AimsTo assess the numeracy and literacy skills of individuals with Type 1 diabetes and determine if there was a relationship with achieved glycaemic control independent of socio-economic factors. Methods112 patients (mean age 43.8+/-12.5 years, 47% male, mean duration of diabetes 22.0+/-13.2 years) attending Bournemouth Diabetes and Endocrine Centre were randomly selected from the Centre's diabetes register and invited to participate in the study. The Skills for Life Initial Assessments were used to measure numeracy and literacy. These indicate skills levels up to Level 2, equivalent to the national General Certificate of Secondary Education grades A*-C. HbA 1c was also measured.Pearson's correlation was used to measure the correlation of numeracy and literacy scores with HbA 1c. T-tests were used to compare mean HbA 1c between those with or without Level 2 skills and multiple linear regression was used to investigate whether any differences were independent of demographic and socio-economic factors. ResultsLiteracy was not associated with achieved HbA 1c . In contrast, participants with numeracy skills at Level 2 or above achieved a HbA 1c lower than those with numeracy skills below Level 2 (p=0.03). Although higher socio-economic status was associated with lower mean HbA 1c , the relationship between numeracy and HbA 1c appeared to be independent of socio-economic factors.Diabetic Medicine final manuscript 2.12.10 3 ConclusionLow numeracy skills were adversely associated with diabetes control. Assessment of numeracy skills may be relevant to the structure of diabetes education programmes. Word count 228Diabetes UK Abstract reference MARD8558IN
SummaryThe Confidential Enquiries into Maternal Deaths in the UK have recommended obstetric early warning systems for early identification of clinical deterioration to reduce maternal morbidity and mortality. This survey explored early warning systems currently used by maternity units in the UK. An electronic questionnaire was sent to all 205 lead obstetric anaesthetists under the auspices of the Obstetric Anaesthetists' Association, generating 130 (63%) responses. All respondents reported use of an obstetric early warning system, compared with 19% in a similar survey in 2007. Respondents agreed that the six most important physiological parameters to record were respiratory rate, heart rate, temperature, systolic and diastolic blood pressure and oxygen saturation. One hundred and eighteen (91%) lead anaesthetists agreed that early warning systems helped to prevent obstetric morbidity. Staffing pressures were perceived as the greatest barrier to their use, and improved audit, education and training for healthcare professionals were identified as priority areas.
Background: The systematic support of parents of children with eczema is essential to their effective management. The few existing support models have a limited evidence base. This paper reports the outcome-orientated service evaluation of an original, extensive social learning theory based, nurse-led Eczema Education Programme (EEP).Objectives: To evaluate the EEP using specified child and parental outcomes and service impact data.Methods: From a sample of 257 parent-child dyads attending the EEP, a pretest-posttest design evaluated its child impact using health related quality of life measures (Infant's Dermatitis Quality of Life index, IDQOL, which includes a small dermatitis severity element; Children's Dermatology Life Quality Index, CDLQI), severity measures (Patient Orientated Eczema Measure, POEM), a new parental measure (Parental Self-Efficacy in Eczema Care Index, PASECI) and service impact data based on General Practice (GP) attendance patterns pre-post intervention.Results: Statistically significant impacts were observed, compared to baseline, on infant quality of life (p<0.001), child quality of life (p=0.027), disease severity (p<0.001) and parental self-efficacy (p<0.001). Improvements in child quality of life, parental efficacy and service impact were also evident from qualitative data. The cumulative total of all GP visits for selected participants post EEP reduced by 62%. Conclusions:The EEP appears to be an effective model of delivering structured education to parents of children with eczema and one generalizable to other multi-ethnic metropolitan populations. As a non-controlled study, this rigorous service evaluation highlights the model's significance and the case for an evaluative multi-centre randomised controlled trial of this educational intervention to inform a nurse-led programme of care.
Purpose-Although South Asia is a growing supplier of migrant labour, there is a paucity of research on the health and wellbeing of male Nepalese migrant workers. This study assessed the health and mental wellbeing of Nepalese construction and factory workers employed in Malaysia, Qatar, and Saudi Arabia. Design-A structured questionnaire administered, in and around Nepal's international airport, to 403 migrants who had worked for over six months in their host countries. Logistic regression was used to investigate factors associated with self-reported health status and mental health symptoms. Findings-Over 13% reported poor or very poor health and nearly a quarter reported mental health issues. Whilst age and exercise were (only) significantly associated with health status, poor work environments and perceived health risks at work were associated with both mental health issues and health status. Research limitations/implications-The study is limited to males only and those working in the factories and the construction industry. To improve migrant health and mental wellbeing, the Government of Nepal and host governments should consider mandatory health insurance and a range of pre-departure and arrival education around general literacy, mental health assessments and workplace health and safety. Originality/value-There have been no known studies on the health and wellbeing of Nepalese migrant construction and factory workers in the Middle East and Malaysia. The strong association between self-reported poor health and perceived work environment is an important issue that policy makers in Nepal and destination countries should address.
Background: Nepal is a growing supplier of migrant labour for factories in Malaysia and building sites in the Middle East. This study assessed the extent of workplace accidents among Nepalese migrant workers in Malaysia, Qatar and Saudi Arabia. Methododology:A questionnaire survey was conducted at Nepal's main international airport with men who returned from working in Malaysia, Qatar and Saudi Arabia. The questionnaire was completed by 403 migrant workers from these three countries. Where possible the questionnaire was self-administered and interview-administered for those migrant workers with poor literacy skills. A logistic regression was conducted to identify factors associated with accidents at work and health risks perceived by migrant workers themselves. Results:One in six (17%) experienced accidents at work in their host country. This proportion is lower than that reported in previous studies of Nepali migrant workers. Age, country of work, doctor registration and perceived standard of work environment and accommodation are significantly associated with accidents at work. Conclusion:To help improve Nepalese men's health and well-being whilst working abroad, host countries and the Government of Nepal should ensure that migrants hold health insurance. Mandatory pre-departure and arrival health and safety training is also recommended as a way to reduce risks to the health of migrant workers.
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