Prevalence Of Chronic Conditions Research Articles

Association of Gut Microbiome with Diabetes Mellitus and Alzheimer’s Disease in a Puerto Rican Adult Population: A Preliminary Report

AbstractBackgroundAlzheimer’s disease (AD) is the most common cause of dementia, consisting in a highly debilitating disorder, progressing from slight memory impairments to a complete loss of mental function, resulting in significant disability and death. In Puerto Rico, AD is the fourth leading cause of death. Caribbean Hispanics, including Puerto Ricans living on the island have shown a more severe AD symptomatology and disease mortality than any other ethnic group. This disparity may be due to health, diet, lifestyle, socioeconomic risk factors and more prevalent chronic health conditions such as diabetes in Hispanic people. Diabetes Mellitus is nowadays considered a risk factor for AD. Evidence suggests that the gut microbiome plays a role in the pathophysiology of AD through neuroinflammation and amyloid deposition leading to cognitive impairment. Main objective: Study the microbiome composition and diversity of Puerto Ricans with AD compared to cognitive‐intact controls in association with Diabetes Mellitus.MethodFifty‐three participants (n = 53), 28 with AD and 25 controls were evaluated clinically and cognitively with the Montreal Cognitive Assessment (MoCA) to associate the gut microbiome with cognitive impairment. Stool was collected for genomic DNA extractions and microbiome characterization. NextGen Illumina MiSeq was used to sequence 16S rRNA genes (V4 region) and analyzed with standard pipelines.ResultNo statistically significant differences in bacterial diversity and richness between AD vs. controls. We found slight differences in composition, including an abundance of Euryachaeota in AD, while controls had higher levels of Bacteroidetes. Compared to cognitively intact, a decrease in gut microbiome diversity was seen among participants with cognitive decline (p = 0.02). Roseburia (butyrate producing bacteria) seems to decrease with cognitive impairment severity. Diabetics have significantly reduced Anaerostipes and Ruminococcus also butyrate producing bacteria. AD participants with/without Diabetes have predominance of Euryarchaeota. Controls with Diabetes have more Proteobacteria and Bacteroidetes compared to cognitively impaired.ConclusionBoth Diabetes and neurocognitive decline appear to reduce butyrate‐producing bacterias, which may be related to a decrease in the homeostasis of the gut‐brain axis and lead to microbiome dysbiosis in the setting of disease. A better understanding of the gut microbiome will be an invaluable approach for development of modulation‐based therapeutic interventions.

Comorbid Chronic Conditions and Subjective Cognitive Decline‐ A Snap‐shot

AbstractBackgroundRapidly increasing aging population in Delaware forecasts not only an increased burden of Alzheimer’s disease and related dementias (ADRD) but also a sharp rise in comorbid chronic conditions. Estimating the burden and characteristics of this “dual burden” is critical. Subjective Cognitive Decline (SCD)—a population‐based measure‐ was used to measure ADRD. The primary objective was to study prevalence of selected chronic conditions among Delaware adults with SCD in order to compare the prevalence of chronic conditions among people with and without SCD.MethodData for Delaware were obtained from the 2020 Behavioral Risk Factor Surveillance System. Respondents aged 45 years or older who answered the SCD screening question as “yes” or “no” were included in the analyses. Participants were identified as having a diagnosed chronic disease if they had been told by a doctor or other health care provider that they ever had angina; arthritis; asthma; cancer; chronic kidney disease; chronic obstructive pulmonary disease; diabetes; heart attack; and stroke. Descriptive statistics examined sociodemographic characteristics and chronic conditions in Delawareans with and without SCD.ResultNearly 1 in 12 of Delaware adults reported SCD. Compared with those without SCD, Delawareans with SCD were two or three times more likely to have angina, heart attack, stroke, diabetes, asthma, COPD, cancer, arthritis, or kidney disease. Nearly eighty percent of Delawareans with SCD have at least one other chronic health condition. More than seventy ‐five percent of Delawareans with SCD were two times as likely to have any one of the selected chronic conditions as compared to those without SCD. Adults with comorbid chronic conditions and SCD were more likely to report functional limitations.ConclusionBy 2030 the proportion of Delawareans over 60 will nearly double. Study results can facilitate timely targeted interventions to address the burden of SCD and comorbid chronic conditions in Delaware.

The relationship between physical activity and cognitive functioning in older adults: a cross‐sectional study from the ELSI‐Brazil data

AbstractBackgroundPopulation aging is rapidly taking place in low‐ and middle‐income countries (LMIC) and is contributing to an increased prevalence of chronic conditions, such as dementia. Physical activity (PA) is a well‐known protective factor for cardiovascular conditions and is related to biological processes linked to cognition. Most studies linking PA with cognition come from high income countries. This study explores the relationship between PA and cognitive function in a representative sample of Brazilians aged 50 and above.MethodThis is a secondary analysis of the Brazilian Longitudinal Study of Ageing (ELSI‐Brazil) baseline data. We stratified the level of PA as low, moderate, or high according to the metabolic equivalent of task (MET) spent on different PA over a week. We also considered the level of PA recommended by the World Health Organization (WHO). The domains considered for cognitive function were memory (short‐term memory, episodic and total), and verbal fluency. Logistic regression models were conducted to estimate the relationship between PA and each of the cognitive domains.Result7,994 individuals with complete data were considered for the final sample. They were primarily female (52%), with a mean age of 62.9 years (SD = 9.7), did not live alone (91.5%), and had 5.6 years of schooling (SD = 4.4). Higher levels of PA were related to better cognitive performance in respect of short‐term memory (β = 0.17, CI 95% 0.08‐0.25), total memory (β = 0.14, CI 95% 0.05‐0.22) and global cognition (β = 0.10, CI 95% 0.03‐0.16). The results were in the same direction for the WHO PA recommendations variable.ConclusionThis study shows that different levels of PA, measured in different ways, may have benefits on cognition for older people. These findings can be used to support public health interventions promoting the practice of PA. Longitudinal studies are needed to further clarify this relationship.

Mortality and healthcare assessment among patients with chronic disease over 2 years of COVID-19: a population-based study in a large hard-hit Italian region

ObjectivesWe aimed to provide a region-wide comprehensive account of the indirect effects of COVID-19 on patients with chronic disease, in terms of non-COVID-19 mortality, and access to both inpatient and...

Understanding Core Community Needs for School-Based Asthma Programming: A Qualitative Assessment in Colorado Communities.

Asthma is one of the most prevalent chronic conditions affecting approximately 8.5% of children in Colorado. Our school-based asthma program (SBAP) has effectively improved asthma control and reduced asthma disparities among children but has been largely limited to the Denver area. We interviewed community stakeholders in 5 regions of Colorado to understand community needs for broader dissemination of SBAPs. In-depth, semistructured key informant interviews were conducted with school nurses, parents, pediatric healthcare providers, public health professionals, and community resource organization representatives. Inductive and deductive analyses were informed by the practical, robust, implementation, and sustainability model, an implementation science framework. Participants (n=52) identified 6 types of needs for successful future implementation of our SBAP: (1) buy-in from stakeholders; (2) asthma prioritization; (3) improved relationships, communication, and coordination among school nurses, healthcare providers, and community organizations that address social determinants of health (SDOH) and children/families; (4) resources to address healthcare and SDOH needs and awareness of existing resources; (5) asthma education for children/families, school staff, and community members; and (6) improved coordination for School Asthma Care Plan completion. These needs mapped to a 3-tiered, progressive structure of foundational, relational, and functional needs for implementation success. These 6 types of needs illuminate factors that will allow this SBAP to work well and program delivery approaches and implementation strategies that may need modification to be successful. Next steps should include tailoring implementation strategies to variations in local context to support fit, effectiveness, and sustainment.

Prevalence of non-communicable Diseases (NCDs) in an urban area in Sudan and the role of medical students in health promotion of patients with NCDs

Introduction: Chronic non-communicable diseases are prevalent conditions in developing countries, such as Sudan. The World Health Organization (WHO) recommends ongoing surveillance of non-communicable diseases (NCDs). This study aimed to assess the prevalence of NCDs in urban area in Sudan and the role of medical students in health promotion of patients with NCDs. Materials and methods: A community–based cross-sectional study, conducted in 2022 among families in Wad-Medani city in central part of Sudan. A structured interviewer- administered; questionnaire was used for data collection, it included demographic data, the presence of any type of NCDs. The last part of the questionnaire was filled by medical students about their role in health promotion and health education to patients with NCDs. Results: The total number of population who participated in this study was 607. The prevalence of NCDs in the study population was 20%. Out of those who had NCDs 35% had diabetes mellitus, 40% had hypertension. Bronchial asthma was found in 12% of the individuals, cardiovascular diseases were found in 4%. There were significant association between the age of the patient and the occurrence of diabetes and hypertension (P-value. 0.000 and 0.001) respectively. Role of medical students in the health promotion of patients with NCDs was health education, advised for regular follow up in PHC centres to 40% 0f patients. Conclusion: The prevalence of NCDs among the study population was high with hypertension as the most prevalent chronic condition. Medical students play great role in the health promotion of patients with NCDs.

A review on osteoarthritis

Degenerative joint disease, or osteoarthritis (OA), is a prevalent chronic synovial joint condition characterized by non-inflammatory degeneration, leading to pain and restricted joint movement. OA patients navigate a spectrum of therapeutic options, from social media advice to prescriptions from primary care physicians. This article critically assesses evidence-based treatments for generalized or monoarticular OA, advocating multidisciplinary and multimodal therapy. Evaluation covers patient education, pharmaceuticals, complementary and alternative medicine, surgery, manual techniques, acupuncture, bracing, assistive devices, physical therapy, modalities, and interventional procedures (corticosteroid injection, viscosupplementation, pulsed radiofrequency). Optimal benefits emerge from early diagnosis and prevention combined with multidisciplinary and multimodal treatments. The review highlights the synergy of complementary therapies. Healthcare professionals should be well-versed in diverse OA management resources, emphasizing tailored treatment plans aligned with individual needs and encouraging healthier lifestyle choices for optimal patient outcomes.Top of Form

Dual burden of chronic physical conditions and mental disorders: Findings from the Saudi National Mental Health Survey.

Comorbidities of mental disorders and chronic physical conditions are a common medical burden reported among Western countries. National estimates of such comorbidities among the general population of Arab countries like Saudi Arabia are unknown. This study examined the prevalence of lifetime chronic physical conditions among the Saudi general population with DSM-IV 12-month mental disorders, and the associations with disability in the Kingdom of Saudi Arabia (KSA). The Saudi National Mental Health Survey, a cross-sectional household study - part of the World Mental Health (WMH) Survey Consortium - was conducted between 2013-2016 in the KSA, with 4,001 Saudi citizens aged 15-65 (response rate 61%). The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess prevalence of lifetime chronic physical conditions and 12-month mental disorders; disability was measured in terms of days out of role. The prevalence of any comorbid 12-month mental disorder among those with chronic physical conditions was 24%. Major depressive disorder, social phobia, and adult separation anxiety disorder were the most common comorbid mental disorders across all chronic physical conditions. Gender, education, income, urbanicity, region, and employment were associated with the presence of any chronic physical condition. Respondents with mental / physical comorbidities had 2.97 days out of role (on average) in the last 30 days. Comorbidities of mental disorders and chronic physical conditions are common among Saudis. National efforts are needed to increase awareness of such comorbidities among the general population, and develop prevention and treatment services tailored to the needs of individuals at-risk for comorbidities.

The role of endogenous opioids in mindfulness and sham mindfulness-meditation for the direct alleviation of evoked chronic low back pain: a randomized clinical trial.

Chronic low back pain (cLBP) is the most prevalent chronic pain condition. There are no treatments that haven been found to directly assuage evoked cLBP. To this extent, mindfulness-meditation is a promising pain therapy. Yet, it is unclear if meditation can be utilized to directly attenuate evoked chronic pain through endogenous opioids. A double-blind, randomized, and placebo-controlled clinical trial with a drug crossover design examined if mindfulness-meditation, as compared to sham mindfulness-meditation, attenuated straight leg-raise test evoked chronic pain during intravenous (0.15 mg/kg bolus + 0.15 mg/kg/hour maintenance) naloxone (opioid antagonist) and placebo-saline infusion. Fifty-nine individuals with cLBP (mean age = 46 years; 30 females) completed all study procedures. After the pre-intervention pain testing session, patients were randomized to a four-session (20-min/session) mindfulness (n = 30) or sham mindfulness-meditation (n = 29) intervention. After the interventions, mindfulness and sham mindfulness-meditation were associated with significant reductions in back pain during saline and naloxone infusion when compared to rest (non-meditation) in response to the cLBP-evoking straight leg-raise test. These results indicate that meditation directly reduces evoked chronic pain through non-opioidergic processes. Importantly, after the interventions, the mindfulness group reported significantly lower straight leg-raise induced pain than the sham mindfulness-meditation group during rest (non-meditation) and meditation. Mindfulness and sham mindfulness-meditation training was also associated with significantly lower Brief Pain Inventory severity and interference scores. The pain-relieving effects of mindfulness meditation were more pronounced than a robust sham-mindfulness meditation intervention, suggesting that non-reactive appraisal processes may be uniquely associated with improvements in chronic low-back pain.Trial Registration: ClinicalTrials.gov identifier: NCT04034004.

Using the Functional Comorbidity Index with administrative workers' compensation data: Utility, validity, and caveats.

Chronic health conditions impact worker outcomes but are challenging to measure using administrative workers' compensation (WC) data. The Functional Comorbidity Index (FCI) was developed to predict functional outcomes in community-based adult populations, but has not been validated for WC settings. We assessed a WC-based FCI (additive index of 18 conditions) for identifying chronic conditions and predicting work outcomes. WC data were linked to a prospective survey in Ohio (N = 512) and Washington (N = 2,839). Workers were interviewed 6 weeks and 6 months after work-related injury. Observed prevalence and concordance were calculated; survey data provided the reference standard for WC data. Predictive validity and utility for control of confounding were assessed using 6-month work-related outcomes. The WC-based FCI had high specificity but low sensitivity and was weakly associated with work-related outcomes. The survey-based FCI suggested more comorbidity in the Ohio sample (Ohio mean = 1.38; Washington mean = 1.14), whereas the WC-based FCI suggested more comorbidity in the Washington sample (Ohio mean = 0.10; Washington mean = 0.33). In the confounding assessment, adding the survey-based FCI to the base model moved the state effect estimates slightly toward null (<1% change). However, substituting the WC-based FCI moved the estimate away from null (8.95% change). The WC-based FCI may be useful for identifying specific subsets of workers with chronic conditions, but less useful for chronic condition prevalence. Using the WC-based FCI cross-state appeared to introduce substantial confounding. We strongly advise caution-including state-specific analyses with a reliable reference standard-before using a WC-based FCI in studies involving multiple states.

Estimating Underdiagnosis of Patients in Chronically Ill Populations

Diagnosis coding in administrative data is often incomplete and introduces inaccurate assessments of patients’ health outcomes. The underdiagnosis of chronic conditions reduces the ability to correlate that chronic condition with associated comorbidities. We developed a novel framework to use longitudinal records of claims-based diagnoses to identify latent, or undiagnosed, members likely to have a target chronic condition before their first diagnosis of the condition is included in the records. We applied our approach to the chronic condition of adult incontinence using the 5% Medicare sample of a continuously enrolled cohort between 2014 and 2018. We considered fee-for-service Medicare beneficiaries over the age of 65 years. We identified observed and latent members with the chronic condition and then examined its correlation with four comorbidities commonly associated with incontinence: urinary-tract infections (UTIs), dermatitis, slips and falls, and behavioral disturbances. We increased our identification of incontinence from the 11.2% with an observed diagnosis in 2018 to an estimated prevalence in 2018 of 34.7%. Considering the four comorbidities, our approach increased from 38% to 68% the share of UTIs experienced by those with incontinence, from 20% to 41% for dermatitis, from 22% to 54% for slips and falls, and from 26% to 57% for behavior disturbances. Our methodology highlights the importance of more accurately estimating the prevalence of chronic conditions for understanding the true correlation between the chronic condition and comorbidities.

“It’s Not a Top Priority”: A Qualitative Analysis of Provider Views on Barriers to Reproductive Healthcare Provision for Homeless Women in the United States

ABSTRACT Women experiencing housing insecurity are at an elevated risk for adverse reproductive health outcomes due to the prevalence of chronic health conditions and higher risk behaviors. Social service and healthcare providers are front line in addressing women’s needs when they seek support. Thus, we sought to explore reproductive healthcare barriers using in-depth interviews with 17 providers at 11 facilities serving housing-insecure women in Salt Lake County, Utah, USA from April to July 2018. Providers noted a number of system-, provider-, and individual-level barriers. Dominant themes include reliance on unstable funding, lack of provider training on reproductive health, and perceived logistical challenges to care. Due to the prevalence of immediate needs among housing-insecure women, providers attest that reproductive health needs often do not emerge as their urgent concern. Our findings suggest that addressing policy and funding challenges to prioritizing reproductive needs among housing-insecure women can help mitigate the potential for long-term adverse reproductive outcomes.

Extra pulmonary versus pulmonary presentation of COVID-19 patients: comparative study

BackgroundThe respiratory system is the most frequently affected system by COVID-19. However, a variety of extra-pulmonary systems can be influenced by COVID-19 with subsequent morbidity and mortality.AimThis study aim is to report the most frequent extra pulmonary presentations of COVID-19 with comparison to patients with primary pulmonary presentation. Risk factors for ICU admission in both groups were examined.MethodsIn this prospective comparative cross-sectional study, detailed demographics, medical history, clinical assessment, and computed tomography (CT) scan of the chest were done to all recruited patients with COVID-19.ResultThis study included a total of 1664 confirmed COVID-19 patients. The patients were categorized into two groups. Patients with pulmonary manifestations included 716 patients while 948 patients presented with extrapulmonary manifestations. Patients in the extrapulmonary group were older. The prevalence of certain chronic comorbid conditions was higher in the extra pulmonary group as cardiac, CNS, hepatic, and renal diseases, while chronic respiratory disorders were more prevalent in the pulmonary group (P value: < 0.0001). No significant difference in CT severity score between both groups. CORAD 5 was predominant in the pulmonary group (P value: < 0.0001). Most cases in both groups required hospital admission either inward or in ICU with higher frequency of ICU admission was observed in the pulmonary group. The significant risk factors for ICU admission in both groups were critically ill category of patients, CT severity, low oxygen saturation level, and the presence of comorbid chronic disease (P < 0.0001 with adjusted Odds ratio). CNS, cardiac, renal, and metabolic dysfunctions exert significant risk for ICU admission in the extrapulmonary group.ConclusionAtypical or non-respiratory manifestations could be the presentation of a respiratory pathogen as reported in COVID-19. Our work highlights the extrapulmonary presentation of COVID-19. Older male patients were more prone to present with extra pulmonary symptoms. CNS, cardiac, renal, and metabolic dysfunctions were the most affected systems. This could impact the level of care required for patient management and the extent of resource utility.

Impact of food insecurity and food environment on the diet quality of older African Americans during the COVID-19 pandemic.

A high quality diet is vital in promoting wellbeing and ensuring good health, particularly for those living with chronic conditions. Older African Americans, already burdened with a higher prevalence of chronic conditions, also face a higher risk for suboptimal diets. The COVID-19 pandemic had lasting effects on access to healthy food for all Americans, but some demographic groups were disproportionately affected. Older African Americans, who already experienced reduced access to healthy food pre-pandemic, were particularly afflicted, but the full extent of the pandemic's impact on their food insecurity and food environment remains unclear. To address this gap, we conducted a study among 102 older African Americans in South Los Angeles between October 2021 and July 2022 during the COVID-19 pandemic. Participants completed surveys on dietary intake, food insecurity, and neighborhood food environment. We measured dietary quality using the healthy eating index (HEI)-2015. The analysis included descriptive, bivariate chi-square, t-tests, analysis of variance, and multiple linear and logistic regression. While overall dietary quality was suboptimal, most participants met the guidelines for fruit and vegetable consumption. Food insecurity was associated with lower overall diet quality and lower total fruit and whole fruit intake. However, there was no association between food environment and diet quality. In light of our findings, further intervention is critical to improving diet quality, especially among older African Americans living with chronic conditions in the post-pandemic era.

Diacerein provokes apoptosis, improves redox balance, and downregulates PCNA and TNF-α in a rat model of testosterone-induced benign prostatic hyperplasia: A new non-invasive approach.

One of the most prevalent chronic conditions affecting older men is benign prostatic hyperplasia (BPH), causing severe annoyance and embarrassment to patients. The pathogenesis of BPH has been connected to epithelial proliferation, inflammation, deranged redox balance, and apoptosis. Diacerein (DIA), the anthraquinone derivative, is a non-steroidal anti-inflammatory drug. This study intended to investigate the ameliorative effect of DIA on the prostatic histology in testosterone-induced BPH in rats. BPH was experimentally induced by daily subcutaneous injection of testosterone propionate for four weeks. The treated group received DIA daily for a further two weeks after induction of BPH. Rats' body and prostate weights, serum-free testosterone, dihydrotestosterone, and PSA were evaluated. Prostatic tissue was processed for measuring redox balance and histopathological examination. The BPH group had increased body and prostate weights, serum testosterone, dihydrotestosterone, PSA, and oxidative stress. Histologically, there were marked acinar epithelial and stromal hyperplasia, inflammatory infiltrates, and increased collagen deposition. An immunohistochemical study showed an increase in the inflammatory TNF-α and the proliferative PCNA markers. Treatment with DIA markedly decreased the prostate weight and plasma hormones, improved tissue redox balance, repaired the histological changes, and increased the proapoptotic caspase 3 expression besides the substantial reduction in TNF-α and PCNA expression. In conclusion, our study underscored DIA's potential to alleviate the prostatic hyperplastic and inflammatory changes in BPH through its antioxidant, anti-inflammatory, antiproliferative, and apoptosis-inducing effects, rendering it an effective, innovative treatment for BPH.

Disease awareness and healthcare utilization in rural South Africa: a comparative analysis of HIV and diabetes in the HAALSI cohort

BackgroundStudies from rural South Africa indicate that people living with HIV (PLHIV) may have better health outcomes than those without, potentially due to the frequent healthcare visits necessitated by infection. Here, we examined the association between HIV status and healthcare utilization, using diabetes as an illustrative comparator of another high-burden, healthcare-intensive disease.MethodsOur exposure of interest was awareness of positive disease status for both HIV and diabetes. We identified 742 individuals who were HIV-positive and aware of their status and 305 who had diabetes and were aware of their status. HIV-positive status was further grouped by viral suppression. For each disease, we estimated the association with (1) other comorbid, chronic conditions, (2) health facility visits, (3) household-level healthcare expenditure, and (4) per-visit healthcare expenditure. We used log-binomial regression models to estimate prevalence ratios for co-morbid chronic conditions. Linear regression models were used for all other outcomes.ResultsVirally suppressed PLHIV had decreased prevalence of chronic conditions, increased public clinic visits [β = 0.59, 95% CI: 0.5, 0.7], and reduced per-visit private clinic spending [β = -60, 95% CI: -83, -6] compared to those without HIV. No differences were observed in hospitalizations and per-visit spending at hospitals and public clinics between virally suppressed PLHIV and non-PLHIV. Conversely, diabetic individuals had increased prevalence of chronic conditions, increased visits across facility types, increased household-level expenditures (β = 88 R, 95% CI: 29, 154), per-visit hospital spending (β = 54 R, 95% CI: 7, 155), and per-visit public clinic spending (β = 31 R, 95% CI: 2, 74) compared to those without diabetes.ConclusionsOur results suggest that older adult PLHIV may visit public clinics more often than their HIV-negative counterparts but spend similarly on a per-visit basis. This provides preliminary evidence that the positive health outcomes observed among PLHIV in rural South Africa may be explained by different healthcare engagement patterns. Through our illustrative comparison between PLHIV and diabetics, we show that shifting disease burdens towards chronic and historically underfunded diseases, like diabetes, may be changing the landscape of health expenditure inequities.

Effectiveness of Learning Package on Impact of COVID-19 Pandemic on Physical, Mental, Social and Economic Status among Adults at Selected Villages of Gokak Taluk, Karnataka.

Context: As of march 11, 2021 more than 11 million people in India had been infected with COVID-19, and about 158,000 had died. The spread of COVID-19 in India is of great concern due to the country’s large and densely populated areas with widespread poverty and high migration rates, coupled with a high prevalence of chronic conditions that are generally poorly controlled.&#x0D; Objective: To develop and evaluate learning package to overcome from the impact of COVID-19 among adults.&#x0D; Setting and design: The study was conducted in selected villages of Gokak Taluk and pre-experimental research design was used.&#x0D; Materials and Methods: Population was comprised of adults aged between 18-60 years old. The sample size was 06 and simple random sampling technique was used to select the samples. Self constructed assessment scales were used. Learning package was developed and evaluated for its effectiveness.&#x0D; Statistical Analysis used: Descriptive and inferential statistics were used.&#x0D; Results: The pre-test mean score for functional status was 11.50 and SD was 2.429, anxiety status was 13.67 and SD was 2.685, stress status was 30.00 and SD was 2.898, social status was 26.50 and SD was 4.370 economic status was 5.67and SD was 0.816. In post-test mean score for functional status was 7.50 and SD was 2.258 with mean difference score of 4.00, anxiety status was 7.33 and SD was 1.366 with mean difference score of 6.33, stress status was 7.33 and SD was 0.81565 with mean difference score of 22.66, social status was 17.00 and SD was 2.098 with mean difference score of 9.50, economic status was 3.33 and SD was 0.516 with mean difference score of 2.33. The statistical paired ‘t’ implies that the difference in the pre test and post test score was found to be statistically significant at 5% level. There exists a statistical in the enhancement of score indicating the positive impact of learning package.&#x0D; conclusions: The impact of COVID-19 was more before distributing the learning package. Hence the learning package was effective.

Examining Influenza Vaccination Patterns and Barriers: Insights into Knowledge, Attitudes, and Practices among Diabetic Adults (A Cross-Sectional Survey).

Diabetes mellitus is a prevalent global chronic condition affecting individuals of all ages. People with diabetes face an elevated risk of lower respiratory tract infections such as pulmonary tuberculosis, influenza, and pneumonia. Additionally, the influenza virus increases the likelihood of deep venous thrombosis and pulmonary embolism. This study examined the knowledge, attitudes, and practices of diabetic patients regarding the influenza vaccine. This study involved 418 diabetic patients (53.3% female) at Jordanian outpatient respiratory clinics, with an average age of 49 (±14) years. The results showed that 70.6% had never received the influenza vaccine, and only 23.7% intended to do so in the current year. A positive attitude toward the influenza vaccine significantly reduced hesitancy to get vaccinated (OR = 0.505, 95% CI 0.424-0.601, p < 0.001). The duration of diabetes exhibited a positive association with vaccine hesitancy (OR = 1.053, 95% CI 1.006-1.102, p = 0.028). The primary reason for not getting vaccinated was a lack of awareness of its benefits (42.6%). Future health education programs should emphasize the importance of the influenza vaccine for diabetic patients and address their concerns.

Blockchain technology in Cardiovascular Medicine: a glance to the future? Results from a social media survey and future perspectives.

The leverage of digital facilities in medicine for disease diagnosis, monitoring, and medical history recording has become increasingly pivotal. However, the advancement of these technologies poses a significant challenge regarding data privacy, given the highly sensitive nature of medical information. In this context, the application of Blockchain technology, a digital system where information is stored in blocks and each block is linked to the one before, has the potential to enhance existing technologies through its exceptional security and transparency. This paradigm is of particular importance in cardiovascular medicine, where the prevalence of chronic conditions leads to the need for secure remote monitoring, secure data storage and secure medical history updating. Indeed, digital support for chronic cardiovascular pathologies is getting more and more crucial. This paper lays its rationale in three primary aims: 1) to scrutinize the existing literature for tangible applications of blockchain technology in the field of cardiology; 2) to report results from a survey aimed at gauging the reception of blockchain technology within the cardiovascular community, conducted on social media; 3) to conceptualize a web application tailored specifically to cardiovascular care based on blockchain technology. We believe that Blockchain technology may contribute to a breakthrough in healthcare digitalization, especially in the field of cardiology; in this context, we hope that the present work may be inspiring for physicians and healthcare stakeholders.

Direct impact of 2 years of COVID-19 on chronic disease patients: a population-based study in a large hard-hit Italian region

ObjectivesWe aimed to provide a region-wide comprehensive account of the direct effects of COVID-19 on chronic disease patients, in terms of disease incidence, severity and mortality, over a 2-year pandemic...