Diabetes-related foot ulceration is prevalent and disabling, usually resulting in the amputation of the limb. The mortality rate is significant, and healed ulcers frequently reoccur. The main purpose of this study was to explore the prevalence of foot ulcers and their associated factors among diabetic patients in Punjab, Pakistan. Multistage cluster random sampling procedure was applied to perform a cross-sectional analysis in the state of Punjab, Pakistan. A sample of 1,503 people with diabetes, including 504 men and 999 women, were selected from different clusters. Data were collected from December 18, 2018, to June 30, 2019. Individuals of 18 years or above were selected. A binary multiple logistic regression analysis was utilized to find the factors associated with a diabetic foot ulcer. The overall prevalence of diabetic foot ulcers was 16.83% (95% CI: 14.9–18.7%). The prevalence among the female was 17.52% (95% CI: 15.2–19.9%), and the male was 15.48% (95% CI: 12.3–18.6%). In rural areas, prevalence was 13.91% (95% CI: 10.6–17.2%) compared to the prevalence of 17.96% (95% CI: 15.7–20.2%) in the urban area. Individuals 75 years and above had the highest prevalence of 66.67% (95% CI: 51.9–81.5%). According to the income status, subjects with monthly income above Rs. 61,000 had a prevalence of 24.24% (95% CI: 15.8–32.7%), and among overweight subjects was 25.49% (95% CI: 21.3–29.7%). This study found a relatively high prevalence of foot ulcers in Punjab, Pakistan. The results indicate that diabetic foot ulcers have become a major health problem in diabetic patients, and better strategies and preventive measures should be opted to deal with the epidemic.

No abstract

The objectives of the study were to identify the relationship between the personal traits and sustainable competence development of library professionals, explore trending practices for the development of the personal and professional competencies of librarians, and find out the challenges affecting the development of modern skills in librarians. The authors applied the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines as a research methodology. Thirty-five peer-reviewed articles were selected to conduct the systematic literature review. The results revealed that there is a strong positive correlation between personal traits and the professional development of librarians. The trending practices for the development of personal and professional skills included expert use of IT, continuous training sessions, teamwork, usage of social media forums, and a customer-oriented approach. The results also showed that old curricula, leadership problems, economic issues, and lack of personal interest were barriers to the development of modern skills in librarians relating to the implementation of value-added services in the networked world. The study contributes theoretically by adding valuable knowledge to the existing literature. It outlines practical implications to help devise strategies for capacity building among librarians related to the implementation of user-centered services in libraries.