Long-term Illness Research Articles

A State-of-the-art Review on Artificial Intelligence and Machine Learning Applications

Background: The integration of artificial intelligence and machine learning holds great promise for enhancing healthcare institutions and providing fresh perspectives on the origins and advancement of long-term illnesses. In the healthcare sector, artificial intelligence and machine learning are used to address supply and demand concerns, genomic applications, and new advancements in drug development, cancer, and heart disease. Objective: The article explores the ways that machine learning, AI, precision medicine, and genomics are changing healthcare. The essay also discusses how AI's examination of various patient data could enhance healthcare institutions, provide fresh insights into chronic conditions, and advance precision medicine. The potential uses of machine learning for genome analysis are also examined in the paper, particularly about genetic biomarker-based disease risk and symptom prediction. Discussion: The challenges posed by the phenotype-genotype relationship are examined, as well as the significance of comprehending disease pathways in order to create tailored treatments. Moreover, it offers a streamlined and modularized method that predicts how genotypes affect cell properties using machine-learning models, enabling the development of personalized drugs. The collective feedback highlights the rapid interdisciplinary growth of medical genomics following the completion of the Human Genome Project. It also emphasizes how important genomic data is for improving healthcare outcomes and facilitating personalized medicine. Conclusion: The study's conclusions point to a revolutionary shift in healthcare: the application of AI/ML to illness control. Even though these innovations have a lot of potential benefits, problems like algorithm interpretability and ethical issues need to be worked out before they can be successfully incorporated into routine medical practice. Using machine learning in medicine has enormous potential benefits for the biotech industry. Further research, ongoing regulatory frameworks, and collaboration between medical professionals and data analysts are necessary to fully utilize machine learning as well as artificial intelligence in disease management.

Elderly people's perceptions on the use of mobile phones to support the self-management of long-term illnesses at Kiruddu National Referral Hospital.

The global estimate of the aging population is progressively increasing in low and middle-income countries and this is accompanied by the limitations associated with the need for equitable and efficient healthcare delivery among this dire population. Unfortunately, despite the increasing numbers, the adoption of mobile phones is not balanced in the different populations with research showing young persons' adoption rate is higher than that of elderly persons. This current study was conducted to identify elderly people's perceptions of the use of mobile phones to support the self-management of long-term illnesses at Kiruddu National Referral Hospital. This descriptive-cross-sectional design study was conducted on a sample population of 30 elderly individuals older than 60 years admitted at the outpatient department of Kiruddu National Referral Hospital, Kampala, Uganda. We conducted face-to-face interviews following an interview guide and one focus group discussion. We later used a feature mobile phone and a tablet mobile phone to assess the individual ease of use of each device. The audio recordings were professionally transcribed and transcripts were coded into NVIVO version 12 analysis software for thematic analysis. Almost all of the respondents who visited the facility had an ailment that hindered their full utilization of the mobile phone to support their self-care. This together with other factors like financial constraints, lack of support from the health workers on how to use mobile phones to support health, inadequate support from the facility, and cost of mobile data among others. This study provides empirical evidence that there is hardly a known mobile phone adoption model to enable policymakers, systems developers, and health workers to promote the elderly population's use of mobile phones to manage their long-term illnesses in Uganda.

Role of Micronutrients (Vitamins & Minerals)

Micronutrients are essential nutrients. Micronutrients are needed mostly below 100 milligrams per day for human nutrition, although macronutrients are needed in grams daily. Essential nutrients cannot be produced in human beings and, therefore needed by the diet. Micronutrients play a fundamental role in digestion and tissue maintenance but effects in inhibiting or medication of sickness which is not caused by lack of nutrients cannot be predictable from increasing the consumption. Medical insufficiency of nutrients is unfamiliar in industrialized nations i.e. High consumption of micronutrients such as folic acid and b-carotene is linked with a high threat of long-term illnesses for example cardiovascular disease, and inferior threat of congenital heart disease and cancer at different places. Above 2 billion persons in both developing and industrial Countries are disturbed by deficiencies. The actions or absorption of vitamins is slowed down by Anti-vitamins i.e., enzymes that use vitamin B1 are suppressed by Pyrithiamine. Biotin absorption is inhibited by avidin, although by cooking it is inactivated. In the human body four main basic elements (O, H, C, and N) by weight, are often not involved in the tilts of main minerals. For plants, nitrogen is a “mineral" because it is normally involved in manures. 96% of the weight of the human body is composed of these elements, and the remaining percent is composed of trace elements and macrominerals. Phosphorus, Calcium, sodium, potassium, and magnesium (macro minerals, microelements) are the five main elements in the human body. Sulfur, manganese, molybdenum, copper, iodine, selenium zinc, chlorine, cobalt, and iron are microelements, with specific biological functions in the human body. The current review analyzes the different methodologies for the study of nutritive consumption of micronutrients and will reflect the indication of the valuable influence of the supplements of micronutrients on health.

Impact of an Internet-Delivered Sound Healing Intervention on Chronic Non-Malignant Pain and Sleep Disturbances in Community Settings

IntroductionChronic pain patients often contend with insomnia symptoms, creating a reciprocal relationship that adds complexity to their condition. Evaluating interventions targeting insomnia in this population becomes paramount, given the intertwined nature of pain and sleep disturbances.ObjectivesThis retrospective pretest design aimed to assess the efficacy of an Internet-delivered sound healing intervention in reducing insomnia severity and addressing sleep- and pain-related parameters among individuals with chronic pain.MethodsConducted as a community-based project, Tuning for Health provided support to individuals grappling with long-term illnesses. The intervention involved the virtual delivery of a specially crafted sound track using tuning forks over a 6-week period, supervised by an experienced therapist and administered weekly for an hour. Participants were instructed to play the track daily at a time convenient for them. A total of 68 participants (mean age 59.3 years) completed the intervention. Outcome measures, including the Insomnia Severity Index (ISI), a sleep diary, and assessments for anxiety, depression, and pain-related parameters, were collected at the end of the 6-week intervention and repeated after a 6-month follow-up. Negative effects were monitored and reported.ResultsSignificant immediate interaction effects (time by treatment) were observed for the pain severity, ISI and various sleep parameters, such as sleep efficiency, sleep onset latency, early morning awakenings, and wake time after sleep onset. A time effect for anxiety and depression was noted at the 6-month follow-up. The group exhibited highly significant improvements in pain-related parameters. At the 6-month follow-up, sustained enhancements in sleep parameters and mental health were reported, with no reported side effects.ConclusionsThese unique results suggest the potential efficacy of sound healing in alleviating chronic pain and associated insomnia. Further research with a larger sample size is warranted to validate these findings. Combining sound healing with other treatments may offer enhanced outcomes for individuals dealing with both chronic pain and comorbid insomnia. This study lays the groundwork for future investigations into the promising intersection of sound healing, chronic pain management, and sleep improvement.Disclosure of InterestNone Declared

Risk factors for suicidal ideations and suicide attempts among medical students

IntroductionMedical students are a high-risk population for having suicidal thoughts and behaviors. However, few studies have been fulfilled on this subject.ObjectivesThe objective of this study was to provide a systematic overview of risk factors for suicidal ideations (SI) and suicide attempts (SA) among medical students.Methods We set out to summarize the literature on the MEDLINE (via PUBMED) and Science Direct databases, regarding risk factors for SI and SA in medical students, using the key words : « medical student» ; « suicide attempt» ; « suicidal ideation », « risk ».Results Recent studies showed that poor mental health outcomes including depression, anxiety, burnout, comorbid mental illness, and stress presented the strongest risk for SI among medical students. In addition, SI was statistically significantly associated with alcohol use, Tobacco consumption, personal history of suicide attempt, female gender and poor social support.On the other hand, SA were significantly associated with the presence of a long-term illness, anxiety and depression. Conversely, stress, female gender, and alcohol use were not significant risk factors for SA among medical students.ConclusionsMedical students face a number of personal, environmental, and academic challenges that may put them at risk for SI and SA. Additional research on individual risk factors is needed to construct effective suicide prevention programs in medical schools.Disclosure of InterestNone Declared

Smart IoT-enabled Healthcare Systems: Real-time Anomaly Detection and Decision Support using Deep Learning Models

Smart healthcare systems that use Internet of Things (IoT) technologies are changing the medical field by letting data about patients be monitored and analyzed in real time. This paper suggests a new way to improve these kinds of systems by adding deep learning models to help find problems and make decisions.IoT devices are used in the suggested system to gather real-time information about things like vital signs, patient behavior, and surrounding factors. Deep learning algorithms, especially convolutional neural networks (CNNs) and recurrent neural networks (RNNs), are then used to handle this data and look for changes in the patient's health that aren't normal. These strange things could be signs of possible health problems or accidents, which would require quick action.Deep learning models are also trained on big datasets to find trends and connections in the data. This lets them help healthcare workers make decisions. For instance, the system can figure out how likely it is that a patient will get a certain illness by looking at their present health and their medical background.One of the best things about this method is that it can change and get better over time. More information is put into the models over time, making them more accurate and good at finding problems and giving useful information. This makes the method very useful for keeping an eye on people with long-term illnesses or finding diseases early. In adding deep learning models to healthcare systems that are connected to the internet of things (IoT) is a useful way to make patient care better. These tools could save lives and improve health by finding problems and helping people make decisions in real time.

Computational Synaptic Modeling of Pitch and Duration Mismatch Negativity in First-Episode Psychosis Reveals Selective Dysfunction of the N-Methyl-D-Aspartate Receptor.

Mismatch negativity (MMN) to pitch (pMMN) and to duration (dMMN) deviant stimuli is significantly more attenuated in long-term psychotic illness compared to first-episode psychosis (FEP). It was recently shown that source-modeling of magnetically recorded MMN increases the detection of left auditory cortex MMN deficits in FEP, and that computational circuit modeling of electrically recorded MMN also reveals left-hemisphere auditory cortex abnormalities. Computational modeling using dynamic causal modeling (DCM) can also be used to infer synaptic activity from EEG-based scalp recordings. We measured pMMN and dMMN with EEG from 26 FEP and 26 matched healthy controls (HCs) and used a DCM conductance-based neural mass model including α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid, N-methyl-D-Aspartate (NMDA), and Gamma-aminobutyric acid receptors to identify any changes in effective connectivity and receptor rate constants in FEP. We modeled MMN sources in bilateral A1, superior temporal gyrus, and inferior frontal gyrus (IFG). No model parameters distinguished groups for pMMN. For dMMN, reduced NMDA receptor activity in right IFG in FEP was detected. This finding is in line with literature of prefrontal NMDA receptor hypofunction in chronic schizophrenia and suggests impaired NMDA-induced synaptic plasticity may be present at psychosis onset where scalp dMMN is only moderately reduced. To the best of our knowledge, this is the first report of impaired NMDA receptor activity in FEP found through computational modeling of dMMN and shows the potential of DCM to non-invasively reveal synaptic-level abnormalities that underly subtle functional auditory processing deficits in early psychosis.

Accessible and Inclusive Tourism: The Hotel Industry in Porto – The InterContinental Porto, Palácio das Cardosas

Porto is internationally renowned for its hospitality. A city that knows how to welcome, a tourist destination that excels in hospitality, according to the opinion of millions of tourists who visit us every year. Tourism, on its side, has become increasingly specialised to respond to a growing demand for unique, sustainable and accessible experiences for everyone. In recent years we have been faced with the demands of different and new markets. According to a study by Booking.com, 54% of travellers in 2023 will choose to travel as a family, with the aim of reuniting the various members. This multi-generational market is very challenging as it includes different age groups in the same group with different motivations and needs, needs that can be special. In addition, physical and mental disabilities are increasingly present, such as limited or reduced mobility, visual and/or hearing impairments, learning difficulties caused by long-term illnesses, in a general way, target public with specific needs to which the tourist offer must be adapted. These new demand requirements should therefore be considered a central point in the discussion of accessible and inclusive tourism. As the hotel industry is a fundamental pillar of tourism, there is an increasing need to rethink its approach in terms of offer.In this article we will present the Intercontinental Porto - Palácio das Cardosas Hotel as an example of this new way of looking at tourist services, making a significant contribution to affirming Porto as an accessible and inclusive destination.

Impact of cotton dust, endotoxin exposure, and other occupational health risk due to indoor pollutants on textile industry workers in low and middle- income countries

The textile industry consists of several units that engage different processes namely ginning, spinning, weaving, dyeing, printing, and several other processes which required for converting raw cotton fiber into finished fabrics. Exposure to cotton dust, endotoxin, chemicals, noise, and musculoskeletal disorders causes several health-related hazards to textile workers. This review article aims to study the health issues due to various risk factors associated with the working environment in detail and its impacts on workers' health. This review article also reports dust and endotoxin concentrations in indoor environments of textile industries, as well as discusses the association between workplace exposure to cotton dust, endotoxin, and the prevalence of respiratory disorders. In this review, the focus is also given to the prevalence of indoor pollutants like Particulate Matter (PM), Carbon dioxide (CO2), Carbon monoxide (CO), and Volatile Organic Compounds (VOCs), Formaldehyde (HCHO) in the workplace and its effects on human health. The study expands to other aspects that influence human comfort and health during working hours like occupational noise, musculoskeletal disorders, and eyesight problems. In addition, the advanced technologies for monitoring indoor air quality for control and reduction of pollutants indoor environment the current regulatory limits of cotton dust and indoor pollutants, and suggestions to enhance the occupational safety and health conditions in textile sectors are also pointed out. In conclusion, the current study stresses the need to regulate and apply international standards in the textile sector to prevent short- and long-term occupational illness.

Leading determinants of incident dementia among individuals with and without the apolipoprotein E ε4 genotype: a retrospective cohort study

BackgroundLittle is known regarding the leading risk factors for dementia/Alzheimer’s disease (AD) in individuals with and without APOE4. The identification of key risk factors for dementia/Alzheimer’s disease (AD) in individuals with and without the APOE4 gene is of significant importance in global health.MethodsOur analysis included 110,354 APOE4 carriers and 220,708 age- and sex-matched controls aged 40–73 years at baseline (between 2006–2010) from UK Biobank. Incident dementia was ascertained using hospital inpatient, or death records until January 2021. Individuals of non-European ancestry were excluded. Furthermore, individuals without medical record linkage were excluded from the analysis. Moderation analysis was tested for 134 individual factors.ResultsDuring a median follow-up of 11.9 years, 4,764 cases of incident all-cause dementia and 2065 incident AD cases were documented. Hazard ratios (95% CIs) for all-cause dementia and AD associated with APOE4 were 2.70(2.55–2.85) and 3.72(3.40–4.07), respectively. In APOE4 carriers, the leading risk factors for all-cause dementia included low self-rated overall health, low household income, high multimorbidity risk score, long-term illness, high neutrophil percentage, and high nitrogen dioxide air pollution. In non-APOE4 carriers, the leading risk factors included high multimorbidity risk score, low overall self-rated health, low household income, long-term illness, high microalbumin in urine, high neutrophil count, and low greenspace percentage. Population attributable risk for these individual risk factors combined was 65.1%, and 85.8% in APOE4 and non-APOE4 carriers, respectively. For 20 risk factors including multimorbidity risk score, unhealthy lifestyle habits, and particulate matter air pollutants, their associations with incident dementia were stronger in non-APOE4 carriers. For only 2 risk factors (mother’s history of dementia, low C-reactive protein), their associations with incident all-cause dementia were stronger in APOE4 carriers.ConclusionsOur findings provide evidence for personalized preventative approaches to dementia/AD in APOE4 and non-APOE4 carriers. A mother’s history of dementia and low levels of C-reactive protein were more important risk factors of dementia in APOE4 carriers whereas leading risk factors including unhealthy lifestyle habits, multimorbidity risk score, inflammation and immune-related markers were more predictive of dementia in non-APOE4 carriers.

Fetal loss and long-term maternal morbidity and mortality: A systematic review and meta-analysis.

Evidence suggests common pathways between pregnancy losses and subsequent long-term maternal morbidity, rendering pregnancy complications an early chronic disease marker. There is a plethora of studies exploring associations between miscarriage and stillbirth with long-term adverse maternal health; however, these data are inconclusive. We systematically searched MEDLINE, EMBASE, AMED, BNI, CINAHL, and the Cochrane Library with relevant keywords and MeSH terms from inception to June 2023 (no language restrictions). We included studies exploring associations between stillbirth or miscarriage and incidence of cardiovascular, malignancy, mental health, other morbidities, and all-cause mortality in women without previous pregnancy loss. Studies reporting short-term morbidity (within a year of loss), case reports, letters, and animal studies were excluded. Study selection and data extraction were performed by 2 independent reviewers. Risk of bias was assessed using the Newcastle Ottawa Scale (NOS) and publication bias with funnel plots. Subgroup analysis explored the effect of recurrent losses on adverse outcomes. Statistical analysis was performed using an inverse variance random effects model and results are reported as risk ratios (RRs) with 95% confidence intervals (CIs) and prediction intervals (PIs) by combining the most adjusted RR, odds ratios (ORs) and hazard ratios (HRs) under the rare outcome assumption. We included 56 observational studies, including 45 in meta-analysis. There were 1,119,815 women who experienced pregnancy loss of whom 951,258 had a miscarriage and 168,557 stillbirth, compared with 11,965,574 women without previous loss. Women with a history of stillbirth had a greater risk of ischaemic heart disease (IHD) RR 1.56, 95% CI [1.30, 1.88]; p < 0.001, 95% PI [0.49 to 5.15]), cerebrovascular (RR 1.71, 95% CI [1.44, 2.03], p < 0.001, 95% PI [1.92, 2.42]), and any circulatory/cardiovascular disease (RR 1.86, 95% CI [1.01, 3.45], p = 0.05, 95% PI [0.74, 4.10]) compared with women without pregnancy loss. There was no evidence of increased risk of cardiovascular disease (IHD: RR 1.11, 95% CI [0.98, 1.27], 95% PI [0.46, 2.76] or cerebrovascular: RR 1.01, 95% CI [0.85, 1.21]) in women experiencing a miscarriage. Only women with a previous stillbirth were more likely to develop type 2 diabetes mellitus (T2DM) (RR: 1.16, 95% CI [1.07 to 2.26]; p < 0.001, 95% PI [1.05, 1.35]). Women with a stillbirth history had an increased risk of developing renal morbidities (RR 1.97, 95% CI [1.51, 2.57], p < 0.001, 95% [1.06, 4.72]) compared with controls. Women with a history of stillbirth had lower risk of breast cancer (RR: 0.80, 95% CI [0.67, 0.96], p-0.02, 95% PI [0.72, 0.93]). There was no evidence of altered risk of other malignancies in women experiencing pregnancy loss compared to controls. There was no evidence of long-term mental illness risk in women with previous pregnancy losses (stillbirth: RR 1.90, 95% CI [0.93, 3.88], 95% PI [0.34, 9.51], miscarriage: RR 1.78, 95% CI [0.88, 3.63], 95% PI [1.13, 4.16]). The main limitations include the potential for confounding due to use of aggregated data with variable degrees of adjustment. Our results suggest that women with a history of stillbirth have a greater risk of future cardiovascular disease, T2DM, and renal morbidities. Women experiencing miscarriages, single or multiple, do not seem to have an altered risk.

Beyond the Needle: Unmasking Atypical Mycobacteria in Postvaccination Abscesses in Children.

Atypical or nontuberculous mycobacteria (NTM) are an environmental organism responsible for opportunistic infection. Rapid-growing NTM are more commonly associated with hospital-acquired infections. Many of the organisms responsible for diseases in immunocompromised patients and hospital-acquired infections originate from tap water, such as Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium gordonae, Mycobacterium simiae, Mycobacterium mucogenicum, Mycobacterium fortuitum, Mycobacterium chelonae, and Mycobacterium abscessus. NTM is a rare organism responsible for the injection abscess. Considering low incidents, not much clinical data are available for this condition. Here, we discuss such cases which can be helpful to spread awareness and provide data for future policy makers. This was a retrospective study. Data on patients with injection abscess were collected from the last 6 years. Detailed history and clinical examination findings were analyzed. Children with injection abscess were operated and their further management and outcome were studied. A total of 13 cases with confirmed culture of NTM were treated over 6 years. The age ranged from 2½ months to 5¾ years with male:female ratio of 7:6. All patients hailed from the same geographical area. All children were healthy with no history of any long-term or chronic illness, without additional symptoms and had received Bacillus Calmette-Guérin vaccination at birth. The total duration of illness varied from 1 to 5 months, with a mean of 3 months. All patients had a history of intramuscular age-appropriate vaccination as per the national immunization schedule. All patients were followed up to 6 months after intervention and none of our patients developed relapse. Patient who does not respond with optimum treatment should have a high suspicion of such opportunistic infection, which is crucial to their management. Hospital-acquired NTM infections often result from contaminated instruments or fluids. Adherence to strict aseptic precautions, hand hygiene and environmental precautions are the key to preventing these infections. In case of skin and soft tissue infections / abscesses, surgical intervention plays a significant role for managing the patient.

Insights Into Informal Caregivers' Well-being: A Longitudinal Analysis of Care Intensity, Care Location, and Care Relationship.

This study investigates the psychological well-being of informal caregivers over time. It identifies the thresholds (or "tipping points") of caring intensity at which caregiving is associated with lower psychological well-being, and how this varies by care location and caregiver-care recipient relationships. It also examines how caring location and relationship are linked to informal caregivers' psychological well-being while controlling for caring intensity. Waves 1-18 (1991-2009) of the harmonized British Household Panel Survey and Waves 1-8 (2009-2017) of the U.K. Household Longitudinal Study were analyzed. Psychological well-being was measured using the General Health Questionnaire (GHQ)-12 score. Care intensity was measured by the weekly hours of care provided. Fixed-effects estimators were applied to the GHQ-12 score of caregivers across different care intensities, caring locations, and caring relationships. All levels of informal care intensity are associated with lower psychological well-being among spousal caregivers. The thresholds to well-being are 5 hours per week when caring for a parent, and 50 hours per week when caring for a child (with a disability or long-term illness). Caring for "other relatives" or nonrelatives is not negatively associated with psychological well-being. The thresholds are 5 hours per week for both coresident and extraresident caregivers. Extraresident caregivers experience better psychological well-being compared to coresident caregivers, given relatively lower weekly care hours. Caring for primary kin (especially spouses) is linked to lower psychological well-being compared to other caregiving relationships, regardless of care intensity. Policy and practice responses should pay particular attention to spousal caregivers' well-being. Caregiving relationship has a stronger association with the caregiver's well-being than care location.

Adolescent Young Carers Who Provide Care to Siblings

A child’s disability, long-term illness, or mental ill-health is known to affect siblings’ health, social life, school engagement, and quality of life. This article addresses a research gap by its focus on young sibling carers and the impact of providing care to a sibling. A cross-national survey study was conducted in 2018–2019 (Italy, the Netherlands, Slovenia, Sweden, Switzerland, the UK) to examine the incidence of adolescent sibling carers, the extent of care they provide, and their self-reported health, well-being, and school situation. The survey was completed by 7146 adolescents, aged 15–17, and 1444 of them provided care to family members with health-related conditions. Out of these, 286 were identified as Sibling Carers and 668 as Parent Carers, while 181 had both sibling(s) and parent(s) with health-related conditions, and thus were identified as Sibling–Parent Carers. Sibling Carers and Sibling–Parent Carers carried out higher levels of caring activities compared to Parent Carers. They reported both positive aspects of caring, such as increased maturity, and negative aspects, such as mental ill-health, impact on schooling and a lack of support. To reduce the negative aspects of a sibling carer role, it is important to recognise them and to implement early preventive measures and formal support.

Factors associated with non-treatment for long-term illness among incarcerated individuals

PurposeThe prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals.Design/methodology/approachThis study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model.FindingsThe authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03–1.19), using the Spanish language (PR: 1.15, CI95%: 1.01–1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06–1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06–1.18) increased the prevalence of non-treatment.Originality/valueIdentifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.

Chronic diseases and self-assessment of health as predictors of unmet health needs of the elderly population in the Republic of Serbia: National health survey

Introduction/Aim. Unmet health needs are the difference between the health services considered necessary to solve a particular health problem and the health services that were actually received. Unmet health needs in the elderly population with chronic diseases can lead to deterioration of the health condition and complications. The aim of the study was to analyze the connection between the presence of chronic diseases and self-assessment of health with the unmet health needs of the elderly population. Methods. The study was part of the latest National Population Health Survey of the Republic of Serbia, conducted as a cross-sectional study on a representative stratified two-stage sample. Data from 3,450 respondents aged 65 and above were used for the purposes of the research. The research was conducted according to the European population health research methodology. Univariate and multivariate logistic regression were used to assess predictors of unmet health needs. Results. Every third respondent with a chronic disease did not receive the necessary form of health care (36.3%). Dominant predictors of unmet health needs were self-assessment of health [odds ratio (OR) = 0.63; 95% confidence interval (CI) = 0.58-0.68] along with chronic diseases (OR = 2.29; 95% CI = 1.87- 2.81) and depression (OR = 2.12; 95% CI = 1.71-2.64). Respondents with a chronic health disorder were 2.2 times more likely to fail in the realization of the necessary health service compared to respondents who did not have long-term illnesses. Respondents who assess their own health as poor/very poor report unfulfilled health needs two times more often than respondents in good health. Conclusion. Unmet health needs in the elderly population are associated with self-reported health and the presence of chronic diseases. The results of such research can be the basis for a better organization of health care and the creation of health policies in order to improve the health of this population group.

Health-related quality of life and associated factors among family caregivers of patients with cancer in oncologic centers of Northwest Ethiopia.

Providing care for individuals dealing with long-term illnesses like cancer demands significant amounts of time, energy, and emotional investment, potentially resulting in a challenging and overwhelming quality of life for those providing the care. The purpose of this study was to assess the level of health-related quality of life (HRQoL) and associated factors among family caregivers of patients with cancer in oncologic centers of Northwest Ethiopia. A cross-sectional study was conducted among 412 family caregivers of patients with cancer who were following treatment at oncologic centers in Northwest Ethiopia from August to October 2023. Systematic random sampling was used to enroll study participants. Epi-data version 4.6.1 and SPSS version 26 were used for data entry and analysis, respectively. The relationship between quality of life and independent variables was examined using linear regression. Statistical significance was determined for variables having a p-value of less than 0.05 at a 95% confidence range. A total of 412 eligible caregivers were included in the study out of 422 approached samples, yielding a 97.6% response rate. The mean score of the overall Quality of Life Brief-Scale Version was 52.7 ± 9.57. Being Spouse (β = -3.39; 95% CI: -6.49, -0.29), presence of chronic illness (β = -3.43; 95% CI: -5.56, -1.31), depression, (β = -2.55; 95% CI: -4.34, -0.75), anxiety (β = -3.27; 95% CI: -5.22, -1.32),and social support, (β = -3.61; 95% CI: -6.20, -1.02) were negatively associated with quality of life. In this study, the psychological domain had the lowest mean score. Caregivers being as spouse, who were with chronic illness, manifested depression and anxiety and had a poor social support needs attention and support to improve HRQoL.

Advanced psoriasis treatment: Development and optimization of resorcinol-loaded nanoemulgel with lavender oil

&lt;p&gt;Psoriasis, a long-term autoimmune illness, affects 2%–5% of people worldwide. Drugs from BCS class II that are commonly used to treat psoriasis include resorcinol, which presents burning feelings and itchiness as adverse effects. To minimize adverse effects and increase the effectiveness of treatment, a topical nanoemulgel was developed in the current research. A resorcinol-loaded nanoemulgel was developed using the nanoemulsion technique, and the Design Expert&lt;sup&gt;®&lt;/sup&gt; CCD method was used for optimization. Particle size (PS), zeta potential (ZP), and percentage of entrapment efficiency (EE%) served as the foundation for the optimization. The morphology, chemical interactions between excipients, crystallinity, and thermal behavior of the optimized resorcinol-loaded nanoemulgel were examined by TEM, FTIR, and XRD physicochemical studies. The resorcinol-loaded nanoemulgel was successfully loaded and characterized. For the in vitro release, the dialysis bag technique was employed. The ideal PS, PDI, and ZP values for the optimized resorcinol-loaded nanoemulgel were 31.32 ± 3.1 nm, 0.24 ± 0.005, and −10.6 ± 1.0 mV, respectively. The FTIR data revealed that no chemical interactions were observed between the components of resorcinol-loaded nanoemulgel, while the TEM results supported the spherical shape. The in vitro study confirmed a sustained release of resorcinol-loaded nanoemulgel.&lt;/p&gt;

Corelation Between Driving Position and Other Factor to Musculoskeletal Complaints with Reba in Online Taxibike Drivers in West Jakarta 2021

Poor posture is the main cause of Musculoskeletal Disorders, MSDs in motorcyclists can affect daily activities, reduce work efficiency and productivity, increase the risk of work accidents and long-term illness. This study aims to determine whether there is a relationship between driving position and musculoskeletal disorders with the Rapid Entire Body Assessment hoping that the complaints can be minimized or prevented. Research data collection took place in December 2021. Research participants were online taxibike drivers in West Jakarta who were still actively working in 2021. Demographic data and riding position were obtained through the Nordic Body Map questionnaire and online questionnaire via Google Form. For the riding position, respondents were asked to ride the motorbike they used for work and were photographed by the researcher, and calculated using the REBA calculator software. The statistical test showed a value of P: 0.682 (p&gt; 0.05) which indicated that there was no significant relationship between riding position and musculoskeletal complaints among online motorcycle drivers in West Jakarta in 2021. Even though there was no relationship between riding position and musculoskeletal complaints, to reduce the increased risk of MSDs, riders can make the best use of their rest time outside of work hours or before work by doing small sports or stretching to stretch tense muscles and reduce the accumulation of lactic acid.

Integrated Care Systems in England: Progress towards forming new multi-stakeholder partnerships to develop quality.

Background: Health and social care services in England have been restructured to 42 Integrated Care Systems (ICS). ICSs are responsible for delivering integrated services in their local area to prevent illness; identify and treat illness effectively; and provide support to improve quality of life for people with long-term illness or disability. Under the umbrella of ICSs, previously siloed organisations need to work together to deliver quality care. This study aimed to understand how these new ways of working impact on the development of their quality agenda.&#x0D; Methods: Semi-structured interviews were undertaken with senior representatives in demographically and geographically diverse ICS. Interviews were audio recorded, transcribed verbatim and analysed in NVivo using a thematic framework approach. Two Patient and Public Involvement team members contributed to the study design and data analysis. The study is conducted at two points in time; the data reported here is the baseline collected shortly (November 2021 to May 2022) before the ICSs’ formal constitution in July 2022.&#x0D; Results: Sixty interviews across four ICSs were conducted with senior representatives (e.g. ICS CEO, chief nurse, quality leads, director of social services, director of public health, the public and local communities). Across all ICSs, progress had been made with creating ICS specific committees, with new roles created and leaders appointed, and new partnerships emerging. Positive learning on collaborating with diverse partners had occurred during the COVID-19 pandemic and through previous local initiatives to integrate services. In two ICSs, there was less history of such collaborative work and their new partnerships were emerging more slowly. &#x0D; Generally, it was agreed that strong leadership, supported by broad and effective system partnerships, was essential to develop the ICSs’ structure and to deliver quality. Key partners to support the leadership were senior partners in acute hospital trusts, primary care, social care, public health, Healthwatch (the health and social care champion for service users), voluntary services, and patient representatives. &#x0D; Some concerns were raised that made collaborations more challenging, including differences in language and work culture between the key partners, and health dominating the quality agenda. Overall, it was felt that social care, public health and voluntary services were heard less. They were being consulted, but rarely had leadership roles and leaders from these communities often felt that they were not equal partners. Most participants highlighted the importance of consulting patients and the public and acknowledged that this was not done effectively yet with too few people, who lacked diversity, consulted; and an overreliance on Healthwatch. &#x0D; Discussion: This restructure of the health and social care system shows that new partnerships can be formed between previously siloed organisations but that these take time to develop. In particular, organisations or people who have traditionally been less consulted such as social care, public health, and patients and the public still need to become more equal partners in developing the quality agenda. Follow up interviews will bring greater clarity on how this restructure will maintain and promote quality across services. &#x0D;