Factors Associated with Achievement of Glycemic Goal in Africa—Results from the International Diabetes Management Practices Study (IDMPS)

Abstract Background. Despite the high health and financial burden imposed by diabetes in Mexico, few studies have estimated the cost per patient treated. The objective of this study was to estimate the average annual cost per patient (unit cost) with diabetes among 60 primary health facilities in Mexico comparing comprehensive diabetes management medical offices (MIDE) and those from general practice (Non-MIDE). Methods. We described the variation in unit costs across these two types of medical offices and explored factors associated. Unit costs were the sum of staff, medications, laboratory tests, and equipment. We show descriptive statistics to analyze the heterogeneity of unit costs, and the distribution of total costs by input and the distribution of staff costs by personnel all by medical office. We estimated a multivariate linear regression model to explore factors associated with the unit costs. Results. Unit costs vary from $267.2 USD in Non-MIDE offices to $410.6 for MIDE. Unit costs were negatively associated with scale, Non-MIDE offices, medical competence, patient knowledge of diabetes and positively associated with comorbidities. Conclusions. Results from this study might help design more efficient programs for diabetes care in primary health facilities to reduce the burden of diabetes in the system. Investing in staff training and educational interventions to increase patient knowledge of diabetes could be promising interventions to reduce diabetes care costs in primary care settings.

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Socio-demographic determinants of health-care seeking options and alternative management practices of childhood diarrhoeal illness: A household survey among mothers in Iraq

10.21203/rs.2.11331/v1 ◽

2019 ◽

Author(s):

Ihab Habib ◽

Ali Harb ◽

Sam Abraham ◽

Mark O’Dea ◽

Haidar Ali Hantosh ◽

...

Keyword(s):

Health Care ◽

Management Practices ◽

Household Survey ◽

University Education ◽

Relative Risk Ratio ◽

P Value ◽

Health Care Seeking ◽

Care Seeking ◽

Alternative Management ◽

Factors Associated

Abstract Background Diarrhoea remains a significant cause of child morbidity and mortality in Iraq. The objective of this study was to examine the current practices of home-based management of diarrhoeal illnesses among Iraqi children. We surveyed mothers of children below five years of age in order to identify the socio-demographic factors associated with maternal health-care seeking practices. Methods A total of 500 mother-child pairs were interviewed in a cross-sectional household survey in Thi-Qar Governorate, south-eastern Iraq between March 2016 and February 2017. Logistic and multinomial regression models were utilized to infer socio-demographic predictors of the health-care seeking and alternative management practices adopted by the mothers. Results The interviewees reported that 35.2% of their children had diarrhoea in the two weeks prior to the survey. The least likelihood of reported occurrence of diarrhoea was among mother-child pairs where the mothers had received university education, as compared to mothers who were illiterate or received only primary or secondary education. Lower odds (OR=0.4, P-value <0.001) of reported childhood diarrhoea was revealed among mothers aged >25 years old compared to those younger. Self-ordered medicine from a pharmacy was the most preferred alternative management option in almost half (52.4% (262/500)) of the interviewed mothers in Thi-Qar. Interestingly, 69.6% (348/500) of the mothers reported supplying their children suffering from diarrhoea with antibiotics. Relative to mothers with university education, those with high school education had more likelihood of selecting medical center (relative risk ratio (rrr) = 2.4) and pharmacy (rrr = 3.7) as against no treatment. Conclusions Lower maternal educational level, mothers' age <25 and the district of residence were important factors associated with diarrhoea occurrence among under-five children. In light of the findings from this study, intervention aimed at improving health-care seeking for managing diarrhoea in Iraqi children should jointly consider the influence of mothers age, education, as well as the level of economic status of the communities in which mothers of these children resides. The results of this study indicate the need for enhancing public health education in order to improve the maternal management of diarrhoeal disease and the avoidance of unnecessary use of antimicrobials.

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Awareness of Employee Stress Response: How Employers Can Mitigate Workplace Burnout and Workplace Depression

NHRD Network Journal ◽

10.1177/2631454118800855 ◽

2018 ◽

Vol 11 (4) ◽

pp. 78-82

Author(s):

Tony Deblauwe

Keyword(s):

Cognitive Neuroscience ◽

Social Cognitive ◽

Management Practices ◽

Building Blocks ◽

Factors Associated ◽

Leadership Management ◽

Social Cognitive Neuroscience ◽

Prosocial Behaviours ◽

The Brain ◽

Effective Conditions

By examining the science behind leadership, management practices and how they relate to social cognitive neuroscience, we can understand how to target the most effective conditions for preventing workplace burnout and workplace depression. This process begins with the ability of managers to recognise and react responsively to create a culture of trust within the organisation, and identify and promote prosocial behaviours to prevent feelings of disengagement and displacement. This review discusses how one’s ability to inspire employees is particularly important, because followers with low self-concepts are drawn to a highly personalised vision. Through the promotion of the brain chemical, oxytocin, the material presents eight building blocks to promote a culture of trust, while mitigating the factors associated with workplace burnout and workplace depression.

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Suboptimal glycemic control among subjects with diabetes mellitus in India: a subset analysis of cross-sectional wave-7 (2016) data from the International Diabetes Management Practices Study (IDMPS)

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018820937217 ◽

2020 ◽

Vol 11 ◽

pp. 204201882093721

Author(s):

Ambady Ramachandran ◽

Sunil M. Jain ◽

Sagarika Mukherjee ◽

Sanjeev Phatak ◽

Shailesh Pitale ◽

...

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Management Practices ◽

Diabetes Management ◽

Diabetes Education ◽

Glycated Haemoglobin ◽

Oral Glucose ◽

Eligibility Criteria ◽

Cross Sectional ◽

Glycemic Targets

Objective: To assess the real-world management practices of subjects with type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) in India. Methods: This cross-sectional study was conducted between 7 March 2016 and 15 May 2016 in India as part of the seventh wave (2016) of the International Diabetes Management Practices Study (IDMPS). Adult subjects with T1DM or T2DM visiting physicians during a 2-week recruitment period were included. Results: A total of 55 physicians included 539 subjects who met eligibility criteria. Of 495 subjects with T2DM, 303 were treated with oral glucose lowering drugs (OGLDs) only, 158 were treated with OGLD + insulin, and 27 received insulin only. Among 44 subjects with T1DM receiving insulin, 13 (29.5%) were also treated with OGLD therapy. The most commonly used insulin regimens were basal alone (69/184; 37.5%) and premixed alone (63/184; 34.2%) in subjects with T2DM, and basal + prandial insulin (24/44; 54.5%) in subjects with T1DM. Proportions of subjects achieving glycemic targets were low [glycated haemoglobin (HbA1c) <7%: T1DM = 7.3% (3/44), T2DM = 25.2% (106/495); as targeted by the treating physician: T1DM = 31.8% (14/44), T2DM = 32.1% (59/185); global target: T1DM = 4.8% (2/42) and T2DM = 1.7% (8/482)]. In subjects with T2DM, HbA1c <7% was noted in 11/22 subjects receiving insulin only and 76/260 receiving only OGLDs. Lack of experience in self-managing insulin dosing, poor diabetes education and failure to titrate insulin dosages were the main reasons for non-achievement of glycemic targets. Conclusion: Timely insulinization, education and empowerment of people with diabetes may help improve glycemic control in India.

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Prevalence and risk factors associated with Campylobacter spp. and Salmonella enterica in livestock raised on diversified small-scale farms in California

Epidemiology and Infection ◽

10.1017/s095026881900205x ◽

2019 ◽

Vol 147 ◽

Cited By ~ 1

Author(s):

A. F. A. Pires ◽

L. Patterson ◽

E. A. Kukielka ◽

P. Aminabadi ◽

N. Navarro-Gonzalez ◽

...

Keyword(s):

Risk Factors ◽

Salmonella Enterica ◽

Management Practices ◽

Risk Mitigation ◽

Significant Risk ◽

Mitigation Strategies ◽

Farm Size ◽

Small Scale ◽

Animal Products ◽

Factors Associated

Abstract Diversified farms are operations that raise a variety of crops and/or multiple species of livestock, with the goal of utilising the products of one for the growth of the other, thus fostering a sustainable cycle. This type of farming reflects consumers' increasing demand for sustainably produced, naturally raised or pasture-raised animal products that are commonly produced on diversified farms. The specific objectives of this study were to characterise diversified small-scale farms (DSSF) in California, estimate the prevalence of Salmonella enterica and Campylobacter spp. in livestock and poultry, and evaluate the association between farm- and sample-level risk factors and the prevalence of Campylobacter spp. on DSSF in California using a multilevel logistic model. Most participating farms were organic and raised more than one animal species. Overall Salmonella prevalence was 1.19% (95% confidence interval (CI95) 0.6–2), and overall Campylobacter spp. prevalence was 10.8% (CI95 = 9–12.9). Significant risk factors associated with Campylobacter spp. were farm size (odds ratio (OR)10–50 acres: less than 10 acres = 6, CI95 = 2.11–29.8), ownership of swine (OR = 9.3, CI95 = 3.4–38.8) and season (ORSpring: Coastal summer = 3.5, CI95 = 1.1–10.9; ORWinter: Coastal summer = 3.23, CI95 = 1.4–7.4). As the number of DSSF continues to grow, evaluating risk factors and management practices that are unique to these operations will help identify risk mitigation strategies and develop outreach materials to improve the food safety of animal and vegetable products produced on DSSF.

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Characterization of the factors associated with the growth phase of dairy cattle in family farming

Semina Ciências Agrárias ◽

10.5433/1679-0359.2018v39n4p1653 ◽

2018 ◽

Vol 39 (4) ◽

pp. 1653

Author(s):

Rodrigo De Andrade Ferrazza ◽

Gilvando Fabio Uliana de Moura ◽

Marcos Aurélio Lopes

Keyword(s):

Dairy Cattle ◽

Growth Phase ◽

Management Practices ◽

Production Systems ◽

Family Farming ◽

Factors Associated ◽

Family Farmers ◽

Survey Form ◽

Husbandry System ◽

Transition Milk

The aim of this study was to characterize the factors associated with the growth phase of dairy cattle used in family farming. We investigated 20 family-run milk production systems located in the Conceição de Ipanema municipality, MG, Brazil. Farmers were interviewed using a semi-structured survey form containing 152 questions. The questions were aimed at characterizing the farmer, herd, and husbandry system at pre- and post-weaning phases. Data were processed by using Sphinx® software, and descriptive analyses were performed in MS Excel® software. The results showed strengths, including navel healing (100%), location of the calf housing above (45%) or next to the pen (35%), and existence of a sanitary calendar (90%). However, several limitations in the management of calves and heifers were identified, such as lack of zootechnical bookkeeping (55%), manual milking with calf at the foot (65%), absence of herd sizing (100%), no routine weighing of calves (95%), incorrect colostrum management (80%), non-supply of transition milk to calves (85%), and likely failure to diagnose diseases by a fraction of the farmers. Thus, training regarding adequate management practices by extension technicians is imperative, along with the formulation of public policies that comply with the aspirations of family farmers, while promoting their economic and social sustainability.

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