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Background: There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown. Methods: Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150 minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations. Results: Data on 14,585 people aged ≥65 years were analyzed (mean [SD] age 72.6 (11.5) y, maximum age 114 y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%). Conclusions: Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels. [ABSTRACT FROM AUTHOR]

Rheumatology faces a critical shortage of health-care professionals, exacerbated by an ageing patient population and escalating costs, resulting in widening gaps in care. Exponential advances in digital health technologies (DHTs) in the past 5 years offer new opportunities to address these challenges and could contribute to overall improved health care. However, keeping pace with innovations and integrating them into clinical practice can be challenging. This Review explores the transformative potential of DHTs for rheumatology in reshaping the entire patient pathway and redefining the roles of patients and providers, and discusses the potential barriers to DHT integration. Key technologies, such as large language models, clinical decision-support systems, digital therapeutics, electronic patient-reported outcomes, digital biomarkers, robots, self-sampling devices and artificial intelligence-based scribes, can be implemented along the patient pathway. A digital-first hybrid stepped-care patient pathway could combine in-person and remote care, enabling personalized and continuous monitoring through a digital safety net. The potential benefits and risks of transforming the traditional patient–provider relationship into a digital health triad with technology are discussed. Collaborative efforts are needed to navigate the evolving digital health landscape and harness the potential of DHTs to improve rheumatology care. Digital health has the potential to improve patient care in rheumatology and alleviate strain on the health-care system. This Review explores the current status of the transition from traditional health care to a model that harnesses the potential of digital health technologies, including discussion of the main benefits and barriers. Key points: Digital health improves access to care by offering decentralized and continuous services along the entire patient pathway that effectively bridge current care gaps. Digital-first hybrid care models and integrating remote and in-person care enable more flexible and need-adapted patient monitoring, reducing unnecessary visits and improving resource allocation in rheumatology. Digital health technologies empower patients to take a more active role in self-managing their conditions. Implementation of artificial intelligence reduces the burden of care for patients and health-care professionals and fosters data-driven medical decisions. Regulatory hurdles, reimbursement and scarcity of evidence represent major barriers preventing digital health technology implementation. By sharing lessons learned and fostering collaboration, rheumatologists can accelerate the digital health transition and fully harness its potential. [ABSTRACT FROM AUTHOR]

Background: We aimed to assess temporal trends in type 2 diabetes mellitus (T2DM)-related deaths and disability-adjusted life years (DALYs) at global and cross-social demographic index (SDI) levels, using data from the Global Burden of Disease (GBD) in 2021. Methods: We used geospatial mapping to visualize the global distribution of T2DM-related mortality and DALYs in 2021. Joinpoint regression assessed annual and average percent changes in DALYs and deaths from 1990 to 2021 across SDI regions. Age-period-cohort modeling examined the effects of age, period, and cohort on trends. Decomposition analysis evaluated the impact of population growth, aging, and epidemiological changes on DALY trends. A stratified projection forecasted future T2DM burden by age and sex from 2020 to 2044. Results: T2DM-related mortality and DALYs were highest in low-SDI regions. Globally, T2DM-related deaths and DALYs have increased, with the most rapid rise in low and low-middle SDI regions, driven by population growth and epidemiological shifts. High-SDI countries showed a slower increase in DALYs, influenced more by aging. Age-period-cohort analysis indicated higher DALY rates in later birth cohorts and recent periods, especially in high-SDI regions. Future projections show a significant increase in the 70-74 age group and a gradual rise in other age groups. Conclusion: The burden of T2DM is projected to continue increasing, especially in low-SDI and low-middle SDI regions, where population growth and epidemiological shifts are the main contributors. This underscores the need for targeted, region-specific healthcare policies, preventive strategies, and age-specific interventions to address the increasing T2DM burden globally. [ABSTRACT FROM AUTHOR]

ABSTRACT Diabetes is one of the most pressing health issues in the Southeast Asian region, and hypertension has been commonly reported as a comorbidity in adults with diabetes. This systematic review aimed to synthesize evidence on the prevalence and management of hypertension in adults with diabetes in Southeast Asian countries. A literature search was conducted in Ovid MEDLINE and Embase Classic + Embase from database inception until March 15, 2024. Studies were included if (1) they were conducted in Southeast Asian countries, (2) the study populations were adults with diabetes, and (3) there was information related to hypertension or blood pressure (BP) in the study results. Of the 7486 abstracts found, 90 studies qualified for this review. Most studies reported a hypertension prevalence of 70% or higher (ranging from 29.4% to 93.4%). Despite this high prevalence, a substantial proportion of these populations did not receive adequate BP control, with most studies indicating a control rate of less than 40%. There was limited evidence on the prescription of antihypertensive therapies and medication adherence. There was a lack of studies from 4 of the 11 countries in the region. This review highlights that BP control in adults with diabetes remains a significant challenge in Southeast Asia. Given the ongoing epidemiological transition, and the increasing older population in this region who are likely to accumulate multiple chronic conditions complicating medication strategies, this review highlights the urgent need to improve BP management in those with diabetes. [ABSTRACT FROM AUTHOR]

In 1977, Michael Lipton introduced the Urban Bias Thesis as a framework for understanding how most economic policy initiatives have contributed to the overdevelopment of urban areas and the underdevelopment of rural areas. In Latin America, there has historically been a positive correlation between urbanization and mortality decline, as the region's health transition generally began in the main cities and tended to proceed more rapidly in countries with higher levels of urbanization. This paper seeks evidence of a residual urban bias in the region's mortality patterns. Using a sample of Latin American countries over the 2000–2010 period, I analyse the disparities in mortality patterns and avoidable causes of death by looking closely at urban and rural areas using continuum categories. The results indicate that the urban advantage does persist and that rural–urban mortality differentials have consistently favoured the largest cities. The metropolitan advantage in mortality is an outcome of lower mortality in causes of death that are avoidable through primary interventions. Even in scenarios of high mortality at younger adult ages (15–44), the metropolitan advantage remains, due primarily to unsuccessful efforts to reduce mortality in populations aged 45 years and over outside the main and large cities. [ABSTRACT FROM AUTHOR]

Background: Current methods for oral health workforce planning lack responsiveness to dynamic needs, hampering efficiency, equity and sustainability. Effective workforce planning is vital for resilient health care systems and achieving universal health coverage. Given this context, we developed and operationalised a needs-adaptive oral health workforce planning model and explored the potential of various future scenarios. Methods: Using publicly available data, including the Special Eurobarometer 330 Oral Health Survey, we applied the model in a hypothetical context focusing on the Dutch population's dental needs from 2022 to 2050. We compared current and future provider supply and requirement and examined, in addition to a base case scenario, several alternative scenarios. These included epidemiological transition scenarios with different oral health morbidity trajectories, skill-mix scenarios with independent oral hygienists conducting check-ups and multiple dental student intake and training duration (5 instead of 6 years) scenarios. Results: Based on the aforementioned historical data, our model projects that provider requirement will exceed supply for the planning period. If the percentage of people having all natural teeth increases by 10% or 20% in 2032, 34 or 68 additional full-time equivalent (FTE) dentists will be required, respectively, compared to the base case scenario. In the skill-mix scenario, the model indicates that prioritising oral hygienists for check-ups and shifting dentists' focus to primarily complex care could address population needs more efficiently. Among the student intake and training duration scenarios, increasing intake to 375 and, to a lesser extent, reducing training to 5 years is projected to most effectively close the provider gap. Conclusions: The study underscores the importance of understanding oral health morbidity trajectories for effective capacity planning. Due to limited dental epidemiological data, projections carry substantial uncertainty. Currently, demand for FTE dentists seems to exceed supply, though this may vary with epidemiological changes. Skill-mix strategies could offer efficiency gains by redistributing tasks, while adjustments in dental intake and training duration could also help address the requirement-supply gap. Resolving dentistry workforce challenges requires a multifaceted approach, including strengthening oral epidemiology projections, addressing the root causes of dental health issues and prioritising harmonious dental public health and general practice prevention measures. [ABSTRACT FROM AUTHOR]

The document introduces a supplement focusing on multidisciplinary perspectives on dementia and related population health trends. It highlights the anticipated increase in older adults living with dementia globally and the pressures it will place on families and public services. The supplement includes papers from the Michigan Center on the Demography of Aging's TRENDS network, supported by the National Institute on Aging, covering topics such as cognitive impairment trends, dementia prevalence, care projections, and racial disparities in dementia care. The articles underscore the need for further research on dementia trends, projections, and care, especially in low- and middle-income countries where data gaps exist. [Extracted from the article]

Objectives: This study aims to examine the change in mental health fromthe clinical to community setting in personswith spinal cord injury and to identify the role of psychosocial resources for this transition. Design: Longitudinal survey self-report data fromN = 240 personswith spinal cord injury from the Swiss Spinal Cord Injury Cohort study. Results: Latent profile analysis identified three profiles for each the clinical and the community setting: low, medium, and high mental health load. Latent transition analysis revealed that persons with spinal cord injury were most likely to stay in the same profile from discharge of initial rehabilitation to community, followed by a decrease from a high mental health load to a medium mental health load and an increase from a low mental health load to a medium mental health load. Individuals staying in the low mental health load profile showed significantly higher levels of psychosocial resources compared to individuals increasing to the medium mental health load profile, whereas individuals who stayed in the high mental health load profile showed lower levels of psychosocial resources compared to individuals decreasing to the medium mental health load profile. Conclusions: This study highlights a positive role of psychosocial resources onmental health transitions, underlining the need for strengthening psychosocial resources beyond initial rehabilitation. [ABSTRACT FROM AUTHOR]

China has experienced a notable upsurge in pertussis cases post-COVID-19, alongside an age shift to older children, increased vaccine escape, and a notable rise in the prevalence of macrolide-resistant Bordetella pertussis. Here, we present a genomic epidemiological investigation of these events. We performed a retrospective observational study using culture-positive B pertussis isolated in Shanghai, China, from 2016 to 2024. We analysed strain and pertussis epidemiology dynamics by integrating whole-genome sequencing of 723 strains with antimicrobial susceptibility, transcriptomic profile, and clinical data. We compared the genome sequences of Shanghai strains with 6450 Chinese and global strains. From pre-COVID-19 (before December 2019) to post-COVID-19, patients shifted from predominantly infants (90%, 397/442) to a higher proportion of infections in older children (infant: 16%, 132/844), with the share of vaccinated individuals surging from 31% (107/340) to 88% (664/756). The macrolide-resistant Bordetella pertussis prevalence increased from 60% (267/447) to 98% (830/845). The emergence and expansion of a ptxP3 -lineage macrolide-resistant clone, MR-MT28, which is uniquely capable of causing substantial infections among older children and vaccinated individuals, was temporally strongly associated with the pertussis upsurge and epidemiological transition. Although MR-MT28 showed increased expression of genes encoding pertussis toxin, it was associated with significantly milder clinical symptoms and a lower hospitalization rate. MR-MT28 likely originated in China around 2016, after acquiring several key mutations, including a novel prn150 allele, and has been detected across multiple regions in China. In addition, 26% (50/195) of MR-MT28 has evolved into predicted Pertactin (PRN)-deficient strains, with an IS481 insertion being the predominant mechanism. : We report that the post-COVID-19 upsurge of pertussis in China is associated with ptxP3 -MR-MT28, and provide evidence that pathogen evolution is likely the primary factor driving + pertussis upsurge, age shift, and vaccine escape. MR-MT28 poses a high risk of global spread and warrants global surveillance. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

AbstractGrievers recall memories from both the life of the deceased and the dying days, but differences in recall across these memory types are not well-characterized. In this study, 100 bereaved German adults described up to ten important memories of a deceased close other (M = 7.86). Memories from the dying days were classified into: final memories, health transition events, last time events, and temporal markers. Among those who provided at least one dying days memory (73%), these memories were reported to be recalled privately and shared socially more often than memories from the deceased’s life. Memories from the dying days were rated as less emotionally positive than those from the life, and contextual factors from the loss shaped memory recall frequency and emotional valence. Results underscore the need for appropriate end-of-life care to lay a foundation for adaptive remembering and suggest the relevance of dying days memories in therapeutic settings. [ABSTRACT FROM AUTHOR]

Context Methods Findings Conclusions Policy Points A large population of incarcerated people may be eligible for prerelease and transition services under the new Medicaid Reentry Section 1115 Demonstration Opportunity. We estimated the largest relative population increases in Medicaid coverage from the opportunity may be expected in smaller and more rural states. We found that mental illness, hepatitis C, and chronic kidney disease prevalence rates were sufficiently high among incarcerated populations to likely skew overall Medicaid population prevalence of these diseases when prerelease and transition services are expanded, implying the need for planning of additional data exchange and service delivery infrastructure by state Medicaid plans. A large population of incarcerated people may be eligible for prerelease and transition services under the new Medicaid Reentry Section 1115 Demonstration Opportunity. We estimated the largest relative population increases in Medicaid coverage from the opportunity may be expected in smaller and more rural states. We found that mental illness, hepatitis C, and chronic kidney disease prevalence rates were sufficiently high among incarcerated populations to likely skew overall Medicaid population prevalence of these diseases when prerelease and transition services are expanded, implying the need for planning of additional data exchange and service delivery infrastructure by state Medicaid plans. As states expand prerelease and transition services for incarcerated individuals under the Medicaid Reentry Section 1115 Demonstration Opportunity, we sought to systematically inform Medicaid state and plan administrators regarding the population size and burden of disease data available on incarcerated populations in both jails and prisons in the United States.We analyzed data on eligibility criteria for new Medicaid prerelease and transition services based on incarceration length and health conditions across states. We estimated the potentially eligible populations in prisons and jails, considering various incarceration lengths and health status requirements. We also compared disease prevalence in the incarcerated population with that of the existing civilian Medicaid population.We found that rural and smaller states would experience a disproportionately large proportion of their Medicaid populations to be eligible for prerelease and transition services if new Medicaid eligibility rules were broadly applied. Self‐reported psychological distress was notably higher among incarcerated individuals compared with those currently on Medicaid. The prevalence rates of previously diagnosed chronic hepatitis C and kidney disease were also much higher in the incarcerated population than the existing civilian Medicaid population.We estimated large volumes of potentially Medicaid‐eligible entrants as coverage policy changes take effect over the coming years, particularly impacting smaller and more rural states. Our findings reveal very high disease prevalence rates among the incarcerated population subject to new Medicaid coverage, including specific chronic, infectious, and behavioral health conditions that state Medicaid programs, health plans, and providers may benefit from advanced planning to address. [ABSTRACT FROM AUTHOR]

The article "Re-Writing Pandemic Histories: Introduction" delves into the evolving study of pandemics, particularly in the context of the COVID-19 pandemic. It emphasizes the importance of global perspectives and diverse methodologies in understanding epidemic and pandemic histories. The text explores the racialization of risk, the global impact of pandemics, and the need for nuanced approaches to studying disease phenomena. By incorporating various disciplines and narratives, historians aim to advance public health equity and memory while addressing current global health challenges. [Extracted from the article]

Positive affect journaling (PAJ) encourages individuals to focus on positive aspects of life experiences. To test its efficaciousness on hedonic well-being, college students (N=119) were asked to remember transitions during the start of the COVID-19 pandemic in one of three conditions: (i) positive affect journaling (PAJ), in which participants were instructed to journal about positive changes, (ii) control journaling, in which participants were asked to journal about any changes, or (iii) a no journaling condition. Emotional outcomes were explicitly and more subtly assessed after only thinking about the COVID-19 transition period and after journaling about it. Those in the PAJ condition had enhanced positive emotion compared to those in the control journaling condition after only thinking about the COVID-19 transition period. However, even when controlling for this difference in reflection, PAJ continued to be efficacious on a more subtle indicator of positive emotional well-being. Implications for integrating PAJ with clinical interventions are discussed. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of squamous carcinoma of the oropharynx (OPSCC) has presented an increase worldwide, a fact that occurs along with a phenomenon of epidemiological transition, whose pathogenesis is linked to human papilloma virus (HPV) in a significant part of the cases. Published evidence at the Latin American level is scarce. The present study aims to evaluate the epidemiological and clinical characteristics of patients with oropharyngeal cancer treated in a public oncology reference centre in Chile. Methodology: A cross-sectional study was carried out. Patients with histological confirmation of OPSCC aged 18 years or older, referred to the National Cancer Institute of Chile between 2012 and 2023 were included. The association with HPV was determined by immunohistochemistry for p16. Results: 178 patients were analysed, most of them in locoregionally advanced stages involving the palatine tonsil. Seventy-seven percent were male, with a median age of 60 years. Sixty-seven percent of patients were positive for p16, with a progressive increase to 85% in the last 2 years of the study. The p16(+) patients were younger and had fewer classical risk factors. Primary treatment was radiotherapy in 94% of patients. Conclusion: The epidemiological profile of patients with OPSCC treated in a Chilean public oncology referral centre reflects the epidemiological transition observed in developed countries. This change justifies the need to adapt health policies and conduct research that considers the characteristics of this new epidemiological profile. [ABSTRACT FROM AUTHOR]

Background: Owing to epidemiological transition and factors like rapid urbanization, the prevalence of non-communicable diseases has risen to alarming levels instigating global attention. Early detection of risk factors is of paramount importance when it comes to combating non-communicable diseases. Risk factors for non-communicable diseases can be broadly classified into behavioural and metabolic risk factors. Objectives: To assess the prevalence of non-communicable disease risk factors and determine their association with sociodemographic variables among the adult population of rural Manipur. Methods: A cross-sectional study was conducted among adult population in rural areas of Bishnupur district, Manipur during February and March 2023.Multistage stratified random sampling technique was employed. Data were collected from 426 individuals using interviewer-administered questionnaire. Descriptive statistics like mean with standard deviation and percentage were used. Chi-square test was used for statistical significance. Results: The overall prevalence of current smoking was 22.3%, and 55.6% of respondents were currently using smokeless tobacco products. The prevalence of current alcohol consumption was 25.8%, 77.5% of the respondents had insufficient consumption of fruits and/or vegetables, 30% had insufficient physical activity, 21.4% were having daily salt intake of >5g, 58.2% were found to have overweight/obesity, and 47.4% were found with raised blood pressure. Occupation was found to be significantly associated with all non-communicable disease risk factors assessed in this study. Conclusion: Life-style behaviour modification interventions are a must to reduce risk factors of non-communicable diseases. [ABSTRACT FROM AUTHOR]

Despite recent economic growth and reductions in child mortality in many African countries, the region has experienced a slow fertility transition. In this study, we explore whether the slow structural economic change on the continent can explain this discrepancy. We construct a unique panel dataset combining Demographic and Health Surveys and nighttime light intensity data (an indicator of industrialization) from 57 countries at the subnational region level over three decades to analyze the drivers of fertility transitions across low- and middle-income countries. Our results confirm that household wealth, reduced child mortality, and female primary education are crucial for fertility declines. However, our analysis also highlights the importance of indicators of structural economic change, including the share of labor in nonagricultural occupations, industrialization, the share of women with higher education, and the formalization of the economy. Our simulations suggest that if high-fertility countries in sub-Saharan Africa underwent structural economic transformations comparable to those of other low- and middle-income countries with low fertility rates, their fertility levels could fall by 1 to 1.6 children. [ABSTRACT FROM AUTHOR]

Multiple births strain mothers' and families' resources in ways that should highlight preferences for family size, birth spacing, and parity-dependent stopping behavior. Couples with surviving twins reach their target family size sooner than other couples and should be more likely to practice family limitation. Twins are also a greater burden on the mother's time and health, which could lead to postponing the next birth, even among couples who want additional children. We examine these hypotheses by analyzing families with twins in the 1900 and 1910 U.S. Censuses. Using reconstructed birth histories for more than 7 million women in the IPUMS full-count 1900 and 1910 datasets and event-history methods (Kaplan–Meier curves, cure models), we find clear evidence of family limitation following a multiple birth. Couples who had twins or triplets were more likely to stop childbearing, and those who continued having children delayed their next birth. Responses to multiple births were larger in groups previously identified as leaders in the transition to smaller families, and roughly one third of couples stopped after one or two children. We find no evidence that some groups relied primarily on birth spacing to reduce family size while others relied primarily on stopping. [ABSTRACT FROM AUTHOR]

Introduction: Non – Communicable Diseases, driven by factors like increased life expectancy, urbanization and unhealthy lifestyles have become a leading cause of morbidity and mortality worldwide. India is undergoing a health transition, with Cardio Vascular Diseases now representing a significant part of its disease burden. Objectives: To estimate the prevalence of CVD risk and its associated factors using World Health Organization/ International Society of Hypertension risk prediction charts. Method: A community based cross-sectional study was conducted for a period of 18 months among 545 participants in Poonamallee Taluk, Tiruvallur district. Participants were selected using a multistage simple random sampling method. Sociodemographic data were collected through interviews, and blood samples were taken to assess blood sugar and cholesterol levels. Descriptive statistics for background variables were computed using SPSS 21. The association between various factors and cardiovascular disease (CVD) risk was analysed using the chi square test. Multiple logistic regression was performed to identify independent risk factors. Results: The mean age of the study subjects was 54.3+9 years with 60.2% being females. The 10-year CVD risk, based on the WHO/ISH risk prediction chart 30.6% had low risk (5 – 10%) and 30.3% had moderate risk (10 -

The rapid epidemiological transition in Asian countries, resulting from the rising trend of urbanisation and lifestyle changes, is associated with an increasing risk of obesity in women of reproductive age. This is the first study to investigate the trends and population-attributable fraction (PAF) of obesity, and the interaction effects of education and wealth on obesity among reproductive-age women aged 15–49 years in ten Asian countries. This cross-sectional study examined the most recent (2000 to 2022) Demographic and Health Surveys (DHS) data from ten Central and Southeast Asian countries. Multilevel multinomial logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor. This study included a weighted sample of 743,494 reproductive-age women. All the countries showed an increasing trend for obesity and a decreasing trend for underweight, except for the Maldives. The highest PAFs of obesity were associated with women who were married (PAF = 22.2%; 95% CI 22.1, 22.4), aged 35–49 years (PAF = 16.4%; 95% CI 15.5, 17.1), resided in wealthy households (PAF = 14.5%; 95% CI 14.4, 14.5), watched television regularly (PAF = 12.5%; 95% CI 12.1, 12.8), and lived in urban areas (PAF = 7.8%; 95% CI 7.7, 8.0). The combined PAF showed that these five risk factors were associated with 73.3% (95% CI 71.8, 74.9) of obesity among reproductive-age women. Interaction analysis between women's education and household wealth revealed that having a secondary or higher level of education and residing in a wealthier household was associated with a lower risk of obesity (OR = 0.71, 95% CI 0.66, 0.76). The findings of this study suggest that, in order to address the rising rate of obesity among women in Asian countries, education and lifestyle modifications in urban areas should be a priority. Pakistan and the Maldives need to be a priority given the rapidly increasing trends in obesity and underweight subpopulations in their respective countries. [ABSTRACT FROM AUTHOR]

Introduction: The Democratic Republic of Congo (DRC) does not have national prevalence data for arterial hypertension (HTN) or diabetes (type I and II combined) to aid evidence-based decision-making, despite the assumption of epidemiological transition in low- and middle-income countries. The aim of this study was to estimate a proxy of prevalence for HTN and diabetes. Methodology: This study used routine monthly reported data pertaining to HTN and diabetes from the District Health Information Software 2 (DHIS2), spanning 2019–2023. Data underwent quality assessment and adjustments using standardization before analysis. Equity analyses were carried out at the national and sub-national levels. Epidemiological curves and maps were produced to analyze trends in the prevalence of HTN and diabetes among adults aged 18 and over. Permission to use the data was obtained from the regulatory authority. Results: Over five years, incidence of HTN increased from 13.23% (CI 95%: 13.22–13.24) to 15.23% (CI 95%: 15.22–15.24) (+15.1% relative increase), and diabetes rose from 2.73% (CI 95%: 2.72–2.74) to 3.345% (CI 95%: 3.34–3.35) (+16.3% relative increase), with provincial variations observed. Conclusions: In the DRC, hypertension and diabetes are advancing rapidly. Primary and preventative healthcare services and public health interventions must prioritize these diseases. [ABSTRACT FROM AUTHOR]

Objective: This study examines the 2022 distribution of primary healthcare centers across Saudi Arabia's 20 regions, focusing on disparities and healthcare accessibility. Methods: A quantitative analysis of the Ministry of Health's data was conducted. Primary healthcare centers distribution was evaluated by calculating the number of primary healthcare centers per 100,000 population across different administrative regions. Results: The study uncovered regional disparities, with the PHCs-per-100,000-people ratio showing significant variance. Regions like Riyadh had an above-average ratio with 7.5 PHCs-per-100,000-people, while Jeddah lagged behind with a concerning 3.2 PHCs-per-100,000-people despite being a populous city. The PHC-per-capita ratio declined to 6.6 in 2022 from 8.0 in 2017. The data also revealed that the Eastern Province showed an increase in the number of primary healthcare centers. Conclusion: Disparities in the distribution of primary healthcare centers in 2022 highlight a critical need for equitable healthcare access across Saudi Arabia. Many regions require increased primary healthcare center allocation to match population needs. The findings underscore the urgency of integrating these insights into policy frameworks to achieve the goals of Vision 2030, emphasizing the development of a sustainable and equitable healthcare system. Implications: Policymakers need to consider these disparities to guide the strategic placement of primary healthcare centers and ensure an equitable healthcare system. This study provides a basis for targeted policy interventions to improve healthcare equity and prepare the health system for future demographic and epidemiological transitions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Académica Internacional de Educación Física is the property of Asociacion Cientifica Internacional de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: India is facing a heavy burden of non-communicable diseases (NCDs) due to explosion in the epidemiological transition worldwide. In that mainly cardiometabolic risk factors like dyslipidemia play an important role in the prevalence of NCDs. According to the National Obesity Forum in Nottingham, UK, obesity itself can be the fundamental cause of numerous other illnesses and conditions, including cardiovascular disease, hypertension, stroke, hyperlipidemia, diabetes, cancers, osteoarthritis, respiratory disorders, sleep apnea, fertility problems, Alzheimer's disease, depression, and other psychological disorders. Obesity has not historically been categorized as a disease; therefore, treatment options covered by health insurance plans have been limited. A combination of genetics, lifestyle behaviors, and comorbidities represents the lion's share of determinants. Aims and Objectives: The effect of Kalonji (Nigella sativa) seed oil on lipid profile is seen on cardiometabolic risk factors partly, that is, dyslipidemia in high-fat diet-induced hyperlipidemic albino rats. Materials and Methods: After obtaining approval from the Animal Ethics Committee, the albino rats of weighing 120-200 g were selected and induced hyperlipidemia by giving high-fat diet for 4 weeks. The basal lipid profiles were estimated and also hyperlipidemic levels were estimated after 4 weeks of high-fat diet. Then, oral feeding started with the standard drug atorvastatin 10 mg and with extract of Kalonji seed oil of low dose 200 mg and 600 mg/kg body weight of high dose is given for a period of 1 month. Again lipid profile estimation was done on days 14 and 30. The data analyzed statistically analyzed by drawing mean and standard deviation. Results: It is observed that a high dose 600 mg/kg body weight of Kalonji showed significant hypolipidemic activity as compared to a low dose 200 mg/kg. It lowers total cholesterol and low-density lipoprotein levels significantly as that of the standard drug atorvastatin 10 mg/kg. Conclusion: Kalonji (N. sativa) has produced hypolipidemic activity significantly with a high dose 600 mg/kg significantly as that of atorvastatin 10 mg/kg. Kalonji also has not produced any toxic changes like hepatotoxicity at high doses. Hence, Kalonji as anti-dyslipidemic proves in decreasing the risk factors in the development of NCDs. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Management Analysis / Revista Gestão em Análise is the property of Revista Gestao em Analise and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The global burden of disease caused by cardiovascular diseases (CVDs) is increasing despite technical advancements in healthcare because of a dramatic rise in the developing nations that are experiencing rapid health transitions. The World Health Organization (WHO) estimates 17.9 million deaths worldwide in 2021 and is connected to CVDs, or 32% of all deaths. Since ancient times, people have experimented with the methods that extend their lives. The proposed technology is still a long way for attaining the aim of lessening the mortality rates. Early detection and proactive management of CVD risk factors are crucial for reducing the burden of these diseases. In recent years, researchers have been exploring the potential of deep learning methods for predicting cardiovascular disease risk depending upon data collected from IoMT devices. Deep learning (DL) methods used for cardiovascular diseases prediction have been popular in this domain. Several DL techniques are implemented to accomplish efficient prediction-based CVD. There are several steps in the CVD employing deep learning model. IoT sensors and deep learning techniques are used to process large amounts of patient-related biomedical data, enabling doctors to closely monitor their patients and make choices in real-time. An outline of the IoT, sensors, and deep learning is provided after a discussion of cardiac disease and its existing treatments. A complete analysis of the current and pertinent deep-learning techniques for heart disease prediction is reviewed. The result shows the performance metrics of the comparison of different deep learning approaches. This review is undertaken by pulling data from 44 papers published between the years 2020 and 2023, provides a thorough statistical analysis. Finally, this survey will be beneficial for CVD prediction researchers. [ABSTRACT FROM AUTHOR]

This article explores the significance of analyzing historical mortality data to gain insights into current health disparities. It highlights the shift in causes of death from infectious diseases to non-communicable diseases over the past century and a half. The article emphasizes the need to contextualize recent events, such as the COVID-19 pandemic, within long-term historical trends. It also recognizes the persistence of socio-demographic inequalities in health and the importance of comprehensive population-based studies to address these disparities. The text discusses international initiatives, like the EU COST Action "The Great Leap," which aim to understand the drivers of health inequalities through historical analysis. However, the authors note that additional long-term population-based studies are necessary to tackle the public health challenges of the 21st century. The authors express gratitude to their collaborators and acknowledge financial support from the Swiss National Science Foundation. [Extracted from the article]

Despite a global epidemiological transition towards increased burden of non-communicable diseases, communicable diseases continue to cause substantial morbidity and mortality worldwide. Understanding the burden of a wide range of infectious diseases, and its variation by geography and age, is pivotal to research priority setting and resource mobilisation globally. We estimated disability-adjusted life-years (DALYs) associated with 85 pathogens in 2019, globally, regionally, and for 204 countries and territories. The term pathogen included causative agents, pathogen groups, infectious conditions, and aggregate categories. We applied a novel methodological approach to account for underlying, immediate, and intermediate causes of death, which counted every death for which a pathogen had a role in the pathway to death. We refer to this measure as the burden associated with infection, which was estimated by combining different sources of information. To compare the burden among all pathogens, we used pathogen-specific ratios to incorporate the burden of immediate and intermediate causes of death for pathogens modelled previously by the GBD. We created the ratios by using multiple cause of death data, hospital discharge data, linkage data, and minimally invasive tissue sampling data to estimate the fraction of deaths coming from the pathway to death chain. We multiplied the pathogen-specific ratios by age-specific years of life lost (YLLs), calculated with GBD 2019 methods, and then added the adjusted YLLs to age-specific years lived with disability (YLDs) from GBD 2019 to produce adjusted DALYs to account for deaths in the chain. We used standard GBD methods to calculate 95% uncertainty intervals (UIs) for final estimates of DALYs by taking the 2·5th and 97·5th percentiles across 1000 posterior draws for each quantity of interest. We provided burden estimates pertaining to all ages and specifically to the under 5 years age group. Globally in 2019, an estimated 704 million (95% UI 610–820) DALYs were associated with 85 different pathogens, including 309 million (250–377; 43·9% of the burden) in children younger than 5 years. This burden accounted for 27·7% (and 65·5% in those younger than 5 years) of the previously reported total DALYs from all causes in 2019. Comparing super-regions, considerable differences were observed in the estimated pathogen-associated burdens in relation to DALYs from all causes, with the highest burden observed in sub-Saharan Africa (314 million [270–368] DALYs; 61·5% of total regional burden) and the lowest in the high-income super-region (31·8 million [25·4–40·1] DALYs; 9·8%). Three leading pathogens were responsible for more than 50 million DALYs each in 2019: tuberculosis (65·1 million [59·0–71·2]), malaria (53·6 million [27·0–91·3]), and HIV or AIDS (52·1 million [46·6–60·9]). Malaria was the leading pathogen for DALYs in children younger than 5 years (37·2 million [17·8–64·2]). We also observed substantial burden associated with previously less recognised pathogens, including Staphylococcus aureus and specific Gram-negative bacterial species (ie, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii , and Helicobacter pylori). Conversely, some pathogens had a burden that was smaller than anticipated. Our detailed breakdown of DALYs associated with a comprehensive list of pathogens on a global, regional, and country level has revealed the magnitude of the problem and helps to indicate where research funding mismatch might exist. Given the disproportionate impact of infection on low-income and middle-income countries, an essential next step is for countries and relevant stakeholders to address these gaps by making targeted investments. Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care using UK aid funding managed by the Fleming Fund. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease. However, the relationship between the systemic immune-inflammation index (SII) and the prognosis of RA patients remains unclear. This study aimed to investigate the association between inflammatory biomarker SII and all-cause and cardiovascular mortality in RA patients. A retrospective analysis was conducted using data from the National Health and Nutrition Examination Survey database spanning from 1999 to March 2020. We assessed the association between the SII and all-cause as well as cardiovascular mortality in RA patients employing multivariable Cox proportional hazards regression analysis and restricted cubic spline plots. Receiver operating characteristic curves were employed to evaluate the prognostic capacity of SII in predicting outcomes in both the RA patients and the general population, alongside its predictive performance compared to other markers. This study comprised 2247 RA patients and a control cohort of 29,177 individuals from the general population. Over a 20-year follow-up period, 738 all-cause deaths and 215 deaths attributable to cardiovascular disease were documented in RA patients. We observed a nonlinear positive correlation between the SII and both all-cause and cardiovascular mortality in RA patients. Of significance, at an SII level of 529.7, the hazard ratio reached 1, signifying a transition from low to high mortality risk. Moreover, subgroup analysis did not reveal any potential interactions. Our study findings indicate a nonlinear positive correlation between the inflammatory biomarker SII and both all-cause and cardiovascular mortality in patients with RA. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic Syndrome (MetS), diabetes, and other noncommunicable diseases (NCDs) have been a major focus of research in recent decades as the prevalence of these conditions continues to rapidly increase globally. However, the timing and patterns of development from metabolic risk factors to disease states are less well understood and are especially critical to understand in low- and middle-income countries (LMICs) and populations undergoing epidemiological transitions. Methods: Nationally representative sociodemographic, anthropometric, and point-of-care biomarker data from the 2016 Tunisian Health Examination Survey (n = 8170) were used to determine the prevalence of diabetes and MetS components in Tunisia and to investigate associations between glycated hemoglobin (HbA1c) and MetS components (blood pressure [BP], HDL cholesterol [HDL], triglycerides [TG], and waist circumference [WC]) in participants aged 15-97 years old. To better understand how sustained metabolic dysregulation and disease states impact these associations, diabetic and nondiabetic groups were analyzed separately. Results: The overall prevalence of diabetes based on measured HbA1c was 18.2%. The diabetic groups had a higher prevalence of each individual MetS component, and significantly higher (BP, TG, WC, and HbA1c) and lower (HDL) values than the nondiabetic groups. Yet, there were a higher number of significant associations between HbA1c and MetS components found in nondiabetic women and men when compared to diabetic women and men. HbA1c was positively associated with the cumulative number of MetS components, irrespective of diabetes status in men and women. Conclusions: The prevalence of both diabetes and MetS components (particularly low HDL cholesterol and elevated TG) is high among the Tunisian population. More MetS components were associated with HbA1c in nondiabetic individuals, showing a strong connection between the development of MetS components and diabetes. However, once the diabetes disease state manifests, there is more variability in the relationships. These results show the potential for HbA1c to be an indicator of metabolic health below clinical disease cutoffs, which may allow insights into the physiological changes that precipitate the emergence of diabetes. [ABSTRACT FROM AUTHOR]

Background: Southeast Asia is undergoing an epidemiological transition with non-communicable illnesses becoming increasingly important, yet infectious diseases (tuberculosis, HIV, hepatitis B, malaria) remain widely prevalent in some populations, while emerging and zoonotic diseases threaten. There are also limited population-level estimates of many important heath conditions. This restricts evidence-based decision-making for disease control and prevention priorities. Cross-sectional surveys can be efficient epidemiological tools to measure the prevalence of a wide range of diseases, but no systematic assessment of their coverage of different health conditions has been produced for the region. Methods: We conducted a systematic search in Medline, Embase, Global Health, CINAHL, Scopus, Web of Science Core Collection, and Global Index Medicus, and additionally Google Scholar. Our inclusion criteria were cross-sectional surveys conducted with community-based recruitment, in Bangladesh, Cambodia, Laos, Myanmar, and Thailand, published between January 1, 2010 and January 27, 2021, and reporting the prevalence of any health condition. Results: 542 publications from 337 surveys were included. Non-communicable conditions (n = 205) were reported by more surveys than infectious conditions (n = 124). Disability (n = 49), self-report history of any disease or symptoms (n = 35), and self-perceived health status (n = 34), which reflect a holistic picture of health, were studied by many fewer surveys. In addition, 45 surveys studied symptomatic conditions which overlap between non-communicable and infectious conditions. The most surveyed conditions were undernutrition, obesity, hypertension, diabetes, intestinal parasites, malaria, anemia, diarrhea, fever, and acute respiratory infections. These conditions overlap with the most important causes of death and disability in the Global Burden of Disease study. However, other high-burden conditions (e.g. hearing loss, headache disorder, low back pain, chronic liver and kidney diseases, and cancers) were rarely studied. Conclusion: There were relatively few recent surveys from which to estimate representative prevalences and trends of health conditions beyond those known to be high burden. Expanding the spectrum of health conditions in cross-sectional surveys could improve understanding of evolving disease patterns in the region. [ABSTRACT FROM AUTHOR]

Background: Suicide is among the leading causes of death for adults with schizophrenia spectrum disorders (SSDs), and there is a paucity of evidence-based suicide prevention-focused interventions tailored for this vulnerable population. Cognitive-Behavioral Suicide Prevention for psychosis (CBSPp) is a promising intervention developed in the UK that required modifications for delivery in community mental health (CMH) settings in the United States of American. This pilot trial evaluates the feasibility, acceptability, and preliminary effectiveness of our modified CBSPp intervention in comparison to services as usual (SAU) within a CMH setting in a Midwestern state of the USA. Methods: This is a single-site randomized pilot trial with a planned enrollment of 60 adults meeting criteria for both SSD and SI/A. Eligible participants will be randomized 1:1 to either 10 sessions of CBSPp or SAU. Clinical and cognitive assessments will be conducted within a 4-waive design at baseline (prior to randomization and treatment) and approximately 1 month (mid-treatment), 3 months (post-treatment), and 5 months (follow-up) after baseline assessment. Qualitative interviews will also be conducted at post-treatment. The primary objective is to determine whether CBSPp is feasible and acceptable, involving examinations of recruitment rate, treatment engagement and adherence, retention and completion rates, and experiences in the CBSPp treatment and overall study. The secondary objective is to preliminarily evaluate whether modified CBSPp is associated with reductions in clinical (suicide ideation, suicide attempt, symptoms of psychosis, depression, and emergency/hospital service, hopelessness, defeat, and entrapment) and cognitive (information processing biases, appraisals, and schemas) outcomes in comparison to SAU from baseline to post-treatment assessment. Discussion: This randomized pilot trial will provide clinically relevant information about whether CBSPp can improve SI/A, depression, and psychosis among adults with SSDs. Testing this modified cognitive-behavioral suicide prevention-focused intervention has the potential for a large public health impact by increasing the intervention's utility and usability in CMH where many individuals with SSDs receive care, and ultimately working towards reductions in premature suicide death. Trial registration: ClinicalTrials.gov NCT#05345184. Registered on April 12, 2022. [ABSTRACT FROM AUTHOR]

For decades, educational inequalities in mortality have widened and mortality among the least educated has stalled, even as overall mortality has improved, and an increasing proportion of young people have completed secondary and tertiary education. While researchers recognize that these trends are in part related to changing selection into education groups, there has been no unifying framework for understanding why the trends may be related. This article provides a unifying framework by introducing a concept called the “convex inequality regime,” a diminishing returns relationship between relative education and mortality. In populations where convex inequality regimes prevail, even without any changes in the institutions governing inequality or any changes in overall mortality conditions, education transitions result in an increase in mortality for the less educated and an increase in mortality inequality between education groups. The model also shows that lifespan variation increases for lower education groups because convex inequality regimes tend to increase relative mortality more rapidly at younger ages during an education transition. Even after an education transition is complete, inequality between education groups will continue to increase for decades due to the momentum of inequality, a cohort replacement phenomenon where younger more unequal cohorts replace older more equal cohorts. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of squamous carcinoma of the oropharynx (OPSCC) has presented an increase worldwide, a fact that occurs along with a phenomenon of epidemiological transition, whose pathogenesis is linked to human papilloma virus (HPV) in a significant part of the cases. Published evidence at the Latin American level is scarce. The present study aims to evaluate the epidemiological and clinical characteristics of patients with oropharyngeal cancer treated in a public oncology reference centre in Chile. Methodology: A cross-sectional study was carried out. Patients with histological confirmation of OPSCC aged 18 years or older, referred to the National Cancer Institute of Chile between 2012 and 2023 were included. The association with HPV was determined by immunohistochemistry for p16. Results: 178 patients were analysed, most of them in locoregionally advanced stages involving the palatine tonsil. Seventy-seven percent were male, with a median age of 60 years. Sixty-seven percent of patients were positive for p16, with a progressive increase to 85% in the last 2 years of the study. The p16(+) patients were younger and had fewer classical risk factors. Primary treatment was radiotherapy in 94% of patients. Conclusion: The epidemiological profile of patients with OPSCC treated in a Chilean public oncology referral centre reflects the epidemiological transition observed in developed countries. This change justifies the need to adapt health policies and conduct research that considers the characteristics of this new epidemiological profile. [ABSTRACT FROM AUTHOR]

Introduction: After a promising start in Australia, elimination efforts for hepatitis C are not on track. Following the global campaign to 'find the missing' in hepatitis C response, this qualitative study explores stakeholder perspectives on the 'missing' in the 'endgame' of hepatitis elimination in the state of New South Wales, Australia. Method: Twenty‐eight key informants working in New South Wales, elsewhere in Australia and internationally in high income countries participated in a semi‐structured qualitative interview. Analysis examined key informant accounts of the 'missing' in efforts to eliminate hepatitis C. Results: Participants' accounts framed the missing in relation to epidemiological knowledge, making‐up four population categories 'missing' or 'missed' in hepatitis C response. In turn, accounts situated the missing in relation to where and how individuals were presumed to connect, or not, with existing health‐care infrastructures. This gave rise to concerns about the capacity of health services to be made available for those at risk or in need, with systems said to create opportunities for people to 'miss out' on hepatitis C services. Discussion and Conclusions: The 'missing' in the 'endgame' of hepatitis C elimination effort is not simply a function of who—populations missed—but of where and how, that is, situation and context. Our findings encourage a focus on how services, systems and contexts may create situations in which people become missed or are 'made missing' from care. We therefore advocate for a systemic, and not only population‐based, approach in the final push towards hepatitis C's elimination. [ABSTRACT FROM AUTHOR]

Background: Africa is the epicenter of the HIV epidemic, with over two-thirds of the global population living with HIV. It is also facing a dramatic increase in non-communicable diseases (NCDs) amidst its aging population. This necessitates a healthcare approach that addresses both infectious diseases and NCDs in HIV-positive individuals. In Kenya, with 1.4 million HIV-positive people, efforts include widespread ART access and integrating HIV services into the health system. Challenges remain in healthcare infrastructure, particularly in rural areas. The Comorbidities in HIV/AIDS Outpatients (CHAO) Project, funded by the Italian Cooperation Agency, aims to improve understanding and management of comorbidities in HIV patients, highlighting the need for cost-effective healthcare strategies to address this dual burden. Methods: The CHAO (Comorbidities in HIV/AIDS Outpatients) project conducted a cross-sectional epidemiological study across 25 clinics in Meru County, Kenya. The study included comprehensive surveys and screenings for various comorbidities among HIV-positive patients receiving treatment, utilizing both clinical evaluations and laboratory tests to assess the prevalence of infectious diseases and NCDs. Results: A total of 1051 HIV-positive individuals were included in the study: 75 % females, 25 % males, median age 47 years, the majority (96 %) on long-term ART, mostly Dolutegravir-based (95 %). 55.4 % had at least one comorbidity, with NCDs such as dyslipidemia (21.22 %) and hypertension (20.17 %) being the most prevalent. The study also noted significant occurrences of communicable diseases, including syphilis (5.23 %), hepatitis B (2.19 %), and hepatitis C (0.29 %). The prevalence of comorbidities varied with age, highlighting the impact of aging on disease burden. Discussion: The high prevalence of comorbidities among HIV-positive patients in Meru County underscores the need for integrated healthcare strategies that address both infectious diseases and NCDs. The findings advocate for systematic screening and management of comorbidities within HIV care programs, emphasizing the need for holistic health approaches to improve outcomes for this population.

BackgroundWe aimed to assess temporal trends in type 2 diabetes mellitus (T2DM)-related deaths and disability-adjusted life years (DALYs) at global and cross-social demographic index (SDI) levels, using data from the Global Burden of Disease (GBD) in 2021.MethodsWe used geospatial mapping to visualize the global distribution of T2DM-related mortality and DALYs in 2021. Joinpoint regression assessed annual and average percent changes in DALYs and deaths from 1990 to 2021 across SDI regions. Age-period-cohort modeling examined the effects of age, period, and cohort on trends. Decomposition analysis evaluated the impact of population growth, aging, and epidemiological changes on DALY trends. A stratified projection forecasted future T2DM burden by age and sex from 2020 to 2044.ResultsT2DM-related mortality and DALYs were highest in low-SDI regions. Globally, T2DM-related deaths and DALYs have increased, with the most rapid rise in low and low-middle SDI regions, driven by population growth and epidemiological shifts. High-SDI countries showed a slower increase in DALYs, influenced more by aging. Age-period-cohort analysis indicated higher DALY rates in later birth cohorts and recent periods, especially in high-SDI regions. Future projections show a significant increase in the 70-74 age group and a gradual rise in other age groups.ConclusionThe burden of T2DM is projected to continue increasing, especially in low-SDI and low-middle SDI regions, where population growth and epidemiological shifts are the main contributors. This underscores the need for targeted, region-specific healthcare policies, preventive strategies, and age-specific interventions to address the increasing T2DM burden globally.

Chronic non-communicable diseases are a major risk factor for mortality and disability worldwide. The growing number of NCDs and their impact on the labour market and the productivity calls for the development of strategies and policies that include chronically ill people in the labour market. The paper discusses Bulgaria’s social policy on safety and health in the working environment, main principles and regulations as well as recommendations for recruiting and retaining people with chronic diseases as a human resource with knowledge and experience, and workplace loyalty and work ethics. [ABSTRACT FROM AUTHOR]

Abstract Background Demographic and epidemiological dynamics characterized by lower fertility rates and longer life expectancy, as well as higher prevalence of non-communicable diseases such as diabetes, represent important challenges for policy makers around the World. We investigate the risk factors that influence the diagnosis of diabetes in the Mexican population aged 50 years and over, including childhood poverty. Results This work employs a probabilistic regression model with information from the Mexican Health and Aging Study (MHAS) of 2012 and 2018. Our results are consistent with the existing literature and should raise strong concerns. The findings suggest that risk factors that favor the diagnosis of diabetes in adulthood are: age, family antecedents of diabetes, obesity, and socioeconomic conditions during both adulthood and childhood. Conclusions Poverty conditions before the age 10, with inter-temporal poverty implications, are associated with a higher probability of being diagnosed with diabetes when older and pose extraordinary policy challenges.

Physical Activity and Health Promotion as a Scientific Discipline Research emanating from Sub-Saharan Africa, including Cameroon, remains disproportionately low, despite recent growth in global health research. In Cameroon, these obstacles include scarcity of trained health personnel, limited knowledge about the effects of PA as a mean of NCDs prevention, poverty, inadequate PA policies implementation, and an inappropriate environment to support PA interventions. Physical activity (PA) has shown substantial benefits versus inactivity, such as improvement in bone and muscle strength, weight and balance control, cognitive health, mental health and mood, ability to perform daily activities, sleep, well-being, life span, preventing falls, as well as considerable contribution in the protection from the risk of several types of noncommunicable diseases (NCDs).[1]-[3] As a drug-free and powerful intervention for health promotion and disease prevention,[4] PA would be an appropriate strategy priority for improving global health. [Extracted from the article]

In the first half of the twentieth century, deaths from infectious disease, especially among the very young, fell dramatically in American cities. However, as infant mortality fell and life expectancy rose, racial inequality in urban infectious disease mortality grew. In this paper, we show that the fall in mortality and the rise in racial inequality in mortality reflected two countervailing processes. The dramatic decline in infant mortality from waterborne diseases drastically reduced the total urban infectious disease mortality rate of both Black and white Americans while having a comparatively small effect on the total racial disparity in urban infectious disease mortality. In contrast, the unequal fall in tuberculosis mortality, particularly in the prime of life, widened racial inequality in infectious disease mortality in US cities.

Objectives: Due to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care. Methods: Population-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services' locations and identify geographic disparities. Results: A total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards. Conclusions: Palliative care services are concentrated in three main regions (Bogotá D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs. [ABSTRACT FROM AUTHOR]

The study delves into the epidemiological transition, examining the intricate changes in health status patterns and their connection to morbidities. Specifically, it assesses morbidity transition at both national and subnational levels in India and their determinants from 1995 to 2018. This study examines self-reported morbidities in India by utilising four rounds of National Sample Survey Organisation (NSSO) data (52nd, 60th, 71st, and 75th) from 1995–2018. We estimated prevalence by conducting descriptive analysis on socio-demographic determinants and morbidities such as: Infectious and Communicable Diseases (In&CDs), Non-communicable diseases (NCDs), Disability and other diseases. Moreover, we employed pooled regression analysis to explore morbidity risk transitions over the past decades. The study revealed a steady upsurge in morbidity prevalence in India, doubling from 56 (per thousand) in 1995 to 106 in 2014. However, a considerable decline was observed in the most recent round in 2018 (79 per thousand). From 1995 to 2018, NCDs gained a prominent share in morbidity trends. Kerala in the southern region reported the highest rates, followed by states like Lakshadweep, Andhra Pradesh, Karnataka, West Bengal, Punjab, and others. Age, sex, residence, education, caste, religion, and wealth are pivotal factors in determining the severity of different disease burdens in different sections of the population in India. Over the study period (1995, 2004, 2014, and 2018), the odds of reported morbidities risk transition significantly increased over successive decades: 1.81 times in 2004 (95% CI: 1.78–1.84), 2.16 times in 2014 (95% CI: 2.12–2.2), and 1.44 times in 2018 (95% CI: 1.41–1.46), compared to 1995 (52nd round). The study reveals significant disparities in morbidity reporting across Indian states from 1995 to 2018, attributed to distinct demographic, social, and economic determinants. India continues to grapple with the dual burden of diseases, but the NCDs burden is mounting at a faster pace than CDs. [ABSTRACT FROM AUTHOR]

Background: There is a treatment gap for those living with severe mental illnesses in low- and middle-income countries, yet not enough is known about those who are currently accessing clinical services. A better understanding of potentially modifiable factors associated with functioning and quality of life will help inform policies and programming. Aims: To describe the functioning and quality of life for a psychiatric treatment-engaged population living with psychotic disorders in two urban areas of Tanzania, and to explore their respective correlates. Methods: This study analyzed cross-sectional data from 66 individuals enrolled in the Kuwezeshana Kupata Uzima (KUPAA) pilot clinical trial who had a diagnosis of schizophrenia or schizoaffective disorder, recent relapse, and who were receiving outpatient treatment. Baseline functioning (WHO Disability Assessment Schedule 2.0) and quality of life (WHO Quality of Life BREF scale) were measured. Univariable and multivariable regression analyses were conducted to determine correlates of functioning and quality of life. Results: Adjusted analyses indicated that higher disability was associated with higher food insecurity, more symptomatology, more self-stigma, less instrumental support, less hope, lower self-efficacy, and/or lower levels of family functioning. Higher quality of life was associated with higher levels of self-efficacy, more hopefulness, more instrumental support, less self-stigma, and better family functioning. Conclusions: Identification of factors associated with disability and quality of life can help clinicians and policymakers, as well as consumers of mental health services, to better co-design and target psychosocial interventions to optimize their impact in low-resource settings. Trial registration: Trial registration: ClinicalTrials.gov # NCT04013932, July 10, 2019. [ABSTRACT FROM AUTHOR]

Background: Changes in demographics with an older population, the illness panorama with increasing prevalence of non-communicable diseases, and the shift from hospital care to home-based care place demand on primary health care, which requires multiprofessional collaboration and team-based organization of work. The COVID-19 pandemic affected health care in various ways, such as heightened infection control measures, changing work practices, and increased workload. Objectives: This study aimed to investigate the association between primary care practices' organization, and quality and safety changes during the COVID-19 pandemic. Design: Data were collected from 38 countries in a large online survey, the PRICOV-19 study. For this paper, the participating practices were categorized as "Only GPs", comprising practices with solely general practitioners (GPs) and/or GP trainees, without any other health care professionals (n = 1,544), and "Multiprofessional," comprising practices with at least one GP or GP trainee and one or more other health professionals (n = 3,936). Results: Both categories of practices improved in infection control routines when compared before and during the COVID-19 pandemic. A larger proportion of the multiprofessional practices changed their routines to protect vulnerable patients. Telephone triage was used in more "Multiprofessional" practices, whereas "Only GPs" were more likely to perform video consultations as an alternative to physical visits. Both types of practices reported that the time to review new guidelines and scientific literature decreased during the pandemic. However, both had more meetings to discuss directives than before the pandemic. Conclusions: Multiprofessional teams were keener to introduce changes to the care organization to protect vulnerable patients. However, practices with only GPs were found to be more aligned with video consultations, perhaps reflecting the close patient-doctor relationship. In contrast, telephone triage was used more in multiprofessional teams. [ABSTRACT FROM AUTHOR]

Background: Health is an inseparable part of life and central to all life supporting systems. The reproductive and child health shares a major portion of public health cases that is crucial for socio-economic development. Studies on reproductive and child health have traditionally been focused on demographic aspects using socio-economic parameters. Given the emphasis of Sustainable Development Goal (SDG)-3 on health and well-being, it is imperative to understand the geo-spatial dimension with the visible transition of key health indicators of fertility, maternal and infant/child health in the high burdened districts within these high focus Empowered Action Group (EAG) states of Rajasthan, Madhya Pradesh, Uttar Pradesh and Bihar that make up nearly 40% of India's population with relatively laggard health status. Methodology: This paper aims to understand the status and trend of key reproductive and child health indicators and vital statistics based on the recent representative demographic surveys. We intend to undertake a district level spatio-temporal analysis by developing District Composite Health Profile (DCHP) using Composite Index Method on selected 13 equally weighted key reproductive and child health indicators. The study has been carried out using data from National Family Health Survey-4 (2015–16) and National Family Health Survey-5 (2019–21) survey rounds. We employed geo-spatial techniques i.e. Moran's–I, and univariate LISA to comprehend the geographical clustering of high and low health burden districts and their heterogeneities at the district level. Results/Conclusions: The study highlights emerging inter-districts, and inter-state disparities over survey periods. With consistent improvement in the selected EAG states over time, the overall reproductive and child health status through DCHP along with each indicator was relatively better in the states of Rajasthan and worse in Bihar. Districts along the Terai belt in Uttar Pradesh and Bihar consistently performed sluggish during survey rounds. The geo-spatial clustering follows the political boundary of states, albeit with intra-state variations. Monitoring of key health indicators using composite index method provides a useful leverage for identifying priority districts/regions for universal health access that should also consider geographical space as an important policy dimension. [ABSTRACT FROM AUTHOR]