Impact of Covid-19 Pandemic on Patients with Non-Communicable Disease: An Observational Cross-Sectional Study at AYUSH Set Ups of Krishna and Darjeeling District, India

Objective: To determine the impact of covid-19 in patients suffering from NCDs in terms of their knowledge, awareness, perception about COVID-19, use of AYUSH immune boosters, and management of chronic condition during the pandemic. Method: During the unlock down period (October 2020), a cross-sectional study was conducted in the Krishna and Darjeeling district of Andhra Pradesh and West Bengal, India. 499 individuals suffering from at least one chronic disease were interviewed using a structured questionnaire. Logistic regression was applied to investigate the relationship of socio-demographic characteristics with pandemic-related care challenges, Ayush Immune boosters(AIB). Principal Component Analysis was applied to minimize the dimensionality of factors related to covid care challenges. Results: 499 individuals were surveyed. 91% identified at least three correct covid appropriate behaviour. 92.2% considered the coronavirus to be a potential threat (mean±sd: 5.8±2.6). 44.7% and 55.3% lived with one and 2 or more chronic conditions respectively. Hypertension alone (27.4%) and diabetes with hypertension (33%) were leading presentations. Out of 499, participants, 88.8% had at least one form of AIB. 52% took Ars. alb with other AIB and 40% took Ars. alb. alone. Only 09 participants were infected from Covid-19. Conclusion: In the interest of a densely populated country like India, the inclusion of simple and safe AYUSH measures is realistic, ethical and cost-effective. Ayush interventions as Covid-19 prophylactic and treatment as well as Integrative care of chronic illnesses such as NCDs is suggested.

Sopeutumisvalmennuskursseille osallistuvien lasten vanhempien arvioita hyvinvoinnista, toimintakyvystä ja kurssiodotuksista

Sopeutumisvalmennus on psykososiaalista kuntoutusta, joka tarjoaa tietoa ja tukea sairaudesta tai vammasta, sen hoidosta ja selviytymiskeinoista. Lapset ja nuoret, joilla on pitkäaikaissairaus tai kehityksen häiriöitä, osallistuvat sopeutumisvalmennukseen useimmiten perheenjäsentensä kanssa. Tämän tutkimuksen tavoitteena oli 1) selvittää vanhempien käsityksiä lasten hyvinvoinnista ja toimintakyvystä, 2) arvioida vanhempien omaa hyvinvointia ja perheiden valtaistumista ja 3) selvittää kurssiodotuksia ja niihin yhteydessä olevia tekijöitä. Tutkimus kohdistui Kelan kuntoutuksena vuosina 2014–15 toteutettuihin diabeteskursseihin, oppimisen tai psyykkisen kehityksen häiriöiden kursseihin sekä moni- ja liikuntavammaisten lasten kursseihin. Lasten vanhemmat vastasivat kurssin alussa lomakekyselyyn (n = 357, vastausprosentti 59 %). Kaikissa kurssiryhmissä useimmat vanhemmat arvioivat lapsen terveydentilan hyväksi tai melko hyväksi. Vanhempien arviot niin omasta kuin lapsenkin hyvinvoinnista erosivat kurssiryhmittäin, mutta myös kurssiryhmien sisällä ilmeni vaihtelua. Vanhemmat, joiden lapsella oli diabetes, arvioivat hyvinvointia myönteisemmin kuin vanhemmat, joiden lapsella oli kehityksellinen häiriö. Vanhempien arviot omasta hyvinvoinnistaan korreloivat melko vahvasti lasta koskeviin hyvinvointiarvioihin. Sopeutumisvalmennukseen liittyvät odotukset ja tuen tarpeet koskivat erityisesti vertaistukea ja virkistäytymistä sekä tiedon saantia sairaudesta ja sen hoidosta ja kuntoutuksesta. Kurssiryhmä, lapsen toimintakyvyn rajoitteet, vanhempien hyvinvointi ja perheiden valtaistuminen olivat yhteydessä perheiden odotuksiin ja tuen tarpeisiin. Tutkimuksen keskeinen tulos koski perheen valtaistumisen ja kurssiodotusten välistä yhteyttä. Tarve ammatilliseen asiantuntijuuteen pohjautuvaan tietoon ja psykososiaaliseen tukeen oli vahvempaa niillä perheillä, joilla valtaistumisen tunne oli heikompaa. Sen sijaan ne perheet, joilla valtaistuminen oli voimakkaampaa, odottivat kursseilta vähemmän asiantuntijan tukea ja enemmän vertaistukea ja virkistäytymistä. Abstract Parents´ evaluations of their children´s wellbeing and functioning and identified expectations for psychosocial rehabilitation Finnish adaptation training represents psychosocial rehabilitation, which aims to offer information and guidance for living with an illness or disability as well as promoting coping skills. Children and adolescents with chronic illnesses or developmental disorders participate adaptation training mostly with their family members. The aim of this study was to 1) examine the parents´ perceptions of their child´s wellbeing and functioning, 2) depict their assessments on their own wellbeing and family empowerment, and 3) investigate their needs and expectations for the adaptation training as well as factors connected with different expectations. The study focused on three courses arranged for children either with diabetes, learning or psychological development disorders or multiple or mobility disabilities. The courses were organized in three rehabilitation centers. The parents answered the questionnaire at the beginning of the course (n=357, response rate 59 %). In all course groups most parents perceived their child’s health fairly good or good. The parents of children with diabetes evaluated their child’s wellbeing more positively than the parents of children with developmental disorders. The parents’ wellbeing correlated positively with the children´s wellbeing. Strongest rehabilitation needs and expectations were related to the domains of peer support and recreation, and information about illness or disability and its treatment. The course group, disability of the child, wellbeing of parents and children, and family empowerment were associated with the expectations and needs factors. The main finding of this study addressed the relationship ofthe family empowerment to the expectation domains. Families with weaker empowerment expressed more expectations and needs for professional information and support. More strongly empowered families expressed less needs for professional support and information but more expectations for peer support and recreation.

Smart Heart Disease Prediction System with IoT and Fog Computing Sectors Enabled by Cascaded Deep Learning Model

Chronic illnesses like chronic respiratory disease, cancer, heart disease, and diabetes are threats to humans around the world. Among them, heart disease with disparate features or symptoms complicates diagnosis. Because of the emergence of smart wearable gadgets, fog computing and “Internet of Things” (IoT) solutions have become necessary for diagnosis. The proposed model integrates Edge-Fog-Cloud computing for the accurate and fast delivery of outcomes. The hardware components collect data from different patients. The heart feature extraction from signals is done to get significant features. Furthermore, the feature extraction of other attributes is also gathered. All these features are gathered and subjected to the diagnostic system using an Optimized Cascaded Convolution Neural Network (CCNN). Here, the hyperparameters of CCNN are optimized by the Galactic Swarm Optimization (GSO). Through the performance analysis, the precision of the suggested GSO-CCNN is 3.7%, 3.7%, 3.6%, 7.6%, 67.9%, 48.4%, 33%, 10.9%, and 7.6% more advanced than PSO-CCNN, GWO-CCNN, WOA-CCNN, DHOA-CCNN, DNN, RNN, LSTM, CNN, and CCNN, respectively. Thus, the comparative analysis of the suggested system ensures its efficiency over the conventional models.

Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh

Background While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh. Methods A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease. Results Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12–0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35–18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34–2.85). Conclusion Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people’s health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.

Nursing Recommendations for the Management of HIV and Hypertension in a rural Primary Health Care Setting, Eastern Cape, South Africa

South Africa has an increased number of people living with the human immunodeficiency virus (PLWH). In addition, older PLWH are prone to developing non-communicable diseases (NCDs) as co-morbid illnesses, in particular hypertension. South Africa is experiencing a dual burden of care, that being the co-morbidity of HIV and hypertension. The integration of HIV and non-communicable disease management is needed towards a synergised and comprehensive approach within primary health care (PHC) settings. This article presents nursing recommendations yielded by a descriptive phenomenological study on the management of HIV and hypertension in a rural PHC context. A qualitative research approach, using Husserl’s descriptive phenomenology, was employed, and data were gathered using semi-structured interviews. The interviews were conducted by the first author at Sakhisizwe sub-district clinics, Eastern Cape. Purposive sampling was used to select nine participants. Giorgi’s phenomenological steps underpinned data analysis. Six nursing recommendations were developed to support professional nurses in the management of the co-morbidity of HIV and hypertension: 1) disease-specific health education as opposed to generic health education; 2) utilisation of existing programmes on the integration and management of chronic illnesses; 3) creating social support platforms or spaces; 4) referral pathways; 5) surveillance and monitoring; and 6) management of disease-related stigma. Professional nurses working in PHC clinics have several guidelines to manage chronic illnesses. However, there are limited nursing recommendations on how to manage the co-morbidity of HIV and hypertension. This study focused on a smaller sample of nine participants, in one sub-district and in one district.

Knowledge, Attitudes, and Practices Concerning COVID-19 in Bangladesh: A Qualitative Study of Patients With Chronic Illnesses

The novel coronavirus disease (COVID-19) has posed a serious risk with pre-existing health conditions. This study was conducted to understand the knowledge, attitude, and practices concerning COVID-19 among patients with chronic illnesses in Bangladesh during the pandemic. The study was conducted in Khulna city of Bangladesh following a qualitative research design. We employed telephone interviews to collect data from 40 participants with four common pre-existing chronic illnesses (diabetes, hypertension, respiratory/asthma, and heart disease). Findings show that the majority of the participants had a moderate level of knowledge and an overall positive attitude regarding COVID-19 but appropriate safety practices were often ignored as the pandemic grows older. We also observed that the knowledge, attitude, and practice regarding COVID-19 varied based on age, marital status, education, social class, and rural/urban residence. We concluded that improving medical advice/support, promotion of awareness through mass media, strict monitoring of protective measures and subsidies from the government, and self-consciousness could be effective strategies to mitigate the transmission of the disease and reduce risks for patients with chronic illness in Bangladesh during the COVID-19 pandemic.

Applications of Cannabis Sativa L. in Food and Its Therapeutic Potential: From a Prohibited Drug to a Nutritional Supplement

Hemp (Cannabis sativa L.) is a herbaceous anemophilous plant that belongs to the Cannabinaceae family. The cannabis seed (hemp) has long been utilized as a food source and is commercially important as an edible oil source. In this review, the positive and negative health effects of cannabis, the relationship between cannabis and various diseases, and the use of cannabis in various food products have been discussed. In addition, the scientific literature on the potential use of cannabis and its derivatives as a dietary supplement for the prevention and treatment of inflammatory and chronic degenerative diseases in animals and humans has been reviewed. Cannabis is being developed as a key ingredient in a variety of food items, including bakery, confectionery, beverages, dairy, fruits, vegetables, and meat. Hemp seeds are high in readily digestible proteins, lipids, polyunsaturated fatty acids (PUFA), insoluble fiber, carbs, and favorable omega-6 PUFA acid to omega-3 PUFA ratio and have high nutritional value. The antioxidants of cannabis, such as polyphenols, help with anxiety, oxidative stress, and the risk of chronic illnesses, including cancer, neurological disorders, digestive problems, and skin diseases. Cannabis has been shown to have negative health impacts on the respiratory system, driving, and psychomotor functions, and the reproductive system. Overall, the purpose of this research is to stimulate more in-depth research on cannabis’s adaptation in various foods and for the treatment of chronic illnesses.

COVID-19: Source, Symptoms, Screening, Prevention and Treatment

Background: COVID-19 is an infectious disease caused by the newly acquired SARS-COV2 virus. The disease is rapidly changing, as well as our understanding of the emerging virus. Not knowing what it was at the beginning of the year 2020, scientists have been able to classify, track, classify, and establish diagnostic tests. Severe illness may strike the elderly and those with chronic illnesses, such as heart disease, diabetes, or cancer. Conclusion: Over the past four decades, the emergence of new infectious, global threats has reshaped national and international thinking and the level of public health responses needed to combat these threats. All countries are at risk of new diseases, according to International Health Regulations.

Designing an mHealth Roadmap for the Journey to Self-Management: A Qualitative Study with Adolescents and Young Adults Living with Chronic Illness

Objectives Adolescents and young adults (AYA) with chronic illnesses often struggle with illness self-management. The objective of this study is to understand how AYA with various chronic illnesses develop self-management skills and which mobile health (mHealth) strategies they believe could be helpful. Methods Semi-structured interviews were conducted with patients, between 16 to 20 years old, living with at least one chronic illness (N = 19), between 2018 and 2019 in Los Angeles, CA. Three coders completed thematic coding to understand how AYA develop and maintain self-management skills, to inform the development of mHealth interventions appropriate across a variety of chronic conditions. Results Results suggest that AYA develop self-management skills through several strategies, including (1) getting organized, (2) making it work for me and (3) keeping the right mentality. AYA described developing these strategies through: (1) receiving social support, (2) accessing helpful tools and technologies, and (3) going through a maturation process. They provided recommendations for mHealth intervention developers. Discussion The results suggest that an appealing mHealth intervention could support AYA patients in proactively acquiring self-management skills and prevent having to rely on trial and error or uneven access to guidance and support. Interventions should be responsive to individual technology preferences and practices.