An investigation to identify potential risk factors associated with common chronic diseases among the older population in India

© 2017 Indian Journal of Community Medicine. Background: In India, chronic diseases are the leading cause of death and their prevalence has constantly increased over the last decade. Objective: This study aimed to identify risk factors associated with common chronic diseases among people aged 50 years and over in India. Materials and Methods: Data from Wave 1 of the 2007/2008 Indian Study on Global Ageing and Adult Health (SAGE) was used to investigate the association between lifestyle choices and chronic diseases using logistic regression. Result: The fully adjusted model showed that significant independent risk factors for angina included area of residence, being diagnosed with diabetes, chronic lung disease (CLD) [highest odds ratio (OR) 4.77, 95% confidence interval (CI): 2.95-7.70] and arthritis. For arthritis, risk factors included having underlying diabetes, CLD diagnosis, or angina (highest OR 2.32, 95% CI: 1.63-3.31). Risk factors associated with CLD included arthritis, angina (highest OR 4.76, 95% CI: 2.94-7.72), alcohol use, and tobacco use. Risk factors associated with diabetes included level of education, area of residence, socioeconomic status, angina (highest OR 3.59, 95% CI: 2.44-5.29), CLD, arthritis, stroke, and vegetable consumption. Finally, risk factors associated with stroke included diabetes and angina (highest OR 3.34, 95% CI: 1.72-6.50). The presence of any other comorbidity was significantly associated with all five chronic diseases studied. Conclusion: The results show that within the older population, the contribution of lifestyle risk factors to the common chronic diseases investigated in this study was limited. Our findings showed that the major health issue within the study population was multimorbidity

An Investigation Into Thermal Comfort In Residential Buildings In The Hot Humid Climate Of Sub-Saharan Africa: A Field Study In Abuja-Nigeria

A field study was conducted to understand the real and preferred conditions of thermal comfort in low-income residential buildings in Abuja, Nigeria. Knowing the temperatures people are experiencing in their houses and the limits which residents can tolerate is a first step to proffer passive solutions to reduce discomfort. During the study, 40 people responded to a post occupancy questionnaire and two households were issued a comfort survey questionnaire. Physical measurements were taken simultaneously during the comfort survey in both an air-conditioned and naturally ventilated residential building. The ASHRAE and air flow sensation scale were chosen as voting scales. The results from this study show that during the monitoring period the average and maximum temperatures in an air conditioned residential building were 31°C and 34°C; and 33°C and 36°C for natural ventilated buildings in Abuja. This compares with the external average and maximum air temperatures of 31°C and 39°C

Thermal comfort of occupants during the dry and rainy seasons in Abuja, Nigeria

The paper presents the results of a recent study on the thermal comfort of occupants in four low-income residential buildings, at two different locations, within the hot-humid climate of Abuja. A comfort survey questionnaire was administered to occupants of four casestudies to assess their perception of their thermal environment. Simultaneously, the indoor temperatures and relative humidity of the living room and bedroom spaces were monitored as well as outdoor parameters to evaluate the actual building performance. To support the comfort survey, a post-occupancy survey was carried out to evaluate an additional 86 buildings nearby in the case studies areas. The paper focuses on analysing the thermal conditions of respondents of the post-occupancy survey, the comfort survey and indoor monitoring findings from the case studies. The maximum daytime average temperature of the naturally ventilated buildings was only 2.0°C more than in the air-conditioned buildings. The maximum indoor air temperature in the living spaces during the dry season was 36.8°C(and 26.4% RH) and the minimum 28.4°C (and 66.6% RH),while during the rainy season these were respectively 35.9°C(and 43.7% RH) and the minimum 24.3°C (and 75.5% RH). The results suggest that there was significant thermal discomfort in the low income residential buildings

Penyelenggaraan fasiliti stadium

Penyelenggaraan adalah kerja yang dilakukan untuk memelihara, menjaga, mengendali, memperbaiki dan mengawalselia struktur bangunan, kemudahan, kelengkapan, perkhidmatan bangunan dan persekitaran bagi memastikan bangunan sentiasa berada pada tahap piawaian yang telah ditetapkan. Selain itu, penyelenggaraan juga dapat mempertahankan utiliti dan nilai fasiliti kemudahan serta berada dalam keadaan selamat digunakan

The epidemiology of childhood psoriasis: a scoping review

Psoriasis is an inflammatory noncommunicable skin disease that affects both adults and children. At present, the epidemiology and natural history of psoriasis are not widely understood. This scoping review aimed to map the existing literature on the epidemiology of childhood psoriasis, identify research gaps for future studies and provide a comprehensive, clinically useful review. Search strategies were developed for Ovid Medline, Ovid Embase, Google Scholar and hand searching. In total, 131 articles met the inclusion criteria and were mapped; 107 articles were included for data extraction. Over the last 25 years there has been a dramatic increase in the volume of published observational epidemiological studies on childhood psoriasis. The majority were case series or cross-sectional studies, concentrated in Europe, Asia and North America. The prevalence of childhood psoriasis was found to be higher in European countries, older children and girls. Up to 48·8% of children had a family history of psoriasis in a first-degree relative. The most frequent subtype was plaque psoriasis and the most common initial sites of presentation were the scalp, limbs and trunk. Specific genetic differences have been found between child-onset and adult-onset populations. Case–control and cohort studies investigating risk factors for psoriasis onset, comorbidities and long-term health outcomes were extremely limited. The choice of study design and heterogeneity in methodology limit the validity and generalizability of the information, consistency of the results, and comparability of the studies. Well-designed epidemiological studies are needed to provide precise and consistent information about the frequency and clinical presentation, risk factors, associated diseases and long-term outcomes in childhood psoriasis

Ideas and Enhancements Related to Mobile Applications to Support Type 1 Diabetes

Background: Mobile devices have become increasingly important to young people who now use them to access a wide variety of health-related information. Research and policy related to the integration of health information and support with this technology do not effectively consider the viewpoint of a younger patient. Views of young people with type 1 diabetes are vital in developing quality services and improving their own health-related quality of life (HRQOL), yet research on their lifestyle and use of Web and mobile technology to support their condition and in non–health-related areas is sparse. Objective: To develop insight into young people with type 1 diabetes and their current use of Web and mobile technology and its potential impact on HRQOL. This can be achieved by constructing an in-depth picture of their day-to-day experiences from qualitative interviewing and exploring how they make use of technology in their lives and in relation to their condition and treatment. The goal was then to build something to help them, using the researcher’s technical expertise and seeking users’ opinions during the design and build, utilizing sociotechnical design principles. Methods: Data were collected by semistructured, in-depth qualitative interviews (N=9) of young people with type 1 diabetes aged 18-21. Interviews were transcribed and loaded onto NVivo for theme identification. Data analysis was undertaken during initial interviews (n=4) to locate potential ideas and enhancements for technical development. Latter interviews (n=5) assisted in the iterative sociotechnical design process of the development and provided additional developmental ideas. Results: Six themes were identified providing an understanding of how participants lived with and experienced their condition and how they used technology. Four technological suggestions for improvement were taken forward for prototyping. One prototype was developed as a clinically approved app. A number of ideas for new mobile apps and enhancements to currently existing apps that did not satisfactorily cater to this age group’s requirements for use in terms of design and functionality were suggested by interviewees but were not prototyped. Conclusions: This paper outlines the nonprototyped suggestions from interviewees and argues that young people with type 1 diabetes have a key role to play in the design and implementation of new technology to support them and improve HRQOL. It is vital to include and reflect on their suggestions as they have a radically different view of technology than either their parents or practitioners. We need to consider the relationship to technology that young people with type 1 diabetes have, and then reflect on how this might make a difference to them and when it might not be a suitable mechanism to use

Strengthening close to community provision of maternal health services in fragile settings: an exploration of the changing roles of TBAs in Sierra Leone and Somaliland.

Efforts to take forward universal health coverage require innovative approaches in fragile settings, which experience particularly acute human resource shortages and poor health indicators. For maternal and newborn health, it is important to innovate with new partnerships and roles for Traditional Birth Attendants (TBAs) to promote maternal health. We explore perspectives on programmes in Somaliland and Sierra Leone which link TBAs to health centres as part of a pathway to maternal health care. Our study aims to understand the perceptions of communities, stakeholder and TBAs themselves who have been trained in new roles to generate insights on strategies to engage with TBAs and to promote skilled birth attendance in fragile affected settings. A qualitative study was carried out in two chiefdoms in Bombali district in Sierra Leone and the Maroodi Jeex region of Somaliland. Purposively sampled participants consisted of key players from the Ministries of Health, programme implementers, trained TBAs and women who benefitted from the services of trained TBAs. Data was collected through key informants and in-depth interviews and focus group discussions. Data was transcribed, translated and analyzed using the framework approach. For the purposes of this paper, a comparative analysis was undertaken reviewing similarities and differences across the two different contexts. Analysis of multiple viewpoints reveal that with appropriate training and support it is possible to change TBAs practices so they support pregnant women in new ways (support and referral rather than delivery). Participants perceived that trained TBAs can utilize their embedded and trusted community relationships to interact effectively with their communities, help overcome barriers to acceptability, utilization and contribute to effective demand for maternal and newborn services and ultimately enhance utilization of skilled birth attendants. Trained TBAs appreciated cordial relationship at the health centres and feeling as part of the health system. Key challenges that emerged included the distance women needed to travel to reach health centers, appropriate remuneration of trained TBAs and strategies to sustain their work. Our findings highlight the possible gains of the new roles and approaches for trained TBAs through further integrating them into the formal health system. Their potential is arguably critically important in promoting universal health coverage in fragile and conflict affected states (FCAS) where human resources are additionally constrained and maternal and newborn health care needs particularly acute

Modelling Behaviour Change in Online Users: A Study of Influencing Healthier Shopping Habits in E-commerce Shoppers

While a lot of effort and research has gone towards influencing people to be more active with the use of apps, games, and exercise tools not much has been done in influencing people to eat healthy foods, especially by influencing healthy shopping habits. The use of persuasive strategies to change people’s behaviour is an active research area in several domains including e-commerce. Research suggests that persuasive strategies are more effective in bringing about the desired behaviour change when they are tailored to individuals or groups of similar individuals. There is, therefore, a need to identify what factors can be used to tailor persuasive strategies in ecommerce. To fill this gap and to tailor persuasive strategies to consumers, this dissertation proposes two consumer behaviour traits commonly used in consumer studies research: consumers’ need for uniqueness and their need for status (called "status consumption" in the literature), as well as a factor called "shopper type" accounting to the shopper's motivation. Two structural research models were developed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to identify the receptiveness of shoppers to persuasive strategies based on their consumer behaviour trait (consumers’ need for uniqueness and status consumption) and their shopping motivation (shopper types: convenience shoppers, variety seekers, store oriented shoppers, and balanced buyers). These models were tested by conducting a user study of 244 e-commerce shoppers. The results from these models were used to develop ShopRight, a persuasive game to influence behaviour change in e-commerce shoppers and to help them develop healthier shopping habits. To evaluate the game's effectiveness, a study of 305 participants was conducted using a data-driven approach to measure the receptiveness of participants to the persuasive strategies. The findings from this dissertation suggest that consumer behaviour traits and consumer’s online shopping motivation can be used to tailor persuasive strategies in ecommerce and in particular, influence healthy shopping online. This dissertation’s findings also show that tailored persuasive strategies are more likely to bring about a change in attitude or behaviour than non-tailored strategies. Furthermore, a serious game can be used as a learning tool to influence healthy shopping habits, educate shoppers on the nutritional value of foods and show that healthy foods can be purchased on a budget

TRIPS Compliance and Biotechnology Patenting in Africa: Lessons from India

This paper considers India’s obligation under the TRIPS Agreement 1994 (as amended) in relation tobiotechnology patents. Specifically, it examined how India has incorporated the TRIPS provisions into itspatent law to provide insights for African countries on meeting their international obligations whileconsidering their national interests in biotechnology research and innovation to address pertinent issuessuch as nutrition, food security and public healthcare. As in the past two decades, African countries havebeen amending their patent laws to bring them in conformity with the TRIPS Agreement 1994 (as amended),it is strongly recommended that they leverage the policy space under the TRIPS Agreement 1994 (asamended) like India to ensure nutrition, food security and public healthcare in the continent

Patenting in Biotechnology: An Analysis of the Three Tests of Patentability under the Nigerian Patent Law

Biotechnology has the potential to address some of the problems, including food insecurity andmalnutrition, the emergence and re-emergence of infectious diseases, and climate change,besetting developing countries such as Nigeria. However, it poses a significant challenge to theexisting patent system in Nigeria due to its inherent connection to naturally occurring substances.Therefore, this paper provides a legal analysis of the applicability of the patent standard tests ofnovelty, inventiveness and industrial application to biotechnology in Nigeria. The analysis drawson the interpretations of similar provisions in the European Union, the United States and theUnited Kingdom. The primary purpose is to identify and clarify possible issues that could arise inthe bid to apply relevant provisions of the existing patent law to biotechnological inventions inNigeria. The paper found that biotechnological inventions and innovations have provenchallenging to the requirements of novelty, inventiveness and industrial applicability under theglobalised patent standards. This is because patent laws evolved primarily in response to thedevelopment of machines and chemical processes, so they do not necessarily contemplate thepeculiarities of biotechnological inventions and innovations. It is recommended that for clarity,there is a need for Nigeria to formulate principles that would guide the application of the patentlaw to biotechnology as obtained in other jurisdictions, bearing in mind the possible implicationsof biotechnology patents on public health, food security, traditional knowledge and theenvironment among other factors