1
|
Mon AS, Win HH, Sandar WP, Walton P, Swe KH, Vervoort JPM, Landsman JA, Rusnak M, Koot JAR. Co-occurrence of behavioural risk factors for non-communicable diseases among 40-year and above aged community members in three regions of Myanmar. Open Res Eur 2024; 3:77. [PMID: 38357680 PMCID: PMC10864818 DOI: 10.12688/openreseurope.15859.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 02/16/2024]
Abstract
Background Risky behaviours such as smoking, alcohol consumption, physical inactivity and inadequate consumption of fruits and vegetables are known contributing factors for non-communicable diseases (NCDs) which account for 74% of global mortality. Such behavioural risk factors co-occur frequently resulting in synergistic action for developing NCD related morbidity and mortality. This study aims to assess the existence of multiple risk behaviours and determine the socio-economic and demographic factors associated with co-occurrence of behavioural risks among Myanmar adult population. Method Data were collected, in the context of the SUNI-SEA project (Scaling Up NCD interventions in Southeast Asia), from 660 community members aged 40 years and above of both sexes, residing in selected urban and rural areas from Ayeyawaddy, Yangon and Mandalay regions of Myanmar. The co-occurrence of behavioural risk factors was presented as percentage with 95% CI and its determinants were identified by multinomial logistic regression. Results The co-occurrence of two risk behaviours and three or four risk behaviours were found in 40% (95% CI: 36.2%, 43.9%) and 10.8% (95% CI: 8.5%, 13.4%) respectively. Urban residents, men, participants without formal schooling and unemployed persons were more likely to exhibit co-occurrence of two risk behaviors and three or four risk behaviours. Conclusion The current study shows high prevalence of co-occurrence of behavioural risk factors among Myanmar adults in the study area. NCD prevention and control programs emphasizing management of behavioural risks should be intensively promoted, particularly directed towards multiple behavioural risk factors, and not focused on individual factors only.
Collapse
Affiliation(s)
- Aye Sandar Mon
- Department of Biostatistics and Medical Demography, University of Public Health, Yangon, Yangon, Yangon, 11011, Myanmar
| | - Hla Hla Win
- University of Public Health, Yangon, Yangon, Yangon, 11011, Myanmar
| | - Win Pa Sandar
- SUNI-SEA project, HelpAge International Myanmar, Yangon, Yangon, 11011, Myanmar
| | - Poppy Walton
- SUNI-SEA project, HelpAge International Myanmar, Yangon, Yangon, 11011, Myanmar
| | - Khin Hnin Swe
- SUNI-SEA project, HelpAge International Myanmar, Yangon, Yangon, 11011, Myanmar
| | - Johanna P. M. Vervoort
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, Groningen, 9713 AV, The Netherlands
| | - Jeanet A. Landsman
- Department of Health Science, University Medical Center Groningen, Groningen, 9700 RB, The Netherlands
| | - Martin Rusnak
- Department of Public Health, Faculty of Health Care and Social Work, University of Trnava, Trnava, Slovakia
| | - Jaap A. R. Koot
- Global Health Unit, Department of Health Sciences, University Medical Center Groningen, Groningen, 9713 AV, The Netherlands
| |
Collapse
|
2
|
Badacho AS, Mahomed OH. Facilitators and barriers to integration of noncommunicable diseases with HIV care at primary health care in Ethiopia: a qualitative analysis using CFIR. Front Public Health 2023; 11:1247121. [PMID: 38145060 PMCID: PMC10748758 DOI: 10.3389/fpubh.2023.1247121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background The rise in non-communicable diseases (NCD), such as hypertension and diabetes among people living with human immunodeficiency virus (PLWH), has increased the demand for integrated care due to multiple chronic care needs. However, there is a dearth of evidence on contextual factors implementing integrated hypertension and diabetes care with HIV care. This study aimed to identify facilitators and barriers that could affect the integration of hypertension and diabetes with HIV care at primary health care in Ethiopia. Methods Five primary health facilities from five districts of the Wolaita zone of South Ethiopia were included in the qualitative study. Fifteen key informant interviews were conducted with healthcare providers and managers from the zonal, district, and facility levels from October to November 2022. Data collection and analysis were guided by a consolidated framework of implementation research (CFIR). Results Ten CFIR constructs were found to influence the integration. Perceived benefit of integration to patients, healthcare providers, and organization; perceived possibilities of integration implementation; availability of NCD guidelines and strategies; a supportive policy of decentralization and integration; perceived leaders and healthcare provider commitment were found to be facilitators. Perceived increased cost, insufficient attention to NCD care needs, inadequate number of trained professionals, inadequate equipment and apparatus such as blood pressure measurement, glucometers, strips, and NCD drugs, inadequate allocation of budget and weak health financing system and poor culture of data capturing and reporting were identified as barriers to integration. Conclusion It is important to address contextual barriers through innovative implementation science solutions to address multiple chronic care needs of PLWH by implementing integrated hypertension and diabetes with HIV care in primary healthcare. Training and task shifting, pairing experienced professionals, and strengthening the health care financing system to implement evidence-based integration of hypertension and diabetes are recommended.
Collapse
Affiliation(s)
- Abebe Sorsa Badacho
- School Public Health, Wolaita Sodo University, Sodo, Ethiopia
- School of Nursing and Public Health, Public Health Medicine Discipline, Durban, South Africa
- Health Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa
| | - Ozayr Haroon Mahomed
- School of Nursing and Public Health, Public Health Medicine Discipline, Durban, South Africa
- Dasman Diabetes Institute, Kuwait City, Kuwait
| |
Collapse
|
3
|
Mallafré-Larrosa M, Papi G, Trilla A, Ritchie D. Development and Promotion of an mHealth App for Adolescents Based on the European Code Against Cancer: Retrospective Cohort Study. JMIR Cancer 2023; 9:e48040. [PMID: 38015612 DOI: 10.2196/48040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/09/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Mobile health technologies, underpinned by scientific evidence and ethical standards, exhibit considerable promise and potential in actively engaging consumers and patients while also assisting health care providers in delivering cancer prevention and care services. The WASABY mobile app was conceived as an innovative, evidence-based mobile health tool aimed at disseminating age-appropriate messages from the European Code Against Cancer (ECAC) to adolescents across Europe. OBJECTIVE This study aims to assess the outcomes of the design, development, and promotion of the WASABY app through a 3-pronged evaluation framework that encompasses data on social media promotion, app store traffic, and user engagement. METHODS The WASABY app's content, cocreated with cancer-focused civil society organizations across 6 European countries, drew upon scientific evidence from the ECAC. The app's 10 modules were designed using the health belief model and a gamification conceptual framework characterized by spaced repetition learning techniques, refined through 2 rounds of testing. To evaluate the effectiveness of the app, we conducted a retrospective cohort study using the WASABY app's user database registered from February 4 to June 30, 2021, using a 3-pronged assessment framework: social media promotion, app store traffic, and user engagement. Descriptive statistics and association analyses explored the relationship between sociodemographic variables and user performance analytics. RESULTS After extensive promotion on various social media platforms and subsequent traffic to the Apple App and Google Play stores, a sample of 748 users aged between 14 and 19 years was included in the study cohort. The selected sample exhibited a mean age of 16.08 (SD 1.28) years and was characterized by a predominant representation of female users (499/748, 66.7%). Most app users identified themselves as nonsmokers (689/748, 92.1%), reported either no or infrequent alcohol consumption (432/748, 57.8% and 250/748, 33.4%, respectively), and indicated being physically active for 1 to 5 hours per week (505/748, 67.5%). In aggregate, the app's content garnered substantial interest, as evidenced by 40.8% (305/748) of users visiting each of the 10 individual modules. Notably, sex and smoking habits emerged as predictors of app completion rates; specifically, male and smoking users demonstrated a decreased likelihood of successfully completing the app's content (odds ratio 0.878, 95% CI 0.809-0.954 and odds ratio 0.835, 95% CI 0.735-0.949, respectively). CONCLUSIONS The development and promotion of the WASABY app presents a valuable case study, illustrating the effective dissemination of evidence-based recommendations on cancer prevention within the ECAC through an innovative mobile app aimed at European adolescents. The data derived from this study provide insightful findings for the implementation of Europe's Beating Cancer Plan, particularly the creation of the EU Mobile App for Cancer Prevention.
Collapse
Affiliation(s)
- Meritxell Mallafré-Larrosa
- Association of European Cancer Leagues, Brussels, Belgium
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Ginevra Papi
- Association of European Cancer Leagues, Brussels, Belgium
| | - Antoni Trilla
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - David Ritchie
- Association of European Cancer Leagues, Brussels, Belgium
| |
Collapse
|
4
|
Lebina L, Malatji T, Nabeemeeah F, Motsomi K, Siwelana T, Hlongwane K, Martinson N. The prevalence of multimorbidity in virally suppressed HIV-positive patients in Limpopo. South Afr J HIV Med 2023; 24:1495. [PMID: 37795429 PMCID: PMC10546900 DOI: 10.4102/sajhivmed.v24i1.1495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/31/2023] [Indexed: 10/06/2023] Open
Abstract
Background Non-communicable diseases (NCDs) are an emerging global public health problem. Objectives To assess the prevalence of NCDs and their risk factors among adults on antiretroviral therapy (ART). Method This was a cross-sectional study (July 2019 - January 2020) in Limpopo, South Africa. Patients were enrolled if they were ≥ 40 years, HIV-positive, and virologically suppressed on ART. Data were analysed descriptively, and a binomial regression model was used to identify risk factors for NCDs. Results The majority of participants (65%; 319/488) were women. Most (83%; 405/488) were aged 40-59 years; 60% (285/472) were overweight or obese. Based on self-report, 22% (107/488) were currently smokers. Almost half (44%) 213/488) reported daily consumption of vegetables and 65% (319/488) exercised regularly and 39% (190/488) reported treatment for another chronic disease. The leading comorbid conditions were hypertension (32%; 158/488) and diabetes mellitus (5%; 24/488). Risk factors for hypertension included age 60 years and older (relative risk [RR]: 1.72; 95% confidence interval [CI]: 1.29-2.30) diabetes (RR: 1.42; 95% CI: 1.08-1.87), overweight (RR: 1.32; 95% CI: 1.03-1.69) and obesity (RR: 1.69; 95% CI: 1.32-2.17). Conclusion There is a high prevalence, both of risk factors for NCDs and multimorbidity (> 1 chronic disease) in patients who are ≥ 40 years and virologically suppressed on ART.
Collapse
Affiliation(s)
- Limakatso Lebina
- Perinatal HIV Research Unit, SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
- Clinical Research Department, Africa Health Research Institute, Durban, South Africa
| | - Tumiso Malatji
- Department of Public Health Medicine, University of Limpopo, Polokwane, South Africa
| | - Firdaus Nabeemeeah
- Perinatal HIV Research Unit, SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
| | - Kegaugetswe Motsomi
- Perinatal HIV Research Unit, SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
| | - Tsundzukani Siwelana
- Perinatal HIV Research Unit, SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
| | - Khuthadzo Hlongwane
- Perinatal HIV Research Unit, SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
| | - Neil Martinson
- Perinatal HIV Research Unit, SAMRC Soweto Matlosana Collaborating Centre for HIV/AIDS and TB, University of the Witwatersrand, Johannesburg, South Africa
- Center for TB Research, Johns Hopkins University, Baltimore, United States of America
| |
Collapse
|
5
|
Hamada Y, Quartagno M, Law I, Malik F, Bonsu FA, Adetifa IM, Adusi-Poku Y, D'Alessandro U, Bashorun AO, Begum V, Lolong DB, Boldoo T, Dlamini T, Donkor S, Dwihardiani B, Egwaga S, Farid MN, Celina G.Garfin AM, Mae G Gaviola D, Husain MM, Ismail F, Kaggwa M, Kamara DV, Kasozi S, Kaswaswa K, Kirenga B, Klinkenberg E, Kondo Z, Lawanson A, Macheque D, Manhiça I, Maama-Maime LB, Mfinanga S, Moyo S, Mpunga J, Mthiyane T, Mustikawati DE, Mvusi L, Nguyen HB, Nguyen HV, Pangaribuan L, Patrobas P, Rahman M, Rahman M, Rahman MS, Raleting T, Riono P, Ruswa N, Rutebemberwa E, Rwabinumi MF, Senkoro M, Sharif AR, Sikhondze W, Sismanidis C, Sovd T, Stavia T, Sultana S, Suriani O, Thomas AM, Tobing K, Van der Walt M, Walusimbi S, Zaman MM, Floyd K, Copas A, Abubakar I, Rangaka MX. Association of diabetes, smoking, and alcohol use with subclinical-to-symptomatic spectrum of tuberculosis in 16 countries: an individual participant data meta-analysis of national tuberculosis prevalence surveys. EClinicalMedicine 2023; 63:102191. [PMID: 37680950 PMCID: PMC10480554 DOI: 10.1016/j.eclinm.2023.102191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/24/2023] [Accepted: 08/16/2023] [Indexed: 09/09/2023] Open
Abstract
Background Non-communicable diseases (NCDs) and NCD risk factors, such as smoking, increase the risk for tuberculosis (TB). Data are scarce on the risk of prevalent TB associated with these factors in the context of population-wide systematic screening and on the association between NCDs and NCD risk factors with different manifestations of TB, where ∼50% being asymptomatic but bacteriologically positive (subclinical). We did an individual participant data (IPD) meta-analysis of national and sub-national TB prevalence surveys to synthesise the evidence on the risk of symptomatic and subclinical TB in people with NCDs or risk factors, which could help countries to plan screening activities. Methods In this systematic review and IPD meta-analysis, we identified eligible prevalence surveys in low-income and middle-income countries that reported at least one NCD (e.g., diabetes) or NCD risk factor (e.g., smoking, alcohol use) through the archive maintained by the World Health Organization and by searching in Medline and Embase from January 1, 2000 to August 10, 2021. The search was updated on March 23, 2023. We performed a one-stage meta-analysis using multivariable multinomial models. We estimated the proportion of and the odds ratio for subclinical and symptomatic TB compared to people without TB for current smoking, alcohol use, and self-reported diabetes, adjusted for age and gender. Subclinical TB was defined as microbiologically confirmed TB without symptoms of current cough, fever, night sweats, or weight loss and symptomatic TB with at least one of these symptoms. We assessed heterogeneity using forest plots and I2 statistic. Missing variables were imputed through multi-level multiple imputation. This study is registered with PROSPERO (CRD42021272679). Findings We obtained IPD from 16 national surveys out of 21 national and five sub-national surveys identified (five in Asia and 11 in Africa, N = 740,815). Across surveys, 15.1%-56.7% of TB were subclinical (median: 38.1%). In the multivariable model, current smoking was associated with both subclinical (OR 1.67, 95% CI 1.27-2.40) and symptomatic TB (OR 1.49, 95% CI 1.34-1.66). Self-reported diabetes was associated with symptomatic TB (OR 1.67, 95% CI 1.17-2.40) but not with subclinical TB (OR 0.92, 95% CI 0.55-1.55). For alcohol drinking ≥ twice per week vs no alcohol drinking, the estimates were imprecise (OR 1.59, 95% CI 0.70-3.62) for subclinical TB and OR 1.43, 95% CI 0.59-3.46 for symptomatic TB). For the association between current smoking and symptomatic TB, I2 was high (76.5% (95% CI 62.0-85.4), while the direction of the point estimates was consistent except for three surveys with wide CIs. Interpretation Our findings suggest that current smokers are more likely to have both symptomatic and subclinical TB. These individuals can, therefore, be prioritised for intensified screening, such as the use of chest X-ray in the context of community-based screening. People with self-reported diabetes are also more likely to have symptomatic TB, but the association is unclear for subclinical TB. Funding None.
Collapse
Affiliation(s)
- Yohhei Hamada
- Institute for Global Health, University College London, United Kingdom
| | - Matteo Quartagno
- MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, United Kingdom
| | - Irwin Law
- Global Tuberculosis Programme, World Health Organization, Switzerland
| | - Farihah Malik
- UCL Great Ormond Street Institute of Child Health, University College London, United Kingdom
| | | | - Ifedayo M.O. Adetifa
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Gambia
- Department of Infectious Diseases Epidemiology, London School of Hygiene & Tropical Medicine, United Kingdom
| | - Yaw Adusi-Poku
- National Tuberculosis Programme, Ghana Health Service, Ghana
| | - Umberto D'Alessandro
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Gambia
| | - Adedapo Olufemi Bashorun
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Gambia
| | | | | | - Tsolmon Boldoo
- Tuberculosis Surveillance and Research Department, National Center for Communicable Disease, Mongolia
| | - Themba Dlamini
- Eswatini National Tuberculosis Program, Ministry of Health, Eswatini
| | - Simon Donkor
- Disease Control and Elimination Theme, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Gambia
| | - Bintari Dwihardiani
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Indonesia
| | - Saidi Egwaga
- Tuberculosis and Leprosy Programme, Ministry of Health and Social Welfare, United Republic of Tanzania
| | | | | | | | | | - Farzana Ismail
- Centre for Tuberculosis, National Institute for Communicable Diseases, A Division of the National Health Laboratory Services, South Africa
- Department of Medical Microbiology, University of Pretoria, South Africa
| | - Mugagga Kaggwa
- World Health Organization, Country Office for Uganda, Uganda
| | - Deus V. Kamara
- Tuberculosis and Leprosy Programme, Ministry of Health and Social Welfare, United Republic of Tanzania
| | - Samuel Kasozi
- National Tuberculosis Control Programme, Ministry of Health, Uganda
| | | | | | - Eveline Klinkenberg
- Department of Global Health, Amsterdam University Medical Center, Netherlands
| | - Zuweina Kondo
- Tuberculosis and Leprosy Programme, Ministry of Health and Social Welfare, United Republic of Tanzania
| | - Adebola Lawanson
- National Tuberculosis and Leprosy Control Programme, Federal Ministry of Health, Nigeria
| | - David Macheque
- National Tuberculosis Program, Ministry of Health, Mozambique
| | - Ivan Manhiça
- National Tuberculosis Program, Ministry of Health, Mozambique
| | | | - Sayoki Mfinanga
- Institute for Global Health, University College London, United Kingdom
- National Institute for Medical Research, Muhimbili Medical Research Centre, United Republic of Tanzania
- Liverpool School of Tropical Medicine, United Kingdom
- Alliance for Africa Health and Research, United Republic of Tanzania
| | - Sizulu Moyo
- Human Sciences Research Council, South Africa
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - James Mpunga
- National Tuberculosis Programme, Ministry of Health, Malawi
| | | | | | | | | | | | | | - Philip Patrobas
- World Health Organization, Country Office for Nigeria, Nigeria
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh
| | - Mahbubur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh
| | | | | | | | | | - Elizeus Rutebemberwa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Uganda
| | | | - Mbazi Senkoro
- National Institute for Medical Research, Muhimbili Medical Research Centre, United Republic of Tanzania
| | | | - Welile Sikhondze
- Eswatini National Tuberculosis Program, Ministry of Health, Eswatini
| | | | | | | | - Sabera Sultana
- World Health Organization, Country Office for Bangladesh, Bangladesh
| | | | | | | | | | | | | | - Katherine Floyd
- Global Tuberculosis Programme, World Health Organization, Switzerland
| | - Andrew Copas
- Institute for Global Health, University College London, United Kingdom
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, United Kingdom
| | - Molebogeng X. Rangaka
- Institute for Global Health, University College London, United Kingdom
- Division of Epidemiology and Biostatistics & CIDRI-AFRICA, University of Cape Town, South Africa
| |
Collapse
|
6
|
Delnoij DMJ, Derks M, Koolen L, Shekary S, Suitela J. Using Patient Blogs on Social Media to Assess the Content Validity of Patient-Reported Outcome Measures: Qualitative Analysis of Patient-Written Blogs. JMIR Form Res 2023; 7:e43210. [PMID: 37505797 PMCID: PMC10422175 DOI: 10.2196/43210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/02/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) are questionnaires that measure patient outcomes related to quality of life, health, and functioning, and are increasingly used to assess important outcomes from the patient's perspective. For PROMs to contribute to better health and better care, it is vital that their content validity be adequate. This requires patient involvement in various steps of PROM development. PROM developers not only recognize the benefits of patient involvement but also report difficulties in recruiting patients and experience patient involvement as time-consuming, logistically challenging, and expensive. OBJECTIVE This study seeks to explore different strategies for disclosing the experiential knowledge of patients, namely through analyzing patient stories on the web and social media. The research questions are as follows: (1) how do bloggers living with a disease experience their health-related quality of life? (2) How are these experiences reflected in the domains and items of PROMs related to their disease? METHODS First, a qualitative analysis of blogs written by patients was performed. Second, subthemes and underlying codes resulting from this qualitative analysis were systematically compared with the domains and items in PROMs for the respective diseases that the bloggers write about. Blogs were identified via the Google search engine between December 2019 and May 2021. RESULTS Bloggers describe a wide range of experiences regarding their physical functioning and health; mental well-being; social network and support; daily life, education, work, and leisure; coping; and self-management. Bloggers also write about their positive and negative experiences with health care delivery, the organization of health care, and health care professionals. In general, patients' experiences as described in blogs were reflected in the domains and items of the PROMs related to their disease. However, except for diabetes mellitus, in all the sets of PROMs, potentially missing topics could be identified. Similarly, with the exception of Parkinson disease, all PROMs address issues that patients did not write about in their blogs and that might therefore be redundant. CONCLUSIONS Web-based patient stories in the form of blogs reveal how people living with a certain disease experience their health-related quality of life. These stories enable analyses of patients' experiences that can be used to assess the content validity of PROMs. This can be a useful step for researchers who are looking for sets of measuring instruments that match their purposes.
Collapse
Affiliation(s)
- Diana M J Delnoij
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
- National Health Care Institute (Zorginstituut Nederland), Diemen, Netherlands
| | - Meggie Derks
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Laura Koolen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Shuka Shekary
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Jozua Suitela
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, Netherlands
| |
Collapse
|
7
|
Djalalinia S, Azadnajafabad S, Rezaei N, Malekpour MR, Ghasemi E, Yoosefi M, Naderimagham S, Ghamari A, Haghshenas R, Farzi Y, Moghaddam SS, Rezaei N, Farzadfar F. The first nationally and sub-nationally representative non-communicable diseases cohort study in Iran: Iran Cohort Study (ICS) protocol. J Diabetes Metab Disord 2023; 22:913-920. [PMID: 37255781 PMCID: PMC10225386 DOI: 10.1007/s40200-022-01143-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 09/09/2022] [Indexed: 06/01/2023]
Abstract
Purpose Non-communicable diseases (NCDs) have become a global health priority with a great need for prompt evidence-based preventing and managing interventions. Here, we describe the development of a comprehensive cohort study that provides the most accurate results for NCDs' risk factors, named the Iran Cohort Study (ICS) to estimate the effect size of the risk factors associated with major NCDs. Methods This cohort is an observational prospective study, which its baseline data was gathered through the Iran STEPwise Approach to NCD Risk Factor Surveillance (STEPs) survey in 2016. Following the STROBE criteria, the protocols for investigation of several areas were developed. The follow-up phase began through telephone calls to estimate the effect size of socio-demographic, behavioral, and metabolic risk factors on the incidence of or death due to major NCDs during the three years of study period. Delinerables The main deliverables of ICS are planned to be as following; a comprehensive bank of primary data and follow-up data, national and subnational reports on estimation of the effect size of various risk factors, and a policy brief on the policy options and recommendations for promotion of ongoing programs and designing new interventions. Also, the collected data on the individuals' health status will be sent to the participants as an electronic health record. Conclusion The present study is the first comprehensive national and sub-national representative cohort study on NCDs' risk factors in Iranian adults. The results could be used for promotion of health planning and also future complementary studies and programs.
Collapse
Affiliation(s)
- Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Mohammad-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Shohreh Naderimagham
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Ghamari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713136 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Zhang Y, Li S, Zhang Q, Zhao Y, Liu M, Zhang D, Cai X, Wang N, Wang W. Structural characterization and transformation of nitrogen compounds in waste tire pyrolysis oils. J Chromatogr A 2023; 1702:464093. [PMID: 37257369 DOI: 10.1016/j.chroma.2023.464093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/02/2023]
Abstract
The waste tire pyrolysis oil (WTPO) has been widely concerned because it's a promising recycling method of waste tires. However, the high content of nitrogen in WTPO is unfavorable to its application. In this work, nitrogen compounds in the full distillation range of a waste tire pyrolysis oil were characterized by gas chromatograph-nitrogen chemiluminescence detector (GC-NCD), gas chromatograph-mass spectrometry (GC-MS) and Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS). In the gasoline fraction of WTPO, the most abundant nitrogen compounds were benzonitrile, aniline and small molecule nitriles. In the diesel fraction of WTPO, the most abundant nitrogen compounds were benzothiazole, quinoline derivatives, p-phthalodinitrile, benzonitrile derivatives, hexadecanenitrile and octadecanenitrile. In the heavy fraction of WTPO, significant amounts of NxOy (x = 2-3 and y = 1-2) species were discovered after the separation of solvent dissolution and solid phase extraction. The molecular structures of these NxOy species were determined as amide derivatives of diphenylamine by tandem mass spectra of FT-ICR MS. Therefore, the origin of nitriles in the light fractions of WTPO was suspected as the pyrolysis of these amides in the heavy fractions. Finally, the nitrogen transformation during the pyrolysis of waste tires was suggested based on the results of quantum chemistry simulations. These results would be helpful for the treatment and removal of these undesirable nitrogen compounds in WTPO.
Collapse
Affiliation(s)
- Yueqin Zhang
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Songcan Li
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Qundan Zhang
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Yi Zhao
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Mingxing Liu
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Dengqian Zhang
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Xinheng Cai
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Naixin Wang
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China
| | - Wei Wang
- Sinopec Research Institute of Petroleum Processing Co., Ltd., Beijing 100083, China.
| |
Collapse
|
9
|
Teuber A, Caniglia G, Wild M, Godejohann M, Kranz C, Mizaikoff B. Espresso Science: Laser-Based Diamond Thin-Film Waveguide Sensors for the Quantification of Caffeine. ACS Sens 2023; 8:1871-1881. [PMID: 37125943 DOI: 10.1021/acssensors.2c01841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Diamond thin-film waveguides with a nanocrystalline diamond layer of approximately 20 μm thickness were used in the mid-infrared regime in combination with quantum cascade lasers to detect the IR signature of caffeine. The diamond thin-film waveguides were fundamentally characterized with respect to their morphological properties via AFM and SEM. Theoretical simulations confirmed the feasibility of using a larger sensing area of approximately 50 mm2 compared to conventionally used strip waveguides. A comprehensive and comparative analysis confirmed the performance of the diamond thin-film-waveguide-based sensing system vs data obtained via conventional attenuated total reflection Fourier transform infrared spectroscopy using a single-bounce diamond internal reflection element. Hence, the utility of innovative diamond thin-film-waveguide-based sensors coupled with quantum cascade laser light sources has been confirmed as an innovative analytical tool, which may be used in a wide range of application scenarios, ranging from environmental to medical sensing, taking advantage of the robustness and inertness of nanocrystalline diamond.
Collapse
Affiliation(s)
- Andrea Teuber
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Ulm 89081, Germany
| | - Giada Caniglia
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Ulm 89081, Germany
| | | | | | - Christine Kranz
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Ulm 89081, Germany
| | - Boris Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, University of Ulm, Ulm 89081, Germany
- Hahn-Schickard, Ulm 89077, Germany
| |
Collapse
|
10
|
Shibata S, Kobayashi K, Tanaka M, Asayama K, Yamamoto E, Nakagami H, Hoshide S, Kishi T, Matsumoto C, Mogi M, Morimoto S, Yamamoto K, Mukoyama M, Kario K, Node K, Rakugi H. COVID-19 pandemic and hypertension: an updated report from the Japanese Society of Hypertension project team on COVID-19. Hypertens Res 2023; 46:589-600. [PMID: 36550205 DOI: 10.1038/s41440-022-01134-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/19/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
The number of reported cases with coronavirus disease 2019 (COVID-19) has exceeded 620 million worldwide, still having a profound impact on people's health and daily lives since its occurrence and outbreak in December 2019. From the early phase of the COVID-19 pandemic, there has been a concern that the rapid spread of this communicable disease can negatively influence non-communicable diseases. Accumulating data indicate that the restriction on the access to medical care, psychological distress, and life-style changes triggered by the pandemic have indeed affected blood pressure control in hypertensive patients. Since our previous report in 2020 that summarized the findings of the literature related to COVID-19 and hypertension, there has been a considerable progress in our understanding of the association between these two disorders; nonetheless, there are remaining challenges and emerging questions in the field. In this article, we aim to summarize the latest information on the impact of the pandemic on blood pressure control, the use of the renin-angiotensin system inhibitors in patients with COVID-19, and the blood pressure changes as one of the possible post-acute sequelae of COVID-19 (also known as long COVID). We also summarize the evidence of telemedicine and COVID-19 vaccination in hypertensive subjects, based on data available as of June 2022.
Collapse
|
11
|
Santos NE, Mendes JC, Braga SS. The Gemstone Cyborg: How Diamond Films Are Creating New Platforms for Cell Regeneration and Biointerfacing. Molecules 2023; 28:molecules28041626. [PMID: 36838614 PMCID: PMC9968187 DOI: 10.3390/molecules28041626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
Diamond is a promising material for the biomedical field, mainly due to its set of characteristics such as biocompatibility, strength, and electrical conductivity. Diamond can be synthesised in the laboratory by different methods, is available in the form of plates or films deposited on foreign substrates, and its morphology varies from microcrystalline diamond to ultrananocrystalline diamond. In this review, we summarise some of the most relevant studies regarding the adhesion of cells onto diamond surfaces, the consequent cell growth, and, in some very interesting cases, the differentiation of cells into neurons and oligodendrocytes. We discuss how different morphologies can affect cell adhesion and how surface termination can influence the surface hydrophilicity and consequent attachment of adherent proteins. At the end of the review, we present a brief perspective on how the results from cell adhesion and biocompatibility can make way for the use of diamond as biointerface.
Collapse
Affiliation(s)
- Nádia E. Santos
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
- Instituto de Telecomunicações and University of Aveiro, 3810-193 Aveiro, Portugal
| | - Joana C. Mendes
- Instituto de Telecomunicações and University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence: (J.C.M.); (S.S.B.)
| | - Susana Santos Braga
- LAQV-REQUIMTE, Department of Chemistry, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence: (J.C.M.); (S.S.B.)
| |
Collapse
|
12
|
Sornpaisarn B, Limmade Y, Pengpid S, Jayasvasti I, Chhoun P, Somphet V, Mustapha FI, Kaung KK, Chailek C, Bao TQ, Rehm J. Assessing data availability of NCD prevention and control in six ASEAN countries based on WHO global monitoring framework and the progress monitor indicators. BMC Public Health 2023; 23:272. [PMID: 36750861 PMCID: PMC9906914 DOI: 10.1186/s12889-023-15165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND To tackle noncommunicable disease (NCD) burden globally, two sets of NCD surveillance indicators were established by the World Health Organization: 25 Global Monitoring Framework (GMF) indicators and 10 Progress Monitoring Indicators (PMI). This study aims to assess the data availability of these two sets of indicators in six ASEAN countries: Cambodia, Lao PDR, Malaysia, Myanmar, Thailand, and Vietnam. METHODS As data on policy indicators were straightforward and fully available, we focused on studying 25 non-policy indicators: 23 GMFs and 2 PMIs. Gathering data availability of the target indicators was conducted among NCD surveillance experts from the six selected countries during May-June 2020. Our research team found information regarding whether the country had no data at all, was using WHO estimates, was providing 'expert judgement' for the data, or had actual data available for each target indicator. We triangulated their answers with several WHO data sources, including the WHO Health Observatory Database and various WHO Global Reports on health behaviours (tobacco, alcohol, diet, and physical activity) and NCDs. We calculated the percentages of the indicators that need improvement by both indicator category and country. RESULTS For all six studied countries, the health-service indicators, based on responses to the facility survey, are the most lacking in data availability (100% of this category's indicators), followed by the health-service indicators, based on the population survey responses (57%), the mortality and morbidity indicators (50%), the behavioural risk indicators (30%), and the biological risk indicators (7%). The countries that need to improve their NCD surveillance data availability the most are Cambodia (56% of all indicators) and Lao PDR (56%), followed by Malaysia (36%), Vietnam (36%), Myanmar (32%), and Thailand (28%). CONCLUSION Some of the non-policy GMF and PMI indicators lacked data among the six studied countries. To achieve the global NCDs targets, in the long run, the six countries should collect their own data for all indicators and begin to invest in and implement the facility survey and the population survey to track NCDs-related health services improvements once they have implemented the behavioural and biological Health Risks Population Survey in their countries.
Collapse
Affiliation(s)
- Bundit Sornpaisarn
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, M5S 2S1 Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, M5T 3M7 Toronto, ON Canada ,grid.10223.320000 0004 1937 0490Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, 10400 Bangkok, Thailand
| | - Yuriko Limmade
- Medical Service Department, International SOS, Jl. Pangeran Antasari No. 10, Cipete, 12410 Jakarta, Indonesia
| | - Supa Pengpid
- grid.10223.320000 0004 1937 0490Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi, 10400 Bangkok, Thailand
| | - Isareethika Jayasvasti
- Institute of Nutrition, Mahidol University, 999 Phutthamonthon sai 4, 73170, Nakhon Pathom, Thailand.
| | - Pheak Chhoun
- grid.513124.00000 0005 0265 4996KHANA Center for Population Health Research, #33, street 71, Tonle Bassac, Phnom Penh, Cambodia
| | - Vathsana Somphet
- grid.412958.30000 0004 0604 9200Department of Epidemiology and Statistic, University of Health Science, Ban Kaoyot, Samsenthai Rd., Vientiane Capital, Lao PDR
| | - Feisul Idzwan Mustapha
- grid.415759.b0000 0001 0690 5255Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - Kyaw Kan Kaung
- grid.500538.bDepartment of Public Health, Ministry of Health and Sports, Naypyidaw, Myanmar
| | - Chanatip Chailek
- grid.415836.d0000 0004 0576 2573Field Epidemiology Training Program (FETP), Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Mueang Nonthaburi, Thailand
| | - Tran Quoc Bao
- grid.67122.30Non-Communicable Diseases Control Division, General Department of Preventive Medicine, Viet Nam Ministry of Health, Hanoi, Viet Nam
| | - Jürgen Rehm
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, M5S 2S1 Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, M5T 3M7 Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, CAMH, 250 College Street, M5T 1R8 Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, M5T 1R8 Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, University of Toronto, 1 King’s College Circle, M5S 1A8 Toronto, ON Canada ,grid.448878.f0000 0001 2288 8774Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, 119992 Moscow, Russian Federation
| |
Collapse
|
13
|
Hort J, Duning T, Hoerr R. Ginkgo biloba Extract EGb 761 in the Treatment of Patients with Mild Neurocognitive Impairment: A Systematic Review. Neuropsychiatr Dis Treat 2023; 19:647-660. [PMID: 36994422 PMCID: PMC10041984 DOI: 10.2147/ndt.s401231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/04/2023] [Indexed: 03/31/2023] Open
Abstract
Background Many clinical trials testing Ginkgo biloba extract EGb 761 in patients with mild forms of cognitive impairment were conducted before widely accepted terms and diagnostic criteria for such conditions were available. This makes it difficult to compare any results from earlier and more recent trials. The objective of this systematic review was to provide a descriptive overview of clinical trials of EGb 761 in patients who met the diagnostic criteria for mild neurocognitive disorder (mild NCD) according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Methods MEDLINE, PubMed and EMBASE were searched for randomized, placebo-controlled double-blind trials of EGb 761 in mild impairment of cognitive functioning. All trials involving patients who met retrospectively applied diagnostic criteria for mild NCD were included. Trials of primary prevention of dementia and trials of combinations of medical treatments were excluded. Results Among 298 records found in databases and 76 further records related to EGb 761 in references of systematic reviews, 9 reports on clinical trials involving 946 patients met the pre-specified criteria for inclusion. Beneficial effects of EGb 761 were seen in neuropsychological tests (8 of 9 studies), scales for neuropsychiatric symptoms (3 of 3 studies), geriatric rating scales (1 of 2 studies) and global ratings of change (1 of 1 study). Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning). Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved. No differences between EGb 761 treatment and placebo were seen with regard to the rates of adverse events. Discussion The included studies demonstrate treatment benefits of Ginkgo biloba extract EGb 761, mainly on cognitive deficits and neuropsychiatric symptoms, in patients with mild NCD. The drug was safe and well tolerated.
Collapse
Affiliation(s)
- Jakub Hort
- Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - Thomas Duning
- Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany
| | - Robert Hoerr
- Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany
- Correspondence: Robert Hoerr, Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Str. 4, Karlsruhe, 76227, Germany, Tel +49 721 4005 429, Email
| |
Collapse
|
14
|
Vu LTH, Bui QTT, Khuong LQ, Tran BQ, Lai TD, Hoang MV. Trend of metabolic risk factors among the population aged 25-64 years for non-communicable diseases over time in Vietnam: A time series analysis using national STEPs survey data. Front Public Health 2022; 10:1045202. [PMID: 36530703 PMCID: PMC9747924 DOI: 10.3389/fpubh.2022.1045202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/01/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction The study aims to examine the trends of 4 metabolic NCDs risk factors including raised blood pressure, increased blood glucose, elevated blood lipids and overweight/obesity over the last 10 years in Vietnam as well as examine these trends among different sub-population by geographical area, gender, and age groups. Methods The study combined the national representative data from three rounds of STEPs survey in Vietnam conducted in 2010, 2015, and 2020 on people aged 25-64 years. The overall prevalence of each metabolic factor together with 95% CI for each time point as well as the stratified prevalence by rural/urban, male/female, and 4 separated age groups were calculated and considered the sampling weight. Cochran-Armitage test for trend was used to test for the differences in the prevalence over time. Results The prevalence of hypertension, overweight/obesity, hyperglycemia, and hyperlipidemia among the population aged 25-64 years old was 28.3, 20.57, 6.96, and 15.63%, respectively in the year 2020. All NCD metabolic risk factors examined in this analysis show significantly increasing trends over time. For most age groups, the increasing burden of NCD metabolic risk factors was more significant during the period 2015-2020 compared to the period 2010-2015. Male population and population aged 55-64 experienced the most dramatic changes in the burden of all NCD metabolic risk factors. Conclusion To reverse the increasing trend of NCD metabolic factors in Vietnam, intervention, and policy need to apply a comprehensive life course approach.
Collapse
Affiliation(s)
- Lan Thi Hoang Vu
- Faculty of Fundamental Science, Hanoi University of Public Health, Hanoi, Vietnam
| | - Quyen Thi Tu Bui
- Faculty of Fundamental Science, Hanoi University of Public Health, Hanoi, Vietnam,*Correspondence: Quyen Thi Tu Bui
| | | | - Bao Quoc Tran
- General Department of Preventive Medicine, Ministry of Health (Vietnam), Hanoi, Vietnam
| | - Truong Duc Lai
- World Health Organization Country Office for Viet Nam, Hanoi, Vietnam
| | | |
Collapse
|
15
|
Madede T, Damasceno A, Lunet N, Augusto O, Silva-Matos C, Beran D, Levitt N. Changes in prevalence and the cascade of care for type 2 diabetes over ten years (2005-2015): results of two nationally representative surveys in Mozambique. BMC Public Health 2022; 22:2174. [PMID: 36434584 PMCID: PMC9701039 DOI: 10.1186/s12889-022-14595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa is predicted to have the steepest increase in the prevalence of diabetes in the next 25 years. The latest Mozambican population-based STEPS survey (STEPS 2005) estimated a 2.9% prevalence of diabetes in the adult population aged 25-64 years. We aimed to assess the change in prevalence, awareness, and management of diabetes in the national STEPS survey from 2014/2015 compared to 2005. METHODS We conducted an observational, quantitative, cross-sectional study following the WHO STEPS surveillance methodology in urban and rural settings, targeting the adult population of Mozambique in 2015. We collected sociodemographic data, anthropometric, and 12 hour fasting glucose blood samples in a sample of 1321 adults. The analysis consisted of descriptive measures of the prevalence of impaired fasting glucose (IFG), diabetes and related risk factors by age group, sex, and urban/rural residence and compared the findings to those of the 2005 survey results. RESULTS The prevalence of IFG and diabetes was 4.8% (95CI: 3.6-6.3) and 7.4% (95CI: 5.5-10.0), respectively. These prevalence of IFG and diabetes did not differ significantly between women and men. The prevalence of diabetes in participants classified with overweight/obesity [10.6% (95CI: 7.5-14.6)] and with central obesity (waist hip ratio) [11.0% (95CI: 7.4-16.1)] was almost double the prevalence of their leaner counterparts, [6.3% (95CI, 4.0-9.9)] and [5.2% (95CI: 3.2-8.6)], respectively. Diabetes prevalence increased with age. There were 50% more people with diabetes in urban areas than in rural. Only 10% of people with diabetes were aware of their disease, and only 44% of those taking oral glucose-lowering drugs. The prevalence of IFG over time [2.0% (95CI: 1.1-3.5) vs 4.8% (95CI: 3.6-6.3)] and diabetes [2.9% (95CI: 2.0-4.2) vs 7.4% (95CI: 5.5-10.0)] were more than twofold higher in 2014/2015 than in 2005. However, awareness of disease and being on medication decreased by 3% and by 50%, respectively. Though this was not statistically significant. CONCLUSIONS While the prevalence of diabetes in Mozambique has increased from 2005 to 2015, awareness and medication use have declined considerably. There is an urgent need to improve the capacity of primary health care and communities to detect, manage and prevent the occurrence of NCDs and their risk factors.
Collapse
Affiliation(s)
- Tavares Madede
- grid.8295.60000 0001 0943 5818Departament of Community Health, Faculty of Medicine, University Eduardo Mondlane, 702 Salvador Allende Ave, PO Box 257, Maputo, Mozambique ,grid.7836.a0000 0004 1937 1151Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Albertino Damasceno
- grid.8295.60000 0001 0943 5818Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique ,grid.470120.00000 0004 0571 3798Research Unit, Department of Medicine, Maputo Central Hospital, Maputo, Mozambique
| | - Nuno Lunet
- grid.5808.50000 0001 1503 7226Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal ,grid.5808.50000 0001 1503 7226EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Orvalho Augusto
- grid.8295.60000 0001 0943 5818Departament of Community Health, Faculty of Medicine, University Eduardo Mondlane, 702 Salvador Allende Ave, PO Box 257, Maputo, Mozambique
| | - Carla Silva-Matos
- grid.415752.00000 0004 0457 1249Ministry of Health, Maputo, Mozambique
| | - David Beran
- grid.8591.50000 0001 2322 4988Division of Tropical and Humanitarian Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - Naomi Levitt
- grid.7836.a0000 0004 1937 1151Chronic Disease Initiative for Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
16
|
Napalai P, Seangpraw K, Boonyathee S, Ong-Artborirak P. COVID-19-related knowledge influences mental health, self-care behaviors, and quality of life among elderly with non-communicable diseases in Northern Thailand. Front Public Health 2022; 10:993531. [PMID: 36388338 PMCID: PMC9650286 DOI: 10.3389/fpubh.2022.993531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/14/2022] [Indexed: 01/26/2023] Open
Abstract
Background A growing body of research shows that individuals with non-communicable diseases (NCDs), such as hypertension, diabetes, hypercholesterolemia, and heart disease, are more likely to suffer from severe COVID-19 and, subsequently, death. The purpose of this study was to assess the influence of COVID-19-related knowledge on mental health, healthcare behaviors, and quality of life among the elderly with NCDs in Northern Thailand. Methods In this cross-sectional study, the participants were 450 elderly people with NCDs, living in the Chiang Rai province, Northern Thailand. Random sampling was applied to select the subjects. Data collection included demographic information, COVID-19-related knowledge, healthcare behaviors, the Suanprung Stress Test-20, the Thai General Health Questionnaire (GHQ-28) for the assessment of mental health, and the Thai version of the World Health Organization Quality of Life-BREF. Results Almost half of the participants (45.6%) had poor knowledge about COVID-19. More than half of the sample had high stress (52.0%) and a low score in healthcare behaviors (64.9%), while approximately one-third of the participants had mental health problems (34.0%). The overall quality of life during the COVID-19 pandemic was moderate (70.7%). The score of COVID-19-related knowledge was significantly correlated with scores of stress (r = -0.85), mental health (r = -0.74), healthcare behaviors (r = 0.50), and quality of life (r = 0.33). Multiple linear regression found that history of COVID-19 detection and COVID-19-related knowledge were associated with scores of stress and quality of life (p < 0.05). Multiple logistic regression showed that history of COVID-19 detection (OR = 4.48, 95% CI = 1.45-13.84) and COVID-19-related knowledge (OR = 0.23, 95% CI = 0.17-0.31) were associated with mental health problem (p < 0.05). Discussion The findings emphasize the importance of COVID-19-related knowledge concerning the improvement of self-care behaviors and quality of life in the elderly population with NCDs during the pandemic, especially due to the high rate of stress and mental health problems documented in our sample. Health education interventions for this vulnerable population should be organized.
Collapse
|
17
|
Ruckstuhl L, Czock A, Haile SR, Lang P. Influence of cantonal health policy frameworks & activities on the influenza vaccination rate in patients with non-communicable diseases in Switzerland. Vaccine 2022; 40:6326-6336. [PMID: 36154757 DOI: 10.1016/j.vaccine.2022.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVE Seasonal influenza may cause serious illness, especially in high-risk populations such as older adults and individuals suffering from non-communicable diseases (NCD) and may be prevented by a vaccination. However, an assessment of the impact of the Swiss legal frameworks and number of health activities on influenza vaccination coverage of the population at the cantonal level is lacking. METHODS Two participating healthcare insurers sent out 25,000 semi-structured questionnaires to their subscribers aged 60-85 in five Swiss cantons selected according to the number of health activities and legal framework regarding influenza vaccination and linguistic region. Influenza vaccination coverage of the participants was evaluated and stratified by disease status, age, canton, and linguistic region. Results were compared by cantonal activities, legal framework, and linguistic region. RESULTS 7,617 valid questionnaires were evaluated from the cantons Aargau, Jura, St. Gallen, Schwyz, and Vaud. 47.9 % stated to have an NCD, with the most frequent being muscle/ skeletal disease (36.7%). Before 2018, 48.6% were vaccinated against influenza, and 35.9% in 2019, with the highest in canton Vaud. In all cantons and in both survey periods, NCD patients and those aged 73-85 had a higher vaccination coverage than participants without NCD, and aged 60-72. There was no difference in the odds of getting an influenza shot based on legal framework. Although a comparison of the number of activities between the German-speaking cantons did not reveal any significant differences, the odds of the participants living in a French-speaking canton getting an influenza vaccination was more likely than those living in a German-speaking canton. CONCLUSION There was no association between the investigated cantonal frameworks and number of health activities and influenza vaccination coverage in NCD patients in the selected cantons. However, age, disease status and linguistic region appear to have an influence on vaccination uptake.
Collapse
Affiliation(s)
- Lisa Ruckstuhl
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
| | | | - Sarah R Haile
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland
| | - Phung Lang
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
| |
Collapse
|
18
|
Gatterer L, Kriwan F, Tanous D, Wirnitzer K. Human health in peril: The need to upgrade medical education in light of COVID-19. Front Med (Lausanne) 2022; 9:999671. [PMID: 36262279 PMCID: PMC9574097 DOI: 10.3389/fmed.2022.999671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/09/2022] [Indexed: 11/22/2022] Open
Abstract
While we might leave the COVID-19 pandemic behind, future health professionals are still confronted with another global phenomenon: the increasing pandemic of non-communicable diseases (NCDs). Both issues are strongly interwoven, yet current medical education fails to address their syndemic nature accordingly. There is scientific consensus that (i) most emerging infectious diseases are zoonotic, (ii) the overexploitation of earth's resources for animal protein production (i.e., tropical deforestation) rapidly escalates human contact with unknown pathogens, and (iii) people following a healthy plant-based diet present fewer rates of NCDs as well as severe illness and mortality from COVID-19. A shift toward whole food plant-based nutrition in the general population thus holds the potential to tackle both public health threats. We are convinced that it is every physician's responsibility to care for individual, public, and global health issues; however, future health professionals are not trained and educated regarding the health potential of plants and plant-based diets. The COVID-19 pandemic has demonstrated the urgent need for a "prevention first" approach. Therefore, in order to upgrade medical education worldwide and protect current and future human health properly, greater medical professional awareness of evidence on plant-based diets is urgently needed in classes, universities, and hospitals.
Collapse
Affiliation(s)
- Lukas Gatterer
- Department of Internal Medicine, Clinical Division of Internal Medicine III, St. Pölten University Hospital, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Fabian Kriwan
- Department of Internal Medicine, Clinical Division of Internal Medicine I, State Hospital Feldkirch, Feldkirch, Austria
| | - Derrick Tanous
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
| | - Katharina Wirnitzer
- Department of Sport Science, Leopold-Franzens University Innsbruck, Innsbruck, Austria
- Department of Research and Development in Teacher Education, University College of Teacher Education Tyrol, Innsbruck, Austria
- Research Center Medical Humanities, Leopold-Franzens University Innsbruck, Innsbruck, Austria
| |
Collapse
|
19
|
Berner-Rodoreda A, Jahn A. Commercial Influence on Political Declarations: The Crucial Distinction Between Consultation and Negotiation and the Need for Transparency in Lobbying Comment on "Competing Frames in Global Health Governance: An Analysis of Stakeholder Influence on the Political Declaration on Non-communicable Diseases". Int J Health Policy Manag 2022; 11:1219-1221. [PMID: 34634870 PMCID: PMC9808164 DOI: 10.34172/ijhpm.2021.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/10/2021] [Indexed: 01/12/2023] Open
Abstract
Suzuki and colleagues' rare and elaborate analysis of the political processes behind the 2018 United Nations (UN) non-communicable diseases (NCD) Declaration discloses various pathways towards influencing global public health policies. Their study should be a wake-up call for further scientific political scrutiny and analysis, including clearly distinguishing between consultations such as UN multi-stakeholder hearings preceding high-level meetings and the actual negotiating and decision making process. While stakeholder positions at interactive hearings are documented and published and thus made transparent, the negotiating process among member states is not publicly known. The extent to which intergovernmental negotiations are influenced at country or regional levels by commercial interests through direct and indirect lobbying outside of public consultations should be given more attention. Lobby registers should be implemented more stringently and legislative footprints required and applied not only to legally binding but also to internationally important documents such as political declarations.
Collapse
|
20
|
Mngumi EB, Mpenda FN, Buza J. Epidemiology of Newcastle disease in poultry in Africa: systematic review and meta-analysis. Trop Anim Health Prod 2022; 54:214. [PMID: 35705876 DOI: 10.1007/s11250-022-03198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
The present study intended to determine the prevalence of Newcastle disease in unvaccinated backyard poultry in Africa. Using the PRISMA approach, a systematic review and meta-analysis of 107 epidemiological studies was conducted. The meta-analysis identified significant variation of both seroprevalence (I2 = 99.38, P = 0.00) and Newcastle disease virus prevalence (I2 = 99.52, P = 0.00) reported in various studies included in this review. Publication bias was not detected in either case. Seroprevalence of Newcastle disease was 40.2 (95%CI 32.9-47.8). Seroprevalence was significantly influenced by sampling frame and the African region where the studies were conducted. The prevalence of Newcastle disease virus (NDV) was 12% (95%CI 7.3-17.8), and the variation was influenced by sampling frame, diagnostic test, and regions where the studies were conducted. Also, Newcastle disease (ND) accounted for 33.1% (95%CI 11.9-58.1) of sick chickens. Results also indicated that genotypes VI and VII are widely distributed in all countries included in the study. However, genotype V is restricted in East Africa, and genotypes XIV, XVII, and XVIII are restricted in West and Central Africa. On the other hand, genotype XI occurs in Madagascar only. In addition, virulent genotypes were isolated from apparently healthy and sick birds. It is concluded that several genotypes of NDV are circulating and maintained within the poultry population. African countries should therefore strengthen surveillance systems, be able to study the viruses circulating in their territories, and establish control programs.
Collapse
|
21
|
Jakob R, Harperink S, Rudolf AM, Fleisch E, Haug S, Mair JL, Salamanca-Sanabria A, Kowatsch T. Factors Influencing Adherence to mHealth Apps for Prevention or Management of Noncommunicable Diseases: Systematic Review. J Med Internet Res 2022; 24:e35371. [PMID: 35612886 PMCID: PMC9178451 DOI: 10.2196/35371] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/31/2022] [Accepted: 04/09/2022] [Indexed: 12/14/2022] Open
Abstract
Background Mobile health (mHealth) apps show vast potential in supporting patients and health care systems with the increasing prevalence and economic costs of noncommunicable diseases (NCDs) worldwide. However, despite the availability of evidence-based mHealth apps, a substantial proportion of users do not adhere to them as intended and may consequently not receive treatment. Therefore, understanding the factors that act as barriers to or facilitators of adherence is a fundamental concern in preventing intervention dropouts and increasing the effectiveness of digital health interventions. Objective This review aimed to help stakeholders develop more effective digital health interventions by identifying factors influencing the continued use of mHealth apps targeting NCDs. We further derived quantified adherence scores for various health domains to validate the qualitative findings and explore adherence benchmarks. Methods A comprehensive systematic literature search (January 2007 to December 2020) was conducted on MEDLINE, Embase, Web of Science, Scopus, and ACM Digital Library. Data on intended use, actual use, and factors influencing adherence were extracted. Intervention-related and patient-related factors with a positive or negative influence on adherence are presented separately for the health domains of NCD self-management, mental health, substance use, nutrition, physical activity, weight loss, multicomponent lifestyle interventions, mindfulness, and other NCDs. Quantified adherence measures, calculated as the ratio between the estimated intended use and actual use, were derived for each study and compared with the qualitative findings. Results The literature search yielded 2862 potentially relevant articles, of which 99 (3.46%) were included as part of the inclusion criteria. A total of 4 intervention-related factors indicated positive effects on adherence across all health domains: personalization or tailoring of the content of mHealth apps to the individual needs of the user, reminders in the form of individualized push notifications, user-friendly and technically stable app design, and personal support complementary to the digital intervention. Social and gamification features were also identified as drivers of app adherence across several health domains. A wide variety of patient-related factors such as user characteristics or recruitment channels further affects adherence. The derived adherence scores of the included mHealth apps averaged 56.0% (SD 24.4%). Conclusions This study contributes to the scarce scientific evidence on factors that positively or negatively influence adherence to mHealth apps and is the first to quantitatively compare adherence relative to the intended use of various health domains. As underlying studies mostly have a pilot character with short study durations, research on factors influencing adherence to mHealth apps is still limited. To facilitate future research on mHealth app adherence, researchers should clearly outline and justify the app’s intended use; report objective data on actual use relative to the intended use; and, ideally, provide long-term use and retention data.
Collapse
Affiliation(s)
- Robert Jakob
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
| | - Samira Harperink
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Aaron Maria Rudolf
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Elgar Fleisch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction, Zurich University, Zurich, Switzerland
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, 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, Singapore, Singapore
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| |
Collapse
|
22
|
Tesfay FH, Backholer K, Zorbas C, Bowe SJ, Alston L, Bennett CM. The Magnitude of NCD Risk Factors in Ethiopia: Meta-Analysis and Systematic Review of Evidence. Int J Environ Res Public Health 2022; 19:ijerph19095316. [PMID: 35564716 PMCID: PMC9106049 DOI: 10.3390/ijerph19095316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
Background: Non-communicable Diseases (NCDs) and their risk factors are the leading contributors to morbidity and mortality globally, particularly in low- and middle-income countries including Ethiopia. To date, there has been no synthesis of the literature on the relative prevalence of NCD risk factors in Ethiopia. Methodology: We conducted a systematic review and meta-analysis of primary studies reporting on the prevalence of NCD risk factors in Ethiopia published in English from 2012 to July 2020. Pre-tested NCD search terms were applied to Medline, Embase, Scopus, CINAHL, and Global Health. Three reviewers screened and appraised the quality of the identified papers. Data extraction was conducted using a pilot tested proforma. Meta-analysis was conducted using Stata 16 and pooled prevalence estimated with associated 95% confidence intervals. Clinically heterogeneous studies that did not fulfil the eligibility criteria for meta-analysis were narratively synthesised. I2 was used to assess statistical heterogeneity. Results: 47 studies fulfilled the inclusion criteria and contributed 68 NCD risk factor prevalence estimates. Hypertension was the most frequently examined NCD risk factor, with a pooled prevalence of 21% (n = 27 studies). The pooled prevalence percentages for overweight and obesity were 19.2% and 10.3%, respectively (n = 7 studies each), with a combined prevalence of 26.8% (n = 1 study). It was not possible to pool the prevalence of alcohol consumption, smoking, metabolic disorders, or fruit consumption because of heterogeneity across studies. The prevalence of alcohol use, as reported from the included individual studies, ranged from 12.4% to 13.5% (n = 7 studies). More than 90% of participants met the WHO-recommended level of physical activity (n = 5 studies). The prevalence of smoking was highly variable, ranging between 0.8% and 38.6%, as was the prevalence of heavy alcohol drinking (12.4% to 21.1%, n = 6 studies) and metabolic syndrome (4.8% to 9.6%, n = 5 studies). Fruit consumption ranged from 1.5% up to the recommended level, but varied across geographic areas (n = 3 studies). Conclusion and recommendations: The prevalence of NCD risk factors in Ethiopia is relatively high. National NCD risk factor surveillance is required to inform the prioritisation of policies and interventions to reduce the NCD burden in Ethiopia.
Collapse
Affiliation(s)
- Fisaha Haile Tesfay
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
- College of Medicine and Health Sciences, School of Public Health, Mekelle University, Mekelle P.O. Box 231, Ethiopia
- Correspondence:
| | - Kathryn Backholer
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Christina Zorbas
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Steven J. Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong 3220, Australia;
| | - Laura Alston
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| | - Catherine M. Bennett
- Institute for Health Transformation, Deakin University, Geelong 3220, Australia; (K.B.); (C.Z.); (L.A.); (C.M.B.)
| |
Collapse
|
23
|
Mengesha SD, Teklu KT, Weldetinsae A, Serte MG, Kenea MA, Dinssa DA, Woldegabriel MG, Alemayehu TA, Belay WM. Tobacco use prevalence and its determinate factor in Ethiopia- finding of the 2016 Ethiopian GATS. BMC Public Health 2022; 22:555. [PMID: 35313839 PMCID: PMC8935848 DOI: 10.1186/s12889-022-12893-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 02/28/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Tobacco, one of the risk factors for non-communicable diseases, kills 8 million people each year. Like other sub-Saharan countries, Ethiopia faces the potential challenge of a tobacco epidemic. However, there is no organized data on the prevalence of tobacco use in the country. Therefore, this study aims to determine adult tobacco use in Ethiopia. METHODS The study was conducted using the WHO and CDC GATS survey methods. Complex survey analysis was used to obtain prevalence and population estimates with 95% confidence intervals. Bivariate regression analyses were employed to examine factors related to tobacco use. RESULTS The overall tobacco use percentage was 5.0% [95% CI (3.5, 6.9)], of which 65.8% [95% CI (53.4, 76.3)] only smoked tobacco products; 22.5% [95% CI (15.7, 31.2)] used smokeless tobacco only; and 11.8% [95% CI (6.5, 20.4)] used both smoked and smokeless tobacco products. In 2016, more men adults (8.1%) used tobacco than women did (1.8%). Eight out of eleven states have a higher smoking rate than the national average (3.7%). Gender, employment, age, religion, and marital status are closely linked to current tobacco use (p-value< 0.05). Men adults who are employed, married, and mostly from Muslim society are more likely to use tobacco. CONCLUSION The prevalence of tobacco use is still low in Ethiopia. However, the percentage of female smokers is increasing, and regional governments such as Afar and Gambella have a relatively high prevalence. This calls for the full implementation of tobacco control laws following the WHO MPOWER packages. A tailored tobacco control intervention targeting women, younger age groups, and regions with a high proportion of tobacco use are recommended.
Collapse
Affiliation(s)
- Sisay Derso Mengesha
- Ethiopian Public Health Institute, Gulelle Patriot Street, P.O.Box 1242, Addis Ababa, Ethiopia
| | - Kirubel Tesfaye Teklu
- Ethiopian Public Health Institute, Gulelle Patriot Street, P.O.Box 1242, Addis Ababa, Ethiopia
| | - Abel Weldetinsae
- Ethiopian Public Health Institute, Gulelle Patriot Street, P.O.Box 1242, Addis Ababa, Ethiopia
| | - Melaku Gizaw Serte
- Ethiopian Public Health Institute, Gulelle Patriot Street, P.O.Box 1242, Addis Ababa, Ethiopia
| | - Moa Abate Kenea
- Ethiopian Public Health Institute, Gulelle Patriot Street, P.O.Box 1242, Addis Ababa, Ethiopia
| | - Daniel Abera Dinssa
- Ethiopian Public Health Institute, Gulelle Patriot Street, P.O.Box 1242, Addis Ababa, Ethiopia
| | | | | | - Wassihun Melaku Belay
- World Health organization- Country office for Ethiopia, UNECA Compound, Zambezi Building, Addis Ababa, Ethiopia
| |
Collapse
|
24
|
Gupta MK, Raghav P, Tanvir T, Gautam V, Mehto A, Choudhary Y, Mittal A, Singh G, Singh G, Baskaran P, Rehana VR, Jabbar SA, Sridevi S, Goel AD, Bhardwaj P, Saurabh S, Srikanth S, Naveen KH, Prasanna T, Rustagi N, Sharma PP. Recalibrating the Non-Communicable Diseases risk prediction tools for the rural population of Western India. BMC Public Health 2022; 22:376. [PMID: 35193546 DOI: 10.1186/s12889-022-12783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to recalibrate the effectiveness of Indian Diabetes Risk Score (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistic screening of Diabetes Mellitus (DM) and Hypertension (HT) among the people attending health centres, and estimating the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) among them using WHO/ISH charts. METHODS All the people aged ≥ 30 years attending the health centers were screened for DM and HT. Weight, height, waist circumference, and hip circumferences were measured, and BMI and Waist-Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score, and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden's index were calculated for different cut-offs of IDRS and CBAC scores. RESULTS A total of 942 participants were included for the screening, out of them, 9.2% (95% CI: 7.45-11.31) were diagnosed with DM for the first time. Hypertension was detected among 25.7% (95% CI: 22.9-28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score > 4. As much as 26.1% were at moderate to higher risk (≥ 10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58-0.70), with 67.1% SN and 55.2% SP (Youden's Index 0.22). While the AUC for CBAC was 0.59 (0.53-0.65). For hypertension both the AUCs were 0.66 (0.62-0.71) and 0.63 (0.59-0.67), respectively. CONCLUSIONS IDRS was found to have the maximum AUC and sensitivity thereby demonstrating its usefulness as compared to other tools for screening of both diabetes and hypertension. It thus has the potential to expose the hidden NCD iceberg. Hence, we propose IDRS as a useful tool in screening of Diabetes and Hypertension in rural India.
Collapse
|
25
|
Wolf TG, Cagetti MG, Fisher JM, Seeberger GK, Campus G. Non-communicable Diseases and Oral Health: An Overview. Front Oral Health 2022; 2:725460. [PMID: 35048049 PMCID: PMC8757764 DOI: 10.3389/froh.2021.725460] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 08/11/2021] [Indexed: 01/12/2023] Open
Abstract
Non-communicable diseases (NCDs) such as cardiovascular and metabolic diseases, diabetes, cancer and diseases of the oral cavity such as caries or periodontitis represent a global and highly relevant problem due to demographic and epidemiological changes. NCDs are not only responsible for millions of deaths worldwide, but they cause relevant costs for national economies arise for the health care of societies. Assuming that oral health and general health are directly linked, emerging interactions between systemic and oral diseases are increasingly being researched. Common important risk factors have implications for economic, social, and moral determinants of health. Interdisciplinarity trained oral health professionals are needed to address the excessively high rates of inequities in oral health. The main reason that oral diseases are still a global health problem is related to mainly individual subjective high-risk approaches, which resulting in high costs and low effectiveness. A paradigm shift for a public health approach is needed at population level that integrates different health professionals who deal with NCDs. Oral care, like physical activity, is one of the most important lifestyle-related determinants of health. Widespread recognition of this kind of approach is critical to both reducing the impact of oral and non-oral NCDs. A multi-sectoral, comprehensive and integrated strategy is therefore necessary. The focus should be on social, environmental and population strategies, but should also support individual strategies.
Collapse
Affiliation(s)
- Thomas Gerhard Wolf
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Julian-Marcus Fisher
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland.,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy.,School of Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| |
Collapse
|
26
|
Mngumi EB, Bunuma E. Seroprevalence and risk factors of Newcastle disease virus in local chickens in Njombe and Bahi districts in Tanzania. Trop Anim Health Prod 2022; 54:53. [PMID: 35024961 DOI: 10.1007/s11250-022-03052-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Newcastle disease virus (NDV) causes significant losses of poultry in Tanzania. Like in many African countries, the regular surveillance of NDV is important for the control of disease. The objective of this study was to determine seroprevalence of NDV in unvaccinated backyard poultry in Bahi and Njombe districts of Tanzania over the rainy (May) and dry (November) seasons in 2016. Using hemaglutination inhibition test, the overall seroprevalence was determined to be 26.8%. The significant differences in seroprevalence were between seasons (higher (34.9%) in dry season, p < 0.0001) and age (higher (30.3%), p < 0.0001 in adult birds). There were no significant differences in seroprevalence between the districts or sex. The higher levels of "protective" antibody titers were significantly associated with location: Njombe (RR 1.15), dry season (RR 1.08), and age: adult birds (RR 1.16); however, the prevalence of these titers was not high enough to conclude any herd immunity among these flocks. This study therefore concludes that local chickens are naturally exposed to NDV and the birds in highlands, dry season, and adults are more protected. Future studies focusing on transmission, strain type, and monthly dynamics of NDV in backyard flocks will provide greater insight into the disease dynamics and allow new practical strategies to alleviate the effects of NDV for the smallholder farmers.
Collapse
|
27
|
Holla R, Bhagawan D, Unnikrishnan B, Masanamuthu DN, Bhattacharya S, Kejriwal A, Chellakkannu VP, Shreshtha N, Moras E. Risk Assessment for Diabetes Mellitus by Using Indian Diabetes Risk Score Among Office Workers of Health Institutions of South India. Curr Diabetes Rev 2022; 18:e251121198316. [PMID: 34823460 DOI: 10.2174/1573399818666211125143630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/07/2021] [Accepted: 10/10/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is one of the non-communicable diseases plaguing the world and contributes a major part to the total disease burden. Diabetes has been prevalent in all countries throughout the years, with the majority of diabetics living in low- and middle-income countries. Madras Diabetes Research Foundation developed the Indian Diabetes Risk Score (IDRS), a simple and cost-effective method to assess the chances of developing diabetes. OBJECTIVES To assess the diabetes risk profile of office workers using IDRS and to determine the proportion of individual risk factors of diabetes among the participants. METHODS This cross sectional study included 94 non-diabetic office workers working in two health care institutions situated in coastal South India. Data was collected by a study questionnaire consisting of three sections. Section A included details related to participant characteristics, Section B included anthropometric measurements, and Section C consisted of the Indian Diabetes Risk Score. The collected data were coded and entered into Statistical Package for Social Sciences. RESULTS The mean age of the study participants was 40.88 (±9.761) years, and the mean BMI was 23.8 (±3.6) kg/m2. Majority (n=65, 67%) of the study participants did not have a family history of diabetes. One-third of the study participants had IDRS ≥ 60, which allocated them in the high risk category for type 2 diabetes (n=34, 35.1%). CONCLUSION It has been conclusively shown from the study that most of the office workers have moderate to high risk of developing diabetes and are also overweight or obese.
Collapse
Affiliation(s)
- Ramesh Holla
- Department of Community Medicine, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Darshan Bhagawan
- Department of Community Medicine, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Bhaskaran Unnikrishnan
- Department of Community Medicine, Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Srinjoy Bhattacharya
- Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Arushi Kejriwal
- Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | - Nidhi Shreshtha
- Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Errol Moras
- Kasturba Medical College, Mangalore Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
28
|
Babel A, Taneja R, Mondello Malvestiti F, Monaco A, Donde S. Artificial Intelligence Solutions to Increase Medication Adherence in Patients With Non-communicable Diseases. Front Digit Health 2021; 3:669869. [PMID: 34713142 PMCID: PMC8521858 DOI: 10.3389/fdgth.2021.669869] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/04/2021] [Indexed: 11/30/2022] Open
Abstract
Artificial intelligence (AI) tools are increasingly being used within healthcare for various purposes, including helping patients to adhere to drug regimens. The aim of this narrative review was to describe: (1) studies on AI tools that can be used to measure and increase medication adherence in patients with non-communicable diseases (NCDs); (2) the benefits of using AI for these purposes; (3) challenges of the use of AI in healthcare; and (4) priorities for future research. We discuss the current AI technologies, including mobile phone applications, reminder systems, tools for patient empowerment, instruments that can be used in integrated care, and machine learning. The use of AI may be key to understanding the complex interplay of factors that underly medication non-adherence in NCD patients. AI-assisted interventions aiming to improve communication between patients and physicians, monitor drug consumption, empower patients, and ultimately, increase adherence levels may lead to better clinical outcomes and increase the quality of life of NCD patients. However, the use of AI in healthcare is challenged by numerous factors; the characteristics of users can impact the effectiveness of an AI tool, which may lead to further inequalities in healthcare, and there may be concerns that it could depersonalize medicine. The success and widespread use of AI technologies will depend on data storage capacity, processing power, and other infrastructure capacities within healthcare systems. Research is needed to evaluate the effectiveness of AI solutions in different patient groups and establish the barriers to widespread adoption, especially in light of the COVID-19 pandemic, which has led to a rapid increase in the use and development of digital health technologies.
Collapse
Affiliation(s)
- Aditi Babel
- Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Richi Taneja
- Medical Product Evaluation, Pfizer Ltd, Mumbai, India
| | | | | | | |
Collapse
|
29
|
Ferat LR, Forrest R, Sehmi K, Santos RD, Stewart D, Boulton AJM, Jiménez BY, Riley P, Burger D, Jones ESW, Tomaszewski M, Milanese MR, Laffin P, Jha V, Borisch B, Moore M, Pinto FJ, Piñeiro D, Eiselé JL, Lackland DT, Whelton PK, Zhang XH, Stavdal A, Li D, Hobbs R, Pandian JD, Brainin M, Feigin V; Global Coalition for Circulatory Health. Preventing the Next Pandemic: The Case for Investing in Circulatory Health - A Global Coalition for Circulatory Health Position Paper. Glob Heart 2021; 16:66. [PMID: 34692391 DOI: 10.5334/gh.1077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 12/23/2022] Open
Abstract
The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs). In addition to older age, people living with CVD, stroke, obesity, diabetes, kidney disease, and hypertension are at a particularly greater risk for severe forms of COVID-19 and its consequences. Meta-analysis indicates that hypertension, diabetes, chronic kidney disease, and thrombotic complications have been observed as both the most prevalent and most dangerous co-morbidities in COVID-19 patients. And despite the nearly incalculable physical, mental, emotional, and economic toll of this pandemic, forthcoming public health figures continue to place cardiovascular disease as the number one cause of death across the globe in the year 2020. The world simply cannot wait for the next pandemic to invest in NCDs. Social determinants of health cannot be addressed only through the healthcare system, but a more holistic multisectoral approach with at its basis the Sustainable Development Goals (SDGs) is needed to truly address social and economic inequalities and build more resilient systems. Yet there is reason for hope: the 2019 UN Political Declaration on UHC provides a strong framework for building more resilient health systems, with explicit calls for investment in NCDs and references to fiscal policies that put such investment firmly within reach. By further cementing the importance of addressing circulatory health in a future Framework Convention on Emergency Preparedness, WHO Member States can take concrete steps towards a pandemic-free future. As the chief representatives of the global circulatory health community and patients, the Global Coalition for Circulatory Health calls for increased support for the healthcare workforce, global vaccine equity, embracing new models of care and digital health solutions, as well as fiscal policies on unhealthy commodities to support these investments.
Collapse
|
30
|
Bourdillon PM, Parzynski CS, Minges KE, Curtis JP, Desai NR. Trends in ICD Implantations and in-Hospital Outcomes After DOJ Investigation. J Card Fail 2021:S1071-9164(21)00389-4. [PMID: 34628015 DOI: 10.1016/j.cardfail.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Department of Justice (DOJ) investigated implantable cardioverter-defibrillators (ICDs) not meeting the Centers for Medicare & Medicaid Services National Coverage Determination (NCD) criteria, resulting in increased adherence to the NCD criteria. Trends of the specific reasons for patients not meeting the NCD criteria and in-hospital outcomes for those patients are not known. METHODS AND RESULTS We analyzed 300,151 primary-prevention ICDs from 2007-2015 at 1809 hospitals. We calculated the rates of in-hospital adverse events and the proportion of ICDs not meeting the 4 NCD criteria before and after the announcement of the DOJ investigation, stratified by whether hospitals paid settlements to the DOJ. Most reductions in the use of devices in patients not meeting NCD criteria were in patients with recently diagnosed heart failure (15.5%-6.8% for settled; 13.5%-7.3% for nonsettled) and who had had a recent myocardial infarction (8.4%-1.3% for settled; 7.4% to 1.5% for nonsettled). Adverse-event rates were significantly higher for ICDs not meeting NCD criteria (odds ratio 1.26 for settled; P < 0.001; 1.18 for nonsettled; P = 0.001). CONCLUSIONS After the investigation, there was a rapid reduction in the placement of ICDs in patients with recent acute myocardial infarction or recent diagnosis of heart failure. Patients who did not meet NCD criteria experienced more in-hospital adverse events and higher mortality rates.
Collapse
|
31
|
Monaco A, Casteig Blanco A, Cobain M, Costa E, Guldemond N, Hancock C, Onder G, Pecorelli S, Silva M, Tournoy J, Trevisan C, Votta M, Yfantopoulos J, Yghemonos S, Clay V, Mondello Malvestiti F, De Schaetzen K, Sykara G, Donde S. The role of collaborative, multistakeholder partnerships in reshaping the health management of patients with noncommunicable diseases during and after the COVID-19 pandemic. Aging Clin Exp Res 2021; 33:2899-2907. [PMID: 34319512 PMCID: PMC8316535 DOI: 10.1007/s40520-021-01922-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/20/2021] [Indexed: 12/19/2022]
Abstract
Background Policies to combat the COVID-19 pandemic have disrupted the screening, diagnosis, treatment, and monitoring of noncommunicable (NCD) patients while affecting NCD prevention and risk factor control. Aims To discuss how the first wave of the COVID-19 pandemic affected the health management of NCD patients, identify which aspects should be carried forward into future NCD management, and propose collaborative efforts among public–private institutions to effectively shape NCD care models. Methods The NCD Partnership, a collaboration between Upjohn and the European Innovation Partnership on Active and Healthy Ageing, held a virtual Advisory Board in July 2020 with multiple stakeholders; healthcare professionals (HCPs), policymakers, researchers, patient and informal carer advocacy groups, patient empowerment organizations, and industry experts. Results The Advisory Board identified barriers to NCD care during the COVID-19 pandemic in four areas: lack of NCD management guidelines; disruption to integrated care and shift from hospital-based NCD care to more community and primary level care; infodemics and a lack of reliable health information for patients and HCPs on how to manage NCDs; lack of availability, training, standardization, and regulation of digital health tools. Conclusions Multistakeholder partnerships can promote swift changes to NCD prevention and patient care. Intra- and inter-communication between all stakeholders should be facilitated involving all players in the development of clinical guidelines and digital health tools, health and social care restructuring, and patient support in the short-, medium- and long-term future. A comprehensive response to NCDs should be delivered to improve patient outcomes by providing strategic, scientific, and economic support.
Collapse
|
32
|
Marubashi S, Takahashi A, Kakeji Y, Hasegawa H, Ueno H, Eguchi S, Endo I, Goi T, Saiura A, Sasaki A, Takiguchi S, Takeuchi H, Tanaka C, Hashimoto M, Hiki N, Horiguchi A, Masaki T, Yoshida K, Gotoh M, Konno H, Yamamoto H, Miyata H, Seto Y, Kitagawa Y. Surgical outcomes in gastroenterological surgery in Japan: Report of the National Clinical Database 2011-2019. Ann Gastroenterol Surg 2021; 5:639-658. [PMID: 34585049 PMCID: PMC8452469 DOI: 10.1002/ags3.12462] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND We aimed to present the 2019 annual report of the gastroenterological section of the National Clinical Database (NCD). METHODS We reviewed 609,589 cases recorded in 2019 and 5,029,764 cases registered from 2011 to 2019 for the 115 selected gastroenterological surgical procedures. RESULTS The main features of gastroenterological surgery in Japan were similar to those described in the 2018 annual report, namely, that 1) operative numbers gradually increased in all procedures, except gastrectomy and hepatectomy, which decreased in these years; 2) in all eight major gastroenterological surgeries, the age distribution tended toward older patients; 3) the morbidity of esophagectomy, hepatectomy, and pancreaticoduodenectomy increased, but mortality was minimized in all procedures; 4) all eight major gastroenterological procedures have increasingly been performed under laparoscopy; and 5) board-certified surgeons were increasingly involved. These trends in recent years were more prominent in 2019. CONCLUSIONS Thanks to the continuous cooperation and dedication of the surgeons, medical staff, and surgical clinical reviewers who registered the clinical data into the NCD, it is possible to understand the comprehensive landscape of surgery in Japan and to disclose new evidence in this field. The Japanese Society of Gastroenterological Surgery will continue to promote the value of this database and encourage the use of feedback and clinical studies using the NCD, now and in the future. Generating further approaches to surgical quality improvement are important directions for future research.
Collapse
Affiliation(s)
| | - Arata Takahashi
- Department of Health Policy and ManagementSchool of MedicineKeio UniversityTokyoJapan
- Department of Healthcare Quality Assessment Graduate School of MedicineThe University of TokyoTokyoJapan
| | | | | | - Hideki Ueno
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Susumu Eguchi
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Itaru Endo
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Takanori Goi
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Akio Saiura
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Akira Sasaki
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Shuji Takiguchi
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Hiroya Takeuchi
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Chie Tanaka
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | | | - Naoki Hiki
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | | | - Tadahiko Masaki
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | | | - Mitsukazu Gotoh
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Hiroyuki Konno
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Hiroyuki Yamamoto
- Department of Health Policy and ManagementSchool of MedicineKeio UniversityTokyoJapan
- Department of Healthcare Quality Assessment Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Hiroaki Miyata
- Department of Health Policy and ManagementSchool of MedicineKeio UniversityTokyoJapan
- Department of Healthcare Quality Assessment Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Yasuyuki Seto
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | - Yuko Kitagawa
- The Japanese Society of Gastroenterological SurgeryTokyoJapan
| | | |
Collapse
|
33
|
Klonizakis M, Bugg A, Hunt B, Theodoridis X, Bogdanos DP, Grammatikopoulou MG. Assessing the Physiological Effects of Traditional Regional Diets Targeting the Prevention of Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials Implementing Mediterranean, New Nordic, Japanese, Atlantic, Persian and Mexican Dietary Interventions. Nutrients 2021; 13:3034. [PMID: 34578911 DOI: 10.3390/nu13093034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022] Open
Abstract
Traditional regional diets are considered as sustainable dietary patterns, while many have been examined with regard to their health benefits. The aim of the present systematic review was to aggerate all evidence on the physiological effects of regional diets among adults at high risk for cardiovascular disease (CVD). Three databases were searched for randomized controlled trials (RCTs) implementing any regional diet (Mediterranean (MedD), Persian, Southern European Atlantic, Japanese, Chinese, new Nordic, or other) while examining cardiovascular risk factors among adults at increased risk. Primary outcomes included anthropometric indices and secondary outcomes involved blood lipid concentrations, glucose metabolism, inflammation and other markers of CVD progression. Twenty RCTs fulfilled the study’s criteria and were included in the qualitative synthesis, with the majority implementing a MedD. Adherence to most of the regional diets induced a reduction in the BW and anthropometric indices of the participants. The majority of RCTs with blood pressure endpoints failed to note a significant reduction in the intervention compared to the comparator arm, with the exception of some new Nordic and MedD ones. Despite the interventions, inflammation markers remained unchanged except for CRP, which was reduced in the intervention groups of one new Nordic, the older Japanese, and the Atlantic diet RCTs. With regard to blood lipids, regional diet interventions either failed to induce significant differences or improved selective blood lipid markers of the participants adhering to the experimental regional diet arms. Finally, in the majority of RCTs glucose metabolism failed to improve. The body of evidence examining the effect of regional dietary patterns on CVD risk among high-risk populations, while employing an RCT design, appears to be limited, with the exception of the MedD. More research is required to advocate for the efficacy of most regional diets with regard to CVD.
Collapse
|
34
|
Hadian M, Mozafari MR, Mazaheri E, Jabbari A. Challenges of the Health System in Preventing Non-Communicable Diseases; Systematized Review. Int J Prev Med 2021; 12:71. [PMID: 34447513 PMCID: PMC8356955 DOI: 10.4103/ijpvm.ijpvm_487_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 12/13/2022] Open
Abstract
Background: The basis of prevention of non-communicable diseases is the identification of primary risk factors and the prevention and control of these factors. The purpose is to prevent the spread of the disease and to control it as much as possible. If population growth continues at this rate, by 2030, 52 million people will die from these diseases each year. The aim of this study was to evaluate the challenges of preventing non-communicable diseases. Methods: The present study was a systematic review that conducted in July 2020 and the articles related to prevention of non-communicable diseases on databases of web of science, PubMed, Scopus, science direct, Ovid, Pro Quest and Google Scholar. Strategy for searching and selecting the articles was PRISMA Guidelines. Results: Challenges of non-communicable disease prevention, in 4 main codes, including infrastructure, economic, demographic and management and 12 sub-codes that include, lack of preventive infrastructure, restrictions on access to medicine, restrictions on primary health care, restrictions on access to Technology, disease-oriented disease, unsustainable financial resources, failure to implement poverty reduction projects, increase in aging population, migration, rapid and unplanned urban planning, hasty planning and lack of internal and external coordination were classified. Conclusions: To reduce non-communicable diseases, strengthen global capacities, reduce risk factors for NCDs and place social determinants by creating health-promoting environments, strengthen health systems to implement prevention and control of NCDs, and place determinants Social can play an effective role through people-centered primary health care.
Collapse
Affiliation(s)
- Marziye Hadian
- Department of Health Services Management, Student Research Committee, School of Management and Medical Information Sciences, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M R Mozafari
- Australasian Nanoscience and Nanotechnology Initiative (ANNI), 8054 Monash University LPO, Clayton, Victoria 3168, Australia.,Supreme NanoBiotics Co. Ltd. and Supreme Pharmatech Co. Ltd., 399/90-95 Moo 13 Kingkaew Rd. Soi 25/1, T. Rachateva, A. Bangplee, Samutprakan 10540, Thailand
| | - Elaheh Mazaheri
- Department of Medical Library and Information Sciences, Health Information Technology Research Center, Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Jabbari
- Department of Health Services Management, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
35
|
Phaiyarom M, Kosiyaporn H, Pudpong N, Sinam P, Suphanchaimat R, Julchoo S, Kunpeuk W. Access to Non-Communicable Disease ( NCD) Services Among Urban Refugees and Asylum Seekers, Relative to the Thai Population, 2019: A Case Study in Bangkok, Thailand. Risk Manag Healthc Policy 2021; 14:3423-3433. [PMID: 34429673 PMCID: PMC8380139 DOI: 10.2147/rmhp.s314090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/10/2021] [Indexed: 11/23/2022] Open
Abstract
Background The health of urban refugees and asylum seekers (URAS) in Thailand has been under-researched compared with other groups of non-Thai populations, especially in the area of chronic non-communicable diseases (NCD). The objectives of this study were to i) examine NCD prevalence; ii) access to NCD services; and iii) factors associated with access to NCD services among urban refugees and asylum seekers (URAS) in comparison with the Thai population. Methods A cross-sectional study, using a self-administrative questionnaire adapted from the Thai Health and Welfare Survey (HWS), was conducted in 2019. URAS were randomly selected from the register of the Bangkok Refugee Center. One hundred and eighty-one URAS participated in the survey. The data were combined with 2941 Thai records from the HWS. The population scope was confined to Bangkok. Bivariate analysis by Chi-square, Fisher's exact, and Mann-Whitney U-tests was conducted to examine difference in demographic and access to NCD services between URAS and Thais. Multivariable logistic regression was performed to identify factors associated with access to NCD services. Results Overall, URAS were young, less educated, and poorer than Thais. The trend of NCDs was similar to the Thai population, except mental health disorders appeared to be more prevalent in URAS. Almost half of the URAS did not receive any formal treatment. Being insured, abiding with Buddhism, and living in more affluent households were factors associated with better access to NCD services. URAS from Asian countries had greater access to NCD care than those from non-Asian countries. Conclusion Policymakers should consider expanding the insurance coverage to URAS, similar to coverage for Thai populations. Additional studies on refugees' health status and service utilization in other settings outside Bangkok are strongly recommended.
Collapse
Affiliation(s)
- Mathudara Phaiyarom
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Hathairat Kosiyaporn
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Nareerut Pudpong
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand.,Sirindron College of Public Health, Chonburi, Thailand
| | - Pigunkaew Sinam
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Rapeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand.,Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Sataporn Julchoo
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand
| | - Watinee Kunpeuk
- International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand
| |
Collapse
|
36
|
Abstract
Non-communicable diseases are a leading cause of death and levels are rising. Lifestyle changes, including physical activity, have benefits in all-cause mortality, cardiovascular and metabolic disease, respiratory conditions and cognitive and mental health. In some cancers, particularly colon, prostate and breast, physical activity improves quality of life and outcomes before, during and after treatment. Sedentary time is an independent risk factor with adverse effects in hospitalised patients. Mechanisms include anti-inflammatory effects and augmentation of physiological and neuroendocrine responses to stressors. Engaging patients is affected by barriers: for clinicians, awareness of guidelines and personal physical activity levels are important factors; for patients, barriers are influenced by life events, socioeconomic and cultural factors. Interventions to increase activity levels are effective in the short- and medium-term, including brief interventions. Face-to-face is more effective than remote advice and behavioural interventions are more effective than cognitive. There are no published guidelines for physical activity in hospitalised patients.
Collapse
Affiliation(s)
| | | | | | - Jack Collins
- Trafalgar Medical Group Practice, Portsmouth, UK
| | | |
Collapse
|
37
|
Khin ET, Aung MN, Ueno S, Ahmad I, Latt TS, Moolphate S, Yuasa M. Social Support between Diabetes Patients and Non-Diabetes Persons in Yangon, Myanmar: A Study Applying ENRICHD Social Support Instrument. Int J Environ Res Public Health 2021; 18:ijerph18147302. [PMID: 34299754 PMCID: PMC8303506 DOI: 10.3390/ijerph18147302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/28/2022]
Abstract
Diabetes patients, due to the chorionic nature of the disease, need complex and long-term care for control and prevention of complications. The patients themselves find it difficult to adopt appropriate disease management after diagnosis and they need social support from family, friends, and their environment, especially in lower- and middle-income countries where medical service is limited, and they need self-care of disease and lifestyle modification. In Myanmar, however, the study for social support among diabetes patients is still limited. Therefore, we conducted a case-control study to investigate the social support among diabetes patients and the association between socioeconomic factors in Yangon, which has the highest prevalence of diabetes in Myanmar. Social support between diabetes patients who came to diabetes special clinics and non-diabetes community control was assessed by applying transculturally translated ENRICHD Social Support Instrument (ESSI). Among the diabetes patients’ group, more than 70% had high perceived social support, specifically higher level of informational and emotional social support. Robust multiple regression models revealed significant positive associations between total social support and independent variables: p value < 0.001 for monthly household income and being married, and p value < 0.05 for household number and frequency of having meals together with family. These findings suggest that perceived social support among patients with diabetes may be mainly affected by the patients’ family conditions, such as household income and living with a spouse, in Myanmar culture.
Collapse
Affiliation(s)
- Ei Thinzar Khin
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Myo Nyein Aung
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Correspondence: ; Tel.: +81-33813-3111
| | - Satomi Ueno
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of Nursing, Seisen Jogakuin College, Nagano 381-0085, Japan
| | - Ishtiaq Ahmad
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
| | - Tint Swe Latt
- Myanmar Diabetes Association (MMDA), Yangon 11211, Myanmar;
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiangmai 50300, Thailand;
| | - Motoyuki Yuasa
- Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (E.T.K.); (S.U.); (I.A.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
| |
Collapse
|
38
|
Dózsa K, Mezei F, Tóth T, Perjés Á, Pollner P. Countrywide survey on utilization of medical devices by GPs in Hungary: advantages of the cluster-practice model. Prim Health Care Res Dev 2021; 22:e34. [PMID: 34184625 DOI: 10.1017/S1463423621000372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Expectations towards general practitioners (GPs) are continuously increasing to provide a more systematic preventive- and definitive-based care, a wider range of multidisciplinary team-based services and to integrate state-of-the-art digital solutions into daily practice. Aided by development programmes, Hungarian primary care is facing the challenge to fulfil its role as the provider of comprehensive, high quality, patient-centred, preventive care, answering the challenges caused by non-communicable diseases (NCDs). AIM The article aims to provide an insight into the utilization of simple, digital, medical devices. We show the relationship between the primary health care (PHC) practice models and the used types of devices. We point at further development directions of GP practices regarding the utilization of evidence-based medical technologies and how such devices support the screening and chronic care of patients with NCDs in everyday practice. METHODS Data were collected using an online self-assessment questionnaire from 1800 Hungarian GPs registered in Hungary. Descriptive statistics, Wilcoxon's test and χ2 test were applied to analyze the ownership and utilization of 32 types of medical devices, characteristics of the GP practices and to highlight the differences between traditional and cluster-based operating model. FINDINGS Based on the responses from 27.7% of all Hungarian GPs, the medical device infrastructure was found to be limited especially in single GP-practices. Those involved in development projects of GP's clusters in the last decade reported a wider range and significantly more intensive utilization of evidence-based technologies (average number of devices: 5.42 versus 7.56, P<.001), but even these GPs are not using some of their devices (e.g., various point of care testing devices) due to the lack of financing. In addition, GPs involved in GPs-cluster development model programmes showed significantly greater willingness for sharing relatively expensive, extra workforce-demanding technologies (χ2 = 24.5, P<.001).
Collapse
|
39
|
Sibai AM, Najem Kteily M, Barazi R, Chartouni M, Ghanem M, Afifi RA. Lessons learned in the provision NCD primary care to Syrian refugee and host communities in Lebanon: the need to 'act locally and think globally'. J Public Health (Oxf) 2021; 42:e361-e368. [PMID: 31763670 DOI: 10.1093/pubmed/fdz096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/15/2019] [Accepted: 07/21/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prevention and control of non-communicable diseases (NCDs) remain inadequate in resource-scarce countries, particularly in conflict situations. This paper describes a multicomponent intervention for management of hypertension and diabetes among older adult Syrian refugees and the Lebanese host community and reflects on challenges for scaling up NCD integration into primary care in humanitarian situations. METHODS Using a mixed method approach, the study focused on monitoring and evaluation of the three components of the intervention: healthcare physical facilities and documentation processes, provider knowledge and guideline-concordant performance, and refugee and host community awareness. RESULTS Findings revealed overall high compliance of healthcare workers with completing data collection forms. Their knowledge of basic aspects of hypertension/diabetes management was adequate, but diagnosis knowledge was low. Patients and healthcare providers voiced satisfaction with the program. Yet, interruptions in medicines' supplies and lapses in care were perceived by all study groups alike as the most problematic aspect of the program. CONCLUSIONS Our intervention program was aligned with internationally agreed-upon practices, yet, our experiences in the field point to the need for more 'local testing' of modified interventions within such contexts. This can then inform 'thinking globally' on guidelines for the delivery of NCD care in crisis settings.
Collapse
Affiliation(s)
- Abla M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Martine Najem Kteily
- Center for Public Health Practice, Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Rana Barazi
- Center for Public Health Practice, Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Mia Chartouni
- Center for Public Health Practice, Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Maguy Ghanem
- HelpAge International, Lebanon Office, Beirut 1107 2020, Lebanon
| | - Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| |
Collapse
|
40
|
Zimba CC, Akiba CF, Matewere M, Thom A, Udedi M, Masiye JK, Kulisewa K, Go VFL, Hosseinipour MC, Gaynes BN, Pence BW. Facilitators, barriers and potential solutions to the integration of depression and non-communicable diseases ( NCDs) care in Malawi: a qualitative study with service providers. Int J Ment Health Syst 2021; 15:59. [PMID: 34116699 PMCID: PMC8196431 DOI: 10.1186/s13033-021-00480-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 05/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background Integration of depression services into infectious disease care is feasible, acceptable, and effective in sub-Saharan African settings. However, while the region shifts focus to include chronic diseases, additional information is required to integrate depression services into chronic disease settings. We assessed service providers’ views on the concept of integrating depression care into non-communicable diseases’ (NCD) clinics in Malawi. The aim of this analysis was to better understand barriers, facilitators, and solutions to integrating depression into NCD services. Methods Between June and August 2018, we conducted nineteen in-depth interviews with providers. Providers were recruited from 10 public hospitals located within the central region of Malawi (i.e., 2 per clinic, with the exception of one clinic where only one provider was interviewed because of scheduling challenges). Using a semi structured interview guide, we asked participants questions related to their understanding of depression and its management at their clinic. We used thematic analysis allowing for both inductive and deductive approach. Themes that emerged related to facilitators, barriers and suggested solutions to integrate depression assessment and care into NCD clinics. We used CFIR constructs to categorize the facilitators and barriers. Results Almost all providers knew what depression is and its associated signs and symptoms. Almost all facilities had an NCD-dedicated room and reported that integrating depression into NCD care was feasible. Facilitators of service integration included readiness to integrate services by the NCD providers, availability of antidepressants at the clinic. Barriers to service integration included limited knowledge and lack of training regarding depression care, inadequacy of both human and material resources, high workload experienced by the providers and lack of physical space for some depression services especially counseling. Suggested solutions were training of NCD staff on depression assessment and care, engaging hospital leaders to create an NCD and depression care integration policy, integrating depression information into existing documents, increasing staff, and reorganizing clinic flow. Conclusion Findings of this study suggest a need for innovative implementation science solutions such as reorganizing clinic flow to increase the quality and duration of the patient-provider interaction, as well as ongoing trainings and supervisions to increase clinical knowledge. Trial registration This study reports finding of part of the formative phase of “The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building—A Clinic-Randomized Trial of Strategies to Integrate Depression Care in Malawi” registered as NCT03711786
Collapse
Affiliation(s)
| | - Christopher F Akiba
- Gillings School of Global and Public Health, University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | | | - Annie Thom
- Malawi Ministry of Health, Lilongwe, Malawi
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Ndione I, Aerts A, Barshilia A, Boch J, Rosiers SD, Ferrer JME, Saric J, Seck K, Sene BN, Steinmann P, Venkitachalam L, Shellaby JT. Fostering cardiovascular health at work - case study from Senegal. BMC Public Health 2021; 21:1108. [PMID: 34112133 PMCID: PMC8194249 DOI: 10.1186/s12889-021-11109-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Of the 15 million annual premature deaths from non-communicable diseases (NCDs), 85% occur in low- and middle-income countries (LMICs). Affecting individuals in the prime of their lives, NCDs impose severe economic damage to economies and businesses, owing to the high mortality and morbidity within the workforce. The Novartis Foundation urban health initiative, Better Hearts Better Cities, was designed to improve cardiovascular health in Dakar, Senegal through a combination of interventions including a workplace health program. In this study, we describe the labor policy environment in Senegal and the outcomes of a Novartis Foundation-supported multisector workplace health coalition bringing together volunteering private companies. METHODS A mixed method design was applied between April 2018 and February 2020 to evaluate the workplace health program as a case study. Qualitative methods included a desk review of documents relevant to the Senegalese employment context and work environment and in-depth interviews with eight key informants including human resource representatives and physicians working in the participating companies. Quantitative methods involved an analysis of workplace health program indicators, including data on diagnosis, treatment and control of hypertension in employees, provided by the coalition companies, and a cost estimate of NCD-related ill-health as compared to the investment needed for hypertension screening and awareness raising events. RESULTS Senegal has a legal and regulatory system that ensures employee protection, supports social security benefits, and promotes health and hygiene in companies. The Dakar Workplace Health Coalition comprised 18 companies, with a range of staff between 300 and 4'220, covering 36'268 employees in total. Interviews suggested that the main enablers for workplace program success were strong leadership support within the company and a central coordination mechanism for the program. The main barrier to monitor progress and outcomes was the reluctance of companies to share data. Four companies provided aggregated anonymized cohort data, documenting a total of 21'392 hypertension screenings and an increasing trend in blood pressure control (from 34% in Q4 2018 to 39% in Q2 2019) in employees who received antihypertensive treatment. CONCLUSION Evidence on workplace health and wellness programs in Africa is scarce. This study highlights how private sector companies can play a significant role in improving cardiovascular population health in LMICs.
Collapse
Affiliation(s)
| | - Ann Aerts
- Novartis Foundation, Basel, Switzerland
| | | | | | | | | | - Jasmina Saric
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | | |
Collapse
|
42
|
Ho HT, Jenkins C, Nghiem HLP, Hoang MV, Santin O. Understanding context: A qualitative analysis of the roles of family caregivers of people living with cancer in Vietnam and the implications for service development in low-income settings. Psychooncology 2021; 30:1782-1788. [PMID: 34101301 DOI: 10.1002/pon.5746] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/17/2021] [Accepted: 06/04/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Research on the needs of family caregivers of people living with cancer remains disproportionately focused in high income contexts. This research gap adds to the critical challenge on global equitable delivery of cancer care. This study describes the roles of family caregivers of people living with cancer in Vietnam and possible implications for intervention development. METHODS Semi-structured interviews and focus groups with family caregivers (n = 20) and health care providers (n = 22) were conducted in two national oncology hospitals. Findings were verified via workshops with carers (n = 11) and health care professionals (n = 28) in five oncology hospitals representing different regions of Vietnam. Data was analyzed collaboratively by an international team of researchers according to thematic analysis. RESULTS Family caregivers in Vietnam provide an integral role in the delivery of inpatient cancer care. In the hospital environment families are responsible for multiple roles including feeding, hydration, changing, washing, moving, wound care and security of personal belongings. Central to this role is primary decision making in terms of treatment and end-of-life care; relaying information, providing nutritional, emotional and financial support. Families are forced to manage severe complications and health care needs with minimal health literacy and limited health care professional input. CONCLUSIONS Understanding context and the unique roles of family caregivers of people living with cancer is critical in the development of supportive services. As psycho-oncology develops in low and middle income contexts, it is essential that family caregiver roles are of significant importance.
Collapse
Affiliation(s)
- Hien Thi Ho
- Hanoi University of Public Health, Hanoi, Viet Nam
| | - Chris Jenkins
- Centre for Public Health, Institute of Clinical Sciences, Royal Victoria Hospital, Queen's University Belfast, Belfast, UK
| | | | | | - Olinda Santin
- School of Nursing and Midwifery, Queen's University Belfast, Medical Biology Centre, Belfast, UK
| |
Collapse
|
43
|
Bertram MY, Chisholm D, Watts R, Waqanivalu T, Prasad V, Varghese C. Cost-Effectiveness of Population Level and Individual Level Interventions to Combat Non-communicable Disease in Eastern Sub-Saharan Africa and South East Asia: A WHO-CHOICE Analysis. Int J Health Policy Manag 2021; 10:724-733. [PMID: 34273918 PMCID: PMC9278376 DOI: 10.34172/ijhpm.2021.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: To determine the health system costs and health-related benefits of interventions for the prevention and control of non-communicable diseases (NCDs), including mental health disorders, for the purpose of identifying the most cost-effective intervention options in support of global normative guidance on the best-buy interventions for NCDs. In addition, tools are developed to allow country contextualisation of the analyses to support local priority setting exercises.
Methods: This analysis follows the standard WHO-CHOICE (World Health Organization-Choosing Interventions that are Cost-Effective) approach to generalized cost-effectiveness analysis applied to two regions, Eastern sub-Saharan Africa and South-East Asia. The scope of the analysis is all NCD and mental health interventions included in WHO guidelines or guidance documents for which the health impact of the intervention is able to be identified and attributed. Costs are measured in 2010 international dollars, and benefits modelled beginning in 2010, both for a period of 100 years.
Results: There are many interventions for NCD prevention and management that are highly cost-effective, generating one year of healthy life for less than Int. $100. These interventions include tobacco and alcohol control policies such as taxation, voluntary and legislative actions to reduce sodium intake, mass media campaigns for reducing physical activity, and treatment options for cardiovascular disease (CVD), cervical cancer and epilepsy. In addition a number of interventions fall just outside this range, including breast cancer, depression and chronic lung disease treatment.
Conclusion: Interventions that represent good value for money, are technically feasible and are delivered for a low per-capita cost, are available to address the rapid rise in NCDs in low- and middle-income countries. This paper also describes a tool to support countries in developing NCD action plans.
Collapse
Affiliation(s)
- Melanie Y Bertram
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
| | - Daniel Chisholm
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Rory Watts
- Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland
| | - Temo Waqanivalu
- Department of Prevention of Non-Communicable Diseases, World Health Organization, Geneva, Switzerland
| | - Vinayak Prasad
- Department of Prevention of Non-Communicable Diseases, World Health Organization, Geneva, Switzerland
| | - Cherian Varghese
- Department of Management of Non Communicable Diseases, Violence and Injury, World Health Organization, Geneva, Switzerland
| |
Collapse
|
44
|
Kubjane M, Berkowitz N, Goliath R, Levitt NS, Wilkinson RJ, Oni T. Tuberculosis, Human Immunodeficiency Virus, and the Association With Transient Hyperglycemia in Periurban South Africa. Clin Infect Dis 2021; 71:1080-1088. [PMID: 31557282 PMCID: PMC7428387 DOI: 10.1093/cid/ciz928] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/16/2019] [Indexed: 12/27/2022] Open
Abstract
Background Diabetes mellitus (DM) increases tuberculosis (TB) risk. We assessed the prevalence of hyperglycemia (DM and impaired glucose regulation [IGR]) in persons with TB and the association between hyperglycemia and TB at enrollment and 3 months after TB treatment in the context of human immunodeficiency virus (HIV) infection. Methods Adults presenting at a Cape Town TB clinic were enrolled. TB cases were defined by South African guidelines, while non-TB participants were those who presented with respiratory symptoms, negative TB tests, and resolution of symptoms 3 months later without TB treatment. HIV status was ascertained through medical records or HIV testing. All participants were screened for DM using glycated hemoglobin and fasting plasma glucose at TB treatment and after 3 months. The association between TB and DM was assessed. Results Overall DM prevalence was 11.9% (95% confidence interval [CI], 9.1%–15.4%) at enrollment and 9.3% (95% CI, 6.4%–13%) at follow-up; IGR prevalence was 46.9% (95% CI, 42.2%–51.8%) and 21.5% (95% CI, 16.9%–26.3%) at enrollment and follow-up. TB/DM association was significant at enrollment (odds ratio [OR], 2.41 [95% CI, 1.3–4.3]) and follow-up (OR, 3.3 [95% CI, 1.5–7.3]), whereas TB/IGR association was only positive at enrollment (OR, 2.3 [95% CI, 1.6–3.3]). The TB/DM association was significant at enrollment in both new and preexisting DM, but only persisted at follow-up in preexisting DM in patients with HIV-1 infection. Conclusions Our study demonstrated high prevalence of transient hyperglycemia and a significant TB/DM and TB/IGR association at enrollment in newly diagnosed DM, but persistent hyperglycemia and TB/DM association in patients with HIV-1 infection and preexisting DM, despite TB therapy.
Collapse
Affiliation(s)
- Mmamapudi Kubjane
- Division of Public Health Medicine, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Natacha Berkowitz
- Division of Public Health Medicine, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.,Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, and Department of Medicine, University of Cape Town, Observatory, South Africa
| | - Rene Goliath
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, and Department of Medicine, University of Cape Town, Observatory, South Africa
| | - Naomi S Levitt
- Division of Diabetes and Endocrinology, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa and Chronic Disease Initiative for Africa
| | - Robert J Wilkinson
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, and Department of Medicine, University of Cape Town, Observatory, South Africa.,The Francis Crick Institute, London, United Kingdom.,Department of Infectious Diseases, Imperial College London, United Kingdom
| | - Tolu Oni
- Division of Public Health Medicine, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.,Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, and Department of Medicine, University of Cape Town, Observatory, South Africa.,Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| |
Collapse
|
45
|
Tippairote T, Bjørklund G, Yaovapak A. The continuum of disrupted metabolic tempo, mitochondrial substrate congestion, and metabolic gridlock toward the development of non-communicable diseases. Crit Rev Food Sci Nutr 2021; 62:6837-6853. [PMID: 33797995 DOI: 10.1080/10408398.2021.1907299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Non-communicable diseases (NCD) are the slow-motion disasters with imminent global health care burden. The current dietary management for NCD is dominated by the calorie balance model. Apart from the quantitative balance of calorie, healthy bioenergetics requires temporal eating and fasting rhythms, and the subsequent switching for different metabolic fuels. We herein term these three bioenergetic attributes, i.e., caloric balance, diurnal eating-fasting rhythm, and metabolic flexibility, as the metabolic tempo. These three attributes are intertwined with each other; alteration of one attribute affects one or more other attributes. Lifestyle-induced disrupted metabolic tempo presents a high flux of mixed carbon substrates to mitochondria, with the resulting congestion and indecisiveness of metabolic switches. Such indecisiveness impairs metabolic flexibility, promotes anabolism, and accumulates the energy storage pools. The triggers from hypoxic inducible factor expression could further promote the metabolic gridlock and adipocyte maladaptation. The maladaptive adipocytes lead to ectopic fat deposition, increased circulating lipid levels, insulin resistance, and chronic systemic inflammation. These continuum set stages for clinical NCDs. We propose that the restoration of all tempo attributes through the combined diet-, time-, and calorie-restricted interventions could be the preferred strategy for NCD management.
Collapse
Affiliation(s)
- Torsak Tippairote
- Nutritional and Environmental Section, Thailand Initiatives for Functional Medicine, Bangkok Thailand.,Nutritional and Environmental Medicine, Healing Passion Medical Center, Bangkok Thailand
| | - Geir Bjørklund
- Nutritional and Environmental Medicine, Council for Nutritional and Environmental Medicine, Mo i Rana, Norway
| | - Augchara Yaovapak
- Nutritional and Environmental Section, Thailand Initiatives for Functional Medicine, Bangkok Thailand.,Nutritional and Environmental Medicine, Healing Passion Medical Center, Bangkok Thailand
| |
Collapse
|
46
|
Portela-Pino I, Alvariñas-Villaverde M, Martínez-Torres J, Pino-Juste M. Influence of the Perception of Barriers in Practice of PA in Adolescents: Explanatory Model. Healthcare (Basel) 2021; 9:380. [PMID: 33915678 DOI: 10.3390/healthcare9040380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sedentarism is an important risk factor for non-communicable diseases. To avoid it, it is necessary to establish the barriers which influence a low level of practice of Physical Activity. METHODS This study, conducted with 833 students, aims to describe a model to explain the barriers determining the level of practice of Physical Activity in adolescents according to age, school year, BMI and gender. The inclusion of the analyzed barriers followed the tetra-factorial model: Body image/physical and social anxiety; Tiredness/laziness; Responsibilities/lack of time and Environment/facilities. RESULTS The barriers to Physical Activity in adolescents are fatigue and sloth, and temporary obligations. The barrier that least influences the practice of Physical Activity is the environment and body image. It is determined that the subjects with the lowest Physical Activity index were those with a high fatigue and laziness score and higher age. The level of physical activity of this population is medium (95% CI, 2.8274-2.9418). CONCLUSIONS It is necessary to overcome tiredness or apathy towards the practice of Physical Activity, especially in those under 16 years of age.
Collapse
|
47
|
Bastin C, Bahri MA, Bernard C, Hustinx R, Salmon E. Frontal hypometabolism in neurocognitive disorder with behavioral disturbance. J Nucl Med 2021; 62:jnumed.120.260497. [PMID: 33789936 PMCID: PMC8612193 DOI: 10.2967/jnumed.120.260497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 11/16/2022] Open
Abstract
Criteria for the behavioral variant of frontotemporal dementia (bvFTD) include decreased frontal metabolism. FDG-PET was used to investigate whether patients with neurocognitive disorder and behavioral disturbance (bvNCD) who did not fulfill three bvFTD criteria had characteristic brain metabolic pattern. Methods: Patients were referred from memory clinic to nuclear medicine for differential diagnosis of NCD with dysexecutive syndrome and predominant mild frontal atrophy. Patients were classified into two groups before FDG-PET, probable bvFTD (n = 25) or bvNCD (n = 27) when only two bvFTD criteria were met. Results: Voxel-based and multivariate PLS analyses of FDG-PET did not show significant between-group difference at inclusion. After 4.8 years of follow-up, most patients with probable bvFTD received the same diagnosis, 3 remained very stable and one participant was given a psychiatric diagnosis. Five patients with bvNCD fulfilled criteria for probable bvFTD at 4.4 years mean follow up, while 2 participants remained very stable and 3 received alternative neurological or psychiatric diagnoses. When initial FDG-PET were compared between groups stratified at follow up (26 bvFTD versus 17 bvNCD), there was a trend (p<.001uncorrected) for lower prefrontal with relatively preserved premotor metabolism in bvFTD compared to bvNCD. Twelve bvNCD participants had neuropsychological testing before inclusion. They all presented executive dysfunction and normal visuospatial performance, and most (n = 9) had memory encoding impairment. Conclusion: Frontal hypometabolism was observed in a dysexecutive presentation of frontal neurodegenerative disorder (bvNCD) that did not fulfill all clinical criteria for bvFTD.
Collapse
Affiliation(s)
- Christine Bastin
- GIGA Cyclotron Research Centre, University of Liege, Liege, Belgium
| | | | - Claire Bernard
- Nuclear Medicine Department, CHU Liege, Liege, Belgium; and
| | - Roland Hustinx
- GIGA Cyclotron Research Centre, University of Liege, Liege, Belgium
- Nuclear Medicine Department, CHU Liege, Liege, Belgium; and
| | - Eric Salmon
- GIGA Cyclotron Research Centre, University of Liege, Liege, Belgium
- Memory Clinic, Department of Neurology, CHU Liege, Liege, Belgium
| |
Collapse
|
48
|
Aekplakorn W, Suriyawongpaisal P, Srithamrongsawadi S, Kaewkamjonchai P. Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients' perspectives. BMC Health Serv Res 2021; 21:223. [PMID: 33711999 PMCID: PMC7953793 DOI: 10.1186/s12913-021-06220-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients about the health care services after the implementation. Methods We conducted a cross-sectional survey of 4071 patients with hypertension and/or diabetes registered with 27 primary care units and 11 hospital non-communicable diseases (NCDs) clinics in 11 provinces. The patients were interviewed using a validated questionnaire of the Patient Assessment of Chronic Illness Care. Upgraded primary care units (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect logistic models were employed to examine the association of subscales (high vs low score) of patient perception of the care quality with type of PCUs. Results Compared to hospital NCD clinics, ordinary PCUs were the best in the odds of receiving high score for every CCM subscale (ORs: 1.46–1.85; p < 0.05), whereas the trained upgraded PCUs were better in terms of follow-up (ORs:1.37; p < 0.05), and the upgraded PCU did not differ in all domains. According to the 5 A model subscales, patient assessment also revealed better performance of ordinary PCUs in all domains compared to hospital NCD clinics whereas upgraded PCUs and trained upgraded PCUs did so in some domains. Seeing the same doctor on repeated visits (ORs: 1.82–2.17; p < 0.05) or having phone contacts with the providers (ORs:1.53–1.99; p < 0.05) were found beneficial using CCM subscales and the 5A model subscales. However, patient assessment by both subscales did not demonstrate a statistically significant association across health insurance status. Conclusions The policy implementation might not satisfy the patients’ perception on quality of chronic care according to the CCM and the 5A model subscale. However, the arrangement of chronic care with patients seeing the same doctors or patients having telephone contact with healthcare providers may satisfy the patients’ perceived needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06220-x.
Collapse
Affiliation(s)
- Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, 10400, Thailand
| | - Paibul Suriyawongpaisal
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, 10400, Thailand
| | - Samrit Srithamrongsawadi
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, 10400, Thailand
| | - Phanuwich Kaewkamjonchai
- Department of Community Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, 10400, Thailand.
| |
Collapse
|
49
|
Al-Mawali A, Al-Harrasi A, Jayapal SK, Morsi M, Pinto AD, Al-Shekaili W, Al-Kharusi H, Al-Balushi Z, Idikula J. Prevalence and risk factors of diabetes in a large community-based study in the Sultanate of Oman: STEPS survey 2017. BMC Endocr Disord 2021; 21:42. [PMID: 33673840 PMCID: PMC7934365 DOI: 10.1186/s12902-020-00655-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Type 2 diabetes in the Gulf Cooperation Council countries, including Oman, is currently the fastest growing health crisis and is a significant cause of premature mortality and disability. There is currently insufficient up-to-date information available on prevalence of type 2 diabetes. This study aimed to assess the latest prevalence of type 2 diabetes mellitus and its associated demographic, behavioural, and clinical risk factors. METHODS Using the WHO STEPwise approach to chronic disease surveillance, a nationally representative population-based survey was conducted from January to April 2017 of adults aged 18 years and above. A multi-stage, stratified, geographically clustered random sampling surveyed 9053 households including Omani nationals and non-Omani residents. Univariate and multiple logistic regression analysis was performed to determine the predictors of diabetes. RESULTS Overall prevalence of diabetes among the population was 15.7% (95% CI: 14.0-17.5%) whereas prevalence of prediabetes was 11.8% (95% CI: 11.4-12.2%). Age, educational level, raised blood pressure, family history of diabetes, abnormal waist-to-hip ratio, and hypertriglyceridemia were found to be significantly associated with diabetes mellitus. Of the cases of diabetes mellitus, 17% were newly diagnosed and 13.2% were on medication and had an uncontrolled glucose level while 55.5% were not taking medication (although diagnosed) and had an uncontrolled blood glucose level. CONCLUSIONS The present study provides reliable information regarding the high prevalence of diabetes mellitus among the adult population in Oman with urgent attention needed to address this significant burden on the health system. The high proportion of uncontrolled cases warrants further research, awareness programmes, and community interventions.
Collapse
Affiliation(s)
- Adhra Al-Mawali
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman.
- Strategic Research Program for Non-Communicable Diseases, Ministry of Higher Education, Research and Innovation, Muscat, Sultanate of Oman.
| | - Ayaman Al-Harrasi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | | | - Magdi Morsi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | | | - Waleed Al-Shekaili
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | - Hilal Al-Kharusi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | - Zainab Al-Balushi
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| | - John Idikula
- Centre of Studies & Research, Ministry of Health, Muscat, Sultanate of Oman
| |
Collapse
|
50
|
Staub K, Matthes KL, Rühli F, Bender N. Clash of the pandemics - At least 150'000 adults in Switzerland suffer from obesity grades 2 or 3 and are thus at elevated risk for severe COVID-19. F1000Res 2020; 9:1413. [PMID: 33796278 PMCID: PMC7970431 DOI: 10.12688/f1000research.27819.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/27/2020] [Indexed: 01/27/2023] Open
Abstract
Background: Grade 2 and 3 obesity, alongside with other relevant risk factors, are substantially and independently associated with adverse outcomes of coronavirus disease 2019 (COVID-19). However, for Switzerland, due to the lack of synthesis studies, it is currently unknown how many people are affected by obesity at all. This knowledge may help to better estimate the relevance and size of this group at elevated risk, which could be incorporated into strategies to protect risk groups during the still unfolding COVID-19 pandemic. This study aimed to provide a first overall estimation of how many people in Switzerland are currently affected by grade 2 or 3 obesity. Methods: Five representative national population-based studies were accessed which were conducted between 2012 and 2017 and which include data on height and weight of adult men and women in Switzerland. Results: In Switzerland in 2012-2017, among the 11.20% adults who were obese (body mass index (BMI) ≥30.0kg/m2), 1.76% (95% CI 1.50-2.02) suffered from grade 2 obesity (BMI 35.0-39.9 kg/m2), and 0.58% (95% CI 0.50-0.66) from grade severe 3 obesity (BMI ≥40.0 kg/m2). Converted into estimated absolute population numbers, this corresponds to a total of approximately n=154,515 people who suffer from grade 2 or 3 obesity (n=116,216 and n=38,298, respectively). Conclusions: This risk group includes many younger people in Switzerland. The number of people with obesity-related risk becomes 3.8 to 13.6 times higher if grade 1 obesity and overweight people are also included in this risk group, for which there are arguments arising in the latest literature. In general, this large group at risk for severe COVID-19 should be given more attention and support. If it is confirmed that obesity plays a major role in severe COVID-19 courses, then every kilo of body weight that is not gained or that is lost in lockdown counts.
Collapse
Affiliation(s)
- Kaspar Staub
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health SSPH+, Zurich, Switzerland
| | - Katarina L. Matthes
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Frank Rühli
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health SSPH+, Zurich, Switzerland
| | - Nicole Bender
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Swiss School of Public Health SSPH+, Zurich, Switzerland
| |
Collapse
|