IntroductionAs non-communicable disease (NCD) burden rises worldwide, community-based programmes are a promising strategy to bridge gaps in NCD care. The HealthRise programme sought to improve hypertension and diabetes management for underserved communities in nine sites across Brazil, India, South Africa and the USA between 2016 and 2018. This study presents findings from the programme’s endline evaluation.MethodsThe evaluation utilises a mixed-methods quasi-experimental design. Process indicators assess programme implementation; quantitative data examine patients’ biometric measures and qualitative data characterise programme successes and challenges. Programme impact was assessed using the percentage of patients meeting blood pressure and A1c treatment targets and tracking changes in these measures over time.ResultsAlmost 60 000 screenings, most of them in India, resulted in 1464 new hypertension and 295 new diabetes cases across sites. In Brazil, patients exhibited statistically significant reductions in blood pressure and A1c. In Shimla, India, and in South Africa, country with the shortest implementation period, there were no differences between patients served by facilities in HealthRise areas relative to comparison areas. Among participating patients with diabetes in Hennepin and Ramsey counties and hypertension patients in Hennepin County, the percentage of HealthRise patients meeting treatment targets at endline was significantly higher relative to comparison group patients. Qualitative analysis identified linking different providers, services, communities and information systems as positive HealthRise attributes. Gaps in health system capacities and sociodemographic factors, including poverty, low levels of health education and limited access to nutritious food, are remaining challenges.ConclusionsFindings from Brazil and the USA indicate that the HealthRise model has the potential to improve patient outcomes. Short implementation periods and strong emphasis on screening may have contributed to the lack of detectable differences in other sites. Community-based care cannot deliver its full potential if sociodemographic and health system barriers are not addressed in tandem.

Posing speculative questions about a software system is an important yet often unsupported activity. Current impact analysis techniques tend to focus upon the functionality of the system, whilst the effects of change upon performance requirements are largely ignored until after implementation. This tendency can lead to costly and time-consuming mistakes. Event-Based traceability provides a robust method for handling both long-term evolutionary change as well as the short-term speculative change needed to support performance related impact analysis. By establishing dynamic links, capable of propagating data values and commands between requirements and performance models, it becomes possible to automate a wide range of speculative queries and to enhance the overall ability to predict the impact of change upon the performance of the system.

Objectives: Based on the global experience, India has the possibility to be highly affected by coronavirus disease 2019 (COVID-19) pandemic. To contain the spread of the infection, a complete lockdown was enforced from March 25 to May 31, 2020 in India. During the unlock phase from June 1, 2020, only limited mobility was allowed. At present, in the pandemic, mass media is playing a very important role in sharing information and connecting people. The objective of this study is to understand the role and impact of mass media in the general public during COVID-19 pandemic. Material and Methods: This study has been conducted on the above 10-year aged population by the online survey through Google spreadsheets. The semi-structured questionnaire was circulated to the known contacts in north Indian states for responses. The data collection started on June 23 and was closed on July 3, 2020. Results: This study shows that the use of internet/social media was the highest, followed by TV news before and during lockdown. The use of the internet and TV news increased during the lockdown and the use of newspapers, radio, and magazine declined significantly. The anxiety due to COVID-related news through mass media was reported highest (27.3 %) in the 40–49 years age group and lowest (14.49%) in the 20–29 age group. About 43.18% of people of 30–39 years of age group developed fear, and 28% of 50–59 age groups felt panic due to COVID-related news in media. It has been found that the use of social media is highest in the 20–29 age group followed by 10–19 years age group Conclusion: Mass media is playing a very important role in the dissemination of the COVID-related information to the general public in north India. However, the misleading or wrong information shall be checked in the large public interest.

The immature gastrointestinal (GI) tract makes infants vulnerable to transient disorders including colic, gastro-oesophageal reflux (GER) and constipation. These conditions cause a significant distress to infants and caregivers, and are among the most common reasons for the paediatrician referral. In addition, these conditions are associated with a significant morbidity, hospitalisations and high healthcare costs, adding to the burden of the disease. Although they are additions to the ongoing physiological development or arise from maladaptive behavioural responses, the evidence remains limited. The vague aetiology and the self-limiting nature, has devoid these conditions of robust clinical attention, both in the research and clinical practice. Frequent early-life intestinal insults may translate as a risk factor in the development of chronic GI disorders and psychological problems later in life. Emerging evidence suggests that providing an optimal nutritional intervention closer to the breast milk can be a path breaking approach to manage these frequently encountered conditions and aid the growth and development of infants.

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