Palliative care delivery in India during COVID-19 pandemic: role of faith-based hospitals - a qualitative study.

Objectives: The COVID-19 pandemic challenged palliative care (PC) services globally. We studied the ways healthcare professionals (HCPs) working in faith-based hospitals (FBHs) experienced and adapted care through the pandemic, and how this impacted patients with PC needs.

Methods: In-depth interviews were conducted with HCPs from FBHs serving rural and urban population across India.

Constellation of Von Hippel-Lindau Disease-Related Findings on a 68Ga-DOTATATE PET/CT.

Von Hippel-Lindau (VHL) is a rare predominantly hereditary syndrome characterized by multiple benign and malignant tumors that can affect different organ systems. We present representative images of a 68Ga-DOTATATE PET/CT in a patient with confirmed VHL gene mutation, which demonstrates a constellation of findings commonly seen in these patients in one single imaging modality.

'COVID-19 and palliative medicine: faith-based hospitals in India'.

Objectives: Faith-based organisations (FBOs) in India provide health services particularly to marginalised communities. We studied their preparedness and delivery of palliative care during COVID-19 as part of a mixed-method study. We present the results of an online questionnaire.

Life Expectancy Predictions for Older Diabetic Patients as Estimated by Physicians and a Prognostic Model.

Unlabelled: Multiple medical organizations recommend using life expectancy (LE) to individualize diabetes care goals. We compare the performance of patient LE predictions made by physicians to LE predictions from a simulation model (the Chicago model) in a cohort of older diabetic patients.

Design: Retrospective cohort study of a convenience sample (n = 447) of diabetes patients over 65 years and their physicians.

Impact and Feasibility of Personalized Decision Support for Older Patients with Diabetes: A Pilot Randomized Trial.

Background: Diabetes guidelines recommend individualizing glycemic goals (A1C) for older patients. The aim of this study was to assess a personalized Web-based decision support tool.

Methods: We randomized physicians and their patients with type 2 diabetes (≥65 years of age) to a support tool or educational pamphlet (75:25 patients).

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study.

Introduction: PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched.

Aim: The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP).

Modified Whale's tail technique for the management of bone-defect in anterior teeth.

The purpose of this case report is to describe the efficacy of a modified Whale's tail technique to achieve primary closure and thereby aid in regeneration of an interdental osseous defect between maxillary central incisors complicated by an aberrant frenal attachment. A healthy 32-year-old female patient reported with the complaint of spacing between her upper front teeth. Clinical examination revealed an aberrant frenum extending into the interdental papilla in relation to the central incisors.

Rates of complications and mortality in older patients with diabetes mellitus: the diabetes and aging study.

Importance: In the coming decades, the population of older adults with type 2 diabetes mellitus is expected to grow substantially. Understanding the clinical course of diabetes in this population is critical for establishing evidence-based clinical practice recommendations, identifying research priorities, allocating resources, and setting health care policies. OBJECTIVE To contrast the rates of diabetes complications and mortality across age and diabetes duration categories.

Cost-effectiveness of MODY genetic testing: translating genomic advances into practical health applications.

OBJECTIVE To evaluate the cost-effectiveness of a genetic testing policy for HNF1A-, HNF4A-, and GCK-MODY in a hypothetical cohort of type 2 diabetic patients 25-40 years old with a MODY prevalence of 2%. RESEARCH DESIGN AND METHODS We used a simulation model of type 2 diabetes complications based on UK Prospective Diabetes Study data, modified to account for the natural history of disease by genetic subtype to compare a policy of genetic testing at diabetes diagnosis versus a policy of no testing. Under the screening policy, successful sulfonylurea treatment of HNF1A-MODY and HNF4A-MODY was modeled to produce a glycosylated hemoglobin reduction of -1.

Ethnic differences in quality of life in insured older adults with diabetes mellitus in an integrated delivery system.

Objectives: To explore racial and ethnic (ethnic hereafter) differences in health-related quality of life (HRQL) in older adults with diabetes mellitus in an integrated delivery system.

Design: Observational cross-sectional study.

Setting: Kaiser Permanente Northern California.

Association between estimated GFR, health-related quality of life, and depression among older adults with diabetes: the Diabetes and Aging Study.

Background: Although chronic kidney disease (CKD) is a highly prevalent condition among older adults with diabetes, the associations between health-related quality of life (HRQoL) and severity of CKD in this population are not well understood. The objective of this study was to assess HRQoL and depressive symptoms across estimated glomerular filtration rate (eGFR) stages.

Study Design: Cross-sectional.

Combating Obesity at Community Health Centers (COACH): a quality improvement collaborative for weight management programs.

Community health centers (CHCs) seek effective strategies to address obesity. MidWest Clinicians' Network partnered with [an academic medical center] to test feasibility of a weight management quality improvement (QI) collaborative. MidWest Clinicians' Network members expressed interest in an obesity QI program.

Public health implications of recommendations to individualize glycemic targets in adults with diabetes.

Objective: To estimate how many U.S. adults with diabetes would be eligible for individualized A1C targets based on 1) the 2012 American Diabetes Association (ADA) guideline and 2) a published approach for individualized target ranges.

Substantial Medicare savings may result if insurers cover 'artificial pancreas' sooner for diabetes patients.

Technologies to improve diabetes care have advanced considerably with the introduction of the insulin pump and continuous glucose monitoring. These two technologies are now being joined and enhanced to create an artificial pancreas. The current study models the impact of the artificial pancreas on clinical results and costs over time, based on early results from clinical trials.

Symptom burden of adults with type 2 diabetes across the disease course: diabetes & aging study.

Background: Reducing symptom burden is paramount at the end-of-life, but typically considered secondary to risk factor control in chronic disease, such as diabetes. Little is known about the symptom burden experienced by adults with type 2 diabetes and the need for symptom palliation.

Objective: To examine pain and non-pain symptoms of adults with type 2 diabetes over the disease course - at varying time points before death and by age.

Classification of older adults who have diabetes by comorbid conditions, United States, 2005-2006.

Introduction: Older adults who have diabetes vary widely in terms of comorbid conditions; these conditions help determine the risks and benefits of intensive glycemic control. Not all people benefit from intensive glycemic control. The objective of this study was to classify by comorbid conditions older American adults who have diabetes to identify those who are less likely to benefit from intensive glycemic control.

Impact of delaying blood pressure control in patients with Type 2 diabetes: results of a decision analysis.

Background: In patients with diabetes, delays in controlling blood pressure are common, but the harms of delays have not been quantified.

Objective: To estimate the harms of delays in controlling systolic blood pressure in middle-aged adults with newly diagnosed Type 2 diabetes.

Design: Decision analysis using diabetes complication equations from the United Kingdom Prospective Diabetes Study (UKPDS).

Correlates of quality of life in older adults with diabetes: the diabetes & aging study.

Objective: To evaluate associations between health-related quality of life (HRQL) and geriatric syndromes, diabetes complications, and hypoglycemia in older adults with diabetes.

Research Design And Methods: A race-stratified random sample of 6,317 adults with type 2 or type 1 diabetes, aged 60 to 75 years, enrolled in Kaiser Permanente Northern California, who completed a survey that included a HRQL instrument based on the Short Form 8-item health survey. Administrative records were used to ascertain diagnoses of geriatric syndromes, diabetes complications, and hypoglycemia.

Tobacco use habits and beliefs among undergraduate medical and nursing students of two cities in southern India.

Background: Unless effective tobacco control is in place, most tobacco-related deaths in the coming decades are likely to be seen in low- and middle-income countries. Tobacco surveillance among medical students offers an opportunity to assess the preparedness for tobacco control among future healthcare professionals in India.

Methods: We did a cross-sectional survey in two cities (Bangalore and Coimbatore) of India.

Health utilities for children and adults with type 1 diabetes.

Objective: We studied health utilities in patients with type 1 diabetes to understand potential differences in health utilities as function of age, type of respondent (self report vs. proxy report), and method of assessment (direct vs. indirect).

Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study.

Objective: To identify the range of glycemic levels associated with the lowest rates of complications and mortality in older diabetic patients.

Research Design And Methods: We conducted a retrospective cohort study (2004-2008) of 71,092 patients with type 2 diabetes, aged ≥60 years, enrolled in Kaiser Permanente Northern California. We specified Cox proportional hazards models to evaluate the relationships between baseline glycated hemoglobin (A1C) and subsequent outcomes (nonfatal complications [acute metabolic, microvascular, and cardiovascular events] and mortality).

The cost-effectiveness of personalized genetic medicine: the case of genetic testing in neonatal diabetes.

Objective: Neonatal diabetes mellitus is a rare form of diabetes diagnosed in infancy. Nearly half of patients with permanent neonatal diabetes have mutations in the genes for the ATP-sensitive potassium channel (KCNJ11 and ABCC8) that allow switching from insulin to sulfonylurea therapy. Although treatment conversion has dramatic benefits, the cost-effectiveness of routine genetic testing is unknown.

The cost-effectiveness of continuous glucose monitoring in type 1 diabetes.

Objective: Continuous glucose monitoring (CGM) has been found to improve glucose control in type 1 diabetic patients. We estimated the cost-effectiveness of CGM versus standard glucose monitoring in type 1 diabetes. RESEARCH DESIGN AND METHODS This societal cost-effectiveness analysis (CEA) was conducted in trial populations in which CGM has produced a significant glycemic benefit (A1C >or=7.

Using the word 'cancer' in communication about an abnormal Pap test: finding common ground with patient-provider communication.

Objective: To investigate provider and patient views about communication regarding cervical cancer screening follow-up.

Methods: Using qualitative analysis, we interviewed 20 providers and 10 patients from two urban clinics that serve low-income African American and Hispanic women. Semi-structured interviews and focus groups assessed familiarity with National Cancer Institute's Cancer Information Service (CIS) and reactions to a letter asking women with abnormal Pap test to telephone CIS.

Intention-to-treat analyses in behavioral medicine randomized clinical trials.

Background: Intention-to-treat (ITT) is an analytic approach where all randomized participants are included in analyses and in their originally assigned condition, regardless of adherence or protocol deviation.

Purpose: The present study aimed to determine whether reporting and correct use of ITT in behavioral medicine randomized clinical trials (RCTs) published in behavioral journals has improved in recent years.

Method: ITT and related analytic conventions were examined in behavioral medicine RCTs (N = 87) published in Annals of Behavioral Medicine, Health Psychology, and the Journal of Consulting and Clinical Psychology in the years 2000-2003 and then again in 2006-2007.