As 7.8% of the U.S. population is affected by diabetes, health care providers are tasked with providing resources to assist patients toward self-management. Psychosocial issues have an effect on diabetes self-care. Diabetes-related distress associated self-management and lower A1C. This cross-sectional study seeks understand how demographic factors, psychological orientations, support, management behaviors predict diabetes-related distress. uses data from 267 adults Type 2 diabetes. The...

Frequently admitted patients (i.e., ‘high utilizers’) comprise a small percentage of all yet consume relatively large proportion hospital resources. This quality improvement project aimed to reduce resource utilization by implementing individualized care plans (ICPs) for high utilizers. An electronic health record (EHR) report identified A hospitalist workgroup then selected who were young with frequent low-risk admissions. The created and documented ICPs in the EHR, linked from numerous...

The need for all physicians to function as leaders in their various roles is becoming more widely recognized. There are increasing opportunities at levels including Graduate Medical Education (GME) gain leadership skills, but most of these only those interested. Although not an Accreditation Council (ACGME) requirement, some US graduate medical education programs have incorporated training into curricula. Interestingly, the Royal College Physicians and Surgeons Canada adopted Leader role its...

Objective: The purpose of this study was to validate the 10-item DSSI as a brief measure social support for use in diverse adult populations. Methods: EFA performed on 2010 Arizona Health Survey (AHS) data (n = 8215). Confirmatory Factor Analysis (CFA) then confirmed factors structure by gender, ethnicity, and age, well total population. DSSI-10 subscales were compared with variables related support. Results: CFI confirms exhibits good model fit. Low self-reported health status low quality...

Abstract Rationale Current guidelines recommend thyroid stimulating hormone (TSH) alone as the best test to detect and monitor dysfunction, yet free thyroxine (FT4) triiodothyronine (FT3) are commonly ordered when not clinically indicated. Excessive testing can lead added economic burden in an era of rising healthcare costs, while rarely contributing evaluation or management disease. Objective To evaluate our institution's practice ordering function tests (TFTs) identify strategies reduce...

Literature on institutionalization of patients with dementia has not considered the role caregivers' quality care, which encompasses exemplary care (EC) behaviors and potentially harmful (PHBs) toward recipients. This study sought to understand in mediating between caregiving stressors caregiver desire institutionalize (DTI) a patient dementia.A sample 612 family caregivers from diverse racial/ethnic backgrounds was drawn baseline data Resources for Enhancing Alzheimer's Caregiver Heath...

Endogenous testosterone increases with weight loss from diet, exercise, and bariatric surgery. However, little is known about levels after medication.Uncover the effects of Glucagon-Like Peptide-1 receptor agonist (GLP-1 RA) therapy on serum testosterone.Prospective cohort study men starting GLP-1 RA for type 2 diabetes mellitus.51 lost 2.27 kg (p = 0.00162) their HbA1c values improved by 0.7% 0.000503) 6 months therapy. There was no significant change in group as a whole. subgroup analyses,...

Background: Insulin, a high-risk medication, is prone to prescribing errors. Patients with diabetes experience higher hospitalization rates and extended hospital stays. Prescription errors, such as missing orders, inappropriate insulin type, instructions, lack of appropriate intensification regimens are common issues. This project explored the use system-based interventions educational tools minimize errors improve quality discharge regimens. Methods: A needs assessment baseline chart review...

Background: American Diabetes Association (ADA) recommends psychosocial assessment for people with diabetes, including diabetes-related distress. Elevated distress is associated poor self-management, lower medication adherence, and poorer quality of life. Insulin delivery methods are multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII). Because type 1 diabetes mellitus (T1DM) require comprehensive therapy to manage blood glucose, we explored the association in...

While previous studies have demonstrated testosterone's beneficial effects on glycemic control in men with hypogonadism and Type 2 Diabetes, the extent to which these improvements are observed based degree of treatment adherence has been unclear.To evaluate long-term testosterone therapy A1C levels Diabetes Mellitus hypogonadism, controlling for BMI, pre-treatment A1C, age among different groups.We performed a retrospective analysis 1737 diabetes 5 years data from 2008-2018, isolating lipid...

Since there are only 33 endocrinologists within the Department of Defence and over 150 000 beneficiaries with diabetes, most patients diabetes will be treated by primary care providers (PCPs). Comprehensive visits extensive clinical practice guidelines (CPGs) routinely change; thus, providing current evidence-based is difficult. Most professional development courses aim to update PCPs on CPGs but often inadequate as they focus (not interdisciplinary team) without a plan implement changes...

Background: Metabolic syndrome (MetS) is strongly associated with cardiovascular disease. With MetS prevalence rates increasing in the U.S. population, prevention efforts have largely focused on diet and exercise interventions. Before retirement, military service members met fitness requirements for at least 20 years, lower compared to age-matched population controls (23.4% vs. 39.0%), which suggests a protective effect of lifestyle service. However, retirees not been previously reported, so...

The purpose of this study is to understand changes in thinking patients with diabetes and factors related the health care providers significant others that would mediate thinking. Cross-sectional data were collected from three sites. Adults age 21 older type 2 asked about their regarding at diagnosis present time. In addition, respondents questions perceptions (that is, physicians, nurses, educators), others, manage- ment diabetes. Significant other blame self-efficacy found be partial...

The overall rate of obesity is rising in the USA; this also reflected military population. It important that providers appropriately diagnose and discuss treatment options with their patients.The purpose study was to investigate diagnosis compared documented body mass index (BMI) health system.Institutional review board approval obtained by 59th Medical Wing (Lackland Air Force Base, Texas) as an exempt study. This included active duty service members aged 18-65 years who sought outpatient...

The Diabetes Prevention Program (DPP) demonstrated that lifestyle intervention programs were effective in preventing or delaying the onset of diabetes. Group Lifestyle Balance (GLB) program translated DPP curriculum into a 12-wk group for those at risk This retrospective evaluation examined clinical outcomes patients Center Excellence GLB located Wilford Hall Ambulatory Surgical from 2009 to 2013. Objectives included determining rates retention, demographic characteristics completers, and...

IN BRIEF This study examined the relationship between patient commitment and A1C. Patients completed Altarum Consumer Engagement (ACE) measure. Multiple A1C values were extracted from medical records for 273 military beneficiaries. Effects analyzed with generalized linear models. The ACE Commitment subscale was significantly inversely related to trends. Low-commitment patients more likely have a high High-commitment 16% an <7.0%; this likelihood increased 65% over time. domain may be useful...

Psychosocial disadvantage and lower socioeconomic status are associated with increased risk of poor health. The purposes this study to identify a threshold at which cumulative psychosocial factors become significantly decrease in health examine whether women higher than men. Using secondary cross-sectional data, correlation self-reported rating was conducted. Participant characteristics by number health-related risks were constructed. accumulation had negative effect on the two; decreased...

This study focuses on the identification of multiple latent trajectories pain intensity, and it examines how religiousness is related to different classes trajectory. Participants were 720 community-dwelling older adults who interviewed at four time points over a 3-year period. Overall, intensity decreased 3 years. Analysis using growth mixture modeling (GMM) identified three pain: (1) increasing ( n = 47); (2) consistently unchanging 292); (3) decreasing 381). Higher levels intrinsic (IR)...

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Introduction Historically, there has been variability in the methods for determining preventable death within US Department of Defense. Differences methodologies partially explain variable rates ranging from 3% to 51%. The lack standard review process likely misses opportunities improvement combat casualty care. This project identified recommended medical and non-medical factors necessary (1) establish a comprehensive (2) identify throughout entire continuum Methods qualitative study used...