How Might We Tell if Advances in Diabetes Care and Technology are Helping People to Feel Less Constrained? Introducing the Diabetes Constraints Scale.

Background: Recent advances in diabetes care and technology, such as real-time continuous glucose monitoring, can help people live more freely, with more flexibility and fewer constraints, thereby enhancing quality of life (QOL). To date, there has been no validated means for measuring this key psychological dimension. We developed the Diabetes Constraints Scale (DCS) to assess perceived constraints pertaining to diabetes self-management.

EMBARK: A Randomized, Controlled Trial Comparing Three Approaches to Reducing Diabetes Distress and Improving HbA1c in Adults With Type 1 Diabetes.

Objective: To compare the effectiveness of three interventions to reduce diabetes distress (DD) and improve HbA1c among adults with type 1 diabetes (T1D).

Research Design And Methods: Individuals with T1D (n = 276) with elevated DD (a score >2 on the total Type 1 Diabetes Distress Scale) and HbA1c (>7.5%) were recruited from multiple settings and randomly assigned to one of three virtual group-based programs: 1) Streamline, an educator-led education and diabetes self-management program; 2) TunedIn, a psychologist-led program focused exclusively on emotional-focused DD reduction; or 3) FixIt, an integration of Streamline and TunedIn.

A novel approach to understanding and assessing the emotional side of type 1 diabetes: The Type 1-Diabetes Distress Assessment System.

Aims: To describe the development of a novel, conceptually sound instrument with contemporary content for assessing diabetes distress (DD) among adults with type 1 diabetes.

Methods: Qualitative interviews with 15 adults and 7 clinicians were used to develop Core (intensity of DD emotional burden) and primary Source (key DD contributors) items. These were administered to a national sample recruited from the TCOYD Research Registry, T1D Exchange and our previous studies.

The ubiquity of diabetes distress among adults with type 1 diabetes in an urban, academic practice: A template for intervention.

Aims: The aim of this study was to assess the patterns of diabetes distress within an urban, technology-oriented academic clinical practice to inform staff training and intervention.

Methods: Adults with type 1 diabetes completed the Type 1 Diabetes Distress Scale at their regular clinic visit. Descriptive statistics were generated to document the prevalence of diabetes distress overall, and from seven primary sources of distress: powerlessness, disease management, hypoglycaemia, negative social perceptions, eating, physician and family/friends.

Hyperlactatemia in diabetic ketoacidosis.

Aims: The study examined the prevalence and degree of lactate elevation in diabetic ketoacidosis, and explored which biochemical abnormalities predicted L-lactate levels.

Methods: We reviewed episodes of diabetic ketoacidosis from 79 diabetes patients (one episode per patient). Separate univariate linear regression models were specified to predict lactate level from each of nine biochemical variables.

Measuring Explicit Instruction Using Classroom Observations of Student-Teacher Interactions (COSTI).

This article describes the development and technical adequacy of the Classroom Observations of Student Teacher Interactions (COSTI) instrument, a tool for measuring the frequency and rate of explicit instructional interactions, such as those used in Direct Instruction curricula, for teaching children basic reading and math skills. COSTI was originally developed to provide teachers with coaching feedback to improve their explicit reading instructional practices and has been shown in multiple studies to be a reliable and valid predictor of student gains in beginning reading and math skills. This article discusses potential uses of the instrument for training and coaching across curricula with varying instructional design features, and lays out a future research agenda to further improve COSTI and related observation tools for studying explicit instructional practices and their contribution to student learning.

Reductions in Management Distress Following a Randomized Distress Intervention Are Associated With Improved Diabetes Behavioral and Glycemic Outcomes Over Time.

Objective: To explore associations between reductions in diabetes distress (DD) and improvements in glycemic outcomes among adults with type 1 diabetes (T1D) in the context of a DD randomized clinical trial.

Research Design And Methods: Adults with T1D ( = 301) participated in a two-arm trial aimed at reducing DD (DD-focused OnTrack group vs. education-oriented KnowIt group).

Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty.

Investigate the underlying cellular basis of muscle atrophy (Placebo) and atrophy reduction (essential amino acid supplementation, EAAs) in total knee arthroplasty (TKA) patients by examining satellite cells and other key histological markers of inflammation, recovery, and fibrosis. Forty-one subjects (53-76 yr) scheduled for TKA were randomized into two groups, ingesting 20 g of EAAs or placebo, twice-daily, for 7 days before TKA and for 6 wk after surgery. A first set of muscle biopsies was obtained from both legs before surgery in the operating room, and patients were randomly assigned and equally allocated to have two additional biopsies at either 1 or 2 wk after surgery.

Toward effective interventions to reduce diabetes distress among adults with type 1 diabetes: Enhancing Emotion regulation and cognitive skills.

Objective: We tested three models to determine how improvements in emotion regulation (ER) and cognitive skills (CS) as a result of intervention operate to affect reductions in diabetes distress DD.

Methods: Change data were drawn from the baseline and 9-month T1-REDEEM trial. Adults with type 1 diabetes were recruited from several U.

Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial.

Background: Substantial muscle atrophy occurs after total knee arthroplasty (TKA), resulting in decreased strength and impaired mobility. We sought to determine whether perioperative supplementation with essential amino acids (EAA) would attenuate muscle atrophy following TKA and whether the supplements were safe for ingestion in an older surgical population.

Methods: We performed a double-blind, placebo-controlled, randomized trial of 39 adults (age range, 53 to 76 years) undergoing primary unilateral TKA who ingested 20 g of EAA (n = 19) or placebo (n = 20) twice daily for 7 days preoperatively and for 6 weeks postoperatively.

T1-REDEEM: A Randomized Controlled Trial to Reduce Diabetes Distress Among Adults With Type 1 Diabetes.

Objective: To compare the effectiveness of two interventions to reduce diabetes distress (DD) and improve glycemic control among adults with type 1 diabetes (T1D).

Research Design And Methods: Individuals with T1D ( = 301) with elevated DD and HbA were recruited from multiple settings and randomly assigned to OnTrack, an emotion-focused intervention, or to KnowIt, an educational/behavioral intervention. Each group attended a full-day workshop plus four online meetings over 3 months.

Emotion regulation contributes to the development of diabetes distress among adults with type 1 diabetes.

Objective: To demonstrate how maladaptive emotion regulation (ER) can lead to diabetes distress (DD), with subsequent effects on management and metabolic outcomes among adults with type 1 diabetes.

Methods: Data are based on pre-intervention assessment for a random controlled trial to reduce DD. Patients were recruited in California, Oregon, Arizona and Ontario, Canada.

Cultural Adaptation of the Group Lifestyle Balance Program for Chinese Americans.

Purpose: The purpose of this pilot study was to develop and evaluate a culturally adapted, language-translated diabetes prevention program for Chinese Americans.

Methods: This pilot study had a single-group repeated-measures design. Participants were 25 first-generation (n = 20) or second-generation (n = 5) Chinese Americans at risk for diabetes because of overweight (using the Asian-specific criterion of body mass index ≥ 23) and either prediabetes or metabolic syndrome.

Acculturation and bicultural efficacy effects on Chinese American immigrants' diabetes and health management.

The primary goal of this study was to examine effects of bicultural efficacy, or perceived confidence in dealing with bicultural acculturation stressors, on type 2 diabetes management and health for first-generation, Cantonese-speaking, Chinese American immigrants (N = 162) recruited for a larger community-based diabetes intervention study (Chesla et al. in Res Nurs Health 36(4):359-372, 2013. doi: 10.

Diabetes distress in adults with type 1 diabetes: Prevalence, incidence and change over time.

Aims: To document the prevalence and 9-month incidence of elevated diabetes distress (DD) and the stability of DD over time using both single threshold and minimal clinically important differences (MCID) approaches.

Methods: Adults with type 1 diabetes (T1D) (N=224) completed the 28-item T1-Diabetes Distress Scale (T1-DDS) at baseline and 9months. A T1-DDS threshold was identified with spline analysis and MCID was calculated from the standard error of measurement.

Sports Participation and Positive Correlates in African American, Latino, and White Girls.

Purpose: The purpose of the study was to examine relations among sports participation and positive correlates across African American, Latino, and white girls. Positive correlate variables were self-perceptions (self-worth, body attractiveness, athletic competence), less depression, and participation in extracurricular activities.

Methods: The sample comprised 372 girls (mean age = 12.

Relations of Neighborhood Environment Influences, Physical Activity, and Active Transportation to/from School across African American, Latino American, and White Girls in the United States.

Background: Neighborhood environment influences may be particularly important for understanding physical activity (PA) patterns across ethnic subgroups of early adolescent girls.

Purpose: This study examined relationships between neighborhood variables, moderate to vigorous physical activity (MVPA), and active transportation to/from school across African American, Latino American, and White early adolescent girls living in an urban/suburban community in the northwestern U.S.

Personal, Family, and Peer Correlates of General and Sport Physical Activity among African American, Latino, and White Girls.

This study examined associations between personal, family, and peer variables on objectively measured physical activity (PA), and sports participation, of African American, Latino, and white girls. Specific variables included barriers efficacy, parent PA, parent support of PA, the home exercise environment, friends' PA, and friends' support of PA. The sample comprised 372 girls (mean age = 12.

Causal and bidirectional linkages over time between depression and diabetes regimen distress in adults with type 2 diabetes.

Aims: Diabetes regimen distress (RD) and depression are related constructs, however the nature of their relationship has not been explored over time, leading to difficulties differentiating between RD and depression and for selection of programs of care. We examined longitudinal associations between RD and depression to explicate the direction and mechanism of operation between these two constructs.

Methods: 392 adults with type 2 diabetes participated in a randomized control trial (RCT) to reduce diabetes distress.

Understanding the sources of diabetes distress in adults with type 1 diabetes.

Aims: To identify the unique sources of diabetes distress (DD) for adults with type 1 diabetes (T1D).

Methods: Sources of DD were developed from qualitative interviews with 25 T1D adults and 10 diabetes health care providers. Survey items were then developed and analyzed using both exploratory (EFA) and confirmatory CFA) analyses on two patient samples.

School influences on the physical activity of African American, Latino, and White girls.

Background: The purpose of this research was to examine the impact of school-related variables on the physical activity (PA) levels of early adolescent African American, Latino, and White girls.

Methods: Data were collected from 353 African American (N = 123), Latino (N = 118), and White (N = 112) girls. Physical activity levels included a PA latent factor and minutes per day of moderate-to-vigorous physical activity (MVPA).

Minimal intervention needed for change: definition, use, and value for improving health and health research.

Much research focuses on producing maximal intervention effects. This has generally not resulted in interventions being rapidly or widely adopted or seen as feasible given resources, time, and expertise constraints in the majority of real-world settings. We present a definition and key characteristics of a minimum intervention needed to produce change (MINC).

Reductions in regimen distress are associated with improved management and glycemic control over time.

OBJECTIVE Cross-sectional and longitudinal associations among regimen distress (RD), self-management, and glycemic control were undertaken to explore mechanisms of operation among these variables. RESEARCH DESIGN AND METHODS In a behavioral randomized control trial (RCT) to reduce RD, 392 adults with type 2 diabetes were assessed for RD, diet, exercise, medication adherence, and HbA1c at baseline and at 4 and 12 months. Associations among RD, self-management, and HbA1c were examined in cross-sectional analyses at baseline, in prospective analyses using baseline values to predict change over time, and in time-varying analyses.

Essential amino acid supplementation in patients following total knee arthroplasty.

Background: By the year 2030, 3.48 million older U.S.

Linking internet-based diabetes self-management to primary care: lessons learned and implications for research translation and practice implementation.

There has been little discussion of or research on the key translational issue of how to integrate patient self-management programs across multiple primary care clinics within an HMO. The purpose of this study was to summarize our experiences and lessons learned in trying to integrate information from a web-based diabetes self-management program into primary care and the electronic health record (EHR). We describe plans, implementation, adaptations made, and data on patient and physician reactions to the My Path diabetes self-management program provided to 331 adult primary care patients.