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Introduction: Noncommunicable diseases (NCDs) constitute a massive global burden and are the leading cause of death and disability worldwide. In Greenland, the prevalence of NCDs has historically been low. However, during the past approximately 70 years, life circumstances have changed dramatically resulting in increased life expectancy. Today, the proportion of inhabitants in Greenland ≥65 years has nearly tripled since the 1980s, and the prevalence of obesity and diabetes has increased rapidly within the past decades. The aim of this study was to describe the burden of selected NCDs in a primary care setting in Nuuk and compare it to a modern westernized suburban general practice in Denmark. Methods: The study was performed as a cross sectional register-based study using data extracted from the electronic medical records (EMR) based on diagnosis codes from inhabitants living in Nuuk, Greenland, and a suburb in Denmark. Estimates of prevalence were age-standardized to the WHO world standard population. Results: In both Nuuk and the Danish suburb, the highest prevalence was observed for hypertension (13.2% for both populations), followed by asthma (4.4 and 9.5%, respectively) and diabetes (4.3 and 2.9%, respectively). The age-standardized prevalences of diabetes, COPD, atrial fibrillation, and heart failure, were significantly higher in Nuuk, while seven NCDs including asthma, ischemic heart disease, arthritis urica, psoriasis, hyperthyreosis, hypothyreosis and osteoporosis were significantly higher in the Danish suburb. Conclusion: In contrast to the disease pattern observed in Greenland in the last century, the prevalence of diagnosed NCDs in Nuuk is no longer rare. Thus, the overall prevalence of NCDs in the population of Nuuk is now comparable to or even higher than in the suburb in Denmark. This calls for increased focus on all NCDs in the primary healthcare system in Greenland and adaption of the primary healthcare services to a changed disease spectrum. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, general practices in Denmark rapidly introduced video consultations (VCs) to prevent viral transmission. Aim: To study the use of VCs in daytime general practice by describing the rate of VCs, and the patient characteristics associated with having VCs. Design & setting: Register-based study of consultations in daytime general practice in Denmark. Method: We included all consultations in daytime general practice from 1 January 2019–30 November 2021. We calculated the rate of video use and categorised the general practices into no, low, and high use. Logistic regression was used to calculate adjusted odds ratios (aOR) for having a VC for different patient characteristics when contacting a video-using practice, stratified for low- and high-using practices. Results: A total of 30 148 478 eligible consultations were conducted during the pandemic period. VCs were used mostly during the early stage pandemic period, declining to about 2% of all clinic consultations in the late-stage period. Patients having more VCs were young, had a long education, were employed, and lived in big cities. In low-using practices, native Danes and 'western' immigrants had higher odds of receiving a VC than 'non-western' immigrants, and patients with ≥2 comorbidities had lower odds than those without comorbidities. Conclusion: Patients of a younger age, with long education, or employment had higher odds of receiving a VC, while patients of an older age and patients who had retired had lower odds. This difference in the access to VCs warrants further attention. [ABSTRACT FROM AUTHOR]

This study examined the association between salt-related knowledge, attitudes, and behaviors (KAB) and salt excretion using the 24-hour (24 h) urinary collection method. Data were utilized from the Community-Based Management of Non-Communicable Diseases in Nepal (COBIN) Salt Survey, a community-based cross-sectional study conducted among a sub-sample of COBIN cohort in Pokhara Metropolitan City, Western Nepal, from July to December 2018, among adults aged 25–70 years. A total of 451 adults participated in the study, and a single 24 h urine sample was collected from each participant. The mean [(standard deviation (SD)] age of the participants was 49.6 (9.82) years, and the majority were female (65%). The mean urinary salt excretion was 13.28 (SD: 4.72) g/day, with 98% of participants consuming ≥5 g of salt/day. Although 83% of participants knew the risks of high salt intake and 87% believed it was important to reduce their intake, only 10% reported doing so. Salt-related attitude i.e., self-perceived salt intake was significantly associated with urinary salt excretion, adding extra salt to food, consuming processed foods, and taking actions to salt control. Participants who perceived themselves as consuming high salt had higher urinary salt excretion [(14.42 g/day; 95% confidence interval (95% CI): 13.45, 15.39, p = 0.03)], were more likely to add extra [(Odds ratio (OR) = 3.59; 95% CI: 2.03, 6.33, p < 0.001)], and consume processed foods more often (OR = 1.90; 95% CI: 1.06, 3.40, p < 0.05) compared to those who self-perceived consuming a normal amount of salt. Conversely, participants who perceived themselves as consuming low salt were more likely to take actions to control salt intake (OR = 4.22; 95% CI: 1.90, 9.37, p < 0.001) compared to their counterparts who perceived consuming a normal amount of salt. There existed a gap between salt-related knowledge, attitudes, and actual behaviors, resulting in a high salt intake among the Nepalese population. Nepal urgently requires tailored national salt reduction programs that comprise both policy and community-level interventions to achieve a 30% reduction in mean population salt intake by 2025. Further validation studies are needed to assess the effectiveness of community-based intervention in Nepal. [ABSTRACT FROM AUTHOR]

Globally, dietary factors are responsible for about one in five deaths. In many low- and middle-income countries different forms of malnutrition (including obesity and undernutrition) can co-exist within the same population. This double burden of malnutrition is placing a disproportional strain on health systems, slowing progress towards universal health coverage (UHC). Poor nutrition also impedes the growth of local economies, ultimately affecting the global economy. In this article, we argue that comprehensive primary health care should be used as a platform to address the double burden of malnutrition. We use a conceptual framework based on human rights and the Astana Declaration on primary health care to examine existing recommendations and propose guidance on how policy-makers and providers of community-oriented primary health care can strengthen the role of nutrition within the UHC agenda. Specifically, we propose four thematic areas for action: (i) bridging narratives and strengthening links between the primary health care and the nutrition agenda with nutrition as a human rights issue; (ii) encouraging primary health-care providers to support local multisectoral action on nutrition; (iii) empowering communities and patients to address unhealthy diets; and (iv) ensuring the delivery of high-quality promotive, preventive, curative and rehabilitative nutrition interventions. For each theme we summarize the available strategies, policies and interventions that can be used by primary health-care providers and policy-makers to strengthen nutrition in primary health care and thus the UHC agenda. Environ un deces sur cinq dans le monde est du a des facteurs alimentaires. Dans de nombreux pays a faible et moyen revenu, differentes formes de malnutrition (y compris l'obesite et la denutrition) peuvent coexister au sein d'une merme population. Ce double fardeau de malnutrition exerce une pression demesuree sur les systemes de sante, ralentlssant la progression vers une couverture maladle unlverselle (CMU). Une mauvalse alimentation entra ve egalement la crolssance des economies locales, ce qui enfin de compteaffectel'economie mondiale. Dans cet article, nous estimons qu'll est imperatlf d'utillser une approche globale des soins de sante primaires commeplateforme pours'attaquer au double fardeau de la malnutrition. Nous avons employe un cadre conceptuel fonde sur les droits humainset la Declaration d'Astana sur les soins de sante primaires. D'une part pour examiner les recommandations existantes, et d'autre part pour fournir un eclairage sur la maniere dont les legislateurs et les prestataires de soins de sante primaires, implantes au niveau communautaire, peuvent renforcer le role de la nutrition dans le programme de CMU. Nous proposons plusexactementquatre champs d'action: (i) aligner les discours et consolider les liens entre les soins de sante primaires et le programme de nutrition, en integrant ce dernier dans la thematique des droits humains; (ii) encourager les prestataires de soins de sante primaires a soutenlr les Initiatives locales multisectorielles portant sur la nutrition; (iii) donner aux patients et aux collectivites le pouvoir de lutter contre l'alimentation desequilibree; et enfin, (iv) assurer la mise en ceuvre d'interventions de qualite pour la promotion, la prevention, le traitement et la rehabilitation en matiere de nutrition. Pour chaque champ d'action, nous resumons les strategies, politiques et interventions a la disposition des legislateurs et prestataires de soins de sante primaires pour renforcer le role de la nutrition dans les soins de sante primaires et, par consequent, le programme de CMU. Los factores alimentarios son responsables de aproximadamente una de cada cinco muertes en todo el mundo. Diferentes tipos de malnutricion (incluidas la obesidad y la desnutricion) pueden coexistir en la misma poblacion de muchos paises de ingresos bajos y medios. Esta doble carga de la malnutricion esta ejerciendo una presion desproporcionada sobre los sistemas sanitarios, lo que ralentiza los progresos hacia la cobertura sanitaria universal (CSU). Ademas, la mala nutricion dificulta el crecimiento de las economias locales, lo que en ultima instancia afecta a la economia global. En este articulo, se argumenta que la atencion primaria de salud integral se deberia utilizar como plataforma para abordar la doble carga de la malnutricion. Se utiliza un marco conceptual basado en los derechos humanos y en la Declaracion de Astana sobre la atencion primaria de salud para analizar las recomendaciones existentes y proponer directrices sobre como los responsables de formular las politicas y los proveedores de atencion primaria de salud orientada a la comunidad pueden fortalecer la funcion de la nutricion dentro del programa de la CSU. En concreto, se proponen cuatro areas tematicas de accion: (i) narrativas de vinculacion y fortalecimiento de los vinculos entre la atencion primaria de salud y el programa de nutricion en donde la nutricion sea una cuestion de derechos humanos; (ii) alentar a los proveedores de atencion primaria de salud a que apoyen la medida multisectorial local sobre la nutricion; (iii) potenciar a las comunidades y a los pacientes para tratar las dietas poco saludables; y (iv) garantizar la realizacion de intervenciones de nutricion de alta calidad de tipo promocional, preventivo, curativo y de rehabilitacion. Para cada tema se resumen las estrategias, politicas e intervenciones disponibles que los proveedores de atencion primaria de salud y los responsables de formular las politicas pueden utilizar para fortalecer la nutricion en la atencion primaria de salud y, por consiguiente, el programa de la CSU. [phrase omitted], Introduction About one in five deaths globally are attributable to poor diets, making dietary factors responsible for 11 million deaths annually, more than any other risk factors covered by the [...]

Aim: This paper describes the design of the 'Move More' study, which aims to develop and assess the feasibility of a social-prescribing intervention to increase physical activity among physically inactive Danes. Background: Physical inactivity constitutes a public-health challenge in Denmark. Social prescribing may be a promising tool to tackle physical inactivity by linking physical activity support from general practitioners with community-based activities in sports clubs, as this may help physically inactive citizens become more physically active. Given the range of stakeholders and behaviours required for social prescribing of physical activity, an intervention that harnesses this approach may constitute a complex intervention. The methods and decisions made in the stages of developing complex interventions are seldom reported. The present study enabled us to describe how co-creation can be used in a pragmatic development process for a complex intervention that considers the needs of stakeholders and the conditions of the delivery context. Methods: The study is based on the core elements of the development and feasibility phases of the Medical Research Council Framework for Developing and Evaluating Complex Interventions. Additionally, it is informed by a framework for the co-creation and prototyping of public-health interventions, drawing from a scoping review, stakeholder consultations and co-creation workshops. Ultimately, a feasibility study will be conducted to refine the programme theory by introducing the proposed intervention in case studies. Perspectives: The study will result in a prototype intervention manual and recommendations for implementation of an adapted social-prescribing intervention targeting physical inactivity in Denmark. [ABSTRACT FROM AUTHOR]