Psychosocial family factors and glycemic control among children aged 1-15 years with type 1 diabetes: a population-based survey

Background: Being the parents of children with diabetes is demanding. Jay Belsky’s determinants of parenting model emphasizes both the personal psychological resources, the characteristics of the child and contextual sources such as parents’ work, marital relations and social network support as important determinants for parenting. To better understand the factors influencing parental functioning among parents of children with type 1 diabetes, we aimed to investigate associations between the children’s glycated hemoglobin (HbA1c) and 1) variables related to the parents’ psychological and contextual resources, and 2) frequency of blood glucose measurement as a marker for diabetes-related parenting behavior. Methods: Mothers (n = 103) and fathers (n = 97) of 115 children younger than 16 years old participated in a population-based survey. The questionnaire comprised the Life Orientation Test, the Oslo 3-item Social Support Scale, a single question regarding perceived social limitation because of the child’s diabetes, the Relationship Satisfaction Scale and demographic and clinical variables. We investigated associations by using regression analysis. Related to the second aim hypoglycemic events, child age, diabetes duration, insulin regimen and comorbid diseases were included as covariates. Results: The mean HbA1c was 8.1%, and 29% had HbA1c ≤ 7.5%. In multiple regression analysis, lower HbA1c was associated with higher education and stronger perceptions of social limitation among the mothers. A higher frequency of blood glucose measurement was significantly associated with lower HbA1c in bivariate analysis. Higher child age was significantly associated with higher HbA1c both in bivariate and multivariate analysis. A scatterplot indicated this association to be linear. Conclusions: Most families do not reach recommended treatment goals for their child with type 1 diabetes. Concerning contextual sources of stress and support, the families who successfully reached the treatment goals had mothers with higher education and experienced a higher degree of social limitations because of the child’s diabetes. The continuous increasing HbA1c by age, also during the years before puberty, may indicate a need for further exploring the associations between child characteristics, context-related variables and parenting behavior such as factors facilitating the transfer of parents’ responsibility and motivation for continued frequent treatment tasks to their growing children

The Study of Triple Integral Equations with Generalized Legendre Functions

A method is developed for solutions of two sets of triple integral equations involving associated Legendre functions of imaginary arguments. The solution of each set of triple integral equations involving associated Legendre functions is reduced to a Fredholm integral equation of the second kind which can be solved numerically

Longitudinal relationship between diabetes-specific emotional distress and follow-up HbA1c in adults with Type 1 diabetes mellitus

Aim To examine whether diabetes-specific emotional distress was related to follow-up glycaemic control in adults with Type 1 diabetes mellitus. Methods Adults with Type 1 diabetes mellitus completed the Diabetes Distress Scale and reported sociodemographic information when attending a clinical consultation at a university endocrinology unit. Blood samples to determine baseline HbA1c were taken during consultations. All respondents' HbA1c measurements registered from January 2009 to December 2011 were collected from medical records. The relationship between baseline diabetes-specific emotional distress and HbA1c was examined with linear mixed-effects models in 175 patients with complete data. Results After controlling for confounders, baseline diabetes-specific emotional distress and glycaemic control were significantly associated (fixed-effect coefficient 0.40, P < 0.001) and the regimen-related distress subscale had the strongest association with glycaemic control (fixed-effect coefficient 0.47, P < 0.001). The two-item measure of diabetes-specific distress had a weaker but still significant association with glycaemic control (fixed-effect coefficient 0.31, P < 0.001). None of these relationships was significant after adjusting for the baseline HbA1c. Conclusions People with elevated baseline diabetes-specific emotional distress are at risk of prolonged suboptimum glycaemic control; therefore, elevated diabetes-specific emotional distress, especially regimen-related distress, might be an important marker for prolonged suboptimum glycaemic control, and might indicate a need for special attention regarding patient self-management

A comparative histologic and histomorphometric investigation on Biostite in surgical defects

Statement of Problem: The goal of bone regenerative therapy is to reconstruct the damaged tissues to initial condition, which seems so important in periodontoiogy and implantology. In such therapies, different biomaterials, with some advantages and disadvantages, may by use.&quot;nPurpose: The aim of this research was to evaluate the quality, bone trabecular density and thickness of newly forming bone as well as foreign body reaction against Biostite&amp;reg;, in comparison with the control group.&quot;nMaterial and Methods: In this experimental study the total number of 5 sheep was operated with&quot;ngeneral anesthesia. At first 10 standard defects were created in 5x5x5mm on the left and right edentulous&quot;nmandibular ridge. Five defects were randomly treated by Biostite&amp;reg;, the remaining five were considered&quot;nas controls. After six months, the sheep were sacrificed and the separated defect areas with intact margin&quot;nwere placed in 10% formaline and prepared for histologic and histomorphometric study. To analyze the&quot;ndata, Mann-Whitney U test was used.&quot;nResults: The mean percentage of new bone formation in Biostite&amp;reg; group was statistically more than the&quot;ncontrol group (PO.05). Newly formed bone was vital in both groups which was a combination of&quot;nlamellar and woven types, however, the thickness and density of new bone in biostite&amp;reg; group was more&quot;nthan the controls. Foreign body reaction was observed in Biostite&amp;reg; group.&quot;nConclusion: It is suggested that Biostite&amp;reg; synthetic material can be useful in bone regenerative&quot;ntherapies

Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes

Aim: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA1c ≥ 64 mmol/mol (8.0%)]. Methods: This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Results: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P < 0.001), indicating that lower perceived competence was associated with greater perceived distress. Conclusions: There was an indirect (fully mediated) relationship between autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control

DUAL SERIES EQUATIONS INVOLVING GENERALIZED LAGUERRE POLYNOMIALS

An exact solution is obtained for the dual series equations involving generalized Laguerre polynomials

Closed-Form Solutions for a Mode-III Moving Interface Crack at theInterface of Two Bonded Dissimilar Orthotropic Elastic Layers

An integral transform technique is used to solve the elastodynamic problem of a crack of fixed length propagating at a constant speed at the interface of two bonded dissimilar orthotropic layers of equal thickness. Two cases of practical importance are investigated. Firstly, the lateral boundaries of the layers are clamped and displaced inequal and opposite directions to produce antiplane shear resulting in a tearing motion along the leading edge ofthe crack, and secondly, the lateral boundaries of the layers are subjected to shear stresses. The analytic solutionfor a semi-infinite crack at the interface of two bonded dissimilar orthotropic layers has been derived. Closed-formexpressions are obtained for stressing the intensity factor and other physical quantities in all cases.Peer Reviewe

The Study of Triple Integral Equations with Generalized Legendre Functions

A method is developed for solutions of two sets of triple integral equations involving associated Legendre functions of imaginary arguments. The solution of each set of triple integral equations involving associated Legendre functions is reduced to a Fredholm integral equation of the second kind which can be solved numerically.Peer Reviewe

Closed-form solution for piezoelectric layer with two collinear cracks parallel to the boundaries

We consider the problem of determining the stress distribution in an infinitely long piezoelectric layer of finite width, with two collinear cracks of equal length and parallel to the layer boundaries. Within the framework of reigning piezoelectric theory under mode III, the cracked piezoelectric layer subjected to combined electromechanical loading is analyzed. The faces of the layers are subjected to electromechanical loading. The collinear cracks are located at the middle plane of the layer parallel to its face. By the use of Fourier transforms we reduce the problem to solving a set of triple integral equations with cosine kernel and a weight function. The triple integral equations are solved exactly. Closed form analytical expressions for stress intensity factors, electric displacement intensity factors, and shape of crack and energy release rate are derived. As the limiting case, the solution of the problem with one crack in the layer is derived. Some numerical results for the physical quantities are obtained and displayed graphically.Peer Reviewe