Health Care Agencies Research Articles

Fall risk screening and balance rehabilitation in elderly: a missing healthcare intervention in Pakistani healthcare system.

Elderly are one of the fastest-growing population globally and require significant healthcare services due to age-related deterioration in physiological systems. Poor postural control due to aging results in impaired balance leading to increase in frequency of falls, poor quality of life, and rise in disability and mortality rates. In Pakistan, due to lack of awareness, and resources, fall prevention and screening programmes for the elderly are lacking. Regular fall risk screening utilizing balance assessment tools, integration of fall prevention programmes and balance rehabilitation approach as part of elderly healthcare services can serve as tools to lower the incidence of falls in the elderly population of Pakistan. Moreover, integration of latest technology as part of balance rehabilitation can also be considered. The review aims to highlight appropriate strategies for fall risk screening and balance rehabilitation in an effort to promote an important healthcare intervention for elderly in Pakistan.

Social Suffering: Indigenous Peoples' Experiences of Accessing Mental Health and Substance Use Services.

In this paper, we present findings from a qualitative study that explored Indigenous people's experiences of mental health and addictions care in the context of an inner-city area in Western Canada. Using an ethnographic design, a total of 39 clients accessing 5 community-based mental health care agencies were interviewed, including 18 in-depth individual interviews and 4 focus groups. Health care providers also were interviewed (n = 24). Data analysis identified four intersecting themes: normalization of social suffering; re-creation of trauma; the challenge of reconciling constrained lives with harm reduction; and mitigating suffering through relational practice. The results highlight the complexities of experiences of accessing systems of care for Indigenous people marginalized by poverty and other forms of social inequity, and the potential harms that arise from inattention to the intersecting social context(s) of peoples' lives. Service delivery that aims to address the mental health concerns of Indigenous people must be designed with awareness of, and responsiveness to, the impact of structural violence and social suffering on peoples' lived realities. A relational policy and policy lens is key to alleviate patterns of social suffering and counter the harms that are unwittingly created when social suffering is normalized.

Paying Family Medical Caregivers for Children’s Home Healthcare in Colorado: A Working Medicaid Model

To compare the characteristics and healthcare use of children with medical complexity who receive paid certified nursing assistant (CNA) care by a family member (family CNA) and by a traditional nonfamily member (nonfamily CNA). This was retrospective cohort study of children who received CNA care through Colorado's Medicaid paid family caregiving program between 2017 and 2019 by a home healthcare agency. We compared patient characteristics between the family CNA and nonfamily CNA groups. A multivariable Poisson regression model was used to compare hospitalization rates (days in the hospital per year), adjusting for patient age patient sex, nursing care, and complex chronic condition. Of 861 patients, 79% (n=680) received family CNA care and 21% (n=181) received nonfamily CNA care. Patient demographics and hospitalization did not differ between the groups, although patients who had family CNAs were less likely to receive additional nursing-level care (42% vs 60%, P<.01). Family and nonfamily CNA caregivers had similar characteristics, except that family CNA caregivers had substantially better 3-year retention (82% vs 9%, P<.01) despite lower average hourly pay ($14.60 vs $17.60 per hour, P<.01). Hospitalizations were rare (<10% of patients). In the adjusted model, patients who received family CNA care experienced 1 more hospitalized day per year, compared with patients who received nonfamily CNA care (P<.001). Paid family caregivers provided CAN-level care to children with medical complexity with a greater employee retention compared with nonfamily CNA caregivers, with marginally different hospitalization rates using a family-centered approach. This model may help address workforce shortages while also providing income to family caregivers.

A three-step optimization-based algorithm for home healthcare delivery

This paper examines the problem of providing healthcare services to patients who reside at various aging, rehabilitation and treatment facilities or who are home bound, and who may require multiple visits per week. To meet this goal, a 3-step algorithm is developed that efficiently constructs weekly schedules for individual providers working through an agency. The objective is to balance a set of metrics that include travel distance, productivity points, daily workload, equity, overtime and the need to accommodate breaks. Additional factors include patient time windows, continuity of care, and nurse skill qualifications, all of which are treated as soft constraints. In Step 1 of the algorithm, we divide locations of requested visits into distinct clusters and assign each visit to a provider. Both k-means clustering and a mixed-integer linear programming model are applied iteratively until no local improvement is possible. In Step 2, a modified traveling salesman problem is formulated and solved for each nurse each day to find optimal schedules and routes. In Step 3, a local search heuristic based on swapping and gap adjustments is developed to improve the solution obtained in Step 2 and to add a lunch break to each schedule. The procedure is tested on instances with up to 20 nurses and 440 requested visits per week with data provided by a national home healthcare agency, and comparisons are drawn with the actual schedules used over several months. Statistical tests verify that the proposed approach offers significantly better schedules for both nurses and patients. We conclude with a sensitivity analysis of the demand–supply ratio to determine its effect on solution quality.

A novel curriculum for the Same-Sex Marriage Act and Patient Right to Autonomy Act (SMPRA) module based on two new laws in Taiwan: a mixed-methods study

BackgroundThe establishment of laws has had a tremendous impact on holistic medical care. The Patient Right to Autonomy (PRA) Act and the Same-Sex Marriage Act have been passed in Taiwan, and both have sparked intense societal debate. The Same-Sex Marriage Act and PRA Act (SMPRA) teaching module was created for the Gender, Medicine, and Law (GML) course of the medical curriculum. This video trigger-assisted problem-based learning (VTA–PBL) software has integrated content on the aforementioned legislative proclamations. It upends conventional beliefs and fosters reflective practices on sexual rights and the right to representation among medical students. This study examined how the SMPRA module affected the knowledge and attitudes of medical students taking up the GML course.MethodsA simple pre-/post-test design evaluated the outcomes of the PBL module to examine the changes in knowledge and attitudes of medical students toward same-sex marriage rights. In 2019 and 2020, 126 and 49 5th-year medical students took up the GML course, respectively. The GML components included a video scenario representing advanced decision-making and a healthcare agency with a same-sex couple, a PBL discussion, and student feedback presentations. The mechanisms of feedback collection and measuring student knowledge and attitudes toward sexual rights differed between one cohort in 2019 and the other in 2020. Pre- and post-lecture tests were used in the first school year, whereas a post-lecture open-ended questionnaire survey was used in the second school year.ResultsIn total, 90 and 39 eligible questionnaires were received in the first and second school years, respectively, which corresponded to response rates of 71% and 80%. Students showed a better understanding of and positive enhancement of proficiency in legal and ethical content and relevant clinical practice. Qualitative analysis revealed that students viewed healthcare providers as checkpoints for conflicts of interest; medical ethics as the cornerstone of clinical practice; cultural background as a significant influence on decision-making; and empathetic communication as the cornerstone of relationships between patients, family members, and doctors.ConclusionThe GML course of the SMPRA module fosters reflective practices on ethical and legal sexual rights issues.

Healthcare Systems across Europe and the US: The Managed Entry Agreements Experience.

This systematic study aims at analyzing the differences between the approach of the European healthcare systems to the pharmaceutical market and the American one. This paper highlights the opportunities and the limitations given by the application of managed entry agreements (MEAs) in European countries as opposed to the American market, which does not regulate pharmaceutical prices. Data were collected from the Organisation for Economic Co-operation and Development (OECD), the European Medicines Agency, and the national healthcare agencies of US and European countries. A literature review was undertaken in PubMed, Scopus, MEDLINE, and Google for a period ten years (2010-2019). The period 2020-2021 was considered to compare health expenditure before and after the SARS-CoV-2 pandemic. Scarce information from national agencies has been given in terms of MEAs related to the COVID-19 pandemic. The comparison between the United States approach and the European one shows the importance of a market access regulation to reduce the cost of therapies, increasing the efficiency of national healthcare systems and the advantages in terms of quality and accessibility to the final users: patients. Nevertheless, it seems that the golden age of MEAs for Europe was during the examined period. Except for Italy, countries will move to other forms of reimbursements to obtain higher benefits, reducing the costs of an inefficient implementation and outcomes in the medium term.

Evaluation of an educational program for people with dementia and their caregivers.

This study evaluated the impact of a 5-week educational and supportive program for people newly diagnosed with dementia and their caregivers. The study involved a pretest-posttest survey followed by interviews. Wilcoxon signed-rank test was conducted to determine postprogram changes. Kruskal-Wallis tests measured variation in responses between the people with dementia and their caregivers. Interviews were analysed using the NVivo software identifying themes against the program objectives of improving knowledge on dementia, coping strategies, communication and support services for people with dementia and their caregivers. Fifty-three dyads (n=106) completed the survey. There were significant improvements in participants' level of understanding of dementia (z=-8.04, p < 0.001), knowledge of local services (z=-8.11, p < 0.001) and coping with life with dementia (z=-6.93, p < 0.001). These findings were consistent with interview data from 16 dyads. The increasing number of people with dementia and their caregivers living in the community present health challenges. Programs that assist this group to function well in the community are important. Evaluation of this program indicated improved outcomes in relation to adjusting to life with dementia, enhancing knowledge, fostering communication and reducing feelings of isolation. Areas of improvement included lengthening the program with ongoing contact sessions with program facilitators and other participants. Given the positive effects of the program on this vulnerable group of people, it maybe useful for health-care agencies involved in dementia care to conduct this type of program as a matter of routine treatment and care for people newly diagnosed with dementia.

Possible adverse effects of low-level laser on oral and oropharyngeal cancer cells: A scope review.

The effects of laser therapy on normal cells are well known and accepted, but the impact of this therapy on malignant cells are not yet fully understood. This review aims to map and outline what the scientific literature addresses on the effects of laser therapy on malignant cells. This review article followed the guidelines of the PRISMA-ScR protocol, being all the search, analysis, and selection of articles based on it. After all application of the predetermined criteria, five studies were included, dated between the years 2013 and 2021. With the complete reading of the selected studies, 100% of the articles were classified as category III of the Agency for Healthcare as Research and Quality classification. Similar themes among the papers included were investigated and compared. In these five studies, the visible red and near infrared wavelengths were used, and energy densities varied between 1 and 5 J/cm2 . It was observed that low-level laser could alter the expression of cell proliferation and migration proteins, such as cyclin D1, E-cadherin, and β-catenin. In addition, changes related to increased cell viability and metabolism were also identified. The low-level laser seems to positively regulate the proliferative, migratory, and viability capacity of neoplastic cells, depending on the protocol used. All these studies included in the review are equivalent to in vitro studies; the cells are not in such a complex environment as is an organized tissue, making it necessary to carry out more complex tests, such as in vivo research.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Kidney Transplant Practice in Pandemic Times: Lessons Learned for the Future.

Metode AdaBoost dan Random Forest untuk Prediksi Peserta JKN-KIS yang Menunggak

The contribution of participants, employers, and/or the government is one of the most important things in the National Health Insurance Program-Healthy Indonesia Card (JKN-KIS) implementation. All Indonesian residents were required to participate in the JKN-KIS program which is divided into four types of participation, one of which is Non-Wage Recipient Participants (PBPU) whose contributions are paid independently. However, based on December 2021 data, 60% of PBPU participants were late in paying monthly until they were in arrears. Arrears in payment of contributions cause several problems, including payment of claims to deficits. This research utilized big data owned by the Healthcare and Social Security Agency (BPJS Kesehatan) and machine learning based on ensemble trees, namely AdaBoost and random forest to get the predictions of participants in arrears. The results showed that machine learning based on an ensemble tree was able to predict PBPU participants in arrears with high accuracy, as evidenced by the AUC values in both models above 80%. The random forest model has an F1-score and the AUC value is better than the AdaBoost, namely the F1-score of 85,43% and the AUC value of 87,20% in predicting JKN-KIS participants who are in arrears in payment of contributions.

1304 LAXATIVES PRESCRIPTION MONITORING FOR AN OVERLOOKED PROBLEM

Abstract Introduction Constipation is a common diagnosis among hospitalized patients. It results in considerable morbidity in elderly patients, healthcare utilization and economic burden. Laxatives are commonly prescribed but poorly monitored due to benign side effect perception. Aim We undertook a review of the quality of laxative prescribing and subsequent monitoring amongst an inpatient cohort. We propose new standards: - Medication review at least once weekly; - Documented rationale for choice of medication - Specified timeframe review and outcome documentation We reviewed current hospital trust policy of laxative prescribing and produced a new constipation management guideline in response to early audit data. Method Data collected across medical wards in Trafford General Hospital, Manchester. Data was collected on types of laxatives, reason for prescription, date of review, length of course, compliance and effect of laxatives. Two rounds of audit were performed 6 months apart, with an interim intervention of staff education and local introduction of a new constipation management guideline. The guideline consisted of decision algorithm and suggested treatment. Results 47 individual prescriptions were audited in round 1 and 72 prescriptions in round 2, this represented 23 and 32 patients respectively. Review of medications within first week of prescription improved from 17% to 83.7% across the two cycles. Documentation of constipation diagnosis improved from 52.2% to 97.2%. There were large percentage improvements in documentation of specified treatment outcomes across all audited fields, despite overall poorer medication compliance among patients in round 2 (56.9% versus 66% in round 1). The average length of laxative use decreased from 18.6 days to 15.3 with overall percentage of patient with constipation resolved increased from 65% in round 1 to 73% in Round 2 Conclusion Staff education and implementation of treatment guidelines made a substantial improvement to the medical management of constipation in hospitalized patients.

Impact of Nutrition Education Intervention Programme On Nutritional Awareness Among Pregnant Women in Ningi Local Government Area of Bauchi State. Nigeria

This study assessed the impact of nutrition education intervention programme on nutritional awareness among pregnant women in Ningi Local Government Area of Bauchi State. Nigeria. The population for this study comprised of thirty-three thousand and thirty-five (33,035) pregnant women in Ningi LGA, Bauchi State. Multi-stage sampling techniques of clustered, simple random sampling, proportionate sampling and systematic sampling technique were used to select one hundred (100) participants as a sample size of the study. Quasi-experimental research design was adopted for this study. The research instrument for the collection of relevant data for this study is a researcher-developed closed-ended questionnaire which is divided into four (4) sections (A, B, C and D) on the adapted General Nutritional Awareness Questionnaire (AGNAQ) developed by Kliemann, Wardle, Jonhson, and Croker (2016). The instrument was validated by five (5) experts in the field of Human Kinetics and Health Education, Public Health and Nursing Science. Reliability index of 0.71 was obtained using split-half method of thirty (30) pregnant women who were attending ANC at the general hospital in the Birnin Kudu Local Government Area of Jigawa State and data collected was subjected to statistical test using Spearman Brown’s Prophecy Formula. Frequency count and percentage were used to describe the described the socio-demographic information of the respondents. Paired sample t-test and independent t-test was used to test formulated null-hypotheses at 0.05 level of significant. The result of the study indicated that there is significant impact of nutrition education intervention programme on nutritional awareness among pregnant women in Ningi LGA, Bauchi State (t-52.723, df: 99; P&lt;0.05); and there is significant difference between the experimental and the control groups after nutrition education intervention programme (t=-39.2, df: 98; P&lt;0.05). It was recommended that Seminar and workshop should be organized periodically to the primary health workers on nutritional education intervention programme during ANC to improves nutritional awareness of pregnant women by optimising collaboration between primary health care agency, government, non-governmental organizations, and maternal and child health service providers.

'Consultas em dia': consultations at the day care center for the elderly.

Gonçalo, a village with 1316 inhabitants of which 573 are 65 years old or older, presents itself as the 'Cradle of Fine Basketry'. Its population, rich in culture and stories to tell, has the support of a day care center for the elderly, where around 20 elderly people spend their days and find social connection. These patients make individual trips to access medical and nursing consultations. Creation of a monthly consultation at the day care center for the elderly patients there. Reduction in the number of individual trips by the elderly patients, through the displacement of the family team;Optimizing the management of each individual health plan with the support of the day center's technical director, including therapeutic management and carrying out complementary diagnostic tests;Observation of the elderly patients in a safer way, avoiding traveling and maintaining a familiar space;Closer ties between the elderly patients and healthcare team; and Training of day care center professionals. At the heart of the practice of a healthcare team is the health and well-being of each patient. Therefore, meeting their needs, reallocating resources and involving the community will lead to health gains. The 'Consultas em Dia' project reflects this same onjective: the need of each elderly person to have access to GP/family nurse consultations joined with the healthcare team's willingness to provide an adapted response. Together we improved access and care delivery … we improved the health of our community!

Efficacy of Virtual Care for Depressive Disorders: Systematic Review and Meta-analysis.

The COVID-19 pandemic has created an epidemic of distress-related mental disorders such as depression, while simultaneously necessitating a shift to virtual domains of mental health care; yet, the evidence to support the use of virtual interventions is unclear. The purpose of this study was to evaluate the efficacy of virtual interventions for depressive disorders by addressing three key questions: (1) Does virtual intervention provide better outcomes than no treatment or other control conditions (ie, waitlist, treatment as usual [TAU], or attention control)? (2) Does in-person intervention provide better outcomes than virtual intervention? (3) Does one type of virtual intervention provide better outcomes than another? We searched the PubMed, EMBASE, and PsycINFO databases for trials published from January 1, 2010, to October 30, 2021. We included randomized controlled trials of adults with depressive disorders that tested a virtual intervention and used a validated depression measure. Primary outcomes were defined as remission (ie, no longer meeting the clinical cutoff for depression), response (ie, a clinically significant reduction in depressive symptoms), and depression severity at posttreatment. Two researchers independently selected studies and extracted data using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Risk of bias was evaluated based on Agency for Healthcare and Research Quality guidelines. We calculated odds ratios (ORs) for binary outcomes and standardized mean differences (SMDs) for continuous outcomes. We identified 3797 references, 24 of which were eligible. Compared with waitlist, virtual intervention had higher odds of remission (OR 10.30, 95% CI 5.70-18.60; N=619 patients) and lower posttreatment symptom severity (SMD 0.81, 95% CI 0.52-1.10; N=1071). Compared with TAU and virtual attention control conditions, virtual intervention had higher odds of remission (OR 2.27, 95% CI 1.10-3.35; N=512) and lower posttreatment symptom severity (SMD 0.25, 95% CI 0.09-0.42; N=573). In-person intervention outcomes were not significantly different from virtual intervention outcomes (eg, remission OR 0.84, CI 0.51-1.37; N=789). No eligible studies directly compared one active virtual intervention to another. Virtual interventions were efficacious compared with control conditions, including waitlist control, TAU, and attention control. Although the number of studies was relatively small, the strength of evidence was moderate that in-person interventions did not yield significantly better outcomes than virtual interventions for depressive disorders.

Counterfactual Decomposition of Health Care Expenditures: From Cost-Based Payment to a Global Budget System

Abstract This study divides health care expenditures into observable effects and structural shifts to explore the impacts of population ageing and high technology on the growth in outpatient service, inpatient service, and prescription drug expenditures in a health care system that has experienced a shift in payment schemes from a cost-based to a global budget system. By using the quantile decomposition method to examine data from Taiwan, the study shows that, in the short run, all expenditures exhibit an increasing trend in the higher percentiles. In the long run, an observable effect dominates the growth of health care expenditures. Specifically, population ageing leads to the growth of prescription drug expenditures in the higher percentiles. The adoption of high technology drives the growth of the top outpatient and inpatient service expenditures. These results suggest that while the government health care agency aims to control health care expenditures, improving the management of high-cost patients is likely to be one important avenue to improving the effectiveness of the cost control policy.

Artificial intelligence in elderly healthcare: A scoping review.

The ageing population has led to a surge in the adoption of artificial intelligence (AI) technologies in elderly healthcare worldwide. However, in the advancement of AI technologies, there is currently a lack of clarity about the types and roles of AI technologies in elderly healthcare. This scoping review aimed to provide a comprehensive overview of AI technologies in elderly healthcare by exploring the types of AI technologies employed, and identifying their roles in elderly healthcare based on existing studies. A total of 10 databases were searched for this review, from January 1 2000 to July 31 2022. Based on the inclusion criteria, 105 studies were included. The AI devices utilized in elderly healthcare were summarised as robots, exoskeleton devices, intelligent homes, AI-enabled health smart applications and wearables, voice-activated devices, and virtual reality. Five roles of AI technologies were identified: rehabilitation therapists, emotional supporters, social facilitators, supervisors, and cognitive promoters. Results showed that the impact of AI technologies on elderly healthcare is promising and that AI technologies are capable of satisfying the unmet care needs of older adults and demonstrating great potential in its further development in this area. More well-designed randomised controlled trials are needed in the future to validate the roles of AI technologies in elderly healthcare.

Contextualizing Diabetes and Obesity Care for Immigrant and Refugee Populations.

Context: Personalized healthcare strategies are recommended for diabetes and obesity. This approach helps to identify and address root causes and barriers to patients' health, and provides them with a sense of agency in healthcare. To develop such strategies for migrant patients, there should be a deeper understanding of their situation. Objective: To understand healthcare gaps and opportunities for enhancing diabetes and obesity care for immigrant and refugee populations in primary care. Study Design, Setting and Population Studied: A community-based research, involving 3 qualitative studies conducted in Edmonton, Alberta. Study participants were: 1) members of ethnocultural communities with diabetes and/or obesity; 2) Multicultural Health Brokers (MCHB) - community health workers (CHW) in these communities; and 3) Healthcare providers (HCP). Data set and Analysis: We generated data through interviews and focus groups. Community member (CM) study had 3 focus groups (two groups of 8 males & females (mixed); one of 13 females); and 22 interviews (5 males, 8 females). MCHB study had 10 interviews (females) and 2 observation sessions. HCP study had 4 focus groups (two groups of 6; 2 groups of 8 mixed) and 9 interviews (2 males, 7 females). Data were thematically analyzed. Outcome Measures: CM study explored lived experiences of diabetes and obesity. HCP study examined experiences with caring for patients with diabetes and obesity from ethnocultural communities. MCHB study examined broker roles in relation to primary care. Results: CM study showed that pre- and post-immigration stressors interact synergistically with the lived experience of diabetes and obesity thereby compounding the adverse disease effects. HCP study showed significant challenges navigating cultural distance and trying to address the non-medical issues of migrant patients. MCHB study illustrated their embeddedness in ethnocultural communities playing an invaluable but largely unrecognized role as partners in primary healthcare. Conclusions: Our findings highlight the challenges of intercultural care in primary care settings. CHWs like the MCHB can provide context for healthcare providers, thereby supporting a personalized and context-informed care that understands the intersecting realities of migrant populations. Collaborations with CHWs in primary care have widespread implications for improving healthcare and reducing health disparities for migrants with diabetes and/or obesity.

Evaluation of the Tinnitus Teleconsulting System's Back-Referral Program for National Health Insurance Patients with Diabetes Mellitus in Primary Care.

One of the techniques available through Social Security healthcare organizations to assist the government in the implementation of social distancing without restricting patients access to particular health treatments is primary healthcare Tinnitus Teleconsulting. The purpose of this research is to gather data on how well the City of South Jakarta's primary medical care Audiology Teleconsulting strategy was implemented during the COVID-19 pandemic. This study uses a qualitative research method and was conducted during November 2022-Mei 2023 at the City of South Jakarta Primary Health Care, the social security agency of health's South Jakarta Branch, and the social security agency of health's Primary Health Care Guarantee Division at the Head Office. Data collection techniques were through Focus Group Discussions, in-depth interviews with key informants, and document review. The results showed that most of the informants already knew the process and output of FKTP Tinnitus Teleconsulting performance; only a few FKTPs did not understand the process and output of policy performance, so even though they acknowledged that they had implemented it, there were no documents recorded in the logbook or electronically recorded patient medical data through the social security agency's health care application. The findings of this study can be used by FKTP and other district or city social security agencies of health to improve the performance achievement of FKTP Tinnitus Teleconsulting implementation.

What Is Dentists’ Role in Modulating Environmental and Epigenetic Determinant in Oral Health of Diabetic Patients?

Background and Purpose: With the unexpectedly rapid increase in the prevalence of types of diabetes worldwide, this chronic disease is no longer being viewed as a systemic health issue, but also treated as the start of the deadly disease. As the sixth complication of diabetes, periodontitis is a chronic inflammatory condition that leads directly and indirectly to a severer condition of diabetes via its underlying mechanisms. Interestingly, both diseases are not been fully identified in their bidirectional relationships by researchers. Thus, healthcare agencies must pay appropriate attention. This literature review paper aims to investigate and discuss dentists’ role in modulating environmental and epigenetic determinants in the oral health of diabetic patients based on the bidirectional relationship between these diseases, their prevalence and how treatment of one disease affects the other. Methods: The authors conducted electronic searches in PubMed, Google Scholar, One Search UofT, ScienceDirect, and the National Library of Medicine. The paper also included gray literature from government resources related to the topic. The paper will review the epidemiology, pathogenesis, and epigenetics of both diabetes and periodontal disease and their functions with each other. Results: The literature has consistently shown that diabetes and periodontal disease have responded to the formation and severity of each other. Patients with pre- and diabetes have potentially higher risks of causing periodontal disease and other complications if adequate diagnosis and treatment are not involved timely. The combination of risk factors, including individual, social, environmental, and genetic, play a crucial role in the development of diabetes and the severity of periodontitis. Conclusions: Based on the results, the collaboration between dentists and other healthcare practitioners is inevitable in the overall development of treatment for both diseases. With the proper and updated knowledge, dentists can benefit patients’ overall physical conditions through strategic intervention in diabetes patients.

Study of health seeking behaviour in parents of children in a population-based childhood visual impairment study in North India - "CHVI 2".

The background of this study is to determine the awareness about health seeking behaviour (HSB) in parents of visually impaired children in a population-based study. The study was conducted in population <16 years in urban area of North India. A total of 20,955 (97.3%) children underwent visual acuity examination. Of these, 789 children were referred to the centrally based clinic with unaided visual acuity <6/12 in any eye for undergoing detailed ophthalmic examination. Along with ocular examination, the parents of these 789 referred children, were interviewed for the questions related to HSB, the most common ocular symptom known to them was redness of eyes followed by watering and diminution of vision, 249 (34.6%) denied for any ocular problem in their children previously, amongst the remaining 469 parents/care takers with any ocular problem, a total of 367 (51.1%) referred children wore glasses and the proportion of parents wearing glasses was similar amongst these children (11.7% fathers and 11% mothers). Amongst the 118 respondents of visually impaired children (presenting visual acuity less than 6/18 in better eye with available correction), 56 (47.5%) denied for any ocular problem in their children previously, of the remaining 62 (52.5%), parents, 58 (93.5%) had consulted various healthcare agencies, 45.8% of the respondents reported not said that their children wore glasses prescribed to them. Only 24 (20.3%) respondents were aware that Vitamin A is good for eye health. Diminution of vision, watering and redness of eyes were the most common ocular symptoms known to parents of referred children. HSB can be further improved via primary healthcare physicians by primary healthcare creating awareness about importance of wearing glasses and healthy diet in parents of visually impaired children.