A pilot study of support and education groups for college students with insulin-dependent diabetes mellitus

College students with insulin-dependent diabetes mellitus often ignore the care of their illness. Faced with managing this illness independently for the first time, they lack the knowledge and experience to do so effectively. Their need to establish autonomy often prevents them from seeking the advice of health professionals. In view of this, the author undertook a pilot study to investigate the role of a peer support group on a college campus as a means of improving the diabetic students' management of their illness. Three closed-membership groups met for 10 weekly sessions. Hemoglobin A1c (the measure of average blood sugar over the preceding 3-month interval) determinations prior to participation in the group ranged from 4.0 to 11.7, with a mean of 8.16; after participation in the group, the mean hemoglobin A1c levels of group members dropped to 6.10 (p less than .001). (Hemoglobin A1c measures lower than 6.2 reflect physiologic blood sugar measures of someone without diabetes.) These results suggest that the peer-group approach may be a viable way to improve the metabolic control of young adults with diabetes at the time in their lives when they are learning to manage their illness independently.     

Changes in type 1 diabetes health indicators from high school to college

ABSTRACT

Objective: Evaluate trajectories of type 1 diabetes health indicators from high school through the first year of college. Participants: Seventy-four students with type 1 diabetes who maintained pediatric endocrinology care during the first year of college. Methods: Hemoglobin A_1c (HbA1c), blood glucose monitoring frequency, body mass index (BMI), and clinic attendance data were collected via retrospective medical chart review in spring 2012. Group-based trajectory models evaluated diabetes-related health indicators over time and identified distinct growth trajectory groups. Results: BMI increased and clinic attendance decreased in the first year of college. Trajectories for other health indicators were heterogeneous and stable over time; 69% of students were classified as having stable good glycemic control. Racial minority youth and youth on conventional insulin regimens were disproportionally represented in higher-risk groups. Conclusions: Diabetes health indicators are stable or decline upon college entrance. Results signal the need for targeted support for college students with type 1 diabetes.     

Illness uncertainty and illness intrusiveness as predictors of depressive and anxious symptomology in college students with chronic illnesses

Objective: To examine predictors of psychological functioning in college students with chronic illnesses. Participants: Participants (N = 1413) included 364 students with self-reported diagnoses of asthma or allergies, 148 students with other chronic illnesses (eg, epilepsy, type 1 diabetes), and 901 healthy students. Data were collected between November 2013 and May 2015. Methods: Participants completed online measures of psychosocial functioning, including illness uncertainty, illness intrusiveness, depression, and anxiety. Results: Students with chronic illnesses other than asthma or allergies evidenced the greatest levels of anxious (p <. 05), but not depressive symptomology. Additionally, this group reported greater illness uncertainty and intrusiveness (p <. 05) compared to their peers. Uncertainty and intrusiveness independently predicted depressive and anxious symptoms for students in both illness groups. Conclusions: Compared to peers with asthma or allergies, college students with other chronic illnesses reported higher levels of anxious symptoms. Illness uncertainty and intrusiveness appear to be predictors of psychological distress, regardless of illness.     

Effects of long-term testosterone replacement therapy,with a temporary intermission,on glycemic control of nine hypogonadal men with type 1 diabetes mellitus – a series of case reports

Abstract

Type 2 diabetes mellitus (T2DM) is often associated with obesity and subnormal serum testosterone (T) levels. Until 5 years ago there was no indication that men with type 1 diabetes mellitus (T1DM) had subnormal serum T. But recent studies indicate that about 10% of men with T1DM suffer from hypogonadism, as a rule aged men and men with obesity. While hypogonadal men with T2DM benefit from normalization of their serum T, this has not been investigated in men with T1DM. Nine men with T1DM, erectile dysfunction and hypogonadism (total testosterone?≤?12?nmol/L) received testosterone replacement therapy (TRT). In seven men TRT was intermitted: one man with prostate malignancy and six men because of problems of reimbursement. Incidentally, this provided an opportunity to monitor the effects of withdrawal and of the reinstatement of TRT. In all men, glycemic control (serum glucose and HbA_1c), weight, waist circumference, lipid profiles and erectile function improved upon TRT. The seven men whose TRT was intermitted showed a deterioration which improved again upon reinstatement of TRT. The data suggest that aging and obese men with T1DM might have subnormal T levels and that their glycemic control, lipid profiles and erectile function might benefit from TRT.     

Development of a Testicular Self-Examination Program for College Men

Abstract

“When to Perform Biopsies of Enlarged Peripheral Lymph Nodes in Young Patients,” GAIL B. SLAP, et al. Identification of young patients with peripheral lymphadenopathy who will benefit from lymph node biopsy often is difficult. A model was developed to differentiate patients whose biopsy results do not lead to treatment (normal, hyperplastic, or benign inflammatory lymph nodes) from those whose biopsy results do lead to treatment (granulomatous or malignant nodes). The medical records and histopathology slides of 123 nine- to 25-year-old patients who underwent biopsies of enlarged peripheral lymph nodes were reviewed for pathological diagnosis and 22 clinical findings. Seventy-two (58%) patients had biopsy results that did not lead to treatment, and 51 (42%) had results that did lead to treatment. Using stepwise discriminant analysis, a predictive model was developed that assigned 95% of the cases to the correct biopsy group based on lymph node size; history of recent ear, nose, and throat symptoms; and chest roentgenogram. When tested prospectively on new patients, the model correctly classified 32 (97%) of 33. We conclude that this simple model can help select adolescents and young adults with peripheral lymphadenopathy for biopsy. (Journal of the American Medical Association 1984;252:1321-1326.)

“The Clinical Information Value of the Glycosylated Hemoglobin Assay,” David M. Nathan, et al. We evaluated the clinical information value of the glycosylated hemoglobin assay by comparing it with practitioners' estimates of glucose control over the preceding 10 weeks in 216 patients with diabetes. Twenty-four percent of the practitioners' estimates, which were based on historical and laboratory data collected during a routine office visit, differed by more than ± 75 mg per deciliter from the actual mean blood glucose levels calculated with the glycosylated hemoglobin assay. One third of the mean blood glucose concentration fell outside the confidence intervals physicians used to bound their estimates. When examined individually or in the aggregate, historical information, such as polyuria, nocturia, or home urine testing for glucose, and laboratory information, such as fasting or random blood glucose levels, were weak predictors of the actual mean concentration of blood glucose.     

What's in It for Me?

Abstract

Social service workers' values and religious beliefs often differ greatly from those of their clients. This paper will assist helping professionals to develop a deeper understanding of the motivations behind clients' religious behaviors by describing religious participation through the lens of rational choice theory. A working definition of rational choice is provided. A graphic construct explaining the interaction of demand and supply on religious participation is presented. This model shows how a feedback loop develops to increase religious involvement. A discussion follows regarding religious participation as viewed from a demand side and supply side perspective. The paper concludes with ideas of how the information applies to social service workers and researchers.     

Evaluation of the relationship between microalbuminuria and 25-(OH) vitamin D levels in patients with type 2 diabetes mellitus

Background: 25-(OH) vitamin D (VD) deficiency has been described as potential risk factor for the development of diabetes in many epidemiological studies. 25-(OH) VD deficiency and insulin resistance associated with this deficiency are common findings in patients with type 2 diabetes mellitus. The objective of this study is to evaluate the relationship between 25-(OH) VD levels and microalbuminuria.

Methods: The patients with type 2 diabetes mellitus aged between 40 and 65 years, who were admitted to the diabetes outpatient clinics of our hospital, were evaluated in two different groups. The first group consisted of 119 patients with insufficient 25-(OH) VD levels (10–30?ng/mL) and the second group consisted of 121 patients with 25-(OH) VD deficiency (≤10?ng/mL). The relationship between 25-(OH) VD levels and the level of microalbuminuria was evaluated in the two groups.

Results: The mean 25-(OH) VD level was 11.5?ng/mL and the mean HbA1c level was 9.1%. When the patient groups were evaluated according to 25-(OH) VD levels, HbA1c values were significantly higher in patients with a 25-(OH) VD level of 10?ng/mL or lower (p?=?.039). 25-(OH) VD levels were not significantly different between patients with different stages of renal failure (p?=?.119), whereas the level of microalbuminuria was significantly different (p?=?.030).

Conclusions: This study found that the level of microalbuminuria was significantly higher in patients with 25-(OH) vitamin D deficiency compared to patients with 25-(OH) VD insufficiency.     

Differences in Sleep Quality and Health-Related Quality of Life in Young Adults With Allergies and Asthma and Their Healthy Peers

Abstract

Objective: The current study examined the relationship between sleep quality and health-related quality of life (HRQOL). Participants: Participants were 501 undergraduate students with allergies (167), asthma + allergies (167), or with no history of a chronic illness (167) completed study measures from August 2011 to April 2012. Methods: The undergraduate students completed questionnaires online as part of a larger study of psychosocial adjustment of young adults. Results: Young adults with allergies and asthma + allergies reported significantly worse sleep quality and HRQOL than healthy peers. Additionally, those with allergies and asthma + allergies had significantly more sleep disturbances and used sleeping medication significantly more often in the previous month than healthy peers. Conclusions: These results highlight concerns regarding quality of life and sleep problems in an often-overlooked population. Importantly, sleep difficulties can result in difficulties in daily living and impairment in academic functioning.     

Acquired disability in young women: a challenge for identity?

ABSTRACT

Youth can be described as a transitional phase for the formation of identity. As young people often hold taken-for-granted assumptions regarding their future, disability may pose a challenge for their identity development. This paper analyses the retrospectively written autobiographical narratives by three young women who became disabled during their adolescence. The structure of the narratives is approached with sociologist Arthur Frank’s typology of illness narratives and identity through data-driven content analysis. This paper suggests that chaotic stories may hinder the development of identity, as the identity is described as delayed, hidden, silenced or neglected.     

Practice Wisdom on Custodial Parenting with Mental Illness: A Strengths View

ABSTRACT

Social work principles of strengths, empowerment, and consumer-centered care for persons with mental illness are currently being adapted to broader contexts. This article presents study findings on practice wisdom about custodial parents with mental illness, a potentially increasing group of consumers in light of mental health reform. The research team organized thirty-six professionals with practice experience into five focus groups. Findings reflect strengths perspective categories of resilience, social support, family functioning, self-care, and parents' positive experience of their symptoms. Implications discuss how providers who work with custodial parents and their children can apply these findings in assessments and interventions.     

Small-Group Learning and Hypothetical Families in a Large Introductory Course

Abstract

Increased university enrollments and large class sizes, especially at the introductory level, demand creative approaches to promote learning and engagement in the classroom. Small-group work can help achieve these goals, creating a positive and memorable student experience. We propose a small-group exercise that can supplement the traditional lecture format in an introductory marriage and families course. Students are assigned to small groups as members of hypothetical families and are presented with real-life situations over the course of the semester (e.g., job loss or promotion, illness, or extended absence of a family member). Students write about each new situation's effects on their individual character and discuss the implications and potential adjustments for the family. To ensure participation, students who miss class can complete an online version of the assignment. This exercise encourages a critical imagination, promotes interaction and participation, and challenges students to think critically by applying course concepts.     

No Fear,Just Relax and Play: Social Anxiety,Alcohol Expectancies,and Drinking Games Among College Students

Abstract

Objective: The authors examined the association between social anxiety and drinking game (DG) involvement as well as the moderating role of social anxiety–relevant alcohol outcome expectancies (AOE) in social anxiety and DG involvement among college students. Participants: Participants were 715 students (74.8% women, M _age = 19.46, SD = 1.22) from 8 US colleges. Methods: Data were collected via self-report survey from Fall 2005 to Spring 2007. Results: Tension Reduction and Liquid Courage AOE moderated the association between social anxiety and DG participation. Tension Reduction AOE and DG participation were positively related among those with high social anxiety, but were associated negatively for those with low social anxiety. Liquid Courage AOE were associated with increased DG participation for those with low social anxiety, but not for those with high social anxiety. Conclusions: Findings suggest that social anxiety acts as a protective or a risk factor for DG participation among college students, depending upon AOE.     

Gender differences in physical activity are partially explained by anxiety sensitivity in post-secondary students

Abstract

Objective: Female post-secondary students typically engage in less physical activity than their male counterparts. Given that women have greater anxiety sensitivity (ie, fear of arousal-based body sensations) and anxiety sensitivity is inversely related to physical activity participation, this study sought to determine if anxiety sensitivity mediates gender differences in self-reported physical activity. Participants and methods: A sample of 802 post-secondary students completed the Anxiety Sensitivity Index-3 and a Lifestyles Questionnaire in September 2017. Results: Women reported significantly less physical activity and significantly greater anxiety sensitivity. Anxiety sensitivity was significantly and inversely related to self-reported physical activity. A significant indirect effect of gender on physical activity via anxiety sensitivity was shown (B?=?5.56, SE?=?2.81, p?<?.05, 95% CI [1.31, 12.78], P_M?=?.0843). Conclusions: Results suggest that anxiety sensitivity partially explains gender differences in physical activity. Anxiety sensitivity reduction interventions might increase physical activity participation and reduce the existing gender gap.     

The effect of lifestyle modification and glycemic control on the efficiency of sildenafil citrate in patients with erectile dysfunction due to type-2 diabetes mellitus

Abstract

Objectives: We evaluated the effect of lifestyle modifications and glycemic control on the efficiency of sildenafil citrate in patients with type-2 diabetes (T2DM) and erectile dysfunction (ED).

Methods: Eighty-three men with ED due to T2DM were included in the study. The Group 1 (n?=?41) patients received lifestyle modifications (diet and exercise), and medical treatment for intensive glycemic control. In Group 2 (n?=?42), in addition to the intensive glycemic control, the patients were given sildenafil citrate® 100?mg for 2–3 per weeks. The changes in ED were compared between the two groups after three months of treatment.

Results: The mean age was 54.9?±?9.1 (26–75) years. An increase in the IIEF-5 scores was observed in 23 of 41 patients in Group 1 (44.2%) and 29 of 42 in Group 2 (55.8%). When the changes of the IIEF-5 scores were evaluated, the mean increase was 2.5 in Group 1, and 5.0 in Group 2 (p?=?0.012). The mean IIEF changes according to the duration of diabetes were 4.8 in <5 years, 3.6 in 5–10 years and 1.6 in >10 years (p?=?0.021).

Conclusions: Glycemic control and lifestyle changes are not solely adequate for a better sexual function in ED due to diabetes, and sildenafil citrate should be used additionally.     

Incremental Change: The Pace of Progress in Health

Abstract

In a prospective study of acute diarrheal illness among college students, during one academic year, the incidence of Campylobacter enteritis was 5.57 per 1,000. Approximately 17% of all patients with acute diarrheal illness had Campylobacter enteritis. Campylobacter enteritis is briefly discussed. The value of the stool wet-mount examination is emphasized. It can serve as a guide to which stools to culture and often can lead to a presumptive diagnosis of Campylobacter enteritis. Student health center labs are urged to perform stool wet-mount exams and to provide cultures for isolating the Campylobacter organism.     

A Night to Remember: A Harm-Reduction Birthday Card Intervention Reduces High-Risk Drinking During 21st Birthday Celebrations

Objective: In collaboration with Residence Life, the Heads UP research team developed a 21st birthday card program to help reduce the risky drinking often associated with these celebrations.

Participants: 81 students (28 males, 53 females) completed a post-21st birthday survey. Of these, 74 reported drinking during their 21st birthday and were included in the analyses.

Methods: During the 2005-2006 school year, the authors assigned students celebrating 21st birthdays to either receive an alcohol risk-reduction birthday card or to a no-card condition. The students completed a survey after their birthday.

Results: Students who received the card consumed fewer drinks and reached lower blood alcohol content (BAC) levels on their birthday than did students who did not receive it. Female students who received the card consumed 40% fewer drinks and reached nearly 50% lower BAC levels than women who did not receive it.

Conclusion: This program is easily replicated, inexpensive, and may be used by universities to reduce risk related to celebratory alcohol consumption.     

Kinship Care: Analysis of the Health and Well-Being of Grandfathers Raising Grandchildren Using the Grandparent Assessment Tool and the Medical Outcomes Trust SF-36 TM Health Survey

ABSTRACT

As more and more children are being separated from their biological parents because of AIDS, substance abuse, mental and physical illness, incarceration, and child abuse and neglect, child welfare agencies are relying more often on kinship care as a viable option for out-of-home placements. In many cases, kinship care falls on the grandparents. While keeping children within their families is generally viewed as preferable by child welfare agencies, it can be a burden on grandparent caregivers, who often exist on severely limited incomes and without much assistance or support from social service agencies. A research project was conducted which used both quantitative and qualitative data from research conducted by Jones and Gibbons (2000) on grandparent care, but this study focuses on the experiences of grandfathers who participated in the project and examines their outcomes in several different areas.     

Self-esteem,Self-focused Attention,and the Mediating Role of Fear of Negative Evaluation in College Students With and Without Asthma

Abstract

Objective: The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Participants: Young adults with (n = 148) and without (n = 530) childhood-onset asthma were recruited from a college student population. Methods: Self-focused attention and fear of negative evaluation measures were completed. Participants also answered questions about inclusion in a social activity. Results: Higher levels of self-focused attention and fear of negative evaluation were associated with lower self-esteem in both groups within the context of social activity participation. Fear of negative evaluation mediated the relationship between self-consciousness and self-esteem. No significant differences were found between groups. Conclusions: Findings indicate significant relationships among self-focused attention, fear of negative evaluation, and self-esteem in the context of social activity participation. Further examination of self-esteem regarding participation in social activities among college students appears warranted.     

EDITORIAL

Abstract

This exploratory, qualitative research was conducted to obtain the perspectives of people with significant physical disabilities regarding factors that have facilitated and hindered the development of a positive self-concept, participation in the broader society, and the formation of interpersonal relationships. The sample was high achieving in terms of education and/or career and attributed positive self-perceptions and their success in the broader society and interpersonal relationships to the attitudes and perceptions regarding their abilities, talents, and potential modeled in supportive family relationships. Females reported the influence of significant others most often, and males the effectiveness of their personality characteristics. Societal barriers, both practical and attitudinal, were reported along with the process for developing a positive self-perception despite these.     

The Experience of Trauma Recovery: A Qualitative Study of Participants in the Women Recovering from Abuse Program (WRAP)

ABSTRACT

The efficacy of intensive group treatment programs for child maltreatment has been established. The aim of this qualitative study was to understand how women with a history of child maltreatment experienced the Women Recovering from Abuse Program (WRAP), an existing intensive group treatment program. Seven women were interviewed following their participation in WRAP. Three themes emerged: Breaking Trauma-Based Patterns, Doing Therapy, and The Healing Journey as a Continuous Process. These findings deepen our understanding about how participants view the recovery process. Theoretical and clinical implications are discussed.