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Le malattie non trasmissibili sono un gruppo di patologie croniche che rappresentano la causa del 70% dei decessi nel mondo. Purtroppo, con l’invecchiamento della popolazione queste patologie stanno aumentando sempre di più e si ritiene che nel 2030 costituiranno la prima causa di morte, con gravi ripercussioni sia economiche che sanitarie. L’alimentazione e lo stile di vita sono tra i fattori esogeni più influenti nello sviluppo delle NCDs, per questo motivo è importante trovare molecole che possano essere assunte per prevenire lo sviluppo di queste malattie. Il mondo vegetale rappresenta, sin da tempi antichi, un’importante fonte di molecole bioattive capaci di migliorare lo stato di salute dell’uomo grazie ad azioni preventive e/o curative. Al giorno d’oggi anche gli scarti agroindustriali iniziano ad essere considerati una buona fonte per il recupero di molecole bioattive. Lo smaltimento di questi scarti provoca un elevato costo di gestione ed un impatto ambientale. Attualmente differenti modalità di gestione degli scarti sono state sviluppate ed utilizzate per la produzione di energia, mangimi animali o come fonte di metaboliti attivi con proprietà benefiche. Alcuni scarti della filiera alimentare possono avere, un contenuto maggiore di metaboliti o presentare analiti diversi dalla porzione edibile normalmente utilizzata. Per questo motivo è importante analizzare il profilo metabolico delle piante e dei sottoprodotti al fine di valutarne la composizione qualitativa ed individuarne potenziali bioattività. A questo scopo sono disponibili numerose tecniche analitiche che possono, con analisi target e untarget, essere usate per uno studio di metabolomica. L’estrazione di composti bioattivi, comunemente effettuata con tecniche convenzionali ad alto impatto ambientale, ha subito un significativo cambiamento nel corso del tempo. Stanno diventando sempre più frequenti tecniche non convenzionali come l’estrazione con ultrasuoni (USAE), liquidi pressurizzati (PLE, Non-communicable diseases (NCDs) are a group of chronic diseases that are responsible for 70% of deaths worldwide. Unfortunately, with an aging population, these diseases are increasing and are expected to be the leading cause of death by 2030, with many health and economic impacts. Diet and lifestyle are among the most influential factors in the development of NCDs, so it is important to find molecules that can be taken to prevent the development of these diseases. Since ancient times, nature has been an important source of bioactive compounds that could improve human health through preventive and/or curative actions. Nowadays, agro-industrial waste is also starting to be considered a good source for the recovery of bioactive molecules. The disposal of these wastes causes a high costs and environmental impact. Currently, different waste management methods have been developed and used for the production of energy, animal feed or as a source of active metabolites with beneficial properties. Some wastes from the food chain may have a higher metabolite content or present different analytes than the edible portion normally used. For this reason, it is important to analyze the metabolic profile of plants and by-products to assess their qualitative composition and identify potential bioactivities. For this purpose, numerous analytical techniques are available that can, with target and untarget analysis, be used for a metabolomics study. The extraction of bioactive compounds has changed significantly over time. Unconventional techniques such as ultrasonic extraction (USAE), pressurised fluid extraction (PLE), supercritical fluid extraction (SFE) and microwave extraction (MAE) are becoming increasingly common. These have certain advantages, such as increased extraction yield and efficiency, reduced extraction cost and time, reduced environmental impact and the use of less toxic solvents that are unsafe for food use in favour of safe solvents such as water and ethanol. The a

Obesity, the leading cause of many non-communicable diseases, occurs mainly for eating more than our body requirements and lack of proper activity. So, being healthy requires heathy diet plans, especially for patients with comorbidities. But it is difficult to figure out the exact quantity of each nutrient because nutrients requirement varies based on physical and disease conditions. In our study we proposed a novel machine learning based system to predict the amount of nutrients one individual requires for being healthy. We applied different machine learning algorithms: linear regression, support vector machine (SVM), decision tree, random forest, XGBoost, LightGBM on fluid and 3 other major micronutrients: carbohydrate, protein, fat consumption prediction. We achieved high accuracy with low root mean square error (RMSE) by using linear regression in fluid prediction, random forest in carbohydrate prediction and LightGBM in protein and fat prediction. We believe our diet recommender system, OBESEYE, is the only of its kind which recommends diet with the consideration of comorbidities and physical conditions and promote encouragement to get rid of obesity.

Obesity, the leading cause of many non-communicable diseases, occurs mainly for eating more than our body requirements and lack of proper activity. So, being healthy requires heathy diet plans, especially for patients with comorbidities. But it is difficult to figure out the exact quantity of each nutrient because nutrients requirement varies based on physical and disease conditions. In our study we proposed a novel machine learning based system to predict the amount of nutrients one individual requires for being healthy. We applied different machine learning algorithms: linear regression, support vector machine (SVM), decision tree, random forest, XGBoost, LightGBM on fluid and 3 other major micronutrients: carbohydrate, protein, fat consumption prediction. We achieved high accuracy with low root mean square error (RMSE) by using linear regression in fluid prediction, random forest in carbohydrate prediction and LightGBM in protein and fat prediction. We believe our diet recommender system, OBESEYE, is the only of its kind which recommends diet with the consideration of comorbidities and physical conditions and promote encouragement to get rid of obesity.

Four areas make up 75% of our healthcare costs: cardio-, onco-, neuro- and metabolic diseases. These are largely preventable, even reversible. Instead, they are currently often ‘managed’ and made chronic, not cured. This is too costly. Research is showing new opportunities for enhancing our body’s self-repair in a matter of hours or days. Our research question: what could be an intervention- and bio-feedback portfolio to promote health self-repair within hours or days? There are large cross-domain differences regarding: intervention aims, (self-)measurement options, focus on symptoms vs. causes, plus degree of attention for health self-management. Given recent research into rapid cure, we advise advanced daily bioinformatics feedback, using molecular biomarkers. This creates a quantified self ‘endoself’, showing key biological opportunities for cure and self-repair. Thus, we shift from the current ‘antibiotics/external fix’ paradigm of healthcare to a ‘wound healing’ paradigm, improving use of resources in health., Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public., Interactive Intelligence

Microorganisms do not cause non-communicable diseases (NCDs) but tend to change in modern lifestyles that do not apply CERDIK. In past research, the risk of suffering from non-communicable diseases was influenced by behavior, which consisted of three domains, namely knowledge, attitudes, and actions, without considering other individual factors. This study aims to assess the influence of individual health history factors, BMI, and behavior. The design used is cross-sectional. A sample of 302 people aged 15-59 are at risk of NCD and often visit fast food restaurants. Sampling using cluster random sampling. The variables collected are individual health history, BMI, and behavior. Data collection was carried out from April to June 2023. The analysis carried out was descriptive and structural equation modeling using PLS (Partial Least Square) software. The influence of the individual health history factor is 0.116, the BMI factor is 0.277, and the behavioral factor is -0.107. The resulting formula is . This formula can be used as a method to calculate the individual risk of suffering from NCDs.

Obesity, the leading cause of many non-communicable diseases, occurs mainly for eating more than our body requirements and lack of proper activity. So, being healthy requires heathy diet plans, especially for patients with comorbidities. But it is difficult to figure out the exact quantity of each nutrient because nutrients requirement varies based on physical and disease conditions. In our study we proposed a novel machine learning based system to predict the amount of nutrients one individual requires for being healthy. We applied different machine learning algorithms: linear regression, support vector machine (SVM), decision tree, random forest, XGBoost, LightGBM on fluid and 3 other major micronutrients: carbohydrate, protein, fat consumption prediction. We achieved high accuracy with low root mean square error (RMSE) by using linear regression in fluid prediction, random forest in carbohydrate prediction and LightGBM in protein and fat prediction. We believe our diet recommender system, OBESEYE, is the only of its kind which recommends diet with the consideration of comorbidities and physical conditions and promote encouragement to get rid of obesity.

Objective: The World Health Organization (WHO) recommends that adults consume less than 5 grams of salt per day to reduce the risk of cardiovascular disease. This study aims to examine the average population daily salt intake in the 53 Member States of the WHO European Region. Design: A systematic review was conducted to examine the most up-to-date salt intake data for adults published between 2000 and 2022. Data were obtained from peer-reviewed and grey literature, WHO surveys and studies, as well as from national and global experts. Setting: The 53 Member States of the WHO European Region. Participants: People aged 12 years or more. Results: We identified 50 studies published between 2010-2021. Most countries in the WHO European Region (n = 52, 98%) reported salt intake above WHO recommended maximum levels. In almost all countries (n = 52, 98%), men consume more salt than women, ranging between 5.39 – 18.51g for men and 4.27 – 16.14g for women. Generally, Western and Northern European countries have the lowest average salt intake, whilst Eastern European and Central Asian countries have the highest average. 42% of the fifty-three countries (n = 22) measured salt intake using 24h urinary collections, considered the gold standard method. Conclusions: This study found that salt intakes in the WHO European Region are significantly above WHO recommended levels. Most Member States of the Region have conducted some form of population salt intake. However, methodologies to estimate salt intake are highly disparate and underestimations are very likely.

Non-communicable diseases (NCDs) occur in individuals of the productive age and its risk can be diminished if such individuals possess healthy behaviors. BMI is a calculation which is frequently administered to express individuals at risk of suffering from NCDs. Predicting the risk of an individual from suffering from non-communicable diseases is possible by employing CERDIK behavioral (knowledge, attitude, and actions) questionnaires, but it does not yet elaborate the role of body mass index (BMI). The objective of this study is to compare the body mass index and behavior with individuals’ risk factors suffering from non-communicable diseases. The study administered a cross-sectional design. The sample amounted to 200 individuals in the productive age who generally fast-food establishments in Blitar from April to June of 2022. Sample was selected by administering the simple random sampling method. The results demonstrated that merely few individuals experienced a high risk of contracting non-communicable diseases. Behavioral factors are no longer used to determine an individual's risk of developing non-communicable diseases when body mass index is taken into account as a contributing factor. Therefore, body mass index is not a risk factor. According to research, adopting healthy lifestyle habits can lower the risk of developing non-communicable diseases.

Non-communicable diseases (NCDs) occur in individuals of the productive age and its risk can be diminished if such individuals possess healthy behaviors. BMI is a calculation which is frequently administered to express individuals at risk of suffering from NCDs. Predicting the risk of an individual from suffering from non-communicable diseases is possible by employing CERDIK behavioral (knowledge, attitude, and actions) questionnaires, but it does not yet elaborate the role of body mass index (BMI). The objective of this study is to compare the body mass index and behavior with individuals’ risk factors suffering from non-communicable diseases. The study administered a cross-sectional design. The sample amounted to 200 individuals in the productive age who generally fast-food establishments in Blitar from April to June of 2022. Sample was selected by administering the simple random sampling method. The results demonstrated that merely few individuals experienced a high risk of contracting non-communicable diseases. Behavioral factors are no longer used to determine an individual's risk of developing non-communicable diseases when body mass index is taken into account as a contributing factor. Therefore, body mass index is not a risk factor. According to research, adopting healthy lifestyle habits can lower the risk of developing non-communicable diseases.

Introduction: Mitigation strategies towards birthweight outcomes pose a potential to reduce the increasing trajectory of NCDs in LMICs. The assessment of geophagy consumption, at the intersection of nutritional intake in iron and zinc and biological markers of ferritin and hemoglobin, will establish contextual inferences on the best public health measures to guide prenatal and nutritional support to pregnant women in Tanzania. Objective: An investigation into the interactions between iron and zinc, anemia and frequencies of geophagy to determine the birthweight of offspring from a cohort of women in North-East Tanzania Methods: A community based, prospective cohort study of pregnant women from North East Tanzania. Baseline characteristics were recorded at inclusion, anthropometric measurements, physical activity and biomedical markers for nutrition status taken at antenatal visits throughout each trimester. Visual assessment of dietary intake and geophagy observed at each trimester. Birth weight of offspring recorded either at birth or earliest appointment at a clinic. Results: Increasing serum ferritin is associated with a 3.2% reduction in geophagia. Increases in hemoglobin are associated with 33.5% reduction in geophagia. Anemia increases the odds of women consuming pica by 2.1 times. A positive case of geophagy can be associated with an increase of birthweight by 261.8g. A decrease of ferritin equal to 41.3mg is associated with a decrease of birthweight by 58.8g. Hemoglobin had an insignificant and null effect on birthweight. Conclusion: Geophagy in pregnancy is strongly associated with hemoglobin and has an adaptive response to birthweight. Geophagy is weakly associated to serum ferritin but decreasing ferritin levels correlate to a reduced birthweight. Keywords: Nutrition, Anemia, Geophagy, Low Birth Weight, NCDs, Pregnancy, Tanzania

Introduction: Mitigation strategies towards birthweight outcomes pose a potential to reduce the increasing trajectory of NCDs in LMICs. The assessment of geophagy consumption, at the intersection of nutritional intake in iron and zinc and biological markers of ferritin and hemoglobin, will establish contextual inferences on the best public health measures to guide prenatal and nutritional support to pregnant women in Tanzania. Objective: An investigation into the interactions between iron and zinc, anemia and frequencies of geophagy to determine the birthweight of offspring from a cohort of women in North-East Tanzania Methods: A community based, prospective cohort study of pregnant women from North East Tanzania. Baseline characteristics were recorded at inclusion, anthropometric measurements, physical activity and biomedical markers for nutrition status taken at antenatal visits throughout each trimester. Visual assessment of dietary intake and geophagy observed at each trimester. Birth weight of offspring recorded either at birth or earliest appointment at a clinic. Results: Increasing serum ferritin is associated with a 3.2% reduction in geophagia. Increases in hemoglobin are associated with 33.5% reduction in geophagia. Anemia increases the odds of women consuming pica by 2.1 times. A positive case of geophagy can be associated with an increase of birthweight by 261.8g. A decrease of ferritin equal to 41.3mg is associated with a decrease of birthweight by 58.8g. Hemoglobin had an insignificant and null effect on birthweight. Conclusion: Geophagy in pregnancy is strongly associated with hemoglobin and has an adaptive response to birthweight. Geophagy is weakly associated to serum ferritin but decreasing ferritin levels correlate to a reduced birthweight. Keywords: Nutrition, Anemia, Geophagy, Low Birth Weight, NCDs, Pregnancy, Tanzania

Background: The epidemics of non-communicable diseases (NCDs) and war-related injuries are a significant health concerns, and are rapidly emerging as major causes of mortality and disability globally, particularly in low and middle-income countries (LMICs) such as Palestine. Health research on the epidemiology and management of NCDs and war injuries is scarce and largely neglected. Therefore, this research responds to epidemiologic and public health concerns due to the increasing incidences of NCDs and war-injuries. The objective of this thesis was to describe, characterize and analyze the burden, incidence and management of NCDs and war-related injuries in the Palestinian health system (PHS). Methods: A combination of methods was employed in the research, including quantitative (study I and II), and qualitative approaches (study III and IV) in order to achieve the study aims and to gain a better understanding of NCDs and war injuries related issues in the PHS. For study I, the Disability-Adjusted Life Years (DALYs) framework was employed using available registry data of NCDs from 2010 to quantify the burden of NCDs, whereas, for study II a registry injuries data of the 2014 Gaza war was used to analyze the incidence and patterns of war injuries in the PHS. For study III, a qualitative focus group strategy was used to explore healthcare providers’ perspectives on NCDs and war injuries management and for study IV, a qualitative interview strategy was applied, using study topic guides to explore patients and policy makers’ perspectives of barriers to managing and delivering of care to war injured survivors or patients with NCDs. The participants were purposely selected and invited to be involved in the focus group discussions and interviews. The qualitative data were transcribed verbatim and analyzed using manifest content and thematic analysis in study III and IV respectively. Results: The research concludes that the total burden of reported NCDs was estimated at 57

This study was projected to find out the prevalence of depression, anxiety and stress in patients with non-communicable diseases having follow-up in Black Lion Specialized Hospital and investigate certain predictor variables behind the negative mental states. This cross-sectional study comprised of a sample of 382 patients with confirmed non-communicable diseases selected via convenience sampling technique. The data was collected using interview based structured questionnaires, after taking informed consent, from 16th January to 2nd April, 2019. Levels of depression, anxiety and stress were gauged using the short version of the Depression Anxiety Stress Scales (DASS)-21. The study findings revealed that significant proportion of the studied respondents had mild to severe levels of depression, anxiety and stress scores, with a prevalence of 38.2 %, 51.6 %, & 27.7 %, respectively. There was no statistically significant difference between the two types of non-communicable diseases studied. The strongest predictors for high depression, anxiety & stress scores among diabetic and hypertensive patients were marital status and clinical stage of the disease, each with p value <0.001. Similarly, sex, average monthly income, and duration of the disease showed significant predictive role. On the basis of this result, the researcher came to know that great numbers of patients of non-communicable diseases on medical follow up were suffering from different levels of anxiety, depression and stress. Thus, this study implied that psychological aid should be synchronized with and be a litmus test to the overall clinical care of non-communicable disease patients.

This study was projected to find out the prevalence of depression, anxiety and stress in patients with non-communicable diseases having follow-up in Black Lion Specialized Hospital and investigate certain predictor variables behind the negative mental states. This cross-sectional study comprised of a sample of 382 patients with confirmed non-communicable diseases selected via convenience sampling technique. The data was collected using interview based structured questionnaires, after taking informed consent, from 16th January to 2nd April, 2019. Levels of depression, anxiety and stress were gauged using the short version of the Depression Anxiety Stress Scales (DASS)-21. The study findings revealed that significant proportion of the studied respondents had mild to severe levels of depression, anxiety and stress scores, with a prevalence of 38.2 %, 51.6 %, & 27.7 %, respectively. There was no statistically significant difference between the two types of non-communicable diseases studied. The strongest predictors for high depression, anxiety & stress scores among diabetic and hypertensive patients were marital status and clinical stage of the disease, each with p value <0.001. Similarly, sex, average monthly income, and duration of the disease showed significant predictive role. On the basis of this result, the researcher came to know that great numbers of patients of non-communicable diseases on medical follow up were suffering from different levels of anxiety, depression and stress. Thus, this study implied that psychological aid should be synchronized with and be a litmus test to the overall clinical care of non-communicable disease patients.

Background: The epidemics of non-communicable diseases (NCDs) and war-related injuries are a significant health concerns, and are rapidly emerging as major causes of mortality and disability globally, particularly in low and middle-income countries (LMICs) such as Palestine. Health research on the epidemiology and management of NCDs and war injuries is scarce and largely neglected. Therefore, this research responds to epidemiologic and public health concerns due to the increasing incidences of NCDs and war-injuries. The objective of this thesis was to describe, characterize and analyze the burden, incidence and management of NCDs and war-related injuries in the Palestinian health system (PHS). Methods: A combination of methods was employed in the research, including quantitative (study I and II), and qualitative approaches (study III and IV) in order to achieve the study aims and to gain a better understanding of NCDs and war injuries related issues in the PHS. For study I, the Disability-Adjusted Life Years (DALYs) framework was employed using available registry data of NCDs from 2010 to quantify the burden of NCDs, whereas, for study II a registry injuries data of the 2014 Gaza war was used to analyze the incidence and patterns of war injuries in the PHS. For study III, a qualitative focus group strategy was used to explore healthcare providers’ perspectives on NCDs and war injuries management and for study IV, a qualitative interview strategy was applied, using study topic guides to explore patients and policy makers’ perspectives of barriers to managing and delivering of care to war injured survivors or patients with NCDs. The participants were purposely selected and invited to be involved in the focus group discussions and interviews. The qualitative data were transcribed verbatim and analyzed using manifest content and thematic analysis in study III and IV respectively. Results: The research concludes that the total burden of reported NCDs was estimated at 57

Background: The epidemics of non-communicable diseases (NCDs) and war-related injuries are a significant health concerns, and are rapidly emerging as major causes of mortality and disability globally, particularly in low and middle-income countries (LMICs) such as Palestine. Health research on the epidemiology and management of NCDs and war injuries is scarce and largely neglected. Therefore, this research responds to epidemiologic and public health concerns due to the increasing incidences of NCDs and war-injuries. The objective of this thesis was to describe, characterize and analyze the burden, incidence and management of NCDs and war-related injuries in the Palestinian health system (PHS). Methods: A combination of methods was employed in the research, including quantitative (study I and II), and qualitative approaches (study III and IV) in order to achieve the study aims and to gain a better understanding of NCDs and war injuries related issues in the PHS. For study I, the Disability-Adjusted Life Years (DALYs) framework was employed using available registry data of NCDs from 2010 to quantify the burden of NCDs, whereas, for study II a registry injuries data of the 2014 Gaza war was used to analyze the incidence and patterns of war injuries in the PHS. For study III, a qualitative focus group strategy was used to explore healthcare providers’ perspectives on NCDs and war injuries management and for study IV, a qualitative interview strategy was applied, using study topic guides to explore patients and policy makers’ perspectives of barriers to managing and delivering of care to war injured survivors or patients with NCDs. The participants were purposely selected and invited to be involved in the focus group discussions and interviews. The qualitative data were transcribed verbatim and analyzed using manifest content and thematic analysis in study III and IV respectively. Results: The research concludes that the total burden of reported NCDs was estimated at 57

Background: The epidemics of non-communicable diseases (NCDs) and war-related injuries are a significant health concerns, and are rapidly emerging as major causes of mortality and disability globally, particularly in low and middle-income countries (LMICs) such as Palestine. Health research on the epidemiology and management of NCDs and war injuries is scarce and largely neglected. Therefore, this research responds to epidemiologic and public health concerns due to the increasing incidences of NCDs and war-injuries. The objective of this thesis was to describe, characterize and analyze the burden, incidence and management of NCDs and war-related injuries in the Palestinian health system (PHS). Methods: A combination of methods was employed in the research, including quantitative (study I and II), and qualitative approaches (study III and IV) in order to achieve the study aims and to gain a better understanding of NCDs and war injuries related issues in the PHS. For study I, the Disability-Adjusted Life Years (DALYs) framework was employed using available registry data of NCDs from 2010 to quantify the burden of NCDs, whereas, for study II a registry injuries data of the 2014 Gaza war was used to analyze the incidence and patterns of war injuries in the PHS. For study III, a qualitative focus group strategy was used to explore healthcare providers’ perspectives on NCDs and war injuries management and for study IV, a qualitative interview strategy was applied, using study topic guides to explore patients and policy makers’ perspectives of barriers to managing and delivering of care to war injured survivors or patients with NCDs. The participants were purposely selected and invited to be involved in the focus group discussions and interviews. The qualitative data were transcribed verbatim and analyzed using manifest content and thematic analysis in study III and IV respectively. Results: The research concludes that the total burden of reported NCDs was estimated at 57

This study was projected to find out the prevalence of depression, anxiety and stress in patients with non-communicable diseases having follow-up in Black Lion Specialized Hospital and investigate certain predictor variables behind the negative mental states. This cross-sectional study comprised of a sample of 382 patients with confirmed non-communicable diseases selected via convenience sampling technique. The data was collected using interview based structured questionnaires, after taking informed consent, from 16th January to 2nd April, 2019. Levels of depression, anxiety and stress were gauged using the short version of the Depression Anxiety Stress Scales (DASS)-21. The study findings revealed that significant proportion of the studied respondents had mild to severe levels of depression, anxiety and stress scores, with a prevalence of 38.2 %, 51.6 %, & 27.7 %, respectively. There was no statistically significant difference between the two types of non-communicable diseases studied. The strongest predictors for high depression, anxiety & stress scores among diabetic and hypertensive patients were marital status and clinical stage of the disease, each with p value <0.001. Similarly, sex, average monthly income, and duration of the disease showed significant predictive role. On the basis of this result, the researcher came to know that great numbers of patients of non-communicable diseases on medical follow up were suffering from different levels of anxiety, depression and stress. Thus, this study implied that psychological aid should be synchronized with and be a litmus test to the overall clinical care of non-communicable disease patients.

The analysis is done using the data collected from 785 adults of randomly selected families of 207 students of American International University - Bangladesh. The respondents are classified by levels of Body Mass Index (BMI). Among the respondents 86.4% are in the obese and overweight group and the prevalence of Non-communicable diseases (NCDs) and diabetes are higher among them. The important variables for the higher prevalence of overweight and obesity are residence, age, occupation, marital status and income. The obesity is more among the urban people. It is also more among aged persons, service and retired persons. The prevalence of diabetes is more among obese and overweight group of respondents.

Background Bikesharing is a versatile intervention, that enables cheap and convenient cycling for urban populations, and according to recent literature, has a positive impact on health, safety and the economy. Many of these impacts are based on the assumption of a modal shift induced by bikesharing, i.e. implementing a Bicycle Sharing System (BSS) will increase population cycling. However, the evidence is inconclusive. The aim of this study was to evaluate if the intervention of implementing a BSS increases cycling. The study was conducted using bicycle count data from Helsinki between 2014 to 2018. Methods A controlled interrupted time series design was used in combination with segmented regression as the method. An intervention series and a control series were analysed separately. The slopes (trend) and intercepts (level) of pre-intervention (2014&2015) segments were compared with post-intervention segments (2016-2018). The same analysis was performed in both intervention series and control series. ResultsThe results from the intervention series showed an increase of 105% in the level of the outcome after the implementation of the intervention. Simultaneously, the control series showed that the underlying trend of cycling remained largely unchanged during the whole study period (level increased by 3%). Stratified analysis supported these results in both intervention and control series. Conclusion The analysis of the intervention series revealed, that the level of the outcome increased sharply after the intervention, implying that the intervention had an immediate effect. However, the lack of statistical significance in the analysis of the slopes made it impossible to determine if the effect was sustained.

Objectives To determine the sex-specific prevalence, inequality and factors associated with healthcare utilisation for diabetes mellitus (DM), hypertension and comorbidity among the adult population of Bangladesh.Study design This study analysed cross-sectional nationwide Bangladesh Demographic and Health Survey data from 2011. Comorbidity was defined as the coexistence of both DM and hypertension. Several socioeconomic and demographic factors such as age, sex, education, geographic location, administrative division, employment status, education and wealth index were considered as major explanatory variables. Inequality in prevalence and healthcare utilisation was measured using the ‘Lorenz curve’. Adjusted multiple logistic regression models were performed to observe the effects of different factors and reported as adjusted ORs (AORs) with 95% CIs. A p value of <0.05 was adopted as the level of statistical significance.Setting The study was conducted in Bangladesh.Participants A total of 7521 adult participants with availability of biomarkers information were included.Results The mean age of the study participants was 51.4 years (SD ±13.0). The prevalence of hypertension, diabetes and comorbidity were 29.7%, 11.0% and 4.5% respectively. Socioeconomic inequality was observed in the utilisation of healthcare services. A higher prevalence of hypertension and comorbidity was significantly associated with individuals aged >70 years (AOR 7.0, 95% CI 5.0 to 9.9; AOR 6.7, 95% CI 3.0 to 14.9). The risk of having hypertension, diabetes and comorbidity were significantly higher among more educated, unemployed as well as among individuals from Khulna division.Conclusions The study revealed a rising prevalence of hypertension, diabetes and comorbidity with inequality in service utilisation. A joint effort involving public, private and non-governmental organisations is necessary to ensure improved accessibility in service utilisation and to reduce the di

OBJECTIVE: To review the publicly available policies and commitments of selected food companies in Thailand relating to obesity and non-communicable diseases (NCDs) prevention, and to assess these stated policies and commitments against global recommendations. METHODS: Nineteen food and beverage companies, including 13 packaged food, three non-alcoholic beverage, two food retailer, and one fast food company were selected, based on their market share by sector and food category. A review of publicly available policies and commitments related to four domains (product reformulation, food marketing, nutrition information and food accessibility) was carried out for each company. Content analysis of all data was conducted, including a comparison of policy content against global recommendations in each domain. RESULTS: Eleven companies (58%) reported at least one policy or commitment across the four domains. The packaged food companies reported policies in all four domains while the beverage companies committed to implement policies in all except the accessibility domain. The food retailers and fast food company only had policies in the reformulation and nutrition information domains. Very few of the policies and commitments covered all of the recommended components in each domain, and most lacked sufficient specificity to allow detailed monitoring and evaluation. CONCLUSION: A small number of the most prominent food companies in Thailand have several nutrition-related policies in place. However, these policies do not sufficiently cover recommended areas for NCD and obesity prevention. Moreover, the extent to which policy statements translate to implementation has yet to be evaluated. Successful implementation of nutrition-related policies by the food industry in Thailand will likely require concrete, measurable indicators to guide both corporate policy making as well as public monitoring. The Thailand Government requires greater capacity to establish effective multi-secto

Background Bikesharing is a versatile intervention, that enables cheap and convenient cycling for urban populations, and according to recent literature, has a positive impact on health, safety and the economy. Many of these impacts are based on the assumption of a modal shift induced by bikesharing, i.e. implementing a Bicycle Sharing System (BSS) will increase population cycling. However, the evidence is inconclusive. The aim of this study was to evaluate if the intervention of implementing a BSS increases cycling. The study was conducted using bicycle count data from Helsinki between 2014 to 2018. Methods A controlled interrupted time series design was used in combination with segmented regression as the method. An intervention series and a control series were analysed separately. The slopes (trend) and intercepts (level) of pre-intervention (2014&2015) segments were compared with post-intervention segments (2016-2018). The same analysis was performed in both intervention series and control series. ResultsThe results from the intervention series showed an increase of 105% in the level of the outcome after the implementation of the intervention. Simultaneously, the control series showed that the underlying trend of cycling remained largely unchanged during the whole study period (level increased by 3%). Stratified analysis supported these results in both intervention and control series. Conclusion The analysis of the intervention series revealed, that the level of the outcome increased sharply after the intervention, implying that the intervention had an immediate effect. However, the lack of statistical significance in the analysis of the slopes made it impossible to determine if the effect was sustained.

Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a di, Errata: Ginsburg, C., Bocquier, P., Béguy, D. et al. Correction to: association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data. BMC Public Health 21, 1555 (2021). DOI: 10.1186/s12889-021-11604-z

Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a di, Errata: Ginsburg, C., Bocquier, P., Béguy, D. et al. Correction to: association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data. BMC Public Health 21, 1555 (2021). DOI: 10.1186/s12889-021-11604-z

Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a di, Errata: Ginsburg, C., Bocquier, P., Béguy, D. et al. Correction to: association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data. BMC Public Health 21, 1555 (2021). DOI: 10.1186/s12889-021-11604-z

Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a di

Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a di, Errata: Ginsburg, C., Bocquier, P., Béguy, D. et al. Correction to: association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data. BMC Public Health 21, 1555 (2021). DOI: 10.1186/s12889-021-11604-z

Background: Many low- and middle-income countries are facing a double burden of disease with persisting high levels of infectious disease, and an increasing prevalence of non-communicable disease (NCD). Within these settings, complex processes and transitions concerning health and population are underway, altering population dynamics and patterns of disease. Understanding the mechanisms through which changing socioeconomic and environmental contexts may influence health is central to developing appropriate public health policy. Migration, which involves a change in environment and health exposure, is one such mechanism. Methods: This study uses Competing Risk Models to examine the relationship between internal migration and premature mortality from AIDS/TB and NCDs. The analysis employs 9 to 14 years of longitudinal data from four Health and Demographic Surveillance Systems (HDSS) of the INDEPTH Network located in Kenya and South Africa (populations ranging from 71 to 223 thousand). The study tests whether the mortality of migrants converges to that of non-migrants over the period of observation, controlling for age, sex and education level. Results: In all four HDSS, AIDS/TB has a strong influence on overall deaths. However, in all sites the probability of premature death (45q15) due to AIDS/TB is declining in recent periods, having exceeded 0.39 in the South African sites and 0.18 in the Kenyan sites in earlier years. In general, the migration effect presents similar patterns in relation to both AIDS/TB and NCD mortality, and shows a migrant mortality disadvantage with no convergence between migrants and non-migrants over the period of observation. Return migrants to the Agincourt HDSS (South Africa) are on average four times more likely to die of AIDS/TB or NCDs than are non-migrants. In the Africa Health Research Institute (South Africa) female return migrants have approximately twice the risk of dying from AIDS/TB from the year 2004 onwards, while there is a di, Errata: Ginsburg, C., Bocquier, P., Béguy, D. et al. Correction to: association between internal migration and epidemic dynamics: an analysis of cause-specific mortality in Kenya and South Africa using health and demographic surveillance data. BMC Public Health 21, 1555 (2021). DOI: 10.1186/s12889-021-11604-z

BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India. METHODS: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). RESULTS: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33). CONCLUSIONS

BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India. METHODS: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). RESULTS: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33). CONCLUSIONS

BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. METHODS: The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. RESULTS: In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth quintiles contr

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India. METHODS: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). RESULTS: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33). CONCLUSIONS

BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. METHODS: The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. RESULTS: In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth quintiles contr

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India. METHODS: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). RESULTS: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33). CONCLUSIONS

BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. METHODS: The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. RESULTS: In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth quintiles contr

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India. METHODS: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). RESULTS: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33). CONCLUSIONS

BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. METHODS: The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. RESULTS: In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth quintiles contr

BACKGROUND: Expenditure on medications for highly prevalent chronic conditions such as diabetes mellitus (DM) can result in financial impoverishment. People in developing countries and in low socioeconomic status groups are particularly vulnerable. China and India currently hold the world's two largest DM populations. Both countries are ageing and undergoing rapid economic development, urbanisation and social change. This paper assesses the determinants of DM medication use and catastrophic expenditure on medications in older adults with DM in China and India. METHODS: Using national standardised data collected from adults aged 50 years and above with DM (self-reported) in China (N = 773) and India (N = 463), multivariable logistic regression describes: 1) association between respondents' socio-demographic and health behavioural characteristics and the dependent variable, DM medication use, and 2) association between DM medication use (independent variable) and household catastrophic expenditure on medications (dependent variable) (China: N = 630; India: N = 439). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). RESULTS: Prevalence of DM medication use was 87% in China and 71% in India. Multivariable analysis indicates that people reporting lifestyle modification were more likely to use DM medications in China (OR = 6.22) and India (OR = 8.45). Women were more likely to use DM medications in China (OR = 1.56). Respondents in poorer wealth quintiles in China were more likely to use DM medications whereas the reverse was true in India. Almost 17% of people with DM in China experienced catastrophic healthcare expenditure on medications compared with 7% in India. Diabetes medication use was not a statistically significant predictor of catastrophic healthcare expenditure on medications in either country, although the odds were 33% higher among DM medications users in China (OR = 1.33). CONCLUSIONS

Skin barrier structure and function is essential to human health. Hitherto unrecognized functions of epidermal keratinocytes show that the skin plays an important role in adapting whole-body physiology to changing environments, including the capacity to produce a wide variety of hormones, neurotransmitters and cytokine that can potentially influence whole-body states, and quite possibly, even emotions. Skin microbiota play an integral role in the maturation and homeostatic regulation of keratinocytes and host immune networks with systemic implications. As our primary interface with the external environment, the biodiversity of skin habitats is heavily influenced by the biodiversity of the ecosystems in which we reside. Thus, factors which alter the establishment and health of the skin microbiome have the potential to predispose to not only cutaneous disease, but also other inflammatory non-communicable diseases (NCDs). Indeed, disturbances of the stratum corneum have been noted in allergic diseases (eczema and food allergy), psoriasis, rosacea, acne vulgaris and with the skin aging process. The built environment, global biodiversity losses and declining nature relatedness are contributing to erosion of diversity at a micro-ecological level, including our own microbial habitats. This emphasises the importance of ecological perspectives in overcoming the factors that drive dysbiosis and the risk of inflammatory diseases across the life course.

BACKGROUND: Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. METHODS: The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. RESULTS: In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth quintiles contr

Des de la Carta d'Ottawa, l'Organització Mundial de la Salut ha liderat iniciatives d'entorns saludables promovent a nivell global iniciatives per crear entorns saludables, com hospitals, escoles, etc. L'entorn laboral és un lloc privilegiat per desenvolupar polítiques de promoció de salut per canviar els hàbits de vida que augmenten el risc de malalties. Aquest TFM fa una explotació estadística d'una base de dades de reconeixements mèdics de treballadors espanyols l'any 2015 per evaluar l'estat de salut d'aquests i proporcionar directrius per a la gestió i promoció de la salut.

Background: Edentulism (loss of all teeth) is a final marker of disease burden for oral health common among older adults and poorer populations. Yet most evidence is from high-income countries. Oral health has many of the same social and behavioural risk factors as other non-communicable diseases (NCDs) which are increasing rapidly in low- and middle-income countries with ageing populations. The "common risk factor approach" (CRFA) for oral health addresses risk factors shared with NCDs within the broader social and economic environment. Methods: The aim is to improve understanding of edentulism prevalence, and association between common risk factors and edentulism in adults aged 50 years and above using nationally representative samples from China (N = 11,692), Ghana (N = 4093), India (N = 6409) and South Africa (N = 2985). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). Multivariable logistic regression describes association between edentulism and common risk factors reported in the literature. Results: Prevalence of edentulism: in China 8.9 %, Ghana 2.9 %, India 15.3 %, and South Africa 8.7 %. Multivariable analysis: in China, rural residents were more likely to be edentulous (OR 1.36; 95 % CI 1.09-1.69) but less likely to be edentulous in Ghana (OR 0.53; 95 % CI 0.31-0.91) and South Africa (OR 0.52; 95 % CI 0.30-0.90). Respondents with university education (OR 0.31; 95 % CI 0.18-0.53) and in the highest wealth quintile (OR 0.68; 95 % CI 0.52-0.90) in China were less likely to be edentulous. In South Africa respondents with secondary education were more likely to be edentulous (OR 2.82; 95 % CI 1.52-5.21) as were those in the highest wealth quintile (OR 2.78; 95 % CI 1.16-6.70). Edentulism was associated with former smokers in China (OR 1.57; 95 % CI 1.10-2.25) non-drinkers in India (OR 1.65; 95 % CI 1.11-2.46), angina in Ghana (OR 2.86; 95 % CI 1.19-6.84) and hypertension in South Africa (

Background: Edentulism (loss of all teeth) is a final marker of disease burden for oral health common among older adults and poorer populations. Yet most evidence is from high-income countries. Oral health has many of the same social and behavioural risk factors as other non-communicable diseases (NCDs) which are increasing rapidly in low- and middle-income countries with ageing populations. The "common risk factor approach" (CRFA) for oral health addresses risk factors shared with NCDs within the broader social and economic environment. Methods: The aim is to improve understanding of edentulism prevalence, and association between common risk factors and edentulism in adults aged 50 years and above using nationally representative samples from China (N = 11,692), Ghana (N = 4093), India (N = 6409) and South Africa (N = 2985). The data source is the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 (2007-2010). Multivariable logistic regression describes association between edentulism and common risk factors reported in the literature. Results: Prevalence of edentulism: in China 8.9 %, Ghana 2.9 %, India 15.3 %, and South Africa 8.7 %. Multivariable analysis: in China, rural residents were more likely to be edentulous (OR 1.36; 95 % CI 1.09-1.69) but less likely to be edentulous in Ghana (OR 0.53; 95 % CI 0.31-0.91) and South Africa (OR 0.52; 95 % CI 0.30-0.90). Respondents with university education (OR 0.31; 95 % CI 0.18-0.53) and in the highest wealth quintile (OR 0.68; 95 % CI 0.52-0.90) in China were less likely to be edentulous. In South Africa respondents with secondary education were more likely to be edentulous (OR 2.82; 95 % CI 1.52-5.21) as were those in the highest wealth quintile (OR 2.78; 95 % CI 1.16-6.70). Edentulism was associated with former smokers in China (OR 1.57; 95 % CI 1.10-2.25) non-drinkers in India (OR 1.65; 95 % CI 1.11-2.46), angina in Ghana (OR 2.86; 95 % CI 1.19-6.84) and hypertension in South Africa (