Tag Archives: health

Sedentary behavior increases risk of death for frail, inactive adults

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Sedentary time, for example, time spent sitting, increases the risk of death for middle-aged and older people who are frail and inactive, but does not appear to increase the risk for nonfrail people who are inactive, according to a new study published in CMAJ (Canadian Medical Association Journal).

Many studies have looked at the benefits of physical activity on health, although little data exists on sedentary behaviour and risk of death linked to levels of frailty. Frailty refers to a person’s overall health state, determined by the number of health problems this person has.

To understand if level of frailty and prolonged sitting are linked to a higher risk of death, researchers looked at data on 3141 adults aged 50 and over in the US National Health and Nutrition Examination Survey (NHANES) from 2003/04 and 2005/06. Participants used activity trackers during waking hours and were assessed using a 46-item frailty index; they were then followed until 2011 or date of death.

“We found that in people who scored low on the frailty index, sitting time was not linked to risk of death,” states Dr. Olga Theou, Department of Medicine, Dalhousie University, Halifax, Nova Scotia. “Prolonged sitting was associated with a higher risk of death only in vulnerable or frail people who did not meet the weekly recommendation for 2.5 hours of moderate physical activity.”

The authors note study limitations such as limited activity tracking data for people with higher levels of frailty, which prevented them from segmenting people with severe frailty into one category for analysis.

“Physicians should stress the harms of inactivity with patients, similar to the harms of smoking, to encourage movement,” states Dr. Olga Theou. “Even something as simple as getting up and walking around the house with a walker or cane can benefit frailer people.”

The authors suggest this key public health message should be included in health promotions about the importance of healthy behaviours.

Depression overshadows the past as well as the present

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Depressed people have a peculiar view of the past – rather than glorifying the ‘good old days’, they project their generally bleak outlook on to past events, according to new research.

It is known depression makes sufferers see the present and the future as sad, but this is the first time research has shown it also casts a long shadow over people’s memories of the past.

Psychologists at Germany’s Heinrich Heine Universität Düsseldorf and at the UK’s University of Portsmouth published their research in Clinical Psychological Science.

It establishes the first clear link between depression and hindsight bias, or a distorted view of the past.

Dr Hartmut Blank, in the University of Portsmouth’s Department of Psychology, is one of the authors.

He said: “Depression is not only associated with a negative view of the world, the self and the future, but we now know with a negative view of the past.”

Hindsight bias includes three core elements: exaggerated perceptions of foreseeability – we think we knew all along how events would turn out; inevitability – something ‘had’ to happen; and memory bias – misremembering what we once thought when we know the outcome of something.

Hindsight bias has been studied in various settings, including sports events, political elections, medical diagnoses or bankers’ investment strategies. Until now, it hasn’t been used to study depression.

Dr Blank said: “Everyone is susceptible to hindsight bias, but it takes on a very specific form in depression. While non-depressed people tend to show hindsight bias for positive events but not negative events, people with depression show the reverse pattern.

“Making things worse, depressed people also see negative event outcomes as both foreseeable and inevitable – a toxic combination, reinforcing feelings of helplessness and lack of control that already characterise the experience of people with depression.

“Everyone experiences disappointment and regret from time to time and doing so helps us adapt and grow and to make better decisions. But people with depression struggle to control negative feelings and hindsight bias appears to set up a cycle of misery.

“We have shown hindsight bias in people who are depressed is a further burden on their shoulders, ‘helping’ to sustain the condition in terms of learning the wrong lessons from the past.”

The researchers tested over 100 university students, about half of whom suffered from mild to severe depression. They were asked to imagine themselves in a variety of everyday scenarios with positive or negative outcomes (from different domains of everyday life, e.g. work, performance, family, leisure, social, romantic). For each scenario, the researchers then collected measures of hindsight bias (foreseeability, inevitability and distorted memory for initial expectations).

The results showed that with increasing severity of depression, a specific hindsight bias pattern emerged – exaggerated foreseeability and inevitability of negative (but not positive) event outcomes, as well as a tendency to misremember initial expectations in line with negative outcomes. Characteristically, this ‘depressive hindsight bias’ was strongly related to clinical measures of depressive thinking, suggesting that it is part of a general negative worldview in depression.

Dr Blank said: “This is only a first study to explore the crucial role of hindsight bias in depression; more work needs to be done in different experimental and real-life settings, and also using clinical samples, to further examine and establish the link between hindsight bias and depression.”

Kidney, Heart Transplants On Rise

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As per the data available with National Organ and Tissue Transplant Organisation (NOTTO), 54, 110, 235 and 190 heart transplants and 720, 1024, 1368 and 805 kidney transplants have been undertaken in 2014, 2015, 2016 and 2017, respectively. The State/UT wise details of heart and kidney transplants are given below:

 

S.No. States 2014   2015   2016   2017  
Heart Kidney   Heart Kidney   Heart Kidney   Heart Kidney  
1 Tamilnadu 41 227   51 290   100 339   Consolidate data for year 2017 Consolidate data for year 2017  
2 Kerala 6 104   14 132   18 113    
3 Maharashtra 0 89   5 106   34 229    
4 Telangana & Andhra Pradesh 1 92   19 168   15 182    
  Andhra Pradesh x x   x x   18 87    
5 Karnataka 5 72   11 91   14 142    
6 Gujarat 0 55   0 77   4 83    
7 Madhya Pradesh x x   1 6   7 28    
8 Uttar Pradesh 0 14   0 8   1 16    
9 Delhi /NCR 0 32   6 45   18 62    
10 Puducherry 0 26   1 18   1 20    
11 Chandigarh 1 9   1 69   2 51    
12 Rajasthan x x   1 14   3 16    
  Total 54 720   110 1024   235 1368   190 805  

The Minister of State (Health and Family Welfare), Smt Anupriya Patel stated this in a written reply in the Lok Sabha here today.

Aajeevika Grameen Express Yojana (AGEY) to be Launched

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The Government of India has decided to launch a new sub-scheme named “Aajeevika Grameen Express Yojana (AGEY)” as part of the Deendayal Antyodaya Yojana – National Rural Livelihoods Mission (DAY-NRLM). The Self Help Groups under DAY-NRLM will operate road transport service in backward areas. This will help to provide safe, affordable and community monitored rural transport services to connect remote villages with key services and amenities (such as access to markets, education and health) for the overall economic development of backward rural areas. This will also provide an additional avenue of livelihood for SHGs. The basic outline of AGEY was discussed in a meeting of State Transport Ministers of 13 States held in June 2016 at Dharamshala, Himachal Pradesh and all the Transport Ministers had expressed their appreciation of this initiative.

The Community Investment Fund (CIF) provided to Community Based Organization (CBOs) under DAY-NRLM will be utilized to support the SHG members in this new livelihoods initiative. The beneficiary SHG member will be provided an interest free loan by the CBO from its Community Investment Fund upto Rs.6.50 lakh for purchase of the vehicle. Alternative, CBO will own the vehicle and lease it to an SHG member to operate the vehicle and pay lease rental to the CBO

AGEY will be initially implemented in 250 Blocks in the country on pilot basis with each Block provided upto 6 vehicles to operate the transport services. During the current year implementation of the scheme has been so far approved for 52 Blocks in 8 States namely Andhra Pradesh, Jharkhand, Maharashtra, Tamil Nadu, Telangana, Uttarakhand and West Bengal with a total provision of Rs.16.06 Crore of which the Government of India share would be Rs.10.16 Crore. The balance funding would be provided by the respective States.

The Blocks will be selected by States from among the Blocks where NRLM is being implemented intensively and where mature CBOs are already functioning. Backwardness, lack of transportation links and sustainability of service would be the guiding factors in the selection of Blocks and routes.

The State Rural Livelihood Missions (SRLMs) will do a feasibility study and traffic survey in the selected blocks to identity the routes and the number and capacity of vehicles which can be operated on sustainable basis. The study will be conducted by technically sound organizations with expertise in transport network planning. The choice of vehicle could be either e-riksha, 3 wheeler or 4 wheeler within a cost ceiling of Rs.6.50 lakh.

The SRLMs will be co-ordinating with State Transport Department for issue of permit for the vehicle. The SHG member operating the vehicle shall ensure that all necessary legal and statutory requirement such as valid permit, road tax permit, valid insurance policy etc. are met.

The SHG member shall run the vehicle on approved routes at pre-determined frequency as jointly agreed between the CBO and the SHG operator based on financial viability and the need for transport link.

All vehicles under the scheme shall have a defined colour code and carry AGEY branding to ensure their identity and avoid diversion to other routes.

The State Rural Livelihood Mission will arrange capacity building for their staff at State, District and Block levels for operating the Scheme. The members of the CBO and the beneficiary SHG member shall also be provided adequate training in the Rural Self Employment Training Institutes (RSETIs) and other partner organizations.

Early puberty may mean less time in education for girls

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The age at which girls have their first period may influence how long they stay in education.

The findings come from a study in which researchers have tried to untangle the effect of the age at first period from other complex factors that might affect time spent in education, revealing that young women who start their periods earlier may spend less time in the education system.

Previous research has indicated girls who reach sexual maturity earlier may be more prone to developing depression and, in low and middle income countries, more vulnerable to early pregnancy and negative sexual health outcomes, but whether it affects how long they spend in education was unclear.

Studies trying to pick apart the link between the age at which a girl has her first period — called menarche — and how long they spend in education can be muddied by numerous factors, including obesity, socio-economic status, and parental education level.

Now, a team led by researchers at Imperial College London has tried to untangle this complex relationship by turning to genetic markers as a proxy for the age of first period. Using a statistical method called Mendelian randomization, they attempted to remove the influence of external factors such as diet and lifestyle — which are known to be associated with both early menarche and less time in education.

By using genetic markers known to be associated with menarche, the researchers have revealed an impact of the age of first menstruation on the amount of time spent in education.

“It’s well established that the length of time that someone spends in education can have repercussions later on in life,” said Dr Dipender Gill, a Wellcome Trust Clinical Research Fellow at Imperial and lead author of the study. “It is associated with socio-economic status, rates of depression, risk-taking behaviour and a range of health outcomes, so clearly time spent in education is important. This study identifies that the age of puberty may have an effect on the length of time that women spend in education.”

In the study, published in the journal Behaviour Genetics, researchers looked at data from more than 180,000 European women, where 122 points in the genome where a single ‘letter’ difference in the DNA — called a single nucleotide polymorphism (SNP) — were associated with the onset of menstruation in girls.

The effects of these markers on time spent in education were then estimated using a separate dataset including more than 118,000 women over the age of 30 and of European descent, where participants had provided the number of years spent in education.

Analysis revealed a small but statistically significant causal link between markers for age at menarche and the length of time women spent in education. The findings showed that on average, starting menstruation one year later was associated with approximately an additional 53 days spent in education.

According to the researchers, one possible explanation for the observed effect could be due to young women being treated as more mature due to physical changes, while their emotional development takes time to catch up. Such a delay between physical and mental maturation may give rise to factors which lead to less time spent in education, such as increased risk-taking behaviour, or a failure to adapt psychologically to changes in how they are treated.

The group reports that the data could be skewed by women self-reporting the age they had their first period. In addition, the extended age ranges of women in the study group — born over nine decades (1901 to 1989) — overlaps with societal changes and the establishment of educational programmes. They add that the findings cannot be used to predict how long a young woman might stay in education, based on her age at her first period.

According to the researchers, now that a link has been established, the next step is to work out why age of menarche is having such an effect.

“Once we understand the mechanism, it might give us the opportunity address the discrepancies that we’re seeing,” explained Dr Gill.

“Going through puberty is associated with various physiological and psychological changes,” he adds. “It might be that girls who go through puberty earlier are less well-equipped to deal with the pressures. They may be suffering as a result and this might be manifest in the length of time that they spend in school.”

‘Age at menarche and time spent in education: a Mendelian Randomization study’ by Gill, D. et al, is published in the journal Behavior Genetics.

Action plan for new generation of youths

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The Minister of State (I/C) for Youth Affairs and Sports Shri Vijay Goel said in the Rajya Sabha today that for unleashing the creative power and commitment of the new generation of youth, the Government has introduced the National Youth Policy, 2014 (NYP-2014). The vision of the Policy is “To empower youth of the country to achieve their full potential, and through them enable India to find its rightful place in the community of nations”. The policy lays down five well thought out objectives and 11 priority areas, namely, Education, Employment and Skill Development, Entrepreneurship, Health and Healthy Lifestyle, Sports, Promotion of Social Values, Community Engagement, Participation in politics and governance, Youth engagement, Inclusion and Social Justice.

In a written reply he said, the implementation of the Policy is the collective responsibility of all concerned Central Ministries/Departments, State Governments as well as other stakeholders. A number of Central Ministries/Departments, including the Ministry of Youth Affairs and Sports, are implementing schemes/programmes having bearing on development and empowerment of youth in the 11 specified priority areas. The Department of Youth Affairs is playing the coordinating/ facilitating role, for implementation of the Policy, besides directly implementing some Schemes/ Programmes for development and empowerment of youth.

Electronic Health Records

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A scheme to set up an ‘Integrated Health Information Platform (IHIP) to create the Electronic Health Records (EHRs) of citizens and to be made available nationwide online for medical history, with the help of Health Information Exchange(s), has been approved and is being implemented.

MoHFW has notified Electronic Health Record (EHR) Standards Version 2016 for India in December 2016 (whilst the earlier version of EHR Standards was notified in September 2013) with the intent to bring standardisation and homogeneity, inter-operability in capture, storage, transmission, use etc. of healthcare information across various health IT systems.

State/UTs have been advised and are already working on computerisation and implementation of hospital information system (for creation electronic records) in their hospitals/health facility with support under National Health Mission.

With the advent of the envisaged system of EHRs of citizens in an inter-operable manner pan-nation, online availability and accessibility would be ensured facilitating continuity of care, better affordability, better health outcome and better decision support system. This is expected to help in reducing expenditure on avoidable repetitive and similar diagnostic tests.

The Minister of State (Health and Family Welfare), Smt Anupriya Patel stated this in a written reply in the Lok Sabha here today.

Cheap Medicines

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The Drugs Policy as amended from time to time envisages making available quality medicines at affordable prices to the masses. National Pharmaceuticals Pricing Authority (NPPA) under the Department of Pharmaceuticals has fixed the ceiling price of drugs placed in the first schedule to the Drugs (Prices Control) Order, 2013. In case of non-scheduled formulations, the Maximum Retail Prices (MRP) cannot be increased by more than 10% during the preceding 12 month period.

Public Health and hospitals being a state subject, the States/UTs also take requisite action to ensure the availability of cheap/free medicines for the people. The Central Government, under the National Health Mission (NHM), provides financial and technical support to theStates/UTs for strengthening their healthcare delivery system including support for provision of essential drugs free of cost to those who access public health facilities under the NHM Free Drugs Service Initiative. All the States/UTs have reported that they have notified free drug policy in their respective States/UTs.

The Department of Pharmaceuticals has prepared a Uniform Code for Pharmaceutical Marketing Practices (UCPMP) which has been implemented by pharmaceutical companies with effect from 01.01.2015.

Further, Medical Council of India (MCI) or the appropriate State Medical Councils have been empowered to take disciplinary action against a doctor for violation of the provisions of the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002.

In order to promote the use of cheap generic drugs in the country including in rural areas and with the objective of making available quality generic drugs at affordable prices to all, 2052 Kendras have been startedin the country under a countrywide campaign in the name of ‘PradhanMantriBhartiyaJanaushadhiPariyojana’ (PMBJP).

Further, the Ministry of Health and Family Welfare has started AMRIT (Affordable Medicines and Reasonable Implants for Treatment) stores where essential life saving medicines and implants including stents are being provided at a substantial discount vis-à-vis the Maximum Retail Price.

The Minister of State (Health and Family Welfare), Sh Faggan Singh Kulaste stated this in a written reply in the Lok Sabha here today.

Life Style Diseases

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The Indian Council of Medical Research (ICMR) is conducting a study namely ICMR-INDIAB involving all States and Union Territories – both urban and rural population for ascertaining the exact number of Diabetic patients. 15 States have been covered so far and the prevalence of diabetes varies from 4.3% in Bihar to 13.6% in Chandigarh.

According to report published by International Diabetes Federation (IDF; 6th Edition, 2013), number of people with diabetes (20-79 years) in Urban setting of India were about 30.5 millions in 2013.

As informed by Indian Council of Medical Research (ICMR), current estimates from one-time cross sectional studies conducted in different regions of country indicate that the prevalence of coronary heart disease (CHD) is between 8-10 percent in urbanand 3 to 4 percent in rural India.

As informed by ICMR the estimated prevalence of cancer cases in India during 2013, 2014 and 2015 are 2934314, 3016628 and 3101467 respectively.

Nationwide scientific estimation of number of patients of Chronic Kidney Diseases (CKD) has not been carried out. However, in some of the small population based studies, it was found to be in 0.79 % in North India and 0.16% in South India.

National Center for Disease Informatics and Research (NCDIR), Bengaluru is running Hospital and Population based Cancer Registries. As informed by ICMR some studies have been conducted on NCDs. A study is commissioned to ICMR on Burden of Non-Communicable Diseases and Associated Risk Factors for India (BOD-NCD).

The factors responsible for increase in Lifestyle Diseases (NCDs) are unhealthy diet, lack of physical activity, harmful use of alcohol, overweight, obesity, tobacco use, etc.

Public health is a State subject, however, under National Health Mission(NHM), financial and technical support is provided to States/UTs to strengthen their healthcare systems including setting up of / upgradation of public health facilities, based on the requirements posed by the States/UTs in their Programme Implementation Plans (PIPs).

Government of India is implementing National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) for interventions up to District level under the National Health Mission. Under NPCDCS, diagnosis and treatment facilities are provided through different levels of healthcare by setting up NCD Clinics in District Hospitals and Community Health Centres (CHCs). Intervention of Chronic Kidney Diseases (CKD) has also been included in NPCDCS for proper management.

For early diagnosis, Population-based Screening of common NCDs viz. Diabetes, Hypertension and Common cancers (Oral, Breast, Cervical) is initiated under NHM utilizing the services of the Frontline- workers and Health-workers under existing Primary Healthcare System. This process will also generate awareness on risk factors of common NCDs.

Under strengthening of Tertiary Care for Cancer Centre (TCCC) Scheme, Government of India is assisting States to set up / establish State Cancer Institute (SCI) and Tertiary Care Cancer Centres (TCCCs) in different parts of the country. Support under the National Health Mission (NHM) is also being provided to States for provision of dialysis services free of cost to the poor under Pradhanmantri National Dialysis Programme (PNDP).

The Central Government, through its hospitals augments the efforts of the State Governments for providing health services in the country. Under Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), 6 new AIIMS have been set up and upgradation of identified medical colleges has been undertaken which will also improve health care facilities.

The Minister of State (Health and Family Welfare), Smt Anupriya Patel stated this in a written reply in the Lok Sabha here today.

Queen Elizabeth’s Health Triggers Anxiety Levels in London

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The long-reigning monarch of the United Kingdom, Queen Elizabeth II’s health after she missed mass on Christmas Day for the first time in six decades has fuelled enough fire over the next course of events in Buckingham Palace. The palace, however, said the queen had a “heavy cold” and preferred to stay indoors, though she would participate in other ceremonies.

Queen Elizabeth II is longest reigning monarch of the United Kingdom surpassing the earlier record created by her great-great-grandmother Queen Victoria, who took over India’s Queen in 1857, heralding the long British rule in the country. She is the only monarch who has visited over 115 countries so far.

Queen Elizabeth ascended the throne on February 6, 1952, at the age of 25 years and now she is 90. While other media outlets rubbished the reports in some quarters of the British media, the BBC said it was merely "undue concern”.

The queen has four children – Prince Charles, Princess Anne, Prince Andrew and Prince Edward. The ledest Prince Charles is the heir to the throne even if the Queen relinquishes her throne or dies.

Weight Loss, Diabetes Interlinked, Says New Study

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Since diabetes can only be controlled by an individual either by medicines, diet contrl or regular exercise, experts have come out with the finding that diabetes can be reversed if people who reversed it keep their weight considerably low.

A study by Roy Taylor at the Newcastle University showed that those with Type 2 diabetes who were able to loose their weight could also successfully reverse the chronic ailment because the excess fat remooved from the pancreas helped normal production of insulin.

The researchers studied 30 volunteers who have Type 2 diabetes for 10 years or less and found that it may not apply to those with more than 10 years of chronic ailment. Out of 30 volunteers, 12 had the ailment for less than 10 years and were able to reverse their condition and remain free from diabetes after six months, said the study published in Diabetes Care.

The volunteers reducedd their weight by a strict diet of 600 to 700 calories per day, mostly consisting of three diet shakes per day and 240 grams of non-starchy vegetables for 8 weeks. Later they returned to their normal food but within the control regime for next two weeks. Later, they ate only one-third of their normal food to maintain their weight loss.

For those who had diabetes for over 10 years, Taylor has an advice: “If you had the diagnosis for longer than that, then don’t give up hope – major improvement in blood sugar control is possible.”

Explaining the Personal Fat Threshold theory, he said:“If a person gains more weight than they personally can tolerate, then diabetes is triggered, but if they lose that amount of weight then they go back to normal.” It depends on each individual as to how much weight they can afford to keep their metabolism in tact, said Taylor.

Even 70% of those who are obese are not necessarily diabetics. Even the 13 volunteers who reversed their condition were either overweight or obese, but their insulin production levels remained the same, he explained. Taylor is planning a bigger sample of 280 volunteers to study the finding in-depth.

About two-thirds of American adults are overweight or obese, facing an increased risk for diabetes, hypertension, heart disease, osteoarthritis, stroke, gallbladder disease, sleep apnea and respiratory problems, while India is also increasingly facing the problem of obesity and overweight, thanks to modern life and TV viewing by kids and adults alike.