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Trajectories of lived experiences of people living with Diabetes Mellitus in Africa: An evidence mapping of conceptual framework

Introduction: Diabetes Mellitus remains a major public health problem in Africa in the last two decades. A new conceptual framework for studying and understanding trajectories of experiences of people with diabetes mellitus in Africa is presented. Objective: The paper examines all known factors influencing the trajectories of lived experiences of persons with diabetes and how these factors interact with each other at micro and macro levels. Methods: A systematic mapping of peer reviewed literature (n=61) conducted in Africa and published between 01/01/1990 and 31/12/2020 was utilised. Results: Using a conceptual framework, we synthesised the factors influencing trajectories of lived experiences of diabetes in Africa, grouped into six domains: diabetes risk factors, socio demographic characteristics, individual level experiences, household/family level experiences, community/society level experiences and national level experiences. Conclusion: This framework can be used to test hypotheses about facilitators and barriers to health care seeking behaviour. As well as understand how trajectories of lived experience of diabetes might be influenced by policy or practice. Research based on understanding of trajectories is expected to improve diabetes patient’s experiences and outcome in diabetes management and care in Africa.

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Open Access
Evaluation of functional training along with online nutritional education on autistic children's metabolic status during Covid-19 pandemic-A randomized clinical trial

Physical inactivity and poor dietary pattern are considered as health related challenges in ASD (ASD) which seems to be affected by Covid-19 pandemic. The purpose of this clinical trial was to investigate the effect of functional training along with online nutritional education on metabolic related biomarkers in children with ASD. 80 verified children with ASD (age=9.73 ± 1.29, weight=49.94 ± 2.08 kg, stature=146.08 ± 40 cm, BMI percentile= 64.88 ± 2.89, FM percentage+24.71 ± 1.48) were randomly divided into four groups including: (1) functional training, (2) online nutritional education, 3) training+ education and 4) control group. Pre-test was taken for metabolic related biomarkers and each experimental group received their interventions for 8 weeks. Post-test was taken at the end of 8 weeks. The results from this study, did not show significant changes for WHR (sig=0.06). Significant changes was indicated for FM (sig?0.001), TC(sig?0.001), TG (sig=0.006), HDL (sig?0.001), LDL (sig=0.001), HOMA (sig=0.04). In conclusion, functional training and online nutritional education can be considered as beneficial interventions for metabolic related biomarkers improvement in children with ASD during Covid-19 pandemic.

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Socio-Demographic Profile, Asymptomatic Malaria Parasitaemia and Glycemic Control among Midled-Aged and Elderly Type 2 Diabetes Mellitus Patients in Rural Southwestern Nigeria: A Cross Sectional Study

The main therapeutic goal for all type 2 diabetes mellitus (T2DM) patients is to maintain good control so as to prevent the risk of complications associated with poor control. This study determined the prevalence of poor control and its association with socio-demographics and malaria parasitaemia among middle aged and elderly T2DM patients at a tertiary hospital in rural Southwestern Nigeria. We conducted a retrospective observational study on 250 T2DM using semi-structured interviewer administered questionnaire. Venous blood samples were collected and processed for glycated hemoglobin sugar estimation and malaria parasite detection by microscopy. Data were analyzed using SPSS version 20.0. Multivariate logistic regression identified the association of socio-demographics and asymptomatic malaria parasitaemia with poor control. The prevalence of poor glycemic control was 31.6% (95%CI: 34.4%-45.8%). Old age, (AOR=4.868; 95% CI: 1.258-24.574), female genders (AOR=7.100; 95% CI: 1.875-34.655), no formal education (AOR=3.447; 95% CI: 1.098-21.478), presence of malaria parasitaemia (AOR=48.423; 95% CI: 4.987-411.366), and higher parasite density (AOR=7.102; 95% CI: 1.785-15.002), were significantly associated with poor control. Health facilities should integrate screening of malaria parasitaemia into the management of T2DM patients while also exploring other barriers of poor control.

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Open Access
Preventive measures for obesity pandemic during COVID-19 quarantine; choosing the right diet

Until recently, obesity was one of the greatest public health issues. At the moment, the world is counting deaths from COVID-19, and raging obesity pandemic is not in the focus. While the quarantine is the mainstay of COVID-19 prevention, it also opposes obesity prevention. Obesity is a risk factor for severe COVID-19 infection. Treatment of obesity during quarantine is challenging; trying to lose weight without the opportunity for outdoor activity or access to fresh and healthy foods may lead to frustration, depression and overeating. Therefore, we propose that patients should focus on preventing new weight gain instead of losing weight. It can be achieved by practicing indoor physical exercise together with adequate diet. The diet should be opposite from, “Western diet pattern’’ and include foods easily obtainable during quarantine; with longer shelf life, but also rich in anti-inflammatory and immune-modulatory bioactive compounds. These characteristics of the diet make it simple to implement during quarantine, it helps in the process maintaing weight and supports immune system-all what is required to possibly reduce the risk of severe COVID-19 infection. The anti-inflammatory properties from given diet have beneficial role, especially in obese patients, as they have low grade chronic inflammation which additionally may worsen clinical course of COVID-19 infection.

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Is it ethical to use sensory marketing for food products: A perspective regarding sense of taste?

Marketing strategies often use some aspects of human nature balancing among ethics and profit. Sensory marketing is based on “embodied cognition” the concept that bodily sensations help to determine human decisions without conscious awareness. Consumers don’t perceive such messages as marketing and don’t react with the usual resistance. Taste is unique among other sensory systems in its instinctive association with mechanisms of reward and aversion, related to close contact with consumer. The background of obesity is in interaction of genetic, metabolic, behavioural and environmental factors: the rapidity with which obesity increases suggests that behavioural and environmental influences are accelerating the epidemic. Traditionally, “addiction” is applied to the abuse of drugs that activate the brain’s reward pathways. There is wider understanding of the term including so-called “behavioural addictions” including compulsive overeating phenomenon. Food addiction is described as loss of control, overconsumption and withdrawal symptoms experienced in relation to highly palatable foods. It is proposed that some foods have the potential for abuse in a manner similar to conventional drug. This article argues a concept of ethic in marketing when classifying obesity as an addiction. If so, sensory marketing targeting food is doing much more harm way than we thought.

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Open Access