A study on diabetes-related self-care plan and its determinants among diabetes patients in a Warangal region, Telangana, India

Abstract The prevalence of epidemiological diseases, including diabetes, has continued to increase because of the adaption of Western culture and the lack of self-care activities among patients with diabetes. Therefore, in this cross-sectional study, we aimed to assess self-care plans and determinants among diabetes outpatients in Warangal. We conducted a prospective observational study among diabetes outpatient clinic in Warangal, India over 6 months from October 2019 to March 2020. We used the expanded Summary of Diabetes Self-Care Activities (SDSCA) questionnaire. A P value of less than < 0.05 was considered statistically significant. Respondents (mean age, 52.3 (standard deviation (SD), 11.01) years) had an overall SDSCA score of 49.18 ± 3.57 (SD). Mean scores for the diet, physical activity, foot care, medication adherence, and blood sugar testing scales were 12.79 (SD, 1.61), 10.24 (SD, 1.77), 15.67 (SD, 1.5), 5.66 (SD, 1.17), and 4.80 (SD, 0.68), respectively. Patients' age, education, disease duration and hemoglobin A1C (HbA1C) levels of <7.5% (P < 0.001)) had significantly higher mean scores for blood sugar testing, diet, physical activity, and adherence (P < 0.001). The employment status is associated with all the domains of Summary of Diabetes Self-Care Activities (P < 0.001). Taken together, our results revealed that patients with diabetes in Warangal had poor self-care planning, highlighting the need for strengthening initiatives that generate awareness regarding diabetes and improving related self-care practices

Niveles de eficiencia de las policlínicas de Matanzas, Cuba, según el método de análisis envolvente de datos / Efficiency of outpatient clinics in Matanzas, Cuba, using data envelopment analysis

OBJETIVOS: Determinar el índice de eficiencia de todas las policlínicas de la provincia de Matanzas, Cuba, identificar las unidades de mejor práctica y estimar las reservas de eficiencia de cada unidad. METODOLOGÍA: Se realizó una investigación descriptiva durante el primer trimestre de 2006 en las 40 policlínicas de la provincia de Matanzas, Cuba. Las policlínicas se agruparon según su nivel de complejidad y el nivel socioeconómico del municipio en el que se ubican. Se consideraron cinco indicadores de resultados y seis de recursos. Para los cálculos se empleó el análisis envolvente de datos y se asumieron el modelo de maximización de resultados y los supuestos de rendimientos constantes y variables a escala. RESULTADOS: La eficiencia relativa de las unidades estudiadas fue alta, con un valor medio de 0,95 ± 0,11. Once (27,5 por ciento) de las policlínicas estudiadas fueron ineficientes (0,77 ± 0,12). Las principales reservas para elevar la eficiencia fueron aumentar la detección de los casos de tuberculosis en la comunidad, reducir el índice de mortalidad infantil evitable y ampliar la cobertura de inmunización. En las 11 policlínicas ineficientes había holgura de recursos en al menos un indicador. CONCLUSIONES: La identificación de policlínicas de referencia permitió aportar elementos organizacionales que podrían contribuir a mejorar la eficiencia de las unidades deficientes. Debe revisarse el proceso de asignación de recursos para evitar el exceso de recursos innecesarios como vía para aumentar la eficiencia.

OBJECTIVES: To rate the efficiency of all the outpatient clinics in Matanzas, Cuba; identify the best-performing clinics; and find opportunities for improvement at the others. METHODS: A descriptive study of the 40 outpatient clinics in the province of Matanza was carried out during the first trimester of 2006. Clinics were grouped according to the complexity of services they offer and the socioeconomic level of the municipality in which they are located. Five output and six input variables were analyzed. Calculations were performed using data envelopment analysis, including optimization of results and constant and variable returns-to-scale. RESULTS: In general, the clinics studied had high efficiency rates, with a mean of 0.95 ± 0.11. Eleven (27.5 percent) clinics studied were rated inefficient (0.77 ± 0.12). The following Three key areas for improvement were identified: increasing tuberculosis detection rates in the community, reducing rates of preventable infant mortality, and expanding immunization coverage. Among the 11 clinics rated as inefficient, there were resource gaps in at least one indicator. CONCLUSIONS: By recognizing successful clinics, best practices were identified that could be used to improve the weaker clinics. The resource distribution process should be reviewed to ensure that additional, unneeded resources are not used to improve efficiency.

Pneumonias em menores de cinco anos, atendidos em ambulatório / Pneumonias in pediatric outpatients, under five years of age

O objetivo desta pesquisa foi estudar pneumonias em crianças de 2 meses a 4 anos de idade, atendidas no ambulatório de pediatria da Fundaçäo Santa Casa de Misericórdia do Pará. Fez-se revisäo de prontuários dos pacientes, no período de janeiro de 1995 a dezembro de 1997; o diagnóstico de pneumonia (como definido pelo Programa para Infecçöes Respiratórias Agudas - IRA, da OPAS/OMS, em 1992), foi estabelecido em 128 crianças. Tosse esteve presente em 97,7 por cento dos pacientes e febre em 95,3 por cento; 45,3 por cento tiveram alteraçöes à ausculta pulmonar; houve solicitaçäo de radiografia torácica em 65,6 por cento dos casos, número considerado excessivo; 87,4 por cento das crianças foram tratadas com antimicrobianos recomendados pelo Programa IRA; 9 de 25 pacientes, com pneumonia confirmada radiologicamente, medicados com sulfametoxazol-trimetropim, näo responderam à terapêutica e apenas 38,3 por cento das crianças compareceram à consulta de controle, em 24 ou 48 horas. esforços devem continuar, para o controle das IRA, atendendo as orientaçöes do Programa