Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.

Influencing factors of self-management ability among dry eye patients in west China

AIM:To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China.METHODS:A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University.All participants completed the rating scale of health self-management skill for adults(AHSMSRS),Huaxi Emotional-Distress Index(HEI),e-health literacy scale(e-HEALS)and Brief Illness Perception Questionnaire(Brief-IPQ).A generalized linear model was employed to establish a multivariate linear model with demographic data,psychological state,e-HEALS,and illness perception as independent variables and health selfmanagement skill score as the dependent variable.RESULTS:The mean score for health self-management skill was 165.58±15.79.Multivariate analysis revealed that advanced age,better illness perception and improved psychological state were associated with better health selfmanagement ability among dry eye patients.Furthermore,the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y.CONCLUSION:The health self-management ability of dry eye patients in west China is relatively high.Age,duration of disease,illness perception and psychological state are the influencing factors on the health selfmanagement ability of dry eye patients.

Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Self-management in patients with diabetic foot ulcer:a concept analysis

Objective:This paper presents an analysis of the concept of patient outcomes.Methods:The present study conducted searches on various databases,including Wanfang,Sinomed,CNKI,Pub Med,Cochrane Library,Embase,Web of Science,and Ovid.The paper followed the Walker and Avant concept-analysis approach.Results:Initially,899 pieces of literature were identified through the search process,and after screening,41 of them were ultimately included in the analysis.The identified attributes of the concept included(1)capability,(2)decision making,and(3)action.These antecedents were shaped by factors such as illness perception,self-efficacy,and family and social.The consequences included(1)physiological effects,(2)psychological effects,and(3)social influence.Conclusions:The concept analysis of self-management in patients with diabetic foot ulcers(DFUs)not only aids in clinical practice and suppor ts interventions,but also contributes to the development of self-management theory.The common goal of clinical medical staff is to assist DFU patients in improving cognitive ability,making correct self-management decisions,and enhancing self-management behavior.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

Irregular dietary habits as a predictor of stunting occurrence among children under 5 years of age:a literature review

Objective:To identify the illustration of feeding patterns of stunting children using literature review method.Methods:This study was a descriptive narrative research using literature review approach to explore dietary habits of children with stunting problem.All the literature review processes employed Guideline Review measurement of Joanna Briggs Institute.Related ar ticles in literature were obtained from journal databases,such as Pub Med,Science Direct,Google Scholar,and Dimensions through structured research question with Patient,Exposure an interest,Outcome or response(PEO)methods.Results:This study found 2246 published ar ticles from 2018 to 2021 about children with stunting.Screening process was conducted fur ther to eliminate ar ticles with irrelevant titles and abstracts,and also the unsuitable ar ticles with the research question;hence,about 9 ar ticles were eligible to be reviewed ahead.All these ar ticles mentioned that children with irregular dietary habits would likely experience stunting.The low intake of nutritional food became the major predictor of stunting.Conclusions:Inappropriate feeding patterns and the variety of food were being the factors of stunting emergence among children<5 years of age.High consumption of carbohydrates,less animal-based protein,and misunderstanding about intake of sweetenedcondensed milk predisposed children to suffer stunting.

Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

Research on the Influence of Family Education on Children’s Behavioral Habits

Under the background of the all-round deepening of quality education,the cultivation of comprehensive quality has become the main theme of contemporary education reform.Good behavior and habits are of great significance to children’s future learning,growth,and development.Through literature review and other methods,this paper analyzes the current situation of children’s family education and the influence of family education on the cultivation of children’s behavioral habits and provides some strategies for cultivating children’s good behavioral habits in family education.

Consumer Psychology in the Digital Age:How Online Environments Shape Purchasing Habits

The advent of the digital age has profoundly changed consumers’mindsets and habits.The rapid development of e-commerce and the widespread use of mobile applications have created enormous demand for individual recommendation systems based on mass data.This system not only increases the convenience of purchases and conversions but also alters the purchasing behavior of consumers,leading them to make choices subconsciously.Potential risks associated with large-scale data sharing and usage have heightened consumer concerns regarding privacy,thereby weakening the foundational trust in platforms and deterring them from shopping.Additionally,the rapid growth of e-commerce in the digital age,coupled with changing market circumstances,has intensified psychological pressure on consumers,making their decision-making processes more complex and difficult.Furthermore,the program will explore issues related to improving customer experience,developing individual marketing strategies,and designing customer loyalty plans.It will also address questions of privacy in a digital environment,the dilemmas of excessive or disruptive consumption behavior,and the complexity and diversity of consumer behavior in the face of digital change.The objective of this study is to develop a fear study that will enable a better understanding of the impact of online shopping on consumer behavior and provide a strategic guide for retailers to meet the challenges and opportunities presented by the digital age.

The History of Habits:A Critical Unknown in the History of Chinese Medicine

This essay articulates a new conceptual distinction-that between repertories and habits-and urges that the history of habits is the most critical unknown in the study of Chinese medical history.

Eating Habits of High School Students in the District of Bamako in the Context of Nutritional Transition

Introduction: Eating habits are consolidated in early childhood and continue throughout life. Adolescence is a stage of rapid growth linked to puberty affected by the nutritional transition. This study aimed to evaluate the eating habits of high school students in the district of Bamako. Methodology: The cross-sectional, descriptive study was conducted from June 15 to July 4, 2023. The sample size was calculated with the StatCalc program of the Epi 7.2 software. Data was collected using a questionnaire on KoboCollect. Analyses were performed using SPSS 26 software. Results: A total of 2400 high school students were surveyed. The average age of high school students was 16.9 years ± 1.4. The median age was 17, with extremes of 14 and 19. Of the high school students, 53.3% were boys. The sex ratio (M/F) was 1.14. About 89.4% of high school students had a Smartphone. Among high school students, 51.1% did not engage in physical activity outside of high school. Rice was the cereal most consumed by high school students (99.2%). Consumption of fish and seafood was very low (25.5%). Soft drinks were consumed on average 4.2 days/week. In addition, 60.8% of high school students consumed energy drinks. Certain eating behaviors were found in this study, such as nibbling (38.5%), eating in front of screens (79.0%), and skipping meals (46.1%). Conclusion: The most consumed cereal by high school students was rice. The consumption of ultra-processed products and sedentary leisure are habits to be monitored in the context of the prevention of food-related non-communicable diseases among high school students in the district of Bamako.

Factors related to self-management behavior among persons with mild-to-moderate chronic obstructive pulmonary disease in Wenzhou,China

Objective:To describe the self-management(SM)behavior among persons with mild-to-moderate chronic obstructive pulmonary disease(COPD),and it examines the correlation between COPD knowledge,self-efficacy,perceived social support,and SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Methods:A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou,China.Research instruments include a demographic data questionnaire,COPD SM scale,COPD knowledge questionnaire,6-item chronic disease self-efficacy scale,and perceived social suppor t scale.Descriptive statistics and Pearson's Correlation were used for data analysis.Results:The findings show that the mean score of COPD SM scale was 2.70(SD=0.45).The Pearson correlation analysis revealed that the COPD knowledge(r=0.47,P<0.001),self-efficacy(r=0.28,P=0.001),and perceived social support(r=0.48,P<0.001)were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou,China.Conclusions:The findings indicate that disease knowledge,self-efficacy,and perceived social support were related to SM behavior in persons with mild-to-moderate COPD,which provides a theoretical basis for developing SM interventions for persons with mildto-moderate COPD and improving this population's SM behavior.

Morphological Characteristics, Ecological Habits and Utilization Value of Acrossocheilus fasciatus

Acrossocheilus fasciatus is a small omnivorous benthic fish widely distributed in the middle and upper reaches of mountain streams and small rivers in hilly and mountainous areas,suitable for stocking in the forks of reservoirs,streams or rivers,and artificial culture in larger ponds and eel farms,etc.The paper describes the morphological characteristics,ecological habits,geographic distribution,resources and utilization value of A.fasciatus,in order to provide scientific and practical reference information for individuals or enterprises interested in A.fasciatus culture and promote the sustainable development of A.fasciatus culture industry.

Research on feeding habits and stomach fungi in Eothenomys miletus from Hengduan mountain regions

Eothenomys miletus(E.miletus)is one of the rodent species found in Yunnan,and it has caused significant harm to local agricultural production.In this study,we aimed to investigate the differences in feeding habits and stomach fungi of E.miletus across different areas in the Hengduan mountain regions.By exploring the main factors affecting the feeding habits and fungi of E.miletus,this study provides a theoretical basis for the prevention and control of this species.We collected E.miletus specimens from five regions,namely Deqin,Xianggelila,Lijiang,Jianchuan,and Ailaoshan.We measured their feeding habits and the types of fungi in their stomachs using high-throughput sequencing technology.The results showed that E.miletus primarily fed on Poaceae,Oxalidaceae,Asteraceae,and Fabaceae.Food diversity of E.miletus in Ailaoshan and Jianchuan was significantly lower than in the other three regions.As for stomach fungi,Ascomycota and Basidiomycota were the absolute dominant sectors.Changes in the diversity of fungi in different regions were consistent with changes in food diversity.The diversity of fungi in Ailaoshan and Jianchuan regions was lower than in the other three regions.These findings suggest that the feeding habits of E.miletus in different regions were affected by plant species,which,in turn,affects the diversity of fungi in their stomachs.

Genome-Wide Association Study and Genomic Selection for Plant Growth Habit in Peanuts Using the USDA Public Data

Peanut (Arachis hypogaea L.) production is valued at $1.28 billion annually in the USA. Plant growth habit can be used to determine plant population density and cultivation practices a given farmer uses. Erect plants are generally more compact and can be more densely planted unlike plants with more prostrate growth. The objectives of this study were to analyze publicly available datasets to identify single-nucleotide polymorphism (SNP) markers associated with plant growth habit in peanuts and to conduct genomic selection. A genome-wide association study (GWAS) was used to identify SNPs for growth habit type among 775 USDA peanut accessions. A total of 13,306 SNPs were used to conduct GWAS using five statistical models. The models used were single-marker regression, generalized linear model (PCA), generalized linear model (Q), mixed linear model (PCA), and mixed linear model (Q) and a total of 181, 1, 108, 1, and 10 SNPs were found associated with growth habit respectively. Based on this dataset, results showed that genomic selection can achieve up to 61% accuracy, depending on the training population size being used for the prediction. SNP AX-176821681 was found in all models. Gene ontology for this location shows an annotated gene, Araip.0F3YM, found 2485 bp upstream of this SNP and encodes for a peptidyl-prolyl cis-trans isomerase. To the best of our knowledge, this is the first report identifying molecular markers linked to plant growth habit type in peanuts. This finding suggests that a molecular marker can be developed to identify specific plant growth habits in peanuts, enabling early generation selection by peanut breeders.

Development of a Dietary Habit Self-Management Skills Scale for Post-Gastrectomy Cancer Patients in Japan

Purpose: The purpose of the present study was to develop a Dietary Habit Self-Management Skill (DHSMS) scale, and to test the reliability and validity of this scale. Methods: A questionnaire survey was then conducted using a 69-item DHSMS scale (second draft) for which content validity had been confirmed. The participants were post-gastrectomy cancer patients aged from 40 to under 80 years who had undergone initial gastrectomy with an interval of from 1 month since discharge to <3 years post-operative. Results: The scale is a second-order factor model with “Dietary habit self-management skills” as a higher-order factor, four factors—”Skill to form partnerships with other important people”, “Skill to prevent or cope with post-gastrectomy disorder”, “Skill to grasp issues accompanying post-gastrectomy disorder”, and “Self-efficacy”—and 27 items. The construct validity of the scale was confirmed. Cronbach’s alpha coefficient of the DHSMS scale was 0.915. The criterion- related validity of the DHSMS scale was confirmed based on the correlations between overall DHSMS scale scores and “Number of post-gastrectomy disorder symptoms experienced”, the score for the subscale “Skill to grasp issues accompanying post-gastrectomy disorder” and “Number of post-gastrectomy disorder symptoms experienced”, and the subscale “Self-efficacy” and the SF-8. Discussion: By using patients’ self-administered DHSMS scale scores, medical professionals are able to assess the level of a patient’s self-management skills and the status of their dietary habits as a result of post-gastrectomy disorder.

Life Origin in the Milky Way Galaxy: II. Scanning for Habitable Stellar Systems on Behalf of Future Space Missions

The possibility of the life origin in the stellar systems, located at a distance of ~200 pc from the solar system, was investigated. The stars, in the spectrums of which C (carbon), O (oxygen), N (nitrogen), and P (phosphorus) are found, are called DNA-stars. Based on stellar abundances a new method for searching for habitable exoplanets has been developed and a list of 48 DNA-stars in the solar neighborhood, on which life is possible, has been defined. The quota of DNA-stars is equal 1.3% of the total amount of Hypatia Stellar Catalog. Only three DNA-stars out of selected 48 stars belong to the spectral class as our Sun (G2V). The closest to the solar system is the DNA-star with the number HIP 15510, which belongs to the G8V class and is 6 pc away from the solar system. Nine DNA-stars, which have the highest chemical similarity with solar spectrum, were identified. It is identified that one of these nine stars, HIP 24681, has six planets.

Impact of Exercise Atmosphere on Adolescents’Exercise Behavior:Chain Mediating Effect of Exercise Identity and Exercise Habit

Appropriate physical exercise has a positive impact on adolescents’physical and mental health,but there is a serious lack of physical exercise among Chinese adolescents.How to shape their exercise behavior(EB)has become an important task in promoting their development.A questionnaire survey was conducted using stratified cluster random sampling on three middle schools by class in Zhejiang Province,China to investigate the impact of exercise atmosphere(EA)on adolescents’exercise behavior and the mediating role of exercise identity(EI)and exercise habit(EH).806 adolescents were investigated by the Exercise Atmosphere Scale(EAS),Exercise-Identity Scale(EIS),Self-Report Habit Index(SRHI),and Physical Activity Rating Scale(PARS-3).The results show that:There is a significant positive correlation between each two of exercise atmosphere,exercise identity,exercise habit,and exercise behavior(p<0.05).Exercise atmosphere could not only directly affect adolescents’physical exercise behavior but can also indirectly affect their physical exercise behavior through the mediating effect of exercise identity and exercise habit,involving three mediating pathways,namely,the mediating path through exercise identity,the mediating pathway through exercise habit and the chain mediating pathway through exercise identity and exercise habit.The direct effect of exercise atmosphere on exercise behavior was 0.459(p<0.01),accounting for 62.62% of the total effect of 0.733,and its indirect effect was 0.274,accounting for 37.28% of the total effect.To a certain extent,the mediating effect model reveals the mechanism of exercise atmosphere affecting exercise behavior and has a certain reference value for promoting adolescents’exercise behavior.We should start by creating an exercise atmosphere,cultivating exercise identity,and enhancing exercise habits to help teenagers form active physical exercise behaviors.

Habitable Land Will Soon Become the World’s Scarcest Resource: Why Appalachia Should Choose Climate Change Havens over Millionaire Estates and Golf Courses

This research advocates for the construction of Climate Change Haven Communities across the Appalachian Region. The proposed development plan can be extended to the northern tier states across the US and also to the northern and mountainous regions of Europe and Asia. We present an analogy to the earlier climate change period of the Last Glacial Maximum/“Ice Age” in which these same northern regions of the planet were covered in ice sheets making them uninhabitable for most humans and many plant and animal species. In some significant ways, the Ice Age scenario can be a reverse-model for our current climate crisis. We also advocate strongly for the prevention of upscale real estate development projects in these same regions of the globe, as these will foreclose the possibility of safely sheltering the millions of persons who will be displaced by climate change over the next 5 to 10 years.