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Morsy MHE, Nabil ZI, Darwish ST, Al-Eisa RA, Mehana AE. Anti-Diabetic and Anti-Adipogenic Effect of Harmine in High-Fat-Diet-Induced Diabetes in Mice. Life (Basel) 2023; 13:1693. [PMID: 37629550 PMCID: PMC10455780 DOI: 10.3390/life13081693] [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: 07/03/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
One of the most important health issues facing the world today is obesity. It is an important independent risk factor for developing type 2 diabetes. Harmine offers various pharmacological effects, such as anti-inflammatory and anti-tumor effects. The current study aims to investigate Harmine's anti-diabetic and anti-adipogenic properties in albino mice after inducing low-grade inflammation with a high-fat diet (HFD). About forty-eight male albino mice were divided into four groups. Group 1: control mice were injected with daily saline and fed a normal chow diet of 21% protein for 5 months. Group 2: mice were treated daily with IP-injected Harmine (30 mg/kg body weight) and were fed a normal chow diet for 5 months. Group 3: mice were fed HFD to induce type 2 Diabetes Mellitus (T2DM) for 5 months. Group 4: mice were fed HFD for 14 weeks and treated with Harmine for the last 6 weeks. A figh-fat diet caused a significant increase in body and organ weight, lipid profiles, and destructive changes within the pancreas, kidney, and liver tissue. The administration of Harmine led to a remarkable improvement in the histological and ultrastructural changes induced by HFD. The findings indicate that mice cured using Harmine had lower oxidative stress, a higher total antioxidant capacity, and a reduced lipid profile compared to HFD mice. Harmine led to the hepatocytes partly restoring their ordinary configuration. Furthermore, it was noticed that the pathological incidence of damage in the structure of both the kidney and pancreas sections reduced in comparison with the diabetic group. Additional research will be required to fully understand Harmine and its preventive effects on the two forms of diabetes.
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Affiliation(s)
- Menna H E Morsy
- Department of Zoology, Faculty of Science, Arish University, Arish 45511, Egypt
- Department of Zoology, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt
| | - Zohour I Nabil
- Department of Zoology, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt
| | - Samah T Darwish
- Department of Zoology, Faculty of Science, Arish University, Arish 45511, Egypt
| | - Rasha A Al-Eisa
- Department of Biology, College of Sciences, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Amir E Mehana
- Department of Zoology, Faculty of Science, Suez Canal University, Ismailia 41522, Egypt
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Afshari M, Teymourlouy AA, Maleki M, Asadi-Lari M. Enhancing global health diplomacy for non-communicable diseases: application of the global health network framework. Global Health 2023; 19:41. [PMID: 37344896 DOI: 10.1186/s12992-023-00944-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 06/03/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND AND AIM Understanding the characteristics of global policy actors and the political context in which they address diplomatic issues in the field of NCDs can play an important role in advancing NCD-related goals. The purpose of this study was to identify and analyze the network of global health actors in the field of NCDs in Iran. METHODS This study was conducted in 2020 using a qualitative methodology and framework analysis. In-depth semi-structured interviews were conducted with subject-matter experts from all levels of diplomacy, including global, regional, and national, who had managerial, administrative, and academic experience. FINDINGS A total of 21 interviews were conducted with individuals who met the inclusion criteria. Following the framework of the World Health Network, the findings were divided into three general areas: the features of the network and the actors; the policy environment; and the characteristics of the issue. CONCLUSION A successful and sustainable program to combat NCDs requires the participation of multiple actors from governments, the private sector, and civil society at international, national, and local levels. The Global Network for Prevention and Control of NCDs should enhance the effectiveness of NCDs policies by highlighting the need to simultaneously improve the internal factors of the network, including relationships among the actors; external factors, including the policy environment; and the complex nature of NCDs.
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Affiliation(s)
- Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Marten R, Hanefeld J, Smith RD. How states engage in and exercise power in global health: Indonesian and Japanese engagement in the conceptualization of Sustainable Development Goal 3. Soc Sci Med 2023; 321:115455. [PMID: 36854234 DOI: 10.1016/j.socscimed.2022.115455] [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: 02/21/2021] [Revised: 08/14/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022]
Abstract
While long overlooked, power is central to understand how actors engage in global health policymaking. We reviewed how the Japanese and Indonesian governments exerted power and engaged in global health diplomacy during negotiations to conceptualize the post-2015 Sustainable Development Goal for health (SDG3). We conducted deliberative policy analysis including semi-structured, in-depth, interviews with more than 71 policymakers, which we analyzed adapting Barnett and Duvall's power framework. We find that both Japan and Indonesia exerted non-material power (institutional, productive and structural power) to advance largely domestic political interests. Japan's government mainly exerted institutional power, leveraging relationships within the World Bank and the World Health Organization, whereas Indonesia's government focused on structural power, with its president serving as co-chair of the UN Secretary-General's High-Level Post-2015 Panel. Our analysis suggests that the ways in which states engage in global health diplomacy is shaped by the relationship between different intra-state institutions, particularly the Ministry of Foreign Affairs and the Ministry of Health, and is further determined by broader foreign policy and diplomatic priorities. We find that the decline of states' influence is over-stated: states continue to exercise significant power in global health diplomacy, pursuing domestic political imperatives and strategies to improve population health. As states expand their global health engagement, researchers should seek to better understand how states participate in an increasingly crowded and contested global health field.
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Affiliation(s)
- Robert Marten
- London School of Hygiene and Tropical Medicine, University of London, London, WC1H 9SH, UK.
| | - Johanna Hanefeld
- London School of Hygiene and Tropical Medicine, University of London, London, WC1H 9SH, UK
| | - Richard D Smith
- University of Exeter, Medical School Building, St Luke's Campus, Magdalen Road, Exeter, EX1 2LU, UK
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Neyazi N, Mosadeghrad AM, Afshari M, Isfahani P, Safi N. Strategies to tackle non-communicable diseases in Afghanistan: A scoping review. Front Public Health 2023; 11:982416. [PMID: 36908476 PMCID: PMC9992526 DOI: 10.3389/fpubh.2023.982416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023] Open
Abstract
Non-communicable diseases (NCDs) and their risk factors are the leading cause of death worldwide and contribute to 74.3% of deaths globally in 2019. The burden of NCDs is escalating in Afghanistan. Currently, every seconds, people in Afghanistan are dying of NCDs. Addressing this challenge in Afghanistan needs effective and practical interventions. This study aimed to identify the strategies developed and implemented in countries with low non-communicable premature death. To conduct a scoping review, we followed the six-step Arksey and O'Malley protocol and searched for eligible articles on eight international databases and the gray literature. The study followed the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines. The inclusion criteria were English documents and evidence produced up to 30 November 2021 for the control of NCDs. We excluded incomplete texts, duplicates, and dissertations due to lack of access. We used EndNote X9 and MaxQDA software for data management and analysis. We conducted content analysis for this study. A total of 122 documents developed between 1984 and 2021 met the inclusion criteria. We identified 35 strategies from which the most used strategies were related to unhealthy diets and smoking cessation programs. Canada (26.4%), Korea (19.8%), and the United Kingdom (19%) have the most publications on the control and prevention of NCDs among the countries included in the study. Most strategies were implemented over 2 years (41%). This study recommends specific interventions to control and prevent NCDs for the main risk factors of tobacco use, unhealthy diet, physical inactivity, and the main non-communicable diseases such as heart diseases, cancers, diabetes, and chronic obstructive pulmonary diseases. Afghanistan Ministry of Public Health, the WHO country office, and other involved stakeholders can use the findings of this review to design and implement strategies for controlling and preventing NCDs in Afghanistan. International organizations such as the World Health Organization, United Nations Agencies, the World Bank, and other involving communities should invest in strengthening good health governance in Afghanistan. The Afghan Government should focus on promoting and funding health literacy among the public and self-care to control and prevent NCDs.
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Affiliation(s)
- Narges Neyazi
- International Campus, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
| | - Ali Mohammad Mosadeghrad
- Health Information Management Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Parvaneh Isfahani
- School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Najibullah Safi
- Health System Development, World Health Organization Country Office, Kabul, Afghanistan
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Augustin J, Andrees V, Walsh D, Reintjes R, Koller D. Spatial Aspects of Health-Developing a Conceptual Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1817. [PMID: 36767185 PMCID: PMC9914219 DOI: 10.3390/ijerph20031817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Numerous studies and models address the determinants of health. However, in existing models, the spatial aspects of the determinants are not or only marginally taken into account and a theoretical discussion of the association between space and the determinants of health is missing. The aim of this paper is to generate a framework that can be used to place the determinants of health in a spatial context. A screening of the current first serves to identify the relevant determinants and describes the current state of knowledge. In addition, spatial scales that are important for the spatial consideration of health were developed and discussed. Based on these two steps, the conceptual framework on the spatial determinants of health was derived and subsequently discussed. The results show a variety of determinants that are associated with health from a spatial point of view. The overarching categories are global driving forces, policy and governance, living and physical environment, socio-demographic and economic conditions, healthcare services and cultural and working conditions. Three spatial scales (macro, meso and micro) are further subdivided into six levels, such as global (e.g., continents), regional (e.g., council areas) or neighbourhood (e.g., communities). The combination of the determinants and spatial scales are presented within a conceptual framework as a result of this work. Operating mechanisms and pathways between the spatial levels were added schematically. This is the first conceptual framework that links the determinants of health with the spatial perspective. It can form the working basis for future analyses in which spatial aspects of health are taken into account.
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Affiliation(s)
- Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - David Walsh
- Glasgow Centre for Population Health, Glasgow G40 2QH, UK
| | - Ralf Reintjes
- Department of Health Sciences, Faculty of Life Sciences, Hamburg University of Applied Sciences, 20999 Hamburg, Germany
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
| | - Daniela Koller
- IBE—Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
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Zhidkova EA, Shlipakov SV, Zaborova VA, Krikheli NI, Drapkina OM, Barnard RT, Gurevich KG. Risk Factors for Heart Disease in Working Railwaymen. Am J Mens Health 2022; 16:15579883221136983. [PMID: 36458594 PMCID: PMC9720816 DOI: 10.1177/15579883221136983] [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] [Indexed: 12/04/2022] Open
Abstract
Heart diseases are the most common non-communicable diseases worldwide. We examined the prevalence of risk factors for heart disease among a sub-population of working men. In total, 11,059 railway crew workers of the Russian Railways Company were included in the study. We also asked participants to answer several questions based on the WHO STEPwise approach to surveillance (STEPS) translated into Russian. Only 30% of drivers had normal body mass index (BMI), whereas 70% were overweight or obese. In 12% of subjects, total cholesterol was higher than 5 mmol/L. In 15% of participants, glucose level was higher than 5.5 mmol/L. 38% of drivers reported smoking. Physical inactivity was registered in 54% of persons. Only 29% ate according to the key principles of good diet quality. 24% of respondents had a family history of heart disease. MANOVA demonstrated that BMI was determined by age, profession, smoking, physical inactivity, and diet quality. As age increased, the number of people with normal cholesterol levels decreased. It was demonstrated that a correlation existed between glucose levels and BMI. In the total group, the correlation was 0.46 (p < .05). The correlation between those parameters increased due to age, from 0.33 in the <30 years of age group up to 0.52 in the >50 years of age group. This study demonstrated that there is a high prevalence of risk factors for heart disease in train drivers in the Russian Federation.
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Affiliation(s)
- Elena A. Zhidkova
- Central Directorate of
Healthcare-Branch of Joint Stock Company “Russian Railways,” Moscow, Russia,“Moscow State Medical and Dental
University named after A. I. Evdokimov” Ministry of Health of the Russian
Federation, Moscow, Russia
| | | | - Victoria A. Zaborova
- Sechenov First Moscow State Medical
University (Sechenov University), Moscow, Russia,Moscow Institute of Physics and
Technology (National Research University), Moscow Region, Russia
| | - Natella I. Krikheli
- “Moscow State Medical and Dental
University named after A. I. Evdokimov” Ministry of Health of the Russian
Federation, Moscow, Russia
| | - Oksana M. Drapkina
- State Research Center for Preventive
Medicine of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Ross T. Barnard
- School of Chemistry and Molecular
Biosciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Konstantin G. Gurevich
- “Moscow State Medical and Dental
University named after A. I. Evdokimov” Ministry of Health of the Russian
Federation, Moscow, Russia,Research Institute of Health
Organization and Medical Management of the Department of Health of the City of
Moscow, Moscow, Russia,Konstantin G. Gurevich, “Moscow State
Medical and Dental University named after A. I. Evdokimov” Ministry of Health of
the Russian Federation, Delegatskaya Street, 20/1, Moscow 127473, Russia.
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Owolade A, Mashavakure H, Babatunde AO, Aborode AT. Time to relook into Non-Communicable Diseases (NCDs) in Africa: A silent threat overwhelming global health in Africa. Ann Med Surg (Lond) 2022; 82:104522. [PMID: 36164642 PMCID: PMC9508432 DOI: 10.1016/j.amsu.2022.104522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
In Sub Saharan Africa, the morbidity and mortality rate from Non-Communicable Diseases is increasing more than in any place in the world. However, Sub-Saharan Africa faces many challenges such as problems with financing, health system issues, contending interests from industry actors as well as low NCD awareness levels, which have impeded all efforts to curb the burden of these diseases. This perspective discussed the causes, effects and the need to the prioritize prevention and control of non-communicable diseases in Africa, together with practical recommendations. Some of the causes include fast urbanization, dietary changes, lack of health insurance and political instability amongst others, these have had huge implications on not only health indices but also socio-economic development in African countries. There is a need for political will and engagement, community engagement, behavioral changes, and interdisciplinary coordination to reduce the prevalence of NCDs in Africa. In Sub Saharan Africa, the morbidity and mortality rate from Non-Communicable diseases is increasing. Some of the causes include fast urbanization, dietary changes, lack of health insurance and political instability amongst others. There is a need for political will and engagement, community engagement, behavioral changes, and interdisciplinary coordination to reduce the prevalence of NCDs in Africa.
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Luciani S, Agurto I, Caixeta R, Hennis A. Prioritizing noncommunicable diseases in the Americas region in the era of COVID-19. Rev Panam Salud Publica 2022; 46:e83. [PMID: 35875322 PMCID: PMC9299393 DOI: 10.26633/rpsp.2022.83] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/24/2022] [Indexed: 01/14/2023] Open
Abstract
This article describes the situation of noncommunicable diseases (NCDs) in the Americas, implementation of NCD interventions according to key progress indicators, the impact of COVID-19 on NCD services, and ways to reprioritize NCDs following COVID-19. Information was retrieved from institutional data and through a supplementary scoping review of published articles related to NCDs and COVID-19 in the Americas published April 2020–November 2021. While NCDs account for 80.7% of all deaths in the Americas, implementation of a key set of NCD interventions has been limited, with only three countries reporting implementation of 12 or more of the 19 NCD indicators. By mid-May 2022, the Americas had reported about 29.9% of all COVID-19 cases in the world (154 million of 515 million) and 43.5% all COVID-19 deaths (2.7 million of 6.2 million). This pandemic has hampered progress on NCDs and significantly disrupted services for people who require ongoing care. Adaptive strategies, such as telehealth and mobile pharmacies, have been used to mitigate service disruptions. However, NCD prevention and management must be an integral part of recovering from the COVID-19 pandemic. This will require scaled up efforts to establish/re-establish and enforce policies on NCD risk factors, especially for tobacco control and obesity prevention, as well as greater investment in primary care and expansion of telemedicine and digital health solutions for continuous care for people with NCDs. Lastly, limited data are available on the impact of COVID-19 on NCDs, and hence NCD data and surveillance need to be strengthened.
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Affiliation(s)
- Silvana Luciani
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America
| | - Irene Agurto
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America
| | - Roberta Caixeta
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America
| | - Anselm Hennis
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, United States of America
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Risk Factors for Locomotive Crew Members Depending on Their Place of Work. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127415. [PMID: 35742665 PMCID: PMC9224354 DOI: 10.3390/ijerph19127415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to examine the prevalence of workplace exposure, behavior, and individual health conditions, along with resulting medical activity among locomotive crew members depending on their place of work. PATIENTS AND METHODS Participants included 5585 train drivers and 3723 train drivers' assistants (7% of the total train operators in the Russian Federation). Measured height and weight were used to calculate body mass index (BMI), and waist circumference, pulse rate, and blood pressure were also measured. The risk assessment was conducted using the STEPS tool. The level of commitment to a Healthy Lifestyle was assessed based on World Health Organization recommendations. Occupational risk factors were surveyed. Morbidity was analyzed over the past year. RESULTS The lowest frequency of work exposure risk factors was found for employees of the Trans-Baikal railway; the highest was among Krasnoyarsk, North, and South-East. The participants from the Far East and October Railways had the lowest self-reported frequency of behavioral risk factors. The participants from the Eastern Siberian, October, and Southern Urals railways had the lowest occurrence of individual health conditions. The participants from the East Siberian, Far East, Kuibyshev, and Sverdlovsk railways were the least likely to visit their doctor, take temporary disability leave, or be hospitalized. The total assessed Healthy Lifestyle commitment index was higher for participants from the Far Eastern and Southern Urals railways. The participants from the Moscow and October railways were the least committed to a Healthy Lifestyle. CONCLUSIONS Significant differences exist between risk factors and Healthy Lifestyle commitment between railways. Future research should examine changes due to a new corporate health program introduced in 2020.
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Gharekhani A, Somi M, Ostadrahimi A, Hatefi A, Haji Kamanaj A, Hassannezhad S, Faramarzi E. Prevalence and Predicting Risk Factors of Polypharmacy in Azar Cohort Population. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH 2022; 21:e126922. [PMID: 36060920 PMCID: PMC9420226 DOI: 10.5812/ijpr-126922] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/12/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
Background As polypharmacy has some medically negative impacts, it has become a challenging issue for public health and affected people. Therefore, we decided to investigate the prevalence of polypharmacy and its predicting risk factors in the Azar cohort population. Methods In this cross-sectional population-based cohort study, the prevalence of polypharmacy was evaluated in 15,001 subjects who participated in the Azar cohort study. We measured demographic characteristics (age, gender, socioeconomic status, smoking status, marital status, and education level), physical activity level, body mass index (BMI), blood pressure, multimorbidity (coexistence of two or more chronic diseases (CDs)), and polypharmacy status (a daily intake of five or more medicines for a minimum of 90 days). Results Based on our results, 9.51% of the population had polypharmacy. The five most prescribed medications were drugs acting on the cardiovascular system (19.9%), central nervous system (16.7%), endocrine system (13.3%), NSAIDs (11.5%), and drugs used for musculoskeletal and joint diseases (11.4%). Being female, illiterate, and having the lowest tertile of physical activity level significantly increased the risk of polypharmacy. The risk of polypharmacy was 49.36 times higher in patients with four or more CDs than in those without. Conclusions Our study emphasized the importance of routine monitoring to evaluate polypharmacy among those aged 35 to 59 and the elderly. Physicians should carefully assess drug suitability, especially in multimorbid and obese patients, to prevent excessive polypharmacy and its potentially negative impacts.
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Affiliation(s)
- Afshin Gharekhani
- Department of Clinical Pharmacy (Pharmacotherapy), Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammadhossein Somi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayda Hatefi
- Student Research Committee, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arash Haji Kamanaj
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sina Hassannezhad
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding Author: Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Golgahsht st., Tabriz, Iran.
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Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Eslambolchi L, Afshari M. Challenges and opportunities for Iranian global health diplomacy: lessons learned from action for prevention and control of noncommunicable diseases. Health Res Policy Syst 2021; 19:152. [PMID: 34952614 PMCID: PMC8703215 DOI: 10.1186/s12961-021-00800-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The steady rise in noncommunicable diseases (NCDs) worldwide has been a key global health challenge. Governments have the primary responsibility for taking action to prevent and control NCDs. Given the growing importance of globalization of healthcare as well as the increasing use of soft power, governments need to identify challenges and opportunities to enhance global health diplomacy (GHD) for NCD prevention and control. The purpose of this qualitative research was to explain the challenges and opportunities of GHD for NCDs in Iran. METHODS This study was conducted in 2020 using a qualitative approach and through in-depth, semi-structured interviews with 21 experts and specialists in related fields such as health policy, healthcare management, epidemiology and other related specialties. The participants were selected from all levels of diplomacy, including global, regional and national levels, with at least 3 years of experience in managerial, executive and scientific activities. Data analysis was performed by content analysis with an inductive approach. Data were analysed using inductive content analysis. RESULTS The identified challenges were categorized into five main themes, including content challenges, structural challenges, process challenges, governance challenges and cultural challenges. Opportunities extracted from the interviews were also categorized into four main themes, including strong political will, utilizing the capacity of nongovernmental organizations (NGOs), multisectoral collaborations and a well-developed health system. CONCLUSIONS NCD prevention and control requires a multilateral collaboration-based solution. Recognition of the challenges and opportunities in GHD can help draw significant lessons for building the necessary capacities and implementing more effective policies to prevent and control NCDs.
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Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Eslambolchi
- Health Management and Economics Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. .,Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.
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12
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Asadi-Lari M, Ahmadi Teymourlouy A, Maleki M, Afshari M. Opportunities and challenges of global health diplomacy for prevention and control of noncommunicable diseases: a systematic review. BMC Health Serv Res 2021; 21:1193. [PMID: 34736461 PMCID: PMC8567539 DOI: 10.1186/s12913-021-07240-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background and aim The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs. Methods A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10. Findings There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level. Conclusion Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07240-3.
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Affiliation(s)
- Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi Teymourlouy
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Afshari
- Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Singh B, Chattu VK. Prioritizing 'equity' in COVID-19 vaccine distribution through Global Health Diplomacy. Health Promot Perspect 2021; 11:281-287. [PMID: 34660222 PMCID: PMC8501485 DOI: 10.34172/hpp.2021.36] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/30/2021] [Indexed: 12/03/2022] Open
Abstract
With over 4 million deaths worldwide, the current coronavirus disease 2019 (COVID-19)pandemic is regarded as one of the worst pandemics in history. With its wider devastating consequences, even so-called affluent countries could not provide full coverage for COVID-19vaccines and medications to all of their citizens. Against this backdrop, the main aim of this article is to examine how Global Health Diplomacy (GHD) can play a role in prioritizing vaccine equity in the global health agenda in the fight against COVID-19. The majority of developed countries’ healthcare systems have been exposed and have reached a tipping point.After the completion of eighteen months of the pandemic, only five countries were able to produce vaccines for the treatment of COVID-19. This pandemic has divided the world into two blocs: those with vaccines, such as the United States, the United Kingdom, Russia, China, and India; and those without, such as the rest of the world. The greatest challenges are vaccine inequalities, inequities and distribution, which undermine the global economic recovery. Many poor countries are still waiting for the initial doses to be delivered to their citizens, while some rich nations are planning for booster doses. GHD plays a critical role in establishing successful global collaborations, funding mechanisms and ensuring international cooperation through the combined efforts of all stakeholders. Besides, global solidarity is necessary to lessen the wider gaps between the vaccination status of rich and poor nations. Therefore, through GHD, the vaccine gaps and inequities can be addressed to strengthen global health security and accelerate global economic recovery.
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Affiliation(s)
- Bawa Singh
- Department of South and Central Asian Studies, School of International Studies, Central University of Punjab, Bathinda, India
| | - Vijay Kumar Chattu
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada.,Institute of International Relations, The University of the West Indies, St. Augustine, Trinidad and Tobago.,Department of Public Health, Saveetha Medical College, SIMATS, Saveetha University, TN, Chennai, India
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14
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Jailobaeva K, Falconer J, Loffreda G, Arakelyan S, Witter S, Ager A. An analysis of policy and funding priorities of global actors regarding noncommunicable disease in low- and middle-income countries. Global Health 2021; 17:68. [PMID: 34187499 PMCID: PMC8240078 DOI: 10.1186/s12992-021-00713-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Noncommunicable diseases (NCDs), including mental health, have become a major concern in low- and middle-income countries. Despite increased attention to them over the past decade, progress toward addressing NCDs has been slow. A lack of bold policy commitments has been suggested as one of the contributors to limited progress in NCD prevention and management. However, the policies of key global actors (bilateral, multilateral, and not-for-profit organisations) have been understudied. METHODS This study aimed to map the key global actors investing in action regarding NCDs and review their policies to examine the articulation of priorities regarding NCDs. Narrative synthesis of 70 documents and 31 policy papers was completed, and related to data collated from the Global Health Data Visualisation Tool. RESULTS In 2019 41% of development assistance for health committed to NCDs came from private philanthropies, while that for other global health priorities from this source was just 20%. Through a range of channels, bilateral donors were the other major source of NCD funding (contributing 41% of NCD funding). The UK and the US were the largest bilateral investors in NCDs, each contributing 8%. However, NCDs are still under-prioritised within bilateral portfolios - receiving just 0.48% of US funding and 1.66% of the UK. NGOs were the key channels of funding for NCDs, spending 48% of the funds from donors in 2019. The reviewed literature generally focused on NCD policies of WHO, with policies of multilateral and bilateral donors given limited attention. The analysis of policies indicated a limited prioritisation of NCDs in policy documents. NCDs are framed in the policies as a barrier to economic growth, poverty reduction, and health system sustainability. Bilateral donors prioritise prevention, while multilateral actors offer policy options for NCD prevention and care. Even where stated as a priority, however, funding allocations are not aligned. CONCLUSION The growing threat of NCDs and their drivers are increasingly recognised. However, global actors' policy priorities and funding allocations need to align better to address these NCD threats. Given the level of their investment and engagement, more research is needed into the role of private philanthropies and NGOs in this area.
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Affiliation(s)
- Kanykey Jailobaeva
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Jennifer Falconer
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Giulia Loffreda
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Stella Arakelyan
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Sophie Witter
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
| | - Alastair Ager
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU UK
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A Randomized Trial of Tai Chi on Preventing Hypertension and Hyperlipidemia in Middle-Aged and Elderly Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105480. [PMID: 34065454 PMCID: PMC8160700 DOI: 10.3390/ijerph18105480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 01/22/2023]
Abstract
In our randomized controlled trial, we investigated whether Wu-style Tai Chi (Tai Chi combined with Daoyin) as a potential exercise prescription is more effective than simplified Tai Chi in the prevention and treatment of hypertension and hyperlipidemia in the middle-aged and elderly. We randomly assigned 66 patients with hypertension and hyperlipidemia to one of the two groups: the Wu-style Tai Chi group or the simplified Tai Chi group; the simplified Tai Chi group only exercised simplified Tai Chi three times a week for 6 weeks. The Wu-style Tai Chi group participated in 60 min of Wu-style Tai Chi three times a week for 6 weeks. Serum biochemical tests were conducted at baseline and at the end of the study. Measurements of blood pressure were performed at the same time. Primary outcomes were compared within and between groups at baseline and at 6 weeks. The participants in the Wu-style Tai Chi group performed, at 6 weeks, significantly better than baseline on all of the primary outcomes (p value ≤ 0.05). The results also show significant difference within the simplified Tai Chi group from baseline to 6 weeks in TCHO (mmol/L), SBP (mmHg), and LDL-C (mmol/L) (p value < 0.05). From baseline to 6 weeks, the Wu-style Tai Chi group had significant differences at more test indexes in serum and blood pressure than the simplified Tai Chi group. At 6 weeks, the Wu-style Tai Chi group had a significantly greater mean improvement in the SBP (mmHg) than did the simplified Tai Chi group (mean between-group difference, −5.80 (mmHg) [95% CI, −14.01 to 2.41]; p = 0.007). The results showed that, compared with simplified Tai Chi, Wu-style Tai Chi had a better effect on hypertension in the middle-aged and elderly. At 6 weeks in LDL-C (mmol/L), the Wu-style Tai Chi group had significantly greater improvement between the two groups (means between-group difference, −0.45 (mmol/L) [95% CI, −0.89 to −0.17]; p = 0.03). The results showed that Wu-style Tai Chi protected the cardiovascular system of the middle-aged and elderly in improving LDL-C (mmol/L), and was more significant than simplified Tai Chi. After 6 weeks of exercise, Wu-style Tai Chi could effectively improve hyperlipidemia and hypertension. The total effective rate of cardiovascular disease was 90.00%. There was significant difference in the treatment effect of hypertension and hyperlipidemia between the two groups during 6 weeks (p = 0.039), showing that, in a small population of middle-aged and elderly subjects, Wu style Tai Chi could be useful in managing important CV risk factors, such as hypertension and hyperlipidemia.
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Monaco A, Palmer K, Holm Ravn Faber N, Kohler I, Silva M, Vatland A, van Griensven J, Votta M, Walsh D, Clay V, Yazicioglu MC, Ducinskiene D, Donde S. Digital Health Tools for Managing Noncommunicable Diseases During and After the COVID-19 Pandemic: Perspectives of Patients and Caregivers. J Med Internet Res 2021; 23:e25652. [PMID: 33464206 PMCID: PMC7850778 DOI: 10.2196/25652] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/24/2020] [Accepted: 01/13/2021] [Indexed: 02/07/2023] Open
Abstract
Background A reduction in the number of face-to-face medical examinations conducted for patients with noncommunicable diseases (NCDs) during the first wave of the COVID-19 pandemic has led to health care professionals quickly adopting different strategies to communicate with and monitor their patients. Such strategies include the increased use of digital health tools. However, patient preferences, privacy concerns, a lack of regulations, overregulation, and insufficient evidence on the efficacy of digital health tools may have hampered the potential positive benefits of using such tools to manage NCDs. Objective This viewpoint aims to discuss the views of an advisory board of patient and caregiver association members. Specifically, we aim to present this advisory board’s view on the role of digital health tools in managing patients with NCDs during and after the COVID-19 pandemic, and to identify future directions based on patients’ perspectives. Methods As an initiative under the NCD Partnership (PARTners in Ncds Engage foR building Strategies to improve Healthy ageing In Patients) model of Upjohn, a web-based advisory board of patient and caregiver advocates was held on July 28, 2020, to bring together key stakeholders from public and private sectors. Results The following key themes emerged: (1) technology developers should understand that the goals of patients may differ from those of health care professionals and other stakeholders; (2) patients, health care professionals, caregivers, and other end users need to be involved in the development of digital health tools at the earliest phase possible, to guarantee usability, efficacy, and adoption; (3) digital health tools must be better tailored to people with complex conditions, such as multimorbidity, older age, and cognitive or sensory impairment; and (4) some patients do not want or are unable to use digital health care tools, so adequate alternatives should always be available. Conclusions There was consensus that public-private partnership models, such as the Upjohn NCD Partnership, can be effective models that foster innovation by integrating multiple perspectives (eg, patients’ perspectives) into the design, development, and implementation of digital and nondigital health tools, with the main overall objective of improving the life of patients with NCDs.
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Affiliation(s)
- Alessandro Monaco
- École des hautes études commerciales de Paris (HEC Paris), Jouy-en-Josas, France
| | | | | | - Irene Kohler
- Healthwatch Wiltshire, Trowbridge, United Kingdom
| | | | | | | | - Mariano Votta
- Cittadinanzattiva/Active Citizenship Network, Rome, Italy
| | - Donna Walsh
- European Federation of Neurological Associations, Brussels, Belgium
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Shahabi S, Jalali M, Lankarani KB. Global health diplomacy: a solution to meet the needs of disabled people in Yemen. Confl Health 2020; 14:66. [PMID: 32989382 PMCID: PMC7512209 DOI: 10.1186/s13031-020-00310-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/18/2020] [Indexed: 02/08/2023] Open
Abstract
People with disabilities (PWD) are one of the most vulnerable groups in society during armed conflicts. According to the statistics, four million persons with disability live in Yemen. Lack of access and the use of rehabilitation services make PWD unable to retrieve their social and economic roles, which would have substantial negative impacts both on their families and community. The conflict escalation, an increase in the number the of displaced, COVID-19 pandemic, an increase in non-communicable diseases, and the exacerbation of poverty and malnutrition have rapidly enhanced the population at risk of disability in Yemen. Accordingly, effective and comprehensive approaches such as global health diplomacy (GHD) should be considered to meet the emerged needs. GHD seeks to address the common challenges in the global health system by involving all key stakeholders and establishing negotiations and diplomatic dialogue among official actors. Given the presence of various regional and international actors in Yemen and the examples of the successful use of GHD under conflict and post-conflict conditions in Iraq and Afghanistan, the use of diplomacy is crucial to respond to the needs of PWD in this war-torn country appropriately.
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Affiliation(s)
- Saeed Shahabi
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Jalali
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
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