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Risk Perceptions of Noncommunicable Diseases among Cambodian Adults: A Cross-Sectional Study
... However, there was inconsistent evidence on perceived susceptibility to NCDs as a predictor of screening utilisation. Some literature showed higher perceived susceptibility as a more robust predictor [34] while other findings did not support that claim [35][36][37]. However, one intervention conducted in the United States reported that individuals utilised screening services more after their risk perception improved [38]. ...
Background
Healthy Lifestyle Centres (HLCs) are state-owned, free-of-charge facilities that screen for major noncommunicable disease risks and promote healthy lifestyles among adults older than 35 years in Sri Lanka. The key challenge to their effectiveness is their underutilisation. This study aimed to describe the underutilisation and determine the factors associated, as a precedent of a bigger project that designed and implemented an intervention for its improvement.
Methods
Data derived from a community-based cross-sectional study conducted among 1727 adults (aged 35 to 65 years) recruited using a multi-stage cluster sampling method from two districts (Gampaha and Kalutara) in Sri Lanka. A prior qualitative study was used to identify potential factors to develop the questionnaire which is published separately. Data were obtained using an interviewer-administered questionnaire and analysed using inferential statistics.
Results
Forty-two percent (n = 726, 95% CI: 39.7–44.4) had a satisfactory level of awareness on HLCs even though utilisation was only 11.3% (n = 195, 95% CI: 9.80–12.8). Utilisation was significantly associated with 14 factors. The five factors with the highest Odds Ratios (OR) were perceiving screening as useful (OR = 10.2, 95% CI: 4.04–23.4), perceiving as susceptible to NCDs (OR = 6.78, 95% CI: 2.79–16.42) and the presence of peer support for screening and a healthy lifestyle (OR = 3.12, 95% CI: 1.54–6.34), belonging to the second (OR = 3.69, 95% CI: 1.53–8.89) and third lowest (OR = 2.84, 95% CI: 1.02–7.94) household income categories and a higher level of knowledge on HLCs (OR = 1.31, 95% CI: 1.24–1.38). When considering non-utilisation, being a male (OR = 0.18, 95% CI: 0.05–0.52), belonging to an extended family (OR = 0.43, 95% CI: 0.21–0.88), residing within 1–2 km (OR = 0.29, 95% CI: 0.14–0.63) or more than 3 km of the HLC (OR = 0.14, 95% CI: 0.04–0.53), having a higher self-assessed health score (OR = 0.97, 95% CI: 0.95–0.99) and low perceived accessibility to HLCs (OR = 0.12, 95% CI: 0.04–0.36) were significantly associated.
Conclusion
In conclusion, underutilisation of HLCs is a result of multiple factors operating at different levels. Therefore, interventions aiming to improve HLC utilisation should be complex and multifaceted designs based on these factors rather than merely improving knowledge.
Background
India faces a high burden of diabetes and hypertension. Currently, there is a dearth of economic evidence about screening programmes, affected age groups, and frequency of screening for these diseases in Indian settings. We assessed the cost effectiveness of population-based screening for diabetes and hypertension compared with current practice in India for different scenarios, according to type of screening test, population age group, and pattern of health-care use.
Methods
We used a hybrid decision model (decision tree and Markov model) to estimate the lifetime costs and consequences from a societal perspective. A meta-analysis was done to assess the effectiveness of population-based screening. Primary data were collected from two Indian states (Haryana and Tamil Nadu) to assess the cost of screening. The data from the National Health System Cost Database and the Costing of Health Services in India study were used to determine the health system cost of diagnostic tests and cost of treating diabetes or hypertension and their complications. A total of 962 patients were recruited to assess out-of-pocket expenditure and quality of life. Parameter uncertainty was evaluated using univariate and multivariable probabilistic sensitivity analyses. Finally, we estimated the incremental cost per quality-adjusted life-year (QALY) gained with alternative scenarios of scaling up primary health care through a health and wellness centre programme for the treatment of diabetes and hypertension.
Findings
The incremental cost per QALY gained across various strategies for population-based screening for diabetes and hypertension ranged from US0·03 million. At the current pattern of health services use, none of the screening strategies of annual screening, screening every 3 years, and screening every 5 years was cost-effective at a threshold of 1-time per capita gross domestic product in India. In the scenario in which health and wellness centres provided primary care to 20% of patients who were newly diagnosed with uncomplicated diabetes or hypertension, screening the group aged between 30 and 65 years every 5 years or 3 years for either diabetes, hypertension, or a comorbid state (both diabetes and hypertension) became cost-effective. If the share of treatment for patients with newly diagnosed uncomplicated diabetes or hypertension at health and wellness centres increases to 70%, from the existing 4% at subcentres and primary health centres, annual population-based screening becomes a cost saving strategy.
Interpretation
Population-based screening for diabetes and hypertension in India could potentially reduce time to diagnosis and treatment and be cost-effective if it is linked to comprehensive primary health care through health and wellness centres for provision of treatment to patients who screen positive.
Funding
None.
Background: Soft drinks are an attractive and popular drink, consumed by many people to fulfill their energy. However, soft drink consumption is an important risk factor for non-communicable diseases. This study aimed to investigate the association between socioeconomic factors and soft drink consumption among adults in Cambodia.
Methods: A cross-sectional analytical study with multi-stage random sampling was used to select 749 respondents from 12 communes across 5 districts in Phnom Penh, the capital city of Cambodia. A structured questionnaire was used to assess socioeconomic factors and soft drink consumption. Data were analyzed using bivariate and multivariable logistic regression. Crude odds ratios and adjusted odds ratios (AORs) with 95% confident intervals (CI) were calculated to show the strength of associations.
Results: The overall prevalence of soft drink consumption was 44.73% (95%CI: 41.16-48.30%) across the sample population. The final model of multiple logistic regression showed only four factors to be significantly associated with soft drink consumption: gender, age, family size and income. Respondents most likely to consume soft drinks were men (AOR: 1.49, 95%CI: 1.10-2.00; p=0.009), those aged 31-59 years (AOR: 1.93, 95%CI: 1.98-4.62; p<0.001), those in a household of less than 5 individuals (AOR: 1.38, 95%CI: 1.44-3.19; p=0.036), and those earning <300$/month (AOR: 1.59, 95%CI: 1.10-2.31; p=0.003).
Conclusion: The prevalence of soft drink consumption in Cambodia is a major concern for public health. The predictive factors significantly associated with soft drink consumption identified by this study were gender, age, household size and income. Therefore, all stakeholders should contribute to social marketing and intervention focusing on reducing the consumption of soft drinks through advertising on social media, television and other popular media platforms. Furthermore, additional taxation of soft drinks should be considered.
Background
Increasing demands on Canada’s healthcare system require patients to take on more active roles in their health. Effective self-management has been linked to improved health outcomes; and there is evidence that effective behaviors, and subsequent healthcare utilization, are linked to self-efficacy and health literacy; however, this link has had minimal testing in the cancer context. Our aim is to examine the association between self-efficacy, health literacy, chemotherapy self-management behaviors, and health service utilization.
Design and methods
A cross-sectional survey that included validated measures of self-efficacy, health literacy, chemotherapy self-management, and health service utilization was completed by participants (N = 213). Multivariable modeling using hierarchical linear regression was used to examine the association between variables.
Results
Self-efficacy contributed significantly to explaining variation in chemotherapy self-management score. Health literacy was not significantly associated with any of the dependent variables.
Conclusion
Participants with higher self-efficacy had higher chemotherapy self-management scores compared to participants with low self-efficacy. Contrary to evidence in the chronic disease self-management literature, this study demonstrated that health literacy was not associated with chemotherapy self-management behavior nor was it associated with self-efficacy. Building patient self-efficacy in the context of chemotherapy self-management could be particularly helpful both in the cancer center and in the domain of oral chemotherapy management at home where patients are required to take on significant responsibility for self-management.
Objective:
Iran has a low incidence of cervical cancer (CC). The country is introducing an organized screening system, including human papillomavirus screening. Studies show a high dropout rate among eligible women in continuing testing.
Methods:
This descriptive-analytic study was part of the first phase of a clinical trial conducted on a random sample of 400 women aged 18-49 in Andimeshk City, Khuzestan Province, in 2020. The data collection tool consisted of a man-made questionnaire that included domains of demographic characteristics, knowledge, attitude, practice, and self-efficacy in the Pap smear test. The data were analyzed with Stata-16 using linear and logistic regression models.
Results:
The mean knowledge, attitude, and self-efficacy scores were 6.80±2.33, 34.99±4.32, and 28.67±7.34, respectively. In the multiple models, every unit increase in the knowledge or attitude scores raised the mean self-efficacy score by 1.04 and 0.48, respectively (P<0.001). Every unit increase in the knowledge and self-efficacy scores increased the chance of performing Pap smear 1.61 and 1.41 times, respectively (P<0.001).
Conclusion:
Given the association of women's knowledge and self-efficacy with practice in performing the Pap smear, it seems that an effective program promoting women's health behavior regarding CC screening would include applied education to raise community awareness and improve women's attitudes, self-efficacy, and practice.
Background: Soft drinks are an attractive and popular drink, consumed by many people to fulfill their energy. However, soft drink consumption is an important risk factor for non-communicable diseases. This study aimed to investigate the association between socioeconomic factors and soft drink consumption among adults in Cambodia.
Methods: A cross-sectional analytical study with multi-stage random sampling was used to select 749 respondents from 12 communes across 5 districts in Phnom Penh, the capital city of Cambodia. A structured questionnaire was used to assess socioeconomic factors and soft drink consumption. Data were analyzed using bivariate and multivariable logistic regression. Crude odds ratios and adjusted odds ratios (AORs) with 95% confident intervals (CI) were calculated to show the strength of associations.
Results: The overall prevalence of soft drink consumption was 44.73% (95%CI: 41.16-48.30%) across the sample population. The final model of multiple logistic regression showed only four factors to be significantly associated with soft drink consumption: gender, age, family size and income. Respondents most likely to consume soft drinks were men (AOR: 1.49, 95%CI: 1.10-2.00; p=0.009), those aged 31-59 years (AOR: 1.93, 95%CI: 1.98-4.62; p<0.001), those in a household of less than 5 individuals (AOR: 1.38, 95%CI: 1.44-3.19; p=0.036), and those earning <300$/month (AOR: 1.59, 95%CI: 1.10-2.31; p=0.003).
Conclusion: The prevalence of soft drink consumption in Cambodia is a major concern for public health. The predictive factors significantly associated with soft drink consumption identified by this study were gender, age, household size and income. Therefore, all stakeholders should contribute to social marketing and intervention focusing on reducing the consumption of soft drinks through advertising on social media, television and other popular media platforms. Furthermore, additional taxation of soft drinks should be considered.
Background
Non-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs).
Methods
A systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD intervention delivery to conflict-affected women or children in LMICs were included. A grey literature search of 10 major humanitarian organisation websites for publications dated between 1 January 2013 and 30 November 2018 was also conducted. We extracted and synthesised information on intervention delivery characteristics and delivery barriers and facilitators.
Results
Of 27 included publications, most reported on observational research studies, half reported on studies in the Middle East and North Africa region and 80% reported on interventions targeted to refugees. Screening and medication for cardiovascular disease and diabetes were the most commonly reported interventions, with most publications reporting facility-based delivery and very few reporting outreach or community approaches. Doctors were the most frequently reported delivery personnel. No publications reported on intervention coverage or on the effectiveness of interventions among women or children. Limited population access and logistical constraints were key delivery barriers reported, while innovative technology use, training of workforce and multidisciplinary care were reported to have facilitated NCD intervention delivery.
Conclusion
Large and persistent gaps in information and evidence make it difficult to recommend effective strategies for improving the reach of quality NCD care among conflict-affected women and children. More rigorous research and reporting on effective strategies for delivering NCD care in conflict contexts is urgently needed.
PROSPERO registration number
CRD42019125221
Objective
To determine the association between the perceptions on obesity of Saudi university students and their Physical Activity (PA) as measured by Metabolic Equivalents (METs) Score.
Methods
This study utilized an analytical cross-sectional design. The level of perception on obesity was determined based on the responses to the Obesity Health Belief Model questionnaire while the Global Physical Activity Questionnaire (GPAQ) was used to measure the students’ activity levels. Students with METs scores of less than 600 were classified as inactive. Descriptive and inferential statistics were computed using Epi Info version 7.
Results
Majority (75.54%) of participants had a high level of perception of the seriousness of obesity. Only half of the participants had a high level of the perception of susceptibility towards becoming obese. Although most (93.53%) of the students had a high level of perception of the benefits of physical activity on obesity prevention, 98.2% had a moderate to high perception of the barriers to engage in physical activity. The prevalence of physical inactivity was 44.6% (95% CI: 38.67 - 50.66%) and was higher among female (51.71%) than male (24.66%) students. There was a positive linear relationship between the university students’ perception of obesity and their level of physical activity with a β coefficient = 72.6 ( p value = 0.0003).
Conclusion
Saudi university students have a high perception of the seriousness of obesity and the benefits of physical activity towards obesity prevention; however, only half of them believe that they are susceptible to becoming obese. The students’ perceptions of obesity influence their physical activity.
Background: This study was conducted to enumerate the results of screening for non-communicable diseases in the NCD clinic over a period of one year in a tertiary health centre.Methods: The results from screening tests conducted in the NCD clinic, for detecting hypertension, diabetes mellitus, breast cancer and cervical cancer, in Government tertiary care Hospital for Women, Chennai, were recorded. The flowchart and screening methods followed were those recommended by the NHM - NPCDCS. Data thus obtained was analyzed using standard statistical methods.Results: Of 42,519 women screened for common non communicable diseases - hypertension, diabetes mellitus, breast cancer and cervical cancer, nearly 5.55% women (n = 2359) had positive results, for any one of the diseases screened. Of 11,708 women screened for diabetes mellitus and 13,971 screened for hypertension, positive results were found in 856 women and 1,216 women respectively. Around 7,568 women were screened for cervical cancer and 175 women tested positive. A large number of 9,272 women were screened for breast cancer and 112 women had positive results. As per the guidelines, women who tested positive for screening tests were referred to the concerned departments in RGGGH.Conclusions: Nearly 42,519 women were screened for common non-communicable diseases (NCDs) - hypertension, diabetes mellitus, breast cancer and cervical cancer, and 5.55% women had positive test results for any one of the diseases screened. The screening revealed, 8.7% of women had raised blood pressure, 7.31% had raised blood sugar levels, 1.21% women had positive screening test results for breast cancer, and 2.31% women for cervical cancer.
Objective: To determine if the tenets of the health belief model explain exercise behavior among residents of Kakamega county. Design: The study design was a cross-sectional analytical, that utilized quantitative methods. Setting: The study was conducted in Kakamega County, located in Western Kenya. Kakamega County has twelve sub-counties; Kakamega North (Malava), Kakamega Central (Lurambi), Kakamega South (Ikolomani), Kakamega East (Shinyalu) and Butere/Mumias. Sample: Simple random sampling was used to sample respondents. The formula that was used for calculating the sample size was Cochran with an attrition rate of 10% (n = 221). The sample consisted of participants from five sub-counties of Kakamega: Kakamega central (23.1%), Kakamega south (22.6%), Kakamega east (22.2%), Butere (17.5%) and Kakamega north (14.5%) Analysis: Data were analyzed through structural equation modeling (SEM). The alpha level for all the computations was considered significant at an α <0.05. Main outcome measures: Perceived susceptibility, modifying factors, perceived threat, perceived severity, cues to action and exercise behavior Results: The measurement model included six latent constructs measured by 22 indicator variables. All of the completely standardized parameter estimates obtained were significantly different from zero (t > 1.96) and loaded satisfactorily onto their corresponding latent variable. In the structural model, the estimation of this hypothesized structural model yielded an acceptable fit to the data, χ2 =1434.7, df = 680; χ2/df ratio =2.453(good), CFI = .822; RMSEA = .059, with 90% C.I. = .045 - .075, SRMR = .058. The perceived threat was a direct predictor of exercise behavior (β = .294, p < .001), the variable formed by perceived benefits minus perceived barriers was a direct predictor of exercise behavior (β = .017, p <.001). All variables explained 57% of the variance in exercise behavior. Conclusion: The health belief model provided useful insight in explaining exercise behavior of the respondents. Other theories should be investigated (e.g. Social Cognitive Theory, Health Action Process Approach) to determine which theory better explains behavior in the context and population of interest.
Background:
The Sustainable Development Goals (SDGs) are seen in most corners as the embodiment of a more inclusive and holistic development approach, key to addressing the numerous and urgent challenges the world faces. In the health realm, a true SDG approach will require a five-fold paradigm shift according to Buse and Hawkes. This article explores whether early traces of this paradigm shift can already be witnessed in the Indian context, focusing on Non-Communicable Diseases (NCDs) more in particular.
Discussion:
By now, NCDs make up a large health burden in India, both individually and on the health system. Inspired by an SDG vision, tackling NCDs will require a comprehensive approach rooted in preventive, curative and rehabilitative services. In India, some early momentum in this respect can already be witnessed, certainly in addressing the first two challenges identified by Buse and Hawkes, leadership and intersectoral coherence, and a shift from treatment to prevention. A central plan addressing health through an inter-sectoral approach has shaped the trajectory so far, moving away from silos to engagement with sectors beyond health. New guidelines addressing comprehensive primary healthcare propose a community outreach and preventive approach for NCDs. At a broader level, NCD prevention is also closely linked to tackling the so called "commercial determinants of health" and will require among others strong (central and state level) regulation, teaming up with global advocacy networks and capitalizing on global frameworks, where they exist. Strong political leadership will be indispensable for this, and is according to Buse and Hawkes closely linked to seeing health as a right and the government as accountable when it comes to providing for the right to health through its policies and actions.
Conclusion:
National stewardship will thus be key, via a more adaptive network governance structure with the central level coordinating with the state level to ensure implementation, while also engaging with other stakeholders, sectors, the private sector and civil society. As one can expect, networked governance, necessary for the battle against NCDs, is a work in progress in India. In sum, some of the early (paradigm shift) signs are encouraging, but by and large it is still too early to assess whether a real paradigm shift has taken place.
Background. Non-communicable diseases (NCDs) in South Africa (SA) occur simultaneously with an ageing HIV-positive population, resulting in premature deaths in persons <70 years of age. Poor risk perception of NCDs results in poor adoption practices of NCD preventive measures. There is a gap in age-related research regarding risk perceptions of NCDs among the SA population.
Objective. To investigate age-group differences in risk perceptions of NCDs based on the Health Belief Model.
Methods. This cross-sectional design used secondary data obtained from Community AIDS Response (CARe), Johannesburg, SA. Data were collected by means of a cross-sectional survey in Extension 2 (Blocks I, J, K and L) of Diepsloot township, Johannesburg, SA. The Pearson χ2 test of independence was used to examine the relationship between age groups and risk perceptions of NCDs. A p<0.05 value was considered statistically significant.
Results. A total of 2 135 participants were included in the analysis, of whom 71.5% were young adults (18 - 35 years). The mean age of the study participants was 32.1 (standard deviation 9.87) years. Significant associations were found between age groups and risk perceptions of NCDs. More middle-aged adults than young adults and older-aged adults perceived family history (74.00% v. 72.74% v. 62.39%, p=0.045) and smoking (83.80% v. 77.20% v. 74.31%, p=0.004) as risk factors that would increase their risk of NCDs. A higher proportion of older-aged adults than young adults and middle-aged adults perceived effects on life and family (89.91% v. 77.39% v. 75.40%, p=0.004) as risks of NCD morbidities. More middle-aged adults than young adults and older-aged adults perceived the usefulness of not smoking (84.60% v. 81.06% v. 74.31%, p=0.028) as an effective NCD preventive measure. More young adults than middle-aged and older-aged adults considered health check-ups (59.31% v. 58.00% v. 41.28%, p=0.001) as a time-consuming process to prevent risks of NCDs.
Conclusion. Young adults had poorer risk perceptions of NCDs than middle-aged and older-aged adults in Diepsloot township, resulting in poor practice of NCD preventive measures among young adults in the area. This may be due to the misunderstanding of the concept of invulnerability, possibly resulting from the limited access and exposure to NCD-related information among young adults compared with middle-aged and older-aged groups. This highlights the need to expand public health education programmes to increase outreach to the young adult population and increase accessibility to information relating to NCD risks, and encourage adoption of NCD preventive measures.
Non-communicable diseases (NCDs) are emerging as a public health issue in sub-Saharan Africa. This paper examines the relationship between the risk of NCDs and perceptions about such risk among urban slum population in Nairobi, Kenya. The analysis is based on data collected between 2008 and 2009 as part of a cross-sectional survey that was designed to assess linkages between socioeconomic status, perceived personal risk, and risk factors for cardiovascular and non-communicable diseases in urban slums of Nairobi. A total 5,190 study participants were included in the analysis. Low risk perception about NCDs in spite of the presence of NCD risk factors suggests the need for programmes aimed at creating awareness about the diseases and promoting the adoption of preventive healthy lifestyles among the urban poor populations of Nairobi
•Collecting data in one language and presenting the findings in another involves researchers taking translation-related decisions that have a direct impact on the validity of the research and its report.
•Factors which affect the quality of translation in social research include: the linguistic competence of the translator/s; the translator’s knowledge of the culture of the people under study; the autobiography of those involved in the translation; and the circumstances in which the translation takes place.
•There is a need for social researchers who have to translate data from one language to another to be explicit in describing their choices and decisions, translation procedures and the resources used
Using the weight efficacy lifestyle questionnaire (WEL), we examined whether a group-mediated intervention for weight loss among older, obese adults resulted in changes in self-regulatory self-efficacy for eating behavior and whether these changes mediated weight loss.
This was a randomized controlled design, and 288 older adults received 1 of 3 treatments for 6 months: physical activity only (PA), weight loss + physical activity (WL + PA), or a successful aging (SA) health education program. The WEL was administered prior to randomization and again at the 6-month follow-up visit.
A significant treatment effect was observed for the WEL, F (2249) = 15.11, p < .0001, partial eta2 = .11, showing that improvement occurred only in the WL + PA group as compared with PA and SA. Changes in WEL scores partially mediated the effects of the WL + PA intervention on weight loss.
These results illustrate that WL + PA can be effective in improving older adults' self-efficacy for the self-regulation of eating behavior and that these changes are prospectively related to the amount of weight loss. Further research is warranted on an expanded concept of self-efficacy as well as controlled experimental studies on eating behavior in older adults.
G*Power is a free power analysis program for a variety of statistical tests. We present extensions and improvements of the version introduced by Faul, Erdfelder, Lang, and Buchner (2007) in the domain of correlation and regression analyses. In the new version, we have added procedures to analyze the power of tests based on (1) single-sample tetrachoric correlations, (2) comparisons of dependent correlations, (3) bivariate linear regression, (4) multiple linear regression based on the random predictor model, (5) logistic regression, and (6) Poisson regression. We describe these new features and provide a brief introduction to their scope and handling.
Objective
To investigate the relationship between health beliefs and preventive behaviors against noncommunicable diseases (NCDs).
Methods
A survey was conducted in Health Management Center of the First Affiliated Hospital of Fujian Medical University from August 2019 to December 2019. An structured questionnaire was designed to collect the data on sociodemographic characteristics, health belief model (HBM) constructs and NCD-related behaviors. Structural equation model was used to describe the relationship between health beliefs and the behaviors.
Results
Among 4453 participants, the most common unhealthy behaviors were sedentary living and working, mood disorders and staying up late. Female, aging, living in urban areas, good physical health were associated with healthy behaviors. HBM constructs including perceived barriers, self-efficacy, cues to action, perceived benefits, perceived severity, and perceived susceptibility were directly or indirectly related to NCD-related behaviors. Perceived barriers (effect coefficient=0.495) and self-efficacy (effect coefficient=0.435) were found to have the greatest impact on the behaviors.
Conclusion
Health beliefs are verified to be associated with preventive behaviors against NCDs.
Practice implications
Changing sedentary living and working, mood disorders and staying up late are the top priority of health education. Health education based on HBM, especially focusing on helping overcome difficulties and building confidence of behavior change, may be more effective for the prevention of NCDs.
Context: Energy drinks are the fastest growing product in the beverage industry. However, there is concern regarding potential for adverse effects with use.
Objective: To evaluate the reported adverse effects of energy drink consumption.
Data Sources: The electronic databases MEDLINE, EMBASE, and PubMed were searched for relevant studies from inception to November 2019, and pertinent data were abstracted.
Study Selection: Only clinical studies reporting adverse events after energy drink consumption were included.
Study Design: Systematic review.
Level of Evidence: Level 4.
Data Extraction: Data regarding sample size characteristics, energy drink characteristics, comparators, and all adverse events were extracted in duplicate and recorded.
Results: A total of 32 studies and 96,549 individuals were included. Frequently reported adverse events in the pediatric population were insomnia (35.4%), stress (35.4%), and depressive mood (23.1%). Frequently reported adverse events in the adult population were insomnia (24.7%), jitteriness/restlessness/shaking hands (29.8%), and gastrointestinal upset (21.6%). Alcohol mixed with energy drinks significantly reduced the likelihood of sedation effects but increased the likelihood of stimulatory effects. Energy drink consumption significantly increased the odds of insomnia (OR, 5.02; 95% CI, 1.72-14.63) and jitteriness/activeness (OR, 3.52; 95% CI, 1.28-9.67) compared with the control group.
Conclusion: The authors recommend that individuals avoid frequent energy drink consumption (5-7 energy drinks/week) and avoid co-consumption with alcohol; increased regulatory standards should be placed in the sale of energy drinks, particularly with regard to the pediatric population.
Non-communicable diseases are no longer largely limited to high-income countries and the elderly. The burden of non-communicable diseases is rising across all country income categories, in part because these diseases have been relatively overlooked on the global health agenda. Historically, communicable diseases have been prioritized in many countries as they were perceived to constitute the greatest disease burden, especially among vulnerable and poor populations, and strategies for prevention and treatment, which had been successful in high-income settings, were considered feasible and often affordable in low-income settings. This prioritization has reduced the communicable diseases burden globally but has left non-communicable diseases largely neglected. A new approach is urgently needed to tackle non-communicable diseases. Based on an analysis of potential features which may have underlain the different approaches to non-communicable diseases and communicable diseases until now, including acuity of disease, potential for control or cure, cost, infectiousness, blaming of individuals and logistical barriers, little ethical or rational justification can be found to support continued neglect of non-communicable diseases. Justice demands access to quality and affordable care for all. An equitable approach to non-communicable diseases is therefore strongly mandated on medical, ethical, economic, and public health grounds. Funding must not however be diverted away from communicable diseases, which continue to require attention—but concomitantly, funding for noncommunicable diseases must be increased. International and multi-sectoral action is required to accelerate progress towards true universal health coverage and towards achievement of all of the sustainable development goals, such that prevention and access to care for non-communicable disease can become a global reality.
Cholangiocarcinoma (CCA) is a neoplasm known as one of the most common causes of cancer-related deaths in Southeast Asia, particularly in Thailand, Laos, and Cambodia. Prevention and health education are required. Therefore, this study aimed to determine the effectiveness of an educational intervention to prevent CCA among a rural population in Thailand based on the health belief model (HBM) and self-efficacy frameworks. In this quasi-experimental study, 60 participants (30 participants in the experimental group and 30 participants in the control group) were selected in 2017. The educational intervention for the experimental group consisted of seven training sessions (introduction to CCA, risk factors, complications, benefits and barriers to proper consumption of cooked fish, carcinogenic agents, behavioral protection, and self-efficacy in applying preventive behaviors). A questionnaire that consisted of demographic information, knowledge, and HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy) was used to measure CCA preventive behaviors before and 3 months after the intervention. Data were analyzed using SPSS-22 via chi-squared, paired t-tests, and independent samples t tests at a significance level of 0.5. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and CCA preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and self-efficacy in the adoption of CCA preventive behaviors 3 months post intervention in the risk group. Thus, these models may serve as a framework for designing and implementing educational interventions for the prevention of CCA.
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