Which patients with Type 2 diabetes will have greater compliance to participation in the Diabetes Conversation Map™ program? A retrospective cohort study.

AIM: To investigate the characteristics of participants in the Diabetes Conversation Map™ (Map™) program who had higher vs. lower compliance to the program, to determine if program tailoring and monitoring is needed among these groups. METHODS: This was a retrospective cohort study of 8990 patients enrolled in the Map™ program (low compliance [attending 0-1 sessions, n = 2759] and high compliance [attending ≥2 sessions, n = 6231]). Socio-demographic, clinical, health behaviors, and healthcare utilization characteristics were extracted. Multivariable stepwise logistic regression was used as the analysis strategy. RESULTS: Those who were of higher socio-economic status (OR = 1.567, 95%CI:1.317-1.865), who lived in urban area (OR = 1.501, 95%CI:1.254-1.798), with greater frequency of primary care visits (OR = 1.012, 95%CI:1.002-1.021), with medium (OR = 1.176, 95%CI:1.013-1.365) or high oral medication adherence (OR = 1.198, 95%CI:1.059-1.356), and with a greater frequency of blood glucose tests (OR = 1.102, 95%CI:1.033-1.175) had greater odds of being in the high compliance group. Conversely, those aged 35-44 (OR = 0.538, 95%CI:0.402-0.721) and 45-54 years (OR = 0.763, 95%CI:0.622-0.937), with longer Type 2 diabetes duration (OR = 0.980, 95%CI:0.967-0.993), with higher blood glucose levels (OR = 0.999, 95%CI:0.998-1.000), and current (OR = 0.659, 95%CI:0.569-0.762) or former smokers (OR = 0.831, 95%CI:0.737-0.938) had reduced odds for being in the higher compliance group. CONCLUSIONS: Instructors in advance can target sub-groups to increase their attendance rates, and consequently improve their outcomes.

Comparing the distress of American and Israeli medical students studying in Israel during a period of terror.

INTRODUCTION: Medical school is a very stressful environment with multiple sources of stress, including academic, social and other issues. International medical students are exposed to additional stressors such as homesickness and culture shock. METHODS: In order to assess the influence of cultural background on the level of perceived distress, we examined Israeli and American students studying at the same university during a period of terror. RESULTS: We found clear differences between the 2 groups of students, with Americans reporting a higher level of anxiety and a poorer level of social functioning than the Israelis. Although there was no significant difference between the 2 groups in terms of their sense of safety, the American students reported a higher level of fear and more change in their daily activities to a greater extent than did the Israelis. CONCLUSIONS: These findings underscore the effect of culture on students' responses to the same stressful stimuli and to a perceived dangerous environment. Faculty needs to be aware that cultural factors may affect students' adjustment to the medical school environment.