Pandemic Makes Chronic Disease Prevention a Priority

Chrysanthemum morifolium as a traditional herb: A review of historical development, classification, phytochemistry, pharmacology and application

ETHNOPHARMACOLOGICAL RELEVANCE

In recent years, Chinese herbal medicine has gained more and more recognition in disease prevention and control due to its low toxicity and comprehensive treatment. C. morifolium (Chrysanthemum morifolium Ramat.), as the medicine food homology plant with the bioactivity of anti-oxidation, anti-inflammatory, neuroprotection and cardiovascular protection, has important therapeutic effects and health benefits for colds, inflammation, cardiovascular diseases and various chronic diseases.

AIM OF THE STUDY

By reviewing the historical development, classification and distribution of germplasm resources, phytochemistry, pharmacology, and modern application of C. morifolium, the paper provides a reliable basis for the further research and application of chrysanthemum as therapeutic agents and functional additives.

MATERIALS AND METHODS

The literature and information about C. morifolium published in the last ten years were collected from various platforms, including Google Scholar, PubMed, ScienceDirect, Web of Science and China Knowledge Network.

RESULTS

A comprehensive analysis confirmed that C. morifolium originated in China, and it went through the development process from food and tea to medicine for more than 3000 years. During this period, different cultivars emerged through several breeding techniques and were distributed throughout the world. Moreover, A variety of chemical components such as flavonoids, phenolic acids, volatile oils, and terpenes in chrysanthemum have been proven they possess various pharmacology of anti-inflammatory, anti-oxidant, and prevention of chronic diseases by regulating inflammatory cytokines, oxidative stress responses and signaling pathways, which are the essential conditions to play a role in TCM, nutraceuticals and diet.

CONCLUSION

This paper provides a comprehensive review of historical development, classification, phytochemistry, pharmacology, and modern application of C. morifolium. However, future studies should continue to focus on the bioactive compounds and the synergistic mechanism of the "multi-component, multi-target, and multi-pathway" of chrysanthemum, and it is necessary to develop more innovative products with therapeutic effects.

Prioritization of healthcare systems during pandemics using Cronbach's measure based fuzzy WASPAS approach

Pandemics are well-known as epidemics that spread globally and cause many illnesses and mortality. Because of globalization, the accelerated occurrence and circulation of new microbes, the infection has emerged and the incidence and movement of new microbes have sped up. Using technological devices to minimize the visit durations, specifying days for handling chronic diseases, subsidy for the staff are the alternatives that can help prevent healthcare systems from collapsing during pandemics. The study aims to define the efficient usage of optimization tools during pandemics to prevent healthcare systems from collapsing. In this study, a new integrated framework with fuzzy information is developed, which attempts to prioritize these alternatives for policymakers. First, rating data are assigned respective fuzzy values using the standard singleton grades. Later, criteria weights are determined by extending Cronbach´s measure to fuzzy context. The measure not only understands data consistency comprehensively, but also takes into consideration the attitudinal characteristics of experts. By this approach, a rational weight vector is obtained for decision-making. Further, an improved Weighted Aggregated Sum Product Assessment (WASPAS) algorithm is put forward for ranking alternatives, which is flexibly considering criteria along with personalized ordering and holistic ordering alternatives. The usefulness of the developed framework is tested with the help of a real case study. Rank values of alternatives when unbiased weights are used is given by 0.741, 0.582, 0.640 with ordering asR 1 ≻ R 3 ≻ R 2 . The sensitivity/comparative analysis reveals the impact of the proposed model as useful in selecting the best alternative for the healthcare systems during pandemics.

A qualitative study of high-performing primary care practices during the COVID-19 pandemic

BACKGROUND

Primary care practices have remained on the frontline of health care service delivery throughout the COVID-19 pandemic. The purpose of our study was to understand the early pandemic experience of primary care practices, how they adapted care processes for chronic disease management and preventive care, and the future potential of these practices' service delivery adaptations.

METHODS

We interviewed 44 providers and staff at 22 high-performing primary care practices located throughout the United States between March and May 2020. Interviews were transcribed and coded using a modified rapid assessment process due to the time-sensitive nature of the study.

RESULTS

Practices reported employing a variety of adaptations to care during the COVID-19 pandemic including maintaining safe and socially distanced access through increased use of telehealth visits, using disease registries to identify and proactively outreach to patients, providing remote patient education, and incorporating more home-based monitoring into care. Routine screening and testing slowed considerably, resulting in concerns about delayed detection. Patients with fewer resources, lower health literacy, and older adults were the most difficult to reach and manage during this time.

CONCLUSION

Our findings indicate that primary care structures and processes developed for remote chronic disease management and preventive care are evolving rapidly. Emerging adapted care processes, most notably remote provision of care, are promising and may endure beyond the pandemic, but issues of equity must be addressed (e.g., through payment reform) to ensure vulnerable populations receive the same benefit.

Nonmetropolitan COVID-19 Incidence and Mortality Rates Surpassed Metropolitan Rates Within the First 24 Weeks of the Pandemic Declaration: United States, March 1-October 18, 2020

PURPOSE

This report compares COVID-19 incidence and mortality rates in the nonmetropolitan areas of the United States with the metropolitan areas across three 11-week periods from March 1 to October 18, 2020.

METHODS

County-level COVID-19 case, death, and population counts were downloaded from USAFacts.org. The 2013 NCHS Urban-Rural Classification Scheme was collapsed into two categories called metropolitan (large central, large fringe, medium, and small metropolitans) and nonmetropolitan (micropolitan/noncore). Daily COVID-19 incidence and mortality rates were computed to show temporal trends for each of these two categories. Maps showing the ratio of nonmetropolitan to metropolitan COVID-19 incidence and mortality rates by state identify states with higher rates in nonmetropolitan areas than in metropolitan areas in each of the three 11-week periods.

FINDINGS

In the period between March 1 and October 18, 2020, 13.8% of the 8,085,214 confirmed COVID-19 cases and 10.7% of the 217,510 deaths occurred among people residing in nonmetropolitan counties. The nonmetropolitan incidence and mortality trends steadily increased and surpassed those in metropolitan areas, beginning in early August.

CONCLUSIONS

Despite the relatively small size of the US population living in nonmetropolitan areas, these areas have an equal need for testing, health care personnel, and mitigation resources. Having state-specific rural data allow the development of prevention messages that are tailored to the sociocultural context of rural locations.