Accessibility and Openness to Diabetes Management Support via Mobile Phones: A Survey of People with Type 1 Diabetes Using Advanced Diabetes Technologies (Preprint)

2022 ◽  
Author(s):  
Yu Kuei Lin ◽  
Caroline Richardson ◽  
Iulia Dobrin ◽  
Rodica Pop-Busui ◽  
Gretchen Piatt ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Interactive Voice Response ◽  
Medical Center ◽  
Academic Medical Center ◽  
Text Messages ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Cross Sectional

BACKGROUND Little is known about the feasibility of mobile health (mHealth) support among people with type 1 diabetes (T1D) using advanced diabetes technologies including continuous glucose monitors (CGMs) and hybrid closed-loop insulin pumps (HCLs). OBJECTIVE To evaluate patient access and openness to receiving mHealth diabetes support in people with T1D using CGMs/HCLs. METHODS We conducted a cross-sectional survey among T1D patients using CGMs or HCLs managed in an academic medical center. Participants reported information regarding their mobile device usage, cellular call/text message/internet connectivity, and openness to various channels of mHealth communication (smartphone applications or “apps”, text messages, and interactive voice response calls or IVR calls). Participants’ demographic characteristics and CGM data were collected from medical records. Analyses focused on differences in openness to mHealth and mHealth communication channels across groups defined by demographic variables and measures of glycemic control. RESULTS Among all participants (n=310; 64% female; mean age: 45 (SD:16)), 98% reported active cellphone use, and 80% were receptive to receiving mHealth support to improve glucose control. Among participants receptive to mHealth support, 98% were willing to share CGM glucose data for mHealth diabetes self-care assistance. Most (71%) were open to receiving messages via apps, 56% were open to text messages, and 12% were open to IVR calls. Older participants were more likely to prefer text messages (P=0.009) and IVR (P=0.03) than younger participants. CONCLUSIONS Most people with T1D who use advanced diabetes technologies have access to cell phones and are receptive to receiving mHealth support to improve diabetes control. CLINICALTRIAL Not applicable

scholarly journals The Use of Mobile Health to Deliver Self-Management Support to Young People With Type 1 Diabetes: A Cross-Sectional Survey

JMIR Diabetes ◽  
2017 ◽  
Vol 2 (1) ◽  
pp. e4 ◽  
Author(s):  
Rosie Dobson ◽  
Robyn Whittaker ◽  
Rinki Murphy ◽  
Manish Khanolkar ◽  
Steven Miller ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Mobile Health ◽  
Self Management ◽  
Management Support ◽  
Cross Sectional Survey ◽  
Cross Sectional

scholarly journals Differential resting state connectivity responses to glycemic state in type 1 diabetes

2019 ◽  
Author(s):  
Lisa Parikh ◽  
Dongju Seo ◽  
Cheryl Lacadie ◽  
Renata Belfort-DeAguiar ◽  
Derek Groskreutz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Functional Connectivity ◽  
Resting State ◽  
Medical Center ◽  
Academic Medical Center ◽  
Angular Gyrus ◽  
Resting State Functional Connectivity ◽  
The Impact ◽  
Resting State Connectivity

Abstract Context Individuals with type 1 diabetes (T1DM) have alterations in brain activity which have been postulated to contribute to the adverse neurocognitive consequences of T1DM; however, the impact of T1DM and hypoglycemic unawareness on the brain’s resting state activity remains unclear. Objective To determine whether individuals with T1DM and hypoglycemia unawareness (T1DM-Unaware) had changes in the brain resting state functional connectivity compared to healthy controls (HC) and those with T1DM and hypoglycemia awareness (T1DM-Aware). Design Observational study Setting Academic medical center Participants 27 individuals with T1DM and 12 healthy control volunteers participated in the study. Intervention All participants underwent BOLD resting state fMRI brain imaging during a 2-step hyperinsulinemic euglycemic (90 mg/dl)-hypoglycemic (60mg/dl) clamp. Outcome Changes in resting state functional connectivity Results Using two separate methods of functional connectivity analysis, we identified distinct differences in the resting state brain responses to mild hypoglycemia amongst HC, T1DM-Aware and T1DM-Unaware participants, particularly in the angular gyrus, an integral component of the default mode network (DMN). Furthermore, changes in angular gyrus connectivity also correlated with greater symptoms of hypoglycemia (r = 0.461, P = 0.003) as well as higher scores of perceived stress (r = 0.531, P = 0.016). Conclusion These findings provide evidence that individuals with T1DM have changes in the brain’s resting state connectivity patterns, which may be further associated with differences in awareness to hypoglycemia. These changes in connectivity may be associated with alterations in functional outcomes amongst individuals with T1DM.

scholarly journals Burnout and Compassion Satisfaction: Survey Findings of Healthcare Employee Wellness During COVID-19 Pandemic using ProQOL

2021 ◽  
Vol 14 ◽  
pp. 121-127
Author(s):  
Meagan Dwyer ◽  
Marcus Alt ◽  
Joanna Brooks ◽  
Hannah Katz ◽  
Albert Poje
Keyword(s):  
Compassion Fatigue ◽  
Online Survey ◽  
Medical Center ◽  
Academic Medical Center ◽  
Compassion Satisfaction ◽  
Healthcare Systems ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Healthcare Employees

Introduction. Healthcare systems are being bombarded during the COVID-19 pandemic. Understanding burnout, compassion fatigue, and potential protective factors, such as compassion satisfaction, will be important in supporting the vital healthcare workforce. The goal of the current study was to understand the key factors of burnout, compassion fatigue, and compassion satisfaction among healthcare employees during the pandemic within the U.S. in April 2020. Methods. The authors conducted a single-center, cross-sectional online survey using the Professional Quality of Life (ProQOL) Questionnaire and three open-ended questions around stress and responses to stress during COVID-19 at a large Midwestern academic medical center with nearly 16,000 employees.    Results. Healthcare employees (613) representing over 25 professions or roles and 30 different departments within the health system were surveyed. Participants reported low levels of compassion fatigue and burnout, but moderate levels of compassion satisfaction. Compassion satisfaction was notably higher than prior literature. Key areas of stress outside of work included family, finances and housing, childcare and homeschooling, and personal health.  Conclusions. This was a cross-sectional survey, limiting causal analyses. Also, based on the qualitative responses, the ProQOL was somewhat insufficient in assessing the breadth of stressors, particularly outside of work, that healthcare employees faced due to the pandemic. Although compassion satisfaction was elevated during the initial phases of the pandemic, providing some possible protection against burnout, this may change as COVID-19 continues to surge. Healthcare systems are encouraged to assess and address the broad range of work and non-work-related stressors to best serve their vital workforce.

scholarly journals The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Anelah McGinness ◽  
Margaret Lin-Martore ◽  
Newton Addo ◽  
Ashkon Shaahinfar
Keyword(s):  
Online Survey ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Perceived Usefulness ◽  
Point Of Care Ultrasound ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
Unmet Demand

Abstract Background Point-of-care ultrasound (POCUS) is a noninvasive bedside tool with many pediatric applications but is not currently a formal part of pediatric training and practice. Formal surveys of general pediatricians regarding POCUS training are lacking. We aimed to quantify the baseline ultrasound experience and training needs of general pediatricians and pediatric residents across different practice settings. Methods In 2020, we sent an online survey to 485 current faculty, residents, and graduates from an urban pediatric academic medical center in Northern California. Pediatric subspecialists were excluded. Survey questions about baseline experience, comfort, and perceived usefulness of 20 common POCUS applications were developed by two POCUS experts using existing literature. Chi-squared analysis was used to compare residents versus attendings and to compare attendings practicing in inpatient versus outpatient versus mixed settings. Results Response rate was 20% (98/485). Compared to attendings (n = 73), residents (n = 25) endorsed more exposure to POCUS in medical school (32% vs 5%, p = 0.003) and residency (12% vs 5%, p = 0.003). Respondents endorsed low comfort with POCUS (mean 1.3 out of 5 on Likert scale). Of 20 procedural and diagnostic applications, respondents identified abscess drainage, bladder catheterization, soft tissue, neck, advanced abdominal, and constipation as most useful. Overall, 50% of pediatricians (and 70% of pediatric residents) responded that there were opportunities to use POCUS multiple times a week or more in their clinical practice. Conclusions There is an unmet demand for POCUS training among general pediatricians and trainees in our study. Although the majority of respondents were not POCUS users, our results could guide future efforts to study the role of POCUS in general pediatrics and develop pediatric curricula.

scholarly journals Stigma and Its Association With Glycemic Control and Hypoglycemia in Adolescents and Young Adults With Type 1 Diabetes: Cross-Sectional Study (Preprint)

2017 ◽  
Author(s):  
Anne-Sophie Brazeau ◽  
Meranda Nakhla ◽  
Michael Wright ◽  
Mélanie Henderson ◽  
Constadina Panagiotopoulos ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Severe Hypoglycemia ◽  
Poor Glycemic Control ◽  
Self Report ◽  
Diabetes Diagnosis ◽  
Hypoglycemic Episode ◽  
Cross Sectional

BACKGROUND Qualitative studies in type 1 diabetes indicate that visibility of diabetes supplies, self-care, and hypoglycemia symptoms are associated with stigma and suboptimal management. This may be particularly salient in youth who face concurrent challenges such as establishing autonomy and making vocational choices. OBJECTIVE The aim of the study was to estimate stigma prevalence in youth (aged 14-24 years) with type 1 diabetes and its associations with glycemic control. METHODS Participants, recruited largely through social media, were asked to complete a Web-based survey and to send via mail capillary blood samples for glycated hemoglobin (HbA1c) measurement. The primary definition of stigma required endorsement of one or more of 3 stigma-specific items of the Barriers to Diabetes Adherence questionnaire. These addressed avoidance of diabetes management with friends present, difficulty telling others about diabetes diagnosis, and embarrassment in performing diabetes care with others present. Poor glycemic control was defined as HbA1c>9% (ie, >75 mmol/mol; measured value when available, else self-report) and/or ≥1 severe hypoglycemic episode in the previous year (reported requiring assistance from someone else during the episode). Stigma prevalence was computed (95% CI), and associations with glycemic control were evaluated (multivariate logistic regression models). RESULTS Among the 380 respondents, stigma prevalence was 65.5% (95% CI 60.7-70.3). Stigma was associated with a 2-fold higher odds of poor glycemic control overall (odds ratio [OR] 2.25, 95% CI 1.33-3.80; adjusted for age, sex, and type of treatment). There were specific associations with both HbA1c>9% (75 mmol/mol; OR 3.05, 95% CI 1.36-6.86) and severe hypoglycemia in the previous year (OR 1.86, 95% CI 1.05-3.31). CONCLUSIONS There is a high prevalence of stigma in youth with type 1 diabetes that is associated with both elevated HbA1c levels and severe hypoglycemia. Targeted strategies to address stigma are needed. CLINICALTRIAL ClinicalTrials.gov NCT02796248; http://clinicaltrials.gov/ct2/show/NCT02796248 (Archived by WebCite at http://www.webcitation.org/6yisxeV0B)

scholarly journals A Qualitative Identification of Gaps in Understanding About Brain Death Among Trainees, Health Care Personnel and Families at an Academic Medical Center

2020 ◽  
Vol 10 (4) ◽  
pp. 266-271
Author(s):  
Patrick M. Chen ◽  
Jamie Nicole LaBuzetta
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Brain Death ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Care Personnel ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Families

Background and Purpose: Death by whole brain criteria (brain death) is a clinical diagnosis. We sought to identify aspects of brain death that were unclear to both health care personnel and patient families. Methods: Institutional review board approved cross-sectional survey study of attendings, medical trainees (residents and fellows), senior medical students, advanced practice providers (APPs), and critical care nursing (registered nurses [RNs]) at a tertiary referral center over 6 months (March 2018 to September 2018). Surveys were completed on paper or electronically. Participants supplied the top 3 of (1) their own personal questions regarding brain death and (2) questions received from patient families about brain death from a prepared list of questions. Results: Two hundred twenty-nine individuals participated in the survey, with a response rate of 46%. Participation rates in brain death declaration among attendings (92%), RNs (84%), APPs (100%), and trainees of which included fellows (92%) and residents (85%) were high. Most frequently asked questions by trainees and health care personnel were “What are brain death mimics?” and “What is the gold standard testing?”. Questions received from patient families most commonly include “What is brain death?” and “Is brain death reversible?”. All medical students had questions about brain death. Greater than 75% of attendings endorsed having questions regarding brain death. Conclusion: Many health care personnel are involved with brain death declaration, but there are gaps in their understanding about fundamentals regarding brain death. We identify a need for early and targeted brain death education regarding brain death and family communication for various members of the health care profession.

scholarly journals Evaluation of lipid profile among children and adolescents with type 1 diabetes mellitus in Bangladesh

Mediscope ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 15-21
Author(s):  
M Parveen ◽  
MA Muttalib ◽  
ST Huq ◽  
N Nazneen ◽  
MA Kabir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Detailed Medical History

The study, a cross-sectional survey, was carried out at the Department of Biochemistry in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital from July 2015 to June 2016. A total of 576 clinically diagnosed children and adolescents with type 1 diabetes mellitus (T1DM) aged 10-18 years attending in ‘Changing Diabetes in Children’ clinic, BIRDEM-2, Dhaka were selected according to appropriate inclusion and exclusion criteria. The study subjects underwent detailed medical history and examination. Fasting blood samples were drawn from the participants for biochemical assays such as fasting blood sugar (FBS), glycated haemoglobin (HbA1c), total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides. Anthropometric data and blood pressures both systolic and diastolic were measured. Student unpaired t-test and Chi-square test were used to determine the association between different groups. Out of 576 T1DM patients, 45.0% (259) were male and 55.0% (317) were female. Of the 576 T1DM patients, 35.1% were without dyslipidemia (DLP) and 64.9% were with DLP. Study revealed that the patients with DLP were more likely to have higher values of HbA1c (10.1±2.2% vs 9.4±1.9%, p < 0.001) and FBS (13.0±4.4 mmol/L vs 10.2±2.9 mmol/L, p < 0.001). A substantial proportion of children and adolescents with T1DM had DLP. We found an association between poor glycemic control and abnormal lipid profiles in those patients. Mediscope Vol. 5, No. 1: Jan 2018, Page 15-21

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