Understanding the risk and protective factors associated with obesity amongst Libyan adults - a qualitative study

BACKGROUND: There are a range of multifaceted behavioural and societal factors that combine to contribute to the causes of obesity. However, it is not yet known how particularly countries' cultural norms are contributing to the global obesity epidemic. Despite obesity reaching epidemic proportions in Libya, since the discovery of oil in 1959, there is a lack of information about obesity in Libyan adults. This study sought to explore the views of key informants about the risk and protective factors associated with obesity among Libyan men and women. METHODS: A series of qualitative semi-structured interviews were conducted with Libyan healthcare professionals and community leaders. RESULTS: Eleven main themes (risk and protective factors) were identified, specifically: socio-demographic and biological factors, socioeconomic status, unhealthy eating behaviours, knowledge about obesity, social-cultural influences, Libya's healthcare facilities, physical activity and the effect of the neighbourhood environment, sedentary behaviour, Libyan food-subsidy policy, and suggestions for preventing and controlling obesity. CONCLUSIONS: Key recommendations are that an electronic health information system needs to be implemented and awareness about obesity and its causes and consequences needs to be raised among the public in order to dispel the many myths and misconceptions held by Libyans about obesity. The current political instability within Libya is contributing to a less-active lifestyle for the population due to security concerns and the impact of curfews. Our findings have implications for Libyan health policy and highlight the urgent need for action towards mitigating against the obesity epidemic in Libya

A real-world prospective study of the effectiveness and safety of automated insulin delivery compared with other modalities of type 1 diabetes treatment during Ramadan intermittent fasting

Objective: To compare the fasting experience and glycemic control during Ramadan among people with type 1 diabetes (PWT1D) who use automated insulin delivery (AID) versus other modalities of treatment. Research Design and Methods: A total of 294 PWT1D who attempted fasting during Ramadan 2022 were categorized based on treatment modality into: 1) AID (n=62); 2) Conventional pump + CGM (n=37); 3) Pump + self-monitoring of blood glucose (SMBG)(n=8); 4) Multiple daily injections (MDI) + CGM (n=155); and 5) MDI + SMBG (n=32). Predictors of fasting most days of Ramadan (i.e. breaking fast because of diabetes ≤2 days) were analyzed using uni- and multi-variable logistic regression. Results: The median numbers of days when fasting was broken because of diabetes were: 2, 5, 3, 3.5, and 2.5 for AID, conventional pump + CGM, MDI + CGM, pump + SMBG, and MDI + SMBG users, respectively(p=0.047). Users of AID had a significantly greater TIR; and lower glycemia risk index, TBR, and TAR compared to users of conventional pumps and MDI(both p<0.05). Likewise, 53% of AID users attained the “double target” of a)breaking fast because of diabetes ≤2 days and b)maintaining TIR≥70% during Ramadan compared to only 3% of the conventional pump users and 44% of the MDI + CGM users (both p<0.05). Compared to MDI + CGM users, AID users were twice as likely to complete fasting most days of Ramadan. Conclusion: Use of AID is associated with the highest rates of fasting and best glycemic control during Ramadan fasting.</p

Lean and Green Supply Chain Management: A Comprehensive Review

Companies and enterprises are becoming more and more aware of reducing their environmental impact of supply chains due to the pressures of various stakeholders; i.e. government and law enforcement bodies, customers and employees. Recently, the deployment of lean and green practices in supply chains, either sequential or consolidated, has attracted attention among academicians and practitioners. This attention is evident by the growing number of publications in scientific journals on lean and green supply chain management (LGSCM), which have been published in recent years. However the number of review papers in the literature is insufficient to present existing literature on LGSCM and provide future directions for researchers and practitioners. Hence, the aim of this paper is to review recently published papers on LGSCM in scientific journals. For this review, a total of 41 papers published between 2000 and 2017 were selected and reviewed. The papers are analyzed and categorized to present the current literature and highlight the future directions for academicians and practitioners. © Springer Nature Switzerland AG 2019