An Online Survey of the Perceptions of Clinical and Non-Clinical Professionals on Healthcare for Non-Communicable Diseases and COVID-19 Measures During the Pandemic in Malaysia.

Objectives: This study assesses the opinions of health professionals in Malaysia on the disruption of non-communicable disease (NCD) services during the COVID-19 pandemic from March 2020 to January 2022. Methods: We conducted a cross-sectional online survey with 191 non-clinical public health workers and clinical health service workers in Malaysia from November 2021 to January 2022. Participants were recruited by the Malaysian Ministry of Health using major networks including key experts and practitioners. Secondary respondents were subsequently enrolled through snowballing. Results: The most notable issues raised by the survey participants relate to NCD service disruption, the redirection of NCD care resources, and NCD care being overburdened post-pandemic. Respondents also reported accounts of resilience and prompt reaction from the healthcare system, as well as calls for innovation. Conclusion: Most respondents perceived that the challenges arising from COVID-19 were mostly managed well by the healthcare system, which was able to provide the necessary services to NCD patients during this health emergency. However, the study identifies gaps in the health system response and preparedness capacity, and highlights solutions for strengthening NCD services.

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression.

Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21-33%), hypertension (32-43%), diabetes (34-47%), and HIV (31-45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa.

Non-communicable Diseases Surveillance: Challenged by COVID-19.

Non-communicable diseases as a leading cause of death have a surveillance system in most countries. This is disturbed by the emergence of coronavirus disease-2019 (COVID-19) in December 2019. In this regard, health system managers at decision-making levels tried to overcome this problem. Therefore, strategies to deal with this issue and bring the surveillance system to an ideal state were proposed and considered.

Health Diplomacy in the CARICOM Region

In today's globalized world, with high connectivity and interdependence on other nations, the germs can cross borders within minutes making the Caribbean region more vulnerable. The paramount role of health diplomacy is increasing day by day, especially with the recent COVID-19 pandemic. In 2007, the Caribbean region formulated the "Port of Spain Summit Declaration”, a unique, comprehensive policy addressing chronic non-communicable diseases with a high-level commitment from the head of the states. Health diplomacy is not something new to the region as it has developed many regional initiatives for collective action against HIV/AIDS, other infectious diseases in the past decades but never had a dedicated centre to further the concept or conduct more research. This chapter examines various challenges in the region and emphasizes the region's role in addressing its needs on global platforms to negotiate for more assistance and robust policies to safeguard peace, health, and development. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Explainable artificial intelligence (XAI) in medical decision systems (MDSSs): healthcare systems perspective

The healthcare sector is very interested in machine learning (ML) and artificial intelligence (AI). Nevertheless, applying AI applications in scientific contexts is difficult due to explainability issues. Explainable AI (XAI) has been studied as a potential remedy for the problems with current AI methods. The usage of ML with XAI may be capable of both explaining models and making judgments, in contrast to AI techniques like deep learning. Computer applications called medical decision support systems (MDSS) affect the decisions doctors make regarding certain patients at a specific moment. MDSS has played a crucial role in systems' attempts to improve patient safety and the standard of care, particularly for non-communicable illnesses. They have moreover been a crucial prerequisite for effectively utilizing electronic healthcare (EHRs) data. This chapter offers a broad overview of the application of XAI in MDSS toward various infectious diseases, summarizes recent research on the use and effects of MDSS in healthcare with regard to non-communicable diseases, and offers suggestions for users to keep in mind as these systems are incorporated into healthcare systems and utilized outside of contexts for research and development.

Using machine learning to comprehend and forecast Post-COVID-19 pharmaceutical sales

The COVID-19 crisis has severely hampered the worldwide market, leading to several issues in the supply chain of several necessities, but a considerable increase in the healthcare sector for the pharmaceutical industry. Using machine learning, this research aims to comprehend and forecast pharmaceutical sector sales post-COVID-19. This paper analyzed the major non-communicable diseases and the pharmaceuticals used to treat them, discovered and determined the most significant factors, and utilized them to construct appropriate models for the study. An online survey was performed among Indian families using a structured questionnaire, including both open-ended and closed-ended questions on the family's health. Prior to and during the lockdown, information on non-communicable diseases and the usage of medications was gathered. Our results suggest that the unanticipated transformation in lifestyle has altered disease prevalence, which is a consideration for the pharmaceutical sector to address. And these models helped to figure out how disease levels were changing and how likely it was that the number of people with certain diseases would go up based on their symptoms. This gave a better idea of how to treat the patients. © 2023 IEEE.

Isolation, identification, and S1 gene sequencing of two strains of Avian Infectious bronchitis virus

Objective: Epidemiology and genetic variations of the infectious bronchitis virus(IBV) in Fujian province were studied. Method: Two strains of virus isolated from the diseased chickens in Fujian in 2021 were identified by chicken embryo pathogenicity test, electron microscope observation, and RT-PCR. S1 genes of the isolates were cloned, sequenced, and analyzed using biological software. Result: The two IBV strains were code named FJ-NP01 and FJ-FZ01. The full length of S1 of FJ-NP01 was 1 629 nt encoding 543 amino acids, and that of FJ-FZ01, 1 620 nt encoding 540 amino acids. The S1 gene cleavage site of FJ-FZ01 was HRRRR, same as all reference strains of genotype I branch;while that of FJ-NP01 HRRKR differed from the reported site of IBV isolated from genotype IV but same as that of TC07-2 reference strain of genotype VI. The homology of nucleotide and amino acid between the two isolates was 83.2% and 79.6%, respectively, but merely 75.7%-76.3%and 77.1%-83.5% with the Mass-type conventional vaccines H120 and H52, respectively. Further analysis showed that FJ-NP01was from a recombination event between CK CH GD LZ12-4 and L-1148, the homology of nucleotide acid between 1438-1506 nt of FJ-NP01 with CK CH GD LZ12-4 was 97%, and 95.9% between the other nucleotide acid of S1 gene with L-1148. Conclusion: It appeared that the IBV epidemic experienced in the province was complex in nature and that the existing Mass vaccines would not provide sufficient immune protection to deter the spread.

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The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health.

Marketing unhealthy products by multinational corporations has caused considerable harm to individual health, collective wellbeing, and environmental sustainability. This is a growing threat to all societies and a significant contributor to the rising global burden of non-communicable diseases and early mortality. While there is growing consideration of the commercial determinants of health, this is largely focused on the methods by which unhealthy products are marketed and disseminated, including efforts to manipulate policy. Little attention has been paid to the underlying psychological traits and worldviews that are driving corporate greed. Here, we consider the role of "dispositional greed" in the commercial determinants of health with a focus on the historical attitudes and culture in the ultra-processed food industry-exemplified by "The Founder" of the McDonald's franchise. We argue that greed and associated psychological constructs, such as social dominance orientation and collective narcissism, permeate the commercial determinants of health at a collective level. This includes how a culture of greed within organizations, and individual dispositional greed, can magnify and cluster at scale, perpetuated by social dominance orientation. We also consider the ways in which "showbiz" marketing specifically targets marginalized populations and vulnerable groups, including children-in ways that are justified, or even celebrated despite clear links to non-communicable diseases and increased mortality. Finally, we consider how greed and exploitative mindsets mirror cultural values and priorities, with trends for increasing collective narcissism at scale, recognizing that many of these attitudes are cultivated in early life. A healthier future will depend on navigating a path that balances material prosperity with physical and spiritual wellbeing. This will require cultural change that places higher value on kindness, reciprocity, and mutualistic values especially in early life, for more equitable flourishing.

Comparing Health Service Reception in Individuals with and Without Non-communicable Diseases Before and During the COVID-19 Pandemic: Shahrekord Cohort Study

Introduction: The utilization of health services is an opportunity for using health services by the needy. Since COVID-19 can have significant effects on all life dimensions, including the utilization patterns, especially in patients with non-communicable diseases (NCDs), this study aimed to determine and compare the extent of utilizing health services by individuals with and without NCDs in the Shahrekord cohort study before and during the COVID-19 pandemic. Materials and Methods: The present cross-sectional study was conducted on 760 patients of the age group of 35-70 years in the Shahrekord cohort study, which addressed the urban areas of Shahrekord and the rural regions of Ardel city during two separate periods. For all patients, the questionnaire on benefiting from health services was completed. The data was collected using the telephone interview method and then analyzed using SPSS software. Results: The mean and standard deviation of the age was 44.95±8.65 years in the patients without NCDs and 53.38±8.60 years in those with NCDs(p<0.001). The rates of medical service reception in those without common NCDs before and during the corona epidemic were 3.2% and 15.3%, respectively. In those with common NCDs, the rates were 7.1% and 27.1%, respectively (p<0.001). During the coronavirus epidemic, the average duration of receiving service, duration of service, paid fee, and the frequency of receiving service were longer in the participants with chronic NCDs (P<0.001).Conclusion: The reception of medical services and outpatient services in the two groups of patients with and without NCDs during the coronavirus pandemic increased compared to the pre-pandemic period. This point should be considered as a lesson learned from the epidemic by the health system policymakers and planners to lay the grounds for providing care services, especially for chronic patients during epidemics. © 2022, Research Institute for Endocrine Sciences. All rights reserved.

Relevance of PM in Infectious and Non-communicable Chronic Diseases and Pandemics

Precision medicine (PM) in the form of Pharmacogenomics (PGx) promises the use of diagnostic testing to provide the best clinical decisions based on a patient's genetic profile, by analyzing the coding and structural variants in a patient's genome to provide information about the causes of existing conditions, future risks for disease, and responsiveness to drugs. PM's major future goals include preventing premature deaths, reduction of healthcare cost, and better prevention and management of emerging infectious diseases (EIDs), non-communicable diseases (NCDs), and management of pandemics, and development of vaccines – locally as well as globally. With the raging COVID-19 pandemic, PM is also expected to play a critical role in addressing the "emergence and reemergence” of new and more virulent pathogen infectious diseases, which remain a challenge as of today – killing several millions of people each year globally. Despite all these advantages, it will be difficult to navigate through the challenges and the ethical and social issues that are anticipated to arise for the clinical practice, public health, and policy making in the era of PM. This chapter looks at the importance of PM in infectious diseases and NCDs, and pandemics – while identifying and addressing some of the anticipated challenges. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Tobacco: A Looming Epidemic in Sub-Saharan African Countries

Sub-Saharan Africa, a region already burdened with HIV/AIDS, other infectious diseases, and competing priorities, is battling with the increasing burden of COVID-19 and non-communicable diseases (e.g., cardiovascular diseases, lung cancer). Africa's statistics on young people aged 13-15 years already hooked to tobacco are at an alarming 17%, matching the global trend. It is estimated that the number of smokers in sub-Saharan Africa will increase to 208 million (148%) by 2030, if robust tobacco control measures are not implemented. The chapter highlights the global trends of tobacco use, and exposure to tobacco smoke, all of which aggravate the prevalence of communicable and non-communicable diseases. The chapter also explores the harmful impact of tobacco use on people's health, suggesting that tobacco control should be a public health priority. The chapter presents the evidence for effective community-based interventions on tobacco control and prevention to reverse the tobacco epidemic in sub-Saharan Africa. © The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021.

The Epidemiologic Transition in French Guiana: Secular Trends and Setbacks, and Comparisons with Continental France and South American Countries.

There are great variations between population subgroups, notably in poorer countries, leading to substantial inconsistencies with those predicted by the classical epidemiologic transition theory. In this context, using public data, we aimed to determine how the singular case of French Guiana fit and transitioned in the epidemiologic transition framework. The data show a gradual decline in infant mortality to values above 8 per 1000 live births. Premature mortality rates were greater but declined more rapidly in French Guiana than in mainland France until 2017 when they reascended in a context of political turmoil followed by the COVID-19 pandemic and strong reluctance to get vaccinated. Although infections were a more frequent cause of death in French Guiana, there is a marked decline and circulatory and metabolic causes are major causes of premature death. Fertility rates remain high (>3 live births per woman), and the age structure of the population is still pyramid-shaped. The singularities of French Guiana (rich country, universal health system, widespread poverty) explain why its transition does not fit neatly within the usual stages of transition. Beyond gradual improvements in secular trends, the data also suggest that political turmoil and fake news may have detrimentally affected mortality in French Guiana and reversed improving trends.

Macroeconomics and health: Understanding the impact of a declining economy on health outcomes of children and young adults in South Africa.

Background: The current covid-19 economic crisis continues to weaken economic growth in South Africa. This study was designed to show how a declining economic state affects the mental health conditions, metabolic risk factors, communicable conditions, and non-communicable conditions of adolescent (18-year cohorts) and adult (25-year cohorts) population groups comparatively. Study design: This was a panel analysis using secondary data issued by Statistic South Africa. Methods: The author used a Two-stage Least Squared Model (2SLS) to quantify the impact of the declining economy on mental health conditions (depression and traumatic stress), non-communicable conditions (cancer and diabetes), metabolic risk factors (alcohol abuse and hypertension), and communicable conditions (influenza, diarrhea, dry cough) of both adolescent and young adult population groups. Each group comprised a treatment and a control group. Results: The declining economic state of 2008-2014 worsens the mental health conditions, metabolic risk factors, and non-communicable conditions of adolescent and young adult populations. However, the declining economy reduced cases of communicable conditions. The impact of the declining economy worsens mental health conditions, metabolic risk factors, and non-communicable conditions more in urban settings than in rural regions. Men abuse alcohol more than women during economic decline, triggering worsening mental health conditions, hypertension, and non-communicable conditions, especially in the adult population residing in urban settings. Conclusions: Economic decline worsen mental health conditions, metabolic risk factors, and non-communicable conditions. The South African government may want to prioritize these conditions as covid-19 economic shocks continue to backslide economic growth.

Exploring key-stakeholder perceptions on non-communicable disease care during the COVID-19 pandemic in Kenya.

Introduction: over one third of total Disability-Adjusted-Life-Years lost in Kenya are due to non-communicable diseases (NCD). In response, the Government declared significant commitment towards improving NCD care. The COVID-19 pandemic increased the burden on the already overstretched health systems in Kenya. The aims of this study are to assess whether health care providers perceived NCD care to be optimal during the pandemic and explore how to improve responses to future emergencies. Methods: this cross-sectional online survey included healthcare personnel with non-clinical roles (public health workers and policy-makers) and those delivering health care (doctors and nurses). Respondents were recruited between May and September 2021 by random sampling, completed by snowball sampling. Results: among 236 participants (42% in clinical, 58% in non-clinical roles) there was an overall consensus between respondents on NCD care being disrupted and compromised during the pandemic in Kenya. Detracted supplies, funding, and technical resources affected the continuity of NCDs' response, despite government efforts. Respondents agreed that the enhanced personnel capacity and competencies to manage COVID-19 patients were positive, but noted a lack of guidance for redirecting care for chronic diseases, and advocated for digital innovation as a solution. Conclusion: this paper explores the perceptions of key stakeholders involved in the management of NCDs in Kenya to improve planning for future emergency responses. Gaps were identified in health system response and preparedness capacity during the pandemic including the perceived need to strengthen NCD services, with solutions offered to guide resilience efforts to protect the health system from disruption.

The resiliency of noncommunicable diseases services during the public health crisis: a lesson from Bangkok, Thailand.

BACKGROUND: The healthcare services for non-communicable diseases (NCD) are commonly affected by public health crises like the COVID-19 pandemic. During the pandemic, all healthcare facilities in Bangkok had been overwhelmed by the extreme caseload of COVID-19. Health service resiliency is crucial for the continued service of healthcare facilities post pandemic. This study aims to explore the impacts of COVID-19 on NCD service disruption and addressed the resilience of healthcare services at the operational level. METHODS: Healthcare facility-based surveys and in-depth interviews were conducted among representatives of the facilities in Bangkok from April 2021 to July 2021. The web-based, self-administered questionnaire, was sent to directors or authorities of all healthcare facilities in Bangkok Thailand (n = 169). Two healthcare facilities from three levels of health services were purposively selected. The directors or medical doctors and nurses who are in charge of the NCD service, and working at the six selected health facilities, were invited to participate in the in-depth interviews. Descriptive statistics were used to analyze the survey data, and thematic analysis was used to analyze the data from the in-depth interviews. RESULTS: The impact of COVID-19 on NCD service disruption in the second wave (2021) was more severe than in the first wave (2020). The main reasons for NCD service disruptions are insufficient staff, and the closure of some services offered by the healthcare facilities. Surprisingly, both the budget and medical supply for healthcare facilities in Bangkok are less affected by the COVID-19 pandemic. Our study revealed resilience capability i.e. absorptive, adaptive, and transformative capabilityamong the healthcare facilities that provide a continuum of care by increasing availability and accessibility to healthcare services for chronic illness as DM. The service disruption in Bangkok may alter from other provinces because of variations in COVID-19 incidence and health services contexts. CONCLUSION: During the public health crisis, using affordable and common digital technologies to ensure DM patients can access a continuum of care and providing alternative services such as mobile medical laboratories, medication delivery, and medical refill at drug stores can increase consistent monitoring of glycemic levels and use of prescribed medication.

Prospect of Vaccinia virus vector vaccine for wildlife

Against a pandemic of emerged infectious disease, COVID-19, new generation vaccines based on nucleic acids or recombinant viruses, which had not been used as vaccines in humans, have been inoculated and shown to be successful. They are, however, heat-labile and need a cold-chain including deep-freezers for storage and transportation. Vaccinia virus (VAC) vector vaccine (VACV) is a pioneer of new generation of vaccines constructed by using molecular biological technology. VACV, which has contributed to eradication of smallpox, has excellent characteristics of vaccinia virus such as a high heat-stability and long-lasting immunological effects. It is possible to distinguish the immunological responses of vaccination from those of natural infections. We started our developmental researches 35 years ago, using attenuated VAC strains established in Japan. In this article, we first describe the early researches of VACVs;development of two VACVs for Bovine leukemia virus and Rinderpest morbillivirus antigens and their protective immunity in large mammals, sheep and cows. Second, application of VACV is described;Rabies-VACV, which has already been licensed, used in the field in Europe and USA, and resulted in a prominent decrease of rabies. Then, current status of VACV research is described;non-replicating VACVs in mammalian cells have been developed as new-generation and ultimately-safe vaccines. We discuss the possibility of future application of VACV for wildlife.

Future perspectives of health care: Closing remarks

The Covid-19 pandemic has demonstrated the vulnerability of our health care systems as well as our societies. During the year of 2020, we have witnessed how whole societies globally have been in a turbulent state of transformation finding strategies to manage the difficulties caused by the pandemic. At first glance, the health promotion perspective might seem far away from handling the serious impacts caused by the Covid-19 pandemic. However, as health promotion is about enabling people to increase control over their health and its determinants, paradoxically health promotion seems to be ever more important in times of crisis and pandemics. Probably, in the future, pandemics will be a part of the global picture along with the non-communicable diseases. These facts strongly demand the health care services to reorient in a health promoting direction. The IUHPE Global Working Group on Salutogenesis suggests that health promotion competencies along with a reorientation of professional leadership towards salutogenesis, empowerment and participation are required. More specifically, the IUHPE Group recommends that the overall salutogenic model of health and the concept of SOC should be further advanced and applied beyond the health sector, followed by the design of salutogenic interventions and change processes in complex systems. © The Author(s) 2021.

SMOKING PLAYING AS A RISK FACTOR TO OTHER DISEASES: A META-ANALYSIS

On July 21, 2021, a report from the World Health Organization indicated that there are presently 1.3 billion tobacco smokers globally. Data statistics show that the mortality rate of tobacco use is already at 3,021,098. Although smoking receives the lowest mortality rate among other communicable and non-communicable diseases in 2021, research suggests that smoking could hamper the quality of life of someone who already has an existing illness. This study investigated the adverse effects of smoking as a contributory factor to communicable diseases such as HIV/AIDS, Tuberculosis, and COVID-19, noncommunicable diseases like Malaria and Dengue, and risk factors such as alcohol and obesity. The locale of the study is Philippines. Meta-analysis is utilized in order to examine data statistics of the Philippines in comparison to its Southeast Asian neighbors. Meta-analysis was used by the author to extrapolate data from various quantitative and qualitative documents from 2000 up to the present. Specifically, open-access journal articles and data from legitimate databases like ISI Scopusindexed journals and/or websites were collated substantially. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)