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Aims: Among persons with hypertension and diabetes on treatment for at least 1 year at the Rural Health Centre (RHC) noncommunicable disease (NCD) clinic, 1. To determine the control status for hypertension and diabetes. 2. To assess the relationship between proxy behavior for collection of medications and the control status. Settings and Design: Rural Health Centre, Ramanathapuram, Puducherry, India; record-based retrospective observational study. Methods and Material: The study employed a universal sampling of 396 eligible persons with diabetes and hypertension who had been on medication for over a year at the RHC NCD clinic and had recorded blood pressure and glucose values within the last 4 months. Case sheets of these patients were retrieved from the Medical Registration Department, and data from the past 12 months were collected and analyzed to assess proxy behaviors and absenteeism. Statistical Analysis Used: Data were entered from the case sheets in Epicollect5 and analyzed using Stata v17. Results: Among hypertensive patients, 48.01% were aged 60 and above, with 55.63% being female. Fifty-six percent of hypertensive patients had their condition controlled. For diabetic patients, 40.88% were aged 45–59 years, with 59.75% being female. Only 18.24% of diabetic patients had their condition controlled. The multivariable analysis examined factors associated with the control status of hypertension and diabetes. Those aged 30–44 (aRR: 1.47, 95% CI: 1.01–2.15) and 45–59 (aRR: 1.37, 95% CI: 1.03–1.82) had a higher risk of uncontrolled hypertension compared to those aged 60 and above. Gender did not show significant associations with hypertension control status. Regarding attendance status, patients who had both proxy and missed visits (RR: 1.46, 95% CI: 1.02–2.07) had a higher risk of uncontrolled hypertension. There was also a significant association with patients having more than three proxies (aRR: 1.51, 95% CI: 1.10–2.17) exhibiting a higher risk of uncontrolled hypertension. Absenteeism status showed that those absent for 1–3 visits had a higher relative risk (RR: 1.37, 95% CI: 1.03–1.82) of uncontrolled hypertension compared to those with no absenteeism. Conclusion: Proxy behavior affects the control status of persons with hypertension and diabetes. A longitudinal study is warranted to assess the relationship between proxy visits and control status.

ABSTRACT: Aims: Among persons with hypertension and diabetes on treatment for at least 1 year at the Rural Health Centre (RHC) noncommunicable disease (NCD) clinic, 1. To determine the control status for hypertension and diabetes. 2. To assess the relationship between proxy behavior for collection of medications and the control status. Settings and Design: Rural Health Centre, Ramanathapuram, Puducherry, India; record-based retrospective observational study. Methods and Material: The study employed a universal sampling of 396 eligible persons with diabetes and hypertension who had been on medication for over a year at the RHC NCD clinic and had recorded blood pressure and glucose values within the last 4 months. Case sheets of these patients were retrieved from the Medical Registration Department, and data from the past 12 months were collected and analyzed to assess proxy behaviors and absenteeism. Statistical Analysis Used: Data were entered from the case sheets in Epicollect5 and analyzed using Stata v17. Results: Among hypertensive patients, 48.01% were aged 60 and above, with 55.63% being female. Fifty-six percent of hypertensive patients had their condition controlled. For diabetic patients, 40.88% were aged 45–59 years, with 59.75% being female. Only 18.24% of diabetic patients had their condition controlled. The multivariable analysis examined factors associated with the control status of hypertension and diabetes. Those aged 30–44 (aRR: 1.47, 95% CI: 1.01–2.15) and 45–59 (aRR: 1.37, 95% CI: 1.03–1.82) had a higher risk of uncontrolled hypertension compared to those aged 60 and above. Gender did not show significant associations with hypertension control status. Regarding attendance status, patients who had both proxy and missed visits (RR: 1.46, 95% CI: 1.02–2.07) had a higher risk of uncontrolled hypertension. There was also a significant association with patients having more than three proxies (aRR: 1.51, 95% CI: 1.10–2.17) exhibiting a higher risk of uncontrolled hypertension. Absenteeism status showed that those absent for 1–3 visits had a higher relative risk (RR: 1.37, 95% CI: 1.03–1.82) of uncontrolled hypertension compared to those with no absenteeism. Conclusion: Proxy behavior affects the control status of persons with hypertension and diabetes. A longitudinal study is warranted to assess the relationship between proxy visits and control status. [ABSTRACT FROM AUTHOR]

Abstract Background Noncommunicable diseases (NCDs) account for a substantial number of deaths in Afghanistan. Understanding the prevalence and correlates of major NCD risk factors could provide a benchmark for future public health policies and programs to prevent and control NCDs. Therefore, this study aimed to examine the prevalence and correlates of NCD risk factors among adults aged 18–69 years in Afghanistan. Methods We used data from the Afghanistan STEPS Survey 2018. The study population were 3650 (1896 males and 1754 females) adults aged 18–69 years sampled from all 34 provinces through a multistage cluster sampling process. Information on behavioural and biological risk factors was collected. We used STATA (version 18.0) for data analysis. Results Of the total participants, 42.8% were overweight or obese, 8.6% were current smokers, 26.9% had insufficient physical activities, 82.6% had low consumption of fruits and vegetables, and only 0.5% had ever consumed alcohol. Approximately 15% of participants had a high salt intake, while 25% and 8% had elevated blood pressure and blood glucose levels, respectively. Similarly, around 18% had elevated total cholesterol. The study revealed a lower prevalence of current smoking among females [AOR = 0.17, 95%CI (0.09–0.30)] compared with males, but a higher prevalence in those who had higher education levels [1.95 (1.13–3.36)] compared with those with no formal education. Insufficient physical activity was higher in participants aged 45–69 years [1.96 (1.39–2.76)], females [4.21 (1.98–8.84)], and urban residents [2.38 (1.46–3.88)] but lower in those with higher education levels [0.60 (0.37–0.95)]. Participants in the 25th to 75th wealth percentiles had higher odds of low fruit and vegetable consumption [2.11 (1.39–3.21)], while those in the > 75th wealth percentile had lower odds of high salt intake [0.63 (0.41–0.98)]. Being overweight/obese was more prevalent in participants aged 45–69 years [1.47 (1.03–2.11)], females [1.42 (0.99–2.01)], currently married [3.56 (2.42–5.21)] or ever married [5.28 (2.76–10.11)], and urban residents [1.39 (1.04–1.86)]. Similarly, high waist circumference was more prevalent in participants aged 45–69 years [1.86 (1.21–2.86)], females [5.91 (4.36–8.00)], those being currently married [4.82 (3.12–7.46)], and those being in 25th to 75th wealth percentile [1.76 (1.27–2.43)]. A high prevalence of elevated blood pressure was observed in participants aged 45–69 years [3.60 (2.44–5.31)] and currently married [2.31 (1.24–4.31)] or ever married [6.13 (2.71–13.8)] participants. Elevated blood glucose was more prevalent in older adults ([1.92 (1.09–3.39)] for 45–69 and [3.45 (2.44–5.31)] for 30–44 years), urban residents [2.01 (1.33–3.03)], and ever-married participants [4.89 (1.48–16.2)]. A higher prevalence of elevated cholesterol was observed in females [2.68 (1.49–4.82)] and those currently married [2.57 (1.17–5.63)] or ever married [4.24 (1.31–13.73)]. Conclusion This study used up-to-date available data from a nationally representative sample and identified the prevalence of NCDs and associated risk factors in Afghanistan. Our findings have the potential to inform and influence health policies by identifying people at high risk of developing NCDs and can assist policymakers, health managers, and clinicians to design and implement targeted health interventions.

Fluorescent nanoparticles known as quantum dots (QDs) have unique properties that make them useful in biomedicine. Specifically, CdSe/ZnS QDs, while good at fluorescing, show toxicity. Due to this, safer alternatives have been developed. This study uses a tetrazolium dye (XTT) viability assay, reactive oxygen species (ROS) fluorescent imaging, and apoptosis to investigate the effect of QD alternatives InP/ZnS, CuInS2/ZnS, and nitrogen-doped carbon dots (NCDs) in liver cells. The liver is a possible destination for the accumulation of QDs, making it an appropriate model for testing. A cancerous liver cell line known as HepG2 and an immortalized liver cell line known as THLE-2 were used. At a nanomolar range of 10–150, HepG2 cells demonstrated no reduced cell viability after 24 h. The XTT viability assay demonstrated that CdSe/ZnS and CuInS2/ZnS show reduced cell viability in THLE-2 cells with concentrations between 50 and 150 nM. Furthermore, CdSe/ZnS- and CuInS2/ZnS-treated THLE-2 cells generated ROS as early as 6 h after treatment and elevated apoptosis after 24 h. To further corroborate our results, apoptosis assays revealed an increased percentage of cells in the early stages of apoptosis for CdSe/ZnS-treated (52%) and CuInS2/ZnS-treated (38%) THLE-2. RNA transcriptomics revealed heavy downregulation of cell adhesion pathways such as wnt, cadherin, and integrin in all QDs except NCDs. In conclusion, NCDs show the least toxicity toward these two liver cell lines. While demonstrating less toxicity than CdSe/ZnS, the metallic QDs (InP/ZnS and CuInS2/ZnS) still demonstrate potential concerns in liver cells. This study serves to explore the toxicity of QD alternatives and better understand their cellular interactions. [ABSTRACT FROM AUTHOR]

IntroductionThe surge in non-communicable diseases (NCDs) has been linked to excessive sugar-sweetened beverage (SSB) consumption. In response, the World Health Organization advocates for SSB taxes as a preventive measure. This study conducts a systematic literature review, encompassing simulation modeling and empirical evidence, to evaluate the effectiveness of SSB taxes in diminishing NCD prevalence.MethodA systematic search from August 2002 to August 2022, utilizing databases like ScienceDirect, PubMed, Google Scholar, Wiley Online Library, Springer, and ResearchGate, identified 29 relevant articles worldwide following PRISMA 2020. The Critical Appraisal Skill Programme (CASP) 2018 tool was employed for economic evaluationResultAmong the selected articles, 22 utilized simulation models in group of countries such as South Africa, the US, the UK, Asia (Philippines, India, Indonesia, Thailand), Australia, and Europe (Germany), while seven were based on US and UK evidence. Simulation modeling consistently demonstrated that SSB taxes significantly reduced NCD incidence, prevalence, and mortality, also bolstering government revenue. Tax rates in simulations ranged from 10 to 25%. However, empirical evidence indicated a limited impact, primarily due to low tax rates. Notably, a UK-specific tax led to a 2.7% reduction in SSB sugar purchases and 40.2% higher purchases of no-levy drinks.DiscussionThe findings suggest that while simulation models demonstrate the potential effectiveness of SSB taxes in reducing NCDs, empirical evidence reveals there is no significant effect of the SSB tax, Based on the study conducted in this study, the SSB tax is not effective in reducing the prevalence of NCDs due to consumer preferences that have not changed. , likely due to the implementation of lower tax rates and failure to fulfill the assumption of subtitution product, physical activity, and so on. The study highlights that SSB tax is not effective in reducing the prevalence of NCDs due to consumer preference that have not change. Multi-actions are needed to support the sustainability of the implementation of the SSB tax, including education and promotion of healthy lifestyles and encouragement to reformulate SSB products by industry.

Abstract Background Non-communicable diseases (NCDs) are high on the priority list of the Kerala government, and exploring the extent to which transgender and gender diverse (TGD) community members benefit from the services of national programmes for NCDs can provide valuable insights on improving the inclusivity of the health system as it moves towards Universal Health Coverage. This study was conducted to explore the prevalence of NCD risk factors as well as facilitators and barriers to NCD management among the TGD population in Kerala. Methods A multiple methods study, including a cross-sectional survey of 120 self-identifying TGD people that included an adaptation of the WHO STEPS questionnaire, as well as in-depth interviews with thirteen individuals, was conducted in three districts of Kerala to explore the barriers and facilitators to NCD prevention and management. Results The results are presented using the key dimensions emerging out of the Diederichsen framework. A range of discrimination faced by TGD people in Kerala traps them in situations of low educational outcomes with consequent disadvantages in the job market when they search for livelihoods. This results in a large proportion of our sample living away from families (69 percent), and finding themselves in precarious jobs including sex work (only 33 percent had a regular job), with all these aforementioned factors converging to marginalise their social position. This social position leads to differential risk exposures such as increased exposure to modifiable risk factors like alcohol (40 percent were current alcohol users) and tobacco use (40.8 percent currently used tobacco) and ultimately metabolic risk factors too (30 and 18 percent were hypertensive and diabetic respectively). Due to their differential vulnerabilities such as the discrimination that TGD people are subjected to (41.7 percent had faced discrimination at a healthcare centre in the past one year), those with higher exposure to risk factors often find it hard to bring about behavioural modifications and are often not able to access the services they require. Conclusions The disadvantaged social position of TGD people and associated structural issues result in exacerbated biological risks, including those for NCDs. Ignoring these social determinants while designing health programmes is likely to lead to sub-optimal outcomes.

Non-communicable diseases (NCDs) are still a morbidity and mortality problem in Southeast Asia. However, NCD in Southeast Asia still needs to be handled faster. WHO recommends the use of digital in treating NCDs in Southeast Asia. Therefore, this literature review study aims to describe how mHealth is utilized to overcome the problem of NCDs in Southeast Asian countries. The author collected articles using Google Scholar and Proquest, which were published in 2019-2023. The focus of the search was articles published in English-language Research Journals. Researchers used advanced search with the keywords NCD, Non-communicable diseases, mHealth, Mobile Health, Nursing, and Health Promotion. Keywords are combined using Boolean and/or the online database that the researcher chose. Articles that have been filtered are filtered again by selecting research locations in Southeast Asian countries. Ten articles obtained came from research in Southeast Asian countries Indonesia (n=4), Malaysia (n=1), Singapore (n=1), Vietnam (n=1), Thailand (1), Cambodia (n=1), Philippines (n=1). All articles discussed the use of mHealth for NCD management in their countries and aimed to determine the barriers (n=3), feasibility (n=1), effectiveness (n=2), impact (n=2), potential (n=1), perception (n=1), and perspective (n=1) of service providers, as well as the experience of using mHealth in remote areas (n=1). It can be concluded that mHealth can be used for independent screening for PTM, providing education about NCDs, and can be applied in rural areas as a comprehensive effort to handle NCDs.

BACKGROUND: Data on the prevalence of non-communicable diseases (NCDs) in TB household contacts (HHCs) are limited, yet important to inform integrated screening and care for NCD within contact investigations. It is also unclear if screening these contacts reveals more people with NCDs than individuals in the same neighbourhood. METHOD: We conducted a pilot cross-sectional study in South Africa and Tanzania, enrolling adult HHCs of TB and individuals in neighbourhood households (controls). We inquired about known NCD and systematically measured blood pressure, and tested for spot blood glucose and haemoglobin A1c. RESULTS: We enrolled 203 adult contacts of 111 persons with TB and 160 controls. Among contacts, respectively 12.2% (95% CI 8.3–17.6) and 39.7% (95% CI 33.1–46.7) had diabetes and hypertension, compared to 14.1% (95% CI 9.2–21.0) and 44.7% (95% CI 36.9–52.7) among controls. More than half of NCDs were newly identified. We did not find a significant difference in the prevalence of at least one NCD between the two groups (OR 0.85, 95% CI 0.50–1.45, adjusted for age and sex). CONCLUSIONS: We found a high prevalence of undiagnosed NCDs among contacts, suggesting a potential benefit of integrating NCD screening and care within contact investigations. Screening in the same community might similarly find undiagnosed NCDs.

To control non-communicable diseases, the NCD Posyandu (integrated service post) monitors and detects possible risk factors for non-communicable diseases in the community. This study used qualitative research methods with in-depth interview questionnaires for informants at the NCD Posyandu, UPT Puruk Cahu Health Center. The study’s results comparing the NCD Posyandu implementation standards for 2014 showed that the NCD Posyandu work area had good and competent cadres, with patients getting NCD services and counseling for free. Recommendations are needed to improve partnerships, funding support, and NCD Posyandu implementation tools, increase the number of cadres, and provide training to all NCD Posyandu cadres and meetings for the community on non-communicable diseases so that coordination among all parties in NCD Posyandu, including the community, runs optimally both in quality and quantity.

Background: Non-communicable diseases (NCDs) are high on the priority list of the Kerala government, and exploring the extent to which transgender and gender diverse (TGD) community members benefit from the services of national programmes for NCDs can provide valuable insights on improving the inclusivity of the health system as it moves towards Universal Health Coverage. This study was conducted to explore the prevalence of NCD risk factors as well as facilitators and barriers to NCD management among the TGD population in Kerala. Methods: A multiple methods study, including a cross-sectional survey of 120 self-identifying TGD people that included an adaptation of the WHO STEPS questionnaire, as well as in-depth interviews with thirteen individuals, was conducted in three districts of Kerala to explore the barriers and facilitators to NCD prevention and management. Results: The results are presented using the key dimensions emerging out of the Diederichsen framework. A range of discrimination faced by TGD people in Kerala traps them in situations of low educational outcomes with consequent disadvantages in the job market when they search for livelihoods. This results in a large proportion of our sample living away from families (69 percent), and finding themselves in precarious jobs including sex work (only 33 percent had a regular job), with all these aforementioned factors converging to marginalise their social position. This social position leads to differential risk exposures such as increased exposure to modifiable risk factors like alcohol (40 percent were current alcohol users) and tobacco use (40.8 percent currently used tobacco) and ultimately metabolic risk factors too (30 and 18 percent were hypertensive and diabetic respectively). Due to their differential vulnerabilities such as the discrimination that TGD people are subjected to (41.7 percent had faced discrimination at a healthcare centre in the past one year), those with higher exposure to risk factors often find it hard to bring about behavioural modifications and are often not able to access the services they require. Conclusions: The disadvantaged social position of TGD people and associated structural issues result in exacerbated biological risks, including those for NCDs. Ignoring these social determinants while designing health programmes is likely to lead to sub-optimal outcomes. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Access to medicine is a concern in India and other developing countries. In India, Pradhan Mantri Bhartiya Janaushadhi Priyojana (PMBJP) helps to a certain extent in provision of medicines to people experiencing poverty. PMBJP is India's central government scheme hosted by the Department of Pharmaceuticals, which comes under the Ministry of Chemicals and Fertilizers. The scheme was uniformly introduced in all the states of the country to benefit the people at large in 2008. The objective of the scheme is to provide high-quality medication to everyone belonging to different strata of the population, especially underprivileged and impoverished people. The state has high regional inequality where few districts are economically developed while many others are economically backward, and access to medicine remains a challenge. This paper explores the knowledge and awareness of the scheme among PMC owners, grievances, and market competition of PMCs. METHODS: This study adopted a qualitative research method to understand the concerns of pharmacists and PMCs. An interview schedule was used to assess the situation. The research revolves around subjects such as proprietorship, motivational aspects, monetary provision, faith, satisfaction, perceived benefits, and challenges of the stakeholders. Therefore, openended, in-depth interviews were best suited for the study. PMC pharmacists were the only participants in the study. The data collection took place in January and February 2023. RESULTS: The results are presented under three themes pertaining to the PMC business: awareness, grievances, and market competition. The study revealed that the ownership of the PMCs was of two types in the state of Odisha, India: one was an old PMC that started between 2008 and 2015, and the other type was a new PHC that started after 2015. In 2015, radical changes were brought into the scheme. The popularity of the scheme among private pharmacists became a phenomenon after 2015; earlier, it was under the control of the government and the District Red Cross (DRC). The scheme was made open for all independent private pharmacists in 2015. The risk of expired stocks constantly loomed over the PMC business. PMC owners discussed expired drug management mechanisms. Market competition was very much in favor of the PMC owners, as thei r products were much cheaper than the branded market products. However, they reel under small earnings due to the low price of their products. CONCLUSION: Disseminating information about the PMBJP scheme is currently limited to existing pharmacists. The scheme could be promoted to recent graduates with D. Pharma or B to expand its reach. Pharma degrees, encouraging them to become independent PMC pharmacists. Additionally, enhancing mechanisms for managing expired drugs would make the PMC business more appealing. Reforms are also needed for older PMCs (established between 2008 and 2015) to prevent conflicts with authorities and other schemes. While PMCs benefit from lower product prices, they must increase sales volume to achieve satisfactory income, which should be considered to improve the financial outcomes for PMC owners. [ABSTRACT FROM AUTHOR]

Based on observations, information was obtained that the elderly hypertension rate was quite high (70%) in Ngaran II Hamlet. Some of the possible causes are the lack of knowledge and public awareness about non-communicable diseases (NCD), in addition to the lack of cadres and equipment. This causes the Posyandu not to run optimally. Integrated activities for field supervisors and students include forming a NCD care group. NCD prevention and screening training was given to members of the NCD Care group, with material on blood pressure checks, simple blood tests and determination of body mass index. At the beginning and end of the training, an evaluation was conducted to assess the level of knowledge of the participants. The NCD care group consists of 9 health cadres. The training methods include theory, discussion, and practice. Participants were aged between 36-54 years (43.6) with 55.56% high school education and 44.44% junior high school education. Of the 9 participants, only 7 completed the test. It can be seen that there is an increase in knowledge from the average pretest score of 45.54 to 68.75 post-test score. Statistical test using Paired T-test showed a significant increase (p 0.001). It was concluded that the training succeeded in significantly increasing knowledge about NCDs and their prevention

BackgroundDiabetes and hypertension are leading public health problems, particularly affecting low- and middle-income countries, with considerable variations in the care continuum between different age, socio-economic, and rural and urban groups. In this qualitative study, examining the factors affecting access to healthcare in Kerala, we aim to explore the healthcare-seeking pathways of people living with diabetes and hypertension.MethodsWe conducted 20 semi-structured interviews and one focus group discussion (FGD) on a purposive sample of people living with diabetes and hypertension. Participants were recruited at four primary care facilities in Malappuram district of Kerala. Interviews were transcribed and analyzed deductively and inductively using thematic analysis underpinned by Levesque et al.’s framework.ResultsThe patient journey in managing diabetes and hypertension is complex, involving multiple entry and exit points within the healthcare system. Patients did not perceive Primary Health Centres (PHCs) as their initial points of access to healthcare, despite recognizing their value for specific services. Numerous social, cultural, economic, and health system determinants underpinned access to healthcare. These included limited patient knowledge of their condition, self-medication practices, lack of trust/support, high out-of-pocket expenditure, unavailability of medicines, physical distance to health facilities, and attitude of healthcare providers.ConclusionThe study underscores the need to improve access to timely diagnosis, treatment, and ongoing care for diabetes and hypertension at the lower level of the healthcare system. Currently, primary healthcare services do not align with the “felt needs” of the community. Practical recommendations to address the social, cultural, economic, and health system determinants include enabling and empowering people with diabetes and hypertension and their families to engage in self-management, improving existing health information systems, ensuring the availability of diagnostics and first-line drug therapy for diabetes and hypertension, and encouraging the use of single-pill combination (SPC) medications to reduce pill burden. Ensuring equitable access to drugs may improve hypertension and diabetes control in most disadvantaged groups. Furthermore, a more comprehensive approach to healthcare policy that recognizes the interconnectedness of non-communicable diseases (NCDs) and their social determinants is essential.

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Background: In the current digital era, eHealth literacy plays an indispensable role in health care and self-management among older adults with noncommunicable diseases (NCDs). Measuring eHealth literacy appropriately and accurately ensures the successful implementation and evaluation of pertinent research and interventions. However, existing eHealth literacy measures focus mainly on individuals' abilities of accessing and comprehending eHealth information (Web1.0), whereas the capabilities for web-based interaction (Web2.0) and using eHealth information (Web3.0) have not been adequately evaluated. Objective: This study aimed to examine the reliability, validity, and measurement invariance of the eHealth Literacy Scale-Web3.0 (eHLS-Web3.0) among older adults with NCDs. Methods: A total of 642 Chinese older adults with NCDs (mean age 65.78, SD 3.91 years; 55.8% female) were recruited in the baseline assessment, of whom 134 (mean age 65.63, SD 3.99 years; 58.2% female) completed the 1-month follow-up assessment. Baseline measures included the Chinese version of the 24-item 3D eHLS-Web3.0, the Chinese version of the 8-item unidimensional eHealth Literacy Scale (eHEALS), and demographic information. Follow-up measures included the 24-item eHLS-Web3.0 and accelerometer-measured physical activity and sedentary behavior. A series of statistical analyses, for example, Cronbach α, composite reliability coefficient (CR), confirmatory factor analysis (CFA), and multigroup CFA, were performed to examine the internal consistency and test-retest reliabilities, as well as the construct, concurrent, convergent, discriminant, and predictive validities, and the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence. Results: Cronbach α and CR were within acceptable ranges of 0.89-0.94 and 0.90-0.97, respectively, indicating adequate internal consistency of the eHLS-Web3.0 and its subscales. The eHLS-Web3.0 also demonstrated cross-time stability, with baseline and follow-up measures showing a significant intraclass correlation of 0.81-0.91. The construct validity of the 3D structure model of the eHLS-Web3.0 was supported by confirmatory factor analyses. The eHLS-Web3.0 exhibited convergent validity with an average variance extracted value of 0.58 and a CR value of 0.97. Discriminant validity was supported by CFA results for a proposed 4-factor model integrating the 3 eHLS-Web3.0 subscales and eHEALS. The predictive validity of the eHLS-Web3.0 for health behaviors was supported by significant associations of the eHLS-Web3.0 with light physical activity (β=.36, P =.004), moderate to vigorous physical activity (β =.49, P <.001), and sedentary behavior (β =–.26, P =.002). Finally, the measurement invariance of the eHLS-Web3.0 across gender, education level, and residence was supported by the establishment of configural, metric, strong, and strict invariances. Conclusions: The present study provides timely empirical evidence on the reliability, validity, and measurement invariance of the eHLS-Web3.0, suggesting that the 24-item 3D eHLS-Web3.0 is an appropriate and valid tool for measuring eHealth literacy among older adults with NCDs within the Web3.0 sphere. [ABSTRACT FROM AUTHOR]

Background: Gestational Diabetes Mellitus (GDM) is a Glucose tolerance disorder first diagnosed during pregnancy. WHO recommend that all pregnant women or at least women with predisposing risk factors should be screened at the beginning of the 3rd trimester of pregnancy with the Oral Glucose Tolerance Test (OGTT). Here, blood glucose level is screened 2hrs after giving a 75g oral glucose load. This is recommended for both screening and diagnosis. Not many studies have been done regarding the outcome of GDM mothers in India. Objective: 1. To describe the Obstetric profile of the mothers 2. To assess the outcome of GDM among the Mothers 3. To determine the neonatal outcome of GDM. Methodology: Study setting: The study was carried out at Kasturba Medical College Hospital, Attavar, and District Lady Goschen Hospital, Mangalore. Study design: Hospital based retrospective study. Study population: Pregnant women admitted to above mentioned hospitals with GDM and the new born. Inclusion criteria: All women diagnosed with GDM and have delivered in District Lady Goschen Hospital or KMCH Attavar. Sample size was 266. Results: Our study concluded that 24.8% of the women with GDM also had Pregnancy Induced Hypertension, which is comparable to the study done in Qatar where they found 19.2% of the women with GDM suffered from PIH. We also found that 15.8% of the women suffered from Pre-Eclampsia, over twice the percentage of people surveyed in the Qatari study. However the amount of babies suffering from Macrosomia was only 6.8% as opposed to 10.3% according to the aforementioned study and 19.3% as was found in a study in Poznan, Poland. Conclusion: No significant association was found between obstetric profile and antenatal & postpartum complications.

Background Risky behaviours such as smoking, alcohol consumption, physical inactivity and inadequate consumption of fruits and vegetables are known contributing factors for non-communicable diseases (NCDs) which account for 74% of global mortality. Such behavioural risk factors co-occur frequently resulting in synergistic action for developing NCD related morbidity and mortality. This study aims to assess the existence of multiple risk behaviours and determine the socio-economic and demographic factors associated with co-occurrence of behavioural risks among Myanmar adult population. Method Data were collected, in the context of the SUNI-SEA project (Scaling Up NCD interventions in Southeast Asia), from 660 community members aged 40 years and above of both sexes, residing in selected urban and rural areas from Ayeyawaddy, Yangon and Mandalay regions of Myanmar. The co-occurrence of behavioural risk factors was presented as percentage with 95% CI and its determinants were identified by multinomial logistic regression. Results The co-occurrence of two risk behaviours and three or four risk behaviours were found in 40% (95% CI: 36.2%, 43.9%) and 10.8% (95% CI: 8.5%, 13.4%) respectively. Urban residents, men, participants without formal schooling and unemployed persons were more likely to exhibit co-occurrence of two risk behaviors and three or four risk behaviours. Conclusion The current study shows high prevalence of co-occurrence of behavioural risk factors among Myanmar adults in the study area. NCD prevention and control programs emphasizing management of behavioural risks should be intensively promoted, particularly directed towards multiple behavioural risk factors, and not focused on individual factors only.

Jakub Hort,1 Thomas Duning,2 Robert Hoerr3 1Memory Clinic, Department of Neurology, Charles University, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic; 2Department of Neurology, Klinikum Bremen-Ost, Bremen, Germany; 3Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, GermanyCorrespondence: Robert Hoerr, Research and Development, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Str. 4, Karlsruhe, 76227, Germany, Tel +49 721 4005 429, Email robert.hoerr@schwabe.deBackground: Many clinical trials testing Ginkgo biloba extract EGb 761 in patients with mild forms of cognitive impairment were conducted before widely accepted terms and diagnostic criteria for such conditions were available. This makes it difficult to compare any results from earlier and more recent trials. The objective of this systematic review was to provide a descriptive overview of clinical trials of EGb 761 in patients who met the diagnostic criteria for mild neurocognitive disorder (mild NCD) according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).Methods: MEDLINE, PubMed and EMBASE were searched for randomized, placebo-controlled double-blind trials of EGb 761 in mild impairment of cognitive functioning. All trials involving patients who met retrospectively applied diagnostic criteria for mild NCD were included. Trials of primary prevention of dementia and trials of combinations of medical treatments were excluded.Results: Among 298 records found in databases and 76 further records related to EGb 761 in references of systematic reviews, 9 reports on clinical trials involving 946 patients met the pre-specified criteria for inclusion. Beneficial effects of EGb 761 were seen in neuropsychological tests (8 of 9 studies), scales for neuropsychiatric symptoms (3 of 3 studies), geriatric rating scales (1 of 2 studies) and global ratings of change (1 of 1 study). Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning). Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved. No differences between EGb 761 treatment and placebo were seen with regard to the rates of adverse events.Discussion: The included studies demonstrate treatment benefits of Ginkgo biloba extract EGb 761, mainly on cognitive deficits and neuropsychiatric symptoms, in patients with mild NCD. The drug was safe and well tolerated.Keywords: Ginkgo biloba, EGb 761, mild neurocognitive disorder, NCD, mild cognitive impairment, systematic review

Abstract Background To tackle noncommunicable disease (NCD) burden globally, two sets of NCD surveillance indicators were established by the World Health Organization: 25 Global Monitoring Framework (GMF) indicators and 10 Progress Monitoring Indicators (PMI). This study aims to assess the data availability of these two sets of indicators in six ASEAN countries: Cambodia, Lao PDR, Malaysia, Myanmar, Thailand, and Vietnam. Methods As data on policy indicators were straightforward and fully available, we focused on studying 25 non-policy indicators: 23 GMFs and 2 PMIs. Gathering data availability of the target indicators was conducted among NCD surveillance experts from the six selected countries during May-June 2020. Our research team found information regarding whether the country had no data at all, was using WHO estimates, was providing ‘expert judgement’ for the data, or had actual data available for each target indicator. We triangulated their answers with several WHO data sources, including the WHO Health Observatory Database and various WHO Global Reports on health behaviours (tobacco, alcohol, diet, and physical activity) and NCDs. We calculated the percentages of the indicators that need improvement by both indicator category and country. Results For all six studied countries, the health-service indicators, based on responses to the facility survey, are the most lacking in data availability (100% of this category’s indicators), followed by the health-service indicators, based on the population survey responses (57%), the mortality and morbidity indicators (50%), the behavioural risk indicators (30%), and the biological risk indicators (7%). The countries that need to improve their NCD surveillance data availability the most are Cambodia (56% of all indicators) and Lao PDR (56%), followed by Malaysia (36%), Vietnam (36%), Myanmar (32%), and Thailand (28%). Conclusion Some of the non-policy GMF and PMI indicators lacked data among the six studied countries. To achieve the global NCDs targets, in the long run, the six countries should collect their own data for all indicators and begin to invest in and implement the facility survey and the population survey to track NCDs-related health services improvements once they have implemented the behavioural and biological Health Risks Population Survey in their countries.

BackgroundThe rise in non-communicable diseases (NCD), such as hypertension and diabetes among people living with human immunodeficiency virus (PLWH), has increased the demand for integrated care due to multiple chronic care needs. However, there is a dearth of evidence on contextual factors implementing integrated hypertension and diabetes care with HIV care. This study aimed to identify facilitators and barriers that could affect the integration of hypertension and diabetes with HIV care at primary health care in Ethiopia.MethodsFive primary health facilities from five districts of the Wolaita zone of South Ethiopia were included in the qualitative study. Fifteen key informant interviews were conducted with healthcare providers and managers from the zonal, district, and facility levels from October to November 2022. Data collection and analysis were guided by a consolidated framework of implementation research (CFIR).ResultsTen CFIR constructs were found to influence the integration. Perceived benefit of integration to patients, healthcare providers, and organization; perceived possibilities of integration implementation; availability of NCD guidelines and strategies; a supportive policy of decentralization and integration; perceived leaders and healthcare provider commitment were found to be facilitators. Perceived increased cost, insufficient attention to NCD care needs, inadequate number of trained professionals, inadequate equipment and apparatus such as blood pressure measurement, glucometers, strips, and NCD drugs, inadequate allocation of budget and weak health financing system and poor culture of data capturing and reporting were identified as barriers to integration.ConclusionIt is important to address contextual barriers through innovative implementation science solutions to address multiple chronic care needs of PLWH by implementing integrated hypertension and diabetes with HIV care in primary healthcare. Training and task shifting, pairing experienced professionals, and strengthening the health care financing system to implement evidence-based integration of hypertension and diabetes are recommended.

Background: In the current century, a significant challenge is addressing the escalating global burden of Non-Communicable Diseases. Integrating Alternative and Complementary Medicine into the existing healthcare system is a major initiative to combat this issue. Despite increased access to free healthcare facilities, heightened disease awareness, and widespread exposure through electronic and print media, the popularity of unprescribed alternative medicine persists in India. Objectives: To assess the Prevalence, Patterns, and Predictors of Complementary and Alternative Medicine use among non-communicable disease patients in the urban field practice area of Bangalore Medical College and Research Institute, Bengaluru. Methodology: A cross-sectional study conducted among non-communicable disease patients residing in the urban field practice area of Bangalore Medical College and Research Institute, Bengaluru. A sample size of 250 was determined based on a pilot study and systematic random sampling used for participant recruitment. Data collection utilized a pre-tested structured questionnaire. Data analysed using SPSS 21.0 Results: Among the 250 participants, 55 (22%) used both Allopathic and Alternative medicines, only 11 (20%) exclusively relying on Alternative systems. Ayurveda was the most utilized alternative medicine 15(27.2%), followed by Sidda 8(14.5%). Statistically significant associations were observed between the usage of Alternative medicine and patients’ religion and education. Conclusion: A relatively small percentage of adults exclusively used Alternative systems of medicine in this study. Ayurveda emerged as the predominant alternative medicine, followed by Sidda. The prevalence of alternative medicine was higher among Hindus and participants with education below the primary level. These findings shed light on the complex dynamics of healthcare.

Background: In India, due to high rates of urbanization and economic improvement, there is a shift in disease spectrum from communicable to non-communicable diseases. In a study made by khan etal 2015 at Bilapsur, Chhattisgarh prevalence of stroke was 67.6% due to infarct and 32.4 % had hemorrhage (ICH). The percentages of young stroke (< 45 yrs) were 12.5% (n=35). About 7.1% (n=20) and 5.3% (n=15) in males and females respectively. Thus, early detection will reduce the burden and cost of diseases in the family, community and on the nation. Objectives: A cross sectional study to find out risk factors for non- communicable diseases among residents of Raipur City, Chhattisgarh. Methodology: This is a cross-sectional study conducted in Raipur City of Chhattisgarh state during the month October 23-January 2024. A pre-designed, self-administered, semi-structured questionnaire was used for data collection. Systematic Random sampling technique was adopted to select the 350 Study participants. Results: The majority of subjects were between the ages of 30 and 40. Females constituted 55.3% of the subjects, while males accounted for 44.7%. Additionally, 45.6% of participants had completed primary schooling. Preobesity was observed in 58.8% of males and 51.7% of females.84.7% of study subjects were not engaging in physical activity, 89.1% were consuming an unhealthy diet, 97.6% were using tobacco, and 94.5% were consuming alcohol, all of which contributed to a raised BMI. There is a significant association between tobacco and alcohol use with BMI, where p-values are 0.001 and 0.005, respectively, which is

Background: Healthcare at people’s doorstep called Makkalai Thedi Maruthuvam (MTM) scheme was launched by Tamil Nadu Government in 2021 to further improve the access to NCD care by ensuring door step blood sugar & blood pressure screening, drug delivery by designated trained manpower called Women Health Volunteers (WHV). Assessing the programme awareness and its utilization at this juncture is the need of the hour. Hence, the present study was conducted. Objectives: 1. To assess the awareness about MTM scheme among adults >30 years in the field practice area, Madurai district 2. To determine the factors influencing awareness and utilization of MTM services Methodology: A community based cross-sectional study was done among 165 adults of >30 years in field practice area of our department in October 2023. By cluster sampling, participants were interviewed using a pre-structured validated questionnaire containing socio-demographic details and data to assess awareness and factors influencing awareness and utilization of MTM services. Data were entered in MS Excel and analysed using SPSS. Results: Mean age was 54±13.60 years. 60% were females, 83% were literates,63% were employed.80% were aware about the scheme and 74% awareness was through healthcare workers,98% preferred door to door services. Awareness regarding lifestyle modifications, breast, cervix and oral cancer screening were 56%,40%,39% and 20% respectively. There is statistically significant association between MTM awareness and age, occupation, blood sugar and blood pressure check-up in the last one year. By multiple logistic regression, awareness among those 50 yrs. Those with awareness had 2.62 times odds of utilization of services as compared to those without awareness. Conclusion: There is a good awareness and utilization of MTM services. To sustain this, IEC activities can be done at regular intervals with special emphasis on cancer screening.

Abstract Background Sub-Saharan Africa is predicted to have the steepest increase in the prevalence of diabetes in the next 25 years. The latest Mozambican population-based STEPS survey (STEPS 2005) estimated a 2.9% prevalence of diabetes in the adult population aged 25-64 years. We aimed to assess the change in prevalence, awareness, and management of diabetes in the national STEPS survey from 2014/2015 compared to 2005. Methods We conducted an observational, quantitative, cross-sectional study following the WHO STEPS surveillance methodology in urban and rural settings, targeting the adult population of Mozambique in 2015. We collected sociodemographic data, anthropometric, and 12 hour fasting glucose blood samples in a sample of 1321 adults. The analysis consisted of descriptive measures of the prevalence of impaired fasting glucose (IFG), diabetes and related risk factors by age group, sex, and urban/rural residence and compared the findings to those of the 2005 survey results. Results The prevalence of IFG and diabetes was 4.8% (95CI: 3.6-6.3) and 7.4% (95CI: 5.5-10.0), respectively. These prevalence of IFG and diabetes did not differ significantly between women and men. The prevalence of diabetes in participants classified with overweight/obesity [10.6% (95CI: 7.5-14.6)] and with central obesity (waist hip ratio) [11.0% (95CI: 7.4-16.1)] was almost double the prevalence of their leaner counterparts, [6.3% (95CI, 4.0-9.9)] and [5.2% (95CI: 3.2-8.6)], respectively. Diabetes prevalence increased with age. There were 50% more people with diabetes in urban areas than in rural. Only 10% of people with diabetes were aware of their disease, and only 44% of those taking oral glucose-lowering drugs. The prevalence of IFG over time [2.0% (95CI: 1.1-3.5) vs 4.8% (95CI: 3.6-6.3)] and diabetes [2.9% (95CI: 2.0-4.2) vs 7.4% (95CI: 5.5-10.0)] were more than twofold higher in 2014/2015 than in 2005. However, awareness of disease and being on medication decreased by 3% and by 50%, respectively. Though this was not statistically significant. Conclusions While the prevalence of diabetes in Mozambique has increased from 2005 to 2015, awareness and medication use have declined considerably. There is an urgent need to improve the capacity of primary health care and communities to detect, manage and prevent the occurrence of NCDs and their risk factors.

Fault detection and continuous condition monitoring in structural and machine elements are very sensitive topics and gaining significant value as a current research area. Due to the continuous loading and unloading of these elements, fatigue occurs. For the above-mentioned reason, crack is initiated and propagated. The initiation of any type of crack changes the physical properties of the structural and machine elements, which directly affects the lifetime of the element. The presence of any discontinuity changes the physical properties of the element, which also changes elastic properties. These alterations in physical properties change the modal properties of the structural elements. These changes in the vibration criteria can be used for the identification and quantification of the damage. In this research work, the vibration parameters are combined with Artificial Intelligence (AI) to predict the damage location. Here the natural evolution-based Genetic Algorithm (GA) has been used for the training of vibration features (frequencies). It has been discovered that the original AI methods are sometimes not able to give the proper prediction of damage location as they may be trapped in the local optimum. So, to counteract this loophole and to make it more flexible so that it can adjust to the constraints of real-life problems, a data mining method using Regression Analysis (RA) has been proposed and the results have been compared.

Summary: Background: Non-communicable diseases (NCDs) and NCD risk factors, such as smoking, increase the risk for tuberculosis (TB). Data are scarce on the risk of prevalent TB associated with these factors in the context of population-wide systematic screening and on the association between NCDs and NCD risk factors with different manifestations of TB, where ∼50% being asymptomatic but bacteriologically positive (subclinical). We did an individual participant data (IPD) meta-analysis of national and sub-national TB prevalence surveys to synthesise the evidence on the risk of symptomatic and subclinical TB in people with NCDs or risk factors, which could help countries to plan screening activities. Methods: In this systematic review and IPD meta-analysis, we identified eligible prevalence surveys in low-income and middle-income countries that reported at least one NCD (e.g., diabetes) or NCD risk factor (e.g., smoking, alcohol use) through the archive maintained by the World Health Organization and by searching in Medline and Embase from January 1, 2000 to August 10, 2021. The search was updated on March 23, 2023. We performed a one-stage meta-analysis using multivariable multinomial models. We estimated the proportion of and the odds ratio for subclinical and symptomatic TB compared to people without TB for current smoking, alcohol use, and self-reported diabetes, adjusted for age and gender. Subclinical TB was defined as microbiologically confirmed TB without symptoms of current cough, fever, night sweats, or weight loss and symptomatic TB with at least one of these symptoms. We assessed heterogeneity using forest plots and I2 statistic. Missing variables were imputed through multi-level multiple imputation. This study is registered with PROSPERO (CRD42021272679). Findings: We obtained IPD from 16 national surveys out of 21 national and five sub-national surveys identified (five in Asia and 11 in Africa, N = 740,815). Across surveys, 15.1%–56.7% of TB were subclinical (median: 38.1%). In the multivariable model, current smoking was associated with both subclinical (OR 1.67, 95% CI 1.27–2.40) and symptomatic TB (OR 1.49, 95% CI 1.34–1.66). Self-reported diabetes was associated with symptomatic TB (OR 1.67, 95% CI 1.17–2.40) but not with subclinical TB (OR 0.92, 95% CI 0.55–1.55). For alcohol drinking ≥ twice per week vs no alcohol drinking, the estimates were imprecise (OR 1.59, 95% CI 0.70–3.62) for subclinical TB and OR 1.43, 95% CI 0.59–3.46 for symptomatic TB). For the association between current smoking and symptomatic TB, I2 was high (76.5% (95% CI 62.0–85.4), while the direction of the point estimates was consistent except for three surveys with wide CIs. Interpretation: Our findings suggest that current smokers are more likely to have both symptomatic and subclinical TB. These individuals can, therefore, be prioritised for intensified screening, such as the use of chest X-ray in the context of community-based screening. People with self-reported diabetes are also more likely to have symptomatic TB, but the association is unclear for subclinical TB. Funding: None.

Background: Non-communicable diseases (NCDs) are an emerging global public health problem. Objectives: To assess the prevalence of NCDs and their risk factors among adults on antiretroviral therapy (ART). Method: This was a cross-sectional study (July 2019 – January 2020) in Limpopo, South Africa. Patients were enrolled if they were ≥ 40 years, HIV-positive, and virologically suppressed on ART. Data were analysed descriptively, and a binomial regression model was used to identify risk factors for NCDs. Results: The majority of participants (65%; 319/488) were women. Most (83%; 405/488) were aged 40–59 years; 60% (285/472) were overweight or obese. Based on self-report, 22% (107/488) were currently smokers. Almost half (44%) 213/488) reported daily consumption of vegetables and 65% (319/488) exercised regularly and 39% (190/488) reported treatment for another chronic disease. The leading comorbid conditions were hypertension (32%; 158/488) and diabetes mellitus (5%; 24/488). Risk factors for hypertension included age 60 years and older (relative risk [RR]: 1.72; 95% confidence interval [CI]: 1.29–2.30) diabetes (RR: 1.42; 95% CI: 1.08–1.87), overweight (RR: 1.32; 95% CI: 1.03–1.69) and obesity (RR: 1.69; 95% CI: 1.32–2.17). Conclusion: There is a high prevalence, both of risk factors for NCDs and multimorbidity ( 1 chronic disease) in patients who are ≥ 40 years and virologically suppressed on ART.

Background: In the era of non-communicable diseases (NCDs), it is quite important to understand the root-cause and method of management, as NCDs are not curable in most cases. Factory workers are exposed to several risk factors, such as smoke, dust, different harmful chemicals, metals etc. everyday. Their food habit, consumption of tobacco, alcohol etc., stressful responsibilities are other factors those may induce NCDs. Hence, to demark a baseline and reduce the NCD burden gradually, regular medical examination (RME) was planned and this study was conducted to estimate the change in NCD prevalence and risk reduction occurred after a year. Methods: The participants in this study were 602 workers from various departments of a steel plant, located in Dhenkanal, Odisha. Two phases of data were acquired for systolic and diastolic blood pressure, random blood sugar level, body mass index (BMI) and serum cholesterol. Continuous variables were described as mean and standard deviation or median with inter-quartile range, while categorical variables were presented as frequency and percentage. Wilcoxon Signed Ranks test was applied to evaluate the mean difference before and after one year. Results: Most of the participants either improved their health or maintained their health status. Except for serum cholesterol, all other blood parameters (systolic and diastolic blood pressure, blood sugar level) reduced significantly, though BMI increased significantly. Only serum cholesterol increased marginally. Conclusion: The initiative of RME was found to be effective. If continued, RME has the potential to keep employees healthy in a factory setup.

Purpose: Non-communicable diseases (NCDs) have become a global health priority with a great need for prompt evidence-based preventing and managing interventions. Here, we describe the development of a comprehensive cohort study that provides the most accurate results for NCDs' risk factors, named the Iran Cohort Study (ICS) to estimate the effect size of the risk factors associated with major NCDs. Methods: This cohort is an observational prospective study, which its baseline data was gathered through the Iran STEPwise Approach to NCD Risk Factor Surveillance (STEPs) survey in 2016. Following the STROBE criteria, the protocols for investigation of several areas were developed. The follow-up phase began through telephone calls to estimate the effect size of socio-demographic, behavioral, and metabolic risk factors on the incidence of or death due to major NCDs during the three years of study period. Delinerables: The main deliverables of ICS are planned to be as following; a comprehensive bank of primary data and follow-up data, national and subnational reports on estimation of the effect size of various risk factors, and a policy brief on the policy options and recommendations for promotion of ongoing programs and designing new interventions. Also, the collected data on the individuals' health status will be sent to the participants as an electronic health record. Conclusion: The present study is the first comprehensive national and sub-national representative cohort study on NCDs' risk factors in Iranian adults. The results could be used for promotion of health planning and also future complementary studies and programs. [ABSTRACT FROM AUTHOR]

The results of deposition and investigation of crystalline carbon films in a MWCVD reactor Cyrannus i6 at pressures 100 to 300 mbar with usage of fixed Ar/ CH4 gas mixture are presented in this work. Deposition was carried out from plasma containing dominating concentration of C2 dimers. The films in the range from microcrystalline diamond to amorphous coatings were deposited without hydrogen in the plasma.

Abstract Background In sub-Saharan Africa, the prevalence of non-communicable diseases (NCDs) has risen sharply amidst a high burden of communicable diseases. An integrated approach to HIV and NCD care offers the potential of strengthening disease control programmes. We used qualitative methods to explore patients’ and care-providers’ experiences and perspectives on the acceptability of integrated care for HIV-infection, diabetes mellitus (DM), and hypertension (HT) in Tanzania. Methods A qualitative study was conducted in selected health facilities in Dar es Salaam and Coastal regions, which had started to provide integrated care and management for HIV, DM, and HT using a single research clinic for patients with one or more of these conditions. In-depth interviews were held with patients and healthcare providers at three time points: At enrolment (prior to the patient receiving integrated care, at the mid-line and at the study end). A minimum of 16 patients and 12 healthcare providers were sampled for each time point. Observation was also carried out in the respective clinics during pre- and mid-line phases. The Theoretical Framework of Acceptability (TFA) underpinned the structure and interpretation of the combined qualitative and observational data sets. Results Patients and healthcare providers revealed a positive attitude towards the integrated care delivery model at the mid-line and at study end-time points. High acceptability was related to increased exposure to service integration in terms of satisfaction with the clinic setup, seating arrangements and the provision of medical care services. Satisfaction also centred on the patients’ freedom to move from one service point to another, and to discuss the services and their own health status amongst themselves. Adherence to medication and scheduling of clinic appointments appeared central to the patient-provider relationship as an aspect in the provision of quality services. Multi-condition health education, patient time and cost-saving, and detection of undiagnosed disease conditions emerged as benefits. On the other hand, a few challenges included long waiting times and limited privacy in lower and periphery health facilities due to infrastructural limitations. Conclusion The study reveals a continued high level of acceptability of the integrated care model among study participants in Tanzania. This calls for evaluation in a larger and a comparative study. Nevertheless, much more concerted efforts are necessary to address structural challenges and maximise privacy and confidentiality.

Abstract Background A paucity of studies focused on the genetic association that tuberculosis (TB) patients with non-communicable diseases (NCDs) are more likely to be infected with Mycobacterium tuberculosis (MTB) with more potent virulence on anti-TB drug resistance than those without NCDs. The study aimed to document the predominant genotype, determine the association between MTB genotypes and NCD status and drug resistance. Methods We conducted a molecular study in 105 TB patients based on a cross-sectional study focused on the comorbid relationship between chronic conditions and TB among 1773 subjects from September 1, 2019 to August 30, 2020 in Guizhou, China. The participants were investigated through face-to-face interviews, followed by NCDs screening. The DNA of MTB isolates was extracted prior to genotyping using 24 loci MIRU-VNTR. The subsequent evaluations were performed by phylogenetic trees, combined with tests of statistical power, Chi-square or Fisher and multivariate logistic regression analysis. Results The Beijing family of Lineage 2 (East Asia) was the predominant genotype accounting for 43.8% (46/105), followed by Lineage 4 (Euro-America) strains, including Uganda I (34.3%, 36/105), and the NEW-1 (9.5%, 10/105). The proportion of Beijing strain in patients with and without NCDS was 28.6% (8/28) and 49.4% (38/77), respectively, with a statistical power test value of 24.3%. No significant association was detected between MTB genotype and NCD status. A low clustering rate (2.9%) was identified, consisting of two clusters. The rates of global, mono-, poly- and multi-drug resistance were 16.2% (17/105), 14.3% (15/105), 1.0% (1/105) and 4.8% (5/105), respectively. The drug-resistant rates of rifampicin, isoniazid, and streptomycin, were 6.7% (7/105), 11.4% (12/105) and 5.7% (6/105), respectively. Isoniazid resistance was significantly associated with the Beijing genotype of Lineage 2 (19.6% versus 5.1%). Conclusions The Lineage 2 East Asia/Beijing genotype is the dominant genotype of the local MTB with endogenous infection preponderating. Not enough evidence is detected to support the association between the MTB genotype and diabetes/hypertension. Isoniazid resistance is associated with the Lineage 2 East Asia/Beijing strain.

Diamond is a promising material for the biomedical field, mainly due to its set of characteristics such as biocompatibility, strength, and electrical conductivity. Diamond can be synthesised in the laboratory by different methods, is available in the form of plates or films deposited on foreign substrates, and its morphology varies from microcrystalline diamond to ultrananocrystalline diamond. In this review, we summarise some of the most relevant studies regarding the adhesion of cells onto diamond surfaces, the consequent cell growth, and, in some very interesting cases, the differentiation of cells into neurons and oligodendrocytes. We discuss how different morphologies can affect cell adhesion and how surface termination can influence the surface hydrophilicity and consequent attachment of adherent proteins. At the end of the review, we present a brief perspective on how the results from cell adhesion and biocompatibility can make way for the use of diamond as biointerface. [ABSTRACT FROM AUTHOR]

Background: To tackle noncommunicable disease (NCD) burden globally, two sets of NCD surveillance indicators were established by the World Health Organization: 25 Global Monitoring Framework (GMF) indicators and 10 Progress Monitoring Indicators (PMI). This study aims to assess the data availability of these two sets of indicators in six ASEAN countries: Cambodia, Lao PDR, Malaysia, Myanmar, Thailand, and Vietnam. Methods: As data on policy indicators were straightforward and fully available, we focused on studying 25 non-policy indicators: 23 GMFs and 2 PMIs. Gathering data availability of the target indicators was conducted among NCD surveillance experts from the six selected countries during May-June 2020. Our research team found information regarding whether the country had no data at all, was using WHO estimates, was providing 'expert judgement' for the data, or had actual data available for each target indicator. We triangulated their answers with several WHO data sources, including the WHO Health Observatory Database and various WHO Global Reports on health behaviours (tobacco, alcohol, diet, and physical activity) and NCDs. We calculated the percentages of the indicators that need improvement by both indicator category and country. Results: For all six studied countries, the health-service indicators, based on responses to the facility survey, are the most lacking in data availability (100% of this category's indicators), followed by the health-service indicators, based on the population survey responses (57%), the mortality and morbidity indicators (50%), the behavioural risk indicators (30%), and the biological risk indicators (7%). The countries that need to improve their NCD surveillance data availability the most are Cambodia (56% of all indicators) and Lao PDR (56%), followed by Malaysia (36%), Vietnam (36%), Myanmar (32%), and Thailand (28%). Conclusion: Some of the non-policy GMF and PMI indicators lacked data among the six studied countries. To achieve the global NCDs targets, in the long run, the six countries should collect their own data for all indicators and begin to invest in and implement the facility survey and the population survey to track NCDs-related health services improvements once they have implemented the behavioural and biological Health Risks Population Survey in their countries. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) are questionnaires that measure patient outcomes related to quality of life, health, and functioning, and are increasingly used to assess important outcomes from the patient's perspective. For PROMs to contribute to better health and better care, it is vital that their content validity be adequate. This requires patient involvement in various steps of PROM development. PROM developers not only recognize the benefits of patient involvement but also report difficulties in recruiting patients and experience patient involvement as time-consuming, logistically challenging, and expensive. Objective: This study seeks to explore different strategies for disclosing the experiential knowledge of patients, namely through analyzing patient stories on the web and social media. The research questions are as follows: (1) how do bloggers living with a disease experience their health-related quality of life? (2) How are these experiences reflected in the domains and items of PROMs related to their disease? Methods: First, a qualitative analysis of blogs written by patients was performed. Second, subthemes and underlying codes resulting from this qualitative analysis were systematically compared with the domains and items in PROMs for the respective diseases that the bloggers write about. Blogs were identified via the Google search engine between December 2019 and May 2021. Results: Bloggers describe a wide range of experiences regarding their physical functioning and health; mental well-being; social network and support; daily life, education, work, and leisure; coping; and self-management. Bloggers also write about their positive and negative experiences with health care delivery, the organization of health care, and health care professionals. In general, patients' experiences as described in blogs were reflected in the domains and items of the PROMs related to their disease. However, except for diabetes mellitus, in all the sets of PROMs, potentially missing topics could be identified. Similarly, with the exception of Parkinson disease, all PROMs address issues that patients did not write about in their blogs and that might therefore be redundant. Conclusions: Web-based patient stories in the form of blogs reveal how people living with a certain disease experience their health-related quality of life. These stories enable analyses of patients' experiences that can be used to assess the content validity of PROMs. This can be a useful step for researchers who are looking for sets of measuring instruments that match their purposes. [ABSTRACT FROM AUTHOR]

Abstract Background Tobacco, one of the risk factors for non-communicable diseases, kills 8 million people each year. Like other sub-Saharan countries, Ethiopia faces the potential challenge of a tobacco epidemic. However, there is no organized data on the prevalence of tobacco use in the country. Therefore, this study aims to determine adult tobacco use in Ethiopia. Methods The study was conducted using the WHO and CDC GATS survey methods. Complex survey analysis was used to obtain prevalence and population estimates with 95% confidence intervals. Bivariate regression analyses were employed to examine factors related to tobacco use. Results The overall tobacco use percentage was 5.0% [95% CI (3.5, 6.9)], of which 65.8% [95% CI (53.4, 76.3)] only smoked tobacco products; 22.5% [95% CI (15.7, 31.2)] used smokeless tobacco only; and 11.8% [95% CI (6.5, 20.4)] used both smoked and smokeless tobacco products. In 2016, more men adults (8.1%) used tobacco than women did (1.8%). Eight out of eleven states have a higher smoking rate than the national average (3.7%). Gender, employment, age, religion, and marital status are closely linked to current tobacco use (p-value

Non-Communicable Disease is a chronic disease that tends to last a long time and can cause death. It can cause individuals to become less productive. However, controlling risk factors through early detection can prevent these problems. At this time, early detection is mostly carried out at the village / health facilities level, not yet at work / institutional level. Bondowoso Campus Jember University is one of the largest educational institutions in the BASUKI RAYA area, which has many employees, and an average age of over 20 years, which is the productive age group. Early detection through Non-Communicable Disease screening activities is important in preventing and reducing morbidity and mortality due to the disease. This activity is also useful in regularly monitoring the health of employees and also minimizing lost opportunities for employees to carry out early detection of diseases due to examinations. Methods of this activity include counseling, early detection of PTM as well as counseling and counseling based on screening results. Data analysis were performed using univariate and bivariate. Different test was performed using Wilcoxon with a level of a = 0.05. The results showed that there was an increase in employee knowledge regarding non-communicable diseases and how to prevent them. (p = 0.03, sig

Abstract Background The aim of the present study was to recalibrate the effectiveness of Indian Diabetes Risk Score (IDRS) and Community-Based Assessment Checklist (CBAC) by opportunistic screening of Diabetes Mellitus (DM) and Hypertension (HT) among the people attending health centres, and estimating the risk of fatal and non-fatal Cardio-Vascular Diseases (CVDs) among them using WHO/ISH charts. Methods All the people aged ≥ 30 years attending the health centers were screened for DM and HT. Weight, height, waist circumference, and hip circumferences were measured, and BMI and Waist-Hip Ratio (WHR) were calculated. Risk categorization of all participants was done using IDRS, CBAC, and WHO/ISH risk prediction charts. Individuals diagnosed with DM or HT were started on treatment. The data was recorded using Epicollect5 and was analyzed using SPSS v.23 and MedCalc v.19.8. ROC curves were plotted for DM and HT with the IDRS, CBAC score, and anthropometric parameters. Sensitivity (SN), specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Accuracy and Youden’s index were calculated for different cut-offs of IDRS and CBAC scores. Results A total of 942 participants were included for the screening, out of them, 9.2% (95% CI: 7.45–11.31) were diagnosed with DM for the first time. Hypertension was detected among 25.7% (95% CI: 22.9–28.5) of the participants. A total of 447 (47.3%) participants were found with IDRS score ≥ 60, and 276 (29.3%) with CBAC score > 4. As much as 26.1% were at moderate to higher risk (≥ 10%) of developing CVDs. Area Under the Curve (AUC) for IDRS in predicting DM was 0.64 (0.58–0.70), with 67.1% SN and 55.2% SP (Youden’s Index 0.22). While the AUC for CBAC was 0.59 (0.53–0.65). For hypertension both the AUCs were 0.66 (0.62–0.71) and 0.63 (0.59–0.67), respectively. Conclusions IDRS was found to have the maximum AUC and sensitivity thereby demonstrating its usefulness as compared to other tools for screening of both diabetes and hypertension. It thus has the potential to expose the hidden NCD iceberg. Hence, we propose IDRS as a useful tool in screening of Diabetes and Hypertension in rural India.

Background. Self-monitoring of blood glucose (SMBG) is a widely accepted standard of practice for management of insulin-dependentdiabetes, yet is largely unavailable in rural sub-Saharan Africa (SSA). This prospective cohort study is the first known report ofimplementation of SMBG in a rural, low-income country setting.Objectives. To evaluate adherence and change in clinical outcomes with SMBG implementation at two rural hospitals in Neno, Malawi.Methods. Forty-eight patients with type 1 and insulin-dependent type 2 diabetes were trained to use glucometers and logbooks. Participantsmonitored preprandial glucose daily at rotating times and overnight glucose once a week. Healthcare providers were trained to evaluateglucose trends, and adjusted insulin regimens based on results. Adherence was measured as the frequency with which patients checked anddocumented blood glucose at prescribed times, while clinical changes were measured by change in glycated haemoglobin (HbA1c) over a6-month period.Results. Participants brought their glucometers and logbooks to the clinic 95 - 100% of the time. Adherence with measuring glucose valuesand recording them in logbooks eight times a week was high (mean (standard deviation) 69.4% (15.7) and 69.0% (16.6), respectively). MeanHbA1c decreased from 9.0% (75 mmol/mol) at enrolment to 7.8% (62 mmol/mol) at 6 months (mean difference 1.2% (95% confidenceinterval (CI) 0.6 - 2.0; p=0.0005). The difference was greater for type 1 diabetes (1.6%; 95% CI 0.6 - 2.7; p=0.0031) than for type 2 diabetes(0.9%; 95% CI 0.1 - 1.9; p=0.0630). There was no documented increase in hypoglycaemic events, and no hospitalisations or deaths occurred.Conclusion. SMBG is feasible for patients with insulin-dependent diabetes in a rural SSA population, and may be associated with improvedHbA1c levels. Despite common misconceptions, all patients, regardless of education level, can benefit from SMBG. Further research onlong-term retention of SMBG activities and the benefits of increasing frequency of monitoring is warranted.

Suzuki and colleagues’ rare and elaborate analysis of the political processes behind the 2018 United Nations (UN) non- communicable diseases (NCD) Declaration discloses various pathways towards influencing global public health policies. Their study should be a wake-up call for further scientific political scrutiny and analysis, including clearly distinguishing between consultations such as UN multi-stakeholder hearings preceding high-level meetings and the actual negotiating and decision making process. While stakeholder positions at interactive hearings are documented and published and thus made transparent, the negotiating process among member states is not publicly known. The extent to which intergovernmental negotiations are influenced at country or regional levels by commercial interests through direct and indirect lobbying outside of public consultations should be given more attention. Lobby registers should be implemented more stringently and legislative footprints required and applied not only to legally binding but also to internationally important documents such as political declarations.

Background To determine the health system costs and health-related benefits of interventions for the prevention and control of non-communicable diseases (NCDs), including mental health disorders, for the purpose of identifying the most cost-effective intervention options in support of global normative guidance on the best-buy interventions for NCDs. In addition, tools are developed to allow country contextualisation of the analyses to support local priority setting exercises. Methods This analysis follows the standard WHO-CHOICE (World Health Organization-Choosing Interventions that are Cost-Effective) approach to generalized cost-effectiveness analysis applied to two regions, Eastern sub-Saharan Africa and South-East Asia. The scope of the analysis is all NCD and mental health interventions included in WHO guidelines or guidance documents for which the health impact of the intervention is able to be identified and attributed. Costs are measured in 2010 international dollars, and benefits modelled beginning in 2010, both for a period of 100 years. Results There are many interventions for NCD prevention and management that are highly cost-effective, generating one year of healthy life for less than Int. $100. These interventions include tobacco and alcohol control policies such as taxation, voluntary and legislative actions to reduce sodium intake, mass media campaigns for reducing physical activity, and treatment options for cardiovascular disease (CVD), cervical cancer and epilepsy. In addition a number of interventions fall just outside this range, including breast cancer, depression and chronic lung disease treatment. Conclusion Interventions that represent good value for money, are technically feasible and are delivered for a low per-capita cost, are available to address the rapid rise in NCDs in low- and middle-income countries. This paper also describes a tool to support countries in developing NCD action plans.

Background. Many patients have their healthcare needs met at primary healthcare (PHC) clinics in KwaZulu-Natal (KZN), without having to travel to a hospital. Doctors form part of the teams at many PHC clinics throughout KZN, offering a decentralised medical service in a PHC clinic. Objectives. To assess the benefit of having a medical doctor managing patients with more complex clinical conditions at PHC clinic level in uMgungundlovu District, KZN. Two key questions were researched: (i) were the patients whom the clinic doctors managed of sufficient clinical complexity that they warranted a doctor managing them, rather than a PHC nurse clinician? and (ii) what was the spectrum of medical conditions that the clinic doctors managed? Methods. Doctors collected data at all medical consultations in PHC clinics in uMgungundlovu during February 2020. A single-page standardised data tool was used to collect data at every consultation. Results. Thirty-five doctors were working in 45 PHC clinics in February 2020. Twenty-six of the clinic doctors were National Health Insurance (NHI)-employed. The 35 doctors conducted 7 424 patient consultations in February. Staff in the PHC clinics conducted 143 421 consultations that month, mostly by PHC nurse clinicians. The doctors concluded that 6 947 (93.6%) of the 7 424 doctor consultations were of sufficient complexity as to warrant management by a doctor. The spectrum of medical conditions was as follows: (i) consultations for maternal and child health; n=761 (10.2%); (ii) consultations involving non-communicable diseases (NCDs), n=4 372 (58.9%) – the six most common NCDs were, in order: hypertension, diabetes, arthritis, epilepsy, mental illness and renal disease; (iii) consultations involving communicable diseases constituted 1 745 (23.5%) of cases; and (iv) consultations involving laboratory result interpretation 1 180 (15.9%). Conclusion. This research showed that at a PHC clinic the more complex patient consultations did indeed require the skills and knowledge of a medical doctor managing these patients. These data support the benefit of a doctor working at every PHC clinic: the doctor is a ‘musthave’ member of the PHC clinic team, offering a regular, reliable and predictable medical service.

IntroductionThe study aims to examine the trends of 4 metabolic NCDs risk factors including raised blood pressure, increased blood glucose, elevated blood lipids and overweight/obesity over the last 10 years in Vietnam as well as examine these trends among different sub-population by geographical area, gender, and age groups.MethodsThe study combined the national representative data from three rounds of STEPs survey in Vietnam conducted in 2010, 2015, and 2020 on people aged 25–64 years. The overall prevalence of each metabolic factor together with 95% CI for each time point as well as the stratified prevalence by rural/urban, male/female, and 4 separated age groups were calculated and considered the sampling weight. Cochran–Armitage test for trend was used to test for the differences in the prevalence over time.ResultsThe prevalence of hypertension, overweight/obesity, hyperglycemia, and hyperlipidemia among the population aged 25–64 years old was 28.3, 20.57, 6.96, and 15.63%, respectively in the year 2020. All NCD metabolic risk factors examined in this analysis show significantly increasing trends over time. For most age groups, the increasing burden of NCD metabolic risk factors was more significant during the period 2015–2020 compared to the period 2010–2015. Male population and population aged 55–64 experienced the most dramatic changes in the burden of all NCD metabolic risk factors.ConclusionTo reverse the increasing trend of NCD metabolic factors in Vietnam, intervention, and policy need to apply a comprehensive life course approach.

While we might leave the COVID-19 pandemic behind, future health professionals are still confronted with another global phenomenon: the increasing pandemic of non-communicable diseases (NCDs). Both issues are strongly interwoven, yet current medical education fails to address their syndemic nature accordingly. There is scientific consensus that (i) most emerging infectious diseases are zoonotic, (ii) the overexploitation of earth's resources for animal protein production (i.e., tropical deforestation) rapidly escalates human contact with unknown pathogens, and (iii) people following a healthy plant-based diet present fewer rates of NCDs as well as severe illness and mortality from COVID-19. A shift toward whole food plant-based nutrition in the general population thus holds the potential to tackle both public health threats. We are convinced that it is every physician's responsibility to care for individual, public, and global health issues; however, future health professionals are not trained and educated regarding the health potential of plants and plant-based diets. The COVID-19 pandemic has demonstrated the urgent need for a “prevention first” approach. Therefore, in order to upgrade medical education worldwide and protect current and future human health properly, greater medical professional awareness of evidence on plant-based diets is urgently needed in classes, universities, and hospitals.

BackgroundA growing body of research shows that individuals with non-communicable diseases (NCDs), such as hypertension, diabetes, hypercholesterolemia, and heart disease, are more likely to suffer from severe COVID-19 and, subsequently, death. The purpose of this study was to assess the influence of COVID-19-related knowledge on mental health, healthcare behaviors, and quality of life among the elderly with NCDs in Northern Thailand.MethodsIn this cross-sectional study, the participants were 450 elderly people with NCDs, living in the Chiang Rai province, Northern Thailand. Random sampling was applied to select the subjects. Data collection included demographic information, COVID-19-related knowledge, healthcare behaviors, the Suanprung Stress Test-20, the Thai General Health Questionnaire (GHQ-28) for the assessment of mental health, and the Thai version of the World Health Organization Quality of Life-BREF.ResultsAlmost half of the participants (45.6%) had poor knowledge about COVID-19. More than half of the sample had high stress (52.0%) and a low score in healthcare behaviors (64.9%), while approximately one-third of the participants had mental health problems (34.0%). The overall quality of life during the COVID-19 pandemic was moderate (70.7%). The score of COVID-19-related knowledge was significantly correlated with scores of stress (r = −0.85), mental health (r = −0.74), healthcare behaviors (r = 0.50), and quality of life (r = 0.33). Multiple linear regression found that history of COVID-19 detection and COVID-19-related knowledge were associated with scores of stress and quality of life (p < 0.05). Multiple logistic regression showed that history of COVID-19 detection (OR = 4.48, 95% CI = 1.45–13.84) and COVID-19-related knowledge (OR = 0.23, 95% CI = 0.17–0.31) were associated with mental health problem (p < 0.05).DiscussionThe findings emphasize the importance of COVID-19-related knowledge concerning the improvement of self-care behaviors and quality of life in the elderly population with NCDs during the pandemic, especially due to the high rate of stress and mental health problems documented in our sample. Health education interventions for this vulnerable population should be organized.

Abstract Background We aimed to present the 2019 annual report of the gastroenterological section of the National Clinical Database (NCD). Methods We reviewed 609,589 cases recorded in 2019 and 5,029,764 cases registered from 2011 to 2019 for the 115 selected gastroenterological surgical procedures. Results The main features of gastroenterological surgery in Japan were similar to those described in the 2018 annual report, namely, that 1) operative numbers gradually increased in all procedures, except gastrectomy and hepatectomy, which decreased in these years; 2) in all eight major gastroenterological surgeries, the age distribution tended toward older patients; 3) the morbidity of esophagectomy, hepatectomy, and pancreaticoduodenectomy increased, but mortality was minimized in all procedures; 4) all eight major gastroenterological procedures have increasingly been performed under laparoscopy; and 5) board‐certified surgeons were increasingly involved. These trends in recent years were more prominent in 2019. Conclusions Thanks to the continuous cooperation and dedication of the surgeons, medical staff, and surgical clinical reviewers who registered the clinical data into the NCD, it is possible to understand the comprehensive landscape of surgery in Japan and to disclose new evidence in this field. The Japanese Society of Gastroenterological Surgery will continue to promote the value of this database and encourage the use of feedback and clinical studies using the NCD, now and in the future. Generating further approaches to surgical quality improvement are important directions for future research.

Mathudara Phaiyarom,1 Hathairat Kosiyaporn,1 Nareerut Pudpong,1,2 Pigunkaew Sinam,1 Rapeepong Suphanchaimat,1,3 Sataporn Julchoo,1 Watinee Kunpeuk1 1International Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, Thailand; 2Sirindron College of Public Health, Chonburi, Thailand; 3Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, 11000, ThailandCorrespondence: Mathudara PhaiyaromInternational Health Policy Program, Ministry of Public Health, Nonthaburi, 11000, ThailandTel +66 2 590 2382Fax +66 2 590 2385Email mathudara@ihpp.thaigov.netBackground: The health of urban refugees and asylum seekers (URAS) in Thailand has been under-researched compared with other groups of non-Thai populations, especially in the area of chronic non-communicable diseases (NCD). The objectives of this study were to i) examine NCD prevalence; ii) access to NCD services; and iii) factors associated with access to NCD services among urban refugees and asylum seekers (URAS) in comparison with the Thai population.Methods: A cross-sectional study, using a self-administrative questionnaire adapted from the Thai Health and Welfare Survey (HWS), was conducted in 2019. URAS were randomly selected from the register of the Bangkok Refugee Center. One hundred and eighty-one URAS participated in the survey. The data were combined with 2941 Thai records from the HWS. The population scope was confined to Bangkok. Bivariate analysis by Chi-square, Fisher’s exact, and Mann–Whitney U-tests was conducted to examine difference in demographic and access to NCD services between URAS and Thais. Multivariable logistic regression was performed to identify factors associated with access to NCD services.Results: Overall, URAS were young, less educated, and poorer than Thais. The trend of NCDs was similar to the Thai population, except mental health disorders appeared to be more prevalent in URAS. Almost half of the URAS did not receive any formal treatment. Being insured, abiding with Buddhism, and living in more affluent households were factors associated with better access to NCD services. URAS from Asian countries had greater access to NCD care than those from non-Asian countries.Conclusion: Policymakers should consider expanding the insurance coverage to URAS, similar to coverage for Thai populations. Additional studies on refugees’ health status and service utilization in other settings outside Bangkok are strongly recommended.Keywords: urban refugee, asylum seeker, NCD, healthcare, Thailand

Introduction: Non-communicable diseases (NCDs) are increasing in trend and associated with modifiable risk factors and subsequently reducing physical activity; hence the Government of India (GOI) has launched a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) in 2010 to curb increasing prevalence. The present study was planned for assessment of the activities conducted under NPCDCS in rural Jaipur. Methods and Material: This observational study was conducted in rural Jaipur. NPCDCS reports, status of logistics and manpower were assessed for 1 year. Field level cross-checking survey was done to assess the gap between the actual screening work done and the work reported. All staffs were assessed for the level of awareness regarding NCDs as well as NPCDCS programs. Data were entered and analysed in Microsoft excel. Result: Around 48% (6674/13917) of persons >30 years were screened during 1 year study period. Around 51.5% of the screened persons had one or more NCDs (13.5% newly screened NCDs cases and 38% were prediagnosed of NCD cases). Status reports that 10 (83.33%) out of the total 12 expected reports were sent regularly on a monthly basis. Reason for not sending reports was a sudden lockdown due to COVID-19. Conclusion: The study concludes that the implementation of NPCDCS program activities is not in synch with the health staff awareness level. IEC activities were deficient and no work was done for adoption of behavioural change and healthy lifestyle. Actual cases of hypertension were more while cases of diabetes were less than the reported cases found on cross-check survey. [ABSTRACT FROM AUTHOR]

Abstract Background Integration of depression services into infectious disease care is feasible, acceptable, and effective in sub-Saharan African settings. However, while the region shifts focus to include chronic diseases, additional information is required to integrate depression services into chronic disease settings. We assessed service providers’ views on the concept of integrating depression care into non-communicable diseases’ (NCD) clinics in Malawi. The aim of this analysis was to better understand barriers, facilitators, and solutions to integrating depression into NCD services. Methods Between June and August 2018, we conducted nineteen in-depth interviews with providers. Providers were recruited from 10 public hospitals located within the central region of Malawi (i.e., 2 per clinic, with the exception of one clinic where only one provider was interviewed because of scheduling challenges). Using a semi structured interview guide, we asked participants questions related to their understanding of depression and its management at their clinic. We used thematic analysis allowing for both inductive and deductive approach. Themes that emerged related to facilitators, barriers and suggested solutions to integrate depression assessment and care into NCD clinics. We used CFIR constructs to categorize the facilitators and barriers. Results Almost all providers knew what depression is and its associated signs and symptoms. Almost all facilities had an NCD-dedicated room and reported that integrating depression into NCD care was feasible. Facilitators of service integration included readiness to integrate services by the NCD providers, availability of antidepressants at the clinic. Barriers to service integration included limited knowledge and lack of training regarding depression care, inadequacy of both human and material resources, high workload experienced by the providers and lack of physical space for some depression services especially counseling. Suggested solutions were training of NCD staff on depression assessment and care, engaging hospital leaders to create an NCD and depression care integration policy, integrating depression information into existing documents, increasing staff, and reorganizing clinic flow. Conclusion Findings of this study suggest a need for innovative implementation science solutions such as reorganizing clinic flow to increase the quality and duration of the patient-provider interaction, as well as ongoing trainings and supervisions to increase clinical knowledge. Trial registration This study reports finding of part of the formative phase of “The Sub-Saharan Africa Regional Partnership (SHARP) for Mental Health Capacity Building—A Clinic-Randomized Trial of Strategies to Integrate Depression Care in Malawi” registered as NCT03711786

Abstract Background Of the 15 million annual premature deaths from non-communicable diseases (NCDs), 85% occur in low- and middle-income countries (LMICs). Affecting individuals in the prime of their lives, NCDs impose severe economic damage to economies and businesses, owing to the high mortality and morbidity within the workforce. The Novartis Foundation urban health initiative, Better Hearts Better Cities, was designed to improve cardiovascular health in Dakar, Senegal through a combination of interventions including a workplace health program. In this study, we describe the labor policy environment in Senegal and the outcomes of a Novartis Foundation-supported multisector workplace health coalition bringing together volunteering private companies. Methods A mixed method design was applied between April 2018 and February 2020 to evaluate the workplace health program as a case study. Qualitative methods included a desk review of documents relevant to the Senegalese employment context and work environment and in-depth interviews with eight key informants including human resource representatives and physicians working in the participating companies. Quantitative methods involved an analysis of workplace health program indicators, including data on diagnosis, treatment and control of hypertension in employees, provided by the coalition companies, and a cost estimate of NCD-related ill-health as compared to the investment needed for hypertension screening and awareness raising events. Results Senegal has a legal and regulatory system that ensures employee protection, supports social security benefits, and promotes health and hygiene in companies. The Dakar Workplace Health Coalition comprised 18 companies, with a range of staff between 300 and 4′220, covering 36′268 employees in total. Interviews suggested that the main enablers for workplace program success were strong leadership support within the company and a central coordination mechanism for the program. The main barrier to monitor progress and outcomes was the reluctance of companies to share data. Four companies provided aggregated anonymized cohort data, documenting a total of 21′392 hypertension screenings and an increasing trend in blood pressure control (from 34% in Q4 2018 to 39% in Q2 2019) in employees who received antihypertensive treatment. Conclusion Evidence on workplace health and wellness programs in Africa is scarce. This study highlights how private sector companies can play a significant role in improving cardiovascular population health in LMICs.