Prevalence of chronic diseases in private healthcare sector of South Africa: A threat to public health

Purpose: To evaluate the prevalence of patients suffering from registered chronic disease list (CDL) conditions in a section of the South African private health sector from 2008 - 2012. Methods: This study was a retrospective analysis of the medicine claims database of a nationally (South African) representative Pharmacy Benefit Management (PBM) company data between 2008 and 2012. Statistical analysis was used to analyse the data. Descriptive analysis was performed to calculate the prevalence of CDL conditions for the entire population, and stratified by age and gender. However, MIXED linear modelling was used to determine changes in the average number of CDL conditions per patient, adjusted for age and gender from 2008 - 2012. Results: An increase of 0.20 in chronic diseases was observed from 2008 - 2012 in patients having any CDL condition, with an average of 1.57 (1.57 - 1.58, 95 % CI) co-morbid CDL conditions in 2008 and 1.77 (1.77 - 1.78, 95 % CI) in 2012. This increase in average number of CDL conditions per patient between 2008 and 2012 was statistically significant (p < 0.05), but with no large practical significance (d < 0.8). Conclusion: Prevalence of patients with CDL conditions along with risk of co-morbidity has been increasing with time in the private health sector of South Africa. Risk of increased co-morbidity with age and among different genders was prevalent.

Public health implications of dietary fiber intake to reduce the cost of chronic diseases

Objective: To assess the epidemiological evidence on dietary fiber intake and chronic diseases and make public health recommendations for the population in Romania based on their consumption. Populations that consume more dietary fiber from cereals, fruits and vegetables have less chronic disease. Dietary Reference Intakes recommend consumption of 14 g dietary fiber per 1,000 kcal, or 25 g for adult women and 38 g for adult men, based on epidemiologic studies showing protection against cardiovascular disease, stroke, hypertension, diabetes, obesity, metabolic syndrome, gastrointestinal disorders, colorectal -, breast -, gastric -, endometrial -, ovarian - and prostate cancer. Furthermore, increased consumption of dietary fiber improves serum lipid concentrations, lowers blood pressure, blood glucose leads to low glycemic index, aids in weight loss, improve immune function, reduce inflammatory marker levels, reduce indicators of inflammation. Dietary fibers contain an unique blend of bioactive components including resistant starches, vitamins, minerals, phytochemicals and antioxidants. Dietary fiber components have important physiological effects on glucose, lipid, protein metabolism and mineral bioavailability needed to prevent chronic diseases. Materials and methods: Data regarding diet was collected based on questionnaires. We used mathematical formulas to calculate the mean dietary fiber intake of Romanian adult population and compared the results with international public health recommendations. Results: Based on the intakes of vegetables, fruits and whole cereals we calculated the Mean Dietary Fiber Intake/day/person (MDFI). Our research shows that the national average MDFI was 9.8 g fiber/day/person, meaning 38% of Dietary Requirements, and the rest of 62% representing a “fiber gap” that we have to take into account. This deficiency predisposes to chronic diseases. Conclusions and recommendations:The poor control of relationship between dietary fiber intake and chronic diseases is a major issue that can result in adverse clinical and economic outcomes. The population in Romania is at risk to develop such diseases due to the deficient fiber consumption. A model of chronic diseases costs is needed to aid attempts to reduce them while permitting optimal management of the chronic diseases. This paper presents a discussion of the burden of chronical disease and its socio-economic implications and proposes a model to predict the costs reduction by adequate intake of dietary fiber.

Alcohol consumption among university students: a typology of consumption to aid the tailoring of effective public health policy

Objective: Elevated levels of alcohol consumption among university students are well documented. Policymakers have attempted to combat this issue at a university, national and international level. Tailoring public health policy to effectively tackle alcohol use is crucial. Using Q-methodology, the current study aims to develop a typology of alcohol consumption in the Irish university student population. Setting: A large Irish university. Participants Hundreds of possible statements on types of consumption were generated from a systematic review and a set of one-on-one interviews. These were reduced to 36 statements, 6 statements which define each of the 6 previously defined consumption types. Participants were advised to scan through the 36 statements and fill the statements into a ‘forced choice, standardised distribution’. Following this, a 45–90 min interview was conducted with students to illuminate subjectivity surrounding alcohol consumption. Analysis was conducted using PQ Method and NVivo software. Principal component analysis, followed by varimax rotation, was conducted to uncover the final factor information. Results: In total, 43 students completed the Q-study: 19 men and 24 women. A typology describing 4 distinct groupings of alcohol consumer was uncovered: the guarded drinker, the calculated hedonist, the peer-influenced drinker and the inevitable binger. Factor loadings of each of the consumer groupings were noted for type description. Conclusions: This is the first study to propose ideal types of alcohol consumption among a university student population. Further research is required to investigate the degree to which each of these ideal types is subscribed. However, this typology, in addition to informing public policy and strategies, will be a valuable analytic tool in future research.

Iowa Department of Public Health's Office of Multicultural Health Strategic Plan FY 2007-2011, September 26, 2008

The Iowa Department of Public Health's Office of Multicultural Health invited 21 representatives, key informants throughout the State of Iowa and five state personnel to help chart a strategic map for the OMH staff and it constituents to travel during the next 3-5 years, as the office strengthens its infrastructure and continues to meet its mission.

Iowa Department of Public Health Office of Minority and Multicultural Health Strategic Plan 2012 to 2017, February 19, 2013

The Iowa Department of Public Health's Office of Multicultural Health invited 21 representatives, key informants throughout the State of Iowa and five state personnel to help chart a strategic map for the OMH staff and it constituents to travel during the next 3-5 years, as the office strengthens its infrastructure and continues to meet its mission. This two day strategic planning session brought forth the consensus of maintaining the four major function areas held within the 2007 to 2011 strategic plan. Those four areas are: education, advocacy, data and training and development. 2

South Carolina Public Health Region Snapshot

This document gives abbreviated health statistics for the four regions of South Carolina.

INTERNATIONAL EDUCATION & RESEARCH FOR OH. Experiences of international networks for collaborative education and research using the One Health approach.

The Authors describe first-hand experiences carried out within the framework of selected International projects aimed at developing collaborative research and education using the One Health (OH) approach. Special emphasis is given to SAPUVETNET, a series of projects co-financed under the EU-ALFA program, and aimed to support an International network on Veterinary Public Health (VPH) formed by Veterinary Faculties from Latin-America (LA) and Europe (EU). SAPUVETNET has envisaged a series of objectives/activities aimed at promoting and enhancing VPH research/training and intersectoral collaboration across LA and EU using the OH approach, as well as participating in research and/or education projects/networks under the OH umbrella, namely EURNEGVEC-European Network for Neglected Vectors & Vector-Borne Infections, CYSTINET-European Network on Taeniosis/Cysticercosis, and NEOH-Network for Evaluation of One Health; the latter includes expertise in multiple disciplines (e.g. ecology, economics, human and animal health, epidemiology, social and environmental sciences, etc.) and has the primary purpose of enabling quantitative evaluation of OH initiatives by developing a standardized evaluation protocol. The Authors give also an account of the ongoing creation of OHIN-OH International Network, founded as a spin-off result of SAPUVETNET. Finally, some examples of cooperation development projects characterised by an OH approach are also briefly mentioned.