The outcome and cost-effectiveness of nurse-led care in the community for people with rheumatoid arthritis:a non-randomised pragmatic study

To determine the outcome and cost-effectiveness of nurse-led care in the community for people with rheumatoid arthritis (RA)

О "труднопереводимости" фразеологизмов

В данной статье рассматриваются теоретические вопросы перевода всех типов фразеологических словосочетаний.У цій статті розглядаються теоретичні питання перекладу всіх типів фразеологічних словосполучень.The article deals with the theoretical problems of all type idiom combination translations

Associations of Patient Health-Related Problem Solving with Disease Control, Emergency Department Visits, and Hospitalizations in HIV and Diabetes Clinic Samples

BACKGROUND: Patient problem solving and decision making are recognized as essential to effective self-management across multiple chronic diseases. However, a health-related problem-solving instrument that demonstrates sensitivity to disease control parameters in multiple diseases has not been established. OBJECTIVES: To determine, in two disease samples, internal consistency and associations with disease control of the Health Problem-Solving Scale (HPSS), a 50-item measure with 7 subscales assessing effective and ineffective problem-solving approaches, learning from past experiences, and motivation/orientation. DESIGN: Cross-sectional study. PARTICIPANTS: Outpatients from university-affiliated medical center HIV (N = 111) and diabetes mellitus (DM, N = 78) clinics. MEASUREMENTS: HPSS, CD4, hemoglobin A1c (HbA1c), and number of hospitalizations in the previous year and Emergency Department (ED) visits in the previous 6 months. RESULTS: Administration time for the HPSS ranged from 5 to 10 minutes. Cronbach’s alpha for the total HPSS was 0.86 and 0.89 for HIV and DM, respectively. Higher total scores (better problem solving) were associated with higher CD4 and fewer hospitalizations in HIV and lower HbA1c and fewer ED visits in DM. Health Problem-Solving Scale subscales representing negative problem-solving approaches were consistently associated with more hospitalizations (HIV, DM) and ED visits (DM). CONCLUSIONS: The HPSS may identify problem-solving difficulties with disease self-management and assess effectiveness of interventions targeting patient decision making in self-care

Importance of native language in a population-based health survey among ethnic Chinese in Australia

Objective: To assess the impacts of survey languages on participation and representativeness of the study subjects in a health survey in a Chinese community in Australia

Continuous glucose monitors and virtual care in high-risk, racial and ethnic minority populations: Toward promoting health equity

Continuous glucose monitors (CGMs) have become an important tool to aid self-management of blood glucose for many patients with diabetes in the U.S., and the benefits of CGM use are well-documented. However, disparities in CGM use exist, with lower use in certain marginalized racial and ethnic groups. CGM may be an important and underutilized tool to help reduce inequities. Evidence supporting the use of CGMs as a part of virtual care is discussed, with an emphasis on designing virtual diabetes care programs to promote health equity. Recommendations for clinical practice and research are presented. In clinical practice, CGM should be an option for all people with diabetes who qualify based on clinical practice guidelines, regardless of race, ethnicity, or other individual characteristics. Future research should characterize the use of, benefit from, and preferences for CGM among individuals from racial and ethnic groups to guide interventions at the health system, clinic, provider, and patient levels to promote equitable, evidence-based, and guideline-directed CGM use in marginalized racial and ethnic groups with diabetes

Factors that influence food choices in secondary school canteens: a qualitative study of pupil and staff perspectives

BackgroundAdolescence is recognised as a period of nutritional vulnerability, with evidence indicating that United Kingdom adolescents have suboptimal dietary intakes with many failing to meet dietary recommendations. Additionally, adolescence is a time of transition when they become more independent in their dietary choices and begin to develop their own sense of autonomy and are less reliant on their parent’s guidance, which is reported to lead to less favourable dietary behaviours. Reducing the prevalence of poor dietary intakes and the associated negative health consequences among this population is a public health priority and schools represent an important setting to promote positive dietary behaviours. The aim of this school-based study was to explore the factors and barriers which influence food choices within the school canteen and to identify feasible strategies to promote positive dietary behaviours within this setting.MethodsThirteen focus groups with 86 pupils in Year 8 (n = 37; aged 11–12 years) and Year 9 (n = 49; aged 12–13 years) in six secondary schools across Northern Ireland, United Kingdom were conducted. Additionally, one-to-one virtual interviews were conducted with 29 school staff [principals/vice-principals (n = 4); teachers (n = 17); and caterers (n = 7)] across 17 secondary schools and an Education Authority (EA) senior staff member (n = 1). Focus groups and interviews were audio-recorded, transcribed, and analysed following an inductive thematic approach.ResultsUsing the ecological framework, multiple factors were identified which influenced pupils’ selection of food in the school canteen at the individual (e.g., time/convenience), social (e.g., peer influence), physical (e.g., food/beverage placement), and macro environment (e.g., food provision) level. Suggestions for improvement of food choices were also identified at each ecological level: individual (e.g., rewards), social (e.g., pupil-led initiatives), physical (e.g., labelling), and macro environment (e.g., whole-school approaches).ConclusionLow-cost and non-labour intensive practical strategies could be employed, including menu and labelling strategies, placement of foods, reviewing pricing policies and whole-school initiatives in developing future dietary interventions to positively enhance adolescents’ food choices in secondary schools

Guide to Best Practice in Seascape Assessment

Seascape is a crucial element in any maritime nation’s sense of identity and culture. It has played an important part in the history and development of Ireland and Wales. The coast and the sea is a primary holiday and leisure location and is a significant asset in a nation’s recreational resource. The coast and related seascape is a finite resource under almost continual pressure for development. In both Ireland and Wales we are currently experiencing a period of exceptional change around our coasts. The response to sea level rise is generating more proposals for coastal defence works. We have seen the development of new ports and the upgrading of existing facilities, and proposals for aquaculture schemes have become more prevalent around some coasts. Energy strategies are giving rise to wind turbine projects off both coasts. We have also become more aware of how valuable and important our seascapes are to the character and identity of much of our countryside, towns and cities. With all of these development pressures related to the coast and the sea, a systematic approach to issues raised is now timely and essential to ensure that the decision making process has the tools to deal with the upcoming changes. For these reasons development that affects our coasts and seascapes require particular attention and care. Such consideration can best be given in a structure based upon a thorough understanding of the character and values attributable to the relevant seascapes. This guide attempts to provide a methodology to deal with the issues involved.Funder: European Unio