Impact of a Nurse-Led Chronic Disease Management Intervention Model on Quality of Care and Satisfaction of Maintenance Hemodialysis Patients

Objective:To explore the impact of a nurse-led chronic disease management model on the quality of care and satisfaction of maintenance hemodialysis patients.Methods:72 patients who received maintenance hemodialysis(MHD)from June 2021 to March 2022 were selected to undergo the nurse-led chronic disease management model.The hemodialysis indexes,nutritional status,and the occurrence of adverse events were assessed after 24 weeks of the intervention,and patients’satisfaction was investigated and analyzed.Results:Comparing pre-intervention and after 24 weeks of intervention,urea reduction rate and urea clearance were improved but not statistically different(P>0.05),butβ2-microglobulin was significantly reduced compared with pre-intervention(P<0.05);after 24 weeks of intervention,the effect of decreasing blood calcium,parathyroid hormone,and potassium levels was not obvious(P>0.05),and the level of blood phosphorus decreased significantly compared with pre-intervention(P<0.01),albumin and hemoglobin levels were increased and better than before intervention(P<0.05);after 24 weeks of intervention,the incidence of intradialytic hypotension and hypertension was lower than before intervention(P<0.05),and the total incidence of complications was significantly lower than before intervention(P<0.01);there was no significant difference in the Self-Depression Scale scores after 24 weeks of intervention(P>0.05),and Self-Anxiety Scale scores were significantly lower and better than before intervention(P<0.01).Patient satisfaction was greatly improved,with a statistically significant difference(P<0.05).Conclusion:The chronic disease management intervention model led by specialized nurses is conducive to improving the psychological state and nutritional status of dialysis patients,enhancing the adequacy of dialysis for patients,reducing the incidence of related complications,and ultimately achieving the purpose of improving the quality of life of patients,which has significant clinical value.

Problems, challenges and future of plant disease management: from an ecological point of view

Plant disease management faces ever-growing challenges due to： （i） increasing demands for total, safe and diverse foods to support the booming global population and its improving living standards; （ii） reducing production potential in agriculture due to competition for land in fertile areas and exhaustion of marginal arable lands; （iii） deteriorating ecology of agro-ecosystems and depletion of natural resources; and （iv） increased risk of disease epidemics resulting from agricultural intensification and monocultures. Future plant disease management should aim to strengthen food security for a stable society while simultaneously safeguarding the health of associated ecosystems and reducing dependency on natural resources. To achieve these multiple functionalities, sustainable plant disease management should place emphases on rational adaptation of resistance, avoidance, elimination and remediation strategies individually and collectively, guided by traits of specific host-pathogen associations using evolutionary ecology principles to create environmental （biotic and abiotic） conditions favorable for host growth and development while adverse to pathogen reproduction and evolution.

Triple bottom-line consideration of sustainable plant disease management:From economic,sociological and ecological perspectives

Plant disease management plays an important role in achieving the sustainable development goals of the United Nations(UN)such as food security,human health,socio-economic improvement,resource conservation and ecological resilience.However,technologies available are often limited due to different interests between producers and society and lacks of proper understanding of economic thresholds and the complex interactions among ecology,productivity and profitability.A comprehensive synergy and conflict evaluation of economic,sociological and ecological effects with technologies,productions and evolutionary principles as main components should be used to guide sustainable disease management that aims to mitigate crop and economic losses in the short term while maintaining functional farm ecosystem in the long term.Consequently,there should be an increased emphasis on technology development,public education and information exchange among governments,researchers,producers and consumers to broaden the options for disease management in the future.

The Value of the Wearable Single-lead Remote Monitoring Device with the Scatterplot in Chronic Disease Management

Objective:To study the value of the wearable single-lead remote monitoring device with the scatterplot in chronic disease management.Methods:dmitted into 435 residents accord with the inclusion criteria of 20 primary medical institutions of Yinchuan city,and grouped voluntarily by the implementation schemes were grouped voluntarily according to the implementation schemes.According to one of the three implementation schemes selected,the general practitioner guided the subjects to take on the wearable single-lead remote monitoring device,collecting and uploading the EEG data,then diagnosed and analyzed by the synchronously generated ECG scatterplot,finally,summarized the incidence and the categories,analyzed the differences among these three groups.Results:Among 435 subjects,there were 61 normal patients and 374 arrhythmias with the detection rate of 85.98%;and among the 1672 data collected,there were 606 normal data and 1066 arrhythmia with the detection rate of 63.76%;880 data in total 333 cases with atrial premature beat;442 data in total 215 cases with occasional ventricular premature beat;37 data of 22 cases with frequent atrial beat;65 data of 28 cases with frequent ventricular premature beat;13 data of 6 cases with atrial fibrillation;25 data of 15 cases with excitation conduction disorder;2 data of 2 cases with atrial flutter;31 data of 19 cases with ventricular tachycardia;30 data of 16 cases with conduction block;and 14 data of 8 cases with Para systolic rhythm.comparing the detection rate of arrhythmia in three groups,the difference was not statistically significant(P>0.05).Conclusion:The wearable singlelead remote monitoring device with the scatterplot has high application value in cardiovascular chronic disease management.Its effectively screening,validly diagnosing and detailed classifying are helpful to the early intervention,and the protection of the patients’lives.

Laryngopharyngeal reflux disease management for recurrent laryngeal contact granuloma:A case report

BACKGROUND Laryngeal contact granuloma(LCG)is difficult to treat and frequently associated with high persistence and recurrence,despite the availability of both surgical and pharmacological treatment options.An appropriate strategy is therefore needed to help patients with multiple recurrences of LCG to potentially avoid unnecessary surgery.CASE SUMMARY We describe the case of a 34-year-old male patient with recurrent LCG in which a good response was achieved through successful management of laryngopharyngeal reflux disease using a combination pharmacotherapeutic regimen consisting of anti-reflux therapy,pepsin secretion inhibition,bile acid neutralization,and lifestyle modifications.This patient underwent surgery to excise the granuloma,then relapsed,underwent a second surgery,which was followed by a second recurrence.The granuloma then disappeared after 9 mo of combined treatment with ilaprazole enteric-coated capsules(10 mg qd),mosapride tablets(5 mg tid)and compound digestive enzyme capsules(2 tablets).The drug regimen was discontinued after one year,and no recurrence of the lesion has been reported during the one-year follow-up period.CONCLUSION We report a combination of pharmacotherapeutics and lifestyle modifications for the management of laryngopharyngeal reflux disease to address recurring LCG.

Current advances in pathogen-plant interaction between Verticillium dahliaeand cotton provide new insight in the disease management

Verticillium wilt is the second serious vascular wilt caused by the phytopathogenic fungus Verticillium dahliae Kleb.It has distributed worldwide,causing serious yield losses and fiber quality reduction in cotton production.The pathogen has developed different mechanisms like the production of cell wall degrading enzymes,activation of virulence genes and protein effectors to succeed in its in fection.Cott on plant has also evolved multiple mechanisms in response to the fungus infection,including a strong production of lignin and callose deposition to strengthen the cell wall,burst of reactive oxygen species,accumulation of defene hormones,expression of defense-related genes,and target-directed strategies like cross-kingdom RNAi for specific virulent gene silencing.This review summarizes the recent progress made over the past two decades in understanding the interactions between cotton plant and the pathogen Verticillium dahliae during the infection process.The review also discusses the achievements in the control practices of cotton verticillium wilt in recent years,including cultivation practices,biological control,and molecular breeding strategies.These studies reveal that effective management strategies are needed to control the disease,while cultural practices and biological control approaches show promising results in the future.Furthermore,the biological control approaches developed in recent years,including antagonistic fungi,endophytic bacteria,and host induced gene sile ncing strategies provide efficie nt choices for in teg rated disease management.

Community-based intervention of chronic disease management program in rural areas of Indonesia

Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery

BACKGROUND Esophageal cancer is one of the most common malignant tumors.The three-dimensional quality structure model is a quality assessment theory that includes three dimensions:Structure,process,and results.AIM To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery.METHODS In this prospective study,the control group received routine nursing,and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care.Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale(GSES)and Exercise of Self-Care Agency scale,respectively.IBM SPSS Statistics for Windows,version 17.0,was used for the data processing.RESULTS This study recruited 112 patients who were assigned to the control and experi-mental groups(n=56 per group).Before the intervention,there was no significant difference in GSES scores between the two groups(P>0.05).After the inter-vention,the GSES scores of both groups increased,with the experimental group showing higher values(P<0.05).At the time of discharge and three months after discharge,the scores for positive attitudes,self-stress reduction,and total score of health promotion in the experimental group were higher than those in the control group(P<0.05).CONCLUSION The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

Effect of Health Management in Raising Awareness Rate of Disease Prevention and Treatment in Patients with Prehypertension

Objective: To analyze the effect of health management on improving the awareness rate of disease prevention and treatment in patients with prehypertension, so as to provide guidance for clinical management of patients with prehypertension. Methods: 108 patients diagnosed with prehypertension in our hospital were divided into a control group and an experimental group. The control group was not given management measures, while the experimental group was given health management. The incidence of hypertension and cognition level of hypertension knowledge were compared between the two groups after management. Results: The incidence of hypertension in the experimental group was 7.41% lower than that in the control group 29.63%. The cognitive level of hypertension in the patients (66.54 ± 1.25) was significantly higher than that in the patients without health management (41.45 ± 2.45), and P < 0.05;Conclusion: For patients with prehypertension, the implementation of health management is helpful to improve their cognition of hypertension, master related prevention knowledge, and reduce the incidence of hypertension.

Relevance of Advanced Plant Disease Detection Techniques in Disease and Pest Management for Ensuring Food Security and Their Implication: A Review

Plant diseases and pests present significant challenges to global food security, leading to substantial losses in agricultural productivity and threatening environmental sustainability. As the world’s population grows, ensuring food availability becomes increasingly urgent. This review explores the significance of advanced plant disease detection techniques in disease and pest management for enhancing food security. Traditional plant disease detection methods often rely on visual inspection and are time-consuming and subjective. This leads to delayed interventions and ineffective control measures. However, recent advancements in remote sensing, imaging technologies, and molecular diagnostics offer powerful tools for early and precise disease detection. Big data analytics and machine learning play pivotal roles in analyzing vast and complex datasets, thus accurately identifying plant diseases and predicting disease occurrence and severity. We explore how prompt interventions employing advanced techniques enable more efficient disease control and concurrently minimize the environmental impact of conventional disease and pest management practices. Furthermore, we analyze and make future recommendations to improve the precision and sensitivity of current advanced detection techniques. We propose incorporating eco-evolutionary theories into research to enhance the understanding of pathogen spread in future climates and mitigate the risk of disease outbreaks. We highlight the need for a science-policy interface that works closely with scientists, policymakers, and relevant intergovernmental organizations to ensure coordination and collaboration among them, ultimately developing effective disease monitoring and management strategies needed for securing sustainable food production and environmental well-being.

Complexity and Management of Chronic Kidney Disease

Chronic Kidney Disease (CKD) is ongoing damage of the kidneys, which affects their ability to filter the blood the way they should. Worldwide CKD is considered as the 16th leading cause of death and affects 8% - 16% of the population. CKD often goes unnoticed and is revealed as an incidental finding. Healthcare providers diagnose the condition as CKD based on persistent abnormal kidney function tests revealing kidney damage markers > 3 months, urine albumin creatinine ratio (UACR) > or equal to 30 mg/g per 24 hours, and GFR < 60 mL/min/1.73m2. In this article, we have discussed chronic kidney disease in terms of kidney physiology, chronic kidney disease pathophysiology, etiology, diagnosis, signs and symptoms, and management.

Study on the Management of Chronic Diseases in American and British Community Pharmacy

Objective To provide a reference for promoting the construction of chronic disease management in community pharmacies in China.Methods Literature research and comparative research methods were used to analyze the management of chronic disease carried out by community pharmacies in the United States and the United Kingdom.Results and Conclusion The management of chronic diseases in American and British community pharmacies has formed retail health clinic and online chronic disease mode.It is recommended that Chinese government should issue measures and supporting guidelines for the management of chronic diseases in community pharmacies as soon as possible.Community pharmacies should be encouraged to carry out chronic disease management with the concept of prudent inclusion and gradual progression.Meanwhile,the concentration of drug retail industry should be improved to carry out the systematic construction of chronic disease management and build a standardized chronic disease service process.Besides,community pharmacies should make full use of new technologies such as the Internet,cloud computing and big data,smart wearable devices,and chronic disease management Apps to explore and carry out online professional chronic disease management mode.

Different effects of 24 dietary intakes on gastroesophageal reflux disease: A mendelian randomization

BACKGROUND In observational studies,dietary intakes are associated with gastroesophageal re-flux disease(GERD).AIM To conduct a two-sample mendelian randomization(MR)analysis to determine whether those associations are causal.METHODS To explore the relationship between dietary intake and the risk of GERD,we extracted appropriate single nucleotide polymorphisms from genome-wide asso-ciation study data on 24 dietary intakes.Three methods were adopted for data analysis:Inverse variance weighting,weighted median methods,and MR-Egger's method.The odds ratio(OR)and 95%confidence interval(CI)were used to eva-luate the causal association between dietary intake and GERD.RESULTS Our univariate Mendelian randomization(UVMR)results showed significant evidence that pork intake(OR,2.83;95%CI:1.76-4.55;P=1.84×10–5),beer intake(OR,2.70,95%CI:2.00-3.64;P=6.54×10–11),non-oily fish intake(OR,2.41;95%CI:1.49-3.91;P=3.59×10–4)have a protective effect on GERD.In addition,dried fruit intake(OR,0.37;95%CI:0.27-0.50;6.27×10–11),red wine intake(OR,0.34;95%CI:0.25-0.47;P=1.90×10-11),cheese intake(OR,0.46;95%CI:0.39-0.55;P=3.73×10-19),bread intake(OR,0.72;95%CI:0.56-0.92;P=0.0009)and cereal intake(OR,0.45;95%CI:0.36-0.57;P=2.07×10-11)were negatively associated with the risk of GERD.There was a suggestive asso-ciation for genetically predicted coffee intake(OR per one SD increase,1.22,95%CI:1.03-1.44;P=0.019).Multi-variate Mendelian randomization further confirmed that dried fruit intake,red wine intake,cheese intake,and cereal intake directly affected GERD.In contrast,the impact of pork intake,beer intake,non-oily fish intake,and bread intake on GERD was partly driven by the common risk factors for GERD.However,after adjusting for all four elements,there was no longer a suggestive association between coffee intake and GERD.CONCLUSION This study provides MR evidence to support the causal relationship between a broad range of dietary intake and GERD,providing new insights for the treatment and prevention of GERD.

Clinical value of precise rehabilitation nursing in management of cerebral infarction

BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.

Nonalcoholic fatty liver disease in lean subjects:Prognosis,outcomes and management

Nonalcoholic fatty liver disease(NAFLD)accounts for most cases of chronic liver disease worldwide,with an estimated global prevalence of approximately 25%and ranges from simple steatosis to nonalcoholic steatohepatitis and cirrhosis.NAFLD is strongly connected to metabolic syndrome,and for many years,fatty liver was considered to be an exclusive feature of obese patients.However,recent studies have highlighted the presence of NAFLD in non-obese subjects,with or without increased visceral fat or even in lean subjects without increased waist circumference.“Lean NAFLD”is a relatively new concept and there is significant scientific interest in understanding the differences in pathophysiology,prognosis and management compared with NAFLD in overweight/obese patients.In the present editorial,we discuss the clinical and metabolic profiles and outcomes of lean NAFLD compared with both obese NAFLD and lean healthy individuals from Asian and Western countries.Moreover,we shed light to the challenging topic of management of NAFLD in lean subjects since there are no specific guidelines for this population.Finally,we discuss open questions and issues to be addressed in the future in order to categorize NAFLD patients into lean and nonlean cohorts.

New models for chronic disease management in the United States and China

In the United States(US)the role of the general practitioner in primary care is changing rapidly as the team leader in the new“Patient-centered Medical Home”model of care that is designed to improve the management of chronic disease.The“Collaborative Care Model”is an integrated model of treating multiple medical and behavioral conditions.These new approaches include a nurse case manager who serves as the key point of contact to provide education,facilitate treatment adherence,and guide the patient to improvements in nutrition and physical activity that cause obesity and chronic disease.A gap analysis was conducted comparing the US and Chinese general practitioner models for providing care to patients with chronic diseases.The results of the analysis were used to make recommendations for adding components of these models that are feasible and effective for Chinese general practitioners in community health centers.

Traditional Chinese Practice,A Promising Integrative Intervention for Chronic Non-Infectious Disease Management

The number of people with chronic diseases rises rapidly in recent years worldwide. Except for drug medication, mind-body exercises are indispensable for chronic disease management. Traditional Chinese practice （TCP）, as an integrative intervention, is known as an effective means to keep in good health and fitness, as well as help regulate emotion. This paper introduces the domestic and overseas studies on effectiveness of TCP for chronic diseases, and explores the key action links from three aspects, including functional training of multiple-joint guided by consciousness, relieving psychological risk factors, improving respiratory and digestive function, blood and lymph circulation through respiratory training, and regulation of nerve, metabolic, and immune system. Finally, the authors discussed how to integrate TCP in the chronic disease management, and put forward that the practice methods and evaluation standard should be assessed academically.

Moving from death sentence to chronic disease management

In Europe today, HIV/AIDS prevention, treatment and care are needed more than ever. HIV incidence steady in western and central Europe, and dramatically increasing in eastern Europe remains a major challenge to public health in the 21st century. With more than two million people living with HIV/AIDS in the WHO European Region, no country has been spared.

Management of Patients with Inflammatory Bowel Disease during the Prevention of COVID-19

Objective: To explore the disease management methods and effects for patients with inflammatory bowel disease (IBD) in the special period of pandemic. Methods: Medical staffs carried out the management of patients with IBD on the inflammatory disease service platform of this center from February to May of 2020 in addition to routine clinical works. Results: None of the nearly 3000 IBD patients who are being followed up at our center were infected with COVID-19. During this period, no patients experienced drug-related serious side effects or disease recurrence that could not be treated in time due to failure to reach the medical staffs. Conclusion: The disease management methods based on IBD platform allow the patients to be properly managed during this special period.

Mobile health technology: a novel tool in chronic disease management

The successful control of chronic diseases mainly depends on how well patients manage their disease conditions with the aid of healthcare providers.Mobile health technology—also known as mHealth—supports healthcare practice by means of mobile devices such as smartphone applications,web-based technologies,telecommunications services,social media,and wearable technology,and is becoming increasingly popular.Many studies have evaluated the utility of mHealth as a tool to improve chronic disease management through monitoring and feedback,educational and lifestyle interventions,clinical decision support,medication adherence,risk screening,and rehabilitation support.The aim of this article is to summarize systematic reviews addressing the effect of mHealth on the outcome of patients with chronic diseases.We describe the current applications of various mHealth approaches,evaluate their effectiveness as well as limitations,and discuss potential challenges in their future development.The evidence to date indicates that none of the existing mHealth technologies are inferior to traditional care.Telehealth and web-based technologies are the most frequently reported interventions,with promising results ranging from alleviation of disease-related symptoms,improvement in medication adherence,and decreased rates of rehospitalization and mortality.The new generation of mHealth devices based on various technologies are likely to provide more efficient and personalized healthcare programs for patients.