A New Paediatric Diabetes Knowledge Test - M-WIKAD Development and Factor Analysis.

The purpose of this study was to develop a measure of type 1 diabetes mellitus (T1DM) knowledge that is aimed at youth and is based on contemporary management standards. An 88-item test was derived from the American Association of Diabetes Educators 7 Self-Care Behaviors. A multidisciplinary team selected the best 49 items which were piloted in a sample of 119 youths (59 males, aged 12-18, having a mean ± standard deviation glycated haemoglobin (A1C) of 9.

A Pilot Study Evaluating the Impact of an Adherence-promoting Intervention Among Nonadherent Youth With Inflammatory Bowel Disease.

Purpose: This study examined the feasibility and impact of a multicomponent adherence intervention among youth with Inflammatory Bowel Disease (IBD) who presented to clinic with poor adherence.

Design And Methods: Medical providers referred twelve adolescents for the intervention, who participated in 4 weekly visits with a caregiver aimed at improving adherence.

Results: Intervention session attendance was 100% and the intervention was rated as feasible and acceptable.

Adapting an HIV Risk Reduction Curriculum: Processes and Outcomes.

Becoming a Responsible Teen (BART) is a community-based, HIV risk reduction curriculum shown to increase safer sex behaviors among African American adolescents. However, BART does not address common barriers to sexual health care access, which may limit program efficacy. We used a community-engaged adaptation process to maximize program relevance and health outcomes by incorporating a broad ecological perspective.

Association of HbA1c to BOLUS Scores Among Youths with Type 1 Diabetes.

Background: Frequency of mealtime insulin bolusing (BOLUS) is a promising new objective assessment of adherence in youths with type 1 diabetes (T1D). As further confirmation of the validity of BOLUS, we compare the associations of glycated hemoglobin (HbA1c) values of T1D youths with the original scoring of BOLUS and two alternative scoring procedures: mean mealtime boluses within a 2-h meal window (2h-BOLUS) and total daily frequency of boluses (TOTAL-BOLUS). In addition, we assess HbA1c associations of these three procedures, including interaction terms for mealtime boluses plus correction boluses.

Sleep duration and its impact on adherence in adolescents with type 1 diabetes mellitus.

Background: Adherence to the type 1 diabetes (T1D) regimen, while predictive of glycemic control, decreases during adolescence. For adolescents, attaining adequate sleep is an additional challenge. This study evaluates the impact of sleep on adherence in teens with T1D.

Developing a risk stratification model for predicting future health care use in asthmatic children.

Background: Previous studies have stratified pediatric asthma patients for risk of future exacerbation and/or health care use, but most incorporate multiple clinical parameters.

Objective: To determine whether historical acute care visits (ACVs) alone could predict risk of future health care use.

Methods: Children seen for asthma in an outpatient visit during a 3-year period were identified.

Evaluation of the Average Daily Risk Range as a Measure of Glycemic Variability in Youths with Type 1 Diabetes.

Objective: The Average Daily Risk Range (ADRR) is a measure of glycemic variability (GV) developed for adults with diabetes. Although the ADRR is increasingly being reported in pediatric diabetes research and may also be used in clinical management, it has never been examined for its sensitivity to predicting hyper- and hypoglycemia in youths or compared for its predictive ability with other measures of GV in youths. Thus, we present predictive validity data for the ADRR in youths with type 1 diabetes.

High hemoglobin A1c variability is associated with early risk of microalbuminuria in children with T1D.

Objective: To test the hypothesis that HbA1c variability, as measured by standard deviation (SD), is associated with increased risk for incident microalbuminuria and persistent microalbuminuria in pediatric type 1 diabetes (T1D).

Methods: A retrospective analysis using data from electronic health records was performed on 1195 patients from a pediatric diabetes clinic network in the Midwest USA from 1993 to 2009 with ≥1 yr of T1D, ≥4 total HbA1c values, ≥2 HbA1c values/yr, ≥1 urine microalbumin. Microalbuminuria, the main outcome was defined as albumin excretion rate ≥20 mcg/min or 2 of 3 consecutive urine microalbumin/creatinine ≥30 mg/gm.

Frequency of mealtime insulin bolus predicts glycated hemoglobin in youths with type 1 diabetes.

Background: Within pediatric diabetes management, two electronic measures of adherence exist: frequency of daily blood glucose monitoring (BGM) and the BOLUS score, a measure of frequency of mealtime insulin bolusing. Past research has demonstrated that the BOLUS score is superior to daily BGM in predicting youths' glycated hemoglobin (HbA1c) in a cross-sectional study. We present data comparing the two adherence measures in predicting HbA1c using a prospective, longitudinal design.

Frequency of mealtime insulin bolus as a proxy measure of adherence for children and youths with type 1 diabetes mellitus.

Background: Electronic measures of adherence can be superior to patient report. In type 1 diabetes, frequency of blood glucose monitoring (BGM), as measured by patients' home blood glucose meters, has already been identified as a valid proxy of adherence. We present methodology to calculate adherence using insulin pump records and evaluate the reliability and validity of this methodology.

Cost savings of telemedicine utilization for child psychiatry in a rural Kansas community.

The costs of pediatric telemedicine services remain underreported and understudied; however, there is evidence that telepediatric services can be cost competitive with traditional ones. For 15 years, the University of Kansas Center for Telemedicine and Telehealth has been providing telemental health outreach from the University of Kansas Medical Center (KUMC). One service site is located in Crawford County, Kansas, which provides telepsychiatry services to children and adolescents.