***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Eighty-five diabetic patients who were proficient in English were studied to assess the impact of educational material of varying literacy levels on patient comprehension . Two sample s of available diabetes foot care material of Grade 11 and 9 readability ( measured by SMOG formula ) and purpose ly written in-house material of Grade 6 readability were used . Patients were r and omized to read information of either  Grade 6 and Grade 11 or Grade 6 and Grade 9 readability . Socio-demographic data and reading habits were collected to allow for identification of literacy markers . The mean CLOZE score ( a measure of comprehension ) was better in patients who read the Grade 6 information than for both the Grade 11 and Grade 9 information ( 59.5 + /- 11.8 , 46.8 + /- 22.0 , 45.8 + /- 22.2 respectively , p < 0.001 ) . When evaluated in terms of percent of patients that could independently underst and the material , Grade 6 information outperformed the Grade 11 and Grade 9 information ( 60 % , 19 % , 21 % , respectively , p < 0.001 ) . For the Grade 11 and Grade 9 information , poorer comprehension was associated with a non-English speaking background , early school leaving age , infrequent reading habits , and preference for tabloids ( p < 0.02 ) . Comprehension when patients read the Grade 6 information was no longer dependent on two of the four identified literacy markers . We conclude that reducing literacy dem and s of health literature improves patients ' comprehension . Attention to socio-demographic data and reading habits can assist educators in assessing patients ' literacy status and ensuring patients are given literature of compatible readability OBJECTIVE To test whether a theory-based , literacy , and culturally tailored self-management intervention , Latinos en Control  , improves glycemic control among low-income Latinos with type 2 diabetes . RESEARCH DESIGN AND METHODS A total of 252 patients recruited from community health centers were r and omized to the  Latinos en Control intervention or to usual care . The primarily group-based intervention consisted of 12 weekly and 8 monthly sessions and targeted knowledge , attitudes , and self-management behaviors . The primary outcome was HbA1c . Secondary outcomes included diet , physical activity , blood glucose self-monitoring , diabetes knowledge and self-efficacy , and other physiological factors ( e.g. , lipids , blood pressure , and weight ) . Measures were collected at baseline and at 4- and 12-month follow-up . Change in outcomes over time between the groups and the association between HbA1c and possible mediators were estimated using mixed-effects models and an intention-to-treat approach . RESULTS A significant difference in HbA1c change between the groups was observed at 4 months ( intervention −0.88 [ −1.15 to −0.60 ] versus control −0.35 [ −0.62 to 0.07 ] , P < 0.01 ) , although this difference decreased and lost statistical significance at 12 months ( intervention −0.46 [ −0.77 to −0.13 ] versus control −0.20 [ −0.53 to 0.13 ] , P = 0.293 ) . The intervention result ed in significant change differences in diabetes knowledge at 12 months ( P = 0.001 ) , self-efficacy ( P = 0.001 ) , blood glucose self-monitoring ( P = 0.02 ) , and diet , including dietary quality ( P = 0.01 ) , kilocalories consumed ( P < 0.001 ) , percentage of fat ( P = 0.003 ) , and percentage of saturated fat ( P = 0.04 ) . These changes were in turn significantly associated with HbA1c change at 12 months . CONCLUSIONS Literacy-sensitive , culturally tailored interventions can improve diabetes control among low-income Latinos ; however , strategies to sustain improvements are needed BACKGROUND Type 2 diabetes is up to four times more common in British Asians , but they know little about its management and complications . AIM To design and evaluate a structured pictorial teaching programme for Pakistani Moslem patients in Manchester with type 2 diabetes . METHOD A r and omized controlled trial of pictorial flashcard one-to-one education in 201 patients attending a hospital outpatient clinic or diabetic clinics in ten general practice s in Manchester . Patients ' knowledge , self-caring skills and attitudes to diabetes were measured on four topics before the structured teaching , and compared with results six months later . RESULTS All parameters of knowledge were increased in the study group ; for example , percentage scores for correctly identifying different food values increased from 57 % to 71 % ( Analysis of Variance ( ANOVA ) adjusted difference + 11.8 % ) and knowledge of one diabetic complication from 18 % to 78 % . Self-caring behaviour improved , with 92 % of patients doing regular glucose tests at six months compared with 63 % at the start . Attitudinal views were more resistant to change , with patients still finding it hard to choose suitable foods at social occasions . Haemoglobin A1c control improved by 0.34 % over six months ( ANOVA adjusted difference , 95 % CI -0.8 % to + 0.1 % ) . CONCLUSION It is concluded that this health education programme can empower Asian diabetics to take control of their diets , learn to monitor and interpret glucose results , and underst and the implication s of poor glycaemic control for diabetic complications BACKGROUND Cardiovascular disease ( CVD ) and diabetes account for one-third of the mortality difference between African American and white patients . We evaluated the effect of a CVD risk reduction intervention in African Americans with diabetes . METHODS We r and omized 359 African Americans with type 2 diabetes to receive usual care or a nurse telephone intervention .  The 12-month intervention provided monthly self-management support and quarterly medication management facilitation . Co primary outcomes were changes in systolic blood pressure ( SBP ) , hemoglobin A1c ( HbA1c ) , and low-density lipoprotein cholesterol ( LDL-C ) over 12 months . We estimated between-intervention group differences over time using linear mixed-effects models . The secondary outcome was self-reported medication adherence . RESULTS The sample was 72 % female ; 49 % had low health literacy , and 37 % had annual income < $ 10,000 . Model-based estimates for mean baseline SBP , HbA1c , and LDL-C were 136.8 mm Hg ( 95 % CI 135.0 - 138.6 ) , 8.0 % ( 95 % CI 7.8 - 8.2 ) , and 99.1 mg/dL ( 95 % CI 94.7 - 103.5 ) , respectively . Intervention patients received 9.9 ( SD 3.0 ) intervention calls on average . Primary providers replied to 76 % of nurse medication management facilitation contacts , 18 % of these result ed in medication changes . There were no between-group differences over time for SBP ( P = .11 ) , HbA1c ( P = .66 ) , or LDL-C ( P = .79 ) . Intervention patients were more likely than those receiving usual care to report improved medication adherence ( odds ratio 4.4 , 95 % CI 1.8 - 10.6 , P = .0008 ) , but adherent patients did not exhibit relative improvement in primary outcomes . CONCLUSIONS This intervention improved self-reported medication adherence but not CVD risk factor control among African Americans with diabetes . Further research is needed to determine how to maximally impact CVD risk factors in African American patients Objective To examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged BACKGROUND AND AIM The risk of death from coronary heart disease ( CHD ) in women with diabetes is more than three times that of non-diabetic women . We assessed the difference in CHD risk levels of Afro-Caribbean diabetic women provided with facilities for self-monitoring of blood glucose and their counterparts without such facilities MATERIAL S AND METHODS Forty-nine patients who never used gluco-meters were studied as intervention ( 23 ) and control ( 26 ) groups . The intervention group was trained on self-monitoring of blood glucose . At baseline , BP , anthropometric indices , and fasting blood glucose of all patients were measured . Subsequently , the intervention patients were provided with gluco-meters , testing strips , and advised to self-monitor fasting and postpr and ial blood glucose every other day for 6 months .  CHD risk was determined with the United Kingdom Prospect i ve Diabetes Study risk engine calculator . RESULTS The age , duration of diagnosis of diabetes , BP , and anthropometric indices were similar in the two groups ( all , P > 0.05 ) . The majority of the patients were unemployed or retired with only primary education . After 3 months , the HbA 1c levels of the control patients did not change ( 8.3 ± 0.4 % vs. 7.8 ± 0.4 % , P > 0.05 ) whereas the HbA 1c levels of the intervention patients reduced significantly from the baseline at 3 ( 9.2 ± 0.4 % vs. 7.4 ± 0.3 % , P < 0.001 ) and 6 ( 9.2 ± 0.4 % vs. 7.3 ± 0.3 % , P < 0.001 ) months . The 10-year CHD risk level of the intervention group was remarkably reduced from the baseline level after 6 months ( 7.4 ± 1.3 % vs. 4.5 ± 0.9 % ) of the study . CONCLUSION Provision of facilities for self-monitoring of blood glucose in Afro-Caribbean women with type 2 diabetes improves both their glycemic control and CHD risk profile The promotion of regular physical activity for people with type 2 diabetes poses a challenge for public health authorities . The purpose of this study was to evaluate the efficiency of a  computer-tailoring print-based intervention to promote the adoption of regular physical activity among people with type 2 diabetes . An experimental design was used ; 325 participants between the age of 35 and 55 years old were r and omized in one of two experimental conditions : the computer-tailoring intervention and the generic intervention . The two dependant variables were the frequency of participation and the intention to participate in leisure-time physical activities . Among the research hypotheses , only one was confirmed : the first computer-tailoring print on the practice of physical activity  was more efficient than the first generic intervention at 1-month follow-up . Other similar studies will be necessary to determine the real potential of this type of approach for people with type 2 diabetes in a real-life setting Purpose The purpose of the study was to test the feasibility and efficacy of a diabetes self-management and education program for Chinese Americans in a support group format . The rationale for the study was to create culturally appropriate diabetes education and management programs in response to the growing diabetes prevalence among Chinese Americans . The investigators hypothesized that participants will have improved diabetes knowledge and practice s , hemoglobin A1C 
    Output:
    
Other outcome measures ( blood pressure , body mass index , self-efficacy and empowerment ) also showed neutral effects compared with control groups .
Culturally appropriate health education has short- to medium-term effects on glycaemic control and on knowledge of diabetes and healthy lifestyles .