scholarly journals Adherence to Antidiabetic Medications among Women with Gestational Diabetes

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Michelle Asiedu-Danso ◽  
Irene A. Kretchy ◽  
Jeremiah Kobby Sekyi ◽  
Augustina Koduah

Background. Optimal adherence to prescribed medications in women with gestational diabetes is relevant for perinatal outcomes. Objective. To summarize available information on the prevalence and factors contributing to medication adherence in women with gestational diabetes from the biological and psychosocial perspectives. Methods. A literature search on adherence in gestational diabetes was conducted in PubMed/MEDLINE, CINAHL, Scopus, and the Directory of Open Access Journals for studies published on the topic. The Arksey and O’Malley framework for scoping reviews was used to explore and summarize the evidence. Results. A total of 2395 studies were retrieved of which 13 fully met the eligibility criteria. The studies were reported in Zimbabwe ( n = 5 ), Iran ( n = 1 ), Mexico ( n = 1 ), South India ( n = 1 ), the United States of America ( n = 4 ), and one multinational study covering Australia, Europe, North and South America. The main types of antidiabetic medications used were insulin ( n = 6 ), metformin ( n = 4 ), and glyburide ( n = 2 ). The prevalence of adherence ranged from 35.6% to 97%, with the assessment tool being self-report measures ( n = 8 ). The main factors associated with nonadherence included worsening pregnancy symptoms, side effects of medications, perceived risks, mental health symptoms, poor social support, and socioeconomic status. Recommendations that evolved from the studies to improve adherence included education, counselling, improved support networks, and social interventions, while the main reported interventional study employed continuous education on the impact of adherence on perinatal outcomes. Conclusion. Medication nonadherence in gestational diabetes seems to be influenced by multiple factors with some educational interventions positively impacting adherence behaviours. Thus, future research in women with gestational diabetes could consider interventions from a multifactorial perspective to improve therapeutic outcomes.

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1432 ◽  
Author(s):  
Sally Moore ◽  
Judy Donnelly ◽  
Steve Jones ◽  
Janet Cade

The potential for nutrition labels to impact on population health is dependent on consumer ability to understand and use this information. Consumer understanding of this information varies across sociodemographic groups and with different label design formats. Labeling legislation requires consumer education on how to use nutrition labels, and recent mandatory changes to the Nutrition Facts Panel (NFP) are underway to improve comprehensibility. This review aimed to evaluate if educational programs can improve understanding and use of nutrition labels. Database searches were performed to identify interventions which delivered education on nutrition labels with outcomes measuring aspects of comprehension or use. A total of 17 studies were selected for review, including nine randomized and eight cohort studies. The majority of studies were conducted in the United States Study participants included school aged children, older adults, and those with diabetes within a range of intervention types involving taught sessions or web-based education. Whilst outcome measures were heterogenous, all studies reported a statistically significant improvement in one or more outcomes of participant understanding or use of nutrition labels. Aspects such as general nutrition knowledge, health literacy, and program delivery format warrant attention in future research. Education which optimizes comprehension and use of nutrition labels may have the potential to improve the impact of this information on dietary health.


BMJ ◽  
2018 ◽  
pp. k4372 ◽  
Author(s):  
Yash S Khandwala ◽  
Valerie L Baker ◽  
Gary M Shaw ◽  
David K Stevenson ◽  
Ying Lu ◽  
...  

AbstractObjectiveTo evaluate the impact of advanced paternal age on maternal and perinatal outcomes in the United States.DesignRetrospective, population based cohort study.SettingUS.Population40 529 905 documented live births between 2007 and 2016.Main outcome measuresPrimary perinatal outcomes were gestational age, birth weight, Apgar score at five minutes, admission to a neonatal intensive care unit, need for postpartum antibiotics, and seizures. Primary maternal outcomes were gestational diabetes and pre-eclampsia. Secondary outcome was the number of preventable perinatal events.ResultsHigher paternal age was associated with an increased risk of premature birth, low birth weight, and low Apgar score. After adjustment for maternal age, infants born to fathers aged 45 years or older had 14% higher odds of premature birth (odds ratio 1.14, 95% confidence interval 1.13 to 1.15), independent of gestational age, and 18% higher odds of seizures (1.18, 0.97 to 1.44) compared with infants of fathers aged 25 to 34 years. The odds of gestational diabetes was 34% higher (1.34, 1.29 to 1.38) in mothers with the oldest partners. 13.2% (95% confidence interval 12.5% to 13.9%) of premature births and 18.2% (17.5% to 18.9%) of gestational diabetes in births associated with older fathers were estimated to be attributable to advanced paternal age.ConclusionsAdvanced paternal age is associated with negative effects on both mothers and offspring. Given the relatively low prevalence of advanced paternal age in the US, population level impacts are currently modest. Nevertheless, as advanced paternal age has doubled in the US over the past generation, further investigation is warranted of the impact on birth outcomes and public health.


2017 ◽  
Vol 17 (1) ◽  
pp. 220-225 ◽  
Author(s):  
Ida K. Flink ◽  
Ester Klein-Strandberg ◽  
Steven J. Linton

AbstractBackground and aimsContext insensitivity has been put forward as a potential mechanism explaining the high co-occurrence of pain and emotional distress. In the pain literature, the concept has only been introduced at a theoretical level and an assessment tool for exploring its impact is lacking. In an interpersonal setting, a core aspect of context sensitivity and insensitivity concerns when to disclose and when to avoid expressing pain and related distress. Both context insensitive disclosure and context insensitive avoidance may hamper interpersonal support and fuel the problem. This exploratory study describes an attempt to develop a self-report instrument to assess tendencies to disclose vs. avoid expressions of pain and related distress, as well as self-perceived adjustment of disclosure vs. avoidance to the context.MethodsApool of items was systematically developed to assess different aspects of context insensitivity, including disclosure vs. avoidance of expression. 105 participants with persistent pain were recruited at pain rehabilitation clinics (80% of the sample) and in a university setting (20% of the sample). The participants responded to the pool of items as well as to a number of validated self-report instruments covering pain, pain-related disability, pain catastrophizing, emotion regulation tendencies, self-compassion and pain acceptance. The analyses explored the factorial structure of the initial instrument, as well as the criterion and construct validity.ResultsThe analyses confirmed a stable underlying structure of the initial scale, with four distinct factors explaining 64.4% of the total variance. However, the criterion and construct validity could only be confirmed for one of the factors, which contained items reflecting context insensitive avoidance of expression. Consequently, only this factor, demonstrating very good internal consistency, was kept in the final version of the instrument which was named context insensitive avoidance (CIA).ConclusionsWe found support for the final version of our instrument, capturing one prominent aspect of context insensitivity. Avoidance of expression was related to higher ratings of pain, disability, catas- trophizing and suppression as well as to lower levels of self-compassion. We encourage further studies to explore the impact of context insensitive avoidance for regulating pain and associated negative emotions. Yet, more research is needed that goes beyond self-report and includes other aspects of context. It is urgent to develop systematic ways for assessing context insensitivity, as it will enhance our understanding of regulatory strategies as potential transdiagnostic mechanisms in pain and emotion.ImplicationsThis tool for assessing contextually insensitive avoidance of expression could potentially be used both clinically and in future research to advance our understanding of comorbid problems with pain and emotional distress. Further research is needed to develop methods for assessing other aspects of context insensitivity to fully understand its impact in patients suffering from pain.


Author(s):  
Han Shi Jocelyn Chew ◽  
Violeta Lopez

Objective: To provide an overview of what is known about the impact of COVID-19 on weight and weight-related behaviors. Methods: Systematic scoping review using the Arksey and O’Malley methodology. Results: A total of 19 out of 396 articles were included. All studies were conducted using online self-report surveys. The average age of respondents ranged from 19 to 47 years old, comprised of more females. Almost one-half and one-fifth of the respondents gained and lost weight during the COVID-19 pandemic, respectively. Among articles that examined weight, diet and physical activity changes concurrently, weight gain was reported alongside a 36.3% to 59.6% increase in total food consumption and a 67.4% to 61.4% decrease in physical activities. Weight gain predictors included female sex, middle-age, increased appetite, snacking after dinner, less physical exercise, sedentary behaviors of ≥6 h/day, low water consumption and less sleep at night. Included articles did not illustrate significant associations between alcohol consumption, screen time, education, place of living and employment status, although sedentary behaviors, including screen time, did increase significantly. Conclusions: Examining behavioral differences alone is insufficient in predicting weight status. Future research could examine differences in personality and coping mechanisms to design more personalized and effective weight management interventions.


Author(s):  
Miriam Blume ◽  
Petra Rattay ◽  
Stephanie Hoffmann ◽  
Jacob Spallek ◽  
Lydia Sander ◽  
...  

This scoping review systematically mapped evidence of the mediating and moderating effects of family characteristics on health inequalities in school-aged children and adolescents (6–18 years) in countries with developed economies in Europe and North America. We conducted a systematic scoping review following the PRISMA extension for Scoping Reviews recommendations. We searched the PubMed, PsycINFO and Scopus databases. Two reviewers independently screened titles, abstracts and full texts. Evidence was synthesized narratively. Of the 12,403 records initially identified, 50 articles were included in the synthesis. The included studies were conducted in the United States (n = 27), Europe (n = 18), Canada (n = 3), or in multiple countries combined (n = 2). We found that mental health was the most frequently assessed health outcome. The included studies reported that different family characteristics mediated or moderated health inequalities. Parental mental health, parenting practices, and parent-child-relationships were most frequently examined, and were found to be important mediating or moderating factors. In addition, family conflict and distress were relevant family characteristics. Future research should integrate additional health outcomes besides mental health, and attempt to integrate the complexity of families. The family characteristics identified in this review represent potential starting points for reducing health inequalities in childhood and adolescence.


2021 ◽  
Vol 10 (2) ◽  
pp. 348
Author(s):  
Friederike Weschenfelder ◽  
Friederike Hein ◽  
Thomas Lehmann ◽  
Ekkehard Schleußner ◽  
Tanja Groten

The aim of diabetes care of pregnant women with gestational diabetes mellitus (GDM) is to attain pregnancy outcomes including rates of large-for-gestational-age (LGA) newborns, pre-eclampsia, C-sections (CS) and other neonatal outcomes similar to those of the non-GDM pregnant population. Obesity and excessive weight gain during pregnancy have been shown to also impact perinatal outcome. Since GDM is frequently associated with elevated body mass index (BMI), we evaluated the impact of maternal prepregnancy BMI, development of GDM and gestational weight gain (GWG) during pregnancy on perinatal outcome. We compared 614 GDM patients with 5175 non-diabetic term deliveries who gave birth between 2012 and 2016. Multivariate regression analysis was used to evaluate the independent contribution of each factor on selected perinatal outcome variables. Additionally, subgroup analysis for obese (BMI ≥ 30 kg/m2) and non-obese women (BMI < 30 kg/m2) was performed. LGA was significantly influenced by BMI, GWG and GDM, while Neonatal Intensive Care Unit (NICU) admission was solely impacted by GDM. Maternal outcomes were not dependent on GDM but on GWG and prepregnancy BMI. These results remained significant in the non-obese subgroup only. Thus, GDM still affects perinatal outcomes and requires further improvement in diabetic care and patient counseling.


2018 ◽  
Vol 12 (2) ◽  
pp. 218-233
Author(s):  
J.D. DeFreese ◽  
Travis E. Dorsch ◽  
Travis A. Flitton

Burnout and engagement are important psychological outcomes in sport with potential to impact athletes as well as sport parents. The present study examined associations among markers of the sport-based parent child-relationship (warmth and conflict) and parent burnout and engagement in organized youth sport. Youth sport parents (N = 214) aged 26–66 years (M = 43.2,SD = 6.2) completed valid and reliable self-report assessments of study variables. Study results showcased warmth, but not conflict, in the parent–child relationship as a significant negative contributor to global burnout and a significant positive contributor to global engagement in sport parents. Results offer preliminary insight into the impact of parent–child warmth in sport on parents’ experiences of burnout and engagement. Findings have implications for future research and practice designed to promote positive psychosocial experiences for sport families.


2019 ◽  
Author(s):  
Teal Bohrer ◽  
Cass Dykeman

Rates of death by suicide continue to increase across the United States. Mental health clinicians often have contact with individuals expressing suicidal ideation, but research suggests clinicians may not be appropriately prepared to assess a client’s suicide risk. Numerous models and theories explain and assess suicidal ideation. In 2009, Thomas Joiner and his colleagues proposed the interpersonal-psychological theory of suicide (IPT), which focused on three main factors strongly supported by research over the preceding decade. The present study utilized a nonconcurrent, multiple-baseline, multiple-probe design as well as a one-group pretest–posttest design to examine the impact of an IPT-based training model. Participants were preservice mental health clinicians currently enrolled in Master’s degree programs. Participants completed assessments on IPT knowledge and suicide-assessment self-efficacy, and results from this study indicated a significant increase in knowledge after completion of the training, as well as a slight decrease in self-efficacy. This study suggests that suicide-assessment training, even when done remotely, can increase suicide-assessment knowledge. Future research should explore preservice mental health clinicians’ self-efficacy as well as those factors influencing the confidence these professionals feel in their assessments of risk.


2018 ◽  
Vol 64 (3) ◽  
pp. 276-285 ◽  
Author(s):  
Kimiko Tanaka ◽  
Larry Davidson ◽  
Thomas J Craig

Background: While the neighborhood community literature well documents a link between participation in supportive and effective community groups or activities and empowerment, there is as yet little empirical evidence of this relationship in the context of community mental health programs. Aim: The primary purpose of the study was to examine the relationship between sense of community belonging and empowerment among members of mental health clubhouses. Methods: A secondary analysis using a hierarchical regression model was conducted on cross-sectional structured interview data collected through a self-report questionnaire from 102 clubhouse members from six clubhouses in the United States and Finland. Results: The results indicated that members’ sense of clubhouse community belonging positively contributes to their empowerment. Conclusion: Fostering sense of community belonging appears to be a valid approach to catalyze empowerment. Study limitations and future research agendas were discussed.


2021 ◽  
Vol 111 (1) ◽  
pp. 136-144
Author(s):  
Sylvester O. Orimaye ◽  
Nathan Hale ◽  
Edward Leinaar ◽  
Michael G. Smith ◽  
Amal Khoury

Objectives. To examine the differences in adolescent birth rates by deprivation and Health Professional Shortage Areas (HPSAs) in rural and urban counties of the United States in 2017 and 2018. Methods. We analyzed available data on birth rates for females aged 15 to 19 years in the United States using the restricted-use natality files from the National Center for Health Statistics, American Community Survey 5-year population estimates, and the Area Health Resources Files. Results. Rural counties had an additional 7.8 births per 1000 females aged 15 to 19 years (b = 7.84; 95% confidence interval [CI] = 7.13, 8.55) compared with urban counties. Counties with the highest deprivation had an additional 23.1 births per 1000 females aged 15 to 19 years (b = 23.12; 95% CI = 22.30, 23.93), compared with less deprived counties. Rural counties with whole shortage designation had an additional 8.3 births per 1000 females aged 15 to 19 years (b = 8.27; 95% CI = 6.86, 9.67) compared with their urban counterparts. Conclusions. Rural communities across deprivation and HPSA categories showed disproportionately high adolescent birth rates. Future research should examine the extent to which contraceptive access differs among deprived and HPSA-designated rural communities and the impact of policies that may create barriers for rural communities.


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