UNASSIGNED: The COVID-19 pandemic has significantly impacted Thailand, including urban centers like Bangkok and surrounding areas, highlighting a critical need for effective management within densely populated communities to mitigate its effects.
UNASSIGNED: This qualitative study sought to explore community management strategies developed in Khlong Toei, a large, congested urban community in Bangkok, Thailand. Seven in-depth interviews (n=7), six focus groups (n=23), and two brainstorming sessions (n=12) were conducted for this study. Data were collected using Zoom, an online communication platform, and through on-site interviews between August 2021 and March 2022 in the congested urban community of Bangkok, Thailand. The data were analyzed using content analysis.
UNASSIGNED: All informants (age range: 20-66 years, female respondents: 73.33%) were recruited by a community leader and the abbot of Saphan Temple, the community waiting area in Khlong Toei. The findings revealed two main themes: (1) Caring people, including two subthemes, and (2) Caring community, including two subthemes.
UNASSIGNED: The study\'s findings provide guiding inputs for management of public fear to prevent emerging or re-emerging infectious pandemics within congested urban communities.

Background: Nowadays, mental health problems have become a major concern affecting economic and social development, with severe mental health disorders being the top priority. In 2013, Beijing began to implement the Community Free-Medication Service policy (CFMS). This article aims to evaluate the effect of the policy on medication adherence. Methods: In this study, multi-stage sampling was used to select representative patients as samples. Some of the baseline data were obtained by consulting the archives, and information about patient medication adherence measured by Brooks Medication Adherence Scale was obtained through face-to-face interviews. Logistic regression was used to examine the impact of the policy. Results: Policy participation had a significant positive impact on medication adherence (OR = 1.557). The effect of policy participation on medication adherence in the Medication-only mode and Subsidy-only mode were highly significant, but it was not significant in the Mixed mode. Conclusion: This study found that the CFMS in Beijing as an intervention is effective in improving the medication adherence of community patients. However, the impact of the policy is not consistent among service modes. Reinforcement magnitude and frequency should be considered when designing reinforcement interventions.

Online patient communities are becoming more prevalent as a resource to help patients take control of their health. However, online patient communities experience challenges that require active moderation.
This study aimed to identify the challenges of sustaining a thriving online patient community and the moderation practices employed to address the challenges and manage the online patient community successfully.
An inductive case study of Mayo Clinic Connect was analyzed using the grounded theory methodology. Insights for the analysis were obtained from semistructured interviews with community managers and community members. Secondary data sources, such as community management documents, observational meeting notes, and community postings, were used to validate and triangulate the findings.
We identified four challenges unique to online patient communities. These challenges include passion, nonmedical advice, personal information, and community participation. We identified five categories of practices that community members used to address these challenges and moderate the community successfully. These practices include instructive, semantic, connective, administrative, and policing practices.
Successful moderation in online patient communities requires a multitude of practices to manage the challenges that arise in these communities. Some practices are implemented as preventive measures while other practices are more interventive. Additionally, practices can come from both authority figures and exemplary members.

To examine measures for managing mentally disordered patients in communities, this study aimed to examine the association between medication adherence (MA) and disease stability (DS), and their area variations in a sample of 145,860 patients with severe mental disorders in 19 municipalities during 2006-2013 in southwest China. The rates of stability and adherence varied from 27.7-64.4% to 28.8-63.6%, respectively, over the same period. MA was positively associated with DS (adjusted odds ratio = 1.39, 95% confidence interval 1.29-1.51). Large variations in the rate of DS and MA among municipalities could reflect management differences at this level.

UNASSIGNED: Three feeding regimens-centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food-were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6-59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks.
UNASSIGNED: Costs were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting. Direct costs were estimated for human resources using a price times quantity approach, based on their salaries and average time taken for each activity. The cost per week per child for food, medicines and other consumables was estimated based on the total expenditure over the period and children covered. Indirect costs for programme management including training, transport, non-consumables, infrastructure and equipment were estimated per week per child based on total expenditures for research study and making suitable adjustments for estimations under government setting.
UNASSIGNED: No significant difference in costs was found across the three regimens per covered or per treated child. The average cost per treated child in the government setting was estimated at US$56 (<3500 rupees).
UNASSIGNED: Home-based management of SAM with a locally produced ready-to-use therapeutic food is feasible, acceptable, affordable and very cost-effective in terms of the disability-adjusted life years saved and gross national income per capita of the country. The treatment of SAM at home needs serious attention and integration into the existing health system, along with actions to prevent SAM.
UNASSIGNED: NCT01705769; Pre-results.

This study aimed to evaluate the glycemic levels in Chinese patients with type 2 diabetes mellitus (T2DM) and to explore the factors related to the results of glycemic control. A total of 2454 T2DM patients from 11 communities were examined for glycosylated hemoglobin levels and glycemic control options. Potential factors related to the results of glycemic control were analyzed using logistic regression. Of all the patients, 55.3 % achieved the glycemic control target of HbA1c < 7 %. Multivariate analysis showed that male sex (OR 1.345, 95 % CI 1.022-1.769; P = 0.034), higher levels of fasting blood glucose (OR 1.954, 95 % CI 1.778-2.147; P < 0.001), and low-density lipoprotein cholesterol (OR 1.181, 95 % CI 1.020-1.367; P = 0.026) were significantly associated with poor glycemic control. The complexity of antidiabetics was also associated with poor glycemic control (P < 0.05). Compared to diet and exercise, insulin injection was most strongly associated with poor glycemic control (OR 6.210, 95 % CI 4.054-9.514; P < 0.001). Male patients with higher levels of total cholesterol, lower levels of high-density lipoprotein cholesterol, or longer diabetic durations showed poor glycemic control, which was not found in female patients. Glycemic control was not satisfactory in T2DM patients of Nanjing communities. Various factors are associated with poor results of glycemic control.

BACKGROUND: In resource-constrained settings of developing countries, promotion of community-based health interventions through community health workers (CHWs) is an important strategy to improve child health. However, there are concerns about the sustainability of such programmes owing to the high rate of CHW attrition. This study examined factors influencing retention of volunteer CHWs in a cluster randomised trial on community management of under-5 fever in a rural Ghanaian district.
METHODS: Data were obtained from structured interviews (n=520) and focus group discussions (n=5) with CHWs. Factors influencing CHWs\' decisions to remain or leave the programme were analysed using a probit model, and focus group discussion results were used to elucidate the findings.
RESULTS: The attrition rate among CHWs was 21.2%. Attrition was comparatively higher in younger age groups (25.9% in 15-25 years group, 18.2% in 26-45 years group and 16.5% in ≥46 years group). Approval of a CHW by the community (p<0.001) and the CHW\'s immediate family (p<0.05) were significant in influencing the probability of remaining in the programme. Motivation for retention was related to the desire to serve their communities as well as humanitarian and religious reasons.
CONCLUSIONS: The relatively moderate rate of attrition could be attributed to the high level of community involvement in the selection process as well as other aspects of the intervention leading to high community approval and support. Attention for these aspects could help improve CHW retention in community-based health interventions in Ghana, and the lessons could be applied to countries within similar settings.