Time to First Optimal Glycemic Control and its Predictors Among Type 1 Diabetic Children<15 Years in Bahir Dar City Public Referral Hospitals, North West Ethiopia: A Retrospective Follow Up Study

Background: Recognizing the level of glycemic control of a client is an important predictor of the development of complication and risk of death from diabetes. However, the other most important predictor which is the time that the patient stayed in that poor glycemic level before reaching optimal glycemic control has not been studied so far. Objective: The aim of this study was to estimate time to first optimal glycemic control and identify predictors among type 1 diabetic children<15 years in Bahir Dar city public referral hospitals, Northwest, Ethiopia, 2021Methods: Retrospective cohort study was conducted at Bahir Dar city public referral hospitals among randomly selected sample of 385 patients with type 1 diabetes who were on follow up from January1, 2016 to February30, 2021.Data were collected by using data abstraction tool and then entered into Epi-data version 4.2 and exported into STATA 14.0 statistical software. Descriptive statistics, Kaplan Meier plots and median survival times, Log-rank test and Cox-proportional hazard regression were used for analysis. After performing Cox-proportional hazard regression, model goodness-of-fit and assumptions were checked. Finally, association between independent variables and time to first optimal glycemic control in months were assessed using multivariable Cox Proportional Hazard model and Variables with p-value < 0.05 were considered as statistically significant.Result: Median survival time to first optimal glycemic control among type 1 diabetic client was 8 months (95%CI: 6.9-8.9).First optimal glycemic achievement rate was 8.2(95%CI: 7.2-9.2) per 100 person/month observation. Factors that affect time to first optimal glycemic control were age (AHR=0.32;95%CI=0.19-0.55),weight(AHR=0.96;95%CI=0.94-0.99),primary care giver(AHR=2.09;95%CI=1.39-3.13), insulin dose (AHR=1.05;95%CI=1.03-1.08),duration of diabetes (AHR=0.64;95%CI=0.44-0.94), adherence (AHR=9.72;95%CI=6.09-15.51),carbohydrate counting(AHR=2.43;95%CI=1.12-5.26),and comorbidity (AHR=0.72;95%CI=0.53-0.98).Conclusion and Recommendation: The median survival time to first optimal glycemic control in this study was long. Age, weight, primary care giver, insulin dose, duration of diabetes, adherence, and carbohydrate counting including history of comorbidity were determinant factors. Therefore, clinicians should advice weight reduction, increase the dose of insulin during initial treatment, counsel their parents about adherence of insulin drug and auditing their children diet as prescription helps to reduce the length of glycemic control.

Effect of home quarantine due to COVID19 pandemic on psychological status and behaviour of children 1½ to 5 years old. An online study

BackgroundChildren are largely spared from the direct health effects of COVID-19, nevertheless, they are among the biggest victims because of the profound effect on their mental well-being, social development, safety, privacy, and their economic security.ObjectivesStudying the effect of home quarantine on the mental and psychological wellbeing of the under five years' children compared with their own status prior to the quarantine.Subjects and Methods: A comparative retrospective cross sectional survey study was carried out online. A sample of 200 under-five age children was taken and their primary care giver had answered the questions. The study was done in 2020.ResultsA statistically significant difference between the mean score of the children before and after quarantine (t= -6.8, p=.0001),most of the changes were increase screen time, increase stubbornness, clinging to parents, anger and sleeping problems.ConclusionsHome quarantine had a significant effect on the psychological status and behaviour of under-five age children.

The Quality of Life of Mothers Who Have Children with Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a complex intellectual and developmental disability clinically diagnosed when s/he is 2 or three years old. These children demand special care to meet their special needs to enable optimized potentials in their development. This qualitative study aims at understanding the stressors affecting the quality of life of the primary care-giver. Parenting for children with ASD is usually more complicated and demanding than for children without disabilities. Four case studies were selected to represent typical mothers of ASD children in different phases of development. Their ages ranged from 29-50 years old and the ages of their children were 6 to 22 years old. Research credibility is constructed through interviews with significant others and observation of social media activities. The instrument for the study is WHO-QoL-BREF which is adjusted for an interview protocol. The results indicated that mothers who were not supported by their spouse and family members often had to deal with the uncertain future alone. Those who felt accomplished in caring for their children were strengthened by the parenting experiences. Support from professionals is crucial for mothers in addition to support from significant others and peers, in maintaining their quality of life.

Cognitive behavioural therapy for psychogenic non-epileptic seizures in the context of mild intellectual disability: a case study

Purpose There is a growing evidence base for cognitive behavioural therapy (CBT) as a treatment for psychogenic non-epileptic seizures (PNES) in the general population. Despite the relatively high proportion of individuals with PNES who have an intellectual disability (ID) there is a paucity of literature on the use of CBT for PNES in this population. The purpose of this paper is to describe the use of an adapted CBT approach to treat PNES in a woman with mild ID. Design/methodology/approach The intervention used a CBT approach that included both the client and her mother, her primary care giver, throughout the therapy sessions. It involved 13 1-hour sessions over 20 weeks. Findings Over the course of the intervention the client experienced a reduction in seizure activity. Both the client and her mother reported increases in her perceived ability to cope with the seizures. Originality/value This report describes an adapted CBT-based intervention for individuals with PNES in the context of ID. It is the first report to include the involvement of a care-giver in adapting this approach for individuals with ID.

Assessment of the Functional Capacity of the Elderly of Barangay San Fabian, Echague, Isabela

Normal aging process, acute illness, worsening chronic illness, and hospitalization can contribute to a decline in the ability of the older adults to perform task necessary to live independently. One of the best way to evaluate the health status of the elderly is through functional assessment which provides data that may indicate future decline allowing the nurse and their primary care giver to intervene appropriately. This study was conducted to assess the functional capacity of the elderly living at San Fabian, Echague, Isabela. The Descriptive-Inferential design was used. A total of 107 respondents with a mean age of 70.26, majority are female (52.3%), married (62.6%), and obtained college education 29.9% and 10.3% are graduate and undergraduate respectively. 43% receives pension. Respondents and significant others were interviewed using a 3-point Likert scale. On the level of functional capacity, researcher found out that the elderly are independent in performing BADL and need assistance in performing of IADL such as ability to use phone, shopping, performing heavy domestic works, laundry, taking medication in correct time and handling of finances. Age has a negative significant relationship with their ability to perform both the BADL and IADL and there is a difference between gender and source of income and their ability to perform IADL. The study also shows a significant relationship between the respondent’s marital status and their education with their ability to do IADL. Keywords: functional capacity; elderly; assessment

Assessment Of The Functional Capacity Of The Elderly Of Barangay San Fabian, Echague, Isabela, Philippines

Normal aging process, acute illness, worsening chronic illness, and hospitalization can contribute to a decline in the ability of the older adults to perform task necessary to live independently. One of the best way to evaluate the health status of the elderly is through functional assessment which provides data that may indicate future decline allowing the nurse and their primary care giver to intervene appropriately. This study was conducted to assess the functional capacity of the elderly living at San Fabian, Echague, Isabela. The Descriptive-Inferential design was used. A total of 107 respondents with a mean age of 70.26, majority are female (52.3%), married (62.6%), and obtained college education 29.9% and 10.3% are graduate and undergraduate respectively. 43% receives pension. Respondents and significant others were interviewed using a 3-point Likert scale. On the level of functional capacity, researcher found out that the elderly are independent in performing BADL and need assistance in performing of IADL such as ability to use phone, shopping, performing heavy domestic works, laundry, taking medication in correct time and handling of finances. Age has a negative significant relationship with their ability to perform both the BADL and IADL and there is a difference between gender and source of income and their ability to perform IADL. The study also shows a significant relationship between the respondent’s marital status and their education with their ability to do IADL.

Awareness and Perception of Senior Citizens on the Implementation of R.A. 9994 in San Isidro in Nueva Ecija in the Philippines

This study determined the awareness and perception of senior citizens on the implementation of R.A. 9994, or the Expanded Senior Citizen Act of 2010. It employed both qualitative and quantitative research design as it described the profile of the respondents, determined the level of awareness of the respondents on the benefits granted by RA 9994, and analyzed the extent of implementation of the benefits and privileges based on R.A. 9994. The respondents came from the three clustered barangays of San Isidro, Nueva Ecija in the Philippines. The researcher used a 5-point Likert Scale questionnaire. The data gathered revealed that Senior Citizens were “Moderately Aware” of most of the parameters presented such as the 20% discount, government assistance, and priority in express lanes. On the other hand, the mean response on the extent of implementation was verbally described as “Slightly Implemented.” The Analysis of Variance showed that the level of awareness of respondents across the clustered barangays does not vary significantly. Thus, from the findings, it is recommended that a thorough study with a greater number of respondents, including the relatives/primary care giver, should be involved. Firm and systematic assessment is also recommended to monitor the implementation of the programs.

Music Therapy and Parent-Infant Programmes

Parent-infant work in music therapy provides the opportunity for the existing musicality of the infant-care giver pair to be accessed and enhanced. Music therapy is provided to support and enhance the skills of the dyad thus improving the relational strengths where a difficulty or impairment of satisfying contact in the relationship has occurred. The approaches developed in parent infant music therapy group and individual work have been informed primarily from an understanding of the importance of an infant achieving secure attachment with a primary care giver as the basis of ongoing lifelong mental health. This chapter provides an overview of practice in parent-infant music therapy programmes, including considerations for starting groups. Additionally, the growing literature in this field is presented and discussed.

Elasticity of care networks and the gendered division of care

ABSTRACTThe gender gap in family care-giving is an established research finding: men dedicate less time to care-giving and provide specific gendered types of help. This article argues that in order to grasp men's contribution to care arrangements one should recognise the multifaceted nature of care and examine care networks beyond the ‘care receiver–primary care-giver’ dyad with a dynamic perspective. A qualitative analysis of the care networks of three large Dutch families with an older parent in need of care confirms the greater involvement of women in care-giving and men's tendency to provide specific types of care. However, men also contribute to the elasticity and stability of the care arrangement by filling temporary gaps and supporting the female care-givers. This article puts forward the idea that men's contribution is in turn a factor in the perpetuation of the gendered structure of care-giving.