ArticlEObjectives. To identify health care provider-related determinants of diabetes and hypertension management in patients attending public sector community health centres (CHCs). Methods.A random sample of 18 CHCs in the Cape Peninsula providing hypertension and diabetes care was selected. Twenty-five patients with diabetes and 35 with hypertension per clinic were selected and interviewed by trained fieldworkers, and their medical records were audited. Regression analyses identified predictors of controlled hypertension (<140/90 mmHg) and diabetes (HbA1c <7%). In-depth interviews with nurses and doctors explored their experiences in working at the CHCs. Height, weight and blood pressure (BP) were measured for all patients and random blood samples collected for lipids, glucose, HbA1c and creatinine.results. Of the participants 923 had hypertension and 455 diabetes (289 had both conditions). Of the hypertensive patients 33% had a BP <140/90 mmHg, while 42% of the patients with diabetes had non-fasting glucose levels below 11.1 mmol/l. Patients' knowledge about their conditions was poor. Prescriptions for drugs were not recorded in medical records of 22.6% of the patients with diabetes and 11.4% of those with hypertension.conclusions. Primary care for patients with hypertension and diabetes at public sector CHCs is suboptimal. This study highlights the urgent need to improve health care for patients with these conditions in public sector clinics in the Cape Peninsula.
Histone deacetylases (HDACs) are epigenetic enzymes that play a central role in gene regulation and are sensitive to the metabolic state of the cell. The cross talk between metabolism and histone acetylation impacts numerous biological processes including development and immune function. HDAC inhibitors are being explored for treating cancers, viral infections, inflammation, neurodegenerative diseases, and metabolic disorders. However, how HDAC inhibitors impact cellular metabolism and how metabolism influences their potency is unclear. Discussed herein are recent applications and future potential of systems biology methods such as high throughput drug screens, cancer cell line profiling, single cell sequencing, proteomics, metabolomics, and computational modeling to uncover the interplay between metabolism, HDACs, and HDAC inhibitors. The synthesis of new systems technologies can ultimately help identify epigenomic and metabolic biomarkers for patient stratification and the design of effective therapeutics.
Food choices affect the isotopic composition of the body with each food item leaving its distinct isotopic imprint. The common view is that the natural abundance of the stable isotopes of nitrogen (expressed as δ15N) is higher in animals than in plants that constitute our contemporary diets. Higher δ15N is thus increasingly viewed as a biomarker for meat and fish intake. Here we show that organic compared to conventional farming increases plant δ15N to an extent that can appreciably impact the performance of δ15N as a biomarker. The error that can arise when organic plants are consumed was modelled for the entire range of proportions of plant versus animal protein intake, and accounting for various intakes of organic and conventionally grown crops. This mass balance model allows the interpretation of differences in δ15N in light of organic food consumption. Our approach shows that the relationship between δ15N and meat and fish intake is highly contextual and susceptible to variation at the population, community or group level. We recommend that fertilization practices and organic plant consumption must not be overlooked when using δ15N as a biomarker for meat and fish intake or to assess compliance to nutritional interventions.
The study was carried out to determine the health and morbidity status of Bharia tribe. A total of ten villages were surveyed, and total of 172 households and nine hundred ten individuals were covered. The major occupation of the head in the households surveyed is agriculture and agriculture labor. 66.4 percent of the population was illiterate. Acute respiratory infection and fever were the commonest morbidity found more in preschool and school going children than adult population. According to weight for age, 52.5 percent of the Preschool children were underweight (<-2SD). Stunting was 48.1 and wasting was 33.9 percent. Prevalence of chronic energy deficiency (BMI<18.5) was about 35.6 percent in adult population. Bharia Children are suffering with more morbidity like fever, respiratory infection and malnutrition than adult population.
BackgroundUrbanization is increasing around the world, and in India, this trend has translated into an increase in the size of slum dwellings whose environments are suspected of being associated with poor health outcomes, particularly those relating to women’s nutritional status. With this study, we sought to determine the factors associated with Indian women’s body mass index (BMI) in slum environments, with special attention paid to women with tribal status.MethodsA multiple linear regression analysis was performed on data from the Indian National Family Health Survey (2005–2006), modeling demographic and behavioral factors suspected of being associated with BMI, with additional focus on the measures of social class, specifically caste and tribal status.ResultsIncreasing BMI is significantly and positively associated with frequency of watching television, having diabetes, age, wealth index, and residency status in the areas of New Delhi, Andhra Pradesh, or Tamil Nadu.ConclusionAlthough belonging to a scheduled tribe was not associated with changes in BMI, unadjusted rates suggest that tribal status may be worthy of deeper investigation. Among slum dwellers, there is a double burden of undernutrition and overnutrition. Therefore, a diverse set of interventions may be required to improve the health outcomes of these women.
ResultsWe have 114 facilitators engaged in using Real Talk; 67% clinicians (n=76; 52 doctors, 12 nurse specialists, 8 allied health, 4 nurses) and 33% educators (n=38; 16 faculty, 13 hospice, 10 end of life facilitators). Table of diversity of interprofessional groups and settings. Conclusions Our findings show a growing number of Real Talk facilitators are clinicians embedded in practice, shifting delivery from educators. Emerging themes from our evaluation are that the resource is user friendly, very impactful in embedding communication skills in practice, is adaptable as a resource to use in a range of learning events, and is relevant to the inter-professional audience. Facilitators and learners alike appreciate the authentic nature, and value the video clips in demonstrating the softer skills and nuances of communication. Bridging the evidence to practice gap by naming the skills, can build confidence to engage patients in end of life talk. Next steps will be formalising impacts in practice over time.
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