Prevention Of Premature Death Research Articles

Prevalence of tobacco smoking among dental practitioners: A hospital-based study.

ABSTRACTBackground:Consumption of tobacco is a prevalent public health problem in Saudi Arabia and worldwide. It remains one of the world’s leading causes of preventable premature death and a public health concern. We aim to Estimation the prevalence of tobacco smoking among dental practitioners working at the Security Forces Hospital in Riyadh, Saudi Arabia.Methods:A cross-sectional study was conducted in one of the largest government hospitals in Riyadh using a self-administered questionnaire. The study targeted dental practitioners including; oral and maxillofacial surgeons, orthodontists, periodontists, prosthodontists, endodontists, pediatric dentists, restorative dentists, general dentists, dental hygienists, dental assistants, and dental lab technicians. The study data were analyzed using the SPSS statistical software package.Results:Overall, 74 dental practitioners completed the study questionnaire; 54.1% were females. The age of study participants ranged between 24 to 56 years, while their mean age was 33.84 years. The prevalence of current smokers among the respondents in was 25.67%. Of the participants, 9.45% were ex-smokers. Stress relief was the main reason for smoking (52.6%), followed by relaxation (31.6%). Most respondents agreed that dental practitioners should serve as role models (73%), and that health care practitioners should give advice or information about smoking cessation to patients (79.7%). Most participants had insufficient training about tobacco hazards (56.8%).Conclusion:The prevalence of tobacco smoking among dental practitioners included in this study was closer to that in previous studies. Furthermore, study participants lacked sufficient training about tobacco hazards and control.

Cognizance towards implementation and adherence of Cigarette and other Tobacco Products Act (COTPA) directives - A descriptive cross-sectional study among security guards in Goa.

ABSTRACTObjective:The use of tobacco has proven to be one of the leading cause of preventable premature deaths and diseases across the globe. The World Health Organization (WHO) claims that tobacco consumption alone kills more people annually as compared to Acquired Immunodeficiency Syndrome (AIDS), alcohol, and other addictions (drugs, etc.) put together. Although the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law to curb the tobacco epidemic, the effectiveness of its implementation remains disputed. The current study aims to examine the role of the security guards in the implementation of the COTPA by assessing their awarenessMethod:A cross-sectional questionnaire-based study was conducted among 258 security guards in Goa to ascertain the knowledge regarding the tobacco legislation in the country. A self-administered 20-item close-ended questionnaire was used to collect information regarding the demographic variables, tobacco use, and knowledge regarding COTPA. Data analysis was done using SPSS version 22.0Results:The mean age of the study participants was 29.93 ± 6.93 years. Overall, 68.6% of the study participants were aware of any tobacco control law in India. It was observed that 71% of the subjects had adequate knowledge of the COTPA. The participants with higher secondary educational levels had significantly higher knowledge scoresConclusion:The overall awareness of the security guard was good but there is a need to provide in-depth knowledge on certain key aspects of the COTPA. Efforts should be made to train the security personnel to increase their awareness of the act.

Acute and subchronic oral toxicity assessments of BTL tea in experimental animals

Tobacco smoking remains a leading cause of preventable diseases and premature death in many countries. Many smokers want to quit smoking but are not offered the highly effective treatments available to manage tobacco dependency. There has been a current trend for researchers to find new natural ingredients that were safe and still effective in treating tobacco dependence. BTL tea was a herbal-derived product prepared from Herba Menthae, Pogos cablin (Blanco) Benth., Zingiber Officinale Rosc., Flos Chrysanthemi, Radix Glycyrrhizae, Pericarpium Citri deliciosa, and Flos Lonicera. At this time, the safety of this product has not been reported. Thus, this study aimed to evaluate BTL tea’s acute and subchronic toxicity through oral administration in experimental animals. The acute toxicity was determined by Litchfield-Wilcoxon method in mice at the doses of 45.0 g/kg b.w/day to 112.5 g/kg b.w/day. The subchronic toxicity was evaluated following WHO and OECD’s Guidelines in rats with oral doses of 1.08 g/kg b.w/day (equal to recommended human dose) and 3.24 g/kg b.w/day (three times as high as recommended human dose) for four consecutive weeks. As a result, in the acute toxicity test, the mice showed no abnormal sign or death. The subchronic toxicity test, hematological indexes, hepato-renal functions, and microscopic images of liver and kidney were unchanged. However, compared with the control group, there were significant differences in various indexes, including total WBC, lymphocytes, neutrophils, and AST level, but the levels were still safe. In conclusion, BTL tea does not appear to produce acute and subchronic toxicities in mice and rats.

Association of number of primary care physicians with preventable hospitalizations and premature deaths

Background Primary Care Physicians (PCPs) may be the first providers for the patients in a healthcare interaction, putting them in a unique position which may determine health trajectory of a patient. Assessing whether PCPs improve the overall health of a community through reducing preventable hospital stays and premature deaths may provide necessary information towards improving the health outcomes at grass roots. Methods County-level data on the number of primary care physicians, preventable hospital stays and ‘years of potential life lost’ (YPLL) were obtained from the Physician Master File data of the American Medical Association, Centers for Medicare & Medicaid Services Office of Minority Health’s Mapping Medicare Disparities data, and Center for Disease Control and Prevention’s WONDER database, respectively. We employed linear regression model to assess the association of PCP rate with preventable hospital stays and YPLL. Results Preventable hospitalization rate in the United States was 6303.4 (95% CI, 6212.5-6394.3) hospitalizations per 100,00 population per year while the average YPLL across the counties in the United States was 7792.9 (95% CI, 7697.6-7888.3) years per 100,000 population. For an increase of 1 PCP in a county, around 16 hospitalizations were prevented per 100,000 population (P=0.001) each year. Furthermore, around 14 years of life were saved per 100,000 population for every additional PCP in a county across the United States (P <0.001). Conclusion Higher number of PCPs in a county was associated with lower hospitalizations for preventable causes and lower premature deaths. Increasing PCPs may be important metric to improve overall health in a community.

Association Between Initiation, Intensity, and Cessation of Smoking and Mortality Risk in Patients With Cardiovascular Disease: A Cohort Study

Objectives: To examine the effect of smoking status, smoking intensity, duration of smoking cessation and age of smoking initiation on the risk of all-cause and cause-specific mortality among cardiovascular disease (CVD) patients.Design: A population-based prospective cohort study.Setting: The National Health Interview Survey (NHIS) in the U.S. that were linked to the National Death Index (NDI).Participants: 66,190 CVD participants ≥ 18 years of age who were interviewed between 1997 and 2013 in the NHIS linked to the NDI through December 31, 2015.Outcome Measures: The primary outcome was all-cause mortality and the secondary outcome was cause-specific mortality including CVD mortality and cancer mortality.Results: During the mean follow-up of 8.1 years, we documented 22,518 deaths (including 6,473 CVD deaths and 4,050 cancer deaths). In the overall CVD population, former and current smokers had higher risk of all-cause (Former smokers: hazard ratios (HRs), 1.26; 95% confidence interval (CI), 1.21–1.31, P < 0.001; Current smokers: HRs, 1.96; 95%CI, 1.86–2.07, P < 0.001), CVD (Former smokers: HRs, 1.12; 95%CI, 1.05–1.21, P = 0.001; Current smokers: HRs, 1.80; 95%CI, 1.64–1.97, P < 0.001) and cancer mortality (Former smokers: HRs, 1.49; 95%CI, 1.35–1.64, P < 0.001; Current smokers: HRs, 2.78; 95%CI, 2.49–3.09, P < 0.001) than never smokers. Furthermore, similar results were observed when the study subjects were stratified according to the type of CVD. Among current smokers, the risk for cancer mortality increased as the daily number of cigarettes increased, regardless of the specific type of CVD. However, the association of the risk for all-cause and CVD mortality with smoking intensity did not present a dose-response relationship. In participants with angina pectoris or stroke, smoking intensity was inversely associated with deaths from CVD. In addition, the risk for all-cause, CVD and cancer mortality declined as years of smoking cessation increased. Finally, the relative risk of all-cause mortality was not significantly different in individuals with a younger age of smoking initiation.Conclusions: CVD patients who are smokers have an increased risk of all-cause, CVD and cancer mortality, and the risk decreases significantly after quitting smoking. These data further provide strong evidence that supports the recommendation to quit smoking for the prevention of premature deaths among individuals with CVD.

The Effect of Behavioral Changes on the Treatment of Hypertension.

Hypertension is one of the leading causes of preventable premature death. Strongly advocating for lifestyle changes to improve blood pressure control is of paramount importance in the successful management of hypertension. In this review, we will discuss the effect of various behavioral and lifestyle changes and review the evidence to support these changes to improve blood pressure control. These include dietary modifications, alcohol consumption, weight loss, various types of exercise, device-guided breathing, relaxation, and biofeedback techniques.

Assessing Substances Abuse-Induced Mortality Rates by Autopsy Method in Iran

Background: Substance abuse is among the main causes of preventable diseases and premature deaths worldwide. Despite legal efforts to prevent substance abuse, it has increased and imposed significant economic costs on societies. This analytical cross-sectional study aimed to explore the rate of substance abuse-induced mortality in the provinces of Iran, in 2017. We elaborated an evaluation structure to identify nationwide different substance abuse-related mortality rates. Methods: We employed the retrospective data extracted from autopsy, forensic medicine examination, and demographic characteristics from the recordings in the Iranian Legal Medicine Organization (ILMO). Stata and ArcGIS were applied for data analysis. Results: Nationwide, 3089 substance abuse-related deaths were recorded in the ILMO; the incidence rate was 38.17 per million subjects. The deaths mostly occurred in the 30-39 age group and males accounted for 90% of cases. The provinces of Kermanshah, Lorestan, Fars, Hamadan, and Semnan reported significantly higher rates, compared with the provinces of Mazandaran, West-Azerbaijan, and Golestan with the lowest mortality rates per million (74.72, 69.81, 63.42, 61.70, 58.53 vs. 10.82, 12.11, 14.30, respectively). Mortality rates due to the abuse of methadone (20.29), morphine (12.34), amphetamine (5.32), methamphetamine (7.05), codeine (4.21), tramadol (5.96), benzodiazepine (1.47), and diphenoxylate (0.05) were calculated per million populations of Iran. Conclusion: The obtained data suggested that preventive interventions should focus on the 20-40 age group. Methadone, morphine, and methamphetamine were associated with the highest mortality, compared to other substances; thus, they require effective treatment and preventive programs. Iranian Drug Control Headquarters, police department, and policymakers should act more efficiently regarding a preventive strategic plan in this respect.

Epileptic heart: A clinical syndromic approach.

Prevention of premature death in patients with chronic epilepsy remains a major challenge. Multiple pathophysiologic factors have been implicated, with intense investigation of cardiorespiratory mechanisms. Up to four in five patients with chronic epilepsy exhibit cardiovascular comorbidities. These findings led us to propose the concept of an "epileptic heart," defined as "a heart and coronary vasculature damaged by chronic epilepsy as a result of repeated surges in catecholamines and hypoxemia leading to electrical and mechanical dysfunction." Among the most prominent changes documented in the literature are high incidence of myocardial infarction and arrhythmia, altered autonomic tone, diastolic dysfunction, hyperlipidemia, and accelerated atherosclerosis. This suite of pathologic changes prompted us to propose for the first time in this review a syndromic approach for improved clinical detection of the epileptic heart condition. In this review, we discuss the key pathophysiologic mechanisms underlying the candidate criteria along with standard and novel techniques that permit evaluation of each of these factors. Specifically, we present evidence of the utility of standard 12-lead, ambulatory, and multiday patch-based electrocardiograms, along with measures of cardiac electrical instability, including T-wave alternans, heart rate variability to detect altered autonomic tone, echocardiography to detect diastolic dysfunction, and plasma biomarkers for assessing hyperlipidemia and accelerated atherosclerosis. Ultimately, the proposed clinical syndromic approach is intended to improve monitoring and evaluation of cardiac risk in patients with chronic epilepsy to foster improved therapeutic strategies to reduce premature cardiac death.

Faktor-faktor yang Mempengaruhi Pola Makan Siswa Sekolah Dasar di Kabupaten Banyumas

Good nutrition during childhood is necessary for growth and development, health, well-being, and prevention of obesity and several other chronic diseases. Children's eating practices can also have short- and long-term health consequences, increase the risk of some non-communicable diseases (PTM), and contribute significantly to the burden of preventable diseases and premature death. School-age children have the characteristics of a lot of physical activity so that they require sufficient energy to meet their activity and growth needs. In general, the factors that influence diet are physical activity, education, knowledge of nutrition, work status and family socioeconomic status. This study aims to see the factors that influence the diet of elementary school children in Banyumas Regency. Data collection using Google Forms to prevent the transmission of the Covid-19 virus. The data were analyzed using multiple linear regression analysis to determine the factors that influence the diet of school children. The results showed that physical activity (0.045), age (0.27), mother’s education (0.37), knowledge of nutrition (0.34), employment status (0.12), eating patterns (0.34) and family income (0.25) affects food consumption pattern of children with a level of confidence, while gender does not affect the diet of school children. This study concludes that mother’s factors greatly affect the dietary consumption patterns of school children.

Prevalence, and associated factors of tobacco smoking among adults in the United Arab Emirates; results from national health survey

BackgroundCigarette smoking is one of the major public health concerns and is the primary cause of preventable illness and premature death. This study examined the prevalence, and associated factors of tobacco smoking among adults living in the United Arab Emirates (UAE). The study further aims to study the socioeconomic determinants such as employment, education, and income of the UAE population, with respect to the status of smoking.MethodsA population-based survey of adults aged 18+ was undertaken. Around 10,000 randomly selected households across all seven Emirates were selected to yield representative data. A total of 8188 adults (18 years and above) participated in the national health survey. The overall response rate was 87% among adult participants.ResultsOverall, the prevalence of current smoking was 9.1% among the selected population; 0.8% of the respondents smoked tobacco on a daily basis. Smoking rates were higher in individuals having lower levels of education, students studying in university, and people who had no income.ConclusionProviding data on the prevalence and factors associated with smoking among specific populations may offer an improved understanding of tobacco use patterns, and will help to develop interventions or health-related policies.

Health Risk Associated with Near-Road Ambient Air Concentration of Particulate Matter in Mukono Municipal Council, Uganda

More than 98% of urban centres exceeding 100,000 people in Low and Middle-Income Countries (LMICs), do not meet the WHO air quality limits. Data on air pollution from LMICs is scarce. We measured the mean concentrations of near-road PM2.5 in the period of Aug.-Dec. 2020, described the Mukono Municipality’s near-road populations’ exposure to PM2.5, and assessed the associated health risk. PurpleAir PA-II laser particle counters, measured near-road ambient air PM2.5 concentration in Mukono Municipality during the period of 09/1/20 to 12/04/20. Excel Toolpak was used for data analysis and the health risk assessed with the WHO AirQ+ tool. The mean ambient near–road PM2.5 in Mukono Municipality were 30.97, 33.84 and 47.74 ug/m3for background, near-unpaved and near-paved roads, respectively. Mukono Municipality’s population was exposed to ambient PM2.5 concentrations higher than the WHO annual limit of 10 ug/m3. This level of air pollution is associated with preventable annual premature deaths of up to 133.11 per 100,000 population. Vehicles were assumed to be the predominant source of near-road ambient air PM2.5 pollution. The Municipality’s population was exposed to near-road ambient air PM2.5 exceeding the WHO annual limit by as much as *4.7 for the paved roads, *3.3 for the unpaved roads and *3 for the background. This leads to increased risk of preventable premature deaths in the Municipality.Mukono Municipality could monitor PM2.5; guide developers to placebuildings more than 100 meters away from roadsides and should promotepolicies for newer vehicles on Ugandan roads.

The Impact of Psychiatric Disorder Diagnosis on Motivation to Quit and Stage of Change Among Patients at a Hospital-Based Outpatient Smoking Cessation Clinic

Objective Smoking is among the greatest international public health concerns, causing excessive levels of preventable premature death, disability, and economic costs. The prevalence of tobacco use among people with psychiatric disorders (PDs) remains persistently high relative to the general population, highlighting the need to improve smoking cessation (SC) strategies in this group. We aimed to assess the associations between having a PD and baseline motivation to quit (MtQ) smoking and Prochaska’s stage of change (SoC), two clinically important metrics linked to SC outcomes. Methods: This retrospective chart review included patients who completed a baseline visit at a hospital-based outpatient SC clinic (N = 896). Multivariate hierarchical logistic and linear regression models were developed to assess variables associated with MtQ (importance and confidence in quitting) and SoC, primarily PD category (externalizing, internalizing, externalizing/internalizing, psychotic or no PD) and secondarily, demographics, physical health history, and tobacco use/dependence metrics. Results: The variables negatively associated with MtQ were female sex (p = .011), older age (p = .038), deriving income from social assistance (p < .001), and age at smoking initiation (p = .005), whereas ≥ 1 quit attempt in the past year predicted higher MtQ (p < .0001). Being in the preparative/action SoC (versus the pre-contemplative/contemplative) was associated with income from social assistance (OR 0.39, p = .001), more daily cigarettes smoked (OR 0.98, p = .005) and ≥ 1 past-year quit attempt (OR 1.69, p = .013). Conclusions: Having a PD was not associated with either MtQ or SoC. Deriving income from social assistance predicted lower MtQ and SoC. Having made ≥ 1 quit attempt in the past year was associated with higher MtQ and SoC. Our study suggests that people with PDs are as motivated to quit smoking and ready for change as people without PDs, and smoking cessation efforts should be amplified in this group to address the disproportionately high level of tobacco use, especially because having at least one quit attempt may enhance MtQ and SoC.

Air pollution and cardiovascular diseases

Die Luftverschmutzung in der Umgebung und in Haushalten ist weltweit jährlich für mittlerweile knapp 9 Mio. vermeidbare, vorzeitige Todesfälle und innerhalb Europas für knapp 800.000 solcher Todesfälle verantwortlich. Die Luftverschmutzung verkürzt somit weltweit die Lebenserwartung um knapp 3 Jahre. Das Rauchen, ein nachgewiesener Herz-Kreislauf-Risiko-Faktor, verkürzt die mittlere Lebenserwartung um 2,2 Jahre. Epidemiologische Studien zeigen, dass Luftverschmutzung durch Feinstaub mit erhöhter kardiovaskulärer Morbidität und Mortalität assoziiert ist. Hierfür verantwortlich sind hauptsächlich durch Feinstaub ausgelöste oder verschlimmerte Herz-Kreislauf-Erkrankungen, wie koronare Herzkrankheit (KHK), Herzinfarkt, Herzinsuffizienz, Schlaganfall, Hypertonie und auch Diabetes. Feinstaubpartikel können nach Inhalation zum einen direkt ins Gehirn und zum anderen über einen Transitionsprozess in die Blutbahn gelangen. Dort werden sie in die Blutgefäße aufgenommen, wo sie die Bildung reaktiver Sauerstoffspezies (ROS) in der Gefäßwand stimulieren. Damit begünstigen sie die Entstehung atherosklerotischer Veränderungen und steigern so das kardiovaskuläre Risiko, insbesondere eine Zunahme an chronisch-ischämischer Herzerkrankung und Schlaganfall. Neuere Untersuchungen berichten, dass bei COVID-19(„coronavirus disease 2019“)-Patienten ein hoher Grad an Luftverschmutzung mit schweren Krankheitsverläufen mit kardiovaskulären Komplikationen und Lungenerkrankungen korreliert. Dies macht präventive Maßnahmen, wie z. B. eine Absenkung der Grenzwerte für Luftschadstoffe, erforderlich. Individuelle Maßnahmen, um die gesundheitlichen Folgen von Feinstaub abzumildern, werden ebenfalls diskutiert.

Cardiovascular Risk Factors among Outpatients: An Alarming Sign of the Epidemiological Transition in Developing Country?

Background: Noncommunicable diseases are the leading cause of death in the world and low and middle-income countries suffer from preventable premature death. The aim of this study was to assess the risk factors for non- communicable disease (NCDs) in general and particular cardiovascular diseases (CVDs) among the outpatients of our department of medicine. Methods: We performed a cross-sectional study from April to December 2017 by the consecutive enrollment of outpatients who attended in our department of medicine of Hôpital Sominé DOLO de Mopti, Mali. Clinical and laboratory data were measured for cardiovascular risk assessment. Framingham Risk Score (FRS) and Systemic Coronary Risk Estimation (SCORES) were computed by using Framingham and SCORE equations. Metabolic syndrome was defined using the harmonized criteria from the International Diabetes Federation (IDF) and the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). Data were captured in excel and analyzed with R version 4.0.3. The statistical significance was set at p = 0.05. Results: A total of 292 patients were enrolled in this study. The prevalence of traditional cardiovascular risk factors was 36.64%, 21.57%, 14.04%, and 13.01% for high blood pressure, hyperglycemia, smoking, and alcohol consumption, respectively. The metabolic syndrome accounted for 23.63%. The mean body mass index was 26.10 ± 7 kg/m2. The overall 10-year risk for cardiovascular events or death was 26.3% and 8.6% according to the FRS and SCORE equation, respectively. The 10-year risk of cardiovascular events according to the FRS was significantly higher in subjects aged 50 and above compared to subjects aged under 50 years, 34.46% vs 13.16%, p Conclusion: Our data corroborate the increasing prevalence of cardiovascular risk factors in SSA. A comprehensive cardiovascular risk factors assessment should be implemented in all stages of health facilities and a longitudinal follow-up could help shed a light on the epidemiology of NCDs in general and particularly CVDs and thereby improve their control policies in SSA.

Rheumatic Heart Disease Patients' Adherence to Secondary Prophylaxis and Associated Factors at Hospitals in Jimma Zone, Southwest Ethiopia: A Multicenter Study.

BackgroundRheumatic heart disease (RHD) is a major cause of preventable premature cardiovascular-related death in developing countries. However, information regarding adherence rates and associated factors is limited and inconsistent in Ethiopia.MethodsA cross-sectional study was conducted from August to November 2019 among selected RHD patients on follow-up at four hospitals in Jimma zone. Data were collected using a structured questionnaire. Adherence of RHD patients to secondary prophylaxis in the previous consecutive 12 months was assessed based on the annual frequency of received prophylaxis (monthly injection of benzathine penicillin). Good adherence was considered the patient receiving >80% of the annual dose. The collected data were entered into Epidata 3.1 and analysed using SPSS 23.ResultsA total of 253 RHD patients taking prophylaxis were included in the analysis, and of those 178 (70.4%) were female, giving a male:female ratio of 1:2.4. The mean age was 24±11 (6–65) years. About 63% had good adherence to benzathine penicillin prophylaxis. New York Heart Association functional class I and II, rural residence, >30 km from health facility, and duration of prophylaxis >5 years were associated with poor adherence (respectively: AOR 12.6 [95% CI 2.5–63], P=0.016; AOR 6.8 [95% CI 1.9–24.4], P=0.003; AOR 5.5 [95% CI 1.2–26.7], P=0.046; AOR 1.2 [95% CI 1.1–3.2], P=0.021). Leading barriers to good adherence were long distance from the treatment setting (56.9%), followed by lack of money (38%).ConclusionPatients with class I and II heart failure and those living in rural areas, especially >30 km from a hospital, were identified to be poorly adherent to secondary prophylaxis.

A research agenda for non-communicable disease prevention and control in India

BackgroundNon-communicable diseases contribute to 62% of total deaths in India; of concern are the preventable premature deaths, which account for a staggering 48% of mortality. The objective of this study was to establish a consensus research agenda for non-communicable disease prevention and control that has the potential to impact polices, programmes and healthcare delivery in India.MethodsTo develop a non-communicable disease research agenda, we engaged our community collaborative board and scientific advisory group in a three-step process using two web-based surveys and one in-person meeting. First, the Delphi methodology was used to generate topics. Second, these ideas were deliberated upon during the in-person meeting, leading to the prioritisation of 23 research questions, which were subjected to Strength, Weakness, Opportunities and Threat analysis by the stakeholders using the Snow Card methodology with the scientific advisory group and community collaborative board. This step resulted in the identification of 15 low effort, high impact priority research questions for various health outcomes across research disciplines based on discussion with the larger group to reach consensus. Finally, the second web-based survey resulted in the identification of 15 key priority research questions by all stakeholders as being the most important using a linear mixed effect regression model.ResultsThe final set of 15 priority research questions focused on interventions at the individual, community, systems and policy levels. Research questions focused on identifying interventions that strengthen healthcare systems and healthcare delivery, including models of care and improved access to non-communicable disease screening, diagnosis and treatment, determining the impact of government policies, assessing the effectiveness of prevention programmes (e.g. tobacco, environmental improvements), and testing research tools and resources to monitor non-communicable diseases at the population level.ConclusionTo produce the evidence base for selecting and implementing non-communicable disease programmes and policies in India, investments are needed. These investments should be guided by a national research agenda for the prevention and control of non-communicable diseases in India. Our findings could form the backbone of a national research agenda for non-communicable diseases in India that could be refined and then adopted by government agencies, the private sector, non-governmental and community-based organisations.

The moral and legal foundations of bioethics in the context of human rights: legal theory and international practice

Modern processes of globalization taking place in the field of law are a great challenge to the idea of human nature, which is recognized in Ukraine as the highest social value, as well as to the concept and essence of law itself. In our opinion, this is a threat on a global scale and necessitates the search for an adequate response to the threat from the scientific and technical process in the field of biomedicine, both for the natural (physical) existence of man and the preservation of his moral identity. In fact, these foundations have become the prerequisites for the development of the science of bioethics. Bioethics studies controversial and ambiguous issues and proposes a humanitarian examination, which aims to assess the arguments in favor of the development of human creativity, health and prevention of premature death, and arguments in favor of preserving human identity in its spiritual and physical integrity. The purpose of the article is to study the essence of controversial bioethical problems, the reasons for their occurrence and prospects for solving these problems. human, manipulation of stem cells and others. Bioethical issues usually include the ethical issues of abortion; contraception and new reproductive technologies (artificial insemination, surrogacy); conducting experiments on humans and animals; obtaining informed consent and ensuring patients' rights; determination of death, suicide and euthanasia; problems in relation to dying patients (hospices); demographic policy and family planning; genetics (including problems of genome research, genetic engineering and gene therapy); transplantology; health equity; human cloning, manipulation of stem cells and others. These issues related to the progress of genetics, genomics, pharmacology, transplantation, biotechnology, cloning are becoming increasingly important as a direction of international law in the context of ensuring and protecting human rights. IN legal literature indicates the formation of "biolaw", "bioethical legislation", "bioethical human rights". Thus there is a combination of possibilities and purposes of medicine and law. In our article, we have explored only some of these issues, which are currently the most relevant, debatable, and therefore require detailed analysis. These include, in our view, the legal status of the embryo, therapeutic and reproductive cloning, abortion, the use of assisted reproductive technologies and organ transplantation. In order to adequately cover these issues, we compare the rules of law governing these debatable issues with the views of church representatives and scholars on these issues. We also proposed changes that need to be made to the legislation of Ukraine so that the rules of law governing these issues meet the moral and ethical principles. As a conclusion is marked, that as bioethics as science dealing with survival combines in itself biological knowledge and general human values, then it is possible to consider natural human rights, her honour and dignity morally-legal principles of bioethics, a self right and law must become on defence of that, in particular, with the aim of providing of natural (physical) existence of man, and maintenance of her moral identity. Keywords: human rights, moral, bioethics, abortion, reproductive technologies, cloning.

May Measurement Month 2018: an analysis of blood pressure screening results from Mexico.

In 2015, arterial hypertension was responsible for 18.1% of the total deaths in Mexico and its mortality rate has increased to 29.9% in the last 6 years. It is currently the main risk factor for preventable premature deaths of adults in the country. Good quality epidemiological information is the first step to improve health services. May Measurement Month 2018 (MMM18) in Mexico is an opportunistic survey, which follows the previously published methodology. MMM18 included screening 10 139 participants, 2187 (21.6%) of whom were classified as having hypertension. Of these, 42.0% were aware of the condition before measurement, and 38.0% were on medication, of which 66.5% were controlled. Hence, of all hypertensive patients, 25.3% were controlled (<140/90 mmHg). MMM18 in Mexico provides complementary data to the existing information on arterial hypertension in the country and helps to increase the visibility of hypertension: a priority health problem.

Association of Walnut Consumption with Total and Cause-Specific Mortality and Life Expectancy in U.S. Women and Men

Abstract Objectives We aim to 1) examine the association between walnut consumption and subsequent total and cause-specific mortality; 2) to estimate life expectancy that would be potentially gained by varying intake of walnuts in U.S. women and men. Methods Walnut consumption was assessed using validated food frequency questionnaires in 1998 (baseline year) and updated every 4 years. We included data from 68,308 women of the Nurses’ Health Study (1998–2016) and 26,760 men of the Health Professionals Follow-up Study (1998–2016) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models adjusting for confounders to estimate mortality risk associated with walnut consumption stratified by sex and dietary quality. We used population based multistate life tables to calculate the differences in life expectancy and years lived in relation to walnut consumption. Results During up to 18 years of follow-up, we documented 30,502 deaths from any cause. The multivariable-adjusted hazard ratios (HRs) for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.91 (95% confidence interval [CI], 0.89–0.94), for &amp;lt;1 serving/week, 0.87 (95% CI, 0.83–0.92) for 1 serving/week, 0.79 (95% CI, 0.75–0.85), for 2–4 servings/week, and 0.77 (95% CI,: 0.71–0.81) for &amp;gt;= 5 servings/week (P for trend &amp;lt;0.0001). Per 0.5 serving/day walnut consumption was associated of a reduced risk of total mortality (HR: 0.82, 95% CI,: 0.77–0.88), CVD mortality (HR: 0.78, 95% CI,: 0.67–0.33), and cancer mortality (HR: 0.93, 95% CI:, 0.81–1.07) in participants with a suboptimal diet (AHEI score &amp;lt;60% of cohort distribution). A greater life expectancy of 1.78 years in women and 1.94 years in men was observed among those who consumed walnuts more than 5 servings/week, compared to non-consumers at age 60. Conclusions Higher walnut consumption was associated with lower risk for total mortality and longer estimated life expectancy among U.S. men and women of two prospective cohort studies. Our results provide evidence on the potential role of walnut in the prevention of premature death. Funding Sources UM1 CA186107, UM1 CA176726, UM1 CA167552 Y.L. was partly funded by the California Walnut Commission. The funders have no roles in the design and conduct of the study.

Prevention of premature death and seizures in a Depdc5 mouse epilepsy model through inhibition of mTORC1.

Mutations in DEP domain containing 5 (DEPDC5) are increasingly appreciated as one of the most common causes of inherited focal epilepsy. Epilepsies due to DEPDC5 mutations are often associated with brain malformations, tend to be drug-resistant, and have been linked to an increased risk of sudden unexplained death in epilepsy (SUDEP). Generation of epilepsy models to define mechanisms of epileptogenesis remains vital for future therapies. Here, we describe a novel mouse model of Depdc5 deficiency with a severe epilepsy phenotype, generated by conditional deletion of Depdc5 in dorsal telencephalic neuroprogenitor cells. In contrast to control and heterozygous mice, Depdc5-Emx1-Cre conditional knockout (CKO) mice demonstrated macrocephaly, spontaneous seizures and premature death. Consistent with increased mTORC1 activation, targeted neurons were enlarged and both neurons and astrocytes demonstrated increased S6 phosphorylation. Electrophysiologic characterization of miniature inhibitory post-synaptic currents in excitatory neurons was consistent with impaired post-synaptic response to GABAergic input, suggesting a potential mechanism for neuronal hyperexcitability. mTORC1 inhibition with rapamycin significantly improved survival of CKO animals and prevented observed seizures, including for up to 40days following rapamycin withdrawal. These data not only support a primary role for mTORC1 hyperactivation in epilepsy following homozygous loss of Depdc5, but also suggest a developmental window for treatment which may have a durable benefit for some time even after withdrawal.