Adequacy of Diabetes Care for Older U.S. Rural Adults: A Cross-sectional Population Based Study Using 2009 BRFSS Data

Background: In the U.S. diabetes prevalence estimates for adults ≥ 65 years exceed 20%. Rural communities have higher proportions of older individuals and health disparities associated with rural residency place rural communities at risk for a higher burden from diabetes. This study examined the adequacy of care received by older rural adults for their diabetes to determine if older rural adults differed in the receipt of adequate diabetes care when compared to their non-rural counterparts. Methods: Cross-sectional data from the 2009 Behavioral Risk Factor Surveillance Survey were examined using bivariate and multivariate analytical techniques. Results: Logistic regression analysis revealed that older rural adults with diabetes were more likely to receive less than adequate care when compared to their non-rural counterparts (OR = 1.465, 95% CI: 1.454-1.475). Older rural adults receiving less than adequate care for their diabetes were more likely to be: male, non-Caucasian, less educated, unmarried, economically poorer, inactive, a smoker. They were also more likely to: have deferred medical care because of cost, not have a personal health care provider, and not have had a routine medical check-up within the last 12 months. Conclusion: There are gaps between what is recommended for diabetes management and the management that older individuals receive. Older adults with diabetes living in rural communities are at greater risk for less than adequate care when compared to their non-rural counterparts. These results suggest the need to develop strategies to improve diabetes care for older adults with diabetes and to target those at highest risk

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Not AvailableAim: Seroepidemiological study of leptospirosis in cattle of various South Gujarat district (Navsari, Tapi, Surat, Valsad). Materials and Methods: Whole blood samples were collected randomly from different age groups, and breeds of cattle of either sex reared in different districts (Navsari, Surat, Tapi, Valsad) of South Gujarat. To obtain serum, whole blood was kept in slanting position in 9.0 ml plain vacutainers until serum extracted out of the whole blood. Then these 9.0 ml plain vacutainers were centrifuged at 7000 rpm for 10 min. The straw colored serum was then collected in 1.5 ml sterile cryo vials and aliquoted and stored at −20°C for microscopic agglutination test. Results: In the present study, overall 12.81% (51/398) seroprevalence were recorded with highest seroprevalence (47.06%, 24/51) from Valsad followed by Navsari (9.14%, 18/197), Surat (6.90%, 2/29) and Tapi (5.79%, 7/121) among cattle. The seroprevalence rate of breed and sex wise did not differ significantly (p≤0.05). Maximum incidence of seropositivity was found above 4 years (16.32%, 39/239) of age group followed by animals between 1 and 4 years (9.68%, 12/124). Thus, the age was significantly influencing the seropositivity (p≤0.05). In cattle out of 398 sera screened, 51 were positive with one or more serovars. The highest seropositivity was recorded against serovar Pomona (28.89%). Conclusions: Overall 12.81% seroprevalence of leptospirosis in apparently healthy and clinically ailing bovine of South Gujarat indicating potential zoonotic risk to farmers, labor, and animal owners.Not Availabl