scholarly journals 1469Inequalities in diabetes management by area deprivation: the mediating role of healthcare resource distribution

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Rangkyoung Ha ◽  
Kyunghee Jung-Choi
Keyword(s):  
Diabetes Management ◽  
Healthcare Resource ◽  
Diabetic Complication ◽  
Area Deprivation ◽  
Related Factors ◽  
Healthcare Resources ◽  
Mediating Role ◽  
Regional Inequalities ◽  
Policy Interventions ◽  
Community Health Survey

Abstract Background We sought to identify the existence of regional socioeconomic inequalities in diabetes management and to examine whether the distribution of healthcare resources could explain regional inequalities in diabetes management. Methods Data were derived from the Korean Community Health Survey in 2018. Our study subjects included 23,760 participants who have been diagnosed with diabetes by a doctor. The dependent variables were self-reported glycemic control, Hemoglobin A1c (HbA1c) testing, recognition of the term HbA1c, and diabetic complications testing. Socio-demographics, health behavior-related factors, and factors related to regional healthcare resources were considered as potential mediating variables in explaining the association between diabetes management and area deprivation. A multilevel logistic regression analysis was used. Results Compared to the least deprived area, the likelihood of not taking HbA1c tests, not recognizing the term HbA1c, and not taking diabetic complication tests in the most deprived area were approximately 1.5, 2.6, and 2 times higher, respectively. In the most deprived areas, the coefficient of variation value of clinics was the highest and the number of doctors was the lowest. Regional healthcare resource factors explained regional inequalities in managing diabetes by 14% to 18%, especially in the most deprived area. Conclusions Policy interventions for more even distribution of healthcare resources would contribute to reducing the magnitude of regional inequalities in diabetes management. Key messages Our study suggests that reducing inequality in diabetes management could be possible through the appropriate allocation of healthcare resources.

scholarly journals The Mediating Role of Alexithymia in the Relationship Between Defense Mechanisms and Tendency to High-risk Behaviors Among Adolescents

2021 ◽  
Vol 11 (1) ◽  
pp. 29-36
Author(s):  
Zahra Nikmanesh ◽  
◽  
Mehdi Darvish Molla ◽  
Mehrnosh Mehranfard ◽  
◽  
...  
Keyword(s):  
High School Students ◽  
High Risk ◽  
Path Analysis ◽  
Risk Behaviors ◽  
Defense Mechanisms ◽  
Related Factors ◽  
High Risk Behaviors ◽  
Mediating Role ◽  
The Relationship

Background: Although high-risk behaviors lead to adverse physical, psychological, and sociological consequences, less attention has been paid to identifying their related factors. The aim of this study was to investigate the mediating role of alexithymia in the relationship between defense mechanisms and high-risk behaviors among adolescents in Zahedan. Methods: In this descriptive-correlative study, junior and senior high school students of Zahedan, Iran were studied in the academic year 2015-2016. A sample of 250 (125 males and 125 females) students were chosen by multi-stage cluster sampling and asked to complete the Defense Style Questionnaire (DSQ), Toronto Alexithymia Scale (TAS), and the Risk-Taking Scale (IARS) for Iranian Adolescents. Data analysis was conducted by measuring coefficients of correlation and performing a path analysis. Results: Path analysis showed a significant correlation between defense mechanisms and alexithymia (P<0.01) and a significant correlation was found between immature defense mechanisms and high-risk behaviors (P<0.01). Conclusion: In the relationship between dysfunctional defense mechanisms and high-risk activities, alexithymia played a mediating role. It can be inferred that dysfunctional defense mechanisms play a key role in high-risk activities by influencing alexithymia.

Marketing and family-related factors affecting food label use: the mediating role of consumer knowledge

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daleen Van der Merwe ◽  
Hanli de Beer ◽  
Marli Nel ◽  
Susanna M. Ellis
Keyword(s):  
Food Choices ◽  
Healthy Food ◽  
Objective Knowledge ◽  
Food Label ◽  
Healthy Foods ◽  
Related Factors ◽  
Content Type ◽  
Mediating Role ◽  
The Relationship

PurposeThis study investigated the influence of marketing- and family-related factors on consumers' in-store usage of different types of food label information. Furthermore, the authors determined the mediating role of consumers' knowledge about healthy foods between these factors and their label consultation.Design/methodology/approachThe authors conducted a survey among 223 purposively selected South African working female consumers via social media. Subjective and objective knowledge about healthy foods, the importance of marketing- and family-related factors and the extent of food label usage were determined. Structural equation modelling served to test the mediating effect of knowledge in the relationship of the marketing and family-related factors with food label usage.FindingsMarketing-related factors demonstrated a strong direct effect on food label usage. Subjective knowledge about healthy foods mediated the relationship between family members' dietary needs and food label usage. However, objective knowledge was not a mediator.Practical implicationsRespondents' firm reliance on marketing-related factors (instead of knowledge) during food label usage is not in the best interest of consumers' healthy food choices. Healthy food choices based on factual knowledge rather than marketing efforts are necessary to establish long-term healthy food habits, hence the need for retailers' response in supplying healthier food options. Role players in consumer education should focus on increasing consumers' healthy food knowledge.Originality/valueIn the context of rising awareness of public health concerns, healthy food choice among consumers is essential. This study contributes to the complexity of consumers' need to make healthy food choices within an economic-driven marketing environment.

scholarly journals Hand Hygiene Practices Among Adults with Diabetes Living in Communities: The 2015 Korea Community Health Survey

2019 ◽  
Vol 16 (7) ◽  
pp. 1279
Author(s):  
Mi Ah Han
Keyword(s):  
Hand Hygiene ◽  
Infectious Diseases ◽  
Community Health ◽  
Health Survey ◽  
Diabetes Management ◽  
Comparison Group ◽  
Regression Analyses ◽  
Improve Hand Hygiene ◽  
Hygiene Practices ◽  
Community Health Survey

Hand hygiene is the most effective strategy to prevent infectious diseases. This study investigated and compared the hand hygiene practices of adults with diabetes and an age- and gender-matched comparison group. Adults with diabetes (n = 22,920) who participated in the 2015 Korea Community Health Survey and an appropriate comparison group (n = 22,920) were selected. Descriptive analyses, chi-square tests, and multiple logistic regression analyses were used. Greater than 98% of participants with diabetes recognized that hand hygiene helps prevent infectious diseases. Among participants with diabetes, 84.3%, 82.4%, 72.5%, and 64.1% washed their hands frequently before eating, after using the restroom, after returning from the outdoors, and with soap or hand sanitizer, respectively, but these values were significantly lower than those of the comparison group. After performing multiple regression analyses, treatments for diabetes, being educated about diabetes management and handwashing, and awareness of hemoglobin A1c levels were significantly associated with hand hygiene practices in participants with diabetes. Almost all people with diabetes were aware of the efficacy of hand hygiene, but handwashing rates were significantly lower in people with diabetes than in the comparison group. Considering treatments for diabetes, educational campaigns regarding handwashing, and increasing awareness of handwashing efficacy will help improve hand hygiene in people with diabetes.

The mediating effect of logistics integration on supply chain performance

2014 ◽  
Vol 25 (3) ◽  
pp. 553-580 ◽  
Author(s):  
Arshad Alam ◽  
Prabir K. Bagchi ◽  
Bumsoo Kim ◽  
Subrata Mitra ◽  
Fernando Seabra
Keyword(s):  
Supply Chain ◽  
Indirect Effect ◽  
Mediating Effect ◽  
Supply Chain Performance ◽  
Related Factors ◽  
Content Type ◽  
Composite Variable ◽  
Mediating Role ◽  
The Impact

Purpose – The purpose of this paper is to analyze the impact of individual logistics-related factors, namely, supplier involvement (SI), length of supplier relationship (LSR), use of information technology (IT), and logistics integration (LI) on a firm's supply chain performance (SCP) and test for the mediating effect of LI in a multi-country survey conducted in Brazil, Korea and India. The paper also develops a composite variable, supply chain competency (SCC), as an overall measure of the quality of a firm's supply chain and demonstrate its effect on a firm's SCP. Design/methodology/approach – The research methodology was based on designing and administering a survey instrument. Data collected from 187 organizations in Brazil, Korea and India were analyzed using the partial least squares structural equation modeling methodology. Findings – Results show that for the combined data, the direct effects of SI, LSR and IT on SCP are insignificant while LI has a very significant direct effect on SCP. On the other hand, except for SI, LSR and IT have significant effects on SCP through LI establishing the mediating role of LI. The paper also finds that SCC has a significant effect on SCP. Further, when countries are considered individually the paper finds that IT has a significant indirect effect on SCP in the case of all the countries while LSR has a significant indirect effect on SCP, both in the case of Brazil and Korea. Additionally, in the case of Korea SI has a significant indirect effect on SCP. Research limitations/implications – Like other survey-based research, the findings of this paper are also limited by the sample size. Especially, the observations specific to individual countries are as good as the respective sample sizes. Also, since all the respondents belonged to manufacturing firms, the findings of this paper are relevant for the manufacturing sector. Practical implications – This paper establishes the mediating effect of LI in assessing the impact of logistics-related factors on a firm's SCP. It confirms that although logistics-related factors are necessary for a firm's superior SCP, they are not sufficient unless their interactions are taken into consideration, as evidenced by the significant positive relationship between SCC and SCP. Originality/value – To the best of the authors’ knowledge, this paper is the first paper to study the effect of logistics-related factors on a firm's SCP and establish the mediating role of LI in a multi-country setting. This paper also develops a composite variable SCC and examines its effect on SCP.

scholarly journals Do epigenetic clocks provide explanations for sex differences in lifespan? A cross-sectional twin study

2021 ◽  
Author(s):  
Anna Kankaanpää ◽  
Asko Tolvanen ◽  
Pirkko Saikkonen ◽  
Aino Heikkinen ◽  
Eija K. Laakkonen ◽  
...  
Keyword(s):  
Sex Differences ◽  
Life Expectancy ◽  
Biological Aging ◽  
Related Factors ◽  
Cross Sectional ◽  
Mediating Role ◽  
Epigenetic Age ◽  
Path Modelling ◽  
Epigenetic Age Acceleration ◽  
The Difference

ABSTRACTBackgroundThe sex gap in life expectancy has been narrowing in Finland over the past four to five decades; however, on average, women still live longer than men. Epigenetic clocks are markers for biological aging that predict lifespan. In this study, we examined the mediating role of lifestyle factors on the association between sex and biological aging in younger and older adults.MethodsOur sample included same-sex younger and older twins (21-42-y, n = 1110; 50-76-y, n = 763) and younger opposite-sex twins (21-30-y, n = 302). Blood-based DNA methylation (DNAm) was used to compute epigenetic age acceleration by four epigenetic clocks as a measure of biological aging. Path modelling was used to study whether the association between sex and biological aging is mediated through lifestyle-related factors, i.e. education, body mass index, smoking, alcohol use, and physical activity.FindingsIn comparison to women, men were biologically older and, in general, they had unhealthier life habits. The effect of sex on biological aging was partly mediated by smoking, but only in older twins. Sex was directly associated with biological aging and the association was stronger in older twins.InterpretationPreviously reported sex differences in lifespan are also evident in biological aging. Declining smoking prevalence among men is a plausible explanation for the narrowing of the difference in life expectancy between the sexes. Data generated by the epigenetic clocks may help in estimating the effects of lifestyle and environmental factors on aging and in predicting aging in future generations.

scholarly journals Assessment of the contributing risk factors in adult diabetic patients attending the diabetic clinic in Bankura Sammilani Medical College, Bankura

2020 ◽  
Vol 7 (2) ◽  
pp. 588
Author(s):  
Indu Padmey ◽  
Arindam De ◽  
Eashin Gazi ◽  
Aditya Prasad Sarkar ◽  
Asit Baran Saren ◽  
...  
Keyword(s):  
Healthcare Services ◽  
Diabetic Complication ◽  
Diabetic Patients ◽  
Related Factors ◽  
Cross Sectional ◽  
Medical College ◽  
Levels Of Care ◽  
Diabetic Clinic ◽  
Control Of Diabetes ◽  
And Control

Background: Diabetes affects all segments of the population and is one of the leading causes of premature morbidity and mortality and requires life-long healthcare services. The National Rural Health Mission launched in 2005 and the new pilot National Programme for Prevention and Control of Diabetes, Cardiovascular diseases and Stroke offer opportunities for improving care for diabetes and other non-communicable diseases through service provision at the primary and secondary levels of care. This article describes the health services related factors and ascertains the physical status of adult diabetic patients.Methods: It is an institution based, cross-sectional, descriptive study. Complete enumeration of all patients attending diabetic clinic of Bankura Sammilani Medical College and hospital, Bankura, West Bengal was done. Eligible consenting adult patients, who were diagnosed as a case of diabetes and on treatment were interviewed with review of medical record. The study was preceded after obtaining ethical clearance. Data were entered in MS Excel spread sheet. Calculation was done with the help of software SPSS 22.0 free version.Results: Only 5.3% of study subjects had drug supply from hospital fully but rest of them had to buy from the shop. 79.3% of study subjects skipped the drug when it was finished. Diabetic complication was found to be more when distance of home from hospital was more.Conclusions: Antidiabetic drug were not regularly available in hospital so all most all had to purchase drug from the shop when not available at hospital. 

scholarly journals Exploring differences in Canadian adult men and women with Diabetes management: results from the Canadian Community Health Survey

2021 ◽  
Author(s):  
Margaret De Melo ◽  
Eric de Sa ◽  
Enza Gucciardi
Keyword(s):  
Sex Differences ◽  
Community Health ◽  
Health Survey ◽  
Diabetes Management ◽  
Estimation Method ◽  
Self Care ◽  
Canadian Community Health Survey ◽  
Men And Women ◽  
Community Health Survey ◽  
Human Cost

Background Over two million Canadians are known to have diabetes. In addition to the economic burden placed on the healthcare system, the human cost associated with diabetes poses a heavy burden on those living with diabetes. The literature shows that apparent differences exist in diabetes complications and diabetes management between men and women. How self-care management and utilization of health services differ by sex is not clearly understood. The purpose of this study was to explore sex differences in diabetes self-care and medical management in the Canadian population, using a nationally representative sample. Methods Data collected from the cross-sectional, population-based Canadian Community Health Survey (2007–2008) were used in these analyses. A bootstrap variance estimation method and bootstrap weights provided by Statistics Canada were used to calculate 95% confidence intervals. Bivariate analyses identified variables of interest between females and males that were used in subsequent multivariate analyses. Results A total of 131,959 respondents were surveyed for the years of 2007 and 2008, inclusive. Fully adjusted multinomial and logistic regression analyses revealed sex differences for those living with diabetes. Compared to men with diabetes, women were more likely to be in the lowest income quintiles than the highest (OR: 1.8, 95% CI: 1.3-2.6) and were more likely not to have a job in the previous week (OR: 1.8, 95% CI: 1.4-2.4). Women were also more likely to avoid foods with fats or high calories (OR: 2.1, 95% CI: 1.4-3.0 and OR: 2.2, 95% CI: 1.6-3.0, respectively), to be concerned about heart disease (OR: 1.6, 95% CI: 1.1-2.2), and to be non-smokers (OR: 2.2, 95% CI: 1.6-3.0). However, despite their increased concern, women checked their blood-glucose less frequently on a daily basis than men (μwomen = 1.7, 95% CI: 1.7-1.8; μmen = 3.1, 95% CI: 2.9-3.2). Women were more likely to have an anxiety disorder (OR: 2.3, 95% CI: 1.7-3.2) and a mood disorder (OR: 2.4, 95% CI: 1.8-3.1), and more likely to be physically inactive (OR: 1.5, 95% CI: 1.2-1.8). Conclusions Our findings underscore the importance of addressing sex differences which may interfere with diabetes self-care. In women, addressing socioeconomic and psychological barriers, as well as limitations to active living are important; in men, the benefit of more effective nutrition therapy and smoking cessation interventions are suggested. The results for this study highlight the need to further investigate and eliminate disparities between the sexes in order to optimize health outcomes among Canadians with diabetes.

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