A Systematic Review of Community Health Center Based Interventions for People with Diabetes.

Community health centers (CHCs) focus on serving socioeconomically disadvantaged populations with heightened chronic disease burden, making CHCs an ideal setting for implementing diabetes care programs that target vulnerable populations. We aimed to synthesize evidence concerning the effects of CHC interventions in people with diabetes. To do this, four electronic databases were searched, including PubMed, EMBASE, CINAHL, and Scopus, and hand searches of reference collections were undertaken to identify intervention trials published in English. We screened 892 unique titles and abstracts. Two reviewers then independently evaluated 221 full-text articles. We discovered 29 articles met our eligibility criteria for inclusion. We found 27 unique studies with two companion articles. Seventeen studies were randomized controlled trials and the majority had a higher proportion of female and racial/ethnic minorities in the study sample. CHC interventions often involved either one-on-one or group education sessions supplemented by a phone follow-up that were delivered by health providers, nutritionists, or community health workers. CHC interventions using education sessions combined with follow up via phone generally resulted in significant improvements in hemoglobin A1C, while sole telephone-based education studies showed no significant improvements. CHC interventions had no significant effects on physical activity in all six studies that examined the outcome. Overall, we found that CHC interventions were in general effective in improving glucose control when using face-to-face interactions in low-income, underserved, and racial and ethnic minority patients with diabetes. Evidence was limited, however, in regards to other outcomes which suggests the need for continued evaluations of CHC intervention models.

Characterization of cellulosic wastes and gasification products from chicken farms.

The current article focuses on gasification as a primary disposal solution for cellulosic wastes derived from chicken farms, and the possibility to recover energy from this process. Wood shavings and chicken litter were characterized with a view to establishing their thermal parameters, compositional natures and calorific values. The main products obtained from the gasification of chicken litter, namely, producer gas, bio-oil and char, were also analysed in order to establish their potential as energy sources. The experimental protocol included bomb calorimetry, pyrolysis combustion flow calorimetry (PCFC), thermo-gravimetric analyses (TGA), differential scanning calorimetry (DSC), Fourier transform infrared (FT-IR) spectroscopy, Raman spectroscopy, elemental analyses, X-ray diffraction (XRD), mineral content analyses and gas chromatography. The mass and energy balances of the gasification unit were also estimated. The results obtained confirmed that gasification is a viable method of chicken litter disposal. In addition to this, it is also possible to recover some energy from the process. However, energy content in the gas-phase was relatively low. This might be due to the low energy efficiency (19.6%) of the gasification unit, which could be improved by changing the operation parameters.