bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Family Context of an Intervention to Prevent Type 2 Diabetes in High-Risk Teens
Authors: Seibold Esther S. , Knafl Kathleen , Grey Margaret 
Published: April 2008

PURPOSE This research describes the family context of eating and mealtime patterns in young adolescents at high risk for type 2 diabetes and the implications for preventing this disease. METHODS Ten families, each consisting of a child and one parent, participated in individual, semistructured interviews that focused on family eating patterns. Topics included meal schedules, food preparation, family eating patterns, school eating patterns, and perception of the child's weight. Interviews were audiotaped, transcribed verbatim, and analyzed using focused summaries and thematic analysis methods. RESULTS Four main themes were identified: child and family eating patterns, perspectives on obesity, perspectives on weight control, and health concerns. Family eating patterns were often inconsistent, and few healthy eating models were available at home or school. Obesity was not always seen as a negative factor, particularly by the youth. Weight-control efforts were sporadic, typically unsuccessful, and consisted primarily of intermittent increases in physical activity. Parents did not actively participate in their child's weight-control efforts. CONCLUSIONS Effective interventions for obesity and prevention of type 2 diabetes in youth should include parents in both cognitive and behavioral strategies.
Use of Cognitive Interviewing to Adapt Measurement Instruments for Low-Literate Hispanics
Authors: Rosal Mllagros C. , Carbone Elena T. , Goins Karin Valentine 
Published: April 2008

PURPOSE Cognitive interviewing techniques were used to adapt existing measures for use with a population of low-literate Spanish-speaking people with diabetes. METHODS Five individuals of Caribbean origin with diabetes participated in cognitive interviews for 4 instruments (measuring diabetes knowledge, quality of life, self-management, and depression) adapted for oral administration to low-literate individuals. Audiotaped interviews and handwritten notes were subjected to content analysis to identify problems across the 4 instruments as well as specific to a given instrument. RESULTS The following key problems were identified: general instructions were not helpful, items that were not specific enough generated a variety of interpretations, some wording was confusing, abstract concepts were difficult to understand, some terminology was unfamiliar, and interpretation of certain words was incorrect. CONCLUSIONS The data illustrate the usefulness of cognitive interviewing as a first step in the process of adapting measurement instruments.
Exercise: A Vital Component for Patients on the Biostator
Authors: Summers Sally 
Published: April 2008

Exercise was incorporated into the treatment of diabetic patients on the Biostator. As the purpose of the Bio stator is to determine the patient's in sulin requirements over a 24 hour pe riod, activity and exercise are impor tant to normalize that 24-hour period as much as possible. Individual exercise programs were developed for each of the patients on the Biostator. The most common ex ercise vehicle chosen was a bicycle ergometer. Physical Therapy devel oped these programs based on the pa tient's "Home Activity Assessment. " Nursing and Physical Therapy then monitored the patient's compliance with the exercise program during the "run" on the Biostator. The Biostator print-out (see Table I, p. 13) was used in a retrospective study of the effect of exercise on the patient's blood glucose levels. It was found that the median decrease in blood sugar immediately after cessa tion of exercise was - 6mgldl and for 15 minutes after cessation of exercise was — 12mg/dl. Empirical data is im portant to the patient so that they may balance exercise, diet, and insulin to keep blood glucose levels in control.
Biostator Education For Staff Development
Authors: Jacobson Bonnie 
Published: April 2008

The Biostator Glucose Controller requires a profession al team that has received specialized training in setting up the machine, monitoring, and troubleshooting the system. The training program at United Hospitals of St. Paul covers a three-day orientation, plus further education for set-up and monitoring, hands on exploration through the use of worksheets and practicum assignments, and reviews of procedures every couple of months as needed. One expanded role for a diabetes educator is that of the Biostator Nurse Specialist, who has the overall respon sibility for the Biostator and its operation. The technical education required of the nursing staff is delineated in this article in terms of specific competencies that are required, monitoring skills, and evaluation.
Aiding the Person who is Visually Impaired from Diabetes
Authors: Cleary Margaret E. 
Published: April 2008

Some degree of diabetic retinopathy exists with alarm ing frequency in persons who have diabetes mellitus. The diabetes educator is often in a position to direct, teach, and counsel the patient who is involved in diagnosis, treat ment, and rehabilitation. The educator's role may vary — offering an informed listening ear; providing simple explanations about the eye, the disease processes, and treatment; giving clear instruc tions about how to perform some activity independently; and directing the person to the appropriate resources for specialized assistance. Being an expert in retinopathy or rehabilitation of per sons who are visually impaired is not necessary. Being in terested, innovative, aware, and curious can help the dia betes educator obtain the knowledge, skills, and direction that need to be imparted to the patient. This article is offered to provide information about the effects of diabetic retinopathy on vision, the difficulties ex perienced by persons with both diabetes and visual impair ment, and helpful hints as a means of resolving some dilemmas. The text will indicate references where further information can be obtained. A numbered resource list will be found at the end.
Reagent Strip Performance as Evaluated by a Meter
Authors: Auerhahn Carolyn , Bergman Michael , Kumar Sunita Ravi , Morgan Joan 
Published: April 2008

The stability of 98 Chemstrip bG (CS) was assessed with a specially de signed meter (Accu-Chek) to deter mine the length of time patient-read CS can be saved in order to evaluate the accuracy of self-monitoring. Visual readings of 70 CS from 21 patients were compared with meter readings immediately after capillary blood glu cose (CBG) determination to assess patient accuracy. The rate with which meter-read CS changed was significant by three days (p<0.001). To determine the clinical significance of this change, the abso lute values of initial meter readings were compared to subsequent meter readings for 14 days. Significant changes in CBG values occurred after 5-10 days dependent upon the initial CBG value. If the initial CBG value was less than or equal to 180 mg/dl, CS deteriorated significantly after ten days. When the initial CBG value was greater than 180 mgldl, significant deterioration occurred after five days. Patient accuracy was found to be 97% ± 15. In conclusion, (1) when properly stored, CS can be saved for up to ten days in order to assess individual pa tient accuracy in performing self-moni toring, and (2) despite considerable variability, patient interpretation of CS is accurate.
Flexible Diets For Diabetes Care
Authors: Tietyen Janet , Jones Sarah E. , Leichter Steven B. 
Published: April 2008

The nutritional aspect of diabetes treatment is often the most difficult component of care for the patient and the health professional. The demands imposed by major alter ations in lifestyle, the artificiality of therapeutic eating pro grams, and the lack of available and proven counseling are possible causes of poor patient compliance. "Diets" may also be socially stigmatic to patients with diabetes. While advances have been made in many areas of nutrition and diabetes, there has been relatively little change in the traditional nutritional counseling methods, intended to lead to an understanding and adherence to a sound nutritional program. The evolving definition of the general goals of nutri tional therapy and the lack of success with traditional ap proaches to nutritional care of diabetes have recently stimu lated the search for alternate nutritional regimens. These programs have been called "flexible diets. " They all base food selection upon the quality of food content rather than food group as in the exchange diet. Indiuidual counseling is important and is directed primarily to modify present eat ing habits rather than radical changes. The continued de velopment of flexible diets may be an exciting area of nutri tional development in the future.
Impacts of Professional Education in Diabetes on Trainees' Reports
Authors: Warren-Boulton Elizabeth , Hershey Phyllis S. , Hopper Susan V. , Lange Marcia H. , Flavin Karen S. , Epstein Marilyn G. , Auslander Wendy F. , Fisher Edwin B. 
Published: April 2008

Over a three-year period, 202 nurses and dietitians attended professional edu cation courses conducted at the Diabetes Research and Training Center. The courses were designed to develop trainee knowledge and skill for diabetes management and to guide the expansion of patient education programs. Trainees' satisfaction with the course components was high and knowledge changes were significant. Sixty-one percent of the trainees returned a follow- up survey indicating im provements in counseling and teaching skills. Trainees' reports indicated greatest progress in areas over which they had most direct control. Professional education may have positive effects on trainee knowledge, teaching preparation and counseling skills, and patient education programs.
Diabetes and Job Performance: An Empirical Investigation
Authors: Greene David S. , Geroy Gary D. 
Published: April 2008

There are approximately 11 million people in the United States with diabetes, and the numbers are increasing by 6% annually. Still, the relationship between diabetes and job performance remains unclear and marked by bias. To help clarify this relationship, a multicriterion job-performance rating scale was developed to rate task behaviors, interpersonal behaviors, dowr-time behaviors, and hazardous behaviors. A volunteer sample of 53 subjects was selected from people with insulin-dependent diabetes mellitus (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM). All subjects were rated individually by a supervisor; who also rated the norm for the work group. The norm rating was used to determine a norm-referenced control group. The subjects were rated better than the norm in all categories and on all criteria: composite job performance (P<.001), task behaviors (P<.01), interpersonal behaviors (P<.01), down-time behaviors (P<.05), and hazardous behaviors (P<.001).
Revisiting Nurse Knowledge About Diabetes: An Update and Implications for Practice
Authors: Jayne Rael , Rankin Sally H. 
Published: April 2008

This study attempted to ascertain the diabetes knowledge level of nurses in a university medical center, to describe correlates of nurse knowledge, and to compare levels of diabetes knowledge between nursing units. A convenience sample of staff nurses (n=99) from six inpatient units and an ambulatory care center volunteered to complete a previously developed, 45-item questionnaire testing their knowledge of basic concepts about diabetes mellitus. Analysis of variance, comparing the nursing units, indicated a significant difference between units (P=.04) on the knowledge questionnaire. In a 4-step, hierarchial, multiple regression analysis, variables related to how competent the nurses felt in caring for diabetic patients and the number of diabetic patients cared for in the past month explained 28% of the variance in diabetes knowledge. Although this study corroborates earlier findings, questions still remain concerning the general adequacy of nurses' knowledge about diabetes.
The Impact of the Trial Coordinator in the Diabetes Control and Complications Trial (DCCT)
Authors: Ahern Joann , Grove Nancy , Strand Trudy , Wesche Jacqueline , Seibert Carolyn , Brenneman Anne T. , Tamborlane William V. 
Published: April 2008

The Diabetes Control and Complications Trial (DCCT) is a multicenter, randomized clinical trial studying the effects of two different diabetes regimens on the development and progression of early vascular complications in persons with insulin-dependent diabetes mellitus (IDDM). All of the centers have a Trial Coordinator. We administered a self-report questionnaire to each center to document the different activities for which the Trial Coordinator assumed responsibility, in successfully orchestrating the trial. All Trial Coordinators were responsible primarily for recruitment, screening, medical management, education and training, and adherence and administration. Although documentation indicated that the Trial Coordinator was responsible for all of the above activities, the original applications reflected that very few of the Principal Investigators anticipated such a wide variety of duties. A Trial Coordinator was named in only 13 of the 21 applications and of these, only 6 actually assumed the position. This study points out the need to develop a means to define characteristics, background, and training appropriate for candidates for a Trial Coordinator position in future studies.
Identifying and Treating Common and Uncommon Infections in the Patient with Diabetes
Authors: Garrison Mark W. , Campbell R. Keith 
Published: April 2008

Patients with diabetes represent a unique group of individuals who appear more prone than others to developing infections. Several mechanisms have been proposed to explain the association between diabetes and infections. However, few conclusive studies exist and considerable debate continues regarding evidence for this predisposition. Despite this lack of documented proof, many health care practioners acknowledge that a number of infections are overrepresented in patients with diabetes. Some of these infections appear to occur exclusively in patients with diabetes, especially patients who are poorly controlled. The presenting clinical features, causative organisms, and preferred treatment approaches will be discussed in this article for a variety of common and uncommon infections observed in patients with diabetes. In addition, the proposed predisposing factors will be addressed briefly
Beliefs About Smoking and Diabetes Care
Authors: Haire-Joshu Debra , Heady Susan , Thomas Leela , Schechtman Ken , Fisher Edwin B. 
Published: April 2008

The purpose of this study was to address the following questions: 1) Do smokers with diabetes believe that cigarettes have favorable outcomes associated with diabetes management? 2) Do smokers with diabetes believe that quitting smoking negatively impacts diabetes management? 3) Do smokers with diabetes perceive significant Others as being supportive ofattempts to quit smoking? and 4) What is the relationship between these factors and attitude toward quitting smoking? Patients with insulin-dependent diabetes mellitus (IDDM) completed a measure of Attitude Toward Quitting Smoking, which assessed desire and confidence in ability to achieve cessation, and the Diabetes and Smoking Beliefs Questioltllaire, which assessed beliefs regarding cigarettes and diabetes management. Smokers whose attitudes reflected less desire to quit and less confidence in doing so reported that cigarettes had utilit y in diabetes management, that quitting has negative effects on diabetes, and perceived significant others as only moderately supportive of attempts to quit smoking. Implications of these findings for diabetes education are discussed.
Ethical Conflicts Reported by Registered Nurse/Certified Diabetes Educators
Authors: Redman Barbara K. , Fry Sara T. 
Published: April 2008

The purpose of this pilot study was to identify types of ethical conflicts reported by Certified Diabetes Educators who also are Registered Nurses (RN/CDEs). Ethical conflicts expressed by RN/CDEs in active practice in Maryland, Virginia, and the District of Columbia were described by these healthcare professionals. Each conflict was analyzed according to three themes: the practice context, the ethical principles in conflict, and how the conflict was experienced by the nurse subject. The majority of ethical conflicts (75%) concerned disagreement with the quality of medical care the patient was receiving. The principles most often in conflict were beneficence and nonmaleficence. Most conflicts were experienced as dilemmas (two or more principles that seem to apply but support mutually inconsistent courses of action).
A Computerized Model for Home Glucose Monitoring Proficiency Testing: Efficacy of an Innovative Testing Program
Authors: Schrot Richard J. , Foulls Philip R. , Morrison Anthony D. , Farese Robert V. 
Published: April 2008

PURPOSE A newly instituted computerized system for proficiency testing of home glucose monitoring was evaluated comparing accuracy of patient determination of glucose with serum values measured in the laboratory. METHODS Patients returning for routine blood glucose testing ordered by their care provider brought their glucose monitoring equipment to the laboratory. They performed a finger-stick glucose check in the laboratory while the laboratory phlebotomist drew blood for glucose determination; both results were computer analyzed. Patients with a 25% or less variation from the laboratory were considered proficient, while those with greater than 25% variation were defined as nonproficient. RESULTS Over a 19-month period, 300 of the 3208 patients notified about the study completed proficiency testing at least once. Using the defined proficiency of 25% variation or less, 12% of the participants were nonproficient. Using a variation of 15% or less, 31% of patients were nonproficient. CONCLUSIONS An annual methodology evaluation such as the one in this study should become a standard of care to identify patients for remedial classes to correct the source of error. The goal must be to meet or exceed the American Diabetes Association standard of 15% total error in home glucose monitoring.
The Scope of Practice of Diabetes Educators in the State of Georgia
Authors: Kaufman Melissa W. , All Anita C. , Davis Harry 
Published: April 2008

PURPOSE The purpose of this study was to identify and describe the scope of practice trends of diabetes educators in the state of Georgia. METHODS The Diabetes Educator Responsibilities Questionnaire (DERQ) was sent to 221 members of the American Association of Diabetes Educators listed in the 1995 membership directory in Georgia. Of the 221 members, 97 returned completed questionnaires. This population of healthcare professionals comprised the sample population. RESULTS In assessing the primary responsibilities of the sample, more than 50% of the respondents performed six of the nine educator roles. Less than 50% of the respondents indicated that they "Always" or "Frequently" used behavior modification strategies in teaching people with diabetes. CONCLUSIONS The questionnaire used in this study should be expanded to elicit more detailed information regarding decisions to use or not use behavior modification techniques in diabetes education.
Developing a Computerized Diabetes Self-Management Education Module for Documenting Outcomes
Authors: Tomky Donna M. 
Published: April 2008

PURPOSE This paper describes a process used to develop a computerized diabetes self-management education record that complies with the National Standards for Diabetes Self-Management Education Programs. METHODS A working prototype was developed to computerize 1 of the 15 content modules outlined in the National Standards for use on the World Wide Web. During program development, three consultants reviewed the content and proposed structure. For the subsequent prototype, five diabetes educators served as users and evaluated the content, design, and flow of the system. RESULTS The module was found to be thorough in terms of curriculum content and proposed structure for subsequent teaching. Overall, users were satisfied with the graphic interface screens and provided important feedback for determining specific modifications for future development. CONCLUSIONS The World Wide Web format provides a universal platform for documenting diabetes education outcomes and allows a broad range of access and networking capabilities.
Involvement in Health Behaviors Among Youth With Diabetes
Authors: Hanna Kathleen M. , Outhrle Diana W. 
Published: April 2008

PURPOSE The purpose of this study was to examine involvement in a broad range of health behaviors among adolescents and young adults with diabetes. METHODS The sample consisted of 107 adolescents and young adults (12 to 24 years old) with Type 1 diabetes mellitus. Participants were asked to report involvement in health-enhancing, health-compromising, and diabetes mismanagement behaviors. RESULTS The participants reported low levels of health-compromising behaviors and high levels of health-enhancing behaviors. Females reported significantly higher levels of diabetes mismanagement than males. Males in late adolescence (18 to 24 years) reported significantly higher levels of health-compromising behaviors than males in early (12 to 14 years) and middle (15 to 17 years) adolescence. Females in late adolescence (1 8 to 24 years) reported significantly higher levels of health-compromising behaviors than females in early adolescence (12 to 14 years). CONCLUSIONS Diabetes educators who work with youth may want to assess all of these health behaviors, keeping in mind age and gender differences.
Culture Counts: Why Current Treatment Models Fail Hispanic Women With Type 2 Diabetes
Authors: Oomen Jody S. , Owen Lynda J. , Suggs L. Suzanne 
Published: April 2008

PURPOSE The purpose of this article is to evaluate whether current treatment models adequately address the cultural factors involved in treatment adherence in Hispanic females with Type 2 diabetes. METHODS A review of relevant professional literature was conducted. RESULTS Established health behavior models do not adequately address the unique needs of the female Hispanic population, especially those older women who hold traditional religious and cultural beliefs. CONCLUSIONS To decrease the devastating effects of Type 2 diabetes among Hispanic women, interventions must be based on a comprehensive, culturally sensitive model that works with cultural values, not against them.
Clinical Implications of Amylin and Amylin Deficiency
Authors: Kruger Davida F. , Gatcomb Patricia M. , Owen Susan K. 
Published: April 2008

PURPOSE this paper presents an overview of the physiology of glycemic control and the mechanisms of amylin deficiency in people with diabetes. Benefits of replacement therapy with both pramlintide and insulin are discussed. METHODS The discovery of the pancreatic p-cell hormone amylin, which is cosecreted with insulin in response to hyperglycemia, has prompted a reanalysis of the mechanisms underlying the control of glucose homeostasis. A review of the current literature on amylin and amylin deficiency provides the basis of this reanalysis, with a discussion of the clinical implications for people with diabetes. RESULTS Amylin appears to work with insulin to regulate plasma glucose concentrations in the bloodstream, suppressing the postprandial secretion of glucagon and restraining the rate of gastric emptying. People with diabetes have a deficiency in the secretion of amylin that parallels the deficiency in insulin secretion, resulting in an excessive inflow of glucose into the bloodstream during the postprandial period. CONCLUSIONS While insulin replacement therapy is a cornerstone of diabetes treatment, replacement of the function of both amylin and insulin may allow a more complete restoration of the normal physiology of glucose control.