School performance, psychiatric comorbidity, and healthcare utilization in pediatric multiple sclerosis: A nationwide population-based observational study

Background: Pediatric multiple sclerosis (MS) may hamper educational achievements due to psychiatric comorbidity and cognitive impairment. Our aims were to investigate school performance, psychiatric comorbidity, and healthcare utilization following pediatric MS and to differentiate between disability in MS and that arising from a non-brain-related chronic disease. Methods: We included all children (<18 years) with MS onset during 2008–2015 in Denmark with a medical record–validated MS diagnosis. The control groups were children from the general population or children with non-brain-related chronic diseases. Outcomes were register-based on 9–12 grade point average, psychiatric comorbidity, and healthcare visits. Results: Cohorts were children with MS ( n = 92), control children matched to children with MS ( n = 920), children with non-brain-related chronic diseases ( n = 9108), and “healthy” children with neither MS nor brain-related chronic disease ( n = 811,464). School performance in grades 9–12 was similar, but children with MS compared to those with non-brain-related chronic disease had an almost doubled hazard for psychiatric comorbidity (hazard ratio = 1.87; 95% confidence interval = 1.38–2.53; p < 0.0001) and a higher rate of all hospital visits ( p < 0.0001) but a lower rate of hospital admissions ( p = 0.001). Conclusion: Children with MS have a seemingly standard school performance but increased psychiatric comorbidity and a high rate of healthcare utilization.

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MicroRNA expression classification for pediatric multiple sclerosis identification

Journal of Ambient Intelligence and Humanized Computing ◽

10.1007/s12652-021-03091-2 ◽

2021 ◽

Author(s):

Gabriella Casalino ◽

Giovanna Castellano ◽

Arianna Consiglio ◽

Nicoletta Nuzziello ◽

Gennaro Vessio

Keyword(s):

Machine Learning ◽

Multiple Sclerosis ◽

Expression Profiles ◽

Healthy Children ◽

Multifactorial Diseases ◽

Hyperactivity Disorder ◽

Pediatric Multiple Sclerosis ◽

Mirna Expression Profiles ◽

Selection Algorithms ◽

Expression Classification

Abstract MicroRNAs (miRNAs) are a set of short non-coding RNAs that play significant regulatory roles in cells. The study of miRNA data produced by Next-Generation Sequencing techniques can be of valid help for the analysis of multifactorial diseases, such as Multiple Sclerosis (MS). Although extensive studies have been conducted on young adults affected by MS, very little work has been done to investigate the pathogenic mechanisms in pediatric patients, and none from a machine learning perspective. In this work, we report the experimental results of a classification study aimed at evaluating the effectiveness of machine learning methods in automatically distinguishing pediatric MS from healthy children, based on their miRNA expression profiles. Additionally, since Attention Deficit Hyperactivity Disorder (ADHD) shares some cognitive impairments with pediatric MS, we also included patients affected by ADHD in our study. Encouraging results were obtained with an artificial neural network model based on a set of features automatically selected by feature selection algorithms. The results obtained show that models developed on automatically selected features overcome models based on a set of features selected by human experts. Developing an automatic predictive model can support clinicians in early MS diagnosis and provide new insights that can help find novel molecular pathways involved in MS disease.

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Investigating the attitude of patients with chronic diseases about using mobile health

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320000070 ◽

2020 ◽

Vol 36 (2) ◽

pp. 139-144 ◽

Cited By ~ 1

Author(s):

Reza Abbasi ◽

Sahar Zare ◽

Leila Ahmadian

Keyword(s):

Multiple Sclerosis ◽

Chronic Disease ◽

Chronic Diseases ◽

Mobile Health ◽

Asthmatic Patient ◽

Health Conditions ◽

Asthmatic Patients ◽

Patients With Diabetes ◽

Mhealth Technology ◽

Willingness To Use

BackgroundMobile health (mHealth) due to its popularity and accessibility can be widely applied in different health areas such as the management of chronic diseases. However, its success depends on the acceptance of their users. Therefore, the aim of this study was to survey the attitudes of patients with chronic disease toward mHealth technology and their willingness to use it.MethodsThis study was conducted within a 2-year period (2016–2018) to determine and compare the attitude and willingness of patients with asthma, diabetes, and multiple sclerosis (MS) toward using mHealth technology in a province in Iran.ResultsIn total, 222 patients participated in this study. More than 93 percent of the patients with diabetes and MS, and 65 percent of the asthmatic patients preferred using mHealth services rather than consulting a physician (p < .0001). About 98, 94, and 49 percent of the MS, diabetic, and asthmatic patients, respectively felt comfortable if their health conditions checked by physicians through mHealth technology (p < .0001).ConclusionsOur results showed that the majority of the patients felt comfortable and preferred using mHealth technology rather than consulting the physicians. The attitudes of diabetic and MS patients toward mHealth technology were rather more positive compared to asthmatic patient attitude. These results may be helpful for the developers of mHealth technology, and researchers who design mHelath interventions for patients with chronic disease.

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Needs and Experiences of Children and Adolescents with Pediatric Multiple Sclerosis and Their Caregivers: A Systematic Review

Children ◽

10.3390/children8060445 ◽

2021 ◽

Vol 8 (6) ◽

pp. 445

Author(s):

Shashank Ghai ◽

Elisabeth Kasilingam ◽

Roberta Lanzillo ◽

Masa Malenica ◽

Vincent van Pesch ◽

...

Keyword(s):

Mental Health ◽

Multiple Sclerosis ◽

Social Support ◽

Systematic Review ◽

Social Relationships ◽

School Performance ◽

Mixed Method ◽

Pediatric Multiple Sclerosis ◽

Negative Impacts

In the present study we conduct a systematic review to evaluate the needs and experience of people with pediatric multiple sclerosis (MS) and their caregivers. The literature search was conducted across 10 academic databases, adhering to PRISMA-P guidelines. Quality appraisal was conducted using the mixed method appraisal test for individual studies, and GRADE-CERQual to establish overall confidence of findings. Results were analyzed using a process of narrative synthesis. We identified 26 studies which included 2253 children/adolescents with MS (CAMS) and 1608 caregivers. MS was reported to negatively impact experiences for CAMS in domains such as of school performance, social relationships, mental health, and overall physical functioning. Specifically, fatigue and social support were reported as the most important barriers and facilitators for CAMS, respectively. In terms of caregiver experience, negative impacts were reported on social functioning, mental health, and quality of life. Additionally, lack of awareness concerning MS was one of the biggest challenges reported. Caregivers expressed needs for psychological and social support. This study provides the first evidence regarding the needs and experiences of CAMS and their caregivers. Findings can be used to address policy gaps for supporting families affected by pediatric MS.

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Factors Affecting Healthcare Utilization among Patients with Single and Multiple Chronic Diseases

Iranian Journal of Public Health ◽

10.18502/ijph.v49i12.4820 ◽

2020 ◽

Author(s):

Ka Young KIM ◽

Eunmi LEE ◽

Jeonghyun CHO

Keyword(s):

Chronic Disease ◽

Health Status ◽

Chronic Diseases ◽

Healthcare Utilization ◽

Private Insurance ◽

Subjective Health ◽

Subjective Health Status ◽

Factors Affecting ◽

Andersen Model ◽

Multiple Chronic Diseases

Background: We aimed to investigate the factors affecting healthcare utilization among patients with single and multiple chronic diseases using the Andersen healthcare utilization model. Methods: We used a combination of the data from the sixth and seventh Korea National Health and Nutrition Survey (2014–2016). The study population was 3,901 patients with single chronic disease and 1,829 patients with multiple chronic diseases as defined by the WHO. Participants were aged 19 yr or older. Multiple regression analysis was employed using the Andersen model to identify factors affecting healthcare utilization (inpatient and outpatient). Results: According to the Andersen model (comprising predisposing, enabling, and need factors and health behaviors), the factors that increased outpatients with single chronic disease were female, being aged 65 yr or older, having basic livelihood security benefit, immobility, and poor subjective health status. Factors that increased inpatients with single chronic disease were being aged under 65, having private insurance, immobility, poor subjective health status, and nondrinking. Moreover, factors that increased outpatients and inpatients with multiple chronic diseases were female, being aged under 65, immobility, and poor subjective health status and immobility, poor subjective health status, nondrinking, and not engaging in physical activity, respectively Conclusion: We identified factors affecting outpatient and inpatient care utilization among patients with single and multiple chronic diseases, using the Andersen healthcare utilization model. The findings can be used as foundational data to develop preventive and management strategies in healthcare utilization among patients with single and multiple chronic diseases.

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Energy management education and occupation-related outcomes in adults with chronic diseases: A scoping review

British Journal of Occupational Therapy ◽

10.1177/0308022620904327 ◽

2020 ◽

Vol 83 (9) ◽

pp. 561-575

Author(s):

Janine F Farragher ◽

Sarbjit V Jassal ◽

Sara McEwen ◽

Helene J Polatajko

Keyword(s):

Multiple Sclerosis ◽

Chronic Disease ◽

Chronic Diseases ◽

Energy Management ◽

Management Education ◽

Relevant Literature ◽

Management Program ◽

Occupational Performance ◽

Group Setting ◽

The Impact

Introduction Fatigue is a pervasive symptom of chronic disease that often interferes with occupational performance. Our objective was to describe what is known about energy management education and occupation-related outcomes in adults with chronic diseases. Methods Seven electronic databases were searched for relevant literature published before August 2019. Eligible articles were full-text, available in English, and studied energy management education in adults with a chronic disease. The first author assessed article eligibility with validation from a second reviewer, extracted characteristics of included studies, and described them using descriptive statistics. A narrative synthesis of findings was conducted for each chronic disease population. Results Forty-four studies addressed eight different chronic disease populations. The most common program delivery format was face-to-face in a group setting (42%), 39% of programs were informed by a learning theory, and their median cumulative length was 8 hours. Positive outcomes were associated with a specific, group-based energy management program in people with multiple sclerosis. The evidence on other energy management programs and in other chronic disease populations was more limited and inconclusive. Conclusions Further research is needed to understand the impact of energy management education in chronic disease populations beyond multiple sclerosis, and its impact on occupational performance.

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Impacts of chronic disease prevention programs implemented by private health insurers: a systematic review

BMC Health Services Research ◽

10.1186/s12913-021-07212-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sithara Wanni Arachchige Dona ◽

Mary Rose Angeles ◽

Natasha Hall ◽

Jennifer J. Watts ◽

Anna Peeters ◽

...

Keyword(s):

Chronic Disease ◽

Disease Prevention ◽

Chronic Diseases ◽

Hospital Admissions ◽

Grey Literature ◽

Significant Proportion ◽

Chronic Disease Prevention ◽

Public Healthcare ◽

Prevention Interventions ◽

Health Insurers

Abstract Background Chronic diseases contribute to a significant proportion (71%) of all deaths each year worldwide. Governments and other stakeholders worldwide have taken various actions to tackle the key risk factors contributing to the prevalence and impact of chronic diseases. Private health insurers (PHI) are one key stakeholders, particularly in Australian health system, and their engagement in chronic disease prevention is growing. Therefore, we investigated the impacts of chronic disease prevention interventions implemented by PHI both in Australia and internationally. Method We searched multiple databases (Business Source Complete, CINAHL, Global Health, Health Business Elite, Medline, PsycINFO, and Scopus) and grey literature for studies/reports published in English until September 2020 using search terms on the impacts of chronic disease prevention interventions delivered by PHIs. Two reviewers assessed the risk of bias using a quality assessment tool developed by Effective Public Healthcare Panacea Project. After data extraction, the literature was synthesised thematically based on the types of the interventions reported across studies. The study protocol was registered in PROSPERO, CRD42020145644. Results Of 7789 records, 29 studies were eligible for inclusion. There were predominantly four types of interventions implemented by PHIs: Financial incentives, health coaching, wellness programs, and group medical appointments. Outcome measures across studies were varied, making it challenging to compare the difference between the effectiveness of different intervention types. Most studies reported that the impacts of interventions, such as increase in healthy eating, physical activity, and lower hospital admissions, last for a shorter term if the length of the intervention is shorter. Interpretation Although it is challenging to conclude which intervention type was the most effective, it appeared that, regardless of the intervention types, PHI interventions of longer duration (at least 2 years) were more beneficial and outcomes were more sustained than those PHI interventions that lasted for a shorter period. Funding Primary source of funding was Geelong Medical and Hospital Benefits Association (GMHBA), an Australian private health insurer.

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