Search

Abstract Purpose The aim of this research was to investigate the relationship between socio-economic inequalities and fatal and non-fatal cardiovascular events. Methods A systematic review of recently published cohort studies and a meta-analysis of relative risk (RR) of low compared with high socio-economic status (SES) in relation to cardiovascular incidence and mortality was conducted. Supplementary evaluations were conducted considering different proxies of SES in relation to different types of cardiovascular disease (CVD). Results We identified 17 studies including approximately 26.5 million of participants with more than 900,000 CVD events. We estimated a 50% increased CVD risk for low SES with respect to high SES (RR = 1.49 [95% confidence interval: 1.26, 1.78]). For sex-specific risk, we estimated a 79% increased CVD risk for women of low SES (RR = 1.79 [1.30, 2.46]). In men, the same investigation found a 45% increased CVD risk (RR = 1.45 [1.09, 1.92]). We reported that low education (RR = 1.56 [1.27, 1.91]), increased CVD risk the most, more than low income (RR = 1.38 [1.12, 1.70]). Conclusion Although not statistically significant, women of low SES were at higher CVD risk than men. CVD risk was more relevant to educational inequality than economic inequality.

Background: Physical inactivity is a public health concern. Personal factors play a pivotal role in either prohibiting or promoting students’ physical activity (PA) participation. Limited studies have explored the influence that personal factors have on PA participation through a mixed- methodological approach. Therefore, this study aimed to 1) examine PA levels, preferences, motivation and mental health and 2) explore the personal factors that influence PA levels among undergraduate students from a South African university. Methods: A sequential explanatory mixed-methods design was employed. Quantitative data were collected through previously validated questionnaires among a convenient sample of undergraduate university students (n = 534). The questionnaire focused on PA levels, preferences, motivation and mental health. Data were analysed using SPSS V.29. Thereafter, semi-structured interviews commenced with a convenient sample of undergraduate students (n = 18) to provide insights into the quantitative results. Atlas Ti. V.8 was used for the thematic analysis. Results: Approximately a third (29%) of undergraduate students were physically inactive. Evening sessions and endurance activities were most preferred. Improving body shape, finding happiness and achieving one’s personal best were primary motivations for PA participation. Mental health concerns, such as depression (23.2%) and anxiety (40.6%), were extremely severe. Social support, social media and recognition from others were reported as facilitators of PA, while barriers included lack of knowledge, time constraints and financial limitations. Conclusions: The study emphasises that personal factors influence undergraduate students’ PA participation. However, the findings indicate inadequate PA levels among this demographic. Evening sessions were preferred, with endurance activities being the most favoured type. Social support and social media emerged as facilitators, while barriers included limited PA knowledge, time constraints and financial issues. Motivations for PA centered around improving body shape, happiness and achieving personal goals. The prevalence of mental health, particularly depression and anxiety were prevalent. Tailored interventions addressing both mental health and motivational aspects are essential to enhance PA participation.

Background: Globally, noncommunicable diseases (NCDs) have been continuously reported to be the number one leading cause of reduced life expectancy and poor life quality and have thus become a major public health concern. Objective: This study aimed to investigate the complex mediation analysis between physical inactivity and overweight in relation to mortality. Methods: The study is based on public data collected by the Global Health Observatory of the World Health Organization. Results: We showed that the median early mortality attributable to NCDs during the period 2016-2019 in both men and women was 23.2% (5th to 95th range=17.2, 35.6) while that in men alone was 25.1% (16.5, 45.7) and that of women alone was 22.0% (17.0, 27.9). When considering regional early NCDs mortality for both men and women, a systematically high median was observed in Southern Africa [28.7% (22.2, 43.8)] and a low median in Eastern Africa [21.1% (17.15, 27.3)]. The analysis of the overall relation between physical inactivity, overweight and early mortality due to NCDs revealed a statistical significance of the direct association between physical inactivity and early mortality due to NCDs. Conclusion: Our findings revealed three main epidemiological and public health concerns. First, early mortality attributable to NCDs in a range of about 20 to 30% across the sub-Saharan African regions for both sexes was observed. Second, there was a direct effect between physical inactivity and early NCDs mortality as well as the indirect effect mediated by overweight. Finally, a percentage point decrease in physical inactivity prevalence and overweight could effectively generate a reduction in mortality due to NCDs. Future studies are needed to confirm the scientific evidence observed in this study. Such studies should be based on observation of individual subjects, adopt a longitudinal design, and collect information that evaluates the complex relationship between physical inactivity and early NCDs mortality, along with the role of overweight as a possible mediator.

Introduction Physical activity has health benefits, including lowered obesity, diabetes and hypertension levels. However, participation in regular physical activities among undergraduate students is declining and, instead, physical inactivity sets the path for sedentarism. Strategies and best practices used to enhance participation in regular physical activities among undergraduate students are beneficial for mitigating sedentariness and promoting healthy lifestyles. Therefore, this study aims to present a systematic review protocol that focuses on the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students.Methods and analysis Quantitative, qualitative and mixed-methods design studies will be included and appraised. The following databases will be searched: PubMed, Science Direct, Academic Search Complete, ERIC, Web of Science, SAGE, CINAHL Plus and SPORTDiscus. Database searches on physical activities among undergraduate university students will be generated to answer the following research question: What are the strategies and best practices used to enhance participation in regular physical activities among undergraduate university students? Two independent reviewers will conduct the primary screening of articles from 2011 to 2022. A third reviewer will be consulted to solve any disagreements. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and study quality will be assessed by the Johanna Biggs Institute checklist. Results from the selected articles will be extracted, summarised and categorised based on the type of study participants, study design and setting, and methodological quality. A narrative description will synthesise the findings to answer the objectives of this review.Ethics and dissemination Ethics approval for this study was granted by the Humanities and Social Science Research Ethics Committee at the University of the Western Cape, reference number: HS21/10/24. The results will be disseminated through a peer-reviewed publication and conference presentation.

Background Health education and self-management are among key strategies for managing diabetes and hypertension to reduce morbidity and mortality. Inappropriate self-management support can potentially worsen chronic diseases outcomes if relevant barriers are not identified and self-management solutions are not contextualised. Few studies deliberately solicit suggestions for enhancing self-management from patients and their providers. Objective This qualitative study aimed to unravel experiences, identify self-management barriers, and solicit solutions for enhancing self-management from patients and their healthcare providers. Methods Eight in-depth interviews were conducted with healthcare providers. These were followed by four focus group discussions among patients with type-2- diabetes and or hypertension receiving chronic disease care from two health facilities in a peri-urban township in Cape Town, South Africa. The Self-Management framework described by Lorig and Holman, based on work done by Corbin and Strauss was used to analyse the data. Results Patients experienced challenges across all three self-management tasks of behavioural/medical management, role management, and emotional management. Main challenges included poor patient self-control towards lifestyle modification, sub-optimal patient-provider and family partnerships, and post-diagnosis grief-reactions by patients. Barriers experienced were stigma, socio-economic and cultural influences, provider-patient communication gaps, disconnect between facility-based services and patients’ lived experiences, and inadequate community care services. Patients suggested empowering community-based solutions to strengthen their disease self-management, including dedicated multidisciplinary diabetes services, counselling services; strengthened family support; patient buddies; patient-led community projects, and advocacy. Providers suggested contextualised communication using audio-visual technologies and patient-centred provider consultations. Conclusions Community-based dedicated multidisciplinary chronic disease healthcare teams, chronic disease counselling services, patient-driven projects and advocacy are needed to improve patient self-management.

No abstract available.

Background: South Africa established chronic disease management programmes (CDMPs) called ‘clubs’ to ensure quality diabetes care. However, the effectiveness of these clubs remains unclear in terms of disease risk factor monitoring and complication prevention. Aim: We assessed risk factor monitoring, prevalence and determinants of diabetes related complications amongst type-2 diabetes (T2D) and hypertension (HTN) patients attending two CDMPs. Setting: Urban Township in Cape Town, South Africa. Methods: Cross-sectional survey combined with a 10-year retrospective medical records analysis of adult T2D/HTN patients attending two CDMPs, using a structured survey questionnaire and an audit tool. Statistical Software for Social Sciences (SPSS) version 25 was used to analyse risk factor monitoring and calculate prevalence of complications. Potential determinants of complications were explored through logistic regression. Results: There were 379 patients in the survey, 372 (97.9%) had HTN whilst 159 (41.9%) had T2D and HTN; 361 medical records were reviewed. Blood pressure (87.7%) and weight (86.6%) were the best monitored risk factors. Foot care (0.0% – 3.9%) and eye screening (0.0% – 1.1%) were least monitored. Nearly 22.0% of patients reported one complication, whilst 9.2% reported ≥ 3 complications. Medically recorded complications ranged from 11.1% (1 complication) to 4.2% with ≥ 3 complications. The most common self-reported and medically recorded complications were eye problems (33%) and peripheral neuropathy (16.4%), respectively. Complication occurrence was positively associated with age and female gender and negatively associated with perceived illness control. Conclusions: Type-2 diabetes and hypertension patients experienced diabetes related complications and inadequate risk factor monitoring despite attending CDMPs. Increased self-management support is recommended to reduce complication occurrence.

No abstract available.

The novel coronavirus (NCOVID-19) has quickly become a public health concern globally and needs urgent attention. While there is no current evidence of vaccines and specific drugs to prevent and treat the ailments emanating from NCOVID-19 infections, complementary and conventional medical treatments could prove beneficial in ameliorating some of the respiratory difficulties, especially in countries in sub-Saharan Africa. These treatments include specific breathing exercises, a diet that strengthens the immune system, as well as avoiding tobacco smoking and alcohol consumption. On the other hand, for those who have not contracted the virus, participation in indoor and within-the-yard physical activity could be beneficial in preventing unwanted weight gain as well as associated conditions such as anxiety and depression.

Background: Physical activity (PA) is beneficial for the health of people living with HIV and AIDS (PLWHA). Aim: The aim of this study was to determine if age, body weight, height, gender, waist-to-hip ratio (WHR), educational attainment, employment status, CD4+ cell count and body mass index (BMI) can predict overall PA among PLWHA of low socio-economic status (SES). Setting: Participants in this study were HIV-infected patients on first-line antiretroviral therapy (ART) regimen offered by the South African National Department of Health, and those not on ART. Participants were conveniently sampled from a list at a community health care centre in Cape Town. Methods: This study sample consisted of 978 HIV-infected South Africans. Physical activity data were collected using the Global Physical Activity Questionnaire. Backward multiple linear regression modelling was used to determine the relative influence of variables (age, body weight, height, gender, WHR, educational attainment, employment status, CD4+ count and BMI) on total moderate-to-vigorous PA. Alpha level was set at 0.05. Results: The mean age of the participants was 38.2 (standard deviation [SD] = 8.76) years for men and 33.9 (SD = 8.53) years for women. Physical activity was significantly higher in men (480.2 [SD = 582.9] min/week) than among women (369.35 [SD = 222.53] min/week). The results of the multiple linear regression showed that educational attainment (β = 0.127; p = 0.00), employment (β = −0.087; p = 0.01) and gender (β = 0.235; p = 0.00) significantly predicted total moderate-to-vigorous PA. Gender had the greatest effect, followed by educational attainment and employment status. Conclusion: There is a need for PA programmes that are designed to (1) target women, (2) strengthen programmes for education and promotion of PA and (3) engage the unemployed into PA for PLWHA. Physical activity interventions for this particular group should be tailored for persons of low SES.

Background: The absence of culturally relevant measures in indigenous languages could pose a challenge to epidemiological studies on health-related quality of life (HRQoL) in developing nations. Aim: To explore the feasibility and determine the validity and reliability of the Setswana translation of the HRQoL Short Form-8 (SF-8) among Setswana-speaking adults. Setting: Potchefstroom in the North West province. Methods: Sixty healthy men (n = 26) and women (n = 34), aged 45.5 ± 9.3 years, completed a Setswana translation of the SF-8 questionnaire and the original English version twice, with a 4-week interval between completions. Results: The Setswana SF-8 presented good concurrent validity with the Spearman’s correlation coefficients (ρ) of 0.72 for role physical to 0.91 for social functioning. The Cronbach’s alpha coefficients for the first and second measurements were 0.87 and 0.87, respectively, for the Setswana-translated SF-8 and 0.86 and 0.89 for the original English SF-8. The reliability coefficients were moderate for the mental health (ρ = 0.60), social functioning (ρ = 0.56) and role emotional (ρ = 0.50) domains, as well as the mental component summary (ρ = 0.50) and physical component summary (ρ = 0.45), but fair for the role physical (ρ = 0.43), body pain (ρ = 0.43), general health (ρ = 0.42), physical functioning (ρ = 0.41) and vitality (ρ = 0.38) domains on the translated Setswana version of the SF-8. Conclusion: The Setswana SF-8 version was feasible, acceptable and had acceptable concurrent validity and fair to moderate evidence of test–retest reliability for assessing HRQoL among adult Setswana-speaking community dwellers.