Background: There is recognition of an urgent need for clinic-based interventions for young people with type 1 diabetes mellitus that improve glycemic control and quality of life. The Child and Adolescent Structured Competencies Approach to Diabetes Education (CASCADE) is a structured educational group program, using psychological techniques, delivered primarily by diabetes nurses. Composed of four modules, it is designed for children with poor diabetic control and their parents. A mixed methods process evaluation, embedded within a cluster randomized control trial, aimed to assess the feasibility, acceptability, fidelity, and perceived impact of CASCADE.
Methods: 28 pediatric diabetes clinics across England participated and 362 children aged 8-16 years, with type 1 diabetes and a mean glycosylated hemoglobin (HbA1c) of 8.5 or above, took part. The process evaluation used a wide range of research methods.
Results: Of the 180 families in the intervention group, only 55 (30%) received the full program with 53% attending at least one module. Only 68% of possible groups were run. Staff found organizing the groups burdensome in terms of arranging suitable dates/times and satisfactory group composition. Some staff also reported difficulties in mastering the psychological techniques. Uptake, by families, was influenced by the number of groups run and by school, work and other commitments. Attendees described improved: family relationships; knowledge and understanding; confidence; motivation to manage the disease. The results of the trial showed that the intervention did not significantly improve HbA1c at 12 or 24 months.
Conclusions: Clinic-based structured group education delivered by staff using psychological techniques had perceived benefits for parents and young people. Staff and families considered it a valuable intervention, yet uptake was poor and the burden on staff was high. Recommendations are made to inform issues related to organization, design, and delivery in order to potentially enhance the impact of CASCADE and future programs.
Current Controlled Trials: ISRCTN52537669.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4419460 | PMC |
| http://dx.doi.org/10.1136/bmjdrc-2014-000065 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
TiRobot-assisted versus freehand femoral neck system placement in the treatment of femoral neck fractures: a systematic review and meta-analysis.
J Robot Surg
January 2025
The Third Ward of Orthopaedic Department, General Hospital of Ningxia Medical University, 804 Shengli South Street, Hui Autonomous Region, Yinchuan, Ningxia, 750004, People's Republic of China.
The purpose of this study is to assess the safety and effectiveness of TiRobot-assisted treatment for femoral neck fractures, in comparison to traditional freehand treatment methods. Throughout the research process, we conducted an extensive literature search across numerous databases, including PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), CQVIP, and Wanfang. Based on the literature screening criteria, we selected six studies, encompassing 358 cases of femoral neck fracture patients, for this meta-analysis.
View Article and Find Full Text PDFNeural stem cell-derived extracellular vesicles purified by monolith chromatography retain stimulatory effect in in vitro scratch assay.
Cytotherapy
November 2024
Institute of Immunology and Immunotherapy, College of Medicine and Health, University of Birmingham, Birmingham, UK. Electronic address:
Background Aims: Extracellular vesicles (EVs) have gained traction as potential cell-free therapeutic candidates. Development of purification methods that are scalable and robust is a major focus of EV research. Yet there is still little in the literature that evaluates purification methods against potency of the EV product.
View Article and Find Full Text PDFMachine learning techniques for non-destructive estimation of plum fruit weight.
Sci Rep
January 2025
Crop and Horticultural Science Research Department, Mazandaran Agricultural Resources Research and Education Center, Agricultural Research, Education and Extension Organization (AREEO), Tajrish, Iran.
Plum fruit fresh weight (FW) estimation is crucial for various agricultural practices, including yield prediction, quality control, and market pricing. Traditional methods for estimating fruit weight are often destructive, time-consuming, and labor-intensive. In this study, we addressed the problem of predicting plum FW using artificial intelligence (AI) methods based on fruit dimensions.
View Article and Find Full Text PDFDental maxillary sinus pathology: a CBCT-based case-control study.
Odontology
January 2025
Division of Oral Radiology, Faculdade São Leopoldo Mandic, Rua Dr. José Rocha Junqueira 13 Campinas, São Paulo, 13045-755, Brazil.
This study evaluated the association between dental infection and maxillary sinus pathology, and the influence of age, sex, type of tooth, root proximity to the sinus floor, the condition of the primary maxillary ostium, and the presence of an accessory maxillary ostium in this process. Computed Tomography scans were selected, and upper posterior teeth were evaluated for the presence of apical periodontitis (AP), bone loss with furcation involvement, and endoperiodontal lesion (EPL), subsequently, sinuses were evaluated for mucosal thickening (MT) and opacification of the maxillary sinus (OMS). Logistic regression models were constructed, and Chi-squared and Fisher's tests were applied.
View Article and Find Full Text PDF3D CT to 2D X-ray image registration for improved visualization of tibial vessels in endovascular procedures.
Int J Comput Assist Radiol Surg
January 2025
Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Purpose: During endovascular revascularization interventions for peripheral arterial disease, the standard modality of X-ray fluoroscopy (XRF) used for image guidance is limited in visualizing distal segments of infrapopliteal vessels. To enhance visualization of arteries, an image registration technique was developed to align pre-acquired computed tomography (CT) angiography images and to create fusion images highlighting arteries of interest.
Methods: X-ray image metadata capturing the position of the X-ray gantry initializes a multiscale iterative optimization process, which uses a local-variance masked normalized cross-correlation loss to rigidly align a digitally reconstructed radiograph (DRR) of the CT dataset with the target X-ray, using the edges of the fibula and tibia as the basis for alignment.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!