Comparing Health Gains, Costs and Cost-Effectiveness of 100s of Interventions in Australia and New Zealand: An Online Interactive League Table

Background This study compares the health gains, costs, and cost-effectiveness of hundreds of Australian and New Zealand (NZ) health interventions conducted with comparable methods in an online interactive league table designed to inform policy. Methods A literature review was conducted to identify peer-reviewed evaluations (2010 to 2018) arising from the Australia Cost-Effectiveness (ACE) research and NZ Burden of Disease Epidemiology, Equity and Cost-Effectiveness (BODE3) Programmes, or using similar methodology, with: health gains quantified as health-adjusted life years (HALYs); net health system costs and/or incremental cost-effectiveness ratio; time horizon of at least 10 years; and 3–5% discount rates. Results We identified 384 evaluations that met the inclusion criteria, covering 14 intervention domains: alcohol; cancer; cannabis; communicable disease; cardiovascular disease; diabetes; diet; injury; mental illness; other non-communicable disease; overweight and obesity; physical inactivity; salt; tobacco. There were large variations in health gain across evaluations: 33.9% gained less than 0.1 HALYs per 1000 people in the total population over the remainder of their lifespan, through to 13.0% gaining >10 HALYs per 1000 people. Over a third (38.8%) of evaluations were cost-saving. Conclusions League tables of comparably conducted evaluations illustrate the large health gain (and cost) variations per capita between interventions, in addition to cost-effectiveness. Further work can test the utility of this league table with policy makers and researchers.

Development of Educational Media For Type II Diabetes Mellitus Patients in the Work Area of Kedundung Health Center, Mojokerto City

Diabetes is one of the big four non-communicable diseases. According to the Mojokerto City Health Office, the incidence reached 3,365 in 2019 with the highest recorded at the Kedundung Health Center with 822 patients. Although the Ministry of Health has introduced dietary programmes for tackling the incidence of diabetes, a survey of the dietary rules of diabetes patients at the Kedundung Health Center revealed that it is only limited to consultation with nutritionists. Thus, it is necessary to develop a health-education media product in the form of a booklet explaining a more practical diet for diabetes mellitus patients. This study comprised of 10 stages adopted from the Sugiyono’s development model using a qualitative and quantitative descriptive analysis. The booklet produced b this study is titled “How to Diet Diabetes?” and contains information on understanding diabetes diet, the purpose, the calories needed, eating schedule, type of food, diet composition, dietary restrictions, and various menus. An assessment of the final product showed that 91.6% of the media experts considered it “very worthy” and 75% of the members providing the material included in the booklet considered it “eligible with minor revision.” Similarly, 92.7% of a small test group and 88.7% of a large test group classified it as “very worthy.” However, further work is needed to evaluate the effectiveness and impact of the booklet. Expansion of the subject is expected so that the booklet could reach more targets. Keywords: booklet, diabetes mellitus Diet, educational media

Culturally Sensitive Health Education in the Caribbean Diaspora: A Scoping Review

Context: The Caribbean diaspora in the United States is a diverse community that is afflicted with high morbidity and mortality due to preventable chronic diseases. Objective: Our goal is to determine which culturally sensitive health and nutrition educational modalities have the highest efficacy for improving general health in the Caribbean diaspora. Methods: A scoping literature review was performed on the MEDLINE, CINAHL, and Web of Science databases using terms related to health and nutrition in the Caribbean population. Original, peer-reviewed research published from 2010 to 2020, which took place in the U.S. and Caribbean countries, were included in our review. Results: We identified a total of nine articles that met our inclusion criteria. Rate differences for individual education program features were calculated to assess the likelihood of a positive impact on diet, physical activity, and diabetes. Conclusion: Our review helps to identify key educational modalities targeting diabetes, diet, and physical activity levels that can be used to meet the health and nutritional needs of the Caribbean diaspora population.

Sociodemographic and Marital Differences in Spousal Involvement in a Partner’s Diabetes Diet

Spouses are commonly involved in their partners’ diabetes management by supporting and regulating (i.e., controlling) their diet. Little is known, however, about what characteristics are associated with how and how often spouses are involved in this context. This study examined whether sociodemographic and marital characteristics helped explain some of the variability in diet-related spousal involvement in promoting a partner’s adherence to a diabetes diet; specifically, whether gender, race/ethnicity, marital quality, and marital length were related to the frequency of spousal engagement in health-related social support and two types of health-related social control. Gender and race/ethnicity were examined as exploratory moderators of the associations between marital characteristics and spousal involvement. Data from two different data sets of older adults (55+ years) whose partners had type 2 diabetes were examined among four racial/ethnic groups (study 1 n = 205; study 2 n = 155). Regression analyses that controlled for patients’ co-morbid health conditions revealed gender and racial/ethnic differences in the frequency of spousal involvement. In addition, marital quality was related to the frequency of support and positive forms of social control among most participants, particularly African American spouses. No associations between marital length and any type of spousal involvement were found, nor were there any gender differences in any of these associations. These findings provide insight into the importance of sociodemographic characteristics and marital quality in understanding spousal involvement in a partner’s diabetes management.

Perilaku self-management dengan kejadian ulkus diabetikum pada pasien diabetes mellitus tipe 2

Self-management behaviour of diabetic foot ulcer occurrence among patient with type 2 diabetes mellitusBackground: Diabetes mellitus is one of the silent killers. Indonesia is a country with the 4th largest number of people with diabetes mellitus after China, India, and the United States. In Indonesia people with diabetes mellitus increased from 8.4 million in 2000 to 21.3 million in 2030.Purpose: To determine the self-management behaviour and diabetic foot ulcer occurrence among patient with type 2 diabetes mellitus.Method: A quantitative research type, with cross sectional analytic and analytical research designs. The population of all people with diabetes mellitus as many as 432 people and a sample of 38 people with a total sampling technique. Data collection using questionnaire sheets and statistical tests used were Chi-Square statistical tests.Results: The frequency distribution of the incidence of diabetic ulcers in patients with type 2 diabetes mellitus, with the category of diabetic ulcers occurring as many as 14 respondents (36.8%). Diabetes diet adherence in patients with diabetes mellitus, with the category of non-compliance with 16 respondents (42.1%). Monitoring blood sugar levels in patients with type 2 diabetes mellitus, with non-routine categories of 15 respondents (39.5%). Physical activity in patients with type 2 diabetes mellitus, with a less good category of 19 respondents (50%).Conclusion: There is a relationship between blood sugar and diabetic ulcer diabetes in type 2 diabetes mellitus patients. There is a relationship between diabetes diet and diabetic ulcer diabetes in type 2 diabetes mellitus patients. There is a relationship between physical activity and the incidence of diabetic ulcers in patients with type 2 diabetes mellitus. It is expected that DM patients can routinely carry out physical and routine activities with high salt levels) in health care facilities and carry out a diabetes diet in accordance with the rules proposed by nutritionists.Keywords: Self-management; Behaviour; Diabetic foot ulcer; Occurrence; Patient; Type 2 diabetes mellitusPendahuluan: Diabetes melitus salah satu the silent killer. Indonesia merupakan negara dengan jumlah penderita diabetes melitus ke-4 terbanyak setelah Cina, India, dan Amerika Serikat.di Indonesia penyandang diabetes melitus mengalami kenaikan dari 8,4 juta pada tahun 2000 menjadi 21,3 juta pada tahun 2030.Tujuan: Diketahui hubungan perilaku self-management dengan kejadian ulkus diabetikum pada pasien diabetes mellitus tipe 2Metode: Jenis penelitian kuantitatif, dengan rancangan penelitian analitik dan pendekatan cross sectional. Populasi seluruh seluruh penderita diabetes melitus sebanyak 432 orang dan sampel sebanyak 38 orang dengan teknik total Sampling. Pengumpulan data menggunakan lembar kuesioner dan Uji statistik yang digunakan adalah uji statistik Chi-Square.Hasil: Distribusi frekuensi kejadian ulkus diabetikum pada penderita diabetes melitus tipe 2, dengan kategori terjadi ulkus diabetikum sebanyak 14 responden (36,8%). Kepatuhan diet diabetes pada pasien diabetes melitus, dengan kategori tidak patuh sebanyak 16 responden (42,1%). Pemantauan kadar gula darah pada pasien diabetes melitus tipe 2, dengan kategori tidak rutin sebanyak 15 responden (39,5%). Aktivitas fisik pada pasien diabetes melitus tipe 2, dengan kategori kurang baik sebanyak 19 responden (50%).Simpulan: Ada hubungan pemantauan kadar gula darah dengan kejadian ulkus diabetikum pada pasien diabetes melitus tipe 2. Ada hubungan kepatuhan diet diabetes dengan kejadian ulkus diabetikum pada pasien diabetes melitus tipe 2. Ada hubungan aktivitas fisik dengan kejadian ulkus diabetikum pada pasien diabetes melitus tipe 2. Diharapkan pasien DM agar rutin melakukan aktivitas fisik serta rutin mengontrol kadar gula darah pada fasilitas pelayanan kesehatan Serta menjalankan diet diabetes sesuai dengan aturan yang disarankan ahli gizi.