The burden is great and the money little: Changing chronic disease management in low– and middle–income countries

Many health conditions are chronic, and only some of those chronic health conditions are NCDs. If the interest is on cause and prevention, then NCDs should be treated separately from other chronic diseases. If the interest is on health systems and management, then NCDs should be joined with other chronic diseases

Work change in Multiple Sclerosis as motivated by the pursuit of illness-work-life balance: A qualitative study

Individuals with multiple sclerosis have a tendency to make early decisions for work change, even in reversible, episodic, or mild disease stages. To better understand how a multiple sclerosis (MS) diagnosis influences perceptions of work and motivations for work changes, we conducted a hermeneutic phenomenology study to explore the work lives of ten individuals with MS in Malaysia. The interpretive analysis and cumulative narratives depict an overarching change in their concept of ideal work and life aspirations and how participants make preemptive work changes to manage illness-work-life futures in subjectively meaningful ways. Discussions on their integrated pursuit of finding dynamic and subjective illness-work-life balance include reconciling the problem of hard work and stress on disease activity and progress, making positive lifestyle changes as health management behaviour, and the motivational influence of their own life and family roles: the consideration of their spouses, parents, and children. At an action level, work change was seen as moral and necessary for the management of illness futures. Our findings contribute insights on how individual perceptions and holistic life management decisions contribute to on-going and disrupted work trajectories, which can inform practice and policy on early interventions to support continued employment

Complementary feeding and the early origins of obesity risk:A study protocol

Introduction The rise in the prevalence of childhood obesity worldwide calls for an intervention earlier in the life cycle. Studies show that nutrition during early infancy may contribute to later obesity. Hence, this study is designed to determine if the variation in complementary feeding practices poses a risk for the development of obesity later in life. A mixed methods approach will be used in conducting this study.Methods and analysis The target participants are infants born from January to June 2015 in the South East Asia Community Observatory (SEACO) platform. The SEACO is a Health and Demographic Surveillance System (HDSS) that is established in the District of Segamat in the state of Johor, Malaysia. For the quantitative strand, the sociodemographic data, feeding practices, anthropometry measurement and total nutrient intake will be assessed. The assessment will occur around the time complementary feeding is expected to start (7 Months) and again at 12 months. A 24-hour diet recall and a 2-day food diary will be used to assess the food intake. For the qualitative strand, selected mothers will be interviewed to explore their infant feeding practices and factors that influence their practices and food choices in detail.Ethics and dissemination Ethical clearance for this study was sought through the Monash University Human Research and Ethics Committee (application number CF14/3850-2014002010). Subsequently, the findings of this study will be disseminated through peer-reviewed journals, national and international conferences

Gender bias in clinical case reports: A cross-sectional study of the “big five” medical journals

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420Background Gender bias in medical journals can affect the science and the benefit to patients. It has never been investigated in clinical case reports. The oversight is important because of the role clinical case reports play in hypothesis generation and medical education. We investigated contemporary gender bias in case reports for the highest ranked journals in general and internal medicine. Methods PubMed case reports data from 2011 to 2016 were extracted for the Annals of Internal Medicine, British Medical Journal, the Journal of the American Medical Association, The Lancet, and New England Journal of Medicine. The gender of the patients were identified and a text analysis of the Medical Subject Headings conducted. Results A total of 2,742 case reports were downloaded and 2,582 (95.6%) reports contributed to the final analysis. A pooled analysis showed a statistically significant gender bias against female case reports (0.45; 95%CI: 0.43–0.47). The Annals of Internal Medicine was the only journal with a point estimate (non significant) in the direction of a bias against male patients. The text analysis identified no substantive difference in the focus of the case reports and no obvious explanation for the bias. Conclusion Gender bias, previously identified in clinical research and in clinical authorship, extends into the patients presented in clinical case reports. Whether it is driven by authors or editors is not clear, but it likely contributes to and supports an overall male bias of clinical medicine.https://doi.org/10.1371/journal.pone.017738612pubpub

Diseases of Poverty: The Science of the Neglected

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420https://doi.org/10.5772/4795

Social sciences research in neglected tropical diseases 1: the ongoing neglect in the neglected tropical diseases

Centuries of scientific advances and developments in biomedical sciences have brought us a long way to understanding and managing disease processes, by reducing them to simplified cause-effect models. For most of the infectious diseases known today, we have the methods and technology to identify the causative agent, understand the mechanism by which pathology is induced and develop the treatment (drugs, vaccines, medical or surgical procedures) to cure, manage or control

The problem of ‘trickle-down science’ from the Global North to the Global South

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420The Global South desperately needs good, well-funded science; it is facing an existential crisis in the demand and supply side of that science. There is an opportunity to engage more effectively with the growing, if disempowered, talent in the Global South to support the building of enabling environments to raise the leadership, quality and volume of home grown, contextually driven and sustainable solutions. There are some very preliminary models to support this, and waiting for trickle-down science to work will only exacerbate the crisis.http://dx.doi.org/10.1136/bmjgh-2019-00171944

Predicting US state teenage birth rates using search engine query data on pregnancy termination and prevention

Daniel Reidpath - ORCID: 0000-0002-8796-0420 https://orcid.org/0000-0002-8796-0420Background To determine whether aggregated searches for pregnancy prevention or pregnancy termination predicts US State teenage birth rates. Methods US birth rate data for the 50 states, and search engine query data (Google Trends) for “condom” and “abortion” were used in an ecological analysis. Multivariable ordinary least squares regression was used to predict state-level birth rates from state-level searches for condom and abortion. Results The final model accounted for 35% of the variance (R2=0.347). Abortion and condom had similar, absolute, standardized parameters (β≈0.5). High state-levels of searches for abortion were associated with higher teenage birth rates, whereas high state-levels of searches for condom were associated with lower teenage birth rates. Conclusions Google Trends data for abortion and condom can be used to model US state-levels teenage birth rates. This raises the possibility of well targeted, accessible and relevant information for populations wanting to avoid unwanted pregnancies.https://doi.org/10.29392/joghr.2.e20180012pubpu