ContextThe prevalence of hypertension in developing countries is coming closer to values found in developed countries. However, surveys usually rely on readings taken at a single visit, the option to implement the diagnosis on readings taken at multiple visits, being limited by costs.ObjectiveTo estimate more accurately the magnitude and extent of the resource that should be allocated to the prevention of hypertension.DesignPopulation-based cross-sectional survey with triplicate blood pressure (BP) readings taken on two separate home-visits.SettingRural and urban locations in three areas of Yemen (capital, inland and coast).ParticipantsA nationally representative sample of the Yemen population aged 15–69 years (5063 men and 5179 women), with an overall response rate of 92% in urban and 94% in rural locations.Main outcome measureHypertension diagnosed as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg and/or self-reported use of antihypertensive drugs.ResultsHypertension prevalence (age-standardised to the WHO world population 2001) based on fulfilling the same criteria on both visits (11.3%; 95% Cl 10.7% to 11.9%), was 35% lower than estimation based on the first visit (17.3%; 16.5% to 18.0%). Advanced age, blood glucose ≥7 mmol/l or proteinuria ≥1+ at dipstick test at visit one were significant predictors of confirmation at visit 2. The 959 participants found to be hypertensive at visit 1 or at visit 2 only and thus excluded from the final diagnosis had a rate of proteinuria (5.0%; 3.8% to 6.5%) comparable to rates of the general population (6.1%; 5.6% to 6.6%), and of subjects normotensive at both visits (5.6%; 5.1% to 6.2%). Only 1.9% of Yemen population classified at high or very high cardiovascular (CV) risk at visit 1 moved to average, low or moderate CV risk categories after two visits.ConclusionsHypertension prevalence based on readings obtained after two visits is 35% lower than estimation based on the first visit, subjects were excluded from final diagnosis belonging to low CV risk classes.

Although globalization can contribute to increased blood pressure by spreading unhealthy behaviors, it also provides powerful means to tackle hypertension. The dissemination of information about and advice on cardiovascular prevention and facilitated contact with health services are valuable resources. To investigate the effects of urbanization, geographical area, and air temperature on hypertension burden and kidney damage, a survey was performed in 2008 with a door-to-door approach among urban and rural adult dwellers of three geographic areas (capital, inland, coast) of Yemen. Subjects (n=10 242) received two visits several days apart to confirm the diagnosis of hypertension. Proteinuria (dipstick test ⩾+1) was used as a marker of kidney damage. Prevalence rates were weighted to represent the Yemen population aged 15–69 years in 2008. Rates of hypertension and proteinuria progressively increased from the capital (6.4% 95% confidence level (CI) 5.8–7.0 and 5.1% 4.4–5.9, respectively), to inland areas (7.9% 7.0–8.7 and 6.1% 5.1–7.1), to the coastal area (10.1% 8.9–11.4 and 8.9% 7.3–10.4). When compared with urban dwellers, rural dwellers had similar hypertension prevalence (adjusted odds ratios (ORs) 1.03; 95% CI 0.91–1.17) but higher proteinuria rates (adjusted ORs 1.55; 1.31–1.85). Overall, home temperature was associated with a lower hypertension rate (adjusted OR 0.98; 0.96–0.99). This large population study reveals that the highest burden of hypertension and kidney damage is detectable in remote areas of the country.

BackgroundStudents’ perceptions of their learning environment, by defining its strengths and weaknesses, are important for continuous improvement of the educational environments and curriculum. Therefore, the aim of this study was to explore students’ perceptions of their learning environment, among medical students in Malaysia. Various aspects of the education environment were compared between year levels and sex.MethodsThis cross-sectional study was conducted at the Management and Science University, Shah Alam, Malaysia in 2012. A total number of 438 medical students participated in this study, and the response rate was 87.6%. Data were analyzed using SPSS. Comparisons of the mean scores of Dundee Ready Education Environment Measure (DREEM) subscales were calculated. The t-test was used to determine statistically significant differences.ResultsThe majority of the study participants were female, Malay, and from year 3 (68.7%, 65.3%, and 55.7%; respectively). Analysis of each of the 50 items of the DREEM inventory showed that 47 items scored ranged between 2.00 and 3.00, and three items scored below 2.00. These were identified as problem areas in this medical school that are required to be critically addressed. The overall score showed that the medical students’ perceptions were positive. The students’ perception toward educational environment was positive for all five DREEM subscales.ConclusionThe study found that, in general, the perceptions of the participants about the learning environment were positive. Nevertheless, the study also found there is a need for curriculum improvement in this school and identified priority areas for such improvement.

Little information is available on the meanings of proteinuria in low-resource settings. A population-based, cross-sectional survey was performed in Yemen on 10 242 subjects aged 15–69 years, stratified by age, gender and urban/rural residency. Hypertension is defined as systolic blood pressure (BP) of ⩾140 mm Hg and/or diastolic BP of ⩾90 mm Hg, and/or self-reported use of antihypertensive drugs; diabetes is diagnosed as fasting glucose of ⩾126 mg dl−1 or self-reported use of hypoglycaemic medications; proteinuria is defined as ⩾+1 at dipstick urinalysis. Odds ratios (ORs) for associations were determined by multivariable logistic regression models. Prevalence (weighted to the Yemen population aged 15–69 years) of hypertension, diabetes and proteinuria were 7.5, 3.7 and 5.1% in urban, and 7.8, 2.6 and 7.3% in rural locations, respectively. Proteinuria and hypertension were more prevalent among rural dwellers (adjusted ORs 1.56; 95% confidence limit (Cl) 1.31–1.86, and 1.23; 1.08–1.41, respectively), diabetes being less prevalent in rural areas (0.70; 0.58–0.85). Differently from hypertension and diabetes, proteinuria was inversely related with age. Most importantly, 4.6 and 6.1% of urban and rural dwellers, respectively, had proteinuria in the absence of hypertension and diabetes. The approach of considering kidney damage as a consequence of hypertension and diabetes might limit the effectiveness of prevention strategies in low-income countries.

This article is qualitative-descriptive analytical research on multiple intelligences, a theory which Howard Gardner introduced. According to Howard Gardner's findings, the concept of multiple intelligences has been widely known and used in educational institutions. Multiple intelligences are also considered a theory that first recognized the diversity of human intelligence. With multiple intelligences, it can be said that no child is stupid. Therefore, each child is born with intelligence that is not always equal to each other. In Islam, the Quran is a complete guide for life. This research has discovered the powerful instruments to develop Qur'anic multiple intelligences in educational institutions through literature. With the thematic interpretation method (maudhui) approach, this study described the practical efforts, using the mindset of interpretation and reflection, to develop the concept of multiple intelligences based on the perspective of the Quran. After researching, collecting, and analyzing all terms in the Quran that relate to intelligence, it is found that the Quran is distinguishing the concept of multiple intelligences. It can be used further as a practical guide for educational institutions in developing the concept of multiple intelligences from the perspective of the Quran