Current endeavors in diabetes care focus on helping patients and providers deal successfully with the complexities of the disease by improving the system of care, expanding the reach of interventions, and empowering patients to engage in self-care behaviors. Internet technologies that combine the broad reach of mass media with the interactive capabilities of interpersonal media provide a wide range of advantages over standard modes of delivery. The technical affordances of Web delivery enable individualization or tailoring, appropriately timed reinforcement of educational messages, social support, improved feedback, and increased engagement. In turn, these have been significantly correlated with improved health outcomes.This article is a narrative review of Web-based interventions for managing type 2 diabetes published from 2000 to 2007 that utilize Web sites, Web portals, electronic medical records, videoconference, interactive voice response, and short messaging systems. The most effective systems link medical management and self-management. Patient satisfaction is highest when the Web-based system gives them the ability to track blood glucose, receive electronic reminders, schedule physician visits, email their health care team, and interact with other diabetic patients. However, comprehensive medical and self-management programs have not been implemented widely outside of systems funded by government agencies. The cost of developing and maintaining comprehensive systems continues to be a challenge and is seldom measured in efficacy studies. Lack of reimbursement for Web-based treatments is also a major barrier to implementation. These barriers must be overcome for widespread adoption and realization of subsequent cost savings.
Anthropometric measurements were taken on 281 toddlers (24-48 mo old) in Linguère, Sénégal, to determine the prevalence of undernutrition. Blood samples collected from 271 of the toddlers were analyzed for retinol and carotenoids by HPLC. According to the National Center for Health Statistics reference values 30.2% of the population was undernourished. Serum retinol values were below the lower limit of the normal range in 71.5% of the children; 7.4% of this group had concentrations < 0.35 mumol/L, placing them at risk for xerophthalmia. Only 3% of the population had serum retinol values > or = 1.0 mumol/L. Serum carotenoids were low (< 0.70 mumol/L) in 55% of the children. Retinol-binding protein values were low and measurable concentrations of retinyl palmitate were detectable in only 17% of the children. Undernutrition and poor vitamin A status were found to exist at a concentration that would endanger health.
For virtually every letter of the alphabet there is a diet book and the numbers are growing. It is becoming increasingly difficult for consumers to make sound choices among the various weight loss books with conflicting weight loss approaches. Embattled by the burden of escalating rates of obesity and limited successes with achieving long term weight loss in a slimness-revered society many consumers opt for the diet that is receiving the most media coverage and word of mouth promos at the time. This article presents a rubric for evaluating weight loss diet books to reduce the likelihood that nutritional, health, and economic status will be compromised by such unreliable decision-making. The criteria of the rubric-nutritional adequacy, balance, calorie control, disease prevention, and economic affordability (A, B, C, D, E) are simple and familiar enough for most consumers to grasp and apply with minimal guidance from nutrition professionals or paraprofessionals.
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