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diabetic care pathways

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https://www.readbyqxmd.com/read/28616221/time-timing-talking-and-training-findings-from-an-exploratory-action-research-study-to-improve-quality-of-end-of-life-care-for-minority-ethnic-kidney-patients
#1
Emma Wilkinson, Gurch Randhawa, Edwina Brown, Maria Da Silva Gane, John Stoves, Graham Warwick, Tahira Mir, Regina Magee, Sue Sharman, Ken Farrington
Background. With an ageing and increasingly diverse population at risk from rising levels of obesity, diabetes and cardiovascular disease, including kidney complications, there is a need to provide quality care at all stages in the care pathway including at the end of life and to all patients. Aim. This study purposively explored South Asian patients' experiences of kidney end of life care to understand how services can be delivered in a way that meets diverse patient needs. Methods. Within an action research design 14 focus groups (45 care providers) of kidney care providers discussed the recruitment and analysis of individual interviews with 16 South Asian kidney patients (eight men, eight women)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28605006/treating-periodontal-disease-for-preventing-adverse-birth-outcomes-in-pregnant-women
#2
REVIEW
Zipporah Iheozor-Ejiofor, Philippa Middleton, Marco Esposito, Anne-Marie Glenny
BACKGROUND: Periodontal disease has been linked with a number of conditions, such as cardiovascular disease, stroke, diabetes and adverse pregnancy outcomes, all likely through systemic inflammatory pathways. It is common in women of reproductive age and gum conditions tend to worsen during pregnancy. Some evidence from observational studies suggests that periodontal intervention may reduce adverse pregnancy outcomes. There is need for a comprehensive Cochrane review of randomised trials to assess the effect of periodontal treatment on perinatal and maternal health...
June 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28553609/choice-of-insulin-in-type-2-diabetes-a-southeast-asian-perspective
#3
Sanjay Kalra, Hong Quang Thai, Chaicharn Deerochanawong, Goh Su-Yen, Mafauzy Mohamed, Tint Swe Latt, Than Than Aye, Zafar Ahmed Latif, Prasad Katulanda, Touch Khun, Sum Satha, Vadsana Vongvandy
Southeast Asia faces a diabetes epidemic, which has created significant challenges for health care. The unique Asian diabetes phenotype, coupled with peculiar lifestyle, diet, and healthcare-seeking behavior, makes it imperative to develop clinical pathways and guidelines which address local needs and requirements. From an insulin-centric viewpoint, the preparations prescribed in such pathways should be effective, safe, well tolerated, nonintrusive, and suitable for the use in multiple clinical situations including initiation and intensification...
May 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28509690/genetics-and-its-potential-to-improve-type-1-diabetes-care
#4
Stephen S Rich
PURPOSE OF REVIEW: The genetic basis of type 1 diabetes (T1D) is being characterized through DNA sequence variation and cell type specificity. This review discusses the current understanding of the genes and variants implicated in risk of T1D and how genetic information can be used in prediction, intervention and components of clinical care. RECENT FINDINGS: Fine mapping and functional studies has provided resolution of the heritable basis of T1D risk, incorporating novel insights on the dominant role of human leukocyte antigen (HLA) genes as well as the lesser impact of non-HLA genes...
May 15, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28508255/psychosocial-patient-reported-outcomes-in-pediatric-and-adolescent-diabetes-a-review-and-case-example
#5
REVIEW
Sarah D Corathers, Constance A Mara, Pavan K Chundi, Jessica C Kichler
PURPOSE OF REVIEW: The purpose of this review is to define psychosocial patient-reported outcomes (PROs) relevant to pediatric and adolescent diabetes populations. Potential domains for PROs include a spectrum of emotional, behavioral, social, physical, overall health, and/or care management areas. A literature review of potential PRO measures, selection criteria, and implementation strategies including a case example will be presented. RECENT FINDINGS: Among the pediatric, adolescent, and emerging adult populations, research indicates a relative higher risk for distress, depression, anxiety, and eating disorders as compared to peers without diabetes...
July 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28499988/melanocortin-neurons-multiple-routes-to-regulation-of-metabolism
#6
REVIEW
Wen-Jie Shen, Ting Yao, Xingxing Kong, Kevin W Williams, Tiemin Liu
The burden of disability, premature death, escalating health care costs and lost economic productivity due to obesity and its associated complications including hypertension, stroke, cardiovascular disease and type 2 diabetes is staggering [1,2]. A better understanding of metabolic homeostatic pathways will provide us with insights into the biological mechanisms of obesity and how to fundamentally address this epidemic [3-6]. In mammals, energy balance is maintained via a homeostatic system involving both peripheral and central melanocortin systems; changes in body weight reflect an unbalance of the energetic state [7-9]...
May 9, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28492584/-community-pharmacy-towards-a-new-model
#7
Teresa Spadea, Paola Brusa, Roberto Gnavi, Massimo Mana, Mario Giaccone, Giuseppe Costa
In recent years, even in Italy, a new model of "Community pharmacy" is being developed, which identifies the pharmacist as the most accessible health care professional for citizens, and recognizes his role in preventing chronic diseases. A project started in Piedmont (Italy) in 2012 has aimed at applying and evaluating this model of pharmacy in the prevention of diabetes, through the early detection of individuals with undiagnosed diabetes or at high risk of developing the disease, or with counselling to diabetic patients not adhering to the optimal therapeutic pathway...
April 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28478814/fragrance-compounds-the-wolves-in-sheep-s-clothings
#8
Seema Patel
In the past few decades, synthetic fragrance compounds have become ubiquitous components of personal care and household cleaning products. Overwhelming consumerism trends have led to the excess usage of these chemicals. It has been observed that this fragrance-laden unhealthy lifestyle runs parallel with the unprecedented rates of diabetes, cancer, neural ailments, teratogenicity, and transgender instances. The link between fragrances as and the multiplicity of pathogens remained latent for decades. However, now this health hazard and its role in homeostasis breakdown is getting attention...
May 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28439847/the-role-of-the-fda-and-regulatory-approval-of-new-devices-for-diabetes-care
#9
REVIEW
Shelley A Jazowski, Aaron N Winn
PURPOSE OF REVIEW: The Food and Drug Administration (FDA) is responsible for assuring the safety, effectiveness, and quality of medical devices in the USA. Extensive review times coupled with the demand for necessary treatments have prompted the policymakers to implement measures to speed medical devices to market.The purpose of this review is to summarize the evolution of the regulatory pathways through which medical devices utilized in diabetes care gain market access. RECENT FINDINGS: Regulatory pathways, ranging from premarket notification to premarket approval, require distinct, yet necessary ("least burdensome") evidence demonstrating a device's safety and effectiveness...
June 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28437809/reactive-rather-than-proactive-diabetes-management-in-the-perioperative-period
#10
Inge Hommel, Petra J van Gurp, Alfons A den Broeder, Hub Wollersheim, Femke Atsma, Marlies E J L Hulscher, Cees J Tack
As perioperative hyperglycemia is associated with poor postoperative patient outcomes, clinical guidelines provide recommendations for optimal perioperative glucose control. It is unclear to what extent recommended glucose levels are met in daily practice, and little is known about factors that influence these levels. We describe blood glucose levels throughout the hospital care pathway in 375 non-critically ill patients with diabetes who underwent major surgery (abdominal, cardiac, or orthopedic) in 6 hospitals, examine determinants of these levels including adherence to 9 quality indicators for optimal perioperative diabetes care, and perform qualitative interviews to identify barriers for optimal care...
April 24, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28434870/maternal-socioeconomic-disadvantage-is-associated-with-transcriptional-indications-of-greater-immune-activation-and-slower-tissue-maturation-in-placental-biopsies-and-newborn-cord-blood
#11
Gregory E Miller, Ann E Borders, Amy H Crockett, Kharah M Ross, Sameen Qadir, Lauren Keenan-Devlin, Adam K Leigh, Paula Ham, Jeffrey Ma, Jesusa M G Arevalo, Linda M Ernst, Steve W Cole
Children from economically disadvantaged families experience worse cognitive, psychiatric, and medical outcomes compared to more affluent youth. Preclinical models suggest some of the adverse influence of disadvantage could be transmitted during gestation via maternal immune activation, but this hypothesis has not been tested in humans. It also remains unclear whether prenatal interventions can mitigate such effects. To fill these gaps, we conducted two studies. Study 1 characterized the socioeconomic conditions of 79 women during pregnancy...
April 21, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/28393626/in-silico-modelling-and-molecular-dynamics-simulation-studies-of-thiazolidine-based-ptp1b-inhibitors
#12
Manoj Kumar Mahapatra, Krishnendu Bera, Durg Vijay Singh, Rajnish Kumar, Manoj Kumar
Protein tyrosine phosphatase 1B (PTP1B) has been identified as a negative regulator of insulin and leptin signalling pathway; hence, it can be considered as a new therapeutic target of intervention for the treatment of type 2 diabetes. Inhibition of this molecular target takes care of both diabetes and obesity, i.e. diabestiy. In order to get more information on identification and optimization of lead, pharmacophore modelling, atom-based 3D QSAR, docking and molecular dynamics studies were carried out on a set of ligands containing thiazolidine scaffold...
April 21, 2017: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/28389199/weight-change-patterns-and-healthcare-costs-in-patients-with-newly-diagnosed-type-2-diabetes-in-sweden
#13
Ugne Sabale, Johan Bodegard, Bodil Svennblad, Carl Johan Östgren, Gunnar Johansson, Mattias Ekman, Martin Henriksson, Peter Nilsson
AIMS: To describe weight-change pathways in patients with type 2 diabetes (T2D) and associated healthcare costs using repeated BMI measurements and healthcare utilization data. METHODS: Patients with newly-diagnosed T2D with body mass index (BMI, kg/m(2)) at diagnosis and subsequent measures at year 1-3 were identified. Based on three-year BMI change, patients were assigned to one of 27 BMI change pathways defined by annual BMI change: BMI↗ (≥1 BMI unit increase), BMI→ (<1 BMI unit change), and BMI↘ (≥1 BMI unit decrease)...
June 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28370206/adjuvant-psychological-therapy-in-long-term-endocrine-conditions
#14
J Daniels, J M Turner-Cobb
Consideration of psychological distress in long-term endocrine conditions is of vital importance given the prevalence of anxiety and depression in such disorders. Poor mental health can lead to compromised self-care, higher utilization of health services, lower rates of adherence, reduced quality of life and ultimately poorer outcomes. Adjuvant psychological therapy offers an effective resource to reduce distress in endocrine conditions. While the vast majority of work in this area has focused on psychological screening and intervention in diabetes, identification and recognition of psychological distress are equally important in other endocrinological conditions, with supportive evidence in polycystic ovary syndrome and Addison's disease...
June 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28340010/non-proteinuric-rather-than-proteinuric-renal-diseases-are-the-leading-cause-of-end-stage-kidney-disease
#15
Davide Bolignano, Carmine Zoccali
Proteinuria is a distinguishing feature in primary and secondary forms of chronic glomerulonephritis, which contribute to no more than the 20% of the end-stage kidney disease (ESKD) population. The contribution of non-proteinuric nephropathies to the global ESKD burden is still poorly focused and scarce research efforts are dedicated to the elucidation of risk factors and mechanistic pathways triggering ESKD in these diseases. We abstracted information on proteinuria in the main renal diseases other than glomerulonephritides that may evolve into ESKD...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28328996/diaphragmatic-function-is-enhanced-in-fatty-and-diabetic-fatty-rats
#16
Audrey De Jong, Serge Carreira, Na Na, Aude Carillion, Cheng Jiang, Maud Beuvin, Jean-Marc Lacorte, Dominique Bonnefont-Rousselot, Bruno Riou, Catherine Coirault
BACKGROUND: Obesity is associated with a decrease in mortality in the intensive care unit (ICU) (the "obesity paradox"). We hypothesized that obesity may paradoxically improve diaphragmatic function. METHODS: Diaphragm contractility was prospectively recorded in vitro in adult male Zucker lean (control), fatty, and diabetic fatty rats, at rest, after 12h mechanical ventilation and after fatigue. We analyzed diaphragm morphology, cytokines, and protein expression of the protein kinase signaling pathways...
2017: PloS One
https://www.readbyqxmd.com/read/28321553/enhanced-recovery-after-surgery-eras-%C3%A2-in-individuals-with-diabetes-a-systematic-review
#17
Zaina Albalawi, Michael Laffin, Leah Gramlich, Peter Senior, Finlay A McAlister
BACKGROUND: Prevalence of diabetes in surgical patients is 10-40%. It is well recognized that they have higher rates of complications, and longer stays in hospital compared to patients without diabetes. Enhanced recovery after surgery (ERAS) is an evidence-based multimodal surgical care pathway that improves postoperative complications and length of stay in patients without diabetes. This review evaluates the evidence on whether individuals with diabetes would benefit from ERAS implementation...
March 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28320415/the-development-of-integrated-diabetes-care-in-the-netherlands-a-multiplayer-self-assessment-analysis
#18
Nick Zonneveld, Lidewij E Vat, Hans Vlek, Mirella M N Minkman
BACKGROUND: Since recent years Dutch diabetes care has increasingly focused on improving the quality of care by introducing the concept of care groups (in Dutch: 'zorggroepen'), care pathways and improving cooperation with involved care professionals and patients. This study examined how participating actors in care groups assess the development of their diabetes services and the differences and similarities between different stakeholder groups. METHODS: A self-evaluation study was performed within 36 diabetes care groups in the Netherlands...
March 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28316793/development-and-validation-of-an-instrument-to-measure-collaborative-goal-setting-in-the-care-of-patients-with-diabetes
#19
Heather L Morris, Levent Dumenci, Jennifer E Lafata
OBJECTIVE: Despite known benefits of patient-perceived collaborative goal setting, we have a limited ability to monitor this process in practice. We developed the Patient Measure of Collaborative Goal Setting (PM-CGS) to evaluate the use of collaborative goal setting from the patient's perspective. RESEARCH DESIGN AND METHODS: A random sample of 400 patients aged 40 years or older, receiving diabetes care from the Virginia Commonwealth University Health System between 8/2012 and 8/2013, were mailed a survey containing potential PM-CGS items (n=44) as well as measures of patient demographics, perceived self-management competence, trust in their physician, and self-management behaviors...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28292206/mhealth-and-the-management-of-chronic-conditions-in-rural-areas-a-note-of-caution-from-southern-india
#20
Papreen Nahar, Nanda Kishore Kannuri, Sitamma Mikkilineni, G V S Murthy, Peter Phillimore
This article examines challenges facing implementation of likely mHealth programmes in rural India. Based on fieldwork in Andhra Pradesh in 2014, and taking as exemplars two chronic medical 'conditions' - type 2 diabetes and depression - we look at ways in which people in one rural area currently access medical treatment; we also explore how adults there currently use mobile phones in daily life, to gauge the realistic likelihood of uptake for possible mHealth initiatives. We identify the very different pathways to care for these two medical conditions, and we highlight the importance to the rural population of healthcare outside the formal health system provided by those known as registered medical practitioners (RMP), who despite their title are neither registered nor trained...
April 2017: Anthropology & Medicine
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