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Dumcheva A, Nevalainen J, Laatikainen T, Nuorti P. How likely are Eastern European and central Asian countries to achieve global NCD targets: multi-country analysis. BMC Public Health 2024; 24:2714. [PMID: 39369183 DOI: 10.1186/s12889-024-20186-5] [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: 05/07/2024] [Accepted: 09/25/2024] [Indexed: 10/07/2024] Open
Abstract
BACKGROUND In Europe, mortality rates from noncommunicable diseases (NCDs) among persons 30-69 years of age ("NCD premature mortality rates") have declined significantly, except in twelve countries of Eastern Europe and Central Asia, namely Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Data on long-term trends in NCD mortality in these countries are limited. We analyzed NCD premature mortality rates, identified change points in NCD mortality trends and forecasted how likely countries are to achieve the global NCD targets, stratified by gender and NCD type. METHODS We used the 1990-2019 Global Burden of Disease database to analyze NCD trends and identified country-specific change points by using piecewise linear regression. We assessed the likelihood of achieving the global targets for reducing NCD premature mortality rates among persons 30-69 years of age from four NCDs: cancers, diabetes, cardiovascular and chronic respiratory diseases. The global NCD targets are 25% reduction in mortality from 2010 to 2025 (WHO 25X25 target) and 33%-from 2015 to 2030 (SDG 3.4.1). We applied the analysis to both genders and four NCDs. RESULTS Only Kazakhstan and Russia are likely to achieve the global NCD targets. For Kazakhstan, WHO 25X25 and SDG 3.4.1 global targets for mortality rates were 494.3 and 374.8 per 100,000 population respectively; the corresponding predicted values (PVs) were 360.6 [CI 260.1-461.1] and 245.1 [CI 113.4-376.8]. For Russia, WHO 25X25 and SDG 3.4.1 global targets were 560.5 and 442.8 per 100,000 population respectively; the corresponding PVs were 427.7 [CI 270.3-585.1] and 311.0 [CI 102.8-519.1]. Achieving NCD global targets is less likely for Kyrgyzstan, while it is unlikely for the rest of countries. Most countries had higher mortality rates and slower progress among men compared with women. The likelihood of achieving overall global NCD targets was mainly explained by reduction in cardiovascular mortality. CONCLUSIONS In most Eastern Europe and Central Asia countries, progress towards achieving NCD global targets is slow, or there's a reverse trend. Further quantitative and qualitative research is needed to understand the underlying reasons. Separate indicators are needed to monitor trends for cancers, diabetes and chronic respiratory diseases.
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Affiliation(s)
| | | | - Tiina Laatikainen
- University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Pekka Nuorti
- Tampere University, Kalevantie 4, Tampere, 33100, Finland
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Ahmad M, Naja F, Alzubaidi H, Alzoubi KH, Hamid Q, Alameddine M. A stakeholders' perspective on enhancing community pharmacists' roles in controlling non-communicable diseases in the United Arab Emirates. J Pharm Policy Pract 2024; 17:2404080. [PMID: 39314667 PMCID: PMC11418057 DOI: 10.1080/20523211.2024.2404080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 09/09/2024] [Indexed: 09/25/2024] Open
Abstract
Background There is a global call for upscaling and optimising the role of community pharmacists (CPs) in the control of non-communicable diseases (NCDs). In the United Arab Emirates (UAE), where NCDs are classified as a public health pandemic, upscaling CPs contributions has become more critical. Several contextual, professional, and educational challenges constrain the role of CPs. Objective To synthesise the perspectives of key stakeholders in the UAE healthcare system and propose a roadmap for advancing the role of CP s in controlling NCDs in the UAE. Methods This research followed a qualitative design using the International Pharmaceutical Federation (FIP) framework for quality assurance of pharmacy profession development. Data were collected using semi-structured interviews with 28 experts and senior leaders, then analysed using the thematic analysis technique with the assistance of NVivo software. Results The analysis yielded three main themes that outlined the prospective roadmap: education, work environment, and policy. Some of the generated subthemes were establishing accredited NCD-specialised programmes, building a national framework for interprofessional education and collaboration, and upscaling the engagement of CPs in public health platforms and initiatives. Conclusion Improving the role of CPs in controlling the NCD pandemic in the UAE requires coherent and well-structured multidisciplinary endeavours from health policymakers, educational institutions, and all groups of healthcare professionals, including the CPs themselves.
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Affiliation(s)
- Maiss Ahmad
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Hamzah Alzubaidi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Qutayba Hamid
- Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamad Alameddine
- Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Zhang JD, Cheng XF, Min SH, Guo RQ, Wang RN, He YT, Zhang YL, Li B. Burden of non-communicable diseases attributable to high temperature in a changing climate from 1990 to 2019: a global analysis. BMC Public Health 2024; 24:2475. [PMID: 39261784 PMCID: PMC11389303 DOI: 10.1186/s12889-024-19947-z] [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: 08/02/2023] [Accepted: 08/29/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND With global climate change, the health threats of ambient high temperature have received widespread attention. However, latest spatio-temporal patterns of the non-communicable diseases (NCDs) burden attributable to high temperature have not been systematically reported. We aimed to analyze vulnerable areas and populations based on a detailed profile for the NCDs burden attributable to high temperature globally. METHODS We obtained data from the Global Burden of Diseases (GBD) Study (2019) to describe the temporal and spatial patterns of NCDs burden attributable to high temperature globally from 1990-2019. Then we analyzed the differences by region, sex, and socio-demographic index (SDI). Finally, the age‑period‑cohort (APC) model was utilized to explore the age, period, and cohort effects of NCDs mortality caused by high temperature. RESULTS In 2019, the number of deaths and Disability-adjusted life years (DALYs) from high-temperature-related NCDs was about 150,000 and 3.4 million globally, of which about 70% were in South Asia and North Africa and Middle East, and the burden was higher in men. Among 204 countries and territories, the highest age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) were observed in Oman and United Arab Emirates, respectively. The global burden showed an upward trend from 1990 to 2019, with an EAPC of 3.66 (95%CI: 3.14-4.18) for ASMR and 3.68 (95%CI: 3.16-4.21) for ASDR. Cardiovascular diseases were the main contributors to the global burden of high-temperature-related NCDs in 2019. The age and period effect in APC model showed an increasing trend globally. There was a significant negative correlation between SDI and both ASMR (r = -0.17) and ASDR (r = -0.20) from 1990 to 2019. CONCLUSION There was an increasing trend of the global burden of high-temperature-related NCDs. The burden was likely to be higher in males and the elderly, as well as in countries and regions with less economically and socially developed and in tropical climates. Surveillance and prevention measures should be implemented with a focus on these vulnerable areas and susceptible populations.
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Affiliation(s)
- Jin-Dan Zhang
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Xiao-Fen Cheng
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Shu-Hui Min
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Rui-Qi Guo
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Ruo-Nan Wang
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Yan-Ting He
- School of Health Management, Southern Medical University, Guangzhou, 510515, China
| | - Yi-Li Zhang
- School of Health Management, Southern Medical University, Guangzhou, 510515, China.
| | - Bei Li
- School of Health Management, Southern Medical University, Guangzhou, 510515, China.
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Nunes PRP, Kassiano W, Castro-E-Souza P, Camilo BDF, Cristina-Souza G, Vieira-Souza LM, Cyrino ES, Carneiro MADS. Higher volume resistance training enhances whole-body muscle hypertrophy in postmenopausal and older females: A secondary analysis of systematic review and meta-analysis of randomized clinical trials. Arch Gerontol Geriatr 2024; 124:105474. [PMID: 38744142 DOI: 10.1016/j.archger.2024.105474] [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: 02/21/2024] [Revised: 04/23/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE This study explored the effects of resistance training (RT) volume on muscle hypertrophy in postmenopausal and older females. METHODS This systematic review searched randomized controlled trials (RCTs) on PubMed/MEDLINE, Scopus, Web of Science, and SciELO. Studies with postmenopausal (age ≥ 45 y) or older females (age ≥ 60 y) that compared RT (whole-body) effects on muscle hypertrophy with a control group (CG) were included. Independently reviewers selected the studies, extracted data, and performed the risk of bias of RCTs (RoB2) and certainty of the evidence (GRADE). Whole-body lean mass, free-fat mass, and skeletal muscle mass measurements were included as muscle hypertrophy outcomes. A random-effects model standardized mean difference (Hedges'g), and 95% confidence interval (95%CI) were used for meta-analysis. RESULTS Fourteen RCTs (overall RoB2: some concerns, except one study with high risk; GRADE: low evidence) were included. RT groups were divided into low (LVRT, total volume: 445.0 au) and high-volume (HVRT, total volume: 997.3 au). Most exercises performed were arm curl, bench press or chest press, calf raise, leg curl, leg extension, leg press or squat, seated row or lat pulldown, and triceps pushdown. Both groups experienced muscle hypertrophy (HVRT = ∼1.3 kg vs. LVRT = ∼0.9 kg) when compared to CG, although HVRT demonstrated moderate effects size (HVRT = 0.52, 95%CI: 0.27, 0.77) and LVRT demonstrated small effects size (LVRT = 0.34, 95%CI: 0.14, 0.53). CONCLUSIONS Compared to CG, results suggest that the HVRT protocol elicits superior improvements in muscle hypertrophy outcomes than LVRT in postmenopausal and older females.
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Affiliation(s)
- Paulo Ricardo Prado Nunes
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Physical Activity, Health and Ageing Research Group (GPASE), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37701-355 Poços de Caldas, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil.
| | - Witalo Kassiano
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Pâmela Castro-E-Souza
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Bruno de Freitas Camilo
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Physical Activity, Health and Ageing Research Group (GPASE), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37701-355 Poços de Caldas, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil
| | - Gislaine Cristina-Souza
- Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37701-355 Poços de Caldas, MG, Brazil; Department of Education and Human Sciences, Minas Gerais State University (UEMG), 37701-355 Poços de Caldas, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil
| | - Lucio Marques Vieira-Souza
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), 49107-230 São Cristóvão, SE, Brazil
| | - Edilson Serpeloni Cyrino
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
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Prado AC, Arroyo IY, Salinas-Escudero G, Gutiérrez JP. Mapping potentially avoidable premature mortality in Mexico: subnational, sex, and age group trends. CAD SAUDE PUBLICA 2024; 40:e00178723. [PMID: 39194092 DOI: 10.1590/0102-311xen178723] [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: 10/04/2023] [Accepted: 04/11/2024] [Indexed: 08/29/2024] Open
Abstract
This study aimed to analyze the trends and disparities in preventable or treatable mortality rates among different age groups, sexes, and states in Mexico from 2000 to 2019. Using national data from 2000 to 2019, we examined potentially avoidable premature mortality (PAPM) rates, disaggregated into preventable and treatable deaths. Trends over time were visualized using the average annual percent change (AAPC) derived from joinpoint analysis. Subnational analysis was conducted to identify state-specific trends for each sex and age group. The national PAPM rate decreased from 297 deaths per 100,000 in 2000 to 281 per 100,000 in 2019. Potentially preventable premature mortality (PPPM) rates were more pronounced than potentially treatable premature mortality (PTPM) rates, with 170 deaths per 100,000 and 111 per 100,000, respectively. Sex-based disparities were observed particularly in the working-age population. Our analysis at the state level revealed significant differences in trends, as certain regions experienced reductions while others rises. These disparities became more evident when examining the different aspects of PAPM, especially in terms of PTPM. Our study highlights the differences in PAPM rates across age groups, sexes, and states in Mexico. Despite a general downward trend, upward trends were observed in the male working-age group. There was also wide variation among states, highlighting the need to use PAPM in conjunction with other health metrics for a holistic health analysis.
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Affiliation(s)
- Andrés Castañeda Prado
- Facultad de Medicina, Universidad Nacional Autónoma de México, Cuidad de México, México
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Cuidad de México, México
| | - Iliana Yaschine Arroyo
- Programa Universitario de Estudios del Desarrollo, Universidad Nacional Autónoma de México, Cuidad de México, México
| | - Guillermo Salinas-Escudero
- Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, Cuidad de México, México
| | - Juan Pablo Gutiérrez
- Facultad de Medicina, Universidad Nacional Autónoma de México, Cuidad de México, México
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Joundi RA, Hu B, Rangarajan S, Leong DP, Islam S, Smith EE, Mirrakhimov E, Seron P, Alhabib KF, Assembekov B, Chifamba J, Yusuf R, Khatib R, Felix C, Yusufali A, Mohammadifard N, Rosengren A, Oguz A, Iqbal R, Yeates K, Avezum A, Kruger I, Anjana R, Pvm L, Gupta R, Zatońska K, Barbarash O, Pelliza E, Rammohan K, Li M, Li X, Ismail R, Lopez-Jaramillo P, Evans M, O'Donnell M, Yusuf S. Activity limitations, use of assistive devices, and mortality and clinical events in 25 high-income, middle-income, and low-income countries: an analysis of the PURE study. Lancet 2024; 404:554-569. [PMID: 39068950 DOI: 10.1016/s0140-6736(24)01050-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 04/04/2024] [Accepted: 05/16/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND The focus of most epidemiological studies has been mortality or clinical events, with less information on activity limitations related to basic daily functions and their consequences. Standardised data from multiple countries at different economic levels in different regions of the world on activity limitations and their associations with clinical outcomes are sparse. We aimed to quantify the prevalence of activity limitations and use of assistive devices and the association of limitations with adverse outcomes in 25 countries grouped by different economic levels. METHODS In this analysis, we obtained data from individuals in 25 high-income, middle-income, and low-income countries from the Prospective Urban Rural Epidemiological (PURE) study (175 660 participants). In the PURE study, individuals aged 35-70 years who intended to continue living in their current home for a further 4 years were invited to complete a questionnaire on activity limitations. Participant follow-up was planned once every 3 years either by telephone or in person. The activity limitation screen consisted of questions on self-reported difficulty with walking, grasping, bending, seeing close, seeing far, speaking, hearing, and use of assistive devices (gait, vision, and hearing aids). We estimated crude prevalence of self-reported activity limitations and use of assistive devices, and prevalence standardised by age and sex. We used logistic regression to additionally adjust prevalence for education and socioeconomic factors and to estimate the probability of activity limitations and assistive devices by age, sex, and country income. We used Cox frailty models to evaluate the association between each activity limitation with mortality and clinical events (cardiovascular disease, heart failure, pneumonia, falls, and cancer). The PURE study is registered with ClinicalTrials.gov, NCT03225586. FINDINGS Between Jan 12, 2001, and May 6, 2019, 175 584 individuals completed at least one question on the activity limitation questionnaire (mean age 50·6 years [SD 9·8]; 103 625 [59%] women). Of the individuals who completed all questions, mean follow-up was 10·7 years (SD 4·4). The most common self-reported activity limitations were difficulty with bending (23 921 [13·6%] of 175 515 participants), seeing close (22 532 [13·4%] of 167 801 participants), and walking (22 805 [13·0%] of 175 554 participants); prevalence of limitations was higher with older age and among women. The prevalence of all limitations standardised by age and sex, with the exception of hearing, was highest in low-income countries and middle-income countries, and this remained consistent after adjustment for socioeconomic factors. The use of gait, visual, and hearing aids was lowest in low-income countries and middle-income countries, particularly among women. The prevalence of seeing close limitation was four times higher (6257 [16·5%] of 37 926 participants vs 717 [4·0%] of 18 039 participants) and the prevalence of seeing far limitation was five times higher (4003 [10·6%] of 37 923 participants vs 391 [2·2%] of 18 038 participants) in low-income countries than in high-income countries, but the prevalence of glasses use in low-income countries was half that in high-income countries. Walking limitation was most strongly associated with mortality (adjusted hazard ratio 1·32 [95% CI 1·25-1·39]) and most consistently associated with other clinical events, with other notable associations observed between seeing far limitation and mortality, grasping limitation and cardiovascular disease, bending limitation and falls, and between speaking limitation and stroke. INTERPRETATION The global prevalence of activity limitations is substantially higher in women than men and in low-income countries and middle-income countries compared with high-income countries, coupled with a much lower use of gait, visual, and hearing aids. Strategies are needed to prevent and mitigate activity limitations globally, with particular emphasis on low-income countries and women. FUNDING Funding sources are listed at the end of the Article.
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Affiliation(s)
- Raed A Joundi
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada.
| | - Bo Hu
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| | - Darryl P Leong
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
| | | | | | | | | | | | | | | | - Rita Yusuf
- Independent University, Dhaka, Bangladesh
| | - Rasha Khatib
- Advocate Aurora Research Institute, Milwaukee, WI, USA
| | | | | | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Aytekin Oguz
- Istanbul Medeniyet University, Istanbul, Türkiye
| | | | | | - Alvaro Avezum
- International Research Center, Hospital Alemão Oswaldo Cruz and UNISA, São Paulo University, São Paulo, Brazil
| | | | | | - Lakshmi Pvm
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajeev Gupta
- Eternal Heart Care Centre and Research Institute, Rajasthan, India
| | | | | | | | | | - Mengya Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaocong Li
- Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Beijing, China; National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rosnah Ismail
- Universiti Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Marc Evans
- Philippine General Hospital, Manila, Philippines
| | | | - Salim Yusuf
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, ON, Canada
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McCorry K, Maniatopoulos G, Errington L, Land E, Craig M, Vijaykumar S, Bärnighausen T, O'Brien N. Animations to communicate public health prevention messages: a realist review protocol. BMJ Open 2024; 14:e083013. [PMID: 39122406 PMCID: PMC11331919 DOI: 10.1136/bmjopen-2023-083013] [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: 12/09/2023] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
INTRODUCTION With digital and social media advances, animated health communications (health animations) are highly prevalent globally, yet the evidence base underpinning them remains unclear and limited. While individual studies have attempted to explore the effectiveness, acceptability and usability of specific features of health animations, there is substantial heterogeneity in study design, comparators and the animation design and content. Consequently, there is a need to synthesise evidence of health animations using an approach that recognises this contextual complexity, which may affect their impact. METHODS AND ANALYSIS This project aims to understand why, how, for whom, to what extent and in which contexts health animations are expected to promote preventive health behaviours. We will conduct a realist review following Pawson's five iterative stages to (1) define the review scope and locate existing theories; (2) search for evidence; (3) select and appraise evidence; (4) extract data and (5) synthesise data and refine theory. Engagement with stakeholders involved in developing, testing, implementing or commissioning health communications, including animations, will allow the initial programme theory to be tested and refined. The findings will be reported in accordance with Realist and Meta-narrative Evidence Syntheses: Evolving Standards. ETHICS AND DISSEMINATION Ethical approval for the public stakeholder work was provided by the Northumbria University Research Ethics Committee. We will disseminate the findings widely through outputs tailored to target specific professional, public and patient audiences. Dissemination will occur through stakeholder engagement as part of the research, a peer-reviewed publication and conference presentations. PROSPERO REGISTRATION NUMBER CRD42023447127.
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Affiliation(s)
- Kathleen McCorry
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | | | - Linda Errington
- Walton Library, Newcastle University, Newcastle upon Tyne, UK
| | - Ellie Land
- Department of Arts, Northumbria University, Newcastle upon Tyne, UK
| | - Michael Craig
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Santosh Vijaykumar
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
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Mao B, Luo C, Li S, Zhang J, Xiang W, Yang YD. Exposure to light at night (LAN) and risk of overweight/obesity, hypertension, and diabetes: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-15. [PMID: 39011976 DOI: 10.1080/09603123.2024.2378941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024]
Abstract
Current studies have presented conflicting findings regarding the associations between light at night (LAN) exposure and the risk of overweight/obesity, hypertension, and diabetes. Our study systematically summarized the evidence of the association between LAN exposure and the risk of overweight/obesity, hypertension, and diabetes. We searched five databases (PubMed, Web of Science, Embase, Scopus, and Cochrane) for observational studies published up to 1 August 2023. The pooled odds ratio (ORs) and 95% confidence intervals (CIs) were estimated by random-effects models for the association. Eighteen studies were included in the meta-analysis. Compared with the group with the lowest level of LAN, the group with the highest level of LAN is associated with an increased risk of overweight/obesity (pooled OR = 1.19, 95%CI: 1.13-1.26), hypertension (pooled OR: 1.86, 95% CI:1.28-2.72), and diabetes (pooled OR = 1.21, 95%CI: 1.07-1.31). Our meta-analysis demonstrated LAN exposure is associated with increased risk of overweight/obesity, hypertension, and diabetes.
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Affiliation(s)
- Bin Mao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Chuhong Luo
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Shengnan Li
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Jixin Zhang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Wanyun Xiang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yi-de Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
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Wang Q, Yin J, Xu L, Lu J, Chen J, Chen Y, Wufuer A, Gong T. Development and validation of outcome prediction model for reperfusion therapy in acute ischemic stroke using nomogram and machine learning. Neurol Sci 2024; 45:3255-3266. [PMID: 38277052 DOI: 10.1007/s10072-024-07329-7] [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: 10/11/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE To develop logistic regression nomogram and machine learning (ML)-based models to predict 3-month unfavorable functional outcome for acute ischemic stroke (AIS) patients undergoing reperfusion therapy. METHODS Patients undergoing reperfusion therapy (intravenous thrombolysis and/or endovascular treatment) were prospectively recruited. Unfavorable outcome was defined as 3-month modified Rankin Scale (mRS) score 3-6. The independent risk factors associated with unfavorable outcome were obtained by regression analysis and included in the prediction model. The performance of nomogram was assessed by the area under the curve (AUC), calibration curve, and decision curve analysis (DCA). ML models were compared with nomogram using AUC; the generalizability of all models was ascertained in an external cohort. RESULTS A total of 505 patients were enrolled, with 256 in the model construction, and 249 in the external validation. Five variables were identified as prognostic factors: baseline NIHSS, D-dimer level, random blood glucose (RBG), blood urea nitrogen (BUN), and systolic blood pressure (SBP) before reperfusion. The AUC values of nomogram were 0.865, 0.818, and 0.779 in the training set, test set, and external validation, respectively. The calibration curve and DCA indicated appreciable reliability and good net benefits. The best three ML models were extra trees (ET), CatBoost, and random forest (RF) models; all of them showed favorable discrimination in the training cohort, and confirmed in the test and external sets. CONCLUSION Baseline NIHSS, D-dimer, RBG, BUN, and SBP before reperfusion were independent predictors for 3-month unfavorable outcome after reperfusion therapy in AIS patients. Both nomogram and ML models showed good discrimination and generalizability.
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Affiliation(s)
- Qianwen Wang
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100084, People's Republic of China
| | - Jiawen Yin
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Lei Xu
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Jun Lu
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Juan Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Yuhui Chen
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.
| | - Alimu Wufuer
- Department of Neurology, the First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, 830054, Xinjiang, People's Republic of China.
| | - Tao Gong
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100084, People's Republic of China.
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10
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Mongkolsucharitkul P, Surawit A, Manosan T, Ophakas S, Suta S, Pinsawas B, Pongkunakorn T, Pumeiam S, Ratanasuwan W, Homsanit M, Charoencholvanich K, Udomphorn Y, Suktitipat B, Mayurasakorn K. Metabolic and genetic risk factors associated with pre-diabetes and type 2 diabetes in Thai healthcare employees: A long-term study from the Siriraj Health (SIH) cohort study. PLoS One 2024; 19:e0303085. [PMID: 38941315 PMCID: PMC11213315 DOI: 10.1371/journal.pone.0303085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/18/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND The study of non-communicable diseases (NCDs) in a developing country like Thailand has rarely been conducted in long-term cohorts, especially among the working-age population. We aim to assess the prevalence and incidence of risk factors and their associations underlying NCDs, especially type-2 diabetes mellitus (T2DM) among healthcare workers enrolled in the Siriraj Health (SIH) study cohort. METHODS The SIH study was designed as a longitudinal cohort and conducted at Siriraj hospital, Thailand. A total of 5,011 participants (77% women) were recruited and follow-up. Physical examinations, blood biochemical analyses, family history assessments, behavior evaluations, and genetics factors were assessed. RESULTS The average age was 35.44±8.24 years and 51% of participants were overweight and obese. We observed that men were more likely to have a prevalence of T2DM and dyslipidemia (DLP) compared to women. Aging was significantly associated with pre-diabetes and T2DM (P<0.001). Additionally, aging, metabolic syndrome, and elevated triglycerides were associated with the development of pre-diabetes and T2DM. The minor T allele of the rs7903146(C/T) and rs4506565 (A/T) were associated with a high risk of developing pre-diabetes with odds ratios of 2.74 (95% confidence interval [CI]: 0.32-23.3) and 2.71 (95% CI: 0.32-23.07), respectively; however, these associations were statistically insignificant (P>0.05). CONCLUSION The findings of the SIH study provide a comprehensive understanding of the health status, risk factors, and genetic factors related to T2DM in a specific working population and highlight areas for further research and intervention to address the growing burden of T2DM and NCDs.
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Affiliation(s)
- Pichanun Mongkolsucharitkul
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Apinya Surawit
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Thamonwan Manosan
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suphawan Ophakas
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sophida Suta
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Bonggochpass Pinsawas
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Tanyaporn Pongkunakorn
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sureeporn Pumeiam
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Winai Ratanasuwan
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Mayuree Homsanit
- Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Keerati Charoencholvanich
- Department of Orthopedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Yuthana Udomphorn
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Bhoom Suktitipat
- Department of Biochemistry, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Korapat Mayurasakorn
- Siriraj Population Health and Nutrition Research Group, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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11
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Fritz M, Grimm M, My Hanh HT, Koot JAR, Nguyen GH, Nguyen TPL, Probandari A, Widyaningsih V, Lensink R. Effectiveness of community-based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam: a quasi-experimental study. BMJ Glob Health 2024; 9:e015053. [PMID: 38777393 PMCID: PMC11116884 DOI: 10.1136/bmjgh-2024-015053] [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: 01/11/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Non-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence over the past decades. Despite the escalating burden, screening for NCDs remains at very low levels, resulting in undetected cases, premature mortality and high public healthcare costs. We investigate whether community-based NCD prevention and management programmes are an effective solution. METHODS In Indonesia, we compare participants in the community-based NCD screening and management programme Pos Pembinaan Terpadu-Penyakit Tidak Menular with matched non-participants with respect to their uptake of screening activities, health-related behaviour and knowledge and metabolic risk factors. We use statistical matching to redress a possible selection bias (n=1669). In Viet Nam, we compare members of Intergenerational Self-Help Clubs, which were offered similar NCD health services, with members of other community groups, where such services were not offered. We can rely on two waves of data and use a double-difference approach to redress a possible selection bias and to measure the impacts of participation (n=1710). We discuss strengths and weaknesses of the two approaches in Indonesia and Viet Nam. RESULTS In Indonesia, participants have significantly higher uptake of screening for hypertension and diabetes (+13% from a control mean of 88% (95% CI 9% to 17%); +93% from a control mean of 48% (95% CI 79% to 108%)). In both countries, participants show a higher knowledge about risk factors, symptoms and complications of NCDs (Indonesia: +0.29 SD (0.13-0.45), Viet Nam: +0.17 SD (0.03-0.30)). Yet, the improved knowledge is only partly reflected in improved health behaviour (Viet Nam: fruit consumption +0.33 SD (0.15-0.51), vegetable consumption +0.27 SD (0.04-0.50)), body mass index (BMI) (Viet Nam: BMI -0.07 SD (-0.13 to -0.00)) or metabolic risk factors (Indonesia: systolic blood pressure: -0.13 SD (-0.26 to -0.00)). CONCLUSION Community-based NCD programmes are well suited to increase screening and to transmit health knowledge. Due to their extensive outreach within the community, they can serve as a valuable complement to the screening services provided at the primary healthcare level. Yet, limited coverage, insufficient resources and a high staff turnover remain a problem. TRIAL REGISTRATION NUMBER NCT05239572.
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Affiliation(s)
- Manuela Fritz
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
| | - Michael Grimm
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
- IZA Institute of Labor Economics, Bonn, Germany
| | | | - Jaap A R Koot
- Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Thi-Phuong-Lan Nguyen
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, Viet Nam
| | - Ari Probandari
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Vitri Widyaningsih
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Robert Lensink
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
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12
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Alam MZ, Sheoti IH. The burden of diabetes and hypertension on healthy life expectancy in Bangladesh. Sci Rep 2024; 14:7936. [PMID: 38575655 PMCID: PMC10995204 DOI: 10.1038/s41598-024-58554-1] [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: 01/06/2023] [Accepted: 04/01/2024] [Indexed: 04/06/2024] Open
Abstract
Diabetes and hypertension are among the leading causes of death in Bangladesh. This study examined hypertension, diabetes, and either or both, free life expectancy, to measure the effect of the diseases on the overall health of individuals in Bangladesh with regional variations. We utilized data from Bangladesh Sample Vital Statistics 2018 for mortality and Bangladesh Demographic and Health Survey 2017-2018 for diabetes and hypertension. The Sullivan method was employed to estimate age-specific hypertension and diabetes-free life expectancy. Altogether, 10.3% of the people aged 18-19 years lived with either diabetes or hypertension. The hypertension-free life expectancy was 40.4 years, and the diabetes-free life expectancy was 53.2 years for those aged 15-19. Overall, individuals would expect to spend 38.7% of their lives with either of the diseases. Females suffered more from hypertension and males from diabetes. Still, females suffered more from the aggregate of both. Rural people had more diabetes and hypertension-free life expectancy than those of urban. Individuals of Mymensingh had the highest life expectancy free of both diseases compared to other divisions of Bangladesh. Diabetes and hypertension affect a considerable proportion of the life of the population in Bangladesh. Policy actions are needed to guide the prevention, diagnosis, and treatment of both diseases, specifically focusing on women and urban populations. Widespread health-enhancing actions need to be taken to diminish the effect of these two diseases in Bangladesh.
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Affiliation(s)
- Md Zakiul Alam
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh.
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Maryland, 21205, USA.
| | - Isna Haque Sheoti
- Department of Population Sciences, University of Dhaka, Dhaka, 1000, Bangladesh
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13
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Jackowska B, Wiśniewski P, Noiński T, Bandosz P. Effects of lifestyle-related risk factors on life expectancy: A comprehensive model for use in early prevention of premature mortality from noncommunicable diseases. PLoS One 2024; 19:e0298696. [PMID: 38483876 PMCID: PMC10939220 DOI: 10.1371/journal.pone.0298696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
Morbidity and premature mortality from noncommunicable diseases can be largely prevented by adopting a healthy lifestyle at the earliest possible age. However, tools designed for the early identification of those at risk among young adults are lacking. We developed and validated a multivariable model for the prediction of life expectancy, allowing the early identification of apparently healthy adults at risk of lifestyle-related diseases. We used a cross-sectional approach to calculate life expectancy using data from 38,481 participants of the National Health and Nutrition Examination Survey (1999-2014), aged ≥20 years. A multivariable logistic model was used to quantify the impact of risk factors on mortality. The model included the following lifestyle-related mortality risk factors as predictors: smoking, diet, physical activity, and body mass index. The presence of the following chronic diseases was considered: diabetes, arrhythmia, coronary artery disease, myocardial infarction, stroke, and malignant neoplasms. The model showed a good predictive ability; the area under the receiver operating characteristic curve measure was 0.846 (95% uncertainty interval 0.838-0.859). Life expectancy was determined using the life table method and the period life tables for the US population as the baseline. The results of this model underscore the importance of lifestyle-related risk factors in life expectancy. The difference between life expectancy for 30-year-old individuals with lifestyle characteristics ranked in 90% and 10% of their gender and age groups was 23 years for males and 18 years for females, whereas in 75% and 25%, it was 14 years for males and 10 years for females. In addition to early risk identification, the model estimates the deferred effect of lifestyle and the impact of lifestyle changes on life expectancy. Thus, it can be used in early prevention to demonstrate the potential risks and benefits of complex lifestyle modifications for educational purposes or to motivate behavioral changes.
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Affiliation(s)
- Beata Jackowska
- Department of Statistics, Faculty of Management, University of Gdańsk, Sopot, Poland
| | - Piotr Wiśniewski
- Chair and Department of Endocrinology and Internal Diseases, Medical University of Gdańsk, Gdańsk, Poland
- Lab4Life Sp. z o.o., Gdynia, Poland
| | | | - Piotr Bandosz
- Lab4Life Sp. z o.o., Gdynia, Poland
- Division of Preventive Medicine & Education, Medical University of Gdańsk, Gdańsk, Poland
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14
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Nunes PRP, Castro-E-Souza P, de Oliveira AA, Camilo BDF, Cristina-Souza G, Vieira-Souza LM, Carneiro MADS. Effect of resistance training volume on body adiposity, metabolic risk, and inflammation in postmenopausal and older females: Systematic review and meta-analysis of randomized controlled trials. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:145-159. [PMID: 37788790 PMCID: PMC10980902 DOI: 10.1016/j.jshs.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/25/2023] [Accepted: 08/14/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE This meta-analytical study aimed to explore the effects of resistance training (RT) volume on body adiposity, metabolic risk, and inflammation in postmenopausal and older females. METHODS A systematic search was performed for randomized controlled trials in PubMed, Scopus, Web of Science, and SciELO. Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity, metabolic risk, and inflammation with a control group (CG) were included. Independent reviewers selected the studies, extracted the data, and performed the risk of bias and certainty of the evidence (Grading of Recommendations, Assessment, Development, and Evaluation (GRADE)) evaluations. Total body and abdominal adiposity, blood lipids, glucose, and C-reactive protein were included for meta-analysis. A random-effects model, standardized mean difference (Hedges' g), and 95% confidence interval (95%CI) were used for meta-analysis. RESULTS Twenty randomized controlled trials (overall risk of bias: some concerns; GRADE: low to very low) with overweight/obese postmenopausal and older females were included. RT groups were divided into low-volume RT (LVRT, ∼44 sets/week) and high-volume RT (HVRT, ∼77 sets/week). Both RT groups presented improved body adiposity, metabolic risk, and inflammation when compared to CG. However, HVRT demonstrated higher effect sizes than LVRT for glucose (HVRT = -1.19; 95%CI: -1.63 to -0.74; LVRT = -0.78; 95%CI:-1.15 to -0.41) and C-reactive protein (HVRT = -1.00; 95%CI: -1.32 to -0.67; LVRT = -0.34; 95%CI, -0.63 to -0.04)) when compared to CG. CONCLUSION Compared to CG, HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.
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Affiliation(s)
- Paulo Ricardo Prado Nunes
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; University Center of Planalto de Araxá (UNIARAXA), 38180-129 Araxá, MG, Brazil; Physical Activity, Health and Ageing Research Group (GPASE), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil.
| | - Pâmela Castro-E-Souza
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University (UEL), 86050-070 Londrina, PR, Brazil
| | | | - Bruno de Freitas Camilo
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Physical Activity, Health and Ageing Research Group (GPASE), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil
| | - Gislaine Cristina-Souza
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Exercise and Nutrition Research Group (GPEN), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil
| | - Lucio Marques Vieira-Souza
- Department of Body and Human Movement, Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Sport Sciences and Physical Exercise Study and Research Group - (GEPCEEX), Minas Gerais State University (UEMG), 37902-092 Passos, MG, Brazil; Postgraduate Program in Physical Education, Federal University of Sergipe (UFS), 49107-230 São Cristóvão, SE, Brazil
| | - Marcelo Augusto da Silva Carneiro
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University (UEL), 86050-070 Londrina, PR, Brazil
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15
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Stein DT, Reitsma MB, Geldsetzer P, Agoudavi K, Aryal KK, Bahendeka S, Brant LCC, Farzadfar F, Gurung MS, Guwatudde D, Houehanou YCN, Malta DC, Martins JS, Saeedi Moghaddam S, Mwangi KJ, Norov B, Sturua L, Zhumadilov Z, Bärnighausen T, Davies JI, Flood D, Marcus ME, Theilmann M, Vollmer S, Manne-Goehler J, Atun R, Sudharsanan N, Verguet S. Hypertension care cascades and reducing inequities in cardiovascular disease in low- and middle-income countries. Nat Med 2024; 30:414-423. [PMID: 38278990 DOI: 10.1038/s41591-023-02769-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 12/15/2023] [Indexed: 01/28/2024]
Abstract
Improving hypertension control in low- and middle-income countries has uncertain implications across socioeconomic groups. In this study, we simulated improvements in the hypertension care cascade and evaluated the distributional benefits across wealth quintiles in 44 low- and middle-income countries using individual-level data from nationally representative, cross-sectional surveys. We raised diagnosis (diagnosis scenario) and treatment (treatment scenario) levels for all wealth quintiles to match the best-performing country quintile and estimated the change in 10-year cardiovascular disease (CVD) risk of individuals initiated on treatment. We observed greater health benefits among bottom wealth quintiles in middle-income countries and in countries with larger baseline disparities in hypertension management. Lower-middle-income countries would see the greatest absolute benefits among the bottom quintiles under the treatment scenario (29.1 CVD cases averted per 1,000 people living with hypertension in the bottom quintile (Q1) versus 17.2 in the top quintile (Q5)), and the proportion of total CVD cases averted would be largest among the lowest quintiles in upper-middle-income countries under both diagnosis (32.0% of averted cases in Q1 versus 11.9% in Q5) and treatment (29.7% of averted cases in Q1 versus 14.0% in Q5) scenarios. Targeted improvements in hypertension diagnosis and treatment could substantially reduce socioeconomic-based inequalities in CVD burden in low- and middle-income countries.
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Affiliation(s)
- Dorit Talia Stein
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marissa B Reitsma
- Department of Health Policy, Stanford School of Medicine, Stanford University, Stanford, CA, USA
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Stanford University, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Kokou Agoudavi
- Noncommunicable Disease Program, Ministry of Health, Lomé, Togo
| | - Krishna Kumar Aryal
- Bergen Centre for Ethics and Priority Setting in Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Public Health Promotion and Development Organization, Kathmandu, Nepal
| | - Silver Bahendeka
- MKPGMS-Uganda Martyrs University, Kampala, Uganda
- St. Francis Hospital, Nsambya, Kampala, Uganda
| | - Luisa C C Brant
- Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - David Guwatudde
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | | | - Deborah Carvalho Malta
- Department Maternal Child and Public Health, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - João Soares Martins
- Faculty of Medicine and Health Sciences, Universidade Nacional Timor Lorosa'e, Díli, Timor-Leste
| | - Sahar Saeedi Moghaddam
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Kiel Institute for the World Economy, Kiel, Germany
| | - Kibachio Joseph Mwangi
- World Health Organization, Pretoria, South Africa
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Bolormaa Norov
- Nutrition Department, National Center for Public Health, Ulaanbaatar, Mongolia
| | - Lela Sturua
- National Center for Disease Control and Public Health, Tbilisi, Georgia
- Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | | | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Harvard Center for Population and Development Studies, Cambridge, MA, USA
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Justine I Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Department of Global Health, Centre for Global Surgery, Stellenbosch University, Cape Town, South Africa
| | - David Flood
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Center for Indigenous Health Research, Wuqu' Kawoq, Tecpán, Guatemala
| | - Maja E Marcus
- Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Michaela Theilmann
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Professorship of Behavioral Science for Disease Prevention and Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Sebastian Vollmer
- Department of Economics & Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany
| | - Jennifer Manne-Goehler
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, USA
| | - Nikkil Sudharsanan
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Professorship of Behavioral Science for Disease Prevention and Health Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Stéphane Verguet
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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16
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Peng W, Zhang L, Wen F, Tang X, Zeng L, Chen J, Galea G, Wen D, Wang Y. Trends and disparities in non-communicable diseases in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100938. [PMID: 38456093 PMCID: PMC10920054 DOI: 10.1016/j.lanwpc.2023.100938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/03/2023] [Accepted: 09/29/2023] [Indexed: 03/09/2024]
Abstract
The WHO Western Pacific region bears disproportionate deaths from non-communicable diseases (NCDs), with increased overall NCD proportional mortality over the past two decades. The disease burden of mental health increased, resulting from rapid ageing, enhanced stress, and the COVID-19 pandemic, but it was largely neglected. The highly diverse cultures, religions, political systems, socioeconomic contexts, lifestyles, and environmental factors probably have led to massive disparities across countries in NCD mortality, risk factors, and NCD management. Geographically, East Asia had the lowest NCD mortality whilst Pacific islands had the highest. Economic booms, ageing, nutrition transition, social stress, prevalent tobacco use, and fast-increasing obesity and hyperglycaemia are important drivers of NCDs. Men tended to have more adverse behavioural and metabolic risk factors. Rural residents are catching up with their urban counterparts in metabolic risk factors and conditions. Sustainable strategies tailored to NCD patterns are needed to fight the NCD epidemic and related disparities.
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Affiliation(s)
- Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, No. 16 Kunlun Road, Xining 810008, People's Republic of China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmenwai, Beijing 100069, People's Republic of China
| | - Fuyuan Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, People's Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10 Xitoutiao, Youanmenwai, Beijing 100069, People's Republic of China
| | - Xiao Tang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, No. 16 Kunlun Road, Xining 810008, People's Republic of China
| | - Lingxia Zeng
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
| | - Jiapeng Chen
- China Population and Development Research Center, No. 12 Dahuisi Road, Beijing, 100081, People's Republic of China
| | - Gauden Galea
- WHO China Representative Office, No. 23 Dongzhimenwai Street, Beijing 100600, People's Republic of China
| | - Deliang Wen
- Health Sciences Institute, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, People's Republic of China
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
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Páez DC, Flórez J, Gómez MT, García D, Arango-Paternina CM, Duperly J. Curricular and pedagogical approaches for physical activity prescription training: a mixed-methods study of the "Exercise is Medicine" workshops in Colombia. BMC MEDICAL EDUCATION 2024; 24:79. [PMID: 38254169 PMCID: PMC10804704 DOI: 10.1186/s12909-023-04999-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The physical activity (PA) prescription workshop for physicians, through the global health initiative "Exercise is Medicine" (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015. METHODS A mixed methods study, with a sequential explanatory design was implemented among a convenience sample of HCPs attending twenty-six PA prescription workshops. HCPs health status, PA personal habits, and medical practices were collected using a questionnaire at baseline among 795 participants (pre-test measurement), and subsequently quantitatively analyzed. A workshop satisfaction survey was administered after the completion of the workshop among 602 HCPs. The curricular and pedagogical approach of the workshop, the designers' and students' contextual factors, and perceptions about the workshop were measured using qualitative methods (analysis of the procedures manual, two workshop observations, three semi-structured interviews, and one focus group including 8 HCPs). RESULTS The workshop is student-centered and guided by an expert with an academic and clinical background. Learning was achieved with theoretical and practical components using authentic performance and collaborative learning. An active teaching and learning approach was used with strategies such as interactive lectures, hands-on elements, and role-playing (patient-counselor). The workshop emphasized an individual approach when prescribing PA integrating in clinical practice not only health benefits but also patient´s beliefs, motivations, needs, and barriers. CONCLUSIONS Evidence-based practices and authentic performance were the most salient pedagogical elements used by EIM Colombia at the PA prescription workshop. A knowledge assessment that includes the practical aspect is suggested for future workshops. The curricular and pedagogical approach of the PA prescription workshop implemented in Colombia is well received by the medical community and a useful continuing medical education intervention with a potential contribution to current, and future health promotion needs.
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Affiliation(s)
- Diana C Páez
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia.
| | - Johanna Flórez
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
| | - María Teresa Gómez
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
- Centro de Investigación y Formación en Educación, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
| | - Daniel García
- Centro de Investigación y Formación en Educación, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
| | - Carlos M Arango-Paternina
- Instituto Universitario de Educación Física y Deporte, Universidad de Antioquia, Calle 74 # 70 - 59, Medellín, Colombia
| | - John Duperly
- School of Medicine, Universidad de los Andes, Carrera 1, #18a-12, Bogotá, Colombia
- Institute of Exercise Medicine and Rehabilitation, Fundación Santa Fe de Bogotá, Cra. 7 #117 -15, Bogotá, Colombia
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Chen F, Wang M, Jiang Y. Prevalence of chronic kidney disease and metabolic related indicators in Mianzhu, Sichuan, China. Front Public Health 2024; 11:1252110. [PMID: 38298256 PMCID: PMC10827981 DOI: 10.3389/fpubh.2023.1252110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/29/2023] [Indexed: 02/02/2024] Open
Abstract
Background Chronic kidney disease (CKD) is a major public health problem worldwide. Periodic surveys are essential for monitoring the prevalence of CKD and its risk factors. We assessed the prevalence of CKD and its risk factors in Mianzhu City in 2020. Method The Natural Population Cohort Study surveyed 7,770 individuals aged>20 years in Mianzhu City of Sichuan province in 2020. Our investigation encompassed the measurement of CKD prevalence, the evaluation of various renal function indicators, and comparisons based on age, gender, and hukou status. Additionally, some metabolic indices were also measured to identify the underlying causes of CKD. Results (1) Overall, the prevalence of reduced renal function (eGFR<60 mL/min/1.73m2), albuminuria, and CKD were 1.3, 10.0, and 10.4%, respectively, (2) the overall prevalence of CKD was higher among men than among women (14.5% vs. 8.6%). Similarly, the prevalence of CKD was higher among men than women in most age groups, (3) among urban residents, the prevalence of CKD was higher among middle-aged individuals and lower among young individuals and older adults, and (4) considering eGFR, the albuminuria and CKD for group definition, Blood pressure, triglyceride, high-density lipoprotein, blood sugar, and BMI were all statistically different among between normal groups and abnormal groups s in the albuminuria and CKD. Conclusion The incidence of CKD greatly varied between Mianzhu City and other regions in China and other countries. The differences in risk factors of CKD should be explored in the future. The gender difference in the prevalence of CKD in this study was markedly different from that in previous studies. More high-quality studies are needed to further explore this controversy. Based on the different prevalence of CKD and metabolism-related indices in rural and urban areas in this study, we speculated that the high incidence of CKD in Mianzhu City might be related to diet, lifestyle, and availability of healthcare services.
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Affiliation(s)
- Feng Chen
- Department of Integrated Care Management Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Miao Wang
- Public Affairs Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yan Jiang
- Department of Nursing/Evidence-based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Kim J, Jeong K, Lee S, Baek Y. Machine-learning model predicting quality of life using multifaceted lifestyles in middle-aged South Korean adults: a cross-sectional study. BMC Public Health 2024; 24:159. [PMID: 38212741 PMCID: PMC10785386 DOI: 10.1186/s12889-023-17457-y] [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: 03/24/2023] [Accepted: 12/12/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND In the context of population aging, advances in healthcare technology, and growing interest in healthy aging and higher quality of life (QOL), have gained central focus in public health, particularly among middle-aged adults. METHODS This study presented an optimal prediction model for QOL among middle-aged South Korean adults (N = 4,048; aged 30-55 years) using a machine-learning technique. Community-based South Korean population data were sampled through multistage stratified cluster sampling. Twenty-one variables related to individual factors and various lifestyle patterns were surveyed. QOL was assessed using the Short Form Health Survey (SF-12) and categorized into total QOL, physical component score (PCS), and mental component score (MCS). Seven machine-learning algorithms were used to predict QOL: decision tree, Gaussian Naïve Bayes, k-nearest neighbor, logistic regression, extreme gradient boosting, random forest, and support vector machine. Data imbalance was resolved with the synthetic minority oversampling technique (SMOTE). Random forest was used to compare feature importance and visualize the importance of each variable. RESULTS For predicting QOL deterioration, the random forest method showed the highest performance. The random forest algorithm using SMOTE showed the highest area under the receiver operating characteristic (AUC) for total QOL (0.822), PCS (0.770), and MCS (0.786). Applying the data, SMOTE enhanced model performance by up to 0.111 AUC. Although feature importance differed across the three QOL indices, stress and sleep quality were identified as the most potent predictors of QOL. Random forest generated the most accurate prediction of QOL among middle-aged adults; the model showed that stress and sleep quality management were essential for improving QOL. CONCLUSION The results highlighted the need to develop a health management program for middle-aged adults that enables multidisciplinary management of QOL.
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Affiliation(s)
- Junho Kim
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyoungsik Jeong
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Siwoo Lee
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Younghwa Baek
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
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Burnier M. The role of adherence in patients with chronic diseases. Eur J Intern Med 2024; 119:1-5. [PMID: 37479633 DOI: 10.1016/j.ejim.2023.07.008] [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: 05/21/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
In the long-term management of chronic diseases, adherence and persistence to prescribed medications are continuous challenges in order to obtain all the potential benefits of drug therapies. Suboptimal drug adherence and discontinuations of therapies remain the most frequent reasons why several diseases are poorly controlled in the population. One the main issue is that physicians are relatively limited in time and tools to detect patients with a poor adherence. The present review discusses present and future strategies that are now available or are being developed to detect and to support adherence in patients with chronic diseases and provides some simple clues to identify patients at high risk of discontinuation in the clinic.
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Affiliation(s)
- Michel Burnier
- Faculty of Biology and Medicine, University of Lausanne, Switzerland; Hypertension Research Foundation, Switzerland.
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Chen C, Zhao Y, Liu S, Wu Y, Yang S, Su B, Zheng X. Changing Patterns of Mortality in Diabetes Mellitus Among Older Adults - China, 1987-2021. China CDC Wkly 2023; 5:1120-1124. [PMID: 38124885 PMCID: PMC10728560 DOI: 10.46234/ccdcw2023.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
What is already known about this topic? Diabetes mellitus poses a significant public health concern for older adults in China, resulting in increased mortality rates. What is added by this report? This study investigates the evolving pattern of mortality associated with diabetes mellitus and analyzes the contributions of age, period, and cohort effects from 1987 to 2021. The results demonstrate a consistent rise in diabetes mellitus mortality over the last 30 years, notably in rural regions. What are the implications for public health practice? This research offers valuable insights to aid policymakers in developing targeted intervention strategies that address the specific needs of higher-risk populations, such as women, older adults, and individuals in rural areas.
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Affiliation(s)
- Chen Chen
- Department of Population health and Aging science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yihao Zhao
- Department of Chronic Diseases and Multimorbidity, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shangjun Liu
- Institute of Population Research, Peking University, Beijing, China
| | - Yu Wu
- Department of Population health and Aging science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shan Yang
- Department of Population health and Aging science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Binbin Su
- Department of Health Economics, School of Population Medicine and Public Health, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | - Xiaoying Zheng
- Department of Population health and Aging science, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- HeSAY/ Institute of Population Research, Peking University, Beijing, China
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Seyedhamzeh S, Nedjat S, Shakibazadeh E, Doustmohammadian A, Hosseini H, Kazemi A, Azizolahi N, Chamary M, Clark CCT, Motlagh AD. Designing a new physical activity calorie equivalent food label and comparing its effect on caloric choices to that of the traffic light label among mothers: a mixed-method study. Front Public Health 2023; 11:1280532. [PMID: 38035293 PMCID: PMC10683755 DOI: 10.3389/fpubh.2023.1280532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Objective We designed a new type of 'physical activity calorie equivalent' (PACE) food label in Iran to compare its effect with that of the traffic light food label (TLL) on caloric choices. Design Mixed-method study. Participants Mothers of school children between the ages of 6-12 years. Setting In the qualitative phase, 10 focus group discussions (FGDs) were conducted with various groups of mothers, and two FGDs were conducted with food science and nutrition experts to design a new PACE label. In the quantitative phase, 496 mothers were randomly assigned to five groups: (1) no nutrition label, (2) current TLL, (3) current TLL + educational brochure, (4) PACE label, and (5) PACE label + brochure. Samples of dairy products, beverages, cakes, and biscuits were presented. ANOVA and multiple linear regressions were applied to examine the association between label types and calories of the selected products as our main outcome. Results The mothers' perspectives were classified into two sub-themes, the PACE label's facilitators and barriers. The new PACE label's characteristics were divided into two subcategories: (a) appearance, and (b) nutritional information, including 14 codes. In the quantitative section, mean calories of the selected foods were lowest in the TLL + brochure group (831.77 kcal; 95% CI: 794.23-869.32), and highest in the PACE label group (971.61; 95% CI: 926.37-1016.84). Conclusion The new PACE label was a combination of PACE, TLL, and warning labels. It did not significantly affect lower caloric choice, however, the TLL + brochure option was effective in choosing foods with fewer calories.Clinical trial registration: The study was registered in the Iranian Registry of Clinical Trials 23 (IRCT20181002041201N1).
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Affiliation(s)
- Shirin Seyedhamzeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saharnaz Nedjat
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hedayat Hosseini
- Department of Food Sciences and Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asma Kazemi
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nafiseh Azizolahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Chamary
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Ahmadreza Dorosty Motlagh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Hankey A, Kale A. Integrative biology for integrative medicine: A complete approach. J Ayurveda Integr Med 2023; 14:100831. [PMID: 38000316 PMCID: PMC10709119 DOI: 10.1016/j.jaim.2023.100831] [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: 03/07/2022] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND India's AYUSH systems of medicine, Ayurveda, Yoga and Naturopathy, Unani, Siddha and Sowa-Rigpa, and Homeopathy, use natural self-healing abilities of body and mind. Their ways to treat non-communicable diseases reduce use of modern drugs with their side-effects. Scientific acceptance requires them to be explained from a modern biological perspective. This paper indicates how to achieve such an integrative approach, using aspects of biology not yet taught in medical schools. METHODS A new, 'Sandwich Model' of biology is introduced that includes holistic epigenetic regulation; also, complexity biology's concept of self-organized criticality; a systems treatment of organism function from Ayurveda; and Ayurveda's six stages of etiology, Shadkriyakala. RESULTS Molecular biology is upgraded by the sandwich model's layer of epigenetics, leading to a new, scientific definition of health as optimized regulation. Fractal Physiology then expands this to explain self-healing, used in all AYUSH systems. Ayurveda contributes in two ways: its systems approach yields a holistic understanding of organism functioning, while Shadkriyakala improves our understanding of pathophysiology. DISCUSSION These additions create an integrative biology; modern biology expands to include AYUSH systems' concepts. It provides a scientific basis for India's plan for integrative medical education, with AYUSH systems treated as equal to modern medicine.
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Affiliation(s)
| | - Anup Kale
- MIT World Peace University, Pune, India
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Ramani-Chander A, Thrift A, van Olmen J, Wouters E, Delobelle P, Vedanthan R, Miranda JJ, Sherwood S, Teede HJ, Joshi R. Prioritising and planning scale-up research projects targeting non-communicable diseases: a mixed-method study by the Global Alliance for Chronic Diseases upscaling working group. BMJ Glob Health 2023; 8:e012804. [PMID: 37963611 PMCID: PMC10649516 DOI: 10.1136/bmjgh-2023-012804] [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: 05/10/2023] [Accepted: 10/07/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION Governments must scale-up evidence-based interventions to reduce the burden of non-communicable diseases (NCDs). Implementation research can help develop contextually appropriate strategies and optimise interventions for scale-up. We aimed to determine the priorities of the Global Alliance for Chronic Diseases (GACD) 2019 funding round for scale-up research targeting NCD interventions. The research questions were: (a) What was the purpose of the call and what were the specific issues considered by funders when supporting the selected projects? (b) How did the selected research projects align with the objectives of GACD scale-up call? METHODS We undertook a mixed-methods study to examine the projects funded by the GACD in 2019. We completed semistructured interviews with representatives from 5 out of 8 funding agencies and complemented this by reviewing project documents from 21 (78%) of the 27 funded studies. A literature review of scale-up frameworks informed the interview guide and data extraction template. The transcripts were open-coded using thematic analysis to identify critical issues for funders. Data were extracted to identify the common elements considered when planning, implementing and evaluating interventions for scale-up. RESULTS Interviews with the funders revealed three enabling themes related to scale-up: local research priorities (contextualisation through engagement), capacity building (developing knowledge base) and connections (networking opportunities). We further identified that timelines (more flexibility) and equity (funding low-income and middle-income researchers) could be considered for future funding investments. Multidisciplinary international research teams led the development of diverse studies to address funder's priorities. The detailed plans included a range of implementation frameworks to help develop contextual scale-up strategies. CONCLUSIONS Fundamental to NCD scale-up research are (1) funding opportunities that reflect the complexity and time necessary to enable contextualisation; (2) investment in building multidisciplinary research capacity and leadership and (3) better networking to encourage cohesive action and align NCD-related scale-up research activities globally.
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Affiliation(s)
- Anusha Ramani-Chander
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Melbourne, Australia
| | - Amanda Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Melbourne, Australia
| | - Josefien van Olmen
- Department of Family Health and Population Medicine, University of Antwerp, Antwerpen, Belgium
| | - Edwin Wouters
- Department of Sociology, Centre for Population, Family & Health, Faculty of Social Sciences, University of Antwerp, Antwerpen, Belgium
| | - Peter Delobelle
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
- Chronic Diseases Initiative for Africa, University of Cape Town, Rondebosch, Western Cape, South Africa
| | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Stephen Sherwood
- Fundación EkoRural, Quito, Ecuador
- Knowledge, Technology and Innovation, Wageningen University, Wageningen, Netherlands
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Rohina Joshi
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health India, New Delhi, India
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Frick C, Rumgay H, Vignat J, Ginsburg O, Nolte E, Bray F, Soerjomataram I. Quantitative estimates of preventable and treatable deaths from 36 cancers worldwide: a population-based study. Lancet Glob Health 2023; 11:e1700-e1712. [PMID: 37774721 PMCID: PMC10581909 DOI: 10.1016/s2214-109x(23)00406-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Cancer is a leading cause of premature mortality globally. This study estimates premature deaths at ages 30-69 years and distinguishes these as deaths that are preventable (avertable through primary or secondary prevention) or treatable (avertable through curative treatment) in 185 countries worldwide. METHODS For this population-based study, estimated cancer deaths by country, cancer, sex, and age groups were retrieved from the International Agency for Research on Cancer's GLOBOCAN 2020 database. Crude and age-adjusted cancer-specific years of life lost (YLLs) were calculated for 36 cancer types. FINDINGS Of the estimated all-ages cancer burden of 265·6 million YLLs, 182·8 million (68·8%) YLLs were due to premature deaths from cancer globally in 2020, with 124·3 million (68·0%) preventable and 58·5 million (32·0%) treatable. Countries with low, medium, or high human development index (HDI) levels all had greater proportions of YLLs at premature ages than very high HDI countries (68·9%, 77·0%, and 72·2% vs 57·7%, respectively). Lung cancer was the leading contributor to preventable premature YLLs in medium to very high HDI countries (17·4% of all cancers, or 29·7 million of 171·3 million YLLs), whereas cervical cancer led in low HDI countries (26·3% of all preventable cancers, or 1·83 million of 6·93 million YLLs). Colorectal and breast cancers were major treatable cancers across all four tiers of HDI (25·5% of all treatable cancers in combination, or 14·9 million of 58·5 million YLLs). INTERPRETATION Alongside tailored programmes of early diagnosis and screening linked to timely and comprehensive treatment, greater investments in risk factor reduction and vaccination are needed to address premature cancer inequalities. FUNDING Erasmus Mundus Exchange Programme and the International Agency for Research on Cancer. TRANSLATIONS For the German, French, Spanish and Chinese translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Clara Frick
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France; Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Harriet Rumgay
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Jérôme Vignat
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Ophira Ginsburg
- Centre for Global Health, National Cancer Institute, Bethesda, MD, USA
| | - Ellen Nolte
- London School of Hygiene & Tropical Medicine, London, UK
| | - Freddie Bray
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
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Kivuyo S, Birungi J, Okebe J, Wang D, Ramaiya K, Ainan S, Tumuhairwe F, Ouma S, Namakoola I, Garrib A, van Widenfelt E, Mutungi G, Jaoude GA, Batura N, Musinguzi J, Ssali MN, Etukoit BM, Mugisha K, Shimwela M, Ubuguyu OS, Makubi A, Jeffery C, Watiti S, Skordis J, Cuevas L, Sewankambo NK, Gill G, Katahoire A, Smith PG, Bachmann M, Lazarus JV, Mfinanga S, Nyirenda MJ, Jaffar S. Integrated management of HIV, diabetes, and hypertension in sub-Saharan Africa (INTE-AFRICA): a pragmatic cluster-randomised, controlled trial. Lancet 2023; 402:1241-1250. [PMID: 37805215 DOI: 10.1016/s0140-6736(23)01573-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND In sub-Saharan Africa, health-care provision for chronic conditions is fragmented. The aim of this study was to determine whether integrated management of HIV, diabetes, and hypertension led to improved rates of retention in care for people with diabetes or hypertension without adversely affecting rates of HIV viral suppression among people with HIV when compared to standard vertical care in medium and large health facilities in Uganda and Tanzania. METHODS In INTE-AFRICA, a pragmatic cluster-randomised, controlled trial, we randomly allocated primary health-care facilities in Uganda and Tanzania to provide either integrated care or standard care for HIV, diabetes, and hypertension. Random allocation (1:1) was stratified by location, infrastructure level, and by country, with a permuted block randomisation method. In the integrated care group, participants with HIV, diabetes, or hypertension were managed by the same health-care workers, used the same pharmacy, had similarly designed medical records, shared the same registration and waiting areas, and had an integrated laboratory service. In the standard care group, these services were delivered vertically for each condition. Patients were eligible to join the trial if they were living with confirmed HIV, diabetes, or hypertension, were aged 18 years or older, were living within the catchment population area of the health facility, and were likely to remain in the catchment population for 6 months. The coprimary outcomes, retention in care (attending a clinic within the last 6 months of study follow-up) for participants with either diabetes or hypertension (tested for superiority) and plasma viral load suppression for those with HIV (>1000 copies per mL; tested for non-inferiority, 10% margin), were analysed using generalised estimating equations in the intention-to-treat population. This trial is registered with ISCRTN 43896688. FINDINGS Between June 30, 2020, and April 1, 2021 we randomly allocated 32 health facilities (17 in Uganda and 15 in Tanzania) with 7028 eligible participants to the integrated care or the standard care groups. Among participants with diabetes, hypertension, or both, 2298 (75·8%) of 3032 were female and 734 (24·2%) of 3032 were male. Of participants with HIV alone, 2365 (70·3%) of 3365 were female and 1000 (29·7%) of 3365 were male. Follow-up lasted for 12 months. Among participants with diabetes, hypertension, or both, the proportion alive and retained in care at study end was 1254 (89·0%) of 1409 in integrated care and 1457 (89·8%) of 1623 in standard care. The risk differences were -0·65% (95% CI -5·76 to 4·46; p=0·80) unadjusted and -0·60% (-5·46 to 4·26; p=0·81) adjusted. Among participants with HIV, the proportion who had a plasma viral load of less than 1000 copies per mL was 1412 (97·0%) of 1456 in integrated care and 1451 (97·3%) of 1491 in standard care. The differences were -0·37% (one-sided 95% CI -1·99 to 1·26; pnon-inferiority<0·0001 unadjusted) and -0·36% (-1·99 to 1·28; pnon-inferiority<0·0001 adjusted). INTERPRETATION In sub-Saharan Africa, integrated chronic care services could achieve a high standard of care for people with diabetes or hypertension without adversely affecting outcomes for people with HIV. FUNDING European Union Horizon 2020 and Global Alliance for Chronic Diseases.
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Affiliation(s)
- Sokoine Kivuyo
- National Institutes for Medical Research, Dar es Salaam, Tanzania; Barcelona Institute for Global Health Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Josephine Birungi
- The AIDS Support Organisation, Mulago Hospital Complex, Kampala, Uganda; Medical Research Council/Uganda Virus Research Institute & London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM), Uganda Research Unit, Entebbe, Uganda; School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Joseph Okebe
- Institute for Global Health, University College London, London, UK
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kaushik Ramaiya
- Tanzania NCDs Alliance, Dar es Salaam, Tanzania; Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | - Samafilan Ainan
- National Institutes for Medical Research, Dar es Salaam, Tanzania
| | - Faith Tumuhairwe
- The AIDS Support Organisation, Mulago Hospital Complex, Kampala, Uganda
| | - Simple Ouma
- The AIDS Support Organisation, Mulago Hospital Complex, Kampala, Uganda
| | - Ivan Namakoola
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM), Uganda Research Unit, Entebbe, Uganda
| | - Anupam Garrib
- Institute for Global Health, University College London, London, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Gerald Mutungi
- Non-Communicable Diseases Control Programme, Ministry of Health, Kampala, Uganda
| | | | - Neha Batura
- Institute for Global Health, University College London, London, UK
| | | | | | | | - Kenneth Mugisha
- The AIDS Support Organisation, Mulago Hospital Complex, Kampala, Uganda
| | | | | | | | - Caroline Jeffery
- Department of Clinical Infection, Microbiology and Immunology, University of Liverpool, Liverpool, UK
| | - Stephen Watiti
- The National Forum of People Living with HIV Networks in Uganda, Kampala, Uganda
| | - Jolene Skordis
- Institute for Global Health, University College London, London, UK
| | - Luis Cuevas
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Geoff Gill
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Anne Katahoire
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Peter G Smith
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Max Bachmann
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health Hospital Clinic, University of Barcelona, Barcelona, Spain; CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Sayoki Mfinanga
- National Institutes for Medical Research, Dar es Salaam, Tanzania; Institute for Global Health, University College London, London, UK
| | - Moffat J Nyirenda
- Medical Research Council/Uganda Virus Research Institute & London School of Hygiene & Tropical Medicine (MRC/UVRI & LSHTM), Uganda Research Unit, Entebbe, Uganda
| | - Shabbar Jaffar
- Institute for Global Health, University College London, London, UK; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
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Choi M, Sempungu JK, Lee EH, Lee YH. Changes in contributions of age- and cause-specific mortality to the widening life expectancy gap between North and South Korea, 1990-2019: An analysis of the Global Burden of Disease Study 2019. SSM Popul Health 2023; 23:101445. [PMID: 37334332 PMCID: PMC10276181 DOI: 10.1016/j.ssmph.2023.101445] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/08/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023] Open
Abstract
Background Life expectancy gaps between North and South Korea have increased but contributions to these gaps remain poorly understood. Using data from the Global Burden of Disease Study (GBD) 2019, we examined how much death from specific diseases contributed to these gaps in different age groups over three decades. Methods Data for death numbers and population by sex and 5-year age groups in both North and South Korea from 1990 to 2019 were extracted from the GBD 2019 to calculate life expectancy. Joinpoint regression analysis was conducted to investigate changes in life expectancy in North and South Korea. We used decomposition analysis to partition differences in life expectancy within and between the two Koreas into changes in age- and cause-specific death contributions. Results Life expectancy increased in two Koreas from 1990 to 2019, but North Korea experienced a marked decline in life expectancy during the mid-1990s. The life expectancy gaps between the two Koreas were greatest in 1999, with a difference of 13.3 years for males and 14.9 years for females. The main contributors to these gaps were higher under-5 mortality from nutritional deficiencies for males (4.62 years) and females (4.57 years) in North Korea, accounting for about 30% of the total gap in life expectancy. After 1999, the life expectancy gaps reduced but persisted with differences of about ten years by 2019. Notably, chronic diseases contributed to about 8 out of 10 years of life expectancy gap between the two Koreas in 2019. Differential cardiovascular disease mortality in the older groups was the main contributor to the life expectancy gap. Conclusions The contributors to this gap have shifted from nutritional deficiencies in children younger than five years to cardiovascular disease among elderly people. Efforts for strengthening social and healthcare systems are needed to curb this large gap.
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Affiliation(s)
- Minjae Choi
- Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Republic of Korea
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Joshua Kirabo Sempungu
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Program in Public Health, Graduate School, Korea University, Seoul, Republic of Korea
| | - Eun Hae Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
- Program in Public Health, Graduate School, Korea University, Seoul, Republic of Korea
| | - Yo Han Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
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Shu J, Jin W. Prioritizing non-communicable diseases in the post-pandemic era based on a comprehensive analysis of the GBD 2019 from 1990 to 2019. Sci Rep 2023; 13:13325. [PMID: 37587173 PMCID: PMC10432467 DOI: 10.1038/s41598-023-40595-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023] Open
Abstract
This study aimed to assess the burden of communicable diseases (CDs) and non-communicable diseases (NCDs) globally, regionally, and nationally from 1990 to 2019, and propose global strategies to transform the public health policy. Using data from the Global Burden of Disease Study (GBD) 2019, we analyzed CDs and NCDs across various factors such as sex, age, year, and location, and evaluate the temporal trends of these diseases with joinpoint analysis. We also examined the differences between regions based on their socio-demographic index (SDI). In 2019, there were 7,862,907 (95% uncertainty interval [UI], 7,183,475 to 8,654,104) deaths from CDs and 42,034,124 (40,081,323 to 43,942,475) deaths from NCDs recorded worldwide. The low SDI region had markedly high age-standardized death and DALY rates of CDs. Although the age-standardized incidence rate of CDs has decreased in about half of the regions since 1990, NCDs have been on the rise in most regions. Over the past 30 years, the global burden of CDs has decreased significantly, while the burden of NCDs has aggrandized to an extent. In the post-pandemic era, effective interventions and cooperation among countries should be promoted to allocate medical resources more reasonably and improve healthcare for NCD patients.
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Affiliation(s)
- Jianhao Shu
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Weifeng Jin
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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Andrade CAS, Mahrouseh N, Gabrani J, Charalampous P, Cuschieri S, Grad DA, Unim B, Mechili EA, Chen-Xu J, Devleesschauwer B, Isola G, von der Lippe E, Baravelli CM, Fischer F, Weye N, Balaj M, Haneef R, Economou M, Haagsma JA, Varga O. Inequalities in the burden of non-communicable diseases across European countries: a systematic analysis of the Global Burden of Disease 2019 study. Int J Equity Health 2023; 22:140. [PMID: 37507733 PMCID: PMC10375608 DOI: 10.1186/s12939-023-01958-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Although overall health status in the last decades improved, health inequalities due to non-communicable diseases (NCDs) persist between and within European countries. There is a lack of studies giving insights into health inequalities related to NCDs in the European Economic Area (EEA) countries. Therefore, the aim of the present study was to quantify health inequalities in age-standardized disability adjusted life years (DALY) rates for NCDs overall and 12 specific NCDs across 30 EEA countries between 1990 and 2019. Also, this study aimed to determine trends in health inequalities and to identify those NCDs where the inequalities were the highest. METHODS DALY rate ratios were calculated to determine and compare inequalities between the 30 EEA countries, by sex, and across time. Annual rate of change was used to determine the differences in DALY rate between 1990 and 2019 for males and females. The Gini Coefficient (GC) was used to measure the DALY rate inequalities across countries, and the Slope Index of Inequality (SII) to estimate the average absolute difference in DALY rate across countries. RESULTS Between 1990 and 2019, there was an overall declining trend in DALY rate, with larger declines among females compared to males. Among EEA countries, in 2019 the highest NCD DALY rate for both sexes were observed for Bulgaria. For the whole period, the highest DALY rate ratios were identified for digestive diseases, diabetes and kidney diseases, substance use disorders, cardiovascular diseases (CVD), and chronic respiratory diseases - representing the highest inequality between countries. In 2019, the highest DALY rate ratio was found between Bulgaria and Iceland for males. GC and SII indicated that the highest inequalities were due to CVD for most of the study period - however, overall levels of inequality were low. CONCLUSIONS The inequality in level 1 NCDs DALYs rate is relatively low among all the countries. CVDs, digestive diseases, diabetes and kidney diseases, substance use disorders, and chronic respiratory diseases are the NCDs that exhibit higher levels of inequality across countries in the EEA. This might be mitigated by applying tailored preventive measures and enabling healthcare access.
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Affiliation(s)
- Carlos Alexandre Soares Andrade
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary
| | - Nour Mahrouseh
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary
| | - Jonila Gabrani
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sarah Cuschieri
- Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Diana Alecsandra Grad
- Department of Public Health, Babes-Bolyai University, Cluj-Napoca-Napoca, Romania
- RoNeuro Institute for Neurological Research and Diagnostic, Cluj-Napoca-Napoca, Romania
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Enkeleint A Mechili
- Department of Healthcare, Faculty of Health, University of Vlora, Vlora, Albania
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece
| | - José Chen-Xu
- Public Health Unit, Primary Healthcare Cluster Baixo Mondego, Coimbra, Portugal
- National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
- Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Gaetano Isola
- Department of General Surgery and Surgical Medical Specialties, University of Catania, Catania, Italy
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | | | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nanna Weye
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
- Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Mirza Balaj
- Department of Sociology and Political Science, Centre for Global Health Inequalities Research (CHAIN), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Romana Haneef
- Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, 26 Kassai Street, 4028, Debrecen, Hungary.
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Dong X, Wu W, Pan P, Zhang XZ. Engineered Living Materials for Advanced Diseases Therapy. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2023:e2304963. [PMID: 37436776 DOI: 10.1002/adma.202304963] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/13/2023]
Abstract
Natural living materials serving as biotherapeutics exhibit great potential for treating various diseases owing to their immunoactivity, tissue targeting, and other biological activities. In this review, the recent developments in engineered living materials, including mammalian cells, bacteria, viruses, fungi, microalgae, plants, and their active derivatives that are used for treating various diseases are summarized. Further, the future perspectives and challenges of such engineered living material-based biotherapeutics are discussed to provide considerations for future advances in biomedical applications.
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Affiliation(s)
- Xue Dong
- Institute for Advanced Studies, Wuhan University, Wuhan, 430072, P. R. China
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing, 400037, P. R. China
| | - Wei Wu
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma, Burn and Combined Injury, Army Medical University, Chongqing, 400037, P. R. China
| | - Pei Pan
- Key Laboratory of Biomedical Polymers of Ministry of Education and Department of Chemistry, Wuhan University, Wuhan, 430072, P. R. China
| | - Xian-Zheng Zhang
- Institute for Advanced Studies, Wuhan University, Wuhan, 430072, P. R. China
- Key Laboratory of Biomedical Polymers of Ministry of Education and Department of Chemistry, Wuhan University, Wuhan, 430072, P. R. China
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Xi JY, Zhang WJ, Chen Z, Zhang YT, Chen LC, Zhang YQ, Lin X, Hao YT. Potential Gains in Health-Adjusted Life Expectancy by Reducing Burden of Noncommunicable Diseases in 188 Countries: A Population-Based Study. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:802-809. [PMID: 36549356 DOI: 10.1016/j.jval.2022.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 06/04/2023]
Abstract
OBJECTIVES This article quantifies the potential gains in health-adjusted life expectancy for people aged 30 to 70 years (HALE[30-70]) by examining the reductions in disability in addition to premature mortality from noncommunicable diseases (NCDs). METHODS We extracted data from the Global Burden of Disease Study 2019 for 4 major NCDs (cancers, cardiovascular diseases, chronic respiratory diseases, and diabetes mellitus) in 188 countries from 2010 to 2019. Estimates of the potential gains in HALE[30-70] were based on a counterfactual analysis involving 3 alternative future scenarios: (1) achieve Sustainable Development Goals target 3.4 but do not make any progress on disability reduction, (2) achieve Sustainable Development Goals target 3.4 and eliminate NCD-related disability, and (3) eliminate all NCD-related mortality and disability. RESULTS In all scenarios, the high-income group has the greatest potential gains in HALE[30-70], above the global average. For all specific causes, potential gains in HALE[30-70] decrease as income levels fall. Across these 3 scenarios, the potential gains in HALE[30-70] globally of reducing premature mortality for 4 major NCDs are 3.13 years, 4.53 years, and 7.32 years, respectively. In scenario A, all income groups have the greatest potential gains in HALE[30-70] from diabetes and chronic respiratory diseases. In scenarios B and C, the high-income group has the greatest potential gains in HALE[30-70] from cancer intervention, and the other income groups have the greatest potential gains in HALE[30-70] from cardiovascular diseases intervention. CONCLUSION Reducing premature death and disability from 4 major NCDs at once and attaching equal importance to each lead to a sizable improvement in HALE[30-70].
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Affiliation(s)
- Jun-Yan Xi
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wang-Jian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA; School of Economics, Faculty of Humanities and Social Sciences, University of Nottingham Ningbo China, Ningbo, China
| | - Yan-Ting Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Chang Chen
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yu-Qin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Yuan-Tao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China; Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China; Center for Health Information Research, Sun Yat-sen University, Guangzhou, China.
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32
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Castro O, Mair JL, Salamanca-Sanabria A, Alattas A, Keller R, Zheng S, Jabir A, Lin X, Frese BF, Lim CS, Santhanam P, van Dam RM, Car J, Lee J, Tai ES, Fleisch E, von Wangenheim F, Tudor Car L, Müller-Riemenschneider F, Kowatsch T. Development of "LvL UP 1.0": a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders. Front Digit Health 2023; 5:1039171. [PMID: 37234382 PMCID: PMC10207359 DOI: 10.3389/fdgth.2023.1039171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Background Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, "LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs. Materials and Methods A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development. Results Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device. Conclusions The development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers.
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Affiliation(s)
- Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Aishah Alattas
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Roman Keller
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ahmad Jabir
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Xiaowen Lin
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Chang Siang Lim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Prabhakaran Santhanam
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington DC, DC, United States
| | - Josip Car
- Centre for Population Health Sciences, LKCMedicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jimmy Lee
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Research Division, Institute of Mental Health, Singapore, Singapore
- North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - E Shyong Tai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elgar Fleisch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Florian von Wangenheim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Lorainne Tudor Car
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Falk Müller-Riemenschneider
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charite University Medical Centre Berlin, Berlin, Germany
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
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Mair JL, Castro O, Salamanca-Sanabria A, Frese BF, von Wangenheim F, Tai ES, Kowatsch T, Müller-Riemenschneider F. Exploring the potential of mobile health interventions to address behavioural risk factors for the prevention of non-communicable diseases in Asian populations: a qualitative study. BMC Public Health 2023; 23:753. [PMID: 37095486 PMCID: PMC10123969 DOI: 10.1186/s12889-023-15598-8] [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: 10/06/2022] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Changing lifestyle patterns over the last decades have seen growing numbers of people in Asia affected by non-communicable diseases and common mental health disorders, including diabetes, cancer, and/or depression. Interventions targeting healthy lifestyle behaviours through mobile technologies, including new approaches such as chatbots, may be an effective, low-cost approach to prevent these conditions. To ensure uptake and engagement with mobile health interventions, however, it is essential to understand the end-users' perspectives on using such interventions. The aim of this study was to explore perceptions, barriers, and facilitators to the use of mobile health interventions for lifestyle behaviour change in Singapore. METHODS Six virtual focus group discussions were conducted with a total of 34 participants (mean ± SD; aged 45 ± 3.6 years; 64.7% females). Focus group recordings were transcribed verbatim and analysed using an inductive thematic analysis approach, followed by deductive mapping according to perceptions, barriers, facilitators, mixed factors, or strategies. RESULTS Five themes were identified: (i) holistic wellbeing is central to healthy living (i.e., the importance of both physical and mental health); (ii) encouraging uptake of a mobile health intervention is influenced by factors such as incentives and government backing; (iii) trying out a mobile health intervention is one thing, sticking to it long term is another and there are key factors, such as personalisation and ease of use that influence sustained engagement with mobile health interventions; (iv) perceptions of chatbots as a tool to support healthy lifestyle behaviour are influenced by previous negative experiences with chatbots, which might hamper uptake; and (v) sharing health-related data is OK, but with conditions such as clarity on who will have access to the data, how it will be stored, and for what purpose it will be used. CONCLUSIONS Findings highlight several factors that are relevant for the development and implementation of mobile health interventions in Singapore and other Asian countries. Recommendations include: (i) targeting holistic wellbeing, (ii) tailoring content to address environment-specific barriers, (iii) partnering with government and/or local (non-profit) institutions in the development and/or promotion of mobile health interventions, (iv) managing expectations regarding the use of incentives, and (iv) identifying potential alternatives or complementary approaches to the use of chatbots, particularly for mental health.
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Affiliation(s)
- Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
| | - Florian von Wangenheim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - E Shyong Tai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St.Gallen, Switzerland
| | - Falk Müller-Riemenschneider
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Cohen S, Halpern M, Stonbraker S. Mixed method evaluation of a clinic waiting room-based health education program in the Dominican Republic. HEALTH EDUCATION RESEARCH 2023; 38:177-191. [PMID: 36715740 DOI: 10.1093/her/cyad001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 05/31/2023]
Abstract
Waiting rooms provide an ideal location to disseminate health information. In this mixed-methods study, we evaluated waiting room-based health education talks at two clinics in the Dominican Republic and explored recommendations for implementing this intervention in similar settings. The talks addressed noncommunicable diseases, sexually transmitted infections, family planning and gender-based violence. We conducted pre- and posttests to assess attendees' change in knowledge and conducted semi-structured interviews with a subset of them. We conducted a semi-structured focus group with educators. Analyses included Wilcox Signed Rank Tests and McNemar tests for pre- and posttests, conventional content analysis for individual interviews and transcript coding for the focus group. Patient participants were 69.3% female aged 39.6 years (SD = 13.5) on average at one clinic (n = 127) and 100% female aged 17.4 (SD = 1.3) on average at the second clinic (n = 24). Focus group participants (n = 5) had 4.8 years (SD = 3.3) of health educator experience on average. Pre- and posttests showed significant improvement (P < 0.05) across all talks. Qualitative interviews emphasized engaging, clear and brief content delivery with visual aids. The focus group highlighted the importance of patient-centered design with culturally concordant delivery and identified implementation challenges. Findings demonstrate that waiting room-based education talks improve knowledge and provide suggestions for similar interventions.
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Affiliation(s)
- S Cohen
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - M Halpern
- Clínica de Familia La Romana, C. Gaston Fernando Deligne 168, La Romana 22000, Dominican Republic
| | - S Stonbraker
- Clínica de Familia La Romana, C. Gaston Fernando Deligne 168, La Romana 22000, Dominican Republic
- University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO 80045, USA
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Phonbuppha J, Tinikul R, Ohmiya Y, Chaiyen P. High Sensitivity and Low-Cost Flavin luciferase (FLUX Vc)-based Reporter Gene for Mammalian Cell Expression. J Biol Chem 2023; 299:104639. [PMID: 36965614 PMCID: PMC10164909 DOI: 10.1016/j.jbc.2023.104639] [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: 02/23/2023] [Revised: 03/12/2023] [Accepted: 03/13/2023] [Indexed: 03/27/2023] Open
Abstract
Luciferase-based gene reporters generating bioluminescence signals are important tools for biomedical research. Amongst the luciferases, flavin-dependent enzymes use the most economical chemicals. However, their applications in mammalian cells are limited due to their low signals compared to other systems. Here, we constructed Flavin Luciferase from Vibrio campbellii (Vc) for Mammalian Cell Expression (FLUXVc) by engineering luciferase from Vibrio campbellii (the most thermostable bacterial luciferase reported to date) and optimizing its expression and reporter assays in mammalian cells which can improve the bioluminescence light output by >400-fold as compared to the non-engineered version. We found that the FLUXVc reporter gene can be overexpressed in various cell lines and showed outstanding signal-to-background in HepG2 cells, significantly higher than that of firefly luciferase (Fluc). The combined use of FLUXVc/Fluc as target/control vectors gave the most stable signals, better than the standard set of Fluc(target)/Rluc(control). We also demonstrated that FLUXVc can be used for testing inhibitors of the NF-κB signaling pathway. Collectively, our results provide an optimized method for using the more economical flavin-dependent luciferase in mammalian cells.
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Affiliation(s)
- Jittima Phonbuppha
- School of Biomolecular Science & Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Wangchan valley, Rayong 21210 Thailand
| | - Ruchanok Tinikul
- Department of Biochemistry and Center for Excellence in Protein and Enzyme Technology, Faculty of Science, Mahidol University, Bangkok 10400 Thailand
| | - Yoshihiro Ohmiya
- School of Biomolecular Science & Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Wangchan valley, Rayong 21210 Thailand; National Institute of Advanced Industrial Science and Technology (AIST), Ikeda, Osaka 563-8577, Japan; Osaka Institute of Technology (OIT), Osaka, Osaka 535-8585, Japan
| | - Pimchai Chaiyen
- School of Biomolecular Science & Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Wangchan valley, Rayong 21210 Thailand.
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Hu Y, Li J, Yin C, Xu L, Li S, Chen Y, Wang Y, Cheng Z, Bai Y. Mediating effect of metabolic diseases on the relationship between hyperuricemia and coronary heart disease. Nutr Metab Cardiovasc Dis 2023; 33:315-322. [PMID: 36599782 DOI: 10.1016/j.numecd.2022.11.005] [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: 07/05/2022] [Revised: 10/11/2022] [Accepted: 11/02/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Studies have shown that elevated serum uric acid (SUA) may increase the risk of coronary heart disease (CHD). However, it is still disputable how mediate effects between metabolic diseases and hyperuricemia affect the incidence of CHD. This study aimed to explore whether metabolic diseases may mediate the connection from hyperuricemia at baseline to the elevated incidence risk of CHD during follow-ups. METHODS AND RESULTS Based on the Jinchang cohort, 48 001 subjects were followed for 9 years between June 2011 and December 2019. Multivariate-adjusted Cox regression models were applied to estimate hazard ratios (HRs) of CHD with 95% confidence intervals (CIs). Significantly increased risks of CHD were observed in hyperuricemia (HR:1.46, 95%CI:1.28, 1.67) when compared with normouricemia population. The mediating effect model further demonstrated that metabolic diseases could mediate the association between hyperuricemia and CHD pathogenesis, partially for the combined metabolic diseases with mediation effects of 45.12%, 25.24% for hypertension, 28.58% for overweight or obese status, 29.05% for hypertriglyceridemia, 6.70% for hypercholesterolemia, 3.52% for low high density lipoprotein cholesterol (HDL-C), and 6.51% for high low density lipoprotein cholesterol (LDL-C), respectively. CONCLUSIONS Hyperuricemia significantly increased the risk of incident CHD, and this association was partly mediated by metabolic diseases.
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Affiliation(s)
- Yujia Hu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Jing Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Chun Yin
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China
| | - Lulu Xu
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Siyu Li
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Yarong Chen
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China
| | - Yufeng Wang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, China
| | - Zhiyuan Cheng
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Street, Shenzhen, 518055, China
| | - Yana Bai
- Department of Epidemiology and Statistics, School of Public Health, Lanzhou University, 199 Donggang West Street, Lanzhou, Gansu 730000, China.
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Sanz-Martín D, Zurita-Ortega F, Ruiz-Tendero G, Ubago-Jiménez JL. Moderate-Vigorous Physical Activity, Screen Time and Sleep Time Profiles: A Cluster Analysis in Spanish Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2004. [PMID: 36767372 PMCID: PMC9915036 DOI: 10.3390/ijerph20032004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
The study had two aims: (1) To classify the adolescents according to their levels of moderate-vigorous physical activity, screen time and sleep time, and (2) to analyze, in a descriptive and correlational manner, the profiles of moderate-vigorous physical activity, screen time and sleep time of each cluster according to the sex and grade of the adolescents. The study design was cross-sectional, with descriptive and correlational analysis. The sample consisted of 663 adolescents in Compulsory Secondary Education from Soria (Spain). The Four by One-Day Physical Activity Questionnaire was used to measure levels of physical activity, screen time and sleep time. The results showed that the young people had an average of 67.99 ± min/day of moderate-vigorous physical activity, 112.56 min/day of screen time and 548.63 min/day of sleep time. Adolescents were classified into three clusters according to their levels of physical activity, screen time and sleep time (FMANOVA (6,1318) = 314.439; p ≤ 0.001; β = 1; f = 1.177). In conclusion, only 28.21% of the young people accomplished the recommendations for physical activity practice, screen time and sleep time. Moreover, these results vary according to the sex and grade of the adolescents.
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Affiliation(s)
- Daniel Sanz-Martín
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Humanities and Educational Sciences, University of Jaén, 23071 Jaén, Spain
| | - Félix Zurita-Ortega
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
| | - Germán Ruiz-Tendero
- Department of Languages, Arts and Physical Education Teaching, Faculty of Education, Complutense University of Madrid, 28040 Madrid, Spain
| | - José Luis Ubago-Jiménez
- Department of Didactics Musical, Plastic and Corporal Expression, Faculty of Education Science, University of Granada, 18071 Granada, Spain
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Zhang X, Ouyang Y, Yin X, Bai J, Zhang R, Zhang J, Wang Q, Wang H. Consumers' Perceptions of the Design of Front-of-Package Warning Labels-A Qualitative Study in China. Nutrients 2023; 15:nu15020415. [PMID: 36678286 PMCID: PMC9866720 DOI: 10.3390/nu15020415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
The warning label is identified as a simple front-of-package labeling format that assists consumers in making healthier food choices at the point of purchase. The color and/or shape of the design elements of the packaging labels can influence the understanding and purchase intention outcomes. This study aimed to explore the perceptions of consumers regarding differently designed warning labels (WLs) to identify a possibly suitable warning label design in the Chinese context. Using a qualitative approach, we collected data through 12 focus group discussions consisting of 116 participants residing in 6 provinces. Participants were selected by purposive sampling. Data were coded following inductive thematic analysis and summarized into three themes: (1) perceived preference for the appearance of the WLs, (2) perceived benefits of the WLs, and (3) suggestions for promoting the WLs. Participants preferred the black shield label showing a high content of the nutrients of concern (e.g., sodium, added sugar, and saturated fat) in both Chinese and English. Consumers generally agreed that the WLs were easy to understand and offered a simple method for choosing healthier foods. They anticipated that WLs could encourage the food industry to reformulate their products. Our study results will support the design and facilitate the use of WLs in China.
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Affiliation(s)
- Xiaofan Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
| | - Yifei Ouyang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
| | - Xuejun Yin
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jing Bai
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
| | - Run Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
| | - Jiguo Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
| | - Qi Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People’s Republic of China, Beijing 100050, China
- Correspondence: ; Tel.: +86-010-6623-7089
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Ivankova V, Gavurova B, Khouri S. Understanding the relationships between health spending, treatable mortality and economic productivity in OECD countries. Front Public Health 2022; 10:1036058. [PMID: 36620274 PMCID: PMC9810629 DOI: 10.3389/fpubh.2022.1036058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Population health is one of the highest priorities for countries, which can translate into increased economic prosperity. This encourages research on health in an economic context. Methods The objective was to assess the relationships between health spending, treatable respiratory mortality, and gross domestic product (GDP) in countries of the Organization for Economic Co-operation and Development (OECD). The research was conducted with respect to health systems (tax-based, insurance-based) and gender differentiation of the productive population (aged 25-64 years). Descriptive analysis, regression analysis, and cluster analysis were used to achieve the main objective. The data covered the period from 1994 to 2016. Results The results of the regression analysis revealed negative relationships between health spending and treatable respiratory mortality in countries with a tax-based health system for male and female working-age populations, as well as in countries with an insurance-based health system for male population. This means that higher health spending was associated with lower treatable respiratory mortality. Also, lower treatable mortality was associated with higher GDP, especially in the male productive population from countries with an insurance-based health system. In this study, countries with a tax-based health system were characterized by higher health spending, lower rates of treatable mortality from respiratory system diseases, and higher GDP compared to countries with an insurance-based health system. Males reported a higher mortality rate than females. Among the countries with a tax-based health system, the United Kingdom and Latvia showed less positive outcomes, while Italy and Iceland were the countries with the most positive outcomes. Among the countries with an insurance-based health system, Hungary and Slovakia reported poor outcomes, while France, Switzerland and Luxembourg were characterized by very positive outcomes. The United States showed a high mortality rate despite its high economic outcomes, i.e., health spending and GDP. Discussion Health care financing in particular is one of the instruments of health policy. It seems that the leaders of countries should ensure a sufficient level of health financing, as higher health spending can contribute to lower mortality rates in a country. This may translate into higher productivity. Especially countries with underfunded health systems should increase their health spending.
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Affiliation(s)
- Viera Ivankova
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
| | - Beata Gavurova
- Center for Applied Economic Research, Faculty of Management and Economics, Tomas Bata University in Zlín, Zlín, Czechia,*Correspondence: Beata Gavurova ✉
| | - Samer Khouri
- Institute of Earth Resources, Faculty of Mining, Ecology, Process Control and Geotechnologies, Technical University of Košice, Košice, Slovakia
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Shahraki-Sanavi F, Woodward M, Ansari-Moghaddam A, Okati-Aliabad H, Mohammadi M, Khorram A, Shabestari S, Poustchi H, Malekzadeh R. Cohort Profile: The Zahedan Adult Cohort Study (ZACS)-a prospective study of non-communicable diseases in Sistani and Baluch populations. Int J Epidemiol 2022; 51:e350-e357. [PMID: 35138365 DOI: 10.1093/ije/dyac011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/25/2022] [Indexed: 01/21/2023] Open
Affiliation(s)
| | - Mark Woodward
- George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Department of Epidemiology and Biostatistics, George Institute for Global Health, Imperial College London, London, UK
| | | | - Hassan Okati-Aliabad
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahdi Mohammadi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Khorram
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Sahar Shabestari
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Intergenerational educational trajectories and premature mortality from chronic diseases: A registry population-based study. SSM Popul Health 2022; 20:101282. [DOI: 10.1016/j.ssmph.2022.101282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
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Lei L, Liang H, Qu Y, Zhong Q, Zhang Q, Dai L, Lu J, Xiao M, Zhao Z, Zhou F, Li Y, Hu G, Xiu J, Zhang X. Association between triglyceride-glucose index and worsening renal function in the elderly. Front Nutr 2022; 9:951564. [PMID: 36505264 PMCID: PMC9730025 DOI: 10.3389/fnut.2022.951564] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background Triglyceride-glucose (TyG) index is a simple marker of insulin resistance. However, insufficient data is available on whether the TyG index is associated with worsening renal function (WRF) in the elderly. Therefore, this study was designed to explore the association between the TyG index and WRF based on a community elderly cohort. Methods In this study, 7,822 elderly (aged ≥ 65 years) adults from southern China were enrolled and divided into four groups according to the TyG index quartiles. The primary endpoint was incident chronic kidney disease (CKD), defined as incident estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. Additional endpoints included a decline in eGFR of 30% and 40% during the follow-up period. Results During the median 2.04 year follow-up period, 1,541 (19.7%) participants developed CKD. After adjusting for confounding factors, multivariable Cox regression models revealed significant associations between TyG index and incident CKD (HR per SD increase, 1.21; 95% CI: 1.14-1.29), a decline in eGFR of 30% (HR per SD increase, 1.38; 95% CI: 1.26-1.50), and decline in eGFR of 40% (HR per SD increase, 1.42; 95% CI: 1.24-1.63). Furthermore, compared with those in Q1, participants in Q4 demonstrated a higher risk of developing CKD (HR, 1.59; 95% CI: 1.35-1.88). These positive associations remained consistent across different subgroup populations. Conclusion Our study suggests a positive and independent association between the TyG index and WRF in the elderly.
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Affiliation(s)
- Li Lei
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hongbin Liang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yali Qu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qianhong Zhong
- Department of Respiratory Medicine, The Fourth People's Hospital of Foshan (Tuberculosis Control Center of Foshan), Foshan, China
| | - Qiuxia Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lei Dai
- Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China
| | - Junyan Lu
- Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China
| | - Min Xiao
- Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China
| | - Zhimeng Zhao
- Department of Respiratory Medicine, The Fourth People's Hospital of Foshan (Tuberculosis Control Center of Foshan), Foshan, China
| | - Fengyun Zhou
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yun Li
- Department of Public Health Management, Zengcheng Xintang Hospital, Guangzhou, China
| | - Guifang Hu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China,*Correspondence: Guifang Hu
| | - Jiancheng Xiu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Department of Cardiology, Nanfang Hospital Zengcheng Branch, Guangzhou, China,Jiancheng Xiu
| | - Xinlu Zhang
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China,Xinlu Zhang
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Gu X, Lin L, Zhao C, Wu L, Liu Y, He L, Lin G, Lin Y, Zhang F. Chronic non-communicable diseases: Hainan prospective cohort study. BMJ Open 2022; 12:e062222. [PMID: 36400728 PMCID: PMC9677015 DOI: 10.1136/bmjopen-2022-062222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The Hainan Cohort was established to investigate the incidence, morbidity and mortality of non-communicable diseases and their risk factors in the community population. PARTICIPANTS The baseline investigation of the Hainan Cohort study was initiated in five main areas of Hainan, China, from June 2018 to October 2020. A multistage cluster random-sampling method was used to obtain samples from the general population. Baseline assessments included a questionnaire survey, physical examination, blood and urine sample collection, and laboratory measurements, and outdoor environmental data were obtained. FINDINGS TO DATA A total of 14 443 participants aged 35-74 years were recruited at baseline, with a participation rate of 90.1%. The mean age of the participants was 48.8 years; 51.8% were men, and 83.7% had a secondary school or higher education. The crude prevalence of diabetes, coronary heart disease, stroke, hypertension, hyperuricaemia, chronic bronchitis, pulmonary tuberculosis, asthma, cancer, chronic hepatitis and metabolic syndrome were 8.6%, 9.2%, 2.0%, 37.1%, 7.1%, 2.3%, 1.4%, 2.1%, 4.1%, 2.2% and 14.5%, respectively. FUTURE PLANS The Hainan Cohort is a dynamic cohort with no end date. All participants will be monitored annually for cause-specific mortality and morbidity until death. Long-term follow-up will be conducted every 5 years. The baseline population is considered to expand in the next wave of follow-up, depending on the availability of funding support.
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Affiliation(s)
- Xingbo Gu
- Department of Biostatistics, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Liuting Lin
- Laboratory of Tropical Environment and Health, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
- Department of Science and Education, Hainan Cancer Hospital, Haikou, Hainan, China
| | - Chanjuan Zhao
- Department of Biostatistics, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Ling Wu
- Department of Biostatistics, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Yumei Liu
- Laboratory of Tropical Environment and Health, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Limin He
- Laboratory of Tropical Environment and Health, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Guotian Lin
- Laboratory of Tropical Environment and Health, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Yingzi Lin
- Laboratory of Tropical Environment and Health, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
| | - Fan Zhang
- Laboratory of Tropical Environment and Health, International School of Public Health and One Health, Hainan Medical University, Haikou, Hainan, China
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Andrade EL, Cordova A, Schagen CRV, Jula M, Rodriguez-Diaz CE, Rivera MI, Santos-Burgoa C. The impact of Hurricane Maria on individuals living with non-communicable disease in Puerto Rico: the experience of 10 communities. BMC Public Health 2022; 22:2083. [PMCID: PMC9664670 DOI: 10.1186/s12889-022-14552-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Coinciding with the rising non-communicable disease (NCD) prevalence worldwide is the increasing frequency and severity of natural hazards. Protecting populations with NCDs against natural hazards is ever more pressing given their increased risk of morbidity and mortality in disaster contexts. This investigation examined Hurricane Maria’s impacts across ten lower SES municipalities in Puerto Rico with varying community characteristics and hurricane impacts to understand experiences of supporting individuals with NCD management in the six-month period following the hurricane.
Methods
We conducted 40 qualitative interviews with mayors, first responders, faith leaders, community leaders, and municipal employees from 10 municipalities in Puerto Rico. Using QSR NVivo software, we deductively and inductively coded interview transcripts and undertook thematic analysis to characterize community-level hurricane impact and consequences for NCD management, and to identify convergent and divergent themes.
Results
Damages to infrastructure, including healthcare facilities and roadways, complicated the provision of timely health care for NCDs, patient transport, and pharmaceutical/medical supply chain continuity. Lengthy power outages at both healthcare facilities and private residences were barriers to healthcare service delivery, use of medical equipment, and storage of prescription medications with refrigeration, and led to a widespread mental health crisis. Cascading failures such as fuel shortages further compounded these challenges. The consequences of these impacts included the reported exacerbation of health conditions and loss of life among NCD patients.
Conclusions
Study findings identify contributors to morbidity and mortality among individuals with NCDs following Hurricane Maria. With the growing frequency of catastrophic disasters from natural hazards, the experiences of communities that endured these impacts offer important lessons regarding policies and practices to better support community disaster resilience and address the evolving preparedness needs of NCD patients.
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Cavallaro M, Coelho J, Ready D, Decraene V, Lamagni T, McCarthy ND, Todkill D, Keeling MJ. Cluster detection with random neighbourhood covering: Application to invasive Group A Streptococcal disease. PLoS Comput Biol 2022; 18:e1010726. [PMID: 36449515 PMCID: PMC9744322 DOI: 10.1371/journal.pcbi.1010726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/12/2022] [Accepted: 11/10/2022] [Indexed: 12/02/2022] Open
Abstract
The rapid detection of outbreaks is a key step in the effective control and containment of infectious diseases. In particular, the identification of cases which might be epidemiologically linked is crucial in directing outbreak-containment efforts and shaping the intervention of public health authorities. Often this requires the detection of clusters of cases whose numbers exceed those expected by a background of sporadic cases. Quantifying exceedances rapidly is particularly challenging when only few cases are typically reported in a precise location and time. To address such important public health concerns, we present a general method which can detect spatio-temporal deviations from a Poisson point process and estimate the odds of an isolate being part of a cluster. This method can be applied to diseases where detailed geographical information is available. In addition, we propose an approach to explicitly take account of delays in microbial typing. As a case study, we considered invasive group A Streptococcus infection events as recorded and typed by Public Health England from 2015 to 2020.
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Affiliation(s)
- Massimo Cavallaro
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, United Kingdom
- UK Health Security Agency, United Kingdom
| | | | - Derren Ready
- UK Health Security Agency, United Kingdom
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
| | | | | | - Noel D. McCarthy
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Institute of Population Health, School of Medicine, Trinity College Dublin, University of Dublin, 2 Dublin, Ireland
| | - Dan Todkill
- UK Health Security Agency, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Matt J. Keeling
- The Zeeman Institute for Systems Biology & Infectious Disease Epidemiology Research, University of Warwick, Coventry, United Kingdom
- School of Life Sciences and Mathematics Institute, University of Warwick, Coventry, United Kingdom
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Gupta K, Al Rifai M, Hussain A, Minhas AMK, Patel J, Kalra D, Samad Z, Virani SS. South Asian ethnicity: What can we do to make this risk enhancer a risk equivalent? Prog Cardiovasc Dis 2022; 75:21-32. [PMID: 36279943 DOI: 10.1016/j.pcad.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
South Asians account for around 25% of the global population and are the fastest-growing ethnicity in the US. This population has an increasing burden of atherosclerotic cardiovascular disease (ASCVD) which is also seen in the diaspora. Current risk prediction equations underestimate this risk and consider the South Asian ethnicity as a risk-enhancer among those with borderline-intermediate risk. In this review, we discuss why the South Asian population is at a higher risk of ASCVD and strategies to mitigate this increased risk.
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Affiliation(s)
- Kartik Gupta
- Department of Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Mahmoud Al Rifai
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Aliza Hussain
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Jaideep Patel
- Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University Medical Center, Richmond, VA, USA; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Dinesh Kalra
- Rudd Heart & Lung Center, University of Louisville School of Medicine, Louisville, KY, USA
| | - Zainab Samad
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - Salim S Virani
- Section of Cardiology and Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Health Policy, Quality & Informatics Program, Health Services Research and Development Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
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The Reality of Inadequate Patient Care and the Need for a Global Action Framework in Organ Donation and Transplantation. Transplantation 2022; 106:2111-2117. [DOI: 10.1097/tp.0000000000004186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Khatiwada B, Rajbhandari B, Mistry SK, Parsekar S, Yadav UN. Prevalence of and factors associated with health literacy among people with Noncommunicable diseases (NCDs) in South Asian countries: A systematic review. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Bann D, Wright L, Goisis A, Hardy R, Johnson W, Maddock J, McElroy E, Moulton V, Patalay P, Scholes S, Silverwood RJ, Ploubidis GB, O’Neill D. Investigating change across time in prevalence or association: the challenges of cross-study comparative research and possible solutions. DISCOVER SOCIAL SCIENCE AND HEALTH 2022; 2:18. [PMID: 36317190 PMCID: PMC9613735 DOI: 10.1007/s44155-022-00021-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/18/2022] [Indexed: 11/30/2022]
Abstract
Cross-study research initiatives to understand change across time are an increasingly prominent component of social and health sciences, yet they present considerable practical, analytical and conceptual challenges. First, we discuss the key challenges to comparative research as a basis for detecting societal change, as well as possible solutions. We focus on studies which investigate changes across time in outcome occurrence or the magnitude and/or direction of associations. We discuss the use and importance of such research, study inclusion, sources of bias and mitigation, and interpretation. Second, we propose a structured framework (a checklist) that is intended to provide guidance for future authors and reviewers. Third, we outline a new open-access teaching resource that offers detailed instruction and reusable analytical syntax to guide newcomers on techniques for conducting comparative analysis and data visualisation (in both R and Stata formats). Supplementary Information The online version contains supplementary material available at 10.1007/s44155-022-00021-1.
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Affiliation(s)
- David Bann
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Liam Wright
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Alice Goisis
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- Social Research Institute, University College London, London, UK
| | - William Johnson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Eoin McElroy
- School of Psychology, Ulster University, Coleraine, UK
| | - Vanessa Moulton
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Shaun Scholes
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Richard J. Silverwood
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - George B. Ploubidis
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Dara O’Neill
- Social Research Institute, University College London, London, UK
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Noh JW, Kim KB, Jang HE, Heo MH, Kim YJ, Cha J. Non-Communicable Diseases and Transitioning Health System in the Democratic People’s Republic of Korea during COVID-19 Lockdown. Healthcare (Basel) 2022; 10:healthcare10102095. [PMID: 36292542 PMCID: PMC9602564 DOI: 10.3390/healthcare10102095] [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: 09/27/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
While there are increasing concerns on COVID-19 situation in Democratic People’s Republic of Korea (DPRK, or North Korea), little is known about North Korea’s health system function for Non-Communicable Diseases. Given the scarcity of available evidence, a scoping review was conducted in peer review articles from MEDLINE, SCOPUS, and Web of Science, and policy literatures from Rodongshinmun, state-run media in North Korea to analyze the North Korea health system and COVID-19 pandemic. The transition to a market economy is expected to deepen the gap between the rich and the poor over access to health care, causing a new type of health inequality in North Korea. COVID-19 lockdown intensified the DPRK’s economic predicament exacerbating shortage of health financing on non-communicable diseases. The case study of mixed evidence from scoping review indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. This study indicates that NCDs prevention and management are not functional in the transitioning health system under chronic economic crisis and isolation. The destabilized markets under COVID-19 lockdown intensified the DPRK’s economic predicament and exacerbated the chronic shortage of health financing especially to NCDs.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Health Care Convergence, Yonsei University, Wonju 26493, Korea
| | - Kyoung-Beom Kim
- Industry-Academic Cooperation Foundation, Yonsei University, Wonju 26493, Korea
| | - Ha-Eun Jang
- Department of Health Care Management, College of Bio Convergence, Eulji University, Seongnam 34824, Korea
| | - Min-Hee Heo
- Department of Health Administration, Yonsei University Graduate School, Wonju 26493, Korea
| | - Young-Jin Kim
- Department of Health Administration, Dankook University, Cheonan 31116, Korea
| | - Jiho Cha
- Moonsoul Graduate School of Future Strategy, KAIST, Daejeon 34141, Korea
- Correspondence: ; Tel.: +82-42-350-4040
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