RESUMEN
BACKGROUND: Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes. METHODS: A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a self-efficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, role-playing, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants' self-efficacy for management of their diabetes. Secondary outcomes were participants' knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life. RESULTS: At 12 and 18 months after the intervention, participants' knowledge of diabetes was significantly increased compared with baseline (both P < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy (r = 0.594, P = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation. CONCLUSION: The training program significantly improved participants' knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes.
RESUMEN
Reversal of intervertebral disc degeneration can have a potentially monumental effect on spinal health. As such, the goal of this research is to create an injectable, cellularized alginate-based nucleus pulposus that will restore disc function; with the primary goal of creating an alginate gel with tailorable rates of gelation to improve functionality over standard CaCl2 crosslinking techniques. Gelation characteristics of 1% sodium alginate were analyzed over various molar concentrations of a 1:2 ratio of CaCO3:glucono-δ-lactone (GDL), with 10% CaCl2 as the control crosslinker. Alginate construct characterization for all concentrations was performed via ultimate and cyclic compressive testing over a 28day degradation period in PBS. Dehydration, swell testing, and albumin release kinetics were determined, and cytotoxicity and cell homogeneity tests showed promise for cellularization strategies. Overall, the 30 and 60mM GDL alginate concentrations presented the most viable option for use in further studies, with a gelation time between 10 and 30min, low hysteresis over control, low percent change in thickness and weight under both PBS degradation and swelling conditions, and stable mechanical properties over 28days in vitro.