Search

OBJECTIVE - Food insecurity is hypothesized to make diabetes self-management more difficult. We conducted a longitudinal assessment of food insecurity with several diabetes self-care measures. RESEARCH DESIGN AND METHODS - We conducted a secondary, observational analysis of 665 low-income patients with diabetes, all of whom received self-management support as part of a larger diabetes educational intervention. We analyzed baseline food insecurity (measured by the U.S. Department of Agriculture Food Security module) in relation to changes in hemoglobin A1c(HbA1c) as well as self-reported diabetes self-efficacy and daily fruit and vegetable intake. We examined longitudinal differences using generalized estimating equation linear regression models, controlling for time, age, sex, race, income, and intervention arm. RESULTS - Overall, 57% of the sample had an income

Because recognizing depression is of critical importance, we have organized a comprehensive review of current literature on medical, psychiatric, and behavioral science to give primary care physicians a brief, practical, and multidisciplinary survey of diagnostic approaches to depression. The review is also designed to help clarify the disparate approaches, definitions, theories, and classifications of depression found in the literature. We emphasize two emerging perspectives important to primary care physicians in their understanding and treatment of depression. The first is a wider view of masked depression, and the second is depressive behavior related to family and cultural systems. Traditional classifications may have limited applicability to the patient families most often seen in primary care. We hope that the paper will serve as a challenge to physicians to combine open and creative observation with inductive reasoning in the creation of a more useful system for classifying depression in primary care.