Desired Health Outcomes Research Articles

Identifikasi Drug Related Problems Pada Pasien Penyakit Ginjal Kronis Di Rumah Sakit Prof. dr. Chairuddin Panusunan Lubis Tahun 2023

Chronic kidney disease (CKD) is an abnormality of kidney structure or function, present for ≥ 3 months, with implications for health. The high number of medications used by CKD patients can increase the potential for Drug-Related Problems (DRPs) which can interfere with desired health outcomes. This study aimed to determine the occurrence of DRPs in chronic kidney disease patients admitted to Prof. dr. Chairuddin Panusunan Lubis Hospital in 2023. This study was a descriptive retrospective cross-sectional study conducted. Data were obtained from the medical records of CKD inpatients in 2023 (n=51). The sampling technique used was total sampling. The occurrence of DRPs was identified based on the Pharmaceutical Care Network Europe (PCNE) V9.1 classification, which includes problems categories (P1-P3) and causes (C1-C6). There were 28 females (54.90%) and 23 males (45.10%), with an average age of 46.8±11.5 years. The highest stage of CKD was stage 5 (78.43%). The most common comorbid condition was anemia (84.31%), with the most frequently used medication being antihypertensives in the Calcium Channel Blocker class (88.24%). Among the 51 medical records, 21 (41,17%) showed the occurrence of DRPs, consisting of 26 Problems (P) categorized under P1. Treatment effectiveness (46,15%) and P2. Treatment safety (53,85%), and 26 Causes (C) categorized under C1. Drug selection (57,69%) and C3. Dose selection (42,31%). Drug-Related Problems (DRPs) occurred in chronic kidney disease patients admitted to Prof. dr. Chairuddin Panusunan Lubis Hospital in 2023.

Determinants Of Adherence To Anti-Glycaemic Drugs Among Patients With Diabetes Attending A Diabetic Clinic Of A Tertiary Hospital In South-South, Nigeria

INTRODUCTION: Adherence to anti-glycaemic drugs are important to achieve optimal glycaemic control and desirable patient health outcomes. Poor adherence could increase diabetic-related morbidities and mortality. This study aimed to assess adherence to anti-glycaemic drugs and its determinants among patients with diabetes who attended the diabetic clinic in the University of Calabar Teaching Hospital, Calabar, Nigeria from January 2018 to December 2021. METHODS: Cross-sectional descriptive study design was used. Systematic sampling technique was used to select 167 study participants. Adherence to diabetic treatment was determined through self-reports of how patients had been taking their medications within the past one week before the interview. Data was analysed using SPSS version 25.0, p-value set at 0.05 and Confidence Interval was set at 95%. RESULTS: of the 167 patients studied, 46.1% were males while 53.9% were females. The prevalence of adherence to anti-glycaemic medication was 61.7%. Forgetfulness, side effects of drugs, feeling that the dose is high, multiple drugs, how/when to take the drug, type of medication and comorbidities were significantly associated with adherence. Binary logistic regression showed that forgetfulness, side effects and comorbidities were significant determinants of adherence. CONCLUSION: There is need for targeted interventions to promote adherence to anti-glycaemic drugs.

Strategies and Determinants of Knowledge Management and Sharing in Healthcare Organizations: A Narrative Review

Background. Effective and efficient sharing of knowledge in health care can lead to the clarification of health data and dissemination of up-to-date health information among employees, decision-makers, and other stakeholders, thereby improving the probability of occurrence of desirable health outcomes. The current study aimed to identify the determinants of effective knowledge management and sharing in healthcare. Methods. This study was conducted to identify the facilitators and barriers of knowledge sharing in healthcare and also identify successful strategies in this field using the approach of review studies in 2023. A thorough literature review was conducted using relevant keywords in PubMed, Scopus, and SID databases and the Google Scholar search engine. Data extraction was done by two researchers using the data extraction table. The content analysis method was used to analyze the data. Results. Reviewing 21 studies revealed 176 determinants of knowledge management and sharing in healthcare organizations. Among the determining factors, 96 were facilitators, and 80 were barriers to knowledge sharing. After removing duplicate factors and merging similar cases, 54 facilitators and 55 barriers were obtained uniquely. The determining factors were classified into four categories: organizational factors, infrastructure factors, individual factors, and factors related to the information system. Also, 35 effective strategies for knowledge management in healthcare organizations were identified, the most important of which was related to the empowerment of managers in information technology (IT). Conclusion. The success of knowledge sharing in healthcare requires a strong IT infrastructure, supportive leadership, an organizational culture that governs knowledge development, commitment and cooperation among healthcare team members, and effective knowledge management.

Association between Social Demographic Factors and Health Literacy in Jordan

The study highlights that low health literacy is a serious global health threat, causing health problem denial, poor communication with healthcare providers, and widening disparities. It aims to investigate how income, education, and socio-economic status affect health literacy levels. The study conducted an occasional design using quantitative data. This study was conducted using a structured questionnaire to obtain information from 413 randomly selected Ammani residents The questions were designed to assess the impact of health literacy level. The study's quantitative results show that socio-economic factors are the reasons for the health literacy among Amman residents, based on the 413 sample. Although gender only shows little differences, age, income, and education greatly affect health literacy, with those aged 30-60, higher income earners, and people with higher education levels having better understanding. It is necessary to design health literacy interventions for different demographic groups so as to eliminate the disparities and to get the so desired health outcomes. This study assesses the association between social demographic factors and health literacy in Jordan and found the level of literacy affected by social and economic factors, but in varying proportions for each topic with some recommendations.

Leveraging implementation science for secondary prevention of cervical cancer in South Africa

Aim Cervical cancer is the second most common cancer and the top cause of cancer deaths amongst women in South Africa. Evidence-based interventions for secondary prevention of cervical cancer (cervical screening followed by treatment of identified pre-cancerous lesions) are available in South Africa’s health system, yet cervical cancer incidence remains high. This paper argues that this is partly due to implementation failure, i.e., deploying a good intervention ineffectively. Interventions found efficacious in controlled research settings may not achieve desired health outcomes when deployed in the real world due to implementation failure. Methods The field of implementation science offers frameworks for enhancing effective implementation. These frameworks guide the identification of implementation barriers and selection of context-relevant strategies for addressing them. This paper applies implementation science frameworks to secondary prevention in South Africa and promotes using such frameworks in cervical cancer prevention programming. Findings The problem of secondary prevention of cervical cancer in South Africa is contextualised. The paper conceptualises effective implementation as the attainment of implementation outcomes including acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, reach, and sustainability of evidence-based interventions. Drawing from the South African literature, examples of ineffective and failed implementation of secondary prevention interventions are presented including: low acceptability of screening by users and providers, sub-optimal adoption of screening provision by providers, low feasibility of hospital-centred pre-cancer treatment provision, low implementation fidelity, and limited reach of screening and pre-cancer treatment. Finally, using two examples, the paper provides practical guidance on how implementation science frameworks could be leveraged in South Africa to mitigate implementation failure. Conclusions Greater application of and capacity building in implementation science are recommended to contribute towards strengthening cervical cancer secondary prevention in South Africa.

Development of quality indicators for hypertension, extractable from the electronic health record of the general practitioner: a rand-modified Delphi method

BackgroundHypertension, a chronic medical condition affecting millions of people worldwide, is a leading cause of cardiovascular diseases. A multidisciplinary approach is needed to reduce the burden of the disease, with general practitioners playing a vital role. Therefore, it is crucial that GPs provide high-quality care that is standardized and based on the most recent European guidelines. Quality indicators (QIs) can be used to assess the performance, outcomes, or processes of healthcare delivery and are critical in helping healthcare professionals identify areas of improvement and measure progress towards achieving desired health outcomes. However, QIs to evaluate the care of patients with hypertension in general practice have been studied to a limited extent. The aim of our study is to define quality indicators for hypertension in general practice that are extractable from the electronic health record (EHR) and can be used to evaluate and improve the quality of care for hypertensive patients in the general practice setting.MethodsWe used a Rand-modified Delphi procedure. We extracted recommendations from European guidelines and assembled them into an online questionnaire. An initial scoring based on the SMART principle and extractability from the EHR was performed by panel members, these results were analyzed using a Median Likert score, prioritization and degree of consensus. A consensus meeting was set up in which all the recommendations were discussed, followed by a final validation round.ResultsOur study extracted 115 recommendations. After analysis of the online questionnaire round and a consensus meeting round, 37 recommendations were accepted and 75 were excluded. Of these 37 recommendations, 9 were slightly modified and 4 were combined into 2 recommendations, resulting in a list of 35 recommendations. All recommendations of the final set were translated to QIs, made up of 7 QIs on screening, 6 QIs on diagnosis, 11 QIs on treatment, 5 QIs on outcome and 6 QIs on follow-up.ConclusionsOur study resulted in a set of 35 QIs for hypertension in general practice. These QIs, tailored to the Belgian EHR, provide a robust foundation for automated audit and feedback and could substantially benefit other countries if adapted to their systems.

Metatranscriptomic analysis indicates prebiotic effect of isomalto/malto-polysaccharides on human colonic microbiota in-vitro

Isomalto/malto-polysaccharides (IMMPs) are a novel type of soluble dietary fibres with a prebiotic potential promoting growth of beneficial microbes in the gut. However, the mode of action of IMMPs remains unknown. Previous studies on IMMPs showed an increase in total bacteria, especially lactobacilli, and higher production of short chain fatty acids (SCFA) when IMMPs were fed to rats or used during in vitro fermentation. Here we used metatranscriptomics to investigate how IMMPs with different amounts of α − (1 → 6) glycosidic linkages affected microbial function during incubation with human fecal inoculum. We showed that active microbial community dynamics during fermentation varied depending on the type of IMMP used and that the observed changes were reflected in the community gene expression profiles. Based on metatranscriptome analysis, members of Bacteroides, Lactobacillus and Bifidobacterium were the predominant degraders of IMMPs, and the increased gene expression in these bacteria correlated with high amounts of α − (1 → 6) glycosidic linkages. We also noted an increase in relative abundance of these bacteria and an activation of pathways involved in SCFA synthesis. Our findings could provide a baseline for more targeted approaches in designing prebiotics for specific bacteria and to achieve more controlled modulation of microbial activity towards desired health outcomes.

The Patient's Perspective: Does It Align with Dialysis Adequacy?

The concept of patient-centered care puts the individual's health needs and desired health outcomes as the driving forces behind medical decision-making and quality assessment in the healthcare system. Patients with end-stage kidney disease (ESKD) treated by hemodialysis require frequent encounters with the dialysis facility in order to survive. Therefore, their satisfaction with care and perceived patient experience are important aspects that might impact their adherence to the care regimen. The aim of this study was to evaluate patient satisfaction and its association with perceived patient experience and objective clinical quality parameters, across three hemodialysis clinics. A prospective cohort study analyzed the data of 126 patients with ESKD receiving chronic hemodialysis over 9 months in 3 different care facilities. Sociodemographic characteristics, medical history, treatment details, and dialysis adequacy (measures as STDKt/V) were collected. Perceived quality of care, patient satisfaction and clinical outcomes were assessed. Patients differed significantly between sites by age, diabetes status and biochemical parameters. Satisfaction scores varied significantly for 12/14 survey questions and at the site-level, with Site 2 scoring highest. Overall satisfaction did not correlate with Kt/V. At Site 1, a moderate negative correlation was found between satisfaction and Kt/V. Kt/V correlated positively with age but inversely with satisfaction. Hospitalization rates were similar regardless of satisfaction. Mortality trended lower in the highest Kt/V quartile. Achieving clinical quality while optimizing patient satisfaction requires multifactorial approaches tailored to the unique population of the hemodialysis facility. Further research is needed to fully understand factors influencing satisfaction and perceived quality.

Building on Strong Foundations: Deploying Enhanced Replicating Effective Programs for evidence-based prevention curriculum adaptation.

Schools frequently adopt new interventions for each new public health issue, but this is both time- and resource-intensive. Adversity exposure is an example of a pervasive public health issue that emerged during Coronavirus Disease 2019 (COVID-19) with notable consequences, including an elevated risk of developing substance use disorders and mental illnesses. Adapting existing, universal, evidence-based interventions, such as the Michigan Model for HealthTM (MMH), by incorporating trauma-sensitive content is a promising approach to meet this need. We examined critical steps in promoting MMH adaptability as part of the Enhanced REP (Replicating Effective Programs) implementation strategy during the COVID-19 pandemic. We share usability testing from the 2020 to 2021 school year and describe how we apply the results to inform the group randomized trial pilot study. We applied key steps from implementation adaptation frameworks to integrate trauma-sensitive content as COVID-19 unfolded, documenting the process through field notes. We conducted initial usability testing with two teachers via interviews and used a rapid qualitative analysis approach. We conducted member checking by sharing the information with two health coordinators to validate results and inform additional curriculum refinement. We developed an adapted MMH curriculum to include trauma-sensitive content, with adaptations primarily centered on adding content, tailoring content, substituting content, and repeating/reinforcing elements across units. We designed adaptations to retain the core functional elements of MMH. Building foundational relationships and infrastructure supports opportunities to user-test intervention materials for Enhanced REP that enhance utility and relevance for populations that would most benefit. Enhanced REP is a promising strategy to use an existing evidence-based intervention to meet better the needs of youth exposed to adversity. Building on the foundations of existing evidence-based interventions, is vital to implementation success and achieving desired public health outcomes.

PATIENT SAFETY GOALS, AFRICA: DEVELOPMENT OF A CONTEXT FITTING TOOL FOR PATIENT SAFETY AND CARE QUALITY ASSESSMENT IN AFRICA USING THE DECIDE(HUMAN FACTORS) MODEL.

Patient safety practice refers to processes or structures which when applied, reduce the probability of adverse events resulting from exposure to the healthcare system across a range of diseases and procedures. It aims at making health care safer for both clients and staff (Kohn, Corrigan, & Donaldson, 2000). It is “A framework of organized activities that createcultures, processes, procedures, behaviours, technologies and environments in health care that consistently and sustainably lower risks, reduce the occurrence of avoidable harm, make errors less likely and reduce the impact of harm when it does occur.” (WHO, 2021). Quality of care is “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (IOM, 1990 and ahrq.gov., 2016). Healthcare quality is a level or value provided by any healthcare resource, as determined by some measurement (Maxwell, 1984).As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. Other definitions of healthcare quality include: “the degree of conformity with accepted principles and practices (standards), the degree of satisfying the patient’s needs, and the degree of attainment of acceptable outcomes, while making appropriate use of resources.” The Joint Commission defines care quality as “the optimal achievement of therapeutic benefit and avoidance of risk and minimization of harm”. Care quality is also referred to as freedom from deficiencies and therefore less costly because deficiencies which often lead to customer dissatisfaction require additional costs to manage them. Quality care conforms to relevant requirements or standards - the needs and expectations of clients or patients.

The Effects of Stigma Against HIV and Tuberculosis on Healthcare-Seeking Behavior Among Tibetan Refugees in Dharamshala, India

Patients who experience more severe symptoms of Ulcerative Colitis are associated with having greater socioeconomic challenges or higher social barrier scores (SBS). Inflammatory Bowel Disease describes two conditions, Ulcerative Colitis and Crohn's Disease, characterized by gastrointestinal (GI) tract inflammation. Ulcerative Colitis is a type of Inflammatory Bowel Disease (IBD) characterized by large intestine inflammation. Research has shown that multiple social determinants of health (SDOH) hinder achieving desirable health outcomes in the Inflammatory Bowel Disease community. These include financial strains, poor health literacy, and lack of access to education. Additionally, social barriers disproportionately affect non-Hispanic Black and Hispanic people.

The Effect of Socioeconomic Barriers on Health Outcomes in Patients with Inflammatory Bowel Disease

Patients who experience more severe symptoms of Ulcerative Colitis are associated with having greater socioeconomic challenges or higher social barrier scores (SBS). Inflammatory Bowel Disease describes two conditions, Ulcerative Colitis and Crohn's Disease, characterized by gastrointestinal (GI) tract inflammation. Ulcerative Colitis is a type of Inflammatory Bowel Disease (IBD) characterized by large intestine inflammation. Research has shown that multiple social determinants of health (SDOH) hinder achieving desirable health outcomes in the Inflammatory Bowel Disease community. These include financial strains, poor health literacy, and lack of access to education. Additionally, social barriers disproportionately affect non-Hispanic Black and Hispanic people.

Influencing Hospital Employee Communication Behaviors for Desirable Maternal Health Outcomes in Ghana: An Extension of the Microboundary Spanning Theory

ABSTRACT Strategic internal communication management in healthcare settings may improve maternal care and maternal health outcomes, especially in low-income countries. The study examines how hospital internal communication managers in Ghana strategically influence employee communication behaviors for positive maternal health outcomes using the microboundary spanning theory. Twenty-three hospital internal communication managers were interviewed. Findings reveal that strategies hospital internal communication managers use to influence employee communication behaviors and enhance positive patient-provider communication include employee training programs, provision of timely information, maintaining open lines of communication, provision of essential resources, monitoring and informal surveys, utilizing the grapevine, organizing pregnancy schools and use of infographics produced in multiple Ghanaian languages. The study demonstrates that positive employee megaphoning and scouting behaviors can have financial and prosocial benefits, including enhancing patient healthcare experiences, encouraging women to seek maternal care, and ultimately improving maternal health outcomes. Finally, the study extends the microboundary spanning theory to include employee mandatory communication that occurs in healthcare settings and is the first such study to be conducted in Ghana.

Efficacy of interventions and techniques on adherence to physiotherapy in adults: an overview of systematic reviews and panoramic meta-analysis

BackgroundAdherence to physiotherapeutic treatment and recommendations is crucial to achieving planned goals and desired health outcomes. This overview of systematic reviews synthesises the wide range of additional interventions and behaviour change techniques used in physiotherapy, exercise therapy and physical therapy to promote adherence and summarises the evidence of their efficacy.MethodsSeven databases (PEDro, PubMed, Cochrane Library, Web of Science, Scopus, PsycINFO and CINAHL) were systematically searched with terms related to physiotherapy, motivation, behaviour change, adherence and efficacy (last searched on January 31, 2023). Only systematic reviews of randomised control trials with adults were included. The screening process and quality assessment with AMSTAR-2 were conducted independently by the two authors. The extracted data was synthesised narratively. In addition, four meta-analyses were pooled in a panoramic meta-analysis.ResultsOf 187 reviews identified in the search, 19 were included, comprising 205 unique trials. Four meta-analyses on the effects of booster sessions, behaviour change techniques, goal setting and motivational interventions showed a significantly small overall effect (SMD 0.24, 95% CI 0.13, 0.34) and no statistical heterogeneity (I2 = 0%) in the panoramic meta-analysis. Narrative synthesis revealed substantial clinical and methodological diversity. In total, the certainty of evidence is low regarding the efficacy of the investigated interventions and techniques on adherence, due to various methodological flaws. Most of the RCTs that were included in the reviews analysed cognitive and behavioural interventions in patients with musculoskeletal diseases, indicating moderate evidence for the efficacy of some techniques, particularly, booster sessions, supervision and graded exercise. The reviews provided less evidence for the efficacy of educational and psychosocial interventions and partly inconsistent findings. Most of the available evidence refers to short to medium-term efficacy. The combination of a higher number of behaviour change techniques was more efficacious.ConclusionsThe overview of reviews synthesised various potentially efficacious techniques that may be combined for a holistic and patient-centred approach and may support tailoring complex interventions to the patient’s needs and dispositions. It also identifies various research gaps and calls for a more holistic approach to define and measure adherence in physiotherapy.Systematic review registrationPROSPERO CRD42021267355.

Drinking Orange Juice or Eating Orange Fruit: Which is Better for Glycemic Control?

The consumption of 100% fruit juice has been a subject of controversy due to abundance of free sugars leading to inconsistent dietary guidelines. This study aimed to verify the hypothesis if eating whole fruit scores better than drinking fruit juices in terms of glycemic control. 15 type-2 diabetic patients volunteered from author’s online Diabetes Reversal Program to participate in the observational study. The relative effect of consumption of 300-ml orange FJ and 300-gram whole orange fruit on glycemic control was compared to verify the hypothesis. The findings of the study suggested that the consumption of oranges (whether juiced or eaten whole) is safe and well tolerable for diabetics and does not substantially raise the blood glucose levels in the average diabetic, however, individualized dietary modification would be the optimal practice to achieve desired health outcomes.

Mobile Apps for Common Noncommunicable Disease Management: Systematic Search in App Stores and Evaluation Using the Mobile App Rating Scale.

The success of mobile apps in improving the lifestyle of patients with noncommunicable diseases through self-management interventions is contingent upon the emerging growth in this field. While users of mobile health (mHealth) apps continue to grow in number, little is known about the quality of available apps that provide self-management for common noncommunicable diseases such as diabetes, hypertension, and obesity. We aimed to investigate the availability, characteristics, and quality of mHealth apps for common noncommunicable disease health management that included dietary aspects (based on the developer's description), as well as their features for promoting health outcomes and self-monitoring. A systematic search of English-language apps on the Google Play Store (Google LLC) and Apple App Store (Apple Inc) was conducted between August 7, 2022, and September 13, 2022. The search terms used included weight management, obesity, diabetes, hypertension, cardiovascular diseases, stroke, and diet. The selected mHealth apps' titles and content were screened based on the description that was provided. Apps that were not designed with self-management features were excluded. We analyzed the mHealth apps by category and whether they involved health care professionals, were based on scientific testing, and had self-monitoring features. A validated and multidimensional tool, the Mobile App Rating Scale (MARS), was used to evaluate each mHealth app's quality based on a 5-point Likert scale from 1 (inadequate) to 5 (excellent). Overall, 42 apps were identified. Diabetes-specific mHealth apps accounted for 7% (n=3) of the market, hypertension apps for 12% (n=5), and general noncommunicable disease management apps for 21% (n=9). About 38% (n=16) of the apps were for managing chronic diseases, while 74% (n=31) were for weight management. Self-management features such as weight tracking, BMI calculators, diet tracking, and fluid intake tracking were seen in 86% (n=36) of the apps. Most mHealth apps (n=37, 88%) did not indicate whether there was involvement of health professionals in app development. Additionally, none of the apps reported scientific evidence demonstrating their efficacy in managing health. The overall mean MARS score was 3.2 of 5, with a range of 2.0 to 4.1. Functionality was the best-rated category (mean score 3.9, SD 0.5), followed by aesthetics (mean score 3.2, SD 0.9), information (mean score 3.1, SD 0.7), and engagement (mean score 2.9, SD 0.6). The quality of mHealth apps for managing chronic diseases was heterogeneous, with roughly half of them falling short of acceptable standards for both quality and content. The majority of apps contained scant information about scientific evidence and the developer's history. To increase user confidence and accomplish desired health outcomes, mHealth apps should be optimized with the help of health care professionals. Future studies on mHealth content analysis should focus on other diseases as well.

Understanding social dynamics and patient experience in out of hospital care: validation of a co-responsibility questionnaire (CoReCare)

Patient experiences are commonly assessed through patient reported experience measures (PREMs). Ambulatory care models extend traditional care into the patients’ home, meaning that a triangle of health care professionals, patients, and their families need to be considered when assessing the remote care experience. These intertwined responsibilities are described by co-responsibility. Currently, PREMs don’t reflect how elements to remote care impact this remote care experience. Therefore, this study aimed to develop a questionnaire assessing perceived patient-partner co-responsibility as a PREM in remote care. A 30-item questionnaire was assessed among 1000 individuals aged between 18 and 65 years that tried to lose weight with a partner, friend or family member supporting them. Pairwise item correlations, Exploratory Factor Analysis, and Cronbach’s alpha were used for validation. 29-items were identified to reflect co-responsibility across 6 factors: empowerment and support, relational aspects, lack of sympathy, co-participation, accepting help and awareness. Cronbach’s alpha ranged between 0.66 and 0.93, showing good internal consistency. We present a validated CoReCare Questionnaire to understand the impact of social dynamics on achieving desired health outcomes in a remote care setting. The CoReCare Questionnaire extends current PREMs when aiming to assess and improve the patient experience of a care episode outside of the hospital.

Prioritizing Patient Experiences in the Management of Diabetes and Its Complications: An Endocrine Society Position Statement.

Diabetes can be an arduous journey both for people with diabetes (PWD) and their caregivers. While the journey of every person with diabetes is unique, common themes emerge in managing this disease. To date, the experiences of PWD have not been fully considered to successfully implement the recommended standards of diabetes care in practice. It is critical for health-care providers (HCPs) to recognize perspectives of PWD to achieve optimal health outcomes. Further, existing tools are available to facilitate patient-centered care but are often underused. This statement summarizes findings from multistakeholder expert roundtable discussions hosted by the Endocrine Society that aimed to identify existing gaps in the management of diabetes and its complications and to identify tools needed to empower HCPs and PWD to address their many challenges. The roundtables included delegates from professional societies, governmental organizations, patient advocacy organizations, and social enterprises committed to making life better for PWD. Each section begins with a clinical scenario that serves as a framework to achieve desired health outcomes and includes a discussion of resources for HCPs to deliver patient-centered care in clinical practice. As diabetes management evolves, achieving this goal will also require the development of new tools to help guide HCPs in supporting PWD, as well as concrete strategies for the efficient uptake of these tools in clinical practice to minimize provider burden. Importantly, coordination among various stakeholders including PWD, HCPs, caregivers, policymakers, and payers is critical at all stages of the patient journey.

Meeting muscle-strengthening recommendation is associated with lower adiposity, higher physical fitness and healthier lifestyle in adolescents: The EHDLA study.

To determine the prevalence of adolescents who meet muscle-strengthening activities (MSA) recommendation and their associations with anthropometric variables, physical fitness, and lifestyle behaviours in a sample of Spanish adolescents aged 12-17 years. This was a cross-sectional study using data from The Eating Healthy and Daily Life Activities (EHDLA) Study. Participants reported the days on which they engaged in MSA (≥3 days per week were considered to meet World Health Organization recommendation). Physical fitness was assessed with the ALPHA fitness battery. Additionally, body mass index, waist circumference, skinfolds and body fat percentage were assessed. Lifestyle variables were recreational screen time, sleep time and adherence to the Mediterranean diet. The associations between MSA and outcome variables were tested with linear and logistic regressions. Of the 852 participants, 48% met MSA recommendation. Meeting MSA recommendation was associated with lower adiposity and higher performance in the shuttle run test, maximal oxygen consumption, standing long jump, speed-agility, flexibility, lower screen time (in weekdays) and higher adherence to the Mediterranean diet. Engaging in MSA once or twice a week was linked with more desirable health outcomes than not engaging in such activities. However, meet with MSA recommendation (i.e., at least 3 days per week) reinforced these benefits.

Development and usability evaluation of a culturally adapted stroke prevention educational programme on WeChat apps.

The persistently high incidence of stroke in many nations is suggestive of an area for further improvement on existing strategies of primary stroke prevention. Although the era of digitalisation has led to the increasing use of mobile applications (apps) in healthcare, more studies are needed to determine the efficacy of apps in producing the desired health outcomes across different nations and cultures. To describe the development and evaluate the usability of a mobile app in delivering a culturally adapted stroke prevention educational programme for middle-aged adults in the Republic of China. The educational programme was developed in three phases. In Phase 1, the process involved analysing requirements and designing structured modules. Phase 2 concentrated on expert consultation and technical development to deliver the educational programme. Phase 3 included a usability trial and refinement of the educational program based on trial results. Educational content was derived from the Chinese Guidelines for the Prevention and Treatment of Stroke and the Dietary Guidelines for Residents. The WeChat platform was used to deliver the educational programme. Participants expressed satisfaction with the content, interface, and functions of the apps, indicating that the apps have good usability. The development process of the Educational Programme was designed to maximise the culturally appropriate, and impact of lifestyle changes and stroke prevention. An app-based educational programme that has demonstrated good usability is a vital factor prior to deploying it in an intervention to evaluate its effects on health outcomes.