bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lessons Learned: Patient Strategies for a Type 2 Diabetes Intervention in a Primary Care Setting
Authors: Amthauer Hllarea , Gagilo Bridget , Glasgow Russell E. , Dortch Wendy , King Diane K. 
Published: April 2008

PURPOSE this study reports on methods and strategies employed to increase participation rates in diabetes interventions and discusses the reach and representativeness of the Diabetes Priority Program. METHODS A passive mail-out procedure was used to contact patients of participating primary care physicians. Patients who did not return the refusal postcard were contacted. Several attempts were made to contact potential participants. Brochures, "wrong number" postcards, posters, and reports for clinic staff were strategies used to increase participation. RESULTS The recruitment process resulted in a participation rate of 83% among patients who were contacted and eligible. These participants appeared to be representative of both nonparticipants and persons with diabetes in Colorado. In contrast, a low percentage of primary care physicians, estimated at 3%, took part in the program despite efforts to make the program brief, nonintrusive, and compatible with usual care. CONCLUSIONS Recruitment is currently challenging and will become even more difficult with the privacy regulations that affect healthcare research and the public distrust of solicitations. To increase participation rates, it is important that the clinic staff promotes and supports the program, and that participant lists are accurate and adequate in size.
The Impact of Verbal Communication on Physician Prescribing Patterns in Hospitalized Patients With Diabetes
Authors: Martin Kay , Carter Loletta , Ballunas Donna , Sotoudeh Faranak , Moore Debbie , Westerflield Joanne 
Published: April 2008

PURPOSE The purpose of this descriptive clinical research study was to identify which method of communication, verbal or written, has the greatest impact on physician adjustment of the antidiabetes medication regimen for hospitalized patients with hyperglycemia. METHODS The medical records for 1026 patients hospitalized with diabetes at a large, metropolitan, not-for-profit teaching hospital were reviewed by the diabetes inpatient clinicians to identify hyperglycemia and the potential need to initiate or adjust the antidiabetes medication regimen. The study evaluated the effectiveness of verbal versus written communication between the diabetes inpatient clinician and the physician regarding cases where the current antidiabetes medication regimen was not optimal. RESULTS Verbal interaction between the diabetes inpatient clinician and the physician resulted in a greater number of changes in the antidiabetes medication regimen. CONCLUSIONS Communication modality correlates with changes in antidiabetes medications prescribed by physicians and may be an effective tool to facilitate inpatient glycemic control.
Quality of Life in School-Aged Children With Type 1 Diabetes on Intensive Treatment and Their Parents
Authors: Whittemore Robin , Urban Andrea Dann , Tamboriane William V. , Grey Margaret 
Published: April 2008

PURPOSE The purpose of this study was to examine the child, parent, and family factors associated with quality of life and metabolic control in school-aged children with type 1 diabetes on intensive treatment. METHODS A cross-sectional analysis was performed of child, parent, and family psychosocial variables with child quality of life and metabolic control. RESULTS Families of school-aged children were able to intensively manage type 1 diabetes, achieve good metabolic control (<7.5%), experience good quality of life, and cope well with the demands of treatment. However, increased depressive symptoms were reported in the children (8%) and a parent (29%). CONCLUSIONS Most school-aged children and families in this sample coped well with the demands of intensive treatment. However, intensive psychosocial support may also be indicated because managing a complex chronic illness is stressful and potentially difficult for some families.
Assessment and Management of Erectile Dysfunction in Men With Diabetes
Authors: Spollett Geralyn R. 
Published: April 2008

PURPOSE Erectile dysfunction occurs earlier in men with diabetes than in the general population, affecting over 50% of male patients by age 60. This article summarizes the etiologies and presents methods of patient assessment and treatment options for erectile dysfunction. METHODS Assessments of neurologic and vascular complications related to diabetes should be included in a sexual function history. The assessment must be holistic and focus on organic as well as psychogenic causes. Diabetes educators must be prepared to discuss the various pharmacologic treatment options. RESULTS Sildenafil currently is the only oral medication available for erectile dysfunction. Injectable treatments have proven successful but with limited long-term use and poor patient acceptance. Implantable devices carry surgical risk and increased rates of infection. CONCLUSIONS All men with diabetes should be screened for erectile dysfunction. The availability of a new oral medication provides a patient-acceptable treatment option.
Culturally Competent Diabetes Education for Mexican Americans: The Starr County Study
Authors: Brown Sharon A. , Hanis Craig L. 
Published: April 2008

PURPOSE Few culturally competent health programs have been designed for Mexican Americans, a group that bears a disproportionate burden of Type 2 diabetes. In Starr County, a Texas-Mexico border community, investigators designed and tested a culturally competent intervention aimed at improving the health of this target population. The purpose of this article is to describe the development process of this diabetes education and support group intervention. METHODS The development stages were (1) community assessment, (2) intervention design, (3) selection or development of outcomes, (4) pilot testing, and (5) a randomized clinical investigation. RESULTS Focus group participants identified knowledge deficits regarding diabetes and self-management strategies, and suggested characteristics of an effective intervention for Mexican Americans. Outcome measures included metabolic control indicators, a newly developed knowledge instrument, and an existing health belief instrument. Preliminary analyses indicated that the intervention was successful in significantly improving metabolic control in the target population. CONCLUSIONS Developing successful diabetes interventions for minority groups requires a number of stages, careful planning, assessment of cultural characteristics of the target population, and a systematic approach to implementation.
Lispro Insulin: Adsorption and Stability in Selected Intravenous Devices
Authors: Ung Jie , Hu Ming , Hagerup Tore , Campbell R. Keith 
Published: April 2008

PURPOSE The adsorption characteristics and stability profile of an insulin analog, lispro insulin, were evaluated against a recombinant human regular insulin using intravenous infusion sets and syringes. METHODS Studies were performed using either 0.9% NaCl or 5% dextrose intravenous injection solution. Effects of container type, infusion rate, product concentration, presence/absence of an in-line filter, and storage condition on release profiles of lispro and human regular insulin infusion solutions were determined. RESULTS Lispro insulin and m-cresol were chemically stable. Release rates of insulin (both types) were steady after an initial lag time. The lag time was much longer with intravenous bag infusion than with intravenous syringe infusion. A higher product concentration, faster flow rate, and prewash of the infusion tubing were shown to substantially decrease the lag time. CONCLUSIONS The adsorption profile of lispro insulin was the same as that of human regular insulin in both syringes and bags. Use of a load-and-sit prewash scheme may shorten or nearly eliminate the lag time, which in turn may be used to make a more accurate calculation of a patient's dose.
The Diabetes Day Treatment Experiment: A Preliminary Report on What We Learned
Authors: Hendricks Leo E. , Hendricks Rosetta T. , Young Anne L. 
Published: April 2008

PURPOSE this paper presents data on the efficacy of a diabetes day treatment program to modify the healthcare behavior of elderly African Americans with diabetes. METHODS African American patients with Type 1 or Type 2 diabetes who were referred by their certified diabetes educator were eligible to participate in the day treatment program. The program was designed to serve eight patients for 4 hours 1 day a week over 9 months. Participants engaged in informal discussions, low-impact armchair exercises, and discussions of various diabetes issues. A flow sheet was initiated and maintained by the investigators to record information pertaining to each participant's blood pressure, blood sugar, and weight at each session. Attendance and reasons for not attending sessions were recorded. To obtain more in-depth information, the group leaders used a technique known as participant observation. RESULTS Having CDEs administer a blood sugar test, take blood pressure, and weigh each patient at each clinic visit promotes patient adherence to the diabetes treatment regimen. Memory loss was observed to be especially prevalent among the subjects. CONCLUSIONS The Diabetes Day Treatment Program may be used as a model for working with elderly persons with diabetes from different ethnic groups.
Foot Education Improves Knowledge and Satisfaction Among Patients at High Risk for Diabetic Foot Ulcer
Authors: Ward Aileen , Metz Louise , Oddone Eugene Z. , Edelman David 
Published: April 2008

PURPOSE The purpose of this study was to evaluate an intensive diabetes foot education program for veterans at high risk for foot ulcer. METHODS We invited 100 consecutive patients with diabetes from a Department of Veterans Affairs Medical Center clinic who were insensate to the Semmes-Weinstein 5.07 monofilament to participate in a foot care education program. Two sessions were conducted by a nurse diabetes educator 3 months apart. Multiple educational approaches were used to teach patients foot self-examination, foot washing, proper footwear, and encouragement in enlisting proper physician foot care. Knowledge and satisfaction with care was measured before and after each visit. RESULTS The 34 patients who attended both education sessions improved their foot care knowledge over the course of the program. After the second session, the mean improvement over baseline was 14%. These patients also reported improved satisfaction with foot care; mean improvement was 33%. CONCLUSIONS An intensive education program improved the foot care knowledge and behavior of high-risk patients. Those who adhered to a foot care education program were more satisfied with their foot care than prior to the program. Ways to improve accessibility of education sessions must be explored.
Comparing Outpatient and Inpatient Diabetes Education for Newly Diagnosed Pediatric Patients
Authors: Siminerio Linda M. , Charron-Prochownik Denise , Banion Carolyn , Schrelner Barbara 
Published: April 2008

PURPOSE the purpose of this study was to compare the efficacy of outpatient vs inpatient programs on medical, cognitive, behavioral, and psychosocial outcomes. METHODS Using three large, tertiary medical centers in the United States, the sample of 32 children newly diagnosed with diabetes and their parents were recruited. Children and parents who received outpatient education were compared with those who received inpatient education. The following outcome variables were compared: (1) rates of hospital readmissions and/or emergency room visits for either severe hypoglycemia or ketoacidosis, (2) knowledge, (3) sharing of responsibilities, (4) adherence, (5) family functioning, (6) coping, and (7) quality of life. RESULTS In general, no statistically significant differences were found between the groups. A trend was noted in the outpatient group with regard to improved use of emergency precautions on the adherence measure, roles on the family functioning measure, maintaining family integration on the parental coping measure, and disposition on the children's coping instrument. CONCLUSIONS Findings support the safety and efficacy of the outpatient program method.
Use of Lispro Insulin and Quality of Life in Adolescents on Intensive Therapy
Authors: Gray Margaret , Boland Elizabeth A. , Tamborlane William V. 
Published: April 2008

PURPOSE this study examined the metabolic and quality-of-life effects of using lispro insulin in teenagers. METHODS Teenagers on multiple daily injections who had not reached metabolic treatment goals were offered the opportunity to use lispro insulin as part of a larger ongoing study of intensive management in youth. Of the 51 who were eligible, 35 used lispro and were followed for 12 months; the remaining 16 had reached treatment goals, were not offered lispro, and comprised the control group. RESULTS After 12 months, the teens who received lispro insulin achieved equivalent levels of metabolic control to those achieved by teens in the control group, without differences in total daily dose, insulin regimen, or adverse events. Those who received lispro found coping with diabetes less difficult than those who continued on regular insulin, and they reported less negative impact of diabetes on quality of life and fewer worries about diabetes. Both groups were equally satisfied with their diabetes treatment. CONCLUSIONS Lispro insulin is a safe alternative for youth on intensive regimens, may assist youth in coping with diabetes, and may improve their quality of life.
Characteristics of the Adult Learner
Authors: Walker Elizabeth A. 
Published: April 2008

PURPOSE This article provides an overview of adult learner characteristics, with an emphasis on those characteristics studied in diabetes patient education research. METHODS A selected review of the conceptual and research literature on general adult education and adult learning was conducted, with particular attention to diabetes patient education studies. RESULTS Characteristics reviewed included learning styles, literacy level, age/aging, ethnicity or culture, gender, and knowledge. Studies of the learning style of group vs individual education indicated some positive benefits for group learning; questions remain about optimal size or periodicity. Studies evaluating the benefits of culturally specific interventions for diabetes management have yielded some information. Characteristics related to gender and age have been studied, but often in pilot or feasibility studies without the power to answer the study questions. CONCLUSIONS There continue to be many gaps in knowledge related to adult learner characteristics in diabetes education. Lessons from both general adult learning literature and patient education literature from other chronic diseases should be evaluated and incorporated. The complexities of these learner characteristics create challenges in designing studies. However, evidence to support the need for effective educational interventions is of great importance for implementing change in health care.
Behavior Change in Diabetes Education
Authors: Peyrot Mark 
Published: April 2008

PURPOSE The purpose of this paper is to explore how diabetes education produces change in self-care behavior. METHODS Published research on diabetes education relevant to behavior change was examined and a framework was formulated for the study of behavior change. RESULTS Research indicates that education improves patient selfmanagement, which in turn improves glycemic control and health status. Yet, there is relatively little information on what types of education produce what particular benefits for which types of patients. Moreover, we do not know the benefits of various forms of education (for selected groups) relative to their costs. Empirical studies of how education produces behavior change are few, but much preliminary work has been done to identify potential behavioral determinants that can be targeted by interventions. Theoretical models of behavior change have been advanced (eg, stages of change) but they have yet to be rigorously tested. CONCLUSIONS Initial answers to the research questions can be generated by conducting more sophisticated analyses of the type of data already being collected. However, obtaining complete answers to some of these questions will require more extensive data collection, including large-scale studies of multiple interventions in multiple patient groups.
Outcomes of and for Diabetes Education Research
Authors: Glasgow Russell E. 
Published: April 2008

PURPOSE The purpose of this paper is to review outcome measures used to evaluate diabetes self-management education and make recommendations for future research. METHODS Three perspectives were used: (1) the frequency with which different measures were collected prior to 1990 was compared with a sample of the 1997 to 1999 literature, (2) a multilevel pyramid model of psychosocial-environmental factors was used to evaluate the level of outcomes assessed, and (3) the RE-AIM evaluation framework was used to assess the public health impact of studies reported in the literature. RESULTS Knowledge and HbA1c measures are often collected to the exclusion of other, possibly more appropriate outcomes. Research has focused almost exclusively on individual or family level outcomes and paid little attention to effects at systems levels, such as neighborhoods, communities, or healthcare systems. More recent studies have been evaluating the reach of interventions, but more practice-oriented research needs to be conducted with representative patients, providers, and settings. CONCLUSIONS Much has been learned about the efficacy of diabetes selfmanagement and about measurement issues. Future research should now focus on effectiveness and generalization issues.
What do we know about promoting mental health through schools?
Authors: Weare Katherine , Markham Wolfgang 
Published: April 2008

There is a growing evidence base on what schools need to do to promote mental health effectively. There is strong evidence that they need first and foremost to use a whole school approach. This shapes the social contexts which promote mental health and which provide a backdrop of measures to prevent mental health disorders. In this context the targeting of those with particular needs and the work of the specialist services can be much more effective. Schools need to use positive models of mental health, which emphasise well being and competence not just illness- this will help overcome problems of stigma and denial and promote the idea of mental health as 'everyone's business'. The most effective programmes in schools which address mental health have the following characteristics: • They provide a backdrop of universal provision to promote the mental health of all and then target those with special needs effectively. • They are multi-dimensional and coherent. • They create supportive climates that promote warmth, empathy, positive expectations and clear boundaries. • They tackle mental health problems early when they first manifest themselves and then take a long term, developmental approach which does not expect immediate answers. • They identify and target vulnerable and at risk groups and help people to acquire the skills and competences that underlie mental health. • They involve end users and their families in ways that encourage a feeling of ownership and participation, and provide effective training for those who run the programmes, including helping them to promote their own mental health. Using these starting points, we need to develop a rigorous evidence-based approach on this issue. We also require the facilitation of the dissemination of such research findings while encouraging new and innovative approaches.
Successful strategies and lessons learned from development of large-scale partnerships of national non-gowernmental organisations
Authors: Potts-Datema William , Smith Becky J. , Taras Howard , Lewallen Theresa C. , Bogden James F. , Murray Sharon 
Published: April 2008

National governments worldwide work to improve education and health outcomes for children and youth and influence their behaviours. Also heavily engaged are national non-governmental organisations (NGOs) in the voluntary and non-profit sector. While individual agencies and non-profit organisations are often concerned with specific issues of interest related to their charge, constituency or membership, they often develop allegiances with like-minded groups to accomplish broader goals. Two such collaborations in the United States are the focus of this discussion, the National Co-ordinating Committee on School Health and Safety (NCCSHS) and the Friends of School Health (hereafter, "the Friends"). This article reviews these two significant partnerships of public health and education NGOs and outlines successful strategies and lessons learned from the development of these large-scale partnerships. NCCSHS is a collaboration of 64 NGOs and six U.S. government departments representing both the fields of public health and education. Nearly all major NGOs working in fields related to school health are represented, and the six primary governmental agencies all have at least some responsibility for students' health and safety. The group is the primary intersection of NGOs and the Federal government related to school health at the national level. The Friends of School Health ("the Friends") is the primary school health advocacy coalition at the national level in the United States. Sixty-one education and public health NGOs participate. The coalition serves as a communication mechanism and venue for collaborative action on issues before the U.S. Congress and state legislatures that relate to school health. Since the coalition advocates to legislators and other decision makers, no government agencies participate. The paper describes the strategies relating to the initial development of the collaboratives and their ongoing operation. A common theme in development of both of these examples of large-scale partnerships is trust. Like any partnership, the ability to work and grow is dependent on the level of trust among the partners. Both the National Coordinating Committee on School Health and Safety and the Friends of School Health work together successfully within and across their collaborations, to improve health and educational outcomes for children and youth. While both experience challenges, and neither would indicate that its work is near completion, they provide important insight into how these collaboratives can initially develop and subsequently operate productively while providing important contributions to the promotion of healthy schools, and ultimately, healthy nations.