BackgroundAlthough a quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce. The purpose of this study is to: 1) estimate the prevalence and odds of CAM use among participants with hypercholesterolemia, hypertension, diabetes, and obesity; and 2) examine the effects of chronic condition dyads and triads on the use of CAM modalities, specifically manipulative and body-based methods, biological treatments, mind-body interventions, energy therapies, and alternative medical systems.MethodsData were obtained from the 2012 National Health Interview Survey and the Adult Alternative Medicine supplement. Statistical analyses were restricted to persons with self-reported hypercholesterolemia, hypertension, diabetes, or obesity (n = 15,463).ResultsApproximately 37.2% of the participants had just one of the four chronic conditions, while 62.4% self-reported multiple comorbidities. CAM use among participants was as follows (p < 0.001): hypercholesterolemia (31.5%), hypertension (28.3%), diabetes (25.0%), and obesity (10.8%). All combinations of disease dyads and triads were consistently and significantly associated with the use of mind-body interventions (2–4%, p < 0.001). Two sets of three dyads were associated with use of manipulative methods (23–27%, p < 0.05) and energy therapies (0.2–0.3%, p < 0.05). Use of biological treatments (0.04%, p < 0.05) and alternative systems (3%, p < 0.05) were each significant for one dyad. One triad was significant for use of manipulative methods (27%, p < 0.001).ConclusionsThese findings point to future directions for research and have practical implications for family practitioners treating multimorbid patients.

Musculoskeletal diseases and arthritis represent important public health problems with economic implications for the well-being of individuals and society. Identifying CAM use trends by patient weight can be used to improve strategies to increase awareness and access to CAM as part of comprehensive and cost-effective approaches for the management and treatment of these conditions.

Parents of children with special healthcare needs (CSHCN) face tremendous stress in caring for their children. Families of CSHCN face increased barriers to health services as evidence also reflects the influence of socioeconomic factors on access. This study investigates the impact of socioeconomic factors and family functioning on delayed care. Descriptive, bivariate, and adjusted multivariate logistic regression were performed using sampling weights. findings suggest that family dynamics are more impactful on delayed care than socioeconomic predictors. Promoting family-centered care that incorporates social support for families to reduce barriers is essential for improved quality of life and health outcomes.

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Aims: To investigating some demographic variables and red cell parameters of infected persons already accessing antiretroviral therapy with a view to identifying sub- groups with higher proportions of anaemia.  Study Design:  Cross-sectional study. Place and Duration of Study: University of Calabar Teaching Hospital Calabar Nigeria, between August 2017 and July 2018. Methodology: Subjects comprised 60 male and female HIV-infected adults attending University of Calabar Teaching Hospital Calabar, and equal number of age and sex-matched control subjects who were HIV sero-negative as at the time of this study. The infected persons were being treated with either Tenofovir+Lamivudine+Efavirenz (TLE) or Lamivudine+Zidovudine+Nevirapine (LZN). A pre-tested structured questionnaire was administered by two trained interviewers which captured the bio-data, sociodemographic variables and therapy-related information. Venous blood was collected aseptically by standard phlebotomy into appropriate sample containers for CD4 and red cell counts by automation. Results: The proportion of anaemia occurring between TLE and LZN users was observed to be in the ratio of 2:3. The RBC count, haematocrit and haemoglobin concentration were significantly lower (p=.000), while MCV, MCH and RDW were significantly higher (p=.000) in subjects infected with HIV compared to the control subjects, Duration of treatment beyond 6 years significantly raised both MCV (p=.007) and MCH (p=.006) compared to the first 3 years of treatment commencement, while the MCV, MCH and RDW-SD were significantly higher (p=.003, .014 and .018 respectively) among LZN users compared to those on TLE. Conclusion: Human immunodeficiency virus infection triggers pathologic mechanisms that culminate into anaemia. While the use of antiretroviral therapy appears to gradually resolve this derangement, the adverse effects of some of the antiretroviral agents contribute to the persistence of anaemia particularly with increasing years of treatment.