Natural mentoring as an effective public health intervention to promote positive adolescent development among adolescents: A Review Paper

The following literature review is a review of natural mentoring in the United States, and its association with numerous adolescent developmental outcomes. Natural or informal mentoring relationships are relationships in which mentors and mentees are connected through pre-existing social networks and communities. The role of natural mentoring is a relatively new area of research, and a variety of scholars have conducted studies to investigate the effects natural mentoring has on adolescents' academic, emotional, psychological, and health outcomes. The following literature review presents a review of 20 articles with a focus on natural mentoring among adolescents, and demonstrates the association between natural mentoring and academic and psycho-emotional health outcomes. The review concludes with implications for the field of public health.Master of Public Healt

Field Application of Trichogramma chilonis (Ishii) for the Management of Sugarcane Borers

Abstract.-These studies were conducted at farmer's fields in Mardan district during the cropping season [2008][2009] to investigate the efficacy and potentiality of inundative and inoculative release methods of Trichogramma chilonis (Ishii) for the management of sugarcane borers. The experiment was laid out in Randomized Complete Block Design. There were three treatments and four replications in each treatment. The data revealed that both inundative and inoculative release methods of T. chilonis were more effective as compared with the control throughout the entire growing season. Inundative release method of T. chilonis was found the most effective technique against Chilo infuscatellus (Snellen) infestation in both sugarcane plant and ratoon crops with minimum mean percent infestation of 3.50 and 6.50 respectively. This was followed by Inoculative release method, where 6.75 and 10.00 mean percent infestation was recorded in sugarcane plant and ratoon crops respectively. Maximum infestation was recorded in control plots with mean percent infestation of 7.87 and 12.75 in sugarcane plant and ratoon crops respectively. The data further revealed that inundative release method of T. chilonis in both sugarcane plant and ratoon crops also effectively controlled Acigona steniellus (Hamp) with minimum borer's infestation by recording 3.25 and 3.37 mean percent infestations in both sugarcane plant and ratoon crops respectively. It was followed by the plots where T. chilonis were released as inoculative release method, where 4.87 and 6.25 mean percent infestation was recorded in sugarcane plant and ratoon crop respectively. Control plots showed maximum A. steniellus infestation in plant crop (7.27%) and ratoon crop (7.65%). The data further showed that no Scirpophaga nivella Fabric infestation was recorded in both sugarcane plant and ratoon crops. Maximum yield of sugarcane was recorded in both plant and ratoon crops of sugarcane in plots treated with inundative release method (101.5t/ha in plant crop and 69.25 t/ha in ratoon crop) followed by inoculative release method (95.84t/ha in plant crop and 63.14t/ha in ratoon crop). The lowest yield of sugarcane was recorded in control (91.14 t/ha and 58.33 t/ha)

The interdisciplinary team in type 2 diabetes management:challenges and best practice solutions from real-world scenarios

The Global Partnership for Effective Diabetes Management has previously recommended the implementation of an interdisciplinary team (IDT) approach to type 2 diabetes (T2DM) management as one of 10 practical steps for health care professionals to help more people achieve their glycaemic goal. This article discusses some of the key contributors to success and also the challenges faced when applying IDT care, by examining case studies and examples from around the world. The real-world practices discussed show that implementing successful interdisciplinary care in diabetes is possible despite significant barriers such as established hierarchal structures and financial resource constraints. Instituting collaborative, integrated working relationships among multiple disciplines under strong leadership, together with enhanced and active communication and improved patient access to appropriate specialties is essential. Patients have a crucial role in the management of their own disease and including them as part of the treatment team is also critical. IDTs in diabetes care improve patient outcomes in terms of control of glycaemia and cardiometabolic risk factors, and decreased risk of diabetes complications. Ensuring access to an appropriate IDT, in whatever form, is paramount to enable the best care to be delivered

Group Visits: Promoting Adherence to Diabetes Guidelines

BACKGROUND: Current diabetes management guidelines offer blueprints for providers, yet type 2 diabetes control is often poor in disadvantaged populations. The group visit is a new treatment modality originating in managed care for efficient service delivery to patients with chronic health problems. Group visits offer promise for delivering care to diabetic patients, as visits are lengthier and can be more frequent, more organized, and more educational. OBJECTIVE: To evaluate the effect of group visits on clinical outcomes, concordance with 10 American Diabetes Association (ADA) guidelines [American Diabetes Association, Diabetes Care, 28:S4–36, 2004] and 3 United States Preventive Services Task Force (USPSTF) cancer screens [U.S. Preventive Services Task Force, http://www.ahrq.gov/clinic/uspstf/resource.htm, 2003]. RESEARCH DESIGN AND METHODS: A 12-month randomized controlled trial of 186 diabetic patients comparing care in group visits with care in the traditional patient–physician dyad. Clinical outcomes (HbA1c, blood pressure [BP], lipid profiles) were assessed at 6 and 12 months and quality of care measures (adherence to 10 ADA guidelines and 3 USPSTF cancer screens) at 12 months. RESULTS: At both measurement points, HbA1c, BP, and lipid levels did not differ significantly for patients attending group visits versus those in usual care. At 12 months, however, patients receiving care in group visits exhibited greater concordance with ADA process-of-care indicators (p < .0001) and higher screening rates for cancers of the breast (80 vs. 68%, p = .006) and cervix (80 vs 68%, p = .019). CONCLUSIONS: Group visits can improve the quality of care for diabetic patients, but modifications to the content and style of group visits may be necessary to achieve improved clinical outcomes

Identifying older diabetic patients at risk of poor glycemic control

BACKGROUND: Optimal glycemic control prevents the onset of diabetes complications. Identifying diabetic patients at risk of poor glycemic control could help promoting dedicated interventions. The purpose of this study was to identify predictors of poor short-term and long-term glycemic control in older diabetic in-patients. METHODS: A total of 1354 older diabetic in-patients consecutively enrolled in a multicenter study formed the training population (retrospective arm); 264 patients consecutively admitted to a ward of general medicine formed the testing population (prospective arm). Glycated hemoglobin (HbA1c) was measured on admission and one year after the discharge in the testing population. Independent correlates of a discharge glycemia ≥ 140 mg/dl in the training population were assessed by logistic regression analysis and a clinical prediction rule was developed. The ability of the prediction rule and that of admission HbA1c to predict discharge glycemia ≥ 140 mg/dl and HbA1c > 7% one year after discharge was assessed in the testing population. RESULTS: Selected admission variables (diastolic arterial pressure < 80 mmHg, glycemia = 143–218 mg/dl, glycemia > 218 mg/dl, history of insulinic or combined hypoglycemic therapy, Charlson's index > 2) were combined to obtain a score predicting a discharge fasting glycemia ≥ 140 mg/dl in the training population. A modified score was obtained by adding 1 if admission HbA1c exceeded 7.8%. The modified score was the best predictor of both discharge glycemia ≥ 140 mg/dl (sensitivity = 79%, specificity = 63%) and 1 year HbA1c > 7% (sensitivity = 72%, specificity = 71%) in the testing population. CONCLUSION: A simple clinical prediction rule might help identify older diabetic in-patients at risk of both short and long term poor glycemic control

Changing the Treatment Paradigm for Type 2 Diabetes

Based on the results of the U.K. Prospective Diabetes Study (UKPDS), “… treatment of type 2 diabetes [should] include aggressive efforts to lower blood glucose levels as close to normal as possible. …” This was the recommendation the American Diabetes Association promulgated based on the results of the UKPDS when published (1). The suggestion was soon adopted by official guidelines in every region of the world (2). They are generally consistent in recommending an A1C goal of <7.0%. However, the results of the UKPDS remained inconclusive with respect to cardiovascular (CV) complications because of a risk reduction that was only close to statistical significance (−16%, P = 0.052). In support of the UKPDS results, however, a recent meta-analysis of randomized trials in type 2 diabetes (3) calculated a 19% reduction in the incidence of any type of macrovascular event associated with improved long-term glycemic control. Moreover, a strong association between glycemic control and micro- and macrovascular disease has been highlighted in type 1 diabetic patients (4,5)