Results support previous research, pointing to the independent negative effects of both chronic diseases and subjective financial burden, but also extend the literature by suggesting an interactive effect. Specifically, multimorbidity was more strongly associated with worse episodic memory functioning among older Blacks with less financial hardship, which appeared to be driven by the relatively low cognitive functioning among those with the greatest financial hardship. This pattern of results suggest that financial hardship may be just as consequential for cognitive aging as chronic diseases for older Blacks.

Investigating the relationships between social capital, chronic health conditions and health status among Australian adults: findings from an Australian national cohort survey

BackgroundSocial capital is a collective attribute of communities that determines health and well-being of populations. The collective resources in a high social capital community have been reported to result in better health outcomes. While evidence supports the links between social capital and various health outcomes, it is not clear about underlying mechanisms connecting multiple dimensions of social capital to health.MethodsUsing the two-wave data from a nationally representative cohort study of Australian adults (N = 16,637), this study examined the effects of two dimensions of social capital (i.e., structural and cognitive social capital) on physical and mental health in the Australian adult population. Based on prior literature and theoretical reasoning, it was anticipated that the structural and cognitive social capital would influence self-assessed health status (physical and mental health). Additionally, these two dimensions of social capital were hypothesized to moderate the relationships between chronic health conditions and these two aspects of health status.ResultsAnalyses showed that the effects of chronic health conditions on mental health status were moderated by the structural social capital (β = .652, SE = .249, p = .009). Additionally, it was found that perceived community cohesion was predictive of mental health (β = .295, SE = .103, p = .004). Our analysis also indicated that perceptions of disadvantaged neighbourhood environment contributed to poorer mental health status (β = −.461, SE = .144, p = .001). However, none of the social capital variables significantly predicted physical health status.ConclusionsFindings suggest that the structural dimension of social capital would function as a buffer against the malicious effects of chronic health conditions, impairments and disabilities. Specifically, community participation (structural social capital) is indispensable to develop an effective community-based program to improve health and well-being of those with chronic health conditions or disabilities, as increasing active participation may generate beneficial effects in this vulnerable population. Subjective perceptions about communities can also play an important role in improving better health outcomes. Further research is needed to examine underlying mechanisms linking the multiple dimensions of social capital to health outcomes among individuals who are vulnerable to external stressors.

Integrated Care: Provider referrer perceptions of occupational therapy services for homeless adults in an integrated primary care setting

Occupational therapists have a long history of addressing community performance and participation challenges faced by individuals with complex, chronic conditions, including those with serious mental illnesses (SMI) and cognitive issues that present with a traumatic brain injury (TBI). Healthcare reform has shifted incentives to support practices that promote successful community life for people with complex medical conditions. Community based care models emphasizing integrated primary care, such as Federally Qualified Health Centers (FQHC) are emerging, and a generalist role for occupational therapy is being defined. Those with complex comorbid conditions such as mental illness, substance abuse and traumatic brain injury are at risk for negative health outcomes that are further compounded by homelessness. There is a critical need to understand effective treatment options for this population to reduce the negative effects of chronic health conditions. As occupational therapists further define a role serving traditional clients in less traditional settings, such as the FQHC, it is helpful to explore the perceptions of the utility of OT services on the part of provider referrers. This study explored provider referrer perceptions of a new occupational therapy service for homeless adults in an FQHC to assist effective allocation of scarce resources. Twelve provider referrers at an FQHC were interviewed regarding their perception of the role and utility of occupational therapy in this setting. Interviews were then coded for themes. Providers identified the unique value of occupational therapy, emphasizing critical information gleaned from the performance-based assessment of functional cognition, and the positive impact on team interactions and subsequent care decisions. Occupational therapy provides a distinct perspective on client performance in FQHC settings indicating benefit for inclusion of services.

Interactive Effects of Chronic Health Conditions And Financial Hardship On Episodic Memory Among Older Blacks: Findings From The Health And Retirement Study

Previous research links chronic health conditions and financial hardship to cognitive outcomes among older Blacks. However, few studies have explored the moderating effect of financial hardship on chronic disease burden and specific cognitive domains. This study examined whether financial hardship (as measured by difficulty paying monthly bills) modifies the impact of self-reported chronic health conditions (e.g., diabetes, stroke) on episodic memory among 871 older Blacks (50+ years) in the 2006 Health and Retirement Study . Financial hardship modified the association between chronic disease burden and episodic memory performance such that individuals who reported very little difficulty paying their monthly bills had significantly lower memory scores at high levels of disease burden compared to those reporting high financial difficulty after controlling for age, gender and education (F 2, 49 = 5.03, p = .010). This cross-sectional study suggests that both financial and physical wellbeing may have joint effects on cognitive health in older Blacks.

Optimizing Lifestyle Medicine Health Care Delivery Through Enhanced Interdisciplinary Education.

While few may argue about the importance of healthy lifestyle choices on the effects of chronic health conditions, many would highlight the challenge that its practical integration poses in daily clinical practice. The field of lifestyle medicine aims to assist individuals and communities to adopt and sustain healthy behaviors. It is a powerful yet often underutilized tool. This article illustrates the importance of joint multidisciplinary efforts in the effective practice of lifestyle medicine. Furthermore it stresses the importance of equipping healthcare providers with the tools and education necessary to deliver consistent, and high quality holistic care.

Parenting interventions for childhood chronic illness

Every day, thousands of children suffer the effects of chronic health conditions and families struggle with illness management and children's behavioural and emotional adjustment. Many parents experience difficulties with their caregiving role and lack confidence in their ability to manage their child's illness and ensure the child's well-being. While there is consistent evidence as to the extent and impact of childhood chronic illness, there is a paucity of evidence-based parenting approaches to help children with chronic health conditions and their families. This paper provides a narrative review of the current literature to examine relationships between chronic childhood illness, emotional and behavioural disorders and parenting. Key guidelines and recommendations for the development of evidence-based parenting programs for parents of children affected by chronic health conditions are provided.

Health and Functional Limitations Predict Depression Scores in the Health and Retirement Study

Objective: To examine the effects of chronic health conditions and functional status limitations on depression scores in a large representative sample of Americans. Method: The data included 27,461 respondents ages 50 to 90 who completed up to eight test occasions from the Health and Retirement Study. Multivariate adaptive regression splines (MARS) modeling was applied. Possible covariates of depression included arthritis, lung disease, back pain, diabetes, heart disease, high blood pressure, cancer, 28 pairwise combinations of the aforementioned conditions, ADL functional limitations, age, education and being female, being white, and being Hispanic. Results: The best fitting model had a GRSq of 0.18 (comparable to R2 ) and included 12 of 42 covariates. Depression score was predicted by: 1) ADL limitations, 2) education, 3) back pain, 4) lung disease, 5) being female, 6) being Hispanic, 7) heart disease, 8) being white, 9) high blood pressure plus stroke, 10) age, 11) back pain plus arthritis, and 12) back pain plus diabetes. Conclusions: Functional limitations was the strongest predictor of depression; reporting one limitation increased depression scores by nearly double the increase associated with two or more limitations. Back pain and lung disease were the strongest chronic disease predictors of depression; both are associated with considerable discomfort.

Obesity Policy Streams, the Economy, and a Call for Nursing Leadership

Obesity policy has received increasing prominence on the national agenda. Constricting national and state economies, however, threaten the public's perception and support of obesity as a national agenda item. Inversely related to the declining United States (U.S.) economy, obesity rates have continued to climb over the past decade. Economic detractors and incremental healthcare reform underscore the importance of nurses as policy leaders. Informing the policy process while educating the public regarding comprehensive treatment of obesity and related conditions is increasingly important in meeting current and future healthcare needs in a manner that reverses the physical and economic burden of obesity. The public health model is an effective model for addressing, treating, and mitigating the effects of chronic health conditions through primary and secondary management. Nurses are uniquely positioned to impact obesity through primary prevention, secondary prevention, and tertiary disease management. Nursing leadership in the obesity policy streams can mitigate the human and economic impact of obesity and related conditions.

An evaluation of the effects of chronic diseases and health conditions on tobacco cessation

Objective: This study examined the effects of chronic health conditions on tobacco cessation and participation in a follow-up assessment among 13,900 smokers in a telephone-based tobacco cessation programme. Design: This study involved gathering data from individuals during pre- and post-intervention telephonic assessments following their decision to participate in the tobacco cessation wellness programme. Setting: The study sample included participants from across the United States, with a large concentration living in the Midwestern region. Method: The study sample was limited to participants who were eligible to receive three-month, six-month, and 12-month follow-up calls. Logistic regressions were used to allow an estimate of the impact of chronic conditions while holding constant other factors such as age, readiness, and confidence. Results: The results suggest that the presence of certain chronic conditions was associated with a reduced likelihood of quitting smoking. The presence of chronic conditions did not influence the likelihood that participants completed the follow-up assessment. Interestingly, the effect of chronic conditions on cessation was only slightly higher than the impact of gender. The four-point difference warrants further investigation, especially considering the higher rates of depression in women. Conclusion: This study supports prior research that the presence of one or more chronic conditions has a negative effect on the ability to cease tobacco use. More customized programmes are required to overcome the significant effect of gender, the presence of certain chronic conditions such as depression, and the impact of follow-up calls on cessation success.

関東地区の事業場における慢性疾患による仕事の生産性への影響

Chronic disease has a significant impact on workers' productivity. The aim of this study was to determine the prevalence of chronic health conditions, the work impairment score, and the total lost working hours absent at companies in Japan. Eligible participants were all 544 workers of 4 manufacturing companies in the Kanto area. The Stanford Presenteeism Scale that was developed by Merck & Co., Inc and Stanford University was translated into Japanese and was given to the workers at a periodic health examination between April and June 2006. A total of 433 workers completed the questionnaire, and 48.9% of the participants reported having one or more chronic health conditions which affected their work performance. Allergy (13.3%) was the highest primary chronic health condition followed by back/neck disorders (9.7%). The work impairment score was higher for individuals with depression and migraine/chronic headache. The total lost working hours due to the primary chronic health conditions were 1.4% of the total working hours among the participants. The total lost working hours was highest for those with allergy followed by back/neck disorders and depression. These results should make it possible to develop an occupational health program that can reduce the effects of chronic health conditions on work performance.

Use of social resources by the disabled: primary and secondary group influences.

Use of social resources by the disabled in the rehabilitation and recovery process has been viewed primarily as those derived from formal agencies and services. However, the more typical rehabilitation model suggests a negotiated process in which the active patient utilizes not only the formal service system of support (secondary group resources) but other resources that may be available to him, including his personal assets and those sources derived from his informal social network (primary group resources). This study examines the influence of primary and secondary group resources on need levels, i.e., severity of disability, among adult disabled males using data obtained from a national survey in the U.S.A. The availability and use of primary social resources will likely have a positive effect on the disabled's status--on the assumption that these resources mitigate the adverse effects of chronic health conditions. Use of secondary social resources will tend to reflect need and thus more likely be associated with increased severity of disability. The findings are suggestive in that selective personal and social resources of the individual continue to play a role; however, family and kin ties as part of the socially supportive network are less clearly identified from this study. Secondary social resources as formal service supports tend to play a limited role in disability. The implications of these findings are discussed in terms of effective utilization of primary social resources that are supportive of an individual's need, and appear to enhance recovery.