Diabetes Education Needs of Family Members Caring for American Indian Elders

1999 ◽  
Vol 25 (5) ◽  
pp. 747-754 ◽  
Author(s):  
Catherine Hagen Hennessy ◽  
Robert John ◽  
Lynda A. Anderson
Keyword(s):  
Focus Groups ◽  
American Indian ◽  
Family Caregivers ◽  
Diabetes Care ◽  
Care Management ◽  
Diabetes Management ◽  
Wound Care ◽  
Family Members ◽  
Home Dialysis ◽  
Wide Range

PURPOSE this qualitative study investigated diabetes care management among family members of American Indian elders with self-care limitations. Focus groups were used to examine the reasons for and content of diabetes care management, the challenges faced, and the support services needed. METHODS Five focus groups were conducted with family caregivers from six tribes. Caregivers' responses related to care management were identified and categorized into themes. RESULTS Participants reported that they provided assistance with a wide range of diabetes care tasks (eg, skin and wound care, in-home dialysis) depending on the elder's level of impairment. Caregivers described three major challenges related to diabetes care management: (1) anxiety about in-home care, (2) coping with psychosocial issues, and (3) decision making and communication problems with other family members. They emphasized the importance of developing a care routine for successful diabetes management. CONCLUSIONS Based on these findings, we suggest areas where diabetes educators can assist American Indian family caregivers in meeting the needs of frail elders in the home.

scholarly journals Hispanic Families’ Action Plans for a Healthier Lifestyle for Diabetes Management

2018 ◽  
Vol 45 (1) ◽  
pp. 87-95 ◽  
Author(s):  
Karen A. Amirehsani ◽  
Jie Hu ◽  
Debra C. Wallace ◽  
Zulema A. Silva ◽  
Sarah Dick
Keyword(s):  
Focus Groups ◽  
Emotional Eating ◽  
Diabetes Management ◽  
Eating Habits ◽  
Qualitative Content Analysis ◽  
Family Members ◽  
Lifestyle Behaviors ◽  
Action Plans ◽  
Patients With Diabetes ◽  
Family Based

Purpose The purpose of this study was to conduct focus groups with Hispanic patients with type 2 diabetes and their family members who participated in a culturally tailored, family-based diabetes intervention about their action plans for a healthier lifestyle. Methods Five separate focus groups were led in Spanish by an experienced bicultural/bilingual moderator. The audiotaped sessions occurred at the end of the 8-week diabetes educational program. Data were transcribed in Spanish and translated into English. Qualitative content analysis was used to analyze the findings. Results Eighty-four Hispanic adults participated with an equal representation of patients with diabetes and family members. Most persons were female (63.1%) and the majority of persons were born in Mexico. The mean (SD) age of participants was 44.2 (14.3) years. Six themes emerged from the data: healthier eating habits, increasing physical activity, taking care of my sugar, coping with emotions, for the family, and empowerment and increased self-efficacy. Conclusions Hispanics created action plans that promoted healthier lifestyle behaviors individually and as a family. This type of behavior change may result in better diabetes management and fewer complications. Research studies are needed to assess the sustainability of action plans and their impact on glycemic control and diabetes risk factors. Additional studies are needed to address emotional eating and mental health factors.

Unexpectedness

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
John-Carlos Perea ◽  
Jacob E. Perea
Keyword(s):  
American Indian ◽  
San Francisco ◽  
Interdisciplinary Research ◽  
Ethnic Studies ◽  
College Of Education ◽  
Present Moment ◽  
State University ◽  
Research Projects ◽  
Short Survey ◽  
Wide Range

The concepts of expectation, anomaly, and unexpectedness that Philip J. Deloria developed in Indians in Unexpected Places (2004) have shaped a wide range of interdisciplinary research projects. In the process, those terms have changed the ways it is possible to think about American Indian representation, cosmopolitanism, and agency. This article revisits my own work in this area and provides a short survey of related scholarship in order to reassess the concept of unexpectedness in the present moment and to consider the ways my deployment of it might change in order to better meet the needs of my students. To begin a process of engaging intergenerational perspectives on this subject, the article concludes with an interview with Dr. Jacob E. Perea, dean emeritus of the Graduate College of Education at San Francisco State University and a veteran of the 1969 student strikes that founded the College of Ethnic Studies at San Francisco State University.

Supporting Diabetes Management—Perspectives on Care Management in a Medicaid Health Home in Alabama

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2330-PUB
Author(s):  
APRIL A. AGNE ◽  
FAVEL MONDESIR ◽  
JOHN P. SHELLEY ◽  
MARIA PISU ◽  
ANDREA CHERRINGTON
Keyword(s):  
Care Management ◽  
Diabetes Management ◽  
Health Home

scholarly journals The PARP Enzyme Family and the Hallmarks of Cancer Part 1. Cell Intrinsic Hallmarks

Cancers ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2042 ◽  
Author(s):  
Máté A. Demény ◽  
László Virág
Keyword(s):  
Cancer Biology ◽  
Cancer Metabolism ◽  
Replicative Senescence ◽  
Synthetic Lethality ◽  
Family Members ◽  
Hallmarks Of Cancer ◽  
Novel Therapy ◽  
Cancer Hallmarks ◽  
Enzyme Family ◽  
Wide Range

The 17-member poly (ADP-ribose) polymerase enzyme family, also known as the ADP-ribosyl transferase diphtheria toxin-like (ARTD) enzyme family, contains DNA damage-responsive and nonresponsive members. Only PARP1, 2, 5a, and 5b are capable of modifying their targets with poly ADP-ribose (PAR) polymers; the other PARP family members function as mono-ADP-ribosyl transferases. In the last decade, PARP1 has taken center stage in oncology treatments. New PARP inhibitors (PARPi) have been introduced for the targeted treatment of breast cancer 1 or 2 (BRCA1/2)-deficient ovarian and breast cancers, and this novel therapy represents the prototype of the synthetic lethality paradigm. Much less attention has been paid to other PARPs and their potential roles in cancer biology. In this review, we summarize the roles played by all PARP enzyme family members in six intrinsic hallmarks of cancer: uncontrolled proliferation, evasion of growth suppressors, cell death resistance, genome instability, reprogrammed energy metabolism, and escape from replicative senescence. In a companion paper, we will discuss the roles of PARP enzymes in cancer hallmarks related to cancer-host interactions, including angiogenesis, invasion and metastasis, evasion of the anticancer immune response, and tumor-promoting inflammation. While PARP1 is clearly involved in all ten cancer hallmarks, an increasing body of evidence supports the role of other PARPs in modifying these cancer hallmarks (e.g., PARP5a and 5b in replicative immortality and PARP2 in cancer metabolism). We also highlight controversies, open questions, and discuss prospects of recent developments related to the wide range of roles played by PARPs in cancer biology. Some of the summarized findings may explain resistance to PARPi therapy or highlight novel biological roles of PARPs that can be therapeutically exploited in novel anticancer treatment paradigms.

scholarly journals The Development and Testing of KNACC: Knowledgeable Nursing Assistants as Creative Caregivers

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 675-675
Author(s):  
Jacqueline Eaton ◽  
Kristin Cloyes ◽  
Brooke Paulsen ◽  
Connie Madden ◽  
Lee Ellington
Keyword(s):  
Focus Groups ◽  
Long Term Care ◽  
Family Members ◽  
Nursing Assistants ◽  
Direct Care ◽  
Term Care ◽  
Memory Care

Abstract Nursing assistants (NAs) provide 80% of direct care in long-term care settings, yet are seldom viewed as skilled professionals. Empowering NAs is linked to improved resident outcomes. In this study, we collaborate with NAs to adapt and test the feasibility and acceptability of arts-based creative caregiving techniques (CCG) for use in long-term care. We held a series of focus groups (n=14) to adapt, refine, and enhance usability. We then evaluated implementation in two waves of testing (n=8). Those working in memory care units were more likely to use all techniques, while those working in rehabilitation were more hesitant to implement. Participants reported using CCG to distract upset residents. Family members were excited about implementation, and NAs not participating wanted to learn CCG. Nursing assistants have the potential to become experts in creative caregiving but may require in-depth training to improve use.

scholarly journals A global perspective on the issue of access to insulin

Diabetologia ◽  
2021 ◽  
Author(s):  
David Beran ◽  
Maria Lazo-Porras ◽  
Camille M. Mba ◽  
Jean Claude Mbanya
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Multinational Companies ◽  
Global Perspective ◽  
Patient Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wide Range ◽  
Pricing And Reimbursement

AbstractThe discovery of insulin in 1921 changed the prognosis for people with type 1 diabetes. A century later, availability and affordability of insulin remain a challenge in many parts of the globe. Using the WHO’s framework on understanding the life cycle of medicines, this review details the global and national challenges that affect patients’ abilities to access and afford insulin. Current research and development in diabetes has seen some innovations, but none of these have truly been game-changing. Currently, three multinational companies control over 95% of global insulin supply. The inclusion of insulin on the WHO’s Prequalification Programme is an opportunity to facilitate entry of new companies into the market. Many governments lack policies on the selection, procurement, supply, pricing and reimbursement of insulin. Moreover, mark-ups in the supply chain also affect the final price to the consumer. Whilst expenses related to diabetes are mostly covered by insurance in high-income countries, many patients from low- and middle-income countries have to pay out of their own pockets. The organisation of diabetes management within the healthcare system also affects patient access to insulin. The challenges affecting access to insulin are complex and require a wide range of solutions. Given that 2021 marks the centenary of the discovery of insulin, there is need for global advocacy to ensure that the benefits of insulin and innovations in diabetes care reach all individuals living with diabetes. Graphical abstract

scholarly journals Care for Patients with Type 2 Diabetes in a Random Sample of Community Family Practices in Ontario, Canada

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Gina Agarwal ◽  
Janusz Kaczorowski ◽  
Steve Hanna
Keyword(s):  
Best Practices ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Management Strategies ◽  
Chart Audit ◽  
Pressure Reading ◽  
International Data ◽  
One Year ◽  
Control And Management

Objective. Diabetes care is an important part of family practice. Previous work indicates that diabetes management is variable. This study aimed to examine diabetes care according to best practices in one part of Ontario. Design and Participants. A retrospective chart audit of 96 charts from 18 physicians was conducted to examine charts regarding diabetes care during a one-year period. Setting. Grimsby, Ontario. Main Outcome Measures. Glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications in the charts were examined. Results. Mean A1c was within target (less than or equal to 7.00) in 76% of patients (ICC = −0.02), at least 4 readings per annum were taken in 75% of patients (ICC = 0.006). Nearly 2/3 of patients had been counselled about diet, more than 1/2 on exercise, and nearly all (90%) were on medication. Nearly all patients had a documented blood pressure reading and lipid profile. Over half (60%) had a record of their weight and/or BMI. Conclusion. Although room for improvement exists, diabetes targets were mainly reached according to recognized best practices, in keeping with international data on attainment of diabetes targets.

scholarly journals Diabetes clinic reinvented: will technology change the future of diabetes care?

2021 ◽  
Vol 12 ◽  
pp. 204201882199536
Author(s):  
Marwa Al-Badri ◽  
Osama Hamdy
Keyword(s):  
Mobile Health ◽  
Diabetes Care ◽  
Rural Areas ◽  
Patient Monitoring ◽  
Diabetes Management ◽  
Digital Health ◽  
Future Application ◽  
Diabetes Clinic ◽  
Digital Ecosystem ◽  
Morbid Conditions

Diabetes is a chronic disease that affects nearly 463 million people globally and involves multiple co-morbid conditions that require effective treatment and continuous management. These include lifestyle and behavioral modifications, compliance to diabetes medications and close patient monitoring, all of which can be efficiently conducted via telehealth. Integrating digital technology of telehealth and mobile health into diabetes care may improve diabetes management and increase its efficiency. In this review, we examine recent advances in healthcare technology of diabetes. Moreover, we present an example of a comprehensive virtual diabetes clinic, the “Joslin HOME,” as an innovative digital ecosystem for future application in diabetes care. This model utilizes digital health technology and comprises frequent short visits with easy two-way scheduling, focused documentation and simple billing methods. In this new model, a multidisciplinary team is connected with their patients using telehealth and mobile health to overcome the barriers of distance and location. It may possibly extend quality diabetes care to remote, underserved or rural areas.

Abstract 87: Assessment of Stroke Caregiver Readiness: A Primary Prevention Strategy

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Barbara J Lutz ◽  
Mary Ellen Young
Keyword(s):  
Primary Prevention ◽  
Family Caregivers ◽  
Family Members ◽  
Inpatient Rehabilitation ◽  
Stroke Survivors ◽  
Post Discharge ◽  
Readiness Assessment ◽  
Increased Risk ◽  
Transition Home

Introduction: More than 3.5 million family caregivers provide assistance with activities and instrumental activities of daily living for stroke survivors living at home. Studies consistently indicate that stroke family caregivers are inadequately assessed and under prepared for their new caregiver roles and responsibilities as stroke survivors transition home from inpatient rehabilitation. Several tools exist to assess caregivers once they have assumed the caregiving role, however, there are no tools assess stroke caregiver readiness prior to discharge. Research has indicated the need for a thorough and systematic pre-discharge assessment of the caregiver’s ability to assume the caregiving role. The purpose of this presentation is to describe ten critical stroke caregiver readiness assessment domains and to discuss their relevance for long-term outcomes for stroke survivors and family caregivers. Methods: In this grounded theory study, data were collected from19 persons with stroke and 19 family caregivers. Semi-structured interviews were conducted during inpatient rehabilitation and within 6 months post-discharge. First interviews focused on expectations for recovery and caregiving needs post-discharge. Follow-up interviews focused on how families managed the transition from rehabilitation to home and how their initial expectations matched the reality of their post-discharge experience. Interviews were analyzed using dimensional analysis and coded in NVivo data management software. Findings: Participants indicated that stroke was an overwhelming, life changing crisis event. Family members felt abandoned, isolated, and under prepared to assume the fulltime caregiving role as stroke survivors transitioned home. They described using ineffective or risky caregiving strategies that resulted in safety and health issues for both stroke survivors and caregivers. Ten pre-discharge caregiver readiness assessment domains were identified in the interviews and a corresponding stroke caregiver readiness assessment interview guide was developed. Conclusion: Stroke survivors and family caregivers are extremely vulnerable as they transition home from inpatient rehabilitation leaving them at risk for poorer health, depression, and increased risk for injury. In order to prevent these deleterious outcomes, caregivers should be assessed, and potential areas of risk identified and addressed prior to discharge from inpatient rehabilitation. As new interventions are developed to improve survival rates for persons with stroke, we must also develop and implement primary prevention strategies for family members who are called upon to provide care following discharge to protect their health and improve the long-term recovery outcomes for the stroke survivor.

Sign in / Sign up

Export Citation Format

Share Document