BackgroundDiabetes has become a major public health problem in China. Support of patient self-management is a key component of effective diabetes care and improved patient outcomes. A series of peer-led community-based disease-specific self-management programs including diabetes have been widely disseminated in urban communities of Shanghai since 1999. However, the strategy of using trained lay leaders to support patient self-management faces challenges in rural communities in Shanghai. This study developed a Chinese diabetes group visit program as an alternative approach to support patient self-management and examined its effectiveness on self-management behaviors, self-efficacy and health status for patients with type 2 diabetes in rural communities of Shanghai.Methods208 patients with type 2 diabetes aged 35–80 years were randomly assigned to the intervention group (n=119) of 12 monthly group visit sessions or to a control group (n=89) of usual care. The trial was undertaken in two rural communities in Shanghai, China. Randomization and allocation to study group were carried out by using a random number table. Analysis of covariance was used to compare changes in the 17 self-management behavior, self-efficacy and health status related variables in two groups at 12 months’ follow-up based on 176 patients (n=98; n=78).ResultsCompared with controls, the intervention patients, on average, increased their duration of aerobic exercise by more than 40 minutes per week (p=0.001); had significant increase of 0.71 in mean score on self-efficacy to manage diabetes (p=0.02); and had significant improvements in measures of illness intrusiveness and systolic blood pressure. The intervention patients attended an average of 10.1 of the 12 program sessions with 75.6% of them attended 10 and more sessions.ConclusionThe Chinese diabetes group visit model is a feasible, acceptable and effective alternative for supporting diabetes patient self-management in Chinese rural communities. The model requires larger studies to determine its effect on blood glucose control and health care utilization.Trial registrationISRCTN87909028
The tobacco epidemic is one of the biggest public health challenges the world has ever faced, killing more than 8 million people around the world every year. In 2017, tobacco killed 3.3 million users and people exposed to secondhand smoke from lung-related conditions including chronic respiratory diseases, tracheal, bronchus and lung cancers, respiratory infections and tuberculosis. Despite the strong body of evidence around the harms of tobacco use to lung health from direct and passive exposure to tobacco smoke, there are still several knowledge gaps that need to be bridged through targeted research, for example, tobacco and nicotine addiction, surveillance and monitoring, waterpipe tobacco, heated tobacco products, electronic nicotine delivery systems, inhalation of aerosols, cessation aids, and dual use. Operational and implementation research can help make current efforts and interventions, that we know work, more effective and more efficient. Tobacco use is on the decline, but the rate of reduction is not fast enough and it is apparent that the agreed global target of 30% reduction in tobacco use among adults by 2025 will not be met. Therefore, accelerated research is needed to crystalize the impact of tobacco control towards reducing tobacco use prevalence across populations.
GLOBAL BURDEN OF TOBACCO USE
The separation of tiny water droplets
from viscous crude oil is
urgently needed and still remains a substantial challenge because
of severe membrane fouling resulting from the high viscosity and adhesive
property of crude oil. To solve this issue, the electrothermal effect,
for the first time, was utilized to heat the water-in-crude oil emulsion
using electrical current as an energy source to extremely reduce the
viscosity of the water-in-crude oil emulsion and thus to realize efficient
viscous emulsion separation. A silicone-modified stainless-steel mesh
(SSM) was fabricated via coating silicone on the SSM and transient
heating. The as-prepared silicone-modified SSM allows for an outstanding
integration of superhydrophobic/superoleophilic properties from the
partial thermal degradation of the silicone coating and superior electrothermal
capability from SSM. Thanks to the excellent electrothermal capability,
the silicone-modified SSM achieved a high electrothermal power density
of 3.43 W cm–2 at a low input voltage of 5 V. The
resulting Joule heating, superhydrophobicity, and micropore structure
enabled the silicone-modified SSM to efficiently separate a viscous
water-in-crude oil emulsion (2.6 × 104 mPa s at 20
°C) with high separation efficiency (98.9%) and separation flux
(314 L m–2 h–1). Moreover, the
silicone-modified SSM presented optimal reusability and stability
after six cycles for the viscous water-in-crude oil emulsion. This
electrothermal-assisted viscous emulsion separation strategy can provide
some new perspectives for viscous oil/water emulsion separation.
The report aimed to review and assess the status of tobacco cessation services in the Eastern Mediterranean Region (EMR). Nearly 70% of people in the Region have legal access to nicotine-replacement therapy but for 77% of these people the costs of the treatment are not covered. Bupropion and Varenicline are legally available in 10 and 11 EMR countries respectively. Just under 50% of people in the Region have access to at least some cessation support in primary health care facilities. Around 32% of people have access to a national toll-free quit line. Costs for cessation services are fully covered in few EMR countries; however, cessation services in the Region must be improved. Member States should aim to increase the availability of, and financial support for, cessation treatments and support, which should be prioritized in primary health care facilities.
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