Sunday, January 26, 2020

Demographic Profile of Diabetic Patients

Demographic Profile of Diabetic Patients INTRODUCTION Background of the Study In the last few decades, the world prevalence of diabetes among adults have increased more than twice, and expected to ascend to 380 million by 2030, according to a report from the InternationalDiabetes Institute.1 About 3.4 million, roughly 4.6 percent of the total population in the Philippines are diabetics. This figure is expected to rise to 7.8 million in the next 15 years.2 Despite such high incidence, awareness on diabetes, its complications and treatment remain major challenges, particularly in developing countries such as the Philippines. Prevention through patient education is imperative because the burden of disease on healthcare and its economic implications are of great magnitude. There is a significant amount of evidence that patient education is one of the most effective way to lessen the complications of diabetes. 3,4,5,6 When coupled with appropriate medications, it is associated with decreased morbidity and mortality.3 Patient education is more likely to be effective if we know the characteristic of the patients in terms of what they know about their disease, their attitude towards it and what they practice in their medications, diet and lifestyle. Very few studies has been made on our country to find the prevailing awareness, attitudes and practices among diabetic patients, 7,8,9 which can aid in the development of future health education interventions targeting the disease. In this study, we will determine the demographic characteristics of diabetic patients consulting at the Diabetes Clinic of a tertiary hospital in Davao City and assess their level of knowledge, attitude and practices (KAP) towards Diabetes Mellitus (DM) and the relationship of KAP and glycemic control among type 2 diabetic patients in an urban health care facility. REVIEW OF RELATED LITERATURE In the Philippines, the prevalence of diabetes according to the NNHES (National Nutrition Health Survey) study is approximately 4.6-7.2%. This figure expands to 17.8% after adding those who have pre-diabetes (impaired fasting glucose or impaired glucose tolerance or both) which has a prevalence of 10.6%. 2Therefore, one out of every 5 Filipino could potentially have diabetes mellitus or pre-diabetes. As such, the increasing trend of its incidence rate is causing alarm among medical practitioners, and among affected patients as well. In the context of an alarming increase in the magnitude of type 2 diabetes mellitus in our country, the prevailing knowledge, attitudes and practices of these diabetic patients assume immense importance in the control of the disease. Across the globe, a number of studies have been done about perception and practice of diabetic patients10-14, especially in third world countries. An Indian study made by Mukhopadhyay, et al 2010, looked into the perceptions and practices of patients with Diabetes Mellitus Type II in a tertiary hospital.11 In the Philippines, a similar study was done in the rural community of San Juan, Batangas, Philippines. A total of 156 diabetic residents were included as participants of the survey. Knowledge scores were relatively low, with an overall mean of 43%. There were also poor positive responses to attitude scale. The study emphasized the importance of evaluating knowledge, attitudes and practices as crucial means to understand observed behaviors and guide behavioral change.7 According to the American Diabetic Association, self management education is defined as the process of providing the person with diabetes the knowledge and skill that is needed to perform self care, manage immediate concerns and make life style changes. 3 To achieve such effective self care, diabetic patients and their doctors should work hand-in-hand together. Some studies have shown that self-care among individuals with type 2 diabetes had improved glycemic control and reduced complications 15, 16, 17. For people with diabetes, self-management education training is vital since diabetics and their families provide most of their care themselves. It is imperative that regular patient counseling and group education at follow-up visits by health care professionals to help in improving patients’ knowledge and ultimately modify their practices. 19 However, in our setting, adequate diabetes self-management education programs are lacking or weak in most government hospitals in tertiary care. Hence, results of this study could help us design our education programs targeting certain groups or issues that needs further strengthening. Research Question What is the level of knowledge, attitudes, and practices and its association with glycemic control among persons with type 2 diabetes in the Diabetes Clinic of Southern Phiilppines Medical Center? Significance of the Study The study will contribute to the understanding of the current status of diabetes care in our local setting, and help in the implementation of programs that would address pressing needs in our patient education and management, based on their knowledge, attitude and practices. It will also help us identify the association of KAP and glycemic control, and further assess the impact of diabetes self-management in disease control. Objectives: General Objective: 1. To determine the knowledge, attitudes, and practices of patients with type 2 diabetes in the Diabetes clinic of a tertiary hospital. Specific Objectives: To determine the demographic profile of the diabetic patients in the Diabetic clinic of a tertiary hospital in Davao City, in terms of : Age Gender Highest level of educational attainment Employment status Duration of diabetes Antidiabetic medications Co-morbidities To determine the association between patient factors such as age, sex, level of education, employment status, duration of diabetes, antidiabetic medications and co-morbidities and their level of knowledge, attitudes, and practices (KAP) regarding diabetes To establish the association between the patients’ KAP and their corresponding glycemic control based on HBA1c levels METHODOLOGY Research Design: The study will employ a clinic-based, cross-sectional analytic study design. Research Setting: This study will be conducted at the Diabetes outpatient clinic of a tertiary hospital in Davao City, from May 2014 to June 2014. Participants: All patients who are diagnosed with type 2 Diabetes Mellitus type 2 (T2 DM) who are seeking consult at the Diabetes Clinic in a tertiary hospital for the period of May to June 2014. Inclusion Criteria: Patients must be a diagnosed case of Diabetes Mellitus type 2 based on the following criteria: Plasma glucose > 126 mg/dL (7.0 mmol/L) after an overnight fast Fasting is defined as no caloric intake for at least 8 hours up to a maximum of 14 hours, or Two-hour plasma glucose > 200 mg/dl (11.1 mmol/l) during an Oral Glucose Tolerance Test The test should be performed as described by the World Health Organization, using a glucose load containing the equivalent of 75 g anhydrous glucose dissolved in water after an overnight fast of between 8 and 14 hours, or A random plasma glucose > 200 mg/dl (11.1 mmol/l) in a patient with classic symptoms of hyperglycemia (weight loss, polyuria, polyphagia, polydipsia) or with signs and symptoms of hyperglycaemic crisis. Patient must have informed consent. Exclusion Criteria: Patients who does not meet the criteria for T2 DM but are seeking consult at the Diabetes clinic: Impaired fasting glycemia and Impaired glucose intolerance. Patients who have intellect impairment and could not participate in the survey Sampling Procedures All the DMT2 patients visiting the diabetes centre during this period will be identified using the convenient sampling method. Assuming that the prevalence of knowledge among Filipinos is 43% 7 and estimating the proportion within 95% confidence interval with 5% error, the sample size is 168( Raosoft Sample size formula). Data Collection: The data will be collected by giving out pretested predesigned questionnaire to participants with informed consent. Pre-testing of the questionnaire will be done prior to the research proper. Relevant information from the participants will be gathered including: age, gender, highest educational attainment, employment status, duration of diabetes, antidiabetic medications and co-morbidities. Questions pertaining to their knowledge, attitudes and practices will be given in order to assess their corresponding levels. The KAP questionnaire will be adapted from a Malaysian study by Shu Hui Ng et al 15, â€Å"Reality vs Illusion: Knowledge, Attitude and Practice among Diabetic Patients†. The questionnaire has been used in previous KAP studies among diabetics and has proven to be a reliable tool. The self-administered questionnaire had a total of 25 questions (knowledge-14, attitude-5, and practice-6). Each correct answer will be given a score of ‘one’ and the wrong answ er was given a score of ‘zero’. Good knowledge attitude and/or practice will be considered if a patient attains >50% of the total score for each domain. To assess the relationship between KAP towards DM and the actual disease control, most recent(4 +/- 2 weeks) levels of HbA1c will be obtained from the patient records. HbA1C > 7% is considered to have poor control of DM. A. Independent Variables Independent Variables include: sex, age, educational attainment, current employment status, co-morbidities, latest hba1c result. B. Dependent Variables Dependent Variables include: levels of knowledge, attitude and practices Data Handling and Analysis: The principal investigator will ensure that all data collected in the study were of utmost confidential nature. Data analysis will be performed to ensure quality results using frequency, percentage, and statistical analysis. The chi-square test will be used to determine the relationship between KAP and t-test to assess the association between KAP and diabetes control. Spearman correlation test will be used to determine the association between knowledge and attitude, and between knowledge and practice. The level of statistical significance will be set at p

Saturday, January 18, 2020

Haddon House

Jurists Haddam House Food Products has over 50 years of experience in the gourmet food industry. As you know our inventory selection is more than 20,000 items which consists of major brand within ethnic and gourmet categories. One of our most popular brands is Cane's Crazy Mixed-up seasonings. Haddam House is very strong when it comes to selling our products. However, Haddam House needs improvement when it comes to employee turnover.Haddam House has three major locations, two locations in New Jersey, and one in South Carolina. There are 60 people who work in our corporate office and about 700-800 sales representative. Looking back at the last five years there has only been four employees who have been promoted and a handful of employees who left the company or got terminated. It is clear that these promotions happened because the supervisor of Accounts Payable decided to leave the company because she was moving out of state.This left her position open which then the supervisor of Acc ount Receivable decided to take her position this way one of her employees could become the supervisor. This may not be considered a promotion because she was already a supervisor Just moving to a new department. Furthermore, the young lady working in customer service has only been employed with the company for two years and she has a tough time trying to get promoted In addition to the employees in the cooperate office looking at the sales representative there have been at least three employees getting terminated each week.That is a really high number and it should not be like this at all. It should be in the company's strong interest to want to keep their employees. There are many times where a sales representative will leave the company and then get hired again a month later. There are many questions that come with that. Are they leaving the company because their pay is not high enough and then Join the company later to get a better pay increase?This problem can be avoided if the sales representative can give their feedback and the company takes it into consideration to better improve the company. . There is an even amount of males and females that leave the company each year. However, by looking at the numbers more females feel the need to get remoter and have the highest Job whereas, the males feel comfortable in their position. One good aspect about Haddam House is that there are an equal number of males and females in the company.The company is also very diverse. Another variable that we looked into was if there was a correlation between education and promotion within the company. With any other company if a person gets a higher education it can give them a chance to get promoted in the company. However, with this company it rarely happens. Employees feel that when they get hired for a position it does not matter if they further their education they will be stuck that session.This comes to be a big problem because individuals do not want to keep looking for a Job because they cannot go further. Haddam house is very particular with who is in the right position and they fear that only these people are right for the Job. It would help them in the long run if they were willing to trust more people and willing to promote more people than they do now. If they can get past this threshold they may notice an increase in moral and loyalty. Which will help people stay in the company and keep it a happy and healthy environment.

Friday, January 10, 2020

The Hidden Truth About 300 Essay Topics

The Hidden Truth About 300 Essay Topics The Battle Over 300 Essay Topics and How to Win It You don't need to find super technical with legal argumentative essays, but be certain to do your homework on what the recent laws about your preferred topic actually say. Analyzing a present event appears to be a favorite topic chosen for argumentative essays. There are several interesting and challenging Shakespeare essay topics to select from. The sample topics given in the above list ought to be sufficient when you must create a winning essay. Our site is just one of the most appropriate for essay help. You can trust the ideal essay help online. If needed, do some studying to assist you in getting ideas for your short essay. Choosing fantastic essay topics for middle school needs to be a careful procedure, where a balance must be struck between topics that could be too simplistic, more fit for the key school, and choosing argumentative essay topics that can be too intricate or controversial. With the right planning and a comprehensive understanding of the subject, you will be able to compose an essay which gets an excellent grade. Therefore, below are some basic tips to aid you in writing of good descriptive essay. How to Find 300 Essay Topics If it comes to write engineering essay for those students that are studying in electrical engineering school becomes confused since they are engineers and not the writers. Writing descriptive essay students need to be more personal and use their imagination to the complete extent. Since the Writing section demands multiple abilities, you'll want multiple study tools as a way to be wholly prepared. Lastly, you may also practice writing about topics that don't have anything to do with the TOEFL. The 5-Minute Rule for 300 Essay Topics Sports and great education both together come to be the best way to attain success in the life span of a young child. Conclusion A healthy mind resides in a wholesome body and outdoor sport is the very best fitness alternative for the folks who don't have the time to visit the gym or maybe to exercise. Generally the subject of advantages and importance of sports are argues by the folks. When thinking about joining a school sports team, there are lots of benefits and disadvantages to consider. Therefore, if there's any reason why you cannot have your extended essay written on time yourself, all you have to do is place your order on our site, and leave the rest to us! When you're picking your topic, remember that it's much simpler to write about something which you presently have interest ineven in case you don't know a go od deal about it. Should you want, highlight the critical words and phrases in the stimulus to have the ability to look at it from time to time to be sure you adhere to the topic. Our list of prompts is split into categories to make it simpler to use and the topics we've included cover every element of modern-day life, so you are certain to find one which interests you, inspires you or that you truly feel strongly about. All About 300 Essay Topics The cost of an essay rides on the total amount of effort the writer has to exert. You need to be preparing to compose a good essay within half an hour. An excellent prep book can be absolutely the most important study tool you use, and we've got information on all the very best TOEFL prep books you should think about. After you own a topic and a list of references, you might want to write down all of the important points you should include, developing a plan for your justice paper that could be developed into the very first draft sim ply by describing each point. The essay will probably be directed by means of a question or a prompt, such as, for instance, a quote, with a question. So, the choice of the topic is very important. Even if you're free to select the topic you enjoy, be ready to do a little research on it. From time to time, you're provided a particular topic to write about. Finding the most suitable arguments can help you prove your point and win. Odds are, all you have to do is relax and locate a topic you're passionate about and, naturally, one that's debatable. Picking an emotional topic is also a great idea. A good idea is going to be to look at some examples of 1000 word essay matching the overall skeleton you've prepared. Use what you read to assist you create some search terms, and to assist you choose your own position. Other times, you're able to select from a couple of different topics. It's important to select debatable argumentative essay topics since you need opposing points which you can counter to your own points. The New Fuss About 300 Essay Topics You may continue to keep your argumentative essays for your upcoming job portfolio in case they're highly graded. Then you may begin writing whenever you have completed all your research. You also need to include extensive evidential support if you would like your paper to be persuas ive. Presenting The Research Paper Research papers must be presented well to make the best effect. 300 Essay Topics for Dummies Do everything you can to steer clear of the most frequent pitfalls and mistakes. To provide a sound design you'll require no less than three supporting facts to back this up. When searching for help, utilize the sources you're knowledgeable about. The actual folks highly praise our essay help site.

Wednesday, January 1, 2020

Informative Speech Mexico The World Below Us - 1512 Words

Informative Speech Outline Format – Template (Note, all boldface terms represent labels as they should appear in the outline you hand in – you need not bold yours but please have the label in place). Name: __Megan Bianco___ Title: Mexico: The World Below Us Specific Purpose: The specific purpose identifies information you want to communicate and a goal for the audience – â€Å"After listening to my speech, the audience will†¦Ã¢â‚¬  (Not in spoken text) After listening to my speech the audience will have a better understanding of the culture of Mexico and their traditions, as well as a look into some of their problems. Introduction: I. Attention Getter: (Spoken text starts here) Mexico is a very diverse country, and is extremely different from others. Throughout history, Mexico has faced a very bloody and violent history that has been known around the world. As a result, their society is somewhat different from anything that has been seen before and is in itself unique compared to societies such as the United States II. Thesis Statement: Mexico is an interesting country, with many different and people and customs, as well as major problems. III. Credibility Step: Needs two parts 1. What personally connects you to this topic? – I took four years of Spanish in high school in which we learned about the culture in Mexico, and I always found it very interesting. 2. 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