جستجوی مقالات مرتبط با کلیدواژه « non–communicable diseases » در نشریات گروه « پزشکی »

High levels of stress in obese people, hypothalamic-pituitary-adrenal (HPA) axis disorder, and social pressures can increase cortisol level and lead to psychological disorders. The aim of this study is to compare psychological distress, biochemical parameters, and metabolic syndrome components between normal-weight and overweight (OW)/obese women.

This was an analytical cross-sectional study conducted on 75 women aged 18 to 60; they were divided into three groups: obese and OW on diet (obese/OW on diet), obese and OW without diet (obese/OW without diet), and normal-weight. The components of metabolic syndrome, serum cortisol, and high sensitive C-reactive protein (hs-CRP) levels were measured. General health questionnaire-28 (GHQ-28) was also completed to assess psychological distress.

The results revealed that there was a significant difference between normal weight and the other two groups regarding metabolic syndrome components, which included waist circumference (WC), fasting blood sugar (FBS), systolic blood-pressure (SBP), and hs-CRP (P<0.05). Serum cortisol level was significantly higher in obese/OW on diet compared with the other two groups (P<0.001). Moreover, the total-GHQ score was significantly lower in normal weight compared with the group of obese/OW on diet and the group without diet (P=0.001). 

Being on a diet may expose a person to stress and increase the serum cortisol level. Elevated psychological distress, metabolic syndrome components, and inflammation were apparent in obese and OW women compared to normal-weight ones.

While research has explored the health-promoting behaviors (HPBs) of older adults on a global scale during the first and second waves of COVID-19, there is limited knowledge about the factors that influence HPBs among older adults with non-communicable diseases (NCDs) in the "new normal" following the COVID-19 era.

The aim of this study was to identify the factors that affect HPBs among community-dwelling older adults with NCDs.

This cross-sectional study involved surveying 250 older adults with NCDs in both urban and rural communities within Ubon Ratchathani province, northeast Thailand, between September 10 and November 10, 2022, during the COVID-19 pandemic. Data collection was conducted using a self-administered questionnaire, which included the Self-rated Abilities Scale for Health Practice, Health Literacy Scale, Access to COVID-19 Preventive Material, Lubben Social Network Scale, and Health- Promoting Behaviors Scale. The analysis utilized descriptive statistics and hierarchical regression analysis, setting the significance level at P < 0.05 for all analyses.

Among the 250 older adults with NCDs surveyed, 65.60% had hypertension. These individuals demonstrated HPBs at a good level, along with a high level of perceived self-efficacy, good health literacy, adequate access to COVID-19 preventive materials, and greater social engagement. The analysis indicated that perceived self-efficacy (β = 0.343, P < 0.001), attitudes towards smoking (β = 0.226, P < 0.001), age (β = 0.204, P < 0.001), health literacy (β = 0.199, P = 0.016), and access to COVID-19 preventive materials (β = 0.123, P = 0.026) were significant predictors of HPBs in older adults with NCDs.

The results suggest that improved access to COVID-19 preventive materials, enhanced health literacy, and increased self-efficacy contribute to better health-promoting behaviors among older adults with NCDs. Multidisciplinary healthcare teams should consider these factors in their intervention strategies to achieve a deeper understanding and better health outcomes. Future research should investigate the causal relationships among these variables and examine older adults’ perceptions of HPBs in long-term care settings, particularly in the "new normal" era.

Increased political commitment and financial input to primary care have led to a growing role of performance measurement. Rasooly et al studied the implementation of performance measurement for primary care for people with diabetes in China. This is an important topic that has received little attention from previous literature. In light of the findings from the article, this paper argues for rethinking the current use of performance measurement. It also suggests potential ways to improve primary care performance measurement, in order to avoid some of the pitfalls of top-down performance measurement and to create an enabling environment for primary care strengthening.

Taxes on sugar sweetened beverages (SSBs) have been widely implemented and heralded as a panacea in reversing the growing burden of non-communicable diseases (NCDs). Using a qualitative research methodology, Forde et al explored how sugary drink companies respond to changes in taxation positing that relative effectiveness of sugar taxes will not only depend on how prices are affected, and how consumers respond, but also how producers respond by reformulating their products or engaging in counteractive marketing strategies. They argue that these responses may undermine the public health goal. We discuss some of the key issues that arise in their paper and conclude that company responses may not be sufficient in undermining the public health goal, and that consumption of sugary drinks fall after imposition of taxes, though demand is inelastic. We argue that inelasticity of demand for SSB may require a combination of interventions to sufficiently reduce excess consumption of sugar drinks.

Complex interactions between political economy factors and corporate power are increasingly recognized to prevent transformative policy action on non-communicable disease (NCD) prevention. System science offers promising methods for analysing such causal complexity. This study uses qualitative system dynamics methods to map the political economy of diet-related NCD (DR-NCD) prevention policy-making aiming to better understand the policy inertia observed in this area globally.

  We interviewed 25 key policy actors. We analysed the interviews using purposive text analysis (PTA). We developed individual then combined casual loop diagrams to generate a shared model representing the DR-NCD prevention policy-making system. Key variables/linkages identified from the literature were also included in the model. We validated the model in several steps including through stakeholder validation interviews.

  We identified several inter-linked feedback processes related to political economy factors that may entrench different forms of corporate power (instrumental, structural, and discursive) in DR-NCD prevention policy-making in South Africa over time. We also identified a number of feedback processes that have the potential to limit corporate power in this setting.

  Using complex system methods can be useful for more deeply understanding DR-NCD policy inertia. It is also useful for identifying potential leverage points within the system which may shift the existing power dynamics to facilitate greater political commitment for healthy, equitable, and sustainable food system transformation.

Hypertension is a common public health problem with potentially serious consequences. We aimed to explore the direct costs of hypertension treatment in Iran.

Literature review and STEPS survey were used to estimate the incidence and prevalence of hyperten-sion for Iranian males and females and the proportion of its treatment coverage in 2020. A standard national protocol for hypertension treatment was used to estimate the required medical services including visits, medica-tions, and lab tests. The cost of each service and the total cost of the disease were identified using the national reference costs.

About 23.39 million people suffer from moderate systolic blood pressure (BP of 120 to 139 mm/Hg) and a further 14.6 million people had severe BP (≥140 mm/Hg). Nearby 39.8% of these patients, receive BP treatment. The direct costs of hypertension treatment were 19,006.08 billion IR Rials (USD 87.54 million), of which 16.60% and 83.40% of the costs were related to new and prior cases, respectively. The costs of patient visits, medications, and lab tests were 56%, 35.51%, and 8.49% of the total costs, respectively.

The prevalence and economic burden of hypertension are relatively high in Iran. Early detection and treatment of hypertension might have a significant effect on reducing its complications and costs.

Non-communicable diseases as a leading cause of death have a surveillance system in most countries. This is disturbed by the emergence of coronavirus disease-2019 (COVID-19) in December 2019. In this regard, health system managers at decision-making levels tried to overcome this problem. Therefore, strategies to deal with this issue and bring the surveillance system to an ideal state were proposed and considered.

Contextual risk factors such as social capital have a vital role in affecting behavioral and biologi-cal risk factors of NCDs. We aimed to systematically identify the relationship between different aspects of so-cial capital (SC) with metabolic, and behavioral risk factors of non-communicable diseases (NCDs).

This is a systematic review. The period of study was 2000-2021. We searched the English interna-tional databases, i.e. PubMed/Medline, Scopus, and Web of Science. Studies that reported NCDs' metabolic and behavioral risk factors as independent variables, were excluded. We also included studies if they analyzed the association between SC and metabolic and behavioral risk factors of NCDs.

After the primary and quality appraisal process, 97 studies were entered in the final phase of the anal-ysis. Five out of 18 studies reported an inverse association between SC and the level of alcohol drinking. Twen-ty-seven out of 32 studies reported a significant inverse association between SC and smoking and tobacco use, while only one study reported a significant positive association. Nine studies reported a significant inverse asso-ciation between SC and high blood pressure. Three studies showed a significant inverse association between SC and diabetes. Seventeen studies indicated a significant positive association between SC and physical activity. Thirteen out of 17 studies reported a significant inverse association between SC, body mass index (BMI) and overweight.

High SC, people's participation and interaction are vital in tackling NCDs. Evidence shows posi-tive effects of SC on prevention, control and improvement of NCDs' metabolic and behavioral risk factors.

 Assessment of quality and cost of medical care has become a core health policy concern. We conducted a nationwide survey to assess these measures in Iran as a developing country. To present the protocol for the Iran Quality of Care in Medicine Program (IQCAMP) study, which estimates the quality, cost, and utilization of health services for seven diseases in Iran.

 We selected eight provinces for this nationally representative short longitudinal survey. Interviewers from each province were trained comprehensively. The standard definition of seven high-burden conditions (acute myocardial infarction [MI], heart failure [HF], diabetes mellitus [DM], stroke, chronic obstructive pulmonary (COPD) disease, major depression, and end-stage renal disease [ESRD]) helped customize a protocol for disease identification. With a 3-month follow-up window, the participants answered pre-specified questions four times. The expert panels developed a questionnaire in four modules (demographics, health status, utilization, cost, and quality). The expert panel chose an inclusive set of quality indicators from the current literature for each condition. The design team specified the necessary elements in the survey to calculate the cost of care for each condition. The utilization assessment included various services, including hospital admissions, outpatient visits, and medication.

 Totally, 156 specialists and 78 trained nurses assisted with patient identification, recruitment, and interviewing. A total of 1666 patients participated in the study, and 1291 patients completed all four visits.

 The IQCAMP study was the first healthcare utilization, cost, and quality survey in Iran with a longitudinal data collection to represent the pattern, quantity, and quality of medical care provided for high-burden conditions.

Irregular working times or atypical working schedules, accompanied by the risk of unhealthy dietary habits, physical inactivity, and partial sleep deprivation, potentially lead to increased metabolic risk factors. This study aimed to evaluate the nutritional status, physical activity level, and the knowledge, attitude and practice (KAP) of South Zagros Oil and Gas Production Company (SZOGPC) employees (predominantly irregular-shift workers) toward diet and nutrition. This cross-sectional study was conducted from January to October 2017 on 997 SZOGPC workers. Demographic characteristics, anthropometric measures, biochemical markers, physical activity status, KAP, and dietary intake of the employees were assessed and analyzed. The offered menus were also analyzed. The participants’ mean age was 37.0±6.7 years; the majority of them were married (88.2%) and had irregular-shift work (85.6%). Approximately four-fifths of the participants were either pre-obese or obese, and two-thirds had central obesity. Over half of the participants had high serum triglyceride concentrations and inadequate high-density lipoprotein cholesterol levels. Alkaline phosphatase and alanine transaminase levels were higher than the normal range in 79.0% and 36.2% of the subjects, respectively. The KAP survey showed that only 28-31% of the interviewed participants had acceptable KAP subscale or total scores on the principles related to weight gain and obesity. The mean energy intake was almost 50% more than the average recommendations. Irregular-shift workers appear to be at increased health risk, particularly in terms of acquiring non communicable diseases. Effective lifestyle interventions such as nutrition education and basic menu changes must be considered as a major priority to promote health in such populations.

Understanding national trends in noncommunicable disease (NCD) risk factors may have health policy implications. We aimed to evaluate trends in the prevalence and correlates of eight risk factors for NCD from 2005 to 2019 in Mongolia.

Cross-sectional data were analyzed from 9,356 individuals (15-64/69 yr, mean age=37.3 yr) who participated in the Mongolia STEPS 2005, 2009, 2013 or 2019 surveys and had complete measurement of the risk factor for NCD.

The proportion of having 3-8 NCD risk factors significantly decreased from 59.1% in 2005 to 49.4% in 2019, and the mean number of NCD risk factors significantly decreased from 2.8 in 2005 to 2.6 in 2019. In linear regression analyses by study year, older age and male sex were across all study years positively associated with eight NCD risk factors. The prevalence of low physical activity increased from 8.2% in 2005 to 28.4% in 2019, overweight/ obesity from 49.6% in 2005 to 64.0% in 2019, and raised total cholesterol from 23.9% in 2005 to 27.6% in 2019, there was a significant decrease in inadequate fruit and vegetable intake from 85.1% in 2005 to 79.5% in 2019, current smoking from 26.6% in 2005 to 24.1% in 2019, hypertension from 28.2% in 2005 to 23.2% in 2019, while the prevalence of diabetes remained unchanged from 2005 to 2019.

The prevalence of eight risk factors for NCD decreased in the last 15 years in Mongolia. Several associated variables for eight and individual NCD risk factors were identified that can help guide interventions.

The trend of chronic diseases is increasing globally. Socioeconomic status (SES) is a major factor underlying many chronic diseases. This study was conducted to investigate the socioeconomic inequalities in distribution of chronic diseases in Iran, as a middle-income country.

This cross-sectional study was conducted using the baseline data of the Kharameh cohort study, that were collected between 2014 and 2016. The number of participants in this study was 10663 people in the age range of 35 to 70 years. Principal component analysis was used for calculating the SES of the people under study. In addition, we used concentration index and concentration curve to measure socioeconomic inequality in chronic disease.

The mean age of 10,663 participants in our study was 52.15±8.22 years and the male to female ratio was 1.26. Recurrent headache (25.8%( and hypertension (23.5%) were the most prevalent diseases. The concentration index showed that the distribution of movement disorder, recurrent headaches and gastroesophageal reflux diseases is significantly concentrated among people with low SES, and obesity among people with high SES. The results of the analysis by gender were similar to the results seen in all participants.

The findings of this study show that socioeconomic inequality is the cause of the concentration of non-communicable diseases among people with low socio-economic status. Therefore, health policy makers should pay special attention to identifying vulnerable subgroups and formulate strategic plans to reduce inequalities.

Non-communicable diseases (NCDs) require multifaceted responses from healthcare systems that must complement sustainable healthcare programs.

This study aims to investigate the current state of sustainability of Non-Communicable Disease Prevention and Control Programs (NCP-PCP) and to identify related challenges in various intra- and inter-organizational domains.

This mixed-methods study used a researcher-made sustainability assessment tool and qualitative interviews of 46 managers responsible for implementing NCP-PCP in Iran. Graneheim and Lundman's approach, as well as descriptive statistics, were utilized to analyze the data. The sustainability questionnaire comprised nine domains: environmental support, funding stability, partnerships, organizational capacity, program evaluation, program adaptation, communications, strategic planning, and law and governance.

The overall mean score for sustainability was 3.54 ± 0.86, with funding stability (2.79 ± 1.03) and program adaptation (4.24 ± 1.12) receiving the lowest and highest mean scores, respectively. Qualitative data revealed several challenges, including financial instability, lack of budget allocation for such programs, absence of specific mechanisms for program evaluation, inadequate resources, deficiencies in intersectoral cooperation, and failure to utilize hidden community capacities.

It is crucial to maintain and strengthen the current state of program adaptation and program evaluation to ensure the sustainability of NCD-PCP. On the other hand, funding instability is a significant obstacle in prevention and control programs that can bring the entire program to a halt, regardless of its sustainability in other domains.