Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus

<p>Abstract</p> <p>Background</p> <p>Individual health education is considered to be essential in the overall care of patients with type 2 diabetes (DM2), although there is some uncertainty regarding its metabolic control benefits. There have been very few randomized studies on the effects of individual education on normal care in DM2 patients with a control group, and none of these have assessed the long-term results. Therefore, this study aims to use this design to assess the effectiveness of the PRECEDE (Predisposing, Reinforcing, Enabling, Causes in Educational Diagnosis, and Evaluation) education model in the metabolic control and the reduction of cardiovascular risk factors, in patients with type 2 diabetes.</p> <p>Methods</p> <p>An open community effectiveness study was carried out in 8 urban community health centers in the North-East Madrid Urban Area (Spain). Six hundred patients with DM2 were randomized in two groups: PRECEDE or conventional model for health promotion education. The main outcome measures were glycated hemoglobin A1c, body mass index (BMI), blood pressure, lipids and control criteria during the 2-year follow-up period.</p> <p>Results</p> <p>Glycated hemoglobin A1c and systolic blood pressure (SBP) levels decreased significantly in the PRECEDE group (multivariate analysis of covariance, with baseline glycated hemoglobin A1c, SBP, and variables showing statistically significant differences between groups at baseline visits). The decrease levels in diastolic blood pressure (DBP), triglycerides and LDL cholesterol were nonsignificant. PRECEDE increased compliance in all control criteria, except for LDL cholesterol. BMI did not change during the study in either of the two models analyzed.</p> <p>Conclusions</p> <p>PRECEDE health education model is a useful method in the overall treatment in patients with type 2 diabetes, which contributes to decrease glycated hemoglobin A1c and SBP levels and increase the compliance in all the control criteria, except for LDL cholesterol.</p> <p>Trial registration number</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01316367">NCT01316367</a></p

Role of the Lateral Paragigantocellular Nucleus in the Network of Paradoxical (REM) Sleep: An Electrophysiological and Anatomical Study in the Rat

The lateral paragigantocellular nucleus (LPGi) is located in the ventrolateral medulla and is known as a sympathoexcitatory area involved in the control of blood pressure. In recent experiments, we showed that the LPGi contains a large number of neurons activated during PS hypersomnia following a selective deprivation. Among these neurons, more than two-thirds are GABAergic and more than one fourth send efferent fibers to the wake-active locus coeruleus nucleus. To get more insight into the role of the LPGi in PS regulation, we combined an electrophysiological and anatomical approach in the rat, using extracellular recordings in the head-restrained model and injections of tracers followed by the immunohistochemical detection of Fos in control, PS-deprived and PS-recovery animals. With the head-restrained preparation, we showed that the LPGi contains neurons specifically active during PS (PS-On neurons), neurons inactive during PS (PS-Off neurons) and neurons indifferent to the sleep-waking cycle. After injection of CTb in the facial nucleus, the neurons of which are hyperpolarized during PS, the largest population of Fos/CTb neurons visualized in the medulla in the PS-recovery condition was observed in the LPGi. After injection of CTb in the LPGi itself and PS-recovery, the nucleus containing the highest number of Fos/CTb neurons, moreover bilaterally, was the sublaterodorsal nucleus (SLD). The SLD is known as the pontine executive PS area and triggers PS through glutamatergic neurons. We propose that, during PS, the LPGi is strongly excited by the SLD and hyperpolarizes the motoneurons of the facial nucleus in addition to local and locus coeruleus PS-Off neurons, and by this means contributes to PS genesis

Faith and Fair Trade: The Moderating Role of Contextual Religious Salience

Normative and historical arguments support the idea that religion potentially shapes decisions to support fair trade products. That said, the question of how religion influences organizational decision-makers to purchase fair trade products in a business-to-business context has remained largely unaddressed. This research examines the interactive effect of individual religious commitment and contextual religious salience on an individual's willingness to pay a price premium for a fair trade product, when buying on behalf of an organization. Findings from two experimental studies (involving 75 and 87 working individuals, respectively) reveal that the effect of a decision-maker's religious commitment on his or her willingness to pay a price premium, for the purchase of a fair trade product on behalf of an organization, is moderated by the contextual salience of religion. Specifically, when religion is highly salient in the organizational context, religious commitment is positively related to the decision-maker's willingness to pay a premium for the fair trade product; when contextual religious salience is low, religious commitment and willingness to pay a premium are unrelated. Implications for theory and practice are presented. © 2013 Springer Science+Business Media Dordrecht

Social consciousness in post-conflict reconstruction.

This paper sheds light on the complexities intergovernmental organizations are facing during post-conflict reconstruction. The article discusses the added-value of Social Responsibility in the context of the Comprehensive Approach, involving collaboration amongst defense, diplomacy and development. To better understand the role of public-private partnerships in enabling Corporate Social Responsibility activities we conducted a single case study. The aim is to better grasp the organizational design of the Comprehensive Approach as well as to comprehend the type of relations during the decision-making process. The results of the content analysis of 8 semi-structured interviews with senior diplomats, military commanders, and civilian entrepreneurs support the discussion. Particular attention is paid to the existing variety in norms relevant to the involvement of the private sector, social consciousness, and the potential role of public-private partnerships in enabling stabilization as well as reconstruction in post-conflict zones. Lessons learned are presented in the conclusio