Importance of regional differences in the features of type 2 diabetes mellitus in one and the same country—The example of Thailand

Background: A dataset from a nationwide assessment of type 2 diabetes mellitus (T2DM) patients fromThailandwas reassessed. Objective: Prevalence of T2DM is highest in the northeast ofThailandand the intention of the study was to assess whether the clinical picture and behavior of patients from the northeast differ from the rest of the country. Materials and Methods: The variables of two groups of patients i.e. those from the northeast ofThailandand patients from the remaining three other regions, with the exception ofBangkok, were compared. The dataset consisted out of clinical laboratory data and the results of a questionnaire recording knowledge and admitted compliance of patients. Results: A higher proportion of patients from the northeast have elevated triglyceride levels and lower high density lipoprotein (HDL) fractions in comparison with the patients derived from the other three regions. The northeasterners know very well and better than the patients of the other regions how to take care of them while having T2DM yet the proportion of those with glycated hemoglobin (HbA1c) values over 6.4% was higher for them than for the other group of patients. Conclusion: In depth investigation by health educators would be useful in order to find out how the relationship between knowledge and practice could be improved for patients from the northeast of Thailand.

Prevalence and Determinants of Traditional,Complementary and Alternative Medicine Provider Use among Adults from 32 Countries

Objective： To estimate recent prevalence data（2011-2013） on traditional,complementary and alternative medicine（TCAM） provider use and sociodemographic and health related correlates in nationally representative population samples from 32 countries from all world regions.Methods： This secondary analysis was based on the International Social Survey Program（ISSP）,2011-2013,Health and Health Care Module.In a cross-sectional population-based survey（N=52,801）,simple or multi-stage stratified random sampling was used,resulting in representative samples of the adult population of respective countries.Results： Overall,the 12-month TCAM provider use prevalence was 26.4%,ranging from under 10% in Bulgaria,Poland and Slovenia to over 50% in China mainland,the Philippines and Republic of Korea.Over 80% TCAM treatment satisfaction was found in Europe in Denmark,Slovenia,Spain and Switzerland,in Asia in Taiwan（China） and USA.Multivariate logistic regression found sociodemographic variables（middle age,female sex,lower educational status,not having a religious affiliation,and lower economic indicators） and health variables（perceived poor or fair health status,being unhappy and depressed,having a chronic condition or disability,and having positive attitudes towards TCAM） were associated with TCAM provider use.Conclusions： A high prevalence TCAM provider use was found in all world regions and several sociodemographic and health related factors of its use were identified.

Vector-borne disease and climate change adaptation in African dryland socialecological systems

Background:Drylands,which are among the biosphere's most naturally limiting and environmentally variable ecosystems,constitute three-quarters of the African continent.As a result,environmental sustainability and human development along with vector-borne disease(VBD)control historically have been especially challenging in Africa,particularly in the sub-Saharan and Sahelian drylands.Here,the VBD burden,food insecurity,environmental degradation,and social vulnerability are particularly severe.Changing climate can exacerbate the legion of environmental health threats in Africa,the social dimensions of which are now part of the international development agenda.Accordingly,the need to better understand the dynamics and complex coupling of populations and environments as exemplified by drylands is increasingly recognized as critical to the design of more sustainable interventions.Main body:This scoping review examines the challenge of vector-borne disease control in drylands with a focus on Africa,and the dramatic,ongoing environmental and social changes taking place.Dryland societies persisted and even flourished in the past despite changing climates,extreme and unpredictable weather,and marginal conditions for agriculture.Yet intrusive forces largely out of the control of traditional dryland societies,along with the negative impacts of globalization,have contributed to the erosion of dryland's cultural and natural resources.This has led to the loss of resilience underlying the adaptive capacity formerly widely exhibited among dryland societies.A growing body of evidence from studies of environmental and natural resource management demonstrates how,in light of dryland system's inherent complexity,these factors and top-down interventions can impede sustainable development and vector-borne disease control.Strengthening adaptive capacity through community-based,participatory methods that build on local knowledge and are tailored to local ecological conditions,hold the best promise of reversing current trends.Conclusions:A significant opportunity exists to simultaneously address the increasing threat of vector-borne diseases and climate change through methods aimed at strengthening adaptive capacity.The integrative framework and methods based on social-ecological systems and resilience theory offers a novel set of tools that allow multiple threats and sources of vulnerability to be addressed in combination.Integration of recent advances in vector borne disease ecology and wider deployment of these tools could help reverse the negative social and environmental trends currently seen in African drylands.

Effect of prenatal antioxidant intake on infants' respiratory infection is modified by a CD14 polymorphism

Background:Prenatal maternal diet may influence disease susceptibility in offspring with specific genetic backgrounds.We hypothesized that interactions between prenatal antioxidant intake and polymorphisms in immunity genes influence respiratory tract infection (RTI) susceptibility in infants at 12 months of age.Methods:This study included 550 infants.In the Cohort for Childhood Origin of Asthma and Allergic Diseases (COCOA) birth cohort study,prenatal maternal diet was assessed by administering a food frequency questionnaire.Infants' cord blood was genotyped for CD14 (rs2569190),TLR4 (rs1927911),and GSDMB (rs4794820) polymorphisms by the TaqMan method.Results:Higher prenatal intake of total fruit and vegetables (FV) was associated with the decreased risk of RTI in offspring (P-trend=0.0430).In children with TT genotype at rs2569190,a higher prenatal intake of vitamins A and C,fruits,and total FV decreased RTI risk (P-trend <0.05),while in infants with TC+CC genotype,a higher prenatal intake of fruit increased RTI risk (P-trend <0.05).When analyzing the 3 genotypes,children with TT genotype at rs2569190 were more protected against RTIs compared with those with CC genotype with respect to vitamin C and fruits [odds ratio (OR)=5.04 and OR=10.30,respectively].In children with CC genotype at rs1927911,RTI risk showed a dose-response association with a higher prenatal intake of vitamin C (P for interaction<0.05).A higher prenatal intake of fruits and total FV reduced RTI risk in infants with GA+AA genotype of rs4794820 (P for interaction<0.05).Conclusion:Prenatal antioxidant intake may reduce RTI risk in infants and this relationship may be modified by CD14,TLR4,and GSDMB polymorphisms.