Improving Public Health Policy by Comparing the Public Response during the Start of COVID-19 and Monkeypox on Twitter in Germany: A Mixed Methods Study.

Little is known about monkeypox public concerns since its widespread emergence in many countries. Tweets in Germany were examined in the first three months of COVID-19 and monkeypox to examine concerns and issues raised by the public. Understanding views and positions of the public could help to shape future public health campaigns. Few qualitative studies reviewed large datasets, and the results provide the first instance of the public thinking comparing COVID-19 and monkeypox. We retrieved 15,936 tweets from Germany using query words related to both epidemics in the first three months of each one. A sequential explanatory mixed methods research joined a machine learning approach with thematic analysis using a novel rapid tweet analysis protocol. In COVID-19 tweets, there was the selfing construct or feeling part of the emerging narrative of the spread and response. In contrast, during monkeypox, the public considered othering after the fatigue of the COVID-19 response, or an impersonal feeling toward the disease. During monkeypox, coherence and reconceptualization of new and competing information produced a customer rather than a consumer/producer model. Public healthcare policy should reconsider a one-size-fits-all model during information campaigns and produce a strategic approach embedded within a customer model to educate the public about preventative measures and updates. A multidisciplinary approach could prevent and minimize mis/disinformation.

Comparison of diabetes risk estimate in the cities of Riyadh and Amman.

A significant rise in the prevalence of type 2 diabetes mellitus (T2DM) in the Middle-east and North Africa (MENA) region has seen over the last few decades. The present observational study aimed to evaluate and compare the risk of developing T2DM in the cities of Riyadh and Amman using the Arab Diabetes Risk Assessment Questionnaire (ARABRISK).The ARABRISK was administered in a total of 1116 healthy male and female individuals in the age group of 40 to 74 years with no prior history of diabetes in the city of Riyadh (Saudi Arabia) and Amman (Jordan). ARABRISK is an Arabic version of the Canadian Diabetes Risk Assessment Questionnaire (CANRISK), which was adapted and validated for the use in Arab-speaking individuals in Saudi Arabia and Jordan.The participants from Amman region had higher mean total ARABRISK score compared to the Riyadh region for all categories of ARABRISK. However, the difference was significant in both low- and high-risk categories (P = .02 and P = .01, respectively) but not significant for moderate category (P = .17). In the Riyadh population, female participants had significantly higher ARABRISK total scores compared to male in both moderate- and high-risk categories (P = .01). However, in the Amman population, male participants had significantly higher ARABRISK total scores compared to female in both low- and moderate-risk categories (P = .01).The present study suggested an increased risk of developing T2DM in the cities of Riyadh and Amman. However, the population of Amman had a higher risk of developing T2DM compared to the population of Riyadh.

Ten-year Diabetes Risk Forecast in the Capital of Jordan: Arab Diabetes Risk Assessment Questionnaire Perspective-A Strobe-Complaint Article.

The prevalence of diabetes in Jordan has been increasing. The early diagnosis of diabetes is vital to slow its progression. The Arab Risk (ARABRISK) screening tool is a self-administered questionnaire used to determine people who are at high risk for developing diabetes. This study aimed to identify people at high risk for developing type 2 diabetes by using the ARABRISK in the capital of Jordan.A cross-sectional study was conducted with a convenience sample of people in the capital of Jordan. The ARABRISK screening tool was administered to identify the participants' risk for developing diabetes. In addition to descriptive statistics, percentages of the ARABRISK categories were represented, and an independent samples t test was used to explore the differences between men and women. A total of 513 participants with a mean age of 51.94 (SD = 10.33) were recruited; 64.9% of the participants were men (n = 333).The total ARABRISK score ranged from 0 to 25 with a mean score of 12.30 (SD = 4.76). Using the independent samples t test, women (mean = 13.25, SE = 0.10) had significantly higher ARABRISK total scores than men did (mean = 12.95, SE = 0.09), t(141) = -2.23, P = 0.03 in the "moderate risk" category. All of the items in the ARABRISK questionnaire were found to be good predictors of the ARABRISK total scores. Among them, age, body mass index (BMI), and high blood glucose (HBG) were the best predictors as indicated by the standardized regression coefficient (ß). Older age, obesity, elevated weight circumference, absence of daily physical activity, daily consumption of fruits/vegetables, presence of high blood pressure (HBP), and HBG were significantly associated with increased odds of high ARABRISK total scores. Neither a history of gestational diabetes nor a positive family history was associated with an increased odds of high ARABRISK total scores.By identifying risk factors in these participants, interventions and lifestyle changes can be suggested and implemented to reduce the risk and incidence of diabetes.

Validation of the comprehensive international classification of functioning, disability and health core set for diabetes mellitus: physical therapists' perspectives.

OBJECTIVE: The Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for Diabetes Mellitus (DM) is an application of the ICF and represents the typical spectrum of problems in functioning in patients with diabetes. The aims of this study were to explore the content validity of this Core Set from the perspectives of physical therapists (PTs) and to identify the most common problems of patients with DM from the perspectives of PTs using the ICF. DESIGN: In this observational study, PTs experienced in DM treatment were asked about patients' problems, patients' resources, and aspects of environment treated by PTs in their practices. The survey was conducted in three rounds using the Delphi technique. Responses were linked to the ICF by two persons. The degree of agreement was calculated using the kappa statistic. RESULTS: Twenty-four PTs, from 11 countries, answered in the first round; 23 PTs completed the second and third Delphi rounds. The PTs reached consensus on 49 ICF categories; 73% of the ICF categories are represented in the ICF Core Set for DM, whereas 27% of the categories are not represented in the ICF Core Set for DM. Five concepts were linked to the ICF component personal factors, which is not yet classified into detailed categories. CONCLUSIONS: The validity of the ICF Core Set for DM from the perspective of PTs was supported. From the perspective of the PTs, some additional categories qualified for future inclusion in the ICF Core Set for DM. The ICF seems to provide an effective framework describing functioning and disability in DM from the perspective of PTs.

Addressing the common pathway underlying hypertension and diabetes in people who are obese by maximizing health: the ultimate knowledge translation gap.

In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

Diabetic heel ulcers: a major risk factor for lower extremity amputation.

Of all the ulcers seen in patients with diabetes, heel ulcers are the most serious and often lead to below-the-knee amputation. Management of heel ulcers requires a thorough knowledge of the major risk factors for ulceration in the heel area and a standardized program of local ulcer care, metabolic control, early control of infection, and improvement of blood supply to the foot. The most common risk factors for ulceration in the heel region include immobility of the lower limbs, diabetic neuropathy, structural deformity, and peripheral arterial occlusive disease. Patient education regarding foot hygiene, skin care, and proper footwear is crucial to reducing the risk of an injury that can lead to heel ulceration. A careful foot examination that tests for neuropathy and arterial insufficiency can identify patients at risk for heel ulcers and appropriately classify patients with ulcers into different grades to design proper therapeutic plans for management. Team management programs that focus on education, prevention, regular foot examinations, aggressive intervention, and proper use of therapeutic measures can significantly reduce the risk of lower-extremity amputations from heel ulcers.