ORCID Profile
0000-0002-0018-6963
Current Organisations
Charles Darwin University
,
La Trobe University - Bendigo Campus
,
Københavns Universitet
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In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Psychology | Developmental Psychology And Ageing | Personality, Abilities And Assessment
Youth/child development and welfare | Behavioural and cognitive sciences |
Publisher: SAGE Publications
Date: 04-2015
Abstract: The purpose of this study was to investigate participants’ experiences of and satisfaction with the content and outcome of 13 different sessions of a 4-day diabetes education programme and to compare participants’ experiences with the extent of educator talk in the sessions. A 10-second event coding was used to evaluate educators’ application of participatory methods in patient education. Four diabetes education courses, each consisting of 13 sessions with 10–12 participants, were monitored, using the 10-second event coding to assess educator talk ratios. Three focus group interviews were performed after the course, and 19 exploratory interviews were performed with participants within 3 months of the end of the course. Participants were asked about their experiences of personal outcomes derived from participation in the programme in general and from participation in each session. Qualitative data were analysed using systematic text condensation focused on participants’ perceptions of the personal outcomes derived from each session. Participant reports were compared to measured educator talk ratios to assess relationships between experiences and educator talk ratios. Positive participant-reported outcomes such as learning from each other and a feeling of safety and freedom were associated with low educator talk ratios in specific sessions. However, participants appreciated high talk ratios when educators presented knowledge attendees perceived as essential and meaningful to everyday life. The educator talk ratio is a useful metric to evaluate the quality of group-based diabetes education using participatory methods. However, it must be used in combination with an assessment of education content and format.
Publisher: Wiley
Date: 29-08-2008
DOI: 10.1111/J.1464-5491.2008.02492.X
Abstract: To determine whether differences in the amount of time educators talk during a self-management education programme relate to the degree of change in participants' reported beliefs about diabetes. Educators trained to be facilitative and non-didactic in their approach were observed delivering the DESMOND self-management programme for in iduals newly diagnosed with Type 2 diabetes. Observers used 10-s event coding to estimate the amount of time educators spoke during different sessions in the programme. Facilitative as opposed to didactic delivery was indicated by targets for levels of educator talk set for each session. Targets were based on earlier pilot work. Using the revised Illness Perceptions Questionnaire (IPQ-R) and the Diabetes Illness Representations Questionnaire (DIRQ), participants completed measures of: perceived duration of diabetes (timeline IPQ-R), understanding of diabetes (coherence IPQ-R), personal responsibility for influencing diabetes (personal responsibility IPQ-R), seriousness of diabetes (seriousness DIRQ) and impact on daily life (impact DIRQ), before and after the education programme. Where data from the event coding indicated educators were talking less and meeting targets for being less didactic, a greater change in reported illness beliefs of participants was seen. However, educators struggled to meet targets for most sessions of the programme. The amount of time educators talk in a self-management programme may provide a practical marker for the effectiveness of the education process, with less educator talk denoting a more facilitative/less didactic approach. This finding has informed subsequent improvements to a comprehensive quality development framework, acknowledging that educators need ongoing support to facilitate change to their normal educational style.
Publisher: American Diabetes Association
Date: 05-2001
Abstract: OBJECTIVE—Personal models of diabetes have been shown to be proximal determinants of self-care behavior in adults with diabetes, both cross-sectionally and prospectively. This study set out to test the predictive utility of this approach in adolescents with diabetes. RESEARCH DESIGN AND METHODS—Participants were recruited from four regional hospitals in southern England (n = 54). They completed questionnaires assessing diabetes self-care, well-being, and personal models of diabetes (perceived impact, perceived seriousness, and short- and long-term treatment effectiveness) at baseline and 1-year follow-up. GHb assays performed as part of the patients’ usual diabetes care were used to assess glycemic control. RESULTS—After controlling for baseline anxiety, change in perceived impact of diabetes prospectively predicted adolescents’ anxiety (β = −0.21 t = −2.65 P & 0.01). After controlling for baseline dietary self-care, change in perceived effectiveness of the diabetes treatment regimen to control diabetes predicted dietary self-care (β = −0.39 t = −3.28 P & 0.0005). Poorer dietary self-care and being female were predictive of poorer glycemic control (r2 = 0.29 F = 2.74 P & 0.005). CONCLUSIONS—This study provides further support for the role of personal models of illness in determining responses to illness. As adolescents take responsibility for the management of their diabetes, parents, clinicians, educators, and interventionists should consider these adolescents’ beliefs about their diabetes and its treatment as key factors influencing self-care, emotional well-being, and glycemic control.
Publisher: Hindawi Limited
Date: 20-11-2017
DOI: 10.1111/PEDI.12606
Abstract: The reason for center differences in metabolic control of childhood diabetes is still unknown. We sought to determine to what extent the targets, expectations, and goals that diabetes care professionals have for their patients is a determinant of center differences in metabolic outcomes. Children, under the age of 11 with type 1 diabetes and their parents treated at the study centers participated. Clinical, medical, and demographic data were obtained, along with blood s le for centralized assay. Parents and all members of the diabetes care team completed questionnaires on treatment targets for hemoglobin A1c (HbA1c) and recommended frequency of blood glucose monitoring. Totally 1113 (53% male) children (mean age 8.0 ± 2.1 years) from 18 centers in 17 countries, along with parents and 113 health-care professionals, participated. There were substantial differences in mean HbA1c between centers ranging from 7.3 ± 0.8% (53 mmol/mol ± 8.7) to 8.9 ± 1.1% (74 mmol/mol ± 12.0). Centers with lower mean HbA1c had (1) parents who reported lower targets for their children, (2) health-care professionals that reported lower targets and more frequent testing, and (3) teams with less disagreement about recommended targets. Multiple regression analysis indicated that teams reporting higher HbA1c targets and more target disagreement had parents reporting higher treatment targets. This seemed to partially account for center differences in Hb1Ac. The diabetes care teams' cohesiveness and perspectives on treatment targets, expectations, and recommendations have an influence on parental targets, contributing to the differences in pediatric diabetes center outcomes.
Publisher: Springer Science and Business Media LLC
Date: 27-07-2023
DOI: 10.1186/S40814-023-01367-2
Abstract: This study examined the feasibility and acceptability of the low-intensity mental health support via telehealth - enabled network (LISTEN) intervention, for adults with diabetes, facilitated by diabetes health professionals (HPs). LISTEN training . Three HPs participated in three half-day online workshops and applied their learnings during training cases (maximum four). Competency was assessed with a validated tool and achieved ‘satisfactory’ ratings for three consecutive sessions. LISTEN pilot. A single-group, pre-post study (up to four LISTEN sessions) with online assessments at baseline, post-intervention, and 4-week follow-up. Eligible participants were adults with type 1 or type 2 diabetes, with diabetes distress, but excluded if they had moderate/severe depressive and/or anxiety symptoms. Feasibility was assessed via recruitment and session completion rates. Acceptability was assessed with post-intervention self-report data. Changes in diabetes distress and general emotional well-being from baseline (T1) were explored at post-intervention (T2) and at 4-week follow-up (T3). Two HPs achieved competency (median training case sessions required: 7) and progressed to deliver LISTEN in the pilot study. In the pilot, N = 16 adults ( Med [IQR] age: 60 [37–73] years 13 women) with diabetes participated (median sessions per participant: 2). Twelve participants (75%) completed the post-intervention assessment (T2): 92% endorsed the number of sessions offered as ‘just right’, 75% felt comfortable talking with the HP, and 67% were satisfied with LISTEN. Perceived limitations were the structured format and narrow scope of problems addressed. Diabetes distress scores were lower post-intervention. This pilot demonstrates the feasibility of training HPs to deliver LISTEN, and the acceptability and potential benefits of LISTEN for adults with diabetes. The findings highlight adaptations that may enhance the delivery of, and satisfaction with, LISTEN that will be tested in a hybrid type 1 effectiveness-implementation trial.
Publisher: Wiley
Date: 15-07-2010
DOI: 10.1111/J.1464-5491.2010.03028.X
Abstract: To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes. Post hoc analysis of data from a randomized controlled trial of self-management education for 824 in iduals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology. The prevalence of depressive symptoms in in iduals recently diagnosed with diabetes (18-22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology. The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes.
Publisher: Hindawi Limited
Date: 22-11-2018
DOI: 10.1111/PEDI.12602
Abstract: Few diabetes-specific quality of life (QOL) tools are available for young children. To design and evaluate, a new age-specific QOL questionnaire and its associations with treatment regimens and metabolic control. Clinical, demographic data and centrally analyzed HbA1c were collected on 1133 children <11 years (girls 48% mean ± SD age 8.0 ± 2.1 years diabetes duration ≥1 year) from 18 centers (Europe, Japan, North America and Australia). Children completed the 10-item Smiley Faces QOL questionnaire constructed for the study, and children ≥7 years also completed the KIDSCREEN-10 Index. In total, 1035 children completed the new Smiley Faces questionnaire which was well understood by 993 (70% ≥4 years and 96% ≥5 years, respectively). Internal consistency and reliability were good (Cronbach's α = .73). Inter-item correlation ranged r = 0.047 to 0.451 indicating each item measures separate aspects of children's satisfaction construct. Convergent validity assessed by comparison to the HrQOL KIDSCREEN-10 Index showed moderate correlation coefficient 0.501. Factor analysis revealed 3 factors explaining 51% of the variance. Children reported good QOL with most items positive, mean values between 1 and 2 on a 5-point scale (lower scores indicating greater QOL). Diabetes satisfaction was unrelated to age, diabetes duration, HbA1c, or severe hypoglycemia. Girls were more satisfied than boys. Children on intensive regimens reported better QOL (P < .02). Main dissatisfaction related to insulin injections and blood sugar testing. The Smiley Faces questionnaire enables QOL assessment in young children and identification of areas of dissatisfaction and other clinically relevant items relating to diabetes management.
Publisher: Wiley
Date: 10-2017
DOI: 10.1111/JSR.53_12618
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.PCD.2018.10.006
Abstract: Gestational diabetes (GDM) and Type 2 diabetes pose tremendous health and economic burdens as worldwide incidence increases. Primary care-based systematic diabetes screening and prevention programs could be effective in women with previous GDM. GooD4Mum aimed to determine whether a Quality Improvement Collaborative (QIC) would improve postpartum diabetes screening and prevention planning in women with previous GDM in general practice. Fifteen general practices within Victoria (Australia) participated in a 12-month QIC, consisting of baseline and four quarterly audits, guideline-led workshops and Plan-Do-Study-Act feedback cycles after each audit. The primary outcome measures were the proportion of women on local GDM registers completing a diabetes screening test and a diabetes prevention planning consultation within the previous 15 months. Diabetes screening increased with rates more than doubled from 26% to 61% and postpartum screening increased from 43%-60%. Diabetes prevention planning consultations did not show the same level of increase (0%-10%). The recording of body mass index improved overall (51%-69%) but the number of women with normal body mass index did not. GooD4Mum supported increased diabetes screening and the monitoring of high risk women with previous GDM in general practice.
Publisher: American Diabetes Association
Date: 12-2010
DOI: 10.2337/DC10-1113
Abstract: To implement and evaluate a regional prepregnancy care program in women with type 1 and type 2 diabetes. Prepregnancy care was promoted among patients and health professionals and delivered across 10 regional maternity units. A prospective cohort study of 680 pregnancies in women with type 1 and type 2 diabetes was performed. Primary outcomes were adverse pregnancy outcome (congenital malformation, stillbirth, or neonatal death), congenital malformation, and indicators of pregnancy preparation (5 mg folic acid, gestational age, and A1C). Comparisons were made with a historical cohort (n = 613 pregnancies) from the same units during 1999–2004. A total of 181 (27%) women attended, and 499 women (73%) did not attend prepregnancy care. Women with prepregnancy care presented earlier (6.7 vs. 7.7 weeks P & 0.001), were more likely to take 5 mg preconception folic acid (88.2 vs. 26.7% P & 0.0001) and had lower A1C levels (A1C 6.9 vs. 7.6% P & 0.0001). They had fewer adverse pregnancy outcomes (1.3 vs. 7.8% P = 0.009). Multivariate logistic regression confirmed that in addition to glycemic control, lack of prepregnancy care was independently associated with adverse outcome (odds ratio 0.2 [95% CI 0.05–0.89] P = 0.03). Compared with 1999–2004, folic acid supplementation increased (40.7 vs. 32.5% P = 0.006) and congenital malformations decreased (4.3 vs. 7.3% P = 0.04). Regional prepregnancy care was associated with improved pregnancy preparation and reduced risk of adverse pregnancy outcome in type 1 and type 2 diabetes. Prepregnancy care had benefits beyond improved glycemic control and was a stronger predictor of pregnancy outcome than maternal obesity, ethnicity, or social disadvantage.
Publisher: Wiley
Date: 2002
Publisher: Wiley
Date: 15-08-2006
Publisher: Springer Science and Business Media LLC
Date: 09-2019
Publisher: BMJ
Date: 20-08-2010
DOI: 10.1136/BMJ.C4093
Publisher: JMIR Publications Inc.
Date: 31-07-2023
Abstract: omen with overweight and obesity are at higher risk of developing complications in pregnancy such as gestational diabetes and longer-term chronic conditions. Research concerning health behaviour change interventions during pregnancy and postpartum show promising effects, but implementation into routine services is sparsely investigated. Most interventions focus on the antenatal or postpartum life stages, failing to meet the needs of women. IMPACT DIABETES Bump 2 Baby (B2B) is a multi-centre project across four high income countries developed to test the implementation of an antenatal and postpartum evidence-based mobile health (mHealth) coaching intervention called Bump2Baby and Me (B2B& Me) designed to sit alongside usual care in the perinatal period. e aim to explore the feasibility and implementation of the B2B& Me intervention and investigate the effectiveness of the B2B& Me intervention in women at risk of gestational diabetes. DB2B is a hybrid type two effectiveness-implementation study, which integrates an evidence-based mHealth coaching app that includes personalised health coaching provided by healthcare professionals alongside antenatal care to twelve months postpartum. This randomised controlled trial across four clinical sites within Ireland, UK, Spain, and Australia will recruit 800 women in early pregnancy to evaluate effectiveness on postpartum weight. The Exploration, Preparation, Implementation, Sustainment (EPIS) implementation framework is the theoretical underpinning of the study. The implementation evaluation will be assessed at in idual, hospital staff, and broader community levels using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. he study was approved and registered with the Australian New Zealand Clinical Trials Registry on 19th November 2020. Recruitment commenced on 9th February 2021 and data collection is ongoing. Publication of the results are expected in 2024. his is the first hybrid effectiveness-implementation study of an 18-month mHealth coaching intervention in at risk women that we are aware of. As research aims to move towards real-world implementable solutions, it is critical that hybrid studies are conducted. The data from this large multi-centre study will be useful in planning the implementation and scale-up of evidence-based perinatal health behaviour change interventions. ustralian New Zealand Clinical Trials Registry ACTRN12620001240932. Registered on 19th November 2020.
Publisher: MDPI AG
Date: 26-08-2012
Abstract: Codling moth (CM), Cydia pomonella L., is an important pest of apples worldwide. CM resistance to insecticides is a serious problem in apple production. For effective management and control, monitoring of resistant CM populations is absolutely necessary. Therefore, in this study, we investigated whether it is possible to find a reliable pattern of differences in CM populations related to the type of apple control method. The genetic results showed low estimated value of the pairwise fixation index, FST = 0.021, which indicates a lack of genetic differentiation and structuring between the genotyped populations. Different approaches were used to analyze the genetic structure of codling moth populations: Bayesian-based model of population structure (STRUCTURE), principal component analysis (PCA), and discriminant analysis of principal components (DAPC). STRUCTURE grouped the CM genotypes into two distinct clusters, and the results of PCA were consistent with this. The DAPC revealed three distinct groups. However, the results showed that population genetic differentiation between organic and integrated orchards was not significant. To confirm the genetic results, the forewing morphology of the same CM in iduals was examined using geometric morphometric techniques based on the venation patterns of 18 landmarks. The geometric results showed higher sensitivity and separated three distinct groups. Geometric morphometrics was shown to be a more sensitive method to detect variability in genotypes due to pest control management. This study shows the possibility of using a novel method for a strategic integrated pest management (IPM) program for CM that is lacking in Europe.
Publisher: The Royal Society
Date: 07-07-2021
Abstract: Marine species may exhibit genetic structure accompanied by phenotypic differentiation related to adaptation despite their high mobility. Two shape-based morphotypes have been identified for the green turtle ( Chelonia mydas ) in the Pacific Ocean: the south-central/western or yellow turtle and north-central/eastern or black turtle. The genetic differentiation between these morphotypes and the adaptation of the black turtle to environmentally contrasting conditions of the eastern Pacific region has remained a mystery for decades. Here we addressed both questions using a reduced-representation genome approach (Dartseq 9473 neutral SNPs) and identifying candidate outlier loci (67 outlier SNPs) of biological relevance between shape-based morphotypes from eight Pacific foraging grounds ( n = 158). Our results support genetic ergence between morphotypes, probably arising from strong natal homing behaviour. Genes and enriched biological functions linked to thermoregulation, hypoxia, melanism, morphogenesis, osmoregulation, diet and reproduction were found to be outliers for differentiation, providing evidence for adaptation of C. mydas to the eastern Pacific region and suggesting independent evolutionary trajectories of the shape-based morphotypes. Our findings support the evolutionary distinctness of the enigmatic black turtle and contribute to the adaptive research and conservation genomics of a long-lived and highly mobile vertebrate.
Publisher: Wiley
Date: 13-11-2019
DOI: 10.1111/DME.13836
Abstract: To identify challenges and solutions to integrating psychosocial support into routine diabetes care from the perspective of stakeholders with expertise in diabetes self-management education and support. Ninety-four people attended the annual international Diabetes Self-Management Alliance meeting in 2016, which included plenary sessions and workshops on self-management education, support and prevention. One workshop focused on how to integrate psychosocial support into routine diabetes care this was run four times consecutively, allowing all conference participants to attend the workshops in groups of 20-25 people. Challenges and solutions associated with integrating psychosocial support into routine diabetes care concern the patient-provider relationship, the healthcare system and the community. Challenges identified were: lack of time, skills and resources to deal with psychological well-being a culture of patient blame and care expectations the complexity of person-centred assessment of psychological issues and the substantial healthcare system focus on productivity and biomedical indicators. Lack of involvement of local communities and of inclusion of social determinants of health were also highlighted as challenging. Solutions identified were more patient-provider dialogue more training and better skills among care providers system incentives for psychosocial outcomes and targeting social determinants of health and involvement of family and peers. From the perspective of international stakeholders with an expertise in diabetes self-management and support attending the conference in Denmark, substantial new incentives and systematic cultural changes are needed in healthcare systems to integrate psychosocial support into routine diabetes care, as recommended in international guidelines.
Publisher: JMIR Publications Inc.
Date: 20-12-2022
DOI: 10.2196/40058
Abstract: Lifestyle-related diseases are among the leading causes of death and disability. Their rapid increase worldwide has called for low-cost, scalable solutions to promote health behavior changes. Digital health coaching has proved to be effective in delivering affordable, scalable programs to support lifestyle change. This approach increasingly relies on asynchronous text-based interventions to motivate and support behavior change. Although we know that empathy is a core element for a successful coach-user relationship and positive patient outcomes, we lack research on how this is realized in text-based interactions. Systemic functional linguistics (SFL) is a linguistic theory that may support the identification of empathy opportunities (EOs) in text-based interactions, as well as the reasoning behind patients' linguistic choices in their formulation. This study aims to determine whether empathy and SFL approaches correspond and complement each other satisfactorily to study text-based communication in a health coaching context. We sought to explore whether combining empathic assessment with SFL categories can provide a means to understand client-coach interactions in asynchronous text-based coaching interactions. We retrieved 148 text messages sent by 29 women who participated in a randomized trial of telecoaching for the prevention of gestational diabetes mellitus (GDM) and postnatal weight loss. We conducted a pilot study to identify users' explicit and implicit EOs and further investigated these statements using the SFL approach, focusing on the analysis of transitivity and thematic analysis. We identified 164 EOs present in 42.37% (3478/8209) of the word count in the corpus. These were mainly negative (n=90, 54.88%) and implicit (n=55, 60.00%). We distinguished opening, content and closing messages structures. Most of the wording was found in the content (n=7077, 86.21%) with a declarative structure (n=7084, 86.30%). Processes represented 22.4% (n=1839) of the corpus, with half being material (n=876, 10.67%) and mostly related to food and diet (n=196, 54.92%), physical activity (n=96, 26.89%), and lifestyle goals (n=40, 11.20%). Our findings show that empathy and SFL approaches are compatible. The results from our transitivity analysis reveal novel insights into the meanings of the users’ EOs, such as their seek for help or praise, often missed by health care professionals (HCPs), and on the coach-user relationship. The absence of explicit EOs and direct questions could be attributed to low trust on or information about the coach’s abilities. In the future, we will conduct further research to explore additional linguistic features and code coach messages. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001240932 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380020
Publisher: Wiley
Date: 08-03-2021
DOI: 10.1111/JSR.13326
Abstract: Despite the strong evidence on circadian rhythm disruption in shift workers and consequent increased vulnerability for infection, longitudinal association between shift work and COVID‐19 infection is unexplored. In this study, data from UK Biobank participants who were tested for COVID‐19 infection (16 March to 7 September 2020) were used to explore the link between shift work and COVID‐19 infection. Using the baseline occupational information, participants were categorised as non‐shift workers, day shift workers, mixed shift workers and night shift workers. Multivariable regression models were used to assess the association between shift work and COVID‐19 infection. Among the 18,221 participants (9.4% positive cases), 11.2% were health workers, and 16.4% were involved in shift‐work‐based jobs. Ethnic minorities (18%) and people in night‐shift‐based jobs (18.1%) had a significantly higher prevalence of COVID‐19 infection than others. Adjusted logistics regression model suggest that, compared with their counterparts, people employed in a night‐shift‐based job were 1.85‐fold (95% CI: 1.42–2.41) more likely to have COVID‐19 infection. Sensitivity analysis focusing on people working in a non‐healthcare setting suggests that people in shift‐work‐based jobs had 1.81‐fold (95% CI: 1.04%–3.18%) higher odds of COVID‐19 infection than their counterparts. Shift workers, particularly night shift workers, irrespective of their occupational group, seem to be at high risk of COVID‐19 infection. If similar results are obtained from other studies, then it would mandate to revisit the criteria for defining high‐risk groups for COVID‐19 and implementing appropriate interventions to protect people in shift‐based jobs.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 18-04-2015
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1016/J.APPET.2007.10.004
Abstract: Women who leave school with few or no educational qualifications are less likely to have diets that meet current recommendations than women who attain more qualifications at school. We hypothesise that lower 'food involvement', meaning that food has a lower level of importance in their lives, explains the poorer quality diets of women of lower educational attainment. We administered Bell and Marshall [(2003). The construct of food involvement in behavioral research: Scale development and validation. Appetite, 40, 235-244.] Food Involvement scale to 242 women of varied educational attainment, of whom 127 were also asked how often they ate fruit and vegetables. Women's food involvement decreased with decreasing educational attainment. Forty-two percent of women who had no educational qualifications were in the lowest quarter of the food involvement score, compared with 12% of women with degrees. Women with lower scores on the food involvement scale also reported eating fruit and vegetables less often. The odds of eating fewer fruit and vegetables rose with lower educational attainment and with lower food involvement scores, suggesting that each has an independent effect. We have shown that the Food Involvement scale discriminates between women, is associated with other characteristics and predicts dietary quality. We now plan to use it in a larger, representative population of women of lower educational attainment to examine its role along with other psychological variables in determining dietary quality.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2015
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.DSX.2018.04.007
Abstract: There is inadequate evidence regarding the pattern of unhealthy lifestyle behaviours in Nigeria hence the aim of this study was to assess the pattern of lifestyle-related habits that predispose to risk of cardiovascular disease (CVD) indices in a Nigerian population. A population-based cross-sectional study was carried out on 422 apparently healthy males and females ≥18 years old. The World Health Organisation (WHO) STEPwise questionnaire was used to collect information on tobacco use or smoking habits, alcohol consumption and dietary habits. Logistic regression analysis was employed. 22.8% and 30.2% of participants indicated that someone smoked in their home and/or in closed areas at workplace, respectively, in the past 30 days. 225/422 admitted to taking alcohol including 72% within the past 12 months. 52.8% of the participants consumed <5 servings of fruits and/or vegetables each day. Results further showed that participants with <5 servings of fruits and/or vegetables (OR: 1.06, CI: 1.01-1.13, p = 0.028) and high level of alcohol consumption (OR: 1.85, CI: 1.18-2.88, p = 0.007) were more likely to have hypertension. The relatively high prevalence of alcohol consumption and apparent unhealthy diet are of huge concern given the increasing prevalence of CVD indices in the population.
Publisher: Elsevier BV
Date: 04-2017
DOI: 10.1016/J.DIABRES.2017.02.026
Abstract: To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Postpartum women participated in a lifestyle modification program delivered by telephone (n=33) or group format (n=284). Semi-structured interviews on barriers and enablers to program engagement (defined as completing≥80% sessions) were conducted before (Group) and after (Group and Telephone) interventions. The Health Action Process Approach theory was used as the framework for inquiry. Psychological measures were compared between engagement subgroups before and after group-delivered intervention. In the telephone-delivered program 82% participants met the engagement criteria compared with 38% for the group-delivered program. Engaged participants (Group) had significantly higher risk perception, outcome expectancy, and activity self-efficacy at baseline (P<0.05). There was a greater decrease in body weight (-1.45±3.9 vs -0.26±3.5, P=0.024) and waist circumference (-3.56±5.1 vs -1.24±5.3, P=0.002) for engaged vs non-engaged participants following group program completion. Telephone delivery was associated with greater engagement in postpartum women. Engagement was associated with greater reduction in weight and waist circumference. Further studies are required to confirm the effectiveness of telephone-delivered program for diabetes prevention in postpartum women.
Publisher: Naturalis Biodiversity Center
Date: 30-06-2014
Publisher: Wiley
Date: 24-03-2006
DOI: 10.1111/J.1464-5491.2006.01814.X
Abstract: To review the literature estimating the cross-sectional prevalence of clinical depression in adults with Type 1 diabetes. Electronic databases and published references were used to identify studies published between January 2000 and June 2004, with a previous meta-analysis used to identify studies before 1 January 2000. Between January 2000 and June 2004, a further five eligible studies were identified. Only one was a controlled study using diagnostic interviewing to determine rates of depression. Taking all of the eligible studies identified by the previous meta-analysis and this search, the prevalence of clinical depression in controlled studies was 12.0% for people with diabetes compared with 3.2% for control subjects. In studies with no control group, the prevalence of clinical depression was 13.4%. There are wide-ranging differences reported in the various studies on the prevalence of depression in Type 1 diabetes. In view of the differing methods of diagnosis and small participant numbers, the results should be viewed with caution. A controlled study using diagnostic interviewing techniques to determine levels of depression is recommended to provide a clearer picture of both the prevalence and characteristics of that depression.
Publisher: Wiley
Date: 12-2000
DOI: 10.1034/J.1600-0838.2000.010006326.X
Abstract: Soft tissue injury of tendons represents a major problem within sports medicine. Although several animal and cell culture studies have addressed this, human experiments have been limited in their ability to follow changes in specific tissue directly in response to interventions. Recently, methods have allowed for in vivo determination of tissue concentrations and release rates of substances involved in metabolism, inflammation and collagen synthesis, together with the measurement of tissue blood flow and oxygenation in the peritendinous region around the Achilles tendon in humans during exercise. It can be demonstrated that this region experiences an increase in blood flow during both static and dynamic exercise, and that exercise causes increased metabolic activity, accumulation of inflammatory mediators (prostaglandins) and increased formation of collagen type I in response to acute exercise. This coincides with a surprisingly marked drop in tissue pressure during contraction. With regards to both circulation, metabolism and collagen formation, peritendinous tissue represents a dynamic, responsive region that adapts markedly to acute muscular activity.
Publisher: Informa UK Limited
Date: 03-09-2015
Publisher: Oxford University Press (OUP)
Date: 26-04-2016
Abstract: Prevalence of metabolic syndrome (MetS) and consequential cardiovascular disease (CVD) events are on the increase in Nigeria. The study aimed to identify the prevalence of 10-year CVD risk in a Nigerian population and assess its relationship with different indices of MetS. A cross-sectional study was carried out on apparently healthy persons aged 18 years of age or older. Ten-year risk was calculated using the ATPIII/Framingham criteria. Subjects with risk score 20% at high risk of developing CVD in 10 years. MetS was defined based on the Joint Scientific Statement on Harmonizing the MetS. Of the 211 subjects, mean age was 51.3±17.3 years. Average risk of developing CVD in the next 10 years was 3.7±5.3%. Prevalence of low, moderate and high risk of developing CVD among study participants was 86.3% (95% CI 82.0-91.3%), 11.8% (95% CI 6.9-16.1%) and 1.9% (95% CI 0.0-3.8%), respectively. Prevalence of MetS was 26.7% (95% CI 21.0-33.3%). There was poor agreement between MetS and the CVD risk scores (kappa=0.209, p=0.001) CONCLUSIONS: The results showed that complementary use of MetS and CVD risk score is imperative, as there is indication of risk in in iduals without MetS. Also a large proportion of the study population requires lifestyle intervention. These findings provide the evidence necessary to tailor public health interventions in this population, especially towards younger age groups.
Publisher: Hindawi Limited
Date: 17-06-2013
DOI: 10.1111/PEDI.12038
Abstract: The Hvidoere Study Group (HSG) has demonstrated major differences in glycemic control between pediatric diabetes centers which remain largely unexplained. This study investigates whether these differences are partly attributable to healthy eating norms in the background population. The study involved adolescents from 18 countries from (i) the Health Behaviour in School-Aged Children study (HBSC) and (ii) the HSG. There were 94 387 participants from representative HBSC s les of 11-, 13- and 15-yr-olds and 1483 11- to 15-yr-old adolescents with diabetes from the HSG. The frequency of intake of fruit, vegetables, sweets, sugary soft drinks, and daily breakfast was compared between the two groups. The glycemic control of the adolescents in the HSG cohort was determined by measuring glycated hemoglobin (HbA1c). Across countries in the HSBC survey, there was substantial variation in prevalence of healthy eating behavior and even greater variation between adolescents from the HSG centers. In all countries more adolescents with diabetes reported healthy eating behavior compared to national norms. In in iduals healthy eating behavior had a significant effect on the in idual level HbA1c. There was no significant correlation between the frequencies of these healthy eating behaviors at (i) the national level and (ii) diabetes center level and the center mean HbA1c. Although in idual healthy eating behavior is associated with better glycemic control at the in idual level, such eating behavior does not explain the center differences in HbA1c. Similarly, the reported healthy eating norm of the background populations does not explain the variation in glycemic control among centers.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.DIABRES.2014.12.014
Abstract: To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes. Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression. The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9 these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group. Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY13087
Abstract: Our aim was to document current communication and information-sharing practices and to identify the barriers and enablers to good practices within the context of care planning for chronic condition management. Further aims were to make recommendations about how changes to policy and practice can improve communication and information sharing in primary health care. A mixed-method approach was applied to seek the perspectives of patients and primary health-care workers across Australia. Data was collected via interviews, focus groups, non-participant observations and a national survey. Data analysis was performed using a mix of thematic, discourse and statistical approaches. Central barriers to effective communication and information sharing included fragmented communication, uncertainty around client and interagency consent, and the unacknowledged existence of overlapping care plans. To be most effective, communication and information sharing should be open, two-way and inclusive of all members of health-care teams. It must also only be undertaken with the appropriate participant consent, otherwise this has the potential to cause patients harm. Improvements in care planning as a communication and information-sharing tool may be achieved through practice initiatives that reflect the rhetoric of collaborative person-centred care, which is already supported through existing policy in Australia. General practitioners and other primary care providers should operationalise care planning, and the expectation of collaborative and effective communication of care that underpins it, within their practice with patients and all members of the care team. To assist in meeting these aims, we make several recommendations.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.DIABRES.2012.07.006
Abstract: To undertake a systematic review of diabetes in pregnancy (DIP), determining prevalence and impact on maternal and child health outcomes for Indigenous and Aboriginal women. Electronic searches of MEDLINE, Embase, CINAHL, ERIC, DARE, CDSR, PsycINFO, Austhealth and HealthInfoNet were undertaken. Changes in diagnostic criteria for DIP and variability in methodology meant a qualitative synthesis of the data was undertaken. From the 142 potential studies, 42 peer reviewed journal articles met the inclusion criteria. GDM prevalence in 65% of studies was greater for Indigenous and Aboriginal women than the comparison groups Pacific Islander 8.1%, Canadian Aboriginal 11.5%, American Indian 7.9%, Australian Aboriginal 8.4% compared with 2-5% worldwide. Of studies reporting high birth weight (>4000 g) and DIP, 75% had a higher than expected prevalence, 86% had higher macrosomia prevalence and 63% had higher stillbirth rates. Studies with Alaskan, Australian Aboriginal and Pacific Islander women had GDM prevalence both greater and less than comparison groups. Correcting the health disparity for Indigenous and Aboriginal women with DIP is a health priority. DIP prevalence is not the same for all Indigenous and Aboriginal women. Inconsistent study design without robust data is interfering with accurate prevalence of DIP. New international consensus guidelines provide opportunities for high quality studies of DIP for Indigenous and Aboriginal women.
Publisher: Wiley
Date: 18-12-2021
Publisher: Rockefeller University Press
Date: 29-11-2010
Abstract: PINK1 is a mitochondrial kinase mutated in some familial cases of Parkinson’s disease. It has been found to work in the same pathway as the E3 ligase Parkin in the maintenance of flight muscles and dopaminergic neurons in Drosophila melanogaster and to recruit cytosolic Parkin to mitochondria to mediate mitophagy in mammalian cells. Although PINK1 has a predicted mitochondrial import sequence, its cellular and submitochondrial localization remains unclear in part because it is rapidly degraded. In this study, we report that the mitochondrial inner membrane rhomboid protease presenilin-associated rhomboid-like protein (PARL) mediates cleavage of PINK1 dependent on mitochondrial membrane potential. In the absence of PARL, the constitutive degradation of PINK1 is inhibited, stabilizing a 60-kD form inside mitochondria. When mitochondrial membrane potential is dissipated, PINK1 accumulates as a 63-kD full-length form on the outer mitochondrial membrane, where it can recruit Parkin to impaired mitochondria. Thus, differential localization to the inner and outer mitochondrial membranes appears to regulate PINK1 stability and function.
Publisher: Wiley
Date: 29-09-2019
DOI: 10.1111/DME.14139
Abstract: Depression is common in Type 2 diabetes, yet rates vary. Overlap between symptoms of depression and diabetes may account for this variability in depression prevalence rates. We examined to what extent depression prevalence was a function of the proportion of depression-diabetes symptom overlap (items within symptom dimensions) and s le characteristics. Electronic and hand searching of published and unpublished works identified 147 eligible papers. Of 3656 screened, 147 studies (149 s les, N = 17-229 047, mean s le age 25.4-82.8 years, with 152 prevalence estimates), using 24 validated depression questionnaires were selected. S le size, publication type, s le type, gender, age, BMI, HbA Prevalence rates ranged from 1.8% to 88% (mean = 28.30%) and were higher in younger s les, s les with higher mean HbA The lack of an overall effect of diabetes-depression symptom overlap might suggest that assessment of depression in Type 2 diabetes is generally not confounded by co-occuring symptoms. However, questionnaires with proportionally more or fewer items measuring other symptom categories were associated with higher estimates of depression prevalence. Depression measures that focus on the cardinal symptoms of depression (e.g. negative affect and cognition), limiting symptoms associated with increasing diabetes symptomatology (e.g. sleep disturbance, cognitive) may most accurately diagnose depression.
Publisher: Wiley
Date: 07-2016
DOI: 10.1002/PDI.2036
Publisher: Naturalis Biodiversity Center
Date: 29-06-2020
DOI: 10.3767/PERSOONIA.2020.44.11
Abstract: Novel species of fungi described in this study include those from various countries as follows: Antarctica , Cladosporium arenosum from marine sediment sand. Argentina , Kosmimatamyces alatophylus (incl. Kosmimatamyces gen. nov.) from soil. Australia , Aspergillus banksianus , Aspergillus kumbius , Aspergillus luteorubrus , Aspergillus malvicolor and Aspergillus nanangensis from soil, Erysiphe medicaginis from leaves of Medicago polymorpha , Hymenotorrendiella communis on leaf litter of Eucalyptus bicostata , Lactifluus albopicri and Lactifluus austropiperatus on soil, Macalpinomyces collinsiae on Eriachne benthamii , Marasmius vagus on soil, Microdochium dawsoniorum from leaves of Sporobolus natalensis , Neopestalotiopsis nebuloides from leaves of Sporobolus elongatus , Pestalotiopsis etonensis from leaves of Sporobolus jacquemontii , Phytophthora personensis from soil associated with dying Grevillea mccutcheonii. Brazil , Aspergillus oxumiae from soil, Calvatia baixaverdensis on soil, Geastrum calycicoriaceum on leaf litter, Greeneria kielmeyerae on leaf spots of Kielmeyera coriacea . Chile , Phytophthora aysenensis on collar rot and stem of Aristotelia chilensis . Croatia , Mollisia gibbospora on fallen branch of Fagus sylvatica . Czech Republic , Neosetophoma hnaniceana from Buxus sempervirens . Ecuador , Exophiala frigidotolerans from soil. Estonia , Elaphomyces bucholtzii in soil. France , Venturia paralias from leaves of Euphorbia paralias . India , Cortinarius balteatoindicus and Cortinarius ulkhagarhiensis on leaf litter. Indonesia , Hymenotorrendiella indonesiana on Eucalyptus urophylla leaf litter. Italy , Penicillium taurinense from indoor chestnut mill. Malaysia , Hemileucoglossum kelabitense on soil, Satchmopsis pini on dead needles of Pinus tecunumanii . Poland , Lecanicillium praecognitum on insects' frass. Portugal , Neodevriesia aestuarina from saline water. Republic of Korea , Gongronella namwonensis from freshwater. Russia , Candida pellucida from Exomias pellucidus , Heterocephalacria septentrionalis as endophyte from Cladonia rangiferina , Vishniacozyma phoenicis from dates fruit, Volvariella paludosa from sw . Slovenia , Mallocybe crassivelata on soil. South Africa , Beltraniella podocarpi , Hamatocanthoscypha podocarpi , Coleophoma podocarpi and Nothoseiridium podocarpi (incl. Nothoseiridium gen. nov.)from leaves of Podocarpus latifolius , Gyrothrix encephalarti from leaves of Encephalartos sp., Paraphyton cutaneum from skin of human patient, Phacidiella alsophilae from leaves of Alsophila capensis , and Satchmopsis metrosideri on leaf litter of Metrosideros excelsa. Spain , Cladophialophora cabanerensis from soil, Cortinarius paezii on soil, Cylindrium magnoliae from leaves of Magnolia grandiflora , Trichophoma cylindrospora (incl. Trichophoma gen. nov.) from plant debris, Tuber alcaracense in calcareus soil, Tuber buendiae in calcareus soil. Thailand , Annulohypoxylon spougei on corticated wood, Poaceascoma filiforme from leaves of unknown Poaceae. UK , Dendrostoma luteum on branch lesions of Castanea sativa , Ypsilina buttingtonensis from heartwood of Quercus sp. Ukraine , Myrmecridium phragmiticola from leaves of Phragmites australis. USA , Absidia pararepens from air, Juncomyces californiensis (incl. Juncomyces gen. nov.) from leaves of Juncus effusus , Montagnula cylindrospora from a human skin s le, Muriphila oklahomaensis (incl. Muriphila gen. nov.)on outside wall of alcohol distillery, Neofabraea eucalyptorum from leaves of Eucalyptus macrandra , Diabolocovidia claustri (incl. Diabolocovidia gen. nov.)from leaves of Serenoa repens , Paecilomyces penicilliformis from air, Pseudopezicula betulae from leaves of leaf spots of Populus tremuloides . Vietnam , Diaporthe durionigena on branches of Durio zibethinus and Roridomyces pseudoirritans on rotten wood. Morphological and culture characteristics are supported by DNA barcodes.
Publisher: Wiley
Date: 26-09-2007
DOI: 10.1111/J.1464-5491.2007.02229.X
Abstract: The Families, Adolescents and Children's Teamwork Study (FACTS) is a family-centred structured education programme for children and adolescents with Type 1 diabetes. It aims to integrate group-based diabetes education into routine care, enhance parental responsibility for self management and improve glycaemic control. A randomized wait-list control group study allocated participants to either the immediate (four educational sessions during year 1) or delayed intervention (four educational sessions during year 2). In both groups, glycated haemoglobin (HbA1c) was measured 3-monthly and participants completed the Paediatric Quality of Life Inventory (PedsQL), Problem Areas in Diabetes Scale (PAID) and Diabetes Family Responsibility Questionnaire (DFRQ) before and after the intervention. Intention-to-treat analysis showed no significant difference in HbA1c or parental responsibility between participants randomized to the immediate or delayed programme. However, during 12 months' follow-up, families who attended > or = 2 sessions reported increased parental involvement (P = 0.01), and in children/adolescents who attended > or = 2 sessions HbA1c fell by 0.29% compared with an increase of 0.11% in non-attenders (P = 0.04). This family-centred education programme has been integrated into paediatric diabetes care with potential benefits on parental involvement and glycaemic control, but further study is warranted before routine application into clinical care.
Publisher: Wiley
Date: 04-2010
DOI: 10.1111/J.1464-5491.2009.02895.X
Abstract: In paediatric diabetes, the concept of intensive therapy in the post-Diabetes Control and Complications Trial period has become subverted by a pharmaco-technological paradigm at the expense of other aspects of care such as goal-setting and psychosocial support. This review examines which patients benefit most from intensive therapy in terms of glycaemic control (HbA1c). It also reviews published controlled trial and observational data relating to the impact of various insulin types and delivery systems on glycaemic control and canvasses the literature dealing with the impact of patient support, philosophy of care, goal setting and treating team dynamic on HbA1c. Taking into account the characteristics of those patients who benefit most from intensive therapy, the quantum of HbA1c change and the persistence of changes that have been reported in selected and non-selected patient groups, it appears that there is a clear hierarchy in aspects of therapy that improve glycaemic control for children and adolescents with Type 1 diabetes. Prime issues appear to be patient support, team cohesion and goal setting. The reported glycaemic benefits achieved by an isolated emphasis upon a pharmaco-technological paradigm are limited in children and adolescents. It appears that only after the prime issues have been first considered will the potential benefits of the insulin types and regimens then be realized.
Publisher: JMIR Publications Inc.
Date: 18-02-2014
DOI: 10.2196/GAMES.3183
Publisher: Oxford University Press (OUP)
Date: 05-02-2009
Abstract: This study was conducted to explore the relationships between illness perceptions, emotional representations, treatment beliefs and reported adherence in adolescents with cystic fibrosis (CF). Thirty-eight adolescents completed questionnaires assessing their perceptions of CF, beliefs about prescribed treatments and reported adherence to chest physiotherapy, enzyme supplements, and antibiotics. Reported non-adherence to chest physiotherapy was associated with the way in which patients judged their personal need for treatment relative to their concerns about potential adverse effects. Patients reported strong doubts about the necessity of chest physiotherapy. Reported non-adherence to antibiotics was related to doubts about the necessity of antibiotics, believing that CF is not amenable to treatment control. Despite these beliefs about treatment, participants perceived CF as a chronic condition. The findings provide preliminary support for the self-regulatory model, using the necessity-concerns framework to operationalize treatment beliefs, in explaining adherence to treatment in adolescents with CF.
Publisher: Wiley
Date: 09-05-2005
Publisher: Wiley
Date: 30-08-2017
DOI: 10.1002/EAT.22746
Abstract: To examine gender differences in disordered eating behaviors (DEB) and body dissatisfaction in adolescents with type 1 diabetes. While evidence shows that female youth with type 1 diabetes are more prone to DEB compared to their peers without diabetes, little is known about male adolescents. In a national online survey, adolescents (13-19 years) with type 1 diabetes for ≥1 year completed the Diabetes Eating Problem Survey-Revised (DEPS-R), and the Body Mass Index Silhouette Matching Test (BMI-SMT) and items on binge eating and insulin omission. About 477 adolescents (mean age 16 years 62% females) completed the DEPS-R and 431 the BMI-SMT. The DEPS-R total score was higher for females than males, with scores for females increasing with age. BMI, HbA A large proportion of adolescents with type 1 diabetes, particularly females reported engaging in DEB. Similarly, high rates of body dissatisfaction were reported, though ideal body shape preferences differed by gender. Given the high levels of self-reported DEB and gender-based patterns of body dissatisfaction, future research needs to examine the effectiveness of routine screening of DEB and consider implementation of stepped care approaches.
Publisher: Informa UK Limited
Date: 11-2009
DOI: 10.1080/08870440802460426
Abstract: Women of lower educational attainment are more likely to eat unhealthy diets than women of higher educational attainment. To identify influences on the food choices of women with lower educational attainment, 11 focus groups (eight with women of lower, and three with women of higher educational attainment) were held. Using a semi-structured discussion guide, environmental, social, historical and psychological factors known to be associated with food choice were explored. Audio recordings were transcribed verbatim and thematically analysed. Compared to women of higher educational attainment, women of lower educational attainment had less control over their families' food choices, less support for attempts to eat healthily, fewer opportunities to observe and learn good food-related practices, more negative affect, more perceived environmental constraints and more ambiguous beliefs about the consequences of eating a nutritious diet. These findings provide a starting point for taking forward the design of an intervention to improve the diets of young women.
Publisher: Wiley
Date: 23-12-2020
Publisher: Wiley
Date: 12-09-2020
DOI: 10.1111/DME.14354
Publisher: SAGE Publications
Date: 17-08-2016
Abstract: There is a need to identify proactive, evidence-based interventions to support informal palliative caregivers. Mindfulness-based interventions, evidenced in the literature as providing physical and mental health benefits for erse populations, may have application in the setting of palliative caregiving. To describe, evaluate and synthesise the peer-reviewed literature on the effects of mindfulness-based interventions for informal palliative caregivers. A Systematic Literature Review according to the Preferred Reporting Items for Systematic Review and Meta Analyses guidelines and a Narrative synthesis. The Cochrane Library, CINAHL, MEDLINE, PsycINFO and EMBASE databases, searched from inception to February 2014 and references of included studies. A total of 13 articles, reporting 10 studies ( n = 432 participants) were included. All studies were conducted in the last 5 years. Dementia caregivers were the most frequently researched population ( n = 7). Results suggest that mindfulness-based interventions are feasible and acceptable to offer to informal palliative caregivers and may provide benefit, particularly in terms of reducing depression and caregiver burden and increasing quality of life. However, effects were not as robust as findings in the wider mindfulness intervention literature. This is the first systematic literature review on this topic. Results suggest both feasibility and potential benefit. Further qualitative research is required to explore the outcomes identified by informal caregivers themselves as the reduced magnitude of effect may suggest that we are not measuring the right outcomes in this context. This would inform more sensitive outcome measures for future intervention studies and guide the development and application of mindfulness-based models in this area.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Wiley
Date: 2006
DOI: 10.1002/PDI.964
Publisher: Wiley
Date: 15-07-2010
DOI: 10.1111/J.1464-5491.2010.03042.X
Abstract: To compare the identification of prevalent depressive symptoms by the World Health Organization-5 Wellbeing Index (WHO-5) and Centre for Epidemiological Studies Depression Scale (CES-D) for South Asian and white European people, male and female, attending a diabetes screening programme, and to explore the adequacy of the screening tools for this population. An additional aim was to further explore associations of depressive symptoms with impaired glucose regulation (IGR) and Type 2 diabetes mellitus (Type2 DM). Eight hundred and sixty-four white European (40-75 years old) and 290 South Asian people (25-75 years old) underwent an oral glucose tolerance test (OGTT), detailed history and anthropometric measurements and completed the WHO-5 and CES-D. Depressive symptoms were defined by a WHO-5 score or= 16. Unadjusted prevalence of depressive symptoms with the WHO-5, for people with Type2 DM was 42.3% (47.4% in white European 28.6% in South Asian) and for IGR 30.7% (26% in white European 45.8% in South Asian). With the CES-D, the prevalence in Type2 DM was 27.2% (25.4% in white European 31.8% in South Asian) and for IGR 30.7% (27.8% in white European 40.7% in South Asian). Statistically significant differences in the prevalence of depressive symptoms for sex or ethnicity were not identified. Odds ratios adjusted for age, sex and ethnicity showed no significant association of depression with Type2 DM or IGR, with either WHO-5 or CES-D. Agreement was moderate (kappa = 0.48, 95% confidence intervals 0.42-0.54), and reduced when identifying depressive symptoms in people with Type2 DM. For this group, a WHO-5 cut-point of <or= 10 was optimal. Depressive symptoms, identified by WHO-5 or CES-D, were not significantly more prevalent in people with Type2 DM or IGR. The WHO-5 and CES-D differed in their identification of depressive symptoms in people with Type2 DM, though discrepancies between sex and ethnicity were not identified.
Publisher: Hindawi Limited
Date: 02-06-2023
DOI: 10.1155/2023/8578231
Abstract: Background. Easy accessibility of psychosocial care is recommended for children and adolescents with type 1 diabetes (T1D) and their families. Objective. The study aimed to evaluate the availability of psychological care and its associations with glycemic control in centers from the multinational SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) registry. Subjects. Centers participating in SWEET (n = 112) were invited to complete a structured online survey, designed for the study, regarding their psychology service. Methods. Linear/logistic regression models adjusted for several confounders were used to determine the patient’s HbA1c (mmol/mol) and odds ratios (ORs) for diabetic ketoacidosis (DKA) and severe hypoglycemia (SH) related to survey responses. Results. 76 (68%) centers with relevant data in the SWEET database responded to the survey. Psychological services were provided in 89% of the centers. The availability of psychological service in centers was associated with a slightly lower HbA1c of the patients (72 (62–82) vs. 67 (57–78) mmol/mol, p = 0.004 ) and significantly lower odds for DKA (1.8 (1.1–2.9), p = 0.027 ). Conclusions. Most centers from the SWEET registry offered some form of structured psychological care, consistent with the recommendations of easy access to psychosocial care for children and adolescents with T1D and their families. The main benefit of this psychological care appears to be in the incidence of DKA between centers. The study data also continues to emphasize the importance of treatment targets in shaping the outcomes of pediatric diabetes care. These findings should inform health-service planners and the diabetes community of the importance of mental healthcare in multidisciplinary diabetes teams.
Publisher: Wiley
Date: 06-06-2017
DOI: 10.1111/DME.13386
Abstract: To explore factors associated with non-disclosure of Type 2 diabetes to employers among Danish workers with Type 2 diabetes. A total of 705 workers with Type 2 diabetes completed a Danish cross-sectional survey. Logistic regression models were used to estimate the associations between background characteristics and probability of non-disclosure of diabetes to the employer. The models were mutually adjusted for background characteristics, socioeconomic-, diabetes- and work-related factors. Among the participants, 23% had not disclosed their Type 2 diabetes to their current employer. Non-disclosure was associated with more sickness absence, more years with diabetes, greater use of diabetic medication, higher educational level and a perception of not being respected by superior. Personal traits such as gender, age and well-being were not associated with disclosure. Among the feasible targets for interventions, good psychosocial work environment was associated with disclosure.
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.DSX.2016.01.001
Abstract: In sub-Saharan Africa, there is no precise use of metabolic syndrome (MetS) definitions and risk factors screening indices in many clinical and public health services. Methods proposed and used in Western populations are adopted without validation within the local settings. The aim of the study is to assess obesity indices and cut-off values that maximise screening of MetS and risk factors in the Nigerian population. A consolidated analysis of 2809 s les from four population-based cross-sectional study of apparently healthy persons≥18 years was carried out. Optimal waist circumference (WC) and waist-to-height ratio (WHtR) cut points for diagnosing MetS and risk factors were determined using Optimal Data Analysis (ODA) model. The stability of the predictions of the models was also assessed. Overall mean values of BMI, WC and WHtR were 24.8±6.0kgm(-2), 84.0±11.3cm and 0.52±0.1 respectively. Optimal WC cut-off for discriminating MetS and diabetes was 83cm in females and 85cm in males, and 82cm in females and 89cm in males, respectively. WC was stable in discriminating diabetes than did WHtR and BMI, while WHtR showed better stability in predicting MetS than WC and BMI. The study shows that the optimal WC that maximises classification accuracy of MetS differs from that currently used for sub-Saharan ethnicity. The proposed global WHtR of 0.50 may misclassify MetS, diabetes and hypertension. Finally, the WC is a better predictor of diabetes, while WHtR is a better predictor of MetS in this s le population.
Publisher: Wiley
Date: 03-04-2019
DOI: 10.1111/DME.13934
Publisher: Wiley
Date: 21-07-2020
DOI: 10.1111/DME.14347
Publisher: Elsevier BV
Date: 06-2015
Publisher: BMJ
Date: 14-02-2008
Publisher: Wiley
Date: 02-04-2015
DOI: 10.1111/DME.12729
Abstract: To identify insulin therapy appraisals among adults with Type 2 diabetes using insulin and how negative appraisals relate to clinical, self-care and psychosocial outcomes. Diabetes MILES - Australia 2011 was a national survey of adults with diabetes, focused on behavioural and psychosocial issues. Subgroup analyses were conducted on the responses of 273 adults with Type 2 diabetes using insulin (46% women mean ± sd age: 59 ± 9 years diabetes duration: 12 ± 7 years years using insulin: 4 ± 4). They completed validated measures of insulin therapy appraisals (ITAS), depression (PHQ-9), anxiety (GAD-7), diabetes distress (PAID) and diabetes-specific self-efficacy (DES-SF). Insulin was perceived to be very important, and its benefits (e.g. improves health) were endorsed by most (82%). Fifty-one per cent believed that taking insulin means their diabetes has become worse 51% that insulin causes weight gain 39% that they have 'failed to manage' their diabetes. Those with the greatest and least 'ITAS negative' scores did not differ by diabetes duration or years using insulin, or by average number of insulin injections or blood glucose checks per day. Those with more negative insulin appraisals were significantly younger (Mean Diff. = 5 years, P < 0.001), less satisfied with recent blood glucose levels (P < 0.001, d = 0.63), had reduced diabetes-specific self-efficacy (P < 0.001, d = 0.7), and were more likely to report depressive symptoms, anxiety or diabetes distress (all P < 0.001, d = 0.65-1.1). Negative insulin therapy appraisals are common among adults with Type 2 diabetes using insulin, and are associated with lower general and diabetes-specific emotional well-being, reduced diabetes-specific self-efficacy and satisfaction with blood glucose.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.SLEH.2017.12.006
Abstract: Sleep duration and sleep schedule variability have been related to negative health and well-being outcomes in children, but little is known about Australian Indigenous children. Data for children aged 7-9 years came from the Australian Longitudinal Study of Indigenous Children and the National Assessment Program-Literacy and Numeracy (NAPLAN). Latent class analysis determined sleep classes taking into account sleep duration, bedtimes, waketimes, and variability in bedtimes from weekdays to weekends. Regression models tested whether the sleep classes were cross-sectionally associated with grade 3 NAPLAN scores. Latent change score modeling then examined whether the sleep classes predicted changes in NAPLAN performance from grades 3 to 5. Five sleep schedule classes were identified: normative sleep, early risers, long sleep, variable sleep, and short sleep. Overall, long sleepers performed best, with those with reduced sleep (short sleepers and early risers) performing the worse on grammar, numeracy, and writing performance. Latent change score results also showed that long sleepers performed best in spelling and writing and short sleepers and typical sleepers performed the worst over time. In this s le of Australian Indigenous children, short sleep was associated with poorer school performance compared with long sleep, with this performance worsening over time for some performance indicators. Other sleep schedules (eg, early wake times and variable sleep) also had some relationships with school performance. As sleep scheduling is modifiable, this offers opportunity for improvement in sleep and thus performance outcomes for these and potentially all children.
Publisher: Informa UK Limited
Date: 18-04-2023
Publisher: No publisher found
Date: 2000
DOI: 10.1002/(SICI)1528-252X(200005)17:3<91::AID-PDI59>3.0.CO;2-%23
Publisher: Cambridge University Press (CUP)
Date: 05-2010
DOI: 10.1375/JRC.16.1.27
Abstract: This preliminary study sought to explore the link between depression, experiential avoidance and mindfulness in people with a spinal cord injury (SCI). We surveyed patients listed on the SCI database at Royal Perth Hospital who had experienced an injury over the last 10 years. Respondents (62) completed a questionnaire including the depression subscale of the Depression Anxiety Stress Scale, the Acceptance and Action Questionnaire (AAQ-2 Bond et al., 2007) and the Mindful Attention Awareness Scale (MAAS Brown & Ryan, 2003). Thirty per cent of participants scored above the cut-off for possible depression, with equal numbers experiencing mild, moderate or severe depression. Mindfulness and experiential avoidance were significantly associated with depression, and were intercorrelated. Further, regression analysis indicated that experiential avoidance mediated the relationship between depression and mindfulness. Our preliminary data suggest that in iduals with SCI who are more mindful use less avoidance and have a more positive mood. These results indicate further work in this area is warranted.
Publisher: Wiley
Date: 24-11-2018
DOI: 10.1111/JPC.14308
Abstract: Associations between sleep duration and obesity and between obesity and chronic illness are established. Current rates of obesity for all Australian people are rising. Recent reports indicate that high body mass index (BMI) is a leading contributor to overall burden of disease for Indigenous Australians. Understanding the factors that contribute to higher rates of obesity in Indigenous people is critical to developing effective interventions for reducing morbidity and premature mortality in this population. To explore the effect of sleep duration on the relationship between Indigenous status and BMI in Australian children. 716 non-Indigenous and 186 Indigenous children aged 5-12 years in the Australian Health Survey 2011-2013. Primary carers were interviewed regarding children's sleep times BMI was derived from measurement. Analysis of covariance revealed that regardless of a number of demographic and socio-economic status markers, sleep duration and Indigenous status were independent predictors of BMI. However when both predictors were considered together, only sleep duration remained predictive of BMI. Sleep duration plays an important mediating role in the relationship between Indigenous status and BMI in this Australian s le. Modification of sleep duration for Indigenous children may lead to longer-term positive health outcomes.
Publisher: Springer Science and Business Media LLC
Date: 09-01-2022
DOI: 10.1186/S12913-021-07374-4
Abstract: The aim of this work was to develop a National Evaluation Framework to facilitate the standardization of delivery, quality, reporting, and evaluation of diabetes education and support programs delivered throughout Australia through the National Diabetes Services Scheme (NDSS). The NDSS is funded by the Australian Government, and provides access to diabetes information, education, support, and subsidized product across erse settings in each state and territory of Australia through seven independent service-providers. This article reports the approach undertaken to develop the Framework. A participatory approach was undertaken, focused on adopting nationally consistent outcomes and indicators, nominating objectives and measurement tools, specifying evaluation processes, and developing quality standards. Existing programs were classified based on related, overarching indicators enabling the adoption of a tiered system of evaluation. Two outcomes (i.e., improved clinical, reduced cost) and four indicators (i.e., improved knowledge and understanding, self-management, self-determination, psychosocial adjustment) were adopted from the Eigenmann and Colagiuri national consensus position statement for diabetes education. This allowed for the identification of objectives (i.e., improved empowerment, reduced distress, autonomy supportive program delivery, consumer satisfaction) and related measurement instruments. Programs were categorized as comprehensive, topic-specific, or basic education, with comprehensive programs allocated to receive the highest-level of evaluation. Eight quality standards were developed, with existing programs tested against those standards. Based on the results of testing, two comprehensive (OzDAFNE for people with type 1 diabetes, DESMOND for people with type 2 diabetes), and eight topic-specific (CarbSmart, ShopSmart, MonitorSmart, FootSmart, MedSmart, Living with Insulin, Insulin Pump Workshop, Ready Set Go – Let’s Move) structured diabetes self-management education and support programs were nominated for national delivery. The National Evaluation Framework has facilitated consistency of program quality, delivery, and evaluation of programs delivered by multiple service providers across erse contexts. The Framework could be applied by other service providers who facilitate multiple diabetes education and support programs and could be adapted for use in other chronic disease populations where education and support are indicated.
Publisher: American Diabetes Association
Date: 09-2007
DOI: 10.2337/DC07-0475
Abstract: OBJECTIVE—To reevaluate the persistence and stability of previously observed differences between pediatric diabetes centers and to investigate the influence of demography, language communication problems, and changes in insulin regimens on metabolic outcome, hypoglycemia, and ketoacidosis. RESEARCH DESIGN AND METHODS—This was an observational cross-sectional international study in 21 centers, with clinical data obtained from all participants and A1C levels assayed in one central laboratory. All in iduals with diabetes aged 11–18 years (49.4% female), with duration of diabetes of at least 1 year, were invited to participate. Fourteen of the centers participated in previous Hvidoere Studies, allowing direct comparison of glycemic control across centers between 1998 and 2005. RESULTS—Mean A1C was 8.2 ± 1.4%, with substantial variation between centers (mean A1C range 7.4–9.2% P & 0.001). There were no significant differences between centers in rates of severe hypoglycemia or diabetic ketoacidosis. Language difficulties had a significant negative impact on metabolic outcome (A1C 8.5 ± 2.0% vs. 8.2 ± 1.4% for those with language difficulties vs. those without, respectively P & 0.05). After adjustement for significant confounders of age, sex, duration of diabetes, insulin regimen, insulin dose, BMI, and language difficulties, the center differences persisted, and the effect size for center was not reduced. Relative center ranking since 1998 has remained stable, with no significant change in A1C. CONCLUSIONS—Despite many changes in diabetes management, major differences in metabolic outcome between 21 international pediatric diabetes centers persist. Different application between centers in the implementation of insulin treatment appears to be of more importance and needs further exploration.
Publisher: Wiley
Date: 15-07-2012
DOI: 10.1111/J.1464-5491.2012.03683.X
Abstract: To evaluate the effectiveness of a family-centred group education programme, in adolescents with Type 1 diabetes. Three hundred and five adolescents with Type 1 diabetes age 13.1 ± 1.9 years, diabetes duration 5.6 ± 3.3 years, BMI 20.9 ± 3.7 kg/m(2) , HbA(1c) 78 ± 6 mmol/mol (9.3 ± 1.9%) were randomly allocated to the Families and Adolescents Communication and Teamwork Study (FACTS) diabetes education programme (six 90-min monthly sessions attended by parents and adolescents incorporating skills training and family teamwork) or conventional clinical care. Primary outcome was HbA(1c) at 18 months (12 months post-intervention). Secondary outcomes were HbA(1c) at 9 months, psychosocial outcomes, adolescent quality of life, well-being, family responsibility and insulin dose adjustment behaviours at 12 months (6 months post-intervention) and episodes of severe hypoglycaemia and diabetic ketoacidois during the 12 months post-intervention. All analyses are intention to treat. Session attendance was poor with 48/158 families (30.4%) not attending any sessions and only 75/158 (47.5%) families attending ≥ 4 group education sessions. All biomedical and psychosocial outcomes were comparable between groups. At 18 months there was no significant difference in HbA(1c) in either group and no between-group differences over time: intervention group 75 mmol/mol (9.0%) to 78 mmol/mol (9.3%), control group 77 mmol/mol (9.2%) to 80 mmol/mol (9.5%). Adolescents perceived no changes in parental input at 12 months. Poor attendance of group education sessions delivered in routine clinics was a major challenge. More personalized educational approaches may be required to support and motivate families who are struggling to integrate the demands of intensive insulin regimens into their daily lives.
Publisher: Informa UK Limited
Date: 05-2014
DOI: 10.3852/12-119
Abstract: A non-papillate, heterothallic Phytophthora species first isolated in 2001 and subsequently from symptomatic roots, crowns and stems of 33 plant species in 25 unrelated botanical families from 13 countries is formally described here as a new species. Symptoms on various hosts included crown and stem rot, chlorosis, wilting, leaf blight, cankers and gumming. This species was isolated from Australia, Hungary, Israel, Italy, Japan, the Netherlands, Norway, South Africa, Spain, Taiwan, Turkey, the United Kingdom and United States in association with shrubs and herbaceous ornamentals grown mainly in greenhouses. The most prevalent hosts are English ivy (Hedera helix) and Cistus (Cistus salvifolius). The association of the species with acorn banksia (Banksia prionotes) plants in natural ecosystems in Australia, in affected vineyards (Vitis vinifera) in South Africa and almond (Prunus dulcis) trees in Spain and Turkey in addition to infection of shrubs and herbaceous ornamentals in a broad range of unrelated families are a sign of a wide ecological adaptation of the species and its potential threat to agricultural and natural ecosystems. The morphology of the persistent non-papillate ellipsoid sporangia, unique toruloid lobate hyphal swellings and higynous antheridia does not match any of the described species. Phylogenetic analysis based on sequences of the ITS rDNA, EF-1α, and β-tub supported that this organism is a hitherto unknown species. It is closely related to species in ITS clade 7b with the most closely related species being P. sojae. The name Phytophthora niederhauserii has been used in previous studies without the formal description of the holotype. This name is validated in this manuscript with the formal description of Phytophthora niederhauserii Z.G. Abad et J.A. Abad, sp. nov. The name is coined to honor Dr John S. Niederhauser, a notable plant pathologist and the 1990 World Food Prize laureate.
Publisher: Elsevier BV
Date: 10-2020
Publisher: AMPCo
Date: 03-2014
DOI: 10.5694/MJA13.00185
Publisher: Springer Science and Business Media LLC
Date: 31-01-2023
DOI: 10.1186/S12889-023-15122-Y
Abstract: Prevalence of prediabetes and type 2 diabetes mellitus (T2DM) is increasing worldwide. The objective of this study was to determine the proportion of people in Northern Iceland with prediabetes, at risk of developing T2DM or with manifest undiagnosed T2DM, as this information is lacking in Iceland. A cross-sectional study. Clients of the three largest primary health care centres in the Health Care Institution of North Iceland (HSN) were invited to participate if fulfilling the following inclusion criteria: a) aged between 18 and 75 years, b) not diagnosed with diabetes, c) speaking and understanding Icelandic or English fluently and d) living in the included service area. Data collection took place via face-to-face interviews between 1 March 2020 and 15 May 2021. Participation included answering the Finnish Diabetes Risk Score (FINDRISC), measuring the HbA1c levels and background information. Of the 220 participants, 65.9% were women. The mean age was 52.1 years (SD ± 14.1) and FINDRISC scores were as follows: 47.3% scored ≤8 points, 37.2% scored between 9 and 14 points, and 15.5% scored between 15 and 26 points. The mean HbA1c levels in mmol/mol, were 35.5 (SD ± 3.9) for men and 34.4 (SD ± 3.4) for women, ranging from 24 to 47. Body mass index ≥30 kg/m 2 was found in 32% of men and 35.9% of women. Prevalence of prediabetes in this cohort was 13.2%. None of the participants had undiagnosed T2DM. Best sensitivity and specificity for finding prediabetes was by using cut-off points of ≥11 on FINDRISC, which gave a ROC curve of 0.814. The FINDRISC is a non-invasive and easily applied screening instrument for prediabetes. Used in advance of other more expensive and invasive testing, it can enable earlier intervention by assisting decision making, health promotion actions and prevention of the disease burden within primary health care. This study is a pre-phase of the registered study “Effectiveness of Nurse-coordinated Follow up Program in Primary Care for People at risk of T2DM” at www.ClinicalTrials.gov (NCT01688359). Registered 30 December 2020.
Publisher: Cambridge University Press (CUP)
Date: 13-07-2012
DOI: 10.1017/JRC.2012.10
Publisher: Wiley
Date: 2006
DOI: 10.1002/PDI.968
Publisher: Informa UK Limited
Date: 21-07-2022
Publisher: Informa UK Limited
Date: 03-2011
DOI: 10.1080/08870440903411039
Abstract: This article explores the utility of cluster analysis of illness representations, in comparison to analysing each dimension of the in idual's illness representation, to predict an in idual's response to diagnosis of type 2 diabetes. Participants in a large multi-centre randomised controlled trial of a self-management education intervention for people with type 2 diabetes, completed measures of illness beliefs (coherence, timeline, impact, seriousness, personal responsibility) and depression along with HbA1c and body mass index (BMI), at baseline 4, 8 and 12 months. The results of the cluster analysis were compared with an independent qualitative study of participants' responses to diagnosis and participation in the study. The quantitative analysis of 564 participants for whom complete data were available, identified four clusters of illness representations as the most parsimonious description of the data. The mean profiles of these clusters were comparable with groups identified by the independent qualitative analysis, and predicted the trajectory of illness outcomes over the 1-year follow-up. Combining illness beliefs into discrete clusters may be more useful in understanding patterns of responding to illness than using analysis of illness beliefs dimensions independently.
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-051524
Abstract: Psychological barriers to insulin therapy are associated with the delay of clinically indicated treatment intensification for people with type 2 diabetes (T2D), yet few evidence-based interventions exist to address these barriers. We describe the protocol for a randomised controlled trial (RCT) examining the efficacy of a novel, theoretically grounded, psychoeducational, web-based resource designed to reduce psychological barriers to insulin among adults with non-insulin treated T2D: ‘ Is insulin right for me?’ . Double-blind, parallel group RCT. A target s le of N=392 participants (n=196/arm) will be randomised (1:1) to ‘ Is insulin right for me?’ (intervention) or widely available online resources (control). Eligible participants include adults (18–75 years), residing in Australia, currently taking oral hypoglycaemic agents to manage T2D. They will be primarily recruited via invitations and reminders from the national diabetes registry (from a purposefully selected s le of N≥12 000). Exclusion criteria: experience of self-administered injectable previously enrolled in pilot RCT ‘very willing’ to start insulin as baseline. Outcomes will be assessed via online survey at 2 weeks and 6 months. Primary outcome between-group: difference in mean negative Insulin Treatment Appraisal Scores (ITAS negative) at 2-week and 6-month follow-up. Secondary outcomes: between-group differences in mean positive insulin appraisals (ITAS positive) and percentage difference in intention to commence insulin at follow-up time points. All data analyses will be conducted according to the intention-to-treat principle. Deakin University Human Research Ethics Committee (2020–073). Dissemination via peer-reviewed journals, conferences and a plain-language summary. ACTRN12621000191897 Australian and New Zealand Clinical Trials Registry.
Publisher: Wiley
Date: 2007
DOI: 10.1002/PDI.1047
Publisher: Oxford University Press (OUP)
Date: 06-2000
Abstract: To examine whether peer support and illness representation mediate the link between family support, self-management and well-being. Fifty-two adolescents (12-18 years old) with Type I diabetes were recruited and followed over 6 months, completing assessments of self-management, well-being, and social support. Perceived impact of diabetes and supportive family and friends were prospectively predictive of participants' well-being measures. Although support from family and friends was predictive of better dietary self-care, this relationship was mediated by personal model beliefs. In particular, beliefs about the effectiveness of the diabetes treatment regimen to control diabetes was predictive of better dietary self-care. Both friends and family are important to support adolescents as they live with and manage their diabetes. Personal models of diabetes are important determinants of both dietary self-care and well-being. In addition, personal models may serve to mediate the relationship between social support and dietary behavior.
Publisher: MDPI AG
Date: 30-09-2022
Abstract: The Colorado potato beetle (CPB, Leptinotarsa decemlineata Say) is one of the most successful invasive species worldwide. It has been present in Croatia since 1947, where it has caused significant damage to potato plants and developed resistance to several insecticides. Our study is the first attempt to investigate the population structure of CPBs in Croatia. SNP and GM techniques provided us with data about the population structure of the CPB population. A Bayesian model-based clustering algorithm implemented in STRUCTURE, principal component analysis (PCA), and discriminant analysis of principal components (DAPC) were used to analyze the genetic structure of CPBs. For the morphometric analysis, the hindwing shape of the same CPB in iduals was examined using wing venation patterns. We detected the low genetic and phenotypic variabilities of CPB populations and the presence of a single panmictic population in the study area, well adapted to different environmental conditions, indicating high phenotypic plasticity. Due to such exceptional adaptation of the CPB population, it is necessary to implement an area-wide approach in future pest control management.
Publisher: Springer International Publishing
Date: 2020
Publisher: Wiley
Date: 09-2008
DOI: 10.1002/PDI.1280
Publisher: Wiley
Date: 30-07-2002
DOI: 10.1046/J.1464-5491.2002.00791.X
Abstract: To evaluate changes in self-efficacy for self-management in young people with Type 1 diabetes participating in a "Negotiated Telephone Support" (NTS) intervention developed using the principles of problem solving and social learning theory. One-year RCT with 79 young people (male 39 mean age +/- sd 16.5 +/- 3.2 years, duration 6.7 +/- 4.4 years, HbA(1c) 8.6 +/- 1.5%) randomized into: Group 1 (control group), continued routine management, n = 28 Group 2, continued routine management with NTS, n = 25 Group 3, annual clinic with NTS, n = 26. HbA(1c), self-efficacy, barriers to adherence, problem solving, and diabetes knowledge. There were no differences between the groups at baseline. Participants in Groups 2 and 3 received an average of 16 telephone calls/year (range 5-19), median duration 9 min (2-30), with a median interval of 3 weeks (1-24) between calls. Significant correlations were found between age and average length of call (r = 0.44, P < 0.01) and frequency of contact (r = 0.36, P < 0.05). Social and school topics were discussed frequently. After 1 year, while the participants in the two intervention groups showed significant improvements in self-efficacy (P = 0.035), there was no difference in glycaemic control in the three groups. Barriers to insulin use adherence were a significant predictor of HbA(1c) (P < 0.001) after controlling for baseline. NTS is an effective medium to deliver a simple theory-based psychological intervention to enhance self-efficacy for diabetes self-management. Reduced clinic attendance, combined with NTS, did not result in a deterioration of HbA(1c). Intensive personal support needs to be combined with intensive diabetes therapy to improve glycaemic control in this age group.
Publisher: Informa UK Limited
Date: 09-2010
DOI: 10.2147/VHRM.S12504
Publisher: Medknow
Date: 2021
Publisher: Wiley
Date: 28-03-2013
DOI: 10.1111/RISA.12037
Abstract: People who live in wildfire-prone communities tend to form their own hazard-related expectations, which may influence their willingness to prepare for a fire. Past research has already identified two important expectancy-based factors associated with people's intentions to prepare for a natural hazard: Perceived risk (i.e., perceived threat likelihood and severity) and perceived protection responsibility. We expanded this research by differentiating the influence of these factors on different types of wildfire preparedness (e.g., preparations for evacuation vs. for defending the house) and measured actual rather than intended preparedness. In addition, we tested the relation between preparedness and two additional threat-related expectations: the expectation that one can rely on an official warning and the expectation of encountering obstacles (e.g., the loss of utilities) during a fire. A survey completed by 1,003 residents of wildfire-prone areas in Perth, Australia, revealed that perceived risk (especially risk severity) and perceived protection responsibility were both positively associated with all types of preparedness, but the latter did not significantly predict preparedness after controlling for other predictors and demographics. Also, the two new expectancy-based factors were significantly associated with all types of preparedness, and remained significant predictors of some types of preparedness after controlling for other predictors and demographics: the expectation of being able to rely on an official fire warning and expecting to lose electricity both still predicted less preparedness around house resilience, and expecting to lose water still predicted increased planning preparedness. We discuss public policy implications that follow from this research.
Publisher: Frontiers Media SA
Date: 25-07-2022
DOI: 10.3389/FCDHC.2022.876511
Abstract: As a treatment option for people living with diabetes, automated insulin delivery (AID) systems are becoming increasingly popular. The #WeAreNotWaiting community plays a crucial role in the provision and distribution of open-source AID technology. However, while a large percentage of children were early adopters of open-source AID, there are regional differences in adoption, which has prompted an investigation into the barriers perceived by caregivers of children with diabetes to creating open-source systems. This is a retrospective, cross-sectional and multinational study conducted with caregivers of children and adolescents with diabetes, distributed across the online #WeAreNotWaiting online peer-support groups. Participants—specifically caregivers of children not using AID—responded to a web-based questionnaire concerning their perceived barriers to building and maintaining an open-source AID system. 56 caregivers of children with diabetes, who were not using open-source AID at the time of data collection responded to the questionnaire. Respondents indicated that their major perceived barriers to building an open-source AID system were their limited technical skills (50%), a lack of support by medical professionals (39%), and therefore the concern with not being able to maintain an AID system (43%). However, barriers relating to confidence in open-source technologies/unapproved products and fear of digital technology taking control of diabetes were not perceived as significant enough to prevent non-users from initiating the use of an open-source AID system. The results of this study elucidate some of the perceived barriers to uptake of open-source AID experienced by caregivers of children with diabetes. Reducing these barriers may improve the uptake of open-source AID technology for children and adolescents with diabetes. With the continuous development and wider dissemination of educational resources and guidance—for both aspiring users and their healthcare professionals—the adoption of open-source AID systems could be improved.
Publisher: American Psychological Association (APA)
Date: 10-2017
DOI: 10.1037/PAS0000401
Abstract: The assessment of depression in obstructive sleep apnea (OSA) is confounded by symptom overlap. The Depression, Anxiety, and Stress Scale-short form (DASS-21) is a commonly used measure of negative affect, but it not known whether the DASS-21 is suitable for use in an OSA s le. This study compared the fit of Lovibond and Lovibond's (1995) correlated 3-factor structure of the DASS-21 and measurement invariance between a non-OSA and an OSA s le using confirmatory factor analysis. As measurement invariance was not found, to determine the source of non-invariance differential item functioning (DIF) was examined using dMACS. The correlated 3-factor structure (with correlated errors) of the DASS-21 was a better fit in the non-OSA s le. dMACS indicated that there was a degree of DIF for each of the subscales, especially for the Anxiety subscale, in which 2 symptoms (that are also physiological symptoms of OSA) produced lower severity scores in the OSA s le compared with the non-OSA s le. However, the degree of DIF for each of the subscales is not sufficient to cause concern when using the DASS-21 therefore, the total DASS-21 is suitable for use in an OSA s le. Interestingly, the impact of symptom overlap in anxiety symptoms may be reducing anxiety scores because of DIF, which contrasts with the proposed effect of symptom overlap in depression, where it leads to the inflation of depression scores in OSA. This deserves greater consideration in relation to OSA and other clinical disorders or chronic illness conditions with different patterns of overlapping symptoms. (PsycINFO Database Record
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/WF12213
Abstract: In the event of a wildfire, Australian residents of wildfire-prone areas have a choice to defend their home or evacuate early. However, rather than deciding on and preparing for one of these fire-responses ahead of time, most residents delay deciding on defending v. evacuating (e.g. they wait and see instead). Recent research has shown that delaying this decision is associated with reduced levels of preparedness for both responses and on the day of a fire, an increased risk to life and property. The current study empirically examined what predicts this decision delay regarding one’s fire-response by measuring two personality traits and several decision-related factors. A longitudinal survey study of residents of multiple wildfire-prone areas in Western Australia showed that the strongest predictor of delaying their decision to defend v. evacuate was a lack of difference in perceived values of defending v. evacuating. These findings have important implications for the design of interventions to reduce the risks associated with such delay. For one, agencies could utilise residents’ value base to reduce decision delay. Alternatively, they could focus on the formation of proper contingency plans and stress the necessity to prepare well for both defending and evacuating.
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.DIABRES.2012.03.015
Abstract: Diabetes is the fastest growing chronic condition in Australia, affecting 1.7 million Australians, requiring daily self-care, and known to reduce quantity and quality of life. On average, people with diabetes experience greater emotional distress than those without diabetes. One source of distress can be the language used to refer to diabetes, its management and the person with diabetes. The way verbal and written language is used reflects and shapes people's thoughts, beliefs and behaviours. Language has the power to persuade, change or reinforce beliefs and stereotypes - for better or worse. Words do more than reflect people's reality: they create reality and affect how people view the world and their diabetes. Language needs to engage people with diabetes and support their self-care efforts. Importantly, language that de-motivates or induces fear, guilt or distress needs to be avoided and countered. Diabetes Australia believes optimal communication increases the motivation, health and well-being of people with diabetes, and that careless or negative language can be de-motivating, is often inaccurate, and can be harmful. Diabetes Australia developed this position statement to encourage greater awareness of the language surrounding diabetes and provide recommendations for more careful and positive language use.
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.DIABRES.2013.03.015
Abstract: To investigate differences in access to services and health outcomes between people living with Type 1 (T1DM) and Type 2 (T2DM) diabetes in rural/regional and metropolitan areas. Diabetes MILES--Australia was a national postal/online survey of persons registered with the National Diabetes Services Scheme. Selected variables, including utilisation of health care services and self-care indicators, were analysed for 3338 respondents with T1DM (41%) or T2DM (59%). Respondents from rural/regional (n=1574, 48%) and metropolitan areas were represented equally (n=1700, 52%). After adjusting for diabetes duration, demographic and socioeconomic variables, rural/regional respondents with T1DM (RR 0.90, 95% CI 0.83-0.97) and T2DM (RR 0.69, 95% CI 0.59-0.81) were less likely to report consulting an endocrinologist during the past 12 months. Rural/regional respondents with T1DM were more than twice as likely to have accessed a community ractice nurse for diabetes care (RR 2.22, 95% CI 1.25-3.93) while those with T2DM were more likely to have accessed a diabetes educator (RR 1.21, 95% CI 1.07-1.36) or dietician (RR 1.17, 95% CI 1.07-1.36). For the T1DM and T2DM groups were no differences between rural/regional and metropolitan respondents in self-reported hypoglycaemic events during past week and the majority of self-care indicators. Despite a lack of access to medical specialists, respondents with T1DM and T2DM living in rural/regional areas did not report worse health or self-care indicators. The results suggest that multidisciplinary primary services in rural areas may be providing additional care for people with diabetes, compensating for poor access to specialists.
Publisher: Elsevier BV
Date: 07-2008
DOI: 10.1016/J.PEC.2008.01.026
Abstract: This study sought to inform the development of an educational intervention for people with pre-diabetes in the UK by ascertaining in iduals' experience of screening and diagnosis, their appraisal of the condition, and experience of health service delivery from diagnosis to 1 year post-diagnosis. Qualitative interviews directed by framework methodology. Fifteen people diagnosed with pre-diabetes from the community (Midlands, UK) as part of a screening programme. Respondents consistently expressed the need for education and support at diagnosis. Dominating all respondents' narratives was the theme of 'uncertainty', which linked to two further themes of seriousness and taking action. These themes were influenced by respondents' prior experience and appraisal of both diabetes and pre-diabetes and their interpretation of health professionals' attitudes and actions towards them. Patients identified as having pre-diabetes currently emphasise their uncertainties about their diagnosis, its physical consequences and subsequent management. Interventions to enable the increasing numbers of in iduals with pre-diabetes to manage their health optimally should evolve to address these uncertainties. Those delivering services to those at risk of, or diagnosed with, pre-diabetes should be aware of patient needs and tailor care to support and shape perceptions to enhance health-maintaining behaviours.
Publisher: Springer Science and Business Media LLC
Date: 20-05-2012
Abstract: The prevention of type 2 diabetes is a globally recognised health care priority, but there is a lack of rigorous research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. The aim of the study is to establish whether a pragmatic structured education programme targeting lifestyle and behaviour change in conjunction with motivational maintenance via the telephone can reduce the incidence of type 2 diabetes in people with impaired glucose regulation (a composite of impaired glucose tolerance and/or impaired fasting glucose) identified through a validated risk score screening programme in primary care. Cluster randomised controlled trial undertaken at the level of primary care practices. Follow-up will be conducted at 12, 24 and 36 months. The primary outcome is the incidence of type 2 diabetes. Secondary outcomes include changes in HbA1c, blood glucose levels, cardiovascular risk, the presence of the Metabolic Syndrome and the cost-effectiveness of the intervention. The study consists of screening and intervention phases within 44 general practices coordinated from a single academic research centre. Those at high risk of impaired glucose regulation or type 2 diabetes are identified using a risk score and invited for screening using a 75 g-oral glucose tolerance test. Those with screen detected impaired glucose regulation will be invited to take part in the trial. Practices will be randomised to standard care or the intensive arm. Participants from intensive arm practices will receive a structured education programme with motivational maintenance via the telephone and annual refresher sessions. The study will run from 2009–2014. This study will provide new evidence surrounding the long-term effectiveness of a diabetes prevention programme conducted within routine primary care in the United Kingdom. Clinicaltrials.gov NCT00677937
Publisher: American Diabetes Association
Date: 26-04-2017
DOI: 10.2337/DC16-2688
Abstract: Despite the challenges of living with type 1 diabetes, many adolescents achieve “resilient outcomes”: high engagement in self-management behaviors such as self-monitoring of blood glucose (SMBG), good quality of life (QOL), and within-target glycemic outcomes (HbA1c). Adaptive diabetes-related behaviors (i.e., “strengths”) are associated with resilient outcomes, yet the combination of risks and strengths in relation to resilient outcomes is unclear. The aim of this study was to investigate relations among diabetes strengths and resilient outcomes in the context of psychological and family risk factors. A total of 471 Australian adolescents with type 1 diabetes (mean age 15.7 ± 1.9 years diabetes duration 6.9 ± 4.2 years 62% female 53% using insulin pumps) completed a national cross-sectional survey about their diabetes-related strengths, risk factors (depressive/anxiety symptoms, family conflict), and resilient outcomes (SMBG frequency, general QOL, HbA1c). Greater diabetes strengths were significantly related to resilient outcomes: more frequent SMBG (r = 0.39), lower HbA1c (r = −0.31), and higher general QOL (r = 0.50), as well as to lower risks: fewer depressive (r = −0.45) and anxiety (r = −0.40) symptoms and less conflict (r = 0.28). In multivariate regressions, diabetes strengths consistently related to all resilient outcomes beyond significant risk factors. In a large s le of Australian adolescents, diabetes strengths were strongly related to key resilient outcomes, even in the presence of well-documented psychological and family risk factors. More research is needed to determine whether strengths reduce or buffer other risks. Given the associations with self-management, HbA1c, and general QOL, monitoring and enhancing diabetes strengths may support resilience promotion during a vulnerable developmental period.
Publisher: AMPCo
Date: 30-06-2019
DOI: 10.5694/MJA2.50212
Abstract: To determine the validity, sensitivity, specificity and acceptability of the culturally adapted nine-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander people. Prospective observational validation study, 25 March 2015 - 2 November 2016. 500 adults (18 years or older) who identified as Aboriginal or Torres Strait Islander people and attended one of ten primary health care services or service events in urban, rural and remote Australia that predominantly serve Indigenous Australians, and were able to communicate sufficiently to respond to questionnaire and interview questions. Criterion validity of the aPHQ-9, with the depression module of the Mini-International Neuropsychiatric Interview (MINI) 6.0.0 as the criterion standard. 108 of 500 participants (22% 95% CI, 18-25%) had a current episode of major depression according to the MINI criterion. The sensitivity of the aPHQ-9 algorithm for diagnosing a current major depressive episode was 54% (95% CI, 40-68%), its specificity was 91% (95% CI, 88-94%), with a positive predictive value of 64%. For screening for a current major depressive episode, the area under the receiver operator characteristic curve was 0.88 (95% CI, 0.85-0.92) with a cut-point of 10 points its sensitivity was 84% (95% CI, 74-91%) and its specificity 77% (95% CI, 71-83%). The aPHQ-9 was deemed acceptable by more than 80% of participants. Indigenous Australians found the aPHQ-9 acceptable as a screening tool for depression. Applying a cut-point of 10 points, the performance characteristics of the aPHQ were good.
Publisher: Elsevier BV
Date: 09-2017
Publisher: Elsevier BV
Date: 09-2017
Publisher: Wiley
Date: 12-2013
DOI: 10.1111/AJR.12071
Publisher: Wiley
Date: 05-11-2014
DOI: 10.1111/JOPY.12135
Abstract: Past research suggests that indecisiveness and trait anxiety may both decrease the likelihood of performing risk-mitigating preparatory behaviors (e.g., preparing for natural hazards) and suggests two cognitive processes (perceived control and worrying) as potential mediators. However, no single study to date has examined the influence of these traits and processes together. Examining them simultaneously is necessary to gain an integrated understanding of their relationship with risk-mitigating behaviors. We therefore examined these traits and mediators in relation to wildfire preparedness in a two-wave field study among residents of wildfire-prone areas in Western Australia (total N = 223). Structural equation modeling results showed that indecisiveness uniquely predicted preparedness, with higher indecisiveness predicting lower preparedness. This relationship was fully mediated by perceived control over wildfire-related outcomes. Trait anxiety did not uniquely predict preparedness or perceived control, but it did uniquely predict worry, with higher trait anxiety predicting more worrying. Also, worry trended toward uniquely predicting preparedness, albeit in an unpredicted positive direction. This shows how the lack of performing risk-mitigating behaviors can result from distinct cognitive processes that are linked to distinct personality traits. It also highlights how simultaneous examination of multiple pathways to behavior creates a fuller understanding of its antecedents.
Publisher: SAGE Publications
Date: 03-2008
Publisher: Wiley
Date: 04-2023
DOI: 10.1111/AJR.12990
Publisher: Elsevier BV
Date: 06-2004
Publisher: JMIR Publications Inc.
Date: 07-06-2022
Abstract: ifestyle-related diseases are among the leading causes of death and disability. Their rapid increase worldwide has called for low-cost, scalable solutions to promote health behaviour changes. Digital health coaching has proved to be effective to this aim, with the rising use of text-based interventions. In order to guarantee coaching fidelity and effectivity, there is a need for research in the field of linguistics as a core element of these interventions. State-of-the-art research has considered wording but lacks grammar analysis and the meanings originated from the speaker’s linguistic choices. When investigated, these choices can disclose the speaker’s experiences of the world, their relationship with the receiver and the interpretation of their wording as a text message. Furthermore, empathy is associated with these meanings, and becomes pivotal during coaching for a successful coach-user relationship and positive patient outcomes. e aim to analyse user cues in a digital health intervention and contribute to future research on coach communication. e tested a combination of empathy and a linguistic approach to code 148 text messages sent by 29 women recruited in a randomized trial on tele-coaching for the prevention of gestational diabetes and postnatal weight loss. e identified 143 empathic opportunities present in 42.37% of the word count in the corpus. These were mainly negative (82.2%) and implicit (60%). We distinguished opening, content and closing messages structures. Most of the wording was found in the content (86.2%) with a declarative structure (86.3%). Processes represented a 22.4% of the corpus, with half being material (10.7%) and related to food and diet (26.9%), physical activity (26.9%), and lifestyle goals (11.2%). he combination of empathy and linguistic analysis showed promising results. Our findings reveal preliminary insights on the coach-user relationship. The absence of explicit empathic opportunities and direct questions could be attributed to a low trust or information on the coach's abilities. We will be conducting further research to explore additional linguistic features and code coach messages. rial registered on the Australian New Zealand Clinical Trials Registry (ANZCTR) with registration number ACTRN12620001240932.
Publisher: Hindawi Limited
Date: 30-01-2016
DOI: 10.1111/PEDI.12253
Abstract: Controversy exists regarding which in iduals will benefit most from commencement of diabetes technologies such as continuous subcutaneous insulin infusion (CSII) or continuous glucose monitoring systems (CGMS), such as 'real-time' sensor-augmented pumping (SAP). Because higher usage correlates with haemoglobin A1c (HbA1c) achieved, we aimed to predict future usage of technologies using a questionnaire-based tool. The tool was distributed to two groups of youth with type 1 diabetes group A (n = 50 mean age 12 ± 2.5 yr) which subsequently commenced 'real-time' CGMS and group B (n = 47 mean age 13 ± 3 yr) which commenced CSII utilisation. For the CGMS group, recommended usage was ≥5 days (70%) per week [≥70% = high usage (HU) <70% = low usage (LU)], assessed at 3 months. In the CSII group, HU was quantified as entering ≥5 blood sugars per day to the pump and LU as <5 blood sugars per day, at 6 months from initiation. Binary logistic regression with forward stepwise conditional was used to utilise tool scales and calculate an applied formula. Of the CGMS group, using gender, baseline HbA1c, and two subscales of the tool generated a formula which predicted both high and low usage with 92% accuracy. Twelve (24%) showed HU vs. 38 who exhibited LU at 3 months. Of the CSII group, 32 (68%) exhibited HU vs. 15 who exhibited LU at 6 months. Four tool items plus gender predicted HU/LU with 95% accuracy. This pilot study resulted in successful prediction of in iduals who will and those who will not go on to show recommended usage of CSII and CGMS.
Publisher: National Institute for Health and Care Research
Date: 2001
DOI: 10.3310/HTA5100
Abstract: Insulin-dependent diabetes mellitus, also known as type 1 diabetes, is a life-threatening condition and is the third most common chronic illness among young people. As a result of minimal or non-existent insulin production, people with diabetes must take over the normally automatic task of regulation of blood glucose levels. This is achieved by a complex regimen involving multiple, daily administrations of insulin coordinated with dietary intake and energy expenditure and monitored by blood glucose testing. To examine the effectiveness of educational and psychosocial interventions for adolescents with type 1 diabetes designed to improve their diabetes management. Specifically, it addressed the following research questions: (1) Do educational and psychosocial interventions for adolescents with type 1 diabetes have beneficial effects on biological and psychosocial outcomes? (2) Are there types or features of interventions that have been shown to be more effective than others? (3) What evidence is there of the cost-effectiveness of interventions? A search strategy was formulated, piloted and refined. Three journals were handsearched, 11 electronic databases were searched and personal contacts, flyers, conferences and websites were used to notify the research community of the review to access further literature. This process generated 10,535 abstracts, which, after screening, resulted in 367 articles identified for retrieval. This number was augmented by hand-searching, personal contact and exploding references, and a final total of 457 articles were scrutinised. Of these, 64 reports describing 62 studies were identified as empirical papers evaluating educational or psychosocial interventions. The relevant data were extracted from the papers and summary tables for each study were prepared. Where possible, effect sizes were computed for outcomes from studies that included a randomised control group (CG) and other relevant information. A descriptive analysis of the 62 studies was undertaken. Most studies (67.7%) were conducted in the USA and 41% were randomised controlled trials (RCTs), none of which were UK-based. Only 48% of the reports provided an explicit theoretical rationale for the intervention. The mean number of participants was 53.8. The studies took place in various settings, evaluated a variety of interventions, involved various interventionists, addressed various components and assessed the effects by a range of outcomes, including measures of metabolic control and psychological and behavioural outcomes. Follow-up assessments were relatively rare. RESULTS - THE EFFECTIVENESS OF INTERVENTIONS: The 25 RCTs were examined in more detail and three of the most effective were described in depth. Effect sizes could be calculated for 14 studies. The mean (pooled) effect size for psychosocial outcomes was 0.37 and 0.33 for glycated haemoglobin with outliers (0.08 without outliers), indicating that these interventions have small to medium beneficial effects on diabetes management outcomes. A narrative review of the 21 pre-post studies with no CG was performed, including evaluations of interventions conducted at summer c s, interventions for poorly controlled patients and educational interventions. All studies reported beneficial effects. RESULTS - COST-EFFECTIVENESS: Few studies addressed economic considerations associated with interventions, and the lack of information on costs and the ersity of outcomes included by investigators impeded cost- effectiveness comparisons. Shorter hospitalisation at diagnosis is at least as effective in achieving control and avoiding complications in adolescence as longer stays. Home care may result in improved outcomes but may not be cheaper than hospital care at diagnosis. Targeting poorly controlled subjects may reduce adverse events and hospitalisations and may be more cost-effective than generic interventions. There is a need for rigorous cost-effectiveness studies of educational and psychosocial interventions for adolescents with type 1 diabetes that include longer-term considerations. The following conclusions were drawn from this review: (1) Educational and psychosocial interventions have small to medium beneficial effects on various diabetes management outcomes. (2) Well-designed trials of such interventions are needed in the UK (no completed RCTs of educational or psychosocial interventions for adolescents with type 1 diabetes conducted in the UK were found). (3) The evidence, arising primarily from studies in the USA, provides a starting point for the design of interventions in the UK. (4) Quantitative and narrative analysis of the evidence suggested that interventions are more likely to be effective if they demonstrate the inter-relatedness of the various aspects of diabetes management. (ABSTRACT TRUNCATED)
Publisher: American Psychological Association (APA)
Date: 05-2016
DOI: 10.1037/HEA0000280
Abstract: Depression is common in chronic illness, albeit prevalence can be highly variable. This variability may be a function of symptom overlap between depression and chronic illness. Using Obstructive Sleep Apnoea (OSA) as an exemplar, this meta-analysis explored whether the proportion of overlapping symptoms between OSA and depression, within different depression questionnaires, moderates prevalence estimates. A systematic search identified 13 studies meeting eligibility criteria. Based on depression questionnaires, the prevalence of depression in OSA ranged from 8% to 68%, reflecting marked heterogeneity. Prevalence estimates based on questionnaires with greater symptom overlap between OSA and depression were higher, whereas questionnaires with a higher proportion of anhedonia symptoms were associated with lower prevalence estimates. Overall, these data suggest that when using depression questionnaires to assess the prevalence of depression in OSA, questionnaires that have a lower proportion of symptom overlap between OSA and depression, as well as a higher proportion of anhedonia symptoms, reduce the likelihood of overestimating the prevalence of depression in OSA. This study has implications for other chronic illnesses with symptom overlap with depression, for ex le diabetes, chronic kidney disease, or heart disease, as well as suggesting that depression questionnaires are not equally appropriate for assessing depression symptomatology in chronic illness populations.
Publisher: Frontiers Media SA
Date: 24-12-2021
DOI: 10.3389/FCDHC.2021.769528
Abstract: The aim of this study was to take ‘snapshots’ of how people with diabetes are feeling emotionally during the coronavirus disease 2019 (COVID-19) pandemic. Three ‘snapshot’ surveys were conducted during May 2020, August 2020 and April 2021, each over a two-week period. Adults (≥18 years) with diabetes calling the Australian Government’s National Diabetes Services Scheme Helpline (NDSS) were invited to participate. Those who accepted were asked three questions sourced/adapted from the Problem Areas in Diabetes scale. Responses were recorded on a 5-point scale (0=’not a problem’, 4=’serious problem’). Of interest were scores ≥2, indicating this was at least a ‘moderate problem’. The survey was administered by NDSS Helpline staff via telephone. Basic demographic and clinical data were collected. In total, 1,278 surveys were completed over the three ‘snapshots’ (1 st N=449 2 nd N=414 3 rd N=415). Participants were aged (median[IQR]) 62[47,72] years, 56% were women, and 57% had type 2 diabetes. At the 3rd ‘snapshot’, 21% had received a COVID-19 vaccine. Our findings show that feeling at least moderately ‘burned out’ by the constant effort needed to manage diabetes is salient, and consistently experienced by adults with diabetes calling the NDSS Helpline at three timepoints during the coronavirus pandemic. Those who participated in the 3 rd ‘snapshot’ survey were less likely to report that feeling ‘alone with their diabetes’ or ‘worrying about their diabetes because of the COVID-19 pandemic’ were moderate or serious problems for them. Except for younger adults, findings indicate that the easing of restrictions may mitigate some of the effects of the pandemic on diabetes-specific emotional problems, including feeling ‘burned out’, ‘alone’ with diabetes, and/or worried about diabetes due to COVID-19. Prospective data are needed to improve our understanding of the emotional impact of COVID-19 on people with diabetes and to inform when and how to target support for those who need it most.
Publisher: Wiley
Date: 03-07-2014
DOI: 10.1111/JAN.12203
Abstract: To examine health worker-client interactions during care planning to understand processes that foster client empowerment and disempowerment. It is unclear how health worker-client exchanges and information sharing through chronic condition care planning currently operate in primary health care. Moreover, it is unclear how control in these exchanges either enhances collaborative decision-making, partnership and client empowerment, or works to create client disempowerment and dependency on workers and health services. Critical discourse analysis of qualitative data from ethnographic observations and audio-taped worker-client consultations. Multidisciplinary teams in two Australian community-based primary healthcare sites participated. This included nurses, general practitioners and allied health workers and their clients who had a chronic condition care plan. Nineteen worker-client consultations were observed/recorded in 2011. Control was expressed through multiple processes inherent in the worker role and in their interactions with clients. When workers exercised disproportionate control and clients relinquished their own control, client disempowerment and dependency were evident. Clients' attempts to gain control and workers' attempts to relinquish control alleviated clients' disempowerment and dependency. However, structural features of information sharing systems and workers' care planning behaviours diminished such efforts. Worker awareness of their communication style and the power of their role must improve for client chronic condition self-care management to be achieved. Training on the impacts of control in worker communication and systems where they work must be provided if unbeneficial forms of client dependency are to be overcome and true self-care management is to be realized.
Publisher: BMJ
Date: 21-02-2019
DOI: 10.1136/BJSPORTS-2018-100451
Abstract: From 19th to 22nd November 2018, 26 researchers representing nine countries and a variety of academic disciplines met in Snekkersten, Denmark, to reach evidence-based consensus about physical activity and older adults. It was recognised that the term ‘older adults’ represents a highly heterogeneous population. It encompasses those that remain highly active and healthy throughout the life-course with a high intrinsic capacity to the very old and frail with low intrinsic capacity. The consensus is drawn from a wide range of research methodologies within epidemiology, medicine, physiology, neuroscience, psychology and sociology, recognising the strength and limitations of each of the methods. Much of the evidence presented in the statements is based on longitudinal associations from observational and randomised controlled intervention studies, as well as quantitative and qualitative social studies in relatively healthy community-dwelling older adults. Nevertheless, we also considered research with frail older adults and those with age-associated neurodegenerative diseases, such as Alzheimer’s and Parkinson’s disease, and in a few cases molecular and cellular outcome measures from animal studies. The consensus statements distinguish between physical activity and exercise. Physical activity is used as an umbrella term that includes both structured and unstructured forms of leisure, transport, domestic and work-related activities. Physical activity entails body movement that increases energy expenditure relative to rest, and is often characterised in terms of intensity from light, to moderate to vigorous. Exercise is defined as a subset of structured physical activities that are more specifically designed to improve cardiorespiratory fitness, cognitive function, flexibility balance, strength and/or power. This statement presents the consensus on the effects of physical activity on older adults’ fitness, health, cognitive functioning, functional capacity, engagement, motivation, psychological well-being and social inclusion. It also covers the consensus on physical activity implementation strategies. While it is recognised that adverse events can occur during exercise, the risk can be minimised by carefully choosing the type of activity undertaken and by consultation with the in idual’s physician when warranted, for ex le, when the in idual is frail, has a number of co-morbidities, or has exercise-related symptoms, such as chest pain, heart arrhythmia or dizziness. The consensus was obtained through an iterative process that began with the presentation of the state-of-the-science in each domain, followed by group and plenary discussions. Ultimately, the participants reached agreement on the 30-item consensus statements.
Publisher: Wiley
Date: 22-03-2007
DOI: 10.1111/J.1464-5491.2007.02129.X
Abstract: To test the assumption that professional recall of consultation decisions is valid and more accurate than patient recall of consultation decisions. One hundred and thirty-four consultations between diabetes specialist nurses and diabetes specialist dietitians in an adult out-patient diabetes service were audiotaped. Patients and professionals were asked to recall the treatment decisions made immediately after the consultation. Patient participants were also asked to complete the Health Care Climate Questionnaire (HCC). Recalled decisions, by patient and professional participants, were then compared with those extracted from the audio tapes, and with each other. The mean duration of consultations was 27 min. Patients recalled a mean of 2.5 (SD 1.4) decisions per consultation, and professionals a mean of 3.2 (SD 1.6) decisions per consultation. A mean of 2.2 (SD 1.1, range 0-4) decisions per consultation were identified on the audiotapes. Patients recalled a mean of 2.3 (SD 1.4, range 0-6) decisions per consultations that could not be found on the tapes, with professionals recalling a mean of 1.7 (SD 1.2, range 0-6) decisions per consultation that could not be found on the tape. More autonomy, as measured by the HCCQ, was correlated with better professional recall (r = 0.17 P < 0.05). Both patients and professionals have poor recall of decisions made in diabetes out-patient consultations. Although the mean professional recall is marginally better than that of the patients, they recall a vast number of unmade decisions and the implications of these being recorded in patients' notes is substantial.
Publisher: Cambridge University Press (CUP)
Date: 28-12-2022
DOI: 10.1017/AEE.2021.23
Abstract: Since November 2018, Australian high school climate strikers have become leaders in the movement for climate action, giving rise to a new generation of young people who have learnt how to lead change. This article focuses on the question of leadership across social movements and in global youth movements. It then investigates the different forms of leadership emerging in School Striker for Climate (SS4C) through a qualitative survey of its leaders. We argue that leadership is multifaceted, shaped by the different strategies that movements use to engage people in collective action. We present three different people power strategies – mobilising, organising and playing by the rules – and explore how these different strategies generate varied pathways for leadership development. We identify the strengths and limits of each strategy, and we find that peer learning, mentoring, learning by doing, confrontation, reflective spaces and training are important leadership development tools. This article’s greatest strength comes from the positionally of us as researchers – two of us are student strikers, and the third is an active supporter, giving us a distinctively engaged perspective on a powerful movement for change.
Publisher: Wiley
Date: 07-2010
Publisher: Springer Science and Business Media LLC
Date: 2016
DOI: 10.1007/S11892-015-0694-2
Abstract: Diabetes distress (DD) refers to the negative emotions arising from living with diabetes and the burden of self-management. Among adults, the prevalence and significance of DD are well established, but this is not the case among adolescents. This systematic review investigated among adolescents with type 1 diabetes: the prevalence of DD demographic, clinical, behavioral and psychosocial correlates of DD and interventions that reduce DD. Consistent with adult studies, around one third of adolescents experience elevated DD and this is frequently associated with suboptimal glycemic control, low self-efficacy and reduced self-care. Three measures of DD have been developed specifically for adolescents, as those designed for adults may not be sufficiently sensitive to adolescent concerns. Interventions reducing DD in the short term include strategies such as cognitive restructuring, goal setting and problem solving. Further work is needed to investigate sustainability of effect. Rigorous research is needed to progress this field among adolescents.
Publisher: BMJ
Date: 12-2016
Publisher: American Diabetes Association
Date: 14-02-2019
DOI: 10.2337/DC18-1426
Abstract: The aim was to explore relationships between work-related factors, work-related diabetes distress (WRDD), diabetes distress (measured by Problem Areas in Diabetes [PAID]-5 scale), intentional hyperglycemia at work (IHW), and glycemic control. A cross-sectional survey was conducted with 1,030 working adults with type 1 diabetes and linked with electronic health record data from a specialist diabetes clinic in Denmark. With use of structural equation modeling, two alternative models were compared, based on fit indices, statistical significance, and theoretical meaningfulness. A combined model provided the best fit to the data. WRDD was more strongly affected by work ability, opportunity to self-manage at work, being treated differently, and job demands. PAID-5 was more strongly affected by identity concern and blame and judgment. Both PAID-5 and WRDD were associated with more frequent IHW, which was associated in turn with worse glycemic control. Work-related factors are associated with WRDD and PAID-5. Distress increases the frequency of IHW, which is, in turn, associated with worse glycemic control. Future studies should investigate ways to balance diabetes management and work life without compromising diabetes care.
Publisher: Informa UK Limited
Date: 13-04-2022
Publisher: Elsevier BV
Date: 03-2021
Publisher: Wiley
Date: 04-03-2019
Abstract: Therapeutic strategy based on the restoration of tumor suppressor-microRNAs (miRNAs) is a promising approach for cancer therapy, but the low delivery efficiency of miRNA remains a huge hurdle due to the lack of safe and efficient nonviral carriers. In this work, with the use of newly developed PEGylated biodegradable charged polyester-based vectors (PEG-BCPVs) as the carrier, the miR26a and miR122 codelivering therapeutic strategy (PEG-BCPVs/miR26a/miR122 as the delivery formulation) is successfully developed for efficient treatment of human hepatocellular carcinoma (HCC). In vitro study results show that PEG-BCPVs are capable of effectively facilitating miRNA cellular uptake via a cell endocytosis pathway. Consequently, the restoration of miR26a and miR122 remarkably inhibit the cell growth, migration, invasion, colony formation, and induced apoptosis of HepG2 cells. More importantly, the chemosensitivity of HepG2 to anticancer drug is also considerably enhanced. After treatment with the PEG-BCPV-based miRNA delivery system, the expression of the multiple targeted genes corresponding to miR26a and miR122 in HepG2 cells is greatly downregulated. Accordingly, the newly developed miRNA restoration therapeutic strategy via biodegradable PEG-BCPVs as the carrier should be a promising modality for combating HCC.
Publisher: Wiley
Date: 14-02-2011
DOI: 10.1002/GPS.2520
Abstract: This study investigated the predictive value of various coping processes for the psychological and disease specific aspects of health-related quality of life (HRQoL) in Parkinson's disease (PD). Cross-sectional study of 85 participants with PD using the Ways of Coping Questionnaire (WCQ), Depression, Anxiety, and Stress Scale (DASS-21), quality of life (PDQ-39), and socio-demographic and clinical variables. Greater use of planful problem solving coping was found to be significantly associated with better HRQoL in relation to cognitive impairment, communication and bodily discomfort. In addition to greater disease duration, greater use of escape-avoidance coping processes were identified as significant predictors of poorer HRQoL outcomes in the domains of mood and emotional well-being. Psychological interventions such as mindfulness training, aimed at reducing the use of escape-avoidance copying, may help to improve HRQoL in PD.
Publisher: JMIR Publications Inc.
Date: 07-06-2021
DOI: 10.2196/25409
Abstract: Automated insulin delivery (AID) systems have been shown to be safe and effective in reducing hyperglycemia and hypoglycemia but are not universally available, accessible, or affordable. Therefore, user-driven open-source AID systems are becoming increasingly popular. This study aims to investigate the motivations for which people with diabetes (types 1, 2, and other) or their caregivers decide to build and use a personalized open-source AID. A cross-sectional web-based survey was conducted to assess personal motivations and associated self-reported clinical outcomes. Of 897 participants from 35 countries, 80.5% (722) were adults with diabetes and 19.5% (175) were caregivers of children with diabetes. Primary motivations to commence open-source AID included improving glycemic outcomes (476/509 adults, 93.5%, and 95/100 caregivers, 95%), reducing acute (443/508 adults, 87.2%, and 96/100 caregivers, 96%) and long-term (421/505 adults, 83.3%, and 91/100 caregivers, 91%) complication risk, interacting less frequently with diabetes technology (413/509 adults, 81.1% 86/100 caregivers, 86%), improving their or child’s sleep quality (364/508 adults, 71.6%, and 80/100 caregivers, 80%), increasing their or child’s life expectancy (381/507 adults, 75.1%, and 84/100 caregivers, 84%), lack of commercially available AID systems (359/507 adults, 70.8%, and 79/99 caregivers, 80%), and unachieved therapy goals with available therapy options (348/509 adults, 68.4%, and 69/100 caregivers, 69%). Improving their own sleep quality was an almost universal motivator for caregivers (94/100, 94%). Significant improvements, independent of age and gender, were observed in self-reported glycated hemoglobin (HbA1c), 7.14% (SD 1.13% 54.5 mmol/mol, SD 12.4) to 6.24% (SD 0.64% 44.7 mmol/mol, SD 7.0 P .001), and time in range (62.96%, SD 16.18%, to 80.34%, SD 9.41% P .001). These results highlight the unmet needs of people with diabetes, provide new insights into the evolving phenomenon of open-source AID technology, and indicate improved clinical outcomes. This study may inform health care professionals and policy makers about the opportunities provided by open-source AID systems. RR2-10.2196/15368
Publisher: Elsevier BV
Date: 12-2017
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.DIABRES.2011.05.008
Abstract: To determine whether tighter cardiovascular risk factor control with structured education in in iduals with type 2 diabetes (T2DM) and microalbuminuria benefits cardiovascular risk factors. Participants from a multiethnic population, recruited from primary care and specialist clinics were randomised to intensive intervention with structured patient (DESMOND model) education (n=94) or usual care by own health professional (n=95). change in HbA1c at 18months. changes in blood pressure (BP), cholesterol, albuminuria, proportion reaching risk factor targets, modelled cardiovascular risk scores. Mean (SD) age and diabetes duration of participants were 61.5 (10.5) and 11.5 (9.3) years, respectively. At 18months, intensive intervention showed significant improvements in HbA1c (7.1(1.0) vs. 7.8(1.4)%, p<0.0001), systolic BP (129(16) vs. 139(17) mmHg, p<0.0001), diastolic BP (70(11) vs. 76(12) mmHg, p<0.001), total cholesterol (3.7(0.8) vs. 4.1(0.9) mmol/l, p=0.001). Moderate and severe hypoglycaemia was 11.2 vs. 29.0% p=0.001 and 0 vs. 6.3% p=0.07, respectively. More intensive participants achieved ≥3 risk factor targets with greater reductions in cardiovascular risk scores. Intensive intervention showed greater improvements in metabolic control and cardiovascular risk profile with lower rates of moderate and severe hypoglycaemia. Intensive glycaemic interventions should be underpinned by structured education promoting self-management in T2DM.
Publisher: Public Library of Science (PLoS)
Date: 09-11-2009
Publisher: BMJ
Date: 26-04-2012
DOI: 10.1136/BMJ.E2333
Publisher: American Diabetes Association
Date: 06-2019
DOI: 10.2337/DB19-117-LB
Abstract: Objective: Little is known about why PwD leave traditional pathways and turn to DIY technology. This study aims to examine the motivations of Do-it-Yourself Artificial Pancreas System (DIYAPS) users and caregivers to build and maintain these systems. Methods: An online survey with 34 items was distributed to DIYAPS users and caregivers of children with DIYAPS through Facebook (“Looped” and regional subgroups) and Twitter (Diabetes Online Community). Results: 1058 participants from 34 countries responded to the survey. The majority were adult users (80.2% 43% female median age 41 years) with T1D (98.9%) for 25.2 years ±13.3. 19.8% were caregivers of children (47.4% female median age 10 years) with T1D (99.4%) for 5.1 years ±3.9. With 10.1m ±17.6 on DIYAPS, HbA1c improved from 7.07% ±1.07 to 6.24% ±0.68 %. Time in Range improved from 63.21% ±16.27 to 83.07% ±10.11. Additional out-of-pocket costs of 712 USD/year were spent. Motivations to build a DIYAPS are shown in Fig.1. Conclusions: Improved glycemic control, need for an ‘autopilot’ and less acute and long-term complications were key motivations in both groups as well as better sleep for caregivers. Users were also able to access and afford the required tools. These results may provide a better understanding of unmet needs of PwD and current challenges to uptake, in order to facilitate the involvement of patient-led and open source approaches in healthcare. K. Braune: Advisory Panel Self Medtronic MiniMed, Inc. Speaker’s Bureau Self Dexcom, Inc. S. O’Donnell: None. B. Cleal: None. D.M. Lewis: Consultant Self Diabeloop SA, Roche Diabetes Care. A. Tappe: Consultant Self IME-DC GmbH. Employee Self Hi.health, Gruber-Debong GmbH. Speaker’s Bureau Self Dexcom, Inc., Roche Diabetes Care, Ypsomed AG. Other Relationship Self SOOIL Developments Co., Ltd. B. Hauck: Consultant Self Bayer AG, Eli Lilly and Company, LifeScan, Inc., Novo Nordisk A/S, Roche Diabetes Care, Roche Pharma. I. Willaing: None. R. Scibilia: Speaker’s Bureau Self Roche Diabetes Care. E. Rowley: None. W. Ko: None. G. Doyle: None. T.C. Skinner: None. K. Raile: Advisory Panel Self Abbott, Lilly Diabetes. European Union
Publisher: Wiley
Date: 31-10-2020
DOI: 10.1111/DME.14157
Abstract: The term 'diabetes distress' first entered the psychosocial research vernacular in 1995, and refers to 'the negative emotional or affective experience resulting from the challenge of living with the demands of diabetes'. At first the proponents of the concept were hesitant in advocating that diabetes distress was a major barrier to in iduals' self-care and management of diabetes. Since then, a burgeoning body of evidence, now including several systematic reviews of intervention studies, suggests that diabetes distress, in both type 1 and type 2 diabetes, across ages and in all countries and cultures where it has been studied, is common and can be a barrier to optimal emotional well-being, self-care and management of diabetes. As a consequence, monitoring diabetes distress as part of routine clinical care is part of many national guidelines. The present narrative review summarizes this research and related literature, to postulate the aetiology of diabetes distress, and thus how it may be prevented. The current evidence base for the management of diabetes distress is summarized, and the next steps in the prevention and management of diabetes distress identified.
Publisher: BMJ
Date: 2003
DOI: 10.1136/ADC.88.1.53
Abstract: To determine the current level of diabetes services and to compare the results with previous national surveys. A questionnaire was mailed to all paediatricians in the UK identified as providing care for children with diabetes aged under 16 years. Information was sought on staffing, personnel, clinic size, facilities, and patterns of care. Responses were compared with results of two previous national surveys. Replies were received from 244 consultant paediatricians caring for an estimated 17 192 children. A further 2234 children were identified as being cared for by other consultants who did not contribute to the survey. Of 244 consultants, 78% expressed a special interest in diabetes and 91% saw children in a designated diabetic clinic. In 93% of the clinics there was a specialist nurse (44% were not trained to care for children 47% had nurse:patient ratio >1:100), 65% a paediatric dietitian, and in 25% some form of specialist psychology or counselling available. Glycated haemoglobin was measured routinely at clinics in 88%, retinopathy screening was performed in 87%, and microalbuminuria measured in 66%. Only 34% consultants used a computer database. There were significant differences between the services provided by paediatricians expressing a special interest in diabetes compared with "non-specialists", the latter describing less frequent clinic attendance of dietitians or psychologists, less usage of glycated haemoglobin measurements, and less screening for vascular complications. Non-specialist clinics met significantly fewer of the recommendations of good practice described by Diabetes UK. The survey shows improvements in services provided for children with diabetes, but serious deficiencies remain. There is a shortage of diabetes specialist nurses trained to care for children and paediatric dietitians, and a major shortfall in the provision of psychology/counselling services. The services described confirm the need for more consultant paediatricians to receive specialist training and to develop expertise and experience in childhood diabetes.
Publisher: Informa UK Limited
Date: 04-05-2019
Publisher: Informa UK Limited
Date: 02-01-2018
Publisher: Wiley
Date: 15-03-2007
DOI: 10.1111/J.1464-5491.2007.02120.X
Abstract: To review systematically the published literature addressing whether continuous subcutaneous insulin infusion (CSII) provides any quality of life benefits to people with Type 1 diabetes. Electronic databases and published references were searched and a consultation with two professional groups was undertaken to identify relevant studies published up to July 2005. A multistep selection process was then undertaken to identify those articles which met the specific selection criteria, which were then critically reviewed. Eighty-four potential relevant articles were identified from examination of titles and abstracts published during the specified time frame. Of these, 28 articles were retrieved in full text, of which 17 fulfilled the specific criteria for inclusion. Mixed results emerged from existing literature. Of the five randomized controlled trials, three reported mixed results, with one study reporting quality of life benefits and one reporting no evidence of quality of life benefits. There is conflicting evidence reported in the various studies on the quality of life benefits of CSII in Type 1 diabetes. Existing research is flawed, making a judgement about the quality of life benefits of insulin pump use difficult. There is no strong evidence against quality of life benefits associated with CSII or otherwise, with poor methodology and inconsistent assessment of quality of life clouding the issue. The lack of reported benefit is probably a function of this rather than pump therapy not offering any quality of life benefits.
Publisher: Wiley
Date: 03-11-2006
Publisher: Oxford University Press (OUP)
Date: 10-2003
Abstract: To test whether coping acts to mediate the relationships between illness representations and emotional well-being in adolescents with diabetes. Seventy adolescents between 11 and 18 years of age were asked to complete the Diabetes Illness Representations Questionnaire (DIRQ), the Well-being Questionnaire, and the Kidcope. Perceived impact, identity, and cognitive restructuring were significant independent predictors for depressive symptomatology. For anxiety, perceived impact and identity were significant predictors, and for positive emotional well-being, treatment effectiveness to control diabetes was the only significant predictor. Multiple regression analyses indicated that coping did not mediate the association between illness representations and positive emotional well-being. Perceived impact was consistently associated with participants' indices of negative emotional well-being. Contrary to the hypothesized model, coping did not mediate the association between illness representations and emotional well-being in this s le.
Publisher: Wiley
Date: 25-04-2023
DOI: 10.1111/DME.15117
Abstract: To test ‘Is Insulin Right for Me?’, a theory‐informed, self‐directed, web‐based intervention designed to reduce psychological barriers to insulin therapy among adults with type 2 diabetes. Further, to examine resource engagement and associations between minimum engagement and outcomes. Double‐blind, two‐arm randomised controlled trial (1:1), comparing the intervention with freely available online information (control). Eligible participants were Australian adults with type 2 diabetes, taking oral diabetes medications, recruited primarily via national diabetes registry. Exclusion criteria: prior use of injectable medicines being ‘very willing’ to commence insulin. Data collections were completed online at baseline, 2‐week and 6‐month follow‐up. Primary outcome: negative insulin treatment appraisal scale (ITAS) scores secondary outcomes: positive ITAS scores and hypothetical willingness to start insulin. Analyses: intention‐to‐treat (ITT) per‐protocol (PP) examination of outcomes by engagement. Trial registration: ACTRN12621000191897. No significant ITT between‐arm (intervention: n = 233 control: n = 243) differences were observed in primary (2 weeks: Mdiff [95% CI]: −1.0 [−2.9 to 0.9] 6 months: −0.01 [−1.9 to 1.9]), or secondary outcomes at either follow‐up. There was evidence of lower Negative ITAS scores at 2‐week, but not 6‐month, follow‐up among those with minimum intervention engagement (achieved by 44%) compared to no engagement (−2.7 [−5.1 to −0.3]). Compared to existing information, ‘Is insulin right for me?’ did not improve outcomes at either timepoint. Small intervention engagement effects suggest it has potential. Further research is warranted to examine whether effectiveness would be greater in a clinical setting, following timely referral among those for whom insulin is clinically indicated.
Publisher: Hindawi Limited
Date: 30-04-2013
DOI: 10.1111/PEDI.12036
Publisher: Hindawi Limited
Date: 10-04-2015
DOI: 10.1111/PEDI.12275
Abstract: Modern insulin regimens for the treatment of type 1 diabetes are highly in idualized. The concept of an in idually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.
Publisher: Wiley
Date: 07-10-2022
DOI: 10.1111/DME.14708
Abstract: An emerging group of people with type 1 diabetes are not waiting for commercial solutions, choosing to manage their condition with open‐source artificial pancreas systems (APS). Our aim was to explore their perspectives on the future of APS. Semi‐structured telephone interviews were conducted (in Australia, October 2018 to January 2019) with 23 adults with type 1 diabetes currently using open‐source APS. Interviews were recorded, transcribed and analysed thematically. Participants described five key features of open‐source APS they value: compatibility, user‐led design, customisability, ability to evolve faster and community‐driven. They attributed the success of the open‐source APS movement to benefits they derive from these features: choice, solutions that meet their needs, ownership, staying one step ahead and real‐time support. They expressed hope that future commercial products and healthcare would benefit from their learnings and from collaboration with the open‐source APS community. Participants believed that there will always be a place for the open‐source community. It will continue to build on and advance commercial products, respond to user needs, offering a higher degree of control and customisation than afforded by commercial products and generating optimism for the future. Participants desired that future commercial diabetes technologies would be inspired by the open‐source community and developed collaboratively with people with diabetes.
Publisher: Wiley
Date: 06-2022
DOI: 10.1111/AJR.12893
Publisher: Springer Science and Business Media LLC
Date: 14-09-2015
Publisher: Wiley
Date: 16-08-2018
DOI: 10.1111/JPC.13658
Abstract: Associations between short sleep duration and obesity and the relationship between obesity and chronic illness are well documented. Obese children are likely to become obese adults. To date, there is a paucity of information regarding sleep duration and quality for Indigenous Australian people. It may be that poor-quality, short sleep is contributing to the gap in health outcomes for Indigenous people compared with non-Indigenous adults and children. This study sought to investigate the possibility that poor sleep quality may be contributing to health outcomes for Indigenous children by exploring associations between sleep duration and body mass index (BMI). Participants included 1253 children aged 7-12 years in Wave 7 of the national Longitudinal Study of Indigenous Children survey. Interviewers asked primary carers about children's sleep times. BMI was derived from measurements of children made by researchers. Regardless of age, relative socio-economic disadvantage and level of remoteness, unhealthy weight was associated with less sleep duration than healthy weight for Indigenous children. The relationship between short sleep duration and BMI in Indigenous children has important implications for their future health outcomes. Both overweight conditions and short sleep are established modifiable risk factors for metabolic dysfunction and other chronic illnesses prominent in the Indigenous population. It is important to consider strategies to optimise both for Indigenous children in an attempt to help 'close the gap' in health outcomes and life expectancy between Indigenous and non-Indigenous people.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/WF15051
Abstract: To motivate residents to evacuate early in case of a wildfire threat, it is important to know what factors underlie their response-related decision-making. The current paper examines the role of the value and expectancy tied to potential outcomes of defending vs evacuating on awareness of a community fire threat. A scenario study among 339 Western Australians revealed that residents intending to leave immediately on awareness of a community fire threat differ from those not intending to leave immediately in both value and expectancy. For one, intended leavers were more likely than those intending to defend their property to have children. Also, the data showed a trend towards intended leavers being less likely to have livestock. Furthermore, intended leavers placed less importance on the survival of their property than those with other expressed intentions. They also reported lower expectancies regarding the likelihood of achieving positive outcomes by defending than those intending to defend or wait and see before deciding what to do. Finally, intended leavers perceived it more likely that they would avoid harm to their pets by evacuating than those intending to defend throughout or wait and see. These findings have important implications for strategies to influence residents’ response-related decision-making.
Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.DIABRES.2011.11.004
Abstract: To explore how clinical and demographic variables impact on the management of diabetes mellitus in general practice. A structured vignette survey was conducted in Australia. This included nine vignettes chosen at random from 128 developed around seven clinical variables. Respondents were asked to recommend a change in treatment and make specific recommendations. A random s le of general practitioners (GPs) were recruited. Two diabetologists involved in the development of national guidelines also participated. 125 (13.8%) GPs participated. Statistical analyses were used to generate outcome measures. GPs recommended a change in treatment for most (81.1%) cases were less likely to prescribe a statin (68.5% GPs vs. 76.3% diabetologists), less likely to treat hypertension (66.7% vs.89%) and less likely to refer for lifestyle modification (82.3% vs. 96.5%). Significant disagreement occurred around prescribing or changing oral hypoglycaemics. No GP characteristics showed significant impact. The proportion of GPs who agreed with diabetiologists on dose and choice of drugs was 35.7% for statins, 49.6% for antihypertensives and 39.6% for oral hypoglycaemics. There were significant differences between diabetologists and GPs on the management of diabetes. The survey suggests significant under-dosing by GPs. These findings warrant further investigation.
Publisher: Wiley
Date: 24-04-2007
DOI: 10.1111/J.1464-5491.2007.02128.X
Abstract: To compare combination use of repaglinide, metformin and bedtime Neutral Protamine Hagedorn (NPH) insulin with conventional approaches of insulin initiation in patients with Type 2 diabetes (T2DM). Eighty-two patients with T2DM with suboptimal glycaemic control on oral glucose-lowering agents were randomized to one of three treatment regimens for 4 months. Group 1 received metformin and twice daily biphasic 30/70 human insulin mixture (n = 27), group 2 metformin and bedtime NPH insulin (n = 26) and group 3 metformin, bedtime NPH insulin and mealtime repaglinide (n = 25). Seventy-five patients completed the study. Baseline and end-point mean HbA1c levels fell from 9.0 +/- 1.1 to 7.9 +/- 1.1% in group 1, 10.0 +/- 2.2 to 9.2 +/- 1.4% group 2 and 10.0 +/- 1.7 to 8.1 +/- 1.5% in group 3, respectively. All groups showed improvements in HbA1c. There was no significant difference between groups in the proportions of patients experiencing hypoglycaemia (29.6, 25.0 and 16.7%, respectively P = 0.55) or in mean weight gain (2.9, 0.7 and 2.2 kg, respectively P = 0.06). By 4 months, insulin doses were 0.63 +/- 0.32 IU/kg in group 1, 0.58 +/- 0.21 IU/kg in group 2 and 0.37 +/- 0.22 IU/kg in group 3 (group 3 vs. groups 1 and 2: P < 0.002). The approach using repaglinide, metformin and NPH insulin improved glycaemic control with a similar safety profile to conventional insulin initiation in T2DM and produced final glycaemic control similar to metformin and a twice daily biphasic insulin mixture.
Publisher: Wiley
Date: 27-08-2015
DOI: 10.1111/OBR.12312
Abstract: Post-partum weight loss is critical to preventing and managing obesity in women, but the results from lifestyle interventions are variable and the components associated with successful outcomes are not yet clearly identified. This study aimed to identify lifestyle intervention strategies associated with weight loss in post-partum women. MEDLINE, EMBASE, PubMed, CINAHL and four other databases were searched for lifestyle intervention studies (diet or exercise or both) in post-partum women (within 12 months of delivery) published up to July 2014. The primary outcome was weight loss. Subgroup analyses were conducted for self-monitoring, in idual or group setting, intervention duration, intervention types, the use of technology as a support, and home- or centre-based interventions. From 12,673 studies, 46 studies were included in systematic review and 32 randomized controlled trials were eligible for meta-analysis (1,892 women, age 24-36 years). Studies with self-monitoring had significantly greater weight lost than those without (-4.61 kg [-7.08, -2.15] vs. -1.34 kg [-1.66, -1.02], P = 0.01 for subgroup differences). Diet and physical activity when combined were significantly more effective on weight loss compared with physical activity alone (-3.24 kg [-4.59, -1.90] vs. -1.63 kg [-2.16, -1.10], P < 0.001 for subgroup differences). Lifestyle interventions that use self-monitoring and take a combined diet-and-exercise approach have significantly greater weight loss in post-partum women.
Publisher: Wiley
Date: 2001
DOI: 10.1002/PDI.138
Publisher: Wiley
Date: 08-11-2019
DOI: 10.1111/DME.14165
Publisher: Wiley
Date: 09-2002
Publisher: Wiley
Date: 06-2008
DOI: 10.1002/PDI.1248
Publisher: Wiley
Date: 05-2021
DOI: 10.1002/PDI.2336
Abstract: Gestational diabetes increases a woman's risk of developing type 2 diabetes. In 2011, Australia started the first National Gestational Diabetes Register (NGDR). The register aims to improve risk awareness, promote diabetes prevention, and encourage regular diabetes screening. This study aimed to identify postnatal diabetes prevention activity and the association of NGDR awareness with that activity in a nationally representative s le of Australian women after a pregnancy with gestational diabetes. An anonymous, cross‐sectional, online survey of women previously diagnosed with gestational diabetes and aged 18 years or over was run from June to November 2014. Of 8860 women invited from a stratified NGDR s le, 966 participated (response rate 13%). Postnatal screening rate was 73%. Only 47% of respondents reported receiving NGDR information postnatally. Log‐binomial regression demonstrated an association with women reporting receiving NGDR information and being at intermediate risk of developing type 2 diabetes (relative ratio [RR] 1.307, 95% CI 1.030, 1.660) and at higher disadvantage (RR 1.501, 95% CI 1.080, 2.080). Postnatal screening rates, total diabetes risk perception and lifestyle risk factors were not significantly different between those recalling or not recalling receiving NGDR information. The reach and impact of NGDR information alone are limited. Women's engagement with the NGDR was not associated with better lifestyle, greater postnatal screening or higher risk perception. System‐level integration is needed for improved NGDR functioning and further improvements should yield enhanced diabetes prevention efforts when primary care ties are strengthened. Copyright © 2021 John Wiley & Sons.
Publisher: BMJ
Date: 10-2015
Publisher: Elsevier BV
Date: 07-2020
Publisher: Elsevier BV
Date: 12-1998
Abstract: This study set out to examine whether peer support and illness representation mediates the link between family support, self-management and well-being. Seventy-four participants (12-18-years-old) with type I diabetes mellitus completed questionnaires assessing their self-management, depression, anxiety, perceived social support and personal models of diabetes. Perceived impact of diabetes, but not perceived seriousness, and peer support were significant predictors of depression. Family support was a significant predictor of all self-management measures. However, for dietary self-management this relationship was partially mediated by the perceived efficacy of treatment to control diabetes, but not efficacy of treatment to prevent complications.
Publisher: Hindawi Limited
Date: 06-11-2009
DOI: 10.1111/J.1399-5448.2009.00596.X
Abstract: To evaluate glycaemic targets set by diabetes teams, their perception by adolescents and parents, and their influence on metabolic control. Clinical data and questionnaires were completed by adolescents, parents/carers and diabetes teams in 21 international centres. HbA1c was measured centrally. A total of 2062 adolescents completed questionnaires (age 14.4 +/- 2.3 yr diabetes duration 6.1 +/- 3.5 yr). Mean HbA 1c = 8.2 +/- 1.4% with significant differences between centres (F = 12.3 p < 0.001) range from 7.4 to 9.1%. There was a significant correlation between parent (r = 0.20) and adolescent (r = 0.21) reports of their perceived ideal HbA1c and their actual HbA1c result (p < 0.001), and a stronger association between parents' (r = 0.39) and adolescents' (r = 0.4) reports of the HbA1c they would be happy with and their actual HbA1c result. There were significant differences between centres on parent and adolescent reports of ideal and happy with HbA1c (8.1 17.4 < 0.001). A lower target HbA1c and greater consistency between members of teams within centres were associated with lower centre HbA1c (F = 16.0 df = 15 p < 0.001). Clear and consistent setting of glycaemic targets by diabetes teams is strongly associated with HbA1c outcome in adolescents. Target setting appears to play a significant role in explaining the differences in metabolic outcomes between centres.
Publisher: MDPI AG
Date: 30-12-2022
Abstract: Background and Objectives: Lifestyle interventions such as exercise prescription and education may play a role in the management of peripheral neuropathy in people with diabetes. The aim of this study was to determine the effect of undertaking an exercise program in comparison with an education program on the signs and symptoms of peripheral neuropathy in people with diabetes at risk of neuropathic foot ulceration. Materials and Methods: Twenty-four adult participants with diabetes and peripheral neuropathy were enrolled in this parallel-group, assessor blinded, randomised clinical trial. Participants were randomly allocated to one of two 8-week lifestyle interventions, exercise or education. The primary outcome measures were the two-part Michigan Neuropathy Screening Instrument (MNSI) and vibratory perception threshold (VPT). Secondary outcome measures included aerobic fitness, balance and lower limb muscular endurance. Results: Participants in both lifestyle interventions significantly improved over time for MNSI clinical signs (MD: −1.04, 95% CI: −1.68 to −0.40), MNSI symptoms (MD: −1.11, 95% CI: −1.89 to −0.33) and VPT (MD: −4.22, 95% CI: −8.04 to −0.40). Although the interaction effects did not reach significance, changes in values from pre to post intervention favoured exercise in comparison to control for MNSI clinical signs (MD −0.42, 95% CI −1.72 to 0.90), MNSI clinical symptoms (MD −0.38, 95% CI −1.96 to 1.2) and VPT (MD −4.22, 95% CI −12.09 to 3.65). Conclusions: Eight weeks of exercise training or lifestyle education can improve neuropathic signs and symptoms in people with diabetes and peripheral neuropathy. These findings support a role for lifestyle interventions in the management of peripheral neuropathy.
Publisher: Springer Science and Business Media LLC
Date: 06-01-2017
Publisher: Springer Science and Business Media LLC
Date: 08-2015
DOI: 10.1038/NATURE14893
Publisher: Frontiers Media SA
Date: 12-10-2022
DOI: 10.3389/FCOMM.2022.1034427
Abstract: Online platforms and smartphone applications that facilitate patient-provider communication are ex les of how digital technologies support human interaction. Telehealth enables clinical encounters when physical consultations are not possible, and evidence confirms that face-to-face and remote healthcare encounters have comparable efficacy. Furthermore, research shows that patient-provider communication and relationship influence patient outcomes. However, we lack studies on what happens during these interactions, particularly in text-messages conversations, from a linguistic or behavioral perspective. Our research methods will evolve alongside our communication channels. Currently, there is an overall preference for qualitative methods in patient-provider communication research. Some authors argue that quantitative measures (clinical measurements, questionnaires) lack an understanding of the patients' experiences, whereas qualitative approaches (interviews, focus groups) provide the full picture. Others suggest their combination to interpret interactions thoroughly. As a result, it is often difficult for a communication researcher to choose between one or more approaches. We conducted a mini-review of qualitative approaches, such as corpus linguistics and conversation analysis, as well as quantitative approaches, such as analysis of variance and temporal pattern detection, for patient-provider communication analysis. Additionally, we distinguish relevant communicative features in synchronous or live interactions, such as video-calls, and asynchronous interactions, such as non-instant messaging. We further discuss these methods' potential for combination and their applications in digital communication research. We aim to guide researchers to choose a methodology for digital interaction studies. Our recommendations are based on these approaches' ability to answer a research question, and we suggest a mixed-methods approach in future digital communication research.
Publisher: Springer Science and Business Media LLC
Date: 21-03-2013
DOI: 10.1007/S11325-013-0828-1
Abstract: Obstructive sleep apnoea (OSA) is a common disorder, for which continuous positive airway pressure (CPAP) therapy is a standard treatment. Despite its well-established efficacy, many patients choose not to initiate CPAP treatment. The present study investigated the degree to which biological measures (e.g. Apnoea-Hypopnoea Index [AHI]), symptom experiences (e.g. fatigue) and illness representations (e.g. perceived consequences) predict the decision of in iduals newly diagnosed with OSA to undergo a trial of CPAP therapy. Four hundred forty-nine in iduals (316 males) newly diagnosed with OSA. Epworth sleepiness scale (ESS), Fatigue Severity Scale, Depression Anxiety Stress Scale and Illness Perception Questionnaire-Revised (IPQ-R) were administered at time of sleep study. These, patient demographics and sleep study variables were used to determine factors predicting patient decision to proceed with a trial of CPAP. The participants were most likely to attribute their OSA to unchangeable and psychological factors. For those with moderate OSA (AHI, 15 to 30) IPQ-R illness consequence was predictive of decision to initiate CPAP (p = 0.002). For severe OSA (AHI >30) age, ESS and IPQ illness causal beliefs were predictive of decision to initiate CPAP (p < 0.001). Illness beliefs are important determinants of the choice of recently diagnosed OSA patients whether or not to undertake a trial of CPAP therapy. Concerns about illness consequences were important in those with moderate OSA. In severe OSA, sleepiness symptoms are more prominent and a more significant determinant of CPAP uptake along with age and causal beliefs.
Publisher: Wiley
Date: 07-2008
DOI: 10.1111/J.1464-5491.2008.02473.X
Abstract: We examined the impact of communicating risk of coronary heart disease (CHD) and stroke, using three time frames (1, 5 or 10 years), on Type 2 diabetic (T2D) patients' understanding of risk of CHD/stroke and their memory for these risks. Patients (N = 95) estimated their risk of developing CHD/having a stroke as a result of diabetes, in one of three time frames. Using the United Kingdom Prospective Diabetes Study Risk Engine and the same time frame, patients were then given in idualized, objective risk estimates of developing CHD/stroke. Following explanation of these risks, patients' risk understanding was examined by asking them to report again their risk of developing CHD/stroke. Six weeks later we assessed patient memory for these risks by asking them to recall their actual risk estimates for CHD/stroke. In all time frames, we successfully reduced participants' originally inflated risk perceptions of CHD (F(1,92) = 73.01, P < 0.001) and stroke (F(1,91) = 119.05, P < 0.001), although the 10-year risk group was the most resistant to correction for both CHD (F(1,90) = 9.32, P < 0.001) and stroke (F(2,88) = 3.97, P < 0.02). Participants' recall of their stroke risk at 6 weeks regressed towards original, inflated risk perceptions for the 10-year group only (F(4,176) = 4.73, P < 0.001). Patients' inflated perceptions of CHD/stroke risk can be easily corrected using shorter (1- or 5-year) risk communication time frames.
Publisher: Informa UK Limited
Date: 05-1999
Publisher: Wiley
Date: 2010
DOI: 10.1111/J.1464-5491.2009.02890.X
Abstract: To explore the views of women who did not attend pre-pregnancy care (PPC), in particular their accounts of contraception, previous pregnancies and the influence of healthcare advice. We conducted semi-structured interviews with 29 pregnant women (21 with Type 1 diabetes, eight with Type 2 diabetes) at three UK specialist diabetes antenatal clinics. Interviews explored women's journeys to becoming pregnant, including use of contraception, their views regarding diabetes and pregnancy and the factors which encouraged and discouraged them from attending PPC. All women had some understanding of the issues concerning diabetes during pregnancy, predominantly regarding the benefits of PPC (90%) and optimal glycaemic control (80%) and risks of malformation (48%) and macrosomia (35%). Most were not regularly using contraception (70%), having stopped deliberately (45%), become unintentionally less rigorous (28%) or experienced side effects/contraindications (14%). Knowledge concerning the risks of pregnancy (90%) and past pre-conception counselling (38%) did not encourage women to attend PPC, and neither did personal experience of miscarriage, malformation or stillbirth in women with previous poor pregnancy outcome (41%). Barriers included conceiving faster than anticipated (45%), fertility concerns (31%), negative experiences with health professionals (21%), desire for a 'normal' pregnancy (17%) and the logistics of attending (10%). More integrated diabetes and reproductive health/contraceptive advice, increased awareness of the potentially short time between stopping contraception and conception and more intensive support between pregnancies are required, particularly for women with previously poor outcomes. Research is also needed into how communication between health professionals and women with diabetes can be improved.
Publisher: Wiley
Date: 04-2003
DOI: 10.1046/J.1464-5491.2003.00923.X
Abstract: This article reports on the development and validity of a Diabetes-specific Illness Representations Questionnaire (DIRQ) to assess all five dimensions of an in idual's perception of diabetes, for adolescents with Type 1 diabetes mellitus. There were two development studies. Study 1: participants (n = 115) completed a questionnaire assessing perceptions of the consequences of diabetes and the effectiveness of treatment, along with a questionnaire assessing self-care. Study 2: participants (n = 79) completed a questionnaire assessing their identity, timeline and causal beliefs, along with a diabetes self-efficacy and barriers to adherence questionnaire. Subsequently there were two validation studies. Study 3: participants (n = 44 adolescents and 28 parents) completed the DIRQ and questionnaires assessing their self-care and psychological well-being. Glycaemic control was assessed through retrieval of routine assay results. Study 4: participants (n = 70) completed the DIRQ and questionnaires to assess their psychological well-being, with glycaemic control assessed through retrieval of routine assay results. The development studies suggest that the perceived consequences of diabetes consist of two subscales, perceived threat and perceived impact, and provide further support for the distinction between treatment effectiveness to control diabetes and treatment effectiveness to prevent complications. Along with the validation studies, the results indicate that the questionnaire scales showed good internal consistency and construct validity through their associations with measures of self-care and psychological well-being. The data reported here suggest that the DIRQ has the potential to be a useful tool for clinical assessment and evaluating the impact of psycho-educational and medical interventions.
Publisher: Elsevier BV
Date: 02-2006
Publisher: Elsevier BV
Date: 03-2007
DOI: 10.1016/J.JPSYCHORES.2006.10.007
Abstract: To investigate the effect of mindfulness training on pain tolerance, psychological well-being, physiological activity, and the acquisition of mindfulness skills. Forty-two asymptomatic University students participated in a randomized, single-blind, active control pilot study. Participants in the experimental condition were offered six (1-h) mindfulness sessions control participants were offered two (1-h) Guided Visual Imagery sessions. Both groups were provided with practice CDs and encouraged to practice daily. Pre-post pain tolerance (cold pressor test), mood, blood pressure, pulse, and mindfulness skills were obtained. Pain tolerance significantly increased in the mindfulness condition only. There was a strong trend indicating that mindfulness skills increased in the mindfulness condition, but this was not related to improved pain tolerance. Diastolic blood pressure significantly decreased in both conditions. Mindfulness training did increase pain tolerance, but this was not related to the acquisition of mindfulness skills.
Publisher: Elsevier BV
Date: 11-2007
Publisher: American Diabetes Association
Date: 09-2000
DOI: 10.2337/DIACARE.23.9.1416
Abstract: OBJECTIVE: To evaluate the effectiveness of behavioral interventions for adolescents with type 1 diabetes based on a systematic review of the literature. RESEARCH DESIGN AND METHODS: The literature was identified by searching 11 electronic databases, hand-searching 3 journals from their start dates, and contacting in idual researchers. Only articles that reported evaluations of behavioral (including educational and psychosocial) interventions for adolescents (age range 9-21 years) with type 1 diabetes that included a control group were included in the present review. Data summarizing the key features of the interventions and their effects were extracted from each article. Where possible, effect sizes for the randomized control trials (RCTs) were calculated. RESULTS: The search process identified 64 reports of empirical studies. Of these, 35 studies included a control group, and 24 were RCTs. Effect sizes could be calculated for 18 interventions. The overall mean effect size calculated across all outcomes was 0.33 (median 0.21), indicating that these interventions have a small- to medium-sized beneficial effect on diabetes management. Interventions that were theoretically based were significantly more effective than those that were not (P& .05, 1-tailed). CONCLUSIONS: Research to date indicates that these interventions are moderately effective. Several methodological weaknesses to be avoided in future studies are noted. It is also recommended that investigators use the reach, efficacy, adoption, implementation, and maintenance (RE-AIM) framework to guide the design of future studies, which should result in more disseminable interventions. RE-AIM assesses the intervention's reach, or percent or representativeness of patients willing to participate efficacy across a range of outcomes adoption, or the percent and representativeness of settings willing to implement the intervention implementation, or the consistency of the delivery of the intervention as intended and maintenance, or the extent to which delivery of the intervention becomes a routine part of health care in the medical setting.
Publisher: Informa UK Limited
Date: 19-06-2013
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.DSX.2015.08.010
Abstract: Physical activity is an essential determinant of health. However, there is dearth of evidence regarding prevalence of physical activity in developing countries, especially its association with metabolic syndrome risk factors. This study assessed the association of physical activity with metabolic syndrome in a Nigerian population. A cross-sectional study was carried out on apparently healthy persons who are ≥ 18 years old. The World Health Organisation (WHO) Global Physical Activity Questionnaire (GPAQ) was used to collect five domains of physical activity. Participants were classified as physically active or inactive based on meeting the cut-off value of 600 MET-min/week. Metabolic syndrome was diagnosed using the Joint Scientific Statement on Harmonizing the Metabolic Syndrome criteria. Overall prevalence of physically active in iduals was 50.1% (CI: 45.6-54.7%). Physical inactivity is significantly more in females (p 40 years old (p<0.0001). Whereas in iduals with metabolic syndrome appeared more likely to be physically active (OR=1.48, CI: 0.71-3.09) physical inactivity showed to exist more among participants who were living in urban area (OR=6.61, CI: 3.40-12.85, p<0.001). Participants with prediabetes (OR=1.69, CI: 0.62-4.61) and diabetes (OR=1.91, CI: 0.65-5.63) were more likely to be physically inactive as compared to other metabolic syndrome risk factors. The high prevalence of physical inactivity in this study population is a clear indication that concerted efforts to improve physical activity may be required. However, it seems that metabolic syndrome is not improved by being physically active. This suggests that interventions directed at physical activity alone may not produce optimal efficacy in this study population.
Publisher: JMIR Publications Inc.
Date: 19-11-2019
DOI: 10.2196/15368
Abstract: Digital innovations in health care have traditionally followed a top-down pathway, with manufacturers leading the design and production of technology-enabled solutions and those living with chronic conditions involved only as passive recipients of the end product. However, user-driven open-source initiatives in health care are becoming increasingly popular. An ex le is the growing movement of people with diabetes, who create their own “Do-It-Yourself Artificial Pancreas Systems” (DIYAPS). The overall aim of this study is to establish the empirical evidence base for the clinical effectiveness and quality-of-life benefits of DIYAPS and identify the challenges and possible solutions to enable their wider diffusion. A research program comprising 5 work packages will examine the outcomes and potential for scaling up DIYAPS solutions. Quantitative and qualitative methodologies will be used to examine clinical and self-reported outcome measures of DIYAPS users. The majority of members of the research team live with type 1 diabetes and are active DIYAPS users, making Outcomes of Patients’ Evidence With Novel, Do-It-Yourself Artificial Pancreas Technology (OPEN) a unique, user-driven research project. This project has received funding from the European Commission’s Horizon 2020 Research and Innovation Program, under the Marie Skłodowska-Curie Action Research and Innovation Staff Exchange. Researchers with both academic and nonacademic backgrounds have been recruited to formulate research questions, drive the research process, and disseminate ongoing findings back to the DIYAPS community and other stakeholders. The OPEN project is unique in that it is a truly patient- and user-led research project, which brings together an international, interdisciplinary, and intersectoral research group, comprising health care professionals, technical developers, biomedical and social scientists, the majority of whom are also living with diabetes. Thus, it directly addresses the core research and user needs of the DIYAPS movement. As a new model of cooperation, it will highlight how researchers in academia, industry, and the patient community can create patient-centric innovation and reduce disease burden together. PRR1-10.2196/15368
Publisher: Wiley
Date: 11-2022
DOI: 10.1002/PDI.2425
Abstract: Aim: This study aimed to describe routines for screening, treatment, and follow‐up for prediabetes at primary health care centres in Region Stockholm, Sweden. Methods: The study had a cross‐sectional design. We sent a questionnaire about prediabetes screening, treatment, and follow‐up to diabetes nurses working at primary health care centres in Region Stockholm. Data collection started in October 2019 and ended in June 2021. Results: A total of 84 of the 224 centres that received an invitation responded (37.5%). Routines for screening, treatment, and follow‐up varied widely. This variation meant that people with prediabetes received different care, and the care depended on clinical practice routines at the primary health care centre they attended. Conclusions: A first step toward more consistent, adequate and equitable care should involve developing national and regional guidelines that include a clear and systematic approach to prediabetes screening, treatment and follow‐up. Sufficient funding and human resources will be crucial to implementing these guidelines in primary care to help prevent type 2 diabetes and its complications. Copyright © 2022 John Wiley & Sons.
Publisher: BMJ
Date: 09-2021
DOI: 10.1136/BMJOPEN-2020-045853
Abstract: To develop a theory and evidence-based web intervention to reduce psychological barriers towards insulin therapy among adults with non-insulin-treated type 2 diabetes (T2D). Salient psychological barriers towards insulin were identified from the literature and classified using the Theoretical Domains Framework (TDF). Relevant TDF domains were mapped to evidence-based behaviour change techniques (BCTs), which informed the content for each barrier. Acceptability was explored using cognitive debriefing interviews (n=6 adults with T2D). ‘Is Insulin Right for Me’ addresses eight barriers, phrased as common questions: Does insulin mean my diabetes is more serious? Do insulin injections cause complications? Is it my fault I need to inject insulin? Will I gain weight? Will injecting hurt? What about hypos? Will injecting insulin be a burden? What will others think of me? BCTs, including persuasive communication and modelling/demonstration, were delivered using appropriate methods (eg, demonstration of the injection process). Participant suggestions for improvement included clear and direct messages, normalising insulin and avoiding confronting images. ‘Is Insulin Right for Me’ is the first theory and evidence-based, web intervention designed to reduce psychological barriers towards insulin therapy for adults with T2D. Evaluation is needed to determine its impact on negative appraisals and receptiveness towards insulin.
Publisher: Informa UK Limited
Date: 30-10-2023
Publisher: Mary Ann Liebert Inc
Date: 12-2016
Abstract: The use of mobile applications ("apps") for diabetes management is a rapidly developing area and has relevance to adolescents who tend to be early technology adopters. Apps may be useful for supporting self-management or connecting young people with type 1 diabetes (T1D) with their peers. However, outside controlled trials testing the effectiveness of apps, little is known about app usage in this population. Our aim was to explore app usage among adolescents with T1D. Diabetes MILES Youth-Australia is a national, online cross-sectional survey focused on behavioral and psychosocial aspects relevant to adolescents with T1D. Associations between app usage and demographic, clinical, and psychosocial variables were analyzed using logistic regression. In total, 425 adolescents with T1D responded to the app questions (mean age, 16 ± 2 years 62% female diabetes duration 7 ± 4 years). Overall, 21% (n = 87) indicated that they used an app for diabetes management. Of these, 89% (n = 77) reported carbohydrate counting as the most common purpose. Of those not using apps, 44% (n = 149) indicated that this was due either to no awareness of suitable apps or a belief that apps could not help. App usage was associated significantly with shorter T1D duration, higher socioeconomic status, and at least seven daily blood glucose checks. Only one in five respondents were using apps to support their diabetes management most apps used were not diabetes specific. App users can be characterized as having a more recent T1D diagnosis, checking blood glucose more frequently, and being from a middle-to-high socioeconomic background.
Publisher: Wiley
Date: 05-2013
DOI: 10.1002/DMRR.2392
Abstract: Optimal use of recent technological advances in insulin delivery and glucose monitoring remain limited by the impact of behaviour on self-care. In recent years, there has been a resurgence of interest in psychosocial methods of optimizing care in youth with type 1 diabetes. We therefore sought to examine the literature for demographic, interpersonal and intrapersonal correlates of self-care and/or metabolic control. Studies for this systematic review were obtained via an electronic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycINFO databases. Seventy studies fulfilled the inclusion criteria. These studies have indicated that identifiable in idual characteristics in each domain are robustly associated with metabolic control and/or self-care in children and adolescents. We present these characteristics and propose a theoretical model of their interactions and effect on diabetes outcomes. There is currently no consensus regarding patient selection for insulin pump therapy. In this era of scarce healthcare resources, it may be prudent to identify youth requiring increased psychosocial support prior to regimen intensification. The importance of this review lies in its potential to create a framework for rationally utilizing resources by stratifying costly therapeutic options to those who, in the first instance, will be most likely to benefit from them.
Publisher: Wiley
Date: 02-2010
DOI: 10.1002/DMRR.1065
Abstract: The relationships between co-morbid depression in people with diabetes and adverse outcomes including poor HbA(1c) control, adherence to medication and mortality have been examined and confirmed. However, as the awareness of the decrement to health-related quality of life (HRQOL) in people with diabetes and its clinical consequences grows, investigators have become increasingly interested in measuring HRQOL in clinical trials. Given that the psychological factors such as depression may contribute to diminished HRQOL, the present review sought to summarize the association between these variables in people with type 2 diabetes. Articles for a systematic review were obtained via a search performed using MEDLINE, EMBASE and PsycINFO (1980-2007).Fourteen articles fulfilled the inclusion criteria. Studies indicated that self-reported depressive symptoms markedly impaired HRQOL on several domains. However, depression was not related to all sub-domains of HRQOL in all studies, suggesting that the effects of depression on certain aspects of HRQOL may vary between clinical and demographic subgroups. Although a number of shortcomings identified in the current literature should be taken into account for future research, the importance of this review lies in the possibility it raises that the improvements in HRQOL and clinical practice may potentially be achieved by placing greater attention on the identification and management of depression.
Publisher: American Diabetes Association
Date: 06-2019
DOI: 10.2337/DB19-78-LB
Abstract: There is currently a wave of interest in Do-it-Yourself Artificial Pancreas Systems (DIYAPS) but knowledge about how the use of these systems impacts on the lives of those that develop and use them remains limited. Until now, only a select few have been able to give voice to their experiences in a research context. In this study we present data that addresses this shortcoming, detailing the lived experiences of people using DIYAPS in an extensive and erse way. An online survey with 34 items was distributed to DIYAPS users recruited through the Facebook groups “Looped” (and regional sub-groups) and Twitter pages of the Diabetes Online Community (DOC). Participants were posed two open-ended questions in the survey, where personal DIY APS stories were garnered including knowledge acquisition, decision-making, support and emotional aspects in the initiation of DIY APS, perceived changes in clinical and quality of life (QoL) outcomes after initiation and difficulties encountered in the process. All answers were analysed using thematic content analysis. In total, 886 adults responded to the survey and there were a combined 656 responses to the two open-ended items. Knowledge of DIYAPS was largely obtained via exposure to the communication fora that constitute the DOC. The DOC was also a primary source of practical and emotional support. Dramatic improvements in clinical and QoL outcomes were consistently reported. The emotional impact on everyday life was overwhelmingly positive. Acquisition of the requisite devices to initiate DIYAPS was sometimes problematic. The extensive testimony from users of DIYAPS acquired in this study provides new insights regarding the contours of this evolving phenomenon, highlighting factors inspiring people to adopt such solutions and underlining the transformative impact effective closed-loop systems bring to bear on the everyday lives of people with diabetes. B. Cleal: None. K. Braune: Advisory Panel Self Medtronic MiniMed, Inc. Speaker’s Bureau Self Dexcom, Inc. S. O’Donnell: None. B. Hauck: Consultant Self Bayer AG, Eli Lilly and Company, LifeScan, Inc., Novo Nordisk A/S, Roche Diabetes Care, Roche Pharma. D.M. Lewis: Consultant Self Diabeloop SA, Roche Diabetes Care. T.C. Skinner: None. K. Raile: Advisory Panel Self Abbott, Lilly Diabetes.
Publisher: AME Publishing Company
Date: 11-2021
DOI: 10.21037/JTD-21-1353
Publisher: Wiley
Date: 21-11-2012
DOI: 10.1111/J.1365-2923.2012.04348.X
Abstract: General practice supervisors are said to serve as the cornerstones of general practice postgraduate education and therefore it is important to clearly define their roles and what makes them effective. The commonly used definition of a supervisor is not primarily based on general practice and does not cover aspects predicted to be important according to work-based learning theory. We searched for papers published between 1991 and 2011 inclusive, categorised them according to whether they provided empirical evidence, descriptions or recommendations, open-coded the empirical evidence, and used the resulting coding scheme as an analytic framework within which to present a narrative summary of findings. Recommendations and descriptions far outweighed empirical evidence, which showed how supervisors intertwined clinical and educational activities and formed educational alliances with resident doctors that provided a foundation for learning. Residents needed a balance of challenge, usually provided by patients, and support, provided by supervisors. Supervisors established learning environments, assessed residents' learning needs, facilitated learning, monitored the content and process of learning and the well-being of residents, and summarised learning in ways that turned 'know that' into 'know how'. General practice must be expert in ensuring patients are well cared for 'by proxy' and in giving residents just the right amount of support they need to face the challenges posed by those patients. As general practice responds to contemporary clinical demands and rising numbers of undergraduate medical students, it is essential that the ability of general practice supervisors to develop and sustain supportive supervisory relationships with residents is preserved.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2011
Publisher: Wiley
Date: 02-2023
DOI: 10.1111/AJR.12967
Publisher: MDPI AG
Date: 12-05-2021
Abstract: Using the theoretical framework of Guido Möllering conceptualising trust as a mental process composed of three elements—expectation, interpretation and suspension—we examined the role of trust in relation to young children’s (age ≤ 7 years) psychosocial needs when diagnosed with type 1 diabetes. Based on qualitative interviews with health care professionals (HPCs) from paediatric diabetes clinics in all regions of Denmark, we identified four main themes: trust through meaningful interaction, trust as a key factor at the time of diagnosis, trust in a long-term perspective and caregivers as the bridge to trust. We conclude that trust between young children and HCPs is central to children’s psychosocial experience, as well as a primary need, when children are diagnosed with type 1 diabetes. Trusting relationships counteract children’s experience of fear, anxiety and needle phobia and reinforce HCPs’ experience of providing good psychosocial as well as medical care. The present study offers insights into how trust can positively affect young children’s experience of diagnosis. This study also points out some key barriers to and facilitators of creating trusting relationships. This research is a first step towards a greater understanding that can inform collective future guidelines on the psychosocial care of young children.
Publisher: MDPI AG
Date: 07-02-2021
DOI: 10.3390/LIFE11020130
Abstract: Background: Although research has demonstrated the benefits of yoga to people who have been diagnosed with diabetes or at risk of diabetes, studies have not confirmed these effects can be ascribed to the specific features of the traditional postures, called asanas. Instead, the effects of asanas could be ascribed to the increase in cardiovascular activity and expenditure of energy or to the expectation of health benefits. Therefore, to establish whether asanas are beneficial, researchers need to design a control condition in which participants complete activities, called sham poses, that are equivalent to traditional asanas in physical activity and expectation of benefits. Objectives: The aim of this research was to design an appropriate suite of sham poses and to demonstrate these poses and traditional asanas are equivalent in energy expenditure, cardiovascular response, and expectations of health benefits. Methods: Twenty healthy men at medium to high risk of developing diabetes volunteered to partake in the current study. These men completed two sessions that comprised traditional asanas and two sessions that comprised sham poses—poses that utilize the same muscle groups as the asanas and were assigned fictitious Sanskrit labels. Before and after each session, heart rate, blood pressure, blood glucose levels, triglycerides levels, and oxygen saturation were measured to gauge the intensity of exercise. After each session, using a standard measure, participants also indicated the degree to which they expected the poses to improve health. Results: The degree to which the sessions affected the physiological measures (for ex le, pre-exercise, the heart rate for yoga and sham was 71.06 ± 4.79 and 73.88 ± 6.05, respectively, and post-exercise, the heart rate was 70.19 ± 6.16 and 73 ± 7.55, respectively) and the expectations of health improvements did not differ between the traditional asanas and the sham poses. Likewise, the degree to which each session influenced these physiological measures was negligible in both conditions. Conclusions: This study developed a series of poses that elicit similar physiological and psychological effect as traditional yoga asanas. These poses can be used in an active control group in future randomized trial studies that are designed to assess the benefits of asanas.
Publisher: Association for Computing Machinery (ACM)
Date: 18-04-2023
DOI: 10.1145/3586579
Abstract: Type 2 diabetes (T2D) is a large disease burden worldwide and represents an increasing and complex challenge for all societies. For the in idual, T2D is a complex, multi-dimensional, and long-term challenge to manage, and it is challenging to establish and maintain good communication between the patient and healthcare professionals. This article presents DiaFocus, which is a mobile health sensing application for long-term ambulatory management of T2D. DiaFocus supports an adaptive collection of physiological, behavioral, and contextual data in combination with ecological assessments of psycho-social factors. This data is used for improving patient-clinician communication during consultations. DiaFocus is built using a generic data collection framework for mobile and wearable sensing and is highly extensible and customizable. We deployed DiaFocus in a 6-week feasibility study involving 12 patients with T2D. The patients found the DiaFocus approach and system useful and usable for diabetes management. Most patients would use such a system, if available as part of their treatment. Analysis of the collected data shows that mobile sensing is feasible for longitudinal ambulatory assessment of T2D, and helped identify the most appropriate target users being early diagnosed and technically literate T2D patients.
Publisher: Public Library of Science (PLoS)
Date: 16-10-2019
Publisher: JMIR Publications Inc.
Date: 31-10-2020
Abstract: utomated insulin delivery (AID) systems have been shown to be safe and effective in reducing hyperglycemia and hypoglycemia but are not universally available, accessible, or affordable. Therefore, user-driven open-source AID systems are becoming increasingly popular. his study aims to investigate the motivations for which people with diabetes (types 1, 2, and other) or their caregivers decide to build and use a personalized open-source AID. cross-sectional web-based survey was conducted to assess personal motivations and associated self-reported clinical outcomes. f 897 participants from 35 countries, 80.5% (722) were adults with diabetes and 19.5% (175) were caregivers of children with diabetes. Primary motivations to commence open-source AID included improving glycemic outcomes (476/509 adults, 93.5%, and 95/100 caregivers, 95%), reducing acute (443/508 adults, 87.2%, and 96/100 caregivers, 96%) and long-term (421/505 adults, 83.3%, and 91/100 caregivers, 91%) complication risk, interacting less frequently with diabetes technology (413/509 adults, 81.1% 86/100 caregivers, 86%), improving their or child’s sleep quality (364/508 adults, 71.6%, and 80/100 caregivers, 80%), increasing their or child’s life expectancy (381/507 adults, 75.1%, and 84/100 caregivers, 84%), lack of commercially available AID systems (359/507 adults, 70.8%, and 79/99 caregivers, 80%), and unachieved therapy goals with available therapy options (348/509 adults, 68.4%, and 69/100 caregivers, 69%). Improving their own sleep quality was an almost universal motivator for caregivers (94/100, 94%). Significant improvements, independent of age and gender, were observed in self-reported glycated hemoglobin (HbA sub c /sub ), 7.14% (SD 1.13% 54.5 mmol/mol, SD 12.4) to 6.24% (SD 0.64% 44.7 mmol/mol, SD 7.0 i P /i & .001), and time in range (62.96%, SD 16.18%, to 80.34%, SD 9.41% i P /i & .001). hese results highlight the unmet needs of people with diabetes, provide new insights into the evolving phenomenon of open-source AID technology, and indicate improved clinical outcomes. This study may inform health care professionals and policy makers about the opportunities provided by open-source AID systems. > R2-10.2196/15368
Publisher: Springer Science and Business Media LLC
Date: 18-09-2017
Publisher: Wiley
Date: 20-02-2008
DOI: 10.1111/J.1464-5491.2008.02399.X
Abstract: To assess the importance of family factors in determining metabolic outcomes in adolescents with Type 1 diabetes in 19 countries. Adolescents with Type 1 diabetes aged 11-18 years, from 21 paediatric diabetes care centres, in 19 countries, and their parents were invited to participate. Questionnaires were administered recording demographic data, details of insulin regimens, severe hypoglycaemic events and number of episodes of diabetic ketoacidosis. Adolescents completed the parental involvement scale from the Diabetes Quality of Life for Youth--Short Form (DQOLY-SF) and the Diabetes Family Responsibility Questionnaire (DFRQ). Parents completed the DFRQ and a Parental Burden of Diabetes score. Glycated haemoglobin (HbA(1c)) was analysed centrally on capillary blood. A total of 2062 adolescents completed a questionnaire, with 2036 providing a blood s le 1994 parents also completed a questionnaire. Family demographic factors that were associated with metabolic outcomes included: parents living together (t = 4.1 P < 0.001), paternal employment status (F = 7.2 d.f. = 3 P < 0.001), parents perceived to be over-involved in diabetes care (r = 0.11 P < 0.001) and adolescent-parent disagreement on responsibility for diabetes care practices (F = 8.46 d.f. = 2 P < 0.001). Although these factors differed between centres, they did not account for centre differences in metabolic outcomes, but were stronger predictors of metabolic control than age, gender or insulin treatment regimen. Family factors, particularly dynamic and communication factors such as parental over-involvement and adolescent-parent concordance on responsibility for diabetes care appear be important determinants of metabolic outcomes in adolescents with diabetes. However, family dynamic factors do not account for the substantial differences in metabolic outcomes between centres.
Publisher: Wiley
Date: 20-05-2014
DOI: 10.1111/DME.12484
Abstract: To determine the stability of beliefs of patients with Type 2 diabetes about their diabetes over 3 years, following diagnosis. Data were collected as part of a multicentre cluster randomized controlled trial of a 6-h self-management programme, across 207 general practices in the UK. Participants in the original trial were eligible for follow-up with biomedical data (HbA1c levels, blood pressure, weight, blood lipid levels) collected at the practice, and questionnaire data collected by postal distribution and return. Psychological outcome measures were depression (Hospital Anxiety and Depression Scale) and diabetes distress (Problem Areas in Diabetes scale). Illness beliefs were assessed using the Illness Perceptions Questionnaire-Revised and the Diabetes Illness Representations Questionnaire scales. At 3-year follow-up, all post-intervention differences in illness beliefs between the intervention and the control group remained significant, with perceptions of the duration of diabetes, seriousness of diabetes and perceived impact of diabetes unchanged over the course of the 3-year follow-up. The control group reported a greater understanding of diabetes during the follow-up, and the intervention group reported decreased responsibility for diabetes outcomes during the follow-up. After controlling for 4-month levels of distress and depression, the perceived impact of diabetes at 4 months remained a significant predictor of distress and depression at 3-year follow-up. Peoples' beliefs about diabetes are formed quickly after diagnosis, and thereafter seem to be relatively stable over extended follow-up. These early illness beliefs are predictive of later psychological distress, and emphasize the importance of initial context and provision of diabetes care in shaping participants' future well-being.
Publisher: No publisher found
Date: 2002
Publisher: Wiley
Date: 03-03-2020
DOI: 10.1002/EDM2.120
Publisher: Cambridge University Press (CUP)
Date: 12-2008
DOI: 10.1017/S136898000800178X
Abstract: Women of lower educational attainment have less balanced and varied diets than women of higher educational attainment. The diets of women are vital to the long-term health of their offspring. The present study aimed to identify factors that influence the food choices of women with lower educational attainment and how women could be helped to improve those choices. We conducted eight focus group discussions with women of lower educational attainment to identify these factors. We contrasted the results of these discussions with those from three focus group discussions with women of higher educational attainment. South ton, UK. Forty-two white Caucasian women of lower educational attainment and fourteen of higher educational attainment aged 18 to 44 years. The dominant theme in discussions with women of lower educational attainment was their sense that they lacked control over food choices for themselves and their families. Partners and children exerted a high degree of control over which foods were bought and prepared. Women’s perceptions of the cost of healthy food, the need to avoid waste, being trapped at home surrounded by opportunities to snack, and having limited skill and experience with food, all contributed to their sense they lacked control over their own and their family’s food choices. An intervention to improve the food choices of women with lower educational attainment needs to increase their sense of control over their diet and the foods they buy. This might include increasing their skills in food preparation.
Publisher: Wiley
Date: 26-05-2014
DOI: 10.1111/DME.12483
Abstract: To develop and test a format of delivery of diabetes self-management education by paired professional and lay educators. We conducted an equivalence trial with non-randomized participant allocation to a Diabetes Education and Self Management for Ongoing and Newly Diagnosed Type 2 diabetes (DESMOND) course, delivered in the standard format by two trained healthcare professional educators (to the control group) or by one trained lay educator and one professional educator (to the intervention group). A total of 260 people with Type 2 diabetes diagnosed within the previous 12 months were referred for self-management education as part of routine care and attended either a control or intervention format DESMOND course. The primary outcome measure was change in illness coherence score (derived from the Diabetes Illness Perception Questionnaire-Revised) between baseline and 4 months after attending education sessions. Secondary outcome measures included change in HbA1c level. The trial was conducted in four primary care organizations across England and Scotland. The 95% CI for the between-group difference in positive change in coherence scores was within the pre-set limits of equivalence (difference = 0.22, 95% CI 1.07 to 1.52). Equivalent changes related to secondary outcome measures were also observed, including equivalent reductions in HbA1c levels. Diabetes education delivered jointly by a trained lay person and a healthcare professional educator with the same educator role can provide equivalent patient benefits. This could provide a method that increases capacity, maintains quality and is cost-effective, while increasing access to self-management education.
Publisher: Wiley
Date: 2021
DOI: 10.1002/PDI.2314
Publisher: American Physical Society (APS)
Date: 15-03-2021
Publisher: Proceedings of the National Academy of Sciences
Date: 22-02-2016
Abstract: New information from the ANDRILL-2A drill core and a complementary ice sheet modeling study show that polar climate and Antarctic ice sheet (AIS) margins were highly dynamic during the early to mid-Miocene. Changes in extent of the AIS inferred by these studies suggest that high southern latitudes were sensitive to relatively small changes in atmospheric CO 2 (between 280 and 500 ppm). Importantly, reconstructions through intervals of peak warmth indicate that the AIS retreated beyond its terrestrial margin under atmospheric CO 2 conditions that were similar to those projected for the coming centuries.
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.DIABRES.2005.03.031
Abstract: It has been hypothesized that coverage of diabetes-specific issues (e.g. coping with complications, incapacity, pain) during psychotherapy may optimize the likelihood of treatment success for depression in patients with diabetes. However, it is still unclear how often depression is confounded by diabetes-specific emotional problems. We aim to determine the levels of diabetes-specific emotional problems in diabetic in iduals with high versus low levels of depression in a s le of 539 outpatients with diabetes (202 Dutch, 185 Croatian and 152 English). Subjects completed the Center for Epidemiological Studies Depression and the Problem Areas in Diabetes scales. Percentages of patients with high depression scores were: 39 and 34% (Croatian men and women), 19 and 21% (Dutch men and women), 19 and 39% (English men and women). Moreover, 79% (Croatian), 47% (Dutch) and 41% (English) of the patients with a severe depression score reported to have four or more serious diabetes-specific emotional problems. For patients with low depression scores, these percentages were: 29% (Croatian), 11% (Dutch) and 1% (English). Serious diabetes-specific emotional problems are particularly prevalent in depressed diabetes patients. Randomized controlled trials are warranted to test whether coverage of diabetes-specific issues during psychotherapy can further improve the treatment of depression in diabetes.
Publisher: Wiley
Date: 09-1997
Publisher: MDPI AG
Date: 22-06-2023
DOI: 10.3390/S23135822
Abstract: Regular physical activity is an important component of diabetes management. However, there are limited data on the habitual physical activity of people with or at risk of diabetes-related foot complications. The aim of this study was to describe the habitual physical activity of people with or at risk of diabetes-related foot complications in regional Australia. Twenty-three participants with diabetes from regional Australia were recruited with twenty-two participants included in subsequent analyses: no history of ulcer (N = 11) and history of ulcer (N = 11). Each participant wore a triaxial accelerometer (GT3X+ ActiGraph LLC, Pensacola, FL, USA) on their non-dominant wrist for 14 days. There were no significant differences between groups according to both participant characteristics and physical activity outcomes. Median minutes per day of moderate-to-vigorous physical activity (MVPA) were 9.7 (IQR: 1.6–15.7) while participants recorded an average of 280 ± 78 min of low-intensity physical activity and 689 ± 114 min of sedentary behaviour. The s le accumulated on average 30 min of slow walking and 2 min of fast walking per day, respectively. Overall, participants spent very little time performing MVPA and were largely sedentary. It is important that strategies are put in place for people with or at risk of diabetes-related foot complications in order that they increase their physical activity significantly in accordance with established guidelines.
Publisher: Elsevier BV
Date: 2022
Publisher: Wiley
Date: 22-10-2003
DOI: 10.1046/J.1464-5491.2003.01056.X
Abstract: To explore the degree of agreement between patient and health care professional's perceptions of consultations. Immediately after 141 dietitian/nurse specialist consultations, patients and professional's completed the Health Care Climate questionnaire (HCC), Medical Interview Satisfaction Scale (MISS) and the Treatment Self-Regulation Questionnaire (TSRQ) In addition, both parties were asked about any key points or issues discussed in the consultation any decisions that were made about their diabetes treatment today any goals that were set as a result of today's consultation. Patient and professional's scores on the HCC and MISS were not correlated (r=0.3 and 0.16). Patient and professionals disagreed on the issues discussed 19.6% of the time, on the decisions made 20.7% of the time and goals set 44.3% of the time. More autonomy support in the consultation was associated with greater autonomous motivation for self-care (r=0.31 P<0.001) more controlled motivation was associated with less agreement on issues discussed and goals set (r=-0.20 r= -0.24 P<0.05). There is significant disagreement between patients and professionals perceptions and recollection of the content of consultations. Professional's communications skills need to be developed to ensure these discrepancies are minimized. Skills to provide greater autonomy support in the consultation would help to enhance this process and improve outcomes.
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.DIABRES.2018.03.040
Abstract: Diabetes distress captures a range of emotional responses and reactions to life with diabetes and is considered a part of the experience of managing diabetes and its treatment. Given the importance of the social context of work life for people of working age we set out to explore whether work-related diabetes distress is a distinct and important dimension of diabetes-related emotional distress in working people with type 1 diabetes. A questionnaire with self-reported measures of psychosocial health and well-being at work was completed by 1126 working people with type 1 diabetes from a specialist diabetes clinic in Denmark. Work-related diabetes distress was assessed with two questions about worry and exhaustion related to reconciling work life and diabetes. Diabetes-related emotional distress was assessed with the Problem Areas in Diabetes scale (PAID-5), a short form version of the full PAID scale. We performed inter-item correlation analyses, exploratory factor analysis, and hierarchical multiple regression analyses. Inter-item correlations and exploratory factor analysis indicated that work-related diabetes distress was distinct from diabetes-related emotional distress. Further, work-related diabetes distress was found to be a unique contributor to work ability, quality of life, intentional hyperglycaemia at work, and absenteeism, after adjusting for covariates and diabetes-related emotional distress. The findings suggest that work-related diabetes distress captures an aspect of distress so far unaccounted for in workers with type 1 diabetes. Further studies are needed to strengthen the conceptual basis of work-related diabetes distress, explore its clinical usefulness and clarify its risk factors.
Publisher: Public Library of Science (PLoS)
Date: 16-02-2022
DOI: 10.1371/JOURNAL.PONE.0263233
Abstract: Overweight/obesity is a well-defined risk factor for a variety of chronic cardiovascular and metabolic diseases. Sleep duration has been associated with overweight/obesity and other cardio metabolic and neurocognitive problems. Notably, overweight/obesity and many of the associated comorbidities are prevalent in Indigenous Australians. Generally, sleep duration has been associated with BMI for Australian adults but information about Australian Indigenous adults’ sleep is scant. A recent report established that sleep is a weak predictor of obesity for Indigenous Australian adults. To determine whether sleep remains a predictor of obesity when physical activity, diet and smoking status are accounted for and to determine whether sleep duration plays a mediating role in the relationship between Indigenous status and BMI. Statistical analyses of 5,886 Australian adults: 5236 non-Indigenous and 650 Indigenous people aged over 18 years who participated in the Australian Health Survey 2011–2013. Demographic and lifestyle characteristics were described by χ 2 and t-tests. ANOVA was used to determine the variables that significantly predicted BMI and sleep duration. Stepwise regression analyses were performed to determine the strongest significant predictors of BMI. Sleep duration was self-reported BMI was calculated from measurement. The study revealed two main findings: (i) short sleep duration was an independent predictor of obesity (adjusted- R 2 = 0.056, p .0001) and (ii) controlling for sleep duration and other possible confounders, Indigenous status was a significant predictor of BMI overweight/obesity. Sleep duration played a weak, partial mediator role in this relationship. Increased BMI was associated with lower socioeconomic status and level of disadvantage of household locality for non-remote Indigenous and non-Indigenous people. Indigenous status strongly predicted increased BMI. The effect was not mediated by the socioeconomic indicators but was partially mediated by sleep duration.
Publisher: Informa UK Limited
Date: 10-05-2017
Publisher: SAGE Publications
Date: 22-09-2018
Abstract: Many impulsive behaviors, unpleasant emotions, and misguided cognitions increase the incidence of type 2 diabetes and other conditions. This study tests the premise that such risk factors are inversely related to future clarity—the extent to which the future seems vivid and certain. Specifically, 211 participants completed the measures of future clarity and various determinants of health. Future clarity was positively associated with the inclination of participants to consume healthy food, abstain from cigarettes, participate in physical activity, and experience positive emotions. Future research should examine whether interventions designed to help in iduals clarify and pursue their aspirations could stem lifestyle diseases.
Publisher: Wiley
Date: 07-04-2020
DOI: 10.1111/APA.15219
Abstract: To explore sleep patterns in indigenous Australian children and assess the role of sleep timing in longitudinal changes in body mass index (BMI). Latent profile analysis was conducted with the Australian Longitudinal Study of Indigenous Children (LSIC) cohort data (wave 5), to determine distinct patterns of bed and wake timing, taking account of weekday sleep duration, weekday and weekend bedtimes, and weekday wake times. Multilevel models with a random intercept were used to investigate the role of baseline sleep pattern in predicting longitudinal changes in BMI. Baseline data for 1258 children (50.7% males), mean age 6.32 ± 1.52 years, indicated the presence of five classes of sleep patterns: early/long sleepers (4.5%), normative sleepers (25.5%), late sleepers (49.9%), consistent late sleepers (11.1%) and early risers (9%). Late sleeping was significantly associated with longitudinal gains in BMI. Compared with early sleepers, consistent late sleepers experienced 1.03 unit gain in BMI at follow‐up (95% CI: 0.001‐2.05, P = .05). This study underscores the importance of looking beyond sleep duration and highlights the positive outcomes of early bedtimes in children. As sleep timing is modifiable, this offers the opportunity for improvement in sleep and protecting against future weight gain in indigenous children.
Publisher: Public Library of Science (PLoS)
Date: 11-06-2015
Publisher: Elsevier BV
Date: 02-2011
Publisher: Springer Science and Business Media LLC
Date: 12-2019
DOI: 10.1186/S13047-019-0366-6
Abstract: There is limited Australian epidemiological research that reports on the foot-health characteristics of people with diabetes, especially within rural and regional settings. The objective of this study was to explore the associations between demographic, socio-economic and diabetes-related variables with diabetes-related foot morbidity in people residing in regional and rural Australia. Adults with diabetes were recruited from non-metropolitan Australian publicly-funded podiatry services. The primary variable of interest was the University of Texas diabetic foot risk classification designated to each participant at baseline. Independent risk factors for diabetes-related foot morbidity were identified using multivariable analysis. Eight-hundred and ninety-nine participants enrolled, 443 (49.3%) in Tasmania and 456 (50.7%) in Victoria. Mean age was 67 years (SD 12.7), 9.2% had type 1 diabetes, 506 (56.3%) were male, 498 (55.4%) had diabetes for longer than 10 years and 550 (61.2%) either did not know the ideal HbA1c target or reported that it was ≥7.0. A majority had peripheral neuropathy or worse foot morbidity (61.0%). Foot morbidity was associated with male sex (OR 2.42, 95% CI 1.82–3.22), duration of diabetes 20 years (OR 3.25, 95% CI 2.22–4.75), and Tasmanian residence (OR 3.38, 95% CI 2.35–4.86). A high proportion of the regional Australian clinical population with diabetes seen by the publicly-funded podiatric services in this study were at high risk of future limb threatening foot morbidity, and participants residing in Northern Tasmania are more likely to have worse diabetes-related foot morbidity than those from regional Victoria. Service models should be reviewed to ensure that diabetes-related foot services are appropriately developed and resourced to deliver interdisciplinary evidence-based care.
Publisher: BMJ
Date: 15-01-2014
DOI: 10.1136/BMJ.G153
Publisher: American Diabetes Association
Date: 06-2022
DOI: 10.2337/DB22-583-P
Abstract: Background: Use of open-source automated insulin delivery (AID) is associated with improved psychosocial outcomes among people with type 1 diabetes (T1D) . However, research to date has been qualitative or used study-specific single items. There is a need for quantitative research using validated measures in larger s les. Method: We conducted an international online survey to examine the psychosocial outcomes of open-source AID users and non-users. Validated questionnaires assessed diabetes-specific quality of life (QoL) , impact of the COVID-pandemic on diabetes-specific QoL, diabetes specific-positive well-being, diabetes treatment satisfaction, diabetes distress, fear of hypoglycaemia, general emotional well-being, and subjective sleep quality. Results: 587 participants completed at least one questionnaire, including 447 adults using open-source AID (mean age 43, 42% women) and 140 non-users (mean age 40, 64% women) . Table 1 shows significant between-group differences for all questionnaire scores. Discussion: Adults with T1D using open-source AID report significantly better psychosocial outcomes than non-users. Due to the cross-sectional design of this study, we cannot make any causal inferences about the use of these devices. Further research is needed to examine the reasons for these differences. J.Schipp: None. T.C.Skinner: None. J.Speight: Advisory Panel Insulet Corporation, Research Support Novo Nordisk, Sanofi. C.Hendrieckx: None. K.Braune: None. S.O'donnell: None. H.Ballhausen: None. B.Cleal: None. M.Wäldchen: None. C.Knoll: None. K.A.Gajewska: None. European Commission Horizon 2020 (823902)
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-09-2020
DOI: 10.5664/JCSM.8564
Publisher: Elsevier BV
Date: 04-2021
Publisher: Wiley
Date: 2008
Publisher: S. Karger AG
Date: 2002
DOI: 10.1159/000053320
Abstract: Longitudinal studies indicate that 20% of paediatric patients account for 80% of all admissions for diabetic ketoacidosis (DKA). The frequency of DKA peaks during adolescence and, although in iduals generally go into remission, they may continue to have bouts of recurrent DKA in adulthood. The evidence for insulin omission being the behavioural precursor to recurrent DKA is reviewed and discussed. Thereafter the range of possible psychosocial causes is explored and the evidence for each discussed. Approaches to assessing the in idual and their family to identify aetiology and therefore appropriate intervention are considered and treatment options reviewed. Finally, the paper examines potential risk factors for recurrent DKA, possible strategies for identifying these early and how to use these assessments to prevent subsequent recurrent DKA.
Publisher: American Chemical Society (ACS)
Date: 27-12-2018
Abstract: In this work, we reported the synthesis of an engineered novel nanocarrier composed of biodegradable charged polyester vectors (BCPVs) and graphene quantum dots (GQDs) for pancreatic cancer (MiaPaCa-2 cells) therapy applications. Such a nanocarrier was utilized to co-load doxorubicin (DOX) and small interfering ribonucleic acid (siRNA), resulting in the formation of GQD/DOX/BCPV/siRNA nanocomplexes. The resulting nanocomplexes have demonstrated high stability in physiologically mimicking media, excellent K-ras downregulation activity, and effective bioactivity inhibition for MiaPaCa-2 cells. More importantly, laser light was used to generate heat for the nanocomplexes via the photothermal effect to damage the cells, which was further employed to trigger the release of payloads from the nanocomplexes. Such triggered release function greatly enhanced the anticancer activity of the nanocomplexes. Preliminary colony formation study also suggested that GQD/DOX/BCPV/siRNA nanocomplexes are qualified carrier candidates in subsequent in vivo tests.
Publisher: Informa UK Limited
Date: 21-11-2012
DOI: 10.3109/13813455.2011.625950
Abstract: The views of type 2 diabetes (T2DM) patients have not been considered in the debate on the role of self-monitoring of blood glucose (SMBG) in the management of T2DM. To assess the views of T2DM patients on SMBG. Two previously trained research assistants used a structured pre-tested questionnaire to interview 416 T2DM patients practising SMBG in out-patient clinics in the privacy of the patients after they have consented to be interviewed. 79% of patients were unemployed with mean duration of diabetes of 11.8 ± 0.5 year. 94% of patients did not have health insurance policies while 86% did not belong to any diabetes support group. Although 70% of the patients identified SMBG as expensive, 94% believed it assists glycaemic control, while 89% thought it was worth the expense. Caribbean T2DM patients believe SMBG was beneficial for the management of their diabetes and empowering them may reduce diabetes complications.
Publisher: Frontiers Media SA
Date: 05-06-2023
DOI: 10.3389/FPSYG.2023.1070006
Abstract: Chronic disease self-management and health behavior change programs are becoming increasingly important to health service delivery to prevent the development of chronic disease and optimize health outcomes for those who suffer from it. To train people to deliver these programs effectively, we need to understand both the what and how of program delivery. While there is an abundant literature on what, and a merging evidence about what techniques to use, such as goals setting and self-monitoring, the literature on how programs should be delivered is less well developed. This paper reviews emerging research in this area and identifies an underlying monological approach. We argue that this currently dominant model cannot address the key issues in this area. By considering the theoretical framework of Dialogism, we introduce the method of Conversation Analysis to the field of behavior change interventions. Extensive research into health communication has endeavored to show the importance of language and the organization of interactions. We demonstrate and discuss how a monological approach to interventions prevents exploration of what professionals do to deliver intervention content. In doing so, we show that techniques do not account for how successfully an intervention is delivered.
Publisher: Frontiers Media SA
Date: 11-02-2022
DOI: 10.3389/FCDHC.2021.707553
Abstract: Little is known about the psychosocial experiences and care needs of young children under the age of 7 years who have been diagnosed with type 1 diabetes. To address this knowledge gap, we examine children’s psychosocial care needs through the lens of child-centred care and the framework of Zone of Proximal Development. To explore current care practices for young children with diabetes and identify aspects of child-centred care already successfully integrated into current practice. In idual face-to-face, semi-structured interviews were conducted with 20 Healthcare Professionals, representing 11 of 17 paediatric diabetes clinics in Denmark. Our data provided valuable insights into existing child-centred practices. Our analysis identified practices covering four main themes: 1. Accommodating immediate emotional needs, 2. Putting children before diabetes, 3. Encouraging meaningful participation, 4. Playful communication. Healthcare Professionals provided child-centred care, largely through play-based approaches that make diabetes care meaningful and relevant. Such practices provide the scaffolding necessary to enable young children to gradually engage, comprehend and participate in their own care.
Publisher: Wiley
Date: 22-12-2010
DOI: 10.1111/J.1463-1326.2009.01098.X
Abstract: Type 2 diabetes (T2DM) is a long-term chronic condition that is complex to manage, with the majority of management being done by the person with diabetes outside of the clinical setting. Because of its complexities, effective self-management requires skills, confidence and the ability to make decisions and choices about treatments and lifestyle on a day-to-day basis. Equipping a person with these self-management skills is in itself challenging and it is now widely accepted that structured education is an integral part of the management of T2DM. This paper explores whether structured self-management education can improve outcomes in people with diabetes. The authors explore what self-management education is, why it is needed and then go on to examine the recent evidence from clinical trials from 2006 onwards.
Publisher: Springer Science and Business Media LLC
Date: 28-08-2013
DOI: 10.1007/S11325-012-0763-6
Abstract: The Epworth Sleepiness Scale (ESS) is a widely used tool for measuring sleepiness. In addition to providing a single measure of sleepiness (a one-factor structure), the ESS also has the capacity to provide additional information about specific factors that facilitate sleep onset, including a person's posture, activity and environment. These features of sleepiness are referred to as somnificity. This study evaluates and compares the fit of a one-factor structure (sleepiness) and three-factor structure (reflecting low, medium and high levels of somnificity) for the ESS. All participants (a community s le N = 356 and a clinical s le N = 679) were administered the ESS. Confirmatory factor analysis was used to evaluate and compare the fit of one- and three-factor models of the ESS. In both s les, a three-factor structure (community s le adjusted X (2) = 2.95, root mean square error of approximation (RMSEA) = 0.07, Comparative Fit Index (CFI) = 0.95 clinical s le adjusted X (2) = 3.98, RMSEA = 0.07, CFI = 0.98) provided a level of model fit that was at least as good as the one-factor structure (community s le adjusted X (2) = 5.01, RMSEA = 0.11, CFI = 0.87 clinical s le adjusted X (2) = 8.87, RMSEA = 0.11, CFI = 0.92). In addition to a single measure of sleepiness, the ESS can provide subscale scores which relate to three underlying levels of somnificity. These findings suggest that the ESS can be used to measure an in idual's overall sleep propensity as well as more specific measures of sleep propensity in low, moderate and high levels of situational somnificity.
Publisher: American Physiological Society
Date: 07-2003
DOI: 10.1152/AJPREGU.00029.2003
Abstract: Interstitial K + ([K + ] i ) was measured in human skeletal muscle by microdialysis during exhaustive leg exercise, with (AL) and without (L) previous intense arm exercise. In addition, the reproducibility of the [K + ] i determinations was examined. Possible microdialysis-induced rupture of the sarcolemma was assessed by measurement of carnosine in the dialysate, because carnosine is only expected to be found intracellularly. Changes in [K + ] i could be reproduced, when exhaustive leg exercise was performed on two different days, with a between-day difference of ∼0.5 mM at rest and 1.5 mM at exhaustion. The time to exhaustion was shorter in AL than in L (2.7 ± 0.3 vs. 4.0 ± 0.3 min P 0.05). Furthermore, [K + ] i was higher from 0 to 1.5 min of the intense leg exercise period in AL compared with L (9.2 ± 0.7 vs. 6.4 ± 0.9 mM P 0.001) and at exhaustion (11.9 ± 0.5 vs. 10.3 ± 0.6 mM P 0.05). The dialysate content of carnosine was elevated by exercise, but low-intensity exercise resulted in higher dialysate carnosine concentrations than subsequent intense exercise. Furthermore, no relationship was found between carnosine concentrations and [K + ] i . Thus the present data suggest that microdialysis can be used to determine muscle [K + ] i kinetics during intense exercise, when low-intensity exercise is performed before the intense exercise. The high [K + ] i levels reached at exhaustion can be expected to cause fatigue, which is supported by the finding that a faster accumulation of interstitial K + , induced by prior arm exercise, was associated with a reduced time to fatigue.
Publisher: Elsevier BV
Date: 11-2021
Publisher: MDPI AG
Date: 18-08-2023
Abstract: Background: To identify people at risk of type 2 diabetes. Primary health care needs efficient and noninvasive screening tools to detect in iduals in need of follow-up to promote health and well-being. Previous research has shown people with lower levels of health literacy and/or well-being scores are vulnerable but may benefit from intervention and follow-up care. Aims: This cross-sectional study, aimed to identify people at risk for type 2 diabetes by comparing the Finnish Diabetes Risk instrument with the waist-to-height ratio. Further, the difference was examined in health literacy and well-being scale scores in the countryside versus town areas, respectively. Results: In total, 220, aged 18–75 years, participated. Thereof, 13.2% displayed biomarkers at prediabetes level of HbA1c (39–47 mmol/mol) none had undiagnosed diabetes. Of the participants, 73% were overweight or obese. Waist-to-height ratio demonstrated 93.1% of the prediabetes group at moderate to high health risk and 64.4% of the normal group, with an area under the curve of 0.759, sensitivity of 93.3%, and specificity of 63.1%. Residency did not influence prediabetes prevalence, health literacy, or well-being. Conclusion: Waist-to-height ratio and the Finnish Diabetes Risk instrument may be suitable for identifying who need further tests and follow-up care for health promotion in primary care.
Publisher: Wiley
Date: 24-03-2022
DOI: 10.1111/AJR.12864
Abstract: To determine the work location (metropolitan, regional, rural and remote) of graduates in nursing, allied health and oral health disciplines who complete their professional training, end‐to‐end training, in a regional or rural area noting the potential inclusion of a metropolitan‐based placement for speciality practice not available in rural or regional Victoria. We tracked the place of employment from the Australian Health Practitioners Regulation Agency (AHPRA) of all graduates from a regional/rural tertiary education provider. The student home address at enrolment, locations where they undertook all placements and their current place of work were described using an objective geographical model of access, the Modified Monash Model. Seventy‐five per cent of 5506 graduates were located in the AHPRA database. About one third of graduates were working in metropolitan areas, 1/3 in regional cities and 1/3 in rural areas. Students' origin accounted for 1/3 of variance in current workplace location. The more placement days students completed in regional/ rural areas was also a significant predictor of working in a regional or rural area. End‐to‐end training in regional/rural areas is an effective approach to retaining a regional/rural workforce. Student origin is a strong predictor of working rural or regionally, as is undertaking placements in rural areas. This suggests that priority for rural/ regional student placements should be given to students in end‐to‐end regional/ rural programs and students from a regional/ rural background.
Publisher: Informa UK Limited
Date: 29-06-2022
Publisher: Springer Science and Business Media LLC
Date: 23-05-2023
DOI: 10.1186/S13063-023-07338-5
Abstract: Mental health problems are common among people with diabetes. However, evidence-based strategies for the prevention and early intervention of emotional problems in people with diabetes are lacking. Our aim is to assess the real-world effectiveness, cost-effectiveness, and implementation of a Low-Intensity mental health Support via a Telehealth Enabled Network (LISTEN), facilitated by diabetes health professionals (HPs). A hybrid type I effectiveness-implementation trial, including a two-arm parallel randomised controlled trial, alongside mixed methods process evaluation. Recruited primarily via the National Diabetes Services Scheme, Australian adults with diabetes ( N = 454) will be eligible if they are experiencing elevated diabetes distress. Participants are randomised (1:1 ratio) to LISTEN—a brief, low-intensity mental health support program based on a problem-solving therapy framework and delivered via telehealth (intervention) or usual care (web-based resources about diabetes and emotional health). Data are collected via online assessments at baseline (T0), 8 weeks (T1) and 6 months (T2, primary endpoint) follow-up. The primary outcome is between-group differences in diabetes distress at T2. Secondary outcomes include the immediate (T1) and longer-term (T2) effect of the intervention on psychological distress, general emotional well-being, and coping self-efficacy. A within-trial economic evaluation will be conducted. Implementation outcomes will be assessed using mixed methods, according to the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Data collection will include qualitative interviews and field notes. It is anticipated that LISTEN will reduce diabetes distress among adults with diabetes. The pragmatic trial results will determine whether LISTEN is effective, cost-effective, and should be implemented at scale. Qualitative findings will be used to refine the intervention and implementation strategies as required. This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN: ACTRN12622000168752) on 1 February, 2022.
Publisher: Informa UK Limited
Date: 02-01-2019
Publisher: American Psychological Association (APA)
Date: 2002
Publisher: Elsevier BV
Date: 07-2012
Publisher: Wiley
Date: 15-12-2021
DOI: 10.1111/DME.14759
Abstract: Acceptable and accessible interventions are needed to address ‘psychological insulin resistance’, which is a common barrier to insulin uptake among adults with type 2 diabetes (T2D). Our aim was to test the feasibility of a randomised controlled trial (RCT) study design and acceptability of a theoretically grounded, psycho‐educational, web‐based resource to reduce negative insulin appraisals among adults with T2D. A double‐blinded, parallel group, two‐arm pilot RCT (1:1), comparing intervention with active control (existing online information about insulin). Eligible participants were Australian adults with T2D, taking oral diabetes medications. Exclusion criteria: prior use of injectable medicines being ‘very willing’ to commence insulin. Primary outcomes: study feasibility (recruitment ease, protocol fulfilment, attrition, data completeness) secondary outcomes: intervention acceptability (intervention engagement, user feedback) and likely efficacy (negative Insulin Treatment Appraisal Scale [ITAS] scores at follow‐up). Online surveys completed at baseline and 2 weeks. During 4‐week recruitment, 76 people expressed interest: 51 eligible and 35 enrolled (intervention = 17, control = 18 median[interquartile range] age = 62[53, 69] years 17 women). Protocol fulfilment achieved by 26 (74%) participants ( n = 13 per arm), with low participant attrition ( n = 6, 17%). Intervention acceptability was high ( % endorsement, except format preference = 60%). ITAS negative scores differed between‐groups at follow‐up ( M diff = −6.5, 95% confidence interval: −10.7 to −2.4), favouring the intervention. This novel web‐based resource (“Is insulin right for me?”) is acceptable and associated with a likely reduction in negative insulin appraisals, relative to existing resources. This pilot shows the study design is feasible and supports conduct of a fully powered RCT.
Publisher: Oxford University Press (OUP)
Date: 08-09-2018
DOI: 10.1093/SLEEP/ZSY178
Abstract: The assessment of depression in obstructive sleep apnea (OSA) is confounded by the overlap in symptoms between the disorders. However, previous analysis by our group has suggested that while some depressive symptoms tend to overlap with OSA (such as insomnia, lethargy, impaired concentration, psychomotor retardation) other, nonoverlapping symptoms appear more specific to depression (such as negative affect, anhedonia, and depressive cognitions). We sought to determine the value of such categorization of depressive symptoms in identifying clinical depression within OSA patient populations by examining the response of these two categories of depression symptoms to treatment of OSA by continuous positive airway pressure (CPAP). Three hundred fifty-seven unselected, CPAP-naïve OSA patients were treated with CPAP and followed over 12 weeks. Depressive symptoms were elicited before, during and at the end of this period using the Hamilton Rating Scale for Depression (HAM-D). Data were analyzed using latent growth curve modeling. At baseline, in iduals reported proportionally more severe overlapping than nonoverlapping depressive symptoms. Both overlapping and nonoverlapping symptoms significantly decreased over time, but with a greater reduction in the severity of overlapping than nonoverlapping depressive symptoms. Moreover, greater CPAP use was associated with a faster rate of improvement in overlapping symptoms, but not in nonoverlapping symptoms. These findings suggest that nonoverlapping depressive symptoms may be useful discriminators of clinical depression amongst patients with untreated, symptomatic OSA.
Publisher: Wiley
Date: 04-2002
DOI: 10.1046/J.1464-5491.2002.00678.X
Abstract: In past decades clinicians have increasingly recognized the importance of psychological support for people with diabetes and their families, and many have recommended integrating psychological counselling into routine diabetes care. It is therefore important to consider whether psychological interventions in diabetes are effective in improving clinical outcomes. This review was limited to the literature reporting on the treatment of five common psychological problems known to complicate diabetes management: depression, eating disorders, anxiety/stress, self-destructive behaviour and interpersonal/family conflicts. A literature search was undertaken using MedLine and PsychInfo, including studies published in English peer-reviewed journals between 1990 and 2001, reporting on the effects of psychological interventions in the areas mentioned. Case studies were excluded from the review. In line with earlier reviews, relatively little empirical research was found to substantiate the effect of psychological counselling in complicated diabetes. Most studies are uncontrolled, and involve small s les. In total only 11 randomized controlled trials were identified. Results indicate that cognitive behaviour therapy (CBT) is effective in the treatment of depression in Type 2 diabetes patients, both in reducing depressive symptoms and HbA1c. Favourable effects have been observed in pilot studies applying CBT in the field of stress management, eating disorders and self-destructive behaviour, but future research should substantiate these preliminary findings. Behaviour family therapy proved beneficial in terms of resolving family conflicts, but did not impact glycaemic control. Evidence to support the effect of psychological treatment in problematic diabetes is still scarce, due to limited research in this area. Suggestions are made to further develop psychotherapeutic research in diabetes care. We conclude that future research should gain from a behavioural medicine approach to diabetes, with close collaboration between diabetologists and psychologists.
Publisher: Wiley
Date: 18-11-2014
DOI: 10.1111/DME.12339
Abstract: To determine whether the personality traits of conscientiousness and agreeableness are associated with self-care behaviours and glycaemia in Type 2 diabetes. The Big Five Inventory personality traits Agreeableness, Conscientiousness, Extraversion, Neuroticism and Openness were determined along with a range of other variables in 1313 participants with Type 2 diabetes (mean age 65.8 ± 11.1 years 52.9% men) undertaking their baseline assessment as part of the community-based longitudinal observational Fremantle Diabetes Study Phase II. Age- and sex-adjusted generalized linear modelling was used to determine whether personality was associated with BMI, smoking, self-monitoring of blood glucose and medication taking. Multivariable regression was used to investigate which traits were independently associated with these self-care behaviours and HbA1c . Patients with higher conscientiousness were less likely to be obese or smoke, and more likely to perform self-monitoring of blood glucose and take their medications (P ≤ 0.019), with similar independent associations in multivariate models (P ≤ 0.024). HbA1c was independently associated with younger age, indigenous ethnicity, higher BMI, longer diabetes duration, diabetes treatment, self-monitoring of blood glucose (negatively) and less medication taking (P ≤ 0.009), but no personality trait added to the model. Although there was no independent association between personality traits and HbA1c , the relationship between high conscientiousness and low BMI and beneficial self-care behaviours suggests an indirect positive effect on glycaemia. Conscientiousness could be augmented by the use of impulse control training as part of diabetes management.
Publisher: JMIR Publications Inc.
Date: 21-04-2023
Abstract: espite the fact that commercially developed automated insulin delivery (AID) systems have recently been approved and become available in a limited number of countries, they are not universally available, accessible, or affordable. Therefore, ‘open-source’ AID systems, co-created by an online community of people with diabetes (PwD) and their families behind the hashtag ‘#WeAreNotWaiting’, have become increasingly popular. his study focused on lived experiences, physical and emotional health implications of PwD following the initiation of open-source AID, their perceived challenges, and sources of support, which have not been explored by the existing literature. ata were collected from 383 participants across 29 countries through two sets of open-ended questions of a web-based survey regarding their experience of building and using open-source AID. Narratives were thematically analyzed and a coding framework was identified through iterative alignment. mprovements in glycemia, physical health, sleep quality, emotional impact on everyday life and quality of life were consistently reported. Knowledge of open-source AID was largely obtained through the #WeAreNotWaiting community, which was also the primary source of practical and emotional support. Acquisition of the components to build open-source AID and technical set-up were sometimes problematic. he #WeAreNotWaiting movement represents a primary ex le of how informed and connected patients proactively address their unmet needs, provide peer-support to each other and result in impactful user-driven solutions. Alongside evidence on the safety and efficacy of open-source AID, this qualitative analysis helps understand how patients’ experience and benefits range from psychosocial improvements to a reduction in the burden of managing diabetes. R2-10.2196/15368
Publisher: Springer Science and Business Media LLC
Date: 12-08-2020
DOI: 10.1186/S12889-020-09287-Z
Abstract: Associations between high BMI and sleep duration and chronic illness are recognised. Short sleep is an accepted predictor of high BMI for children, including Indigenous Australian children. Short sleep has also been associated with high BMI in Australian adults, although not specifically in Indigenous Australian adults. This study aims to determine whether the relationship between sleep duration and BMI observed in non-Indigenous adults holds for Indigenous adults. Data collected from 5204 non-Indigenous and 646 Indigenous participants aged over 18 years in a nationally representative Australian Health Survey 2011–2013 were analysed. Sleep duration was self-reported as the time between going to bed and time waking up BMI was derived from measurement and categorised into normal weight (BMI = 18.5–24.9) and overweight/obese (BMI ≥ 25). Logistic regression was performed for the non-Indigenous and Indigenous groups separately to examine the association between sleep duration and BMI in each group. Proportionally more Indigenous people were classified as overweight/obese than non-Indigenous (χ 2 = 21.81, p 0.001). Short sleep was reported by similar proportions in both groups (Indigenous 15% vs non-Indigenous 17%) whereas long sleep of 9 h was reported by proportionally more Indigenous than non-Indigenous people (41% vs 26%). Without accounting for possible confounders, the association between sleep duration and BMI for the Indigenous group was not significant but a possible dose-response relationship was evident, with the odds of overweight/obesity being greatest for those who typically slept 7 h (OR = 1.77, 95% CI 0.38–3.94) and 6 h (OR = 1.55, 95%CI = 0.58–4.14). The same model for the non-Indigenous group was significant, with the odds of overweight/obesity being greatest for those who typically slept 6 h (OR = 1.67, 95%CI 1.25–2.25). The risk of overweight/obesity diminished for both groups with sleep 7 h. Accounting for a range of socioeconomic and personal confounders attenuated the strength of these relationships marginally. Adding to reports relating sleep duration and BMI for Australian adults, this study provides evidence for an inverse relationship in non-Indigenous adults and suggests a similar trend for Indigenous adults. This trend was non-significant but is consistent with previous results for Indigenous children.
Publisher: Frontiers Media SA
Date: 09-06-2022
DOI: 10.3389/FPSYG.2022.876131
Abstract: Hand hygiene is an integral public health strategy in reducing the transmission of COVID-19, yet the past research has shown hand hygiene practices among the public is sub-optimal. This study aimed to (1) quantify hand sanitization rates among the public to minimize the transmission of COVID-19 and (2) evaluate whether different public health messaging, based on various behavior-change theories influences hand hygiene behavior in a natural setting. An observational, naturalistic study design was used with real-time customer activity data recorded against hand sanitizer usage in a regional hardware store. Primary outcome from the study was to measure the usage ratio by counting the amount of activity versus usage of hand sanitizer per hour against in idual messages based on their behavioral change technique (BCT). There was no significant difference between the baseline message and any of the intervention messages [ F (16,904) = 1.19, p = 0.279] or between BCT groups [ F (3,906) = 1.33, p = 0.263]. Post hoc tests showed no significant difference between messages (social comparison, p = 0.395 information, p = 1.00 and action planning, p = 1.00). This study showed that even during a pandemic, hand hygiene usage rates in a public setting were similar to the past studies and that compliance did not shift dependent on the public message displayed. This raises questions on whether requirements imposed on businesses to provide hand sanitizer to patrons are an ineffective and maybe an unnecessary economic burden. A measured approach to risk and behavioral analysis surrounding the use of hand sanitizer in a pandemic is suggested as a better approach to inform public policy on the value of hand sanitizer.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/WF13141
Abstract: In an effort to reduce wildfire risk to community members, researchers and practitioners have sought to identify the factors that are most effective in motivating community members to engage in preparatory behaviours. Quantitative research in this area has been h ered, however, by a lack of consistency in, and validation of household wildfire preparedness assessments. Consequences have included a difficulty in comparing results across quantitative studies, a poor collective understanding of how existing preparedness assessments were developed and an inability to ascertain how specific preparedness actions are tied to householders’ responses to wildfire. We propose to resolve these issues by (1) presenting a definition of wildfire preparedness for adoption as the standard in quantitative studies, (2) developing a typology of wildfire preparedness that distinguishes between household wildfire goals (i.e. safe evacuation, effective active defence and improving the fire resistance of a property in the absence of an active defender), (3) constructing two new standardised measures of preparedness and (4) undertaking a community survey to investigate the validity of the measures. The development of the new measures will facilitate the standardisation of future research into wildfire preparedness, while differentiating between types of preparedness, and is expected to yield practical benefits.
Publisher: American Diabetes Association
Date: 06-2021
DOI: 10.2337/DB21-712-P
Abstract: Background: Despite observational evidence for the efficacy and safety of open-source automated insulin delivery (OS-AID) there is a lack of guidance for healthcare providers. The ethics of providing care for those using unregulated technology is a concern. Methods: Consensus guidelines are in development, through the OPEN project, by an experienced multi-disciplinary group of endocrinologists, diabetes care and education specialists, exercise physiologists and psychologists. Results: The principles of biomedical ethics - autonomy, justice, beneficence and non-maleficence - provide a framework for analysis. Autonomy requires that the user understands system risks and benefits. OS-AID provides complete transparency and customization, facilitating understanding and control. Algorithms used in commercial systems are proprietary, impeding the ability to discuss and personalize operation. Justice requires burdens and benefits be distributed fairly. Commercial systems are not uniformly accessible. OS-AID provides freely available software and allows the mixing and matching of compatible CGMs and pumps, supporting equity. Beneficence means doing good for the in idual. In real-world observational trials both open-source (OpenAPS: n=34, mean TIR 71-& % at max 2.5 years Loop: n=558, mean TIR 67-& % at 6 months) and commercial AID systems (670G: n=3141, mean TIR 66-& % at 3 months Control-IQ: n=1659, median TIR: 68-& % at 1 month) provide a statistically significant and clinically meaningful increase in TIR at the population level. Non-maleficence requires treatment does not harm the in idual. AID systems can reduce burden, hypoglycemia and hyperglycemia. Conclusions: The international consensus group concludes OS-AID is ethical, but unregulated. We recommend legal interpretations and frameworks be clarified and updated so that in iduals are not deprived of beneficial therapy. Commercial AID systems may benefit from transparency and equity offered by OS-AID systems. K. Braune: None. M. Riddell: Advisory Panel Self Zealand Pharma A/S, Consultant Self Lilly Diabetes, Research Support Self Dexcom, Inc., Insulet Corporation, Speaker’s Bureau Self Novo Nordisk Inc., Sanofi, Stock/Shareholder Self Zucara Therapeutics Inc. T. C. Skinner: Advisory Panel Self Liva Health Care, Novo Nordisk. K. Raile: Advisory Panel Self Abbott Diabetes, Lilly Diabetes, Research Support Self Dexcom, Inc. C. Johnston: None. R. Lal: Consultant Self Abbott Diabetes, Biolinq, Capillary Biomedical, Inc., Morgan Stanley, Tidepool. S. Hussain: Speaker’s Bureau Self Novo Nordisk. M. Quigley: None. L. Petruzelkova: None. G. Scheiner: Advisory Panel Self Capillary Biomedical, Inc., Companion Medical, Eli Lilly and Company, Consultant Self ADOCIA, Ascensia Diabetes Care, mySugr, Triple Jump, Ypsomed, Speaker’s Bureau Self Dexcom, Inc., Xeris Pharmaceuticals, Inc. P. Winterdijk: None. S. Schmidt: None. L. H. Raimond: None. K. K. Hood: Consultant Self Cecelia Health, Cercacor, LifeScan Diabetes Institute. National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007217, 1K12DK122550, 1K23DK122017, P30DK116074) European Commission’s Horizon 2020 Research and Innovation Programme/Marie Sklodowska-Curie Action Research and Innovation Staff Exchange (RISE) grant agreement number 823902
Publisher: Wiley
Date: 08-2022
DOI: 10.1111/AJR.12913
Publisher: Hindawi Limited
Date: 23-03-2018
DOI: 10.1111/PEDI.12646
Abstract: The purpose of this study was to estimate clinician qualities that influence metabolic outcomes in youth with type 1 diabetes. Data were gathered over two 3 month periods in a large tertiary diabetes center (1500 patients, 8 clinicians) from patients with type 1 diabetes who received continuous care from each clinician. Data included sex, age, diabetes duration, insulin regimen, body mass index (BMI), insulin dose and episodes of severe hypoglycemia. Clinician data included target blood glucose levels, target glycated hemoglobin (HbA1c), Diabetes Attitude Scale and Big 5 Personality Inventory Scale. Mean HbA1c per clinician was the primary outcome variable. The 8 clinicians saw a total of 464 patients during the first time period, and 603 in the second time period. Lowest to highest mean HbA1c per clinician varied by 0.7%. There were small but statistically significant differences between clinicians with their patients' age at diagnosis, duration of diabetes, age, gender, treatment type and BMI SD score. After controlling for these differences, the clinician characteristics that were associated with lower mean HbA1c were having no lower limit in target HbA1c and being self-reportedly "less agreeable." The impact of these clinician attitudinal traits was equivalent to the combined effects of patient characteristics and treatment type. There was a significant variation in metabolic outcomes between treating clinicians. After controlling for patient clinical differences, clinician mean HbA1c was associated with lower limit in target HbA1c and being "less agreeable." Clinicians who were more demanding and dogmatic appeared to have better outcomes.
Publisher: Public Library of Science (PLoS)
Date: 08-08-2018
Publisher: Public Library of Science (PLoS)
Date: 26-07-2016
Publisher: Elsevier BV
Date: 06-0033
Publisher: Hindawi Limited
Date: 06-2009
DOI: 10.1111/J.1399-5448.2008.00495.X
Abstract: The Hvidoere Study Group on Childhood Diabetes has demonstrated persistent differences in metabolic outcomes between pediatric diabetes centers. These differences cannot be accounted for by differences in demographic, medical, or treatment variables. Therefore, we sought to explore whether differences in physical activity or sedentary behavior could explain the variation in metabolic outcomes between centers. An observational cross-sectional international study in 21 centers, with demographic and clinical data obtained by questionnaire from participants. Hemoglobin A1c (HbA1c) levels were assayed in one central laboratory. All in iduals with diabetes aged 11-18 yr (49.4% female), with duration of diabetes of at least 1 yr, were invited to participate. In iduals completed a self-reported measure of quality of life (Diabetes Quality of Life - Short Form [DQOL-SF]), with well-being and leisure time activity assessed using measures developed by Health Behaviour in School Children WHO Project. Older participants (p < 0.001) and females (p < 0.001) reported less physical activity. Physical activity was associated with positive health perception (p < 0.001) but not with glycemic control, body mass index, frequency of hypoglycemia, or diabetic ketoacidosis. The more time spent on the computer (r = 0.06 p < 0.05) and less time spent doing school homework (r = -0.09 p < 0.001) were associated with higher HbA1c. Between centers, there were significant differences in reported physical activity (p < 0.001) and sedentary behavior (p < 0.001), but these differences did not account for center differences in metabolic control. Physical activity is strongly associated with psychological well-being but has weak associations with metabolic control. Leisure time activity is associated with in idual differences in HbA1c but not with intercenter differences.
Publisher: Elsevier BV
Date: 09-2009
DOI: 10.1016/J.DIABRES.2009.05.006
Abstract: 259 adults with type 1 diabetes completed measure of anxiety, depression and diabetes specific distress, HbA1c from medical records. Anxiety not depression predicted HbA1c, this association was mediated by illness specific cognitions. Targeting illness specific cognitions may be more productive than treatment of general dysphoria in type 1 diabetes.
Publisher: Springer Science and Business Media LLC
Date: 17-05-2015
DOI: 10.1007/S11325-014-1000-2
Abstract: Obstructive sleep apnea (OSA) is a common disorder that is associated with impaired attention, memory and executive function. However, the mechanisms underlying such dysfunction are unclear. To determine the influence of sleep fragmentation and hypoxia, this study examined the effect of sleep fragmentation and hypoxia on cognition in OSA, while controlling for potentially confounding variables including sleepiness, age and premorbid intelligence. Participants with and without OSA (N = 150) were recruited from the general community and a tertiary hospital sleep clinic. All underwent comprehensive, laboratory-based polysomnography (PSG) and completed assessments of cognition including attention, short- and long-term memory and executive function. Structural equation modelling (SEM) was used to construct a theoretically-driven model to examine the relationships between hypoxia and sleep fragmentation, and cognitive function. Although after controlling for IQ, increased sleep disturbance was a significant predictor of decreased attention (p = 0.04) and decreased executive function (p = 0.05), controlling for age removes these significant relationships. No significant predictors of memory function were found. The mechanisms underlying the effects of OSA on cognition remain to be defined. Implications are discussed in light of these findings.
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.DIABRES.2011.03.013
Abstract: The impact differential of diabetes for Aboriginal maternal and infant health outcomes is different to Caucasian outcomes. With maternal diabetes, Aboriginal infant's birth weight increases and stillbirth rate is 22/1000 for gestational diabetes mellitus (GDM) and 53/1000 for pre-existing diabetes while for Caucasian infant's birth weight decreases and stillbirth rate is 3/1000 for GDM and 11/1000 for pre-existing diabetes. Equity of services is required to achieve equality of health outcomes.
Publisher: Wiley
Date: 28-11-2020
DOI: 10.1111/JSR.12958
Abstract: Obstructive sleep apnea (OSA) is a widely prevalent disorder that can affect cognitive function. The relationship between cognitive function and OSA is known to be affected by an in idual's premorbid cognitive ability. Tools to measure premorbid intelligence across OSA disease severity have not been validated. This brief report aims to establish if the National Adult Reading Test (NART) provides a stable estimate of premorbid intelligence across levels of OSA disease severity. We examined if NART scores varied systematically across levels of untreated OSA severity (defined according to the apnea-hypopnea index [AHI]) and mean oxygen saturation in sleep clinic (n = 121) and community s les (n = 398) using regression analysis. Simple linear regression was used to predict NART scores based on the AHI. NART-estimated premorbid IQ scores without demographics did not vary systematically with AHI (F < 1 β = 0.01) or mean SpO
Publisher: Wiley
Date: 22-12-2019
DOI: 10.1111/DME.14208
Publisher: Elsevier BV
Date: 03-2023
Publisher: Springer Science and Business Media LLC
Date: 12-05-2014
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.JDIACOMP.2016.11.013
Abstract: To assess prevalence of severe hypoglycemia, awareness and symptoms of hypoglycemia, and their associations with self-monitoring of blood glucose. Diabetes MILES-Australia Study participants completed validated questionnaires and study-specific items. Of 642 adults with type 1 diabetes, 21% reported ≥1 severe hypoglycemic event in the past six months, and 21% reported impaired awareness of hypoglycemia (IAH). Severe hypoglycemia was increased four-fold for those with IAH compared with intact awareness (1.4±3.9 versus 0.3±1.0). Of those with IAH, 92% perceived autonomic and 88% neuroglycopenic symptoms, albeit at lower glucose thresholds compared to people with intact awareness. Those with IAH were more likely to perceive both symptom types at the same glucose level or to perceive neuroglycopenic symptoms first (all p<0.001). Eighteen percent with IAH treated hypoglycemia only when they perceived symptoms and another 18% only when their capillary glucose was <3.0mmol/L. One in five adults with type 1 diabetes had IAH or experienced severe hypoglycemia in the past sixmonths. Total loss of hypoglycemia symptoms was rare most people with IAH retained autonomic symptoms, perceived at relatively low glucose levels. Frequent self-monitoring of blood glucose prompted early recognition and treatment of hypoglycemia, suggesting severe hypoglycemia risk can be minimized.
Publisher: Elsevier BV
Date: 12-2023
Publisher: Wiley
Date: 04-2009
DOI: 10.1111/J.1464-5491.2009.02697.X
Abstract: To critically appraise the suitability, validity, reliability, feasibility and sensitivity to change of available psychometric tools for measuring the education outcomes identified in the (Australian) National Consensus on Outcomes and Indicators for Diabetes Patient Education. Potentially suitable psychometric measurement tools were identified through a two-step process. Step 1: a structured semi-systematic literature review and consultation with experts step 2: development of inclusion criteria and a formal, purpose-designed, systematically derived Appraisal Checklist-from the literature and with expert psychometric advice-to critically appraise the identified tools for relevance, validity, reliability, responsiveness to change, burden, feasibility and acceptability. Searching medline, PubMed, PsycINFO and cinhal yielded 37 diabetes-specific and generic measurement tools. Eleven of these did not address the research questions, leaving 26 tools. Of these, 11 assessed indicators of psychological adjustment seven assessed various domains of self-determination five measured self-management behaviours, for ex le, foot care, blood glucose testing and lifestyle domains and three measured diabetes knowledge und understanding, respectively. When the Appraisal Checklist was applied, only three tools met all criteria, namely the Problem Areas in Diabetes (PAID) scale, the Summary of Diabetes Self-Care Activities (SDSCA) scale and the Appraisal of Diabetes Scale (ADS). However, a number of other suitable tools [i.e. the Diabetes Integration Scale (ATT19), the Diabetes Health Profile (DHP-1/18), the Self-Care Inventory-Revised (SCI-R), the Diabetes Management Self Efficacy Scale Australian/English version (DMSES-A/E), the Diabetes Empowerment Scale-Short Form (DES-SF)] met all except one criteria, that is, either no formal test-retest or no responsiveness to change data. Although numerous tools were identified, few met rigorous psychometric appraisal criteria. Issues of suitability, adequate psychometric testing for the intended purpose, burden and feasibility need to be considered before adopting tools for measuring diabetes education outcomes.
Publisher: The Sax Institute
Date: 09-2020
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.PCD.2010.01.002
Abstract: To estimate the prevalence of metabolic syndrome in a general population s le of south Asians and white Europeans and compare predictors of metabolic syndrome, using ethnic specific definitions of obesity. 3099 participants (71.4% white European, 28.6% south Asian) aged 40-75 years were screened using a 75 g oral glucose tolerance test. Metabolic syndrome was defined using National Cholesterol Education Programme and International Diabetes Federation definitions. We compared sensitivity, specificity and area under the curve of waist circumference, body mass index and waist-hip ratio. The prevalence of metabolic syndrome using the definitions above was 29.9% (29.2% south Asian, 30.2% white European), and 34.4% (34.2% south Asian, 34.5% white European), respectively. Using the National Cholesterol Education Programme definition, waist circumference was significantly more predictive of metabolic syndrome than body mass index or waist-hip ratio. The area under the curve for waist circumference was 0.75 (95% CI: 0.69-0.80) and 0.76 (0.72-0.81) for south Asian men and women 0.83 (0.80-0.85) and 0.80 (0.77-0.82) for white European men and women. The prevalence of metabolic syndrome is high in both south Asian and white European populations. Waist circumference is a simple and effective measure for predicting metabolic syndrome in different populations.
Publisher: Wiley
Date: 15-08-2006
DOI: 10.1111/J.1464-5491.2006.01816.X
Abstract: A systematic review of the literature in 2000 revealed numerous methodological shortcomings in education research, but in recent years progress has been made in the quantity and quality of psycho-educational intervention studies. This review focuses on diabetes education programmes developed for children, young people and their families in the past 5 years. A comprehensive review of the literature identified 27 articles describing the evaluation of 24 psycho-educational interventions. Data summary tables compare the key features of these, and comparisons are made between in idual, group and family-based interventions. Effect sizes are calculated for nine of the randomized studies. Three research questions are posed: firstly has the recent literature addressed the problems highlighted in the previous review secondly is there sufficient evidence to recommend adaptation of a particular programme and, finally, what do we still need to do? Progress in the quality and quantity of educational research has not resulted in improved effectiveness of interventions. There is still insufficient evidence to recommend adaptation of a particular educational programme and no programme that has been proven effective in randomized studies for those with poor glycaemic control. To develop a range of effective educational interventions, further research involving larger s le sizes with multicentre collaboration is required.
Publisher: Elsevier BV
Date: 12-2020
Publisher: Springer Science and Business Media LLC
Date: 30-06-0026
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/AJR.12805
Abstract: To describe the population distribution and socio‐economic position of residents across all states and territories of Australia, stratified using the 7 Modified Monash Model classifications. The numerical summary, and the methods described, can be applied by a variety of end users including workforce planners, researchers, policy‐makers and funding bodies for guiding future investment under different scenarios, and aid in evaluating geographically focused programs. The Commonwealth Department of Health is transitioning to the Modified Monash Model to objectively describe geographical access. This change applies to the Rural Health Multidisciplinary Training Program, one of the Australian Government's key policies to address the maldistribution of the rural health workforce. Unlike the previously applied Australian Statistical Geography Standard‐Remoteness Areas, a summary of the population in each Modified Monash Model classification is not available, nor is a socio‐economic overview of the communities within these areas. Spatial analysis of Australian Bureau of Statistics data (Modified Monash Model, population data and the Index of Relative Socio‐economic Advantage and Disadvantage collected or derived from the 2016 census) at the Statistical Area 1—the smallest unit for the release of census data. Linking the Modified Monash Model, a socio‐economic index and granular population data at the national level highlights the disadvantage of many residents in small rural towns (Modified Monash 5). The Modified Monash Model does not exhibit a continuum of the largest population residing in the most accessible classification and the smallest population residing in the least accessible classification that is seen in the Australian Statistical Geography Standard‐Remoteness Areas. Coupled with policy relevance, the advantage of using the Modified Monash Model as the basis for analysis is that it highlights areas that have both a critical mass of residents and differing levels of socio‐economic advantage and disadvantage. This will help end users to target funding to those regions where there is potential to improve access to services for the greatest number of rural residents.
Publisher: Wiley
Date: 2001
DOI: 10.1002/PDI.197
Publisher: JMIR Publications Inc.
Date: 04-07-2019
Abstract: igital innovations in health care have traditionally followed a top-down pathway, with manufacturers leading the design and production of technology-enabled solutions and those living with chronic conditions involved only as passive recipients of the end product. However, user-driven open-source initiatives in health care are becoming increasingly popular. An ex le is the growing movement of people with diabetes, who create their own “Do-It-Yourself Artificial Pancreas Systems” (DIYAPS). he overall aim of this study is to establish the empirical evidence base for the clinical effectiveness and quality-of-life benefits of DIYAPS and identify the challenges and possible solutions to enable their wider diffusion. research program comprising 5 work packages will examine the outcomes and potential for scaling up DIYAPS solutions. Quantitative and qualitative methodologies will be used to examine clinical and self-reported outcome measures of DIYAPS users. The majority of members of the research team live with type 1 diabetes and are active DIYAPS users, making italic Outcomes of Patients’ Evidence With Novel, Do-It-Yourself Artificial Pancreas Technology /italic (OPEN) a unique, user-driven research project. his project has received funding from the European Commission’s Horizon 2020 Research and Innovation Program, under the Marie Skłodowska-Curie Action Research and Innovation Staff Exchange. Researchers with both academic and nonacademic backgrounds have been recruited to formulate research questions, drive the research process, and disseminate ongoing findings back to the DIYAPS community and other stakeholders. he OPEN project is unique in that it is a truly patient- and user-led research project, which brings together an international, interdisciplinary, and intersectoral research group, comprising health care professionals, technical developers, biomedical and social scientists, the majority of whom are also living with diabetes. Thus, it directly addresses the core research and user needs of the DIYAPS movement. As a new model of cooperation, it will highlight how researchers in academia, industry, and the patient community can create patient-centric innovation and reduce disease burden together. RR1-10.2196/15368
Publisher: Oxford University Press (OUP)
Date: 10-2004
Abstract: Type 2 diabetes treatment outcomes ultimately depend on patients and their ability to make long-term behavioural changes that support good self-care and metabolic control. Patients' perceptions about diabetes and diabetes-related complications can have a strong influence on their emotional well-being, as well as day-to-day self-care and the quality of metabolic control. The gravity of diabetes is often underestimated, and many patients do not understand the link between poor glycaemic control and long-term complications of the disease. Similarly, people with diabetes commonly undervalue the role of lifestyle changes and pharmacological therapy in preventing future complications. Negative emotions and preconceptions about treatment can also discourage adherence to treatment plans. 'Psychological insulin resistance' caused by fear and concerns about insulin and daily insulin injections can discourage many patients from starting insulin therapy, even if oral agents have failed. Depression, stress and anxiety represent further obstacles to optimum self-care and the attainment of glucose goals. Healthcare professionals should endeavour to understand and accommodate these issues when setting personal treatment goals and developing plans to achieve them. Importantly, the advice and support they provide should be tailored to the unique needs of each patient. There is scope to improve outpatient consultations to ensure agreement between patients and professionals concerning issues discussed and decisions made, and this may help to improve recall and motivation to manage diabetes. Engaging patients in the goal-setting process can help to overcome potential barriers to good self-care and may increase the probability that treatment goals are achieved.
Publisher: JMIR Publications Inc.
Date: 18-09-2023
DOI: 10.2196/51431
Publisher: Wiley
Date: 16-05-2017
DOI: 10.1111/DME.13372
Abstract: To describe the long-term trajectories of depression symptom severity in people with Type 2 diabetes, and to identify predictors and associates of these trajectories. A community-dwelling cohort of 1201 in iduals with Type 2 diabetes from the Fremantle Diabetes Study Phase II was followed for 5 years. The nine-item version of the Patient Health Questionnaire was administered annually to assess depression symptoms, and biomedical and psychosocial measures were assessed at baseline and biennially. Latent class growth analysis was used to identify classes of depression severity trajectories and associated outcomes, and logistic regression models were used to determine predictors of class membership. Three trajectories of depression symptoms were identified: continuously low depression symptoms (85.2%) gradually worsening symptoms that then began to improve (persistent depression - low-start 7.3%) and gradually improving symptoms which later worsened (persistent depression - high-start 7.5%). Younger age, being a woman, and a lifetime history of major depressive disorder, were associated with greater risk of persistent depression symptoms. Persistent depression was associated with consistently higher BMI over time, but not with changes in HbA A subset of in iduals with Type 2 diabetes is at risk of depression symptoms that remain elevated over time. Younger, overweight in iduals with a history of depression may benefit from early and intensive depression management and ongoing follow-up as part of routine Type 2 diabetes care.
Publisher: Wiley
Date: 07-2020
DOI: 10.1111/DME.14344
Publisher: Wiley
Date: 21-08-2019
DOI: 10.1111/DME.14102
Abstract: Time preferences, i.e. in iduals' degree of patience/impatience in intertemporal choice, have been found to be associated with suboptimal health behaviours and health outcomes such as smoking, physical inactivity, unhealthy food intake and obesity. In this systematic review, we aimed to synthesise reported associations between time preferences, diabetes self-management behaviours, including use of diabetes technology, and outcomes. We searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit and all databases in the Web of Science Core Collection. Peer-reviewed studies of people with diabetes that included at least one diabetes-related behaviour or outcome and a measure of time preferences were included. Non-English language studies were excluded. A total of 961 records were identified, of which 12 articles were included. Three studies analysed both time-consistent and time-inconsistent preferences, three studies solely analysed time-inconsistent preferences and six studies did not explicitly define a time preference model. Measured outcomes across studies included self-care activities, such as medication-taking, exercising and eating a healthy diet, and biomedical outcomes, such as HbA Associations between measures of time preferences, diabetes self-management behaviours and clinical outcomes exist. Higher discount rates determined by both time-consistent and time-inconsistent models predict less diabetes-related self-care and worse outcomes. These findings may add to explanations of the observed variation in diabetes-related health and provide new insights for tailoring interventions and policies aimed at improving diabetes self-management.
Publisher: Springer Science and Business Media LLC
Date: 15-11-2021
Publisher: Wiley
Date: 26-08-2014
DOI: 10.1111/DME.12287
Abstract: The aim of this study was to explore the cognitive representations of peripheral neuropathy and self-reported foot-care behaviour in an Australian s le of people with diabetes and peripheral neuropathy. This cross-sectional study was undertaken with 121 participants with diabetes and peripheral neuropathy. Cognitive representations of peripheral neuropathy were measured by the Patients' Interpretation of Neuropathy questionnaire and two aspects of self-foot-care behaviour were measured using a self-report questionnaire. Hierarchical cluster analysis using the average linkage method was used to identify distinct illness schemata related to peripheral neuropathy. Three clusters of participants were identified who exhibited distinct illness schemata related to peripheral neuropathy. One cluster had more misperceptions about the nature of peripheral neuropathy, one cluster was generally realistic about the nature of their condition and the final cluster was uncertain about their condition. The cluster with high misperceptions of their condition undertook more potentially damaging foot-care behaviours than the other clusters (F = 4.98 P < 0.01). People with diabetes and peripheral neuropathy have different illness schemata that may influence health-related behaviour. Education aimed at improving foot-care behaviour and foot-health outcomes should be tailored to specific illness schemata related to peripheral neuropathy.
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.PEC.2007.12.007
Abstract: We examined the accuracy of type 2 diabetes (T2D) patients' risk estimates of developing coronary heart disease (CHD)/having a stroke as a consequence of diabetes and their mood about these risks. Patients reported their perceived risks of developing CHD/having a stroke and rated their mood about these risks using a self-report measure. Using an objective risk calculator, they were then told their actual risk of CHD and stroke and their mood was re-assessed. Patients' estimates of their risk of CHD/stroke were grossly inflated. A negative relationship between disease risk and mood was also seen where higher risk of actual and perceived CHD/stroke was related to worse mood. A positive relationship between mood and extent of perceptual error was further observed the more inaccurate patients' perceptions of CHD/stroke risk were, the better their mood. Mood improved after patients were given accurate risk information. T2D patients are unrealistically pessimistic about their risk of developing CHD/stroke. These risks and the extent of perceptual risk error are associated with mood, which improves upon providing patients with accurate risk information about CHD/stroke. These results have implications for the routine communication of risk to T2D patients.
Publisher: Springer Science and Business Media LLC
Date: 17-10-2013
Abstract: Gestational diabetes mellitus (GDM) is defined as glucose intolerance with its onset or first recognition during pregnancy. Post-GDM women have a life-time risk exceeding 70% of developing type 2 diabetes mellitus (T2DM). Lifestyle modifications reduce the incidence of T2DM by up to 58% for high-risk in iduals. The Mothers After Gestational Diabetes in Australia Diabetes Prevention Program (MAGDA-DPP) is a randomized controlled trial aiming to assess the effectiveness of a structured diabetes prevention intervention for post-GDM women. This trial has an intervention group participating in a diabetes prevention program (DPP), and a control group receiving usual care from their general practitioners during the same time period. The 12-month intervention comprises an in idual session followed by five group sessions at two-week intervals, and two follow-up telephone calls. A total of 574 women will be recruited, with 287 in each arm. The women will undergo blood tests, anthropometric measurements, and self-reported health status, diet, physical activity, quality of life, depression, risk perception and healthcare service usage, at baseline and 12 months. At completion, primary outcome (changes in diabetes risk) and secondary outcome (changes in psychosocial and quality of life measurements and in cardiovascular disease risk factors) will be assessed in both groups. This study aims to show whether MAGDA-DPP leads to a reduction in diabetes risk for post-GDM women. The characteristics that predict intervention completion and improvement in clinical and behavioral measures will be useful for further development of DPPs for this population. Australian New Zealand Clinical Trials Registry ANZCTRN 12610000338066
Publisher: BMJ
Date: 08-2017
Publisher: American Psychological Association (APA)
Date: 10-2018
DOI: 10.1037/PLA0000075
Publisher: Springer Science and Business Media LLC
Date: 22-11-2021
Publisher: Springer Science and Business Media LLC
Date: 09-2020
DOI: 10.1186/S12913-020-05680-X
Abstract: Many women with hyperglycaemia in pregnancy do not receive care during and after pregnancy according to standards recommended in international guidelines. The burden of hyperglycaemia in pregnancy falls disproportionately upon Indigenous peoples worldwide, including Aboriginal and Torres Strait Islander women in Australia. The remote and regional Australian context poses additional barriers to delivering healthcare, including high staff turnover and a socially disadvantaged population with a high prevalence of diabetes. A complex health systems intervention to improve care for women during and after a pregnancy complicated by hyperglycaemia will be implemented in remote and regional Australia (the Northern Territory and Far North Queensland). The Theoretical Domains Framework was used during formative work with stakeholders to identify intervention components: (1) increasing workforce capacity, skills and knowledge and improving health literacy of health professionals and women (2) improving access to healthcare through culturally and clinically appropriate pathways (3) improving information management and communication (4) enhancing policies and guidelines (5) embedding use of a clinical register as a quality improvement tool. The intervention will be evaluated utilising the RE-AIM framework at two timepoints: firstly, a qualitative interim evaluation involving interviews with stakeholders (health professionals, ch ions and project implementers) and subsequently a mixed-methods final evaluation of outcomes and processes: interviews with stakeholders survey of health professionals an audit of electronic health records and clinical register and a review of operational documents. Outcome measures include changes between pre- and post-intervention in: proportion of high risk women receiving recommended glucose screening in early pregnancy diabetes-related birth outcomes proportion of women receiving recommended postpartum care including glucose testing health practitioner confidence in providing care, knowledge and use of relevant guidelines and referral pathways, and perception of care coordination and communication systems changes to health systems including referral pathways and clinical guidelines. This study will provide insights into the impact of health systems changes in improving care for women with hyperglycaemia during and after pregnancy in a challenging setting. It will also provide detailed information on process measures in the implementation of such health system changes.
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S13063-021-05892-4
Abstract: Gestational diabetes (GDM) impacts 8–18% of pregnancies and greatly increases both maternal and child risk of developing non-communicable diseases such as type 2 diabetes and obesity. Whilst lifestyle interventions in pregnancy and postpartum reduce this risk, a research translation gap remains around delivering implementable interventions with adequate population penetration and participation. Impact Diabetes Bump2Baby is an implementation project of an evidence-based system of care for the prevention of overweight and obesity. Bump2Baby and Me is the multicentre randomised controlled trial investigating the effectiveness of a mHealth coaching programme in pregnancy and postpartum for women at high risk of developing GDM. Eight hundred women will be recruited in early pregnancy from 4 clinical sites within Ireland, the UK, Spain, and Australia. Women will be screened for eligibility using the validated Monash GDM screening tool. Participants will be enrolled from 12 to 24 weeks’ gestation and randomised on a 1:1 basis into the intervention or control arm. Alongside usual care, the intervention involves mHealth coaching via a smartphone application, which uses a combination of synchronous and asynchronous video and text messaging, and allows for personalised support and goal setting with a trained health coach. The control arm receives usual care. All women and their children will be followed from early pregnancy until 12 months postpartum. The primary outcome will be a difference in maternal body mass index (BMI) of 0.8 kg/m 2 at 12 months postpartum. Secondary maternal and infant outcomes include the development of GDM, gestational weight gain, pregnancy outcomes, improvements in diet, physical activity, sleep, and neonatal weight and infant growth patterns. The 5-year project is funded by the EU Commission Horizon 2020 and the Australian National Health and Medical Research Council. Ethical approval has been received. Previous interventions have not moved beyond tightly controlled efficacy trials into routine service delivery. This project aims to provide evidence-based, sustainable support that could be incorporated into usual care for women during pregnancy and postpartum. This study will contribute evidence to inform the early prevention of non-communicable diseases like obesity and diabetes in mothers and the next generation. Australian New Zealand Clinical Trials Registry ACTRN12620001240932 . Registered on 19 November 2020
Publisher: OMICS Publishing Group
Date: 11-2009
DOI: 10.4066/AMJ.2009.181
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.PEC.2008.04.006
Abstract: The paper presents the development of a coding tool for self-efficacy orientated interventions in diabetes self-management programmes (Analysis System for Self-Efficacy Training, ASSET) and explores its construct validity and clinical utility. Based on four sources of self-efficacy (i.e., mastery experience, role modelling, verbal persuasion and physiological and affective states), published self-efficacy based interventions for diabetes care were analysed in order to identify specific verbal behavioural techniques. Video-recorded facilitating behaviours were evaluated using ASSET. The reliability between four coders was high (K=0.71). ASSET enabled assessment of both self-efficacy based techniques and participants' response to those techniques. In idual patterns of delivery and shifts over time across facilitators were found. In the presented intervention we observed that self-efficacy utterances were followed by longer patient verbal responses than non-self-efficacy utterances. These detailed analyses with ASSET provide rich data and give the researcher an insight into the underlying mechanism of the intervention process. By providing a detailed description of self-efficacy strategies ASSET can be used by health care professionals to guide reflective practice and support training programmes.
Publisher: Hindawi Limited
Date: 31-01-2018
DOI: 10.1111/PEDI.12641
Abstract: Glycated hemoglobin (HbA1c) is higher during adolescence than at any other life stage. Some research among adolescents indicates that depressive symptoms are associated with suboptimal HbA1c. However, research among adults suggests diabetes distress is a stronger predictor of HbA1c than depressive symptoms. To determine the relative contributions of depressive symptoms and diabetes distress to explain the variance in HbA1c among adolescents with type 1 diabetes. Diabetes MILES Youth Study respondents aged 13 to 19 years completed questionnaires assessing depressive symptoms (Patient Health Questionnaire for Adolescents: PHQA-8), diabetes distress (Problem Areas in Diabetes-Teen version: PAID-T), and self-reported socio-demographic and clinical variables, including their most recent HbA1c. Stepwise hierarchical multiple regression was conducted to examine the contributions of depressive symptoms and diabetes distress to HbA1c. Participants (N = 450) had a (mean ± SD) age of 15.7 ± 1.9 years diabetes duration of 6.9 ± 4.3 years and 38% (n = 169) were male. Twenty-one percent (n = 96) experienced moderate-to-severe depressive symptoms (PHQA-8 ≥ 11) and 36% (n = 162) experienced high diabetes distress (PAID-T > 90). In the final regression model, HbA1c was explained by: diabetes duration (β = .14, P = .001), self-monitoring of blood glucose (β = -.20, P < .001), and diabetes distress (β = .30, P < .001). Following the addition of diabetes distress, depressive symptoms were no longer significantly associated with HbA1c (P = .551). The final model explained 18% of the variance in HbA1c. Consistent with evidence from studies among adults, diabetes distress mediated the relationship between depressive symptoms and HbA1c among adolescents with type 1 diabetes. These findings suggest that clinicians need to be aware of diabetes distress.
Publisher: Rural and Remote Health
Date: 13-09-2023
DOI: 10.22605/RRH7704
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1016/J.PEC.2006.04.007
Abstract: To determine the effects of a structured education program on illness beliefs, quality of life and physical activity in people newly diagnosed with Type 2 diabetes. In iduals attending a diabetes education and self-management for ongoing and newly diagnosed (DESMOND) program in 12 Primary Care Trusts completed questionnaire booklets assessing illness beliefs and quality of life at baseline and 3-month follow-up, metabolic control being assessed through assay of HbA1c. Two hundred and thirty-six in iduals attended the structured self-management education sessions, with 97% and 64% completing baseline and 3-month follow-up questionnaires. At 3 months, in iduals were more likely to: understand their diabetes agree it is a chronic illness agree it is a serious condition, and that they can affect its course. In iduals achieving a greater reduction in HbA1c over the first 3 months were more likely to agree they could control their diabetes at 3 months (r=0.24 p=0.05), and less likely to agree that diabetes would have a major impact on their day to day life (r=0.35 p=0.006). Pilot data indicate the DESMOND program for in iduals newly diagnosed with Type 2 diabetes changes key illness beliefs and that these changes predict quality of life and metabolic control at 3-month follow-up. Newly diagnosed in iduals are open to attending self-management programs and, if the program is theoretically driven, can successfully engage with the true, serious nature of diabetes.
Publisher: AIP Publishing
Date: 12-2021
DOI: 10.1063/5.0071142
Abstract: Multi-photon theranostics, involving the absorption of two or three photons by luminogens, has come to occupy an important place in biomedical research, with its ability to allow real-time observation/treatment of dynamic structures in living cells and organisms. Luminogens with aggregation-induced emission characteristics are recognized as perfect candidates for multi-photon agents, owing to their flexibility of design, resistance to photobleaching, robust stability, and reduced cytotoxicity. Hence, in recent years, significant breakthroughs in design and application of such luminogens have been reported. In this review, we summarize the latest advances in molecular guidelines and photophysical process control for developing luminogens with large multi-photon action cross section. Special attention is paid to how the molecular structure and intermolecular interactions influence the intramolecular charge transfer, and how new strategies have been developed to advance the multi-photon imaging and therapeutic performance. With this review, we hope to encourage further exploitation of luminogens with aggregation-induced emission characteristics to advance multi-photon theranostics.
Publisher: American Diabetes Association
Date: 07-09-2017
DOI: 10.2337/DC17-0441
Abstract: To establish cut point(s) for the Problem Areas in Diabetes–teen version (PAID-T) scale to identify adolescents with clinically meaningful, elevated diabetes distress. Data were available from the Diabetes Management and Impact for Long-term Empowerment and Success (MILES) Youth–Australia Study, a national survey assessing various psychosocial indicators among self-selected National Diabetes Services Scheme registrants. Participants in the current study (n = 537) were (mean ± SD) 16 ± 2 years old, had type 1 diabetes for 6 ± 4 years, and 62% (n = 334) were girls. They completed measures of diabetes distress (PAID-T) and depressive symptoms (Patient Health Questionnaire for Adolescents) and self-reported their most recent HbA1c and frequency of self-monitoring of blood glucose (SMBG). Relationships between the PAID-T and the psychological and clinical variables were examined to identify a clinically meaningful threshold for elevated diabetes distress. ANOVA was used to test whether these variables differed by levels of distress. Two cut points distinguished none-to-mild (& ), moderate (70–90), and high (& ) diabetes distress. Moderate distress was experienced by 18% of adolescents and high distress by 36%. Mean depressive symptoms, self-reported HbA1c, and SMBG differed significantly across the three levels of diabetes distress (all P & 0.001), with moderate-to-large effect sizes. Using the PAID-T, this study defined two clinically meaningful cut points to distinguish none-to-mild, moderate, and high diabetes distress in adolescents (aged 13–19). Based on these cut points, most respondents experienced at least moderate diabetes distress, which was clinically significant. Establishing thresholds for elevated diabetes distress will aid clinicians and researchers to interpret PAID-T scores, prompt discussion and intervention for those with unmet needs, and enable the effectiveness of interventions to be evaluated.
Publisher: Wiley
Date: 24-11-2008
Publisher: Cambridge University Press (CUP)
Date: 12-2011
DOI: 10.1375/JRC.17.2.74
Abstract: This study examined barriers to physical activity reported in iduals with spinal cord injury (SCI) and the degree to which these barriers differed across varying degrees of independence. Participants were 65 in iduals recruited from the Western Australian Spinal Cord Injury database. Data on physical activity participation and perceived barriers to physical activity participation were collected using a cross-sectional survey and analysed using independent s les t-tests. We found that, regardless of level of ambulation or ability to transfer, few participants reported being physically active. While there were no significant differences in the amount of barriers reported by in iduals with different levels of independence, the type of barriers reported varied across groups.
Publisher: Springer Science and Business Media LLC
Date: 12-08-2016
Publisher: Oxford University Press (OUP)
Date: 24-12-2020
Abstract: Research has not definitively ascertained the circumstances that motivate people to live a healthier lifestyle. To redress this shortfall, we report two overlapping studies that examined whether people are more inclined to value health benefits that seem enduring and fundamental rather than transient or superficial—even after controlling effort and cost. In these studies, 242 participants indicated the degree to which they implement 17 health behaviours—as well as the extent to which they perceive the benefits of these behaviours as enduring and fundamental. Furthermore, participants completed a measure that gauges future clarity. Finally, they chose which of two drugs—drugs that differ only on the longevity of effects—they prefer. Participants were more inclined to implement health behaviours that seemed to generate enduring and fundamental benefits. This effect was more pronounced in people who perceive their future as vivid and certain. Furthermore, participants tended to choose the drug that was touted as generating more enduring benefits, even after controlling cost and effort. As these results imply, to encourage healthy behaviour, health practitioners should help people clarify their future goals and then advocate behaviours that generate lasting benefits.
Publisher: American Diabetes Association
Date: 07-2018
DOI: 10.2337/DB18-813-P
Abstract: Aims: We set out to test the hypothesis that intentional hyperglycemia at work (henceforward IHW) mediates the link between diabetes distress and glycemic control in working adults with type 1 diabetes. Methods: Clinical information on HbA1c, complications, diabetes duration and age was linked with self-report measures of psychosocial health and work life from people with type 1 diabetes of working age attending a specialist diabetes clinic in Denmark. Diabetes distress was assessed with a work-comprehensive measure encompassing the PAID-5 and two additional items assessing distress in reconciling diabetes and work life. IHW was assessed with one item. Glycemic control was assessed with HbA1c. Using structural equation modeling techniques we modelled a theory-based structural path model and tested the mediation hypothesis using bootstrap estimates and goodness-of-fit tests. Results: The s le consisted of 1,126 working adults with type 1 diabetes. The model suggested that the effect of diabetes distress on glycemic control was fully mediated by IHW. Diabetes distress was associated with more frequent IHW (β = .23, p & .001) which in turn was associated with elevated HbA1c (β = .28, p & .001). The final model was able to account for 20% of the variance of IHW, and 11% of the variance in glycemic control. There was an excellent fit to the data according to established criteria (in parenthesis) X2/DF=3.3 (& ), GFI=.995 (=.95), CFI=.990 (=.95), RMSEA=.047 [.030-.065] (& .050). Discussion: This study highlights the role of IHW as a mediator for the link between diabetes distress and glycemic control specific to working adults with type 1 diabetes. A sound understanding of the mechanisms linking diabetes distress to suboptimal glycemic control in working people with type 1 diabetes can inform intervention development and ultimately increase the chance of improving diabetes self-care and quality of life of working people with type 1 diabetes. U.M. Hansen: None. K. Olesen: None. T.C. Skinner: Board Member Self Decision Support Analytics. I. Willaing: None.
Publisher: Springer Science and Business Media LLC
Date: 07-10-2019
DOI: 10.1186/S12888-019-2263-8
Abstract: Research can inform culturally-appropriate care to strengthen social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter, the term ‘Indigenous Peoples’ is respectfully used and refers to all Aboriginal and/or Torres Strait Islander Peoples of Australia). We acknowledge the cultural ersity of Australia’s Indigenous First Peoples and they do not represent a homogenous group.) (hereafter Indigenous) Peoples. We explore the perspectives of primary healthcare staff and Indigenous patients about their willingness to and experiences participating in SEWB research. Process evaluation using grounded theory approaches of Getting it Right : The validation study , a national validation designed Indigenous SEWB research project ( N = 500). Primary healthcare staff ( n = 36) and community members ( n = 4) from nine of ten primary healthcare services involved with the research project completed qualitative semi-structured interviews. Interview data were triangulated with participant feedback (responses to structured questions and free-text feedback collected during Getting it Right ), study administrative data (participant screening logs, communication logs, study protocol, deviation logs and ethics correspondence) and interviewer field notes. Three themes about staff, patient and community perspectives concerning research participation developed: (1) considering the needs, risk, preferences and impact of participation in research for staff, patients and community (2) building staff confidence speaking to patients about research and SEWB problems and (3) patients speaking openly about their SEWB. Some staff described pressure to ensure patients had a positive experience with the research, to respond appropriately if patients became upset or SEWB problems were identified during interviews, or due to their dual role as community member and researcher. Patients and staff reported that patients were more likely to participate if they knew the staff outside of the service, especially staff with a shared cultural background, and they perceived SEWB as a community priority. Staff reported their skills speaking to patients about the research and SEWB improved during the research, which built their confidence. Contrary to staff preconceptions, staff and patients reported that many patients appreciated the opportunity to speak about their SEWB and contributing to research that may eventually enhance SEWB in their community. Our research project was considered acceptable by most staff and patients. The positive outcomes reported by staff and feedback from patients highlights the importance of providing opportunities for people to speak about their SEWB and for research-informed SEWB PHC care. Getting it Right is registered on ANZCTR12614000705684 .
Publisher: Elsevier BV
Date: 09-2010
DOI: 10.1016/J.PSYCHRES.2010.04.011
Abstract: This study investigated whether an analysis of narrative style (word use and cross-clausal syntax) of patients with symptoms of generalised anxiety and depression disorders can help predict the likelihood of successful participation in guided self-help. Texts by 97 people who had made contact with a primary care mental health service were analysed. Outcome measures were completion of the guided self-help programme, and change in symptoms assessed by a standardised scale (CORE-OM). Regression analyses indicated that some aspects of participants' syntax helped to predict completion of the programme, and that aspects of syntax and word use helped to predict improvement of symptoms. Participants using non-finite complement clauses with above-average frequency were four times more likely to complete the programme (95% confidence interval 1.4 to 11.7) than other participants. Among those who completed, the use of causation words and complex syntax (adverbial clauses) predicted improvement, accounting for 50% of the variation in well-being benefit. These results suggest that the analysis of narrative style can provide useful information for assessing the likelihood of success of in iduals participating in a mental health guided self-help programme.
Publisher: Frontiers Media SA
Date: 30-06-2022
DOI: 10.3389/FCDHC.2022.902395
Abstract: Globally, Indigenous people have a greater incidence and earlier onset of diabetes than the general population and have higher documented rates of emotional distress and mental illness. This systematic review will provide a synthesis and critical appraisal of the evidence focused on the social and emotional well-being of Indigenous peoples living with diabetes, including prevalence, impact, moderators, and the efficacy of interventions. We will search MEDLINE Complete, EMBASE, APA PsycINFO, and CINAHL Complete from inception until late April 2021. Search strategies will include keywords related to Indigenous peoples, diabetes, and social and emotional well-being. All abstracts will be rated independently by two researchers against specified inclusion criteria. Eligible studies will report social and emotional well-being data for Indigenous people with diabetes, and/or report on the efficacy of interventions designed to address social and emotional well-being in this population. For each eligible study, quality will be rated using standard checklists to appraise each study’s internal validity, to be determined based on study type. Any discrepancies will be resolved through discussions and consultation with other investigators as needed. We expect to present a narrative synthesis of the evidence. The findings of the systematic review will enable greater understanding of the impact of relationships between diabetes and emotional well-being among Indigenous peoples to inform research, policy and practice. The findings will be accessible to Indigenous people affected by diabetes through a summary published in plain language on our research centre’s website. PROSPERO registration number: CRD42021246560.
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.PCD.2015.06.006
Abstract: To investigate the contribution of general and diabetes-specific emotional wellbeing and beliefs about medicines in the prediction of insulin therapy appraisals in adults with non-insulin-treated type 2 diabetes. The s le included Diabetes MILES-Australia cross-sectional survey participants whose primary diabetes treatment was oral hypoglycaemic agents (N=313 49% women mean±SD age: 57±9 years diabetes duration: 7±6 years). They completed validated measures of beliefs about the 'harm' and 'overuse' of medications in general (BMQ General) 'concerns' about and 'necessity' of current diabetes medications (BMQ Specific) negative insulin therapy appraisals (ITAS) depression (PHQ-9) anxiety (GAD-7), and diabetes distress (DDS-17). Factors associated with ITAS Negative scores were examined using hierarchical multiple regressions. Twenty-two percent of the variance in ITAS Negative scores (52±10), was explained by: number of complications (β=-.15, p=.005), DDS-17 subscale 'emotional burden' (β=.23, p<.001), and 'concerns' about current diabetes treatment (β=.29, p<.001). General beliefs about medications and general emotional wellbeing did not contribute significantly to the model. Psychological insulin resistance may reflect broader distress about diabetes and concerns about its treatment but not general beliefs about medicines, depression or anxiety. Reducing diabetes distress and current treatment concerns may improve attitudes towards insulin as a potential therapeutic option.
Publisher: American Diabetes Association
Date: 06-2022
DOI: 10.2337/DB22-787-P
Abstract: Background: Open-source automated insulin delivery (AID) systems have shown to be safe and effective in clinical and real-world studies and to increase quality of life (QoL) in adult users. However, there is a lack of evidence on the effect on health-related QoL and general wellbeing in children and their caregivers. Therefore, the aim of this study was to assess the QoL of children and adolescents with diabetes using open-source AID systems using validated measures. Method: In this cross-sectional, population-based global online survey we examined the caregiver-reported QoL and psychological well-being of users and non-users of open-source AID. Validated questionnaires assessed general emotional wellbeing (WHO-5 Well-being Index) , diabetes-specific QoL (Problem Areas in Diabetes Survey - Parent Revised version (PAID-PR) , Pediatric Quality of Life Inventory (PedsQL, diabetes module) and subjective sleep quality (Pittsburgh Sleep Quality Index (PSQI)) . Results: In total 188 caregivers from 27 countries completed at least one questionnaire on behalf of their children, including 132 children with type 1 diabetes using open-source AID (mean age 11.5 (SD 3.5) , 48% female) and 56 children with type 1 diabetes who were non-users at the time of the survey (mean age 10.4 (SD 3.3) , 41% female) . All questionnaire scores showed significant between-group differences with the AID users reporting higher general (WHO-5: p& .001) , diabetes-related (PAID: p=0.029 PedsQL: p=0.016) and sleep-related QoL (PSQI: p& .001) . Discussion: The results show the beneficial impact that open-source AID systems have on the QoL and psychological well-being of children and adolescents, and can therefore help to inform academia, regulatory decision- and policymakers about the potential that open-source AID systems hold. Further research is needed to examine the reasons for the differences between the groups. C.Knoll: None. K.Raile: Other Relationship Dexcom, Inc. K.Braune: None. H.Ballhausen: None. J.Schipp: None. T.C.Skinner: None. M.Wäldchen: None. S.O'donnell: None. K.A.Gajewska: None. B.Cleal: None. European Commission's Horizon 2020 Research and Innovation Program under the Marie Skłodowska-Curie Action Research and Innovation Staff Exchange (RISE) (grant agreement number 823902)
Publisher: Wiley
Date: 05-2000
DOI: 10.1002/(SICI)1528-252X(200005)17:3<91::AID-PDI59>3.0.CO;2-#
Publisher: Wiley
Date: 2007
DOI: 10.1002/PDI.1079
Publisher: Elsevier BV
Date: 11-2023
Publisher: Wiley
Date: 12-01-2020
DOI: 10.1111/CCH.12730
Abstract: Theory-based interventions have been recommended to target relevant issues and improve outcomes in children and adolescents with Type 1 diabetes. Furthermore, the timing of interventions has been recognized as key to improving outcomes, suggesting a need to focus on preteens (9-12 years old) with Type 1 diabetes. The aim of the present study was to identify the theories that inform interventions targeting preteens with Type 1 diabetes and to analyse the studies for their understandings of theory. We conducted a systematic literature review of intervention studies targeting preteens with Type 1 diabetes to identify the theoretical frameworks applied. Seven databases across different scientific disciplines were searched for papers published between 1995 and 2018. Twenty-four studies were included in the review. Of these, 14 were categorized as theory-inspired and 10 as theory-related studies. Social cognitive theory appeared most frequently. Most studies did not provide a rationale for their choice and application of theory to inform interventions. The studies were characterized by use of adult-centric theories and a focus on the relationships between children and their parents. The present review shows variations and limitations in the description and application of theories across interventions targeting preteens with Type 1 diabetes. This emphasizes the need for future studies to address for what reason and how a certain theory or method is applied. We suggest that interventions might benefit from using theories that are centred on the needs and experiences of children, target family dynamics that include all important family members, and address the mutually constitutive relationship between interventions and the social context in which they are implemented.
Publisher: Mary Ann Liebert Inc
Date: 22-09-2022
Publisher: Cambridge University Press (CUP)
Date: 25-03-2011
DOI: 10.1017/S0142716410000408
Abstract: Psychological research has emphasized the importance of narrative for a person's sense of self. Building a coherent narrative of past events is one objective of psychotherapy. However, in guided self-help therapy the patient has to develop this narrative autonomously. Identifying patients’ narrative skills in relation to psychological distress could provide useful information about their suitability for self-help. The aim of this study was to explore whether the syntactic integration of clauses into narrative in texts written by prospective psychotherapy patients was related to mild to moderate psychological distress. Cross-clausal syntax of texts by 97 people who had contacted a primary care mental health service was analyzed. Severity of symptoms associated with mental health difficulties was assessed by a standardized scale (Clinical Outcomes in Routine Evaluation outcome measure). Cross-clausal syntactic integration was negatively correlated with the severity of symptoms. A multiple regression analysis confirmed that the use of simple sentences , finite complement clauses , and coordinated clauses was associated with symptoms ( R 2 = .26). The results suggest that the analysis of cross-clausal syntax can provide information on patients’ narrative skills in relation to distressing events and can therefore provide additional information to support treatment decisions.
Publisher: Informa UK Limited
Date: 26-08-2015
Publisher: Springer Science and Business Media LLC
Date: 12-08-2019
Publisher: Mary Ann Liebert Inc
Date: 08-2013
Abstract: Exergames have been suggested as an innovative approach to enhance physical activity in the elderly. The objective of this review was to determine the effectiveness of exergames on validated quantitative physical outcomes in healthy elderly in iduals. We used Centre for Review and Disseminations guidance to conduct systematic reviews. Four electronic databases were searched. We included randomized controlled trials (RCTs), the study participants were healthy elderly in iduals, and the intervention of interest was exergaming. The title and abstract screening of the 1861 citations identified 36 studies as potentially eligible for this review, and an additional nine were identified from reference lists. The full text screening identified seven studies with a total of 311 participants, all reporting RCTs with low-to-moderate methodological quality. Six of the seven studies found a positive effect of exergaming on the health of the elderly. However, the variation of intervention approaches and outcome data collected limited the extent to which studies could be compared. This review demonstrates how exergames have a potential to improve physical health in the elderly. However, there is a need for additional and better-designed studies that assess the effectiveness and long-term adherence of exergames designed specifically for the elderly.
Publisher: Wiley
Date: 15-06-2011
DOI: 10.1111/J.1464-5491.2011.03245.X
Abstract: To investigate associations between anxiety and measures of glycaemia in a White European and South Asian population attending community-based diabetes screening. In total, 4688 White European and 1353 South Asian participants (aged 40-75 years) without a previous diagnosis of Type 2 diabetes underwent an oral glucose tolerance test and HbA(1c) measurement, detailed history, anthropometric measurements and completed the short-form Spielberger State Trait Anxiety Inventory. Anxiety was significantly higher in South Asian participants (mean 34.1 sd 0.37) compared with White European participants (mean 29.8 sd 0.13). Significant correlations were not identified between anxiety and fasting (r = -0.01, P = 0.75), 2-h glucose (r = -0.10, P = 0.24) or HbA(1c) (r = 0.01, P = 0.40). Anxiety levels at screening were greater among South Asian people. Fasting, 2-h plasma glucose and HbA(1c) are not affected by anxiety during screening tests for diabetes. Current and proposed screening methods for diagnosis of diabetes are not affected by anxiety at screening.
Publisher: Wiley
Date: 06-2020
DOI: 10.1111/DME.14320
Publisher: Wiley
Date: 19-10-2005
DOI: 10.1111/J.1464-5491.2005.01680.X
Abstract: This study assesses the impact of screening for diabetes on anxiety levels in an ethnically mixed population in the UK, and explores whether beliefs about Type 2 diabetes account for these anxiety levels. This cross-sectional study recruited in iduals who were identified at high risk of developing diabetes through general practitioners' (GPs) lists or through public media recruitment. Participants completed an oral glucose tolerance test (OGTT). Between blood tests, participants completed the Spielberger State Anxiety Scale Short Form, the Emotional Stability Scale of the Big Five Inventory 44 and three scales from the Diabetes Illness Representations Questionnaire, revised for this study. Of the 1339 who completed the OGTT and questionnaire booklet, 54% were female, with 21% from an Asian background. Forty-five per cent of participants reported little to moderate amounts of anxiety at screening (mean 35.2 sd = 11.6). There was no significant effect of family history of diabetes, ethnic group or recruitment method on anxiety. The only variable significantly associated (negatively) with anxiety was the personality trait of emotional stability. Of responders, 64% and 61% agreed that diabetes was caused by diet or hereditary factors, respectively. Only 155 in iduals (12%) agreed that diabetes was serious, shortens life and causes complications. The results of this study replicate that of previous studies, indicating that screening for diabetes does not induce significant anxiety. Bivariate analysis indicated that in iduals who perceived diabetes to be serious, life shortening and resulting in complications had higher anxiety scores, the personality trait of emotional stability being the strongest predictor of anxiety.
Publisher: Wiley
Date: 04-09-2022
DOI: 10.1111/DME.14681
Abstract: This qualitative study aims to explore beliefs, attitudes and experiences of injectable glucagon‐like‐peptide‐1 receptor agonists (GLP‐1RAs) use and discontinuation, as well as attitudes to further injectable treatment intensification, among adults with type 2 diabetes (T2D). Nineteen in‐depth semi‐structured interviews lasting (mean ± standard deviation) 45 ± 18 min were conducted, face‐to‐face ( n = 14) or via telephone ( n = 5). Transcripts were analysed using inductive template analyses. Eligible participants were English‐speaking adults with T2D who had recently initiated (≤3 years) GLP‐1RA treatment. Participants were aged 28–72 years, who predominantly lived in metropolitan areas ( n = 15), and had an experience of daily ( n = 11) and/or once‐weekly ( n = 13) GLP‐1RA formulations. Six participants had discontinued treatment and seven had trialled two or more formulations. Expectations and experiences of GLP‐1RA were related to the perceived: (1) symbolism and stigma of injectable diabetes treatment (2) ease of injectable administration and device preferences (3) treatment convenience and social impact (4) treatment efficacy and benefits, and (5) negative treatment side effects. Some participants reported increased receptiveness to insulin therapy following their GLP‐1RA experience, others emphasised unique concerns about insulin beyond injectable administration. This study provides a novel understanding of expectations and experience of non‐insulin injectables among Australian adults with T2D. Our data suggest expectations may be informed by attitudes to insulin therapy, while perceived treatment benefits (e.g. weight‐related benefits, administration frequency) may motivate uptake and ongoing use despite concerns. Experience of GLP‐1RA injections may impact receptiveness to future insulin use.
Publisher: Elsevier BV
Date: 02-2023
DOI: 10.1016/J.DIABRES.2022.110153
Abstract: Open-source automated insulin delivery (AID) systems have shown to be safe and effective in children and adolescents with type 1 diabetes (T1D) in real-world studies. However, there is a lack of evidence on the effect on their and their caregivers' quality-of-life (QoL) and well-being. The aim of this study was to assess the QoL of caregivers and children and adolescents using open-source AID systems using validated measures. In this cross-sectional online survey we examined the caregiver-reported QoL and well-being of users and non-users. Validated questionnaires assessed general well-being (WHO-5), diabetes-specific QoL (PAID, PedsQL) and sleep quality (PSQI). 168 caregivers from 27 countries completed at least one questionnaire, including 119 caregivers of children using open-source AID and 49 not using them. After inclusion of covariates, all measures but the PAID and one subscale of the PedsQL showed significant between-group differences with AID users reporting higher general (WHO-5: p=0.003), sleep-related (PSQI: p=0.001) and diabetes-related QoL (PedsQL: p<0.05). The results show the potential impact of open-source AID on QoL and psychological well-being of caregivers and children and adolescents with T1D, and can therefore help to inform academia, regulators, and policymakers about the psychosocial health implications of open-source AID.
Publisher: Springer Science and Business Media LLC
Date: 18-09-2019
DOI: 10.1186/S12889-019-7569-4
Abstract: The Getting it Right study determined the validity, sensitivity, specificity and acceptability of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) people. In this process evaluation we aimed to explore staff perceptions about whether Getting it Right was conducted per protocol, and if the aPHQ-9 was considered an acceptable and feasible screening tool for depression in primary healthcare. This process evaluation will provide information for clinicians and policy makers about the experiences of staff and patients with Getting it Right and what they thought about using the aPHQ-9. Process evaluation using grounded theory approaches. Semi-structured interviews with primary healthcare staff from services participating in Getting it Right were triangulated with feedback (free-text and elicited) from participants collected during the validation study and field notes. Data were thematically analysed according to the Getting it Right study protocol to identify the acceptability and feasibility of the aPHQ-9. Primary healthcare staff ( n = 36) and community members ( n = 4) from nine of the ten participating Getting it Right services and Indigenous participants ( n = 500) from the ten services that took part. Most staff reported that the research was conducted according to the study protocol. Staff from two services reported sometimes recruiting opportunistically (rather than recruiting consecutive patients attending the service as outlined in the main study protocol), when they spoke to patients who they knew from previous interactions, because they perceived their previous relationship may increase the likelihood of patients participating. All Getting it Right participants responded to at least six of the seven feedback questions and 20% provided free-text feedback. Most staff said they would use the aPHQ-9 and most participants said that the questions were easy to understand (87%), the response categories made sense (89%) and that they felt comfortable answering the questions (91%). Getting it Right was predominantly conducted according to the study protocol. The aPHQ-9, the first culturally adapted, nationally validated, freely available depression screening tool for use by Indigenous people, appears to be acceptable and feasible to use. Australian New Zealand Clinical Trial Registry ANZCTR12614000705684 , 03/07/2014.
Publisher: Wiley
Date: 13-09-2013
Publisher: Wiley
Date: 27-11-2008
DOI: 10.1111/J.1464-5491.2008.02620.X
Abstract: To describe the characteristics of newly diagnosed people with Type 2 diabetes (T2DM) and compare these with published studies. Baseline data of participants recruited to the DESMOND randomized controlled trial conducted in 13 sites across England and Scotland were used. Biomedical measures and questionnaires on psychological characteristics were collected within 4 weeks of diagnosis. Of 1109 participants referred, 824 consented to participate (74.3%). Mean (+/- sd) age was 59.5 +/- 12 years and 54.9% were male. Mean HbA(1c) was 8.1 +/- 2.1% and did not differ by gender. Mean body mass index (BMI) was significantly higher in women (33.7 vs. 31.3 kg/m2 P 30 kg/m2). Total cholesterol was significantly higher in women (5.6 vs. 5.2 mmol/l P or = 3 times/week) and moderate activity (> or = 5 times/week) were 10.6 and 16.0%, respectively, and were lower in women. Specific illness beliefs included 73% being unclear about symptoms and only 54% believing diabetes is a serious condition. Symptoms indicative of depression were reported by significantly more women than men (16.1% vs. 8.2% P = 0.001). Data from this large and representative cohort of newly diagnosed people with T2DM show that many have modifiable cardiovascular risk factors. Comparison with the literature suggests that the profile of the newly diagnosed may be changing, with lower HbA1c and higher prevalence of obesity. Many expressed beliefs about and poor understanding of their diabetes that need to be addressed in order for them to engage in effective self-management.
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2021-050511
Abstract: The COVID-19 pandemic is creating immense psychosocial disturbance. While global, broad-based research is being conducted, little is known about the effects of the COVID-19 pandemic on health and well-being or how protective and resilience factors influence the human response in Australian rural and regional communities. Rural and regional communities often have less resources to deal with such public health emergencies and face additional environmental adversity. Healthcare workers, including those in rural and regional areas, have felt the immediate impacts of COVID-19 in a multitude of ways and these impacts will continue for years to come. Therefore, this study aims to describe and understand the impacts of the COVID-19 pandemic on the rural and regional healthcare workforce within the Loddon Mallee region, Victoria, Australia. This prospective cohort of rural and regional healthcare workers will be recruited and followed over 3 years to examine the effects of the COVID-19 pandemic on their health and well-being. Self-administered online questionnaires will be administered every 6 months for a 36-month period. Multiple outcomes will be assessed however, the primary outcomes are emotional health and well-being and psychological resilience. Emotional health and well-being will be measured using validated instruments that will assess multiple domains of the emotional health and well-being continuum. Linear and logistic regression and latent growth curve modelling will be used to examine the association between baseline and follow-up participant emotional health, well-being and resilience while adjusting for potentially time-varying confounding variables. Participant characteristics measured at baseline will also be tested for association with incident health, morbidity, mortality and health service utilisation outcomes at follow-up. Ethical approval has been obtained through the Bendigo Health Human Research Ethics Committee. The study findings will be disseminated through international conferences, international peer-reviewed journals and social media. ACTRN12620001269921.
Publisher: Wiley
Date: 04-09-2021
DOI: 10.1002/IJGO.13850
Abstract: To identify successes to date and opportunities for improvement in the implementation of a complex health systems intervention aiming to improve prenatal and postpartum care and health outcomes for women with hyperglycemia in pregnancy in regional and remote Australia. A qualitative evaluation, underpinned by the RE‐AIM framework (reach, effectiveness, adoption, implementation, maintenance), was conducted mid‐intervention. Semi‐structured interviews were conducted with the participants, who included clinicians, regional policymakers and managers, and study implementation staff. Interviewees ( n = 45) reported that the early phase of the intervention had resulted in the establishment of a clinician network, increased clinician awareness of hyperglycemia in pregnancy, and improvements in management, including earlier referral for specialist care and a focus on improving communication with women. Enablers of implementation included existing relationships with stakeholders and alignment of the intervention with health service priorities. Challenges included engaging remote clinicians and the labor‐intensive nature of maintaining a clinical register of women with hyperglycemia in pregnancy. The early phase of this health systems intervention has had a positive perceived impact on systems of care for women with hyperglycemia in pregnancy. Findings have informed modifications to the intervention, including the development of a communication and engagement strategy.
Publisher: MDPI AG
Date: 24-07-2023
DOI: 10.3390/MOLECULES28145616
Abstract: Sedatives promote calmness or sleepiness during surgery or severely stressful events. In addition, depression is a mental health issue that negatively affects emotional well-being. A group of drugs called anti-depressants is used to treat major depressive illnesses. The aim of the present work was to evaluate the effects of quercetin (QUR) and linalool (LIN) on thiopental sodium (TS)-induced sleeping mice and to investigate the combined effects of these compounds using a conventional co-treatment strategy and in silico studies. For this, the TS-induced sleeping mice were monitored to compare the occurrence, latency, and duration of the sleep-in response to QUR (10, 25, 50 mg/kg), LIN (10, 25, 50 mg/kg), and diazepam (DZP, 3 mg/kg, i.p.). Moreover, an in silico investigation was undertaken to assess this study’s putative modulatory sedation mechanism. For this, we observed the ability of test and standard medications to interact with various gamma-aminobutyric acid A receptor (GABAA) subunits. Results revealed that QUR and LIN cause dose-dependent antidepressant-like and sedative-like effects in animals, respectively. In addition, QUR-50 mg/kg and LIN-50 mg/kg and/or DZP-3 mg/kg combined were associated with an increased latency period and reduced sleeping times in animals. Results of the in silico studies demonstrated that QUR has better binding interaction with GABAA α3, β1, and γ2 subunits when compared with DZP, whereas LIN showed moderate affinity with the GABAA receptor. Taken together, the sleep duration of LIN and DZP is opposed by QUR in TS-induced sleeping mice, suggesting that QUR may be responsible for providing sedation-antagonizing effects through the GABAergic interaction pathway.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2008
End Date: 12-2011
Amount: $236,000.00
Funder: Australian Research Council
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