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Davis EC, Monaco CL, Insel R, Järvinen KM. Gut microbiome in the first 1000 days and risk for childhood food allergy. Ann Allergy Asthma Immunol 2024; 133:252-261. [PMID: 38494114 PMCID: PMC11344696 DOI: 10.1016/j.anai.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/11/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVE To summarize recent data on the association between gut microbiome composition and food allergy (FA) in early childhood and highlight potential host-microbiome interactions that reinforce or abrogate oral tolerance. DATA SOURCES PubMed search of English-language articles related to FA, other atopic disease, and the gut microbiome in pregnancy and early childhood. STUDY SELECTIONS Human studies published after 2015 assessing the relationship between the gut bacteriome and virome in the first 2 years of life and FA or food sensitization development in early childhood were prioritized. Additional human studies conducted on the prenatal gut microbiome or other atopic diseases and preclinical studies are also discussed. RESULTS Children who developed FA harbored lower abundances of Bifidobacterium and Clostridia species and had a less mature microbiome during infancy. The early bacterial microbiome protects against FA through production of anti-inflammatory metabolites and induction of T regulatory cells and may also affect FA risk through a role in trained immunity. Infant enteric phage communities are related to childhood asthma development, though no data are available for FA. Maternal gut microbiome during pregnancy is associated with childhood FA risk, potentially through transplacental delivery of maternal bacterial metabolites, though human studies are lacking. CONCLUSION The maternal and infant microbiomes throughout the first 1000 days of life influence FA risk through a number of proposed mechanisms. Further large, longitudinal cohort studies using taxonomic, functional, and metabolomic analysis of the bacterial and viral microbiomes are needed to provide further insight on the host-microbe interactions underlying FA pathogenesis in childhood.
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Affiliation(s)
- Erin C Davis
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, New York
| | - Cynthia L Monaco
- Division of Infectious Disease, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York; Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Richard Insel
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, New York
| | - Kirsi M Järvinen
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Golisano Children's Hospital, Rochester, New York; Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York; Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.
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Pires LDJA, Ribeiro JM, Cruz MMD. [A brief overview of the 2030 Agenda, noncommunicable diseases and the challenges of leaving no one behind]. CAD SAUDE PUBLICA 2024; 40:e00139323. [PMID: 39194138 PMCID: PMC11346611 DOI: 10.1590/0102-311xpt139323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/26/2024] [Accepted: 03/08/2024] [Indexed: 08/29/2024] Open
Abstract
This essay provides a theoretical reflection on the challenges of meeting the Sustainable Development Goals of the 2030 Agenda, considering its motto of "leave no one behind". To exemplify these challenges, we discuss noncommunicable diseases (NCDs), one of the main issues on the global health agenda before the COVID-19 pandemic, and the political and economic dimensions that determine their presence and global spread. After a brief overview of NCDs, the text seeks to answer three questions: In "Leaving no one behind?" we list some themes to reflect on how and who has historically been left behind, delving a little deeper into the examples in "Who has been left behind in the world?" and "Who has been left behind in Brazil?". Using data from the most relevant and recent literature on the subject, we discuss the challenges and some ways to leave no one behind in a world where the mean of production has historically made some social groups vulnerable, especially black and Indigenous populations. In our final remarks, we draw inspiration from the Sankofa ideogram to remember that the answers to the sustainable development we seek may lie somewhere in our most primordial and traditional past. And that it is necessary to invest on building new paths from different worldviews and approaches to epistemology on the other side of the abyssal line.
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Affiliation(s)
| | - José Mendes Ribeiro
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Marly Marques da Cruz
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Abebe TB, Morton JI, Ilomaki J, Ademi Z. Future burden of myocardial infarction in Australia: impact on health outcomes between 2019 and 2038. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:421-430. [PMID: 37852668 PMCID: PMC11307198 DOI: 10.1093/ehjqcco/qcad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/10/2023] [Accepted: 11/01/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Myocardial infarction (MI) remains a major health burden in Australia. Yet the future burden of MI has not been extensively studied for the Australian population. METHODS AND RESULTS A multistate lifetable model was constructed to estimate the lifetime risk of MI and project the health burden of MI for the Australian population aged between 40 and 100 years over a 20-year period (2019-2038). Data for the model were primarily sourced from the Victorian-linked dataset and supplemented with other national data. The lifetime risk of MI at age 40 was estimated as 24.4% for males and 13.2% for females in 2018. From 2019 to 2038, 891 142 Australians were projected to develop incident MI. By 2038, the model estimated there would be 702 226 people with prevalent MI, 51 262 incident non-fatal MI, and 3717 incident fatal MI; these numbers represent a significant increase compared to the 2019 estimates, with a 27.0% (148 827), 62.0% (19 629), and 104.7% (1901) rise, respectively. Projected years of life lived (YLL) (5% discount) accrued by the Australian population was 174 795 232 (84 356 304 in males and 90 438 928 in females), with 7 657 423 YLL among people with MI (4 997 009 in males and 2 660 414 in females). CONCLUSION The burden of MI was projected to increase between 2019 and 2038 in Australia. The outcomes of the model provide important information for decision-makers to prioritize population-wide prevention strategies to reduce the burden of MI.
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Affiliation(s)
- Tamrat Befekadu Abebe
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Jedidiah I Morton
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Jenni Ilomaki
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Zanfina Ademi
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Yang X, Yan J, Lai S, Shen C, Duan N. What affects the direct economic burden of non-communicable diseases on middle-aged and older adult people in Shaanxi Province? Front Public Health 2023; 11:1219199. [PMID: 38186709 PMCID: PMC10766749 DOI: 10.3389/fpubh.2023.1219199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
Non-communicable diseases (NCDs) are the leading cause of death worldwide. NCDs affect the health status and the quality of life. In addition, continuous NCDs treatment expenses place a heavy economic burden on families and cause huge economic losses to the society. The prevention and treatment of NCDs and reduction of their economic burden are key public health issues. Considering middle-aged and older adult people as the focus, their basic socio-demographic characteristics and health behavior status of this group, and a pooled cross-sections regression model was then used to analyze the main factors affecting the direct economic burden. The results showed that from 2013 to 2018, the prevalence of NCDs among the middle-aged and older adult people in Shaanxi province as well as the direct economic burden of NCDs increased. The effect factors primarily included sex, age, employment status, income level, type of medical insurance, urban or rural residency, level of the health care-providing institutions, visiting times of 2-week, and length of hospital stay. Several measures can be taken to control the onset of NCDs and reduce their direct economic burden.
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Affiliation(s)
- Xiaowei Yang
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Ju’e Yan
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Sha Lai
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Chi Shen
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Ning Duan
- Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Dean E. Academy of Plant-based Physical Therapy: overdue to address a nutrition crisis with a transformative population approach. J Phys Ther Sci 2023; 35:645-658. [PMID: 37670763 PMCID: PMC10475644 DOI: 10.1589/jpts.35.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/09/2023] [Indexed: 09/07/2023] Open
Abstract
This timely evidence synthesis supports the need for an Academy of Plant-based Physical Therapy. Given epidemiological and empirical evidence and the profession's values and practice scope, the time has come for a specialty of plant-based physical therapy based on population health principles. This review connects these factors. Non-communicable diseases (NCDs) are largely nutrition-related resulting from unnatural elements of our diet (i.e., heart disease, several cancers, hypertension, stroke, diabetes, obesity, gastrointestinal diseases, autoimmune diseases, renal disease, and Alzheimer's disease). Most adults, even children, have NCD risk factors or manifestations. Alternatively, plant-based nutrition can prevent, manage, as well as potentially reverse these diseases, as well as augment conventional physical therapy outcomes by reducing inflammation and pain. Proposed competencies for plant-based physical therapists include high-level competency in health and NCD risk assessments/evaluations, to establish population health-informed nutrition needs for maximal health, healing and repair, in turn, function and wellbeing; and assessment of patients' nutrition-related knowledge, beliefs/attitudes, self-efficacy, and readiness-to-change. Population-informed nutritional counseling is initiated as indicated. An Academy of Plant-based Physical Therapy could advance the profession globally at this point in history and also serve as a role model to other health professions through practicing evidence-based, plant-based nutrition built upon population health principles.
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Affiliation(s)
- Elizabeth Dean
- Department of Physical Therapy, Faculty of Medicine,
University of British Columbia: Friedman Bldg, Rm 212 2177 Webrook Mall, Vancouver, BC,
V6T 1Z3, Canada
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Braybrook PJ, Tohira H, Birnie T, Brink D, Finn J, Buzzacott P. Types and anatomical locations of injuries among mountain bikers and hikers: A systematic review. PLoS One 2023; 18:e0285614. [PMID: 37647303 PMCID: PMC10468092 DOI: 10.1371/journal.pone.0285614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Mountain biking and hiking continue to grow in popularity. With new participants to these sports, it is likely the number of injuries will increase. To assist medical personnel in the management of these patients we attempted to quantify the types and locations of injuries sustained by mountain bikers and hikers. Objective The objective of this systematic review is to identify the type and anatomical location of injuries for both mountain bikers and hikers. METHODS A systematic search was undertaken using CINAHL, Cochrane, ProQuest, PubMed and Scopus databases. Reviewers assessed the eligibility of articles by a title/abstract review and final full-text review. Studies were included if the types of injuries were reported by medical personnel and contained anatomical locations. Studies were excluded if it did not take place on a trail or if the injuries were self-reported. Risk of bias was assessed utilising the Joanna Briggs Institute (JBI) checklists for study quality. No meta-analysis or comparison between mountain bikers and hikers was possible due to the high heterogeneity of the definition of injury. RESULTS A total of 24 studies met the inclusion criteria, 17 covering mountain biking and 7 hiking. This represented 220,935 injured mountain bikers and 17,757 injured hikers. The most common type of injuries sustained by mountain bikers included contusions, abrasions and minor lacerations, which made up between 45-74% of reported injuries in studies on competitive racing and 8-67% in non-competitive studies. Fractures represented between 1.5-43% of all reported injuries. The most injured region was the upper limbs reported in 10 of 17 studies. For hikers the most common injuries included blisters and ankle sprains with blisters representing 8-33% of all reported injuries. The most common body location to be injured by hikers was a lower limb in all 7 studies. CONCLUSIONS This is the first systematic review to report on the injury epidemiology of the two most common trail users; mountain bikers and hikers. For participants in both activities the majority of injuries were of minor severity. Despite this, the high proportions of upper limb fractures in mountain bikers and ankle sprains in hikers cannot be ignored. TRIAL REGISTRATION Registration: This systematic review was prospectively registered with the University of York PROSPERO database on the 12/4/2021 (CRD42021229623) https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021229623.
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Affiliation(s)
- Paul John Braybrook
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
| | - Hideo Tohira
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- Discipline of Emergency Medicine, Medical School, University of Western Australia, Crawley, Western Australia
| | - Tanya Birnie
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
| | - Deon Brink
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
| | - Judith Finn
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
- Discipline of Emergency Medicine, Medical School, University of Western Australia, Crawley, Western Australia
| | - Peter Buzzacott
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
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Wirnitzer KC, Motevalli M, Cocca A, Tanous DR, Wirnitzer G, Wagner KH, Schätzer M, Drenowatz C, Ruedl G, Kirschner W. Health behavior of Austrian tertiary students focusing on diet type linked to sports and exercise-first glimpse of results from the "sustainably healthy-from science 2 high school and university" study. Front Public Health 2023; 11:1129004. [PMID: 37533531 PMCID: PMC10392833 DOI: 10.3389/fpubh.2023.1129004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Background There is a strong association between lifestyle behavior and health status. While young adulthood is a critical period for adopting and stabilizing lifelong healthy behavior, university life is independently associated with psychological stressors that may further affect health and well-being. Objective The present multidisciplinary study aimed to examine the health behavior of Austrian college and university students, differentiated based on diet types (vegan, vegetarian, and omnivorous) and physical activity (PA) habits. Methods Following a cross-sectional study design, a total number of 6,148 students (65.3% females; 66.1% bachelor students, 67.0% from urban areas; mean age: 24.8 years) from 52 Austrian college/universities participated in an online survey and provided data on sociodemographic characteristics, dietary patterns, PA habits, and other lifestyle behavior characteristics, including alcohol intake and smoking. Results Across the total sample, 74.0% had a normal weight (BMI = 18.5-25.0 kg/m2), while the prevalence of overweight/obesity (BMI ≥ 30.0 kg/m2) was lower in females than males and more in rural than urban students (p < 0.01). The general prevalence of vegetarian and vegan diets was 22.8 and 6.0%, respectively, with a predominance of females, graduates, and urban students compared to their peers (p < 0.01). The majority of students (79.3%) had a regular engagement in sport/exercise, with a predominance of vegetarian or vegan students compared to omnivores (p < 0.01). Vegans and vegetarians had a lower alcohol intake (p < 0.01) but no differences in smoking habits (p > 0.05) compared to omnivores. Students engaging in sport/exercise had a lower smoking rate and higher intake of fruits, vegetables, and fluids compared to inactive students (p < 0.01). Conclusion The present findings suggest that diet type and PA habits of college/university students have an impact on other health behaviors, highlighting the interconnected nature of lifestyle habits and health behavior.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Research Center Medical Humanities, University of Innsbruck, Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition (SIPCAN), Elsbethen, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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Neyazi N, Mosadeghrad AM, Afshari M, Isfahani P, Safi N. Strategies to tackle non-communicable diseases in Afghanistan: A scoping review. Front Public Health 2023; 11:982416. [PMID: 36908476 PMCID: PMC9992526 DOI: 10.3389/fpubh.2023.982416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023] Open
Abstract
Non-communicable diseases (NCDs) and their risk factors are the leading cause of death worldwide and contribute to 74.3% of deaths globally in 2019. The burden of NCDs is escalating in Afghanistan. Currently, every seconds, people in Afghanistan are dying of NCDs. Addressing this challenge in Afghanistan needs effective and practical interventions. This study aimed to identify the strategies developed and implemented in countries with low non-communicable premature death. To conduct a scoping review, we followed the six-step Arksey and O'Malley protocol and searched for eligible articles on eight international databases and the gray literature. The study followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were English documents and evidence produced up to 30 November 2021 for the control of NCDs. We excluded incomplete texts, duplicates, and dissertations due to lack of access. We used EndNote X9 and MaxQDA software for data management and analysis. We conducted content analysis for this study. A total of 122 documents developed between 1984 and 2021 met the inclusion criteria. We identified 35 strategies from which the most used strategies were related to unhealthy diets and smoking cessation programs. Canada (26.4%), Korea (19.8%), and the United Kingdom (19%) have the most publications on the control and prevention of NCDs among the countries included in the study. Most strategies were implemented over 2 years (41%). This study recommends specific interventions to control and prevent NCDs for the main risk factors of tobacco use, unhealthy diet, physical inactivity, and the main non-communicable diseases such as heart diseases, cancers, diabetes, and chronic obstructive pulmonary diseases. Afghanistan Ministry of Public Health, the WHO country office, and other involved stakeholders can use the findings of this review to design and implement strategies for controlling and preventing NCDs in Afghanistan. International organizations such as the World Health Organization, United Nations Agencies, the World Bank, and other involving communities should invest in strengthening good health governance in Afghanistan. The Afghan Government should focus on promoting and funding health literacy among the public and self-care to control and prevent NCDs.
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Affiliation(s)
- Narges Neyazi
- International Campus, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
| | - Ali Mohammad Mosadeghrad
- Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Najibullah Safi
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
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Transitioning food environments and diets of African migrants: implications for non-communicable diseases. Proc Nutr Soc 2023; 82:69-79. [PMID: 36453152 DOI: 10.1017/s0029665122002828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Non-communicable diseases disproportionately affect African migrants from sub-Saharan Africa living in high-income countries (HICs). Evidence suggests this is largely driven by forces that include migration, globalisation of unhealthy lifestyles (poor diet, physical inactivity and smoking), unhealthy food environments, socio-economic status and population ageing. Changes in lifestyle behaviours that accompany migration are exemplified primarily by shifts in dietary behaviours from more traditional diets to a diet that incorporates that of the host culture, which promotes the development of obesity, diabetes, hypertension and CVD. The current paper presents a critical analysis of dietary change and how this is influenced by the food environment and the socio-economic context following migration. We used a food systems framework to structure the discussion of the interaction of factors across the food system that shape food environments and subsequent dietary changes among African migrant populations living in HICs.
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Grau M. Information availability: key to design prevention programmes. Eur J Prev Cardiol 2022; 29:2286-2288. [PMID: 36108136 DOI: 10.1093/eurjpc/zwac213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 01/11/2023]
Affiliation(s)
- María Grau
- Department of Medicine, University of Barcelona, #143 Casanova Street, 08036 Barcelona, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health, Melchor Fernández Almagro St, #3, 28029 Madrid, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Rosselló St, #149, 08036 Barcelona, Spain
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Shi W, Zhang T, Li Y, Huang Y, Luo L. Association between household air pollution from solid fuel use and risk of chronic diseases and their multimorbidity among Chinese adults. ENVIRONMENT INTERNATIONAL 2022; 170:107635. [PMID: 36413929 DOI: 10.1016/j.envint.2022.107635] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/21/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Given the increasing burden of chronic conditions, multimorbidity is now a priority for public health systems worldwide. However, the relationship between household air pollution (HAP) exposure with multimorbidity remains unclear. METHODS We used three waves data (2011, 2013, and 2015) including 19,295 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, to investigate the association between HAP exposure from solid fuel use for heating and cooking with the risk of chronic multimorbidity. Multimorbidity was defined as the coexistence of two or more of 15 chronic diseases (hypertension, diabetes, dyslipidemia, heart disease, stroke, cardiovascular disease, chronic lung disease, asthma, kidney disease, liver disease, digestive disease, cancer, psychiatric disease, memory-related disease, and arthritis). Multiple logistic regression investigated the association between solid fuel use for heating and cooking, separately or simultaneously, with the risk of multimorbidity. Poisson regression with quasi-likelihood estimation explored whether solid fuel exposure could increase the number of morbidities. Stratified analyses and sensitivity analyses examined the effect modification and robustness of the association. RESULTS Of the 19,295 participants (mean age: 58.9 years), 40.9 % have multimorbidity. Compared with participants who used clean fuels for heating and cooking, the risk was higher in mixed fuel (adjusted odds ratio, aOR = 1.26, 95 %CI:1.16-1.36) and solid fuel users (aOR = 1.81, 1.67-1.98) separately. HAP from solid fuel use was positively associated with an increased number of morbidities (adjusted β = 0.329, 0.290 to 0.368), after controlling for confounders. Those living in a one-story building, with poor household cleanliness have a higher risk of multimorbidity. No significant modifications of those associations by the socio-demographic and behaviour characteristics was observed. CONCLUSIONS HAP from solid fuel use is associated with a high risk of chronic multimorbidity in Chinese adults. Our findings provide important implications for reducing chronic disease burden by restricting solid fuel use.
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Affiliation(s)
- Wenming Shi
- School of Public Health, Fudan University, Shanghai 200032, China.
| | - Tiantian Zhang
- School of Social Development and Public Policy, Fudan University, Shanghai 200433, China
| | - Yongzhen Li
- Children's Hospital of Fudan University, Shanghai 201100, China
| | - Yonggang Huang
- Department of Blood Transfusion, Tongling People's Hospital, Tongling 244000, Anhui, China
| | - Li Luo
- School of Public Health, Fudan University, Shanghai 200032, China; Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
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Wirnitzer KC, Motevalli M, Tanous DR, Wirnitzer G, Wagner KH, Cocca A, Schätzer M, Kirschner W, Drenowatz C, Ruedl G. Study Protocol of "Sustainably Healthy-From Science 2 Highschool & University"-Prevalence of Mixed, Vegetarian, and Vegan Diets Linked to Sports & Exercise among Austrian Tertiary Students and Lecturers/Academic Staff. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15313. [PMID: 36430039 PMCID: PMC9690980 DOI: 10.3390/ijerph192215313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Healthy lifestyle is the major indicator of individual and public health especially in target populations (e.g., during emerging adulthood). Evidence indicates that unhealthy lifestyle behaviors are strongly associated with the increasing prevalence of chronic diseases. The dual approach of sustainable health (i.e., physical exercise tied to a healthy diet) is an effective lifestyle strategy to control and manage health-related disorders, including overweight/obesity. Based on the evidence on plant-based diets regarding health and considering the growing prevalence of vegans and vegetarians worldwide, limited data exist on the health-related behaviors of those who follow plant-based vs. mixed diets in young adulthood. This multidisciplinary study is the first to examine the association between diet type (mixed, vegetarian, and vegan diets) and various health-related behaviors (primarily physical activity, sport, & exercise) among college/university students and lecturers/academic staff in Austria nationwide. Following a cross-sectional study design and using online questionnaires, 4510 tertiary students and 1043 lecturers/academic staff provided data on sociodemographic characteristics, dietary patterns, physical exercise habits, and other lifestyle behaviors (sleep, alcohol intake, smoking, etc.) along with information on health status and quality of life. While the data will be analyzed based on differentiated sociodemographic and health-related categories, the influence of the COVID-19 pandemic on lifestyle behaviors will also be evaluated. As a study protocol, this article represents comprehensive details of the design, purposes, and associated analytical measures of the present study within the tertiary educational context.
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Affiliation(s)
- Katharina C. Wirnitzer
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, 6020 Innsbruck, Austria
| | - Mohamad Motevalli
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Derrick R. Tanous
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, 6010 Innsbruck, Austria
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | | | - Karl-Heinz Wagner
- Department of Nutritional Sciences and Research Platform Active Ageing, University of Vienna, 1090 Vienna, Austria
| | - Armando Cocca
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Manuel Schätzer
- Special Institute for Preventive Cardiology and Nutrition—SIPCAN, 5061 Elsbethen, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, 4020 Linz, Austria
| | - Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, 6020 Innsbruck, Austria
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13
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Mekonnen BE, Kebede MA. The Validity of Clinical Scoring in the Diagnosis of Stroke Subtype: Validation Study. Patient Relat Outcome Meas 2022; 13:209-219. [PMID: 36285188 PMCID: PMC9588290 DOI: 10.2147/prom.s374473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/10/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The gold standard for distinguishing stroke subtype is non-contrast CT. However, it's still prohibitively expensive and out of reach for the majority of recourse-constrained settings. Clinically, not all patients will have a definite diagnosis of hemorrhagic/ischemic stroke. To overcome these challenges and improve clinical bedside diagnosis, clinical stroke scores for stroke subtypes have been developed and recommended to be used in the absence of appropriate imaging modality. METHODS We conducted a prospective cross-sectional study among stroke patients to compare the accuracy of level of clinical stroke score methods in differentiating stroke type with CT. it was conducted on 140 people at MTU teaching hospital in Bench-Sheko Zone, South-west Ethiopia. Data were collected using check list. Analysis of the data was done using SPSS version 24. RESULTS Our result revealed an incidence of hemorrhagic stroke were 50%, ischemic stroke were 48.6% by CT evaluation. Specificity, sensitivity, positive predictive value, negative predictive value and the overall accuracy of Siriraj stroke score for differentiation of hemorrhage from ischemic stroke were 68.6%, 83.9%, 74.6%, 79.5%, and 82% respectively, the Guys score were 89.7%, 47.8%, 73.3%, 74.5% and 74.5% respectively and while the Bensson score were 88.6%, 35.3%, 75%, 58.5%, and 62.3% respectively. CONCLUSION We conclude that Siriraj stroke score showed good sensitivity and fair overall accuracy for hemorrhagic stroke even if it had poor specificity.
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Affiliation(s)
| | - Molla Asnake Kebede
- Department of Internal Medicine, School of Medicine, Mizan-Tepi University, Mizan-Aman, Ethiopia
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14
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Tanous DR, Ruedl G, Kirschner W, Drenowatz C, Craddock J, Rosemann T, Wirnitzer K. School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School. PLoS One 2022; 17:e0275012. [PMID: 36201567 PMCID: PMC9536596 DOI: 10.1371/journal.pone.0275012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.
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Affiliation(s)
- Derrick R. Tanous
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- * E-mail:
| | - Gerhard Ruedl
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Werner Kirschner
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
| | - Clemens Drenowatz
- Division of Physical Education, University of Education Upper Austria, Linz, Austria
| | - Joel Craddock
- Sydney School of Education and Social Work, The University of Sydney, Sydney, Australia
| | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Health and Lifestyle Science Cluster Tirol, Subcluster Health/Medicine/Psychology, Tyrolean University Conference, Verbund West, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University of Innsbruck, Innsbruck, Austria
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15
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Erzse A, Karim SA, Foley L, Hofman KJ. A realist review of voluntary actions by the food and beverage industry and implications for public health and policy in low- and middle-income countries. NATURE FOOD 2022; 3:650-663. [PMID: 37118592 DOI: 10.1038/s43016-022-00552-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/14/2022] [Indexed: 04/30/2023]
Abstract
The increasing availability of unhealthy processed food products is linked to rising rates of non-communicable diseases and obesity in low- and middle-income countries. Voluntary actions (VAs) are often adopted in lieu of regulating the composition, production, marketing and sale of unhealthy commodities, but their effectiveness is unclear. This realist review examines VAs adopted by the food and beverage industry in low- and middle-income countries. We developed a conceptual framework and followed a three-stage search to identify literature and VAs and, adhering to the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines, we produced a synthesized analysis of VAs. VAs, often initiated in response to governments' efforts to introduce regulations, were difficult to evaluate due to vague language and a lack of enforcement mechanisms. The review found no evidence indicating that VAs are effective in safeguarding public health. Yet their implementation has resulted in weaker responses and policy substitution, and so we suggest that VAs have the potential to negatively influence public health and policy. The United Nations should rescind their endorsement of industry involvement and mandatory measures should be favoured over VAs.
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Affiliation(s)
- Agnes Erzse
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa.
| | - Safura Abdool Karim
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
| | - Louise Foley
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Karen Joanne Hofman
- SAMRC/Wits Centre for Health Economics and Decision Science - PRICELESS SA, University of Witwatersrand School of Public Health, Faculty of Health Sciences, Johannesburg, South Africa
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16
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A Proposal for a National Cancer Control Plan for the UAE: 2022–2026. Clin Pract 2022; 12:118-132. [PMID: 35200267 PMCID: PMC8870909 DOI: 10.3390/clinpract12010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 11/17/2022] Open
Abstract
The United Arab Emirates (UAE) is one of the fastest growing economies with consequent increase in non-communicable diseases including cancer. The number of reported cases and mortality have been increasing in the UAE over the years, despite screening and early detection efforts which appear to be far from target coverage of the intended population. In this work, we highlight key elements of a proposed national cancer control plan for the UAE. The plan is still a work in progress and has not yet been officially adopted. A comprehensive and effective control plan requires accurate data, a reliable cancer registry, and periodic monitoring and evaluation. The UAE cancer control plan is being prepared in line with the WHO and EMRO framework, with defined objectives and goals. The objectives are to combat cancer, reduce incidence, control mortality, and improve outcomes and quality of life for cancer patients. There is also a focus on improving public health education, prevention, early detection, prompt diagnosis, treatment facilitation, continuity of care, performance evaluation, training of workforce, and research.
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17
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Gender differences in physical activity status and knowledge of Irish University staff and students. SPORT SCIENCES FOR HEALTH 2022. [DOI: 10.1007/s11332-022-00898-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Objectives
The aim of this study is to examine gender differences in physical activity status and knowledge of physical activity guidelines in University staff and students.
Methods
820 survey respondents, 419 males and 401 females (Age: mean 30 ± 12, median 24 years; Weight: mean 73.4 ± 15.8 kg; Stature: mean 172.1 ± 10.2 cm) were recruited via internal email. All participants completed a self-administered online format of the Global Physical activity Questionnaire.
Results
Less females were regularly active than males in students (p ≤ 0.001; Cramer’s V = 0.232 [small]), and staff (p = 0.003; Cramer’s V = 0.249 [small]). Overweight BMI incidence was greater among male students (p = 0.014; Cramer’s V = 0.13 [small]), and staff (p = 0.007; Cramer’s V = 0.31 [large]). A total of 43% of males and 29% of females were overweight or obese. No significant difference between genders for PA recommendations knowledge was observed (students; p = 0.174; Cramer’s V = 0.054 [trivial], staff; p = 0.691; Cramer’s V = 0.035 [trivial]). No significant difference between genders for disease incidence was observed (students; p = 0.894; Cramer’s V = 0.005 [trivial], staff; p = 0.237, Cramer's V = 0.101 [small]).
Conclusions
Males had greater levels of PA participation and incidence of overweight BMI compared to females. These findings suggest PA status alone does not determine BMI status. Further investigation is needed to determine factors related to BMI status.
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18
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Comparative Assessment of the Utility of Anthropometric and Bioelectrical Impedance Indices as Potential Predictors of Hypertension within a Ghanaian Adult Population: A Cross-Sectional Study. Int J Hypertens 2022; 2022:2242901. [PMID: 35127158 PMCID: PMC8813306 DOI: 10.1155/2022/2242901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 12/31/2021] [Indexed: 11/23/2022] Open
Abstract
Background Hypertension is an important public health concern that is claiming millions of lives worldwide. In sub-Saharan African countries, where some of the highest prevalence rates are being recorded, sufficient attention has not been given to its control. Objective The aim of this study was to determine the association and predictive potential of different anthropometric and bioelectrical impedance analysis (BIA) measures for hypertension. Methods A total of 812 individuals (204 men and 608 women) were enrolled, and their blood pressure measurement was determined. Direct anthropometric measures (weight, height, waist circumference (WC), and hip circumference) and derived anthropometric measures (body mass index, conicity index, abdominal volume index (AVI), and body adiposity index) were determined. BIA indices investigated included visceral fat level (VF), percentage body fat (%BF), resting metabolic rate (RMR), and skeletal muscle mass. Results A prevalence of 31.28% was observed for hypertension in the total study population, with males having a slightly higher prevalence than females. Except for the skeletal muscle mass, all the other indices measured showed an increasing trend from normotension to prehypertension and hypertension. Age and visceral fat level showed the highest correlation with systolic blood pressure for both genders. Receiver operator characteristic analysis showed that age was the best predictor of hypertension in both genders, whereas, in predicting prehypertension, RMR was the best predictor in males, and WC was the best predictor in females. VF, WC, and AVI were other good predictors of hypertension in this study population. However, BMI and % BF had a low predictive value for hypertension. Conclusion The result of this study shows that within this study population in addition to age, measures of central obesity rather than general obesity are the likely drivers of the hypertension epidemic; thus, measures aimed at controlling central obesity may offer some therapeutic and preventive advantage.
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Dean E, Olsén MF. A health and lifestyle framework for management of post covid-19 syndrome based on evidence-informed management of post-polio syndrome: a narrative review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2021. [DOI: 10.1080/21679169.2021.2000150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Elizabeth Dean
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Post Polio Clinic, University of British Columbia, Vancouver, Canada
| | - Monika Fagevik Olsén
- Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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20
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Seppo AE, Choudhury R, Pizzarello C, Palli R, Fridy S, Rajani PS, Stern J, Martina C, Yonemitsu C, Bode L, Bu K, Tamburini S, Piras E, Wallach DS, Allen M, Looney RJ, Clemente JC, Thakar J, Järvinen KM. Traditional Farming Lifestyle in Old Older Mennonites Modulates Human Milk Composition. Front Immunol 2021; 12:741513. [PMID: 34707611 PMCID: PMC8545059 DOI: 10.3389/fimmu.2021.741513] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/01/2021] [Indexed: 01/11/2023] Open
Abstract
Background In addition to farming exposures in childhood, maternal farming exposures provide strong protection against allergic disease in their children; however, the effect of farming lifestyle on human milk (HM) composition is unknown. Objective This study aims to characterize the maternal immune effects of Old Order Mennonite (OOM) traditional farming lifestyle when compared with Rochester (ROC) families at higher risk for asthma and allergic diseases using HM as a proxy. Methods HM samples collected at median 2 months of lactation from 52 OOM and 29 ROC mothers were assayed for IgA1 and IgA2 antibodies, cytokines, endotoxin, HM oligosaccharides (HMOs), and targeted fatty acid (FA) metabolites. Development of early childhood atopic diseases in children by 3 years of age was assessed. In addition to group comparisons, systems level network analysis was performed to identify communities of multiple HM factors in ROC and OOM lifestyle. Results HM contains IgA1 and IgA2 antibodies broadly recognizing food, inhalant, and bacterial antigens. OOM HM has significantly higher levels of IgA to peanut, ovalbumin, dust mites, and Streptococcus equii as well TGF-β2, and IFN-λ3. A strong correlation occurred between maternal antibiotic use and levels of several HMOs. Path-based analysis of HMOs shows lower activity in the path involving lactoneohexaose (LNH) in the OOM as well as higher levels of lacto-N-neotetraose (LNnT) and two long-chain FAs C-18OH (stearic acid) and C-23OH (tricosanoic acid) compared with Rochester HM. OOM and Rochester milk formed five different clusters, e.g., butyrate production was associated with Prevotellaceae, Veillonellaceae, and Micrococcaceae cluster. Development of atopic disease in early childhood was more common in Rochester and associated with lower levels of total IgA, IgA2 to dust mite, as well as of TSLP. Conclusion Traditional, agrarian lifestyle, and antibiotic use are strong regulators of maternally derived immune and metabolic factors, which may have downstream implications for postnatal developmental programming of infant's gut microbiome and immune system.
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Affiliation(s)
- Antti E. Seppo
- Division of Allergy and Immunology and Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital, Rochester, NY, United States
| | - Rakin Choudhury
- Department of Microbiology and Immunology and Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Catherine Pizzarello
- Division of Allergy and Immunology and Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital, Rochester, NY, United States
| | - Rohith Palli
- Medical Scientist Training Program, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Sade Fridy
- Division of Allergy and Immunology and Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital, Rochester, NY, United States
| | - Puja Sood Rajani
- Division of Allergy and Immunology and Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital, Rochester, NY, United States
| | - Jessica Stern
- Division of Allergy and Immunology and Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital, Rochester, NY, United States
| | - Camille Martina
- Department of Public Health Sciences & Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Chloe Yonemitsu
- Division of Neonatology and Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States
| | - Lars Bode
- Division of Neonatology and Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States,Mother-Milk-Infant Center of Research Excellence (MOMI CORE), University of California, San Diego, La Jolla, CA, United States
| | - Kevin Bu
- Department of Genetics and Genomic Sciences, Icahn Institute for Data Science and Genomic Technology, Precision Immunology Institue, Icahn School of Medicine at Mount Sinai, New York, New York, NY, United States
| | - Sabrina Tamburini
- Department of Genetics and Genomic Sciences, Icahn Institute for Data Science and Genomic Technology, Precision Immunology Institue, Icahn School of Medicine at Mount Sinai, New York, New York, NY, United States
| | - Enrica Piras
- Department of Genetics and Genomic Sciences, Icahn Institute for Data Science and Genomic Technology, Precision Immunology Institue, Icahn School of Medicine at Mount Sinai, New York, New York, NY, United States
| | - David S. Wallach
- Department of Genetics and Genomic Sciences, Icahn Institute for Data Science and Genomic Technology, Precision Immunology Institue, Icahn School of Medicine at Mount Sinai, New York, New York, NY, United States
| | - Maria Allen
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - R. John Looney
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Jose C. Clemente
- Department of Genetics and Genomic Sciences, Icahn Institute for Data Science and Genomic Technology, Precision Immunology Institue, Icahn School of Medicine at Mount Sinai, New York, New York, NY, United States
| | - Juilee Thakar
- Department of Microbiology and Immunology and Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Kirsi M. Järvinen
- Division of Allergy and Immunology and Center for Food Allergy, Department of Pediatrics, University of Rochester School of Medicine and Dentistry and Golisano Children’s Hospital, Rochester, NY, United States,Division of Allergy, Immunology, and Rheumatology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States,*Correspondence: Kirsi M. Järvinen,
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21
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Herrick C, Okpako O, Millington JDA. Unequal ecosystems of global health authorial expertise: Decolonising noncommunicable disease. Health Place 2021; 71:102670. [PMID: 34543840 DOI: 10.1016/j.healthplace.2021.102670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/24/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
The decolonisation agenda is gathering momentum in global health. Within this movement, one domain of analysis has been the ways in which the geographies of scholarly knowledge production (re)produce the inequities of coloniality. Drawing on the example of noncommunicable diseases (NCDs), here we deviate from this and instead examine the authorship of the key global documents that were used to ignite and mobilise the NCD advocacy agenda from 2000 to 2020. In doing so, we reflect on the changing ecosystems of authorial expertise. It shows that while the geographic distribution of expertise has broadened over time, the NCD domain remains a fairly tight and circumscribed network. Importantly this research also shows the complexities of ascribing location to expertise, a finding that speaks back to the decolonisation debate.
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Affiliation(s)
- Clare Herrick
- Department of Geography King's College London, Bush House NE Wing 6.07, London, WC2R 2LS, UK.
| | - Oritsematosan Okpako
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - James D A Millington
- Department of Geography King's College London, Bush House NE Wing 6.07, London, WC2R 2LS, UK
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22
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Kabir A, Karim MN, Billah B. Primary healthcare system readiness to prevent and manage non-communicable diseases in Bangladesh: a mixed-method study protocol. BMJ Open 2021; 11:e051961. [PMID: 34493524 PMCID: PMC8424828 DOI: 10.1136/bmjopen-2021-051961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/23/2021] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The burden of non-communicable diseases (NCDs) is rapidly increasing in Bangladesh. Currently, it contributes to 67% of annual deaths, and accounts for approximately 64% of the disease burden. Since 70% of the Bangladeshi population residing in the rural area rely on the primary healthcare system, assessment of its capacity is crucial for guiding public health decisions to prevent and manage NCDs. This protocol is designed to recognise and assess the Bangladeshi health system's readiness for NCDs at the primary level. METHODS AND ANALYSIS The study will use a mixed-method design. Numerical data will be collected using households and health facilities surveys, while qualitative data will be collected by interviewing healthcare providers, policy planners, health administrators and community members. The WHO's Service Availability and Readiness Assessment (SARA) methodology and Package of Essential Non-communicable (PEN) Disease Interventions for Primary Healthcare reference manuals will be used to assess the readiness of the primary healthcare facilities for NCD services. Furthermore, Health System Dynamics Framework will be used to examine health system factors. Using the supportive items outlined in the WHO PEN package, and indicators proposed in WHO SARA methodology, a composite score will be created to analyse facility-level data. Two independent samples t-test, analysis of variance and χ2 test methods will be used for bivariate analysis, and multiple regression analysis will be used for multivariable analysis. Complementarily, the thematic analysis approach will be used to analyse qualitative data. ETHICS AND DISSEMINATION The project has been approved by the Monash University Human Research Ethics Committee (Project ID: 27112), and Bangladesh Medical Research Council (Ref: BMRC/NREC/2019-2022/270). The research findings will be shared through research articles, conference proceedings or in other scientific media. The reports or publications will not have any information that can be used to identify any of the study participants.
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Affiliation(s)
- Ashraful Kabir
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Md Nazmul Karim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Rudolf Virchow, poverty and global health: from “politics as medicine on a grand scale” to “health in all policies”. GLOBAL HEALTH JOURNAL 2021. [DOI: 10.1016/j.glohj.2021.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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24
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Randomised trial on effect of involving media reporters in salt reduction programme to increase media reports and the public's knowledge, belief and behaviors on salt and health: Changzhi reporters trial. PLoS One 2021; 16:e0252989. [PMID: 34283844 PMCID: PMC8294101 DOI: 10.1371/journal.pone.0252989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 05/19/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To assess the effects of a novel mass media intervention in increasing media
reports on salt and health by involving media reporters in a scientifically
well designed salt reduction trial. Methods We recruited and trained 66 media reporters in Changzhi, Shanxi province,
China to conduct a randomized controlled trial on blood pressure lowering
effect of salt substitute in Dec, 2012 and Jan 2013 among their own
relatives or friends (253 from 129 families in the salt substitute arm and
263 from 133 families in the control arm for two months). We shared trial
results and other information on salt and health with the reporters within a
month after the trial. We monitored all local newspapers for the number of
relevant articles in 3 months before, 3 months during and 3 months after the
intervention and at the 6th, 12th, 18th,
24th and 48th months after the intervention.
Additionally, we conducted two independent surveys on knowledge, belief and
behaviours of salt and health among local citizens before and after the
intervention. Results As expected, systolic blood pressure was reduced significantly more in the
salt substitute than the control group (-4.7±11.0 mmHg vs -2.6±10.3 mmHg,
p<0.001) in the randomized trial. The monthly mean number of relevant
articles increased from 0.7 before to 1.7 during (p = 0.263), and further to
6.0 after the intervention (p<0.001), and varied from 2 (p = 0.170) to 4
(p = 0.008) from the 6th to 48th month; the awareness
of knowledge on salt and health among local citizens improved significantly
after the intervention. Conclusions Media reporters’ participation in a well-designed salt reduction trial
significantly increased the number of relevant media reports, and the effect
was sustained for a prolonged period. Future mass media public health
education programs should consider this innovative strategy for better and
sustained impacts.
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Jailobaeva K, Falconer J, Loffreda G, Arakelyan S, Witter S, Ager A. An analysis of policy and funding priorities of global actors regarding noncommunicable disease in low- and middle-income countries. Global Health 2021; 17:68. [PMID: 34187499 PMCID: PMC8240078 DOI: 10.1186/s12992-021-00713-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs), including mental health, have become a major concern in low- and middle-income countries. Despite increased attention to them over the past decade, progress toward addressing NCDs has been slow. A lack of bold policy commitments has been suggested as one of the contributors to limited progress in NCD prevention and management. However, the policies of key global actors (bilateral, multilateral, and not-for-profit organisations) have been understudied. METHODS This study aimed to map the key global actors investing in action regarding NCDs and review their policies to examine the articulation of priorities regarding NCDs. Narrative synthesis of 70 documents and 31 policy papers was completed, and related to data collated from the Global Health Data Visualisation Tool. RESULTS In 2019 41% of development assistance for health committed to NCDs came from private philanthropies, while that for other global health priorities from this source was just 20%. Through a range of channels, bilateral donors were the other major source of NCD funding (contributing 41% of NCD funding). The UK and the US were the largest bilateral investors in NCDs, each contributing 8%. However, NCDs are still under-prioritised within bilateral portfolios - receiving just 0.48% of US funding and 1.66% of the UK. NGOs were the key channels of funding for NCDs, spending 48% of the funds from donors in 2019. The reviewed literature generally focused on NCD policies of WHO, with policies of multilateral and bilateral donors given limited attention. The analysis of policies indicated a limited prioritisation of NCDs in policy documents. NCDs are framed in the policies as a barrier to economic growth, poverty reduction, and health system sustainability. Bilateral donors prioritise prevention, while multilateral actors offer policy options for NCD prevention and care. Even where stated as a priority, however, funding allocations are not aligned. CONCLUSION The growing threat of NCDs and their drivers are increasingly recognised. However, global actors' policy priorities and funding allocations need to align better to address these NCD threats. Given the level of their investment and engagement, more research is needed into the role of private philanthropies and NGOs in this area.
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Affiliation(s)
- Kanykey Jailobaeva
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Jennifer Falconer
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Giulia Loffreda
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Stella Arakelyan
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Sophie Witter
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Alastair Ager
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
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Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, Abedi A, Abhilash ES, Abila DB, Aboyans V, Abu-Rmeileh NME, Adebayo OM, Advani SM, Aghaali M, Ahinkorah BO, Ahmad S, Ahmadi K, Ahmed H, Aji B, Akunna CJ, Al-Aly Z, Alanzi TM, Alhabib KF, Ali L, Alif SM, Alipour V, Aljunid SM, Alla F, Allebeck P, Alvis-Guzman N, Amin TT, Amini S, Amu H, Amul GGH, Ancuceanu R, Anderson JA, Ansari-Moghaddam A, Antonio CAT, Antony B, Anvari D, Arabloo J, Arian ND, Arora M, Asaad M, Ausloos M, Awan AT, Ayano G, Aynalem GL, Azari S, B DB, Badiye AD, Baig AA, Bakhshaei MH, Banach M, Banik PC, Barker-Collo SL, Bärnighausen TW, Barqawi HJ, Basu S, Bayati M, Bazargan-Hejazi S, Behzadifar M, Bekuma TT, Bennett DA, Bensenor IM, Berfield KSS, Bhagavathula AS, Bhardwaj N, Bhardwaj P, Bhattacharyya K, Bibi S, Bijani A, Bintoro BS, Biondi A, Birara S, Braithwaite D, Brenner H, Brunoni AR, Burkart K, Butt ZA, Caetano dos Santos FL, Cámera LA, Car J, Cárdenas R, Carreras G, Carrero JJ, Castaldelli-Maia JM, Cattaruzza MSS, Chang JC, Chen S, Chu DT, Chung SC, Cirillo M, Costa VM, Couto RAS, Dadras O, Dai X, Damasceno AAM, Damiani G, Dandona L, Dandona R, Daneshpajouhnejad P, Darega Gela J, Davletov K, Derbew Molla M, Dessie GA, Desta AA, Dharmaratne SD, Dianatinasab M, Diaz D, Do HT, Douiri A, Duncan BB, Duraes AR, Eagan AW, Ebrahimi Kalan M, Edvardsson K, Elbarazi I, El Tantawi M, Esmaeilnejad S, Fadhil I, Faraon EJA, Farinha CSES, Farwati M, Farzadfar F, Fazlzadeh M, Feigin VL, Feldman R, Fernandez Prendes C, Ferrara P, Filip I, Filippidis F, Fischer F, Flor LS, Foigt NA, Folayan MO, Foroutan M, Gad MM, Gaidhane AM, Gallus S, Geberemariyam BS, Ghafourifard M, Ghajar A, Ghashghaee A, Giampaoli S, Gill PS, Glozah FN, Gnedovskaya EV, Golechha M, Gopalani SV, Gorini G, Goudarzi H, Goulart AC, Greaves F, Guha A, Guo Y, Gupta B, Gupta RD, Gupta R, Gupta T, Gupta V, Hafezi-Nejad N, Haider MR, Hamadeh RR, Hankey GJ, Hargono A, Hartono RK, Hassankhani H, Hay SI, Heidari G, Herteliu C, Hezam K, Hird TR, Hole MK, Holla R, Hosseinzadeh M, Hostiuc S, Househ M, Hsiao T, Huang J, Iannucci VC, Ibitoye SE, Idrisov B, Ilesanmi OS, Ilic IM, Ilic MD, Inbaraj LR, Irvani SSN, Islam JY, Islam RM, Islam SMS, Islami F, Iso H, Itumalla R, Iwagami M, Jaafari J, Jain V, Jakovljevic M, Jang SI, Janjani H, Jayaram S, Jeemon P, Jha RP, Jonas JB, Joo T, Jürisson M, Kabir A, Kabir Z, Kalankesh LR, Kanchan T, Kandel H, Kapoor N, Karimi SE, Katikireddi SV, Kebede HK, Kelkay B, Kennedy RD, Khoja AT, Khubchandani J, Kim GR, Kim YE, Kimokoti RW, Kivimäki M, Kosen S, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Kugbey N, Kumar GA, Kumar N, Kurmi OP, Kusuma D, Lacey B, Lam JO, Landires I, Lasrado S, Lauriola P, Lee DW, Lee YH, Leung J, Li S, Lin H, Linn S, Liu W, Lopez AD, Lopukhov PD, Lorkowski S, Lugo A, Majeed A, Maleki A, Malekzadeh R, Malta DC, Mamun AA, Manjunatha N, Mansouri B, Mansournia MA, Martinez-Raga J, Martini S, Mathur MR, Medina-Solís CE, Mehata S, Mendoza W, Menezes RG, Meretoja A, Meretoja TJ, Miazgowski B, Michalek IM, Miller TR, Mirrakhimov EM, Mirzaei H, Mirzaei-Alavijeh M, Misra S, Moghadaszadeh M, Mohammad Y, Mohammadian-Hafshejani A, Mohammed S, Mokdad AH, Monasta L, Moni MA, Moradi G, Moradi-Lakeh M, Moradzadeh R, Morrison SD, Mossie TB, Mubarik S, Mullany EC, Murray CJL, Naghavi M, Naghshtabrizi B, Nair S, Nalini M, Nangia V, Naqvi AA, Narasimha Swamy S, Naveed M, Nayak S, Nayak VC, Nazari J, Nduaguba SO, Neupane Kandel S, Nguyen CT, Nguyen HLT, Nguyen SH, Nguyen TH, Nixon MR, Nnaji CA, Norrving B, Noubiap JJ, Nowak C, Ogbo FA, Oguntade AS, Oh IH, Olagunju AT, Oren E, Otstavnov N, Otstavnov SS, Owolabi MO, P A M, Pakhale S, Pakshir K, Palladino R, Pana A, Panda-Jonas S, Pandey A, Parekh U, Park EC, Park EK, Pashazadeh Kan F, Patton GC, Pawar S, Pestell RG, Pinheiro M, Piradov MA, Pirouzpanah S, Pokhrel KN, Polibin RV, Prashant A, Pribadi DRA, Radfar A, Rahimi-Movaghar V, Rahman A, Rahman MHU, Rahman MA, Rahmani AM, Rajai N, Ram P, Ranabhat CL, Rathi P, Rawal L, Renzaho AMN, Reynales-Shigematsu LM, Rezapour A, Riahi SM, Riaz MA, Roever L, Ronfani L, Roshandel G, Roy A, Roy B, Sacco S, Saddik B, Sahebkar A, Salehi S, Salimzadeh H, Samaei M, Samy AM, Santos IS, Santric-Milicevic MM, Sarrafzadegan N, Sathian B, Sawhney M, Saylan M, Schaub MP, Schmidt MI, Schneider IJC, Schutte AE, Schwendicke F, Seidu AA, Senthil Kumar N, Sepanlou SG, Seylani A, Shafaat O, Shah SM, Shaikh MA, Shalash AS, Shannawaz M, Sharafi K, Sheikh A, Sheikhbahaei S, Shigematsu M, Shiri R, Shishani K, Shivakumar KM, Shivalli S, Shrestha R, Siabani S, Sidemo NB, Sigfusdottir ID, Sigurvinsdottir R, Silva DAS, Silva JP, Singh A, Singh JA, Singh V, Sinha DN, Sitas F, Skryabin VY, Skryabina AA, Soboka M, Soriano JB, Soroush A, Soshnikov S, Soyiri IN, Spurlock EE, Sreeramareddy CT, Stein DJ, Steiropoulos P, Stortecky S, Straif K, Suliankatchi Abdulkader R, Sulo G, Sundström J, Tabuchi T, Tadakamadla SK, Taddele BW, Tadesse EG, Tamiru AT, Tareke M, Tareque MI, Tarigan IU, Temsah MH, Thankappan KR, Thapar R, Tichopad A, Tolani MA, Topouzis F, Tovani-Palone MR, Tran BX, Tripathy JP, Tsegaye GW, Tsilimparis N, Tymeson HD, Ullah A, Ullah S, Unim B, Updike RL, Vacante M, Valdez PR, Vardavas C, Varona Pérez P, Vasankari TJ, Venketasubramanian N, Verma M, Vetrova MV, Vo B, Vu GT, Waheed Y, Wang Y, Welding K, Werdecker A, Whisnant JL, Wickramasinghe ND, Yamagishi K, Yandrapalli S, Yatsuya H, Yazdi-Feyzabadi V, Yeshaw Y, Yimmer MZ, Yonemoto N, Yu C, Yunusa I, Yusefzadeh H, Zahirian Moghadam T, Zaman MS, Zamanian M, Zandian H, Zar HJ, Zastrozhin MS, Zastrozhina A, Zavala-Arciniega L, Zhang J, Zhang ZJ, Zhong C, Zuniga YMH, Gakidou E. Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet 2021; 397:2337-2360. [PMID: 34051883 PMCID: PMC8223261 DOI: 10.1016/s0140-6736(21)01169-7] [Citation(s) in RCA: 496] [Impact Index Per Article: 165.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 02/15/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. METHODS We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. FINDINGS Globally in 2019, 1·14 billion (95% uncertainty interval 1·13-1·16) individuals were current smokers, who consumed 7·41 trillion (7·11-7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5-28·5] reduction) and females (37·7% [35·4-39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98-1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16-8·20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3-21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. INTERPRETATION In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. FUNDING Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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Gupta RD, Talukder A, Hossain MB, Akonde M, Al Kibria GM. Prevalence and associated factors of hypertension among South African adults: findings from the Demographic and Health Survey 2016. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01607-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Dean E, Skinner M, Yu HPM, Jones AYM, Gosselink R, Söderlund A. Why COVID-19 strengthens the case to scale up assault on non-communicable diseases: role of health professionals including physical therapists in mitigating pandemic waves. AIMS Public Health 2021; 8:369-375. [PMID: 34017898 PMCID: PMC8116194 DOI: 10.3934/publichealth.2021028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/14/2021] [Indexed: 02/05/2023] Open
Abstract
As SARS-CoV-2, the virus responsible for COVID-19, spread globally, the most severely affected sub-populations were the elderly and those with multi-morbidity largely related to non-communicable diseases (NCDs), e.g., heart disease, hypertension, type 2 diabetes, obesity. NCDs are largely preventable with healthy nutrition, regular activity, and not smoking. This perspective outlines the rationale for health professionals' including physical therapists' role in reducing COVID-19 susceptibility. Evidence is synthesized supporting the pro-inflammatory effects of the western diet, increasingly consumed globally, inactivity, and smoking; and the immune-boosting, anti-inflammatory effects of a whole food plant-based diet, regular physical activity, and not smoking. An increased background of chronic low-grade systemic inflammation associated with unhealthy lifestyle practices appears implicated in an individual's susceptibility to SARS-CoV-2. It is timely to re-double efforts across healthcare sectors to reduce the global prevalence of NCDs on two fronts: one, to reduce SARS-CoV-2 susceptibility; and two, to reduce the impact of subsequent waves given high blood pressure and blood sugar, common in people with multi-morbidity, can be improved within days/weeks with anti-inflammatory healthy lifestyle practices, and weight loss and atherosclerosis reduction/reversal, within months/years. With re-doubled efforts to control NCD risk factors, subsequent waves could be less severe. Health professionals including physical therapists have a primary role in actively leading this initiative.
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Affiliation(s)
- Elizabeth Dean
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Margot Skinner
- School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Homer Peng-Ming Yu
- Rehabilitation Medical Center, West China Hospital, Sichuan University, and Faculty of Physical Therapy, Rehabilitation Medicine College, Sichuan University, Chengdu, China
| | - Alice YM Jones
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Rik Gosselink
- Department Rehabilitation Sciences, Faculty Movement and Rehabilitation Sciences, Katholieke Universiteit, Leuven, Belgium
| | - Anne Söderlund
- Division of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Fieldes M, Bourguignon C, Assou S, Nasri A, Fort A, Vachier I, De Vos J, Ahmed E, Bourdin A. Targeted therapy in eosinophilic chronic obstructive pulmonary disease. ERJ Open Res 2021; 7:00437-2020. [PMID: 33855061 PMCID: PMC8039900 DOI: 10.1183/23120541.00437-2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/14/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a common and preventable airway disease causing significant worldwide mortality and morbidity. Lifetime exposure to tobacco smoking and environmental particles are the two major risk factors. Over recent decades, COPD has become a growing public health problem with an increase in incidence. COPD is defined by airflow limitation due to airway inflammation and small airway remodelling coupled to parenchymal lung destruction. Most patients exhibit neutrophil-predominant airway inflammation combined with an increase in macrophages and CD8+ T-cells. Asthma is a heterogeneous chronic inflammatory airway disease. The most studied subtype is type 2 (T2) high eosinophilic asthma, for which there are an increasing number of biologic agents developed. However, both asthma and COPD are complex and share common pathophysiological mechanisms. They are known as overlapping syndromes as approximately 40% of patients with COPD present an eosinophilic airway inflammation. Several studies suggest a putative role of eosinophilia in lung function decline and COPD exacerbation. Recently, pharmacological agents targeting eosinophilic traits in uncontrolled eosinophilic asthma, especially monoclonal antibodies directed against interleukins (IL-5, IL-4, IL-13) or their receptors, have shown promising results. This review examines data on the rationale for such biological agents and assesses efficacy in T2-endotype COPD patients. Patients with severe COPD and eosinophilic inflammation experience uncontrolled symptoms despite optimal pharmaceutical treatment. The development of new biomarkers is needed for better phenotyping of patients to propose innovative targeted therapy.https://bit.ly/2KzWuNO
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Affiliation(s)
- Mathieu Fieldes
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France
| | | | - Said Assou
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France
| | - Amel Nasri
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France
| | - Aurélie Fort
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, Montpellier, France
| | - Isabelle Vachier
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France
| | - John De Vos
- IRMB, INSERM, Montpellier University Hospital, Montpellier, France.,Dept of Cell and Tissue Engineering, Montpellier University Hospital, Montpellier, France
| | - Engi Ahmed
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France
| | - Arnaud Bourdin
- Dept of Respiratory Diseases, Montpellier University Hospital, INSERM, Montpellier, France.,PhyMedExp, University of Montpellier, INSERM U1046, Montpellier, France
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Mariamenatu AH, Abdu EM. Overconsumption of Omega-6 Polyunsaturated Fatty Acids (PUFAs) versus Deficiency of Omega-3 PUFAs in Modern-Day Diets: The Disturbing Factor for Their "Balanced Antagonistic Metabolic Functions" in the Human Body. J Lipids 2021; 2021:8848161. [PMID: 33815845 PMCID: PMC7990530 DOI: 10.1155/2021/8848161] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/01/2021] [Accepted: 03/01/2021] [Indexed: 12/19/2022] Open
Abstract
Polyunsaturated fatty acids (PUFAs) contain ≥2 double-bond desaturations within the acyl chain. Omega-3 (n-3) and Omega-6 (n-6) PUFAs are the two known important families in human health and nutrition. In both Omega families, many forms of PUFAs exist: α-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) from the n-3 family and linoleic acid (LA), dihomo-γ-linolenic acid (DGLA), and arachidonic acid (AA) from the n-6 family are the important PUFAs for human health. Omega-3 and Omega-6 PUFAs are competitively metabolized by the same set of desaturation, elongation, and oxygenase enzymes. The lipid mediators produced from their oxidative metabolism perform opposing (antagonistic) functions in the human body. Except for DGLA, n-6 PUFA-derived lipid mediators enhance inflammation, platelet aggregation, and vasoconstriction, while those of n-3 inhibit inflammation and platelet aggregation and enhance vasodilation. Overconsumption of n-6 PUFAs with low intake of n-3 PUFAs is highly associated with the pathogenesis of many modern diet-related chronic diseases. The volume of n-6 PUFAs is largely exceeding the volume of n-3PUFAs. The current n-6/n-3 ratio is 20-50/1. Due to higher ratios of n-6/n-3 in modern diets, larger quantities of LA- and AA-derived lipid mediators are produced, becoming the main causes of the formation of thrombus and atheroma, the allergic and inflammatory disorders, and the proliferation of cells, as well as the hyperactive endocannabinoid system. Therefore, in order to reduce all of these risks which are due to overconsumption of n-6 PUFAs, individuals are required to take both PUFAs in the highly recommended n-6/n-3 ratio which is 4-5/1.
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Affiliation(s)
- Abeba Haile Mariamenatu
- Department of Biotechnology, College of Natural and Computational Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
| | - Emebet Mohammed Abdu
- Department of Biology, College of Natural and Computational Science, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia
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Agazhe M, Eshetu D, Arsicha A, Hamato A, Petros A, Dabaro D, Yohanis N, Getahun B, Hirigo AT. Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia. SAGE Open Med 2021; 9:20503121211001154. [PMID: 33796298 PMCID: PMC7968040 DOI: 10.1177/20503121211001154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/15/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction: In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital. Methods: An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients’ medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant. Result: From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003). Conclusion: The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.
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Affiliation(s)
| | - Daniel Eshetu
- Department of Microbiology, Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Admasu Arsicha
- Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Assefa Hamato
- Department of Microbiology, Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Assefa Petros
- Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | - Desalegn Dabaro
- Yirgalem Hospital Medical College, Yirgalem, Southern-Ethiopia
| | | | - Bekalu Getahun
- Department of Ophthalmology & Optometry, College of Medicine and Health Science, Hawassa University, Hawassa, Southern-Ethiopia
| | - Agete Tadewos Hirigo
- School of Medical Laboratory Sciences, Faculty of Medicine, College of Medicine and Health Science, Hawassa University, Hawassa, Southern-Ethiopia
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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052439. [PMID: 33801381 PMCID: PMC7967573 DOI: 10.3390/ijerph18052439] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 01/02/2023]
Abstract
Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38-4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14-3.22), 4.71 (95%CI = 3.67-6.11), 6.96 (95%CI = 4.95-9.87), 10.59 (95%CI = 7.10-15.80), and 19.89 (95%CI = 11.13-35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.
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Tan MMJ, Han E, Shrestha P, Wu S, Shiraz F, Koh GCH, McKee M, Legido-Quigley H. Framing global discourses on non-communicable diseases: a scoping review. BMC Health Serv Res 2021; 21:20. [PMID: 33407447 PMCID: PMC7786870 DOI: 10.1186/s12913-020-05958-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 11/23/2020] [Indexed: 11/19/2022] Open
Abstract
Background The choices that policymakers make are shaped by how their problems are framed. At last, non-communicable diseases (NCDs) have risen high on the global policy agenda, but there are many disputed issues. First, what are they? Their name refers not to what they are but what they are not. Second, where do their boundaries lie? What diseases are included? Third, should we view their causes as mainly biomedical, behavioural, or social, or a combination? Our failure to resolve these issues has been invoked as a reason for our limited progress in developing and implementing effective remedies. In this scoping review, we ask “What is known from the existing literature about how NCDs are framed in the global policy discourses?” We answer it by reviewing the frames employed in policy and academic discourses. Methods We searched nine electronic databases for articles published since inception to 31 May 2019. We also reviewed websites of eight international organisations to identify global NCDs policies. We extracted data and synthesised findings to identify key thematic frames. Results We included 36 articles and nine policy documents on global NCDs policies. We identified five discursive domains that have been used and where there are differing perspectives. These are: “Expanding the NCDs frame to include mental health and air pollution”; “NCDs and their determinants”; “A rights-based approach to NCDs”; “Approaches to achieving policy coherence in NCDs globally”; and “NCDs as part of Sustainable Socio-economic Development”. We further identified 12 frames within the five discursive domains. Conclusions This scoping review identifies issues that remain unresolved and points to a need for alignment of perspectives among global health policy actors, as well as synergies with those working on mental health, maternal health, and child health. The current COVID-19 pandemic warrants greater consideration of its impact on global NCDs policies. Future global strategies for NCDs need to consider explicitly how NCDs are framed in a changing global health discourse and ensure adequate alignment with implementation and global health issues. There is a need for global strategies to recognise the pertinent role of actors in shaping policy discourses. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-020-05958-0.
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Affiliation(s)
- Melisa Mei Jin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore.
| | - Emeline Han
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Pami Shrestha
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Shishi Wu
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Farah Shiraz
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore
| | - Martin McKee
- London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore, 117549, Singapore.,London School of Hygiene and Tropical Medicine, London, WC1H 9SH, UK
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Rawal L, Jubayer S, Choudhury SR, Islam SMS, Abdullah AS. Community health workers for non-communicable diseases prevention and control in Bangladesh: a qualitative study. Glob Health Res Policy 2020; 6:1. [PMID: 33407942 PMCID: PMC7786185 DOI: 10.1186/s41256-020-00182-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 12/03/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The increasing burden of Non-Communicable Diseases (NCDs) in Bangladesh underscores the importance of strengthening primary health care systems. In this study, we examined the barriers and facilitators to engaging Community Health Workers (CHWs) for NCDs prevention and control in Bangladesh. METHODS We used multipronged approaches, including a. Situation analyses using a literature review, key personnel and stakeholders' consultative meetings, and exploratory studies. A grounded theory approach was used for qualitative data collection from health facilities across three districts in Bangladesh. We conducted in-depth interviews with CHWs (Health Inspector; Community Health Care Provider; Health Assistant and Health Supervisor) (n = 4); key informant interviews with central level health policymakers/ managers (n = 15) and focus group discussions with CHWs (4 FGDs; total n = 29). Participants in a stakeholder consultative meeting included members from the government (n = 4), non-government organisations (n = 2), private sector (n = 1) and universities (n = 2). Coding of the qualitative data and identification of themes from the transcripts were carried out and thematic approach was used for data analyses. RESULTS The CHWs in Bangladesh deliver a wide range of public health programs. They also provide several NCDs specific services, including screening, provisional diagnosis, and health education and counselling for common NCDs, dispensing basic medications, and referral to relevant health facilities. These services are being delivered from the sub-district health facility, community clinics and urban health clinics. The participants identified key challenges and barriers, which include lack of NCD specific guidelines, inadequate training, excessive workload, inadequate systems-level support, and lack of logistics supplies and drugs. Yet, the facilitating factors to engaging CHWs included government commitment and program priority, development of NCD related policies and strategies, establishment of NCD corners, community support systems, social recognition of health care staff and their motivation. CONCLUSION Engaging CHWs has been a key driver to NCDs services delivery in Bangladesh. However, there is a need for building capacity of CHWs, maximizing CHWs engagement to NCD services delivery, facilitating systems-level support and strengthening partnerships with non-state sectors would be effective in prevention and control efforts of NCDs in Bangladesh.
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Affiliation(s)
- Lal Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney Campus, 400 Kent Street, Sydney, NSW, Australia.
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Adelaide, SA, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, Australia.
| | - Shamim Jubayer
- National Heart Foundation Hospital and Research Institute, Mirpur 2, Dhaka, 1216, Bangladesh.
| | - Sohel R Choudhury
- National Heart Foundation Hospital and Research Institute, Mirpur 2, Dhaka, 1216, Bangladesh
| | | | - Abu S Abdullah
- Global Health Research Center, Duke Kunshan University, 8 Duke Avenue, Kunshan, 215347, People's Republic of China.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
- Boston University School of Medicine, Boston Medical Center, Boston, MA, USA.
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Al-Sayegh N, Al-Enezi K, Nadar M, Dean E. Health Status, Behaviors, and Beliefs of Health Sciences Students and Staff at Kuwait University: Toward Maximizing the Health of Future Health Professionals and Their Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238776. [PMID: 33255967 PMCID: PMC7730932 DOI: 10.3390/ijerph17238776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 12/25/2022]
Abstract
Health professionals who engage in healthy lifestyle behaviors are more likely to promote their patients’ health. We evaluated health status, behaviors, and beliefs of students (future health professionals) and staff in four health sciences faculties, Kuwait University. In total, 600 students and 231 staff participated in this descriptive cross-sectional study. Questionnaire surveys were used to evaluate lifestyle-related practices and participants’ beliefs about these practices, in addition to health-related objective measures, e.g., heart rate, blood pressure, and body mass index. Overweight/obesity was prevalent among the participants (staff, 68.7%, students, 48.1%; p < 0.001); 57% of staff had suboptimal resting blood pressures. About half of the participants reported being moderately physically active (staff, 44.8%, students, 52.6%; p < 0.05), and most reported moderate/high stress (staff, 88.8%, students, 90.9%; p > 0.05). Only 25.1% of staff and 27.9% of students reported at least 8 h sleep nightly (p > 0.05). Staff reported healthier dietary practices than students (p-value range < 0.001–0.02). Overall, the participants had sub-optimal health indices. A marked gap existed between participants’ beliefs about healthy lifestyle practices and their actual health status. Healthy lifestyle programs are needed on campus with respect to diet, exercise, and stress management. As emerging health professionals, students in health sciences faculties, Kuwait University, need exposure to a health-promoting environment including healthy staff as role models.
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Affiliation(s)
- Nowall Al-Sayegh
- Department of Physical Therapy, Faculty of Allied Health Sciences, Kuwait University, Safat 12037, Kuwait
- Correspondence: ; Tel.: +965-2463-3510
| | - Khazna Al-Enezi
- Department of Medicine, Faculty of Medicine, Kuwait University, Safat 12037, Kuwait;
| | - Mohammed Nadar
- Department of Occupational Therapy, Faculty of Allied Health Sciences, Kuwait University, Safat 12037, Kuwait;
| | - Elizabeth Dean
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 Friedman Building, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada;
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Bai Y, Wu X, Tsang RCC, Yun R, Lu Y, Dean E, Jones AYM. A Randomised Controlled Trial to Evaluate the Administration of the Health Improvement Card as a Health Promotion Tool: A Physiotherapist-Led Community-Based Initiative. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218065. [PMID: 33147721 PMCID: PMC7663545 DOI: 10.3390/ijerph17218065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/17/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
A randomised controlled trial was conducted to evaluate the administration of the Health Improvement Card (HIC) on lifestyle practices and biometric variables in community-dwelling Chinese participants. Adults living in Shanghai were randomly assigned to either the HIC-intervention or control group. Measurements/assessments were conducted at baseline and three-month follow-up. Supervised physiotherapy students administered the HIC and four standardised questionnaires related to health and wellbeing. Both groups received a health promotion education pamphlet. Based on participants’ HIC biometric and lifestyle scores, students prescribed lifestyle, and exercise advice to the HIC-intervention group. 171 individuals (39 men, 132 women) (mean age 68.4 ± 9.7 y) participated. At follow-up, body mass index (BMI) and waist circumference decreased significantly in the HIC-intervention group. Furthermore, the number of participants in the HIC-intervention group categorised as low risk regarding their physical activity and dietary practices, increased by 32.2% and 20%, respectively. Changes in standardised questionnaire scores did not meet minimum clinically importance differences in either group. This is the first study to demonstrate that HIC-informed health promotion education can improve people’s lifestyle practices, thereby, objective biometric variables. Evaluation of the effect of HIC-informed lifestyle education on some biometric parameters (blood pressure and BMI) may warrant a longer timeframe.
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Affiliation(s)
- Yiwen Bai
- Department of Physical Therapy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; (Y.B.); (X.W.); (R.Y.)
- Department of Rehabilitation Medicine, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
| | - Xubo Wu
- Department of Physical Therapy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; (Y.B.); (X.W.); (R.Y.)
- Department of Rehabilitation Medicine, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
| | - Raymond CC Tsang
- Department of Physiotherapy, MacLehose Rehabilitation Centre, Hong Kong, China;
| | - Ruisheng Yun
- Department of Physical Therapy, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; (Y.B.); (X.W.); (R.Y.)
| | - Yan Lu
- Department of Rehabilitation Medicine, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China;
| | - Elizabeth Dean
- Department of Physical Therapy, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| | - Alice YM Jones
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia
- Correspondence: ; Tel.: +61-407-997-828
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The difference in knowledge and attitudes of using mobile health applications between actual user and non-user among adults aged 50 and older. PLoS One 2020; 15:e0241350. [PMID: 33108792 PMCID: PMC7591083 DOI: 10.1371/journal.pone.0241350] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 10/13/2020] [Indexed: 12/26/2022] Open
Abstract
Background Despite the great benefits of mobile health applications (mHAs) in managing non-communicable diseases (NCDs) internationally, studies have documented general challenges to broad adoption of mHAs among older age groups. By focusing on broad adoption, these studies have been limited in their evaluation of adults aged 50 and older who have high risk of NCDs and can benefit the most from the functionalities provided by mHAs. Objective This study aims to evaluate the knowledge, self-confidence, perceived benefits, and barriers of using mHAs depending on experience with mHAs among adults aged 50 and older. Furthermore, we aim to identify the factors associated with the actual use of mHAs. Methods We conducted a cross-sectional survey at a single tertiary hospital in Seoul, Korea, between May 1 and May 31, 2018. Of the 625 participants who were contacted, 323 participants were granted full inclusion to the study. We compared demographics, knowledge, self-confidence, and perceived benefits and barriers by experience with using mHAs, then performed logistic regression to identify the factors associated with mHA use. Results Among the participants, 64.1% (N = 207) had experience using mHAs. Those in the experienced group were more likely to have more than college education (55.1% vs. 27.5%, P < 0.001) and to report a higher monthly income (≥ $7,000, 22.7% vs. 18.1%, P = 0.05) than their less-experienced counterparts. Although the experienced group was more likely to have higher self-confidence in using mHAs, about half of the study participants, including people with experience using mHAs, did not have appropriate knowledge of mobile technology. With adjusted logistic model, higher educated (adjusted PR (aPR) = 1.53, 95% CI, 1.26–1.80), higher perceived benefits of mHAs (aPR = 1.43, 95% CI, 1.04–1.83), and higher self-confidence using mHAs (aPR = 1.41, 95% CI, 1.12–1.70) were significant factors associated with mHA use. Conclusions The use of mHAs among adults aged 50 and older is becoming more common globally; nevertheless, there are still people unable to use mHAs properly because of lack of experience and knowledge. Strategies are needed to encourage the reliable usage of mHAs among those who may need it the most by improving self-confidence and better articulating benefits.
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Patient experiences in managing non-communicable diseases in Namibia. Res Social Adm Pharm 2020; 16:1550-1557. [PMID: 32919919 DOI: 10.1016/j.sapharm.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 07/30/2020] [Accepted: 08/06/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The prevalence of non-communicable diseases (NCDs) is rising in Namibia, and with it, the need for pharmacists to empower patients. This research aims to 1) identify patient-reported barriers and facilitators to managing chronic NCDs for Namibians, and 2) characterize common patient-reported medication and health-related needs of Namibians with chronic NCDs. METHODS This qualitative study used semi-structured interviews to elicit participant perspectives regarding NCDs. The study used the conceptual frameworks of the Health Belief Model, the Theory of Planned Behavior, and the Explanatory Models of Illness to identify and understand key factors necessary to develop relevant patient-centered interventions. Participants were recruited from pharmacies throughout Namibia. Data were analyzed using thematic analysis from the transcribed interviews. RESULTS A total of 23 interviews were conducted, with 20 being included in the final analysis. Themes identified included: 1) participants were motivated to seek care when they were symptomatic; 2) participants felt motivated to care for their condition to improve their own lives and their families for their family's sake; 3) participants integrated information from a variety of sources into their disease knowledge; 4) participants describe wanting to be more engaged in managing their health and wanting support to help manage their condition; 5) participants describe awareness of lifestyle changes necessary to improve health, but face many barriers to achieving them. CONCLUSION This study identified key factors that are essential for pharmacists and other health care professionals to be aware of in order to support patients who are diagnosed with an NCD. Health care providers should consider strategies to engage patients to harness their motivations, enhance health education, and create systems to reduce barriers to addressing lifestyle.
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Dean E, Jones A, Yu HPM, Gosselink R, Skinner M. Translating COVID-19 Evidence to Maximize Physical Therapists' Impact and Public Health Response. Phys Ther 2020; 100:1458-1464. [PMID: 32589718 PMCID: PMC7337734 DOI: 10.1093/ptj/pzaa115] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/14/2020] [Indexed: 02/05/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has sounded alarm bells throughout global health systems. As of late May, 2020, over 100,000 COVID-19-related deaths were reported in the United States, which is the highest number of any country. This article describes COVID-19 as the next historical turning point in the physical therapy profession's growth and development. The profession has had over a 100-year tradition of responding to epidemics, including poliomyelitis; 2 world wars and geographical regions experiencing conflicts and natural disasters; and, the epidemic of noncommunicable diseases (NCDs). The evidence-based role of noninvasive interventions (nonpharmacological/nonsurgical) that hallmark physical therapist practice has emerged as being highly relevant today in addressing COVID-19 in 2 primary ways. First, despite some unique features, COVID-19 presents as acute respiratory distress syndrome in its severe acute stage. Acute respiratory distress syndrome is very familiar to physical therapists in intensive care units. Body positioning and mobilization, prescribed based on comprehensive assessments/examinations, counter the negative sequelae of recumbency and bedrest; augment gas exchange and reduce airway closure, deconditioning, and critical illness complications; and maximize long-term functional outcomes. Physical therapists have an indisputable role across the contiuum of COVID-19 care. Second, over 90% of individuals who die from COVID-19 have comorbidities, most notably cardiovascular disease, hypertension, chronic lung disease, type 2 diabetes mellitus, and obesity. Physical therapists need to redouble their efforts to address NCDs by assessing patients for risk factors and manifestations and institute evidence-based health education (smoking cessation, whole-food plant-based nutrition, weight control, physical activity/exercise), and/or support patients' efforts when these are managed by other professionals. Effective health education is a core competency for addressing risk of death by COVID-19 as well as NCDs. COVID-19 is a wake-up call to the profession, an opportunity to assert its role throughout the COVID-19 care continuum, and augment public health initiatives by reducing the impact of the current pandemic.
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Affiliation(s)
- Elizabeth Dean
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 Friedman Bldg, 2177 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada,Address all correspondence to Dr. Dean at:
| | - Alice Jones
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Homer Peng-Ming Yu
- Rehabilitation Medical Center, West China Hospital, Sichuan University, Sichuan, China; and Faculty of Physical Therapy, Rehabilitation Medicine College, Sichuan University
| | - Rik Gosselink
- Department Rehabilitation Sciences, Faculty Movement and Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Margot Skinner
- School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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Vidal N, León-García M, Jiménez M, Bermúdez K, De Vos P. Community and health staff perceptions on non-communicable disease management in El Salvador's health system: a qualitative study. BMC Health Serv Res 2020; 20:474. [PMID: 32460769 PMCID: PMC7251854 DOI: 10.1186/s12913-020-05249-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/23/2020] [Indexed: 11/25/2022] Open
Abstract
Background Non-communicable Diseases (NCDs) are the leading cause of global mortality and disability with a rising burden in low- and middle-income countries. Their multifactorial aetiology, and their requirement of long-term care, implies the need for comprehensive approaches. From 2009, the Ministry of Health (MoH) in El Salvador has developed a national public health system based on comprehensive primary health care. This study aims to describe the different stakeholders’ perceptions about the management of NCDs along the pathways of care in this health system. Methods During three fieldwork periods in 2018, three complementary qualitative data collection methods were deployed and conducted in settings with high prevalence of NCDs within El Salvador. First, illness narrative methodology was used to document the life histories of people living with a chronic disease and being treated in second and third level health facilities. Second, through social mapping, support resources that NCD patients used throughout the process of their illness within the same settings were analysed. Third, semi-structured interviews were conducted in the same locations, with both chronic patients and health personnel working at different levels of the primary health care setting. Participants were recruited through purposive and snowball sampling, and a deductive approach was implemented for coding during the analysis phase. After grouping codes into potential themes, a thematic framework was developed using a reflexive approach and following triangulation of the data. Results This innovative approach of combining three well-defined qualitative methods identified key implications for the implementation of a comprehensive approach to NCD management in resource-poor settings. The following elements are identified: 1) social risk factors and barriers to care; 2) patient pathways to NCD care; 3) available resources identified through social connections mapping; 4) trust in social connections; and 5) community health promotion and NCD prevention management. Conclusions The Salvadoran public health system has been able to strengthen its comprehensive approach to NCDs, combining a clinical approach – including long-term follow-up – with a preventive community-based strategy. The structural collaboration between the health system and the (self-) organised community has been essential for identifying failings, discuss tensions and work out adapted solutions.
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Affiliation(s)
- Nicole Vidal
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Montserrat León-García
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK. .,Biomedical Research Institute Sant Pau (IIBSant Pau), Iberoamerican Cochrane Centre, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - Marta Jiménez
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Keven Bermúdez
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Pol De Vos
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK.,Institute of Tropical Medicine, Antwerp, Belgium
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Senanayake S, Graves N, Healy H, Baboolal K, Kularatna S. Cost-utility analysis in chronic kidney disease patients undergoing kidney transplant; what pays? A systematic review. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2020; 18:18. [PMID: 32477010 PMCID: PMC7236510 DOI: 10.1186/s12962-020-00213-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Health systems are under pressure to deliver more effective care without expansion of resources. This is particularly pertinent to diseases like chronic kidney disease (CKD) that are exacting substantial financial burden to many health systems. The aim of this study is to systematically review the Cost Utility Analysis (CUA) evidence generated across interventions for CKD patients undergoing kidney transplant (KT). Methods A systemic review of CUA on the interventions for CKD patients undergoing KT was carried out using a search of the MEDLINE, CINAHL, EMBASE, PsycINFO and NHS-EED. The CHEERS checklist was used as a set of good practice criteria in determining the reporting quality of the economic evaluation. Quality of the data used to inform model parameters was determined using the modified hierarchies of data sources. Results A total of 330 articles identified, 16 met the inclusion criteria. Almost all (n = 15) the studies were from high income countries. Out of the 24 characteristics assessed in the CHEERS checklist, more than 80% of the selected studies reported 14 of the characteristics. Reporting of the CUA were characterized by lack of transparency of model assumptions, narrow economic perspective and incomplete assessment of the effect of uncertainty in the model parameters on the results. The data used for the economic model were satisfactory quality. The authors of 13 studies reported the intervention as cost saving and improving quality of life, whereas three studies were cost increasing and improving quality of life. In addition to the baseline analysis, sensitivity analysis was performed in all the evaluations except one. Transplanting certain high-risk donor kidneys (high risk of HIV and Hepatitis-C infected kidneys, HLA mismatched kidneys, high Kidney Donor Profile Index) and a payment to living donors, were found to be cost-effective. Conclusions The quality of economic evaluations reviewed in this paper were assessed to be satisfactory. Implementation of these strategies will significantly impact current systems of KT and require a systematic implementation plan and coordinated efforts from relevant stakeholders.
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Affiliation(s)
- Sameera Senanayake
- 1Australian Centre for Health Services Innovation, School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Nicholas Graves
- 1Australian Centre for Health Services Innovation, School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, QLD 4059 Australia
| | - Helen Healy
- 2Royal Brisbane Hospital for Women, Brisbane, Australia.,3School of Medicine, University of Queensland, Brisbane, Australia
| | - Keshwar Baboolal
- 2Royal Brisbane Hospital for Women, Brisbane, Australia.,3School of Medicine, University of Queensland, Brisbane, Australia
| | - Sanjeewa Kularatna
- 1Australian Centre for Health Services Innovation, School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, QLD 4059 Australia
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Yen YS, Harnod D, Lin CL, Harnod T, Kao CH. Long-Term Mortality and Medical Burden of Patients with Chronic Obstructive Pulmonary Disease with and without Subsequent Stroke Episodes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072550. [PMID: 32276400 PMCID: PMC7177539 DOI: 10.3390/ijerph17072550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 12/12/2022]
Abstract
Background: We used the Taiwan National Health Insurance Research Database (NHIRD) to determine the differences in mortality and medical burden between patients with chronic obstructive pulmonary disease (COPD) with and without stroke. Methods: We enrolled participants aged ≥20 years and defined four subgroups in this study, namely patients with COPD (International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM): 491, 492, 494, and 496), patients with COPD with stroke (ICD-9 CM: 430–438), with COPD without stroke, and comparison subgroups. We calculated the hazard ratios and 95% CIs for all-cause mortality risk, average duration of hospitalization, and frequency of medical visits in these subgroups after adjustments were made for age, sex, and comorbidities. All participants were followed until the date of death, the date they were censored, the date they withdrew from the NHIRD, or 31 December, 2013. Results: In total, 9.70% (men vs. women, 11.19% vs. 8.28%) of patients with COPD developed subsequent stroke during the 14 year follow-up. After a stroke, the risk of mortality exhibited a 2.66- to 5.05-fold increase, especially in the younger ones. COPD with stroke was also a leading factor in the increase in the average number of hospitalization days and frequency of medical visits. Conclusion: The mortality risk of patients with COPD is considerably increased by stroke independent of the other effects of COPD. Moreover, the average number of hospitalization days and frequency of medical visits dramatically increased in patients with COPD after stroke.
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Affiliation(s)
- Yu-Shu Yen
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
| | - Dorji Harnod
- Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 24352, Taiwan;
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan;
- College of Medicine, China Medical University, Taichung 40402, Taiwan
| | - Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien Hualien 97002, Taiwan
- College of Medicine, Tzu Chi University, Hualien 97071, Taiwan
- Correspondence: (T.H.); (C.-H.K.)
| | - Chia-Hung Kao
- Department of Nuclear Medicine and PET Center, and Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 40447, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 40447, Taiwan
- Correspondence: (T.H.); (C.-H.K.)
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Jimenez Carrillo M, León García M, Vidal N, Bermúdez K, De Vos P. Comprehensive primary health care and non-communicable diseases management: a case study of El Salvador. Int J Equity Health 2020; 19:50. [PMID: 32252764 PMCID: PMC7132977 DOI: 10.1186/s12939-020-1140-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 02/07/2020] [Indexed: 01/12/2023] Open
Abstract
Background One of today’s greatest challenges in public health worldwide - and especially its key management from Primary Health Care (PHC) - is the growing burden of non-communicable diseases (NCDs). In El Salvador, since 2009 the Minister of Health (MoH) has scaled up a national public health system based on a comprehensive PHC approach. A national multi-sectorial strategic plan for a comprehensive approach to NCDs has also been developed. This analysis explores stakeholders’ perceptions related to the management of NCDs in PHC and, in particular, the role of social participation. Methods A case-study was developed consisting of semi structured interviews and official document reviews. Semi-structured interviews were developed with chronic patients (14) and PHC professionals working in different levels within PHC (12). Purposive sampling was used to recruit participants. A non-pure, deductive approach was implemented for coding. After grouping codes into potential themes, a thematic framework was elaborated through a reflexive approach and the triangulation of the data. The research was conducted between March and August of 2018 in three different departments of El Salvador. Results The structure and the functioning of the Salvadoran PHC system and its intersectoral approach is firstly described. The interdisciplinary PHC-team brings holistic health care closer to the communities in which health promoters play a key role. The findings reflect the generally positive perception of the PHC system in terms of accessibility, quality and continuity of care by chronic patients. Community engagement and the National Health Forum are ensuring accountability through social controllership mechanisms. However, certain challenges were also noted during the interviews related to the shortage of medication and workforce; coordination between the levels of care and the importance of prevention and health promotion programmes for NCDs. Conclusions The Salvadoran PHC and its comprehensive approach to NCDs with an emphasis on intersectoral participation has been positively perceived by the range of stakeholders interviewed. Social engagement and the NHF works as a driving force to ensure accountability as well as in the promotion of a preventive culture. The challenges identified provide keys to amplify knowledge for addressing inequalities in health by strengthening PHC and its NCDs management.
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Affiliation(s)
| | - Montserrat León García
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK.,Biomedical Research Institute Sant Pau (IIBSant Pau), Iberoamerican Cochrane Centre, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Nicole Vidal
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Keven Bermúdez
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Pol De Vos
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
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Kellerborg K, Brouwer W, van Baal P. Costs and benefits of early response in the Ebola virus disease outbreak in Sierra Leone. Cost Eff Resour Alloc 2020; 18:13. [PMID: 32190010 PMCID: PMC7074988 DOI: 10.1186/s12962-020-00207-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 02/20/2020] [Indexed: 11/16/2022] Open
Abstract
Background The 2014–2016 Ebola virus disease (EVD) outbreak in West Africa was the largest EVD outbreak recorded, which has triggered calls for investments that would facilitate an even earlier response. This study aims to estimate the costs and health effects of earlier interventions in Sierra Leone. Methods A deterministic and a stochastic compartment model describing the EVD outbreak was estimated using a variety of data sources. Costs and Disability-Adjusted Life Years were used to estimate and compare scenarios of earlier interventions. Results Four weeks earlier interventions would have averted 10,257 (IQR 4353–18,813) cases and 8835 (IQR 3766–16,316) deaths. This implies 456 (IQR 194–841) thousand DALYs and 203 (IQR 87–374) million $US saved. The greatest losses occurred outside the healthcare sector. Conclusions Earlier response in an Ebola outbreak saves lives and costs. Investments in healthcare system facilitating such responses are needed and can offer good value for money.
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Affiliation(s)
- Klas Kellerborg
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Werner Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Pieter van Baal
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Shimoda A, Hayashi H, Sussman D, Nansai K, Fukuba I, Kawachi I, Kondo N. Our health, our planet: a cross-sectional analysis on the association between health consciousness and pro-environmental behavior among health professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2020; 30:63-74. [PMID: 30734575 DOI: 10.1080/09603123.2019.1572871] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/17/2019] [Indexed: 06/09/2023]
Abstract
One possible predictive factor that affects both pro-environmental behavior and health behavior is health consciousness (a psychological state where an individual is aware of and involved in his/her health condition). We examined the relationship between health consciousness and two pro-environmental behaviors (recycling and green purchasing) within health professionals in a Japanese large hospital. Multivariate linear regression analysis revealed a significant association between health consciousness and recycling behavior, while there was no association between health consciousness and green purchasing behavior. We assume that health consciousness can certainly be a factor promoting pro-environmental behavior, but that it may have been insufficient to cause green purchasing, because of the organizational norm of recycling in the Japanese context. Given that there is previous evidence about the relationship between health consciousness and health behavior, health consciousness might be a predictive factor that encourages both health behavior and pro-environmental behavior simultaneously.
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Affiliation(s)
- Akihiro Shimoda
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
- Department of Public Health, McCann Healthcare Worldwide Japan Inc., Tokyo, Japan
| | - Hana Hayashi
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
- Department of Public Health, McCann Healthcare Worldwide Japan Inc., Tokyo, Japan
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - David Sussman
- Global Development and Environment Institute, Tuffs University, Somerville, MA, USA
| | - Keisuke Nansai
- Center for Material Cycles and Waste Management Research, National Institute for Environmental Studies, Ibaraki, Japan
| | | | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Naoki Kondo
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
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Gupta S, Nair A, Jhawat V, Mustaq N, Sharma A, Dhanawat M, Khan SA. Unwinding Complexities of Diabetic Alzheimer by Potent Novel Molecules. Am J Alzheimers Dis Other Demen 2020; 35:1533317520937542. [PMID: 32864980 PMCID: PMC10623924 DOI: 10.1177/1533317520937542] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diabetes mellitus is one of the aggressive disorders in global society. No pharmacotherapy is available for permanent diabetes cure, although management is possible with drugs and physical activities. One of the recent complications noticed in type 2 diabetes mellitus includes diabetes-induced Alzheimer. It has been proposed that the possible diabetes-induced Alzheimer could be of type 3 diabetes. A variety of cross-sectional studies have proved that type 2 diabetes mellitus is one of the factors responsible for the pathophysiology of Alzheimer. New drug molecules developed by pharmaceutical companies with adequate neuroprotective effect have demonstrated their efficacy in treatment of Alzheimer in various preclinical diabetic studies. Patients of type 2 diabetes mellitus may show the benefit with existing drugs but may not cause complete cure. Extensive studies are being carried out to find new drug molecules that show their potential as antidiabetic drug and could treat type 2 diabetes-induced Alzheimer as well. This review provides an overview about the recent advancement in pharmacotherapy of diabetes-induced Alzheimer. The pathomechanistic links between diabetes and Alzheimer as well as neurochemical changes in diabetes-induced Alzheimer are also briefed.
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Affiliation(s)
- Sumeet Gupta
- Department of Pharmacology, MM College of Pharmacy, MM (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Anroop Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Vikas Jhawat
- Department of Pharmaceutical Sciences, G. D Goenka University, Gurugram, Haryana, India
| | - Nazia Mustaq
- Department of Pharmacology, MM College of Pharmacy, MM (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Abhishek Sharma
- Department of Pharmacology, MM College of Pharmacy, MM (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Meenakshi Dhanawat
- Department of Pharmaceutical Sciences, MM College of Pharmacy, MM (Deemed to be University), Mullana (Ambala), Haryana, India
| | - Shah Alam Khan
- Department of Pharmacy, Oman Medical College, Muscat, Oman
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"There's Not Really Much Consideration Given to the Effect of the Climate on NCDs"-Exploration of Knowledge and Attitudes of Health Professionals on a Climate Change-NCD Connection in Barbados. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010198. [PMID: 31892174 PMCID: PMC6982231 DOI: 10.3390/ijerph17010198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 11/21/2022]
Abstract
Despite widespread awareness of the rise of non-communicable diseases (NCDs) and the growing threat of climate change, little research has explored future health outcomes that will occur at the intersection of these challenges. Ten Barbadian health professionals were interviewed to assess their knowledge of health risks of climate change as it relates to NCDs in Barbados as a case study of a small island state at risk. There is widespread concern among health professionals about the current and future prevalence of non-communicable diseases among Barbadians. There is less concern about the future burden of NCDs in the context of a changing climate, largely because of a lack of knowledge among the majority of the health experts interviewed. Those knowledgeable about potential connections noted the difficulty that climate change would pose to the prevention and management of NCDs, given the impacts of climate stressors to food security, the built environment, and physiological and psychosocial health impacts. Lack of awareness among health professionals of the risk climate change poses to NCD prevalence and impact is reflective of the country’s health priorities that fail to recognize the risk of climate change. We recommend efforts to disseminate information about climate change to stakeholders in the health sector to increase awareness.
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Abstract
AbstractIncreasing recognition of interdependencies of the health of humans, other organisms and ecosystems, and of their importance to socio-ecological systems, necessitates application of integrative concepts such as One Health and EcoHealth. These concepts open new perspectives for research and practice but also generate confusion and divergent opinion, prompting new theories, and call for empirical clarification and evaluation. Through a semi-systematic evaluation of knowledge generation in scientific publications (comprised of literature reviews, conceptual models and analyses of communities of practice), we show how integrative concepts and approaches to health evolve and are adopted. Our findings indicate that while their contexts, goals and rationales vary, integrative concepts of health essentially arise from shared interests in living systems. Despite recent increased attention to ecological and societal aspects of health including broader sustainability issues, the focus remains anthropocentric and oriented towards biomedicine. Practices reflect and in turn transform these concepts, which together with practices also influence ways of integration. Overarching narratives vary between optimism and pessimism towards integrated health and knowledge. We conclude that there is an urgent need for better, coherent and more deeply integrative health concepts, approaches and practices to foster the well-being of humans, other animals and ecosystems. Consideration of these concepts and practices has methodological and political importance, as it will transform thinking and action on both society and nature and specifically can enrich science and practice, expanding their scope and linking them better. Transdisciplinary efforts are crucial to developing such concepts and practices to properly address the multiple facets of health and to achieve their appropriate integration for the socio-ecological systems at stake. We propose the term “transdisciplinary health” to denote the new approaches needed.
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Mactaggart I, Maung NS, Khaing CT, Kuper H, Blanchet K. A case-control study of musculoskeletal impairment: association with socio-economic status, time use and quality of life in post-conflict Myanmar. BMC Public Health 2019; 19:1502. [PMID: 31711455 PMCID: PMC6849317 DOI: 10.1186/s12889-019-7851-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/28/2019] [Indexed: 11/25/2022] Open
Abstract
Background Musculoskeletal impairments (MSI) are a major global contributor to disability. Evidence suggests entrenched cyclical links between disability and poverty, although few data are available on the link of poverty with MSI specifically. More data are needed on the association of MSI with functioning, socio-economic status and quality of life, particularly in resource-poor settings where MSI is common. Methods We undertook a case-control study of the association between MSI and poverty, time use and quality of life in post-conflict Myanmar. Cases were recruited from two physical rehabilitation service-centres, prior to the receipt of any services. One age- (+/− 5 years of case’s age) and sex- matched control was recruited per case, from their home community. 108 cases and 104 controls were recruited between July – December 2015. Cases and controls underwent in-depth structured interviews and functional performance tests at multiple time points over a twelve-month period. The baseline characteristics of cases and controls are reported in this manuscript, using multivariate logistic regression analysis and various tests of association. Results 89% of cases were male, 93% were lower limb amputees, and the vast majority had acquired MSI in adulthood. 69% were not working compared with 6% of controls (Odds Ratio 27.4, 95% Confidence Interval 10.6–70.7). Overall income, expenditure and assets were similar between cases and controls, with three-quarters of both living below the international LMIC poverty line. However, cases’ health expenditure was significantly higher than controls’ and associated with catastrophic health expenditure and an income gap for one fifth and two thirds of cases respectively. Quality of life scores were lower for cases than controls overall and in each sub-category of quality of life, and cases were far less likely to have participated in productive work the previous day than controls. Conclusion Adults with MSI in Myanmar who are not in receipt of rehabilitative services may be at increased risk of poverty and lower quality of life in relation to increased health needs and limited opportunities to participate in productive work. This study highlights the need for more comprehensive and appropriate support to persons with physical impairments in Myanmar.
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Affiliation(s)
- Islay Mactaggart
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Nay Soe Maung
- University of Public Health (UPH), Myorma Kyaung Street, Yangon, Myanmar
| | - Cho Thet Khaing
- University of Public Health (UPH), Myorma Kyaung Street, Yangon, Myanmar
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Karl Blanchet
- Health in Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Rawal LB, Kanda K, Biswas T, Tanim MI, Poudel P, Renzaho AMN, Abdullah AS, Shariful Islam SM, Ahmed SM. Non-communicable disease (NCD) corners in public sector health facilities in Bangladesh: a qualitative study assessing challenges and opportunities for improving NCD services at the primary healthcare level. BMJ Open 2019; 9:e029562. [PMID: 31594874 PMCID: PMC6797278 DOI: 10.1136/bmjopen-2019-029562] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To explore healthcare providers' perspective on non-communicable disease (NCD) prevention and management services provided through the NCD corners in Bangladesh and to examine challenges and opportunities for strengthening NCD services delivery at the primary healthcare level. DESIGN We used a grounded theory approach involving in-depth qualitative interviews with healthcare providers. We also used a health facility observation checklist to assess the NCD corners' service readiness. Furthermore, a stakeholder meeting with participants from the government, non-government organisations (NGOs), private sector, universities and news media was conducted. SETTING Twelve subdistrict health facilities, locally known as upazila health complex (UHC), across four administrative divisions. PARTICIPANTS Participants for the in-depth qualitative interviews were health service providers, namely upazila health and family planning officers (n=4), resident medical officers (n=6), medical doctors (n=4) and civil surgeons (n=1). Participants for the stakeholder meeting were health policy makers, health programme managers, researchers, academicians, NGO workers, private health practitioners and news media reporters. RESULTS Participants reported that diabetes, hypertension and chronic obstructive pulmonary disease were the major NCD-related problems. All participants acknowledged the governments' initiative to establish the NCD corners to support NCD service delivery. Participants thought the NCD corners have contributed substantially to increase NCD awareness, deliver NCD care and provide referral services. However, participants identified challenges including lack of specific guidelines and standard operating procedures; lack of trained human resources; inadequate laboratory facilities, logistics and medications; and poor recording and reporting systems. CONCLUSION The initiative taken by the Government of Bangladesh to set up the NCD corners at the primary healthcare level is appreciative. However, the NCD corners are still at nascent stage to provide prevention and management services for common NCDs. These findings need to be taken into consideration while expanding the NCD corners in other UHCs throughout the country.
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Affiliation(s)
- Lal B Rawal
- School of Health Medical and Allied Sciences, CQUniversity Sydney, Sydney, New South Wales, Australia
- Health Systems Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Kie Kanda
- Health Section, Japanese International Cooperation Agency (JICA), Accra, Ghana
| | - Tuhin Biswas
- Health Systems Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Institute for Social Science Research, University of Queensland, Long Pocket Precinct, Indooroopilly Queensland, Brisbane, Queensland, Australia
| | - Md Imtiaz Tanim
- Health Systems Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- mPower Social Enterprises Ltd, Dhaka, Bangladesh
| | - Prakash Poudel
- Collaboration for Oral Health Outcomes, Research, Translation and Evaluation (COHORTE) Research Group, Western Sydney University, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia
| | - Andre M N Renzaho
- School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Sydney, New South Wales, Australia
| | - Abu S Abdullah
- Global Health Program, Duke Kunshan University, Jiangsu, Kunsan, China
- Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | | | - Syed Masud Ahmed
- Centre of Excellence for Universal Health Coverage (CoE-UHC), James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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