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Influence of Parental Lifestyle and Dietary Patterns on Mediterranean Diet Adherence in Children and Adolescents: A Cross-Sectional Study.1 day agoBackground/Objectives: Adherence to the Mediterranean diet (MD) is associated with reduced risk of non-communicable diseases but has declined among children, even in traditionally high-adherence settings such as Greece. As parental lifestyle behaviors strongly influence children's dietary patterns, this study examined the associations between parental lifestyle factors and children's MD adherence in Crete, Greece. Methods: A total of 760 parent-child dyads participated in this cross-sectional study. Children's adherence to the MD was assessed using the KIDMED index. Parents completed validated instruments, including the MEDAS (MD adherence), IPAQ (physical activity), PSQI (sleep quality), and NLS (nutrition literacy), along with questions on dietary habits and screen time behaviors. ANOVA/Kruskal-Wallis tests and multivariable linear regression identified predictors of KIDMED scores. Results: Mean KIDMED score was 5.95 ± 2.65; 32% achieved optimal adherence. Younger children showed higher adherence. Higher children's adherence to MD was positively associated with parental MD adherence (β = 0.493), urban residence (β = 0.544), higher parental education (β = 0.493), consistent daily meal routines (breakfast and mid-morning and mid-afternoon snacks), higher water intake, and fresh juice consumption (all p < 0.05) were positively associated with parental MD adherence. Conversely, lower adherence was associated with parental age ≥ 45 years (β = 0.987), higher parental BMI (β = 0.072), consumption of sugar-sweetened (β = 0.390) or artificially sweetened beverages (β = 0.497), and weekend screen time ≥ 3 h/day (β = 0.383) (all p < 0.05). Conclusions: Children's adherence to the MD is strongly associated with parental dietary behaviors and structured meal routines. These findings support family-focused interventions that emphasize parental dietary role modeling to counter declining MD adherence among Mediterranean youth.Non-Communicable DiseasesAccessCare/ManagementAdvocacy
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Association Between Anxiety and Suicidal Ideation, and Dietary Patterns.1 day agoBackground/Objectives: Diet is considered one of the most important modifiable risk factors for non-communicable diseases in modern society. While numerous studies have reported on the association between diet and mental health, including anxiety, research examining the relationship between dietary patterns and mental health is relatively scarce. Therefore, this study aimed to analyze the association between anxiety and suicidal ideation with macronutrient intake. Methods: This study was conducted on adults aged 19 years or older using raw data from the 2021-2023 Korea National Health and Nutrition Examination Survey. Excluding those with missing test items, 9002 subjects were included. The study subjects were divided into four groups based on macronutrient intake (normal diet group, high-carbohydrate diet group, high-fat diet group, and high-protein diet group; based on Korean Dietary Reference). Results: There was no significant association between dietary patterns and suicidal ideation. However, after adjusting for covariates for moderate or severe anxiety in the HP diet group, the odds ratio was reported to be 0.492 (95% CI 0.298-0.810). Subgroup analysis by gender revealed no significant difference between dietary types and anxiety in women, but in men, the HP diet significantly lowered the odds of moderate or severe anxiety (OR 0.230, 95% CI 0.089-0.599). Conclusions: This study found that higher protein intake was associated with lower levels of moderate to severe anxiety, and this trend was statistically significant, particularly in men. Further research is needed to confirm the causal relationship.Non-Communicable DiseasesMental HealthAccessCare/ManagementAdvocacy
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Burden of Disease Due to Consumption of Alcohol and Other Drugs in Colombia, 2016-2022: A Subnational Regional Analysis.1 day agoAlcohol and psychoactive substance use represent a major burden for global public health, increasing the risk of non-communicable diseases, violence, road traffic injuries, dependence, and mental disorders, and generating impacts on productivity and social welfare. This study aimed to estimate the burden of disease attributable to alcohol and other psychoactive substances in the departments of Colombia from 2016 to 2022. A burden-of-disease study was conducted using the Disability-Adjusted Life Years (DALYs) indicator, following the methodology of the World Health Organization Global Health Estimates. Official morbidity and mortality databases were used. An estimated 236,154.42 DALYs were attributable to alcohol and psychoactive substance use in Colombia during the study period, increasing from 14,158.7 DALYs in 2016 to 40,190.7 DALYs in 2022. The burden was heterogeneous across departments, with values above 1000 DALYs in Quindío (1779.5), Nariño (1624.3), and Norte de Santander (1008.0) and below 132 DALYs in La Guajira, Casanare, and Vaupés. Men accounted for 73.5% of total DALYs. The mean age of morbidity records associated with alcohol and psychoactive substance use disorders was 30.67 years in men and 32.37 years in women. The burden associated with psychoactive substance use is increasing in Colombia, with differences by sex and department of residence.Non-Communicable DiseasesMental HealthAccessAdvocacy
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Organization and Integration of Care in the HIV-Non-Communicable Disease Syndemic: A Rapid Scoping Review.1 day agoAdvances in antiretroviral therapy have transformed infection with HIV into a manageable chronic disease, increasing the survival of people living with HIV, who are also undergoing a demographic aging process marked by the emergence of non-communicable chronic diseases. This study aims to map and analyze how the scientific literature addresses the organization and integration of care in the HIV-NCD syndemic, identifying implications for nursing and for health systems. This is a Rapid Scoping Review, using the databases PubMed, Scopus, CINAHL, and LILACS. Data synthesis was conducted using Microsoft Excel. The research was structured using the PCC framework: Population-people living with HIV (≥18 years); Concept-organization and integration of care in the HIV-NCD syndemic, including care models, care coordination, service integration, and the role of nursing; and Context-health services and systems. Twenty-three studies were included, most of which used qualitative methodology, were conducted in sub-Saharan Africa, and had predominantly female samples. This study demonstrated that the organization of care in the HIV-NCD syndemic remains predominantly characterized by fragmented models, which are insufficient to address the complexity of multimorbidity. Integrated care models emerge as a promising strategy; however, their effects remain limited in settings marked by health inequalities.Non-Communicable DiseasesAccessCare/Management
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From NAFLD to MASLD and MetALD: Conceptual Shifts in Metabolic Liver Disease and Their Implications for Mexico.1 day agoMetabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is now recognized as the leading cause of chronic liver disease worldwide. The updated terminology reflects a conceptual shift by emphasizing metabolic dysfunction rather than excluding alcohol consumption. This redefinition introduced MetALD, a subtype characterized by the coexistence of cardiometabolic risk factors and moderate alcohol intake. In the world, misclassification of MetALD as MASLD is frequent, often due to underreporting of alcohol consumption, which may distort epidemiological estimates. In Mexico, where both obesity and alcohol use are highly prevalent, this reclassification carries important implications for diagnosis, prognosis, and public health policy. This review summarizes the current evidence on MASLD and MetALD, highlighting their prevalence, diagnostic challenges, and implications for liver transplantation and cancer surveillance. We advocate for integrating these diseases into national non-communicable disease policies and adopting a multidisciplinary, preventive approach tailored to the Mexican context.Non-Communicable DiseasesAccessAdvocacy
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Telemedicine in the Management of Arterial Hypertension in Rural Populations: A Narrative Review.1 day agoBackground: Arterial hypertension is one of the most prevalent chronic non-communicable diseases and a leading cause of cardiovascular morbidity and mortality worldwide. Its burden remains particularly high in rural and resource-limited settings, where access to healthcare is often constrained by shortages of healthcare professionals, geographical barriers, and underdeveloped infrastructure. These factors may contribute to delayed diagnosis, suboptimal disease control, and increased risk of complications. In this context, telemedicine has emerged as a useful approach to supporting hypertension management and improving access to care in rural populations. Methods: This study presents a narrative review of the literature focusing on the application of telemedicine in the management of arterial hypertension in rural populations. A structured literature search of PubMed, Scopus, and Web of Science databases was conducted for studies published between 2015 and 2025. The review included randomized controlled trials, systematic reviews, meta-analyses, and observational studies evaluating telemedicine interventions, including remote blood pressure monitoring, mobile health applications, and teleconsultations. Study selection was guided by relevance to the research objective, with particular attention to rural and resource-limited contexts. Results: Telemedicine interventions have been associated with improvements in blood pressure control, treatment adherence, and access to healthcare services. Evidence from randomized controlled trials and meta-analyses suggests modest reductions in systolic and diastolic blood pressure compared with standard care. However, a substantial proportion of the available evidence originates from studies conducted in general or mixed populations rather than exclusively rural settings. Therefore, the applicability of these findings to rural contexts remains limited and should be interpreted with caution. The effectiveness of telemedicine may vary depending on differences in healthcare infrastructure, resource availability, digital accessibility, and organizational models across healthcare systems. Integrated care approaches involving primary healthcare providers and specialist support may contribute to improved continuity of care, although their impact appears to be context-dependent. Key barriers include limited telecommunication infrastructure, digital literacy challenges, and difficulties in integrating telemedicine into routine clinical practice. Conclusions: Telemedicine may represent a useful approach to supporting hypertension management in rural populations. However, its implementation requires careful consideration of local healthcare systems, patient characteristics, and organizational context. Telemedicine should be viewed as a context-dependent strategy rather than a uniform solution. Further context-specific research is needed to evaluate the long-term clinical, organizational, and economic impact of telemedicine interventions in rural hypertension management.Non-Communicable DiseasesCardiovascular diseasesAccessCare/Management
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Determinants of Physical Activity Engagement Among Male Adolescents in Riyadh, Saudi Arabia: A Comparative Study of Athletes and Non-Athletes.1 day agoBackground: Physical inactivity among Saudi Arabian adolescents is a critical public health concern due to its contribution to the rising prevalence of overweight, obesity, and non-communicable diseases. Despite this, the motivational profiles and perceived barriers that differentiate athletic from non-athletic adolescents remain understudied in the Saudi literature, particularly within the school Physical Education (PE) context. Grounded in Self-Determination Theory (SDT), the present study examined the factors preventing and motivating Saudi adolescents to engage in physical activity (PA) and discusses findings in terms of their implications for PE teachers and school-based intervention. Method: A cross-sectional study was conducted with 124 male high school students in Riyadh (mean age: 16.79 ± 0.66 years). Participants were categorized as either athletes (n = 70) or non-athletes (n = 54) based on pre-defined engagement criteria: athletes were required to report vigorous-intensity sport participation on three or more days per week for a minimum of 60 min per session. Anthropometric measurements, lifestyle behaviors (diet, screen time, sleep), motivations, and barriers were assessed using the validated Arab Teens Lifestyle Study (ATLS) questionnaire. Independent samples t-tests and chi-square tests were used to compare between-group differences; effect sizes are reported. Result: Non-athletes had a significantly higher mean BMI (29.40 ± 6.77 kg/m2) and waist circumference (98.65 ± 21.63 cm) compared to athletes (BMI: 22.19 ± 4.44 kg/m2; waist: 78.84 ± 9.51 cm; both p < 0.001). No significant differences were observed in screen time, sleep duration, or dietary habits. The primary motivations for PA among athletes were health benefits (27.1%), recreation (25.7%), and competition (20.0%), reflecting an autonomous motivational profile consistent with SDT. Among non-athletes, the predominant barriers were the lack of suitable facilities (25.9%) and the absence of an exercise partner (22.2%); reflecting unmet SDT needs for competence and relatedness respectively, while only 9.3% cited having a lack of time. Conclusions: Non-athletic participants face a significant health disadvantage characterized by higher rates of overweight and central obesity. In contrast to global trends, where academic commitments dominate barriers to PA, the principal barriers in this population are environmental and social, reflecting unmet psychological needs that PE teachers are uniquely positioned to address. Rather than focusing solely on infrastructure, PE promoters should implement need-supportive teaching practices, including competence-building tasks and cooperative peer structures, to foster the intrinsic motivational profile observed in the athletes and promote long-term PA adherence among non-athletic students, in alignment with the health objectives of Saudi Vision 2030.Non-Communicable DiseasesAccess
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MSIDAT: an automated platform for improved metabolite annotation in mass spectrometry imaging via mass shift evaluation and customized databases.1 day agoSpatially resolved metabolomics based on mass spectrometry imaging (MSI) enables in situ characterization of tissue-specific metabolic functions by mapping the spatial distribution of metabolites. However, accurate metabolite annotation and automated analysis of large-scale MSI data remain challenging, mainly due to mass-to-charge ratio (m/z) shifts and dependence on generic databases. To address these challenges, we developed the MSI Data Analysis Tool (MSIDAT), an automated and user-friendly MSI data processing platform. By integrating liquid chromatography-tandem mass spectrometry (LC-MS/MS)-assisted metabolite identification, customized metabolite ion databases can be constructed to improve the specificity and reliability of metabolite annotation. In addition, m/z shifts in MSI data were systematically evaluated using endogenous reference ions by calculating the relative mass error between theoretical and measured m/z values, enabling adaptive mass tolerance correction. Based on this strategy, mass error-informed metabolite matching and putative annotation were achieved. Furthermore, MSIDAT provides flexible parameter settings, modular workflows, and open-source accessibility, facilitating efficient and reproducible MSI data analysis. The performance of the platform was demonstrated in a clinical cohort of rectal cancer patients, in which hundreds of metabolites were putatively annotated and spatial alterations in tumor-associated metabolites were observed, suggesting fatty acid-related metabolic alterations. Overall, this study presents a robust and versatile analytical platform for improving metabolite annotation in MSI, thereby enhancing data mining efficiency and supporting spatial metabolomics-driven biomarker discovery and clinical applications.Non-Communicable DiseasesCare/Management
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Consumption of four unhealthy commodities and exposure to advertising, sponsorship, and promotion in Bamako, Mali.1 day agoNon-communicable diseases (NCDs) are the leading cause of death and disability globally and risks for many NCDs are associated with commercial determinants of health for tobacco, alcohol, ultra-processed foods (UPFs), and sugar-sweetened beverages (SSBs). Our aim was to understand reported consumption patterns of these four commodities along with reported exposure to advertising, promotion, and sponsorship (APS), focusing on vulnerable groups including young adults (18-24), less wealthy (quintiles 1 and 2), and women. We conducted a systematic randomized household survey of adults at two sites in Bamako, Mali to collect socio-demographic factors and measure reported consumption and exposure to APS for the commodities. We calculated descriptive statistics and performed χ2 tests to assess differences by three vulnerable groups. We surveyed 984 participants and found high reported consumption of SSBs (78%) and UPFs (67%) at least once per week, together with low reported current tobacco use (11%) and low reported alcohol use (1%) in the past 30 days. More than half of participants reported exposure to APS in the past 30 days for SSBs (76%) and UPFs (57%) while tobacco and alcohol reported exposure was lower (38% each). Young adults had higher reported consumption of SSBs and UPFs and higher reported APS exposure for both commodities compared with older groups. Systems-level interventions are recommended including increasing the SSB tax, adding a UPF tax, and strengthening enforcement of the APS ban for tobacco. These findings suggest further research on the usefulness of an APS ban for SSBs and UPFs targeted to young adults.Non-Communicable DiseasesCare/Management
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Aligning Continuing Medical Education with National Health Needs: A Qualitative Analysis of UP Med Webinar Topics and Hospital Admission Patterns in the Philippines.1 day agoContinuing Medical Education (CME) serves as a cornerstone for maintaining clinical competence and improving patient care. In the Philippines, CME has become increasingly digital, with the UP Med Webinars emerging as a leading platform for physician education over the past decade. Despite this growth, there has been limited evaluation of how well these webinars align with national health priorities, particularly those reflected in PhilHealth hospital admissions and claims data, which provide insights into the country's disease burden and healthcare utilization patterns.
This study aimed to determine the extent to which the topics and reach of UP Med Webinars correspond with the Philippine health system's most pressing clinical demands. Specifically, it aimed to analyze the trend in number of webinars by year; analyze the distribution of webinar topics by medical field; assess physician attendance as a proxy for clinical interest and engagement; evaluate the alignment between UP Med Webinar content and national health priorities based on PhilHealth's top conditions, procedures, and reimbursed claims.
The study used a qualitative content analysis of all Continuing Professional Development (CPD)-accredited UP Med Webinars from 2015 to 2024, supported by descriptive statistics. Webinar titles were coded thematically and categorized by topic and medical field. Attendance figures were analyzed to identify high-demand topics. These results were compared with PhilHealth Claims Reports (2020-2024), focusing on the top reimbursed medical diagnoses and procedures, to assess alignment with disease burden and health service delivery trends. These findings can help inform strategic planning for CME programs to ensure they remain responsive to the country's evolving public health needs.
From 2015 to 2024, a total of 686 CPD-accredited UP Med Webinars were conducted, attended by 685,994 participants. The annual number of webinars and attendees steadily increased, peaking during the COVID-19 pandemic (2020-2022) with heightened demand for virtual CME and pandemic-related topics. Internal Medicine consistently emerged as the most frequently covered field, accounting for 54.1% of webinars and 48.8% of total attendance, followed by Obstetrics and Gynecology (14.4% of webinars; 19.6% of attendance) and Pharmacotherapeutics (6.0% of webinars; 6.9% of attendance). Certain fields, including COVID-19 and Psychiatry, attracted disproportionately high attendance despite fewer sessions, indicating strong interest during periods of public health urgency. The top 10 webinar topics included Diabetes, Pregnancy, Cancer, Hypertension, Reproductive Health, COVID-19, Heart Disease, Antimicrobial Treatment, Vertigo, and Vaccination, reflecting a mix of chronic disease management, maternal health, infectious diseases, and emergent health concerns.Comparison with PhilHealth claims data (2020-2024) revealed a high disease burden in Internal Medicine, Obstetrics, and Pediatrics, with top medical conditions including Pneumonia, Dengue, Hypertensive emergencies, and Stroke. These findings indicate a strong alignment between the most covered webinar topics and national healthcare utilization trends, particularly in high-burden clinical areas.
Findings suggest that the UP Med Webinars have generally aligned with national health priorities, as indicated by PhilHealth claims data, particularly in high-burden fields such as Internal Medicine and Obstetrics. However, gaps in coverage for certain high-priority conditions and procedures point to opportunities for more inclusive and data-driven CME planning. Aligning CME content with evolving health system needs can enhance its relevance, support clinical practice improvements, and ultimately contribute to better population health outcomes in the Philippines.Non-Communicable DiseasesCare/Management