Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

Diabetes Distress in Young Adults With Youth-Onset Type 2 Diabetes: TODAY2 Study Results

OBJECTIVE To assess the prevalence of high diabetes distress and associated factors in the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY2) study cohort of young adults with youth-onset type 2 diabetes. RESEARCH DESIGN AND METHODS Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (sex, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, offspring, health care coverage, established with diabetes care provider). Univariate logistic regression identified factors associated with high distress that were controlled for in multivariate logistic regressions. RESULTS Of 438 participants, 66% were female (mean age 26.8 years, 18% non-Hispanic White, 37% non-Hispanic Black, 38% Hispanic). High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high regimen distress and 29.7% with high emotional burden. A greater percentage of those with high distress were female (P = 0.002), diagnosed with hypertension (P = 0.037) and retinopathy (P = 0.005), treated with insulin, had higher HbA1c, and had moderate to severe depressive and anxiety symptoms (all P &lt; 0.001). In multivariate analyses, female sex (P &lt; 0.001), HbA1c (P &lt; 0.001), anxiety symptoms (P = 0.036), and lack of health care coverage (P = 0.019) were associated with high distress, after controlling for potential confounders. Moderate to severe depressive symptoms were associated with high regimen distress (P = 0.018) and emotional burden (P &lt; 0.001); insulin treatment was associated with high emotional burden (P = 0.027). CONCLUSIONS Future research should identify modifiable factors associated with high diabetes distress in young adults with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.

Diabetes Distress in Young Adults with Youth-onset Type 2 Diabetes: TODAY2 Study Results

Objectives<b>:</b> To assess prevalence of high diabetes distress and associated factors in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY2) cohort of young adults with youth-onset type 2 diabetes. <p>Methods<b>:</b> Participants completed the Diabetes Distress Scale (DDS) at end-of-study visits. Factors examined for association with high distress were demographic (gender, race/ethnicity, age, education, income), medical (HbA1c, BMI, complications), psychological (depressive and anxiety symptoms), and social (number in household, have offspring, healthcare coverage, established with diabetes care provider). Univariate logistic regressions identified factors associated with high distress that were controlled for in multivariate logistic regressions.</p> <p><a>Results<b>:</b></a> Of 438 participants, 66% were female, mean age=26.8 years, 18% non-Hispanic white, 37% non-Hispanic Black, 38% Hispanic. High distress (DDS ≥2) was reported by 105 (24%) participants. Subscales identified 40% with high “Regimen Distress,” 29.7% with high “Emotional Burden.” <a>A greater percentage of those with high distress were female (p=0.002), diagnosed with hypertension (p=0.037) and retinopathy (p=0.005), insulin treated, had higher HbA1c, and moderate-to-severe depressive and anxiety symptoms (all p’s <0.001). </a>In multivariate analyses, female gender, HbA1c (p<0.001 for both), anxiety symptoms (p=0.036), and lack of healthcare coverage (p=0.019) were associated with high distress, controlling for potential confounders. Reporting moderate-to-severe depressive symptoms was associated with high regimen distress (p=0.018) and emotional burden (p<0.001); insulin treatment was associated with high emotional burden (p=0.027).</p> <p>Conclusion: Future research should identify modifiable factors associated with high diabetes distress in those with youth-onset type 2 diabetes that may inform distress interventions with this medically vulnerable group.</p>

Destruição da arte tumular por um preço vil / Destruction of tomb art for a vile price

A arte tumular ou funerária representa o respeito dado a um indivíduo dentro do contexto histórico; acompanhada de grande carga emotiva, deve ser preservada para que este legado afetivo seja reverenciado. O bronze é uma liga metálica composta basicamente de cobre e estanho, contendo ainda outros elementos químicos, fusão que aumenta a resistência do cobre sem alterar sua capacidade de deformação, permitindo a realização de obras de arte. Infelizmente, o cobre presente em artefatos de bronze, desperta a ganância de vândalos, que por alguns trocados destroem a memória de pessoas ilustres e queridas, um quadro revoltante pelo descaso dos responsáveis pela preservação do patrimônio cultural abrigado nos cemitérios. Tanto as placas de bronze, vasos e portas dos jazigos levadas de vários cemitérios estão sendo substituídas por desgraciosas peças de granito, sem valor comercial, porém padronizadas, acabando com as referências que individualizam cada jazigo, denegrindo a memória dos que ali repousam. ABSTRACT Tomb or funerary art stands for the respect given to an individual within the historical context; coupled with a great emotional burden, it must be preserved so that this affective legacy is revered. Bronze is a metallic alloy basically composed of copper and tin, also containing some other chemical elements, and producing a fusion that increases the resistance of copper without altering its deformation capacity which allows the creation of art work. Unfortunately, the copper present in bronze artifacts awakens the greed of vandals who, for a few pennies, destroy the memory of distinguished and beloved people. This is a revolting consequence caused by the negligence of those responsible for preserving the cultural heritage housed in cemeteries. Either the bronze plates or vases and tomb doors taken from various cemeteries are being replaced by clumsy pieces of granite, with no commercial value, but standardized, putting an end to the references that individualize each tomb and disparaging the memory of those who rest there.

Psychosocial Contributors to Depressive Symptoms in Hispanic Patients With Type 2 Diabetes

Purpose The purpose of this study is to identify psychosocial factors associated with depressive symptoms in Hispanic patients with diabetes and explore the extent to which their effects may vary by gender and acculturation. Methods The authors completed a secondary analysis of data from 247 Hispanic adults with type 2 diabetes. Gender and language groups were compared using chi-square and t tests. Hierarchical multiple regression was used to examine associations of depressive symptoms with perceived support, diabetes-related distress, and social and personal factors. Results Women reported less support than men. English speakers reported more depressive symptoms than Spanish speakers. When adjusting for age, gender, and acculturation, psychosocial factors significantly associated with depressive symptoms included less support received, greater emotional burden, and less ability to socialize or pursue normal activities because of diabetes. Conclusions Social support provided by family among less acculturated Hispanics may play an important role in reducing emotional burden and lowering the risk of comorbid depression. The quality of interpersonal relationships and the ability to continue normal activities may also be important. More acculturated Hispanic women with diabetes may be at greater risk for comorbid depression and worse health outcomes. Screening for depression and assessment of support needs is warranted for Hispanic women.

Experience of diagnosis and time of chemotherapy of women with breast cancer

Breast cancer is one of the most prevalent malignancies in women worldwide and affects all dimensions of health. The aim of this meta-aggregative review is to describe the experience of diagnosis and the subsequent period of therapy of women with breast cancer. Following a systematic literature research, ten publications were included in the meta-aggregative review and the study results were synthesized by categorization. Emotional burden, challenges, psychosocial support, and individual coping strategies were described by affected women, and disease-related information sharing and fulfilment of expectations in health professionals were experienced as unsatisfactory. There is a need for improvement in the context of information and counseling measures by health professionals.

As Strong as We Are United: Effects of Intrapersonal and Interpersonal Emotion Regulation on Quality of Life in Women With Breast Cancer

Women diagnosed with breast cancer often experience unpleasant emotions, resulting in higher levels of emotional burden and decreased levels of wellbeing and quality of life. The present correlational and cross-sectional study aims to compare the implementation of two regulatory levels, intrapersonal and interpersonal (as social sharing of emotions), and two types of strategies, antecedent-focused and response-focused, and explore their impact on breast cancer patients’ perception of quality of life. Sixty-eight women previously diagnosed with the disease participated in this study, with a mean age of 63years old (SD=11.58). Data were collected through a self-report questionnaire to assess emotional experience, intrapersonal regulation, social sharing of emotions, and breast cancer-related wellbeing and quality of life. Data yielded that most of the participants regulated their negative emotions within social interactions and made more use of antecedent-focused strategies to cognitively reformulate the emotional episode. Social and family wellbeing were positively associated with antecedent-focused strategies, as well as intrapersonal and interpersonal regulatory levels. Moreover, the occurrence of sharing episodes and social interactions played an important and beneficial role on patients’ perceived quality of life. These findings reinforce the importance of promoting an adaptive intrapersonal regulation among breast cancer patients. Results also suggest that social sharing of emotions is an efficient process to help them to better cope with the psychological and emotional burden of the disease, thus positively influencing the way they perceive their social and family wellbeing, as well as their quality of life.

Factors Associated with Diabetes-Related Distress in Patients with Type 2 Diabetes Mellitus

Introduction: The aim of this study was to identify factors associated with diabetes-related distress (DRD) in adult patients with type 2 diabetes mellitus (T2DM). Material and Methods: This was an analysis of data previously obtained from two cross-sectional studies, in which medical charts review and direct interviews were employed to obtain medical and demographic data. Vital status assessment and anthropometric measurements were performed. The patients filled out specific questionnaires for DRD (DDS-17), symptoms of depression (PHQ-9), and of anxiety (GAD-7). A clinical meaningful threshold for DRD was set at ≥2.0 points. Symptoms of depression and anxiety, number of chronic complications, therapy for T2DM, anthropometric and cardio-metabolic parameters, as well as demographic, socio-economic data, and lifestyle habits were evaluated as factors possibly associated with DRD by univariate and multiple regression analyses. Results: A total of 271 patients with T2DM were included in this analysis, of whom 25.1% presented a DDS-17 score ≥2 points (and 9.96% a DDS-17 score ≥3). Subjects with a DDS-17 score ≥2 had higher HbA1c levels (p = 0.018), PHQ-9 and GAD-7 scores (p <0.0001 for both). The multiple regression model indicated that anxiety (p = 0.026), depression (p = 0.001), and ethnicity (p = 0.002) were significantly correlated with DRD (p <0.0001). With regards to subscales, the HbA1c (p = 0.005) and PHQ-9 score (p <0.0001) were significantly associated with emotional burden, ethnicity (p = 0.001) and depression (p = 0.004) with regimen-related distress, whereas ethnicity (p = 0.010) and GAD-7 score (p = 0.012) with interpersonal distress. Conclusions: Psychosocial factors like depression, anxiety, or ethnicity significantly contribute to DRD in patients with T2DM, and worse glycemic control is associated with emotional burden.