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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

Background Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. Methods We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. Results We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). Conclusions Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. more

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Selection of essential medicines for the prevention and treatment of cardiovascular diseases in low and middle income countries

Bazargani, Y.T.; Ugurlu, M.; Leufkens, H.G.M. et al. BMC Cardiovascular Disorders (2018) CC

The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NE... more

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Building better immunity: A life course approach to healthy longevity

Pan American Health Organization PAHO (2023) C_WHO

As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt... more

Individual-level data in 680 102 adults, The state of diabetes treatment coverage in 55 low-income and middle-income countries: a cross-sectional study of nationally representative

Flood, D.; Seiglie, J.A.; Dunn, M.; et al. The Lancet healthy Longevity (2021) C2

Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... more

MEPs Mobilising for Diabetes Blueprint for Action on Diabetes in the European Union by 2030

MEPs Mobilising for Diabetes (2021) CC2

Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people with diabetes (PwD), notably reducing the daily burden of its management. Newer technologies, including those driven by artificial intelligence, have the potentia... more

A New Agenda for Mental Health in the Americas: Report of the Pan American Health Organization High-Level Commission on Mental Health and COVID-19

Pan American Health Organisation PAHO (2024) C_WHO

Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve... more

2023 حالة أطفال العالم لعام

UN Children's Fund UNICEF (2024) CC

The article focuses on "The State of the World’s Children 2023" report published by UNICEF. It highlights the critical role of vaccines in saving lives and the challenges in global immunization efforts, especially for marginalized and underserved children. The report emphasizes the impact of COVID... more

Type 2 diabetes in adults: management

National Institute for Communicable Disease (NICE) National Institute for Communicable Disease (NICE) (2022) CC2

This guideline covers care and management for adults (aged 18 and over) with type 2 diabetes. It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long-term complications.

Management of diabetes A national clinical guideline

Helthcare Improvement Scotland (2017) CC2

Diabetes mellitus is a major cause of morbidity and mortality in Scotland and worldwide, with an increasing prevalence. In 2009 there were around 228,000 people registered as having diabetes in Scotland, an increase of 3.6% from the preceding year. This increase relates, in part, to the increasing a... more

Air pollution and the noncommunicable disease prevention agenda: opportunities for public health and environmental science

Howse, E.; Crane, M.; Hanigan, I. et al. Environmental Research Letters (2021) CC

Air pollution is a major environmental risk factor and contributor to chronic, noncommunicable diseases (NCDs). However, most public health approaches to NCD prevention focus on behavioural and biomedical risk factors, rather than environmental risk factors such as air pollution. This article discus... more

Global alcohol action plan 2022-2030

World Health Organization WHO (2021) C_WHO

Alcohol use is deeply embedded in the social landscape of many societies, and some 2300 million people drink alcoholic beverages in most parts of the world. At the same time, more than half of the global population aged 15 years and older reported having abstained from drinking alcohol during the pr... more

Action plan (2022–2030) to effectively implement the global strategy to reduce the harmful use of alcohol as a public health priority

World Health Organization WHO (2023) C_WHO

Alcohol consumption is deeply embedded in the social landscape of many societies. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and trends i... more

Hypertension in adults: diagnosis and management

the National Institute for Health and Care Excellence (NICE) the National Institute for Health and Care Excellence (NICE) (2023) CC

The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di... more

National Community Health Strategy 2017-2022

Government of the Republic of Malawi (2017) CC

The Government of Malawi is committed to improving health and livelihoods in Malawi through community health – the provision of basic health services in rural and urban communities with the participation of people who live there. Historically, Community Health has significantly contributed to im... more

Report of the workshop for implementing the WHO South-East Asia Regional NCD Roadmap, 2022-2030 WHO

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and diabetes, identifying the most impactful NCD interventions within their context, closing the gaps in ca... more

Global status report on noncommunicable diseases 2014 WHO

World Health Organization (WHO) World Health Organization (WHO) (2014) C_WHO

This global status report on prevention and control of NCDs (2014), is framed around the nine voluntary global targets. The report provides data on the current situation, identifying bottlenecks as well as opportunities and priority actions for attaining the targets. The 2010 baseline estimates on N... more

Global action plan for the prevention and control of noncommunicable diseases 2013-2020 WHO

World Health Organization (WHO) World Health Organization (WHO) (2013) C_WHO

The Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020 by the World Health Organization (WHO) outlines a comprehensive strategy to address the global rise in noncommunicable diseases (NCDs), including cardiovascular diseases, cancer, chronic respiratory diseases,... more

Action Plan for Implementation of Recommendations from the Evaluation of PAHO's Response to COVID-19

Pan American Health Organisation PAHO (2024) CC

An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions... more

Epidemiology and Challenges of Managing COPD in sub-Saharan Africa

Magitta, N.F.; Sciences, A. Acta Scientific Medical Sciences (2018) CC2

There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness and inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for ... more

Monitoring asthma in children

Pijnenburg, M.W.; Baraldi, E.; Brand, P.L. et al. European Respiratory Journal (2015) CC

The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i... more