Management Of Health Problems Research Articles

Naturally Occurring Compounds Targeting Peroxisome Proliferator Receptors: Potential Molecular Mechanisms and Future Perspectives for Promoting Human Health

Background: Peroxisome-proliferator-activated receptors (PPARs) constitute nuclear transcription factors controlling gene expression associated with cell growth and proliferation, diverse proteins, lipids, and glucose metabolism, being related to several other pathophysiological states such as metabolic disorders, atherogenesis, carcinogenesis, etc. The present survey aims to analyze the natural compounds that can act as agonists for the PPAR-α, PPAR-β/δ, and PPAR-γ system targeting, highlighting how the amazing biochemical diversity of natural compounds can yield new insights into this “hotspot” of the scientific field. Methods: A narrative review was performed by searching the recent international literature for the last two decades in the most authoritative scientific databases, like PubMed, Scopus, Web of Science, and Embase, using appropriate keywords. Results: Several natural compounds and/or their synthetic derivatives can act as ligands of PPARs, stimulating their transcriptional activity and enabling their use as preventive and/or therapeutic agents for several disease states, such as inflammation, oxidative stress, metabolic disturbances, atherogenesis, and carcinogenesis. Although synthetic compounds are increasingly used as drugs to manage health problems, serious side effects have been observed, while their natural analogues exhibit only few minor side effects. Conclusions: Further clinical studies on natural compounds such as ligands of PPARs and the evaluation of the related molecular mechanisms are needed to implement an effective strategy concerning the pharmaco-technology, food chemistry, and nutrition to introduce them as part of clinical and dietary practice.

Effectiveness of website-based education program on activities of daily living and fear of falls among sub-acute stroke survivors: a pilot study in South Gujarat Region of India

BackgroundStroke survivors and their caregivers have numerous and diverse educational needs, many of which are unmet because of inadequate training from healthcare professionals. As stroke recovery and rehabilitation can continue for years post-stroke, it is critical that stroke survivors are provided with and have access to a range of support options and evidence-based information. Website-based education programs (WEP) have been adopted in recent years to manage health problems. The present pilot study aims to evaluate the effect of WEP on activities of daily living (ADLs) and the fear of falls among sub-acute stroke survivors.MethodsA total of 16 eligible post-stroke survivors were recruited from multiple study settings across Surat City of Gujarat state in western India and were randomly assigned using a lottery method to either the experimental group (n = 8) receiving WEP or the control group (n = 8) receiving conventional physiotherapy for 4 weeks. Outcome measures were the Indian Stroke Scale (ISS), Modified Barthel Index (MBI), and Falls Efficacy Scale-International (FES-I).ResultsBoth groups showed statistically significant improvements in all outcomes but the experimental group showed more significant improvements in ADLs and fear of falls among sub-acute stroke survivors (p < 0.05).ConclusionWEP for sub-acute stroke survivors is an effective intervention. It improves the performance of ADLs for stroke survivors and helps in better fall management indicating that web-based education programs shall be implemented on a regular basis to improve patient care.

Determinants of the Utilization of Skilled Birth Attendance among Women in Ogun East Senatorial District, Nigeria: A Rural-Urban Comparison

Background: Every woman needs access to skilled care during pregnancy, childbirth, and the following weeks. Recent estimates show that the proportion of deliveries attended by a skilled attendant in many African countries remains low. Objective: To identify the determinants of utilising skilled birth attendance (SBA) among women in Ogun East Senatorial District of Nigeria. Methods: A comparative, cross-sectional study was conducted among 375 women in each rural and urban community selected using multistage sampling. A pretested interviewer-administered, structured questionnaire was used for data collection. Results: A higher proportion of urban respondents (67.7%) utilised SBA compared to rural respondents (53.6%), p&lt;0.001. The determinants of utilisation of SBA services included proximity and means of transportation to the facility (p&lt;0.001). On multivariate analysis, health problems in the preceding pregnancy (AOR = 8.183, 95% CI = 2.621-25.545) and spousal support (AOR = 6.909, 95% CI = 2.013-23.705) remained significant determinants of utilisation of SBA in the rural area but not in the urban area. Conclusion: Rural dwellers face significant barriers in accessing the services of skilled birth attendance. Improving transportation infrastructure, engaging spouses in maternal health education and managing health problems during pregnancy could enhance SBA utilisation and reduce rural-urban disparities.

Integrating metaheuristics and artificial intelligence for healthcare: basics, challenging and future directions

Accurate and rapid disease detection is necessary to manage health problems early. Rapid increases in data amount and dimensionality caused challenges in many disciplines, with the primary issues being high computing costs, memory costs, and low accuracy performance. These issues will arise since Machine Learning (ML) classifiers are mostly used in these fields. However, noisy and irrelevant features have an impact on ML accuracy. Therefore, to choose the best subset of features and decrease the dimensionality of the data, Metaheuristics (MHs) optimization algorithms are applied to Feature Selection (FS) using various modalities of medical imaging or disease datasets with different dimensions. The review starts by giving a general overview of the many approaches to AI algorithms, followed by a general overview of the various MH algorithms for healthcare applications, an analysis of MHs boosted AI for healthcare applications, and using a wide range of research databases as a data source for access to numerous field publications. The final section of this review discusses the problems and challenges facing healthcare application development.

FetoML: Interpretable predictions of the fetotoxicity of drugs based on machine learning approaches.

Pregnant females may use medications to manage health problems that develop during pregnancy or that they had prior to pregnancy. However, using medications during pregnancy has a potential risk to the fetus. Assessing the fetotoxicity of drugs is essential to ensure safe treatments, but the current process is challenged by ethical issues, time, and cost. Therefore, the need for in silico models to efficiently assess the fetotoxicity of drugs has recently emerged. Previous studies have proposed successful machine learning models for fetotoxicity prediction and even suggest molecular substructures that are possibly associated with fetotoxicity risks or protective effects. However, the interpretation of the decisions of the models on fetotoxicity prediction for each drug is still insufficient. This study constructed machine learning-based models that can predict the fetotoxicity of drugs while providing explanations for the decisions. For this, permutation feature importance was used to identify the general features that the model made significant in predicting the fetotoxicity of drugs. In addition, features associated with fetotoxicity for each drug were analyzed using the attention mechanism. The predictive performance of all the constructed models was significantly high (AUROC: 0.854-0.974, AUPR: 0.890-0.975). Furthermore, we conducted literature reviews on the predicted important features and found that they were highly associated with fetotoxicity. We expect that our model will benefit fetotoxicity research by providing an evaluation of fetotoxicity risks for drugs or drug candidates, along with an interpretation of that prediction.

Parent–child conflict and adolescent health literacy in Mexico: Results from a nationwide dyad study in Mexico

ABSTRACT Research suggests that health literacy (HL) is critical in preventing and managing health problems. However, over half of adults in Mexico report having inadequate health literacy. Research suggests the parent–child relationship can be a key predictor of developmental competencies; however, little research has examined how dyadic family interactions relate to HL. This study examined whether parent–child relationship conflict was associated with adolescent health literacy among families living in Mexico. Data from a parent–child dyads in Mexico were gathered using online surveys (N = 746, 373 parent–child dyads). Our findings suggested that child-reported family conflict–but not parent-reported family conflict – was associated with lower adolescent health literacy. Researchers and practitioners should consider how parent–child conflict may impact adolescent health outcomes, and prioritise child reports in data collection.

Catadoras de materiais recicláveis: estratégias de resistência e medicamentos durante a pandemia de covid-19

Abstract The collection of recyclable materials is an occupation with an increasing number of workers, who find in it a livelihood in a context of socioeconomic inequalities and unemployment. This article describes resistance strategies of women collectors who are part of an association in Northeast Brazil, in addition to describing how they managed health problems during the COVID-19 pandemic, especially regarding medicines. A quantitative and an ethnographic approach were used by collecting data on sociodemographic and medicines present in the homes of 13 participants and conducting participant observation and in-depth interviews. Amid the health crisis, the participants mentioned problems such as unemployment, gender relations, violence, and work stigmas. If, on the one hand, the pandemic has further increased vulnerability for certain population segments, on the other hand, it has enhanced collective resistance strategies. The collectors of the association organized to obtain various materials and benefits both for their headquarters and their neighborhood. We identified 58 units of medicines, prescribed and obtained mainly at the Basic Health Unit. Of these, 27.6% had action on the nervous system (analgesics, psycholeptics, and psychoanaleptics) and 17.2% on the cardiovascular system and on the alimentary tract and metabolism. The collectors developed self-attention practices with the medicines highlighting their central role in facing health problems.

The Problems and Needs of Self-Management Among Indonesian Older Adults With Hypertension: A Qualitative Study.

Hypertension is the most common older adults' health problem in Indonesia. Older adults experience various changes in their life that often contribute to their ability to manage health problems, especially in chronic diseases. This study aimed to understand the problems and needs of self-management of older adults with hypertension. This was a qualitative exploratory descriptive design. Data collection was conducted among 62 participants. Participants were 15 older adults with hypertension and 11 older adults' families, 12 primary care nurses, seven medical doctors, 11 health volunteers, three heads of primary care, and three district health officials selected by purposeful sampling. Data were collected using semistructured, face-to-face interviews (older adults and their families) and focus group discussion (healthcare workers). Data analysis was carried out qualitatively descriptively using an inductive thinking process; Colaizzi's measures were used for analysis. This study identified eight main themes: (1) complaints related to aging and hypertension, (2) knowledge and beliefs about hypertension, (3) behavior changes after hypertension, (4) disease management support; access to health services for older adults, (5) the need to manage hypertension for older adults, (6) disease management support, (7) hypertension self-management behavior, and (8) compliance with medication. This study provided evidence regarding older adults' problems and needs in managing hypertension. These findings should be considered while providing nursing care at the community level to initiate the self-management of hypertension in older adults.

BARRIERS TO DISEASE SELF-CARE AMONG OLDER NON-HISPANIC BLACK AND HISPANIC MEN WITH CHRONIC CONDITIONS

Abstract Disease self-care is multi-faceted and influenced by physical, mental, social, and environmental factors. Because males traditionally underutilize preventive healthcare services, self-care is increasingly important to manage disease symptomatology and slow disease progression. This study examines factors associated with barriers to disease self-care among Hispanic and non-Hispanic Black men ages ≥65 years with ≥1 chronic condition. Data were analyzed from a national sample of 470 Hispanic (43.2%) and non-Hispanic Black (56.8%) men and collected with an internet-delivered questionnaire. The 5-item Barriers to Self-Care Scale served as the dependent variable (range=5-20). A least squares regression model was fitted to identify factors associated with barriers to disease self-care. The model adjusted for sociodemographics, disease characteristics, health status, and social engagement and support. On average, participants were age 70.1 (±4.5) years and reported 3.9 (±2.6) chronic conditions. Men with higher body mass index (β=0.13, P=0.001), more depressive symptomatology (β=0.09, P=0.046), and lower self-rated quality of life (β=-0.23, P&amp;lt; 0.001) reported higher barriers to disease self-care. Further, men with poorer access to healthcare (β=-0.17, P&amp;lt; 0.001) and higher healthcare frustrations (β=0.17, P&amp;lt; 0.001) reported higher barriers to disease self-care. Barriers to self-care were positively associated with being more socially disconnected (β=0.09, P=0.049) and higher reliance on others to manage health problems (β=0.14, P&amp;lt; 0.001). Findings reinforce the importance of mental health, healthcare access, and social support for disease self-management among Hispanic and non-Hispanic Black men. Efforts are needed in clinical and community-based settings to reduce self-care barriers through culturally appropriate self-management education, interventions, and services.

INCIDENT AND RECURRENT FALLS AMONG NON-HISPANIC BLACK AND HISPANIC MEN WITH CHRONIC CONDITIONS

Abstract While much is known about the complexities of fall-related risks among older adults, less is known about the risk for falls among men, and especially older non-Hispanic Black and Hispanic men with chronic conditions. This study examined factors associated with incident falls (1 fall) and recurrent falling (2+ falls) among non-Hispanic Black and Hispanic men ages ≥60 years with ≥1 chronic condition. Collected with a web-delivered questionnaire, data were analyzed from a national sample of 779 non-Hispanic Black (58.8%) and Hispanic (41.2%) men. To assess incident and recurrent falls, the number of self-reported falls in the past year was trichotomized (0 falls vs. 1 fall vs. 2+ falls) and used as the dependent variable. A multinomial logistic regression was fitted to assess factors associated with incident and recurrent falls. The model adjusted for sociodemographics, disease characteristics, health status, and social support. On average, participants were age 66.8 (±5.4) years and reported 3.8 (±2.7) chronic conditions. Seventy-three percent of men reported 0 falls, 12.6% reported 1 fall, and 14.4% reported 2+ falls in the past year. Relative to men reporting 0 falls, Hispanic men (P&amp;lt; 0.05), men with worse general health status (P&amp;lt; 0.05), and those with clinical depression (P&amp;lt; 0.05) were more likely to report incident and recurrent falls, respectively. Men with more comorbidities (P&amp;lt; 0.05) and those with less help/support to manage health problems (P&amp;lt; 0.05) were more likely to report recurrent falling. Findings highlight the importance of multi-component interventions to prevent falls by strengthening disease self-management, addressing mental health, and introducing social supports.

Sophomore nursing students’ perception of their Professional Behavior toward Rehabilitation patients: a cross-sectional study

BackgroundRehabilitation is considered one of the elements of universal health coverage, emphasizing its importance for every person in need throughout the life course. Nurses play a pivotal role in the rehabilitation team as they possess the competencies to help individuals manage health problems and maximize potential well-being. Yet, little is known regarding knowledge of this subject among nursing students, as well as regarding their attitudes, thoughts, and professional behavior. This study aimed to explore: (a) Sophomore students’ attitudes, feelings, thoughts, and professional behavior toward rehabilitation patients; and (b) Differences in the research variables as affected by students’ previous exposure to rehabilitation patients.MethodsA cross-sectional survey design among sophomore nursing students. A questionnaire was distributed through a commercial internet survey provider (Qualtrics.com) before the beginning of a mandatory course on “nursing rehabilitation”, introduced for the first time in 2022 in all Israeli universities. Students were divided into three groups according to their previous exposure to rehabilitation patients: no professional or personal previous exposure to rehabilitation patients; previous professional or personal exposure to rehabilitation patients; and previous exposure to rehabilitation patients both in one’s professional and personal life. The study adhered to the STROBE guidelines.ResultsThe sample consisted of 122 participants. Significant differences were found between the groups by their previous exposure to rehabilitation patients. Participants with no previous exposure to rehabilitation patients were found to have lower self-perceived capability to care for rehabilitation patients and more negative professional behavior toward rehabilitation patients and their families compared to the other two groups (H = 22.06, p = 0.006, H = 23.86, p = 0.03, respectively). No other statistical differences were observed between the groups.ConclusionsThe findings emphasize the importance of exposing students to the field of nursing rehabilitation and to the care of rehabilitation patients. Exposure to nursing rehabilitation specifically during one’s studies, through theoretical learning and clinical experience, can promote positive attitudes, professional values, and positive professional behavior toward these patients and their families.

Personal Agency and Social Supports to Manage Health Among Non-Hispanic Black and Hispanic Men With Diabetes.

The prevalence of type 2 diabetes (T2D) is increasing among non-Hispanic Black and Hispanic communities, especially among men who develop this chronic condition at earlier ages. Personal agency and social support are vital aspects to diabetes management. However, less is known about the relationship between these variables among men living with diabetes. The purposes of this study were to identify (1) levels of personal agency to manage health, (2) sources of social supports to manage health based on personal agency levels, and (3) factors associated with lower personal agency to manage health. Cross-sectional data from non-Hispanic Black (n = 381) and Hispanic (n = 292) men aged 40 years or older with T2D were collected using an internet-delivered questionnaire. Three binary logistic regression models were fitted to assess sociodemographics, health indicators, and support sources associated with weaker personal agency to manage health. About 68% of participants reported having the strongest personal agency relative to 32.1% reporting weaker personal agency. Men who relied more on their spouse/partner (odds ratio [OR] = 1.22, p = .025), coworkers (OR = 1.59, p = .008), or faith-based organizations (OR = 1.29, p = .029) for ongoing help/support to improve their health and manage health problems were more likely to have weaker personal agency. Conversely, men who relied more on their health care providers for ongoing help/support to improve their health and manage health problems were less likely to have weaker personal agency to manage health (OR = 0.74, p < .001). Findings suggest personal agency may influence men's support needs to manage T2D, which may also be influenced by cultural, socioeconomics, and the composition of social networks.

Health literacy and health behaviors 3E 2S of Medical Profession

Abstract Background Health literacy (HL) and health behaviors (HB) include skills needed to make appropriate health decisions and successfully navigate the health care system. However, the survey of HL and health behaviors of medical professionals is limited. This cross-sectional study aimed to assess the level of HL and health behaviors 3E 2S of the medical profession, Rajavithi hospital, and their association. Methods Two hundred and eighty-eight medical doctors were recruited and completed three parts of a self-administered questionnaire: demographics, HL, and health behavior 3E 2S scale of Thai adults (2018-revised edition). This HL questionnaire has six components with scoring criteria, and interpretation is designed by the Health Education Section, Health Service Support Department, and Ministry of Public Health. Pearson correlation coefficient was performed. The ethics committee Rajavithi Hospital approved this study. Results Of 288 medical doctors, 59% were female, and the mean age was 30.11±5.77 years. Most had overall HL at good and upper level 54.7%: cognitive skills 70.8%, access to health information 76.7%, health decision making 61.3%, media literacy 66%, and self-management 55.9%. A moderate level of health communication was 35.4%. Most subjects had a poor level of health behavior at 60.8%. HL was positively associated with health behavior (r = 0.483, p &amp;lt; 0.001). Single status significantly related to HL (p = 0.002) and HB (p = 0.011). Conclusions Health literacy was at a good level. Health communication requires improvement. Health behaviors 3E 2S were poor. The organization should formulate a policy. A role model and health program should be proposed to develop health literacy skills best suited for the target group. Key messages • Health literacy can help us prevent health problems, protect our health, and better manage health problems when they arise. • Improved health literacy skills are something that anyone can benefit from, especially if you are dealing with a chronic condition or illness.

Medicial Education Strategy In The Era of Digitalization and Disruption

Background: This article aims to (1) examine the current condition of education in the digitalization and disruption era and (2) examine medical education strategies in the digitalization and disruption era. Writing scientific papers is based on library research, whose object of study uses library data in the form of books as a data source.Content: Based on the literature review, it was found that: (1) global medical education currently uses the SPICES strategy (student-centered learning, problem-based, integrated, community-based, elective, and systematic), accompanied by nine educational trends; (2) SPICES is a medical education strategy that will produce graduate profiles that refer to World Health Organization (WHO) and World Organization of Family Doctor (WONCA) conference agreements. A doctor must have six-star doctor characteristics, namely: care provider, decision makers, communicators, community leaders, managers as well as creators and innovators; (2) the minimum standard of competence for doctors in Indonesia, constitute of seven areas of graduate competency namely; has noble professionalism, is always aware and develops himself, can communicate effectively, is reliable in managing information, always has a scientific basis in medical science, has clinical skills and can manage health problems well.Conclusion: A special strategy for medical education is required in the era of digitalization and disruption by applying a lifelong education approach. Indonesian medical education uses the SPICES strategy to create six-star doctors and master the seven defined competency areas.

Are older people worse off in 2040 regarding health and resources to deal with it? - Future developments in complex health problems and in the availability of resources to manage health problems in the Netherlands.

Developing sustainable health policy requires an understanding of the future demand for health and social care. We explored the characteristics of the 65+ population in the Netherlands in 2020 and 2040, focusing on two factors that determine care needs: (1) the occurrence of complex health problems and (2) the availability of resources to manage health and care (e.g., health literacy, social support). Estimations of the occurrence of complex health problems and the availability of resources for 2020 were based on registry data and patient-reported data. Estimations for 2040 were based on (a) expected demographic developments, and (b) expert opinions using a two-stage Delphi study with 26 experts from policy making, practice and research in the field of health and social care. The proportion of people aged 65+ with complex health problems and limited resources is expected to increase from 10% in 2020 to 12% in 2040 based on demographic developments, and to 22% in 2040 based on expert opinions. There was high consensus (>80%) that the proportion with complex health problems would be greater in 2040, and lower consensus (50%) on an increase of the proportion of those with limited resources. Developments that are expected to drive the future changes refer to changes in multimorbidity and in psychosocial status (e.g., more loneliness). The expected increased proportion of people aged 65+ with complex health problems and limited resources together with the expected health and social care workforce shortages represent large challenges for public health and social care policy.

Validity and reliability of the Chinese version of the Health Literacy Scale Short-Form in the Chinese population

BackgroundHealth literacy is closely related to health status. Measuring public health literacy levels helps to warn of health status and manage health problems through timely interventions. The items of relevant evaluation tools are complex and numerous in China, and there is no recognized health literacy brief scale for the whole population. To translate the 12-item short-form health literacy scale (HLS-SF12) and test the validity and reliability of the Chinese version of the HLS-SF12 in the Chinese population.MethodsThe HLS-SF12 was translated into Chinese using the procedures of translation, back translation, and cultural debugging. 10,951 residents were selected by quota sampling method to test the validity and reliability of the scale, and 33 people were selected to retest after 2 weeks. The reliability was tested by using internal consistency coefficient and test-retest reliability. The validity was tested by using confirmatory factor analysis, content validity, convergent validity and discriminant validity.ResultsThe Cronbach’s Alpha coefficient for the total scale was 0.94, and the test-retest reliability was 0.89. The Cronbach’s Alpha coefficients for the three subscales of health care, disease prevention, and health promotion respectively were 0.86, 0.86, 0.87, and the test-retest reliability respectively were 0.91, 0.79, 0.63. The confirmatory factor analysis identified a three factors model and showed nice goodness of fit indices for Chinese HLS-SF12 (GFI = 0.96, CFI = 0.97, IFI = 0.97, TLI = 0.96, and RMSEA = 0.07).ConclusionThe Chinese version of the HLS-SF12 has good reliability and validity, and can be used as a tool to evaluate the health literacy of Chinese people.

Impact of a smart‐clothes home nursing program in Taiwan during heightened COVID‐19 restrictions

AbstractBackgroundThe COVID‐19 pandemic has required restrictions of daily activities, which has been found to impact the lives of persons with dementia and their family caregivers, who have multiple care demands. The lack of relevant studies in Taiwan emphasized the need to explore the experiences of family caregivers of older persons with dementia faced with the intensified restrictions to control COVID‐19, and the impact of the availability of a smart‐clothes home nursing program.MethodThis qualitative study used semi‐structured interviews with family caregivers of older persons with dementia. Participants were recruited from dementia clinics of a medical center in northern Taiwan from a subset sample of a larger study on smart clothes assisted home nursing care. A total of 12 family caregivers who participated in the original study were interviewed during the follow‐up period; seven were caregivers of a person with dementia wearing a smart vest, which transmitted information to a home care nurse. Interviews were conducted by telephone because the conditions of the pandemic prevented face‐to‐face interviews. Recorded interviews were transcribed and analyzed using content analysis.ResultInterview data showed family caregivers’ felt the care recipient’s health was compromised and functional conditions intensified as Covid‐19‐related pandemic restrictions increased. Specific concerns included a lack social interactions, decreased daily activity levels, loss of interest and lack of motivation for activities, increased mood and behavioral problems, a decline in physical function and an increase in health problems. Family caregivers were also impacted by these restrictions, with significant increases in severity of caregiver role strain, including feeling trapped, a lack of in‐home support, profound powerlessness, and worries about the person with dementia contracting the coronavirus. The smart‐clothes assisted home nursing care program offered supplementary support to family caregivers by providing on‐time interactions, helping them manage health problems, enhancing predictability of the care recipient’s behaviors, and providing caregivers with emotional support.ConclusionThe findings of this study support alternative care such as implementation of technology‐assisted home health services to meet caregiver needs to facilitate family caregiving of persons with dementia during the necessary restrictions in activities during the COVID‐19 pandemic.

Experiences of family caregivers of persons living with dementia with and without a smart- clothes assisted home nursing program during the heightened COVID-19 alert

BackgroundThe COVID-19 pandemic has required restrictions of daily activities, which has been found to impact the lives of persons living with dementia (PLWDs) and their family caregivers, who have multiple care demands. The lack of relevant studies in Taiwan emphasized the need to explore the experiences of family caregivers of older PLWDs faced with the intensified restrictions to control the spread of COVID-19, and the impact of the availability of a smart-clothes home nursing program.MethodsThis qualitative study used semi-structured interviews with family caregivers of older PLWDs. Participants were recruited from dementia clinics of a medical center in northern Taiwan from a subset of a sample from a larger study on smart-clothes assisted home nursing care. A total of 12 family caregivers who participated in the original study were interviewed during the follow-up period; seven family caregivers of a PLWD wearing a smart-vest, which transmitted information to a home care nurse; five caregivers of a PLWD not wearing a smart-vest. Interviews were conducted by telephone because the conditions of the pandemic prevented face-to-face interviews. Recorded interviews were transcribed and analyzed using content analysis.ResultsInterview data showed family caregivers’ felt the care recipient’s health was compromised and functional conditions intensified as Covid-19-related pandemic restrictions increased. Specific concerns included a lack social interactions, decreased daily activity levels, loss of interest and lack of motivation for activities, increased mood and behavioral problems, a decline in physical function and an increase in health problems. Family caregivers were also impacted by these restrictions, with significant increases in severity of caregiver role strain, including feeling trapped, a lack of in-home support, profound powerlessness, and worries about the PLWD contracting the coronavirus. The smart-clothes assisted home nursing care program offered supplementary support to family caregivers by providing on-time interactions, helping them manage health problems, enhancing predictability of the care recipient’s behaviors, and providing caregivers with emotional support.ConclusionsThe findings of this study support alternative care such as implementation of technology-assisted home health services to meet caregiver needs to facilitate family caregiving of PLWDs during the necessary restrictions in activities implemented during the COVID-19 pandemic.Trial registrationClinicalTrials.gov Protocol Record NCT05063045.

Orchids - discoverers and firsts

When Dr. Paromik Bhattacharyya first asked me to write for this special issue of the South African Journal of Botany, I refused for several good reasons: Retired for 20 years, not having done research for 21 years, 89 1/2 years old, no longer reading as extensively as before my retirement, recovering from surgeries, trying to manage health problems, which even if not severe are vexing, and being lazy. However, Dr. Bhattacharyya would not take no for an answer. After exchanging several (too many) emails I agreed to think about it. I did think and decided that since this issue deals with orchid biotechnology it may be a good idea to clear the air.By “stealing” from my previous/other writings, using my extensive library, accessing literature on line, and utilizing knowledge accumulated since about 1956, I decided to write an article, which establishes beyond any doubt who were first to make several orchid discoveries, formulate a number of procedures and develop some methods. At my age, I have the necessary perspective and knowledge. And, most importantly, antagonizing people (so, what is new?) and making enemies (again, what is new?) will not be damaging.I decided to write about who:•Was the first to recognize orchid seeds as such and describe and illustrate them? There are no arguments or claims and counterclaims about it, but the information is buried in old, rare and not very well-known books in languages other than English.•Invented mass rapid clonal propagation of orchids and how to free plants from virus infections. Believe or not these two are tied to each other, there are unjustified claims of priority, and a widely admired “sole discoverer” did not discover them.•Used serology (now an outdated method) first to detect an orchid virus. There was an unwarranted claim at one time.•Inserted genes into orchids first. It becomes clear if one reads the literature, but what if another claim was repeated several times in writing and talks?•First studied control of flowering in mature orchid plants. There are no claims and counterclaims, but the information is not easy to find.•Managed to induce plantlets or seedlings in vitro to flower. The truth may have been late to come out due to political upheavals.

First insight on ethnobotanical appraisal of plants used traditionally as medicine by Berber community (Amazigh-speaking), living in Driouch province (North-eastern Morocco)

Background: Most ethnobotanical studies carried out in different regions of Morocco revolved around documentation of medicinal plants and their medical uses. However, little is known about ethnobotanical knowledge coupled to Berber community living in “Driouch province” (Northeastern region of Morocco). This study aimed to identify and document medicinal plants used traditionally by local people to manage health problems while investigating and comparing ethnobotanical patterns obtained in this region with other findings reported elsewhere. Methods: Ethnobotanical surveys were carried out between January 2017 and August 2019 in several regions within Driouch province. Ethnobotanical data were collected using standard methods and with prior informed consent. Quantitative analyses were performed by using some indexes and formulas, including Use Value (UV), Family Use Value (FUV), Informant Consensus Factor (ICF) and Jaccard Index (JI). Results: A total of 997 local inhabitants (415 male and 582 female) were interviewed. The plants listed (158) were reflected by a high number of families (60) and genera (137). Regarding the number of species/Family, Lamiaceae was the leading family with 15 species. Among diseases treated, respiratory diseases were ranked first with a rate of 26.46%. The high ICF (0.97) was calculated for respiratory diseases and the most important medicinal plant recorded were Origanum compactum Benth with UV=0.55. Conclusions: The present study revealed that the people living in Driouch province holds significant knowledge about medicinal plant resources. Despite the development of medical technology, local people still rely on using these herbs for healthcare. Keywords: Ethnobotanical, Medicinal plants, Driouch province, Morocco.