Suchergebnisse

Background The purpose of this study will be to improve diabetes prevention, access to care and advocacy through a novel cost-effective nurse-led continuum of care approach that incorporates diabetes prevention, awareness, screening and management for low-income settings, and furthermore utilizes the endeavor to advocate for establishing a standard diabetes program in Nepal. Methods We will conduct a two-arm, parallel group, stratified cluster randomized controlled trial of the NUrse-led COntinuum of care for people with Diabetes (N1 = 200) and prediabetes (N2 = 1036) (NUCOD) program, with primary care centers (9 outreach centers and 17 government health posts) as a unit of randomization. The NUCOD program will be delivered through the trained diabetes nurses in the community to the intervention group and the outcomes will be compared with the usual treatment group at 6 and 12 months of the intervention. The primary outcome will be the change in glycated hemoglobin (HbA1c) level among diabetes individuals and progression to type 2 diabetes among prediabetes individuals, and implementation outcomes measured using the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework. Outcomes will be analyzed on an intention-to-treat basis. Discussion The results of this trial will provide information about the effectiveness of the NUCOD program in improving clinical outcomes for diabetes and prediabetes individuals, and implementation outcomes for the organization. The continuum of care model can be used for the prevention and management of diabetes and other noncommunicable diseases within and beyond Nepal with similar context. Trial registration ClinicalTrials.gov, NCT04131257. Registered on 18 October 2019. ; This study will be conducted under the umbrella of a large implementation project and will be supported by a World Diabetes Foundation (WDF17-1483) grant, a China Medical Board (CMB16–260) grant and Dhulikhel Hospital Kathmandu University. However, the funding organizations will have no role in the design of the study, data collection, data analysis, data interpretation or writing of the report.

How can we explain that some Popular education militants are also referring to the Information Society and thus seem to join this plan, carried to a great extent by merchants and the authorities ? Which are the stakes at work in this "meeting" ? Popular education, in addition to a long and plural history, is not homogeneous. However, Popular education is marked by a common philosophy aiming at developing social, cultural and political people's emancipation. In the mean time, political and economic authorities need to get the support of social actors to carry out the Information Society. Within this framework, associations would be the relay of the development of this society ; the necessary social mediator of this plan. Meanwhile, Popular education movements are seeking ways to appropriate this concept in order to make it able to serve the interests of Popular education. But they also question the specific purposes of this model. Indeed, the reference to the Information Society allows the militants of Popular education to update their traditional matters, and also to come out of the crisis they are facing. Lastly, if this meeting seems, at first sight, to generate consensus, the inherent conflicts in the confrontation of the values and identities do not therefore disappear and question the real stakes at work.