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1.
Talanta ; 251: 123791, 2023 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-35987023

RESUMEN

Due to their fascinating chemical, optical, electrical, and biological properties carbon dots (CDs or CDots), carbon quantum dots (CQDs), and graphene quantum dots (GQDs) have attracted attention in biosensing as they can greatly improve the detection limit, sensitivity, and selectivity of biosensors. In general, CDs, CQDs, and GQDs are a class of carbon-based nanomaterials that are characterized by extraordinary fluorescence, a size less than 10 nm, high stability, low toxicity, and being easy to synthesize and presenting functional groups in their surface area that vary according to their synthesis source. In this review, a general description of the main methods and precursors reported in the scientific literature for the synthesis of CDs, CQDs, and GQDs are presented, as well as the chemical, optical, electrical, and biological properties that stand out the most from them; moreover, the main objective of this review is to summarize the application of these carbonaceous nanomaterials in biosensors for the detection of communicable and non-communicable diseases. The article summarizes the applications of CDs, CQDs, and GQDs according to the group of diseases they detected using the international classification of diseases in its 10th edition (ICD-10). To facilitate the reader's access to significant information from these biosensors, several tables summarize the information associated with the type of biomarker, the working ranges, and the biosensor assembly.


Asunto(s)
Técnicas Biosensibles , Grafito , Enfermedades no Transmisibles , Puntos Cuánticos , Biomarcadores , Técnicas Biosensibles/métodos , Carbono/química , Grafito/química , Humanos , Puntos Cuánticos/química
2.
BMJ Open ; 12(12): e066680, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36455999

RESUMEN

INTRODUCTION: Dental caries is one of the most common non-communicable diseases in children. The disease management of caries relies on both a preventive individual approach (fluoridation, risk evaluation) and the surgical treatment of established carious lesions. Similar to other non-communicable diseases (obesity, mental diseases, etc), health professionals' negative perceptions of patients have been shown to affect the quality of disease management. Regarding dental caries in children, some data have indicated the presence of discriminating beliefs and behaviours towards these children and their families in the medical setting. However, oral health stigma related to dental care remains a largely unexplored issue. METHODS AND ANALYSIS: This study presents an exploratory research protocol focusing on the perceptions and attitudes of health professionals towards children with early childhood caries (ECC) and their parents. Semistructured interviews will be conducted among medical and dental health professionals, and verbatim quotations obtained from audio transcriptions will be analysed to identify health professionals' perceptions of ECC and the influence of these perceptions on clinical care for these children. ETHICS AND DISSEMINATION: The research ethics committee of the Department of Family Medicine at University Lyon 1 approved this protocol. The results will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER: NCT05284279.


Asunto(s)
Caries Dental , Enfermedades no Transmisibles , Preescolar , Niño , Humanos , Caries Dental/terapia , Susceptibilidad a Caries Dentarias , Salud Bucal , Investigación Cualitativa
3.
BMJ Glob Health ; 7(12)2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36460323

RESUMEN

The WHO's report Health literacy development for the prevention and control of non-communicable diseases (NCDs) delivers practical what-to-do how-to-do guidance for health literacy development to build, at scale, contextually-relevant public health actions to reduce inequity and the burden of NCDs on individuals, health systems and economies. The key premise for health literacy development is that people's health awareness and behaviours are linked to lifelong experiences and social practices, which may be multilayered, hidden and beyond their control. Meaningful community engagement, local ownership and locally driven actions are needed to identify health literacy strengths, challenges and preferences to build locally fit-for-purpose and implementable actions. Health literacy development needs to underpin local and national policy, laws and regulations to create enabling environments that reduce community exposures to NCD risk factors. Deficit approaches and siloed health system and policy responses need to be avoided, focusing instead on integrating community-based solutions through co-design, cognisant of people's daily experiences and social practices.


Asunto(s)
Alfabetización en Salud , Enfermedades no Transmisibles , Humanos , Enfermedades no Transmisibles/prevención & control , Políticas , Salud Pública , Factores de Riesgo
4.
BMC Health Serv Res ; 22(1): 1473, 2022 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-36463166

RESUMEN

BACKGROUND: In Bangladesh, non-communicable diseases (NCDs) are increasing rapidly and account for approximately 68% of mortality and 64% of disease burden. NCD services have been significantly mobilized to primary healthcare (PHC) facilities to better manage the rising burden of NCDs. However, little is known about community members' preference and willingness to receive NCD services from PHC facilities; therefore, this particular subject is the focus of this study. METHODS: A qualitative study was conducted from May 2021 to October 2021. Data were collected via 16 focus group discussions involving community members and 14 key informant interviews with healthcare professionals, facility managers, and public health practitioners. Based on a social-ecological model (SEM), data were analyzed thematically. The triangulation of methods and participants was conducted to validate the information provided. RESULTS: Preference and willingness to receive NCD services from PHC facilities were influenced by a range of individual, interpersonal, societal, and organizational factors that were interconnected and influenced each other. Knowledge and the perceived need for NCD care, misperception, self-management, interpersonal, and family-level factors played important roles in using PHC facilities. Community and societal factors (i.e., the availability of alternative and complementary services, traditional practices, social norms) and organizational and health system factors (i.e., a shortage of medicines, diagnostic capacity, untrained human resources, and poor quality of care) also emerged as key aspects that influenced preference and willingness to receive NCD services from PHC facilities. CONCLUSION: Despite their substantial potential, PHC facilities may not take full advantage of managing NCDs. All four factors need to be considered when developing NCD service interventions in the primary healthcare system to better address the rising burden of NCDs.


Asunto(s)
Enfermedades no Transmisibles , Humanos , Enfermedades no Transmisibles/terapia , Bangladesh , Investigación Cualitativa , Grupos Focales , Atención Primaria de Salud
5.
Sci Rep ; 12(1): 20913, 2022 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-36463315

RESUMEN

To determine whether a history of previous Cesarean delivery (CD) impacts uterine artery (UtA) Doppler indices throughout pregnancy. Women with and without CD (NCD) were prospectively enrolled for sequential assessments of the UtA mean/median pulsatility index (UtA-PI), resistance index (UtA-RI), and systolic/diastolic ratio (UtA-S/D) at 11-13 + 6, 14-19 + 6, 30-34 + 6, and 35-37 + 6 weeks' gestation. Data from 269/269, 246/257, 237/254, and 219/242 CD/NCD participants from each gestational period were available for analysis. Multiples of the median (MoMs) of UtA Doppler indices showed biphasic temporal (Δ) pattern; with an initial dropping until the second trimester, then a subsequent elevation until late in pregnancy (p < 0.05). The measurements and Δs of the UtA indices between CD and NCD were not different (p > 0.05). Mixed-effects modelling ruled out effects from nulliparity (n = 0 and 167 for CD and NCD, respectively) (p > 0.05). History of CD neither influenced the measurements nor the temporal changes of the UtA Doppler indices throughout pregnancy. The biphasic Δs of UtA Doppler indices added to the longitudinal data pool, and may aid in future development of a more personalized prediction using sequential/contingent methodologies, which may reduce the false results from the current cross-sectional screening.


Asunto(s)
Enfermedades no Transmisibles , Arteria Uterina , Embarazo , Femenino , Humanos , Arteria Uterina/diagnóstico por imagen , Estudios Prospectivos , Estudios de Casos y Controles , Estudios Transversales
6.
Bull World Health Organ ; 100(12): 815-824, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36466205

RESUMEN

The global transition to current low levels of habitual physical activity among children and adolescents began in the second half of the last century. Low physical activity harms health in both the short term (during childhood and adolescence) and long term (during adulthood). In turn, low physical activity could limit progress towards several sustainable development goals, undermine noncommunicable disease prevention, delay physical and mental health recovery from the coronavirus disease 2019 pandemic, increase health-care costs and hinder responses to climate change. However, despite the importance of physical activity, public health surveillance among children and adolescents is very limited globally and low levels of physical activity in children is not on the public health agenda in many countries, irrespective of their level of economic development. This article details proposals for improvements in global public health surveillance of physical activity from birth to adolescence based on recent systematic reviews, international collaborations and World Health Organization guidelines and strategies. Empirical examples from several countries illustrate how improved surveillance of physical activity can lead to public health initiatives. Moreover, better surveillance raises awareness of the extent of physical inactivity, thereby making an invisible problem visible, and can lead to greater capacity in physical activity policy and practice. The time has arrived for a step change towards more systematic physical activity surveillance from infancy onwards that could help inform and inspire changes in public health policy and practice globally.


Durant la seconde moitié du siècle dernier, l'activité physique des enfants et adolescents a commencé à baisser à l'échelle mondiale pour atteindre le faible niveau actuel. La sédentarité a des effets néfastes sur la santé, tant à court terme (pendant l'enfance et l'adolescence) qu'à long terme (à l'âge adulte). Elle peut également entraver la progression vers de nombreux objectifs de développement durable, compromettre les efforts de prévention des maladies non transmissibles, retarder la guérison physique et mentale liée à la pandémie de maladie à coronavirus 2019, accroître les dépenses en soins de santé et freiner les réactions au changement climatique. Pourtant, malgré l'importance que revêt l'activité physique, rares sont les dispositifs de surveillance de la santé publique mis en place pour les enfants et adolescents dans le monde. En outre, la lutte contre la sédentarité chez les plus jeunes ne figure pas parmi les priorités de santé publique dans la plupart des pays, quel que soit le niveau de développement économique de ces derniers. Le présent article détaille une série de propositions visant à améliorer la surveillance de la santé publique en matière d'activité physique de la naissance à l'adolescence, fondées sur des revues systématiques récentes, des collaborations internationales ainsi que des stratégies et lignes directrices de l'Organisation mondiale de la Santé. Des exemples empiriques provenant de plusieurs pays illustrent comment cette amélioration peut déboucher sur des initiatives de santé publique. De plus, une meilleure surveillance permet de sensibiliser à l'ampleur de cette inactivité, donnant ainsi de la visibilité à un problème jusqu'alors invisible, et peut renforcer les capacités politiques et pratiques relatives à l'activité physique. Il est temps de procéder à un changement en profondeur afin de surveiller plus systématiquement l'activité physique dès le plus jeune âge, en vue d'orienter et d'encourager l'évolution des politiques et pratiques en la matière dans le monde.


La transición mundial hacia los niveles bajos actuales de actividad física regular entre niños y adolescentes comenzó en la segunda mitad del siglo pasado. La disminución de la actividad física perjudica la salud tanto a corto plazo (durante la infancia y la adolescencia) como a largo plazo (durante la edad adulta). A su vez, la falta de actividad física podría limitar el progreso hacia varios objetivos de desarrollo sostenible, socavar la prevención de enfermedades no transmisibles, retrasar la recuperación de la salud física y mental tras la pandemia de la enfermedad por coronavirus de 2019, aumentar los costes de la atención sanitaria y dificultar las respuestas al cambio climático. No obstante, a pesar de la importancia de la actividad física, la vigilancia de la salud pública entre los niños y los adolescentes es muy limitada a nivel mundial y los niveles bajos de actividad física en los niños no se incluyen en la agenda de salud pública de muchos países, sea cual sea su nivel de desarrollo económico. En este artículo, se detallan propuestas para mejorar la vigilancia de la actividad física en la salud pública a nivel mundial, desde el nacimiento hasta la adolescencia, a partir de recientes revisiones sistemáticas, colaboraciones internacionales y directrices y estrategias de la Organización Mundial de la Salud. Ejemplos empíricos de varios países ilustran cómo una mejor vigilancia de la actividad física puede conducir a iniciativas de salud pública. Asimismo, una mejor vigilancia aumenta la concienciación sobre el alcance de la inactividad física, haciendo evidente un problema poco visible, y puede conducir a una mayor capacidad en la política y la práctica de la actividad física. Ha llegado el momento de dar un paso adelante hacia una vigilancia más sistemática de la actividad física desde la infancia que podría ayudar a informar e inspirar cambios en la política y la práctica de la salud pública en todo el mundo.


Asunto(s)
COVID-19 , Enfermedades no Transmisibles , Niño , Humanos , Adolescente , Adulto , COVID-19/epidemiología , Conducta Sedentaria , Ejercicio Físico , Política Pública
7.
Front Public Health ; 10: 1044550, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36466449

RESUMEN

Background: Chinese health insurance system faces resource distribution challenges. A patient-centric approach allows decision-makers to be keenly aware of optimized medical resource allocation. Objective: This study aims to use the discrete choice model to determine the main factors affecting the healthcare preferences of the general Chinese population and their weights in the three scenarios (chronic non-communicable diseases, acute infectious diseases, and major diseases). Methods: This study firstly identified the key factors affecting people's healthcare preferences through literature review and qualitative interviews, and then designed the DCE questionnaire. An online questionnaire produced by Lighthouse Studio (version 9.9.1) software was distributed to voluntary respondents recruited from mainland China's entire population from January 2021 to June 2021. Participants were required to answer a total of 21 questions of three scenarios in the questionnaire. The multinomial logit model and latent class model were used to analyze the collected data. Results: A total of 4,156 participants from mainland China were included in this study. The multinomial logit and latent class model analyses showed that medical insurance reimbursement is the most important attribute in all three disease scenarios. In the scenario of "non-communicable diseases," the attributes that participants valued were, from the most to the least, medical insurance reimbursement (45.0%), hospital-level (21.6%), distance (14.4%), cost (9.7%), waiting time (8.3%), and care provider (1.0%). As for willingness to pay (WTP), participants were willing to pay 204.5 yuan, or 1,743.8 yuan, to change from private hospitals or community hospitals to tertiary hospitals, respectively. Conclusions: This study explores the healthcare preferences of Chinese residents from a new perspective, which can provide theoretical reference for the refinement of many disease medical reimbursement policies, such as developing different reimbursement ratios for various common diseases and realizing rational configuration of medical resources.


Asunto(s)
Enfermedades no Transmisibles , Humanos , Asiáticos , Hospitales Comunitarios , China , Atención a la Salud
8.
J Health Popul Nutr ; 41(1): 55, 2022 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-36451189

RESUMEN

BACKGROUND: Food away from home (FAFH) is an 'eating behavior' widely practiced across nations, more common in developed nations. Likewise, in developing countries an increase of close to 50% indicates an upsurge in FAFH consumption. While various indices and tools are used to assess diet quality, diversity, or healthy eating, FAFH is less utilized to study dietary behaviors and the associated disease risk. OBJECTIVE: To calculate the pooled estimate of FAFH and identify the associated non-communicable disease (NCD) markers. DESIGN: Systematic review and meta-analysis. METHODS: Independent electronic searches were conducted across 6 databases: Medline, Web of Science, Scopus, Cochrane library, Ingenta, and CAB direct. Observational studies investigating the association between FAFH and NCD markers published between the year 2011 and 2021 were eligible for inclusion. Studies that included overweight or obese participants, pregnant women, or those under institutional care at baseline were excluded. The guidelines for reporting meta-analysis of observational studies in epidemiology were adhered to in the preparation of this systematic review. RESULTS: The random effects combined estimate for the overall prevalence of FAFH was 39.96% (95% CI 29.97-53.29). High heterogeneity (τ2 = 0.63, I2 = 100%) and high risk of bias were observed among the selected studies. The test for overall effect was observed to be z = 25.11 (p < 0.001). Eleven out of fourteen studies showed a positive association between FAFH and anthropometric changes. Twelve out of seventeen studies showed a positive association between FAFH and cardiovascular disease (CVD) biomarkers. CONCLUSION: Our work confirms FAFH as an evolving dietary behavior in both developing and developed countries, emphasizing the lack of representation from low-income countries. The association of FAFH with obesity and non-communicable disease risk is reinforced by our analyses. These findings should enable policy decisions to meet the rising demand of FAFH with healthier options to prevent the risk of NCD.


Asunto(s)
Enfermedades no Transmisibles , Embarazo , Femenino , Humanos , Enfermedades no Transmisibles/epidemiología , Prevalencia , Alimentos , Biomarcadores , Dieta Saludable , Obesidad/epidemiología , Estudios Observacionales como Asunto
9.
Medicine (Baltimore) ; 101(47): e31523, 2022 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-36451486

RESUMEN

To analyze the change trend of life expectancy, the change trend of premature death due to 4 major chronic diseases, and its impact on the life expectancy of Wuhai residents from 2015 to 2020, and to provide evidence for the prevention and control of chronic diseases in this area. The data on population death comes from the Wuhai City Residents' Causes of Death Network Reporting System and the total population is calculated using statistics from Wuhai City's permanent population management, from 2015 to 2020. Premature mortality from the 4 main chronic illnesses was calculated using the abridged life table approach. The impact of premature death from chronic diseases on life expectancy was analyzed using the Arriaga method. The increasing trend of life expectancy of Wuhai citizens was not statistically significant from 2015 to 2020 (t = 2.570, P = .062). Each year, men had a lower life expectancy than women (P < .05). From 2015 to 2020, the downward trend of premature deaths caused by the 4 major non-communicable diseases in Wuhai City was statistically significant (EAPC = -7.74%, P = .041). Premature death from cancer and chronic respiratory disorders decreased, both of which were statistically significant (EAPC < 0, P < .05). The decline in premature mortality from cancer, cardiovascular and cerebrovascular disorders, and chronic respiratory system diseases has contributed to increased life expectancy. Diabetes's rise in premature mortality made a possible "negative contribution" to life expectancy (-0.036 years, -1.79%). From 2015 to 2020, the decreasing trend of the overall premature mortality caused by the 4 major non-communicable diseases in Wuhai was statistically significant, and the life expectancy of females was higher than that of males. We should concentrate on the prevention and control of major chronic illnesses in males, as well as the influence of changes in diabetes-related early mortality on life expectancy.


Asunto(s)
Mortalidad Prematura , Enfermedades no Transmisibles , Masculino , Femenino , Humanos , Esperanza de Vida , Enfermedad Crónica , China/epidemiología
10.
BMJ Open ; 12(11): e061154, 2022 11 24.
Artículo en Inglés | MEDLINE | ID: mdl-36424108

RESUMEN

OBJECTIVES: India, a major contributor to the global diabetes burden, is witnessing a simultaneous epidemic of obesity leading to rise in diabesity. Diabesity, the coexistence of diabetes and obesity in an individual, has emerged as a risk factor for other morbidities and hence, multimorbidity. Although diabesity has long been recognised, still, there is a poor understanding of its social determinants in India, necessary for its control. We aimed to estimate and compare the prevalence and identify social determinants of obesity, diabetes and diabesity; explore their association with other selected non-communicable diseases (NCDs) multimorbidity; and assess its outcomes among adults aged ≥45 years. DESIGN AND SETTING: We undertook an observational analyses employing nationally representative data from Longitudinal Ageing Study in India, 2017-2018. PARTICIPANTS: This study was conducted among n=59 073 respondents. OUTCOME MEASURES: Descriptive analysis was conducted among n=59 073 respondents to determine prevalence of diabetes, obesity and diabesity. The social determinants were assessed using multinomial regression, reported as adjusted relative risk ratio (RRR). A multiple correspondence analysis generated life satisfaction. RESULTS: The prevalence of obesity, diabetes, and diabesity was 21.2%, 6%, and 5.8%, respectively. We identified women (RRR: 2.16 (1.72 to 2.71)), urban residents (RRR: 3.73 (3.07 to 4.54)) and affluent groups (RRR: 3.60 (2.46 to 4.58)) had a higher likelihood of having diabesity. The association with various NCDs showed multimorbidity to be akin to the diabesity group. We observed inferior life satisfaction and significantly higher healthcare utilisation among participants with diabesity as compared with other two groups. CONCLUSION: Increased obesity prevalence has led to the rise in diabesity in India. Additionally, the level of multimorbidity in this group cannot be overlooked. Rather than focusing on individual conditions, an in toto approach to multimorbidity is warranted.


Asunto(s)
Multimorbilidad , Enfermedades no Transmisibles , Femenino , Humanos , Anciano , Estudios Transversales , Determinantes Sociales de la Salud , India/epidemiología , Obesidad/epidemiología
11.
BMC Public Health ; 22(1): 2166, 2022 11 24.
Artículo en Inglés | MEDLINE | ID: mdl-36434553

RESUMEN

BACKGROUND: Global public health action to address noncommunicable diseases (NCDs) requires new approaches. NCDs are primarily prevented and managed in the community where there is little investment in digital health systems and analytics; this has created a data chasm and relatively silent burden of disease. The nascent but rapidly emerging area of precision public health offers exciting new opportunities to transform our approach to NCD prevention. Precision public health uses routinely collected real-world data on determinants of health (social, environmental, behavioural, biomedical and commercial) to inform precision decision-making, interventions and policy based on social position, equity and disease risk, and continuously monitors outcomes - the right intervention for the right population at the right time. This scoping review aims to identify global exemplars of precision public health and the data sources and methods of their aggregation/application to NCD prevention. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) was followed. Six databases were systematically searched for articles published until February 2021. Articles were included if they described digital aggregation of real-world data and 'traditional' data for applied community, population or public health management of NCDs. Real-world data was defined as routinely collected (1) Clinical, Medication and Family History (2) Claims/Billing (3) Mobile Health (4) Environmental (5) Social media (6) Molecular profiling (7) Patient-centred (e.g., personal health record). Results were analysed descriptively and mapped according to the three horizons framework for digital health transformation. RESULTS: Six studies were included. Studies developed population health surveillance methods and tools using diverse real-world data (e.g., electronic health records and health insurance providers) and traditional data (e.g., Census and administrative databases) for precision surveillance of 28 NCDs. Population health analytics were applied consistently with descriptive, geospatial and temporal functions. Evidence of using surveillance tools to create precision public health models of care or improve policy and practice decisions was unclear. CONCLUSIONS: Applications of real-world data and designed data to address NCDs are emerging with greater precision. Digital transformation of the public health sector must be accelerated to create an efficient and sustainable predict-prevent healthcare system.


Asunto(s)
Enfermedades no Transmisibles , Medios de Comunicación Sociales , Telemedicina , Humanos , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/prevención & control , Salud Pública , Atención a la Salud
12.
Arch Iran Med ; 25(7): 460-472, 2022 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-36404514

RESUMEN

BACKGROUND: The determinants and correlates of severe mental disorders are less understood compared to the common mental disorders, both in the world and in Iran. In this study, we aimed to identify a wide range of determinants of severe stress, severe anger, and severe sadness among Iranian population. METHODS: This study is part of a large nationwide cross-sectional survey entitled STEPs conducted using a comprehensive questionnaire to determine the prevalence of main preventable risk factors of non-communicable diseases (NCDs) in Iran by age and sex groups in 2016. In total, 30541 people aged 18+participated in this study. Univariate and multivariate logistic regression analyses were used to examine the associations between the dependent variable, which is severe mental disorders, and independent variables including socio-economic factors, lifestyle and selected NCDs. RESULTS: The prevalence of severe stress, severe anger and sever sadness in the Iranian society was 33%, 35%, and 25%, respectively. Of the investigated socio-economic factors, being men, older, never married and living in rural areas were associated with significantly lower experience of severe mental disorders compared to other groups. For education, income and wealth index, there was no linear and clear pattern. Among lifestyle factors, being nonsmoker, having low physical activities, and higher intake of fruits and vegetables were found to be preventive of severe mental disorders. Additionally, having NCDs including hypertension, high cholesterol, diabetes and heart attacks were also significantly correlated with severe mental disorders. CONCLUSION: determining factors associated with severe mental disorders in this study would help in raising people's awareness on avoiding harmful factors, and taking healthier lifestyle such as quitting smoke, and consuming enough vegetables and fruits. Screening high risk people in terms of mental health could contribute to the reduction of mental disorders in the Iranian community.


Asunto(s)
Trastornos Mentales , Enfermedades no Transmisibles , Humanos , Masculino , Femenino , Prevalencia , Irán/epidemiología , Estudios Transversales , Población Urbana , Población Rural , Distribución por Edad , Estado de Salud , Encuestas Epidemiológicas , Distribución por Sexo , Muestreo , Predicción , Modelos Logísticos , Trastornos Mentales/epidemiología
13.
Womens Health (Lond) ; 18: 17455057221135493, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36411961

RESUMEN

BACKGROUND: Prevalence of non-communicable diseases (NCDs) is increasing with women affected at an early age. The Mini Female Health Program (MFHP) is a simple screening package to detect NCDs in women. OBJECTIVE: Determine the prevalence of selected NCDs in a hospital-based outpatient setting using MFHP. METHODS: A cross-sectional observational study was conducted in an urban teaching hospital in India. MFHP included medical history, physical examination and investigations. NCDS of interest included anaemia, thyroid disorders, hypertension, diabetes, and obesity. Analysis was performed on groups stratified by age groups (18-30, 31-40 and > 41 years). Between group comparison and association of hypertension with other variables was undertaken. RESULTS: Final analysis included 468 women, of whom 49.8%, 29.9%, and 20.3% were between 18-30, 31-40, and >41 years, respectively. Central obesity was most common NCD (waist to height ratio (WHR) > 0.5 (72.7%), waist circumference (WC) > 80 cm (62.7%)) followed by generalized obesity (body mass index (BMI) > 25 kg/m2 (52.4%)), anaemia (52.6%), thyroid disorders (27.4%), hypertension (14.1%) and diabetes (5.1%). Half of the women between 18 and 30 years were either overweight (BMI: 23-25 kg/m2) or obese. Increasing age was associated with a significant increase in the prevalence of hypertension, diabetes, thyroid disorders and obesity, but not anaemia. Only 9.8% of women were without an NCD with 17.3% having one NCD and 72.8% reporting multiple NCDs. Hypertension was strongly associated with age and WHR in multivariate regression analysis. CONCLUSION: The MFHP has highlighted the high prevalence of NCDs in women, particularly in young women demonstrating the value of simple screening programme in routine clinical care.


Asunto(s)
Diabetes Mellitus , Hipertensión , Enfermedades no Transmisibles , Femenino , Humanos , Adulto , Enfermedades no Transmisibles/epidemiología , Estudios Transversales , Factores de Riesgo , India/epidemiología , Obesidad/epidemiología , Obesidad/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Hospitales de Enseñanza
14.
Prim Health Care Res Dev ; 23: e73, 2022 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-36377062

RESUMEN

AIM: The aim of this study is to review the literature in Commonwealth of Independent States (CIS) countries with regard to their response to non-communicable diseases (NCDs) and the implementation of the World Health Organization (WHO) Package of Essential Non-communicable (PEN) disease interventions for primary health care. BACKGROUND: NCDs are estimated to account from 62% to 92% of total deaths in CIS countries. Current management of NCDs in CIS countries is focused on specialists and hospital care versus primary health care (PHC) as recommended by the WHO. METHODS: This paper uses a scoping review of published and grey literature focusing on diabetes and hypertension in CIS countries. These two conditions are chosen as they represent a large burden in CIS countries and are included in the responses proposed by the WHO PEN. FINDINGS: A total of 96 documents were identified and analysed with the results presented using the WHO Health System Building Blocks. Most of the publications identified focused on the service delivery (41) and human resources (20) components, while few addressed information and research (17), and only one publication was related to medical products. As for their disease of focus, most studies focused on hypertension (14) and much less on diabetes (3). The most studies came from Russia (18), followed by Ukraine (21) and then Kazakhstan (12). Only two countries Moldova and Kyrgyzstan have piloted the WHO PEN. Overall, the studies identified highlight the importance of the PHC system to better control and manage NCDs in CIS countries. However, these present only strategies versus concrete interventions. One of the main challenges is that NCD care at PHC in CIS countries continues to be predominantly provided by specialists in addition to focusing on treatment versus preventative services.


Asunto(s)
Diabetes Mellitus , Hipertensión , Enfermedades no Transmisibles , Humanos , Enfermedades no Transmisibles/terapia , Atención Primaria de Salud , Comunidad de Estados Independientes , Diabetes Mellitus/terapia , Hipertensión/terapia
15.
BMJ Open ; 12(11): e063701, 2022 11 28.
Artículo en Inglés | MEDLINE | ID: mdl-36442898

RESUMEN

OBJECTIVE: To evaluate the costs and client outcomes associated with integrating screening and treatment for non-communicable diseases (NCDs) into HIV services in a rural and remote part in southeastern Africa. DESIGN: Prospective cohort study. SETTING: Primary and secondary level health facilities in Neno District, Malawi. PARTICIPANTS: New adult enrollees in Integrated Chronic Care Clinics (IC3) between July 2016 and June 2017. MAIN OUTCOME MEASURES: We quantified the annualised total and per capita economic cost (US$2017) of integrated chronic care, using activity-based costing from a health system perspective. We also measured enrolment, retention and mortality over the same period. Furthermore, we measured clinical outcomes for HIV (viral load), hypertension (controlled blood pressure), diabetes (average blood glucose), asthma (asthma severity) and epilepsy (seizure frequency). RESULTS: The annualised total cost of providing integrated HIV and NCD care was $2 461 901 to provide care to 9471 enrollees, or $260 per capita. This compared with $2 138 907 for standalone HIV services received by 6541 individuals, or $327 per capita. Over the 12-month period, 1970 new clients were enrolled in IC3, with a retention rate of 80%. Among clients with HIV, 81% achieved an undetectable viral load within their first year of enrolment. Significant improvements were observed among clinical outcomes for clients enrolled with hypertension, asthma and epilepsy (p<0.05, in all instances), but not for diabetes (p>0.05). CONCLUSIONS: IC3 is one of the largest examples of fully integrated HIV and NCD care. Integrating screening and treatment for chronic health conditions into Malawi's HIV platform appears to be a financially feasible approach associated with several positive clinical outcomes.


Asunto(s)
Asma , Infecciones por VIH , Hipertensión , Enfermedades no Transmisibles , Adulto , Humanos , Enfermedades no Transmisibles/terapia , Análisis Costo-Beneficio , Malaui/epidemiología , Estudios Prospectivos , Hipertensión/terapia , Infecciones por VIH/terapia
16.
Health Res Policy Syst ; 20(Suppl 1): 112, 2022 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-36443746

RESUMEN

BACKGROUND: Population ageing and the associated increase in the healthcare needs of older people are putting pressure on the healthcare system in Viet Nam. The country prioritizes healthcare for older people and has developed financial protection policies to mitigate financial hardship due to out-of-pocket health expenditures (OOPHEs) borne by their households. This study examines the level and determinants of the financial burden of OOPHE among households with people aged ≥ 60 years in Viet Nam. METHODS: A cross-sectional household survey was conducted among a sample of 1536 older people living in 1477 households in three provinces representing the North, Central and South regions of Viet Nam during 2019-2020. The financial outcomes were catastrophic health expenditure (CHE), using WHO's definition, and financial distress due to OOPHE. Multivariate binary logistic regression analysis was employed to determine the factors associated with these outcomes. RESULTS: OOPHE for older household members accounted for 86.3% of total household health expenditure. Of households with older people, 8.6% (127) faced CHE, and 12.2% (181) experienced financial distress due to OOPHE. Households were at a higher risk of incurring financial burdens related to health expenditures if they had fewer household members; included only older people; were in rural or remote, mountainous areas; and had older members with noncommunicable diseases. There was no significant association between health insurance coverage and financial burden. However, when older people sought tertiary care or private care, the possibility of a household facing CHE increased. Regardless of the type and level of care, health service utilization by older people results in a higher likelihood of a household encountering financial distress. CONCLUSIONS: This study reveals that OOPHE for older people can impose substantial financial burdens on households, leading them to face CHE and financial distress. This study provides evidence to justify reforming financial protection policies and introducing policy interventions targeted at better protecting older people and their households from the financial consequences of OOPHE. There is also the need to strengthen the grassroots health facilities to provide primary care closer to home at lower costs, particularly for the management of noncommunicable diseases.


Asunto(s)
Estrés Financiero , Enfermedades no Transmisibles , Humanos , Anciano , Estudios Transversales , Vietnam , Instituciones de Salud , Gastos en Salud
17.
Health Res Policy Syst ; 20(Suppl 1): 109, 2022 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-36443781

RESUMEN

BACKGROUND: In Cambodia, economic development accompanied by health reforms has led to a rapidly ageing population and an increasing incidence and prevalence of noncommunicable diseases. National strategic plans recognize primary care health centres as the focal points of care for treating and managing chronic conditions, particularly hypertension and type 2 diabetes. However, health centres have limited experience in providing such services. This case study describes the process of developing a toolkit to facilitate the use of evidence-based guidelines to manage hypertension and type 2 diabetes at the health-centre level. METHODS: We developed and revised a preliminary toolkit based on the feedback received from key stakeholders. We gathered feedback through an iterative process of group and one-to-one consultations with representatives of the Ministry of Health, provincial health department, health centres and nongovernmental organizations between April 2019 and March 2021. RESULTS: A toolkit was developed and organized according to the core tasks required to treat and manage hypertension and type 2 diabetes patients. The main tools included patient identification and treatment cards, risk screening forms, a treatment flowchart, referral forms, and patient education material on risk factors and lifestyle recommendations on diet, exercise, and smoking cessation. The toolkit supplements existing guidelines by incorporating context-specific features, including drug availability and the types of medication and dosage guidelines recommended by the Ministry of Health. Referral forms can be extended to incorporate engagement with community health workers and patient education material adapted to the local context. All tools were translated into Khmer and can be modified as needed based on available resources and arrangements with other institutions. CONCLUSIONS: Our study demonstrates how a toolkit can be developed through iterative engagement with relevant stakeholders individually and in groups to support the implementation of evidence-based guidelines. Such toolkits can help strengthen the function and capacity of the primary care system to provide care for noncommunicable diseases, serving as the first step towards developing a more comprehensive and sustainable health system in the context of population ageing and caring for patients with chronic diseases.


Asunto(s)
Diabetes Mellitus Tipo 2 , Hipertensión , Enfermedades no Transmisibles , Humanos , Diabetes Mellitus Tipo 2/terapia , Cambodia , Hipertensión/terapia , Instituciones de Salud
18.
Washington, D.C.; Organisation panaméricaine de la Santé; 2022-11-23. (OPS/NMH/MH/21-0032).
en Francés | PAHO-IRIS | ID: phr-56756

RESUMEN

Cette fiche d’information met en évidence la relation entre la consommation d’alcool et les maladies cardiovasculaires. La consommation d’alcool peut augmenter le risque de maladies cardiovasculaires, qui causent 1,9 million de décès par an dans les Amériques et sont la principale cause de décès dans le monde. La fiche d’information décrit l’association entre la consommation d’alcool et les maladies cardiovasculaires et fournit des recommandations sur la consommation d’alcool en relation avec la santé cardiaque.


Asunto(s)
Enfermedades no Transmisibles , Consumo de Bebidas Alcohólicas , Trastornos Relacionados con Alcohol , Enfermedades Cardiovasculares , Cardiopatías
19.
Washington, D.C.; Organisation panaméricaine de la Santé; 2022-11-23. (OPS/NMH/MH/21-0027).
en Francés | PAHO-IRIS | ID: phr-56753

RESUMEN

Cette fiche d’information résume les risques de la consommation d’alcool pendant la grossesse. Il explique le terme troubles du spectre de l’alcoolisation fœtale et énumère les problèmes qu’ils peuvent causer, par exemple, des malformations congénitales, des anomalies cérébrales et des problèmes de comportement et d’apprentissage. La fiche d’information souligne l’importance de prévenir le trouble du spectre de l’alcoolisation fœtale chez les enfants et les adultes et explique comment le faire.


Asunto(s)
Enfermedades no Transmisibles , Consumo de Bebidas Alcohólicas , Trastornos Relacionados con Alcohol , Embarazo , Trastornos del Espectro Alcohólico Fetal , Enfermedades Fetales
20.
Washington, D.C.; PAHO; 2022-11-21. (PAHO/NMH/RF/22-0037).
No convencional en Inglés | PAHO-IRIS | ID: phr-56743

RESUMEN

The World Health Organization (WHO) Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2030 (WHO Global Action Plan) recognizes the critical importance of reducing the level of exposure of individuals and populations to common risk factors of noncommunicable diseases (NCDs), including harmful use of alcohol. It particularly recommends taxing alcoholic beverages as one of the most cost-effective regulatory policies to prevent NCDs, as does the WHO Global Alcohol Action Plan 2022-2030. Indeed, harmful use of alcohol is associated with hundreds of health conditions and injuries, acute and chronic. Taxes on alcoholic beverages represent a triple win for governments, because they 1) improve population health, 2) generate revenue, and 3) have the potential to reduce long-term associated healthcare costs and productivity losses. While since 2008, WHO has monitored tobacco taxes and prices with standardized quantitative indicators, including the comparison of tobacco tax share levels across all Member States and time, comparable information on taxation of alcoholic beverages over time and across countries is not currently available. Such monitoring is important for analyzing trends, enabling standardized comparisons across countries, establishing best practices, and providing a powerful tool for advocacy. The Pan American Health Organization (PAHO) is committed to providing Member States with accurate, relevant, and internationally comparable information that they can use to guide the development of policy and to evaluate the impact of measures to prevent the harmful use of alcohol. This note describes the methodology that PAHO developed for estimating a tax share indicator and other tax policy and price indicators for alcoholic beverages, based on the methodology used by WHO to monitor prices and taxes applied on tobacco products. It outlines the definition of the scope and beverages for which the tax share is calculated; a description of the data collection and analysis process; and an explanation of key components of the tax share calculation. It also defines additional indicators on prices, affordability, and tax policies. 


Asunto(s)
Enfermedades no Transmisibles , Factores de Riesgo , Bebidas Alcohólicas , Impuestos
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