Economic and Social Impact Assessment of Chronic Diseases Among the Low-Income Population in Southern Punjab,Pakistan

Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.

Resveratrol combats chronic diseases through enhancing mitochondrial quality

Resveratrol(RSV),as a functional food component extracted from natural plants,has been widely studied and recognized in preventing and treating various diseases,with major mechanisms including executing anti-inflammation and anti-oxidation functions,and improving mitochondrial quality.Chronic diseases as non-communicable diseases are mainly caused by multiple factors,such as physiological decline and dysfunction in the body,and have become a significant challenge on public health worldwide.It is worth noting that chronic diseases such as Alzheimer's disease(AD),Parkinson's disease(PD),muscle atrophy,cardiovascular disease,obesity,and cancer are accompanied by abnormal mitochondrial function.Therefore,targeted regulation of mitochondria may be a meaningful way to prevent and treat chronic diseases.Increasing evidence has confirmed that RSV is actively involved in regulating mitochondria,and it has become an essential consideration to prevent and treat chronic diseases through targeting mitochondria and improving corresponding functions.In this article,current studies on RSV to optimize mitochondrial quality for preventing and alleviating chronic disease are systematically summarized,which can provide a theoretical reference for the development of functional foods or drugs to combat chronic diseases.

Perceptions of Patients with Chronic Diseases on Telenursing in Selected Hospitals of Shandong Province, China: A Comparative Study

Objectives:To explore the perception of telenursing among patients with chronic diseases in the selected community hospitals only in Shandong Province,China,and to compare the differences in perception of telenursing among patients with different chronic diseases.Methods:The purpose sampling method was adopted in this study,and questionnaires were distributed to 324 chronic disease patients in OPD hospitals.Results:Patients with chronic diseases have higher awareness and acceptance of telenursing,and there are significant differences in their cognition of telenursing needs.Conclusion:The disease characteristics of patients with different chronic diseases and their different needs for telenursing require more considerations in the design and use of telenursing services.

Food insecurity increases the risk of overweight and chronic diseases in adolescents: a systematic review and meta-analysis

To investigate the relationship between food insecurity(FI)and overweight/obesity(OW/OB)or corresponding chronic diseases in adolescents,33 studies with 181135 individuals were included in this meta-analysis.Six studies and 10 studies,reported a higher risk of overweight and obesity in adolescents experiencing FI,respectively(OR 1.38,95%CI 1.20‒1.58,P<0.0001;OR 1.11,95%CI 1.01‒1.22,P=0.035,respectively).Based on the pooled results,adolescents with severe FI had the highest risk of OW/OB(OR 1.45,95%CI 1.20‒1.75,P<0.0001).The pooled OR indicated no signifi cant association between FI and OW/OB,when the adolescents were stratifi ed into those under 6 years old and those between 6 and 18 years old.Eleven studies assessed the relationship between FI and the risk of chronic diseases.The anemia subgroup was significantly associated with FI(OR 1.67,95%CI 1.30‒2.13,P<0.0001).Severe FI was reported to increase the risk of hypertension(OR 1.59,95%CI 1.28‒1.98,P<0.0001).Furthermore,a pooled analysis revealed a signifi cant association between FI and the risk of chronic diseases in both 6 and 6-18-year-old subgroups.

An Intelligent Approach for Accurate Prediction of Chronic Diseases

Around the globe,chronic diseases pose a serious hazard to healthcare communities.The majority of the deaths are due to chronic diseases,and it causes burdens across the world.Through analyzing healthcare data and extracting patterns healthcare administrators,victims,and healthcare communities will get an advantage if the diseases are early predicted.The majority of the existing works focused on increasing the accuracy of the techniques but didn’t concentrate on other performance measures.Thus,the proposed work improves the early detection of chronic disease and safeguards the lives of the patients by increasing the specificity and sensitivity of the classifiers along with the accuracy.The proposed work used a hybrid optimization algorithm called the Hybrid Gravitational Search algorithm and Particle Swarm Optimization algorithm(HGSAPSO)to upgrade the detection of chronic diseases.Existing classifier parameters with their optimized parameters are compared and evaluated.Classifiers such as Artificial Neural Network(ANN),Support Vector Machines(SVM),K-Nearest Neighbor(Knn),and Decision tree(DT)are used.Health care data are obtained from the UCI machine learning repository to evaluate the proposed work.The proposed work is assessed on 6 benchmark datasets and the performance metrics such as Accuracy,Specificity,Sensitivity,F-measure,Recall,and Precision are compared.The experimental results exhibit that the proposed work attains better accuracy on Artificial Neural Network-Hybrid Gravitational Search algorithm and Particle Swarm Optimization algorithm(ANN-HGSAPSO)classifier compared to other classifiers.ANN-HGSAPSO provides 93%accuracy for Chronic Kidney Disease(CKD),Cardio Vascular Disease(CVD)96%,Diabetes 82%,Hepatitis 94%,Wisconsin Breast Cancer(WBC)91%,and for Liver disease dataset 96%.

Low Grip Strength and Increased Mortality Hazard among Middle-Aged and Older Chinese Adults with Chronic Diseases

Objective This study aims to evaluate the association between lower grip strength and mortality hazard.Methods We selected 10,280 adults aged 45 to 96 years old from the China Health and Retirement Longitudinal Study and used multivariate Cox proportional hazard models to assess the association of grip strength with mortality hazard.In addition,we explored the possibility of a nonlinear relationship using a 4-knot restricted spline regression.Results We found that elevated grip strength was associated with lower mortality up to a certain threshold.The baseline quartile values of grip strength were 30,37,and 44 kg for males and 25,30,and35 kg for females.After adjusting for confounders,with category 1 as the reference group,the adjusted HRs were 0.58(0.42-0.79)in males and 0.70(0.48-0.99)in females(category 4).We also found a linear association between grip strength values and all-cause death risk(males,P=0.274;females,P=0.883)using restricted spline regression.For males with a grip strength<37 kg and females with a grip strength<30 kg,grip strength and death were negatively associated.Conclusion Grip strength below a sex-specific threshold is inversely associated with mortality hazard among middle-aged and older Chinese adults with chronic diseases.

Health Awareness: A Significant Factor in Chronic Diseases Prevention and Access to Care

Health literacy and awareness are essential strategies in promoting global health and improving access to care. While seen as an essential tool for promoting population health awareness to improve early detection and treatment of chronic diseases, it is yet to be emphasized in most African countries. Health literacy is an essential practice to promote chronic disease prevention and reduce the growing threat to population health. Incidences and mortalities from chronic diseases commonly arise from limited knowledge of the causative risk factors and access to health facilities. Without knowledge about causes, health impacts, and available health services, people continue to indulge in the habits that worsen their health conditions and fail to access care timely. By using health literacy and awareness as a tool for chronic disease prevention, healthcare professionals will develop strategic health awareness programs that fit the socio-demographics of the population they serve. This article explored the significant role health awareness occupies in individual and community health prevention through health promotion and education. It reviewed the concept and dimensions of chronic disease prevention, cultural beliefs and impact on chronic diseases, gaps created by low health literacy, and the significance of health literacy in disease prevention and health promotion. Furthermore, it recommends that health systems and local communities form partnerships to address common and emerging health problems, and health systems should be properly funded.

Utilization of Barley Functional Foods for Preventing Chronic Diseases in China

Chronic diseases are the leading global causes of death in China and the world, especially hypertension ＇and diabetes, and the main reasons are heredity, abnormal metabolism and an unhealthy lifestyle for dietary. Barley is taditional medicine in China. There is an very important effect for functional foods for preventing chronic diseases of barley grains and barley grass powder as well as its products because of its high contents of minerals, vitamins, amino acids, antioxidant enzymes, chlorophyll and bioactive compounds such as β-glucans, phenolic compounds, GABA, alkaloid, tocopherols and tocotrienols, dietary fiber and so on. There are a lot of challenges to promote health for functional food with barley grains and its grass in China. Barley grain will produce pearled barley, grits, flakes and flour, and it adds texture, flavor, aroma, nutritional and medicinal value to product. Barley grass powder can be produced in barley green, barley grass rice noodle, barley grass ersi, barley grass noodles and barley green beer and other new functional foods. The future for barley use in food products is improving and very promising.

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.

Autophagy-associated signal pathways of functional foods for chronic diseases

Functional foods,namely as natural or processed foods containing bioactive compounds,can provide health-promoting effects beyond basic nutrition,or offer the prevention or supplementary treatment of chronic diseases.The bioactive components in functional foods usually have pleiotropic effects,including antioxidant,anti-inflammatory,hypolipidemic,glycemic-regulating,cytoprotective,and neuroprotective functions.Autophagy is one of the highly conserved cellular processes for the clearance of aberrant components in eukaryotic cells,and plays an essential role in health promotion and prevention and treatment of a series of chronic diseases.Once the cells are in the stress environment,the induced autophagy will accelerate the clearance of cellular damaged or toxic protein aggregates or dysfunctional cellular organelles to maintain homeostasis in cells.In this article,we summarize several widely investigated bioactive components used as functional foods,such as resveratrol,epigallocatechin-3-gallate,curcumin and trehalose,with the regulatory function for autophagy during the intervention of chronic diseases,which will provide the references or novel thoughts for the development of functional foods with the modulation of autophagy.

Volunteers as caregivers for elderly with chronic diseases:An assessment of demand and cause of demand

Objective:We sought to examine the demand of volunteers on long-term care of elderly patients with chronic diseases.Further,we evaluated patients'reasons to want long-term care volunteers as well as socioeconomic factors affecting these needs.Methods:Questionnaires were distributed to 516 elderly with chronic diseases from nursing homes,hospitals,and elderly living with relatives.Patient questions dealt with basic socioeconomic questions,their reasons to want care volunteers,and the nature of chronic disease,and their motivation to volunteer and which sorts of activities they perform while volunteering.Results:73.4%of the elderly patients with chronic diseases desired to have volunteers for long-term care.The most desired services were care visits,transportation,and leisure/recreation activities.The number of chronic diseases they had,their marital status,education level,and social support system were all statistically important.Conclusion:The data presented here suggest that the government should actively advocate for volunteer service for elderly with chronic diseases.Additional support is needed in terms of financial support,incentive measures,professional training for volunteers,and supervision of volunteers.Such developments are needed to improve volunteer service standards.

Tai Chi:a new star for the administration of chronic diseases?

Tai Chi Quan(Tai Chi),a traditional Chinese martial art,has become increasingly popular in western countries.Tai Chi integrates deep diaphragmatic breathing with body movements to achieve a harmonious balance between the body and mind,which facilitates the flow of internal energy(Qi).An increasing number of studies have reported that Tai Chi significantly benefits aerobic capacity,muscular strength,balance,and psychological well-being.In addition,Tai Chi offers unique advantages for physical fitness and the treatment of chronic diseases.This paper reviews the existing literatures on Tai Chi,introduces its health-promotion effects and the potential clinical applications,and summarizes recent studies that prove Tai Chi is safe and effective for patients with neurological diseases,rheumatological diseases,musculoskeletal diseases,cardiovascular diseases,chronic obstructive pulmonary diseases,and cancers.After reviewing the literatures in this field,we conclude that the long-term results of practicing Tai Chi may benefit the cardiovascular system,motor system,respiratory system,and nervous system.However,the potential role and mechanism of Tai Chi has not yet been determined.Further studies with long follow-up periods are necessary to meet the standards of clinical applications.

Corrigendum to “Probiotic mixture VSL#3: An overview of basic and clinical studies in chronic diseases”

Correction to:Cheng FS,Pan D,Chang B,Jiang M,Sang LX.Probiotic mixture VSL#3:An overview of basic and clinical studies in chronic diseases.World J Clin Cases 2020;8:1361-1384.We are the team of Min Jiang and Li-Xuan Sang from the First Affiliated Hospital,China Medical University.Now we solemnly declare that the studies mentioned in this article[1]evaluated the probiotic formulation known as VSL#3 before January 31,2016.The probiotic formulation is now commonly referred to as De Simone Formulation.In addition,the product currently known as VSL#3 is not the same as De Simone Formulation.De Simone Formulation is now available as Visbiome in the United States and Vivomixx in Europe.

Views of Parents and Teachers on Ways to Improve the Primary School’s Response to Children with Chronic Diseases

Many children with chronic diseases attend regular classes in public elementary schools,and their various needs are becoming a great challenge for the school and the educational system.Parents and teachers have the care giving responsibility for these children,but they do not always have the support or the means to meet those needs.Therefore,the school faces significant difficulties in responding to the challenge of attending to students with chronic diseases.This study’s purpose is to assess,through an exploratory approach,the opinions of parents and teachers regarding what they consider to be the basic needs of the school to improve its response to the challenge of chronic diseases.Our methodology is qualitative,and we conducted interviews with 28 parents and teachers during the school year 2019-2020.We analyzed our data by applying the Thematic Content Analysis method.According to our findings,parents and teachers believe that if the teachers receive proper training on chronic diseases and specialists are integrated into schools,the response to the challenge will improve dramatically.

Chronic Diseases of Childhood and the International Classification of Functioning, Disability, and Health: A Systematic Review

The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.

Experiences of implementing a coping mechanism for the elderly who face chronic diseases while living with the family: a phenomenology study

Objective: Physical and psychological stress causes harm to the health status of the elderly with chronic diseases. This study aimed to understand coping mechanisms of the elderly with chronic conditions who live with their family. Methods: This study was conducted using a descriptive phenomenology method from the experience of 13 older adults with chronic disease. The study processes were interviewed, tape recorded, transcribed, and explored from the transcripts using Colaizzi’s descriptive phenomenological method. The steps of the descriptive phenomenology process are bracketing, intuiting, analyzing, and describing. Results: The coping mechanisms used by the elderly with chronic diseases are (1) the behavioral focus coping ways by doing sports, and physical activities;(2) Focus on spirituality has been implemented by fasting, chanting, dhikr, and prayer;(3) The cognitive focus by working on hobbies or habitual activities and helping each other;(4) The social interaction focus was by interacting with friends, family, and neighbors. Conclusions: This shows that elderly adults with disease conditions try to adapt various forms of coping mechanisms, which positively affects their psychological state. Families which have elderly with chronic diseases are expected to provide nurturing and psychological support to them so that the elderly can consistently apply coping mechanisms to overcome and tackle chronic diseases. Understanding the coping mechanism implementation of the elderly who have chronic diseases by their family can guide health specialists in designing psychological and spiritual approach interventions.

The Limits of the Intervention of Public Power in Individual Health Choices——From the Perspective of the Realization of the Right to Health in the Prevention and Control of Chronic Diseases

Noncommunicable chronic diseases have become the most important public health problem in the world today,so the focus of public health services should be shifted from the traditional area of communicable diseases to the prevention and control of chronic diseases.Since bad living habits are the most direct cause of chronic diseases,the most effective measure to prevent and control chronic diseases is to promote healthy lifestyles for the individual citizen.The theories of equal health opportunity,the right to health from the perspective of human rights,and determinants of a healthy society provide justified reasons for the intervention of public power in individual health choices.In the current legal system,the intervention of public power is limited to flexible measures such as health education,which shows respect for individual autonomy.However,it is inconsistent with the needs of current public health practice.We should expand diversified intervention means to encourage individuals to make healthy choices under the guidance of the management model.The“ladder of intervention”outlines a panoramic view of the intervention measures available.However,for the selection of specific measures,it is necessary to consider the public health objectives and the invasion of individual freedom,introduce the“legal reservation principle”and“proportionality principle”as policy analysis tools,and reasonably choose intervention measures at different levels on the ladder to properly handle the tension between public power and private rights.

Relationships between Chronic Diseases and Depression among Middleaged and Elderly People in China: A Prospective Study from CHARLS

Given the rapid increase in the prevalence of chronic diseases in aging populations,this prospective study including 17707 adults aged≥45 years from China Health and Retirement Longitudinal Study was used to estimate the associations between chronic discase,multimorbidity,and depression among middle-aged and elderly adults in China,and explore the mediating factors.Depressive symptoms were assessed using the 10-item Centre for Epidemiological Studies Depression Scale(CES-D-10)questionnaire.Twelve chronic physical conditions,including hypertension,diabetes,dyslipidemia,cancer,chronic lung disease,liver disease,heart failure,stroke,kidney disease,arthritis or rheumatism,asthma,digestive disease were assessed.The prevalence rates for physical multimorbidity and depression(CES-D-10≥10)were 43.23%and 36.62%,respectively.Through multivariable logistic models and generalized estimating equation(GEE)models,we found all 12 chronic physical conditions,and multimorbidity were significantly associated with depression.Both mobility problems and chronic pain explained more than 30%of the association for all chronic conditions,with particularly high percentages for stroke(51.56%)and cancer(51.06%)in mobility problems and cancer(53.35%)in chronic pain.Limited activities of daily living(ADL)explained 34.60%of the stroke-cancer relationship,while sleep problems explained between 10.15%(stroke)and 14.89%(chronic lung disease)of the association.Individuals with chronic diseases or multimorbidity are significantly more likely to be depressed.Functional symptoms involving limitations of ADL and mobility difficulties mediated much of the association between chronic diseases and incident depression.These symptoms could be targeted for interventions to ameliorate the incidence of depression among individuals with chronic conditions.

Psychosocial and spiritual needs of patients with chronic diseases: validation of the Chinese version of the Spiritual Needs Questionnaire

OBJECTIVE： Even in secular societies, a small portion of patients find their spirituality to help cope with illness. But for the majority of patients, psychosocial and spiritual needs are neither addressed nor even considered a relevant factor by health care professionals. To measure such specific needs, the Spiritual Needs Questionnaire （SpNQ） was developed. The aim of this study was to validate the Chinese version of the SpNQ （SpNQ-Ch） and thus to measure psychosocial and spiritual needs of Chinese patients. METHODS： This was a cross-sectional study among 168 patients with chronic diseases who were recruited in the Changhai Hospital of Traditional Chinese Medicine, Shanghai, China using standardized questionnaires. We performed reliability and factor analyses, as well as analyses of variance, first order correlations and regression analyses. RESULTS： The 17-item SpNQ-Ch had a similar factorial structure as the original version with two main and three minor factors which accounted for 64% of variance, and internal consistency estimates （Cronbach＇s a） ranging from 0.51 to 0.81. Included were the 4-item scale Inner Peace Needs, the 5-item scale Giving/Generativity （with 2 sub-constructs, Praying and Sources）, and a Needs, the 5-item scale Religious Needs 3-item scale Reflection/Release Needs. In Chinese patients with cancer （63%）, pain affections （10%）, or other chronic conditions （23%）, the needs for Giving/Generativity （which refer to categories of Connectedness and Meaning） and Inner Peace Needs scored highest, while Religious Needs and the Reflection/Release Needs scored lower. CONCLUSION： The SpNQ-Ch is congruent with its primary version, and can be used in future studies with the mostly nonreligious patients from China. First findings indicate specific psychosocial and spiritual needs which should be addressed by health care professionals to support patients in their struggle with chronic illness in terms of psycho-emotional stabilization, finding hope and meaning, and thus achieving peaceful states of mind despite chronic illness.

Circulating adhesion molecules in patients with virus-related chronic diseases of the liver

AIM: In the inflammatory state, intercellular adhesion molecule-1 (ICAM-1) and vascular cellular adhesion molecule-1 (VCAM-1) play a key role in promoting migration of immunological cells from the circulation to target site.Aim of our study was to investigate soluble forms of these molecules in patients with virus-related chronic liver diseases, to assess their behavior in different pathologies and correlation with severity of liver damage.METHODS: Circulating ICAM-1 and VCAM-1 were assayed by EIA commercial kits (R&D System Co.,Abington, UK) in 23 patients with chronic active hepatitis (CH), 50 subjects affected by liver cirrhosis (LC) and 15 healthy controls comparable for sex and age. In patients, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also detected by autoanalyzer.RESULTS: LC patients had significantly higher ICAM-1 values than CH patients (38.56±7.4 ng/mL vs 20.89±6.42 ng/mL; P＜0.001) and these ones had significantly higher values than controls (12.92±1.08 ng/mL; P＜0.001). In CH group, ICAM-1 levels were significantly related to inflammatory activity (P= 0.041) and ALT values (r= 0.77;P＜0.05). VCAM-1 values were significantly increased only in LC patients (P＜0.001) and related to severity of liver impairment.CONCLUSION: These findings suggest that the determination of serum ICAM-1 can be considered as an additional useful marker of hepatocellular necrosis and inflammatory activity in chronic hepatitis, while serum VCAM-1 is an indicator of liver fibrogenesis and severity of disease in cirrhosis.