Low Number Of People Research Articles

Social Functioning of People with HIV/ AIDS (PLWHA) Receiving Antiretroviral Therapy in the City of Bengkulu

The problem in the research is the low number of people with HIV/AIDS (PLWHA) who take antiretroviral drug therapy in Bengkulu City. This occurs because of shame and fear of being stigmatized and discriminated against if other people find out about their status, causing their social functioning to be disrupted (Social Dyscpunction). The purpose of the study was to determine the benefits of antiretroviral drug therapy for people with HIV/AIDS (ODHA) in Bengkulu City on their social functioning. The research uses applied research methods, this research approach uses qualitative research. The research informants were 8 people with HIV/AIDS (ODHA), determined by the snowball sampling technique because the group or person as an informant could not be identified. Data collection techniques include observation, in-depth interviews, and documentation. The results of the research show that there are many benefits for people with HIV/AIDS (PLWHA) who take antiretroviral drug therapy in terms of their social functioning. The physical condition is healthier because antiretroviral drug therapy makes the immune system of PLWHA stable so that the development of viruses can be prevented. Psychologically, people with HIV/AIDS (PLWHA) become better because the therapy process provides a lot of knowledge about HIV/AIDS, thus eliminating fear and worry about the disease they suffer from, ultimately making PLWHA more confident and able to socialize and be able to carry out their social roles or functions. Based on the results of the research, researchers recommend that PLWHA with new status should immediately undergo antiretroviral drug therapy. It is also necessary to carry out interventions to empower families to always provide support to PLWHA, and make efforts to prevent and treat depression problems so that PLWHA remains empowered.

Effects of Commercial Exergames and Conventional Exercises on Improving Executive Functions in Children and Adolescents: Meta-Analysis of Randomized Controlled Trials.

Exergames are promising exercise tools for improving health. To the best of our knowledge, no systematic review has compared the effects of commercial exergames and conventional exercises on improving executive functions (EFs) in children and adolescents. This study aimed to investigate the effects of commercial exergames and conventional exercises on improving EFs in children and adolescents. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 5 randomized controlled trial (RCT) databases (PubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus) were searched from their inception to July 7, 2022, to identify relevant RCTs. The Cochrane Collaboration tool was used to evaluate the risk of bias for each study. GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) was used to evaluate the overall quality of evidence. In total, 8 RCTs including 435 children and adolescents were included in the analysis. Commercial exergames had no significant benefit on overall EFs compared to conventional exercises (Hedges g=1.464, 95% CI -0.352 to 3.280; P=.06). For core EFs, there was no evidence to suggest that commercial exergames are more beneficial for improving cognitive flexibility (g=0.906, 95% CI -0.274 to 2.086; P=.13), inhibitory control (g=1.323, 95% CI -0.398 to 3.044; P=.13), or working memory (g=2.420, 95% CI -1.199 to 6.038; P=.19) than conventional exercises. We rated the evidence for overall EFs, cognitive flexibility, inhibitory control, and working memory as being of very low quality due to inconsistency (large heterogeneity) and imprecision (low number of people). Additionally, no effects of the intervention were observed in the acute and chronic groups. We do not have strong evidence to support the benefit of commercial exergaming on EFs because we did not observe a Hedges g close to 0 with tight CIs. Further research is needed to confirm this hypothesis. PROSPERO CRD42022324111; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=324111.

Human density impacts Nubian Flapshell turtle survival in Sub-Saharan Africa: Future conservation strategies

The Nubian Flapshell Turtle, Cyclanorbis elegans, is classified as one of the most threatened chelonian species globally (Critically Endangered according to the IUCN Red List). The species is presumed extinct in most of its historical distribution range, but still survives along the White Nile between South Sudan and northern Uganda. In this paper, we utilised the maximum entropy model (MaxEnt) to evaluate the habitat suitability of the species to explore its distribution decline by comparing historical and current presence data, as well as correlate the predicted past and present distribution with human population density. Our assumption is that overexploitation of the turtle occurs (and has occurred in the past) in sites with high human density. We show that: (1) a large number of historical sites where the turtle was present had high human population densities, whereas (2) the current distribution model showed low overlap between areas with high probability of turtle presence and high human population density. We suggest that Nubian flapshells are likely to have become extinct because of high human density (and therefore high overexploitation) and remnant populations have only survived along waterbodies with low numbers of people. However, the presence sites of this species in northern Uganda are under pressure by rapidly growing refugees'settlements. We also hypothesize that the range of the Nubian Flapshell may be shifting to the south (where the general environment is wetter and cooler) due to climate change affecting the distribution of this freshwater species. The conservation implications of these evidence are also presented.

The Relationship Between Empowerment and Social Support Among Pregnant Afghan Women: A Crosssectional Study in Kabul City, Afghanistan

Background and Purpose: Afghanistan experiences a significant maternal mortality rate, which could be mitigated through the empowerment of women and increased social support. This study aimed to explore the relationship between empowerment and social support among pregnant women seeking care at governmental hospitals in Kabul City, Afghanistan. Materials and Methods: A cross-sectional study was conducted in 4 governmental hospitals in Kabul, Afghanistan, in 2020. Through a convenient sampling, 428 pregnant women were recruited. The Kameda empowerment (Cronbach α=0.89) was used to measure woman empowerment. Sarason social support questionnaires with two subscales, including social support number (Cronbach α=0.95) and social support satisfaction (Cronbach α=0.96), were used to collect the study data. Then, the obtained data were analyzed using SPSS software, version 16, and the Pearson correlation test determined the association between variables at the significance level of P<0.05. Results: The study participants’ Mean±SD age was 26.55±5 years. Many were illiterate (28.3%), and more than half (79.7%) were homemakers. Almost two-thirds had no sources of income (71.3%). The Mean±SD gestational age was 32.16±5.04 weeks, and 77.6% of participants wanted their pregnancy. The Mean±SD score for empowerment from 428 research samples was 85.48±9.02, for social support number was 5.49±0.65 (which indicates the low number of people who support women), and for social support satisfaction was 1.5±0.43 (which indicates a low level of social support satisfaction). Empowerment had a positive significant relationship with social support satisfaction (r=0.157, P=0.01) and social support number (r=0.129, P=0.007). Conclusion: Given the significant positive relationship between empowerment and social support in pregnant Afghan women, the low scores of social support call for more attention to the special needs of Afghan women to enhance the social safety net and improve social support, particularly among pregnant women, and eventually enhance the empowerment and reduce the maternal mortality rate among them.

Is contributory health insurance indeed an addiction to a bad idea? A comment on its relevance for low- and middle-income countries

Financing of health systems is an enduring concern world wide. Yazbeck and colleagues in their paper make an important point that when there is a choice between financing in which contributions from citizens take place in the form of generalised taxes versus those in which they are in the form of insurance premiums, the overwhelming evidence suggests that tax-based financing is unambiguously superior even in low- and middle-income countries. Despite the strength of their case against contributory insurance, we suggest that the path forward may be more complex than they envisage for a number of reasons. The problem of a high proportion of informal sector workers that they argue impacts contributory approaches is also an issue with taxes because of the very low numbers of people who file returns. Taxes in most developing countries are in fact largely derived from highly regressive indirect taxes which the poor are forced to pay. Additionally, in most developing countries, including large ones like India and Nigeria, the only choice on offer is continued dependence on out-of-pocket expenditures. In such a situation exploring alternatives which are superior to out-of-pocket expenditures becomes imperative. Asking citizens to wait interminably for additional tax resources to be made available would be a grave disservice to them.

Bridging the Divide from Paleoecology to Neoecology

As paleoecologists we often claim that our science is relevant to conservation, but relatively few management plans are steered by paleoecological insights. One of our common justifications that paleoecology should feature in conservation is to determine what is ‘natural’. Intergenerational perceptions of naturalness are shaped by our experiences of ecosystems continuously and progressively influenced by human-induced stresses – the concept of shifting baselines. Those stresses have been present since the last ice-age in the tropical Andes, when fire regimes and megafaunal extinctions pre-dated the onset of the Holocene. Whereas human-induced ecological change is only evident for 200 years on the Galapagos Islands. But both instances are consistent that they show that low numbers of people, probably not even living in permanent settlements wrought lasting ecological changes and extinctions. Cascading effects of tortoise loss were seen on Galapagos vegetation that directly or indirectly led to extinctions among endemic plants. Making paleoecology relevant to conservation requires finding levels of taxonomic and temporal resolution that are relevant to land managers and providing concrete recommendations for restoration.

Antipsychotic prescriptions and neuropsychiatric symptoms (NPS) in nursing home (NH)residents with dementia: a comparison of pre‐ and during COVID pandemic.

AbstractBackgroundThe COVID‐19 pandemic has put tremendous pressures on nursing homes, but there is limited direct data evaluating the impact on residents or prescribing practicesMethodAs part of our clinical trial programme in nursing homes we have baseline data from 971 residents across 69 nursing homes collected in 2016/17 prior to the pandemic, and from 747 participants across 149 nursing homes from the baseline assessment of our COIVD WHELD RCT collected in 2021/22. In both studies the frequency if antipsychotic prescriptions was recorded and the Neuropsychiatric Inventory Nursing Home version was completed.ResultsThe average age of residents (84.5 v 85.1) and gender balance (71%F v 69% F) was similar in both cohorts. In the current study 64% of participating nursing homes had experienced a COVID‐19 outbreak. There were fewer people with severe dementia in the COVID WHELD Cohort (6.7% v 23%). Antipsychotic usage was 55% higher in the COVID WHELD cohort compared to the original WHELD cohort (28% v 18%), with 25% of nursing homes having prescription rates >40%, but the rates of neuropsychiatric symptoms were similar in the 2 studies. To ensure that the results were not confounded by the lower number of people with severe dementia in the COVID WHELD cohort, a further comparison was undertaken for people with moderate/moderately severe dementia, with very similar results. We undertook an additional analysis comparing nursing homes above and below prescription rates of 20% (the pre‐COVID level of prescribing). Nursing homes with increased antipsychotic prescribing had significantly higher levels of overall neuropsychiatric symptoms on the NPI (p = 0.02), and significantly higher levels of agitation (p = 0.02) compared to nursing homes with lower prescribing rates. There were also 31% more staff sick days in the higher prescribing nursing homes.ConclusionThere is a substantial increase in antipsychotic prescriptions in 50% of nursing homes since the onset of the COVID‐19 pandemic, associated in those nursing homes with an increase in neuropsychiatric symptoms. This will need to be a major focus as we begin to move forward from the pandemic.

Assessment of Perception of Treatment Adherence Among HIV Patients

Human Immunodeficiency Virus infection is surveyed a perplexing issue. It attributes to the transmissibility in addition to its chronicity. Objective: To assess the perception regarding treatment adherence among HIV patients in OPD in Jinnah Hospital, Lahore. Methods: A descriptive cross-sectional research study design was conducted among 137 patients at Jinnah Hospital, Lahore. The convenient sampling technique was used. The population that is targeted was only the patients of Jinnah Hospital, Lahore. Results: The overall result of this study shows that majority of the people have very poor perception about the treatment, and few people have good perception. Conclusions: The current study demonstrated that majority of the people had bad perception due to many reason that could be limited support from family, society, stigmatization and low self- esteem. Some people have moderate perception they were responding to the treatment but somehow faced rejection from society. It improved by changing their perception and motivating them. And very low number of people had good perception, they had the to restore their health by receiving the treatment and followed the physician advice

Resource Optimization Through Group Testing in the Detection of Asymptomatic People with COVID-19

Background: The current coronavirus disease 2019 (COVID-19) pandemic is a serious global public health problem. Detection and isolation of people infected with the virus is crucial to public health measures. Hitherto, the real-time PCR (RT-PCR) test is the most useful method for viral detection, although high cost of performance and low supplies have limited testing. New ways to optimize RT-PCR testing performance must be achieved since many million tests have been performed almost exclusively on individual basis. We present the results of a pooling method for testing to optimize resources.Methods: Groups of two to 27 people with no COVID-19 symptoms were tested by RT-PCR. Positive groups were re-analyzed individually, and positive groups were compared to obtain the maximum number of persons per group to achieve optimal resource utilization.Results: Groups of four to six people were found optimal for resources optimization, up to 67%. Groups with higher or lower number of people had results from 37% and 47% that implied higher economic expenses.Conclusion: Group testing of 4 to 6 persons for COVID-19 by RT-PCR are practical and optimize time and economical resources for detection of asymptomatic people infected by the virus.Funding: None to declare. Conflict of Interest: No conflict of interest of any kind.Ethical Approval: The protocol was approved by the research department of the General Hospital of Mexico Eduardo Liceaga of Mexico City (Approval number DI / 20/405103150).

Social Practice of the Restoration of Equal Opportunities in Lithuania: Personal Experience of Discrimination

The article deals with such empirical measures of the quality of democracy as the attitude of the Lithuanian population towards the implementation of the principle of equal opportunities, their preparedness to fight discrimination, and the social experience of the population in the restoration of violated rights. The social practice of restoring violated rights to equal opportunities and non-discrimination is examined in the context of microsociology, that is, at the level of individual cases. Discrimination on the basis of sexual orientation has been chosen for the analysis of individual experience and the examination of social practices for the restoration of violated rights, because, given the high prevalence of discrimination on the basis of sexual orientation and the very low number of people willing to defend their rights, it can be argued that this ground of discrimination plays a crucial role in identifying factors that encourage and/or limit people’s willingness to protect their rights. The paper presents a summary of the qualitative interviews conducted with those who have been discriminated on the basis of their sexual orientation and provides insights from experts with experience in dealing with such cases.

PENGARUH PENDIDIKAN KESEHATAN TENTANG VASEKTOMI TERHADAP PENGETAHUAN DAN MOTIVASI MENGGUNAKAN VASEKTOMI DI DUSUN JELOK DESA BEJI WONOSARI

Background: The number of people who got a vasectomy in Indonesia is still low. The lack of knowledge is one of the factors that cause the low number of people who get a vasectomy. In order to increase the number of people who get a vasectomy, a health education about vasectomy is needed. Objective: To determine the influence of health education about vasectomy on the knowledge about and motivation to get a vasectomy. Methods: This is a quasi- experiment research with a one group pretest posttest design, the research samples were selected using a total sampling technique, the instruments used for this research were questionnaires, and the data collected were analyzed using Wilcoxon’s test and paired t-test. This research was conducted in Jelok hamlet, Beji village, with 31 fertile males involved as respondents. Results: Respondents’ knowledge score before health education was given showed a mean of 9, and after health education, the mean was 1.94. Motivation to get a vasectomy before health education was given showed a median score of 24, after health education was given, the median score was 26. Data analysis on knowledge about vasectomy using a paired t-test showed a p-value of 0.000. An analysis on motivation using Wilcoxon’s test showed a p-value of 0.003. Conclusion: There was a significant influence of health education about vasectomy on the knowledge about and motivation to get a vasectomy.

P1946Hypertension prevalence, awareness, treatment and control and 10-year estimated CVD risk in East and West Africa: pooled analysis of data from 4 African countries

Abstract Background Though the prevalence of hypertension is rising in Sub-Saharan Africa, few studies have characterized the epidemiology and management of hypertension across many heterogeneous communities. We assessed prevalence, awareness, treatment and control of hypertension and estimated the 10-year cardiovascular risk across six sites in East and West Africa. Methods Between June and August 2018, we conducted household-based surveys in 6 rural, semi-urban and urban settings in Kenya, Nigeria, Tanzania and Uganda to enroll community-dwelling adults (aged >18 years) collect data including age, gender, smoking, anthropometric measures, health insurance, utilization of health care facilities. We defined hypertension as systolic blood pressure of at least 140 mm Hg, or diastolic blood pressure of at least 90 mm Hg, or self-reported antihypertensive medication use. We used country specific Globorisk prediction equations to estimate 10-year CVD risk. Results A total 3,150 participants with a mean age of 40 years (SD 15), 61% of whom were women, 8% had ever smoked, and 33% were overweight/obese. About 23.7% (95% CI 22.2, 25.2) of the entire sample had hypertension, of whom 60.6% (56.8, 64.3) were diagnosed. Among diagnosed, 61.7% (57.2, 66.1) were taking antihypertensives, and 27.7% (22.7, 33.1) had controlled BP. The prevalence of hypertension was 38.6% in Ikire-Nigeria, 25.1% Ukonga-Tanzania, 23.3% in Oyo-Nigeria, 21.6% in Okpok-Nigeria, 20.4% in Soroti-Uganda, and 9.7% in Viwandani-Kenya. The overall median estimated 10-yr CVD risk was low 4.6% IQR (2.3, 9.6) and 8.6% had 10-yr CVD risk >10%. (Figure 1) Conclusion Among African adults aged >18 years, nearly a quarter have hypertension, three in 5 being treated, and fewer than three in ten had BP under control. The low number of people in control is ubiquitous in all sites and warrants greater prevention strategies, better screening and more effective and affordable treatment options than what is currently available.

Clinical benefits of switching to insulin degludec irrespective of previous basal insulin therapy in people with Type 1 or Type 2 diabetes: evidence from a European, multicentre, retrospective, non-interventional study (EU-TREAT).

AimsTo investigate whether the benefits of switching to insulin degludec observed in the European retrospective chart review study EU‐TREAT were dependent on the previous basal insulin used.MethodsPeople with Type 1 or Type 2 diabetes were switched to insulin degludec from other basal insulins ≥6 months before data collection. Participants were stratified into three groups based on their previous basal insulin: insulin glargine 100 units/ml (Type 1: n=888; Type 2: n=259); insulin detemir (Type 1: n=726; Type 2: n=415); and neutral protamine Hagedorn (Type 1: n=53; Type 2: n=95). Their glycaemic control and hypoglycaemia incidence at 6 and 12 months post‐switch vs pre‐switch was then evaluated.ResultsSignificant HbA1c reductions were achieved in all previous basal insulin groups for participants with Type 1 diabetes [insulin glargine 100 units/ml: −2.08 mmol/mol (−0.19%); insulin detemir: −2.40 mmol/mol (−0.22%)] and those with Type 2 diabetes [insulin glargine 100 units/ml: −5.90 mmol/mol (–0.54%); insulin detemir: −6.01 mmol/mol (−0.55%); neutral protamine Hagedorn: −2.73 mmol/mol (−0.25%)] at 6 months, except for the relatively small neutral protamine Hagedorn group in those with Type 1 diabetes [−1.75 mmol/mol (−0.16%)], where statistical significance was not reached. At 6 months in the Type 1 diabetes group, switching to insulin degludec from insulin glargine 100 units/ml resulted in significantly lower hypoglycaemia rates across all hypoglycaemia categories; for the insulin detemir group, this significance was also observed for severe and nocturnal non‐severe hypoglycaemia, while the low number of people in the neutral protamine Hagedorn group resulted in nonsignificant reductions in hypoglycaemia rates. At 6 months in the people with Type 2 diabetes, switching to insulin degludec resulted in significantly lower rates of hypoglycaemia across all categories for all groups. Similar outcomes were observed at 12 months.ConclusionsSwitching to insulin degludec from other basal insulins can improve glycaemic control and/or reduce hypoglycaemia risk in people with diabetes (although there was a nonsignificant reduction in HbA1c and hypoglycaemia rates for the neutral protamine Hagedorn group in Type 1 diabetes) under routine care.

New data from Jebel Moya and Shaqadud (central Sudan): implications for Late Mesolithic interconnectivity with the Sahara

AbstractBuilding upon Brass’ previous research on Jebel Moya, which included a comprehensive reanalysis of the pottery from Wellcome's 1911–14 expeditions curated at the British Museum, new research activities by the University College London–University of Khartoum–NCAM Expedition to the Southern Gezira project have included locating and examining for the first time the Late Mesolithic sherds from Jebel Moya curated at the National Museum in Khartoum. Representative samples from the sites of Shaqadud Midden and Shaqadud S21 at the British Museum have also been re-examined. The aims of these activities were threefold: to test the reliability and cohesiveness of and patterning in the Shaqadud collection through the expanded application of attribute analysis, to determine if Caneva's observations of décor patterns on Jebel Moya's Late Mesolithic sherds could be replicated and to obtain better visibility into the nature of its pottery assemblage from this time, and to use the resulting data to test the viability of the central Sudan being a fulcrum of cultural interchanges during the late sixth and early fifth millennium BC. We conclude that there was a piecemeal establishment of networks along which there was diffusion of ideas and animals, and perhaps low numbers of people, into the central and south-central Sudan.

The Influence of Traffic, Area Location, and Other Factors on Operating Room Microbial Load.

OBJECTIVE To determine how the movement of patients, equipment, materials, staff, and door openings within the operating room (OR) affect microbial loads at various locations within the OR. DESIGN Observation and sampling study. SETTING Academic health center, public hospital. METHODS We first analyzed 27 videotaped procedures to determine the areas in the OR with high and low numbers of people in transit. We then placed air samplers and settle plates in representative locations during 21 procedures in 4 different ORs during 2 different seasons of the year to measure microbial load in colony-forming units (CFU). The temperature and humidity, number of door openings, physical movement, and the number of people in the OR were measured for each procedure. Statistical analysis was conducted using hierarchical regression. RESULTS The microbial load was affected by the time of year that the samples were taken. Both microbial load measured by the air samplers and by settle plates in 1 area of the OR was correlated with the physical movement of people in the same area but not with the number of door openings and the number of people in the OR. CONCLUSIONS Movement in the OR is correlated with the microbial load. Establishing operational guidelines or developing OR layouts that focus on minimizing movement by incorporating desirable internal storage points and workstations can potentially reduce microbial load, thereby potentially reducing surgical site infection risk. Infect Control Hosp Epidemiol 2018;39:391-397.

The Vulnerability of People to Damaging Hydrogeological Events in the Calabria Region (Southern Italy).

Background: Damaging Hydrogeological Events (DHEs) are severe weather periods during which floods, landslides, lightning, windstorms, hail or storm surges can harm people. Climate change is expected to increase the frequency/intensity of DHEs and, consequently, the potential harm to people. Method: We investigated the impacts of DHEs on people in Calabria (Italy) over 37 years (1980–2016). Data on 7288 people physically affected by DHEs were gathered from the systematic analysis of regional newspapers and collected in the database named PEOPLE. The damage was codified in three severity levels as follows: fatalities (people who were killed), injured (people who suffered physical harm) and involved (people who were present at the place where an accident occurred but survived and were not harmed). During the study period, we recorded 68 fatalities, 566 injured and 6654 people involved in the events. Results: Males were more frequently killed, injured and involved than females, and females who suffered fatalities were older than males who suffered fatalities, perhaps indicating that younger females tended to be more cautious than same-aged males, while older females showed an intrinsic greater vulnerability. Involved people were younger than injured people and fatalities, suggesting that younger people show greater promptness in reacting to dangerous situations. Floods caused the majority of the fatalities, injured and involved people, followed by landslides. Lightning was the most dangerous phenomenon, and it affected a relatively low number of people, killing 11.63% of them and causing injuries to 37.2%. Fatalities and injuries mainly occurred outdoors, largely along roads. In contrast, people indoors, essentially in public or private buildings, were more frequently involved without suffering harm. Being “dragged by water/mud” and “surrounded by water/mud”, respectively, represented the two extremes of dynamic dangerousness. The dragging effect of rapid-flowing water totally or partially obstructed the attempts of people to save their lives. In contrast, people surrounded by steady water/mud encountered difficulties but ultimately could survive. Conclusions: The study outcomes can be used in informational campaigns to increase risk awareness among both administrators and citizens and to improve community resilience, particularly in promoting self-protective behaviors and avoiding the underestimation of hazardous situations.

Prevalence, awareness, treatment, and control of hypertension in China: data from 1·7 million adults in a population-based screening study (China PEACE Million Persons Project)

Hypertension is common in China and its prevalence is rising, yet it remains inadequately controlled. Few studies have the capacity to characterise the epidemiology and management of hypertension across many heterogeneous subgroups. We did a study of the prevalence, awareness, treatment, and control of hypertension in China and assessed their variations across many subpopulations. We made use of data generated in the China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) Million Persons Project from Sept 15, 2014, to June 20, 2017, a population-based screening project that enrolled around 1·7 million community-dwelling adults aged 35-75 years from all 31 provinces in mainland China. In this population, we defined hypertension as systolic blood pressure of at least 140 mm Hg, or diastolic blood pressure of at least 90 mm Hg, or self-reported antihypertensive medication use in the previous 2 weeks. Hypertension awareness, treatment, and control were defined, respectively, among hypertensive adults as a self-reported diagnosis of hypertension, current use of antihypertensive medication, and blood pressure of less than 140/90 mm Hg. We assessed awareness, treatment, and control in 264 475 population subgroups-defined a priori by all possible combinations of 11 demographic and clinical factors (age [35-44, 45-54, 55-64, and 65-75 years], sex [men and women], geographical region [western, central, and eastern China], urbanity [urban vs rural], ethnic origin [Han and non-Han], occupation [farmer and non-farmer], annual household income [< ¥10 000, ¥10 000-50 000, and ≥¥50 000], education [primary school and below, middle school, high school, and college and above], previous cardiovascular events [yes or no], current smoker [yes or no], and diabetes [yes or no]), and their associations with individual and primary health-care site characteristics, using mixed models. The sample contained 1 738 886 participants with a mean age of 55·6 years (SD 9·7), 59·5% of whom were women. 44·7% (95% CI 44·6-44·8) of the sample had hypertension, of whom 44·7% (44·6-44·8) were aware of their diagnosis, 30·1% (30·0-30·2) were taking prescribed antihypertensive medications, and 7·2% (7·1-7·2) had achieved control. The age-standardised and sex-standardised rates of hypertension prevalence, awareness, treatment, and control were 37·2% (37·1-37·3), 36·0% (35·8-36·2), 22·9% (22·7-23·0), and 5·7% (5·6-5·7), respectively. The most commonly used medication class was calcium-channel blockers (55·2%, 55·0-55·4). Among individuals whose hypertension was treated but not controlled, 81·5% (81·3-81·6) were using only one medication. The proportion of participants who were aware of their hypertension and were receiving treatment varied significantly across subpopulations; lower likelihoods of awareness and treatment were associated with male sex, younger age, lower income, and an absence of previous cardiovascular events, diabetes, obesity, or alcohol use (all p<0·01). By contrast, control rate was universally low across all subgroups (<30·0%). Among Chinese adults aged 35-75 years, nearly half have hypertension, fewer than a third are being treated, and fewer than one in twelve are in control of their blood pressure. The low number of people in control is ubiquitous in all subgroups of the Chinese population and warrants broad-based, global strategy, such as greater efforts in prevention, as well as better screening and more effective and affordable treatment. Ministry of Finance and National Health and Family Planning Commission, China.

Embodying Trust in the Electoral System

This paper proposes a new method for distributing votes in democratic elections in such a way that allows for the public to put their trust in independent candidates or those from small political parties. Using the case of a party founded by the authors called The Pluralist Party the paper presents primary data to evaluate the effectiveness of the method – called delegated transferable voting (DTV). Using an auto-ethnographical empirical study in which one of the authors plays a significant role as anthropologist, the paper finds that DTV is more likely to lead to the election of independent candidates over party political ones. Pluralism advocates the election of those who are independent of political party whips in order to best represent the people. The election of independent candidates or small parties is a model of pluralism that can achieve this. The empirical study, through investigating the campaigning methods used by The Pluralist Party, shows that putting effort into an election – whether money, materials or labour and however funded – can improve outcomes for political parties. Making use of official government data in addition to the collected data showed that a higher number of votes for the Pluralist Party was associated with a higher education level, more rooms in a household, a lower number of people not in education, employment or training, and a lower ‘knol,' which is a unit for measuring brain activity.

Music as a site for Africanness and diaspora cultures: African musicians in the white landscape of Finland

ABSTRACTThis article looks at African musicians in Finland and the ways that they negotiate ideas of ‘Africanness’ in their professional activities. The specific environment of Finland with a relatively low number of people of African descent inevitably shapes the activities of these musicians. Our analysis, based on our many years of fieldwork among African diaspora communities, makes visible the multiplicity of sites where African music is played and performed in Finland, and the various contexts that influence the ways in which Africanness is articulated. In a predominantly white society, African musicians' roles extend from artists and ‘cultural ambassadors’ to active change agents in the fields of identity politics and anti-racism struggles.

Prevalence and risk factors of abdominal obesity in Polish rural children

Secular trends of body mass index (BMI) and waist circumference indicate greater increase in abdominal obesity compared to general obesity. Determinants of obesity described by BMI are relatively well documented in various populations, unlike abdominal obesity described by waist-to-height ratio (WHtR). The aim of the study was to determine prevalence and abdominal obesity (WHtR) risk factors in a cohort of 3048 rural children aged 7–12 years from southern Poland. Biological, socio-demographic and lifestyle factors were analysed, and odds ratio and 95% confidence interval were calculated using a logistic regression analysis. The prevalence of abdominal obesity in rural boys and girls in the sample was 11% and 9% respectively. Obesity in both parents, irregular breakfasts, irregular meals during the day and regularly consumed tea were significant factors of abdominal obesity risks in rural girls. Being the only child, low number of people in a household, obesity in both parents, high energy-dense food index and no exercise significantly increased the risk of abdominal obesity in rural boys. The study demonstrated tendencies similar to other European countries in the prevalence of abdominal obesity among sexes. Lifestyle behaviours should be changed and adapted to each sex since risk factors differ between the sexes and indicate higher eco-sensitivity in boys.