Hypertension Associated with Atherosclerosis Risk Factors in Patients of Family Health Strategy Highlighting the Framingham Risk Score

The Systemic Arterial Hypertension (SAH) stands out among the chronic non-transmissible pathologies that impact the cause and/or aggravation of cardiovascular diseases (CVD) on a global level, as the disease is an underestimated disorder due to non-perceptive symptoms and associated with factors and risk markers of another CVD. Therefore, establishing the risk of progression and aggravation of the SAH, according the Framingham Risk Score (FRS), allows to reducing morbidity and improving preventative measures for DCVs. This observational and transversal study approaches the data collection of patient records at the Health Family Strategy of Senhor do Bonfim, BA, which established differences by descriptive and inferential statistical analysis (correlation and regression). The aspects of hypertension associated with risk factors for atherosclerosis were analyzed, determining the risk of developing cardiovascular events in 10 years by FRS. From 432 families, 746 patients were selected, of which 340 are hypertensive individuals (SAH = 45.57%) and 406 (NSAH = 54.42%) non-hypertensives. Among the SAH the majority (31.17%) was in the age range of 63 - 77, but, in both groups, women were in stronger number. There was greater prevalence in SAH for all the characteristics analyzed, smoking (13.20%), sedentary (29.41%) and cardiovascular accident (22.60%). The SAH group is more susceptive to the CVD progress in 10 years by FRS (P < 0.0001 ANOVA). In the NSAH group, there were significant associations among all the variables analyzed as was expected, without differences between the linear correlation and regression, indicating the physio-metabolic equilibrium of the factors and markers evaluated by FRS. Already in SAH group, despite the correlations have been significant too, the regression analysis revealed that only Total Cholesterol (P = 0.0086);LDL (P < 0.0001), Glucose (P < 0.0006) and Age (P < 0.0001) have significative association with FRS. So, these factors and markers deserve more attention upon the health staff of Health Family Strategy, in the SAH course at studied population, attempt the highest cardiovascular risk by FRS (2.5 to 2.8 times) to SAH. The monitoring of high-risk patients should prioritize the lifestyle changes, employing preventive measures to SAH and CVD and atherosclerosis.

Study on Environmental Health Strategy after Earthquake

The first task in prevention of diseases after an earthquake is to quickly provide an adequate source of safe drinking water.Otherwise,the incidence of infectious intestinal diseases in the disaster area residents will increase rapidly.Additional health measures,such as disinfecting drinking water,protecting the water source,and treating disaster area residents,must be taken at the same time.The sensory test of meat is a useful index of meat decomposition levels.Corpse alkali is a kind of toxic chemical,and personal protective measures must be taken in handling corpses.In general,all of these measures are important not only for achieving the goal of“no severe epidemic after strong earthquake disaster”in the affected areas,but also for enriching knowledge of disaster medicine.1989 Academic Press.Inc.

Insights from respiratory virus co-infections

Respiratory viral co-infections present significant challenges in clinical settings due to their impact on disease severity and patient outcomes.Current diagnostic methods often miss these co-infections,complicating the epidemiology and management of these cases.Research,primarily conducted in vitro and in vivo,suggests that co-infections can lead to more severe illnesses,increased hospitalization rates,and greater healthcare utilization,especially in high-risk groups such as children,the elderly,and immunocompromised individuals.Common coinfection patterns,risk factors,and their impact on disease dynamics highlight the need for advanced diagnostic techniques and tailored therapeutic strategies.Understanding the virological interactions and immune response modulation during co-infections is crucial for developing effective public health interventions and improving patient outcomes.Future research should focus on the molecular mechanisms of co-infection and the development of specific therapies to mitigate the adverse effects of these complex infections.

The development and application of a two-step surveillance process for Healthy China Initiative based on wide coverage interagency data

Background Healthy China is a nationwide health strategy aiming at improving health from diverse dimensions,and strengthening high-quality assessment is essential for its stimulation.However,there is limited evidence in the surveillance of the actual performance of the initiative at regional levels.This study innovatively proposes a twostep surveillance process which comprehensively monitors Healthy China Initiative based on regional realities,thus provides guidance for policymaking.Methods A flexible indicator system was firstly developed basing on Delphi survey and focus group discussions.And then the Analysis Hierarchical Process and the TOPSIS method were used to determine the weights of indicators and calculate comprehensive indexes as the surveillance outcomes.A pilot study was conducted in a typical area in China to verify the applicability of the process.Results Following the surveillance process and basing on the implementation of Healthy China Initiative in the target region,an indicator system comprised of 5 domains and 23 indicators with weights was first developed specifically for the pilot area.Then 1848 interagency data of the study area were collected from 8 provincial institutions/departments to calculate the indexes and ranks of the five domains which were health level,healthy living,disease prevention and control,health service,and healthy environment.The outcomes showed that Healthy China Initiative in the pilot area had been constantly improved since the strategy proposed,while there were still issues to be tackled such as the deficient monitoring mechanisms and unevenly development progress.Conclusions This study proposed a pragmatic surveillance process with indicators which could be tailored for specific context of target regions and produce meaningful surveillance outcomes to inform decision-making for policymakers,and also provided a theoretical foundation as well as empirical evidence for further health strategies and plannings assessment studies.

Hepatitis elimination by 2030: Progress and challenges

Globally, over 300 million people are living with viral he-patitis with approximately 1.3 million deaths per year. In 2016, World Health Assembly adopted the Global Health Sector Strategy on viral hepatitis to eliminate hepatitis by 2030. Different World Health Organization member countries are working on hepatitis control strategies to achieve hepatitis elimination. So far, only 12 countries are on track to achieve hepatitis elimination targets. The aim of the study was to give an update about the progress and challenges to achieving hepatitis elimination by 2030. According to the latest data, 87% of infants had received the three doses of hepatitis B virus （HBV） vaccination in the frst year of their life and 46% of infants had received a timely birth dose of HBV vaccination.There is a strong need to improve blood and injection safety. Rates of hepatitis B and C diagnosis are very low and only 11% of hepatitis B and C cases are diagnosed. There is a dire need to speed up hepatitis diagnosis and find the missing millions of people living with viral hepatitis. Up to 2016, only 3 million hepatitis C cases have been treated. Pricing of hepatitis C virus drugs is also reduced in many countries. The major hurdle to ach-ieve hepatitis elimination is lack of finances to support hepatitis programs. None of the major global donors are committed to invest in the fght against hepatitis. It will be very diffcult for the low and middle-income countries to fund their hepatitis control program. Hepatitis elimination needs strong fnancial and political commitment, support from civil societies, and support from pharmaceutical and medical companies around the globe.

How to improve the COVID-19 health education strategy in impoverished regions:a pilot study

Background:It is of great challenge to raise the public coronavirus disease 2019(COVID-19)related health literacy(CRHL)in impoverished regions due to the limits of poor infrastructure,large proportion of vulnerable groups,etc.However,those limits cannot be solved in the short term.Therefore,this study chose Liangshan Yi Autonomous Prefecture,one of the poorest areas in China,as a pilot,to reveal the quantitative relationships among diferent dimensions under the COVID-19 health education framework,clarify the key points for health promotion,and provide specifc suggestions for COVID-19 health education strategy in impoverished regions.Methods:A cross-sectional questionnaire survey was conducted in fve regions of Liangshan Yi Autonomous Prefecture in 2020.There were 2,100 individuals sampled by multi-stage method.This survey mainly measured the four dimensions:CRHL,COVID-19 related tense psychological reactions(CRTPR),COVID-19 related information report acquisition(CRIRA),and general health literacy(GHL).The multivariate logistic regression was used to explore the infuence of demographic characteristics on each dimension.Furthermore,to quantify the relationships among different dimensions,this study employed the structural equation model(SEM),and analyzed the mediating efects of CRHL and CRIRA as well as the moderating efects of regional characteristic variables.Results:The CRHL played an important role in promoting COVID-19 health education,reaching 52.5%in Liangshan Yi Autonomous Prefecture.The GHL(β=0.336)and age(β=0.136)had statistically positive impacts on CRHL.The CRHL afected CRTPR negatively(β=−0.198)and CRIRA positively(β=0.052).The CRHL played signifcant mediating roles among the four dimensions(P<0.05).Efectiveness of government prevention and control as well as the ethnicity moderated not only the relationships between CRHL and other dimensions,but also the mediating efect of CRHL(P<0.05).People with lower income and education levels had lower GHL(β=0.286,1.292).The youth were more likely to show CRTPR(β=−0.080).Conclusions:By proposing and verifying the theoretical framework,this study put forward specifc suggestions on how to improve COVID-19 health education strategies in impoverished regions via implementation methods,key groups and efect evaluation,which also provided references about future public health emergencies for other impoverished regions of the world.

Enhancing customers prevention efforts:An incentive feedback mechanism design

To improve the inefficient prevention caused by customers unwillingness to adopt prevention strategies in health management,an incentive feedback mechanism that is based on game theory and contract design theory is introduced.The conditions for making customers and health maintenance organizations(HMOs)willing to participate in the proposed mechanism are given.A dual nonlinear programming model is used to identify the optimal prevention effort of customers and the pricing strategy of HMOs.Results show that to generate increased benefits,HMOs need to consider cost sharing when customers are not familiar with the proposed health services.When health services are gradually accepted,the cost sharing factor can be gradually reduced.Simulation shows that under random circumstances in which the market reaches a certain size,the proposed method exhibits a positive network externality.Motivated by network externality,HMOs only need to make their customers understand that the larger the number of participants,the greater the utility of each person.Such customers may then spontaneously invite others to purchase insurance.

Comprehensive Analysis of Diabetes Mellitus-Associated Visual Impairment: Insights from Ophthalmological Screening Program in Libya

Purpose: Diabetes Mellitus (DM) is a prevalent metabolic disorder associated with significant complications, including visual impairment. This study aimed to assess the prevalence and severity of visual impairment and its associated factors in diabetic patients in Libya. Methods: This cross-sectional study included 2365 DM patients (4730 eyes). Most participants were aged 30 - 49 (38.3%) and 50 - 69 (50.8%) with a nearly equal gender distribution (47.8% males, 52.2% females). Type 2 diabetes was predominant (92.6%), and 62.9% had HbA1c levels of 7.5% or higher. Results: Diabetic retinopathy (DR) was present in 2068 eyes (43.8%), with mild non-proliferative diabetic retinopathy (NPDR) affecting 1178 eyes (25%), moderate NPDR 476 eyes (10.1%), severe NPDR 228 eyes (4.8%), and proliferative diabetic retinopathy (PDR) 186 eyes (3.9%). Diabetic maculopathy was observed in 621 eyes (13.1%), with CSME in 287 eyes (6.07%) and non-CSME in 334 eyes (7.06%). Non-retinal conditions included cataracts in 1938 eyes (41%) and glaucoma in 252 eyes (5.3%). Visual impairment was observed in 1159 patients (49%), with 534 (23%) experiencing mild impairment, 382 (18%) moderate impairment, and 243 (12%) severe impairment;142 patients (6%) were classified as legally blind. DR showed a strong association with visual impairment severity (p Conclusions: These findings underscore the urgency for targeted public health interventions to mitigate visual impairment in Libyan individuals with DM.