Risk Factors for Disease Aggravation in Older Patients With Non-communicable Diseases: Interpretive Structural and Hierarchical Holographic Modelling.

AIMS: This study aimed to analyse and determine the risk factors of disease aggravation faced by older patients with non-communicable diseases (NCDs) and their interwoven correlations. DESIGN: We employed a descriptive and cross-sectional study, which followed the STROBE guidelines for reporting. METHODS: We conducted a semi-structured in-depth interview with 26 older patients with NCDs from a hospital in Qingdao, China between July and August 2022 on the basis of the literature review. Then, we analysed data using the directed content analysis and determined risk factors through a focus group discussion and the Delphi consultation. Afterward, we combined interpretive structural modelling and hierarchical holographic modelling to construct a hierarchical structure model and drew relationship framework diagrams to exhibit diversified risk factors and complex interwoven correlations. RESULTS: We identified 30 risk factors from individual, interpersonal, organisational, community and policy levels. The hierarchical structure model constructed by interpretive structural modelling demonstrated a four-layer structure, and the individual and interpersonal levels were at the highest layer. The relationship framework diagrams demonstrated the identification process of risk factors and interwoven correlations at individual and organisational levels. CONCLUSIONS: Risk factors causing disease aggravation amongst older patients with NCDs are diverse. To delay the progression of NCDs, we should comprehensively explore risk factors, interpret the root causes and effects of risks from multiple perspectives and consider the interaction amongst multi-level risk factors to develop precise measures related to risk control. IMPACT: Controlling risk factors is an effective measure to postpone disease aggravation. Through this study, we provide a scientific and comprehensive basis for clinical risk screening so that healthcare providers can sense potential risk factors for disease aggravation in older patients' surroundings and formulate targeted nursing measures according to the risk factors faced by different patients. PATIENT OR PUBLIC CONTRIBUTION: Patients participated in interviews to supplement risk factors included in our study. Experts provided opinions on the inclusion, exclusion and modification of risk factors.

Medication Adherence among Patients with Non-Communicable Diseases in a Tertiary Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Non-communicable diseases (NCDs) are a leading cause of mortality, with a projected rise from 38 million in 2012 to 52 million by 2030. Among NCDs, hypertension, diabetes and Chronic Obstructive Pulmonary Disease are the major burdens in healthcare today, requiring long-term therapies and a significant effort in maintaining treatment adherence. METHODS: A descriptive cross-sectional study design was adopted to determine medication adherence among patients with non-communicable diseases using non-probability, consecutive sampling techniques after ethical approval from same institute (Reference number: 524). Medication adherence was assessed on 322 patients attending the outpatient department, using a structured interview schedule, after getting Ethical approval from the Institution Review Committee. Morisky medication adherence scale (MMAS-4), Culig adherence Scale, and Beliefs about Medications (BMQ) tool were used to determine the adherence level, causes of non-adherence and belief in medication respectively. Data was coded and analysed using SPSS version 16. Descriptive statistics were used to summarise the data. RESULTS: The study population exhibited a mean age of 58 ± 12.80 years, with male participants 190 (59.01%). The present study revealed that 148 (45.96%) of the participants have a high adherence level to prescribed medication, and 246 (76.40%) strongly believed that without medication they would be very sick and life would be impossible. CONCLUSIONS: The study found that less than half of participants fully adhered to prescribed medicine, with forgetfulness identified as a primary cause of non-compliance.

Rethinking Scale-Up of Rehabilitation for Chronic Disease in Low-Resource Settings: Embracing Complexity for Contextual Impact.

As the burden of chronic disease and multiple long-term conditions is increasing globally, disproportionally affecting those in low-resourced settings, there is an increasing call to action to scale effective models of care that can assist in mitigating the impact of chronic disease on functioning, activity, societal participation, and health-related quality of life. The aim of this paper is to unpack the contextual factors that have been implicitly and explicitly voiced by researchers reporting on rehabilitation interventions used to manage chronic disease in low-resourced settings. We systematically engaged the literature and applied a reflexive qualitative and systems thinking lens to unpack the contextual factors and their interplay. A total of 40 different contextual factors were derived through an iterative analysis of 144 eligible articles. The identified factors could be packaged into nine system elements or subsystems relevant to the scale-up of rehabilitation for people with chronic disease. The complexity identified encourages a focus on innovative and intersectoral approaches to address the rehabilitation needs in low-resourced settings.

Performance of health and wellness centre in providing primary care services in Chhattisgarh, India.

INTRODUCTION: Primary health care has regained its importance in global policy making. In 2018, the Government of India initiated the Ayushman Bharat - Comprehensive Primary Health Care (AB-CPHC) programme. It was based on upgrading the existing primary health facilities into Health and Wellness Centers (HWCs). The current study aimed to assess the readiness and performance of HWCs in providing comprehensive primary health care services in India's Chhattisgarh state. METHODS: We conducted a cross-sectional health facility assessment with a state-representative sample of 404 HWCs. A standardized health facility survey tool was used to collect information on essential inputs and service outputs of HWCs. The expected population healthcare needs were estimated using secondary sources. The performance of HWCs was assessed by comparing the volume of services provided against the expected population need for outpatient care. RESULTS: On an average, 358 outpatients including 128 non-communicable disease (NCD) patients were treated monthly at an HWC. HWCs were able to cover 31% of the total population's health need for outpatient care, 26% for hypertension, and 21% for diabetes care. In addition to services for reproductive and child health, HWCs provided services for common acute ailments (cold, cough, fever, aches and pains); infections of skin, eye, ear, and reproductive tract, and minor injuries. HWCs were also contributing significantly to national disease control programmes. Acute ailments followed by NCDs and communicable diseases had the largest share among services provided. The key gaps were in coverage of mental illnesses and chronic respiratory diseases. Most of the HWCs showed adequate readiness for the availability of required human resources, supplies, and infrastructure. CONCLUSION: HWCs were able to provide a comprehensive range of primary care services and able to cater to a sizable portion of the rural population's acute and chronic health care needs. The performance was made possible by the adequate availability of medicines, staff, training programmes and tele-consultation linkages. If HWCs in other states are able to reach a similar level of performance, the initiative will prove to be a game changer for equitable primary care in India.

Overview of anti-inflammatory diets and their promising effects on non-communicable diseases.

An anti-inflammatory diet is characterised by incorporating foods with potential anti-inflammatory properties, including fruits, vegetables, whole grains, nuts, legumes, spices, herbs and plant-based protein. Concurrently, pro-inflammatory red and processed meat, refined carbohydrates and saturated fats are limited. This article explores the effects of an anti-inflammatory diet on non-communicable diseases (NCD), concentrating on the underlying mechanisms that connect systemic chronic inflammation, dietary choices and disease outcomes. Chronic inflammation is a pivotal contributor to the initiation and progression of NCD. This review provides an overview of the intricate pathways through which chronic inflammation influences the pathogenesis of conditions including obesity, type II diabetes mellitus, CVD, autoinflammatory diseases, cancer and cognitive disorders. Through a comprehensive synthesis of existing research, we aim to identify some bioactive compounds present in foods deemed anti-inflammatory, explore their capacity to modulate inflammatory pathways and, consequently, to prevent or manage NCD. The findings demonstrated herein contribute to an understanding of the interplay between nutrition, inflammation and chronic diseases, paving a way for future dietary recommendations and research regarding preventive or therapeutic strategies.

Self-Care Activities Among Diabetic Patients in an Urban Health Centre in Thirumazhisai, Tamil Nadu: A Cross-Sectional Study.

Background Diabetes is a long-term medical condition characterized by consistently high blood glucose levels, which can be attributed to both genetic and environmental factors. Global diabetes prevalence is predicted to reach 10.4% by 2040, impacting over 642 million people. Diabetes is becoming more common in India; by 2030, an estimated 87 million individuals are predicted to have the disease. Self-care activities are essential for managing diabetes, yet adherence to these practices is often low in developing countries like India due to socioeconomic, cultural, and healthcare barriers. Objective In this study, the self-care practices of diabetic patients who visited an Urban Health Center in Thirumazhisai, Tamil Nadu, were assessed, along with the factors influencing these practices. Methods A three-month cross-sectional study was conducted in a facility with 200 type 2 diabetic patients who had been unwell, for a minimum of a year. The participants were selected via purposeful sampling, and interviews were conducted using the most recent version of the Summary Diabetes Self-Care Activities (SDSCA) questionnaire. The data was analyzed using SPSS version 26 (IBM Corp., Armonk, NY, USA) to discover connections between the duration of diabetes and self-care practices using descriptive statistics and chi-square tests. Results The study found that 136 (68%) of participants tested their blood sugar levels at least once in the preceding three months, 104 (52%) exercised for at least 30 minutes each day, and 96 (48%) of individuals maintained a balanced diet. On the other hand, adherence to insulin injections and oral hypoglycemic medications was lower, at 98 (49%) and 79 (39.5%), respectively. Foot hygiene was also not at its best; only 85 (42.5%) people washed their feet daily. Considerable correlations have been shown between the length of diabetes and particular self-care behaviors, including eating patterns, exercise routines, and foot hygiene. Conclusion The results emphasize the necessity of focused interventions, especially in developing nations, to enhance diabetic patients' self-care behaviors. Tailored, patient-centered strategies are essential to address the complex factors influencing diabetes management, ultimately improving glycemic control and patient outcomes.

Silent Diabetes: Key Risk Factors Among the Low-Income Population of Langkawi Island, Kedah, Malaysia (2022-2023).

BACKGROUND: Diabetes mellitus (DM) poses a growing global health challenge, contributing to significant morbidity, mortality, and economic burden. In Malaysia, the prevalence of diabetes is increasing, especially among low-income populations with limited access to healthcare. Many cases remain undiagnosed, increasing the risk of severe complications and further straining healthcare resources. Island populations, such as those in Langkawi, are particularly vulnerable due to geographical isolation, socioeconomic constraints, and inadequate healthcare services. OBJECTIVES: To determine the prevalence of undiagnosed DM and identify the associated risk factors among the low-income population on Langkawi Island, Kedah, Malaysia. METHODS: We conducted a cross-sectional study from January 2022 to December 2023, involving 1,070 participants aged 40 years and above, all eligible under the low-income scheme. Data on sociodemographic characteristics, body mass index (BMI), lifestyle, and medical history were collected through a structured proforma from four local health clinics. Logistic regression analysis was used to identify significant predictors of undiagnosed DM. The model's predictive accuracy was assessed using the area under the receiver operating characteristic (ROC) curve. RESULTS: The prevalence of undiagnosed DM among the low-income population on Langkawi Island was 6.7%. Multiple logistic regression found three important predictors: having a higher BMI (overweight: adjusted odds ratio (AOR): 2.72; 95% confidence interval (CI): 1.40-5.30; p = 0.003; obese: AOR: 2.43; 95% CI: 1.19-5.00; p = 0.015); living on a smaller island (AOR: 1.71; 95% CI: 1.03-2.85; p = 0.039); and having a medical history (AOR: 0.21; 95% CI: 0.12-0.36; p < 0.001). The model demonstrated good predictive accuracy with an area under the ROC curve of 0.758 and correctly classified 93.3% of cases. CONCLUSION: This study reveals a significant burden of undiagnosed DM within Langkawi's low-income population, especially among individuals with higher BMI and those residing in geographically isolated areas. The findings highlight the urgent need for enhanced, context-specific screening programs and early detection efforts tailored to this vulnerable population. Effective public health strategies should prioritize regular health check-ups, obesity management, and improved access to healthcare services in isolated communities to reduce the prevalence and complications associated with undiagnosed diabetes.

Beyond the Badge: A Scoping Review Among Police Personnel in South India Exploring the Impact of Yoga and Health Education on Cardiovascular Health.

Communicable diseases have been the primary cause of morbidity and mortality, affecting populations for decades. However, in recent times, noncommunicable diseases (NCDs) have emerged as the primary cause of illness and premature death due to factors such as urbanization, longer life expectancy, and unhealthy lifestyles. In recent years, noncommunicable illnesses have emerged as the primary cause of morbidity and premature mortality, replacing infectious diseases as the leading cause of illness and death. Among the top five causes of NCD, cardiovascular disease (CVD) is the most important factor, comprising the major diseases with maximum mortality and morbidity. The burden of CVD is greatly increased by modifiable risk factors, such as smoking, high blood pressure, type 2 diabetes, low-density lipoprotein cholesterol, and excess body weight. CVD occurs particularly in certain occupational risk groups, such as doctors, police personnel, and persons working for prolonged hours, predisposing them to unhealthy dietary practices, improper sleeping patterns, and increased psychological stress. As members of this occupational group, police personnel are particularly at risk for cardiovascular diseases, making it imperative to implement preventive measures to reduce the burden of these diseases in this population. The primary objective was to assess the impact of yoga and health education interventions on cardiovascular health outcomes among police personnel in South India, and the secondary objective was to examine the changes in blood pressure levels and lipid profiles following yoga and health education programs among police personnel.

Re-Evaluating Recommended Optimal Sleep Duration: A Perspective on Sleep Literacy.

A significant number of adolescents experience sleepiness, primarily due to sleep deprivation. The detrimental effects of inadequate sleep on both physical and mental health are well documented, particularly during adolescence-a critical developmental stage that has far-reaching implications for later life outcomes. The International Classification of Diseases 11th Revision recently introduced the disorder termed 'insufficient sleep syndrome,' characterized by a persistent reduction in sleep quantity. However, diagnosing this condition based solely on sleep duration is challenging due to significant individual variation in what constitutes optimal sleep. Despite this, managing sleep debt remains difficult without a clear understanding of individual optimal sleep needs. This review aims to reassess recommended sleep durations, with a focus on enhancing sleep literacy. Beginning with an exploration of insufficient sleep syndrome, this review delves into research on optimal sleep duration and examines foundational studies on sleep debt's impact on the developing brain. Finally, it addresses the challenges inherent in sleep education programs from the perspective of sleep literacy. By doing so, this review seeks to contribute to a deeper understanding of the chronic sleep debt issues faced by adolescents, particularly those affected by insufficient sleep syndrome.

Dynamic Progression of Hypertension and Diabetes in the Democratic Republic of Congo from 2019 to 2023.

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.

Gender Differential Prevalence of Overweight and Obesity, Hypertension and Diabetes in South India: A Population-Based Cross-Sectional Study.

Background: India is facing triple epidemic of Non communicable diseases (NCDs) including high body mass index (BMI), high blood pressure and high blood glucose, contributing to more than half of deaths of all mortality, however, information in different demographics is limited, especially, in India. The aim of the study is to compare the prevalence of overweight, obesity, hypertension, and diabetes, along with the occurrence of multi-morbidity, across gender-specific populations in rural, suburban, and urban regions of India. Methods: This was a cross-sectional, population-based study including adults aged 20 and above in rural, suburban, and urban areas near Coimbatore, India. All participants were interviewed using a detailed questionnaire and had their anthropometric measurements, including height, weight, blood pressure, and blood samples collected. Gender specific and location specific prevalence of overweight, obesity, hypertension, diabetes, and multimorbidity were assessed. Results: This study included 2976 individuals, of which 865 were from rural areas, 1030 from sub-urban areas, and 1081 from metropolitan areas. The mean systolic and diastolic blood pressure were higher in rural participants than in sub-urban and urban participants, despite the fact that the prevalence of hypertension was higher in sub-urban (47.1%) than in rural (36.4%) and urban (39.7%, p < 0.001). In sub-group analysis, sub-urban areas had a greater prevalence of hypertension in both men and women (53.5% and 41.7%, p < 0.001) than rural areas (41.9% and 31.3%, p = 0.001) or urban areas (45.9% and 35.5%, p < 0.001). Compared to rural (16.1%) and urban (23%), sub-urban areas had a greater prevalence of diabetes (25.8%, p < 0.001). Urban residents (47.5%) had higher rates of overweight and obesity than rural (31.4%) and sub-urban (34.1%, p < 0.001) residents. The association between diabetes and hypertension was present in the unadjusted model and persisted even after age and BMI adjustments. Though not in men, higher levels of education were associated to a higher prevalence of diabetes in women. Diabetes was associated to being overweight or obese in women, however this association was significantly reduced once BMI was taken into account. The overall multimorbidity was 3.8%, however, women had a higher overlapping prevalence (2.8%) compared to men (1%, p < 0.001). Conclusions: Diabetes and hypertension were prevalent comorbidities across all demographics, with higher rates in suburban and urban areas. Women exhibited higher rates of multimorbidity than men, regardless of the demographic area.

Prevalence of stroke in Bangladesh: A systematic review and meta-analysis.

BACKGROUND: Stroke is a major health concern in Bangladesh due to its high incidence and effect on rates of morbidity and death. The morbidity due to stroke in Bangladesh is indeed increasing. This study aimed to find the pooled prevalence of stroke in Bangladesh. METHODS: An extensive search was conducted using PubMed, MEDLINE, and Google Scholar databases. I2 and Q-tests were employed to evaluate the heterogeneity. A random-effects model and subgroup analysis were performed due to the significant heterogeneity. We used Egger's test and funnel plot to look at publication bias. Meta-regression was carried out to analyze how different study variables influenced the effect estimates and to explore sources of heterogeneity across studies. The GRADE approach was used to evaluate the overall quality of the evidence, and the Joanna Briggs Institute tool was used to assess the risk of bias. Sensitivity analysis was conducted to evaluate the robustness of the meta-analysis results. STATA version 17 was used for analysis. RESULTS: We selected eleven (n = 1577293) studies that met the inclusion criteria for the final synthesis. In Bangladesh, the overall pooled prevalence of stroke was 1.10 % (95 % CI: 0.70-1.51). Subgroup analysis showed that the prevalence of stroke was 1.14 % (95 % CI: 0.58-1.70) from 2005 to 2014 and 1.04 % (95 % CI: 0.40-1.68) from 2015 to 2024. CONCLUSION: Stroke prevalence in Bangladesh is significantly high. The country's healthcare system faces adequate stroke prevention and treatment challenges. Improving healthcare services and public health education are crucial to addressing this increasing public health issue.

The Impact of COVID-19 on Children and Adolescents with Chronic Illness.

Children and adolescents living with chronic illness may already be at a disadvantage when compared to their healthy peers in achieving developmental milestones as they are required to manage healthcare aspects of their condition in addition to the typical transitions associated with this developmental stage. The COVID-19 pandemic has significantly impacted on the physical and mental well-being of children and adolescents including those young people living with a chronic illness. Disruptions and delays of healthcare service provision, prolonged lockdowns, strict social distancing measures, and school closures are some of the pandemic implications that have affected daily routines imposing strains on young people themselves, but also on their caregivers. This chapter presents a critical elaboration on the available evidence documenting the unique impact of the pandemic at an individual-, family-, and system-level on children and adolescents aged up to 18 years old living with a non-communicable disease (e.g., cancer, diabetes, asthma).

Prevalence and influencing factors of metabolic syndrome among rural adult population in a district of South India.

Background: Metabolic syndrome has increased globally due to sedentary lifestyles, unhealthy diets and obesity, which is posing a substantial burden on healthcare systems. Understanding the determinants of metabolic syndrome like lifestyle factors, socioeconomic status and the environment are vital for devising effective prevention and management. Research into these determinants helps to identify high-risk populations and develop interventions to reduce its occurrence. Objectives: i. To estimate the prevalence of metabolic syndrome among the adult population. ii. To determine the factors associated with metabolic syndrome among the adult population. Methodology: A cross-sectional study was carried out among 410 adults (≥18 years). A semi-structured questionnaire was used to collect data and National Cholesterol Education Program's Adult Treatment Panel III criteria was used to diagnose metabolic syndrome. Continuous and categorical data were represented as mean and proportion, respectively. The strength of the association was determined using the prevalence ratio and adjusted prevalence ratio. Results: The mean age of the participants was 44.97 ± 14.7, about 58.3% of them were females. Metabolic syndrome prevalence was 39.8%. Multivariate regression analysis demonstrated that being over 40 years old, marital status, higher socioeconomic status, skilled workers, physical inactivity and obesity were independently linked to metabolic syndrome. Conclusions: The burden can be reduced by identifying the risk factors at the early stage through screening and by adopting a healthy lifestyle.

Food and beverage manufacturing and retailing company policies and commitments to improve the healthfulness of Canadian food environments.

BACKGROUND: Food and beverage companies play a central role in shaping the healthfulness of food environments. METHODS: The BIA-Obesity tool was used to evaluate and benchmark the specificity, comprehensiveness and transparency of the food environment-related policies and commitments of leading food and beverage manufacturing and retailing companies in Canada. Policies and commitments related to the healthfulness of food environments within 6 action areas were assessed: 1) corporate nutrition strategy; 2) product (re)formulation; 3) nutrition information and labelling; 4) product and brand promotion; 5) product accessibility; and 6) disclosure of relationships with external organizations. Data were collected from publicly available sources, and companies were invited to supplement and validate information collected by the research team. Each company was then assigned a score out of 100 for each action area, and an overall BIA-Obesity score out of 100. RESULTS: Overall BIA-Obesity scores for manufacturers ranged from 18 to 75 out of 100 (median = 49), while scores for retailers ranged from 21 to 25 (median = 22). Scores were highest within the product (re)formulation (median = 60) followed by the corporate nutrition strategy (median = 59) domain for manufacturers, while retailers performed best within the corporate nutrition strategy (median = 53), followed by the disclosure of relationships with external organizations (median = 47) domain. Companies within both sectors performed worst within the product accessibility domain (medians = 8 and 0 for manufacturers and retailers, respectively). CONCLUSIONS: This study highlights important limitations to self-regulatory approaches of the food and beverage industry to improve the healthfulness of food environments. Although some companies had specific, comprehensive, and transparent policies and commitments to address the healthfulness of food environments in Canada, most fell short of recommended best-practice. Additional mandatory government policies and regulations may be warranted to effectively transform Canadian food environments to promote healthier diets and prevent related non-communicable diseases.

Understanding Barriers and Facilitators to Disaster Preparedness in Federally Qualified Health Centers in the United States: A Mixed Methods Study.

OBJECTIVE: Severe weather events exacerbate existing health disparities due to poorly managed non-communicable diseases (NCDs). Our objective is to understand the experiences of staff, providers, and administrators (employees) of Federally Qualified Health Centers (FQHCs) in Puerto Rico and the US Virgin Islands (USVI) in providing care to patients living with NCDs in the setting of recent climate-related extreme events. METHODS: We used a convergent mixed-methods study design. A quantitative survey was distributed to employees at 2 FQHCs in Puerto Rico and the USVI, assessing experience with disasters, knowledge of disaster preparedness, the relevance of NCDs, and perceived gaps. Qualitative in-depth interviews explored their experience providing care for NCDs during recent disasters. Quantitative and qualitative data were merged using a narrative approach. RESULTS: Through the integration of quantitative and qualitative data, we recognize: (1) significant gaps in confidence and preparedness of employees with a need for more training; (2) challenges faced by persons with multiple NCDs, especially cardiovascular and mental health disorders; and (3) most clinicians do not discuss disaster preparedness with patients but recognize their important role in community resilience. CONCLUSION: With these results, we recommend strengthening the capacity of FQHCs to address the needs of their patients with NCDs in disasters.

Concordance of weight status between mothers and children: a secondary analysis of the Pakistan Demographic and health survey VII.

BACKGROUND: Familial concordance of weight status is an emerging field of study that may guide the development of interventions that operate beyond the individual and within the family context. There is a dearth of published data for concordance of weight status within Pakistani households. METHODS: We assessed the associations between weight status of mothers and their children in a nationally representative sample of households in Pakistan using Demographic and Health Survey data from 2017-18. Our analysis included 3465 mother-child dyads, restricting to children under-five years of age with body mass index (BMI) information on their mothers. We used linear regression models to assess the associations between maternal BMI category (underweight, normal weight, overweight, obese) and child's weight-for-height z-score (WHZ), accounting for socio-demographic characteristics of mothers and children. We assessed these relationships in all children under-five and also stratified by age of children (younger than 2 years and 2 to 5 years). RESULTS: In all children under-five and in children 2 to 5 years, maternal BMI was positively associated with child's WHZ. For all children under-five, children of normal weight, overweight, and obese women had WHZ scores that were 0.21 [95% CI (confidence interval): 0.04, 0.37], 0.43 [95% CI: 0.25, 0.62], and 0.51 [95% CI: 0.30, 0.71] units higher than children of underweight women, respectively. For children ages 2 to 5, children of normal weight, overweight, and obese women had WHZ scores that were 0.26 [95% CI: 0.08, 0.44), 0.50 [95% CI: 0.30, 0.71), and 0.61 [95% CI: 0.37, 0.84] units higher than children of underweight women, respectively. There was no association between maternal BMI and child WHZ for children under-two. CONCLUSIONS: The findings indicate that the weight status of mother's is positively associated with that of their children, particularly after age 2. These associations further strengthen the call for research regarding interventions and policies aimed at healthy weight promotion among mothers and their children collectively, rather than focusing on individuals in isolation.

High Blood Pressure-Associated Symptoms: Insights From a Population-Based Study in Pakistan.

Background All over the world, millions die of hypertension (HTN) every year. Given the influence of healthcare expenses, HTN represents a serious public health issue in developed and developing countries. HTN is common in Pakistan; however, there are several myths about the symptoms of raised blood pressure that need to be identified. Objective The objective of this study is to compare the frequency of high blood pressure-associated symptoms in normotensive and hypertensive adult populations in Karachi, Pakistan. Methodology A community-based cross-sectional observational study was conducted among 277 patients aged 18 years and above who were attending the OPD of different community health centers in Karachi, with and without HTN. Ethical approval was obtained, and data were collected using a convenient sampling technique on a predesigned questionnaire and analyzed using IBM SPSS Statistics for Windows, Version 20.0 (Released 2011; IBM Corp., Armonk, NY, USA). Results Out of the total study population, 88 (31.65%) were normotensive, and 189 (67.98%) were hypertensive. In the hypertensive group, approximately 100 (52.9%) were men and 89 (47.1%) were women. The mean ages of normotensives and hypertensives were 44.13 + 11.0 and 49.2 + 13.1 years, respectively. Mean age, heart rate, and smoking status were significantly different between the two groups. Among several perceived blood pressure symptoms like vision problems, sleep apnea, and abnormal heartbeat was significantly higher in the hypertensive group. Conversely, although headache, vertigo, edema, and epistaxis were more frequent in the hypertensive group, the difference was not statistically significant. Conclusions In our study, >65% of patients visiting OPD had high blood pressure. Several symptoms were found to be more prevalent in hypertensive individuals compared with non-hypertensive ones. More large-scale studies are recommended to further explore the common symptoms associated with HTN in our population.

Taking on the Challenge: A Case Study on a Community Health Club for Noncommunicable Disease Control.

Background: From 2013 to 2021, the University of the Philippines Community Health and Development Program (UP CHDP) was in partnership with Cavite and its five municipalities of Alfonso, Mendez, Indang, General Emilio Aguinaldo, and Amadeo (AMIGA). They aimed to improve the control of hypertension and diabetes through interventions such as the organization of community health clubs, as recommended by the Department of Health in 2016. Currently there is limited information on the experiences and outcomes related to this strategy. Data on this can help the community and public health institutions in understanding and maximizing the benefits of organizing community health clubs for noncommunicable disease control. Objectives: This study aimed to determine a community health club's membership profile, its organization and maintenance processes, and the benefits, challenges, and enabling factors experienced. Methods: This case study-mixed method was done in 2020 on the Challengers Health Club in Alfonso, Cavite. Group interviews of the club officers and barangay health workers were conducted to explore the club processes, their perceived benefits, challenges, and enabling factors. Health records were reviewed to determine the club's membership profile. Results: The community health club showed an increase in membership since it was established. Most members are elderly, female, non-smoker, and hypertensive. There was increase in proportion of members with controlled hypertension after two years. However, this was not observed among those with diabetes. Perceived benefits for members were free, regular, and accessible services, improved knowledge and better control of their condition, and opportunity to socialize with others. Enabling factors were partnership with UP, teamwork and dedication of club leaders, effective management, and community support. The limited funding and supply of medicines, discontinuation of deployment of UP partners, and the COVID-19 pandemic were the challenges identified by the club. Conclusion: This study described the experiences of a community health club established to control hypertension and diabetes. Benefits of this intervention were reported despite the challenges they encountered because of the support mechanisms that were in place.

Classroom intervention to improve behavioral intention toward regular physical activity among adolescents.

Background: During adolescence, a critical phase in human life, the groundwork for a healthful future is established. Physical inactivity poses a significant risk factor for non-communicable diseases (NCDs) and related mortality worldwide. To assess adolescents' behavioral intentions regarding regular physical activity, the Theory of Planned Behavior (TPB) examines 'Attitude,' 'Subjective norm,' and 'Perceived behavioral control.' Utilizing TPB, this study focuses on evaluating the impact of a school-based health promotion intervention on behavioral intentions toward physical activity among urban adolescents in West Bengal, India. Methods: A school-based nonrandomized controlled interventional study with parallel group design was conducted among adolescents aged between 12 and 16 years. Behavioral intention towards performing regular physical activity was determined with the measurements of the constructs from the TPB. Cluster analysis was conducted using measurements from both the intervention and control groups. Participants with higher mean scores in the constructs were classified as intenders, while the rest were considered non-intenders. The intervention's impact was evaluated by calculating the Relative Risk (RR) through a generalized linear model with robust standard error estimates, to ascertain the probability of belonging to the higher intention cluster. Result: Following the intervention, construct-wise scores improved significantly, particularly the perceived behavioral control mean score in the intervention group. The Relative Risk (RR) of becoming an intender for regular physical activity in the intervention group was 1.24 (95% CI: 1.04-1.48) when compared to the control group. Conclusion: Health Promoting Schools has been recognized as a strategic and cost-effective vehicle to promote positive development and healthful living, and the current evidence suggests they can effectively reduce the emergence of significant NCD risk factor like physical inactivity. Schools must establish strong partnerships with diverse stakeholders to address barriers beyond the school environment and enhance their control over critical issues.