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   2016| April-June  | Volume 1 | Issue 1  
    Online since June 29, 2016

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WHO Global report on diabetes: A summary
Gojka Roglic
April-June 2016, 1(1):3-8
The first WHO Global Report on Diabetes was launched on World Health Day 7 th April 2016 which was dedicated to Diabetes (1). Diabetes has been described in ancient scripts and recognized as a serious illness, but it does not appear to have been frequently encountered by physicians or healers. It is in the past few decades that human health and development is increasingly affected by the rising numbers of people with this condition. Diabetes, together with cardiovascular disease, cancer and chronic respiratory disease has been targeted in the Political Declaration on the Prevention and Control of Noncommunicable Diseases (NCDs) at the Un High-level Political Meeting in 2011. In 2013 WHO member states endorsed a global monitoring framework for noncommunicable diseases, with 9 targets to be reached by 2025. Diabetes and its key risk factors are strongly reflected in the targets and indicators - reduction of exposure to unhealthy diet and physical inactivity, zero rise in the prevalence of diabetes, improved access to treatment and reduction of premature mortality. As part of the 2030 Agenda for Sustainable Development, Member States have set an ambitious target to reduce premature mortality from NCDs - including diabetes - by one third; achieve universal health coverage; and provide access to affordable essential medicines - all by 2030( http://www.un.org/sustainabledevelopment/sustainable-development-goals/).
  14,381 207 -
Contributors to academic failure in postsecondary education: A review and a Canadian context
Tricia L da Silva, Arun V Ravindran
April-June 2016, 1(1):9-17
Postsecondary enrollment has been rising globally over the past years, but poor performance and drop-out have also been increasing and have become an academic concern. Most drop-outs tend not to return, which significantly affects their future prospects. Postsecondary student populations are a diverse mix of local, immigrant, and international students but it is unclear if reasons for academic failure differ between groups. The aim of this review was to examine the published literature for contributors to postsecondary academic failure, including drop-out, among local, immigrant, and international students. A search of the literature was conducted using PubMed, ProQuest, EBSCOHOST, and PsycINFO on the topic for all articles published in English up to March 2016. The results showed that almost all data come from the Western countries. Several personal, sociocultural, and academic factors appear to be associated with postsecondary failure among all students. These include gender, low academic engagement, stress, psychological difficulties, low social support, and poor coping abilities. Immigrant and international students face additional challenges, such as loss of social networks, discrimination, acculturation, and language challenges. Limitations of the data include the relatively small body of literature (particularly from low- and middle-income countries), and lack of subgroup comparisons, such as of local, immigrant and international students. Clarification of the relative contribution of these factors to academic failure will facilitate the development of effective retention strategies, particularly those that focus on addressing psychological distress and building resilience.
  3,341 33 -
Assessment and barriers to medication adherence for secondary prevention of cardiovascular disease among patients with coronary artery disease in Chandigarh, India
Jarnail S Thakur, Rajesh Vijayvergiya, Nidhi Jaswal, Amy Ginsburg
April-June 2016, 1(1):37-41
Context: Medication adherence is critical for the secondary prevention of cardiovascular disease (CVD). Nonadherence to prescribed treatment is associated with adverse health outcomes and higher costs of care. Aims: The present study aimed to assess medication adherence among patients diagnosed with coronary artery disease (CAD) in Chandigarh, India. Settings and Design: This cross-sectional study was conducted in five different hospitals or health centers of Chandigarh. Materials and Methods: The standardized Morisky Medication Adherence Scale-8 item was used to assess medication adherence among adult patients with CAD seen during a visit to major tertiary hospitals, secondary and primary health-care center in Union Territory, Chandigarh. In a separate qualitative study, barriers and facilitators to adherence were assessed through twenty in-depth interviews (ten males and ten females) and one focus group discussion. Statistical analysis was completed using SPSS 16.0 software and simple frequencies and proportions were computed. Results: A total of 260 patients were included in the cross-sectional survey, of which 70.4% were males with a mean age of 58.61 years. More than half (52.7%) of the respondents were from the age group of 41 to 60 years. Low to medium adherence to treatment was observed in about half (47.3%) of the respondents with low adherence among females. Adherence was better in a tertiary hospital as compared to the primary or secondary facility. Provider barriers and access to drugs due to cost barriers were found to be major barriers to treatment adherence in the in-depth interviews. Conclusions: Medication adherence to the secondary prevention of CVD among the CAD patients surveyed in Chandigarh, India, is poor and increased access to essential drugs and improved provider-patient communication is required.
  2,587 91 -
Assessing health workers' capacity for the prevention and control of noncommunicable diseases in Haroli health block of district Una in Himachal Pradesh, India: A mixed methods approach
Gopal Chauhan, JS Thakur
April-June 2016, 1(1):26-29
Background: Noncommunicable diseases (NCDs) account for 60% of the total deaths in India. The National Program for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) is operational in selected districts of India since 2009-2010. Health workers (HWs) are the key stakeholders in the implementation of NPCDCS at community level. Keeping in view the dismal progress of the program implementation in existing districts, it is evident to assess the capacities of the HWs before rolling out the program in new districts. Methodology: This cross-sectional study was conducted in 2015 on all the existing 69 HWs of Haroli Health Block of district Una in Himachal Pradesh. The district is still not covered under NPCDCS. The study tools consisted of self-administered questionnaire, observational findings, and focused group discussions. Results: The HWs capacities for the prevention and control of NCDs are about 26% less than the baseline required as per their perception (mean 3.69, standard deviation [SD] ±0.26). Supportive supervision, trainings, workload, and management information system are the key factors affecting the capacity. Observational finding shows a gap of 39% in their skills (mean 1.83 SD ± 0.06). The health promotional skills and follow-up practices are improving with the working experience of HWs. Conclusions: The capacity of HWs for the prevention and control of NCDs in the selected health block in a district is poor and must be assessed before rolling out NPCDCS in a new district. Special focus shall be given to supportive supervision, training, and management information system.
  2,397 163 -
Economic burden of coronary heart disease in North India
Akashdeep Singh Chauhan, Kanchan Mukherjee
April-June 2016, 1(1):18-25
Background: The treatment of chronic diseases like coronary heart disease (CHD) is expensive and can consume a significant portion of household's income, leading to catastrophic effects on families, particularly those of low socioeconomic status. Methodology: This was a cross-sectional study carried out in a private super specialty hospital and a government tertiary care hospital. Nonprobability purposive sampling method was used to collect primary data from a sample of 102 households; having a member suffering from CHD. Economic burden was assessed regarding average out of pocket (OOP) expenditure and prevalence of distress financing (DF) (borrowings or selling of assets) among the households. Results: Average OOP expenditure among those having an episode of hospitalization and those who got treated in outpatient department sessions only was INR 243,606 and INR 48,578, respectively. This expenditure was statistically higher (P < 0.5) for richest than the poorest households. However this expenditure as a proportion of annual household consumption expenditure was highest for the poorer than the richest (P < 0.5). Expenses were reported higher for those who got treatment in private hospital as compared to government hospital by 26%. The prevalence of DF came out to be 38.2% with poorest reporting higher percentage of 67% as compared to 4% in richest households. Conclusion: There is a need to consider the rising OOP expenditure for the treatment of chronic conditions like CHD. There is a need to develop health financing systems that improve the financial risk protection for those requiring treatment.
  2,277 85 -
Prevalence, awareness, treatment, and control of hypertension in patients with type 2 diabetes: A cross-sectional survey among middle-aged people in China
Zengwu Wang, Xin Wang, Zuo Chen, Linfeng Zhang, Manlu Zhu
April-June 2016, 1(1):30-36
Objective: To assess the prevalence, awareness, treatment, and control of hypertension and their associated factors in patients with type 2 diabetes. Methods: A cross-sectional survey across China, including 12,000 participants aged 35-64 years, was conducted in 2009-2010. Data were collected by using questionnaires, blood pressure (BP) measurement, and laboratory test. About 11,623 participants fitted the inclusion. Diabetes was defined as fasting glucose at least 7.0 mmol/L, and/or use of insulin, and/or oral antidiabetic drug. For diabetic participants, hypertension was considered to be controlled if the average BP was <130/80 mmHg. Results: Overall, there were 1063 patients with diabetes (9.2%). The prevalence of hypertension among the patients with diabetes was 59.6%. Among the hypertensive patients (n = 633), 57.5% were aware of their condition, 41.7% received treatment, and only 3.8% had their BP adequately controlled. Age, region, body mass index (BMI), and family hypertension history were correlated with the prevalence, awareness, treatment, and control of hypertension among patients with diabetes. Conclusion: The prevalence of hypertension among patients with diabetes was higher whereas the control was lower. Age, BMI, and family hypertension history were significantly associated with hypertension.
  2,153 61 -
Birth of a new journal to enable implementation of global noncommunicable diseases prevention and control
Arun Chockalingam, Jarnail Singh Thakur, Anand Krishnan, Rakesh Kapoor, Ashutosh Nath Aggarwal
April-June 2016, 1(1):1-2
  1,754 40 -
A novel device for postburn scar release surgery: Physical therapy
Vikram Singh Chauhan, Jana P Lim, Kimberley Souza, Lawrence Cai
April-June 2016, 1(1):42-43
  1,479 28 -