Illness Recovery Research Articles

The impact of apple cider vinegar on nonalcoholic fatty liver disease in rainbow trout, Oncorhynchus mykiss: A study of therapeutic potential and health benefits

AbstractIn this study, we aimed to experimentally induce fatty liver disease in rainbow trout, Oncorhynchus mykiss, and then assessed the illness recovery process, growth, and changes in the expression of FAAH and ACADL genes in both healthy (0 [C2] and 4% apple cider vinegar [T4]) and diseased fish (0 [C1], 1 [T1], 2 [T2], and 4% [T3]) apple cider vinegar. To conduct the study, 180 rainbow trout were randomly assigned to six different experimental treatments, each with three replications. The investigation lasted for 60 days. Growth indices, liver histology, blood biochemical parameters, and transcription of the ACADL and FAAH genes in the liver tissue were measured. The study found no significant differences in the final weights across all the treatments. Apple cider vinegar (ACV) administration resulted in a decrease in AST, ALT, and ALP; however, these values did not show a significant difference from C2. In T3, triglycerides significantly decreased (p < 0.05), whereas in T4, triglycerides significantly increased (p < 0.05). Hepatocytes from ACV‐containing treatments showed reduced fat compared with T4 and the control group (C1). While there was a significant difference (p < 0.05) in the expression of the FAAH gene, there was no significant difference (p > 0.05) in the expression of the ACADL gene between experimental treatments. The findings of our study indicate that an inclusion of up to 2% ACV may have positive effects on trout aquaculture and NAFLD treatment.

The Determinants of Mental Illness Self-Management for Patients With Schizophrenia and Type 2 Diabetes: A Self-Determination Theory Approach.

This study based on self-determination theory aimed to assess the relationship between motivation, competence in diabetes management and perceived autonomy support respectively and mental illness self-management; furthermore, the authors intended to explore the determinants of mental illness self-management for patients with schizophrenia and diabetes. This was a cross-sectional study. One hundred ten participants were recruited at the psychiatric hospital and assessed with the Illness Management and Recovery Scale, the Treatment Self-Regulation Questionnaire, the Perceived Competence Scale for Diabetes and the Health-Care Climate Questionnaire. Patients with lower educational levels, who were admitted to the chronic ward, were unemployed, had lower motivation in illness management, lower competence in diabetes management and perceived lower autonomy support all had lower mental illness self-management. Competence in diabetes management, employment status, autonomy support, educational levels and living alone were the determinants of mental illness self-management. Recovery from schizophrenia and comorbid diabetes is an enduring and complicated process requiring support from healthcare providers. Health professionals should assess the levels of illness self-management and provide integrated care interventions for patients with schizophrenia and diabetes, helping them manage both conditions. The illness management programme could apply to patients with schizophrenia and diabetes and address patients' characteristics such as low levels of education, living alone and being unemployed while additionally promoting motivation and competence, and providing supporting autonomy. The STROBE checklist was followed. Patients with schizophrenia and diabetes were recruited for this study and voluntarily completed the questionnaire.

Investigation of the Relationship between Environmental Conditions and Public Health in Developing Countries from a Psychological Perspective

The surrounding landscapes and environmental conditions significantly influence humans psychologically, physically, and in quality of life. By examining both environmental conditions and overall human health, it is possible to enhance health support and implement more effective policies. Landscape affects human beings significantly in various aspects, including political, aesthetic, health, and well-being. Although the previous studies focus on developed countries, fewer studies have been conducted in third-world countries. This paper aims to investigate the impact of everyday environmental conditions on health in third-world countries, specifically through the lens of environmental psychology. Data were collected through field research in Guatemala. Generally, suburban and rural areas with suitable environmental conditions have a positive health effect compared to urban areas with poor environmental conditions. Our results suggested that these effects include mental health improvements, physical illness recovery, and overall well-being. Our study advocates for stronger governmental support and increased public awareness regarding the influence of environmental conditions on overall health to reduce emissions and improve both environmental quality and health outcomes.

Assessing attitudes toward mental health illnesses in Saudi Arabia: A national cross-sectional study.

The study aimed to assess the national attitudes toward individuals with mental health illnesses in Saudi Arabia, exploring the relationship between these attitudes and various sociodemographic factors. A cross-sectional design with computer-assisted telephone interviews was employed, covering all 13 administrative regions in Saudi Arabia. A total of 4,533 adults agreed to participate, and their attitudes toward people with mental illnesses (PWMI) were measured using an 11-item scale. The translation of the original English version of the PWMI to Arabic was validated and published previously. The scale used level of agreement on a 5-point Likert scale. The score varies from 11 to 55, where a higher score signifies higher stigma. The associations between total PWMI scores and sociodemographic variables were analyzed using linear regression. The mean age of participants was 35.92 ± 12.84, with equal distribution across regions. The linear regression model showed significant associations between total PWMI scores and gender, education level, marital status, living with, or being friends with someone diagnosed with a mental illness, and working in healthcare. No significant associations were found with age, income level, and previous mental health diagnosis. The study suggests that negative stereotypes about mental illness may be more prevalent in Saudi Arabia, while Saudi participants had a more optimistic view regarding the recovery and outcomes of mental illnesses. The study highlights the importance of assessing mental health stigma and its associations with sociodemographic factors in Saudi Arabia. The significant associations found point to the need for targeted interventions and public health campaigns to address misconceptions and stereotypes surrounding mental health, ultimately improving the societal acceptance and well-being of individuals with mental health illnesses.

Mapping the evidence about the natural history of acute infections commonly seen in primary care and managed with antibiotics: a scoping review

BackgroundKnowing the natural history of acute infections in primary care, defined as the course of a disease over time in the absence of specific therapy or treatment, can inform clinicians’ and patients’ expectations about illness recovery, but this evidence is fragmented across the literature. This scoping review aimed to map existing research and research gaps relevant to the natural history of acute infections.MethodsWe searched MEDLINE, Embase and CENTRAL using a 2-phase hierarchical search approach. In Phase A, we focused on identifying systematic reviews synthesising natural history data for eligible infections (acute respiratory, urinary, and skin and soft tissue) and systematic reviews of treatment effectiveness (of RCTs with placebo or no treatment arm, or cohort studies). For infections without existing reviews, in Phase B, we searched for primary studies (placebo-controlled RCTs or cohort studies). Two reviewers independently screened and extracted the data (study characteristics, outcome data - e.g., symptom duration, proportion with resolution at various time points).ResultsWe identified 40 systematic reviews, reporting on 45 infections, most commonly (90%) respiratory tract infections. Six (15%) of these aimed to synthesise natural history information. Most reviews reported the proportion of participants with symptom resolution at various time point/s, with 58% providing data on mean symptom duration. Recovery data show the spontaneous resolution of some infections in some people. We found no eligible studies for cellulitis, ecthyma, carbuncle, and erysipelas.ConclusionsOur review has shown that natural history evidence exists for many common acute infections. It can be utilised by clinicians in implementing patient-centred antibiotic stewardship strategies in primary care. Future research should focus on generating natural history evidence for skin and soft tissue infections and urinary tract infections.

The Role of Family Physicians in Children's Sleep.

Sleep holds significant importance for maintaining health and aiding in illness recovery. Its deprivation impacts all human organ systems, from cognitive function, social interaction, and work capacity to cellular regeneration and immune function. Therefore, sleep plays a crucial role in our body and maintaining health and well-being. Given its importance and close relationship with the neurodevelopment and growth of children and adolescents, this topic is highly significant in pediatric and adolescent health consultations. Family physicians, due to their proximity and understanding of the individual within their family, have the prerogative to contribute to family literacy, empower them, and significantly enhance the quality of life and overall health.

Using patient and care partner experiences to confirm outcomes of relevance for inclusion in a core outcome set for trials of physical rehabilitation in critical illness: A qualitative interview study

BackgroundIncorporating the perspectives of patients and care partners is crucial in the development of core outcome sets. One effective approach for achieving this involvement is by seeking input to refine the outcomes for consensus.The objectives of the study were to: i) to determine patient and care partner views on outcomes that should be measured in trials of physical rehabilitation interventions across the critical illness recovery continuum; (ii) to map these views with a pre-established list of thirty outcomes for potential inclusion in a core outcome set for these trials; and (iii) to identify any new outcomes that could be considered for inclusion. MethodsA qualitative semistructured telephone interview study was conducted with a convenience sample of post–critical illness patients and care partners, as part of core outcome set development work. Anonymised interview transcripts were analysed using a framework approach, and exemplary narrative quotes from participants were reported used to illustrate outcome reporting. FindingsFourteen participants were recruited (male:female ratio = 8:6, age range [minimum–maximum]: 50–80 years, 13 former patients, one spouse). Time since intensive care unit discharge ranged from less than 1 year to 10 years at the time of interview. Participants described a range of outcomes that could be measured in trials of physical rehabilitation after critical illness that mapped closely with the pre-established list. No new outcomes were introduced by participants during the interviews. Experiences described by participants commonly reflected outcomes related to physical ability and performance, functional level, activities of daily living, and emotional and mental wellbeing. Participants spoke to how the different outcomes directly impacted their day-to-day lives and highlighted their priorities centred around resumption of tasks and activities that had value to them at personal, functional, and societal level. ConclusionQualitative interviews confirmed the relevance of existing outcomes for potential inclusion in a core outcome set for trials of physical rehabilitation interventions across the critical illness recovery continuum. The added significance of our findings is to provide real-world meaning to these outcomes. RegistrationCOMET Initiative, ID288, https://www.comet-initiative.org/studies/details/288.

Characterising illness stages and recovery trajectories of eating disorders in young people via remote measurement technology (STORY): a multi-centre prospective cohort study protocol

BackgroundEating disorders (EDs) are serious, often chronic, conditions associated with pronounced morbidity, mortality, and dysfunction increasingly affecting young people worldwide. Illness progression, stages and recovery trajectories of EDs are still poorly characterised. The STORY study dynamically and longitudinally assesses young people with different EDs (restricting; bingeing/bulimic presentations) and illness durations (earlier; later stages) compared to healthy controls. Remote measurement technology (RMT) with active and passive sensing is used to advance understanding of the heterogeneity of earlier and more progressed clinical presentations and predictors of recovery or relapse.MethodsSTORY follows 720 young people aged 16–25 with EDs and 120 healthy controls for 12 months. Online self-report questionnaires regularly assess ED symptoms, psychiatric comorbidities, quality of life, and socioeconomic environment. Additional ongoing monitoring using multi-parametric RMT via smartphones and wearable smart rings (‘Ōura ring’) unobtrusively measures individuals’ daily behaviour and physiology (e.g., Bluetooth connections, sleep, autonomic arousal). A subgroup of participants completes additional in-person cognitive and neuroimaging assessments at study-baseline and after 12 months.DiscussionBy leveraging these large-scale longitudinal data from participants across ED diagnoses and illness durations, the STORY study seeks to elucidate potential biopsychosocial predictors of outcome, their interplay with developmental and socioemotional changes, and barriers and facilitators of recovery. STORY holds the promise of providing actionable findings that can be translated into clinical practice by informing the development of both early intervention and personalised treatment that is tailored to illness stage and individual circumstances, ultimately disrupting the long-term burden of EDs on individuals and their families.

Navigating athlete mental health: Perspectives from performance directors within elite sport

Performance directors lead high-performance programmes within elite sport and where they opt to invest resources has implications for athletes. This study explores performance directors’ perspectives on mental health and illness and their experiences of managing these within elite sport. We conducted semi-structured interviews with 11 performance directors, resulting in 18 h of data. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. We constructed three themes: 1) making sense of mental health: legitimacy vs. scepticism; 2) mental health as athlete responsibility; and 3) simplifying and sanitising mental health. Performance directors used physical health analogies to make sense of mental health, sometimes describing unrealistic expectations regarding mental health management. They also positioned athletes as responsible for finding solutions to their mental health concerns, at times overlooking the impact of the elite sport environment. Some performance directors shared over-simplified perceptions of mental health, often focusing on ‘the positive’ and neglecting to talk about the more challenging aspects of mental health and illness. Educating performance directors, as well as others in leadership positions, on the complexities of mental health and illness is recommended. This should include how mental illness differs from physical illness and injury, how to respond when athletes disclose mental health concerns, and how mental illness recovery is often nonlinear and subjectively defined.

Qualitative Insights Into Patients' and Family Members’ Experiences of In-Hospital Medication Management After a Critical Care Episode

BackgroundPatient recovery after a critical illness can be protracted, requiring a care continuum that extends along a patient pathway from the critical care unit, hospital ward and into the community care setting. High-quality care on patient transfer from critical care, including medication safety, is facilitated by education for patients and families, family engagement, support systems and healthcare professional-patient communication. Currently, there is uncertainty on how healthcare professionals can and should engage with critical care patients and family members about their medication. Research QuestionWe aimed to explore the views and experiences of critical care patients and family members about their involvement, communication, understanding, and decision making related to their medication following transfer from critical care to the hospital ward. Study Design and MethodsQualitative study, using semi-structured interviews, conducted with critical care patients and family members after transfer from critical care to a hospital ward in a large National Health Service hospital Trust. Anonymized transcripts of interviews were thematically analysed using a coding framework developed from understandings of patient and family engagement in their medication. ResultsTwenty-seven participants (15 patients and 12 family members of patients) completed the interviews. We identified five themes and 15 sub-themes, providing an overview of patients and family members’ views on their medication management during their acute illness and ongoing recovery. Themes identified were: Impact of acute illness and treatment burden on pre-existing illness; Pre-existing knowledge and capability; Beliefs about persons roles and expectations; Care continuity and individualised information exchange; and Engagement in practice. InterpretationCritical care patients and family members want to engage with healthcare professionals about their medication. Health care professionals must take an individualized approach to communication and timing, acknowledging the dynamic interplay between patients and family members, using multimodal forms of communication.

Assessing the Psychometric Properties of the Illness Management and Recovery Scale: A Systematic Review Using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN).

The Illness Management and Recovery Scale (IMR-S) is based on the IMR program, developed to assess the recovery process for people with severe mental disorders by considering the perceptions of clients and clinicians involved in it. The aim of this study was to analyze the psychometric properties of the IMR-S so as to determine the reliability and suitability of its scores for evaluating recovery. Two coders searched five databases for studies, published between January 2004 and May 2023, that describe the psychometric assessment of the IMR-S. Studies were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. Finally, 46 papers were included. Methodological quality was very good for most of the studies that provide information on internal validity, and limited for those that report on responsiveness. Measurement properties were positive for convergent validity and measurement error. The quality of evidence was high for structural validity studies. Although this study only includes research published in English and may have overlooked certain psychometric properties evaluated in studies published in other languages, our findings suggest that the IMR-S is a valid and reliable instrument, demonstrating its potential to offer guidance for clinical practice.

Social Networks as a Key Health Determinant in Acute Illness Recovery: A Lesson from the COVID-19 Pandemic

BackgroundThe COVID-19 pandemic highlighted the importance of considering social determinants of health in health outcomes. Within this spectrum of determinants, social networks garnered attention as the pandemic highlighted the negative effects of social isolation in the context of social distancing measures. Postpandemic, examining the role social networks play in COVID-19 recovery can help guide patient care and shape future health policies. This study aimed to investigate the relationship between social networks and self-rated health change, as well as physical function, in patients recovering from COVID-19 pneumonia. MethodsThis was a retrospective cohort study utilizing clinical data from 2 New York City hospitals and a 9-month follow-up survey of COVID-19 pneumonia survivors. We evaluated a composite Social Network Score from the 6-item Lubben Social Network Scale and its association with 2 outcomes: 1) self-rated health change and 2) physical function. ResultsA total of 208 patients were included in this study. A 1-point increase in the Social Network Score was associated with greater odds of both same or improved self-rated health change (odds ratio [OR] 1.07, 95% CI 1.02-1.12, P = .01), as well as unimpaired physical function (OR 1.08, 95% CI 1.03-1.14, P < .01). ConclusionThis study emphasized the importance of social networks as a social determinant of health among patients recovering from COVID-19 hospitalization. Targeted interventions to enhance social networks may benefit not only COVID-19 patients but also individuals recovering from other acute illnesses.

The Relationship of Functioning and Life Satisfaction with Illness Management and Recovery in Patients with Bipolar Disorder: A Cross-Sectional Study.

The aim of this study was to determine relationship between functioning and life satisfaction with illness management and recovery, and determinants of illness management and recovery in patients with bipolar disorder. This descriptive and correlational study was conducted with 152 participants between August 2022 and February 2023. "Personal Information Form", "Illness Management and Recovery Scale", "Functioning Assessment Short Test" and "Adult Life Satisfaction Scale" were used to collecting data. In study, a positive relationship was found between illness management and recovery and total functionality, autonomy, cognitive functionality, interpersonal relationships, and life satisfaction. Gender, marital status, educational status, employment status, total functioning, autonomy, cognitive functioning, interpersonal relationships, and life satisfaction were found to be effective in illness management and recovery. Being female, single, primary school graduate, unemployed, having low functioning (autonomy, cognitive functioning, interpersonal relationships) and having low life satisfaction were found to be determinants of illness management and recovery.

"How Do I Test the Waters? How Do I Go Forward?": Codesigning a Supportive Pathway after Critical Illness.

Rationale: Long-term recovery after critical illness can be affected by post-intensive care syndrome (PICS), a significant burden, which can impact return to activities and work. There is a need for streamlined support for intensive care unit (ICU) patients in their recovery while enduring PICS symptoms. Objectives: To explore critical illness recovery from the experiences, perspectives, and beliefs of former ICU patients, their caregivers, and multidisciplinary clinicians to design a future rehabilitation intervention prototype to support ICU patients. Methods: This was an experience-based codesign (EBCD) study underpinned by the Behavior Change Wheel framework involving ICU patients (<5 years after illness), caregivers, and multidisciplinary clinicians with current clinical experience with ICU recovery at any point along the care continuum (ICU, acute, subacute, or community settings) from two metropolitan hospitals in Melbourne, Australia. Two rounds of experience-based codesign workshops were held between August 2021 and February 2022. Workshop content was analyzed via a reflective thematic approach to determine themes and develop an intervention. The intervention was mapped according to the template for intervention description and replication framework. Results: Forty people participated in the codesign process: 15 ICU patients, 2 caregivers, and 23 clinicians. Fifteen major themes were identified in the experience of ICU recovery. Returning home was a key time point for change, acceptance, and adjustment, with the burden of physical limitations and mental health problems becoming apparent. Most participants expressed that PICS was poorly understood in the community, and there was a lack of support to aid recovery. Based on these results, an intervention prototype was developed with a primary goal of improving care after hospital discharge. This was further refined in the second round of workshops. A resource toolkit was deemed most acceptable to end-users, including a hospital-directed support program involving psychology and physical therapy and an accompanying digital health package. Conclusions: A critical time point for more support in the recovery journey was the transition from hospital to home. To address this, a rehabilitation prototype including a physical and psychological support intervention and supporting digital health toolkit was codesigned. The intervention package will be developed and trialed with future ICU patients and their families. Clinical trial registered with www.clinicaltrials.gov (NCT05044221).

Burnout, Compassion Fatigue, and the Long Haul of Caring for Long COVID.

The current landscape of clinician burnout is prompting the need for our health care system to revise its approach toward complex conditions such as long coronavirus disease (COVID), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and other postinfectious fatiguing illnesses (PIFIs). We discuss our efforts here at Family Health Center of San Diego (FHCSD) to help share insight and glean perspective from clinicians who have participated in our Centers for Disease Control and Prevention (CDC)-funded 3-year continuing professional development initiative. The Long COVID and Fatiguing Illness Recovery Program uses multidisciplinary team-based case consultation and peer-to-peer sharing of emerging best and promising practices (ie, teleECHO [Extension for Community Healthcare Outcomes]) to support the management of complex cases associated with long COVID, ME/CFS, and other PIFIs. We believe that this perspective captures a key moment in the trajectory of postpandemic clinician burnout and prompts further reflection and action from the health care system to improve clinician- and patient-level outcomes related to the care of patients with postinfectious fatiguing illnesses.

Scale based entropy measures and deep learning methods for analyzing the dynamical characteristics of cardiorespiratory control system in COVID-19 subjects during and after recovery

COVID-19, known as Coronavirus Disease 2019 primarily targets the respiratory system and can impact the cardiovascular system, leading to a range of cardiorespiratory complications. The current forefront in analyzing the dynamical characteristics of physiological systems and aiding clinical decision-making involves the integration of entropy-based complexity techniques with artificial intelligence. Entropy-based measures offer promising prospects for identifying disturbances in cardiorespiratory control system (CRCS) among COVID-19 patients by assessing the oxygen saturation variability (OSV) signals. In this investigation, we employ scale-based entropy (SBE) methods, including multiscale entropy (MSE), multiscale permutation entropy (MPE), and multiscale fuzzy entropy (MFE), to characterize the dynamical characteristics of OSV signals. These measurements serve as features for the application of traditional machine learning (ML) and deep learning (DL) approaches in the context of classifying OSV signals from COVID-19 patients during their illness and subsequent recovery. We use the Beurer PO-80 pulse oximeter which non-invasively acquired OSV and pulse rate data from COVID-19 infected patients during the active infection phase and after a two-month recovery period. The dataset comprises of 88 recordings collected from 44 subjects(26 men and 18 women), both during their COVID-19 illness and two months post-recovery. Prior to analysis, data preprocessing is performed to remove artifacts and outliers. The application of SBE measures to OSV signals unveils a reduction in signal complexity during the course of COVID-19. Leveraging these SBE measures as feature sets, we employ two DL techniques, namely the radial basis function network (RBFN) and RBFN with dynamic delay algorithm (RBFNDDA), for the classification of OSV data collected during and after COVID-19 recovery. To evaluate the classification performance, we employ standard metrics such as sensitivity, specificity, false positive rate (FPR), and the area under the receiver operator characteristic curve (AUC). Among the three scale-based entropy measures, MFE outperformed MSE and MPE by achieving the highest classification performance using RBFN with 13 best features having sensitivity (0.84), FPR (0.30), specificity (0.70) and AUC (0.77). The outcomes of our study demonstrate that SBE measures combined with DL methods offer a valuable approach for categorizing OSV signals obtained during and after COVID-19, ultimately aiding in the detection of CRCS dysfunction.

Acute Kidney Injury Caused by Rhabdomyolysis Is Ameliorated by Serum Albumin-Based Supersulfide Donors through Antioxidative Pathways.

Oxidative stress is responsible for the onset and progression of various kinds of diseases including rhabdomyolysis-induced acute kidney injury (AKI). Antioxidants are, therefore, thought to aid in the recovery of illnesses linked to oxidative stress. Supersulfide species have been shown to have substantial antioxidative activity; however, due to their limited bioavailability, few supersulfide donors have had their actions evaluated in vivo. In this study, human serum albumin (HSA) and N-acetyl-L-cysteine polysulfides (NACSn), which have polysulfides in an oxidized form, were conjugated to create a supersulfide donor. HSA is chosen to be a carrier of NACSn because of its extended blood circulation and high level of biocompatibility. In contrast to a supersulfide donor containing reduced polysulfide in HSA, the NACSn-conjugated HSAs exhibited stronger antioxidant activity than HSA and free NACSn without being uptaken by the cells in vitro. The supersulfide donor reduced the levels of blood urea nitrogen and serum creatinine significantly in a mouse model of rhabdomyolysis-induced AKI. Supersulfide donors significantly reduced the expression of oxidative stress markers in the kidney. These results indicate that the developed supersulfide donor has the therapeutic effect on rhabdomyolysis-induced AKI.

Deciphering drug discovery and microbial pathogenesis research in tuberculosis during the two decades of postgenomic era using entity mining approach.

We examined literature on Mycobacterium tuberculosis (Mtb) subsequent to its genome release, spanning years 1999-2020. We employed scientometric mapping, entity mining, visualization techniques, and PubMed and PubTator databases. Most popular keywords, most active research groups, and growth in quantity of publications were determined. By gathering annotations from the PubTator, we determined direction of research in the areas of drug hypersensitivity, drug resistance (AMR), and drug-related side effects. Additionally, we examined the patterns in research on Mtb metabolism and various forms of tuberculosis, including skin, brain, pulmonary, extrapulmonary, and latent tuberculosis. We discovered that 2011 had the highest annual growth rate of publications, at 19.94%. The USA leads the world in publications with 18,038, followed by China with 14,441, and India with 12,158 publications. Studies on isoniazid and rifampicin resistance showed anenormous increase. Non-tuberculous mycobacteria also been the subject of more research in effort to better understand Mtb physiology and as model organisms. Researchers alsolooked at co-infections like leprosy, hepatitis, plasmodium, HIV, and other opportunistic infections. Host perspectives like immune response, hypoxia, and reactive oxygen species, as well as comorbidities like arthritis, cancer, diabetes, and kidney disease etc. were also looked at. Symptomatic aspects like fever, coughing, and weight loss were also investigated. Vitamin D has gained popularity as a supplement during illness recovery, however, the interest of researchers declined off late. We delineated dominant researchers, journals, institutions, and leading nations globally, which is crucial for aligning ongoing and evolving landscape of TB research efforts. Recognising the dominant patterns offers important information about the areas of focus for current research, allowing biomedical scientists, clinicians, and organizations to strategically coordinate their efforts with the changing priorities in thefield of tuberculosis research.

A LONGITUDINAL STUDY ON SNAP PARTICIPATION AND SELF-REPORTED HEALTH AMONG DIABETIC AND NON-DIABETIC INDIVIDUALS

Abstract Self-reported health is a strong predictor of future health status, new morbidity, mobility decline, illness recovery, and healthcare utilization. Because self-reported health is rooted in social position and social comparison, it dually reflects individual health perceptions and health inequities, especially among those who experience a social struggle for resources. Food insecurity is associated with higher risk of chronic diseases and higher mortality rates. Interventions such as the supplemental nutrition assistance program (SNAP) were created to help address food insecurity. Although morbidity and mortality risks caused by food insecurity is exacerbated for those with nutrition-centered chronic disease, such as diabetes, limited research has assessed the impact of food insecurity and SNAP participation on health among diabetics. Using Health and Retirement Study data, we explore the effect of SNAP participation and food insecurity on the likelihood of reporting fair or poor health comparing 24,446 diabetes to 69,260 non-diabetics individuals aged 65 and above (2004-2020). Our analysis controls for key socioeconomic factors, including age, gender, race/ethnicity, and wealth, accounting for the complex design of HRS. Our key findings reveal that food insecure diabetics have significantly higher odds of reporting fair/poor health, and diabetic SNAP participants also had significantly higher odds of reporting fair/poor health. Our study demonstrates how food insecurity and diabetes concurrently influence health and how, despite the presence of resources, such as SNAP, there was no improvement in self-reported health. This study is important as it highlights the need for future research on the effects of SNAP participation and self-reported health.

Promoting a Sleep-friendly Environment by Minimizing Overnight Room Entries

Introduction: Despite its importance in illness recovery, the sleep of hospitalized children is frequently interrupted. This quality improvement intervention aimed to reduce overnight room entries by minimizing unnecessary interventions. Methods: This study occurred at a university-affiliated children’s hospital on the hospital medicine services from March 26, 2021, to April 14, 2022. The intervention included order set changes and the implementation of a rounding checklist designed to address factors most closely associated with sleep disruption and overnight room entries. The outcome measure was overnight (10 pm to 6 am) room entries, counted using room entry sensors. Process measures reflected the intervention targets (overnight vital sign orders, medication administration, and intravenous fluid use). The method of analysis was statistical process control charting. Results: After identifying special cause variation, the average number of overnight room entries decreased from 8.1 to 6.8, a 16% decrease. This decrease corresponded with the implementation of a rounding checklist. However, there continued to be variability in average room entries, suggesting a process lacking ongoing stability. During this period, avoidance of overnight medications and intravenous fluid increased by 28% and 17%, respectively. Conclusions: Implementing a rounding checklist to a broad patient population decreased overnight room entries. However, future work is needed to better understand the factors associated with sustaining such an improvement.