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Kawahara NE, Jacobson CJ, Bahjri KA, Whitley HP. National survey of educational impact on pharmacy learners by volunteering at camps for children with diabetes. CURRENTS IN PHARMACY TEACHING & LEARNING 2023; 15:S1877-1297(23)00071-0. [PMID: 37100729 DOI: 10.1016/j.cptl.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/16/2023] [Accepted: 04/16/2023] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Current literature on pharmacy students' and residents' experience attending camps for children with diabetes focuses on the experience at an individual campsite. The objective of this study was to examine the demographics and gains in understanding that pharmacy learners achieve when volunteering as medical staff at camps for children with type 1 diabetes (T1D). METHODS National listservs were used to identify pharmacists who precept pharmacy students and residents at diabetes camps. These self-identified pharmacists shared pre- and post-camp electronic surveys with their respective pharmacy learners. Statistical analysis was completed using SPSS Version 25 (IBM, Corp.). RESULTS Eighty-six pharmacy learners completed the pre-camp survey and 69 completed the post-camp survey. Most were Caucasian, in their fourth professional year, and participated in residential camps that lasted six and one-half days on average. Learners consistently engaged in patient care activities including: carbohydrate counting (87%), bolus insulin dose calculations (86%), treatment of hypo/hyperglycemic episodes (86%), blood glucose testing (83%), blood sugar trend evaluation (78%), basal insulin dosing calculations (74%), and insulin pump site changes (72%). Learners demonstrated statistically significant gains in every index measured with the exception of glucometer use. Eighty-seven percent indicated they learned how to appropriately manage T1D, 37% gained empathy for those living with T1D, and 13% learned how to work in a medical team. CONCLUSIONS Pharmacy learners who volunteered at diabetes camps experienced large gains in their understanding of concepts and devices, comfort with performing patient care tasks, and compassion for children and their families living with T1D.
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Affiliation(s)
- Nancy E Kawahara
- Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Christopher J Jacobson
- Pharmacy Practice, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Khaled A Bahjri
- Pharmaceutical and Administrative Sciences, Loma Linda University School of Pharmacy, 24745 Stewart Street, Loma Linda, CA 92350, United States.
| | - Heather P Whitley
- Pharmacy Practice, Auburn University Harrison School of Pharmacy and Montgomery Family Medicine Residency Program, 4371 Narrow Lane Rd, Suite 100, Montgomery, AL 36113, United States.
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Moran V, Blanchette J, Whitley H, Pillion D, Albritton A, Israel H. Changes in attitudes toward diabetes in nursing students at diabetes camp. Public Health Nurs 2021; 38:579-587. [PMID: 33682123 DOI: 10.1111/phn.12886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 11/30/2022]
Abstract
AIM The research purpose was to determine whether exposure to residential diabetes camps affects attitudes toward diabetes care and management in nursing students. BACKGROUND Summer camp for children with type 1 diabetes mellitus (T1D) provides a unique and engaging clinical environment for nursing students to learn about evolving diabetes care and to help children develop diabetes management skills. METHODS This prospective, pretest/posttest study assessed student nurses' attitudes about diabetes, who attended one of four residential summer camps in the United States, using the Diabetes Attitude Survey 3 (DAS3). The survey was administered before and after clinical experience designed to fulfill experiential curricula requirements from various nursing programs. RESULTS After attending diabetes camp, nursing students (N = 73) had a positive change in their attitudes regarding the need for special training and the psychosocial impact of diabetes. DISCUSSION The diabetes camp clinical experience impacted nursing students' attitudes. Diabetes camps are a unique clinical setting that uses learned clinical knowledge and judgment to promote health and prevent disease and disability, supporting the integration of primary care and public health nursing.
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Affiliation(s)
- Vicki Moran
- Saint Louis University Trudy Busch Valentine School of Nursing, St. Louis, MO, USA
| | - Julia Blanchette
- Department of Endocrinology and Metabolism, Cleveland Clinic, Cleveland, OH, USA
| | - Heather Whitley
- Auburn University Harrison School of Pharmacy, Auburn, AL, USA
| | - Dennis Pillion
- Department of Pharmacology and Toxicology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Heidi Israel
- Orthopaedic Surgery, Saint Louis University, St. Louis, MO, USA
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Troncone A, Chianese A, Cascella C, Zanfardino A, Iafusco D. Psychological Outcomes in Children and Early Adolescents With Type 1 Diabetes Following Pediatric Diabetes Summer Camp: A 3-Month Follow-Up Study. Front Pediatr 2021; 9:650201. [PMID: 33777869 PMCID: PMC7987815 DOI: 10.3389/fped.2021.650201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: The aim of this study was to assess general psychosocial adjustment to diabetes and perceived disease management among patients with type 1 diabetes (T1D) and their parents before and after patients' participation in a diabetes summer camp. Methods: In this follow-up study, 20 children and adolescents with T1D (eight boys; mean age = 11.01 ± 0.94 years; mean diabetes duration = 3.02 ± 2.27) attending a southern Italian diabetic center, along with their parents, were assessed prior to and 3 months after the youths participated in a 1 week camp-based intervention involving didactic and interactive child-centered education and recreational activities. Patients and their parents completed measures assessing patients' quality of life and strategies employed by patients to cope with pain. Patients also completed measures evaluating their diabetes psychosocial adjustment, diabetes self-efficacy management, and illness perception; also, their parents completed measures of caregivers' perceived diabetes burden and treatment satisfaction. Youths' glycated hemoglobin (HbA1c) and standardized body mass index (z-BMI) values were also assessed. Within-subjects repeated-measures analyses of variance evaluated pre- and post-camp changes. Results: Camp attendance showed no beneficial effects on glycemic control, as indicated by HbA1c values both before (7.02%) and after (7.28%) camp being lower than 7.5%. HbA1c values were found to have increased after camp (pre-camp = 7.02%, post-camp = 7.28%; p = 0.010), but since they still fell within an acceptable range, they did not reveal clinically relevant changes in glycemic control. No substantial significant improvement in psychosocial measures was observed in children or parents (all p > 0.05). According to the parents' evaluation, social support-seeking as a patient pain-coping strategy was slightly increased (p = 0.044) after attending the camp. Conclusions: This study does not provide empirical evidence of benefits of participating in a diabetes camp for either patients or their parents. These findings suggest that healthcare providers rethink such camps as an experience for youths with T1D that actively involves parents and that includes both youth- and parent-focused psychological interventions.
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Affiliation(s)
- Alda Troncone
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Antonietta Chianese
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Crescenzo Cascella
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Angela Zanfardino
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy
| | - Dario Iafusco
- Department of the Woman, Child and General and Specialized Surgery, University of Campania "L. Vanvitelli", Naples, Italy
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Ferrari GE, Valenzuela JM, Wolf RM. Assessing disparities in barriers to attending pediatric diabetes camp. J Pediatr Endocrinol Metab 2020; 33:1597-1600. [PMID: 33035190 DOI: 10.1515/jpem-2020-0348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/03/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES While the benefits of diabetes camp programs are well established, minority youth are underrepresented in camp attendance. No research to date has explored barriers to camp attendance or potential disparities in those barriers. Further, little is known about sources families prioritize in seeking diabetes information and support. METHODS This was a prospective survey of families of children with type 1 diabetes (T1D) using convenience sampling during normally-scheduled clinic visits. Thirty-nine children and their caregivers completed the survey. Results were analyzed for prevalence and mean number of reported barriers, benefits, and diabetes information networks. RESULTS Age range was 5-15 years and mean duration of diabetes was 2.9 years (0.4-9y). The most prevalent barriers were location, cost, and concern about sending children to overnight camp. Caregivers had high level of knowledge of camp benefits. Participants reported engaging with the diabetes community through interactions with their diabetes team, Facebook groups, and the JDRF. CONCLUSION Increasing awareness, transportation assistance, and scholarship funding all may increase accessibility of diabetes camps. Diabetes clinic and online or social media groups are both acceptable means of disseminating information about diabetes camp. Further research is indicated to verify if these results are applicable to the larger diabetes community.
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Affiliation(s)
| | | | - Risa M Wolf
- Johns Hopkins Medicine, Baltimore, United States
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Vernon-Roberts A, Gearry RB, Day AS. Assessment of Knowledge Levels Following an Education Program for Parents of Children With Inflammatory Bowel Disease. Front Pediatr 2020; 8:475. [PMID: 32903635 PMCID: PMC7438864 DOI: 10.3389/fped.2020.00475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/07/2020] [Indexed: 01/22/2023] Open
Abstract
Children with inflammatory bowel disease (IBD) and their parents have increasing roles in disease management and require sufficient, appropriate information for communication with their clinical team. Formal education is effective at improving disease knowledge, disease outcomes, and mental health, yet few interventions have been targeted for parents of children with IBD. A two day parent education program was held at the annual residential camp for children with IBD in New Zealand with knowledge levels tested pre and post intervention using a validated assessment tool: IBD-KID2. Thirty parents consented, 25 completed the study, 70% were female and 83% had a child with Crohn's disease. The pre-intervention mean score (maximum fifteen) was 10.6 (SD 2.9), with no associations with independent variables. Knowledge levels increased significantly following the education program to a mean 12.6 (SD 2.0) (p < 0.005). Disease specific knowledge may improve outcomes and should, therefore, be reinforced during clinic encounters, and regarded as an ongoing endeavor.
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Affiliation(s)
| | - Richard B. Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Andrew S. Day
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
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Anarte MT, Carreira M, Leiva Gea A, Varela E, Mateo-Anarte M, López Siguero JP, Leiva Gea I. Diabetes Summer Camp in children and adolescents with type 1 diabetes: Effects on well-being and quality of life. ENDOCRINOL DIAB NUTR 2020; 67:326-332. [DOI: 10.1016/j.endinu.2019.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 01/09/2023]
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Valenzuela JM, Records SE, Mueller KA, Martin MT, Wolf RM. Racial Ethnic Disparities in Youth With Type 1 Diabetes Participating in Diabetes Summer Camps. Diabetes Care 2020; 43:903-905. [PMID: 31974104 DOI: 10.2337/dc19-1502] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 12/31/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diabetes camps are beneficial for campers and include benefits such as increases in diabetes knowledge, glycemic control, and psychological functioning. Racial/ethnic minority youth are likely to have poorer disease management and glycemic control. We hypothesized that minority youth with type 1 diabetes have reduced participation in diabetes summer camps. RESEARCH DESIGN AND METHODS We analyzed deidentified data from 5,256 campers with type 1 diabetes who participated in a network of 48 American Diabetes Association-affiliated summer camps in 2018, and we compared participation rates by racial/ethnic category to the most recent SEARCH for Diabetes in Youth study prevalence rates. RESULTS Camper demographics were significantly different than in the general population of children with type 1 diabetes (P < 0.001). Minority youth were more likely to attend day camp, be first-time campers, and request financial aid, and they were less likely to be on insulin pump therapy or use continuous glucose monitors. CONCLUSIONS Racial/ethnic minority youth with diabetes are underrepresented in diabetes camps nationwide.
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Tumini S, Comegna L, Fioretti E, Guidone P, Levantini G, Panichi D, Catenaro M, Rossi I, Amaro F, Graziano G, Rossi MC, Cipriano P. Effectiveness and safety of flexible therapeutic schemes including first- and secondgeneration basal insulins during a pediatric summer diabetes camp. Pediatr Rep 2020; 12:8254. [PMID: 32308970 PMCID: PMC7160858 DOI: 10.4081/pr.2020.8254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 02/28/2020] [Indexed: 11/23/2022] Open
Abstract
Outcomes of insulin analogues in pediatric diabetes camps are poorly investigated; no data is available about insulin degludec (IDeg).Our aim was to assess impact of insulin therapy adopted by the participants to a 4-day diabetes camp held in 2017, hypothesizing a possible excess risk of hypoglycemia in patients treated with IDeg. Overall, 40 children with type 1 diabetes (mean age 13.4±3.0 years; 62.5% males) attended the camp (20.0% on continuous subcutaneous insulin infusion and 80.0% on multiple daily injections - MDI). Among children in MDI regimen, 71.9% were treated with IDeg as basal insulin and 28.1% with glargine U100 (IGlar). All patients used Lispro or Aspart as short-acting insulin. Daily plan of the camp included educational sessions, physical exercise, 3 main meals and 2 snacks. At the arrival, IGlar and short-acting insulin doses were revised according to existing guidelines, while IDeg dose was revised based on an empirical individualized approach. At the arrival, insulin doses were reduced in 22 participants (-19.4±10.5%), while doses were increased in 17 children (+17.8±12.7%), based on individual needs. No statistically significant between-group difference emerged in mean blood glucose and glucose variability. No excess risk of hypoglycemia was found in the IDeg group. The study suggests similar effectiveness and safety of different insulin schemes when associated with appropriate diabetes education and management, and flexible dose adjustments. Despite its longer halflife and the lack of a validated algorithm, IDeg was not associated with an excess risk of hypoglycemia.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Giusi Graziano
- CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Maria Chiara Rossi
- CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
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Colomo N, López-Siguero JP, Leiva I, Fuentes N, Rubio-Martín E, Omiste A, Guerrero M, Tapia MJ, Martín-Tejedor B, Ruiz de Adana MS, Olveira G. Relationship between glucose control, glycemic variability, and oxidative stress in children with type 1 diabetes. ACTA ACUST UNITED AC 2019; 66:540-549. [PMID: 30853269 DOI: 10.1016/j.endinu.2018.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/14/2018] [Accepted: 12/20/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Few studies assessing the relationship between oxidative stress and glycemic variability in children with type 1 diabetes mellitus (T1DM) are available, and most of them reported no significant results. OBJECTIVE To assess the relationship between glucose control, glycemic variability, and oxidative stress as measured by urinary excretion of 8-iso-prostanglandin F2-alpha (8-iso-PGF2α) in children with T1DM. MATERIALS AND METHODS A cross-sectional study including 25 children with T1DM. Participants were evaluated during five days in two different situations: 1st phase during a summer camp, and 2nd phase in their everyday life at home. The following data were collected in each study phase:. - Six capillary blood glucose measurements per day. Mean blood glucose (MBG) levels and glucose variability parameters, including standard deviation, coefficient of variation, and mean amplitude of glycemic excursions (MAGE), were calculated. - Capillary HbA1c level. - 24-h urine sample to measure 8-iso-PGF2α. RESULTS There were no statistically significant differences in urinary 8-iso-PGF2α levels (142±37 vs. 172±61pg/mg creatinine) and glucose control and glycemic variability parameters between both phases. In the 2nd phase, statistically significant correlations were found between urinary 8-iso-PGF2α and HbA1c levels (r=0.53), MBG (r=0.72), standard deviation (r=0.49), and MAGE (r=0.42). No significant correlations between glucose control, glycemic variability and urinary 8-iso-PGF2α excretion were found in the 1st phase. CONCLUSIONS A significant correlation was found between glycemic variability and HbA1c level and urinary 8-iso-PGF2α excretion in a group of children with T1DM during their daily lives. Additional studies are needed to confirm this finding and to explore its long-term impact on health.
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Affiliation(s)
- Natalia Colomo
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III, C/Sinesio Delgado 4, 28029 Madrid, Spain.
| | - Juan Pedro López-Siguero
- Servicio de Endocrinología Pediátrica, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Avenida Arroyo de los Ángeles sn, 29011 Málaga, Spain
| | - Isabel Leiva
- Servicio de Endocrinología Pediátrica, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Avenida Arroyo de los Ángeles sn, 29011 Málaga, Spain
| | - Noemí Fuentes
- Servicio de Endocrinología Pediátrica, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Avenida Arroyo de los Ángeles sn, 29011 Málaga, Spain
| | - Elehazara Rubio-Martín
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III, C/Sinesio Delgado 4, 28029 Madrid, Spain
| | - Antonio Omiste
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain
| | - Mercedes Guerrero
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain
| | - María José Tapia
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III, C/Sinesio Delgado 4, 28029 Madrid, Spain
| | - Beatriz Martín-Tejedor
- Servicio de Endocrinología Pediátrica, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Avenida Arroyo de los Ángeles sn, 29011 Málaga, Spain
| | - María Soledad Ruiz de Adana
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III, C/Sinesio Delgado 4, 28029 Madrid, Spain
| | - Gabriel Olveira
- Servicio de Endocrinología y Nutrición, Hospital Regional de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Plaza del Hospital Civil sn, 29009 Málaga, Spain; CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III, C/Sinesio Delgado 4, 28029 Madrid, Spain
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Faith MA, Mayes S, Pratt CD, Carter C. Improvements in Hope and Beliefs about Illness Following a Summer Camp for Youth with Chronic Illnesses. J Pediatr Nurs 2019; 44:56-62. [PMID: 30683282 DOI: 10.1016/j.pedn.2018.10.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/23/2018] [Accepted: 10/23/2018] [Indexed: 11/29/2022]
Abstract
This study evaluated changes in hope, attitude toward illness, and perceptions of illness benefit and burden following participation in a summer camp designed for youth with a variety of chronic illnesses. Participants were 62 youth campers (Age M = 13.45 years, SD = 2.41) with a variety of chronic illnesses. For youth who began camp low in hope about future goal attainment, participation in optional camp activities negatively predicted post-camp hope about future goal attainment. This relation was nonsignificant for campers who began camp high in hope. We found no significant changes in attitude toward illness or perceptions of illness benefit or burden. This study provides an important contribution to burgeoning research on summer camps designed for children with varying chronic illnesses. Findings were inconsistent with previous studies on chronic illness summer camp outcomes. Further work is needed to identify camp components that are related to desirable psychosocial outcomes for youth with chronic illnesses.
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Affiliation(s)
- Melissa A Faith
- Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Sunnye Mayes
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Chelsea D Pratt
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carrick Carter
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Pihoker C, Forsander G, Fantahun B, Virmani A, Corathers S, Benitez-Aguirre P, Fu J, Maahs DM. ISPAD Clinical Practice Consensus Guidelines 2018: The delivery of ambulatory diabetes care to children and adolescents with diabetes. Pediatr Diabetes 2018; 19 Suppl 27:84-104. [PMID: 30144259 DOI: 10.1111/pedi.12757] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/10/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Catherine Pihoker
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Gun Forsander
- Division of Diabetes, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Bereket Fantahun
- Department of Pediatrics and Child Health at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Anju Virmani
- Department of Pediatrics, Max, Pentamed and SL Jain Hospitals, Delhi, India
| | - Sarah Corathers
- Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Paul Benitez-Aguirre
- Sydney Medical School, Discipline of Child & Adolescent Health, The Children's Hospital at Westmead Clinical School Children's Hospital, Westmead, New South Wales, Australia
| | - Junfen Fu
- Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - David M Maahs
- Department of Pediatrics, Stanford University, Stanford, California
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Rankin D, Harden J, Barnard KD, Stephen J, Kumar S, Lawton J. Pre-adolescent children's experiences of receiving diabetes-related support from friends and peers: A qualitative study. Health Expect 2018; 21:870-877. [PMID: 29961962 PMCID: PMC6186536 DOI: 10.1111/hex.12802] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2018] [Indexed: 12/11/2022] Open
Abstract
Background While pre‐adolescent children with type 1 diabetes receive most support from their parents/caregivers, others also contribute to their care. This study explored pre‐adolescent children's experiences of receiving diabetes‐related support from friends and peers. The objective was to identify how children could be better supported by their friends and peers to undertake diabetes self‐management. Methods In‐depth interviews with 24 children (aged 9‐12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach. Results Children gave mixed accounts of their experiences of speaking to their school/class about diabetes with some indicating that this had resulted in unwanted attention. Most individuals reported that other children had a limited understanding of diabetes and sometimes acted in insensitive ways or said things they found upsetting. Virtually all children described having a small number of close friends who were interested in learning about diabetes and provided them with support. These friends provided support in three overlapping ways, as “monitors and prompters,” “helpers” and “normalizers.” While some children described benefiting from meeting peers with type 1 diabetes, most indicated that they would prefer to develop friendships based on shared interests rather than a common disease status. Discussion and conclusions Friends and peers provide several kinds of support to pre‐adolescent children with diabetes. Health professionals could consider ways to assist small friendship groups to undertake monitoring and prompting, helping and normalizing roles. Parents, schools and health professionals could explore ways to normalize self‐management practices to better support children with diabetes in school settings.
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Affiliation(s)
- David Rankin
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Jeni Harden
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | | | | | | | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Lontchi-Yimagou E, Mapa-Tassou C, Dehayem MY, Essi MJ, Saji J, Takogue R, Sobngwi E, Mbanya JC. The effect of free diabetes care on metabolic control and on health-related quality of life among youths with type 1 diabetes in Cameroon. BMJ Open Diabetes Res Care 2017; 5:e000397. [PMID: 28761659 PMCID: PMC5530241 DOI: 10.1136/bmjdrc-2017-000397] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/19/2017] [Accepted: 05/10/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To assess the effect of free diabetes care on metabolic control and on health-related quality of life (HRQoL) of youths living with type 1 diabetes in Cameroon. RESEARCH DESIGN AND METHODS We conducted a clinical audit of a multicenter prospective cohort, performed in three of the nine clinics of the 'Changing Diabetes in Children' (CDiC) project in Cameroon. We collected data on demography, glycemic control, diabetes acute complications, and patients' HRQoL at baseline and after 1 year of follow-up. RESULTS One hundred and four patients (51 female) were included. The mean age was 16±2 years (min-max: 9-18), the mean duration of diabetes was 5±3 years, and the mean HbA1C level was 11.4%±2.7%. A significant reduction in HbA1c (11.4%±2.7% vs 8.7±2.4%), episodes of severe hypoglycemia (27/104 vs 15/104), and episodes of ketoacidosis (31/104 vs 7/104) were observed after 1 year (p<0.05). We did not observe any significant difference in the total HRQoL score (p=0.66). However, we observed a significant decrease in diabetes-associated symptoms (p<0.05). Age, level of education, duration of diabetes, glycemic control, and the presence or absence of diabetes complications did not significantly affect the total HRQoL score. CONCLUSIONS One year after free diabetes care offered through the CDiC project, a significant improvement was observed in glycemic control and acute complications of diabetes, but not in the total score of HRQoL of youths living with type 1 diabetes enrolled in the project.
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Affiliation(s)
- Eric Lontchi-Yimagou
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, The University of Yaoundé I, Yaoundé, Cameroon
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Clarisse Mapa-Tassou
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Mesmin Y Dehayem
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Marie-José Essi
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Jude Saji
- Public Health Research Institute, University of Montreal, Montreal, Canada
| | - Remy Takogue
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
| | - Eugène Sobngwi
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, The University of Yaoundé I, Yaoundé, Cameroon
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Center, The University of Yaoundé I, Yaoundé, Cameroon
- Endocrine and Diabetology Service, National Obesity Centre, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon
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14
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Abstract
Camps for youth with type 1 diabetes (T1D) have grown in size and scope since they first emerged in the 1920s. Anecdotal evidence suggests that attending camp with other youth with T1D is beneficial, largely attributed to sharing fun, active experiences and removing the isolation of living with diabetes. However, few studies have evaluated the psychosocial and medical impacts of T1D camp attendance during and after camp sessions. In addition, T1D camps have been a setting for numerous studies on a variety of T1D-related research questions not related to camp itself, such as testing novel diabetes management technologies in an active, non-laboratory setting. This paper reviews the evidence of psychosocial and medical outcomes associated with T1D camp attendance across the globe, provides an overview of other research conducted at camp, and offers recommendations for future research conducted at T1D camp.
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Affiliation(s)
- Kelly Fegan-Bohm
- Department of Pediatrics, Diabetes and Endocrine Section, Texas Children’s Hospital/Baylor College of Medicine, 6701 Fannin St. Suite 1020, Houston, TX 77030, USA
| | - Jill Weissberg-Benchell
- Department of Psychiatry and Behavioral Sciences, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University’s Feinberg School of Medicine, 225 East Chicago Ave, Box 10, Chicago, IL 60611, USA
| | - Daniel DeSalvo
- Department of Pediatrics, Diabetes and Endocrine Section, Texas Children’s Hospital/Baylor College of Medicine, 6701 Fannin St. Suite 1020, Houston, TX 77030, USA
| | - Sheila Gunn
- Department of Pediatrics, Diabetes and Endocrine Section, Texas Children’s Hospital/Baylor College of Medicine, 6701 Fannin St. Suite 1020, Houston, TX 77030, USA
| | - Marisa Hilliard
- Department of Pediatrics, Psychology Section, Texas Children’s Hospital/Baylor College of Medicine, 1102 Bates Ave, Suite 940, Houston, TX 77030, USA
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15
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Barone MTU, Vivolo MA, Madden PB. Are diabetes camps effective? Diabetes Res Clin Pract 2016; 114:15-22. [PMID: 27103364 DOI: 10.1016/j.diabres.2016.01.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Revised: 11/18/2015] [Accepted: 01/08/2016] [Indexed: 11/30/2022]
Abstract
In the present article data about Diabetes Camps (DC) from all continents were reviewed in order to answer the title question "are diabetes camps effective?". Articles from peer reviewed journals and abstracts published in international conferences proceedings were raised. The effectiveness was considered in terms of knowledge acquisition, and psychosocial and physiological changes. Even though expected improvements were not found in all studies, in a deeper and wider analysis the aspects that influence the most toward gains are identified. Among them are: number of participations in a DC, post-camp educational opportunities, staff training, and program oriented toward campers' autonomy. To conclude, practical recommendations are addressed intending to amplify DC's potential.
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Affiliation(s)
- Mark Thomaz Ugliara Barone
- Associação de Diabetes Juvenil (ADJ Diabetes Brasil), Rua Padre Antonio Tomas, 213, São Paulo 05003-010, SP, Brazil; Grupo Multidisciplinar de Desenvolvimento e Ritmos Biológicos (GMDRB/EACH/USP), Rua Arlindo Bettio, 1000, Ermelino Matarazzo, São Paulo 03828-000, SP, Brazil; Young Leaders in Diabetes Programme, IDF (YLD-IDF), Chaussee de la Hulpe 166, B-1170 Brussels, Belgium.
| | - Marco Antonio Vivolo
- Associação de Diabetes Juvenil (ADJ Diabetes Brasil), Rua Padre Antonio Tomas, 213, São Paulo 05003-010, SP, Brazil; NR Camps, Tv. Ubirassanga, 41, Campo Belo, São Paulo 04614-050, SP, Brazil.
| | - Paul B Madden
- Young Leaders in Diabetes Programme, IDF (YLD-IDF), Chaussee de la Hulpe 166, B-1170 Brussels, Belgium; Diabetes Education and Camping Association (DECA), 1138 Spring Cove Road, Florence, AL 35634, USA.
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16
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Dehayem MY, Takogue R, Choukem SP, Donfack OTS, Katte JC, Sap S, Sobngwi E, Mbanya JC. Impact of a pioneer diabetes camp experience on glycemic control among children and adolescents living with type 1 diabetes in sub-Saharan Africa. BMC Endocr Disord 2016; 16:5. [PMID: 26791079 PMCID: PMC4721200 DOI: 10.1186/s12902-016-0086-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 01/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The metabolic impact of participating in a diabetes camp is little known among children and adolescents living with type 1 diabetes in sub-Saharan Africa. We aimed to assess the changes in glycemic control and insulin doses in a group of children and adolescents living with type 1 diabetes in Cameroon during and after camp attendance. METHODS During a 5-day camp, we collected data on insulin doses, HbA1c, weight and blood glucose at least six times per day in a group of children and adolescents living with type 1 diabetes. We compared the evolution of these parameters 3 and 12 months after camp. RESULTS Thirty-two campers completed the study. The mean age was 19 ± 2 years and the median duration of diabetes was 2 [IQR: 1.8-5] years. The mean HbA1c was 7.9 ± 2.2 % and the mean insulin dose was 49 ± 20 units/day upon arrival at camp. HbA1c dropped by 0.6 % after 12 months (p = 0.029). Despite the significant (p = 0.04) reduction in insulin dose from 49 ± 20 to 44 ± 18 units/day at the end of camp, hypoglycemic episodes occurred in 26 campers. However, the mean number of hypoglycemic episodes reduced from 1.32 (range: 0-4) on the first day, to 0.54 (range: 0-2) on the last day of camp (p = 0.006). Weight increased by 6 kg (p = 0.028) between 3 and 12 months after camp, but insulin doses remained unchanged. CONCLUSIONS Attending camp for children and adolescents living with diabetes is associated with a significant decrease in HbA1c twelve months after camp without changes in insulin doses. Including camps as an integral part of type 1 diabetes management in children and adolescents in sub-Saharan Africa may yield some benefits. TRIAL REGISTRATION ClinicalTrials.gov NCT02632032 . Registered 4 December 2015.
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Affiliation(s)
- Mesmin Y Dehayem
- Endocrine and Diabetes Service, Yaoundé Central Hospital, PO Box 87, Yaoundé, Cameroon.
| | - Rémy Takogue
- Endocrine and Diabetes Service, Yaoundé Central Hospital, PO Box 87, Yaoundé, Cameroon.
| | - Siméon-Pierre Choukem
- Health and Human Development Research Group, Douala, Cameroon.
- Diabetes and Endocrine Unit, Internal Medicine Service, Douala General Hospital, Douala, Cameroon.
- Department of Internal Medicine and Pediatrics, Faculty of Health Sciences, University of Buea, Buea, Cameroon.
| | - Olivier T S Donfack
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
| | | | - Suzanne Sap
- Mother and Child Centre, Chantal Biya Foundation, Yaoundé, Cameroon.
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Eugène Sobngwi
- Endocrine and Diabetes Service, Yaoundé Central Hospital, PO Box 87, Yaoundé, Cameroon.
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
| | - Jean-Claude Mbanya
- Endocrine and Diabetes Service, Yaoundé Central Hospital, PO Box 87, Yaoundé, Cameroon.
- Laboratory for Molecular Medicine and Metabolism, Biotechnology Centre, University of Yaoundé I, Yaoundé, Cameroon.
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
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17
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Beck J, Chretien K, Kind T. Professional Identity Development Through Service Learning: A Qualitative Study of First-Year Medical Students Volunteering at a Medical Specialty Camp. Clin Pediatr (Phila) 2015; 54:1276-82. [PMID: 25667311 DOI: 10.1177/0009922815571108] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the experience of medical students volunteering at a camp for children with a variety of medical conditions. METHODS Rising second-year medical students who had served as counselors for 1 week at a medical specialty camp were invited to participate. We conducted a 2-part qualitative study using on-site focus groups and follow-up individual interviews. RESULTS Nine medical students participated. Students described their experience as motivating and career reinforcing. It helped them "move beyond the textbook" and deepened their commitment to serving future patients with compassion. One theme that emerged was the idea that their camp experience fostered the development of their professional identities. CONCLUSIONS A 1-week, immersive community service experience at a medical specialty camp played a role in influencing the early formative professional identities of rising second-year medical students. Medical schools could use camps as a promising community service-learning experiences to foster professional identity.
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Affiliation(s)
- Jimmy Beck
- Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - Katherine Chretien
- The George Washington University School of Medicine and Health Sciences, Washington DC VA Medical Center, Washington, DC, USA
| | - Terry Kind
- The George Washington University School of Medicine and Health Sciences, Children's National Health System, Washington, DC, USA
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18
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Pihoker C, Forsander G, Fantahun B, Virmani A, Luo X, Hallman M, Wolfsdorf J, Maahs DM. ISPAD Clinical Practice Consensus Guidelines 2014. The delivery of ambulatory diabetes care to children and adolescents with diabetes. Pediatr Diabetes 2014; 15 Suppl 20:86-101. [PMID: 25182310 DOI: 10.1111/pedi.12181] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/13/2014] [Indexed: 01/01/2023] Open
Affiliation(s)
- Catherine Pihoker
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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19
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Sawyer SM, Ambresin AE. Successful transitions: beyond disease control to better life chances. J Adolesc Health 2014; 54:365-6. [PMID: 24656532 DOI: 10.1016/j.jadohealth.2014.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia
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20
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Woods K, Mayes S, Bartley E, Fedele D, Ryan J. An Evaluation of Psychosocial Outcomes for Children and Adolescents Attending a Summer Camp for Youth With Chronic Illness. CHILDRENS HEALTH CARE 2013. [DOI: 10.1080/02739615.2013.753822] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Modi AC, Pai AL, Hommel KA, Hood KK, Cortina S, Hilliard ME, Guilfoyle SM, Gray WN, Drotar D. Pediatric self-management: a framework for research, practice, and policy. Pediatrics 2012; 129:e473-85. [PMID: 22218838 PMCID: PMC9923567 DOI: 10.1542/peds.2011-1635] [Citation(s) in RCA: 334] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Self-management of chronic pediatric conditions is a formidable challenge for patients, families, and clinicians, with research demonstrating a high prevalence of poor self-management and nonadherence across pediatric conditions. Nevertheless, effective self-management is necessary to maximize treatment efficacy and clinical outcomes and to reduce unnecessary health care utilization and costs. However, this complex behavior is poorly understood as a result of insufficient definitions, reliance on condition-specific and/or adult models of self-management, failure to consider the multitude of factors that influence patient self-management behavior, and lack of synthesis of research, clinical practice, and policy implications. To address this need, we present a comprehensive conceptual model of pediatric self-management that articulates the individual, family, community, and health care system level influences that impact self-management behavior through cognitive, emotional, and social processes. This model further describes the relationship among self-management, adherence, and outcomes at both the patient and system level. Implications for research, clinical practice, and health care policy concerning pediatric chronic care are emphasized with a particular focus on modifiable influences, evidence-based targets for intervention, and the role of clinicians in the provision of self-management support. We anticipate that this unified conceptual approach will equip stakeholders in pediatric health care to (1) develop evidence-based interventions to improve self-management, (2) design programs aimed at preventing the development of poor self-management behaviors, and (3) inform health care policy that will ultimately improve the health and psychosocial outcomes of children with chronic conditions.
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Affiliation(s)
- Avani C. Modi
- Address correspondence to Avani C. Modi, PhD, Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Adherence and Self-Management, MLC-7039, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229. E-mail:
| | - Ahna L. Pai
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Kevin A. Hommel
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Korey K. Hood
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Sandra Cortina
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Marisa E. Hilliard
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Shanna M. Guilfoyle
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Wendy N. Gray
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Dennis Drotar
- Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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22
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Abstract
AIMS To examine the effects of insulin dose adjustments on rates of hypoglycaemia for school-aged children with Type 1 diabetes attending camp. METHODS Camp records for 256 children aged 7-15 years (55% on continuous subcutaneous insulin infusion) attending a week-long residential summer camp were analysed. RESULTS In anticipation of increased physical activity, basal insulin was decreased for all children on continuous subcutaneous insulin infusion and injection therapy by 10% upon arrival at camp. During the first day, children on continuous subcutaneous insulin infusion received 11.1±6.3% less basal insulin than home doses, whereas children on injections decreased intermediate/long-acting insulin by 8.2±12.8%. Despite these decreases, 60% had at least one blood sugar level <70 mg/dl (3.9 mmol/l) during the first day. Children on continuous subcutaneous insulin infusion were more likely to have hypoglycaemia during the first day than those on injections. The number of episodes of hypoglycaemia increased with increasing camper age. Overall, children did not have further significant reductions in their total daily insulin dose by the last day of camp. However, on the last day, children had fewer episodes of hypoglycaemia than during the first day (0.7±0.9 vs. 1.1±1.2, P<0.001) and 51% had no low blood sugar levels that day. CONCLUSIONS An empiric 10% reduction in basal insulin appears reasonable, as nearly equal numbers of children required dose increases as dose decreases as camp progressed. However, hypoglycaemia was still common in all age groups. Prospective studies characterizing individual variables are needed in order to facilitate tailored insulin dose adjustments that minimize glycaemic variability while optimizing control in the diabetes camp setting.
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Affiliation(s)
- A R Miller
- Indiana University School of Medicine, Department of Pediatrics, Riley Hospital for Children, Indianapolis, IN, USA
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23
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Abstract
The first summer camps for children with burn injuries started over 25 years ago, and as of 2008, there were 60 camps worldwide. This review examines the literature on summer pediatric burn camps. The authors describe common characteristics of burn camp structure, activities, and staffing and then examine the scientific evidence regarding the effect of burn camp programs on campers and camp staff volunteers. A search of Pubmed and Psychinfo databases from 1970 to 2008 for articles related to pediatric burn summer camps identified 17 articles, of which 13 fit the inclusion criteria. Existing literature consists primarily of qualitative studies, suggesting that burn camp can decrease camper isolation, improve self-esteem, and promote coping and social skills. Studies examining volunteer staff at burn camp have consistently found that there are both personal and professional benefits. Quantitative studies of self-esteem have yielded equivocal results. No studies have examined safety or the effect of burn camp on medical or rehabilitation outcomes. For the past 25 years, pediatric summer camps for children with burn injuries have played an important rehabilitation role and provided a strong community that benefits both campers and staff. Future research using more rigorous research methods and examining a broader range of outcomes (eg, safety and medical/rehabilitation outcomes) is recommended.
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24
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Huber J, Fröhlich-Reiterer EE, Sudi K, Suppan E, Weinhandl G, Jasser-Nitsche H, Aigner R, Borkenstein MH. The influence of physical activity on ghrelin and IGF-1/IGFBP-3 levels in children and adolescents with type 1 diabetes mellitus. Pediatr Diabetes 2010; 11:383-5. [PMID: 19863750 DOI: 10.1111/j.1399-5448.2009.00604.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of the study was to determine the influence of regular physical activity on ghrelin and IGF-1/IGFBP-3 levels during a diabetes camp. METHODS Twenty-eight children and adolescents (14 boys; mean age 12.1 yr) with type 1 diabetes mellitus (T1DM, mean duration of diabetes 4.8 yr) attending a 2-wk diabetes camp that features increased regular physical activities have been studied. Serum levels of ghrelin (total and acylated), growth hormone (GH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor-bindng protein-3 (IGFBP-3) and insulin were measured in fasting state on day 1 and day 14. Improvement of metabolic control was documented by haemoglobin A1c (HbA1c). Glucose levels and insulin doses were determined daily. RESULTS Mean insulin dosage decreased from 0.87 to 0.78 U/kg/d, mean HbA1c levels decreased from 8.6 to 8.3%, but the changes were not statistical. There was a significant decline in total ghrelin. IGFBP-3 and IGF-1 decreased also significantly. Total basal ghrelin was inversely related to the change in IGFBP-3. CONCLUSIONS We hypothesize an association between ghrelin and metabolic control in T1DM. Higher ghrelin levels might be associated with poor metabolic control. The dynamic of IGFBP-3 levels appears to be under the influence of basal ghrelin concentrations in T1DM.
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Affiliation(s)
- Julia Huber
- Department of Paediatrics, Medical University of Graz, Graz, Austria.
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25
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Wood J, Rami B. Report of the 35th ISPAD-Meeting, Ljubljana, Slovenia, 2-5 September 2009. Pediatr Diabetes 2010; 11:74-80. [PMID: 19958459 DOI: 10.1111/j.1399-5448.2009.00623.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Jamie Wood
- Center for Endocrinology, Diabetes, and Metabolism, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, USA.
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