Diabetes conversation map - A novel tool for diabetes management self-efficacy among type 2 diabetes patients in Pakistan: A randomized controlled trial

Background: This study aimed to measure the effect of diabetes education using the novel method of "diabetes conversation map (DCM)"as compared to routine counselling (RC) on diabetes management self-efficacy (DMSE) among patients living with type 2 diabetes in Karachi, Pakistan. Methods: A parallel arm randomized controlled trial among patients with type 2 diabetes aged 30-60 years, with HbA1c > 7%, diagnosed for at least 5 yrs., was conducted at the national institute of diabetes and endocrinology in Karachi, Pakistan. A total 123 type 2 diabetes patients were randomized into DCM (n = 62) or RC (n = 61). Four weekly diabetes control sessions of 40 min each using the DCM or RC was provided. DMSE was measured using a validated Urdu language DMSE tool at baseline and after three months of the randomization. Change in DMSE and HbA1c levels within groups (pre-post) and between the groups after 3 months of enrollment was compared. Results: Baseline characteristics except HbA1c were similar between the two arms. After 3 months of enrollment, there was no change in the DMSE score in the RC arm however, significant increase in DMSE score was noted in the DCM arm (P = < 0.001). The average difference (95% confidence interval) in DMSE score between the DCM and RC arm was 33.7(27.3, 40.0; p = < 0.001) after 3 months of the enrollment. Difference in HbA1c within groups was not significant. Conclusions: DCM significantly improved DMSE among type 2 diabetes patients in a developing country setting like Pakistan. Healthcare workers caring for type 2 diabetes patients need to be trained on DCM to effectively utilize this novel tool for educating diabetes patients. Trial registration: This trial was prospectively registered. ClinicalTrials.gov Identifier: NCT03747471. Date of registration: Nov 20. 2018

Correlation between maternal and neonatal blood Vitamin D level; A cross sectional study of 416 participants visiting a tertiary care hospital in Pakistan

In Pakistan there is limited evidence for the levels and relationship of 25 (OH) Vitamin D [25(OH)D] status in pregnant women and their newborns while the association between maternal 25(OH)D and newborn anthropometric measurements remains unexplored. Sociodemographic data was collected from 213 pregnant mothers during their visit to a tertiary care hospital at the time of childbirth. Anthropometric measurements were performed on all mothers and their newborns and blood samples collected from both for 25(OH)D levels. Participants were classified into two groups according to their 25(OH)D status: Sufficient (25(OH)D ≥50nmol/l) and Deficient (25(OH)D 0.05). Our study shows a high prevalence of 25(OH)D deficiency in pregnant women and their newborns and a strong positive association between maternal and newborn 25(OH)D levels. Findings of this study indicate the importance of maintaining sufficient 25(OH)D levels during pregnancy

Substance use and its predictors among undergraduate medical students of Addis Ababa University in Ethiopia

<p>Abstract</p> <p>Background</p> <p>Substance use remains high among Ethiopian youth and young adolescents particularly in high schools and colleges. The use of alcohol, <it>khat </it>and tobacco by college and university students can be harmful; leading to decreased academic performance, increased risk of contracting HIV and other sexually transmitted diseases. However, the magnitude of substance use and the factors associated with it has not been investigated among medical students in the country. This study was conducted to determine the prevalence of substance use and identify factors that influenced the behavior among undergraduate medical students of Addis Ababa University in Ethiopia.</p> <p>Methods</p> <p>A cross-sectional study using a pre-tested structured self-administered quantitative questionnaire was conducted in June 2009 among 622 medical students (Year I to Internship program) at the School of Medicine. The data were entered into Epi Info version 6.04d and analyzed using SPSS version 15 software program. Descriptive statistics were used for data summarization and presentation. Differences in proportions were compared for significance using Chi Square test, with significance level set at p < 0.05. Multivariate logistic regression analyses were used to assess the magnitude of associations between substance use and socio-demographic and behavioral correlates.</p> <p>Results</p> <p>In the last 12 months, alcohol was consumed by 22% (25% males vs. 14% females, p = 0.002) and <it>khat </it>use was reported by 7% (9% males vs. 1.5% females, p < 0.001) of the students. About 9% of the respondents (10.6% males vs. 4.6% females, p = 0.014) reported ever use of cigarette smoking, and 1.8% were found to be current smokers. Using multiple logistic regression models, being male was strongly associated with alcohol use in the last 12 months (adjusted OR = 2.14, 95% CI = 1.22-3.76). Students whose friends currently consume alcohol were more likely to consume alcohol (adjusted OR = 2.47, 95% CI = 1.50-4.08) and whose friends' use tobacco more likely to smoke (adjusted OR = 3.89, 95% CI = 1.83-8.30). <it>Khat </it>use within the past 12 months was strongly and positively associated with alcohol consumption (adjusted OR = 15.11, 95% CI = 4.24-53.91). Similarly, ever use of cigarette was also significantly associated with alcohol consumption (adjusted OR = 8.65, 95% CI = 3.48-21.50).</p> <p>Conclusions</p> <p>Concordant use of alcohol, <it>khat </it>and tobacco is observed and exposure to friends' use of substances is often implicated. Alcohol consumption or <it>khat </it>use has been significantly associated with tobacco use. While the findings of this study suggest that substance use among the medical students was not alarming, but its trend increased among students from Year I to Internship program. The university must be vigilant in monitoring and educating the students about the consequences of substance use.</p

Young people's views on the potential use of telemedicine consultations for sexual health: results of a national survey

<p>Abstract</p> <p>Background</p> <p>Young people are disproportionately affected by sexually transmissible infections in Australia but face barriers to accessing sexual health services, including concerns over confidentiality and, for some, geographic remoteness. A possible innovation to increase access to services is the use of telemedicine.</p> <p>Methods</p> <p>Young people's (aged 16-24) pre-use views on telephone and webcam consultations for sexual health were investigated through a widely-advertised national online survey in Australia. Descriptive statistics were used to describe the study sample and chi-square, Mann-Whitney U test, or t-tests were used to assess associations. Multinomial logistic regression was used to explore the association between the three-level outcome variable (first preference in person, telephone or webcam, and demographic and behavioural variables); odds ratios and 95%CI were calculated using in person as the reference category. Free text responses were analysed thematically.</p> <p>Results</p> <p>A total of 662 people completed the questionnaire. Overall, 85% of the sample indicated they would be willing to have an in-person consultation with a doctor, 63% a telephone consultation, and 29% a webcam consultation. Men, respondents with same-sex partners, and respondents reporting three or more partners in the previous year were more willing to have a webcam consultation. Imagining they lived 20 minutes from a doctor, 83% of respondents reported that their first preference would be an in-person consultation with a doctor; if imagining they lived two hours from a doctor, 51% preferred a telephone consultation. The main objections to webcam consultations in the free text responses were privacy and security concerns relating to the possibility of the webcam consultation being recorded, saved, and potentially searchable and retrievable online.</p> <p>Conclusions</p> <p>This study is the first we are aware of that seeks the views of young people on telemedicine and access to sexual health services. Although only 29% of respondents were willing to have a webcam consultation, such a service may benefit youth who may not otherwise access a sexual health service. The acceptability of webcam consultations may be increased if medical clinics provide clear and accessible privacy policies ensuring that consultations will not be recorded or saved.</p

Basic Formal Education Quality, Information Technology and Inclusive Human Development in Sub-Saharan Africa

This study assesses the relevance of basic formal education in information technology for inclusive human development in 49 countries in sub-Saharan Africa for the period 2000-2012. The question it aims to answer is the following: what is the relevance of basic formal education in the effect of mobile phone penetration on inclusive human development in sub-Saharan Africa when initial levels of inclusive human development are taken into account? The empirical evidence is based on instrumental quantile regressions. Poor primary education dampens the positive effect of mobile phone penetration on inclusive human development. This main finding should be understood in the perspective that, the education quality indicator represents a policy syndrome because of the way it is computed, notably: the ratio of pupils to teachers. Hence, an increasing ratio indicates decreasing quality of education. It follows that decreasing quality of education dampens the positive effect of mobile phone on inclusive development. This tendency is consistent throughout the conditional distribution of inclusive human development. Policy implications for sustainable development are discussed

\u201cThe Role of Perceived University Support in the Formation of Students' Entrepreneurial Intention\u201d

Entrepreneurship education is central to student entrepreneurship. Previous research has attempted to understand the role of entrepreneurship education in the formation of students' entrepreneurial intention and behavior, albeit in an isolated manner. Universities can support entrepreneurship in many ways, but it is important to measure students' perception of the support that they receive in order to understand the extent of such support and its impact on students. The current study proposed and tested an integrative, multiperspective framework. We have hypothesized that the three dimensions of university support, that is, perceived educational support, concept development support, and business development support, together with institutional support, shape students' entrepreneurial self-efficacy. In turn, entrepreneurial self-efficacy and individual motivations constitute the fundamental elements of the intention to start a business. A sample of 805 university students took part in the study and data were analyzed using structural equation modeling. Our findings showed that perceived educational support exerted the highest influence on entrepreneurial self-efficacy, followed by concept development support, business development support, and institutional support. Self-efficacy in turn had a significant effect on entrepreneurial intention. Individual motivations such as self-realization, recognition, and role had an additional impact on intention. However, intention was not related to financial success, innovation, and independence. The findings suggest that a holistic perspective provides a more meaningful understanding of the role of perceived university support in the formation of students' entrepreneurial intention. Theoretical and practical implications are discussed. \ua9 2013 International Council for Small Business

Factors affecting internet banking preferences and their relation to demographic characteristics

Internet banking has a very important place in the banking sector. The majority of banks located in Turkey offer many technological services. However, it is also seen that the use of internet banking does not reach the desired levels. The purpose of this study is to determine the factors affecting the internet banking preferences of the bank customers and the relationships between the demographic characteristics of bank customers and internet banking usage in Usak city of Turkey. Data from the questionnaires were analyzed using factor analysis, t-test and ANOVA analysis. As a result, seven factors were found to be effective in the use of internet banking. These are (1) “effect of social circle”; (2) “benefits of internet banking”; (3) “the usefulness of internet banking”; (4) “speed and time savings”; (5) “ease of use and cost”; (6) “the ability to use the internet and the advantages of internet banking”; and (7) “the suitability to life and work style.” In addition, it was determined that there is a significant relationship between the demographic characteristics of bank customers and internet banking usage. © 2019 by Emerald Publishing Limited All rights of reproduction in any form reserved