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Under national or state-based legislation, local governments are commonly required to prepare municipal health and wellbeing plans. Yet, the issues these plans aim to address are often complex, and programmatic planning approaches traditionally used by practitioners struggle to engage with such complexity as they assume these issues can be 'solved' in isolation. Systems thinking is increasingly being used as an approach to deal with those struggles more effectively, yet little is known about whether local governments and other stakeholders think systems approaches are feasible and acceptable in practice. This study tested a systems thinking approach to gauge if it could better address complex place-based health and wellbeing issues, such as to reduce noncommunicable diseases. Guided by a systems change framework, the approach comprised a facilitated systemic inquiry and rich picture process involving diverse stakeholders in a remote municipality in the Australian state of Tasmania. Among the participants there was broad support for the systems approach tested and they thought it was effective for increasing systems thinking capacity, collaboratively revealing systemic issues, and identifying opportunities to address those issues. They valued the rich picture because it created shared understandings of local issues. The findings suggest more is needed from macro-level policy to support place-based stakeholders to undertake systems approaches in practice, which could result in more sustainable and effective systems change required to improve health and wellbeing outcomes. The findings have implications for theory, research, and practice across interdisciplinary fields concerned with placed-based systems change, especially in rural and remote municipalities. [ABSTRACT FROM AUTHOR]

Noncommunicable diseases (NCDs) account for 58% of the total deaths in Pakistan. Modifiable risk factors, including physical inactivity, unhealthy diets, and tobacco and alcohol use, are the major contributors to NCDs. Their prevalence and causal factors vary among age groups, and the aim of this review is to assess these differences and their causes. A search in "Google Scholar" AND "PubMed" showed a total of 31,200 articles after using the appropriate keywords. After adjusting for time period and relevance, 66 articles were selected based on the inclusion criteria such as being in the English language, published within the last 10 years, and containing information on lifestyle risk factors of NCDs in adolescent, adult, and elderly age groups. The prevalence of physical activity in adolescents, adults, and the elderly is 20, 34.8, and 15.7%, respectively. Unhealthy diets have been observed in 20.9% of adolescents and 96.5% of adult NCD patients, while 78% of the elderly reported good eating habits. Smoking is prevalent in 15% of college students, 40% of adult males, and 22% of the geriatric male population. Interventions targeted toward the prevention and management of NCDs should consider the role age plays in the development of these diseases and how the prevalence of these risk factors differs among them. Specific considerations need to be put into place when dealing with adolescents and the elderly to reduce the national and global burden of disease. [ABSTRACT FROM AUTHOR]

Background and Aims: Noncommunicable diseases (NCDs) have emerged as a substantial burden in developing countries, representing the leading cause of mortality. Addressing this critical issue necessitates effective interventions and policy measures. Therefore, this study aims to investigate the risk factors associated with NCD prevalence in Tanzania. Methods: This study employed a nonexperimental research design due to its ability to analyze secondary data without altering variables. The used data set of the study was sourced from National Panel Survey 2020/21 and Household Budget Survey 2017/18. The econometrics analysis applied in the study include two‐stage residual inclusion (2SRI) and control function approach due to their ability to suppress endogeneity and enhance the clarity of results. Results: The findings indicate a significant positive correlation between alcohol consumption (0.4110382, p = 0.02), cigarette smoking (0.3354297, p < 0.001), and NCDs, emphasizing the urgency of targeted interventions to mitigate these behaviors. Conversely, a negative correlation is observed between fruit and vegetable intake (−0.1063375, p < 0.001), physical exercises (−0.3744925, p < 0.001), and NCDs, underscoring the importance of promoting healthy dietary habits and frequent exercises. Conclusion: These results accentuate the immediate need for targeted interventions and policy measures to address these risk factors and effectively combat the escalating burden of NCDs in Tanzania and similar contexts. Moreover, the need for improved public awareness campaigns and the promotion of healthy life campaigns are vital in the fight to lower the prevalence of NCDs across communities. Key points: While the global share of noncommunicable diseases (NCDs) deaths is uncontrollable, the disease accounts for 34% of total deaths in Tanzania.Adequate physical exercises, fruit and vegetable intake protects against NCDs, while alcohol, cigarette smoking, and NCDs have strong positive correlations.Urban residence, age, and sex vary in their correlation with NCD risk, highlighting the complexity of NCD determinants.Poor healthcare infrastructure makes NCDs more vulnerable, emphasizing the need to improve it.Public health campaigns, health education, healthcare system strengthening, and evidence‐based policies are needed to reduce NCD prevalence, promote healthier lifestyles, and reduce risk factors. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Noncommunicable diseases (NCDs) have emerged as a substantial burden in developing countries, representing the leading cause of mortality. Addressing this critical issue necessitates effective interventions and policy measures. Therefore, this study aims to investigate the risk factors associated with NCD prevalence in Tanzania. Methods This study employed a nonexperimental research design due to its ability to analyze secondary data without altering variables. The used data set of the study was sourced from National Panel Survey 2020/21 and Household Budget Survey 2017/18. The econometrics analysis applied in the study include two‐stage residual inclusion (2SRI) and control function approach due to their ability to suppress endogeneity and enhance the clarity of results. Results The findings indicate a significant positive correlation between alcohol consumption (0.4110382, p = 0.02), cigarette smoking (0.3354297, p

Background: Multimorbidity is the multiple chronic conditions due to Non-communicable diseases (NCDs) for an extended period. Such chronic conditions are associated with an individual's livelihood and other factors. The study aims to determine the association between demographic and socioeconomic indicators with multimorbidity and its spatial differentials. Methods: The study has been conducted incorporating NFHS-5 (2019–2021) data. For statistical analysis, we have used bivariate analysis and a Multinomial Logistic Regression model at a 95% confidence interval (CI) to show the Odds Ratio (OR) of multimorbidity; and crude odds ratio to test the strength and precision of the association of effect of demographic and socioeconomic variables. The geospatial analysis was also done to show the geographic variation of multimorbidity. Results: The result revealed that the age group of 45–54 years (OR: 5.889; CI:4.763–7.281), those who were married (OR: 2.117; CI:1.664–2.693), belonged more affluent wealthy group (OR: 1.512; CI:1.195–1.912), overweight (OR: 2.022; CI:1.634–2.502), lived in eastern (OR: 2.328; CI:1.833–2.957) and southern region (OR: 1.973; CI:1.569–2.483) and consumed substances (OR: 1.164; CI:1.034–1.310) as well as consume alcohol (OR: 1.608; CI:1.427–1.811) are more likely to suffer with multimorbidity. Conclusions: Many aspects of the multimorbidity challenges still need to be understood to prevent and reduce its burden. Thus, more attention is required from epidemiologists, health researchers, and policymakers to reduce premature mortality due to NCDs, universal health coverage, financial risk protection, and access to essential healthcare services to achieve Sustainable Development Goal-3 (SDG-3) by 2030.

mHealth (mobile health) is an application designed to run on the Operating System (SO) on a mobile phone device. Specifically, mHealth is actually an application designed to run on mobile phone devices with Android OS, which is specialized in managing health information. Meanwhile, mHealth referred to here is an application developed to help prevent and control various Non-Communicable Diseases (NCDs) in particular, for those who in the era of Special Autonomy of West Papua Province are underserved. The development of the mHealth application is intended to record various indicators that determine a person's NCD risk. This indicator is recorded every time someone conducts an examination at various clinics/pharmacies/hospitals. The medical record data will be stored in a cloud-based repository (Firebase Realtime Database) that can be accessed from anywhere and anytime at any time only by that person or trained medical personnel (doctors, other medical personnel) as decision makers who have obtained permission by the owner of the medical record. The methodology used in this study uses Design Science Research Methodology (DSRM). The final result of this study is in the form of a smartphone-based MMR (Mobile Medical Record) application, which can be used to help prevent as early as possible the symptoms of a person's NCD so as not to cause more serious NCD complications such as kidney failure, diabetes mellitus, heart failure, stroke to death. [ABSTRACT FROM AUTHOR]

Abstract Introduction As the major cause of premature death worldwide, noncommunicable diseases (NCDs) are complex and multidimensional, prevention and control of which need global, national, local, and multisectoral collaboration. Governmental stakeholder analysis and social network analysis (SNA) are among the recognized techniques to understand and improve collaboration. Through stakeholder analysis, social network analysis, and identifying the leverage points, we investigated the intersectoral collaboration (ISC) in preventing and controlling NCDs-related risk factors in Iran. Methods This is a mixed-methods study based on semi-structured interviews and reviewing of the legal documents and acts to identify and assess the interest, position, and power of collective decision-making centers on NCDs, followed by the social network analysis of related councils and the risk factors of NCDs. We used Gephi software version 0.9.2 to facilitate SNA. We determined the supreme councils' interest, position, power, and influence on NCDs and related risk factors. The Intervention Level Framework (ILF) and expert opinion were utilized to identify interventions to enhance inter-sectoral collaboration. Results We identified 113 national collective decision-making centers. Five councils had the highest evaluation score for the four criteria (Interest, Position, Power, and Influence), including the Supreme Council for Health and Food Security (SCHFS), Supreme Council for Standards (SCS), Supreme Council for Environmental Protection (SCIP), Supreme Council for Health Insurance (SCHI) and Supreme Council of the Centers of Excellence for Medical Sciences. We calculated degree, in degree, out-degree, weighted out-degree, closeness centrality, betweenness centrality, and Eigenvector centrality for all councils. Supreme Council for Standards and SCHFS have the highest betweenness centrality, showing Node's higher importance in information flow. Interventions to facilitate inter-sectoral collaboration were identified and reported based on Intervention Level Framework's five levels (ILF). Conclusion A variety of stakeholders influences the risk factors of non-communicable diseases. Through an investigation of stakeholders and their social networks, we determined the primary actors for each risk factor. Through the different (levels and types) of interventions identified in this study, the MoHME can leverage the ability of identified stakeholders to improve risk factors management. The proposed interventions for identified stakeholders could facilitate intersectoral collaboration, which is critical for more effective prevention and control of modifiable risk factors for NCDs in Iran. Supreme councils and their members could serve as key hubs for implementing targeted inter-sectoral approaches to address NCDs' risk factors.

Noncommunicable diseases (NCDs) account for over 50% of total premature mortality in most lowand middle-income countries (LMICs). However, responses to the fight against NCDs are yet to be efficient in most of these countries. There is little published data on how this response is structured from a governance perspective in the context of global health systems. This study explored from existing research, the state of the governance in the fight against NCDs in the ECOWAS region. It consists of a review of articles published in peerreviewed journals between 2010 and 2020 on ECOWAS countries. Of three hundred thirty-three (333) articles initially identified, eight (8) publications were included in these studies. There is a serious lack of information on the governance of NCDs in French-speaking countries such as Burkina Faso where no article has been identified. Of the 8 studies meeting the inclusion criteria, none has addressed the coherence of policies and programs. Seven (7) publications provided information on the component national NCDs policies, strategies and action plans, four (4) studies on the component of actors, interventions and the multisectoral coordination mechanism, five (5) on the issue of budget allocations and financing of NCD prevention and control interventions. Political commitment and government leadership has been discussed in three (3) publications. While some studies have provided information on the components of governance, it is important to remember that most of the studies were literature reviews and not empirical studies, which does not allow a better understanding of the situation of governance in each country. Designing an empirical study to answer some questions related to the governance of NCDs in the selected countries is necessary. [ABSTRACT FROM AUTHOR]

Planetary health provides a perspective of ecological interdependence that connects the health and vitality of individuals, communities, and Earth's natural systems. It includes the social, political, and economic ecosystems that influence both individuals and whole societies. In an era of interconnected grand challenges threatening health of all systems at all scales, planetary health provides a framework for cross‐sectoral collaboration and unified systems approaches to solutions. The field of allergy is at the forefront of these efforts. Allergic conditions are a sentinel measure of environmental impact on human health in early life—illuminating how ecological changes affect immune development and predispose to a wider range of inflammatory noncommunicable diseases (NCDs). This shows how adverse macroscale ecology in the Anthropocene penetrates to the molecular level of personal and microscale ecology, including the microbial systems at the foundations of all ecosystems. It provides the basis for more integrated efforts to address widespread environmental degradation and adverse effects of maladaptive urbanization, food systems, lifestyle behaviors, and socioeconomic disadvantage. Nature‐based solutions and efforts to improve nature‐relatedness are crucial for restoring symbiosis, balance, and mutualism in every sense, recognizing that both personal lifestyle choices and collective structural actions are needed in tandem. Ultimately, meaningful ecological approaches will depend on placing greater emphasis on psychological and cultural dimensions such as mindfulness, values, and moral wisdom to ensure a sustainable and resilient future. [ABSTRACT FROM AUTHOR]

Obesity is one of the major factors contributing to noncommunicable diseases (NCDs), which is associated with a high intake of a sugar-rich diet. Sugar blend (a novel combination of sugar and stevia) has half the calories of sugar with the same sweetness at recommended use and offers better compliance. A randomized controlled trial was conducted to evaluate the efficacy and safety of this sugar blend in normal to mildly overweight subjects with a body mass index (BMI) of 23–26 kg/m. Sixty subjects were categorized into Group A: Sugar group (n = 30), and Group B: Sugar blend group (n = 30). The primary outcomes evaluated were weight, waist circumference, hip circumference, waist/hip ratio, BMI, and the secondary outcomes evaluated were lipid profile, random blood sugar, and HbA1c. All these parameters were assessed at baseline, 30 days, 60 days, and 90 days. Group B showed a significantly higher weight loss (p = 0.013) at 90 days compared with Group A. A significant reduction in waist circumference (p < 0.0001) by 4.4 cm was noted at 90 days, in addition to reduction in total cholesterol (p < 0.0001), triglyceride (p = 0.006), LDL cholesterol (p = 0.0490), and VLDL cholesterol (p = 0.006) in Group B compared with the baseline. The study revealed that the sugar blend is an effective formulation in reducing weight, anthropometric factors, and other related metabolic parameters. It has been proven to be well tolerated and promotes weight loss when used in conjunction with a daily balanced diet and exercise plan. [ABSTRACT FROM AUTHOR]

Background: The increasing prevalence and subsequent mortality due to non-communicable diseases (NCDs) among Indian prisoners are often ignored by policymakers. This systematic review and meta-analysis aim to analyze the rising burden of Noncommunicable Diseases in Indian prisons and estimate the pooled prevalence of depression among Indian prisoners. Methods: A total 9 studies were chosen in accordance with PRISMA guidelines that investigated the burden of NCDs in Indian prisons and were published between January 2010 and August 2022. Statistical analysis was performed in STATA Version 16 software, and the funnel plot was used to identify publication bias. Results: A total of 167 articles were identified, and 9 were included in this analysis. The pooled prevalence of depression among prisoners was 48.78% (95% CI, 27.24–70.55%). According to the review, prisoners showed a significant prevalence of moderate to severe depression, dental caries, poor periodontal condition, and suicide ideation. This study is the first to analyze NCDs prevalence among Indian prisoners. Poor mental and dental health standards and the virtual absence of healthcare facilities necessitate governmental actions to boost inmates' health. It is essential to develop preventative interventions for this extremely isolated and vulnerable group in addition to diagnosing and treating noncommunicable diseases. Conclusions: Our study findings will enable decision-makers to structure and develop appropriate preventative and curative programs for inmates' general wellbeing. [ABSTRACT FROM AUTHOR]

Introduction: As the major cause of premature death worldwide, noncommunicable diseases (NCDs) are complex and multidimensional, prevention and control of which need global, national, local, and multisectoral collaboration. Governmental stakeholder analysis and social network analysis (SNA) are among the recognized techniques to understand and improve collaboration. Through stakeholder analysis, social network analysis, and identifying the leverage points, we investigated the intersectoral collaboration (ISC) in preventing and controlling NCDs-related risk factors in Iran.Methods: This is a mixed-methods study based on semi-structured interviews and reviewing of the legal documents and acts to identify and assess the interest, position, and power of collective decision-making centers on NCDs, followed by the social network analysis of related councils and the risk factors of NCDs. We used Gephi software version 0.9.2 to facilitate SNA. We determined the supreme councils' interest, position, power, and influence on NCDs and related risk factors. The Intervention Level Framework (ILF) and expert opinion were utilized to identify interventions to enhance inter-sectoral collaboration.Results: We identified 113 national collective decision-making centers. Five councils had the highest evaluation score for the four criteria (Interest, Position, Power, and Influence), including the Supreme Council for Health and Food Security (SCHFS), Supreme Council for Standards (SCS), Supreme Council for Environmental Protection (SCIP), Supreme Council for Health Insurance (SCHI) and Supreme Council of the Centers of Excellence for Medical Sciences. We calculated degree, in degree, out-degree, weighted out-degree, closeness centrality, betweenness centrality, and Eigenvector centrality for all councils. Supreme Council for Standards and SCHFS have the highest betweenness centrality, showing Node's higher importance in information flow. Interventions to facilitate inter-sectoral collaboration were identified and reported based on Intervention Level Framework's five levels (ILF).Conclusion: A variety of stakeholders influences the risk factors of non-communicable diseases. Through an investigation of stakeholders and their social networks, we determined the primary actors for each risk factor. Through the different (levels and types) of interventions identified in this study, the MoHME can leverage the ability of identified stakeholders to improve risk factors management. The proposed interventions for identified stakeholders could facilitate intersectoral collaboration, which is critical for more effective prevention and control of modifiable risk factors for NCDs in Iran. Supreme councils and their members could serve as key hubs for implementing targeted inter-sectoral approaches to address NCDs' risk factors. [ABSTRACT FROM AUTHOR]

Since December 2019, a novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pandemic has affected more than 18.6 million people worldwide. Male gender, older age, obesity, and comorbid noncommunicable diseases (NCDs) like diabetes, hypertension, cardiovascular disease (CVD), chronic respiration illnesses, and cancer have higher risk and fatal outcome of COVID-19. India has a huge burden of NCDs and their associated risk factors which could act in harmony with COVID-19 to produce severe and fatal outcome. Till date the specific treatment options for COVID-19 are elusive and as NCDs are reported as the main causative risk factors for COVID-19 which can worsen the outcome, the focus should be made on continuing and improving the healthcare facilities related to the prevention, management, and control of NCDs. The management of NCDs in the context of SARS-CoV-2 infection are quite challenging. The restrictive measures imposed by governments all over the world such as complete or partial lockdown, travel restrictions, and physical distancing to contain the spread of SARS-CoV-2 infection have affected the people with NCDs by limiting their access to healthcare facilities, physical activity access to healthy food, and even to medicines and essential supplies. These factors increase the risk of developing obesity, diabetes, and CVDs. This article reviews the burden of NCDs in India, the cross-connection between NCDs and COVID-19, disruptions of healthcare services for NCDs, and proposes research priorities during COVID-19 for effective management and control of NCDs.

Background:Studies have not provided clear enough evidence on the direct association between cigarette smoking and poverty. This study aims to assess the association of householder smoking with near-poverty households, and the potential mediating effect of NCDs.MethodsA cross-sectional survey was conducted from November 2019 to October 2020 in relatively underdeveloped regions in China. In total, 2,409 households were investigated in areas under the jurisdiction of 24 primary health care (PHC) institutions of eight provinces. Pearson's χ2-test was performed, and multivariable logistic regression and extended probit regression models were fitted to examine the association between householder smoking and near-poverty households. Moreover, generalized structural equation modeling was used to explore the mediating effect of NCDs.ResultsAfter adjusting for all other potential confounding factors, compared with households headed by never-smokers, households headed by smokers exhibited significantly elevated risks of being near poverty, with an odds ratio of 2.01 (95% CI: 0.48–0.91). We also found that living in rural areas and having a low education level both had a negative effect on being near poverty. Additionally, NCDs had a significantly positive mediating effect, with a 31.57% effect of householder smoking on near-poverty status mediated by NCDs; the indirect effect was estimated to be 0.17 (95% CI: 0.04–0.31).ConclusionsHouseholder smoking significantly elevated the risk of the household being near poverty, and suffering NCDs had a positive mediating effect.

Abstract Background Breast cancer incidence is increasing in Vietnam with studies indicating low levels of knowledge and awareness and late presentation. While there is a growing body of literature on challenges faced by women in accessing breast cancer services, and for delivering care, no studies have sought to analyse breast cancer messaging in the Vietnamese popular media. The aim of this study was to investigate and understand the content of messages concerning breast cancer in online Vietnamese newspapers in order to inform future health promotional content. Methods This study describes a mixed-methods media content analysis that counted and ranked frequencies for media content (article text, themes and images) related to breast cancer in six Vietnamese online news publications over a twelve month period. Results Media content (n = 129 articles & n = 237 images) sampled showed that although information is largely accurate, there is a marked lack of stories about Vietnamese women’s personal experiences. Such stories could help bridge the gap between what information about breast cancer is presented in the Vietnamese media, and what women in Vietnam understand about breast cancer risk factors, symptoms, screening and treatment. Conclusions Given findings from other studies indicating low levels of knowledge and women with breast cancer experiencing stigma and prejudice, more nuanced and in-depth narrative-focused messaging may be required.

Obesity is one of the major factors contributing to noncommunicable diseases (NCDs), which is associated with a high intake of a sugar-rich diet. Sugar blend (a novel combination of sugar and stevia) has half the calories of sugar with the same sweetness at recommended use and offers better compliance. A randomized controlled trial was conducted to evaluate the efficacy and safety of this sugar blend in normal to mildly overweight subjects with a body mass index (BMI) of 23–26 kg/m. Sixty subjects were categorized into Group A: Sugar group (n = 30), and Group B: Sugar blend group (n = 30). The primary outcomes evaluated were weight, waist circumference, hip circumference, waist/hip ratio, BMI, and the secondary outcomes evaluated were lipid profile, random blood sugar, and HbA1c. All these parameters were assessed at baseline, 30 days, 60 days, and 90 days. Group B showed a significantly higher weight loss (p = 0.013) at 90 days compared with Group A. A significant reduction in waist circumference (p < 0.0001) by 4.4 cm was noted at 90 days, in addition to reduction in total cholesterol (p < 0.0001), triglyceride (p = 0.006), LDL cholesterol (p = 0.0490), and VLDL cholesterol (p = 0.006) in Group B compared with the baseline. The study revealed that the sugar blend is an effective formulation in reducing weight, anthropometric factors, and other related metabolic parameters. It has been proven to be well tolerated and promotes weight loss when used in conjunction with a daily balanced diet and exercise plan.

Background: The increasing prevalence and subsequent mortality due to non-communicable diseases (NCDs) among Indian prisoners are often ignored by policymakers. This systematic review and meta-analysis aim to analyze the rising burden of Noncommunicable Diseases in Indian prisons and estimate the pooled prevalence of depression among Indian prisoners. Methods: A total 9 studies were chosen in accordance with PRISMA guidelines that investigated the burden of NCDs in Indian prisons and were published between January 2010 and August 2022. Statistical analysis was performed in STATA Version 16 software, and the funnel plot was used to identify publication bias. Results: A total of 167 articles were identified, and 9 were included in this analysis. The pooled prevalence of depression among prisoners was 48.78% (95% CI, 27.24–70.55%). According to the review, prisoners showed a significant prevalence of moderate to severe depression, dental caries, poor periodontal condition, and suicide ideation. This study is the first to analyze NCDs prevalence among Indian prisoners. Poor mental and dental health standards and the virtual absence of healthcare facilities necessitate governmental actions to boost inmates’ health. It is essential to develop preventative interventions for this extremely isolated and vulnerable group in addition to diagnosing and treating noncommunicable diseases. Conclusions: Our study findings will enable decision-makers to structure and develop appropriate preventative and curative programs for inmates’ general wellbeing.

This paper traces the history of noncommunicable disease public health research and programming at the World Health Organization. Specifically, it investigates the origins of the now pervasive 4 × 4 framework focusing on four sets of diseases (cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers) caused by four behavioral risk factors (tobacco use, harmful use of alcohol, unhealthy diets, and physical inactivity). We have found that the 4 × 4 framework developed as a generalization from strategies to control epidemics of cardiovascular disease and stroke in high-income countries during the second half of the twentieth century. These strategies, which were narrowly focused on interventions to address behavioral “lifestyle” risk factors as well as pharmacotherapy for physiologic risk factors, were ultimately packaged as an integrated approach initially in high-income countries and subsequently extended to low- and middle-income countries, where they have failed to address much of the burden among very poor populations.

Successful prevention and control of the epidemic of noncommunicable diseases (NCDs) cannot be achieved by the health sector alone: a wide range of organisations from multiple sectors and across government must also be involved. This requires a new, inclusive approach to advocacy and to coordinating, convening and catalysing action across civil society, best achieved by a broad-based network. This comment maps the experience of the NCD Alliance (NCDA) on to Shiffman’s challenges for global health networks – framing (problem definition and positioning), coalition-building and governance – and highlights some further areas overlooked in his analysis.

Background: Breast cancer incidence is increasing in Vietnam with studies indicating low levels of knowledge and awareness and late presentation. While there is a growing body of literature on challenges faced by women in accessing breast cancer services, and for delivering care, no studies have sought to analyse breast cancer messaging in the Vietnamese popular media. The aim of this study was to investigate and understand the content of messages concerning breast cancer in online Vietnamese newspapers in order to inform future health promotional content.Methods: This study describes a mixed-methods media content analysis that counted and ranked frequencies for media content (article text, themes and images) related to breast cancer in six Vietnamese online news publications over a twelve month period.Results: Media content (n = 129 articles & n = 237 images) sampled showed that although information is largely accurate, there is a marked lack of stories about Vietnamese women's personal experiences. Such stories could help bridge the gap between what information about breast cancer is presented in the Vietnamese media, and what women in Vietnam understand about breast cancer risk factors, symptoms, screening and treatment.Conclusions: Given findings from other studies indicating low levels of knowledge and women with breast cancer experiencing stigma and prejudice, more nuanced and in-depth narrative-focused messaging may be required. [ABSTRACT FROM AUTHOR]

Background: Noncommunicable diseases (NCDs) are the leading global cause of death and share common risk factors. Little quantitative data are available on the patterns of each NCDs death and dietary factors by national income level and region. We aimed to identify the trend of NCDs deaths and dietary factors with other health-related behaviors across national income levels and geographical regions. Methods: Three databases were collected, including the World Health Organization, Food and Agriculture Organization, and World Bank in 2014. These were analyzed to describe the trend for NCDs deaths and dietary factors with health-related behaviors across national income levels (high income, upper-middle income, lower-middle income, and low income) from 151 countries using variance-weighted least-squares linear regression. Results: Lower-middle-income and low-income countries in Africa and Asia had higher death rates of NCDs. More than 30% of the population had raised blood pressure with higher carbohydrate intake and lower protein and fat intake compared to high-income European countries in 2014. High-income countries had the highest prevalence of raised total cholesterol, overweight, and obesity, the highest total energy, fat, and protein intake, and the highest supplies of animal fat, stimulants, sugar and sweetener, vegetable oil, and milk, as well as insufficient activity with an increasing trend (p for trend < 0.001). Conclusion: There were differences in NCDs risk factors and dietary factors by national income and region. Accordingly, measures should be taken to suit the situation in each country. Our findings have significance for health workers and health policies preventing and controlling the rise of NCDs.

NonCommunicable Diseases (NCDs) have been the public concern worldwide, both in developed and developing countries. The issues are not only about the number of mortality but also the economic implications caused by the diseases. This paper aims to exploit the mobile technology potential by developing an mHealth medical record to assist the prevention and controlling of diseases in Indonesia, particularly in the West Papua Province. Design Science Research (DSR) methodology in Information System (IS) is employed to guide these research activities. This solution enables the medical data to be deposited by a person directly and personally utilising the developed mHealth application installed in the smart phone. By the time that person needs a further health examination for the NCD symptoms, the deposited data allows a General Practitioner (GP) making decision relatively easier at the first place. Some issues have been identified: data integrity and reliability as well as the manual assessment by the GP. Therefore, further evaluations are sought. [ABSTRACT FROM AUTHOR]

In 1979 in Alma-Ata city, a meeting of all States was held to set the framework of Primary Health Care modern approach. Forty years later, a meeting was held in Astana to confirm the lessons learned from the proclamation delineated in 1979. Primary Health Care in Greece has been amended since 1983 and is characterized by incomplete legislative reforms. The latest milestoneof Primary Health Care was the creation of Local Healthcare Units providing the institution of "family doctor". According to Astana's fifth article the Primary Health Care will provide a comprehensive range of services, including the prevention of communicable diseases. The lifestyle of modern society has increased NCDS (Noncommunicable diseases), with obesity contributing to their rapid increase. Indicators of obesity, diabetes deaths and ischemic episodes in Greece differ significantly compared to the United Kingdom. The reform changes set by the Ministry of Health in 2017 share the same features as the pillars of the Astana Declaration. Their aim is to promote social, physical and mental progress of "health for all". [ABSTRACT FROM AUTHOR]

Objectives: The management of HIV disease is complicated by the incidence of a new spectrum of comorbid noncommunicable diseases (NCDs). It is important to document changes in the prevalence of NCDs over time. The aim of the study was to describe the impact of ageing on HIV markers and on the prevalence of NCDs in people living with HIV (PLWHIV) in the Italian Cohort of Individuals, Naïve for Antiretrovirals (ICONA) seen for care in 2004–2014. Methods: Analyses were conducted separately for a closed cohort (same people seen at both times) and an open cohort (all people under follow‐up). We used the χ2 test for categorical factors and the Wilcoxon test for quantitative factors to compare profiles over time. Results: The closed cohort included 1517 participants and the open cohort 3668 under follow‐up in 2004 and 6679 in 2014. The median age of the open cohort was 41 [interquartile range (IQR) 37–46] years in 2004 and 44 (IQR 36–52) years in 2014. Analysis of the closed cohort showed an increase in the prevalence of some NCDs [the prevalence of dyslipidaemia increased from 75% in 2004 to 91% in 2014, that of hypertension from 67 to 84%, and that of cardiovascular disease (CVD) from 18 to 32%] and a decrease in renal function (5% with eGFR < 60 mL/min per 1.73 m2 in 2004 versus 30% in 2014); the percentage of people in the high‐risk group for the Framingham CHD score more than tripled (from 13 to 45%). Results in the open cohort were similar. Conclusions: The burden of NCDs in our PLWHIV population markedly worsened over a 10‐year time‐span, which is likely to be a result of the effects of both ageing and HIV infection as well as their interaction. Special attention must be given to the management and prevention of NCDs. [ABSTRACT FROM AUTHOR]

Background: Nationally representative data on noncommunicable disease (NCD) risk factors are lacking in Bangladesh. This study was done to determine the prevalence of common risk factors for major NCDs among men and women of rural and urban areas of Bangladesh. Materials and Methods: This survey was done with 9,275 individuals aged 25 years or older randomly drawn from all over the country. Information on diet, physical activity, tobacco and alcohol, and treatment history for hypertension and diabetes were collected. Height, weight, waist circumference, and blood pressure (BP) were measured. Results: There were 4,312 men and 4,963 women with the mean age of 42 years (standard deviation 13 years). Half of them (54%) used tobacco in some form,

One Health (OH) is a crucial concept, where the interference between humans, animals and the environment matters. This review article focusses on the role of horses in maintaining the health of humans and the environment. Horses’ impact on environmental health includes their influence on soil and the biodiversity of animal and plant species. Nevertheless, the effect of horses is not usually linear and several factors like plant−animal coevolutionary history, climate and animal density play significant roles. The long history of the relationship between horses and humans is shaped by the service of horses in wars or even in mines. Moreover, horses were essential in developing the first antidote to cure diphtheria. Nowadays, horses do have an influential role in animal assisted therapy, in supporting livelihoods in low income countries and as a leisure partner. Horses are of relevance in the spillover of zoonotic and emerging diseases from wildlife to human (e.g., Hendra Virus), and in non-communicable diseases (e.g., post-traumatic osteoarthritis in horses and back pain in horse riders). Furthermore, many risk factors—such as climate change and antimicrobial resistance—threaten the health of both horses and humans. Finally, the horse is a valuable factor in sustaining the health of humans and the environment, and must be incorporated in any roadmap to achieve OH.

Amaç: Bu çalışmanın amacı Dünya Sağlık Örgütü (DSÖ)'ne üye olan 193 ülkeyi gelir gruplarına göre Bulaşıcı Olmayan Hastalıklar (BOH) ile ilgili veriler bakımından sınıflandırmaktır. Gereç-Yöntem: Ülkelerin sınıflandırılmasında veri madenciliği yöntemleri içerisinde danışmanlı öğrenme yöntemleri arasında bulunan destek vektör makinesi ve random forest yöntemleri kullanılmıştır. Analizlerde bir açık kaynak kodlu yazılım olan Orange programından yararlanılmıştır. Bulgular: Analizler sonucunda random forest yöntemi kullanılarak elde edilen performans sonuçlarının destek vektör makinesine göre daha yüksek olduğu görülmüştür. Sonuç: Araştırma sonuçlarının küresel sağlık yöneticilerine Bulaşıcı Olmayan Hastalıklar (BOH) ile mücadele etmek konusunda ve etkin politikalar üretmede faydalı olacağı düşünülmektedir.

Successful prevention and control of the epidemic of noncommunicable diseases (NCDs) cannot be achieved by the health sector alone: a wide range of organisations from multiple sectors and across government must also be involved. This requires a new, inclusive approach to advocacy and to coordinating, convening and catalysing action across civil society, best achieved by a broad-based network. This comment maps the experience of the NCD Alliance (NCDA) on to Shiffman's challenges for global health networks -- framing (problem definition and positioning), coalition-building and governance -- and highlights some further areas overlooked in his analysis. [ABSTRACT FROM AUTHOR]

Background and Objectives: This review manuscript examines the burden and national response to non-communicable diseases (NCDs), food and nutrition security in Vietnam from 1975 to 2015.Methods and Study Design: We extracted data from peer-reviewed manuscripts and reports of nationally representative surveys and related policies in Vietnam.Results: In 2010, NCDs accounted for 318,000 deaths (72% of total deaths), 6.7 million years of life lost, and 14 million disability-adjusted life years in Vietnam. Cardiovascular diseases, cancers, chronic obstructive pulmonary disease, and diabetes mellitus were major contributors to the NCD burden. Adults had an increased prevalence of overweight and obesity (2.3% in 1993 to 15% in 2015) and hypertension (15% in 2002 to 20% in 2015). Among 25-64 years old in 2015, the prevalence of diabetes mellitus was 4.1% and the elevated blood cholesterol was 32%. Vietnamese had a low physical activity level, a high consumption of salt, instant noodles and sweetened non-alcoholic beverages as well as low consumption of fruit and vegetables and seafood. The alcohol consumption and smoking prevalence were high in men. Exposure to second-hand tobacco smoke was high in men, women and youths at home, work, and public places. In Vietnam, policies for NCD prevention and control need to be combined with strengthened law enforcement and increased program coverage. There were increased food production and improved dietary intake (e.g., energy intake and protein-rich foods thanked to appropriate economic, agriculture, and nutrition strategies.Conclusions: NCDs and their risk factors are emerging problems in Vietnam, which need both disease-specific and sensitive strategies in health and related sectors. [ABSTRACT FROM AUTHOR]

The emerging concept of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political, and otherwise)—emphasizes that the health of human civilization is intricately connected to the health of natural systems within the Earth’s biosphere. In the clinical setting, narrative medicine underscores the importance of absorbing, reflecting upon, and responding to the narratives—the stories—conveyed by patients. Education and interventions using the tenets of narrative medicine have demonstrated value to both patient and provider. Given the grand interconnected challenges of our time—compounded by misinformation and quasi-scientific narratives propagated by the ideology of neoliberalism—we argue that the principles and practice of narrative medicine can be applied on a larger scale, one with planetary health in mind. The role of beliefs, expectations, and agency—mindsets—in the link between narrative and planetary health are emphasized. We use a story of our own to demonstrate that the biological buffering capacity in response to a fast-food meal does not sit on a level socioeconomic playing field. Patient, community, and global health narratives are melding with powerful narratives set by commercial entities. The success of planetary health as a new concept will be strengthened by attention to the ways in which storytelling can influence positive change. No less important is an understanding of the ways in which stories contribute to what ails person, place, and planet.

In China, with fast economic growth, health and nutrition status among the rural population has shown significant improvement in the past decades. On the other hand, burden of non-communicable diseases and prevalence of related risk factors such as overweight and obesity has also increased. Among rural children, the double burden of malnutrition and emerging overweight and obesity has been neglected so far. According to the theory of Developmental Origin of Health and Diseases (DOHaD), malnutrition, including both undernutrition (stunting and wasting) and over-nutrition (overweight and obesity) during childhood is closely related to worsened health outcomes during adulthood. Such a neglected problem is attributable to a complicated synergy of social and environmental factors such as parental migration, financial situation of the household, child-rearing knowledge and practices of the primary caregivers, and has implications for public health. Based on literature review of lessons from the field, intervention to address malnutrition among rural children should be a comprehensive package, with consideration of their developmental environment and geographical and socioeconomic diversity. The scientific evidence on DOHaD indicates the probability and necessity of prevention of adult disease by promotion of maternal and child health and reducing malnutrition by provision of high-quality complementary foods, promotion of a well-balanced dietary pattern, and promotion of health literacy in the public would bring a potential benefit to reduce potential risk of diseases. [ABSTRACT FROM AUTHOR]

Background and Objectives: Hypertension is key contributor to the current pandemic of cardiovascular diseases. This randomized control trial compared decrease in systolic and diastolic blood pressures in the study and control groups in response to a lifestyle intervention in borderline hypertensives. The intervention was carried out for the period of three months. Methodology: A total of 102 adult participants were included with borderline hypertension (B.P between 120/80 to 139/89 mmHg) in Lahore, Pakistan. Participants were randomized into study and control groups. The study group was provided with 30 minutes daily exercise advice (both written and verbal) with regular monthly follow-ups from May to December 2013. Data were collected using a structured questionnaire. Blood pressures were recorded by Sphygmomanometer. Data were analysed using SPSS v.17. Chi-square test of significance was applied for comparison of proportions and t test for comparison of means. Relative Risks and Confidence Intervals were generated. Results: Out of 51 participants in study group, a total of 25 (49.0%) showed a reduction in their systolic blood pressure (P = 0.0002) and 23 (45.0%) showed a reduction in their diastolic blood pressures (P = 0.0001) after a three months physical activity intervention, as compared to only 08 (15.6%) and 06 (11.7%) out of 51 in the control group. Reduction in systolic and diastolic blood pressures was found to be significant in study group at P < 0.05. Reduction in post intervention mean systolic and diastolic blood pressures was found to be statistically significant in study group (t-test) that is > 5 mmHg at P < 0.01. Where as no such reduction in mean systolic and diastolic blood pressures was seen in control group at the start and end of three month period. Conclusions: Physical activity can lower borderline hypertension. Reducing blood pressure can prevent the excess risk of cardiovascular diseases associated with borderline hypertension. However a study on a large sample size is required to generalize results for wider community. Also a three month period for physical activity is not predictive of change in lifestyle behaviors. The effect of intervention should have been evaluated after six months and one year intervals to measure long term outcomes. [ABSTRACT FROM AUTHOR]

The relative importance of cardiovascular disease (CVD) and cancer as leading causes of premature death are examined in this communication. CVD and cancer are now the leading causes in 127 countries, with CVD leading in 70 countries (including Brazil and India) and cancer leading in 57 countries (including China). Such observations can be seen as part of a late phase of an epidemiologic transition, taking place in the second half of the 20th century and the first half of the present one, in which the dominance of infectious diseases is progressively superseded by noncommunicable diseases. According to present ranks and recent trends, cancer may surpass CVD as the leading cause of premature death in most countries over the course of this century. Clearly, governments must factor in these transitions in developing cancer policies for the local disease profile. Cardiovascular disease and cancer are now the leading causes of premature death in the majority of countries worldwide, and cancer is likely to surpass cardiovascular disease as the leading causes of death at ages 30‐70 in most countries over the course of this century. Governments must factor in these transitions in formulating and implementing their cancer and noncommunicable disease plans and tailor cost‐effective measures to the local disease profile. [ABSTRACT FROM AUTHOR]

It is time to bring our imagination, creativity and passion to the fore in solving the global challenges of our age. Our global health crisis and the pandemic of noncommunicable diseases (NCDs) is clearly rooted in complex modern societal and environmental changes, many of which have effects on developing immune and metabolic responses. It is intimately related to wider environmental challenges. And it is unsurprising that many NCDs share similar risk factors and that many are associated with a rising predisposition for inflammation. Allergy is one of the earliest signs of environmental impact on these biological pathways, and may also offer an early barometer to assess the effects of early interventions. There is dawning awareness of how changing microbial diversity, nutritional patterns, sedentary indoor behaviours and modern pollutants adversely affect early metabolic and immune development, but still much to understand the complexity of these interactions. Even when we do harness the science and technology, these will not provide solutions unless we also address the wider social, cultural and economic determinants of health - addressing the interconnections between human health and the health of our environment. Now more than ever, we need a wider vision and a greater sense of collective responsibility. We need long-range approaches that aim for life long benefits of a 'healthier start to life', and stronger cross-sectoral collaborations to prevent disease. We need to give both our hearts and our minds to solving these global issues. [ABSTRACT FROM AUTHOR]

Abstract: Worksite health and wellness (WH&W) are gaining popularity in targeting cardiovascular (CV) risk factors among various industries. India is a large country with a larger workforce in the unorganized sector than the organized sector. This imbalance creates numerous challenges and barriers to implementation of WH&W programs in India. Large scale surveys have identified various CV risk factors across various industries. However, there is scarcity of published studies focusing on the effects of WH&W programs in India. This paper will highlight: 1) the current trend of CV risk factors across the industrial community, 2) the existing models of delivery for WH&W in India and their barriers, and 3) a concise evidence based review of various WH&W interventions in India. [Copyright &y& Elsevier]

Of 7792 refugees resettled to the United States, 44% are infected with tuberculosis (43% latent tuberculosis and <1% active); 7% are infected with chronic viral hepatitis, and 4% with parasitic infections (strongyloides 2%, schistosomes 1%, miscellaneous 1%). No refugees had malaria.Background. Many nations are struggling to develop structured systems and guidelines to optimize the health of new arrivals, but there is currently no international consensus about the best approach.Methods. Data on 7792 migrants who crossed international borders for the purpose of resettlement and underwent a protocol-based health assessment were collected from the GeoSentinel Surveillance network. Demographic and health characteristics of a subgroup of these migrants seen at 2 US-based GeoSentinel clinics for protocol-based health assessments are described.Results. There was significant variation over time in screened migrant populations and in their demographic characteristics. Significant diagnoses identified in all migrant groups included latent tuberculosis, found in 43% of migrants, eosinophilia in 15%, and hepatitis B infection in 6%. Variation by region occurred for select diagnoses such as parasitic infections. Notably absent were infectious tuberculosis, soil-transmitted helminths, and malaria. Although some conditions would be unfamiliar to clinicians in receiving countries, universal health problems such as dental caries, anemia, ophthalmologic conditions, and hypertension were found in 32%, 11%, 10%, and 5%, respectively, of screened migrants.Conclusions. Data from postarrival health assessments can inform clinicians about screening tests to perform in new immigrants and help communities prepare for health problems expected in specific migrant populations. These data support recommendations developed in some countries to screen all newly arriving migrants for some specific diseases (such as tuberculosis) and can be used to help in the process of developing additional screening recommendations that might be applied broadly or focused on specific at-risk populations. [ABSTRACT FROM PUBLISHER]

Background: Studies have not provided clear enough evidence on the direct association between cigarette smoking and poverty. This study aims to assess the association of householder smoking with near-poverty households, and the potential mediating effect of NCDs., Methods: A cross-sectional survey was conducted from November 2019 to October 2020 in relatively underdeveloped regions in China. In total, 2,409 households were investigated in areas under the jurisdiction of 24 primary health care (PHC) institutions of eight provinces. Pearson's χ 2 -test was performed, and multivariable logistic regression and extended probit regression models were fitted to examine the association between householder smoking and near-poverty households. Moreover, generalized structural equation modeling was used to explore the mediating effect of NCDs., Results: After adjusting for all other potential confounding factors, compared with households headed by never-smokers, households headed by smokers exhibited significantly elevated risks of being near poverty, with an odds ratio of 2.01 (95% CI: 0.48-0.91). We also found that living in rural areas and having a low education level both had a negative effect on being near poverty. Additionally, NCDs had a significantly positive mediating effect, with a 31.57% effect of householder smoking on near-poverty status mediated by NCDs; the indirect effect was estimated to be 0.17 (95% CI: 0.04-0.31)., Conclusions: Householder smoking significantly elevated the risk of the household being near poverty, and suffering NCDs had a positive mediating effect., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yang, Chen, Guo, Song, Cheng and Jin.)

Background: Noncommunicable diseases (NCDs) are the leading global cause of death and share common risk factors. Little quantitative data are available on the patterns of each NCDs death and dietary factors by national income level and region. We aimed to identify the trend of NCDs deaths and dietary factors with other health-related behaviors across national income levels and geographical regions. Methods: Three databases were collected, including the World Health Organization, Food and Agriculture Organization, and World Bank in 2014. These were analyzed to describe the trend for NCDs deaths and dietary factors with health-related behaviors across national income levels (high income, upper-middle income, lower-middle income, and low income) from 151 countries using variance-weighted least-squares linear regression. Results: Lower-middle-income and low-income countries in Africa and Asia had higher death rates of NCDs. More than 30% of the population had raised blood pressure with higher carbohydrate intake and lower protein and fat intake compared to high-income European countries in 2014. High-income countries had the highest prevalence of raised total cholesterol, overweight, and obesity, the highest total energy, fat, and protein intake, and the highest supplies of animal fat, stimulants, sugar and sweetener, vegetable oil, and milk, as well as insufficient activity with an increasing trend (p for trend < 0.001). Conclusion: There were differences in NCDs risk factors and dietary factors by national income and region. Accordingly, measures should be taken to suit the situation in each country. Our findings have significance for health workers and health policies preventing and controlling the rise of NCDs. [ABSTRACT FROM AUTHOR]