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Hu Y, Liu H, Wu J, Fang G. Factors influencing self-care behaviours of patients with type 2 diabetes in China based on the health belief model: a cross-sectional study. BMJ Open 2022; 12:e044369. [PMID: 35953256 PMCID: PMC9379478 DOI: 10.1136/bmjopen-2020-044369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The study aimed to explore the status and predictors of self-care behaviours in patients with type 2 diabetes in China based on the health belief model. DESIGN The cross-sectional study included 1140 patients aged ≥36 years with type 2 diabetes who had established health records in community health service institutions. A questionnaire was designed based on the health belief model, which mainly included perceived susceptibility, severity, benefits, barriers, effectiveness, sociodemographic characteristics and self-care behaviours. SETTING Using a multistage sampling method, 36 villages and communities were randomly selected in China. PARTICIPANTS A total of 1260 patients with type 2 diabetes were contacted, but 118 refused to participate in the study. Of the 1142 participants, two were subsequently excluded, and the final number of participants included in the study was 1140 (90.5% response rate). RESULTS The average score of health beliefs was 0.71 (SD=0.08). The logistic regression analysis showed that sex, region, perceived severity, perceived barriers and perceived benefits were related to self-care behaviours. CONCLUSIONS Perceived severity, benefits and barriers were key factors affecting self-care behaviours in patients with type 2 diabetes; health education for patients should be strengthened to improve the self-care level of patients with diabetes.
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Affiliation(s)
- Yue Hu
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China
| | - Huijun Liu
- The First Clinical Medical College, Anhui Medical University, Hefei, Anhui, China
| | - Jie Wu
- Zhangjiagang First People's Hospital, Zhangjiagang, Jiangsu, China
| | - Guixia Fang
- School of Health Service Management, Anhui Medical University, Hefei, Anhui, China
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Exploring the lived experience of diabetes through an intersectional lens: A qualitative study of adults with type 1 and type 2 diabetes. Can J Diabetes 2022; 46:620-627. [DOI: 10.1016/j.jcjd.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/23/2022] [Accepted: 06/08/2022] [Indexed: 11/24/2022]
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Chung GKK, Lai FTT, Yeoh EK, Chung RYN. Gender-specific trends of educational inequality in diagnosed diabetes from 1999 to 2014 in Hong Kong: a serial cross-sectional study of 97,481 community-dwelling Chinese adults. Popul Health Metr 2021; 19:37. [PMID: 34629087 PMCID: PMC8504033 DOI: 10.1186/s12963-021-00268-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 09/22/2021] [Indexed: 12/19/2022] Open
Abstract
Background Gender differences in the trend of educational inequality in diabetes have been widely observed in the Western populations, indicating the increasing importance of educational attainment as a social determinant of diabetes among women. Nonetheless, relevant evidence is scarce in developed Asian settings for comparisons. This study examined the gender-specific trends of educational inequality in diagnosed diabetes in Hong Kong between 1999 and 2014.
Methods A series of eight territory-wide population-representative samples of 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were surveyed between 1999 and 2014. Regression-based Relative Index of Inequality (RII) and age-standardized Slope Index of Inequality (SII) were adopted to examine the extent and trend of gender-specific educational inequality in self-reported physician-diagnosed diabetes. Results Age-standardized prevalence of diabetes increased in both genders over time, with a steeper surge among men. In addition, educational inequalities in diabetes, in both relative and absolute terms, significantly widened among women over the study period (annual RII change = 1.04; 95% CI = 1.02–1.07, annual SII change = 0.36%; 95% CI = 0.16–0.56%), with the peak in 2011 (RII = 2.44; 95% CI = 1.83–3.24, SII = 9.21%; 95% CI = 6.47–11.96%). However, no significant widening inequality was found among men. Further adjustment for household income level did not attenuate the observed educational inequality. Conclusions Despite a greater increase in diabetes prevalence among men, disparity in diabetes substantially widened across education levels among women in the past decade in Hong Kong. The gender perspective should be taken into considerations for policy making to alleviate the prevalence surge and rising educational inequality in diabetes. Supplementary Information The online version contains supplementary material available at 10.1186/s12963-021-00268-x.
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Affiliation(s)
- Gary Ka-Ki Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.,CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Francisco Tsz Tsun Lai
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.,Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | - Eng-Kiong Yeoh
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.,CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China
| | - Roger Yat-Nork Chung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China. .,CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China.
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Readmission after epilepsy monitoring unit discharge in a nationally representative sample. Epilepsy Res 2021; 174:106670. [PMID: 34051574 DOI: 10.1016/j.eplepsyres.2021.106670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/22/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine the 30-day readmission rate after Epilepsy Monitoring Unit (EMU) discharge in a nationally representative sample, as well as patient, clinical, and hospital characteristics associated with readmission. METHODS This is a retrospective cohort study of adults discharged from an elective hospitalization with continuous video electroencephalography (vEEG) monitoring, sampled from the Healthcare Cost and Utilization Project's 2014 Nationwide Readmissions Database. Descriptive statistics were used to quantify and characterize readmission within 30 days and logistic regression models were built to examine factors associated with readmission. RESULTS 6869 admissions met inclusion criteria, with 292 people (4.2 %) readmitted within 30 days. 79.5 % (n = 232/292) of all readmissions were non-elective. Patient characteristics associated with readmission included a higher Elixhauser comorbidity score [adjusted odds ratio (AOR) 1.03, 95 % confidence interval (CI) 1.02-1.04 per 1 point increase in Elixhauser score], a longer length of stay [AOR 1.05, 95 % CI 1.02-1.09 per one day increase in length], non-routine discharge [AOR 1.85, 95 %CI 102-3.38], and comorbid brain tumor diagnosis [AOR 2.55, 95 %CI 1.46-4.46]. Female sex was inversely associated with 30-day readmission [AOR 0.68, 95 % CI 0.54-0.85]. The most common reason for readmission was epilepsy or convulsion (27.6 %), followed by sepsis (5.8 %) and complications of surgical procedures or medical care (5.5 %). CONCLUSIONS Patients electively admitted for continuous vEEG monitoring are infrequently readmitted. These data provide a preliminary national readmission benchmark for patients with elective admissions for vEEG monitoring.
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Stanimirovic A, Francis T, Cooper Reed A, Meerai S, Sutakovic O, Merritt R, Brent M, Rac V. Impact of Intersecting Systems of Oppression on Diabetic Retinopathy Screening Among Those Who Identify as Women of Low Socioeconomic Status: Protocol for a Convergent Mixed Methods Study. JMIR Res Protoc 2021; 10:e23492. [PMID: 33666559 PMCID: PMC7980119 DOI: 10.2196/23492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/06/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background By 2025, 5 million Canadians will be diagnosed with diabetes, and women from lower socioeconomic groups will likely account for most new diagnoses. Diabetic retinopathy is a primary vision complication of diabetes and a leading cause of blindness among adults, with 26% prevalence among women. Tele-retina is a branch of telemedicine that delivers eye care remotely. Screening for diabetic retinopathy has great potential to reduce the incidence of blindness, yet there is an adverse association among screening, income, and gender. Objective We aim to explore gender disparity in the provision of tele-retina program services for diabetic retinopathy screening in a cohort of women of low socioeconomic status (SES) receiving services in South Riverdale Community Health Centre (SRCHC) between 2014 and 2019. Methods Using a convergent mixed methods design, we want to understand patients’, providers’, administrators’, and decision makers’ perceptions of the facilitators and barriers associated with the implementation and adoption of tele-retina. Multivariate logistic regression will be utilized to assess the association among client characteristics, referral source, and diabetic retinopathy screening. Guided by a grounded theory approach, systematic coding of data and thematic analysis will be utilized to identify key facilitators and barriers to the implementation and adoption of tele-retina. Results For the quantitative component, we anticipate a cohort of 2500 patients, and we expect to collect data on the overall patterns of tele-retina program use, including descriptions of program utilization rates (such as data on received and completed diabetic retinopathy screening referrals) along the landscape of patient populations receiving these services. For the qualitative component, we plan to interview up to 21 patients and 14 providers, administrators, and decision makers, and to conduct up to 14 hours of observations alongside review of relevant documents. The interview guide is being developed in collaboration with our patient partners. Through the use of mixed methods research, the inquiry will be approached from different perspectives. Mixed methods will guide us in combining the rich subjective insights on complex realities from qualitative inquiry with the standard generalizable data that will be generated through quantitative research. The study is under review by the University Health Network Research Ethics Board (19-5628). We expect to begin recruitment in winter 2021. Conclusions In Ontario, the screening rate for diabetic retinopathy among low income groups remains below 65%. Understanding the facilitators and barriers to diabetic retinopathy screening may be a prerequisite in the development of a successful screening program. This study is the first Ontario study to focus on diabetic retinopathy screening practices in women of low SES, with the aim to improve their health outcomes and revolutionize access to quality care. International Registered Report Identifier (IRRID) PRR1-10.2196/23492
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Affiliation(s)
- Aleksandra Stanimirovic
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Troy Francis
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Anna Cooper Reed
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sonia Meerai
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Gender, Feminist & Women Studies, Faculty of Graduate Studies, York University, Toronto, ON, Canada.,Lyle S Hallman Faculty of Social Work, Wilfrid Laurier University, Brantford, ON, Canada
| | - Olivera Sutakovic
- Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Department of Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - Rebecca Merritt
- South Riverdale Community Health Centre, Toronto, ON, Canada
| | - Michael Brent
- Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Department of Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - Valeria Rac
- Program for Health System and Technology Evaluation, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Diabetes Action Canada, CIHR SPOR Network, Toronto, ON, Canada.,Toronto Health Economics and Technology Assessment Collaborative, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
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6
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Tremblay J, Hamet P. Environmental and genetic contributions to diabetes. Metabolism 2019; 100S:153952. [PMID: 31610851 DOI: 10.1016/j.metabol.2019.153952] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/18/2019] [Accepted: 07/18/2019] [Indexed: 01/18/2023]
Abstract
Diabetes mellitus (DM) is a heterogeneous group of disorders characterized by persistent hyperglycemia. Its two most common forms are type 1 diabetes (T1D) and type 2 diabetes (T2D), for which genetic and environmental risk factors act in synergy. Because it occurs in children and involves infectious, autoimmune or toxic destruction of the insulin-secreting pancreatic beta-cells, type 1 diabetes has been called juvenile or insulin-deficient diabetes. In type 2, patients can still secrete some insulin but its effectiveness may be attenuated by 'insulin resistance.' There is also a group of rare forms of diabetes in the young which are inherited as monogenetic diseases. Whether one calls the underlying process 'genes vs. environment' or 'nature vs nurture', diabetes occurs at the interface of the two domains. Together with our genetic background we are born tabula rasa-a blank slate upon which the story of life, with all its environmental inputs will be written. There is one proviso: the influence of epigenetic inheritance must also be considered. Thus, in the creation of databases that include "big data" originating from genomic as well as exposome (defined as: the totality of environmental exposure from conception to death), a broad perspective is crucial as these factors act in concert in such chronic illnesses as diabetes that, for example, are likely to require adoption of an appropriate lifestyle change. Also, it is becoming increasingly evident that epigenetic factors can modulate the interplay between genes and environment. Consequently, throughout the life of an individual nature and nurture interact in a complex manner in the development of diabetes. This review addresses the question of the contribution of gene and environment and their interactions in the development of diabetes.
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Affiliation(s)
- Johanne Tremblay
- CRCHUM Research Center, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Pavel Hamet
- CRCHUM Research Center, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
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Cimo A, Dewa CS. Symptoms of Mental Illness and Their Impact on Managing Type 2 Diabetes in Adults. Can J Diabetes 2018; 42:372-381. [DOI: 10.1016/j.jcjd.2017.08.256] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/26/2017] [Accepted: 08/31/2017] [Indexed: 12/16/2022]
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Soriano-Reixach MM, Vivanco-Hidalgo RM, Ois A, Rodríguez-Campello A, Roquer J. Interaction of Sex and Diabetes on Outcome After Ischemic Stroke. Front Neurol 2018; 9:250. [PMID: 29706931 PMCID: PMC5908882 DOI: 10.3389/fneur.2018.00250] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/29/2018] [Indexed: 12/18/2022] Open
Abstract
Background The relationship between ischemic stroke (IS), diabetes mellitus (DM), and sex is intriguing. The aim of this study was to assess the effect modification of sex in the association between DM and short- and long-term disability and mortality in first-ever IS patients. Methods In a retrospective, observational, hospital-based study of a prospective series including first-ever IS patients from January 2006 until July 2011, differences in 3-month and 5-year mortality, and disability between diabetic and non-diabetic patients [modified Rankin Scale (mRS) from 3 to 5] were analyzed by sex. Results In total, 933 patients (36.3% with DM, 50.5% women) were included. Overall 3-month and 5-year mortality were 150 (16.1%) and 407 (44.1%), respectively. Adjusted for age, previous mRS, and stroke severity, patients with DM had significantly higher 3-month disability [hazard ratio (HR): 1.49 (95% confidence interval (CI): 1.39–1.70), p < 0.0001], 5-year disability [HR: 1.41 (95% CI: 1.07–1.86), p = 0.015], and 5-year mortality [HR: 1.48 (95% CI: 1.20–1.81), p < 0.0001], compared with the non-DM group. Compared with non-DM women, women with diabetes had worse 3-month disability [HR: 1.81 (95% CI: 1.33–2.46), p < 0.0001] and 5-year mortality [HR: 1.72 (95% CI: 1.30–2.20), p < 0.0001], and a trend for 5-year disability [HR: 1.40 (95% CI: 0.99–2.09), p = 0.057]. In men, DM had an effect on 3-month disability [HR: 1.45 (95% CI: 1.07–1.96), p = 0.018], a trend for 5-year disability [HR: 1.43 (95% CI: 0.94–2.19), p = 0.096], but no clear effect on 5-year mortality [HR: 1.22 (95% CI: 0.91–1.65), p = 0.186]. Conclusion Sex has a modifier effect on mortality in first-ever IS diabetic patients. Long-term mortality is increased in diabetic women compared with non-diabetic women, a difference not observed in men.
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Affiliation(s)
| | | | - Angel Ois
- Servei de Neurologia, IMIM-Hospital del Mar, Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ana Rodríguez-Campello
- Servei de Neurologia, IMIM-Hospital del Mar, Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Roquer
- Servei de Neurologia, IMIM-Hospital del Mar, Barcelona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
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Avedzi HM, Mathe N, Storey K, Johnson JA, Johnson ST. Examining sex differences in glycemic index knowledge and intake among individuals with type 2 diabetes. Prim Care Diabetes 2018; 12:71-79. [PMID: 28823516 DOI: 10.1016/j.pcd.2017.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 06/29/2017] [Accepted: 07/11/2017] [Indexed: 12/18/2022]
Abstract
AIM We examined self-reported dietary behaviours and actual food intakes among adult men and women with type 2 diabetes participating in Alberta's Caring for Diabetes (ABCD) Study. METHODS Participants completed 3-day food records and questions about glycemic index (GI) concept knowledge and dietary behaviours. Daily average GI and glycemic load (GL) were calculated for all carbohydrates consumed. Dietary intake was analyzed using ESHA FoodPro (version 10.13.1). Sex differences in nutrient intakes were explored across categories of GI knowledge and dietary practices. RESULTS Participants (N=170) mean (SD) age 65.8 (9.6) years were 46.5% women, 90.6% Caucasian with a mean BMI of 31.3 (7.0)kg/m2 and diabetes duration of 13.4 (8.6) years. Overall, 60% of men versus 40% of women consumed carbohydrates in quantities below Acceptable Macronutrient Distribution Ranges (AMDR). About 80% of men versus 90% of women consumed proteins above AMDR whereas 60% versus 65% of women consumed fats above AMDR. Fibre intake among men was lower than recommended (p<0.01). Men who reported having knowledge of the GI-concept also reported lower GI intake versus men who did not (p=0.03). CONCLUSION Sex differences exist in low-GI diabetes self-care dietary behaviours among adults with type 2 diabetes participating in this study. Gender-sensitive approaches for enhancing diabetes self-care low-GI dietary behaviour should be explored.
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Affiliation(s)
| | - Nonsikelelo Mathe
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada; Centre for Nursing and Health Studies, Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | | | - Steven Thomas Johnson
- Centre for Nursing and Health Studies, Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada.
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Kirkpatrick SI, Vanderlee L, Raffoul A, Stapleton J, Csizmadi I, Boucher BA, Massarelli I, Rondeau I, Robson PJ. Self-Report Dietary Assessment Tools Used in Canadian Research: A Scoping Review. Adv Nutr 2017; 8:276-289. [PMID: 28298272 PMCID: PMC5347105 DOI: 10.3945/an.116.014027] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Choosing the most appropriate dietary assessment tool for a study can be a challenge. Through a scoping review, we characterized self-report tools used to assess diet in Canada to identify patterns in tool use and to inform strategies to strengthen nutrition research. The research databases Medline, PubMed, PsycINFO, and CINAHL were used to identify Canadian studies published from 2009 to 2014 that included a self-report assessment of dietary intake. The search elicited 2358 records that were screened to identify those that reported on self-report dietary intake among nonclinical, non-Aboriginal adult populations. A pool of 189 articles (reflecting 92 studies) was examined in-depth to assess the dietary assessment tools used. Food-frequency questionnaires (FFQs) and screeners were used in 64% of studies, whereas food records and 24-h recalls were used in 18% and 14% of studies, respectively. Three studies (3%) used a single question to assess diet, and for 3 studies the tool used was not clear. A variety of distinct FFQs and screeners, including those developed and/or adapted for use in Canada and those developed elsewhere, were used. Some tools were reported to have been evaluated previously in terms of validity or reliability, but details of psychometric testing were often lacking. Energy and fat were the most commonly studied, reported by 42% and 39% of studies, respectively. For ∼20% of studies, dietary data were used to assess dietary quality or patterns, whereas close to half assessed ≤5 dietary components. A variety of dietary assessment tools are used in Canadian research. Strategies to improve the application of current evidence on best practices in dietary assessment have the potential to support a stronger and more cohesive literature on diet and health. Such strategies could benefit from national and global collaboration.
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Affiliation(s)
- Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada;
| | - Lana Vanderlee
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada;
| | - Amanda Raffoul
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Ilona Csizmadi
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Beatrice A Boucher
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada;,Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
| | | | | | - Paula J Robson
- Cancer Measurement, Outcomes, Research, and Evaluation (C-MORE), Alberta Health Services Cancer Control, Edmonton, Alberta, Canada
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Bilandzic A, Rosella L. The cost of diabetes in Canada over 10 years: applying attributable health care costs to a diabetes incidence prediction model. Health Promot Chronic Dis Prev Can 2017; 37:49-53. [PMID: 28273040 PMCID: PMC5607525 DOI: 10.24095/hpcdp.37.2.03] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Our objective was to estimate the future direct health care costs due to diabetes for a 10-year period in Canada using national survey data, a validated diabetes risk prediction tool and individual-level attributable cost estimates. METHODS We used the Diabetes Population Risk Tool to predict the number of new diabetes cases in those aged 20 years and above over a 10-year period (to 2022), using 2011 and 2012 Canadian Community Health Survey data. We derived attributable costs due to diabetes from a propensity-matched case control study using the Ontario Diabetes Database and other administrative data. We calculated total costs by applying the respective attributable costs to the incident cases, accounting for sex, year of diagnosis and annual disease-specific mortality rates. RESULTS The predicted 10-year risk of developing diabetes for the Canadian population in 2011/12 was 9.98%, corresponding to 2.16 million new cases. Total health care costs attributable to diabetes during this period were $7.55 billion for females and $7.81 billion for males ($15.36 billion total). Acute hospitalizations accounted for the greatest proportion of costs (43.2%). A population intervention resulting in 5% body weight loss would save $2.03 billion in health care costs. A 30% risk-reduction intervention aimed at individuals with the highest diabetes risk (i.e. the top 10% of the highest-risk group) would save $1.48 billion. CONCLUSION Diabetes represents a heavy health care cost burden in Canada through to the year 2022. Our future cost calculation method can provide decision makers and planners with an accessible and transparent tool to predict future expenditures attributable to the disease and the corresponding cost savings associated with interventions.
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Affiliation(s)
- Anja Bilandzic
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
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Clinical and Sociodemographic Factors Associated with Cognitive Impairment and Neuroprotection in Diabetes Patients. SPANISH JOURNAL OF PSYCHOLOGY 2015; 18:E65. [DOI: 10.1017/sjp.2015.61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractThe aim of this study is to analyze the potential impact of factors (clinical and demographic variables and comorbidities) associated with Diabetes Mellitus (DM) on certain mental processes related to cognitive impairment, with special attention to the analysis of parameters that define processing speed and executive function. Neuropsychological examination of elderly Spanish patients (N = 59, 33 females, Mage 70.98 years) diagnosed with DM, in addition to application of an ad hoc questionnaire to collect information on comorbidities and other relevant demographic variables. Based on a cross-sectional design, correlational analysis was carried out. Cognitive performance showed an inverse relationship to age and cardiopathology while years of schooling and regular physical activity appeared as neuroprotective factors. DM is an illness which, linked to other variables, can be regarded as a risk factor for the development of cognitive impairment. Certain factors (physical activity and cognitive stimulation) have the potential to mitigate this tendency. There is a need to further our understanding of the neurobiological mechanisms involved.
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Bermudez-Millan A, Schumann KP, Feinn R, Tennen H, Wagner J. Behavioral reactivity to acute stress among Black and White women with type 2 diabetes: The roles of income and racial discrimination. J Health Psychol 2015; 21:2085-97. [PMID: 25721453 DOI: 10.1177/1359105315571776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated relationships of income and self-reported racial discrimination to diabetes health behaviors following an acute stressor. A total of 77 diabetic women (51% Black, 49% White) completed a laboratory public speaking stressor. That evening, participants reported same-day eating, alcohol consumption, and medication adherence; physical activity was measured with actigraphy, and the next morning participants reported sleep quality. Measures were repeated on a counterbalanced control day. There was no mean level difference in health behaviors between stressor and control days. On stressor day, lower income predicted lower physical activity, sleep quality, and medication adherence, and higher racial discrimination predicted more eating and alcohol consumed, even after accounting confounders including race and control day behaviors.
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