Health care seeking behaviors in type 2 diabetic patients in East Azerbaijan

Background. Timely and effective use of health care services is essential to delay or prevent complications and reduce the burden of diabetes. Positive health care seeking behaviors can improve diabetes control and, as a result, reduce the incidence of the complications. So, this study aimed to investigate the status of health care seeking behaviors and affecting factors in type 2 diabetic patients. Materials and methods. This was a cross-sectional study. There were 1139 patients with type 2 diabetes aged > 18 years selected who referred to educational hospitals, Endocrinologist office, primary health care centers, and Clinics. Data collected using a researchermade questionnaire and analyzed using SPSS software version 22. Results. 36.3% of diabetic patients initially referred to a physician in the event of illness symptoms, and 70.7% of patients referred to a physician in case of exacerbating of disease symptoms. 58.4% of patients preferred to consult a specialist directly. 78.85 of patients reported that they had referred to a physician on a regular basis and 59.9% of patients followed up their treatment process on a regular basis. The physician was the main source of information for the majority of patients. Income, education and health insurance status, disease severity, chronicity of DM, the history of hospitalization due to DM were the affecting factors on health care seeking behaviors (p < 0.05). Conclusion. Most of the diabetics often did not follow the official structure of health care providing to manage their illness, and despite the referral system and family practitioner program more than half of the patients went directly to the specialist physician’s office. Factors related to the patient (an income and education status), disease characteristics (disease severity, chronicity of DM and the history of hospitalization due to DM) and health care system factors (type of the basic insurance and supplementary insurance status) affect the health care seeking behaviors

Solving a System of Fractional-Order Volterra-Fredholm Integro-Differential Equations with Weakly Singular Kernels via the Second Chebyshev Wavelets Method

In this paper, by means of the second Chebyshev wavelet and its operational matrix, we solve a system of fractional-order Volterra–Fredholm integro-differential equations with weakly singular kernels. We estimate the functions by using the wavelet basis and then obtain the approximate solutions from the algebraic system corresponding to the main system. Moreover, the implementation of our scheme is presented, and the error bounds of approximations are analyzed. Finally, we evaluate the efficiency of the method through a numerical example

Convergence and Stability of a Split-Step Exponential Scheme Based on the Milstein Methods

We introduce two approaches by modifying split-step exponential schemes to study stochastic differential equations. Under the Lipschitz condition and linear-growth bounds, it is shown that our explicit schemes converge to the solution of the corresponding stochastic differential equations with the order 1.0 in the mean-square sense. The mean-square stability of our methods is investigated through some linear stochastic test systems. Additionally, asymptotic mean-square stability is analyzed for the two-dimensional system with symmetric and asymmetric coefficients and driven by two commutative noise terms. In particular, we prove that our methods are mean-square stable for any step-size. Finally, some numerical experiments are carried out to confirm the theoretical results

Investigation on Ginzburg-Landau equation via a tested approach to benchmark stochastic Davis-Skodje system

We propose new numerical methods with adding a modified ordinary differential equation solver to the Milstein methods for solution of stiff stochastic systems. We study a general form of stochastic differential equations so that the Ginzburg-Landau equation and the Davis-Skodje model can be considered as special states of them. The efficiency of the method is experimented, in terms of the convergence rate and accuracy of approximate solution, employing some numerical examples, including stochastic Ginzburg-Landau equation and a paradigm of chemical reaction systems

Zachowania związane z wyborem usług medycznych u chorych na cukrzycę typu 2 w Azerbejdżanie Wschodnim

Wstęp i cel badania. Zapewnienie terminowych i skutecznych usług medycznych, zwłaszcza na poziomie podstawowej opieki zdrowotnej, ma zasadnicze znaczenie dla zmniejszenia obciążeń związanych z cukrzycą. Pozytywne zachowania zdrowotne mogą poprawić kontrolę cukrzycy, a tym samym zmniejszyć częstość powikłań. Dlatego celem niniejszego badania była ocena zachowań zdrowotnych i wpływających na nie czynników u chorych na cukrzycę typu 2. Materiał i metody. Badanie miało charakter przekrojowy. Do udziału w badaniu wytypowano 1139 chorych na cukrzycę typu 2 w wieku > 18 lat, którzy zgłosili się do szpitali klinicznych, prywatnych gabinetów endokrynologicznych, ośrodków podstawowej opieki zdrowotnej i prywatnych klinik. Dane zbierano, opierając się na kwestionariuszu przygotowanym na potrzeby badania, i analizowano za pomocą oprogramowania SPSS w wersji 22. Wyniki. Wykazano, że 36,3% chorych na cukrzycę udawało się do lekarza w przypadku wystąpienia objawów choroby, a 70,7% chorych zgłaszało się do lekarza w przypadku zaostrzenia objawów. Uzyskane dane wskazują, że 58,4% pacjentów zgłasza się bezpośrednio do specjalisty, 78,85 pacjentów deklarowało, że regularnie odwiedzają lekarza, a 59,9% pacjentów regularnie monitorowało proces leczenia. Głównym źródłem informacji dla większości chorych był lekarz. Czynnikami wpływającymi na zachowania osób poszukujących usług medycznych były: dochody, poziom wykształcenia, rodzaj ubezpieczenia zdrowotnego, ciężkość i czas trwania cukrzycy oraz hospitalizacje z powodu cukrzycy (p < 0,05). Wnioski. Większość chorych na cukrzycę, szukając pomocy medycznej w przypadku problemów zdrowotnych, nie postępowała zgodnie z oficjalną strukturą systemu opieki zdrowotnej i pomimo systemu skierowań oraz programu lekarzy rodzinnych ponad połowa pacjentów udawała się bezpośrednio do lekarza specjalisty. Na zachowania związane z poszukiwaniem usług medycznych wpływają czynniki związane z pacjentem (dochód i poziom wykształcenia), chorobą (nasilenie i czas trwania cukrzycy, hospitalizacje z powodu cukrzycy) i systemem opieki zdrowotnej (rodzaj podstawowego ubezpieczenia i dodatkowe ubezpieczenie)

Coping with Stress in Patients with Inflammatory Bowel Disease and Its Relationship with Disease Activity, Psychological Disorders, and Quality of Life

Background: Inflammatory bowel diseases (IBD) are chronic diseases with significant impact on patients’ well-being. The aim of this study was to determine stress coping strategies in IBD patients and their association with disease activity, psychological health, and quality of life (QOL).Methods: This cross-sectional study was conducted on IBD patients referred to a gastroenterology clinic in Isfahan city (Iran). Disease activity, severity of anxiety and depression symptoms, stress coping strategies, and QOL were assessed using self-administered questionnaires. Coping strategies in IBD patients were compared to an unaffected control group.Results: In the present study, 80 patients with mean age of 52.9 years (57.5% female) and mean disease duration of 6.5 years were studied. Compared to the controls, IBD patients had higher scores in the maladaptive coping styles (evasive and palliative) (P &lt; 0.05). Association between coping strategies and disease activity was not significant. Severity of anxiety and depression was directly correlated with the maladaptive strategies (fatalistic and emotional) (r = 0.283 to 0.468) and inversely correlated with the adaptive strategies (confrontive, optimistic, and self-reliant) (r = -0.320 to -0.534). In addition, QOL was inversely correlated with the maladaptive strategies (fatalistic and emotional) (r = -0.278 to -0.327) and directly correlated with the adaptive strategies (confrontive and optimistic) (r = 0.262 to 0.355).Conclusion: Patients with IBD use more maladaptive and less adaptive stress coping strategies which are associated with their psychological health and QOL. Larger and prospective studies on the dynamic and interactive network of biopsychosocial factors in IBD patients are required.</div

Prevalence of type 2 diabetes complications and its association with diet knowledge and skills and self‐care barriers in Tabriz, Iran: A cross‐sectional study

Abstract Background and Aims Diabetes can lead to multiple complications that can reduce the quality of life, impose additional costs on the healthcare systems and ultimately lead to premature death. Proper self‐care in diabetic patients can impede or delay the onset of diabetes complications. This study aimed to investigate diabetes complications and their association with diet knowledge, skills, and self‐care barriers. Methods This was a cross‐sectional study. A total of 1139 patients with Type 2 Diabetes Mellitus (T2DM) referring to health centers in Tabriz, Iran, were included from January to July 2019. Data were collected using two questionnaires: (1) a sociodemographic questionnaire and (2) a Personal Diabetes Questionnaire (PDQ). Data were analyzed using SPSS software version 22. χ2 test was used to examine the association between the socioeconomic and disease‐related variables and the prevalence of diabetes complications. T‐test was used to examine the association between diet knowledge and skills, self‐care barriers, and the incidence of diabetes complications. Results In this study, 76.1% of patients had at least one complication, and 30.2% had a history of hospitalization due to diabetes complications during the past year. Approximately 49% and 43% were diagnosed with high blood pressure and hyperlipidemia, respectively. Cardiovascular disease was the most common diabetes complication (15.9%) and the cause of hospitalization (11.01%) in patients with diabetes. Barriers to diet adherence, blood glucose monitoring, and exercise were significantly associated with self‐reported diabetes complications (p < 0.001). Our results showed no significant association between the number of complications and diet knowledge and skills (p = 0.44). Conclusion This study indicated that the prevalence of diabetes complications was higher among patients with more barriers to self‐care. In light of these findings, taking appropriate measures to reduce barriers to self‐care can prevent or delay the onset of diabetes complications

Association of Psychological Disorders with Extra-intestinal Symptoms in Patients with Irritable Bowel Syndrome

present study, we determined the relationship between psychological disorders and extraintestinal symptoms in patients with IBS.Methods: Adult patients with IBS referred to 4 gastroenterology clinics in Isfahan, Iran, completed the irritable bowel severity scoring system (IBSSS), extraintestinal symptoms scale, Hospital Anxiety and Depression Scale, and Irritable Bowel SyndromeQuality of Life (IBS-QOL) Questionnaire. Univariate and multivariate analyses were conducted.Results: The patients included 113 females and 45 males with mean age of 34.8 ± 11.1 years. Cumulative frequency of extraintestinal symptoms was 3.3 ± 2.4 (0 to 10). Anxiety and depression were present in 79.7% and 54.4% of the patients, respectively. Frequency of extraintestinal symptoms was correlated with anxiety and depression (r = 0.289 to 0.531), IBS severity (r = 0.373 to 0.505), and quality of life (r = -0.317 to -0.398). Severity of IBS was independently associated with extraintestinal digestive symptoms’ frequency (β = 0.248). Female gender, education level, and anxiety were independently associated with extraintestinal non-digestive symptoms’ frequency (β = -0.225 to 0.260). Severity of IBS and frequency of non-digestive symptoms were independent predictors of quality of life (β = -0.494 and -0.218). After controlling for psychological factors, IBS severity and depression were independent predictors of quality of life (β = -0.435 and -0.318).Conclusion: Extraintestinal symptoms and psychological disorders are common in patients with IBS and impact their quality of life. Psychological disorders are associated with extraintestinal symptoms, especially non-digestive symptoms. These results highlight the need for an integrated biopsychosocial approach to the management of IBS patients with physical and mental comorbidities.</div