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Eades CE, Burrows KA, Andreeva R, Stansfield DR, Evans JM. Prevalence of gestational diabetes in the United States and Canada: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2024; 24:204. [PMID: 38491497 PMCID: PMC10941381 DOI: 10.1186/s12884-024-06378-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/28/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND An understanding of the prevalence of gestational diabetes mellitus among pregnant women is essential at local, national and international level so that appropriate health care interventions can be planned, financed and delivered. METHODS A systematic review and meta-analysis of primary research reporting the prevalence of gestational diabetes mellitus in Canada or the United States were carried out according to Meta-analysis of Observational Studies in Epidemiology guidelines. Four electronic databases were systematically searched in June 2023 to identify articles that reported gestational diabetes mellitus prevalence using universal screening in pregnant women from eligible general population samples. Estimates were combined using a random effects model, and the effects of moderator variables analysed. RESULTS There were 36 separate samples of women or deliveries (total sample size 1,550,917). Overall mean prevalence of gestational diabetes mellitus was 6.9% (95% CI: 5.7-8.3); 13.7% (95% CI: 10.7-17.3) in studies using a one-step screening strategy, and 5.2% (95% CI: 4.4-6.1) in those using a two-step strategy. Heterogeneity in technical methods between studies produced differences in estimates, as did different diagnostic thresholds used. CONCLUSIONS The meta-analysis suggests a slightly higher prevalence of gestational diabetes mellitus in Canada and the United States, compared to Europe, but highlights the need for standardised protocols for estimating gestational diabetes mellitus prevalence.
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Affiliation(s)
- Claire E Eades
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Katherine A Burrows
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | - Roza Andreeva
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
| | | | - Josie Mm Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland, UK
- Public Health Scotland, Edinburgh, Scotland
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Cameron DM, Muratore F, Tower M, Eades CE, Evans JMM. Exploration of health and health behaviours of undergraduate nursing students: a multi-methods study in two countries. Contemp Nurse 2022; 58:473-483. [PMID: 35638838 DOI: 10.1080/10376178.2022.2085128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Nurses play a vital role in health promotion, and there may be a link between a nurse's own lifestyle practices and how they educate others. Supporting health and well-being in student nurses is critical given they will be educating others once registered and practicing. OBJECTIVES To explore the health and health behaviours of undergraduate nursing and midwifery students considering the demands of their profession, their public health role and their ability to be role models. DESIGN Multi-methods study. METHODS Undergraduate nursing students in the second and third years of their programme were invited to self-complete a health and health behaviour questionnaire in a Scottish and Australian Higher Education Institution. Qualitative data were collected from a convenience sample of 20 third-year nursing and midwifery students. RESULTS Two hundred and thirty-five Scottish students and 113 Australian students, 175 (85%) and 84 (74%), respectively, completed the questionnaire. Some differences and similarities were noted across groups, in particular, perceived physical health, the prevalence of binge drinking, smoking and being overweight/obese and some dietary measures were found to be less favourable among Scottish students. There were worryingly high levels of poor mental well-being at both higher education institutions, with scores on a mental well-being scale suggesting that (82) 34.7% of Scottish students and 33 (29.6%) of Australian students were at risk of depression. Nine Scottish students and 11 Australian students were interviewed. Key contributors and barriers to healthy behaviours were noted across both groups of students in relation to lifestyle. Students perceived that certain elements of their curriculum had implications on their ability or motivation to make healthy lifestyle choices. CONCLUSION The poor health and health behaviours of future nurses need to be addressed in their higher education to shape resilient role models for future nursing practice. IMPACT STATEMENT Priority should be given to supportive learning environments for student nurses that foster emotional support and encourage healthy lifestyles.
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Affiliation(s)
- Dawn M Cameron
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Pathfoot Building, Stirling FK9 4LA, UK.,School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Hamilton International Technology Park, Stephenson Place, Blantyre, Glasgow G72 0LH, UK
| | - Francesca Muratore
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Pathfoot Building, Stirling FK9 4LA, UK
| | - Marion Tower
- School of Nursing, Midwifery and Social Work, University of Queensland
| | - Claire E Eades
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Pathfoot Building, Stirling FK9 4LA, UK
| | - Josie M M Evans
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Pathfoot Building, Stirling FK9 4LA, UK.,School of Health and Life Sciences, University of the West of Scotland, Lanarkshire Campus, Hamilton International Technology Park, Stephenson Place, Blantyre, Glasgow G72 0LH, UK
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Hunter EJ, Eades CE, Evans JMM. Violence experienced by undergraduate nursing students during clinical placements: An online survey at a Scottish University. Nurse Educ Pract 2022; 61:103323. [DOI: 10.1016/j.nepr.2022.103323] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/16/2022] [Accepted: 02/28/2022] [Indexed: 11/26/2022]
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Evans JMM, Ireland AV, Cameron DM, Clarke KM, Eades CE. Postpartum opportunistic advice in primary care for women who have had gestational diabetes: a qualitative study of health care professionals' views. BMC Fam Pract 2021; 22:209. [PMID: 34666697 PMCID: PMC8527649 DOI: 10.1186/s12875-021-01558-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/06/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Women who have had gestational diabetes during pregnancy are at very high risk of developing type 2 diabetes later in life, but their understanding of the risks is often limited. In this study we explored the views of health care professionals regarding offering brief opportunistic advice to women after their pregnancy, during unrelated consultations in primary care, relating to reducing diabetes risk. METHODS The study took place in three Health Boards in Scotland. We conducted semi-structured one-to-one interviews (either face-to-face or telephone) with two health visitors, three practice nurses, two GPs, two diabetes consultants and two obstetricians. A focus group with five health visitors was also held. A topic guide was followed, covering the feasibility and acceptability of delivering brief opportunistic advice during a routine consultation, the optimal way to identify and recall women with previous gestational diabetes, and the possible content and timing of any such intervention. A thematic approach was used to analyse the qualitative data generated. RESULTS The interviews/discussion lasted from 15 to 51 min. There was widespread support from all participants for offering opportunistic advice, and general consensus that health visitors would be best placed to do this as part of the Universal Health Visiting Pathway in Scotland. Thematic analysis generated three significant points of discussion: implications for training of health visitors, the need for a systematic approach to identifying women with gestational diabetes, and the optimal timing of delivery. Despite an already demanding schedule of providing advice and education to women, health visitors were confident that they could offer educational advice, provided that they received appropriate training to do so. However, there would need to be a watertight system for identifying women in their care who had had gestational diabetes. In terms of timing, later visits around 6-8 months after delivery were considered most suitable. CONCLUSIONS There is support from health care professionals, and most pertinently from health visitors, that the frequency of routine visits with women during the Universal Health Visiting Pathway programme in Scotland provides potential opportunities for education around future diabetes risk to women who have had gestational diabetes.
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Affiliation(s)
- Josie M. M. Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland FK9 4LA UK
| | - Aileen V. Ireland
- Faculty of Social Sciences, University of Stirling, Stirling, Scotland FK9 4LA UK
| | - Dawn M. Cameron
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, G72 OLH UK
| | - Kate M. Clarke
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland FK9 4LA UK
| | - Claire E. Eades
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland FK9 4LA UK
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Evans JMM, Andreis F, Cameron DM, Eades CE. How does the self-reported health of undergraduate nursing students change during their degree programme? Survey results from a Scottish University. BMC Nurs 2021; 20:44. [PMID: 33731063 PMCID: PMC7968279 DOI: 10.1186/s12912-021-00563-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The lifestyle behaviours, and the physical and mental health of nurses, are poorer than those of other allied health professionals, and of the general population. However, these were no less favourable among first year undergraduate nursing students at a Scottish Higher Education Institution (HEI) than among similar people of the same age. We compared health and health behaviours among the same cohort of undergraduate nursing students over the course of their degree. METHODS An anonymous self-complete repeat cross-sectional survey was administered during a timetabled teaching session at three time-points to undergraduate nursing students at the start of Years 1, 2 and 3 of their programme. They had received written information about the study previously. RESULTS Self-reported health did not change significantly over time, but there was a clear decline over the 3 years in the proportions of students rating their mental health as excellent/very good/good and a concomitant increase in those rating their mental health as fair/poor. Correspondingly, the mean WEMWBS wellbeing score declined over the 3 years, with the proportion of students with a score of < 46 (indicating either high risk of major depression, or in high risk of psychological distress and increased risk of depression) increasing from one quarter to one half. This effect was captured and described using a Bayesian regression analysis. The most noticeable change in health behaviours was a decline in physical activity levels over the study period. The proportion of students managing 150 min of weekly physical activity decreased from three quarters to two thirds. This was reflected in higher self-reported sedentary time, although there were no observable trends over time in mean BMI, or proportions of students categorised as overweight or obese. CONCLUSIONS This paper suggests that there may be a decline in mental health and in participation in physical activity among nursing students over the course of their degree. We recommend the incorporation of an intervention into the undergraduate nursing curriculum that promotes and encourages regular physical activity, offering students the opportunity to learn about health promotion and lifestyle change in practice, to improve their own physical health, and to address mental wellbeing.
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Affiliation(s)
- Josie M M Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, FK9 4LA, UK.
| | - Federico Andreis
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, FK9 4LA, UK
| | - Dawn M Cameron
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, FK9 4LA, UK
| | - Claire E Eades
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland, FK9 4LA, UK
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Eades CE, Clarke KM, Cameron DM, Coulson N, Evans JMM. Analysis of spontaneous, user-generated data about gestational diabetes on online forums: implications for diabetes prevention. Diabet Med 2020; 37:2058-2066. [PMID: 32575157 DOI: 10.1111/dme.14348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/18/2023]
Abstract
AIMS To explore the experiences and perceptions of gestational diabetes mellitus reported by women within online parental-support forums and, specifically, to analyse what women say about a diagnosis of gestational diabetes, their future risk of type 2 diabetes, and lifestyle behaviour for management of gestational diabetes and prevention of type 2 diabetes. METHODS The discussion boards of two parenting websites (Mumsnet and Netmums) were searched using the search term 'gestational diabetes or GD' in February 2019. Relevant posts made by users with gestational diabetes on or after 1 January 2017 were retained for analysis. Framework analysis using pre-existing framework from a previous study was used to organize and analyse the data. RESULTS A total of 646 posts generated by 282 unique users were included in the analysis. Analysis of the online content identified three important implicit messages that may be being conveyed to readers. The first is that gestational diabetes is not a serious diagnosis that warrants undue concern. Secondly, few users recognized the importance of their own behaviours or lifestyle, with others minimizing personal responsibility or attributing gestational diabetes to non-modifiable factors. Finally, there was a lack of acknowledgment of heightened risk of type 2 diabetes. These three messages will all directly mitigate against the efforts of clinicians (and others) to encourage women with gestational diabetes to improve their lifestyle behaviours in the longer term. CONCLUSIONS These findings highlight messages that are being widely disseminated and that are unlikely to support prevention of type 2 diabetes.
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Affiliation(s)
- C E Eades
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Stirling, UK
| | - K M Clarke
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Stirling, UK
| | - D M Cameron
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Stirling, UK
| | - N Coulson
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - J M M Evans
- Faculty of Health Sciences and Sport, Pathfoot Building, University of Stirling, Stirling, UK
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Abstract
AIM Women with gestational diabetes mellitus (GDM) are at increased risk of Type 2 diabetes. This study aimed to explore experiences, knowledge and perceptions of women with GDM to inform the design of interventions to prevent or delay Type 2 diabetes. METHODS Semi-structured interviews were carried out with 16 women with GDM who were recruited from a clinic in one Scottish health board. A framework approach was used to manage and analyse data according to themes informed by psychological theory (self-regulation model and theory of planned behaviour). RESULTS GDM is not seen as an important, or even real diagnosis among some women, and this perception may result from the perceived minimal impact of GDM on their lives. Some women did experience a bigger emotional and practical impact. Knowledge and understanding of Type 2 diabetes was poor in general and many women were unconcerned about their future risk. Lower concern appeared to be linked to a lower perceived impact of GDM. Lifestyle changes discussed by women mostly related to diet and were motivated primarily by concern for their baby's health. Many women did not maintain these changes postnatally, reporting significant barriers. CONCLUSIONS This study has suggested potential avenues to be explored in terms of content, timing and potential recipients of interventions. Educational interventions postnatally could address illness perceptions in women with GDM and redress the situation where lack of aftercare downplays its seriousness. For lifestyle interventions, the child's health could be used as a motivator within the context of later joint or family interventions.
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Affiliation(s)
- C E Eades
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - E F France
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - J M M Evans
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
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Abstract
AIMS Estimates of the prevalence of gestational diabetes vary widely. It is important to have a clear understanding of the prevalence of this condition to be able to plan interventions and health care provision. This paper describes a meta-analysis of primary research data reporting the prevalence of gestational diabetes mellitus in the general pregnant population of developed countries in Europe. METHODS Four electronic databases were systematically searched in May 2016. English language articles reporting gestational diabetes mellitus prevalence using universal screening in general pregnant population samples from developed countries in Europe were included. All papers identified by the search were screened by one author, and then half screened independently by a second author and half by a third author. Data were extracted by one author. Values for the measures of interest were combined using a random effects model and analysis of the effects of moderator variables was carried out. RESULTS A total of 3258 abstracts were screened, with 40 studies included in the review. Overall prevalence of gestational diabetes mellitus was 5.4% (3.8-7.8). Maternal age, year of data collection, country, area of Europe, week of gestation at testing, and diagnostic criteria were found to have a significant univariate effect on GDM prevalence, and area, week of gestation at testing and year of data collection remained statistically significant in multivariate analysis. Quality category was significant in multivariate but not univariate analysis. CONCLUSIONS This meta-analysis shows prevalence of GDM that is at the upper end of previous estimates in Europe.
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Affiliation(s)
- Claire E Eades
- Faculty of Health Sciences and Sport, University of Stirling, United Kingdom.
| | - Dawn M Cameron
- Faculty of Health Sciences and Sport, University of Stirling, United Kingdom
| | - Josie M M Evans
- Faculty of Health Sciences and Sport, University of Stirling, United Kingdom
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Eades CE, Styles M, Leese GP, Cheyne H, Evans JM. Progression from gestational diabetes to type 2 diabetes in one region of Scotland: an observational follow-up study. BMC Pregnancy Childbirth 2015; 15:11. [PMID: 25643857 PMCID: PMC4320450 DOI: 10.1186/s12884-015-0457-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 01/27/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate long-term risk of type 2 diabetes (T2D) following a diagnosis of gestational diabetes and to identify factors that were associated with increased risk of T2D. METHODS An observational cohort design was used, following up all women diagnosed with gestational diabetes mellitus (GDM) attending a Diabetes Antenatal Clinic in the Dundee and Angus region of Scotland between 1994 and 2004 for a subsequent diagnosis of T2D, as recorded on SCI-DC (a comprehensive diabetes clinical information system). RESULTS There were 164 women in the study who were followed up until 2012. One quarter developed T2D after a pregnancy with GDM in a mean time period of around eight years. Factors associated with a higher risk of developing T2D after GDM were increased weight during pregnancy, use of insulin during pregnancy, higher glycated haemoglobin (HbA1c) levels at diagnosis of GDM, and fasting blood glucose. CONCLUSIONS These findings suggest there is a viable time window to prevent progression from GDM to T2D and highlights those women who are at the greatest risk and should therefore be prioritised for preventative intervention.
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Affiliation(s)
- Claire E Eades
- School of Health Sciences, University of Stirling, Stirling, FK9 4LA, UK.
| | - Maggie Styles
- School of Health Sciences, University of Stirling, Stirling, FK9 4LA, UK.
| | - Graham P Leese
- Department of Diabetes and Endocrinolog, Ninewells Hospital and Medical School, DD1 9SY, Dundee, UK.
| | - Helen Cheyne
- Nursing, Midwifery and Allied Health Professions Research Unit, Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF, UK.
| | - Josie Mm Evans
- School of Health Sciences, University of Stirling, Stirling, FK9 4LA, UK.
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Evans JMM, Eades CE, Leese GP. The risk of total mortality and cardiovascular mortality associated with impaired glucose regulation in Tayside, Scotland, UK: a record-linkage study in 214 094 people. BMJ Open Diabetes Res Care 2015; 3:e000102. [PMID: 26405556 PMCID: PMC4577610 DOI: 10.1136/bmjdrc-2015-000102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/03/2015] [Accepted: 06/09/2015] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Mortality among adults of all ages diagnosed with impaired glucose regulation (IGR) in Tayside, Scotland, UK, was evaluated using routinely collected healthcare data sets. RESEARCH DESIGN AND METHODS Using record-linked data in 2003-2008, all instances of blood glucose testing in the population defined 2 cohorts of patients aged 18+years: those with IGR (whether impaired fasting glucose or impaired glucose tolerance (IGT)) according to the WHO criteria, and those who were normoglycemic. They were followed in survival analyses for mortality or cardiovascular mortality (censoring deaths that occurred within a 30-day period of testing), to derive HRs (with 95% CI) for IGR status using Cox regression, adjusted for age, sex, and an area measure of deprivation. RESULTS There were 2 372 712 tests for 214 094 patients, with 196 799 patients in the non-IGR cohort and 50 080 in the IGR cohort. During follow-up, 19 147 (9.7%) and 8397 (16.8%) patients died in 2 cohorts, respectively, with mortality rates of 33.2/1000 patient-years and 70.7/1000 patient-years. In multivariable analyses, the overall adjusted risk of mortality for IGR was 1.16 (95% CI 1.13 to 1.20). However, it was 2.59 (95% CI 2.17 to 3.10) for people aged <45 years, decreasing to 0.94 (95% CI 0.85 to 1.00) in those aged 85+years. The HRs for cardiovascular mortality were lower overall, but they followed the same pattern, with statistically significant increased risks for patients aged <64 years only. The mortality risk was highest among patients with IGT. CONCLUSIONS IGR is associated with an increased mortality risk which declines with age. It is therefore important to prioritize young people with IGR for prevention; but less important to be aggressive about risk factor modification in older people.
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Affiliation(s)
- Josie M M Evans
- School of Health Sciences, University of Stirling , Scotland , UK
| | - Claire E Eades
- School of Health Sciences, University of Stirling , Scotland , UK
| | - Graham P Leese
- Department of Diabetes and Endocrinology , Ninewells Hospital and Medical School , Dundee , UK
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Eades CE, Leese GP, Evans JMM. Incidence of impaired glucose regulation and progression to type 2 diabetes mellitus in the Tayside region of Scotland. Diabetes Res Clin Pract 2014; 104:e16-9. [PMID: 24507868 DOI: 10.1016/j.diabres.2014.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 01/06/2014] [Accepted: 01/08/2014] [Indexed: 11/16/2022]
Abstract
This study assessed incidence of impaired glucose regulation (IGR) and progression to type 2 diabetes (T2D) in adults in one region of Scotland using routinely collected health-care data. Incidence of IGR was 2720 per 100,000 person years. Nine percent of IGR patients progressed to T2D in a mean time of 34 months.
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Affiliation(s)
- C E Eades
- University of Stirling, United Kingdom.
| | - G P Leese
- University of Dundee, United Kingdom
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Eades CE, Ferguson JS, O'Carroll RE. Public health in community pharmacy: a systematic review of pharmacist and consumer views. BMC Public Health 2011; 11:582. [PMID: 21777456 PMCID: PMC3146877 DOI: 10.1186/1471-2458-11-582] [Citation(s) in RCA: 312] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 07/21/2011] [Indexed: 11/29/2022] Open
Abstract
Background The increasing involvement of pharmacists in public health will require changes in the behaviour of both pharmacists and the general public. A great deal of research has shown that attitudes and beliefs are important determinants of behaviour. This review aims to examine the beliefs and attitudes of pharmacists and consumers towards pharmaceutical public health in order to inform how best to support and improve this service. Methods Five electronic databases were searched for articles published in English between 2001 and 2010. Titles and abstracts were screened by one researcher according to the inclusion criteria. Papers were included if they assessed pharmacy staff or consumer attitudes towards pharmaceutical public health. Full papers identified for inclusion were assessed by a second researcher and data were extracted by one researcher. Results From the 5628 papers identified, 63 studies in 67 papers were included. Pharmacy staff: Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Pharmacists' confidence in providing public health services was on the whole average to low. Time was consistently identified as a barrier to providing public health services. Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported by some pharmacists as barriers. A need for further training was identified in relation to a number of public health services. Consumers: Most pharmacy users had never been offered public health services by their pharmacist and did not expect to be offered. Consumers viewed pharmacists as appropriate providers of public health advice but had mixed views on the pharmacists' ability to do this. Satisfaction was found to be high in those that had experienced pharmaceutical public health Conclusions There has been little change in customer and pharmacist attitudes since reviews conducted nearly 10 years previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health.
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Affiliation(s)
- Claire E Eades
- Department of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
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