Incident all-cause and cardiovascular disease (CVD) mortality (per 1000 person-years of follow-up) in participants with and without diabetes, with further stratification by status for anaemia and existing CVD.

<p>+ denotes the presence of the characteristic, and – denotes its absence.</p

Kaplan-Meier estimates of the probability of all-cause and cardiovascular mortality during follow-up in participants with and without diabetes, and by status for anaemia.

<p>The upper figure panel is for cardiovascular disease and the lower for all-cause mortality.</p

Baseline characteristics by status for anaemia and diabetes.

<p>SD, standard deviation.</p

Effect of various coding of total haemoglobin on the association with cardiovascular disease (upper panels) and all-cause (lower panels) mortality in age, sex and cohort adjusted Cox regression models.

<p>The solid curve depicts the shape of the shape of the association across the continuum of total haemoglobin, and the shaded area if for the 95% confidence interval around the curve.</p

Incidence all-cause and Cardiovascular and all-cause mortality per 1000 person-years of follow-up and hazard ratios.

*<p>Cox models are adjusted for cohort, age, sex,</p>†<p>Cox models are further adjusted for smoking systolic blood pressure, total cholesterol, BMI and prior CVD.</p><p>CI, confidence interval; HR, hazard ratio; prs, person-years.</p

Effects of selected dietary constituents on high-sensitivity C-reactive protein levels in U.S. adults

<p><b>Background and aim:</b> Growing evidence suggests that some of the effects of diet on cardiovascular disease (CVD) occur through mechanisms involving subclinical inflammation. We assessed the relationship between selected dietary constituents and serum high-sensitivity C-reactive protein (hsCRP) concentration in a population-based sample of United States adults.</p> <p><b>Methods:</b> In this cross-sectional analysis, participants were selected from the US National Health and Nutrition Examination Survey (NHANES) and restricted to those with available data on dietary intake, biochemical and anthropometric measurements from 2001 to 2010. All statistical analyses accounted for the survey design and sample weights by using SPSS Complex Samples v22.0 (IBM Corp, Armonk, NY).</p> <p><b>Results:</b> Of the 17,689 participants analysed, 8607 (48.3%) were men. The mean age was 45.8 years in the overall sample, 44.9 in men and 46.5 in women (<i>p</i> = .047). The age-, race-, sex-, energy intake- and body mass index-adjusted mean dietary intakes of total dietary fibre, polyunsaturated fatty-acids, vitamin E, vitamin A, vitamin B6, total folate, vitamin B family, vitamin C, vitamin K, magnesium, iron, copper and potassium monotonically decreased across increasing hsCRP quarters (<i>p</i> < .001 for all), whereas sugar intake increased (<i>p</i> < .001). In analysis of covariance adjusted for potential confounders (age-, race-, sex-, energy intake- and body weight-) hsCRP levels increased across increasing quarters of sugar intake (<i>p</i> < .001).</p> <p><b>Conclusions:</b> This study provides further evidence of an association between dietary sugar, polyunsaturated fatty-acids, fibre and antioxidant intake and hsCRP levels, a subclinical inflammation marker. hsCRP concentrations are likely modulated by dietary intake.KEY MESSAGES</p><p>Serum high-sensitivity C-reactive protein (hsCRP) concentration is positively associated with sugar intake, and negatively with the consumption of minerals, vitamins and polyunsaturated fatty-acids (fruit and vegetables).</p><p>hsCRP concentrations, and accordingly subclinical inflammation, are likely influenced by dietary intake.</p><p></p> <p>Serum high-sensitivity C-reactive protein (hsCRP) concentration is positively associated with sugar intake, and negatively with the consumption of minerals, vitamins and polyunsaturated fatty-acids (fruit and vegetables).</p> <p>hsCRP concentrations, and accordingly subclinical inflammation, are likely influenced by dietary intake.</p

Task Shifting for Non-Communicable Disease Management in Low and Middle Income Countries – A Systematic Review

<div><p>Background</p><p>One potential solution to limited healthcare access in low and middle income countries (LMIC) is task-shifting- the training of non-physician healthcare workers (NPHWs) to perform tasks traditionally undertaken by physicians. The aim of this paper is to conduct a systematic review of studies involving task-shifting for the management of non-communicable disease (NCD) in LMIC.</p><p>Methods</p><p>A search strategy with the following terms “task-shifting”, “non-physician healthcare workers”, “community healthcare worker”, “hypertension”, “diabetes”, “cardiovascular disease”, “mental health”, “depression”, “chronic obstructive pulmonary disease”, “respiratory disease”, “cancer” was conducted using Medline via Pubmed and the Cochrane library. Two reviewers independently reviewed the databases and extracted the data.</p><p>Findings</p><p>Our search generated 7176 articles of which 22 were included in the review. Seven studies were randomised controlled trials and 15 were observational studies. Tasks performed by NPHWs included screening for NCDs and providing primary health care. The majority of studies showed improved health outcomes when compared with usual healthcare, including reductions in blood pressure, increased uptake of medications and lower depression scores. Factors such as training of NPHWs, provision of algorithms and protocols for screening, treatment and drug titration were the main enablers of the task-shifting intervention. The main barriers identified were restrictions on prescribing medications and availability of medicines. Only two studies described cost-effective analyses, both of which demonstrated that task-shifting was cost-effective.</p><p>Conclusions</p><p>Task-shifting from physicians to NPHWs, if accompanied by health system re-structuring is a potentially effective and affordable strategy for improving access to healthcare for NCDs. Since the majority of study designs reviewed were of inadequate quality, future research methods should include robust evaluations of such strategies.</p></div

The process of identifying relevant papers.

<p>The process of identifying relevant papers.</p

Inclusion and Exclusion Criteria.

<p>Inclusion and Exclusion Criteria.</p

Studies included in the review.

<p>*Randomised Control Trial # Cluster Randomised Control Trial.</p