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The dual epidemic of non-communicable diseases (NCDs) and human immuno-deficiency virus (HIV) in Sub-Saharan Africa has increased substantially in recent years, with cardiovascular disease representing a significant contributor to the regional burden of disease. Very little is known about the cardiovascular health of people deprived of their liberty in the region. The purpose of this study was to collate extant literature on the topic.

A scoping review mapped and described what is known about cardiovascular disease in prison populations in Sub-Saharan Africa. A systematic search of empirical literature with no date limitation was conducted in English. Sixteen studies representing six Sub-Saharan African countries (Cameroon, Nigeria, Guinea, Burkina Faso, Ghana and Ethiopia) were charted, categorised and thematically analysed.

Seven key themes were identified: custodial deaths and autopsy; cardiorespiratory fitness and exercise; cardiovascular disease and elderly people in prison; cardiovascular disease and women in prison; dietary deficiencies; influence of sleep patterns on cardiovascular disease; and other associated risk factors. Most natural deaths at autopsy of custodial deaths were due to cardiovascular disease. Cardiorespiratory fitness was low in prisons, and poor sleep patterns and dietary deficiencies are likely contributors to the burden of cardiovascular disease in prisons. The needs of elderly and female prison populations are ill-considered.

To the best of the authors’ knowledge, this is the first known attempt to scope extant literature on cardiovascular disease in Sub-Saharan African prisons. A strategic focus on the cardiovascular health of people in prison is warranted. Routine monitoring and expansion of existing prison health-care services and integration of NCD services with infectious disease (HIV and tuberculosis) programmes in prisons are required.

In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

This study aims to analyze the pattern of deaths in detention in Northern Tunisia as well as the causes of death.

The authors conducted a cross-sectional retrospective study including all the casualties of death in detention examined in the legal medicine Department in the main teaching hospital from 2005 to 2019. The department covers 10 out of the 11 governorates of Northern Tunisia and 13 prisons.

Of a total of 197 casualties, only 2 were females. The mean age was 45.39 ± 14.43 years. A known medical history was reported in 63.5%, mainly cardiovascular disease, mental health disorders and diabetes. Half of the deaths occurred at the hospital. A total of 53 victims spent less than one year in custody before their death. Most deaths occurred due to disease-related causes (78.7%; n = 155); among these, 69 victims died from cardiovascular disease. Suicide accounted for 3.6% of the casualties and homicides for four cases.

Several missing data regarding the details of the detention circumstances as well as the absence in some cases of the toxicological and histopathology analysis results, which could bias the study findings.

Death in detention in Northern Tunisia involved mainly males between their 30s and their 50s who died mainly from cardiovascular or pulmonary disease. These results underscore the importance of empowering the penitentiary health system.

To the best of the authors’ knowledge, this study is one of largest studies with regard to the number of decedents and the number of prisons from the Arab countries allowing to draw a pattern of casualties of death in prison.

The health of people living in prisons (PLP) frequently remains marginalised in national development discourse, particularly in resource-constrained settings like Ghana. This study aims to determine the prevalence of cardiovascular disease (CVD) risk factors among PLP at a prison facility in the Northern Region of Ghana.

A cross-sectional study involving 134 male persons in prison, aged 18–79 years, was conducted to assess their dietary habits, tobacco use, alcohol consumption, sleep behaviour and physical activity practices. Serum lipid profile, fasting blood glucose (FBG), blood pressure (BP) and body mass indices of participants were also measured.

Almost half (48.1%) of the participants had abnormal lipid levels. Those with FBG in the diabetes range (= 7.0 mmol/l) constituted 3.9%, while 16.7% were in the impaired FBG range (6.1–6.9 mmol/l). Participants with BP within the pre-hypertension range were 54.5%. The majority of participants (92%) had a low daily intake of fruits and vegetables. Few participants were active smokers (5%) and alcohol users (2%). The average sleep duration at night among the participants was 5.54 ± 2.07 h. The majority (74%) of the participants were sedentary. About a quarter of the participants (24.6%) had overweight/obesity.

This study highlights the CVD risks among PLP. Findings suggest the need for targeted interventions, such as dietary and lifestyle modification strategies, regular physical activity and routine screening for diabetes, dyslipidaemia and hypertension. These interventions within the prison space could significantly improve the cardiovascular health of PLP in resource-limited settings.

This study aims to determine the relationship between body mass index (BMI) and Global Registry of Acute Coronary Events (GRACE) risk score in patients diagnosed with acute coronary syndrome (ACS) and to evaluate the results in this context.

This was a prospective cohort study of ACS patients admitted to a cardiac care unit in high specialization hospital's cardiology service. The study included 140 men aged >35 years who were diagnosed with ACS.

The mean age of the individuals participating in the study was 61.4 ± 10.9 years old. The mean BMI of the individuals was 25.3 ± 6.6 kg/m², and the mean value of the waist/hip ratio was 0.85 ± 0.01. Individuals were divided into four quarters according to the GRACE score. It was determined that individuals with the highest GRACE score were very underweight or morbidly obese according to their BMI values (p = 0.04).

It has been observed that there is a U-shaped relationship between the GRACE score and the BMI in individuals diagnosed with ACS. The risk of death of ACS patients with very high or very low BMI values was found to be close to each other. Although there is a relationship between BMI and GRACE score, it is concluded that it is insufficient to determine the risk in coronary disease alone, and body fat distribution should be examined together with BMI.

Blood lipid and lipoprotein abnormalities are common among patients with diabetes. The study aimed to assess dietary fat intake and its association with blood lipids among patients with Type 2 diabetes mellitus (T2DM) considering sex differences.

A cross-sectional observational study was conducted with patients (207 males and 197 females) with T2DM. The daily food intake and its contents of fat and fat types were assessed through face-to-face interview. Anthropometric measurements, glycated hemoglobin (HbA1c), triglyceride, total cholesterol (TC), high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol were initially recorded.

The results revealed that TC, LDL and HDL cholesterol levels were significantly higher in females than in males. However, the TC: HDL ratio was significantly higher in males than in females. The results also showed that the daily intake of saturated fatty acid (SFA) slightly exceeded the daily recommended allowance. However, the monounsaturated fatty acid + polyunsaturated fatty acid/SFA (MUFA + PUFA/SFA) ratio was within the recommended ratio. In addition, this study found that the main sources of SFA and cholesterol intake were milk and milk products. A significant association between high fat intake and HbA1c levels was observed (r = 0.234, p < 0.001).

As it is a cross-sectional observational study, this study has the natural limitation where it can only demonstrate an association.

The types of dietary fat intake may contribute to blood lipid abnormalities and differences effects may exist among male and female. Studies on the effect of daily fat intake and its types on blood lipids in patients with diabetes, in particular Saudi patients with diabetes are limited. This study focused on the amount and type of the consumed fat among male and female Saudi patients with T2DM and studied the relationship between the type of consumed fat and blood lipid profiles.

According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.

This study aims to investigate the impact of regular Kung Fu and Taekwondo practice on the health and quality of life among elderly individuals in the Maule region, Chile.

The authors designed a 12-week Kung Fu and Taekwondo workshop with activities suitable for their age. Through semistructured interviews (at the beginning and the end of the workshop), along with periodic monitoring of vital signs and cardiovascular components, the authors observed an improvement in participants’ physical (strength, speed of reaction and flexibility) and psychological conditions (self-esteem and resilience), quality of life (relationships with family and friends and ability to deal with stressful events in working life) and health (waist circumference, percentage of oxygen saturation in blood, blood pressure, among other values).

From these results, the authors affirm that this workshop improves health and physical condition and helps the participants develop the coping capacity to deal with stressful situations and complicated interpersonal relationships. In this sense, the authors conclude that Kung Fu and Taekwondo as regular sports activities can benefit senior citizens’ aging process.

This research is based on an original study project.

To better understand the reality of living with the diseases and conditions that its drugs and therapies are developed to treat, the Novartis leadership determined a need for more meaningful insights into patients’ lives. They sought to develop a systematic, creative methodology – informed by the psychology of insightful rather than analytical thinking – to properly integrate and deploy the research commissioned into its day-to-day business decision-making. For it is well established that better understanding of the patient reality drives both compliance and adherence “beyond the pill”. The purpose of this paper is to bring the novel methodology of creativity to a wider audience and ensure that many others – notably in patient advocacy organizations – can benefit from this approach.

A core team of Insight and Analytics and Patient Engagement leads from various therapeutic area teams worked in partnership with a psychologist and practitioner in the field of insightful thinking, to develop an effective methodology that could reliably surface and articulate genuine patient insights. This methodology – the i4i Insights Discovery™ process – was developed, piloted, refined and codified in 2020 and implemented across the company in 2021–2022. It uses a combination of convergent and divergent thinking techniques – human rather than artificial intelligence, combining diverse research outputs – to understand patients’ lives better. With enhanced understanding, the insights then shape educational and behavioral strategies to drive adherence and compliance.

At a time of tightening budgets and demands to deliver enhanced impact from research budgets, i4i Insights Discovery™ has enabled Novartis teams to turn existing research outputs into profound and useful understandings of what it means to live with specific diseases and develop evidence-based patient engagement strategies; insight-driven decision-making around the lifecycle of any compound. i4i Insights Discovery™ has been applied across Novartis’s diverse areas of expertise, from heart disease to cancer, from organ transplantation to dermatology, from food allergy to ophthalmology.

The i4i Insights Discovery™ process enables Novartis teams to gain deeper understanding of patients’ lives without the need to commission additional research; to do more with less. These insights enable cross-functional Novartis teams to develop better-informed strategies that better address the needs of patients and their care partners, of health-care professionals and health-care systems. The team creating the process is looking to make the i4i Insights Discovery™ approach a gold standard of insight discovery, both for pharma and health care and in other categories, too.

The i4i Insights Discovery™ process is a practical, novel application of well-established principles in the psychology of insightful thinking to address a clear business imperative. By repurposing and reinterpreting existing research outputs using creative verbal and visual exercises, it delivers a more human and empathetic understanding of the patient reality. It moves teams from “So what?” – this is what the data mean – to “Now what?” – this is what we should do as a result.

The purpose of this study is to collect and assess the evidence available on the effect of non nutritive sweeteners on appetite, weight and glycemic regulation. As a replacement for sugars, non-nutritive sweeteners (NNSs) are widely being used in different food products with the assumption that these would lower calorie intake and help to manage weight and blood sugar levels better. However, studies using animal models have reported that chronic exposure to NNSs leads to increased food consumption, weight gain and insulin resistance.

Evidence was acquired from systematic reviews or meta-analyses (2016–2021) of relevant clinical studies, especially randomized control trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

The review showed NNSs exposure did not conclusively induce increased food intake or change in subjective appetite ratings. Appetite biomarkers like ghrelin, gastric inhibitory peptide, C-peptide levels and Peptide YY remained mostly unaffected by NNSs. Meta-analyses of human randomized control studies showed a reduced energy intake and body weight. No significant change was seen in blood glucose levels, post-prandial glycemic or insulin response after consumption of NNSs. Adequate evidence is not available to conclusively say that NNSs influence gut health at doses relevant to human use.

Most studies which are prospective cohort, observational and cross-sectional studies suggest that use of NNSs may promote obesity and metabolic syndrome in adults. Such studies are plagued by confounding variables and reverse causation. Mechanistic evidence is mostly based on in-vitro and in-vivo studies. The same causal pathways may not be operative or relevant in humans.

This review of available literature concludes that to achieve specific public health and clinical goals, the safe use of NNSs for the reduction of intakes of free sugars and energy should be explored. This would be possible by educating the consumer about energy compensation and understanding the nutritional content of artificially sweetened products in terms of calories coming from fat and complex carbohydrates used in the product.

This study was, thus, designed with the objective of examining the usefulness of NNSs in human population, especially with respect to insulin regulation, glycemic control and weight management. Well-designed randomized control trials which control for confounding variables are needed to generate high quality evidence.