Barriers to Prevention and Treatment of Type 2 Diabetes Mellitus Among Outpatients in Belarus

ObjectivesThis study aimed to determine the main barriers and reasons for non-adherence to preventive measures and treatment for type 2 diabetes mellitus among outpatients in Belarus.MethodsAn anonymous questionnaire survey was conducted with 814 adults aged 18 years and over who visited outpatient health care units and hospitals in Belarus. The questionnaire was developed to analyze the perceived barriers that limit adherence to preventive measures and treatment for type 2 diabetes.ResultsThe proportion of respondents who reported doing daily physical activity was 53.2%, and 46.6% consumed at least 400 grams of fruit and vegetables per day. Among the 42.8% of respondents with a prescribed treatment for type 2 diabetes mellitus, 50.1% sometimes forgot to take their medicine. The specific barriers to treatment most frequently identified by survey respondents were “Financial situation” (23.5% of respondents), and “Fear of side effects” (25.2%). Those for lifestyle instructions were “Insufficient knowledge” (29.3%), “Financial situation” (27.9%), and “Lack of motivation” (21.7%).ConclusionsThe study revealed that the main barriers to adherence were insufficient knowledge of diabetes and its treatment and an underestimation of the role of behavioral risk factors in health, combined with financial difficulties. We recommend that physicians should take a patient-centered approach to raising awareness of behavioral risk factors for type 2 diabetes mellitus, and suggest that the importance of adhering to preventative measures and treatment should be promoted in consultations in Belarus.

The system of indicators of behavioral risk factors in Russia at the national and regional levels

Introduction. Behavioral risk factors are associated with 47% of all-cause mortality in Russia.The goal of this study was to assess and to select the available data sources on the burden of behavioral risk factors in Russia and its regions.Methods included collection and systematization of medical, demographic and survey which reflected the burden of behavioral risk factors in Russia.Results. The spectrum of sources of the data on behavioral risk factors among adults in Russia has significantly expanded in recent years. Rosstat agency provided regional survey data on prevalence of consumption of tobacco and other nicotine-containing products, physical activity, overweight and obesity. The survey results may underestimate alcohol and tobacco consumption due to the sensitivity of these questions. Therefore, the use of morbidity and mortality data is needed well. Detailed regional data on food product consumption in Russia are available, but the list of food groups needs to be updated to reflect current scientific knowledge. At the same time, there is no monitoring of the consumption of table salt and iodine by the Russian citizens. The data from Rosstat surveys on physical activity is available by the regions, and it provides more reliable results in comparison with the reports of sports organizations. Monitoring of behavioral risk factors among children and adolescents in Russia has yet to be organized.Conclusions. A number of data sources have been identified that can be used to assess the burden of behavioral risk factors in Russia and the regions, and ways to improve such monitoring are proposed.

Risks of health disorders in pedagogical, medical workers and preventive measures

The formation of a healthy lifestyle and a healthy lifestyle in the work of various activities, developing a program that includes appropriate measures to correct the functional state of employees of nervous and emotional labor, is currently one of the essential areas of occupational health. The study aims to assess the prevalence of behavioral risk factors for health disorders and the effectiveness of measures to correct overstrain in pedagogical and medical workers, depending on the personal level of anxiety. The researchers conducted comprehensive physiological and hygienic studies. We described behavioral risk factors, awareness of health-saving issues based on a questionnaire (346 teachers), a professional graphical assessment of the intensity of efforts. Psychophysical studies help to study the states of various functions of the central nervous system and the cardiovascular system, psychological testing, and general physical performance (GPP) according to the RWC170 test when evaluating the implemented model of motor activity and assess the effectiveness of relaxation in the shungite room. We performed static processing of the data obtained using statistical programs EpiInfo 3.5.2., Statistica 10, Microsoft Excel 2010 using adequate methods of statistical analysis. The study of the prevalence of the factors risky cheek of life for the health of teachers revealed insufficient physical activity (61.1% (95% CI 54.7-67.2)), inadequate sleep duration (46.1% (95% CI 40.0-52.4)), eating disorders (16.2% (95% CI 11.9-21.5)) tobacco smoking (15.8% (95% CI 11.5-20.9)). The developed and implemented regime, which increases the volume of motor activity to 8-9 hours a week instead of 3-4 hours, contributed to an increase in resistance to stress effects, a decrease in the percentage of identified teachers with a low level of physical fitness. A high degree of nervous and emotional tension in the work of general practitioners, the possibility of infection with COVID-19 leads to the formation of a high level of anxiety in a significant part (63.7-72.2%) of medical workers, which indicates the purposefulness of a psychological correction measure. The conducted production studies have shown the usefulness of using in programs for correcting the functional conformity of pedagogical and medical workers, an increase in motor activity using physical culture and sports, and relaxation in the shungite room.

Occurrence of Obesity in Patients with Cardiovascular Diseases

Objective: The aim of this research is to identify behavioral risk factors in patients with cardiovascular diseases with a focus on obesity. Design: Descriptive study. Participants: The sample group consisted of 878 patients with ischemic heart disease. Methods: Clinical, laboratory parameters and a questionnaire focused on identifying behavioral risk factors of one ́s lifestyle. Data processing through descriptive and inductive statistics. Results:The mean BMI is 29.39 (± SD 4.69). The results show that 355 (40.2%) patients have obesity and we identified overweight as a precursor to obesity in 377 (42.93%) patients. We found deficiencies in behavioral risk factors (smoking, al- cohol consumption, nutrition, physical activity) in all patients. A significant relationship was confirmed between smoking, alcohol consumption and obesity. Conclusion: The results of our research suggest that there is a need to improve primary and secondary prevention inpa- tients, healthcare professionals and government policy.

Review on Non-Communicable Diseases in India and their Respective Diagnostic Platforms

Non-communicable diseases (NCDs) increasing the burden in India. NCDs are viewed as pandemic because of the expanding pace of mortality and morbidity. Urbanization in India prompts undesirable ways of lifestyle, physical inactivity, biological, behavioral risk factors, and migration of the country metropolitan populace in India, the thought of different NCDs and their danger factors shows wide varieties across the populace. It’s believed the health care system can curb the situation by managing preventive measures that allow controlling the threat. Keywords: Non-communicable diseases (NCDs), mortality, morbidity.

A Study on Behavioral Risk Factors of Non-Communicable Diseases among Rural School Going Adolescents in a Block of Hooghly District, West Bengal

Introduction: Cost effective interventions (educational and behavioural interventions) for the reduction of non-communicable diseases risk factors should be promoted especially in the low and middle income countries such as India. Method: A pre-designed and pre-tested questionnaire was used in class-room setting to collect information from students regarding their socio- demographic characteristics and presence of behavioral risk factors of non-communicable diseases. Results: A total of 761 students of class VI-XII participated in the study of which 61.4% were boys and rests were girls. Most common risk factor was ‘intake of extra salt with food’ (54.7%), followed by fast food intake >3 times/week (33.8%). Statistical analysis by chi square test revealed that extra salt intake, tobacco use and alcohol use was significantly associated with age. Similarly, sex of the students was significantly associated with tobacco use, alcohol use and physical activity (p <0.05). Father’s education was significantly associated with extra salt intake in food. Mother’s education was significantly associated with unsatisfactory intake of fruits and vegetables (< 5 times/week), extra salt intakes in food and tobacco use (p <0.05). Father’s occupation was significantly associated with fast food intakes and physical activity whereas mother’s occupation had significant association with tobacco use (p <0.05). Conclusion: Healthy children are the foundation for a healthy nation. The universal belief is that schools are designated as an important setting in which children should develop behaviour and skills for physical, emotional and social well-being. Keywords: Adolescents, Behavioral Risk factor, Socio- Demographic characteristics, Rural school.

901. Integrated Community Health Screening for COVID-19 and HIV Promotes HIV Diagnoses and Linkage to Care

Background New Jersey experienced a 64% decrease in HIV screening during the COVID-19 pandemic, hampering the Federal “End the Epidemic Initiative”. From March 2020- May 2021, North Jersey Community Research Initiative, a community-based organization in Newark, NJ, noted a HIV seropositivity of 3.1% despite a decrease of 25% in testing. Qualitative interviews conducted virtually with community individuals and focus groups during that time period indicated that COVID-19 suggested clients were taking more risks due to feelings of isolation, depression and anxiety. NJCRI in collaboration with Robert Wood Johnson Medical School in Somerset, NJ and five other community-based partners in NJ wanted to assess if offering community combination COVID-19 screening and HIV screenings during the pandemic would increase community screening for HIV. Methods CLIA Waived Screening for COVID-19 from two antigen assays, LumiraDx and BD Veritor was combined with a referenced laboratory based molecular screening from saliva Infinity Biologix under FDA emergency use authorization within CDC guidance with HIV Alere/Determine and INSTI in those individuals that identified as asymptomatic for COVID-19 but with high risk for HIV Results NJCRI began the COVID-19 and HIV rapid screening to clients on January 4, 2021.Clients tested for COVID-19 (N=274), 3% tested positive for HIV and &lt; 3% are self-reported HIV+ (94% of the sample tested negative for HIV). Overall, 92% of clients tested negative for COVID-19. Clients testing positive for COVID-19 (N=19), there was a 6% positivity rate utilizing COVID-19 Antigen by nasal swab. Those positive via COVID-19 Molecular (N=19) method, results indicate clients also tested positive 6% of the time using a saliva indicator. Approximately, 5% of the study sample are confirmed COVID-19 positives via both testing methods (separately 1% Antigen and &lt; 2% Molecular). 19% of the sample (N=3) tested positive for both HIV and COVID-19. Figure 2. Demographics Figure 3. Social and Economic Risk Factors Conclusion Newly diagnosed patients were treated the same day with antiretroviral therapy; linked to medical care, behavioral health and risk reduction services. Combining COVID-19 and HIV screening in a trusted community-based setting improved delivery of HIV care and linkage to care for newly diagnosed individuals in Newark, NJ. Figure 4. Behavioral Risk Factors Figure 3. Social and Behavioral Risk Factors Disclosures All Authors: No reported disclosures

Regional, Ethnic and Age-Sexual Features of Acute Coronary Syndromes in Fergana Region

Background. Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. The most important behavioral risk factors for heart disease and stroke are unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol. Exposure to behavioral risk factors can manifest in humans as high blood pressure, high blood glucose, high blood lipids, and overweight and obesity. Methods. The research was conducted on hospitalized male and female patients aged from 26 to 88 years with suspicion of the acute coronary syndrome (ACS) at the time of admission to the hospital in the Andijan and Fergana Valley. Overall, 653 patients were examined. The study included a retrospective and prospective part with the inclusion of patients with ACS. Findings. Fairly wide prevalence of ACS was revealed in terms of their epidemiological characteristics in both gender groups, as well as in different age groups. It is necessary to improve the work on "life-saving prevention" among the population in relation to an adequate assessment of the symptoms of CVD in patients and the implementation of medical recommendations for optimizing prevention, early detection and treatment of ACS.

Behavioral risk factors and clinical course of cardiovascular diseases and other noncommunicable diseases during quarantine in various regions of Russia

Aim. To assess the behavioral risk factors and the clinical course of cardiovascular diseases (CVDs) and other noncommunicable diseases (NCDs) during quarantine in various regions of Russia.Material and methods. This multicenter cohort cross-sectional study included 205 men and women from 6 Russian cities. Further, 4 of them (Saransk, Nizhny Novgorod, Penza, Ulyanovsk) were combined into one group — the Volga region. The study included men and women aged 30-69 years with one or more NCDs (hypertension, coronary artery disease with or without myocardial infarction, type 2 diabetes, chronic obstructive pulmonary disease/asthma and cancer in patients receiving chemotherapy and/or radiation therapy) who were self-isolated during coronavirus disease 2019 (COVID-19) pandemic. For all patients, a questionnaire was used, which included socio-demographic parameters, behavioral risk factors, status of the underlying disease, incidence of COVID-19 and its complications. Self-assessment of the state of health was carried out using the European Quality of Life Questionnaire.Results. In every third Muscovite, the intensity of physical activity decreased, and in the groups of patients from Omsk and the Volga region, it was 45% and 43%, respectively. An increase in meal frequency and an impairment of eating habits in Moscow and Omsk was noted in 18,2% and 18,7% of participants, while in Volga region subjects, these parameters were 2 times higher (42,4%). At the same time, no significant changes of alcohol consumption and smoking was revealed in the cohorts. Hypertensive crises during a pandemic were noted in all three subgroups, but more of them were recorded in the Volga region — in every third patient (p< 0,05 compared to Moscow), in the Omsk group — in every fourth patient, and among Muscovites — no more than 5%. Clinical deterioration in patients with angina was noted in 15% of cases, while the smallest number was noted in Omsk subjects (5,3%), three times less than in other subgroups. Changes in intensity and regimen of hypoglycemic therapy were noted in patients from Omsk, while 30% of them (p< 0,05 compared with the Volga region) increased the doses of medications taken. Chronic obstructive pulmonary disease was registered in the group with the largest number of Volga region patients — 14,1% (p< 0,05 compared to Omsk), while 17% of patients in this group increased the dose of drugs. Any cancer was recorded in 13,6% of Muscovites, while in the other two groups — about 5%. The largest number of patients from the Volga region noted a health decline over the past year (30,8%), while every fifth patient from Omsk (19,6%) and 13,6% of Muscovites reported health changes.Conclusion. During quarantine and self-isolation, changes in dietary habits and physical activity decline were noted among patients with NCDs, while alcohol consumption and smoking remained practically unchanged. The change in clinical status was characterized by an increase in hypertensive crisis incidence, an increase in doses of antihypertensive and hypoglycemic medication. Depending on the region, the health decline was noted by 13-31% of patients with NCDs.