scholarly journals Artificial intelligence decision-making in mobile health

2019 ◽  
Vol 41 (5) ◽  
pp. 20-24 ◽  
Author(s):  
Marianne Menictas ◽  
Mashfiqui Rabbi ◽  
Predrag Klasnja ◽  
Susan Murphy
Keyword(s):  
Chronic Disease ◽  
Healthy Eating ◽  
Chronic Conditions ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Physically Active ◽  
Prevention And Health Promotion ◽  
The Usa ◽  
The Many ◽  
Sleeping Habits

It is likely that you or someone you know is affected by a chronic health condition. For example, a staggering six in 10 adults in the USA are currently suffering from a chronic disease (National Center for Chronic Disease Prevention and Health Promotion, 2019). Unfortunately, chronic conditions are not treatable overnight, but they can often be improved by regular incorporation of preventative behaviours (e.g., taking medication, healthy sleeping habits, being physically active, healthy eating, etc.). However, due to the many contingencies that arise in our lives, regular incorporation of healthy behaviours is difficult, and often when we need help in enacting these behaviours, support from clinical professionals is not available.

Multimorbidity is associated with higher out-of-pocket spending: a study of older Australians with multiple chronic conditions

2013 ◽  
Vol 19 (2) ◽  
pp. 144 ◽  
Author(s):  
Ian McRae ◽  
Laurann Yen ◽  
Yun-Hee Jeon ◽  
Pushpani M. Herath ◽  
Beverley Essue
Keyword(s):  
Chronic Disease ◽  
Chronic Conditions ◽  
Financial Burden ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Economic Consequences ◽  
Multiple Chronic Conditions ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Related

Most older Australians have at least one chronic health condition. The management of chronic disease is associated with potentially severe economic consequences for patients and their households, partially due to the financial burden associated with out-of-pocket costs for medical and health-related care. A questionnaire was mailed to a cross-sectional sample of older Australians in mid-2009, with 4574 responding. Multivariate logistic regression models were developed to investigate the relationships between multimorbidity and out-of-pocket spending on medical and health-related expenses, including the factors associated with severe financial stress among older Australians. We found a positive relationship between number of chronic conditions and out-of-pocket spending on health and that people with multiple chronic conditions tend to be on lower incomes. People with five or more chronic conditions spent on average five times as much on their health as those with no diagnosed chronic conditions and each additional chronic disease added 46% to the likelihood of a person facing a severe financial burden due to health costs. While health policy may minimise out-of-pocket spending for individual conditions, costs compound rapidly for patients with multiple conditions and this burden falls most heavily on those with the lowest incomes.

scholarly journals A Postcard From Italy: Challenges and Psychosocial Resources of Partners Living With and Without a Chronic Disease During COVID-19 Epidemic

2020 ◽  
Vol 11 ◽  
Author(s):  
Giada Rapelli ◽  
Giulia Lopez ◽  
Silvia Donato ◽  
Ariela Francesca Pagani ◽  
Miriam Parise ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronically Ill ◽  
Well Being ◽  
Chronic Health Condition ◽  
Protective Role ◽  
Health Condition ◽  
World Health ◽  
Italian Population ◽  
Cross Sectional ◽  
Psychological Well Being

The new Coronavirus (COVID-19) has been declared a global pandemic by the World Health Organization (WHO). The sudden outbreak of this new virus and the measure of lockdown adopted to contain the epidemic have profoundly changed the lifestyles of the Italian population, with an impact on people’s quality of life and on their social relationships. In particular, due to forced and prolonged cohabitation, couples may be subject to specific stressors during the epidemic. In addition, living with a chronic health condition may add specific challenges to the ones posed by the epidemic itself. The present cross-sectional study aimed to provide a picture of the challenges as well as the resources for both individual and relational well-being of Italian individuals in a couple relationship (N = 1921), with a specific attention to the comparison between individuals living with and without a chronic disease. Results showed that people with a chronic disease had lower psychological well-being and more fears and worries about the COVID-19. People with a chronic disease perceived fewer resources than healthy people. Moreover, the challenges are shown to be associated with less psychological well-being and high pessimism about the future. Instead individual, relational, and social resources play a protective role during the pandemic for both healthy and chronically ill people.

Chronic Conditions, Socioeconomic Risks, and Behavioral Problems in Children and Adolescents

PEDIATRICS ◽  
1990 ◽  
Vol 85 (3) ◽  
pp. 267-276 ◽  
Author(s):  
Steven L. Gortmaker ◽  
Deborah K. Walker ◽  
Michael Weitzman ◽  
Arthur M. Sobol
Keyword(s):  
Behavior Problems ◽  
Behavioral Problems ◽  
Chronic Conditions ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Chronic Health ◽  
Physical Conditions ◽  
Childhood Conditions ◽  
Chronic Physical Conditions ◽  
Chronic Childhood

Children with a chronic health condition have long been considered at excess risk for psychosocial morbidity. Despite an increasing prevalence of chronic childhood conditions and heightened concerns for the quality of life of the chronically ill, population-based studies of behavior problems among children with chronic physical conditions are rare. Findings on the epidemiology of behavior problems in a nationally representative sample of 11 699 children and adolescents aged 4 to 17 years in the United States are reported. Data included a 32-item parent-reported behavior problem index, measures of chronic childhood conditions, measures of school placement and performance, and sociodemographic variables. Analyses confirmed that chronic physical conditions were a significant risk factor for behavior problems, independent of sociodemographic variables. Among children these differences were observed across all subscales; among adolescents the largest differences were found for the Depression/Anxiety and Peer Conflict/Social Withdrawal subscales. Rates of extreme behavior problem scores (those in the top 10th percentile) were 1.55 times higher among children with a chronic health condition compared with children without a chronic condition (95% confidence interval 1.29 to 1.86). These independent odds were lowered to 1.44 when covariates for confounding were introduced via a multivariate logistic regression. Other independent risks included the absence of either biologic parent (odds ratio 2.05), male gender (1.53), low vs high family income (1.30), low vs high maternal education (1.51), and young vs old maternal age at childbirth (2.57). Chronic health conditions were also a major risk factor for placement in special education classes and having to repeat grades. Despite evidence for effective interventions, health services for children with chronic conditions—particularly mental health services—remain fragmented, signaling the need for increased attention to behavioral problems and their treatment among all health professionals caring for children.

scholarly journals Risk of Poor Outcomes with COVID-19 Among U.S. Detained Immigrants: A Cross-Sectional Study

2021 ◽  
Author(s):  
Caitlin Patler ◽  
Altaf Saadi
Keyword(s):  
Chronic Conditions ◽  
Chronic Health Condition ◽  
Cross Sectional Study ◽  
Health Condition ◽  
Health Conditions ◽  
Multiple Chronic Conditions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Poor Outcomes ◽  
Immigrant Detention

AbstractConditions in immigrant detention centers facilitate the spread of infectious diseases like COVID-19. However, there is no publicly-available data on detainees’ health characteristics, making it difficult to estimate the prevalence of risk among detained people. We use cross-sectional survey data from the only survey of detained immigrants, conducted in California in 2013–2014, to assess the prevalence and health-related correlates of health conditions among detained immigrants. We calculated the proportion of detained immigrants with chronic conditions, their interruptions in care, and stratified by sociodemographic characteristics, evaluating differences using two-tailed tests. Among 529 detained immigrants, 42.5% had at least one chronic health condition; 15.5% had multiple chronic conditions. 20.9% experienced disruption in care upon entering detention. 95.6% had access to stable housing in the U.S. Many detained people face health conditions that confer greater risk for poor outcomes with COVID-19. Stable residence can facilitate release of detainees via Alternatives to Detention programs.

scholarly journals Social inequality and the syndemic of chronic disease and COVID-19: county-level analysis in the USA

2021 ◽  
pp. jech-2020-215626
Author(s):  
Nazrul Islam ◽  
Ben Lacey ◽  
Sharmin Shabnam ◽  
A Mesut Erzurumluoglu ◽  
Hajira Dambha-Miller ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Social Vulnerability ◽  
Chronic Conditions ◽  
Vulnerability Index ◽  
Social Disadvantage ◽  
Social Vulnerability Index ◽  
Incidence And Mortality ◽  
The Usa ◽  
Rate Ratios

BackgroundGiven the effect of chronic diseases on risk of severe COVID-19 infection, the present pandemic may have a particularly profound impact on socially disadvantaged counties.MethodsCounties in the USA were categorised into five groups by level of social vulnerability, using the Social Vulnerability Index (a widely used measure of social disadvantage) developed by the US Centers for Disease Control and Prevention. The incidence and mortality from COVID-19, and the prevalence of major chronic conditions were calculated relative to the least vulnerable quintile using Poisson regression models.ResultsAmong 3141 counties, there were 5 010 496 cases and 161 058 deaths from COVID-19 by 10 August 2020. Relative to the least vulnerable quintile, counties in the most vulnerable quintile had twice the rates of COVID-19 cases and deaths (rate ratios 2.11 (95% CI 1.97 to 2.26) and 2.42 (95% CI 2.22 to 2.64), respectively). Similarly, the prevalence of major chronic conditions was 24%–41% higher in the most vulnerable counties. Geographical clustering of counties with high COVID-19 mortality, high chronic disease prevalence and high social vulnerability was found, especially in southern USA.ConclusionSome counties are experiencing a confluence of epidemics from COVID-19 and chronic diseases in the context of social disadvantage. Such counties are likely to require enhanced public health and social support.

scholarly journals Perceived Neighborhood Crime Safety Moderates the Association Between Racial Discrimination Stress and Chronic Health Conditions Among Hispanic/Latino Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Elizabeth L. Budd ◽  
Nicole R. Giuliani ◽  
Nichole R. Kelly
Keyword(s):  
Chronic Disease ◽  
Racial Discrimination ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Neighborhood Crime ◽  
Chronic Health ◽  
Neighborhood Walkability ◽  
Latino Adults

Background: Little is known about the link between perceived neighborhood walkability and prevalence of chronic disease. Even less is known regarding this association among Hispanic/Latino adults, despite exhibiting high rates of chronic diseases. Stress due to racial discrimination is a harmful social determinant of health in Hispanics/Latinos. Having both low perceived neighborhood walkability and high racial discrimination stress may exacerbate the chronic disease status of Hispanics/Latinos. Among a U.S. national sample of Hispanic/Latino adults, this cross-sectional study aims to examine (1) the associations among overall perceived neighborhood walkability, racial discrimination stress, and having a chronic health condition; and (2) whether overall perceived neighborhood walkability moderates the hypothesized association between racial discrimination stress and having a chronic health condition.Methods: In January 2018, 798 Hispanic/Latino adults (M age = 39.7 years, SD = 15.1; 58.6% female; 70.0% U.S. born; 52.0% Mexican/Mexican American) responded to a survey via Qualtrics Panels. Surveys included the Neighborhood Environment Walkability Scale-Abbreviated, Hispanic Stress Inventory-2, and self-reported presence/absence of chronic health conditions (e.g., hypertension, heart disease). A logistic regression was conducted testing for the moderation of the main effect of racial discrimination stress on the presence of a chronic health condition by overall perceived neighborhood walkability.Results: After controlling for age, body mass index, and income, racial discrimination stress was inversely associated with overall perceived neighborhood walkability (b = −0.18, p < 0.001) and positively associated with having a chronic health condition (OR = 1.02; 95% CI [1.00, 1.03]). While overall perceived neighborhood walkability was not associated with having a chronic health condition, perceived crime safety was inversely associated with having a chronic health condition (OR = 0.94; 95% CI [0.89, 0.99]). Perceived crime safety moderated the positive association between discrimination stress and having a chronic health condition, such that the association was only significant among those who perceived their neighborhood to be less safe (β = −0.004, 95% CI [−0.01, −0.00]).Conclusions: Overall perceived neighborhood walkability was inversely associated with racial discrimination stress, but not associated with having a chronic health condition. Perceived neighborhood crime safety, but not infrastructure or aesthetics, matters when it comes to the link between racial discrimination stress and having a chronic health condition among Hispanics/Latinos.

scholarly journals Mapping Three Versions of the International Classification of Diseases to Categories of Chronic Conditions

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Amani F. Hamad ◽  
Shantanu Banerji ◽  
Pingzhao Hu ◽  
Mohammad Jafari Jozani ◽  
Elizabeth Wall-Wieler ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
International Classification Of Diseases ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Health Data ◽  
International Classification ◽  
Chronic Health ◽  
Classification Of Diseases ◽  
Icd 10

IntroductionAdministrative health data capture diagnoses using the International Classification of Diseases (ICD), which has multiple versions over time. To facilitate longitudinal investigations using these data, we aimed to map diagnoses identified in three ICD versions – ICD-8 with adaptations (ICDA-8), ICD-9 with clinical modifications (ICD-9-CM), and ICD-10 with Canadian adaptations (ICD-10-CA) – to mutually exclusive chronic health condition categories adapted from the open source Clinical Classifications Software (CCS). MethodsWe adapted the CCS crosswalk to 3-digit ICD-9-CM codes for chronic conditions and resolved the one-to-many mappings in ICD-9-CM codes. Using this adapted CCS crosswalk as the reference and referring to existing crosswalks between ICD versions, we extended the mapping to ICDA-8 and ICD-10-CA. Each mapping step was conducted independently by two reviewers and discrepancies were resolved by consensus through deliberation and reference to prior research. We report the frequencies, agreement percentages and 95% confidence intervals (CI) from each step. ResultsWe identified 354 3-digit ICD-9-CM codes for chronic conditions. Of those, 77 (22%) codes had one-to-many mappings; 36 (10%) codes were mapped to a single CCS category and 41 (12%) codes were mapped to combined CCS categories. In total, the codes were mapped to 130 adapted CCS categories with an agreement percentage of 92% (95% CI: 86%–98%). Then, 321 3-digit ICDA-8 codes were mapped to CCS categories with an agreement percentage of 92% (95% CI: 89%–95%). Finally, 3583 ICD-10-CA codes were mapped to CCS categories; 111 (3%) had a fair or poor mapping quality; these were reviewed to keep or move to another category (agreement percentage=77% [95% CI: 69%–85%]). ConclusionsWe developed crosswalks for three ICD versions (ICDA-8, ICD-9-CM, and ICD-10-CA) to 130 clinically meaningful categories of chronic health conditions by adapting the CCS classification. These crosswalks will benefit chronic disease studies spanning multiple decades of administrative health data.

Risk Factors for Developing Comorbid Sleeping Problems: Results of a Survey of 1,925 Women Over 50 With a Chronic Health Condition

2019 ◽  
Vol 32 (5-6) ◽  
pp. 472-480 ◽  
Author(s):  
Sophie Meredith ◽  
Jane Frawley ◽  
David Sibbritt ◽  
Jon Adams
Keyword(s):  
Service Use ◽  
Sleep Problems ◽  
Significant Risk ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Medical Outcomes ◽  
Physically Active ◽  
Chronic Health ◽  
Sleeping Problems ◽  
Outcomes Study

Objective: To test the association between sleeping problems and multiple epidemiological factors among women over 50 with a chronic condition. Method: The Medical Outcomes Study Sleep Scale (MOS-SS) was employed to measure sleep problems among 1,925 participants with chronic conditions who also responded to questions about health service use, self-care and demographics. Results: About 43% of women reported sleeping problems. Women were more likely to have a sleeping problem if they reported some difficulties with available income, odds ratio (OR) = 1.61; 95% confidence interval (CI): [1.27, 2.04]; p < .005, or were struggling with available income (OR = 2.84; 95% CI: [2.04, 3.96]; p < .005). Women were less likely to have sleeping problems if they were highly physically active (OR = .63; 95% CI: [0.51, 0.79]; p < .005). Discussion: Medical professionals should be aware of the significant risk of sleeping problems among mid-age and older women with chronic health conditions, particularly those who have financial concerns, are sedentary, or are not highly physically active.

The “Green Revolution”, Ethics and Engineering in the USA

1992 ◽  
Vol 25 (9) ◽  
pp. 235-243 ◽  
Author(s):  
W. F. Garber ◽  
D. R. Anderson
Keyword(s):  
Green Revolution ◽  
Final Analysis ◽  
Clean Water ◽  
Ethical Decisions ◽  
Societal Needs ◽  
Economic Methods ◽  
The Usa ◽  
Scientific Technical ◽  
The Many ◽  
Technical Organizations

Ethical behavior applied to any activity within our society is, in the final analysis, the responsibility of each of the individuals involved in that activity. The “Green Revolution”, which erupted in the U.S.A. resulted in conditions which presented difficult ethical decisions to individuals and organizations working on ecological/environmental questions. The problems posed are best observed in an examination of the enforcement of the U.S.A. Clean Water Act where construction workers, the media, regulators, lawyers, politicians, environmentalists, treatment facility operators, scientists, engineers, academics and scientific/technical organizations all substantially benefited. Unfortunately this legislation does not require ecological or net environmental improvement. It requires equitable distribution of the costs of compliance throughout the nation. This has encouraged nonscientific standards and criteria, and a narrow focus, which have in turn resulted in both nonresponsible environmental results, and costs such that other important ecological/societal needs cannot be funded. All societies, whether developing or industrialized, must conserve their resources by utilizing scientific/economic methods to attack clean water and similar problems if they are to really improve their ecology/environment. Since this procedure is minimally used in the U.S.A., what should or can be the ethical positions of the many individuals and groups now benefiting by the present flawed system?

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