Trends in prevalence, awareness, treatment and control of hypertension in the Republic of Seychelles (African region) between 1989 and 2013 [Poster]

Background: Few data exist on secular trends of high blood pressure (HBP) detection and control in low and middle income countries, particularly in the African region. This study examines trends of HBP over 25 years based on 4 independent population surveys. In the Seychelles, heath care is free to all inhabitants within a national health system, inclusive all HBP medications. Previous studies have shown a transition from traditional to cardiometabolic cardiovascular risk factors in Seychelles. Age adjusted cardiovascular disease mortality rates is high but decreasing over the last two decades

Self-reported adherence and associated factors regarding antihypertensive medication in Seychelles

Introduction. Adherence to medication for asymptomatic disease is often low. We assessed factors associated with good adherence to medication for high blood pressure (HBP) in a country of the African region. Methods. A population-based survey of adults aged 25-64 years (N=1240 and participation rate=73%). Information was available in knowledge attitude and practice, SES and other variables. One question assessed adherence. Good adherence to treatment was defined as answering "I forget very rarely" vs "I forget on 1-2 days in a week" or "I forget on 3 or more days in a week". Results. In a univariate model adherence was strongly associated with belief that hypertension is a long-term disease (OR 2.6, p<0.001) and was negatively associated with concomitant use of traditional medicine (OR 0.36, p<0.005). The following variables tended to be associated with good adherence for HBP treatment: age, SES, BMI, belief that HBP is not symptomatic, going to government's clinics, medium stress level, controlled hypertension, taking statins. The following variables were not associated with good adherence for HBP treatment: education, higher BP, knowing people who had a stroke/MI, suffering from another chronic condition. In a multivariate model, pseudo R2 was 0.14. Conclusion. We built a multidimensional model including a wide range of variable. This model only predicted 14% of adherence variability. Variables associated with good adherence were demographics or related to knowledge attitude and practice. The latter one is modifiable by different type of interventions

Rapid brain discrimination of sounds of objects.

Electrical neuroimaging in humans identified the speed and spatiotemporal brain mechanism whereby sounds of living and man-made objects are discriminated. Subjects performed an "oddball" target detection task, selectively responding to sounds of either living or man-made objects on alternating blocks, which were controlled for in their spectrogram and harmonics-to-noise ratios between categories. Analyses were conducted on 64-channel auditory evoked potentials (AEPs) from nontarget trials. Comparing responses to sounds of living versus man-made objects, these analyses tested for modulations in local AEP waveforms, global response strength, and the topography of the electric field at the scalp. In addition, the local autoregressive average distributed linear inverse solution was applied to periods of observed modulations. Just 70 ms after stimulus onset, a common network of brain regions within the auditory "what" processing stream responded more strongly to sounds of man-made versus living objects, with differential activity within the right temporal and left inferior frontal cortices. Over the 155-257 ms period, the duration of activity of a brain network, including bilateral temporal and premotor cortices, differed between categories of sounds. Responses to sounds of living objects peaked approximately 12 ms later and the activity of the brain network active over this period was prolonged relative to that in response to sounds of man-made objects. The earliest task-related effects were observed at approximately 100 ms poststimulus onset, placing an upper limit on the speed of cortical auditory object discrimination. These results provide critical temporal constraints on human auditory object recognition and semantic discrimination processes

Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

BACKGROUND: Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. METHODS: The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. RESULTS: Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. CONCLUSION: Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources

Association of socioeconomic status with overall and cause specific mortality in the republic of seychelles : results from a cohort study in the african region

BACKGROUND: Low socioeconomic status (SES) is consistently associated with higher mortality in high income countries. Only few studies have assessed this association in low and middle income countries, mainly because of sparse reliable mortality data. This study explores SES differences in overall and cause-specific mortality in the Seychelles, a rapidly developing small island state in the African region. METHODS: All deaths have been medically certified over more than two decades. SES and other lifestyle-related risk factors were assessed in a total of 3246 participants from three independent population-based surveys conducted in 1989, 1994 and 2004. Vital status was ascertained using linkage with vital statistics. Occupational position was the indicator of SES used in this study and was assessed with the same questions in the three surveys. RESULTS: During a mean follow-up of 15.0 years (range 0-23 years), 523 participants died (overall mortality rate 10.8 per 1000 person-years). The main causes of death were cardiovascular disease (CVD) (219 deaths) and cancer (142 deaths). Participants in the low SES group had a higher mortality risk for overall (HR = 1.80; 95% CI: 1.24-2.62), CVD (HR = 1.95; 1.04-3.65) and non-cancer/non-CVD (HR = 2.14; 1.10-4.16) mortality compared to participants in the high SES group. Cancer mortality also tended to be patterned by SES (HR = 1.44; 0.76-2.75). Major lifestyle-related risk factors (smoking, heavy drinking, obesity, diabetes, hypertension, hypercholesterolemia) explained a small proportion of the associations between low SES and all-cause, CVD, and non-cancer/non-CVD mortality. CONCLUSIONS: In this population-based study assessing social inequalities in mortality in a country of the African region, low SES (as measured by occupational position) was strongly associated with overall, CVD and non-cancer/non-CVD mortality. Our findings support the view that the burden of non-communicable diseases may disproportionally affect people with low SES in low and middle income countries

Association between Adiposity and disability in the Lc65+ Cohort.

To examine the longitudinal association between body mass index (BMI) and waist circumference (WC) with mortality and incident disability in Lc65+ cohort. Population-based cohort of non-institutionalized adults with up to 8.9 years of follow-up. City of Lausanne, Switzerland. 1,293 individuals aged 65 to 70 at baseline (58% women). BMI, WC and covariates were measured at baseline in 2004-2005. Vital status was obtained up to the 31st December 2013 and difficulty with basic activities of daily living (BADL) was reported in a self-administered questionnaire sent to participants every year. Main outcomes were total mortality and disability, defined as difficulty with BADL for ≥2 years or institutionalization. Cox regression was used with BMI/WC quintiles 2 as the reference. 130 persons died over a median follow-up of 8.47 years (crude mortality rate, men: 16.5/1,000 person-years, women: 9.7/1,000 person-years). In Cox regression adjusted for age, sex, education, financial situation, smoking and involuntary weight loss (IWL) at baseline, mortality was significantly associated with neither BMI nor WC, but there were trends towards non-significant J-curves across both BMI and WC quintiles. Disability (231 cases) tended to increase monotonically across both BMI and WC quintiles and was significantly associated with BMI quintile 5 (HR=2.44, 95% CI [1.65-3.63]), and WC quintiles 4 (HR=1.81 [1.15-2.85]) and 5 (HR=2.58, [1.67-4.00]). Almost half of the study population had a substantially increased HR of disability, as compared to the reference BMI/WC categories. This observation emphasizes the need for life-long strategies aimed at preventing excess weight, muscle loss and functional decline through adequate nutrition and regular physical activity, starting at early age and extending throughout life

Chiral Prediction for the πN\pi N Scattering Length a−a^- to Order O(Mπ4){\cal O}(M_\pi^4)

We evaluate the S-wave pion--nucleon scattering length $a^-$ in the framework of heavy baryon chiral perturbation theory up--to--and--including terms of order $M_\pi^4$. We show that the order $M_\pi^4$ piece of the isovector amplitude at threshold, $T^-_{\rm thr}$, vanishes exactly. We predict for the isovector scattering length, $0.088 \, M_{\pi^+}^{-1} \le a^- \le 0.096 \, M_{\pi^+}^{-1}$.Comment: 5 pp, LaTeX file, 2 figures (appended as separate compressed tar file, amin.uu

The Role of the IRA in Twitter during the 2016 US Presidential Election: Unveiling Amplification and Influence of Suspended Accounts

The impact of the social media campaign conducted by the Internet Research Agency (IRA) during the 2016 U.S. presidential election continues to be a topic of ongoing debate. While it is widely acknowledged that the objective of this campaign was to support Donald Trump, the true extent of its influence on Twitter users remains uncertain. Previous research has primarily focused on analyzing the interactions between IRA users and the broader Twitter community to assess the campaign's impact. In this study, we propose an alternative perspective that suggests the existing approach may underestimate the true extent of the IRA campaign. Our analysis uncovers the presence of a notable group of suspended Twitter users, whose size surpasses the IRA user group size by a factor of 60. These suspended users exhibit close interactions with IRA accounts, suggesting potential collaboration or coordination. Notably, our findings reveal the significant role played by these previously unnoticed accounts in amplifying the impact of the IRA campaign, surpassing even the reach of the IRA accounts themselves by a factor of 10. In contrast to previous findings, our study reveals that the combined efforts of the Internet Research Agency (IRA) and the identified group of suspended Twitter accounts had a significant influence on individuals categorized as undecided or weak supporters, probably with the intention of swaying their opinions.Comment: 13 Tables, 12 Figure