Prevention Of Non-communicable Diseases Research Articles

Understanding the complex systems of climate change and NCDs: A Causal Loop Diagram

Abstract Background WHO has identified climate change as one of the greatest health threats of the 21st century. At the same time, noncommunicable diseases (NCDs), including cardiovascular diseases, diabetes, chronic respiratory disease and cancer, are the leading cause of death globally and in the WHO European Region, are responsible for around 90% of deaths and 84% of years lived with disability each year. However, the complex relationships between climate change and NCDs are not well understood. Methods The aim of this research was to identify, discuss and map the linkages between factors and policy actions designed to prevent NCDs and address climate change. Objectives included to: discuss and clarify the pathways of how NCDs and climate change relate to each other and the co-benefits to addressing both using Group Model Building methods; to identify key multi-sectoral actors and priority actions for international collaboration and national responses to NCDs and climate change. We co-designed and created a Causal Loop Diagram (CLD) with local stakeholders, following the principles of Group Model Building. Results 29 participants were involved in the workshop included WHO staff and experts in NCD prevention and/or climate change and health and health emergencies. The CLD was meaningful to the stakeholders as a consensual and co-produced understanding of the problem, as well as forming the basis of a tool to explore the future impact on how sectoral and multi-sectoral public policies to address these complex challenges are shaped and implemented. Participants identified a range of priority actions that, in their view, could impact and help reshape the system and influence NCDs and climate change in Europe. Conclusions The CLD was reflective of the various stakeholders’ experience, knowledge, perceptions, and views about the factors, and the inter-relationships between these factors, by which climate change influences NCDs and NCD risk factors in Europe. Key messages • Climate change is one of the greatest threats of the 21st century. • Systems thinking approaches can help identify ‘win-win’ solutions to complex issues.

Food for thought: a look at the food industry’s corporate political activity in Portugal

Abstract Background Corporate political activity (CPA) stands for the strategies used by industries to attempt at influencing government policymaking in ways that are beneficial to the company. In the food industry context, these often collide with public health concerns, constituting a major barrier to noncommunicable diseases (NCDs) prevention efforts. This study aimed to characterise the CPA activity of the food industry in the Portuguese context. Methods The methodology conceptualised by Mialon et al. (2015) to identify and monitor the CPA activity of the food industry concerning public health was used in this study. Prominent food industry actors were selected, including processed food and non-alcoholic beverage manufacturers, fast food companies, and food retailers. To depict current practices, publicly available information from 2019 onwards was collected from the 7 selected food industry actors’ websites. A thematic qualitative analysis was performed by classifying the retrieved content according to the 6 CPA framework categories and subcategories. Results Collected data indicate that out of the 151 analysed written records, nearly half were information and messaging CPA strategies that mostly frame the debate on diet and public health-related issues. Constituency building through seeking community involvement was the second most represented category. Policy substitution was barely present, whereas financial incentive, legal, and opposition fragmentation and destabilisation strategies were not identified. Most of the coded content was retrieved from McDonald's and the Dairy Industry National Association websites. Conclusions Recognising the CPA strategies used by the food industry will enable more targeted and informed decisions at the public health intervention and policy levels. Notably, more attention should be paid to the way the food industry frames the diet and public health debate to avoid misinformation among consumers. Key messages • Addressing the global burden of noncommunicable diseases implies recognising corporate political activity strategies used by the food industry that counteract NCDs prevention efforts. • The way the food industry frames the diet and public health debate should be of concern to public health professionals and policymakers to prevent misinformation among consumers.

The burden of breast cancer attributable to modifiable risk factors

Abstract Introduction Breast cancer (BC) is a preventable non-communicable disease and the most common cancer among women of reproductive age. Although largely associated with non-modifiable risk factors, the prevention of modifiable risk factors for BC (smoking, alcohol use, physical inactivity, and dietary risks) can help decrease society's burden. The aim of this study was to examine the BC burden among women of reproductive age attributable to these risk factors in the ten leading countries in the World Health Organization (WHO) European region, in order to describe the potential burden which can be avoided. Methods Within the EU CA 18218, we analyzed Disability-Adjusted Life-Years (DALY) rates of BC per 100,000 among women aged 15-49 years attributable to the four modifiable risk factors: smoking, alcohol use, physical inactivity and dietary risks. Estimates were taken from the Global Burden of Disease Study 2019, for ten countries with the highest DALY rates of BC in WHO European region in 2019: Monaco, Georgia, Bulgaria, Montenegro, Ukraine, North Macedonia, Armenia, Serbia, Greece and Romania. Results The highest DALY rate for BC was in Monaco (758.37) and Georgia (708.99). The highest DALY rate attributable to the four modifiable risk factors combined was in Monaco (178.89) and Bulgaria (171.68). The highest attributable DALY rate to smoking was in Bulgaria (49.04), and Monaco (44.67). The highest attributable DALY rate to alcohol use was in Ukraine (87.24) and Bulgaria (83.25). The highest attributable DALY rate to physical inactivity was in Monaco (9.88), followed by Bulgaria (3.49), as was the DALY rate attributable to dietary risks (48.51, and 35.90, respectively). Conclusions The variable burden of BC attributable to the modifiable risk factors between the examined countries calls for strengthening regional activities. The proportion of BC burden attributable to these risk factors is non-negligible, given its impact on the total burden of the disease. Key messages • A combination of four modifiable risk factors significantly contributes to the burden of breast cancer. • Regional collaboration on risk factors is needed to prevent the burden of breast cancer.

Willingness for Medical Screening in a Dental Setting-A Pilot Questionnaire Study.

An important way to manage noncommunicable diseases (NCDs) is to focus on prevention, early detection, and reducing associated risk factors. Risk factors can be detected with simple general health checks, which can also be performed in dental clinics. The purpose of this study was to investigate participants' willingness to participate in general health checks at the dentist, in particular the difference in opinion between medical patients and random healthy dental attendees. A total of 100 medical patients from an outpatient internal medicine clinic and 100 dental clinic attendees were included (total of 200 participants). The participants were asked for their opinion using six closed-ended questions. Overall, 91.0% of participants were receptive to information about the risk of diabetes mellitus (DM) and cardiovascular diseases (CVD). The majority (80-90%) was receptive to screening for DM and CVD risk, such as weight and height measurements, blood pressure measurement, saliva testing for CVD and to measure glucose and cholesterol via finger stick. No significant differences were found in the frequencies of the responses between the different groups based on health status, age, sex, or cultural background. This study shows that most participants are willing to undergo medical screening at the dentist for early detection and/or prevention of common NCDs.

15 years of Gaining Health strategy in Italy: what's new about behavioral risk factors?

Abstract In Europe chronic non-communicable diseases (NCDs) are responsible for the majority of deaths, premature deaths and disabilities. Actions to fight against smoking, excessive alcohol consumption, sedentary behaviours and obesity are central for the prevention of NCDs. In Italy in 2007 the National Program Gaining Health (GH) was launched and the behavioral risk factor surveillance system (including PASSI and PASSI d’Argento) was promoted. This study has the aim to contribute to assess the impact of the strategies implemented with GH, analyzing over time data on behavioral risk factors in Italy since 2008. Data from PASSI 2008-2021 (468.000 interviews of 18-69 years old people) and PASSI d’Argento 2016-2021 (74.000 interviews of over 65 years old people). i) time series models on smoking, alcohol, sedentary behaviours and obesity data in adults, stratified by gender, age, residence and social determinants; ii) Regression models to evaluate the changes in associations over time between behavioral and social determinants. Smokers’ prevalence dropped from 30% to 24%, not equally in population groups. Excessive consumption of alcohol is stable since 2010 (∼16%); although, it is the result of opposite trends in the different components of the indicator (binge, between meals and usually high) and of improvements in some groups and worsening in others: it increases in the North but not in the Center-South, it is reduced in men but increased among women; it remains stable among young people aged 18-24 (∼27%). Sedentariness is increasing everywhere (31% in 2021), especially in the South (43%) and among the youngest. Obesity also increased in the South and in the North; today about one out of 10 is obese. Social inequalities continue and worse in affecting these phenomena. These data show no improvement in the last 15 years. Prevention Plan is an opportunity to change course. Surveillance is strategic, as long as it is used to guide policies and to monitor their effectiveness over time. Key messages • Data on behavioral risk factors show no improvement in Italy since 2008. • Surveillance is strategic to guide health policies and to monitor their effectiveness over time.

Health of people with selected citizenships in Germany: results from the interview survey GEDA Fokus

Abstract Background Health chances and risks of people with a history of migration vary according to a wide range of social, migration-related as well as structural factors. Aim of this contribution is to describe the health of people with selected citizenships living in Germany on the basis of various health indicators from the field of non-communicable diseases and to identify relevant determinants of the respective outcomes. Methods Analyses are based on data from the multilingual and multimodal interview survey GEDA Fokus, which was conducted from 11/21 until 05/22 among 18- to 79-year-old people with Croatian, Italian, Polish, Syrian or Turkish citizenship living in Germany. Poisson regressions were used to calculate prevalence ratios and 95% confidence intervals to examine the association between the individual indicators (chronic diseases or long-term health problems, coronary heart disease, diabetes mellitus and depression) and various social as well as migration-related characteristics. Results In particular, older age, low income, a longer duration of stay, a low sense of belonging to society in Germany and self-reported experiences of discrimination in everyday life are associated with higher prevalence of all the health outcomes. Conclusions Given the importance of subjective sense of belonging to the society in Germany and self-reported experiences of discrimination for the health outcomes studied, the results point to health inequalities among people of selected citizenships that are partly caused by mechanisms of social exclusion. Key messages • Low income, self-reported experiences of discrimination in everyday life and a lower sense of belonging to society in Germany are associated with increased prevalence of non-communicable diseases. • Social and structural exclusion mechanisms must be sustainably dismantled in order to ensure health equity.

How can public health agencies support the adoption of a population health management approach in PHC? The case of SVN

Abstract Slovenia has a longstanding tradition of providing accessible and comprehensive PHC services. Established in 1927, Slovenian PHC strongly emphasizes addressing health equity and reaching out to vulnerable populations in local communities to identify environmental, social and behaviour-related risk factors and diagnose disease in its early stage of development. Through a cross-sectoral cooperation based on a community based approach and a strong collaboration of public health and primary care services, Slovenia has improved health and reduced health inequality over the last decades. Registered nurses in family medicine teams conduct regular screening and follow-up for people with noncommunicable diseases to reduce family doctors’ growing burden and workload. Each family medicine practice has a list of registered patients (a capitation list), managed in defined groups of healthy individuals; those with risk factors; and those with the most common chronic diseases. Financial incentives are given for meeting target values in screening check-ups. The National Public Health Institute manages and leads the noncommunicable disease prevention and control programme at the national level.

Prevalence and Predictors of Hypertension among Army Personnel in Adekunle Fajuyi Military Cantonment, Ibadan, Nigeria

Background: Hypertension is one of the most prevalent non-communicable diseases globally. Hospital records show that it is a common reason for out-patient visits and admissions. This study was conducted to determine the prevalence and predictors of hypertension among Army personnel in Adekunle Fajuyi Cantonment, Ibadan, Nigeria. Methods and materials: This descriptive cross-sectional study was conducted among 400 officers and soldiers selected through a stratified random sampling method. Interviewer-administered questionnaire was used to collect data. Measurement of blood pressure, height and weight was done using standardized instruments and methods; urinalysis was done with Uristix. Hypertension was defined as systolic BP≥140 mmHg, diastolic BP≥90 mmHg or being currently on antihypertensive drugs. Data was analyzed with SPSS version 20. Chi-square test and logistic regression were used to test associations with level of significance set at ≤0.05.

Factors perceived by health professionals to be barriers or facilitators to caries prevention in children: a systematic review

BackgroundConsidered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight prevention as a major strategy for caries management in children, health professionals still struggle to implement prevention into their clinical practice. Further research is needed to understand the gap between the theoretical significance of dental prevention and its lack of implementation in the clinical setting. This systematic review aims to identify and classify factors perceived by health professionals to be barriers or facilitators to caries prevention in children.MethodA systematic literature search was conducted in three electronic databases (Medline, Web of Science and Cairn). Two researchers independently screened titles, abstracts and texts. To be selected, studies had to focus on barriers or facilitators to caries prevention in children and include health professionals as study participants. Qualitative and quantitative studies were selected. The factors influencing caries prevention in children were sorted into 3 main categories (clinician-related factors, patient-related factors, and organizational-related factors) and then classified according to the 14 domains of the theoretical domains framework (TDF).ResultsA total of 1771 references were found by combining manual and database searches. Among them, 26 studies met the inclusion criteria, of which half were qualitative and half were quantitative studies. Dentists (n = 12), pediatricians (n = 11), nurses (n = 9), and physicians (n = 5) were the most frequently interviewed health professionals in our analysis. Barriers and facilitators to caries prevention in children were categorized into 12 TDF domains. The most frequently reported domains were Environmental Context and Resources, Knowledge and Professional Role and Identity.ConclusionThis systematic review found that a wide range of factors influence caries prevention in children. Our analysis showed that barriers to pediatric oral health promotion affect all stages of the health care system. By highlighting the incompatibility between the health care system’s organization and the implementation of caries prevention, this study aims to help researchers and policy-makers design new interventions to improve children’s access to caries prevention.Trial registrationPROSPERO CRD42022304545.

Management of chronic conditions in resource limited settings: multi stakeholders’ perception and experiences with receiving and providing integrated HIV, diabetes and hypertension services in Tanzania

BackgroundThe rising prevalence of non-communicable diseases (NCDs) alongside the continuing high burden of HIV poses a serious challenge to middle- and low-income countries’ healthcare systems. Pilot studies of integrated models of service delivery for HIV, hypertension and diabetes have demonstrated that they are feasible and acceptable among patients and care providers. This study assessed multi-stakeholders’ perspectives of the delivery and receipt of integrated care in Tanzania.MethodsA qualitative process evaluation was conducted in Dar es Salaam region of Tanzania where the integrated service delivery model was implemented from July to November 2021. In-depth interviews were held with seven key informants at the national, regional and district levels, eight healthcare providers, two researchers working at the integrated clinic and forty patients benefiting from integrated services at a large hospital. Three focus group discussions were held with community leaders and residents of the hospital’s catchment area, and clinic level observations were conducted. Thematic analysis was conducted followed by the use of Bronfenbrenner’s ecological model to identify factors pertinent to sustaining and scaling up of the integrated model.ResultsParticipants of the study at all levels were aware of the increased prevalence of NCDs specifically for hypertension and diabetes and were concerned about the trend of increasing co-morbid conditions among people living with HIV (PLHIV). The integrated service delivery model was positively perceived by stakeholders because of its multiple benefits for both patients and the healthcare system. These include stigma and discrimination reduction, improved quality of care, efficient use of limited resources, cost and time saving, reduced duplication of services and fostering of early detection for undiagnosed conditions. The organisation of the clinic was critical in increased satisfaction. Several challenges were observed, which included costs for NCD services relative to free care for HIV and inconsistent availability of NCD medications.ConclusionStakeholders reported numerous benefits of the integrated service delivery model that are fundamental in improving the health of many Tanzanians living with NCDs and HIV. These benefits highlight the need for policy and decision-makers to sustain and expand the integrated service delivery model as a solution to many challenges facing the health system especially at the primary care level.

Pengaruh pemberian media poster kesehatan terhadap minat remaja mengikuti posbindu PTM

Non-communicable diseases (NCD) are still a health problem in Indonesia in recent years. Non-communicable diseases often go undetected because no symptoms are found, so they are difficult to cure or will end in disability or death. There has been an epidemiological transition by shifting morbidity and mortality rates from infectious diseases to non-communicable diseases at a young age. The Indonesian government has created a program to overcome the problem of NCDs with the existence of NCDs Posbindu aimed at people over 15 years old who are still healthy and people with NCDs. There is a need to provide information using poster media regarding NCDs and NCDs Posbindu problems in adolescent understanding to prevent and control NCDs now and in the future. This study aims to determine the effect of giving poster media on teenagers' interest in participating in Posbindu at Ambarawa 1 High School. The results of the analysis showed that there was an influence of poster media on teenagers' involve in participating in NCDs Posbindu (p:0,001). The results showed a decrease in the average interest of adolescents in participating in the NCDs Posbindu by 3.15. This happened because adolescents objected to the implementation of the NCDs Posbindu, which was held one a month. Adolescents need to know that participating in Posbindu is an effort to prevent and control NCDs in the future. The data can be provided through cooperation between schools and community health centers that can involve existing extracurriculars and provide a better understanding of the importance of NCDs prevention and control efforts to adolescents, teachers and parents.

Section of the Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ) "New generation specialists"

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Risk assessment of obesity-related noncommunicable diseases through body mass index trajectories in adulthood: NHANES 2007-2018.

To assess the impact of adult body mass index (BMI)trajectories on the risk of obesity-related noncommunicable diseases (NCDs) in the U.S. adults after adjustment for sociodemographic and lifestyle factors. Data were extracted from the National Health and Nutrition Examination Survey conducted from 2007 to 2018, including male and female participants aged 29-59 years. Rao-Scott adjusted chi-square was employed to detect associations between categorical variables in descriptive analyses. Cox proportional hazards models estimated hazard ratios (HR) and 95% confidence intervals (CI) for NCDs and BMI trajectories, adjusted for sociodemographic and lifestyle factors. Kaplan-Meier curves illustrated the cumulative incidence over time. Analyses were carried out on 15 721 participants and revealing significant differences among BMI trajectories in terms of demographic, lifestyle, and health characteristics. The overall prevalence of NCDs was 28.0% (95%CI:26.6-28.9). The cumulative incidence over time was higher in the high increase, moderate increase, and mixed trajectory groups, with a correspondingly higher cumulative risk (p < 0.001). Non-overweight trajectory was considered reference category in Cox models. The BMI trajectories were independently associated with an increased risk of NCDs, even after adjusting for potential confounders (HR: 1.7; 95%CI: 1.4-1.9 for moderate increase; HR: 3.6; 95%CI: 3.2-4.1 for high increase; and HR: 2.4; 95%CI: 2.1-2.7, for mixed). Furthermore, differences between males and females were also observed. The transition to and persistence of obesity into adulthood increases the risk of NCDs. The implementation of targeted interventions with long-term monitoring of BMI may be beneficial in the prevention of future obesity-related NCDs.

Sahel terrorist crisis and development priorities: case of financial allocations for the control of non-communicable diseases in Burkina Faso.

In Africa, nearly 46% of all mortality will be attributed to non-communicable diseases (NCDs) by 2030. While the cost of inaction far exceeds the cost of action against NCDs, global funding for the prevention and control of NCDs is minimal. The objective of this was to explore the Ministry of Health budget allocations for NCDs from 2010 to 2020 as well as the effect of the terrorism crisis on these allocations. The methodology was based on the budget tracking tool developed by the Scaling Up Nutrition Movement. Twenty-nine budget lines related to the prevention and/or control of NCDs have been identified. About 29.9 million USD were allocated to the fight against NCDs with an absorption rate of more than 98%.There is an upward trend of allocated budget characterized by an exponential increase from the development of the national integrated strategic plan for the fight against NCDs (2016-2020). In 2017, an increase of 184% compared to 2016 was observed. However, the efforts were challenged by the emergence of the terrorist threat which triggered in January 2016, leading to a drastic reduction in allocations for NCDs in favor likely of defense and security priorities as well as addressing the needs of internally displaced persons. A trend analysis suggests that the NCDs budget significantly decrease as the country global terrorist index increase. Further analysis is needed to better understand the implication on NCD incidence, and identify advocacy opportunities for mitigating the negative impact of the terrorist treat on NCDs and other development issues.

Environmental allergen reduction in asthma management: an overview.

Asthma is a prevalent non-communicable disease that affects both children and adults. Many patients with severe, uncontrolled asthma could not achieve total control despite using anti-asthmatic drugs. There is increasing evidence that allergy to environmental allergens, including both indoor and outdoor allergens, is associated with asthma symptoms and severe asthma. Frequently reported sensitized allergens were dust mites, cockroaches, grass pollens, molds, pets, and rodents in allergic asthma patients, although the patterns of widespread allergens differed from each country. Allergen avoidance is the cornerstone of asthma management, especially in sensitized subjects. This review summarizes environmental allergen avoidance and clarifies their effects on asthma control. Despite contrasting results about the impact of allergen exposure reduction on asthma control, several studies supported the beneficial effects of reducing asthma-related symptoms or risk of exacerbations as a nondrug therapy. Identifying environmental allergens is helpful for asthma patients, and further studies on clinically effective avoidance methods are required.

The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Non-communicable diseases (NCDs) are increasing among people living with HIV (PLHIV), especially in Sub-Saharan Africa (SSA). We determined the prevalence of NCDs and NCD risk factors among PLHIV in SSA to inform health policy makers. We conducted a systematic review and meta-analysis on the prevalence of NCDs and risk factors among PLHIV in SSA. We comprehensively searched PubMed/MEDLINE, Scopus, and EBSCOhost (CINAHL) electronic databases for sources published from 2010 to July 2023. We applied the random effects meta-analysis model to pool the results using STATA. The systematic review protocol was registered on PROSPERO (registration number: CRD42021258769). We included 188 studies from 21 countries in this meta-analysis. Our findings indicate pooled prevalence estimates for hypertension (20.1% [95% CI:17.5-22.7]), depression (30.4% [25.3-35.4]), diabetes (5.4% [4.4-6.4]), cervical cancer (1.5% [0.1-2.9]), chronic respiratory diseases (7.1% [4.0-10.3]), overweight/obesity (32.2% [29.7-34.7]), hypercholesterolemia (21.3% [16.6-26.0]), metabolic syndrome (23.9% [19.5-28.7]), alcohol consumption (21.3% [17.9-24.6]), and smoking (6.4% [5.2-7.7]). People living with HIV have a high prevalence of NCDs and their risk factors including hypertension, depression, overweight/obesity, hypercholesterolemia, metabolic syndrome and alcohol consumption. We recommend strengthening of health systems to allow for improved integration of NCDs and HIV services in public health facilities in SSA. NCD risk factors such as obesity, hypercholesterolemia, and alcohol consumption can be addressed through health promotion campaigns. There is a need for further research on the burden of NCDs among PLHIV in most of SSA. This study did not receive any funding.

Adoption of Electronic Medical Records for Chronic Disease Care in Kenyan Refugee Camps: Quantitative and Qualitative Prospective Evaluation.

Noncommunicable disease (NCD) prevention and control in humanitarian emergencies is a well-recognized need, but there is little evidence to guide responses, leading to varying care delivery. The Sana.NCD mobile health (mHealth) app, initially developed in Lebanon, is the only known mHealth tool for NCD management designed to increase care quality and coverage for providers in humanitarian settings. We evaluated a specialized mHealth app consisting of an abbreviated medical record for patients with hypertension or diabetes, adapted for a Kenyan refugee camp setting. We tested an adapted version of the Sana.NCD app (diabetes and hypertension medical record) in an 11-month (May 2021 to March 2022) quantitative and qualitative prospective evaluation in Kenya's Hagadera refugee camp. Leveraging the rollout of a general electronic medical record (EMR) system in the Kakuma refugee camp, we compared a specialized NCD management app to a general EMR. We analyzed secondary data collected from the Sana.NCD app for 1539 patients, EMR data for 68 patients with NCD from Kakuma's surgical and outpatient departments, and key informant interviews that focused on Hagadera clinic staff perceptions of the Sana.NCD app. The Hagadera NCD clinic reported 18,801 consultations, 42.1% (n=7918) of which were reported in the NCD app. The Kakuma EMR reported 350,776 visits, of which 9385 (2.7%) were for NCDs (n=4264, 1.2% hypertension; n=2415, 0.7% diabetes). The completeness of reporting was used as a quality-of-care metric. Age, sex, prescribed medicines, random blood sugar, and smoking status were consistently reported in both the NCD app (>98%) and EMR (100%), whereas comorbidities, complications, hemoglobin A1c, and diet were rarely reported in either platform (≤7% NCD app; 0% EMR). The number of visits, BMI, physical activity, and next visit were frequently reported in the NCD app (≥99%) but not in the EMR (≤15%). In the NCD app, the completeness of reporting was high across the implementation period, with little meaningful change. Although not significantly changed during the study, elevated blood sugar (P=.82) and blood pressure (P=.12) were reported for sizable proportions of patients in the first (302/481, 62.8%, and 599/1094, 54.8%, respectively) and last (374/602, 62.1%, and 720/1395, 51.6%, respectively) study quarters. Providers were satisfied with the app, as it standardized patient information and made consultations easier. Providers also indicated that access to historic patient information was easier, benefiting NCD control and follow-up. A specialized record for NCDs outperformed a more general record intended for use in all patients in terms of reporting completeness. This CommCare-based NCD app can easily be rolled out in similar humanitarian settings with minimal adaptation. However, the adaptation of technologies to the local context and use case is critical for uptake and ensuring that workflows and time burden do not outweigh the benefits of EMRs.

Effect of dihydroquercetin on oxidative metabolism in young athletes engaged in winter sports in a northern region

AIM: To study the effect of dihydroquercetin on the indicators of oxidative metabolism in young athletes engaged in the winter sports in the Khanty-Mansiysk Autonomous Okrug (KhMAO).&#x0D; MATERIAL AND METHODS: The indicators of oxidative metabolism were studied in a group of 56 male students (mean age 19.300.51 years) from the Khanty-Mansiysk boarding school of the Olympic reserve. These students were actively involved in winter sports such as cross-country skiing and biathlon. To assess the impact of the plant-derived antioxidant bioflavonoid Baikal dihydroquercetin (DHQ), the participants were administered a daily dose of 120 mg of DHQ for a period of 60 days. Measurements were taken before and after the exposure. Blood lipid peroxidation (LPO) products were studied, namely, lipid hydroperoxides (LHP) and products that react with 2-thiobarbituric acid products (PR-TBA). Additionally, we examined the indicators of the body's antioxidant defense system (ADS) through the assessment of total antioxidant activity (TAA) and thiol status (TS). To quantify the overall oxidative stress experienced by the participants, we calculated the oxidative stress coefficient (OSC) using the formula: OSC = LHP PR-TBA / TAA TS.&#x0D; RESULTS: The average levels of LPO values (HPL and PR-TBA) among KhMAO athletes have surpassed the upper limit of optimal values. On the other hand, the ADS parameters (TAA and TS) fall within the range of physiologically optimal values, albeit closer to the lower limit. Notably, athletes have exhibited an OSC increase that is nearly 3.5 times higher than the maximum allowable value. A quarter of the individuals examined displayed elevated HPL values, while more than 30% showed increased PR-TBA levels. A third of male athletes exhibited reduced ADS values compared to the physiologically optimal range. In total, 70.4% of skiers and biathletes in KhMAO have exceeded the OSC parameters. After two months of daily intake of 120 mg DHQ, the normalization of indicators of oxidative metabolism was observed. All parameters aligned with physiologically optimal values, except for OSC. We found a decrease in primary (LHP, 1.15 times) and secondary (PR-TBA, p=0.046) LPO indicators parallel to a significant increase in ADS indicators, specifically TAA (p=0.022) and TS (p=0.049). Conversely, there was a significant increase in ADS indicators, specifically TAA (p=0.022) and TS (p=0.049).&#x0D; Despite these positive changes, the OSC value, although significantly reduced (p 0.001) by 2.3 times compared to the initial value, remained above the upper limit of the physiological norm.&#x0D; CONCLUSION: The study demonstrated that young athletes engaged in winter sports experienced improved indicators of oxidative metabolism after a consistent two-month intake of the potent antioxidant DHQ. This led to the restoration of a balanced prooxidant-antioxidant state, enhanced overall well-being, and expedited recovery following intense physical exertion. Furthermore, our results may suggest that DHQ may contribute to prevention of non-communicable diseases in the future.

Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review.

In this review, we aim to highlight the evidence base for the benefits of exercise in relation to the treatment of noncommunicable diseases (NCDs), draw on the Health Triangular Policy Framework to outline the principal facilitators and barriers for implementing exercise in health policy, and make concrete suggestions for action. Literature review and framework analysis were conducted to deal with the research questions. Exercise prescription is a safe solution for noncommunicable diseases prevention and treatment that enables physicians to provide and instruct patients how to apply exercise as an important aspect of disease treatment and management. Combining exercise prescription within routine care, in inpatient and outpatient settings, will improve patients' life quality and fitness levels. Inserting exercise prescription into the healthcare system would improve population health status and healthy lifestyles. The suggestions outlined in this study need combined efforts from the medical profession, governments, and policymakers to facilitate practice into reality in the healthcare arena.

Prevalence of self-reported noncommunicable diseases in grassroot-level health worker of Petlad taluka: A cross-sectional study

ABSTRACT Context: Noncommunicable diseases (NCDs) kill 41 million people each year globally. The financial burden of NCDs, including lifelong and expensive treatment with loss of income, forces many people into poverty. Healthcare workers (HCWs) are an essential group of the workforce in building a healthier society. They must choose a healthy lifestyle to have better health for themselves. Aim: To estimate the prevalence of self-reported NCDs in grassroot-level HCWs of Petlad taluka along with the study of various healthcare and lifestyle practices among them Methods and Material: In this cross-sectional study, grassroot-level HCWs of Petlad taluka of Anand district were given a self-administered questionnaire, which included their demographic details, their current health status, and health practices followed by them Statistical Analysis: The data collected were entered in Microsoft Excel-2019 and analysed by SPSS version 15. Descriptive analysis and univariate analysis were performed. Results: NCDs’ prevalence was 10.2%. Hypertension and diabetes were the commonest. Nearly 50% HCWs have their body mass index in a normal range. The majority of them were aware of healthy diet practices and exercise. Conclusions: Our study reported a lower prevalence of NCDs than other studies (50%). Dietary practices appear to be healthy, but a significant proportion of them are overweight. The majority of them prefer to consult at a government hospital. Healthy behaviour and practices should be encouraged and maintained in HCWs.