Physicians' therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria

The objectives of the study were to investigate physician's therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient's knowledge and skills, patient's compliance, doctor-patient relationship, and glycemic control. About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause [63.3%] of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient's knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin [HbAlc] revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. Patient's compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient's compliance should be improved by conducting educational and training programs

Child maltreatment: behaviors of mothers in Jeddah, Saudi Arabia

Cross-cultural research has shown that children throughout the world experience various forms of violence. Important to tackling child maltreatment problem is an understanding of the mechanisms contributing to abusive parenting. The present study aims to investigate child disciplinary and maltreatment practices, and to determine the predictors of mothers' severe physical maltreatment practices against their children aged < 18 years. Twenty-five female primary schools in Jeddah were selected during the educational year 2007/2008, with invitation of students' mothers to participate in the study. A total of 537 mothers fulfilled confidentially, anonymous, self administered questionnaire. The Standardized Arabic Version of Child Abuse Screening Tool for Parents was used to inquire about the disciplinary and maltreatment practices, during the 12 months preceded the study. Results revealed that discussing / explaining [96.8%] was the commonest non-abusive mothers' disciplinary behavior. On the other hand, high proportions of mothers practiced child maltreatment; 96.3%, 89% and 56.8% employed at least one kind of emotional, moderate and severe physical maltreatment, respectively. While, 10.1% of mothers reported that their children were exposed to negligence. Shouting / yelling [91.4%], pinching [60.7%] and hitting the child, not on buttock, with objects [42.3%] were the most prevalent mothers' emotional, moderate and severe physical maltreatment, respectively. Results of regression analysis indicated that children aggressive behavior [aOR = 2.32; 95% Cl: 1.55-3.46], mothers' age < 30 years, and non-university graduated mothers were the independent predictors of mothers' severe physical maltreatment practice. In conclusion, mothers practiced high percentages of child maltreatment Establishing parenting classes, institution of family education intervention for teens, and construction of television and web-based educational programs on sound parenting skills are recommended