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Background: Pneumonia is one of the leading causes of death in under-5 children in India. This led the Ministry of Health & Family Welfare (MoHFW) in India to decide for the nationwide roll-out of the Pneumococcal Conjugate Vaccine (PCV). However, the introduction of PCV became more complex in the face of unprecedented challenges set forth by the COVID-19 pandemic. The study aims to assess enablers and barriers to the introduction of PCV in India during the pandemic. Methodology: Qualitative research approach involving key-informant interviews from John Snow India (JSI), the lead technical agency that supported MoHFW in the PCV expansion was employed to delineate the enablers and barriers. Principle of saturation was employed to derive the sample size. Thematic analysis using inductive approach was based on the modified World Health Organization (WHO) framework for new vaccine introduction impact on the Immunization and Health Systems, using NVIVO 12 qualitative data analysis software. Results: A total of 11 key informants (4 national-level program managers and 7 state technical officers) were telephonically interviewed. The study found social acceptance, lower cost of the vaccine, and intensive communication activities as potential enablers. Other enablers for PCV introduction included a robust vaccine supply-chain system, ample cold-chain space availability, and strong political commitment, despite the ongoing second wave. Further, the identified barriers included poor physical access, insufficient social mobilization, and limited advocacy along with a stretched workforce. Conclusion: The study delineated several enablers and barriers to introducing PCV in the country during the pandemic. The existing barriers in the PCV roll-out prompted the need to address these gaps, making key program-based recommendations to improve future new vaccine introductions during the pandemic.

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The cost of childbirth has been confirmed as a vital factor in families' fertility decision-making, and family welfare policies are capable of compensating for the increase in household living expenses regarding childbirth, such that the country's fertility situation can be optimized. In this study, the fertility promotion effects of family welfare policies in OECD(Organization for Economic Co-operation and Development) countries are investigated through regression analysis, grey correlation (GRA), and the fuzzy set qualitative comparative analysis fsQCA method. As indicated by the results: (1) Family welfare policies notably boost fertility, and the boosting effect is long-lasting. However, this boost will be weakened in countries where fertility rates remain below 1.5. (2) The contribution of welfare policy measures to the fertility-promotion effect varies by country. The contribution of cash benefits is highest in over half of the countries worldwide, the contribution of relevant services and in-kind expenditure is highest in 29% of the countries, and that of tax incentive expenditure is highest in 14% of the countries. (3) The policy mix to boost fertility also varies according to the social context, with three policy groups derived using the fsQCA method. To be specific, the core antecedent conditions comprise cash benefits, relevant services, and in-kind expenditure. On that basis, China should pay attention to the following three points when formulating family welfare policies to tackle their demographic challenges. First, a system of family welfare policies should be developed as early as possible in the context of increasingly severe demographic issues since the incentive effect of family welfare policies will be weakened in countries with chronically low fertility rates. Second, the effects of improvements vary by country, and China should comprehensively consider its national circumstances when formulating and dynamically adjusting the mix of government fertility support policies in accordance with its social development. Third, employment is the main means of securing family income and takes on critical significance to sustaining families. Unemployment exerts a significant disincentive effect, such that it is imperative to reduce youth unemployment and enhance the quality of youth employment. On that basis, the disincentive effect of unemployment on fertility can be reduced.

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Background: India has seen more than 43 million confirmed cases of COVID-19 as of April 2022, with a recovery rate of 98.8%, resulting in a large section of the population including the healthcare workers (HCWs), susceptible to develop post COVID sequelae. This study was carried out to assess the nature and prevalence of medical sequelae following COVID-19 infection, and risk factors, if any. Methods: This was an observational, multicenter cross-sectional study conducted at eight tertiary care centers. The consenting participants were HCWs between 12 and 52 weeks post discharge after COVID-19 infection. Data on demographics, medical history, clinical features of COVID-19 and various symptoms of COVID sequelae was collected through specific questionnaire. Finding: Mean age of the 679 eligible participants was 31.49 ± 9.54 years. The overall prevalence of COVID sequelae was 30.34%, with fatigue (11.5%) being the most common followed by insomnia (8.5%), difficulty in breathing during activity (6%) and pain in joints (5%). The odds of having any sequelae were significantly higher among participants who had moderate to severe COVID-19 (OR 6.51; 95% CI 3.46-12.23) and lower among males (OR 0.55; 95% CI 0.39-0.76). Besides these, other predictors for having sequelae were age (≥45 years), presence of any comorbidity (especially hypertension and asthma), category of HCW (non-doctors vs doctors) and hospitalisation due to COVID-19. Interpretation: Approximately one-third of the participants experienced COVID sequelae. Severity of COVID illness, female gender, advanced age, co-morbidity were significant risk factors for COVID sequelae. Funding: This work is a part of Indian Council for Medical Research (ICMR)- Rational Use of Medicines network. No additional financial support was received from ICMR to carry out the work, for study materials, medical writing, and APC.

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There have been more than 31378143 confirmed coronavirus disease 2019 (COVID-19) cases in India. It was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Because the risk of severe COVID-19 is not consistent across all individuals, uncertainty is linked to disease development. COVID-19 results have been related to systemic inflammation as a predictor. In COVID-19, increased levels of inflammatory markers have been associated with cytokine storm, coagulopathy, and endothelial dysfunction. A significant amount of research suggests that these results have a role in the cause of death in individuals suffering from a severe form of COVID-19. We aim to show our experience of COVID-19 at GITAM Institute of Medical Sciences and Research (GIMSR), Visakhapatnam. We analyzed data on 558 patients admitted to our dedicated COVID hospital during post unlock (UL) 2.0 in India from August 2 to August 31, 2020. The mean age was 43.65 years; 69% of them were male. Using MoHFW India severity guidelines, 68.10% were mild, 18.64% were moderate, and 13.26% were severe cases. Fatigue (66.13%) was the most common complaint, followed by anosmia (63.80%), fever (57.53%), diarrhea (56.09%), shortness of breath (22.40%), and others. The most common preexisting comorbidity seen in our patients was diabetes mellitus and hypertension, respectively. Laboratory parameters revealed mean hemoglobin of 13.04±1.91 gm/dl, mean total leukocyte count of 7378.49±3229 cells/cumm, mean platelet count of 2.3±0.8 lakhs/cumm, mean erythrocyte sediment rate of 40±30 mm/hr, mean ferritin level of 335.96 ng/ml, mean D-dimer level of 794.88 ng/ml and mean CRP of 23.27 mg/l. Severity was associated with higher age, symptomatic presentation, elevated leucocytes, and elevated inflammatory markers.

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BACKGROUND: Children living with a problem gambling parent are at risk of harm but no previous systematic reviews have specifically focused on the relationship of parental problem gambling and child wellbeing outcomes. The current review aimed to redress this gap by reviewing all available empirical evidence on parental problem gambling and child wellbeing. METHOD: Articles were identified by searching PsychINFO, CINAHL, Medline and Scopus. The search included terminology pertaining to parents, problem gambling and children and we included all peer-reviewed articles that reported parental problem gambling and child wellbeing outcome(s). RESULTS: Overall, 35 studies reporting a relationship between parental problem gambling and child wellbeing were included. Child wellbeing outcomes were reported across six domains: (1) psychological (k = 14); (2) family relationships (k = 17); (3) violence (k = 9); (4) behavioural (k = 7); (5) financial (k = 9); and (6) physical health (k = 3). The included studies were mostly unequivocal about negative impacts of parental problem gambling across the six domains. Sixteen studies provided evidence of negative child outcomes that were directly attributed to parental problem gambling (e.g., as a result of your parent's problematic gambling, you felt depressed). Nineteen studies reported evidence of the association of child negative outcomes and parental problem gambling but child outcomes were not directly attributed to parental problem gambling (e.g., parent is a problem gambler, child is depressed). Evidence was particularly robust on child distress and family dysfunction directly attributed to parental problem gambling. CONCLUSION: This is the first systematic review focusing exclusively on specific intra- and interpersonal problems experienced by children whose parents have a gambling problem.

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BACKGROUND: According to WHO, 536,000 women die every year in the world from causes relating to pregnancy, childbirth, or postpartum. Ninety nine percent of these deaths occur in the developing countries. Primary health centres (in densely populated areas and in urban slums are also referred to as family welfare centres, since they provide the whole continuum of care, from birth through adolescent and delivery and thereafter. AIM: To evaluate the antenatal services under Reproductive, Maternal, Newborn, Child plus Adolescent (RMNCHA) programme at a family welfare centre located in Central Delhi, India. We have proposed an action plan that will help in evaluating and improving these services. METHODOLOGY: The study included health providers of antenatal services and the beneficiaries. With a response rate of 90% from a sample of 218, 203 consenting antenatal women (beneficiaries) visiting the centre for ANC check-up under RMNCH + A programme and PMSMA were included. For quantitative component, a pre-designed, pre-tested semi-structured screening questionnaire were administered to the beneficiaries and healthcare providers to evaluate the antenatal services under RMNCH + A programme at the family welfare centre. RESULTS: Qualitative and quantitative analysis was done separately. Only 43% of ANC women said health workers visited them at home during pregnancy and very few could tell about importance of lab investigations. Almost all (97%) knew about key messages given by health workers. Nearly all participants considered that the screening process was smooth. The waiting time and time to undergo varied from 4 to 6 min.

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BACKGROUND: In today's world, the mass media plays an important role, and it can provide a unified platform for all public health communication, comprehensive healthcare education, and guidelines. As a result, we investigated the various types of general health and oral health messages and advertisements broadcast through various forms of mass media. OBJECTIVE: The main objective is to identify & analyze the health & oral-health related dialogue and messages with the content of the mass media. METHOD: ology: Content analysis of general health and oral health-related advertisements was done in various media, like the print media (magazines & newspapers), television (audio-visual) and radio stations (audio). The data was collected by an independent investigator, like prime time, advertisements, articles, and public service announcements (PSAs), etc., and the observations were recorded for subsequent analysis. RESULTS: Only n â€‹= â€‹753 incidents of health n â€‹= â€‹663 (88.1%) and oral health n â€‹= â€‹90 (11.9%) were reported during the study period, out of 6180 pages of published print media and 200 â€‹h of prime-time broadcast channel & station advertisements, respectively. There are n â€‹= â€‹506 incidents in the print media, implying that health n â€‹= â€‹481 (95.1%) and oral health n â€‹= â€‹25 (4.9%) are, respectively. Compared to other media, audio-visual media, n â€‹= â€‹229, show 26.7% of incidents of oral health information (n 58), while 73.3% of incidents are of general health information (n 171). Only 38.9% of oral health incidents (n â€‹= â€‹7) were broadcast during prime time. CONCLUSION: The findings of this study may help promoters, policymakers, public health providers, and other stakeholders, to be more precise about general or oral health-related information to be effective in the messages the mass media have been utilizing and in improving future health.

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BACKGROUND/OBJECTIVE: There is a paucity of data on the management of gastrointestinal (GI) bleeding in patients with Coronavirus disease -2019 (COVID-19) amid concerns about the risk of transmission during endoscopic procedures. We aimed to study the outcomes of conservative treatment for GI bleeding in patients with COVID-19. METHODS: In this retrospective analysis, 24 of 1342 (1.8%) patients with COVID-19, presenting with GI bleeding from 22nd April to 22nd July 2020, were included. RESULTS: The mean age of patients was 45.8 ± 12.7 years; 17 (70.8%) were males; upper GI (UGI) bleeding: lower GI (LGI) 23:1. Twenty-two (91.6%) patients had evidence of cirrhosis- 21 presented with UGI bleeding while one had bleeding from hemorrhoids. Two patients without cirrhosis were presumed to have non-variceal bleeding. The medical therapy for UGI bleeding included vasoconstrictors-somatostatin in 17 (73.9%) and terlipressin in 4 (17.4%) patients. All patients with UGI bleeding received proton pump inhibitors and antibiotics. Packed red blood cells (PRBCs), fresh frozen plasma (FFPs) and platelets were transfused in 14 (60.9%), 3 (13.0%) and 3 (13.0%), respectively. The median PRBCs transfused was 1 (0-3) unit(s). The initial control of UGI bleeding was achieved in all 23 patients and none required an emergency endoscopy. At 5-day follow-up, none rebled or died. Two patients later rebled, one had intermittent bleed due to gastric antral vascular ectasia, while another had rebleed 19 days after discharge. Three (12.5%) cirrhosis patients succumbed to acute hypoxemic respiratory failure during hospital stay. CONCLUSION: Conservative management strategies including pharmacotherapy, restrictive transfusion strategy, and close hemodynamic monitoring can successfully manage GI bleeding in COVID-19 patients and reduce need for urgent endoscopy. The decision for proceeding with endoscopy should be taken by a multidisciplinary team after consideration of the patient's condition, response to treatment, resources and the risks involved, on a case to case basis.

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BACKGROUND: Limited medical facilities are available due to Covid-19 pandemic. Nevertheless, all efforts should be made in planning judicial and possible methods of delivering health care, particularly to pregnant woman with GDM. GDM may play a crucial role in the increasing prevalence of diabetes and obesity and also may be the origin of cardiometabolic diseases. METHODS: It is mandatary to diagnose and care pregnant woman with GDM. The test suggested to diagnose GDM has to be evidence based and in this regard "a single test procedure" evaluated meets this requirement. This doable test has been accepted by the Diabetes in Pregnancy Study Group India (DIPSI) and approved by MHFW-GOI, WHO, International Diabetes Federation, and International Federation of Obstetricians and Gynecologists. MHFW-GOI also recommends testing at first antenatal visit and then at 24-28 weeks of gestation. This opportunity can also be utilized for performing ultrasonography for assessing fetal development. RESULT: The first-line management is MNT and life style modifications. Non-responders may require insulin or OHA. The target glycemic control is FPG ~ 5.0 mmol/dl (90 mg/dl) and 2 h PPPG ~ 6.7 mmol/dl (120 mg/dl). The goal is to obtain newborns birth weight appropriate for gestational age between 2.5 and 3.5 kg, a step to prevent offspring developing diabetes. CONCLUSION: The essential precaution required during COVID pandemic is to wear face mask, avoid crowded places, and maintain social distancing. Finally, the economical and evidence based "single test procedure" of DIPSI is most appropriate for screening during the COVID pandemic.

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BACKGROUND: Low availability of women physicians in rural areas can compromise women's health care seeking, where need can be greatest. We examined the associations between availability of women physicians and maternal and child health service utilization in India. METHODS: We analyzed cross-sectional district-level data from all 256 districts in 18 states, from India's District-Level Household and Facility Survey (2012-13) and the National Family Health Survey (2015-16). Assessed measures included lady medical officers (LMOs) availability at Primary Health Centers (PHCs, which are largely rural serving), modern contraceptive use, antenatal care (ANC), skilled birth attendance (SBA), maternal postnatal care (PNC), infant PNC, and child immunization. Multilevel regression models nesting districts in states examined associations between LMO availability and health service utilization, adjusting for district-level socioeconomic status (SES) indicators (e.g., women's education, household water access), urbanicity, health insurance coverage and sampled PHCs (15 on average) within districts. FINDINGS: Only 72 of 256 districts (28.1%) reported >50% of PHCs with LMOs. In multivariable models, LMO availability in PHCs was associated with higher district prevalence (%) of modern contraceptive use [ß=0.04 (95% CI: 0.007, 0.08)], 4+ ANC [ß =0.07 (95% CI: 0.008, 0.13)], skilled birth attendance [ß=0.09 (0.03, 0.14) and maternal PNC [ß=0.08 (95% CI: 0.03, 0.12)], but not infant PNC or child immunization. INTERPRETATION: Higher district availability of women physicians is associated with higher maternal health care utilization but not child health care utilization. Improving gender parity in the physician workforce and rural women physician access may improve maternal health care use in India.

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BACKGROUND: The selection of a low-risk blood donor involves a dialogue between the trained medical staff and the volunteer blood donor, and this is where the knowledge of the prospective blood donor with regard to the risk factors for acquiring hepatitis B and C and the mode of spread through a blood transfusion is of utmost importance. Therefore, the study was conducted to assess the knowledge and attitude on hepatitis B and C with regard to blood donation, in the existing and the potential donor base. MATERIALS AND METHODS: This is a cross-sectional study conducted on 4000 participants, including 2000 blood donors and 2000 nondonors. The study tool was a pilot-tested, self-administered questionnaire, content and construct validated using Delphi methodology. RESULTS: The mean age of the study participants was 25.12 ± 8.43 years ranging from 18 to 60 years; 24.64 ± 8.31 years in donors and 25.61 ± 8.55 years in non-donors. The study included 69.8% males and 30.2% females, with 87.5% males and 12.6% females in donors and 52.1% males and 47.9% females in non-donors. Overall knowledge score was 51.02%, being 51.21% in donors and 50.84% in non-donors. Overall attitude score was 47.93%, being 47.09% in donors and 48.77% in non-donors. There was a low degree of significant linear correlation between knowledge and attitude in the study participants. CONCLUSION: Based on the results obtained in the study, it is evident that neither the existing level of knowledge nor the attitude of both donors and nondonors towards hepatitis B and C is adequate for being able to select a low-risk blood donor.

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Increasing choice and introducing new contraceptive methods in the National Family Welfare Program in India could play a significant role in increasing adoption of contraception and meeting the unmet need of a large proportion of couples. However, inclusion of any new contraceptive method in India has to face many challenges at different steps: from clinical trials, administrative processes, acceptance in the national program, and reaching the intended beneficiaries. Having a good product is necessary but not sufficient for widespread accessibility, acceptance, and use. This article reviews the challenges based on the available policy documents, literature review, and discussions with senior program managers of the Ministry of Health and Family Welfare and development organizations. It concludes that comprehensive strategic planning is needed to address all possible barriers to ensure new contraceptive access at an affordable price by the beneficiaries it is intended for.

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INTRODUCTION: The role of community health workers in healthcare delivery system is considered inevitable to meet the goal of universal healthcare provision. The study was planned to assess the knowledge and practices for maternal health care delivery among Accredited Social Health Activist (ASHA) workers in North-East district of Delhi, India. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted in North-East district of Delhi among 55 ASHA workers after taking written informed consent. Data were collected using a pretested semi-structured questionnaire consisted of items on sociodemographic profile of ASHA workers, knowledge, and practices about maternal health. The data was analyzed by using SPSS software version 17. Qualitative data were expressed in percentages and quantitative data were expressed in mean ± standard deviation (SD). RESULTS: Mean age (±SD) of ASHAs was 31.84 ± 7.2 years. Most of the ASHAs workers were aware of their role in provision of maternal health services. Most of the ASHAs workers were aware of their work of bringing mothers for antenatal check-up (94.5%), counseling for family planning (96.4%), and accompanying them for hospital for delivery (89.1%). 87% of ASHAs knew that iron tablets have to be taken for minimum 100 days during pregnancy. 51 (92.7%) ASHAs reported that they used to maintain antenatal register. Some problems reported by ASHAs while working in community were shortage of staff at health center (16.4%), no transportation facility available (14.5%), no money for emergency, and opposition from local dais (12.7% each). CONCLUSION: Present study showed that ASHAs knowledge is good but their practices are poor due to number of problems faced by them which need to be addressed through skill based training in terms of good communication and problem solving. Monitoring should be made an integral part of ASHA working in the field to ensure that knowledge is converted into practices as well.

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In spite of wide availability of menstrual regulation services, women often resort to a variety of medicines for inducing abortion. The Bangladeshi Government is now supporting attempts to investigate the introduction of medical menstrual regulation in the public sector. This study examined the acceptability of medical menstrual regulation in public sector urban-based clinics, public sector rural-based clinics and urban-based clinics run by Marie Stopes, a non-governmental organization. Of the 2,976 women who attended for menstrual regulation services during the eight-month study period, 68% attended urban Maternal and Child Welfare Centres and the Marie Stopes clinics, while 32% went to the rural public facilities of the Union Health and Family Welfare Centre. Women were offered both medical and manual vacuum aspiration methods of menstrual regulation; 1,875 (63%) chose the medical method and 1,101 (37%) chose manual vacuum aspiration. Around 7.1% of women at Maternal and Child Welfare centres and 11.9% at the Marie Stopes clinics knew about medical menstrual regulation before taking the service, compared to a much higher proportion (43%) at the rural facilities. Overall 61.4% of women who used medical menstrual regulation found the method satisfactory, and 34.2% were very satisfied. Of the 3.9% of women who were not satisfied, most received services from rural facilities.

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A growing number of innovative mAb therapeutics are on the global market, and biosimilar versions have now also been approved, including in India. Although efficacy and safety is demonstrated prior to approval, targeted pharmacovigilance is essential for the identification and assessment of risk for any mAb products. We analyzed the ADR data related to mAbs reported to the NCC-PvPI through the spontaneous reporting system Vigiflow during April 2011 to February 2014 to identify mAbs with the highest number of ADR including fatal/serious ADR. Only 0.72% reports were related to mAbs. Although 15 mAbs are approved in the country, only 6 mAbs were reported through Vigiflow. Rituximab was highly reported, and no fatal/serious ADR related to any mAbs were reported during the study period. Our study shows that PvPI is effective and robust system in the detection and assessment of risks associated with the use of mAbs.

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Los procesos de acogimiento familiar que se producen en cada país dependen de factores históricos y culturales que dan lugar a grandes diferencias internacionales. A pesar de que las comparativas internacionales ofrecen un medio de intercambio de experiencias, lo que permite el aprendizaje mutuo y la transferencia de buenas prácticas, a menudo encontramos enormes barreras para su realización debido, entre otros factores, al limitado acceso a los datos sobre la práctica de la protección infantil. Frente a estas limitaciones, este artículo ofrece una investigación comparativa realizada en España y Portugal, cuyo objetivo ha sido la evaluación del acogimiento familiar en dos países donde la investigación en el ámbito de la protección infantil ha sido tradicionalmente desatendida. Sobre una muestra de 357 casos en España y 289 en Portugal, se realizó un estudio del perfil de características de los niños acogidos, las familias de origen y los acogedores, así como de los procesos de acogida en ambos países. La comparativa reveló importantes diferencias relacionadas con la mayor edad al inicio del acogimiento de los niños en España; el perfil de los acogedores, con edades más avanzadas, un bajo nivel educativo y llevando a cabo acogidas de más de un niño simultáneamente en Portugal. El estudio comparado nos ha permitido identificar áreas que requieren mayor atención en ambos países, como la renovación generacional del banco de acogedores en Portugal o la necesidad de acelerar los procesos de toma de decisiones para la entrada en acogimiento familiar en España. Se pretende que este artículo sirva de aliento para la recogida de datos y comparación con otros países iberoamericanos.

Fostering processes that occur in each country depend on historical and cultural factors that give rise to large international differences. Despite the fact that international comparisons offer a way of exchanging experiences, allowing mutual learning and transfer of good practice, we often encounter major barriers for its completion due to limited access to data on child protection practice, among other factors. Given these limitations, this article provides a comparative study conducted in Spain and Portugal. The aim is the evaluation of family foster care interventions in two countries where research in the field of child protection has traditionally been neglected. The profile of foster children, families of origin and foster families, as well as the features of the fostering processes were studied in a sample of 357 cases in Spain and 289 in Portugal. The comparison revealed significant differences related to the older age of Spanish foster children at the beginning of the foster placement. The profile of foster carers revealed older age, low educational level and frequent situations of multiple placements in Portugal. The comparative study has identified areas that require further attention in both countries, such as the generational shift of foster carers in Portugal or the need to speed up the decision-making processes for entry into a family foster placement in Spain. This article intends to be an encouragement for data collection and comparison in other Latin American countries.

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Child and family welfare organizations around the world aspire to achieve missions that will improve outcomes for vulnerable children and families and ultimately reduce the prevalence and impact of child maltreatment. In Australia, this work is currently being influenced by an increasingly turbulent political and economic climate; one that is requiring organizations to engage with evaluation in new and advanced ways so that they are not left behind in the increasingly complex and competitive environment that they now operate in. Despite the apparent awareness and understanding of the essential place of evaluation in quality and effective service delivery, it is also understood that evaluation of the human services work that child and family welfare organizations undertake is extremely challenging due to its intricate, ever-changing and often innovative nature. Embedding evaluation within such organizations therefore requires a tailored and planned decision-making and implementation process. This paper will briefly describe the recent socio-political history and environment that Australian child and family welfare organizations operate in and how this has impacted on engagement with evaluation. With consideration to this, it will describe the evaluation approaches available to organizations and the factors that may influence selection of a specific approach. It will then explore the benefits and challenges of these evaluation approaches, and consider the implications for child and family welfare agencies more broadly.

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Se efectuó una intervención comunitaria en 47 familias con pacientes diabéticos del Consejo Popular Sueño, perteneciente al Policlínico Docente "Armando García Aspurú" de Santiago de Cuba, desde enero del 2009 hasta febrero del 2010, con vistas a instruirles en algunos aspectos fundamentales relacionados con la diabetes mellitus. Antes y después de aplicadas las técnicas educativas en los familiares (durante 6 sesiones de trabajo), se les realizó una encuesta, y luego de 6 meses se entrevistó a los afectados. La información fue procesada de manera computarizada y se emplearon el porcentaje y el test de Mc Nemar como medidas de resumen y comparación, respectivamente. Posterior a la instrucción diabetológica, se obtuvo un incremento del apoyo familiar, lo cual favorecería el logro de una mejor atención a estos pacientes y un mayor control de la enfermedad.

A community intervention was performed in 47 families with diabetic patients of Sueño People's Council, belonging to "Armando García Aspurú" Teaching Polyclinic of Santiago de Cuba, from January 2009 to February 2010, in order to educate them in some fundamental aspects related to diabetes mellitus. Before and after educational techniques were applied in the family (during 6 working sessions), they were surveyed, and after 6 months patients were interviewed. The information was computerized and the percentage and the McNemar's test as summary measures and comparison were used respectively. After diabetes education there was an increase of family support, which would encourage the achievement of better care for these patients and a greater control of the disease.

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The article addresses the strength and character of intergenerational family solidarity under different family cultures and welfare state regimes in order to answer the following two questions: (1) Is intergenerational solidarity stronger under the more collectivist southern family tradition than under the more individualist northern tradition? (2) Is more generous access to social care services a risk or a resource for family care? These questions are explored with data from the OASIS project, a comparative study among the urban populations aged 25+ (n=6,106) in Norway, England, Germany, Spain, and Israel. The findings indicate that the welfare state has not crowded out the family in elder care, but has rather helped the generations establish more independent relationships. Intergenerational solidarity is substantial in both the northern and southern welfare state regimes, and seems to vary in character more than in strength.