Community insights into, and an international perspective on the role food environments and diet play in the self-management of type 2 diabetes mellitus in urban and rural South Africa

Philosophiae Doctor - PhDType 2 diabetes mellitus (T2DM) and pre-diabetes contribute increasingly to the global burden of disease. Along with other behavioural risk factors, diet plays a key role in the onset and management of the disease, in turn largely determined by what foods are immediately accessible in local food environments. With this in mind, this thesis aims to answer the research question: What role do local food environments play in promoting or inhibiting access to healthy foods as part of the self - management of T2DM in urban and rural communities in South Africa, and what can be learned from an international perspective? Specific research objectives include, to: 1. Understand the current national-level policy context with regard to the observed rise in NCDs, their proximal determinants (specifically an observed change in diet patterns), and contributing environmental factors; 2. Identify the current food-related environmental factors associated with the onset and/or management of T2DM in an urban and a rural setting (as well as in four additional international settings in order to provide an international perspective); 3. Explore community perspectives of the role the local food environment plays in the self-management of T2DM in an urban and a rural setting; and, consequently 4. Recommend intervention- and/or policy-related actions that can be implemented based on study findings. A review of the literature and relevant policies was conducted towards achieving the first research objective. Quantitative data were systematically collected at an urban and rural site in South Africa through the creation of an ‘environmental profile’ in an attempt to achieve the second objective – comparable urban and rural data was also collected as part of a larger study at two other international sites (Kampala, Uganda and Stockholm, Sweden) to provide an international perspective. Included in the third objective is the collection of qualitative data through a community based participatory research method at the same urban and rural sites in South Africa. Finally, intervention and/or policy-related recommendations are developed based on study findings and in consultation with relevant stakeholders through interviews

Snapshots of urban and rural food environments: EPOCH-based mapping in a high-, middle-, and low-income country from a non-communicable disease perspective

A changing food environment is implicated as a primary contributor to the increasing levels of non-communicable diseases (NCDs). This study aimed to generate snapshots of selected external food environments to inform intervention strategies for NCD prevention in three countries: Uganda (low income), South Africa (middle income) and Sweden (high income), with one matched pair of urban–rural sites per country. Fifty formal and informal food retail outlets were assessed, and descriptive and comparative statistical analyses were performed

Prospectus, March 26, 1981

PC GRADUATE TRANSFORMS A HOBBY INTO A FLOURISHING BUSINESS THAT HAS BECOME VERY SUCCESSFUL; Woman\u27s Place is always there; Letter to the Editor: Conley doesn\u27t see point; Handicapped Awareness Week next week; Profile Bingo begins April 5 at 3 p.m.; Classifieds; Attention; PATH Presents: The Other Side of the Mountain; WPCD airs \u27Community Health Interests\u27; The old relics: still nice to see; Conley catches up on music during break; Motorcycles are becoming popular \u27second cars\u27; Office careers contest April 25; Arobics may be the perfect thing for you; \u27X-Rays and You\u27 featured; Here come the tornadoes!; Campus Question: Do you think marijuana should be legalized?; \u27Don\u27t ruin your feet,\u27 says Reaoe: Get good running shoes; Learn what you meed to: go to the PC Career Center; Parents learn how to make games; Television Production offered next semester; Cobras look impressive already; Baseball team returns seven lettermen; Technology is everywhere: Even in the cameras; Women\u27s Softball Schedule And Roster; Women\u27s Roster; Park district has volleyball registration; Soccer! Soccer meeting todayhttps://spark.parkland.edu/prospectus_1981/1023/thumbnail.jp

Collaborate With Whom? Clergy Responses to Psychologist Characteristics (Chapter 2 of Psychology and the Church)

Some clergy and psychologists are willing to collaborate in providing for people under their care and some are reticent. The purpose of this research is to see if clergy are more likely to collaborate with psychologists of a particular sex or training background. Six groups of clergy were given written descriptions of a psychologist that varied on these two dimensions-the institution from which the psychologist received training and sexand were then asked to rate how likely they would be to participate in 7 collaborative scenarios with the psychologist. No group differences were found. Furthermore, clergy characteristics were not significantly related to their likelihood of collaborating with psychologists. Differences were observed among the 7 collaborative scenarios, suggesting that clergy are more interested in some forms of collaboration than others. It appears that idiographic relational factors are ultimately more important than general demographic categories in establishing clergy-psychologist collaboration

Diet-related non-communicable diseases in South Africa: determinants and policy responses

Non-communicable diseases (NCDs) are the leading cause of death globally and they are on the rise both in low- and middle-income countries, with South Africa being no exception. Implicated in this upward trend in the country is an observed change in diet - a transition from traditional foods, to what has come to be known as the 'western' diet, i.e. more energy-dense, processed foods, more foods of animal origin, and more added sugar, salt and fat. Increasingly, international research links rapidly changing food environment with escalating chronic disease, i.e. it implicates population-level dietary change over individual factors such as knowledge, attitudes and behaviours. Environmental and/or policy interventions can be some of the most effective strategies for creating healthier food environments. This chapter explores the link between the rise in diet-related NCDs, their proximal determinants (specifically an observed change in diet patterns), contributing environmental factors, what is currently being done or recommended to address this internationally, and the most relevant national-level policies for South Africa. The authors conclude that to improve dietary patterns and reduce chronic diseases in South Africa will require a sustained public health effort that addresses environmental factors and the conditions in which people live and make choices. Overall, positive policies have been made at national level; however, many initiatives have suffered from a lack of concerted action. Key actions will be to reduce the intake of unhealthy foods and make healthy foods more available, affordable and acceptable in South Africa.DHE

Optimizing the post-graduate institutional program evaluation process

Abstract Background Reviewing program educational efforts is an important component of postgraduate medical education program accreditation. The post-graduate review process has evolved over time to include centralized oversight based on accreditation standards. The institutional review process and the impact on participating faculty are topics not well described in the literature. Methods We conducted multiple Plan-Do-Study-Act (PDSA) cycles to identify and implement areas for change to improve productivity in our institutional program review committee. We also conducted one focus group and six in-person interviews with 18 committee members to explore their perspectives on the committee’s evolution. One author (MLL) reviewed the transcripts and performed the initial thematic coding with a PhD level research associate and identified and categorized themes. These themes were confirmed by all participating committee members upon review of a detailed summary. Emergent themes were triangulated with the University of Michigan Medical School’s Admissions Executive Committee (AEC). Results We present an overview of adopted new practices to the educational program evaluation process at the University of Michigan Health System that includes standardization of meetings, inclusion of resident members, development of area content experts, solicitation of committed committee members, transition from paper to electronic committee materials, and focus on continuous improvement. Faculty and resident committee members identified multiple improvement areas including the ability to provide high quality reviews of training programs, personal and professional development, and improved feedback from program trainees. Conclusions A standing committee that utilizes the expertise of a group of committed faculty members and which includes formal resident membership has significant advantages over ad hoc or other organizational structures for program evaluation committees.http://deepblue.lib.umich.edu/bitstream/2027.42/117363/1/12909_2016_Article_586.pd

Knowledge Discovery and Data Mining (KDDM) survey report.

The large number of government and industry activities supporting the Unit of Action (UA), with attendant documents, reports and briefings, can overwhelm decision-makers with an overabundance of information that hampers the ability to make quick decisions often resulting in a form of gridlock. In particular, the large and rapidly increasing amounts of data and data formats stored on UA Advanced Collaborative Environment (ACE) servers has led to the realization that it has become impractical and even impossible to perform manual analysis leading to timely decisions. UA Program Management (PM UA) has recognized the need to implement a Decision Support System (DSS) on UA ACE. The objective of this document is to research the commercial Knowledge Discovery and Data Mining (KDDM) market and publish the results in a survey. Furthermore, a ranking mechanism based on UA ACE-specific criteria has been developed and applied to a representative set of commercially available KDDM solutions. In addition, an overview of four R&D areas identified as critical to the implementation of DSS on ACE is provided. Finally, a comprehensive database containing detailed information on surveyed KDDM tools has been developed and is available upon customer request