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Paper-based analytical products with regard to point-of-care blood assessments.
Preschoolers with higher daily fruit and vegetable intake had lower SSB intake [OR 0.4; 95% CI, 0.2-0.8; p = 0.011]. A positive association of higher weekly vigorous PA [OR 2.0; 95% CI, 1.1-3.7; p = 0.030] and daily screen-based practices [OR 2.0; 95% CI, 1.2-3.6; p  less then  0.001] on habitual SSBs intake was also substantiated. CONCLUSION Multiple diet, physical activity and sedentary behaviour factors were significantly associated with SSB intake among Malaysian preschoolers. Continued effort is required to encourage healthier beverage choices, as well as healthy diet and active lifestyle practices among children during the critical early years of growth and development.BACKGROUND This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA). METHOD This analyze used data of 3068 Vietnamese people aged 18-65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score - the indicator of individual PA - as the dependent variable. HS-10296 RESULTS Male and female participants with insufficient PA accounted for 20.2 and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level. As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreased. CONCLUSION Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.BACKGROUND Dysphagia is common after stroke. Patients with dysphagia have a higher risk of stroke-associated pneumonia (SAP) and poor outcomes. Early detection of dysphagia is necessary to identify and manage patients at high risk of aspiration. The aim of the study was to assess the impact of the systematic administration of the volume-viscosity swallow test (V-VST) in patients with acute ischaemic stroke. METHODS This was a retrospective observational study that enrolled patients with acute ischaemic stroke in two consecutive time periods pre-V-VST, when the 30-mL water-swallowing test (WST) was systematically administered, and V-VST, when all patients underwent the WST and the V-VST test was systematically administered if the patient failed the WST. RESULTS Two hundred and 42 patients were enrolled. The mean age of the participants was 68.8 ± 10.88 years, 61.2% were male, and the median National Institutes of Health Stroke Scale score was 3 (IQR, 1-6). A total of 147 patients were enrolled during the pre-V-VST period and 95 were enrolled during the V-VST period. There was a significant difference in the occurrence of SAP (21.8% vs. 10.5%, p = 0.024) and the rate of nasogastric tube feeding (25.9% vs. 14.7%, p = 0.040) between the two groups, and no differences were found in the length of hospital stay (p = 0.277) or the total cost of hospitalization (p = 0.846). CONCLUSIONS The V-VST was a better clinical screening tool, and it can also provide detailed suggestions regarding dietary modifications to prevent aspiration and SAP.BACKGROUND Low- and Middle-Income Countries (LMIC) have remained plagued with the burden of severe acute malnutrition (SAM). The decomposition of the educational inequalities in SAM across individual, household and neighbourhood characteristics in LMIC has not been explored. This study aims to decompose educational-related inequalities in the development of SAM among under-five children in LMIC and identify the risk factors that contribute to the inequalities. METHODS We pooled successive secondary data from the Demographic and Health Survey conducted between 2010 and 2018 in 51 LMIC. We analysed data of 532,680 under-five children nested within 55,823 neighbourhoods. Severe acute malnutrition was the outcome variable while the literacy status of mothers was the main exposure variable. The explanatory variables cut across the individual-, household- and neighbourhood-level factors of the mother-child pair. Oaxaca-Blinder decomposition method was used at p = 0.05. RESULTS The proportion of children whose mothemedia(p = 0.001), birth weight(p  less then  0.001) and neighbourhood socioeconomic status disadvantage(p  less then  0.001). On the average, neighbourhood socioeconomic status disadvantage, location of residence were the most important factors in most countries. Other contributors to the explanation of educational inequalities are birth weight, maternal age and toilet type. CONCLUSIONS SAM is prevalent in most LMIC with wide educational inequalities explained by individual, household and community-level factors. Promotion of women education should be strengthened as better education among women will close the gaps and reduce the burden of SAM generally. We recommend further studies of other determinate causes of inequalities in severe acute malnutrition in LMIC.BACKGROUND Metabolic syndrome is diagnosed by a cluster of risk factors that associated with an increased risk of coronary heart disease (CHD). We aimed to explore the impact of and interactions between individual metabolic syndrome components on the risk of CHD in Xinjiang. METHODS The baseline population included 7635 participants. The degree to which the components increase the risk of CHD and the multiplicative interactions between them were assessed using hazard ratios (HRs) and 95% confidence intervals (CIs). Additive interactions were appraised by the relative excess risk due to interaction, synergy index (SI), and attributable proportion of interaction. RESULTS A total of 304 CHD patients were enrolled from rural residents of Xinjiang. Elevated blood pressure (HR 1.81; 95% CI 1.35-2.44) and elevated fasting blood glucose (FBG) (HR 1.82; 95% CI 1.38-2.38) increased the risk of CHD after adjustment for confounding factors. We found a positive additive interaction (SI 1.14; 95% CI 0.51-2.51) between elevated blood pressure and elevated FBG, but none were significant. As the number of components increased, the risk of CHD increased. The combinations of [high triglycerides (TG) + low high-density lipoprotein cholesterol (HDL-C) + elevated FBG + large waistline] (HR 4.26; 95% CI 1.43-12.73) and [elevated blood pressure + elevated FBG + low HDL-C + large waistline] (HR 1.82; 95% CI 1.38-2.38) increased the risk of CHD. CONCLUSIONS We provide evidence that elevated blood pressure and elevated FBG are independent risk factors for CHD and it might be necessary to maintain the normal waistline for preventing CHD.BACKGROUND Although it has been established that low socioeconomic status is linked to increased risk of death after stroke, the mechanisms behind this link are still unclear. In this study we aim to shed light on the relationship between income level and survival after stroke by investigating the extent to which differences in stroke severity account for differences in survival. METHODS The study was based on patients registered in Riksstroke (the Swedish stroke register) with first time ischemic stroke (n = 51,159) or intracerebral hemorrhage (n = 6777) in 2009-2012. We used causal mediation analysis to decompose the effect of low income on 3-month case fatality into a direct effect and an indirect effect due to stroke severity. Since causal mediation analysis relies on strong assumptions regarding residual confounding of the relationships involved, recently developed methods for sensitivity analysis were used to assess the robustness of the results to unobserved confounding. RESULTS After adjustment for objustment for a confounder of greater impact than age would be required to considerably alter our conclusions.BACKGROUND Examining various problems after disasters is important for the affected people. Managing humanitarian aid and donations among the affected people is considered as one of the most important problems after disasters. Therefore, the present study aimed to evaluate the challenges and barriers of humanitarian aid management in 2017 Kermanshah Earthquake. METHODS This study was conducted from November 2017 to January 2018, with qualitative case study design. The population included 21 people including 6 humanitarian aid manager, 6 volunteers, 4 aid workers, and 5 affected people. The data were collected through semi-structured interviews and purposeful sampling, which continued until saturating the data. The strategies recommended by Guba were used for evaluating the trustworthiness of the data. The data was analyzed with conventional content analysis method according to method suggested by Graneheim and Lundman. RESULTS Based on the results, two themes, nine categories, and 19 sub-categories were identified considering the challenges and barriers of humanitarian aid and donors' management during the 2017 Kermanshah Earthquake. The categories included education, command and coordination, communication and information, rules, security, traffic and overcrowding, assessment, providing system, and cultural setting. Also, two themes including managerial and structural barriers were extracted. CONCLUSION Adopting an effective management and appropriate policies with respect to humanitarian aid and modifying structural and managerial barriers can improve the performance and management of humanitarian aid.BACKGROUND Government of India is introducing new and relatively costly vaccines under immunization program. Monitoring of vaccine wastage is needed to guide the program implementation and forecasting. Under pilot introduction of rotavirus vaccine in two districts both 5- and 10-doses vials were used, which was considered as an opportunity for documenting the wastage. The wastage rates for other routine vaccines were also documented. METHODS A survey conducted in two districts (Kangra, Himachal Pradesh and Pune, Maharashtra) covered 49 vaccine stores, 34 sub-centres and 34 outreach sessions collected vaccine receipt, distribution and usage data for two complete years 2016 and 2017. RESULTS The overall wastage rates for almost all vaccines were higher in Kangra district (BCG 37.1%, DPT 32.1%, Measles 32.2%, OPV 50.8%, TT 34.1% and pentavalent 18.4%) than Pune district (BCG 35.1%, DPT 25.4%, Measles 21.7%, OPV 14.3%, TT 23.1% and pentavalent 13.2%). Wastage for pneumococcal conjugate and measles-rubella vaccines in Kangra district were 27 and 40.5%, respectively. With transition from 5- to 10-doses vials for rotavirus vaccine, wastage at stores levels increased in both Kangra (29 to 33.2%) and Pune (17.8 to 25.7%) districts. With transition from intramuscular to intradermal fractional inactivated polio vaccine, the wastage increased from 36.1 to 54.8% in Kangra and 18.4 to 26.9% in Pune district. CONCLUSIONS The observed vaccine wastage rates for several vaccines were relatively higher than program assumption for forecasting. The observed variations in the vaccine wastage indicates need for state or region based documentation and monitoring in India for appropriate programmatic action.
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