Public health of chronic diseases

Le Rapport de la Commission Macroéconomie et santé et le rapport publié ultérieurement par l’OMS Scaling
Up the Response to Infectious Diseases: A Way Out of Poverty établissent les liens irréfutables qui existent
entre la santé et le développement économique ainsi que la demande croissante de soins de santé en
rapport avec les maladies infectieuses telles que le VIH/SIDA et la tuberculose. Plus généralement, la
prise en charge de toutes les affections chroniques - maladies non transmissibles, troubles mentaux de
longue durée et certaines maladies transmissibles telles que le VIH/SIDA - est l’un des plus grands défis
pour les systèmes de soins de santé partout dans le monde. Les affections chroniques sont actuellement
responsables de 60% de la charge mondiale de morbidité. Elles progressent à un rythme tel que, d’ici à
2020, les pays en développement peuvent s’attendre à ce que leur charge de morbidité soit imputable à
80% aux affections chroniques. L’observance des traitements dans ces pays ne dépasse guère 20%, d’où
des résultats médiocres en termes de santé et des coûts très élevés pour la société, les gouvernements et
les familles. Les systèmes de santé, pourtant, n’ont pas de plan relatif à la prise en charge des affections
chroniques et se contentent de traiter les symptômes à mesure qu’ils apparaissent.
Consciente de l’opportunité d’améliorer les soins de santé pour les affections chroniques, l’OMS a
lancé un nouveau projet Des soins novateurs pour les affections chroniques. La première phase de ce projet
a consisté à définir et analyser les meilleures pratiques et les modèles de soins de santé économiquement
accessibles pour les affections chroniques, et à faire le point de la situation. Des experts, des organisations
et des établissements internationaux ont été associés à ces travaux.
Des soins novateurs pour les affections chroniques: éléments constitutifs décrit le travail accompli, à savoir la
mise en place d’un cadre de grande envergure devant permettre l’actualisation des soins de santé compte
tenu des besoins liés aux affections chroniques. Les éléments proposés et le cadre général faciliteront la
prévention et la prise en charge des maladies dans les services de soins de santé. Cela est d’autant plus
important que la plupart des affections chroniques peuvent être prévenues. Réunis pour examiner ces
stratégies et le cadre général, les décideurs ont estimé qu’ils étaient de nature à résister, que les pays en
développement soient appelés, selon le scénario, à faire face à une épidémie de VIH/SIDA, à l’exode
des ressources humaines qualifiées vers le secteur privé, à un effondrement général de l’économie ou à
un changement de gouvernement. Les participants ont également jugé que le cadre était adapté à des
affections chroniques diverses, y compris le VIH/SIDA, la tuberculose, les maladies cardio-vasculaires,
le diabète et les troubles mentaux de longue durée.
Les étapes suivantes incluront des projets de démonstration de la mise en oeuvre des stratégies décrites dans
ce rapport. Les partenaires de la santé publique seront étroitement associés à la réalisation de ce projet.
Ce rapport sera très utile pour les décideurs, les planificateurs des services de santé et les autres parties
intéressées qui envisagent de prendre des mesures pour réduire les menaces que les maladies chroniques
font peser sur la santé des citoyens, le système de soins de santé et l’économie nationale.

This paper presents a proposal for OMG! Obesity Must Go! (OMG!), an employee assistance program (EAP) to be implemented at Thereyouare University (TU), a large university located in Arkansas, one of the top five states for obesity in the United States.  It is intended for consideration by TU’s initial hiring entity, which is composed of the human resources and finance departments, the occupational health, labor/management, and leadership staff; and all entities within the EAP and health promotion communities. The mission of the OMG! program is to educate, inform, and raise the awareness of obesity and its impact on health, to encourage and empower employees to lead healthier, more meaningful lives; and to substantially improve the identified health outcomes by reducing the percent overweight by 5 points in the first year, reducing cholesterol and blood pressure levels, and providing a healthier environment for all.

In the long human tradition honey has been used not only as a nutrient but also as a medicine. Its composition is rather variable and depends on the floral source and on external factors, such as seasonal, environmental conditions and processing. In this review, specific attention is focused on absorption, metabolism, and beneficial biological activities of honey compounds in human. Honey is a supersaturated solution of sugars, mainly composed of fructose (38%) and glucose (31%), containing also minerals, proteins, free amino acids, enzymes, vitamins and polyphenols. Among polyphenols, flavonoids are the most abundant and are closely related to its biological functions. Honey positively affects risk factors for cardiovascular diseases by inhibiting inflammation, improving endothelial function, as well as the plasma lipid profile, and increasing low-density lipoprotein resistance to oxidation. Honey also displays an important antitumoral capacity, where polyphenols again are considered responsible for its complementary and overlapping mechanisms of chemopreventive activity in multistage carcinogenesis, by inhibiting mutagenesis or inducing apoptosis. Moreover, honey positively modulates the glycemic response by reducing blood glucose, serum fructosamine or glycosylated hemoglobin concentrations and exerts antibacterial properties caused by its consistent amount of hydrogen peroxide and non-peroxide factors as flavonoids, methylglyoxal and defensin-1 peptide. In conclusion, the evidence of the biological actions of honey can be ascribed to its polyphenolic contents which, in turn, are usually associated to its antioxidant and anti-inflammatory actions, as well as to its cardiovascular, antiproliferative and antimicrobial benefits.

Background: Gait and balance deficits are reported in adults with HIV infection and are associated with reduced quality of life. Current research suggests an increased fall-incidence in this population, with fall rates among middle-aged adults with HIV approximating that in seronegative elderly populations. Gait and postural balance rely on a complex interaction of the motor system, sensory control, and cognitive function. However, due to disease progression and complications related to ongoing inflammation, these systems may be compromised in people with HIV. Consequently, locomotor impairments may result that can contribute to higher-than-expected fall rates. The aim of this review was to synthesize the evidence regarding objective gait and balance impairments in adults with HIV, and to emphasize those which could contribute to increased fall risk. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An electronic search of published observational studies was conducted in March 2016. Methodological quality was assessed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Narrative synthesis of gait and balance outcomes was performed, and meta-analyses where possible. Results: Seventeen studies were included, with fair to low methodological quality. All studies used clinical tests for gait-assessment. Gait outcomes assessed were speed, initiation-time and cadence. No studies assessed kinetics or kinematics. Balance was assessed using both instrumented and clinical tests. Outcomes were mainly related to center of pressure, postural reflex latencies, and timed clinical tests. There is some agreement that adults with HIV walk slower and have increased center of pressure excursions and-long loop postural reflex latencies, particularly under challenging conditions. Conclusions: Gait and balance impairments exist in people with HIV, resembling fall-associated parameters in the elderly. Impairments are more pronounced during challenging conditions, might be associated with disease severity, are not influenced by antiretroviral therapy, and might not be associated with peripheral neuropathy. Results should be interpreted cautiously due to overall poor methodological quality and heterogeneity. Locomotor impairments in adults with HIV are currently insufficiently quantified. Future research involving more methodological uniformity is warranted to better understand such impairments and to inform clinical decision-making, including fall-prevention strategies, in this population.

* Chronic physical, sexual, or psychological abuse can
have a long-lasting impact on a woman even after
the abuse or the relationship has ended.
* The most direct health consequence of chronic
intimate partner violence is the possibility of death.
* Intimate partner violence may directly impact a
woman’s health through physical attacks and related
injuries - chronic pain, broken bones, arthritis,
hearing or sight deficits, seizures, or frequent
headaches.
* Abuse victims can often suffer repeated "mild" brain
injury that can have a lifelong impact which includes:
sleep disturbances, headaches, dizziness, depression,
irritability, anxiety, changes in social or sexual
behavior, speech problems, cognitive impairment,
and memory issues.
* Sexual violence often co-occurs with partner
violence. Sexual violence can lead to vaginal or anal
injuries, high levels of stress linked to sexual
dysfunction and immune system problems,
depression, and increased risk of bacterial infection.
* Abuse can cause ongoing physical and psychological
pain, which over an extended period of time results
in physiologic changes to stress-response areas of the
body's central nervous system. These stressors can
lead to life-long changes in the body's functioning
and increases vulnerability to chronic pain
syndromes and psychological dysfunction.

Chronic kidney disease is an emergent worldwide public health problem. The increasing incidence of chronic renal failure warrants a need for an epidemiological approach to better understand the disease and its prevention. While statistics have been identified concerning world demographics, there is not enough information on how to better prevent and screen for this disease. There is evidence on the global distribution suggesting that chronic renal failure is a growing issue in developed and developing countries. While screening and intervention can prevent chronic kidney disease, awareness of the disorder, however, remains low in many communities and among many healthcare workers hence, this paper explores the epidemiology, diagnosis, treatment and management of chronic kidney disease.

INTRODUCTION:
Healthcare utilisation, assesses the consumption of healthcare resources, i.e. a health system’s capacity.

This study aimed to survey utilisation patterns of local chronic disease sufferers, and derive determinants underlying provider selection; to explore reforms to enhance the capacity to address future challenges of the global chronic diseases epidemic.

OBJECTIVES:
The primary objective was to scope for patterns of healthcare utilisation among subjects by comparing frequency of services uptake across various service domains.

The secondary objective was to evaluate the association of theoretical constructs and demographic factors with the choice of sector for services utilisation.

METHODS:
In this cross-sectional survey, the study population were chronic disease patients aged forty or above, and were recruited by purposive sampling via personal, medical and societal connections. Pencil-and-paper questionnaires were interviewer- or self-administered.

Frequency measures were compared using the Wilcoxon Signed-Rank, and constructs’ associations were analysed using logistic regression.

RESULTS:
One-hundred-and-seventy respondents (age=60.3110.718years, meanstandard deviation) were recruited. The public sector was mainly visited (74.4%), and more significantly frequently utilised for diagnostic exams, chronic disease care and screening (all p<0.001). This trend held for consultations, but not significantly (p=0.086).

From multivariable analysis, adjusted odds ratio (AOR)<1 indicated the association towards the public sector. Significant predictors were; age [p=0.010;AOR(95%CI)=0.930(0.889-0.972)], physicians’ performance [p=0.025;AOR(95%CI)=39.995(1.596-1000.100)], staff-patient relationships [p=0.016;AOR(95%CI)=0.074 (0.009-0.618)], coverage [p=0.001;AOR(95%CI)=56.886(4.978-650.028)], and waiting time [p<0.001;AOR(95%CI)=112.495(10.937-1157.064)].

CONCLUSIONS:
Results indicated a greater burden on the public sector and suggested some underlying determinants. Further studies and policy analyses should be considered to reroute patients to the private sector to improve the efficaciousness of local healthcare services delivery.

Context: Currently there are many investigations that are carried out around the complex problem of therapeutic adherence due to its negative consequences.

Aims: To evaluate the therapeutic adherence in patients with chronic diseases hospitalized in an Internal Medicine Service.

Methods: An observational, descriptive and transversal study was carried out in 50 patients characterized according to biosocial and clinical variables. For the determination of therapeutic adherence, the Battle test and the Morisky-Green test were used, defining the patients as adherent and non-adherent. Possible factors associated with adherence were analyzed and educational interventions were carried out. The review of the clinical histories and the interview as a working instrument were used, the statistical significance of the influence of the factors was evaluated through Chi-square.

Results: Predominance of the feminine sex, the average age of 65 years and the level of primary schooling, hypertension prevailed in 90% of patients and antihypertensive drugs as the most used drugs. 54% of adherent patients were obtained compared to 46% of non-adherent patients. Factors such as number of chronic diseases, limitation of social activity and accessibility to the pharmaceutical service were associated with therapeutic adherence. The educational interventions carried out were the talk and the advice/information.

Conclusions: The results reveal therapeutic adherence in most patients and the need to continue with health education to groups with chronic diseases.

The specialty of family medicine is centered on lasting, caring relationships with patients and their families. Family physiciansintegrate the biological, clinical and behavioral sciences to provide continuing and comprehensive health care. The scope of family medicine encompasses all ages, sexes, each organ system and every disease entity. Read more about the history, scope and definition of family medicine by reviewing the following resources.



Public-health-family-medicine



Family medicine is a three-dimensional specialty, incorporating (1) knowledge, (2) skill and (3) process. At the center of the process element is the patient-physician relationship with the patient viewed in the context of the family. It is the extent to which this relationship is valued, developed, nurtured and maintained that distinguishes family medicine from all other specialties.



Family physicians integrate the biological, clinical and behavioral sciences to provide continuing and comprehensive health care. Family medicine encompasses all ages, sexes, each organ system and every disease entity. Family physicians also pay special attention to their patients' lives within the context of family and the community.

Adolescent Medicine
Geriatric Medicine
Pain Medicine
Sleep Medicine
Sports Medicine
Sexual Health
Geriatric Medicine
For more details, PS: https://clinicalcasereports.conferenceseries.com/events-list/case-reports-on-public-health-family-medicine

Malaria is a fatal insect-borne tropical disease that continues to pose public health challenges in Nigeria. This study was carried out to assess the prevalence of malaria infection among persons seeking treatment from private sector drug outlets and Proprietary and Patent Medicine Vendors (PVMs). Rapid diagnostic tests and microscopy were carried out to examine the blood samples collected from the study subjects. A total of 1,300 subjects of varying ages that came to seek for malaria treatment were randomly selected for the study after their free consent had been obtained. Finger prick and venous methods were used to collect blood for the rapid diagnostic test and microscopy. The results of this study revealed that of the total of 700 blood samples analyzed for Males, 402 (57.43%) were positive for microscopy and 396 (56.57%) were positive for RDT. While for females, the result showed that of the 600 blood samples screened, 304 (50.67%) were positive for microscopy and 288 (48.0%) ...

Prevalence of chronic respiratory diseases among office workers in 1,4-1,6 times the average in Ukraine, as of 2010-2012. According to the medical examination of IT-specialists, in the structure of a chronic otolaryngology morbidity, mainly revealed chronic catarrhal pharyngitis (10,2 % of all surveyed), chronic compensated tonsillitis (2,6 %) and rhinopharyngitis (1,8 %), allergicrhinitis (1,3 %) background on isolated cases of chronic sensorineural hearing loss (0,9 %) and catarrhal rhinitis (0,45 %). Such a spectrum of a chronic otolaryngology morbidity may reflect an adverse effect of occupational factors working, including microclimatic conditions. Sufficiently high levels of chronic otolaryngology diseases indicate the need for implementation of appropriate engineering measures to normalize the microclimatic conditions in the enterprises and attract an otolaryngologist to conduct medical examinations of office workers working with personal computers.

Распространенность хронических заболеваний верхних дыхательных путей среди офисных работников в 1,4-1,6 раза превышает средний показатель по Украине, по данными за 2010-2012 гг. По данным медицинского осмотра IT-специалистов, в структуре заболеваний ЛОР-органов, главным образом, выявляются хронические катаральные фарингиты (10,2 % от всех обследованных), хронические компенсированные тонзиллиты (2,6 %) и ринофарингиты (1,8 %), аллергические риниты (1,3 %) встречаются на фоне единичных случаев хронической сенсоневральной тугоухости (0,9 %) и катарального ринита (0,45 %). Такой спектр хронических оториноларингологических заболеваний может отражать неблагоприятное влияние факторов производственной среды на работающих, в том числе и микроклиматических условий. Достаточно высокие показатели хронических заболеваний ЛОР-органов свидетельствуют о необходимости внедрения соответствующих инженерно-технических мероприятий по нормализации микроклиматических условий на данных предприятиях и привлечения отоларинголога к проведению медицинских осмотров офисных работников, пользующихся персональными компьютерами.