Enforcement of Hospital Nurse Staffing Regulations Across the United States: Progress or Stalemate?

Enactment of hospital nurse staffing regulations was brought about by changes in the U.S. health care system that resulted in large-scale reductions in nurse staffing.

Use of three computer training methods in elderly underserved rural patients enrolled in a diabetes telemedicine program.

A telephone survey of Medicare beneficiaries with diabetes living in rural underserved areas and enrolled in the Informatics for Diabetes Education and Telemedicine project identified 109 subjects who requested further training in functions of the home telemedicine unit after initial in-home training by regional nurse installers. The initial training provided the skills needed to videoconferences with nurse case managers and to transmit blood glucose and blood pressure readings, but further instruction was needed for access to Web-based education features and messaging. This study evaluated these elderly patients' perceptions of the helpfulness of three additional telemedicine training methods:in-home visit with an regional nurse installer referencing a user's manual, unassisted patient use of the user's manual, and telephone-based training not using regional nurse installers reinforcing the user's manual.

Telemedicine intervention effects on waist circumference and body mass index in the IDEATel project.

Background: We examine the changes in waist circumference (WC) and body mass index (BMI) in older adults enrolled in a diabetes telemedicine program. The subjects were elderly Medicare beneficiaries participating in the rural (upstate New York) cohort of Informatics and Diabetes Education and Telemedicine, a randomized, controlled trial using telemedicine to improve diabetes care in which the primary outcome was glycemic control.

Methods: Ninety-two percent of the subjects had BMI >25 kg/m(2), and 65.

School-centered telemedicine for children with type 1 diabetes mellitus.

Objectives: To test the feasibility and effectiveness of telemedicine to improve care of children with type 1 diabetes in schools.

Study Design: Subjects, ages 5 to 14 years (grades kindergarten through eighth) were randomized to usual care (18 students; 13 schools) or intervention (23 students; 12 schools). Usual care included medical visits every 3 months and communication between school nurse and diabetes team as needed by phone.

Detection and remediation of medically urgent situations using telemedicine case management for older patients with diabetes mellitus.

Introduction: Detection and response to medically urgent situations in patients with diabetes mellitus can improve the process and outcomes of care and potentially decrease morbidity and mortality. We examined the detection and remediation of medically urgent situations among older patients receiving telemedicine case management for diabetes.

Methods: In the setting of a randomized trial, 338 patients in the intervention group and living in upstate New York received a home telemedicine unit to transmit blood glucose and blood pressure values to a nurse case manager, videoconference with a nurse or dietitian every 4-6 weeks and access educational websites.

A randomized trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus.

Background: Telemedicine is a promising but largely unproven technology for providing case management services to patients with chronic conditions who experience barriers to access to care or a high burden of illness.

Methods: The authors conducted a randomized, controlled trial comparing telemedicine case management to usual care, with blinding of those obtaining outcome data, in 1,665 Medicare recipients with diabetes, aged 55 years or greater, and living in federally designated medically underserved areas of New York State. The primary endpoints were HgbA1c, blood pressure, and low-density lipoprotein (LDL) cholesterol levels.

Age affects ERK1/2 and NRF2 signaling in the regulation of GCLC expression.

We previously reported that activator protein-1 (AP-1) DNA binding activity was increased in vascular smooth muscle cells (VSMC) from old rats when exposed to high glucose or tumor necrosis factor (TNF-alpha) (Li et al., 2003. J Cell Physiol 197:418-425).

A comparison of diabetes education administered through telemedicine versus in person.

Objective: To determine whether diabetes education can be provided as effectively through telemedicine technology as through in-person encounters with diabetes nurse and nutrition educators.

Research Design And Methods: A total of 56 adults with diabetes were randomized to receive diabetes education in person (control group) or via telemedicine (telemedicine group) and were followed prospectively. The education consisted of three consultative visits with diabetes nurse and nutrition educators.