Similar Health Conditions Research Articles

Challenges of Creating a Peer Support Online Community for Patients With Diabetes-A Case Study.

This study aims to explore the challenges and strategies in creating online communities for individuals with diabetes, emphasizing their role in fostering connections among individuals facing similar health conditions. Using a single-case approach, we investigated the design process of a diabetes online community using the classic waterfall model. Participants were recruited from a diabetes local association, and usability was assessed using the System Usability Scale and the think-aloud method. Subsequently, semistructured interviews were conducted to evaluate functionality and user experience. Data collection was conducted from August until December 2023. The development of the community unveiled significant usability challenges, highlighting the need for user feedback and improvement. Ethical considerations, including anonymity, usage conditions, privacy terms, and health information sharing, emerged as critical areas requiring meticulous attention. Furthermore, healthcare professional moderation was deemed essential to ensure a secure environment. Users expressed strong interest in enhanced interaction features and personalized notifications. Although online diabetes communities hold potential for peer support, addressing usability challenges, ethical considerations, and moderation issues is essential. This study emphasizes the ongoing necessity for research to enhance the development of patient communities, ensuring accessibility, mitigating ethical risks, and leveraging nurses as moderators.

Experiences of Certified Peer Support Specialist Providing Formal Peer Support in Mental Health Services: ASystematic Review and Meta-Synthesis.

Peer support specialists (PSSs) in mental healthcare services are individuals recovering from mental health conditions and providing formal peer support to clients with similar conditions. Despite evidence of the benefits of this modality and the increasing demand for it, little is known about the PSSs' experiences in mental healthcare services. This review systematically synthesises available qualitative data on the certified PSSs' experiences in providing formal peer support in mental healthcare services. A search was performed across six electronic databases and one grey literature database for all published and unpublished qualitative studies in English between 2014 and 2022. Mixed-methods studies were included if their qualitative data were extractable. This review included PSSs who provided formal peer support to clients with similar mental health conditions. The included studies were appraised through the Critical Appraisal Skills Program Qualitative checklist, while data extraction was done through a customised tool. Our meta-synthesis revealed an overarching theme on certified PSSs' journey in mental healthcare services, alongside four main themes: (i) emotional impacts of being PSSs, (ii) struggle to justify their roles, (iii) complex roles of PSSs and (iv) sources of support. The review has provided an insightful understanding of the PSSs' roles and needs, for which there is a need to cultivate a supportive working environment. Given the difficulties in adopting the PSSs' roles, as demonstrated by our findings, future research should explore how mental healthcare organisations can address their work-related challenges and cultivate a supportive working environment.

Can you be a peer if you don’t share the same health or social conditions? A qualitative study on peer integration in a primary care setting

BackgroundPeer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds.MethodsA participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker.FindingsFindings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians’ understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system.ConclusionOur results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services.

Effectiveness of a Community-Based Ostomy Nursing Technique to Enhance the Delivery of Patient Care and Quality of Life

ABSTRACT This study aimed to develop and validate a community-based ostomy care training program for nursing staff, with the goal of enhancing their ostomy nursing competencies and improving patient satisfaction. Between March 2021 and October 2021, 20 registered nurses and 50 patients with enterostomy surgery who took part in the promotion of a new nursing technique in five community health service centers in the Wuxing District, Huzhou City, were enrolled in this study (forming the intervention group). In addition, 15 registered nurses and 40 patients with enterostomy surgery from four community health service centers with similar economic and health conditions in the same area were randomly selected as the control group. All community health service centers were independent institutions. The indexes before and after the promotion of the technique were compared, and the effectiveness of the training was evaluated by observing the improvement in nursing skills and changes in patient quality of life after the training. The “quality-of-life scale” was used to analyze the quality of life of patients who had undergone colostomy surgery. The new approach to ostomy care delivered in a community setting was found to improve staff knowledge and skill in ostomy care (p < 0.001), improve the quality-of-life scores of patients and reduce patient travel time and medical expenses. The promotion of ostomy nursing techniques in community health service centers has several benefits. It improves the ostomy nursing skill levels of community medical staff. This reduces the occurrence of ostomy complications. Additionally, it establishes an effective connection between tertiary hospitals and community health service centers. This connection is conducive to better nursing care for patients who have undergone ostomy surgery. The hospital – community – family nursing model can improve self-management abilities and reduce the incidence of complications of enterostomies.

Impacts of Long COVID on workers: A longitudinal study of employment exit, work hours and mental health in the UK.

The COVID-19 pandemic has had enormous implications for the world of work. However, there has been relatively little focus on the employment and workforce challenges of the virus in relation to workforce health, beyond the immediate management of the spread of the disease. There is an important gap in understanding the ongoing workforce issues created by the significant incidence of Long COVID in the population. This paper examines the effects of Long COVID on employment and workers' mental health to contribute to understanding of work-limiting health conditions and to offer policy implications for COVID-19 and similar health conditions on employment and the workforce. A large national panel study for the UK is used to estimate the likelihood of exiting employment as well as on changes in working hours and general mental health and happiness of those who remain in work. The sample includes individuals 16 years and older who were in employment in January/February 2020 and followed during the pandemic 2020-2021. Long COVID is self-reported in the data. Informed by conceptual consideration of employment protection in the UK, two groups of individuals with Long COVID are defined based on the duration of symptoms. Group 1 has Long COVID 5-28 weeks after an infection with COVID-19, which is up to the maximum length of Statutory Sick Pay in the UK. Group 2 has symptoms for 29+ weeks, which is beyond the statutory entitlement to sickness pay. Panel regression models are fitted both with fixed-effects and random-effects. Individual and job characteristics are used as controls Those with no COVID-19 symptoms are the reference group. In between-person comparison, Group 2 is at higher risk of exiting employment compared to those with no COVID-19 symptoms. Between-person estimates of mental health and well-being show negative effects of Long COVID for both groups but these are greatest in Group 2. Within-person estimates suggest that factors associated with earnings mediate the negative Long COVID effects on mental health in Group 1 and that Group 2 adapts to working with Long COVID. Group 1 is at risk of working zero hours (i.e. being on sick leave) but neither Group 1 nor Group 2 have a higher probability of working fewer hours compared to those with no COVID-19 symptoms. The negative impact of Long COVID on working hours stems primarily from working zero hours (sickness leave) rather than working fewer hours, suggesting a lack of accommodation by employers of Long COVID at work. The extension of Statutory Sickness Pay and greater flexibility to manage partial (returns to) work would help preserve employment and mental health. Those with Long COVID for 12 months are likely to meet the definition of disability and so have a right to receive reasonable workplace adjustments.

Effects of Dandelion Extract on Promoting Production Performance and Reducing Mammary Oxidative Stress in Dairy Cows Fed High-Concentrate Diet.

This study investigated the effects of rumen bypass dandelion extract on the lactation performance, immune index, and mammary oxidative stress of lactating dairy cows fed a high-concentrate diet. This study used a complete randomized block design, and initial milk production, somatic cell counts, and parities were set as block factors. Sixty Holstein cows with similar health conditions and lactating periods (70 ± 15 d) were divided into three groups with 20 replicates per group. The treatments included the LCD group (low-concentrate diet, concentrate-forage = 4:6), HCD group (high-concentrate group, concentrate-forage = 6:4), and DAE group (dandelion aqueous extract group, HCD group with 0.5% DAE). The experimental period was 35 d, and cows were fed three times in the morning, afternoon, and night with free access to water. The results showed the following: (1) Milk production in the HCD and DAE groups was significantly higher (p < 0.05) than that in the LCD group from WK4, and the milk quality differed during the experimental period. (2) The HCD group's pH values significantly differed (p < 0.01) from those of the LCD and DAE groups. (3) In WK2 and WK4 of the experimental period, the somatic cell counts of dairy cows in the HCD group were significantly higher (p < 0.05) than those in the DAE group. (4) The serum concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and protein carbonyl (PC) in the HCD group were significantly higher (p < 0.05) than those in the LCD group. The activity of catalase (CAT) in the LCD and DAE groups was stronger (p < 0.01) than that in the HCD group. (5) The correlation analysis revealed significantly positive correlations between the plasma LPS concentration and serum concentrations of 8-OHdG (p < 0.01), PC (p < 0.01), and malondialdehyde (MDA, p < 0.05) and significantly negative correlations (p < 0.01) between the plasma LPS concentration and activities of CAT and superoxide dismutase. (6) Compared with that in the HCD and DAE groups, the mRNA expression of α, β, and κ casein and acetyl CoA carboxylase in bovine mammary epithelial cells was significantly higher (p < 0.05) in the LCD group, and the mRNA expression of fatty acid synthetase and stearoyl CoA desaturase in the LCD group was significantly higher (p < 0.01) than that in the HCD group. (7) Compared with that in the LCD and HCD groups, the mRNA expression of Nrf2 was significantly higher (p < 0.01) in the DAE group, and the mRNA expression of cystine/glutamate transporter and NAD (P) H quinone oxidoreductase 1 in the DAE group was significantly higher (p < 0.05) than that in the HCD group. Overall, feeding a high-concentrate diet could increase the milk yield of dairy cows, but the milk quality, rumen homeostasis, and antioxidative capability were adversely affected. The supplementation of DAE in a high-concentrate diet enhanced antioxidative capability by activating the Nrf2 regulatory factor and improved rumen homeostasis and production performance.

Integrating incentive spirometry and progressive muscle training in managing respiratory compromise in Guillain–Barré syndrome

BackgroundGuillain–Barré syndrome (GBS) is one of the most common causes of acute neuromuscular paralysis in developed and developing countries. It is a complex autoimmune disorder characterized by progressive skeletal muscle weakness, potentially involving respiratory muscles. The purpose of this case report was to explore the importance of combined use of incentive spirometry and progressive muscle training as essential therapies in a 20-year-old male diagnosed with GBS.Case presentationThis is a case report of a 20-year-old Nigerian male university student who was brought to the trauma center on a wheelchair with weakness of both upper and lower limbs which was said to be progressive, and a diagnosis of GBS was made by the attending physician. On examination, he was discovered to have quadriparesis with mild respiratory muscle involvement. He deteriorated with cardiopulmonary compromise and was transferred into intensive care unit. He was managed with supplementary oxygen therapy until there was significant improvement and he was weaned off oxygen therapy and then needed further evaluation and management. The patient was placed on immunoglobulin in conjunction with incentive spirometry, progressive strengthening exercise and exercise training which proved to be effective as he regained all the lost function within a few weeks of symptoms.ResultsThis intervention delves into the synergistic potential of fortifying respiratory muscles and improving respiratory function alongside overall muscle strength which resulted in the patient regaining all the lost function within a few weeks.ConclusionsThe combined use of incentive spirometry and progressive muscle training in addition to immunoglobulin was effective in modulating GBS related impairments. We recommend the use of a multifaceted strategy in the management of patients with GBS and other similar health conditions.

Plasmids in the human gut reveal neutral dispersal and recombination that is overpowered by inflammatory diseases

Plasmids are pivotal in driving bacterial evolution through horizontal gene transfer. Here, we investigated 3467 human gut microbiome samples across continents and disease states, analyzing 11,086 plasmids. Our analyses reveal that plasmid dispersal is predominantly stochastic, indicating neutral processes as the primary driver of their wide distribution. We find that only 20-25% of plasmid DNA is being selected in various disease states, constraining its distribution across hosts. Selective pressures shape specific plasmid segments with distinct ecological functions, influenced by plasmid mobilization lifestyle, antibiotic usage, and inflammatory gut diseases. Notably, these elements are more commonly shared within groups of individuals with similar health conditions, such as Inflammatory Bowel Disease (IBD), regardless of geographic location across continents. These segments contain essential genes such as iron transport mechanisms- a distinctive gut signature of IBD that impacts the severity of inflammation. Our findings shed light on mechanisms driving plasmid dispersal and selection in the human gut, highlighting their role as carriers of vital gene pools impacting bacterial hosts and ecosystem dynamics.

Exploring Exercise Intervention as a Therapeutic Catalyst within the Mental Health and Addiction Program in Nova Scotia: A Proof-of-Concept Study

IntroductionMany mental health conditions, including anxiety, mood disorders, and depression, can be effectively treated at a relatively low cost. Exercise interventions can be a therapeutic strategy, but even though exercise has consistently been shown to improve physical health, cognitive function, and psychological well-being, as well as reduce depression and anxiety symptoms, this intervention is often neglected in mental health care services.ObjectivesThe study aims to assess the feasibility of incorporating an Exercise Intervention Program (EIP) as a therapeutic pathway within the Mental Health and Addictions Program (MHAP) in Nova Scotia, as well as to evaluate the effectiveness of the program on mental health outcomes and incremental costs, and the patient acceptability and satisfaction with the program.Methods This proof-of-concept study has a pragmatic, prospective, controlled observational design with an embedded one-phase qualitative component. Patients with a primary diagnosis of depression or anxiety attending the Rapid Assessment and Stabilization Program (RASP, Halifax, Nova Scotia, Canada) will be offered to receive 60-minute exercise sessions three times per week, per 12 weeks. Patients with similar mental health conditions that have opted to wait for Cognitive Behavioral Therapy (CBT) with the community provider and declined from the EIP will be part of the control group. A certified recreational therapist will conduct the EIP. Participants of both groups (EIP and control condition) will be assessed at baseline and then weekly for four weeks, six weeks and then at 12 weeks post-enrollment. Primary outcomes include differences in the mean change in functional (well-being, resilience, and recovery) and symptom variables (depression, anxiety, and suicidal risk), which will be assessed through online validated scales/questionnaires. Service variables (patient acceptance and satisfaction) and health care utilization (crisis calls, emergency department visits, hospital admissions and readmissions, length of stay for each admission) will comprise the secondary outcomes.Results The results of the study will provide information about the effectiveness of EIP in the treatment of anxiety and depression compared to those only wait-listed to receive CBT or counselling from a CMHA provider. The study will also inform about the acceptability and satisfaction of the EIP, as well as the incremental cost-effectiveness of the intervention compared to the control condition.ConclusionsThis proof-of-concept study will demonstrate the effectiveness of EIP as an adjunctive or alternative therapeutic option for the treatment of anxiety and depression in patients seeking mental health support from the MHAP in Nova Scotia.Disclosure of InterestNone Declared

Stakeholders' Perspectives, Needs, and Barriers to Self-Management for People With Physical Disabilities Experiencing Chronic Conditions: Focus Group Study.

While self-management programs have had significant improvements for individuals with chronic conditions, less is known about the impact of self-management programs for individuals with physical disabilities who experience chronic conditions, as no holistic self-management programs exist for this population. Similarly, there is limited knowledge of how other stakeholders, such as caregivers, health experts, and researchers, view self-management programs in the context of disability, chronic health conditions, and assistive technologies. This study aimed to obtain insight into how stakeholders perceive self-management relating to physical disability, chronic conditions, and assistive technologies. Nine focus groups were conducted by 2 trained facilitators using semistructured interview guides. Each guide contained questions relating to stakeholders' experiences, challenges with self-management programs, and perceptions of assistive technologies. Focus groups were audio recorded and transcribed. Thematic analysis was conducted on the focus group data. A total of 47 individuals participated in the focus groups. By using a constructivist grounded approach and inductive data collection, three main themes emerged from the focus groups: (1) perspectives, (2) needs, and (3) barriers of stakeholders. Stakeholders emphasized the importance of physical activity, mental health, symptom management, medication management, participant centeredness, and chronic disease and disability education. Participants viewed technology as a beneficial aide to their daily self-management and expressed their desire to have peer-to-peer support in web-based self-management programs. Additional views of technology included the ability to access individualized, educational content and connect with other individuals who experience similar health conditions or struggle with caregiving duties. The findings suggest that the development of any web-based self-management program should include mental health education and resources in addition to physical activity content and symptom management and be cost-effective. Beyond the inclusion of educational resources, stakeholders desired customization or patient centeredness in the program to meet the overall needs of individuals with physical disabilities and caregivers. The development of web-based self-management programs should be holistic in meeting the needs of all stakeholders. ClinicalTrials.gov NCT05481593; https://clinicaltrials.gov/study/NCT05481593.

Treatment of Diabetes Mellitus by Acupuncture: Dynamics of Blood Glucose Level and Its Mathematical Modelling

The aim of this research is to present the effects of acupuncture treatment on morning blood glucose level (BGL) in type 2 diabetes mellitus (T2DM) patients, and to describe them by a predictive model. The morning BGL is measured after overnight fasting during a three-month long acupuncture treatment for two persons diagnosed with T2DM and is compared with the BGL of two persons in similar health conditions taking only metformin-based drugs. It is shown that the morning BGL is highly affected by each single acupuncture treatment and by the number of the already applied treatments. Significant lowering of BGL after each treatment is observed, as well as an overall BGL lowering effect, which is the result of the repeated acupuncture. The observed BGL reduction was found to be maintained during a follow-up performed a year after the acupuncture. The measured BGL dynamics curves are analyzed and described by a model. This model describes well all of the key features of the measured BGL dynamics and provides personal parameters that describe the BGL regulation. The model is used to simulate BGL regulation by acupuncture performed with different frequencies. It can be used generally to predict the effects of acupuncture on BGL and to optimize the time between two treatments. The results will enable a better understanding of acupuncture application in diabetes, and a prediction of its effects in diabetes treatment.

Patient Perspectives on Artificial Intelligence in Radiology

There are two major areas for patient engagement in radiology artificial intelligence (AI). One is in the sharing of data for AI development; the second is the use of AI in patient care. In general, individuals support sharing deidentified data if used for the common good, to help others with similar health conditions, or for research. However, there is concern with risk to privacy including reidentification and use for other than intended purposes. Lack of trust is mentioned as a barrier for data sharing. Individuals want to be involved in the data-sharing process. In the use of AI in medical care, patients generally support AI as an assist to the radiologist but lack trust in unsupervised AI. Patients worry about liability in case of bad outcomes. Patients are concerned about loss of the human connection and the loss of empathy during a vulnerable time in their lives. Patients expressed concern about risk of discrimination due to bias in AI algorithms. Building trust in AI requires transparency, explainability, security, and privacy protection. Radiologists can take action to prepare their patients to become more trusting of AI. Developing and implementing data-sharing agreements allows patients to voluntarily help in the algorithm development process. Developing AI disclosure guidelines and having AI use disclosure discussions with patients will help them understand the use of AI in their care. As the use of AI increases, there is an opportunity for radiologists to develop and maintain close relationships with their patients and to become more involved in their care.

Use of video group consultations by general practice staff during the COVID-19 pandemic

Background: Video group consultations (VGCs) are one approach to delivering care using a virtual platform for a group of patients with the same or similar health conditions. However, little is known about the use and uptake of VGCs in the UK.Aim: To describe the use and uptake of VGCs by UK general practice staff during the coronavirus disease 2019 pandemic.Method: A cross-sectional design using an online questionnaire. Data analysis adopted the principles of content analysis and demographic data were analysed descriptively.Findings: A total of 36 participants completed the questionnaire across nine UK regions and representing 36 general practices. A lack of standardisation regarding the use and uptake of VGCs across UK general practices was identified, hindering implementation, scale-up and delivery.Conclusion: While the VGC model looks promising, further research is needed to demonstrate its use and uptake, developing a more robust evidence base for implementation.

Diagnosis and Assessment of Oral Health Conditions Among Institutionalized and Non-institutionalized Elderly Individuals

Objective This study aimed to evaluate the perception of the quality of life of institutionalized elderly individuals (MB group) and non-institutionalized elderly individuals (CLIN group), and to compare these results with the results of dental indices. Study Design Elderly women and men aged 60 years or older were evaluated. Anthropometric and cardiac measurements were performed. A questionnaire related to geriatric oral health (GOHAI) and the SF-36, which addresses quality of life, were administered. Results The Mann-Whitney t test was used to perform the statistical analyses (α < 0.05). no statistically significant differences were found in the domains of the GOHAI. Despite the intensive care provided by the institution, self-perceived quality of life, in the physical aspect, was more pronounced in noninstitutionalized participants. Conclusions The participants presented similar overall oral health conditions. The institutionalized participants showed a higher salivary flow. Non-institutionalized participants showed higher salivary cortisol levels. Halitosis proved to be similar. The participants in both groups predominantly used total maxillary prostheses, but those in the non-institutionalized group used more partial mandibular prostheses. No differences were found in self-perceived health among the participants. The non-institutionalized participants presented better physical health; however, mental health was similar between the two groups. This study aimed to evaluate the perception of the quality of life of institutionalized elderly individuals (MB group) and non-institutionalized elderly individuals (CLIN group), and to compare these results with the results of dental indices. Elderly women and men aged 60 years or older were evaluated. Anthropometric and cardiac measurements were performed. A questionnaire related to geriatric oral health (GOHAI) and the SF-36, which addresses quality of life, were administered. The Mann-Whitney t test was used to perform the statistical analyses (α < 0.05). no statistically significant differences were found in the domains of the GOHAI. Despite the intensive care provided by the institution, self-perceived quality of life, in the physical aspect, was more pronounced in noninstitutionalized participants. The participants presented similar overall oral health conditions. The institutionalized participants showed a higher salivary flow. Non-institutionalized participants showed higher salivary cortisol levels. Halitosis proved to be similar. The participants in both groups predominantly used total maxillary prostheses, but those in the non-institutionalized group used more partial mandibular prostheses. No differences were found in self-perceived health among the participants. The non-institutionalized participants presented better physical health; however, mental health was similar between the two groups.

“Why don't they talk to our daughter?”: Eye-tracking AAC and medical communication in Rett syndrome

This investigation explores medical advocacy for Rett syndrome—a rare neurological disorder causing loss of speech and hand function—through the lens of eye-tracking augmentative and alternative communication (AAC) technology. We gathered data from five individuals with Rett syndrome and their caregivers, encompassing semi-structured virtual interviews, video analyses of AAC device usage, and examination of AAC pageset screenshots. The findings reveal diverse AAC strategies employed to express discomfort or illness and highlight caregivers' pivotal role in processing medical information. Notwishstanding challenges like cost, time limitations in medical contexts, training needs, and the lack of standardized AAC symptom descriptions, eye-tracking AAC technology has the potential to enhance symptom assessment, foster patient autonomy, and facilitate personalized medical care. This study illuminates the transformative power of this AAC technology in medical communication, showcasing its promise in tackling communication challenges and underscoring its capacity to enhance quality of life for those with Rett syndrome and similar health conditions.

Multiple Chronic Conditions and Disability among Vietnamese Older Adults: Results from the Vietnamese Aging and Care Survey (VACS).

Using data from Vietnamese-origin older immigrants/refugees in the Houston, Texas area, we assessed their overall health, chronic conditions, disability, depressive symptoms, and cognitive impairment, and examined the association between their chronic conditions and disability by comorbidity clusters. The mean age of the sample was 76years old. The majority were married in fair/poor health with several chronic conditions and disabilities and lived with families in low-income households. Hypertension and arthritis were the most common health conditions, but cognitive impairment had the most significant impact on their disability. They experienced similar health conditions to other older Americans but had higher rates of depressive symptoms and cognitive impairment possibly due to cultural factors that may have delayed mental health treatment. Culturally and linguistically tailored services created by policymakers, healthcare professionals, and local social service agencies are recommended for the well-being of immigrants/refugees who migrated to the U.S. for a better life.

Self-efficacy resources program for behavior changes

Self-efficacy resources program for behavior changes

Prevalence and influencing factors of self-medication during the COVID-19 pandemic in the Arab region: a multinational cross-sectional study

BackgroundThe novel coronavirus pandemic (COVID-19) has begun with a wave of misinformation and fear of infection. This may have led people to self-medicate inappropriately. The World Health Organization describes self-medication (SM) as utilizing medicines to relieve symptoms or health conditions without consulting a physician. Inappropriate drug use is a burden on both health resources and patient health in the Arab region. This study aimed to detect the prevalence and influencing factors of self-medication among the general Arab population during the COVID-19 pandemic.MethodsA multinational cross-sectional study was conducted among the general population of ten Arab countries from early August to late October 2021. Participants aged 18 years or older could join the study via social media platforms. A convenience sampling technique was used. A developed and validated web-based questionnaire was used to collect data on self-medication practice, associated influencing factors, information sources, commonly used medications, and commonly treated conditions. Descriptive, univariate, and multivariate regression analyses were applied using IBM SPSS v 26 and R v 4.0.0 software.ResultsA total of 8163 participants completed the questionnaire, and 518 participants were excluded from the analysis due to inconsistencies in their data. Almost two-thirds (62.7%) of participants reported practicing self-medication during the COVID-19 pandemic. At the country level, Egypt had the highest prevalence of self-medication practice (72.1%), while Palestine had the lowest prevalence (40.4%). The most commonly used drugs were analgesics, antipyretics, and vitamins (86, 65.1, and 57.1%, respectively), while antitussives and antibiotics scored 47.6 and 43.3%, respectively. Experience with similar health conditions (74.6%) and urgency of the problem (47.2%) were the most frequent factors that led to self-medication. Additionally, 38.2% of the self-medicated participants (SMPs) used drugs as prophylaxis against COVID-19. Pharmacist consultation was the most common source of information about self-medication (66.7%). Multivariate analysis showed that predictors of self-medication were older age (p = 0.008), presence of chronic illness (p = 0.015), and having monthly income or medical insurance that does not cover the treatment cost (p = 0.001, p < 0.001, respectively).ConclusionSelf-medication is considered a common practice across the Arab population. It is necessary to regulate policies and raise awareness among the public about self-medication.

Development of an Artificial Intelligence–Guided Citizen-Centric Predictive Model for the Uptake of Maternal Health Services Among Pregnant Women Living in Urban Slum Settings in India: Protocol for a Cross-sectional Study With a Mixed Methods Design

Pregnant women are considered a "high-risk" group with limited access to health facilities in urban slums in India. Barriers to using health services appropriately may lead to maternal and child mortality, morbidity, low birth weight, and children with stunted growth. With the increase in the use of artificial intelligence (AI) and machine learning in the health sector, we plan to develop a predictive model that can enable substantial uptake of maternal health services and improvements in adverse pregnancy health care outcomes from early diagnostics to treatment in urban slum settings. The objective of our study is to develop and evaluate the AI-guided citizen-centric platform that will support the uptake of maternal health services among pregnant women seeking antenatal care living in urban slum settings. We will conduct a cross-sectional study using a mixed methods approach to enroll 225 pregnant women aged 18-44 years, living in the urban slums of Delhi for more than 6 months, seeking antenatal care, and who have smartphones. Quantitative and qualitative data will be collected using an Open Data Kit Android-based tool. Variables gathered will include sociodemographics, clinical history, pregnancy history, dietary history, COVID-19 history, health care facility data, socioeconomic status, and pregnancy outcomes. All data gathered will be aggregated into a common database. We will use AI to predict the early at-risk pregnancy outcomes (in terms of the type of delivery method, term, and related complications) depending on the needs of the beneficiaries translating into effective service-delivery improvements in enhancing the use of maternal health services among pregnant women seeking antenatal care. The proposed research will help policy makers to prioritize resource planning, resource allocation, and the development of programs and policies to enhance maternal health outcomes. The academic research study has received ethical approval from the University Research Ethics Committee of Dehradun Institute of Technology (DIT) University, Dehradun, India. The study was approved by the University Research Ethics Committee of DIT University, Dehradun, on July 4, 2021. Enrollment of the eligible participants will begin by April 2022 followed by the development of the predictive model by October 2022 till January 2023. The proposed AI-guided citizen-centric tool will be designed, developed, implemented, and evaluated using principles of human-centered design that will help to predict early at-risk pregnancy outcomes. The proposed internet-enabled AI-guided prediction model will help identify the potential risk associated with pregnancies and enhance the uptake of maternal health services among those seeking antenatal care for safer deliveries. We will explore the scalability of the proposed platform up to different geographic locations for adoption for similar and other health conditions. PRR1-10.2196/35452.

Development and Implementation of an Acute Kidney Injury Remote Patient Monitoring Program: Research Letter.

The objective of this report was to describe the development and preliminary feasibility of an AKI RPM program launched in October 2021. Academic medical center. Patients enrolled in the AKI RPM program were those who experienced AKI during a hospitalization and underwent nephrology consultation. At enrollment, patients were provided with home monitoring technology and underwent weekly laboratory assessments. Nurses evaluated the data daily and adhered to prespecified protocols for management and escalation of care if needed. Twenty patients were enrolled in AKI RPM in the first 5 months. Median duration of program participation was 36 (31, 40) days. Eight patients (40%) experienced an unplanned readmission, or an emergency department visit, half (N = 4) of which were attributed to AKI and related circumstances. Of the 9 postgraduation survey respondents, all were satisfied with the RPM program and 89% would recommend RPM to other patients with similar health conditions. Acute kidney injury RPM was made possible by the existing infrastructure in our integrated health system and the robust resources available in the Mayo Clinic Center for Digital Health. Such infrastructure may not be universally available which could limit scale and generalizability of such a program. Remote patient monitoring can offer a unique opportunity to bridge the care transition from hospital to home and increase access to quality care for the AKI survivors.